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ORIGINAL ARTICLES
Seroprevalence of Hepatitis B, Hepatitis C, and human immunodeficiency virus among healthy voluntary first-time blood donors in Kolkata
BK Das, BK Gayen, Subhra Aditya, Sumit Kumar Chakrovorty, PK Datta, Ajay Joseph
July-December 2011, 4(2):86-90
DOI
:10.4103/1755-6783.85758
Background:
Transfusion transmitted infections (TTIs) threaten safety of the recipients and the community as a whole and are a subject of real concern worldwide.
Aims and Objectives:
To know prevalence of Hepatitis-B (HBV), Hepatitis-C (HCV), and Human immunodeficiency virus (HIV) in voluntary first-time blood donors.
Design and Setting:
Cross-sectional observational study done in a teaching hospital.
Materials and Methods:
A total of 3 745 voluntary first-time blood donors were recruited and tested for HBV, HCV, and HIV with Enzyme-linked immunosorbent assay (ELISA).
Results and Analysis:
Among 3 745 blood donors, majority (90.95%) were male and 18 to 39 years age group. Prevalence of HBV was higher than HCV and HIV. HBV was maximum in 40 to 49 years (2.25%) and 18 to 29 years (1.86%) age group, whereas HCV and HIV were maximum in >50 years age group (0.93% and 1.86%, respectively). HIV positivity showed increasing prevalence with increase in age.
Statistical Analysis:
Statistical analysis was done using %, Chi square test, and Chi square for trend analysis.
Conclusion:
Seroprevalence of HBV, HCV, and HIV in voluntary blood donors is high in Kolkata and is high throughout this decade. Prevalence is even higher in other parts of India and Indian subcontinent. As voluntary blood donations are the major source of blood supply, chance of TTIs are very high in this part of the world.
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Knowledge, attitude and practice of HIV/AIDS: Behavior change among tertiary education students in Lagos, Nigeria
Oyewole C Durojaiye
January-June 2011, 4(1):18-24
DOI
:10.4103/1755-6783.80516
Background
: Globally, the spread of HIV/AIDS remains on the rise with young people at increased risk of infection. Sexual behavior change remains the most effective way of preventing further transmission.
Aim:
To gain the knowledge needed to develop appropriate interventions that will enable young people to adopt safe sexual practices.
Materials and Methods:
A cross-sectional study was conducted using structured questionnaires among 315 randomly selected students enrolled at a tertiary institution in Lagos State, Nigeria.
Results:
The mean age of the respondents was 23 years. Although the mean score of the participants' responses to ten HIV/AIDS knowledge questions was 8.3 of 10 points, 73.5% of them did not perceive themselves at risk of being infected. Majority (53.8%) had not changed their dating behaviors as a result of concerns for HIV/AIDS and 70.3% had multiple lifetime sexual partners. Those who perceived themselves at risk of infection are significantly (
P
= 0.019) more likely to always use condoms. Using the AIDS Risk Reduction Model (ARRM), it was found that the students are in the first stage of behavior change process: recognition of the problem. The low risk perception has prevented movement to the second stage of making commitment to change behavior.
Conclusion:
The awareness and knowledge of HIV/AIDS is high among tertiary education students in Lagos, Nigeria. However, risk perception is low with high-risk sexual behaviors. The failure to perceive HIV/AIDS as a personal risk has prevented commitment to behavior change. Interventions aimed at influencing risk perception are paramount to curb the spread of this dreaded disease.
