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Denigration is the most common bullying tactic involving public figures like celebrities and politicians where rumourous stories, pictures and videos are posted online to discredit and defame. It involves online "dissing" or "gossiping" about someone by writing and distributing vulgar, derogatory, cruel, mean, or untrue rumours. An online denigrate comment is typically posted as a malicious viral rumour to hurt the victim. A model to detect defamatory posts in the form of online reputation rumours can facilitate pinpointing cases of denigration in target profiles. The key bottlenecks in analyzing rumours in real-time are characterized by the cross-platform, cross-lingual, multimodal, often skewed, high-dimensional nature of data. Optimal feature selection can avoid the curse of dimensionality, increase model accuracy, decrease model training time and enhance the generalizability of the model by reducing overfitting. This research proffers an implicit mechanism that comprehends the truth value of the reputation rumour using meta-heuristic optimization algorithm, Wolf Search algorithm (WSA). An empirical evaluation on the rumour dataset affirms that using feature selection maximizes the relevance and minimizes the redundancy in feature set to build an efficient rumour classification model. [ABSTRACT FROM AUTHOR]

Swaziland is among the countries in the sub-Saharan Africa with high rates of HIV infection. The Swazi Government established Voluntary Counseling and Testing Services (VCT) as part of its response to the epidemic. This study describes the day-to-day experiences of nurses working in VCT services in Swaziland in order to answer the question, 'What is it like to work at VCT services.' Data were obtained through in-depth interviews. The sample consisted of 6 nurses who were purposively selected from the 4 geographical regions of Swaziland. Data were analyzed through the steps suggested by Tesch (1990). Findings from the analysis revealed that nurses working in VCT services experienced constant stress. The stress was attributed to the complexity of HIV, staff shortages, lack of social support, lack of supportive practice environments, and constant exhaustion. The experience of constant stress lead these nurses to feel disempowered. Data suggest that nurses working in VCT services in Swaziland need programs to support their efforts and to empower them in their testing activities. [ABSTRACT FROM AUTHOR]

Abstract: Background: Tuberculin skin testing (TST) is a reliable tool in the diagnosis of tuberculous infection and is important in its control. However, it may be false negative in immunocompromised patients like HIV-infected. Method: We examined the pattern of TST results in 523 newly diagnosed HIV-positive patients. CD4, CD8 and absolute lymphocyte counts were done by flowcytometry in 63 of these cases. Results: 56 (44.10%), 15 (11.81%) and 56 (44.10%) of the 127 cases with tuberculosis and 293 (73.99%), 41 (10.35%) and 62 (15.66%) of the 396 cases without any clinical evidence of tuberculosis showed TST results of 0–4, 5–9 and = or > 10 mm respectively. Significantly more (P<0.05) number of cases with TST of = or > 10mm and significantly lesser (P<0.05) number of cases with TST of 0–4 mm are likely to develop tuberculosis. The average CD4+lymphocyte count was found to be significantly lower in cases with nil TST results than with = or >10mm. HIV infected cases associated with tuberculosis with induration on TST had average CD4 counts of 129.5 as compared to 246.3/cmm in those without tuberculosis. Conclusion: In India where both these diseases are endemic, tuberculosis may develop during early HIV infection, while the body''s immunity is still largely unimpaired and TST shows = or >10mm results in almost 45% of our cases. In another 45% with TST of 0–4mm, the CD4+ lymphocyte count is likely to be lower than 200/cmm. In those with nil induration, TST of 5–9 mm cannot be taken as an independent marker for suspecting tuberculosis in the HIV infected. Hence we recommend that all cases with TST of = or >10mm and cases with nil induratrion with CD4+ count of <200/cmm should be considered as high-risk for developing tuberculosis. [Copyright &y& Elsevier]

