scholarly journals Zidovudine Induced Pancytopenia: A Case Study

2021 ◽  
Vol 11 (5) ◽  
pp. 8-10
Author(s):  
Santreena Simon K ◽  
Serene Maria ◽  
Cyril Tom
Keyword(s):  
Combination Therapy ◽  
Who Guidelines ◽  
First Line ◽  
Drug Induced ◽  
Epigastric Discomfort ◽  
The Past ◽  
Laboratory Results ◽  
Probable Interpretation ◽  
Recommended Guidelines

Zidovudine is the oldest anti-retroviral agent that is in clinical use. It’s common adverse effects are headaches (42-62.5%), nausea (46-61%), anorexia (11-20%), vomiting (6-25%), anemia (1.1-29%), granulocytopenia (1.8-37%) and neutropenia (3%). This study is to increase awareness of Zidovudine induced pancytopenia. This is an observational type of case report of a 40 year old man with known complaints of HIV on anti-retroviral therapy since 8 years who came with complaints of easy fatigability since 1 year which was aggravated since 1 week, epigastric discomfort, constipation since 2 weeks, chest pain retrosternal in position which was radiating to both upper limbs, sweating, palpitations, decreased appetite since 1 week and cough with expectoration. He was given tablet ZLN (Zidovudine 300 mg + Lamivudine 150 mg + Nevirapine 200 mg) twice daily regularly for the past 8 years. His last CD4 count was 300 cell/mm3. He had pallor. His laboratory results were: hemoglobin (6.6 g/dL), TLC (2400/μL), platelets (18,000/μL), neutrophil (36%) and MCV (107.4fL). He was diagnosed with pancytopenia (dimorphic anemia + leucopenia + thrombocytopenia) and neuropathic pain. It was confirmed to be Zidovudine induced pancytopenia by objective analysis and Naranjo score suggesting “probable” interpretation. Pancytopenia improved after withholding Zidovudine along with Oxcarbazepine. Suggestion was made to change his anti-retroviral regimen once his counts improve.  Tenofovir + Lamivudine (or Emtricitabine) + Efavirenz is the preferred first line combination therapy according to latest WHO guidelines (2013 and 2015). In case Zidovudine is used in first line combination therapy (2009 WHO guidelines), physicians should monitor for its toxicity. A clinical pharmacist can help in such situations by creating awareness among prescribers regarding latest WHO and other recommended guidelines, checking whether the prescriptions follow these guidelines and also by monitoring patients for toxicities. Keywords: Zidovudine, Drug induced pancytopenia, Adverse drug reaction

scholarly journals Investigating the efficacy of triple artemisinin-based combination therapies (TACTs) for treatingPlasmodium falciparummalaria patients using mathematical modelling

2018 ◽  
Author(s):  
Saber Dini ◽  
Sophie Zaloumis ◽  
Pengxing Cao ◽  
Ric N Price ◽  
Freya J.I. Fowkes ◽  
...  
Keyword(s):  
Combination Therapy ◽  
South East Asia ◽  
Comprehensive Model ◽  
Artemisinin Derivative ◽  
Who Guidelines ◽  
Combination Therapies ◽  
First Line ◽  
Standard Regimen ◽  
Global Threat ◽  
Novel Model

AbstractThe first line treatment for uncomplicated falciparum malaria is artemisinin-based combination therapy (ACT), which consists of an artemisinin derivative co-administered with a longer acting partner drug. However, the spread ofPlasmodium falciparumresistant to both artemisinin and its partner drugs poses a major global threat to malaria control activities. Novel strategies are needed to retard and reverse the spread of these resistant parasites. One such strategy is triple artemisinin-based combination therapy (TACT). We developed a mechanistic within-host mathematical model to investigate the efficacy of a TACT (dihydroartemisinin-piperaquine-mefloquine - DHA-PQ-MQ), for use in South-East Asia, where DHA and PQ resistance are now increasingly prevalent. Comprehensive model simulations were used to explore the degree to which the underlying resistance influences the parasitological outcomes. The effect of MQ dosing on the efficacy of TACT was quantified at varying degrees of DHA and PQ resistance. To incorporate interactions between drugs, a novel model is presented for the combined effect of DHA-PQ-MQ, which illustrates how the interactions can influence treatment efficacy. When combined with a standard regimen of DHA and PQ, the administration of three 8.3 mg/kg doses of MQ was sufficient to achieve parasitological efficacy greater than that currently recommended by WHO guidelines.

