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2013

Eldaroti, HH, Gadir SA, Refat MS, Adam AM.  2013.  Preparation, spectroscopic and thermal characterization of new charge-transfer complexes of ethidium bromide with π-acceptors. In vitro biological activity studies. Abstract

Ethidium bromide (EtBr) is a strong DNA binder and has been widely used to probe DNA structure in drug-DNA and protein-DNA interaction. Four new charge-transfer (CT) complexes consisting of EtBr as donor and quinol (QL), picric acid (PA), tetracyanoquinodimethane (TCNQ) or dichlorodicyanobenzoquinone (DDQ) as acceptors, were synthesized and characterized by elemental analysis, electronic absorption, spectrophotometric titration, IR, Raman, (1)H NMR and X-ray powder diffraction (XRD) techniques. The stoichiometry of these complexes was found to be 1:2 ratio and having the formula [(EtBr)(acceptor)]. The thermal stability of the synthesized CT complexes was investigated using thermogravimetric (TG) analyses, and the morphology and particle size of these complexes were obtained from scanning electron microscopy (SEM). The CT complexes were also tested for its antibacterial activity against two Gram-positive bacteria Staphylococcus aureus and Bacillus subtilis and two Gram-negative bacteria; Escherichia coli and Pseudomonas aeuroginosa strains by using Tetracycline as standard and antifungal property against Aspergillus flavus and Candida albicans by using amphotericin B as standard. The results were compared with the standard drugs and significant conclusions were obtained. The results indicated that the [(EtBr)(QL)2] complex had exerted excellent inhibitory activity against the growth of the tested bacterial strains.

Adam, AM.  2013.  Structural, thermal, morphological and biological studies of proton-transfer complexes formed from 4-aminoantipyrine with quinol and picric acid. Abstract

4-Aminoantipyrine (4AAP) is widely used in the pharmaceutical industry, biochemical experiments and environmental monitoring. However, residual amounts of 4AAP in the environment may pose a threat to human health. To provide basic data that can be used to extract or eliminate 4AAP from the environment, the proton-transfer complexes of 4AAP with quinol (QL) and picric acid (PA) were synthesized and spectroscopically investigated. The interactions afforded two new proton-transfer salts named 1,5-dimethyl-3-oxo-2-phenyl-2,3-dihydro-1H-pyrazol-4-aminium-4-hydroxyphenolate and 1,5-dimethyl-3-oxo-2-phenyl-2,3-dihydro-1H-pyrazol-4-aminium-2,4,6-trinitrophenolate for QL and PA, respectively, via a 1:1 stoichiometry. Elemental analysis (CHN), electronic absorption, spectrophotometric titration, IR, Raman, (1)H NMR and X-ray diffraction were used to characterize the new products. The thermal stability of the synthesized CT complexes was investigated using thermogravimetric (TG) analyses, and the morphology and particle size of these complexes were obtained from scanning electron microscopy (SEM). It was found that PA and 4AAP immediately formed a yellow precipitate with a remarkable sponge-like morphology and good thermal stability up to 180°C. Finally, the biological activities of the newly synthesized CT complexes were tested for their antibacterial and antifungal activities. The results indicated that the [(4AAP)(QL)] complex exhibited strong antimicrobial activities against various bacterial and fungal strains compared with standard drugs.

2011

Refat, MS;, Saad HA;, Adam AM.  2011.  Intermolecular hydrogen bond complexes by in situ charge transfer complexation of o-tolidine with picric and chloranilic acids.. Abstract

A two new charge transfer complexes formed from the interactions between o-tolidine (o-TOL) and picric (PA) or chloranilic (CA) acids, with the compositions, [(o-TOL)(PA)(2)] and [(o-TOL)(CA)(2)] have been prepared. The (13)C NMR, (1)H NMR, (1)H-Cosy, and IR show that the charge-transfer chelation occurs via the formation of chain structures O-H⋯N intermolecular hydrogen bond between 2NH(2) groups of o-TOL molecule and OH group in each PA or CA units. Photometric titration measurements concerning the two reactions in methanol were performed and the measurements show that the donor-acceptor molar ratio was found to be 1:2 using the modified Benesi-Hildebrand equation. The spectroscopic data were discussed in terms of formation constant, molar extinction coefficient, oscillator strength, dipole moment, standard free energy, and ionization potential. Thermal behavior of both charge transfer complexes showed that the complexes were more stable than their parents. The thermodynamic parameters were estimated from the differential thermogravimetric curves. The results indicated that the formation of molecular charge transfer complexes is spontaneous and endothermic.

2008

ADAM, PROFADAMMOHAMED.  2008.  Adam AM, Maritim MC.Pseudoxanthoma elasticum in a patient with sickle cell disease: case report. East Afr Med J. 2008 Feb;85(2):98-101.. The Proceedings of the Kenya Society of Anaesthesilogists. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
An 18 year female sickler (HbSS) presented with repeated history of epistaxis and bleeding gums. Features consistent with pseudoxanthoma elasticum were observed, such as hyper-extensile redundant skin folds in the neck, axilla, inguinal areas and abdomen. The skin biopsy showed swollen, clumped and fragmented elastic fibres and calcium deposits in the deep and mid reticular dermis, consistent with pseudoxanthoma elasticum. This is a well recognised complication of sickle cell disease which has not been described in Kenya.

