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   2012| March-April  | Volume 5 | Issue 2  
    Online since May 10, 2012

 
 
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CASE REPORTS
Oral myiasis
Atul P Sattur, Meera Kulkarni, Arpita Rai, Venkatesh G Naikmasur
March-April 2012, 5(2):130-132
DOI:10.4103/1755-6783.95970  
Oral myiasis is a rare condition characterized by infestation of tissues and organs of animals and humans with the larvae of Dipteran flies. Oral myiasis has been previously ascribed to poor oral hygiene, alcoholism, senility, supparative lesion, neoplasia and in patients with neuro-psychiatric defecits. The aim of the present paper is to report a case of oral myiasis involving the anterior palate in a schizophrenic patient and to discuss the importance of its diagnosis and management in clinical oral practice. Medical personnel taking care of old or debilitated patients, especially those with neurologic deficit need to bear in mind the possibility of infestation with Dipteran flies' larvae to be able to make a prompt diagnosis and implement relevant intervention to prevent extensive tissue destruction.
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A rare case of staphylococcal cold abscess of anterior chest wall in an immunocompetent adult
Sibes Kumar Das, Anirban Das, Sunanda Dey
March-April 2012, 5(2):142-144
DOI:10.4103/1755-6783.95977  
Staphylococcus aureus is an important causative organism for skin and soft tissue infection, which presents with the classical local signs of acute inflammation. Staphylococcal abscess without signs of inflammation (staphylococcal cold abscess) is a very rare entity, sometimes seen in immunocompromised host. Here, we report a case of a 50-year-old male patient who presented with bilateral asymptomatic cold abscess of staphylococcal origin over the anterior chest wall. The patient had no immunodeficiency and there was no distant/underlying source of staphylococcal infection. Smear and culture of pus proved the staphylococcal etiology and excluded tuberculosis, its close differential diagnosis. The patient was treated with antistaphylococcal antibiotics and local drainage of pus with complete recovery.
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A case of Plasmodium vivax malaria associated with severe autoimmune hemolytic anaemia
Dinesh Singh, Vivek Gupta, Sourya Acharya, Satish N Mahajan, Anuj Verma
March-April 2012, 5(2):133-136
DOI:10.4103/1755-6783.95972  
Anemia in malaria is multifactorial. Autoimmune hemolysis is an extremely rare cause of anemia in malaria and more so in vivax malaria. A 35-year-old female presented to us with fever and anemia. She was diagnosed as vivax malaria with autoimmune hemolytc anemia by a positive Direct Coomb's test. We treated her with antimalarial durgs, corticosteroids, and transfused her with the least incompatible blood. The patient recovered and was discharged. Hence, we suggest that autoimmune hemolysis be considered an important cause of anemia in Plasmodium vivax (P. vivax) malaria.
  6,047 17 2
ORIGINAL ARTICLES
Bacterial and clinical profile of diabetic foot patients
Sageera Banoo, DS Shubha, V Shashidhar, D Venkatesha
March-April 2012, 5(2):69-73
DOI:10.4103/1755-6783.95952  
Background and Objective: Diabetic foot ulceration is a multifactorial process involving various intrinsic complications of diabetes mellitus which cause injury to the foot at risk. The diabetic foot ulcer infections are polymicrobial in nature. Failure to recognize and control of the infectious process may have devastating consequences of limb amputation, sepsis, and mortality. Hence, the study was undertaken to determine the bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques and the antimicrobial sensitivity pattern of the isolates. Materials and Methods: A total of 100 patients with diabetic foot ulcer of Wagner's grade I and above were included in the study. Pus and tissue biopsy were collected for bacteriological study. The specimen was processed in the microbiology laboratory for Gram stain, aerobic culture, and anaerobic culture. The organisms isolated were identified by standard procedures and antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method. Results: A total of 187 organisms were isolated, with an average of 1.87 organisms per specimen. Pseudomonas sp, 36 (21.9%), was the most common aerobic organisms isolated followed by Klebsiella sp, 32 (19.4%). Anaerobic organisms isolated were 22 (11.77%). The predominant anaerobic organisms isolated were Peptostreptococcus sp, 10 (45.5%). All the aerobic Gram-negative organisms were sensitive to imipenem (100%). Gram-positive organism was 100% sensitive to vancomycin. Methicillin resistant staphylococcus aureus (MRSA) was seen in 66.7%. All the anaerobes were sensitive to metronidazole, clindamycin, cefoxitin, and penicillin G . Conclusion: Pseudomonas was the most common organism isolated in our study. MRSA was seen in 66.7% of the isolate.
