Acceptability of using mobile Health (mHealth) as an intervention tool for people with drug use disorders in Tanga, Tanzania.

Evidence on the additional benefit in treatment and recovery process among PWDUD using digital health interventions is lacking. This study aimed to describe the acceptability of using a digital intervention to increase information access for PWDUD in Tanga region, Tanzania. This study was conducted among 465 participants in Tanga, a coastal region on the Northeast of Tanzania has the second highest number of PWDUD in Tanzania. This cross-sectional descriptive study used both quantitative and qualitative approaches. The majority of the PWDUD 67.6% do not own mobile phones. Out of the 156 participants with mobile phones, only 6.4% owned a smartphone. Most of the participants, 83.6%, reported living with someone who owns a mobile phone. Importantly, a significant number of participants, 98.5% from both areas showed readiness to use mobile phones to access information about the harmful use of substance and substance use disorder treatment options. Participants described how mobile phones can be useful to them in accessing information related to treatment and access to treatment options. The findings of this study helped to inform the target audience for the developed Huru App that should not be only PWDUD but the community at large.

Drug use and associated factors in a North Eastern region of Tanzania: a cross-sectional study.

Introduction: Tanzania has experienced an increase in the number of people who use drugs (PWUDs) and people who inject drugs (PWIDs). Understanding the characteristics of PWUDs is crucial to addressing the increasing burden of drug use in Tanzania. This study was set to examine drug use and its related factors among PWUDs in a North Eastern region of Tanzania. Methods: a cross-sectional study conducted among 481 PWUDs in Tanga region, Tanzania. R statistical language was used for analysis and plotting. Logistic regression was performed to establish associations between knowledge and practice scores with drug use. A p-value of < 0.05 was considered statistically significant. Results: people who inject drugs comprised mostly of male (97.5%) and those with primary level education (71.1%). About three in four PWUDs had poor knowledge and practices towards drug use. Factors associated with adequate knowledge and practices towards drug use included residing in urban setting (aOR: 0.47, 95% CI; 0.29 - 0.74, p=0.001) while low level of education and use of drugs for less than 10 years were independent predictors for poor practices. Conclusion: drug use poses a significant threat among male and individuals with low education in Tanga region. Poor knowledge and practices towards drug use was more pronounced among rural and lowly educated PWUDs. Owing to variabilities of predictors, tailored and innovative interventions are needed to curb this growing drug use and associated effects in Tanga and other settings with similar contexts.

Potential Role of Lisinopril in Reducing Atherosclerotic Risk: Evidence of an Antioxidant Effect in Human Cardiomyocytes Cell Line.

The cellular mechanisms involved in myocardial ischemia/reperfusion injury (I/R) pathogenesis are complex but attributable to reactive oxygen species (ROS) production. ROS produced by coronary endothelial cells, blood cells (e.g., leukocytes and platelets), and cardiac myocytes have the potential to damage vascular cells directly and cardiac myocytes, initiating mechanisms that induce apoptosis, inflammation, necrosis, and fibrosis of myocardial cells. In addition to reducing blood pressure, lisinopril, a new non-sulfhydryl angiotensin-converting enzyme (ACE) inhibitor, increases the antioxidant defense in animals and humans. Recently, it has been shown that lisinopril can attenuate renal oxidative injury in the l-NAME-induced hypertensive rat and cause an impressive improvement in the antioxidant defense system of Wistar rats treated with doxorubicin. The potential effect of lisinopril on oxidative damage and fibrosis in human cardiomyocytes has not been previously investigated. Thus, the present study aims to investigate the effect of different doses of lisinopril on oxidative stress and fibrotic mediators in AC16 human cardiomyocytes, along with a 7-day presence in the culture medium. The results revealed that AC16 human cardiomyocytes exposed to lisinopril treatment significantly showed an upregulation of proteins involved in protecting against oxidative stress, such as catalase, SOD2, and thioredoxin, and a reduction of osteopontin and Galectin-3, critical proteins involved in cardiac fibrosis. Moreover, lisinopril treatment induced an increment in Sirtuin 1 and Sirtuin 6 protein expression. These findings demonstrated that, in AC16 human cardiomyocytes, lisinopril could protect against oxidative stress and fibrosis via the activation of Sirtuin 1 and Sirtuin 6 pathways.

