1) This study examined hematologic abnormalities in 64 HIV-infected children on highly active antiretroviral therapy (HAART) in Ethiopia.
2) The prevalence of anemia, thrombocytopenia and neutropenia decreased after starting HAART, from 53.1%, 18.8%, and 7.8% to 21.9%, 7.8%, and 4.7% respectively.
3) Mean hemoglobin levels, CD4 count, platelet count, and total leukocyte count increased significantly after HAART initiation.
Scrub typhus manifesting with intracerebral hemorrhage: Case report and revie...Ahmad Ozair
Scrub typhus (ST), hitherto absent from many parts of India, is now recently being recognized as a significant cause of morbidity and mortality throughout the country. Its diverse clinical presentations, low of the index of suspicion by the treating physician, and lack of diagnostic testing in many parts of the country result in delayed treatment, leading to a host of complications. We here report such a complication, where ST manifested with a large intracerebral hemorrhage, of which, to the best of our knowledge, only nine cases have been reported in the English language worldwide. Family physicians, who are the often first point of contact for treatment of febrile illness, as ST typically manifests, need to be aware of this entity to prevent such catastrophic consequences.
study of hematological paremeter in sepsis patients and its prognostic implic...RahulGupta1687
The current study was a cross-sectional study with a sample size of 117 patients with sepsis. Various hematological parameters of all the patients were obtained on day of admission (day 1) and seventh day (day 7) using hemogram reports and the difference of their statistical mean and standard deviation was estimated.
Deep vein thrombosis prophylaxis in a tertiary care center: An observational ...Apollo Hospitals
Deep vein thrombosis (DVT) is a major health problem with substantial mortality and morbidity in medically ill patients. Prevention of DVT by risk factor stratification and subsequent antithrombotic prophylaxis in moderate- to severe-risk category patients is the most rational means of reducing morbidity and mortality.
Scrub typhus manifesting with intracerebral hemorrhage: Case report and revie...Ahmad Ozair
Scrub typhus (ST), hitherto absent from many parts of India, is now recently being recognized as a significant cause of morbidity and mortality throughout the country. Its diverse clinical presentations, low of the index of suspicion by the treating physician, and lack of diagnostic testing in many parts of the country result in delayed treatment, leading to a host of complications. We here report such a complication, where ST manifested with a large intracerebral hemorrhage, of which, to the best of our knowledge, only nine cases have been reported in the English language worldwide. Family physicians, who are the often first point of contact for treatment of febrile illness, as ST typically manifests, need to be aware of this entity to prevent such catastrophic consequences.
study of hematological paremeter in sepsis patients and its prognostic implic...RahulGupta1687
The current study was a cross-sectional study with a sample size of 117 patients with sepsis. Various hematological parameters of all the patients were obtained on day of admission (day 1) and seventh day (day 7) using hemogram reports and the difference of their statistical mean and standard deviation was estimated.
Deep vein thrombosis prophylaxis in a tertiary care center: An observational ...Apollo Hospitals
Deep vein thrombosis (DVT) is a major health problem with substantial mortality and morbidity in medically ill patients. Prevention of DVT by risk factor stratification and subsequent antithrombotic prophylaxis in moderate- to severe-risk category patients is the most rational means of reducing morbidity and mortality.
Management of Peripheral Neuropathy and Cardiovascular Effects in Vitamin B1...PARUL UNIVERSITY
Peripheral nerves are susceptible to damage by a wide array of toxins, medications, and vitamin
deficiencies. Vitamin B12 (VB12) deficiency neuropathy is a rare debilitating disease that affects
mostly the elderly. It is important to consider these etiologies when approaching patients with a variety
of neuropathic presentations in this review were have included most relevant and latest information on
mechanisms causing Peripheral neuropathy in VB12 deficiency. We also have included cardiovascular
disorders and their management. Hyperhomocysteinemia has been implicated in endothelial
dysfunction and cardiovascular disease. The association of homocysteine (Hcy) and VB12 with
cardiovascular risk factors in patients with coronary artery disease (CAD) has also been studied
Clinical Profile and Outcome of Children Admitted with Acute Encephalitis Syn...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Association of the HLA-B alleles with carbamazepine-induced Stevens–Johnson s...UniversitasGadjahMada
Carbamazepine (CBZ) is a common cause of life-threatening cutaneous adverse drug reactions such as Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Previous studies have reported a strong association between the HLA genotype and CBZ-induced SJS/TEN.We investigated the association between the HLA genotype and CBZ-induced SJS/TEN in Javanese and Sundanese patients in Indonesia. Nine unrelated patients with CBZ-induced SJS/TEN and 236 healthy Javanese and Sundanese controls were genotyped for HLA-B and their allele frequencies were compared. The HLA-B*15:02 allele was found in 66.7% of the patients with CBZ-induced SJS/TEN, but only in 29.4% of tolerant control (p = 0.029; odds ratio [OR]: 6.5; 95% CI: 1.2–33.57) and 22.9% of healthy controls (p = 0.0021; OR: 6.78; 95% CI: 1.96– 23.38). These findings support the involvement of HLA-B*15:02 in CBZ-induced SJS/TEN reported in other Asian populations. Interestingly, we also observed the presence of the HLA-B*15:21 allele. HLA-B*15:02 and HLA-B*15:21 are members of the HLA-B75 serotype, for which a greater frequency was observed in CBZ-induced SJS/TEN (vs tolerant control [p = 0.0078; OR: 12; 95% CI: 1.90–75.72] and vs normal control [p = 0.0018; OR: 8.56; 95% CI: 1.83–40]). Our findings suggest that screening for the HLA-B75 serotype can predict the risk of CBZ-induced SJS/TEN more accurately than screening for a specific allele.
