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The Effect of Lipid-Based Nutrient Supplements Containing Vitamins and Minerals on Renal Excretion of Electrolytes and Tenofovir Concentrations in Blood among Zambian HIV/AIDs Patients
No full textBackground: Advanced HIV-infection combined with under-nutrition and anti-retroviral therapy (ART) places patients at high risk of electrolyte abnormalities and/or losses as well as increased mortality. Aims: This study evaluated if nutritional supplements would help curtail renal electrolyte loss and determined tenofovir blood concentrations in HIV/AIDS patients. Methods: 130 malnourished HIV-positive patients were enrolled in a sub-study embedded in the „Nutritional Support for African Adults Starting ART (NUSTRAT) trial. Inclusion criteria were, ART-naive, body mass index (BMI) 6.4%); FEK was significantly lowered in the LNS-VM group (6.2 ± 3.4%); p 18.5 kg/m2 (n=41) categories at 12 weeks of ART showed that patients with lower BMI had significantly elevated blood tenofovir concentrations than those with higher BMI (253.7±95.7 ng/mL; 95% CI 224.1-282.3 versus 166.2±85.9 ng/mL; 95% CI 136.7-195.7, p<0.001). Conclusions: The LNS-VM regimen appeared to offer protection against phosphate and potassium loss. This offers potential opportunities to improve care and support of poorly nourished HIV-infected patients. Malnourished HIV/AIDS patients attained a relatively higher blood tenofovir concentration that was inversely correlated with their BMI. High drug concentrations may predispose patients to drug-related adverse events
Quality analysis of some first-line HIV/AIDS medicines dispensed in Lusaka District Health facilities of Zambia
Get PDFIn the last few years governments around the world have pledged to massively scale up the
delivery of antiretroviral drugs (ARVs) to achieve universal access for all. However, recent reports of generic medicines including ARVs containing little or no active pharmaceutical ingredients are disturbing.In Zambia anecdotal data show that there is an increase in morbidity and mortality in people living with HIV/AIDS due to ARV drug resistance, treatment failure and adverse drug reactions.For instance, a physician at the University Teaching Hospital (UTH) reported that his eight
patients did not respond to any combination after developing resistance to first-line ARVs(Geloo 2005). It is a well known fact that poor drug quality can contribute to poor treatment outcomes of the patient. In Zambia there is currently insufficient publicly available data describing the ARV drug quality in terms of active pharmaceutical ingredients (API), and
labeling standards according to official monographs. The purpose of this study was to determine the quality of some first-line HIV/AIDS medicines dispensed in health facilities and to assess the proportion of substandard ARVs in Lusaka District.
A Cross Section Survey was conducted in nine health facilities of Lusaka District, using
convenience sampling technique. A few ARV drug samples were selected randomly from the
nine facilities. Eleven sample units were analyzed. Each sample unit was sealed in a tin of either 30 or 60 tablets. The tablets were removed from their original containers and number coded before taken for analysis after recording the names, strengths, batch numbers and expiry dates. The quality analysis of (1) Stavudine (d4T)/Lamivudine (3TC)/Nevirapine (NVP), (2) Lamivudine (3TC)/Zidovudine (AZT), (3) Nevirapine (NVP), (4) Efavirenz (EFV) and (5)
Stavudine (d4T)/Lamivudine (3TC) was carried out using the protocol adapted from German
Pharm Health Fund (GPHF-minilab) that employs Thin Layer Chromatography (TLC)
techniques at Tejay Pharmaceutical Laboratories in Lusaka, Zambia. A total of eleven drug samples were assayed and analyzed.The analytical tests that were performed included: the identification of the API, measurement of the percentage content of API in the samples and assessment of packaging material according to
prescribed monographs.The findings of the study indicated that:- In all the samples assayed, API was identified as per label claim on the container.- One (3A) of the eleven samples was found to contain less than 80% API content. Sample 3A had Nevirapine percentage content less than the recommended 80-100%.- Samples 1B and 1C did not comply with the labeling requirements on the package according to the Statutory Instrument No. 47 of 1993. They did not reflect medicine category on the package.
- All the eleven samples complied with labeling information on the inserts as per standard.The meaning of the results is that over 94% of the first-line HIV/AIDS medicines sampled contained the API in the right amounts as per label claim on the packages and that on average over 90% of these drugs were correctly labeled in accordance with the Statutory Instrument No.
