Aesthetic outcome and the need for revision of unilateral cleft lip repair at Komfo Anokye Teaching Hospital

Background: The Millard method of unilateral cleft lip repair has been  associated with a short lip and a flattened nose on the cleft side. The aim of this study was to determine the need for revision surgery followingrepair of unilateral cleft lip repair at the Komfo Anokye Teaching HospitalMethod: Satisfaction with facial appearance (upper lip, nose and general facial appearance) was assessed quantitatively by means of a Visual Analogue Scale (VAS), where 0cm indicates totally unsatisfied or “highly unattractive” and 10cm indicates totally satisfied or “highly attractive”. Three assessors - parents, surgeon and layperson - were purposively selected to score their level of satisfaction with repair of complete and incomplete unilateral cleft lip. The assessors also indicated the need for any revision.Results: The total sample size was 120, of which 40.0% were male and 60.0% were female. There were 79 cases of repaired complete unilateral cleft lip and 41 incomplete unilateral cleft lip. Average scores of satisfactionof parents were 6.6, 6.8 and 7.2 for nose, lip and general facial  appearance (GFA) respectively. Satisfaction scores for surgeon were  6.1(nose), 6.0(lip) and 6.5(GFA), while those of the lay-assessor were5.2(nose), 5.4 (lip) and 6.0(GFA). Concerning the need for revision, parents indicated 30.2% as needing revision, surgeon 33%; and  lay-assessor 40%. Of the cases that needed revision, 33.3% were complete cleft lip and 0.1% were incomplete cleft lip.Conclusion: Parents were more satisfied with unilateral cleft lip repair using the Millard procedure than either the surgeon or lay assessor. Those who needed revision were mostly children who presented with complete unilateral cleft lip

HIV mortality in urban slums of Nairobi, Kenya 2003-2010: a period effect analysis.

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.BACKGROUND: It has been almost a decade since HIV was declared a national disaster in Kenya. Antiretroviral therapy (ART) provision has been a mainstay of HIV treatment efforts globally. In Kenya, the government started ART provision in 2003 with significantly scale-up after 2006. This study aims to demonstrate changes in population-level HIV mortality in two high HIV prevalence slums in Nairobi with respect to the initiation and subsequent scale-up of the national ART program. METHODS: We used data from 2070 deaths of people aged 15-54 years that occurred between 2003 and 2010 in a population of about 72,000 individuals living in two slums covered by the Nairobi Urban Health and Demographic Surveillance System. Only deaths for which verbal autopsy was conducted were included in the study. We divided the analysis into two time periods: the "early" period (2003-2006) which coincides with the initiation of ART program in Kenya, and the "late" period (2007-2010) which coincides with the scale up of the program nationally. We calculated the mortality rate per 1000 person years by gender and age for both periods. Poisson regression was used to predict the risk of HIV mortality in the two periods while controlling for age and gender. RESULTS: Overall, HIV mortality declined significantly from 2.5 per 1,000 person years in the early period to 1.7 per 1,000 person years in the late period. The risk of dying from HIV was 53 percent less in the late period compared to the period before, controlling for age and gender. Women experienced a decline in HIV mortality between the two periods that was more than double that of men. At the same time, the risk of non-HIV mortality did not change significantly between the two time periods. CONCLUSIONS: Population-level HIV mortality in Nairobi's slums was significantly lower in the approximate period coinciding with the scale-up of ART provision in Kenya. However, further studies that incorporate ART coverage data in mortality estimates are needed. Such information will enhance our understanding of the full impact of ART scale-up in reducing adult mortality among marginalized slum populations in Kenya

Seroprevalence of Hepatitis B and C Viruses among Human Immunodeficiency Virus Infected Patients Accessing Healthcare in Federal Medical Centre, Keffi, Nigeria

