ABSTRACT
Background: Literature on the spectrum of opportunistic disease in human immunodeficiency virus (HIV)-infected patients from developing countries is sparse. HIV-related opportunistic infections (OIs) continued to cause morbidity and mortality in HIV-infected individuals. Objectives: The objective for this study was to elucidate the prevalence and spectrums of OIs in HIV- infected patients in the Gandhinagar Civil Hospital. Material and methods: The evaluation of the prevalence and spectrums of OIs was conducted by using the clinical data of 834 HIV-infected patients in the Gandhinagar Civil hospital from November 2012 to December 2013 those who were attended physician OPD for OIs. Results: The prevalence and spectrums of OIs varied contingent on sex, age, CD4 levels and treatment with ART. We found that tuberculosis was most common OI with prevalence being 20.50%, followed by Pneumocystis pneumonia (PCP) (5.16%) mycobacterium avium complex(MAC) (1.80%), candidiasis (1.56%), cytomegalovirus (CMV) infection (0.24%), progressive multifocal leukoencephalopathy (PML) (0.12%). Males (31.85%) were more prone to get OIs than females (27.85%). Pulmonary OI infections were the most prevalent morbidity and mortality in patients in the AIDS stage including pulmonary tuberculosis (7.43%) and PCP (5.16%). Fungal OIs were one of most prevalent morbidity in patients in the AIDS stage, including oral candidiasis (1.79). EPTB (13.07%) was more common than PTB (7.43%). OI in AIDS is more common in 41 to 60 years (32.93%) of age group. OI was more common in patients with CD4 count from 51-100 (86.96%) followed by 101 to 150 (69.05%). OI was more common in patients who were not on ART (72.33%) than those on ART (27.67%). Conclusion: The prevalence and spectrums of OIs, was discussed in this study. It would help to increase the awareness for physicians to make a diagnosis and empirical treatment sooner and plan good management strategies, especially in resource limited regions.
ABSTRACT
Background and Objectives: Chlamydia trachomatis is a sexually transmitted organism and an important public health problem in the sexually active age group. Limited studies are found regarding the prevalence of Chlamydia trachomatis in Nepal. Moreover, no study in Nepal reports the association of Chlamydia and HIV infection. The current study attempts to determine the burden of Chlamydia on HIV positive patients. Material and Methods: A total of 117 HIV positive patients visiting a HIV clinic in Kathmandu, were screened for Chlamydia infection. For this, Urine samples were collected and analyzed using the Multiplex polymerase chain reaction technique (MPCR) and Agarose gel electrophoresis. DNA isolation was performed using QIAamp DNA and Blood mini kit handbook protocol. Results: C. trachomatis was detected in 4.27% of the total 117 HIV patients. Out of positive cases 60% were males and 40% were females. However, Chlamydia is found more prevalent among females (6.89%) than in males (3.4%). Eighty percent of positive cases were asymptomatic. Conclusion: Chlamydia infection was found less commonly among studied patients and most of those cases were asymptomatic. So there is difficulty in timely detection of C. trachomatis and track the clinical sequel, which might be devastating. Hence, routine checkup is recommended for all suspected cases for timely management of the disease.
ABSTRACT
Background and Objectives: Multidrug-resistant (MDR) Mycobacterium tuberculosis strains are serious threats to the control of tuberculosis and comprise an increasing public health problem. Rapid detection of such strains is quite critical in timely management of such issues. The study was performed with an objective to compare Genotype MTBDRplus reverse hybridization probe assay (Hain Lifescince, GmBH, Nehern, Germany) with culture based proportion method for rapidly identifying MDR-TB strains from suspected multi drug resistant cases, referred to GENETUP Kathmandu, Nepal. Methodology: A commercially available new Genotype MTBDRplus assay was evaluated for its ability to detect mutations in Mycobacterial isolates conferring resistance to rifampicin (RMP) and isoniazid (INH). A total of 64 MDR isolates (i.e., at least resistant to RMP and INH), 5 fully susceptible strains and 1 RMP sensitive strains by conventional proportion method were analyzed using Genotype MTBDRplus assay. MTBDRplus assay is designed to detect the mutations in the hot spot region of rpoB gene, katG and regulatory region of inhA gene. Results: The MTBDRplus assay detected 59 of 61 RMP resistant strains (96.72%) with mutations on 81-bp hot spot region of rpoB gene and 60 of 63 INH resistant strains (95.23%) with mutation in codon 315 katG and regulatory region of inhA. The sensitivity and specificity for the detection of RMP resistance were 96.72% and 100% respectively. While, value of the same two variables for INH resistance were 95.23% and 100%, respectively. Conclusions: The new Genotype MTBDRplus assay represents a rapid, reliable, upgraded tool with high sensitivity and specificity for the detection of INH and RMP resistance strains that can readily be included in a routine laboratory work for the early diagnosis and control of MDR-TB.
ABSTRACT
Toxicity of copper on some metabolic processes can lead to disturbance and imbalance of various physiological activities such as respiration, reproduction, bone formation, and metabolism of some nutrients. Copper sulphate is frequently used as a general biocide in the aquaculture industry. The present study reflects the effect of copper sulphate on lipids in some vital organs of the freshwater crab Barytelphusa gureini. Crabs of equal size were treated with different concentrations of copper sulphate (0.5, 1.0, 1.5, 2.0, and 2.5 ppm) respectively. The mortality rate was noted up to 96 hours. After deducing the LC50, the crabs were treated with a sub-lethal concentration of copper sulphate (1.5 ppm) for 24, 48, 72 and 96 hours respectively. Total lipid estimation was done in the case of sub-lethal concentration (1.5 ppm) of copper sulphate exposure and compared with the control group of crabs. The results showed a significant decline in the total lipid in the following organs of Barytelphusa gureini at sublethal concentration of copper sulphate – hepatopancreas (67.7%) < muscle (58.8%) < gills (47.3%) < haemolymph (powder form) (28.8%). In contrast, there was an increase in the lipid in various organs of control crabs – hepatopancreas (0.091 mg/100 mg) > gills (0.076 mg/100 mg) > haemolymph (powder form) (0.052 mg/100 mg) > muscle (0.034 mg/100 mg). The lipid reduction in the present study is a reflection of breakdown of lipid in stress situation.