Annals of Tropical Medicine and Public Health
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  Citation statistics : Table of Contents
   2009| July-December  | Volume 2 | Issue 2  
    Online since June 10, 2010

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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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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.
  2 5,050 67
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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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.
  2 6,535 158
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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Hepatitis-B infection: Awareness among medical, dental interns in India
Pazhaniaandi Tirounilacandin, Subhashraj Krishnaraj, Kameshvell Chakravarthy
July-December 2009, 2(2):33-36
Aim: The aim of the study was to compare the level of awareness on Hepatitis-B infection among medical and dental interns in Pondicherry, India. Materials and Methods: Questionnaire containing a set of 20 different questions on Hepatitis B infection was distributed among 64 Medical and 49 Dental Interns of Arupadai Veedu Medical College and Mahatma Gandhi Dental College, Pondicherry, India, respectively. Results: The majority of interns (94.7%) were aware that Hepatitis B virus is the major cause of Hepatitis. About 33.6 and 59.3% of interns had very good and moderate knowledge respectively. The study shows that dental interns (34.7%) had better awareness than medical interns (32.8%). About 52.2% believed that Hepatitis B virus can be transmitted by semen and vaginal secretions. Only 39.9% of the interns believed that doctors, dentists infected with HBV should not have direct contact with patients. Conclusion: One- third of the interns had very good knowledge about Hepatitis B. The majority had good knowledge regarding the mode of transmission and attitude towards HBV patients. However, there is a misconception about prophylaxis, vaccination and treatment of HBV. Hence there is an imperative need for health education to improve the knowledge and attitude of the interns towards Hepatitis B.
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Gall bladder tuberculosis
Kafil Akhtar, Sifian Zaheer, S Shamshad Ahmad, Tariq Mansoor
July-December 2009, 2(2):61-62
Abdominal tuberculosis is common in developing countries, but gall bladder involvement is extremely rare. The diagnosis of gall bladder tuberculosis is often not suspected prior to surgery or a biopsy. This paper presents a case of gall bladder tuberculosis in a 40-year-old female, who presented with clinical features of chronic cholecystitis. Abdominal ultrasound showed a dilated gall bladder with multiple gall stones located in the fundus, with no other appreciable features. The patient had a retrograde open cholecystectomy and treated with antitubercular drugs. The literature on this topic is reviewed.
  - 3,471 58
Mixed infections of leg, inguinal ulcer and cellulites in HIV patient
MA Hashmi, SK Sharma, G Guha, P Sengupta, Bibhuti Saha, P Singhania
July-December 2009, 2(2):63-64
Human retrovirus leads to deficiency in the immune system of our body and the body is prone to multiple infections. We present the case of leg ulcer and subsequent development of inguinal ulcer with mixed infections in an immunodeficient patient. The diagnosis was confirmed by serological and bacteriological examination.
  - 2,718 49
Microabrasion of the enamel to soften the hypoplasia
Leila Maues Oliveira HANNA, Rodolfo Jose GOMES DE ARAUJO, Layla Cristine Oliveira GOMES, Antonio Bruno Aguiar AZEVEDO, Antonio Jose da Silva NOGUEIRA
July-December 2009, 2(2):53-56
The enamel hypoplasia, the demineralization, and the dental fluorosis are the result of general or local lesions at the dental enamel, which causes esthetic damage, since they are in disharmony within the natural aspect of the teeth. The search for a perfect esthetic has become one of the main goals of the patient and the dental surgeon as well. Microabrasion is an efficient method for intrinsic and superficial spots removal from the enamel, restoring the esthetics with minimal tissue waste. This study presents a clinical case in which the patient who presented enamel hypoplasia heredity type (imperfect amelogenesis) distinguished by brownish spots, mainly in the upper medial incisor teeth, underwent the micro abrasion technique.
  - 5,392 92
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