Infections of Hepatitis B and C viruses among seropositive Human immunodeficiency virus patients are a growing public health problem in Sub Saharan Africa characterized by unaffordable treatment, severe morbidity and associated mortality. This study was aimed at evaluating the seroprevalence of Hepatitis B and C viruses among HIV infected patients accessing health care at Federal Medical Centre, Keffi, Nigeria. The cross-sectional study took place between May-July 2016. A total of 200 blood samples were collected from HIV patients after informed consent and self-administered questionnaires were completed. The samples were centrifuged and the serum screened for HBV and HCV using the immunochromatographic technique. A general prevalence of infection with hepatitis B and C viruses in the study population was 17.5%. The prevalence of HBV infection was 12.5% while HCV was 5.0%. Females have higher infection rates for both viruses (p > 0.05). HBV infection was highest among those aged 20-29 years (14.3%) and lowest among those aged 30-39 years (6.5%). HCV infection was highest among those aged > 40 years (8.7%) and least among those aged 30-39 years (0.0%). Infection rates with blood transfusion, smoking habit, scarification marks and alcohol intake as risk factors were more for HBV than HCV (p > 0.05). The HIV/HBV and HIV/HCV coinfection prevalence of 12.5% and 5.0% respectively is a cause for concern. This finding underscores the urgent need for more proactive HBV immunization programs and screening of HIV patients for HBV and HCV before and even during antiretroviral therapy. Health education against these silent killers should also be advocated

An investigation on the suitability of hydrated building lime from travertine limestone outcrop of Bogongo, South West of Cameroon

peer reviewedIn the present study, physico-chemical investigations were carried out on hydrated lime produced from the limestone of the travertine outcrop of Bogongo in the South West Region of Cameroon. The aim was to evaluate the suitability of that hydrated lime as building lime. The raw material was characterized and then fired at 900 °C. The fired product was hydrated, dried and also characterized. Chemical and mineralogical analyses, density, BET specific surface measurements and thermal analyses were performed. Results were compared to those for an EN 459-1 CL 90-S industrial commercial hydrated lime. It has been shown that, hydrated lime production using the raw material from the Bogongo travertine could yield products with almost similar physico-chemical properties compared to imported CL 90 S hydrated lime, thus could have positive consequence in the commercial exploitation of the Bogongo travertine limestone outcrop.11. Sustainable cities and communitie

Foreign direct investment and technological advancement in the construction sector of developing countries: A critical perspective

Foreign Direct Investment (FDI) inflows are commonly used in developing countries (DCs) to ‘measure’ technology transfer, and consequently as an indicator for the technological advancement of economic sectors. An implied assertion being that increased FDI in a sector means an increase in foreign technology and knowledge (T&K) in that sector and in effect, technological advancement in the recipient country. An effect of this assumption is an increase in attempts by DCs to attract more FDI through incentive-laden policy reforms. While these efforts have contributed to increase in FDI, particularly in the construction sectors of DCs in Africa; there is, however, scant evidence suggesting that the rising inflows resulted in technological advancements. Thus, construction industries in many DCs continue to lag behind those of advanced countries. This paper takes as a point of departure the relationship between FDI and technological advancement. It argues that reliance on FDI to estimate ‘how much’ technology has been transferred and as an indicator of attendant advancement has limitations. From a critical perspective, such an assessment is inaccurate and neglects specific nuances of T&K transfer and technological advancement in the construction sector. Examining the Ghanaian construction sector as a case with coeval data, the paper unpacks the blind-spots inherent in the assessment of technological advancements that are heavily reliant on the use of FDI inflows. Insights from the paper contribute to the literature and policy regarding interrelations involving FDIs, the transfer of T&K and technological advancement in the construction sector in DCs

Wind Energy Dynamics of the Separately Excited Induction Generator

This paper covers the analysis, dynamic modelling and control of an isolated self-excited induction generator (SEIG) driven by a wind turbine. The proposed dynamic model consists of induction generator, self-excitation capacitance and load model which are expressed in stationary d-q reference frame. The dynamic performance of SEIG is investigated under no load and on load. To predict the performance of the system, a MATLAB based simulation study using matlab embedded function block was carried out. Simulations from the variations of the speed and load display the dynamic behavior of the generator. A constant capacitor value of 100 micro-farads was used in this work. The simulation results obtained illustrate the changes in the voltage, currents, torque and magnetizing inductance of the generator. The wind velocity increase led to the increase in mechanical input from the wind turbine. This results in the increased rotor speed leading also to increased stator phase voltage. The obtained simulations also show that the output voltage of the induction generator depends greatly on its shaft speed and load; this poses a potential threat as it is capable of causing a significant variation in the power consumption in the load of the machine

Mortality from external causes in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System Sites.

