Giant urinary bladder calculus: Case report

A vertical calculus weighing more than 100 g is categorised as a giant urinary bladder stone. Giant urinary bladder stones are very rare and very few cases have been reported in English literature and only one case from Africa. This is a case report of a patient with a giant urinary bladder calculus presenting as a rectal tumour. The stone was removed by open cystolithotomy. Possible etiological factors and imaging modalities are discussed

Comparative radio-opacity of bones of commonly consumed fish species in western Kenya region on digitalised lateral neck X-ray films

Objective: To determine the comparative radio-opacity on digital plain radiographs of bones of 10 fish species commonly consumed in Western Kenya Region.Design: Descriptive cross sectional study.Setting: Jaramogi Oginga Teaching and Referral Hospital, Kisumu Kenya.Results: There was excellent interobserver agreement on the rating of 21out of 25 films evaluated. The overall sensitivity of plain radiographs in detection of raw and cooked fish bones was 72% and 69% respectively but varied significantly between fish species. The specificity of the technique was 100% overall.Conclusion: Lateral soft tissue neck radiograph is an appropriate screening tool in cases of a suspected impacted fishbone. If a fishbone is identified on a radiograph, the patient should be referred for endoscopy without further imaging. If the radiograph is normal, then there should be no further imaging or endoscopy. An observation policy can be adopted. Radiographs may be of limited value in cases of Butter fish (Schilbe intermedius) and Elephant snout fish (Momuruscarnume) bone impaction as these bones are radiolucent. In such cases, further imaging by CT scan or endoscopy without further imaging may be recommended when clinically indicated

Upper Abdominal Ultra-Sonography Findings in HIV Patients at Kenyatta National Hospital and the Defense Forces Memorial Hospital

Background: Easy availability, accessibility and affordability make ultra-sonography an invaluable  diagnostic tool in clinical investigation of infectious and non-infectious complications of human immunodeficiency virus (HIV).Objective: To determine the pattern of upper abdominal abnormalities in HIV infected patients at ultra-sonography and correlate with clinical presentations.Design: A descriptive cross-sectional study.Setting: Kenyatta National Hospital and the Defence Forces Memorial Hospital, Nairobi, Kenya.Subjects: HIV infected patients referred for upper abdominal sonography within the study duration of eight months.Results: Two hundred and seventy three (273) patients were included in the study. Overall, upper abdominal pain accounted for 31.9%, pyrexia of unknown origin 30.40% and general abdominal pains  27.68% of clinical indications for sonography. The main clinical indication for liver sonography was  hepatitis (45.80%) and the kidney was renal failure (66.67%). The most common liver pathology was diffuse fat infiltration at 35.71%. The most common renal pathology was renal parenchymal disease (93%). Para-aortic lymphadenopathy was present in 42.90% and ascites 25.60% of patients. Conclusion: Renal parenchymal changes (type I and II), fatty liver, intra-abdominal lymphadenopathy and gallbladder sludge are common findings in HIV infected individuals despite paucity of clinical suspicion

Smallholder access to quality and diverse seed in Uganda: implications for food security

This policy briefs presents smallholder farmers' preferences and major challenges when accessing seed in Uganda. It reflects on the weaknesses of the formal and informal seed production and distribution systems and presents some practical recommendations for putting in place alternative and integrative seed quality control systems that can help fill in the gaps that the formal and informal systems cannot address separately

The Global Financial Crisis, Inflation Rate And Stock Market Returns In Kenya

The moderating effect of events such as the 2008 Global Financial Crisis (GFC) on the relation between stock market returns and macroeconomic variables has attracted very little attention. This study investigates the extent to which the 2008 GFC moderated the relationship between inflation rate and stock market returns. The study uses month-onmonth inflation rate and year-on-year inflation rate from 1st January 1993 to 31st December 2015 and divides the sample data into pre-crisis period (from 1st January 1993 to 31st December 2007); crisis period (from 1st January 2008 to 30th June 2009); and post-crisis period (from 1st July 2009 to 31st December 2015). It uses a product-term regression model instead of the most widely applied additive regression model. Results indicate that a unit increase in the both measures of inflation rate had significant depressing effects on stock market returns after the crisis compared to before the crisis. Likewise, the results reveal that average stock market returns were significantly higher after the crisis compared to before the crisis at low rather than medium or high values of the two measures of inflation rate. These results suggest that the Kenyan stock market is highly sensitive to variations in inflation rate, especially as it emerges from a financial or political turmoil. This study is empirically innovative in the sense that it is the first to examine the moderating effect of the 2008 GFC on the relation between inflation rate and stock market returns in Kenya using a product-term model

Mathematical model for pneumonia dynamics among children

The 2012 Southern Africa mathematical sciences association Conference (SAMSA 2012)26th -29th Nov 2012There are major advances which have been made to understand the epidemiology of infectious diseases. However, more than 2 million children in the developing countries still die from pneumonia each year. The eorts to promptly detect, eectively treat and control the spread of pneumonia is possible if its dynamics is understood. In this paper,we develop a mathematical model for pneumonia among children underve years of age. The model is analyzed using the theory of ordinary dierential equations and dynamical systems. We derive the basic reproduction number, R0, analyze the stability of equilibrium points and bifurcation analysis. The results of the analysis shows that there exist a locally stable disease free equilibrium point, Ef when R0 1.The analysis also shows that there is a possibility of a forward bifurcation

Human metapneumovirus prevalence and patterns of subgroup persistence identified through surveillance of pediatric pneumonia hospital admissions in coastal Kenya, 2007–2016