2005

ADAM, PROFADAMMOHAMED.  2005.  Adam AM: Benign positional vertigo and hyperuricaemia. East Afr Med J. 2005 Jul;82(7):376-8.. East Afr Med J. 2005 Jul;82(7):376-8.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
OBJECTIVE: To find out if there is any association between serum uric acid level and positional vertigo. DESIGN: A prospective, case controlled study. SETTING: A private neurological clinic. SUBJECTS: All patients presenting with vertigo. RESULTS: Ninety patients were seen in this period with 78 males and 19 females. Mean age was 47 +/- 3 years (at 95% confidence level) with a standard deviation of 12.4. Their mean uric acid level was 442 +/- 16 (at 95% confidence level) with a standard deviation of 79.6 umol/l as compared to 291 +/- 17 (at 95% confidence level) with a standard deviation of 79.7 umol/l in the control group. The P-value was less than 0.001. CONCLUSION: That there is a significant association between high uric acid and benign positional vertigo.
ADAM, PROFADAMMOHAMED.  2005.  A M ADAM Creutzfeldt-Jakob disease in Kenya. Tropical Medicine and International Health. 10: 710-712, 2005.. Tropical Medicine and International Health. 2005 Jul;10(7):710-2. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
OBJECTIVE: To study the pattern of occurrence of Creutzfeldt-Jakob disease (CJD) in Kenya. Study design Prospective, cross-sectional, descriptive study of clinical, encephalographic and natural history of CJD, backed by histology in as many patients as possible. METHODS: Consecutive patients presenting with the criteria laid down by WHO expert committee for diagnosis of CJD were recruited between January 1990 and May 2004. We analysed the clinical features and electroencephalography of all participants and took brain biopsies from four patients. RESULTS: There were four definite, seven probable and two possible cases. The electroencephalographic and histological features were typical of sporadic CJD. CONCLUSION: Sporadic CJD occurs in Kenya and the clinical, encephalographic and histological features were no different to those described elsewhere. Although we did not see variant, hereditary and iatrogenic forms of CJD, neurologists should not exclude these in making diagnoses

2003

ADAM, PROFADAMMOHAMED.  2003.  Adam AM:Human genetics in the Holy Qur'an and Sunna.J R Coll Physicians Edinb. 2003;33(1):44-5.. J R Coll Physicians Edinb. 2003;33(1):44-5.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
OBJECTIVE: To find out if there is any association between serum uric acid level and positional vertigo. DESIGN: A prospective, case controlled study. SETTING: A private neurological clinic. SUBJECTS: All patients presenting with vertigo. RESULTS: Ninety patients were seen in this period with 78 males and 19 females. Mean age was 47 +/- 3 years (at 95% confidence level) with a standard deviation of 12.4. Their mean uric acid level was 442 +/- 16 (at 95% confidence level) with a standard deviation of 79.6 umol/l as compared to 291 +/- 17 (at 95% confidence level) with a standard deviation of 79.7 umol/l in the control group. The P-value was less than 0.001. CONCLUSION: That there is a significant association between high uric acid and benign positional vertigo.

2001

ADAM, PROFADAMMOHAMED.  2001.  A M ADAM; Benign Positional Vertigo as a clinical manifestation of Hyperuricaemia- RECENT DISCOVERY Journal of Neurological Sciences 187: s222. 2001.. RECENT DISCOVERY Journal of Neurological Sciences 187: s222. 2001.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
OBJECTIVE: To find out if there is any association between serum uric acid level and positional vertigo. DESIGN: A prospective, case controlled study. SETTING: A private neurological clinic. SUBJECTS: All patients presenting with vertigo. RESULTS: Ninety patients were seen in this period with 78 males and 19 females. Mean age was 47 +/- 3 years (at 95% confidence level) with a standard deviation of 12.4. Their mean uric acid level was 442 +/- 16 (at 95% confidence level) with a standard deviation of 79.6 umol/l as compared to 291 +/- 17 (at 95% confidence level) with a standard deviation of 79.7 umol/l in the control group. The P-value was less than 0.001. CONCLUSION: That there is a significant association between high uric acid and benign positional vertigo.

2000

ADAM, PROFADAMMOHAMED.  2000.  Environmental Protection in the Tomsk Region of the Russian Federation: A Case Study.Environ Manage. 2000 Nov;26(5):585. Environ Manage. 2000 Nov;26(5):585. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract

Implementation of environmental management in Russia is undergoing rapid changes. Federal responsibility rests with the Russian Federation State Committee for Environmental Protection (RFSCEP) and is delegated at regional level to local State Committees for Environmental Protection (SCEPs). This paper focuses on the functioning of the SCEP for Tomsk oblast' (region) in Siberia, which is strongly committed to forging constructive links with regional government, academia, industry, and environmental NGOs. Considerable difficulties exist for SCEPs in Russia, however, and prominent among these are (1) a rigidly vertical civil service structure, with separate organs having responsibility for different natural resources, persisting from Soviet times, which hinders effective intergrated and holistic environmental management; and (2) a lack of open access to environmental information from military and quasi-military sites

ADAM, PROFADAMMOHAMED.  2000.  Mukhtar MM, Sharief AH, el Saffi SH, Harith AE, Higazzi TB, Adam AM, Abdalla HS.Detection of antibodies to Leishmania donovani in animals in a kala-azar endemic region in eastern Sudan: a preliminary report. Trans R Soc Trop Med Hyg. 2000 Jan-Feb;94(1):33. Environ Manage. 2000 Nov;26(5):585. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
The prevalence of antibodies against Leishmania donovani in selected domestic and wild animal species in 2 villages in Sudan with active L. donovani transmission in humans was investigated. Screening of domestic animals (donkeys, cows, sheep, goats, camels and dogs) with the direct agglutination test (DAT) detected reaction rates above the cut-off titres in donkeys (68.7%), cows (21.4%) and goats (8.5%), and which were also found in wild rats (5.5%). Sera of sheep, camels and dogs had a weak agglutination reaction below the cut-off titre. Testing of the same sera by enzyme-linked immunosorbent assay (ELISA), against a lysate of L. donovani promastigotes, showed reaction rates above the cut-off optical density in cows (47.6%), goats (13.6%), and in rats (4.1%). No Leishmania parasite was isolated from spleen, liver, bone-marrow or spleen of Nile rats.
ADAM, PROFADAMMOHAMED.  2000.  A M ADAM; Unusual cause of severe muscle stiffness: Historical aspects of genetics. The Nairobi Hospital Proceedings. IV: 142-145. 2000.. The Nairobi Hospital Proceedings. IV: 142-145. 2000.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
OBJECTIVE: To find out if there is any association between serum uric acid level and positional vertigo. DESIGN: A prospective, case controlled study. SETTING: A private neurological clinic. SUBJECTS: All patients presenting with vertigo. RESULTS: Ninety patients were seen in this period with 78 males and 19 females. Mean age was 47 +/- 3 years (at 95% confidence level) with a standard deviation of 12.4. Their mean uric acid level was 442 +/- 16 (at 95% confidence level) with a standard deviation of 79.6 umol/l as compared to 291 +/- 17 (at 95% confidence level) with a standard deviation of 79.7 umol/l in the control group. The P-value was less than 0.001. CONCLUSION: That there is a significant association between high uric acid and benign positional vertigo.

