Monitoring diagnosis, retention in care and viral load suppression in children testing HIV polymerase chain reaction-positive in two districts in South Africa

Background. Retention in care is associated with improved virological control and survival among HIV-infected children. However, retention of children in HIV care remains a challenge.Objectives. To describe, using routine laboratory HIV test data, the retention-in-care and virological outcomes of HIV-infected children aged <18 months in two districts in South Africa.Methods. HIV polymerase chain reaction (PCR)-positive results of children from uMkhanyakude and Tshwane districts in KwaZulu-Natal and Gauteng provinces, respectively, tested between April 2015 and May 2016, were extracted from the National Health Laboratory Service's Corporate Data Warehouse (CDW). HIV-related tests (PCR, viral load (VL), CD4+) were documented longitudinally for each child for ≥13 months after the first positive PCR result by manually searching demographics within the CDW, supplemented by an automated patient-linking algorithm. Test sets were linked if two or more demographics (surname, name, date of birth, folder number) matched exactly. Programmatic indicators assessed included age at first positive PCR test, presumed confirmatory test rates, retention in care, and VL suppression at 6 and 12 months.Results. Ninety-four and 304 children tested HIV PCR-positive in uMkhanyakude and Tshwane, respectively. The median age at diagnosis was 3.6 months (interquartile range (IQR) 1.4 - 7.1) for uMkhanyakude and 2.3 months (IQR 0.1 - 6.7) for Tshwane. In uMkhanyakude, confirmed in utero infections accounted for 18.1% of transmissions (n=17), compared with 29.6% (n=90) in Tshwane. Presumed confirmatory test rates following an initial positive PCR result were 77.7% and 71.7% for uMkhanyakude and Tshwane, respectively. Within 6 months of starting antiretroviral therapy, 43 children (58.9%) were lost to follow-up in uMkhanyakude compared with 160 (73.4%) in Tshwane. Of those retained in care at 6 months with a VL measurement, 15 (60.0%) from uMkhanyakude had a VL <1 000 copies/mL, compared with 24 (48.0%) in Tshwane. For both districts, a third of all HIV PCR-positive children were retained in care at the end of follow-up, with 29 (30.9%) in uMkhanyakude and 99 (32.5%) in Tshwane. Of these, 12 (41.4%) had a VL <1 000 copies/mL in uMkhanyakude compared with 28 (28.3%) in Tshwane.Conclusions. We demonstrate the value of routine laboratory data in monitoring diagnosis, retention and VL suppression in HIV-infected children. This approach is scalable, can be reported near real-time, is relatively inexpensive to implement, and provides a tool for improving paediatric HIV services until clinical databases can assume this role

[Hepatoprotective effect of sodium molybdate on carbon tetrachloride-induced liver damage in rats]

The liver as a key organ of metabolism and excretion is constantly endowed with the task of detoxification. Hepatotoxicants can induce various disorders of the organ. Carbon tetrachloride [CCl4] is a potent hepatotoxin producing centrilobular hepatic necrosis and is widely used for animal models of hepatotoxicity. Molybdenum functions as a co-factor for a limited number of enzymes including xanthine oxidase, aldehyde oxidase and sulfite oxidase in mammals, and is believed to be an essential trace element in human and nutrition. The aim of the present study was to evaluate the protective effect of sodium molybdate against experimentally induced-CCl4 liver injury. Adult male rats were orally administered with different doses of sodium molybdate [0.05, 0.1 and 0.2g/kg bw/daily] along with CCl4 [50% CCl4, in olive oil, 1ml/kg bw, intrapertioneally] twice a week for 28 consecutive days. Biochemical parameters like alanine amino transferase, aspartate amino transferase, alkaline phosphatase and total protein levels in the serum were determined. In present study, the level of serum markers such as alanine amino transferase, aspartate amino transferase, and alkaline phosphatase were significantly increased in CCl4 treated rats. While Simultaneous treatment of sodium molybdate at doses 0.05, 0.1 and 0.2g/kg bw significantly decreased alanine amino transferase, aspartate amino transferase and alkaline phosphatase at the dependent dosage manner. Moreover, it had no effect on serum total protein levels. The results of this study demonstrate the hepatoprotective effect of molybdenum and thus scientifically supports the use of this trace element for treatment of liver disorders

Hypoglycemic effect of ethanolic extract of Carum carvi L. seeds in normal and streptozotocin-induced diabetic rats

