A Study on Etiopathological Evaluation of Anaemia in Newly Diagnosed HIV-Infected Adults at a Tertiary Health Care Centre of Eastern India.

Background: Anaemia is a common feature among HIV infected people and has been uniformly demonstrated that the severity of anaemia increase the morbidity and mortality in PLWH independent of CD4 count. There are wide variations in the prevalence of anaemia from different countries all over the world and gender specific variation observed in different studies. Aims and Objectives: Aims of our study were to study the different types and the various etiologies of anaemia in newly diagnosed HIV infected adults. Also to find out the relation between absolute CD4 counts and severity of anaemia. Methods: Fifty newly diagnosed HIV infected adults with anaemia were included in the study. Study conducted from July 2014 to June 2015 at a tertiary care hospital and medical teaching institute in eastern India. Detailed medical history was taken, thorough physical examination was done and relevant routine laboratory investigations were done in all patients. Few special investigations were done in selected patients. Results: In this study 70 % of the patients belonged to the lower socio economic group and 58% of the cases were addicted to alcohol which is also a significant associated risk factor. The mean CD4 count was 170.1 with a standard deviation of 123.16. The mean Hb% of the population was 7.13 with a standard deviation of 1.27031492. The most common etiology found was anaemia of chronic disease (34%) and other etiologies were HIV induced myelodysplasia (32%), iron deficiency anaemia (16%), helminth infection (14%) and vitamin B12 deficiency leading to megaloblastic anaemia was seen in 4% cases. Conclusion: Anaemia of chronic disease is the most common etiology, which has correlation with disease activity.

Castlemans disease in HIV infected patient from eastern India.

Castlemans disease is a rare lymphoproliferative disorder. We report a patient of Castlemans disease with advanced HIV infection who responded well to conventional HAART. This case is interesting because of the rarity of the disease in the eastern part of India and its good out come with antiretroviral therapy.

Juvenile idiopathic arthritis.

This study attempts to determine the clinical manifestations, severity and immunological features of JIA and its influence on growth and associated cardiac involvement in children below 16 years of age. This is a cross sectional study in a tertiary referral center on 50 consecutive children below the age of 16 years. Each patient was thoroughly examined and scored on Juvenile Arthritis Functional Assessment Scale. Relevant blood tests, cardiac and ophthalmic evaluation was done. Growth patterns were noted. There was an overall equal sex ratio, though there was a male preponderance in the systemic and oligoarthritis groups. Disturbance of growth frequently occurred in children suffering from JIA. Cardiac involvement should be looked for in cases of JIA. Significant number of cases of PSRA is diagnosed in children presenting with chronic arthritis.

Primary neurological manifestations of lung cancer--a retrospective analysis of 8 patients.

Neurological manifestations are reported in 5 to 10% of cases of lung cancer. We present a series of 216 consecutive patients of lung cancer of which 8 patients presented first with neurological manifestations without overt respiratory symptoms. The present study aimed to identify the number of patients of lung cancer presenting with primary neurological symptoms, the nature of the presentations, and the outcome of these patients among 216 patients who presented over a 2 year period in the Institute of Postgraduate Medical Education and Research, Kolkata. Out of 8 patients, 3 patients presented with seizures, 3 patients with hemiparesis and 2 patients with paraparesis. Thus, 3.7% (8/216) of patients in our series presented with a neurological manifestation. We concluded that primary neurological manifestations are rare in lung cancer. The lungs should be the first site of evaluation in a case of a cerebral metastasis with an unknown primary.

A study of relapse after MDT in a district in West Bengal, India.

