Factors of Adherence to Concurrent Tuberculosis Treatment and Antiretroviral Therapy among HIV-TB Co-Infected Individuals in the East Region, Cameroon in the COVID-19 Era: A Retrospective Cohort Study

Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed in all situations where patients are required to administer their own medication, whatever the type of illness. The general objective of this study was to assess the factors affecting adherence to treatment among HIV-TB co-infected patients in health facilities in the East Region in the COVID context. Method: A retrospective cohort study before and during COVID-19 was conducted in HIV care units in 13 health districts in the East Region of Cameroon. Data were collected using a questionnaire recorded in the Kobo Collect android application, analyzed using SPSS version 25 software and plotted using Excel. Results: The pre-COVID-19 cohort compared to the during-COVID-19 cohort had a 1.90 risk of not adhering to treatment (OR: 1.90, CI {1.90 - 3.37}) and the difference was statistically significant at the 5% level (p-value = 0.029). Frequency of adherence was 65.4% (140/214). Adherence before COVID-19 was 56.9% whereas during COVID-19, it was 74.3%. Conclusion: The implementation of targeted interventions in the COVID-19 context, using evidence-based data and integrating the individual needs of HIV-TB co-infected patients, improved adherence to concurrent anti-tuberculosis treatment and antiretroviral therapy during the COVID-19 Era.

Factors Associated with Non-Adherence to Treatment in Sickle Cell Patients Monitored at the National Reference Center for Sickle Cell Disease in Niger

Introduction: Sickle cell disease is a real public health problem in the world and particularly in Niger where the prevalence of the S gene is estimated at 25% and that of the homozygous forms at between 1% and 2%. Treatment combines quarterly follow-up of patients and management of complications. The objective of this study was to identify the potential explanatory factors of non-adherence to treatment in sickle cell patients followed at the national reference center for sickle cell disease in Niger. Methods: This is a cross-sectional study of sickle cell cases followed at the CNRD in Niger. The population consisted of all sickle cell patients followed in this center in 2021. The data collection techniques were individual interviews and documentary reviews. Non-adherence was assessed with the Girerd test. Descriptive statistical tests and simple and multiple logistic regression models were performed. Results: A total of 368 patients were enrolled. The median age is 7 years (4;10) and the sex ratio is 1.04. Ninety-eight (98) or 26.6% were compliant and 270 (73.4%) were non-compliant. In multivariate analysis, the factors independently and negatively associated with non-adherence to treatment were schooling (adjusted OR [95% CI], p-value), 0.17 [0.10 - 0.30];p Conclusion: The factors influencing treatment compliance identified in this study are all modifiable. To prevent the complications of sickle cell disease, we must fight against ignorance, make care services accessible and make care free.

Changes of serum inflammatory factors and miR-145 expression in patients with osteoarthritis before and after treatment and their clinical value

BACKGROUND Osteoarthritis is a chronic degenerative disease with an incidence of 50%in people over 65 years old and 80%in people over 80 years old worldwide.It is the second leading reason of loss of working capacity after cardiovascular diseases and severely affects the society and families.Therefore,finding biological markers related to the diagnosis and treatment of osteoarthritis is of great significance in clinical practice.AIM To observe the changes and clinical value of serum inflammatory factors and miR-145 expression in patients with osteoarthritis before and after treatment.METHODS Eighty-three patients with knee osteoarthritis(observation group)who were admitted to our hospital from April 2013 to June 2015,and 60 healthy people(control group)during the same period were selected.After 4 wk of treatment,the levels of miR-145,tumor necrosis factor(TNF)-α,interleukin(IL)-6,and IL-10 were compared between the control group and the observation group before treatment.The correlation of miR-145,TNF-α,IL-6,and IL-10 levels with visual analogue scale(VAS),Lysholm,and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores was assessed by Pearson correlation analysis.The correlation of the expression of miR-145,TNF-α,IL-6,and IL-10 with Kellgren-Lawrence(K-L)grades was assessed by Spearman correlation analysis.The critical levels of miR-145,TNF-α,IL-6,and IL-10 in distinguishing different K-L grades were determined by receiver operating characteristic(ROC)curve analysis.RESULTS The expression level of miR-145 in the observation group was significantly higher than that in the control group before treatment(P<0.05).After treatment,the expression level of miR-145 in the observation group was significantly lower than that before treatment(P<0.05).The levels of TNF-αand IL-6 in the observation group were significantly higher than those in the control group(P<0.05),and the level of IL-10 was significantly lower than that in the control group(P<0.05).After treatment,the levels of TNF-αand IL-6 in the observation group were significantly lower than those before treatment(P<0.05),and IL-I0 level was significantly higher than that before treatment(P<0.05).VAS and WOMAC scores were both positively correlated with miR-145,TNF-α,and IL-6(P<0.05),and negatively correlated with IL-10(P<0.05),while Lysholm scores were negatively correlated with miR-145,TNF-α,and IL-6(P<0.05),and positively correlated with IL-10(P<0.05).K-L grades were positively correlated with miR-145,TNF-α,and IL-6(P<0.05),and negatively correlated with IL-10(P<0.05).The area under the ROC curve(AUC)and specificity of TNF-αin differentiating K-L grades I-II were the highest,which were 0.785 and 97.45%,respectively,and miR145 had the highest sensitivity of 94.59%;the AUC and sensitivity of IL-6 in differentiating K-L grades II-III were the highest,which were 0.766 and 97.30%,respectively,and TNF-αhad the highest specificity of 86.68%.CONCLUSION MiR-145 and inflammatory factors have certain diagnostic value in osteoarthritis,and they are expected to become potential indicators for the diagnosis and evaluation of osteoarthritis in the future.