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REVIEW ARTICLE
Understanding cervical cancer in the context of developing countries
Farhad Ali, Rainer Kuelker, Belaynew Wassie
January-February 2012, 5(1):3-15
DOI
:10.4103/1755-6783.92871
Cancer is one of the leading causes of deaths worldwide. Among the women, gynecological cancers are most common. Cervical cancer is a main gynecological cancer of the women. The global burden of cervical cancer is disproportionately high among the developing countries where 85 per cent of the estimated 493, 000 new cases and 273, 000 deaths occur worldwide. There are several dimensions of the problem. Cervical cancer is a problem where people are poor, where the socio-economic status of the women is low and sometimes specific ethnicity also posses additional risk to the women to develop cervical cancer. Human papillomavirus infection is a main risk factor for the cervical cancer however there are some other factors which increase the risk. Among them some are number of sexual partners, age of first sexual intercourse, infection of sexually transmitted diseases, use of hormonal contraceptives, parity, age, smoking, food and diet. Apart from these factors, some other issues, such as policy on cancer, capacity of health system, socio-economic and cultural factors and awareness among the women are also associated with the cervical cancer related morbidity and mortality across the developing countries. There some interventions which give promising results in terms of reducing cervical cancer related morbidity and mortality. Among them visual inspection of cervix with acetic acid followed by treatment is one such effective method.
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ORIGINAL ARTICLES
Artesunate opens mitochondrial membrane permeability transition pore
GN Anyasor, E.I.O. Ajayi, JA Saliu, O Ajagbonna, OO Olorunsogo
July-December 2009, 2(2):37-41
The incidence of malaria is dramatically increasing, especially because parasites responsible for the majority of fatal malaria infections have now become resistant to commonly used antimalarial drugs such as chloroquine, mefloquine, and quinine. To combat this menace, the World Health Organization (WHO) introduced a new antimalarial drug called artesunate; a hemi-succinate derivative of artemisinin. The in vivo effects of artesunate on rat liver mitochondrial membrane permeability transition (MMPT) pore were investigated in Wister strain albino rats exposed to various doses of artesunate (1.5, 2.0, 3.0 and 5.0 mg per kg body weight per day) for five days. Membrane permeability transition was estimated under energized and de energized spectrophotometric method of Lapidus and Sokolove. The results revealed that artesunate tested at the various doses induced mitochondrial pore opening, induction being minimal (68%) at 5 mg/kg and maximal (240%) at 1.5 mg/kg.
In vitro
, artesunate at 30, 50 and 70 mg/ml also had an inductive effect in a concentration-dependent manner with minimum induction (18.1%) at 30 mg/ml and maximum induction (32.7%) at 70 mg/ml. Further, preincubation of mitochondria with artesunate for five minutes caused an induction of pore opening in a concentration-dependent manner, with minimum induction (7.9%) at 10 mg/ml and maximum induction (48.6%) at 70 mg/ml. In conclusion, these findings indicate that artesunate could be cytotoxic, opening mitochondrial membrane permeability transition pore, causing the release of cytochrome c and eventually apoptosis.
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Prevalence of cutaneous fungal infections among sports-active individuals
Shahindokht Bassiri-Jahromi, Ali Asghar Khaksar
July-December 2010, 3(2):53-57
DOI
:10.4103/1755-6783.77182
Background:
This study was conducted to evaluate the occurrence of cutaneous fungal infections affecting athletes.
Methods:
A respectively study of superficial fungal infections in athletes was carried out during the period March 2002 to December 2006 on 656 mycologically proven cases of dermatophytosis found in athletes in Tehran. Mycological examination consisted of culturing of pathologic material followed by direct microscopic observation. Mycological cultures were carried out on Sabouraud Chloramphenicol Agar, Sabouraud Chloramphenicol and Cyclohexamide Agar, and Dermatophyte Agar incubated at 25° C for at least 28 days. Diagnosis was based on macroscopic and microscopic characteristics of the colonies.
Results:
We surveyed 1075 athletes suspected of having cutaneous fungal infections from 201 institutions and found that 656 (61%) were positive for fungal infections. The fungal isolates comprised
Trichophyton tonsurans
(56%),
Epidermophyton floccosum
(11.8%),
Trichophyton mentagrophytes
(8.9%),
Trichophyton rubrum
(8.3%),
Trichophyton verrucosum
(3.9%),
Trichophyton violaceum
(3.3%),
Microsporum canis
(2.5%),
Malassezia fur fur
(3.3%), and
Pityrosporum oval
(2%). The distribution of the lesions on the body was: trunk> groin> hair and scalp> sole and toe webs> finger nails> toe nails. Fungal infections were more commonly seen in wrestlers and aerobics.
