This study evaluated isolated proteinuria in 100 patients with hepatitis A virus (HAV) or hepatitis E virus (HEV) infections in Bangladesh. The researchers found that 43% of HAV patients and 45% of HEV patients had protein in their urine. Proteinuria was most common in patients in their third decade of life. The level and pattern of proteinuria differed between HAV and HEV patients. HEV female patients had significantly higher urine protein levels than HAV females. The study suggests that urine protein tests should be routinely performed in patients recovering from HAV or HEV infections to detect any underlying kidney impairment.
The relationship between the molecular epidemiology of hepatitis c and the be...Alexander Decker
This study examined the molecular epidemiology and prevalence of hepatitis C virus (HCV) infection in Jordan. Researchers tested 1929 patients for HCV antibodies between 2010-2011. A total of 149 patients (9%) tested positive, with the infection being twice as common in males compared to females. The most common causes of infection were blood transfusion (68%), kidney dialysis (17%), addiction treatment centers (6%), and unknown causes (9%). HCV RNA detection and genotyping was performed on positive samples. The results suggest blood transfusion is a major route of HCV transmission in Jordan and screening of blood donors has helped reduce prevalence over time.
frequency of hepatitis C virus infection in patients with type 2 diabetes mel...Dr Tarique Ahmed Maka
ABSTRACT
Objective: To determine the frequency of hepatitis C virus infection in patients with type 2 diabetes mellitus and to look for the common risk factors leading to this infection in diabetics. Study Design: Descriptive cross sectional study design. Place and Duration of Study: Department of Medicine, Combined Military Hospital (CMH) Kharian, from Jan 2015 to Jun 2015. Patients and Methods: This study was conducted in the department of Medicine, Combined Military Hospital Kharian. Through a descriptive cross sectional study design, a total of 140 patients with type 2 diabetes mellitus, admitted through casualty, OPD or private clinics were selected and tested for Hepatitis C virus infection. The common risk factors leading to such infection among positive cases were also scrutinized. Results: The mean age of patients was 48.82 ± 10.14 with 60.7% female gender predominating the overall sample of diabetics. Using 3rd generation ELISA method, hepatitis C virus was found in 45 (32.1%) of patients with 41-50 years of age group most commonly affected age group (34.7%) and female (57.8%) commonly affected gender. The distribution of risk factors leading to hepatitis C virus in diabetics are: 21 (46.7%) had history of surgery in the past, 13 (28.9%) had history of blood transfusion in the past, 7 (15.55%) had history of hemodialysis while only 4 (8.9%) had history of tattooing in the past. Conclusion: Hepatitis C virus infection is still a common problem in diabetic patients of our local population and we recommend further research work over its risk factors so that the guidelines for its control may be formulated. Keywords: Blood transfusion, Diabetes Mellitus, Haemodialysis, Hepatitis C virus infection, Risk Factors, Surgery, Tattooing.
Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...paperpublications3
Abstract: Increased Oxidative Stress markers in HIV/AIDS Patients may be as a result of free radicals generation and evidence is accumulating that Highly Active Antiretroviral Therapy (HAART) mimics AIDS progression but may be costly due to its Nephrotoxicity. In this research serum levels of Alpha tocopherol ( α- tocopherol), Urea, Creatinine as well as CD4 Counts were measured in 70 HIV Seropositive Patients (40 on HAART and 30 HAART-Naïve) and Thirty (30) apparently healthy individuals as controls in Federal Medical Centre Katsina, Nigeria.CD4 Counts, Serum Levels of Alpha tocopherol, Urea and Creatinine of HIV-HAART and HAART Naïve were 0.72±0.27mg/dl, 16.8±5.6 mmol/l, 237±123 µmol/l and 646±254cell/µl and 0.3±0.1mg/dl, 10.4±2.9 mmol/l, 91±26 µmol/l and 364±17 cell/ µl respectively. There were significantly (p<0.05) increased CD4 counts, serum levels of Alpha tocopherol, Urea and Creatinine in HIV/AIDS Patients on HAART compared to HAART- Naive. This is an indication that HIV/AIDS are predisposed to oxidative stress and that also HAART has debilitating effects on kidneys.
The Prevalence of Hcv Infection among Renal Failure Patients Before Starting ...CrimsonpublishersMedical
HCV infection is common and associated with significant morbidity and mortality among heamodialysis (HD) patients [1]. Heamodialysis is a trusted intermediate procedure for management of chronic kidney disease (CKD) patients. As such CKD is an immunedeficient state, hence blood borne viral infection particularly HCV pose great risk to patients treated by heamodialysis [2]. A high prevalence of HCV infection in heamodialysis patients has been reported in heamodialysis units since the introduction of heamodialysis therapy. Risk factors such as the number of blood transfusions or duration on heamodialysis. The prevalence of HCV infection in patients undergoing dialysis is greater than that in the general population, suggesting that patients on dialysis may be at higher risk of acquiring HCV infection.
Prevalence of anti-HCV Antibodies Among Healthy Asymptomatic Indian Blood Don...Apollo Hospitals
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a bulk of acute and chronic liver diseases world-wide. Since, both the viruses share similar risk factors and modes of transmission, a combined HBV and HCV infection is frequently encountered especially in the HBV endemic areas. Until lately anti-HBc antibodies were considered as surrogate marker for HCV infection. But with the development of advanced tests for HCV detection the role of anti-HBc in this regard stands uncertain.
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.
This article summarizes a study of 785 Tanzanian children living in an area with intense malaria transmission. The study found that iron deficiency (ID), as measured by ferritin levels in blood samples taken at routine visits, significantly decreased the odds of subsequent malaria parasitemia, severe malaria, and all-cause mortality in children. When samples from sick visits were also included, ID was associated with significantly lower prevalence of parasitemia, hyperparasitemia (very high parasite levels), and severe malaria at the time of sample collection. The results suggest that naturally occurring ID protects against severe malaria and death in young children, and that iron supplementation may increase malaria risk even in children with ID. Future studies are needed to determine
This study analyzed the prevalence of anemia in 758 HIV-infected patients receiving care at a single public health clinic in 2000. The key findings were:
1) The overall prevalence of anemia (hemoglobin <12.5 g/dL) was 30.3%. Anemia was more common in females (54%) than males (20.2%).
2) Risk factors for anemia included black race, CD4 count <50 cells/μL, viral load >100,000 copies/mL, and use of zidovudine-containing antiretroviral regimens.
3) The majority (67%) of patients who experienced anemia had mild to moderate an
The relationship between the molecular epidemiology of hepatitis c and the be...Alexander Decker
This study examined the molecular epidemiology and prevalence of hepatitis C virus (HCV) infection in Jordan. Researchers tested 1929 patients for HCV antibodies between 2010-2011. A total of 149 patients (9%) tested positive, with the infection being twice as common in males compared to females. The most common causes of infection were blood transfusion (68%), kidney dialysis (17%), addiction treatment centers (6%), and unknown causes (9%). HCV RNA detection and genotyping was performed on positive samples. The results suggest blood transfusion is a major route of HCV transmission in Jordan and screening of blood donors has helped reduce prevalence over time.
frequency of hepatitis C virus infection in patients with type 2 diabetes mel...Dr Tarique Ahmed Maka
ABSTRACT
Objective: To determine the frequency of hepatitis C virus infection in patients with type 2 diabetes mellitus and to look for the common risk factors leading to this infection in diabetics. Study Design: Descriptive cross sectional study design. Place and Duration of Study: Department of Medicine, Combined Military Hospital (CMH) Kharian, from Jan 2015 to Jun 2015. Patients and Methods: This study was conducted in the department of Medicine, Combined Military Hospital Kharian. Through a descriptive cross sectional study design, a total of 140 patients with type 2 diabetes mellitus, admitted through casualty, OPD or private clinics were selected and tested for Hepatitis C virus infection. The common risk factors leading to such infection among positive cases were also scrutinized. Results: The mean age of patients was 48.82 ± 10.14 with 60.7% female gender predominating the overall sample of diabetics. Using 3rd generation ELISA method, hepatitis C virus was found in 45 (32.1%) of patients with 41-50 years of age group most commonly affected age group (34.7%) and female (57.8%) commonly affected gender. The distribution of risk factors leading to hepatitis C virus in diabetics are: 21 (46.7%) had history of surgery in the past, 13 (28.9%) had history of blood transfusion in the past, 7 (15.55%) had history of hemodialysis while only 4 (8.9%) had history of tattooing in the past. Conclusion: Hepatitis C virus infection is still a common problem in diabetic patients of our local population and we recommend further research work over its risk factors so that the guidelines for its control may be formulated. Keywords: Blood transfusion, Diabetes Mellitus, Haemodialysis, Hepatitis C virus infection, Risk Factors, Surgery, Tattooing.
Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...paperpublications3
Abstract: Increased Oxidative Stress markers in HIV/AIDS Patients may be as a result of free radicals generation and evidence is accumulating that Highly Active Antiretroviral Therapy (HAART) mimics AIDS progression but may be costly due to its Nephrotoxicity. In this research serum levels of Alpha tocopherol ( α- tocopherol), Urea, Creatinine as well as CD4 Counts were measured in 70 HIV Seropositive Patients (40 on HAART and 30 HAART-Naïve) and Thirty (30) apparently healthy individuals as controls in Federal Medical Centre Katsina, Nigeria.CD4 Counts, Serum Levels of Alpha tocopherol, Urea and Creatinine of HIV-HAART and HAART Naïve were 0.72±0.27mg/dl, 16.8±5.6 mmol/l, 237±123 µmol/l and 646±254cell/µl and 0.3±0.1mg/dl, 10.4±2.9 mmol/l, 91±26 µmol/l and 364±17 cell/ µl respectively. There were significantly (p<0.05) increased CD4 counts, serum levels of Alpha tocopherol, Urea and Creatinine in HIV/AIDS Patients on HAART compared to HAART- Naive. This is an indication that HIV/AIDS are predisposed to oxidative stress and that also HAART has debilitating effects on kidneys.
The Prevalence of Hcv Infection among Renal Failure Patients Before Starting ...CrimsonpublishersMedical
HCV infection is common and associated with significant morbidity and mortality among heamodialysis (HD) patients [1]. Heamodialysis is a trusted intermediate procedure for management of chronic kidney disease (CKD) patients. As such CKD is an immunedeficient state, hence blood borne viral infection particularly HCV pose great risk to patients treated by heamodialysis [2]. A high prevalence of HCV infection in heamodialysis patients has been reported in heamodialysis units since the introduction of heamodialysis therapy. Risk factors such as the number of blood transfusions or duration on heamodialysis. The prevalence of HCV infection in patients undergoing dialysis is greater than that in the general population, suggesting that patients on dialysis may be at higher risk of acquiring HCV infection.
Prevalence of anti-HCV Antibodies Among Healthy Asymptomatic Indian Blood Don...Apollo Hospitals
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a bulk of acute and chronic liver diseases world-wide. Since, both the viruses share similar risk factors and modes of transmission, a combined HBV and HCV infection is frequently encountered especially in the HBV endemic areas. Until lately anti-HBc antibodies were considered as surrogate marker for HCV infection. But with the development of advanced tests for HCV detection the role of anti-HBc in this regard stands uncertain.
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.
This article summarizes a study of 785 Tanzanian children living in an area with intense malaria transmission. The study found that iron deficiency (ID), as measured by ferritin levels in blood samples taken at routine visits, significantly decreased the odds of subsequent malaria parasitemia, severe malaria, and all-cause mortality in children. When samples from sick visits were also included, ID was associated with significantly lower prevalence of parasitemia, hyperparasitemia (very high parasite levels), and severe malaria at the time of sample collection. The results suggest that naturally occurring ID protects against severe malaria and death in young children, and that iron supplementation may increase malaria risk even in children with ID. Future studies are needed to determine
This study analyzed the prevalence of anemia in 758 HIV-infected patients receiving care at a single public health clinic in 2000. The key findings were:
1) The overall prevalence of anemia (hemoglobin <12.5 g/dL) was 30.3%. Anemia was more common in females (54%) than males (20.2%).
2) Risk factors for anemia included black race, CD4 count <50 cells/μL, viral load >100,000 copies/mL, and use of zidovudine-containing antiretroviral regimens.
3) The majority (67%) of patients who experienced anemia had mild to moderate an
This study found that patients with type 2 diabetes mellitus in Ghana had a 46% increased risk of infection with the malaria parasite Plasmodium falciparum compared to people without diabetes. While most malaria infections detected were asymptomatic and only found by PCR testing, the risk of infection was higher in people with diabetes and increased with higher blood glucose levels. As diabetes prevalence increases in sub-Saharan Africa, more people may be at risk for malaria infection due to the immune dysfunction caused by diabetes.
New Treatment for hepatitis C: Impact on morbidity and mortality - Dr Helen H...ReShape
Treating hepatitis C patients with direct-acting antiviral drugs (DAAs) could significantly reduce disease burden in the UK. Strategies focusing only on advanced disease may reduce liver disease cases but will have little impact on transmission. Models show treating mild and moderate cases, including people who inject drugs (PWID), could reduce prevalence and incidence of hepatitis C among PWID by over 50% by 2030, curbing new infections. Achieving WHO elimination targets by 2030 will be challenging and require improved testing, treatment, and harm reduction for PWID. Monitoring outcomes like new infections and liver disease cases can assess progress toward elimination goals.
Evolution and Revolution: Current Issues in HIV and HCV Co-infection
Chapter 1 – HIV-Hepatitis C Virus Co-infection: An evolving epidemic
Chapter 2 - Management of HIV infection in HIV/HCV co-infected patients
Chapter 3 - Management of HCV in co-infected patients
Chapter 4 - HCV Therapy: Direct acting antiviral agents in co-infected individuals
Chapter 5 - Drug interactions with directly acting antivirals for HCV: Overview & challenges in HIV/HCV Co-infection
Chapter 6 - Complicated cases
Chapter 7 - Future trials of Hepatitis C therapy in the HIV co-infected
Chapter 8 - HCV infection in marginalized populations
Chapter 9 - HIV/HCV Co-infection: Through the eyes of a co-infected hemophiliac
Sydney Sexual Health Centre Journal Club presentation by Cherie Desreaux on the British Medical Journal and the Medical Journal of Australia editions published between November 2015 and March 2016.
The Sydney Sexual Health Centre Journal Club allows our team to stay up-to-date with what is being published in the field of sexual health. Staff members take turns to read, review and share the contents of an allocated journal. Journal Club encourages knowledge sharing and discussion about topics raised.
This document summarizes a clinical trial that evaluated the efficacy and safety of a 12-week treatment with sofosbuvir and velpatasvir (a fixed-dose combination tablet) in patients with chronic hepatitis C virus (HCV) genotype 1, 2, 4, 5, or 6 infection, including those with cirrhosis. The trial found that the treatment provided high rates (99%) of sustained virologic response at 12 weeks after treatment in both previously treated and untreated patients with HCV genotypes 1, 2, 4, 5, or 6 infection, including those with cirrhosis. Serious adverse events occurred in 2% of patients receiving sofosbuvir-velpatasvir and none in the placebo group
The International Journal of Engineering & Science is aimed at providing a platform for researchers, engineers, scientists, or educators to publish their original research results, to exchange new ideas, to disseminate information in innovative designs, engineering experiences and technological skills. It is also the Journal's objective to promote engineering and technology education. All papers submitted to the Journal will be blind peer-reviewed. Only original articles will be published.
The papers for publication in The International Journal of Engineering& Science are selected through rigorous peer reviews to ensure originality, timeliness, relevance, and readability.
This research article examines the time to antiretroviral treatment (ART) initiation among HIV-infected patients treated for rifampicin-resistant tuberculosis (RR-TB) in Khayelitsha, South Africa. The study found that of 303 RR-TB and HIV co-infected patients not on ART at RR-TB treatment initiation, 257 (85%) started ART during RR-TB treatment, with varying times to initiation. Treatment success and mortality did not differ based on time to ART initiation. However, 15% of patients never started ART, and those who never received ART had a significantly higher risk of death. The study concludes that all RR-TB/HIV patients should initiate ART regardless of CD4 count
A study of health comprehension about the cholera among a slicesin74
A study was conducted among 98 University of Baghdad employees and 30 randomly selected individuals to assess their knowledge of cholera. Most participants correctly identified that cholera is transmitted through contaminated water and food and causes watery diarrhea. While over half of the study group identified bacteria as the causative agent, answers varied more among the control group. The results indicate relatively good understanding of cholera transmission and symptoms but lack of complete knowledge about the bacterial cause.
Clinico-haematological Profile of Falciparum Malaria in a Rural Hospital of T...iosrphr_editor
Aim: To study the clinico-haematological profile malaria in a rural hospital of Tripura.
Material and methods: A cross-sectional hospital-based study was done from at Kulai District
Hospital,Tripura. This hospital based cross sectional study was done on 60 confirmed cases of falciparum
malaria (either by peripheral smear or rapid diagnostic test) admitted in Kulai District Hospital. A case sheet
proforma was prepared and data (demographic profile,clinical feature, investigation, treatment, and
complication) from all indoor patients was collected and analyzed.
Result: Out of 60 patients, 40(66.6%) were males and 20 (33.4%) were females. Most of the patients were
between the age group 21-40 years with the highest prevalence between the age group of 21-30. Fever was the
most common symptom. Anemia was present in 42(70%) patients, out of which 6(10%) patients had severe
anemia. Thrombocytopenia was present in 36(60%) patients.Abnormal liver function tests were observed in
26(43.3%) subjects while abnormal kidney function tests were observed in16(26.6%) patients. All the 60
patients received Artemisinin based antimalarial drugs.
Conclusion: Early detection, prompt management, and adequate supportive therapy may reduce mortality due
to falciparum cerebral malaria.
