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   2013| November-December  | Volume 6 | Issue 6  
    Online since September 6, 2014

 
 
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CASE REPORTS
Cyanide poisoning after bitter almond ingestion
Y Mouaffak, F Zegzouti, M Boutbaoucht, M Najib, AG El Adib, M Sbihi, S Younous
November-December 2013, 6(6):679-680
DOI:10.4103/1755-6783.140262  
Plants are responsible for 5% poisoning recorded by Poison Control Centers. Among all known toxic plants, some present a real danger if ingested. We report the case of a five years old child, who presented, after ten bitter almonds ingestion, consciousness disorders progressing to coma with generalized tonic-clonic seizures, miosis and metabolic acidosis. Bitter almonds and nuclei of stone fruits or other rosaceae (apricot, peach, plum) contain cyanogenic glycosides, amygdalin, that yields hydrogen cyanide when metabolized in the body. Swallowing six to ten bitter almonds may cause serious poisoning, while the ingestion of fifty could kill a man. The binding of cyanide ions on cytochrome oxidase lead to a non hypoxemic hypoxia by blocking the cellular respiratory chain. Therapeutic measures include, oxygen support, correction of acidosis and cyanide antidote by hydroxocobalamin in case of serious poisoning.
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ORIGINAL ARTICLES
Gastric aspirate smear microscopy as a diagnostic tool for childhood pulmonary tuberculosis
Eziyi Iche Kalu, Chiedozie Kingsley Ojide, Nwadike Victor Ugochukwu
November-December 2013, 6(6):608-613
DOI:10.4103/1755-6783.140218  
Background: Most tuberculosis (TB) control programs use positive sputum Ziehl-Neelsen (Z-N) smear microscopy results as a basis for TB case confirmation, valid enough to warrant commencement of treatment. Children do not only produce poor quality sputum a proportion cannot produce sputum, at all. Gastric aspirate (GA) smear microscopy, a recommended alternative, is the only available bacteriologic test in most health-care institutions. Objectives: This study was aimed to determine the usefulness of acid fast smears of GA for the diagnosis of pulmonary TB in children. Materials and Methods: A total of 263 GA samples from children with suspected pulmonary TB underwent Z-N staining and culture on Ogawa medium. Acid-fast isolates on Ogawa medium were sub-cultured on Ogawa medium containing para-nitrobenzoic acid (PNBA-Ogawa medium). Lack of growth on PNBA-Ogawa confirmed Mycobacterium tuberculosis complex (MTBC) and ruled out non-tuberculous mycobacteria. Validity parameters were calculated with GA culture as "Gold standard". Results: GA samples from 33 (12.5%) of the 263 patients were smearing positive. However, GA culture on Ogawa medium was positive for MTBC in 97 (37%) of the 263 patients. Twenty-nine of the 97 culture-positive GA were also Z-N smear-positive, giving a GA Z-N smear sensitivity of 29.9%. Of the166 culture-negative cases, 162 were Z-N smear-negative, giving a GA Z-N smear specificity of 97.6%. Positive- and negative-predictive values were 88% and 70% respectively. Conclusion: GA smear microscopy is highly specific for diagnosis of pulmonary TB in children. The test can be useful in culture facility-limited settings as acceptable sensitivity can be achieved if specimen collection/handling protocols are strictly adhered to.
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CASE REPORTS
An unusual case report showing combination of melanotic oral pigmentation and nonspecific ulcer in human immunodeficiency virus positive patient
Mayur Chaudhary, Shweta Dixit Chaudhary, Anuraag Choudhary
November-December 2013, 6(6):664-667
DOI:10.4103/1755-6783.140250  
Human immunodeficiency virus (HIV) infection has caused a severe degree of morbidity and mortality amongst the individuals worldwide. Those affected usually belong to low socioeconomic status especially from developing countries like India. There are numerous diagnostic criteria and thousands of tests to detect HIV positivity. One such criterion is European Commission Clearinghouse, wherein HIV positivity may be detected by thorough clinical observation of the oral cavity. This criterion is being followed worldwide and has been proven to be effective for dental professionals and general physicians, as it is stated that these oral lesions precede the other lesions of HIV positivity. We report one such case of unusual combination of melanotic hyperpigmentation and nonspecific ulcer in an adult patient, where HIV positivity was confirmed later by Western blot. To our knowledge, none such case has been reported in literature previously.
