scholarly journals Spectrum Of Chest X-Ray Findings Among Human Immunodeficiency Virus Positive Individuals In A Nigerian Tertiary Hospital

2014 ◽  
Vol 10 (2) ◽  
pp. 27-34 ◽  
Author(s):  
Rachael Adeyanju Akinola ◽  
TM Balogun ◽  
AA Adeniyi ◽  
JAA Onakoya ◽  
IO Fabeyibi
Keyword(s):  
Immune System ◽  
Teaching Hospital ◽  
Cd4 Count ◽  
University Teaching ◽  
Hiv Positive ◽  
X Rays ◽  
Cd4 Counts ◽  
X Ray ◽  
Ciency Virus ◽  
Chest X Ray

Introduction: Human immunodefi ciency virus infection damages the immune system making those affected more susceptible to opportunistic infections and malignancies which are common in the chest. This study sought to determine the pattern of chest X-ray lesions and the corresponding CD4 counts of HIV positive patients reporting in the antiretroviral clinic of this teaching hospital for the fi rst time. Methodology: Consecutive HIV positive patients that attended the antiretroviral clinic of the Lagos State University Teaching Hospital, (LASUTH) from September 2009 to January 2011 were recruited. Their chest x-rays were assessed for the presence of pulmonary lesions and baseline CD 4 counts were done to assess their degree of immunosuppression. Data were analyzed using the Statistical Package for Social Sciences, version 16.0. Results: There were 211 subjects, 151 females and 60 males with a M:F ratio of 1:2.5 The mean age of participants was 36.5±11.9. Mean baseline CD4 count for the subjects was 279±220.7 cells/mm3. Almost two thirds (64.9%) cases had normal chest x-rays with their mean CD4 count as 277.65±228.54 cells/mm3. The commonest lesions seen in the lungs include pulmonary infi ltrations, 55 (26.1%), cardiomegaly, 24 (11.4%), pulmonary consolidation, 21 (10%) and lymphadenopathy, 14 (6.6%). The commonest radiological diagnosis made were Atypical pneumonitis, 39 (18.5%), pulmonary TB, 13 (6.2%), pneumonia 13 (6.2%) and cardiomegaly13 (6.2%) respectively.Patients with chest findings had lower mean CD4 counts, 239 cells/mm3 when compared to those without, 244 cells/mm3. Conclusion: Pulmonary infiltration was the commonest lesion, while the commonest diagnosis was atypical pneumonitis. Patients with chest x-ray lesions were found to have lower CD4 counts with probable worse destruction of their immune system. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(2); 27-34 DOI: http://dx.doi.org/10.3126/saarctb.v10i2.9710

scholarly journals Chest X-Ray Findings Among Adult Patients Attending Usmanu Danfodiyo University Teaching Hospital Sokoto Northwestern Nigeria

2020 ◽  
Author(s):  
Mohammed Abacha ◽  
Isma'il Salima ◽  
Sadiq Abubakar Audu ◽  
Abubakar Umar ◽  
Gurama Aminu Dahiru ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Hypertensive Heart Disease ◽  
Adult Patients ◽  
University Teaching ◽  
Pathologic Finding ◽  
X Rays ◽  
X Ray ◽  
Number Of Patients ◽  
Male Preponderance ◽  
Chest X Ray

Background: Chest x-ray is the most frequently performed diagnostic examination particularly in patients with respiratory and cardiac diseases and for routine medical checkup and planning for surgery. A study on the image quality of chest x-rays had been conducted but the findings on the chest x-rays have not been studied in this tertiary health institution. This study aimed at revealing the most common pathologies and sex distribution of the pathologies on chest x-rays of adult patients attending the hospital. Materials and Methods: A retrospective study of 190 adult (aged 18 and above) patients’ chest x-ray reports was conducted using the existing reported documents of chest x-rays from the archives of Radiology Department of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto from January 2018 - October 2019 using data capture sheet as instrument for data collection. Data was analyzed using Microsoft excel version 2010. Results: Out of the 190 chest x-rays, 54% were for male while 46% were for female patients with the highest number of patients in the 29-38 years age group. Most of the radiographs studied were normal examinations (38.95%). Moreover, the most common pathology was hypertensive heart failure (26.84%) with male preponderance (13.68%). Conclusion: Hypertensive heart disease is the most common pathologic finding of adult chest x-ray in the study area with elderly male preponderance.

scholarly journals Study of Clinical, Laboratory and Radiological Spectrum of Tuberculosis in HIV-Infected Individuals and Its Correlation with CD4 Count

