CERVICAL CANCER AMONG 39 YEARS OR YOUNGER FEMALES IN SOUTH INDIA; A RETROSPECTIVE STUDY

Background: Cervical cancer in young women is rare and disparity exists in its characteristics in the available reports. The study aimed to determine the disease burden and to compare its clinicopathological characteristics with older women. Materials and methods: Retrospective study was performed by retrieving data from the cancer registry for consecutive 843 cervical cancer patients treated in the center between 2017 and 2020. Patients were divided into younger (<40 years) and older (≥ 40 years) age. Statistical analysis was performed using SPSS software version 23 for windows. Chi square test was used for analyzing the categorical variables and P < 0.05 was considered signicant. Results: Cervical cancer in young women constituted 9.4%, with majority (96.2%) belonged to 30-39 years age. Higher prevalence of human immunodeciency virus (HIV) was found among younger compared to older women (P = 0.000). Younger women commonly presented late compared to older women (patients presented after 4 months are 49.4% vs. 18.8% respectively, P=0.000). Squamous cell carcinoma was commonest histology in both the groups and no difference in histology pattern between the two groups. Younger women had higher rate of bulky tumor (>4cm) compared to older (62.2% vs. 44.4%, P = 0.023). Conclusion: Delayed and advanced stage of presentation of cervical cancer in younger women in this region of India warrants promotion of health education, knowledge translation, regular cervical cancer screening for its prevention and early detection

SEXUALLY TRANSMITTED INFECTIONS (STI) TRENDS AT A TERTIARY CARE HOSPITAL IN NORTH-INDIA: AN OBSERVATIONAL STUDY

Sexually transmitted infections (STI’s) are a global health issue. There can be serious repercussions apart from the immediate effect of the infection including increased risk of acquisition of Human Immunodeciency Virus (HIV) infection especially with ulcerative STIS. A retrospective study was conducted amongst the patients who attended STI (Suraksha) clinic at Government medical college ,Amritsar between June 2014 to May 2020. STIs have a tremendous impact on public health. They are responsible for a signicant proportion of infertility in both the sex, morbidity, economic loss to the family, and increased susceptibility to HIV infection. STIs are a major contributor to fetal deaths, abortions, and the delivery of low birth weight babies. It is of great signicance to study their incidence periodically and region wise, and understand the changing trends in order to plan the control strategies. The present study aimed at studying the clinical prole of STIs in this part of the country over 6 years. Since many patients refrain from seeking medical advice, this study was restricted to the patients attending the hospital.

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

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 PREVALENCE AND PATTERNS OF THYROID DYSFUNCTION IN HIV INFECTED PATIENTS FROM RURAL BACKGROUND OF EASTERN INDIA

The national prevalence of HIV (Human Immunodeciency Virus ) infection among adults in India is estimated to be 0.22% in the year 2017 . Amongst all endocrine abnormalities , abnormal thyroid function tests are common among HIV infected patients . This study is an attempt to know the magnitude of thyroid dysfunction in HIV infected patient . This observational , cross sectional study was carried out on 153 adult patients attending ART centre of our institution . The gross prevalence of thyroid dysfunction in HIV infected patients and patterns of different thyroid abnormalities were assessed .The serum T3 , Free T4 and TSH were correlated with CD4 count and duration of HAART ( highly active anti retroviral therapy) . The prevalence of thyroid dysfunction in HIV infected patient is found to be 30.06% . The most common thyroid disorder , subclinical hypothyroidism was found in 20.26% of the HIV infected patients . Mean CD4 cell count is positively correlated with mean serum T3 and serum free T4 and negatively correlated with mean TSH without any statistical signicance in all study population . The correlation of duration of HAART with serum T3 is signicantly negative and with serum free T4 , TSH is nonsignicantly negative . So, denitely there is more prevalence of thyroid dysfunction in HIV infected patients than general population . Although there is normal serum free T4 level in subclinical hypothyroid patients , the serum free T4 level decreases within the normal laboratory reference range with severity of HIV infection . The thyroid abnormalities progress further in HIV infected patients who are on HAART . We conclude that more attention to thyroid dysfunction in HIV infected patient should be paid so that timely treatment is done .

