Association between Knowledge and Drug Adherence in Patients with Hypertension in Quetta, Pakistan

Purpose: To evaluate the association between patient’s knowledge of hypertension management and medication adherence.Methods: A cross-sectional study was undertaken with 385 hypertensive patients who visited outpatient departments in two public hospitals in Quetta City, Pakistan. Besides demographic and disease-relatedquestions, two validated questionnaires (Hypertension Fact Questionnaire and Drug Attitude Inventory) were used for data collection. Descriptive statistics were to determine the demographic and diseasecharacteristics of the patients while Spearman rank correlation was employed to measure the association between knowledge and drug adherence.Results: Out of 385 patients, 236 (61.3 %) of the patients had average knowledge about hypertension while 249 (64.7 %) were categorized as poor adherent. No patient was considered as good adherent in the study. Correlation coefficient between total score of knowledge and total adherence was – 0.170 (p < 0.001), indicating an inverse association between knowledge scores and adherence level.Conclusion: Although the level of knowledge was average, patients were unsure of the benefits of continuous medication use which resulted in non-adherence to regimens. Educating patients about the benefits of medications and clarifying doubts regarding medication use should result in better control of hypertension

Assessment of the drug therapy for sexually transmitted diseases in the White .ile State – Sudan

Back ground:Irrational drug prescribing is a global problem. It results in development of resistance to antimicrobials, ineffective treatment, adverse effects and economic burden on patient and society.Objectives: This study was carried out to assess the use of drugs for treatment of sexually transmitted diseases (STDs) and to determine their prevalence in the White Nile State-Sudan 2002-2003.Material and Methods: Twenty urban health centers were selected randomly, 30 prescriptions were collected from each health center and assessed against recommended standard therapy.Results: The appropriate drug therapy according to diagnosis was selected in only 10.6% of the collected prescriptions, only 42.2% of them were with appropriate doses and duration of therapy, poly pharmacy was detected in 28.8%, generic prescribing in 35.5% and possible drug- drug interactions in 17.3% of the total collected sample. The prevalence of STDs among total patients was 1.9%. 78.8% of the cases were females, 59.3% were 15-29 years old and Kenana Health Centers showed the highest prevalence of STDs 3.4%. (P&lt;0.05)Conclusion: The results of the present study revealed that prescribing practices for the treatment of STDs were illogical; the reference chart prepared by federal ministry of health Sudan National HIV/AIDS/STD program must be reevaluated, because it is inappropriate and illogical. Continuous training courses are urgently needed locally and nationally to raise the updating levels of medical

Studies of the Effect of Schistosoma Mansoni Infection on Work Capacity

Estimates of labour productivity loss due to schistosomiasis have been put as high as 40% but there are no satisfactory objective measurements of deterioration in physical working capacity to support these claims. The effect of s. mansoni infection on work performance in the Sudan has been investigated in the present study using the criteria of maximal aerobic power measured in the laboratory and the habitual activity pattern verified by energy expenditure measurements in the field. The study relates to economically active males aged between 18 and 45 years: infected and non-infected villagers, heavily infected canal-cleaners, hospital patients, physically trained soldiers and non-infected townspeople. All had received anti-malarial prophylaxis. Laboratory measurements included anthropometric, sociological, haematologic and biochemlcul investigations together with pulmonary function tests and bicycle ergometer measurements of aerobic work output using a semi-automated system. In 37 non-infected and 147 schistosomiasis-infected villagers no differences were found in pulmonary function, submaximal exercise performance and predicted maximum aerobic power. Statistically significant reductions in all these parameters were, however, found in a group of heavily infected canal cleaners. A changing pattern of quantitative egg excretion from moderate (2000 eggs/g) egg loads was shown to bo associated with decrements of up to 20% in maximum aerobic power. The results wore not attributable to anthropometric (particularly leg muscle volume which affects performance on the bicycle ergometer) or to nutritional differences between the groups, but predicted maximum aerobic power, egg load and haemoglobin concentrations were significantly correlated. In a further study of anti-schistosomal (hycanthone) treatment on two groups of villagers, one of which served as a control, a significant improvement in physiological work capacity occurred after treatment. The empirical findings presented in this thesis provide abasis for a clearer understanding of the relationship between schistosomiasis infection, tropical productivity and health of an infected community

