American Journal of Medical and Natural Sciences
https://ajmns.com/index.php/journal
<div align="justify">American Journal of Medical and Natural Sciences (AJMNS) is a multidisciplinary, double blind reviewed, open-access, international peer-reviewed journal which publish original and innovative research works which will significantly contribute to the advances in Medical and Natural Sciences. AJMNS publishes the Original Research articles, Reviews on current topics, Short-Communications, Letter to the Editor, Case Reports, Image challenges, Clinical Vignettes in Medical and Natural Sciences.</div>American Journal of Medical and Natural Sciencesen-USAmerican Journal of Medical and Natural Sciences2582-6182<p>All the articles are published in AJMNS are under Creative Commons License. Any further distribution or use of content published under CC BY-NC 4.0 must maintain attribution to the author(s) and the published article’s title, journal citation <a href="https://creativecommons.org/licenses/by-nc/4.0">Creative Commons Attribution-NonCommercial 4.0 Unported License</a>.</p>CLINICAL METAGENOMICS IN MICROBIOLOGY DIAGNOSTICS: ANALYTICAL CHALLENGES, QUALITY ASSURANCE, AND EMERGING FUTURE-READY APPROACHES
https://ajmns.com/index.php/journal/article/view/22
<p>Metagenomic sequencing has quickly developed into a revolutionary method in clinical microbiology by making it possible to identify and characterise pathogens directly from clinical specimens without the need for culture. In contrast to focused PCR tests, which need previous information of suspected species, metagenomics facilitates the wide identification of bacteria, viruses, fungi, and parasites and can offer insights into strain-level epidemiology and antibiotic resistance determinants. However, obstacles such low microbial biomass, host DNA dominance, contamination, variable extraction efficiency, bioinformatics complexity, interpretative ambiguity, and expense continue to limit routine application in diagnostic laboratories.The modern metagenomic workflows—sample preparation, nucleic acid extraction, library building, sequencing techniques, and computational pipelines—are summarised in this study, which also emphasises the crucial quality assurance and control procedures needed for accurate reporting. Meningitis/encephalitis, respiratory infections, sepsis, bloodstream infections, and outbreak investigations are among the clinical applications we cover. We also assess translation obstacles including standardisation, regulatory frameworks, reference databases, and result interpretation.</p>Rawat Deepanshu
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2026-02-012026-02-0116REAL-WORLD EFFICACY OF DOLUTEGRAVIR: A REVIEW OF VIROLOGICAL SUPPRESSION AND CD4+ RECOVERY TRENDS
https://ajmns.com/index.php/journal/article/view/24
<p>Background: Since its recommendation by the World Health Organization as a preferred first-line agent, Dolutegravir (DTG) has transformed HIV management due to its high genetic barrier to resistance and superior tolerability. While clinical trials have established its efficacy, there is a critical need for real-world validation of its impact on primary clinical markers during the early stages of treatment. This review evaluates the effectiveness of DTG-based antiretroviral therapy (ART) on virological outcomes and immunological recovery within the first six months of initiation. Methods: A comprehensive review of prospective and retrospective clinical data was conducted, focusing on HIV-1 infected adults (\ge18 years) initiating DTG-based regimens. The primary endpoints assessed were the rate of virological suppression (defined as HIV-1 RNA <50 or <200 copies/mL) and the mean change in CD4+ T-cell count from baseline to month 6. Secondary considerations included treatment adherence and early safety signals such as weight gain. Results: DTG regimens show rapid efficacy, with most patients achieving viral suppression within 24 weeks. This is accompanied by significant immune restoratio</p> <ol> <li>Bantayehu Addis Tegegne, Agumas Alemu Alehegn & Mengistie Kassahun (2024) Drug Use