Archives-January 2021

Rapunzel syndrome is defined by the presence of a gastric trichobezoar that extends beyond into the small intestine. It is an uncommon pathology, which mainly affects female patients. The association with intussusception is rare. Here we report the case of a 5-year-old girl who presented to the emergency room with abdominal pain and was diagnosed with Rapunzel syndrome complicated by intussusception. She was then operated on with satisfying post-operative results and recovery

Biodegradation and trace element content of three different animal wastes were evaluated in green house study. The study was a factorial experiment in a randomized complete block design (RCBD) with three different rates of 0, 5, 10 and 20 tha-1 each for poultry manure, pig manure and cow dung. Each treatment was replicated three times. The result showed that biodegradation rate of the wastes varied while poultry manure (PM) and pig manure (PG) decomposed fast, cow dung (CD) decomposed relatively slow. Hence nutrient release ability will be more on the PM and PG than in CD. The result of the study showed that it will require more oxygen to degrade CD than PG or PM thus cow dung has higher pollution potential followed by PG and PM. The result also showed that the incorporation of the animal wastes enriched maize shoot with trace metals. These metals at above critical levels are toxic to animals and human beings.

The design and optimization of broadband, beam steering and high gain traveling wave slotted waveguide array antenna using substrate integrated waveguide (SIW) is discussed in this paper. The antenna has been designed on Rogers 5880 with a dielectric constant of 2.2 and height of 0.762 mm. The functional frequency range is from 13.5 - 15.5 GHz and the gain is about 14 dB at 15.5 GHz. The proposed antenna radiation beam steers from -330 at 13.5 GHz to 50 at 15.5 GHz in elevation plane. This antenna possesses the benefits of low profile, low weight, low cost and it can be used for Ku band applications.

This study investigated the effectiveness of Free Primary Education (FPE) as one of the integrated education management strategies (IEMS) on enrolment aspect of pupils’ participation in public primary schools of Kakamega County, Kenya. The study conformed to the 8-4-4 system of education in 3 phases: pre-FPE Phase( 1995 – 2002), First-FPE Phase(2003-2010) and Second-FPE Phase (2011- 2018). A sample size of 82 schools representing 30% of Public Primary Schools was purposively sampled from 273 schools in four selected sub-counties: Lurambi(20), Shinyalu(24), Mumias East(18) and Navakholo (20). The research found that FPE policy had positive impact on retention of pupils in school.

Multi-drug-resistant tuberculosis remains a significant threat in people living with HIV and promotes increased mortality rates. It is often a combination of pulmonary tuberculosis forms and extra-pulmonary forms. We report 6 cases of patients with HIV and multi-drug-resistant tuberculosis collected over a two-year period from 01/01/2018 to 31/12/2019 hospitalized for multi-drug-resistant tuberculosis at Moulay Youssef Hospital. We describe the radiological, evolutionary and therapeutic clinical characteristics of resistant TB in this patient category. The average age of our patients was 36. These are 2 women and 4 men. Of which 4 were known to carry retroviral infection, followed and treated with antiretroviral therapy, there was only one diabetic patient on insulin therapy. The signs of calls were respiratory in 3 patients, digestive in one patient, neurological in one case, and an alteration of the general state in the last case. Exclusive pulmonary involvement was noted in 4 patients, associated with neuromeningeal localization in one patient and cervical lymph node localization in the last case The radiological aspect was dominated by bilateral micronodular opacities often associated with sequellary opacities. Based on the results of the xpert Tb Rif and Hain Test 1 st line and 2 nd line 3 cases of our patients were Prexdr (resistant to injectable 1/3 cases, resistant to furoquinolone 2/3 cases), MDR in one patient, two patients were classified as RR due to the unavailability of genotypic tests. The evolution during hospitalization was marked by the occurrence of pneumocystosis in 2 patients who had progressed well under Bactrim high curative dose and systemic corticosteroids, pneumothorax in one case; we deplore the death of a patient by tuberculosis meningitis. Five patients were put individualized regimen of 20-24 months and only one case on a standardized regimen for 9-11 months, antiretroviral treatment was initiated after 1 month of the start of anti-bacillary treatment in 2 cases (CD4 rate > 500). Major adverse effects were observed in 3 patients. These were bilateral deafness, significant hepatic cytolysis, and severe cytopenia which required the permanent discontinuation of amikacin, Pza, Linezolid respectively. Minor side effects, a type of digestive intolerance, were noted in 2 patients who progressed well under symptomatic treatment. Minor side effects, a type of digestive intolerance, were noted in 2 patients who progressed well under symptomatic treatment.HIV infection increases the risk of the emergence of resistant strains of the TB bacillus in HIV-positive subjects. The combination of multi-drug-resistant tuberculosis and HIV infection is a major risk factor for morbidity-mortality.