Glial cell line-derived neurotrophic factor as a treatment after spinal cord injury

Spinal cord injury（SCI）is a devastating trauma that currently affects 54 people out of every million,which is approximately 270,000people in the United States（National Spinal Cord Injury Statistical Center,2013）.The effects of such an injury can cause a loss of both motor and sensory function below the injury site,normally leaving the patient unable to care for themselves entirely and relying on family and friends to provide personal care.Currently there are no.

Analysis of the risk factors for severity in post endoscopic retrograde cholangiopancreatography pancreatitis: The indication of prophylactic treatments

AIM To determine the risk factors of severe post endoscopic retrograde cholangiopancreatography pancreatitis(s PEP) and clarify the indication of prophylactic treatments.METHODS At our hospital, endoscopic retrograde cholangiopancreatography(ERCP) was performed on 1507 patients from May 2012 to December 2015. Of these patients, we enrolled all 121 patients that were diagnosed with post endoscopic retrograde PEP. Fourteen of 121 patients diagnosed as s PEP were analyzed.RESULTS Forty-one patients had contrast media remaining in the pancreatic duct after completion of ERCP. Seventy-one patients had abdominal pain within three hours after ERCP. These were significant differences for s PEP(P < 0.05). The median of Body mass index, the median time for ERCP, the median serum amylase level of the next day, past histories including drinking and smoking, past history of pancreatitis, sphincter of Oddi dysfunction, whether emergency or not, expertise of ERCP procedure, diverticulum nearby Vater papilla, whether there was sphincterotomy or papillary balloon dilation, pancreatic duct cannulation, use of intraductal ultrasonography enforcement, and transpapillary biopsies had no significant differences with s PEP.CONCLUSION Contrast media remaining in the pancreatic duct and the appearance of abdominal pain within three hours after ERCP were risk factors of s PEP.

Influence of psychosocial factors on treatment of elderly Chinese patients with hypertension

Objective The aim of the study is to investigate the effects of psychosocial factors on the treatment of elderly patients with hypertension. Methods Atotalof 260 elderly Chinese patients with hypertension were treated with benazepril alone or benazepril combined with amlodipine for 8 weeks. The target blood pressure (BP) (both <140 mmHg systolic, SBP, and <90 mmHg diastolic, DBP) was achieved in 180 patients, who were then assigned to the well-controlled BP group;the rest were placed in the modestly controlled BP group. The psychosocial factors present in both groups were assessed by the Hamilton depression scale, Hamilton anxiety scale, life event scale and social support evaluation list before and after anti-hypertensive treatment. Results There were no significant differences in gender, mean age, hist ory of hypertension, education and smoking habit, or in SBP and DBP between the groups before treatment. Significant differences were also not found in all psychosocial factors before and after treatment in the patients. However, significant differences were found between the groups with respect to post-treatment SBP and marital status. The patients with modestly controlled BP had significantly higher scores, as well as incidents, on the depressive, anxiety, and stressful life event scales than those with well-controlled BP. The patients with well-controlled BP had significantly higher scores in tangible support, subjective support, and social support compared to the patients with modestly controlled BP. Logistic regression analysis showed the independent contribution of psychosocial factors in reaching the goal of lowering BP at treatment endpoint in these hypertensive patients. Conclusions The results suggest that psychosocial factors stand as a main barrier to achieving the BP-lowering target in the management of elderly Chinese patients with hypertension.(J Geriatr Cardiol 2007;4:202-207.)

