Hematological Parameters in HIV Patients: Association with CD4 Count

Background: Around 2.1 million people are currently living with human immunodeficiency virus (HIV) infection in India. Hematological parameters have been proposed as alternative markers of HIV infection in areas with limited resources. This study aimed to describe hematological parameters in patients with HIV infection and to determine their association with CD4 cell counts. Methods: This cross-sectional study assessed 100 HIV patients on antiretroviral therapy (ART). Their blood samples were collected to measure complete blood count (CBC) and CD4 count. Patients with known hematological disorders, critically ill patients, and those not willing to give informed consent were excluded. The Chi-square test was used to find the association between hematological parameters and CD4 counts. Results: Most patients with HIV infection had anemia (85%), followed by thrombocytopenia (42%) and neutropenia (36%). There was a statistically significant association between the number of patients having anemia and CD4 cell counts. Conclusion: Hematological changes are common in HIV patients. Hematological parameters should be routinely monitored and managed to reduce morbidity. Also, patients with unexplained low blood counts should be screened for underlying HIV infection

The Brief Memory and Executive Test (BMET) for detecting vascular cognitive impairment in small vessel disease: a validation study.

Cognitive impairment is common in patients with cerebral small vessel disease, but is not well detected using common cognitive screening tests which have been primarily devised for cortical dementias. We developed the Brief Memory and Executive Test (BMET); a rapid screening measure sensitive to the impaired executive function and processing speed characteristic of small vessel disease (SVD). To assess the BMET's validity for general use, we evaluated it when administered by non-psychologists in a multicentre study and collected control data to derive normative scores.The BMET study was funded by The Stroke Association (TSA2010/08). Recruitment to BMET was supported by the NIHR Stroke Clinical Research Network. Hugh Markus is supported by an NIHR Senior Investigator award and his work is supported by the Cambridge University Hospitals NIHR Comprehensive BRC. Matthew Hollocks is supported by a Stroke Association/British Heart Foundation Grant (TSA BHF 2010/01). Robin Morris receives consultancy fees for P1Vital Limited. The authors disclose no competing interests financial or otherwise

Identification and characterization of the Bcl-2- associated athanogene (BAG) protein family in rice

The Bcl-2-associated athanogene (BAG) proteins are involved in the regulation of Hsp70/HSC70 in animals. There are six BAG genes in human that encode nine isoforms with different subcellular locations. Arabidopsis thaliana is reported to contain seven BAG proteins. We searched BAG proteins in Oryza sativa using profile-sequence (Pfam) and profile-profile (FFAS) algorithms and found six homologs. The BAG protein family in O. sativa can be grouped into two classes based on the presence of other conserved domains. Class I consists of four OsBAG genes (1 to 4) containing an additional ubiquitin-like domain, structurally similar to the human BAG1 proteins and might be BAG1 orthologs in plants. Class II consists of two OsBAG genes (5 and 6) containing calmodulin-binding domain. Multiple sequence alignment and structural models of O. sativa BAG proteins showed conservation of surface charge (except OsBAG5) and critical residues for the binding of BAG domain to Hsp70 nucleotide binding domain (NB). Meta analysis of microarray data showed that OsBAG genes are up or down regulated under different stresses (biotic and abiotic). Data obtained from real-time PCR of OsBAG genes under heat stress showed that maximum induction in the expression of all the genes occurred after one hour exposure to heat stress, while reduction in the expression was observed in the following time course and ultimately returned to the basal level at 24 h treatment. These results suggest that OsBAG genes might play important role at the onset of heat stress. A further detailed study may explore the exact function of the members of this gene family and help to make understanding of programmed cell death (PCD) mechanism in plants.Key words: Rice, ubiquitin-like domain, nucleotide-binding domain, real-time PCR

Antibiotic Resistance Pattern and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Colonization in Burns Unit of a Tertiary Care Hospital in Peshawar, Pakistan

