Journal of the Association of Physicians of India
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Item To Study the Effectiveness of Inhalation Technique Training in Patients with COPD and Asthma(Association of Physicians of India, 2023-05) Meena, M; Arora, P; Goud, MS; Kumar, LokenderIntroduction: Asthma and chronic obstructive pulmonary disease (COPD) are characterized by chronic airway inflammation. Lack of knowledge about the correct inhalation techniques leads to poor control of both diseases. This study aimed to study the effectiveness of inhalation technique training in patients with COPD and asthma. Materials and methods: A total of 132 patients fulfilling the inclusion criteria were trained with the correct technique of inhalation on day 0 and at the end of 1 and 6 months. Evaluation of technique training was done on these three occasions posttraining. The mean score of devices was obtained, and the mean inhalation technique score of various devices was compared. Results: Out of 132 patients, 65.1% (86/132) patients were using a dry powdered inhaler (DPIs), 26.5% (35/132) patients used metered dose inhalers (MDIs), and 8.4% (11/132) patients used MDI with spacer. The mean scores of patients using MDI at baseline were 5.68 ± 0.83, and after 1 month, 6.68 ± 0.58 (p < 0.000). The inhalation technique mean score of MDI improved after 6 months, 7.02 ± 0.56 as compared to baseline (p < 0.008) mean score of the patients using DPIs improved after 1 month, 5.53 ± 0.58 as compared to baseline 4.37 ± 5.53 (p < 0.000). There was no statistical improvement in the device mean score of DPIs after 6 months, 5.62 ± 0.55 when compared with 1 month, 5.53 ± 0.58 (p < 0.117). Patients who used pressurized metered-dose inhalers (pMDI) with spacers improved their inhalation score after 1 month by 6.90 ± 0.94 as compared to the baseline score of 6.90 ± 0.94 (p < 0.001). The mean score decreased marginally after 6 months, 7.818 ± 0.60, as compared to the score at the end of 1 month of 8.27 ± 0.64 (p < 0.053). Discussion: Patients showed improvement in the technique of inhalation after educational training, reinstructions, and a standard checklist.Item Prevalence of Hypouricemia and Hyperuricemia and Looking Beyond Serum Uric Acid in Patients with Newly Onset Type 2 Diabetes Mellitus in Eastern Part of Uttar Pradesh: A Cross-sectional Study(Association of Physicians of India, 2023-05) Singh, SK; Singh, R; Singh, SK.Introduction: The prevalence of hyperuricemia (HU) and hypouricemia (Hypo-U) is highly variable in different parts of India and there is a lack of data from the Eastern part of Uttar Pradesh. We designed this study in order to know the exact prevalence of HU and Hypo-U. Materials and methods: This is a cross-sectional study conducted in Varanasi. Data were collected from newly onset diabetic patients over a period of 1 year. Results: Among the 312 diabetic patients, 12.5 and 19.23% were found to have HU and Hypo-U, respectively. Hypouricemic diabetic patients are phenotypically different. They are characterized by the female sex, higher glycated hemoglobin A1c (GlyHbA1c), higher estimated glomerular filtration rate (eGFR), lower body mass index (BMI), and less insulin resistance. Conclusion: The prevalence of HU and Hypo-U is high in newly-onset diabetic patients. Hypouricemic diabetic patients are phenotypically different. Hence routine screening of uric acid is essential for proper diagnosis and appropriate treatment of hypouricemic diabetic patients.Item Clinical Profile and Outcome of Snake Bite Patients from Tertiary Healthcare Center: In Sub-Himalayan Region: A Medical College-based Study(Association of Physicians of India, 2023-05) Negi, RC; Machhan, P; Raj, M; Barwal, Vijay Kumar; Chander, Subhash; Thakur, Suman; Mokta, JatinderObjective: Snake bite is an emergency in tropical and subtropical countries. It is a neglected disease and is most commonly seen in rural setups, where people are ignorant about the venomous snake bites. It results in increased mortality and morbidity because precious time is wasted, either in consulting traditional healers or waiting for the development of signs and symptoms of envenomation. Then only the patient is shifted to a health center. Here we studied the clinical profile, management, and outcome of snake bite patients. Materials and methods: This study was done by retrieving the records of patients with snake bites admitted to the Department of Medicine, Indira Gandhi Medical College & Hospital, Shimla, from 1st January 2017 through December 2019. The recorded data was entered in a precoded performa, and analysis was done with respect to various variables. Result: We evaluated the records of 190 patients. The incidence of the bite was higher among females, 62.1% (n = 118). The commonest age group involved was 21–50 years, 70.1% (n = 34). In 55.8% (n = 106), the site of the bite was the upper limb. The daytime bite was present in 54.7% (n = 106). The maximum incidence of snake bites was found during the rainy season, 81.5% (n = 155). 