unusual presentation of colonic duplication

Gastrointestinal duplication is an uncommon congenital abnormality, usually diagnosed early in life; a minority may remain unsuspected until adulthood. Ileal duplications are the most common while colonic duplications are rare and remain asymptomatic and undiagnosed in most cases. The main symptoms include pain and/or abdominal distension. Rarely, duplications present with signs of acute abdomen or acute bleeding. We report about a case of a colonic cystic duplication in an adult revealed by rectal bleeding. This report illustrates the difficulties that can be encountered when establishing this rare diagnosis and emphasis that colonic duplication should be looked for in search for an aetiology of obscure colonic bleeding

Evaluating the therapeutic care of HIV infection in Tunisia

Our aim is to determine different therapeutic response profiles in Tunisian HIV- 1 infected patients, to identify those with therapeutic failure and to compare the results of the genotypic resistance test used in Tunisia [INNO LiPA Test] with those of automatic sequencing to evaluate its efficacy. The retrospective survey concerns 392 infected patients enrolled from January 2001 to December 2006. Evaluation of HIV INNO LiPA test was performed by comparing these test results with those of automatic sequencing in 36 plasmatic samples for 13 infected patients with therapeutic failure. on the basis of the HIV viral load evolution, 57.55% of patients present a good therapeutic response and 42.44% a bad one. Patients with therapeutic failure require genotypic resistance test. A comparison of HIV INNO LiPA test and direct sequencing showed a strong concordance between the two tests results either for reverse transcriptase gene or protease gene. However, the uninterruptible results obtained by INNO LiPA test [8.79% of analysed codons] and the limited number of analysed codons were the defaults of INNO LiPA technique .the contribution of INNO LiPA technique in the knowledge of the epidemiological HIV resistance profiles of virus strains of HIV infected individuals failing therapy was considerable. However, due to INNO LiPA technique limitations, sequence analysis must be considered a more complete assay for the monitoring of antiretroviral resistance of HIV infected patients