Overnight soaking or boiling of "Matooke" to reduce potassium content for patients with chronic kidney disease: does it really work?

BACKGROUND: There is an increase in number of patients with chronic kidney disease (CKD) in Uganda's health facilities looking for different options of preparing matooke (bananas), their staple food. OBJECTIVE: To establish and evaluate an effective method of removing potassium from bananas (matooke). METHODS: Bananas were sampled from 5 markets in Kampala, Uganda. Deionized water was used to soak the bananas and the potassium concentration was determined using an atomic absorption spectrophotometer in both the bananas and water after soaking for varying time intervals. We also determined the potassium concentrations in the bananas and the water after boiling the bananas at 200 degrees Celsius at intervals of 10 minutes (for 60 minutes). RESULTS: The potassium concentration did not appear to change on soaking alone without boiling. However, on boiling, the concentration in the bananas decreased from about 1.4 ppm to approx. 1 ppm after 60 min; yet the concentration of potassium released into deionized water increased steadily from 0.0 ppm to about 1.2 ppm after 60 min of boiling. CONCLUSION: This study demonstrates that boiling the bananas is a more effective way of removing the potassium from bananas than simply soaking them.

Hepatotoxicity from first line antiretroviral therapy: an experience from a resource limited setting.

BACKGROUND: Highly active antiretroviral therapy (HAART) has been associated with liver toxicity. The role of monitoring for liver toxicity has not been well studied in resource-limited settings (RLS). OBJECTIVES: To determine the background prevalence and incidence of liver injury and describe the associated signs and symptoms of acute hepatitis after initiating HAART; and to determine the role of liver enzyme tests in monitoring hepatotoxicity. METHODS: In this prospective study, in Mulago Hospital AIDS Clinics, we consecutively enrolled adult patients initiated on one of three first line HAART regimens [Stavudine (d4T)-Lamivudine (3TC) and nevirapine (NVP); Zidovudine (AZT)-3TC and Efavirenz (EFV) or d4T-3TC-EFV]. We monitored ALT (alanine aminotransferase) and clinical evidence of acute hepatitis at baseline, 2(nd), 6(th), 10(th) and 14(th) week of therapy. RESULTS: Two hundred and forty HIV-positive HAART- naïve patients were enrolled in the study. The baseline prevalence of transaminitis was 1.7% with an incidence of 4.2% at 14 weeks. Grade 3-4 hepatotoxicity was documented in 1.3%. Jaundice was seen in grade 2-4 ALT elevations. Being on concurrent HAART and antituberculous drugs was associated with grade 2-4 toxicity compared to those who were only on HAART [OR; 16.0 (95% CI; 2.4-104.2)]. CONCLUSIONS: Incidence of severe hepatotoxicity within three months of first-line antiretroviral therapy was low, suggesting that routine measurement of transaminases may not be necessary in all patients initiating HAART in RLS. Routine measurement may be important in following patients on HAART and concurrent TB treatment as well as those with jaundice to avoid missing hepatotoxicity.