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ORIGINAL ARTICLES
Bacteriological analysis of drinking water in relation to diarrheic illness in and around Khammam
Basavaraju Anuradha, D Praveena
November-December 2013, 6(6):618-621
DOI:10.4103/1755-6783.140222  
Background: Drinking water is a major source of microbial pathogens in developing regions although, poor sanitation and food sources are integral to enteric pathogen exposure. Poor water quality, sanitation and hygiene are responsible for the majority of deaths a year world-wide and mainly through infectious diarrhea. Objectives: The objectives of this study were to evaluate the bacteriological quality of drinking water at the source and point of use, to analyze the relationship between the presence of bacteria in water and diarrheic illness. Materials and Methods: A cross-sectional study was conducted on 100 water samples collected from various sources-bore wells, municipal tap waters, wells, and mineral water plants and also from storage containers in the house. Simultaneously, stool samples were also collected from households and processed. Results: Out of 100 water samples majority of them were consuming municipal water 16 (32%), followed by mineral water 14 (28%). For storage majority of them were using the candle filter 17 (34%), followed by steel containers 13 (26%). Escherichia coli was isolated in candle filters in the majority of cases 10 (29.4%), Enterobacter isolated in steel containers 6 (23%). Only in 50% diarrheal cases similar bacteria were observed both in water and stool samples. Conclusion: Water has become non-potable after storage due to various hygienic practices. Water may get contaminated at various levels, which is responsible for diarrheic illness. Safe water is essential for health. An efficient and well-maintained distribution system coupled with good hygienic practices would ensure that water is safe at the point of collection and before consumption.
  5,107 9 -
REVIEW ARTICLE
Ethics in medical education, practice, and research: An insight
KV Ramana, Sabitha Kandi, Prabhakar Rao Boinpally
November-December 2013, 6(6):599-602
DOI:10.4103/1755-6783.140200  
A combination of moral principles and values that are applied to take judgements in medical education, practice, and research are termed as medical ethics. There have been other many traditional medical ethics guidelines brought about by Muslim Ishaq ibn Ali al-ruhawi wrote "the Conduct of physicians", Jewish and Catholic scholastic thinkers over time. Ethics in modern medicine started way back in 18 th century when Thomas Percival, a physician based in England, wrote a book on medical ethics and coined the terminology of medical ethics and medical jurisprudence. The medical profession should be viewed differently and a rethought on the ethical practices is the need of hour to make it an exciting and fulfilling profession. A rethink on the status of modern medicine will certainly pave the way for obtaining specific answers for many dilemmas in modern medicine including the best ethical codes and practices.
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CASE REPORTS
Uterine cervical prolapse following delivery
Mamour Guèye, Mame D Ndiaye-Gueye, Magatte Mbaye, Mamadou L Cisse, Serigne M Kane-Gueye, Jean C Moreau
November-December 2013, 6(6):671-673
DOI:10.4103/1755-6783.140255  
Uterine cervical prolapse concurrent with pregnancy is rare. This article reports three cases of third-degree cervical prolapse following delivery. No history of preexisting prolapse was reported. The first case was treated by hysterectomy, the second case by partial cervical excision and the third case, conservatively. Uneventful recoveries and any further complications were noted. We believe that an extensive uterine cervical prolapse needs surveillance and can be managed conservatively.
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ORIGINAL ARTICLES
Polycystic ovarian syndrome: Prevalence and its correlates among adolescent girls
Nagaraja Bhuvanashree, Sandhya Gupta, Medabalmi Anitha, Epari Venkatarao
November-December 2013, 6(6):632-636
DOI:10.4103/1755-6783.140233  
Background: Polycystic ovarian syndrome (PCOS) is the most frequent endocrinological disorder affecting young women of reproductive age having wide spread morbidity. Though, several factors have been identified attributing to its cause, yet it demands further investigations. Materials and Methods: A community-based cross-sectional study was carried out among 253 adolescent females (age: 10-19 years) to elicit the associations between PCOS and the cesarean mode of delivery, eruption of wisdom tooth and other factors through a binary logistic regression analysis. Results: The mean age was 18.57 ΁ 0.19 (standard error of mean) years. The prevalence of PCOS in Nellore district is 15.4% (95% confidence interval: 10.97-19.83). Higher risk of PCOS was associated with the cesarean mode of delivery (odds ratio [OR] = 4.91, P < 0.0001), eruption of at least 1 wisdom tooth (OR = 2.61, P = 0.025) and the presence of central obesity (OR = 2.57, P = 0.05). Discussion: An attempt has been taken to hypothesize causal association of associated factors with PCOS from the available literature, which in turn may pave the path for newer approaches for prevention and management.
