Thesis (M.D.S.)--University of Hong Kong, 2004. / Also available in print.

Dissertation (Ph.D.)--University of Toledo, 2010. / Typescript. "Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Doctor of Philosophy Degree in Engineering." "A dissertation entitled"--at head of title. Title from title page of PDF document. Bibliography: p. 191-212.

Thesis (M.S.)--University of Michigan, 1982.

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 42-49).

The search for cheap, non toxic and readily available antidiabetic drugs has been a challenge for researchers and the pharmaceutical industries. Diabetes mellitus is a metabolic disease characterized by defects in the synthesis of insulin and/or insensitivity to the action of insulin at the target cells. The disease has been on the increase mostly in developing countries where large proportions of the population have little access to good medical care due to either accessibility or non availability of synthetic drugs. This has led to the use of medicinal plants to treat diabetes because it is safe, cheap and with few side effects. There is little scientific evidence on the dosages, active compounds, mechanisms of action and toxicity of these traditionally used plants. Two of the most frequently used plants; Albuca setosa and Albuca bracteata were investigated in this study. The qualitative analysis of different extractions of these plants revealed the presence of phenolics, alkaloids, tannins and saponins. The antioxidant properties of aqueous, acetone and methanollic extracts of Albuca setosa and Albuca bracteata were investigated using models such as Diphenyl-1-Picrylhydrazyl (DPPH), 2, 2’-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS), Ferric ion reducing antioxidant potential (FRAP), Nitric Oxide and Hydrogen Peroxide (H2O2). Both plants revealed inhibitions against DPPH in a concentration - dependent manner with Albuca setosa (0.330 mg/ml) showing higher activity than Albuca bracteata (0.647 mg/ml) determined from the IC50. The aqueous extract of Albuca setosa showed a higher inhibition against DPPH radical compared to the Albuca bracteata aqueous extract at all concentrations investigated. The isolated saponins from Albuca bracteata had a higher DPPH scavenging activity than the crude methanolic extract of the plant in a concentration - dependent manner but are significantly different from each other at 0.4, 0.6 and 1.0 mg/ml only. The IC50 of the saponins was also observed to be higher than the crude extracts and standards.The Albuca setosa aqueous extract showed a higher percentage inhibition of ABTS radicals than Albuca bracteata at all the concentrations investigated. Overall, the Albuca setosa aqueous extract (0.0809 mg/ml) showed maximum activity against ABTS radicals. The iron reducing power was significantly higher (P < 0.05) in the methanolic extract of both plants compared to the aqueous counterpart. Overall, the Albuca bracteata aqueous extract (0.344 mg/ml) showed maximum activity as indicated by the IC50. The aqueous extracts of both plants also revealed percentage inhibitions in a concentration - dependent manner against NO2. The aqueous extract of Albuca bracteata bulb was more active against nitric oxide and hydrogen peroxide inhibition. In this study, the cytotoxicity of the extracts was evaluated at a high dose of 100 μg/ml on Chang liver cells and determined using MTT, crystal violet, glucose consumption, lactate production and lactate dehydrogenase release and FRAP. The aqueous extracts of both Albuca setosa and Albuca bracteata were non-toxic on Chang liver cells at the concentrations investigated. The MTT revealed that the aqueous extract of Albuca setosa bulb had the optimum cell viability of 108.09 percent while the acetonic extract of Albuca bracteata showed the least cell viability (37.72 percent) compared with the control. The crystal violet test also revealed the acetone extract of Albuca bracteata to have the least percentage of cell viability at 31.47 percent, while the aqueous extract of Albuca setosa showed the maximum cell viability at 112.5 percent. The aqueous extracts of both plants showed higher percentage cell density on the second day of incubation from the proliferation assay. All the tested samples were observed to consume more glucose than the blank except for the methanollic and acetone extracts of Albuca bracteata bulb. The aqueous and methanolic extracts of Albuca setosa bulbs produced the highest lactate with 120.2 μg/ml and 113.7 μg/ml respectively. The acetone extracts of both Albuca setosa and Albuca bracteata revealed toxicity with a higher lactate dehydrogenase release compared to the control.

