Reviewer's report
Title:Correlations of CD4 counts, enteric protozoan infestation and seasonal
variations in AIDS patients - An experience of a tertiary care hospital in Varanasi
(India)
Version: 1Date:4 March 2008
Reviewer: Klaus Mönkemüller
Reviewer's report:
Tuli et al report on the etiology of acute and chronic diarrhea in a cohort of
patients from North India. The study is well conducted, well written and
informative.
Although there are similar studies from other parts of the world already
published, it is important to additionally publish data such as Tuli’s et al. to better
comprehend the complications due to the AIDS pandemic.
Major comments:
Methods: were these consecutive patients? Please clarify.
What were the inclusion and exclusion criteria?
Positive aspect of the study: stool was collected from family members. I would
expand on this in the discussion.
36% of patients on ART showed immune restitution. How was immune restitution
defined. How many patients were on ART? How many were on HAART?
Results:
In how many patients were antiretroviral potential culprits for the diarrhea.
Discussion:
Could it be that because you did not perform colonoscopy that you did not find
Cytomegalovirus? I would add this important aspect in the discussion. I would
also add the study of Blanshard et al showing that the more stool samples you
collect and the more invasive you look (i.e. EGD and colonoscopy) the more you
find. Certainly, discussing this will not decrease your chances of publishing your
study, but it needs to be clear that only stool sampling is NOT enough to
completely solve the question of the etiology of diarrhea.
Could you discuss on why Ascaris was less common in HIV positive patients?
It appears that CD4 counts did not correlate with the occurrence of Cyclsopora
cayetanensis. Please comment.
Minor comments:
Abstract: Background confusing, pelase clarify (simplify what your are trying to
say)
Background:
What do you mean by Westrn U.P.?
Methods:
HIV positive was defined as HIV1 and HIV2 positivity. Do you mean or (instead of
and)
What next?: Accept after minor essential revisions
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests
Reviewer's report
Title:Correlations of CD4 counts, enteric protozoan infestation and seasonal
variations in AIDS patients - An experience of a tertiary care hospital in Varanasi
(India)
Version: 1Date:4 March 2008
Reviewer: Klaus Mönkemüller
Reviewer's report:
Tuli et al report on the etiology of acute and chronic diarrhea in a cohort of
patients from North India. The study is well conducted, well written and
informative.
Although there are similar studies from other parts of the world already
published, it is important to additionally publish data such as Tuli’s et al. to better
comprehend the complications due to the AIDS pandemic.
Major comments:
Methods: were these consecutive patients? Please clarify.
What were the inclusion and exclusion criteria?
Positive aspect of the study: stool was collected from family members. I would
expand on this in the discussion.
36% of patients on ART showed immune restitution. How was immune restitution
defined. How many patients were on ART? How many were on HAART?
Results:
In how many patients were antiretroviral potential culprits for the diarrhea.
Discussion:
Could it be that because you did not perform colonoscopy that you did not find
Cytomegalovirus? I would add this important aspect in the discussion. I would
also add the study of Blanshard et al showing that the more stool samples you
collect and the more invasive you look (i.e. EGD and colonoscopy) the more you
find. Certainly, discussing this will not decrease your chances of publishing your
study, but it needs to be clear that only stool sampling is NOT enough to
completely solve the question of the etiology of diarrhea.
Could you discuss on why Ascaris was less common in HIV positive patients?
It appears that CD4 counts did not correlate with the occurrence of Cyclsopora
cayetanensis. Please comment.
Minor comments:
Abstract: Background confusing, pelase clarify (simplify what your are trying to
say)
Background:
What do you mean by Westrn U.P.?
Methods:
HIV positive was defined as HIV1 and HIV2 positivity. Do you mean or (instead of
and)
What next?: Accept after minor essential revisions
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Correlations of CD4 counts, enteric protozoan infestation and seasonal
variations in AIDS patients - An experience of a tertiary care hospital in Varanasi
(India)
Version: 1Date:4 March 2008
Reviewer: Klaus Mönkemüller
Reviewer's report:
Tuli et al report on the etiology of acute and chronic diarrhea in a cohort of
patients from North India. The study is well conducted, well written and
informative.
Although there are similar studies from other parts of the world already
published, it is important to additionally publish data such as Tuli’s et al. to better
comprehend the complications due to the AIDS pandemic.
Major comments:
Methods: were these consecutive patients? Please clarify.
What were the inclusion and exclusion criteria?
Positive aspect of the study: stool was collected from family members. I would
expand on this in the discussion.
36% of patients on ART showed immune restitution. How was immune restitution
defined. How many patients were on ART? How many were on HAART?
Results:
In how many patients were antiretroviral potential culprits for the diarrhea.
Discussion:
Could it be that because you did not perform colonoscopy that you did not find
Cytomegalovirus? I would add this important aspect in the discussion. I would
also add the study of Blanshard et al showing that the more stool samples you
collect and the more invasive you look (i.e. EGD and colonoscopy) the more you
find. Certainly, discussing this will not decrease your chances of publishing your
study, but it needs to be clear that only stool sampling is NOT enough to
completely solve the question of the etiology of diarrhea.
Could you discuss on why Ascaris was less common in HIV positive patients?
It appears that CD4 counts did not correlate with the occurrence of Cyclsopora
cayetanensis. Please comment.
Minor comments:
Abstract: Background confusing, pelase clarify (simplify what your are trying to
say)
Background:
What do you mean by Westrn U.P.?
Methods:
HIV positive was defined as HIV1 and HIV2 positivity. Do you mean or (instead of
and)
What next?: Accept after minor essential revisions
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests
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