Interferon beta(IFN-β) treatment exerts potential neuroprotective effects through neurotrophic factors and novel neurotensin/neurotensin high affinity receptor 1 pathway

Multiple sclerosis（MS）is a chronic autoimmune disease of the central nervous system（CNS）characterized by coexisting processes of inflammation,demyelination,axonal neurodegeneration,and gliosis.It is the most common disabling neurological disease in young adulthood.

Volumetric fluid analysis of fixed monthly anti-VEGF treatment in patients with neovascular age-related macular degeneration

·AIM:To evaluate visual outcomes and changes in fluid after administering monthly anti-vascular endothelial growth factor(VEGF)injections to treat neovascular agerelated macular degeneration(n AMD)with subretinal fluid(SRF)and pigment epithelial detachment(PED).·METHODS:This prospective study included eyes with n AMD previously treated with as-needed anti-VEGF injections.The patients were treated with six monthly intravitreal injections of ranibizumab.Quantitative volumetric segmentation analyses of the SRF and PED were performed.The main outcome measures included best-corrected visual acuity(BCVA),and SRF and PED volumes.·RESULTS:Twenty eyes of 20 patients were included in this study.At the 6-month follow-up,BCVA and PED volume did not change significantly(P=0.110 and 0.999,respectively)but the mean SRF volume decreased from 0.53±0.82 mm3 at baseline to 0.08±0.23 mm3(P=0.002).The absorption rate of the SRF volume was negatively correlated with the duration of previous antiVEGF treatment(P=0.029).Seven of the 20 eyes(35%)showed a fluid-free macula and significant improvement in BCVA(P=0.036)by month 6.·CONCLUSION:Quantifying the SRF can precisely determine the patient’s responsiveness to anti-VEGF treatment of n AMD.

Microthrombosis induced by mechanical factors and light-dye treatment

Introduction Thrombosis is the formation of a blood clot in a blood vessel. When thrombosis happens in the brain,it would cause stroke; when happens in the heart,it would cause heart attack. If a thrombus breaks and travels to the lung,it would

An Ethnographic Study on the Factors Affecting Adherence to Directly Observed Treatment Short-Course in Typical Indian Settings

Efficient management of chronic illness remains a common clinical problem. Non-adherence to a prescribed medical regimen remains a tremendous barrier to the effective medical management of chronic diseases and is considered one of the most serious problems that the medical world faces in the present. Tuberculosis is one such chronic disease which has been a prevalent problem in most of the developing nations, including India. In this paper, we describe an ethnographic study conducted in the state of Assam, with the objective of deciphering the multiple factors that are associated with the failure of the treatment regimen of Tuberculosis, viz. the DOTS (Directly Observed Treatment Short course) programme under RNTCP (Revised National Tuberculosis Control Programme).

Influence Factors of Phosphorus Removal by Chemical Method in Sewage Treatment System

[Objective] The research aimed to study influence factors of phosphorus removal by chemical method in sewage treatment system. [ Method] In different reaction systems, removal effect of the phosphorus in sewage by dosing lime and influence of the constraint factor were stud- ied. [ Result] Lime precipitation method treating high-concentration phosphorus wastewater could not only decline cost of phosphorus removal by chemical method, but also reach better treatment effect under suitable stirring and precipitation conditions by controlling alkalinity and pH. Phosphor- us content of chemical sludge after treatment could reach 9% -12%, with higher recyclable value. E Conclusion] Lime method treating phosphorus- rich sewage was more economic than low-concentration phosphorus sewage, and had very great potential for recycling phosphorus.

THE FACTORS AND TREATMENT OF LOCAL RECURRENCE AFTER RADICAL RESECTION RESERVING THE ANUS IN THE PATIENTS WITH RECTAL CANCER

Of seventy-one patients with rectal cancer after radical resection retaining the anus, 15 developed local recurrence with a recurrence rate of 21.1%. Local recurrence was correlated with improper safety margin from the lower edge of cancer to the anal end. There was statistical significant difference between 3 cm or more and 2 cm or less. The local recurrence was also related to the pathologic stage, histologic differentiation and implant of free cancer cells. It is suggested that the surgical indication of saving the anus be strict and without stretching, the safety margin from the lower edge of cancer to the anal end should not be less than 2 cm in early rectal cancer and not less than 4 cm in advanced lesions. During the operation, no touching tumor technique, thorough rinsing of the peritoneal cavity and pre- or post-operative radiotherapy are important for prevention of local recurrence. Early local recurrent rectal cancer can be detected by periodic examinations.

