This study aims to determine if the psychological trauma (stress, anxiety, and depression) experienced by the HIV serodiscordant pregnant patient because of her retroviral status in the index pregnancy has any effect on the birth weight of her baby. Dedicated doctors, midwives, nurses, and laboratory scientists working at Imo State University Teaching Hospital, Orlu, Imo State, were recruited as facilitators for the study. Consenting HIV serodiscordant pregnant women who met the inclusion criteria were interviewed by a psychologist recruited for the study during the third trimester of their pregnancy using a prepared questionnaire containing questions relevant to the study. The women were grouped into two groups, A and B. Group A was for those women that are confirmed to be HIV serodiscordant but did not experience emotional distress (stress, anxiety, and depression) in the index pregnancy because of their serodiscordance, while group B was for those HIV serodiscordant patients who experienced emotional distress in the index pregnancy because of their serodiscordance. Those with emotional distress because of their serodiscordance were further classified into the stressed group, anxiety group, and those with frank depression using the DAS scale (Depression, Anxiety, and Stress). At delivery, the birth weights from the two groups were recorded in the notebook provided by the researcher for the study. Using the Statistical Package for Social Sciences (SPSS) for data analysis, the study revealed the statistical difference between the birth weights of babies delivered by mothers that had emotional distress (stress, anxiety and depression) in pregnancy and mothers that did not have emotional distress in pregnancy, and significant difference between the mean birth weights of the neonates in group A and group B was identified as well.

Targeted DNA methylation of the JSRV LTR suppresses Env-driven pulmonary adenocarcinoma: Epigenetic silencing as a potential veterinary therapeutic strategy.

<p>Introduction: Human immunodeficiency virus (HIV) has emerged as a cause of morbidity and mortality worldwide. HIV positive patients commonly suffer from various hematological abnormalities of all lineages, which are diverse and can occur at any stage of infection. Hematologists should be aware of bone marrow changes associated with retroviral disease (RVD) so that appropriate and prompt treatment can be given to these patients. </p><p> Methods: The study was carried out in the department of clinical pathology of a tertiary care hospital for the duration of 1 year, from January 2023 to December 2023. Out of a total of 90 bone marrow received, 20 patients were retrospectively studied for morphological changes in bone marrow who were HIV positive on ELISA and confirmed on Western blot.</p><p> Results: The age range of the study population was 22 to 60 years. There was a predominance of male participants (85%). The predominant hematological abnormality on peripheral smear was anemia (90%). Microcytic hypochromic type of anemia was the most frequently observed finding. The bone marrow was hypercellular (70%) in most cases. Erythroid hyperplasia was seen in 14 cases. Erythroid normoblastic maturation was predominant (70%). Dysplasia was noted in 12 cases out of 20 cases, with isolated erythroid dysplasia (25%) being the most common. Reactive changes associated with HIV were also observed. In addition, we also reported one case of autoimmune hemolytic anemia and another of visceral leishmaniasis, both associated with HIV infection.</p><p> Conclusion: A bone marrow study, along with a detailed approach to all relevant possible contributors and clinical history, should be considered for the diagnostic approach in documenting peripheral hematological abnormalities, opportunistic infections, and malignancies in HIV positive patients.</p>.

