Testicular feminization syndrome. Four case reports with a brief review of the literature

Four cases of testicular feminization syndrome in Ethiopian patients are described. All four patients had normal female breasts, scanty pubic and axillary hair and absent internal genital organs. Three had bilateral inguinal or labial masses. The main features of their clinical presentation and histological studies are briefly discussed with a review of the literature.     

HIV/AIDS among pastoralists and refugees in north-east Africa: a neglected problem

The eight member states (Djibouti, Eritrea, Ethiopia, Kenya, Somalia, South Sudan, Sudan and Uganda) of the Intergovernmental Authority for Development (IGAD) have the largest proportions of cross-border mobile pastoralists and refugees in Africa. Although all IGAD countries have had national HIV/AIDS prevention, care and treatment programmes since the late 1980s, the IGAD Regional HIV & AIDS Partnership Program was (IRAPP) established in 2007 to mitigate the challenges of HIV among neglected pastoral and refugee communities. This article assesses vulnerability of pastoralists and refugee communities to HIV and interventions targeting these groups in the IGAD countries. Outcomes from this study may serve as a baseline for further research and to improve interventions. Published articles were accessed through web searches using PubMed and Google Scholar engines and unpublished documents were collected manually. The search terms were HIV risk behaviour, vulnerability, HIV prevalence and interventions, under the headings pastoralists, refugees, IGAD and north-east Africa for the period 2001–2014. Of the 214 documents reviewed, 78 met the inclusion criteria and were included. Most HIV/AIDS related studies focusing of pastoral communities in IGAD countries were found to be limited in scope and coverage but reveal precarious situations. Sero-prevalence among various pastoral populations ranged from 1% to 21% in Ethiopia, Kenya, Somalia and Uganda and from 1% to 5% among refugees in Sudan, Kenya and Uganda. Socioeconomic, cultural, logistic, infrastructure and programmatic factors were found to contribute to continuing vulnerability to HIV. Interventions need to be further contextualised to the needs of those impoverished populations and integrated into national HIV/AIDS programmes. HIV/AIDS remains a major public health concern among the pastoral and refugee communities of IGAD countries. This calls for IGAD to collaborate with national and international partners in designing and implementing more effective prevention and control programmes. Furthermore, interventions must extend beyond the health sector and improve the livelihood of these populations.     

HIV Prevalence and Associated Factors Among Men Who have Sex with Men (MSM) in New Jersey,U.S., 2017

AIDS and Behavior - This study assessed the HIV prevalence among MSM in the greater Newark New Jersey area including Essex, Hudson, Morris and Union Counties and examined correlates of HIV...     

A community based study of urogenital chlamydia trachomatis in males aged fifteen years and above,Dembia District,northwest Ethiopia

Chlamydia trachomatis is one of the most common causes of sexually transmitted diseases in sexually active males and females. Infertility is one of the serious complications of urogenital chlamydial infections. This study was carried out in Chuwahit town and the surrounding village, which is located southwest of Gondar town. The main objective was to estimate the prevalence of urogenital Chlamydia trachomatis among males aged fifteen years and above. The design used was a cross sectional survey. First catch urine was collected from males 15 years and above and interviews were made using a questionnaire. The urine samples were tested with an Enzyme Immuno-Assay (EIA), which is useful in rapid detection of chlamydia antigen. Among 199 males included in the study, thirty-three (16.6%) had laboratory evidence of urogenital Chlamydia trachomatis. The mean (SD) age of the study subjects was 29.3 (+/- 9) years. Students (8 out of 21, 38%) had the highest prevalence of urogenital Chlamydia compared to the other groups (OR = 4.10, 95% CI = 1.12, 14.48). The magnitude of urogenital chlamydia infection in males was high in the study area. Health professionals need to consider genital Chlamydial infections in the management and control of sexually transmitted diseases. Increasing the awareness of students towards urogenital Chlamydial trachomatis and teaching them about the benefits of using condoms is recommended.     

Therapeutic efficacy of chloroquine and chloroquine plus primaquine for the treatment of Plasmodium vivax in Ethiopia

Plasmodium vivax is the second most important cause of morbidity in Ethiopia. There is, however, little information on P. vivax resistance to chloroquine and chloroquine plus primaquine treatment although these drugs have been used as the first line treatment for over 50 years. We assessed the efficacy of standard chloroquine and chloroquine plus primaquine treatment for P. vivax infections in a randomized open-label comparative study in Debre Zeit and Nazareth in East Shoa, Ethiopia.A total of 290 patients with microscopically confirmed P. vivax malaria who presented to the outpatient settings of the two laboratory centers were enrolled: 145 patients were randomized to receive CQ and 145 to receive CQ + PQ treatment. Participants were followed-up for 28-157 days according to the WHO procedures. There were 12 (6.5%) lost to follow-up patients and 9 (3.1%) withdrawals. In all, 96% (277/290) of patients were analysed at day 28. Baseline characteristics were similar in all treatment groups. In all, 98.6% (275/277) of patients had cleared their parasitemia on day 3 with no difference in mean parasite clearance time between regimens (48.34 ± 17.68, 50.67 ± 15.70 h for the CQ and CQ + PQ group, respectively, P = 0.25). The cumulative incidence of therapeutic failure at day 28 by a life-table analysis method was 5.76% (95% CI: 2.2-14.61) and 0.75% (95% CI: 0.11-5.2%) in the CQ and CQ + PQ group, respectively (P = 0.19). The relapse rate was 8% (9/108) for the CQ group and 3% (4/132) for the comparison group (P = 0.07). The cumulative risk of relapse at day 157 by a life-table method was 61.8% (95% CI: 20.1-98.4%) in the CQ group, compared with 26.3% (95% CI: 7.5-29.4%) in the CQ + PQ group (P = 0.0038).The study confirms the emergence of CQ and PQ resistance/treatment failure in P. vivax malaria in Ethiopia. Although treatment failures were detected, they were similar between the treatment groups. We recommend regular monitoring and periodic evaluation of the efficacy of these antimalarial drugs in systematically selected sentinel sites to detect further development of resistance and to make timely national antimalarial drug policy changes.     

