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FAMILY PLANNING AND SAFER SEX PRACTICES AMONG HIV INFECTED WOMEN RECEIVING PREVENTION OF MOTHER-TO-CHILD TRANSMISSION SERVICES AT KITALE DISTRICT HOSPITAL
No full textObjectives: To determine the usage of family planning services and safer sex practices among HIV infected mothers who had gone through the prevention of mother to child transmission (PMTCT) process.Design: Descriptive cross-sectional study.Setting: The maternal and child health and family planning (MCH-FP) clinics in Kitale District Hospital, Western Kenya.Results: A total of 146 respondents were recruited for this study. Only 44% of the respondents were using some form of family planning. The most popular method of contraception was the hormonal injectable contraceptives. Although 73% of respondents were no longer planning to have more babies, only 45% of them were using a family planning method. Only 38% of respondents reported condom use with their partners for safe sex. Married women and those who had revealed their HIV status to theirpartners were more likely to use condoms (p<0.05).Conclusions: Usage of family planning services in this study was low. A large percentage of the women were still planning to have more babies and very few women were using condoms for safe sex. Women who had informed their partners about their HIV status were more likely to use condoms than those who had not. Male partner involvement is crucial in decisions pertaining to family planning use and safe sex practices
Laparoscopic myomectomy of a large pedunculated fibroid: case report
No full textA 37 year old para 0 + 0 presented with abdominal pain and progressive abdominal swelling. She had no menstrual complains. Abdominal examination revealed a large 30 week non-tender, firm and mobile mass. A pelvic / abdominal ultrasound confirmed a 15.7 x 9.9 cm pedunculated fibroidarising from the uterine fundus. A laparoscopic myomectomy was successfully undertaken, and the morcellated fragments weighed 1490 grams
ORAL COMBINATION CHEMOTHERAPY IN THE TREATMENT OF AIDS - ASSOCIATED HODGKIN’S DISEASE
No full textObjectives: To determine the effectiveness of an oral combination chemotherapy regimen administered to patients with AIDS-associated Hodgkin’s disease.Design: Prospective, pilot phase II clinical trial.Setting: Consecutive patient recruitment occurred at two medical centers in the United States: Albany Medical Center, Albany, New York, where patients were recruited prior to December 31, 1996 (pre-HAART era); and University Hospitals of Cleveland, Cleveland, Ohio, where patients were recruited after January 1, 1997 (HAART era).Intervention: Oral chemotherapy consisted of lomustine (100 mg/m2 day I for cycle one and odd cycles thereafter); etoposide (200 mg/m2 days 1 through 3); and cyclophosphamide and procarbazine (each 100 mg/m2 days 22 through 31). Cycles were repeated every sixweeks. Colony-stimulating factor support (G-CSF in all instances) was allowed.Main outcome measures: Clinical demographic variables, peripheral blood counts, serum chemistries, CD4 lymphocyte count, histopathological subtype of Hodgkin’s disease were identified for all patients, who were staged according to Ann Arbor criteria.Data analysis: Common Toxicity Criteria were utilized to assess safety; response was assessed using ECOG criteria; and survival was analyzed by Kaplan-Meier methods and difference of survival between pre-HAART and HARART era was compared using log-rank test.Results: Eleven patients (six in pre-HAART era), all but one male, with a median age of 36 years, excellent performance status and advanced International Prognostic Score were treated. Myelosuppression was the major side effect and there were minimal other grade 3 or greater toxicity all of which were promptly reversible. An overall objective response rate of 82% (with 18% complete rcsponses) and median survival duration of24 months (range 2.5 ± 68) were observed. Survival was markedly improved in patients treated in the HAART era (median not reached versus 7.25 months, p = 0.034).Conclusions: This feasibility study demonstrates acceptable tolerance and excellent clinical activity of oral combination chemotherapy in patients with AlDS-associated Hodgkin’s disease. Improved survival is observed in combination with HAART therapy. Dose-modification of this regimen would be suitable to evaluate in the resource constrained setting and larger confirmatory studies are encouraged
Incorporation into the Market Economy and Food Security among the Gusii: Paradise Lost or Paradise Gained?
