Background:Musculoskeletal involvement in human immunodeficiency virus (HIV) infected patients are important disease manifestations, responsible for increased morbidity and also decreased quality of life.Objectives:To study the spectrum of different musculoskeletal involvement in HIV infected patients and its impact on quality of life.Patients and Methods:Three hundred (n = 300) HIV-1 reactive patients were evaluated in respect to different musculoskeletal involvement including the quality of life from January 2010 to January 2011.Results:Male to female ratio was 11:1 with a mean age of 35 (±6.4) years and mean duration of the disease was 3 (±1.54) years. Majority of cases were truck drivers, motel workers, and jewelry workers. Musculoskeletal disorders were observed in a total of 190 cases (63.33%). The spectrum of musculoskeletal involvement was: Body ache in 140 (46.7%), arthralgia in 80 (26.7%), mechanical low back pain in 25 (8.3%), osteoporosis in 20 (6.7%), painful articular syndrome in 10 (3.3%), hypertrophic osteoarthropathy in two (0.7%), pyomyositis in two (0.7%), osteomyelitis in one (0.3%), and avascular bone necrosis in one patient (0.3%). Rheumatologic disorders associated were: Reactive arthritis in seven (2.3%), fibromyalgia in four (1.3%), septic arthritis in three (1%), acute gout in three (1%), spondyloarthropathy in two (0.7%), rheumatoid arthritis in two (0.7%), dermatomyositis in one (0.3%), and systemic lupus erythematosus (SLE) in one patient (0.3%). But HIV associated arthritis and diffuse infiltrative lymphocytosis syndrome (DILS) were not detected. Most of the patients had decreased quality of life.Conclusions:Musculoskeletal involvement was common in HIV patients causing increased morbidity, so early detection and timely intervention is essential to improve quality of life.

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Background: Tetanus is still a public health problem in developing countries with high morbidity and mortality. Aims and Objectives: To evaluate the effects of magnesium sulfate in the treatment of moderate to very severe tetanus cases. Patients and Methods: Eighty-six patients suffering from of moderate to very severe tetanus, treated with injection magnesium sulphate in combination with injection diazepam were evaluated and compared to the tetanus patients from the hospital record (treated with only diazepam) regarding outcomes. Results: The average duration of re lex spasm was 12 vs. 8 days in moderate group, 18 vs. 15 days in severe group and 21 vs. 17 days in very severe group in the previous and study year respectively. Average duration of hospital stay was 20 vs. 17 days in moderate group, 27 vs. 22 days in severe group and 36 vs. 30 days in very severe group in the previous and study year respectively. It had been observed that in both severe and very severe tetanus cases, occurrence of autonomic instability, respiratory depression, aspiration pneumonia, cardiac arrhythmia and total death -all were decreased in the study period than previous year. Conclusion: Magnesium sulfate in combination with diazepam may be a better option in the treatment of tetanus particularly in developing countries with limited intensive care facility because of morbidity and mortality bene its.

Environmental hygiene, basic health education, increased in immunization coverage, proper wound care - even following minor injuries - and more facilities for intensive care units, may reduce the overall incidence of tetanus and mortality following onset of the disease.

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