Objective:Lipodystrophy syndromes are extremely rare disorders of deficient body fat associated with potentially serious metabolic complications, including diabetes, hypertriglyceridemia, and steatohepatitis. Due to their rarity, most clinicians are not familiar with their diagnosis and management. This practice guideline summarizes the diagnosis and management of lipodystrophy syndromes not associated with HIV or injectable drugs.Participants:Seventeen participants were nominated by worldwide endocrine societies or selected by the committee as content experts. Funding was via an unrestricted educational grant from Astra Zeneca to the Pediatric Endocrine Society. Meetings were not open to the general public.Evidence:A literature review was conducted by the committee. Recommendations of the committee were graded using the system of the American Heart Association. Expert opinion was used when published data were unavailable or scarce.Consensus Process:The guideline was drafted by committee members and reviewed, revised, and approved by the entire committee during group meetings. Contributing societies reviewed the document and provided approval.Conclusions:Lipodystrophy syndromes are heterogeneous and are diagnosed by clinical phenotype, supplemented by genetic testing in certain forms. Patients with most lipodystrophy syndromes should be screened for diabetes, dyslipidemia, and liver, kidney, and heart disease annually. Diet is essential for the management of metabolic complications of lipodystrophy. Metreleptin therapy is effective for metabolic complications in hypoleptinemic patients with generalized lipodystrophy and selected patients with partial lipodystrophy. Other treatments not specific for lipodystrophy may be helpful as well (eg, metformin for diabetes, and statins or fibrates for hyperlipidemia). Oral estrogens are contraindicated.

Free-living plant growth-promoting rhizobacteria (PGPR) can be used in a variety of ways when plant growth enhancements are required. The most intensively researched use of PGPR has been in agriculture and horticulture. Several PGPR formulations are currently available as commercial products for agricultural production. Recently developing areas of PGPR usage include forest regeneration and phytoremediation of contaminated soils. As the mechanisms of plant growth promotion by these bacteria are unravelled, the possibility of more efficient plant-bacteria pairings for novel and practical uses will follow. The progress to date in using PGPR in a variety of applications with different plants is summarized and discussed here.

Background: Infections due to methicillin resistant S. aureus (MRSA) present global challenges to clinicians since therapeutic options are limited and suboptimal dosing contributes to heightened mortality and increased length of hospital stay particularly among the HIV infected patients. Objectives: To assess the prevalence and relative risk of MRSA infections in HIV infected patients. Design: Cross sectional analytical study. Setting: Kenya Medical Research Institute, Opportunistic Infection Laboratories in Nairobi. Subjects: Four hundred and thirty six male and female patients aged one to 65 years, of whom 220 were HIV-infected and 216 were non-infected. Results: There was 436 male (57.1%) and female (42.9%) respondents. The prevalence of MRSA was 26.3% with majority infecting the HIV infected patients (P=0.046). Likewise, the overall Staphylococcal infections were more common in HIV patients (P <0.001). The common test for MRSA oxacillin disk diffusion had a sensitivity and specificity of 100% and 92%. Conclusion: HIV is a predisposing factor to Staphylococcal infection and there are indications that treatment with β-lactam antibiotics may no longer be relied on as sole empiric therapy for several ill HIV patients whose infections may be of MRSA in origin. There is need for an informed choice in administration of appropriate antibiotics in order to minimise treatment failures due to the multidrug resistance and Vanvomycin intermediate S. aureus (VISA) strains. Molecular epidemiology of MRSA strains in understanding new and emerging trends is recommended.

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Introduction: Antiretroviral therapy (ART) has proved to be an important intervention in the reduction of both morbidity and mortality of HIV infected patients. As the use of ART increases, a number of studies have associate it to some metabolic complications including glucose intolerance, dyslipidaemia, and diabetes mellitus. Despite the high prevalence of HIV/AIDS in Africa and the recent increased access to Antiretroviral drugs, information on ART related insulin resistance and glucose metabolism in the African population including children is scarce if not almost non-existent posing a barrier to implementation of a monitoring plan in Angola. Objective: To describe the pattern of insulin resistance and glucose metabolism among HIV infected children on ART between 3-14 years of age at Lubango paediatric hospital. Methods: The study adopted a Cross-sectional study design and data were collected using an interviewer administered questionnaire, clinical examination and anthropometric measurements of HIV infected children on ART. Venous blood sample was obtained for fasting blood glucose and fasting insulin and HOMA-IR was calculated, followed by an Oral glucose tolerance test as per World Health Organization guidelines. Result: In this study, 40% (20) and 20% (10) of the children had an OGTT and calculated HOMA-IR of more than 7.8 mm/l and 1.999 respectively. In the bivariate analysis, children who had history of diabetes in the family were significantly more likely to have Insulin Resistance (p 0.027). Female sex (p 0.038), advanced clinical stage of the AIDS disease (p < 0.001) had a strong association with abnormal OGTT while long time on ARV were moderately associated with abnormal OGTT (p 0.057). Conclusion: There is a high prevalence of insulin resistance and glucose intolerance among HIV positive children on ART on follow up at Lubango paediatrics hospital. Insulin resistance was associated with family history of Diabetes white glucose intolerance was associated with female sex, advance stage of AIDS and long time on antiretroviral therapy.