2021 ◽  
Vol 8 (16) ◽  
pp. 1025-1029
Author(s):  
Lavanya Devi Palaniswamy ◽  
Moogaambiga Solai Raja Pandiyan ◽  
Punitha Murugesan
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tuberculin Test ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Cd4 Counts ◽  
X Ray ◽  
Keywords Hiv ◽  
Chest X Ray ◽  
Extra Pulmonary

BACKGROUND Tuberculosis is often more difficult to diagnose and more complicated to treat among people who are human immunodeficiency virus (HIV) positive. This study was conducted to assess the clinical, microbiological, laboratory and radiological spectrum of tuberculosis (TB) in HIV seropositive patients, and explore its possible correlation with their CD4 count. METHODS A total of 104 patients who were western blot positive for HIV and co-infected with tuberculosis were studied in Salem district of Tamil Nadu. A detailed history was obtained and patients were examined clinically. CD4 count, sputum smear for acid fast bacilli (AFB), chest x-ray, and tuberculin test, were done along with other relevant investigations. The relationship between CD4 count, and the type of tuberculosis, sputum smear, chest x-ray, and tuberculin test, were analysed statistically, and P < 0.05 was considered significant. RESULTS Most of the patients were between 30 to 39 years. Males (84.6 %) outnumbered females (15.4 %). Pulmonary tuberculosis alone was seen in 47 patients, while extra pulmonary tuberculosis in 36 cases, and both pulmonary and extra pulmonary occurred in 21 cases. They had a mean CD4 count of 237.7 cells / μL, 135.2 cells / μL and 120.9 cells / μL respectively. Extrapulmonary tuberculosis and combined forms were associated with lower CD4 counts (P-value 0.005). The mean CD4 count of sputum positive, sputum negative, and multiple drug resistant (MDR) tuberculosis were 294.2, 168.3 and 90.2 cells / μL respectively. Lower CD4 count was associated with sputum - ve TB (P < 0.041). Lower CD4 counts were associated with atypical chest X-ray findings (P < 0.006) and negative tuberculin test (P < 0.001). CONCLUSIONS Sputum smear positivity for AFB decreases as CD4 count reduces. Involvement of lungs tend to be atypical in immunocompromised patients. The diagnosis of TB in HIV positive individuals is complex and a high index of suspicion is needed. KEYWORDS HIV, Tuberculosis, CD4 Cell Count, Sputum Smear for AFB, Chest X-Ray

HIV-TUBERCULOSIS: A STUDY OF CHEST X-RAY PATTERNS IN RELATION TO CD4 COUNT

2021 ◽  
pp. 10-12
Author(s):  
Abdhesh Kumar ◽  
Naveen Kumar ◽  
Kumar Sourav
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Hospital ◽  
Hiv Positive ◽  
Who Guidelines ◽  
X Ray ◽  
Ciency Virus ◽  
Chest X Ray ◽  
Radiological Patterns ◽  
High Index Of Suspicion ◽  
Ray Patterns

Background: Fight against human immunodeciency virus (HIV) is incomplete without addressing problems associated with difcult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV. Aim: To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts. Materials and Methods: Prospective cohort study was conducted in a tertiary hospital in J.L.N.M.C.H Bhagalpur from april 2019 to january 2021 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. Results: 27% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33%) among CD4 less than 200 as compared to CD4 more than 200 (14%). Inltration (39%) followed by consolidation (30%), cavity (11%), and lymphadenopathy (9%) seen with CD4 less than 200. Inltration (37.5%) followed by cavity (25%) and miliary (25%) with CD4 above 200. Bilateral (68.5%) and mid and lower zones or all zone involvement more commonly seen. Conclusion: In patients with CD4 lower than 200 noncavitory inltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement was higher than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIVpositive patients.

A STUDY OF CARDIAC MANIFESTATIONS IN PATIENTS WITH HIV/AIDS

2021 ◽  
Vol 9 (10) ◽  
pp. 411-422
Author(s):  
Ajay Bang ◽  
◽  
Deepti Deshmukh ◽  
Sanjay Raut ◽  
◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Cd4 Count ◽  
Hiv Positive ◽  
X Ray ◽  
Cardiac Abnormalities ◽  
Ventricular Diastolic Dysfunction ◽  
Chest X Ray ◽  
Cardiac Manifestations

