Publish in OALib Journal

ISSN: 2333-9721

APC: Only $99


Any time

2019 ( 151 )

2018 ( 274 )

2017 ( 292 )

2016 ( 458 )

Custom range...

Search Results: 1 - 10 of 223752 matches for " R. Atukunda "
All listed articles are free for downloading (OA Articles)
Page 1 /223752
Display every page Item
Missed Doses and Missed Appointments: Adherence to ART among Adult Patients in Uganda
C. Shumba,L. Atuhaire,R. Imakit,R. Atukunda,P. Memiah
ISRN AIDS , 2013, DOI: 10.1155/2013/270914
Abstract: Background. Missed doses and appointments are predictors of incomplete adherence among patients on ART. The AIDSRelief model emphasizes treatment preparation and continuous treatment support for ART patients including community followup. Methods. In August 2008, a survey was conducted among patients on antiretroviral therapy (ART) (interquartile range for duration of ART?=?29–46 months, median?=?33 months, , age >16 years), in 15 health facilities in Uganda. Missed doses and appointments among adult patients on ART and the factors most associated with these were identified. Reasons for missed doses were also explored. Results. The survey revealed that 97% of the patients had not missed their doses in the last week while 93% had not missed their appointments in the last three months. For those who had missed their doses, the most common reasons were travel (48%) and forgetfulness (28%). There was a significant association between missing doses and missing appointments ( ) and between alcohol use and missed doses ( ). Conclusions. The level of adherence to medication and clinic appointments for patients on ART in the study population was very high. It is important to strengthen adherence strategies at both facility and community levels to assist patients that are likely to miss their doses or appointments. 1. Background Uganda has more than 1.2 million people living with HIV infection and in 2010 more than 120,000 got infected with HIV [1]. Although there are various efforts to scale up AIDS treatment, many HIV-infected people are unable to access treatment and the increasing new HIV infections still exceed the government’s capacity to provide treatment [2]. While attempts are being made to reduce new infections and to scale up antiretroviral therapy (ART), it is equally important to improve adherence to regimens among the few who are already accessing ART for successful treatment [3]. ART delays progression to AIDS and death, hence, improved the quality of life for people living with HIV [4, 5]. Maintaining good adherence has been found to be difficult to achieve and sustained by both patients and health care providers [6, 7]. A major concern with the use of ART is the emergence of viral resistance, which is mainly due to insufficient compliance [8]. Different tools have been used to determine ART adherence rates and on average the rate of adherence to ART is about 70% [9]. A meta-analysis found adherence rates for African patients to be approximately 77% [10]. A study by Oyugi et al., that assessed correspondence between multiple measures of adherence
Sublingual Misoprostol versus Intramuscular Oxytocin for Prevention of Postpartum Hemorrhage in Uganda: A Double-Blind Randomized Non-Inferiority Trial
Esther C. Atukunda ,Mark J. Siedner,Celestino Obua,Godfrey R. Mugyenyi,Marc Twagirumukiza,Amon G. Agaba
PLOS Medicine , 2014, DOI: 10.1371/journal.pmed.1001752
Abstract: Background Postpartum hemorrhage (PPH) is a leading cause of maternal death in sub-Saharan Africa. Although the World Health Organization recommends use of oxytocin for prevention of PPH, misoprostol use is increasingly common owing to advantages in shelf life and potential for sublingual administration. There is a lack of data about the comparative efficacy of oxytocin and sublingual misoprostol, particularly at the recommended dose of 600 μg, for prevention of PPH during active management of labor. Methods and Findings We performed a double-blind, double-dummy randomized controlled non-inferiority trial between 23 September 2012 and 9 September 2013 at Mbarara Regional Referral Hospital in Uganda. We randomized 1,140 women to receive 600 μg of misoprostol sublingually or 10 IU of oxytocin intramuscularly, along with matching placebos for the treatment they did not receive. Our primary outcome of interest was PPH, defined as measured blood loss ≥500 ml within 24 h of delivery. Secondary outcomes included measured blood loss ≥1,000 ml; mean measured blood loss at 1, 2, and 24 h after delivery; death; requirement for blood transfusion; hemoglobin changes; and use of additional uterotonics. At 24 h postpartum, primary PPH occurred in 163 (28.6%) participants in the misoprostol group and 99 (17.4%) participants in the oxytocin group (relative risk [RR] 1.64, 95% CI 1.32 to 2.05, p<0.001; absolute risk difference 11.2%, 95% CI 6.44 to 16.1). Severe PPH occurred in 20 (3.6%) and 15 (2.7%) participants in the misoprostol and oxytocin groups, respectively (RR 1.33, 95% CI 0.69 to 2.58, p = 0.391; absolute risk difference 0.9%, 95% CI ?1.12 to 2.88). Mean measured blood loss was 341.5 ml (standard deviation [SD] 206.2) and 304.2 ml (SD 190.8, p = 0.002) at 2 h and 484.7 ml (SD 213.3) and 432.8 ml (SD 203.5, p<0.001) at 24 h in the misoprostol and oxytocin groups, respectively. There were no significant differences between the two groups in any other secondary outcomes. Women in the misoprostol group more commonly experienced shivering (RR 1.91, 95% CI 1.65 to 2.21, p<0.001) and fevers (RR 5.20, 95% CI 3.15 to 7.21, p = 0.005). This study was conducted at a regional referral hospital with capacity for emergency surgery and blood transfusion. High-risk women were excluded from participation. Conclusions Misoprostol 600 μg is inferior to oxytocin 10 IU for prevention of primary PPH in active management of labor. These data support use of oxytocin in settings where it is available. While not powered to do so, the study found no significant differences in rate of
Behavioral Characteristics of Adult Patients on Highly Active Antiretroviral Therapy (HAART) in Uganda
Constance Shumba,Ruth Atukunda,Richard Imakit,Peter Memiah
Global Journal of Medicine and Public Health , 2012,