Treatment of hepatitis C in liver transplant patientApollo Hospitals
A significant proportion of patients with chronic hepatitis C virus (HCV) infection develop cirrhosis and complications of end-stage liver disease over two to three decades and require liver transplantation. However, reinfection is common and leads to further adverse events under immunosuppression. Pretransplant antiviral or pre-emptive therapy is limited to mildly decompensated patients due to poor tolerance. The main stay of management represents directed antiviral therapy after evidence of recurrence of HCV in the transplanted patient.
Prevalence of Hepatitis B Surface Antigen among Undergraduate Students of Gom...IOSR Journals
Incidence of Hepatitis B virus among healthy asymptomatic students in Gombe State University was determined, this was in an effort of providing baseline data on the diseases burden, and the possible risk factors associated with the infection in the study population. A total of 100 serum samples were collected from volunteers and screened using rapid immune chromatographic test kits for Hepatitis B surface antigen (HBsAg). The study revealed that 14% were HBsAg positive. The highest incidence rate of 18.2% (12) was recorded among the age group of 16-25 years, and males recorded the highest incidence rate of 20% (12), indicating that gender but not age might have greater influence on the infection (P= 0.05).
This study analyzed serious non-AIDS events (SNAs) among HIV-infected adults in Latin America. The researchers identified 130 patients with SNA events out of 6007 patients in the cohort, representing an incidence rate of 0.86 events per 100 person-years. Risk factors like hepatitis B/C coinfection, diabetes, and alcohol abuse were associated with SNA events. Lower CD4 cell counts prior to and at the index date were significantly associated with SNA events occurring, even in patients receiving antiretroviral treatment. The study found HIV-associated immune deficiency increased the risk of SNA events.
This document provides a summary of the methods used to develop recommendations for testing, managing, and treating hepatitis C virus (HCV) infection from the American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society of America (IDSA). An expert panel reviews evidence from various sources to develop recommendations that are rated based on strength. The guidance aims to provide up-to-date advice for healthcare providers as new therapies become available.
Hepatitis C virus infection and type 2 diabetes mellitus in Mexican patients. Erwin Chiquete, MD, PhD
34. Chiquete E, Ochoa-Guzmán A, García-Lamas L, Anaya-Gómez F, Gutiérrez-Manjarrez JI, Sánchez-Orozco LV, Godínez-Gutiérrez SA, Maldonado M, Román S, Panduro A. Hepatitis C virus infection and type 2 diabetes mellitus in Mexican patients. Rev Med Inst Mex Seguro Soc. 2012;50(5):481-6. [PMID: 23282259]
This document summarizes a study on the prevalence of type 2 diabetes among hepatitis C virus seropositive subjects in Dutse, Nigeria. The study found that 16.1% of male and 19.4% of female HCV-infected subjects had fasting blood sugar levels above 7 mmol/L, indicating a higher risk of diabetes compared to the control group. Liver enzymes were significantly higher in the HCV group. While some metabolic syndrome parameters differed between groups, the differences were not statistically significant. The study concludes that there is a high prevalence of type 2 diabetes among HCV-infected individuals in Dutse, and factors like age, BMI, triglycerides, and HDL may contribute to the development of diabetes.
This document discusses remaining gaps in hepatitis C research. It notes that while treatment has advanced greatly, a vaccine is still needed. Better strategies are also needed for diagnosis and treatment. Specifically, treatment could be smarter by tailoring duration based on factors like viral load. Most patients may receive more treatment than necessary despite high costs. Global access remains a major challenge as hepatitis C is a leading infectious disease globally.
This study evaluated the safety and efficacy of pegylated interferon alpha-2a (PEG-IFN) monotherapy in 78 hepatitis C virus (HCV) positive hemodialysis patients. An early viral response was seen in 61.5% of patients at 12 weeks. However, only 19.2% had undetectable HCV RNA levels at end of treatment. A sustained viral response was achieved in 14.1% of the initial population. Adherence was poor, with 32% unable to complete the 48-week treatment due to adverse effects. Adverse events were common, occurring in 83% of patients. The incidence of serious adverse events was high at 0.19 per patient-year. The study
This document describes a study that aimed to generate a clinical prediction rule to predict hepatitis C viremia using both clinical and serologic data from 114 hepatitis C virus-seropositive patients. The researchers identified independent predictors of hepatitis C viremia using logistic regression. They found that a ratio of the immunoassay signal strength of the sample to the cutoff value (S/CO) greater than 15 had the best performance at detecting cases with viremia. A rule combining a history of blood transfusion before 1993 and S/CO greater than 15 had the highest accuracy, positive predictive value, and positive likelihood ratio for predicting viremia in all patients. This clinical rule performed even better for predicting viremia in asymptomatic patients
Este documento presenta a Austin Mahone, un joven de San Antonio, Texas que le gusta practicar deportes y escuchar música. Austin disfruta comer pizza y tocar la guitarra, pero no le gusta leer ni ir a la escuela. Se comunica con amigos por teléfono y correo electrónico.
This study found that patients with type 2 diabetes mellitus in Ghana had a 46% increased risk of infection with the malaria parasite Plasmodium falciparum compared to people without diabetes. While most malaria infections detected were asymptomatic and only found by PCR testing, the risk of infection was higher in people with diabetes and increased with higher blood glucose levels. As diabetes prevalence increases in sub-Saharan Africa, more people may be at risk for malaria infection due to the immune dysfunction caused by diabetes.
New Treatment for hepatitis C: Impact on morbidity and mortality - Dr Helen H...ReShape
Treating hepatitis C patients with direct-acting antiviral drugs (DAAs) could significantly reduce disease burden in the UK. Strategies focusing only on advanced disease may reduce liver disease cases but will have little impact on transmission. Models show treating mild and moderate cases, including people who inject drugs (PWID), could reduce prevalence and incidence of hepatitis C among PWID by over 50% by 2030, curbing new infections. Achieving WHO elimination targets by 2030 will be challenging and require improved testing, treatment, and harm reduction for PWID. Monitoring outcomes like new infections and liver disease cases can assess progress toward elimination goals.
Evolution and Revolution: Current Issues in HIV and HCV Co-infection
Chapter 1 – HIV-Hepatitis C Virus Co-infection: An evolving epidemic
Chapter 2 - Management of HIV infection in HIV/HCV co-infected patients
Chapter 3 - Management of HCV in co-infected patients
Chapter 4 - HCV Therapy: Direct acting antiviral agents in co-infected individuals
Chapter 5 - Drug interactions with directly acting antivirals for HCV: Overview & challenges in HIV/HCV Co-infection
Chapter 6 - Complicated cases
Chapter 7 - Future trials of Hepatitis C therapy in the HIV co-infected
Chapter 8 - HCV infection in marginalized populations
Chapter 9 - HIV/HCV Co-infection: Through the eyes of a co-infected hemophiliac
Sydney Sexual Health Centre Journal Club presentation by Cherie Desreaux on the British Medical Journal and the Medical Journal of Australia editions published between November 2015 and March 2016.
The Sydney Sexual Health Centre Journal Club allows our team to stay up-to-date with what is being published in the field of sexual health. Staff members take turns to read, review and share the contents of an allocated journal. Journal Club encourages knowledge sharing and discussion about topics raised.
This document summarizes a clinical trial that evaluated the efficacy and safety of a 12-week treatment with sofosbuvir and velpatasvir (a fixed-dose combination tablet) in patients with chronic hepatitis C virus (HCV) genotype 1, 2, 4, 5, or 6 infection, including those with cirrhosis. The trial found that the treatment provided high rates (99%) of sustained virologic response at 12 weeks after treatment in both previously treated and untreated patients with HCV genotypes 1, 2, 4, 5, or 6 infection, including those with cirrhosis. Serious adverse events occurred in 2% of patients receiving sofosbuvir-velpatasvir and none in the placebo group
The International Journal of Engineering & Science is aimed at providing a platform for researchers, engineers, scientists, or educators to publish their original research results, to exchange new ideas, to disseminate information in innovative designs, engineering experiences and technological skills. It is also the Journal's objective to promote engineering and technology education. All papers submitted to the Journal will be blind peer-reviewed. Only original articles will be published.
The papers for publication in The International Journal of Engineering& Science are selected through rigorous peer reviews to ensure originality, timeliness, relevance, and readability.
This research article examines the time to antiretroviral treatment (ART) initiation among HIV-infected patients treated for rifampicin-resistant tuberculosis (RR-TB) in Khayelitsha, South Africa. The study found that of 303 RR-TB and HIV co-infected patients not on ART at RR-TB treatment initiation, 257 (85%) started ART during RR-TB treatment, with varying times to initiation. Treatment success and mortality did not differ based on time to ART initiation. However, 15% of patients never started ART, and those who never received ART had a significantly higher risk of death. The study concludes that all RR-TB/HIV patients should initiate ART regardless of CD4 count
A study of health comprehension about the cholera among a slicesin74
A study was conducted among 98 University of Baghdad employees and 30 randomly selected individuals to assess their knowledge of cholera. Most participants correctly identified that cholera is transmitted through contaminated water and food and causes watery diarrhea. While over half of the study group identified bacteria as the causative agent, answers varied more among the control group. The results indicate relatively good understanding of cholera transmission and symptoms but lack of complete knowledge about the bacterial cause.