Contemporary Management of HIV.How Common Comorbidities Affect ART Management...hivlifeinfo
In this downloadable slideset, expert faculty review key data and offer important guidance on managing HIV treatment in patients with frequently encountered comorbidities, including cardiovascular disease, osteopenia, and HCV coinfection.
Format: Microsoft PowerPoint (.ppt)
File size: 2.27 MB
Date posted: 2/12/2018
Liao2011 phân tích máu cuống rốn để khẳng định chẩn đoán nhanh trước sinh bện...Võ Tá Sơn
CORD BLOOD ANALYSIS FOR RAPID PRENATAL CONFIRMATION OF Hb BART’S DISEASE USING THE SEBIA CAPILLARY ELECTROPHORESIS SYSTEM
Liao2011 phân tích máu cuống rốn để khẳng định chẩn đoán nhanh trước sinh bệnh Hb Bart's bằng cách sử dụng hệ thống điện di mao quản
bs võ tá sơn
bsvotason
bác sĩ võ tá sơn
A Clinical Study: Tumour Necrosis Factor Alpha as a Clinical Marker in Malari...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Eczema simply means “inflamed skin”. Skin can become inflamed for a number of reasons, but the big three reasons are: Contact, Atopic, and Irritant.
This comprehensive overview covers symptoms, treatments.
Management of Peripheral Neuropathy and Cardiovascular Effects in Vitamin B1...PARUL UNIVERSITY
Peripheral nerves are susceptible to damage by a wide array of toxins, medications, and vitamin
deficiencies. Vitamin B12 (VB12) deficiency neuropathy is a rare debilitating disease that affects
mostly the elderly. It is important to consider these etiologies when approaching patients with a variety
of neuropathic presentations in this review were have included most relevant and latest information on
mechanisms causing Peripheral neuropathy in VB12 deficiency. We also have included cardiovascular
disorders and their management. Hyperhomocysteinemia has been implicated in endothelial
dysfunction and cardiovascular disease. The association of homocysteine (Hcy) and VB12 with
cardiovascular risk factors in patients with coronary artery disease (CAD) has also been studied
Clinical Profile and Outcome of Children Admitted with Acute Encephalitis Syn...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Association of the HLA-B alleles with carbamazepine-induced Stevens–Johnson s...UniversitasGadjahMada
Carbamazepine (CBZ) is a common cause of life-threatening cutaneous adverse drug reactions such as Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Previous studies have reported a strong association between the HLA genotype and CBZ-induced SJS/TEN.We investigated the association between the HLA genotype and CBZ-induced SJS/TEN in Javanese and Sundanese patients in Indonesia. Nine unrelated patients with CBZ-induced SJS/TEN and 236 healthy Javanese and Sundanese controls were genotyped for HLA-B and their allele frequencies were compared. The HLA-B*15:02 allele was found in 66.7% of the patients with CBZ-induced SJS/TEN, but only in 29.4% of tolerant control (p = 0.029; odds ratio [OR]: 6.5; 95% CI: 1.2–33.57) and 22.9% of healthy controls (p = 0.0021; OR: 6.78; 95% CI: 1.96– 23.38). These findings support the involvement of HLA-B*15:02 in CBZ-induced SJS/TEN reported in other Asian populations. Interestingly, we also observed the presence of the HLA-B*15:21 allele. HLA-B*15:02 and HLA-B*15:21 are members of the HLA-B75 serotype, for which a greater frequency was observed in CBZ-induced SJS/TEN (vs tolerant control [p = 0.0078; OR: 12; 95% CI: 1.90–75.72] and vs normal control [p = 0.0018; OR: 8.56; 95% CI: 1.83–40]). Our findings suggest that screening for the HLA-B75 serotype can predict the risk of CBZ-induced SJS/TEN more accurately than screening for a specific allele.
Contemporary Management of HIV.How Common Comorbidities Affect ART Management...hivlifeinfo
In this downloadable slideset, expert faculty review key data and offer important guidance on managing HIV treatment in patients with frequently encountered comorbidities, including cardiovascular disease, osteopenia, and HCV coinfection.
Format: Microsoft PowerPoint (.ppt)
File size: 2.27 MB
Date posted: 2/12/2018
Liao2011 phân tích máu cuống rốn để khẳng định chẩn đoán nhanh trước sinh bện...Võ Tá Sơn
CORD BLOOD ANALYSIS FOR RAPID PRENATAL CONFIRMATION OF Hb BART’S DISEASE USING THE SEBIA CAPILLARY ELECTROPHORESIS SYSTEM
Liao2011 phân tích máu cuống rốn để khẳng định chẩn đoán nhanh trước sinh bệnh Hb Bart's bằng cách sử dụng hệ thống điện di mao quản
bs võ tá sơn
bsvotason
bác sĩ võ tá sơn
A Clinical Study: Tumour Necrosis Factor Alpha as a Clinical Marker in Malari...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Eczema simply means “inflamed skin”. Skin can become inflamed for a number of reasons, but the big three reasons are: Contact, Atopic, and Irritant.
This comprehensive overview covers symptoms, treatments.
