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Time to Increase WHO Clinical Stage of People Living with HIV in Public Health Facilities of Arba Minch Town, South Ethiopia
Direslgne Misker Abyu,
Eskezyiaw Agidew Getahun,
Marelgn Tilahun Malaju,
Habtamu Mellie Bizuayehu
Issue:
Volume 3, Issue 5, September 2014
Pages:
119-124
Received:
2 August 2014
Accepted:
12 August 2014
Published:
20 August 2014
Abstract: Background: Highly Active Antiretroviral Therapy improves time to death and recurrence of any opportunistic infections in peoples living with HIV. But little is known about its effect on time to increase WHO clinical stage. Thus, this study was aimed at assessing time to increase WHO clinical stage and associated factors. Method: Retrospective cohort study was used and the required sample size was 464. Study participants were selected randomly from the list of adult people living with HIV attending the public health facilities for ART. Univariate analysis was used to describe patients’ baseline and follow up characteristics. Kaplan-Meier survival and log rank test were used to estimate survival and compare survival curves respectively. Cox proportional-hazard regression model was used to calculate hazard rate and to determine independent predictors of time to increase WHO clinical stage. Result: A total of 464 patients (232 in each cohort) contribute for 898.12 person years of follow up. The overall incidence rate of increased WHO clinical stage was 16.6 per 100 person years of follow up and the incidence of increased WHO clinical stage was 38.5 per 100 person year and 3.8 per 100 person year of follow up in ART and HAART cohorts respectively. Being on Highly Active Antiretroviral Therapy and taking prophylaxis at baseline were the identified predictors’ that prevent increment of WHO clinical stage. In contrary being widowed and single marital status, substance use, rural residence and being in age category 45 years and above were independent predictors for increment of WHO clinical stage. Conclusion: Increment of WHO clinical stage was higher in pre ART cohorts. Special consideration should be given for those who are widowed, substance users and aged 45 years and above.
Abstract: Background: Highly Active Antiretroviral Therapy improves time to death and recurrence of any opportunistic infections in peoples living with HIV. But little is known about its effect on time to increase WHO clinical stage. Thus, this study was aimed at assessing time to increase WHO clinical stage and associated factors. Method: Retrospective coho...
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Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents
Roman S. Tarasov,
Vladimir I. Ganyukov,
Alexey V. Protopopov,
Olga L. Barbarash,
Leonid S. Barbarash
Issue:
Volume 3, Issue 5, September 2014
Pages:
125-129
Received:
6 August 2014
Accepted:
23 August 2014
Published:
30 August 2014
Abstract: Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Methods: Six-month outcomes of 89 consecutive patients with STEMI and multivessel coronary artery disease (CAD) (SYNTAX 18.6±7.9 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity; Medtronic) were studied. We used two strategies of multivessel stenting: in primary PCI (MS primary, n=46) (the IRA was opened followed by dilatation of other significantly narrowed arteries during the same procedure) and multivessel stenting in staged revascularisation (MS staged, n=43) (the IRA only was treated during the primary intervention while the complete revascularization was planned in a second procedure (8.5±4.2 days)) in our prospective randomized study. Results: During follow-up of 6 months there was no cardiac death in overall group. We observed 1 (2.3%) non-cardiac death in MS staged group vs 0 in MS primary (p=0.9), 0 non-fatal myocardial infarction (MI) in MS staged group vs 3 (6.5%) in MS primary (p=0.3) due to definite stent thromboses (ST) (2.5% on the number of stents). There was no target vessel revascularization (TVR) in MS staged group, but it was performed in 2 cases (4.3%) in MS primary group (p=0.5). Major adverse cardiac event (MACE) (cardiac death, MI, TVR) was diagnosed in 2.3% and 6.5% in MS staged and MS primary group (p=0.7). Conclusions: second generation DES in STEMI patients with multivessel CAD are satisfactory safely and effectively as part of the strategy of multivessel stenting in primary PCI and multivessel staged PCI (8.5±4.2 days). Multivessel stenting in primary PCI was associated with higher risk of stent thrombosis (ST) compared with multivessel staged PCI in six month follow-up period.
Abstract: Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Method...
