Cardiovascular Journal of Africa: Vol 24 No 5 (June 2013)

Introduction: This review explores angiogenesis, vascular dysfunction, the complement system, RAAS, apoptosis and NETosis as potential pathways that are dysregulated during preeclampsia, HIV infection and ART usage. Results: HIV-1 accessory and matrix proteins are protagonists for the elevation of oxidative stress, apoptosis, angiogenesis, and elevation of adhesion markers. Despite the immunodeficiency during HIV-1 infection, HIV-1 exploits our cellular defence arsenal by escaping cell-mediated lysis, yet HIV-1 infectivity is enhanced via C5a release of TNF-α and IL-6. This review demonstrates that PE is an oxidatively stressed microenvironment associated with increased apoptosis and NETosis, but with a decline in angiogenesis. Immune reconstitution in the duality of HIV-1 and PE by protease inhibitors, HAART and nucleoside reverse transcriptase, affect similar cellular pathways that eventuate in loss of endothelial cell integrity and, hence, its dysfunction. Conclusions: HIV-1 infection, preeclampsia and ARTs differentially affect endothelial cell function. In the synergy of both conditions, endothelial dysfunction predominates. This knowledge will help us to understand the effect of HIV infection and ART on immune reconstitution in preeclampsia.

Purpose: Polycystic ovary syndrome (PCOS) presents psychological challenges in women due to persistent symptoms such as hirsutism, irregular menstruation, and weight gain, and long-term complications like infertility. Women with PCOS face higher risks of depression, anxiety, body image dissatisfaction, and social challenges. Research often overlooks the psychological burden of PCOS, despite its documented effects. This systematic review aims to explore the lived psychological experiences of women with PCOS, encompassing mental health challenges, emotional well-being, and psychosocial factors. It also aims to identify sociocultural variations in psychosocial challenges. Methods: A systematic search was conducted across six bibliographic databases (MEDLINE, Web of Science, Cochrane, CINAHL, PubMed, and SCOPUS) from inception to April 2024. Qualitative and mixed-methods studies in English exploring the psychological experiences of women with PCOS were included. Study quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI), and findings were synthesized using a JBI-guided pragmatic meta-aggregation approach. Results: A total of 43 studies were included, yielding 240 unequivocal findings and 46 credible findings which were meta-aggregated into two themes: (1) Mental Health Challenges associated with PCOS (2) Psychosocial Challenges associated with PCOS. Conclusion: Depression, anxiety, body image dissatisfaction, and social stigma significantly impact women with PCOS. Hirsutism and being overweight are prominent stressors, particularly affecting psychological well-being in this group. Sociocultural factors play a role in shaping psychological experiences. Effective PCOS care requires mental health support, fertility counselling, and culturally sensitive interventions to improve health outcomes.

The COVID-19 pandemic resulted in South African universities and institutes of higher learning experiencing an unprecedented shift to online learning in 2020, coupled by limited access to campus, in order to prevent community transmission. However, the potential impact of the outbreak on the academic and psychosocial wellbeing of students warrants further exploration, as the rapid changes and the disruption to normal academic life, has left many students feeling socially isolated and struggling to cope with massive uncertainty. In addition, Health Sciences students may experience added anxiety due to their line of work, which places them at the forefront of the healthcare environment. This study explored the academic and psychosocial challenges experienced by students enrolled in a Health Sciences faculty in a University of Technology (UoT), as they transitioned through the COVID-19 pandemic and the ensuing lockdown. A qualitative approach with an exploratory descriptive design was used to guide the study. A sample of students across all levels of study (first, second and third years as well as postgraduates) from the Faculty of Health Sciences at the Durban University of Technology (DUT) in South Africa were selected. Sample recruitment was done through non-probability sampling techniques which include purposive and convenience sampling. Data saturation was reached after interviewing 15 participants on Microsoft Teams. The interview schedule comprised key points on understanding how the COVID-19 pandemic and the ensuing lockdown affected students personally and academically. Interviews were recorded, transcribed and subjected to content and thematic analyses. Six broad themes emerged from the data, which captured the disruption students experienced within the context of their academic life, their personal fears and anxieties, struggles with online learning and connectivity issues. Students also expressed challenges whilst studying remotely at home. The findings suggested that there is an urgent need for universities to reflect on ensuring students’ mental health wellbeing as well as ensuring academic success amidst a turbulent physical and psychological environment.

Polycystic ovary syndrome (PCOS) research is dominated by the clinical perspective, whilst the psychological experiences of women with PCOS remain less understood. This narrative review explores mental health challenges of women with PCOS, encompassing common psychiatric disorders, emotional challenges, and psychosocial challenges. An online search of published literature was conducted via PubMed and Google Scholar using the terms “polycystic ovary syndrome”, “mental health”, “psychological”, “emotional” and “psychosocial”. Only articles that were directly applicable to mental health, emotional and psychosocial challenges were reviewed. Women with PCOS face increased risks of anxiety, depression, and eating disorders, alongside emotional burdens such as stress and social isolation, which stem from the syndrome’s symptoms and societal stigma. Psychosocial challenges, including body image dissatisfaction and social functioning difficulties, further exacerbate these issues. These findings underscore the necessity for comprehensive PCOS management that includes regular mental health screenings and addresses the complex interplay of psychological factors, emphasizing the importance of further research to deepen understanding and improve care strategies.