Modeling Time to Death of HIV Infected Patients on Antiretroviral Therapy in ...Premier Publishers
The main aim of this study was modeling the factors that affect survival time of HIV infected patients by using Cox ph and parametric survival regression models. The analytical methodologies were used the Kaplan-Meier and Log Rank Test to estimate Descriptive analysis, Cox’s regression model was employed to identify the covariates that have a statistical significant effect on the survival time of HIV infected patients and exponential, weibull, log logistic and log-normal survival regression models were applied to compare efficiency of the models. The overall mean estimated survival time of patients was 51.5 months. The Cox Proportional Hazards Regression Model result revealed that baseline weight, ART adherence, baseline CD4 count, WHO clinical stage, level of education, substance use and TB co-infection of patients are the major factors that affect significantly survival time of HIV infected patients. Among the parametric regression models, based on model Comparison methods, the Weibull regression model is better fit. The Weibull regression model results revealed that baseline weight<50 kg, low CD4 count at baseline, no education, WHO stages III and IV, poor ART adherence, co-infection with TB and substance abuse are the categories that reduce the survival probability of HIV infected patients.
Comparison of Infection Episodes in CKD Patients with or without Hemodialysis...ijtsrd
Chronic kidney diseases CKD is a progressive and irreversible deterioration of renal function. Patients with CKD are prone to a variety of infections. Further chronic hemodialysis increases the infections and related morbidity and mortality. The present study was conducted to assess the probability of infection episode in CKD patients in patients with or without haemodialysis. A Cross sectional observational study was conducted with a total 56 patients with CKD. Clinical and biochemical data related to infections were collected from the individual patient records. The results showed that the chills and rigors, increased TLC, and elevated ESR were found to more in CKD patients on chronic haemodialysis. Further, our results suggested that CKD patient population showed increased-risk for the development of lethal sepsis. Hence, identification of the causes of infection and the appropriate treatment based on the severity of symptoms are essential for CKD patients who are on dialysis. Punit Gupta | Swati Sharma | Ashish Deo "Comparison of Infection Episodes in CKD Patients with or without Hemodialysis from Tribal Population" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-1 , December 2018, URL: http://www.ijtsrd.com/papers/ijtsrd19000.pdf
http://www.ijtsrd.com/medicine/other/19000/comparison-of-infection-episodes-in-ckd-patients-with-or-without-hemodialysis-from-tribal-population/punit-gupta
ABSTRACT- Introduction: Blood group antigens have been reported to be associated with many diseased conditions
severally. Studies have suggested that ABO blood groups have an impact on infection status of the individuals
possessing a particular blood group due to the significant associations observed when analyzed. However there is
limited information on the relationship between these blood group antigens with haemoglobin genotype and CD4 cell
count in Human Immunodeficiency Virus (HIV) infection, hence the need for this study.
Materials and Method: Exactly 240 newly enrolled seropositive patients attending the HIV Clinic of LAUTECH
Teaching Hospital, Osogbo, Nigeria and 120 healthy blood donors were recruited for this study. Antibodies to HIV
were determined using determine rapid HIV 1/HIV 2 test kit (Abbott), enzyme linked immunosorbent assay (ELISA)
(GenScreen plus HIV Ag-Ab test kit, Paris) and Western blot (New-LAV Blot 1, BioRad, France) for confirmatory test.
ABO and Rhesus blood grouping was determined by standard tile and tube techniques. Haemoglobin genotype
determined by alkaline cellulose acetate haemoglobin electrophoresis while CD4 cell count was estimated with Partec
Cyflow analyser.
Result: There is no significant association between the ABO/Rh antigens and haemoglobin genotypes of the test and
control groups (P<0.05). All participants in the control group had CD4 count >200cells/mm3 while 198 (55%) HIV
infected subjects had CD4 count ≥200cells/mm3 and 42 (11.7%) had CD4 count <200cells/mm3. A significant
association was observed between the CD4 cell count of the patients and their ABO blood group antigens (P<0.05) with
blood group A and AB having the highest CD4count.
Conclusion: The outcome of this study reiterates the fact that blood group antigens are involved in immune protection
against infectious disease. Blood group A which has been implicated to confer susceptibility in some diseased condition
has been observed to confer immunity in this study.
Key-words- CD4 cells, Blood Group Antigens, HIV and Haemoglobin Genotype
People Living with Human Immunodeficiency Virus in Hadhramout: Clinical Prese...asclepiuspdfs
The objective of the study was to determine the clinical features and outcome of patients living with human immunodeficiency virus (HIV) in Hadhramout and nearby governorates. Materials and Methods: This descriptive study was conducted in the antiretroviral therapy (ART) site at Ibn-Sina General Hospital, Mukalla, Hadhramout governorate. All 145 patients were enrolled in HIV treatment and care program from December 2008 to the end of December 2016 with confirmed HIV test. Data included all personal data, clinical staging, drugs taken, and outcomes. Patients were grouped according to the decades to five groups, ≤15 years, 16–30 years, 31–50 years, 51–70 years, and >70 years. Cases classify according to the antiretroviral drugs to ART group and Pre-ART group. The relevant data parameters were analyzed using SPSS statistical software version 21 and Excel 10. Results: A total of 145 cases, most adults (97.9%), males and females were104 (71.7%) and 41 (28.3%), respectively. Mean age was 36.46 years and 30–50 years the most affected age group (55.2%). Clinical Stages 3 and 4 were the common presentation in 73.8%, and most cases were from Mukalla city. Of the total cases, 74.5% were on ART 53.1 of them improved, pulmonary tuberculosis was found in 4 cases, and death cases were (18.5%), mostly due to late presentation and non-adherence, and mostly occurred in early 6 months of starting the ART. 37 patients were in a pre-treatment group (21.6%), where the mortality rate is 35.1%, mainly due to loss of follow-up. Conclusions: Most cases were adult males, young age and have had late presentation, where mortality is higher in the pre-treatment group due to loss of follow-up and in early 6 months of treatment.