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Prevalence of non-albican candida infection in Maharashtrian women with leucorrhea
Seema M Bankar, Rajaram M Powar, Sunanda A Patil, Sneha G Kalthur
March-April 2012, 5(2):119-123
DOI:10.4103/1755-6783.95967  
Background: Candida is the most common agent causing leucorrhea affecting the women of all strata. It is becoming difficult to completely eradicate the infection mainly due to recurrence caused by non-albican species of Candida. Most of the non-albican species of Candida are resistant to commonly used antifungal agent - azole. Therefore, studying the prevalence of Candida species in vaginal secretion is of great significance. Objective: To study the prevalence of different species of Candida and the efficiency of different Candida detection methods in women from low socio-economic setup of Miraj and Sangli, Maharashtra, India. Materials and Methods: The study was conducted on 150 patients with specific complaints of leucorrhea. In the control group, 50 asymptomatic women were included for comparison. Results: In 33% of the women the leucorrhea was due to Candida infection with highest incidence in women of sexually active age (20-40 years). Sabouraud's culture was the most efficient method (100% efficiency) to detect the Candida compared to wet mount, KOH and gram stain method. Candida albicans was the most common strain identified and Candida krusei was the least common one. Conclusion: Candida infection is the commonest reason for leucorrhea and non-albican candida species significantly contribute to candidiasis in women of Miraj and Sangli.
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Epidemiology of measles outbreaks in Kerala, India, during 2007-2008
Tony Lawrence, Thekkumkara Surendran Nair Anish, Krishnapillai Vijayakumar, Reshmi Ramachandran, Erath T Suchithra, Renjini S Rajasi
March-April 2012, 5(2):89-93
DOI:10.4103/1755-6783.95957  
Context: Measles imparts high morbidity and mortality in low-income countries with weak health infrastructure. The coverage of measles vaccination in Kerala which is best performing state of India in indicators of health has also not reached the elimination level and outbreaks of measles continue to occur. Aim: The aim of the paper was to study the profile of measles outbreaks in Kerala during the years 2007-2008. Settings and Designs: The study design was cross-sectional and data of the measles surveillance project of Kerala were analyzed . Results: The total number of clinically suspected measles outbreaks in Kerala during the 2-year period of 2007 and 2008 was 29. But only 15(53.6%) were found to be 'measles only' outbreak. The total number of epidemiologically linked measles cases was 718 (314 in 2007 and 404 in 2008). The cases that were immunized but developed the disease were 187 (28.6%), the number of cases that were not immunized was 355 (54.3%) and those whose immunization status was unknown were 112 (17.1%). The mean age of occurrence of disease was higher in the vaccinated group as compared to not vaccinated group. Two deaths were recorded in the study. Conclusions: Significant morbidity and mortality due to measles do occur in the most developed state of India. The epidemics were clustered in some districts. The study indicated an age shift in occurrence of measles cases among who received the vaccination.
