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INTRODUCTION:Tuberculosis is the most common HIV-related opportunistic infection in India, and caring for patients with both diseases is a major public health challenge, which places an immense burden on health care systems and poses particular diagnostic and therapeutic challenges, increasing the risk of treatment failure, relapse and death. Estimates by the World Health Organization (WHO) indicate that there are more than 9 million new active cases of TB and close to 2 million deaths per year. MATERIALS AND METHOD: The present retrospective study was conducted for a period of one year. HIV status was confirmed for patients attending voluntary counselling and testing centre (VCTC). HIV positive patients were referred to designated microscopic centre (DMC) for sputum examination for AFB and ART centre for estimation of CD4 count and necessary relevant investigations were carried out for extrapulmonary tuberculosis (EPTB). RESULTS: Out of 682 HIV positive patients, 93(13.6%) cases were diagnosed with pulmonary tuberculosis. Extrapulmonary tuberculosis was detected in16 (2.3%) patients. The commonest form of EPTB was cervical adenitis detected in13 (1.9%) of cases and pleural effusion in 3 (0.4%) of cases respectively. The mean CD4 count was 208 cells/µl in patients with pulmonary tuberculosis (PTB) and 192cells /µl , 162 cells /µl in patients with cervical adenitis and pleural effusion. CONCLUSIONS: Further reduction of CD4 count occurs in dually infected patients. Early diagnosis and prompt institution of ART and ATT reduces mortality and morbidity significantly.

Infection with Hepatitis B virus (HBV) and Hepatitis C virus (HCV) in occupationally exposed health care workers (HCWs) should be accepted as a realistic possibility. This study aimed at estimating prevalence of hepatitis B and hepatitis C virus infections among health care workers with the final goal to encourage HBV vaccination of the non-immune Indian health care worker in a tertiary hospital. A total of 219 samples were screened from November 2012 to October 2013. They were screened for the presence of hepatitis B surface antigen (HBs Ag), and anti-HCV antibodies by the third generation ELISA. The HBsAg prevalence was 1.37%. Anti-HCV antibody was not detected in any of the health care worker screened. 63.47% of health care workers were not immunised. All HCWs who were positive for HBsAg were non-immunised. A moderate HBV infection rate and low HBV vaccination coverage were found in the study. India is a tropical country still endemic for HBV infection and new strategies to promote HBV vaccinations are to be adopted. KEYWORDS: Hepatitis B & C, Health care workers, Vaccination INTRODUCTION:Approximately three million health care workers (HCW) are exposed to percutaneous blood each year. 1 The risk of HBV infections among HCWs is four times higher than in the general population and depends on the prevalence of HBV infected patients, nature and frequency of contact with blood and body fluids, duration of employment and immunization status. A high prevalence of these infections in the general population, the large capacity of infectious virus and daily contact with biological fluids and potentially contaminated instruments are key risk factors for HCWs for the transfer of HBV and HCV infection. 2 Infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in occupationally exposed health care workers (HCWs) should be accepted as a realistic possibility. 3 Blood contains the highest HBV titres and is the most important vehicle of transmission in the health-care setting. HBV is relatively stable in the environment, remains viable for at least 7 days on environmental surfaces at room temperature. 4 Screening for hepatitis B & C is still not being performed in many health setups. Due to tremendous increase in surgical workload, operation theaters could be one of the main sources of transmission of hepatitis B & C 5 . Preoperative screening for hepatitis B & C in patients is not routinely performed even for elective surgery in our country because of multiple factors and this may pose a major risk to health care workers. Major factors are, lack of public awareness about the disease, inadequate funding for health care and poor health facilities throughout the country. Whereas the literature on hepatitis B virus infection in India is growing, there is still paucity of information on HBV and HCV among HCWs. This paper contributes to this discourse by presenting the prevalence estimates for hepatitis B and hepatitis C virus infections among health care workers.

BACKGROUND Thyroid gland disorders are the most common endocrine disorders seen in clinical practice and solitary thyroid nodule is one of the common presentations of thyroid disorders. MATERIALS AND METHODS The study was conducted in the Department of General Surgery at Government General Hospital, Guntur district consisting of 116 cases of solitary thyroid nodule in all the surgical units, during the period of 2015 to 2017. The clinical study was done through questionnaires and clinical examination. All patients were investigated with routine and special investigations. Necessary treatment was planned once arrived at a definitive diagnosis of solitary thyroid nodule. Postoperative complications were also included. RESULTS 116 cases of clinically solitary nodule of the thyroid treated in Government General Hospital, Guntur during a three-year period (2015-2017) have been reviewed. In the present study females outnumbered the males with a male-to-female ratio of 1: 8.66, most of the patients are (i.e. 91 out of 116) between 21 and 40 years. Benign nodules constitute about 87.93% and malignant nodules about 12.06% of all clinically solitary nodules. Of all the 116 cases of clinically solitary nodules, 60 cases were turned out to be multinodular goitres at exploration or on histopathology. So, only 56 cases were true solitary nodules constituting 48.27% of clinically solitary nodules. CONCLUSION Thyroid scan carries great diagnostic, therapeutic and prognostic significance in toxic nodular goitre. Recently developed immunohistochemical and genetic techniques for examining FNAB specimens may produce nearly 100% reliability in the near future. Technical advances in HRUS have benefited the diagnosis of thyroid nodules.

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