Seborrhoeic dermatitis is a chronic debilitating dermatosis manifesting as recurrent erythematous macules and plaques with a greasy scaly appearance on sebum-rich areas of the skin; especially the face. It occurs worldwide; peaking at puberty and infancy. The dermatosis has also been associated with chronic conditions like Parkinson’s disease and Retroviral disease. Due to its chronicity, this dermatosis often creates great concerns for affected persons, thus impacting on their quality of life. There is paucity of data among people with skin of colour characterizing the clinical patterns of this dermatosis and its impact on affected subjects. This study aims to describe the clinical patterns of Seborrhoeic dermatitis and evaluate its impact on quality of life among subjects. This was a descriptive cross-sectional study carried out among consenting adult subjects with Seborrhoeic dermatitis who were recruited consecutively from the dermatology clinic of University of Benin Teaching Hospital. Clinical examination was carried out to describe the patterns of the dermatosis. The subjects also had anthropometric measurements taken and Quality of life was assessed using the Dermatology Life Quality Index (DLQI) questionnaire. The demographic and clinical characteristics of the study population were examined. The mean age was 34.0 ± 13.9 years, with an equal gender distribution (male-to-female ratio, 1:1.2). All lesions exhibited scaling, with 26(83.3%) subjects experiencing pruritus. Lesion were morphologically characterized by hypopigmentation (58.1%) and erythema (51.6%), presenting as macules and papules (80.6%) primarily affecting the face and scalp. Concurrently, 22.6% and 19.4% of subjects had obesity and hypertension, respectively. Quality of life assessments revealed significant impairment, with a mean DLQI score of 8.74 ± 5.70. The greatest impact on quality of life was recorded in the "symptoms and feelings" domain. A positive correlation between increasing age and impact on this domain was observed (r=0.39, p = 0.039).

INTRODUCTION/BACKGROUNDThyroid function test (TFT) abnormalities in retroviral disease (RVD) are well documented, ranging from isolated low fT4 levels to overt hypothyroidism. However, careful evaluation of TFTs is essential as it presents a diagnostic challenge. CASEThis is a case of a 28-year-old male with hypertension and end-stage kidney disease on peritoneal dialysis. He was diagnosed with vertical transmission of HIV since childhood, and the viral load is suppressed by regular antiretroviral therapy; oral lamivudine 500 mg daily, oral efavirenz 600 mg daily, and oral abacavir 600 mg daily. He was referred for abnormal TFT: fT4 7.88 (9.01–19.05 pmol/L), TSH 1.99 (0.35–4.94 mIU/L). TFT was done for a pre-cadaveric renal transplant workup. Clinically, he is euthyroid without any palpable goiter. He denied consuming biotin-containing supplementation. The results of the serial TFT showed a similar pattern. The pituitary hormonal workup excludes a central cause. Total T4 was normal at 68.1 (66–181 nmol/L). TSH assay interference was subsequently evaluated. Of the three different analyzers used (Lab A, B, and C), Lab A analyzer displayed normal TFT results: TSH 1.93 (0.4–4 mIU/L), fT4 10.8 (10–26 pmol/L), while the other labs showed low fT4 and normal TSH. Macro-TSH, heterophile antibody, and rheumatoid factor interference run by Lab B were negative. CONCLUSIONA low fT4 level combined with a normal TSH level may be affected by multiple factors, such as antiretroviral therapy (ART) and assay interference, as seen in this patient's case. Due to limited resources and testing capacity, the specific antibody or causative agent cannot be identified. It is essential to take the necessary actions to eliminate other causes for the discordant TFT results and to prevent unnecessary thyroxine replacement. For this patient, any future TFT testing should be conducted at Lab A to rule out any potential assay interference with upcoming samples, if needed.

BackgroundSelf-harm, as intentionally hurting oneself, has grown to be a major public health issue in recent years. Such act can be carried out without the deliberate intent to kill oneself. This study aimed to profile self-harming patients admitted to a South African hospital.MethodsA cross-sectional design based on retrospective record review of self-harming patients between June 2022 and May 2023 at Dr George Mukhari Academic Hospital (DGMAH).ResultsOut of 223 records retrieved, the participants’ mean age was 24.6 years. Their ages ranged from 13 years to 75 years. The majority were single (n = 198; 89.56%), unemployed (n = 103; 46.19%) and did not have any comorbidities (n = 171; 76.68%). Human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) (n = 19; 8.52%) was the most common comorbidity. Overdose and poisoning (n = 220; 98.65%) are common methods utilised, and with high rate happened in October (n = 39; 17.65%). The most common reasons were interpersonal, including family conflict (69; 30.80%) and relationship issues (n = 61; 27.23%). Age was linked with sex, comorbidities, method and reason (p = 0.008). Conflict was linked with females and relationship problems with males (p = 0.008).ConclusionSelf-harm is common among single females under 40 years, often because of romantic and family conflicts. Age and sex influence risk, with younger females using over-the-counter medication, older females with retroviral diseases using prescriptions. Further research, including prevention, may assist in the management of the behavior.ContributionAn alarming and growing public health risk has been raised.

