Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
Indian J Sex Transm Dis
The Journal | Search | Ahead Of Print | Current Issue | Archives | Instructions | Subscribe | Reader Login   Users online: 123   Home Email this page Print this page Bookmark this page Decrease font size Default font size Increase font size
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
  Most cited articles *

 
 
  Archives   Most popular articles   Most cited articles
 
Hide all abstracts  Show selected abstracts  Export selected to
  Cited Viewed PDF
REVIEW ARTICLES
Quality of life in HIV/AIDS
KH Basavaraj, MA Navya, R Rashmi
July-December 2010, 31(2):75-80
DOI:10.4103/0253-7184.74971  PMID:21716787
Given the longevity achievable with current prophylactic and therapeutic strategies for persons with HIV infection, quality of life (QOL) has emerged as a significant medical outcome measure, and its enhancement has an important goal. This review highlights the relevance and complexity of physical, psychological, and social factors as determinants of health-related quality of life in HIV-infected persons. Existing data suggest that physical manifestations, antiretroviral therapy, psychological well-being, social support systems, coping strategies, spiritual well-being, and psychiatric comorbidities are important predictors of QOL in this population. Consequently, the impact of HIV infection on the dimensions of QOL, including physical and emotional well-being, social support systems, and life roles, has emerged as a key issue for persons infected with HIV.
  12 8,501 309
ORIGINAL ARTICLES
Exploring dynamics of anal sex among female sex workers in Andhra Pradesh
Saroj Tucker, Rama Krishna, Parimi Prabhakar, Swarup Panyam, Pankaj Anand
January-June 2012, 33(1):9-15
DOI:10.4103/0253-7184.93787  PMID:22529447
Objective: The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). Materials and Methods: The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Results: Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. Conclusion: The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP.
  10 6,094 166
REVIEW ARTICLE
Pre-exposure prophylaxis of HIV
Smriti Naswa, YS Marfatia
January-June 2011, 32(1):1-8
DOI:10.4103/0253-7184.81246  PMID:21799568
Pre-exposure prophylaxis (PrEP) is an experimental approach to HIV prevention and consists of antiretroviral drugs to be taken before potential HIV exposure in order to reduce the risk of HIV infection and continued during periods of risk. An effective PrEP could provide an additional safety net to sexually active persons at risk, when combined with other prevention strategies. Women represent nearly 60% of adults infected with HIV and PrEP can be a female-controlled prevention method for women who are unable to negotiate condom use. Two antiretroviral nucleoside analog HIV-1 reverse transcriptase inhibitor drugs are currently under trial as PrEP drugs, namely tenofovirdisoproxilfumarate (TDF) alone and TDF in combination with emricitabine (FTC), to be taken as daily single dose oral drugs. There are 11 ongoing trials of ARV-based prevention in different at risk populations across the world. The iPrex trial showed that daily use of oral TDF/FTC by MSM resulted in 44% reduction in the incidence of HIV. This led to publication of interim guidance by CDC to use of PrEP by health providers for MSM. Few other trials are Bangkok Tenofovir Study, Partners PrEP Study, FEM-PrEP study, and VOICE (MTN-003) study. Future trials are being formulated for intermittent PrEP (iPrEP) where drugs are taken before and after sex, "stand-in dose" iPrEP, vaginal or rectal PrEP, etc. There are various issues/concerns with PrEP such as ADRs and resistance to TDF/FTC, adherence to drugs, acceptability, sexual disinhibition, use of PrEP as first line of defense for HIV without other prevention strategies, and cost. The PrEP has a potential to address unmet need in public health if delivered as a part of comprehensive toolkit of prevention services, including risk-reduction, correct and consistent use of condoms, and diagnosis and treatment of sexually transmitted infections.
