depended on severity of injury. Modes of management varied between attending surgical firms. There was a 20% change in the mode of management and a 16.1% rate of negative laparotomy. Penetrating injuries had a better interventional outcome. Penetrating abdominal injuries had higher rates of complications while the blunt injuries had higher rates of mortality. Overall, both the complication and mortality rates were 12.5%. Correlates of mortality included delay before surgery, associated injuries, need for blood transfusion, admission to intensive care unit and duration prior to admission. Abdominal injury patients stayed an average of 6.4 days with the blunt injuries with complications staying close to twice as much as their penetrating counterparts. Conclusion: Abdominal injuries are a predominantly male disease with the majority in the third decade of life. As opposed to previous studies, gunshot wounds are now a significant cause of abdominal injuries in Kenyatta National Hospital (KNH). The rate-of negative laparotomies has come down by 10% over the past 15 years. The outcome of management depends on the severity and type of injury sustained.

Background: There is an increasing demand for quality healthcare in the face of limited resources. With the health personnel consuming up to three quarters of recurrent budgets, a need arises to ascertain that a workforce for any health facility is the optimal level needed to produce the desired product. Objective: To highlight the experience and findings of an attempt at establishing the optimal staffing levels for a tertiary health institution using the Workload Indicators of Staffing Need (WISN) method popularised by the World Health Organisation (WHO), Geneva, Switzerland. Design: A descriptive study that captures the activities of a taskforce appointed to establish optimal staffing levels. Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya, a tertiary hospital in the Rift valley province of Kenya from September 2005 to May 2006. Main outcome measures: The cadres of workers, working schedules, main activities, time taken to accomplish the activities, available working hours, category and individual allowances, annual workloads from the previous year's statistics and optimal departmental establishment of workers. Results: There was initial resentment to the exercise because of the notion that it was aimed at retrenching workers. The team was given autonomy by the hospital management to objectively establish the optimal staffing levels. Very few departments were optimally established with the majority either under or over staffed. There were intradepartmental discrepancies in optimal levels of cadres even though many of them had the right number of total workforce. Conclusion: The WISN method is a very objective way of establishing staffing levels but requires a dedicated team with adequate expertise to make the raw data meaningful for calculations.

Alisklamp has an excellent safety profile and excellent acceptability among men who undergo circumcision using the device. This technique is easy to teach and it would prove to be a handy device to scale up the rate of male circumcision. Based on these findings the device merits a comparative clinical trial.

Background: Dishonesty can be found in all aspects of human interaction and is known to be rampant in educational institutions. Little is known about it in medical training and the characteristics of those involved. This study explores the factors that drive academic dishonesty among aspiring doctors. Objective: To establish the factors driving academic dishonesty among senior medical students. Design: Cross sectional survey using self-administered questionnaire. Setting: The School of Medicine, Moi University. Subjects: One hundred and fifty-six students in the clinical years of study. Results: Those who had past experience with academic dishonesty had a 70.4% chance of cheating in university compared to 58.9% for those not previously exposed. The odds ratio was 3.6 for males to be involved in academic dishonesty than females. Being aware of academic dishonesty in the Medical School made it 86.3% likely that a student would participate. Having witnessed academic dishonesty in progress was the strongest predictor of likely involvement in cheating. Conclusion: The cheating medical student in the clinical years is likely to be a male in the early part of the study with similar previous experience, has witnessed cheating and believes that the classmates are actively equally involved.

Background: Academic dishonesty is widespread across the world and studies done have largely relied on self-reporting to establish the extent and factors contributing to the practice. This demands of researchers to take at face value what people who may not be entirely truthful are saying. It is not a surprise, therefore, that varied interesting findings have been made in different studies. This paper delves into the complexity of determining the key components of academic dishonesty and brings into focus the role of truthfulness in understanding the elicited data. The objective of this study was to establish the role of truthfulness in understanding various components of academic dishonesty. Methods: This was a Cross sectional study using self-administered questionnaire. The Setting was the School of Medicine, Moi University, Eldoret -Kenya. The study subjects were 156 students in the clinical (4 th , 5 th and 6 th ) years of study. They anonymously filled a 20-item self-administered questionnaire. The questionnaire captured the demographic data and the views of the students on various aspects of academic dishonesty ranked in a Likert scale of six levels starting with strongly agree to strongly disagree. Results: The overall level of truthfulness among these medical students was 55.8%. While more males had prior experience with academic dishonesty in secondary school and involvement at College, they were also more truthful than the females. The untruthful were 2.2 times as often involved in academic dishonesty as the truthful and were also less likely to report on their classmates. Conclusion: There are hidden facts in academic dishonesty that can only be revealed by subjecting gathered data to a scrutiny on how truthful the respondents are. Truthfulness is an inversely proportional surrogate predictor of academic dishonesty.