ABSTRACT
Background: NAFLD is one of the most common indications for liver transplantation in the Western population. The studies in India have been conducted in the general population. The present study is the first in India to be conducted in the medical community. Objective: To assess the prevalence of NAFLD among nursing staff in our institute and to assess the association of NAFLD with its risk factors. Materials and Methods: The study was an institute based cross-sectional analytical study conducted among the nursing staff of our institute. A pretested interview was used to collect the participants’ demographic details and personal and medical history. This was followed by measurement of blood pressure, weight, height and, waist circumference, and blood investigation for fasting blood sugar, fasting lipid profile, serum AST, ALT, HBsAg and anti-HCV. The staff underwent ultrasound abdomen to look for presence of fatty liver. Results: About 150 nursing staffs were included with a mean age of 34.2 years. The prevalence of NAFLD was 28.7 %. Of the subjects, 54% had obesity, 40.7% had abdominal obesity, 9.3% had diabetes, 3.3% had hypertension, 46.7% had dyslipidemia and 18% had metabolic syndrome. The prevalence of NAFLD was seen to be significantly higher among subjects with these risk factors: age > 40 years, obesity, abdominal obesity, dyslipidemia and metabolic syndrome. Conclusion: The prevalence of NAFLD among nursing staff is higher than the national prevalence. The risk factors for NAFLD in the studied population were age > 40 years, obesity, abdominal obesity, dyslipidemia and metabolic syndrome.
ABSTRACT
India has the third largest number of people living with HIV/AIDS. Provision of free antiretroviral therapy (ART) for eligible persons living with HIV (PLHA) has been scaled up significantly both in terms of facilities for treatment and number of beneficiaries. This study aimed at describing the profile of HIV/AIDS patients on ART from a tertiary-care hospital and to explore the factors associated with treatment-seeking behaviour, family support, and perceptions regarding HIV and ART. This is a descriptive study conducted at the ART centre in a tertiary-care hospital in Puducherry. Study population consisted of 130 HIV-positive patients aged more than 18 years on free firstline ART for at least 6 months. Data on sociodemographic details, clinical details, treatment-seeking behaviour, family support, and perceptions regarding HIV and ART were collected using a pretested questionnaire. Data are presented as percentages. In total, 130 patients on ART for at least 6 months were included in the study—61% were males (n=79), 39% were females (n=51); half of them belonged to the age-group of 36-50 years. Half of the participants were diagnosed to have HIV/AIDS between 1 and 3 year(s); two-thirds had one or more co-infection(s). The majority were aware of the side-effects of ART. After advice to start ART, there was a delay in starting treatment in one-fifth of the subjects due to depression, fear of stigma, disclosure to family, and side-effects. More than two-thirds of the patients travelled more than 30 km distance. Families of HIV-positive subjects were supportive in accompanying to the ART centre, collecting drugs, reminders to take medication, and motivation to complete the treatment. Alcohol (50%) and tobacco consumption (39%) was common among the subjects. Half of the respondents stated stigma, death, and pain as the main fears, and all of them stated high levels of trust and rapport with their doctors. This study reveals several positive aspects among ART beneficiaries. However, issues, like tobacco and alcohol consumption, travelling long distance for drug collection, fear of stigma and death, and concerns regarding the future, need to be addressed.
ABSTRACT
Background. In India, the data are scanty on long-term outcome of patients with HIV/AIDS treated with first-line antiretroviral therapy. Methods. We retrospectively studied the first 100 patients enrolled for antiretroviral therapy between February 2006 and March 2007 at Jawaharlal Institute of Postgraduate Medical Education and Research, a tertiary care hospital in southern India. Adherence, side-effects and clinical status were recorded at follow-up visits. The outcome measures were immunological recovery, attrition rate and first-line failure rate. First-line failure was defined on the basis of WHO clinical and immunological criteria. Results. The median age of the patients was 36 years. The median baseline CD4 count was 117 cells/cmm. After a median follow-up of 44 months, of the initial 100 patients, 41 patients continued to be on follow-up, 10 patients had died and 41 patients had been lost to follow-up. The attrition rate was 20 per 100 patient-years. Fifty-five patients received >6 months of antiretroviral therapy; of these, 36 patients continued to have good immunological status with a median CD4 count of 548 cells/cmm after a median follow-up of 62 months. The first-line failure rate was 6.12 per 100 patient-years. Conclusion. The initial loss of patients to follow-up is a matter of concern particularly when durable improvement in immunological status is achievable if patients with HIV/AIDS can continue to be on long-term antiretroviral therapy.
