STUDY OF PREVALENCE OF HIV INFECTION AND IT’S CLINICAL PROFILE AMONG TUBERCULOSIS PATIENTS AND NON-TUBERCULOSIS PATIENTS – CASE CONTROL STUDY
DR.S.ABBAS ALI
MD, DNB,MNAMS
FCGP, FPC (cardiology)
PGDHSc (Ultrasonography)
PGDHSc (Echocardiogram)
M : 9412178773
Email: dr.abbas1968@gmail.com

ABSTRACT
INTRODUCTION: Tuberculosis is a major opportunistic infection in HIV patients’ world wide. Many patients were being treated for tuberculosis without knowledge of the presence or absence of concurrent HIV infection. Relapse rate is high in HIV-TB, which may be due to re-infections rather than true relapse of TB. Detection of HIV status in a TB patient is critical from both patient and public health perspectives and for holistic management of HIV-TBpatients
Objectives: To determine the prevalence of HIV infection and its clinical profile among tuberculosis patients (Cases) and Non-TB patients (Controls)
Methods: A case-control study study was conducted at SKM hospital, Mathura, Uttar Pradesh during the period September 2009 to February 2011. 252 proven Tuberculosis patients as cases and 252 non-tuberculosis patients (having similar clinical features like TB) as controls selected stratified random sampling method
Results: Out of 252 tuberculosis patients 26 were HIV seropositive and none was positive in Non-TB patients. The percentage of prevalence in TB patients was 10.3%. The prevalence in males 13.2% (19/143) and in females, 6.4% (7/252), 12 (46.15%) were married and 14 (53.85%) were singles, 17 (65.38%) patients were Hindus and 9 (34.62%) were Muslims. 14 (53.85%) patients were from rural areas and 12 (46.15%) patients were from urban areas. 96.2% HIV –TB patients has income below 10000/Rs and all most all HIV – TB patients has heterosexual sexual behavior and not used protective measures during unprotected extramarital sex. The most peculiar clinical features of HIV seropositive TB patients of this study were chronic diarrhea (73%) aphthous ulceration (92.3%), pain in abdomen (38.4%) oral candidiasis (26%) lymphadenopathy (39.8%).
Conclusions: HIV seroprevalence was higher among TB patients and calls for routine HIV screening and counseling of TB suspects for holistic management. Despite the synergy between the human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics, the public health responses have largely been separate. Intensive efforts and early diagnosis of HIV infection among tuberculosis patients was crucial for holistic management of HIV-TB patients. With this study screening of HIV antibodies in TB patients adds one more classification, which will be more helpful in predicting prognosis of disease.


Classification
TB: it is assumed all TB cases (pulmonary and extra-pulmonary) were curable. It can be easily diagnosed by AFB sputum and x-ray chest PA View
Resistant TB: it includes MDR-TB and XDR-TB, which can be easily predicted with the help of previous prescriptions. Management of Resistant TB was beyond the reach of family physician and can be referred to higher centre.
HIV-TB: Can be easily diagnosed in TB patients by rapid card tests. Beside ATT it requires services of nearest ART centre.
Knowledge of HIV status in a TB patient is critical from both patient and public health perspectives. In those patients who test seropositive for HIV, better care can be provided in the form of effective combined antitubercular (ATT) therapy and antiretroviral treatment. ATT was alone insufficient for the treatment of HIV seropositive TB and it was observed during this study that curative outcome was more with addition of antiretroviral therapy. If a HIV-positive TB patient on ATT worsens or fails to improve with therapy, the possibility of other co-existing opportunistic infections or immune reconstitution syndrome should be considered. Knowledge of a person's HIV serostatus also provides the opportunity to administer prophylaxis for opportunistic infections and thereby reduces morbidity and mortality. The spouse and relatives of HIV-seropositve patients may also be counseled on HIV infection and its modes of transmission and prognosis, preventing the spread of infection. Spouses may be educated on safe sex practices and may be offered testing themselves.

Cavity: a cavity is gas containing space with in the lung surrounded by a wall greater than 1mm thick (a gas containing space possessing wall 1mm or thinner is a bulla). The wall thickness up to 5mm is benign and between 5 to 15 mm may be benign or malignant and above 15mm is definitely malignant. see example in photo album nazira x-ray

LOVE AND NAMASMARAN DR SHRINIWAS JANARDAN KASHALIKAR

Love is acclaimed as the best thing to happen in life!
But it is difficult to define love!
In simple words; love springs from within my heart and reaches the depths of the hearts of the others, when I am selfless!
How to be selfless?
The way to become selfless is simple.
It is not by trying to stop earning. It is not by trying to donate more.
It is by getting rid of subjectivity! What is subjectivity?
It is the urge to seek “my” wants, pursue “my” interests and assert “my” priorities and fancies; irrespective of the needs of the others.
How to get rid of the subjectivity?
Subjectivity is shed off in the course of the practice of NAMASMARAN. That is how I become increasingly selfless and love springs from my heart and reaches to the depths of the hearts of the others! This love is more benevolent and rejuvenating than anything else in the world!

