Polymeric carriers in medicine

The application of inorganic chemistry to medicine is a rapidly developing field, and novel therapeutic and diagnostic metal complexes are now having an impact on medical practice. The family of platinum-containing medicinal agents used for the chemotherapy of malignancies ranks among the most potent types of anticancer drug in present use. While highly potent against many cancers, cisplatin like other anticancer drugs suffers from virtually all of the clinical limitations observed with metal-free antitumor agents in current clinical use, most notably toxic side effects and a propensity for eliciting drug resistance in the cancerous cell. In an effort to increase the effectiveness of chemotherapy, one of the techniques in, use involves the binding of, the monomeric anticancer drug systems to water-soluble, biocompatible and biodegradable polymeric carriers. The interest in, and use of, polymers as drug delivery systems has received considerable attention worldwide; and this technique was utilized in this project. In the present project monomers bearing suitable side groups (aspartic and glycolic acid) for platinum drug anchoring in a chelating form were synthesized. These monomers were incorporated into the polymer backbone as side chain units. Functionalized polyaspartamides and polyamidoamines were water-soluble carriers used in this project, and they were obtained by condensation and Michael addition polymerization. Leaving group ligands (dicarboxylato, carboxylatohydroxylato, and dihydroxylato) were used to anchor the platinum drug to the polymer backbone. The platinum content of conjugates was in the range of 0.92 % - 18.15 %. A certain number of the resulting conjugates were bio-evaluated in vitro for their antiproliferative activities against the HeLa, Colo 320 DM and MCF 7 human cancer cell lines, while the corresponding carriers were in vitro tested for toxicity against resting and stimulated human lymphocyte cell lines. For 50 % cell growth inhibition, concentrations varying from 0.000044 to 9 μg/mL Pt for conjugates and 4 to >50 μg/mL for carriers were reported

Macromolecular co-conjugate of bisphosphonate : synthesis and kinetic drug release study

Cancer chemotherapy often results in side effects such as high toxicity and drug resistance. Sequential and simultaneous delivery of drug combinations have been found to reduce the side effects associated with systemic delivery of anticancer drugs. An alternative approach to systemic delivery of anticancer drugs is the co-conjugation of two or more of these agents to a single polymeric carrier via biofissionable linkages. In this study, macromolecular co-conjugates of bisphosphonate and ferrocene were synthesized and the kinetic drug release studied. Phosphorus and proton NMR and FTIR were used to characterize the co-conjugates. The mass percentages incorporation of ferrocene analogue were found to be between 4–5 % and 10–12 % for bisphosphonate. Kinetic drug release results at selected pH (1.2, 5.5 and 7.4) were fitted in different mathematical drug release model to determine the mechanism of release of ferrocene and bisphosphonate from a co-conjugate pro-drug. The best model describing the release of ferrocene were found to be Korsmeyer– Peppas model at pH 1.2 and zero order model at pH 5.5 and 7.4. For bisphosphonate, Korsmeyer–Peppas, Higuchi and zero order models were found to best fit the release mechanism at pH 1.2, 5.5 and 7.4 respectively

Reducing instruction cache energy using gated wordlines

Thesis (M.Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 1999.Includes bibliographical references (p. 87-88).by Mukaya Panich.M.Eng

Clinical and Demographic Predictors of Acute Pulmonary Embolism in Central Africa Using 64-Rows Multi-Detector Computed Tomography Angiography

Background: Acute pulmonary embolism is a life-threatening entity. Its diagnosis remains a challenge for clinicians and it is important to be aware of factors that increase risks of the disease. In this study, we access the clinical and demographic predictors of pulmonary embolism using 64-rows multi-detector Computed Tomography Angiography in central Africa.Methods: From 01 January to 30 July 2016, the data record of patients who underwent chest 64-rows multi-detector Computed Tomography Angiography indicated for clinical suspicion of acute pulmonary embolism at Biamba Marie Mutombo Dikembe Hospital were retrospectively were revisited and analyzed using logistic regression models.Results: Sixty-five consecutive patients (age range, 24 to 84 years and mean age 56.8 ± 14.9 years) were included with a female predominance. Pulmonary embolism was formerly detected in 17 patients (26.2% of cases). Age ? 65 years (OR = 9.5 CI 95%:14.74, 60.79, p = 0.018) and obesity (OR = 40.8 CI 95%:2.85, 58.44, p = 0.006) were the predictors of pulmonary embolism. Heart disease and pneumonia were the main pathologies associated and the main alternative diagnoses.Conclusion: This study shows that age and obesity were independent predictors of PE. In central Africa where Computed Tomography machine is not widely available, aged and obese patients with a clinical suspicion of pulmonary embolism should be dealt with as a higher suspicion of true pulmonary embolism

