Hand replantation using loupe magnification in a resource constrained environment: Case report.

Hand replantation is a common surgical procedure worldwide. However, this practice is underdeveloped in many resource-constrained countries in part due to a lack of surgical microscopes. We present a patient successfully managed using loupe magnification. A 17-year-old patient presented with an amputated right hand secondary to a chaff cutter. After an 8-hour surgical procedure, the amputated hand was successfully re-attached to the stump using loupes. The patient's functional recovery was satisfactory after two years of follow-up. In conclusion, replantation of extremities can be successfully achieved using loupe magnification. Loupes should be considered an alternative to operating microscopes for replantation of extremities especially in resource-constrained countries.

Nutrition in agricultural development: land settlement in Coast Province, Kenya.

PIP: Coast Province is the third area of population concentration in Kenya with more than 1.8 million people at the time of the census in 1989. The region is economically underdeveloped relative to central and western Kenya. In response to a great demand for land, the government of Kenya has since 1963 parcelled out tracts of land in Coast Province among smallholder tenants. This paper reviews the settlement of land in the province during 1960-70 and the effects upon later household income, food production, and nutrition. Findings are based upon information gathered from 300 tenant households surveyed between August 1985 and September 1986 in the Ukunda, Mtwapa, and Roka-East schemes respectively established in 1962, 1968, and 1969, and 150 households in rural comparison locations visited during the same period. In all aspects studied, including living conditions, household resources and income, food self-sufficiency and consumption, and nutritional status of children, the settlement tenants were better off than the rural population. Further analysis determined that the relatively better nutritional status of tenant households is only partly due to increases in food production and agricultural income. Income from employment was also higher than that of the rural comparison population. Households with large farms generally realized larger incomes, but they also had much larger families and food consumption, and the nutritional status of young children was lower among those households.^ieng