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   2017| March-April  | Volume 10 | Issue 2  
    Online since June 22, 2017

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Sub‐center health profiling and health care delivery services in a rural community of northern India
Sheikh Mohd Saleem, S Muhammad Salim Khan, Shah Sumaya Jan
March-April 2017, 10(2):436-439
Background: Sub-Center is the most peripheral point of contact where the staffs is assigned tasks relating to bring behavioral changes in the community and offer services related to maternal and child health, nutrition, immunization, family welfare and contraception, school health services, adolescent health care, water and sanitation, disease surveillance, control of communicable diseases, implementation of national health programmes, house to house visits and outreach/field services. Material and Methods: This paper is based on the secondary data which was available at the Sub-Center which is located in a rural area, 25 kms from the capital city of Jammu & Kashmir state on the hilly terrains. The data was collected from April 2016 to January 2017 by trained FMPHW/ANMs who carried out the door to door visits of each household and recorded data on a predesigned pretested Pro forma. Results: Socio-demographic characteristics of the community subject's shows female predominant population with women outnumber men with a ratio of 94 men to 100 women. 74% of the population is in the adult age group. Among the total households (180), most are joint families with 100% non-vegetarian diet pattern see in the community. 66% of the total households belong to the middle socioeconomic status. Accessibility of health-care services was analyzed using indicators for which all the households mentioned to have easy access to the health care system, always find the health worker at the subcenter during duty hours and find the services provided at the sub-center cost-effective. Most of the households had easy access to the Sub-Center location while some of the households find in difficult in reaching the Subcenter and some household's complaint of non-availability of drugs. Conclusion: Our study was one of its kind studies which demonstrated the health profiling and health services assessment of a particular sub-center located in hilly rural area of Kashmir valley. The presence of the sub-center in the area and the services delivered by it are well accepted by the local rural community, which in turn has resulted in better health status of the community population.
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The assessment of patient clinical outcome: A literature discussion
Mouíath A Hourani, Nidal M Turab, Qusai Y Shambour
March-April 2017, 10(2):321-333
A patient's safety in clinical field is critical, important and complex. The patients are still suffering from preventable harms from diagnostic errors, procedure mistakes, teamwork failures, and the failure to deliver recommended therapies. Patient outcome is the status upon a patient's adherence to treatment. An assessment of patient's clinical outcome is one of the important aspects of patient safety, and requires the assessment of the benefits, harms and risks of therapeutic options and comparing between them. Very few methods are developed for the clinical field and there is still a need for more accurate methods for such assessment. To achieve the above objective, we have performed an integrative review of the literature using different online databases and search engines including PubMed, Scopus, Google, and Google Scholar to explore current issues regarding the assessment of patient clinical outcome. This paper presents:
  1. an overview of the existing assessment methods for patient clinical outcome and their conceptual limitations; and
  2. a discussion of the primitiveness of the current assessment methods.
Based on the literature research in this paper, researchers, clinicians and health care professionals working in the field of assessment of patient clinical outcome, will be able to
  1. understand all the critical issues in this area, and
  2. design and develop novel general methods for the assessment of patient clinical outcome that avoid the conceptual limitations of existing methods.
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Study of antibiotic susceptibility pattern of Salmonella typhi in children suffering from enteric fever
Parmarth Chandane, Akansha Gandhi, Sneha Bowalekar
March-April 2017, 10(2):440-443
Background: Due to the lack of sanitation measures and clean water, typhoid fever is prevalent in developing countries such as India. Also, increasing cases of antibiotic resistance as well as multiple drug resistance (MDR) have been reported in Indian subcontinents. However, there is inadequate data available on the antibiotic sensitivity pattern of Salmonella enterica serovar Typhi (S. typhi) among children in Indian subcontinents. Materials and Methods: A total of 43 isolates of S. typhi were collected from the blood samples of children in the age group of 3-12 years and further were tested for antimicrobial susceptibility according to the CLSI guidelines. Results: Of the total isolates studied, 44% were found to be multidrug resistant (MDR) (defined as resistance against more than one group of antibiotic). The isolates showed the highest resistance against aminoglycoside antibiotics and least against carbapenem antibiotics. Conclusion: The presence of MDR S. typhi imposes a serious concern about the drug of choice for treatment of typhoid fever in children. A careful consideration should be given before deciding the antibiotic for treatment in order to prevent the emergence of antibiotic resistance.
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Vibration exposure and work‐musculoskeletal disorders among traffic police riders in Malaysia: A review
Nur Athirah Diyana, Karmegam Karuppiah, Irniza Rasdi, Sivasankar Sambasivam, Shamsul Bahri Mohd Tamrin, Kulanthayan K. C. Mani, Putri Anis Syahira, Ihtifazuddeen Azmi
March-April 2017, 10(2):334-340
Background: The traffic police force is one of the occupations that utilize motorcycles as the main mode of transport. The main ergonomic hazard with the constant use of motorcycles is exposure of riders to vibration while riding their motorcycles, which can potentially lead to work.related musculoskeletal disorders (WMSDs). Objective: This review is meant to provide an overview of the available vibration exposure with WMSDs for traffic police riders and to review the related guidelines. Method: This study involved comprehensive search of database from 1945 to 2015. Published research paper that reported on the vibration exposure, prevalence, and/or risk factors of WMSDs and occupational riders were assessed and reviewed. Result: The review suggests that the main factors involving vibration in motorcycles come from the motorcycles itself, the posture of the hands and arms during the gripping of the handlebars, the surrounding environment, and the period of riding motorcycles. Majority of the studies agreed that police riders had higher percentage of WMSDs especially in lower back, neck, and shoulder. Conclusion: Overall, police riders have a high incidence of WMSDs, which in combination with exposure to vibrations with prolonged sitting and static posture may increase their susceptibility to WMSDs. Further research is required to explore the level of exposure to vibrations and WMSDs among traffic police riders, its potentially consequences, and ways to reduce exposure and risk associated with vibrations and WMSDs.
