A Study on Neurological Manifestations of HIV With Regard to CD4 Count

BACKGROUND AND OBJECTIVES: HIV/AIDS has posed many unprecedented challenges. It causes a white spectrum of disease manifestation. Approximately 60 % of the AIDS patients have neurological symptoms and 80-90 % is found to have neuro-pathological abnormality at biopsy. The pattern of neurological complication in HIV infection in India is different from that of western countries. This study was under taken to 1-Study the neurological manifestations in HIV patients admitted in to CMC Hospital, Coimbatore 2-to note differences with various studies carried out in other parts of the world. METHODS: Patents admitted in CMC Hospital, Coimbatore between August 2013 to August 2014 with symptoms referring to nervous system were screened and confirmed to have HIV-1 and/or HIV-2 infection (seropositive) by ICTC (Trispottest, Trilenetest, Dot immunoassay )were enrolled if they met the inclusion criteria. RESULTS: 74 of the 672 HIV positive patients fulfilled the inclusion criteria and were studied for neurological manifestations (>11 %). 51 were males and 23females with F:M ratio 1:2.2 and mean age ranged from 21-51 years. Majority of the patients were in economically productive age group. 61% were presenting with neurological symptoms and signs for the first time and were diagnosed HIV positive following admission. Tuberculosis is the single most common organism affecting CNS (64%.) Headache, fever and altered sensorium were commonest symptoms in HIV patients with Neurological pathology. CD4 count less than 200 was seen in 24 of these patients (32%). others above 200 but below 500.so there is strong association between development of opportunistic infection and CD4 count. As compared to western literature CNS TB was the commonest disease associated with HIV infections in our study. It was presenting pathology in 68% of the cases. It was associated with Pulmonary TB in 10% the cases. 23patients showed Space occupying lesion. Mean CD4 Count observed to be 210.7. INTERPRETATION AND CONCLUSION: There is high incidence of neurological manifestations with tuberculosis and Toxoplasmosis being commonest pathogenic agents in course of HIV infections in this study. Simple investigations like CD4 count may provide a clue to the degree of underlying immunosuppression and indicate the need to start ART in HIV/AIDS patients

Congenital anomalies: the spectrum of distribution and associated maternal risk factors in a tertiary teaching hospital

Background: To study the system-wise occurrence of congenital anomalies in newborns admitted in a tertiary hospital and to study the associated maternal factors.Methods: This is a retrospective study of all the mothers and their newborn babies with congenital anomalies who were delivered or referred to the Obstetrical Department / Neonatology unit during a two-year study period. The maternal risk factors and associated Obstetric complications were studied.Results: Among the babies born with congenital anomalies, the systems most involved were Genito-urinary System (28.5%) and Cardiovascular System (20.5%). Among the maternal risk factors, Diabetes (14.01%), previous abortions (12.7%) and hypothyroidism (8.7%) were the most significant associated factors. Intrauterine growth restriction (17.4%) was noted to be more common in these babies.Conclusions: The incidence of anomalies was most involving the Genito-urinary System and Cardiovascular System. The major risk factor identified was maternal Diabetes. Prevention by public awareness during adolescence, pre-conceptional counseling and antenatal screening is stressed. Availability of Pediatric surgery and Rehabilitative facilities to improve the quality of life would be warranted

Analysis of railway track deaths-an autopsy based study

Background: Railway related deaths account for approximately one percentage of all fatalities submitted to medicolegal autopsies. The study is undertaken with the aim of better understanding of railway track deaths by analyzing the demographic details of victims and other contributing factors which favours the occurrence of railway track deaths.Methods: A cross sectional descriptive study of all railway track deaths brought for medicolegal autopsy at Thiruvananthapuram Medical College, Kerala, India from 1st March 2010 to 28th February 2011 was done. A total of 104 cases of railway track deaths were studied excluding cases with advanced decomposition. Clinical case records were studied in treated cases. details regarding nature dimensions and location of injury was entered in a proforma. The data were entered in MS Excel and statistical analysis was done.Results: Out of 104 cases studied 83 (79.8%) victims were male and 21 (20.2%) victims were female. The lowest and highest age of the victim involved in the study was 15 years and 90 years respectively. Elderly people with impairment of vision and hearing are most vulnerable to such accidents 12.5%. The highest frequency of incidence of railway deaths occurred while crossing the Railway track (32.7%), followed by jumping in front of the train (19.2%) and walking along the side or through track (16.3%). In 17.3% of the cases there was no exact history regarding the incident. The most common types of external injuries were lacerated wound and abrasion. In all the cases head showed lacerated wounds and the upper limbs showed abrasion.Conclusions: Present study concludes that majority of victims were males showing a female ratio 4:1, The peak incidence was noted in the 6th decade. Most of the victims were manual labourers. Travelling, moving and crossing near railway tracks in intoxicated condition is very usual practice. Survival period was found to be very less

