A significant number of individuals on combination anti-retroviral therapy (cART) are also chronic alcohol consumers. Alcohol and cART independently induce perturbed intestinal function, but their combined effects on Paneth cells (PCs) and intestinal stem cells (ISCs) remain unclear. Thirty-two adult male Sprague-Dawley rats were divided into 4 groups and treated with normal saline, alcohol treated (AC), cART, and a combination of alcohol and cART (AC+cART) for 90 days.Sections of the small intestine were studied for histomorphology, PC granules, crypts, and ISCs in the jejunum and ileum using hematoxylin and eosin, Alcian Blue Periodic Acid-Schiff, Masson trichrome stains, and immunohistochemistry. This study reveals alcohol-induced collagen increase and cART-induced impairment in the crypts, PC granules, and diminished Musashi-1 expression of ISCs, in the jejunum and ileum. Additionally, depleted goblet cells, crypt depth, and number, but increased intestinal wall thickness and collagen in the ileum of the AC+cART group. Minimal PC granules in the stem cell and transit amplifying zone, with reduced Musashi-1 expression in the jejunum and ileum of the AC+cART group. Moreover, all the independent effects of alcohol and cART are exacerbated in the AC+cART group, resulting in perturbations of the small intestine epithelium, ISC, and PC granules, which may adversely affect the regulation of gut innate immunity, intestinal absorptive function, with adverse health outcomes when exposed to infections. These findings are clinically invaluable in managing patients who receive cART prophylaxis, considering the critical significance of PCs and ISCs in the absorption of medications and necessary nutrients for better treatment outcomes.

Methods: Eighty-nine adult cadavers were dissected to reveal ILV patterns. The variations (origin, course, and drainage pattern), morphometries, and topography of the ILVs were studied. A total of 19 (10 proximal, nine distal) ILVs were processed for hematoxylin and eosin, Masson’s trichrome, and Verhoeff’s histological staining to determine the tissue composition. Results: The ILVs were identified in 100% of the cases, and 45% of the ILVs were anastomosed to each other bilaterally. The rightside ILVs terminated into the posterior surfaces of the iliac vessels (p =0.001), whereas the left-side ILVs terminated into the lateral surfaces (p =0.001). The left-side proximal ILVs had higher elastic fiber composition (p =0.030). The ratio of the ILVs’ elastic fibers to collagen fibers was 1:9, and 61% of the cadavers exhibited type 1 ILV pattern. Moreover, 42% of the ILVs were at the S1 vertebral level with 31% lying between L4 and L5 spinal nerve roots. The obturator nerve coursed anteriorly to the ILVs in 96% of cases. Conclusions The ILV variations described for South Africans present new additional patterns, such as bilateral anastomosis and laterality of the terminal drainage. The ILVs have more collagen fibers than elastic fibers, predisposing them to avulsion during surgical retraction. The identification of all the ILVs is crucial to minimize inadvertent hemorrhage and damage to adjacent structures.

Supernumerary lumbar ribs are usually asymptomatic and discovered incidentally during routine diagnostic radiography. During a routine inventory of the research skeletal repository at the University of the Witwatersrand, a rare case of bilateral supernumerary ribs on the first lumbar vertebra was observed. The skeletal specimen belonged to a 70-year-old African male whose recorded cause of death was esophageal carcinoma. Plain radiography revealed bilateral joint cavities between the transverse processes of the first lumbar vertebra and the supernumerary ribs. Clinically, supernumerary lumbar ribs may present with pain of the renal angle, cause confusion during enumeration of the vertebral levels on radiographs, and may be misinterpreted as fractures, kissing osteophytes, and/or calcification of abdominal vasculature.
Adult* ; Aged ; Cause of Death ; Humans ; Joints ; Male* ; Osteophyte ; Radiography ; Ribs* ; Skeleton* ; Spine