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HCV among Male Injection Drug Users and their Female Partners in Almaty, Kazakhstan: Implications for HCV Treatment and Prevention
No full textHCV infection is a serious concern among people who inject drugs. Despite imposing a major disease burden in countries with high rates of injection drug use such as Kazakhstan, other Central Asian and East Asian countries, Eastern Europe, and Russia, HCV remains an understudied issue. This study includes 728 individuals (364 couples) from Almaty, Kazakhstan, where at least one member of the dyad reported recent injection drug use. Participants were recruited to participate in a couple-based HIV prevention study. We examine the prevalence of HCV and co-infections between HCV and HIV, correlates of HCV, and the association between HCV prevalence and sexual behaviors after adjusting for non-injection illicit drug use, unsafe injection behaviors, and socio-demographic characteristics. Of the total sample, 90.2% of people who had ever injected drugs were diagnosed HCV positive and 15.5% of those who did not report injecting drugs were HCV positive. The prevalence of HIV and HCV co-infection among the total sample was 20.7%. In the multivariate analysis, having sex while high on alcohol and/or drugs was associated with HCV after adjusting for unsafe injection practices, non-injection drug use, and socio-demographic characteristics (PR=1.20; 95% CI=1.04, 1.39). The high rates of HCV and co-infection of HIV and HCV found in the study underscore the need for attention to HCV testing and treatment among people who inject drugs in Kazakhstan and their sex partners.Keywords: HCV, Injection drug use, Central Asia, HIV, Kazakhstan
Two Novel 7-(9-decenyl)-2,3-dihydro-1,2,4-Triazolo[3,4-b][1,3,4]Thiadiazepine Derivatives: Synthesis, Stereochemistry, Cytotoxic and Antimicrobial Activities
No full textThe synthesis of two novel triazolo-thiadiazepine derivatives namely, 2-(4-chlorophenyl)-4-[2-(4-chlorophenyl)ethenyl]—7-(9-decenyl)-2,3-dihydro-1,2,4- triazolo [3,4-b] [1,3,4] thiadiazepine (4) and 2,4-bis (4-chlorophenyl)-7-(9-decenyl)-2,3-dihydro-1,2,4-triazolo[3,4-b][1,3,4]thiadiazepine (7) from 3-(9-decenyl)-4-amino-5-mercapto-1,2,4-triazole (1) using 1,5-bis(4-chlorophenyl)pent-1,4-dien-3-one (2) in the former and 4,4’-dichlorochalcone (5) in the latter is described. The respective uncyclized products, 1,5-bis(4-chlorophenyl)-5-[3-(9-decenyl)-4-amino-5-thio-1,2,4-triazolyl]pent-1-en-3-one (3) and 1,3-bis(4-chloro-phenyl)-3-[3-(9-decenyl)-4-amino-5-thio-1,2,4-trizolyl]propan-1-one (6) are also obtained in low yields. The reaction of (1) with 1,3-bis(2-thienyl)propen-1-one (8) afforded the uncyclized compound, 1,3-bis(2-thienyl)-3-[3-(9-decenyl)-4-amino-5-thio-1,2,4-triazolyl]prpan-1-one (9) as the sole product. Structural assignment, stereochemistry and biological assays are discusse
The Effects of Hypericum Extract on Blood Factors in Diabetic Rats
No full textDiabetes mellitus comprises a heterogeneous group of metabolic diseases characterized by chronic hyperglycemia and impaired metabolism of carbohydrates, lipids and proteins caused by defects in insulin secretion or function. It is said to be the sixth factor of mortality and its complications, if untreated, include: atherosclerosis, nephropathy, neuropathy, foot ulcers, disability and death. To treat diabetes either insulin is administrated or some chemicals that lower blood sugar levels are prescribed. However, due to their various complications, the use of medicinal herbs has been increasingly taken into consideration. In this study, the effects of Hypericum extract on blood parameters in diabetic rats-male Wistar rats-were studied.Methods: In this study, male rats (n =36) were randomly divided into six groups: control, 21 day treated control, 28 day treated control, diabetic, 21 day treated diabetic rats, and 28 day treated diabetic rats. To induce diabetes, streptozotocin was used intraperitoneally at a single dose of 60 mg per 1kg body weight. The treated groups were gavaged with the extract at a dose of 60 mg per kg body weight in a period of 3-4 weeks. After this period, blood serum parameters were measured and the data were analyzed using multivariate analyze of varianceResults: The results showed that there is a significant difference between the six groups in parameters FBS, Total P, and Na in blood, and PU, FBSU, KU in urine.Conclusion: The administration of Hypericum extract in the experimental models of diabetes mellitus has improved the biochemical parameters in diabetic rats.Â
Correlation between Nasal Symptoms and Nasal Nitric Oxide at Baseline and while Humming
