Introduction Poor aqueous solubility presents a major formulation challenge for many active pharmaceutical ingredients. The use of surface-active agents is a common strategy to address poor drug solubility. Griseofulvin has previously been studied as a model of poorly soluble drugs, shown to posses improved solubility in the presence of surfactants. This study seeks to evaluate the effect of selected surface-active agents on the dissolution of griseofulvin granules prepared by melt granulation. Methodology Griseofulvin granules were prepared by melt granulation technology. The molten binder mimicked the granulating liquid and no additional liquid added. Polyethylene glycol 4000 was incorporated as the melt binder. The surfactants studied were Gelatin, Tween 80 and Sodium lauryl sulphate (SLS), at concentrations of 0.5%, 1% and 2% w/w. Dissolution was performed and sampling done at 5, 10, 20, 30 and 45 min. The griseofulvin released was quantified using Ultraviolet spectrophotometry and its assay in all formulations performed in accordance to the British Pharmacopoeia (2019) specifications. Griseofulvin tablets from Universal Corporation Ltd in the market were subjected to dissolution; sampling was done at 45 minutes. Results and Discussion Formulations containing SLS recorded the highest drug release of 96.7% at a concentration of 2% w/w whereas Tween 80 recorded its highest release of 79.9% at a concentration of 2% w/w. Gelatin formulations recorded the lowest release at all time points. The control formulation that did not have any surfactant had insignificant release at all time points confirming that the surfactants played a critical role in enhancing the dissolution. In all the formulations containing

Most large mammalian carnivores are in global decline, partly due to their involvement in livestock predation. Research that advances our understanding of predator livestock interaction is crucial to conflict mitigation and carnivore conservation and management. The study investigated the influence of environmental and socio-ecological factors on livestock predation by large carnivores in pastoral villages adjacent to the Amboseli National Park in Kenya during a 13-month period (July 2012 - July 2013). A number of factors were identified related to temporal and spatial variation that influences livestock predation rates. Aassessment on how environmental changes affected the distribution and dynamics of vegetation and animal populations. The overall purpose of this study was to determine the intensity of livestock predation by large carnivores in space and time around Amboseli National Park. In the study we investigated livestock predation by large carnivores and factors predisposing in Olgulului and Kimana community group ranches in the southern Kenya during the period between July 2012 and July 2013. In addition if livestock predation rate and intensity varied with season, boma (livestock shed) density and the carnivore species as well. Large camivore - livestock predation incidences were mapped and a total of 26 herbivore transect counts were conducted in and outside the park during both dry and wet season. The result revealed that there were more prey (herbivores) density inside the park during the dry season as compared with wet season. There was negative correlation between vegetation density, boma density and livestock predation incidences. A total of 1409 predation incidences recorded during the 13 months periods which were attributed to specific predators. Hyenas killed more livestock followed by Jackals, Cheetah and lions respectively. There were a positive correlation (r = 0.766, P = 0.131, n=5) indicating that some carnivores especially hyenas preferred to keep a certain distance from human settlements. More animals were killed while on the grazing fields and lions killed more livestock inside Borna. Conflict was most frequent during evening, late night and mid-morning. The predations by carnivore species were spatially clustered. This conforms to the assumption of non-homogenous distribution of natural resources needed by tbe animals. Some environmental variables such as human settlement and density of wild prey greatly influenced the observed pattern of carnivore attack distribution.

