Biomedical subjects
Publications and source records attributed to A Sud.
A variety of operations are now being done on the aortic root. To make it easier to understand the aortic root, a schematic diagram of its anatomy is presented, along with a description of the procedures that are being performed and an illustrative case report of repair of a recurrent perivalvular leak through a right ventricular incision.
Acquired intracardiac shunt after prosthetic valve replacement is a rare complication, and reoperation for correction of this disorder carries a high mortality rate. We report such a case of left ventricular-right atrial fistula after mitral valve replacement in which the patient died of multiple complications. Awareness, prevention, and early diagnosis are, therefore, extremely important.
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AIMS: Both the human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) share similar routes for their transmission, encouraging the possibility of a coinfection with the two viruses in some individuals. We wanted to find out the prevalence of HCV in patients infected with the HIV virus. METHODS: We tested 57 HIV positive patients for anti-HCV antibodies. Liver functions tests, ultrasound abdomen and upper gastrointestinal endoscopy were carried out in the anti-HCV positive patients. RESULTS: Coinfection with HCV was seen in 5.3% of patients. Of these 2 had acquired the infections through blood transfusions and one through heterosexual contact. One patient had cirrhosis with portal hypertension and one had raised alkaline phosphatase as the only abnormality on liver function tests. CONCLUSIONS: Because HCV is more infectious by the parenteral route, the incidence of coinfection is lower in our population possibly due to the fact that majority of our HIV positive patients acquire infection through heterosexual contact.
Primary immunodeficiency syndromes are rarely diagnosed among adults. In this report, we describe a young male who had common variable immunodeficiency. He was treated with intravenous immunoglobulin and, on follow up, has been free of opportunistic infections.
Pulmonary fibrosis is a common complication in progressive systemic sclerosis (PSS). Physical examination and/or routine pulmonary function tests can, however, detect only relatively advanced disease. We assessed the utility of static lung pressure-volume analysis in detecting lung involvement in patients of PSS without obvious clinical, radiological or spirographic evidence of pulmonary disease. Static lung volumes were determined and expiratory lung pressure-volume measurements were obtained in 10 patients with PSS, using a computerized whole body plethysmograph. Static pressure-volume data was also subjected to monoexponential analysis. All patients had normal total lung capacity. Three patients had reduced static compliance, of whom one also had reduced value for the shape constant K (calculated from exponential analysis of pressure-volume data). Examination of pressure volume curve showed a pattern consistent with interstitial fibrosis in these patients. We conclude that detailed study of lung mechanics can help identify early pulmonary involvement in patients with PSS.
AIM: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share the same routes of transmission. Co-infection with the two viruses has been reported to occur in upto 90% of HIV infected patients, depending on the prevailing risk factors for acquiring infection in a given population. We studied our HIV positive patients for the prevalence of HBV co-infection in them. METHODS: Eighty consecutive HIV positive patients underwent ELISA for HBsAg and antiHBc antibodies. HBeAg was tested for in all HBsAg positive patients. Polymerase chain reaction for HBV DNA was carried out in 40 randomly selected patients who showed no serological evidence of HBV infection. RESULTS: There were 56 males and 24 females (mean age 33.2 +/- 8.3 years). Twenty seven (33.8%) patients (23 males, 4 females) had evidence of co-infection with HBV. Of these 6 (22.2%) were HBsAg positive, 22 had antiHBc antibodies and HBV DNA was positive in one. Four patients had evidence of replicating virus (3 HBeAg+ve, 1 DNA+ve). All 4 had normal transaminases and advanced HIV infection. HBV co-infection was significantly higher among males (p < 0.05). There was no significant difference in the liver functions of HBV positive and negative individuals. The risk factor for acquiring infection was heterosexual exposure in al HBV+ve patients except one. CONCLUSIONS: Hepatitis B virus co-infection was seen in 33.8% of our HIV positive patients. Males were more likely to be co-infected. All except one of the patients acquired infection through heterosexual exposure.
Helicobacter pylori is a causative organism for chronic gastritis and associated with peptic ulcer disease. Infection may be asymptomatic as well. Human immuno-deficiency virus infection predisposes to a multitude of opportunistic infections, many of them resulting in gastrointestinal symptoms. We studied the prevalence of H pylori co-infection with HIV and its correlation with gastrointestinal symptoms in HIV infected patients. Seventy-three consecutive HIV infected patients presenting to the medical out patient department of Postgraduate Institute of Medical Education & Research, Chandigarh, India, were included in the study. Antibodies (IgG) to H pylori were tested by ELISA. There were 43 males, 30 females; mean age 26.1 +/- 4.7 years. Risk factors for acquiring HIV infection was predominantly heterosexual exposure. Eleven patients presented with gastrointestinal symptoms. Thirty-five of the 73 (47.9%) patients had serological evidence of H pylori infection. Six of them had gastrointestinal symptoms. These were odynophagia in 5, dyspepsia in 4 and recent diarrhoea in 2. Twenty-four patients with H pylori infection had AIDS. There was no difference in the prevalence of H pylori infection between patients with and without AIDS.
BACKGROUND: Leptospirosis is one of the common zoonoses but, in most instances, the infection goes unnoticed. Rapid diagnostic modalities are needed to diagnose the disease in the early stages. We assessed the usefulness of clinical criteria and compared these with enzyme-linked immunosorbentassay (ELISA) for the early detection of leptospirosis. METHODS: One hundred patients with a febrile illness for > 7 days were screened by Faine criteria and their sera were subjected to both IgM and IgG ELISA using a commercially available kit (Institut Virion Serion GmbH, Warburg, Germany). RESULTS: Twenty-six patients satisfied the clinical criteria for leptospirosis and 8 of them tested positive for IgM antibodies while 1 patient who was clinically negative tested positive by serology. Thus, Faine criteria had a sensitivity of 88.9%, specificity of 80.2%, positive predictive value of 30.8% and a negative predictive value of 98.6%. Paired serum samples were obtained from 70 patients but the IgG levels of only 2 showed a 4-fold rise. CONCLUSION: Faine criteria has moderate sensitivity and specificity but a high negative predictive value in comparison with IgM ELISA. The high negative predictive value may help to screen patients with acute febrile illness for leptospirosis during the early phase of the disease.
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