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Home > The Influence of Antiretroviral Therapy on Qtc Interval Amongst Hiv Patients at Aga Khan University Hospital, Nairobi

The Influence of Antiretroviral Therapy on Qtc Interval Amongst Hiv Patients at Aga Khan University Hospital, Nairobi

Thesis Info

Author

Shavadia, Jay

Department

Pathology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2009

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728072050

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Aim: To determine the influence of antiretroviral (ARV) therapy on the QTC interval amongst HIV-infected patients. Design: Prospective Comparative survey of two population samples Patients and Setting: One hundred and thirty ARV naïve and one hundred and thirty treated HIV-positive patients selected from in and out patient departments of Aga Khan University Hospital underwent clinical evaluation and 12 lead resting ECG between August 2008 and March 2009. Methodology: Eligible HIV-positive patients were conveniently sampled and had a 12-lead electrocardiogram (ECG) performed to determine the QTinterval, corrected for the heart rate by the Bazzet formula. Analysis was then performed to determine the odds of development of a prolonged QTC interval (QTC ≥ 440ms) in the ARV-experienced arm compared to the ARV-naïve arm. Results: One hundred and thirty patients in each of the two study arms’ had ECG assessment of the QTC interval. 16.2% of the patients in the ARV-experienced arm had QTC prolongation compared to 6.9% in the ARV-naïve arm (chi square 5.43, p= 0.01) giving rise to an odds ratio of 2.5 (95% CI 1.01-6.67). Conclusion: ARV use significantly increases the risk of development of an acquired long QTC syndrome by two-and-a-half times.
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نہ میرے دل پہ مرا کوئی اختیار رہا

نہ میرے دل پہ مرا کوئی اختیار رہا
کہ میری جان کے دشمن پہ یہ نثار رہا

وہ ہر جگہ پہ مرے نام سے ہی جانا گیا
یہ اور بات وہ اوروں کا غمگسار رہا

لیے ہیں رنج سدا ہی خلوص کے بدلے
کہ دل جلوں کا ہمیشہ یہ کاروبار رہا

تمام رات رہا ہم کلام تاروں سے
لباس جس کے مقدر کا تار تار رہا

وہ کوئی اور نہیں تھا وہ تیرا تائبؔ تھا
تمام عمر جسے تیرا انتظار رہا

ہمارے تعلیمی مسائل اور ان کا حل: اسلامی تناظر میں

Education plays a very important role in the life of individulals, society and the state. Dawa, tarbiya and modern media are also considered informal parts of education. Edcuational issues being confronted by the Pakistani community today are not mere outcome of recent government policies but are rather extension of legacy of our colonial past. Aligarh is the symmbol of Westernized modern education advocated by pro-West Sir Syed Ahamd Khan whereas Deoband is the role model of religious education sponsored by the religious elite of that time. The former is deprived of religious education and tarbiya while the latter ignores secular knowledge and skills. The need of the hour is that we get rid of this educational dichotomy and develop an holistic educational system integrating healthy aspecths of both these streams so that graduates of general and modern education do benefit from religious norms; and graduates of religious education are also well aware of modern knowledge and skills. We will discuss these issues in this paper in perspective of Dr. Mahmood Ahmad Ghazi’s reflections on this topic.

Cultural Drivers of Plant Biodiversity of District Tor Ghar

Interactions between people and plant diversity are indispensable. Ethnobiology explores such interactions in a scientific way to unearth the reality that cultureand plant diversity of a region influences each other in a reciprocal manner. Relations between plants and people are much stronger in remote cultural societies. District Tor Ghar is one of such remote and rugged mountainous region of the western Himalayas that has historically established tribal cultural values, traditions and customs. There is no evidence of previous qualitative or quantitative ethnobotanical research that tells something about culture of the region. Present PhD project was initiated by selecting a total of 43 villages from 5 tribal belts (Basikhel, Nusratkhel, Akazai, Hasanzai and Madakhel) using random table number method. 732 informants of all age groups were interviewed via semi-structured questionnaire method during the years 2012 and 2013. Group discussions, Ethnobotanical Participatory Appraisal (EPA) and extensive field visits were also arranged. Quantitative ethnobotanical techniques i.e., Informant Consensus Factor (ICF), Cultural Importance Index (CI), mean Cultural Importance Index (mCI) and Cultural Importance of Families (CIF) were used to report cultural diversity among 5 tribes of the region. The conservation stata of all culturally significant plant species were also assessed quantitatively by developing first time a special mathematical relation i.e., CS =K (OC+AV+CE)/TF x RPwhich was in harmony with IUCN criteria. Cluster Analysis (CA), Two Ways Cluster Analysis (TWCA) and Detrended Correspondence Analysis (DCA) were appliedtodraw and understand cultural gradient of the ethno-ecologically important species of the region using robust software packages PCORD version 5& CANACO version 4.5.Our findings show that 295 species of vascular plants providing 33 cultural services in the form of food, medicine, fodder, timber wood, fuel, cosmetics, aesthetic, spiritual and veterinary etc.Assessment of conservation status via newly developed formula confirmed 20 species as critically endangered, 35 as endangered, 56 as vulnerable, 58 near threatened (rare) and 126 least concerned(Secure). The use of multivariate statistics brought forward a pattern in large multivariate data sets to a presentable and structurally recognizable form. Findings based on CA, TWCA and DCA showed a cultural gradient among the various tribes of the region. There is a significant correlation on the plant use pattern and conservation management of Basikhel to Nusratkhel and Akazai to Hasanzai while a significant diversity of such patterns exist between Madakhel and the remaining tribes.The current study contributes to an enhanced understanding of ecosystem services in the Tor Ghar, cultural uses of mountain vegetation within the context of anthropogenic impacts and the role of indigenous culture in regional plant conservation strategies and priorities.