Indian Journal Of Clinical Practice
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Spectrum of Opportunistic Infections in People Living with HIV: A Tertiary Care Center Experience from North India
Get PDFIntroduction: Patients with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) are prone toopportunistic infections (OIs) given their immunosuppressed state. OIs continue to cause morbidity and mortality in HIV/AIDSpatients even after highly-active antiretroviral therapy (HAART); hence, attainment of the goals on health care programs,particularly in resource-poor countries, is hard to achieve. The prevalence of specific OIs varies in different countries and evenin different areas within the same country. Little information is available about the prevalence of OI in HIV patients fromdeveloping countries, especially India. Early diagnosis and prompt treatment contribute to increased life expectancy amonginfected patients delaying progression to AIDS. Hence, the present study was carried out to elucidate current frequencies andspectrum of OIs in HIV seropositive adult patients in Haryana and to evaluate the associated risk factors for OIs. Materialsand methods: This was a cross-sectional study carried out at the Dept. of General Medicine in a tertiary care hospital in NorthIndia. Basic demographic details, anthropometric measurements, symptoms of HIV/OI, clinical examination, biochemicalinvestigations, and treatment details were recorded. Patients aged 18 to 70 years and HIV seropositive subjects were includedin the study. Results: The study found that about 53.21% of HIV/AIDS patients on ART had one or more OIs. Tuberculosis(TB) was the predominant OI identified, with a prevalence of 25.71%. Candidiasis and herpes zoster were the second and thethird most prevalent OIs at 13.8% (101/731) and 7.25% (53/731), respectively. Age (43.4 ± 10.7 years), low-income, illiteracy,low socioeconomic status, initial 4 months since initiation of ART, CD4 count <200/mm3, body mass index of <18.5 kg/m2, poorART adherence, hemoglobin, albumin were strongly associated with OIs. Conclusion: The present study shows that TB is thecommonest OI in adults and the overall population of people living with HIV (PLHIV) in Haryana and proves that OIs acrossdifferent patient groups vary significantly. Various factors like adherence to HAART, socioeconomic and education status ofpatients can influence the occurrence and outcome of these deadly infections
DRS-WCPD: 11th World Congress on Prevention of Diabetes and Its Complications
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Early Diagnosis of Secondary Hypertension in South Asia: A Public Health Imperative
Get PDFmortality. While essential hypertension forms the bulk of cases, a substantial proportion- estimated around 10%- is attributableto secondary hypertension. These cases are often underdiagnosed, particularly in resource-limited settings. Failure to detectand treat secondary causes early leads to resistant hypertension, target organ damage, and increased health care costs. Thisarticle emphasizes the critical need for awareness, early diagnosis, and structured management of secondary hypertension inSouth Asia. We propose policy-level interventions and region-specific solutions to address the systemic gaps and recommendan integrated, multidisciplinary approach. 
Chronotype, Myokines, and Muscle Mass: A New Dimension in Metabolic Disorders
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Iron Deficiency in Heart Failure: Unveiling the Hidden Culprit
Get PDFIron deficiency (ID) is a frequent comorbidity in patients with heart failure (HF). Coexistent HF and ID make the issuesmore challenging to diagnose and treat. Iron deficiency exacerbates clinical symptoms, impairs quality of life and increasesthe risk of recurrent hospitalization for HF. Conversely, a proinflammatory state and altered gut kinetic in HF may resultin absolute or functional ID, which conventional laboratory makers may not diagnose and differentiate accurately. Noveldiagnostic markers like soluble transferrin receptor (sTfR), reticulocyte hemoglobin concentration, red blood cell distributionwidth, sTfR: log (ferritin) ratio and serum hepcidin levels may help to diagnose ID more accurately in the setting of HF. Theintravenous (IV) iron formulation has shown promising results in improving the functional class and reducing recurrenthospitalization in patients with HF and ID. Futuristic therapies like nanosized iron preparations, hepcidin inhibitors andhepcidin antagonists may help manage ID more efficiently and conveniently in HF. This manuscript explores the relationshipbetween ID and HF. It also provides the latest information related to the diagnosis and treatment of ID in HF patients
