Prevalence of Cutaneous Manifestations of Diabetes Mellitus: A Hospital- Based Cross- Sectional Study in Northern Tanzania

Background: Diabetes mellitus is a non- communicable disease with an increasing prevalence in  developing countries. Skin manifestations in this condition are due to metabolic derangements or chronic degenerative complications. Skin manifestations are commonly observed after developing clinical  diabetes mellitus, but may also precede the diagnosis of the disease.Objective: To determine the prevalence and the spectrum of cutaneous diseases in patients with  diabetes mellitusDesign: A hospital- based descriptive cross sectional study.Setting: Regional Dermatology Training Center at Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania.Results: A total of 544 patients with diabetes mellitus were recruited. The majority (64.2%, n= 349) were females with a male to female ratio of 1:1.8 and mean age of 54.8 years (SD±18.4). The overall prevalence of cutaneous manifestations in diabetic patients was 43.9% (n=239). Some patients had more than one skin condition giving a total of 297 skin conditions diagnosed in 239 patients. From a total of 297 skin conditions, there were 150 (50.5%) primary non-infectious skin conditions in patients with diabetes. Infections accounted for 38.0% (n=113), whereas 6.7 % (n=16) were skin conditions due to complications of diabetes and 7.6% (n=18) were skin reactions caused by treatment for diabetes Conclusions: Primary non-infectious cutaneous manifestations of diabetes mellitus are the most frequent manifestations as compared with infectious cutaneous manifestations in our setting

Extensive lupus vulgaris-like chromoblastomycosis responding to itraconazole: case report

We present a case report of a patient with extensive chromoblastomycosis that mimicks lupus vulgaris. This is a rare clinical presentation with atrophic patches on the trunk and crusted lesion on the lower extremities. The diagnosis was confirmed by histology, potassium hydroxide preparation and culture. Fonsecaea Pedrosoi was isolated on fungal culture. Patient was treated with itraconazole tablets 100mgs twice daily for three months with rapid improvement. Sporadic cases of chromoblastomycosis occur in Eastern Africa. Patients present with disfiguring disease due to delay in treatment

The efficacy of retirement plans and flexible scheduling in improving the quality of service delivery among civil servants in Nandi south Kenya

Retirement plans and flexible scheduling guides most organizations and is part of most complaints of citizen’s due to poor service in government counties such complaints was reflected during the year 2002 Constitutional Referendum in Kenya which in part called for an overhaul of the civil service structure through various Civil Service Reform Programmes and major reshuffles. This paper highlighted therefore the effects of these variables in service delivery within Civil Service offices in Kenya: A case of Nandi south. Stratified random sampling techniques were used to select 350 employees of Nandi south. Data collected through the use of questionnaires was analyzed using both descriptive and regression statistics. Descriptive findings revealed that there was low level of retirement plan services to the employees of Nandi south. Nevertheless, high levels of Flexible Scheduling services among employees were observed an indicator that retirement plans in the Workplace had significant effect on Service Delivery. Keywords: Services Delivery, Workplace, Retirement Plans and Flexible Schedulin

The efficacy of retirement plans and flexible scheduling in improving the quality of service delivery among civil servants in Nandi south Kenya

Retirement plans and flexible scheduling guides most organizations and is part of most complaints of citizen’s due to poor service in government counties such complaints was reflected during the year 2002 Constitutional Referendum in Kenya which in part called for an overhaul of the civil service structure through various Civil Service Reform Programmes and major reshuffles. This paper highlighted therefore the effects of these variables in service delivery within Civil Service offices in Kenya: A case of Nandi south. Stratified random sampling techniques were used to select 350 employees of Nandi south. Data collected through the use of questionnaires was analyzed using both descriptive and regression statistics. Descriptive findings revealed that there was low level of retirement plan services to the employees of Nandi south. Nevertheless, high levels of Flexible Scheduling services among employees were observed an indicator that retirement plans in the Workplace had significant effect on Service Delivery. Keywords: Services Delivery, Workplace, Retirement Plans and Flexible Schedulin

New Oldowan locality Sare-Abururu (ca. 1.7 Ma) provides evidence of diverse hominin behaviors on the Homa Peninsula, Kenya