1999

ADAM, PROFADAMMOHAMED.  1999.  A. M. ADAM, Neurological manifestations of Acquired Immunodeficiency Syndrome in a Large teaching hospital in Africa. Advances in Neurology. J. S. Chopra et al editors, Amsterdam Elsevier science publishers, 1999. J. S. Chopra et al editors, Amsterdam Elsevier science publishers, 1999. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
The prevalence of antibodies against Leishmania donovani in selected domestic and wild animal species in 2 villages in Sudan with active L. donovani transmission in humans was investigated. Screening of domestic animals (donkeys, cows, sheep, goats, camels and dogs) with the direct agglutination test (DAT) detected reaction rates above the cut-off titres in donkeys (68.7%), cows (21.4%) and goats (8.5%), and which were also found in wild rats (5.5%). Sera of sheep, camels and dogs had a weak agglutination reaction below the cut-off titre. Testing of the same sera by enzyme-linked immunosorbent assay (ELISA), against a lysate of L. donovani promastigotes, showed reaction rates above the cut-off optical density in cows (47.6%), goats (13.6%), and in rats (4.1%). No Leishmania parasite was isolated from spleen, liver, bone-marrow or spleen of Nile rats.
ADAM, PROFADAMMOHAMED.  1999.  A M ADAM, Hyperuricaemia as a cause of benign positional vertigo: European Journal of Neurology. 6: s85. 1999.. European Journal of Neurology. 6: s85. 1999.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
The prevalence of antibodies against Leishmania donovani in selected domestic and wild animal species in 2 villages in Sudan with active L. donovani transmission in humans was investigated. Screening of domestic animals (donkeys, cows, sheep, goats, camels and dogs) with the direct agglutination test (DAT) detected reaction rates above the cut-off titres in donkeys (68.7%), cows (21.4%) and goats (8.5%), and which were also found in wild rats (5.5%). Sera of sheep, camels and dogs had a weak agglutination reaction below the cut-off titre. Testing of the same sera by enzyme-linked immunosorbent assay (ELISA), against a lysate of L. donovani promastigotes, showed reaction rates above the cut-off optical density in cows (47.6%), goats (13.6%), and in rats (4.1%). No Leishmania parasite was isolated from spleen, liver, bone-marrow or spleen of Nile rats.

1998

ADAM, PROFADAMMOHAMED, M PROFBHATTSHRIKANTBABU.  1998.  Some effects of the rising case load of adult HIV-related disease on a hospital in Nairobi. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Jul 1;18(3):234-40.. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Jul 1;18(3):234-40.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract

Increasing numbers of HIV-infected adults in Africa need hospital care. It remains unclear what impact this has on health care services or on how hospitals respond. The aim of this study was to describe the effects of a rising case load of adult HIV-related disease by comparing results from a prospective cross-sectional study of acute adult medical admissions to a government hospital in Nairobi conducted in 1992 with results from a previous study done in 1988 and 1989 in the same hospital, using the same study design and protocol. Data on age, gender, number admitted, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared. In 1992, 374 consecutive patients were admitted in 15 24-hour periods (24.9 patients/period) compared with the 1988 to 1989 study, which enrolled 506 patients in 22 24-hour periods (23.0 patients/period). Patients' age, gender, and length of hospital stay were similar in both studies. In 1992, 39% of patients were HIV-positive compared with 19% in 1988 to 1989 (p < 10(-6)); whereas seropositive admissions rose 123% between the two periods (p < .0001), HIV-negative admissions declined 18% (p < .05). Clinical surveillance for AIDS consistently identified <40% of HIV-positive patients. Irrespective of HIV status, tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys. No change was found in the diagnoses recorded for HIV-positive patients, but in HIV-negative patients, reductions were significant in the case mix (p < .00001) and range of diagnoses (p < .001) seen in 1992. Outcome remained unchanged for HIV-positive patients with approximately 35% mortality in both surveys. Outcome significantly worsened, in relative and absolute terms, for HIV-negative patients: in 1992, mortality was 23%, compared with 13.9% in 1988 to 1989 (p < .005), with 3.5 deaths per 24-hour period in 1992 compared with 2.6 deaths per 24-hour period in 1988 to 1989 (p < .05, one-tailed). These data suggest that increasing selection for admission is taking place as demand for care increases because of HIV/AIDS. This process appears to favor HIV-positive patients at the expense of HIV-negative patients who seem to be crowded out and, once admitted, experience higher mortality rates. The true social costs of the HIV epidemic are underestimated by not including the effects on HIV-negative people. PIP: The impact of the escalating demand for HIV/AIDS-related care on hospital services in Nairobi, Kenya, was investigated in two prospective cross-sectional studies conducted at Kenyatta National Hospital. Data on age, gender, number of admissions, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared in a 1988-89 study that enrolled 506 consecutive patients in a total of 22 24-hour periods and in a 1992 study of 374 patients admitted in 15 24-hour periods. 18.7% of hospital patients in 1988-89 were HIV-positive compared with 38.5% in 1992, with a concomitant decline of 18% in the number of HIV-negative admissions. Clinical surveillance for AIDS consistently identified less than 40% of HIV-positive patients. Tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys among HIV-positive and HIV-negative patients. Diagnoses recorded for HIV-positive patients did not change over time; however, among HIV-negative patients, there was a significant narrowing in the range of diagnoses seen. Mortality among HIV-positive patients remained constant at 35% in both surveys. Among HIV-negative patients, mortality increased from 13.9% in 1988-89 to 23% in 1992 (2.6 and 3.5 deaths per 24-hour period, respectively). These findings suggest that increasing demand for hospital care by HIV-positive patients has been accompanied by deteriorating conditions for HIV-negative patients, especially an admissions selection process that favors HIV/AIDS patients. Recommended to address the worsening crisis in health care delivery are general guidelines on admission criteria that neither crowd out HIV-negative patients nor discriminate against those with HIV/AIDS.