Herbal medicine has been used for many years by different cultures around the world for the treatment of diabetes. The hypoglycemic effect of caraway ethanolic extract [Carum carvi L.] was investigated in normal and streptozotocin-induced diabetic rats. Intraperitoneal administration of caraway ethanolic extract seeds [0.1, 0.2, 0.4 and 0.6 g/kg body wt.] on the level of serum glucose and insulin in normal and streptozotocin-induced diabetic rats were evaluated. Before administration and 1, 3 and 5 h after administrations of the ethanolic extract, blood samples were drawn from the retro-orbital sinus. Serum glucose and insulin levels were determined. The results showed that the caraway ethanolic extract seeds at doses 0.2, 0.4 and 0.6 g/kg body wt. significantly decreased serum glucose and insulin in diabetic rats in 3 and 5 h but not in healthy rats. It could be proofed that the traditional use of caraway as a hypoglycemic agent is justified and that extract from this plant show a dose-dependent hypoglycemic activity

[Acute effects of apple cider vinegar intake on some biochemical risk factors of atherosclerosis in rabbits fed with a high cholesterol diet]

Metabolic changes in postprandial stage, especially after consumption of high fat meal cause atherosclerosis and increase the risk of cardiovascular diseases. Apple cider vinegar is an acidic juice with useful medicinal effects. In this research; we investigated acute effects of apple cider vinegar intake on some of the biochemical atherosclerosis risk factors in high cholesterol fed rabbits. Thirty two male New Zealand rabbits were randomly divided into four groups: normal diet group, high cholesterol diet group [%1cholesterol],%1 cholesterol with 5ml apple cider vinegar group,%1 cholesterol with 10ml apple cider vinegar group. The C-Reactive Protein [CRP], low density lipoprotein [LDL-C], high density lipoprotein [HDL-C], total cholesterol [TC], malondialdehyde [MDA], oxidized-LDL [OxLDL], serum glutamic pyruvic transaminase [SGPT], serum glutamic oxaloacetate transaminase [SGOT], nitrite, nitrate, glucose, fibrinogen triacylglycerol [TG], apolipoprotein A [ApoA1], apolipoprotein B [ApoB100] were all measured before the experiment and three hours after feeding with these treatment diets. In high cholesterol diet fibrinogen, nitrite, glucose, OxLDL, MDA and CRP showed a significant increase compared to normal diet. Significant differences were observed between both groups of apple cider vinegar by fibrinogen in comparison with hypercholesterolemic diet. Using 10ml apple cider vinegar with cholesterolemic diet caused a significant reduction in Ox-LDL, MDA and glucose in comparison with hypercholesterolemic diet. Moreover, the consumption of 5ml apple cider vinegar with cholesterolemic diet caused a significant decrease in LDL-C and TC compared to hypercholesterolemic diet. No significant difference was found between apple cider vinegar taking groups and hypercholesterol diet in CRP, TG ApoA, HDL-C, ApoB, SGOT, SGPT, nitrite and nitrate. The results showed that acute consumption of apple cider vinegar [as an antioxidant] causes significant reduction on some risk factors of atherosclerosis

[General dental practitioners and management of traumatic dental injuries in children]

Usually, traumatic dental injuries are considered a bad experience to children. It is important to treat these conditions as soon as possible. The aim of the present study was to evaluate the knowledge of general dentists practicing in Tehran regarding the management of such injuries. This cross sectional survey was carried out in Tehran. A total of 165 general private dentists were included in this study. A questionnaire was used to collect information from the study participants. The SPSS statistical software package [Version 11.5] and Mann-Whitney, Kruskal-Wallis, Independent sample t-test and Pearson correlation coefficient were used for statistical analyses. Knowledge of dentists regarding traumatic injuries to children's teeth was 64% and the amount of their Knowledge had inverse relation with their age and direct relationship with the time of graduation from dental school. Based on the results of this study, general dentists practicing in Tehran have relatively adequate knowledge of dental trauma. However, it is necessary to further expand their knowledge through continuing medical educations

Assessment of radioprotective effects of amifostine on human lymphocytes irradiated in vitro by gamma-rays using cytokinesis-blocked micronucleus assay