Understanding the intricate interplay between hormonal contraceptive utilization and the unique healthcare needs of women with retroviral disease on antiretroviral therapy is of paramount importance in ensuring effective family planning strategies and optimal health outcomes. This research examined the patterns of hormonal contraceptive usage among this specific demographic within the setting of a referral hospital in Kenya, shedding light on the factors influencing choice, preferences, and the broader implications for reproductive health. A cross-sectional retrospective study design was employed for this study, conducted at the Comprehensive Care Centre of Nakuru County Referral and Teaching Hospital in Kenya. The Taro Yamane formula determined the sample size, yielding 226 participants. Data was collected using a structured questionnaire validated through a pilot study, employing random sampling. Data was protected, monitored, and analyzed using descriptive statistics and the Chi-squared test, with ethical considerations in place. The sociodemographic characteristics of participants were analyzed. Most were aged 35-39, married, self-employed, and had at least secondary education. Public hospitals were the primary source of contraceptives. Pregnancy prevention was the main reason for hormonal contraceptive use. Injectable contraceptives were preferred (37%), followed by implants (31.9%) and IUDs (15.7%). Notable association between employment status and use of specific contraceptives (P-value=0.007175) was found to be statistically significant. Further, there was a statistically significant association between ease of availability of implants (P-value=0.02), ease of use of injectables (P-value=0.05), and fewer side effects of IUDs (P-value=0.00) and their preference. We recommend emphasizing postpartum contraception services, ensuring contraceptive availability in public hospitals, promoting long-acting reversible contraceptives, and providing tailored counseling and education to empower women's informed choices.

Contraception among women living with HIV is crucial not only to avoid unplanned pregnancies but also to minimize transmission of the virus to either partner or unborn child. Uptake of contraception by such cohort of women is however governed by multiple factors. This study thus aimed to examine the knowledge, attitudes, and barriers influencing hormonal contraceptive utilization among women living with HIV/AIDS who are on antiretroviral therapy. The study was a cross-sectional retrospective study carried out at the Comprehensive Care Centre (CCC) at NCRTH from March 2023 to April 2023. Taro Yamane formula was used to determine the sample size. Simple random sampling was our method of sample determination. The use of structured questionnaires with close-ended questions was our method of data collection. Data analysis was conducted using a statistical package for social sciences (SPSS) software version 26. Descriptive data was presented using frequency tables, bar graphs, and percentages. The descriptive statistics included mode, median, and mean while the inferential statistics were done using chi-square analysis. P&lt;0.05 was considered significant. Healthcare providers were the main source (67.2%) of hormonal contraceptive knowledge followed by social media (14%) emerged as an influential platform, while traditional media had a limited impact. Peer and partner influence played roles, with 61.06% making independent contraceptive decisions. Partners (30.09%) and healthcare providers (21.68%) also influenced decisions. The majority (82%) used contraceptives to avoid unwanted pregnancies, while 74.77% valued their benefits over side effects. Bleeding was the most common hormonal contraceptive side effect across the different methods, particularly in injectables (45.23%). Injectable, implant and IUD users reported amenorrhea. Weight-related effects varied by method. Mood swings were prevalent, especially in implant users (14.86%). Chi-squared analysis indicated associations between methods and specific side effects; with injectables and mini pills having the highest and lowest frequency of associated side effects respectively. Participants' religious values (75%), affordability (70%), and lack of belief in contraceptive-related infertility (69%) were influential in contraceptive use decisions. No religion was found to outright deny contraceptive use. The factors influencing knowledge acquisition and decision-making on hormonal contraceptives among women underscore the need for effective communication strategies, diversified information dissemination, and individualized healthcare guidance to empower women in making informed reproductive health choices

