Patient and Health System Related Factors Associated with Non-Adherence to Antihypertensive Medication among Patients at Chuka Referral Hospital, Kenya

Background: Non-adherence to hypertensive medication continues to become a contributing factor to hypertensive complications like stroke, heart attacks, kidney disease heart failure. Associated factors to non-adherence are complex, are both internal and external to the patient and are difficult to extrapolate. Reports from Chuka referral hospital records showed that in 2016 there were 140 patients with hypertensive complications from 560 patients who attended the medical clinic that year. Objective: This study sought to explore the patient’s related factors that are associated with non-adherence to hypertension medication. Methods: This is a descriptive study design of (N = 575) people among them doctors, pharmacists, nurses, record officers and hypertension patients. Simple random sampling for patients (n = 81) and census sampling for health care workers was done and data collected using questionnaires and interview schedules between April 4th-May 30th 2019. Inferential and descriptive statistics were used for data analysis, aided by SPSS version 25. Results: 64% of the patients stated that they had missed medication. A significant negative correlation (rpb = -0.23, p < 0.05) between age and non-adherence, significant positive correlation with monthly income (rpb = 0.24, p < 0.04), non-significant relationship between non-adherence and marital status (rpb = -0.13, p = 0.25) and patients’ level of education (rpb = -0.06, p = 0.57). The overall model of health system related factors were found to be significant (p < 0.05) and this included;quality of health service, physician patient relationship, stock out, health education, and availability of medicine (p = 0.012). Conclusion: Lacks of funds, unavailability of drugs are the leading factors to regimen completion. This could be easily be addressed by the government.

Inhibition of epidermal growth factor receptor signaling protects human malignant glioma cells from hypoxia - induced cell death

Epidermal growth factor receptor(EGFR)signaling has become an importanttarget for drug development becauseEGFR signaling enhances tumor cell proliferation,migration,and invasion and inhibits apoptosis.However,theresults of clinical trials using EGFR inhibitors in patients with solid tumors have been disappointing.Here,wereport a protective effect of the EGFR inhibitors AG1478 and PD153035 against cell death induced by acute hy-poxia,which contrasts with their proapoptotic effects under normoxia.Under hypoxic conditions,both agents re-

The Role of IκBα in TNF-α-induced Apoptosis in Hepatic Stellate Cell Line HSC-T6

To investigate the role of NF-κB in TNF-α induced apoptosis in HSC-T6, a mutant IκBα was transfected into HSC-T6 cells by lipofectin transfection technique and its transient effect was examined 48 h after the transfection. The activation of NF-κB was detected by immune fluorescence cytochemistry and Western blotting with anti-p65 antibody. The apoptosis and the rate of inhibition by TNF-α in both transfected and untransfected HSC-T6 cells were measured respectively by FAC-Scan side scatter analysis and MTF methods. Our results showed that TNF-α could activate NF-κB in untransfected cells but not in transfected HSC-T6 cells. The percentage of apoptosis in transfected cells were significantly higher than that in the untransfected ones （P〈0.01） and it was also true of the inhibition rate （P〈0.01）. It is concluded that the resistance of HSC-T6 towards apoptosis induced by TNF-α can be mediated by NF-κB activation. The inhibition of NF-κB activation by mutant IκBα can attenuate the resistance of HSC-T6 cells and increase its sensitivity to TNF-α.

Neuroendocrine Control of Posterior Regeneration in Tropical Earthworm, Eudrilus eugeniae （Kinberg）

Eudrilus eugeniae （Kinberg）, well known vermicomposting earthworms, are often subjected to predator attacks leading to loss of body parts due to their surface living habit. Thus nature has gifted them the power of regeneration of lost body parts. As neurosecretion is the sole source of hormone in oligochaetes, we hypothesize that neurohormone secreted from the neurosecretory cells of the central nervous system （CNS） will control the phenomenon of regeneration in earthworms. In Eudrilus eugeniae, appearance of regeneration blastema was noticed within 72 h of posterior amputation. In fact, posterior amputation brought about multiple cytoplasmic alteration in the neurosecretory cells （NSCs） viz. deep stained A cells and moderately stained B cells in cerebral ganglia, deep stained ＇U＇ cells and moderately stained B cells in the sub-esophageal and ventral nerve cord ganglia. Massive depletion followed by marginal accumulation of NSM in the NSCs following 24 h and 48 h of amputation were recorded. Thereafter （72 h and 96 h of amputation） moderate to massive engorgement of NSM in the B cells, coupled with spectacular increase in number of A cells were noticed. Sequential changes involved in the secretory dynamics of NSCs, as well as, NSM accumulation both within and periphery of the ganglia （perineurium） provides evidence for the utilization of materials through repaired vascular systems during posterior regeneration in E. eugeniae.

