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Background. Tuberculosis (TB) coinfection in human immunodeficiency virus- (HIV-) infected patients is considered a risk of antiretroviral therapy (ART) failure. Coadministration of antitubercular therapy (ATT) with ART is another challenge for TB management. Objective. The study was aimed at investigating contributing factors affecting treatment outcomes in HIV-/TB-coinfected patients. Design. Cross-sectional. Setting. Samples were collected from the Pakistan Institute of Medical Sciences Hospital Islamabad. Subject and Methods. Clinicodemographic and immunovirological factors between the two groups were compared. The Student t -test and chi-square test were applied to compare outcome variables, and logistic regression was applied to determine the effect of TB on virological failure (VF). Main Outcome Measures. TB coinfection did not increase VF even in univariate (p = 0.974) and multivariate analysis at 6 and 12 months of 2nd-line ART start. ARV switching was significant (p = 0.033) in TB-coinfected patients. VF was significantly high in ATT-coadministered patients along with a viral load of ≥1000 (p = 0.000). Sample Size and Characteristics. We recruited seventy-four HIV patients on 2nd-line ART; 33 coinfected with TB were followed for at least 12 months. Conclusion. In HIV-/TB-coinfected patients, CD4 count, CD4 gain, and VF remained comparable to HIV patients with no TB infection. ATT significantly affects the treatment outcome, suggesting drug-to-drug interactions. These factors are important to revisit the therapeutic guidelines to maximize the benefit of dual therapy in resource-limited settings. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is the third most prevalent cause of tumorigenesis and several pathogenic bacteria have been correlated with aggressive cases of cancer i.e., genotoxin (colibactin) producing Escherichia coli (E. coli). This study was designed to investigate the genetic diversity of clb+clb+E. coli strains and their association with CRC. Pathogenic E. coli isolates from colorectal biopsies were characterized based on phylotypes, antibiotic resistance pattern, and (Enterobacterial Repetitive Intergenic Consensus Sequence-based Polymerase Chain Reaction) ERIC-PCR. Furthermore, isolates were screened for the presence of the Pks (polyketide synthase) Island specifically targeting colibactin genes A and Q. The selective clb+clb+ isolates were subjected to cytotoxicity assay using Human embryonic kidney (HEK) cell lines. We revealed that 43.47% of the cancer-associated E. coli isolates were from phylogroup B2 comparatively more pathogenic than rest while in the case of healthy controls no isolate was found from B2. Moreover, 90% were found positive for colibactin and pks (polyketide synthase) island, while none of the healthy controls were found positive for colibactin genes. All healthy and cancer-associated isolates were tested against 15 antibiotic agents, we observed that cancer-associated isolates showed a wide range of resistance from 96% against Nalidixic acid to 48% against Doxycycline. Moreover, E. coli isolates were further genotyped using ERIC-PCR, and selected clb+clb+E. coli isolates were subjected to cytotoxicity assay. We recorded the significant cytotoxic activity of clb+clb+ E. coli phylogroup B2 isolates that might have contributed towards the progression of CRC or dysbiosis of healthy gut microbiota protecting against CRC pathogenesis. Our results revealed a significant p<0.023 association of dietary habits and hygiene p<0.001with CRC. This is the first study to report the prevalence of E. coli phylogroups and the role of colibactin most virulent phylogroup B2 among Pakistani individuals from low socioeconomic setup. [ABSTRACT FROM AUTHOR]

Ovarian tumors, or ovarian neoplasms, are benign or malignant tumors arising from the ovaries. They may arise from any of the three components of ovary i.e. surface epithelium, germ cells and the stroma of the ovary including sex cords. Tumors in the ovary can also be secondary or metastatic tumors. Objective: To determine the frequency of Ovarian Tumors according to WHO Histological classification and their relation to age at diagnosis in almost one year. Methods: A cross-sectional study was carried out, that included all the consecutive cases of ovarian neoplasms diagnosed at the Pathology department of a public sector university in Lahore from 1 January 2015 to 13 February 2016. Results: In 95 female patients diagnosed with ovarian tumors, the mean age was found to be 29.58 ± 11.493 with a range of 3-65 years. Tumors were most common between the ages of 15 to 30 years. The highest rates of malignancy were in the 0-15 and 45-60 age groups (Figure 1). About 78.9% of the tumors (75/95) were benign, 1.1% (1/95) were borderline and 20% (19/95) were malignant (Figure 3), 72.6% (69/95) were epithelial tumors, 23.2% (22/95) were germ cell and 4.2% (4/95) were sex cord stromal tumors (Figure 4). Among the 95 cases, serous tumors were the most common (49.5%), followed by mucinous (16.8%) and teratomas (15.8%). Conclusion: According to our study, ovarian tumors were common between the age of 15 to 29 years. Benign neoplastic lesions were more common than malignant neoplastic lesions. The frequency of malignant and benign ovarian neoplasms found in our research differed from other studies conducted in Pakistan. There is a significant association of ovarian tumors in age less than 30 year as compared to older age groups (P < 0.001). [ABSTRACT FROM AUTHOR]