Accidentally swallowed dentures can lead to severe complications in the gastrointestinal tract- especially the oesophagus. Therefore, an early diagnosis and institution of an effective therapeutic approach are of utmost importance. Though the primary treatment of an impacted foreign body in the oesophagus is an endoscopic removal, a primary surgical treatment is advised for dentures with sharp hooks especially due to the increased complication rates. Here in we are report a case of accidentally swallowed denture with delayed presentation in a female patient with retroviral disease. Attempts at endoscopic removal was not successful and transhiatal oesophagotomy was done by cardiothoracic unit. There was suspected oesophago-bronchial fistula as patient developed cough which necessitated percutaneous endoscopic gastrostomy tube placement. This case highlights the importance of an early and preferred treatment in the form of a controlled surgical intervention as compared to an endoscopic extraction for patients with impacted dentures with sharp hooks.

CMR unravels a complex left ventricular pseudo-aneurysm as the cause of ventricular tachycardia in a patient with retroviral disease an syphilis

The complex dynamics of protein expression in plasma during hyperacute HIV-1 infection and its relation to acute retroviral syndrome, viral control, and disease progression are largely unknown. Here, we quantify 1293 blood plasma proteins from 157 longitudinally linked plasma samples collected before, during, and after hyperacute HIV-1 infection of 54 participants from four sub-Saharan African countries. Six distinct longitudinal expression profiles are identified, of which four demonstrate a consistent decrease in protein levels following HIV-1 infection. Proteins involved in inflammatory responses, immune regulation, and cell motility are significantly altered during the transition from pre-infection to one month post-infection. Specifically, decreased ZYX and SCGB1A1 levels, and increased LILRA3 levels are associated with increased risk of acute retroviral syndrome; increased NAPA and RAN levels, and decreased ITIH4 levels with viral control; and increased HPN, PRKCB, and ITGB3 levels with increased risk of disease progression. Overall, this study provides insight into early host responses in hyperacute HIV-1 infection, and present potential biomarkers and mechanisms linked to HIV-1 disease progression and viral load.

Human DDX49 is an emerging target in cancer progression and retroviral diseases through its essential roles in nucleolar RNA processing. Here, we identify nuclease activity of human DDX49, which requires active site aspartate residues within a conserved region of metazoan DDX49s that is absent from yeast and archaeal DDX49 homologues. We provide evidence that DDX49 nuclease activity is facilitated by its helicase activity. Using CRISPR-Cas9 genetic editing, we show that a heterozygous (DDX49+/−) U2OS cell line is defective at cell migration, a phenotype supporting the association of DDX49 with cancer cell invasiveness. Measurement of RNAs in DDX49+/− indicates that DDX49 is required to sustain levels of 5.8S rRNA.

Introduction Ritonavir is a commonly prescribed protease inhibitor for human immune deficiency (HIV) treatment. It is a potent inhibitor of hepatic cytochrome P450 (CYP450) enzyme. Interaction between ritonavir and corticosteroids induces iatrogenic Cushing’s Syndrome. We share a case of an acute onset of Cushing’s Syndrome in a young female with HIV. Case A 25-year-old female with stable retroviral disease on ritonavir along with tenofovir, emtricitabine and atazanavir developed Cushing’s syndrome within 2 weeks of receiving injectable hydrocortisone from a general practitioner's clinic for skin itchiness. Facial swelling, hirsutism, abdominal striae, body acne, weight gain and proximal myopathy were noted. Early morning cortisol was 28 nmol/L and the 24-hour urine-free cortisol was 45 nmol/day. She was diagnosed with iatrogenic Cushing’s syndrome with suppression of the hypothalamic-pituitary adrenal (HPA) axis secondary to drug interaction between ritonavir and intravenous hydrocortisone. She was started on oral hydrocortisone 20 mg in the morning and 10 mg in the evening. Throughout her hospitalization and upon discharge, she remained clinically well. She is planning for a Synacthen test on an outpatient basis to reassess her HPA axis. Conclusion Drug interaction between ritonavir and corticosteroids may result in increased levels of plasma corticosteroids, potentiated by the CYP450 metabolism which prolongs the half-life of hydrocortisone, that can lead to Cushing’s syndrome. This highlights the importance of a thorough review of the patient’s medications to prevent drug-todrug interaction. If corticosteroid administration cannot be avoided, the patient needs to be monitored for symptoms of Cushing’s syndrome.