  5,030 11 3
Pulmonary bacterial and fungal infections in human immunodeficiency virus patients: A study from India
K Shreevidya, Meena Dias
March-April 2012, 5(2):80-84
DOI:10.4103/1755-6783.95954  
Background: Human Immunodeficiency Virus (HIV)-reactive patients are more prone to infections. The morbidity and mortality in HIV-reactive patients is due to opportunistic infections. Most of the infections seen in Acquired Immunodeficiency Syndrome are endemic to that geographical region. Hence, this study was undertaken to document the occurrence of pulmonary bacterial and fungal infections in HIV patients. Materials and Methods: Expectorated and induced sputum samples were collected from 100 HIV-reactive patients and processed for bacterial and fungal pathogens including Pneumocystis carinii. Results: Of 100 samples, 66 were culture positive. Among the isolates, Mycobacterium tuberculosis constituted the highest number, 55 (83.3%), followed by other bacterial infections, 11 (16.6%), and fungi, 2 (3.03%). Tuberculosis patients had a CD4 count of less than 250 cells/μl with a mean count of 186 cells/μl and those with bacterial infections had a CD4 count of more than 300 cells/μl. The study showed that males were infected with HIV more than females and most of them belonged to the adult age group in the prime of their working life. Weight loss followed by fever and cough were the most common symptoms. Conclusion: M. tuberculosis is the most common opportunistic pathogen followed by bacterial pathogens infecting the lung in HIV. Low CD4 count is a dangerous signal of decreased immune status and higher chances of opportunistic infections and high mortality.
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CASE REPORTS
Rhinosporidiosis: A case report with review of literature
Suresh Babu, A Anuradha, Sathish Chandra, Bina Kashyap
March-April 2012, 5(2):127-129
DOI:10.4103/1755-6783.95969  
Rhinosporidiosis is a chronic infestation by the fungus Rhinosporidium seeberi, which predominantly affects the mucus membranes of the nose and nasopharynx. We report a case of rhinosporidiosis with presentation as a mass extending up to the oropharynx. Functional endoscopic sinus surgery was performed.
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ORIGINAL ARTICLES
Socioeconomic factors associated with compliance with mass drug administration for lymphatic filariasis elimination in Kenya: Descriptive study results
Doris W Njomo, M Amuyunzu-Nyamongo, Dunstan A Mukoko, Japheth K Magambo, Sammy M Njenga
March-April 2012, 5(2):103-110
DOI:10.4103/1755-6783.95962  
Background: Annual Mass Drug Administration (MDA) to at least 65 - 80% of the population at risk is necessary for Lymphatic Filariasis (LF) elimination. In Kenya, MDA based on diethylcarbamazine and albendazole, using the community-directed treatment (ComDT) approach has been implemented thrice in the Kwale and Malindi districts. To identify the socioeconomic factors influencing compliance with MDA, a retrospective cross-sectional study was conducted in the two districts after the 2008 MDA. Materials and Methods: In Kwale, the Tsimba location was selected for high and Gadini for low coverage, while in Malindi, the Goshi location represented high and Gongoni, low coverage. Using systematic sampling, nine villages were selected from the four locations. Quantitative data was collected from 965 systematically selected household heads and analyzed using SPSS v. 15. For qualitative data, which was analyzed manually according to core themes of the study, 80 opinion leaders and 80 LF patients with clinical signs were purposively selected and interviewed, and 16 focus group discussions (FGDs) conducted with adult and youth male and female groups. Results: Christians were slightly more (49.1%) in the high compliance areas compared to Muslims (34.3%), while Muslims prevailed (40.6%) in the low compliance areas compared to Christians (29%). On the income level, 27% from the low compared to 12.2% from the high compliance areas had a main occupation, indicative of a higher income, and 95% from the low compared to 78% from high compliance areas owned land, also an indicator of higher economic status. Accurate knowledge of the cause of swollen limbs was higher (37%) in the high compared to 25.8% in the low compliance areas, and so was accurate knowledge about the cause of swollen genitals (26.8% in high compared to 14% in low). Risk perception was higher in the high compliance areas (52% compared to 45%) and access to MDA information seemed to have been better in the high compared to low compliance areas. Patients from the high compliance areas had a higher mean number of years with chronic disease (15.2 compared to 9.7). Conclusions: There is a need for more investment in reaching out to groups that are often missed during MDAs. Different strategies have to be devised to reach those in specific religious groupings and those in casual employment. This could include prolonging the duration of MDA to capture those who are out during the week seeking for casual and other forms of employment.
