Friday, June 27, 2008


cut and paste:


Saturday, June 28, 2008-DN.

Sunday, June 22, 2008




Hepatitis in itself- is the inflammation of the liver. Many illnesses and conditions can cause inflammation of the liver, for example, drugs/medications, alcohol, chemicals, and autoimmune diseases. Also many organisms most specifically viruses,i.e virus of mononucleosis and the cytomegalovirus can inflame the liver. Most viruses, however, do not primarily attack the liver; the liver is just one of several organs that the viruses affect. When doctors/health professions speak of viral hepatitis, they usually are referring to hepatitis caused by a few specific viruses that primarily attack the liver. There are several hepatitis viruses; they have been named types A, B, C, D, E, F (not confirmed), and G. As the knowledge of hepatitis viruses grows, it is likely that this alphabetical list will become longer. The most common hepatitis viruses are types A, B, and C.

The liver, located in the upper right hand side of the abdomen and mostly behind the rib cage normally weighs close to 1.5kgs. It does the following vital functions:

1. The liver helps purify the blood by changing harmful chemicals into harmless ones. The source of these chemicals can be external, such as medications or alcohol, or internal, such as ammonia or bilirubin. Typically, these harmful chemicals are broken down into smaller chemicals or attached to other chemicals that then are eliminated from the body in the urine or stool.
2. The liver produces many important substances, especially proteins that are necessary for good health. For example, it produces albumin, the protein building block of the body, as well as the proteins that cause blood to clot properly.
3. The liver stores many sugars, fats and vitamins until they are needed elsewhere in the body.
4. The liver builds smaller chemicals into larger, more complicated chemicals that are needed elsewhere in the body. An example of this type of function is the manufacture of cholesterol.

When the liver is inflamed, it does not perform these functions well, which brings about many of the symptoms, signs, and problems associated with hepatitis.





Liver abscess occurs when bacteria or protozoa destroy liver tissue, producing a cavity that fills with infectious organisms, liquefied liver cells and white blood cells. The dead tissues may then seal off the cavity from the rest of the liver making it less effective. Although uncommon, sometimes the puss-filled abscesses may rapture into another body cavity resulting into multiple abscesses, posing serious complications for the patient and can sometimes be fatal.


The puss-filled liver abscesses commonly result from infection by such bacteria as Escherichia coli (E.coli), Klebsiella, Entrobacter, Salmonella, Staphylococcus and Enterococcus. These bacteria may invade the liver through liver wound, or spread from the lungs, skin, or other organs through the liver’s artery, veins or bile duct. And usually more than one abscess is present often allowing peritonitis, cholecystitis, pneumonia and bacterial endocarditis.

An amoebic abscess is usually caused by the infection of protozoa- Entamoeba histolytica..the same organism that is mostly associated with dysentery. And usually there is one amoebic abscess occurring in the right lobe of the liver.


The symptoms vary from one individual to another. In some people, they are acutely ill while in others, the abscess is recognized only during autopsy after death from another illness. The bacterial symptoms are sudden and those of protozoan origin are more subtle. And the common signs may include; right abdominal and shoulder pains, weight loss, fever, chills, perspiration, nausea, vomiting and anemia. If the abscess extends to the diaphragm, there will be signs in the lungs. Abscess related liver damage may also cause jaundice.


Usually the doctor reviews the patients’ medical history and among other tests evaluates a liver scan to check for filling defects at the area of abscess. A liver ultrasound may also indicate the presence of an abscess but is less definitive than a liver scan. Computed tomography scan (CAT scan) can be used to confirm the diagnosis. Also laboratory tests such as blood/stool cultures are used to provide additional details as the protozoa or bacteria responsible can be easily identified.


The physician can start antibiotic therapy immediately if the causal organism has not been isolated. And if cultures show that the infection is caused by E.coli, the treatment includes drugs like ampicillin-(good for gram negative rods such as E.coli)

If the tests show the presence of Entamoeba histolytica, then the treatment will include Aralen or Flagyl. The therapy usually continues for 2 to 4 months. And an abscess that fails to respond can be surgically removed.

Friday, June 20, 2008


Typhoid fever is an enteric form of (fever) caused by Salmonella typhi, the typhoid bacillus. It is characterized by prolonged fever and multi-system involvement, including lymph nodes, liver, and spleen. The sudden onset of sustained fever, severe headache, and nausea, loss of appetite, constipation or sometimes diarrhea can be life threatening. Severe forms have been described with mental dullness and meningitis. The paratyphoid fever can be caused by any of three serotypes of Salmonella paratyphi A, B and C. It is similar in its symptoms to typhoid fever, but tends to be milder, with a lower fatality rate. In endemic areas, the incidence of typhoid fever is highest in children and young adults from 5-19 years old.


