243 research outputs found
Sustainability Awareness Week 2021: esa New York presents Halima Garrett of Threads of Habit
No full textIn this workshop, master-thrifter and designer, Halima Garrett, will describe the importance and craft of upcycling. She will give advice for identifying materials that can be upcycled and take the audience through a short upcycling tutorial to show how it is done in a way that minimizes waste and maximizes utility and style. Ms. Garrett is the founder of Threads of Habit, a New Jersey-based outlet offering bold, eccentric, and unique vintage pieces.Sustainability is a key component of FIT’s mission and is embedded in the college’s curriculum and operations. During virtual Sustainability Awareness Week, we invite our community to learn about recent innovations from leaders in the industry, FIT students, faculty, staff, and alumni; experience FIT’s efforts to make a positive impact on the earth; and discover new ways to live with a smaller footprint
The traumatic experience and sexual violence in Halima Bashir’s tears of the desert
No full textEl objetivo principal de este trabajo se centra en el análisis de la experiencia traumática de la escritora sudanesa Halima Bashir en su obra autobiográfica Las lágrimas del desierto. A la hora de analizar la obra hemos tenido en cuenta los postulados del trauma para entender la función de la memoria como herramienta a partir de la cual la memoria individual de Halima se convierte en memoria colectiva para los sudaneses oprimidos en Darfur. La obra de Halima, aunque se centra en la experiencia de violación de un individuo, implica un mensaje político y un testimonio histórico de las atrocidades en Darfur.This paper applies trauma theory to Tears of the Desert, an autobiography written by the Sudanese author Halima Bashir. It examines the traumatic experience of the protagonist Halima Bashir who has been raped during Darfur conflict. In applying the aforementioned theory, this paper shows how the traumatic memory of Halima stands as a collective memory for the oppressed Sudanese in Darfur. Halima’s work, although focusing on the rape experience of an individual, implies a political message that many Sudanese were subjected to physical and psychological traumas as they were bearing witness to the conflict in Darfur
A description of the profile of the patients and outcomes of fiber-optic bronchoscopies, performed at a tertiary care hospital in KwaZulu-Natal, South Africa, from January to December 2011.
No full textMaster of Medicine in Internal Medicine. University of KwaZulu-Natal. Durban, 2014.Background
Tuberculosis (TB), pneumonia and human immunodeficiency virus (HIV) were the three leading causes of natural deaths in South Africa in 2013 and 11.9% of all deaths in KwaZulu Natal were attributed to TB. In 2013, there was an estimated 5.26 million people infected with HIV in South Africa. HIV infected individuals have an increased risk of respiratory tract infections including smear negative TB. Lung cancer is the most common type of cancer in the world. However, due to infrequent updates of the cancer registry in South Africa, current prevalence is unknown. Bronchoscopy is a useful tool for the diagnosis of broncho-respiratory pathology.
Aims and Objectives
This study describes the patient profile and outcomes of bronchoscopy in a tertiary centre in KwaZulu Natal in 2011. Specific objectives were to describe bronchoscopy indications, microbiological, cellular and histological findings and prevalence of TB amongst smear negative patients by broncho-alveolar lavage (BAL). In addition, the common types of lung cancer diagnosed on biopsy during bronchoscopy were to be described.
Background
Tuberculosis (TB), pneumonia and human immunodeficiency virus (HIV) were the three leading causes of natural deaths in South Africa in 2013 and 11.9% of all deaths in KwaZulu Natal were attributed to TB. In 2013, there was an estimated 5.26 million people infected with HIV in South Africa. HIV infected individuals have an increased risk of respiratory tract infections including smear negative TB. Lung cancer is the most common type of cancer in the world. However, due to infrequent updates of the cancer registry in South Africa, current prevalence is unknown. Bronchoscopy is a useful tool for the diagnosis of broncho-respiratory pathology.
Aims and Objectives
This study describes the patient profile and outcomes of bronchoscopy in a tertiary centre in KwaZulu Natal in 2011. Specific objectives were to describe bronchoscopy indications, microbiological, cellular and histological findings and prevalence of TB amongst smear negative patients by broncho-alveolar lavage (BAL). In addition, the common types of lung cancer diagnosed on biopsy during bronchoscopy were to be described.
