Archives-October 2020

the study of the bacterial ecology in a surgical intensive care unit has a huge interest for the fight against the infections. the aim of this work is to analyze the epidemiological and the bacteriological profiles of infections, also to identify the risk factors and others influence the prognosis, finally to propose the measures of prevention. during one year at the bacteriology unit of mohammed V military teaching hospital of Rabat city in Morocco this prospective study was giving: the results of the total samples about the surgical intensive care unit patients. The characteristics of the patients “having infectious state” in intensive care unit: the middle age is 45,5 years old, the majority of cases correspond to male people, the high blood pressure (35,29%) and diabetes (23,53%) are the most frequent breeding . the severe cranial trauma corresponds to the most cases (16, 33%), secondly, we find the polytrauma 14, 28%. the infection incidence was considered as 6, 10%. the gram-negative bacilli are the most observed (69, 23%), secondly, we find the gram-positive cocci 23,10%. the klebsiella pneumoniaei is the most frequently identified species (25%), is the most frequently isolated on catheters samples, it has an important susceptibility to imipeneme. the acinetobacter baumanii is present in the second row (13,46%), having a susceptibility to colistine. the escherichia coli (9, 62%) and staphylococcus coagulase negative (9,62%) are both in the third row, this one is the most frequently isolated species in blood cultures and presents a neatly susceptibility to teicoplanine and vancomicine. in the fourth row we find enterococcus faecalis (7, 69%), corresponds to the second germ isolated from protected bronchial specimens, pratically found in the almost specimens, and presents a high susceptibility to ampicilline, vancomycine and teicoplanine. the mortality dealing with infections is 55, 56%, while the mortality happened to “sepsis states” is 20%; the male people are frequently affected (73%). a global strategy of prevention must be established for fighting infections and making better the prognosis.

The purpose of the study was to determine the extent to which principals’ forms of communication influence students’ discipline in secondary schools in Nandi County, Kenya. The study used systems theory by Ludngvan Bartalanffy. Descriptive survey design was adopted. The study sample consisted of 118 public and private schools’ principals, 108 teacher and 1534 student leaders. Each school provided 13 student leaders. Questionnaires for principals, interview guide for teachers and student leaders were used as instruments of data collection. Data was analysed using SPSS. Descriptive statistics was used to analyse data then, tabulate and present data. The results generated were reported in tables. The study establishes that communication clarity is a key component to adherence of instructions given. The information has highest clarity when given in student baraza. The principal is able to explain himself to the satisfaction of the students and issues raised are promptly answered. The students are able seek clarifications on issues they want sorted out. This enhances discipline. The national and county quality and standards officers should be designed by MOEST to bolstering their assessment capabilities to adequately report accurately on true causes of discipline cases in schools and particularly in Nandi County and give out specific remedies to work out on how to reduce the prevalence.

The purpose of the study was to determine the extent induction of students into school culture influence students’ discipline in secondary schools in Nandi County, Kenya. The study used systems theory by Ludngvan Bartalanffy. Descriptive survey design was adopted. The study sample consisted of 118 public schools’ principals, 108 teacher and 1534 student leaders. Each school provided 13 student leaders. Questionnaires for principals, interview guide for teachers and student leaders were used as instruments of data collection. Data was analysed using SPSS. Descriptive statistics was used to analyse data then, tabulate and present data. The results generated were reported in tables. The study established that school culture defines the students, the school, the reputation, mannerisms and performance. Formal induction sets the rules, norms, expectations, behaviour patterns, the goals and objectives and the set school agendas. The study established that pairing of new students to older ones is not significantly related. It established that formal orientation, giving documents on school ethos, guest speakers who inculcate long lasting impressions on the students, introducing them to successful alumni of the school for inspiration give guiding principle to stay in the school. This impacts positively and the student discipline improves. The government should ascertain that Student leaders are inducted and due to its sensitivity the MOEST should devise a system of encouraging the formation of county bodies to specifically carry out induction of the chosen leaders in clusters of sub counties or the lower units. This will enhance the training and its impacts. The present scenario is national conference for a few students for three days and the sub county a day and this is grossly insufficient and will not make much impacts.

The principal as the key implementer assumes the role of moderator of all aspects of participatory practices. The purpose of the study was to determine the extent to which involvement of students in decision making influence students discipline in secondary schools in Nandi County, Kenya. The study used systems theory by Ludngvan Bartalanffy. Descriptive survey design was adopted. The study sample consisted of 118 public and private schools’ principals, 108 teacher and 1534 student leaders. Each school provided 13 student leaders. Questionnaires for principals, interview guide for teachers and student leaders were used as instruments of data collection. Data was analysed using SPSS. Descriptive statistics was used to analyse data then, tabulate and present data. The results generated were reported in tables. The findings indicated that most of school students were involved in decision making. The incidences of student discipline in those schools were high a factor that could have been occasioned by students sense of ownership and feeling respected and recognised. The study concludes that involvement in decision making and highly correlate to student’s discipline. The study recommends a replication of the same in a number of counties involving teachers and Board members as respondents.