Injuries to the great vessels: an autopsy-based study

Background: Injuries of the chest causing disruption of the thoracic cage, damaging the great vessels are increasing daily. Aorta is most vulnerable to injury in deceleration trauma from road and air accidents, fall from height and penetrating injuries. Incidence of traumatic rupture of the aorta is rising with higher travel speed.  Methods: In this study we analysed the pattern of injury to great vessels and the socio-demographic pattern of the victims in trauma. 250 cases brought to a tertiary care institution for autopsy were studied from 1st January 2005 to 30th November 2005 (1st July 2005 - 30th November prospectively, and 1st January - 30th June 2005, retrospectively). A cross sectional study design including all cases of trauma to the chest was done with consecutive sampling. Data was collected in pro forma and analysed.Results: 206 victims were males. Commonest cause of chest injury was trauma. 130 (52%) were victims of road traffic accidents and the vehicle implicated the most was bus (41 cases, 16.4%). Pedestrians constituted the majority (26.4%). 15 cases (6%) involved major blood vessels of the thorax. Descending part of the thoracic aorta was vulnerable, with transection of the great vessels in 5 cases (2%). Haemothorax was observed in 102 cases on right side and 94 cases on the left side. 9 cases (4%) of bronchial or tracheal ruptures with 6 cases of severance and 3 incidences of tear were recorded.Conclusions: The wound of aorta or pulmonary artery are immediately fatal and commonly seen in case of vehicular accident or fall from height due to the intense compression to the chest with or without any sign of external injury. Most ruptures are due to automobile accidents and the mechanism of injury is sudden motion of the heart and great vessels

Studies on the Zetapotential of Calcite/p-Sulfonatocalix[ 4,8]arenes

Zeta potential of calixarenes has been reported for the first time. The water-soluble calixarenes has been used as dispersion media in solid/liquid interface. p-sulfonato-calix[4]arene (PSC4) and p-sulfonato-calix[8]arene (PSC8) were synthesized and characterized by FTIR, NMR, mass spectrometry, and HPLC techniques. It was proved that the zeta potential is a fast and simple measurement to know the adsorption behavior of sufonato calixarnes on calcite. The chemisorption of p-sulfonato-calix[n]arene was confirmed by shift in iso electric point, adsorption studies and FTIR. The calculated free energy of adsorption value and its sign suggests the chemical interaction between the calcite surface and p-sulfonato calix[4]and[8]arene

Coinfection of Dengue and Chikungunya viruses: a serological study in a tertiary care hospital in Warangal, Telangana, India

Background: All around India, Dengue and Сhikungunya (CHIK) diseases seem to be rising. Aedes aegypti mosquitoes frequently transmit the CHIK virus and Dengue virus (DENV). Both viruses can spread together in regions where they cocirculate. Objectives: The objective of the current investigation is to determine the seroprevalence of coinfection with Dengue and Сhikungunya. Methods: The present study was conducted at the Virus Research and Diagnostic Laboratory, Kakatiya Medical College, Warangal, Telangana, India, from January to December 2022. The district health authority and the admitted cases provided the samples. The patients had symptoms typical of CHIK and DEN infections, including high fever (>39°C), chills, rashes, joint pain, joint swelling, nausea, and headache, myalgia, and pain behind the eyes. Results: Between January 2022 and December 2022, a total of 4892, 3344, and 2103 hospitalised patients underwent serological testing for the Dengue virus (DENV), the Сhikungunya virus (CHIKV), and both Dengue and Сhikungunya virus for co-infection, respectively. IgM Capture ELISA was used for all tests. 153 (7.8%) of the cases had both Dengue virus (DENV) and Сhikungunya virus IgM positivity. (CHIKV). Dengue virus (DENV) monoinfection, or 703 (14.3%), denotes the presence of Dengue virus. 313 (9.3%) individuals tested positive for the Сhikungunya virus, or mono-infected with the virus (CHIKV). Chikungunya IgM, Dengue IgM, and Co-infection Conclusion: Dengue and Chikungunya virus co-infections are clinically more serious than a single infection. However, in endemic regions, particularly during the monsoon season, clinically suspected cases should be tested for both viruses. To determine the severity and clinical result of co-infection, more thorough investigations are needed to analyse the pathophysiology and complications of co-infection

