CASE REPORTS Case - 1 Mr. S..S, aged about 25 years uneducated agriculture labor lives 30 kms away from the hospital presented on 07/03/2006 with H/O – fever Generalized lymphedinopathy since 2 months H/O exposer to CSW 3 years back No H/O blood transfusion / surgery. On examination : Febrile, anemic with generalized lymphedinopathy B.P 100 / 70, P.R 96 / min R.R 22 / min. Other systemic and genital examination normal. Investigation reviled H.b 9 grams spot test for HIV and western blot test positive CXR-PA-normal. After tharough counseling and written consent – patients started on NONI health henasner. Patients could not afford anti-retro viral medicines because of poverty. Improvement with in 15 days: - Sense of well being - Good sleep

Improvement with in 1 month : - Skin completion improved - Appetite increased - Weight increased by 1 kg Improved with in 3 months: - Increased weight 2.5 kgs - Lymphnodes size decreased by 50% Viral load brought down by 10,000 from initial load of 1,00,000 CD4 count as increased to 204 from initial reading 153 There is increase of total lymphosite count by 2100 initial of 4140 Improvement with in 6 months - Weight gain by 5.5 kgs - CD4 count 296 viral load 70,000 - Patient feel much better then before.

Case – 2 Mrs. U. a, aged 45 housewife, widow came to the hospital on 25/04/2006 with H/O weakness, loss of weight since 2 months. And fever past 1 month. Husband was HIV positive and died 2 months back. No H/O of blood transfusions / surgery On examination patient was pale, thin built with mild generalized lymphedinopathy BP 110/70, PR 86/min. R.R 16/min, weight 47 kgs. Systemic examination: No significant findings noted. Investigations: H.b 9.4 grams %, spot test for HIV – positive W. Blot positive, CD4 count 95, viral load 5,00,000 total lymphocyte count 2930 / cmm. After counseling and written consent NONI health enhancer was started on the patient.

Improvement with in 15 days: - Developed itching. - Not much clinical changes Improvement with in 1 month: - No itching - Well being - Good sleep - Weight gain by 0.5 kg Improvement with in 3 months: - Feeling happy - Weight gain 2 kgs - Good appetite - Hb increased to 10.5 grams - TLC CD4 count increased by 10.5% (105) - Viral load dropped to 50,000 from 5,00,000

Case – 3 Mrs. V.a. aged 35 years servant maid, came to the hospital on 10/03/2006 with complaints of fever on and off loose motions and weight loss of 4 months duration. Husband died of HIV 2 years back. No blood transfusion or no H/O surgery. General examination : Pallor, Angular stomatitis, scabies, Tinea infection over the skin. BP 100/60 mmHg, PR 100/ min, R.R 20/min System examination : Respiratory system – lungs – occasion crupts + CVS, CNS, GIT normal Investigations : Hb 7.4%, ESR 45, spot test HIV and W.Blot tests are positive. CXR – PA – increased Hila on both side. Viral load 5,00,000 TC 6,500 CD4 count 486 Conformed the diagnosis – counselled the patient, started on NONI after written consent.

Improvement with in 15 days: - No change - Mild cough present Improvement with in 1 month: - Feeling better - Appetite increased - Cough present - Fever present Improvement with in 3 months: - Viral load same - CD4 count Cough present - Fever present CXR – PA same, Montoux positive, Hb 7 grams, ESR 60/1st hour, sputum for AFB negative. Patient was kept on ATT. Patient improve her general condition after starting of ATT.

Improvement with in 6 months: - Appetite good - Skin complexion increased - Hb 9 grams - ESR 50 - Viral load 4,00,000 - CD4 count 235 -Weight gained 3 kgs (initial 45 kgs)

Case – 4 Mrs. L.x aged 35 years, agriculture labor, came to the hospital on 30/05/2006 with the H/O weakness of 1 month duration. Husband died of HIV 2 months back. H/O tubectomy 10 years back. On examination: Thin built, mild lymphedinopathy BP 110/70, PR 80/min, R.R 20/min Systemic generation – no significant Investigations: Hb 10.5 grams, CXR – PR normal, spot test, W.Blot positive. Viral load less then detectable limits, CD4 count 595. After counseling and written consent NONI food supplement was given. Improvement with in 15 days: - Feeling energetic - Good sleep

Improvement with in 1 month: - Weight increased by 0.5 kg - Good appetite Improvement with in 3 months: - Weight gain by 3 kgs (Initial 44 kgs) - Viral load less then detectable limits -CD4 count 608 (increased by 2.1%)

Case-5 Mr. P.r aged 29 years, tailor brought to the hospital on 17/07/2006 with the H/O weight loss and fever. He is known HIV patient since 5 years and having pulmonary TB for the past 4 months. Using ATT irregularly On examination thin built individual, pale, LN. System examination: lungs shows crepts on the left base. Investigations: Viral load 1,50,000, CD4 count -, Hb 9.5 grams, ESR 80 /1st hour CXR – PA - PT After counseling and written consent NONI food supplement was given along with ATT. Improvement with in 15 days: - Feeling better - Appetite increase

Improvement with in 1 month: - Weight gain by 1 kg (Initial 47 kgs) - Cough reduced - No fever

Case – 6 Mrs. R.l aged 30 years, labor, presented on 09/05/2006 with H/O fever, weight loss and loose motions since 3 months. She was diagnosed as HIV 3 years back. Husband died of HIV 1 year back On examination: Thin built with oral and dermal, candidacies. Temperature 1010 F, PR 104/ min, BP 90/70. RR 22/min System examination: No significant findings Investigations: 7.4 grams%, ESR – 45/1st hour, CD4 count 94, viral load 8,00,000 CXR – PA normal. After counseling and written consent NONI food supplement was given.

Improvement with in 15 days: - Feeling energetic - Appetite increase - Skin color improved to fair Patient died because of gastro enteritis with sever dehydration in a remote village when she attend a function on 28th day on 07/06/2006