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Impact assessment of IEC intervention on knowledge attitude and practice (KAP) of HIV/AIDS in Assam
Forhad Akhtar Zaman
November-December 2013, 6(6):644-648
DOI:10.4103/1755-6783.140238  
Backgrounds: Recognized as an emerging disease only in the early 1980s, AIDS has rapidly established itself throughout the world, and is likely to endure and persist well into the 21 st century. India has the highest number of HIV-positive persons in the world. The geographical location of Assam adjoining high prevalence states like Manipur and Nagaland will probably make it a high-risk zone in the coming years if appropriate intervention measures are not taken adequately beforehand. Objective: To assess the impact of Information, Education, and Communication (IEC) on Knowledge, Attitude, and Practice on HIV/AIDS among the slum dwellers of Dhubri town of Assam. Materials and Methods: A total of 492 slum dwellers aged 15-60 years were selected from all the slums of Dhubri by probability proportional to size (PPS) sampling method. The study was conducted in three stages. First, a baseline KAP survey on HIV/AIDS was done followed by IEC intervention. Then, just after the intervention, another survey was conducted, and after six months period, the final survey was conducted. Results: Eighty-seven percent of the study subjects were found to have heard about HIV/AIDS. Baseline knowledge regarding prevention of transmission of HIV/AIDS by having one faithful sex partner was there among 65% of the respondents, which increased amongst 82.2% of the respondents just after the intervention and amongst 68.5% of the respondents after six months period; similarly, knowledge of prevention by using condom increased from 70.7% to 80.3% and 76.3% of the respondents; using safe blood increased from 57.7% to 75.4% and 62.9% of the respondents. Conclusions: From the above findings, it can be suggested that, intervention programs were useful in enhancing the awareness regarding HIV/AIDS among the underprivileged population.
  3,247 7 -
Empirical use of anti-snake venom in the early morning neuroparalysis
Vinayak Y Kshirsagar, Minhajuddin Ahmed, Sylvia M Colaco
November-December 2013, 6(6):627-631
DOI:10.4103/1755-6783.140224  
Background: Snake bite is a common acute medical emergency, which can present with atypical symptoms in the pediatric age group. Objective: The objective of the present study is to determine the outcome of patients presenting in the early morning with acute onset of atypical symptoms, no history of snake bite or bite marks be considered as a snake bite and treat with anti-snake venom (ASV) and mechanical ventilation. Materials and Methods: The prospective interventional study conducted over a 6 year period between January 2006 and December 2012 at a Rural Health Center in Maharashtra. Results: Out of 41 patients, 28 (68%) were males and 13 (32%) were females with a mean age of 8.59 ± 3.23 and 8.46 ± 2.96 years, respectively. Patients presented between 12 midnight to 7 a.m. with the maximum presentation between 2 a.m. and 4 a.m. (54%). Patients presented with vague complaints such as abdominal pain (60.97%), unconsciousness (17.07%), vomiting (12.19%) and abnormal sensation over body (7.31%) and convulsion (2.43%). All patients were treated with 15 units of ASV and needed mechanical ventilation within 6 h of admission. Duration of ventilation ranged from 36 h to 168 h with and an average of 115 ± 34.753 h. Hospital stay varied from 5 days to 17 days with a mean of 10.892 ± 3.361 days. All patients responded to treatment and there was 1 (2.43%) death owing to the aspiration pneumonitis. Conclusion: Diagnosis of possible snake bite should strongly be considered when patient presents in the early morning with acute onset of atypical symptoms and without any underlying illness, especially krait bite. The study concludes that timely interventions with a bolus dose of ASV and ventilation can definitely save many lives.