Abstract: Background: Trends in mode of detection of HIV infection in the Armed Forces required to be analyzed to formulate future strategies for early detection. Methods: A retrospective study was thus conducted in 612 newly diagnosed HIV-positive cases between January 1997 to August 2002. Results: 182(29.74%) patients had already developed Category C conditions when detected to be HIV-positive, 176(96.70%) with mycobacterial disease, majority (67.61%) of them being pulmonary tuberculosis, followed by recurrent bacterial pneumonia in 3 (1.65%), pneumocystis carinii pneumonia (PCP) in 2(1.1%) and oesophageal candidiasis in one (0.55%). Herpes zoster was the third most common mode of detection accounting for 86 (14.05%) of the cases (24.6% of them with involvement of ophthalmic branch of trigeminal nerve), after tuberculosis in 176(28.76%) and blood donors in 98(16.01%), followed by constitutional symptoms in 59(9.64%) cases, investigation for STDs in 56(9.15%), bacterial pneumonia in 6(0.98%) and oral mucosal candidiasis in only one (0.16%) case. None was detected during acute retroviral illness and only 5(0.82%) cases were detected while being investigated for generalized lymphadenopathy. Amongst the cases detected during investigation for STDs, majority (26.79%) were on STD surveillance. 22(3.60%) cases tested positive when their spouses were detected to be HIV-positive, 20(3.27%) while being screened for surgery, 4(0.65%) for posting abroad and 2(0.32%) each during investigation when child was found HIV-positive and investigation for HBV infection. Remaining 69(11.27%) patients were detected during investigation of various related or unrelated conditions including one (0.16%), which reported voluntarily after a high-risk exposure. Conclusion: There is a need to encourage voluntary reporting and identify more number of cases during acute retroviral syndrome and PGL stage. [Copyright &y& Elsevier]

Abstract: CD4, CD8 and absolute lymphocyte counts (ALC) were carried out by flowcytometry in 36 HIV-infected cases with various orocutaneous manifestations, 50 asymptomatic HIV infected individuals and 50 HIV-negative controls. Average CD4 counts and CD4: CD8 ratio in symptomatic HIV-infected cases were found to be 245.39/cmm and 0.27 respectively, significantly lower than that of HIV-infected asymptomatic individuals (622.4 and 0.45 respectively) and HIV-negative controls (798.81 and 1.03 respectively). Patients with one (77.78%), two (19.44%) and three (2.78%) orocutaneous manifestations had average CD4 counts of 280.25, 131.3 and 68/cmm respectively. All the 7 cases with oral mucosal candidiasis had CD4 counts lower than 200/cmm (average 105.28/cmm), thus fulfilling AIDS-defining criteria. Although 6 (85.71%) of the 7 cases had CD4 counts less than 200, Herpes zoster should not be considered as an AIDS-defining illness, as the HIV-infected who had had H zoster in the past had higher CD4 count (average 299/cmm). Dermatoses like seborrhoeic dermatitis and lichen planus, and some infections and infestations like scabies, bacillary angiomatosis, human papilloma virus infection, molluscum contagiosum and dermatophytosis cannot be considered as AIDS-defining illnesses per se. [Copyright &y& Elsevier]

Abstract: Background: Photosensitivity to Chlamydia trachomatis has been described in almost 50% of chronic cases of lymphogranuloma venereum (LGV) caused by L1, L2 or L3 serovars. Photosensitivity in non LGV strains of C trachomatis has not been studied. We studied the association of various photosensitive dermatoses with C trachomatis infection in non LGV cases. Methods: Sera of all the cases of photosensitivity, melasma, chronic actinic dermatitis (CAD), polymorphic light eruption (PLE), actinic prurigo (AP) and rosacea were tested for the presence of IgM, IgG and IgA antibodies to C trachomatis by ELISA method. The results were compared with 30 healthy controls. Result: Seventeen (25.53%) of 57 cases of photosensitivity as against two (6.67%) controls were seropositive for IgM/IgG/IgA antibodies, a statistically significant difference (χ2 6.18, p 0.013). Similarly, significantly higher seropositivity was observed in 12 (25.53%) of 47 cases of melasma (χ2 4.38, p 0.0363) and six (46.15%) of 13 cases with CAD (χ2 6.91, p 0.0086). Although higher proportion of patients of rosacea [five (31.25%) of 16 cases] and PLE [four (25.0%) of 16 cases] were seropositive, the difference was not statistically significant (χ2 3.23, p >0.05, OR 6.36, CI 95% 0 to 48 and χ2 3.09, p 0.078, OR 4.67, CI 95% 5 to 41 respectively). There was no association of AP. Conclusion: The observations suggest that C trachomatis infection in non LGV cases is an important cause of PS, melasma and CAD. It appears to be an important cause of rosacea and PLE. We recommend that all cases of photosensitivity, melasma, CAD, PMLE and rosacea and their spouses/sexual contacts be investigated for C trachomatis infection. [Copyright &y& Elsevier]

