Primary lumbar hernia in an elderly woman: case report

Lumber hernia is a rare posterior abdominal wall defect with fewer than 300 cases reported in literature. It accounts for less than 1.5% of total hernia incidence. Herniation is mainly through the inferior lumber triangle (Petit’s hernia) or through the superior lumber triangle (Grynfeltt’s triangle); with both these anatomical boundaries accounting for 95% of lumber hernias. Lumber hernias are classified as either congenital (20%) or acquired (80%), and the typical presentation is a patient with a protruding bulge in the back with a slow growth. Our patient was a 70-year-old woman who presented at the surgical outpatient department with a swelling on the right flank for two years. She revealed no known cause of the swelling that was progressively increasing in size, with a dull pain. Physical examination and ultrasonography revealed a defect in the posterolateral abdominal wall. Surgical dissection revealed a large hernial sac, which contained retro peritoneal fat, protruding through a 3-4 centimetres defect in the transversalis fascia lining the floor of the superior lumbar triangle. The hernia sac was reduced and the defect closed. There was no recurrence four months post-operative. Lumber hernias are rare, but a good history and physical examination is important to rule out most of the differential diagnoses. Early surgical management is recommended but the surgical approach should be individualised

Census and ear-notching of black rhinos (Diceros bicornis michaeli) in Tsavo East National Park, Kenya

This paper updates the status of the black rhino population in Tsavo East National Park (NP). Data were acquired through aerial counts of the black rhino between 3 and 9 October 2010 using three fixed-wing husky aircrafts and a Bell 206L helicopter in an area of about 3,300 km2. Based on previous sightings of rhinos, the area was divided into 14 blocks, with each block subdivided into 400 m transects. An aircraft flying at about 500 m above the ground was assigned to carry out the aerial survey following these transects within each block. Observers scanned for rhinos about 200 m on either sides of the flight paths. Intensive searches in areas with dense vegetation, especially along the Galana and Voi Rivers and other known rhino range areas was also carried out by both the huskies and the helicopter. The count resulted in sighting of 11 black rhinos. Seven of these individuals were ear notched and fitted with radio transmitters and the horns were tipped off to discourage poaching. Three of the seven captured rhinos were among the 49 animals translocated to Tsavo East between 1993 and 1999. The other four animals were born in Tsavo East. Two female rhinos and their calves were not ear-notched or fitted with transmitters. It is recommended that another count be carried out immediately after the wet season as the rhinos spend more time in the open areas while the vegetation is still green. The repeat aerail count is to include blocks north of River Galana

Correlates of Behavior Management Strategies Among Learners With Autistic Spectrum Disorders In Primary Schools In Western Kenya

Practitioners handling learners with Autistic Spectrum Disorders (ASDs) often feel ill-prepared to effectively manage this disorder.  Quite often, when faced with cases of challenging behaviour, teachers use coping strategies which may be counter-productive. This paper reports the findings of a study that sought to determine factors that influence practitioners’ choice of behaviour management strategies among learners with ASDs in primary schools in Western Kenya. An exploratory analysis set out to determine the practitioners’ perception of challenging behaviour and its influence on the choice of management strategies. The findings of the study revealed that practitioners training, work experience, collaboration and networking with other professionals, staffing levels, and support received from parents of children with ASDs played a significant role in the choice of strategies in management of behaviour presented by learners with ASDs. Key words: Challenging behavior, Practitioners, Teachers, Autistic Spectrum Disorde

Prevalence and Correlates of Tobacco Use Among School-Going Adolescents in Madagascar

Approximately 90% of adults start smoking during adolescence, with limited studies conducted in low-and-middle-income countries where over 80% of global tobacco users reside. The study aims to estimate prevalence and identify predictors associated with adolescents\u27 tobacco use in Madagascar. We utilized tobacco-related information of 1184 school-going adolescents aged 13-15 years, representing a total of 296,111 youth from the 2008 Madagascar Global Youth Tobacco Survey to determine the prevalence of tobacco use. Gender-wise multivariable logistic regression models were conducted to identify key predictors.Approximately 19% (30.7% males; 10.2% females) of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females) currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS) and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females\u27 tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents\u27 tobacco use

Targeting dairy interventions in Kenya: a guide for development planners, researchers and extension workers

