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Zachariah Mbugua Mburu,Sabyasachi Mondal,Precious Sibanda 한국CDE학회 2021 Journal of computational design and engineering Vol.8 No.1
This study reports on combined thermal radiation, chemical reaction, and magnetic field effects on entropy generation in an unsteady nanofluid flow past an inclined cylinder using the Buongiorno model. We consider the impact of viscous dissipation, velocity slip conditions, thermal slip conditions, and the Brownian motion. The transport equations governing the flow are solved using an overlapping grid spectral collocation method. The results indicate that entropy generation is suppressed significantly by thermal radiation and chemical reaction parameters but enhanced with the magnetic field, viscous dissipation, the Brinkman number, and the Reynolds number. Also, fluid flow variables are affected by the thermophoresis parameter, the angle of cylinder inclination, and the Richardson number. We present the findings of the skin friction coefficient, the Nusselt number, and the Sherwood number. The model is applicable in fields such as the petroleum industry, building industries, and medicine.
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( Njeri Rahab Mbugua ),( Asunta Wagura Wagura ),( Elizabeth Ann Bukusi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Among children, early mortality following highly active antiretroviral therapy (HAART) remains high. It is important to defi ne correlates of mortality in order to improve outcome. Methods: HIV-1-infected children aged 18 months-12 years were followed up at Kenyatta National Hospital, Nairobi after initiating NNRTI-based HAART. Cofactors for mortality were determined using multivariate Cox regression models. Results: Between August 2004 and November 2008, 149 children were initiated on HAART of whom 135 were followed for a total of 238 child-years (median 21 months) after HAART initiation. Baseline median CD4% was 6.8% and median HIV-1-RNA was 5.98-log10 copies/ml. Twenty children (13.4%) died at a median of 35 days post- HAART initiation. Mortality during the entire follow-up period was 8.4 deaths per 100 child-years (46 deaths/100 child-years in fi rst 4 months and 1.0 deaths/100 childyears after 4 months post-HAART initiation). On univariate Cox regression, baseline hemoglobin (Hb) < -2, and WHO clinical stage 4 were associated with increased risk of death (Hb < -2 HR 3.41 [95% C.I. 1.28-9.08], p = 0.01, and WHO clinical stage 4, HR 3.08 [1.17-8.12], p = 0.02). On multivariate analysis Hb < 9 g/dl remained predictive of mortality after controlling for age, baseline CD4%, WHO clinical stage and weightfor- height z-score (HR 2.95 (95% C.I. 1.04-8.35) p = 0.04). Conclusions: High early mortality was observed in this cohort of Kenyan children receiving HAART, and low baseline hemoglobin was an independent risk factor for death.
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( Njeri Rahab Mbugua ),( Asunta Wagura Wagura ),( Elizabeth Ann Bukusi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: To determine the prevalence and correlates of neonatal conjunctivitis in infants born to human immunodefi ciency virus type 1 (HIV-1) infected mothers. Methods: This was a nested case-control study within a perinatal HIV-1 cohort. HIV-1 seropositive mothers were enrolled during pregnancy and mother-infant pairs followed after delivery with assessment for neonatal conjunctivitis at 48 hours and up to 4 weeks after birth. Genital infections (chlamydia, gonorrhea, syphilis, trichomonas, bacterial vaginosis, and candida) were screened for at 32 weeks gestation. Mothers received treatment for genital infections diagnosed during pregnancy and shortcourse zidovudine. Newborns did not receive ocular prophylaxis at hospital deliveries. Multivariate logistic regression models were used to determine cofactors for neonatal conjunctivitis overall and stratifi ed for infant HIV-1 status. Results: Four hundred and fi fty-two infants were assessed and 101 (22.3%) had neonatal conjunctivitis during the fi rst month postpartum. In multivariate analyses using odds ratios (OR) and confi dence intervals (CI), neonatal conjunctivitis was associated with neonatal sepsis (adjusted OR 21.95, 95% CI 1.76, 274.61), birth before arrival to hospital (adjusted OR 13.91, 95% CI 1.39, 138.78) and birth weight (median 3.4 versus 3.3 kilograms, p=0.016, OR 1.79, 95% CI 1.01, 3.15). Infant HIV-1 infection was not associated with conjunctivitis. Conclusions: Despite detection and treatment of genital infections during pregnancy, neonatal conjunctivitis was frequently diagnosed in infants born to HIV-1 infected mothers suggesting a need for increased vigilance and prophylaxis for conjunctivitis in these infants. Neonatal sepsis, birth before arrival to hospital, and higher birthweight are factors that may predict higher risk of neonatal conjunctivitis in this population.