Varijacija gena β-tubulin izotip 1 u kodonu 167 i 200 odgovorna za rezistenciju Haemonchus contortus na benzimidazol iz ovaca uzgajanih u distriktu Krishna, AP, Indija.

A study was carried out for detection of single nucleotide polymorphisms at codon 167 and 200 of the β-tubulin isotype 1 gene that are linked to BZ resistance of Haemonchus contortus in sheep. A total of 226 adult male worms were genotyped from different regions of Krishna district, Andhra Pradesh. Amplification of DNA from each worm by PCR, followed by semi-nested PCR, yielded an expected fragment of 488 bp product. The PCR product was subsequently digested with restriction endonuclease SnaBI and TaaI to detect mutation at codon 167 and 200 respectively. On digestion, three different fragment patterns were observed at codon 200, one with 215 bp, 206 bp and 67 bp (homozygous resistant; ‘rr’), the second with 282 bp, 215 bp, 206 bp and 67 bp (heterozygous; ‘rS’), and another with 282 bp and 206 bp fragment (homozygous susceptible; ‘SS’). No resistance allele (TAC) was evident at codon 167 in any worms including the worms that carried a susceptible allele (TTC) at codon 200. The overall genotype frequencies varied significantly (P<0.01) with respect to the β-tubulin gene/TaaI locus in the study area. The frequency of ‘rS’ (64.60%) genotypes was high compared to that of ‘rr’ and ‘SS’ genotypes. The genotype frequency for ‘rr’ worms ranged from 6.25% to 31.82% among different regions. In general, the prevalence of BZ resistance allele was found to be significantly (P<0.01) higher (54.0%). Results revealed β-tubulin isotype 1 polymorphism at codon 200 in H. contortus of sheep indicating the occurrence of resistance allele in the study area.Provedeno je istraživanje s ciljem otkrivanja polimorfizama pojedinačnih nukleotida u kodonu 167 i 200, β-tubulin izotip 1 gena koji je povezan s otpornošću ovčjeg parazita Haemonchus contortus prema benzimidazolu (BZ). Genotipizirano je ukupno je 226 odraslih muških crva iz različitih područja distrikta Krishna, Andhra Pradesh. Umnažanje DNA iz svakoga crva pomoću PCR-a praćeno je poluugniježđenim PCR-om, čime je proizveden očekivani fragment od 488 bp. PCR produkt potom je pomiješan s restrikcijskim endonukleazama SnaBI i TaaI radi otkrivanja mutacije u kodonu 167 i 200. U kodonu 200 opažena su tri različita fragmenta, jedan s 215 bp, 206 bp i 67 bp (homozigotno rezistentan, „rr“), drugi s 282 bp, 215 bp, 206 bp i 67 bp (heterozigot, „rS“) i treći s 282 bp i 206 bp fragmentom (homozigotno sumnjiv, „SS“). Rezistentni alel (TAC) nije ustanovljen u kodonu 167 svih istraženih crva, uključujući crve koji su nosili sumnjivi alel (TTC) u kodonu 200. Ukupna učestalost genotipova znatno je varirala (P<0,01) u odnosu na β-tubulin gen/TaaI lokus istraženog područja. Učestalost genotipa „rS“ (64,60 %) bila je visoka u usporedbi s učestalošću genotipova „rr“ i „SS“. Učestalost genotipa „rr“ kod crva iz različitih područja kretala se u rasponu od 6,25 % do 31,82 %. Općenito, opažena je signifikantno (P<0,01) viša (54,0 %) prevalencija BZ rezistentnog alela. Rezultati potvrđuju da polimorfizam kodona 200 u β-tubulin izotip 1 genu ovčjeg parazita H. contortus upućuje na pojavu rezistentnih alela u istraženim područjima