Conclusion:
The results suggest that athletic activity seems to be a predisposing factor, especially for fungal infections.
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CASE REPORTS
Unusual localization of hydatidosis: Hydatid cyst of gallbladder
K Rabbani, Y Narjis, A Louzi, R Benelkhaiat, Hicham Jalal, B Finech
July-December 2011, 4(2):119-121
DOI
:10.4103/1755-6783.85766
The case of a 38-year-old man suffering from hydatid cyst located in the gallbladder is presented. Although Morocco remains an endemic area for echinococcosis, this presentation of the disease is rare. Pericyst was tightly attached to the liver. Complete pericystectomy followed by cholecystectomy was done. Histopathology confirmed the presence of calcified hydatid cyst of the gallbladder. Perioperative adjuvant medical therapy with albendazole was administered. In a 2-year follow-up, no recurrence has occurred.
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EDITORIAL
Intestinal parasitic infections: An overview
KV Ramana
July-August 2012, 5(4):279-281
DOI
:10.4103/1755-6783.101988
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EDITORIAL COMMENTARY
"Opportunities for improving public health system in India" analysis of current state of affairs and pointers for future
Giridhara R Babu
July-December 2011, 4(2):69-70
DOI
:10.4103/1755-6783.85754
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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.
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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.
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Clinico-radiological profile and treatment outcomes in neurocysticercosis: A study of 40 patients
Tushar B Patil, Madhuri M Paithankar
July-December 2010, 3(2):58-63
DOI
:10.4103/1755-6783.77186
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 conducted in a tertiary care hospital.
Subjects and Methods:
Forty patients coming under Definitive or Probable Diagnosis of neurocysticercosis as per the revised diagnostic criteria for neurocysticercosis were included in this study. Cinical history, physical examination and neuroimaging [computed tomography (CT) or magnetic resonance imaging (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%); 29 (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 3 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 the 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 stage. Clinical and radiological response to 4 weeks therapy with albendazole is quite satisfactory. All cases of young and adult onset epilepsy in tropical countries should be investigated for neurocysticercosis.
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Racial differences in susceptibility to infection by
Mycobacterium tuberculosis
Auda Fares
July-August 2012, 5(4):307-312
DOI
:10.4103/1755-6783.102032
Background:
The prevalence of tuberculosis among blacks is known to be higher than among whites. The basis for these differences remains unclear. The purpose of this paper is to review the literature and evaluate the data which bears on the question of racial differences in susceptibility to tuberculosis.
Materials and Methods:
Systematic review of peer reviewed studies identified through Medline. The search was restricted to articles published in English. The references of the identified papers for further relevant publications were also reviewed.
Results:
For the review, 31 papers were eligible from 417 identified in the search. The prevalence of TB among black skin people was 81.5% and 18.5% in white skin people. The black subjects demonstrated higher frequency of the Fok1 E2-C4T F allele, Bsm1 E8-G-+ 284A- B allele, APa1 e9-T-48G- a allele, and Taq1 E9-T-32C- t allele and marked differences in IL-6, IL-10, TNF-α, TGF-β, and IFN-γ than white subject. There were no significant differences in MCP-1 2518 A, G allele between black and white subjects. White subjects tended to have borderline significantly higher mean serum of vitamin D (58.4 nmol/l) than black subjects (37.7 nmol/l). The capacities of skin to synthesize vitamin D Post-UVB were significantly higher in whites than in black subjects.
Conclusions:
Black skin people had consistently higher susceptibility to infection by
M. tuberculosis
than are whites skin peoples. The mechanism of a racial difference in infectibility by M. tuberculosis is the result of a complex interaction between the environmental, immunologic, and genetic factors.