Starch-modified fillers for linerboard and paper grades: A perspective review

TAPPI Journal ◽  
2010 ◽  
Vol 9 (4) ◽  
pp. 31-36 ◽  
Author(s):  
YULIN DENG ◽  
PHIL JONES ◽  
LESLIE MCLAIN ◽  
ART J. RAGAUSKAS
Keyword(s):  
Filler Content ◽  
Product Platform ◽  
Laboratory Studies ◽  
The Past ◽  
Development Opportunity ◽  
Laboratory Results ◽  
Addition Rate ◽  
Institute Of Technology ◽  
Paper Product ◽  
Detrimental Impact

High-filler-content paper is a growing research and development opportunity in papermaking. These new products must address traditional paper product properties while providing papermakers with distinct product platform benefits. Over the past decade, a research team involving researchers from the Institute of Paper Science and Technology at Georgia Institute of Technology and from Imerys have significantly advanced the application of starch-encapsulated papermaking fillers. This review summarizes these accomplishments from initial laboratory studies to mill trials. Laboratory results have illustrated that starch-encapsulated fillers can facilitate a near-doubling of filler content over conventional levels at equal tensile and z-direction tensile (ZDT) values. Equally important is that the use of starch-encapsulated kaolin (SEK) filler has been shown to facilitate a doubling of filler addition rate without any detrimental impact on ring crush compared with control studies with filler. Pilot-plant and mill trials have shown that SEK can function as a fiber extender, reduce steam demand for drying by 10%, and increase papermaking speeds and production rates.

From hard to soft: theory and Neolithic studies in Scotland

2011 ◽  
Vol 33 (1-2) ◽  
pp. 7-19
Author(s):  
Kenneth Brophy
Keyword(s):  
The Past

The Scottish Theoretical Archaeology Group (STAG) conference organisers expressed some doubts about how far theory has changed, and impacted, archaeological establishment and academia in Scotland. In this paper, I will argue that Scotland is certainly not isolated in a theoretical sense, although in the past, Scottish archaeology could be accused of being theoretically conservative, or at least dependent on ideas and models developed elsewhere. A case-study looking at Neolithic studies will be used to illustrate that despite some recent critical historiographies of the study of the period in Scotland, archaeologists in Scotland and those working with Scottish material have been theoretically innovative and in step with wider paradigm changes. The study of the Neolithic in Scotland, it could be argued, has been shaped by theory more than the study of any other period; we are not isolated, but rather part of wider networks of discourse.

THE URBAN MIGRANT FUTURE DESIRE: A STUDY OF REVERSE MIGRATION IN MALAYSIA

2017 ◽  
Vol 3 (2) ◽  
pp. 177
Author(s):  
Nur Huzeima Mohd Hussain ◽  
Hugh Byrd ◽  
Nur Azfahani Ahmad
Keyword(s):  
Oil And Gas ◽  
Industrial Society ◽  
Peak Oil ◽  
Population Mobility ◽  
Reverse Migration ◽  
The Past ◽  
Urban Migrants ◽  
Urban Migrant ◽  
Oil Crisis

Globalisation combined with resources of oil and gas has led to an industrial society in Malaysia.  For the past 30 years, rapid urban growth has shifted from 73% rural to 73% urban population. However, the peak oil crisis and economic issues are threatening the growth of urbanisation and influencing the trends of population mobility. This paper documents the beginnings of a reverse migration (urban-to-rural) in Malaysia.  The method adopted case study that involves questionnaires with the urban migrants to establish the desires, definite intentions and reasons for future migration. Based on this data, it predicts a trend and rate of reverse migration in Malaysia. 

