Liver injury caused by a herbal and dietary supplement: a case report

We present a case of a previously healthy male admitted with acute hepatitis while using a body building supplement. An exhaustive laboratory workup for causes of hepatitis was unrevealing. He responded well to withdrawal of the supplement and a course of corticosteroids

The Environment Of Microfinance Institutions: The Role Of Economic Freedom

Microfinance provides saving and lending services to the poor. It is not conceptually different from banking in the USA. People are able to save money at and borrow money from microfinance institutions. They are compensated for saving and charged for borrowing by an interest rate that compounds on savings or loans. It is different primarily in the magnitude of the financial transactions. Loans to the poor are much smaller on average than loans traditionally given by banks; these loans can be as small as $71. Also, because of their poverty, borrowers tend to have little or no collateral to secure loans (Murdoch, Dec. 1999)

The determinants of health related quality of life of patients on maintenance haemodialysis at Kenyatta National Hospital, Kenya

Background: Health related quality of life (HRQOL) is increasingly being recognised as a primary outcome measure in the treatment of end stage renal disease. In addition to being an important surrogate marker of quality of care in patients on maintenance haemodialysis, HRQOL measures have being shown to be robust predictors of mortality and morbidity.Objective: To determine the health related quality of life and its determinants in patients on maintenance haemodialysis at the Kenyatta National Hospital.Design: A cross-sectional descriptive study.Setting: Renal unit, Kenyatta National HospitalSubjects: Adult patients with end stage renal disease on maintenance haemodialysis.Results: The mean physical composite summary and mental composite summary scores were 39.09±9.49 and 41.87±10.56 respectively. The burden of kidney disease sub-scale, symptom and problems sub-scale and effect of kidney disease on daily life sub-scale scores were 16.15±21.83, 73.46±18.06 and 67.63±23.45 respectively. No significant correlations were found between the health-related quality of life scores, socio-demographic and clinical factors assessed.Conclusion: The health-related quality of life of patients on maintenance haemodialysis is reduced. The physical quality of life is more affected than the mental quality of life. No independent determinants of health-related quality of life were identified

Time to presentation and diagnosis of esophageal cancer in patients seen at the Kenyatta National Hospital

Background: Esophageal Cancer (EC) is one of the leading causes of cancer death in Kenya. Majority of the patients with esophageal cancer at Kenyatta National Hospital (KNH) present at an advanced stage limiting their treatment options. Objective: To determine diagnostic time lines and factors associated with delayed health care service delivery among patients with established histological diagnosis of EC at KNH. Design and Setting: A retrospective diagnostic cohort study was carried out at the Cardiothoracic, endoscopy and radiotherapy units at KNH.Results: Eighty-five participants with established histological diagnosis of EC consented and were enrolled into the study. Majority (89.4%) were diagnosed in stage III and IV of the disease. The median time to  histological diagnosis of EC was 90 days. The time to first presentation was more than 30 days among 78.8% of subjects. The median time from first consultation to referral to a diagnostic-capable facility was 30 days, with 76.5% of the participants taking more than 30 days to reach KNH. Those who could not afford transport and consultation were more likely to report delay to first presentation (OR 3.6 95% CI 1.2-11.3, p=0.022). Referral delay was associated with residence, with those living in the rural areas less likely to delay (OR 0.2, 95% CI 0.0-0.8, p=0.019). Conclusion: Overall this study found that there was significant delay in the diagnostic process of EC patients. Over 75% of the patients delayed in presenting for the first consultation, being referred to higher level facilities, getting an endoscopy done and receiving histological diagnosis.  Consequently, about 90% of the patients were diagnosed at an advanced stage of the disease

Farmers\u27 Screening of Indigenous Fodder Trees and Shrubs in Kenya

The lack of fodder quantity and quality is a constraint for small scale livestock production systems in central Kenya which are intensive or are rapidly becoming so. This study examined farmers’ knowledge about indigenous fodder trees and shrubs (IFTS) which are fed to livestock. The study consisted of a formal survey in three agroecological zones with mean annual rainfall varying from 750 to 1400 mm. Farmers rated IFTS for different qualities, which were analysed by Chi square. Differences of ratings among species for these qualities were significant (p\u3c0.05). The most promising species for the sub-humid zone, in terms of what farmers want to plant and in terms of preliminary nutritive analysis, were: Tithonia diversifolia, Commiphora zimmermanii, Ficus spp. and Trema orientalis. The species that show promise for the same reasons, in the semi-arid zones, are: Crotalaria goodiiformis, Aspilia mossambicensis, Indigofera lupatana, T. diversifolia, Grewia tembensis and Acacia ataxacantha

Cooperative Learning Method and Development of Pre-School Children’s Competences Acquisition in Mathematical Concepts in Kirinyaga County, Kenya

