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Primary Antiretroviral Drug Resistance Profiles Among Hiv-1 Therapy Naïve Patients in Two Referral Hospitals in Kenya

Thesis Info

Author

Nyangena, Simon Onsongo

Department

Pathology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2013

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728064288

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Objective: To characterize antiretroviral drug resistance mutations among drug naïve patients in two referral hospitals in Kenya Background: Acquired immunodeficiency syndrome (AIDS) caused by Human immunodeficiency virus (HIV) was first described in 1982. Since then the virus has spread globally to infect millions of people. HIV was first described in Kenya in the period between 1984/1985. Currently, Kenya has an estimated HIV-1 prevalence of 6.2% with a country population of about 40 million people. With the introduction of antiretroviral drugs, the survival of most HIV patients has been prolonged markedly. However this is greatly threatened by increasing rates of antiretroviral dug resistance, which may eventually lead to suboptimal treatment outcomes. Methods: The aim of this study was to determine antiretroviral mutation profiles among drug naïve patients in two referral hospitals in Kenya. Antiretroviral naïve HIV patients in Aga Khan University Hospital and Thika Level 5 Hospital were consecutively recruited to participate in the study. Participants with viral loads >1000 copies/millilitre had their samples screened for antiretroviral resistance mutations by genotypic testing. A total of 121 participants were recruited into this study from two centres. Eighty four participants had their samples successfully genotyped for drug resistance mutations. Results: A total of five NRTI mutations (two Y115F, K219Q, K219E, and T215F) and one V106I mutation against NNRTIs were found among participants in this study. One study participant had one protease mutation, M46L. The estimated primary antiretroviral resistance rate against reverse transcriptase inhibitors was 8.7 % (95% CI 4.0-17.7). Resistance against protease inhibitors was found to be low at 1.46% (95% CI 0.26-7.9). The most common viral subtype was A1 at 52%. Others subtypes included D at 17%, subtype C at 13%, viral recombinants (CRF01_AE, CRF02_AG) at 12%, B at 3% and others subtypes (H, J) at 3%. Conclusion: Antiretroviral drug resistance mutations are showing an increasing trend among therapy naïve patients since the introduction of antiretroviral therapy in Kenya in the early 2000. This might affect the efficacy of antiretroviral regimens used for treating HIV patients. Funding: The study was co-funded by the Aga Khan University Research Council Grant (URC Grant Project 102001KEN Under Dr Nancy Okinda) and Aga Khan University Postgraduate Medical Education Seed Funding.
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مولانا پروفیسرسید محمد اجتباء ندوی

آہ! مولانا پروفیسر سید محمد اجتباء ندوی مرحوم
افسوس کہ گذشتہ ماہ ہندوستان کی ملت اسلامیہ، ایک اور نمایاں اور قابل قدر ہستی کی خدمات سے محروم ہوگئی، خبر آئی کہ مشہور عالم، عربی اور اردو کے ممتاز صاحب قلم مولانا پروفیسر سید محمد اجتباء ندوی نے ۲۰؍ جون کو دہلی میں داعی اجل کو لبیک کہا، اناﷲ وانا الیہ راجعون۔
مولانا مرحوم ہمارے علما کے اس طبقے سے تھے جن کی تعلیم و تربیت خالص دینی بنیادوں پر استوار ہوئی لیکن جن کے فیضان نظر سے عصری تعلیم کے ادارے بھی بہرہ ور ہوئے اور جنہوں نے اپنے علم و عمل سے جدید دانش گاہوں میں صرف دینی اداروں کی عظمت و توقیر میں ہی اضافہ نہیں کیا بلکہ اس مذہبی حمیت و غیرت اور خالص دینی تشخص کی پاسداری، بڑی استواری سے کی جس کا اولین سبق انہوں نے اپنے والد ماجد مولانا سید محمد مصطفی سے حاصل کیا تھا، ان کے والد ضلع بستی میں حضرت سید احمد شہیدؒ کی دعوت اور طرز تربیت میں اپنے جدامجد سید جعفر علی نقوی کے جانشین تھے جن کو امام شہیدؒ کی قربت ومعیت حاصل تھی، حضرت سید احمد شہیدؒ سے تعلق کا مبارک اثر ان کے پورے خاندان پر رہا، جس کی وجہ سے والدین نے بچپن ہی سے اسلامی و اخلاقی کہانیاں سنا کر اور خود اپنے عمل سے ایسی ذہن سازی کی کہ آئندہ زندگی میں وہ جہاں بھی رہے، راہ حق و جادۂ اعتدال سے ذرا منحرف نہیں ہوئے، دارالعلوم ندوۃ العلما کے بعد انہوں نے دمشق یونیورسٹی اور علی گڑھ مسلم یونیورسٹی سے سندیں حاصل کیں اور طالب علمی کے بعد معلمی کا دور جامعہ ملیہ اسلامیہ، کشمیر یونیورسٹی اور الہ آباد یونیورسٹی میں پورا کیا، پروفیسر ہوئے، صدر شعبہ ہوئے، اس کے علاوہ درمیان میں کچھ وقفہ مدینہ منورہ، ریاض و...

