Zidovudine (AZT), a nucleoside reverse transcriptase inhibitor was the first breakthrough in AIDS therapy in 1990.This study was conducted with an aim to determine prevalence of AZT induced anaemia in HIV infected patients initiated on AZT containing anti retroviral therapy(ART) regimen and also to find out any risk factor for causing AZT induced anaemia. Study was carried out in ART centre, M.K.C.G, MCH, Berhampur between Jan 2009 and Dec 2011. HIV infected patients registered at ART centre were treated according to National AIDS Control Organisation (NACO) guidelines. Patients (n = 1221) with Hb [8 gm/dl were prescribed AZT based ART regimen. Patients having anaemia (\8 gm/dl) were excluded from the study. Correlation of baseline characteristics (age, sex, weight, Hb level, CD 4 count, World Health Organization (WHO) clinical stage) with risk of developing anaemia was also calculated. 178 (14.6 %) patients on AZT regimen developed anaemia. Patients with low CD 4 count were more prone to develop severe anaemia. Age, sex, weight, WHO clinical stage had no relation with development of anaemia. Incidence of AZT induced anaemia was very high and patients having low CD 4 count were more susceptible to develop anaemia.

Histoplasmosis is an opportunistic fungal infection caused by inhaling the spores of a fungus called Histoplasma capsulatum. Disseminated histoplasmosis is the most common form associated with acquired immune deficiency syndrome (AIDS). Here, we report a case of histoplasmosis presenting as isolated cervical lymphadenopathy in a human immunodeficiency virus (HIV)-infected patient diagnosed by a less invasive method (fine-needle aspiration cytology) and confirmed by fungal culture of fine-needle aspiration material. Due to varied and nonspecific clinical manifestations of histoplasmosis, most of the infections are misdiagnosed or underreported. It has to be considered in differential diagnosis of cervical lymphadenopathy, particularly in immunocompromised patients so that patients can be treated medically at an early stage before dissemination occurs and unnecessary surgery can be avoided. Here, we present this case because of its rare presentation as isolated cervical lymphadenopathy and classical cytological picture.

A 60-year-old male presented to the Department of Medicine of MKCG Medical College with complaints of sudden onset, severe localized pain over the distal part of fingers and toes of both the hands, feet and tip of the nose. The hands were affected more than the feet, right hand more than the left, 2 nd and 3 rd digits more than the rest of the fingers [Table/ Fig-1]. The pain gradually increased in intensity over the last two days, did not subside by analgesics and was associated with sensation of pins and needles over the affected parts. He also complained of joint pain over bilateral knee, ankle, distal interphalangeal and metacarpophalangeal joints of hand.There was no history of fever, intake of ergotamine drugs or beta blockers, any insect bite, or living at high altitude at any point of time. There was no history of diabetes, hypertension, peripheral vascular diseases, respiratory ailment, rheumatoid arthritis, Raynaud's phenomenon or any other connective tissue disorders. He was not a smoker.General physical examination was unremarkable. Pulse was 84/ minute, regular and all peripheral pulses were well felt. Blood pressure was 130/80 mm Hg. Systemic examination was also normal except for decreased touch, pain and temperature sensation over the tips of fingers and toes. The affected parts revealed a cold, cyanosed distal phalanx of both hands and feet. Allen's and Adson's tests were negative.A provisional diagnosis of symmetrical peripheral gangrene was made.Complete haemogram along with peripheral smear revealed dimorphic anemia [ ABSTRACTCryoglobulins are monoclonal or polyclonal immunoglobulins that undergo reversible precipitation at low temperatures. Cryoglobulinemia is associated with HCV infection in more than 90% cases, the remaining 10% being called as Essential Cryoglobulinemia which is generally associated with a severe course and suboptimal response to conventional therapies. As the digital vessels are more prone to colder temperatures, hyperviscosity in those vessels can initiate local thrombosis and may manifest as ischemic ulceration and gangrene. We report here a very unusual case of HCV negative cryoglobulinemic vasculitis presenting as symmetrical peripheral gangrene of fingers and toes.Keywords: Acronecrosis, Essential mixed cryoglobulinemia, Symmetrical digital gangrene, Vasculitis.normal. Serum antibodies against malarial parasite, HIV, Hepatitis B and Hepatitis C virus were absent. C-Reactive Protein (CRP) and Rheumatoid factor were positive.Antinuclear antibody (ANA) came out to be positive (47.2)(Positive = >23 IU/ml). Anti ds-DNA, anti Smooth muscle Ab, anti Scl-70 were negative. Complement studies revealed a normal C3 levels (110 mg/dL) (Reference range: 88-252 mg/dl) and low C4 levels (8 mg/dL) (Reference range: 12-72 mg/dl). Bone marrow aspiration study revealed hypercellular marrow with no evidence of metastatic deposits or leukemia. Reactive plasma cells were increased in number.Serum was then evaluated for the presence of cryoglobulins (qualitative) which revealed presence o...

BACKGROUND Breast carcinoma is the most common non-skin malignancy in women. More recently, it has been suggested that extracellular proteinase regulates growth factors and cytokines that might contribute to tumour progression. Since CD10 is a cell surface metalloproteinase which inactivates various biologically active peptides, it might facilitate cancer cell invasion and/or metastasis. MATERIALS AND METHODS 48 cases of Invasive Breast Carcinomas were taken up for the study along with 5 cases of benign tumour as a control group (fibro adenoma and phyllodes). Statistical Analysis: For all statistical data chi-square test was applied using IBM SPSS Statistics 20. RESULTS CD10 was found to be positive in 89% (n=43) cases of which 30.3% (n=13) cases showed weak immunoreactivity whereas strong immunoreactivity was observed in 69.7% (n=30) cases. Stromal CD10 expression correlated with well-established prognostic markers, i.e. higher tumour grade (P<0.001), lymph node metastasis (P=0.003), high mitotic rate (P=0.002), increasing NPI (P=0.003), ER negativity (P=0.032), PR negativity (P=0.041) and HER2/neu positivity (P=0.849). CONCLUSION Stromal CD10 expression in Invasive breast carcinomas is closely correlated with invasion and metastasis and it might play an important role in the pathogenesis.

Acquired Amegakaryocytic Thrombocytopenic Purpura (AATP) is a rare cause of thrombocytopenia presenting over a wide age group with symptoms of bleeding and bone marrow showing isolated absence of megakaryocytes in an otherwise normal marrow. Here, we report a case of AATP in a three year old female child who was then treated with anti thymocyte globulin successfully. We report this case because of it's under diagnosis or misdiagnosis as immune thrombocytopenia (ITP) in most of the cases. We also review the literature regarding the pathogenesis and treatment of this undiagnosed entity.