GIANT OVARIAN SEROUS CYSTOADENOMA IN PATIENT AFFECTED BY COVID19: EXPERIENCE OF AN EXCEPTIONAL CASE

In the last 40 years, humanity has been affected by three major pandemics that have claimed many deaths: the increase in the incidence and prevalence rates of chronic non-communicable diseases, the pandemic of the immunodeciency virus disease human-AIDS (HIV / AIDS) and currently the pandemic caused by covid-19. Covid-19 is an emerging viral infectious disease, which has contributed to increasing mortality from chronic diseases in a very short time. Epidemics of unknown emerging diseases such as covid-19 put to the test not only the technical and human capacity of health professionals who directly care for the sick, but, and above all, that of health systems and society usually. For an adequate understanding of this phenomenon, they must be approached with a general approach that integrates many elements that, otherwise, can only give a partial vision of the matter. Due to the aforementioned, we consider it necessary to present this clinical case, based on ovarian pathology of a positive patient for the new coronovarirus and its subsequent interdisciplinary management. Giant ovarian cysts are considered this way when they weigh more than 12 kilos. They are a rare entity today. By denition, a cystic growth of the ovary must be at least 3 cm in diameter to be called a cyst. In the 1970s and 1980s, 20 cases of cysts greater than 20 kg were reported in the world literature. Ovarian tumors are not as common as those of the uterus and breast. They constitute the third group of benign and malignant tumors in women. Ovarian serous cystadenoma arises from the supercial (coelomic) epithelium, made up of cystic areas. There are macroscopically small tumors and massive tumors that occupy the entire pelvis and even the abdominal cavity. Until now, no literature has been found that gives us information on ovarian pathology during the course of the pandemic that we are now experiencing; reason for which this clinical case is presented. Objective: Describe the adnexal pathology associated with covid-19 infection. Design: Prospective, observational in a single center. Methodology: This is a systematic review of adnexal pathology in a patient affected by the new coronavirus (Covid-19); emphasizing its clinical characteristics and its short-term complications. The information and images obtained belong to the medical staff in charge of the case, whose reinforcements are provided by the Excel, Word and JPG statistical package.

A comprehensive measures ensuring the safety of blood component transfusions

Introduction. Human immunodefi ciency virus (HIV), Hepatitis B and C viruses (HBV, HCV) are the major blood-borne infections. Donor blood components cannot be currently replaced with synthetic substitutes, which determines the necessity of improving the viral safety of blood component transfusions.Aim. To describe a multicomponent system for monitoring the viral safety of donor blood component transfusions. General fi ndings. Measures ensuring the safety of blood component transfusions include the maintenance of regular communication with donors, pre-donation laboratory tests, viral screening, production, storage and clinical use of blood products, as well as monitoring of blood transfusion results. The selection of donors from low-risk behaviour groups ensures the viral safety of blood transfusion procedures at the initial stages of blood production. A necessary condition for improving the safety of transfusions is additional examination of donor blood samples for antibodies against the hepatitis B core antigen. Algorithms are described for investigating the initial occurrence of infectious markers in blood transfusion recipients, a retrospective investigation in cases where viral infection markers are identifi ed in recurrent donors, as well as for the monitoring of the virological status of patients with blood system disorders. The implementation of these measures can increase the overall safety of blood transfusion.

Analysis of the role of socio-demographic and psychosocial factors of the occurrence of maladaptive behavior among patients with Human immunodefi ciency virus

A comprehensive clinical and psychodiagnostic examination of 114 HIVinfected patients with non-psychotic mental disorders was carried out, including a clinical diagnostic interview using an independently developed patient research map, pathological and experimental psychological methods, in particular (SCL-90-R and the Schmiszek questionnaire). The age of the examined ranged from 21 to 62 years, the average age of which was 39.77 years. Among the examined, there were 49.12 % of men and 50.88 % of women with secon dary specialized education (50 %), with physical work (67.54 %), single people (69.3 %) heterosexual orientation (89.47 %), unemployed — 24.78 %. The duration of HIV infection in them ranged from 1 month to 24 years and averaged 5.0 years. 48.25 % of patients took HAART regularly, 31.58 % took HAART irregularly, 20.18 % did not take HAART. The leading psychosocial factors in the emergence of maladaptive behavior among HIV patients were the absence of close relationships (80.39 %; p < 0.05). Highlighting the characteristics of HIV patients in the team: isolation (78.07 %), confl ict (77.19 %), selfl essness (71.05 %), selfi shness (64.04 %), vulnerability (61.4 %). Characteristic features of HIV patients: hyperimmunity, emotivism, anxiety, cyclotimism, exaltation and demonstrativeness. Among HIV-infected people with deviant behavior, indicators of anxiety and dysthymia are violated. Socio-demographic factors of maladaptive behavior among HIV-infected people are included: low level of education, the predominance of physical labor, lack of social support, a complex diagnostic and treatment route. The above factors, combined with the psychosocial characteristics of this group of patients, can aff ect the development and progression of deviant behavior, which in turn leads to a complication of the course of the disease and mental disorders. Keywords. HIV-infected, socio-demographic factors, psychosocial factors, non-psychotic mental disorders, disadaptation, deviant behavior

IDIOPATHIC, TREATMENT RESISTANT, GIANT OESOPHAGEAL ULCER IN A KIDNEY TRANSPLANT RECIPIENT.

