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Predictors of antiretroviral therapy interruptions and factors influencing return to care at the Nkolndongo Health District, Cameroon
Get PDFBackground: Antiretroviral therapy is a lifelong commitment that
requires consistent intake of tablets to optimize health outcomes,
attain and maintain viral suppression. Objective: We aimed to elicit
predictors of treatment interruption amongst PLHIV and identify
motivating factors influencing return to care. Method: We conducted a
cross-sectional study using a mixed-method approach in four hospitals
in Yaound\ue9. Sociodemographic and clinical data were collected from
ART registers. Using purposeful sampling, thirteen participants were
enrolled for interviews. Quantitative data were analyzed using Epi-Info
and Atlas-TI for qualitative analysis. Ethical clearance approved by
CBCHS-IRB. Results: A total of 271 participants records were assessed.
The mean age was 33 years (SD\ub111years). Private facilities CASS
and CMNB registered respectively 53 (19.6%) and 14 (5.2%) participants
while CMA Nkomo and IPC had 114 (42.1%) and 90 (33.2%) participants.
Most participants (75.3%) were females [OR 1.14; CI 0.78-1.66] compare
with males. 78% had no viral load test results. Transport cost and
stigmatization constituted the most prominent predictors of treatment
interruption (47.5%) and (10.5%) respectively. Belief in the discovery
of an eminent HIV cure and the desire to raise offspring motivated 30%
and 61%, respectively to resume treatment. Conclusion: Structural
barriers like exposed health facility, and dispensing ARVs in open
spaces stigmatizes clients and increases odds of attrition. Attrition
of patients on ART will be minimized through implementation of client
centered approaches like multiplying proxy ART pick points, devolving
stable clients to community ARV model
Indian scenario of IgA nephropathy: a systematic review and meta-analysis
Get PDFBackground: IgA nephropathy (IgAN) is most common primary
glomerulopathy. There are variations in prevalence of IgAN and its
clinical features in different studies from India. Aim: To summarize
overall scenario of IgAN in India. Methods: In this systematic review,
studies related to IgAN and related renal disease were included. Data
searched were PubMed, EMBASE, Google scholar, and Cochrane Database
from inception to 31st January 2019 Results: Total 49 studies (N=2480)
were included: 21studies (N=2309) of primary IgAN; 19 studies (N=21) of
Secondary IgAN; four studies (N=133) of IgA vasculitis nephropathy
(IgAVN); and five studies (N=17) of IgA dominant nephropathy (IgADN).
Prevalence of IgAN was 16.5% in India. Age of affected persons was
ranging from 27.2\ub116.7 to 48.6\ub121.3 years . Male female ratio
was 1.8:1. Clinical features of Primary IgAN, IgAVN, IgADN &
Secondary IgAN were microscopic hematuria (49.6%, 44.4%, 15.6% &
59.5%), macroscopic hematuria (5.1%, 0.4%,40.9%,& 35.7%),
Subnephrotic proteinuria (42.1%, 29.4%, 23.2%, & 52.3%), nephrotic
proteinuria (16.0%, 4.4%, 76.8%,& 47.6%), and hypertension
(25.8%,18.3%, 35.5%,& 47.6%).. The 24 hours proteinuria was ranging
from 2.6\ub11.5 to 4.7\ub12.3 gm/day and serum creatinine (mg/dl)
was ranging from 0.9\ub10 to 3.5\ub13.9 mg/dl.
Histolomorphologically, all type of IgAN showed mesangial
hypercellularity and Immunofluorescence revealed IgA deposition..
Conclusion: The overall prevalence of primary IgAN in India was 16.5%.
The subnephrotic proteinuria and microscopic hematuria were common
clinical features
COVID-19: sitting is the new smoking; the role of exercise in augmenting the immune system among the elderly
Get PDFIntroduction: Like smoking, sedentary lifestyle is an issue of great
concern because of its deleterious health challenges and implications.
