Ministry of Health, Kuwait
Alex Cherian is working as a registered nurse in MOH Kuwait under Neurology Department. He completed his BSN in 2008 from K.R College of Nursing, Bengaluru, India. Presently, he’s specializing on Neurological cases through a distance education programme under Rajiv Gandhi University, Bengaluru. He is doing research focusing especially on Neurological Manifestation of HIV patient in Tertiary Hospital. During his research, he came across with the multiple research entitled Neurological Manifestations of HIV patients in Tertiary Hospital. He also referred the book Neurological Manifestation of HIV-1 infection and makers for HIV progression by Rahana Basri and Wan Mohammed Wan Majdiah.
Introduction: The World Health Organisation estimates that 40 million people in the world are infected with HIV. In this developing world, approximately 95% of deaths occur via AIDS. Neurological Manifestations of HIV disease can be seen in 20% of outpatient. The prevalence of HIV related neurologic manifestations is not applicable due insufficient medical facilities, which lead to under diagnosis. Neurologic manifestations stems are largely from studies of populations infected with HIV clade with B virus subtype in North America and Western Europe. Apart from HIV virus subtype, it may be also influenced by factors such as baseline health and nutritional states, hosts, genetics, environment, endemic diseases access to therapy and environment factors unique to particular region. Objectives: To evaluate the prevalence of neurological manifestations in AIDS patient admitted in hospital. To describe the neurological manifestations documented. To find the possible predictors of neurological manifestations. Methods: The study was a prospective cross sectional study in which 100 HIV patients were analysed. All patients were interviewed personally and evaluated by the investigator, which referenced to neurological manifestation. They were classified into various stages of HIV the WHO staging system. Results: Mean age in male 37 and female 35 had shorter duration of illness as compared to their male counter parts. Majority of the patients were diagnosed in systematic state during screening, either during pregnancy or when the spouse found to be positive. Headache associated with vomiting was the common neurologic symptom, followed by seizure altered sensorium, fundus abnormalities including ADC, Neuropathy and CNS lymphoma. One patient had Stavudine included neuropathy. Thus, infections are the most neurological manifestations in HIV patient. Among the non-neurological manifestations, oral candidate was the commonest followed by anemia, disseminated Koch’s, pleural effusion and HIV associated pancytopenia. 69% of patient were in stage 3 and 4 of WHO HIV staging Cryptococcal meningitis, 6% of the patient had HIV related neurological problem documented (6 out 4) included ANC, Neuropathy and CNS lymphoma. Three patient had co-existent TBM and cryptococcal meningitis emphasizing the need for clinicans to be aware that multiple OIs were documented in patient with CDH counts below 200/mm3. Conclusion: Neurological complications didn’t show any correlation with the patient being on ART or otherwise or with duration of art. The possible reason for this include differing baseline CD4 counts at the start ART and treatment failure is a subset of patients.