Abstract: Background: Although lymphadenopathy, hepatomegaly and splenomegaly are commonly seen in human immunodeficiency virus (HIV) infection, little is known about the prognostic significance of these findings. Method: A retrospective study of lymphoreticular involvement in 612 HIV-positive patients was done. Result: Lymphadenopathy was found in 301 (49.18%), hepatomegaly in 102 (16.66%) and splenomegaly in 58 (9.47%) patients. Sixty eight (32.54%) of the 209 patients with only lymphadenopathy had acquired immunodeficiency syndrome (AIDS), as compared to 70 (23.97%) of the 292 patients without lymphadenopathy or hepatosplenomegaly (χ2 4.49, df-1, p<0.05). There was a higher chance of having AIDS if hepatomegaly was present with lymphadenopathy. Eight (72.73%) of 11 patients with hepatomegaly alone, had AIDS. Thirty (68.18%) of 44 cases with splenomegaly, with lymphadenopathy and hepatomegaly, three (50%) of six cases having splenomegaly with lymphadenopathy and one (33.33%) of three cases with splenomegaly had AIDS. Majority of lymphoreticular involvement cases were due to Mycobacterium tuberculosis infection. All 29 cases with abdominal lymphadenopathy and one with hilar lymphadenopathy had AIDS. Bilateral discrete cervical, axillary and inguinal lymphadenopathy was the most common presentation. CD4 counts were significantly (p<0.05) lower in those with lymphadenopathy and hepatosplenomegaly. Conclusion: HIV cases with lymphadenopathy and hepatomegaly should be investigated for the presence of opportunistic infection. [Copyright &y& Elsevier]

Abstract: p24 antigen was estimated in human immunodeficiency virus (HIV) sero-negative individuals attending various sexually transmitted diseases (STD) clinics and also in sero-negative voluntary blood donors. A total of 300 STD cases and 500 voluntary blood donors, who also acted as controls, were included in this study. Antibody to HIV was detected by ELISA and was confirmed by western blot. In sero-negative individuals, p24 antigen detection was carried out by standard assay and immune-complex dissociation assay (ICD assay) using ELISA method and confirmation was done by neutralisation assay. In voluntary blood donors, 4 (0.8%) individuals were found to be HIV positive and no sero-negative individual was positive for p24 antigen. 41 out of 300 patients attending STD clinics were found to be positive for HIV and in 259 sero-negative patients, p24 antigen was detected in 6 (2.3%) cases by ICD assay whereas only 4 cases were detected by standard assay. By estimating p24 antigen an additional 2.3% HIV positive cases that were in window period were detected. Further, an ICD assay improves the detection of p24 positive individuals. [Copyright &y& Elsevier]

Abstract: Background: Melasma is an acquired photosensitive hypermelanosis in sun-exposed areas, especially seen in females. The exact cause of this disorder is not known. Association of melasma with chronic pelvic inflammatory disease (PID) has been described earlier. Chlamydia trachomatis is an important etilogical agent in acute and chronic PID and photosensitivity has been described in almost 50% cases of chronic lymphogranuloma venereum caused by 1.1, 1.2 and 13 serovars of C. trachomatis. Method: Blood of 38 cases of melasma in women and 31 healthy females was tested for the presence of C. trachomatis IgM antibodies by ELISA. Results: The average age of the patients was 35.6(range 19–51) years and that of controls was 38(range 24–55). 7(18.42%) and 5 (13.16%) of the patients of melasma were positive and borderline positive for IgM antibodies respectively. None of the healthy controls were positive. The difference was statistically significant. Conclusion: Melasma in women is most likely due to photosensitivity to C.trachomatis in cases of chronic pelvic inflammatory disease. [Copyright &y& Elsevier]