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The objective of this study was to describe the sociodemographic aspects, presenting symptoms and findings of clinical examination of laboratory confirmed cases of trichomoniasis. Cases of trichomoniasis were studied, focusing on the sociodemographic aspects and presenting symptoms and signs at clinical examination. There were 29 laboratory confirmed cases of trichomoniasis. The infection was prevalent in equal proportions in all age groups (36-45, 15-25, 26-35 years- 38%, 31%, and 31%). The majority (76%) were married. There were 35% house wives and 28% sex workers. Contraceptives were not used by 48%. Only 41% were symptomatic at the time of detection. Out of those with a vaginal discharge, 50% complained of greenish yellow discharge and 34% a whitish thick discharge. In addition to the discharge, 7% had itching. None of the patients who were positive complained of dysuria. Findings at the clinical examination were mostly different to the symptoms described by the patients. On examination, the majority (81%) of T vaginalis infected women had a serous vaginal discharge and 14% a greenish yellow discharge. Twenty eight percent of infected females did not have any discharge. Presence of typical symptoms or type of vaginal discharge on examination cannot be used as the sole criterion for the diagnosis of trichomoniasis. These results indicate that treatment of patients based on symptoms per se can lead to over usage of metronidazole. This also shows the importance of laboratory support to diagnose T vaginalis infection. DOI: http://dx.doi.org/10.4038/sljid.v3i1.4690

PolyCystic Ovarian Syndrome (PCOS) poses significant challenges to women's reproductive health due to its diagnostic complexity arising from a variety of symptoms, including hirsutism, anovulation, pain, obesity, hyperandrogenism, and oligomenorrhea, necessitating multiple clinical tests. Leveraging Artificial Intelligence (AI) in healthcare offers several benefits that can significantly impact patient care, streamline operations, and improve medical outcomes overall. This study presents an Explainable Artificial Intelligence (XAI)-driven PCOS smart predictor, structured as a hierarchical ensemble consisting of two tiers of Random Forest classifiers following extensive analysis of seven conventional classifiers and two additional stacking ensemble classifiers. An open-source data set comprising numerical parametric features linked to PCOS for classifier training was used. Moreover, to identify essential features for PCOS prediction three feature selection methods: Threshold-driven Optimized Principal Component Analysis (TOPCA), Optimized Salp Swarm (OSSM), and Threshold-driven Optimized Mutual Information Method (TOMIM) were fine-tuned through thresholding and improvisation to detect diverse attribute sets with varying numbers and combinations. Notably, the two-level Random Forest classifier model outperformed others with a remarkable 99.31 % accuracy by employing the top 17 features selected through the Threshold-driven Optimized Mutual Information Method (TOMIM) along with anoverallaccuracy of 99.32 % with 8 fold cross validation for 25 runs. The Smart predictor, constructed using Shapash - a Python library for Explainable Artificial Intelligence - was utilized to deploy the two-level Random Forest classifier model. Ensuring transparency and result reliability, visualizations from robust Explainable AI libraries were employed at different prediction stages for all considered classifiers in this study., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Bolivian hemorrhagic fever (BHF) caused by Machupo virus (MACV) is a New World arenavirus having a reported mortality rate of 25-35%. The BHF starts with fever, followed by headache, and nausea which rapidly progresses to severe hemorrhagic phase within 7 days of disease onset. One of the key promoters for MACV viral entry into the cell followed by viral propagation is performed by the viral glycoprotein (GPC). GPC is post-transcriptionally cleaved into GP1, GP2 and a signal peptide. These proteins all take part in the viral infection in host body. Therefore, GPC protein is an ideal target for developing therapeutics against MACV infection. In this study, GPC protein was considered to design a multi-epitope, multivalent vaccine containing antigenic and immunogenic CTL and HTL epitopes. Different structural validations and physicochemical properties were analysed to validate the vaccine. Docking and molecular dynamics simulations were conducted to understand the interactions of the vaccine with various immune receptors. Finally, the vaccine was codon optimised in silico and along with which immune simulation studies was performed in order to evaluate the vaccine's effectiveness in triggering an efficacious immune response against MACV., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The deep inferior epigastric perforator (DIEP) free flap is the gold standard procedure for autologous breast reconstruction. Although breast-related complications have been well described, donor-site complications and contributing patient risk factors are poorly understood., Methods: We examined a multi-institutional, prospectively maintained database of patients undergoing DIEP free flap breast reconstruction between 2015 and 2020. We evaluated patient demographics, operative details, and abdominal donor-site complications. Logistic regression modeling was used to predict donor-site outcomes based on patient characteristics., Results: A total of 661 patients were identified who underwent DIEP free flap breast reconstruction across multiple institutions. Using logistic regression modeling, we found that body mass index (BMI) was an independent risk factor for umbilical complications (odds ratio [OR] 1.11, confidence interval [CI] 1.04-1.18, p = 0.001), seroma (OR 1.07, CI 1.01-1.13, p = 0.003), wound dehiscence (OR 1.10, CI 1.06-1.15, p = 0.001), and surgical site infection (OR 1.10, CI 1.05-1.15, p = 0.001) following DIEP free flap breast reconstruction. Further, immediate reconstruction decreases the risk of abdominal bulge formation (OR 0.22, CI 0.108-0.429, p = 0.001). Perforator selection was not associated with abdominal morbidity in our study population., Conclusions: Higher BMI is associated with increased abdominal donor-site complications following DIEP free flap breast reconstruction. Efforts to lower preoperative BMI may help decrease donor-site complications., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Nipple-sparing mastectomy offers several advantages for women seeking postmastectomy breast reconstruction, but compromised skin and nipple perfusion may lead to skin and nipple necrosis. It is unclear whether the incisional approach contributes to these complications; therefore, the purpose of this study was to compare the impact of incision type on outcomes in patients undergoing nipple-sparing mastectomy., Methods: This is a prospective cohort study of patients undergoing nipple-sparing mastectomy with prosthetic breast reconstruction through an inframammary fold versus a lateral radial incision. Skin and nipple perfusion as represented by fluorescence intensity, mammometric parameters, patient-reported outcomes, and clinical outcomes were analyzed and compared for the two cohorts, and multivariable logistic regression models were performed to evaluate the effects of covariates on outcomes., Results: Seventy-nine patients were studied: 55 in the inframammary fold cohort and 24 in the lateral radial cohort. The inframammary fold group had significantly less fluorescence intensity to the inferior (21.9 percent versus 36.9 percent; p = 0.001) and lateral portions of breast skin (23.1 percent versus 40.7 percent; p = 0.003) after reconstruction. Decreased fluorescence intensity was associated with smoking, decreased mean arterial pressure, and greater specimen weight. Postreconstruction breast volumes were increased over preoperative volumes in the inframammary fold group (38.3 percent) versus the lateral radial (31.2 percent) group; however, patients with a lateral radial incision had a greater increase in satisfaction with their breasts and psychosocial well-being., Conclusions: There are significant differences in patient-reported outcomes and final breast volumes based on the incisional approach to nipple-sparing mastectomy. These data can be used to guide providers and counsel patients considering nipple-sparing mastectomy with prosthetic reconstruction., Clinical Question/level of Evidence: Therapeutic, II.

