Background: The aim of this study was to determine proportion of newly diagnosed male HIV cases with thyroid dysfunction at different levels of CD4 counts.Methods: 195 newly diagnosed male HIV patients attending medical OPD, ART centre and medical wards of SMS Medical College and Hospital, during a period of May 2012 to April 2013 were enrolled in the study. These patients were divided in three groups on the basis of CD4 cell counts. Group A: CD4 counts <200/mm3, Group B: CD4 counts 200-499/mm3 and Group C: CD4 counts >500/mm3.Results: We concluded a negative correlation between the CD4 counts and serum TSH level (r = -0.382) which was significant (p-value <0.05). Overall 32 (16.41%) patients had increased TSH, 4 (2.05%) patients had decreased and 159 (81.53%) patients had normal TSH level. Plasma TSH values in group A were higher than group B and C and they were highly significant (p<.001). Mean plasma TSH values in patients of group A, B and C was 4.56±3.60 µIU/mL (range: 1.10-17.74), 2.20±1.02 µIU/mL (range:0.24-4.22) and 2.23±1.06 µIU/mL (range:0.28-4.25) respectively. (Reference normal value = 0.4-4.0 µIU/mL). There was significantly positive correlation (p-value < 0.01) found between the CD4 counts and serum free T4 levels (r = +0.378).Conclusions: This study has demonstrated a high prevalence of thyroid dysfunction in HIV infected patients of this part of country. High prevalence of thyroid dysfunction may contribute to the morbidity of the patients and have a bearing on quality of life of the HIV infected patients. Severity of hypothyroidism was correlated with decreasing CD4 cell count.
Background: Fracture of calcaneum accounts for about 2% of all fractures and 75% of all calcaneum fractures are intra-articular. Numerous controversies existed regarding optimal treatment of displaced intraarticular calcaneum fractures. In this study evaluate post-operative functional outcome and complication of fracture calcaneum treated with locking calcaneum plate. Methods: This hospital based prospective descriptive study was conducted on 108 patients (120 calcaneum fracture) operated between July 2016 to December 2018 by open reduction and internal fixation with locking calcaneum plate through extensive lateral approach at Department of Orthopaedics, SMS Medical college and hospital, Jaipur. All close displaced intraarticular calcaneal fracture was included in the study. Results: Average duration between injury and surgery was 8.3±2.97 days. Out of 120 calcaneum fracture 52 fractures (43.33%) were Sander's type II, 52 fractures (43.33%) were Sander's type III, and 16 fractures (13.33%) were Sander's type IV. Pain on weight bearing was noted in 20 patients (16.66%) implant prominence was noted in 8 patients and delayed wound healing was seen in 4 patients. Maryland foot score was excellent in 44 fracture (36.67%), good in 56 fractures (46.67%), fair in 8 fractures (6.67%), and poor in 12 fractures (10%). Conclusions: Open reduction and internal fixation (ORIF) with locking calcaneum plate in an indicated case, with respect to soft tissue envelope and early rehabilitation, leads to better therapeutic results as compared to other operative technique.
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