The insecticide dimethoate, an organophosphate, was first introduced in 1962 for broad spectrum control of a wide range of insects including mites, flies, aphids, and plant hoppers. It inhibits AChE activity, resulting in nerve damage, which may lead to death. It is considered highly toxic to insects although dimethoate resistance has been observed. Dimethoate has both a low vapor pressure (0.247 mPa) and Henry's law constant (l.42x10(-6) Pa m3/mol), thus volatilization is not a major route of dissipation from either water or moist soils. Photolysis is considered a minor dissipation pathway. However, studies have shown that in the presence of a catalyst, the rate of photolysis does increase. The insecticide has high water solubility (39,800 mg/L) and under alkaline conditions, hydrolysis predominates representing a major degradation pathway. It has a low soil sorption capacity (Koc=20) which varies by soil type and organic matter content. Dimethoate is degraded by microbes under anaerobic conditions and bacterial species have been identified that are capable of using dimethoate as a carbon source. Although many intermediate by-products have been identified by abiotic and biotic processes, the major degradation product is omethoate. Dimethoate has been found to adversely impact many organisms. In plants, photosynthesis and growth are highly impacted, whereas birds exhibit inhibition in brain enzyme activity, thus sublethal effects are apparent. Furthermore, aquatic organisms are expected to be highly impacted via direct exposure, often displaying changes in swimming behavior. Toxicity results include inhibition in growth and more importantly, inhibition of acetylcholinesterase activity.
Entecavir can be considered in addition to TDF/FTC in HBV/HIV co-infected treatment-experienced patients failing to fully suppress their HBV viral load.
The experience of using maraviroc by our study participants shows similarity in terms of efficacy and safety to the MERIT and MOTIVATE clinical trials.
Milk alkali syndrome is a cause of hypercalcaemia, renal failure and alkalosis, and is potentially reversible if detected early and the calcium and alkali source withdrawn. It was originally described in patients ingesting large amounts of calcium containing milk for the treatment of peptic ulcer disease. We present a modern day version of the syndrome in three cases which were associated with excessive intake of Rennie, a calcium carbonate containing antacid.
Diarrhoeal diseases continue to play a major role in the lives of HIV-positive people, impacting negatively on quality of life and causing significant morbidity and mortality. Within the global HIV pandemic, there are distinct geographical variations in the aetiology of chronic diarrhoea and the strategies towards its diagnosis and management. This article aims to highlight the contemporary approach to chronic diarrhoea in HIV-positive people, expand upon the myriad agents responsible for this presentation, and explore present and future therapeutic and management options.
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