The effect of Second Order Autoregressive (AR-2) model and non-normality on the power function of the control chart for known ? is studied. The power function is derived by considering the first four terms of an Edgeworth series for AR-2 model. The values of power function for three situation viz. when the roots are (i) real and distinct (ii) real and equal and (iii) complex conjugate along with case when there is no dependency are presented.

The clinical manifestations of cardiac myxoma are often non-specific and may delay diagnosis. We report the case of a 53-year-old man who has been presenting for the past four years a recurrent skin rash on his back associated with muscle pain. He was admitted to the emergency room for sudden right-sided hemiparesis and aphasia due to a subacute ischemic stroke at the frontal- parietal and temporal lobes.Echocardiogram revealed a mass in the left atrium suggestive of myxoma. After surgery, the patient remained free of cutaneous symptoms. Atypical manifestations of cardiac myxoma should be considered in order to not delay adequate management.

In India, cancers account for about 3.3% of the disease burden and about 9% of all deaths. Malignant neoplasms of the stomach can lead to malnutrition as a result of excessive blood and protein loss or more commonly due to obstruction and mechanical interference with food intake. The purpose of this study was to assess the nutritional status of hospitalized gastrointestinal cancer patients using Nutrition Risk Screening tool (NRS), Subjective Global Assessment tool (SGA) and Questionnaire. Method: Gastrointestinal cancer patients were selected on the bases of the inclusion & exclusion criteria. The NRS 2002, SGA & FFQ were applied by qualified dietitians. Results: Malnutrition evolves during the course of cancer and is modulated by therapeutic interventions. Among the selected patients 23.4% each had colon & stomach cancer followed by esophageal cancer. According to the NRS scoring 43.3% had a score of four indicating malnutrition and only 6.7% were well nourished according to the SGA scoring. Duncan’s Post Hoc tests indicated that as the fruit intake was increased the subjects were nourished and nutritional care plan can be initiated for them; whereas for the group whose intake was less, they were consecutively malnourished and there was a need for nutritional care plan along with care to avoid the associated risk status. Conclusion: Malnutrition in cancer patients should be considered and treated as an additional disease, as it has been shown to worsen clinical outcomes and increase morbidity, mortality, and complication rates, thus causing additional costs

The apparent and thermodynamic parameters (pKa, pKb, Ka, Kb) are among the most common used physical parameters and their determinations are of interest to a broad range of research. It is apparent that hypersaline hydrochemical environment in concentrated salt lake brines has a profound modifying influence on parameters such as Ka, pKa's and buffer capacities. This study presents chemical parameters (Ka, pKa and buffer capacities) at typical high ionic strength salt lake brines, which were evaluated at 25 oC and have revealed both pKa1 and pKa2 to decrease as ionic strength of the solution increases. The apparent dissociation constant Ka for HF is increasing as the ionic strength increases and thermodynamic Ka = 7.46 x 10-4 found is in good agreement with the values reported in the literature. The phosphate buffer capacity in the target Rift Valley Salt Lake systems is observed to exceed that of pure water by a factor of 36 to 1000.

The unresolved land issue in Chepyuk ward for decades had adversely affected farming competitiveness in spite of the region being fertile and viable for competitive farm production. Lack of security of tenure on the untitled land had a direct bearing on investment (farm inputs) and therefore to a large extends affected farm output. Despite many researches that had been undertaken on Chepyuk land issue, land and conflict had been widely studied rather than farming competitiveness. The studies on farming competitiveness in Chepyuk ward remains scanty and therefore justify more research on the aspect of farming competitiveness. The main objective of this study was to assess the influence of the local culture on land administration and its effects on farming competitiveness in Chepyuk Ward of Bungoma County. A descriptive survey research design was used in this study. The study was guided by theory of land ownership in a free society advanced by Ingalls (2012). The target population was 3120, households, 10 land officers and 10 agricultural officers located at the county level. Multistage sampling technique was used in this study where Simple random sampling was employed when selecting 312 respondents among the households. Five Land officers and Five Agricultural officers were respectively and purposefully sampled for this study. The researcher used questionnaires, interviews and document analysis as the main tools for collecting data. The data from the questionnaires, interviews and document analysis was analyzed using descriptive statistics. The researcher used frequencies and percentages in summarizing data. Information obtained through interviews was discussed to support or dispute the findings from the questionnaires. Tables were used to present the data for purposes of interpretation. The study informs Ministry of lands on the existing gaps in the fight against irregular allocation of land. The study also enables land policy experts in the government review existing mechanisms and systems set to support the Chepyuk area residents in dealing with cases that bring about land conflicts in the area and entire nation. Cultural norms of the community also denied women land ownership rights. The Land officers and Agricultural officers gave similar opinion. Lack of land documentation denied people opportunity to seriously venture into farming with sole aim of attaining food security and profit negatively affecting livelihood of the residents. The government should reposes illegally acquired plots and re-issue to the rightful owners, it should also process land titles for the scheme. The community should also be sensitized to embrace gender equity on land allocations. This will enable residents to actively engage in farming activities hence enhance farming competitiveness in Chepyuk ward.