Nonvisualization of fetal gallbladder: a case report and review of the literature.

Failure to visualize prenatally the gallbladder at ultrasound scan may indicate different fetal malformations with a highly variable prognosis, but also a simple anatomic variable. An adequate prenatal management could help in defining diagnosis and prognosis.

Parvovirus B19 during pregnancy: a review.

Several infections in adults warrant special consideration in pregnant women given the potential fetal consequences. Among these is parvovirus B19 deserves special attention since the harmful effects on the pregnant woman and fetus. It can then cause fetal anemia, non-immune fetal hydrops and fetal death. Among cases with fetal demise, B19 is foundin significant numbers, especially in the second andthird trimesters of pregnancy. There is no specific treatment or prophylaxis available against B19 infection, but counseling of non-immune mothers and active monitoring of confirmed maternal infections with intervention to correct fetal anemia is likely to decrease mortality.

Update on systemic lupus erythematosus pregnancy.

Women with Systemic Lupus Erythematosus (SLE) still face significant risks when embarking on a pregnancy. Improvements in the field of pathophysiology, in diagnosis and a greater number of therapeutic options in the treatment of SLE, have made the medical community regard these patients with less trepidation. Despite these advances, however, the risk of significant morbidity to both the mother and the fetus still exists. THE INTERACTION OF LUPUS AND PREGNANCY IS VERY COMPLEX: the consensus is that pregnancy can worsen the lupus disease process, even if this is not predictable, and pregnancy can mimic the clinical manifestations of lupus, particularly preeclampsia/eclampsia. More specifically, pregnancy is associated in 50 to 60% of cases with a clinical flare manifesting as renalor hematological symptoms. Severe flares are uncommon (10%) and the risk of maternal death is now2 to 3%. The risk of the fetus remains high, however with increased risk of spontaneous fetal wastage and premature births, by 4.8 and 6.8 times, respectively. It is well documented that antiphospholipid syndrome and antiphospholipid antibodies are strongly associated with fetal wastage. Low-dose aspirin orheparin improves fetal outcome in these cases.Timing a pregnancy to coincide with a period of disease quiescence for at least 6 months strongly increases the chances for a healthy and uneventful pregnancy for both mother and baby. Close surveillance, with monitoring of blood pressure, proteinuria and placental blood flow by doppler studies helps the early diagnosis and treatment of complications such as preeclampsia andfoetal distress. Women with SLE frequently need treatment throughout pregnancy based on hydroxychloroquine, lowdose steroids and azathioprine. This update, based on previous available literature, should inform rheumatologists, obstetricians and neonatologists who guide patients in their reproductive decisions.

Ultrasound in the evaluation of the inflammatory myopathies.

The lack of precise measures of disease activity may complicate the care of patients with inflammatory myopathies (IM). Techniques currently available to physicians in practice rely on measurement of function, strength, laboratory indices, muscle biopsy, and imaging techniques. Although MRI has become the method of choice to assess IM, it is expensive, difficult for some patients to tolerate, and contraindicated in those with pacemakers, aneurysm clips, and other ferromagnetic biomedical implants. Ultrasonography is an alternative approach to image the muscular system. Newer applications of ultrasound, such as power Doppler sonography (PDS), contrast-enhanced ultrasound, and sonoelastography, show some promising results in further characterizing normal and pathologic states. Technical improvements, including extended field-of-view, compound imaging, and harmonic imaging, further enhance one's ability to display changes in muscle morphology. This article reviews the sonographic appearances of normal and pathologic muscle with respect to inflammatory myopathies.