BACTERIA IN HUMAN SEMEN MAY AFFECT HIV /AIDS TRANSMISSION
PROF.DRRAM ,HIV/AIDS,SEX Diseases, Weakness & Hepatitis Expert
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Human semen is naturally colonized by bacteria, and a new study suggests the microbes might have a role to play in both HIV transmission and levels in infected men.U.S. researchers found that bacteria in semen — the “microbiome” — play a role in local inflammation and in the production of HIV by infected men. They say the findings point to possible targets for reducing transmission of the AIDS-causing virus.
The study couldn’t prove that the bacteria was causing changes in HIV levels, and the researchers say more research is needed. However, the findings do “suggest an interaction between semen microbiome, local immunology and semen viral load,” wrote a team led by Lance Price of the Translational Genomics Research Institute in Phoenix.
Although HIV is found in many bodily fluids, the virus is most commonly spread through semen. In addition to sperm, semen naturally contains bacteria and chemical immune factors. One such immune factor is interleukin-1beta (IL-1b), which is involved in the body’s inflammatory responses.
“Higher bacterial load in semen could lead to higher IL-1b levels, which in turn could induce viral shedding [production], thereby increasing viral load,” the researchers theorize.
In the study, Price’s team analyzed semen samples from 49 gay or bisexual men. Of all the participants, 27 were infected with HIV. These men provided samples before they started antiretroviral drug therapy, as well as one six months later.
These samples were compared to 22 others taken from the men not infected with HIV.
The study, published July 24 in PLOS Pathogens, found that HIV infection appeared to alter the relationship between semen bacteria and immune factors. This affects viral load and could play a role in the sexual transmission of HIV, the team of scientists said.
Among the men with HIV who were not on antiretroviral therapy, the overall semen bacterial load correlated with their HIV viral load, the study found.
After examining the bacterial DNA in the semen samples of the men who did not have HIV, a total of 248 different types of bacteria were detected. On average, each sample contained 71 different strains of bacteria. However, immune factors were not tied to the amount of bacteria in the semen of these uninfected men.
In contrast, there was significantly less bacterial diversity in the semen samples taken from the HIV-positive men.
After taking six months of antiretroviral therapy however, semen viral load was reduced to undetectable levels. At the same time, bacterial diversity and semen composition became similar to the semen of the men who did not have HIV, the researchers said.

Pregnancy is an ideal time to start taking really good care of you both physically and emotionally. If you follow the few simple guidelines, you will be having best chance of a problem-free pregnancy and a healthy baby. Becoming a mom is an exciting time, but it can also be daunting especially if you are expecting your first child. When you find you are expecting it is an exciting time for you and your loved ones! While your due date may seem a long way off, there are things that you should do immediately that can get your pregnancy and your baby off to a healthy start. At this time your mind will be filled with many questions as to what you should do now onwards for yours and baby’s health. Probably you will start looking for accurate information and resources so that you are well informed about pregnancy and make healthy choices right from the beginning.

Before starting pregnancy and planning for parenthood, stop your birth control a couple of months before you plan to start trying. The earlier you know you're pregnant, the sooner you can see your doctor to start prenatal care and make sure your eating, drinking, and other habits are as healthy as possible. On getting pregnant following are the questions that are eminent and seek an answer to it.

1. When can be the home pregnancy test to detect pregnancy is taken?

A pregnancy test, whether done at home or in the doctor's office, measures the hormone hCG (human chorionic gonadotropin) in your urine. This hormone becomes elevated during pregnancy and can be detected as early as the first day after a missed period if you do the test correctly. However, it is likely to be more accurate if you wait a few days or weeks after a missed period.

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2. When should I make an appointment with the doctor?

As soon as you find out you're pregnant, get in touch with your GP or a midwife or gynecologist to organise your antenatal care. Organising your care early means you'll get good advice for a healthy pregnancy right from the start. You'll also have plenty of time to organise any ultrasound scans and tests that you may need. If you have any medical concerns, such as high blood pressure, diabetes, or thyroid disease it is best that you take the appointment as soon as possible.

3. What should I do once I find out I'm pregnant?

The most important thing you can do is begin taking prenatal vitamins. In fact, if you are planning to become pregnant it is smart to start taking prenatal vitamins in advance. Prenatal vitamins contain important nutrients (i.e. folic acid and vitamin D) that can help with the early development of your baby. You should also start avoiding alcohol, tobacco, caffeine, stop smoking or other things that may be harmful to your baby.

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Select a maternity home that is fully equipped with latest technology and has the capacity to meet any type of emergencies. If you are pregnant or thinking about starting your family, Rupal hospital for Women will be the best choice. Rupal Hospitals Gynaecology & Obstetrics Section has renowned female Doctors and each one of them is outstanding in their own field of expertise. We at Rupal Hospital are dedicated to providing the highest quality in women's health. The team of doctors is capable of handling every aspect of a woman's life and it has been a long one. It is the result of years of experience, knowledge, understanding and constant updating and effort. The maternity section is available round the clock. We have State of the art labor room along with facilities of electronic fetal heart monitoring during labor. Rupal Hospital has all means for instrumental deliveries and apparatus to deal with emergencies. We have fully equipped operation theatre for all obstetrics and gynaecology operations.

Rupal Hospital seeks to guide you through your pregnancy and birth, helping you to make choices that are safe and healthy for you and your baby. We understand that it’s important that you feel comfortable, confident and at ease during this journey of pregnancy, and that you have the support and information you need each step of the way. Visit our website at http://www.rupalhospital.com or at http://www.rupalhospital.com/gynaecology.html# or give us a call today to schedule an appointment with us.