Macrophage activation syndrome is a rare but a potentially fatal disease. This pathology is defined not only by clinical criteria (fever, splenomegaly), but also by biological criteria (bi or pancytopenia, hypofibrinogenemia, hypertriglyceridemia, hyperferritinemia) and cyto histological ones (hemophagocytosis in the bone marrow, in the spleen or in the peripheral lymph nodes). It may be primary or more often reactive to an infectious or a malignant pathology, an immune deficiency, or an autoimmune systemic disease. Its occurrence imposes a quite exhaustive etiological assessment, as the associated diseases are multiple. We report in this work the case of a patient in whom a macrophage activation syndrome secondary to a bacteraemia was diagnosed in the laboratory of Hematology of the Hassan II University Hospital -Fez, and whose evolution was marked by a good response to antibiotic therapy with a regression of clinical symptoms and an improvement of the biological parameters. However, the prognosis for macrophage activation syndrome remains severe with about 50% mortality in the literature. It is therefore considered as a serious condition, with a severe prognosis and a treatment that is still poorly codified.

Streptococcus constellatus is a germ that belongs to the Streptococcus milleri group, it has a particular tropism for the digestive tract and the hepatobiliary region. It is found in deep abscesses in immunocompromised patients. 70-year-old patient admitted to the emergency room for a pain in the right iliac fossa. The abdominal scan showed a retro cecal collection probably related to an appendicular abscess. The cytobacteriological study of abscess sampling in peroperatively demonstrated the presence of Streptococcus constellatus associated with Escherichia coli. The identification of a streptococcus of the milleri group is difficult by ordinary methods and must make search for an abscess.

The purpose of the study was to determine anemia prevalence on less than ten years old children patients’ attending Rongo sub-county hospital, Kenya. The country has experienced rapid economic growth over the last few decades, significant health and nutritional problems remain. Unfortunately, because little work has been done to track basic diseases, such as iron-deficiency anemia, the exact problem of these health problems still remain unknown. The study comprise 250 parents, 7 medical laboratory technologists/technicians, 1 medical superintendent 1 hospital administrator.The study adopted hospital based cross sectional survey design.Since the hospital is one, there is one medical superintended and an administrator; purposive sampling was used to select them as they were few. Due to the fact that there are 250 parents of anemic children attending the hospital 30 percent of them was considered hence 75 parents/guardians. The study used questionnaire. The actual data collection, a pilot study was conducted in the same county among the parents of less than ten years old attending Minyenya health centre which was not included in the final study population. From this health centre where 10 parents were be randomly selected for the pilot study, 3 medical laboratory technologists, and their respective hospital administrator and medical superintendent. A minimum correlation coefficient of 0 .65 is recommended and considered reliable.

The aim of this study was to estimate the prevalence and risk factors for different neurological disorders. We also aimed to explore the effect of different socio-demographic variables in neurological disorders. Methods: A prospective cross-sectional study was carried out at Neurology Outpatient Clinic of United Hospital Ltd., Bangladesh, from December 2015 to March 2016 to explore the experiences of patients with neurological disorders. A separate questionnaire was used to collate the information. All registered patients medical records were reviewed. Microsoft Office Excel 2007 software package was used for statistical analysis. Data of 438 patients were collected and analyzed of which 239 (54.57 %) were females and 199 (45.43 %) were males. This study showed a high prevalence of epilepsy, stroke and migraine and an overall low prevalence of Parkinsonism, Alzheimer’s and dementia. The values were 121, 97, 52, 43, 23 and 102 for epilepsy, stroke, Alzheimer’s, Dementia, Parkinson’s and Migraine accordingly. Most of the patients (79.95%) were unmarried in our observational study. Only 20.06% were married. 41.03% and 26.18% patients were alcoholic and smoker respectively. Highest percentage of the patients (27.27 %) belonged to the age group 61 - 70 years, 21.23% to the age group 41 - 50 years and 17.05 % to the age group 51 – 60 years. Moreover, 42.98% of the patients were from community colony. The findings from the present study supported some previ¬ous research studies showing that women are more adversely affected by different neurological disorders than men. Therefore, more epidemiological studies need to be conducted to look into the changing pattern of neurological disorders using a uniform methodology.