Genetic heterogeneity in spondylo-epimetaphyseal dysplasias: a clinical and radiological study

Introduction: Spondylo-epi-metaphyseal dysplasias (SEMD) are a heterogeneous group of skeletal disorders characterized by defective growth and modeling of the spine and long bones. Different types are described in the literature. Accurate classification of SEMDs is essential for proper genetic counseling. Patients and Methods: This study included 20 cases of SEMDs diagnosed by clinical and radiological findings. Cases were classified based on additional associated clinical and/or radiological features into 7 subtypes. Different subtypes were discussed with review of the literature. Results: The study illustrated the heterogeneity of SEMDs and emphasized the importance of detailed and meticulous clinical genetic and biochemical evaluation in addition to comprehensive radiological investigations for such group of disorders. It also recommends further molecular studies to identify the molecular bases of the different types. Keywords: Spondyloepimetaphyseal dysplasias, Genetic heterogeneity, Dyggve- Melchior-Clausen dysplasia, Glycoaminoglycans. Egypt. J. Hum. Genet Vol. 8 (2) 2007: pp. 147-17

Global burden of human brucellosis : a systematic review of disease frequency

BACKGROUND: This report presents a systematic review of scientific literature published between 1990-2010 relating to the frequency of human brucellosis, commissioned by WHO. The objectives were to identify high quality disease incidence data to complement existing knowledge of the global disease burden and, ultimately, to contribute towards the calculation of a Disability-Adjusted Life Years (DALY) estimate for brucellosis.METHODS/PRINCIPAL FINDINGS: Thirty three databases were searched, identifying 2,385 articles relating to human brucellosis. Based on strict screening criteria, 60 studies were selected for quality assessment, of which only 29 were of sufficient quality for data analysis. Data were only available from 15 countries in the regions of Northern Africa and Middle East, Western Europe, Central and South America, Sub-Saharan Africa, and Central Asia. Half of the studies presented incidence data, six of which were longitudinal prospective studies, and half presented seroprevalence data which were converted to incidence rates. Brucellosis incidence varied widely between, and within, countries. Although study biases cannot be ruled out, demographic, occupational, and socioeconomic factors likely play a role. Aggregated data at national or regional levels do not capture these complexities of disease dynamics and, consequently, at-risk populations or areas may be overlooked. In many brucellosis-endemic countries, health systems are weak and passively-acquired official data underestimate the true disease burden.CONCLUSIONS: High quality research is essential for an accurate assessment of disease burden, particularly in Eastern Europe, the Asia-Pacific, Central and South America and Africa where data are lacking. Providing formal epidemiological and statistical training to researchers is essential for improving study quality. An integrated approach to disease surveillance involving both human health and veterinary services would allow a better understand of disease dynamics at the animal-human interface, as well as a more cost-effective utilisation of resources

Management of SARS-CoV-2 Infection: Key Focus in Macrolides Efficacy for COVID-19

Macrolides (e.g., erythromycin, fidaxomicin, clarithromycin, and azithromycin) are a class of bacteriostatic antibiotics commonly employed in medicine against various gram-positive and atypical bacterial species mostly related to respiratory tract infections, besides they possess anti-inflammatory and immunomodulatory effects. Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2). It was first detected in Wuhan, Hubei, China, in December 2019 and resulted in a continuing pandemic. Macrolides have been extensively researched as broad adjunctive therapy for COVID-19 due to its immunostimulant abilities. Among such class of drugs, azithromycin is described as azalide and is well-known for its ability to decrease the production of pro-inflammatory cytokines, including matrix metalloproteinases, tumor necrosis factor-alpha, interleukin (IL)-6, and IL-8. In fact, a report recently published highlighted the effectiveness of combining azithromycin and hydroxychloroquine for COVID-19 treatment. Indeed, it has been underlined that azithromycin quickly prevents SARS-CoV-2 infection by raising the levels of both interferons and interferon-stimulated proteins at the same time which reduces the virus replication and release. In this sense, the current review aims to evaluate the applications of macrolides for the treatment of COVID-19.NC-M acknowledges the Portuguese Foundation for Science and Technology under the Horizon 2020 Program (PTDC/PSI-GER/28076/2017)

