Brief Review of Options to Treat In-stent Restenosis of Femoro-popliteal Artery

Peripheral arterial disease (PAD) is affecting millions of people all around the world. The different kind of stents to treat PAD has been in use from last couple of decades. In-stent restenosis is common problem, faced by endovascular specialists that is still challenging to treat. In this article, we reviewed the different options available to treat in-stent restenosis of the femoral-popliteal artery.

A Brief Overview of Medical Management Options in Peripheral Arterial Disease

Pulmonary artery malignancies are extremely rare, with a reported occurrence of 0.001-0.03% and almost all being sarcomas from the intima and worldwide less than 250 cases have been reported [1, 2]. A high degree of suspicion is required to diagnose this tumor as imaging modalities may not adequately identify this tumor [1-3] posing challenges in diagnosis as illustrated in our case. Because of the high mortality associated with this malignancy, early and aggressive intervention is crucial.

The latent gram-negative bacterium Brucella induced different immune responses to general gram-negative bacterium Escherichia coli

Brucellosis is one of the most common zoonoses in the world, and no effective methods for Brucella clearance completely until now. Therapy of brucellosis requires deeply understanding of mechanism of Brucella infection and immune responses. We collected human blood samples to analyze the difference of immune responses between latent gram-negative bacterium Brucella and general gram-negative bacterium Escherichia coli. To analyze cytokines release in plasma from patients, a multiplex MAP human cytokine/chemokine immunoassay was used. Human coagulation factor XI expression was detected using ELISA following instructions. In comparison with samples from patients infected with latent gram-negative bacterium Brucella, cytokines secreted by Th2 cells increased in patients infected with general gram-negative bacteria Escherichia coli, and also the chemokines, such as monocyte chemotactic protein 1(MCP-1), macrophage inflammatory protein (MIP-1α, MIP-1β). In the other side, in comparison with samples from patients infected with general gram-negative bacterium Escherichia coli, Interferon inducible protein 10 (IP-10) increased in patients infected with latent gram-negative bacterium Brucella, accompany with increased IFN-γ secretion. Meanwhile, we also found only bacterium Brucella can increased factor XI secretion. Understanding immune response and coagulation function during bacterium Brucella infection will help us to find effective methods for Brucella clearance.

Improvement of the Pre-Analytical Phase of Nasopharyngeal Samples During the COVID 19 Pandemic: Experience of the Institute Pasteur De Côte d’Ivoire in 2020

The clinical laboratory is playing an increasingly important role in the patient-centered approach to the delivery of health services. Early detection of the importation of COVID-19 is a crucial challenge for all countries at risk of importation from areas of active transmission. This article aims to share the experience of the IPCI in the optimum management of the pre-analytical phase related to diagnostic tests for COVID 19. From the start of the pandemic the state and the IPCI made several organizational decisions to respond effectively to all trends of the COVID 19 epidemic in our country. Outsourcing of pre-analysis with creation of several sections: preparation of tube kits, aliquoting of samples from patients suspected of COVID19, reception, sorting and decontamination. Exemplary use of administrative and laboratory support staff. Our findings should help establish urgent priorities for intensified preparedness and response support in specific African countries with moderate or high risk of COVID-19 importation and whose capacity to manage the health emergency is low relatively low.

A Novel Vaccine RNA-peptide against HIV-1: Exosomes as Carrier in Viral Progression

Introduction of a new drug/vaccine model against HIV-1 with prophylactic and therapeutic actions, also useful, in HIV-1 rehabilitation. This RNA-peptide vaccine projects involving RNA from SARS-CoV-2, and peptides from human HIV-1 and human PARP-1 proteins. As mRNA target, we used primers miRNA repertoire and host immune factor regulation upon avian coronavirus infection in eggs. The primers were modified with poly adenine (A) target. We designed the peptides target from HIV-1 protein and PARP-1 human protein. Our analysis, according to the algorithms Cruz Rodriguez (CR) identified an RNA-peptide with theorical fusion value stability FS=80.04 cruz, EA= 97.22 ro and BA= 1.21 to treat HIV-1. Where, we are proposing, the exosomes and how these vesicles could function as carriers of our RNA-peptide molecule. In this study, we expect that major histocompatibility complex l (MHC l) bind the molecule peptide (B) generated by hydrolysis (DEVD) of molecule RNA-peptide (AB) after induction of apoptosis pathways by caspase 3 or caspase 7. Also, we expect that major histocompatibility complex ll (MHC ll) bind the molecule RNA-peptide (A) generated and recognition by appropriate T-cells at the infected cell with HIV-1.

An Unusual Cause of Facial swelling – Bot Fly Larva in an Infant – A Case Report

‘Myiasis’ is a term used to describe an infestation of humans or animals with dipterous larvae [1]. Due to increased international travel in recent times, health professionals in the UK may encounter these infections more commonly than before. We present a case of a 6 month infant who had been bitten by Dermatobia hominis Bot fly in Brazil and travelled back to the UK. The original diagnosis was of an infected insect bite, which ultimately delayed appropriate management. A detailed travel history is therefore paramount and these types of infections should be considered in differential diagnoses. Management should also involve the infectious diseases team.