1997

ADAM, PROFADAMMOHAMED.  1997.  A. M. ADAM, Progressive multi-system degeneration : Report of five cases. Health Line 1: 82 . Report of five cases. Health Line 1: 82 . : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract

Increasing numbers of HIV-infected adults in Africa need hospital care. It remains unclear what impact this has on health care services or on how hospitals respond. The aim of this study was to describe the effects of a rising case load of adult HIV-related disease by comparing results from a prospective cross-sectional study of acute adult medical admissions to a government hospital in Nairobi conducted in 1992 with results from a previous study done in 1988 and 1989 in the same hospital, using the same study design and protocol. Data on age, gender, number admitted, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared. In 1992, 374 consecutive patients were admitted in 15 24-hour periods (24.9 patients/period) compared with the 1988 to 1989 study, which enrolled 506 patients in 22 24-hour periods (23.0 patients/period). Patients' age, gender, and length of hospital stay were similar in both studies. In 1992, 39% of patients were HIV-positive compared with 19% in 1988 to 1989 (p < 10(-6)); whereas seropositive admissions rose 123% between the two periods (p < .0001), HIV-negative admissions declined 18% (p < .05). Clinical surveillance for AIDS consistently identified <40% of HIV-positive patients. Irrespective of HIV status, tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys. No change was found in the diagnoses recorded for HIV-positive patients, but in HIV-negative patients, reductions were significant in the case mix (p < .00001) and range of diagnoses (p < .001) seen in 1992. Outcome remained unchanged for HIV-positive patients with approximately 35% mortality in both surveys. Outcome significantly worsened, in relative and absolute terms, for HIV-negative patients: in 1992, mortality was 23%, compared with 13.9% in 1988 to 1989 (p < .005), with 3.5 deaths per 24-hour period in 1992 compared with 2.6 deaths per 24-hour period in 1988 to 1989 (p < .05, one-tailed). These data suggest that increasing selection for admission is taking place as demand for care increases because of HIV/AIDS. This process appears to favor HIV-positive patients at the expense of HIV-negative patients who seem to be crowded out and, once admitted, experience higher mortality rates. The true social costs of the HIV epidemic are underestimated by not including the effects on HIV-negative people. PIP: The impact of the escalating demand for HIV/AIDS-related care on hospital services in Nairobi, Kenya, was investigated in two prospective cross-sectional studies conducted at Kenyatta National Hospital. Data on age, gender, number of admissions, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared in a 1988-89 study that enrolled 506 consecutive patients in a total of 22 24-hour periods and in a 1992 study of 374 patients admitted in 15 24-hour periods. 18.7% of hospital patients in 1988-89 were HIV-positive compared with 38.5% in 1992, with a concomitant decline of 18% in the number of HIV-negative admissions. Clinical surveillance for AIDS consistently identified less than 40% of HIV-positive patients. Tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys among HIV-positive and HIV-negative patients. Diagnoses recorded for HIV-positive patients did not change over time; however, among HIV-negative patients, there was a significant narrowing in the range of diagnoses seen. Mortality among HIV-positive patients remained constant at 35% in both surveys. Among HIV-negative patients, mortality increased from 13.9% in 1988-89 to 23% in 1992 (2.6 and 3.5 deaths per 24-hour period, respectively). These findings suggest that increasing demand for hospital care by HIV-positive patients has been accompanied by deteriorating conditions for HIV-negative patients, especially an admissions selection process that favors HIV/AIDS patients. Recommended to address the worsening crisis in health care delivery are general guidelines on admission criteria that neither crowd out HIV-negative patients nor discriminate against those with HIV/AIDS.

1993

ADAM, PROFADAMMOHAMED.  1993.  A. M. ADAM, Subacute demyelinating polyneuropathy in twelve Human Immunodeficiency Virus seropositive patients in Nairobi, Kenya. African Journal of Neurosciences. 1: 92-92, 1993.. African Journal of Neurosciences. 1: 92-92, 1993.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract

Increasing numbers of HIV-infected adults in Africa need hospital care. It remains unclear what impact this has on health care services or on how hospitals respond. The aim of this study was to describe the effects of a rising case load of adult HIV-related disease by comparing results from a prospective cross-sectional study of acute adult medical admissions to a government hospital in Nairobi conducted in 1992 with results from a previous study done in 1988 and 1989 in the same hospital, using the same study design and protocol. Data on age, gender, number admitted, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared. In 1992, 374 consecutive patients were admitted in 15 24-hour periods (24.9 patients/period) compared with the 1988 to 1989 study, which enrolled 506 patients in 22 24-hour periods (23.0 patients/period). Patients' age, gender, and length of hospital stay were similar in both studies. In 1992, 39% of patients were HIV-positive compared with 19% in 1988 to 1989 (p < 10(-6)); whereas seropositive admissions rose 123% between the two periods (p < .0001), HIV-negative admissions declined 18% (p < .05). Clinical surveillance for AIDS consistently identified <40% of HIV-positive patients. Irrespective of HIV status, tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys. No change was found in the diagnoses recorded for HIV-positive patients, but in HIV-negative patients, reductions were significant in the case mix (p < .00001) and range of diagnoses (p < .001) seen in 1992. Outcome remained unchanged for HIV-positive patients with approximately 35% mortality in both surveys. Outcome significantly worsened, in relative and absolute terms, for HIV-negative patients: in 1992, mortality was 23%, compared with 13.9% in 1988 to 1989 (p < .005), with 3.5 deaths per 24-hour period in 1992 compared with 2.6 deaths per 24-hour period in 1988 to 1989 (p < .05, one-tailed). These data suggest that increasing selection for admission is taking place as demand for care increases because of HIV/AIDS. This process appears to favor HIV-positive patients at the expense of HIV-negative patients who seem to be crowded out and, once admitted, experience higher mortality rates. The true social costs of the HIV epidemic are underestimated by not including the effects on HIV-negative people. PIP: The impact of the escalating demand for HIV/AIDS-related care on hospital services in Nairobi, Kenya, was investigated in two prospective cross-sectional studies conducted at Kenyatta National Hospital. Data on age, gender, number of admissions, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared in a 1988-89 study that enrolled 506 consecutive patients in a total of 22 24-hour periods and in a 1992 study of 374 patients admitted in 15 24-hour periods. 18.7% of hospital patients in 1988-89 were HIV-positive compared with 38.5% in 1992, with a concomitant decline of 18% in the number of HIV-negative admissions. Clinical surveillance for AIDS consistently identified less than 40% of HIV-positive patients. Tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys among HIV-positive and HIV-negative patients. Diagnoses recorded for HIV-positive patients did not change over time; however, among HIV-negative patients, there was a significant narrowing in the range of diagnoses seen. Mortality among HIV-positive patients remained constant at 35% in both surveys. Among HIV-negative patients, mortality increased from 13.9% in 1988-89 to 23% in 1992 (2.6 and 3.5 deaths per 24-hour period, respectively). These findings suggest that increasing demand for hospital care by HIV-positive patients has been accompanied by deteriorating conditions for HIV-negative patients, especially an admissions selection process that favors HIV/AIDS patients. Recommended to address the worsening crisis in health care delivery are general guidelines on admission criteria that neither crowd out HIV-negative patients nor discriminate against those with HIV/AIDS.