Dietary Supplementation with Soluble Plantain Non-Starch Polysaccharides Inhibits Intestinal Invasion of Salmonella Typhimurium in the Chicken

Soluble fibres (non-starch polysaccharides, NSP) from edible plants but particularly plantain banana (Musa spp.), have been shown in vitro and ex vivo to prevent various enteric pathogens from adhering to, or translocating across, the human intestinal epithelium, a property that we have termed contrabiotic. Here we report that dietary plantain fibre prevents invasion of the chicken intestinal mucosa by Salmonella. In vivo experiments were performed with chicks fed from hatch on a pellet diet containing soluble plantain NSP (0 to 200 mg/d) and orally infected with S.Typhimurium 4/74 at 8 d of age. Birds were sacrificed 3, 6 and 10 d post-infection. Bacteria were enumerated from liver, spleen and caecal contents. In vitro studies were performed using chicken caecal crypts and porcine intestinal epithelial cells infected with Salmonella enterica serovars following pre-treatment separately with soluble plantain NSP and acidic or neutral polysaccharide fractions of plantain NSP, each compared with saline vehicle. Bacterial adherence and invasion were assessed by gentamicin protection assay. In vivo dietary supplementation with plantain NSP 50 mg/d reduced invasion by S.Typhimurium, as reflected by viable bacterial counts from splenic tissue, by 98.9% (95% CI, 98.1–99.7; P<0.0001). In vitro studies confirmed that plantain NSP (5–10 mg/ml) inhibited adhesion of S.Typhimurium 4/74 to a porcine epithelial cell-line (73% mean inhibition (95% CI, 64–81); P<0.001) and to primary chick caecal crypts (82% mean inhibition (95% CI, 75–90); P<0.001). Adherence inhibition was shown to be mediated via an effect on the epithelial cells and Ussing chamber experiments with ex-vivo human ileal mucosa showed that this effect was associated with increased short circuit current but no change in electrical resistance. The inhibitory activity of plantain NSP lay mainly within the acidic/pectic (homogalacturonan-rich) component. Supplementation of chick feed with plantain NSP was well tolerated and shows promise as a simple approach for reducing invasive salmonellosis

Integrating teachers’ TPACK levels and students’ learning motivation, technology innovativeness, and optimism in an IoT acceptance model

The growing use of the Internet of Things (IoT) around the world has encouraged researchers to investigate how and why the IoT is implemented in colleges and universities. Previous studies have focused on individual attitudes rather than the integration of attitudes from two different perspectives. Furthermore, other studies have investigated the use of the IoT in non-educational settings, ignoring the effect of the IoT related to the technology acceptance model (TAM) and technological pedagogical content knowledge (TPACK) model. The present work aims to address this research gap by determining the main factors that influence acceptance of the IoT, leading to increased awareness in collaborative learning, where technology forms the core tool in enhancing the use of the IoT. A questionnaire was used to collect data from teachers and students from colleges and universities in Oman and the United Arab Emirates (UAE). The data were analyzed through the structural equation modeling (SEM) method. The findings indicated that there are two levels of positive effects on the intention to use IoT. The first level is technology features, which are represented by technology optimism and technology innovation; these factors are crucial to using the IoT. The second level is learning motivation, which has a close relationship with teachers’ knowledge, and content pedagogy, which has a significant effect on the familiarity with IoT tools and applications. TAM constructs have a positive and direct impact on the intention to use IoT. The practical and managerial implications show that teachers, educators, and students can obtain benefits from these results to help IoT features to suit users’ needs