Mixed nontuberculous mycobacteria in an immunocompromised patient with probable progressive multifocal leukoencephalopathy.

Objectives: Nontuberculous mycobacteria (NTM) are increasingly recognized opportunistic pathogens found ubiquitously in the environment. The presence of multiple NTM species at the site of disease complicates diagnosis and treatment.

Case And Management: A 40-year-old patient who tested positive for HIV, with an absolute clusters of differentiation 4+ T-cell count of 3 cells/µl and cryptococcaemia, presented with hemoptysis, productive cough, and weight loss.

Genomic Medicine in the Developing World: Cancer Spectrum, Cumulative Risk and Survival Outcomes for Lynch Syndrome Variant Heterozygotes with Germline Pathogenic Variants in the and Genes.

: Although genetic testing has improved our ability to diagnose Lynch syndrome (LS), there is still limited information on the extent of variations in the clinical and genetic landscape among LS variant heterozygotes (LSVH) in Africa. We sought to investigate the cancer spectrum, cumulative risk, and survival outcomes of LSVH with pathogenic/likely pathogenic variants (P/LPVs) in the and genes using a LS registry in South Africa over the last 30 years. : A retrospective study was conducted to retrieve demographic, clinical, and genetic data of all LSVH with P/LPVs in the and genes from our LS registry.

Preeclampsia and eclampsia: Enhanced detection and treatment for morbidity reduction.

Preeclampsia is a life-threatening complication that develops in 2-8% of pregnancies. It is characterized by elevated blood pressure after 20 weeks of gestation and may progress to multiorgan dysfunction, leading to severe maternal and fetal morbidity and mortality. The only definitive treatment is delivery, and efforts are focused on early risk prediction, surveillance, and severity mitigation.

Electronic cigarette usage amongst high school students in South Africa: a mixed methods approach.

Background: The WHO has highlighted that: "promotion of e-cigarettes has led to marked increases in e-cigarette use by children and adolescents." The long-term neuropsychiatric and psychological consequences of substance abuse in adolescence is well recognised. Limited data exists on the adolescent burden of vaping-related nicotine addiction and behavioural and/or psychological dependence to guide pharmacological or behavioural interventions to stop electronic cigarette usage.

Understanding the relationship between the frequency of HbA1c monitoring, HbA1c changes over time, and the achievement of targets: a retrospective cohort study.

Background: The goal of post-diagnosis diabetes management is the achievement and maintenance of glycaemic control. Most clinical practice guidelines recommend 3-6 monthly HbA1c monitoring. Despite this guidance, there are few data supporting the impact of monitoring frequency on clinical outcomes, particularly from low- and middle-income country settings.

Solitary fibrous tumor of the bladder: A rare cause of bladder outlet obstruction in an adult male.

Introduction: Solitary fibrous bladder tumors are extremely uncommon, with only a few cases reported. These fibroblastic mesenchymal neoplasms are typically benign, indolent, and slow growing.

Case Presentation: A 44-year-old male patient with obstructive uropathy was referred to our unit for workup.

Epidemiological pattern of trauma among children 0-9 years in Cameroon.

Background: In low- and middle-income countries, trauma is the leading cause of death among youth and it is also a major cause of disability. Globally, more than 1,600 children and adolescents below the age of 19-years die every day from preventable injuries. Traffic-related injuries, falls, sports-related injuries, assaults, burns, and drownings are the most commonly reported causes of traumatic mortality among children.

Utility of colposcopy for the screening and management of cervical cancer in Africa: a cross-sectional analysis of providers' training and practices.

Introduction: Cervical cancer is a public health issue in Africa with devastating socioeconomic consequences due to the lack of organized screening programs. The success of screening programs depends on the appropriate investigation and management of women who test positive for screening. Colposcopic assessment following positive screening results is a noteworthy issue in Africa.

Silicotuberculosis: a critical narrative review.

Silicotuberculosis, the combination of silicosis and pulmonary tuberculosis (TB), remains a substantial clinical and public health problem in high TB burden countries with silica-exposed workforces. The objectives of this narrative review are to propose a definition of silicotuberculosis which includes post-tuberculous lung disease, to emphasise the importance of understanding how the two diseases modify each other, and to identify as yet unanswered questions relevant to clinical practice and disease control and mitigation. The unique aetiological relationship between silica exposure and TB is now firmly established, as is the accelerated impairment and mortality imposed by TB on individuals with silicosis.

