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1.
Anesth Essays Res ; 7(1): 25-8, 2013.
Article in English | MEDLINE | ID: mdl-25885715

ABSTRACT

BACKGROUND: Tramadol is licensed primarily as an analgesic, but has additional properties, one of which is the ability to increase gastric pH. However, it has not been established if this action is dose related, hence we set out to provide further evidence about this action of tramadol. PATIENTS AND METHODS: Fifty-five female adult patients presenting for gynecological surgery were randomized into three groups. After induction, 2.5 ml of gastric juice was aspirated to determine baseline pH, after which groups 1, 2, and 3 received 50 mg, 75 mg, and 100 mg of IV tramadol, respectively. Gastric pH was subsequently assessed every 30 min for as long as the surgery lasted. RESULTS: There was no significant difference in the pH of the three groups before anesthesia (3.88 ± 0.75, 3.54 ± 0.73, and 3.75 ± 0.70; P = 0.393). Similarly, no significant statistical difference was observed in the pH of the three tramadol groups during the subsequent three readings (pH1: 4.21 ± 0.93, 4.27 ± 0.95, 4.07 ± 0.82; pH2: 4.75 ± 1.00, 4.68 ± 0.94, 4.59 ± 0.78; pH3: 5.33 ± 0.86, 5.13 ± 0.95, 4.97 ± 0.78; P = 0.793, 0.876, and 0.490). There were statistically significant increases in the pH of each group when the baseline pH was compared with the subsequent three readings, with P values of 0.002, 0.0001, 0.001 in the 50 mg group, 0.0001, 0.0001, 0.0001 in the 75 mg group, and 0.008, 0.0001, 0.001 in the 100 mg group. CONCLUSION: Our result further confirms that tramadol elevates gastric pH. However, the degree of elevation was not found to be dose dependent.

2.
Malar J ; 6: 41, 2007 Apr 11.
Article in English | MEDLINE | ID: mdl-17428334

ABSTRACT

BACKGROUND: Chloroquine (CQ) has been in use in Africa for a long time. Because of misuse, this drug has now lost its efficacy due to the emergence of resistance strains in most parts of Africa. Recently, it was shown that after chloroquine has been withdrawn from the market, chloroquine-sensitive Plasmodium falciparum re-emerged and chloroquine could again be used successfully as an antimalarial. Surveillance of parasite populations is, therefore, important to decide whether chloroquine could be re-introduced. METHODS: To estimate the prevalence of the most pivotal polymorphisms, including Pfcrt K76T, Pfmdr1 N86Y and Pfmdr1 Y184F mutations, and their contributions to the outcome of CQ treatment, isolates from Osogbo Western Nigeria were tested using the Fluorescence Resonance Energy Transfer (FRET) method on a real-time PCR instrument. RESULTS: 116 children with acute uncomplicated P. falciparum malaria infections were treated with the standard dosage of CQ and followed-up for 28 days. Blood samples were collected on filter paper at enrollment and during follow-up for identification of parasite carrying the chloroquine resistant transporter (pfcrt) and P. falciparum-multi drug resistance (pfmdr1) gene mutations. Parasitological assessment of response to treatment showed that 62% of the patients were cured and 38% failed the CQ treatment. The presence of single mutant pfcrt (T76) alleles (P = 0.003) and in combination with mutant pfmdr1 Y86 (P = 0.028) was significantly associated with in vivo CQR. No other mutation on its own or in combinations was significantly associated with treatment outcome. Mutant pfcrt was more prevalent in both pre- and post-treatment isolates. No association was observed between age or initial level of parasitaemia and chloroquine treatment outcome. CONCLUSION: The result established the usefulness and accuracy of real time PCR in pfcrt and pfmdr1 mutation detection and also give further evidence to the reliability of the pfcrt T76 point mutation as a molecular marker for CQ resistance.


Subject(s)
Antimalarials/therapeutic use , Chloroquine/therapeutic use , Malaria, Falciparum/parasitology , Membrane Transport Proteins/genetics , Multidrug Resistance-Associated Proteins/genetics , Plasmodium falciparum/genetics , Point Mutation , Protozoan Proteins/genetics , Animals , Child , Child, Preschool , Drug Resistance , Female , Fluorescence Resonance Energy Transfer , Humans , Infant , Malaria, Falciparum/blood , Malaria, Falciparum/drug therapy , Male , Nigeria , Plasmodium falciparum/isolation & purification , Polymerase Chain Reaction/methods , Treatment Outcome
3.
Afr J AIDS Res ; 5(3): 233-6, 2006 Nov.
Article in English | MEDLINE | ID: mdl-25865913

ABSTRACT

To assess the affordability of antiretroviral drugs (ARVs) and accessibility to treatment for opportunistic infections (OIs) among HIV-1 seropositive persons, we used semi-structured interviewer-administered questionnaires to interview 154 individuals seeking ARV treatment at the Daughter of Charity German Leprosy and Tuberculosis Centre in South-West Nigeria. The respondents' mean age was 37 years (range 13-65 years) and their average monthly income was NGN9 603 (approx. US$73). One hundred and eleven respondents (72.1%) had sought care elsewhere before seeking ARV therapy: 67 (60.4%) from private hospitals, 26 (23.4%) from public hospitals, 17 (15.3%) from traditional healing homes, and one from an NGO; the remaining 43 (27.9%) had not sought medical care before ARV therapy. Thirty-nine respondents (25.3%) had symptomatic AIDS with evidence of opportunistic infections (OIs), and 115 (74.7%) were HIV-1 seropositive only. One hundred and twenty-six (81.8%) believed that ARV treatment would prolong their lives, of which 27 anticipated a cure for AIDS; eight (11.7%) had no knowledge of the benefits of ARV therapy, six (3.9%) had strong fears of stigmatisation and discrimination as a consequence of ARV therapy, and four (2.6%) did not express any opinion. Sixty-three respondents (40.9%) perceived the cost of ARVs as expensive and unaffordable, 58 (37.7%) wanted free drugs, 20 (12.9%) wanted to pay a maximum of NGN2 000 (US$15) for monthly supplies (while the actual cost was NGN13 000 or US$98), and 13 (8.5%) did not comment. There was a strong association between literacy level and knowledge of ARV therapy. The more educated tended to have higher incomes and their perception of ARV therapy was laudable despite having sought other treatment elsewhere, while the less educated tended to earn less and perceived ARV therapy as unaffordable, and therefore had not bothered to seek previous treatment. We urge that ARVs be made more affordable to enhance their accessibility and treatment compliance, especially among lower-income patients.

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