An Interesting Case of Chromonychia in an Immunosuppressed Individual

An Interesting Case of Chromonychia in an Immunosuppressed Individua

Prevalence of mucocutaneous manifestations in human immunodeficiency infection - learning from a rural centre in Tamilnadu, India

Background: Ever since its recognition in 1981, HIV continues to ravage all the continents of the world.  HIV infection produces a panorama of mucocutaneous manifestations ranging from the macular rash seen in acute ‘sero conversion’ syndrome to extensive end-stage Kaposi’s sarcoma. Skin disease may be the first presenting feature of the disease and it raises the suspicion to screen for HIV infection. Disease progression may result in significant morbidity.Methods: This study   was undertaken in 116 People living with HIV, who attended the well health clinic in Department of Skin and STD, IRT Perundurai Medical College, Erode, in rural Tamilnadu, from 15th June 2005 to 14th August 2005.  The study patients were interviewed   after pre and post-test counselling. All the patients underwent a complete physical and genital examination with keen clinical analysis for the mucocutaneous manifestations of HIV infection.Results:   96% of HIV positives in our study had mucocutaneous manifestations. Commonest disease observed was oral candidiasis n=63 (56.25%). Dermatophytosis n=46 (41.07%) was the second most common infection followed by papular and follicular eruptions in HIV (n=34, 30.3%).Conclusions: Respiratory system illnesses were the commonest presenting opportunistic illnesses followed by the gastrointestinal tract

Dermatological manifestations in PLHIV visiting link ART centre at rural medical college hospital in Western Tamilnadu, India

Background: Ever since the early reports of human immuno deficiency infection, it presented as wide range of infectious and non-infectious dermatoses which correlate with the degree of immunodeficiency. Skin assessment remains a vital tool in the diagnosis and management of HIV infection due to relative easiness of examination. Most of skin diseases are amenable to diagnosis by inspection and biopsy. In this descriptive study, we have enumerated in detail the dermatological manifestations of Link ART centre clients.Methods: To analyze the dermatological manifestations in people living with HIV, we undertook a prospective observational study of all PLHIV on ART visiting IRT Perundurai Medical College Hospital link anti- retroviral therapy centre (LAC) during July 2015 to August 2016 with focus to skin manifestations.Results: Among the 140 clients, 22 in 2010, 12 in 2011, 6 in 2012, 51 in 2013, 36 in 2014, and 9 in 2015, 3 up to June 2016 enrolled for follow up. 31 were transferred to nearby ART, Link ART centres during this period as per their request, 4 lost for follow up and 6 deceased after enrolment, finally ninety-nine (39 male; 60 female) were utilizing our centre during the study period. Majority of participants were on ZLN (zidovudine, lamivudine, and nevirapine) regimen, hailing from rural zones, belonged to low or low middle income group, were undertaking farming, cattle rearing. CD4 counts of the asymptomatic clients in the ZLN group noted increase and decrease in the ZLE (zidovudine, lamivudine, and efavirenz), TLN (tenofovir, lamivudine, and nevirapine) group.  In the symptomatic clients, decline in the individual and the mean counts except in female ZLN subset. 70% were clinically asymptomatic and 30 % were having some dermatological manifestations. Multiple manifestations were seen in 5 clients during the study period. Dermatological manifestations observed commonly were fungal and viral infections, xerosis/ichthyoses, adverse drug reactions like lipodystrophy, and discoloration of nails.Conclusions: Skin manifestations observed in this study were due to aging and long term cosmetic side effects of highly active antiretroviral therapy  (HAART). Lipodystrophy posed significant aesthetic distress in HAART clients. Hence, early management would decrease the most offending cosmetolgical side effects of the disease and drugs. Therapy yields the declining trend in the inflammatory, infectious dermatoses