28.4% (n = 54) of patients presented within 6 hours of the bite. Coagulopathy [whole blood clotting test (WBCT) of >20 minutes] and neurotoxicity were seen in 77.9 and 7.9% of patients, respectively. Anti-snake venom (ASV) was given to 87.8% (n = 167) of patients. In 80% (n = 152) of the cases, hospital stay was up to 3 days. Mortality was seen in only two (1.05%) cases. Conclusion: There is a need to create awareness among the community, particularly in rural areas, about snake bite envenomation and early transportation of victims to the nearest health center. Training of health professionals is also needed to manage cases of snake bites efficiently and judiciously, thereby reducing morbidity and morbidity.Item Unusual Case of Secondary Pneumothorax in a Patient of Allergic Bronchopulmonary Aspergillosis (ABPA)(Association of Physicians of India, 2023-05) Kumar, H; Kumar, S; Sandal, S.Pulmonary aspergillosis is a well-recognized fungal lung disease caused by the Aspergillus species (especially Aspergillus fumigatus). Allergic bronchopulmonary aspergillosis (ABPA) is milder form of pulmonary aspergillosis compared to other more invasive forms. However, if left untreated, ABPA can cause significant lung damage. We present the case of a 33-year-old man who came with complaints of shortness of breath, chest discomfort, and productive cough. The patient underwent High Resolution Computed Tomography (HRCT) scan of the chest which, suggested the diagnosis of ABPA with secondary tension pneumothorax.Item Pulsatile Swelling of Chest(Association of Physicians of India, 2023-05) Bhardwaj, R.Item “Status Quo”: A Necessity for Clinical Medicine due to Corporatization: Clinician’s Perspective in a Developing Country(Association of Physicians of India, 2023-05) Balakrishna, AM; Goel, A.Item Naftifine: A Topical Allylamine for Superficial Dermatophytosis(Association of Physicians of India, 2023-05) Trailokya, A A; Shirsat, A B; Madhu, R; Shah, BelaDermatophytosis is a very common public health problem with high prevalence. Dermatophytes are a highly specialized set of filamentous fungi, which are adapted to keratinized tissues of humans and animals. Dermatophytosis is the most common fungal infection worldwide, affecting approximately 20–25% of the world’s population. The etiological agents of dermatophytosis, called dermatophytes, change with geography and socioeconomic status. Trichophyton rubrum (T. rubrum) is the prime species for skin and nail infections followed by T. mentagrophytes/ T. interdigital complex. There is a shift from T. rubrum to T. mentagrophytes in India for superficial fungal infections. In order to deal with fungal infections, treatment strategies involve the use of systemic antifungals and/or topical antifungal agents. Naftifine is a synthetic allylamine antifungal first reported in 1974 and in 1985 became the first commercially available allylamine. The highly lipophilic nature of allylamine allows efficient penetration and reasonably high concentrations in the stratum corneum (SC) and hair follicles. Naftifine is fungicidal as well as fungistatic. The higher efficacy rates of allylamines over imidazoles for the treatment of fungal infections, even for months after cessation of treatment, is thought to be due to their fungicidal effect, as well as to potentially greater keratin binding and slower release from the SC. The effectiveness of naftifine is also demonstrated against various bacteria belonging to both gram-negative and gram-positive classes. The antiinflammatory property of naftifine has been reported in various preclinical studies where it has been shown to target the prostaglandin pathway. Naftifine 1 and 2% gel and cream is approved by The United States Food and Drug Administration (USFDA), recently naftifine has been approved in India by the Indian regulatory authority Drug Controller General of India (DCGI) for the treatment of dermatophytosis. Naftifine 2% also appears to be a promising treatment, requiring fewer applications than the 1% formulation. Naftifine appears to be effective in a single dose and has a shorter treatment duration than azoles. Naftifine demonstrated its efficacy and safety in various clinical studies of tinea infections. Naftifine offers a very useful and promising option for treating dermatophytosis.Item A Study of Thyroid Profile and Lipid Profile in Patients with Chronic Kidney Disease with or without Hemodialysis in a Tertiary Care Hospital(Association of Physicians of India, 2023-05) Gupta, N; Dahiya, S; Bansal, P; Kumar, Satish; Agarwal, Ashok