The regional human capital trend is scrutinized in this article relying on indicators of the cultural and intellectual potential based on the statistical data of Primorsky krai region. Additionally, the effect of migration processes on the labor potential is deliberated, just as the budgetary and fiscal stimulation of human capital inflow is considered at an angle of the regional labor potential increase.

This study looked at if there was any significant difference between teachers‟ and students‟ perceptions on the ban of corporal punishment in school in Kosirai Division, of Nandi County public secondary schools by gender, age, highest level of education and experience in school. Descriptive-comparative survey research design was used. Fifty eight (58) teachers participated. Questionnaires were used to collect data from the respondents. Validity was determined by the use of expert opinion in matters education in the department of educational administration, curriculum and teaching of University of Eastern Africa, Baraton. The reliability of the questionnaire was done through a pilot study done in two (2) public secondary schools in Eldoret Municipality. Thirty (30) teachers participated in the pilot study. Cronbach‟s alpha of 0.6 was set as the cut-off point. The Cronbach‟s alpha for teachers‟ questionnaire was .654 T-test was used to determine the difference between the mean ratings of boys and girls, female and male teachers, age, teaching experience and level of education of teachers. The findings indicated that there was no significant difference between teachers‟ perception on the ban of corporal punishment in schools in Kosirai Division secondary schools when categorized by gender, age, education and experience. This study recommends that alternative ways of discipline be sourced and applied to avoid physical pain to students.

Staphylococcus aureus stays a standout amongst the most much of the time segregated pathogens in both group and hospital practices. The organism form has been observed to be the most widely recognized bacterial agent recuperated from blood circulation system diseases, skin and soft tissue contaminations, pneumonia and healing facility procured post-agent wound diseases. Changes in the example of antimicrobial helplessness of S. aureus and different living beings have been accounted for around the world, particularly in developing countries, making antimicrobial agents progressively less viable in treating bacterial infections. Most strains of the Gram-positive bacterium Staphylococcus aureus are avirulent, anti-infection soft commensals; in any case, in the course of recent decades there have developed various pandemic, harmful, anti-microbial safe strains including methicillin-resistant (MRSA) and vancomycin-resistant (VRSA) strains. This paper presents the review analysis of various studies based on antimicrobial patterns detection of Staphylococcus aureus.

Thromboprophylaxis methods mainly include pharmacological and mechanical options, such as intermittent pneumatic compression devices (IPCDs). In a specific population (post-operative and post-traumatic patients) the risk of VTE is combined with increased risk of bleeding complication which is the side effect of the pharmacological prophylaxis. The aim of this integrative review is to assess the effectiveness and safety of IPCDs as an alternative choice to pharmacological prophylaxis in post-surgery and post-trauma patients. The electronic databases CINAHL, MEDLINE EMBASE, and Cochrane libraries were systematically searched for primary studies. We included studies that had evaluated the effectiveness and safety of the sole use of IPCD against the sole use of pharmacological prophylaxis in post-surgical and post-trauma patients. A total of 13 eligible articles were identified. Post-trauma patients were enrolled only in two studies and the remaining 11 studies were conducted on post-surgery patients. The findings suggest that IPCDs, compared with pharmacological prophylaxis, are equally effective in reducing DVT, PE and mortality rate and offered a reduced risk of bleeding. There were no consistent relations between the types of IPCDs and the clinical outcomes. This review demonstrates that there is lack of strong evidence informing the comparative effectiveness of IPCDs against pharmacological prophylaxis. Additionally, there is very limited evidence that can inform which type of IPCD is more appropriate as a thromboprophylaxis tool. Thus, until further robust research is conducted, it is difficult to conclude that IPCDs can replace pharmacological prophylaxis for post-surgery and post-trauma patients