  10 5,624 507
ORIGINAL ARTICLES
Cost of treatment: The single biggest obstacle to HIV/AIDS treatment adherence in lower-middle class patients in Mumbai, India
Eknath Naik, Beata Casanas, Amar Pazare, Gauri Wabale, John Sinnott, Hamisu Salihu
January-June 2009, 30(1):23-27
DOI:10.4103/0253-7184.55476  PMID:21938110
Background: This study analyzes the social, economic and behavioral factors most frequently associated with adherence to Highly Active Antiretroviral Treatment (HAART) in urban India. Materials and Methods: Data was collected in a metropolitan teaching hospital in Mumbai using a cross-sectional survey design. Face-to-face interviews were conducted with 152 patients. The semistructured survey included both open and closed ended questions on socio-demographic, economic and behavioral factors. Factors affecting treatment adherence were analyzed. Results: The median age of patients was 40.5 years, 73% were males and all were heterosexual. Patients had been given ART from six months to five years (median is equal to 3.5). Ninety per cent lived at home and commuted to the clinic by bus or train. Behaviorally, 37% were sexually active, but only 55% used condoms. In assessing adherence, income, education, knowledge of their drugs, transportation, side effects, cost of treatment, distance from clinic and personal clinic satisfaction were analyzed. We found that 75% of patients reported cost of HAART to be the single greatest obstacle to adherence (p less than 0.01). Additionally, those claiming knowledge of their drugs were 2.3 times more likely to be adherent (p less than 0.03), while those who abused drugs or alcohol were 53% less likely to be adherent (p less than 0.03). There was no correlation with other factors. Conclusions: Our study population was representative of the lower middle class of India. It found that an educated, employed group considered the cost of treatment to be a significant obstacle for successful therapy. Additionally, it showed a significant increase in adherence when patients had knowledge of their HAART medications. Therefore, reducing the cost of medication as well as teaching about antiretroviral medications are both likely to improve adherence.
  9 5,053 240
Pattern of sexually transmitted infections and performance of syndromic management against etiological diagnosis in patients attending the sexually transmitted infection clinic of a tertiary care hospital
Shilpee Choudhry, VG Ramachandran, Shukla Das, SN Bhattacharya, Narendra Singh Mogha
July-December 2010, 31(2):104-108
DOI:10.4103/0253-7184.74998  PMID:21716796
Background and Objectives: The availability of baseline information on the epidemiology of sexually transmitted infections (STIs) and other associated risk behaviors is essential for designing, implementing, and monitoring successful targeted interventions. Also, continuous analysis of risk assessment and prevalence-based screening studies are necessary to evaluate and monitor the performance of syndromic management. The aim of the present study was to document the pattern of common STIs and to evaluate the performance of syndromic case management against their laboratory diagnoses. Materials and Methods: Three hundred consecutive patients who attended the STI clinic of a tertiary care hospital at Delhi, with one or more of the complaints as enunciated by WHO in its syndromic approach for the diagnosis of STIs, were included as subjects. Detailed history, demographical data, and clinical features were recorded and screened for common STIs by standard microbiological methods. Results: The mean age was 24 years and most of the male patients were promiscuous and had contact with commercial sex workers (CSWs 63.9%). Majority came with the complaint of genital discharge (63 males; 54 females) followed by genital ulcer (61 males; 30 females). Genital herpes accounted for the maximum number of STI (86/300) followed by syphilis (71/300). The sensitivity of genital discharge syndrome (GDS) was high for Neisseria gonorrhoeae and Chlamydia trachomatis (96% and 91%, respectively) while specificity was low (76% and 72%, respectively). The sensitivity of genital ulcer syndrome for herpes simplex virus-2 (HSV-2) and Treponema pallidum was 82.65% and 81.2%, respectively, while specificity reached 99% approximately. Conclusions: Viral STIs constitute the major burden of the STI clinic and enhance the susceptibility of an individual to acquire or transmit HIV through sexual contact. Syndromic algorithms have some shortcomings, and they need to be periodically reviewed and adapted to the epidemiological patterns of STI in a given setting.
  8 4,639 325
REVIEW ARTICLE
Pregnancy and sexually transmitted viral infections
P Singhal, S Naswa, YS Marfatia
July-December 2009, 30(2):71-78
DOI:10.4103/0253-7184.62761  PMID:21938124
Viral infections in pregnancy are a major cause of morbidity and mortality for both mother and fetus. Viral STIs occur as surface infection and then gradually infect immunologically protected sites. Therefore, these are asymptomatic, hidden and hence underdiagnosed, persistent and difficult to treat. HSV, HPV, HBV, HIV and CMV (cytomegalovirus) are the common ones. Most of these are transmitted during intrapartum period. Proper screening, identification and treatment offered during prenatal period may help in preventing their complications. Twenty five percent of women with a history of genital herpes have an outbreak at some point during the last month of pregnancy. Acyclovir is the accepted efficacious and safe therapy for HSV in pregnancy. Globally, HPV infection is the most common sexually transmitted infection. Neonatal transmission can occur in the absence of clinically evident lesions. HPV 6 or 11 may lead to Juvenile Onset Recurrent Respiratory Papillomatosis (JORRP). TCA, liquid nitrogen, laser ablation or electrocautery can be used to treat external genital HPV lesions at any time during pregnancy. Cesarean section is recommended only if the lesions are obstructing the birth canal. Mother to child transmission (MTCT) in HIV accounts for 15-30% during pregnancy and delivery, and a further 5-20% of transmission occurs through breastfeeding. HBV infection during pregnancy does not alter the natural course of the disease. In women who are seropositive for both HBsAg and HBeAg, vertical transmission is approximately 90%. Pregnancy is not a contraindication for HBV vaccination. Cytomegalovirus (CMV) is the most common intrauterine infection. Cytomegalic inclusion disease (CID) is the most severe form of congenital CMV infection. Treatment is supportive.
