Primary Tuberculosis of the Breast Manifested as Abscess: a Rare Case Report

Primary breast tuberculosis is a rare entity. We are reporting a case of primary breast tuberculosis, which presented as breast abscess. On histopathology, it was diagnosed as breast tuberculosis. Aspiration cytology was not done due breast abscess. Patient was put on anti-tubercular drugs. In follow up, after 3 months patient condition was improved. Key words: breast, abscess, tuberculosis, conservative treatment

HIV specific CD8+ TRM-like cells in tonsils express exhaustive signatures in the absence of natural HIV control

Lymphoid tissues are an important HIV reservoir site that persists in the face of antiretroviral therapy and natural immunity. Targeting these reservoirs by harnessing the antiviral activity of local tissue-resident memory (TRM) CD8+ T-cells is of great interest, but limited data exist on TRM-like cells within lymph nodes of people living with HIV (PLWH). Here, we studied tonsil CD8+ T-cells obtained from PLWH and uninfected controls from South Africa. We show that these cells are preferentially located outside the germinal centers (GCs), the main reservoir site for HIV, and display a low cytolytic and a transcriptionally TRM-like profile distinct from blood CD8+ T-cells. In PLWH, CD8+ TRM-like cells are expanded and adopt a more cytolytic, activated, and exhausted phenotype not reversed by antiretroviral therapy (ART). This phenotype was enhanced in HIV-specific CD8+ T-cells from tonsils compared to matched blood suggesting a higher antigen burden in tonsils. Single-cell transcriptional and clonotype resolution showed that these HIV-specific CD8+ T-cells in the tonsils express heterogeneous signatures of T-cell activation, clonal expansion, and exhaustion ex-vivo. Interestingly, this signature was absent in a natural HIV controller, who expressed lower PD-1 and CXCR5 levels and reduced transcriptional evidence of T-cell activation, exhaustion, and cytolytic activity. These data provide important insights into lymphoid tissue-derived HIV-specific CD8+ TRM-like phenotypes in settings of HIV remission and highlight their potential for immunotherapy and targeting of the HIV reservoirs

Influence of customized demand generation as a strategy to increase uptake of voluntary counseling and testing services amongst sex workers in Mumbai and Thane

Background: To demonstrate that customized demand generation leads to increased voluntary HIV counseling and testing (VCT) among Sex Workers (SWs). Methods: FHI 360 Aastha implemented Vivek intervention among SWs in Mumbai and Thane, India using customized demand generation through outreach services for VCT. Program monitoring data and integrated counseling and testing center tracking sheets were used to assess the intervention effect. Results: Higher proportion of registered SWs tested during: 1) Vivek months than other months (17% vs. 5%, p \u3c 0.001); 2) Post-initiation non-Vivek months than pre-Vivek months (4.7%, vs. 1.5% p \u3c 0.001). Conclusions: Customized demand generation approach is successful in increasing HIV testing

A rare anomaly of the foot presented as polydactyly

Presence of one or more digit is called as polydactyly and may manifest singly or with other genetic disorders. The frequency of polydactyly varies widely among populations. It can occur as an isolated condition or as a feature of a congenital condition. Polydactyly is a rare condition, but still rare is in form of triple great toes. We describe a case in a 4-year-old child diagnosed as triphalangism foot with no other obvious visible anomaly. Osteoplasty-combined surgery, which was ideal for anatomical reconstruction. In a 16-month follow-up period child recovered very well

Relationship of internet addiction with social connectedness, self-esteem, anxiety, depression, and insomnia

Internet Addiction Disorder (IAD) refers to excessive use of internet which lead to distress and impairment in socio-occupational functioning. A number of psychological and personality variables seem to be correlated to it. The aim of this study was to find out the relationship of Internet Addiction with Anxiety, Depression, Self Esteem, Social connectedness and Insomnia. Around 140 college going students, both males and females in the age range of 16-35 years were recruited using purposive sampling technique. Online questionnaire consisting of Young’s Internet Addiction Scale (Kimberly,1998), Rosenberg Self Esteem Scale (Rosenberg,1965), Generalized Anxiety Disorder-7item Scale-GAD7(Spitzer,2006), Patient Health Questionnaire-PHQ9 (Kroenke,2001) Social Connectedness Scale-R(Lee,2001), Insomnia Severity Scale (Morin,2011) were administered. Descriptive-analytic correlation revealed that Internet addiction was positively related to Depression, Anxiety and Insomnia Scores and negatively related to Social Connectedness and Self-esteem Scores. Regression analysis indicated that Internet addiction was able to predict the variance in psychological variables like social connectedness, self-esteem, depression, anxiety and insomnia to some extent. Current study is replicating results from studies worldwide. It can be concluded that IA is associated with poor sleep quality, low scial connectedness, low Self Esteem and High depression and Anxiety severity. Further longitudinal studies and larger sample sizes are required to establish sound model for etiopathogenesis of IA, as these variables are also dependant on each other

Primary germ cell tumor of the mediastinum - presenting as a huge mass

Germ cell tumors compromise 15-20% of all anterior mediastinal masses; 50-60% of these are benign mediastinal teratoma. There may be mature, immature, and rarely with malignant component within the tumor mass. There are more chances of malignancy with immature type. We are reporting a case in 20-year young male diagnosed as giant benign cystic teratoma which was adherent to superior vena cava. The patient underwent surgical excision. In follow up of 2 years, the patient is not having any complaints

An Experience of Video Based Training on Basic Life Support

Introduction: Basic life support is foundation to save lives. In contrast to the developed countries, there is still no national standard BLS training module in Nepal. Basic life support training is being provided by various institutions but lack in consistency and coordination. The Nepal basic life support Course is the video based training in Nepali language with reference to recent advances which was intended for all health care personnel of Nepal in urban as well as rural setting. We aimed to describe the features of this video based training module in local language, to analyse the differences of knowledge and find out the participants perception and satisfaction with this course. Methods: This is a descriptive cross-sectional study based on data of trainings conducted over the study period. Ethical approval was taken. The post-test score was recorded and compared with the occupational using ANOVA. On the spot and delayed feedbacks from the participants were collected voluntarily and summarized. Results: Total of 576 participants (435 clinical doctors, 92 nurses/paramedics, 18 non-clinical doctors and 41 intern doctors) successfully completed the training. The difference in post test scores (mean = 12.9±1.8) among the different occupational background was not significant (P=0.159). The feedbacks from the participants were mostly positive and encouraging. Conclusions: The knowledge of basic life support improved significantly irrespective of the occupation of the participants. A universal, nationwide video based training module in Nepali language should be developed focusing all health care personnel of urban as well rural Nepal