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The antiretroviral efficacy of highly active antiretroviral therapy and plasma nevirapine concentrations in HIV-TB co-infected Indian patients receiving rifampicin based antituberculosis treatment
Sanjeev Sinha, Sahajal Dhooria, Sanjiv Kumar, Nipam Shah, T Velpandian, AK Ravi, Narendra Kumar, Hafeez Ahmad, Akshat Bhargwa, Karan Chug, Naresh Bumma, Rahul Chandrashekhar, Meera Ekka, Vishnu Sreenivas, Surendra K Sharma, JC Samantaray, Ronald Mitsuyasu
AIDS Research and Therapy , 2011, DOI: 10.1186/1742-6405-8-41
Abstract: 63 cases included antiretroviral treatment na？ve HIV-TB co-infected patients with CD4 counts less than 200 cells/mm3 started on rifampicin-containing ATT followed by nevirapine-containing HAART. In control group we included 51 HIV patients without tuberculosis and on nevirapine-containing HAART. They were assessed for clinical and immunological response at the end of 24 and 48 weeks. Plasma nevirapine concentrations were measured at days 14, 28, 42 and 180 of starting HAART.97 out of 114 (85.1%) patients were alive at the end of 48 weeks. The CD4 cell count showed a mean increase of 108 vs.113 cells/mm3 (p=0.83) at 24 weeks of HAART in cases and controls respectively. Overall, 58.73% patients in cases had viral loads of less than 400 copies/ml at the end of 48 weeks. The mean (± SD) Nevirapine concentrations of cases and control at 14, 28, 42 and 180 days were 2.19 ± 1.49 vs. 3.27 ± 4.95 (p = 0.10), 2.78 ± 1.60 vs. 3.67 ± 3.59 (p = 0.08), 3.06 ± 3.32 vs. 4.04 ± 2.55 (p = 0.10) respectively and 3.04 μg/ml (in cases).Good immunological and clinical response can be obtained in HIV-TB co-infected patients receiving rifampicin and nevirapine concomitantly despite somewhat lower nevirapine trough concentrations. This suggests that rifampicin-containing ATT may be co administered in resource limited setting with nevirapine-containing HAART regimen without substantial reduction in antiretroviral effectiveness. Larger sample sized studies and longer follow-up are required to identify populations of individuals where the reduction in nevirapine concentration may result in lower ART response or shorter response duration.There are 33.3 million people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the world [1]. Out of these, around 40% of patients are co-infected with tuberculosis (henceforth, called HIV-TB co-infected patients), forming a total estimated co-infection prevalence of 13-15 million persons worldwide [2]. As per the latest
Anaemia in a Patient with Diffuse Systemic Scleroderma  [PDF]
Karan Grover, Rohit Peshin
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.47056
Abstract: We hereby present a case of anaemia in a 73 years old patient with known past medical history of diffuse systemic scleroderma, who presented with acute onset of dizziness and haemetemesis. Blood tests revealed sudden drop of haemoglobin and an urgent gastroscopy revealed gastric antral vascular ectasia (GAVE) or “watermelon stomach”. GAVE is a rare but well recognised cause of acute bleeding in systemic scleroderma patients and should be kept as a differential diagnosis in the work up of anaemia in these patients.
Common Radial Velocity vs. Rare Microlensing: Difficulties and Futures
Karan Molaverdikhani
Physics , 2010,
Abstract: In this paper, effective factors for success of Microlensing and Radial Velocity methods were choose. A semi-Delphi process applied on the factors to evaluating them and finding the most important factors for present situation of ML and RV, with help from about 100 experts, in or related exoplanets detection. I found the public definition on "success of exoplanets detection methods" is not correct and we should change it, as some experts did it, in the form of fundamental questions in planetary science. Also, the views of "Special Experts" are different from other experts that help us to choose the right way in evaluating. The next step was choosing the best strategy for future and finally, from SWOT landscape and with a new objective of ML method (New Game Board Strategy) I suggested four critical future strategies for completing current strategic directions.
