RESUMEN
Background: Opportunistic infections of the central nervous system (CNS) are common complications of advanced immunodeficiency in individuals with human immunodeficiency virus (HIV) infection. We aimed to study the clinical profile of CNS infections in HIV patients, effect of antiretroviral therapy (ART) on various patient variables and mortality outcomes associated with various patient characteristics. Methods: After approval of the ethics committee, we enrolled 100 patients from the Department of Medicine at Lokmanya Tilak Municipal General Hospital from January 2011. Patients who were diagnosed with HIV using ELISA and admitted with a CMS infection were consented and enrolled for the study. Various clinico-laboratory parameters like CD4 counts, ART, signs and symptoms were collected and analysed with approapriate statistical techniques. P vlaue less than 0.05 was taken as staistically significant. Results: Out of 100 patients, 71 were males, average age 35.24 years. Majority had headaches, CD4 counts between 101-200 cells/mm3and 57 were on ART. Tubercular mengitis was the most common CNS infection in our patient population. We found statistical signifiance in the occurance of CNS infections and ART among patients. Mortality outcomes were significantly associated with signs and symptoms of the patients (p < 0.05). Conclusion: Our results show that CNS infections can occur even with high CD4 counts. So strict monitoring and long term followup of HIV patients is needed. Areas of future research should focus on long term clinical outcomes of HIV patients and elucidating factors reponsible for it.
RESUMEN
Context: Accurate assessment of periapical status is critical in diagnosis, treatment planning, and evaluation of healing. Novel imaging modalities like sonography offer promising results with reduced radiation risks. Aims: To evaluate the potential of ultrasound imaging technique together with the application of color Doppler to differentiate between periapical lesions of endodontic origin. Materials and Methods: Twenty patients with periapical lesions of endodontic origin who were already scheduled for undergoing endodontic surgery were examined further using sonography. Color Doppler was performed to assess blood flow. Information on the size of the lesion, its content, and vascular supply was gained and recorded by means of ultrasound images. The sonographic images were analyzed and discussed with an expert sonologist, and a tentative diagnosis between a periapical cyst and periapical granuloma was made. Endodontic surgery and histopathological examination was done for each case and the results were compared. Results: The sonograms revealed the lesions within the bone in three dimensions and their contents, that is, fluids or tissues or blood vessels. Measurements of the periapical lesions in three dimensions were also obtained. Of the twenty cases studied, ultrasound could detect periapical granulomas in all 9 cases and radicular cysts in all 11 cases. Conclusion: Ultrasound imaging had the potential to be used for the evaluation of periapical lesions of endodontic origin. However, further studies are required to establish a definite correlation.