Conservation and Preservation of Nature Reserves, Monuments andSpecial Architectural or Historic Interest in Nigeria: Towards Promotion of Sustainable Cultural Tourism

2015 ◽  
Vol 3 (2) ◽  
pp. 201-218
Author(s):  
Francis Chuma Osefoh
Keyword(s):  
Cultural Tourism ◽  
Nature Reserves ◽  
Communication Link ◽  
Built Environments ◽  
Tourist Attraction ◽  
The Past ◽  
Personal Experiences ◽  
Historical Heritage ◽  
Developed Nations

Some of the renowned world tourism countries have special peculiarities in character in terms of their nature reserves and built environments; that made them stand out for their attractions and visits. These qualities range from conservation and preservation of nature reserves, built environments- epoch architectural supports over the years; historical heritage; political; religious; socio-economic; cultural; and  high technology that enhance culture. The virtues of multi- ethnic groups and multi- cultural nature gave Nigeria a rich cultural heritage, and she is blessed with natural wonders, unique wildlife, and a very favorable climate. More often than not less attention and importance are placed over the nature reserves and built environments to the detriment of tourism in lieu of other sectors. Summarily the country lacks the culture of conservation and preservation of her abundant resources to promote cultural tourism. Case study strategy was applied in the research tours with reports of personal experiences, documentaries and analyses of sites visited in Europe and Nigeria were highlighted with references to their attributes in terms of structures and features that made up the sites as relate to culture and attraction.The task in keeping rural, city landscapes and nature reserves alive stands out as the secret of communication link from the past to present and the future; which tourism developed nations reap as benefits for tourist attraction.

Risk Factor Of Substitution ARV First Line People Living With HIV/AIDS In General Hospital Buleleng Bali

2020 ◽  
Vol 9 (1) ◽  
pp. 190-197
Author(s):  
Luh Putu Desy Puspaningrat ◽  
Gusti Putu Candra ◽  
Putu Dian Prima Kusuma Dewi ◽  
I Made Sundayana ◽  
Indrie Lutfiana
Keyword(s):  
Risk Factor ◽  
General Hospital ◽  
Medical Records ◽  
Secondary Data ◽  
District General Hospital ◽  
People Living With Hiv ◽  
First Line ◽  
The Past ◽  
Factor Substitution ◽  
Living With Hiv

Substitution is still a threat to the failure of ARV therapy so that no matter how small it must be noted and monitored in ARV therapy. The aims  was analysis risk factor substitution ARV first line in therapy ARV. This study was an analytic longitudinal study with retrospective secondary data analysis in a cohort of patients receiving ARV therapy at the District General Hospital of Buleleng District for the period of 2006-2015 and secondary data from medical records of PLHA patients receiving ART.  Result in this study that the percentage of first-line ARV substitution events is 9.88% (119/1204) who received ARV therapy for the past 11 years. Risk factors that increase the risk of substitution in ARV therapy patients are zidovudine (aOR 4.29 CI 1.31 -2.65 p 0.01), nevirapine (aOR1.86 CI 2.15 - 8.59 p 0.01) and functional working status (aOR 1.46 CI 1.13 - 1.98 p 0.01). 

The Local Government of Kulon Progo Regency Innovation in Subduing Capitalism through Community Empowerment

2020 ◽  
Vol 4 (2) ◽  
pp. 229
Author(s):  
Muhammad Eko Atmojo ◽  
Helen Dian Fridayani
Keyword(s):  
Qualitative Method ◽  
Positive Impact ◽  
Community Empowerment ◽  
Case Study Approach ◽  
Study Approach ◽  
The Past ◽  
The People ◽  
District Government ◽  
The Government

