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.

Demographic Profile and Clinical Features of Admitted HIV Positive Patients and their Correlation with CD4 Counts in a North India Tertiary Care Hospital.

Background: HIV Infections continues to be a burden globally and presents serious public health problems in the developing countries, especially in India. Aims and objectives: To study the demographic profile and clinical features of HIV positive admitted patients and to evaluate the correlation of clinical features with their CD4 counts. Methods: The present study was conducted to assess the socio-demographic profile and clinical features of 150 HIV+ve /AIDS patients admitted in various wards of Department of Medicine, Rajindra Hospital, Patiala from September 2013 to October 2015. For these patients a preformed questionnaire was prepared to enquire about socio-demographic characteristics such as age, sex, literacy status, marital status, occupation and socio-economic status. Thorough clinical examination was performed and correlation of clinical features with CD4 counts was evaluated using Pearson Coefficient of correlation. Results: The results of study showed that the most common age group affected was 26-45 years (56%). Male patients were 69.3% and females constituted 30.7%. Most common mode of transmission was heterosexual (73.3%), followed by intravenous drug abuse (6.7%), unsafe injections/needle stick injury (4.6%), blood transfusion (2.7%), 8% were both HS and IDU and transmission was unknown in 2.7%. The common presenting symptoms in admitted HIV patients were fever (71.3%), weight loss (50%), night sweats (39.3%), dry cough (36%), anaemia (32%), cough with expectoration (26%), lymphadenopathy (24%), shortness of breath (22%), chest pain (20.7%),diarrhoea (15.3%) and mouth ulcers (8.7%). Others were, headache (10.7%), haemoptysis (10%), icterus (6.7%), change of voice (4%), altered sensorium (14%) and neurological deficit (7.3%). 16 patients had pulmonary and 13 had extra pulmonary tuberculosis. It was also found that most patients (52%) had CD4 count in range of 200-500, with mean CD4 count of 282.61 + 14.31 cells/cmm at time of presentation. The frequency of these symptoms increased with fall in CD4 count indicating negative correlation. Conclusion: A thorough knowledge of the demographical & clinical profile of admitted patients will go a long way in managing resources and planning management of these patients. This will serve as a great step in achieving zero deaths as envisaged by NACO.

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.

Tubercular Arthritis of Sternoclavicular Joint: A Case Report.

Sternoclavicular joint (SCJ) is a rare site for occurrence of tubercular arthritis. Diagnosis often gets delayed due to rarity, leading to annoyance to patient. Here we report a case of 66 years old female who presented to us with painful swelling of Right>Left sternoclavicular joint. Diagnosis was clinched by clinical evaluation, appropriate imaging and strongly positive Interferon gamma release assay and fine needle aspiration cytology. Patient was put on ATT with significant improvement after 2 months.

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.