Liver injury after commencing haart and the effect of baseline CD4 cell count

Background: During treatment of HIV disease, a number of factors may influence the effect of the medications used: the presence and/or treatment of viral hepatitides, opportunistic infections, alcoholism, the use of various recreational drugs, immune reconstitution and/or the presence or emergence of diabetes and dyslipidemia which can adversely affect liver injury. The effect of CD4 cell count on liver injury after commencing HAART varies between cohorts. This study aims to determine the type of liver injury after commencing HAART in HIV infected patients and the effect of baseline CD4 cell count. Method: This study was carried out on patients with HIV on HAART attending infectious disease clinic, gastroenterology clinic or admitted into the medical wards of the University of Benin Teaching Hospital. Patients with HIV but not on HAART were used as controls. A clinical evaluation and relevant laboratory investigations were done. Hepatotoxicity was defined using a standardized toxicity grade scale. Results: A total of 84 cases and 42 controls were studied. The mean ages were 35.2΁ 9.9years and 35.5΁9.0years for the cases and the controls respectively. Over 70% of the study population and controls were females. The overall incidence of hepatotoxicity was 17.9% and severe hepatotoxicity occurred in 10.7% of the patients. Liver injury after commencing HAART in this study was 100% cytotoxic and was not affected by baseline CD4 Cell Count. Conclusion: This study shows that Liver injury associated with usa of HAART in HIV patients is cytotoxic and unaffected by baseline CD4 Cell Count

An Overview of Intestinal Amoebiasis

spp restricted to the large intestine. It is a common disease thriving in areas of poor hygiene. Most cases present as self limiting diarrhea or dysentery but a small proportion present with severe disease and complications. Treatment is relatively simple in uncomplicated cases but the emphasis must be on preventive measures (improved hygiene) rather than treatment. IFEMED Journal Vol. 14 (1) 2008: pp. 89-9

Pattern of presentation of diseases at the university of Benin teaching hospital gastroenterology out patients’ clinic.

This study set out to assess the pattern of presentation of diseases in the gastroenterology outpatients’ clinic of the University of Benin Teaching Hospital, Benin City, Nigeria.Method: The Gastroenterology clinic records of the hospital for a period of one year were reviewed retrospectively and the relevant data extracted from them and analyzed.Results: A total of 1232 patients were seen during the study period of which 675 (54.8%) of the patients seen were female, while 557 (45.2%) were male. The ages of majority of the patients ranged from 21 to 70 years. The most common condition encountered in the clinic was peptic ulcer disease (33.9%), followed by chronic liver disease (15.4%), then acute hepatitis (9.6%), gastroesophageal reflux disease (6.7%), hepatocellular carcinoma (5.9%), and then chronic hepatitis (5.2%)

Receptor-defined subtypes of breast cancer in indigenous populations in Africa: a systematic review and meta-analysis.

BACKGROUND: Breast cancer is the most common female cancer in Africa. Receptor-defined subtypes are a major determinant of treatment options and disease outcomes but there is considerable uncertainty regarding the frequency of poor prognosis estrogen receptor (ER) negative subtypes in Africa. We systematically reviewed publications reporting on the frequency of breast cancer receptor-defined subtypes in indigenous populations in Africa. METHODS AND FINDINGS: Medline, Embase, and Global Health were searched for studies published between 1st January 1980 and 15th April 2014. Reported proportions of ER positive (ER+), progesterone receptor positive (PR+), and human epidermal growth factor receptor-2 positive (HER2+) disease were extracted and 95% CI calculated. Random effects meta-analyses were used to pool estimates. Fifty-four studies from North Africa (n=12,284 women with breast cancer) and 26 from sub-Saharan Africa (n=4,737) were eligible. There was marked between-study heterogeneity in the ER+ estimates in both regions (I2>90%), with the majority reporting proportions between 0.40 and 0.80 in North Africa and between 0.20 and 0.70 in sub-Saharan Africa. Similarly, large between-study heterogeneity was observed for PR+ and HER2+ estimates (I2>80%, in all instances). Meta-regression analyses showed that the proportion of ER+ disease was 10% (4%-17%) lower for studies based on archived tumor blocks rather than prospectively collected specimens, and 9% (2%-17%) lower for those with ≥ 40% versus those with <40% grade 3 tumors. For prospectively collected samples, the pooled proportions for ER+ and triple negative tumors were 0.59 (0.56-0.62) and 0.21 (0.17-0.25), respectively, regardless of region. Limitations of the study include the lack of standardized procedures across the various studies; the low methodological quality of many studies in terms of the representativeness of their case series and the quality of the procedures for collection, fixation, and receptor testing; and the possibility that women with breast cancer may have contributed to more than one study. CONCLUSIONS: The published data from the more appropriate prospectively measured specimens are consistent with the majority of breast cancers in Africa being ER+. As no single subtype dominates in the continent availability of receptor testing should be a priority, especially for young women with early stage disease where appropriate receptor-specific treatment modalities offer the greatest potential for reducing years of life lost. Please see later in the article for the Editors' Summary