Prevalence and patterns of psychiatric morbidity in people living with HIV

Background: Diagnosis of HIV infection creates an overwhelming stress and leads to symptoms like guilt, fear, anxiety, sad mood, grief and suicidal ideation. Though the rate of suicide has decreased after the introduction of highly active anti-retroviral therapy (HAART), it still remains high. Indian studies assessing suicidal ideation in people living with HIV (PLHIV) are scarce. Psychiatric evaluation and treatment improves the quality of life in PLHIV. Aim of the study was to assess the prevalence and patterns of psychiatric morbidity including suicidal ideation in PLHIV attending Integrated Counselling and Testing Centre (ICTC), prior to initiation of ART.Methods: A cross sectional study design was used. 11476 persons attending ICTC of IRT Perundurai Medical College, Erode, Tamil Nadu, India were tested for their HIV status over a period of two years. 211 persons were found to be positive, 143 persons gave consent and met inclusion criteria. Every patient underwent a semi-structured clinical interview and their psychiatric morbidity was assessed based on ICD 10. Current suicidal behavior, hopelessness and depression were measured by appropriate rating scales. Data was analyzed by using the SPSS 16.Results: Psychiatric diagnosis was present in 36.4% of the sample. Depression was the commonest diagnosis followed by adjustment disorder, alcohol related problems and anxiety disorder. 26 persons (18.2%) had current suicidal ideation. 3 out of 143 persons had attempted suicide within 6 months following notification of their HIV status.Conclusions: Nearly 1/3rd of PLHIV require psychiatric referral and 1/5th of PLHIV have suicidal ideation. It will be highly beneficial to integrate psychiatric services into daily care of PLHIV

Ophthalmic Complications of Dengue

A case series suggests that the spectrum of complications in dengue infection is widening

US-India relations after the Modi visit

For more about the East-West Center, see http://www.eastwestcenter.org/Rajesh Rajagopalan, Professor of International Politics at Jawaharlal Nehru University, New Delhi, explains that "there has been a refreshing change on the Indian side in being willing to openly declare India's key strategic interests.

Motion modeling and video processing

Knowledge of motion fields is crucial to several applications such as video coding, image scene analysis and noise reduction. Estimation of this field is frequently done using constraints such as smoothness deduced from physical considerations of the process generating the video. Smoothness of motion is a qualitative statement regarding local relationships of elements of this field. In this work, our primary focus is on quantitatively modeling the relationships between elements of the motion field at spatial neighborhoods of pixels and in filtering of motion. These are accomplished by generalizing popular techniques in statistical signal processing--autoregressive (AR) models and moving average (MA) filtering. First, we show an equivalence between estimates from AR models (output of MA filtering) to the solution of a weighted least squares problem. This least squares problem is then generalized to enable modeling (filtering) of motion fields. Our AR model for motion is significantly different from previous approaches in that instead of computing motion at a pixel as a linear combination of motion at a spatial neighborhood of pixels, we compute the motion at a pixel using the observable data (i.e., pixel intensities) directly. An extension of this temporal AR model to a joint spatiotemporal model is also presented. Applications to interframe estimation reveal that interframe prediction accuracy is improved over previous methods by as much as 37%.A temporal MA filtering formulation is proposed and applied to preprocessing video prior to coding. Preprocessing results indicate that coding gains using MPEG1 of 20% may be obtained while maintaining the same level of visual quality of decoded pre-processed video as compared to the decoded original sequence. Extending the temporal filtering to a joint spatiotemporal filtering, we propose algorithms for noise reduction. At low and moderate signal to noise ratios, our algorithms perform reasonable well, but worse than the best results in the literature, while at high SNR, they perform better. It is believed that with improved estimation of parameters used in the algorithms, performance may be improved.Aside from the above main focus, we also present investigations into two other issues: (1) Efficient motion estimation algorithms for overlapped block motion compensation--we present algorithms that can trade off computational complexity for prediction accuracy in an efficient manner and (2) Supports to be used in linear predictive models--algorithms are presented which compute supports yielding up to 37% improvements in prediction over nearest neighbor based supports.U of I OnlyETDs are only available to UIUC Users without author permissio