Relevant Textbooks Research Articles

Approaches Towards Professional Studies and Spare-time Activities Among Preclinical and Clinical Year Medical Students.

ObjectiveThis study aims at a recognition of the differences in the study habits, approach to teaching resources, and spare-time activities of medical students in the preclinical and clinical training periods at King Abdulaziz University (KAU) Jeddah, Saudi Arabia (SA).MethodsStudy sampling was carried out in 2017 at the Faculty of Medicine, KAU, Jeddah, SA. Students from both genders were included and further subdivided to preclinical (2nd and 3rd years) and clinical groups (4th, 5th, and 6th years). Students were asked to respond to an online questionnaire. SPSS-Version 21 (IBM Corp., Armonk, NY, US) was utilized for statistical analysis of the collected data,ResultsOf the 347/500 (response rate 69.4%) medical students, 85 (24.5%) were from the preclinical students (2nd and 3rd years), and 262 (64.5%) were enrolled in the clinical group (4th to 6th years of MBBS). The majority of students 330 (94.1%) were unmarried, only 17 of them, i.e., 4.9%, were married. Analysis of the data revealed that medical textbooks, essential versions of basic medical books, online resources, and online version of books were used more frequently by the clinical group as compared to the preclinical students. Teacher-provided lecture handouts and lecture notes taken during classes were being equally used by both groups. There was a significant difference in the opinion on the usefulness of different resources between both groups.Students faced difficulty in understanding the English language, observed more in the pre-clinical years as compared to relatively groomed clinical students. The preclinical group could not understand the teaching material in books due to a weaker understanding of the English language. Social media software was used for keeping both groups busy, but clinical students also used social media for academic purposes. More than half of the participants from the preclinical and almost one-third from the clinical years admitted that their teachers recommended them for relevant medical textbooks. An encouraging trend was observed in most preclinical group students: they found teaching modalities, such as problem-based learning (PBL) and other academic activities, as a trigger to promote book reading.ConclusionOur results show that the students in the clinical phase had a more methodical approach to professional studies and a difference in spare-time activities.

Polycystic Ovary Syndrome: Impact of Lipotoxicity on Metabolic and Reproductive Health.

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy of reproductive-aged women. Women with PCOS are at increased risk of developing several metabolic and reproductive abnormalities, including metabolic syndrome. Underlying the combined metabolic and reproductive dysfunction is lipotoxicity, defined as the ectopic deposition of lipid in nonadipose tissue where it induces oxidative stress linked with insulin resistance and inflammation. To examine what metabolic components underlie insulin resistance in PCOS, how lipotoxicity through insulin resistance impairs metabolism and reproduction in these women, and why evidence-based, individualized management is essential for their care. PubMed search was performed using relevant terms to identify journal articles related to the subject. Relevant textbook chapters were also used. Polycystic ovary syndrome by Rotterdam criteria represents a complex syndrome of heterogeneous expression with variable adverse metabolic and reproductive implications. Women with classic PCOS are often insulin resistant and at greatest risk of developing metabolic syndrome with preferential fat accumulation and weight gain. Moreover, PCOS women may also have an altered capacity to properly store fat, causing ectopic lipid accumulation in nonadipose tissue, including the ovaries, where it can perpetuate insulin resistance and inflammation and harm the oocyte. A personalized approach to managing PCOS is essential to improve the health of all PCOS women through cost-effective prevention and/or treatment, to minimize the risk of pregnancy complications in those individuals wishing to conceive, and to optimize the long-term health of PCOS women and their offspring.

Civic Education and Pupils’ Civic Dispositions in Ghana and Nigeria: A Comparative Analysis

The ultimate desire of any sensitive government is to build responsible citizens who will participate meaningfully in the developmental efforts within and outside society. The current social-political upheavals in Ghana and Nigeria underscored the need for national value orientation and reorientation for effective nation-building. The study adopted a descriptive survey to assess gender differences in pupils’ civic disposition in Ghana and Nigeria. A multistage sampling procedure was used to select 920 Basic 8 pupils from four educational circuits in Central Region, Ghana and four Local Government Education Authorities in Lagos and Ogun State in South-West, Nigeria. The research tool was tagged: Basic Education Pupils’ Questionnaire (BEPQ). The data were analysed using simple percentages, mean scores and independent t-tests at 0.05 level of significance. The results showed that there is no significant gender difference in the contribution of basic education to pupils’ civic disposition. The main conclusion drawn from this study is that the difference in the level of civic awareness of basic school pupils is due to the quality of basic education and that civic disposition increases the likelihood of a person engaging in civic activities. Government at all levels should encourage publication of relevant textbooks and research findings on basic school pupils especially in value-laden subjects like civic education.