The purpose of the study was to determine the Principals’ mentorship programmes in secondary schools in Nandi County. The study used social learning theory by Albert Bandura. Descriptive survey design was adopted. The study sample consisted of 118 public and private schools’ principals, 108 teacher and 1534 student leaders. Each school provided 13 student leaders. Questionnaires for principals, interview guide for teachers and student leaders were used as instruments of data collection. Data was analysed using SPSS. Descriptive statistics was used to analyse data then, tabulate and present data. The results generated were reported in tables and charts. The study established that Mentorship builds confidence, established that on academic excellence, it reduces theft of student’s items, reduced prevalence of strikes and prevalence of failing to do duties. On the ethical living it reduced strikes but not much with theft and attendant to duties. The study finds mentorship the key and the most useful in terms of upholding discipline in the schools. Students mentorship programmes in schools in the county be mandatory. Study established that it enhances respect for diversity amongst students and teachers, improves academic excellence, improves career choices, ethical considerations, self-awareness, improves on leadership traits, learning on etiquette, assertiveness and diversity. The principals should make a regular practice and introduce mentorship programmes since if this was in the study it’s an indicator the discipline turn round will be within reach.

Concrete is the major construction material which plays a vital role in the development of current civilization. Construction and demolition waste is one among the various types of waste materials which can be reused in concrete production. Construction wastes are obtained during construction, renovation and demolition of a building. Dumping of these wastes to landfill causes serious environmental issues. The major factor that affects the quality of recycled coarse aggregate which is obtained from construction and demolition waste is the large amount of cement mortar that remains on the surface of it. Hence, it is essential to determine the properties of concrete containing construction and demolition waste as recycled coarse aggregate (RCA). The objective of this study is to develop the equations in order to predict compressive strength of concrete for different cement content with varying water cement ratio using RCA.

The port of Mombasa is one of the busiest ports along the East African coast because it serves the landlocked countries in the neighbourhood. With the increase in growth of trade in East and Central African countries, the volume of goods, with varying complexities of hazards and awkward weights requiring specialized handling equipment, passing through the port of Mombasa will increase. This presents high probability of occurrence of major accidents. Major accident may include explosion, fire, toxic chemical spill or even lifting equipment failure. This study focused on four key determinants of effective control to occurrence of major accidents namely: Safe systems of work, cargo handling equipment maintenance, training and risk assessment. The study was done adopting a stratified random sampling technique with a target population of 650 and a sample population of 248 determined using Slovin’s formula. The target population consisted of dockworkers majority of whom are ship clerks, tally clerks, lifters, signalers, crane operators, maintenance technicians and truck drivers. There was also middle level management like engineers, technologists, safety and environment officers. The questionnaires, interviews and observation checklist were used to collect data. Results showed 58.2% of the respondents had worked for the organization for more than ten years. The port was found to be a multi-stakeholder operations site with 20% of employees being contractors. A high percentage of 94.2% of respondents held the view that safe operations procedures would not help in control of major accidents in the port when jobs needed to be completed faster, showing the underlying poor safety culture levels in the organization.This could also mean that sometimes the procedures would be disregarded to get the job done. Cargo handling equipment seen in use at the port included: Cranes, container handlers, forklifts, bulk handling equipment. 89.8% of the respondents held the view that cargo handling equipment had potential to lead to occurrence of major accidents.Interview with respondents confirmed that there had been recent and past fatality and dangerous occurrences and incidents related to use of equipment. For the review period of Oct to Dec 2017, over 63% of (88 of 139) the accidents had occurred at the container terminal as compared to the conventional terminal probably because of less equipment used and less traffic compared to the container terminal. Most of the accidents were related to equipment failure and private trucks operated by contractors. Training gaps existed and in various contexts where 53.1% of respondents said they had not undergone any training or awareness on prevention of accidents or hazards despite operating in a potentially risky environment. There were no inclusion of major accidents prevention and awareness topics in the training curriculum reviewed and 82.5% of respondents felt that the training they had received had not given them the confidence required in terms of responding to or handling major accidents if they did occur in their workplaces. The extent of implementing actions and recommendations arising from risk assessment would take long due to delays or bureaucratic approval process, hence increasing risk exposure. It is recommended that a major accident control policy is developed and implemented and that topics in prevention of occurrence of major accident are included in the training curriculum.

Type I neurofibromatosis (NF) is the most common autosomal dominant disease. It concerns one in 3000 births, the penetrance is close to 100%. Cranio-maxillofacial region is concerned in 10% of the cases. We are reporting the case of a patient who has been surgically cared for in the department of stomatology and maxillofacial surgery at the Rabat specialty hospital, for a nasal plexiform neurofibromatosis with a good post-operative evolution and a very satisfactory esthetic result.

Isolated fractures of the floor of the orbit are secondary to intraorbital hyperpressure that results from a direct anteroposterior impact on the eyeball.Our study is a retrospective study over a period of 03 years (2017_2020) relating to 20 cases of isolated fracture of the floor of the orbit with a mean follow-up of 01 year. The average age of our patients is 25 years with extremes ranging from 13 to 40 years, in 80% of cases our patients were victims of aggression.The initial clinical examination showed diplopia in 80% of cases with enophthalmia in 20% of cases. Computed tomography and lancaster test were performed for all our patients.The surgical treatment consisted of a musculograissory disincarceration with a reconstruction of the floor of the orbit .With a mean decline of one year the evolution was favorable in 80% of the cases. Isolated fractures of the floor of the orbit respond to a precise mechanism of direct ocular impact, vertical diplopia and enophthalmia are the major clinical signs, and CT remains the standard radiological examination for diagnosis and analysis. The surgical treatment must be rapid. The complications are mainly due to delayed management.

Fusiform cell lipomas are rare adipocytic tumours characterized by proliferation of mature adipocytes and fusiform cells; we report the case of a 59-year-old patient who received surgical removal from a left cervical tumor whose anatomopathological examination returned in favor of a fusiform cell lipoma.