ADAM, PROFADAMMOHAMED.  1993.  Disseminated histoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS): a case report.East Afr Med J. 1993 Jan;70(1):61-2. Links. East Afr Med J. 1993 Jan;70(1):61-2. Links. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
A 27 year old female with AIDS and disseminated histoplasmosis is presented. The clinical features include fever, weight loss, productive cough, splenomegaly and moderate pallor. The initial working diagnosis was pulmonary tuberculosis. The diagnosis of disseminated histoplasmosis was made terminally from bone marrow aspirate examination. Disseminated histoplasmosis with its varied clinical picture is likely to be missed in a patient with AIDS, and therefore a high index of suspicion is necessary for diagnosis. PIP: A 27-year old female from Nairobi was admitted to the medical wards of the Kenyatta National Hospital in May 1991. She presented with a 4-week history of productive cough, fever, weight loss, and night sweats. She acknowledged a history of contact with a patient known to have pulmonary tuberculosis. She has never received a blood transfusion. She was single and para 3 + 0. Examination revealed a sick patient, with moderate pallor, fever of 38 degrees Celsius, and who was wasted with moderate dehydration and oral thrush. There was no finger clubbing, lymphadenopathy, or pedal edema. Chest examination revealed bilateral basal pneumonia. The spleen was palpable 4 cm below the costal margin; the liver was not enlarged. The rest of the examination was normal. On admission, complete blood count showed a haemoglobin of 5.4 g/dl, total white cells were 12.5 x 10-9/L, with 82% polymorphonuclear cells and 18% lymphocytes, erythrocyte sedimentation rate (ESR) was 85 mm/hour, and platelet count was normal. The anemia was normocytic, normochromic, and no malaria parasites were seen. Urea and electrolytes and liver function tests were normal. Sputum showed no acid fast bacilli on Ziel-Neelson Stain. HIV-1 antibodies were positive by enzyme-linked immunosorbent assay (ELISA) and Western blot. Bone marrow aspirate revealed a hypercellular marrow with reversed M:E ration, dyserythropoesis, reticulum cell hyperplasia, plentiful golden yellow pigment, and clumps of Histoplasma capsulatum. Chest X-ray showed bilateral basal pneumonia. She was treated with antibiotics and intravenous fluids, but she remained febrile, her general condition progressively deteriorated, and she died a week after admission. Treatment for histoplasmosis had not been commenced, and no postmortem examination was carried out.

1992

ADAM, PROFADAMMOHAMED.  1992.  A.M. ADAM. Unusual form of motor neuron disease in Kenya. 10: East Afr Med J. 1992 Feb;69(2):55-7.. East Afr Med J. 1992 Feb;69(2):55-7. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
Over the period November 1978 to October 1988, 46 cases of motor neuron disease were seen at Kenyatta National Hospital, Nairobi. One case was seen in private practice. A bimodal age distribution of the disease was identified with a peak in the fourth decade of life and another peak in the sixth decade of life. The disease seen in the fourth decade of life was different as seen in other parts of the world in that the majority of patients tended to present with very rapidly progressive disease despite the primary presentation with limb symptoms and signs. Serum cholinesterase activity in five of these patients and five of the classical motor neuron disease revealed no abnormalities. This unusually rapidly progressive disease in young adults has not been described anywhere. The disease seen in older age groups and especially in patients over fifty years of age was not different from the one seen in other parts of the world.

1990

ADAM, PROFADAMMOHAMED.  1990.  R. W. Vaughan, A. M. ADAM, et. al. Major histocompatibility complex class I and II Polymorphism in chronic idiopathic demyelinating polyradiculoneuropathy. Journal of Neuroimmunology. 27: 149-153, 1990.. Journal of Neuroimmunology. 27: 149-153, 1990.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
Thirty-one chronic idiopathic demyelinating polyradiculoneuropathy (CIDP) patients have been typed for HLA-A, -B and -C antigens serologically and for HLA-DR, -DQ and -DP class II genes by RFLP analysis. Our results confirm a previously reported slight association with HLA-B8 and identify a stronger association with HLA-Cw7.