Learning problem solving skills: Comparison of E-learning and M-learning in an introductory programming course

Problem solving skills are considered an integral part of grasping the precise concepts of the programming domain for novices in introductory programming (IP) courses. But these skills are mostly covered only in early lectures of such courses or are included in just a few early chapters of some relevant textbooks. Consequently, high failure and dropout rates are often reported in IP courses. In this study, we developed and introduced an application, called PROBSOL, which is designed to focus on, and enhance, novice programmers’ problem solving skills. Two versions of the application were developed, a web-based version and a mobile app. The applications were based on pseudo-code techniques. A survey was implemented to collect students’ feedback and semi-structured interviews were conducted to collect instructors’ opinion about the applications. Moreover, final exam grades over two semesters were compared to determine the impact of including the PROBSOL applications in the course. The results show that both students and instructors appreciated the applications and that their use supports students’ cognitive gains and engagement. Moreover, they promote students’ affective engagement in the IP course. The use of the applications improves novices’ programming understanding, logic capabilities and problem solving skills. However, students preferred the mobile version rather than the web-based version during the course. The comparison of students’ grades showed that the students’ achievements were improved and attrition rates were reduced after introducing the PROBSOL applications in the course.

Pathology of Gastrointestinal and Liver Complications of Hematopoietic Stem Cell Transplantation.

Despite advances in therapeutic and preventive measures, hematopoietic stem cell transplant recipients remain at risk for a variety of gastrointestinal and liver complications. To detail the pathologic features of the various gastrointestinal and liver complications occurring after hematopoietic stem cell transplantation in relation to their clinical context. The specific complications covered include graft-versus-host disease, mycophenolate mofetil-induced injury, timeline of infections, neutropenic enterocolitis, gastrointestinal thrombotic microangiopathy, sinusoidal obstruction syndrome, hepatic iron overload, and the controversy around cord colitis syndrome. The content of this article is based on pertinent peer-reviewed articles in PubMed, relevant textbooks, and on the authors' personal experiences. The final histopathologic diagnosis requires the integration of clinical and histologic findings and the exclusion of other competing causes of injury. Review of the clinical data, including the original disease pretransplant, the type of transplant, the timing of the gastrointestinal and/or liver manifestations, the timing of the biopsy after transplant, the presence of graft-versus-host disease in other organs and sites, the list of drug regimens, and the clinical and laboratory evidence of infection, is the key to reaching the proper histologic diagnosis.

Using Information and Communication Technology (ICT) in Secondary Schools in Nigeria: Problems and Prospects.

There is no doubt that modern life is dominated by technology. Although it has been rightly said that what is wrong with education cannot be fixed with technology, there is a universal recognition of the need to use Information and Communication Technology (ICT) in education as we enter the era of globalization where the free flow of information via satellite and the internet hold sway in the dissemination of knowledge and information. Already, Nigeria is on the wrong side of the international digital divide, as it has not made significant effort to integrate ICT into secondary school curriculum. A great deal of instructional and administrative work in secondary school in Nigeria is still carried out manually. This paper, therefore, examines the major obstacles militating against the use of ICT in secondary education in Nigeria. It identifies the high cost of computer hardware and software, weak infrastructure, lack of human skills and knowledge in ICT, and lack of relevant software appropriate and culturally suitable to Nigeria as the major stumbling block of the adoption of ICT in secondary education in Nigeria. Also, secondary schools in Nigeria are not given adequate funds to provide furniture, relevant textbooks and adequate classroom let alone being given adequate fund for high-tech equipment. At present the cost of subscribing to the Internet is too high for many of the impoverished secondary schools in Nigeria. Nigeria needs ICT to aid teaching, learning and educational management. ICT is an instrument for economic and technological development in the 21st century. Therefore, Nigeria cannot afford to be on the wrong side of the digital divide.

