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1.
Kehinde AO Obaseki FA Cadmus SI Bakare RA 《Journal of the National Medical Association》2005,97(3):394-396
Tuberculosis (TB) is of great public health concern globally, and the impact is most felt in developing countries of Asia and Africa, where 95% of cases and 98% of deaths are attributable to the disease, The disease is poverty-driven and the situation is further worsened by absence of rapid diagnostic tools to facilitate early diagnosis of the illness, thus leading to widespread of the disease. While attention is being focused on the HIV/AIDS pandemic, little is being heard of TB, especially in the areas of laboratory diagnosis despite the fact that the disease is the commonest cause of death in people living with HIV/AIDS. The importance of a diagnostic laboratory in a TB control program cannot be overemphasized. Smear microscopy, which is the cornerstone of World Health Organization (WHO) 'DOTS' strategy for the treatment of TB, has many drawbacks among which is its inability to detect latent infection and the dependency of its sensitivity on a trained and motivated microscopist. Therefore, there is a need for a more reliable, sensitive and rapid diagnostic test to facilitate early diagnosis of cases and prompt initiation of therapy for a TB control program to have a meaningful impact in the community. 相似文献
2.
Jaime Libes MD MPH Oliver Oruko ECN Fatmah Abdallah MBChB MMed Jessie Githanga MBChB MMed James Ndung'u MBChB MMed Joyce Musimbi MBA Festus Njuguna MBChB MMed Kirtika Patel PhD John White BS Jason R. Axt MD MPH James A. O'Neill MD Jr. Martha Shrubsole PhD Ming Li PhD Harold N. Lovvorn MD III 《Pediatric blood & cancer》2015,62(2):252-256
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Priyathama Vellanki Rachel Bean Festus A. Oyedokun Francisco J. Pasquel Dawn Smiley Farnoosh Farrokhi Christopher Newton Limin Peng Guillermo E. Umpierrez 《Diabetes care》2015,38(4):568-574
OBJECTIVE
Clinical guidelines recommend point-of-care glucose testing and the use of supplemental doses of rapid-acting insulin before meals and at bedtime for correction of hyperglycemia. The efficacy and safety of this recommendation, however, have not been tested in the hospital setting.RESEARCH DESIGN AND METHODS
In this open-label, randomized controlled trial, 206 general medicine and surgery patients with type 2 diabetes treated with a basal-bolus regimen were randomized to receive either supplemental insulin (n = 106) at bedtime for blood glucose (BG) >7.8 mmol/L or no supplemental insulin (n = 100) except for BG >19.4 mmol/L. Point-of-care testing was performed before meals, at bedtime, and at 3:00 a.m. The primary outcome was the difference in fasting BG. In addition to the intention-to-treat analysis, an as-treated analysis was performed where the primary outcome was analyzed for only the bedtime BG levels between 7.8 and 19.4 mmol/L.RESULTS
There were no differences in mean fasting BG for the intention-to-treat (8.8 ± 2.4 vs. 8.6 ± 2.2 mmol/L, P = 0.76) and as-treated (8.9 ± 2.4 vs. 8.8 ± 2.4 mmol/L, P = 0.92) analyses. Only 66% of patients in the supplement and 8% in the no supplement groups received bedtime supplemental insulin. Hypoglycemia (BG <3.9 mmol/L) did not differ between groups for either the intention-to-treat (30% vs. 26%, P = 0.50) or the as-treated (4% vs. 8%, P = 0.37) analysis.CONCLUSIONS
The use of insulin supplements for correction of bedtime hyperglycemia was not associated with an improvement in glycemic control. We conclude that routine use of bedtime insulin supplementation is not indicated for management of inpatients with type 2 diabetes. 相似文献5.
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Christine?Njuguna Annoesjka?Swart Marc?Blockman Gary?Maartens Briony?Chisholm Annemie?Stewart Anri?Uys Karen?CohenEmail author 《AIDS research and therapy》2016,13(1):40
Background
Gynaecomastia is associated with exposure to antiretroviral therapy (ART), in particular efavirenz. There is limited data on clinical characteristics of patients with ART-associated gynaecomastia in resource-limited settings and little guidance on the optimal management of this adverse drug reaction (ADR). We describe the clinical characteristics, management and outcomes of gynaecomastia cases reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa.Methods
We identified all gynaecomastia cases in adolescent boys and men on ART reported to the hotline between June 2013 and July 2014. We collected follow up data telephonically at monthly intervals to document clinical management and outcomes.Results
We received 51 reports of gynaecomastia between June 2013 and July 2014; 11% of the 475 patient-specific ADR queries to the hotline. All patients were on efavirenz-based ART. Mean age was 34 years (standard deviation 12) and seven were adolescents. The median onset of gynaecomastia was 15 months after efavirenz initiation (interquartile range 6–42). Gynaecomastia was bilateral in 29 patients (57%) and unilateral in 16 (31%). Serum testosterone was quantified in 25 of 35 patients with follow up data, and was low in 2 (8%). Efavirenz was replaced with an alternative antiretroviral in 29/35 patients (83%) and gynaecomastia improved in 20/29 (69%).Conclusions
Gynaecomastia was a frequently reported ADR in our setting, occurring with prolonged efavirenz exposure. Testosterone was low in the minority of tested cases. Most clinicians elected to switch patients off efavirenz, and gynaecomastia improved in the majority.8.
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Edith U Ebeledike Godwin IC Nwokedi Okechukwu O Ndu Festus BC Okoye Izuchukwu S Ochiogu 《Asian Pacific journal of tropical medicine》2010,3(5):395-398
ObjectiveTo investigate the calcium and phosphorus contents of four domestic animals used as sources of meat in Nigeria.MethodsThe calcium contents of the body parts of the animals were determined using atomic absorption spectrometer. Their phosphorus contents were determined colorimetrically using the molybdenum blue method.ResultsThe calcium and phosphorus contents were significantly higher in the bone samples than in the other animal parts investigated (P<0.05). The calcium contents of all the edible parts were higher in chicken than in the other animals. High calcium and phosphorus contents were detected in the faeces of chicken and goat, and that of cattle and goat, respectively. Low calcium and phosphorus contents were detected in the urine samples. Calcium: phosphorus ratios calculated for the bones of chicken, cattle and goat were satisfactory.ConclusionsIn conclusion, calcium and phosphorus contents of the animal parts vary significantly and their relative contents may be related to the animal's diet. Chicken parts may be the preferred dietary source of these minerals. This study highlights the need for routine investigation of the mineral contents of food, which is necessary for proper nutritional guidelines. 相似文献
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