An Observational Study on Metabolic Derangements in People Living with HIV

Background: HIV infection is a global pandemic. The adult HIV prevalence in India is 0.22%. Successful therapy is transforming HIV into a chronic medical condition, and there are many metabolic complications. This study aimed to evaluate the metabolic abnormalities in people living with HIV (PLHIV) who were on antiretroviral therapy (ART) for at least 2 years and compare it with ART-naïve patients as well as the effect of protease inhibitor-based (PI-based) and non-protease inhibitor-based (non-PI-based) ART was assessed. Methodology: Adult HIV-positive patients both ART-naïve and on ART for more than 2 years were included. Detailed history and clinical examination, including blood pressure and anthropometric measurements were done. This was followed by investigations like lipid profile including total cholesterol, triglyceride, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), fasting plasma glucose, and hemoglobin A1c (HbA1C) estimation. Standard statistical tools were utilized to assess derangements and association to therapy. Results: The study was conducted for 1.5 years in a tertiary care hospital. A total of 70% of the study population was male with mean age of participants being 43.2 years, 40% were ART-naïve, 37% received non-PI-based ART, and 23% PI-based ART. The mean total cholesterol level and mean triglyceride value were significantly higher in the PI-based ART group than in the therapy-naïve group. The ART-naïve group was seen to have more subjects with abnormally low HDL-C values. The PI-based ART study subjects were found to have a greater number of cases of glucose intolerance in relation to the rest of the two groups significantly (p-value <0.001). The LDL-C systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and waist circumference had no association with the different ART regimens or with the HIV infection itself. CD4 T cell count at diagnosis in the three study groups was compared with all the variables of metabolic syndrome and no association was found. Conclusion: Total cholesterol, triglycerides, and glucose levels are the main parameters found to be affected in PLHIV on therapy.

Isthmus agenesis with variant topography of levator glandulae thyroideae: A case report

The thyroid gland is an imperative endocrine gland present in the neck known commonly for its morphological variations. During routine dissection agenesis of the isthmus of the thyroid gland was observed with levator glandulae thyroidea extending from both the lateral lobes with stout stalks of pyramidal lobes bilaterally. The Levator glandulae thyroidea is a fibro-musculo-glandular band. usually, present unilaterally or extending from isthmus connecting the pyramidal lobe of the thyroid gland to the hyoid bone. The site of the isthmus is often associated with anastomosis of vessels supplying thyroid gland but strikingly no such anastomosis was observed. The presence of such variant of levator glandulae thyroidea with agenesis of the isthmus is a rare finding and knowledge of such topographical anatomical variations is crucial for understanding associated pathologies related to the thyroid gland and modus operandi in their management.

Zoonoses and bats: a look from human health viewpoint.

Bats are the most abundant and most widely distributed mammals on the Earth after humans. Except Antarctica and some small remote islands, they are prevalent worldwide. Although the actual role played by bats as reservoir or in disseminating zoonoses is still enigmatic a multitude of zoonotic diseases are known to be associated with bats. Such diseases including viral, bacterial, parasitic, fungal and rickettsial diseases, reported from all over the world including India have been briefed in this article as an informative approach because dramatically increased and diversified human activities during the last few decades perturbing natural ecosystems are enough to compel public health personnel to have an investigative look at these flying mammals.

Isolation of verotoxin producing Escherichia coli from diarrhoeal and urinary tract infection patients.

Fourty nine Escherichia coli strains, isolated from diarrhoeal and urinary tract infection (UTI) patients, attending Bareilly district hospital, Uttar Pradesh during October to December, 1998 were screened for verotoxin (VT) production by Vero cell assay. Five strains produced characteristic cytopathic effect on Vero cell line, of which 4 were from diarrhoeal and one was from UTI-patient. The level of VT-production varied widely. Antibiotic sensitivity tests revealed that the VT-producing E. coli (VTEC) were mostly sensitive to kanamycin, norfloxacin and nalidixic acid but resistant to ampicillin and tetracycline.

Enzymes of PEP-succinate pathway in Setaria cervi and effect of anthelmintic drugs.

Localization of different enzymes of PEP-succinate pathway has been done in Setaria cervi, a bovine filarial worm. Succinate dehydrogenase and fumarate reductase were localized in mitochondria rich particulate fraction while all other enzymes were cytosolic. The in vitro effect of certain antifilarial/anthelmintic agents on these enzymes was also investigated. Sumarmin, at low concentration, could cause a marked inhibition of most of the enzymes of this pathway. Centperazine, an antifilarial drug being developed by CDRI showed significant inhibitory action on pyruvate kinase, lactate dehydrogenase, fumarase and succinate dehydrogenase while CDRI compound 72/70 showed significant inhibition of PEP-carboxykinase activity. Diethylcarbamazine and levamisole, however, were found to be more or less ineffective at lower concentrations against all the enzymes of this pathway.

Effect of anthelmintics and phenothiazines on adenosine 5'-triphosphatases of filarial parasite Setaria cervi.

S. cervi showed particulate bound Ca2+ ATPase and Na+,K(+)-ATPase activities while Mg2+ ATPase was detected in traces. ATPase of S. cervi was also differentiated from the nonspecific p-nitrophenyl phosphatase activity. Female parasite and microfilariae exhibited higher Ca2+ ATPase and Na+,K(+)-ATPase activities than the male adults and the enzyme Na+,K(+)-ATPase was mainly concentrated in the gastrointestinal tract of the filarial parasite. Na+,K(+)-ATPase of the filariid was ouabain-sensitive while Ca2(+)-ATPase activity was regulated by concentration of Ca2+ ions and inhibited by EGTA. Phenothiazines, viz. trifluoperazine, promethazine and chlorpromazine caused significant inhibition of Ca2+ ATPase and Na+,K(+)-ATPase. Diethylcarbamazine was a potent inhibitor of these ATPases. Mebendazole, levamisole and centperazine also caused significant inhibition of the ATPases indicating this enzyme system as a common target for the action of anthelmintic drugs.

Effect of thiabendazole & mebendazole on in vitro metabolism of Nippostrongylus brasiliensis adults.

Mebendazole and thiabendazole were found to inhibit glucose uptake and its metabolism in the adult rat hookworm (N. brasiliensis) in vitro. Rates of endogenous glycogen utilisation, and excretion of one of the end products of glycolysis viz., lactic acid, were found to be increased, when the intact N. brasiliensis adults were incubated for 60 min with mebendazole and thiabendazole, respectively.

Comparative analysis of surface components of adult, micro-filariae and infective larvae of Brugia malayi.

A comparative analysis of surface proteins of adult, microfilariae and infective larvae of Brugia malayi, the human filarial parasite, has been carried out using IODOGEN (1,3,4,6-tetrachloro-3,alpha 6 alpha-diphenyl-glycoluril) and lactoperoxidase methods. SDS-polyacrylamide gel electrophoretic and autoradiographic analyses revealed the presence of 9 proteins (15-200 kDa) in adults, while microfilariae and infective larvae showed 8 and 6 proteins (15-120 kDa), respectively. The pattern of proteins radiolabelled by IODOGEN method was very similar to that of proteins labelled by the lactoperoxidase method. Since these proteins are released by the protease treatment of whole parasites, they are likely to be present on the surface of the parasite.