Get PDFThis article loOks at the Gusii's movement into the market economy and its impact on the region's food security. The primary aim is to capture shfls in the Gusii 's food security position vis-à-vis incorporation into the market economy and in particular, the weakening of cultivation as a source of food, and the challenges that surround markets as an emerging alternative. The overall observation is that once the Gusii entered commodity markets, and the more such links were established, their food needs, until then secured largely through cultivating land, faced new challenges. The discussion is based on data from the national archives, district agricultural records, oral narratives and empirical literature
Education and Information & Communication Technologies (ICT) inAfrica: Using ICT to improve education in Sub-Saharan Africa
Get PDFThis paper examines the role of Information and Communication Technologies (ICT) in expanding opportunities in education and improving access to quality education in Sub-Saharan Africa. The paper observes that the application of ICTs has become the engine of change in emerging information societies of the new millennium. While development is increasingly ICT driven, Africa still has limited capacities and infrastructures that support ICT By use of secondary data, the conditions of ICT development and use in education in Africa are highlighted. The paper further illustrates the potential for improvement in performanceof the education sector in Africa with appropriate application of ICT The conclusion drawn is that the application of ICTs would improve the education sector in Africa in three critical areas namely; Increased access to education, improved quality of teaching and learning and improved efficiency in administration and management of schools.
MAXILLARY INCISOR ROOT FORMS IN ORTHODONTIC PATIENTS IN NAIROBI, KENYA
No full textABSTRACTObjective: To evaluate, radiographically, the root forms of maxillary incisors in a sampleof patients seeking orthodontic treatment in Nairobi, Kenya.Design: A retrospective study of maxillary incisor root forms based on periapicalradiographs.Setting: A private dental clinic in Nairobi, Kenya.Materials and Methods: The study comprised 393 maxillary incisors in 100 consecutivesubjects(51 boys, 49 girls) aged 9-24 years. Intra-oral periapical radiographs of theincisors were evaluated. An index was used to categorise the roots as follows: 0=normal,1=short, 2-blunt, 3=apical bend, 4=pippete apex.Results: Normal root form was recorded in 60%, short in 12.5%, blunt in 7%, apicalbend in 13%, and pippete-apex in 7% of the roots. Sixty nine percent of the pippeteapexroots were in central incisors and 94% of the roots with apical bend were in lateralincisors. Seventy three percent of short roots were in females.Conclusion: Based on evidence from previous studies on risk of root resorption whichindicates that pipette and blunt roots are the forms mostly involved in this phenomenon,the present data imply that about 14% of the roots may have been at risk of moderateto severe resorption during fixed orthodontic treatment
CLEFT LIP AND PALATE: THE JOS EXPERIENCE
No full textObjective: To determine the pattern of occurrence of cleft lip/palate and the factorsthat may have influenced treatment outcome.Design: Descriptive Study.Setting: Jos University Teaching Hospital, Jos, Nigeria.Subject: This study included 107 consecutive patients with cleft lip/palate managedbetween January 1991 and June 1997.Main outcome measures: The pattern of occurrence of cleft lip/palate, the peculiaritiesof the malformation in this environment as well as factors that influenced treatmentoutcome.Results: The 107 patients were aged between one day and twenty-six years atpresentation. There were three adults aged between 18 and 26 years with a mean of22.3 years and 104 children with a mean age of 9.5 months. The male/female ratio was1. 1:1, the anomaly was 2.4 times commoner on the left and the cleft lip alone wasthe most frequent mode of presentation (52%). The incidence was higher in the 3rdand 4th siblings. In 13% of these patients, there were other associated congenitalanomalies such as Van der Woude’s Syndrome, Down’s Syndrome and congenital heartdisease. Complications were noted in 16(14.9%) patients and these included dehiscenceafter repair in 8(7.5%) patients, oronasal fistulae in 2(1.9%), nasal speech in 4(3.7%)and hypertrophic scar in 2(1.9%). Eighty nine percent of these repairs were satisfactoryto the parents of the affected children. All the adult patients were satisfied with theirrepair.Conclusion: The low incidence of this anomaly in our environment may be due to underreportingin the rural areas. Public enlightenment programs should help improve earlypresentation
