Hypertension, kidney disease, HIV and antiretroviral therapy among Tanzanian adults: a cross-sectional study.

BACKGROUND: The epidemics of HIV and hypertension are converging in sub-Saharan Africa. Due to antiretroviral therapy (ART), more HIV-infected adults are living longer and gaining weight, putting them at greater risk for hypertension and kidney disease. The relationship between hypertension, kidney disease and long-term ART among African adults, though, remains poorly defined. Therefore, we determined the prevalences of hypertension and kidney disease in HIV-infected adults (ART-naive and on ART >2 years) compared to HIV-negative adults. We hypothesized that there would be a higher hypertension prevalence among HIV-infected adults on ART, even after adjusting for age and adiposity. METHODS: In this cross-sectional study conducted between October 2012 and April 2013, consecutive adults (>18 years old) attending an HIV clinic in Tanzania were enrolled in three groups: 1) HIV-negative controls, 2) HIV-infected, ART-naive, and 3) HIV-infected on ART for >2 years. The main study outcomes were hypertension and kidney disease (both defined by international guidelines). We compared hypertension prevalence between each HIV group versus the control group by Fisher's exact test. Logistic regression was used to determine if differences in hypertension prevalence were fully explained by confounding. RESULTS: Among HIV-negative adults, 25/153 (16.3%) had hypertension (similar to recent community survey data). HIV-infected adults on ART had a higher prevalence of hypertension (43/150 (28.7%), P = 0.01) and a higher odds of hypertension even after adjustment (odds ratio (OR) = 2.19 (1.18 to 4.05), P = 0.01 in the best model). HIV-infected, ART-naive adults had a lower prevalence of hypertension (8/151 (5.3%), P = 0.003) and a lower odds of hypertension after adjustment (OR= 0.35 (0.15 to 0.84), P = 0.02 in the best model). Awareness of hypertension was ≤ 25% among hypertensive adults in all three groups. Kidney disease was common in all three groups (25.6% to 41.3%) and strongly associated with hypertension (P 2 years had two-fold greater odds of hypertension than HIV-negative controls. HIV-infected adults with hypertension were rarely aware of their diagnosis but often have evidence of kidney disease. Intensive hypertension screening and education are needed in HIV-clinics in sub-Saharan Africa. Further studies should determine if chronic, dysregulated inflammation may accelerate hypertension in this population

Combinatorial Drug Therapy with Phytochemicals as Adjuvants in Prostate Cancer Management

Prostate cancer is one of the leading cancers in men needs a long period for development from small lesion to become a clinical manifestation. The prostate specific antigen is a prominent tumor marker for prostate cancer. Androgens are involved in the development and progression of prostate cancer regulating the androgen receptor as androgen-dependent or androgen-independent types. The latter occurs in metastatic conditions of prostate cancer developed as hormone resistant prostate cancer (HRPC) that inappropriately activates transcription of other genes involved in molecular pathways inducing cellular proliferation and inhibiting apoptosis. Since prostate cancer is characterized by slow growth and long latency period and thus integration of phytochemicals/compounds in combination with other existing therapies have promising future to manage cancer, thus controlling the disease progression and mortality rate. Therefore, the medicinal plants therapeutic or prophylactic activities on prostate cancer exhibiting anti-androgenic effects, depleting PSA, down-regulating expression of androgen receptor, regulating cell cycle regulators have promising future to be applied as adjuvant drugs in prostate cancer treatment

Low Digit Ratio Predicts Early Age at Menarche in Colombian Schoolgirls

Background:  The ratio between the lengths of the second and fourth fingers (digit ratio: 2D : 4D), a purported negative correlate of prenatal androgen exposure, has been inversely related to age at menarche. However, a recent study found high digit ratios in carriers of a single variant in the LIN28B gene, which has been linked to delayed menarche. Methods:  We investigated the association of digit ratio and age at menarche in 299 pre‐menarcheal girls aged 5–12 years who participated in a longitudinal cohort study in Bogotá, Colombia. Finger lengths were measured at baseline and the occurrence of menarche was periodically ascertained over a median 32 months of follow‐up. We used time‐to‐event analysis to estimate median ages at menarche as well as hazard ratios for menarche according to tertiles of the digit ratio for each hand. Results:  Estimated median age at menarche was lower for girls in the lowest digit ratio tertile of the right hand compared with those in the highest (12.0 vs. 12.3 years; P ‐value = 0.04). After adjustment for baseline age, height‐ and body mass index‐for‐age z ‐scores, the hazard of menarche was 86% higher in girls of the lowest digit ratio tertile (hazard ratio 1.9 [95% confidence interval 1.2, 2.9]) compared with those in the highest digit ratio tertile of the right hand. No significant associations were found with the left hand. Conclusions:  Digit ratio was positively associated with age at menarche in this longitudinal investigation, consistent with results from a recent gene‐linkage study.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93549/1/j.1365-3016.2012.01310.x.pd

Antenatal depression and its risk factors: An urban prevalence study in KwaZulu-Natal

Objective. There has been a recent increase in interest in antenatal depression, which is associated with adverse obstetric, neonatal andmaternal outcomes and has been overlooked and underdiagnosed. Local data on prevalence and risk factors are lacking.Aim. To determine the prevalence and risk factors associated with antenatal depressive symptoms in a KwaZulu-Natal population.Methods. The Edinburgh Postnatal Depression Scale and a socio-demographic questionnaire in English and isiZulu were administered to 387antenatal outpatients at King Edward VIII Hospital in Durban.Results. Of the participants, 149 (38.5%) suffered from depression and 38.3% had thought of harming themselves in the preceding 7 days.Risk factors for depression included HIV seropositivity (p=0.02), a prior history of depression (p=0.02), recent thoughts of self-harm (p<0.000), single marital status (p=0.04) and unplanned pregnancy (p=0.01).Conclusion. The high prevalence of antenatal depressive symptoms and thoughts of deliberate self-harm supports a policy of routine screening for antenatal depression in South Africa, especially in HIV-seropositive women

The effect of corticosteroid therapy on growth in Black South African children with nephrotic syndrome.