Purpose: To develop strategies for the control of hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) which is a serious threat to burns patients with the aid of molecular studies.Methods: Staphylococcus aureus strains were collected from the Burns Unit of Khyber Teaching Hospital (KTH) Peshawar, Pakistan from July - December 2011. Antibiotic resistance was determined according to the recommendations of Clinical Laboratory Standard Institute (CLSI). Molecular epidemiology of the S. aureus strains were determined by pulse field gel electrophoresis (PFGE).Results: PFGE identified 14 clusters which included 29 different pulso-types prevailing in the Burns Unit. Of the 29 types, 11 contained two or more strains of the same pulso-type. These MRSA isolates  were highly resistant to various kinds of penicillin and cephalosporin (85 – 100 %). Among the important anti-staphylococal agents tested, 17 % of the isolates were resistant to fusidic acid and linezolid. All the 54 strains were susceptible to vancomycin.Conclusion: Several of the same pulso-types prevail in the Burns Unit of KTH. Furthermore, 29 pulsotypes  mong the 54 strains suggest the diversity of the MRSA strains collected from burns patients.Keywords: Epidemiology, Pulso-type, Fusidic acid, Linezolid, Vancomycin, Methicillin-resistant Staphylococcus aureus, Burn

Clinicopathological Profile and Surgical Treatment of Abdominal Tuberculosis: A Single Centre Experience in Northwestern Tanzania.

Abdominal tuberculosis continues to be a major public health problem worldwide and poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. This study was conducted to describe the clinicopathological profile and outcome of surgical treatment of abdominal tuberculosis in our setting and compare with what is described in literature. A prospective descriptive study of patients who presented with abdominal tuberculosis was conducted at Bugando Medical Centre (BMC) in northwestern Tanzania from January 2006 to February 2012. Ethical approval to conduct the study was obtained from relevant authorities. Statistical data analysis was performed using SPSS version 17.0. Out of 256 patients enrolled in the study, males outnumbered females. The median age was 28 years (range = 16-68 years). The majority of patients (77.3%) had primary abdominal tuberculosis. A total of 127 (49.6%) patients presented with intestinal obstruction, 106 (41.4%) with peritonitis, 17 (6.6%) with abdominal masses and 6 (2.3%) patients with multiple fistulae in ano. Forty-eight (18.8%) patients were HIV positive. A total of 212 (82.8%) patients underwent surgical treatment for abdominal tuberculosis. Bands /adhesions (58.5%) were the most common operative findings. Ileo-caecal region was the most common bowel involved in 122 (57.5%) patients. Release of adhesions and bands was the most frequent surgical procedure performed in 58.5% of cases. Complication and mortality rates were 29.7% and 18.8% respectively. The overall median length of hospital stay was 32 days and was significantly longer in patients with complications (p < 0.001). Advanced age (age ≥ 65 years), co-morbid illness, late presentation, HIV positivity and CD4+ count < 200 cells/μl were statistically significantly associated with mortality (p < 0.0001). The follow up of patients were generally poor as only 37.5% of patients were available for follow up at twelve months after discharge. Abdominal tuberculosis constitutes a major public health problem in our environment and presents a diagnostic challenge requiring a high index of clinical suspicion. Early diagnosis, early anti-tuberculous therapy and surgical treatment of the associated complications are essential for survival

Protocol study: Sexual and reproductive health knowledge, information-seeking behaviour and attitudes among Saudi women: A questionnaire survey of university students

Copyright © 2014 Farih et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background - Sexual and reproductive health (SRH), a basic right for women worldwide, is infrequently researched in countries in the Middle East and North Africa (MENA). No empirical studies of SRH among Saudi women exist. This protocol describes a study to explore the SRH knowledge, information-seeking behaviour and attitudes of Saudi female university students. Methods/Design - This study will administer a questionnaire survey to female students at 13 universities in Riyadh, Saudi Arabia. The questionnaire was developed following a literature search to identify relevant content, with psychometrically tested tools used when available. The content layout and the wording and order of the questions were designed to minimize the risk of bias. The questionnaire has been translated into Arabic and piloted in preparation for administration to the study sample. Ethical approval for the study has been granted (reference no. QMREC2012/54). After questionnaire administration, the data will be collated, analysed and reported anonymously. The findings will be published in compliance with reporting guidelines for survey research. Discussion - This study will be the first to provide fundamental information concerning Saudi females university students SRH knowledge and information needs.King Abdullah Scholarship Program, Saudi Arabi

Earliest-deadline-based scheduling to reduce urban traffic congestion

One of the major problems, caused by traffic congestion, owes its existence to the unwanted delay experienced by the priority vehicles. The evaluation of two scheduling algorithms as adaptive traffic control algorithms has been proposed here to reduce this unwanted delay. One of these algorithms is the earliest deadline first (EDF) algorithm, whereas the other is the fixed priority (FP) algorithm. The performance of both algorithms as adaptive traffic light control algorithms is evaluated for isolated traffic intersections. A comparative study is performed here, where the performance of these algorithms is compared against a fixed static traffic light controller. Moreover, their performance is also compared against each other. Conclusive results from the simulation of the algorithms reveal that the number of stops, average delay, and mean trip time of the priority vehicles is significantly reduced by the implementation of these algorithms. Furthermore, it has been shown that the overall performance of EDF is much better than FP in terms of improvement of different performance measures for congestion reduction of priority vehicles. © 2014 IEEE