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( Njeri Rahab Mbugua ),( Asunta Wagura Wagura ),( Elizabeth Ann Bukusi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: To examine the practices of anal intercourse and dry sex within a cohort of female sex workers (FSWs) in Kenya, focusing on the prevalence and perceived risk of the practices, demographic and behavioural correlates, and association with sexually transmitted infections (STI). Methods: A survey was conducted among FSWs with 147 participants randomly sampled from an existing cohort of self identifi ed FSWs.Results: 40.8% of participants reported ever practising anal intercourse and 36.1% reported ever practising dry sex. Although the majority of women surveyed believed anal intercourse and dry sex to be high risk practices for HIV infection compared with vaginal sex, about one third of women reported never or rarely using condoms during anal intercourse, and about 20% never or rarely using condoms during dry sex. Reported consistent condom use was lower with both of these practices than with penile-vaginal intercourse. Anal intercourse was associated with experience of recent forced sexual intercourse, while dry sex was not. Anal intercourse was almost always initiated by clients, whereas dry sex was likely to be initiated by the women themselves. Sex workers reported charging higher fees for both practices than for vaginal intercourse. Both practices were associated with reported symptoms and diagnoses of STI. Conclusions: Both anal intercourse and dry sex were common in this sample, and although perceived as high risk practices, were not adequately protected with condom use. Education and other interventions regarding these high risk sexual behaviours need to be translated into safer practices, particularly consistent condom use, even in the face of fi nancial vulnerability.
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Poster Session : PS 0371 ; Immunology ; Pediatric HIV -1 in Kenya
( Njeri Rahab Mbugua ),( Elizabeth Ann Bukusi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: There is limited information regarding the pattern and correlates of viral replication in vertically HIV-1-infected children and its role on their outcomes in resource- limited settings. Methods: HIV-1-infected infants were followed from birth to 24 months. Serial HIV- 1 RNA levels were compared in infants infected in utero (<48 hours), peripartum (48 hours-1 month), and late postnatal (after 1 month). Cofactors for viral peak [highest viral load (VL) within 6 months of infection] and set point and mortality were determined. Results: Among 85 HIV-1-infected infants, 24 were infected in utero, 41 peripartum, 13 late postnatal; 7 had no 48-hour assay. HIV-1 VL set point was signifi cantly lower in infants infected >1 month vs. =1 month (5.59 vs. 6.24 log10 copies per milliliter, P = 0.01). Maternal VL correlated with peak infant VL (P < 0.001). Univariately, infant peak and set point VL and 6-month CD4% <15% predicted mortality; and 6-month CD4% <15% remained independently predictive in multivariate analyses (hazard ratio = 4.85, 95% confi dence interval: 1.90 to 12.36). Conclusions: Infants infected after the age of 1 month contained virus better than infants infected before 1 month of age. Maternal VL predicted infant VL, which, in turn was associated with early mortality.
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Poster Session : PS 0373 ; Immunology ; Acute HIV Infection among Kenyan Infants
( Njeri Rahab Mbugua ),( Elizabeth Ann Bukusi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Clinical signs and symptoms of acute human immunodefi ciency virus (HIV) infection in infants are not well characterized. Methods: Clinical signs and symptoms of acute human immunodefi ciency virus (HIV) infection in infants are not well characterized. Results: There were 125 acute infection visits (among 56 infants) and 3491 noninfection visits (among 306 infants). Acute HIV infection was associated with rash (odds ratio [OR], 1.8; 95% confi dence interval [CI], 1.1-2.8), failure to thrive (OR, 1.9; 95% CI, 1.0-3.5), and lymphadenopathy (OR, 2.5; 95% CI, 1.4-4.8). Acute HIV infection was associated with lymphadenopathy (OR, 2.6; 95% CI, 1.3-5.0) in infants <2 months of age and with pneumonia (OR, 3.2; 95% CI, 1.1-9.3) and dehydration (OR, 6.0; 95% CI, 1.9-18.5) in infants >or=2 months of age. Infant peak viral load and mortality were not associated with symptoms of acute HIV infection. However, infants with symptoms had higher viral levels later in the course of infection than did those without symptoms (P=.05). Conclusions: Infants may manifest symptoms early during the course of HIV infection, and symptoms of acute HIV infection may correlate with poor viral control. Rash, failure to thrive, lymphadenopathy, pneumonia, and dehydration may signify acute HIV infection in infants.
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( Njeri Rahab Mbugua ),( Judy W Kamau ),( Muthoni Mathai ),( Wangari Kuria ),( Elizabeth Ann Bukusi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The objective of the study was to determine the risk of depression in caregivers ofchildren with intellectua ldisability. Caregivers of children with intellectual disability have a great responsibility that may be stressful. The psychological well-being of the care giver may a ect the quality of care given to children with intellectual disability. Methods: The study was conducted at Gachie Catholic Parish, Archdiocese of Nairobi (Kenya). Design. Cross sectional, descriptive study.The study was conducted among 114 caregivers registered at the Gachie Parish program (in Kenya) for the intellectual disabled children. A researcher-designed social demographic questionnaire and the Beck depression inventory were administered to those that met the inclusion criteria Results: Seventy-nine percent (79%) of the caregivers were at risk of clinical depression. Conclusions: Majority of the caregivers of children with intellectual disability were at risk of developing clinical depression.
