Australasian Medical Journal
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Solitary Intramuscular Cysticercosis-A Report of Two Cases
Get PDFCysticercosis , -- the infestation with the encysted larval stage of Taenia solium, is a major health problem in most countries of Latin America, Asia, and Africa. It involves mainly the central nervous system. Muscle involvement is also seen, although it usually remains asymptomatic. Solitary intramuscular cysticercosis, without involvement of central nervous system is a rare entity. We present two cases of solitary intramuscular cysticercosis, without any systemic or neurologic manifestations
Prognostic Markers in HIV
No full textBackgroundOpportunistic infections are an important cause of morbidity and mortality in persons infected with HIV. In recent years, antiretroviral treatment (ART) and prophylaxis against various other opportunistic infections have contributed to a decrease in AIDS-related mortality. We conducted a study of HIV infected inpatients in our centre to study the various factors contributing to mortality in HIV/AIDS patients and to study the role of antiretroviral drugs in increasing longevity. Method We retrospectively reviewed the medical records of HIV/AIDS patients who were admitted to a tertiary care hospital from 1 January 2005 to 28 February 2006. Socio demographic information, CD4 lymphocyte counts (wherever available); diagnoses at discharge, incidence of opportunistic infections in patients and final outcome of the patients were collected. ResultsThere was no difference in mean age between the patients who died and those who are surviving. Body weight was comparatively lower for the patients who died than the survivors. Albumin levels were significantly lower among those who died (0.56 + 1.29 versus 2.73 + 1.13). CD4 counts did not predict a worse prognosis. History of fever (76.7% versus 53.17%) and weight loss (56.7% versus 33.33%) predictably pointed to a bad prognosis. On the brighter side, administration of specific therapy which included Lamivudine was associated with a better outcome (OR - 0.07, p = 0.004) than any other combination of ART. ConclusionThe above findings could be a rough guide for evaluating the status of HIV/AIDS patients who cannot afford frequent medical investigations in developing countries. Moreover as in our study, it was found that CD4 count was not a very reliable marker for the prognosis in such patients. A broader study could offer more robust data to a more cost-effective and cheaper alternative mode of assessment for HIV/AIDS patients in developing countries where medical facilities are not just unaffordable but also scanty
Orthopaedic Surgical Site Infections
Get PDFBackgroundCoryneform species other than Corynebacterium diphtheriae are coming up as important pathogens with the potential to cause serious and life-threatening infections not only in immunocompromised but in immunocompetent individuals as well. The exact infectious potential of these bacteria and their rational antimicrobial treatment is a challenging but essential task.Method The study was conducted in the Department of Microbiology and the Department of Orthopaedics, JNMCH, AMU, Aligarh between August 2007 and May 2009. Pus samples were collected from patients of osteomyelitis and other bone infections including orthopaedic surgical site infections. The Corynebacterium species isolated in the study was identified using standard microbiological techniques and antimicrobial sensitivity testing was done by Kirby bauer disc diffusion method.ResultsA total of 312 Corynebacterium species were isolated. The majority of the coryneforms were isolated from the immunocompetent patients 270 (86.54%). C.jeikium was the most common coryneform isolated. Nearly half of the patients 153 (49.04%) had acute infection caused by Corynebacterium species after orthopaedic surgery, a quarter 66 (21.15%) had chronic infection and 72 (23.08%) patients had device-related infection. Coryneforms exhibited maximum resistance to aminoglycosides (58.65%) and β-lactams (penicillin group- 57.55%. C.jeikium was found to be the most resistant amongst all the Corynebacterium species.ConclusionThe study highlights the fact that the coryneforms are no longer just opportunistic pathogens but they are also becoming important pathogens among immunocompetent individuals as well. The emergence of drug resistance amongst these isolates is of most concern. More studies should be done on identification and on antimicrobial susceptibility of these organisms for the proper treatment of patients with such infections
Pharmacists and Cardiovascular Disease Prevention and Management
Get PDFThere is ample evidence in the international literature for pharmacist involvement in the prevention and management of cardiovascular disease (CVD) conditions in primary care. Systematic reviews and meta-analyses have confirmed the significant clinical benefits of pharmacist interventions for a range of CVD conditions and risk factors. Evidence generated in research studies of Australian community pharmacist involvement in CVD prevention and management is summarised in this article. Commonwealth funding through the Community Pharmacy Agreements has facilitated research to establish the feasibility and effectiveness of new models of primary care involving community pharmacists. Australian community pharmacists have been shown to effect positive clinical, humanistic and economic outcomes in patients with CVD conditions. Improvements in blood pressure, lipid levels, medication adherence and CVD risk have been demonstrated using different study designs. Satisfaction for GPs, pharmacists and consumers has also been reported. Perceived ‘turf’ encroachment, expertise of the pharmacist, space, time and remuneration are challenges to the implementation of disease management services involving community pharmacists
Capacity Building Initiatives for Better Response to HIV/AIDS in India
Get PDFHuman resource capacity building is a key strategy in the design, delivery, sustainability and scaling up of HIV treatment and prevention programmes. The review aims to present human resource capacity building initiatives undertaken by the National AIDS Control Organisation (NACO) and to discuss the available opportunities in India. There was minimal emphasis on human resource capacity building in National AIDS control programme (NACP)-I. The focus of capacity building in NACP-II was on strengthening the capacity of partners implementing various HIV/AIDS interventions. NACP-III (2007–2012) focussed on capacity building as a priority agenda. Other than short-term training programmes, NACP-III is strengthening the capacity of partners through the State Training and Resource Centre, Technical Support Unit, District AIDS Prevention Control Unit, Fellowship Programme and Network of Indian Institutions for HIV/AIDS Research. Various opportunities to enhance and consolidate capacity building responses in HIV/AIDS in India may include mainstreaming of capacity building, appropriate management of knowledge and resources, effective delivery of training, measuring and documenting impact, accreditation of programmes and institutes, use of information technology, identifying and implementing innovations and working for sustainability. Growing demand for capacity-building in HIV/AIDS needs substantial efforts to ensure that these are implemented effectively and efficiently. NACO had made significant strides in these regards, but at the same time there are arduous challenges like measuring impact, quality, documentation, operational research, and sustainability. NACO is formulating Phase-IV of NACP. This review will provide feedback to the NACO for strengthening its strategic document for human resource capacity building.
