Background:Adverse cardiovascular effect of hypothyroidism has been identified in many studies. Early identification of patients with sub-clinical hypothyroidism may lead to early treatment and thereby favourable effect on cardiovascular morbidity and mortality.Objectives:To find out the association of sub clinical hypothyroidism and left ventricular dysfunction and also to find out relationship between systolic and diastolic dysfunction in these patients.Material and Methods:A total 30 cases of sub clinical hypothyroidism along with 15 age sex matched healthy control subjects were included in study. Serum TSH, T4, T3 hormone level was measured and those who were found to have sub-clinical hypothyroidism underwent for 2DEcho.Results:Significant reduction in peak early filling velocity (PE) (p<0.001) and early filling time velocity integral (Ei) (p<0.001). Ratio of early and late peak velocities (PE/PA) (p<0.001), ratio of time velocity integral of early and atrial filling (Ei/Ai) (p<0.001) and ratio of the early peak to average velocity (PE/M) (p<0.001) were also reduced. Mean EF was 54.9± 5.55 as compared to 55.7 ± 3.46 of control subjects with a T.value of 0.48 ,however there was significant diastolic dysfunction in case of hypothyroid patients (mean Ei/Ai = 1.35 ± 0.53) as compared to control group subjects (mean Ei/AI = 2.11 ± 0.26) with a T value of 5.22.Conclusion:Sub-clinical hypothyroidism showed significant diastolic dysfunction in the absence of significant impairment of systolic function.

Background: HIV, the disease, whose mode of transmission is known and is largely preventable, but due to lack of knowledge and practices about HIV/AIDS in general population causes its rapid spread. Aims & Objective: To assess and compare the knowledge, attitude and practices about HIV in patients group, care giver and in general population. Material and Methods: A total of 102 HIV/AIDS patients, 60 care givers (35 attendant, 19 nurses, 6 doctors) and 40 general population (control) were included in the present study. The patients who were registered for study were followed up for three visits. The responses were recorded on a pre-designed and pre-tested, semi-structured questionnaire. Results: Illiteracy was more common in HIV patient group (27.5%). A high proportion of HIV/AIDS cases were engaged in transport/ production industry (24.5%). Electronic media and print media are major source of information. 35.3% patients, 22.9% care givers and 47.5% general population group thought that with medication HIV is curable. Sexual contact (63.8%) was the commonest mode of transmission. 80.0% medical staff thought that a newly diagnosed HIV person, first to talk with doctor. After 6 month follow up: 82% patients write sexual contact as major mode of transmission, and Use of condom was most important preventive measure (68%). Conclusion: Understanding the KAP about HIV/AIDS of Patients, care givers and in general populations will help us in formulating strategy for prevention and treatment.

Background: The nervous system is among the most frequent and serious target of HIV infection, occurring in patients with profound immunosuppression even some time neurological disease is the first manifestation of symptomatic HIV infection in 10-20% of patients. Aims & Objective: (1) To study the clinical, investigation profile and various neurological disorders in HIV positive patients; (2) To correlate neurological manifestations in HIV patients with CD4 Counts. Materials and Methods: 40 HIV positive patients with neurological manifestations were enrolled. Apart from routine investigations, CD4 cell count, MRI brain, CSF, electromyography and nerve conduction study were done whereas required. Results: Meningitis was the commonest diagnosis (52.5%) followed Peripheral neuropathy (20%). Cerebrovascular accident was present in 3 cases. Intracranial space occupying lesion was found in 3 cases. Headache was the commonest neurological symptom seen in 25(62.5%) patients. Altered sensorium was found in 55%. Cranial nerve involvement was seen in 7 (17.5%) patients. Convulsion was reported in 10 (25 %) of the patients. Choreoathetoid movement was present in one patient. CD4 Count was done in 37 patients. In 13 patients it was between 200-500/µl & <200/µl in 24 Patients. CD4 count was <200/ µl in most of the patients having TBM (73%), < 200/ µl in 75% of cryptococcal meningitis. Conclusion: Most of the neurological sign symptoms are due to secondary causes which vary according to the geographical areas. So the knowledge of epidemiology of neurological presentation may help in early diagnosis and treatment of patients.