KBackground: Chronic kidney disease (CKD), due to increasing frequency and prevalence, has become one of the leading public health issues. The Kidney Disease Outcome Quality Initiative (KDOQI) defines CKD as kidney injury or a reduction in the glomerular filtration rate (GFR) to <60 mL/minute/1.73 m2 for at least 3 months. This study aims to compare the effects of decreased renal function on thyroid profile and lipid profile in CKD patients. Materials and methods: This is a prospective cross-sectional observational study conducted among the patients attending Outpatient Department/Inpatient Department (OPD/IPD) at the School of Medical Sciences & Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India, in known cases of CKD, irrespective of the treatment/stage of CKD. All patients of >18 years of age with CKD were included in the study. Result: A total of 200 patients who met the inclusion criteria were included after obtaining detailed informed consent, of which 100 were cases and 100 were controls. The mean age of patients in the study was 47.74 years, with the mean age in patients with CKD 52 years, and the control was 43 years. The mean level of triglycerides (TGs) was significantly higher among the cases, and the high-density lipoprotein (HDL) was significantly lower among cases compared to controls (p < 0.05). Pearson’s correlation between thyroid-stimulating hormone (TSH) with creatinine showed a weak albeit significant positive association (r = 0.200; p < 0.05). Conclusion: Our study shows a higher incidence of alteration in thyroid profile and dyslipidemia among the patients with CKD compared to controls. There is a necessary need to screen routinely for hypothyroidism and dyslipidemia among patients with CKD. Importantly, thyroid hormone levels and their effects on the progression of CKD have not been studied exhaustively.Item Coagulation Abnormalities in Severe Scrub Typhus and Their Association with Complications(Association of Physicians of India, 2023-05) Singla, D; Singh, B; Ahire, K; Mahajan, Sanjay KAim: To describe coagulation abnormalities and their association with complications in patients with severe scrub typhus. Materials and methods: A cohort study was conducted among all patients of severe scrub typhus [immunoglobulin M (IgM) positive] who reported to this facility from 1st August 2019 to 31st July 2020 and met our inclusion criteria. We estimated the incidence of severe thrombocytopenia (<50,000/µL) and overt disseminated intravascular coagulation (DIC) (DIC score of ?5). We determined the association [risk (RR) ratios] of these abnormalities with complications of scrub typhus, namely—septic shock, multiple organ dysfunction syndrome (MODS), and septic shock with MODS. Results: In total, 71 patients were studied with a mean age of 50 ± 15.5 years, of which 45 (63.4%) were females. On presentation, fever 70 (98.5%), myalgias 22 (31.0%), loose stools 13(18.3%), cough, vomiting, headache 11 (15.5%), altered sensorium 10(14.1%), and pain abdomen 9 (12.7%) were main symptoms. On examination, hypotension 31 (43.7%), eschar 25 (35.2%), icterus 17 (23.9%), and rash 16 (22.5%) were noted. The d-dimer (>0.5 µg/mL) levels were increased in all (100%) patients. Thrombocytopenia (91.5%) was the commonest hematological abnormality and 31 (43.6%) of them had severe thrombocytopenia, 25 (35.2%) patients had low fibrinogen levels (<200 mg/dL) and prothrombin time (PT >16.7 seconds) was prolonged in 20 (28.1%). A total of 42 (59.1%) patients developed MODS, 33 (46.4%) developed septic shock, 24 (33.8 %) had MODS with septic shock, 17 (23.9%) developed overt DIC, and eight (11.2%) died. Severe thrombocytopenia (p = ?0.028) and overt DIC (p = 0.045) were significantly associated with septic shock development. Conclusion: In the patients admitted with severe scrub typhus; thrombocytopenia was the commonest hematological abnormality. The development of septic shock was significantly associated with severe thrombocytopenia and overt DIC.Item Carl Linnaeus: Father of Taxonomy(Association of Physicians of India, 2023-05) Pai-Dhungat, J.Item A Diagnostic Journey(Association of Physicians of India, 2023-05) Thakker, D; Kulkarni, A; Hegde, A V.We describe the case of a patient who came with features suggestive of diabetic ketoacidosis. On further evaluation of DKA, we found that it was caused by acute pancreatitis. This acute pancreatitis was found to be caused by hypercalcemia, which was in turn due to primary hyperparathyroidism. Imaging studies done for hyperparathyroidism revealed a thyroid nodule which later turned out to be malignant. This patient was also incidentally found to have hypertrophic obstructive cardiomyopathy.Item Dilemma in a Patient with Paratracheal Enlargement: Tuberculosis, Malignancy or Else?