1989

ADAM, PROFADAMMOHAMED.  1989.  A. M. ADAM, P. F. Atkinson, S. M.Hall, R. A. C. Hughes, and W. A. Taylor: Chronic Experimental allergic neuritis in Lewis rats. Neuropathology and Applied Neurobiology. 15: 249-264, 1989.. Neuropathol Appl Neurobiol. 1989 May-Jun;15(3):249-64. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
An experimental chronic relapsing demyelinating neuropathy was produced by immunizing adult Lewis rats with bovine myelin in low (2.5 mg) and high (5 mg) doses, with and without Mycobacterium tuberculosis in the adjuvant. Each regime produced a similar disease course: acute severe hind limb weakness was followed by apparent recovery and then reappearance of mild neurological deficit with occasional spontaneous exacerbations. The partially recovered animals were relatively resistant to reimmunization with myelin. Immunization of four-week-old rats with myelin in complete adjuvant produced disease with a similar course. Subsequent immunization of these juvenile rats with adjuvant alone precipitated exacerbations. In the late stages, the prominent changes in peripheral nerves and nerve roots were axon loss, axonal regeneration and remyelination while inflammatory cell infiltration was confined to occasional foci. Onion bulb formation was extremely common in the dorsal root ganglia and affected in particular the nerve fibres close to the dorsal root ganglion cells. The cells forming the onion bulbs resembled the satellite cells surrounding the axon hillocks. Onion bulb formation also occurred in the portion of the ventral roots adjacent to the dorsal root ganglion but was rare elsewhere. Immunocytochemistry revealed only occasional lymphocyte infiltration but there was increased Class I and Class II MHC antigen expression throughout the peripheral nervous system. The results are relevant to the interpretation of biopsies from patients with chronic demyelinating neuropathy of possible inflammatory or autoimmune origin.
ADAM, PROFADAMMOHAMED.  1989.  A. M. ADAM. Multiple sclerosis and epidemic in Kenya. 12: East Afr Med J. 1989 Aug;66(8):503-6. East Afr Med J. 1989 Aug;66(8):503-6. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
Over a period of five years, November, 1983 to October, 1988 six cases of definite multiple sclerosis were identified at Kenyatta National Hospital. Four were females and two were males. Age of onset of disease ranged from 12 years to 30 years. Their mode of presentation, clinical features and prognosis is the same as that of multiple sclerosis seen at higher latitudes. The consequences of misdiagnosis to the patient is discussed. A theory is put forward to explain the increased numbers of MS seen recently as compared to the past decades.

1988

ADAM, PROFADAMMOHAMED.  1988.  A. M. ADAM. Co-author in Multi Center trial of azathioprine in Multiple sclerosis. Lancet. I: 179-183, 1988.. Lancet. I: 179-183, 1988.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
Over a period of five years, November, 1983 to October, 1988 six cases of definite multiple sclerosis were identified at Kenyatta National Hospital. Four were females and two were males. Age of onset of disease ranged from 12 years to 30 years. Their mode of presentation, clinical features and prognosis is the same as that of multiple sclerosis seen at higher latitudes. The consequences of misdiagnosis to the patient is discussed. A theory is put forward to explain the increased numbers of MS seen recently as compared to the past decades.

1987

ADAM, PROFADAMMOHAMED.  1987.  Adam AM, Hughes RA, Payan J, McColl I.Peripheral neuropathy and hyperthermia. Lancet. 1987 May 30;1(8544):1270-1. No abstract available.. Surgical and Radiologic Anatomy. Vol. 9 issue 3, 1987.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract

One hundred normal lateral skull radiographs were studied and those of ten patients with basilar impression attending Kenyatta Hospital, Nairobi. The mean shortest distance of the odontoid tip to McGregor's basal line was 1.2 +/- 2.28 mm below the basal line (range 6 mm below to 3 mm above basal line), in normals and 9 +/- 2.7 mm (6-14 mm) above basal line in patients. The mean basal angle was 113 degrees +/- 7 degrees (102 degrees-133 degrees) in normals and 122 degrees +/- 6 degrees (113 degrees-125 degrees) in patients. The mean nasion-basion-opisthion angle was 162 degrees +/- 4 degrees (154 degrees-169 degrees) in normals and 178 degrees +/- 5 degrees (173 degrees-185 degrees) in patients. The mean total length of clivus was 48 +/- 3.7 mm (43-56 mm) in normals and 44 +/- 6.6 (36-48 mm) in patients group. The mean median diameter of the foramen magnum was 39 +/- 5 mm (30-48 mm), atlas 21 +/- 3 mm (18-25 mm) axis 18 +/- 3 mm (14-23 mm), third cervical vertebra 16 +/- 2 mm (13-22 mm) in normals and in patients: 39 +/- 4 mm (36-45 mm), atlas 23 +/- 6 (15-30 mm) axis 19 +/- 4 mm (16-25 mm), third cervical vertebra 16 +/- 3 (14-20). There was a significant difference in the position of the odontoid tip and the nasion-basion-opisthion angle between the normal and patient groups. All the other parameters measured in this work did not differ significantly between the two groups.

ADAM, PROFADAMMOHAMED.  1987.  A. M. ADAM: Skull radiographic measurements of normals and patients with basilar impression Use of Landzert. Surgical and Radiologic Anatomy. Vol. 9 issue 3, 1987.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract

One hundred normal lateral skull radiographs were studied and those of ten patients with basilar impression attending Kenyatta Hospital, Nairobi. The mean shortest distance of the odontoid tip to McGregor's basal line was 1.2 +/- 2.28 mm below the basal line (range 6 mm below to 3 mm above basal line), in normals and 9 +/- 2.7 mm (6-14 mm) above basal line in patients. The mean basal angle was 113 degrees +/- 7 degrees (102 degrees-133 degrees) in normals and 122 degrees +/- 6 degrees (113 degrees-125 degrees) in patients. The mean nasion-basion-opisthion angle was 162 degrees +/- 4 degrees (154 degrees-169 degrees) in normals and 178 degrees +/- 5 degrees (173 degrees-185 degrees) in patients. The mean total length of clivus was 48 +/- 3.7 mm (43-56 mm) in normals and 44 +/- 6.6 (36-48 mm) in patients group. The mean median diameter of the foramen magnum was 39 +/- 5 mm (30-48 mm), atlas 21 +/- 3 mm (18-25 mm) axis 18 +/- 3 mm (14-23 mm), third cervical vertebra 16 +/- 2 mm (13-22 mm) in normals and in patients: 39 +/- 4 mm (36-45 mm), atlas 23 +/- 6 (15-30 mm) axis 19 +/- 4 mm (16-25 mm), third cervical vertebra 16 +/- 3 (14-20). There was a significant difference in the position of the odontoid tip and the nasion-basion-opisthion angle between the normal and patient groups. All the other parameters measured in this work did not differ significantly between the two groups.