  7 5,996 634
Human papilloma virus vaccines: Current scenario
Deepika Pandhi, Sidharth Sonthalia
July-December 2011, 32(2):75-85
DOI:10.4103/0253-7184.85409  PMID:22021967
Genital human papillomavirus (HPV) infection is the most common sexually transmitted infection with an estimated worldwide prevalence of 9-13% and approximately 6 million people being infected each year. Mostly acquired during adolescence or young adulthood, HPV presents clinically as anogenital warts and may progress to precancerous lesions and cancers of the cervix, vagina, vulva, penis and anus, and oropharynx. HPV infection is considered to contribute to almost 100% cervical cancers and at least 80% of anal and 40-60% of vulvar, vaginal, and penile cancers. At present, two prophylactic HPV vaccines are commercially available and both are prepared from purified L1 structural proteins. These proteins self-assemble to form virus-like particles that induce a protective immunity. Gardasil® is a quadrivalent vaccine against HPV types 6, 11, 16, and 18 and is recommended for use in females 9-26 years of age, for the prevention of cervical, vulvar, and vaginal cancers and intraepithelial neoplasia and condyloma acuminata and recently for vaccination in boys and men 9-26 years of age for the prevention of genital warts. Cervarix™ is a bivalent vaccine approved for the prevention of cervical cancer and precancerous lesions caused by HPV 16 and 18, in females 10-25 years. HPV vaccines are safe and efficacious against type-specific HPV-induced anogenital warts, precancerous lesions, and cervical cancer. The vaccines are most effective when given before the onset of sexual activity and provide long-term protection. Effective vaccination coverage in young adolescent females will substantially reduce the incidence of these anogenital malignancy-related morbidity and mortality. There is need to generate India-specific data on HPV epidemiology and HPV vaccination efficacy as well as continue worldwide surveillance and development of newer vaccines.
  7 8,033 543
CASE REPORTS
Successful treatment of cerebral toxoplasmosis with cotrimoxazole
Harsha V Patil, Virendra C Patil, Vijaya Rajmane, Vinayak Raje
January-June 2011, 32(1):44-46
DOI:10.4103/0253-7184.81255  PMID:21799577
Cerebral toxoplasmosis is an acquired immunodeficiency syndrome (AIDS)-related infection and is one of the causes of CNS mass lesions in AIDS. Toxoplasmosis is the most common cerebral mass lesion encountered in HIV-infected patients, and its incidence has increased markedly since the beginning of the AIDS epidemic. Cerebral toxoplasmosis is associated with high mortality and morbidity in patients with acquired immunocopromised state. We are reporting a case of cerebral toxoplasmosis presented with status epileptics and treated with cotrimoxazole. Refractory status epilepsy was controlled with intravenous levetiracetam, which has a unique drug profile.
  6 6,014 71
ORIGINAL ARTICLES
Herpes simplex virus type 2: Seroprevalence in antenatal women
Shagufta Rathore, Aditi Jamwal, Vipin Gupta
January-June 2010, 31(1):11-15
DOI:10.4103/0253-7184.68994  PMID:21808430
Aims: To determine the seroprevalence of herpes simplex type 2 (HSV-2) infection in pregnant females, assess the frequency of unrecognized infection and identify the demographic profile and risk factors associated with the seroprevalence. Materials and Methods: Two hundred randomly selected, asymptomatic pregnant females attending the Obstetrics and Gynecology Outpatient Department for a routine antenatal check-up constituted the study group. Serum specimens were screened for HSV-2 infection by detecting IgG class antibodies against HSV-2-specific glycoprotein G-2 using an enzyme-linked immunosorbent assay kit. Results: A seroprevalence of 7.5% was found in our study. Seropositivity was maximum in the age group ≥30 years (22.20%), followed by 26-30 years (9.7%), 21-25 years (2.20%) and ≤20 years (0%). HSV-2 seropositivity was found to be significantly associated with increasing age, parity, number of sexual partners, duration of sexual activity and history of abortions (P < 0.05). No statistically significant correlation was observed between seropositivity and other demographic variables such as place of residence, education, annual family income and occupation (P > 0.05). No statistically significant association of seropositivity with present or past history suggestive of other sexually transmitted infections was found. None of our cases tested positive for human immunodeficiency syndrome (HIV). Conclusion: A relatively low prevalence of HSV-2 seropositivity was found in our study, with a high frequency of unrecognized and asymptomatic infections. Our findings suggest that type-specific serotesting could be an efficient strategy to diagnose clinically asymptomatic HSV-2 infections and, therefore, to reduce the risk of HSV-2 and HIV sexual transmission by prophylactic counseling against unprotected intercourse. It may also be a useful adjunct in detecting cases who present with symptoms not directly suggestive of genital herpes.