A Dance With Mrs Chan
Abraar Karan
- , 2016, DOI: 10.1370/afm.1922
Abstract: As a third-year medical student on an internal medical clerkship, I learned the most important lesson about how to care for patients. I saw my attending physician give attention first to the person he was treating, and then to the patient and her clinical picture. They are not the same, and our training in medical school does not always teach us this distinction. Months later I found myself with an opportunity to truly help another individual who had been clinically and emotionally overcome by his disease. My attending physician’s lesson guided me in a very meaningful way: it allowed me to remind a man that he was more than the disease he was fighting. Many times, it may be something very little that we need to do or say but to our patients, these little things end up being the biggest of them all
Suppl 1: M5: Promoting Access Through Integrated Mental Health Care Education
Karan Kverno
- , 2016, DOI: 10.2174/187443460160101073
Abstract: Mental disorders are the leading cause of non-communicable disability worldwide. Insufficient numbers of psychiatrically trained providers and geographic inequities impair access. To close this treatment gap, the World Health Organization (WHO) has called for the integration of mental health services with primary care. A new innovative online program is presented that increases access to mental health education for primary care nurse practitioners in designated mental health professional shortage areas. To create successful and sustainable change, an overlapping three-phase strategy is being implemented. Phase I is recruiting and educating primary care nurse practitioners to become competent and certified psychiatric mental health nurse practitioners. Phase II is developing partnerships with state and local agencies to identify and support the psychiatric mental health nurse practitioner education and clinical training. Phase III is sustaining integrated mental health care services through the development of nurse leaders who will participate in interdisciplinary coalitions and educate future students
Rugovska povelja — dokument samoupravnog suzbijanja krvne osvete u kosovskom selu
Karan, Milenko
- , 1974,
Abstract: Hr？ak ID: 11894
THE RUGOVSKA CHARTER — EXAMPLE OF SELF-MANAGEMENT CONTROL OF VENDETTA IN A KOSOVO VILLAGE
Karan, Milenko
- , 1974,
Abstract: Sa？etak This work reviews the wide use and nature of vendetta in Kosovo The author gives particular attention to possibilities for controlling the blood-feud in modern day. According to tradition, the quarrelling parties were reconciliated by the so-called ple？nija (Council of wise Men), whereas in more recent times the state government undertook this task. This articles however discusses the character of the peace councils which, within the frame of the Socialist Federation, work to prevent blood-feuds. As example of a document which helps prevent blood-feuds in a controlled manner is the Rugovska Charter. All inhabitants of the mentioned area in Kosovo have accepted the charter, promising they will not take revenge among themselves in the future. The results achieved from this charter have surpassed all optimistic expectations. After its adoption, not one murder as a result of vendetta took place in this area. The peace council, using this charter as its basis, gained recognition in controlling vendetta. The author emphasizes the advantage of using such prevention methods, which are based on traditional law, yet adopted to the modern selFmanagcment system principles
Socijalnopsiholo？ke pretpostavke prisustva krvne osvete u na？im danima
Karan, Milenko
- , 1973,
Abstract: Hr？ak ID: 15647
Socio-Psychological Assumptions of the Vendeta of the Kosovo
Karan, Milenko
- , 1973,
Abstract: Sa？etak Some basic socio-psychological determinants of the phenomenon of the blood-feud in present days are discussed, with the special empasision Kosovo, where its incidence and consequences are most pronounced. Up to now the blood feud phenomenon has been mainly analyzed from the historical and legal point of view, and rarely from the sociological or psychological one. After discussing some definitions of criminal behavior, the paper argues in favour of socialpsychological approach which seems to be most promising for an adequate appraisal of the phenomenon. Theoretically, it is based on relevant assumptions of Freud,s and Marx's work which account most adequately for the personality and social framework fostering the occurrence of the blood-feud. The review of the recent literature points to such socio-psychological factors as low developmental level of the region, low employment ratio — especially among women, limited educational and cultural opportunities and predominantly rural characteristics of the population. A prominent feature of this complex is the social uncertainty, especially in villages, which is manifested as the anxiety concerning future. These factors are favoring primary group solidarity (the blood-feud being one of its expression) and the revival of the ways of behavior potterned after common low principles. A certain discrepancy between the ideal and actual behavior is the most pronounced feature in modern Kosovo: blood-feud being the ？retained？ mode of behavior, not in accordance with the general social trends, but reflecting partially still existing low level of living conditions. The hypotheses proposed here point to a need of an intensive research project that would take into account all the factors: historical, ethnological, legal, sociological, psychological and psychiatric, and at the same time direct the necessary course of action in preventing the occurrence of blood-feud in Kosovo
Wind and thermodynamic profiler observations of a late-mature gust front
Haldun Karan
- , 2014,
Abstract:
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