Contrastive Analysis: Gorontalonese and English Noun Phrase

The main objective of this study is to gain an understanding of the different and similar features of Noun Phrase in the vernacular language of Indonesia; Gorontalonese, with English. Gorontalonese is one of Indonesia's vernaculars that is rarely investigated, including the structure of Noun Phrases. Comparative study of Gorontalonese and English is also very rare. This study presents the similarities and the differences of Noun Phrase structures of Gorontalonese and English. To achieve this purpose, the structure of the Noun Phrases in both of the languages have been provided. They were taken from newspapers, relevant text-books, online journals and other data sources. The theories about Gorontalonese are very limited, because there was only handful of researchers. The findings of this study will be helpful for further researchers to develop their arguments when conducting their study in the same field. This study has supported the theory, in which the order and structure of Noun Phrases in both languages are distinct, while Gorontalonese is considered as a head-last language and English is a head-initial language. In Gorontalonese, the head of the Noun Phrase is always placed at beginning of the phrase followed by the other supporting elements, which helps in the description of the head noun. On the other hand, the Noun Phrase in English follows the supporting elements, which is placed in the beginning of the Noun Phrase, which helps in the description of the head Noun Phrase.

Pharmacology related to paediatric anaesthesia.

A child is not a mini adult. They differ from adults in terms of weight, shape, anatomical size and major body systems such as cardiovascular and respiratory as well as psychologically. Each organ system is immature in paediatric age group and their growth and development can dramatically affect the pharmacokinetics of different drugs. Children differ in every way from an adult thus mandating to have a basic knowledge of the pharmacokinetic and pharmacodynamic principles in paediatric population to prevent under dosing or toxicity of drugs. This review article aims to simplify the basic principles of pharmacokinetics and pharmacodynamics in paediatric population. It also highlights physiological and pharmacological differences between adults and paediatric age. We performed a PUBMED search for English language articles using keywords including pharmacology, child, paediatric anaesthesia. We also hand searched references from relevant review articles and text book chapters. We have also discussed drug interaction in anaesthesia, pharmacology pertaining to neuromuscular junction and effects of anaesthesia over the developing brain.

The medical costs of terror: A review of the literature.

The threat of terrorism is intensifying with a recent rise in the number of death and injuries. Nevertheless, few articles deal with the short and long-term medical costs of treating and assisting the civilian victims of terror. The objective of this article is to review the literature and describe the medical costs of supporting victims of terrorism. The authors reviewed the literature on the medical costs following terror attacks in the PubMed/Medline and Google Web sites. Relevant scientific articles, textbooks, and global reports were included in the research. There was a scarcity of data related to the medical costs of terror. The authors review the few articles that describe the hospital and outpatient expenses. The terror attacks lead to increasing length of stay and the use of supplementary medical support. The authors detail the relevant global reports and working papers on terrorism that included the cost of injury and the over-all economic impact assessment. The medical costs result from hospital and outpatient treatment support. There is a clear need to track the long-term fate of the victims of terror. The authors recommend that future research should include all sectors of the healthcare system, including the whole rehabilitation process and have a precise tracking system for all victims.

The role of Platelet-rich fibrin (PRF) in Periodontology

Periodontal disease is characterized by the loss of attached connective tissue and other periodontal tissues. Growth factors secreted from platelets promote tissue formation and wound healing. Platelet-rich fibrin (PRF) is composed of fibrin, platelets leukocytes and other cells that have a great role in different wounds healing processes. The aim of the current review was to highlight the role and mechanism of PRF usage in periodontal regeneration for periodontally affected teeth. A systematic search was made using an online database Medline to locate relevant peer-reviewed articles and textbooks published between 1990 to 2017 in English. Specific search keywords were used to obtain all possible articles concerned with the subject. We found 25 articles meeting our criteria and 20 of them were specifically related to the subject were selected for final analysis. Few studies have focused on the role of PRF in periodontology especially for periodontal regeneration and most of them were trials. PRF is considered a simple and inexpensive way for successful periodontal regeneration.

