ABSTRACT
Introduction: TB is the most common opportunistic infection in HIV positive people. HIV-TB co-infection is a fatal combination with higher death rates in developing countries. In cured TB cases in HIV positive people, chances of recurrent also high. ART prevents the progression of HIV, reduces the chances of another opportunistic infection that could make management of care more complicated, and reduces the chances of TB recurring. Objectives: To document the profile of HIV positive TB patients availing both Anti-Retroviral (ART) and Anti Koch's Treatment (AKT) at a tertiary care hospital. Method: A retrospective descriptive study was conducted using available records of 198 HIV positive TB patients enrolled at an ART Centre of South Gujarat from November 2016 to November 2017. Age at enrollment at ART Centre, sex, native place, ART status, CD4 count were recorded along with detection, category, previous history and treatment of TB. Test of significance (t test) was applied to analyze the difference between CD4 count before and after treatment with AKT. Results: Mean age of male (n=123) and female (n=75) patients at the time of HIV detection was mean 37.62 (SD±11.61) years and mean 34.05 (SD±8.85) years respectively. Majority (86.87 %) were migrants from states other than Gujarat, of which 31.31% were from Maharashtra. Among them, 66% patients were on CAT-I AKT and 10.6% had previous history of TB. Among 56.1% patients who had extra-pulmonary TB, common were abdominal TB (47.75%), lymphadenopathy (18.02%) and pleural effusion (16.22%). While 32% of patients had completed their AKT regimen, 68% were on AKT. Among those were missed out (8.6%) and lost to follow up (3.5%) from ART, almost half (41.67%) had been initiated under CAT-II AKT. Mean CD4 count for 84 patients who completed their AKT was increase, this was statistically significant (p=0.001). Conclusion: Majority of patients were migrants and extra pulmonary TB was more common in this study group. Mean CD4 count increased significantly after completion of AKT. Prompt treatment and preventing loss to follow up are key to successful treatment completion and cure.
ABSTRACT
Purpose of the study: Demonstration of nerve-muscle experiments play a vital role for teaching Physiologyto undergraduate medical students. In recent days, procuring frogs for the conduction of these experimentshave become a major concern. Therefore, we have designed an innovative method to carry out nerve-musclePhysiology experiments in human subjects.Methodology: We designed a simple and feasible method to demonstrate the effect of increasing strengthof stimuli, two successive stimuli and tetanic stimuli on human finger muscle twitch response.Main findings: Results of four nerve-muscle experiments performed in a human subject using an innovativemethod has been presented in this article. First, recording of finger muscle twitch by ulnar nerve stimulation.Second, effect of subthreshold, threshold, maximal and supramaximal stimulus with increase in the strengthof stimulus. Third, effect of two successive stimuli on finger twitch response. Four, effect of tetanizingstimuli on finger twitch response.Conclusion: Here we propose a simple innovative practical for effective demonstration of nerve-musclePhysiology experiments using human subject for under-graduate teaching.