47 of 1993 of PRA, Ministry of Health in Zambia.Finally, from the study it can be concluded that first-line HIV/AIDS medicines dispensed in Lusaka District of Zambia are of good quality and meet the requirements as stipulated in the official monographs
The effects of lipid-based nutrient supplements containing vitamins and minerals on renal excretion of electrolyte and tenofovir concentrations in blood among Zambian HIV/AIDS patients
Get PDFPHD IN PHILOSOPHY IN PHARMACOLOGY AND CLINICAL NUTRITIONThe Effect of Lipid-Based Nutrient Supplements Containing Vitamins and Minerals on Renal Excretion of Electrolytes and Tenofovir Concentrations in Blood among Zambian HIV/AIDS Patients by Derick Munkombwe
Background: Advanced HIV-infection combined with under-nutrition and anti-retroviral therapy (ART) places patients at high risk of electrolyte abnormalities and/or losses as well as increased mortality. Aims: This study evaluated if nutritional supplements would help curtail renal electrolyte loss and determined tenofovir blood concentrations in HIV/AIDS patients. Methods: 130 malnourished HIV-positive patients were enrolled in a sub-study embedded in the „Nutritional Support for African Adults Starting ART (NUSTRAT) trial. Inclusion criteria were, ART-naive, body mass index (BMI) 6.4%); FEK was significantly lowered in the LNS-VM group (6.2 ± 3.4%); p 18.5 kg/m2 (n=41) categories at 12 weeks of ART showed that patients with lower BMI had significantly elevated blood tenofovir concentrations than those with higher BMI (253.7±95.7 ng/mL; 95% CI 224.1-282.3 versus 166.2±85.9 ng/mL; 95% CI 136.7-195.7, p<0.001). Conclusions: The LNS-VM regimen appeared to offer protection against phosphate and potassium loss. This offers potential opportunities to improve care and support of poorly nourished HIV-infected patients. Malnourished HIV/AIDS patients attained a relatively higher blood tenofovir concentration that was inversely correlated with their BMI. High drug concentrations may predispose patients to drug-related adverse events
The effects of lipid-based nutrient supplements containing vitamins and minerals on renal excretion of electrolyte and tenofovir concentrations in blood among Zambian HIV/AIDS patients
No full textPHD IN PHILOSOPHY IN PHARMACOLOGY AND CLINICAL NUTRITIONThe Effect of Lipid-Based Nutrient Supplements Containing Vitamins and Minerals on Renal Excretion of Electrolytes and Tenofovir Concentrations in Blood among Zambian HIV/AIDS Patients by Derick Munkombwe
Background: Advanced HIV-infection combined with under-nutrition and anti-retroviral therapy (ART) places patients at high risk of electrolyte abnormalities and/or losses as well as increased mortality. Aims: This study evaluated if nutritional supplements would help curtail renal electrolyte loss and determined tenofovir blood concentrations in HIV/AIDS patients. Methods: 130 malnourished HIV-positive patients were enrolled in a sub-study embedded in the „Nutritional Support for African Adults Starting ART (NUSTRAT) trial. Inclusion criteria were, ART-naive, body mass index (BMI) 6.4%); FEK was significantly lowered in the LNS-VM group (6.2 ± 3.4%); p 18.5 kg/m2 (n=41) categories at 12 weeks of ART showed that patients with lower BMI had significantly elevated blood tenofovir concentrations than those with higher BMI (253.7±95.7 ng/mL; 95% CI 224.1-282.3 versus 166.2±85.9 ng/mL; 95% CI 136.7-195.7, p<0.001). Conclusions: The LNS-VM regimen appeared to offer protection against phosphate and potassium loss. This offers potential opportunities to improve care and support of poorly nourished HIV-infected patients. Malnourished HIV/AIDS patients attained a relatively higher blood tenofovir concentration that was inversely correlated with their BMI. High drug concentrations may predispose patients to drug-related adverse events
Quality analysis of some first-line HIV/AIDS medicines dispensed in Lusaka District Health facilities of Zambia
No full textIn the last few years governments around the world have pledged to massively scale up the
delivery of antiretroviral drugs (ARVs) to achieve universal access for all. However, recent reports of generic medicines including ARVs containing little or no active pharmaceutical ingredients are disturbing.In Zambia anecdotal data show that there is an increase in morbidity and mortality in people living with HIV/AIDS due to ARV drug resistance, treatment failure and adverse drug reactions.For instance, a physician at the University Teaching Hospital (UTH) reported that his eight
patients did not respond to any combination after developing resistance to first-line ARVs(Geloo 2005). It is a well known fact that poor drug quality can contribute to poor treatment outcomes of the patient. In Zambia there is currently insufficient publicly available data describing the ARV drug quality in terms of active pharmaceutical ingredients (API), and
labeling standards according to official monographs. The purpose of this study was to determine the quality of some first-line HIV/AIDS medicines dispensed in health facilities and to assess the proportion of substandard ARVs in Lusaka District.
A Cross Section Survey was conducted in nine health facilities of Lusaka District, using
convenience sampling technique. A few ARV drug samples were selected randomly from the
nine facilities. Eleven sample units were analyzed. Each sample unit was sealed in a tin of either 30 or 60 tablets. The tablets were removed from their original containers and number coded before taken for analysis after recording the names, strengths, batch numbers and expiry dates. The quality analysis of (1) Stavudine (d4T)/Lamivudine (3TC)/Nevirapine (NVP), (2) Lamivudine (3TC)/Zidovudine (AZT), (3) Nevirapine (NVP), (4) Efavirenz (EFV) and (5)
Stavudine (d4T)/Lamivudine (3TC) was carried out using the protocol adapted from German
Pharm Health Fund (GPHF-minilab) that employs Thin Layer Chromatography (TLC)
techniques at Tejay Pharmaceutical Laboratories in Lusaka, Zambia. A total of eleven drug samples were assayed and analyzed.The analytical tests that were performed included: the identification of the API, measurement of the percentage content of API in the samples and assessment of packaging material according to
prescribed monographs.The findings of the study indicated that:- In all the samples assayed, API was identified as per label claim on the container.- One (3A) of the eleven samples was found to contain less than 80% API content. Sample 3A had Nevirapine percentage content less than the recommended 80-100%.- Samples 1B and 1C did not comply with the labeling requirements on the package according to the Statutory Instrument No. 47 of 1993. They did not reflect medicine category on the package.
- All the eleven samples complied with labeling information on the inserts as per standard.The meaning of the results is that over 94% of the first-line HIV/AIDS medicines sampled contained the API in the right amounts as per label claim on the packages and that on average over 90% of these drugs were correctly labeled in accordance with the Statutory Instrument No.
47 of 1993 of PRA, Ministry of Health in Zambia.Finally, from the study it can be concluded that first-line HIV/AIDS medicines dispensed in Lusaka District of Zambia are of good quality and meet the requirements as stipulated in the official monographs
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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