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Community knowledge and attitude towards Japanese encephalitis in Darrang, India: a cross-sectional study
Akram Ahmad, Muhammad Umair Khan, Sadiqa Malik, Shazia Qasim Jamshed, Lakhya Jyoti Gogoi, Manabendra Kalita, Atul Prasad Sikdar
March-April 2017, 10(2):377-383
Background: The prevalence of Japanese encephalitis (JE) in Assam was exceptional in a global context in the year 2014. Darrang district is amongst the most affected districts that is hit by deadly JE virus in Assam. Therefore, we conducted this study to evaluate the knowledge and attitudes of the residents regarding JE at Darrang. Methods: A descriptive, cross-sectional study was performed for the period of 3 months from November 2014 to January 2015 in Darrang. Multistage stage sampling was done to select participants from the district. A pretested interviewer-administered questionnaire was used to collect data from the participants. Descriptive analysis and logistic regression tests were used to analyze the data. Results: A total of 396 participants responded to the questionnaire, thus giving the response rate of 51.5%. One-fourth of the participants exhibited a good knowledge of JE (24.7%). The majority of the participants incorrectly answered the questions relating to management (83.3%) and prevention of JE (66.7%). Further, tertiary education and JE patient in family/relative were significantly associated with the knowledge of the participants (P < 0.001). A large proportion of the respondents exhibited positive attitudes towards JE (96.5%). Television was the major source of information of the participants regarding JE (29.2%). Conclusion: The findings of this study indicate a lack of knowledge regarding JE among the residents of Darrang. However, their attitudes towards JE were generally positive. Further studies on this topic need to be conducted throughout the state of Assam to identify and subsequently bridge the knowledge gaps among its residents.
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Vibrio harveyi, V. parahaemolyticus, and V. vulnificus detection in Thai shellfishes by the triplex PCR method
Kanittada Thongkao, Yuttana Sudjaroen
March-April 2017, 10(2):417-422
Context: Shellfish sold in Southeast Asian markets are highly contaminated. Uncooked seafood samples were collected from markets in Bangkok, Thailand, which were contaminated with Vibrio species (27%) and in which antibiotic resistance was relatively high. Aims: To simultaneously detect V. harveyi, V. parahaemolyticus, and V. vulnificus in shellfish samples including life mussel (Perna viridis), blood clam (Tegillarca granosa), and baby clam (Paphia undulata) in the local markets in Bangkok. The sensitivity, accuracy, and specificity of triplex PCR method were also evaluated. Materials and Methods: The 150 frozen shellfishes were purchased from five local markets in Bangkok. Each sample was homogenized, enriched, and prepared for colony counting and isolation. Three Vibrio species were identified according to biochemical tests and then later confirmed by triplex PCR. The accuracy and specificity of triplex PCR were evaluated and compared with conventional tests. The sensitivity of triplex PCR was explained as total count (CFU/mL) of Vibrio species. Results: Using the biochemical test and triplex PCR method in the three Vibrio species of marine shellfishes, 14 and 15 isolates of V. harveyi, 8 isolates of V. parahaemolyticus, and undetectable and 1 isolate for V. vulnificus were identified, respectively. The accuracy of triplex PCR was higher than the conventional method. Triplex PCR was shown to be sensitive as total bacterial count for three Vibrio detection in marine shellfishes was 1.2 × 107-2 × 106 CFU/mL. Conclusions: Triplex PCR assay was higher in sensitivity, accuracy, and specificity, which proved to be convenient, simple, and effective method for Vibrio detection and identification in shellfishes.
  4,182 22 -
Characteristics of mineral water from nature hot springs in Ranong Province, Thailand
Yuttana Sudjaroen, Kanittada Thongkao, Kowit Suwannahong
March-April 2017, 10(2):366-370
Background: There is interest in characteristics of mineral waters from two famous hot springs in Ranong province, Thailand, including Raksawarin and Porn-Rang hot springs. Aims: To objective is to determine characteristics of thermal mineral waters of Ranong region and describe its classification and therapeutic indications. Material and Methods: Mineral waters were collected from Rahsawarin and Porn-Rang hot springs. All analyses were conducted according to American Public Health Association. Temperature was measured in the field at the time of sample collection. Analyses of fecal coliforms and total bacterial count were performed. Physical-chemical analyses were used to evaluate pH, total dissolved solids (TDS), and conductivity. Total hardness was measured in the laboratory by titration. Metals (Al, Si, Fe, Mn, Pb, Cd, Ni, Cu) were measured by graphite furnace atomic absorption spectroscopy (GFAAS); major ions (Ca, Mg, Na, K, Cl, F, HCO3-, SO4, S2-) and nutrients (NH4, PO4-, NO3) were measured by ion chromatography technique. Results and Discussion: The mean of pH, TDS, and conductivity values observed for hot springs were met to reference value of Thai tap water standard by WHO guideline. Neither hot spring contained fecal coliform bacteria. Chemical parameters were also within standard excepted aluminum concentration. Potassium levels from mineral waters were also high. Ranong mineral spring water can be thermal waters and define to hot waters. Ranong mineral spring water can be define to fresh and low sodium water. Conclusions: Our suggestions regarding this mineral water indication were properly for external use and may concern in case of drinking.
