Opportunistic infections in relation to CD4 counts in human immunodeficiency virus seropositive patients in a tertiary care hospital in North India

Context: The human immunodeficiency virus (HIV) seropositive patients have decreased immunity predisposing them to various opportunistic infections (OI). The CD4 counts in the patient can be taken as a marker to evaluate the immune status. Aim: The aim of the study is to screen the HIV seropositive patients for OI in relation to their CD4 counts in a tertiary care hospital. Settings and Design: The present study was prospective in design conducted in the Department of Microbiology in a tertiary care hospital. Materials and Methods: A total of 80 HIV-seropositive patients, admitted from a period of 1΍ years were screened for OI. CD4 counts were done in all patients and measured by flow cytometry. Sputum and bronchoalveolar lavage samples were tested for tuberculosis and pneumocystis carinii pneumonia (PCP); oral candidiasis was detected by potassium hydroxide preparation; stool samples were subjected to direct and ether concentration method and stained for opportunistic stool infections; serum samples were tested for toxoplasmosis and cytomegalovirus (CMV) infection by enzyme-linked immunosorbent assay. Cerebrospinal fluid samples were tested for cryptococcosis. Results: A total of 38 (47.5%) patients were positive for OI. There were 13.6% patients presenting with infections having a CD4 count of below 200 cells/μL of whom, oral candidiasis (40.8%), cryptosporidiosis (23.68%), tuberculosis (5.92%), and CMV immunoglobulin M (IgM), PCP, isosporiasis and cryptococcosis were (2.96%). Conclusions: Majority of OI are present in patients with HIV with a low CD4 count, which emphasizes the need for monitoring such patients

Effect of long-term smoking on salivary flow rate and salivary pH

Introduction: Saliva is a complex and important body fluid which is very essential for oral health and it is the first biological fluid that is exposed to cigarette smoke, which contains numerous toxic compositions responsible for structural and functional changes in saliva. Aim: To evaluate the long-term effect of smoking on salivary flow rate (SFR) and salivary pH. Materials and Methods: The subjects of the study were divided into smokers and nonsmokers. Each group comprised of 35 male adults. The saliva of each subject was collected under resting conditions. They were asked to spit in a graduated container at an interval of 60 s for 5 min. Salivary pH was measured immediately after measuring SFR using the (Indikrom Paper) pH indicator and calibrated cylinder. Based on the color change of the indicator paper strip, the pH was assessed in comparison with a color chart. Data were analyzed by Student′s t-test using SPSS 15. Results: The mean (±standard deviation) SFR and pH were 0.20 (±0.05) ml/min and 6.30 (±0.36) respectively in smokers while the mean SFR and pH were 0.36 (±0.06) ml/min and 7.10 (±0.24) in nonsmokers. The difference was statistically significant (P = 0.00). Conclusion: Long-term smoking significantly reduces the SFR and salivary pH