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Epstein-barr virus shedding and cytokine alterations in the oropharynxduring HIV-1 infectionPerera, Ranawaka Arachchige Prasad Mahendra. January 2010 (has links)
published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy
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Effects of abacavir on cardiovascular systemLi, Wai-sum, Rachel., 李蕙琛. January 2010 (has links)
published_or_final_version / Pharmacology and Pharmacy / Doctoral / Doctor of Philosophy
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The prevalence of human immundeficiency seroposivity in patients presenting with first episode psychosis.Mashaphu, Sibongile. January 2007 (has links)
Background Patients infected with the human immunodeficiency virus (HIV), the causative agent of the acquired immunodeficiency syndrome (AIDS), have high rates of psychiatric morbidity. The effects of HIV on the Central Nervous System may lead to psychiatric morbidity even before the appearance of the full-blown AIDS syndrome. Sero-prevalence studies of patients with psychoses have found an estimated 5-20% to be HIV positive. However, sero-prevalence estimates vary from study to study due to the differences in sampling by geographic location, socio-economic class, race and ethnicity, and psychiatric-diagnostic composition. The Republic of South Africa has some of the highest prevalence rates in the world and research in this field is escalating rapidly. However research on HIV in patients with mental illness, particularly psychosis is very sparse. Aim of the study To determine the prevalence of HIV sero-positivity amongst patients admitted to Town Hill hospital presenting with first episode psychosis. Method All patients presenting to Town Hill hospital with first episode of psychotic symptoms were recruited to participate in the study. The treating doctor in collaboration with the multi-disciplinary team made the diagnosis of Psychosis. A total number of 63 patients participated in the study. Results. 23.8% of the patients tested positive for the human immunodeficiency virus. Conclusions. The prevalence of HIV sero-positivity is high amongst patients presenting with first episode psychosis. The HIV epidemic could have an important effect on the aetiology and clinical presentation of psychosis. Recommendations State mental health authorities should pursue the promotion of voluntary HIV testing programs, in patients presenting with first episode psychosis as soon as they are capable of giving informed consent. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2007.
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Knowledge, attitude and perception of 4th and 5th year UKZN medical school students towards the use of HIV drug resistance interpretation algorithms.Zhandire, Tracy. January 2013 (has links)
HIV drug resistance (HIVDR) has emerged as a major clinical and public health challenge in many resource poor countries especially in Africa. HIVDR testing has become increasingly important and is of significant value in the management of HIV. The use of low cost technologies and procedures in testing HIVDR is being recommended. HIVDR computer interpretation algorithms make use of artificial intelligence and other computer technologies to predict HIVDR, and are recommended for use in resource poor countries. However, there is little known about the knowledge, attitude and perception of HIVDR computer algorithms by doctors in developing countries who are supposed to use computer algorithms.
This study aimed to determine the knowledge, attitude and perception regarding computer interpretation algorithms of the 4th and 5th year medical students at Nelson R. Mandela School of Medicine, University of KwaZulu Natal in South Africa. Primary data collection was done using a questionnaire administered to a convenience sample of 216 4th and 5th year medical students. The study revealed that 90% of the respondents were aware of HIV drug resistance testing in South Africa but only 4% had knowledge of the computer interpretation algorithms. The study revealed that although the UKZN medical students are not aware of computer interpretation algorithms, majority are willing to use them in the future. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.
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A study at the Brooklyn Chest Hospital to assess the change in the oral carriage of Candida species in patients co-infected with HIV and TB, before and after antifungal therapyFisher, Julian Marcus 03 1900 (has links)
Thesis (MSc)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: The aim of this study at the Brooklyn Chest Hospital (BCH) was to assess the
change in the oral carriage of Candida species in twenty-nine patients co-infected
with the Human Immunodeficiency Virus (HIV) and Tuberculosis (TB), before and
after anti-fungal treatment.
Each patient accepted onto the study underwent a comprehensive oral and peri-oral
examination where the presence, site and clinical features of all oral and peri-oral
lesions were recorded. The purpose of the examination was to provide a clinical
diagnosis of oral candidasis.
Each patient was also asked to provide a sample of oral fluid for laboratory analysis.
This was collected using an oral rinse. The results of a variety of laboratory
investigations were used to identify the species of Candida obtained from the oral
rinse. Both the oral and peri-oral examination and the oral rinse procedure were
repeated after one month and at three months.
