Knowledge, Attitude and Practice in First Aid Management of Epistaxis by Accident and Emergency Clinical Staff at Kenyatta National Hospital

Background: Epistaxis is one of the commonest emergencies in Accident & Emergency and Ear, Nose & Throat departments. A vast majority of these patients settle with simple standard first aid measures. The aim of this study was evaluate knowledge, attitude and practice in first aid  management of epistaxis among the clinical staff at the Accident and Emergency (A&E) Department of Kenyatta National Hospital, Kenya.Methods: This was a prospective descriptive cross- sectional study  conducted at the Accident and Emergency Department of Kenyatta National Hospital, Kenya. The principal researcher administered a questionnaire to the clinical staffs who were doctors and nurses in the department.Results: Data was collected from 70 clinical staff between October and December 2010. Nurses were the most respondents (68.6%); 17.1% were medical officers and 14.3% were senior house officers. Majority of the respondents had worked for over 10 years after highest qualification. The commonest first aid measures reported to be known by respondents included pinching the nose (94%), nasal packing (80.6%) and sitting leaning forward position (76.1%). Only 38.1% of respondents  demonstrated the correct site for pinching the nose. The main source of information for first aid measures was the curriculum in training (64.2%) while 16.4% sourced from a first aid course they had done. On positioning of patient with epistaxis, 60% gave correct responses while 51% correctlysaid patient should be referred if epistaxis persists. All the 70 respondents felt that first aid was necessary in treatment of epistaxis. Majority (72.9%) of the respondents said they had ever given first aid to a patient with epistaxis.Conclusion: The clinical staffs in the A & E Department have inadequate knowledge on the standard first aid measures of epistaxis. However, most had good attitude and had provided first aid to patients presenting with epistaxis. There is need for training the staff on these measures.Keywords: Epistaxis, first aid, clinical staff

Hepato-Protective Potential of Methanol Extract of Leaf of Ziziphus mucronata (zmlm) against Dimethoate Toxicity: Biochemical and Histological Approach

Background: The leaves of Ziziphus mucronata are used locally as food and a health drink; the leaf paste can also be used in the treatment of boils. The root of the plant is usually used in the treatment of a wide range of pains.Objective: The study was carried out to evaluate the hepatoprotective potential of the methanol leaf extract of Ziziphus mucronata (ZMLM).Method: The extract was prepared by soaking in 70% methanol/water and rotary evaporation. The phenol content of extract was then estimated. Twenty five adult male Sprague dawley rats (aged 21 weeks) were divided into five groups of five rats each and treated as follows; normal control (NC) received distilled water. Dimethoate control (DC) (received 6 mg/kg.bw.day-1 dimethoate dissolved in distilled water). Experimental Groups (E1) received dimethoate (6mg/kg.bw) + ZMLM (100 mg/kg.bw-1); (E2) received dimethoate (6 mg/kg.bw) + ZMLM (200 mg/kg.bw-1) and (E3) received dimethoate (6 mg/kg.bw) + ZMLM (300 mg/kg.bw-1). In both the cases a normal control and dimethoate control were kept to compare the results. After 90 days, blood was collected and rats were sacrificed to collect the liver tissue for biochemical assays and histological estimations.Results: The results of E1 did not show much change from the normal control group but was significantly different from the dimethoate control group (P≤ 0.05). The preventive effect which was tested in E2 and E3 proved that the extract could almost retain the normal condition in 90 days time. Histological observations also agreed with the results obtained in biochemical parameters.Conclusions: Ziziphus mucronata methanol leaf extract possesses a preventive effect against dimethoate induced oxidative stress as observed in male albino Sprague Dawley rats.Keywords: Leaf methanol extract, hepatoprotective, Ziziphus mucronata, oxidative stress, phenol conten

Influence of Rice Husk Ash Density on the Workability and Strength of Structural Concrete

Supplementary cementitious materials (SCMs) have been known to improve the properties of fresh and hardened concrete, and at the same time enhance the sustainability of concrete. Rice husk Ash (RHA), is one such material, but has neither been widely studied nor applied in practice. This work investigated the effect of the density of RHA on the workability and compressive strength of fresh and hardened RHA-replaced concrete respectively. Cement was replaced with RHA in concrete by weight (RHA-W) and by volume (RHA-V) at steps of 0%, 5%, 7.5%, 10%, 15%, 20%, 25% and 30%. The 0% replacement was used as the reference point from which performances were measured. Results showed that unlike the characteristic of other established pozzolans, RHA significantly reduced the workability of wet concrete and the rate of compressive strength gain over curing time due to a high water demand that is caused by the increased volume of replaced concrete, which results from its low density. Workability reduced with increased replacement for both RHA-W and RHA-V. Replacements of above 15% were not possible for the RHA-W due to the high water demand. However, replacements of up to 30% were achieved for the RHA-V. RHA-W specimens achieved lower compressive strengths and were observed to gain strength at a lower rate over the 28 to 91-days period of curing compared to RHA-V specimens. This behavior was attributed to the shortage of water that is necessary for the hydration of cement and subsequent pozzolanic reaction, which is the basis of the contribution that is made to the strength and performance of concrete by SCMs. However, the compressive strengths achieved were above the study’s target concrete strength of class C32/40 at 91 days, which is among those classes that are listed as being durable and suitable for structural applications. A conclusion that RHA should supplement cements by volumetric replacement rather than simple substitution by weight was drawn