The role of genetic factors in Hypertension among Iraqi citizensAI Publications
In this study, 140 patients were collected, and they were divided into two groups (120 patients and 30 control groups). The average age in this study ranged from 25 to 65 years. This paper aims to know the role of genetic factors in hypertension among Iraqi citizens and. This study was designed through cooperation with the hospital for the purpose of withdrawing the information found in the electronic record to patients, which includes primary information from demographic data (age - gender - body mass index - blood samples - smoking - alcohol - clinical history - genetic history and blood pressure. The data and demographic information related to the patients were analysed by relying on the statistical analysis program IBM soft SPSS 22. The results that were found were a collection of 140 patients (no positive result for 30 patients) (and 120 patients with a positive result), and the statistical value and the mean for the age of the patients was 45.2±15.3 as was done. Proportion of Family History with Hypertension patients and patient distribution (parents for 90 patients with 64.2% - siblings for 28 patients with 20% - offspring for 32 patients with 22.8%. Through the statistical analysis, a statistically significant relationship was found between genetic factors and their effect on arterial hypertension, with a p-value of 0.001.
Red cell alloimmunization in blood transfusion dependent Patients with Sickle...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Adherence to Antiretroviral Therapy among HIVPositive Patients in Central Hos...Efe Clement Abel
Abstract: Adherence is the quantified level to which an individual follows a prescribed treatment and a low level of adherence to antiretroviral therapy(ART) adversely affects a patient’s treatment outcome and results in a rebound of plasma viraemia, development of resistant strains of HIV, more rapid immune deterioration, development of AIDS and death. This study is aimed at assessing the level of adherence to ART among HIV-positive patients assessing care in Central Hospital, Warri, Delta State, Nigeria. A descriptive cross-sectional study. Data were obtained using a semi-structured, interviewer-administered questionnaire and analysed using SPSS version 23. A total of 303 persons were recruited for the study. The mean age of respondents was 36.2±10.8years. Less than half of the subjects (45.5%) were adherent to their ART. Among the non-adherent subjects, the common reasons reported for missing doses of ART were forgetfulness (50.9%), too busy with other things (43.6%) and away from home (35.8%). This study showed that adherence to ART among the study population was poor. Forgetfulness, too busy with other things and being away from home were the most common reason for non-adherence. It is, therefore, recommended that; regular health education should be organised for HIV patients on ART on the importance of being adherent to their ART, regular assessment of adherence to ART should be carried out and a method of reminding patients who are non-adherent to ART on the need to take their ART as at when due should be considered as part of the routine services provided by ART centres.
Clinical Epidemiological Study of Secondary Syphilis - Current Scenarioiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Prevalence of Malaria Infection and Malaria Anaemia among Children Attending ...theijes
Malaria associated anaemia represent a major public health problem. Thestudy considered Out-Patient children at Emergency Paediatric Unit, Federal Medical Centre, Yola aged 6 months-15 years from June to November 2015. Questionnaires were used to collect information relating to gender, age and parents/guardians sociodemographic characteristics. Microscopic examination of Thick and Thin blood films a technique was employed, Pack Cell Volumewas used to screen for anaemia. Of the 168 children sampled, the prevalence of malaria infection and malaria anaemia was 29.2% and 26.2% respectively and it was associated with P. falciparum. Malaria infection in relation to anaemia, children with mild anaemia (47.6%) had the highest infection rate. It was observed that malaria infection was higher among males (32.2%) than the females (25.6%), age group 5-9 years (34.2%) had the highest malaria infection and least was ≥15 years (20.0%) but these were statistically insignificant within gender and age of the children and malaria infection (p˃0.05). Higher malaria infection among children whose parents/guardians were unemployed (38.5%), attended primary education (52.6%) and reside in village setting (31.4%). Malaria anaemia in relation to children epidemiological data, males (31.6%), 5-9 years (31.6%) recorded with high prevalence rate while sociodemographic characteristics of parents/guardians, children whose parents/guardians were civil servant (18.9%), attended tertiary education (13.8%) and live in quarters (11.1%) had the least prevalence rate of malaria anaemia. Children gender, parents/guardians occupation and educational qualification were significantly associated with malaria anaemia (p˂0.05). Therefore, parents/guardians sociodemographic factors such as better occupation, higher educational qualification and well layout and refined area of residence reduces the prevalence of malaria infection and malaria anaemia in children. There is need to sensitized public on the importance of management of malaria and the possible effects of malaria anaemia on children in order to circumvent the menace.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
1. Hematologic Abnormalities Among Children on Haart Muluneh A.. et al 83
ORIGI AL ARTICLE
HEMATOLOGIC AB ORMALITIES AMO G CHILDRE O
HAART, I JIMMA U IVERSITY SPECIALIZED HOSPITAL,
SOUTHWESTER ETHIOPIA
Muluneh Abebe, MD, Fessahaye Alemseged, MD,MPHE
ABSTRACT
BACKGROU D: In individuals infected with human immunodeficiency virus, hematological abnormalities are
associated with increased risk of disease progression and death. However, the magnitude and severity of
hematological abnormalities in those patients who are taking antiretroviral drugs is not known in Ethiopia. Hence
this study was conducted to determine the magnitude and severity of anemia, neutropenia and thrombocytopenia in
HIV infected children who are taking highly active antiretroviral therapy in Jimma University Specialized Hospital.