Oral Condyloma Acuminatum: A Case Report of a Sexually Transmitted Infection in a Female Geriatric Patient

Condyloma acuminatum (CA) is a sexually transmitted infection (STI) that results in psychosocial distress. The etiologic agent is the human papillomavirus (HPV), genotypes 6 and 11. Sexually transmitted infections from the HPV are the world’s most common infection. Infections occur on the skin, and mucous membranes of the genital and perianal region, and less frequently in the oral cavity. But, with an increase in oral sexual practices with infected partners of all ages, CA should be considered in the differential diagnosis of oral lesions. The mode of transmission is through oral sex. Dental clinicians will often be the first healthcare provider to detect lesions in the oral cavity, especially HPV origin. In addition to obtaining a complete medical and dental history, histopathologic diagnosis will enable the healthcare team in arriving at an accurate diagnosis of CA. In this case report, we diagnose condyloma acuminatum in a geriatric female who was unaware of the STI on the left buccal mucosa of the cheek that was treated by complete surgical excision.

Outcome of HIV Partner Notification Service Among People Living With HIV Infection in North-Central Nigeria

Introduction: According to the Nigeria National HIV/AIDS Indicator and Impact Survey (NAIIS) conducted in 2018 but released in 2019 the current HIV prevalence in Nigeria is 1.4% among adults aged 15–49 years. This implies that there are about 1.9 million people living with HIV in Nigeria. Yet the percentage of Nigerians that had access to HIV counselling and testing services was just 37% in 2018 and about 46.9% of PLHIV aged 15-64 years knew their HIV status according to NAIIS 2018 report. . To improve on the HIV testing coverage, HIV testing services programming must be focused on utilizing strategies that maximise efficiency while expanding access to accurate, high-quality services. One of such strategies is to prioritise index case testing services for sexual partners of index clients. Partner Notification Services (PNS) Partner HIV Testing service is a type of index case testing among sexual network of an index case. Methods: Partner Notification Services (PNS) is a voluntary process where sexual partners of HIV-infected persons are contacted, counselled and are offered HIV test administered by a trained counselor. Each infected contact can then become the starting point for new contact tracing, until no more contacts can be found. This study was a retrospective review of the hospital records of HIV positive clients who participated in the HIV partner notification services. Results: A total of 705 HIV patients (Female-68%, Male-32%) enrolled in care at the two centers accessed the HIV partner notification services (PNS). These index cases were counselled and brought their 719 sexual partners to the hospitals for HIV testing. About 27% of the sexual partners were HIV infected and 71% were HIV negative while 2% were of unknown HIV status because they did not take the HIV test. Viral load suppression rate was about 48% among the index cases., more female are virally suppressed than men (71% vs 29%). About 100% of the index with suppressed viral load had one sexual partner while for index cases with unsuppressed viral load 80% had one sexual partner, 19% had two sexual partners and 1% had 3 sexual partners. The frequency of unmarried sexual partners was higher among index cases with suppressed viral load (22%) compared with index cases with unsuppressed viral load (36%). Surprisingly, incidence of HIV infection was higher at 36% among partners of index cases with suppressed viral load when compared with HIV incidence of 11% among partners of index with unsuppressed viral load. Conclusion and Recommendations: Uptake of PNS was 100% among index cases while 98% of their sexual contacts received HIV testing services. This shows PNS as a very effective strategy in increasing HIV testing services. Likewise, the HIV testing yield of 27% was higher than the yield from routine walk-in clients at the centers. It is therefore recommended that PNS be the standard of care at all centers offering HIV testing services

Will COVID-19 Vaccination Be Successful Without Social Distancing? A Simulation of an Outbreak in Sri Lanka

Coronavirus disease (COVID-19) pandemic is causing morbidity, mortality and economic damage in an unprecedented manner across the world. Many non-pharmacological interventions such as restricting community mobility, social distancing, handwashing and face mask use have been carried out to prevent COVID-19. Promising vaccine results and their approval for emergency use in some countries has created much interest in their use as the ultimate solution to control the outbreak at global level, Sri Lanka being no exception. Objective of this study was to compare the success of a COVID-19 vaccination with or without social distancing during a simulated outbreak of widespread transmission of COVID-19 in Sri Lanka. The beta version of the online application of the mathematical model developed by the London School of Tropical Medicine and Hygiene using the Susceptible, Exposed, Infected and Removed Model was used for the simulation. The results show that COVID-19 vaccination in Sri Lanka without social distancing is unlikely to reduce case number, symptomatic admissions or deaths. In the absence of social distancing, making vaccines available earlier, faster or in increased quantities will not contribute to any meaningful reduction of the disease outcomes. The continued adherence to social distancing is recommended for any benefits of vaccination to be meaningful.

Mycobacterium Fortuitum Cholangitis and Sepsis in an Immunocompetent Patient

Mycobacterium fortuitum is an ubiquitous, environmental and opportunistic organism belonging to rapid growing mycobacteria (RGM), a distinctive subset of non-tuberculous mycobacteria. It is mainly transmitted by direct inoculation and causes a wide spectrum of clinical syndromes, including skin, bone, soft tissue and disseminated infections, surgical wound infections, catheter-related sepsis and prosthetic device infections. Scientific literature abounds with cases occurred to cancer and immunosuppressed patients, especially in the presence of vascular devices. Hereby we report an event of Mycobacterium fortuitum sepsis and cholangitis, happened to an apparently immunocompetent individual, with no history of neoplasm, nor of immunosuppressive therapy, nor holding a central venous catheter (CVC). The man had previously undergone transitory biliary prosthesis positioning, followed by laparoscopic cholecystectomy; however, investigations on both the endoscopic and surgical equipment, as well as environmental samplings, ruled out a nosocomial infection. After adequate antibiotic treatment, our patient recovered.