ADAM, PROFADAMMOHAMED.  1987.  Adam AM, Bhatt SM, Otieno LS.Beh. Surgical and Radiologic Anatomy. Vol. 9 issue 3, 1987.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract

One hundred normal lateral skull radiographs were studied and those of ten patients with basilar impression attending Kenyatta Hospital, Nairobi. The mean shortest distance of the odontoid tip to McGregor's basal line was 1.2 +/- 2.28 mm below the basal line (range 6 mm below to 3 mm above basal line), in normals and 9 +/- 2.7 mm (6-14 mm) above basal line in patients. The mean basal angle was 113 degrees +/- 7 degrees (102 degrees-133 degrees) in normals and 122 degrees +/- 6 degrees (113 degrees-125 degrees) in patients. The mean nasion-basion-opisthion angle was 162 degrees +/- 4 degrees (154 degrees-169 degrees) in normals and 178 degrees +/- 5 degrees (173 degrees-185 degrees) in patients. The mean total length of clivus was 48 +/- 3.7 mm (43-56 mm) in normals and 44 +/- 6.6 (36-48 mm) in patients group. The mean median diameter of the foramen magnum was 39 +/- 5 mm (30-48 mm), atlas 21 +/- 3 mm (18-25 mm) axis 18 +/- 3 mm (14-23 mm), third cervical vertebra 16 +/- 2 mm (13-22 mm) in normals and in patients: 39 +/- 4 mm (36-45 mm), atlas 23 +/- 6 (15-30 mm) axis 19 +/- 4 mm (16-25 mm), third cervical vertebra 16 +/- 3 (14-20). There was a significant difference in the position of the odontoid tip and the nasion-basion-opisthion angle between the normal and patient groups. All the other parameters measured in this work did not differ significantly between the two groups.

ADAM, PROFADAMMOHAMED.  1987.  A. M. ADAM, R. C. Hughes, J. Payan, I. McColl: Peripheral neuropathy and hyperthamia Lancet I : 1270-1271, 1987.. Lancet I : 1270-1271, 1987.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
Over a period of five years, November, 1983 to October, 1988 six cases of definite multiple sclerosis were identified at Kenyatta National Hospital. Four were females and two were males. Age of onset of disease ranged from 12 years to 30 years. Their mode of presentation, clinical features and prognosis is the same as that of multiple sclerosis seen at higher latitudes. The consequences of misdiagnosis to the patient is discussed. A theory is put forward to explain the increased numbers of MS seen recently as compared to the past decades.
ADAM, PROFADAMMOHAMED.  1987.  A. M. ADAM, S. M. Bhatt. and L. S. Otieno: Behcet. East Afr Med J. 1987 Aug;64(8):558-60. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
Over a period of five years, November, 1983 to October, 1988 six cases of definite multiple sclerosis were identified at Kenyatta National Hospital. Four were females and two were males. Age of onset of disease ranged from 12 years to 30 years. Their mode of presentation, clinical features and prognosis is the same as that of multiple sclerosis seen at higher latitudes. The consequences of misdiagnosis to the patient is discussed. A theory is put forward to explain the increased numbers of MS seen recently as compared to the past decades.

1986

ADAM, PROFADAMMOHAMED.  1986.  A. M. ADAM, D. O. Orinda: Focal kinesigenic choreoathetosis preceding the development of Steele . Journal of Neurology, Neurosurgery and Psychiatry. 49: 957- 959, 1986.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract

One hundred normal lateral skull radiographs were studied and those of ten patients with basilar impression attending Kenyatta Hospital, Nairobi. The mean shortest distance of the odontoid tip to McGregor's basal line was 1.2 +/- 2.28 mm below the basal line (range 6 mm below to 3 mm above basal line), in normals and 9 +/- 2.7 mm (6-14 mm) above basal line in patients. The mean basal angle was 113 degrees +/- 7 degrees (102 degrees-133 degrees) in normals and 122 degrees +/- 6 degrees (113 degrees-125 degrees) in patients. The mean nasion-basion-opisthion angle was 162 degrees +/- 4 degrees (154 degrees-169 degrees) in normals and 178 degrees +/- 5 degrees (173 degrees-185 degrees) in patients. The mean total length of clivus was 48 +/- 3.7 mm (43-56 mm) in normals and 44 +/- 6.6 (36-48 mm) in patients group. The mean median diameter of the foramen magnum was 39 +/- 5 mm (30-48 mm), atlas 21 +/- 3 mm (18-25 mm) axis 18 +/- 3 mm (14-23 mm), third cervical vertebra 16 +/- 2 mm (13-22 mm) in normals and in patients: 39 +/- 4 mm (36-45 mm), atlas 23 +/- 6 (15-30 mm) axis 19 +/- 4 mm (16-25 mm), third cervical vertebra 16 +/- 3 (14-20). There was a significant difference in the position of the odontoid tip and the nasion-basion-opisthion angle between the normal and patient groups. All the other parameters measured in this work did not differ significantly between the two groups.

1985

Adam, A.M; Rogers, HJ, Bradbrook ID;, Rogers HJ.  1985.  High-performance liquid chromatographic assay for simultaneous estimation of aminoglutethimide and acetylaminoglutethimide in biological fluids. Abstract

A simple rapid high-performance liquid chromatographic assay for simultaneous estimation of aminoglutethimide and its acetylated metabolite acetylamidoglutethimide in plasma, saliva, and urine is described. This assay is suitable for pharmacokinetic studies in normal subjects and patients receiving other medication in addition to aminoglutethimide.

ADAM, PROFADAMMOHAMED.  1985.  A. M. ADAM, I. D. Bradbrook, H. J. Rogers: The simultaneous assay of aminoglutethimide and Its acetyl metabolite by high performance liquid chromatography. Journal of Cancer Chemotherapy and Pharmacology . 15: 176-178, 1985.. Journal of Cancer Chemotherapy and Pharmacology . 15: 176-178, 1985.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
A simple rapid high-performance liquid chromatographic assay for simultaneous estimation of aminoglutethimide and its acetylated metabolite acetylamidoglutethimide in plasma, saliva, and urine is described. This assay is suitable for pharmacokinetic studies in normal subjects and patients receiving other medication in addition to aminoglutethimide
ADAM, PROFADAMMOHAMED.  1985.  A. M. ADAM. And H. J. Rogers: Gas-liquid chromatographic assay of aminoglutethimide And high-performance liquid chromatographic assay of its acetyl metabolite in biological Fluids. Cancer Chemother Pharmacol. 1985;15(2):176-8. Cancer Chemother Pharmacol. 1985;15(2):176-8. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
A simple rapid high-performance liquid chromatographic assay for simultaneous estimation of aminoglutethimide and its acetylated metabolite acetylamidoglutethimide in plasma, saliva, and urine is described. This assay is suitable for pharmacokinetic studies in normal subjects and patients receiving other medication in addition to aminoglutethimide