METHODS: A cross-sectional study was conducted from August to ovember, 2007 on 64 HIV infected children
who have been taking highly active antiretroviral therapy for more than two months in the study hospital. Data
were collected using structured questionnaire that included variables related to socio-demographic characteristics,
immunohematological profiles and clinical conditions of the study individuals. Data was analyzed using SPSS for
Windows version 12.0.1.
RESULT: The prevalence of anemia, thrombocytopenia and neutropenia among the study children was 21.9%,
7.8% and 4.7%, respectively. Severe life threatening anemia was seen in 2(14.3% of the child). The mean level of
hemoglobin, thrombocyte count and CD4 count showed statistically significant increment from the baseline (p-
value <0.05).
CO CLUSIO : Hematologic abnormalities were common problems among the children taking highly active
antiretroviral therapy. Therefore, clinicians need to routinely investigate and treat hematological abnormalities
before and after treatment and furthermore large scale and longitudinal studies are recommended to strengthen
and explore the problem in depth.
KEYWORDS: Anemia, Thrombocytopenia, eutropenia, HIV, Highly Active Antiretroviral Therapy, Zidovudine
I TRODUCTIO disease progression and death; patients on Highly Active
Antiretroviral Therapy (HAART) commonly suffer from
Acquired Immunodeficiency Syndrome (AIDS) is one of side effects of the drug (5-7). Each antiretroviral drug is
the most destructive epidemics in the history of mankind. associated with specific adverse effects. Among the
In Ethiopia the adult prevalence of HIV was estimated to antiretroviral drugs, Zidovudine (AZT) remains to be the
be 2.2% in 2008. The total number of People Living with most widely used drug resulting in myelosuppression (6,
HIV/AIDS (PLHIV) in the same period was estimated to 8).
be 1,037,267 adults and 68,136 of them were children. Several studies in developed countries have shown
Furthermore the number of deaths due to AIDS for the that AZT alone and AZT based HAART regimen is
same period was estimated to be 58,290 for adults and associated with significant reduction of hemoglobin (Hb)
9,284 among children (1). level and neutrophil number (3, 7, and 8). Though most
In HIV infected individuals hematological of the studies on hematological abnormalities are on
abnormalities are common and they increase the risk of adults, one randomized comparative trial done to assess
morbidity and mortality. In both antiretroviral-treated and the safety and efficacy of AZT and d4T in symptomatic
untreated individuals, anemia is independently associated HIV infected children showed a prevalence of anemia to
with an increased risk of disease progression and death be 5% among the AZT group whereas 2% among the
(2-4). d4T group. Similarly the prevalence of neutropenia was
Although HAART is known to profoundly suppress higher in AZT group (9).
viral replication, it increases CD4 cell count and delays
1
Department of pediatrics and Children Health, Jimma University
2
Department of Epidemiology & Biostatistics, Jimma University
2. 84 Ethiop J Health Sci. Vol.19 No.2 July 2009
Although 25.8 million people are living with HIV/AIDS on the data collection format. To ensure the quality of
in Sub Saharan Africa, few studies tried to assess the data, training was given to data collectors and supervisors
safety and efficacy of HAART. In one multicentered and pre-test was done on adult patients. Besides, the
study conducted in Uganda, Kenya and Zambia 12% of collected data were checked for completeness and
patients on AZT-based HAART regimen switched drug internal consistency.
because of drug related severe anemia or GI toxicity (10). Data were coded, cleaned, entered and analyzed
At the end of February, 2007, 72,127 HIV patients using SPSS for Windows version 12.0.1. Descriptive
were started on Antiretroviral Therapy (ART) at 234 analysis was done to assess the prevalence of anemia,
facilities across the country (11). Regardless of the fact neutropenia and thrombocytopenia. Bivariate and
that Ethiopians’ normal immunohematologic profile is multivariate analyses were done to look for association
known to be lower than the white population by 2 to 3% between the presence of anemia and independent
(12), AZT-based HAART is one of the first line regimens variables.
in the guideline (13). Anemia, neutropenia and thrombocytopenia were
The impact of HAART on the hematological profile defined based on World Health Organization (WHO)
of Ethiopian HIV/AIDS patients is not known. Hence this grading of hematologic toxicity (14). Accordingly,
research was conducted to determine the magnitude of anemia was defined as Hb concentration less than or
hematological abnormalities and the possible associated equal to 10g/dl for all children and further severity was
factors. classified into grades as follows: Hb level of 8.5 – 10 g/dl
as Grade 1; 7.5 - <8.5 g/dl as Grade 2; 6.5 - < 7.5 g/dl as
METHODS Grade 3; and < 6.5 g/dl as Grade 4. Grade 3 and 4 are
further labeled as severe life threatening anemia.
This cross-sectional study was conducted from August 1 Neutropenia was defined as absolute neutrophil count
to November 10, 2007 at Jimma University Specialized (ANC) of less than 1000 /mm3 and based on Pediatric
Hospital (JUSH), Southwest of Ethiopia which is a Adult Clinical Trial Group (PACTG) classification,
teaching and referral hospital for about 15 million people. severity was further classified as follows: Grade 1: 750 -
The hospital has ART center that provides voluntary <1000 /mm3; Grade 2: 500 - 749 /mm3; Grade 3: 250 –
counseling and testing, care and treatment for HIV 499 /mm3 and Grade 4: < 250 /mm3. Platelet count
infected children and adults. At the time of the study between 150,000 and 450,000/mm3 was classified as
there were 2,166 PLWHA on follow-up care, of which normal, greater than 450,000/mm3 as thrombocytosis and
997 were adults and 68 children were on ART (13). Sixty less than 150,000/ mm3 as thrombocytopenia.
