The prevalence of depression, anxiety and associated factors among adults with living human immunodeficiency virus in University Malaya Medical Centre.

BACKGROUND: This study estimates prevalence of depression and anxiety among adults living with Human Immunodeficiency Virus (HIV) in University Malaya Medical Centre (UMMC) and determines its associated factors. METHODS: This cross-sectional study was conducted between August 2020 and January 2021, in the Infectious Disease clinic and ward. One hundred ninety-one patients were recruited via convenience sampling. Patients' sociodemographic were obtained, followed by Depression, Anxiety, Stress Scale -21 (DASS-21), Multidimensional Scale of Perceived Social Support (MSPSS), and M.I.N.I. international neuropsychiatric interview (M.I.N.I.) The cut off DASS-21 point for depression is ≥5, for anxiety, ≥ 4. Mann-Whitney U and Chi square test were used to analyse the association between variables, and logistic regression to find predictability. RESULTS: Of the 191 participants, 89.5% outpatient, mean age 40 years (SD 0.742), 91.1% male, 65.4% single, 71.2% working, 46.1% Malaysian Chinese, 59.8% non- heterosexual, mean 6 years of being HIV positive; mean CD4 count 449/µL; mean viral load 116,690 (median = 20). 85.9% were taking antiretroviral therapy. The prevalence of depression was 35.1% (n = 67); anxiety was 42.9% (n = 82). Regression analysis revealed anxiety and stress increased odds of depression by 3.8 times (p = .001) and 12 times (p < .001) respectively. Those 40 years old and younger had 2.3 times odds of anxiety (p = .048). Increased social support from friends increased odds of anxiety by 1.7 times (p = .018). Depression and stress increased odds of anxiety by 4.4 times (p = .001) and 3.7 times (p = .008) respectively. CONCLUSIONS: Depression and anxiety among people with HIV is often under-recognised. Early identification and treatment of the mental illness is warranted. Screening with DASS-21 is useful to detect depression in patients with HIV.

Medical Technology: A Systematic Review on Medical Devices Utilized for Epilepsy Prediction and Management.

BACKGROUND: Epilepsy is a devastating neurological disorder that affects nearly 70 million people worldwide. Epilepsy causes uncontrollable, unprovoked and unpredictable seizures that reduce the quality of life of those afflicted, with 1-9 epileptic patient deaths per 1000 patients occurring annually due to sudden unexpected death in epilepsy (SUDEP). Predicting the onset of seizures and managing them may help patients from harming themselves and may improve their well-being. For a long time, electroencephalography (EEG) devices have been the mainstay for seizure detection and monitoring. This systematic review aimed to elucidate and critically evaluate the latest advancements in medical devices, besides EEG, that have been proposed for the management and prediction of epileptic seizures. A literature search was performed on three databases, PubMed, Scopus and EMBASE. METHODS: Following title/abstract screening by two independent reviewers, 27 articles were selected for critical analysis in this review. RESULTS: These articles revealed ambulatory, non-invasive and wearable medical devices, such as the in-ear EEG devices; the accelerometer-based devices and the subcutaneous implanted EEG devices might be more acceptable than traditional EEG systems. In addition, extracerebral signalbased devices may be more efficient than EEG-based systems, especially when combined with an intervention trigger. Although further studies may still be required to improve and validate these proposed systems before commercialization, these findings may give hope to epileptic patients, particularly those with refractory epilepsy, to predict and manage their seizures. CONCLUSION: The use of medical devices for epilepsy may improve patients' independence and quality of life and possibly prevent sudden unexpected death in epilepsy (SUDEP).

Epiglottic granular cell tumour: a case report and literature review.

Granular cell tumour is a rare, benign tumour that may arise in the soft tissues of various locations. It is often asymptomatic; hence, it gets misdiagnosed as other conditions. This is a case of an asymptomatic 50-year-old male with an incidental finding of a supraglottic lesion during routine oesophagogastroscopy. Examination under general anaesthetic showed a whitish non-ulcerating exophytic lesion on the laryngeal surface of the epiglottis, sparing anterior commissure and vocal cords. Surgical excision was performed with an open supraglottic laryngectomy approach. Histopathology confirmed GCT, strongly positive for S-100 protein and weakly positive for CD68. Accurate histologic analysis is a key to identify this rare tumour among other differentials. Although benign, ongoing monitoring is advised due to risk of recurrence.

An unusual finding of schwannoma in the columellar area-A case report.

INTRODUCTION: Schwannomas are benign tumours of the nerve sheath that originate from Schwann cells. Less than 4% of these tumours arise in the sinonasal tract. Columellar involvement is extremely rare - three other cases involving the columella have been reported since 1967. PRESENTATION OF CASE: A 25-year-old woman presented with a swelling of the nasal columella from eight months into pregnancy. She presented with right nasal obstruction and discomfort over the nasal bridge. Pre-operative MRI and ultrasound were performed. The mass was surgically excised using an external septorhinoplasty approach giving a good cosmetic outcome. Histopathologic examination demonstrated schwannoma. DISCUSSION OF CASE: Nasal schwannoma may present with variable symptoms. We discuss the MRI and histological features of schwannoma. A literature review suggests that schwannomas may have accelerated growth in pregnancy. The open rhinoplasty approach is the favoured method for excision of schwannomas near the columellar region. CONCLUSION: Nasal schwannomas are rare in the sinonasal tract, however they need to be considered part of the differential diagnosis for nasal masses. The treatment of choice for these lesions is surgical excision.

Male-specific RNA coliphages detected by plaque assay and RT-PCR in tropical river waters and animal fecal matter.

Male-specific RNA coliphages (FRNA) have been recommended as indicators of fecal contamination and of the virological quality of water. In this study, 16 river water and 183 animal fecal samples were examined for the presence of FRNA coliphages by a plaque assay using Salmonella typhimurium WG49 and WG25 to differentiate between male-specific and somatic phages, a RNase spot test to differentiate between DNA and RNA phages and a reverse transcriptase-polymerase chain reaction (RT-PCR) for the specific identification of FRNA phages. The overall recovery rate for F-specific coliphages was 8.0%. (4.4% from animal fecal matter and 50% from river water samples). Plaque counts were generally low (< 6 x 10(2) pfu per g feces or ml water), with FRNA (6.5%) and Male-specific DNA coliphages (FDNA) (7.0%) phages occurring at almost equal frequencies. The RT-PCR was positive in all FRNA plaques and was able to identify FRNA phages in mixed populations of FRNA, FDNA and somatic phages.