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Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2016-08-04T19:05:43Z No. of bitstreams: 2 Dissertação - Émelin Alves dos Santos - 2016.pdf: 1617820 bytes, checksum: 16ea9a34990cb6d247fd464223a95256 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-08-05T12:41:27Z (GMT) No. of bitstreams: 2 Dissertação - Émelin Alves dos Santos - 2016.pdf: 1617820 bytes, checksum: 16ea9a34990cb6d247fd464223a95256 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-08-05T12:41:27Z (GMT). No. of bitstreams: 2 Dissertação - Émelin Alves dos Santos - 2016.pdf: 1617820 bytes, checksum: 16ea9a34990cb6d247fd464223a95256 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-04-04 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / Strongyloidiasis is mainly predominant in regions of tropical and subtropical climates may present asymptomatic limited to the gastrointestinal tract. However, immunosuppression can cause hyperinfection and dissemination of larvae. Diabetes Mellitus (DM) causes immune dysregulation, became the individual more susceptible to secondary infections as strongyloidiasis. The chronicity of the disease in this group patients difficult the diagnosis, this fact conduct to research new methodologies such as circulating immune complex detections. Currently, there are few reports in literature on the evaluation immunological profile of strongyloidiasis in patients with DM and epidemiological research this disease important for monitoring the number of cases. In this context, this study had as objective determine serum levels of specific IgG antibodies and circulating immune complex in serum samples of infected patients and control individuals negative by ELISA. The survey was conducted with patients attended at the diabetes ambulatory in Jataí - GO and nondiabetic individuals residing in the city. The authorization for collect blood samples was obtained by signature Term of Informed Consent (TIC) it is characterized individuals in two groups: Group I patients with DM1 and 2, Group II individuals negative control for S. stercoralis and DM. Serum samples were tested by ELISA for detection of IgG and circulating immune complexes. We analyzed 50 serum samples from Group I and 50 in Group II, 30% were male and 70% female, for both groups. A total of 19 (38%) serum sample were positive for IgG in Group I and 2 (4%) for Group II, the majority were female age between 57 and 69 years. For detection circulating immune complexes only one sample was positive in Group I (2%) and Group II (0%). The seroprevalence of IgG anti-Strongyloides detection in diabetic patients was high when compared to the control group, detection of circulating immune complexes in Group I was low. In this context, we emphasize the importance the realization of immune complex research by ELISA as complementary tool in diagnosis of active infection S. stercoralis. / A estrongiloidíase é predominante principalmente em regiões de climas tropicais e subtropicais, podendo apresentar-se assintomática quando limitada ao trato gastrointestinal. No entanto, a imunodepressão pode levar a quadros de hiperinfecção e disseminação das larvas. O Diabetes Mellitus (DM) provoca disfunção do sistema imune, tornando o indivíduo mais susceptível a infecções secundárias, como a estrongiloidíase. A cronicidade da doença neste grupo de pacientes dificulta o seu diagnóstico, fato este que tem levado a pesquisa de novas metodologias, como a detecção de imuncomplexos circulantes. Atualmente, existem poucos relatos na literatura sobre a avaliação do perfil imunológico da estrongiloidíase em pacientes com DM, sendo a investigação epidemiológica desta doença importante para o acompanhamento do número de casos. Neste contexto, o presente estudo tem como objetivo determinar os níveis séricos de anticorpos IgG específicos e imunocomplexos circulantes em amostras de soros de pacientes infectados e de indivíduos controle negativo, por ELISA. A pesquisa foi realizada com pacientes atendidos no ambulatório de diabetes da prefeitura de Jataí - GO e indivíduos não diabéticos residentes no município. A autorização para coleta das amostras de sangue foi obtida pela assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), sendo os indivíduos caracterizados em dois grupos: Grupo I pacientes portadores de DM1 e 2, Grupo II indivíduos controle negativo para S. stercoralis e DM. As amostras de soro foram testadas pela técnica imunoenzimática ELISA para detecção de IgG e imunocomplexos circulantes. Foram analisadas 50 amostras de soro do Grupo I e 50 do Grupo II, sendo que 30% eram do sexo masculino e 70% do sexo feminino, para ambos os grupos. Um total de 19 (38%) amostras de soro foram reagentes para IgG no Grupo I e 2 (4%) para o Grupo II, sendo a maioria do sexo feminino com faixa etária entre 57 e 69 anos. Para detecção de imunocomplexos circulantes, apenas uma amostra foi reagente no Grupo I (2%) e nenhuma no Grupo II (0%). A soroprevalência para detecção de IgG anti-Strongyloides em pacientes diabéticos foi elevada quando comparado ao grupo controle, enquanto que a detecção de imunocomplexos circulantes no Grupo I foi baixa. Neste contexto, ressalta-se a importância da realização da pesquisa de imunocomplexos por ELISA como ferramenta complementar para o diagnóstico da infecção ativa por S. stercoralis.