Statistics on enrolment indicates that, Kenya is experiencing class repetition in primary school education despite the gains earlier made associated with universal access to primary school education. The practice increases the possibility of the pupil to drop out of school. The purpose of this study was to investigate head teachers’ transformational leadership intervention strategies on class repetition in primary school education in Kenya. The study was guided by Self-Efficacy theory developed by Bandura Albert and pragmatism philosophy and conducted in Uasin Gishu County in Kenya. The study found out that, pupil academic performance, curriculum instruction, school culture and dynamic leadership are important intervention strategies related to head teachers’ transformational leadership that have an influence on class repetition. The study recommends a further study on a situational analysis of transformational leadership training as a new management strategy in primary schools in the 21st century in the country.

This paper presents the difference between hospital nurses’ and clinical instructors’ experienced job stress as well as their attitude towards performing their work. Results revealed that clinical instructors experience moderate stress in terms of their physical environment, workload and responsibilities, and social relationship. Despite their perception with respect to their stress level, they can still cope with their stressors as evidenced by their good work attitude. Hospital nurses, on the other hand, experience high stress level in terms of physical environment and moderate stress level in terms of their workload and responsibilities and social relationship. Clinical instructors still utilize their coping strategies in dealing with stressors as supported by their fair and good work attitude in terms of their organizational commitment and job satisfaction.

Etiological factors leading to hyperbilirubinemia vary among different geographic regions. The present study was planned to study the pattern, causes, risk factors, treatment and outcome of neonatal hyperbilirubinemia in a tertiary care setup from northern India. A retrospective cohort of jaundiced neonates seeking care for their illness at this tertiary care centre during formed the study population. All treated cases of neonatal hyperbilirubinemia were analyzed and data on gender, gestation age, mode of delivery, blood group incompatibility, sepsis, parity and birth weight were obtained. The commonest cause of neonatal hyperbilirubinemia was physiological jaundice (41.04%). Mean bilirubin values for pathological cases (18.11± 5.54 mg/dl) were higher than physiological jaundice (12.06 ± 3.59 mg/dl). Top three causes of pathological hyperbilirubinemia were ABO incompatibility (32.55%), Rh incompatibility (11.79%) and breast feeding (6.13%). Mean age of presentation with jaundice was three days. Majority (48.58%) of the cases had their total bilirubin levels equal to or below 15mg/dl. Almost all the neonates showed improvement with phototherapy and exchange transfusion. Hyperbilirubinemia is a commonly encountered problem in our NICUs. ABO and Rh incompatibility are mainly responsible for pathological jaundice. Phototherapy is found to be a safe and cost-effective way to manage neonatal jaundice.

Abstract: Media remains an important institution that continues to transform lives of people in Kenya as in any part of the world. News is a basic need and continues to shape the perceptions of people on issues affecting them socially, politically and economically. Studies suggest (as will be demonstrated in this paper) a steady increase of media and news consumption as well as coverage throughout the country since 2002. However, we cannot run away with the fact that the ideology of the government of the day is seen to determine media policy framework in Kenya. The paper compares media issues (ownership, usage and control) in the regimes of Mwai Kibaki (2002-2012) and that of Uhuru Kenyatta (2013-2017). The paper seeks to answer three questions: what are the trends of media ownership between the two regimes? What are the media ownership patterns within the established legal framework that defines ownership patterns of media outlets? The paper tackles the issue of media ownership together with technological adoption policy of each of the two regimes. The second question is whether the two regimes used media (including mainstream media and social media) in their political communication process the same way. Here, the implementation of the constitution to accord the media freedom as provided is explored and the enacted legislation is analysed. The third is what is the nature and level of media control and manipulation by the both regimes? Through analysis of already existing literature and reviewing of unfolding events, the paper explores the social, economic and political influence of both presidents to establish these differing relations with the media.