  3,823 13 3
NEWS AND FILLER
Chronic co-morbidities associated with depression in elderly
Ankur Barua, Mihir K Ghosh, Nilamadhab Kar, Mary A Basilio
March-April 2012, 5(2):145-148
Background: Depression is a common mental health problem in the elderly population of the world. Objective: To study the chronic co-morbid conditions associated with depression in elderly population. Materials and Methods: A systematic review was conducted on 74 community-based mental health surveys on depression in elderly which were conducted in continents of Asia, Europe, Australia, North America, and South America. All the studies were conducted between 1955 and 2005. The researchers had included only community-based cross-sectional surveys and some prospective studies that had not excluded depression on baseline. These studies were conducted on homogenous community of elderly population in the world, who were selected by simple random sampling technique. A qualitative analysis on 11 of these articles was conducted to study the chronic co-morbidities associated with depression in elderly. Results and Conclusion: The univariate analysis results from 11 studies on various chronic co-morbid conditions associated with depression in elderly revealed that depression in elderly was significantly associated with arthritis, cognitive impairment, visual impairment, functional impairment, and restricted activities of daily living (ADL). The prevalence of depression followed an increasing trend as the number of chronic co-morbidities increased.
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ORIGINAL ARTICLES
Behavioral pattern of menopausal Nigeria women
Mohammed J Saka, Rakiya Saidu, Abdulgafar Jimoh, Tanimola Akande, Abdul W Olatinwo
March-April 2012, 5(2):74-79
DOI:10.4103/1755-6783.95953  
Context : Menopause is one area that has been shrouded in myths and taboos and the way women perceive menopause depends largely on the social belief about menopause in their society. Objective : The aims of this study are to assess how women perceived the physical changes during menopause, what the social as well as the individual adjustment practice to menopausal changes might be. Materials and Methods : Qualitative focal group study among women aged 40 years and above where eight to ten volunteers formed a group. Six sessions were held for different focal group, each lasting 1-2 h. A tape recorder and a notepad were used to record the discussions. Opinions of the women were sought on socio-cultural differences in the perception of aging, perception of menstruation, perceived causes and consequences of menopause, sexual intercourse after menopause, social support networks for menopausal women, and types of care and treatment for women in menopause. Results: The participants in the FGDs used various phrases to describe menopause in local term; while some of the participants attributed disease to be a cause of menopause, others believed that it be could be caused by witchcraft or sorcery. However, younger and old women whose menstrual flow stops prematurely seek assistance, often from traditional or spiritual healers. Conclusion: This study reveals the poor menopausal knowledge among the study group with more than half of the respondents having negative attitude towards menopause in addition to mixed feelings about religious obligation and cohabitation.
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Characterization and antimicrobial susceptibility pattern of clinical isolates of Enterococci at a tertiary care hospital in Mumbai, India
Rupali S Shinde, Geeta V Koppikar, Seema Oommen
March-April 2012, 5(2):85-88
DOI:10.4103/1755-6783.95956  
Context: Enterococcus is considered an important nosocomial pathogen because of its intrinsic as well as acquired antibiotic resistance. It also has the potential of transferring vancomycin resistance to other organisms such as Listeria monocytogens and Staphylococcus aureus. Aims: The objective of the present study was to determine antibiotic-resistance pattern of Enterococcus with special reference to vancomycin. Settings and Design: A total of 54 clinical isolates of enterococci were collected during the study period of 1 year at a tertiary care center in Mumbai. Material and Methods: Speciation and antibiotic sensitivity testing were done by standard procedures. Minimum inhibitory concentration (MIC) to vancomycin was carried out by agar dilution method. Results: Speciation and antibiotic sensitivity testing were done by standard procedures. The MIC to vancomycin was done by agar dilution method. Conclusions: Vancomycin, Linezolid, and Teicoplanin can be safely used for the treatment of serious enterococcal infections.
