Navjot Singh

Disseminated cryptococcosis presenting with generalized lymphadenopathy.

Cryptococcosis is a common opportunistic infection among immunocompromised individuals. Some of the commonly affected sites are respiratory and central nervous system. Lymph node is an unusual site of involvement which could mimic tuberculosis, as seen in our case. We report a 32-year-old male immunocompromised patient presenting with generalized lymphadenopathy who was clinically suspected to have tuberculous lymphadenitis. He was diagnosed to have disseminated cryptococcosis on fine needle aspiration cytology and fungal isolation on culture.

To Study The Clinical Profile And Complications And Response To Treatment of Patients With Malaria At Tertiary Care Center of North India

The aim of the study is to describe the clinical manifestations, complications and response to treatment of patients with Malaria, and to find out the factors which determine the severity of the disease. This will be a one year retrospective and one and half year prospective study. All patients diagnosed to have Malaria will be included in this study. Clinical features, complications and response to treatment will be recorded carefully and the data will be analysed by the appropriate statistical methods.

Conventional versus molecular methods for diagnosis of tuberculosis in a tertiary care center: A study from Punjab

Background: A fast and accurate diagnosis is necessary to control and eliminate tuberculosis (TB). There have been various studies evaluating the efficacy of polymerase chain reaction (PCR) testing in clinical practice. Most of these studies have found PCR as a useful tool to diagnose TB and more so for the extra-pulmonary cases. Aims and Objectives: The aim of the study was to evaluate the results of TB by real-time PCR versus the conventional methods of diagnosis in a tertiary care center in Punjab. Materials and Methods: This study was done in a tertiary care center of Punjab to look for the results of clinical samples tested for TB using PCR, Ziehl–Neelsen staining and culture on Lowenstein–Jensen medium. 16S rRNA gene was used for Mycobacterium tuberculosis detection in PCR. This study included all samples tested for TB from July 2015 to October 2015. Results: A total of 214 samples were tested for TB using smear microscopy, culture and PCR (including 194 [90.6%] extra-pulmonary and 20 [9.3%] pulmonary samples). These included 76 cerebrospinal fluid, 30 pleural fluid, 42 tissues, 17 ascitic fluid, 13 urine, 15 bronchoalveolar lavage (BAL), 16 pus, and 5 sputum samples. Smear microscopy was positive in a total of 4 samples out of 214 (1.8%), which included 2 sputum, 1 tissue, and 1 ascitic fluid samples, while culture was positive for 6 samples (2.8%) which included 2 sputum, 1 pus, 1 BAL, 1 tissue, and 1 ascitic fluid sample. The TB PCR results were positive in a total of 71 (33.1%) samples out of 214. In addition, three samples also tested positive for Mycobacteria other than TB. Conclusion: PCR is a very rapid and accurate diagnostic tool for early detection of TB in particularly for extrapulmonary TB.

Central nervous system manifestations in human immunodeficiency virus patients in the antiretroviral therapy era - Scenario from a developing country

Background: Central nervous system (CNS) infections associated with Human immunodeficiency virus (HIV) has decreased markedly in the developed countries. However, the scenario is different in Indian patients and is not unusual to have CNS infections as their initial presentation. Considering this, we undertook this study to look at the incidence of CNS manifestations in HIV infected patients. Materials and Methods: This was a cross sectional study conducted in the Departments of Medicine and Neurology in Christian Medical College Ludhiana, a tertiary teaching institution in North West India. All the HIV infected patients with Central nervous system manifestations who presented to our institution from 1st April 2009 to 31st of March 2014 were included in the study. The demographic and clinical profile along with the outcome of these patients was studied. Results: There were 280 patients diagnosed during this 5 year period, 43(15%) of who had CNS manifestations. The male: female ratio was 5:1. Majority of them were in the age group of 31 to 50 years of age (68.89%).In 72% of patients CNS manifestations were the initial manifestation of HIV infection.The CNS manifestations noted were cryptococcal meningitis in 20, toxoplasmosis in 3, CNS tuberculosis in 11, PMLE in 6, ischemic stroke in 4 and Diffuse B cell Lymphoma (DLBCL) with aseptic meningitis in 1. Conclusions: Even though in the era of HAART the incidence of CNS manifestations has decreased, CNS manifestations continue to be the presenting symptom for HIV infection in over 16% of the cases.