Adherence to antiretroviral drug therapy by adult patients attending HIV/AIDS clinic at a Kenyan tertiary helath institution

Objective: To determine antiretroviral drug adherence levels of HIV/AIDS in adult patients.Design: A cross sectional study.Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya.Subjects: Three hundred and eighty four HIV/AIDS adult patients who attended HIV/AIDS clinic in MTRH for antiretroviral treatment and had been on treatment for at least three months as confirmed by clinicians.Results: Three hundred and eighty four respondents participated in this research; two third of whom were females (68%) and a third were males (32%). Fifty two per cent of these had attained secondary or post secondary education. The mean age was 36.1±8.5, years and ranged 18-63 years. While 93.5% of the participants adhered to clinic appointments, only 43.2% adhered to taking the drugs as per time schedule.Conclusion: Adherence to time of taking medications was low and could result in reduced efficacy

Comparisons Between Experimental Measurments and Numerical Simulations of Spheromak Formation in SSPX

Data from a recently installed insertable magnetic probe array in the Sustained Spheromak Physics Experiment (SSPX) [E. B. Hooper et al., Nucl. Fusion 39, 863 (1999)] is compared against NIMROD [C. R. Sovinec et al., J. Comp. Phys. 195, 355 (2004)], a full 3D resistive magnetohydrodynamic code that is used to simulate SSPX plasmas. The experiment probe consists of a linear array of chip inductors arranged in clusters that are spaced every 2 cm, and spans the entire machine radius at the flux conserver midplane. Both the experiment and the numerical simulations show the appearance, shortly after breakdown, of a column with a hollow current profile that precedes magnetic reconnection, a process essential to the formation of closed magnetic flux surfaces. However, there are differences between the experiment and the simulation in how the column evolves after it is formed. These differences are studied to help identify the mechanisms that eventually lead to closed-flux surfaces (azimuthally averaged) and flux amplification, which occur in both the experiment and the simulation

Factors Affecting Antiretroviral Drug Adherence Among HIV/AIDS Adult Patients Attending HIV/AIDS Clinic At Moi Teaching And Referral Hospital, Eldoret, Kenya

Objective: To determine important factors that affect antiretroviral drug adherence among HIV/AIDS male and female adult patients (18 years and above) attending Moi Teaching and Referral Hospital, Eldoret, Kenya. Methods: A cross sectional study involving 384 HIV/AIDS adult patients attending Moi Teaching and Referral Hospital, Eldoret was conducted. These patients were on ARV drugs. They were investigated for factors that affected their drug adherence based on observing the timing of doses and keeping of clinic appointments for drug refills during the months of May, June and July 2005. Data were collected from the respondents using interviewer–administered questionnaires to patients and self-administered questionnaires by ten key informants (nurses and clinicians in charge of HIV/AIDS clinic) selected by purposive sampling. The key variables examined were demographic, other characteristics of the patients and adherence factors. Data were analysed using Statistical Package for Social Sciences (SPSS) version 10.0 for frequencies, cross-tabulations and Chi-Squared test and statistical significance set at p<0.05. Results: Sixty-eight percent of the respondents on ARVs were females. 52.1% had secondary and post secondary education. They were aged between 18-63 years (mean age 36.1 ±8.5 years). Results showed that only 43.2% adhered to the prescribed time of taking drugs. The most commonly cited reasons for missing the prescribed dosing time by the patients were: Being away from home 68.8%, being too busy 58.9%, forgetting 49.0%, having too many medicines to take 32.6% and stigma attached to ARVs 28.9%. There was no significant difference between males and females based on timing of taking medications (χ2= 2.9412, p = 0.0861). On the basis of keeping clinic appointments, all the respondents claimed to adhere to scheduled clinics. However, from hospital records, it was established that only 93.5% of the respondents kept clinic appointments. The most common reasons for poor adherence to clinic appointments were; Being away from home (50%), forgetting (50%), being too busy (50%), stigma (70%), feeling sick (80%) and changes in work routine (60%). Conclusion: The key factors affecting adherence were; being away from home, being busy and forgetting. It was recommended that patients should be educated on the importance of strict adherence to the prescribed doses of ARVs as a suitable measure of intervention. Future research should explore multiple–target interventions to resolve the barriers to adherence

Discovery of chemically induced mutations by TILLING

The term functional genomics encompasses a number of different approaches aimed at determining gene function on a genome-wide scale. The application of these approaches is greatly facilitated by the utilisation of new, high-throughput technologies applicable to almost any organism. As an example, sequence alignment-based comparisons are used to identify homologous sequences between and within species, transcriptional profiling to determine gene expression patterns and interaction analyses to help elucidate pathways, networks and protein complexes. However, although these analyses are extremely useful to extrapolate important features of a novel gene from a biochemical or a molecular point of view, they are not very informative in the context of the functional complexity of a living organism. In order to overcome these limitations, different reverse-genetics approaches have been conceived. Nonetheless, the tools for reverse genetics are not always transferable from one organism to another or from model species to non-model ones because in most cases the main drawback is the lack of efficient technical protocols exploitable for the majority of the plant species. A novel, reverse-genetics approach that combines the advantages of point mutations provided by chemical mutagenesis, with the advantages of PCR-based mutational screening has been introduced recently under the name of TILLING (Targeting Induced Local Lesion IN Genomes; McCallum et al. 2000). From a technical standpoint, the first step of a TILLING assay is the PCR amplification of a target DNA fragment of interest from pooled DNAs of multiple mutant individuals. In sample pools, heteroduplexes with a mismatched base pair are formed between wild-type and mutated fragments by denaturing and reannealing PCR products (Fig 21.1). Heteroduplexes are cleaved by an endonuclease enzyme able to recognize the mismatch position. Cleaved products are then resolved using denaturing polyacrilamide gel or capillary electrophoresis. When a positive signal is identified, individual DNA samples of the pools are mixed in equal amounts with the wild-type DNA and one-by-one reanalysed to identify the mutant individual plant; the induced mutations are eventually confirmed by sequencing. A detailed description of the technical aspects of the TILLING procedure is presented in the following section