Given the global spread of the new coronavirus (COVID-19), social
isolation regulations and laws have been implemented in many countries
to contain the spread of the virus and this has caused a drastic shift
from the usual physically demanding life to a sedentary lifestyle
characterized by significantly reduced physical activities and prolong
sitting. Methods/Data Source: Human and nonhuman primate literature was
examined to compare experimental and clinical modulation of
inflammatory cytokines by exercised-induced myokines. Data synthesis:
Experimental and clinical evidence was used to examine whether
exercised-induced myokines can prime the immune system of the elderly
population during the COVID-19 pandemic. Conclusion: The immune system
changes with advancement in age which increases the likelihood of
infectious disease morbidity and mortality in older adults. Several
epidemiological studies have also shown that physical inactivity among
geriatric population impacts negatively on the immune system. Evidences
on the importance of exercise in priming the immune system of elderly
individuals could be an effective therapeutic strategy in combating the
virus as it may well be a case of \u201clet those with the best immune
system win\u201d
Social support as a correlate of depression among people living with HIV and AIDS in Nigeria
Get PDFBackground: Depression is a highly prevalent mental disorder among
PLHIV, whilst social support is important in disease prevention, health
promotion, therapeutic measure especially for PLHIV. Objectives: To
ascertain the different types and sources of social support and their
association with depression among PLHIV in Nigeria. Materials and
Methods: The study was a correlation with 2515 PLHIV in three teaching
hospitals in South-Eastern Nigeria. Data were collected between January
to June, 2019 through interviews, using socio-demographic and Clinical
Form and a Social Support Scale for PLHIV. SPSS-20 used for data
analysis. Results: It was shown that average scores of instrumental and
emotional social supports (IESS) were satisfactory and not influenced
by sex (p = 0.894; p = 0.496), education (p = 0.805; p = 0.182),
marital status (p = 0.076; p = 0.446) and length of antiretroviral
therapy (p = 0.510; p = 0.136). People diagnosed for less than three
years had more instrumental support (p = 0.05) than those diagnosed
over three years. The regression score also revealed a high predictive
power of IESS on depression of PLHIV. Conclusion: PLHIV have
satisfactory social support, especially from family not residing in the
same household and emotional social support from friends. Analyses
identified knowledge gaps in the community regarding the social support
received by PLHIV and their depression symptoms
A novel survival algorithm in COVID-19 intensive care patients: the classification and regression tree (CRT) method
Get PDFBackground/aim: The present study aimed to create a decision tree for
the identification of clinical, laboratory and radiological data of
individuals with COVID-19 diagnosis or suspicion of Covid-19 in the
Intensive Care Units of a Training and Research Hospital of the
Ministry of Health on the European side of the city of Istanbul.
Materials and methods: The present study, which had a retrospective and
sectional design, covered all the 97 patients treated with Covid-19
diagnosis or suspicion of COVID-19 in the intensive care unit between
12 March and 30 April 2020. In all cases who had symptoms admitted to
the COVID-19 clinic, nasal swab samples were taken and thoracic CT was
performed when considered necessary by the physician, radiological
findings were interpreted, clinical and laboratory data were included
to create the decision tree. Results: A total of 61 (21 women, 40 men)
of the cases included in the study died, and 36 were discharged with a
cure from the intensive care process. By using the decision tree
algorithm created in this study, dead cases will be predicted at a rate
of 95%, and those who survive will be predicted at a rate of 81%. The
overall accuracy rate of the model was found at 90%. Conclusions: There
were no differences in terms of gender between dead and live patients.
Those who died were older, had lower MON, MPV, and had higher D-Dimer
values than those who survived
Inflammatory cytokines and sleep parameters response to life style intervention in subjects with obese chronic insomnia syndrome
No full textBackground: Chronic primary insomnia is a prevalent sleep disorder that
is associated with adverse effects on health outcomes. Sleep
disturbance is usually associated with abnormal level of systemic
inflammation biomarkers. Objective: The aim of this study was to detect
changes in sleep quality and inflammatory markers following weight loss
among subjects with chronic primary insomnia. Material and Methods:
Eighty previously sedentary subjects with chronic primary insomnia
subjects enrolled in this study, their age ranged from 32-51 year were
randomly assigned to life style intervention group (group A, n=40) or
control group (group B, n=40). Polysomnographic recordings for sleep
quality assessment, IL-6, IL-10 and TNF-\u3b1 were measured before and
at the end of the study after six months. Results: There was a
significant increase in the total sleep duration, sleep efficiency,
sleep onset latency and IL-10 in addition to significant reduction in
awake time after sleep onset, REM latency, IL-6 and TNF-\u3b1 after 6
months of in group(A) as a result of weight loss program; while the
results of the control group (group B) were not significant. Also,
there were significant differences between both groups at the end of
the study. Conclusion: Life style intervention modulates systemic
inflammatory parameters and sleep quality among subjects with chronic
primary insomnia
Disability management in a public-private health care facility in South Africa: an organisational perspective
No full textBackground: Job retention, long-term absenteeism and medical boarding
pay-outs are significant concerns for employers within the public
health care sector of South Africa. Objective: To describe disability
management policies, procedures and programmes of employees following
impairment and disability in a public-private healthcare facility in
South Africa. Methods: An exploratory qualitative study design was used
with key informants in senior management and nursing managers (n=12)
selected via purposive sampling. Audio-recorded data from
semi-structured interviews and a focus group were thematically analysed
using inductive reasoning. Results: There is poor adherence to
occupational health and disability management policies and the current
referral process is informal with managers using discretion to manage
employees with ill health and acquired disability. The procedures
prescribed in the policy and procedure on incapacity and
ill-health-retirement need to be followed, and an early return to work
programme within the health care facility needs to be implemented.