Evaluation of Tenofovir/Lamivudine/Dolutegravir (TLD) Fixed-Dose Combination for Initiation and Transition Among HIV-Infected Individuals Attending Lumame Primary Hospital, North West Ethiopia, Integrated Pharmacy Research and Practice, , 31-42, DOI: 10.2147/IPRP.S455351</li> <li>Arora S, Singh D, Ashta K, Kisenjang N, Mohan C, Anilkumar A, Raman N. (2025) Virological Effectiveness of Dolutegravir-based Second-line ART in the Context of NRTI Resistance Among HIV-Positive Patients in India . Open AIDS J, 2025; 19: e18746136382073. http://dx.doi.org/10.2174/0118746136382073250806110823</li> <li>Gebremedhin T, Aynalem M, Adem M, Geremew D, Aleka Y, Kiflie A. Dolutegravir based therapy showed CD4+ T cell count recovery and viral load suppression among ART naïve people living with HIV AIDS: a pilot evaluation. Sci Rep. 2024 Feb 8;14(1):3297. doi: 10.1038/s41598-024-53282-y. PMID: 38331983; PMCID: PMC10853173.</li> <li>Girón-Callejas A, Lorenzana R, Pickles M, Inzaule S, Jordan MR, Diaz S, Vrinten C. High HIV viral suppression among adults receiving WHO-recommended first-line dolutegravir-based antiretroviral therapy in low- and middle-income countries: a systematic review and meta-analysis of programmatic evidence. AIDS Res Ther. 2025 Sep 26;22(1):91. doi: 10.1186/s12981-025-00788-8. PMID: 41013566; PMCID: PMC12465354.</li> <li>Erico C. Cardoso-Neto, Eduardo Martins Netto, Carlos Brites, Weight gain in patients starting Dolutegravir-based ART according to baseline CD4 count after 48 weeks of follow up, The Brazilian Journal of Infectious Diseases, Volume 27, Issue 5, 2023, 102807, ISSN 1413-8670, https://doi.org/10.1016/j.bjid.2023.102807.</li> <li>Martin MA, Blenkinsop A, Moffa M, Reynolds SJ, Nalugoda F, Quinn TC, Kigozi G, Ssekubugu R, Gupta RK, Grayson NE, MacIntyre-Cockett G, Kagaayi J, Nakigozi G, Abeler-Dörner L, Fraser C, Ratmann O, Tobian AAR, Laeyendecker O, Moyo S, Kennedy CE, Bonsall D, Galiwango RM, Grabowski MK. Patterns of HIV-1 viral load suppression and drug resistance during the dolutegravir transition: a population-based longitudinal study. medRxiv [Preprint]. 2025 Sep 2:2025.09.01.25334862. doi: 10.1101/2025.09.01.25334862. PMID: 40950453; PMCID: PMC12424902.</li> <li>Srujana K, Vyshnavi P, Jessy R, Venkatesh P. Study of the utilization of antimicrobial agents in surgical devices at a tertiary care hospital, Nellore. UPI Journal of Pharmaceutical, Medical and Health Sciences. 2022 Jun 28:44-50.</li> <li>Michael A. Martin, Alexandra Blenkinsop et al., (2025) Patterns of HIV-1 viral load suppression and drug resistance during the dolutegravir transition: a population-based longitudinal study doi: https://doi.org/10.1101/2025.09.01.25334862</li> <li>Archana Mahadev Rao, Fayaz SM et al., (2025) Exploring the Potential of HIV Integrase Inhibitors as Therapeutic Agents Against HSV and HCMV: A Molecular Docking Study Volume 2025:17 Pages 507—518</li> <li>Srujana K, Vyshnavi P, Jessy R, Venkatesh P. Study of the utilization of antimicrobial agents in surgical devices at a tertiary care hospital, Nellore. UPI Journal of Pharmaceutical, Medical and Health Sciences. 2022 Jun 28:44-50.</li> <li>Hare S, Smith SJ, Métifiot M, Jaxa-Chamiec A, Pommier Y, Hughes SH, Cherepanov P. Structural and functional analyses of the second-generation integrase strand transfer inhibitor dolutegravir (S/GSK1349572). Mol Pharmacol. 2011 Oct;80(4):565-72. doi: 10.1124/mol.111.073189. Epub 2011 Jun 30. PMID: 21719464; PMCID: PMC3187526.</li> <li>Deanda, Felix & Hightower, Kendra & Nolte, Robert & Hattori, Kazunari & Yoshinaga, Tomokazu & Kawasuji, Takashi & Underwood, Mark. (2013). Dolutegravir Interactions with HIV-1 Integrase-DNA: Structural Rationale for Drug Resistance and Dissociation Kinetics. PloS one. 8. e77448. 10.1371/journal.pone.0077448.</li> <li>Gunturu LN, Pamayyagari K, Dornadula GR. A Case Report on Herpes Zoster Eruption Associated with Chronic Obstructive Pulmonary Disease. International Journal of Therapeutic Applications, Volume 37, 2020.