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JAM - Volume 5 - Issue 1

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Title: Prevalence of adherence, adverse effect and response of Anti Retroviral Therapy on People living with HIV in a programmatic setting - A Retrospective study
Abstract :
Background and objective: With the advent of Anti retroviral Therapy (ART), HIV is now regarded as a chronic manageable disease. But adherence of more than 95% is essential for around 80% efficacy. Also the various side effect of the ART need to be addressed in order to increase its response. This study was done with objective to determine the response of treatment offered to patients in a programmatic setting. Methods: A retrospective study was done in Anti Retroviral Treatment (ART) Centre, S.S. Hospital, Banaras Hindu University, Varanasi in which all patient between 18 to 55 years of age registered between March 2006 to March 2007 were taken and response to therapy, adverse effects and adherence were seen at 12 months of therapy by going through records. Patients were divided into two groups based on drugs. Group I had patients on Zidovudine based regimen and Group II consisted of patients on Stavudine based regimen. Patient already on antiretroviral drugs at the time of enrollment to ART center and pregnant females were excluded in the study. Results: Out of 946 patients, 210(22.3%) of patients were lost to follow-up and 54(5.7%) patients expired. The mean CD4 count significantly improved with level of 98.48 + 60.55 /µl at the start of therapy and 379.62+185.37/µl at 12 months (p<0.005). Among the adverse side effect, the most common was zidovudine induced anemia (23.4%). Overall adherence of >95% in 76.5% patients.
Conclusion: ART is effective in a programmatic setting provided adherence is adequate. Also, monitoring for side effects of ART should be done which is one of the limiting factors of decrease adherence.
Title: Kala-Azar- Treatment Update
Abstract :
The sparse treatment options in Visceral Leishmaniasis (VL) makes its treatment very challenging. Long treatment duration and toxic adverse effect of anti-lesihmanial drugs further add to the problem of effective management. As still no effective vaccine is available, the sole treatment of VL is only based on anti-lesihmanial drugs. Also the increasing resistance to existing drugs also pose a hurdle to VL treatment. In Indian sub-continent, single dose of liposomal amphotericin B (L-AmB) and multidrug therapy (L-AmB + miltefosine, L-AmB + paromomycin (PM), or miltefosine + PM) are the treatment of choice for VL.
Title: Geriatric Anaesthesia: A review
Abstract :
Aging is a gradual and progressive decline in body function as a result of degenerative changes in both the structure and the function of organ system.
Anaesthetic agents have variable effect on geriatric patients requiring less dose and having prolong effect. Fast recovery without any functional decline are the most important objective of anaesthetic management of geriatric population. As aging involves a decrease in functional reserve in all organ systems in variable capacity, proper peri-operative care in must taking into account for the same in order to avoid complication.
Title: A Case of Mounier-Kuhn Syndrome
Abstract :
Mounier-Kuhn syndrome is an uncommon respiratory syndrome characterized
by dilatation of tracheobronchial pathway. We report the case of a 25-year-old man who had history of recurrent chest infection in form of cough and fever since childhood. Computed tomography of chest revealed tracheal dilation and hence diagnosis of this rare syndrome was made.
Title: A Case of Pregnancy with Systemic Sclerosis Presenting with Acute Dyspnoea
Abstract :
Pregnancy in women diagnosed with systemic sclerosis generally has a favorable outcome. It is now known that the majority of these women undergo
a normal progression of pregnancy if the right time for delivery is chosen and
a close obstetric care is delivered. The obstetric risk will depend on the subtype and clinical stage of the disease, and the presence and severity of the internal organ involvement during the pregnancy. The management of these pregnancies should be provided in a specialized center, with a multidisciplinary team capable of identifying and promptly treating complications. Here we report a case of systemic sclerosis in a young woman with good pregnancy outcome.