Background
Tuberculosis (TB), pneumonia and human immunodeficiency virus (HIV) were the three leading causes of natural deaths in South Africa in 2013 and 11.9% of all deaths in KwaZulu Natal were attributed to TB. In 2013, there was an estimated 5.26 million people infected with HIV in South Africa. HIV infected individuals have an increased risk of respiratory tract infections including smear negative TB. Lung cancer is the most common type of cancer in the world. However, due to infrequent updates of the cancer registry in South Africa, current prevalence is unknown. Bronchoscopy is a useful tool for the diagnosis of broncho-respiratory pathology.
Aims and Objectives
This study describes the patient profile and outcomes of bronchoscopy in a tertiary centre in KwaZulu Natal in 2011. Specific objectives were to describe bronchoscopy indications, microbiological, cellular and histological findings and prevalence of TB amongst smear negative patients by broncho-alveolar lavage (BAL). In addition, the common types of lung cancer diagnosed on biopsy during bronchoscopy were to be described.
Methods
A retrospective review of consecutive bronchoscopies performed by the pulmonologist at a tertiary hospital in western KwaZulu Natal, between 1 January and 31 December 2011 was performed. A total of 107 patients met the inclusion criteria. Data was collected from clinical records, laboratory and radiology computerised record systems and entered on an Excel workbook using Microsoft Office 2010® software. Data was analysed using Epi-Info Version 3.5.4® and Stata/IC 13.0®. The demographic, bronchoscopy and chest CT scan findings were summarised with descriptive summary measures and expressed as means ± standard deviation (SD) and/or medians with the range and interquartile range for quantitative variables. Percentages, frequencies and proportions were used to describe categorical variables.
Results
The median age of patients was 55 ± 14.4 (Interquartile range (IQR) 43 - 63) years and 68 (63.6%) patients were male. Twenty-eight (26.2%) patients were HIV infected with a median cluster of differentiation 4 count of 254 ±164 (IQR 126 – 366.5) cells per cubic millimetre. Nine patients were on antiretroviral therapy.
The commonest indications for bronchoscopy were investigation of a lung mass (35.8%), non-resolving lower respiratory tract infection (15%) and suspected TB (15%). Microbiological findings on BAL samples included gram positive and negative bacteria (14%) and fungi (20%). TB microscopy, polymerase chain reaction and culture revealed mycobacterium tuberculosis on 22.2% of all BAL samples. Two patients with mycobacterium tuberculosis on BAL samples were HIV infected. The prevalence of TB on smear negative patients was 11.1%. Cytological analysis of BAL samples detected pathology on eight (13.1%) patients and two (3.3%) of these patients had lung cancer. Malignant (52.9%) (squamous cell carcinoma and adenocarcinoma) and benign (11.1%) (pneumonia and interstitial fibrosis) pathology was found on histology. Squamous cell carcinoma (37%) was the commonest lung cancer detected.
Bronchoscopy was helpful in determining broncho-respiratory pathology in 38 (35.5%) patients. The commonest diagnosis was lower respiratory tract infection in 7 of 15 (46.7%) patients referred with diffuse pulmonary infiltrates. Bronchoscopy also assisted with the diagnosis of lung cancer in 20 of 43 (46.5%) patients referred with suspected lung mass. Overall the procedure complication rate was 3.7%.
Conclusion
Bronchoscopy may be a useful tool in diagnosing and decreasing the morbidity associated with respiratory illness in South Africa as the diagnostic yield was greatest for lower respiratory tract infections. Samples collected during BAL had a relatively low diagnostic yield for TB. Prompt referral of smear negative TB suspects is recommended to assist with the microbiological diagnosis of TB and direct therapy thereof.
Cytological examination of BAL samples was associated with a low yield of lung cancer and biopsy samples were more useful for this purpose. SCC was the commonest histological subtype of lung cancer in this cohort. Bronchoscopy was a relatively safe procedure in determining the aetiology of broncho-respiratory pathology
Apoptosis in peripheral blood mononuclear cells of human immunodeficiency virus (HIV) infected patients undergoing highly active antiretroviral therapy.
