Enteric fever is a very common infection in south East Asian countries with varied complication including neurological complications. However most common neurological complication of enteric fever is aseptic meningitis. This a case report of rare presentation of enteric fever with cerebellar signs and neuroimaging showing cytotoxic lesions. Furthermore, this case came out to be a case of drug resistant enteric fever. This is a concern in recent area of antimicrobial resistance as this atypical presentation can be attributed to resistant salmonella infection.

This report documents the case of a 28-year-old male who developed widespread psoriasis following getting the second dose of the Pfizer-BioNTech COVID-19 vaccine in 2022. Despite half a year of treatment with Western medicine, there was no improvement in symptoms. In 2023, the patient sought Traditional Chinese Medicine (TCM) treatment. The initial examination by the Chinese medicine practitioner revealed that the psoriasis affected 17% of the Body Surface Area with a PASI (Psoriasis Area and Severity Index) score of 16.4. The TCM diagnosis identified the condition as predominated by dampness with spleen deficiency. The treatment plan involved the internal administration of Chinese herbal formulas, including Chai Hu Gui Zhi Gan Jiang Tang and Wu Ling San, along with the topical application of Indigo Naturalis gel. After six months of treatment, his psoriasis condition significantly improved, with the PASI score decreasing to 2.9. By January 2024, the condition had fully recovered. Globally, approximately 125 million adults are affected by psoriasis, and there has been an increase in cases of psoriasis worsening or emerging post-vaccination. This case demonstrates the effectiveness of TCM and herbal treatments in managing vaccine-induced psoriasis and COVID-19-related psoriasis. It also opens new avenues for research into applying alternative treatment in modern medical practices.

Purpose: We conducted a meta-analysis by searching and analyzing literature studies published through December 1, 2023, executing to assess the Event Rates (ERs) of vertigo, tinnitus, hearing loss, earache and aural fullness by confirmed coronavirus disease 2019 (COVID-19) or its vaccine.

Methods: A database (PubMed, Embase, Web of Science) search for studies released up to December 01, 2023 was conducted. The ERs of potential ear illness of take notice of crowd papers of COVID-19 or COVID-19 vaccine draw our focus, we as well as paid attention to uncommon ear symptoms described in person with COVID-19. The information retrieved from the respective papers were evaluated and summarized.

Results: We accepted 91 study’s that met the eligibility criteria. The comprehensive assessment of ERs based heavily on retrospective review of common symptoms in ear of COVID-19 patient was 13% (95% confidence interval [CI]: 0.09-0.18), 10% (95% CI: 0.06-0.15), 8% (95% CI: 0.05-0.12), 5% (95% CI: 0.02-0.08) and 13% (95% CI: 0.06-0.22) for vertigo, tinnitus, hearing loss, earache and aural fullness, respectively. The ERof vertigo, tinnitus, and hearing loss after COVID-19 vaccine injection were 7% (95% CI: 0.05-0.11), 6% (95% CI: 0.01-0.15) and 2% (95% CI: 0.00-0.06), in proper order.

Conclusions: Our findings suggest that COVID-19 or COVID-19 vaccine can cause vertigo, tinnitus, hearing loss, earache and aural fullness. Besides, it can cause some less common but not insignificant ear symptoms, such as hemorrhage of the membranous labyrinth, otitis media. This phenomenon should be of great concern to ear nose throat surgeon.

Listeria monocytogenes is often associated with foodborne illness, with invasive infections reported at the extremes of age, but it can cause meningitis in immunocompetent hosts. We report a case of an adolescent male successfully treated with a second-line agent, with no residual sequelae.

HBV Capsid Assembly Modulators (CAMs) had emerged as promising oral agents for Anti-Hepatitis B Virus (HBV) drug development, with a potential for Chronic Hepatitis B (CHB) functional cure. Here we report the discovery and preclinical characterization of GST-HG141, a novel HBV CAM, currently under phase II clinical evaluation in CHB patients. In vitro, GST-HG141 induced HBV core protein assembly and the formation of intact capsids without affecting capsid morphology. GST-HG141 potently inhibited HBV DNA secretion in HepG2 2.15 cells, and was additive with nucleos(t)ide analogs, but with no shift from T = 4 towards T = 3 capsid formation in contrast to other CAM-Es. Furthermore, GST-HG141 retained potent antiviral activity against HBV genotypes A-D, and against nucleos(t)ide- and CAM-resistant mutants, but with significantly different resistance profile from other CAMs. In the HBV-infected Primary Human Hepatocytes (PHH), GST-HG141 inhibited de novo synthesis of the HBV cccDNA, but had no effect on the established cccDNA pools. Finally, in an AAV/HBV mouse model in vivo, GST-HG141 robustly and dose-dependently reduced serum (~3.0 log10) and liver (0.9 log10) HBV DNA with no significant effect on body weight. Our data demonstrate that GST-HG141 acts on different steps of the HBV life cycle, consistent with the CAM-E MOA, but its exact MOA and resistance profile appears to be distinct from other CAM-Es and CAM-As reported in the literature. GST-HG141 has since completed Ph1a clinical study in healthy subjects (NCT04386915) (9), and demonstrated robust antiviral efficacy in a 28-day Ph1b study in CHB patients (NCT04868981) (data will be reported elsewhere). Further clinical evaluation of GST-HG141 is ongoing.