Effect of Standard vs Intensive Blood Pressure Control on Cerebral Blood Flow in Small Vessel Disease The PRESERVE Randomized Clinical Trial

Importance: Blood pressure lowering is considered neuroprotective in patients with cerebral small vessel disease, however more “intensive” regimens may increase cerebral hypoperfusion. We examined the effect of intensive vs. standard blood pressure treatment on cerebral perfusion in severe small vessel disease patients. Objective: To determine whether intensive vs. standard blood pressure lowering over 3 months causes decreased cerebral perfusion. Design, Setting and Participants: This randomised, parallel, controlled, blinded-outcomes clinical trial took place in 2 English university medical centres. A central, online randomisation system (1:1 ratio) allocated grouping. 70 hypertensive patients with MRI confirmed symptomatic lacunar infarct and confluent white matter hyperintensities were recruited between 2012 and 2015, and randomised (36/34 in standard/intensive arms). Analysable data were available in 62 patients, 33/29 in the standard/intensive groups respectively, for intention to treat analysis. This experiment examines the 3 month follow-up period. Intervention: Patients were randomised to “standard” (systolic=130-140mmHg) or “intensive” (systolic=<125mmHg) blood pressure targets, to be achieved through medication regimen changes. Main Outcome and Measure: Cerebral perfusion was determined using arterial spin labelling; the primary end point was change in global perfusion between baseline and 3 months, compared between treatment groups by ANOVA. Linear regression compared change in perfusion against change in blood pressure. MR scan analysis was blinded to treatment arm. Results: Patients were 69.3 years old (mean) and 59.7% male. Mean(SD) systolic blood pressure reduced by 8(12) and 27(17)mmHg in the standard/intensive groups, respectively (p<0.001), with achieved pressures of 141(13) and 126(10) mmHg respectively. Change in global perfusion did not differ between treatment arms: standard, mean(SD) (ml/min/100g)= -0.5(9.4); intensive, 0.7(8.6), partial ETA2= 0.004, 95% CI= -3.6–5.8, p= 0.63. No differences were observed when analysis examined grey/white matter only, or was confined to those achieving target blood pressure. The number of adverse events did not differ between treatment groups (standard/intensive mean(SD)= .21(.65)/.32(.75), p=.44). Conclusions and Relevance: Intensive blood pressure lowering did not reduce cerebral perfusion in severe small vessel disease.This study was funded by a joint Stroke Association/British Heart Foundation program grant (TSA BHF 2010/01). The study received additional support from the Newcastle Biomedical Research Centre, which is funded by the National Institute for Health Research (NIHR). Drs O’Brien, Ford, and Markus are supported by NIHR Senior Investigator awards. Drs O’Brien and Markus are also supported by the Cambridge University Hospitals NIHR Comprehensive Biomedical Research Centre

A phase II trial of lomeguatrib and temozolomide in metastatic colorectal cancer

To evaluate the tumour response to lomeguatrib and temozolomide (TMZ) administered for 5 consecutive days every 4 weeks in patients with metastatic colorectal carcinoma. Patients with stage IV metastatic colorectal carcinoma received lomeguatrib (40 mg) and TMZ (50–200 mg m−2) orally for 5 consecutive days every 4 weeks. Response was determined every two cycles. Pharmacokinetics of lomeguatrib and TMZ as well as their pharmacodynamic effects in peripheral blood mononuclear cells (PBMC) were determined. Nineteen patients received 49 cycles of treatments. Despite consistent depletion of O6-methylguanine-DNA methyltransferase in PBMC, none of the patients responded to treatment. Three patients had stable disease, one for the duration of the study, and no fall in carcinoembryonic antigen was observed in any patient. Median time to progression was 50 days. The commonest adverse effects were gastrointestinal and haematological and these were comparable to those of TMZ when given alone. This combination of lomeguatrib and TMZ is not efficacious in metastatic colorectal cancer. If further studies are to be performed, emerging data suggest that higher daily doses of lomeguatrib and a dosing period beyond that of TMZ should be evaluated