Clinico-haematological Profile of Falciparum Malaria in a Rural Hospital of T...iosrphr_editor
Aim: To study the clinico-haematological profile malaria in a rural hospital of Tripura.
Material and methods: A cross-sectional hospital-based study was done from at Kulai District
Hospital,Tripura. This hospital based cross sectional study was done on 60 confirmed cases of falciparum
malaria (either by peripheral smear or rapid diagnostic test) admitted in Kulai District Hospital. A case sheet
proforma was prepared and data (demographic profile,clinical feature, investigation, treatment, and
complication) from all indoor patients was collected and analyzed.
Result: Out of 60 patients, 40(66.6%) were males and 20 (33.4%) were females. Most of the patients were
between the age group 21-40 years with the highest prevalence between the age group of 21-30. Fever was the
most common symptom. Anemia was present in 42(70%) patients, out of which 6(10%) patients had severe
anemia. Thrombocytopenia was present in 36(60%) patients.Abnormal liver function tests were observed in
26(43.3%) subjects while abnormal kidney function tests were observed in16(26.6%) patients. All the 60
patients received Artemisinin based antimalarial drugs.
Conclusion: Early detection, prompt management, and adequate supportive therapy may reduce mortality due
to falciparum cerebral malaria.
Treatment of hepatitis C in liver transplant patientApollo Hospitals
A significant proportion of patients with chronic hepatitis C virus (HCV) infection develop cirrhosis and complications of end-stage liver disease over two to three decades and require liver transplantation. However, reinfection is common and leads to further adverse events under immunosuppression. Pretransplant antiviral or pre-emptive therapy is limited to mildly decompensated patients due to poor tolerance. The main stay of management represents directed antiviral therapy after evidence of recurrence of HCV in the transplanted patient.
Prevalence of Hepatitis B Surface Antigen among Undergraduate Students of Gom...IOSR Journals
Incidence of Hepatitis B virus among healthy asymptomatic students in Gombe State University was determined, this was in an effort of providing baseline data on the diseases burden, and the possible risk factors associated with the infection in the study population. A total of 100 serum samples were collected from volunteers and screened using rapid immune chromatographic test kits for Hepatitis B surface antigen (HBsAg). The study revealed that 14% were HBsAg positive. The highest incidence rate of 18.2% (12) was recorded among the age group of 16-25 years, and males recorded the highest incidence rate of 20% (12), indicating that gender but not age might have greater influence on the infection (P= 0.05).
This study analyzed serious non-AIDS events (SNAs) among HIV-infected adults in Latin America. The researchers identified 130 patients with SNA events out of 6007 patients in the cohort, representing an incidence rate of 0.86 events per 100 person-years. Risk factors like hepatitis B/C coinfection, diabetes, and alcohol abuse were associated with SNA events. Lower CD4 cell counts prior to and at the index date were significantly associated with SNA events occurring, even in patients receiving antiretroviral treatment. The study found HIV-associated immune deficiency increased the risk of SNA events.
This document provides a summary of the methods used to develop recommendations for testing, managing, and treating hepatitis C virus (HCV) infection from the American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society of America (IDSA). An expert panel reviews evidence from various sources to develop recommendations that are rated based on strength. The guidance aims to provide up-to-date advice for healthcare providers as new therapies become available.
Hepatitis C virus infection and type 2 diabetes mellitus in Mexican patients. Erwin Chiquete, MD, PhD
34. Chiquete E, Ochoa-Guzmán A, García-Lamas L, Anaya-Gómez F, Gutiérrez-Manjarrez JI, Sánchez-Orozco LV, Godínez-Gutiérrez SA, Maldonado M, Román S, Panduro A. Hepatitis C virus infection and type 2 diabetes mellitus in Mexican patients. Rev Med Inst Mex Seguro Soc. 2012;50(5):481-6. [PMID: 23282259]
This document summarizes a study on the prevalence of type 2 diabetes among hepatitis C virus seropositive subjects in Dutse, Nigeria. The study found that 16.1% of male and 19.4% of female HCV-infected subjects had fasting blood sugar levels above 7 mmol/L, indicating a higher risk of diabetes compared to the control group. Liver enzymes were significantly higher in the HCV group. While some metabolic syndrome parameters differed between groups, the differences were not statistically significant. The study concludes that there is a high prevalence of type 2 diabetes among HCV-infected individuals in Dutse, and factors like age, BMI, triglycerides, and HDL may contribute to the development of diabetes.
This document discusses remaining gaps in hepatitis C research. It notes that while treatment has advanced greatly, a vaccine is still needed. Better strategies are also needed for diagnosis and treatment. Specifically, treatment could be smarter by tailoring duration based on factors like viral load. Most patients may receive more treatment than necessary despite high costs. Global access remains a major challenge as hepatitis C is a leading infectious disease globally.
This study evaluated the safety and efficacy of pegylated interferon alpha-2a (PEG-IFN) monotherapy in 78 hepatitis C virus (HCV) positive hemodialysis patients. An early viral response was seen in 61.5% of patients at 12 weeks. However, only 19.2% had undetectable HCV RNA levels at end of treatment. A sustained viral response was achieved in 14.1% of the initial population. Adherence was poor, with 32% unable to complete the 48-week treatment due to adverse effects. Adverse events were common, occurring in 83% of patients. The incidence of serious adverse events was high at 0.19 per patient-year. The study
This document describes a study that aimed to generate a clinical prediction rule to predict hepatitis C viremia using both clinical and serologic data from 114 hepatitis C virus-seropositive patients. The researchers identified independent predictors of hepatitis C viremia using logistic regression. They found that a ratio of the immunoassay signal strength of the sample to the cutoff value (S/CO) greater than 15 had the best performance at detecting cases with viremia. A rule combining a history of blood transfusion before 1993 and S/CO greater than 15 had the highest accuracy, positive predictive value, and positive likelihood ratio for predicting viremia in all patients. This clinical rule performed even better for predicting viremia in asymptomatic patients
Este documento presenta a Austin Mahone, un joven de San Antonio, Texas que le gusta practicar deportes y escuchar música. Austin disfruta comer pizza y tocar la guitarra, pero no le gusta leer ni ir a la escuela. Se comunica con amigos por teléfono y correo electrónico.
Este documento promueve unirse al Plan de Regalos Perfectos (PGP), un sistema que ofrece abundancia a través de regalos monetarios. PGP funciona llenando una matriz de 2x2 a través de referidos, lo que genera regalos proporcionales al nivel de inversión inicial. Al compartir PGP con otros y completar la matriz, se recibirán mayores cantidades a través de la aplicación de leyes universales como la reciprocidad y la causa y efecto. Se invita a participar por los bajos costos de registro e ingreso
Las TICs no están diseñadas específicamente para la educación y no incluyen una guía pedagógica, sino que ofrecen herramientas y aplicaciones. Se requiere sentido común para determinar cómo usar las TICs de manera efectiva en el aula.
Creating Smarter Cities 2011 - 19 - Mike Thacker - User profiling for descisi...Smart Cities Project
Mike gives the first public viewing of tools for understanding the make-up of households served by municipalities in the North Sea Region and more widely in Europe. He shows how the European Service List, developed by Smart Cities, can be combined with information on local populations to predict service demand and target public sector services at the right people.
The document describes a Christmas party held on the last day of school, where students baked goods, joked around, talked with their teacher, invited older students, listened to music, sang carols, made pictures, and looked forward to returning to class next year.
There are 3 main ways to record a PowerPoint presentation:
1. Using the built-in PowerPoint recording feature which records audio and slides but not the presenter.
2. Using Camtasia Studio which records the presentation within PowerPoint and allows recording of audio, slides, and camera footage of the presenter.
3. Specific steps are outlined for setting up, recording, editing, and cancelling a recording within Camtasia Studio to capture a PowerPoint presentation with audio and video.
The document provides information about Bill Riddle's professional experience and qualifications. It summarizes that Bill has 35 years of experience as a journeyman carpenter but is looking to change careers to shipping/receiving due to his age. It also lists his previous work experience with various construction companies from 1975 to 2000 and notes he has never received a callback to repair any of his work.
This document provides tips for creating effective PowerPoint slides and avoiding common pitfalls. It discusses best practices for slide structure, fonts, colors, backgrounds, graphs, spelling and grammar. Key recommendations include using point form, limiting text per slide, large readable fonts, high contrast between text and background, simple attractive backgrounds, properly formatted graphs with labels and titles, and proofreading for errors. The conclusion emphasizes ending strongly and inviting questions.