The purpose of this study was to compare the perception of the nurse and the perception of the patient in identifying priorities for his learning needs with respect to the hospital environment and to his medical condition. A Q-sort of statements related to these two learning needs was developed and used to test the nurses' perception and the patients' perception of these learning needs. The diabetic patient was selected for study because his learning needs with respect to his condition are well documented, and the general staff nurse was selected because she is responsible for direct patient care. To test the hypotheses, the Q-sort was administered to 50 newly hospitalized diabetic patients, to 50 general staff nurses directly responsible for the care of these patients, and to 50 general staff nurses having no contact with a patient or no direct responsibility for his care. The study was conducted in a large hospital in Vancouver, British Columbia. The hypotheses assumed that the two groups of nurses and the patients would assign different priorities to the patients' learning needs. The .05 level of significance was used in this study. An analysis of selected personal characteristics of the patients provided a description of the patient population. The findings showed that all but one patient had been in hospital before, and that only three patients were newly diagnosed diabetics. An analysis of selected personal characteristics of the nurses indicated that there was no significant difference between the two groups. Thus, any differences in perception could not be attributed to these characteristics. The Q-sort scores of all three groups were examined for differences in perception and the selected personal characteristics were tested with respect to these scores. The results indicated that both groups of nurses and the patients assigned a greater degree of importance to the patient's learning needs related to his diabetic condition than those related to the hospital environment. Although the nurses attached a greater degree of importance to the former needs than did the patients, the difference was not significant. The results also indicated that a majority of nurses and patients, matched as pairs, perceived the patient's learning needs related to the diabetic condition as more important, and yet there was a significant difference in perception. Other results showed a high degree of correlation between both groups of nurses and the patients and the nurses responsible for their care, with respect to priorities assigned to statements within each of the two categories of learning needs. Although the selected personal characteristics of each group were tested with respect to their more important Q-sort scores, only a limited number of relationships were significant for the patients and the nurses directly responsible for their care and none for the other group of nurses. These significant relationships were age, marital status, duration of illness, and education of the patients, and additional education and experience of the nurses. The results of the study have demonstrated the value of the Q-sort technique as a procedure for acquiring data with respect to the learning needs of the patient. The analysis of the data of the nurses and the patients under their care provided a measurement of the quality of patient care. In addition, the analysis of the data of the patients provided a guide for the establishment of a desirable learning sequence for the individual patient. / Education, Faculty of / Graduate

MMed, Internal Medicine, Faculty of Health Sciences,University of the Witwatersrand / Aims: To determine whether impairment of the executive functioning domain of cognition could be detected by a battery of simple bedside cognitive tests of executive function associated with inadequate glycaemic control. Methods: People with type 2 diabetes attending a tertiary referral diabetic clinic who consented to participate in the study underwent a brief battery of cognitive testing (the Bedside Executive Screening Test) designed to detect executive function impairment. Glycaemic control was determined using glycated haemoglobin levels (HbA1c). Inadequate glycaemic control was defined as HbA1c ≥ 7.0%. Results: Executive function impairment was detected in 51 (52%) of the 98 study participants. The presence of executive function impairment was significantly associated with poor glycaemic control (HbA1c ≥ 7.0%) (odds ratio 4.9, 95% confidence interval 1.3 – 18.8, p=0.019). There were no significant differences between patients with and without executive function impairment with regard to age, target organ damage, patient reported adherence, and hypoglycaemic therapy. Patients with a lower level of education were more likely to demonstrate executive impairment when glycaemic control was poor (p=0.013). Conclusion: Executive function impairment is common in a population of people with difficult-to-manage type 2 diabetes. The presence of executive impairment is significantly associated with poor glycaemic control.