ABSTRACT
Cardiovascular disease is one of the major complications of hypothyroidism which is one of the most common endocrine disorders in India. In the present study, we have analyzed the link among oxidative stress, C reactive protein which is an inflammatory marker and the cardiovascular lipid risk factors in hypothyroid patients which has not been analyzed before. Sixty seven untreated hypothyroid patients were recruited consecutively for the study. Their ultrasensitive C reactive protein level and oxidative stress profile were measured apart from various lipid risk factors of cardiovascular disease. Ultra sensitive C reactive protein was significantly correlated with increased lipid risk factors of cardiovascular disease, thyroid stimulating hormone level and indices of oxidative stress in these patients. Low grade inflammation in hypothyroidism plausibly acts as the link between higher oxidative stress and the underlying cardiovascular risk among hypothyroid patients.
ABSTRACT
The aim of the study was to investigate the role of spectral analysis of heart rate variability (HRV) for assessing the type and degree of sympathovagal imbalance (SVI) and their link to cardiovascular morbidities in thyroid dysfunctions. Forty-five female subjects (15 control subjects and freshly diagnosed untreated 15 hypothyroid and 15 hyperthyroid patients) were recruited for the study. Thyroid profile, body mass index (BMI), basal heart rate (BHR), blood pressure (BP) and spectral indices of HRV (TP, LFnu, HFnu and LF-HF ratio, mean RR, SDNN and RMSSD) were assessed in all the three groups. LF-HF ratio was correlated with thyroid profile, BMI, BHR and BP. SVI was more prominent in hyperthyroid (P<0.001) compared to hypothyroid (P<0.05) subjects. LF-HF ratio was correlated with thyroid profile in both hypo and hyperthyroid subjects; but correlation with BHR and BP was significant only in hyperthyroidism. Though the SVI was found to be due to both vagal withdrawal and sympathetic activation, especially in hyperthyroidism, contribution by vagal inhibition was prominent. Vagal inhibition contributes significantly to SVI in thyroid dysfunctions, especially in hyperthyroidism. As the present study indicates poor cardiovascular health due to vagal inhibition in patients suffering from thyroid dysfunctions, attempt should be made to improve vagal tone especially in hyperthyroid subjects to attain a stable sympathovagal and cardiovascular homeostasis.
ABSTRACT
BACKGROUND: Helicobacter pylori infection may play a role in iron-deficiency anemia. METHODS: In 52 patients with iron-deficiency anemia, H. pylori status was determined using rapid urease test and histology. H. pylori -positive patients were randomly assigned to receive anti- H. pylori treatment either immediately (Group I) or after a delay of one month (Group II); in addition, all patients received oral ferrous sulfate for three months. Patients testing negative for H. pylori (Group III) received only oral ferrous sulfate. Hematological parameters were tested every month. RESULTS: Of 52 patients, 32 (61.5%) had H. pylori infection. At the end of one month, median increase in hemoglobin level was lower in Group II than in Groups I and III (1.1 g/dL vs. 3.6 g/dL and 1.9 g/dL, respectively; p=0.025), as were that in serum iron (19 mcg/dL vs. 55.5 mcg/dL and 41 mcg/dL; p=0.019). During the second month, after H. pylori infection in Group II had been treated, median increase in hemoglobin in this group was comparable to those in Groups I and III (3.7 g/dL vs. 2.5 g/dL and 2.5 g/dL. CONCLUSION: In patients with iron-deficiency anemia, presence of H. pylori infection is associated with a poorer response to oral iron therapy, which improves with treatment for H. pylori infection.
Subject(s)
Anemia, Iron-Deficiency/drug therapy , Anti-Infective Agents/therapeutic use , Case-Control Studies , Delayed-Action Preparations/administration & dosage , Drug Therapy, Combination , Female , Ferrous Compounds/administration & dosage , Helicobacter Infections/drug therapy , Helicobacter pylori , Humans , Male , Prospective Studies , Treatment OutcomeABSTRACT
A case of congenital erythropoietic porphyria born out of consanguineous marriage with features of red coloured urine, photosensitivity, hypertrichosis of face and extremities, erythrodontia and haemolytic anaemia is reported.