Seroprevalence of toxoplasmosis among AIDS patients in Hospital Kuala Lumpur, 2001

Four hundred and six AIDS patients were recruited in this retrospective study. The seroprevalence of toxoplasmosis among 406 AIDS patients was 208 (51.2). Their age ranged from 17 to 74 years with a median of 35 years. The majority of patients were males 172 (82.6), Malays 99 (47.5), single 109 (52.4), unemployed 99 (47.6) and heterosexual with commercial sex workers (CSW) 97 (46.6) as the risk marker to HIV infection. Thirty-one (14.9) of 208 AIDS-related toxoplasmosis were diagnosed as active toxoplasmic encephalitis. The most common clinical manifestation was headache (67.7). The CT scan findings showed most lesions to be multiple (87.5), hypodense (66.7), and in frontal region (41.7). Twenty-two (71) patients had chronic (latent) Toxoplasma infection as evidenced by seropositivity for anti-Toxoplasma (IgG) antibody. They were statistically significant in the association between CD4 count and toxoplasmic encephalitis (P = 0.019; OR = 2.6; 95 CI = 1.14-6.02). After the initial six weeks of anti-TE therapy, relapsing toxoplasmic encephalitis was detected in 9.7 in this study

Macro-demarketing: The Key to unlocking unsustainable production and consumption systems?

Drawing on the multi-level perspective of socio-technical change and social practice theory, this paper argues that macrosocial marketing must attend to the challenge of aggregate demand reduction in order to support transition to more sustainable marketing systems. However, reversal of current production and consumption system trajectories is a prodigious challenge. To provide deeper insight into that challenge, an ethnographic case study of a failed plastic bag tax identified the mechanisms reinforcing unsustainable marketing systems. Despite widespread awareness and espoused support, the tax failed to meet policy goals. Embeddedness of plastic bags in two inseparable practices (waste management and household provisioning) gave rise to seven themes: Valuableness, skepticism, subversion, blame, juxtaposition, ubiquity and embeddedness, rights and responsibilities, highlighting the roles of habitus and dominant technological regimes, and the notion of markets as sites of conflict. Mapping the system mechanisms highlighted regulating loops locking in systems behaviors at macro (landscape), meso (regimes of technology and practice) and micro (individual consumer and firm) levels. Building on the idea of demarketing, a process of macrodemarketing is proposed as a multi-level challenge to systems unsustainability. A series of macrosocial marketing interventions is proposed, ranging from electoral and education policy, to incentives for closed loop supply chain innovations. Addressing the limitations of the voluntary individual choice perspective, the study contributes insight into sources of resistance and potential capitulation to systems interventions at multiple levels and among multiple stakeholders

Highly active antiretroviral therapy reduces mortality and morbidity in patients with AIDS in Sungai Buloh Hospital

Background Highly active antiretroviral therapy (HAART) was introduced in Malaysia in 1997, but its effectiveness has never been evaluated. Methods This 12-year retrospective cohort study is the first attempt at evaluating the effectiveness of HAART in Malaysia. Records from Infectious Diseases Clinic, Hospital Sungai Buloh, from 1997 to 2008, were matched with the National Registration Department Death Records 1997-2008 and Selangor State HIV/AIDS/Death Surveillance database 1997-2008. Results The median survival time was 134 (95 confidence interval: 97.93-170.07) months. Those on HAART lived significantly longer. The HAART group had a lower all-cause mortality rate (almost 30 times fewer than those not on HAART,) and AIDS-defining events (at least 3 times less than those not on HAART). The mortality and morbidity of our patients were significantly lower with than without HAART. HAART should therefore be made accessible to all AIDS patients

Toxoplasmosis in HIV/AIDS patients in Malaysia

Three hundred and one sera of HIV/AIDS patients were tested for anti-Toxoplasma IgG antibody by ELISA technique. The seroprevalence of toxoplasmosis was 41.2 (95CI: 35.5-46.9) in HIV/AIDS patients. The seroprevalence was significantly higher in the Malay (57.9) than the Chinese (38.7), followed by the Indian patients (29.6) (p 0.05). Multivariate analysis was employed to find any association between Toxoplasma seroprevalence and a single subject having single or multiple risk factors. It was found that the association was not statistically significant (p>0.05). Among the HIV/AIDS study samples, 124 (41.2) samples were found to have positive anti-Toxoplasma antibody, the association between the presence of anti-Toxoplasma antibody and CD4 cell count was determined but no statistically significant association was found (p>0.05). During the study period, only one case of active CNS toxoplasmosis was registered and the diagnostic criteria included: clinical presentations, CT scan finding, serological evidence of anti-Toxoplasma IgG antibody, and respose to anti-Toxoplasma therapy

Tissue-engineering approach to the repair and regeneration of tendons and ligaments

Tissue Engineering9SUPPL. 1S31-S44TIEN