Introduction Interruptions in treatment pose risks for people with HIV (PWH) and threaten progress in ending the HIV epidemic; however, the COVID‐19 pandemic's impact on HIV service delivery across diverse settings is not broadly documented. Methods From September 2020 to March 2021, the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium surveyed 238 HIV care sites across seven geographic regions to document constraints in HIV service delivery during the first year of the pandemic and strategies for ensuring care continuity for PWH. Descriptive statistics were stratified by national HIV prevalence (<1%, 1–4.9% and ≥5%) and country income levels. Results Questions about pandemic‐related consequences for HIV care were completed by 225 (95%) sites in 42 countries with low ( n = 82), medium ( n = 86) and high ( n = 57) HIV prevalence, including low‐ ( n = 57), lower‐middle ( n = 79), upper‐middle ( n = 39) and high‐ ( n = 50) income countries. Most sites reported being subject to pandemic‐related restrictions on travel, service provision or other operations (75%), and experiencing negative impacts (76%) on clinic operations, including decreased hours/days, reduced provider availability, clinic reconfiguration for COVID‐19 services, record‐keeping interruptions and suspension of partner support. Almost all sites in low‐prevalence and high‐income countries reported increased use of telemedicine (85% and 100%, respectively), compared with less than half of sites in high‐prevalence and lower‐income settings. Few sites in high‐prevalence settings (2%) reported suspending antiretroviral therapy (ART) clinic services, and many reported adopting mitigation strategies to support adherence, including multi‐month dispensing of ART (95%) and designating community ART pick‐up points (44%). While few sites (5%) reported stockouts of first‐line ART regimens, 10–11% reported stockouts of second‐ and third‐line regimens, respectively, primarily in high‐prevalence and lower‐income settings. Interruptions in HIV viral load (VL) testing included suspension of testing (22%), longer turnaround times (41%) and supply/reagent stockouts (22%), but did not differ across settings. Conclusions While many sites in high HIV prevalence settings and lower‐income countries reported introducing or expanding measures to support treatment adherence and continuity of care, the COVID‐19 pandemic resulted in disruptions to VL testing and ART supply chains that may negatively affect the quality of HIV care in these settings.

There are a variety of pesticides that are used to control the pests in agricultural lands and other places. Newer pesticides, developed as an alternative to highly toxic organophosphates such as imidacloprid including other neonicotinoid compounds, are being increasingly used considering their less harmful effects in case of human exposures. Though it is considered relatively safer to human beings, it can lead to potentially life-threatening complications and acute poisoning with these compounds may be fatal in large ingestion. We report a case of poisoning with imidacloprid compound presenting with a variety of systemic features including respiratory failure and patient's improvement with conservative management.

INTRODUCTIONType 2 diabetes mellitus (type 2 DM) is associated with cardiovascular complications, of which metabolic syndrome (Mets) plays a prominent role. The metabolic syndrome is a cluster of cardiovascular risk factors that is characterized by central obesity, insulin resistance, dyslipidemia and hypertension. 1 Hyperuricemia or elevated serum uric acid levels (SUA) is a biochemical entity that is gaining increasing importance as it is found by some researchers to be not only a cardiovascular risk factor but also plays a role in development of renal and metabolic diseases.2-4 Some reports on SUA and metabolic syndrome have noted that increased SUA concentration is associated with increased prevalence of some of the parameters of the metabolic syndrome like obesity, dyslipidemia and hypertension. 5,6 In these reports, the documented prevalence rates of hyperuricemia ranged from 13-19% with greater proportions of males having elevated levels of SUA compared to females. 5,6 Although SUA levels are usually higher in males than females, there is an increase in SUA ABSTRACT Background: Type 2 diabetes mellitus (Type 2 DM) is associated with cardiovascular complications, of which metabolic syndrome plays a prominent role. The metabolic syndrome is a cluster of cardiovascular risk factors characterized by central obesity, insulin resistance, dyslipidemia and hypertension. Hyperuricemia is gaining importance as cardiovascular risk factor and has role in renal and metabolic diseases. Our study was aimed to find out the prevalence of hyperuricemia and metabolic syndrome in type 2 DM and to evaluate association of hyperuricemia with metabolic syndrome. Methods: This observational longitudinal study was carried out on 150 patients of type 2 DM patients for determination of hyperuricemia and components of metabolic syndrome. Results: Metabolic syndrome was diagnosed in 68 patients (45.3%) with higher prevalence in males (53.4%) than females (33.9%). Hyperuricemia was found in 38 patients (25.3%) with higher prevalence in males (33%) than females (14.5%). Hyperuricemia and metabolic syndrome was found in 32 (21.3%) patients with higher prevalence among males (27.3%) than females (12.9%). The patients with hyperuricemia and metabolic syndrome compared to those without hyperuricemia and metabolic syndrome had higher mean age (63.16 Conclusions: Prevalence of hyperuricemia is higher in patients of type 2 diabetes with metabolic syndrome and is positively correlated with BMI, blood pressure and triglycerides and negatively correlated with HDL-C.

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