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A prospective randomized and blinded study was carried out to compare the effects of epidural xylazine, lidocaine and their combination on body temperature in dogs. Fifteen healthy dogs were used in this study. The dogs were randomly assigned to three groups of five animals each. The first group was injected with 2% lidocaine at 4 mg/kg body weight, the second with 2% xylazine at 0.6 mg/kg body weight while the third group was injected with the drug combination of lidocaine and xylazine at 2 mg/kg body weight and 0.3 mg/kg body weight, respectively, in the same syringe. All injections were made into the lumbosacral space. Changes in rectal temperature were recorded over a 4-hour monitoring period. A significant (p

Background: Tuberculosis (TB) continues to be a public health challenge globally. The most common organ to be involved is the lung although it can affect any organ in the body. The diagnosis of extra-pulmonary TB (EPTB) has faced many challenges mainly due to inadequate expertise to diagnose or lack of equipment for diagnosis.Objective: To compare the demographic and clinical characteristics between pulmonary and extrapulmonary tuberculosis in Kiambu CountyDesign: Retrospective cross-sectional studySetting: Kiambu County, KenyaSubjects: Tuberculosis patients notified in TIBU surveillance systemResults: Of the 15, 833 patients analyzed, 2,704 (17%) had extra-pulmonary tuberculosis. Male to female ratio was 1:1.7 in PTB and 1:1.3 in EPTB patients. There was declining trend of TB cases notified over the years for both PTB and EPTB. Pleural TB accounted for 38% with TB lymphadenitis accounting for 14% of the EPTB subtypes. TB-HIV co-infection was higher among EPTB (36%) compared to PTB (30%). The treatment success rate was 85% and 86% among PTB and EPTB cases respectively. The mortality was 10% among EPTB and 5% in PTB cases. The 5-14 age category were more likely to developing EPTB compared to PTB (AOR 4.67 95% CI (1.5-13.99). Kabete zone was most affected with EPTB (AOR 2.11(1.19-2.74) while a protective factor was observed among the HIV positive clients (AOR 0.58 (0.43 - 0.78)Conclusion: There was a general decline in cases for both EPTB and PTB. However, the age category most affected was 5-14 years. The co-infectivity rate was higher among the EPTB patients compared to the PTB patients. High index of suspicion and appropriate diagnostic tools are needed in evaluation particularly in EPTB which will assist in early management of the patients. ART uptake could play a big role in protecting HIV positive clients from getting EPTB.

Background: The World Health Organization’s end TB strategy recommends that over 90% of TB patients should be diagnosed based on testing. The modalities available for TB testing in Kiambu County are the X‐ray, Sputum Smear Microscopy, Cultures and GeneXpert MTB/RIF. There is minimal knowledge on the uptake of these diagnostics in actual practice in the county.Objective: To assess the variations in methods of diagnosis amongst patients at initiation of TB treatment seen in Kiambu county between 2012 and 2016Design: A cross‐sectional studySetting: Kiambu County, KenyaPopulation: 11,841 patients notified into TIBU within Kiambu CountyResults: In the study period, there was a gradual increase in the uptake of bacteriological confirmation from 43.6% in 2014 to 58.2% in 2016. Chest X‐rays were mostly used in children (62.9%) while Sputum Smear Microscopy was used mostly in adults (69.1%). Uptake of culture was very poor with use in only 1% of adults, and no use (0%) in children in the whole study period. Use of GeneXpert MTB/RIF was also low, though there was a drastic improvement in 2016 with a 500% increase in the absolute number of tests done in comparison with 2015.Conclusion: Our study showed that there is low uptake of TB diagnostic modalities, especially amongst children, in Kiambu County. However, there was a gradual increase in their use since 2014. Further efforts are needed to increase clinician awareness and use of diagnostics.

