A prospective study was carried out to elucidate the clinical, epidemiological and laboratory features of human brucellosis. A total of 26 948 blood samples (from adults aged 15 years and above) were screened for serological evidence of brucellosis over a period of 16 years. The slide agglutination/Rose Bengal plate agglutination test gave positive results in 517 patients, of which 509 had detectable titres by the standard tube agglutination test (SAT). The diagnosis of brucellosis was documented in 495 (1?8 %) patients based on diagnostic titres (¢1 : 160, 490 cases) and rising titres from insignificant titres (four cases) by serology and for one case by blood-culture isolation alone. Blood cultures were carried out in 345 cases, of which 191 cases (55?3 %) yielded Brucella melitensis. In 77/79 cases undertaken for follow up, there was a steady fall in 2-mercaptoethanol (2ME) agglutination titres along with clinical improvement (P <0?01). SAT titres remained detectable in most cases for a longer period in spite of an effective antimicrobial therapy and clinical recovery. A substantial number of patients (84?2 %) presented with fever, this being the only complaint in 51?1 % of the cases. Complications were present in 8?8 % of the patients (arthritis excluded): this included the unusual complications of hydrocele (two cases), Stevens-Johnson syndrome (one case) and urinary tract infection (one case). Brucella agglutinins were demonstrated in synovial, testicular, hydrocele and cerebrospinal fluids. There was no clinical suspicion of brucellosis in 439 cases (88?7 %) and the diagnosis was made only by routine serology. A two-drug regimen for 42-84 days with a follow-up 2ME test resulted in lower levels of relapse. These results suggest that, in endemic areas of the world, it should be mandatory to screen routinely for brucellosis due to protean clinical manifestations. INTRODUCTIONBrucellosis is a worldwide zoonotic disease caused by Brucella spp. The genus Brucella comprises Gram-negative, facultative, intracellular pathogens (Alton et al., 1975). Currently, there are six recognized species of Brucella based on phenotypic characteristics, antigenic variation and prevalence of infection in different animal hosts: Brucella abortus (cattle), Brucella canis (dogs), Brucella melitensis (goats, sheep), Brucella neotomae (desert wood rats), Brucella ovis (sheep) and Brucella suis (pigs, reindeer and hares) (Corbel, 1997;Moreno et al., 2002). Recently, two Brucella strains from marine mammals have been reported (Bricker et al., 2000;Cloeckaert et al., 2000) and the names Brucella pinnipediae (seal/otter) and Brucella cetaceae (porpoise/ whale) have been proposed (Cloeckaert et al., 2003). There has also been a report of human infection with marine brucellae (Sohn et al., 2003). Although each species of Brucella has a preferred host, all can infect a wide range of animals, including humans. Brucellosis is a worldwide reemerging zoonosis causing high economic losses and severe human disease. It has areas of high endemicity...

Background:Opportunistic infections (OI) are the major cause of morbidity and mortality among human immunodeficiency virus (HIV) infected individuals. The pattern of OIs differs widely, hence it is necessary to correlate spectrum of OIs and CD4 counts among HIV infected individuals in specific localities.Materials and Methods:The present study describes the clinical and laboratory profiles of different OIs among 55 HIV seropositive patients. CD4 count was estimated and antiretroviral therapy (ART) was started in 27 patients as per National Acquired Immunodeficiency Syndrome Control Organization guidelines. These 27 patients were classified into stage 1, stage 2 and stage 3 based on CD4 counts of >500 cells/μl, 200-499 cells/μl and <200 cells/μl respectively. The OIs presented by respective groups were documented.Results:Pulmonary tuberculosis was found to be the most common OI constituting 43.6% of all cases followed by candidiasis (30.9%), cryptosporidial diarrhea (21.8%), herpes zoster (16.3%), cryptococcal meningitis (3.63%), Pneumocystis jirovecii pneumonia (1.81%), and other miscellaneous infections (23.6%). Only 1 patient was found in stage I while 13 patients each were grouped in stage II or stage III. The mean CD4 count in our study population who were on ART was 230 ± 150 cells/µl.Conclusion:The pattern of OIs among our study group did not differ significantly from patients not receiving ART. The effect of ART on CD4 count differs from patient to patient based on the degree of depletion of CD4 count before the initiation of ART, drug adherence, concomitant OIs and their treatment.

BACKGROUND Raised serum uric acid has been associated with a lot of diseases like hypertension, cardiovascular diseases, chronic kidney disease, peripheral vascular diseases and metabolic disorders. But, the association of serum uric acid levels to that of diabetes mellitus has not been successfully understood. A sincere effort has been put in this study to find out the serum uric acid levels in normal individuals, prediabetics and diabetics and come to a conclusion on the correlation of serum uric acid in diabetes mellitus. MATERIALS AND METHODS One hundred eighty people who visited the Department of Medicine were selected. The study included ninety males and ninety females and in each group there were thirty non-diabetic, thirty prediabetics and thirty diabetics. Prediabetics were considered as 110 to 125 mg/dL (6.1 mM/L to 6.9 mM/L)-that is WHO criteria was followed. All the subjects were aged between 40-60 years. The correlations were made between the serum uric acid levels and serum fasting glucose, serum postprandial and HbA1c. RESULTS The results show a rise in the serum uric acid levels in the prediabetic and not so much in the non-diabetics and the confirmed diabetics. CONCLUSION The serum uric acid level measurements can be used as a powerful tool in identifying the prediabetic condition and help an individual to make the necessary lifestyle adjustments so that the progression of the diseases can be stopped or maybe infinitely delayed.

Background: Aim: To estimate microalbuminuria in non-diabetic patients with Acute Coronary Syndrome And assess the relationship between the two. Methodology: All patients age >18yrs, both sexes diagnosed as acute coronary syndrome based on history and relevant investigations and admitted in BLDEU'S Shri B.M PATIL Medical college hospital and research centre Vijayapur. microalbuminuria was measured at admission and compared with standard normal mean value. Results: This study was conducted on 60 patients, of the study group 70.0% were male and30.0% were female. The age ranged from 30 to 85 years of age. The mean age of thegroup was 55.5 ±13.19 SD. The known risk factors of ACS were studied and correlated,37.2 % of all patients were smokers, 31% were tobacco chewers, 24.7 % had diabetesmellitus, 31.8% were hypertensive and 8 % had family history of ACS. The meanmicroalbuminuria value in mg/dl for STEMI was 35 ± 0.30 SD, for NSTEMI it was 21±1.6 and for unstable angina it was 22 ± 1.0 SD. The mean microalbuminuria in patientswith ACS was 44.6 ± 3.2 SD mg/dl incompared to microalbuminuria levels of 30mg/l innormal population (p<0.0001). Conclusion: This study showed an correlation of microalbuminuria with ACS. This reinforcesthe fact that microalbuminuria acts as emerging potential risk factor marker.