Key Issues at the Forefront of Diagnosis and Testing for Antiphospholipid Syndrome.

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by antiphospholipid antibodies associated with thrombosis and pregnancy complications. Catastrophic APS is a severe form involving multiple organ systems with a high mortality rate. The pathogenesis involves antiphospholipid antibodies which target phospholipid-binding proteins and damage endothelial cells thus activating coagulation, triggering a pro-thrombotic state.

First ABO-Incompatible Pediatric Kidney Transplant in South Africa-A Case Report.

Background: Blood group incompatibility previously represented an obstacle to living related donor (LRD) options; desensitization modalities have expanded LRD options. ABO-incompatible kidney transplants have been successful in adults and pediatric liver transplants, but to date not yet in pediatric kidney transplants in South Africa.

Case Report: Patient X is a 5 year old male with end-stage kidney failure due to Posterior Urethral Valves, requiring peritoneal dialysis pre-transplant.

Spectrum of offending drugs and cutaneous adverse drug reactions requiring hospitalisation in a tertiary South African hospital in TB/HIV endemic setting.

Introduction: Cutaneous immune-mediated adverse drug reactions are more prevalent in people with human immunodeficiency virus (PWH). Severe cutaneous adverse drug reactions (SCAR) are a life-threatening subset of cutaneous adverse drug reactions (CADRs) and a significant public health issue in settings endemic for human immunodeficiency virus and tuberculosis. However, limited data are available on CADR requiring hospitalisation in African settings.

Vaccine safety surveillance in South Africa through COVID-19: A journey to systems strengthening.

Background: Surveillance systems for monitoring and reporting adverse events following immunisation (AEFI) and adverse events of special interest (AESI) are vital in understanding safety profiles of post-marketed vaccines. Evaluation of surveillance systems is necessary for systems strengthening. We conducted the first evaluation of the South African AEFI surveillance system in its current form, established in 2018.

Posterior cruciate ligament injuries managed with internal bracing.

Background: Synthetic augmentation in the form of an internal brace is increasingly used to stabilize injured knee ligaments. This study aimed to evaluate the clinical and radiological outcome of patients with knee dislocations treated with a posterior cruciate ligament (PCL) internal brace.

Methods: Synthetic suture tape drilled into the femoral and tibial PCL footprints was performed in patients with multiple knee ligament injuries.

Novel small fragment removal system may improve extraction of renal calculi: an in vitro study.

Objective: To describe a novel Small Fragment Removal System (SFRS) which is hypothesized to improve stone fragment removal during flexible ureteroscopy in patients with urolithiasis. The SFRS consists of three parts: a Syphon Ureteric Access Sheath (SUAS), a Dual Action Pump (DAP) and an Agitator. This bench assessment aims to assess the SFRS's impact on intra-renal pressure (IRP), irrigant flow rate and stone fragment removal compared to a traditional UAS.

Home visits for preterm/low birthweight infants in South Africa: Qualitative evidence synthesis.

Background: Prematurity and low birth weight (LBW) are the main causes of neonatal mortality in South Africa (SA). Home visits by lay health workers (LHWs) may be effective in addressing this.

Aim: To inform a national guideline on LHW home visits as part of the Global Evidence, Local Adaptation (GELA) project, we conducted a rapid qualitative evidence synthesis exploring the acceptability, feasibility and equitability of this intervention for preterm and LBW babies.

Clinical and Histopathological Findings in HIV-positive to HIV-positive Kidney Transplant Recipients.

Background: The spectrum of histological findings in transplanted kidneys from HIV-positive donors to HIV-positive recipients is relatively unexplored. This study describes the type and timing of histological diagnoses observed in this unique cohort.

Methods: Adequate biopsies were analyzed at implantation and posttransplant between September 2008 and May 2022.

Hodgkin lymphoma: the role of EBV plasma viral load testing in an HIV-endemic setting.

South Africa has a high burden of human immune deficiency virus (HIV)-associated Hodgkin lymphoma (HL) which is typically Epstein-Barr virus (EBV) infected, detected by histological stains. Circulating plasma EBV derived from apoptotic EBV infected tumour cells is a potential biomarker. This study aimed to evaluate the role of plasma EBV load testing in newly diagnosed HL patients and correlate pretreatment plasma EBV levels, HIV status and EBV tumour status with overall survival (OS).