  3,998 35 -
Snake bite envenomation seen at a specialist hospital in Zamfara state, North-Western Nigeria
Aminu Muhammad Sakajiki, Garba Bilkisu Ilah, Abdul-Aziz Shehu Lukman, Ahmad Maifada Yakasai
March-April 2017, 10(2):391-395
Introduction: Snake bite is an underreported public health problem in Nigeria, with a prevalence of 5 per 1,000 persons per year. Morbidity and mortality from snake bites is higher in developing than in developed countries. We aim to audit the clinical parameters, complications, and outcome of patients with snake bites admitted at our hospital. Materials and Methods: The study was a retrospective secondary data analysis whereby all children and adults managed for snake bite over a 2 and a half year period were included. Their case records were retrieved and relevant demographic and clinical information obtained and statistically analyzed using Statistical Package for the Social Sciences version 18. Results: Out of 5,375 admissions, 25 had snake bite giving an incidence of 0.00465 (4.65/1000). There were 17 (68%) children and 8 (32%) adults. Males were 18 (72%) giving a M:F ratio of 1.4:1. Mean age was 20.6 ± 14.36 with a range of 3–55 years. Most bites, 18 (72%) occurred on the lower limbs, during the day time 15 (65%) and happened in the farm. The highest prevalence of bite was between the months of May and August. Prior to presentation, 12 (48%) had received various interventions and features of envenomation including local swelling and pain (76%), prolonged clotting time (56%), bleeding from various sites (52%), while (32%) had various complications. All patients had antitetanus toxin, while 23 (92%) received antisnake venom. Majority of the patients were discharged 19 (76%), 4 (16%) signed against medical advice, and 1 (4%) absconded, while only 1 (4%) died. Conclusion: Snake bite in our environment commonly affects children and adolescents with majority of patients coming late to hospital. Protective clothing and health awareness campaigns to educate the community are urgent interventions needed to reduce the morbidity from snake bite.
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Correlation between personality traits and organizational commitment in the staff of Kermanshah University of Medical Sciences in 2015
Arash Ziapour, Alireza Khatony, Faranak Jafari, Neda Kianipour
March-April 2017, 10(2):371-376
Background: The staff' personality traits are important factors that can affect their organizational commitment. Objective: The current research was aimed to determine the relationship between personality traits and organizational commitment among the staff of Kermanshah University of Medical Sciences. Materials and Methods: In this descriptive-analytic study, 270 staff working in the headquarters of Kermanshah University of Medical Sciences were selected through simple random sampling. The instrument of data collection included NEO personality inventory and Allen and Meyer's organizational commitment scale. Data were analyzed by descriptive and inferential statistics (Pearson's correlation coefficient and regression analysis). Results: The maximum and minimum means for personality traits were reported for conscientiousness (2.96 ± 0.40) and neuroticism (1.85 ± 0.55), respectively. With regard to organizational commitment, however, affective commitment (4.77 ± 0.80) and continuance commitment (4.77 ± 0.80) obtained the maximum and minimum means, respectively. From among the five personality traits, conscientiousness and agreeableness were significantly correlated with organizational commitment. Conclusion: Since conscientiousness and agreeableness variables were correlated with organizational commitment, it is suggested that the managers of organizations pay a special attention to the given personality traits in the selection and appointment of the staff in organizational positions in order to enhance the efficiency of human resources in organizations. They are also recommended to take these variables into account during job interviews.
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Stenotrophomonas maltophilia: A rare cause of bacteraemia in a patient of end stage renal disease on maintenance hemodialysis
Sonal R Bangde, Lata B Galate
March-April 2017, 10(2):450-452
We report a case of bacteraemia due to Stenotrophomonas maltophilia in 60-year-old male patient who presented with high fever to hospital. He was on maintenance hemodialysis (HD) suffering from end stage renal disease. Blood culture from central line was sent from which S. maltophilia was isolated which was resistance to most of antibiotics tested. Central line was removed and peripheral line was established for maintenance HD. Patient was started on levofloxacin to which it was sensitive for 2 weeks, the fever subsided thereafter, and repeat blood culture was negative. S. maltophilia is resistance to most of routinely used antibiotic so this case highlights the importance of early detection and antibiotic sensitivity workup.
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A study on the prevalence of direct vs indirect etiology, prognostic determinants and mortality in ARDS
Aakash Teja Durbesula, KB Chetan Reddy, Gangaram Usham, Rajesh Kumar Meriga, T Venkata Krishnan, Bhimasen Soren, Rohith Karnati
March-April 2017, 10(2):409-416
Objective: The objective of this study is to determine the etiology and risk factors for the development of acute respiratory distress syndrome (ARDS) and also the association between clinical and laboratory parameters and outcome in patients with ARDS. Methodology: This was an observational prospective study conducted in the intensive care units of Narayana Medical College and Hospital, Nellore between November 2015 and May 2016. Patients who fulfilled the AECC definition for ARDS and who were mechanically ventilated for more than a 24 h period were selected for the study. Results: Fifty patients who met the predefined criteria were enrolled for the study. Of these 50 cases, females (52%) were slightly more than the male patients and the most common age group was 31–50 years. ARDS was mostly secondary to infectious causes (92%) and the most common etiology for ARDS in our study was direct cause (52%) followed by indirect cause (48%). Factors associated with poor outcome and high mortality are low PaO2/FiO2 (P value <0.001), high SAPS II score (P value <0.001), high SOFA scores (P value 0.001), high max SOFA scores (P value 0.001), and severe lung injury scores (P value <0.001). High procalcitonin levels and C-reactive protein (CRP) levels less than 226 mg/mL showed more number of nonsurvivors (71.8%). There was significant increase in the mortality among patients who were prescribed inotropic support when compared to those who were not (P <0.001). Of the 50 patients enrolled in the study, 33 patients succumbed to their illness with the mortality of 66%. Conclusion: Direct etiology by pulmonary infection was the most common cause for ARDS. Prognostic determinants like PaO2/FiO2 and clinical scores like SOFA, maxSOFA, SAPS II, and LIS had a statistically significant association with mortality. Laboratory parameters like serum albumin were associated with significant mortality whereas CRP and procalcitonin did not show a statistically significant correlation with mortality. The use of a combination of clinical factors and biological markers is a promising strategy that needs to be prospectively validated.
