Human immunodeficiency virus (HIV) is a part of the lentivirus genus of the retroviridae family that incorporates its genome into the host DNA via a series of complex steps. HIV can be classified into two types, HIV-type 1 (HIV-1) and HIV-type 2 (HIV-2), with HIV-1 being the most common type worldwide. Seventy-six million people have been infected since the start of the pandemic, with a mortality rate of 33 million. Even after 40 years, no cure has been developed for this pandemic. The development of the mRNA vaccine has led to further research for the utilization of mRNA vaccine in HIV, in attempts to create a prophylactic and therapeutic treatment. Although messenger RNA (mRNA) vaccine has been around for many years, it has recently drawn attention due to its role and response in the unforeseen coronavirus pandemic. mRNA vaccine has faced its fair-share of challenges, but it also offers many advantages compared to conventional vaccines such as safety, efficacy, rapid preparation, and versatility. mRNA vaccine has shown promising results and has great potential. In this review, we discuss the types of mRNA vaccine, along with development, delivery, advantages, challenges, and how we are working to overcome these challenges.

Ischemic heart disease (IHD) is the leading cause of death worldwide, and it is defined as an imbalance between myocardial oxygen supply and demand. Coronary artery disease (CAD) and left ventricular hypertrophy (LVH) are two common causes of IHD that independently result in myocardial ischemia. CAD decreases myocardial blood and oxygen supply whereas LVH increases myocardial oxygen demand. The coexistence of both CAD and LVH results in a significant increase in oxygen demand while simultaneously lowering oxygen supply.Since hypertension is a shared predisposing condition for both CAD and LVH, the left ventricular (LV) mass on noninvasive echocardiography can reflect on the severity of coronary artery stenosis. In clinical practice, it can help physicians decide whether to perform invasive cardiac catheterization to visualize the extent of the coronary block. Although, both CAD and LVH are directly proportional to mortality risk, the addition of eccentric LVH can further increase morbidity and mortality due to myocardial infarction. Therefore, the latest management of both the acute and chronic phases of CAD places an increased emphasis on controlling the predisposing factors to prevent or reverse LVH. For example, angiotensin-converting enzyme inhibitors and diuretics reduce LV mass by lowering the cardiac preload and afterload. This article aims to investigate the deleterious effects of the collaboration between CAD and LVH, establish a causal relationship, and explore the new prevention and management strategies.

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Background and Aims Calcineurin inhibitors, cyclosporine and tacrolimus have a narrow therapeutic index and have wide intra- and inter individual pharmacokinetic variability. They are metabolized mainly by CYP3A4 and CYP3A5. The P450 oxidoreductase POR*28 variant allele has been associated with changes in cytochrome P450 enzymatic activity that can affect the therapeutic level of both medications. The aim of this study is to investigate the allelic frequency of the POR*28 in Egyptian renal transplant patients and to evaluate the effect of the presence of CYP3A5*1, CYP3A4*22, and POR*28 genetic polymorphism on calcineurins inhibitos dose requirements and adjustments. Method A prospective clinical trial that included 130 renal transplant patients placed on either tacrolimus or cyclosporine. Patients were genotyped for POR*28, CYP3A4*22, and CYP3A5*1. The relation between the present genetic polymorphisms and tacrolimus and cyclosporine doses and dose adjustments were studied at days 14, 30, and 90 post-transplantation. Results The POR*28 allele frequency in the studied population was 29.61%. The tacrolimus dose-adjusted trough concentration ratio (C0/D) was highly statistically significant in the fast metabolizers group (CYP3A5*1/POR*28T carriers) than in the slow metabolizers group (CYP3A5*3/*3/CYP3A4*22 carriers) throughout the study (14, 30, and 90 days) (p value 0.001, <0.001, and 0.003, respectively). There was no significant effect for this gene combination on cyclosporine (C0/D). Conclusion Combining the CYP3A5*1, POR*28, and CYP3A4*22 genotypes can be of significant value in early tacrolimus dose requirements and adjustments. However, it does not have any influence on cyclosporine dose requirements.

A 74 year-old woman presented with a 9 month history of a slowly enlarging exophytic lesion over her left nasal alar. Examination revealed a firm, cystic mass fixed to underlying skin. It was pedunculated with occasional superficial telangiectasia and a violaceous hue. A differential diagnosis of dermoid or sebaceous cyst, dermatofibroma, and neurofibroma was considered. Histopathological examination confirmed the rare diagnosis of chondroid syringoma (CS), which has a reported incidence of 0.01-0.098% of excised skin tumors. It is unusual for CS to present in an elderly woman, as these benign primary skin tumors normally present in adult males. Dermoscopy does not reveal any specific features and the diagnosis is difficult to make based on clinical examination alone.