No full textBackground: Chronic rhinosinusitis (CRS) is important in asthma and chronic cough assessment. An accurate diagnosis of CRS based solely on symptoms and nasal endoscopy can be difficult. Sinus CT-imaging is usually recommended in patients with negative rhinoscopy. Nasal nitric oxide (nNO) levels obtained passively and while humming are decreased in sinusitis due to ostiomeatal complex blockage of paranasal sinus gas exchange by inflamed tissue. A nNO measurement is a potential point-of-care test (POCT) for CRS. The SinoNasal Outcome Test (SNOT-20) is a clinical tool to assess symptoms in CRS.Objective: To evaluate if nNO levels provided objective information about CRS that would correlate with individual elements in the SNOT-20 and 6 additional CRS related symptoms. To examine these 26 symptom parameters for related clusters, and test correlation of the clusters with nNO measurements.Methods: In 180 patients, basal and humming nNO level measurements, and 26 symptoms (SNOT-20 plus 6 added items) were collected. Hierarchical cluster analysis was applied to sort the data into clusters.Results: The 26 questions grouped into 5 different clusters. 2 clusters contained questions that were most disease specific for sinonasal diseases in patients referred for subspecialty asthma and chronic cough evaluation. We demonstrated that nNO levels during humming, and the ratio between humming and basal nNO, correlated best with clusters 2 and 4.Conclusion: Baseline and humming nNO measurements provide objective information about CRS. nNO measurements offers the potential of a POCT for objective assessment of CRS in patients presenting to a pulmonary clinic
An Investigation into the Nature of Emotional Dysregulation in Borderline Personality Disorder
No full textDysregulation of the emotional domain is considered the core disorder in borderline personality disorder (BPD), and a greater intensity of emotional reaction is seen as central to this dysregulation. Empirical data has shown that people with BPD experience negative emotions more intensely than controls, however there is currently little support for the concept of dysregulation across the range of emotional experience. In this study the emotional intensity of negative and positive emotion was compared between a BPD sample (n=24) and non-clinical control group (n=24). Participants completed self-report questionnaires to assess general intensity of emotional experience and rated their reactions to emotionally salient visual stimuli. The results indicated a higher intensity of emotional experience in the BPD sample; however this effect was no longer significant when anxiety was controlled for. Self-reported anxiety about overwhelming emotional reactions was significantly higher in the BPD sample and this difference remained when a measure of current anxiety was controlled for. There was no difference between groups in the rating of visual stimuli for both negative and positive salience. The implications of the results are discussed with reference to the wider literature
Dissemination of a Brief Psychoeducational Intervention for Bipolar Disorder in Community Mental Health Settings
No full textVarious efficacious psychosocial interventions for Bipolar Disorder (BD) share common elements, with psychoeducation being a main component. Recent treatment guidelines for BD recommend psychoeducation, especially when delivered in brief, cost-effective formats. Its format has several implications for the feasibility of its dissemination in the health care system. The Life Goals Program (LGP) is an evidence-based, cost-effective psychoeducational treatment for BD. Despite its demonstrated benefits for patients and the healthcare system, most patients do not have access to this type of treatment. The goal of this study is to examine the dissemination of the LGP and its effectiveness in three community mental health care centers in Quebec, Canada. A sample of 15 healthcare service providers received thorough training in the delivery of the LGP and delivered the treatment to 73 patients with BD. The treatment consisted of six 90-minute sessions described in the treatment manual with session six being repeated with a family member attending. Treatment integrity and clinical effectiveness were assessed with objective measures. The intervention was successfully implemented, with high rates of treatment fidelity and positive impacts on clinical outcomes. Patients demonstrated marked gains in knowledge about BD, increased acceptance of the illness, reductions in depressive symptoms and improvements in medication behaviors. Treatment effect sizes were moderate to large. Results show that the LGP can be successfully implemented in routine mental health settings given the brief format of the intervention, its proven cost effectiveness, and its less extensive training requirements
Is there an Association between Blood Nutrient Levels and Depression? A Systematic Review
No full textThis review presents a summary of the available evidence on the relationship between blood nutrient levels and depression. Sixty relevant articles were identified from database searches of studies published from 1994 to 2013. Studies reviewed demonstrated fair support for an association between blood levels of vitamin D and iron with depression, and limited support for an association between blood levels of omega-3 polyunsaturated fatty acids and zinc with depression. Conflicting results were found for other nutrients of interest such as folate, vitamin B12, magnesium and antioxidants. Five prospective cohort studies reviewed here have demonstrated that for some nutrients (vitamin D, iron, folate, omega-3 fatty acids) low blood nutrient levels precede the development of depression. There is insufficient evidence to establish a causal relationship, and it appears likely that that the relationship between blood nutrient levels and depression is bi-directional. There is also limited evidence to demonstrate that low blood nutrient levels are related to dietary intake. Further research is needed to elucidate whether the associations between blood nutrient levels and depression are related to dietary intake. Randomised controlled trials investigating both nutrient supplementation and specific dietary patterns are needed to provide evidence to support dietary recommendations for the prevention and management of depressive disorders
