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HIV-tuberculosis co-infection in an Indian scenario:The role of associated evidence of immunosuppression

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Asian Pacific Journal of Tropical Medicine 2013年第4期6卷 320-324页

作者： Kushal Naha Sowjanya Dasari mukhyaprana prabhu Department of Medicine Kasturba HospitalManipal 576104KarnatakaIndia

Objective:To determine the relationship between tuberculosis and the degree of immunosuppression as determined by CD4 *** impact of immunosuppression on the severity of tuberculosis was also ***:A retrospective analysis was performed in patients newly diagnosed with HIV infection and antiretroviral therapy(ART)-naive patients with known HIV *** patients were diagnosed with active tuberculosis between January 2008 and December 2010,based on review of their medical *** on chemoprophylaxis for opportunistic infection were *** and severity of tuberculosis,associated stigmata of immunosuppression,and CD4 counts were ***:Of 140 patients satisfying the inclusion criteria.52 had mild tuberculosis with no other evidence of immunosuppression,52 had tuberculosis of variable severity with associated evidence of immunosuppression,and 36 had severe tuberculosis with no other evidence of *** CD4 count was highest in the first group[<109.2±99.9) cells/μL]and least in the second group[(58.4±39.8) cells/μL], and the difference was statistically significant(P=0.004).No statistical difference was observed in the CD4 count between those with mild tuberculosis and those with severe tuberculosis. Conclusions:In developing countries with a high prevalence of tuberculosis in the general population,the possibility of incidental tuberculosis in patients with HIV should always be ***4 count does not appear to influence the severity of *** presence of concomitant evidence of immunosuppression in the form of category B and C conditions is indicative of underlying immunosuppression and associated with a significantly lower CD4 count.

关键词： HIV Tuberculosis Co-infection Immunosuppression

Brucellosis and tuberculosis:Clinical overlap and pitfalls

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Asian Pacific Journal of Tropical Medicine 2013年第10期6卷 823-825页

作者： Sowjanya Dasari Kushal Naha mukhyaprana prabhu Department of Medicine Kasturba HospitalManipal-576 104KarnatakaIndia

Objective:To identify characteristic features of tuberculosis in patients with culture proven ***:A retrospective analysis was performed on patients diagnosed with culture proven brucellosis between January and December 2011,based on review of their medical *** with demonstrable co-infection with tuberculosis were *** features,laboratory parameters and tissue histopathology reports where available were ***:Thirty-two patients with brucellosis were included in the ***-one(65.63%)patients had chronic fever,thirteen(40.63%)had a productive cough,while significant weight loss,evening rise of temperature and night sweats were reported by eight(25.00%),eleven(34.38%)and five(15.63%)patients ***(28.13%)patients had at least three of these ***,hepatomegaly and splenomegaly were noted on examination in seven(21.88%),fifteen(46.88%)and twelve(37.50%)patients ***(25.00%)patients had hepatosplenomegaly,of these only two had associated significant *** examination was normal in all *** ESR greater than 50 mm/hr was seen in eight(25.00%),it was greater than 100 mm/hr in five(15.63%)*** was seen in eight(25.00%)*** marrow biopsy showed non-caseating granulomas in three(9.38%)cases,lymph node biopsy showed granulomas in one ***,three(9.38%)patients had known risk factors for tuberculosis,while six(18.75%)had risk factors for ***:There is a clear overlap between brucellosis and tuberculosis both in terms of clinical presentation and laboratory *** is essential to c-arefully rule out tuberculosis in all cases of suspected or proven brucellosis before initiating antimicrobial therapy,in order to forestall development of drug-resistant tuberculosis.

关键词： Brucellosis Tuberculosis Overlap Drug resistance

Unilateral massive hemothorax in Dengue hemorrhagic fever:A unique presentation

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Asian Pacific Journal of Tropical Medicine 2012年第9期5卷 753-754页

作者： Suman S Karanth Anurag Gupta mukhyaprana prabhu Department of Medicine KMC ManipalKarnatakaIndia Department of Neurosurgery KMC ManipalKarnatakaIndia

Dengue hemorrhagic fever is a more serious form of disease characterised by plasma leakage syndrome,thrombocytopenia and disseminated intravascular *** present a 51 year old male who presented with fever,petechiae and acute onset of *** chest rhoentogram showed a massive riglit sided pleural *** insertion of intercostal drain,there was a sudden gush of blood tinged fluid suggestive of *** was no history of trauma or bleeding *** investigations revealed a raised hematocrit and severe *** IgM was surprisingly *** aggressive supportive management the patient gradually improved and was *** bilateral pleural effusion is a known occurrence in dengue hemorrhagic fever,massive hemothorax is unheard *** report the first case in literature ol dengue hemorrhagic fever presenting as unilateral massive hemothorax.A suspicion of dengue must also be borne in mind in cases of non-traumatic hemothorax especially in endemic areas.