Background: Despite blood being lifesaving, it is not always available when needed. Prolonged turnaround time (TAT) and unavailability of blood and its components impact negatively on patient care. At the Kenyatta National Hospital (KNH) medical wards, the current practices of blood and blood components transfusion and the existing gaps and challenges had not been studied. Objective: The main objective of this study was to determine the practices and document challenges associated with blood and blood components use in the medical wards at KNH. Significance of the study: Results from the study have documented the current blood transfusion practices, existing gaps and challenges in the provision of blood transfusion services, and will inform blood transfusion policy formulation at KNH. Methodology: This was a cross-sectional descriptive study carried out at the KNH medical wards and the blood transfusion unit (BTU) in KNH. Blood request forms of patients admitted in the medical wards and healthcare workers working in the medical wards and the BTU were enrolled in the study. A data collection sheet was used to obtain demographic, clinical and laboratory data from in-patient files. The units of blood components transfused and TAT were obtained from the in-patient file 7 days from the date of the request. An open-ended questionnaire was used to document the challenges experienced by healthcare workers. Results: One hundred and thirty-eight blood request forms and 203 healthcare workers were enrolled in the study. Packed red cells were the most frequently requested blood component (29.0%). The transfusion rate was 8.7%. The top five clinical indications for blood and blood components were neoplasms, disorders of blood and blood forming organs, upper gastrointestinal bleeding, infections and chronic kidney disease, in that order. The mean TAT was 2.2 days (SD1.9). The unmet blood demand was 78.9%. Notably, 59.4% of the requests weren’t issued with a single unit of blood. Unavailability and delays in getting blood for transfusion were the most frequently reported challenges by all healthcare workers. Conclusion: The blood transfusion practices in the medical wards were comparable to standard practices in the world. However, the unmet blood demand in the medical wards was very high, with unavailability of blood being the most frequently cited challenge by all healthcare workers.

I. Introduction Metabolic syndrome (MS) is a combination of interrelated risk factors of metabolic origin; the components include increased insulin resistance, obesity, dyslipidemia and hypertension. WHO defines HAART (highly active antiretroviral therapy) as a form of antiretroviral therapy for the treatment of persons infected with HIV. The use of HAART has decreased morbidity and mortality. The use of protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NTRIs) have been associated to development of lipodystrophy and metabolic abnormalities. In spite of the success of HAART, the prevalence of dyslipidemia, insulin resistance and fat redistribution have increased after its global step up. The prevalence of MS among HIV –infected patients globally ranges from 17.0% to 45.4%, with most reports produced in developed nations. The diagnosis of MS using the International Diabetes Federation is a rise in triglycerides greater than 1.7mMol/l, elevated fasting blood sugar greater than 5.6mMol/l and reduced HDL cholesterol less than 1.03mMol/l. There exists no data on the prevalence of MS among the prison population in Kenya. II. Study objectives The broad objective is to determine the prevalence of metabolic syndrome in inmates on HAART at Embu GK prison dispensary, comprehensive care clinic (CCC). The specific objectives were: i. To determine the serum concentration of fasting blood sugar, TC, LDL-C, HDL-C and triglyceride, ii. To determine the BMI and blood pressure among patients on HAART iii. To compare the different types of regimens to metabolic syndrome iv. To determine the prevalence of MS in prisoners on HAART

Background: Evaluation of the larynx and pharynx areas is not always performed during oesophagogastroduodenoscopy(OGD) despite the oropharynx and laryngopharynx being bypassed to get to the oesophagus. Laryngopharyngeal abnormalities have been picked in up to 5.4% OGDs. Main objective: To determine the diagnostic yield of laryngeal and pharyngeal pathology during OGD at Kenyatta national hospital (KNH) Study design and setting: This was a prospective cross sectional study on patients undergoing OGD from February to July 2020 at KNH endoscopy unit. Methodology: One hundred and twenty-one patients aged 18 years and above were recruited into the study. History and physical examination including video laryngoscopy were done followed by endoscopic evaluation of the pharynx and larynx during OGD. Data management and analysis: Data was expressed as means and standard deviations. Comparison between subsites and between both endoscopic groups was done using chi-squared. Sensitivity and specificity was calculated using indirect video laryngoscopy as the gold standard. Diagnostic accuracy was obtained using receiver operating characteristics curve. A P-value of <0.05 for a 95% confidence interval was considered significant. Results Among 121 patient recruited into the study, 17.35 % had laryngeal and pharyngeal abnormalities on OGD whereas 25.61% had abnormalities on video laryngoscopy(VL).The common pathologies on video laryngoscopy were LPR (10.79%), vocal cord paralysis (8.33%) then laryngeal leukoplakia (2.49%) while vocal cord paralysis (5.69%), LPR (4.96%) ,laryngeal and oropharyngeal leukoplakia (2.49%) were common on OGD. VL had higher odds of diagnosing pathologies of the oropharynx, larynx and hypopharynx compared to OGD. The mean time taken to evaluate the larynx and pharynx was 43±20.9 seconds while OGD procedure took 237.3±106.4 seconds. OGD was 63.4% sensitive and 91.3% specific in diagnosing pathologies of the various subsites, with positive and negative predictive values of 78.9% and 83.0% respectively. Conclusion The diagnostic yield of laryngeal and pharyngeal pathologies during OGD is significant and it only requires 43 seconds to do examination. Examination of the larynx and pharynx should be made part of OGD examination and reporting.