Thesis (M.Med.)-University of Natal, Durban, 1986.The most useful drugs in the management of nephrotic syndrome are the corticosteroids. These drugs are as well known for their adverse effects as they are for their therapeutic advantages. The two most common paediatric side effects are suppression of linear growth and posterior subcapsular cataracts. Both of these untoward effects are insiduous and therefore less easily perceived. Although many workers have studied the growth inhibiting effects of the corticosteroids in the various diseases e.g. asthma, very little work was done to investigate these effects in patients with nephrotic syndrome. Furthermore, the Renal Clinic, King Edward VIII Hospital, Durban continues to use a daily regime of prednisone instead of the alternate day regime which is widely recommended to minimise growth retardation. This study was therefore undertaken to investigate the growth inhibiting effects of repeated courses of daily, high-dose prednisone in African and Indian children with nephrotic syndrome. All children with nephrotic syndrome with relevant data in their records and with no other chronic illness were selected from the Renal Clinic. Of the 125 selected, 87 children had been treated with prednisone for an average of 35,9 weeks and 38 had been treated symptomatically. The heights of those that received prednisone were measured at an averace of 77 weeks after completion of therapy. The mean height standard deviation score (SDS) of the treatment and control groups of Indian children were -1,06 and -0,92 respectively, both being between the 10th and 25th percentile, whilst the mean height SDS of the treatment and control groups of African children were -1,82 (just below the 5th percentile) and -1,77 (between the 5th and 10th percentile) respectively. From the results, it is evident that repeated courses of daily prednisone therapy, even when it exceeds 36 weeks, does not inhibit growth in both African and Indian children. Although there was no significant difference between the races and sexes with respect to growth and corticosteroid therapy, this study does confirm earlier reports that most of the African children with nephrotic syndrome had obvious glomerular lesions whilst most of the Indians had minimal change nephrotic syndrome

ANTI-CANCER POTENTIAL OF POLYSACCHARIDE ISOLATED FROM METHANOLIC EXTRACT OF TINOSPORA CORDIFOLIA STEM BARK

Objective: The exploration of the anticancer potential of polysaccharide isolated from the methanolic extract of Tinospora cordifolia (T. cordifolia) stem bark against breast cancer in DMBA-induced female albino Wistar rat models were examined by various hematological parameters. Methods: Analysis of Red blood cell (RBC), White blood cell (WBC) and platelet level, Tumor markers Carcino Embryonic Antigen (CEA) and Cancer Antigen 15.3 (CA 15.3) in the serum, was done in the normal, cancer and compound treated rats using specific kits. Histological studies were performed to examine the changes in the tissue morphology and cell patterns in breast tissue. Results: The decreased levels of RBC, WBC and platelets in 7,12-Dimethylbenz [a] anthracene (DMBA)-induced breast cancer (Group III) animals were revived to the normal conditions in polysaccharide treated breast cancer (Group IV) animals as that of normal (Group I). The level of tumor markers CEA and CA 15.3, was found elevated in serum of DMBA-induced breast cancer groups (Group III) when compared to their levels in the normal groups (Group I) whereas polysaccharide treatment (Group IV) prevented this rise in the levels of tumor markers. The histological studies on the breast tissue samples of all the groups showed the appropriate features where the normal (Group I) animals were characterized with normal cells uniformly arranged without any change in orientation and morphology, DMBA-induced cancer (Group III) animals showed an improper orientation of cells arranged as glandular structures, as nest, or cords of various sizes or as solid sheets foci of necrosis in some areas with margins infiltrating, pushing, circumcised or mixed and the polysaccharide treated (Group IV) animals showed results resembling that of the normal (Group I) animals. Conclusion: Thus, polysaccharide is proved as an effective chemo preventive agent against breast cancer

CLOUD-SLA: Service Level Agreement for Cloud Computing

Abstract In the last few years, the cloud computing becomes the most important developing platform for both scientific and commercial application. Clouds are rapidly becoming an important platform for scientific applications. In the Cloud environment with uncountable numeric nodes, resource is inevitably unreliable, which has a great effect on task execution and scheduling. In cloud computing, cloud providers can offer cloud consumers two provisioning plans for computing resources, namely reservation and on-demand plans. In general, cost of utilizing computing resources provisioned by reservation plan is cheaper than that provisioned by on-demand plan, since cloud consumer has to pay to provider in advance. With the reservation plan, the consumer can reduce the total resource provisioning cost. However, the best advance reservation of resources is difficult to be achieved due to uncertainty of consumer's future demand and providers' resource prices. To address this problem, The SLA can provision computing resources for being used in multiple provisioning stages as well as a long-term plan, The Service Level Agreement (SLA) based super scheduling approach promotes cooperative resource sharing. Super scheduling is facilitated between administratively and topologically distributed sites via resource schedulers such as Resource brokers and workflow engines