BACKGROUND HIV infection has become a global pandemic with more than 36 million people infected throughout the world. HIV related cardiac involvement has been reported with increasing frequency in recent years. The above study was undertaken to study the prevalence of cardiac abnormalities in HIV infected individuals and to correlate the cardiac abnormalities with stage of infection. MATERIALS AND METHODS We have conducted a cross-sectional study in the Department of Internal Medicine, Thanjavur Medical College and Hospital on the prevalence of cardiac manifestations among the parents living with HIV/ AIDS on ART. The duration of study was for a period of 6 months, August 2016 to January 2017. A total of 100 patients who were seropositive and who fit the inclusion criteria were chosen and an attempt was made out to find the prevalence of cardiac manifestations among them. All patients diagnosed to have HIV infection/ AIDS after ELISA test being positive were included in the study. RESULTS In our study among 100 patients, 30 patients (32.60%) had cardiac abnormalities either in the form of ECG or Echocardiography abnormality. It is observed that 1 patient out of 13 patients (7.69%) in Stage I, 7 patients out of 27 (25.92%) patients in Stage II, 11 patients out of 33 (33.33%) patients in Stage III and 11 patients out of 27 (40.74%) patients in Stage IV had cardiac abnormalities. There was a statistically significant correlation between cardiac abnormalities and CD4 count (P value was 0.02). As the stage of infection increases, the cardiac abnormalities increase proportionally. Cardiac abnormalities are directly proportional to the stage of infection. CONCLUSION Prevalence of cardiac abnormalities was 32.60% in our study. Diastolic dysfunction was the most common echocardiographic abnormality. Poor progression of R waves was the most common electrocardiographic abnormality. Cardiac abnormalities specifically correlated with stage of infection. People with cardiac abnormalities did not necessarily have cardiac symptoms and the frequency of cardiac symptoms did not correlate with the stage of infection in this study. Cardiac symptoms in HIV infected individuals are likely to be attributed to other concurrent illnesses and the cardiac abnormalities remain undiagnosed further contributing to the morbidity and mortality of HIV patients. Cardiac abnormalities correlated with the increase in the duration of infection and the decline in CD4 count.

Non-Hodgkin lymphoma (NHL) comprises of heterogeneous group of lymphoid malignancies originating from lympho-reticular tissues and is quite uncommon in pregnancy (0.8 cases per 1,00,000 women). Anaplastic large cell lymphoma (ALCL) is a large-cell neoplasm with anaplastic morphology classified under NHL. Here, a 31 year old primigravida diagnosed with NHL of ALCL subtype in third trimester, started on chemotherapy which resulted in severe pancytopenia during which she had to undergo emergency caesarean section for fetal indication. This patient was transfused with blood products and managed in isolated intensive care unit. She had a good outcome in postnatal period and went on to complete her chemotherapy and ended with remission of lymphoma.

BACKGROUND This study was conducted in a major neurological Tertiary Care Centre in Thanjavur District of Tamilnadu, India, which is a Tertiary Care Center which covers almost 5-6 Districts which has a population of around 75 lakhs. Around 5000 cases of stroke has been managed successfully in this Tertiary Care Neurology Centre during this time period of April 01, 2011 to December 31, 2016. MATERIALS AND METHODS In this retrospective study, data was obtained from our hospital stroke registry from April 01, 2011 to December 31, 2016. All patients who presented to our emergency room with symptoms of new onset stroke were included in this study. RESULTS 70% of patients who got admitted had ischemic strokes. Males were predominant. Predominant risk factors included diabetes mellitus, systemic hypertension and dyslipidaemia. 55% patients had large artery stroke in anterior circulation. Out of these ischemic patients 9.5% underwent successful IV thrombolysis. Intra cerebral haemorrhage accounted for 18%. Cortical venous sinus thrombosis accounted for 6.6% of the total stroke population. Sub arachnoid haemorrhage was seen in 16% of total stroke population. Subdural haemorrhage was seen in 16% of total strokes. Subdural haemorrhage was seen in 2.7% of total strokes. CONCLUSION The incidence of stroke was far higher in the rural population than earlier estimated. The predominant stroke was ischemic. The risk factors encountered were similar except that alcohol and tobacco were the most important risk factors in the younger age group and in people of low socio economic status. The patients eligible for thrombolysis and thrombolysis rates are equivalent to the rates achieved elsewhere.

Cardiomyopathy is a group of disorders characterised by structural and functional abnormalities in the myocardium in the absence of other cardiac diseases of myocardial abnormality. Its occurrence in pregnancy is uncommon and exact incidence is unknown even though some studies shows that the incidence of peripartum cardiomyopathy is 1 in 1000 to 4000 births. Here we have discussed about a 34 years primigravida with twin pregnancy conceived after 12 years of married life by assisted reproductive technique (ART), admitted with preterm premature rupture of membranes (PPROM) at 28 weeks of gestation who developed a rare condition called Takotsubo cardiomyopathy (TC) in the peripartum period. She was managed in intensive care unit with oxygen supplementation, beta blockers, diuretics and heparin. Patient had an excellent recovery in the early postoperative period.