Upon ingestion, typhoid bacilli rapidly penetrate the small intestinal mucosa by transcytosis through M cells and enterocytes, and are taken up by macrophages or diffuse into mesenteric lymph nodes. A primary bacteraemia follows and the pathogen rapidly attains intracellular haven throughout the reticuloendothelial system. This is followed by a sustained secondary bacteraemia associated with clinical illness. S. typhi also shows remarkable predilection for the gall-bladder, where infection tends to become chronic especially in individuals with a pathologic gall-bladder condition.

The disease is almost exclusively transmitted by food and water contaminated by the faeces and urine of infected people and those that are carriers. Polluted water is the most common source of typhoid transmission. In addition, shellfish taken from sewage-contaminated beds, vegetables fertilized with night-soil and eaten raw, contaminated milk and milk products also have been shown to be a source of infection. People can transmit the disease as long as the bacteria remain in their body; most people are infectious prior to and during the first week of convalescence, but 10% of untreated patients will discharge bacteria for up to 3 months. In addition, 2–5% of untreated patients will become permanent, lifelong carriers of the bacteria in their gall-bladder. Usually 10% of the cases can be reduced to less than 1% with appropriate antibiotic therapy. However, strains resistant to chloramphenicol and other recommended antibiotics (ampicillin, cotrimoxazole and even ciprofloxacin) have become prevalent in recent years.


The two most commonly used are: - oral typhoid vaccine and a single-dose injectable vaccine. These two produces fewer side effects than the older two-dose injectable vaccines. Both vaccines are equally effective and offer 65% to 75% protection against the disease. It is also important to note that, at present no vaccine offers 100% immunity.

The oral vaccine (Vivotif) contains a live but weakened strain of the Salmonella bacteria that causes typhoid fever. The vaccine consists of four capsules that are taken every other day over a one-week period. The capsule protects the vaccine against stomach acid so it remains active when it reaches the intestine where the immunity develops. The oral vaccine can be given either as a first-time dose or as a booster dose. The protection should last about 5 years, at which time another booster dose may be needed. The oral vaccine is not recommended for children under 6 years old.

The single-dose injectable vaccine, (Typhim VI) contains capsular polysaccharide antigen given as a single 0.5 cc/ml intramuscular injection. Immunity is conferred seven days after vaccination and should last for 2 years. Subsequent booster doses are recommended at 2-year intervals. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. Side effects, while greater than those of the oral vaccine, are much less than those experienced with the old 2-dose injectable vaccine.

The safety of typhoid vaccine during pregnancy is unknown. If typhoid immunization is necessary during pregnancy, the injectable polysaccharide vaccine (Typhim Vi) is probably preferable, because it does not contain live bacteria. Oral typhoid vaccine is safe in HIV-infected individuals as long as their CD4 lymphocyte counts remain above 200.

Breastfeeding is probably protective against typhoid fever in infants.

Due to limited efficacy of the typhoid vaccine, and the fact that many other infections can be acquired from contaminated food and beverages, immunization against typhoid should not in any way limit the importance of following food and water precautions.

Sunday, June 8, 2008



** super delegate numbers **

- Feb. 5: Clinton 260-170 Obama
- Feb. 28 (after Obama's winning streak of 11-straight contests): Clinton 254-204 Obama
- March 6 (after OH/TX/RI/VT): 254 Clinton-215 Obama
- March 14 (After Obama's wins in WY 3/8; MS 3/11): Clinton 253-217 Obama
- March 31: Clinton 255-222 Obama
- April 15: Clinton 257-231 Obama
- April 23 (the day after the PA primary): Clinton 263-239 Obama
- April 30: Clinton 268-248 Obama
- May 5: (day before Indiana/NC primaries): Clinton 272.5-256 Obama
- May 12: Obama 279-276.5 Clinton
- May 13:Clinton added 20(in West Virginia{28}): Obama added 8
- May 20 : (Kentucky:Clinton 37-14 Obama {51}: Oregon:Obama 31-21 Clinton {52}
-June 1 : (Puerto Rico:Clinton 38-17 Obama {55}
-June 3 : (Montana:Obama 9-7 Clinton {16}: South Dakota:Clinton 8-7 Obama {15})

Total number of delegates for 2008 primary:

Barack Obama-2,158.5(100% of the 2,118 needed)
Hillary Clinton-1,920(90.7% of the 2,118 needed)

**Florida and Michigan delegates fully seated, but with ONE-HALF voting power compromise due to Democratic Party rules violations**


Sunday, June 1, 2008


It should be appalling to every Kenyan at this juncture that a culprit who planned -along with his friends/relatives, executed-like a six y/o would, but somehow succeeded in getting a way with one of the most heinous crime on Kenyan soil now has lectures to give. He and his group has the gall and chutzpah to lecture anyone about obeying the law...etcetera etcetera! what a world. President Kibaki is the wrong candidate to talk about law and order as far as Kenya is concerned. No one is that forgetful. Not long ago -some time towards the end of last year, the exact date would be Dec. 27, 2007. When kibaki and his ilk decided to do what they did and Kenyans and the world at large saw what happened shortly afterwards. Nobody needs to be reminded of it.

