Context: Coronary atherosclerosis still presents one of the main causes of death. Efficacious prevention should focus on the early control of cardiovascular risk factors, including lipid profiles, which are unable early detect in subclinical cases. High-sensitive C-reactive protein (hs-CRP) can prove to be an early cardiac risk predictor. Aims: 1) To compare hs-CRP levels between healthy volunteer with normal blood pressure and those with prehypertension, and 2) to use hs-CRP levels along with other risks to be a cardiac risk predictor. Setting and Design: This was a cross-sectional study for 6 months' duration from January to June 2013 at Kudjab Hospital located in Udon Thani province, Thailand. Materials and Methods: Forty (40) healthy volunteers with prehypertension and 40 volunteers with normal blood pressure were included in the study. Both groups were similar in age range and sex. Twelve-hour (12-h) fasting blood samples were collected from all the participants. Serum was assayed for hs-CRP and lipid profile. Results: All of parameters were statistically significant difference (P < 000.1). The hs-CRP level (6.27 ± 7.8 mg/L) was elevated in the prehypertension group. The relative risk of hs-CRP for prehypertension was 6.3 with the odds ratio of 15.48, whereas the relative risk of lipid profiles for prehypertension prediction was only 1.28, with the odds ratio of 1.67. Statistical Analysis: SPSS version 11.0 using the unpaired t-test for comparing demographic data and blood parameters and risk prediction of hs-CRP and lipid profiles were calculated by relative risk with odds ratio [95% confidence interval (CI)]. Conclusions: Hs-CRP is an early cardiac risk predictor even with normal lipid profile, and can help measure additional risk especially subclinical people such as prehypertension.

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Background: There are few epidemiological studies regarding the effects of pesticides on enzymes related to liver function or on the hematological and biochemical parameters in occupationally exposed individuals. Aims: The aim was to evaluate biochemical and hematological parameters in pesticide sprayers. Materials and Methods: Medical history, characteristics of pesticide use, and related symptoms were recorded, and blood samples were collected from farmers at Samut Songkhram, Thailand during the period November-December 2014. Samples were divided into the pesticide sprayer group (N = 30) and the organic farmer group (N = 41). The collected blood samples were prepared for the following purposes: 1) to determine cholinesterase (ChE) activity, blood glucose, liver function test, kidney function test, and lipid profiles, which were analyzed by the automatic analyzer cobas C501 (Roche Diagnostics, Switzerland) and 2) to evaluate hematological status using complete blood count (CBC), which was analyzed by Celltac E MEK-7222 (Nihon Kohden, Japan). Results and Discussion: The levels of ChE, blood glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin, total protein, albumin, blood urea nitrogen (BUN), and creatinine between the two groups were also not statistically different and were almost within the reference range. Lipid profiles, including levels of cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were significantly different between the two groups at P = 0.035, P = 0.049, P = 0.032, and P = 0.043, respectively. Mean corpuscular hemoglobin concentration (MCHC) values of pesticide sprayers and organic farmers were lower than the reference range (30.6 ± 1.9 g/dL and 29.9 ± 1.7 g/dL) and were interpreted as anemia. Conclusions: Subchronic exposure to pesticides may alter the metabolism, which can cause hyperlipidemia and also anemia, as observed in this study.

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We report the case of a 25-year-old male patient who presented with bilateral panophthalmitis as the initial ocular manifestation of dengue fever. The diagnosis was a little confusing as he initially presented with features suggestive of retrobulbar hemorrhage secondary to his very low platelet count, which is a common feature of dengue fever. Ophthalmic complications are usually seen in young adults who often present at the nadir of thrombocytopenia. Ocular findings may include anterior uveitis, vitritis, retinal hemorrhages, retinal vascular sheathing, yellow subretinal dots, retinal pigment epithelium (RPE) mottling, foveolitis that is clinically seen as a round subretinal yellowish lesion at the fovea, retinochoroiditis, choroidal effusion, optic disc swelling, optic neuritis, neuroretinitis, and oculomotor nerve palsy. ^[1] There is only one reported case of unilateral endogenous panophthalmitis due to dengue fever. Hence, clinicians and ophthalmologists have to be aware of this vision-threatening complication of dengue for early recognition and prompt treatment to save the vision of these young patients and prevent morbidity.

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Background: Tuberculous meningitis (TBM) is a major, global public health problem and its diagnosis remains problematic even after years of experience. Early diagnosis and treatment are of paramount importance as a delay in diagnosis can lead to irreversible central nervous system damage and mortality. Aims: To evaluate the role of cerebrospinal fluid (CSF) IS6110-based tuberculosis (TB) polymerase chain reaction analysis (PCR) as an efficient diagnostic tool for the diagnosis of TBM. Materials and Methods: This is a cross-sectional study carried out with patients clinically suspected to have TBM. A total of 102 cases were enrolled, out of which 15 patients were excluded from the study because of alternative diagnoses. An in-house IS6110-PCR method using a specific pair of primers designed to amplify the insertion sequence, IS6110 in the Mycobacterium tuberculosis genome was used to analyze CSF. Results: Our study showed PCR positivity in 51.7% cases. PCR gave a sensitivity of 100% and specificity of 68.9% against the cases of TBM confirmed by culture. Conclusion: IS6110 TB-PCR is a novel diagnostic tool that can diagnose a greater number of individuals with clinically suspected TBM with its rapidity, accuracy, and reliability, and its positivity even after 4 weeks of starting treatment makes it the diagnostic tool of choice.

