Fournier’s gangrene in the HIV era

Background: Fournier’s gangrene is a devastating condition that affects mostly patients whose immunity has been reduced. There is increasing evidence for increasing incidence of the disease in those with HIV disease.Objective: To evaluate the presentation, bacteriology and outcome of Fournier’s gangrene in our area in recent times in view of the high prevalence in Nairobi and its environs.Results: One hundred and forty six patients were treated for Fournier’s gangrene during the study period; all were male. They had a mean age of 38.6 years (range 2 months – 86 years). HIV infection was the most common associated underlying illness (16.4 %), followed by diabetes mellitus and alcoholism (11%).Conclusions: HIV infection is emerging as leading predisposing factor and has overtaken diabetes in predisposing for Fournier’s gangrene in Kenyatta National Hospital.Keywords: Fournier’s gangrene, HIV

Intestinal malrotation and Ladd’s bands in a young child

The case we present, is an interesting example of intestinal malrotation, which is a well known congenital condition, which tend to manifest early in life. In our case the age of our patient made the diagnosis potentially more challenging, as it was not the most typical age for duodenal stenosis due to Ladd’s bands, which is often mostly observed earlier in life. Stenosis of the duodenum is relatively rare, and may represent a surgical challenge, especially in setting with limited diagnostic and treatment facilities. We also discuss implication of language barriers to potentially delay timely diagnosis and optimal management

Beyond The Millennium Development Goals: An Evaluation Of The War On HIV/AIDS In Kenya

HIV/AIDS remains a threat to Kenya and other developing nations. This thesis aimed at assessing the HIV/AIDS situation in Kenya by examining the knowledge of Kenyans towards infection and spread HIV/AIDS, attitudes towards people living with HIV/AIDS, involvement of community opinion leaders in the HIV/AIDS campaigns, sharing of HIV/AIDS information, and government efforts to control HIV/AIDS. A sample of Kenyans (N= 103) was surveyed and asked to respond to several scales assessing each of the above items. Quantitative and qualitative methods reveal the knowledge and attitudes portrayed by Kenyans and show that, although much has been achieved, there is need for multi-strategies to help curb the spread of HIV/AIDS. The results revealed some knowledge gaps concerning the infection and spread of HIV/AIDS and unfavorable attitudes towards people living with the pandemic. Specific theoretical implications, limitations, strengths, and suggestions for future research are discussed in detail

Contribution of Peer Counseling to Student Behavior Change in Secondary Schools in Maara Sub County, Kenya

Peer counseling has popularly been accepted as an important contributor of behavior change among learners in learning institutions. Peer counseling utilizes role- playing and modeling to change behavior. The study assessed the contribution of peer counseling skills like mentoring, role modeling and academic tutoring in student behavior change in Maara sub County Kenya. The study employed descriptive survey research design. Stratified and purposive sampling technique methods were used to come up with a sample size. Data was collected by use of questionnaires for the students and peer counselors and an interview schedule for teacher counsellors. Descriptive statistics was used for data analysis.  The study established that peer counselors are important in mentoring other students as they address issues related to  the youth.  Most peer counselors are academically above average making them effective academic tutors.  Peers counselors are further more established in many schools giving them the opportunity to model good behavior.  The study recommends that peer counselors require adequate orientation on their roles like basic counseling skills. Keywords: Peer, Peer Counseling, Students behavior, Secondary Schoo

Electrophoretic Deposition of TiO2 Thin Films for Photocatalytic Degradation of Organic Pollutants in Water

In this study, electrophoretic deposition (EPD) technique was used to deposit titanium dioxide (TiO2) thin films on conducting glass substrates for application in photocatalytic degradation of organic pollutants in water. Phenol was used as a model pollutant. The EPD suspension related parameters and deposition conditions were first optimized for good quality film deposits. The suspension stability and deposition conditions that result in good adherence of TiO2 particles to the substrate with homogeneous film coatings  are ethanol, a TiO2 solid loading of 4 wt%, a 0.2 wt% iodine concentration in the solvent and a deposition voltage of 20 V in a time of 3.5 minutes. The photocatalytic activity of TiO2 thin films decreased exponentially with the ultraviolet light (UV) illumination time and it was also dependent on film thickness, and sintering temperature of the TiO2 thin films. Highest rate of photocatalytic activity was observed at an optimal film thickness of 95 ± 2 µm sintered at 300 °C. The implications of these results are discussed for design of inexpensive wastewater purification systems for light industries as well for semi urban small communities.Keywords: Electrophoretic deposition; Titanium dioxid