(Association of Physicians of India, 2023-05) Garg, Kranti; Saini, Varinder; DeepaliItem Program to Enhance Well-being and Psychospiritual Understanding Implications in Indian Medical Care Perspective(Association of Physicians of India, 2023-05) Pal, A; Mukhopadhyay, P; Dawar, Pal N.Background: Spirituality is an important dimension of life. The medical practitioner’s well-being is an under-appreciated priority in India. As research on spirituality is minimal, this study attempts to introduce an online 6-week Eastern spirituality-based educational program for physicians. The primary aim was to see the effects of the intervention on the well-being of the participants. The secondary aim was to form an opinion about an extension to medical practice. Materials and methods: A total of 60 medical practitioners were randomized into two groups— one attended the spirituality sessions while the other placebo “self-care” sessions. Quantitative outcome measures were Warwick-Edinburg Mental Well-being Scale (WEMWBS) and World Health Organization (WHO) Well-being Index (WHO-5) noted pre and postprogram. Qualitative data was collected to support the quantitative outcomes. Statistical tests used were unpaired and paired t-tests for quantitative data. A 5-point Likert scale and Cochran’s Q test were used for the qualitative data. Results: In the spirituality group, postsession WEMWBS and WHO-5 scores improved with p < 0.0001 and p = 0.0033, respectively. Regarding qualitative data, 94.44% of physicians “agreed/strongly agreed” in favor of the benefits of sessions with p = 0.0242 and Q = 5.0793. A total of 86.67% of physicians felt the sessions have helped them to understand other’s spirituality-related problems and made them more confident to discuss spirituality with others. Conclusion: The online Eastern spirituality program had a positive impact on the well-being of Indian medical practitioners. There appears to be a potential for extension to the medical care setting. The results need to be substantiated by further studies.Item Clinico-laboratory Profile and Outcomes of Megaloblastic Anemia presenting as Severe Pyrexial Illness mimicking Tropical Infection(Association of Physicians of India, 2023-05) Behera, V; Kumar, R; Agrawal, C; Kapoor, Rajan; Kaur, Navjyot; Nair, VeluBackground: Anemia-causing fever has been described in patients with megaloblastic anemia. Although the exact mechanism of this is unknown, high-grade fever is relatively less reported. Materials and methods: This prospective observational study included all new cases of megaloblastic anemia presenting with febrile illness (>101°F) during a 3-year period. Patients with existing anemia, comorbidities, and other causes of macrocytosis were excluded. A detailed evaluation for megaloblastic anemia and workup for excluding tropical infections was done. The patients were treated with parenteral vitamin B12, folic acid, and other hematinics. Results: Around 24 cases of megaloblastic anemia presenting with high-grade fever were included, with 14 (58.3%) males, mean duration of fever 7.7 days (4–18 days), and 09 (37.5%) having temperature >103°F. The mean hemoglobin (Hb) was 8.15 g/dL (3.7–11.1 g/dL), the mean corpuscular volume (MCV) was 111 ± 7.8 fL, 18 (75%) had unconjugated hyperbilirubinemia, the mean lactate dehydrogenase (LDH) was 814 ± 24 IU/L, and 21 (87.5%) had low B12 or folate levels. Most showed good therapeutic response to B12 or folic acid with defervescence in 1–5 days (mean 2.6 days) and improvement in lab parameters in 1 week. The study population was divided into those with temperature ?103°F, and temperature <103°F it was seen that there was a significant association (p < 0.05) with leucocyte count of ?3000/cumm, and MCV ?110 fL, in patients with temperature ?103°F Conclusion: Megaloblastic anemia should be considered in the differentials of a patient presenting with a febrile illness with no clinical localization and a negative initial fever workup. Early identification and prompt therapy of this easily treatable disorder are very essential.Item Knowledge, Attitudes, and Practices regarding Oral Fluid, Electrolyte, and Energy Management in Acute Nondiarrheal Illnesses among Physicians in India(Association of Physicians of India, 2023-05) Malve, H; Sathe, P; Chakravarty, P; Thakor, Priti; Tesado, ChristianBackground: Fluid, electrolytes, and energy (FEE) management is important in the treatment of acute nondiarrheal illnesses. However, the use of FEE drinks in managing such illnesses is not well-documented. Objective: This study aimed to understand physicians’ knowledge, attitude, and practices (KAP) and perceived patient outcomes in treating FEE deficits in acute nondiarrheal illnesses using FEE drinks in India. Materials and methods: A cross-sectional respondent-blinded survey was designed and administered among practicing physicians across various specialties and prescribing statuses in India. KAP among groups of physicians was assessed, and the correlations between knowledge– attitudes, knowledge–practice, and knowledge–perceived outcomes were explored. Results: A total of 494 physicians participated in the study from September to October 2021. Overall, knowledge scores were moderate. Prescribers had a higher average knowledge score and more proactive attitudes and practices as compared to nonprescribers. Most physicians agreed that FEE management recommendations could improve patients’ recovery speed. There were significant positive correlations between knowledge scores and physicians’ attitudes toward the importance of FEE management awareness, the importance of FEE management for patient recovery, and a physician’s perception that FEE drinks improved patients’ recovery time. There was no significant correlation between knowledge score and practices. Conclusion: There may be benefits from improving the knowledge of physicians in India in FEE management and developing guidelines for the use of FEE drinks in acute nondiarrheal illnesses. Further research exploring the knowledge–practice gap and evaluating the clinical benefit of FEE drinks in acute nondiarrheal illnesses should also be undertaken to develop such guidelines.Item A Review on Vitamin D Deficiency and Related Disorders: What is the Right Serum Vitamin D Level?(Association of Physicians of India, 2023-05) Bantwal, G.To maintain a healthy skeleton, vitamin D is crucial for phosphate as well as calcium uptake. It is of great significance for maintaining the various adaptive and innate immune response components. To reduce the development of various immune-related disorders, such as diabetes, hypertension, cardiovascular diseases, rheumatoid arthritis, and coronavirus disease 2019 (COVID-19), numerous studies evaluating the optimal threshold levels for serum 25-hydroxyvitamin D [25(OH)D]. It is documented in various evidence to increase the serum 25(OH)D intake from the current mindset of 30–50 ng/mL to attain the best overall vitamin D benefits. These values are in line with the results of various research showing that increased vitamin D intake is linked to a decreased risk of cancer and cardiovascular diseases. Therefore, it becomes vital to understand the “right” vitamin D levels to avoid deficiency along with its related disorders. In contrast to 30 ng/mL, this review emphasizes the significance of increasing vitamin D levels to 50 ng/mL to obtain several physiological benefits. An individual needs at least 60000 IU for 12 weeks to maintain serum vitamin D levels above 30 ng/mL. The article will interest physicians who desire to profit fully from vitamin D’s influence on clinical practice.Item Porencephaly may Present even in Elderly(Association of Physicians of India, 2023-05) Santra, GourangaItem The Correlation of Urine Protein/osmolality and Protein/creatinine Ratio as Predictor of 24-hour Urinary Protein Excretion(Association of Physicians of India, 2023-05) Balar, S; Beke, N; Patki, D; Bahulikar, Arun; Phalgune, DeepakBackground: The drawback of 24-hour urine collection is that it is troublesome, takes a lot of time, and is inaccurate because of collection errors and improper timing. The research in the Indian adult population about the correlation of spot urine protein/osmolality ratio (UPOR) and spot urine protein/creatinine ratio (UPCR) as a predictor of 24-hour urinary protein excretion is lacking. Objectives: To study the correlation of spot UPOR and spot UPCR as the prognosticator of 24-hour urinary protein excretion. Materials and methods: The present cross-sectional observational study was undertaken on 50 patients >18 years of age and of either sex who presented with proteinuria (dipstick test or urine routine) and were advised 24-hour urine protein examination. A 24-hour urine was collected for protein analysis starting from any time of day. Random urine samples were collected and processed for protein, creatinine, and osmolality. The spot UPOR and UPCR were calculated. The sensitivity and specificity were determined. Pearson’s correlation was used to find the correlation. Results: There was a statistically significant positive correlation of UPOR and UPCR (r = 0.418 and r = 0.512, respectively) with 24-hour urinary protein excretion. The sensitivity and specificity of UPOR to predict 24-hour urinary protein at cutoff point 1.32 was 82.3% and 81%, respectively. The sensitivity and specificity of UPCR to predict 24-hour urinary protein at cutoff point 1.09 was 87 and 86%, respectively. Conclusion: For the medical determination of proteins in urine, spot UPOR and UPCR