  2,955 18 -
Knowledge, attitude and practice of Pap smear among Omani women
Nasar Yousuf Alwahaibi, Nasra Mohammed Alramadhani, Atheer Mohammed Alzaabi, Waad Abdullah Alsalami
March-April 2017, 10(2):396-403
Background: Absence or low uptake of Pap smear is probably the main barrier for high incidence of cervical cancer. Aim: To assess the knowledge, practice, attitude, main barriers and motivating factors of Pap smear among Omani women. Methods: Cross-secal survey in a tertiary referral hospital. The participants were divided into three groups: the patients who attended Outpatient Gynecology Department in Sultan Qaboos University Hospital (SQUH), Oman, the female staff from SQUH, College of Medicine and Health Science and College of Nursing at Sultan Qaboos University (SQU) and the graduating female students at SQU. Results: There were 204 patients, 133 staff, and 157 students. The knowledge of Pap smear among patients, staff and students was as follows: 56.9%, 56.4% and 23.6%, respectively. Those who had an adequate knowledge, 36.8% patients, 23.3% staff and 0.0% students performed Pap smear. Those who performed Pap smear, 32.4% of patients were reminded by their health professionals and 23.3% of staff understood the importance of Pap smear. The common barrier that prevents the uptake of Pap smear among the three groups was their belief that they have a healthy lifestyle. All the groups (70 – 96%) believed that Pap smear can lead to more successful prevention and treatment for cervical cancer. Conclusions: The findings of this study show poor knowledge and performance of Pap smear and good attitude towards Pap smear. More public health education is required to inform the community about the importance of Pap smear as well as to strengthen the curriculum taught in undergraduate university.
  2,865 20 -
Molecular identification, phylogeography, and genetic diversity of Culex quinquefasciatus in Central Java province, Indonesia
Irfanul Chakim, Winda Septi Tyasningrum, Hakiki Chandra Wardani, Sayono Sayono
March-April 2017, 10(2):341-347
Species identification of Culex quinquefasciatus mosquitoes is crucial for planning vector control program. The progress of molecular entomology tool supports a better understanding of the species identification. In the molecular study, it has grown ITS2 sequences which are used as a potential marker for species identification and phylogenetic analysis. The genetic diversity of Culex quinquefasciatus mosquitoes has been reported worldwide, but until now there has been no study of diversity of Cx. quinquefasciatus mosquitoes in Indonesia. The purpose of this study is to determine the genetic diversity of Culex quinquefasciatus as a filariasis vector in Central Java on the basis of ITS2 genes from ribosomal DNA. This study is done descriptively by collecting samples from filariasis endemic areas in Central Java. Results of the morphological and molecular analysis showed a difference of identification. ITS2 sequence alignment results of Cx. pipien complex from Central Java isolates have similarities with some isolates in many worlds. Phylogenetic analysis showed that ITS2 sequence of mosquitoes in this study is not monophyletic. The further results indicate the fact of introgression history ITS2 from Cx. pipien toCx. quinquefasciatus in Central Java. The introgression may occur before Cx. quinquefasciatus proliferate and spread in the Central Java region.
  2,837 18 -
Comparison of virulence factors fimA, papC, and hly among uropathogenic Escherichia coli isolates producing and nonproducing extended spectrum beta-lactamases
Sargol Fattahi, Mohammad Aghazadeh, Mohammad Reza Nahaei, Mohammad Asgharzadeh, Hossein Samadi Kafil
March-April 2017, 10(2):404-408
Introduction: The aim of present study was to investigate virulence factors fimA, papC, and hly in clinical isolates of uropathogenic Escherichia coli (UPEC) producing and nonproducing extended spectrum beta-lactamases (ESBLs) in patients with urinary tract infection (UTI). Materials and Methods: A total of 112 Escherichia coli strains isolated from patients with UTI were collected and characterized by biochemical and bacteriological methods. The presence of beta-lactamase enzymes were determined by phenotypic combined disk test. Then, for detection of fimA, papC, and hly virulence genes polymerase chain reaction assay was performed. Moreover, data analysis was conducted by using SPSS 16.0 software. Results: From 112 E. coli strains, 90% were producing ESBLs (resistant to beta-lactam antibiotics) and 10% were none producing ESBLs enzymes by phenotypic method. Out of 32 hly positive strains 28 (87.5%) were ESBLs positive, from 103 fimA positive strains 93 (90.3%) were ESBLs producer and among 52 papC positive strains 47 (90.4%) were detected that have ESBL enzymes by molecular method. Prevalence of ESBL enzymes among fimA, papC, and hly negative strains was closely similar with positive strains and demonstrated high resistance to beta-lactam antibiotics. Conclusion: The results showed the high prevalence of virulence genes hly, papC, and fimA. There is high resistance to beta-lactam antibiotics due to production of ESBLs regardless to prevalence of virulence genes in clinical strains of UPEC. Indeed, there is no significant relationship between presence of virulence gene and ESBL production. Thus, the virulence and drug resistance genes are needed to be examined as a target for therapeutic intervention.
