No abstract

Introduction: Chronic HIV infection and antiretroviral therapy (ART) are the major causes of cardiovascular diseases (CVDs) and mortality in HIV patients. This study was conducted to look upon the effect of ART on CVD risk markers in patients on different ART regimens and ART-naïve patients. Methods: It was a cross-sectional, observational study done on 120 HIV-infected patients. CV risk markers were assessed and correlated with disease-specific factors within individual subgroups differentiated as Group A (ART naïve), Group B (first-line ART), and Group C (second-line ART). Carotid intimal medial thickness (CIMT) and high-sensitivity C reactive protein (hsCRP) were done to classify cases as having CVD. Results: CVD risk parameters were found to be significantly higher in cases on ART, as compared to ART-naïve cases. The mean CIMT among cases in Group C, Group B, and Group A was 0.072 ± 0.01 cm, 0.063 ± 0.01 cm, and 0.055 ± 0.01 cm, respectively ( P < 0.01). 95%, 65% and 25% cases in Group C, Group B, and Group A, respectively, had high CIMT (>0.06 cm) and were seen to be directly correlated with disease-related factors, i.e., duration of disease and ART, type of ART, and low CD4 cell counts. hsCRP was significantly increased in 65 out of total 120 cases. The mean hsCRP in Group A, Group B, and Group C was 3.69 ± 3.37, 4.21 ± 3.4, and 5.72 ± 3.54 mg/L, respectively ( P < 0.01), which corresponds to the high risk of CVD. Conclusion: CVD risk parameters of CIMT and hsCRP are seen to be higher in patients on ART than ART-naive subjects.

Background: Kikuchi-Fujimoto Disease (KFD) is a rare disease and is commonly seen in Asian population. It usually presents with prolonged fever, leukopenia and persistent cervical lymphadenopathy. It is a benign disease with a female preponderance. The cause is unknown but many theories have been postulated, like autoimmune, inflammatory, infectious agents and molecular mimicry. Most of the patients will recover themselves without any sequelae, in six-month time. However, it may rarely also convert to autoimmune disease, like SLE. The recurrence rate is very low. It is important to consider it as a differential diagnosis in chronic persistent lymphadenopathy, like tuberculosis, lymphoma, HIV and autoimmune lymphadenitis. Cases: Here we present a case of a 37-year-old female who initially went to a private practitioner with chief complaint of a persistent neck mass of approximately 6 months duration, multiple small joints pain and persistent fever. She underwent excisional biopsy for suspected lymphoma, but final pathology rendered a diagnosis of KFD. Second case also presented with multiple neck swelling and joint pains, suspect of SLE, connective tissue disorder or young-onset still's disease was made clinically but excisional biopsy revealed KFD. Both the patients improved with NSAIDS and low dose wysolone therapy. Conclusion: The purpose of this article is not only to review the literature but also to create awareness of this entity in the differential diagnosis of persistent lymphadenopathy, especially for the general otolaryngologist in a community-based setting. In addition, this review would be beneficial for other practitioners as well, specifically paediatricians, infectious disease physicians, rheumatologists, pathologists, and medical oncologists.

Chronic Obstructive Pulmonary Disease (COPD) is a chronic respiratory airway disease characterized by both pulmonary and systemic inflammatory response and associated extra-pulmonary complications. Female gender, age and smoking are common pathogenic risk factors for both COPD and osteoporosis. Many other factors like low daily physical activity, chronic malnutrition, hypogonadism, vitamin D deficiency and chronic steroid therapy are risk factors for osteoporosis. Objectives: The study was done to evaluate the prevalence of osteopenia and osteoporosis in patients of COPD and to correlate the severity of COPD with osteopenia/ osteoporosis. Material & Method: The study was conducted at a tertiary care hospital in Delhi after ethical clearance from institutional review board. Total of 76 patients of both genders were taken. COPD diagnosis and staging was done as per Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Bone mineral density (BMD) was evaluated by DEXA scan in all patients. All data was entered in preformed data sheets. Statistical analysis for association of COPD with osteoporosis was done by chi-square test. Result: Mostly patients were having either osteopenia or osteoporosis, only 6% patients were having normal BMD. COPD stage III-IV were having significant bone mass loss. Those having long smoking history were more osteoporotic as compared to others. Conclusion: There is a very high prevalence of osteopenia and osteoporosis in COPD patients especially those with prolonged smoking history, GOLD stage III-IV. 35.5% of COPD patients had osteopenia and 57.9 % had osteoporosis.