Study title:Effect of timed phone call surveillance versus routine care on postpartum care, selected adverse maternal and neonatal outcomes at KNH, a randomized controlled trial. PI-Brian Liyayi; Supervisors: Bosire Alex, Osoti Alfred, Chemwey Rose Correspondence to: niqliy@gmail.com Background: Postnatal care (PNC) can lower newborn and or maternal morbidity and deaths by increasing recognition and management of postnatal complications that may affect the baby and the mother. In Kenya, only 51% receive good PNC in 48 hours after delivery while 57 % go for a postnatal checkup at 6 weeks postpartum. It is estimated that 10-27% of newborn deaths would be averted by adequate utilization of PNC. Mobile phone based postpartum interventions have improved day 3 PNC attendance from 45% to 81% in South Africa. They can therefore be scaled in the postpartum period to increase quality of PNC through recognition of danger signs and reminders for PNC visits. Objective: To determine the effect of timed phone call-based PNC compared to routine PNC on PNC attendance and selected adverse maternal and neonatal outcomes at 72 hours, 10-14days, and 6 weeks after delivery. Methodology: This was an open label randomized controlled trial where eligible postnatal women at KNH were randomly assigned to either an intervention, a timed phone call(n=70) or control, routine of care(n=71). The nature of intervention was impossible to blind. The intervention group received a phone call at 72 hours,10-14 days and 6 weeks postpartum. The routine care group received a phone call only at 6 weeks postpartum. During enrollment and each call, participants underwent interviewer administered questionnaire using a checklist. The primary outcomes were PNC attendance and identification of risk factors for adverse maternal and neonatal outcomes while the secondary outcomes were adverse maternal and neonatal outcomes. Study Population: Women who delivered at KNH and were within first 3 days postpartum. Study setting: KNH labor and postnatal wards. Analysis plan: Data was collected via ODK collect application, cleaned and analyzed using Stata®14. Categorical data were summarized as frequencies and proportions and compared between the two groups using Chi-square test or Fishers exact test. Continuous data were summarized as means and standard deviations or median and interquartile range and compared between the two groups using independent student t test or Mann Whitney u test. Relative Risk (RR)were also calculated. P value <0.05 was considered statistically significant.All analysis was intention to treat. Results: Between October and December 2019, 161 postnatal women were screened and 141 enrolled. The baseline characteristics were similar. The mobile phone call increased PNC attendance at 72 hours (5.7% vs 4.2%, RR=1.35[(95%CI 0.31 5.82) p=0.684].and at 10-14 days (69% vs 44%, RR=1.57[(95%CI 1.15 2.14) p=0.003]) compared to routine PNC. Women in the phone call group were more likely to identify risk factors for adverse outcomes compared to the routine care group (36.6% vs 8.6%, RR=4.56, P<0.001). Adverse maternal and neonatal outcomes were more likely to be recorded in the phone call group compared to the routine care group (20%vs 8.5%, RR=2.37, p=0.049). The study did not involve any medical intervention therefore no reported risk to the participants. Conclusion: Compared to routine care, phone calls for PNC follow up improved the 2-week clinic attendance and resulted in more risk factor identification for adverse maternal and neonatal outcomes among women who delivered at KNH and were randomized into this study. Recommendations:Mobile Phone call interventions are recommended for use in the postpartum period to improve 10-14-day postnatal retention. They can as well be used to improve risk factor identification for adverse maternal and neonatal outcomes. Trial registration:PACTR202005876065918 Funding:Self-funded