  2,690 19 -
A clinico‐pathologic study of soft tissue neoplasms: An experience from a rural tertiary care hospital
BD Baste, Sunil Y Swami, VV Narhire, MP Dhamecha, Grace DíCosta
March-April 2017, 10(2):348-352
Context: Soft tissue is a non-epithelial extra skeletal tissue of the body exclusive of reticuloendothelial system, glia and supporting tissue of the various parenchymal organs. Aims: To study the clinico-pathological correlation, relative incidence of benign & malignant neoplasms, frequency of age, sex & site wise distribution & histopathological pattern of soft tissue neoplasms [STNs]. Setting and Design: Comprises of soft tissue neoplasms studied during six months. Cases of STNs diagnosed based on history and clinical examination and subjected to biopsy or surgery and subsequent histopathological examination were included while patients who were treated conservatively or referred to other hospitals and STNs of systemic organs were excluded. Materials & Methods: The tissues were fixed in 10% formalin and were processed. Sections of approximately 5 microns were cut and stained by routine hematoxylin and eosin [H & E] and immunohistochemistry [IHC] was done where ever required. All STNs were classified as per 2013 WHO classification. Result: Out of 70 cases of STNs recorded, 95.72% were benign and 04.28% were malignant. STNs in general had slightly male preponderance. Of all benign soft tissue neoplasms, the commonest was lipoma (64.28%) followed by peripheral nerve sheath (11.4%), vascular (8.5%), fibroblastic (4.28%), fibro-histiocytic (2.8%) and tumors of uncertain differentiation (2.8%) in the decreasing order to frequency. Conclusion: Availability of a modern, more logical histopathologic classification and standard nomenclature now offers a better clinic-pathological co-relation. The clinico-morphological evaluation is still the gold standard for the proper diagnosis of soft tissue neoplasms.
  2,403 20 -
Seroepidemiological survey of toxoplasmosis among female university students in Shiraz, southern Iran
Hajar Taghizadeh, Reza Shahriarirad, Amirhossein Erfani, Fatemeh Nekouei, Sarvin Seifbehzad, Samaneh Abdolahi Khabisi, Bahador Sarkari
March-April 2017, 10(2):362-365
Background: Seroprevalence of toxoplasmosis in different populations in Iran varies according to the people eating behaviors and also geographic and climatic differences of each area. Objective: The current study aimed to provide recent data regarding the seroprevalence of toxoplasmosis among female university students in Shiraz University of Medical Sciences, in Fars province, southern Iran. Materials and Methods: The subjects of the study were 503 female university students. Blood samples were collected from each participant and tested for anti-Toxoplasma IgG and IgM antibodies, using a commercial Enzyme-Linked Immunosorbent Assays (ELISA) kit. Demographic characteristics and risk factor related to Toxoplasma were also recorded during the samples collection. Results: The mean age of participants was 22.2 (±3.83) years and the majority (54.9%) of subjects was in the age group of 20-25 years old. Anti T. gondii antibodies was detected in sera of 43 out of 503 enrolled students, corresponding to an overall seroprevalence of 8.5%. Of these, 37 (7.4%) were seropositive for only IgG, 7 (1.4%) were seropositive for only IgM and 1 (0.2%) were seropositive for both IgG and IgM. The differences between age and animal contact with seropositivity to toxoplasmosis were not statistically significant. Conclusion: The findings of the study indicated that more than 90 % of the female university students in this study were seronegative for toxoplasmosis. As these students are in their childbearing age, there is a possibility for their newborns to become infected with Toxoplasma. The control and preventative measurements are necessary to reduce the rate of T. gondii infection in such individuals.
  2,300 25 -
Squirrel bite: Analysis of 35 cases
Won Sriwijittalai, Viroj Wiwanitkit
March-April 2017, 10(2):478-478
  2,263 31 -
Cysteinyl leukotrienes as biomarkers of effect in linking exposure to air pollutants and respiratory inflammation among school children
Nur Faseeha Suhaimi, Juliana Jalaludin, Suhaili Abu Bakar
March-April 2017, 10(2):423-431
Background: Industrial activities contribute to poor air quality either directly or through background concentrations, bringing to fore health issues regarding the health effects of the release of malodourous air pollutants. Methods: This research focused on the effects of exposure of air pollutants from industrial facilities and traffic on school children by using selected airway inflammation biomarker, cysteinyl leukotrienes (CysLTs), in sputum. Questionnaires adapted from the American Thoracic Society (ATS) and the International Study of Asthma and Allergies in Childhood (ISAAC) were used to compile respiratory symptoms, history of exposure, and demographic data. Results: CysLTs level measured by using enzyme.linked immunosorbent assay (ELISA) was higher in the exposed group (0.402 ± 0.389 ng/mL) than in the comparative group (0.191 ± 0.231 ng/mL). A strong, significant correlation was established between sulfur dioxide (SO2) (r = 0.924, P < 0.001) and particulate matter 2.5 (PM2.5) (r = 0.242, P = 0.014), with the levels of CysLTs among school children in exposed group. This study reveals that SO2 is the most significant factor that influenced CysLTs levels among school children at P less than 0.001. Conclusion: CysLTs are proven to be reliable biomarkers of airway inflammation in healthy children, whereas sputum method is proven to be a reliable, safe and noninvasive procedure for school children with their reproducibility and sensitivity as portrayed in this study. Thus, the findings provide fundamental aspects relevant to future interventions to healthy children living near an industrial area from the environmental scope.
  2,267 20 -
Urinary schistosomiasis among primary school children at Al‐Takamul area, eastern Khartoum state‐Sudan: An example for urban schistosomiasis
Babiker Salih Al-Basheer, Alfatih Saifudinn Aljafari
March-April 2017, 10(2):353-356
Background: Urinary Schistosomiasis, caused by Schistosoma haematobium, is classically associated with rural areas that provide the hospitable condition for transmission. With the recent massive internal displacement, new communities were settled and created urban extensions to the big cities. These extensions bridged the space between the urban areas and the agricultural schemes around them. The area selected for this study is a good example for these settings. Given that the new population was displaced from known endemic areas, the transmission cycle seems to be completed. Objective: The aim of this study is to identify the frequency of urinary schistosomiasis among school children form Al-Takamul, which is a suburban district located in the Eastern Khartoum State. Materials and Methods: 150 school children were enrolled in this study, all were boys. Half of them were 11 year old or less. 20 ml of fresh voided urine (including terminal urine) were collected from each participant after a short period of exercise. Following physical and chemical examination, 10 ml sample of each specimen was centrifuged and the sediment was then thoroughly examined under the microscope. Results: 22% of study populations were found infected with S. haematobium (sensitivity 96.97%, specificity 100%), 87.9% of them were more than 11 year old (RR 2.23). 27.27% of the infected individuals had a history of past infection. 84.8% of infected population knew about schistosomiasis and its transmission. The results suggested that urban schistosomiasis is prevalent in the study area and it is presented with a distinguished pattern, that is, it is prevalent among children over 11 years old, and it is associated with knowledge but no awareness. Conclusion: The study area may be a potential focal point of urinary schistosomiasis transmission for neighboring areas. Massive survey and preventive chemotherapy is urgent.