  2,486 12 -
Scrub typhus in adults in a teaching hospital in north Karnataka, 2011-2012
Umesh G Rajoor, Shiddappa K Gundikeri, Jayaraj C Sindhur, M Dhananjaya
November-December 2013, 6(6):614-617
DOI:10.4103/1755-6783.140221  
Background and Objectives: Scrub typhus is grossly under-diagnosed in India due to its non specific clinical presentation, limited awareness and low index of suspicion among clinicians, and lack of diagnostic facilities. As there is a resurgence of scrub typhus in this part of north Karnataka, an attempt is made to study the clinical prolife and complications of scrub typhus in adult patients. Materials and Methods: All cases of febrile illness diagnosed as scrub typhus over a period of 1 year were analysed. Diagnosis was based on the presence of the eschar and /or positive Weil Felix test with a titre of > 1:80. Results: 50 patients diagnosed to have scrub typhus during study period of one year were included in the study. Headache, myalgia, nausea, vomiting and dry cough were common symptoms. More than half of the patients had fever of 7-14 days duration (54%). Eschar was seen only in six patients. Transaminitis was noted in 86.67% patients. Weil Felix test was positive in 48/50 patients with titers of 1:160 in 13 patients, 1:320 in 31 patients and 1:640 in 4 patients. In our study complications noted were acute renal failure (07cases), ARDS and encephalitis 04 cases each and septic shock 01 case. Conclusion: There is a resurgence of scrub typhus in this part of north Karnataka, as one of the important cause of acute febrile illness. Weil Felix test serves as a useful and cheap test for the laboratory diagnosis of Rickettsial disease.
  2,379 6 -
LETTERS TO THE EDITOR
Rehabilitation: Lone hope for stroke survivors
Saurabh Ram Bihari Lal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
November-December 2013, 6(6):683-684
DOI:10.4103/1755-6783.140267  
  2,312 6 -
ORIGINAL ARTICLES
Pattern of occupational injury and its effect on the health of male police officers in Calicut, India
T Thejus, T Jayakrishnan, Raj Meharoof, MC Jeeja
November-December 2013, 6(6):622-626
DOI:10.4103/1755-6783.140223  
Context: Police officers play an important role in the society by ensuring security and are an occupational group at high risk for sustaining injuries, which is associated with an increased risk of adverse physical and mental health. Studies suggest that they die at an earlier age than expected for the general population for all causes of death. Risks for occupational injury and illness among policemen have not been tracked adequately; the relationships between chronic disease and mortality have not been adequately evaluated and health and hazard surveillance system have not been yet developed in India. Objectives: The main objective was to document the pattern of injuries and associated factors among police officers and to study its effect on their health. Materials and Methods: The study was cross sectional and covered 900 policemen (n = 900). Details of injury and related history were elicited using a semi structured questionnaire. Anthropometric and biochemical measurements were carried out using standard techniques. Multivariate analysis was done to identify associated risks and to assess the impact of injury on the physical and mental health of policemen. Results: Injury was reported by 20% of the policemen. The main cause of injury was encounters (52.7%) followed by accidents (35.5%). Commonest type of injury was laceration (43.2%) followed by fractures (36.7%). The injury group had higher prevalence of smoking, frequency of alcohol consumption, less satisfaction levels, and also reported more joint pain and body aches. Though the perceived stress and metabolic syndrome were high it was not statistically significant. Conclusions: Our study indicates high susceptibility of police officers to injury. Availability of equipments for personal protection of police should be improved and its compliance ensured for the safety of the police and the community.
  2,298 6 -
LETTERS TO THE EDITOR
Afebrile dengue: An easily forgotten manifestation
Somsri Wiwanitkit, Viroj Wiwanitkit
November-December 2013, 6(6):686-686
DOI:10.4103/1755-6783.140273  
  2,206 10 -
ORIGINAL ARTICLES
The understanding and perception of service providers about the community-based cervical screening in Nigeria
Abiodun Olumide Adetokunbo, Fatungase Olatunbosun Kehinde, Olu-Abiodun Oluwatosin Oluwaseun
November-December 2013, 6(6):637-643
DOI:10.4103/1755-6783.140237  
Background: Community-based cervical screening based on the single visit approach using the visual inspection approach (VIA) and treatment with cryotherapy is the most appropriate method in limited resource settings in the short- to medium-term for the control of cervical cancer. Aim: The study is aimed at assessing the service providers understanding and perception of community-based cervical screening. Materials and Methods: A cross-sectional study of 31 health workers providing cervical screening services in Ogun State, Nigeria, using closed and open ended questions. Results: There was a huge turnover of health workers who had been involved in cervical screening. Over 90% of the health workers opined that screening should commenced before the age of 25 years. Their opinion of the recommended screening interval for cervical cancer varied; with 54.8%, 16.1%, and 29.0% giving 3, 2 years, and 1 year, respectively. The VIA is the most recommended screening test by the health workers (74.2%). The majority of health workers (87.1%) felt that the logistic and technical support provided for the cervical screening program was not adequate. Cervical cancer screening is thought to be of low priority within the health system by 45.2% of the respondents while 32.3% think that it is of moderate priority. The majority of the health workers (90.3%) said that the health authority in their local government do not budget funds for cervical cancer prevention. Conclusion: The service providers perceive the need for an urgent improvement in the community-based cervical screening through awareness creation, reduction in health worker turnover, and support and integration of cervical screening services.