A sample from each oral rinse was inoculated on CHROMagar Candida chromogenic
medium (CHROMagar Candida, France, Paris).
CHROMagar is used for the isolation and presumptive identification of Candida sp.
from other yeasts on the basis of strongly contrasted colony colours, which are
produced by the reactions of species-specific enzymes with a proprietary
chromogenic substrate.
After forty-eight hours the CHROMagar plate was examined for growth, when a
record of colony morphology and colour was made. A single sample from each
different colour-coded colony was taken and streaked onto a Sabouraud plate
(Oxoid, Basingstake, England) and then incubated for forty eight hours at thirty-seven
degrees centigrade.
A variety of laboratory investigations were subsequently carried out on a single
colony taken from the Sabouraud agar plate (Oxoid). The results of these tests were
used to identify the individual species of Candida isolated from each oral rinse.
Oral candidasis was the most prevalent oral lesion observed on admission and at
three months.
Six different species of Candida were identified during this study, namely Candida
albicans, Candida dubliniensis, Candida krusei, Candida glabrata, Candida
parapsilosis, and Candida tropicalis. C.albicans was the most commonly identified
species in study population. Candida dubliniensis was isolated and identified for the
first time in a South African HIV population.
Each specimen of Candida sp. identified by laboratory analysis was tested for
sensitivity to Nystatin, Amphotericin B and Fluconazole anti-fungal agents. An
additional sensitivity test was performed using Ajoene and Allicin (extracts of garlic)
to assess the comparative antifungal properties of these compounds. / AFRIKAANSE OPSOMMING: Die doelwit van hierdie studie by die Brooklyn Borshospitaal (BCH) was om die
verandering in orale draerstatus van die Kandida spesies in nege-en-twintig HIVfTB
koïnfekteerde pasiënte vas te stel, voor- en na antifungale behandeling.
Elke pasiënt in die studie het 'n volledige intra- en ekstra-orale ondersoek
ondergaan. Die teenwoordigheid, area en kliniese voorkoms van alle letsels is
noteer.
Die doel van die ondersoek was om 'n kliniese diagnose van orale kandidiase te
verkry.
'n Monster orale vloeistof is geneem van elke pasiënt vir laboratorium analise. Die
monster is in die vorm van 'n mondspoel geneem. Verskeie toetse is gedoen om die
verskillende Kandida spesies in elke monster te identifiseer.
Die orale- en ekstra-orale ondersoek sowel as die mondspoelmonster is na 1 en 3
maande herhaal. Elke mondspoelmonster is op CHROMagar Kandida chromogene
medium (CHROMagar Candida, France) inokuleer.
CHROMagar word gebruik vir die vermoedelike identifikasie en isolasie van Kandida
spesies teenoor ander swamme. Dit word gedoen op die basis van kontrasterende
koloniekleure, wat teweeggebring word deur spesie-spesifieke ensiemreaksies op 'n
chromogene substraat.
Die CHROMagar plate is na 48 uur ondersoek vir groei en die kolonie-morfologie en -
kleur is noteer.
'n Enkel monster. is geneem van elke verskillende kolonie (geskei op kleur) en is
uitgestreep op 'n Saboraud plaat (Oxoid, Basingstoke, England). Dit is dan vir 48 uur
inkubeer teen 37°C.
Verskeie laboratorium ondersoeke is daarna uitgevoer op 'n enkel kolonie geneem
vanaf die Saboraud agar plaat (oxoid). Die resultate van die ondersoeke is gebruik
om individuele spesies van Kandida te identifiseer.
Orale Kandidiase was die mees algemene orale letsel geïdentifiseer by toelating en 3
maande ondersoeke. Ses verskillende spesies Kandida is identifiseer tydens die
studie, naamlik: Kandida albicans, K.dubliniensis, K.Krusei, K.glabrata,
K.parapsilosis en K.tropicalis. K.albicans was die mees algemeen identifiseerde
spesie in die studiepopulasie.
K.dubliniensis is vir die eerste keer in Suid-Afrika in 'n HIV<+lpopulasie isoleer en
geïdentifiseer. Elke monster van identifiseerde Kandida spesies is getoets vir
sensitiwiteit teenoor Nistatien, Amfotensien B en Flukonasool. Addisioneel is ook
getoets vir sensitiwiteit teenoor Ajoene en Allicin (knoffelekstrakte).