Treatment Outcome and Prognostic Factors for Pediatric Medulloblastoma Patients: The Egyptian National Cancer Institute Experience

Purpose: To evaluate treatment outcomes and prognostic factors of pediatric Medulloblastoma (MB) patients treated by adjuvant post-operative riskadapted radiotherapy (RT) and chemotherapy (CT). Patients and Methods: A retrospective analysis was conducted based on medical records of pediatric patients with pathologically confirmed MB treated between 2006 and 2013 at the National cancer Institute (NCI), Egypt. Various patients’ and disease characteristics, treatment details and outcome data were reviewed. Results: Fifty patients’ records were included in the analysis with a median age of 6 years at diagnosis (range 3 - 18). According to the Chang staging system;38%, 44%, 4%, and 14% were M0, M1, M2, and M3, respectively. All patients underwent primary surgery;gross total resection (with no residual) in 38%, near total resection (with residual ≤1.5 cm2) in 8%, subtotal resection (with residual > 1.5 cm2) in 34%, and 20% had only biopsy. All patients were treated by riskadapted craniospinal irradiation (CSI);high-risk patients were treated by CSI 36 Gy/20 fractions over 4 weeks followed by posterior fossa (PF) boost 18 Gy/10 fractions over 2 weeks (180 cGy per fraction), while standard-risk patients were treated by CSI 23.4 Gy/13 fractions over 2 and half weeks followed by PF boost 30.6 Gy/17 fractions over 3 and half weeks. Median overall treatment time (OTT) was 52 days. All patients received adjuvant CT;47 patients (94%) received concomitant chemo radiotherapy (CCRT), while 4 patients (8%) only received neoadjuvant CT (NB: only one patient received all neoadjuvant, concomitant and adjuvant CT). With a median follow up time of 32.5 months, ranging from 6 to 104 months, the whole group estimates of the overall survival (OS) at 1, 3, and 5 years were 83%, 70%, and 64%, respectively, while, the progression-free survival (PFS) rates at 1, 3, and 5 years were 79%, 62%, and 57% respectively. Four patients relapsed. Neural-axis was the commonest site of relapse (3 patients). Both risk groups were equally represented in relapsed patients (2 standard risk & 2 high risk patients) and relapse took place within 2 years. In univariate analysis, performance status,extent of surgery, and post-operative residual tumor size were significant prognostic factors for OS. On the other hand, factors which affected the PFS included gender, extent of surgery, and post-operative residual tumor. Conclusion: Neural-axis relapse was the commonest site of relapse for pediatric MB patients. Extent of surgical resection, post-operative residual tumor, and gender are powerful prognostic factors. Maximal safe resection is the standard surgical approach for MB patients to achieve cure.

Induction of vascular endothelial growth factor receptor expression in human umbilical vein endothelial cells after repeated bevacizumab treatment in vitro

AIM： To investigate the mechanism underlying the loss of responsiveness to anti-vascular endothelial growth factor（VEGF） treatment after repeated injections for choroidal neovascularization, VEGF and VEGF receptor（VEGFR） expressions were evaluated following repeated bevacizumab treatments in hypoxic human umbilical vein endothelial cells（HUVECs） in vitro.METHODS： HUVECs were incubated under hypoxic conditions in two media of different bevacizumab concentrations（1.0 or 2.5 mg/m L） for 17 h, and then in a new medium without bevacizumab for 7h. This procedure was repeated twice more. A culture with an identical volume of excipients served as the control. Cytotoxicity and cell proliferation were assessed using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide and Ki-67 assays, respectively. Levels of VEGF and VEGFR were assessed using enzyme-linked immunosorbent assay and Western blot respectively.RESULTS： Cytotoxic effects were not reported for either bevacizumab concentration. Cell proliferation was not reduced after anti-VEGF treatments. VEGF level after single treatment was significantly higher than that of the control and after repeated treatments. Phosphorylated VEGFR-2 expression increased significantly after singleand repeated bevacizumab treatments compared with the control. The 1.0 mg/m L bevacizumab induced significantly higher expressions of VEGFR-2 than the 2.5 mg/m L in single and repeated treatment groups.CONCLUSION： Bevacizumab treatment of HUVECs elevated VEGFR expression in both single and repeated treatments, indicating a mechanism for the reduced efficacy of anti-VEGF therapy in ocular neovascular disorders.