El documento discute los efectos del calentamiento global y la necesidad de tomar acciones para proteger el medio ambiente. Argumenta que el ser humano es la única especie capaz de dañar el planeta y que el calentamiento global ya ha comenzado, lo que podría tener consecuencias graves como un aumento de 4-6°C en la temperatura y la extinción del 40% de las especies animales. Se enfatiza la importancia de concientizar a otros y adoptar estilos de vida más sostenibles, como ahorrar energía, plantar árboles y elegir
El documento proporciona instrucciones en 5 pasos para actualizar la ficha de matrícula en la página web del Sena, incluyendo ingresar con nombre de usuario y contraseña, hacer clic en "Ver Actualizar Ficha", diligenciar los datos requeridos, y seleccionar una opción de "CARACTERIZACIÓN" para evitar que el sistema rechace la solicitud.
Michael D. Rapp has completed all course requirements for an OSHAcademy training course on Safety Supervision and Leadership. The course covered topics such as supervisor responsibilities, hazard identification, safety inspections, accident investigation, job hazard analysis, correcting hazards, safety training, leadership styles, accountability, discipline, and safety culture. The certificate verifies Michael Rapp received 6 hours of training that conforms to OSHA and ANSI standards for safety training.
Matu! muy feliz cumple! te amamos ojitos de cielo!!!! 06/02/14Maribel Espinosa
A birthday card celebrates a 7-year-old boy named Mateo on his birthday. It expresses happiness for his special day and that his parents Lautaro, Papá and Mamá all love him.
Technology provides various forms of entertainment for people of all ages. Entertainment technology uses components to enhance experiences. Television is a popular entertainment medium that has advanced from black and white to modern LCDs. Shopping malls allow people to shop, eat, and be entertained under one roof. LEDs and Swarovski crystals are used to create dazzling dresses. iPhone applications can add interactivity. Special effects in movies have advanced from physical to digital using cameras and computers. Amusement parks and virtual reality simulations provide thrilling indoor entertainment. Cinemas now offer enhanced 3D experiences. Discos and interactive exhibits make events more engaging. The internet allows people to socialize and learn from home.
This document contains daily schedules for science classes in grades 5th, 6th and 7th/8th from November 18th through November 22nd. Each day lists the bell work topic, agenda items like labs and lessons, and any homework assigned. On the last day, November 22nd, the schedules wished all students a great break.
This document provides instruction on using object pronouns in English. It begins with a review of subject pronouns and how they identify the subject of a sentence. It then introduces object pronouns, which replace nouns that are the object of a verb. Examples are provided to illustrate their use. The forms of the object pronouns are presented, along with guidance on using them to replace singular and plural nouns. The document concludes with practice exercises for the reader to write sentences using object pronouns correctly.
The document summarizes information about several hepatitis viruses including HAV, HBV, HCV, HDV, and HEV. It provides details on their geographical distribution, modes of transmission, clinical presentation, natural history, and markers used to diagnose infection. Highlights include that HBV is a major cause of liver cancer and cirrhosis worldwide, with 400 million chronic carriers. Chronic HBV infection progression can lead to complications like liver failure, cancer, and death if left untreated.
Need of Dual Antiviral Treatment in Chronic Hepatitis BJohnJulie1
The primary indication for an esophagectomy is esophageal cancer or Barrett’s esophagus with high-grade dysplasia. Patients undergoing esophagectomy often present with dysphagia, side effects from chemotherapy, decreased appetite, and weight loss. Esophagectomy may be an operation involving the abdomen, neck, and/or chest requiring 5 to 7 days of NPO status to permit healing of the anastomosis between the upper esophagus and new esophageal conduit (usually the stomach).
Need of Dual Antiviral Treatment in Chronic Hepatitis BJohnJulie1
Approximately one third of the world’s population has serological evidence of past or present infection with the hepatitis B virus (HBV). An estimated 350-400 million people are surface HBV antigen (HBsAg) carriers. India has 40 million HBV carriers i.e. 10–15% share of total pool of HBV carriers of the world. In India.
Approximately one third of the world’s population has serological evidence of past or present infection with the hepatitis B virus (HBV). An estimated 350-400 million people are surface HBV antigen (HBsAg) carriers. India has 40 million HBV carriers i.e. 10–15% share of total pool of HBV carriers of the world. In India.
Hepatitis is inflammation of the liver that can be caused by infectious or noninfectious factors. Liver function tests evaluate hepatocellular damage and include ALT, AST, alkaline phosphatase, bilirubin, and others. Hepatitis A and E viruses are transmitted fecally-orally and cause self-limiting hepatitis, while hepatitis B, C, and D are blood-borne and can lead to chronic infection. Diagnosis involves serologic testing for viral antigens and antibodies. Treatment depends on viral type and stage of infection.
This document discusses hepatitis and cirrhosis. It defines hepatitis as inflammation of the liver and describes various causes including infectious viruses like hepatitis A, B, C, D, and E. It also discusses liver function tests used to evaluate hepatitis and liver damage. Cirrhosis is defined as progressive scarring of the liver caused by chronic liver disease like viral hepatitis or alcoholism. The document details clinical presentation, diagnosis, and management of various liver diseases.
ABSTRACT- Background: Viral hepatitis B and C can lead to the end stage liver disease and diabetes mellitus is also
a life-long chronic disease. Simultaneous presences of both of these conditions lead to synergistic detrimental outcome.
So identification of diabetes mellitus at the initial evaluation of a patient having chronic hepatitis B and C is essential.
Materials and methods: This study was designed as a retrospective single center cross-sectional study. The association
of viral hepatitis B and C with diabetes mellitus was investigated at the Liver Centre Dhaka, Bangladesh for a period of
12 years. HBsAg was tested for hepatitis B virus infection and anti-HCV for hepatitis C virus infection. Demographic
profile and biochemical data were retrieved from records.
Results: A total of 29425 cases were analyzed in the study [median age 31(19–95) years, 24615(84%) males]. HBsAg
positive were 27475 and hepatitis C were 1950. Patients with hepatitis C were older than hepatitis B (p<0.001).
Although previous history of jaundice was similar in both infections but history of blood transfusion was more common
among hepatitis C patients (p<0.001). Analyzing different conditions of liver disease, it was observed that hepatitis B
virus infection was highly responsible for acute hepatitis than hepatitis C (10.7% vs 1.1%) (p<0.001). Chronic hepatitis
was similar in rate (73.3% vs 59.9%). But in both conditions of cirrhosis of liver like compensated and decompensated
states, hepatitis C virus was significantly responsible than the hepatitis B virus 24.7% vs 9.6% (p<0.001) and 14.3% vs
6.4% (p<0.001) respectively. The most significant finding was very higher rate of diabetes among hepatitis C which
was 22.6% while only 1.8% among hepatitis B virus infection (p<0.001).
Conclusion: Hepatitis C virus was highly related with the presence of diabetes than hepatitis B.
Key-words- Diabetes mellitus, Prevalence, Hepatitis B virus, Hepatitis C virus
Assessment of serum lipid profile in patients with chronic hepatitis cTanveer00786
1. The document discusses a study that assessed the serum lipid profiles of 100 patients diagnosed with chronic hepatitis C.
2. It found that 63% of patients had normal lipid levels, 3% were hyperlipidemic, and 34% were hypolipidemic.
3. The study indicates that progression of hepatitis C viral infection can lead to decreased levels of lipids.
This study examined the prevalence of hepatitis C virus (HCV) among indoor and outdoor patients at a tertiary care hospital in India over one year. Blood samples from 10,750 patients were tested for HCV antibodies. Overall, 3.74% of samples were positive. The positivity rate was higher in males (4.16%) than females (2.95%) and highest in the 11-20 age group (5.6%). Indoor samples had a higher positivity rate (7.8%) than outdoor samples (2.3%). Groups with especially high rates included patients on dialysis (13.1%), those in the thalassemia unit (12.8%), and patients in the gastroenterology surgery
A 45-year-old woman presents with fatigue, weakness, loss of appetite, and abnormal liver function tests. Laboratory results show elevated AST, ALT, bilirubin levels and positive tests for HCV antibody and RNA. A liver biopsy revealed severe inflammation and bridging fibrosis. The patient is diagnosed with chronic hepatitis C virus infection based on her history of blood transfusion, symptoms, laboratory abnormalities and biopsy findings. The best course of action is to treat her HCV infection with antiviral therapy to reduce liver damage and prevent progression to cirrhosis.
Hepatitis is inflammation of the liver that can be caused by infections or non-infectious factors. Chronic hepatitis can lead to cirrhosis, where liver tissue is scarred and architecture is destroyed. Common causes of cirrhosis include hepatitis C, alcoholic liver disease, and nonalcoholic fatty liver disease. Cirrhosis presents with symptoms ranging from fatigue to complications like bleeding and hepatic encephalopathy. Diagnosis involves blood tests, imaging, and biopsy. Treatment focuses on managing complications and transplantation for late-stage disease.