</li> <li>Kintu K, Malaba TR, Nakibuka J, Papamichael C, Colbers A, Byrne K, Seden K, Hodel EM, Chen T, Twimukye A, Byamugisha J, Reynolds H, Watson V, Burger D, Wang D, Waitt C, Taegtmeyer M, Orrell C, Lamorde M, Myer L, Khoo S; DolPHIN-2 Study Group. Dolutegravir versus efavirenz in women starting HIV therapy in late pregnancy (DolPHIN-2): an open-label, randomised controlled trial. Lancet HIV. 2020 May;7(5):e332-e339. doi: 10.1016/S2352-3018(20)30050-3. PMID: 32386721; PMCID: PMC10877544.</li> <li>Silva GJ, Mendicino CC, Menezes de Pádua CA, Tupinambás U. Suppression of HIV in the first 12 months of antiretroviral therapy: a comparative analysis of dolutegravir- and efavirenz-based regimens. einstein (São Paulo). 2023;21:eAO0156.</li> <li>Nabitaka VM, Nawaggi P, Campbell J, Conroy J, Harwell J, Magambo K, et al. (2020) High acceptability and viral suppression of patients on Dolutegravir-based first-line regimens in pilot sites in Uganda: A mixed-methods prospective cohort study. PLoS ONE 15(5): e0232419. doi:10.1371/journal.pone.0232419</li> <li>Calza L, Colangeli V, Giglia M, Rigamonti C, Bon I, Cretella S, Viale P. Efficacy and Safety of Dolutegravir/Lamivudine in Antiretroviral Therapy-Naive People Living With HIV-1 and With High-Level Viremia. J Acquir Immune Defic Syndr. 2025 May 1;99(1):93-97. doi: 10.1097/QAI.0000000000003600. PMID: 39806529; PMCID: PMC11970585.</li> <li>Narasimha GL, Dornadula GR. A Case Report on Pleural Effusion Induced by Pulmonary Tuberculosis Reactivation. International Journal of Science and Research (IJSR) ISSN: 2319-7064, Volume 8 Issue 8, August 2019.</li> <li>Ron Raquel , MartÃnez-Sanz Javier , Herrera Sabina , Ramos-Ruperto Luis , DÃez-Vidal Alejandro , Sainz TalÃa et al., (2024) CD4/CD8 ratio and CD8+ T-cell count as prognostic markers for non-AIDS mortality in people living with HIV. A systematic review and meta-analysis. Frontiers in Immunology Volume 15 – 2024 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1343124. DOI=10.3389/fimmu.2024.1343124. ISSN=1664-3224</li> <li>Vamsi V, SomaSekhar K, Sandeep R, Meghana B, Sharmila S. Case Report on Pulmonary mucormycosis. International Journal of Health Care and Biological Sciences. 2023 Nov 25:7-9.</li> <li>Jemal M. A review of dolutegravir-associated weight gain and secondary metabolic comorbidities. SAGE Open Med. 2024 Jun 13;12:20503121241260613. doi: 10.1177/20503121241260613. PMID: 38881592; PMCID: PMC11179510.</li> <li>Menard, Amélie & Meddeb, Line & Tissot-Dupont, Herve & Ravaux, Isabelle & Dhiver, Catherine & Mokhtari, Saadia & Tomei, Christelle & Brouqui, Philippe & Colson, Philippe & Stein, Andreas. (2017). Dolutegravir and weight gain: An unexpected bothering side effect?. AIDS. 31. 1499-1500. 10.1097/QAD.0000000000001495.</li> <li>Ait-Khaled, Mounir & Madero, Juan & Estrada, Vicente & Gulminetti, Roberto & Hagins, Debbie & Tsai, Hung-Chin & Man, Choy & Sievers, Jörg & Grove, Richard & Zolopa, Andrew & Wynne, Brian & van Wyk, Jean. (2021). Impact of treatment adherence on efficacy of dolutegravir plus lamivudine and dolutegravir plus tenofovir disoproxil fumarate/emtricitabine: pooled analysis of the GEMINI-1 and GEMINI-2 clinical studies. HIV research & clinical practice. 23. 1-6. 10.1080/25787489.2021.2016303.</li> <li>Venkatesh P. Review on tuberculosis. UPI Journal of Pharmaceutical, Medical and Health Sciences. 2022 Jan 26:15-8.</li> <li>Maggiolo F, Valenti D, Teocchi R, Comi L, Filippo ED, Rizzi M. Adherence to and Forgiveness of 3TC/DTG in a Real-World Cohort. J Int Assoc Provid AIDS Care. 2022 Jan-Dec;21:23259582221101815. doi: 10.1177/23259582221101815. PMID: 35695220; PMCID: PMC9203954</li> <li>Jorge Francisco da Cunha Pinto, Luiza Brito Gomes, Natalia Dias Melo, Fabiana Barbosa Assumpção de Souza, Debora Viana Freitas, Sara Gonzalez Viega, Erica Ramos dos Santos Nascimento, Lidia Theodoro Boullosa, Cynthia Chester Cardoso, Amilcar Tanuri, Transmission of Dolutegravir resistance in treatment-naive individuals with HIV-1: A cohort study, The Brazilian Journal of Infectious Diseases, Volume 29, Issue 2, 2025, 104513, ISSN 1413-8670, <a href="https://doi.org/10.1016/j.bjid.2025.104513">https://doi.org/10.1016/j.bjid.2025.104513</a></li> <li>Dorward, Jienchi & Masombuka, Xolani & Lewis, Lara & Pastellides, Claudia & Molen, Johan & Asare, Kwabena & Tlhaku, Kwena & Brown, Jennifer & Bottomley, Christian & Jacobs, Dave & Collie, Shirley & Garrett, Nigel. (2025). Risk of major adverse cardiovascular events with dolutegravir versus efavirenz-based antiretroviral therapy: emulated target trials using routine, de-identified data from South Africa. 