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A systematic review of the management of oral candidiasis associated with HIV/AIDSAlbougy, Hany Ahed 03 1900 (has links)
On t.p.: Degree MSc Dental Science (Community Dentistry) / Thesis (MSc)--Stellenbosch University, 2002. / ENGLISH ABSTRACT:
The purpose of this review was to investigate the management of oral candidiasis in
HIV/AIDS patients and to evaluate the different guidelines that are available for its
management. To achieve this aim, three objectives were identified: (i) to identify and
report on the different interventions used to manage oral candidiasis, in patients with
HIV/AIDS, (ii) to determine the efficacy of these interventions, and (iii) to provide
guidelines for management. A thorough systematic search of the literature was carried
out and all relevant papers were graded into three levels of evidence (A, B, and C) and
scored for quality according to set criteria.
A number of topical and systemic antifungal medications are used to treat oral
candidiasis in HIV-positive patients. These include the poleyne antibiotics, nystatin and
amphotericin B. Milder episodes of oral candidiasis respond to topical therapy with
nystatin, clotrimazole troches or oral ketoconazole. Fluconazole has been extensively
evaluated as a treatment for candidiasis. With HIV-infection, a cure rate of 82% has
been achieved with a daily oral dose of 50 mg. Fluconazole was found to be a better
choice of treatment for relapsing oropharyngeal candidiasis, resulting in either better
cure rates or better prevention of relapse. Intravenous amphotericin B has been found to
be effective therapy in azole refractory candidiasis where it was shown to be safe and
well tolerated.
Topical therapies were found to be effective treatment for uncomplicated oropharyngeal
candidiasis, however patients relapsed more quickly than those treated with oral
systemic antifungal therapy. Overall, nystatin appears less effective than clotrimazole
and the azoles in the treatment of oropharyngeal candidiasis. With regard to the resolution of clinical symptoms, clotrimazole was found to be just as effective as
the azoles, except when patient compliance was poor. Fluconazole-treated patients were
more likely to remain disease-free during the fluconazole follow-up period than with
those treated with other interventions.
Relatively few studies were qualified to address the provision of guidelines for the
management of oral candidiasis in primary health care settings. Most of the studies
found were of moderate and low quality level of evidence. These studies included the
assessment of different guidelines for identification, treatment and dental needs. They
stressed that patients with HN need dentists who will act as primary health care
providers, together with other providers to ensure adequate overall care.
Given the level of interest and importance of candidiasis associated with treatment of
HN -positive patients, it is surprising to find that little high quality research has been
undertaken. As such, it is hoped that this review would provide researchers, oral health
care workers and other health care providers with an overview of the management of
oral candidiasis associated with HN/AIDS. / AFRIKAANSE OPSOMMING:
Die doelstelling van die oorsig was om ondersoek in te stel na die hantering van orale kandidiase in
HIV/AIDS pasiënte asook om die verskillende beskikbare riglyne vir die behandeling daarvan te
evalueer. Ter verwesenliking van hierdie doelstelling is drie doelwitte geïdentifiseer: (i) om die
intervensies wat gebruik word in die hantering van orale kandidiase behandeling te identifiseer, (ii)
om die effektiwiteit van hierdie intervensies te identifiseer en (iii) om op grond hiervan riglyne vir
die hantering voor te stel. 'n Sistematiese literatuursoektog is uitgevoer en alle relevante artikels is
in drie groepe geklassifiseer (A, B en C) op grond van die data kwaliteit.
'n Verskeidenheid topikale en sistemiese antifungale middels word gebruik om orale kandidiase in
HIV-positiewe pasiënte te behandel. 'n Sukseskoers van 82% is met die gebruik van 'n daaglikse
dosis van 50 mg medikament gerapporteer. Fluconazole was die beter keuse van middel vir die
behandeling van terugkerende orofaringeale kandidiase.
Topikale behandeling was effektief in die behandeling van ongekompliseerde orofaringeale
kandidiase, hoewel die kans op terugkeer van die toestand groter was as met die sistemiese middels.
Pasiënte wat met flukonasool behandel is, het 'n groter kans gehad om siektevry te bly vergeleke
met pasiënte op die ander intervensies.
Meeste van die studies was van middelmatige tot lae kwaliteit en gevolglik was dit moeilik om
behandelingsriglyne te stel. Wat egter wel duidelik is, is dat HIV pasiënte primêre mondsorg
benodig wat saam met ander versorging omvattende sorg sal verseker.
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