This study analyzed 223 HIV-HBV co-infected patients in France to describe epidemiological, virological and clinical characteristics. Most patients were male (82%) with a mean age of 42. HBV genotypes identified (A 52%, E 23.3%, D 16.1%) reflected different risk factors and geographic origins. Advanced liver lesions were seen in 54% and associated with older age and lower CD4 counts. 74.7% received antiviral therapy including 47% receiving tenofovir, though persistent HBV replication in some suggested non-optimal adherence. Findings support further optimizing management and HBV vaccination in HIV patients.
This study examined the association between blood group antigens, CD4 cell count, and hemoglobin patterns in HIV-infected patients. 240 newly diagnosed HIV-positive patients and 120 healthy controls were analyzed. There was no significant association found between ABO/Rh blood groups or hemoglobin genotypes between the two groups. However, a significant association was observed between CD4 cell count and ABO blood group, with blood groups A and AB having higher average CD4 counts. The study suggests blood group A may confer some immunity against HIV infection.
Hepatitis c. diagnosis and treatment.assld guidelines.2016 .2017Dr. Afzal Haq Asif
A 45-year-old woman presented with fatigue, weakness, loss of appetite, and anemia. Liver function tests showed elevated AST, ALT, and bilirubin levels indicating liver inflammation and damage. A liver biopsy revealed necroinflammation and fibrosis. This suggests a diagnosis of chronic hepatitis C, which would be confirmed by a positive HCV RNA test. The best course of action would be to treat the patient with direct-acting antiviral therapy to cure the hepatitis C infection, advise lifestyle changes to protect the liver, and monitor for complications like cirrhosis or liver cancer.
1) A 29-year-old woman presented with jaundice, abdominal pain, and nausea/vomiting. Her liver enzymes were elevated and ultrasound showed a normal liver. She was diagnosed with acute hepatitis A.
2) A 38-year-old man with a history of elevated liver enzymes presented with mildly elevated enzymes. He tested positive for hepatitis B and C markers, indicating chronic hepatitis C infection.
3) Hepatitis C is a major cause of liver disease in the US, infecting an estimated 4 million people, with 30,000 new infections annually and 12,000-15,000 deaths from hepatitis C each year.
This document provides information on managing hepatitis C in primary care. It discusses gaps in the hepatitis C care continuum, with up to 90-95% of individuals living with hepatitis C being unaware of their infection. Screening for hepatitis C is important for improving detection and treatment. The natural history of hepatitis C infection is described, showing how timely treatment can arrest disease progression and prevent death. Groups at risk for hepatitis C infection are identified. Guidelines for pre-treatment assessment and approved direct-acting antiviral treatment regimens are presented, along with considerations for special patient groups such as those with HIV, hepatitis B, or kidney disease coinfection. Monitoring during and after treatment is also covered.
This document discusses several viruses that cause gastroenteritis in humans. Rotavirus is identified as the leading cause of severe diarrhea in children under 5 years old worldwide. Latex agglutination testing is described as a rapid method for detecting rotavirus in stool samples. The study found a higher prevalence of rotavirus infection in HIV-positive patients compared to HIV-negative patients presenting with diarrhea. Enteric adenoviruses, norovirus, and sapovirus are also discussed as important causes of viral gastroenteritis. Electron microscopy, enzyme immunoassays, and PCR-based methods are described for laboratory diagnosis of these viruses from stool specimens.
A 45-year-old woman presented with fatigue, weakness, and loss of appetite. Laboratory tests found elevated liver enzymes and HCV RNA. A liver biopsy showed severe inflammation and fibrosis. She was diagnosed with chronic hepatitis C based on her history of blood transfusion, laboratory results, and biopsy findings. The best course of action would be to treat her hepatitis C with pegylated interferon and ribavirin therapy to reduce liver damage and prevent progression to cirrhosis.
This document discusses a protocol for a systematic review that aims to synthesize evidence on the relative risk of mortality in type 2 diabetes mellitus (T2DM). It provides background on the prevalence of T2DM and discusses inconsistencies in reported mortality rates. The systematic review will explore all-cause mortality risk in T2DM expressed as hazard ratios, and examine subgroups based on age, gender, socioeconomic factors and causes of death. The review expects to pool data from large cohort studies to accurately summarize the actual mortality risk in T2DM with limited bias and help direct future research.
1) The document discusses the role of platelets in malaria-related acute lung injury (MALI) and acute respiratory distress syndrome (MARDS). Platelets are recognized as playing a role in immune responses and their presence in the lungs suggests they may contribute to respiratory diseases.
2) Two key steps in the pathogenesis of both MALI/MARDS and non-malarial ALI/ARDS are neutrophil activation/infiltration into the lungs and increased pulmonary capillary permeability. The document hypothesizes that platelets may facilitate these steps in MALI/MARDS through physical interactions with immune cells and secretion of inflammatory factors.
3) Studies of mouse models of MALI/MARDS have provided insights
The letter describes the author's negative experiences with medical treatment that have left her disabled. She details being mistreated during childbirth and receiving epidural steroid injections for back pain that caused permanent damage, leaving her unable to care for herself. The author believes the injections were performed for profit without proper patient consent. She now suffers constant pain and loss of mobility due to adhesive arachnoiditis caused by the medical procedures. The letter calls for reform to prevent other patients from experiencing similar harm.
A 53-year-old man experienced a seizure after taking 20mg of fluoxetine daily for 3 weeks to treat depression. He had no known risk factors for seizures. While fluoxetine is generally considered to have a low risk of seizures, there have been some reports of isolated cases of fluoxetine-induced seizures. The clinician concluded that fluoxetine was likely associated with the seizure in this case, as most potential risk factors were ruled out. Clinicians should be aware of the potential for fluoxetine and other antidepressants to lower seizure thresholds, especially in the first few weeks of treatment or at higher than normal doses.
This document reports on two cases of patients with Wilson's disease who developed severe gastric ulcers after beginning treatment with zinc acetate. Both patients presented with epigastric pain months after starting zinc acetate therapy. Endoscopies revealed gastric ulcers in both patients, which resolved after discontinuing zinc acetate and starting proton pump inhibitor therapy. This is the first reported case of zinc acetate-induced gastric ulcers in Wilson's disease patients. Clinicians should be aware of this potential side effect when prescribing zinc salts to Wilson's disease patients.
This document discusses the relationship between vitamin D, calcium levels, and type 2 diabetes (T2DM). It suggests that low vitamin D and calcium levels may play a role in the development of T2DM by impacting insulin secretion and resistance. The document reviews studies showing associations between low vitamin D levels and impaired glucose tolerance/diabetes. While vitamin D's main role is maintaining calcium levels and bone health, emerging evidence indicates it may also influence T2DM risk and glycemic control through effects on insulin and immune function.
This document discusses the importance of therapists addressing their own unresolved issues and childhood conflicts in order to effectively help patients. It notes that unresolved problems in a therapist's life can negatively influence the therapeutic process through countertransference. The document recommends therapy for therapists to help recognize and manage countertransference responses that could violate patient boundaries or priorities. It emphasizes the need for self-reflection in therapists to prevent their own needs from interfering with the patient's therapeutic process.
This document discusses nutrigenomics and nutrigenetics, which are two related but distinct fields that examine the relationship between genetics and nutrition. Nutrigenomics looks at how foods and nutrients influence gene expression, while nutrigenetics focuses on how genetic variations impact an individual's response to specific foods and nutrients. The document provides examples of how knowledge in these fields can help identify personalized diets and nutritional interventions tailored to one's genetic profile that may help prevent or treat chronic diseases like obesity, cardiovascular disease, and cancer. It also discusses some specific genetic disorders like lactose intolerance and phenylketonuria where restricting certain foods can benefit affected individuals.
This study aimed to determine the correlation between stature and cranial measurements in a population from North India. Cranial length, breadth, and height were measured on 800 medical students aged 17-25 years. Regression analyses found significant positive correlations between stature and both cranial length and breadth for both males and females. Regression equations were generated that could estimate stature based on cranial measurements, which the authors concluded could be useful for forensic and anthropological applications when only skull remains are available. Measurement reliability was high, with technical error of less than 0.5 cm. The study provides population-specific equations for estimating height from cranial dimensions in North Indians.
1) The study investigated the dietary patterns and prevalence of anemia among 108 female adolescent garment workers in Bangladesh.
2) It found extremely high prevalence of anemia, with 92% of participants anemic, including 54% moderately anemic and 38% mildly anemic.
3) The participants' diets were found to be generally inadequate, as most did not consume foods like milk, meat, or snacks regularly during the week.
This study examined the correlation between body height and cranial measurements in 800 medical students (400 male, 400 female) aged 17-25 years in North India. Cranial length and breadth were measured and found to be significantly larger in males than females. A positive correlation was found between height and cranial dimensions in both sexes. Regression equations were derived that could estimate height from cranial length or breadth measurements. Precision estimates for height and cranial dimension measurements showed a high degree of accuracy. The results indicate cranial dimensions could help estimate height, which has importance for anthropology and forensic sciences.