Introduction:HIV/AIDS pandemic is evolving as a major public concern. Cardiovascular diseases are common in HIV-positive patients. Many patients without any symptoms or signs were found to have a cardiovascular disease on autopsy.It is expected that the risk of cardiovascular disease willrise in the following years due to the cardiovascular risk profile andincreased life expectancy of infected patients. Therefore,diagnosis andtherapy of HIV-associated cardiovascular diseases should be part of the evaluation and management of the HIV-positive patient. Objectives: To find out the frequency of cardiac manifestations on clinical examination, electrocardiography, chest X-ray, and echocardiographic examination. To assess the association of Cardiac abnormality with CD4 Count in patients with HIV/AIDS. Toevaluate the association between cardiac abnormalities with types and duration of antiretroviral therapy regimen (ART). Method:A total of 100 consecutive patients visiting ART OPD and admitted to our institute were examined for signs and symptoms of cardiovascular disease. All patients were evaluated with electrocardiography, chest X-ray, and 2 D echocardiography. CD4 count was measured for all patients using flowcytometry using a BD FACS Count system. Results:Out of 100 patients, 53% were male and 47% were female. Patients were divided into subgroups with CD4 count <200, 200-349, 350-499, and ≥500. The mean CD4 count was 403.62 ± 284.98. Prevalence of the cardiovascular abnormality on ECG, chest X-ray, and echocardiography were 74%, 10%, and 51% respectively. The left ventricular systolic dysfunction was the most common finding in our study with fractional shortening ≤25% in 34% of patients and LVEF <50% in 27% of patients followed by left ventricular diastolic function (26%), dilated cardiomyopathy (6%), pulmonary hypertension (4%), and regional wall motion abnormality (2%).Reduced LV ejection fraction (<50%) and left ventricular diastolic dysfunction were statistically significant in patients with CD4 count less than 200/mm3. Conclusion: In present study electrocardiographic, chest X-ray and echocardiographic abnormalities were present in 74%, 10% and 51% patients respectively. Cardiac abnormalities such as QTc prolongation, LBBB, reduced left ventricular ejection fraction, and left ventricular diastolic dysfunction were more significantly higher in patients with CD4 count less than 200/mm3. We could not find any statistically significant difference in cardiac abnormalities in patients on different ART regimens. Further studies are required with a higher sample size.

scholarly journals Determinants of Successful Tuberculosis Treatment Outcome in a State University Teaching Hospital in South East, Nigeria: A 5 Year Retrospective Study

2019 ◽  
pp. 1-8
Author(s):  
Chinonyelu J. Orji ◽  
Onyinye H. Chime ◽  
Edmund N. Ossai
Keyword(s):  
Treatment Outcome ◽  
Teaching Hospital ◽  
Treatment Success ◽  
Tuberculosis Treatment ◽  
University Teaching ◽  
World Health ◽  
State University ◽  
Female Ratio ◽  
X Ray ◽  
Chest X Ray

Aim: The 2018 World Health Organization Global Tuberculosis Report enlisted Nigeria as one of the seven countries worldwide that accounted for 64% of all new cases of tuberculosis. The aim of this study was to assess the magnitude and determinants of tuberculosis treatment outcomes at a Tertiary Hospital in South East, Nigeria. Study Design: Retrospective cohort. Place and Duration: The Enugu State University Teaching Hospital Directly Observed Treatment Center, between April 2009 and March 2013. Methods: Completely filled data were extracted from tuberculosis treatment cards and registers of 445 clients (255 males, 190 females; age range 0-90 years) who assessed care at the DOTS clinic.  Tuberculosis treatment success outcome is defined as cured or completed TB treatment. Results: Of 445 registered patients, majority was males (57.3%), lived in urban areas (68.1%), and were newly diagnosed (97.8%). Of the 93.7% with pulmonary tuberculosis, 62% were smear negatives cases (62%). While the male to female ratio of the clients was 1.3:1, their mean age was 42 ± 16.7 years. About half (50.6%) had chest x-ray findings that were not diagnostic of Tuberculosis. While TB/HIV co-infection rate was 32.8%; 16% and 19.3% had commenced anti -retroviral and co-trimoxazole preventive treatment respectively. Treatment success was reported in 67.9% of all clients and was associated with being older than 14 year (AOR=12.0, 95% CI: 2.5 – 58.0) and having positive chest findings (AOR = 2.6, 95% CI: 0.3-0.6). Conclusions: The TB success rate in was 67.9% Being older than 14 years, having PTB and positive chest x ray findings were the predictors of good treatment outcome in this study. There is an urgent need to track and report the treatment outcome of patients who are lost to follow up since they constitute 20% of missed cases in this center.

scholarly journals CheXaid: deep learning assistance for physician diagnosis of tuberculosis using chest x-rays in patients with HIV