  6 3,946 167
Frequency of HBV, HCV and HIV infections among hospitalized injecting drug users in Kashan
M Sharif, Alireza Sherif, Mansour Sayyah
January-June 2009, 30(1):28-30
DOI:10.4103/0253-7184.55477  PMID:21938111
Context: Infectious diseases including HIV and viral hepatitis constitute a major health issue, with high prevalence among injecting drug users (IDUs). Aims: The present study assessed the frequency of HIV, and hepatitis B and C viruses (HBV and HCV) among 200 IDUs, hospitalized between 2001 and 2006, in Shahid Beheshti Hospital of Kashan, Iran. Setting and Design: A population-based cross-sectional study in Iran. Materials and Methods: A total of 200 subjects participated in this study. Serological markers including HBsAg, anti-HCV antibodies and HIV were assessed by ELISA method using Monobid kits made in US. Demographic data was collected by using a questionnaire, which was designed by a researcher. Statistical Analysis Used: Frequencies were determined by employing SPSS:PC version 15.0, and Chi-square and Fisher's exact tests were used to compare proportions. Results: The mean age of subjects was 36.5 ± 10.2 years. Approximately 88.5% (177 cases) were male and 11.5%. (23 cases) were female. The frequency of positive infection test results for males with respect to HBV, HCV, and HIV was 4% (8 cases), 10.5% (21 cases), and 1.5% (3 cases); and for females it was 0.5% (1 case), 1.5% (3 cases), and 0% (0 case), respectively. Conclusion: This study demonstrates that the frequency of HBV, HCV, and HIV infection in the IVD user in Kashan, Iran, is relatively high and this condition is more serious in male than female drug addicts. It is very important, especially for health providers and policy makers, to recognize the risk factors of HBV, HCV and particularly HIV infection in this area and design effective preventive programs.
  6 3,062 164
Profile of attendee for voluntary counseling and testing in the ICTC, Ahmedabad
Rashmi Sharma
January-June 2009, 30(1):31-36
DOI:10.4103/0253-7184.55479  PMID:21938112
Human immunodeficiency virus (HIV) testing with pre and postcounseling aiming behavior change communication (BCC) for core/bridge population is the main element of holistic model of health care. Voluntary counseling and testing center (VCTC) remodeled as integrated counseling and testing center (ICTC)-general is the 'gateways to care'. It was hospital-based cross sectional study of 811 clients registered at VCTC of Kesar SAL Hospital from January to December 2007. These patients either came voluntarily or by referral. Anonymous and unlinked information was collected on predesigned schedule and data was analyzed to find out the seropositivity, demographic characteristics (among attendees and HIV positives), and epidemiological vulnerability of different segments of population. Among the attendees, 64% were males, 75% in the age group of 20-49 years, 80% were currently married, and 70% were literate (<10 th standard). Also, 66% clients were gainfully employed, while one-fourth were housewives; 98% lived with families, 75% were referred by doctors, and only 19% walked in directly. Dominant reason for visiting ICTC was the history/presence of high risk behavior (HRB) (34%). 35% indulged in heterosexual route; other HRB (men having sex with men or MSM and injecting drug users or IDU) were rare. There were more positive among males, 20-49 years of age group, those living singly, unmarried, divorcee, widow(er) and separated. Similarly positives were more amongst illiterates, less educated and those engaged in unskilled and semi skilled jobs. Adolescent students (>14 years) accounted for one-fifth of the total positives. Direct walk in clients were more positive compared to those referred by doctors. Those who confessed of history/presence of HRB accounted for all except 3 (85%) positives. 51% indulged in heterosexual sex followed by MSM (8%). Overall sero positivity was 4.8%; high in males, 30-49 years age, unmarried and divorcee etc. Sero prevalence decreased with improvement in education and also with improvement in job nature. It was also high in those living alone compared to those staying with their family. Such study shall in evaluating the performance of ICTC and designing the information, education, and communication (IEC) to increase the client uptake in terms of quality and quantity.