Mental disorders account for nine percent of the overall global burden of disease and are among the top ten leading causes of disability. Mental illness and tuberculosis share risk factors including poverty, overcrowding, stigma, poor nutrition, substance use and retro-viral disease co-infection. Presence of mental illness in tuberculosis delays health-seeking, affects drug adherence, increases cost of treatment, prolongs disease duration, lowers quality of life, and increases mortality. Early diagnosis, linkage, and treatment of psychiatric morbidity among patients with tuberculosis would improve outcomes for both. This study thus aimed to determine the prevalence and factors associated with psychiatric morbidity among patients on treatment for tuberculosis at a low- middle- income country. A cross-sectional study carried out at the tuberculosis clinic at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. 367 participants on TB treatment were interviewed using Mini-International Neuropsychiatric Interview (MINI) tool. The key outcome was presence of psychiatric illness. Pearson's Chi-square and logistic regression were used to assess relationships at bivariate and multivariate level respectively. Majority of the respondents were male (61.3%) and overall median age was 33 years. About half of participants (48.5%) had at least one psychiatric illness. Common disorders were alcohol use disorder (30.3%), depression (23.4%), substance use disorder (12.8%) and suicidality (8.2%). Odds of 'any psychiatric illness' were increased by being male (aOR = 1.92; P = 0.04), being separated or divorced (aOR = 6.86; P = 0.002), using alcohol (aOR = 3.2; P<0.001), having been previously treated for tuberculosis (aOR = 2.76; P = 0.01), having other medical comorbidities (aOR = 4.2; P = 0.004) and family history of mental illness (aOR = 2.4; P = 0.049). Almost half of the patients on treatment for tuberculosis had at least one psychiatric illness. Introduction of protocols for screening for mental illness and integration of mental health services with tuberculosis care would aid prompt diagnosis, referral, and quality of care.

Human immunodeficiency virus, a retrovirus, causes AIDS, a chronic immune system disease. HIV interferes with the ability of our body to combat disease and infection by weakening our immune system. An essential enzyme necessary for HIV replication is reverse transcriptase (RT). RT inhibitors (RTIs) are a class of antiretroviral drugs that target HIV's RT enzyme, blocking its ability to convert viral RNA into DNA. The RT-1 enzyme has been found to be inhibited by imidazole. It attaches to the RT-1 enzyme's active site and prevents it from performing its usual activity. As a result, viral replication is inhibited, which can eventually aid in slowing the course of HIV and other retroviral diseases. A computational tool allows researchers to simulate and analyze the drug's behaviour in a virtual environment, providing valuable insights into its pharmacological properties, efficacy, and safety. QSAR modelling uses machine learning methods to create predictive models from datasets of chemical substances and the accompanying biological activity. Here, a comparative analysis of the model performances by four different algorithms for the Imidazole scaffold are reported. The algorithms of Support Vector Regression (SVR), Random Forest Regression (RFR), Decision Tree Regression (DTR) and Hist Gradient Boosting Regression (HGBR) have given promising results with the R2 value of 0.905, 0.993, 0.688 and 0.921 respectively for the train sets and for the test set 0.843, 0.977, 0.567 and 0.880. The best performed RFR model have been validated using developed RFR codes for randomly selected compounds and it shows the error percentage of about 0.151% only. From the R2 values, it is observed that the RFR and HGBR models show a better fit with the variables compared to the other models thereby making them the potential models for predicting the activity of novel anti-viral compounds.