BACKGROUND: Mortality from external causes, of all kinds, is an important component of overall mortality on a global basis. However, these deaths, like others in Africa and Asia, are often not counted or documented on an individual basis. Overviews of the state of external cause mortality in Africa and Asia are therefore based on uncertain information. The INDEPTH Network maintains longitudinal surveillance, including cause of death, at population sites across Africa and Asia, which offers important opportunities to document external cause mortality at the population level across a range of settings. OBJECTIVE: To describe patterns of mortality from external causes at INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories. DESIGN: All deaths at INDEPTH sites are routinely registered and followed up with VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provide person-time denominators for mortality rates. RESULTS: A total of 5,884 deaths due to external causes were documented over 11,828,253 person-years. Approximately one-quarter of those deaths were to children younger than 15 years. Causes of death were dominated by childhood drowning in Bangladesh, and by transport-related deaths and intentional injuries elsewhere. Detailed mortality rates are presented by cause of death, age group, and sex. CONCLUSIONS: The patterns of external cause mortality found here generally corresponded with expectations and other sources of information, but they fill some important gaps in population-based mortality data. They provide an important source of information to inform potentially preventive intervention designs

Analysis of AML genes in dysregulated molecular networks

<p>Abstract</p> <p>Background</p> <p>Identifying disease causing genes and understanding their molecular mechanisms are essential to developing effective therapeutics. Thus, several computational methods have been proposed to prioritize candidate disease genes by integrating different data types, including sequence information, biomedical literature, and pathway information. Recently, molecular interaction networks have been incorporated to predict disease genes, but most of those methods do not utilize invaluable disease-specific information available in mRNA expression profiles of patient samples.</p> <p>Results</p> <p>Through the integration of protein-protein interaction networks and gene expression profiles of acute myeloid leukemia (AML) patients, we identified subnetworks of interacting proteins dysregulated in AML and characterized known mutation genes causally implicated to AML embedded in the subnetworks. The analysis shows that the set of extracted subnetworks is a reservoir rich in AML genes reflecting key leukemogenic processes such as myeloid differentiation.</p> <p>Conclusion</p> <p>We showed that the integrative approach both utilizing gene expression profiles and molecular networks could identify AML causing genes most of which were not detectable with gene expression analysis alone due to the minor changes in mRNA level.</p

Identifying gaps in HIV policy and practice along the HIV care continuum: evidence from a national policy review and health facility surveys in urban and rural Kenya

The last decade has seen rapid evolution in guidance from the WHO concerning the provision of HIV services along the diagnosis-to-treatment continuum, but the extent to which these recommendations are adopted as national policies in Kenya, and subsequently implemented in health facilities, is not well understood. Identifying gaps in policy coverage and implementation is important for highlighting areas for improving service delivery, leading to better health outcomes. We compared WHO guidance with national policies for HIV testing and counselling, prevention of mother-to-child transmission, HIV treatment and retention in care. We then investigated implementation of these national policies in health facilities in one rural (Kisumu) and one urban (Nairobi) sites in Kenya. Implementation was documented using structured questionnaires that were administered to in-charge staff at 10 health facilities in Nairobi and 34 in Kisumu. Policies were defined as widely implemented if they were reported to occur in > 70% facilities, partially implemented if reported to occur in 30–70% facilities, and having limited implementation if reported to occur in < 30% facilities. Overall, Kenyan national HIV care and treatment policies were well aligned with WHO guidance. Policies promoting access to treatment and retention in care were widely implemented, but there was partial or limited implementation of several policies promoting access to HIV testing, and the more recent policy of Option B+ for HIV-positive pregnant women. Efforts are needed to improve implementation of policies designed to increase rates of diagnosis, thus facilitating entry into HIV care, if morbidity and mortality burdens are to be further reduced in Kenya, and as the country moves towards universal access to antiretroviral therapy