  5 4,943 290
Prevention of parent to child transmission services and interventions - coverage and utilization: A cohort analysis in Gujarat, India
Urvish Joshi, Amimuddin Kadri, Sudeshna Bhojiya
July-December 2010, 31(2):92-98
DOI:10.4103/0253-7184.74983  PMID:21716800
Background and Objectives: Risk of vertical transmission (largest source of HIV in children) reduces from 33% to 3% with effective prevention of mother to child transmission (PMTCT) interventions. NACP-III has got an objective of testing all pregnant women for earliest linkage with PMTCT. Study was carried out to find out PPTCT service coverage, dropouts, intervention efficacy with other determinants. Materials and Methods: At ICTCs, registered ANCs are counseled and tested for HIV. HIV +ve ANCs are additionally linked to services and followed-up for institutional delivery, sdNVP, nutrition and children testing. HIV +ve ANCs since 2005 subsequently delivered till June 2008 and their exposed children in Gujarat's category A, B districts constituted study cohort. Results: 259622 pregnant women registered, 72.1% were counseled pre-test, 83.4% of them tested, 74.4% received post-test counseling. 541 ANCs were detected HIV+ve. 45.5% delivered institutionally, 12.8% were unregistered. 12.1% were cesarian section and 66% delivered vaginally. 96.8% were live births, 92.13% mother-baby pair received sdNVP. 35% children could be traced till 18 months, 89% were alive. 90% were tested, 3 were found HIV +ve. Of them, none received MB Pair. Two were delivered vaginally, two received mixed feeding, two children's mothers were not linked with ART. Conclusions: PMTCT services - counseling and testing should be provided to all ANCs. EDD-based tracking, institutional deliveries, postnatal counseling to be encouraged along with complete MB pair coverage, capacity building of concerned staff regarding delivery of HIV+ve ANCs and exposed children tracking.
  5 3,100 140
Prevalence and clinical presentation of Cryptococcal meningitis among HIV seropositive patients
Vasant Baradkar, M Mathur, A De, S Kumar, M Rathi
January-June 2009, 30(1):19-22
DOI:10.4103/0253-7184.55474  PMID:21938109
A total of 573 HIV seropositive and clinically suspected cases of Cryptococcal meningitis were included in the study, from January 2006 to January 2007. CSF samples were processed by negative staining with 10% Nigrosin, cultured on Sabouraud's dextrose agar, biochemical tests, such as urease test and brownish growth in Niger seed agar. The prevalence of Cryptococcal meningitis was found to be 2.79%. The most common signs and symptoms were: fever (100%), headache (100%), altered sensorium (100%), and neck stiffness (90%). All the patients responded to intravenous Amphotericin B treatment.
  5 4,327 382
Incidence of occupational exposures in a tertiary health care center
Amrita Shriyan, Roche R Annamma
July-December 2012, 33(2):91-97
DOI:10.4103/0253-7184.102111  
Introduction: Occupational exposure to Hepatitis B virus (HBV), human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) infection is a cause of concern to all health care workers (HCWs), especially those, in hospitals. Among the HCWs, nurses, interns, technicians, resident doctors and housekeeping staff have the highest incidence of occupational exposure. Aims: To analyze the cases of needle stick injuries and other exposures to patient's blood or body fluids among health care workers. Materials and Methods: A detailed account of the exposure is documented which includes incidence of needle stick injuries (NSI) and implementation of post-exposure prophylaxis (PEP) as per the hospital guidelines. We report a two-year continuing surveillance study where 255 health care workers (HCWs) were included. PEP was given to HCWs sustaining NSI or exposures to blood and body fluids when the source is known sero-positive or even unknown where the risk of transmission is high. Follow-up of these HCW's was done after three and six months of exposure. Results: Of the 255 HCWs, 59 sustained needle stick injuries and two were exposed to splashes. 31 of the NSI were from known sources and 28 from unknown sources. From known sources, thirteen were seropositive; seven for HIV, three for HCV and three for HBV. Nineteen of them sustained needle stick during needle re-capping, six of them during clean up, six of them while discarding into the container, 17 during administration of injection, eight of them during suturing, two occurred in restless patient, 17 during needle disposal. Conclusion: So far, no case of sero-conversion as a result of needle stick injuries was reported at our center.