  3,443 15 1
CASE REPORTS
Osteomyelitis variolosa with fracture: A unique case report
Pradeep K Singh
March-April 2012, 5(2):124-126
DOI:10.4103/1755-6783.95968  
Smallpox has been eradicated completely but its unique pathology and sequlae are still found in routine clinical practice. We present a report of a patient having osteomyelitis variolosa in both elbow joints and wrist with fracture of humerus. The condyles were typically elongated as central portion of distal humerus absorbed. The fracture united uneventfully following stabilization with dynamic compression plate and bone grafting. Patient had satisfactory elbow function at the end of the last follow-up.
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Staphylococcal tricuspid valve endocarditis in a non-addicted patient with structurally normal heart
Sibes K Das, Tapan D Bairagya, Somnath Bhattacharaya, Bhabani Prasad Chottopadhaya
March-April 2012, 5(2):139-141
DOI:10.4103/1755-6783.95975  
Tricuspid valve endocarditis in non-addicted patients without underlying cardiac disease is extremely rare. Therefore, its diagnosis often presents a clinical challenge. We report a case of a 24-year-old female who presented with bilateral lower lobe cavitary pneumonia. She remained febrile in spite of 5 days of intravenous antibiotic therapy. On subsequent investigations, she was found to have isolated tricuspid valve endocarditis caused by Staphylococcus aereus. She was not an intravenous drug abuser and there was no underlying cardiac disease. She responded well to medical therapy. We report this case because of rarity of tricuspid valve endocarditis is a non-addicted person with structurally normal heart and its atypical presentation with paucity of cardiac symptoms at initial stage.
  2,930 15 -
ORIGINAL ARTICLES
Highly sensitive C reactive protein in patients with metabolic syndrome and cardiovascular disease
Mukta N Chowta, Prabha M Adhikari, Rishav Sinha, Sahana D Acharya, HN Gopalakrishna, John T Ramapuram
March-April 2012, 5(2):98-102
DOI:10.4103/1755-6783.95960  
Context: Although there are several studies reported in the western literature regarding the association of C reactive protein (CRP) level with components of metabolic syndrome, data in the Indian population were lacking. As there will be a considerable difference in the profile of risk factors for cardiovascular diseases (CVDs), studies regarding the correlation of CRP level with cardiovascular risk factors and metabolic syndrome in the Indian population are required. Objective: To correlate the highly sensitive CRP (hsCRP) level to individual components of metabolic syndrome and coronary vascular disease. Materials and Methods : Forty patients who were diagnosed clinically with metabolic syndrome were included in the study. Detailed history with regard to diabetes mellitus, hypertension and other CVD was collected from each patient. All the patients underwent complete physical examination, including ECG. Height, weight, fasting blood glucose and lipid levels were measured in all the patients. CVD was assessed with the following: new-onset angina, fatal and non-fatal myocardial infarction or stroke, transient ischemic attack, heart failure or intermittent claudication. Results: The mean hsCRP level was higher in patients with CVD compared with those without CVD. The CRP level correlation with CVD showed a statistically significant correlation. hsCRP level was very high in eight hypertensive patients, whereas it was very high in five normotensives. But, statistical analysis has not shown any significant correlation between hypertension and hsCRP level. Similarly, although a higher hsCRP level was seen in diabeteics, statistical analysis failed to show a significant correlation between diabetes and the hsCRP level. Analyses of hsCRP correlation with body mass index, fasting glucose, cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein did not show a significant correlation with the hsCRP level. Conclusions: Increased hsCRP levels are associated with an increase in the incidence of CVDs. Higher values of hsCRP were observed in patients with hypertension and diabetes. No correlation was seen between hsCRP and components of the metabolic syndrome.
