Zidovudine (AZT), a nucleoside reverse transcriptase inhibitor was the first breakthrough in AIDS therapy in 1990.This study was conducted with an aim to determine prevalence of AZT induced anaemia in HIV infected patients initiated on AZT containing anti retroviral therapy(ART) regimen and also to find out any risk factor for causing AZT induced anaemia. Study was carried out in ART centre, M.K.C.G, MCH, Berhampur between Jan 2009 and Dec 2011. HIV infected patients registered at ART centre were treated according to National AIDS Control Organisation (NACO) guidelines. Patients (n = 1221) with Hb [8 gm/dl were prescribed AZT based ART regimen. Patients having anaemia (\8 gm/dl) were excluded from the study. Correlation of baseline characteristics (age, sex, weight, Hb level, CD 4 count, World Health Organization (WHO) clinical stage) with risk of developing anaemia was also calculated. 178 (14.6 %) patients on AZT regimen developed anaemia. Patients with low CD 4 count were more prone to develop severe anaemia. Age, sex, weight, WHO clinical stage had no relation with development of anaemia. Incidence of AZT induced anaemia was very high and patients having low CD 4 count were more susceptible to develop anaemia.

A 38-year-old female presented to the emergency department of MKCG Medical College and hospital with chief complaints of a two day history of generalized headache associated with nausea, vomiting, blurring of vision and photophobia. This was associated with one episode of generalized tonic-clonic seizure a few hours prior to arrival at the ER. Her previous history was not suggestive of any prior episode of transient ischemic attacks, stroke or seizures. She was diagnosed as a case of Ulcerative Colitis (UC) two years back. She was on oral steroids, 5-Amino Salicylic Acid (5-ASA) and sulfasalazine following which she was symptom-free for last one year.On examination she was afebrile and normotensive. Glasgow Coma Scale (GCS) was 11/15 (E3V4M4) with bilateral plantar extensor. Fundoscopy revealed changes suggestive of early papilloedema in both eyes. Routine tests revealed a normocytic normochromic anaemia with a haemoglobin of 9.8 g%, total leukocyte count of 10,400/mm 3 , Erythrocyte Sedimentation Rate (ESR) of 18mm in 1 st hour, platelet count was 3.01 lakhs/mm 3 . C-Reactive Protein (CRP)was 10.6 mg/dl. Prothrombin Time (PT) was 13.0 seconds (Reference range: 12-13 seconds), International Normalised Ratio (INR) was 1.45, activated partial thromboplastin time (aPTT) was 36 seconds (Reference range: 32-40 seconds). Liver and renal function tests along with serum electrolytes were within normal limits. Sickling test was negative. Blood and stool cultures collected on the day of admission were negative for known pathogens. Stool routine and microscopy revealed few leukocytes and erythrocytes. Rectal examination was negative for melena, bleeding or diarrhoea. Non-Contrast Computerised Tomography (NCCT) scan of the head was normal. Owing to her young age and absence of known risk factors for stroke, cerebral venous sinus thrombosis was suspected and MRI venography was ordered which showed a filling defect in left transverse sinus and left sigmoid sinus [Table/ Fig-1]. A provisional diagnosis of Cerebral Venous Sinus Thrombosis (CVST) was made and she was immediately put on intravenous Low Molecular Weight Heparin (LMWH) therapy and phenytoin.Prothrombotic work-up and coagulation studies were negative for protein C and protein S activity, Antithrombin III activity, Anti-phospholipid antibody, Homocysteine and factor V Leiden

Background: Present study was done to estimate the level of serum uric acid in acute ischemic stroke and to find out whether it is protective against or increases the risk for ischemic stroke and its effect on stroke outcome.Methods: A total of 100 patients and 100 controls were taken randomly. Risk factors of stroke were considered such as hypertension, diabetes, adverse lipid profile, smoking and obesity. Serum uric acid level was measured in both cases and controls. Modified National Institute of Health (NIH) stroke scale score was calculated at the time of admission and discharge. Statistical analysis was done using SPSS 21.0 software.Results: Out of 100 patients studied 65 were males and 35 were females. The mean serum uric acid level in stroke cases was 6.11±1.47 where as it was 4.85±1.12 in controls. SUA levels was higher among males than females. The mean SUA in hypertensive subjects (6.58±1.33) was significantly higher than in normotensive subjects (5.23±1.42). There was statistically significant difference between SUA levels in diabetic (6.66±1.26) and non-diabetic patients (5.63±1.49). Mean SUA among overweight patients was (7.0±1.16) where as it was (5.22±1.23) in patients with normal weight. The mean SUA in smokers (6.33±1.38) was higher than that in non-smokers (6.02±1.51). There was significant positive correlation between SUA an NIH stroke scale score(P<0.05). SUA levels were significantly higher in patients who succumbed as compared to those who were discharged from hospital.Conclusions: SUA can be used as a marker for increased of stroke. Higher SUA is associated with a bad prognosis.

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