Prevalence and risk factors of type II diabetes mellitus among people living with HIV in Texas.

This study aimed to determine the prevalence and risk factors associated with type II diabetes mellitus (T2DM) among people living with HIV (PLWH). Cross-sectional data of 989 PLWH in Texas obtained from the 2015-2017 Texas and Houston Medical Monitoring Project were examined. T2DM was identified by formal medical chart diagnosis, insulin/oral hypoglycemic prescriptions, or most recent fasting blood glucose ≥126 mg/dL. T2DM adjusted prevalence ratios and 95% confidence intervals (CIs) were estimated using multiple logistic regression. Participants were mostly male (72%), ≥40 years (68%), overweight (31%) or obese (28%) and virally suppressed (62%). T2DM prevalence was 15% with variations by age, body mass index, education and health insurance (p < 0.05 for all). Compared to PLWH ≥60 years, 18-39-year-olds had significantly lower likelihood of T2DM (p < 0.001). Overweight and obese PLWH were 2.11 (95% CI: 1.23-3.63) and 3.89 times (95% CI: 2.30-6.56) more likely to have T2DM compared to normal weight PLWH. Over 1 in 6 PLWH in Texas had T2DM, with age and BMI as significant predictors. Since DM is a risk factor for cardiovascular disease and PLWH are living longer, increased education and lifestyle modification interventions are warranted to prevent T2DM development among PLWH.

The influence of graded levels of Cyathula prostrata (Linn.) Blume on semen quality characteristics of adult New Zealand white bucks.

Cyathula prostrata (Linn.) Blume is a tropical herbal plant known for its important phytochemical contents and medicinal properties. But its impact on animal reproduction and fertility is yet to be fully established. Therefore, we tested the hypothesis that C. prostrata (Linn.) Blume will improve the semen quality characteristics of New Zealand White buck rabbit. Twenty-eight post-pubertal buck rabbits were used for the study. The animals were randomly assigned to four treatment groups (n = 7 per treatment) where they were fed either the control diet-0 g C. prostrata (Linn.) Blume or any of the three experimental diets containing the graded levels of C. prostrata (Linn.) Blume incorporated into rabbit pellets at 10, 20 or 30 g C. prostrata (Linn.) Blume per kg feed. The results showed that the semen volume and pH were not different between groups. Interestingly, sperm motility significantly decreased (P < 0.05) in a dose-dependent manner. Similarly, the sperm morphology also decreased in a dose-related fashion with 20 g (77.75 ± 1.31%) and 30 g (79.00 ± 2.20%) C. prostrata (Linn.) Blume being significantly (P < 0.05) lower compared with groups 0 g (88.50 ± 1.44%) and 10 g (87.50 ± 4.33%) C. prostrata (Linn.) Blume, respectively. In conclusion, the addition of C. prostrata (Linn.) Blume into the normal rabbit feeds had a positive effect on sperm count, but reduced sperm motility and morphology, and may be associated with spermatogenesis-related problems.

HIV Non-Occupational Post Exposure Prophylaxis in Nigeria: A Systematic Review of Research Evidence and Practice.

BACKGROUND: Although non-occupational Human Immunodeficiency Virus (HIV) post-exposure prophylaxis (nPEP) has been proven to be efficacious in preventing HIV, it remains an underutilized prevention strategy in Nigeria. We aimed to conduct an overview of research studies on nPEP and practice in Nigeria from 2002 to 2018 examining: sociodemographic characteristics of study sample, awareness, knowledge and prior use of nPEP, reasons for HIV nPEP, timeliness in presenting for PEP, antiretrovirals (ARVs) used for nPEP, side effects and adherence, monitoring and follow-up visits, adherence to guidelines and recommendations for nPEP by healthcare institutions and the strength of evidence of reviewed studies. METHODS: An electronic search on PubMed, PubMed Central (PMC), cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Embase and Google Scholar for published studies on nPEP from January 2002 to December 2018. We conducted our search using different combinations of the keywords "HIV," "non-occupational," "nonoccupational," "post-exposure," "postexposure," "prophylaxis" and "Nigeria." RESULTS: Five articles met the inclusion criteria for this study. About 25.4% of college students were aware of PEP.PEP awareness was significantly determined by the following factors ever tested for HIV, nude picture exchanges, sex without condom, and knowledge of partner's HIV status. Across studies, exposed victims who presented for PEP were mostly females (64%-78%). Rape was the most frequently occurring reason for seeking nPEP (25.9%-64.1%). Although most patients presented for nPEP within 72 hours, follow up visits were generally low (0%-2%) across studies assessed, except for one study that reported a high follow up visit of 83.3%. Guidelines adherence by healthcare institutions could not be established due to lack of information on key variables. CONCLUSION: Our study highlights the paucity of research evidence on nPEP use in Nigeria, the societal and cultural contexts in which non-occupational exposures occur, healthcare providers' roles and the public health and practice implications.