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Curative Effect of Botulinum Toxin-A Injection in Myopia Treatment: Two Case Reports
Issue:
Volume 3, Issue 5, September 2014
Pages:
130-131
Received:
11 August 2014
Accepted:
26 August 2014
Published:
10 September 2014
Abstract: Purpose: To study the curative effect of botulinum toxin-A injection in myopia treatment and whether this method can promote the vision of the patients with myopia. Methods: The left visual acuity of a 37 years old woman was improved from 0.5 to 0.8 after cosmetic injection in July 2011. Another 9 years old girl with pseudomyopia was treated by bilateral ciliary injection in September 2012, and the doses were 2.5IU respectively. Results: The woman was true myopia, and her left visual acuity was lasting at 0.8 for 5 months. The left visual acuity of the girl was enhanced from 0.6 to 0.8, and the right was improved from 0.7 to 1.0. And the improvement is for more than 18 months. Conclusions: BTX-A injection can relax the ciliary muscle tension and promote the myopic vision, especially in pseudomyopia patients.
Abstract: Purpose: To study the curative effect of botulinum toxin-A injection in myopia treatment and whether this method can promote the vision of the patients with myopia. Methods: The left visual acuity of a 37 years old woman was improved from 0.5 to 0.8 after cosmetic injection in July 2011. Another 9 years old girl with pseudomyopia was treated by bil...
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Anesthetic Considerations of Conn Syndrome: A Case Presentation and Mini-Review the Anesthesiologist and Conn Syndrome
Arber Jano,
Rudin Domi,
Leart Berdica,
Hektor Sula,
Ilir Ohri
Issue:
Volume 3, Issue 5, September 2014
Pages:
132-135
Received:
11 August 2014
Accepted:
25 August 2014
Published:
10 September 2014
Abstract: Conn syndrome is characterized by increased secretion of aldosterone. Hyperaldosteronism induces sodium and water retention, hypertension, decreased potassium blood level, muscle weakness, and fatigue. The diagnosis is usually confirmed by decreased renin level, increased aldosteron level, hypokalemia, and imagining tools. Perioperative care consists on blood pressure and hypervolemia control, spironolactone administration, and preoperative potassium correction. We present a case scheduled for left adrenalectomy for Conn syndrome, 5 years after the right adrenalectomy was performed. The surgery and postoperative period were uneventful and the patient was discharged in 6-th postoperative day referring to the endocrinologist. A good cooperation between the anesthesiologist, endocrinologist, and surgeon is strongly recommended.
Abstract: Conn syndrome is characterized by increased secretion of aldosterone. Hyperaldosteronism induces sodium and water retention, hypertension, decreased potassium blood level, muscle weakness, and fatigue. The diagnosis is usually confirmed by decreased renin level, increased aldosteron level, hypokalemia, and imagining tools. Perioperative care consis...
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Comparison of the Therapeutic Effects of Two Recombinant Erythropoietin Beta, Biosimilar and Reference Formulations in Patients with Chronic Kidney Disease under Hemodialysis
Maria del Carmen Popoca-Martínez,
Julio Flores-Garnica,
Odette Díaz-Avendaño,
Emmanuel Canales-Vázquez,
Raúl Meixueiro-Montes De Oca
Issue:
Volume 3, Issue 5, September 2014
Pages:
136-141
Received:
21 August 2014
Accepted:
3 September 2014
Published:
20 September 2014
Abstract: Anemia is common in patients with chronic kidney diseases under hemodialysis and it’s managed with recombinant erythropoietin formulation. The objective of the study is to compare the safety and efficacy of two recombinant erythropoietin formulations in patients undergoing hemodialysis with chronic kidney diseases. In this randomized, controlled, prospective, parallel open study 70 patients were treated for 24 weeks with either reference β recombinant erythropoietin (100 IU/kg) or biosimilar β recombinant erythropoietin (100 IU/kg). The primary efficacy endpoint was the hemoglobin and hematocrit levels from baseline to 24 week of treatment. The secondary endpoints were safety, weekly doses of both erythropoietins required to maintain hemoglobin levels and immunogenicity. There was no significant difference between the two preparations in terms of hemoglobin and hematocrit levels achieved. The weekly doses of both erythropoietins required to maintain hemoglobin levels were the same in both groups. The frequency of adverse events was similar in the two groups of treatment. Two patients of the reference erythropoietin group developed anti-erythropoietin antibodies. The biosimilar erythropoietin was comparable since the safety and efficacy point of view with the innovator erythropoietin in hemodialysis patients based on hemoglobin changes. The biosimilar erythropoietin when administered subcutaneously will be equally efficacious and may be interchangeable as therapy.