  4 5,038 159
Screening of pregnant women attending the antenatal care clinic of a tertiary hospital in eastern Saudi Arabia for Chlamydia trachomatis and Neisseria gonorrhoeae infections
Alhusain J Alzahrani, Obeid E Obeid, Manal I Hassan, Abdalaziz A Almulhim
July-December 2010, 31(2):81-86
DOI:10.4103/0253-7184.74976  PMID:21716786
Inroduction: Of the "top ten" sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoeae are ranked second and fifth, respectively, worldwide. Aim: The aim of this study was to screen the pregnant women for C. trachomatis and N. gonorrhoeae infections and to detect antimicrobial resistance pattern of N. gonorrhoeae. Materials and Methods: This study was a prospective, hospital-based analysis of a random sample of pregnant women visiting the antenatal clinic of a tertiary hospital in eastern Saudi Arabia. Endocervical and high vaginal swabs were collected both from pregnant women and female patients attending gynecology clinic with lower genital tract infection (control group). C. trachomatis antigen was detected using enzyme-linked immunosorbent assay (ELISA). N. gonorrhoeae was detected by culture and identification of isolates, and antimicrobial susceptibility testing was performed. Statistical Package for Social Sciences (SPSS) version 13.0 and Chi-square test were used for statistical analysis. Results: C. trachomatis antigen was detected in 10.5% (10/95) and 34.4% (35/102) of pregnant women and control group, respectively (P < 0.001). The isolation rate of N. gonorrhoeae among pregnant women was 0.0% compared to 7.8% (8/102) among the control group (P < 0.01). N. gonorrhoeae were resistant to penicillin (62.5%), tetracycline (50%), ampicillin (25%), amoxycillin-clavulinic acid (25%) and ciprofloxacin (37.5%), while they were susceptible to cefepime, ceftriaxone, ceftazidime, spectinomycin, and cefuroxime. Conclusion: Screening of pregnant women for C. trachomatis infection should be included in the antenatal care in this area. The detection rate of both organisms among the control group highlights the importance of preventive strategies. Certain antibiotics previously used in treating gonorrhea are no longer effective.
  4 3,804 86
An overview of post exposure prophylaxis for HIV in health care personals: Gujarat scenario
Manoj Shevkani, B Kavina, Pradeep Kumar, H Purohit, U Nihalani, Asha Shah
January-June 2011, 32(1):9-13
DOI:10.4103/0253-7184.81247  PMID:21799569
Average risk of acquiring HIV infection after a percutaneous exposure to HIV infected blood is 0.3%. Post exposure prophylaxis (PEP) for HIV refers to a set of comprehensive services to prevent HIV infection in exposed individuals where the exposure can be occupational/ non occupational and a provision of short term (28 days) antiretroviral drugs are given depending on the risk assessment. It also includes counselling and relevant laboratory investigations after taking informed consent of the exposed person and source. PEP inhibits the replication of the initial inoculum of virus and thereby prevents establishment of chronic HIV infection, and is best effective when initiated within 2 hours but certainly within 72 hours. Present communication deals with the registry of 278 cases of PEP from Gujarat in terms of various determinants, their status and the outcome in terms of HIV sero positivity.
  4 4,139 219
Seroprevalence of HIV infection among the patients attending various emergency departments in a tertiary care hospital
Pushpa Devi, Usha Arora, Shalini Yadav, Sita Malhotra
January-June 2010, 31(1):27-29
DOI:10.4103/0253-7184.68997  PMID:21808433
Emergency departments (EDs) receive patients from every background, socioeconomic group and health status. Hence, EDs can play a critical role in offering human immunodeficiency virus (HIV) testing and help in the national strategy of early HIV detection. The present study was conducted on 400 patients attending various EDs after taking Institutional Review Board approval. They were screened for HIV antibodies by three rapid/simple assay tests having different principles/antigens as per the NACO guidelines. Twenty-three (5.75%) of the 400 patients were HIV reactive. Fifteen (65.22%) of the 23 HIV-reactive patients were unaware of their reactive status. Majority of the HIV-reactive (65.22%) patients were from the Medicine emergency followed by Orthopaedics and Surgery (13.04%). Seven (30.43%) had history of fever of more than 1 month duration. Eight (34.78%) of them were later on clinically diagnosed as having various opportunistic infections. Thus, the study emphasizes the need for expansion of routine voluntary HIV counseling and testing to all the patients who come to the ED and practicing universal work precautions by health care workers.
