Treatment outcome of antiretroviral treatment naive HIV infected patients initiated on antiretroviral therapy in a tertiary care hospital in South India

Background: About 2.1 million people are infected with HIV in India. Clinical profile of patients has evolved over a period of time in the Antiretroviral treatment (ART) era. This study was done to document the clinical presentation of patients in a tertiary care in Mysuru in Karnataka. The aim of the study was to follow the patients who were initiated on ART over a period of time and to know its effect on the clinical outcome and overall morbidity and mortality of the patients.Methods: A prospective study of HIV positive patients who were initiated on ART was done regarding clinical profile and outcome over a period of one and a half to two years depending on when they were initiated on ART.Results: Totally 183 patients were registered during the period, out of which 114 patients (62.29%) were males and the rest were females (37.70%). The commonest route of transmission was heterosexual route seen in 97.3% (178). Most (56.8%) of the patients were asymptomatic. The mean basal CD4 count was 162.70. The mean age of patients was 39.07. The mean BMI was 20.29. A 23.5% (43) had one or other side effects. Anemia (44.2%) was the most common side effects seen. There were 18 deaths (12.2%). A 39.34% (72) patients had opportunistic infections (OI), the commonest being tuberculosis 45(%).Conclusions: It was concluded that patients with low CD4 count, low BMI were more prone for Opportunistic infections and death. Early initiation of ART can prevent such incidences and improve the quality of life of HIV positive patients

Comparison of pocket pulse oximeter and standard pulse oximeter with ABG analysis in critically ill patients

Background: Pulse oximetry (SpO2) is a standard monitoring device in patients presenting to EMDs and intensive care units (ICUs). Pocket pulse oximeters (PPOs) are used widely in wards, EMDs, and small hospitals/clinics. These inexpensive PPOs also guide therapeutic interventions. Few studies have evaluated the accuracy of SpO2 in patients presenting to critical care areas vis-à-vis devices like PPO and standard pulse oximeter (SPO). This study becomes extremely relevant in view of the ongoing crisis of the COVID-19 pandemic wherein SpO2 monitoring is very important in hospitals, quarantine centers, small clinics, or even at home.Methods: Patients presenting to critical areas who underwent arterial blood gases (ABG) analysis on the recommendation of the treating physician between November 2016 and October 2018 were included in this study. Along with the ABG analysis, a simultaneous assessment of SpO2 was done with a single PPO and SPO and all values were noted. Statistical analysis was done using the SPSS v.21.0 for Windows.Results: The study included 300 patients. We compared the O2 saturations of ABG, SPO, and PPO with respect to sex, different age groups, and at different levels of ABG pCO2, HCO3, and pH in all patients. All parameters were compared using the Pearson’s correlation test; the results showed that ABG O2 saturations were closer to the SPO than the PPO but the differences were not statistically significant as the Pearson’s correlation values for all parameters were >0.8. We also compared the parameters by Bland Altman Plot and all observations were outside 95% CI (confidence interval), which means that there was a good agreement between O2 saturations by all three methods, that is, ABG, SPO, and PPO; however, ABG O2 saturations were closer to SPO than PPO but this difference was not statistically significant. Hence, we conclude that the PPO is a useful tool for reliable monitoring of O2 saturations.Conclusion: This study highlights that inexpensive and noninvasive PPO can be used as a standard monitoring device with reliability in critically ill patients presenting to EMDs, ICUs, and small hospitals/clinics, quarantine centers, and even at home

Comparison of Pocket Pulse Oximeter and Standard Pulse Oximeter With ABG Analysis in Critically Ill Patients