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Clinico-radiological profile and treatment outcomes in neurocysticercosis: A study of 40 patients
Tushar B Patil, Madhuri M Paithankar
March-April 2012, 5(2):63-68
DOI:10.4103/1755-6783.95951  
Aims: This study was aimed to study the clinical and radiological profile of neurocysticercosis and outcomes of treatment in neurocysticercosis. Settings and Design: A prospective observational study in a tertiary care hospital. Methods and Material: A total of 40 patients coming under definitive or probable diagnosis of neurocysticercosis as per the revised diagnostic criteria for neurocysticercosis were included in this study. Clinical history, physical examination, and neuroimaging (CT or MRI) studies were done at the beginning. Patients were treated with albendazole, corticosteroids, and antiepileptic drugs. They were followed up clinically for 3 months and neuroimaging study was repeated 3 months after albendazole therapy. Results: Definitive cases were 28 (70%) and probable cases were 12 (30%). Male: female ratio was 2.07. Mean age of 29.62 ± 9.08 years. The commonest presentation was seizures in 38 (95%). Twenty-nine (72.5%) patients had a single lesion and 11 (27.5%) had multiple lesions in initial imaging study. Commonest site of lesion was parietal lobe (45%). Most common stage of presentation was colloidal (55%). Thirty-seven (92.5%) patients were free of seizures at the end of three months. At the end of 3 months, 23 (57.5%) patients had radiological resolution (Complete resolution + partial resolution + calcification). Conclusions: Neurocysticercosis usually affects young persons, mostly in third decade, being equally common among vegetarians. Most common clinical manifestation is seizures. Single lesion is more common than multiple lesions, commonly presenting in colloidal. Clinical and radiological response to 4-week therapy with albendazole is quite satisfactory. All cases of young- and adult-onset epilepsy in tropical countries should be investigated for neurocysticercosis.
  2,466 14 -
GUEST EDITORIAL
Domestic accidents among the elderly
Gajanan D Velhal
March-April 2012, 5(2):61-62
DOI:10.4103/1755-6783.95950  
  2,240 12 -
ORIGINAL ARTICLES
Cardiovascular health promotion in schools of Delhi, India: A baseline evaluation of environment and policies
Ravneet Kaur, Puneet Mishra, Davender Kumar Taneja
March-April 2012, 5(2):114-118
DOI:10.4103/1755-6783.95965  
Background: Cardiovascular diseases (CVDs) are one of the most common causes of morbidity and mortality. Most of the risk factors of CVDs develop early in childhood. Schools immensely influence the thinking pattern of students and can thus shape their behavior. However, no amount of knowledge and awareness can change health behaviours of students until they get support from enabling environment in the schools. The Ottawa charter has also emphasized on building healthy public policy and creating supportive environments for health promotion in schools. Materials and Methods: The present study was conducted in 10 schools in Delhi, India. School policies, environment, community participation and approach of school health agency were assessed by interviewing authorities, review of related documents and direct observation in schools. Results: It was found that none of the schools had any written health policy. Environment in most of the schools was not conducive for cardiovascular health promotion. Conclusion: The study highlights that the schools lack health policies and environment for cardiovascular health and also points out the approach of school health agency, focusing on medical check-ups and treatment of minor illnesses.