Factors Associated with Antiretroviral Treatments Failure among HIV-Positive Patients in Congo: A Retrospective Cohort Study

Background: Viral load is the key indicator of the effectiveness of antiretroviral treatment in HIV patients. Study aimed to determine antiretroviral treatments failure rates and associated risk factors among HIV-infected adult patients in Congo. Methods: Data from the Congolese AIDS and Epidemics Control Council were combined to create a historical cohort. Patients were followed up between 2003 to 2017. Mixed logistic regression was used to identify treatment failure associated-factors. Intercooled Stata 10 (StataCorp LP, College Station, Texas, USA) software packages was used for analysis. Results: Over 14 years of follow-up, a total of 25,500 visits for 6391 adult patients were reported. Among them, 88% i.e. 22,328 visits (for a total of 6127 patients) were visits with treatment failure. In the multivariate analysis, being aged >26 years, having primary education level, being student, others nationality, unspecifiedmarital status and being worker in informal sector were found associated with a higher risk of treatment failure. Conversely, being pensioners, receiving second line therapeutic protocols and having good adherence to treatment were found significantly associated with a lower risk of treatment failure. Conclusion: Antiretroviral treatments failure among HIV-treated patients is common in Congo. Developing treatment adherence-centered interventions with focus in patients who have low socio-economic status needed to reduced treatments failure. As treatment failure is not only determined by individual factors, psychosocial supports and availability of antiretroviral drugs needs to be taken into account.

Factor Ⅺ as A Novel Target for Treatment of Thrombotic Disease

Introduction Thrombosis is a major pathological process that threatens human health.It underlies the pathogenesis of the leading causes of death myocardial infarction (MI)and ischemic stroke (IS),as well as life-threatening disseminated intravascular coagulation ( DIC),and deep venous thromboembolism (DVT) and pulmonary embolism.Antithrombosis encompasses several aspects:coagulation,platelets,fibrinolysis,vascular endothelial cells,hemodynamics and hemorheology.Among them,anticoagulation is a fundamental step in antithrombotic therapy.Existing anticoagulants inhibit coagulation factors effectively,and are countered by substantial limitations with severe bleeding risk.For newer generation anticoagulant development,it is important to achieve a low ratio of hemorrhagic risk/antithrombotic benefit.

The application of the “Treatment in Accordance with Three Categories of Etiologic Factors” theory in the prevention and treatment of epidemic diseases in traditional Chinese medicine since the Ming and Qing Dynasties

“Treatment in accordance with three categories of etiologic factors”(consideration of the climatic and seasonal conditions,environment and individual’s constitution in the treatment of diseases),that is,treatment following time,place and individual,is one of the basic principles followed by Chinese medicine in the clinical treatment of diseases.This paper analyzes the similarities and differences in traditional Chinese medicine treatment of patients with epidemic diseases in different regions and periods since the Ming(1368-1644 C.E.)and Qing(1636-1912 C.E.)Dynasties.In addition,the theory of epidemic disease prevention and control based on the application of“treatment in accordance with three categories of etiologic factors”was discussed to inspire and guide the prevention and treatment of COVID-19.

Evaluating the Role of Internal Factors in the Damage and the Methods of Treatment of the Limestone of Emir Hasan Mosque in Akhmim, Sohag, Egypt

The present paper examines the deterioration of the limestone of Emir Hasan Mosque as a result of internal damage factors. Tests were done and carried to determine the rate of damage to the limestone that was used in the past in Egypt. Chemical analyses were done to identify soluble salts. The study utilized optical microscopy, scanning electron microscope equipped with EDS unit, and X-ray diffraction analysis to identify the main causes of increased limestone damage rates because of being affected by internal destructive factors. The study discussed different ways to conserve separate parts through the use of one consolidated material through the study of changes to limestone during the period of treatment to determine the appropriate treatment methods.

An Alternative Regression-Based Approach to Estimate the Crash Modification Factors of Multiple Treatments Using Before-and-After Data

Before-and-after methods have been effectively used in the road safety studies to estimate Crash Modification Factors (CMFs) of individual treatments as well as the multiple treatments on roadways. Since the common practice is to apply multiple treatments on road segments, it is important to have a method to estimate CMFs of individual treatment so that the effect of each treatment towards improving the road safety can be identified. Even though there are methods introduced by researchers to combine multiple CMFs or to isolate the safety effectiveness of individual treatment from CMFs developed for multiple treatments, those methods have to be tested before using them. This study considered two multiple treatments namely 1) Safety edge with lane widening 2) Adding 2 ft paved shoulders with shoulder rumble strips and/or asphalt resurfacing. The objectives of this research are to propose a regression-based method to estimate individual CMFs estimate CMFs using before-and-after Empirical Bayes method and compare the results. The results showed that having large sample size gives accurate predictions with smaller standard error and p-values of the considered treatments. Also, results obtained from regression method are similar to the EB method even though the values are not exactly the same. Finally, it was seen that the safety edge treatment reduces crashes by 15% - 25% and adding 2 ft shoulders with rumble strips reduces crashes by 25% - 49%.