Describe treatment patterns by disease severity among biologic-treated psoriasis patients.We selected our study cohort in the IQVIA PharMetrics Plus adjudicated claims database linked to Electronic Health Record data from Modernizing Medicine Data Services. Patients were classified as having mild, moderate, or severe psoriasis based on a hierarchy of available severity measures. Patients were followed for 360 days to assess combination therapy, therapy switching and restarting, adherence and persistence.The cohort comprised 2130 biologic-treated patients (mean age: 47.6 years; 45.4% female); 447 (21%) had available disease severity measures. Compared to patients with mild (N = 282) psoriasis, more patients with moderate (N = 116) or severe (N = 49) disease used combination therapy (21.3% vs. 34.5% and 32.7%, respectively), switched therapies (12.1% vs. 19.8% and 22.4%), and discontinued biologics (18.4% vs. 27.6% and 36.7%). Mean adherence was 75% by Medication Possession Ratio (MPR) (73.9%) and Proportion of Days Covered (PDC) (70.2%). Overall, 52.2% had a mean MPR 80%. Mean persistence to biologics was 297.6 days. Persistence and adherence decreased with increasing disease severity.Biologic-treated psoriasis patients had inadequate adherence (i.e., MPR 80%) and modest persistence to biologics, with moderate and severe patients demonstrating lower adherence and persistence than mild patients.

To describe healthcare resource utilization (HCRU) and costs among biologic-treated psoriasis patients in the US, overall and by disease severity.IQVIA PharMetrics Plus administrative claims data were linked with Modernizing Medicine Data Services Electronic Health Record data and used to select adult psoriasis patients between April 1, 2010 and December 31, 2014. Eligible patients were classified by disease severity (mild, moderate, severe) using a hierarchy of available clinical measures. One-year outcomes included all-cause and psoriasis-related outpatient, emergency department, inpatient, and pharmacy HCRU and costs.This study identified 2,130 biologic-treated psoriasis patients: 282 (13%) had mild, 116 (5%) moderate, and 49 (2%) severe disease; 1,683 (79%) could not be classified. The mean age was 47.6 years; 45.4% were female. Relative to mild psoriasis patients, patients with moderate or severe disease had more median all-cause outpatient encounters (28.0 [mild] vs 32.0 [moderate], 36.0 [severe]), more median psoriasis-related outpatient encounters (6.0 [mild] vs 7.5 [moderate], 8.0 [severe]), and a higher proportion of overall claims for medications that were psoriasis-related (28% [mild] vs 37% [moderate], 34% [severe]). Relative to mild psoriasis patients, patients with moderate or severe disease had higher median all-cause total costs ($37.7k [mild] vs $42.3k [moderate], $49.3k [severe]), higher median psoriasis-related total costs ($32.7k [mild] vs $34.9k [moderate], $40.5k [severe]), higher median all-cause pharmacy costs ($33.9k [mild] vs $36.5k [moderate], $36.4k [severe]), and higher median psoriasis-related pharmacy costs ($32.2k [mild] vs $33.9k [moderate], $35.6k [severe]).The assessment of psoriasis disease severity may not have necessarily coincided with the timing of biologic use. The definition of disease severity prevented the assessment of temporality, and may have introduced selection bias.Biologic-treated patients with moderate or severe psoriasis cost the healthcare system more than patients with mild psoriasis, primarily driven by higher pharmacy costs and more outpatient encounters.

Sixteen 1-year-old castrate Dorper sheep were used for the study. The animals were divided into four groups of four animals (n = 4). Three groups were implanted with 129 g, 258 g and 387 g of thin plastic bags into the rumen through rumenotomy, while the fourth group was subjected to rumenotomy without implanting plastic bags, and served as control. All the animals were monitored daily for 6 weeks following implantation. Presence of plastic bags in the rumen was characterized by anorexia, severe depression, discomfort, dehydration, firmness and asymmetrical distension of the abdomen, ruminal hypomotility and diarrhoea with intermittent constipation, weight loss, terminal recumbency and death. The severity of these clinical manifestations increased with increased quantities of plastic bags and their duration in the rumen. Sheep implanted with 258 g and 387 g lost 7.8 percent and 14.2 percent of their initial mean body weight, respectively, by the end of 6 weeks. Presence of plastic bags in the rumen could interfere with digestion, with a gradual loss in body weight, productivity and occasional mortality. Plastic bags in the rumen should be considered as a differential diagnosis in sheep presenting the observed clinical signs, especially in urban and periurban areas.