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Thyroid disorders in adult Nigerians with palpitations
Mathias A Emokpae, Humphrey B Osadolor, Henry O Uwumarongie
March-April 2012, 5(2):111-113
DOI:10.4103/1755-6783.95964  
Background: Thyroid hormones elicit significant cardiovascular effects, and abnormalities of its concentration may lead to palpitations. This study seeks to evaluate the prevalence of thyroid hormone disorders in adult Nigerians with palpitations. Materials and Methods : A total of 62 patients (20 males, aged 36.8 ± 10.0 years and 42 females, aged 39.3 ± 9.9 years) with palpitations referred to the chemical pathology laboratory for biochemical analysis from June 2002 to May 2007 were retrospectively studied. All blood specimens were routinely collected in the morning in fasting state. The thyroid function parameters were analyzed using ELECSYS 1010 autoanalyzer supplied by Roche Diagnostics, Germany. The analyzer uses the principle of electrochemiluminescence immunoassay technique. Results : Out of the 62 patients, 10 (4 males and 6 females) had thyroid disorders representing a prevalence of 16.1%. Conclusions: Prevalence of 16.1% was observed in patients with palpitations. More women than men were observed to have palpitations and the ratio of proportion of thyroid disorders between male and female was 2:3.
  1,743 11 -
CASE REPORTS
Isolated tuberculous liver abscess in an immunocompetent patient
Jyothi B Shetty, VL Prabhu, Amitha S Joshi, Dhanashri V Kulkarni
March-April 2012, 5(2):137-138
DOI:10.4103/1755-6783.95974  
Tuberculosis of the liver is rare and is generally seen as a part of disseminated tuberculosis. With the advent of HIV, isolated tuberculous involvement of the liver has been seen. Here we report a case of isolated tuberculous liver abscess in an immunocompetent patient.
  1,675 13 -
ORIGINAL ARTICLES
Seroprevalence of subclinical HEV infection in asymptomatic, apparently healthy, pregnant women in Dakahlya Governorate, Egypt
Yahia Z Gad, Nasser Mousa, Maher Shams, Ahmed Elewa, Hala A Al-Adrosy, Abd-Elmohsen E El-desoky, Nancy A Ahmad
March-April 2012, 5(2):94-97
DOI:10.4103/1755-6783.95959  
Background/Aim: Hepatitis E virus (HEV) is a major public health problem in the developing countries. HEV infection in pregnant women is more common and fatal in the third trimester. The present study was designed to determine the seroprevalence of subclinical HEV infection in asymptomatic pregnant women. Materials and Methods: A total of 116 asymptomatic pregnant women divided into group 1, including 56 pregnant women with hepatitis C virus (HCV)-positive serology and group 2, including 60 pregnant women with negative HCV serology were included in this study. The prevalence of anti-HEV antibodies and anti-HCV was determined by an enzyme-linked immunosorbent assay (ELISA) kit. Results : The o verall prevalence of anti-HEV IgG was highly significant among pregnant women with chronic HCV infection [40/56 (71.42%)] than in pregnant women free from chronic HCV infection [28/60 (46.7%)] (P = 0.006). Chronic HCV infection in pregnant women appeared to be a risk factor associated with HEV IgG seropositivity (OR = 2.86, CI = 1.24-6.6 ) . The seropositivity of anti-HEV IgG was significantly high in rural areas than in urban areas (62.5% versus 37.5%) in group 1 and (78.58% versus 21.42%) in group 2 (P = 0.15) (OR = 2.2, CI = 0.65-7.7). A significant decrease in albumin (P = 0.047) and increase in bilirubin (P = 0.025), ALT (P = 0.032) and AST (P = 0.044) in pregnant women with positive HCV and IgG anti-HEV than in the second group with negative HCV serology was noted. Conclusions : The seroprevalence of anti-HEV IgG in pregnant women is high in Egypt, especially in the rural areas. With chronic HCV coinfection, marked increase in anti-HEV IgG seropositivity and significant worsening of the biochemical liver indices were noted. Increased public awareness about sound hygienic measures for a lower prevalence of HEV is strongly advised. The need for HEV vaccination for those at risk, especially pregnant ladies, should be considered.
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EDITORIAL COMMENTARY
To publish or not to publish?
Abubakar Yaro
March-April 2012, 5(2):59-60
DOI:10.4103/1755-6783.95948  
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