  4 2,755 87
CASE REPORTS
Post-kala-azar dermal leishmaniasis in HIV-positive patients: A study of two cases
Sejal Shah, Aditya Shah, Sachin Prajapati, Freny Bilimoria
January-June 2010, 31(1):42-44
DOI:10.4103/0253-7184.69001  PMID:21808437
Cutaneous leishmaniasis and human immunodeficiency virus (HIV) co-infection is emerging as increasingly frequent and serious new disease. Leishmaniasis may be acquired before or after HIV infection. We describe two cases of post-kala-azar dermal leishmaniasis in HIV-positive patients. Both the patients had papulonodular lesions on upper extremities and back with low CD4 count. Slit skin smear with giemsa stain revealed Leishman Donovan (LD) bodies and skin biopsy of both the patients revealed lymphohistiocytic infiltrate with numerous intracytoplasmic LD bodies.
  3 4,155 77
Hidradenitis suppurativa in AIDS
Ravi Khambhati, Priyanka Singhal, YS Marfatia
January-June 2010, 31(1):45-46
DOI:10.4103/0253-7184.69002  PMID:21808438
Hidradenitis suppurativa (HS) is a disorder of the terminal follicular epithelium in the apocrine gland-bearing skin, characterized by comedo-like follicular occlusion, chronic relapsing inflammation, mucopurulent discharge, and progressive scarring. In this study, we report a case of 35-year-old HIV-positive man with recurrent nodular skin lesions with foul smelling discharge over face, gluteal region, thighs, and axilla. This case is unique because of its association with HIV leading to atypical manifestations and therapeutic challenges.
  3 4,099 87
LETTERS TO EDITOR
Seroprevalence of Hepatitis B and Hepatitis C virus infection among HIV infected patients in Mumbai
Sandhya Sawant, Sachee Agrawal, Jayanthi Shastri
July-December 2010, 31(2):126-126
DOI:10.4103/0253-7184.75025  PMID:21716799
  3 4,841 86
Skin diseases in HIV-infected patients: Impact of immune status and histological correlation
Saswati Halder, Sabyasachi Banerjee, Atin Halder, Prosanta Ranjan Pal
January-June 2012, 33(1):65-67
DOI:10.4103/0253-7184.93836  PMID:22529463
  3 4,172 71
ORIGINAL ARTICLES
Lower genital tract infections in HIV-seropositive women in India
Vandana Goel, P Bhalla, Abha Sharma, YM Mala
July-December 2011, 32(2):103-107
DOI:10.4103/0253-7184.85414  PMID:22021972
Objectives: The presence of STD facilitates shedding of HIV and increases HIV-1 disease progression, possibly by increasing plasma viremia. Our aim was to study the presence of various associated Sexually transmitted disease/Reproductory tract infections in HIV-seropositive women in India. Materials and Methods: The study included 40 HIV-seropositive women attending the antiretroviral therapy (ART) clinic at Lok Nayak Hospital. An informed consent was taken from all subjects. All cases were subjected to detailed gynecological examination and two types of swabs, i.e., a vaginal swab and a cervical swab were taken for STD/RTIs evaluation. The vaginal swabs were used for preparation of wet mount and KOH mount for diagnosis of trichomoniasis and candidiasis; to make a vaginal smear for Gram staining to diagnose bacterial vaginosis (BV) as per Nugent's criteria; for culture of aerobic bacteria and Candida spp. The cervical swab was used for isolation of Neisseria gonorrhoeae by culture and for detection of Chlamydia trachomatis antigen by Chlamydia microplate enzyme immunoassay kit (BIORAD). All data were analyzed using appropriate statistical tests. Results: All 40 cases were evaluated for the presence of STD/RTIs associated with HIV infection. The women belonged to the reproductive age group (15-45 years) and majority (40%) of them were para 2. Most of the women (14 , 35%) were in World Health Organization (WHO) stage I and maximum number (28, 70%) had their CD4 cell count more than 200 cells/ml. There was no significant correlation between WHO stage of HIV-seropositive women and their CD4 cell count (P=0.092). Out of 40 cases, 15 (37.5%) were on ART with maximum cases (53.3%) in WHO stage III. The duration of ART was more than 6 months in 9 (60%) cases. The most common presenting complaint was vaginal discharge in women with WHO stage II and III and 27.5% women showed vaginitis on per speculum examination. Laboratory tests showed high prevalence of BV (30%), mixed infection (30%), and candidiasis (10%) among HIV-seropositive women (P<0.001 in both). Women with BV were mostly in WHO stage I (38.4%) and stage II (36.3%), while those with mixed infection were mainly in WHO stage III (36.3%) and stage IV (40%).Women with candidiasis were mainly in WHO stage III. C. trachomatis antigen was found only in one subject (prevalence 2.5%). Both WHO stage and CD4 cell count had no significant correlation with presence of BV (P=0.056 and 0.063, respectively) and candidiasis (P=0.492 and 0.530, respectively). Maximum number of patients on ART had mixed infection (53.3%), while most of the patients (36%) not on ART had BV. There was no significant association between duration of ART and the presence of vaginal infections. Conclusions: The prevalence of gynecological symptoms and RTIs in HIV-seropositive women is high enough to warrant routine gynecologic evaluation and RTI screening in these patients. However, larger studies and trials are needed to evaluate the effects of ART on these abnormalities as well as to choose the best screening tool in HIV-seropositive women.