Background: The relationship between uric acid and microalbuminuria in healthy adults without other cardiovascular risk factors may help to clarify the role of uric acid in cardiovascular disease. Objective: To study and compare the association of serum uric acid levels with microalbuminuria in normotensive and pre-hypertensive subjects without a history of cardiovascular disease or renal dysfunction. Materials and Methods: 350 subjects were included in study. All the routine investigations along with serum uric acid and urinary albumin were conducted. Microalbuminuria was detected by immunoprecipitation in a random urine sample. Serum uric acid level was estimated by Spectrophotometry. Results: The overall prevalence of prehypertension was 38.06% (Males, 39.10% and females, 35.56%). The total prevalence of microalbuminuria was 11.61% (9.9% of normotensives and 14.4% of pre-hypertensives). Hyperuricemia was seen in 10.32% of the total study population. Among normotensives, 9% of males and 8.6% of females and in pre-hypertensive subjects, 14% of males & 9.4% of females had hyperuricemia. Among the prehypertensives, those with microalbuminuria had a significantly higher (p<0.001) serum uric acid level (7.024 ± 1.023 mg/dl) as compared to those without microalbuminuria (5.089 ± 0.965 mg/dl). Conclusion: This study demonstrates a strong independent association between uric acid level and microalbuminuria in pre-hypertensive subjects without a history of cardiovascular disease, diabetes decreased renal function.

Introduction: Deficiency of factor VIII (Hemophilia A), factor IX (Hemophilia B) and Von Willebrand's factor are the most frequent coagulation defects. The incidence of inhibitors in patients of factor VIII deficiency is varies in different regions of India. Aim: To determine the prevalence, clinical profile and incidence of formation of inhibitors in patients of Hemophilia in north eastern part of India. Methods: Selected patients were under went for complete Blood Count (CBC), General Blood Picture (GBP), Prothrombin time (PT), Activated partial thromboplastin time (APTT), Thrombin time, Correction experiment to know the specific factor deficiency or inhibitors present by Normal Plasma, Normal aged serum, Al(OH) 3 adsorbed plasma. Results: 92 patients diagnosed as suffering with Hemophilia A or B were included in study. The age of patients ranged from 2.5 month to 53 years. Out of 92, seventy nine (85.87%) were Haemophilia A and thirteen were (14.13%) Hemophilia B patients. 3.50% (2/55) cases of treated Hemophilia A patient develop inhibitor. Conclusion: The prevalence of hemophilia and incidence of inhibitors in these patients is varies in different regions of India. This variation may be due to the type of product used as treatment, intensity of treatment or the genetic characteristics of the patients.

Background: Knowledge on distribution of different mutations of thalassaemia, which are prevalent in a particular area, is a prerequisite for prenatal diagnosis.Objectives: Studying mutations in β -thalassaemia trait among blood donors in eastern Uttar Pradesh, India. Material and Methods:One thousand non -remunerated voluntary blood donors who were between 18 -40 years of age, were included in the study. Both replacement and voluntary healthy blood donors were included. 4ml of venous blood was collected and it was stored at 4ºC. Complete Blood Count (CBC), Haemoglobinopathy Screening and Molecular Analysis by ARMS -PCR (Amplification Refractory Mutation System -PCR) were done. Screening for β thalassaemia was done in a blood bank by using D -10, Bio Rad, which was based on High Performance Liquid Chromatography (HPLC).Results: Twenty Eight subjects with β -thalassaemia trait were found among 1000 voluntary blood donors. IVS 1-5 (G-C) mutation was most common type (50%), followed by FS 8/9 (+G) 25% which was the second most common type. In our study, a rare mutation of CD 16 (-C) was also found. Out of 14 subjects who had IVS 1-5 (G-C) mutation (most common), six were from Varanasi (6/261) and five of them were Sindhis. It was seen that FS 41/42 (TCTT) mutation was distributed among all groups of populations which had higher prevalences of β-thalassaemia trait. Conclusion:A comprehensive knowledge on beta thalassaemia mutations is necessary for determining a prenatal diagnosis. The occurrence of mutations may vary according to geographic region. Therefore, this study dealt with current problem of unknown mutations, in order to avoid complications.

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Background. Systemic lupus erythematosus (SLE) is an autoimmune disease which is known to present with a wide variety of clinical manifestations. Case Report. A 15-year-old male presented with complaints of moderate grade fever and generalized body swelling. There was no history of cough, weight loss, joint pain, oral ulcerations, skin rash, photosensitivity, loss of hair, pain abdomen, jaundice, or any significant illness in the past. Contrast enhanced computerized tomography of the abdomen revealed hypodense lesions in both liver and spleen (without contrast enhancement), suggestive of granulomas along with few retroperitoneal and mesenteric lymph nodes. On the basis of immunological tests and renal biopsy report, SLE with hepatosplenic granulomatosis diagnosis was made. He was given pulse methylprednisolone 500 mg, for 3 days and he showed dramatic improvement clinically. Conclusion. Hepatic and splenic granulomas are not common in SLE, but this should be kept in differential diagnosis.