Prevalence of Coronary Artery Disease in Patients of Rheumatic Heart Disease
No full textBackground: Few studies have focused on the prevalence of CAD in RHD. Coronary angiography should be routinely done in patients of valvular heart disease prior to surgery, especially in patients above 40 years of age. Overlooking CAD can lead to complications and poor results in post-operative period of valvular surgery. Clinical symptoms are common in both CAD and RHD. Indian studies by V. Jacob Jose and Satya N Gupta have studied this aspect in detail and their results are quite different from Western literature.Material & Methods: This study was conducted in all patients of valvular heart disease (RHD) above 40 years of age. Apart from basic investigations and echocardiography, coronary angiogram was done in all patients and were evaluated for presence of CAD (significant ≥ 50% or insignificant). They were also evaluated for SVD/DVD or TVD and risk factors (hypertension, diabetes mellitus, dyslipidemia) and symptoms especially angina were correlated to the presence of CAD.Results: Out of the 100 patients of RHD from Jan 2008- June 2009 at PGIMER, Chandigarh, 38 were males and 62 were females. 12 had significant CAD, while 9 had non-significant CAD. Mean age for significant CAD was 52.58 years. Age distribution was statistically significant in the 51-60 year age group. 66 patients had mitral valve disease, 31 had combined mitral and aortic valve disease, while 3 had predominantly aortic valve disease. Angina was the only symptom which correlated with presence of CAD especially in aortic valve disease group, but p value was non-significant. In risk factor category, only hypertension and total cholesterol were statistically significant with CAD.Conclusion: Prevalence of significant CAD was 12%. 5 patients had SVD, 4 had DVD & 3 had TVD. 2 patients with MS, 4 with MS/MR, 4 with MV+AV and 2 with predominant aortic valve group had significant CAD. Angina was not found to be a useful clinical symptom to predict CAD. Hypertension and total cholesterol were the only risk factors which could be correlated with CAD in RHD group
Safety and Efficacy of Sirolimus-Eluting Stent in Diabetic Patients Compared with Non-Diabetic Patients Undergoing Percutaneous Coronary Intervention
No full textBackground: The research has been shown that the clinical outcomes of diabetic patients undergoing revascularization either coronary artery bypass grafting or percutaneous coronary intervention (PCI) are inferior to that of non-diabetic patients.Objectives: We have carried out the registry to assess the clinical outcomes of the patients with diabetes mellitus (DM) compared to the patients without DM after the PCI with sirolimus-eluting stent.Methods: Indolimus Diabetic registry is a single-centre; single-armed, retrospective registry that enrolled 530 patients who underwent PCI with Indolimus® stent at the Sri Venkateswara Institute of Medical Sciences, Tirupati, India during the study period. The endpoint of the registry was a major adverse cardiac event (MACE) defined as a composite of cardiac death, myocardial infarction (Q-wave and non-Q-wave not clearly attributable to a non-target vessel), target lesion revascularization (TLR) and target vessel revascularization (TVR) and that were observed at 30-days and at 6-monthsfollow-up.Results: Among 530 patients, 169 patients were having DM. It is noteworthy that the patients with DM were more often women (29.6% vs. 18.0%), hypertensive (54.4% vs. 34.1%) and higher incidence of revascularization (4.2% vs. 2.5%). Double vessel disease was more prevalent in diabetic population as compared to non-diabetics (37.9% vs. 24.9%). Total 617 lesions were encountered in 530 patients (202 in diabetic patients and 415 in non-diabetic patients). There was no significant difference observed in the lesion class. There was no statistical significant difference observed for cardiac death (1.8% vs. 1.7%, p=1.00) and MACE (1.8% vs. 1.9%, p=1.00) in diabetic and non-diabetic patients at 30-days follow-up. However, at 6-month follow-up, it has been observed that the occurrence of MACE was higher but not statistically significant in diabetic patients as compared to non-diabetic patients (4.1% vs. 2.5%, p=0.29).Conclusions: In this Indolimus Diabetic registry, MACE rate did not significantly differ between diabetic and non-diabetic population at 30-days and at 6-months follow-up. However, long term follow-up is needed to determine whether a similar safety profile is maintained
Benign Nephrectomies and its Variables along with Vascular Changes in the Renal Artery: A Study from Tertiary Care Centre from South India
No full textNephrectomy remains the standard of care for patients with suspected renal mass despite studies proving that nephrectomy as an independent risk factor for developing chronic renal insufficiency. The indications for nephrectomy depend on the type of disease, extent of renal damage, status of the second kidney and the patient's general condition. The aim of this study is to review the pathological spectrum with vascular changes of total or partial nephrectomy cases for benign renal lesions underwent at our tertiary care referral institute in Bangalore, South India