In the last decade, student politics and governance of universities in Kenya and in other African countries have undergone a tremendous transformation. The unprecedented expansion and massification of public universities, the introduction of ‘Module 2’ programmes, the admission of private, ‘parallel’ and ‘school-based’ students, and the substantial increase in private universities have impacted on the governance of the institutions and student politics in different ways. In this context, this article explores student involvement in university governance and describes the structure of students’ unions in Kenyan universities in comparison with students exercising ‘comrades’ power’ in universities in Kenya.Keywords: Higher education; student politics; student activism; student unionism; university governance; representation

Background Prior studies have shown inconsistent relationships between skin and joint symptoms in patients with comorbid psoriasis (PsO) and psoriatic arthritis (PsA) 1–3 . Objectives To characterize the relationship between skin severity and joint activity in patients with comorbid PsA and PsO at enrollment. Methods Data from the U.S. Corrona PsA/spondyloarthritis (PsA/SpA) registry were obtained from the period 3/21/2013– 9/30/2016. Inclusion criteria included a diagnosis of PsA, a history of PsO, and age greater than 18 years. PsA patients were evaluated for skin severity as defined by Body Surface Area (BSA) and joint activity as defined by the level of clinical disease activity index (CDAI). Patient characteristics, including current and prior PsA medication use, were obtained during the enrollment visit. We evaluated the relationship of skin severity (BSA) and joint activity (CDAI) with multi-variable linear regression. Results 1,542 patients met inclusion criteria: 52.9% were women with mean (SD) age 53.7 (13.2) years, with median 9.0 years PsA disease duration, and 71 (4.6%) with fibromyalgia. 266 (18%) patients were on no DMARD therapy, 430 (29%) were on csDMARDs only, 616 (42%) were on first line biologic/targeted synthetic (ts)DMARD therapy, and 172 (12%) were on second line biologic/tsDMARD therapy. The relationship between skin severity and joint activity was statistically significant (p Conclusions The relationship between skin severity and joint activity is statistically significant and varies by age, gender, MDA, HAQ, and patient reported pain and fatigue. This suggests degree of skin involvement is important to take into account when evaluating PsA patients. References Gottlieb AB, Mease PJ, Mark Jackson J, Eisen D, Amy Xia H, Asare C, Stevens SR: Clinical characteristics of psoriatic arthritis and psoriasis in dermatologists9 offices. J Dermatolog Treat 2006;17:279–287. Jones SM, Armas JB, Cohen MG, Lovell CR, Evison G, McHugh NJ: Psoriatic arthritis: outcome of disease subsets and relationship of joint disease to nail and skin disease. Br J Rheumatol 1994;33:834–839. Cohen MR, Reda DJ, Clegg DO: Baseline relationships between psoriasis and psoriatic arthritis: analysis of 221 patients with active psoriatic arthritis. Department of Veterans Affairs Cooperative Study Group on Seronegative Spondyloarthropathies. J Rheumatol 1999;26:1752–1756. Acknowledgements Corrona, LLC has been supported through contracted subscriptions in the last two years by AbbVie, Amgen, AstraZeneca, BMS, Crescendo, Eli Lilly and Company, Genentech, GSK, Horizon Pharma USA, Janssen, Momenta Pharmaceuticals, Novartis, Pfizer, Roche and UCB. Disclosure of Interest P. Mease Grant/research support from: Celgene, Novartis, Abbvie, Amgen, BMS, Janssen, Lilly, Pfizer, Sun, UCB, Consultant for: AbbVie, Amgen, BMS, Crescendo, Celgene, Corrona, Demira, Janssen, Lilly, Merck, Novartis, Pfizer, UCB, Sun, Zynerba, Speakers bureau: Abbvie, Amgen, BMS, Celgene, Crescendo, Genentech, Janssen, Novartis, Pfizer, UCB, C. Etzel Consultant for: Merk, Employee of: Corrona, LLC, J. Lisse Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, A. Armstrong Grant/research support from: AbbVie, Janssen, Lilly; speaker9s bureau: AbbVie, Lilly, Consultant for: AbbVie, Amgen, Janssen, Merck, Lilly, Celgene, Novartis, and Pfizer, W. Huster Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, S. Rebello Employee of: Corrona, LLC, R. Dodge Employee of: Corrona, LLC, T. Muram Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, S. Al Sawah-Folian Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, M. Murage Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, J. Greenberg Shareholder of: Corrona, LLC, Consultant for: Genentech, Janssen, Novartis and Pfizer, Eli Lilly, Employee of: Corrona, LLC, W. Malatestinic Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company

