The data indicate that the HMB/Arg/Gln mixture can markedly alter the course of lean tissue loss in patients with AIDS-associated wasting.

Aggregatibacter actinomycetemcomitans is a Gram-negative bacillus, member of the HACEK group of bacteria, and it is a very rare cause of endocarditis. It is also an extremely rare cause of device-associated infection of the heart. We describe the case of a 25 year-old man who presented with pacemaker-associated endocarditis due to Aggregatibacter actinomycetemcomitans and also discuss the implications and treatment of this organism.

Chikungunya is an infection caused by the Chikungunya virus and transmitted by the bite of infected mosquito. The most common symptoms of Chikungunya virus infection are fever, joint pain or rash. Chikungunya virus outbreaks had been identified in countries in Africa, Asia, Europe, and the Indian and Pacific Oceans. In late 2013, the first local transmission of Chikungunya virus in the Americas was identified in Caribbean countries and territories. Chikungunya virus disease became a nationally notifiable condition in 2015. There is a threat that Chikungunya will continue to spread to new areas in the Americas.We describe 5 patients who presented to our hospital with Chikungunya infection, shortly after returning from endemic areas. Fever and travel history to endemic areas were documented in all of our cases. Skin rash, arthralgia and contact history were also reported by these patients. Persons with suspected Chikungunya infection should be counseled to avoid mosquito bites during illness to decrease the risk of local transmission. The transmitting mosquitos are present in the US, and limiting the viral spread is essential. In this report, we describe the clinical presentation, risk factors and laboratory tests of each patient, and attempt to ensure awareness on the risk of potential spread of the disease.

Abiotrophia is a nutrition-deficient gram-positive cocci comprising of mainly two species (A. adiacens and A. defective). The name Abiotrophia is derived from the Greek language meaning "life nutrition deficiency". Abiotrophia species is part of normal flora of the human upper respiratory, gastrointestinal, and urogenital tracts. It has been associated with serious infections like bacteremia and endocarditis. This paper discusses a case of A. adiacens causing bacteremia and vertebral osteomyelitis. A 62-year-old male presented with back pain, fever and chills. Spinal imaging study showed spinal abscess and spinal osteomyelitis, and the blood culture grew A. adiacens. Abiotrophia species, formerly referred to as nutritionally variant streptococci, needs supplemented media for growth and survival. There are extremely few cases that have been reported with spinal involvement due to Abiotrophia species. Resistance to multiple antibiotics has been described in this species. Abiotrophia-associated infections are rare but could be life-threatening. Clinicians should be cognizant of its potential in causing severe infections. We report this case in an attempt to increase awareness about this organism.

Background: India is in the intermediate hepatitis B virus endemicity zone with hepatitis B surface antigen prevalence among the general population ranging from 2% to 8%.Health care professionals are at a high risk of getting .Hep B infection which can be prevented by strategies like vaccination, increasing awareness and following universal precautions. The present study was conducted on medical students (3rd Semester) to evaluate their knowledge regarding HBV and to know their vaccination status. Also along with data collection, students were educated about hepatitis B vaccine and about universal precautions before they start with their clinical postings. Methods: Cross sectional study was carried out on 3rd semester MBBS students (batch 2012-2013). All the students present on the day of data collection were included in the study and interviewed using pretested questionnaire. Data was analyzed using percentages. Results: Most of the students had good knowledge about disease and modes of transmission & prevention. Surprisingly only 56.6 percent were aware of high risk of transmission to health professional and doctors. Main source of information was media (85.4percent).Nearly 82% of the students were immunized and main reason among those unimmunized was unawareness about vaccine availability. Conclusions: It is recommended that Hepatitis B vaccination should be made available for all unimmunized students who enter medical profession. The orientation and sensitization programm should be held to create awareness regarding HBV infection preferably at the time of admission into medical college ,else no later than start of their clinical posting.