A study was undertaken to estimate the magnitude of the problem of relapse and to identify factors responsible for relapse in leprosy units that were delivering MDT in Purulia District of West Bengal. From records patients were classified as "Relapse" or "Not relapse". "Not relapse" patients were selected by simple random sampling from the Surveillance Register and were matched according to age, sex, and the leprosy control unit. 128 cases ("Relapse") and 128 controls ("Not relapse") were interviewed in the clinic using a pre-tested questionnaire. Details of methods to identify and confirm relapse were circulated to all reporting units for ensuring uniformity and reliability. NGOs covered 42% of the population, while the State Government covered the remaining. The patients had been followed up after completion of treatment for a period of two years in PB leprosy and for five years in MB leprosy. The study revealed that the relapse rate was 1.71/1000 person-years for original PB cases and 0.76/1000 person-years for original MB cases. The study also showed that history of contact with an active leprosy patient and irregular treatment led more PB cases to relapse than control cases. All patients with an initial BI of 3+ relapsed with a BI of 1+ or 2+.

Primary malignant fibrous histiocytoma of the greater omentum.

Primary malignant mesenchymal tumours of the greater omentum are rare. We report a 40-year old man with a painless abdominal lump of two months duration. At laparotomy, the mass was found to be arising from the greater omentum. A near-total omentectomy was done. Histological examination of the resected tumour revealed features consistent with malignant fibrous histiocytoma.

Mass DEC campaign for filariasis in a hyper endemic district of West Bengal.

As a part of the on-going National Filaria Control Programme, National Filaria Day was observed in Purulia district of West Bengal on 26th Nov 2000 with an extensively organized mass DEC consumption campaign preceded by IEC activities and followed by mopping up operations. In all 81.07% of the targeted population was covered, females (84.3%) being more available than males (78.3%). Percentage of coverage declines with increase in age. Municipalities and notified areas had less coverage as well as supervised consumption than in other areas. Consumption was highest in Balarampur block (88.6%). Supervised consumption among surveyed population was highest in Bandwan (56.0%). Overall patient compliance was very good, with side effects of vomiting, dizziness, headache and fever being 2.12% only among surveyed population. Disease prevalence among population covered showed 0.1% hand swelling, 0.6 to 0.8% leg swelling, while 1.1% of males had hydrocele.

Primary CNS lymphoma: an audit of cases treated over a nine year period and review of the literature.

Primary CNS lymphoma is a rare tumor comprising around one percent of all brain tumors. This report is an audit of eight cases [5 males, 3 females, age range: 17-55 years] which were accrued over nine years. All patients underwent surgical decompression, followed by radical Radiotherapy [RT]. Five out of eight patients received adjuvant chemotherapy in the form of CHOP or PCV. Of the patients who relapsed two received CHOP as a salvage therapy, one received PCV therapy and lomustine with intrathecal methotrexate. At a median follow up of 16 months [range 1 to 39 months] the two year disease free survival and overall survival were 13 percent and 38 percent respectively, which is in accordance with the literature. High dose RT to whole skull with boost therapy is indicated for all the cases. However, the role of chemotherapy and the appropriate regime needs to be defined with certainty.

Prevalence of Bancroftian filariasis in Burdwan District, west Bengal: a comparative study between colliery and non-colliery areas.

The present study reports results of a survey of bancroftian filariasis in Burdwan district West Bengal. 85,974 persons were examined of which 46,221 were inhabitants of the colliery areas of the district and rest 39,753 were from non-Colliery areas, including urban and rural areas of the district. The clinicopositivity, endemicity, microfilaria(mf)-positivity, mf-clinicopositivity, and mf-density were determined. It was found that all these epidemiological and parasitological parameters were significantly higher in the colliery area as compared to non-colliery area. The high vector density in the colliery area may account for such significantly higher prevalence of filariasis in this area. From a differential count of neutrophils, eosinophils and lymphocytes in the mf-positive cases, it was revealed that neutrophil percentage was significantly (P < 0.01) decreased while eosinophils and Lymphocytes increased. The decrease of neutrophils was correlated ((Correlation co-efficient, r = -0.78) with the increase of lymphocytes, indicating an imbalance in the immune-system of the infected persons. The geographical and geological factors resulting in high vector density are considered responsible for the significantly higher rate of bancroftian filariasis in the Colliery area.

Tuberculoid granuloma in a clinically normal looking skin.

A case of tuberculoid leprosy showing well defined tuberculoid granuloma in the skin without any morphological changes is reported.