关键词： Dengue hemorrhagic fever Hemothorax Plasma leakage syndrome

Polymyositis-like syndrome with rhabdomyolysis in association with brucellosis

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Asian Pacific Journal of Tropical Medicine 2012年第9期5卷 755-756页

作者： Kushal Naha Suman Karanth Sowjanya Dasari mukhyaprana prabhu Department of Medicine Kasturba HospitalManipal-576 104Manipal UniversityKarnatakaIndia

Diffuse myositis with progression to rhabdomynlysis has been reported in association with wide range of viral *** report a case of polvmvosilis-like svndrome complicated by rhabdomyolysis secondary to *** case report ... 详细信息

关键词： Polymyositis Rhabdomyolysis Brucellosis Atypical presentation

Dual infection with hepatitis A and E virus presenting with aseptic meningitis:A case report

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Asian Pacific Journal of Tropical Medicine 2012年第7期5卷 587-588页

作者： Kushal Naha Suman Karanth mukhyaprana prabhu Manpreet Singh Sidhu Department of Medicine Kasturba HospitalManipal-576 104KarnatakaIndia

We report the case of a young male who presented with features of aseptic meningitis and elevated serum liver enzymes,hut no symptoms or signs suggestive of an acute hepatitis. Subsequently,he was diagnosed with dual infection with hepatitis A and E viruses,and recovered completely with symptomatic *** aseptic meningitis,unaccompanied by hepatitic features is an unusual presentation of a hepatotrophic viral infection,and is yet to be reported with hepatitis A and E virus co-infection.

关键词： Dual infection Hepatitis A Hepatitis E Aseptic meningitis Atypical presentation

A rare case of community acquired Burkholderia cepacia infection presenting as pyopneumothorax in an immunocompetent individual

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Asian Pacific Journal of Tropical Biomedicine 2012年第2期2卷 166-168页

作者： Suman S Karanth Hariharan Regunath Kiran Chawla mukhyaprana prabhu Department of Medicine Kasturba Medical College Department of Medicine University of Missouri Department of Microbiology Kasturba Medical College

Burkholderia cepacia(***)infection is rarely reported in an immunocompetent *** is a well known occurence in patients with cystic fibrosis and chronic granulomatous disease where it increases both morbidity and *** has also been included in the list of organisms causing nosocomial infections in an immunocompetent host,most of them transmitted from the immunocompromised patient in which this organism *** report a rare case of isolation of *** from the bronchoalveolar lavage fluid of an immunocompetent agriculturist who presented with productive cough and fever associated with a *** is the first case of community acquired infection reported in an immunocompetent person in India.

关键词： Burkholderia cepacia Pyopneumothorax Community acquired Immunocompetent Agriculturist

有 multiorgan 机能障碍的自发的败血症为 Pantoe agglomerans 的一张新面孔？

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Asian Pacific Journal of Tropical Medicine 2012年第1期5卷 83-84页

作者： Kushal Naha Ramamoorthi mukhyaprana prabhu Department of Medicine Kasturba HospitalManipal-576 104KarnatakaIndia

Pantoe agglomerans(***) is an unusual cause for sepsis in immunocompetent individuals,especially in the absence of characterislic risk *** report one such case occurring in a farmer,manifesting with severe *** severe nature of illness and the apparently spontaneous origin of septicemia underline the pathogenic potential of this organism. When coupled with the ubiquity of the organism,there is a definite possibility that this disease may become increasingly frequent in the near future,especially in agronomic countries like India,further studies on the epidemiology and natural history of this disease are required.

关键词： Pantoe agglomerans Spontaneous septicemia Multi-organ dysfunction