Diarrhoea-associated parasites in HIV-1 seropositive and sero-negative patients in a teaching hospital, Northwest Ethiopia

OBJECTIVE: to determine the prevalence and type of intestinal parasites in HIV infected and uninfected patients with diarrhea. DESIGN: A cross-sectional study was conducted at Gondar University hospital, Northwest Ethiopia, between March 2003 and October 2004. PATIENTS AND METHODS: A total 312 consecutive diarrheic patients were included in the study. Stool specimens were collected and examined for intestinal parasites following direct, formol-ether concentration and modified acid fast staining methods. RESULTS: Among the patients, 63.8% were found to be HIV seropositive. The prevalence of intestinal parasites in HIV seropositive and seronegative diarrheic patients was 30.6% and 33.6%, respectively. The most prevalent parasites were Strongyoides stercoralis (9.0%) and Entamoeba histolytica (8.3%) followed by Ascaris lumbricoides (5.4%) and Cryptosporidium species (5. 1%). CONCLUSION AND RECOMMENDATION: The prevalence of intestinal parasites in diarrheic patients was very high. Institution of appropriate intervention measures are needed to reduce morbidity in such patients.     

Pridominant isolates of urinary tract pathogens and their antimicrobial susceptiblity patterns in Gondar University Teaching Hospital, nothwest Ethiopia

BACKGROUND: Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries. Although UTI seldom leads to complications, it can cause significant morbidity and mortality. OBJECTIVE: To identify the etiologic agents of UTIs and to assess their antimicrobial susceptibility pattern. METHODS: A retrospective analysis of 1420 mid-stream urine specimens processed fobr culture and antimicrobial susceptibility testing in the bacteriology laboratory of Gondar University Teaching Hospital between September 2002 and August 2003 was conducted RESULTS: Significant bacteriuria (cultures with > 10(5) colony forming units of bacteria per ml of urine) was observed in 399 (28.1%) of the specimens. Two bacteria each were isolated from 14 specimens, making the number of bacteria isolated to be 413 with the isolation rate of 29.1%. The most commonly isolated bacteria were Escherichia coli 166 (40.2%), Staphylococcus aureus 60 (14.5%), Klebisella species 42 (10.2%) and Citrobacter species 34 (8.2%). Among Gram-positive organisms S. aureus showed high level qf drug resistance for tetracycline 48 (80%), corimoxazole 32 (53.3%), chloramphenicol 32 (53.3%), amnpicillin 26 (43.3%) and penicillin 22 (36.7%). Of the Gram-negative bacteria, extremely high resistance patterns were found in Salmonella species for ampicillin 5 (100%), erythromycin 5 (100%), penicillin 5 (100%), co-trimoxazole 3 (60%), tetracycline 3 (60%) and 3 chloramphenicol (60%). Multiple drug resistance was observed in 85.7% of the isolates. Only 5.1% of the isolates were found to be sensitive to all antibiotics tested. CONCLUSION: Resistance to the commonly used antibiotics was found to be very high among the isolates leaving clinicians with very few choices of drugs or the treatment of UTIs. It is therefore, critical that the use of antimicrobial agents with in a hospital and all other responsible institutions he reviewed     

Colocalization of nitric oxide synthase and NADPH-diaphorase in rat adrenal gland.

The distribution and colocalization of nitric oxide synthase (NOS) and reduced nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase was studied in the neuronal elements of the adrenal gland of the rat. Ganglion cells and many nerve fibres in the gland showed both NOS-immunoreactivity and NADPH-diaphorase staining. The adrenal cortical cells showed NADPH-diaphorase staining but were not immunoreactive for NOS. Positive labelling for both NADPH-diaphorase and NOS was found in bundles and in single fibres with varicosities, preferentially located around the noradrenaline (NA)-storing cells. Adrenaline (A)-storing cells and ganglion cells in the medulla, along with the cortical cells and blood vessels in the zona glomerulosa, received relatively fewer positive fibres.     

Percutaneous interventions in radial artery grafts: clinical and angiographic outcomes.

In the modern era, radial artery graft is being used with increasing frequency to replace saphenous vein as a conduit for coronary artery bypass surgery. Several reports have shown encouraging early results of radial grafts compared to saphenous grafts. Despite these advantages, radial artery graft failure requiring revascularization does occur. We report on the clinical, angiographic, and technical characteristics and the follow-up results of 22 patients who underwent percutaneous intervention of radial grafts.