Background Human metapneumovirus (HMPV) is an important respiratory pathogen that causes seasonal epidemics of acute respiratory illness and contributes significantly to childhood pneumonia. Current knowledge and understanding on its patterns of spread, prevalence and persistence in communities in low resource settings is limited. Methods We present findings of a molecular-epidemiological analysis of nasal samples from children < 5 years of age admitted with syndromic pneumonia between 2007 and 2016 to Kilifi County Hospital, coastal Kenya. HMPV infection was detected using real-time RT-PCR and positives sequenced in the fusion (F) and attachment (G) genes followed by phylogenetic analysis. The association between disease severity and HMPV subgroup was assessed using Fisher’s exact test. Results Over 10 years, 274/6756 (4.1%) samples screened were HMPV positive. Annual prevalence fluctuated between years ranging 1.2 to 8.7% and lowest in the recent years (2014–2016). HMPV detections were most frequent between October of one year to April of the following year. Genotyping was successful for 205/274 (74.8%) positives revealing clades A2b (41.0%) and A2c (10.7%), and subgroups B1 (23.4%) and B2 (24.9%). The dominance patterns were: clade A2b between 2007 and 11, subgroup B1 between 2012 and 14, and clade A2c in more recent epidemics. Subgroup B2 viruses were present in all the years. Temporal phylogenetic clustering within the subgroups for both local and global sequence data was seen. Subgroups occurring in each epidemic season were comprised of multiple variants. Pneumonia severity did not vary by subgroup (p = 0.264). In both the F and G gene, the sequenced regions were found to be predominantly under purifying selection. Conclusion Subgroup patterns from this rural African setting temporally map with global strain distribution, suggesting a well-mixed global virus transmission pool of HMPV. Persistence in the local community is characterized by repeated introductions of HMPV variants from the global pool. The factors underlying the declining prevalence of HMPV in this population should be investigated

Responding to Major Burn Disasters in Resource-Limited Settings: Lessons Learned From an Oil Tanker Explosion in Nakuru, Kenya.

BACKGROUN

Armillaria root rot of tea in Kenya : characterization of the pathogen and approaches to disease management

The rare occurrence of basidiomata and rhizomorphs constrains diagnosis of Armillaria root rot and identification of Armillaria species in Africa. This has had a negative impact on taxonomic research on the genus Armillaria in the continent, where the existence of various genetic groups of the fungus is more easily demonstrated by techniques that do not depend on the presence of basidiomata. DNA analysis by RAPD, ISSR, and RFLP of the IGS and ITS regions showed that Armillaria pathogenic on tea in Kenya consists mainly of two groups. Neither of these is identical to A. mellea , the species to which the disease has been largely attributed in the past. Based on morphological characteristics we conclude that the more predominant of the two groups is probably A. heimii and that the other group may represent a hitherto undescribed species.Infected root residues in the soil comprise the major sources of Armillaria inoculum from which primary infection of tea starts. From these the fungus spreads rapidly within a plantation. Due to the scarcity of rhizomorphs it is assumed that the principal mode of spread of the fungus is through mycelial transfer at points of root-to-root contact. The available control measure against Armillaria root rot is the eradication of the fungus from infested sites through mechanical removal of the inoculum sources and infected plants. However, removal of inoculum is cumbersome and difficult to carry out manually. An isolate of Trichoderma harzianum was selected that readily colonized wood and strongly reduced viability of Armillaria inoculum. Use of this isolate to control Armillaria would work better when applied in combination with soil disinfestation by solarization. By increasing soil temperatures, solarization for 10 wk completely inactivated woody Armillaria inocula, which could be reduced to a solarization period of 5 wk if it was followed with application of T. harzianum . Soil amendment with coffee pulp, earlier reported to enhance development of T. harzianum , did not increase colonisation of Armillaria inoculum sources by the antagonist but did cause a slight reduction in inoculum viability. It is concluded that a combination of solarization with subsequent introduction of T. harzianum has good prospects for managing Armillaria root rot

EFFECT OF CAREER ADVANCEMENT ON RETENTION OF SCIENCE TEACHERS IN PUBLIC SECONDARY SCHOOLS IN KISUMU COUNTY, KENYA: A MIXED METHOD APPROACH

The aim of the study was to determine the effect of career advancement on retention of science teachers in public secondary schools in Kisumu County, Kenya. Embedded research design was adopted for the study. Target population included 905 respondents which comprised 221 principals and 684 science teachers from 221 public secondary schools in Kisumu County. Stratified, simple random and purposive sampling techniques were employed to sample 277 respondents who included 68 principals and 209 science teachers from 68 public secondary schools. Questionnaires and interview schedule were used to collect data. Validity of the data collection instruments was determined through expert judgment whereas reliability was ascertained through internal consistency method using Cronbach’s Alpha coefficient formula. Statistical Package for Social Sciences version 22.0 facilitated analysis of quantitative data. Descriptive statistics, namely; frequencies, percentages, means and standard deviation were used to analyze quantitative data while thematic approach was used to analyze qualitative data. Regression analysis was used to analyze the relationship between career advancement and retention as well as to test the hypotheses. The study revealed that career advancement had a statistically significant effect on retention; training (β =.134, p = 060 > .05); career path (β = .062, p = .382 > .05) and promotion (β = .257, p = .000 < .05). Specifically, promotion had statistically significant effect on retention of science teachers. The study concludes that career advancement especially promotion has statistically significant effect on retention of science teachers in public secondary schools in Kisumu County. Article visualizations