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Seizure related injuries among outpatients in two tertiary hospitals in South East Nigeria
Ezeala-Adikaibe A Birinus, Achor U Justin, Onwukwe U Jojo, Agomoh Ahamefule
July-August 2012, 5(4):340-343
DOI
:10.4103/1755-6783.102047
Introduction:
Epilepsy is the most prevalent and serious neurological disorder occurring in the community. The large treatment gap in developing countries places a lot of patients at risk of severe seizure-related injuries and death. Accurate data on the prevalence and pattern of epilepsy-related injuries does not exist in south-east Nigeria.
Aims:
To determine the prevalence and pattern of seizure-related injuries in patients with epilepsy attending the neurology clinics.
Setting:
Neurology clinic of 2 urban referral centers in south-east Nigeria.
Design:
Questionnaire-based cross-sectional study.
Materials and Methods:
All patients above 18 years with active epilepsy were included and were interviewed. Injuries included in the study were those directly related to seizures or of unknown cause but suspected to be due to seizures. Injuries that patients believed were of a non-seizure related etiology were excluded. Data was analyzed using SPSS v 17.
Results:
86(98.9%) patients reported a history of injury related to seizures; 28 (32.1%) patients had moderate to severe injuries while 59(67.8%) patients had only minor injuries. Loss of teeth and injury to the head were the commonest forms of injury (10.3 and 9.1% respectively). There was a slightly higher rate of serious injuries in women and in patients above 45 years.
Conclusion:
Severe body injuries are common in outpatients with active epilepsy. Loss of tooth and head injuries were the most common forms of severe injuries encountered. Adequate treatment and precautions are needed to prevent seizure-related injury from impacting negatively on the quality of their lives.
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Etiology and sensitivity of uropathogens in outpatients and inpatients with urinary tract infection: Implications on empiric therapy
Vidya Pai, Bhaskaran Nair
May-June 2012, 5(3):181-184
DOI
:10.4103/1755-6783.98610
Background and Objectives:
Urinary Tract Infections (UTI) are the second most common infections after the respiratory tract infections and constitute a great proportion of prescription of antibiotics. The present study was designed to determine the etiology of uropathogens and their susceptibility pattern in outpatients and inpatients of our hospital so as to arrive at an empirical treatment for patients with UTI.
Materials and Methods
: A total of 924 urine samples were obtained from inpatients and outpatients with a clinical diagnosis of UTI. The samples were cultured and antibiotic susceptibility of isolates determined by disc diffusion method.
Results:
Of 924 urine samples processed (828 from inpatients and 96 from outpatients), 262 (28.35%) yielded bacterial isolates. About 216 (26.08%) samples from inpatients and 46 (47.9%) from outpatients showed significant bacteriuria.
Escherichia coli
predominated in both groups, followed by
Klebsiella
spp.,
Pseudomonas
spp.,
Acinetobacter
spp., and
Enterobacter
spp., which were isolated from only the inpatient samples. Sensitivity to nitrofurantoin varied from 73% to 94% and fluoroquinolone resistance was documented as 11%-80%. Resistance to amikacin, ceftazidime, and ceftriaxone was less than 25%. Imipenem resistance was found in <5% of the bacterial isolates.
Conclusion:
E. coli
and
Klebsiella
spp. are the major uropathogens. Resistant strains are prevalent in the community, as evident by the fact that there is not much difference in resistance patterns of isolates from inpatients and outpatients. Taking into account the resistant pattern, nitrofurantoin represents the option of first choice for empirical therapy of uncomplicated UTI.