Among the buried in the piles are the recommendations that the kenya's multicultural groups reconcile and try to forge a way forward with a spirit of forgiveness, togetherness and start a new, a friendship in cases where this might have been severely damaged. For goodness sake! neighbors turned on to neighbors, friends alike and even brothers and sisters on to each other! no country want a scenario like this repeating itself. Now what should bother every kenyan is that it is this selective application of the law that were one of the raw and sour points that actually turned Kenya upside down. And nobody seems to have learned not one thing from the past few months.

It's been reported in the news media that a section of the coalition-government are opposed to what they term as blanket amnesty. Not forgetting that most of them if not all should have been in custody already ha' it that the law was being followed with the same yardstick. Make no mistake anybody who brakes the law should be punished accordingly. And that should apply across the board not selectively. Or in this extraordinary case, some kind of guidelines should be set to either forgive and reconcile so that the country can move forward. Or set some kind of parameters to guide the punishment for all those took part. STARTING from THE FIRST PERSON ON TOP to THE LAST PERSON at THE BOTTOM. And Not some brainwash/hogwash nonsense.

It was also reported that Kibaki ordered those who committed criminal acts during the political crisis earlier this year be punished. He also directed the police to conclude investigation on cases, saying those who engaged in criminal activities will face the full force of the law. The President announced his stand on the issue for the first time only minutes after Raila had said the Government would find a solution to the problem. Saying society should not spare those who unleashed mayhem.

Kibaki observed: "As a society, we should reject those who incite others to violence. We should not spare them or those who recruit the gangs that cause mayhem. Once investigations are complete, those found to be innocent will be released without undue delay. But those who committed murder of innocent citizens, engaged in reckless destruction of property or rape should not expect any mercy." He revisited the issue in his off-the-cuff address in Kiswahili. "Mtu hawezi kuleta fujo na kuchokoza jirani yake halafu aachiliwe hivyo hivyo. Hiyo hatuwezi. Hakuna mtu mwenye akili timamu atapenda hivyo (Nobody should be allowed to harm his or her neighbour and expect to go Scot-free. Nobody can reason that way)" he said.

He was speaking on Sunday at Nyayo National Stadium, Nairobi, where he led the nation in marking the 45th Madaraka Day celebrations. Those present were First Lady Lucy Kibaki Vice President Mr Kalonzo Musyoka, Prime Minister Mr Raila Odinga, Deputy Prime Minister Mr Musalia Mudavadi, Speaker of the National Assembly Mr Kenneth Marende, Chief Justice Mr Evans Gicheru and other Cabinet ministers. The President issued the directive a day after Police Commissioner Maj-Gen Hussein Ali said 12,000 cases were reported during the post-election chaos, of which 103 were capital offences involving 137 suspects now in remand. And another 550 suspects were being sought over 260 other capital offences. The police boss ruled out release of the suspects saying: "We do not know of any ‘youth’. We are talking of criminals.

Sharp differences have emerged in the Cabinet over the call for blanket amnesty for youths arrested following the violence that rocked the country in January after the December 30 announcement of disputed results of the presidential election. More than 1,000 people were killed and an additional 350,000 others uprooted from their homes during the two-month mayhem. On February 28, President Kibaki and Raila signed a power-sharing deal that saw the ODM leader named premier, bringing the violence to an end and hauling the country out of its worst political crisis since Independence. The controversial call for blanket amnesty for youths arrested during the violence seems to be the biggest issue that could split the Cabinet and threaten the fledgling Grand Coalition Government. While ODM ministers have demanded the unconditional release of their supporters, their PNU colleagues insist perpetrators of violence should answer for their crimes.

Raila told a lawyers’ forum on Thursday that the youths should be released unconditionally "because they committed no crime. Is it a crime to fight for your democratic rights? Is it a crime to stand and say that last year’s elections were rigged?" posed the Prime Minister. On the same day, Internal Security minister, Prof George Saitoti, said those linked to the violence should be prosecuted to promote peace and to discourage impunity. He ordered police to speed up investigations and prosecutions of the remaining cases, and particularly those linked to capital and other serious offenses. Justice and Constitutional Affairs minister, Ms Martha Karua, has maintained that the law must be allowed to take its course. The number of youths in custody has been difficult to ascertain, with police saying only 137 were in remand, while some leaders, including Agriculture minister Mr William Ruto saying the figure runs into thousands.