Thesis ((M. A. (Pharm.)) -- University of Limpopo, 2019 / Introduction: Polypharmacy is highly prevalent within the population of patients with diabetes mellitus (DM), with patients being prescribed with four or more medications with mainly preventative medications for cardiovascular complications. The increase in the prevalence of polypharmacy has a major impact on the drug expenditures. Meanwhile, the management of DM is expensive, and the cost affects individuals, families, society, health care providers, and national productivity. The largest component of financial cost is accounted for by medicines. Furthermore, with DM being the second cause of mortality rates in South Africa there is a need for cost of illness studies in order to develop intervention programs to ameliorate or prevent this lifestyle disease Objectives: To identify the medications the patient was taking that were considered as polypharmacy in the management of type 2 diabetes mellitus (T2DM), to calculate and analyse the costs of the medications and to quantify the financial burden of polypharmacy in T2DM patients. Method: This research was a quantitative study, providing the numeric description of the economic cost of polypharmacy. The financial burden of polypharmacy was retrospectively measured using descriptive statistics. The study was conducted using T2DM patient files (n=115) from the outpatient section of the pharmacy as well as from the records department whereby all DM patients’ files were retrieved by aid of a DM register from outpatient department (OPD). The data sheet enabled recording of information that was divided into three sections namely the demographic information, the diagnosis profile, as well as the medications. The cost of drugs was retrieved from the pharmacy purchase invoices for the years 2016 and 2017 as well as Department of Health medicines registry for the retail prices. Data was analysed using statistical Package for Social Sciences (SPSS) version 25 for descriptive analysis and Microsoft Excel TM was used for calculation and quantification of the financial burden. The independent t test was used in Microsoft ExcelTM for statistical significance of differences. Results: The distribution of the population by gender revealed that 68% of females were on polypharmacy as compared to 32% of males. The results also showed that majority of participants accounting 71% of the population were falling within the age xi group of 51-70 years, meanwhile the least number of participants accounting 1% of the population were between the age group of 30-40 years. The total cost of the treatment regimen for the two years of the study period was found to be R179303.50 in hospital (Mean=R35860.80, SD=R58945.15, n=115) and the possible cost of polypharmacy was found to be R1517379.00 in retail (Mean=R303475.76, SD=480115.84, n=115). The difference was statistically significant t (16) = 2.11, p=0.04 (1 tail) at 95% confidence interval. This means that the average cost per patient per year is R1558.18 and R129.93 per month in hospitals but R6597.30 per year and R549.78 per month in retail for the management of T2 DM patients who are on polypharmacy. These numbers are 4 times higher than patients who are on monotherapy. Conclusion: Polypharmacy imposes a high financial burden on the management of T2DM for the government and for patients in cases where medications like insulin which is the most costly component of five out of nine detected regimens are unavailable in hospitals and they therefore have to buy at retail pharmacies. The appreciation and understanding of these costs in real terms by health professionals and decision makers, can add value to processes of budget allocations to pharmaceutical services. Recommendations: Doctors and pharmacists should work together to optimize the quality of care for patients with T2DM but also consider the cost aspect when prescribing and dispensing treatment regimen for a patient. The patient’s prescriptions must be thoroughly reviewed and rationalised according to recent progress of the patient. Non-pharmacological management of T2DM is the mainstay of therapy and prevention so pharmacist and doctors needs to emphasize more on those rather than dispensing a lot of medications to patients that can manage to control their condition with no medications prescribed. Lastly, preventative programs for T2DM needs to be prioritized. / CHIETA and HWSETA