Correlation of CD4+ T cell Count with Total Lymphocyte Count, Haemoglobin and Erythrocyte Sedimentation Rate Levels in Human Immunodeficiency Virus Type-1 Disease.

BACKGROUND: Studies in human immunodeficiency virus (HIV) infected adults have demonstrated association of total lymphocyte count (TLC) <1200/mm (3) and subsequent disease progression or mortality. The association of other surrogate makers such as haemoglobin (Hb), and erythrocyte sedimentation rate (ESR) with CD4 count and disease progression has also been suggested. This study was carried out to determine the relationship of CD4-positive T lymphocyte counts with TLC, Hb and ESR in HIV-infected individuals. METHODS: The study population comprised of 215 antiretroviral treatment naïve HIV-1 infected adults. The CD4 positive T cell counts, TLC, Hb and ESR of study participants were measured. Spearman's rank order correlation and Receiver Operating Characteristic were used for statistical analyses. RESULT: The sensitivity, specificity, positive and negative likelihood ratios for cut-off value of TLC <1200/mm (3) for predicting CD4 counts <200 cells/mm (3) and <350 cells/mm (3) were 9.4 %, 100 %, not measurable and 1.1, and 6.1 %, 98.8 %, 5.13 and 0.95, respectively. The association of Hb (<10,11,12 g/dl and <10,12,14 g/dl for CD4 counts <200 cells/mm (3) and <350 cells/mm (3) , respectively), and ESR (<10, 20 and 30 mm fall after 1 hour) with these two CD4 counts cut-off values were suboptimal. CONCLUSION: This study reveals the poor association of TLC, Hb, and ESR with CD4 counts in HIV infected adults, thus highlighting the need to review the utility of these surrogate markers, for predicting CD4 counts in people living with HIV/AIDS.

IgM Chlamydia Trachomatis Antibodies in Cases of Melasma.

BACKGROUND: Melasma is an acquired photosensitive hypermelanosis in sun-exposed areas, especially seen in females. The exact cause of this disorder is not known. Association of melasma with chronic pelvic inflammatory disease (PID) has been described earlier. Chlamydia trachomatis is an important etilogical agent in acute and chronic PID and photosensitivity has been described in almost 50% cases of chronic lymphogranuloma venereum caused by 1.1, 1.2 and 13 serovars of C. trachomatis. METHOD: Blood of 38 cases of melasma in women and 31 healthy females was tested for the presence of C. trachomatis IgM antibodies by ELISA. RESULTS: The average age of the patients was 35.6(range 19-51) years and that of controls was 38(range 24-55). 7(18.42%) and 5 (13.16%) of the patients of melasma were positive and borderline positive for IgM antibodies respectively. None of the healthy controls were positive. The difference was statistically significant. CONCLUSION: Melasma in women is most likely due to photosensitivity to C.trachomatis in cases of chronic pelvic inflammatory disease.

CHANGES IN PULMONARY VASCULATURE IN LUNG DISEASES WHICH LEAD TO PULMONARY HYPERTENSION.

The pulmonary vasculature was studied in lung biopsy/autopsy specimens of 20 cases, in conditions likely to lead to pulmonary hypertension. The changes were classified as per Edward and Heath classification and morphometric measurements to gauge medial and intimai hypertrophy were done. Medial hypertrophy was found to be the earliest and commonest change in all cases, irrespective of the pathogenic mechanism of pulmonary hypertension. Variable changes specific to various arteriopathies/vasculopathies were noted.

Clonality assessment of lymphoproliferative lesions using the polymerase chain reaction: an analysis of two methods.

BACKGROUND: Lymphoid malignancies are a heterogeneous group of disorders which may be difficult to differentiate from reactive proliferations even after immunohistochemistry. Polymerase chain reaction (PCR) is believed to be a good adjunct tool for diagnosis. MATERIALS AND METHODS: We examined 24 cases of neoplastic and non-neoplastic lymphoproliferative lesions in this study and evaluated the PCR as an additional tool in the confirmation of the diagnosis. Two different PCR methodologies were evaluated. RESULTS: In the evaluation of the T-cell PCR, it was seen that the correlation using both the commercial kits and the custom-synthesized primers was highly significant at a P value of <0.05. In the evaluation of the B-cell PCR, it was seen that the correlation using both the commercial kits and the custom-synthesized primers was not significant using either method (P > 0.05). CONCLUSIONS: Both the methods showed an excellent concordance for T-cell γ gene rearrangements, However, the same was not seen in the B-cell receptor rearrangements. This may be because of the small sample size or the inability of consensus V primers to recognize complementary DNA sequences in all of the V segments.

Glomus tumor of the stomach.

Gastric glomus tumors are rare neoplasms. We report here a case of gastric glomus tumor in a 25-year-old female who presented with exsanguinating gastrointestinal hemorrhage. Clinically and on gross examination, the tumor was suspected to be a gastrointestinal stromal tumor (GIST). Histopathological and immunohistochemical evaluation revealed it to be a glomus tumor.

Chlamydia trachomatis seropositivity during pregnancy.

BACKGROUND: Chlamydia trachomatis infection in pregnant women can lead to serious maternal/neonatal antenatal or postnatal complications. The aim of this study was to find out the quantum of this problem in antenatal cases of Command Hospital, Kolkata. METHODS: Antibodies to C. trachomatis by ELISA method were tested in sera of 24 pregnant women and 10 nonpregnant controls. RESULTS: Five (20.83%) and 3 (12.5%) were positive and borderline positive for IgM and 1 (4.17%) and 2 (8.33%) were positive and borderline positive respectively for IgG antibodies i.e. an overall positivity of 45.83%. Only 1 (10%) of the controls was positive for IgA antibodies. CONCLUSIONS: This study highlights the importance of performing this simple blood test for detecting C. trachomatis infection in antenatal cases, to treat the infected and prevent the complications.