Background: Hepatitis B and Hepatitis C viruses are the major causes of liver disease worldwide. Co-infections with HBV and HCV have turned out to be increasingly very common among people living with HIV, leading to a major public health concernObjective: To determine HBV and HCV diversity among HIV infected patients attending the Ngong sub-county hospital comprehensive care clinic.Design: A cross-sectional studySetting: HIV research laboratory in Centre for virus research at Kenya medical research institute, Nairobi.Subjects: HIV infected patients attending the comprehensive care clinic at Ngong subcounty hospital between May and August 2015.Results: One hundred and ninety (190) HIV-1 positive patients participated in this study, consisting of 78.9% females and 21.1% males. Out of the 190 participants, 11(5.8%) were positive for Hepatitis B surface antigen and eight (4.2%) were positive for anti- HCV antibodies. 5/11 samples were positive for HBV DNA PCR and five belonged to HBV genotype A and E . However, none of the eight samples for HCV were positive for HCV RNA PCR.Conclusion: None of the patients was infected with HCV. HBV genotype A1 was the most dominant circulating genotype in Ngong sub-County followed by genotype E. Nevertheless, there could be other HBV genotypes circulating in Kenya especially among higher risk populations.

Rheumatic heart disease (RHD) is a preventable non-communicable condition that disproportionately affects the world's poorest and most vulnerable. The World Heart Federation Roadmap for improved RHD control is a resource designed to help a variety of stakeholders raise the profile of RHD nationally and globally, and provide a framework to guide and support the strengthening of national, regional and global RHD control efforts. The Roadmap identifies the barriers that limit access to and uptake of proven interventions for the prevention and control of RHD. It also highlights a variety of established and promising solutions that may be used to overcome these barriers. As a general guide, the Roadmap is meant to serve as the foundation for the development of tailored plans of action to improve RHD control in specific contexts.

Drug bio screening for potential anti-diabetics is scientifically motivated by the desire to discover newer, safer and affordable drugs that complement conventional strategies for management of diabetes. Urtica dioica grows naturally in many parts of Africa with a wide variety use in traditional medicine and diet. However, scientific validation for use of U. dioica has not been done for anti-diabetic activity. The aim of the study was to determine the antidiabetic effects of aqueous extracts of U. dioica in alloxan induced mice and the safety of U. dioica on mice models. The plant extracts were administered orally at doses of 25 mg/kg, 100 mg/kg, 200 mg/kg and 300 mg/kg which is the common route used in traditional herbal medicine administration. Evaluation for toxicity was determined at a dose of 1000 mg/kg body weight aqueous extracts of U. dioica. The results from the study indicated that the plant extracts exhibited insulin mimetic anti-diabetic activity. Evaluation for toxicity also indicated that a dose of 1000 mg/kg bw preserved the integrity of liver, kidney and lipid profiles for biochemical markers. Moreover, there was no significant change in the hematological and leucocyte counts. There was no significant change in gross body weight, organ body weight and histopathological changes on tissues of the body organs in this study. Furthermore, qualitative and quantitative phytochemical screening of aqueous leaf extracts of U. dioica indicated the presence of phenols, alkaloids, flavonoids, tannins and saponins. Various levels of different mineral elements were also recorded. In conclusion, this study confirmed that U. dioica at a dose of 50 mg/kg, 100 mg/kg, 200 mg/kg and 300 mg/kg body weights possessed anti-diabetic activity. It is also safe for use at a dose of 1000 mg/kg body weight. More studies should be explored on the potential anti-diabetic effects using other routes of administration.

The contribution of traditional cash crops in the Kenyan economy is slowly being surpassed by horticulture saves for tea which continues to lead in terms of contribution to GDP and foreign exchange earnings. Smallholder tea farmers, who produce 62% of tea in Kenya, have however, also shown an increasing interest in production of horticultural crops for income and livelihoods. This shift is only possible if the tea income is insufficient to meet their needs or if there is a strong incentive to engage in horticultural production. It’s however not well documented on what actually influence the smallholder tea farmers’ resolution to diversify into horticulture. This study aimed at identifying these drivers as well as the determinants of intensity of diversification into horticulture. Using a Heckman two-step model to analyze a sample of 161 smallholder farmers collected using a multistage sampling technique, group membership, value of agricultural assets, amount of hired labour, occupation of the household head, contractual arrangements, farm size and distance to the output market were the major determinants of the farmers decision to diversify into horticulture. The intensity of diversification was influenced by gender of the household head, number of children pursuing post primary education, area under tea, occupation of household head, size of the farm, soil conservation activities and experience of the farmer in cash crop farming. The study specifically identified a need for a comprehensive land policy to address the plight of smallholder tea farmers in the study area.

