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Home > Comparison of Cardiometabolic Risk Profile Between Hiv Patients on Art and Those Who are Art Naïve

Comparison of Cardiometabolic Risk Profile Between Hiv Patients on Art and Those Who are Art Naïve

Thesis Info

Author

Njenga, Erick Kimani

Department

Internal Medicine (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2014

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728039599

Similar


Background: Metabolic syndrome comprises of a set of aggregated risk factors that include: hypertension, central obesity, impaired fasting glucose, hypertriglyceridemia and low HDL-C (1)The is a noted increase in the prevalence of the metabolic syndrome cardiovascular risk factors in the HIV population. Methods: The study is a cross-sectional survey that enrolled 157 HIV positive patients over a 4 month period that were either newly diagnosed (HIV ART naïve) or were on ART from both the inpatient and outpatient setting. Data of their anthropometric, cardiovascular risk factors and clinical characteristics were collected with the aid of a standardized questionnaire and serum biochemical testing was done in the fasted state. The data obtained was used to determine the presence or absence of the metabolic syndrome in the two populations using the NCEP ATP III criteria and their 10 year risk of adverse cardiovascular outcome using the WHO/ISH AFRI E score. Results: The mean age of the study participants was 46 years S.D (9.3). The prevalence of metabolic syndrome was 23.75% and 11.69% in the ART arm and ART naïve arm respectively. Majority of the patients were in the low risk category as calculated by the WHO/ISH AFRI E score 89.61% vs. 91.25% in the naïve and ART arms respectively. 6.49% and 3.89% in HIV ART naïve arm were distributed in the moderate and very high risk categories as compared 6.25% and 2.5% in the HIV ART arm. Conclusions and recommendations: Metabolic syndrome was found to be more prevalent in the HIV ART arm as compared to the naïve arm although the difference did not reach a statistically significant level. Majority of the individuals as by WHO/ISH AFRI E risk score in both arms were found to be in the low risk category and thus would greatly benefit from diet and lifestyle modification to avert the risk of developing metabolic syndrome and subsequent cardiovascular disease..
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باب ششم: قابل تجدید وسائل کا مطالعہ

اللہ تعالیٰ نے انسان کو بے تحاشا قابلِ تجدید ذرائع سے نوازا ہے، ان ذرائع میں پانی سے بجلی، شمسی توانائی، ہوا ئی توانائی ہیں۔ ان ذرائع میں پانی سے بجلی، شمسی توانائی، ہوا سے بجلی وغیرہ ہیں، قابلِ تجدید وسائل کا سب سے زیادہ افادیت یہ ہے کہ یہ کاربن ڈائی آکسائیڈ کی بہت کم مقدار خارج کرتے ہیں، 1 کلو واٹ فی گھنٹہ میں شمسی توانائی سے 87 گرام، جیو تھرمل سے 41گرام، ہوائی توانائی سے 31 گرام، جوہری توانائی سے 52 گرام کاربن بن ڈائی آکسائیڈ خارج ہوتی ہے۔ 1 کلو واٹ فی گھنٹہ میں پن بجلی سے صرف کم از کم ایک گرام سے 1500 گرام تک کاربن ڈائی آکسائیڈ خارج ہوتی ہے۔ جرمنی میں 30 فیصد، چین میں 29 فیصد اور جاپان میں 24 فیصد بجلی شمسی توانائی سے پیدا ہوتی ہے۔ پاکستان میں پن بجلی کی صلاحیت ایک لاکھ میگا واٹ ہے، ہوائی توانائی کی 50 ہزارمیگا واٹ ہے، بائیو ماس سے بھی بجلی پیدا کرنے کی صلاحیت بھی ہزاروں میگا واٹ میں ہے، پاکستان میں ایک مربع کلو میڑ پر ایک کلو واٹ توانائی پڑتی ہے جس سے ہزاروں میگا واٹ بجلی پیدا کی جا سکتی ہے۔ [1]

 مسلم سکالر'عبدالحمید' لکھتا ہے:

“It is the use of non-renewable resources, those minerals and fossil hydrocarbons whose natural cycles are on a geologic time-scale and are thus practically finite in human terms that are ecologically unsound. It is the rampant exploitation of such non-renewable resources over the past 20 years that has led to the industrial and technological way of life that dominates the planet.”[2]

 واپڈا حکام کے مطابق قابل تجدید وسائل سے آئندہ 20 برسوں میں ستانوے سو میگا واٹ پیدا کی جائے گی۔ نیپرا کی سالانہ رپورٹ...