are suitable, cheap, and dependable methods that can substitute the measurement of 24-hour urine protein.Item Study of the Role of Cerebrospinal Fluid C-reactive Protein and Adenosine Deaminase to differentiate Various Types of Meningitis(Association of Physicians of India, 2023-05) Chaurasia, AK; Gupta, P; Mathur, MK; Nagi, ViyaObjective: (1) To study cerebrospinal fluid (CSF) adenosine deaminase (ADA) and CSF C-reactive protein (CRP) levels in the differentiation of viral, pyogenic, and tuberculous meningitis (TBM). (2) To estimate the borderline levels of CRP in CSF in viral, pyogenic, and TBM. Methods: A prospective and cross-sectional study was conducted at the Department of Medicine, SRN Hospital, Prayagraj, Uttar Pradesh, India, between August 2016 and September 2018. In this study, a total of 100 patients with meningitis were included applying specific inclusion and exclusion criteria after proper ethical approval. Results: Out of 100 patients, 61 were TBM, 31 were pyogenic meningitis, and eight were viral meningitis (VM). CSF CRP level was significantly increased in pyogenic meningitis (1.05 ± 0.36 mg/dL) compared to nonpyogenic meningitis [TBM (0.42 ± 0.13 mg/dL) and VM (0.37 ± 0.09 mg/dL)]. At the cut-off level of CRP in CSF > 0.6 mg/dL, its diagnostic sensitivity in pyogenic meningitis was 93.55% and specificity 94.20%. While CSF ADA levels were higher in the TBM group (13.32 ± 3.21 U/L) compared to the other two groups [pyogenic meningitis (6.15 ± 1.27 U/L) and VM (4.86 ± 0.88 U/L)]. At a cut-off, CSF ADA level of >10 U/L, its diagnostic sensitivity for TBM was 91.67% and specificity 90%. Conclusion: Cerebrospinal fluid (CSF) CRP levels were found to be raised in pyogenic meningitis, and CSF ADA was found to be elevated in TBM. While both ADA level and CRP level in CSF are found low in VM.Item Thyroid Function in Newly Diagnosed HIV-positive Patients(Association of Physicians of India, 2023-05) Dutta, SK; Kalita, BC.Background: As of 2019, the highest prevalence of human immunodeficiency virus (HIV) in India is seen in the Northeastern states. Endocrine and metabolic disturbances can occur in HIV infection. Thyroid dysfunction is one of the common endocrinopathies. In HIV infection, thyroid function abnormalities are seen in about 4–35% of adult patients. Thyroid function abnormalities range from overt hypothyroidism, subclinical hypothyroidism, and sick euthyroid syndrome to overt hyperthyroidism. Among them, subclinical hypothyroidism is the commonest abnormality. To our knowledge, there have been no studies from Northeastern India done in this regard. Aims and objectives: To study the thyroid function in newly diagnosed cases of HIV infection attending anti-retroviral therapy (ART) center, Assam Medical College. To estimate the prevalence and types of thyroid dysfunction in newly diagnosed HIV-infected individuals. To study thyroid dysfunctions with respect to age, sex, and cluster of differentiation (CD) 4 count. Materials and methods: Hospital-based observational study was done at a tertiary care centre of upper Assam on newly diagnosed HIV-positive patients who were not started on antiretroviral therapy and who attended the ART centre, Assam Medical College during the period of our study. History, examinations and laboratory investigations, including thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and CD4 count, are done in all such patients, and only those who fulfilled the inclusion and exclusion criteria of our study are taken as study participants, and their findings tabulated. Results and observations: A total of 95 newly diagnosed HIV-positive patients fulfilling the inclusion and exclusion criteria of our study were taken. In our study, a total of 36.84% of the patients had thyroid dysfunction. We got subclinical hypothyroidism, overt hypothyroidism, sick euthyroid syndrome, and overt hyperthyroidism as the types of thyroid dysfunction. Among all the types of thyroid dysfunction, subclinical hypothyroidism was the commonest abnormality in our study. Under sick euthyroid syndrome, we got only low FT3 as the biochemical abnormality. Thyroid dysfunctions were more common in females (42.3%) than males (35.8%) and were more common in the age group of 30–39 years. In the present study, among patients with thyroid dysfunction, it was seen that 51.43% of the patients had a CD4 cell count in the range 101–200 cells/mm3, whereas only 11.43% of patients had a CD4 cell count in the range <50 cells/mm3 and no patient had a CD4 cell count >500 cells/mm3 . Conclusion: In our study, we found that thyroid dysfunctions were common in newly diagnosed HIV-positive patients, the prevalence of which was much higher in the general population. Thyroid dysfunction was present in all the stages of the HIV disease.