The Homa Peninsula, in southwestern Kenya, continues to yield insights into Oldowan hominin landscape behaviors. The Late Pliocene locality of Nyayanga (∼3–2.6 Ma) preserves some of the oldest Oldowan tools. At the Early Pleistocene locality of Kanjera South (∼2 Ma) toolmakers procured a diversity of raw materials from over 10 km away and strategically reduced them in a grassland-dominated ecosystem. Here, we report findings from Sare-Abururu, a younger (∼1.7 Ma) Oldowan locality approximately 12 km southeast of Kanjera South and 18 km east of Nyayanga. Sare-Abururu has yielded 1754 artifacts in relatively undisturbed low-energy silts and sands. Stable isotopic analysis of pedogenic carbonates suggests that hominin activities were carried out in a grassland-dominated setting with similar vegetation structure as documented at Kanjera South. The composition of a nearby paleo-conglomerate indicates that high-quality stone raw materials were locally abundant. Toolmakers at Sare-Abururu produced angular fragments from quartz pebbles, representing a considerable contrast to the strategies used to reduce high quality raw materials at Kanjera South. Although lithic reduction at Sare-Abururu was technologically simple, toolmakers proficiently produced cutting edges, made few mistakes and exhibited a mastery of platform management, demonstrating that expedient technical strategies do not necessarily indicate a lack of skill or suitable raw materials. Lithic procurement and reduction patterns on the Homa Peninsula appear to reflect variation in local resource contexts rather than large-scale evolutionary changes in mobility, energy budget, or toolmaker cognition

Clinical epidemiologic profile of vitiligo

Background: Vitiligo is an acquired de-pigmenting disorder of unknown aetiologyaffecting 1-2% of the world’s population. It is a chronic skin disease, characterised by the appearance of white depigmented macules and patches due to loss of melanocytes. This disorder is common in all races, regardless of age and sex. The onset of the disease may vary from early infancy to old age.Objective: To determine the clinical and epidemiological characteristics of patients with vitiligo.Design: This was a cross sectional descriptive study.Setting: Regional Dermatology Training Centre in Moshi, Tanzania.Subjects: One hundred and twenty two patients.Results: The male to female ratio was 1:1.8 and a median age of 24 years (range 3 to 87). The mean age at disease onset was 26.2 years (SD 19.5). The types of vitiligo observed were as follows: vitiligo vulgaris (50.8%) focal non segmental (23%) and Acrofacial (12.3%). Positive family history was noted in about 10% of the population studied. The commonest sites of initial onset were head and neck (41.8) and lower limbs (18.0%). The median body surface area affected was 6% (range 1 to 90%). Autoimmune diseases were noted in 17.2% of the patients. Atopic dermatitis (9.8%) was the most common associated disease.Conclusion: Vitiligo affects all ages with more females affected. Vitiligo vulgaris is the commonest type and few patients have first degree relatives with vitiligo

The use of special stains at two dermatopathology laboratories in East Africa.

BACKGROUND Histopathology is often essential to establish an accurate diagnosis. Pathology laboratories are scarce in most Sub-Saharan Africa where dermatopathology is a developing field. In resource-poor countries, most specimens are analyzed only after hematoxylin and eosin staining. The availability of special stains is very limited and restricted to only few centers. The aim of this study is to analyze the extent of dermatopathological cases which can be adequately diagnosed after hematoxylin and eosin alone. Secondly, to investigate which cases required further special stains. METHODS All skin specimens submitted to two University Hospitals (Tanzania and Kenya) were included in this study. All specimens were first analyzed with hematoxylin and eosin and a diagnosis established when possible. All cases in which an accurate diagnosis after hematoxylin and eosin only was not possible, were registered and evaluated after further special stains. RESULTS A total of 386 specimens were examined. A proper histopathologic diagnosis with hematoxylin and eosin alone was possible in 344 (89.1%) samples. In 45 (11.6%) cases, mostly skin infections, further special stains were necessary. CONCLUSION A proper histopathologic diagnosis was possible after hematoxylin and eosin alone in almost 90% of the specimens submitted to the two laboratories in Sub-Saharan Africa

Kenyan Iron Ore: Mining and prospects of Processing

Industrialization is one of the economic pillars in the Kenya Vision 2030 thus iron and steel will be prominent in the industrialization process. Kenya relies heavily on the importation of manufactured goods with iron and steel products forming the bulk of the raw materials. The country has some iron ore deposits and coal reserves among other input for steel making. The main deposits of the ore are found in Kishushe, Marimanti and Samia. The paper focuses on the iron ore from Kishushe location in the Coast region. The iron is mined and exported in semi-processed state. The chemical composition of the ore has been analyzed. There are interests to produce steel from the local ore. The challenges are on the estimation of the deposits, the quality, beneficiation methods and the selection of the extraction technologies