The malaria parasite Plasmodium falciparum has a great capacity for evolutionary adaptation to evade host immunity and develop drug resistance. Current understanding of parasite evolution is impeded by the fact that a large fraction of the genome is either highly repetitive or highly variable and thus difficult to analyze using short-read sequencing technologies. Here, we describe a resource of deep sequencing data on parents and progeny from genetic crosses, which has enabled us to perform the first genome-wide, integrated analysis of SNP, indel and complex polymorphisms, using Mendelian error rates as an indicator of genotypic accuracy. These data reveal that indels are exceptionally abundant, being more common than SNPs and thus the dominant mode of polymorphism within the core genome. We use the high density of SNP and indel markers to analyze patterns of meiotic recombination, confirming a high rate of crossover events and providing the first estimates for the rate of non-crossover events and the length of conversion tracts. We observe several instances of meiotic recombination within copy number variants associated with drug resistance, demonstrating a mechanism whereby fitness costs associated with resistance mutations could be compensated and greater phenotypic plasticity could be acquired.

A study was conducted to investigate the changes in microbial biomass carbon (C), nitrogen (N) and phosphorus (P) following cultivation of Brachiaria grasses in semi-arid region of Kenya. The Brachiaria grass cultivars included Brachiaria decumbens cv. Basilisk, B. brizantha cvs Marandu, MG4, Piatã and Xaraes, B. humidicola cv. Llanero and B. hybrid cv. Mulato II which were compared with two locally cultivated forage grasses (Chloris gayana cv. KAT R3 and Pennisetum purpureum cv. Kakamega 1) and a bare plot (negative check). The grass treatments were evaluated with fertilizers application (40 kg P applied at sowing and 50 kg N ha-1 in each wet season) and with no fertilizer applications. Microbial biomass C, N and P were determined on field moist rhizosphere soil (18-23% by weight) from a depth of 10 cm. Microbial biomass was influenced (p < 0.01) by grass cultivars and N and P fertilizers. Generally, microbial biomass N was higher in plots with grasses than in the bare plots. A significant enrichment of organic matter was noted in the microbial biomass when Brachiaria grasses are grown with N and P fertilizers. Among Brachiaria cultivars, the highest microbial biomass C was recorded in plots with cv. Mulato II and the lowest from the plots with cv. MG4. Brachiaria grasses with fertilizers application accumulated the highest microbial C and N compared to grasses without fertilizers, but no interaction was observed between fertilizer and grass cultivars. The cv. Marandu had the highest microbial biomass N (21.2 mg N kg-1) in fertilizer treatments whereas cv. Mulato II hybrid had the highest microbial N (14.6 mg N kg-1) in no fertilizer treatments.

Soil aggregation is a key short term indicators of soil quality attributed to changes in land management. A study was conducted to investigate changes in the size distribution and stability of soil aggregates in a structurally unstable sandy loam soil following cultivation of Brachiaria grass in semi-arid region of Kenya. Brachiaria grass cultivars included Brachiaria decumbens cv. Basilisk, B. brizantha cvs Marandu, MG4, Piata and Xaraes, B. humidicola cv. Llanero and B. hybrid cv. Mulato II which were compared with two locally cultivated forage grasses (Chloris gayana cv. KAT R3 and Pennisetum purpureum cv. Kakamega 1) and a bare plot (negative check). The grass treatments were evaluated with fertilisers application (40 kg P applied at sowing and 50 kg N ha−1 in each wet season) and with no fertiliser applications. Aggregate size fractions were isolated using the wet sieving method. Aggregation based on the proportion of small macro-aggregates (250–2000 μm) increased in soils cultivated with all grass types compared to the control and was greatest in soils under B. hybrid cv. Mulato II. Aggregate stability in terms of mean weight diameter (MWD) differed among the grasses and was highest in soils under cv. Mulato II and cv. Marandu with MWD of 4.49 and 4.31 mm, respectively. Changes in small macro-aggregates fraction was positively correlated with particulate organic matter (POM) (r=0.9104, P= 0.001), microbial biomass carbon (MBC) (r=0.5474, P= 0.01), soil organic carbon (SOC) (r=0.3654, P= 0.05) and root biomass (r=0.4977, P= 0.01). This indicated that the binding agents were important in the aggregation of soils cultivated with Brachiaria grasses.