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REVIEW ARTICLES
Physico-chemical properties and toxic effect of fruit-ripening agent calcium carbide
Mohammad Asif
May-June 2012, 5(3):150-156
DOI
:10.4103/1755-6783.98602
Ripening is the final stage of the maturation process, when the fruit changes color, softens and develops the flavor, texture and aroma that constitute optimum eating quality. This study was conducted to discuss the use of unsatisfactory calcium carbide to ripen fruits for domestic markets as well as their toxic effects on human health. The commonly used ripening agents are calcium carbide, acetylene, ethylene, propylene, ethrel (2-chloroethyl phosphonic acid), glycol, ethanol and some other agents. The calcium carbide is one of the most commonly used ripening agent for fruits, while other calcium salts like calcium ammonium nitrate, calcium chloride and calcium sulfate are used to delay fruit ripening agents for local fruit industries. The use of calcium carbide is being discouraged worldwide, due to associated health hazards. Calcium carbide treatment of food is extremely hazardous because it contains traces of arsenic and phosphorous, and once dissolved in water, it produces acetylene gas. Arsenic, phosphorous and acetylene gas may affect the different body organs and causes various health problems like headache, dizziness, mood disturbances, sleepiness, mental confusion, memory loss, cerebral edema, seizures and prolonged hypoxia.
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CASE REPORTS
A rare case of spinal epidural abscess due to
Mycobacterium tuberculosis
in a 15-year-old girl
K Wanjari, VP Baradkar, M Mathur, S Kumar
July-December 2009, 2(2):65-67
Clinical infection of spinal epidural space is a rare infectious disorder that often has delayed diagnosis and is associated with significant morbidity and mortality. Initial clinical presentation may be fever, low backache that is non- specific and may mimic urinary tract infection, malignancy, and neuralgia. Hence, a high index of suspicion is required to diagnose such cases. MRI and diagnostic aspiration is necessary so that the pathogen-directed therapy could be instituted to prevent mortality. Most reported cases occur in the age group of 40-60 years, with very few reported in younger age groups. Most commonest pathogen reported is
Staphylococcus aureus
, and only few cases due to
Mycobacterium tuberculosis
are reported. Here, we report a case of epidural abscess in a 15-year-old female caused by M. tuberculosis. The diagnosis was done by MRI scan and microbiological investigations on the aspirated pus. The patient was responding to combination therapy i.e. surgical drainage and chemotherapy when last follow-up was taken.
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50
Kala Azar without splenomegaly
Sameer Gulati, HP Paljor, Sanjay Pandit, Richa Jindal
July-December 2009, 2(2):57-60
Leishmaniasis is a major public health problem in Bangladesh, North East India, Nepal, Sudan and North East Brazil. To add to the challenge, there has been emergence of leishmaniasis in new geographic areas and host populations. Visceral infection can remain subclinical or become symptomatic with an acute, subacute or chronic course. Atypical presentations can be equally challenging to the clinician. We present an atypical presentation of kala azar with lymphadenopathy and evidence of auto immune hemolytic anemia. Absence of splenomegaly was the most striking aspect in our patient. Also, lymphadenopathy is commonly seen in Sudan rather than in India.
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A rare case of genital myiasis in a woman with genital prolapse and malignancy and review of the literature
Jahar Baidya
January-June 2009, 2(1):29-30
Myiasis is a parasitic infestation caused by the larvae of several species. The infestations reduce host physiological functions; destroy host tissues, and causes significant economical losses. It is very rare disease in USA and Europe, seen rarely in tropical and subtropical countries in persons with poor personal hygiene. Diagnosis and treatment are simple. The location of this infestation at genital region is, however, an extremely rare occurrence. The authors present here one case of genital myiasis affecting a village woman with genital prolapse and advanced vaginal malignancy.
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ORIGINAL ARTICLES
Study of hospital based malaria cases in Davangere district of Karnataka, India
Kavitha Prabhu, R Lava, MG Usha
January-June 2010, 3(1):19-22
DOI
:10.4103/1755-6783.76179
Background and Objectives
: The incidence of malaria worldwide is estimated to be 300 - 500 million cases each year, and in India about 1.5 - 2 million cases have been reported annually. This study has been conducted to identify the present scenario of malaria in the Davangere district of Karnataka, India, from April 2007 to April 2008, and to compare the available diagnostic tests for malaria.