No full textThesis (M.Med.Sci.)--University of KwaZulu-Natal, 2008.Highly active antiretroviral therapy (HAART) is currently the only treatment that effectively reduces the morbidity and mortality of individuals infected with Human Immunodeficiency Virus-1 (HIV-1). Standard HAART regimens typically comprise 2 nucleoside reverse transcriptase inhibitors and either one non-nucleoside reverse transcriptase inhibitor or a protease inhibitor. These drugs bind to and inhibit the HIV-1 Reverse Transcriptase and Protease enzymes respectively, thereby suppressing viral replication. The nucleoside reverse transcriptase inhibitors promote mitochondrial (mt) dysfunction by strongly inhibiting mt polymerase gamma (Pol-y) and subsequently, mtDNA replication. In contrast, the non-nucleoside reverse transcriptase inhibitors, efavirenz (EFV) and nevirapine (NVP) do not inhibit Pol-y although EFV has been shown to induce mt depolarisation ( mlow) in vitro at supra-therapeutic concentrations. However, the capacity of non-nucleoside reverse transcriptase inhibitor drugs to induce mt toxicity in vivo previously remained undetermined. The objective of this study was to determine the influence of EFV and NVP on peripheral lymphocyte mt transmembrane potential (Avj/m) and apoptosis in HIV-1-infected patients treated with these non-nucleoside reverse transcriptase inhibitors. Thirty-two HIV-1-infected patients on HAART between 4 and 24 months (12 on EFV, 20 on NVP) and 16 HAART-naive HIV-1-infected patients were enrolled into this study. All participants were black South African patients. Spontaneous peripheral lymphocyte apoptosis and mlow were measured ex vivo by flow cytometry for all patients. CD4 T-helper apoptosis for the EFV and NVP cohorts was 19.38% ± 2.62% and 23.35% ± 1.51% (mean ± SEM), respectively, whereas total lymphocyte mlow was 27.25% ± 5.05% and 17.04% ± 2.98%, respectively. Both parameters for each cohort were significantly lower (P < 0.05) than that of the HAART-naive patients. The NVP cohort exhibited both a significant time dependent increase in peripheral lymphocyte ö¿mlow (P = 0.038) and correlation between Thelper apoptosis and low (P = 0.0005). These trends were not observed in the EFV cohort. This study provides evidence that both EFV and NVP induce peripheral lymphocyte ö¿ m low in HIV-1-infected patients on non-nucleoside reverse transcriptase inhibitor-based HAART, which in the case of NVP is sufficient to induce the apoptosis cascade
Halima C. Schmaling, Lawan Bala Hausawa (co-author of Book 1). Maganar Hannu. Harshen Bebaye na ƙasar Hausa/Hausa Sign Language. Liffafi na farko: Iyali/Book 1: Family, Kano: Good Image Printing Ltd., 2011, 28 pp; Littafi na biyu: Haɗuwa da sadarwa/Book 2: Meeting and communicating, Hamburg: Helmut Buske Verlag, 2013, 31 pp; Littafi na uku: Kwatancin mutane da abubuwa/Book 3: Describing people and things, Hamburg: Helmut Buske Verlag, 2016, 35 pp; Littafi na huɗu: Kasuwanci da kiɗaya/Book 4: Commerce and counting, Hamburg: Helmut Buske Verlag 2016, 32 pp; Littafi na biyar: Ayyukan yau da kullum/Book 5: Everyday activities, Hamburg: Helmut Buske Verlag, 2017, 35 pp.
No full textA review of series of books by Halima C. Schmaling, Lawan Bala Hausawa (co-author of Book 1). Maganar Hannu
A Case of Immune Reconstitution Syndrome to Disseminated Histoplasmosis
No full text Histoplasmosis is an uncommon cause of hepatosplenomegaly in South Africa. A case of immune reconstitution syndrome (IRS) to disseminated histoplasmosis in a patient presented to a tertiary hospital in Kwazulu-Natal, South Africa, is described. </jats:p
Risk of Nephrotoxicity in Patients With Drug-Resistant Tuberculosis Treated With Kanamycin/Capreomycin With or Without Concomitant Use of Tenofovir-Containing Antiretroviral Therapy
No full textBackground: The intersection of HIV and drug-resistant (DR) tuberculosis (TB) presents the challenge of managing convergent drug toxicities.