Background: Pulse oximetry (SpO2) is a standard monitoring device in patients presenting to EMDs and intensive care units (ICUs). Pocket pulse oximeters (PPOs) are used widely in wards, EMDs, and small hospitals/clinics. These inexpensive PPOs also guide therapeutic interventions. Few studies have evaluated the accuracy of SpO2 in patients presenting to critical care areas vis-à-vis devices like PPO and standard pulse oximeter (SPO). This study becomes extremely relevant in view of the ongoing crisis of the COVID-19 pandemic wherein SpO2 monitoring is very important in hospitals, quarantine centers, small clinics, or even at home.  Methods: Patients presenting to critical areas who underwent arterial blood gases (ABG) analysis on the recommendation of the treating physician between November 2016 and October 2018 were included in this study. Along with the ABG analysis, a simultaneous assessment of SpO2 was done with a single PPO and SPO and all values were noted. Statistical analysis was done using the SPSS v.21.0 for Windows.  Results: The study included 300 patients. We compared the O2 saturations of ABG, SPO, and PPO with respect to sex, different age groups, and at different levels of ABG pCO2, HCO3, and pH in all patients. All parameters were compared using the Pearson’s correlation test; the results showed that ABG O2 saturations were closer to the SPO than the PPO but the differences were not statistically significant as the Pearson’s correlation values for all parameters were >0.8. We also compared the parameters by Bland Altman Plot and all observations were outside 95% CI (confidence interval), which means that there was a good agreement between O2 saturations by all three methods, that is, ABG, SPO, and PPO; however, ABG O2 saturations were closer to SPO than PPO but this difference was not statistically significant. Hence, we conclude that the PPO is a useful tool for reliable monitoring of O2 saturations.  Conclusion: This study highlights that inexpensive and noninvasive PPO can be used as a standard monitoring device with reliability in critically ill patients presenting to EMDs, ICUs, and small hospitals/clinics, quarantine centers, and even at home

Centrality evolution of the charged-particle pseudorapidity density over a broad pseudorapidity range in Pb-Pb collisions at root s(NN)=2.76TeV

Peer reviewe

Dynamic indentation hardness and rate sensitivity in metals

An experimental technique for determining the dynamic indentation hardness of materials is described. Unlike the traditional static hardness measurements, the dynamic hardness measurements can capture the inherent rate dependent material response that is germane to high strain rate processes such as high speed machining and impact. The dynamic Vickers hardness (DHV) of several commonly used engineering materials is found to be greater than the static Vickers hardness (HV). The relationship between the hardness and yield stress under static conditions, i.e., HV = 3σy, is also found to be valid under dynamic conditions. It is suggested that this simpler technique can be used to assess the rate sensitive nature of engineering materials at moderate strain rates in the range of around 2000/s. © 1999 by ASME

Treatment outcome of antiretroviral treatment naive HIV infected patients initiated on antiretroviral therapy in a tertiary care hospital in South India

Background: About 2.1 million people are infected with HIV in India. Clinical profile of patients has evolved over a period of time in the Antiretroviral treatment (ART) era. This study was done to document the clinical presentation of patients in a tertiary care in Mysuru in Karnataka. The aim of the study was to follow the patients who were initiated on ART over a period of time and to know its effect on the clinical outcome and overall morbidity and mortality of the patients.Methods: A prospective study of HIV positive patients who were initiated on ART was done regarding clinical profile and outcome over a period of one and a half to two years depending on when they were initiated on ART.Results: Totally 183 patients were registered during the period, out of which 114 patients (62.29%) were males and the rest were females (37.70%). The commonest route of transmission was heterosexual route seen in 97.3% (178). Most (56.8%) of the patients were asymptomatic. The mean basal CD4 count was 162.70. The mean age of patients was 39.07. The mean BMI was 20.29. A 23.5% (43) had one or other side effects. Anemia (44.2%) was the most common side effects seen. There were 18 deaths (12.2%). A 39.34% (72) patients had opportunistic infections (OI), the commonest being tuberculosis 45(%).Conclusions: It was concluded that patients with low CD4 count, low BMI were more prone for Opportunistic infections and death. Early initiation of ART can prevent such incidences and improve the quality of life of HIV positive patients

Correlation of carotid intimal-medial thickness with estimated glomerular filtration rate and cardiovascular risk factors in chronic kidney disease