four of the 68 children who took HAART for more than Ethical clearance was obtained from Jimma
two months were included in the study. University (JU) ethical committee and permission was
Data were collected using structured pre-tested obtained from hospital authorities to conduct the study.
questionnaire. The questionnaire had three parts, the first After informing parents/caregivers about the objective of
part for collecting data about socio-demographic the study and the confidentiality of the data, consent was
characteristics of the study subjects, the second part for obtained. To ensure confidentiality of data, study subjects
collecting data concerning baseline characteristics of the were identified using codes and unauthorized persons did
individuals before initiation of HAART mainly clinical, not have access to the collected data. Furthermore, the
laboratory and immunological characteristics and the hematological findings were utilized for proper
third part for collecting data related to HAART treatment management of the patients.
and the change in baseline parameters after taking
HAART. The respondents were parents or immediate RESULTS
caregivers of the study children.
Data were collected by two nurses who had training Of the 68 children, 64 who have been taking HAART for
certificate and experience in care and treatment of more than two months were included in the study. The
patients with HIV. Laboratory measurements were done mean age of the study subjects was 6.9 (3.2) years. The
by experienced laboratory technologist. One medical male to female ratio was 1.13:1. With regard to the
doctor worked as supervisor of the whole process. All survival status of their parents, majority, 50(78.1%) of
study subjects were approached during their respective the study children had lost one or both of their parents.
appointment schedule for follow up. After interview and Concerning the caregivers’ educational status, 15(23.4
detailed review of the medical record, the study subjects %) were illiterate, 22(34.4%) were elementary and
were sent to laboratory where blood was collected for 27(42.2%) were high school and above. 36(56.3%) of the
determination of complete blood count and CD4 count, caregivers were unemployed and 42 (65.6%) earned
and the result was collected with in six hours and filled monthly income below 300 Birr (Table 1).
3. Hematologic Abnormalities Among Children on Haart Muluneh A.. et al 85
Table 1. Socio-demographic Characteristics of HIV Infected Children on HAART at JUSH, 2007.
Demography N (%) (n=64)
Sex
Male 34(53.1)
Female 30(46.9)
Age in years
<3 5(7.8)
3-5 22(34.4)
6-8 15(23.4)
9-13 22(34.4)
Religion
Muslim 27(42.2)
Orthodox 33(51.6)
Protestant 4(6.3)
Ethnicity
Oromo 34(53.1)
Amhara 21(32.8)
Kefa 3(4.7)
Dauro 5(7.8)
Gurage 1(1.6)
Parent status
Both alive 14(21.9)
Father alive 13(20.3)
Mother alive 18(28.1)
Neither alive 19(29.7)
Family income
< or = 300 42(65.6)
301-600 10(15.6)
601+ 12(18.8)
Educational Status of Care givers
Illiterate 15(23.4)
Grade 1-6 22(34.4)
Grade 7-12 22(34.4)
Grade12 plus 5(7.8)
Employment Status of Care Givers
Unemployed 36(56.3)
Employed 28(43.8)
Child Knows HIV status
Yes 22(34.4)
No 42(65.6)
With regard to the type and duration of HAART regimen, initiation of HAART, the proportion of underweight and
62(96.9%) were taking AZT based HAART and 48(75%) stunted children decreased to 27(42.2%) and 39(60.9%),
took treatment for a duration of more than 6 months. respectively. The decrements were statistically
According to WHO clinical staging 5(7.9%) of the study significant (p-value <0.001). Before initiation of
participants were in stage 1 and 2 while 59(92.2%) of the HAART, majority 57(89.1%) had history of
study participants had advanced clinical stage (stage 3 Opportunistic Infections (OI), the commonest being
and 4). Of the study children 36(56.3%) and 27(42.2%) Tuberculosis (TB) seen in 36(56.2%), While after
had severe immune suppression (CD4 percentage below initiation of HAART the prevalence of OI was 51.5%
15%) before initiation of HAART and after initiation of and pneumonia being the commonest 23(34.4%) (Table
HAART, respectively (Table 2). 2).
46(71.9%) and 47(73.4%) were underweight and The mean Hb concentration increased from baseline
stunted before initiation of HAART whereas, after 10.5 gm/dl to 11.2 gm/dl after treatment with HAART.
4. 86 Ethiop J Health Sci. Vol.19 No.2 July 2009
Total leukocyte count (TLC), thrombocyte, and CD4 values. The increments of hemoglobin, thrombocyte
count and percent also showed increment. Whereas ANC count and CD4 count were statistically significant
and CD8 values showed some decrement in their mean (p-value <0.05) (Table 3).
Table 2 . Clinical and Immunological Characteristics of HIV Infected Children on HAART at JUSH, 2007.
Variable Before (n=64) After HAART (n=64) P-value
N (%) N (%)
CD4 lymphocyte %
Less than 15% 36(56.3) 27(42.2) 0.00
15-24% 10(15.6) 20(31.3)
Greater than 25% 14(21.9) 17(26.6)
Wt for Age
< 5th percentile 46(71.9) 27(42.2) 0.00
> or 5th Percentile 18(28.1) 37(57.8)
Ht for Age
< 5th percentile 47(73.4) 39(60.9) 0.00
> or = 5th percentile 17(26.6) 25(39.1)
Wt for Ht
<70 percent 1(1.6) 0 0.08
70 – 79 percent 4(6.3) 3(4.7)
80 – 89 percent 20(31.3) 11(17.2)
> or = 90 percent 39(60.9) 50(78.1)
Opportunistic infections
Chronic GE 4(6.3) 0
Pneumonia 13(20.3) 21(32.8) 0.01
PCP 2(3.1) 3(4.7)
TB 34(53.1) 6(9.4)
TB & Pneumonia 2(3.1) 0
PCP & Pneumonia 2(3.1) 1(1.6)
No OI 7(10.9) 33(48.5)
Hematological abnormalities were present both before the 34 anemic patients at baseline 20 (58.8%) improved
and after treatment with HAART. Anemia (Hb from anemia.