Abstract: Background: Behavioral factors have an impact on patient adherence and treatment outcomes. Specific information on behavioral factors is however minimal at health facilities in resource settings. Such information is vital in helping health facilities to provide targeted interventions. Method: Adherence surveys (n=783) were carried out to assess self-reported condom use, alcohol intake in the past month and disclosure in patients 19 years and above on HAART in 19 HIV clinics. Health workers were trained on how to administer the survey questions. The questions aimed at determining risky behaviors and disclosure of HIV illness. Results: More than half of the patients (59%) do not use condoms in the 19 HIV clinics. 30% reported using condoms always. Most of the patients (79%) on HAART had not taken alcohol in the past one month suggesting that most patients on HAART did not use alcohol. The majority of the patients (99%) disclosed their status with implications for better adherence and increased psychosocial support. Conclusion: It may be important to relate condom use, alcohol intake and disclosure to viral suppression and also advocate for comprehensive positive prevention at the HIV clinics. There is need to carry out an in-depth analysis of alcohol intake among HAART patients. Steps should be taken to address these behavioral issues in support groups and community programs
Power Aware Routing Protocol (PARP) for Wireless Sensor Networks  [PDF]
R. Prema, R. Rangarajan
Wireless Sensor Network (WSN) , 2012, DOI: 10.4236/wsn.2012.45019
Abstract: Several wireless sensor network applications ought to decide the intrinsic variance between energy efficient communication and the requirement to attain preferred quality of service (QoS) such as packet delivery ratio, delay and to reduce the power consumption of wireless sensor nodes. In order to address this challenge, we propose the Power Aware Routing Protocol (PARP), which attains application-specified communication delays at low energy cost by dynamically adapting transmission power and routing decisions. Extensive simulation results prove that the proposed PARP attains better QoS and reduced power consumption.
An Innovative Low Cost EM Pollution Measurement System  [PDF]
R. Sittalatchoumy, R. Seetharaman
Circuits and Systems (CS) , 2016, DOI: 10.4236/cs.2016.78176
Abstract: Mobile phones and other electronic devices are emitting radiations that will provide harmful effects to the human health. In order to measure the radiation, an innovative low cost measurement system is proposed in this paper. The ideology is to simplify the circuit’s value by converting a voltage detecting circuit to a field detecting circuit by finding an optimum resistance on trial and error basis. The requirement for a trial and error technique is to not allow too high or too low resistance which can be either short or open, resulting provides more damage to the circuit.
Ant Lion Optimization Approach for Load Frequency Control of Multi-Area Interconnected Power Systems  [PDF]
R. Satheeshkumar, R. Shivakumar
Circuits and Systems (CS) , 2016, DOI: 10.4236/cs.2016.79206
Abstract: This work proposes a novel nature-inspired algorithm called Ant Lion Optimizer (ALO). The ALO algorithm mimics the search mechanism of antlions in nature. A time domain based objective function is established to tune the parameters of the PI controller based LFC, which is solved by the proposed ALO algorithm to reach the most convenient solutions. A three-area interconnected power system is investigated as a test system under various loading conditions to confirm the effectiveness of the suggested algorithm. Simulation results are given to show the enhanced performance of the developed ALO algorithm based controllers in comparison with Genetic Algorithm (GA), Particle Swarm Optimization (PSO), Bat Algorithm (BAT) and conventional PI controller. These results represent that the proposed BAT algorithm tuned PI controller offers better performance over other soft computing algorithms in conditions of settling times and several performance indices.
Obtaining Optimal Solution by Using Very Good Non-Basic Feasible Solution of the Transportation and Linear Programming Problem  [PDF]
R. R. K. Sharma
American Journal of Operations Research (AJOR) , 2017, DOI: 10.4236/ajor.2017.75021
Abstract: For the transportation problem, Sharma and Sharma [1] have given a very computationally efficient heuristic (runs in O(c*n2) time) to give very good dual solution to transportation problem. Sharma and Prasad [2] have given an efficient heuristic (complexity O(n3) procedure to give a very good primal solution (that is generally non-basic feasible solution) to transportation problem by using the very good dual solution given by Sharma and Sharma [2]. In this paper we use the solution given by Sharma and Prasad [2] to get a very good Basic Feasible Solution to transportation problem, so that network simplex (worst case complexity (O(n3*(log(n))) can be used to reach the optimal solution to transportation problem. In the second part of this paper, we give a simple heuristic procedure to get a very good BFS to linear programming problem from the solution given by Karmarkar [3] (that generally produces a very good non-basic feasible solution in polynomial time (O(n5.5)). We give a procedure to obtain a good BFS for LP by starting from the solution given by Karmarkar [3]. We note that this procedure (given here) is significantly different from the procedure given in [4].
Power Analysis of Sensor Node Using Simulation Tool  [PDF]
R. Sittalatchoumy, R. Kanthavel, R. Seetharaman
Circuits and Systems (CS) , 2016, DOI: 10.4236/cs.2016.713348
Abstract: Power consumption of sensor node is analyzed in this paper. In order to analyze the energy consumption, the node model is simulated using Proteus Software tool. The proposed sensor nodes power characteristics are measured by using different combinations of microprocessors and sensors. Using this, the energy consumption of the node is calculated. This is a cost-effective method and provides appropriate power model for specific applications.
Studies on Dissolution Behaviour of Nanoparticulate Curcumin Formulation  [PDF]
R. Ravichandran
Advances in Nanoparticles (ANP) , 2013, DOI: 10.4236/anp.2013.21010

