Frequency of HIV infection amongst children with disseminated tuberculosis and tuberculous meningitis in Aligarh [North India] - a low HIV prevalence area

To determine frequency of HIV in children with disseminated tuberculosis and tuberculous meningitis in a low HIV prevalence area, and to study clinical profile of those found HIV positive. Cross-sectional, descriptive study. Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India from February 2005 to January 2008. The study was conducted on 215 children under 14 years of age with either disseminated tuberculosis or tuberculous meningitis. HIV infection was diagnosed in accordance with WHO strategy II. In children younger than 18 months, the strategy [to cut down costs] was to screen first by HIV antibody testing and subject only positive cases to virological tests. Parents of HIV positive children were also tested for HIV and counselled. The clinical profile of HIV positive patients was noted. The frequency of HIV was 5.12%, while that in cases of disseminated tuberculosis was much higher [22%]. No case with isolated tuberculous meningitis was HIV positive. The majority [45.45%] of patients with HIV were between 1-5 years of age. The mode of infection in 7[63.63%] cases was parent to child transmission. Loss of weight, prolonged fever, pallor, hepato-splenomegaly and oral candidiasis were the commonest clinical manifestations among HIV positive patients. Clinically directed selective HIV screening in cases of disseminated tuberculosis can pickup undiagnosed cases of the same in areas with low prevalence of HIV infection

Incidence of SIRS in acute biliary pancreatitis

To see the incidence of systemic inflammatory response syndrome [SIRS] in acute biliary pancreatitis. Setting: Department of surgery, Armed Forces Hospital Dhahran, Saudi Arabia. Period: From January 2001 to January 2009. Patients and Clinical and biochemical data of 102 patients of acute biliary pancreatitis was analyzed retrospectively. Acute biliary pancreatitis was more common in females [74.5% vs. 25.5%] with a female to male ratio of 2.9:1. Majority of patients [70.6%] were in the age range of 21-50 years. All patients had ultrasound abdomen, hemoglobin, TLC, BUN, Creatinine, blood gases, liver function tests, serum amylase and lipase. Computed tomography of abdomen [CT] was done in 16 [15.69%] patients and ERCP was done in 30 [29.4%] patients. Only 2 patients had fever and leukocytosis consistent with SIRS whereas 8 [7.8%] had fever above 38°C only and another group of 22 [21.6%] patients had TLC >12000 cu mm. Clinical and biochemical abnormalities normalized in almost all patients within 72 hours. The group of patients who do not show SIRS and their clinical and biochemical abnormalities settle quickly should be named differently for statistical correction and management