Undisclosed conflicts of interest in German-language textbooks of anesthesiology, critical care, and emergency medicine

BackgroundMedical textbooks are important throughout postgraduate internship, residency and fellowship programs but authors’ conflicts of interest (COI) are rarely disclosed. In anesthesiology, two high-profile cases of research fraud/unethical publishing have previously been identified. This study evaluated whether anesthesiology textbooks in German include controversial recommendations on hydroxyethyl starch (HES) and whether authors had undisclosed COI. MethodsForty-five anesthesiology, critical care, and emergency medicine electronic textbooks (January 2015–August 2017) were identified on the websites of German, Austrian, and Swiss publishers. Six textbooks were excluded (irrelevant content; compilation of peer-reviewed articles). Content on HES (‘Kolloid’, ‘Hydroxyäthylstärke’, ‘Hydroxyethylstärke’, ‘HES’, ‘HAES’) and COI (‘Interessenkonflikt‘) was electronically searched; subject lists were manually searched. Recommendations on HES were analyzed in the context of indications/warnings/international guidelines. Potential COI for authors of controversial recommendations were searched on PubMed/EMBASE (January 2016–May 2018). ResultsCOI statements were absent in 38/39 textbooks (present for 1/553 authors; 0.2 %). Twelve textbooks did not discuss HES for volume resuscitation. HES was recommended in 13 textbooks; many recommendations were controversial (10/39 textbooks, 26 %; 25/553 authors, 5 %). Journal COI statements were available for 18/25 authors; 7 authors had financial/other COI, including 4/18 (22 %) with ties to HES manufacturers. ConclusionsRecommendations on volume resuscitation with HES are highly controversial in German-language electronic textbooks; about one-quarter of relevant textbooks are inconsistent with regulatory authority or international guideline criteria. Undisclosed potential COI of textbook authors making controversial recommendations of HES were frequent, linking roughly one in five authors to the HES-producing industry. Against this background, COI statements must become part of standard textbook publication ethics.

Key features of the nephrogenic zone in the fetal human kidney-hardly known but relevant for the detection of first traces impairing nephrogenesis.

In healthy newborn babies, nephrogenesis proceeds unnoticed until birth. With start of the perinatal period, morphogenetic activity in the renal outer cortex consisting of an inner maturation zone and an outer nephrogenic zone is downregulated by unknown signals. One of the results is that the entire nephrogenic zone as well as the contained progenitor cells and niches disintegrate. In contrast, a too early inactivation of the nephrogenic zone takes place in the kidneys of preterm and low birth weight babies. Although they are born in a period of active nephrogenesis, pathological findings show that they evolve to a high incidence oligonephropathy. However, very few data exist about cell biological changes that are evoked by harming, further most of causing molecules, exact cell targets, and related molecular pathways are not identified. Although impairment of nephrogenesis was the subject of research in animal species, there is only limited information available pertaining to the pathological traces in the nephrogenic zone of the human fetal kidney. In this situation, the lack of basic morphological data is particularly aggravating. Surprisingly, there are not even ultrastructural investigations available. Since concrete information is lacking also in relevant textbooks, the current contribution likes to present key features of the nephrogenic zone in the fetal human kidney. Simultaneously, it is a call to explore systematically a hardly known area.

THE COMPARISON OF UNESCAP'S CHARACTERISTICS OF GOOD GOVERNANCE AND ISLAMIC CHARACTERISTICS OF GOVERNANCE FOR PUBLIC SERVICES REFORM IN INDONESIA

Good governance is a global and sustainable issue. International institutions offer the concept of good governance for bureaucracy and public services reform to various countries. Indonesia is one of the countries that have implemented and developed the concept of good governance.However, the establishment of such structures and regulations, is not a guarantee for improving the effectiveness of good governance implementation. In connection with the above mentioned issues, it is deemed necessary to conduct researc. The reasons of consideration that the majority of Indonesia's population adheres to Islam as great potential toward Islamic governance. This study is conducted to answer the problem formulation, what is similarities and differences between UNESCAP's Characteristics of Good Governance and Islamic Characteristics of Governance? The study used library research method, based on Holy Qur'an and Hadith Nabawi, relevant textbooks and websites, with direct observation in the field. Collecting and analyzing data based on descriptive qualitative method. This study was conducted in Indonesia, in the first half of 2018. Concluded, Islamic characteristics of governance consist of: shari’ah, ‘adl, ta’awun, bayan, itqan & tawazun, shura, at-tabayun and mas’uliyah. There are similarities of categories, and differences the annotation of categories between UNESCAP's characteristics of governance and Islamic Characteristics of Governance. As an implication then government officials must apply Islamic governance and ethics for public service reform in Indonesia.

