No abstract

Introduction: Cryptococcal meningitis is one of the leading opportunistic infections associated with high mortality. The present study was carried out to determine the prevalence of cryptococcal antigenemia in HIV-infected patients with CD4 + T-cell count ≤ 200 cells/μl. Material and methods: A cross-sectional study including a total of 100 blood samples of HIV-infected patients with CD4 + T-cell count ≤ 200 cells/μl was carried out in a tertiary care hospital. The Cryptococcal Antigen Latex Agglutination Test was performed on serum separated from blood samples included in the study group. A positive cryptococcal antigenemia was diagnosed by positive latex agglutination test of cryptococcal polysaccharide antigen in serum. BMI of all patients included in the study group was calculated and WHO clinical staging of all patients was noted. Results: Three cases out of 100 were positive for cryptococcal antigenemia. The positive cases showed correlation with low BMI and WHO Clinical stage II and III of HIV disease. In the present study, 33.33% and 66.67% of positive cases had CD4 + T-cell count within the range of 0-100cells/μl and 101-200cells/μl respectively. Conclusion: It is important to implement routine screening for cryptococcal antigen among HIV-infected cases with CD4 + T-cell count ≤ 200 cells/μl for early detection of cryptococcal antigenemia. It will help in identifying the risk of subsequent cryptococcal meningitis and initiation of preemptive antifungal treatment.

Background: Tinea is a common fungal infection seen in the tropical and subtropical countries affecting the skin and its appendages. The presentation may vary from mild scaling to severe inflammation with bacterial super infection. It may be confused with other manifestation such as psoriasis, seborrhea, drug eruptions, eczema, and contact dermatitis. Hence correct diagnosis is necessary for appropriate treatment, which will reduce morbidity, discomfort and lessens possibility of transmissions. The aims and objectives were to determine clinicomycological profile of Tinea infections in patients attending dermatology OPD of B. J. Govt. Medical College and Sassoon General Hospital, Pune. Methods: Skin scrapings, nail clippings; hair samples from clinically suspected cases of tinea were collected. Identification of dermatophytes from these samples was done by conventional technique. Results: 119 clinically suspected cases of Tinea infections were processed over a period of one year. Out of these cases mixed infection of Tinea cruris with corporis was the predominant (27.73%) clinical presentation. Among all the samples, fungal filaments were seen by KOH mount in 48 (40.33%) whereas 35 (29.41%) samples were confirmed as dermatophytes by culture. Among these 35 isolates of dermatophytes 20 were T. rubrum, 7 isolates were T. tonsurans. 8 isolates were of T. mentagrophytes. Conclusions: In present study mixed infections of tinea cruris with corporis was the predominant clinical presentation and T. rubrum was the most common dermatophyte isolated.

Introduction: Dengue is commonly found in tropical and subtropical zones. The gold standard for diagnosing and serotyping the virus is through virus isolation. However, a helpful biomarker for diagnosis is NS1, which is released by infected cells 5 to 6 days after the onset of the disease. In settings with a high sample load, the Dengue NS1 ELISA test is a cost-effective and more efcient option. NS1 antigen is considered a surrogate marker for viremia. Additionally, the Dengue RT-PCR test can detect viral RNA not only in primary and secondary dengue infections but also in cases of infection with DENV-4 within 24-48 hours of the acute stage of the disease. Therefore, the aim of this study was to evaluate the role of RT-PCR in patients with acute febrile illness caused by dengue. We analyzed Methods: a total of 150 samples from patients with acute febrile illnesses. Specically, we included 50 samples from patients with NS1 ELISA-positive dengue fever, 50 samples from patients suspected of having dengue fever but with NS1 ELISA-negative results, and an additional 50 samples from patients with other types of acute febrile illnesses. We extracted viral RNA from whole blood samples collected from the 150 patients, and then performed a dengue Real Time PCR analysis. Our study revealed that relying s Results: olely on NS1 ELISA testing may result in a missed diagnosis of dengue fever in 30% of acute febrile cases. For accurate diagnosis of de Conclusion: ngue in the acute stage of febrile illness, we recommend using a combination of NS1 ELISA and dengue RT-PCR, especially when NS1 ELISA results are negative.

Introduction:Co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) is a common event due to similar routes of transmission, with significant clinical implications. Progression to liver disease is more rapid in HIV-HBV coinfected patients. The present study was designed to find the sero-prevalence of HBV in newly diagnosed HIV positive patients. Materials and Methods: 200 newly diagnosed HIV positive cases were enrolled in present study. 3-5 cc blood was collected from these patients and HBsAg ELISA was carried out on serum obtained. HBsAg positive samples were processed further to detect HBeAg and anti-HBeAg by ELISA. Liver Function Tests (LFTs) and CD4 T cell count were noted. Results: Out of 200 HIV positive patients, 4% were co-infected with HBV. Out of the 4% co-infected cases 37.5% were HBeAg positive and 62.5% were anti-HBe positive None of the HIV-HBV co-infected case had a CD4 T-cell count >500 cells/µL whereas 55.2% of HIV mono-infected cases had CD4 T-cell counts > 500 cells/µL. 37.5% HIV-HBV co-infected cases had CD4 T-cell count ≤200 cells/µL whereas only 11.4% HIV mono-infected cases had CD4 T-cell count ≤200 cells/µL.HIV-HBV co-infected cases had more deranged liver enzymes. 50% of HIV-HBV co-infected cases belonged to WHO stage II, whereas majority (91.6%) of HIV mono-infected cases belonged to WHO stage I. Conclusion: This study highlights that, routine screening of HBsAg should done in all HIV infected patients and virological markers of HBV, Liver Function Tests and CD4 T cell count of HIV-HBV co-infected patients should be assessed for appropriate management.