HIV Comorbidities-Pay Attention to Hypertension Amid Changing Guidelines: An Analysis of Texas Medical Monitoring Project Data.

BACKGROUND: Hypertension is a significant risk factor for cardiovascular disease, a leading cause of death among people living with HIV (PLWH). Studies suggest that hypertension prevalence among PLWH is high, yet none assess how the 2017 redefinition of hypertension as ≥130/80 rather than the previous standard of ≥140/90 mm Hg will affect prevalence among PLWH. This study addresses this gap. METHODS: We examined medical record abstractions of 957 PLWH in Texas from the 2013-2014 Medical Monitoring Project survey. Participants with hypertension were identified by charted diagnosis, antihypertensive medication use, or blood pressure readings ≥140/90 and ≥130/80 mm Hg. Associations with sociodemographic and clinical variables were assessed using Rao-Scott chi-square tests, and odds of having hypertension were calculated using multivariable logistic regression models while adjusting for several demographic and HIV-related variables. RESULTS: The 2017 redefinition of hypertension increased prevalence in the sample by 44.3%, from 47.6% to 68.7%. Age group, body mass index, sex, and race remained significantly associated with hypertension (all P < 0.01). Although prevalence was near equal between males and females at ≥140/90 mm Hg (47.4% and 48.5%, respectively), males were 2.36 times more likely to have hypertension than females (95% confidence interval [CI]: 1.55-3.60) at ≥130/80 mm Hg. Prevalence remained comparable between white (73.3%) and black participants (72.9%). CONCLUSIONS: This study shows that hypertension prevalence is remarkably high among PLWH and is further increased by updated guidelines. Barriers to hypertension control in the HIV care setting should be identified and addressed to facilitate continued improvement in the quality and length of life for PLWH.

Hormonal changes, semen quality and variance in reproductive activity outcomes of post pubertal rabbits fed Moringa oleifera Lam. leaf powder.

ETHNOPHARMACOLOGICAL RELEVANCE: Moringa oleifera Lam. (Moringaceae) is an important plant based staple food, known for its nutritional and medicinal value and is usually prescribed by herbal practitioners in Nigeria and in other tropical countries for the treatment of male infertility problems and reproductive diseases in females. Although the aphrodisiac properties and fertility enhancement potential in males have been reported, the underlying mechanisms for the activity remain unclear. In this study, we investigated the influence of supplementing the diet with M. oleifera Lam. leaf powder on reproductive hormones and semen quality of New Zealand White (NZW) rabbits. MATERIALS AND METHODS: Thirty-two (32) NZW rabbits of 50:50 ratio bucks to does, were randomly distributed to four treatment groups (n = 4 bucks, n = 4 does per group). Graded levels (0, 5, 10 and 15 g/kg) of M. oleifera Lam. leaf powder was incorporated into rabbit growers pellet. The does and bucks were housed separately in hutches and sheltered under the same environmental conditions with free access to their respective treatment diets for a period of 12 weeks. RESULTS: In female rabbits, treatment revealed significant (P < 0.05) dose-dependent reduction in the concentration of serum FSH, LH and oestrogen. While in contrast the highest dose of leaf powder significantly (P < 0.05) increased progesterone and prolactin concentrations remained unaffected. On the other hand, the concentration of FSH and LH in bucks was significantly (P < 0.05) increased in treatment groups compared to the control group. Serum testosterone concentrations were significantly lower in the 5 and 10 g/kg treatment groups. Semen volume, sperm count and motility were significantly improved in a dose dependent manner with increasing amounts of M. oleifera Lam. leaf powder in the diet. CONCLUSIONS: We conclude that M. oleifera Lam. leaf powder supplementation to the diet was more beneficial to male rabbit fertility than the female, where it tended to have a negative impact through the hypothalamic-pituitary-gonadal axis. However, with the varying impact of M. oleifera Lam. leaf powder on the hypothalamic-pituitary-gonadal axis of male and female animals, further investigation is necessary to determine the mechanism through which it operates.