Textbooks revealing the development of a concept—the case of the number line in the analytic geometry (1708–1829)

The purpose of this paper is to use historical textbooks to explore the number line, a mathematical object common to our time, contextualizing its use during its initial development period in the seventeenth century until its current use as in the nineteenth century. Relevant analytic geometry textbooks are explored, mainly from France and from Germany of that time, to understand when and how this notion was used. Additionally, pertinent entries from encyclopedias of that time are used to contrast with what was not sufficiently explained in the aforementioned textbooks, until, finally, we can identify this object as it is currently characterized. I analyze how the negative numbers were used to constitute the number line and survey several number line diagrams, which were sometimes similar, but most often quite different from each other. The intention is to understand the historical contexts that configure the emergence and development of the notion of the number line.

Medicalizing tensions in counselor education?

The aim of this paper is to summarize research into the tensions associated with medicalization in graduate counselor education in a primarily Canadian context. Counselor education, until recently, has largely embraced pluralistic traditions of practice that are potentially at odds with a medicalized approach to practice. Medicalization here refers to a diagnostic and treatment focus most commonly associated with use of DSM5 diagnostic procedures and evidence-based treatment. Tensions, in this study, refer to competing accountabilities encountered in reconciling medicalized with other approaches to practice. Following a review of relevant textbooks, graduate program websites and curricula, Master’s-level counseling students, counselor educators, and profession leaders were surveyed and/or interviewed regarding how medicalization influenced counselor education, and for how they responded to its influence. Data across all sources were analyzed using the mapping procedures of Situational Analysis, a method useful in analyzing contested phenomena and processes. We report our findings as navigable, negotiable, and dilemmatic tensions shaping the experiences of students and other stakeholders in counselor education. We recommend ways to enable students and educators to navigate and negotiate potential dilemmas associated with medicalizing influences on counselor education. We close by discussing the implications of our findings with respect to practice and training in the UK context.

Pharmaceutical employees compensation plan-A case study on their satisfaction

This study examines the present salary system, incentives and reward provided in the pharmaceutical company. If the employers fails to fulfill the salary structure company the performance level will not improve as expected by the higher authorities. The data utilized in this study were obtained from both primary and secondary sources. While the primary data were got from the company employee with the help of the questionnaire prepared by consulting with the HR professionals. Secondary data were obtained from relevant textbooks, journals and government documents. The findings of the study indicate the satisfaction level o the employees about the salary structure offered.

Security Implications of Free Movement for Countries of the Economic Community of West African States

This paper examines the security implications of free movement of people in the member countries of the Economic Community of West African States (ECOWAS). In doing so, it explores the nature and dynamics of the security challenges which the Protocol on free movement has generated for the member states of this sub-regional organisation, and how these fed into and intensified the security problems bedeviling the sub-region over the past decades. The focus on the Protocol, which was adopted in 1979, is informed by the fact that it has, in the last couple of decades, been exploited by criminals to perpetrate all manners of nefarious activities, notably human trafficking, drug trafficking, small arms and light weapons trafficking, smuggling of contraband goods, cross-border armed robbery and banditry, kidnapping for ransom and terrorist activities, all of which constitute serious security concerns to the sub[1]region. It is important, for example, to note that the relative ease with which trafficking and terror gangs traverse the sub-region and carry out targeted attacks on innocent people as well as public and private facilities is directly linked to the provisions of the Protocol which, among other things, abolished requirements for visas and entry permit for Community citizens travelling within the region. The study found out that criminals travel within the region without documents as stipulated by the Protocol and illegally smuggle prohibited goods across national boundaries. It also revealed that ECOWAS does not have a computer database and this makes it difficult for border officials to document the identities of travelers, making it easier for people to commit crimes without being identified. The study discovered that this illegal movement has not only impacted negatively on human security but has also impeded intra regional efforts at ensuring security and sustainable development within the sub-region. The paper recommends that a special regular joint-border patrol should be put in place as a way of strengthening the existing collective regional security framework in West Africa. Both primary and secondary data were used for this study. Primary data were sourced through the conduct of in-depth interviews while secondary data were obtained from relevant textbooks and journals. The analysis of data generated was essentially qualitative, using descriptive and content analyses. The theoretical framework adopted for analysing this work is critical theory, which gives primacy to non-state national and transnational actors rather than making the state the primary referent of security. This theory offers more convincing explanations on how non-state criminal groups have taken advantage of the free movement Protocol of ECOWAS to perpetrate terrorism and trafficking of people and goods, with all their negative security implications.

Xi huang pills enhance the tumor treatment efficacy when combined with chemotherapy: A meta-analysis and systematic review.

