The incidence of falciparum malaria is very high in India. Falciparum malaria is a multiorgan disease which can present with extremely varied presentations. The severity of the disease and difficulty in its diagnosis require a keen sense of suspicion on the part of the treating physician to diagnose it. Here is an unusual case of falciparum malaria presenting as acute appendicitis. This case did not respond to artemether therapy and that also points towards drug resistance emerging in malaria. The child was operated upon and appendix was found to be inflamed. After a tumultuous postoperative course with symptoms suggestive of acute renal failure, a diagnosis of falciparum malaria was made and quinine started. Recovery was uneventful thereafter.

Sub acute sclerosing pan encephalitis (SSPE) is a rare neurodegenerative disorder related to a persistent and aberrant measles virus infection. It is associated with poor prognosis and high mortality. We report a case of a seven- year-old boy who manifested the disease despite proper vaccination and with no documented past history of measles. The case is being reported for its atypical presentation, rarity and its possibility of occurrence in young vaccinated subjects, possibly due to undocumented pre-vaccination measles infection.

Peritonitis due to rupture of liver hydatid cyst secondary to blunt abdominal trauma can present with fatal consequences. Timely diagnosis and appropriate surgical management can be life saving. We report a case of ruptured liver hydatid cyst in the peritoneal cavity following trauma and its successful operative management in a preadolescent previously asymptomatic boy. Importance of detailed physical examination and early diagnosis by using appropriate radiological investigations is highlighted.

Objectives

Online HIV prevention studies have been limited in their ability to obtain biological specimens to measure study outcomes. We describe the factors associated with willingness of MSM to take a free anonymous home HIV test, and the self-identified barriers to home testing as part of an online prevention study.

Methods

Between March-April 2009 we recruited 6163 internet-using self-reported HIV negative MSM, who indicated their willingness to test for HIV infection using a commercially available home collection kit when offered hypothetically no incentive, $10, $25 or $50.

Results

3833 (62%) men reported being very likely and 1236 (20%) men reported being somewhat likely to take a home HIV test offered as part of an online HIV prevention study. When compared to men who were not offered any hypothetical incentive, the odds of being willing to test at home were approximately twice as great for men offered hypothetically $10 (odds ratio (OR), 1.8; 95% confidence interval (CI), 1.5–2.2), $25 (OR, 1.8; CI, 1.5–2.2) or $50 (OR, 2.1; CI, 1.8–2.6). Black MSM (OR, 1.3; CI, 1.1–1.7), men who had unprotected anal intercourse in the past 12 months (OR, 1.3; CI, 1.1–1.5), and men who were unaware of their HIV status (OR, 1.2; CI, 1.0–1.4) had increased odds of being willing to test at home.

Conclusions

Home testing offered as part of online HIV prevention research is acceptable, and future research and interventions should focus on addressing self-identified barriers faced by MSM to testing using home collection kits.