Materials and Methods:
The present study was conducted at the Department of Microbiology, J. J. M. Medical College, Davangere, from April 2007 to April 2008. A total of 202 malaria suspected cases were examined. All the cases were screened by blood smear examination, both by Leishman's staining and JSB (Jaswant Singh Bhattacharji) staining, and also by the antigen detection method.
Results:
In our study, a total of 22 cases out of 202 suspected cases were positive for malaria, with an incidence of 10.9%. Out of them 15 (68.2%) were positive for
Plasmodium falciparum
, four (18.2%) were positive for
Plasmodium vivax
, and three (13.6%) were positive for both
Plasmodium falciparum
and
Plasmodium vivax
. The Malarigen kit detected 20 positive cases compared to the blood smear study, which detected 16 cases. Fourteen cases were detected both by the Malarigen kit and blood smear study. Six cases were positive by the Malarigen kit, but not by the blood smear study. Two cases detected to be positive by the blood smear study were found to be negative by the Malarigen kit. One hundred and eighty cases were negative both by the Malarigen kit and the blood smear study.
Conclusion:
The incidence of malaria in the present study is 10.9%, which is low when compared to other studies. Malaria more commonly affects the pediatric age group and males, rather than females. Light microscopy is the gold standard, but it requires considerable expertise and time for examination. In comparison, the sensitivity of Malarigen is very close to microscopy and it does not require highly skilled personnel to perform or interpret results. Therefore, Malarigen is a simple, sensitive, and effective diagnostic test for
P. falciparum
and
P. vivax
malaria.
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10
Primary health care and public-private partnership: An indian perspective
Ranabir Pal, Shrayan Pal
July-December 2009, 2(2):46-52
Background:
In the new millennium, the progress and success of primary health care (PHC) in India has been delegated to and nurtured in the hands of growing number of 'for-profit' and 'not-for-profit' public-private partnerships along with secondary and tertiary care. This article tries to analyze the adequacy and quality of the ever increasing public-private partnership (PPP) in PHC in India.
Objective:
To assess time trends and overall patterns of public-private partnership in PHC in India.
Materials and Methods:
We conducted a literature search for data sources through an extensive search in indexed literature and website-based population survey reports; 13 states with public-private partnerships working on PHC were identified. A broad criterion to define both 'for-profit' and 'not-for-profit' PPPs was taken. Outcome variables were success of PPPs in PHC implementation.
Results:
The study critically reviewed PPPs in the light of their services in the PHC segment and significant policy perspectives by an in depth analysis with operational issues in the management and functioning of the schemes. In the health sector PPPs in India, as social entities, pool the best features of the two merging authorities of Government and private sector. They have already shown their potential.
Conclusions:
In India, PHC, PPP have shown accountability to the people in India. The time has come to explore this to the fullest extent.
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286
Epidemiological, clinical, diagnostic and treatment aspects of hospitalized
Brucellosis
patients in Hamadan
Massoud Hajia, Mohammad Rahbar, Fariba Keramat
July-December 2009, 2(2):42-45
Background and Objective:
Brucellosis is recognized as a clinical and health problem in underdeveloped countries. This research is a descriptive study to determine the prevalence of brucellosis, clinical aspects and laboratory results as well as epidemiological analysis of hospitalized patients in Hamadan city in a five-year period.
Materials and Methods:
During our study period, 809 patients (61.2% men and 38.8% women) with confirmed brucellosis based on clinical symptoms and serological tests, from all Hamadan hospitals were looked into. Patients' data concerning age, gender, occupation, date of diagnosis and observed symptoms were collected from five regional hospitals. Blood samples were obtained by venepuncture needles and all samples were analyzed using serum agglutination test (SAT), Coombs and 2-mercaptoethanol (2ME) methods. Blood culture was performed by inoculation into biphasic blood culture media for isolation the brucella organisms.