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Pranav Rajpurkar ◽  
Chloe O’Connell ◽  
Amit Schechter ◽  
Nishit Asnani ◽  
Jason Li ◽  
...  
Keyword(s):  
Deep Learning ◽  
Learning Algorithm ◽  
Clinical Information ◽  
Hiv Positive ◽  
X Rays ◽  
Web Based ◽  
X Ray ◽  
Deep Learning Algorithm ◽  
Learning Assistance ◽  
Chest X Ray

Abstract Tuberculosis (TB) is the leading cause of preventable death in HIV-positive patients, and yet often remains undiagnosed and untreated. Chest x-ray is often used to assist in diagnosis, yet this presents additional challenges due to atypical radiographic presentation and radiologist shortages in regions where co-infection is most common. We developed a deep learning algorithm to diagnose TB using clinical information and chest x-ray images from 677 HIV-positive patients with suspected TB from two hospitals in South Africa. We then sought to determine whether the algorithm could assist clinicians in the diagnosis of TB in HIV-positive patients as a web-based diagnostic assistant. Use of the algorithm resulted in a modest but statistically significant improvement in clinician accuracy (p = 0.002), increasing the mean clinician accuracy from 0.60 (95% CI 0.57, 0.63) without assistance to 0.65 (95% CI 0.60, 0.70) with assistance. However, the accuracy of assisted clinicians was significantly lower (p < 0.001) than that of the stand-alone algorithm, which had an accuracy of 0.79 (95% CI 0.77, 0.82) on the same unseen test cases. These results suggest that deep learning assistance may improve clinician accuracy in TB diagnosis using chest x-rays, which would be valuable in settings with a high burden of HIV/TB co-infection. Moreover, the high accuracy of the stand-alone algorithm suggests a potential value particularly in settings with a scarcity of radiological expertise.

scholarly journals Ocular Manifestations In Hiv Positive Patients Attending Khyber Teaching Hospital Peshawar

1970 ◽  
Vol 8 (2) ◽  
pp. 31-36
Author(s):  
M Alam ◽  
S Akbar ◽  
A Khan ◽  
M Aqbal
Keyword(s):  
Cell Count ◽  
Teaching Hospital ◽  
Cd4 Count ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Ocular Motility ◽  
Cd4 Cell Count ◽  
Ocular Manifestations ◽  
Ciency Virus ◽  
Cd4 Cell

Introduction: Human immunodefi ciency virus (HIV) infection is a global health problem. Around 90% of infected persons live in developing countries, particularly those in sub-Saharan Africa and Southeast Asia. Ocular manifestations occur in approximately 70% of these patients. The objective of this study was to document ocular manifestations in HIV positive patients attending Khyber Teaching Hospital Peshawar, Pakistan. Methodology: It was a descriptive case series. The study was conducted at Khyber Teaching Hospital Peshawar from January to December 2007. A total of 14 patients were examined. These patients underwent complete ocular examination including assessment of visual acuity, pupillary reaction, ocular motility, ocular adnexa, anterior segment and posterior segment. CD4 count was done in all the patients. Results: Out of the 14 patients examined 6 (42.9%) had ocular manifestations, all of whom were male. The ocular manifestations included herpes simplex keratitis, herpes zoster ophthalmicus with neurotrophic keratitis, iridocyclitis, HIV retinopathy, retinal vasculitis and cytomegalovirus retinitis in one patient each. Amongst those with ocular manifestations, 5 patients (83.3%) had CD4 cell count of 100/mm3 or less and 1 patient (16.7%) had CD4 count between 101 and 200/mm3; and the mode of transmission was homosexual contact in 5 patients (83.3%) and vertical transmission in 1 patient (16.7%). Conclusion: Ocular manifestations occur in a considerable number of HIV positive patients particularly in those with CD4 cell count less than 100/mm3. Therefore, all HIV positive patients should be screened for ocular manifestations. DOI: http://dx.doi.org/10.3126/saarctb.v8i2.5899 SAARCTB 2011; 8(2): 31-36

scholarly journals 1485. Mobile Bedside Ultrasound (mBSUS) and Use of an Artificial Intelligence Algorithm for Diagnosis of Pediatric Pneumonia in Limited Resource Settings

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S744-S744
Author(s):  
ingrid Y Camelo ◽  
Christopher Gill ◽  
Rachel Pieciak
Keyword(s):  
Artificial Intelligence ◽  
Teaching Hospital ◽  
Gold Standard ◽  
Limited Resource ◽  
Learning System ◽  
University Teaching ◽  
Bedside Ultrasound ◽  
X Ray ◽  
Chest X Ray ◽  
The University