The study had sought to examine the impact of climate variability on poverty in Kenya. Specific objectives included to examine the effect of climate variability and other covariates on poverty in Kenya. To establish the mediating effect of economic growth on the relationship between climate variability and poverty. To examine the direction of causality between climate variability and poverty. The study adopted Keynesian theory, Fosu Growth-Poverty Model and Vulnerability Frameworks. The diagnostic research design was adopted examine the causal effect link between climate variability and poverty levels in Kenya. ARDL model and Error Correction model was adopted. The Error Correction term allowed for detection of short run and long run casual relationships and captures the long run adjustment of the cointegrated variables. The study further adopted pairwise granger causality test to examine the direction of causation between climate variability and poverty. The study results revealed that climate variability and other covariates explained poverty to a major extent as depicted by adjusted R2 of 0.9663 and 0.9419 for the consumption per capita and head count ratio models. Further, widespread climate shock occurrence and rainfall variability had a significant effect on consumption per capita and head count ratio measures of poverty. The study thus accepted the alternative hypothesis that climate variability has a significant effect on poverty in Kenya. Regarding the mediating effect of economic growth on the relationship between climate variability and poverty, it was established that economic growth mediated the relationship between climate variability (Rainfall variability and climate shock) and poverty in Kenya. The alternative hypothesis that economic growth mediates the relationship between climate variability and poverty in Kenya was thus accepted. Finally, regarding the direction of causality between climate variability and poverty in Kenya. The study revealed that poverty granger caused temperature variability. The study therefore concludes there is unidirectional causality between climate variability and poverty in Kenya running from poverty to climate variability. The study thus rejected the hypotheses that climate variability granger causes poverty in Kenya. The study recommended that government should focus on alleviating poverty in a bid to control climate change by raising minimum wages and investing in the Agricultural sector which is the main source of livelihood of poor communities. The government should continue implementing tax policies that hurt the poor masses less to help in redistribution of resources to the poor. Additionally, the government should invest in pro poor projects. Policies that encourage economic growth can help minimise the negative impacts of climate variability on the poor masses. The government should also come up with policies of import minimization to reduce imported inflation that hurt the poor. Further, cost push inflation resulting from wage demands by the lowly paid workers should attract policy from the government inform of having peaceful labour relations in the country.

Diaspora remittances are defined as cash transmitted by an individual in a foreign land to their country of origin. Macroeconomic variables are variables that are a pointer of the existing trends on the economy. Remittances sent from people in diaspora have become one of the biggest ways of external financing for developing republics. The rising attention to diaspora remittances originates from the realization of the vital role they play in alleviating poverty and promoting economic development. This study sought to establish whether diaspora remittances affect macroeconomic variables in East Africa Community (EAC). EAC is currently comprised of six (6) countries: Kenya, Tanzania, South Sudan, Uganda, Burundi and Rwanda. Kenya ranked first in EAC as the leading recipient of remittances and in the next position was Uganda after it was South Sudan then Tanzania, behind it Rwanda and Burundi between 2013 and 2018. However, South Sudan was not included in the data collection and analysis as it joined EAC in 2016 and thus its data was not available for the whole study period. The study used descriptive research design. Secondary data was used for the period 2011-2020 and it was obtained from the respective National Bureaus of Statistics of the countries in EAC, respective Central Banks and World Bank development indicators. The data was evaluated using Statistical Package for Social Sciences (SPSS) version 25 software. The study established that diaspora remittances positively affect GDP growth rate, negatively affect inflation rate, positively affect exchange rate and negatively affect unemployment rate. However the study concluded that at 5% level of significance, diaspora remittances is not statistically significant in affecting in, GDP growth rate, inflation rate, exchange rate and unemployment in EAC. This study will make a contribution to the literature on effect of remittances on macro-economic factors in EAC which will be part of articles that will be useful to researchers willing to further these studies. The study shall also assist the governments in EAC in establishing structures to administer and ways to gain directly into the funds from foreign lands as a strength for ventures and progress of the nations. This study suggested further studies to focus on other macroeconomic variables in the EAC that were not covered in this study such as interest rate. Further, researchers can cover a different and a longer time period to research and do a similar study. Other studies on effects of diaspora remittances can focus more on unemployment and exchange rate in EAC. Studies can also incorporate remittances received through informal channels if data is availed and combine with the formal channels of remittances.