Background: The purpose of this study was to identify the clinical and thin-section CT findings in patients with adenovirus infections occurring at a campus, describe the risk factors for progress in pneumonia. The changes during COVID-19 pandemic were also observed.

Methods: From February to April of 2018, clinical data and samples from the patients were collected. We described characteristics of progressed group (n = 97) versus no-progressed group (n = 12) and compared clinic-laboratory between the two groups. From December 2020 to December 2022, all patients with acute respiratory fever on the campus were tested for adenovirus nucleic acid with nasopharyngeal swabs.

Results: The main clinical manifestations of acute febrile respiratory caused by B55 adenovirus infection were fever, cough, sore throat and aching muscles which had no significant difference between two groups. The duration of fever (> 5 days) was significantly different between the two groups (p = 0.000). The dynamic changes of neutrophil-lymphocyte count ratio (NLR) in no-progressed patients were lower than those of progressed patients (P = 0.000). The fever duration (≥ 5 days) (OR = 14.628; 95% CI = 0.009 ± 0.508; p = 0.009) and the NLR changes (OR = 0.47; 95% CI = 0.279 ± 0.797; p = 0.005) remained independent factors associated with progressed disease. Four and five adenovirus nucleic acid positive cases were detected in October 2021 and 2022 respectively.

Conclusion: Adenovirus infection is associated with the decreased peripheral blood lymphocyte proportion. Proper immunomodulatory treatment may be important for these patients. Hand hygiene, social distance and isolation are import means to control respiratory diseases transmitted by airborne droplets.

Background: Tuberculosis disease is a common opportunistic infection in people living with HIV not initiated Isoniazid Preventive Therapy dose. In 2015 WHO recommended at least, 36-months course for significant population benefits towards reducing Tuberculosis infections in the high-risk population, although the minimum recommended is six months dose. Six months dose completion is sub-optimal and enrolled clients in the treatment discontinue within three months following initiation. The time interval after three months following initiation clients have low dose discontinuation. Isoniazid Preventive Therapy discontinuation within three months following initiation is high although is inadequately routine documented at health facility settings in Tanzania. The study determined predictors of Isoniazid Preventive Therapy discontinuation within three months following initiation among People Living with HIV aged 15 and above years in Dar es Salaam region.

Methods: A retrospective cohort study was conducted using secondary data which are routinely collected. Researcher abstracted data from 58 care and treatment clinics in the region. The study recruited clients who screened negative for TB symptoms and initiated IPT from January 2013 to June 2017. Multilevel Modified Poisson regression model with robust standard errors were used to estimate Prevalence Ratios (PR), 95% Confidence Interval (CI) and p-values at 5% significance level for predictors of IPT discontinuation within three months following initiation among HIV infected individuals. Health facility cluster adjusted model was used to estimate the random effects. The covariates that were adjusted in the final model are age, sex, years of Isoniazid Preventive Therapy, health facility ownership, ART status, WHO stage, CD4+ cells/µL and functional status.

Results: A total of 29,382 clients were initiated Isoniazid Preventive Therapy, with 21,808 (74%) female. Overall 11,826 (40.3%) discontinued IPT, decreasing from 57.2% (1,062/1,857) in year 2013 to 22.9% (883/3,856) in year 2017. Adjusted findings and show that clients with CD4+ cells/µL between 100 to 349 +cells/µL had significant higher Isoniazid Preventive Therapy, discontinuation prevalence than those with CD4+

Conclusion: IPT discontinuation is high although was decreasing over time. Significant higher prevalence of IPT discontinuation was seen in PLHIV with CD4+ between 100 to 349 cells/µL. Patients who were not on ART had lower prevalence than baseline group. Therefore, much intervention for reducing IPT discontinuation within three months following initiation in exposed groups are highly needed, although there was decreasing trend as per year increase.