Learning Objectives: After studying this article, the participant should be able to: 1. Understand how to determine nipple-areola complex positioning on the reconstructed breast. 2. Understand the multitude of local flap and distant graft options for nipple-areola complex reconstruction. 3. Draw at least three fundamental nipple-areola complex reconstruction patterns. 4. Understand the forces that are responsible for flattening of the reconstructed papule. 5. Understand the current techniques used in secondary nipple-areola complex reconstructions., Summary: Nipple-areola complex reconstruction and tattooing represent the final two stages of breast reconstruction. Nipple-areola complex reconstruction is typically accomplished with the use of local flaps, local flaps with augmentation grafts, or a combination thereof. Regardless of the technique used, however, all nipple-areola complex reconstructions lose a degree of projection over time. Options for secondary reconstruction include the use of local tissue flaps alone or in combination with acellular biological matrices.

To characterize male breast cancer in Africa in recent decades, we systematically reviewed literature and conducted a meta-analysis of available data on male breast cancer in Africa. A paper was included if both male and female breast cancer were available. If two publications covered the same geographic area, only the publication with a longer study period was included. Random effects models and mixed effect meta-regressions were used to analyze data of 1201 male and 36,172 female breast cancer patients from 27 African countries. We showed that the male-to-female breast cancer ratio was 0.042 overall and it has decreased in recent years. Additionally, male breast cancer patients in Africa had the disease at age 54.6 on average, 7 years older than female patients. In conclusion, male breast cancers in Africa are characterized as late onset and male-to-female breast cancer ratio in Africa is higher than populations in developed countries., (Copyright © 2012 Elsevier Ltd. All rights reserved.)