Over the past decade, commercial bank credit to agriculture as a percentage of private sector credit has continued to increase. On the contrary, growth in agricultural value added has exhibited a constant trend. It is against this background that the study examined the impact of commercial bank credit on the performance of agricultural sector in Uganda using quarterly data for the period 2008q1 to 2017q4. While using ARDL estimation technique, the study found commercial bank credit to agriculture to have a positive but insignificant impact on the performance of the agricultural sector in Uganda. Variables found to have a significant impact on the performance of agricultural sector include growth in net capital stock, inflation, and lending rate with growth in net capital stock having a positive relationship while inflation and lending rate have a negative impact. Based on the findings, the study recommends realigning commercial bank credit to reach the production base. This entails measures to reduce risks at the production stage (for example through agricultural insurance). The study further recommends measures to reduce inflation rate and commercial bank lending rate. Key words: Agriculture, Credit, Value Added, Autoregressive Distributed Lag Model

The Board of Directors has been the black box of company law in large companies with numerous and dispersed shareholding bodies, the central management of the company’s business is necessary in the hands of the board. Yet company law has traditionally specified very little about how this body should operate. The idea that the board is central to the operation of companies was recognized from the beginning by the development of wide range of duties which apply to directors who undertake to act on behalf of the company. However, the questions of which functions should be assigned to the board and how the board should organize itself for the effective discharge of those duties were ones that company law did not seek to answer. The role of the board is to plan and strategize goals and objectives for the short- and long-term good of the company and to put mechanisms in place to monitor progress against the objectives. To this regard, board directors must review, understand and discuss the company's goals. In particular, the board relies on independent directors to challenge the board's perspectives to ensure sound decision-making. In essence, board directors act as stewards of the company that govern for the present times and provide guidance and direction for the future. It's in the board's best interest to develop good working relationships with managers. Corporations run best when the board and senior management hold the same perspectives on strategy, priorities and risk management. Communication is a vital component of good corporate governance. Boards must communicate clearly and in a timely manner to develop a sense of mutual confidence and trust with their managers. It's important for board directors to be having regular conversations with managers about risk mitigation and prevention. Managers need to understand risks so that they can put processes in place to protect the company. The objective of this study was to undertake a comprehensive review of Uganda’s legal framework regarding the structure, functions and powers of Boards of Directors, highlighting the strengths and weaknesses of such framework and recommending changes aimed at addressing any such inadequacies. The findings of this study are as follows: Chapter I, introduces the study and gives an extensive and detailed background to the area of study and its significance. Chapter II reviews Uganda’s corporate legal and institutional governance framework and the findings are that corporate governance issues in Uganda relate to the role of the board, accountability of the board to both shareholders and stakeholders, and financial malpractices, which have led to the collapse of many organisations in Uganda as a result of poor corporate governance practices. The chapter also deduces that the corporate governance legal regime in Uganda is important because it underscores the crucial role of the board of directors of any company and the significance of good accounting standards. Chapter III analyses the international codes like the Cadbury report in the United Kingdom, The UK Corporate governance Code, Kings Reports of South Africa and the Sarbanes-Oxley Act of the United States, among others. The findings are that corporate governance has developed tremendously around the globe often in reaction to corporate scandals. As it develops it creates new laws, regulations and codes both at a national, regional, sector specific and international level which countries like Uganda have adopted as best practices for corporate governance. Chapter IV analyses the code of corporate governance in the two African countries of South Africa and Kenya in a comparative study with the Companies Act, 2012. The findings are that the code of corporate governance of Uganda under the Companies Act, 2012 in comparison to its counter-parts in South Africa and Kenya is strenuous and not easy to implement especially with regards to private companies where it is voluntary to adopt the said codes into the articles of association of such companies. Finally, Chapter V draws conclusions from the research gathered in the preceding chapters and makes recommendations of how best the code of corporate governance in Ugandan under the Companies Act can be improved to enable the Board of Directors effectively and efficiently carry out its role. The recommendations of this study included inter alia; Sanctions on conflict of interests; Relations with Shareowners and key stakeholders; Selection of board members with skills and experience; Mandatory Corporate Governance Structure for Private Companies; Amendment of Table F to the Companies Act, 2012; Compliance and Enforcement of the code of corporate governance under the Companies Act, 2012, among others.