Disseminated Cysticercosis - A Case Report.

Cysticercosis is a common public health problem in the Tropics. One of the uncommon manifestations and a rare complication is its disseminated form (DCC). Here, we report a case of disseminated cysticercosis with history of generalized tonic clonic seizures for 2 years with characteristic MRI findings and biopsy evidence from para vertebral muscles.

To Study the Association of Depression with Complications of Type 2 Diabetes and to Find Out any Correlation Between Type of Complication and Depression.

Background: Depression is common among people with diabetes and it is associated with poor outcomes. This study was carried out to investigate the association of depression with various complications of type 2 diabetes and to find out any correlation between type of complications and depression. Methods: 200 patients with established T2DM attending the Outpatient department and indoor wards of Medicine Department of Rajindra Hospital, Patiala were evaluated for depression by a previously validated depression questionnaire [PHQ-12 item]. Results: Patients with T2DM (n=200) were evaluated [94 (47%) male and 106 (53%) female]. Maximum number of patients i.e. 68(34%) were in 51-60 years age group. 57(28.5%) patients out of 200 had depression. Depression was commonly associated with retinopathy (68.57%), followed by neuropathy (61.2%), nephropathy (59.57%) & CAD (25.45%). It was most commonly associated with PDR (100 %) and least commonly with CAD. Conclusion: This study showed high prevalence of depression in patients with T2DM. The prevalence of depression is higher in T2DM subjects with retinopathy, neuropathy and nephropathy compared to those without the respective complications. The Chances of becoming depressed increased with increase in number of complications.

To Study the Prevalence of Thyroid Dysfunction in Newly Diagnosed HIV +ve Patients and Correlation between CD4 Count and Thyroid Dysfunction.

Background: Thyroid dysfunction is one of the common endocrine dysfunction in HIV Positive patients. Newly Diagnosed HIV Positive patients are rarely monitored for this problem. Objective:- To study the prevalence of thyroid dysfunction in newly diagnosed HIV positive patients & to Correlate it with CD4 Count. Methods: A prevalence study was carried out on 150 newly diagnosed HIV Positive patients with different CD4 Counts divided in three groups (Group A; CD4<350, Group B; CD4 350-550 and Group C; CD4>550) who were evaluated for thyroid dysfunction. Blood samples were collected for CD4 T Lymphocytes. Counts were determined by flow cytometry and Thyroid function was evaluated by chemiluminescence immunoassay. Results: Out of 150 cases studied, 47 Patients (31.33%) had thyroid dysfunction. Group A, B and C had Thyroid dysfunction in 40 %( 20), 32 %( 16) and 22 %( 11) patients respectively. All except one had hypothyroid state (TSH above normal range).When the results were analyzed for 150 patients with Pearson correlation coefficient. There was an inverse correlation of CD4 count and TSH. There was progressive decline in T3, T4 levels as CD4 count decreased. Conclusion: Thyroid dysfunction is frequent in newly diagnosed HIV positive patients and prevalence of thyroid dysfunction increased with decrease in CD4 count. TSH levels increased as CD4 count declined.

Double Chamber Right Ventricle (DCRV) With Ventricular Septal Defect in Adulthood.

Double-chambered right ventricle (DCRV) is a form of right ventricular outflow tract obstruction. It typically presents in childhood or adolescence. Only a handful of previous cases have been described in which DCRV occurred in adulthood. We report here a case of DCRV with ventricular septal (VSD) presenting in adulthood.

Tubercular Spinal Paravertebral Abscesses Presenting as Multiple Dermal Sinuses in HIV Reactive Patients.

Extra Pulmonary tuberculosis (EPTB) accounts for more than 50% of the cases of Tuberculosis in HIV-reactive patients and the clinically presentation is often atypical. EPTB sometimes poses diagnostic dilemmas as conventional diagnostic methods have a poor diagnostic yield and definite diagnosis may be delayed. Here we report a case of Spinal TB who uncommonly presented with multiple non healing sinuses in the Thoracolumbar region. Diagnosis was clinched by clinical presentation, +ve Interferon Gamma Release Assay (IGRA) accompanied by suggestive Magnetic resonance imaging findings.

Clinical Profile of Neurological Manifestations in HIV-Reactive Patients and Their Relation with CD4 Count.

Background: Neurologic abnormalities have been noted in one-third of patients with AIDS, but at autopsy the nervous system is affected in all of them. Aim: To study the clinical profile of neurological manifestations in HIV reactive patients and their correlation with CD4 counts. Methods: A randomized case study was conducted at Department of Medicine, Government Medical College, Patiala over a period of 2 years. 200 HIV-infected adult and adolescent patients (>15 years of age) were studied. The diagnosis of HIV was confirmed by 3 HIV ELISA& RAPID positive reports in symptomatic patients. Results: In the present study, 37% of the patients were in the age group of 26-35 years. Males are affected more frequently than females, with a male to female sex ratio of 2.56: 1. Meningitis, HIV associated dementia, Progressive multifocal leukoencephalopathy& peripheral neuropathy are the commonest neurological disorders observed in HIV-infected patients. Tuberculosis is the commonest opportunistic infection in retroviral positive patients. Conclusion: Central nervous system infections, intracranial mass lesions, stroke, and HIV-associated dementia are more common in patients with a CD4+ count less than 200.