  2,260 18 -
Severe eosinophilia in dengue patient: An interesting case study
Sora Yasri, Viroj Wiwanitkit
March-April 2017, 10(2):465-466
  2,170 18 -
Respiratory symptoms and sociodemographic factors among agricultural workers exposed to calcium carbide as fruits ripening agent in Kuala Kangsar, Perak: A preliminary study
Noor Shaeda Ismail, Irniza Rasdi, P Sarva Mangala, Emilia Zainal Adidin
March-April 2017, 10(2):432-435
Background: In agriculture, calcium carbide (CaC2) is used as a chemical in fruit ripening and as a source of acetylene gas, which acts as a reducing agent with same fruit-ripening attributes as ethylene. The reaction between CaC2 and moisture produces acetylene, which consequently leads to ripening of fruits. Many existing studies focus on the effects of calcium carbide on fruit texture, taste, and nutritional content, but only a limited number explore the level of occupational exposure of CaC2 and its health effects among workers involved in the ripening process. Objective: The aim of this article is to assess the respiratory symptoms of agricultural workers through questionnaire and to determine the most significant sociodemographic factors contributing to respiratory symptoms. Methods: The respondents were interviewed using two set of questionnaires: a general structured questionnaire and IUALTD Bronchial Symptoms questionnaire. Data in this study were analyzed statistically using SPSS. Chi-square test was used to analyze the relationship between sociodemographic factors with respiratory symptoms. Significant level used for this study was P less than 0.05. Result: The most regular symptom exhibited by the respondents was morning phlegm (37.5%), followed by morning cough (33%), shortness of breath (25%), and chest tightness (16.7%). Age, duration of employment, smoking status, handling of calcium carbide, and awareness of the dangers of calcium carbide did not have a significant association with all the respiratory symptoms. Conclusion: Considering the prevalence of respiratory symptoms among the respondents, we suggest that further studies on the effects of CaC2 are warranted. Findings will be beneficial to creating public awareness on the effects of hazardous chemicals on human health and to increase awareness of impact of the use of calcium carbide on the health of workers working with CaC2.
  2,144 22 -
Breast abscess due to Mycobacterium abscessus: A rare case
Archana Bhimrao Wankhade, Dnyaneshwari Ghadage, Arvind V Bhore
March-April 2017, 10(2):447-449
Non-tubercular mycobacterial infections (NTM-Non-tubercular mycobacterial infections) are becoming increasingly common. Mycobacterium abscessus is a rare cause of human infection and is difficult to diagnose unless suspected for the same. A 31-year-old patient, diagnosed to have right breast abscess associated with axillary lyphadenopathy with fever. When pus was sent to the microbiology laboratory, after culture it was confirmed to be due to M. abscess. Definitive identification of this species of mycobacterium was possible by growth characteristics and biochemical tests. The organism was sensitive to Kanamycin, Clarithromycin, Ciprofloxacin, and Amikacin. However, complete recovery from infection was possible after prolonged treatment with clarithromycin to which the organism was sensitive.
  2,079 18 -
Risk factors and management modalities for sudanese children with hearing loss or hearing impairment done in Aldwha and Khartoum ENT hospitals, Sudan
Safa Ahmed, Mashair Abdelgadir Hajabubker, Satti Abdelrahim Satti
March-April 2017, 10(2):357-361
Introduction: Hearing impairment indicate a full or partial decrease in ability to detect or understand sounds. Their first presentation could be with delayed speech, language and cognitive ability. The goal of universal newborn hearing screeningprograms (UNHS), which are widely used in developed countries, is early recognition and treatment of hearing impairment. All children should be managed by a multidisciplinary team. Objectives: To study the risk factors and treatment of hearing loss and impairement in children seen at Aldwha and Khartoum ENT Hospitals, Sudan. Material and Methods: This is a retrospective, descriptive and hospital-based study done at Aldwha and Khartoum ENT Hospitals, Sudan. Study period was four months. Study population were children with hearing loss and hearing impairment seen in the referal clinics of the two hospitals. Data was collected by using a questionnaire. General examination, developmental assessment and some investigations were done. Data was analyzed using Cochran's equation. Results: A total of 119 children with hearing impairment or hearing losswere selected. M to F ratio was 1.13 to 1. Sensory neural hearing loss was the commonest in 75.6% followed by conductive hearing loss in 21.0%, mixed in 2.5% and rarely central in 0.8%. Bilateral (HL) was detected in 89.1%. As a risk factors, early rubella during pregnancy account for 1.7% , birth asphyxia in 2.5% , prematurity in 5.9%, neonatal jaundice in 6.7% and otitis media in 19.3%. Quinine was the commonest drug that caused HL. Isolated hearing loss was detected in 42.0% , hearing loss and speech defect in 47.9%. Who received ear aids were 70.6%. There was a significant association between otitis media and conductive hearing loss. In conclusion the commonest age group affected were children between 1 and 4 years. Male to Female ratio was 1.13 to 1. Consanguineous marriage was reported in almost ¾ of studied families. Sensory neural hearing loss was the commonest and majority had bilateral (HL). Otitis media was a common risk factor followed by meningitis. Three quarters received ear aids. We recommend early screening of neonates and infants with risk factors by introduction of NHS program, safe administration of drugs, activation of primary health programs & establishment of audiological units.