1984

ADAM, PROFADAMMOHAMED.  1984.  A. M. ADAM, H. J. Rogers, S. A. Amiel, and R. D. Rubens: The effect of acetylator phenotype On the dispostion of aminoglutethimide . British Journal of Clinical Pharmacology 18:495-505, 1984.. Br J Clin Pharmacol. 1984 Oct;18(4):495-505. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
Aminoglutethimide (AG) 500 mg was administered orally to four normal volunteers and eight patients undergoing treatment for metastatic breast cancer. In each subject the acetylator phenotype was established from the monoacetyldapsone (MADDS)/dapsone (DDS) ratio. Acetylaminoglutethimide (acetylAG) rapidly appeared in the plasma and its disposition paralleled that of AG. A close relationship (P less than 0.01) was observed between the acetyl AG/AG and MADDS/DDS ratio suggesting that AG may undergo polymorphic acetylation like DDS. AG half-life was 19.5 +/- 7.7 h in seven fast acetylators of DDS and 12.6 +/- 2.3 h in five slow acetylators and its apparent metabolic clearance was significantly (P less than 0.01) related to the acetylAG/AG ratio. Over 48 h the fast acetylators excreted 7.7 +/- 4.4% of the administered AG dose in the urine as unchanged AG as compared to 12.4 +/- 2.8% in slow acetylators. A much smaller fraction of the dose was excreted as acetylAG: 3.6 +/- 1.5% by fast and 1.9 +/- 1.0% by slow acetylators respectively. After 7 days treatment with AG at an accepted clinical dose regimen to the eight patients there were significant reductions in the half-lives of AG (P less than 0.01) and acetylAG (P less than 0.01) and a trend (0.1 greater than P greater than 0.05) towards reduction of the acetylAG/AG ratio which became significant (P less than 0.05) if the one patient on a known enzyme inducer was omitted. The mean apparent volume of distribution was not significantly (P greater than 0.1) altered but the mean apparent systemic clearance of AG was increased (P less than 0.05). These changes are attributed to auto-induction of oxidative enzymes involved in AG metabolism.

1981

ADAM, PROFADAMMOHAMED.  1981.  A. M. ADAM, J Nganga and C Muthaura: The profile of N-acetylator status in healthy African volunteers. E.A.M. J. 58: 401-404, 1981.. E.A.M. J. 58: 401-404, 1981.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
Aminoglutethimide (AG) 500 mg was administered orally to four normal volunteers and eight patients undergoing treatment for metastatic breast cancer. In each subject the acetylator phenotype was established from the monoacetyldapsone (MADDS)/dapsone (DDS) ratio. Acetylaminoglutethimide (acetylAG) rapidly appeared in the plasma and its disposition paralleled that of AG. A close relationship (P less than 0.01) was observed between the acetyl AG/AG and MADDS/DDS ratio suggesting that AG may undergo polymorphic acetylation like DDS. AG half-life was 19.5 +/- 7.7 h in seven fast acetylators of DDS and 12.6 +/- 2.3 h in five slow acetylators and its apparent metabolic clearance was significantly (P less than 0.01) related to the acetylAG/AG ratio. Over 48 h the fast acetylators excreted 7.7 +/- 4.4% of the administered AG dose in the urine as unchanged AG as compared to 12.4 +/- 2.8% in slow acetylators. A much smaller fraction of the dose was excreted as acetylAG: 3.6 +/- 1.5% by fast and 1.9 +/- 1.0% by slow acetylators respectively. After 7 days treatment with AG at an accepted clinical dose regimen to the eight patients there were significant reductions in the half-lives of AG (P less than 0.01) and acetylAG (P less than 0.01) and a trend (0.1 greater than P greater than 0.05) towards reduction of the acetylAG/AG ratio which became significant (P less than 0.05) if the one patient on a known enzyme inducer was omitted. The mean apparent volume of distribution was not significantly (P greater than 0.1) altered but the mean apparent systemic clearance of AG was increased (P less than 0.05). These changes are attributed to auto-induction of oxidative enzymes involved in AG metabolism.

1973

ADAM, PROFADAMMOHAMED.  1973.  Adam AM.Relations among open-closed mindedness, social desirability and depression in students facing a critical situation involving authority. Nurs Res Conf. 1973;(9):241-76. No abstract available.. E.A.M. J. 58: 401-404, 1981.. : Gitau, W., Ogallo L. A. and Mutemi, J. N., Abstract
Aminoglutethimide (AG) 500 mg was administered orally to four normal volunteers and eight patients undergoing treatment for metastatic breast cancer. In each subject the acetylator phenotype was established from the monoacetyldapsone (MADDS)/dapsone (DDS) ratio. Acetylaminoglutethimide (acetylAG) rapidly appeared in the plasma and its disposition paralleled that of AG. A close relationship (P less than 0.01) was observed between the acetyl AG/AG and MADDS/DDS ratio suggesting that AG may undergo polymorphic acetylation like DDS. AG half-life was 19.5 +/- 7.7 h in seven fast acetylators of DDS and 12.6 +/- 2.3 h in five slow acetylators and its apparent metabolic clearance was significantly (P less than 0.01) related to the acetylAG/AG ratio. Over 48 h the fast acetylators excreted 7.7 +/- 4.4% of the administered AG dose in the urine as unchanged AG as compared to 12.4 +/- 2.8% in slow acetylators. A much smaller fraction of the dose was excreted as acetylAG: 3.6 +/- 1.5% by fast and 1.9 +/- 1.0% by slow acetylators respectively. After 7 days treatment with AG at an accepted clinical dose regimen to the eight patients there were significant reductions in the half-lives of AG (P less than 0.01) and acetylAG (P less than 0.01) and a trend (0.1 greater than P greater than 0.05) towards reduction of the acetylAG/AG ratio which became significant (P less than 0.05) if the one patient on a known enzyme inducer was omitted. The mean apparent volume of distribution was not significantly (P greater than 0.1) altered but the mean apparent systemic clearance of AG was increased (P less than 0.05). These changes are attributed to auto-induction of oxidative enzymes involved in AG metabolism.

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