The infantile visceral leishmaniose (IVL) is a systemic infection of the reticuloendothelial system due to a flagellate protozoan of the genus Leishmania. It is characterized by its geographical distribution most frequently around Mediterranean area, India, east Africa and South America. In recent years, we are witnessing a significant recrudescence preferentially in the very young child in Morocco . Its occurrence in the infant (<24 month old) remains rare, clinical signs are distinguished by more accentuated than in the child. The authors' work consists on a retrospective study of 17 cases of visceral leishmaniasis in infants admitted to the pediatric department at the University Hospital of Fez over a period from January 2013 till June 2016. The average age was 15.64 months, girls are more affected, The majority come from the regions of Fez, mainly Taounate. The main reasons are abdominal distension (70%), fever (100%) and pallor in 90% of cases. The clinical examination finds an anemia, a fever and a splenomegaly in all cases. The diagnosis is confirmed by the myelogram performed at the Hematology Laboratory at the University Hospital of Fez. Treatment is based on glucantim at the dose of 80 to 100 mg / kg / day for 21 to 30 days. The evolution was favorable in the majority of cases. We deplored a case of death that occurred in association with macrophage activation syndrome. IVL is the most frequent zoonotic disease in Morocco. Fez and its surroundings form a highly endemic focus. Its eradication must first of all be achieved through the improvement of socio-economic conditions and the fight against malnutrition which constitutes a risk factor

Abstract: Co-curricular activities, including literary competitions, recreational activities, cultural activities and sports clubs, provide an opportunity to learn and socialize outside the classroom. In Kenya, many resources are allocated to support these activities in schools. However, there is little research on the importance of these activities in enhancing secondary students’ academic performance in KCSE across the country. The purpose of this study therefore, was to assess the influence of student’s participation in music and their academic performance in public secondary schools in Kenya. The study adopted the descriptive survey design with the target population comprising of 285 public secondary schools. The sample size was selected using the simple random sampling and purposive sampling technique and these were 86 public secondary schools from which 344 students’ representatives, 86 teachers in charge of co-curricular activities and 86 head teachers were reached as respondents of the study. Data from the head teachers and teachers was collected using questionnaires, while that from the students’ representatives was collected by use of interview schedules. Data collected was then analysed with the aid of the Statistical Package for Social Sciences computer software for descriptive statistics (frequencies, percentages and means) and inferential statistics such as Pearson moment correlation (r); z score analysis. The results were presented using tables and charts, and interpreted accordingly. The study found that participation in music is moderately correlated with students’ academic performance. The findings of this study may be useful in informing the school administration on the benefits arising from students’ participation in music and its relationship with academic achievement.

Breast cancer is the commonest cause of cancer related death among women globally. The incidence is lowest but increasing in Africa and accompanied by increased mortality. Different expression patterns of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth receptor (HER) 2 have been identified. The aim is to determine the molecular subtypes of breast cancer and evaluate their association with tumour characteristics such as age at presentation, stage of disease and grade of tumour. A 2 year prospective study of all patients that presented at University of Port Harcourt Teaching Hospital. Data was collected and analysed using the Statistical Package for Social Sciences (SPSS) version 17.0. Eighty six patients were seen during the study period and they were all females. Their ages ranged from 26 to 83 and the mean was 46.1 ± 14.3 years. Infiltrating ductal carcinoma was the commonest histological type, and seen in 78 (90.7%) patients. Triple negative was the commonest receptor subtype and observed in 40 (46.5%) patients. Breast cancer receptor subtype was significantly associated with stage and grade of tumour but not with age at presentation. Breast cancer in Nigerian women occurs relatively in younger women and most are triple negative and aggressive. Given the young age of onset and aggressiveness of this disease, it will be imperative to identify women at risk and increase the awareness, target screening and develop prevention strategies