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Allergen immunotherapy (AIT) is the unique curative treatment to help allergic patients to get over their allergies. With a personalized approach, AIT is the best example of precision medicine. After a century of intensive studies and innovative discoveries, allergists have in their hands many tools to orchestrate the best strategy to re-educate the hypersensitive immune systems that decrease the quality of life of their patients. This review describes both the historical and the promising acquisitions in this field, focusing the biochemical and Bioengineering tools that render an allergen more suitable for a secure, convenient and effective immunotherapy.

Background: There is a paucity of data on the burden of acute kidney injury (AKI) in hospitalized HIV-infected patients in Sub-Saharan Africa in the “test and treat” era.Objectives: To study the incidence, risk factors, and outcomes of AKI among HIV-positive medical admissions in a secondary hospital.Materials and methods: We prospectively screened adult HIV-positive patients who gave their informed consent and were admitted to the Bamenda Regional Hospital for AKI from February to June 2020. We excluded participants with Chronic Kidney Disease (CKD) Stage 5 and those with confounders of serum creatinine. On admission and after 2-7 days, we extracted a venous blood sample from each participant to evaluate serum creatinine and diagnose AKI. The participants were then followed up on until they were discharged or died. We measured the need for dialysis, access to dialysis, and renal recovery at three months for patients with AKI. The amended KDIGO 2012 criteria were used to define and classify AKI. The University of Bamenda’s institutional review board provided ethical approval.Results: A total of 206 participants (39.8% men) were enrolled, with a mean (SD) age of 45.71(13.13) years. On enrolment, 89.8% (n = 185) of the participants were on combination antiretroviral therapy (c-ART), with 81.6% (n = 151) on tenofovir-containing regimens. The WHO HIV clinical stages 3 and 4 were present in 81.5% (n = 168) of the individuals. The most common reason for hospitalization was opportunistic infections (69.8%; n = 142). AKI was found in 30.6% (n = 63) of the patients, with 58.7% (n = 37) of them being classified as KDIGO stage 3. A total of 12 (42.9%) participants out of the 28 in need, were dialyzed. AKI was independently associated with use of traditional medicines (aOR = 2.9; 95% CI 1.4-6.3; p = 0.006), WHO HIV stages 3 and 4 (aOR = 4.1; 95% CI 1.1-15.7; p = 0.038), hypotension (aOR = 3.3; 95% CI 1.4-7.8; p = 0.008) and low haemoglobin level ≤ 8.0 g/dl (aOR = 3.5; 95% CI 1.7-7.4; p = 0.001). The AKI group used to have a significantly higher mortality rate (42.9% vs. 16.1%; p < 0.001). Renal recovery was complete in 66.7% of the 30 survivors at three months, partial in 13.3%, and no recovery in 20% of the survivors.Conclusion: Despite the growing use of combination antiretroviral medication, significant immunosuppression is still common in hospitalized HIV-positive patients, increasing the risk of AKI and worsening prognosis. In this high-risk population, early detection of AKI with renal function monitoring may improve results.

Drug-induced Hepatotoxicity and biologic drugs have historically been challenging in IBD. We aim to study the prevalence of hepatotoxicity in adult patients using biologic medications.

Irbesartan (IRB) is one of the drugs used for the treatment of hypertension. The present work develops and validates two methods for the evaluation of irbesartan in bulk and tablets. Sulfonephthalein acid dyes, bromophenol blue (BPB), and bromocresol purple (BCP) were used to produce stable yellow ion-association complexes with the basic drug IRB in dry chloroform. The colored products are quantified spectrophotometrically at their corresponding λmax. The relation between the absorbed signal and the drug concentration was linear up to 45.0 μg mL-1 (n = 6, r ≥ 0.9998). LOD reaches 40 ng mL-1. The composition of the ion associates was found 1:1 by Job’s and mole ratio methods. Application of the suggested methods to dosage forms is presented with percentage recoveries ranging from 99.33% to 101.67%. The results of the analysis were validated statistically and compared with the official method. No interference was observed from common pharmaceutical adjuvants.

Objective: To investigate the occurrence of depressive and anxiety disorders in patients remitted for endovascular treatment of renal artery stenosis (RAS), and whether symptoms of depression and anxiety can be reduced after the treatment of RAS with percutaneous transluminal renal angioplasty (PTRA).Methods Patients: Selected for renal angiography with pressure measurement in the renal arteries due to suspected RAS were invited to participate in the study. 37 patients agreed to answer a questionnaire. Eighteen patients also agreed to a clinical psychiatric examination including the International Neuropsychiatric Interview (M.I.N.I. 6.0) to be diagnosed according to the DSM-IV. Results: Twenty-one of the 37 patients completing the questionnaire were found to have a pressure gradient of ≥ 10 mmHg at angiography, indicating significant stenosis. Ten of the 18 examined patients met the criteria for current DSM-IV anxiety diagnosis and two patients had a current depression. Three of the 18 examined patients had previously made a suicide attempt. Conclusion: The results of this study suggest that patients with suspected RAS have a high psychiatric comorbidity, as 56% of the patients undergoing psychiatric examination met the DSM-IV criteria for a current anxiety disorder.