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( Njeri Rahab Mbugua ),( Asunta Wagura Wagura ),( Elizabeth Ann Bukusi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Breast-feeding by infants exposed to human immunodefi ciency virus type 1 (HIV-1) provides an opportunity to assess the role played by repeated HIV-1 exposure in eliciting HIV-1-specifi c immunity and in defi ning whether immune responses correlate with protection from infection. Methods: Breast-feeding infants born to HIV-1-seropositive women were assessed for HLA-selected HIV-1 peptide-specifi c cytotoxic T lymphocyte interferon (IFN)-gamma responses by means of enzyme-linked immunospot (ELISpot) assays at 1, 3, 6, 9, and 12 months of age. Responses were deemed to be positive when they reached > or = 50 HIV-1-specifi c sfu/1 x 10(6) peripheral blood mononuclear cells (PBMCs) and were at least twice those of negative controls. Results: A total of 807 ELISpot assays were performed for 217 infants who remained uninfected with HIV-1 at approximately 12 months of age; 101 infants (47%) had at least 1 positive ELISpot result (median, 78-170 sfu/1 x 10(6) PBMCs). The prevalence and magnitude of responses increased with age (P = .01 and P = .007, respectively); the median log(10) value for HIV-1-specifi c IFN-gamma responses increased by 1.0 sfu/1 x 10(6) PBMCs/month (P<0.001) between 1 and 12 months of age. Of 141 HIV-1-uninfected infants with 1-month ELISpot results, 10 (7%) acquired HIV-1 infection (0/16 with positive vs. 10/125 [8%] with negative ELISpot results; P = .6). Higher values for log(10) HIV-1-specifi c spot-forming units at 1 month of age were associated with a decreased risk of HIV-1 infection, adjusted for maternal HIV-1 RNA level (adjusted hazard ratio, 0.09 [95% confi dence interval, 0.01-0.72]). Conclusions: Breast-feeding HIV-1-exposed uninfected infants frequently had HIV-1-specific IFN-gamma responses. Greater early HIV-1-specific IFN-gamma responses were associated with decreased HIV-1 acquisition.
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Poster Session:PS 0168 ; Diabetes : Diabetic Patients Have a High Prevalence of Sexual Dysfunction
( Njeri Rahab Mbugua ),( Asunta Wagura Wagurz ),( Elizabeth Ann Bukusi ),( Judy W Kamau ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Sexual dysfunction can impact a person`s ability to form or sustain intimate relationships and co morbidity between sexual dysfunction and anxiety as well as depression has been reported. Yet epidemiological, etiological, and health association to sexual dysfunction has only begun to be explored in Kenya. Methods: To determine the prevalence, types of sexual dysfunction and their socio demographic correlate in diabetic patients. Descriptive cross- sectional study The study was conducted at the outpatient diabetic clinic of Kenyatta National Hospital. Results: This is the main referral hospital in Kenya. A total of 350 participants were enrolled in the study. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) questionnaires were used to evaluate sexual dysfunctions in female and male patients respectively. The participants were composed of 164 females aged between 18-74 years and 186 males aged between 19- 100 years. In males, prevalence of sexual dysfunctions were: erectile dysfunction (68.8%): orgasmic dysfunction (48.4%): sexual desire (81.7%): intercourse satisfaction (86.6%) and overall satisfaction (68.4%).The female sexual dysfunction was 36.6% and was categorized as mild (17.1%): moderate (18.3%) and severe (1.2%). Conclusions: Diabetic patients have a high prevalence of sexual dysfunction.
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( Njeri Rahab Mbugua ),( Asunta Wagura Wagura ),( Elizabeth Ann Bukusi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: We evaluated predictors of consistent condom use among female sex workers (FSWs), a core group for controlling the spread of HIV. Methods: In an analysis of data collected in 2004-2005 from 140 Kenyan FSWs who completed questionnaires administered during a baseline study visit and three bimonthly follow-up visits, we used a case-crossover design to identify predictors of consistent condom use during all coital acts in the preceding 2 weeks, overall and by partner type. Results: Participants (n=140) completed the baseline visit and 390 bimonthly follow- up visits. Alcohol use during sex was negatively associated with consistent condom use with helping partners (defi ned as regular sex partners to whom the woman could go for help or support if needed) (adjusted odds ratio [AOR], 2.6, 95% confi - dence interval [CI] 1.0-6.5) but not associated with condom use with other partners. Coital frequency was associated with condom use with other partners only. Women who reported 1-5 (AOR 11.0, 95% CI 4.3-28.3) or 6-9 recent coital acts (AOR 3.8, 95% CI 1.7-8.8) with other partners were more likely to report consistent condom use with those partners than were women who reported =10 acts. Having a recent partner delay payment was inversely associated with consistent condom use with helping, other, or all partners. Conclusions: Correlates of consistent condom use differed by partner type. By using a case-crossover design, we were able to identify potentially modifi able factors associated with consistent condom use by FSWs who used condoms consistently with a given partner type during some periods but not others.
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