OPPORTUNITIES AND THREATS TOWARDS THE CONTINUITY AND SUCCESS OF COMMUNITY-BASED REPRODUCTIVE HEALTH SERVICE PROGRAMME IN RURAL COMMUNITY OF NORTHEAST ETHIOPIA
No full textObjective: To assess opportunities and threats towards the continuity and success of Community-based reproductive health service programme in Northeast Ethiopia.Design: Community-based comparative cross sectional study.Setting: Two districts of Amhara region, Ethiopia, classified as strong and weak community based reproductive health programme areas.Subjects: Seven hundred Ninety two women aged 15-49 years residing in the selected districts of Amhara region. Community-based reproductive health workers, programmeme coordinators and field supervisors were used as informants of qualitative data collection.Main outcome measure: Current use of modern contraceptive methods.Results: Strong versus weak programme areas: knowledge about modern contraceptive method (MCM), was (90% and 86.8%), [OR (95% CI) = 2.87(1.68, 4.91)], ever use of MCM (61.1 % and 29.7%), [OR (95% CI) = 3.71(2.72, 5.07)] and current use of MCM (54.8% versus 19.7%), [OR (95% CI) =4.95(3.53, 6.95)]. Method interruption was significantly higher, 37.6% in weak than 10.9% in strongly performing programme area. Causes ofdefaulting in strong versus weak programme areas were: wanted more pregnancy (4% and 39.5%), fear of contraceptives’ side effects (16% and 31.6%) and lack of method of choice (20% and 2.6%). Type of religion, husband approval, awareness of service existence and client satisfaction remained to be the predictors of current use of MCM in multivariate analysis. Qualitative study findings were found coherent with thequantitative results.Conclusion: Type of religion, husband approval, client satisfaction and awareness of service existence were the predictors of modern contraceptive methods utilisation in the study population
FREQUENCY OF ADENOTONSILLECTOMY IN SOPIE NAIROBI HOSPITALS
No full textObjectives: To determine the frequency of adenotonsillec tomy in a sample of Kenyanhospitals and to review indications, timing and complications i n97 cases of adenotonsillectomydone by the authors.Design: Retrospective, descriptive study.Setting: Kenyatta National, Nairobi, Aga Khan, Gertrude ;~nd Mater Hospitals.Results: Adenotonsillectomy is the most frequent otolal.yngologic surgical operation.Indications for surgery were upper airway obstruction in 61.3%, recurrent tonsillitis in28.7% and both in 7.5%. Surgery was indicated during tt.e acute stage in 6.8% of cases.There was one case of post-operative acute airway obstructic~n. Post operative bleeding fromthe tonsillar bed was encountered in 2.1 % of cases.Conclusion: Adenotonsillectomy is the most common otolai~yngologic surgical operation inour set-up. The low frequency of complications and a short hospital stay puts up a case forroutine adenotonsillectomy as a day surgery procedure
PSYCHOSOCIAL CORRELATES OF SUBSTANCE USE AMONGST SECONDARY SCHOOL STUDENTS IN SOUTH WESTERN NIGERIA
No full textABSTRACTObjective: To determine the psychosocial correlates of substance use among secondaryschool students in rural and urban communities in South Western Nigerian.Design: A cross-sectional survey of secondary school students using questionnaireeliciting substance use by students (WHO drug use questionnaire) and a well designedquestionnaire on psychosocial variables.Setting: Six secondary schools selected from two local government areas in Ilesa, OsunState, South Western Nigeria.Subjects: The study population comprised of 600 randomly selected senior secondaryschool students from six schools.Results: A total of 662 questionnaires were analysed. Current stimulant use was,significantly associated with lower socio-economic status, coming from 2 polygamousfamily arid self rated poor academic performance. Current alcohol use was associatedwith being a male, polygamous family background, living alone or with friends, notbeing religious arid self rated poor academic performance. Current hypnosedatives usewas commoner in students living alone or. with friends and in those with self ratedpoor academic performance. There was also significant positive relationship betweencurrent tobacco use and the male sex, not being religious and self rated poor academicLifetime use of these substances had similar association with the psychosocial variableswith slight differences.Conclusion: The similarity between the psychosocial correlates highlighted in this studyand those reported in Previous studies from other- parts of Nigeria makes theseobservations useful enough for the planning of preventive strategies