Tamaduni na fasihi za kienyeji kwa lugha za kigeni

Uhusiano baina ya lugha na utamaduni, mila na mirathi ya jamii kwa jumla huenda ukafahamika angalau kwa wepesi, iwapo tutazingatia mambo mawili: kwanza, lugha na matumizi yake ni chombo cha kujieleleza thamani tafauti zilizofungamana na maumbile ya kimila, fikira, maarifa, imani, adabu na utamaduni wa jamii yenyewe kwa jumla. Pili, matumizi ya lugha aghlabu husadifu kuwa ndio msingi wa kuendeleza na kukuza, na hata pia kubuni, uzushi mpya katika mirathi ya utamaduni, mila na khulka za kijamii. Kwa hivyo si rahisi kwa lugha kutengamana na taswira za jamii: utu, utamaduni, mila, mitindo na mengineo. Tungependa kuandaa madhumuni yetu ya kuonesha athari na hatari zinazokabili hali ile ya kutumia lugha geni katika kuendeleza shughuli za jamii au taifa la kienyeji. Muhimu pia, tutashughulika na athari za mtindo huo katika fasihi za kienyeji, hasa tunapozingatia kuwa fasihi ya maandishi ni mfano wa kioo cha hakika ya jamii

Intrauterine foetal death in multiple gestation: to conserve or intervene

There is an increasing incidence of higher order gestations especially due to fertility treatments, associated with higher morbidity and mortality. This is a case of a primigravida with triplet gestation with first foetal demise at 14 weeks who was referred for termination of pregnancy which she declined. Patient was on close followup with weekly ultrasounds. The second demise occurred at 21 weeks. At 26 weeks, patient was noted to have absent foetal movements and Doppler studies revealed a Restrictive Index (R.I) of 1 and Biophysical Profile (BPP) of 2/8.She was to be admitted for emergency hysterotomy but theydeclined. The third foetal demise occurred two days later. The patient was induced and delivered 3 macerated still births (MSBs). Grossly post-delivery umbilical cord entanglement. All the foetuses were male. Patient declined a post-mortem

Bicornuate unicollis uterine Müllerian anomaly with unilateral haematometra in a ten year old: A case report

Acute abdominal pain is a common complaint in the paediatric age group. Gastroenteritis and appendicitis are the common non-surgical and surgical conditions respectively. Haematometra due to a non-communicating horn of a bicornuate uterus is a rare presentation for acute abdomen in this age group. This is a case of a ten year nine month old female who presented with an acute abdomen for a period of two days. Physical examination revealed right iliac fossa tenderness. Pelvic ultrasound showed a bicornuate unicollis uterine Müllerian anomaly with unilateral haematometra. Magnetic Resonance Imaging (MRI) confirmed the ultrasonographic findings. A successful hemi-hysterectomy was done with resolution of symptoms

Updating of a clinical protocol for the prevention and management of postpartum haemorrhage at Kenyatta National Hospital, Nairobi, Kenya

Background: Postpartum haemorrhage (PPH) affects 6% of births and accounts for almost 30% of maternal deaths. The use of clinical protocols for preventing and treating PPH is recommended by WHO. Protocols should be evidence-based, regularly updated, widely available and routinely adhered to.Broad Objective: To update the Kenyatta National Hospital (KNH) PPH prevention and management protocol based on latest recommendations, and ensure its dissemination and use by providers.Materials and Methods: A literature search identified selected PPH-related guidelines which were assessed using the AGREE-II tool for guideline quality. A matrix was created to compare recommendations across  guidelines. Recommendations included in the KNH protocol were based on agreement across guidelines, guideline quality, publication year, and  contextual factors in our setting. To aid implementation, an updated KNH protocol document, a clinical algorithm and a PPH management checklist were developed. These were reviewed and accepted as best practice by KNH and University of Nairobi.Results: Six PPH-related guidelines were used (WHO, FIGO, RCOG, ACOG, FOGSI, and the Kenya National Guidelines for Quality Obstetrics and  Perinatal care). The KNH protocol covers PPH prevention, including: active management of third stage, oxytocin after vaginal or caesarean delivery, other drugs for prevention (when oxytocin is not available), controlled cord traction and delayed cord clamping. It also covers PPH management (supportive and definitive measures).Conclusion: An updated PPH prevention and management protocol for KNH was developed. Implementation and adherence will help standardize PPH-related care and improve health outcomes for women

Induction of antigen-specific tolerance through hematopoietic stem cell-mediated gene therapy: the future for therapy of autoimmune disease?

Based on the principle that immune ablation followed by HSC-mediated recovery purges disease-causing leukocytes to interrupt autoimmune disease progression, hematopoietic stem cell transplantation (HSCT) has been increasingly used as a treatment for severe autoimmune diseases. Despite clinically-relevant outcomes, HSCT is associated with serious iatrogenic risks and is suitable only for the most serious and intractable diseases. A further limitation of autologous HSCT is that relapse rates can be high, suggesting disease-causing leukocytes are incompletely purged or the environmental and genetic determinants that drive disease remain active. Incorporation of antigen-specific tolerance approaches that synergise with autologous HSCT could reduce or prevent relapse. Further, by reducing the requirement for highly toxic immune-ablation and instead relying on antigen-specific tolerance, the clinical utility of HSCT could be significantly diversified. Substantial progress has been made exploring HSCT-mediated induction of antigen-specific tolerance in animal models but studies have focussed on primarily on prevention of autoimmune diseases. However, as diagnosis of autoimmune disease is often not made until autoimmune disease is well developed and populations of autoantigen-specific pathogenic effector and memory T cells have become well established, immunotherapies must be developed to address effector and memory T-cell responses which have traditionally been considered the key impediment to immunotherapy. Here, focusing on T-cell mediated autoimmune diseases we review progress made in antigen-specific immunotherapy using HSCT-mediated approaches, induction of tolerance in effector and memory T cells and the challenges for progression and clinical application of antigen-specific ‘tolerogenic’ HSCT therapy

Tamaduni na fasihi za kienyeji kwa lugha za kigeni

Uhusiano baina ya lugha na utamaduni, mila na mirathi ya jamii kwa jumla huenda ukafahamika angalau kwa wepesi, iwapo tutazingatia mambo mawili: kwanza, lugha na matumizi yake ni chombo cha kujieleleza thamani tafauti zilizofungamana na maumbile ya kimila, fikira, maarifa, imani, adabu na utamaduni wa jamii yenyewe kwa jumla. Pili, matumizi ya lugha aghlabu husadifu kuwa ndio msingi wa kuendeleza na kukuza, na hata pia kubuni, uzushi mpya katika mirathi ya utamaduni, mila na khulka za kijamii. Kwa hivyo si rahisi kwa lugha kutengamana na taswira za jamii: utu, utamaduni, mila, mitindo na mengineo. Tungependa kuandaa madhumuni yetu ya kuonesha athari na hatari zinazokabili hali ile ya kutumia lugha geni katika kuendeleza shughuli za jamii au taifa la kienyeji. Muhimu pia, tutashughulika na athari za mtindo huo katika fasihi za kienyeji, hasa tunapozingatia kuwa fasihi ya maandishi ni mfano wa kioo cha hakika ya jamii