ABSTRACT
Introduction: Internalized HIV stigma remains a significant barrier to successful care retention for people living with HIV (PLHIV). Stigma has been felt as shame, guilt, and self-blame, dampening adherence to antiretroviral therapy (ART) and clinic attendance. Aim: The aim of this study was to explore the impact of internalized HIV stigma on care retention among individuals living with HIV at Chifundo Clinic in Lusaka District, Zambia. Methods: Cross-sectional analytical study with 384 participants aged 18 years and above having been in care for more than six months. Data were collected via an online Kobo Toolbox to measure internalized stigma, demographic variables, and care retention. Logistic regression analysis was used in testing the association between internalized stigma and clinic visitation. Results: Over 75% of the participants had once missed clinic a visit, of whom 5% had previously been declared as no longer in care (NLIC). Internalized stigma measures showed that 26% of the participants very often self-shamed due to HIV status and 31% very often felt guilty. Participants who self-blamed were 70% more likely to miss a clinic visit. Those who feared disclosing their status were 8 times likely to miss a clinic visit. Conclusion: Internalized HIV stigma is a key driver of retention in care among PLHIV at Chifundo Clinic. Stigma reduction is essential using combined, culture-tailored interventions and psychosocial support. Stigma reduction should be policymakers' and healthcare providers' number one priority to increase ART adherence, retention, and yield better health outcomes for PLHIV in Zambia.

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Cup-like acute myeloid leukemia is a rare type of AML with specific and distinct cytological, phenotypic, cytogenetic, and molecular characteristics compared to other AMLs. We will report through this observation the aspects of this pathological entity.

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Hypereosinophilia syndrome is a group of rare diseases characterized by persistent blood eosinophilia (eosinophil count > 1.5 G/L for more than 6 months) associated with organ damage due to infiltration or degranulation of eosinophils. The diagnostic criteria include blood eosinophilia, involvement of multiple organs, and exclusion of other causes. There are three main subtypes: myeloproliferative, lymphocytic, and idiopathic. The first-line treatment is based on corticosteroids, and the prognosis of the disease is variable. Regular monitoring is essential. In this work, we report two distinct observations of HES.

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Vascular abnormalities are very prevalent in type 2 diabetes mellitus (T2DM) and are the major causes of morbidity and mortality in this setting. This study aimed at determining the prevalence and associated risk factors for diabetic peripheral neuropathy (DPN) and peripheral artery disease (PAD) in T2DM subjects at NAUTH, Nigeria. This was a cross-sectional study that evaluated 142 stable T2DM out-patients. Anthropometric and blood pressure measurements were done. Glycated haemoglobin and fasting lipid profile were assayed. Biothesiometry of the feet and Doppler ultrasonography of the brachial and pedal arteries were done for diagnosis of vascular complications. Data was analysed using SPSS version 25. Results of categorical variables were presented in tables as frequencies and percentages. The mean values and standard deviation for the continuous variables were calculated. Chi-square test was used to determine the association between the vascular abnormalities and the categorical variables. The level of significance was set at p ˂ 0.05. The prevalence rate of DPN and PAD was 50.7% and 18.3%, respectively. DPN showed significant association with age (X2 = 14.059; p = 0.001), sex (X2 = 6.630; p = 0.010), education level (X2 = 12.286; p = 0.006), duration of DM (X2 = 5.246; p = 0.022), global obesity (X2 = 5.494; p = 0.019), DM treatment (X2 =11.821; p = 0.003), dyslipidaemia (X2 = 9.767; p = 0.002), lipid-lowering drugs use (X2 = 4.036; p = 0.045) and PAD (X2 = 8.158; p = 0.004). Similarly, PAD showed significant association with systolic hypertension (X2 = 10.942; p = 0.001), diastolic hypertension (X2 = 24.026; p = 0.000), DM treatment (X2 = 7.262; p = 0.026) and DPN (X2 = 8.753; p = 0.003). The prevalence of DPN and PAD from the study was high and depicted a high burden of vascular abnormalities in T2DM subjects.

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Air pollution, particularly fine particulate matter (PM2.5), is a significant health hazard, particularly for urban natives and teenagers. The purpose of this study was to assess the relationship between daily PM2.5 exposure and respiratory symptoms in 132 high school students in Nonthaburi Province, Thailand. From January to February 2025, Daily PM2.5 and students' self-reported respiratory symptom questionnaires obtained online. Results showed a clear relationship between elevated PM2.5 stages and worse respiratory symptoms. The mean PM2.5 concentration during the course of study was 36.2 µg/m³, significantly higher than the recommended safe exposure limit of the World Health Organization. In particular, symptom prevalence increased by 27.6% on days with PM2.5 was exceeding 40 µg/m³ compared to days ≤25 µg/m³. The logistic regression model indicated that PM2.5 concentration was related to 52% higher risk of the occurrence of respiratory symptoms (OR=1.52, 95% CI: 1.26–1.79, p<0.001). The results highlight the urgent requirement for instant air pollution controlling policies, such as school-based monitoring systems, public health education and active intervention to safeguard the development of adolescents in high polluted metropolis.

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Abstract: Introduction: Macrophage activation syndrome (MAS) secondary to visceral leishmaniasis is a rare clinical entity. We report the case of a 4-year-old boy with no prior medical history, who had presented with fever and pallor for three weeks. Clinical examination revealed a temperature of 39°C, hepatomegaly, and splenomegaly. Laboratory tests showed bicytopenia, hypertriglyceridemia, and elevated lactate dehydrogenase (LDH). Bone marrow examination revealed Leishman bodies and hemophagocytic images. The patient was hospitalized and received treatment. The clinical and biological course was favorable. Conclusion: Visceral leishmaniasis associated with hemophagocytic syndrome is severe and may be life-threatening. Physicians should consider this diagnosis in children presenting with fever and splenomegaly. Urgent complementary investigations are needed to confirm this association and initiate appropriate treatment.

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Background: The optimal rate of feeding advancement in preterm LBW infants remains uncertain, especially in low-resource settings. This study aimed to compare feeding intolerance and nutritional outcomes between rapid and gradual feeding protocols. Aim of the Study: The aim of the study was to compare feeding intolerance and nutritional outcomes in preterm low birth weight neonates receiving rapid versus gradual advanced feeding protocols. Methods: This randomized controlled trial at the Department of Neonatology, Bangladesh Shishu Hospital & Institute (BSH&I), Dhaka, from July 2022 to June 2024, included 88 low birth weight preterm neonates. Neonates were randomized to receive either rapid or gradual feeding advancement. Primary outcomes included feed intolerance, sepsis, NEC, hospital stay, and mortality. Data were analyzed using SPSS with a significance level of p < 0.05. Results: The study compared two feeding protocols in preterm low birth weight neonates. There were no significant differences in gestational age or birth weight between the groups. Feed intolerance was more common in group A (29.5%) than in group B (15.9%), but not significantly (p = 0.127). Group A reached full feeds faster (7.0 vs. 8.5 days, p = 0.004) and required less parenteral nutrition (5.0 vs. 7.5 days, p = 0.001). Group B had a longer hospital stay (10.0 vs. 7.0 days, p = 0.002), but no difference in weight at discharge (p = 0.740). Conclusion: Rapid enteral feeding in low-birth-weight preterm neonates improves nutritional outcomes without increasing feed intolerance.