Background: Viral load monitoring is the gold standard for monitoring adherence and confirming treatment response, while treatment failure is often caused by either therapeutic failure due to ART resistance or poor adherence to treatment. Assessment for viral load suppression (< 1000copies/ ml) is one of HIV indicators therefore monitoring and reporting outcome of ART is very important for the program implementation and monitoring. Therefore, the objective of this study is to assess factors associated with high viral load resuppression among HIV patients receiving antiretroviral therapy in Hawassa City public facilities.

Method: A retrospective cross-sectional study was conducted between September 1, 2017 and June 30, 2020, among people living with HIV (PLHIV) in three public facilities at Hawassa city, Ethiopia. Patients with a Viral Load (VL) > 1000 copies/ml received three sessions of Enhanced Adherence Counselling (EAC) one month apart, after which a repeat VL was done. The main outcome was viral re-suppression following EAC. Structured checklist was used to extract data by reviewing medical records focusing on patient related data (age, sex, and residence), monitoring response to ART (VL, CD4 count, WHO clinical staging), Co-morbidities, adherence, and duration of medication. Data was entered in EpiData version 3.1. and the analyses were done using SPSS for Windows version, 25.0.

Result: A total of 220 records of high viral load HIV seropositive were reviewed and 40% of viral re-suppression was observed. Odds of viral re-suppression observed among patients enrolled in to enhanced adherence counseling (AOR = 2.1, 95% (1.0-4.2)) and who had TB infection (AOR = 0.53, 95%CI (0.2-0.8)).

Conclusion: The study showed low viral load re-suppression prevalence among HIV high viral load patients. Enhanced Adherence Counseling (EAC) had great roll in viral re-suppression and TB infection decreases odds of HIV viral re-suppression. Enhanced Adherence Counseling (EAC) and TB infection prevention is recommended for all high viral load HIV patients

A previously healthy 8-year-old girl presented at our hospital with cervical pain and walking difficulty. Initial evaluation was unremarkable, but magnetic-resonance-imaging revealed extensive vertebral involvement. Surgery confirmed Mycobacterium tuberculosis infection and a nine-month antitubercular regimen was started. Early diagnosis, multi-drug therapy and surgery led to a favorable outcome, emphasizing the importance of a multidisciplinary approach in managing pediatric spinal tuberculosis.

Background: At this stage, CHB is mainly pursuing functional cure, which is defined as the completion of a limited course of treatment with persistent undetectable serum HBsAg and HBV DNA, HBeAg negativity (with or without HBsAg seroconversion), persistence of residual cccDNA, regression of hepatic inflammation, improvement of hepatic histopathology, and a significant reduction in the prevalence of end-stage liver disease, i.e., the end of treatment, and a significant reduction in the incidence of end-stage liver disease. An important modality for achieving clinical cure is currently combination therapy. However, in recent years, studies have found that some HBV-infected patients with LLV even after long term antiviral therapy, i.e., HBV-DNA levels are higher than the lower limit of detection but lower than 2000 IU / ml. Many experts believe that weak host immunity and the abundance of deoxynucleotides in the body leading to the competitive inhibition of the NUC is the main reasons. For chronic HBV patients who still have LLV even after more than 1 year of antiviral therapy, the treatment regimen should be modified when appropriate. In this article, we report a case of chronic HBV with LLV during antiviral therapy, and the study of the mechanism of LLV will help us to optimize the antiviral therapy and reduce the incidence of adverse effects such as cirrhosis and hepatocellular carcinoma.

Case Summary: Patients with chronic hepatitis B infection who develop LLV on sequential combination therapy and ultimately achieve clinical cure. The patient had been infected with the hepatitis B virus for 18 years and had recurrent liver function abnormalities for 7 years, and began receiving treatment 7 years ago, and was now suffering from liver function abnormalities, positive surface antigen and core antibodies, and was initially diagnosed with chronic viral hepatitis B. During the sequential combination therapy of Nas and PEG-IFN, the patient developed LLV. During the course of Nas and PEG-IFN sequential combination therapy, the patient developed LLV, and after adjusting the treatment regimen, the surface antigen and HBVDNA became negative, and clinical cure was achieved.

Conclusion: Some HBV-infected patients develop LLV during long-term antiviral therapy, which may be related to the competitive inhibition of NUC due to weak host immunity and abundant deoxynucleotides in the body, and the treatment regimen should be modified at an appropriate time for chronic HBV patients who suffer from LLV even after more than one year of antiviral therapy.