Carotid intimal-medial thickness (CIMT) predicts future vascular events in the general population. However, the correlation of traditional cardiovascular risk factors and stages of chronic kidney disease (CKD) with CIMT is not studied extensively. To determine the correlation of CIMT with traditional cardiovascular risk factors like age, body mass index (BMI), dyslipidemia and various stages of CKD patients, CIMT was measured by means of high-resolution B-mode ultrasonography in 70 CKD patients and compared with the 30 healthy controls. The mean CIMT in patients was 0.86 ± 0.21 mm vs 0.63 ± 0.17 mm in healthy age- and sex-matched controls (P <0.001). There was a significant univariate positive correlation between CIMT and age (r = 0.605, P <0.001), BMI (r = 0.377, P = 0.001), total cholesterol (r = 0.236, P ≤0.018) and serum triglyceride (r = 0.387, P ≤0.001). No statistically significant correlation was found between mean CIMT and estimated glomerular filtration rate (eGFR) (r = -0.02, P = 0.30), very low-density lipoprotein and high-density lipoprotein-cholesterol. Atherosclerotic changes very well correlate with the traditional cardiovascular risk factors like age, BMI, serum total cholesterol and serum triglyceride level in CKD patients. Even though CIMT was marginally more in the late stages of CKD patients, no statistically significant correlation was found with CIMT and eGFR

Correlation of carotid intimal-medial thickness with estimated glomerular filtration rate and cardiovascular risk factors in chronic kidney disease

Carotid intimal-medial thickness (CIMT) predicts future vascular events in the general population. However, the correlation of traditional cardiovascular risk factors and stages of chronic kidney disease (CKD) with CIMT is not studied extensively. To determine the correlation of CIMT with traditional cardiovascular risk factors like age, body mass index (BMI), dyslipidemia and various stages of CKD patients, CIMT was measured by means of high-resolution B-mode ultrasonography in 70 CKD patients and compared with the 30 healthy controls. The mean CIMT in patients was 0.86 ± 0.21 mm vs 0.63 ± 0.17 mm in healthy age- and sex-matched controls (P <0.001). There was a significant univariate positive correlation between CIMT and age (r = 0.605, P <0.001), BMI (r = 0.377, P = 0.001), total cholesterol (r = 0.236, P ≤0.018) and serum triglyceride (r = 0.387, P ≤0.001). No statistically significant correlation was found between mean CIMT and estimated glomerular filtration rate (eGFR) (r = -0.02, P = 0.30), very low-density lipoprotein and high-density lipoprotein-cholesterol. Atherosclerotic changes very well correlate with the traditional cardiovascular risk factors like age, BMI, serum total cholesterol and serum triglyceride level in CKD patients. Even though CIMT was marginally more in the late stages of CKD patients, no statistically significant correlation was found with CIMT and eGFR

A cross-sectional study of paper grip test as an additional test for early-stage screening of the feet in patients with diabetes

Introduction: Studies have shown that foot deformities such as claw foot, hammer toes can occur due to paralysis of intrinsic muscles of the feet which in turn pose a high risk for foot ulcerations, gait disturbances and falls alongside decreased sensations of the foot. Current guidelines for the screening of diabetic foot involves testing for sensations of the foot by the Semmes Weinstein Monofilament (SWM) test but testing for intrinsic muscle weakness is not done routinely. Based on available literature, onset of structural changes of the foot occurs earlier than loss of sensations hence this study was undertaken to identify intrinsic muscle weakness of the feet using a simple, test called Paper Grip test (PGT) in diabetics with normal sensations of the feet. Methodology: &nbsp;An analytical cross-sectional study was conducted in JSS Hospital from November 2018 to September 2020 involving diabetic patients visiting Medicine OPD and admitted patients meeting inclusion criteria of this study. Necessary ethical clearance from the institutional ethics committee of JSS medical college was obtained. Functional status of intrinsic muscles of the foot was tested by PGT and the sensations of the sole of the foot was assessed by SWM