Driving With Single Deformable Polyline Tentacle and Velocity Obstacles

Intelligent transportation systems are emerging as the approach to dramatically improve efficiency while at the same time leading to the goal of zero accidents. Autonomous driving is now possible but still greatly limited to low speed driving. This is mainly due to computational load in detecting the road and objects, path planning and limited controller cycles. The focus of this work is to develop faster trajectory planning scheme given the sensed environment map (occupancy grid). This work utilizes interaction of single projected trajectory from the non-holonomic vehicle kinematic model with the objects in the road. Furthermore, the planned trajectory is made sensitive to car speed. Simulation results with non-linear vehicle kinematic model shows that the proposed combination of single trajectory and velocity objects gives faster satisfactory trajectory with safe obstacle avoidance while following prescribed way points. Key words: Deformable poly-line tentacle, Velocity objects, trajectory planning and non-holonomic constraints

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

Performance of Anthill Soil Replaced Concrete in Sulfate Solutions

Durability of concrete is defined as its ability to resist any form of deterioration, allowing it to retain its original form and quality after it has been exposed to the environment of its intended use. Sulfate attack causes concrete to lose its compressive strength through the decomposition of the products of hydration of cement. Pozzolanic reactions from Supplementary Cementitious Materials (SCMs) help in resisting the sodium sulfate (Na2SO4) attack. This work investigated the potential use of Anthill Soil (AHS) to improve the performance of concrete in sulfate aggressive environments. An AHS replacement of 30% (per cent) by the weight of cement was used to make concrete test bars and cubes. The 0% replacement also referred to as the control was used as the point of reference from which all performances were measured. The specimens were immersed in 5% Na2SO4, 5% magnesium sulfate (MgSO4), and 5% mixed solution of Na2SO4 and MgSO4. Elongation measurements were taken over a period of 9 months, whereas compressive strength tests, which were used to work out the Strength Deterioration Factors (SDFs) and visual observations for surface deterioration were carried out at 9 months. From the results, AHS specimens that were immersed in the Na2SO4, MgSO4 and mixed Na2SO4 and MgSO4 solutions performed poorly in elongation compared with the control specimens, but had lower SDFs in the Na2SO4 and mixed solutions of Na2SO4 and MgSO4. The surface deterioration of AHS specimens in the MgSO4 solution was worse than that of the control specimens but was similar to that of the control in the mixed sulfate solution of Na2SO4 and MgSO4. The SDF results highlight the potential of using AHS with an advantage in Na2SO4 and mixed Na2SO4 and MgSO4 environments

Avifauna of Ishaqbini Community Conservancy in Ijara District, NE Kenya

Ishaqbini community conservancy, in the arid northern-eastern Kenya was established in 2006 by local pastoralists as a community initiative to safeguard their wildlife heritage especially the endemic Hirola Beatragus hunteri. Prior to this survey there were no known recent avifaunal surveys for the area despite the fact that the conservancy lies adjacent to the relatively well-known lower Tana River forests, an important bird area (Bennun & Njoroge 1999), as well as the East Africa coast forests endemic bird area (Stattersfield et al. 1998). In this paper we present the results of an avifaunal survey of the conservancy that includes a description of the bird assemblages in the conservancy, and an annotated account of some species of global and regional conservation concern occurring there

Understanding students’ motivation towards proactive career behaviours through goal-setting theory and the job demands–resources model

The graduate labour market is highly competitive but little is known about why students vary in their development of employability. This study contributes to the literature by applying goal-setting theory and the job demands–resources model to investigate how motivational processes influence students’ proactive career behaviours. We tested four hypotheses using structural equation modelling and moderation/mediation analysis using a nested model approach; 432 undergraduates from 21 UK universities participated in this cross-sectional study. The results showed that students higher in mastery approach had greater perceived employability mediated by two proactive career behaviours (skill development and network building). Students’ career goal commitment was associated with all four proactive career behaviours (career planning, skill development, career consultation and network building). Students’ academic and employment workloads did not negatively impact their proactive career behaviours. University tutors and career services should therefore encourage students to set challenging career goals that reflect mastery approach