  3 2,337 123
Scoring the medical outcomes among HIV / AIDS patients attending antiretroviral therapy center at Zonal Hospital, Hamirpur, using patient satisfaction questionnaire (PSQ-18)
Vishav Chander, AK Bhardwaj, SK Raina, Pardeep Bansal, RK Agnihotri
January-June 2011, 32(1):19-22
DOI:10.4103/0253-7184.81249  PMID:21799571
Aim: To study level of satisfaction among patients attending ART centre using Patient Satisfaction Questionnaire (PSQ - 18). Materials and Methods: A cross-sectional interview based technique was used to study the level of satisfaction. Results: A total of 59 patients attending ART centre were included in the study. The mean score for general satisfaction was 3.22 (SD 0.86), for technical quality 3.03 (SD 0.92), for the interpersonal manner 3.25 (SD 0.93), for communication (SD 0.90), for financial aspects was 2.38 (SD 1.00) and for time spent during the visit, the mean score was 2.97 (SD 0.98) Interpretation: Patient satisfaction is the key in planning and formulating guidelines for treatment and care.
  3 3,087 117
Plasma folate studies in HIV-positive patients at the Lagos university teaching hospital, Nigeria
Akanmu Alani, Osunkalu Vincent, Adediran Adewumi, Adeyemo Titilope, Ernest Onogu, Akinde Ralph, Coker Hab
July-December 2010, 31(2):99-103
DOI:10.4103/0253-7184.74995  PMID:21716795
Introduction: In various studies globally, the prevalence of anemia in persons with HIV infection range from 10 to 20% at initial presentation, and anemia is diagnosed in 70 to 80% of these patients over the course of HIV disease. The etiology of anemia in this group of patients has not been fully established, thus a need to evaluate the role of plasma folate as a possible etiological factor. Objective: This study was set to determine plasma folate levels in newly diagnosed, treatment naÔve, HIV-positive patients, and relate this to other hematological changes. Materials and Methods: A total of 200 participants were recruited for this study, of which 100 were HIV positive, treatment naive patients who were recruited at the point of registration and 100 were HIV-negative subjects (controls). 5 ml of venous blood was collected and plasma extracted for folic acid estimation by HPLC. A full blood count, CD4 and Viral load were estimated. Results: Mean ages for control and study group were 38 ± 2.3 and 32 ± 1.7 years, respectively. Mean plasma folate concentration among the study group (5.04 μg/l) was significantly lower than that for the control group (15.89 μg/l; P = 0.0002). Prevalence of anemia among the study group was 72% (144 of 200), with a mean hemoglobin (Hb) concentration of 9.5 g/dl compared with mean Hb of 13.0 g/dl among the control group (P = 0.002). Plasma folate correlated positively with CD4 cell count (r = 0.304, P<0.05) and inversely with the viral load (r = -0.566; P<0.05). Conclusion: Plasma folate level is a predictor of anemia in early HIV infections.
  3 2,579 52
RESIDENTíS PAGE
Formulating a researchable question: A critical step for facilitating good clinical research
Sadaf Aslam, Patricia Emmanuel
January-June 2010, 31(1):47-50
DOI:10.4103/0253-7184.69003  PMID:21808439
Developing a researchable question is one of the challenging tasks a researcher encounters when initiating a project. Both, unanswered issues in current clinical practice or when experiences dictate alternative therapies may provoke an investigator to formulate a clinical research question. This article will assist researchers by providing step-by-step guidance on the formulation of a research question. This paper also describes PICO (population, intervention, control, and outcomes) criteria in framing a research question. Finally, we also assess the characteristics of a research question in the context of initiating a research project.
  3 12,149 157
* Source: CrossRef
  Editorial Board 
  Addresses 
  Subscriptions 
  My Preferences