≤10gm/dl) was found in 34(53.1%) of subjects before Neutropenia was seen in 5(7.8%) and 3(4.7%),
and in 14(21.9%) of the subjects after initiation of thrombocytosis in 3(4.7%) and 9(14.1%),
HAART. Among the anemic cases, 5(14.7%) and thrombocytopenia in 12(18.8%) and 5(7.8%) of the
2(14.3%) had severe life threatening anemia before and children before and after initiation of HAART,
after initiation of HAART, respectively (Table 4). Out of respectively (Table 4).
5. Hematologic Abnormalities Among Children on Haart Muluneh A.. et al 87
Table 3. Mean Hematological values of HIV Infected Children, before and after Initiation of HAART at JUSH, 2007.
Hematological Values
Before HAART After HAART P-value
Mean (SD) (n=64) Mean (SD) (n=64)
Variables
Hemoglobin (Hb) 10.5 (2.4) 11.2 (1.9) 0.04
AZT based 10.6 (2.5) 11.2 (2.0)
D4T based 8.5 (0.7) 12 (0.0)
WBC x 103 7.0 (3.0) 6.9 (2.6) 0.79
TLC x 103 2.6 (1.6) 3.0 (1.5) 0.08
ANC x 103 3.7 (2.4) 3.2 (1.5) 0.12
Thrombocyte x 103 264 (139) 318 (132) 0.01
CD4 384 (356) 519 (371) 0.00
CD8 1368 (718) 1340 (709) 0.76
After controlling confounding effect, children who were (OR=6.1), were more likely to have anemia as compared
below age five years (OR=2), male (OR=1.6), stunted to their counter parts. However, none of the associations
(OR=1.3), underweight (OR=4.1), and having CD4 count were statistically (Table 5).
<25% after highly active antiretroviral treatment
Table 4. Patterns and Severity of Hematological Abnormalities in HIV Infected Children before and after Initiation of
HAART at JUSH, 2007.
Before (n=64) After(n=64)
Variable N (%) N (%) P value
Hb
Hb > 10gm/dl 30(46.9) 50(78.1) 0.12
Hb < or = 10gm/dl 34(53.1) 14(21.9)
Anemia severity
Grade 1(8.5-10.0) 23(67.7) 9(64.3) *NA
Grade 2 (7.5-8.4) 6(17.6) 3(21.4)
Grade 3(6.5-7.4) 4(11.8) 0
Grade 4(<6.5) 1(2.9) 2(14.3)
Neutrophil count N=59 N=61
> or = 1000 54(84.4) 58(90.6) *NA
< 1000 5(7.8) 3(4.7)
Neutropenia Severity
Grade 1(750-999) 3(4.7) 3(4.6%) *NA
Grade 2(500-749) 2(3.1) 0
Grade 3(250-499) 0 0
Grade 4(< 250) 0 0
Thrombocyte N=57 N=62
>450 x 103 3(4.7) 9(14.1)
150-450 x 103 42(65.6) 48(75.0) *NA
<150 x 103 12(18.8) 5(7.8)
*NA (not applicable) as chi-square requirements are not met.
6. 88 Ethiop J Health Sci. Vol.19 No.2 July 2009
DISCUSSIO compare the mean change of Hb with the meta-analysis
of the six prospective, randomized controlled trials which
In Ethiopia, there is lack of baseline data on HIV or HIV showed a decrement by 0.4g/dl at 6 months and 0.2g/dl at
treatment related hematological abnormalities. The 12 months in AZT group but an increment by 0.45g/dl at
findings of this study hence partially fill the gap. 6 months and 0.58g/dl at 12 months in d4T group, our
However, the small number of study population limits the finding showed higher increment in both regimens (3).
generalizability of the results. This difference could again be due to relatively low
The prevalence of anemia before initiation of baseline prevalence of anemia in the latter study which is
treatment in this study was consistent with reports of conducted in developed country and partly due to the
other studies that ranged from 36.9% to 95% depending difference in study design and size of study populations.
on the stage of the disease (14). Compared to the finding Neutropenia was also seen both before and after
of review of 32,867 adult and adolescent HIV patient initiation of treatment. The prevalence of Neutropenia
medical records that showed a prevalence rate of 36.9%, before treatment (7.8%) was higher than after treatment
our finding is higher. This difference could be attributed (4.7%). All cases of neutropenia were patients who were
to the higher prevalence of anemia in the local context taking AZT based HAART. As compared to the meta-
and possibly due to the difference in age and size of the analysis which reported 26-46% neutropenia in AZT
study population (3, 15). recipients and the prospective randomized comparative
After initiation of HAART therapy the mean Hb trial of d4T and AZT in children which found neutropenia
level increased by 0.7mg/dl from baseline. On further of 20% over one year among AZT recipients (8, 9) our
analysis, the increment in the mean Hb concentration was finding is lower. However, the small size of the study
higher in those patients who have been taking d4T than population in this study could limit making a valid
AZT based HAART (3.5 g/dl Vs 0.6 g/dl). When we comparison between the findings.