فضائی آلودگی کا تدارک اسلامی تعلیمات کی روشنی میں

Allah Almighty has created abundance of natural resources(air, water, plants, animals) for the benefit of man. Air is considered one of the basic necessity for life on Earth.  Air pollution is a major and serious problem of the contemporary world. Rapidly spreading large crowded cities, modern transport, installation of industries and thermal power stations  are the main causes of air pollution. A large number of Industries, power-generating stations, construction projects, brick Kilns and  toxic solid wastes are polluting the atmosphere badly. The transport like buses, trucks, auto rickshaws, airplanes and internal combustion engines are main sources of carbon monoxide, hydrocarbons, nitrogen oxides, and lead pollution in the air. The toxic gases, smog and smoke of industries are affecting humane, animal and plant life rapidly. Treatment devices are not installed in industries and brick kilns  to remove harmful gases before releasing smoke into the atmosphere. This research work explores that Air pollution is the core issue of the entire world, which requires immediate action for removal of  pollution from the air. Test results of air quality indicate that major part of Pakistani population is living at the risk of air pollution. Islam clearly commands each individual to avoid negative and destructive actions. This Study explores that Air pollution can be abated and minimized by adopting Islamic precautionary measures about air cleanliness.

Kernel Operators in Some New Function Spaces

The thesis is devoted to the weighted criteria for integral operators with positive ker- nels in variable exponent Lebesgue and amalgam spaces. Similar results for multiple kernel operators defined with respect to a Borel measure in the classical Lebesgue spaces are also obtained. More precisely, we established necessary and sufficient conditions on a weight function v governing the boundedness/compactness of the weighted positive kernel operator Kv f (x) = v(x) x 0 k(x, y)f (y)dy from Lp(·) (R+ ) to Lq(·) (R+ ) under the local log-H ̈lder continuity condition and the decay condition at o infinity on the exponents p and q. In the case when Kv is bounded but not compact, two-sided estimates of the measure of non-compactness (essential norm) for Kv are obtained in terms of the weight v and kernel k. Criteria guaranteeing the boundedness /compactness of weighted kernel operators defined on R+ (resp. on R) in variable ex- ponent amalgam spaces are found. The kernel operators under consideration involve, x for example, the Riemann-Liouville transform Rα f (x) = 0 f (t) dt, (x−t)1−α 0 < α < 1. Necessary and sufficient conditions ensuring weighted estimates for maximal and po- tential operators in variable exponent amalgam spaces are also established under the local log-H ̈lder continuity condition on exponent of spaces. Further, we establish o criteria on measures governing the boundedness of integral operators with product positive kernels defined with respect to a Borel measure in the classical Lebesgue spaces. Finally, we point out that Fefferman-Stein type inequality for the multi- ple Riemann-Liouville transform defined with respect to a product Borel measure is derived.