Conclusions: Despite South Africa having many policies on recruitment
and reasonable accommodations, there is a lack of implementation of
these policies. An integrated disability management policy and
programme encompassing health prevention, early return to work
strategies, vocational rehabilitation and the implementation of
reasonable accommodation is required to ensure that employees who have
acquired disabilities or ill health are successful in the workplace
Summer temperature and all-cause mortality from 2006 to 2015 for Hyderabad, India
No full textBackground: Studies have documented a significant association between
temperature and all-cause mortality for various cities but such data
are unavailable for Hyderabad City. Objective: The objective of this
work was to assess the association between the extreme heat and
all-cause mortality for summer months (March to June) from 2006 to 2015
for Hyderabad city population. Methods: We obtained the data on
temperature and all-cause mortality for at least ten years for summer
months. Descriptive and Bivariate analysis were conducted. Pearson
correlation coefficient was used to study the relationship between heat
and all-cause mortality for lag time effect. Results: A total of
122,117 deaths for 1,220 summer days (2006 to 2015) were analyzed with
mean daily all-cause mortality was 100.1\ub121.5. There is an
increase of 16% and 17% per day mean all-cause mortality at the maximum
temperature of 6540oC and for extreme danger days (Heat Index
>54oC) respectively. The mean daily all-cause mortality shows a
significant association with maximum temperature (P < 0.001) and
Heat Index from caution to extreme danger risk days (P < 0.0183).
The lag effect of extreme heat on all-cause mortality for the study
period (2006 to 2015) was at peak on same day of the maximum
temperature (r = 0.273 at p<0.01). Conclusion: The study concludes
that the impact of ambient heat in the rise of all-cause mortality is
clearly evident (16% mean deaths/day). There was no lag effect from the
effect of extreme heat on all-cause mortality as the peak period was
the same as the maximum temperature. Hence heat action plans are
needed. However, extreme heat-related mortality merits further
analysis
Pore Pressure Prediction of an Oil-Field in Part of the Niger Delta Basin, Nigeria
No full textIn this study, overpressure prediction was carried out for ten oil
wells in a selected oil-field in part of the Niger Delta basin,
Nigeria. The age of key stratigraphic surfaces (9.5Ma-65Ma), depth,
thickness and sedimentation rates from well logs and biostratigraphic
data was used to build pressure models. The generated pressure model
was calibrated using key petrophysical, geochemical and pressure data
until a match was achieved. The model predicts occurrence of localized
under-compaction driven overpressure at about 11.5Ma. From the results,
the onset of overpressure is likely at depths beyond 14,760ft which
corresponds to the 11.5Ma marker shales, while fluid pressures ranging
from 0.53-0.7psi/ft are estimated at 15,744ft and hard overpressures
ranging from 0.7-0.9psi/ft are likely at depths beyond 19,680ft which
corresponds to the 12.8Ma marker shales. This study provides good
prediction on the occurrence of pressure in the deeper prospect
Analysis of Woody Plants Dimensions on the Affected and Restricted Land Management Practices in Sudan Vegetation Zone, Adamawa State, Nigeria
No full textHuman activities have transformed the vegetal environment into affected
and restricted areas with varied woodland dimensions. The aim of the
study is to identify the difference in distributions, heights, girths
and bole lengths of native woody plants on continuous cultivation,
fallow and reserve lands of Hong Local Government Area in 2018. Data on
woody plants distributions, heights, girths and bole lengths were
generated from the field using quadrat samples and measuring tape.
Stratified sampling technique was adopted to cover the study area while
purposively sampling method was adopted to establish the sample
quadrats on the three dissimilar land management practices adopted.
Variance was used to analyze the data while \u2018F\u2019
distribution at 0.05% confidence limit was used to test for the
significance. From the result, there are 181 woody plant stands
observed on the 12 sample plots (1800m2). The woodland distributions
vary from 17, 13 and 1 on fallow, reserve and continuous cultivation
lands on 100m2. The tallest (11.37m) woodlands are on continuous
cultivation land followed by the reserve (10.20m) while the shortest
(2.58m) is on fallow land. The girths vary from 1.89m, 1.03m and 0.23m
on continuous cultivation, reserve and fallow lands respectively. The
stems are 4.34m, 2.53m and 0.80m for reserve, continuous cultivation
and fallow lands. For significant increase in tree distributions
farmers should preserve seedlings during annual clearing and clean
weeding as well adopt longer fallow period. The result implies with
increase in human activities such as arable farming and wood harvesting
lead to decrease in plant distribution and vice versa