Imperforate Hymen - a rare cause of acute abdominal pain and tenesmus: case report and review of the literature

Imperforate hymen is a rare condition that presents with amenorrhea, cyclical abdominal pains and urine retention among pubertal girls. A 14 year old girl with imperforate hymen underwent hymenotomy for  hematocolpometra, having presented with abdominal pains and tenesmus.Key words: Imperforate hymen, amenorrhea, pubertal girls, urine retentio

Characterization of nitrogen-fixing bacteria from Phaseolus vulgaris L. in Kenya

Phaseolus vulgaris (common bean) is an important food crop in Sub-Saharan Africa. Low soil nitrogen limits the productivity of P. vulgaris in Kenya and a greater exploitation of symbiotic nitrogen fixation, resulting from interactions with rhizobia, has the potential to improve yields. To enable the increased use of the symbiosis in Kenyan agriculture in the future, studies in this thesis examined the genetic diversity of rhizobia that nodulate P. vulgaris in the central and western parts of Kenya, their nitrogen-fixing capabilities, and their competitiveness against Rhizobium tropici CIAT 899, a leading commercial inoculant strain for P. vulgaris. Lastly, studies investigated the relative importance of the genotypes of resident soil rhizobia, soil rhizobial population densities, inocula densities, and levels of soil nitrogen, in determining nodule occupancy by R. tropici CIAT 899 inoculated onto P. vulgaris. Phylogenetic studies using 16S rRNA and recA genes indicated at least five species of Rhizobium viz., R. sophoriradicis, R. phaseoli, R. leucaenae, R. paranaense and R. etli nodulate P. vulgaris in Kenya. In addition to the five species, strains that likely belong to new species in the genus Rhizobium also widely nodulate P. vulgaris in Kenyan soils. In glasshouse studies, recovered strains were variably effective on Kenyan cultivars of P. vulgaris and 11 fixed as much nitrogen as R. tropici CIAT 899. From the 11, strains such as NAK 227, NAK 288, NAK 214 and NAK 157 were also highly competitive in liquid co-inoculation assays, carried out with the aid of gusA and celB marker genes, and are potential future inoculants for P. vulgaris in Kenya. The genotype of the rhizobia in the soil was found to be the primary determinant of the nodule occupancy achieved by the inoculant strain, a finding that conflicts previous reports that indicated nodule occupancy was mainly determined by soil rhizobial densities. The rhizobial genotypes varied in their rhizosphere competence and in their ability to preferentially nodulate the host, suggesting these two traits are important for the successful colonization of P. vulgaris nodules by rhizobia. It is anticipated that future studies will leverage on the results in this thesis, to develop locally-targeted inoculation solutions that optimize nitrogen fixation in P. vulgaris in Kenya, and to elucidate the molecular basis for preferential nodulation in P. vulgaris

Contemporary issues in international law

“Whether International Law is really law is one of those vexed questions that still linger. Prof. Mwenda’s three-pillar approach to looking at International Law is an exceedingly useful conceptual framework which is, at the same time, emblematic of the malleable nature of the discipline. The analysis demonstrates when States pay attention to international law, why they feel compelled to do so, when they choose not to, and why all that matters. This is an extremely timely and accessible book which should be useful to the legal academy and to practitioners.” –DR VICTOR B. MOSOTI Chief Counsel for Environmental and International Law, Legal Vice-Presidency, The World Bank “Prof. Mwenda’s book, ‘Contemporary Issues in International Law’, is a must-read masterpiece on international law for practitioners, academics and students of public international law. It is a thought-provoking book that touches on contemporary issues confronting international law at a time when multilateralism…is under serious threat. It touches on issues that need to be discussed and addressed in order to be able to deal with the emerging challenges of rising nationalism among leading nations of the world.” –BRIAN CHIGAWA, ESQ Director of Legal and Corporate Affairs, Common Market for Eastern and Southern Africa (COMESA)illustrato

From a dream to a resounding reality: the inception of a doctors union in Kenya

After two grueling years of determination and resilience, the Kenyan doctors have formed a doctors’ union. The Kenya Medical Practitioners, Pharmacists and Dentists Union(KMPDU)not only aims at agitating for better terms of service for its members, it also aims to influence the running of the Kenyan health sector and improve health services in Kenya. The union has been fully recognized by the Kenyan government and is engaging the government concerning various health sector policies besides improved terms and working conditions of the doctors in the country

4thStage Transvaginal omental herniation during VBAC complicated by shoulder dystocia: a unique presentation of uterine rupture

BACKGROUND: Uterine rupture is a common complication in women attempting their first virginal birth after caesarean section (VBAC) but the risk diminishes with subsequent VBACs. It occurs in rates of 0.5-9% and is influenced by various factors. CASE PRESENTATION: A unique case of uterine rupture in a Kenyan woman of African descent during a repeat VBAC complicated by shoulder dystocia was discovered during the 4(th) stage of labour when omentum was noted protruding through the vagina. She had delivered 4 years earlier by caesarean section. CONCLUSION: It is not common to experience uterine rupture among women attempting repeat VBAC. When it occurs, it may not always follow the known pattern intra-partum and is often associated with poor foetal outcome

Perceptions on the Level of Influence of Parental Involvement on Acquisition of Literacy Skills among Pupils in Primary Schools in Akithi Division, Tigania West District, Kenya

Literacy is the basis for most school learning, and one of the surest predictors of academic achievement. Studies indicate that parents in Kenya are not actively involved in their children’s literacy acquisition process. This study sought to explore parents’, teachers’, and pupils perceptions on the influence of parental involvement on acquisition of literacy skills. The study was carried out in Akithi Division, Tigania West District, Kenya. Descriptive survey research design was used to carry out this study. Data collection was done using questionnaires and interview schedules. The study suggests that schools administrators need to formulate clear policy guidelines on the involvement of parents in the literacy development of their children. Keywords: “influence”, “Parental improvement”, “Acquisition”, “Literacy skills

Learning from the nurses and the paramedics: the experience of a Kenyan medical officer intern-a call for research

In the Kenyan medical educations system, one has to go through one year of internship after graduating from medical school in order to be licensed to practise medicine. This internship period is laden with work to the extent of overwhelming and stressing the medical officer interns. Irrespective of what competence interns come with into the field there is still a lot they have to learn from the nurses and the paramedics. Most of the learning takes place during the acute care settings when the intern is on call and is from the nurses. The paramedics most helpful to the intern are the theater assistants who teach interns how to use the various surgical instruments and sometimes direct during minor operations.Pan African Medical Journal 2012; 12:3