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Malaria is one of the most common infectious diseases, resulting in the deaths of millions of children around the world. The disease causes approximately half a million to 2.5 million people to die annually. People can only get malaria by being bitten by an infective female Anopheles mosquito that transmits malaria from infected individuals. The increase in international travel and the spread of malaria around the world has resulted in an increased risk of malaria infection. Prophylactic drugs are used to prevent the spread of malaria and to protect individuals in endemic areas. The most efficacious drug for treatment and prophylaxis against malaria is mefloquine (MQ), an antimalarial drug used especially as a prophylaxis against Plasmodium falciparum and as a treatment for malaria. MQ is also used to prevent the treatment of chloroquine-resistant P. falciparum malaria. This review focuses on the advantages of MQ and its adverse events.

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Attaining universal health coverage (UHC) is a common aspiration for many countries across the world. We examine the term UHC in the existing literature, which could help the global community to achieve access to quality health services for all. The term "universal" necessitates aiming for equity to urge the country to provide quality health services, especially to those who are currently unreached. Likewise, the term "health" must focus on social determinants and express an individual's perceived need without any harm to individual values and belief systems. The term "coverage" must make the transition from a measurement of access to quality in terms of coverage, appropriateness of care, and service utilization. Therefore, UHC, one of the post-2015 Sustainable Development Goals (SDGs), involves health targets that must be redesigned and unpacked with doubled governmental efforts to strengthen primary healthcare, the close-to-client service for equitable health outcomes.

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Aims: The present study was undertaken to estimate the prevalence of transfusion-transmitted infections (TTIs) in multitransfused patients of thalassemia major and to determine the association with relation to the number of blood units being transfused in Jammu province. Materials and Methods: The study was conducted on 138 beta thalassemia patients registered for regular blood transfusions at the Department of Blood Transfusion Medicine, Shri Maharaja Gulaab Singh Hospital, Government Medical College, Jammu in the period July-December 2014. The tests for TTIs, i.e., human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), were performed by using third-generation enzyme-linked immunosorbent assay (ELISA) kits. Statistical Analysis: The data were analyzed as proportions. The statistical significance of the results was evaluated using the chi-squared test/Fisher's exact test. A P value of <0.05 was considered significant. Results : Out of 138 patients, 13.7% (19/138) were seroreactive for TTIs. Of these seroreactive patients, 13.04% (18/138) were positive for anti-HCV and 0.72% (1/138) positive for anti-HIV. Of the anti-HCV reactive cases, 66.66% were >15 years of age. Of the anti-HCV positive cases, 94.4% (17 out of 18) had received more than 100 transfusions. Anti-HCV seroreactivity was noted to increase with increase in the age of the patient and the number of transfusions. Conclusion: HCV is the main TTI in multitransfused thalassemic patients. HBV vaccination must be done before starting the transfusion regimen or as soon as otherwise possible.

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Geotrichum candidum (G. candidum), a fungus from the class fungi imperfecti, is found saphrophtically saprophytically in nature and as a commensal in the mouth, bronchi, lungs, and gastrointestinal and genitourinary tracts. The pathogenicity of the fungus G. candidum has not been clearly defined. We describe a patient of perforative peritonitis who developed urinary tract infection (UTI) secondary to catheterization. Urine sample isolated G. candidum with significant colony count and repeated isolation also yielded the same organism. Though it is yeast of low virulence, it is an emerging pathogen associated with infections in immunocompromised and debilitated individuals.

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Introduction: We evaluated if ascitic fluid sample could be used for the diagnosis of tuberculosis intestinal obstruction (TBIO) by a nested polymerase chain reaction (PCR) assay and analyzed the clinical and laboratory findings in 33 patients with confirmed intestinal tuberculosis (TB) compared to 54 patients with other pathologies of intestinal obstruction. Methods: We tested ascitic fluid sample by Ziehl-Neelson staining; Löwenstein-Jensen (L-J) culture method was used for the culture and PCR was performed for targeting the IS6110 sequence. Results: We found that 87.9% (29/33) of cases with intestinal TB and 0% (0/54) with other causes who had positive results with the nested PCR assay. PCR, in principle, is a highly sensitive technique that detects DNA from a single to a few microorganisms with the overall sensitivity, specificity, and positive predictive value (PPV) of 87.87%, 100%, and 100%, respectively. Acid-fast bacillus (AFB) staining alone has positivity of only 24% and histology alone has positivity of 88%. Conclusion: PCR has a potentially important role in improving the diagnostic accuracy.