This easy-to-use guide to effective targeting of selected dairy interventions in Kenya is intended for use by anyone involved in dairy farming in the country, such as development planners, researchers, service providers, suppliers of dairy inputs and extension workers. The guide answers the question often faced by these workers: where is their proposed intervention most likely to be adopted? Using a combination of Geographical Information Systems (GIS) mapping methods and economic regression techniques, this guide shows where and under what circumstances dairy technologies are most likely to succeed. The guide is divided into three sections. The first section deals with concepts, rationale and methodologies for targeting dairy interventions. It also explains, with examples, how to use the guide. The second section presents the targeting maps for various dairy interventions. A total of eleven dairy interventions are considered in this guide. For each, a map shows relative probability of adoption together with a description of the innovation and background information. Also presented are the socio-economic, biophysical and agro-climatic characteristics that predispose uptake of each intervention. The third section presents some policy-relevant research results in three topical areas: Cost of milk production; Evaluation and assessment of alternative milk preservation techniques; and Employment generation in the dairy marketing chain

Higher education systems and institutions, Mozambique

The Republic of Mozambique is a country located in southeast Africa. It is bordered by South Africa and Swaziland to the southwest, Zimbabwe to the west, Zambia and Malawi to the northwest, and Tanzania to the north. With a surface area of roughly 800,000 square km and a rapidly expanding population roughly at 29.5 million, it is the second largest Portuguese-speaking country in Africa. Although Portuguese is the official language, most Mozambicans speak Bantu languages. As other Lusophone countries in Africa, Mozambique became independent in 1975 after a prolonged war with Portugal. After that, it had to endure an even longer civil war between former independentist movements which ended only in 1992. At the same time, between independence and the mid-1980s, the government of Mozambique experimented with socialism as a political and economic model of development and social construction. All of these factors have led the country to a desperate socioeconomic situation until...info:eu-repo/semantics/acceptedVersio

An assessment of facility-based care of diabetes, hypertension, and heart failure across western Kenya

Background: Low- and middle- income countries account for three-fourths of the global non- communicable disease related mortality. In response to the increasing number of non- communicable disease diagnoses in Kenya, the government released a national strategy for non- communicable disease in 2015. The purpose of this study was to assess facility-based care of diabetes, hypertension, and heart failure across western Kenya.Methods: A 71-question cross-sectional survey was administered among facility-based healthcare workers in Siaya County, western Kenya, between October 2015 and January 2016. All Level 4 and 5 facilities, as well as a cohort of lower-level facilities were surveyed.Results: Of the 21 health facilities surveyed, six (31.6%) had specific non-communicable disease clinics. Eleven of the 21 (52.4%) facilities had glucometers, and providers indicated that even these glucometers were often not functional. Three of the 21 facilities (14.3%) had a diabetic registry, one a functioning electrocardiogram machine, and one other a congestive heart failure registry.Conclusions: Facilities at every level were lacking equipment and medications expected by the Kenya’s Essential Package of Health Services. Improvement for follow up and referral services could be achieved through the development of comprehensive non-communicable disease registries

Micro-Dosing of Lime, Phosphorus and Nitrogen Fertilizers Effect on Maize Performance on an Acid Soil in Kenya

High cost of inorganic fertilizers and lime has precluded their use by smallholder farmers to remedy the problem of soil acidity and infertility in Kenya. To address the problem, we tested a precision technique referred to as micro-dosing, which involves application of small, affordable quantities of inorganic inputs on an acid soil in Busia County, Kenya. Experimental treatments were N-fertilizer (0 and 37.5 kg N ha-1), P-fertilizer (0 and 13 kg P ha-1) and lime (0, 0.77 and 1.55 tons lime ha-1). 37.5 kg N and 13 kg P ha-1 are 50% of the recommended fertilizer rates for maize production in Kenya while 0.77 and 1.55 tons lime ha-1 are 25 and 50% of the actual requirement. Soil chemical changes, maize grain yield and nutrient recovery were determined. Lime and P-fertilizer significantly affected only the top-soil pH, Ca, Mg and available P, while the effects of N-fertilizer were evident on both top- and sub-soil N likely due to its faster mobility than P and lime. Grain P-fertilizer recovery efficiencies were 14 and 16-27% due to 13 kg P and 13 kg P + 0.77-1.55 tons lime ha-1, respectively. N-fertilizer recovery efficiencies were 37 and 42-45% due to 37.5 kg N and 37.5 kg N + 0.77-1.55 tons lime ha-1, respectively. Fertilizers applied to supply 37.5 kg N, 13 kg P and 0.77-1.55 tons lime ha-1 increased grain yield above the control by 134, 39 and 12-22%, respectively, therefore micro-dosing of these inputs can increase maize production on Kenyan acid soils