Luteinizing Hormone (LH) like exposure in the mid cycle for inducing the oocyte maturation is the very crucial step in the success of ICSI treatment. Introduction of LH surge endogenously by GnRH-agonist for final oocyte maturation induction, may be more physiological compared with the administration of HCG. Since GnRH agonist would induce FSH surge also along with LH surge, as happens in natural cycle. However, the effects of giving HCG trigger for inducing only LH surge and giving GnRH agonist trigger for inducing both LH and FSH surge, in patients treated for ICSI with GnRH antagonists need more research. Sub fertile patients planned for ICSI, meeting the requirement of inclusion criteria, were started with recombinant FSH from day 2 of menstrual cycle. GnRH antagonists were started from day 6 of stimulation. FSH dose was adjusted according to the individual response. Trigger was planned when the lead follicle reaches 24 mm. For triggering, 100 patients were randomized to receive Recombinant HCG trigger and Triptorelin acetate trigger. Oocyte retrieval was done 36 hours after Recombinant hCG Trigger and 35 hours after Triptorelin acetate trigger. The oocyte maturity rate was assessed by the number of metaphase II oocytes retrieved.

The problems of guaranteeing the best possible social and health services in every part of the world to combat any form of disability and limitation of participation for all, as indicated by international ethical-political documents, are still very great. A critical point that could favour this progress is to enhance the integration between the growing potential of rehabilitation science (medical and clinical evidence, technologies, and training of numerous operators..) and the ability of communities as a whole to stimulate, support and qualify these interventions with the participation of citizens (families, neighbours and associations) who can voluntarily actively carry out important synergistic actions in many fields. This could develop in any socio-economic condition; in developed ones supporting and finalizing any treatment in common life and in developing countries offering competencies and knowledge to the strong funding actions of community projects aimed at populations with disabilities in this part of the World. The community of rehabilitation professionals, national governments and rulers, and international institutions (UN, WHO..) must well understand this aspect and make it their own in training, in the definition of care protocols, in the definition of the organization of socio-health and rehabilitation systems in each country in relation to the different local economic and cultural conditions.

A 73-year-old female patient presented to the emergency department with a 3-day history of acute abdominal pain and diarrhea. She had also a history of hypertension, type 2 diabetes mellitus and hypercholesterolemia. Physical examination revealed examination a generalized abdominal tenderness with an important abdominal distension, with a body temperature of 37.5°, a pulse rate of 115 bpm and a blood pressure of 105/65 mmHg. Laboratory data showed white blood cells at 15.500/mm³, C-reactive protein at 155 mg/l, hemoglobin at 12.3 g/dl and creatinine at 105 µmol/l. Chest radiography was normal. Contrast enhanced CT of the abdomen revealed hepatic portal venous gas with diffuse gas accumulation in the branches of the superior mesenteric vein, gaseous distention of the small bowel with reduced enhancement of the bowel wall (Figure 1). Additionally, an atheromatous obstruction was observed in the superior mesenteric artery at 4cm from its origin (Figure 2). Emergency surgery was decided.

Cadmium is one of the transition metals, known by the scientific name Cd. One of its main characteristics is the high toxicity, even in very little amounts. Cadmium is often released through industrial effluents, pesticides, chemical fertilizers, and the burning of fossil fuels. Since the presence of cadmium ions in the living organisms’ body, especially humans, can cause serious damage to the liver and pancreas, and also because its role in causing cancer has been proven, measuring very low amounts of this metal is of high importance. In the first step, this study has reviewed and analyzed common laboratory methods for measuring small amounts of cadmium. Then, according to economic, environmental, feasibility, speed, and accuracy factors, all available methods were evaluated using the ELECTRE technique. The results showed that the extraction methods using Dowex Optipore V-493 resin and extraction system in Triton X-114 surfactant, placed in the first and second positions.

Despite decades of global and country commitments towards eradicating malaria, malaria remains the most hazardous parasitic disease and the most common cause of fever for humans, especially in tropical countries. Plasmodium falciparum causes 90% of malaria cases. Coma [Cerebral Malaria (CM)], acidosis, hypoglycemia, severe anemia, renal dysfunction, and pulmonary edema are the most common complications of malaria caused by Plasmodium falciparum and the most common cause of death related to malaria. People from less prevalent malaria areas are at high risk of developing these complications. A 16-year-old male from a low malaria transmission area was diagnosed with CM. Prior to developing CM, he was treated with Coartem. CM is a medical emergency and one of the forms of severe malaria. CM has high mortality and morbidity rates. Yet, international health-related agencies, funders, and policy-makers are unfamiliar with it. The continuous occurrence of CM validates the considerable need for global investment in malaria control and elimination programs. Early administration of Artesunate to all patients suspected of having severe malaria would reduce global malaria-related mortality and morbidity. Simple tests, such as the determination of malaria parasitic density either with thin or thick blood smears, may influence the proper management of all severe malaria cases. However, in clinical practice, the determination of malaria parasitic density is not routinely done. Further commitments are needed to ensure routine determination of malaria parasitic density for all suspected severe malaria cases. Moreover, further commitments are needed to guarantee the proper management of CM because it is a major cause of reversible encephalopathy in tropical countries.