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Background: The study determined bacteria population on the skin, throat, and gastrointestinal tract of human immunodeficiency virus (HIV)-seropositive patients and HIV seronegative controls at the baseline, 3 months, and 6 months, respectively, at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ilé-Ifè, Osun State, Nigeria and State Specialist Hospital, Akure, Ondo State, Nigeria between May and November, 2012. Materials and Methods: Seventy HIV-seropositive subjects and 51 HIV seronegative controls who attended the HIV clinics were recruited. Skin, throat, and rectal swabs were obtained from the participants using sterile cotton-tipped applicators introduced into thioglycollate broth and incubated at 37°C overnight. When growth was noticed, the broth culture was streaked on different bacteriologic media and the isolates were characterized by the standard methods and disc diffusion for antibiotic sensitivity. Results: The number of isolates cultured from the HIV-seropositive subjects was 934, with the distribution being 397, 326, and 211 at the baseline, 3 months, and 6 months, respectively. The distribution of 1,138 isolates cultured from 51 HIV-seronegative controls was 433, 354, and 351 at the baseline, 3 months, and 6 months, respectively. At the baseline among HIV-seropositive patients, the predominant isolates were Arcanobacterium haemolyticum, Pseudomonas aeruginosa (P. aeruginosa), and Bacillus cereus (B. cereus). However, Corynebacterium haemolyticum, Enterococcus faecalis, and Escherichia coli (E. coli) were predominant at 3 months while at 6 months, Corynebacterium haemolyticum and Corynebacterium diphtheriae had the highest frequency followed by Pseudomonas fluorescens (P. fluorescens). In the controls, Corynebacterium diphtheriae, Listeria monocytogenes, and Staphylococcus xylosus (S. xylosus) predominated at the baseline and at 3 months while at 6 months, B. cereus, S. xylosus, and Staphylococcus aureus (S. aureus) were prevalent. Multiple resistances were widespread among the isolates. Conclusion: A preponderance of opportunists was observed in the HIV-seronegatives but higher multiresistant strains in the HIV-seropositives, suggesting both groups live in an antibiotic pressurized environment.

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Birth asphyxia is a major cause of neonatal morbidity and mortality in developing countries. Majority of pregnant women in Nigeria still deliver their babies in places where there are no personnel skilled in essential obstetric care and neonatal resuscitation. Consequently newborns are poorly handled at delivery with resultant poor outcome. We report two cases of iatrogenic burns injuries from hot water formentation in an attempt to resuscitate two neonates at peripheral health care facilities in Ilesa, Nigeria. These babies needlessly sustained burns injuries coupled with hypoxic-ischaemic injuries and poor perinatal outcome. These unfortunate cases of "insults upon injuries" underscore the need to strengthen the primary health care system in Nigeria by training and retraining health workers at these facilities. Proper antenatal care, adequate screening of high risk pregnancy for delivery at adequately equipped centres and making efficient referral system available will go a long way in reducing these needless injuries and morbidities.

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Contexts: Association of lipid markers and occurrence of impaired fasting glucose (IFG) have a different pattern in different populations. Aims: The present study aimed to investigate the associations of some lipid markers with impaired fasting glucose in Kermanshah city, 2013. Settings and Designs: By a case-control study, 120 IFG subjects and 240 controls were recruited. Materials and Methods: Each subject was interviewed using a sociodemographic questionnaire and lipid markers including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and fasting plasma glucose (FPG) were checked. Statistical Analysis Used: Chi-square test (χ ² ), independent samples t-test, Pearson correlation coefficient, and a multiple logistic regression were used for statistical analyses. Results: IFG subjects had significantly higher TC, TG, and LDL-c than controls (P < 0.05) but both groups had comparable body mass index (BMI) and HDL-c, (P > 0.05). FPG was positively and significantly correlated with TG and TC ranges but not with BMI, LDL-c, and HDL-c. The highest correlation coefficients (r) with FPG was for TG rather than TC (r = 0.14, P < 0.01). In multivariable regression, the odds ratios (ORs) estimated for lipid markers were not associated with IFG but ORs in those females reported to have a history of oral contraceptive pill (OCP) usage was 2.4-fold compared to the controls [OR = 2.4, confidence interval (CI): 1.16-4.95]. Conclusions: TC, LDL-c, and TG had significantly higher values in IFG subjects and should be taken into consideration for the prevention of IFG.

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Cysticercosis is a common parasitic infection in developing countries involving the central nervous system (CNS), eye, skeletal muscle, and subcutaneous tissue. Solitary intramuscular cysticercosis without CNS involvement is a rare entity. Here, we present a case of solitary cysticercosis involving a rare muscular site without any neurologic or systemic manifestation.

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Mucormycoses are a group of invasive infections caused by filamentous fungi of the Mucoraceae family, with the rhinocerebral form of the disease being the most common in a large case series. Uncontrolled diabetes and increased level of serum iron are regarded as the two leading predisposing factors for the development of the disease. We present a case of a 43-year-old male patient recently diagnosed with diabetes presenting with features of orbital apex syndrome and short-term memory loss. He was found to have rhino-oculocerebral mucormycosis on histopathological and radiological evaluations.

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