This study examined the correlation between body height and cranial measurements in 800 medical students (400 male, 400 female) aged 17-25 years in North India. Cranial length and breadth were measured and found to be significantly larger in males than females. A positive correlation was found between height and cranial dimensions in both sexes. Regression equations were derived that could estimate height from cranial length or breadth measurements. Precision estimates for height and cranial dimension measurements showed a high degree of accuracy. The results indicate cranial dimensions could help estimate height, which has importance for anthropology and forensic sciences.
This document summarizes a study that assessed the prevalence of anxiety and depression in tuberculosis patients and its impact on their quality of life. Some key findings include:
- 37.1% of tuberculosis patients were found to have anxiety and 37.1% had depression according to the Hospital Anxiety and Depression Scale, compared to only 8.6% and 2.9% respectively in the control group.
- Quality of life parameters like perceived health, relationships, and occupational role were found to be significantly impacted in tuberculosis patients compared to healthy individuals.
- Higher levels of anxiety and depression were found in tuberculosis patients who had been undergoing treatment for less than 3 months compared to those being treated for longer durations.
- A study examined the effects of a one-week dietary supplement program consisting of protein shakes and liquid supplements on weight, body fat, cholesterol, and triglycerides in 35 overweight adults.
- After one week, participants experienced statistically significant weight loss of 7.5 lbs on average accompanied by decreased body fat percentage, waist circumference, and other measurements. Cholesterol and triglycerides also decreased significantly.
- Those who continued the program for a second week saw further decreases in weight, body fat, and circumference measurements, suggesting the supplement combination can safely and effectively aid in short-term weight and fat loss.
This document discusses issues with the methodology used to compute suicide rates. It analyzes suicide rate data from India from 1991-2013 when excluding different age populations from 6-9 years old from the total population. Excluding younger ages who likely do not have the cognitive capacity to understand death increases the computed suicide rate, with rates increasing from 11.2 to 14.6 depending on the age cut-off. The percent increase in rates also rises when excluding younger populations, from 16.1% to 33.7%, highlighting that including the entire population dilutes the suicide rate calculation. The document argues for a standardized definition of suicide and debate on a child's concept of death across cultures to better understand suicide rates.
This study used scanning electron microscopy to examine the protoscoleces and hooks of Echinococcus granulosus extracted from infected organs of sheep and camels in Libya. SEM images showed morphological variations in the protoscoleces and differences between large and small hooks. Measurements of the hooks found significant statistical differences between hook sizes from different organs and hosts. The findings suggest the need to further study relationships between hook morphology and E. granulosus strains to aid in identification and epidemiological investigations.
This study used scanning electron microscopy to examine the protoscoleces and hooks of Echinococcus granulosus collected from infected organs in Libya. SEM images showed morphological variations in the protoscoleces and differences between large and small hooks. Measurements of the hooks found significant statistical differences between hook sizes from different organs and hosts. While some hooks appeared normal, others showed abnormalities in shape, notches or guard structure. This suggests a need to further study relationships between hook morphology and E. granulosus strains to help with identification and epidemiological investigations.
This study investigated the morphological and functional aspects of the hand in relation to age, gender, and sports participation. The researchers measured hand dimensions and grip strength in 546 children aged 9-18 years who were grouped as little (9-11 years), youth (12-14 years), and junior (15-18 years). The children were further divided into sporting and non-sporting groups. The results showed statistically significant differences in several hand measurements and grip strength between the sporting and non-sporting groups, with differences seen in both males and females of different age groups. The findings suggest sports participation is associated with morphological and functional differences in the hand.
This study examined the potential protective effects of mesenchymal stem cell (MSC) therapy against cisplatin-induced nephrotoxicity in rats. Rats were treated with cisplatin to induce kidney damage and divided into groups that received either MSCs or no additional treatment. Kidney tissue was analyzed histologically and biochemically after 4 weeks. Cisplatin caused significant kidney damage including atrophied glomeruli, thickened membranes, and tubule damage. It also increased serum markers of kidney injury and electrolyte levels. Rats treated with MSCs after cisplatin showed substantially reduced kidney damage on histology and ultrastructure. Biochemical markers and electrolyte levels were also largely restored to normal
The editorial discusses whether there is a genetic basis for recidivism, or re-offending, among sex offenders and violent criminals. It notes that recidivism rates are around 18.9% for rapists and 12.7% for child molesters. Recent genetic research suggests that certain genes may predispose individuals to impulsive or antisocial behaviors, putting them at greater risk of criminal involvement. Specifically, studies have found a link between low levels of the MAOA enzyme and increased antisocial behavior. While genetics cannot determine behavior directly, an understanding of biological and social factors related to criminality could help develop more preventative and humane criminal justice policies that incorporate genetic risk factors.
1. Isolated Proteinuria in Hepatitis A Versus E Virus
(HAV vs HEV) Infected Patients: A Hospital
Based Observational Study
Corresponding Author:
Dr. Waheeda Nargis, Associate Professor, Department of Biochemistry, Uttara Adhunik Medical College, Dhaka, Bangladesh.
E‑mail: waheedanargis@yahoo.com Original Article
W Nargis1, BU Ahamed2
1Associate Professor, Department of Biochemistry, Uttara Adhunik Medical College, Dhaka, 2Associate Professor, Department of F.Med,
Monno Medical College, Dhaka
ABSTRACT
Introduction: Viral hepatitis, either acute or chronic, may lead to nephropathies as one of its multiple extrahepatic complications
which often remain clinically silent for a long period and are overlooked. Proteinuria can be a useful tool for early detection of the
underlying renal impairment. This study was undertaken to detect the presence of proteinuria and to assess and compare the level
of proteinuria in HAV and HEV- infected cases; the two most common causes of acute hepatitis in Bangladesh. Method: For this
100 diagnosed patients of HAV & HEV (50 each) hepatitis were screened for isolated proteinuria in a random spot urine sample
during their 3rd to 4th post-ecteric follow ups. Result: 43% HAV and 45% HEV patients had high spot urinary protein with maximum
incidence (54 %) occurring in 3rd decades of life. The pattern of isolated proteinuria was significantly different in HAV vs HEV cases.
The mean ± SD value of spot urinary protein of HEV females was significantly higher than that of HAV where highest rate (64%) of mild
proteinuria was observed in HAV and maximum number (46%) of moderate proteinuria in HEV patients. Conclusion: Spot urinary
protein concentration should be checked quantitatively in every HEV as well as HAV- hepatitis patient even when clinically improved.
Keywords: Isolated proteinuria, Nephropathy, Viral hepatitis
a wide range of extrahepatic features, including renal
disease. But, extra-hepatic manifestations are unusual
in hepatitis A, and renal manifestations are even more
infrequent. Still, a variety of renal manifestations
can be observed in patients with HAV infection who
are biochemically stable (normal aminotransferase
levels).2,7,8 Such patients may present with proteinuria
in their post-icteric phase which can be detected
during their third or fourth follow-up. Hepatitis
itself can cause proteinuria which usually subsides
within the first week of jaundice.6,7 Thus, patients
with both HAV or HEV infections are recommended
to be followed up 3-4 weeks after discharge, and if
necessary at monthly intervals for next 3 months5 as
relapse may occur even after complete recovery9 or
course may be prolonged (abnormal aminotransferase
levels) even more than 14 weeks10 resulting in a
complicated outcome with atypical manifestations.
The abscense of severe liver disease precludes a
missed diagnosis of underlying renal manifestations.2,6
Proteinuria, a simple test in practice, can be a useful
tool for early detection of the underlying renal
impairment to halt further disease progression and
for effective interventions. This study was undertaken
to evaluate and compare the prevalence as well as
the degree of proteinuria in HAV and HEV- hepatitis
patients.