Abstract: Anemia is common in patients with chronic kidney diseases under hemodialysis and it’s managed with recombinant erythropoietin formulation. The objective of the study is to compare the safety and efficacy of two recombinant erythropoietin formulations in patients undergoing hemodialysis with chronic kidney diseases. In this randomized, controlled, p...
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A Novel Streptomycin and Spectinomycin Resistance Gene Cassette Occurence in E. cloacae isolated from Zhenjiang
Issue:
Volume 3, Issue 5, September 2014
Pages:
142-144
Received:
11 August 2014
Accepted:
5 September 2014
Published:
20 September 2014
Abstract: The aadA genes, encoding resistance to streptomycin and spectinomycin, have been found as gene cassettes in different gram-negative and gram-positive bacterial species. The present report has revealed that the sequence of a new gene, aadA5, combining with the trimethoprim resistance gene dfr17 occured in a class 1integron. The integron was identified in a nosocomial pathogen Enterobacter cloacae isolates, which indicated that integrons are specialized genetic elements that were capable of capturing, integrating and mobilizing gene-cassette by site-specific recombination and integron was a dangerous factor to lead to bacterial resistance.
Abstract: The aadA genes, encoding resistance to streptomycin and spectinomycin, have been found as gene cassettes in different gram-negative and gram-positive bacterial species. The present report has revealed that the sequence of a new gene, aadA5, combining with the trimethoprim resistance gene dfr17 occured in a class 1integron. The integron was identifi...
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Effects of Capsaicin on Coagulation: Will this be the New Blood Thinner
Jolayemi Adebayo Taiwo Ezekiel,
Ojewole John Akanni Oluwole
Issue:
Volume 3, Issue 5, September 2014
Pages:
145-149
Received:
7 September 2014
Accepted:
18 September 2014
Published:
30 September 2014
Abstract: Background: The effect of capsaicin (the active ingredient in Capsicum frutescensLinn. [Solanaceae] on coagulationwas reported in several studies. Current research is being directed at elucidating if capsaicin has any effect on coagulation. Objectives: To investigate if either the ethyl acetate extract of Capsicum frutescensLinn. [Solanaceae] (CFE) or capsaicin (FlukaBiotechnika-CPF) on coagulation. Methodss: The effects of ethyl acetate extract of Capsicum frutescensLinn. [Solanaceae] (CFE) and capsaicin (FlukaBiotechnika-CPF) was examined on rat hind paw Ten animals in each of three treatment groups received 2.5, 5.0, 10 mg/kg (i.p.) capsaicin respectively. Data obtained were pooled and analysed using repeated ANOVA, in a general linear model with the CPSS software. Results: Compared to the control group, the mean INR was statistically significant (P<0.05). Conclusion: Taken together, the use of capsaicin at therapeutic doses (2.5-10.0 mg/kg) may reduce thromboembolism without any clinically relevant alteration in platelets.
Abstract: Background: The effect of capsaicin (the active ingredient in Capsicum frutescensLinn. [Solanaceae] on coagulationwas reported in several studies. Current research is being directed at elucidating if capsaicin has any effect on coagulation. Objectives: To investigate if either the ethyl acetate extract of Capsicum frutescensLinn. [Solanaceae] (CFE)...
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Late Twiddler’s Syndrome in a Nigerian on a Demand Pacemaker
Adamu Gati Umar,
Ibok Idongesit Okon,
Abdullahi Aishatu,
George Alaba Okuku
Issue:
Volume 3, Issue 5, September 2014
Pages:
150-152
Received:
28 August 2014
Accepted:
15 September 2014
Published:
30 September 2014
Abstract: A 75 year old woman with unipolar ventricular pacemaker presented with cough, difficulty breathing and dizziness. An initial electrocardiogram (ECG) showed atrial fibrillation, incomplete right bundle branch block with no pacemaker spikes. The chest radiograph revealed twisting of the leads at various points. She was managed conservatively with anti-failure drugs and monthly ECG. The pacemaker could not be interrogated due to logistic reasons. However, the ECG during the 8th month of follow-up showed pacemaker spikes and complete left bundle branch block pattern suggestive of spontaneous return of pacemaker function.