To evaluate Xi huang pill combined with chemotherapy for tumor treatment in a meta-analysis. We searched PubMed, Excerpta Medica Database, the Cochrane Library, the China National Knowledge Infrastructure, and the Weipu database and Wanfang Databases for eligible studies. We manually searched for printed journals and relevant textbooks. Statistical analyses were performed with Review Manager 5.3 (Cochrane Community, London, United Kingdom) and STATA 12.0 software packages. Fifteen studies were included. Xi huang pill combined with chemotherapy could enhance response (risk ratio [RR] =1.35, 95% confidence interval [95% CI]: 1.14-1.60, P < 0.0004), improve disease control (RR = 1.13, 95% CI: 1.05-1.21, P = 0.0006), prolong overall survival (hazard ratio = 0.80, 95% CI: 0.08-0.98, P = 0.03), improve patient quality of life (RR = 1.35, 95% CI: 1.10-1.67, P < 0.004), reduce 2-4° leukocyte (white blood cell) and platelet count due to chemotherapy (pooled RR = 0.42, 95% CI = 0.30-0.60, pooled RR = 0.42, 95% CI = 0.25-0.72, respectively). Xi huang pill combined with chemotherapy can enhance the short-term efficacy and overall survival, alleviate treatment-induced side effects, and serve as a suitable regimen for the treatment of patients with tumors. However, the findings of the current study require validation in further high-quality trials.

Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment.

Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. It is often quite concerning to patients and their partners, and sometimes frustrates couples' attempts to conceive. This article aims to review the pathophysiology of DE and anejaculation (AE), to explore our current understanding of the diagnosis, and to present the treatment options for this condition. Electronic databases were searched from 1966 to October 2017, including PubMed (MEDLINE) and Embase. We combined “delayed ejaculation,” “retarded ejaculation,” “inhibited ejaculation,” or “anejaculation” as Medical Subject Headings (MeSH) terms or keywords with “epidemiology,” “etiology,” “pathophysiology,” “clinical assessment,” “diagnosis,” or “treatment.” Relevant sexual medicine textbooks were searched as well. The literature suggests that the pathophysiology of DE/AE is multifactorial, including both organic and psychosocial factors. Despite the many publications on this condition, the exact pathogenesis is not yet known. There is currently no single gold standard for diagnosing DE/AE, as operationalized criteria do not exist. The history is the key to the diagnosis. Treatment should be cause-specific. There are many approaches to treatment planning, including various psychological interventions, pharmacotherapy, and specific treatments for infertile men. An approved form of drug therapy does not exist. A number of approaches can be employed for infertile men, including the collection of nocturnal emissions, prostatic massage, prostatic urethra catheterization, penile vibratory stimulation, probe electroejaculation, sperm retrieval by aspiration from either the vas deferens or the epididymis, and testicular sperm extraction.

Approach to acute kidney injury in HIV-infected patients in South Africa.

BackgroundHIV-infected patients have an increased risk of renal disease. Current first-line antiretroviral therapy contains tenofovir disoproxil fumarate (TDF), which has nephrotoxic potential, characterised by proximal tubular cell injury. This may result in acute kidney injury, chronic kidney disease or partial or complete Fanconi syndrome.ObjectivesWe reviewed the existing literature on acute kidney injury and TDF-associated nephrotoxicity with the aim of providing an approach to diagnosis and management, which is relevant to a general medical practitioner.MethodsWe performed a broad literature search of biomedical databases including PubMed and ScienceDirect. Our search terms included, but were not limited to, ‘tenofovir’, ‘nephrotoxicity’, ‘HIV’, ‘acute kidney injury’ and ‘renal tubular acidosis’.Our aim was not to generate a systematic literature review with weighted evidence, but rather to provide a review of best practice from a variety of sources. Where published studies were not available from the above databases, we relied on relevant textbooks and professional guidelines.ResultsPotential nephrotoxicity is not an impediment to the widespread use of TDF in treating HIV infection, because most patients will tolerate the medication well. However, patients with advanced disease, low body weight, advanced age, pre-existing kidney disease and concomitant use of other nephrotoxic medications are at increased risk of adverse renal events and may develop severe complications if not appropriately managed. These risk factors are unfortunately common in patients initiating antiretroviral therapy in South Africa.ConclusionPrevention of renal damage by means of careful screening and monitoring of high-risk patients is of paramount importance. Increased awareness of this problem and knowledge of how to manage kidney disease should be emphasised for general medical practitioners who work with HIV-infected patients.