A retrospective study of small ruminant necropsy cases between January 1982 and December 2012 was conducted at the Department of Veterinary Pathology, Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Nairobi, Kenya. The objective of the study was to assess the prevalence of plastic materials in the rumen of sheep and goats examined at post mortem over the period. A total of 770 carcasses (367 sheep and 403 goats) presented for post mortem were studied. The overall prevalence of rumen plastic materials in the rumen was 4.2%. The prevalence was higher in goats (7.2%) than sheep (0.8%) and also was significantly (p

Breast cancer is the second leading cause of cancer mortality among women in the developed world. This study assessed the association between occurrence of breast cancer and body mass index (BMI) change from age 25 to age closest to breast cancer diagnosis while exploring the modifying effects of demographic variables. The National Health and Nutrition Examination Survey data were used. Women included were ≥50 years, not pregnant and without a diagnosis of any cancer but breast. The total sample included 2895 women (172 with breast cancer and 2723 controls with no breast cancer diagnosis). Multivariate logistic regression was used to estimate the OR and 95 % CIs and interaction evaluated by including an interaction term in the model. Women whose BMI increased from normal or overweight to obese compared to those who remained at a normal BMI were found to have a 2 times higher odds (OR = 2.1; 95 % CI 1.11–3.79) of developing breast cancer. No significant association was observed for women who increased to overweight. However, a more pronounced association was observed in non-Hispanic black women (OR = 6.6; 95 % CI 1.68–25.86) and a significant association observed when they increased from normal to overweight (OR = 4.2; 95 % CI 1.02–17.75). Becoming obese after age 25 is associated with increased risk of breast cancer in women over 50 years old, with non-Hispanic black women being at greatest risk.

Diabetes is increasingly affecting a growing number of patients and seriously reducing their quality of life. Use of conventional drugs in diabetes management is expensive, thus, unaffordable to most patients. Furthermore most of these conventional drugs are associated with undesirable side effects. Incorporation of herbal medicine into conventional healthcare system may significantly improve the overall healthcare system. Evaluation of efficacy and safety by scientific method is necessary to validate herbal medicine utilization, in most cases even where efficacy of the plants has been established the standard dosage required to bring about healing is not clear. This study was designed to designed to evaluate the antidiabetic potential of aqueous leaf extracts of Acacia nilotica in alloxan induced diabetic mice. As the results show, the aqueous leaf extracts of A. nilotica showed antidiabetic activity. The intraperitoneal route of herbal extract administration was found to be more effective than the oral route. Further, qualitative and quantitative phytochemical screening of aqueous leaf extracts of A. nilotica indicated the presence of phenols, alkaloids, flavonoids, tannins and saponins. However, cardiac glycosides and phylobatanins were not detected.

The drawbacks associated with conventional anti-diabetic agents have largely stimulated desire for alternative and complementary anti-diabetic agents, majority of which are plant-derived. The medicinal plant, Rhoicissus tridentata has been used extensively in traditional medical practice against various ailments. However, its ethno medicinal use against diabetes mellitus has not been scientifically evaluated and validated. This study was, therefore, designed to evaluate the anti-diabetic potential of aqueous leaf extracts of Rhoicissus tridentata in alloxan induced diabetic mice. As the results show, the aqueous leaf extracts of Rhoicissus tridentata showed anti-diabetic activity. The intraperitoneal route of herbal extract administration was found to be more effective than the oral route. Further, qualitative and quantitative phytochemical screening of aqueous leaf extracts of Rhoicissus tridentata indicated the presence of phenols, alkaloids, flavonoids, tannins and saponins. However, cardiac glycosides and phylobatanins were not detected.

