BackgroundThe effects of highly active antiretroviral therapy (HAART) on glucose and lipid metabolism among sub-Saharan Africans, for whom access to antiretroviral therapy is expanding, remain largely unknown. Therefore, the aim of this study was to assess antiretroviral treatment associated hyperglycemia and dyslipidemia among HIV infected patients at Burayu health center, Addis Ababa, Ethiopia.MethodsA cross-sectional comparative study was conducted among HIV infected adults at Burayu Health Center, Addis Ababa, Ethiopia from September, 2011 to May, 2012. Equal number of HAART naïve and HAART initiated patients (n = 126 each) were included in the study. Demographic data were collected using a well-structured questionnaire. Total cholesterol (TC), Triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and glucose were determined. The data were analyzed using SPSS version 20 software.ResultOf 252 study participants, 72.2% were females; mean age was 35.3 years; mean Body Mass Index (BMI) was 21.4(kg/m2); mean time living with the virus was 20.6 months and 15.5% were TB-HIV co-infected. The prevalence of hyperglycemia, increased LDL-C hypercholesterolemia, hypertriglyceridemia and decreased HDL-C were 7.9%, 23%, 42.1%, 46.8% and 50.8% in HAART and 5.6%, 7.1%, 11.1%, 31% and 73% in non-HAART groups, respectively. First line antiretrovirals were drugs containing 2 nucleoside backbones (from Zidovudine/Stavudine/Lamivudine/Tenofovir) with either Nevirapine or Efavirenz. There was statistically significant increase in serum lipid profile levels among HAART initiated patients than HAART naïve individuals (p =0.01 for TG and <0.001 for others).ConclusionFirst-line HAART is associated with potentially atherogenic lipid profile levels in patients with HIV infection compared to untreated patients. This indicates glucose and lipid profile levels need to be monitored regularly in HIV infected patients taking antiretroviral treatment.
Mitochondria are organelles with highly dynamic ultrastructure maintained by flexible fusion and fission rates governed by Guanosine Triphosphatases (GTPases) dependent proteins. Balanced control of mitochondrial quality control is crucial for maintaining cellular energy and metabolic homeostasis; however, dysfunction of the dynamics of fusion and fission causes loss of integrity and functions with the accumulation of damaged mitochondria and mitochondrial deoxyribose nucleic acid (mtDNA) that can halt energy production and induce oxidative stress. Mitochondrial derived reactive oxygen species (ROS) can mediate redox signaling or, in excess, causing activation of inflammatory proteins and further exacerbate mitochondrial deterioration and oxidative stress. ROS have a deleterious effect on many cellular components, including lipids, proteins, both nuclear and mtDNA and cell membrane lipids producing the net result of the accumulation of damage associated molecular pattern (DAMPs) capable of activating pathogen recognition receptors (PRRs) on the surface and in the cytoplasm of immune cells. Chronic inflammation due to oxidative damage is thought to trigger numerous chronic diseases including cardiac, liver and kidney disorders, neurodegenerative diseases (Parkinson's disease and Alzheimer's disease), cardiovascular diseases/atherosclerosis, obesity, insulin resistance, and type 2 diabetes mellitus.
Background and Objective Medical machine learning (ML) models tend to perform better on data from the same cohort than on new data, often due to overfitting, or co-variate shifts. For these reasons, external validation (EV) is a necessary practice in the evaluation of medical ML. However, there is still a gap in the literature on how to interpret EV results and hence assess the robustness of ML models. Methods We fill this gap by proposing a meta-validation method, to assess the soundness of EV procedures. In doing so, we complement the usual way to assess EV with an assessment in terms of the dataset cardinality, as well as with a novel method that considers the similarity of the EV dataset with respect to the training set. We then investigate how the notions of cardinality and similarity can be used to inform on the reliability of a validation procedure, by integrating them into two summative data visualizations. Results We illustrate our methodology by applying it to the validation of a state-of-the-art COVID-19 diagnostic model on 8 EV sets, collected across 3 different continents. The model performance was moderately impacted by data similarity (Pearson ρ = .38, p < .001). In the EV, the validated model reported good AUC (average: .84), acceptable calibration (average: .17) and utility (average: .50). The validation datasets were adequate in terms of dataset cardinality and similarity, thus suggesting the soundness of the results. We also provide
Background Understanding whether the preceding low lipid profile leads to active tuberculosis (TB) or active TB leads to low lipid profile is crucial. Methods Lipid profile concentrations were determined from 159 study participants composed of 93 active TB patients [44 HIV coinfected (HIV+TB+) and 49 HIV negative (HIV−TB+)], 41 tuberculin skin test (TST) positive cases [17 HIV coinfected (HIV+TST+) and 24 HIV negative (HIV−TST+)], and 25 healthy controls (HIV−TST−). Cobas Integra 400 Plus was used to determine lipid profiles concentration level. Results The concentrations of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in HIV−TB+ patients were significantly lower compared to HIV−TST+ and to HIV−TST− individuals. Similarly, the concentrations of the TC, LDL-C, and HDL-C in HIV+TB+ were significantly lower compared to HIV−TB+ patients. After the 6 months of anti-TB treatment (ATT), the concentration levels of TC, LDL-C, and HDL-C in HIV−TB+ patients were higher compared to the baseline concentration levels, while they were not significantly different compared to that of HIV−TST+ concentration. Conclusion The low concentration of lipid profiles in TB patients may be a consequence of the disease and significantly increased in TB patients after treatment.
BackgroundBetter macro and micro nutrient status and their adequate intake by the athletes have great role in balancing losses associated with strenuous exercise, then for better performance. The objective of this study was to determine iron, folate and vitamin B12 status of Ethiopian professional athletes.MethodsA cross sectional study was conducted using a point time convenient sample of 101 male and female Ethiopian professional athletes of different distance categories in the period of February to April 2014. Biochemical samples, detail health and exercise related interview, performance data, 24 h dietary diversity and weekly food frequency were collected.ResultsThe low, medium and high dietary diversity terciles were 36.1, 60.9 and 3.3 % respectively. The mean ± Sd of dietary diversity was 5.44 ± 1.8. Prevalence of iron overload (Serum ferritin >200 μg/L) was 11 %, whereas that of anemia (Hb < 12 g/dL), iron deficiency (ferritin < 12 μg/L) and moderate folate deficiency (<5.9 ng/mL) was 3, 2 and 20.8 % respectively. There was no iron deficiency anemia case in the study. In this study, the mean serum vitamin B12 concentration was 561 ± 231 pg/ml with a minimum and maximum value of 210 and 1736 pg/ml respectively, and there was no deficiency for this nutrient (>210 pg/ml). The iron status of male athletes was significantly different by running-distance categories. In contrast, such difference was absent for female athletes. Performance of the athletes was associated with their red blood cell count (RBC) at p = 0.03. The high performer athletes exhibited high mean value of micronutrient status and hematological variables than their counter parts. However, the RBC of the athletes was the only parameter whose association was statistically significant.ConclusionsThe observed gender difference in the association of running-distance category with iron and folate in this study needs further investigation. Given the 11 % iron overload in the present study; there is a need of awarance creation activities and diet intervention in the athletics federation, the athletes and the coaches in order not aggravate the present overload. Prescription of supplements such as iron-folate, multivitamins and minerals should not be based on broad spectrum rather it should be based on recent history of confirmed deficiency, clinical signs and/or laboratory testing to prevent trace element toxicity.
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