Ogilvie’s syndrome: case report of spontaneous rupture of the ceacum following caesarean section

In acute colonic pseudo-obstruction (ACPO) there is colonic distension without an organic obstacle (intrinsic or extrinsic to intestinal wall). This becomes a potential site of ceacal rapture which can lead to the demise of the patient. Presented is a case of a mother who had spontaneous caecal rapture five days after Caesarean delivery. At Laparotomy the ceacal rapture was confirmed and a colostomy was done. The patient succumbed in Intensive care unit two days post-operatively

Pheochromocytoma in pregnancy: Case report

This is a case presentation of a 32 year old woman with pheochromocytoma diagnosed at 27 weeks of gestation, she was managed till term, induced and had assisted vaginal delivery. The pheochromocytoma was surgically re-sected successfully at six weeks postpartum

THE MODERATING INFLUENCE OF REGIONAL INTEGRATION ON STRATEGIC ALLIANCES AND PERFORMANCE OF KENYAN MANUFACTURING FIRMS IN THE EAST AFRICAN COMMUNITY MARKET

The specific objective of this study was to determine the influence of regionalintegration on the relationship between strategic alliances and performance ofKenyan manufacturing firms in the East African Community market. The studywas anchored on Resource dependency theory, theory of integration and the Opensystem theory. The positivism philosophical paradigm and a cross sectionaldescriptive survey design guided the study. The population of the study was 160Kenyan manufacturing firms in the EAC market. Primary data was collectedusing a semi-structured questionnaire. A response rate of 81.88% was realized.Secondary data was collected from financial statements of the respective firms.Data was analysed using descriptive and inferential statistics. Hypotheses wastested using Baron and Kenny model of stepwise regression analysis to test formoderating effects. From the research findings, regional integration was found tohave a statistically significant moderating influence on the relationship betweenstrategic alliance and firm performance. These results are consistent withpropositions in the resource dependence and open system theories. In a regionalintegration framework, firms depend on each other through strategic alliances togain competitive advantages as envisaged in resource dependency theory. Thestudy recommends that policy makers in EAC partner states should encouragecomplementarity and competitive advantage approaches while promoting skillstransfer and information sharing amongst the firms

Designing a school water treatment and interactive education program in Kenya to enable future scale-up

Many small-scale public health efforts including those to improve water, sanitation and hygiene (WASH) have not expanded beyond their initial scope. To improve the likelihood of scaling, the goal of this project led by the Program for Appropriate Technology in Health (PATH) was to design a small-scale innovative WASH project in three schools (the pilot) that was embedded within a larger-scale, multi-year program (AIDs Population and Health Integrated Assistance plus [APHIAplus]) focused on capacity-building to achieve integrated health delivery in Kenya. The innovative elements of the pilot included use of onsite electrochlorination and an interactive WASH curriculum that resulted in improved water quality and WASH knowledge at the schools. By aligning the pilot with the results framework of APHIAplus and utilizing a pre-existing partnership with schools, the integrated approach provided structure for implementation and an efficient use of resources. The pilot will be expanded to include 23 schools in 2013-2014

How rainfall variation influences reproductive patterns of African Savanna ungulates in an equatorial region where photoperiod variation is absent.

In high temperate latitudes, ungulates generally give birth within a narrow time window when conditions are optimal for offspring survival in spring or early summer, and use changing photoperiod to time conceptions so as to anticipate these conditions. However, in low tropical latitudes day length variation is minimal, and rainfall variation makes the seasonal cycle less predictable. Nevertheless, several ungulate species retain narrow birth peaks under such conditions, while others show births spread quite widely through the year. We investigated how within-year and between-year variation in rainfall influenced the reproductive timing of four ungulate species showing these contrasting patterns in the Masai Mara region of Kenya. All four species exhibited birth peaks during the putative optimal period in the early wet season. For hartebeest and impala, the birth peak was diffuse and offspring were born throughout the year. In contrast, topi and warthog showed a narrow seasonal concentration of births, with conceptions suppressed once monthly rainfall fell below a threshold level. High rainfall in the previous season and high early rains in the current year enhanced survival into the juvenile stage for all the species except impala. Our findings reveal how rainfall variation affecting grass growth and hence herbivore nutrition can govern the reproductive phenology of ungulates in tropical latitudes where day length variation is minimal. The underlying mechanism seems to be the suppression of conceptions once nutritional gains become insufficient. Through responding proximally to within-year variation in rainfall, tropical savanna ungulates are less likely to be affected adversely by the consequences of global warming for vegetation phenology than northern ungulates showing more rigid photoperiodic control over reproductive timing