INTRODUCTION
Hepatitis A and E virus (HAV & HEV) are the most common
causes of acute hepatitis and are endemic in South Asia;
specially in the developing countries, like the Indian
subcontinent1,2 as well as in Bangladesh.2,3 Both viruses
generally cause an acute, self-limiting illness followed by
a complete recovery. Recent studies have shown that both
HAV and HEV can result in severe disease and a poor
outcome. The overall estimated mortality rate associated
with hepatitis A is 0.1% to 0.3%, but this rises to 1.8% over
the age of 50.2,4 On the other hand, HEV draws most of the
attention due to the poorly understood case fatality rate
(>20%) in infected pregnant women, especially in their
second and third trimesters.5
Though complete recovery without squeal is the usual
outcome in these two enteric viral hepatitis, relapsing
form can be seen in 3-20% of the case. Clinically
demonstrable renal disease accounts for about 44.8%
of all extrahepatic manifestations secondary to viral
hepatitis and can occur in acute or chronic cases, which
either may precede or follow overt liver disease6. The
exact mechanism(s) involved are not known yet but
immune complex formation may be an important
etiological factor.2,7 HEV infection is associated with
85 Acta Medica International | Jul - Dec 2014 | Vol 1 | Issue 2 |
2. Nargis and Ahamed: Proteinuria in viral hepatitis
METHODS
A total of 100 diagnosed cases of HAV & HEV (50 each)
hepatitis were selected purposively during their 3rd to
4th follow up in post-ecteric phase. The primary selection
was based on the history, physical examination and
laboratory findings with positive anti-HAV or anti-HEV
antibody, normal serum total bilirubin & serum alanine
transaminase (ALT). The non smoker, non alcoholic
subjects who willingly participated in the study were
duly instructed for sample collection. The random spot
urine specimens were collected along with 5 ml of blood
to conduct all the relevant tests. The specimens were
stored appropriately until analyzed. The cases with
raised fasting plasma glucose (for diabetes), total bilirubin
(acute hepatitis), ALT (for acute state of illness), TG, total
cholesterol (for dyslipidaemia, AGN, nephritic syndrome),
serum creatinine and decreased Ccr (for pre-existing
renal impairment), with raised BP (for hypertension)
and in pregnancy were excluded. The study subjects
were selected from the Department of Hepatology,
and the biochemical tests were done at the Department
of Biochemistry, Bangabandhu Sheikh Mujib Medical
University (BSMMU). The spot urinary protein was
measured by Pyrogallol red molybdate method.9 The spot
urinary protein <10 mg/dl was defined as trace or normal,
≥10 mg/dl as mild proteinuria, >30 mg/dl as moderate and
>100 mg/dl as heavy proteinuria.10 All the collected raw
data was organized and analyzed into statistical format
by using SPSS 12.0 for windows software.
RESULTS
Of all the cases of post viral hepatitis variable amount of spot
urinary protein was detected in a total of 88 cases (43 HAV
and 45 HEV cases). The age range of the selected subjects
was 12 to 35 years with maximum incidence (54 %) occurring
in 3rd decades of life. Distribution of study subjects according
to age, sex is shown in Figure 1. The spot urinary protein
in HAV and HEV study subjects were compared according
to three age ranges (<20, ≥20 and ≥30 years), sex and the
degree of proteinuria, respectively. The mean ± SD value of
spot urinary protein of HEV was higher than that of HAV
though statistically not significant (27.08 ± 14.9 mg/dl vs
22.54 ± 8.7 mg/dl; p>0.05). However, significant difference
was revealed at 3rd decade of life (>20 years) when mean
spot urinary protein of HAV and HEV was compared
among different age ranges (Table-I) and in females when
compared by sex (Table-II).
Out of the total 100 subjects majority (54 %) of cases had mild
proteinuria. Among the rest, 34% had moderate and 12%
had trace proteinuria. The frequency distribution of degree
of spot urinary protein showed significant difference
between HAV and HEV study subjects (Table-III). Majority
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Table 1: Comparison of spot urinary protein in different
age groups of HAV and HEV cases
Age groups
(years)
Spot urinary protein [mean±SD (mg/dl)] p‑value*
<20 27.76±7.8 34.60±20.3 >0.05
≥20 20.76±7.7 26.71±13.6 <0.05
≥30 13.25±8.1 20.00±8.7 >0.05
*Unpaired ‘t’ test
Table 2: Comparison of spot urinary protein in different
age groups of HAV and HEV cases
Sex Spot urinary protein [mean±SD (mg/dl)] p‑value*
HAV HEV
Male 22.19±9.2 24.29±14.1 >0.05
Female 22.96±8.3 30.64±15.5 <0.05
*Unpaired ‘t’ test
Table 3: Comparison of degree of spot urinary protein of
male and female between HAV and HEV cases
Proteinurian (mg/dl) HAV (%) HEV (%) p‑value*
Trace (≤10) 7 (14) 5 (10) <0.05
Mild (11‑30) 32 (64) 22 (44)
Moderate (31‑100) 11 (22) 23 (46)
*Unpaired ‘t’ test
HDUV •HDUV •HDUV
HAV HEV
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Figure 1: Distribution of study subjects according to age range and sex
| Jul - Dec 2014 | Vol 1 | Issue 2 | Acta Medica International 86
3. Nargis and Ahamed: Proteinuria in viral hepatitis
cases) of enteric viral hepatitis. Such higher prevalence
could be explained by the endemicity and the variable
seroprevalence with different genotypes of both HAV and
HEV in South Asian populations. The epidemiology of
HEV is complex, and unlike other enteric pathogens such
as hepatitis A virus (HAV), HEV infection is more common
in the second and third decades of life in endemic South
Asian populations, whereas infection with HAV is more
frequent in young children.16,17 This again may relate to
the higher rate (54%) of proteinuria in the study subjects
at their 3rd decade of life. The age-specific prevalence
estimates seen in this study reflect an unusual distribution
with 52% peak of higher degree (moderate) of proteinuria
at early (2nd) decade of life and highest incidence of mild
proteinuria at 3rd (62%) and 4th (54%) decade of life. Here,
prevalence of mild proteinuria was higher in younger HAV
patients (HAV vs HEV was 42% vs 32% and 4% vs 10%
in 3rd and 4th decades of life respectively). The mean spot
urinary protein in early age group (2nd decade) was higher
than the middle age group (3rd and 4th decades) of both
HAV and HEV study subjects with greater values in HEV
cases.18,19 This may be contributed by the unequal number
of patients in different age groups and the smaller sample
size of our study.
Epidemiological studies have shown that in some individuals
[particularly children] leads to the development of nephritic
syndrome with strong male predominance. But, the highest
mean in this study is observed in female HEV cases (30.64 ±
15.5 mg/dl); though degree of proteinuria was close in
HAV and HEV cases when compared by sex. Sherilock, S,
2002 explained the fact as the marked differences in the
epidemiology of HAV infection between continents and
regions.16 It can be assumed that prevalence as well as the
degree of proteinuria in different age groups and sex of
HAV and HEV patients is significantly different which
may coincide with the impending renal involvement in
these patients.
of the cases (52%) at 2nd decade of life showed moderate
proteinuria whereas highest incidence of mild proteinuria
was observed in 3rd (62%) and 4th (54%) decade of life with
HAV vs HEV of 42% vs 32% and 4% vs 10% cases respectively
(Figure 2a 2b).
DISCUSSION
Total urinary protein excretion in the normal adult should
be less than 150 mg/day. Higher rates of protein excretion
that persist beyond a single measurement should be
evaluated, as they often imply an increased glomerular
permeability.11 Isolated proteinuria is defined as proteinuria
without hematuria or a reduction in glomerular filtration
rate (GFR). In most cases of isolated proteinuria, the
patient is asymptomatic, and the presence of proteinuria is
discovered incidentally by use of a dipstick during routine
urinalysis. The urine sediment is unremarkable (fewer
than three erythrocytes per high power field and no casts),
protein excretion is less than 3 g/day (non-nephrotic),
serologic markers of systemic disease are absent, and there
is no edema, hypertension, diabetes, or hypoalbuminemia.12
Proteinuria, in people with a normal GFR, is associated
with an increase in adverse clinical outcomes, even when
excretion of protein is as low as 7 mg/day.11 The method
most commonly used to measure urinary protein relies on
24-hour urine collection, which is the gold standard but is
time consuming, cumbersome, and often inaccurate and
imprecise. An alternative approach avoiding timed urine
collections is the measurement of the protein: Creatinine
ratio in single random urine specimens.13 But the ratio is
influenced by urinary creatinine excretion, which can vary
considerably among individuals.14 Hence a spot urine
examination for protein would be more acceptable and less
time consuming.9,15
In this study significant amount of spot urinary protein
was detected in 88% cases (43% HAV and 45% HEV
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UV
•UV
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UV
7UDFH 0LOG 0RGHUDWH
*UDQG7RWDO
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7RWDO
)HPDOH
0DOH
7RWDO
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0DOH
7RWDO
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(a) (b)
Figure 2: Comparison of degree of spot urinary protein in HAV vs HEV cases by a) different age groups and b) sex
87 Acta Medica International | Jul - Dec 2014 | Vol 1 | Issue 2 |
4. Nargis and Ahamed: Proteinuria in viral hepatitis
CONCLUSION
The observations presented in this study indicates that
prevalence as well as the degree of proteinuria in different
age groups and sex of HAV and HEV patients is significantly
different which may coincide with the impending renal
involvement in these patients. Thus, spot urinary protein
concentration should be checked in every HAV and
HEV hepatitis patient to detect the presence and level of
proteinuria. Vaccination should be encouraged in high risk
groups. Patients should be monitored for proteinuria even
after recovery for early detection and intervention. Further
prospective study of spot urinary protein estimation with
larger sample size should be done to evaluate the extent of
renal impairment in such patients.
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How to cite this article: Nargis W, Ahamed BU. Isolated proteinuria in
hepatitis A versus E virus (HAV vs HEV) infected patients: A hospital based
observational study. Acta Medica International 2014;1(2):85-88.
Source of Support: Nil, Conflict of Interest: None declared.
| Jul - Dec 2014 | Vol 1 | Issue 2 | Acta Medica International 88