Work-Life Balance Practices on Employee Job Performance at Eco Bank Kenya

Inadequate work life balance is a problem that poses a big risk to workers well being, their performance as well as the organizational performance. Many employees often have difficulties in attempting to balance employment responsibilities with their social life. This is why the main objective of this study focuses on how flexible working options, leave policies and employee assistance programs affect employee job performance. Therefore the study recommends that the management of ECO bank Kenya should consider sharing its best practices on work life balance and the government should look to implement work life balance procedures in the public service. Key words: Employee Assistance Programs, Employee’s Job Performance, Work-life balanc

Prevalence and morphological types of anaemia and hookworm infestation in the medical emergency ward, Mulago Hospital, Uganda

Introduction. Anaemia is common worldwide, although the burden is highest in developing countries where nutrient deficiencies and chronic infections are prevalent.Objective. To determine the prevalence and morphologicaltypes of anaemia and assess the hookworm burden among patients in the medical emergency ward at Mulago national referral hospital, Uganda.Methods. In a cross-sectional descriptive study 395 patients were recruited by systematic random sampling and their socio-demographic characteristics and clinical details collected. A complete blood count and peripheral film examination were done and stool examined for hookworm ova.Statistical analysis. Data were processed using Epi-Info version 6 and Stata version 9. The chi-square test was used for categorical variables and Student’s t-test for non-categorical variables. Multiple logistic regression was used to determine factors predictive of anaemia.Results. Of the patients 255 (64.6%) had anaemia. The prevalence was higher among males (65.8%) than females (63.7%). Fatigue (odds ratio (OR) 2.1, confidence interval (CI) 1.37 - 3.24), dizziness (OR 1.64, CI 1.07 - 2.44), previous blood transfusion (OR 2.83, CI 1.32 - 6.06), lymphadenopathy (OR 2.99, CI 1.34 - 6.66) and splenomegaly (OR 5.22, CI 1.78 - 15.28) were significantly associated with anaemia.Splenomegaly, low body mass index (BMI)

Multidetector CT in Quantitative Morphometric Assessment of Post-Menopausal Vertebral Fractures in Black Women of Central Africa

Background: Osteoporosis and major Non-Communicable Diseases (NCDs) are identified by WHO as leading cause of death worldwide. Its economic burden is heavy worldwide and in particularly in low income countries. DXA availability is poorly in our country. Spine CT scanner with sagittal reformation images are known for the ease quotation of vertebral fractures by quantitative morphometric system described by Genant et al. (1996). This study aims to determine the rate and the features of vertebral fractures in postmenopausal black women living in Kinshasa/DRC using CT scanner sagittal reconstructions.Patients and methods: 430 consecutives post-menopausal women referred for Thoraco-lumbar CT scanner from June 2011 to June 2016 were enrolled in this study and theirs CT images used to quote vertebrae.Results: 12.89% of a total of 4730 vertebrae were fractured whose more than half (7.82%) of grade 1. The fracture rate is lower than in Caucasian and ASEAN and increase with ageing and duration of menopausis (24.51% in 70 years of age and over).Conclusion: Vertebral fracture global frequency was 12.89%. Vertebral fractures are present in our population and adverse consequences will arises in terms of morbidity and mortality. Lack of infrastucture, health policy and powerty will contributes to boost for a bader pronostics.The method is reproductible and can be used as routine clinical tools in conditions of poor availability of DXA

Ultrasound Assessment of Bone Mass in Central Africans Population

Background: Osteodensitometry, a procedure increasingly accepted by clinicians to access osteoporosis is not yet fully validated by WHO. It requires the establishment of normal values and references curves for each population, and in our community, this is not yet assessed.The purpose of this study was twofold: to describe the profile of the speed of sound of proximal phalangeal metaphysis and establish references curves in central Africans and to compare them with those of other populations specially Caucasians.Methods: This cross sectional study was carried out at Kinshasa, Democratic Republic of the Congo in Central Africa from January to December 2016.Four hundred twenty four subjects aged from 20 to 87 years old, were explored and the speed of sound in theirs proximal phalanges measured using ultrasound equipment. Age, gender, hormonal status and speed of sound were collected and analyzed.Results: The mean value of the Amplitude Dependent Speed of Sound (AD-SoS) showed a growth feature with age (from 2056 m/sec at second decade of life to 2145.27 m/sec at fourth decade followed by a progressive decrease which was present in both sexes but more marked in postmenopausal women (1927.06 m/sec). This mean value was higher than in Caucasian studies. In this study, age and hormonal status seems to be the bone quality most influencing anthropometric factors as seen in many series.The curve profile with age was also a polynomial curve as seen in others populations of the world.Conclusion: This study provides normal data for phalangeal ultrasound measurements and reference curve of central Africans which were compared to those of Western studies