Results:
The highest and lowest age groups were 11-20 (23.5%) and over 80 (1.11%) years. The highest brucellosis rate was observed in housekeepers (26.46%) followed by farmers (20.51%). The most common observed symptoms were arthralgia, chill and anorexia with 83.8, 63.10 and 59.45% respectively, while the lowest was urethritis (0.24%). The most common signs were fever and splenomegaly with 83.8 and 20.76% respectively. A combination of rifampin and doxcycline was the most applied treatment protocol (40.91%).
Conclusion:
Brucellosis program needs to be more concerned since most affected patients were young adults with predominance among males. The majority of brucellosis cases in this study were attributed to direct contact with animals or their products. In our study cotrimoxasol-rifampin reported to have the lowest relapse rate.
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158
A study of opportunistic parasitic infections and CD4 counts in HIV-seropositive individuals in Narketpally, South India
KV Ramana, Kranthi Prakash, SK Mohanty
July-December 2010, 3(2):49-52
DOI
:10.4103/1755-6783.77180
Context:
Human immunodeficiency virus (HIV), causative agent in AIDS, is fast becoming a major threat in the Indian subcontinent with an estimated 3.7 million persons being infected with HIV. The progressive decline in immunological and mucosal defensive mechanisms predisposes HIV-positive individuals to gastrointestinal infections, thus increasing susceptibility to a number of opportunistic intestinal pathogens, among which protozoan and coccidian parasites like
Cryptosporidium
Sp.
, Isospora
Sp.
, Cyclospora
Sp. are being frequently detected.
Objectives:
To determine the opportunistic parasitic infections of the gastrointestinal tract in HIV-seropositive individuals and simultaneously their TCD4+ counts in South India.
Settings and Design:
Individuals seropositive for HIV infection were selected, and a Performa including age, sex, marital status, history of exposure, present clinical condition along with socioeconomic status, hygiene, etc was collected.
Statistical Analysis Used:
Percentages, Mean, Standard deviation.
Results:
Cryptosporidium
Sp and
Isospora
Sp were found in 17.8% and 17.1% of all samples, respectively.
Entamoeba histolytica, Giardia lamblia, Entamoeba coli
and
Blastocystis hominis
were seen in 15.6%, 12.6%, 10.4% and 4% of all examined feces, respectively. Among helminths,
Hymenolepis nana, Ascaris lumbricoides
,
Ancylostoma duodenale
, and
Strongyloides stercoralis
were found in 0.5%, 0.4%, 0.1%, and 0.03% of all patients, respectively. The TCD4+ counts in case of coccidian infections were 365 cells/mm 3 ± 86.43 whereas in case of other protozoan, helminthic and mixed parasitic infections they were: 468±40.50 cells/mm
3
, 429±190 cells/mm
3
and 312±65.74 cells/mm
3
respectively. Our data showed that among HIV-seropositive stool samples screened routinely, 44.6% were found positive for at least one parasitic agent. Concentration technique improved the findings to 59.5%. Among the intestinal parasites 88.4% infections were by protozoan parasites compared to 11% by helminthes. Of the protozoan parasitic infections
Cryptosporidium
Sp.
,
Isospora
Sp.,
Entamoeba histolytica
,
Giardia lamblia
were most frequently detected.
Conclusions:
Among intestinal parasites 88.4% infections were by protozoan parasites compared to 11% by helminthes. Of the protozoan parasitic infections
Cryptosporidium
Sp.
, Isospora
Sp.
, Entamoeba histolytica, Giardia lamblia
were detected in the majority of cases. Our findings also suggest that the intestinal parasitic infections vary with the geographical areas and studies must be carried out in respective regions to evaluate the frequent causes of intestinal parasitic infections in HIV-seropositive individuals. Early diagnosis of opportunistic infections and prompt treatment definitely contribute to increased life expectancy of infected individuals by delaying the progression to AIDS.