Submitted in partial fulfillment of the requirements for the Degree of Master of Science in Computer-Based Information Systems Electronic Commerce (e-Commerce) and Mobile Commerce (m-Commerce) are evolving at a pace that is revolutionizing how business is carried out. These two technologies can indeed open up markets beyond borders. The purpose of this research was to propose an integrated framework for e-Commerce and m-Commerce and to suggest a suitable implementation strategy. The objectives of the research were achieved through extensive review of vast literature on the subject matters. The research starts by looking at the various aspects of Electronic Commerce and Mobile Commerce, their barriers, benefits and possible future. Existing electronic payment modes were then discussed to identify common methods in which online transactions take place. It was found that there exists a formal framework for eCommerce, but frameworks for m-Commerce were organization specific. Extensive data collection and analysis was done to ensure that the proposed framework was as close to facts on the ground as possible. Data analysis was done using Statistical Package for the Social Sciences (SPSS) 17 and Microsoft Excel 2007. Results of the analysis indicated that 51% of the population knew about e-Commerce. It also found that only 15% had used credit cards to pay for items bought online. The proposed generic framework can help provide a starting point for e-Commerce businesses in Kenya enabling them to operate on similar platform. This proposed theoretical framework borrows from the works of Turban et al., in 2006 and aside from additional components; it allows implementers focus on important aspects of eCommerce and m-Commerce that would otherwise not receive the attention that they deserve such as policy and infrastructure requirements. This framework can then be modified to meet specific business needs. Lastly, recommendations for further research in this area were made.

Introducción: la lactancia materna es responsable de hasta un 40% de los contagios perinatales del virus de la inmunodeficiencia humana (VIH) en el África subsahariana. La OMS aconseja evitar por completo la lactancia materna solo si la lactancia artificial es aceptable, factible, asequible, segura y sostenible (AFASS). Material y métodos: se analizaron datos de tres programas del Ministerio de Salud para la prevención de la transmisión vertical (PTV) del VIH, en la Provincia Central de Kenia. Las gestantes VIH+ recibieron información y consejo sobre cómo proteger al bebé durante el embarazo, el parto y el periodo de lactancia. Se administró zidovudina (AZT) desde la vigésimo octava semana, más nevirapina -dosis única- (SD-NVP) intraparto si los linfocitos CD4 eran mayores de 350 cel/mm³, o tratamiento antirretroviral de gran actividad (TARGA) si eran menores de 350 cel/mm³. Los neonatos expuestos recibieron AZT + NVP. Se suministró lactancia artificial (LA), filtros de agua y termos a las madres que optaron por no lactar a sus hijos. Se realizó reacción en cadena de la polimerasa (PCR) para ADN-VIH-1 a las seis semanas de vida. Las madres incluidas en el programa recibían apoyo psicológico individualizado y a través de terapias de grupo. Resultados: la mayoría de las madres (66-96%) se decidieron por la LA; 881 lactantes recibieron leche artificial bien desde el nacimiento o tras un periodo inicial con lactancia materna o con leche de vaca; 515 (58%) fueron dados de alta a los seis meses de edad; 272 (31%) permanecían en el programa (niños < 6 meses) en el momento del análisis de datos. Hubo 59 (6,7%) pérdidas de seguimiento y 12 (1,4%) traslados a otros programas. Un total de 23 (2,6%) lactantes fallecieron. Los neonatos infectados por VIH tuvieron diez veces más probabilidades de morir antes de cumplir seis meses que los no infectados (odds ratio [OR]: 10,55; IC 95% [intervalo de confianza del 95%]: 2,51-41,5), p < 0,001). La morbilidad fue baja; la incidencia de diarrea y de infecciones respiratorias fue de 15,3 y de 42,4 por cada 100 personas/año, respectivamente. Conclusiones: es factible y seguro apoyar la lactancia artificial para madres seropositivas y sus bebés en entornos con escasos recursos en programas integrados en instituciones sanitarias del sector público. Background: breast feeding accounts for up to 40% of perinatally acquired HIV infection in sub-Saharan Africa. HIV infected mothers are advised by World Health Organization (WHO) to completely avoid breast feeding only if replacement feeding is acceptable, feasible, affordable, safe and sustainable (AFASS). Methods: data were obtained from 3 Ministry of Health PMTCT programs in Central Province, Kenya. HIV positive pregnant women received AZT starting at 28 weeks + intrapartum SD-NVP if CD4>350 or TARGA if CD4

Ejaculates from 48 bulls comprising equal numbers of Aryshire, Fresian, Guernsey and Jersey breeds at an artificial insemination station in Kenya were analysed. The effect of age, breed and month of the year on semen volume, spermatozoa concentration and motility were studied. The second ejaculate volumes, concentrations and motility were significantly higher (p