PIP: This is the first report from Ethiopia of a case of cryptococcal meningitis in a patient with AIDS. A 20-year-old woman was admitted to Tikur Anbessa Hospital in January 1990 with complaints of generalized pruritic skin lesions of six months, and headache, fever, and poor appetite of three months duration. The headache and low-grade intermittent fever were accompanied by nausea, vomiting, anorexia, and progressive weight loss, without diarrhea. She had had multiple sex partners. Upon admission, after being bedridden for two weeks, she appeared acutely ill and restless. Her temperature was 39.5 degrees Celsius, and she had oral thrush. There was no lymphadenopathy. Widespread, irregular erythematous and whitish macular patches (3 x 5 to 8 x 10 sq. cm in size) with peripheral scaling and tiny vesicles were found on the skin, pubic and perineal regions. She had neck stiffness, but was conscious and well-oriented. Hemoglobin (Hb) was 10.5 g%; the white cell count (WBC) was 3400/cu. mm; the erythrocyte sedimentation rate (ESR) was 92 mm/hr; the platelet count was 175,000/mm; and blood films were negative for hemoparasites. Urinalysis showed 3+ albumin and many pus cells and red cells/HPF. Urine culture was negative, and the VDRL test was nonreactive. Lumbar puncture, which was performed upon arrival, showed clear cerebrospinal fluid (CSF), with normal protein and glucose levels and no cells. CSF culture showed yeast cells, and an India ink preparation was positive for Cryptococcus neoformans. Blood taken for bacterial culture grew yeast cells. Renal and liver function tests, and chest x-rays were normal. A potassium hydroxide (KOH) preparation from a skin snip showed rounded yeast cells. ELISA and Western blot tests were both positive. The patient was given supportive treatment and amphotericin B (0.6 mg/kg daily). Although the fever decreased, the patient's general condition did not improve. She complained of headache, photophobia, nausea, and vomiting. Lumbar puncture was repeated eight days after the start of treatment; CSF culture and India ink preparations were negative. Urea nitrogen (BUN) repeated two weeks later was normal. Four weeks after admission, the patient suddenly vomited massive amounts of fresh blood and died before transfusion could be given. A discussion follows regarding the clinical manifestations, diagnosis, and treatment of this disease, particularly in AIDS patients, with a review of the literature.
In a tiny village, sitting in the shade of tall trees, we met young women in their late teens and early twenties, some of whom had married as young as 8 or 10, and had their first children at 13 or 14. For almost all of them, marriage was not a day of happiness. It was a day that they stopped going to school, began living with a man they had never met and having sex whether they wanted to or not.
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The lyrics are written from the perspective of a fascist Italian Blackshirt soldier during the invasion of Ethiopia. In the song, the Italian narrator tells a beautiful young enslaved Abysinnian (Ethiopian) girl that she will be liberated from slavery and ruled by a new regime. She is invited to parade with the fascist Blackshirts in Rome, where she is promised a new and better life.
This study identified that young women who attended formal education had more odds of being tested for HIV. This finding was consistent with studies conducted in Tanzania [15, 34] and Nigeria [22, 23]. The reason for this is that education can improve HIV knowledge. Education also empowers women to make decisions to visit the health facility and use health services. Besides, education improves income among women which in turn increases health service use [35]. Strengthening the available initiatives to enable all Ethiopian girls to attend primary, secondary or higher level of education may help to improve HIV testing service uptake.
Because women with fistula are often actually leaking feces and urine, Smith says, they are shunned by husbands and family alike. A doctor in the film, Catherine Hamlin, describes one young Ethiopian woman whose husband kicked her out and whose mother isolated her in a shack behind the house. "The little girl is exhausted, dehydrated. She finally pushes out a dead baby. She wakes up to her worst horror . . . Her life is ruined. So they build her a little hut outside. There she will stay until death."
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And the maidens of Nahor went outside thecity gates partly for the same purpose, I suppose,as that for which the girls of other placesgo to the parks and matinées nowadays, for itseems to have been a notorious fact that hadeven spread to other countries, that the girls ofNahor came down to the well in the blushingsunset, and that too, without chaperon orduenna. And I suppose the young men wentdown too, to flirt with the charming damsels,from the fact that the servant of Abrahamtarried there.
I never in my life heard priest or peoplecondemning her for forming the acquaintance ofa stranger without an introduction; she wascalled one of the "mothers in Israel," and evenSt. Paul, who was a regular crank about thegirls, classed her with the "holy women ofold," which proves he didn't know anythingabout her history or was playing upon theignorance of his hearers. She was a leader ofthe ton in Israel, and if in those days they didnot banish her from good society, why should[Pg 54]we censure the same conduct when we are somuch more civilized, enlightened and liberal inour views?
Now if there were any more disreputablepeople in the cities than Lot's two youngdaughters, we don't wonder that the vengeanceof a just God sent a blasting storm of burstingflames to lick with their fiery tongues thesewicked cities from the face of the earth.What does arouse our wonder is that those fairgirls with the devil's instincts smouldering intheir hearts should be allowed to escape thegeneral baking. But excuse us; our business isto state facts and not to wonder or surmise.
As there could hardly be anything butpleasure in kissing a lovely maiden, we naturallyinfer that Jacob was very emotional andwas crying for effect, and that Rachel, with theconsummate tact that all the women of theBible displayed when managing the men, perfectlyunderstood this, and had as little respectfor him at the moment as most women have fora tearful man. A man like Jacob cries easily,and when he thus "lifted up his voice andwept," it is to be hoped the girl entirely understoodhim.
But where did she turn for aid? Did sheclothe herself in the gayest costume of the Jews,[Pg 113]and, conscious of her beauty, try with smilesand coquetry and caressing touch to beguilethe King? No. Did she steal into the tent ofhis greatest general and kneeling at his feetseek to bribe him with her love? No. Shesimply and utterly ignored the men, and selectedthe King's own daughter as the instrument toexecute her design. She knew the royal girlcame down to the river to bathe, and trustingin her baby's great gift of unrivaled beautyand the woman's compassion, she planned adramatic surprise for her.
And the girls spied the basket and wonderedwhat it was, and finally the royal damsel "senther maid to fetch it." And Pharaoh's daughter[Pg 117]opened it and "she saw the child," and thegirls crowded around and gazed in silent admiration.Then the baby, who never before hadseen the purple and fine linen of majesty or thesparkling jewels of wealth, knowing this wasthe opportunity of his life put up his hands inwelcome and said in the universal language ofbabyhood, "Ah, goo! ah, goo!" He was aworthy child of a great mother, and the minutehe was left to himself he came before the footlightsand with one word captivated his audience,and a storm of kisses fell upon his lipsand neck and arms. And when the girls ceasedlest they should kiss him to death, he lookedat them a minute, and then he opened hismouth and laughed a little soft, gurgling laugh;a laugh so sweet that I'm sure even the terribleGod of the Jews must have smiled had heheard it. 2ff7e9595c
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