STUDY ON THE IMMUNE FUNCTION OF ERYTHROCYTE IN PATIENT WITH NIDDM

The author measured the immune function of erythrocyte in 50 cases of noninsulin dependent diabetes mellitus(NIDDM),and researched the effect of erythrocyte immune adherence adjustmeat factor on the immune function of erythrocyte. The results showed that in patients with NIDDM,erythrocyte C3b receptor rosette forming rate(ECRRFR)was much higher(P<0.01),erythrocyte immune adherence exciting factor(EIAEF)was much lower than that of normal controlgroup(P<0.01);erythrocyte immune complexes rosette forming rate(EICRFR)was much lower,and erythrocyte immune adherence inhibiting factor(EIAIF)was much nigher than that of normalPersons(P<0.01).The study also showed that a significant positive correlation was found betweenthe activation of erythrocyte C3b receptor and EIAEF,and a significant negative correlation wasfound between the activation of erythrocyte C3b receptor and EIAIF.

Targeting late SV40 factor: Is the achilles heel of hepatocarcinogenesis revealed?

Hepatocellular carcinoma (HCC) is a dreadful cancer and a major cause of death among patients with chronic liver disease and cirrhosis. The apparent alterations in a diversity of intracellular pathways found in HCC has set the rational for developing molecular-directed drugs that simultaneously inhibit multiple pathways, such as the multi-kinase inhibitor Sorafenib. However, recently this concept has been challenged by showing that HCC is heavily dependent on a single oncogene designated late SV-40 factor (LSF), a transcription factor that is over-expressed in liver cancer cells and that its expression is strongly correlated with tumor grade and aggressiveness. Furthermore, using an intensive screening for drugs that inhibit LSF activity, Grant et al have found a molecule designated factor quinolinone inhibitor 1 that can specifically block the ability of LSF to bind its target promoters, resulting in a massive death of HCC cells both in vitro and in vivo. The innovative findings of HCC representing "oncogene addiction" to LSF and the ability of a single molecule to block the activity of this oncogene resulting in tumor abolishment are encouraging and provide us with the hope that the "Achilles heel" of HCC has been found.

Dobesilate for dry age-related macular degeneration

We have evaluated the effects of intravitreal dobesilate, a synthetic fibroblast growth factor inhibitor, in patients with dry age-related macular degeneration, an inflammatory-related retinal disease without available treatment up to date. 36 eyes from 36 patients with dry age-related macular degeneration were treated with a single intravitreal dobesilate injection. The end points were the improvement from baseline visual acuity and normalization of retinal histology at one month. Intravitreal dobesilate injection resulted in a significant improvement in functional and anatomical outcomes at one month after injection. Our results suggest that intravitreal dobesilate may increase the chance of visual acuity gain in dry age-related macular degeneration, even in cases with initial low vision. This study supports the findings of previously published case reports, regarding the short-term improvement in visual acuity by intravitreal dobesilate injection in different degenerative retinal diseases.

Dynamics and data fitting of a time-delayed SIRS hepatitis B model with psychological inhibition factor and limited medical resources

Hepatitis B is an infectious disease worthy of attention.Considering the incubation period,psychological inhibition factor,vaccine,limited medical resources and horizontal transmission,an SIRS model is proposed to describe hepatitis B transmission dynamics.In order to describe the behavior changes caused by people's psychological changes,the non-monotonic incidence rate is adopted in the model.We use the saturated treatment rate to describe the limited medical resources.Mathematical analysis shows the existence conditions of the equilibria,forward or backward bifurcation,Hopf bifurcation and the Bogdanov-Takens bifurcation.During the observation of the case data of hepatitis B in China,it is found that there are mainly three features,periodic outbreaks,aperiodic outbreaks,and periodic outbreaks turns to aperiodic outbreaks.According to the above features,we select three different representative regions,Jiangxi,Zhejiang province and Beijing,and then use our model to fit the actual monthly hepatitis B case data.The basic reproduction numbers that we estimated are 1.7712,1.4805 and 1.4132,respectively.The results of data fitting are consistent with those of theoretical analysis.According to the sensitivity analysis of Ro,we conclude that reducing contact,increasing treatment rate,strengthening vaccination and revaccinating can effectively prevent and control the prevalence of hepatitis B.