Table 5. Coefficients and OR from logistic regression model predicting the probability of Anemia in HIV Infected
Children on HAART at JUSH, 2007.
Variables ß coefficient Crude OR Adjusted OR
(95% CI) (95% CI)
Age
≤5 years 1.7(0.49, 6.27) 2.0 (0.48, 8.63)
> 5 years 0.714 1 1
Sex
Male 0.453 1.8 (0.528, 6.23) 1.6 (0.39, 6.38)
Female 1 1
Current
Weight for age
< 5 percentile 4.9 (1.32, 17.78) 4.1 (0.72, 23.05)
> or = 5 percentile 1.404 1 1
Height for age
< 5 percentile 2.9 (0.71, 11.60) 1.3 (0.20, 8.92)
> or = 5 percentile 0.282 1 1
Duration of HAART treatment
≤ 6 months
> 6 months 1 1.3 (0.29, 5.65)
0.256 1(0.26, 3.61) 1
CD4 % after HAART treatment
< 25% 6.1 (0.735, 50.914) 6.1 (0.67, 56.38)
> or = 25% 1.812 1 1
Thrombocytosis and thrombocytopenia were also found with finding of the randomized comparative trial of AZT
before and after treatment with HAART. The prevalence and d4T in children which showed 7% (3).
of thrombocytopenia after treatment (7.8%) was similar In addition to the hematological abnormalities, this study
has also given us some insight about the efficacy of
7. Hematologic Abnormalities Among Children on Haart Muluneh A.. et al 89
HAART which was demonstrated by improved weight 6. De Jesus E, Herrera G and Teofilo E. Abacavir
for age from the baseline, decreased rate of opportunistic versus zidovudine combined with lamivudine
infection, increased mean CD4 value and CD4 and efavirenz, for the treatment of antiretroviral-
lymphocyte percentage. naive HIV-infected adults. Clinical Infectious
In conclusion in this study; anemia, neutropenia, Disease, 2004; 39:1038-46.
thrombocytopenia and thrombocytosis were common 7. Eron J, Yetzer S and Ruane J. Efficacy, safety,
both before and after HAART treatment among the study and adherence with a twice-daily combination
subjects. Nonetheless, HAART resulted in increment of lamivudine/zidovudine tablet formulation, plus a
the mean Hb concentration irrespective of the regimen protease inhibitor, in HIV infection. AIDS,
used. Based on these findings it is recommended that 2000; 14:671-81.
physicians giving care for HIV infected children should 8. Moyle G, Sawyer W, Law M, Amin J and Hill
routinely investigate and treat hematological A. Changes in the Efficacy of Thymidine
abnormalities before and after treatment. Additionally Analogue-based HAART: A Meta-analysis of
large scale and longitudinal studies are recommended to Six Prospective, Randomized, Comparative
strengthen and explore the problem in depth. Studies. Clinical Therapeutics, 2004; 26:1.
9. Mark W, Russel B, Jane C, et al. A Randomized
ACK OWLEDGEME TS trial of Stavudine versus Zidovudine in Children
with Human Immunodeficiency Virus Infection.
We would like to acknowledge Jimma University for Pediatrics 1998; 101: 214-220.
funding the study. We also like to express our thanks for 10. Amoroso A, Sheneberger R, Edozien A et al.
all of the study participants. Antiretroviral-associated Drug Toxicities
Leading to a Switch in Medication: Experience
REFERE CES in Uganda, Kenya and Zambia. 14th Conference
on Retroviruses and Opportunistic Infections
1. UNAIDS, December 2007 Report. Los Angeles. California Feb 25- 28, 2007.
2. Mocroft A, Kirk O and Barton S. Anemia is an 11. Ministry of Health of Ethiopia – HAAPCO.
independent predictive marker for clinical Monthly HIV Care ART Update released on
prognosis in HIV-infected patients from across March 22, 2007.
Europe. EuroSIDA study group. AIDS, 1999; 12. Kassu A, Tsegaye A, Petros B, et al.
13:943-50. Distribution of Lymphocyte Subsets in Healthy
3. Sullivan S, Hanson L, Chu Y, Jeffrey J and John Human Immunodeficiency Virus-Negative
W. Epidemiology of anemia in human Adult Ethiopians from Two Geographic
immunodeficiency virus (HIV) infected persons: Locales. Clinical and Diagnostic Laboratory
Results from multistate Adult and Adolescent Immunology. Nov. 2001, p. 1171–1176.
Spectrum of HIV Disease Surveillance Project. 13. Ministry of Health of Ethiopia. Guideline for
Blood. 1998; 91: 301-308. Pediatric HIV/AIDS Care and Treatment in
4. Ludwig H and Strasser K. Symptomatology of Ethiopia. Addis Ababa, July 2007.
Anemia. Semin Oncol. 2001; 28: 7-14. 14. Moyle G. Anemia in Persons with HIV
5. D’Arminio A, Lepri C and Rezza G. Insights Infection: Prognostic Marker and Contributor to
into the reasons for discontinuation of the first Morbidity. AIDS Rev, 2002; 4:13-20.
highly active antiretroviral therapy (HAART) 15. Adish A, Esrey S, Gyorgis T and John T. Risk
regimen in a cohort of antiretroviral naïve factors for iron deficiency anemia in preschool
patients. I.CO.N.A. Study Group. Italian Cohort children in northern Ethiopia. Public Health
of Antiretroviral-Naïve Patients. AIDS, 2000; Nutrition. 1999; 2(3): 243-252.
14:499-507.