BACKGROUNDInfective endocarditis (IE) is an infection of the endocardial surface of the heart structures, and is caused by the microbial bacterial organisms and fungal infection that occurs as a result of colonisation of the endothelium by microorganisms. The following study intended to evaluate the echocardiographic features of infective endocarditis on immunocompromised patients.
BACKGROUND A high proportion of HIV patients in India are having pulmonary tuberculosis. The combined therapy of both HIV + PTB causes many unwanted side effects. The following study mainly aimed to study the impaired glucose metabolism in those patients. The aim of the study is to determine the incidence of disorders of glucose metabolism in HIV-1 infected tuberculosis adult on antiretroviral therapy (ART) and antituberculosis therapy (ATT) admitted in tertiary health centre in Guntur, Andhra Pradesh, India.
MATERIALS AND METHODSThis is two-year observational, analytical, prospective cohort study using data of all the HIV + PTB co-infected people admitted in tertiary health centre from March 2015 to March 2017. HIV infected ART naive tuberculosis patients eligible for ATT and ART (HIV-ART + ATT, n= 75) are included in the study. All participants had demographic, anthropometric, biochemical and radiological assessments at baseline; in addition, the HIV-ART group had follow-up assessments for 24 months on ART. Disorders of glucose metabolism namely diabetes mellitus (DM), impaired glucose tolerance and impaired fasting glucose were defined using WHO criteria at baseline 3, 6, 12, 18 and 24 months. Poisson approximations estimated incidence of disorders of glycaemia. Study Design-The study was a prospective, observational, analytical cohort study for two years among HIV and PTB co-infected patients.
RESULTSAt baseline, the prevalence of DM was 0% in HIV-ART + ATT patients. During the follow-up using glucose-based WHO criteria, 5 patients developed DM during 150.2 person-years with an incidence rate of 3.3 cases per 100 PYFU (95%, CI 0.6 -5.1). 8 participants developed IGT during 156.1 PYFU with an incidence of 5.1 cases per 100 PYFU [95%, CI 3.5 -6.2]) and 5 participants developed IFG during 141.5 PYFU with an incidence of 3.5 cases per 100 PYFU [95%, CI 1.4 -4.6]).
CONCLUSIONART was associated with increased incidence of impaired glucose metabolism. These findings underscore the importance of clinical monitoring of patients on ART and ATT.
Obliteration of Costophrenicangle can be a pleural effusion in a majority of cases but other causes of mediastinal masses, aortic aneurysm, postpneumonectomy, lung and pleural masses and consolidation and collapse of the lung can cause shadows mimicking pleural effusion. It is always essential to take the help of lateral and decubitus films, ultrasonography of chest and CT scan chest to come to a proper diagnosis. Inadvertent pleural aspiration basing on chest x-ray PA alone can have disastrous consequences
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