Economic empowerment and AIDS-related stigma in rural Kenya: a double-edged sword?

Economic empowerment, HIV risk and AIDS-related stigma appear intricately intertwined for women in Kenya. Their interaction must be understood in order to implement effective economic interventions that also decrease HIV risk and stigma. We conducted a qualitative study amongst women in a rural Kamba-speaking community of southeastern Kenya to pursue whether engagement in an economic empowerment initiative (a basket weaving cooperative) influences women's perspectives and experiences with HIV risk and AIDS-related stigma. We conducted seven women's focus groups: participants in the local basket-weaving cooperative comprised four focus groups and non-participants comprised the remaining three groups. The HIV status of the women was not known. Three dominant themes emerged from the focus groups: empowerment, pervasive vulnerability and unanticipated social paradoxes. Contradictions found in these themes suggest that economic empowerment can become a double-edged sword. Economic empowerment enhanced perceived individual, domestic and social community status. However, this enhancement was not protective of domestic violence and perceived HIV risk. Social perceptions may have paradoxically contributed barriers to HIV testing and treatment putting women at greater HIV risk. In conclusion, economic empowerment initiatives for women in developing countries in the context of the HIV epidemic should be coupled with peer mediated support and HIV-risk education.

Maxillary artery pseudoaneurysm causing retinal artery occlusion.

Purpose: To report a novel case of central retinal artery occlusion in a 44-year-old male caused by emboli from a non-traumatic maxillary artery pseudoaneurysm. Observations: A 44-year-old male with history of hypertension presented to clinic with painless vision loss in his left eye. He was found to have a central retinal artery occlusion. Ocular massage and intraocular pressure lowering agents were administered and the patient was transferred to the emergency department for cerebrovascular work-up. Remarkably, the patient had rapid symptom improvement from no light perception to 20/70 after ocular massage and IOP agents. Neuroimaging studies discovered a maxillary artery pseudoaneurysm with anastomotic branches to the internal carotid artery via the foramen rotundum and Vidian artery. Endovascular embolization was performed to prevent further thromboembolic event. Conclusion and Importance: We believe this to be the first reported case of retinal artery occlusion caused by a maxillary artery pseudoaneurysm. This case demonstrates that visual deficits can be the presenting symptom of a non-traumatic maxillary artery pseudoaneurysm.

Not Just Down and Out: Oculomotor Nerve Pathologic Spectrum.

The purpose of this article is to understand the complex pathologic spectrum of oculomotor nerve palsy. We review the detailed anatomy and function of the oculomotor nerve and demonstrate how the location of a lesion can drive the differential diagnosis. Lastly, we review atypical presentations of oculomotor nerve palsy to include oculomotor synkinesis and oculomotor nerve hyperactivity. Radiologists must be aware of the typical and atypical presentations of CN III palsy to accurately localize lesions as well as avoid premature exclusion of CN III pathology.