Influence des facteurs géo-éthniques sur les modifications morphologiques et fonctionnelles de la thyroïde au cours de la grossesse : Cas des gestantes chinoises et congolaises suivies en consultation de Médecine Interne: Geographical and ethnical factors of morphological and functional changes of the thyroid during pregnancy. About Chinese and Congolese pregnant women with goitres followed in the Department of Internal Medecine at Kinshasa University Hospital, DR Congo and Qian Foshan Provincial Hospital in Jinan, China

Context and objectives. The occurrence of pregnancy in patients with goitre or vice-versa limits the field of intervention for the clinician, both for diagnosis and for therapeutic management. Only non-invasive methods can be performed under these conditions. But the data regarding goitre inpregnancy are paradoxically scarce. This study aimed to describe the clinical and ultrasound features of the thyroid gland and to investigate the effects of goitre on surrounding tissues. Racial differences were also assessed. Methods. In a cross-sectional study, 80 pregnant women (40 Chinese and 40 Congolese) with goitres were examined between February 2015 and February 2017 at Kinshasa University Hospital / DR Congo and Qian Foshan Provincial Hospital in Jinan, China. Parameters of interest included age, sex, marital status, parity, family history of goitre, thyroid hormone and TSH measurements, and ultrasound data of goitre. Data were compared between the two groups using the Pearson or t Student or chi-square tests as appropriate. Results. The average age was 32.2 ± 4.9 years; Congolese pregnant women being older (33.5 ± 5.4 vs. 30.9 ± 4.2, p = 0.018). More than 60% of participants were examined during the first trimester of pregnancy. The thyroid function appeared more distuberd among Chinese compared to Congolese pregnant women (25% vs 52.5%, p = 0.02). The average size of the thyroid gland was 5 times bigger than in chinese studied population , with more nodular pattern in the former group (85% vs. 45%, p = 0.0004). Ultrasound data suggesting Hashimoto's thyroiditis with lymph node involvement were more frequent in Chinese population. Conclusion. This study suggests that the goiter occurs more frequently during the 1st trimester of pregnancy in both races. Thyroid dysfunction seems more present in Chinese compared to Congolese. Nodular goiter is more frequent in Congolese pregnant women with subsequent therapeutical implications. Contexte et objectifs. La survenue de la grossesse chez les malades porteuses de goitre ou l’inverse limite le champ d’intervention du clinicien, tant pour le diagnostic que pour la prise en charge thérapeutique. Seules les méthodes non invasives peuvent être réalisées dans ces conditions. Mais, les données y relatives sont paradoxalement fragmentaires. La présente étude visait à décrire les aspects cliniques et échographiques de la thyroïde et à rechercher les retentissements du goitre sur les tissus avoisinants. Les différences raciales ont été également recherchées. Méthodes. Dans une étude transversale, 80 gestantes (40 chinoises et 40 congolaises) porteuses de goitre ont été examinées entre février 2015 et février 2017 aux CUK/RD Congo et à l’Hôpital Provincial Qian Foshan de Jinan en Chine. Les paramètres d’intérêt comprenaient l’âge, le sexe, l’état civil, la parité, les antécédents familiaux de goitre, les dosages des hormones thyroïdiennes et de la TSH et les données échographiques du goitre. Nous avons recouru aux tests de chi carré de Pearson et de student pour comparer respectivement les proportions et les moyennes majorées de l’écart-type. Résultats. L’âge  moyen était de 32,2 ± 4,9 ans ; les gestantes congolaises étaient plus âgées que les chinoises (33,5 ± 5,4 vs 30,9 ± 4,2, p = 0,018). Plus de 60% des participants ont consulté au premier trimestre de la grossesse. L’étude de la fonction thyroïdienne  a révélé plus de perturbation chez les chinoises que chez les congolaises  (52,5% vs 25%, p = 0,02) ;  en dépit d’une taille moyenne de la glande 5 fois plus grande chez ces dernières. Les congolaises avaient également une proportion plus importante de goître nodulaire ou multinodulaire (85% vs 45%, p = 0,0004). Les données échographiques suggestives de la thyroïdite de Hashimoto avec atteinte ganglionnaire ont été plus observées chez les chinoises. Conclusion. L’étude révèle que le goître survient plus fréquemment au courant du premeier de la grossesse dans les 2 groupes. La dysfonction thyroïdienne est toutefois plus observée chez les chinoises. Morphologiquement, les nodules sont plus fréquemment rencontrés chez la congolaise, avec éventuelles implications thérapeutiques