Abstract Background In low and middle-income countries (LMICs) pneumonia is by far the leading cause of death among children &lt; 5 years of age. A key factor is the challenge of pneumonia diagnosis. Chest X-Ray is the gold standard for pneumonia diagnoses but exposes children to ionizing radiation and is mainly restricted to hospital settings. advances in artificial intelligence (AI) render possible the automated interpretation of mobile bedside US (mBSUS) images on a smartphone, obviating the need for a radiologist. Ultraspund findings in pneumonia Artificial intelligence feature recognition Methods We measured the accuracy of mBSUS for the diagnosis of pneumonia using chest X-Ray as the gold standard. Children 1-59 mo presenting at the University Teaching Hospital in Lusaka, Zambia with ages ranging from aged 1-59 months and meeting WHO criteria for severe/very severe pneumonia were enrolled. Clinical data is collected in RedCap. Digital X-Rays were done at the University Teaching Hospital and saved as JPEG images. Pulmonary mBSUS images are taken using a butterfly, a mobile device system, and stored in the butterfly iCloud of the Butterfly app and transmitted to an iOS phone or tablet. Images are stored locally and saved to a secured/encrypted cloud platform for remote viewing with a HIPAA (Health Insurance Portability and Accountability Act) compliant secure cloud. Images are currently extracted from the clips stored in the butterfly icloud, radiologists annotate the images that have abnormal findings and they are then sent to the AI lab where they are analyzed and organized to build a platform of similar images that could be recognized by the machine learning system. Imaging correlation CXR Vs mobile bedside ultrasound mBSUS Butterfly ultrasound system Results Of the 11 patients enrolled so far, ll have been having ultrasound images that correlated with chest x-ray findings. In three of those patients, the ultrasound has shown pulmonary findings not recognized or hardly seen on chest x-ray. The artificial intelligence lab is developing a pull of images that will be used to recognize patterns of consolidation from mBSUS images. Protocol fro obtaining images Conclusion Mobile pulmonary ultrasound mBSUS is a feasible, non radiation technique that could be used in limited-resource settings to diagnose pneumonia in children. Images obtained from mBSUS can be used to build a pattern of recognition based on consolidation findings. Disclosures All Authors: No reported disclosures

Spontaneous Pneumomediastinum: Uncommon Cause of Air Leak in Late Preterm Neonate

2021 ◽  
Vol 35 (2) ◽  
pp. 93-94
Author(s):  
Jyotsna Bhushan ◽  
Shagufta Iqbal ◽  
Abhishek Chopra
Keyword(s):  
Respiratory Distress ◽  
Conservative Management ◽  
Preterm Neonate ◽  
Late Preterm ◽  
Intravenous Fluids ◽  
X Rays ◽  
Blood Gas ◽  
X Ray ◽  
Spontaneous Pneumomediastinum ◽  
Chest X Ray

A clinical case report of spontaneous pneumomediastinum in a late-preterm neonate, chest x-ray showing classical “spinnaker sail sign,” which was managed conservatively and had excellent prognosis on conservative management. Respiratory distress in a preterm neonate is a common clinical finding. Common causes include respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax. Pneumomediastinum is not very common cause of respiratory distress and more so spontaneous pneumomediastinum. We report here a preterm neonate with spontaneous pneumomediastinum who had excellent clinical recovery with conservative management. A male baby was delivered to G3P1A1 mother at 34 + 6 weeks through caesarean section done due to abruptio placenta. Apgar scores were 8 and 9. Maternal antenatal history was uneventful and there were no risk factors for early onset sepsis. Baby had respiratory distress soon after birth with Silverman score being 2/10. Baby was started on oxygen (O2) by nasal prongs through blender 0.5 l/min, FiO2 25%, and intravenous fluids. Blood gas done was normal. Possibility of transient tachypnea of newborn or mild hyaline membrane disease was kept. Respiratory distress increased at 20 h of life (Silverman score: 5), urgent chest x-ray done revealed “spinnaker sign” suggestive of pneumomediastinum, so baby was shifted to O2 by hood with FiO2 being 70%. Blood gas repeated was normal. Baby was managed conservatively on intravenous fluids and O2 by hood. Baby was gradually weaned off from O2 over next 5 days. As respiratory distress decreased, baby was started on orogastric feed, which baby tolerated well and then was switched to oral feeds. Serial x-rays showed resolution of pneumomediastinum. Baby was discharged on day 7 of life in stable condition on breast feeds and room air.

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