  2,052 23 -
Pulmonary tubercular cavitory lesion: An unusual presentation in systemic lupus erythematosus
Arvind Mishra, Shilpa , Shubham Agarwal
March-April 2017, 10(2):444-446
A 26-year-old women diagnosed as having lupus nephritis was managed with immunosuppressive therapy, which included cycles of Inj. Cyclophosphomide along with Inj. Mesna and Inj. Leprolide. After 1-month therapy, the patient developed moderate- to high-grade fever associated with cough and expectoration. Sputum examination was positive for acid-fast bacilli by modified Ziehl - Neelsen (ZN) staining technique. Chest skiagram Posterioanterior (PA) view and Computed tomography (CT) scan thorax depicted thick-walled cavity in right upper zone of lung with air-fluid level. Patient was managed with second-line antituberculosis drugs during hospitalization and was followed.
  1,984 24 -
Addressing the public health concern of depression and anxiety disorders: Financial perspective
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):309-310
  1,939 25 -
Phenotypic and phylogenetic relatedness of selected Staphylococcus aureus strains cultured from HIV seropositive mothers and their neonate's pair
Blessing Itohan Ebhodaghe, Kwashie Ajibade Ako-Nai, Olakunle O Kassim
March-April 2017, 10(2):384-390
Background: Staphylococcus aureus is a major pathogen to man and is invasive when the skin is breached as well as in trauma. The frequency and transmission of S. aureus was determined in high vaginal swabs (HVS), oropharynx, and breast milk of human immunodeficiency virus (HIV)-seropositive women to their neonates at healthcare centres, Ondo State, Nigeria between November 2014 and December 2015. Materials and Methods: A total of 114 HIV pregnant women were screened for S. aureus isolates in the HVS, oropharynx, and breast milk employing sterile cotton tipped applicator. The swabs were subsequently introduced into sterile thioglycollate medium and incubated at 37°C for 24 h. When growth was noticed, a loopful was introduced onto freshly prepared mannitol salt agar (MSA). Colonies of cocci that fermented mannitol on MSA were presumptively deemed as S. aureus, but confirmed as S. aureus isolates by the slide and tube agglutination tests in pooled human plasma. HIV seropositivity was determined by the HIV1/2 strip (Determine Test, Alére, London, England, UK) and confirmed as such by enzyme-linked immunosorbent assay (Abbot laboratories, Chicago, USA). Phenotypes were determined by susceptibility testing and phylogenetic relatedness by random amplified polymorphic DNA polymerase chain reaction. Results: Results showed that 50 (43.85%) were colonized by S. aureus; however, 4 (8%) showed mother-to-child transmission from the three sites. Although all isolates tested were resistant to nalidixic acid and penicillin, 93.75% of isolates were sensitive to imipemen. Conclusion: The study revealed a high frequency of colonization of S. aureus in HVS (64%), oropharynx (20%), and breast milk (16%). Horizontal transmission from mother to neonate was 8% while phylogroups showed similarities in genetic relatedness.
  1,933 20 -
Conditional cash transfer to improve the status of the girl: Indian perspective
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):319-320
  1,723 51 -
Radiation exposure in pediatric imaging: Justification, optimization, and risk communication
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):313-314
  1,744 25 -
Lymphoid polyposis with pseudomembranous colitis in a 4-month child: A rare coexistence
Sunil Y Swami, GF D'Costa, BD Baste, VV Narhire, NC Vinay
March-April 2017, 10(2):453-456
Lymphoid polyposis is a lymphoid hyperplasia of the gastrointestinal tract that usually presents as multiple small polyps in the colon during childhood. This should be differentiated from other neoplastic or familial polyposis of the intestine. Pseudomembranous colitis (PMC) is commonly associated with Clostridium difficile infection (CDI) but can be a consequence of other disease processes. We report a case of benign lymphoid polyposis of the colon with pseudomembranous colitis in a 4-month child.
  1,709 23 -
Zika virus infection, blood glucose, and diabetes mellitus
Somsri Wiwanitkit, Viroj Wiwanitkit
March-April 2017, 10(2):484-485
  1,702 22 -
Uniting the efforts of stakeholders to end tuberculosis globally by 2030
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):297-298
  1,682 24 -
Vaccine coverage estimation using Global Positioning System and Google Earth: A commentary
Tanmay Mahapatra
March-April 2017, 10(2):295-296
  1,649 20 -
Advocating for the community empowerment and family support to improve the quality of care to schizophrenia patients
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):490-491
  1,599 32 -
My experiences in hospital infection control: We have to learn hospital infection control at the first day of medical education for students, do you agree with me?
Ali Mehrabi Tavana
March-April 2017, 10(2):491-492
  1,534 25 -
Public health role of Mahayana Buddhist temple in urban and rural community: A comparison
Wasana Kaewla, Viroj Wiwanitkit
March-April 2017, 10(2):463-464
  1,440 36 -
Zika virus infection: Factor contributing to emergence and pathogenesis
Somsri Wiwanitkit, Viroj Wiwanitkit
March-April 2017, 10(2):458-459
  1,449 18 -
Electrocardiography and echocardiography finding in Zika virus infection: Limited available data
Sim Sai Tin, Viroj Wiwanitkit, Somsri Wiwanitkit
March-April 2017, 10(2):485-485
  1,422 40 -
Accelerating progress to achieve the sustainable development goal target 3.3 worldwide
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):299-300
  1,409 26 -
Addressing the public health challenge of HIV infection among the vulnerable population group of transgender: An urgent global need
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):457-458
  1,370 19 -
Improving urban health standards: Promotion of equity and development of healthier cities for sustainable development
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):301-302
  1,355 19 -
The public health concern of mental illnesses: Strengthening of the mental health sector
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):307-308
  1,265 39 -
Ensuring the universal adoption of health equity assessment toolkit to minimize health inequalities
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):317-318
  1,269 22 -
Is there any role of Porphyromonas endodontalis for dental implant failure or not?