Kulon Progo Regency is one of the districts that has many innovations, one of which is community empowerment in collaboration with a modern shop abbreviated as the shop name owned by the people (tomira). This research was motivated by the achievements of the Kulon Progo district government in carrying out development and innovation in the development of the Kulon Progo region by fully involving the Kulon Progo district community through community empowerment. This initiative was taken by the government of Kulon Progo Regency to improve community empowerment and protect the people of Kulon Progo Regency from various economic threats. Considering that in the past few years many modern shops have mushroomed in each district/city, so this is what makes Kulon Progo Regency move quickly to empower the community by collaborating between MSMEs or cooperative with modern shops. This study uses a qualitative method which case study approach. With the empowerment that has been done, the original products of Kulon Progo Regency or local products can be traded in modern stores so that local products in Kulon Progo Regency can compete with national products in these modern stores. The existence of such cooperation will indirectly improve the image of Kulon Progo Regency and lift the original products of Kulon Progo Regency. The lifting of the original products of Kulon Progo Regency will have a positive impact on the community, where indirectly the economy of the community will increase so that there will be prosperity for the community. Kabupaten Kulon Progo adalah salah satu kabupaten yang memiliki banyak inovasi, salah satunya adalah pemberdayaan masyarakat bekerja sama dengan toko modern disingkat nama toko yang dimiliki oleh masyarakat (tomira). Penelitian ini dilatarbelakangi oleh pencapaian pemerintah kabupaten Kulon Progo dalam melakukan pengembangan dan inovasi dalam pengembangan wilayah Kulon Progo dengan melibatkan sepenuhnya masyarakat kabupaten Kulon Progo melalui pemberdayaan masyarakat. Inisiatif ini diambil oleh pemerintah Kabupaten Kulon Progo untuk meningkatkan pemberdayaan masyarakat dan melindungi masyarakat Kabupaten Kulon Progo dari berbagai ancaman ekonomi. Menimbang bahwa dalam beberapa tahun terakhir banyak toko-toko modern telah menjamur di setiap kabupaten/kota, jadi inilah yang membuat Kabupaten Kulon Progo bergerak cepat untuk memberdayakan masyarakat dengan berkolaborasi antara UMKM atau bekerjasama dengan toko-toko modern. Penelitian ini menggunakan metode penelitian kualitatif dengan pendekatan studi kasus, dengan metode yang digunakan adalah dokumentasi. Dengan pemberdayaan yang telah dilakukan, produk asli Kabupaten Kulon Progo atau produk lokal dapat diperdagangkan di toko modern sehingga produk lokal di Kabupaten Kulon Progo dapat bersaing dengan produk nasional di toko modern ini. Adanya kerjasama tersebut secara tidak langsung akan meningkatkan citra Kabupaten Kulon Progo dan mengangkat produk asli Kabupaten Kulon Progo. Pencabutan produk asli Kabupaten Kulon Progo akan berdampak positif bagi masyarakat, di mana secara tidak langsung perekonomian masyarakat akan meningkat sehingga akan ada kesejahteraan bagi masyarakat.

A LOOK INTO THE EARTH: EVALUATING THE USE OF MAGNETIC SURVEY IN AFRICAN ARCHAEOLOGY

2004 ◽  
Vol 2 (1) ◽  
pp. 49-63 ◽  
Author(s):  
Carlos Magnavita ◽  
Norbert Schleifer
Keyword(s):  
Geophysical Methods ◽  
Field Research ◽  
Archaeological Sites ◽  
Magnetic Survey ◽  
The Past ◽  
Common Technique ◽  
Sub Saharan ◽  
Prehistoric Settlements ◽  
Present Case Study

In the last decades, geophysical methods such as magnetic survey have become a common technique for prospecting archaeological sites. At sub-Saharan archaeological sites, however, magnetic survey and correlated techniques never came into broad use and there are no signs for an immediate change of this situation. This paper examines the magnetic survey undertaken on the Nigerian site of Zilum, a settlement of the Gajiganna Culture (ca 1800-400 BC) located in the Chad Basin and dated to ca 600-400 BC. By means of the present case study, we demonstrate the significance of this particular type of investigation in yielding complementary data for understanding the character of prehistoric settlements. In conclusion, we point out that geophysical methods should play a more important role in modern archaeological field research, as they furnish a class of documentation not achievable by traditional survey and excavation methods, thus creating new perspectives for interpreting the past of African societies.

Disability and Work During the Industrial Revolution in Britain

2018 ◽  
Author(s):  
Daniel Blackie
Keyword(s):  
Disability Studies ◽  
Industrial Development ◽  
Industrial Revolution ◽  
Coal Industry ◽  
Historical Research ◽  
Disabled People ◽  
Industrial Sites ◽  
The Past ◽  
Paid Employment

A common claim in disability studies is that industrialization has marginalized disabled people by limiting their access to paid employment. This claim is empirically weak and rests on simplified accounts of industrialization. Use of the British coal industry during the period 1780–1880 as a case study shows that reassessment of the effect of the Industrial Revolution is in order. The Industrial Revolution was not as detrimental to the lives of disabled people as has often been assumed. While utopian workplaces for disabled people hardly existed, industrial sites of work did accommodate quite a large number of workers with impairments. More attention therefore needs to be paid to neglected or marginalized features of industrial development in the theorization of disability. Drawing on historical research on disability in the industrial workplace will help scholars better understand the significance of industrialization to the lives of disabled people, both in the past and the present.

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