frequency of HBV, HCV and HIV in patients undergoing percutaneous mitral valvuloplasty

Objective: Determine the frequency of Hepatitis B, C and HIV in patients undergoing mitral valvuloplasty with multitrack balloon catheters

Methods: This was a cross sectional study in which 100 consecutive patients of both sexes underwent percutaneous Mitral Valvuloplasty with multi track balloons catheters at the National Institute of Cardiovascular Diseases Karachi from January 2003 to December, 2004. The Viral markers of Hepatitis B Surface Antigen and Antibodies against Hepatitis C and HIV was done in all patients undergoing PTMC prior to procedure

Results: Out of 100 patients undergoing PTMC with multi track balloon catheters, 78 patients were females while 22 of them were males. Screening of these patients showed that 14% of them were Sero positive for HBV while 8% positive for HCV. None of screened patients were HIV positive

Conclusion: 1] The frequency of hepatitis B, C and HIV in patients undergoing PTMC [14% and 8%], as compared to normal population [2.56% for HBsAg] and [5.31% for anti-HCV] respectively. 2] In our country most of patients are non-affording and we have to reuse balloon catheters, so it should be mandatory to screen hepatitis B, C and HIV before undergoing invasive procedures. Balloon used in seropositive patients should be discarded. 3] National guidelines regarding reuse of various hardwire and other preventive measures are mandatory for patient's safety

CD4 T lymphocyte levels and PPD skin test measurements in adult AIDS patients with pulmonary tuberculosis

This pilot study was carried out at the Chonburi General hospital and the zonal tuberculosis [TB] center in Chonburi, Thailand. A total of 22 AIDS patients with pulmonary tuberculosis and 20 HIV seronegative pulmonary tuberculosis patients [Controls] were skin tested with 5 tuberculin units [TU] of PPD. Anergy was observed in 82% of AIDS cases, all with very low CD4 counts. The remaining 18% showed skin reactions ranging between 1 mm and 9 mm. The Pearsons correlation coefficient test showed a good correlation between the PPD induration measurement and the absolute CD4 counts. The coefficient r=0.79 [p< 0.001] with the absolute CD4 counts, and r=0.60[P< 0.001] with the percentage of CD4 lymphocytes. In the control group, no such correlation was found and anergy was not observed in any of the patients. Relationship was established between CD4 counts and the PPD skin induration measurement, though with a larger sample size, the association may be better established and may predict the level of CD4 T lymphocytes and hence disease progression, especially in areas of high case load of AIDS and tuberculosis

Comparison of cd4+ T cells hiv - infected patients with tuberculosis and non hiv - infected patients with tuberculosis after anti tuberculosis treatment

A prospective study of CD4 + T lymphocytes along the course of treatment of 25 HIV-infected patients with active tuberculosis receiving antituberculous drugs was compared with 32 non HIV - infected patients with active tuberculosis, also receiving the same regime of anti tuberculous drugs. The CD4 + T cell among non HIV - infected patients were 525 +/- 415/mm[3] and increased to 675 +/- 378/mm[3] and 902 +/- 267/mm[3] at the third and sixth months of therapy. Among HIV- infected patients, the CD4 + T cell counts were 72 +/- 45/mm[3] and decreased to 50 +/- 25/mm[3] and 42 +/- 20/mm[3] at the third and sixth months of therapy [P < 0.05]

Surveillance of shigellosis in rural Bangladesh: a 10 years review

Over a period of 10 years 35,620 patients, admitted from a defined surveillance area, had a rectal swab culture done at a rural diarrhoea treatment centre in Bangladesh. Shigella spp. were isolated from 3,440 [9.7%] cases. Marked year to year variations were observed in isolation rates of Shigella spp. ranging from 5.7% to 16.7%. Sh. flexneri was the predominant isolate between 1978 to 1982 [56%-67%], Sh. dysenteriae type 1 predominated from 1983 to 1985 [45%-50%], and again Sh. flexneri became predominant in 1986 [55%] and 1987 [61%]. Shigella were most commonly isolated from children aged 1 -4 years followed by children 5-9 years and elderly people aged 45 + years. Sh. flexneri was isolated most frequently during August - January and Sh.dysenteriae type 1 during June to July. The overall case fatality rate in patients with shigellosis was 0.96%. It was 1.10% in children under 5 years of age. Prevalence of multiple antibiotic resistant strains increased over the years and at present most strains are resistant to commonly used antibiotics such as ampicillin and cotrimoxazole. Nalidixic acid is currently the drug of choice for Shigella infection in this area