The research from which this paper is derived explored the effect of cooperative learning method on development of pre-schoolers’ competences in mathematical concepts. 20 pre-school teachers on their regular teaching in their pre-schools were observed teaching their 639 Pre-primary Two learners. The purpose of this study was to establish the difference between the mean score index of pre-school learners taught by a teacher who facilitates learning using the Cooperative Learning Method (CLM) and those taught by a teacher who does not. Data was collected through the use of observation schedule and teacher questionnaire. Each of the twenty pre-school teachers was observed by the researcher while facilitating mathematical concepts’ competences during number work lessons. A documentary analysis guide was used to access the pre-school teachers’ schemes of work and lesson plans to establish their level of preparation in line with CLM. Descriptive and inferential statistics were used to analyse the collected data and guided by the themes arising from the objective of the study the key findings were arrived at. The various levels of the teachers’ facilitation of CLM were tied to the pre-school leaners’ performance in the mathematical concepts competences achievement test. The findings emerging showed that those learners who were taught using CLM achieved higher mean score indices than those who were not. The implication here is that the use of CLM improves pre-school learners’ levels of achievement, indicating that it is a more effective method of teaching. Teachers’ facilitation of CLM seemed to have a significant positive influence on the learners’ Mathematical Concepts Competences Acquisition. These features were; availability of groupings and teacher preparedness, level of provision of learning resources, level of coordination, level of interaction, time taken in CLM activities. This implies that CLM imparts the required mathematical concepts competences better than traditional instructional methods. The study recommends that the Ministry of Education should develop programmes and policies that provide regular in-service training, in which CLM training forms a key part of the agenda and to refresh the mathematical concepts competences instructional skills of pre-school teachers. Keywords: Competences; Cooperative Learning Method; Mathematical Concepts DOI: 10.7176/JEP/12-32-05 Publication date: November 30th 202

Structural and functional studies of the phage Sf6 terminase small subunit reveal a DNA-spooling device facilitated by structural plasticity

In many DNA viruses, genome packaging is initiated by the small subunit of the packaging terminase, which specifically binds to the packaging signal on viral DNA and directs assembly of the terminase holoenzyme. We have experimentally mapped the DNA-interacting region on Shigella virus Sf6 terminase small subunit gp1, which occupies extended surface areas encircling the gp1 octamer, indicating that DNA wraps around gp1 through extensive contacts. High resolution structures reveal large-scale motions of the gp1 DNA-binding domain mediated by the curved helix formed by residues 54-81 and an intermolecular salt bridge formed by residues Arg67 and Glu73, indicating remarkable structural plasticity underlying multivalent, pleomorphic gp1:DNA interactions. These results provide spatial restraints for protein:DNA interactions, which enable construction of a three-dimensional pseudo-atomic model for a DNA-packaging initiation complex assembled from the terminase small subunit and the packaging region on viral DNA. Our results suggest that gp1 functions as a DNA-spooling device, which may transform DNA into a specific architecture appropriate for interaction with and cleavage by the terminase large subunit prior to DNA translocation into viral procapsid. This may represent a common mechanism for the initiation step of DNA packaging in tailed dsDNA bacterial viruses

Health related quality of life of patients on maintenance haemodialysis at Kenyatta National Hospital

Background: Health related quality of life is increasingly being recognised as a primary outcome measure in treatment of end-stage renal disease. The health related quality of life of patients on maintenance haemodialysis is reduced. Several interventions directed at modifiable risk factors have been shown to improve quality of life of patients on haemodialysis.Objective: To assess the health-related quality of life of patients on maintenance haemodialysis at the Kenyatta National Hospital.Design: Cross sectional descriptive study.Setting: Kenyatta National Hospital, Renal Unit.Subjects: The study was conducted on 96 patients with end-stage renal disease on maintenance haemodialysis. Socio-demographic and clinical factors were recorded for all patients. Health-related quality of life was assessed using the Kidney Disease Quality of Life-36 questionnaire. Two summary scores and three subscale scores were calculated.Results: The mean physical composite summary and mental composite summary scores were 39.09±9.49 and 41.87±10.56 respectively. The burden of kidney disease subscale, symptom and problems subscale and effect of kidney disease on daily life subscale scores were 16.15±21.83, 73.46±18.061 and 67.63±23.45 respectively.Conclusion: Health-related quality of life of patients on maintenance haemodialysis is reduced. The physical quality of life is more affected than the mental quality of life. The burden of kidney disease subscale is the most affected subscale score

All-optical delay technique for supporting multiple antennas in a hybrid optical - wireless transmission system

We introduce a novel continuously-variable optical delay technique to support beam-forming wireless communications systems using antenna arrays. We demonstrate delay with 64-QAM modulated signals at a rate of 15 Msymbol/sec with 2.5 GHz carrier frequency

Transmission and evolutionary dynamics of human coronavirus OC43 strains in coastal Kenya investigated by partial spike sequence analysis, 2015-2016

Human coronavirus OC43 (HCoV-OC43) is a major contributor to seasonal outbreaks of acute respiratory illness (ARI). The origins of locally circulating HCoV-OC43 strains and characteristics of their genetic diversity are unknown for most settings despite significance to effective HCoV control strategies. Between December 2015 and June 2016, we undertook ARI surveillance in coastal Kenya in nine outpatients and one inpatient health facility (HF). Ninety-two patient samples tested HCoV-OC43 positive and forty (43.5%) were successfully sequenced in spike (S) gene region (2,864 long, ∼70%). Phylogenetic analysis confirmed co-circulation of two distinct HCoV-OC43 clades that closely clustered with genotype G (n = 34, 85%) and genotype H (n = 6, 15%) reference strains. Local viruses within the same clade displayed low genetic diversity yielding identical sequences in multiple HF. Furthermore, the newly sequenced Kenyan viruses showed close phylogenetic relationship to other contemporaneous sampled strains (2015–16) including those originating from distant places (e.g. USA and China). Using a genetic similarity threshold of 99.1 per cent at nucleotide level, the HCoV-OC43 strains sampled globally between 1967 and 2019 fell into nine sequence clusters. Notably, some of these clusters appeared to have become extinct, or occurred only sporadically in a few geographical areas while others persisted globally for multiple years. In conclusion, we found that HCoV-OC43 strains spread rapidly both locally and across the globe with limited genetic evolution in the spike gene. Full-genome sequences that are spatio-temporally representative are required to advance understanding of the transmission pathways of this important human respiratory pathogen