Spectrometric Detection of Organic Compounds and Toxicity of Ethanolic Leaves Extracts of Prosopis Juliflora

Spectrometric detection of saponins, tannins and alkaloids in Prosopis juliflora using Fourier Transform Infrared (FTIR) spectroscopy is reported in this paper. Crude dry plant powders and corresponding ethanolic extracts were mixed with potassium bromide (KBr) powder and compressed to a thin pellet for infrared examination. The plant powders, ethanolic extracts and leaves ethanolic extract (LEE) fractions  exhibited characteristic infrared spectra due to various functional groups –OH, -C=O, C-H, and C=C absorptions. Phytochemical analysis confirmed the presence of saponins, tannins and alkaloids in the tested specimens. Prosopis juliflora whole plant parts were used as a reference sample. Toxicity and safety levels of P. juliflora were also investigated. Acute and sub-acute toxicity of P. juliflora ethanolic leaves extract was evaluated using Swiss albino rats. All clinical signs and symptoms were recorded within 24 hours. These results indicated that direct detection of bioactive compounds was possible by infrared analysis. Toxicity symptoms were moderately observed and post mortem did not show any major gross effects on the internal organs. Keywords: Prosopis juliflora, infrared examination, potassium bromide, acute and sub-acute toxicity, clinical signs, doses, symptoms

Violence Against Women and Girls: Providing Therapy for Gender Based Violence Survivors

The purpose of the study was to highlight the factors associated with violence against women and girls and how they can benefit from therapy. The study was guided by the following objectives: to establish the factors associated with the occurrence of violence, determining the effectiveness of therapy in dealing with survivors of violence, exploring factors influencing or blocking effectiveness of therapy. A cross sectional research design was used in which questionnaires, an interviewing guide, focus group discussion and psychological assessment scale were used to collect study data. A sample of 75 women and girls was purposively selected from health facilities, counselling centres, chief camps, police station, NGOs and CBOs within Kibra Constituency. All respondents were females aged 18 years and above. The findings showed that all the respondents (100%) had been exposed to violence. The respondents who reported physical abuse were 30%, sexual abuse was reported by 10%, psychological and emotional abuse was reported by 16%, financial coercion was reported by 15%, neglect of children and duty by 13%, and verbal assault was reported by 16%.  Further, the results showed that the most common victims of violence are expectant mothers and children who are under the care of irresponsible persons. The most reported people to perpetrate violence were cited to be men. The responses given by the respondents as factors that trigger violence are: Previous assaults (61%), cultural expectations (61%), alcohol abuse and other drugs (49%), poor communication skills (49%), poor problem solving skills (49%), perpetrator outstretched demands on resources (49%), infidelity(37%), unemployment (37%), peer pressure (37%), frustration emanating from blocked goals (24%), childlessness (24%) and  personality traits (12%). Violence against women and girls impact negatively on their lives. The most common negative impact mentioned are depression by 75 respondents, children suffering cited by 65 respondents, family disintegration cited by 56 respondents, non-productivity, physical injury, and anxiety respectively cited  by 46 respondents. The survivors of violence have knowledge of where they can access help in order to cope with the consequences of violence. Of the 75 respondents, 75 of them said that counselling is very helpful. Perseverance is another coping mechanism mentioned by 75 respondents. Separation and keeping quite are strategies mentioned by 65 respondents. Going to hospital is another support and help available mentioned by 56 respondents. The respondents who opted for spiritual intervention were 47 while those who opted to start a business for sustainability were 38. Those who preferred sharing with significant others as a coping mechanism were 28. Last but not least, 18 women indicated that support groups are helpful in dealing with violence. The study recommended that women and girls should be empowered financially and policies put into place to curb violence. The government and other stakeholders should partner to support women and girls to overcome violence in the society

Socio-Economic and Health Consequences of Drugs and Substance Use in Gachie: : A Peri-Urban Town on the Outskirts of Nairobi