Ali Mehrabi Tavana
March-April 2017, 10(2):486-486
  1,252 33 -
Terminating the status of public health emergency of international concern for ebola outbreak in West Africa: What does it mean? What next?
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):303-304
  1,255 25 -
Bhaisajyaguru and medical container in Mahayana Buddhist temples in eastern Thailand: A public health pharmacological study
Wasana Kaewla, Viroj Wiwanitkit
March-April 2017, 10(2):460-460
  1,234 21 -
Aiming for Malaria elimination: World Health Organization
Saurabh RamBihariLal Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):315-316
  1,192 19 -
Estimated risk for Zika virus seropositivity among pregnant women in area with indexed case in Thailand
Somsri Wiwanitkit, Viroj Wiwanitkit
March-April 2017, 10(2):480-480
  1,187 20 -
Gastric symptom in Zika virus infection: Do we forget it?
Sora Yasri, Viroj Wiwanitkit
March-April 2017, 10(2):478-479
  1,175 20 -
Walking severe thrombocytopenia dengue patient: How about its rate?
Pathoom Sukkaromdee, Viroj Wiwanitkit
March-April 2017, 10(2):466-466
  1,176 18 -
Hemorrhagic presentation and platelet count in dengue patients
Beuy Joob, Viroj Wiwanitkit
March-April 2017, 10(2):483-483
  1,167 24 -
Limiting pesticide access to minimize suicide incidence
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):477-477
  1,168 19 -
Exploring the geographical burden and responding to the threat of the spread of dengue infection to the unaffected nations
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):481-482
  1,160 20 -
Childhood cancers in low-resource settings: Reinforcing the need for intensification of efforts
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):488-489
  1,141 23 -
Moving ahead from leprosy elimination to leprosy-free world by 2020
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):305-306
  1,143 18 -
Temperature that can promote Zika virus infection: A summary from Thai cases
Beuy Joob, Viroj Wiwanitkit
March-April 2017, 10(2):479-479
  1,113 20 -
What can we interpret from the distance between sites with emerging Zika virus infection? A case of Thailand
Somsri Wiwanitkit, Viroj Wiwanitkit
March-April 2017, 10(2):480-481
  1,110 20 -
Advocating for the implementation of the updated guidelines for the management of Hepatitis C infection universally
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):311-312
  1,109 18 -
Health implications of some precepts from Buddhist eight precepts: A religious public health concept
Viroj Wiwanitkit
March-April 2017, 10(2):469-470
  1,103 18 -
World Health Organization advocates for a two-point strategy to achieve eradication of Yaws from the endemic nations
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
March-April 2017, 10(2):475-476
  1,087 18 -
Forgotten human malarial species: Do not forget it
Beuy Joob, Viroj Wiwanitkit
March-April 2017, 10(2):467-467
  1,054 18 -
Peptide similarity, but no structure similarity: Can it explain the autoimmunity theory for pathology in Zika virus infection
Won Sriwijitalai, Viroj Wiwanitkit
March-April 2017, 10(2):483-484
  1,045 20 -
Lymphadenopathy is not common among Thai patients with Zika virus infection
Won Sriwijitralai, Viroj Wiwanitkit
March-April 2017, 10(2):473-473
  1,045 18 -
Committing suicide by physicians: A summary from Thai situation
Sora Yasri, Viroj Wiwanitkit
March-April 2017, 10(2):460-461
  1,038 18 -
Afebrile Zika virus infection
Beuy Joob, Viroj Wiwanitkit
March-April 2017, 10(2):473-474
  1,037 18 -
Zika virus infection: Existence of hemoconcentration
Somsri Wiwanitkit, Viroj Wiwanitkit
March-April 2017, 10(2):486-487
  1,031 18 -
Laboratory acquired skin infection: A concern for exhospital microbiology laboratory
Sora Yasri, Viroj Wiwanitkit
March-April 2017, 10(2):464-465
  1,020 18 -
Zika virus infection: Serious but low fatality
Won Sriwijitralai, Viroj Wiwanitkit
March-April 2017, 10(2):475-475
  1,012 18 -
Ghost and God spirit procession: Cases in Thailand and nutritional public health reflection
Somsri Wiwanitkit, Viroj Wiwanitkit
March-April 2017, 10(2):470-471
  1,011 18 -
Arogayasala in present Thai culture: Adaptation of ancient public health primary care system
Viroj Wiwanitkit
March-April 2017, 10(2):471-472
  1,004 19 -
Bilateral partnering as academic health institution's evolving perspective: What can be the early collaboration?
Achara Phanurat, Wasana Kaewla, Viroj Wiwanitkit
March-April 2017, 10(2):487-488
  995 18 -
What to be concern from the sites of existed emerging cases of Zika virus infection in Thailand?
Sora Yasri, Viroj Wiwanitkit
March-April 2017, 10(2):472-472
  994 18 -
“Have you ever seen mosquito in the airplane?”: Risk implication
Pathoom Sukkaromdee, Viroj Wiwanitkit
March-April 2017, 10(2):462-463
  988 18 -
Not all cases with Zika virus infection have thrombocytopenia
Won Sriwijitralai, Viroj Wiwanitkit
March-April 2017, 10(2):474-474
  981 18 -
Special characters in famous poem: Public health implication from literature analysis
Viroj Wiwanitkit
March-April 2017, 10(2):468-469
  980 18 -
Spirometry screening results among a group of technology college personnel
Sora Yasri, Viroj Wiwanitkit
March-April 2017, 10(2):461-462
  962 18 -
Not only thrombocytopenia but also normal platelet count and thrombocytosis can be seen in dengue patients
Pathoom Sukkaromdee, Viroj Wiwanitkit
March-April 2017, 10(2):467-468
  953 18 -
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