RESUMO
Background: Visual Evoked Potentials (VEPs) was studied in asymptomatic Human Immunodeficiency Virus (HIV) positive persons and corresponding controls to detect subclinical visual system involvement in the early stage of HIV. Aim and Objectives: To study VEPs in asymptomatic HIV-positive persons and corresponding controls. Materials and Methods: In this study,100 participants in the age group 25–45 years were recruited, fifty were HIV positive and asymptomatic (CD4 count >350 cells/mm3) and were not on Anti-Retroviral Treatment, and 50 were healthy age-matched individuals who were HIV negative. Results: P 100 latency was significantly prolonged in the study group than in the control group. No significant difference was observed between the control group and study group for the amplitude of VEP. Conclusion: Study of VEPs in asymptomatic HIV positive persons suggests subclinical visual nervous system involvement in early stages of HIV, as evidenced by prolonged P 100 latency. Hence, VEPs is important to detect subclinical nervous system involvement in the early stages of HIV.
RESUMO
Universal Health Coverage is being adopted on a larger dimension globally. One of the important components for effective implementation of Universal Health Coverage is adequately trained human resources at every level of healthcare. The production and retention of trained human resources is a huge on-going challenge. Several state governments in India have devised a strategy of compulsory rural posting for undergraduates and postgraduates from government institutes, ensuring the availability of medical professionals in rural and tribal areas. The present study was planned with the objective of assessing the understanding of postgraduate and super speciality course students regarding the compulsory rural posting against a financial bond, and evaluate the factors influencing the completion of the bond. The aim was to provide suggestions to improve the compliance towards compulsory rural posting. The study revealed that increased duration of the medical course due to inclusion of bond, career pathway being unclear, lack of incentives in the form of increased salary or extra marks during postgraduate admission, effect on pursuing higher studies, social and personal life were major deterrents in completion of the compulsory rural posting. We also propose measures such as educational reforms, policy level reforms and consideration of social issues so as to make the implementation of this strategy a successful model in taking Universal Health Coverage forward.
RESUMO
Morphological evaluation of 140 bone marrow aspirations received in haematopathology laboratory with serologically established HIV infection, along with other relevant special haematological tests, was done during 1st Jan 1999 - 31st Dec 2002 at state government run tertiary care General Hospital in Maharashtra state, India. Out of 140 cases: 118 (84.28%) patients had anaemia, 25 (17.86%) had leukopenia, while 13 (9.28%) were thrombocytopenic. Dyserythropoiesis was present in 18 (12.86%) cases, dysmyelopoiesis 37 (26.43%) and micromegakaryocytes were noted in 44 (31.43%) cases. Haemophagocytosis was evident in 8 (5.71%) cases. Plasmacytosis encountered in 120 (85.71%) cases was a common feature. Based on clinical profile and results of other investigations 56 (40%) patients were clinically diagnosed to be of Mycobacterium tuberculosis (TB). Of these, 18 (12.86%) bone marrow aspirates were positive for AFB, Mycobacterium tuberculosis. In 4 cases cryptococci were demonstrated (Mucicarmine stain). There was one case each of Histoplasma capsulatum and leishmaniasis. One patient showed dense parasitemia with Plasmodium falciparum. One patient had immunoblastic lymphoma and showed bone marrow infiltration. Findings in this study strongly indicate that in HIV/AIDS, AFB stain should be done on each marrow aspirate to rule out tuberculosis in countries like India; where TB and AIDS are marching together.