Neurocognitive deficits in HIV/AIDS patients on HAART Regime

Human immunodeficiency virus HIV infected individuals on national AIDS control organization NACO India based highly active antiretroviral therapy (HAART) regimen often continue experiencing neurological complications referred to as HIV associated neurocognitive disorders (HAND). The cognitive impairment is attributed to HIV replication in the brain and liberation of inflammatory neurotoxins leading to neuronal dysfunction. The American academy of neurology task force on the acquired immune deficiency syndrome AIDS defined two level of neurological impairment in HIV patients: 1.HIV associated dementia(HAD)and 2.minor cognitive motor disorder (MCMD).A core difference between the two is the degree of functional impairment present . Patient with HAD have more impairment than those with MCMD Timely detection of Cognitive dysfunction in patients with HIV infection is very crucial as HAND could affect patient’s activities of daily living such as medication adherence, employment; driving and so on this worsens disease indirectly. METHODS: A Cross sectional Study on Patients with immune compromised states infected by HIV/AIDS was the main aim. The study includes 75 HIV infected patients attending ART centre in Victoria hospital. Patients taken into study were aged above 18years, of both sexes, then MINI Screening for Psychiatric diagnosis will be applied to rule out Axis I Psychiatric illness IHDS scale will be applied to know the neurocognitive severity (score less than <=10) patients will be considered. RESULTS: More than half of the HIV patients had scored less in IHDS SCALE, reported. CONCLUSION: the results show that patients with HIV states have the high prevalence of prevalence of HIV associated neurocognitive impairment. INTRODUCTION: Electrolyte abnormalities are common in chronic alcoholics as a result of chronic alcohol consumption, acute alcohol intoxication. They are especially significant during alcohol withdrawal. We should be aware of these clinically important disturbances caused by alcohol abuse for their appropriate management. MATERIAL AND METHODS: A cross-sectional observational study was conducted for a period of 18 months and 126 patients of alcohol dependence in withdrawal state were included. Diagnosis of alcohol withdrawal were confirmed using ICD-10 and patients were evaluated using CIWA-Ar. Venous blood was obtained for the determination of serum potassium, sodium and magnesium, calcium, phosphates, bicarbonates concentrations and LFT. RESULTS: The prevalence of electrolyte imbalance was 71%. Hyponatraemia was noted in 28.6% and hypernatremia in 11.9% of individuals with alcohol dependence syndrome. Hypokalemia was noted in 42.1% and hyperkalemia was noted in 1.6% of individuals with alcohol dependence syndrome. 14.3% of the individuals have decreased magnesium levels and 15.1% have increased magnesium levels. 67.5% of individuals have normal calcium levels and hypocalcaemia was noted in 31.7%, while hypercalcaemia was noted in only one patient. Hypophosphatemia was present in 15.1% of individuals while in rest the serum phosphorous levels were normal. Metabolic acidosis was found in 19.8% and metabolic alkalosis in 3.2% patients. CONCLUSION: The prevalence of electrolyte imbalance in patients of alcohol dependance in alcohol withdrawal state was 71%. The most frequent electrolyte disturbances in these patients were hypokalemia (42.1%) followed by hypocalcemia (31.7%), hyponatremia (28.6%), and hypomagnesemia (14.3%). The metabolic disturbances ware present in 23% patients. The patients consuming 7/weeks were significantly more likely to have electrolyte imbalance and deaarranged liver function tests than in individuals consuming 4/weeks or less.