  2,176 6 -
Seroprevalence of Brucellosis among people in contact with livestock in suburban Khartoum, Sudan
Nada A Gaafar, Adil A Ismaeel, Adel H Elduma, Elnageeb S Saeed, Mohamed E Hamid
November-December 2013, 6(6):649-652
DOI:10.4103/1755-6783.140241  
Background and Objective: The objectives of the present study were to survey brucellosis and to determine risk factors among humans in occupational contacts with dairy cattle in suburban and peri-urban regions in Khartoum State, Sudan. Materials and Methods: Serum samples (n = 362) were collected from people in association with 11 farms with history of brucellosis in Khartoum State between August 2009 and February 2010. Results: Out of the 362 serum samples 14 (3.9%) were positive for brucella infection using competitive ELISA (cELISA). A significant association was observed between the seropositivity and community living in association with brucella-infected livestock notably: Illiterate males (P = 0.002), middle age group (20-40 yrs) (P = 0.003), and consumers of raw milk and milk products (P = 0.004) are at risk of infection. Conclusions: A significant association was observed between the seropositivity and community living in association with brucella-infected livestock notably: Illiterate males, middle age group (20-40 years), and consumers of raw milk and milk products are at risk of infection. The study recommends routine serological screening for brucellosis among herders and workers and their livestock particularly in regions with history of brucellosis.
  1,990 7 -
CASE REPORTS
Fulminant necrotizing colitis: A rare complication of a common entity
Suhani , Shadan Ali, Shaji Thomas, Lalit Aggarwal
November-December 2013, 6(6):661-663
DOI:10.4103/1755-6783.140248  
Acute fulminant necrotizing amebic colitis (FNAC) is a rare complication of intestinal amebiasis that is associated with high mortality and requires prompt diagnosis and surgical intervention. We recently cared for a young male who came with complaints of acute onset abdominal pain, obstipation, and abdominal distension along with a past history of recurring diarrhea over a month. On examination, patient had peritoinits with masking of liver dullness. Patient was resuscitated and taken for exploratory laprotomy which revealed pyoperitoneum, flimsy bowel adhesions, gangrene of cecum, and proximal ascending colon, with multiple colonic perforations along the antimesenteric border in the remaining ascending colon and transverse colon up to the splenic flexure. An extended right hemicolectomy with exteriorization of the proximal and distal loops as an end ileostomy and mucus fistula was done. Postoperatively done amebic serology was highly positive and histopathological examination was suggestive of infective necrosis of cecum and ascending colon. Patient was started on antiamebic medication and discharged on day 16 after a satisfactory recovery. This case report lays emphasis on the prompt diagnosis and treatment of FNAC and supports the empirical use of antiamebic medication in a case of recurring diarrhea/undiagnosed colitis in endemic areas.
