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Objective: Miltefosine stands as the sole oral medication approved for the treatment of leishmaniasis. The appearance of severe ophthalmic toxicities induced by miltefosine in the context of leishmaniasis treatment is a matter of significant concern. The main objective of this study is to present a comprehensive summary of the ophthalmic adverse effects associated with miltefosine when used in the treatment of leishmaniasis. Methods: A systematic search was performed on PubMed, ScienceDirect, Embase, Scopus, and Google Scholar, covering articles from inception up to June 2023, without language restrictions, to identify relevant studies documenting ocular toxicity following miltefosine treatment for leishmaniasis. Results: A total of eight studies involving 31 leishmaniasis patients who developed ocular toxicities while undergoing miltefosine treatment were included in the analysis. These studies were conducted in various regions, with five originating from India, two from Bangladesh, and one from Nepal. Patients presented a spectrum of ophthalmic complications, including uveitis, keratitis, scleritis, and Mooren's ulcer. Commonly reported symptoms included pain, redness, excessive tearing, partial vision impairment, permanent blindness, light sensitivity, and the appearance of white spots on the eye. On average, patients received miltefosine treatment for a duration of 47 days before experiencing the onset of ocular problems. It is important to note that the risk of ocular toxicities increases with prolonged use of miltefosine. Conclusions: Therefore, to mitigate the potential for irreversible damage to the eyes, it is imperative that all individuals undergoing miltefosine therapy undergo regular eye examinations. [ABSTRACT FROM AUTHOR]

The complex molecule of the title compound, [Rh2{N(C6H5)COCH3}4(C8H7N)2], exhibits inversion symmetry. The four acetamidate ligands bridging the dirhodium core are arranged in a 2,2-trans manner with two N atoms and two O atoms coordinating to each RhII atom trans to one another. The Neq—Rh—Rh—Oeq torsion angles on the acetamidate bridge vary between −4.07 (5) and −6.78 (7)°. The axial nitrile ligands complete the distorted octahedral coordination sphere of each RhII atom and show a nonlinear coordination with Rh—N—C bond angles of 151.6 (3) and 152.5 (3)°. The bond lengths of the two nitrile triple bonds are 1.133 (5) and 1.137 (5) Å.

In the title compound, [Rh2(C8H8NO)4(C8H7N)], the four acetamidate ligands bridging the dirhodium core are arranged in a 2,2-trans manner. One RhII atom is five-coordinate, in a distorted pyramidal geometry, while the other is six-coordinate, with a disorted octahedral geometry. For the six-coordinate RhII atom, the axial nitrile ligand shows a non-linear Rh–nitrile coordination with an Rh—N—C bond angle of 166.4 (4)° and a nitrile N—C bond length of 1.138 (6) Å. Each unique RhII atom is coordinated by a trans pair of N atoms and a trans pair of O atoms from the four acetamide ligands. The Neq—Rh—Rh—Oeq torsion angles on the acetamide bridge varies between 12.55 (11) and 14.04 (8)°. In the crystal, the 3-methylbenzonitrile ring shows a π–π interaction with an inversion-related equivalent [interplanar spacing = 3.360 (6) Å]. A phenyl ring on one of the acetamide ligands also has a face-to-face π–π interaction with an inversion-related equivalent [interplanar spacing = 3.416 (5) Å].

The complex molecule of the title compound, [Rh2{N(C6H5)COCH3}4(C6H5CN)2], exhibits crystallographically imposed centrosymmetry. The four acetamide ligands bridging the dirhodium core are arranged in a 2,2-cis manner, with two N atoms and two O atoms coordinating to the unique RhII atom cis to one another. The Neq—Rh—Rh—Oeq torsion angles on the acetamide bridges vary between 1.62 (4) and 1.78 (4)°. The Rh—Rh bond length is 2.4319 (3) Å. The axial nitrile ligand completes the distorted octahedral coordination sphere and shows a non-linear coordination with an Rh—N—C bond angle of 167.14 (15)°, while the N—C bond length is 1.135 (3) Å.

BACKGROUND: Increased access to HIV testing is essential in working towards universal access to HIV prevention and treatment in resource-limited countries. We here evaluated currently used HIV diagnostic tests and algorithms in Cameroon for their ability to correctly identify HIV infections. METHODS: We estimated sensitivity, specificity, and positive and negative predictive values of 5 rapid/simple tests, of which 3 were used by the national program, and 2 fourth generation ELISAs. The reference panel included 500 locally collected samples; 187 HIV -1 M, 10 HIV-1 O, 259 HIV negative and 44 HIV indeterminate plasmas. RESULTS: None of the 5 rapid assays and only 1 ELISA reached the current WHO/UNAIDS recommendations on performance of HIV tests of at least 99% sensitivity and 98% specificity. Overall, sensitivities ranged between 94.1% and 100%, while specificities were 88.0% to 98.8%. The combination of all assays generated up to 9% of samples with indeterminate HIV status, because they reacted discordantly with at least one of the different tests. Including HIV indeterminate samples in test efficiency calculations significantly decreased specificities to a range from 77.9% to 98.0%. Finally, two rapid assays failed to detect all HIV-1 group O variants tested, with one rapid test detecting only 2 out of 10 group O specimens. CONCLUSION: In the era of ART scaling-up in Africa, significant proportions of false positive but also false negative results are still observed with HIV screening tests commonly used in Africa, resulting in inadequate treatment and prevention strategies. Depending on tests or algorithms used, up to 6% of HIV-1 M and 80% of HIV-1 O infected patients in Cameroon do not receive ART and adequate counseling to prevent further transmission due to low sensitivities. Also, the use of tests with low specificities could imply inclusion of up to 12% HIV negative people in ART programs and increase budgets in addition to inconveniences caused to patients.