Abstract: A 75 year old woman with unipolar ventricular pacemaker presented with cough, difficulty breathing and dizziness. An initial electrocardiogram (ECG) showed atrial fibrillation, incomplete right bundle branch block with no pacemaker spikes. The chest radiograph revealed twisting of the leads at various points. She was managed conservatively with ant...
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Complementary and Alternative Medicine Use among HIV-Infected Patient’s on Anti-Retroviral Therapy in the Niger Delta Region, Nigeria
Alphonsus Udo Idung,
Festus Abasiubong
Issue:
Volume 3, Issue 5, September 2014
Pages:
153-158
Received:
1 September 2014
Accepted:
22 September 2014
Published:
30 September 2014
Abstract: Background: Since the first case of HIV/AIDS was reported in Nigeria in 1986, HIV/AIDS has continued to penetrate the fabrics of all sectors of the Nigerian population. The plight of HIV/AIDS patients in Nigeria is made worse by inadequate supply of anti-retroviral (ARV) drugs. Methods: A prospective study was done between April and October 2013. Using a systematic sampling technique, 290 adult consenting male and female HIV/AIDS patients aged between 18 and 69 years who were on ARV drugs were recruited. They were assessed for use of complementary and alternative medicine (CAM) along with ARV drugs. Two research assistants assisted in data collection in a rural hospital using a semi-structured questionnaire. Results: Of the 290 subjects recruited, 259 (89.3%) had their data analyzed, while data for 31 (10.7%) subjects were discarded due to incomplete information. Subjects consisted of 101(39.0%) males and 158(61.0%) females. Of the 101 males 50(19.3%) used CAM; compared to 100(38.6%) females who also used CAM (p= 0.028). The mean age of CAM users was 34.39 (sd=10-62) years. Subjects between 29 and 49 years constituted the largest number of HIV- infected respondents who also used CAM. Subjects in the low income cadre patronized CAM more than those in the middle or higher income cadre (p=0.004). Herbal products were the most preferred CAM used by subjects in this study (31.7%); and was followed by faith and prayer healing (14.7%). Five (1.9%) subjects drank urine as a form of therapy. Most subjects in this study preferred CAM because of the naturalness of their source and also because of concern that ARV drugs alone may not effectively manage their HIV/AIDS infection. Conclusions: CAM use is high among HIV/AIDS patients on ARV drugs in the Niger Delta region of Nigeria. Because of the possible risks of interactions following the concurrent use of CAM and ARV drugs, care givers involved in the care of HIV/AIDS patients should be vigilant in this regard.
Abstract: Background: Since the first case of HIV/AIDS was reported in Nigeria in 1986, HIV/AIDS has continued to penetrate the fabrics of all sectors of the Nigerian population. The plight of HIV/AIDS patients in Nigeria is made worse by inadequate supply of anti-retroviral (ARV) drugs. Methods: A prospective study was done between April and October 2013. U...
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Medical Problems in the Honeymoon in Newly Married Couples: An Overview
Raeef Ahmad Qutob,
Mutlak Abdullah Al Malky,
Khalid Mohammad Al Aboud
Issue:
Volume 3, Issue 5, September 2014
Pages:
159-161
Received:
4 September 2014
Accepted:
30 September 2014
Published:
10 October 2014
Abstract: This is an overview on the medical problems, which might occur in the honeymoon period. The medical problems include several uncommon conditions .The most discussed ones in the medical literature are honeymoon cystitis and vaginismus .Future couples are also prone to skin diseases from overuse of cosmetics before wedding. A particular attention, in our paper, is given to the potential sexual injuries which may occur to the couples in this period together with a discussion on how to decrease their occurrence.
Abstract: This is an overview on the medical problems, which might occur in the honeymoon period. The medical problems include several uncommon conditions .The most discussed ones in the medical literature are honeymoon cystitis and vaginismus .Future couples are also prone to skin diseases from overuse of cosmetics before wedding. A particular attention, in...
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