  1,925 7 -
ORIGINAL ARTICLES
Field utilization patterns of insecticide-treated net and intermittent preventive treatment with sulphadoxine-pyrimethamine in a resource poor endemic area: Patterns' associations with adverse mother or birth outcomes
Albert Lukuka Kilauzi, Jose Gaby Tshikuka Mulumba, Benjamin Atua Matindii, Jean Jacques Muyembe Tamfum, Léon Okenge Ngongo, Bibi Mengema
November-December 2013, 6(6):603-607
DOI:10.4103/1755-6783.140207  
Objective: (i) Highlight field realities on proportions of parturient mothers who use during pregnancy intermittent preventive treatment-sulfadoxine-pyrimethamin (IPT-SP) without insecticide-treated net (ITN), IPT-SP in combination with ITN or ITN without IPT-SP; (ii) investigate associations existing between these preventive approaches with low prevalence of peripheral parasitemia, placental malaria, low birth weight (LBW) and anemia. Materials and Methods: Proportions of parturient mothers who utilize any of these approaches during pregnancy were estimated as well as associated rates of peripheral parasitemia, placental malaria, anemia and LBW; associations were investigated by comparing each group with participants who never utilized IPT-SP or ITN during pregnancy. Results and Conclusions: Of the 705 participants, 121 (17.2%) never used IPT-SP or ITN during pregnancy; 83 (11.8%) utilized ITN without IPT-SP and 501 (71.0%) utilized IPT-SP of those, 97% used IPT-SP1 and 3% used IPT-SP2/SP3. 275 (39%) used IPT-SP without ITN and 226 (32%) used IPT-SP in combination with ITN. While significant associations were found between: (i) Combined utilization of IPT-SP with ITN and low prevalence of peripheral parasitemia, placental malaria and LBW, (ii) utilization of IPT-SP without ITN and low prevalence of LBW and (iii) utilization of ITN without IPT-SP and low prevalence of placental malaria, no associations were seen between any of these approaches and low prevalence of anemia. Neither IPT nor ITN alone reduced as much adverse outcomes as when used together in combination, suggesting that in areas of moderate or high transmission of malaria, combined utilization of IPT-SP1/SP2 with ITN was the most effective approach for malaria prevention in pregnancy.
  1,904 8 -
CASE REPORTS
Cryptococcal supraclavicular lymphadenitis: A primary manifestation in AIDS-unusual presentation
Shirish S Chandanwale, Archana C Buch, Shruti S Vimal, Shrinath M Kshirsagar
November-December 2013, 6(6):668-670
DOI:10.4103/1755-6783.140253  
Cryptococcosis is a systemic infectious disease caused by Cryptococcus neoformans which is a yeast-like fungus. It can be one of the opportunistic infections in AIDS. Lymph node involvement is usually a part of disseminated disease. Isolated cryptococcal supraclavicular lymphadenitis alone is a very uncommon primary manifestation in AIDS. Once it disseminates, it can be life-threatening. Early diagnosis by fine needle aspiration is essential and reduces the morbidity and mortality.
  1,811 6 -
De novo pelvic abscess: An unreported primary presentation of Pott's spine
Gunjan Desai, Suhani , Shadan Ali, Shaji Thomas, Kusum Meena, Lalit Aggarwal, Jitendar Kumar
November-December 2013, 6(6):674-676
DOI:10.4103/1755-6783.140256  
Pott's spine leading to pelvic abscess is an uncommon presentation of tuberculosis. We recently cared for a young male who presented with a pelvic abscess without evidence of any primary genitourinary or bowel pathology. On computed tomography (CT), patient was found to have Pott's spine as the primary pathology. The pelvic abscess was drained by high transrectal drainage and its tubercular nature was confirmed by microbiological tests. Patient was subsequently stated on antitubercular drugs. Our patient is a rare and the first reported case of a young immunocompetent male who presented with a pelvic abscess as the sole manifestation of Pott's spine without coexisting psoas involvement or any neurological deficit. To conclude, any patient presenting with pelvic abscess, Pott's spine should be considered amongst the differential diagnosis especially in endemic regions.
  1,722 7 -
LETTERS TO THE EDITOR
Hematology analyzers to identify malaria and dengue
Viroj Wiwanitkit
November-December 2013, 6(6):681-682
DOI:10.4103/1755-6783.140263  
  1,723 6 -
ORIGINAL ARTICLES
Mycobacterium intermedium : A rare form of nontubercular Mycobacteria
Susmita Kundu, Saswata Ghosh, Falguni Mandi, Saurav Kar
November-December 2013, 6(6):658-660
DOI:10.4103/1755-6783.140246  
Nontubercular mycobacteria (NTM) are widely distributed in the environment. Though Mycobacterium avium-intracellulare complex (MAC) is the most common NTM species causing disease in humans, new species of NTM are being isolated due to improved methods of detection and increased physician awareness. One of these rare form of NTM is Mycobacterium intermedium. Although the disease was first reported in 1993, there are only very few cases have been reported so far. Here we are presenting a case of 40-year-old nonsmoker, nondiabetic, non-immunosuppressed person who initially sought medical attention for high grade fever, cough with mucoid expectoration, and breathlessness for 2 weeks and later diagnosed to be a case of M. intermedium.