Background: Human papillomavirus (HPV) infection is associated with oropharyngeal and anogenital cancers in men and women. Approximately 90% of all cervical cancers are attributed to high-risk HPV infections, and 60% of squamous cell carcinomas (SCC) of the vulva, vagina, anus, and penis are due to HPV infection. Case presentation: We present the case of a 26-year-old with retroviral disease managed for locally advanced vulva cancer on external beam radiotherapy followed by wide excision of the residual tumor and bilateral inguino femoral nodal dissection. She later presented with a history of foul-smelling vaginal discharge. A biopsy confirmed moderately differentiated squamous cell carcinoma of the cervix clinically and radiologically staged at 2B and 3B, respectively. She was scheduled to start chemotherapy with carboplatin and paclitaxel after blood transfusion due to anemia. Discussion: Field cancerization was coined by Slaughter et al. to describe the existence of generalized carcinogen-induced early genetic changes in the epithelium from which multiple independent lesions occur, leading to the development of multifocal tumors. In some cases, multiple contiguous tumor foci coalesce, hence the lateral spread of squamous cell cancers. It was also observed that normal-looking cells near malignant cells were histologically abnormal and therefore were part of the transformed cells in a particular tumor field and consequently were responsible for the occurrence of local tumor recurrences. Conclusion: Field cancerization is a well-known and well-documented process of malignant transformation. Several studies have confirmed the importance of this phenomenon in tumor development. Surveillance is the key to detecting early recurrence and secondary malignancies.

Human immunodeficiency virus (HIV) and tuberculosis coinfection are particularly dangerous and involve high morbidity and mortality in developing countries like India. When both pathogens are simultaneously present in the patient, they decline the immunological functions and can also cause premature death. It is imperative to treat the cases judiciously to avoid complications. We present a case of a 45-year-old male with a past medical history of retroviral disease and abdominal tuberculosis. He presented to the emergency department with abdominal pain for a few days. His computed tomography (CT) scan showed a large intercommunicating collection with an air-fluid level in the epigastric region. There was a contrast leak within the collection suggestive of perforation from the ileal loop. The patient underwent ultrasonography (USG)-guided drainage along with broad-spectrum antibiotics, anti-tubercular treatment (ATT), and anti-retroviral therapy (ART). The patient recovered completely and was discharged after 4 weeks on antiretroviral and antitubercular drugs. A brief case report with a review of the literature is presented.

Pulmonary Mucormycosis Mimicking a Lung Tumor in a Patient with Advanced Retroviral Disease

Background: Histoplasmosis is caused by Histoplasma capsulatum which can lead to a broad spectrum of disease. Culture remains the gold standard till date; however, this is a slow-growing fungus that may take a considerable time before a conclusion can be made. This case highlights the importance of careful bone marrow evaluation to identify the fungal bodies, especially in the presence of increased hemophagocytic activity. Case Presentation: We present a 36-year-old man with newly diagnosed retroviral disease, presented with fever, pancytopenia, and hepatosplenomegaly. Bone marrow aspirate smear showed increased hemophagocytic activity with the presence of intracellular organisms. Trephine biopsy showed similar features with the presence of fungal bodies detected via Periodic acid-Schiff stain. Conclusion: In conclusion, bone marrow examination plays a crucial role in the diagnosis of some fungal infections, especially in centers where culture or serological tests are not readily available.

Background: Histoplasmosis is caused by Histoplasma capsulatum which can lead to a broad spectrum of disease. Culture remains the gold standard till date; however, this is a slow-growing fungus that may take a considerable time before a conclusion can be made. This case highlights the importance of careful bone marrow evaluation to identify the fungal bodies, especially in the presence of increased hemophagocytic activity. Case Presentation: We present a 36-year-old man with newly diagnosed retroviral disease, presented with fever, pancytopenia, and hepatosplenomegaly. Bone marrow aspirate smear showed increased hemophagocytic activity with the presence of intracellular organisms. Trephine biopsy showed similar features with the presence of fungal bodies detected via Periodic acid-Schiff stain. Conclusion: In conclusion, bone marrow examination plays a crucial role in the diagnosis of some fungal infections, especially in centers where culture or serological tests are not readily available.