Mapping of poverty and likely zoonoses hotspots

The objective of this report is to present data and expert knowledge on poverty and zoonoses hotspots to inform prioritisation of study areas on the transmission of disease in emerging livestock systems in the developing world, where prevention of zoonotic disease might bring greatest benefit to poor people

Pregnancy rates among female participants in phase 1 and phase 2A AIDS vaccine clinical trials in Kenya

Background: Female participants in AIDS candidate vaccine clinical trials must agree to use effective contraception to be enrolled into the studies, and for a specified period after vaccination, since the candidate vaccines’ effects on the embryo or foetus are unknown.Objectives: To review data on female participants’ pregnancy rates from phase I and IIA AIDS vaccine clinical trials conducted at the Kenya AIDS Vaccine Initiative (KAVI) and to discuss the challenges of contraception among female participants.Design: Descriptive observational retrospective study.Setting: KAVI clinical trial site, Kenyatta National Hospital and University of Nairobi, Kenya.Subjects: Thirty nine female participants were enrolled into these trials. They received family planning counselling and were offered a choice of different contraceptive methods, as per the protocols. All contraception methods chosen by the participants were offered at the study site at no cost to the participant.Results: Four women conceived during the study period when pregnancies were to be avoided. All four had opted for sexual abstinence as a contraceptive method, but reported having been coerced by their partners to have unprotected sexual intercourse.Conclusion: Abstinence is clearly not a reliable contraceptive option for women in developing-country settings. Effective female-controlled contraceptives, administered at the clinical trial site, may empower female participants to better control their fertility, leading to more complete clinical trial data

A randomized, open-label, comparative efficacy trial of artemether-lumefantrine suspension versus artemether-lumefantrine tablets for treatment of uncomplicated Plasmodium falciparum malaria in children in western Kenya

<p>Abstract</p> <p>Background</p> <p>Artemether/lumefantrine (AL) has been adopted as the treatment of choice for uncomplicated malaria in Kenya and other countries in the region. Six-dose artemether/lumefantrine tablets are highly effective and safe for the treatment of infants and children weighing between five and 25 kg with uncomplicated <it>Plasmodium falciparum </it>malaria. However, oral paediatric formulations are urgently needed, as the tablets are difficult to administer to young children, who cannot swallow whole tablets or tolerate the bitter taste of the crushed tablets.</p> <p>Methods</p> <p>A randomized, controlled, open-label trial was conducted comparing day 28 PCR corrected cure-rates in 245 children aged 6–59 months, treated over three days with either six-dose of artemether/lumefantrine tablets (Coartem^®) or three-dose of artemether/lumefantrine suspension (Co-artesiane^®) for uncomplicated falciparum malaria in western Kenya. The children were followed-up with clinical, parasitological and haematological evaluations over 28 days.</p> <p>Results</p> <p>Ninety three percent (124/133) and 90% (121/134) children in the AL tablets and AL suspension arms respectively completed followed up. A per protocol analysis revealed a PCR-corrected parasitological cure rate of 96.0% at Day 28 in the AL tablets group and 93.4% in the AL suspension group, p = 0.40. Both drugs effectively cleared gametocytes and were well tolerated, with no difference in the overall incidence of adverse events.</p> <p>Conclusion</p> <p>The once daily three-dose of artemether-lumefantrine suspension (Co-artesiane^®) was not superior to six-dose artemether-lumefantrine tablets (Coartem^®) for the treatment of uncomplicated malaria in children below five years of age in western Kenya.</p> <p>Trial registration</p> <p>ClinicalTrials.gov NCT00529867</p