  1,503 6 -
CASE REPORTS
Aspergillus terreus - A rare cause of post-operative endophthalmitis: Case report
Vasant P Baradkar, K Bisure, JS Shastri, L Galate
November-December 2013, 6(6):677-678
DOI:10.4103/1755-6783.140259  
We report a case of post-operative endopthalmitis following cataract surgery due to Aspergillus terreus in a 54-years-old patient who presented with pain, redness, watering of eye, and decreased vision after one month of surgery. Aspergillus terreus was isolated from vitreous fluid, vitrectomy was performed, systemic and intravitreal amphotericin B was given, but the patient did not respond, and enucleation had to be performed. The case report highlights importance of prompt and proper diagnosis of Aspergillus terreus endophthalmitis as this agent often shows resistance to amphotericin B.
  1,300 9 -
LETTERS TO THE EDITOR
Emphysematous gastritis with intrahepatic portal venous gas in aluminium phosphide intoxication: A rare radiological presentation
Ujjwal Gorsi, Anmol Bhatia, Tulika Singh, Niranjan Khandelwal
November-December 2013, 6(6):688-688
DOI:10.4103/1755-6783.140276  
  1,272 13 -
ORIGINAL ARTICLES
LRSA suspect, taken to molecular court, PCR trialled, proven guilty
Baishali Chakraborty, Banya Chakraborty, Yeshi Palden Dopthap, Dibyendu Banerjee
November-December 2013, 6(6):653-657
DOI:10.4103/1755-6783.140243  
Background: A 31-year-old patient was admitted in our Medical College and Hospital following a road traffic accident, and with a history of Linezolid treatment for 10 days. Materials and Methods: Culture from wound swab revealed multiple pathogens. Among them, Staphylococcus aureus turned out to be Methicillin resistant (MRSA), and also showed resistance to Linezolid disc diffusion. Then PCR of the resistant strain as well as a sensitive strain followed by DNA sequencing was done. Results: Sequencing of the domain V region of the 23S rRNA gene revealed the presence of a G2576U mutation in LRSA (LZD-resistant S. aureus) in two 23s rRNA copy, rrn1 and rrn5. Conclusions: The patient's wound was infected with an MRSA strain, which was LRSA as well. LRSA is a rare occurrence, and rarely reported from Indian subcontinent. A constant vigil is necessary to detect this resistance, if possible with tools of molecular epidemiology.
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LETTERS TO THE EDITOR
Invasive pneumococcal disease (IPD) in Iranian patients and it's serotyping distribution in order to prevent the infection with suitable vaccine
Ali Mehrabi Tavana
November-December 2013, 6(6):684-685
DOI:10.4103/1755-6783.140269  
  1,180 8 -
First documented outbreak of Hepatitis E in Northern Cameroon
Demanou Maurice, Mahamat Abassora, Nimpa M Marcelin, Njouom Richard
November-December 2013, 6(6):682-683
DOI:10.4103/1755-6783.140266  
  1,168 6 -
Contamination of Cryptococcus spp. in bird dungs collected from public yard in Bangkok
Beuy Joob, Viroj Wiwanitkit
November-December 2013, 6(6):689-690
DOI:10.4103/1755-6783.140279  
  852 7 -
Underdiagnosis of chikungunya virus infections
Somsri Wiwanitkit, Viroj Wiwanitkit
November-December 2013, 6(6):685-686
DOI:10.4103/1755-6783.140271  
  814 10 -
Concurrent dengue and novel H1N1 infection: The first world report
Beuy Joob, Viroj Wiwanitkit
November-December 2013, 6(6):686-687
DOI:10.4103/1755-6783.140274  
  814 7 -
Toxin-induced hemolytic uremic syndrome in E. coli infection cancerous patients: Another side of the coin
Beuy Joob, Viroj Wiwanitkit
November-December 2013, 6(6):687-687
DOI:10.4103/1755-6783.140275  
  776 7 -
Acute hemorrhagic leukoencephalopathy and influenza a (H1N1) virus
Somsri Wiwanitkit, Viroj Wiwanitkit
November-December 2013, 6(6):688-689
DOI:10.4103/1755-6783.140277  
  753 7 -
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