Drug and substance abuse is a major socioeconomic and health problem to the drug users, family and society and is reported to be on a steady global rise. In Kenya, drug abuse is a major societal problem especially in many cosmopolitan cities such as Nairobi and Mombasa and the surrounding immediate environs. The objective of this study was to evaluate the types of drugs, the socio-economic and health consequences of drug abuse among the inhabitants of Gachie Sub-Location, Kiambu County a town within the Nairobi suburbs. A snowballing sampling method was used to recruit a total of 246 study participants aged between 15-65years recruited into the study after consenting and meeting drug and substance use and dependence clinical evaluation according to UNCOPE criteria. Data on the type of drugs abused, socio-economic and health implications of drug use on both drug abusers and the community was captured using a structured questionnaire and the resulting data analysed using SPSS version 21. Over-the counter prescription drugs including, benzodiazepine, Cozepam (“ma-cc”), rohypnol (“ma-blue”), and benzhexol (“ma-white”) as well as the traditional heroine were the major abused drugs reported in the study. Approximately 85% of the sampled drug abusers were men abusing mainly the licit over- the counter prescription drugs and heroine as a result of their easy affordability and accessibility. Failed marriages, conflictual family and communal relationships, unemployment, life of destitution and poverty were the main socioeconomic consequences of drug abuse reported in the study, corroborating reports of some previous studies. Participants’s self-reported feeling of hyperactiveness and euphoria was the major health consequence repoted. This study thus indicates that drug use is slowly creeping into rural areas in the vicinity of major towns with prescription over the counter drugs taking a centre stage than the traditional hard drugs due to the associated low costs, availability and accessibility and can result in myriad socioeconomic consequences in the society. This data provides an insight of the spread of drugs from the traditional cities to the surrounding town environments as these areas provide a safe haven for drug peddlers and thus should be of great focus by drug law enforcers as they strategize and seek to curb drug abuse problem. Future similar studies involving larger area are recommended to acquire more dynamics of this proble

Epigeneti-What? Approaches on Translating Research for Primary Breast Cancer Prevention

In fiscal year 2017, the National Cancer Institute devoted more than a half billion dollars to breast cancer research. Since 2012, the total investment has been more than $3 billion. Despite this significant investment, breast cancer still has no known immediate causes as it generally develops over the life course. Therefore, research is unable to provide the public any sort of magic bullet, or conclusive link between certain environmental exposures and the development of breast cancer later in life. What research is only able to report are likelihoods—possible links—things people might want to consider avoiding or doing in their everyday lives to reduce their future risks of developing breast cancer. This abundance of rigorously performed, albeit causally inconclusive, research focused on “plausible” links poses a challenge for health communicators who are tasked with seeking to find ways to translate this science into advice that people can act upon today. However, if society must wait for the science to provide 100% conclusive evidence before anyone ever takes action, how many lives could have been saved in the interim? Therefore, we advocate a two-pronged approach to translating scientific findings regarding environmental exposures and breast cancer prevention: a bottom-up approach—focused on informing the lay public and individuals, while simultaneously performing a top-down approach—focused on influencing policymakers. The current perspective analyzes the strengths and weaknesses to both of these approaches, and encourages scientists to work closely with health communicators to develop theoretically-driven strategies to drive positive changes over time

Trends in bednet ownership and usage, and the effect of bednets on malaria hospitalization in the Kilifi Health and Demographic Surveillance System (KHDSS): 2008-2015.

BACKGROUND: Use of bednets reduces malaria morbidity and mortality. In Kilifi, Kenya, there was a mass distribution of free nets to children  2500 parasitemia per μl) among children < 5 years were captured using a system of continuous vital registration that links admissions at Kilifi County Hospital to the KHDSS population register. Survival analysis was used to assess relative risk of hospitalization with malaria among children that reported using a bednet compared to those who did not. RESULTS: We observed 63% and 62% mean bednet ownership and usage, respectively, over the eight-survey period. Among children < 5 years, reported bednet ownership in October-December 2008 was 69% and in March-August 2009 was 73% (p < 0.001). An increase was also observed following the mass distribution campaigns in 2012 (62% in May-July 2012 vs 90% in May-October 2013, p < 0.001) and 2015 (68% in June-September 2015 vs 93% in October-November 2015, p < 0.001). Among children <5 years who reported using a net the night prior to the survey, the incidence of malaria hospitalization per 1000 child-years was 2.91 compared to 4.37 among those who did not (HR = 0.67, 95% CI: 0.52, 0.85 [p = 0.001]). CONCLUSION: On longitudinal surveillance, increasing bednet ownership and usage corresponded to mass distribution campaigns; however, this method of delivering bednets did not result in sustained improvements in coverage. Among children < 5 years old bednet use was associated with a 33% decreased incidence of malaria hospitalization