Curcumin is the main biologically active phytochemical compound of turmeric that has been widely used by ancient cultures throughout Asia. However the dissolution rate limited absorption and pre-absorption degradation limits its use as a potential therapeutic. In this study an attempt has been made to overcome the above limitations by curcumin delivery through nanotechnology. Nanocurcumin solid dosage formulations were prepared and studied for its dissolution behaviour. Considerable improvement in the dissolution behavior was observed in the drug nanocrystal-loaded solid dosage forms. This is expected to enhance the bioavailability of poorly soluble medicinal herbs such as turmeric in the body.

Pharmacokinetic Study of Nanoparticulate Curcumin: Oral Formulation for Enhanced Bioavailability  [PDF]
R. Ravichandran
Journal of Biomaterials and Nanobiotechnology (JBNB) , 2013, DOI: 10.4236/jbnb.2013.43037

Curcumin, a bioactive component of turmeric, which is a commonly used spice and nutritional supplement, is isolated from the rhizomes of Curcuma longa Linn. (Zingiberaceae). In recent years, the potential pharmacological actions of Curcumin in inflammatory disorders, cardiovascular disease, cancer, Alzheimer’s disease and neurological disorders have been shown. However, the clinical application of Curcumin is severely limited by its main drawbacks such as instability, low solubility, poor bioavailability and rapid metabolism. Multifarious nanotechnology-based drug delivery systems for Curcumin including liposomes, polymeric nanoparticles, solid lipid nanoparticles, micelles, nanogels, nanoemulsions, complexes and dendrimer/dimer, have been attempted to enhance the oral bioavailability, biological activity or tissue-targeting ability of Curcumin. We attempted the nanosuspensions based delivery of curcumin. Nanonisation renders curcumin completely dispersible in aqueous media. To enhance the curcumin absorption by oral administration, nanoparticulate solid oral formulation of curcumin was prepared by us and the resulting capsule was then examined for its efficiency on bioavailability in Male Wistar rats at a dose of 100 mg curcumin/kg body weight and the pharmacokinetic parameters were compared to those of normal curcumin powder and a commercial curcumin capsule CUR-500. The bio-distribution of curcumin in organs of rat was also studied. Nanoparticulation significantly raised the curcumin concentration in selective organs in the body. The results obtained provide promising results for nanoparticulate Curcumin to improve its biological activities. Enhanced bioavailability of curcumin in the form of nanoparticle is likely to bring this promising natural product to the forefront of therapeutic agents for treatment of human disease. The available information also strongly suggests that nano-formulation of ingredients such as curcumin may be used as a novel nutrient delivery system too.

Page 1 /223752
Display every page Item

Copyright © 2008-2017 Open Access Library. All rights reserved.