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5,772
8
HBsAg serosurveillance among Nepalese blood donors
Surendra Karki, Prakash Ghimire, Bishnu Raj Tiwari, Manita Rajkarnikar
January-June 2008, 1(1):15-18
DOI
:10.4103/1755-6783.43072
Context:
Hepatitis B virus (HBV) is highly infectious and can be transmitted covertly by percutaneous routes and overtly by blood transfusion. Earlier studies among Nepalese blood donors have shown a high seroprevalence of HBV. Regarding this problem Blood Transfusion Service in Nepal has focused seriously for improving its service by various motivation and education programs.
Aims:
The study was aimed to reveal the seroprevalence of HBV among different category of blood donors, in relation to their sex and age.
Settings and Design:
Descriptive cross-sectional Study.
Materials and Methods:
A total of 33,255 blood samples were screened from donors using enzyme-linked immunosorbent assay kits from December 1, 2006 to September 1, 2007 in Central Blood Transfusion Service, Nepal Red Cross Society, Exhibition Road, Kathmandu.
Statistical Analysis:
Chi-square test was used for significance testing by using the software SPSS ver. 11.5.
Results:
The seroprevalence of HBsAg among total blood donors was 0.53% (95% confidence interval [CI] = 0.46-0.62%). Significantly, higher seroprevalence was observed among male donors than in females (0.58% vs. 0.18%, respectively) (
P
< 0.05). The seroprevalence was significantly higher in the age group 41-50 years (0.88%). Similarly, significantly higher seroprevalence was observed among replacement donors (0.81%) than among volunteer donors (0.5%) (
P
< 0.05). Almost similar seroprevalence of HBV was observed among first time and among repeat blood donors (0.53% and 0.54%, respectively) (
P
> 0.05). The hepatitis C virus coinfection rate among HBV-infected donors was 1.67%.
Conclusions:
On the basis of this study, we concluded that the seroprevalence of HBV among Nepalese blood donors in Kathmandu Valley, is decreasing compared to recent past years and is relatively lower than as described for most of the major cities in South Asia. However, similar seroprevalence rate among first time and repeat donors suggests that further improvements are essential.
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88
Inhospital cardiovascular morbidity and mortality in the department of internal medicine at CHU Kigali (Rwanda)
Etienne Amendezo, Marc Twagirumukiza, Osée Sebatunzi, Abel Kagame
January-June 2008, 1(1):9-14
DOI
:10.4103/1755-6783.43071
Cardiovascular diseases (CVD) formerly considered as developed countries pandemic, are becoming nowadays increasingly ubiquitous in developing countries, where in addition to a steady increase in different risk factors, there is substantial inaccessibility to health care. However, data about the burden of CVD is lacking in many sub-Saharan African countries, and their morbimortality characteristics have been poorly described. Authors carried out a descriptive and retrospective study over a 12-month period, to describe the inhospital morbidity and mortality of CVD in the Department of Internal Medicine at University Teaching Hospital in Kigali City. Data were collected from 226 CVD cases (91 males and 135 females). The patients' age ranged from 26 to 94 years (mean age of 47.17 ± 16.04). The 226 CVD cases account for the 8.2% of hospitalized patients. Hypertension was the principal cause of death (43.1% of deaths) and the predominant cause of patients' admission (42.9%), followed by cardiomyopathies (11.9%) and valvular heart diseases (11.5%). The association between a CVD and HIV/AIDS infection was observed in 23.9% of the total patients, but no causality relationship was investigated. Isolated heart failure takes the first place (33.6%) among the cardiovascular complications, followed by stroke (14.2%) and isolated renal failure (7.5%). Findings of this study confirm the importance of CVD in CHU Kigali, not only by their inhospital frequency but also- and especially by their lethality rate and their complications associated. This study stresses also a real need of CVD community survey in Rwanda.
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© Annals of Tropical Medicine and Public Health
The Africa Health Research Organization Publishes the ATMPH & Wolters Kluwer -
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Online since 10
th
June, 2008