Methods: We conducted a retrospective study of adult patients with DR-TB treated with a kanamycin/capreomycin-based (KM) regimen, with or without concomitant antiretroviral therapy (ART). We estimated the incidence of nephrotoxicity (defined as an increase in serum creatinine greater than 26.5 µmol, or an increase in serum creatinine to 1.5 times the baseline value, or a decline in glomerular filtration rate to less than 60 mL/min/1.73 m), and evaluated the association between reported drug use and nephrotoxicity using Kaplan-Meier plots.
Results: A total of 215 patients with DR-TB were treated with a kanamycin/capreomycin-based regimen, with or without concomitant ART. The incidence rate of nephrotoxicity was 3.6 [95% confidence interval (CI): 1.4 to 7.3], 6.9 (95% CI: 5.2 to 9.0), and 12 (95% CI: 3.3 to 30.9) cases per 100 person-months of follow-up in the KM only group (n = 42), the KM + TDF (tenofovir disoproxil fumarate) group (n = 163), and the KM + Other ART group (n = 10), respectively. Using the KM only group as a reference, the hazard ratio was 2.06 (95% CI: 0.92 to 4.63) in the KM + TDF group, and 4.09 (95% CI: 1.17 to 14.25) in the KM + Other ART group. Advancing age was an independent predictor of nephrotoxicity (adjusted hazard ratio 1.29, 95% CI: 1.14 to 1.46).
Conclusions: Our findings provide evidence of a significant risk of nephrotoxicity during treatment with a kanamycin/capreomycin-based DR-TB regimen, with or without concurrent treatment with ART. This study lends further support to calls for the substitution of TDF during the intensive phase of DR-TB treatment and for close monitoring of renal function during DR-TB treatment, especially in settings where the use of kanamycin/capreomycin is unavoidable
A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis.
No full textThesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.HIV epidemic is one of the major challenges to the South Africa’s socio-economic development. The incidence of tuberculosis is rising in sub-Saharan Africa, and in 2009 South Africa had the second highest incidence of tuberculosis in the world. Approximately 80% of incident tuberculosis cases in South Africa are HIV positive. In HIV positive individual, abdominal tuberculosis has been reported as the most common form of extra-pulmonary tuberculosis. HIV/AIDS has resulted in a resurgence of abdominal tuberculosis in South Africa. Making the diagnosis of abdominal tuberculosis is still difficult, though the condition is common. The role of laparoscopy in making the diagnosis is undefined.
Method:
All patients with clinically and radiologically suspected but histologically or microbiologically unconfirmed abdominal tuberculosis were referred to the investigating team and laparoscopy was performed to diagnose abdominal tuberculosis. Histology was performed on tissue biopsy specimens and TB culture on ascitic fluid and peripheral blood specimens.
Results:
From January 2008 to June 2010 a total of 190 patients were referred to us. No surgical intervention was taken in 60 patients; all of them were HIV positive. Twenty six of them died (43%) in the hospital during the evaluation period before the diagnostic laparoscopy, and the rest (57%) were unfit for anaesthesia. Forty nine patients required emergency laparotomy either for bowel obstruction or peritonitis and 39% of them died. Eighty one patients underwent diagnostic laparoscopy and 77% of them were HIV positive, in 16% the HIV status was unknown. Two percent had clinical ascites. Laparoscopic findings included intra-abdominal lymphadenopathy in 56, minimal ascitic fluid in 46, intra-abdominal mass in 17, and deposits on bowel wall, peritoneum or omentum in 20 patients. Fifty five patients (68%) had positive histology for tuberculosis. In 15 patients (19%) histology revealed non-specific inflammation, no pathology was found in one patient and no specimen was taken from one patient. Eighty percent of peritoneal deposits and 77% of lymph nodes were positive for tuberculosis, whereas 35% ascitic fluid culture was positive. In nine patients (11%) an alternative diagnosis was found (appendicitis, adenocarcinoma, lymphoma).
Conclusion:
Laparoscopy was feasible and showed a high yield to establish the diagnosis of abdominal tuberculosis and to provide an alternate diagnosis. Laparoscopy was useful to establish the gross features of abdominal tuberculosis and to provide the adequate specimens for examinations. Very poor follow negated the evaluation of the clinical response to anti tuberculosis therapy
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