10.1101/2025.03.07.25323562.</li> <li>Richard A Murphy, Pradeep H Bedesi, Nirmala Perumal, Bernadett I Gosnell, Timothy J Hatlen, Jaysingh Brijkumar, Dolutegravir Resistance in African Programmatic Settings Among Patients With Failure of Dolutegravir-based ART, Open Forum Infectious Diseases, Volume 11, Issue 7, July 2024, ofae321, https://doi.org/10.1093/ofid/ofae321</li> <li>Joshi K, Shinde S, Karatela S, Mulkalwar A. Clinical Profile and Adverse Effects of Dolutegravir Treatment in HIV-Positive Patients: A Prospective Observational Study. Cureus. 2024 Jun 17;16(6):e62522. doi: 10.7759/cureus.62522. PMID: 39022519; PMCID: PMC11253573.</li> <li>Chanie Gashaw Sisay , Atalay Wagaye , Zeleke Tirsit Ketsela , Bayleyegn Zemenu Wube , Aragie Yonas Sisay , Bizuneh Gizachew Kassahun , Melese Mihret , Abebe Rahel Belete (2025) Incidence and determinants of excessive weight gain in people living with HIV initiating tenofovir, lamivudine, and dolutegravir-based therapy: a multicenter retrospective study in northwest Ethiopia. Frontiers in Pharmacology Volume16–2025. DOI=10.3389/fphar.2025.1394458. ISSN=1663-9812</li> <li>Tiendrebeogo T, Malateste K, Poda A, Minga A, Lahiri CD, Ezechi O, Ekouevi DK, Ofotokun I, Jaquet A; IeDEA West Africa Collaboration. Impact of switching to a dolutegravir-based regimen on body weight changes: insights from West African adult HIV cohorts. J Int AIDS Soc. 2024 Dec;27(12):e26371. doi: 10.1002/jia2.26371. PMID: 39604062; PMCID: PMC11602402.</li> <li>Dinnie, Yushra & Everson, Frans & Kamau, Festus & Webster, Ingrid & Kgokane, Boipelo & De Boever, Patrick & Goswami, Nandu & Strijdom, Hans. (2024). The temporal relationship between body composition and cardiometabolic profiles in an HIV-infected (on antiretroviral therapy) versus HIV-free Western Cape study population. Cardiovascular journal of Africa. 34. 1-9. 10.5830/CVJA-2024-005.</li> <li>Hirigo, A. T., Yilma, D., Astatkie, A., & Debebe, Z. (2023). Effect of dolutegravir-based first-line antiretroviral therapy on weight and body mass index among adult people living with HIV on follow up at health facilities in Hawassa city administration, Southern Ethiopia: a retrospective cohort study. Annals of Medicine, 55(2). <a href="https://doi.org/10.1080/07853890.2023.2242250">https://doi.org/10.1080/07853890.2023.2242250</a></li> </ol> <p>n, typically seeing CD4+ increases of 100–150 cells/mm³. While highly effective, clinicians must monitor for early metabolic changes, such as weight gain. Conclusion: The first six months of DTG-based ART are characterized by superior viral clearance and robust immune recovery, supporting its use as a potent first-line treatment.</p>Sribharathi Y
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2026-02-182026-02-18715REVIEW ON LOSARTAN INDUCED HYPONATREMIA
https://ajmns.com/index.php/journal/article/view/25
<p style="margin: 0in; margin-bottom: .0001pt; text-align: justify;"><span lang="EN-IN" style="font-size: 10.0pt; font-family: 'Gill Sans MT','sans-serif';">Hyponatremia is a frequently encountered electrolyte imbalance associated with significant morbidity and mortality. While diuretics, selective serotonin reuptake inhibitors (SSRIs), and anticonvulsants are well-recognized causes, angiotensin II receptor blockers (ARBs), particularly losartan, have also been implicated in rare cases. This review explores the potential mechanisms, clinical evidence, risk factors, diagnostic considerations, and management strategies related to losartan-induced hyponatremia. Awareness of this uncommon yet clinically significant adverse effect is essential for early recognition and prevention of complications.</span></p>Indhu Harini S
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2026-01-212026-01-211618