Can Metabolic Factors be Used Prognostically for Short-Term Mortality in HIV-Infected Patients?

Background: Metabolic abnormalities are common throughout the course of human immunodeficiency virus (HIV) infection and may occur either due to HIV infection or as a result of side effects of antiretroviral therapy. It has been established that dyslipidemia and dysglycemia associated with HIV disease reduce the long-term survival of the patients; but their role for predicting prognosis of short-term mortality in HIV patients is unknown. Aim: To study dyslipidemia and dysglycemia as a prognostic indicator for short-term mortality (3 months) in HIV patients. Subjects and Methods: An observational; prospective study was conducted at a tertiary care center over a period of 6 months. Consecutive HIV-positive patients hospitalized (both; HIV status known prior to hospitalization and the diagnosis made for the first time at admission) in medical wards from March to May 2010 were studied. All patients had their random blood sugars; fasting blood sugars (if possible); fasting lipid profile; and cluster of differentiation 4 (CD4) counts tested at the time of enrollment. The patients were followed for a period of 3 months; at the end of which they were categorized as survivors and non-survivors; and the demographic; clinical; and investigational parameters were compared between the above groups. Data was analyzed by applying Mann-Whitney U test; two sample t-test; Fisher-Exact test; and stepwise logistic regression analysis of significance; using the computer-based program; Stata; version 11.1. Results: A total of 82 patients were enrolled for the study of which 64 (78.05) were males and 18 (21.95) were females; with a mean (SD) age of 34.00 (7.0) years. The mean CD4 count was 206.23 (129.5) cells/mm 3 . The overall mortality within 3 months was 20.7 (17/82). Mycobacterium tuberculosis as opportunistic infection was found in 42 patients; out of which 13 expired (P

Effects of Aerobic Exercise Training on Psychosocial Status and Serum Uric Acid in Men with Essential Hypertension: A Randomized Controlled Trial

Chronic psychosocial stress and serum uric acid (SUA) level have been implicated in the etiology and cardiovascular events risk factors in hypertension. Studies have reported significant benefit of exercise in the overall management of hypertension. However; studies on the effect of exercise on psychosocial stress and SUA in the management of hypertension seem scanty. Aim: The aim of this study was to determine the effect of continuous training program on SUA and psychosocial status of black African (Nigerian) population with hypertension. Subjects and Methods: Age-matched randomized controlled trial was used; subjects with diagnosis of hypertension attending the hypertensive clinic of Murtala Muhammed Specialist Hospital (MMSH); Kano; Nigeria form the population for the study. Two hundred and seventeen subjects with mild to moderate (systolic blood pressure (SBP) between 140 and180 and diastolic blood pressure (DBP) between 90 and 109 mmHg) essential hypertension were grouped into continuous (112) and control groups (105). The continuous group involved in an 8 weeks continuous training (60-79 HR max) of between 45 and 60 min; 3 times per week; while the controls group remain sedentary. SBP; DBP; SUA; VO 2 max and psychosocial status were assessed. Student t-test and Pearson correlation test were used in data analysis. Results: The study revealed significant beneficial effect of continuous training programs on VO 2 max; SBP; DBP; SUA; and psychosocial status (P 0.05). Psychosocial status and SUA was significantly and positively and negatively correlated respectively with VO 2 max at P 0.01. Conclusions: This study concludes and supports the recommendations of moderate intensity (continuous) training program in blood pressure reduction; SUA and psychosocial stress management in hypertension

Management Issues in Hypertensive Diabetics

Diabetes mellitus and hypertension are common clinical conditions that often co-exist. This combination has been called the deadly duet to emphasise the increased cardiovascular risk when the two conditions co-exist. Hypertension occurs more commonly in diabetics than in comparable non-diabetics; as the prevalence of hypertension in diabetics is about two times higher than that of hypertension as observed in the general population. In type 2 diabetes mellitus; hypertension is often present as part of a possible common underlying metabolic abnormality; such as insulin resistance. However; in type 1 diabetes mellitus; hypertension is often due to the onset of diabetic nephropathy

Maladies héréditaires du métabolisme intermédiaire et prise en charge thérapeutique dans les pays d'Afrique sub saharienne : cas de glycogénose de type 1

Les maladies héréditaires du métabolisme (MHM) sont peu évoquées dans les pays sous-équipés notamment dans les pays de l'Afrique subsaharienne. De nos jours la littérature recommande au clinicien d'intégrer les maladies innées du métabolisme dans toute recherche étiologique. Certaines sont accessibles au traitement par la diététique. Notre étude est descriptive et avait pour objectif d'attirer l'attention du clinicien congolais et de l'Afrique subsaharienne sur l'existence des maladies du métabolisme intermédiaire et, ensuite, décrire la ou les maladie(s) dont le diagnostic et le traitement notamment diététique sont accessibles. Pour inventorier les différentes maladies traitées surtout par la diététique, nous avons parcouru la littérature, Orphanet et Human Gene Mutation Database. Parmi une cinquantaine des maladies traitables, la glycogénose de type 1 nous a paru la mieux appropriée pour les pays d'Afrique sub-saharienne. Cette entité pathologique se manifeste par des hypoglycémies au jeûne court (2 à 3 heures), générées par le déficit du Glucose-6-Phosphatase (G6Pase), l'enzyme ultime situé au carrefour de la glycogénolyse et de la néoglucogenèse. Le diagnostic est apporté par la triade, hypoglycémie-hyperlactacidémie-hépatomégalie. Cette triade doit être associée (corrélation phénotype-génotype) à une anomalie sur le gène de glucose-6-Phosphatase. Ces épisodes récurrents d'hypoglycémie provoquent des lésions sur le système nerveux central (SNC) et au décours des anomalies neurocognitives. L'apport des polymères de glucose sous forme de maïs préviennent les épisodes d'hypoglycémie et les troubles neurocognitifs