فکر اقبال کے تناظر میں تہذیبی تصادم

A thorough critical analysis of human history highlights that the clash of civilizations centered on themes of conflict, war, and struggle. Historical experts use the word encounter to interpret or explain these relations among civilizations. Trade played a vital role in flourishing these ties, however, conflict and encounter have also been a part of almost all the phases or eras of human history. Developing nations have always looked up to the western world as a role model of economic and military progression, but this philosophy has also resulted in the escalation of tensions among these nations. World peace faces daunting challenges and is one of the most talked-about human concerns in the present times. Islam is currently being challenged by the western world in terms of the right interpretation of religious teachings and the true message of the Holy Quran and Sunnah. Islam is still struggling to make its mark in the present world order, particularly after the 9/11 incident which painted Muslims as terrorists and fundamentalists. It is quite evident that the world is divided into factions or groups, where one group is the torchbearer of Islam and religious teachings, while the second group endorses western ideals or secularism. According to Samuel Huntington, it won’t be wrong to say that the next ideological challenge that the world faces after the ultimate demise of the Soviet Union is Islam and the prospective clash between the East and the West in the 21st century will be the most discussed topic. The present-day relationship between the East and the West is based upon rivalry. This conflict is not a new area of research and is centuries old. The only solution to this problem is to promote global peace and harmony and facilitate dialogue among nations. This would help in creating a social system that can center on values, harmony, peace, and love. Also, Iqbal’s philosophy can act as a guiding stone and can help in resolving this crisis. Iqbal’s universal social reconstruction theory highlights how different civilizations can live together and can facilitate constructive dialogue to improve civilizational ties. This article aims to incorporate the teachings of Iqbal, especially the universal social reconstruction theory to propose solutions for inter-civilizational clashes. This article aims to use the teachings of Iqbal as a beacon of light to promote constructive dialogue and peaceful coexistence among the two dominant sides of the world, resultantly leading in much prosperous and peaceful world order. 

Synthesis, Characterization and Modification of Gum Arabic Microgels for Biomedical and Environmental Applications

In this study, Gum Arabic (GA) microgels were successfully synthesized via reverse micellization method with a high yield (78±5.0%) in 5-100 μm size range using divinyl sulfone (DVS) as a crosslinker. The as synthesized GA microgels show 22.8±3.5% biodegradability property at stomach condition (pH 1) in 20 days, whereas no degradation was observed at pH 7.4 and pH 9 conditions at 37 oC. By using diethylenetriamine (DETA) and taurine (TA) as chemical modifying agents, GA microgels were chemically modified as GA-DETA and GA-TA microgels. Remarkably, GA-DETA and GA-TA microgels show zeta potential values of 5.23±4.07 and -24.85±1.33 mV in comparison to GA microgels which give -27.31±4.20 mV overall surface charge. Moreover, blood compatibility of GA, GA-TA, and GA-DETA microgels was tested via in vitro protein adsorption, % hemolysis ratio and blood clotting index. Interestingly, GA based microgels were hemocompatible with % hemolysis ratio between 0.23 and 2.05; and the GA microgels were found highly compatible with a blood clotting index of 81±40. The biocompatibility of GA, GA-DETA and GA-TA microgels against L929 fibroblast cells also indicate 84.4%, 89.1% and 67.0% cell viability respectively at 25.0 μg/mL concentration; suggesting a great deal of potential in vivo biomedical applications up to this concentration. In addition, 5 and 10 mg/mL minimum inhibition concentration (MIC) of protonated GA-DETA microgels (GA-DETA-HCl) was determined against E. coli and S. aureus respectively. The bare and GA-TA microgels present good loading capability of 160 and 57 mg.g-1 for phenylephrine (PHP) whereas, in case of Trimethoprim(TMP), GA-DETA and GA-TA microgels show a relatively higher loading capacity of 80 and 52 mg.g-1 respectively. Contrarily, 39.27 ±1.20, 18.40 ±3.130 and 3.10 ±1.140 mg.g-1 release of PHP was observed in case of GA, GA-TA and GA-DETA microgels respectively to the BPS medium in 8 Hrs. Likewise, GA and GA-TA microgels exhibits upto 4.5 ±3.32 and 9.80 ±4.10 mg.g-1 release respectively and an unexpectedly low release amount of 3.3 ±1.94 mg.g-1 from GA-DETA microgels was monitored in case of TMP. Besides, Zeta potential measurements in this study suggest that GA-DETA microgels denote a positively charged surface in DI water. Due to this fact, GA-DETA microgels were used as micro reactor in removal study of some negatively charged pollutants such as; chromate(Cr(III)), dichromate(Cr(VI)), arsenate(As(V)), methyl orange(MO), eosin Y(EY) and Congo red(CR) from aqueous media. Thus, 0.05 g feed of GA-DETA microgels show upto 69.80, 99.30 %, 40.0 %, 91.0%, 84.10 % and 73.0 % removal capability for As(V), Cr(VI), Cr(III), MO, EY and CR respectively in 2 Hrs. mixing time. Moreover, kinetic models such as; the Langmuir, the Fruendlich and modified Fruendlich isotherms were applied to the obtained adsorption data and it was concluded that modified Fruendlich model exhibits relatively practical fit for almost all pollutants giving R2 value nearer to unity. Moreover, maximum adsorption capacity (Qm) was determined for all the six pollutants with the numerical values of 217, 256, 271, 143, 130 and 116 mg.g-1 for As (V) Cr(III), Cr(VI), MO, EY and CR respectively. Further, it was observed that the modified Fruendlich isotherm give inclusively best fit for all pollutants showing R2 values of 0.9962, 0.9926, 0.9972, 0.9988, 0.9988 and 0.980 in case of adsorption As(V), Cr(VI), Cr(III), MO, EY and CR respectively.