Giant oesophageal ulcers (GOU) are variable dened as ulcers larger than 10-20 millimeters. The initial reports were primarily in association with human immunodeciency virus (HIV). Since then they have been described in the setting of organ transplant including hematopoietic stem cell and lung transplantation. Association with kidney transplantation is rare and only three such cases have been described. The pathophysiology remains an enigma. We report a case of idiopathic, therapy unresponsive, GOU in a young male with Immunoglobulin A nephropathy (IgAN) related end stage kidney disease. Four months following the kidney transplantation he presented with graft dysfunction, reoccurrence of basic disease, odynophagia and weight loss. The endoscopic evaluation showed two GOU in the distal esophagus. The response to therapy was poor; it nally resolved spontaneously. Based on the temporal prole and the review of existing similar case reports, we believe, these GOU represent an extra-renal manifestation of IgAN.

THE RELATIONSHIP BETWEEN CD4 OF T LIMFOSITS TOWARDS THE OPPORTUNISTIC INFECTION OF ESOPHAGEAL CANDIDIASIS IN HUMAN IMMUNODEFICIENCY VIRUS INFECTION/ACQUIRED IMMUNODEFICIENCY SYNDROME IN H. ADAM MALIK GENERAL HOSPITAL

Introduction. The course of infection of the Human Immunodeciency Virus (HIV) can lead to opportunistic infections (OIs). Esophageal Candida Infection (KE) is an opportunistic infection in people with HIV and is classied as an invasive candida infection. Cluster of Differentiation 4 (CD4) as a measure of the immunity of HIV sufferers. Aim. These researchers looked for an association of CD4 cell counts in HIV patients with Esophageal Candidiasis in HIV sufferers, mean CD4 cell count and antifungal resistance. Methods. Sampling was carried out at H. Adam Malik General Hospital using the Case Control method. Data were analyzed using Chi-Square test. Results. Ages 20-40 years are the age of the most frequent occurrence of HIV / AIDS infection, men have a higher percentage of HIV incidence than women, respectively 64.7% and 35.3%. Free sex is the most common risk factor found in research subjects by 52.94%. There was a signicant relationship between CD4 levels and the incidence of oesophageal candidiasis where patients 3 with a CD4 level <41.82 cell/mm would be 5.25 times more likely to suffer from esophageal candidiasis than patients with a 3 CD4 level ≥ 41.82 cell/mm , with a p value of 0.035. The mean absolute CD4 cell count in patients with Esophageal Candidiasis 3 was 41.82 cell/mm (SD ± 35.47). The Albida Candida fungus (29.4%) is the most common species that causes esophageal candidiasis in HIV patients. The pattern of resistance and antifungal sensitivity in patients with Esophageal Candidiasis shows that in general antifungals still have a good sensitivity to Candida fungus including Flusitocin (100%), Micafungin (100%), Ampotericin (100%), Caspofungin (100%), but at Flusitocin (100%), Micafungin (100%), Ampotericin (100%), Caspofungin (100%), but at Fluconazole and Voriconazole antifungals have begun to show a resistance rate of 10%. Conclusion. There was a signicant relationship between CD4 levels and the incidence of esophageal candidiasis in HIV patients at H. Adam Malik General Hospital. Fluconazole which is the rst choice routinely used for antifungal has begun to show resistance value, but still has a good sensitivity value.

Tuberculosis and Human Immunodeficiency Virus Co-Infection: Clinico-Demographic Determinants at an Anti-Retroviral Therapy Center in Northern India

Background: In India, Tuberculosis (TB) is endemic and Human immunodefi ciency virus (HIV) infection is epidemic in few states. The risk of developing TB in people living with HIV (PLHIV) is about 19 (27-22) times greater than those without it. TB is major cause of death in HIV-TB co-infected patients. Globally 0.4 million deaths occur annually due to HIV-TB disease.Material & Methods:The present observational study was conducted at Darbhanga Medical College and Hospital ART (Antiretroviral therapy) center during period from January to June 2017. Data of HIV-TB co-infected patients was collected from HIV-TB register and entered into Microsoft Excel sheet for analysis using Statistical Package for the Social Sciences.Results:Young persons mostly from the labouring class working in other states were most affected. Pulmonary tuberculosis (sputum smear positive) was most common co-infection. Baseline CD4 cell count at the time of presentation was observed to be low (less than 200 cells/μL) in 46.64℅ HIV-TB co-infected patients.Conclusion: Rural young people working as migrant labourer need focus of health interventions. They should be educated and screened for HIV and TB. Baseline CD4 cell count should be done in all PLHIV cases to assess their immune status.SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, Vol. 14, No. 2, 2017, Page: 12-17