A radioprotective effect of amifostine as well as its ability to modulate the level of spontaneous and gamma-irradiation-induced genetic changes on human peripheral blood lymphocytes has been investigated. Amifostine, known as a potent radical scavenger, has been introduced as the most effective radioprotector, yet it is not completely approved for the clinical use. However, further in vitro and clinical studies are needed to clarify its mechanisms of action. Whole blood samples from healthy donors were exposed to various doses of gamma-rays. Lymphocytes in cultures were treated with amifostine at different concentrations [2, 4 and 6 mm] in the presence or in the absence of 1 IU/ml alkaline phosphatase before or after gamma-irradiation. Standard procedure for the cytokinesis-block micronucleus [CBMN] assay was used to assess the effect of amifostine on radiation induced micronucleus in binucleate lymphocytes. Irradiated blood samples showed an increase in the total number of micronuclei [MN] significantly different from controls [p<0.05]. However, pre-treatment of lymphocytes with amifostine in the presence of alkaline phosphatase, 15 minutes before irradiation, led to a significant decrease in the frequencies of MN and cells with more than one MN [p<0.05]. Amifostine, in its own, produced little or no protection. However, the addition of amifostine with alkaline phosphatase to the cell cultures 15 minutes after irradiation produced substantial radioprotection significantly different from the frequencies of MN induced by radiation alone [p<0.05]. Results clearly indicated that gamma-rays induced MN in lymphocytes in a dose dependent manner. The highest protective effect was achieved when amifostine was phosphorilated by alkaline phosphatase and present before irradiation in the cellular environment, indicating its radical scavenging mechanism of radioprotection. Since the administration of amifostime after irradiation also led to a considerable decrease in the frequency of radiation induced MN, which might be possible for other mechanisms such as induction of cell cycle delay and hence influencing DNA repair, are involved in radioprotection by amifostine

[Effect of sexual pheromones, and sexual and paternal behaviors on the plasma level of testosteron in male wistar rat]

Pheromones play a major role in the sexual and social behavior of animals. The main sources of pheromones are urine and paracrine secretions. Pheromones can affect the mammals reproductive physiology. The vomeronasal organ [VNO] is located in the base of nasal cavity and VNO has some effects on amygdal; stimulating the amygdal hence could affectthe mammal's sexual behavior. Through the neuroendocrine system, testosterone is a safe parameter to measure and compare the effects on the sexual behavior. With regard to the neuroendocrine system, testosterone is a safe parameter for measuring the effects of pheromones on sexual behaviors. In this research, we have investigated the of pheromone interaction on sexual behaviors such as intercourse, mating and being near a pregnant female, also paternal behavior after children's birth, have been investigated. The effects of sexual pheromones were determined with a special cage without any sensory stimulation interference, such as visual, auditory, tactile senses [3.58 +/- 0.38 ng/mL]. Proximity between a female and a male rat increased plasma levels of testosterone rapidly [10.59 +/- 2.25 ng/mL, P<0.01]. Mating caused a decrease in testosterone levels comparing to premate groups [4.32 +/- 0.95 ng/mL, P<0.05]. During pregnancy, the testosterone levels increased up to the second week [6.11 +/- 1.58 ng/mL, P<0.017] then decreased rapidly[1.65 +/- 0.37 ng/mL, P<0.017]. After birth of children, the father rat testosterone levels decreased gradually [0.36 +/- 0.14 ng/mL, P<0.017]. But the presence of the father rat's near the strange child rat, the plasma levels of testosterone to increase significantly compared to the increase in mating groups[8.46 +/- 1.26 ng/mL, P<0.017]. These findings suggest that female sexual pheromones and different fatherhood and sexual behaviors, directly affect plasma levels of testosterone and can subsequently affect mating rats' reproductive activities

Control of environmental health and removal of rats by alpha[2]-adrenergic antagonist and potassium channel blocker

In the present study, it is shown that in vivo oral administration of glibenclamide [1-10 mg/kg/day], an adenosine triphosphate -sensitive potassium channel blocker, and yohimbine [1-5 mg/kg/day], an alpha 2-adrenoceptor antagonist, potently reduced glycemia in male rats. Diazoxide [1-45 mg/kg/day], a potassium channel opener, and clonidine [0.05-0.5 mg/kg/day], an alpha 2- adrenoceptor agonist, antagonized the effects of glibenclamide and yohimbine respectively. Administration of glibenclamide and yohimbine separately decreased the serum glucose levels, so it was expected that coadministration of these two drugs significantly decreased this parameter in fasted animals. It is well known that glibenclamide blocks the potassium channels and it is likely that, yohimbine also blocks these channels, but according to our data, it seems that yohimbine acts via a different binding site to that of glibenclamide. In this research it is also observed that administration of yohimbine and glibenclamide causes death in rats, it seems that these drugs causes death in the experimental animals by lowering blood glucose level, which were the aim of this study and could be applied as a way to control the environmental health by abolishing rats