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   2013| April-June  | Volume 5 | Issue 2  
    Online since May 20, 2013

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Mapping the pattern and trends of extrapulmonary tuberculosis
S Rama Prakasha, G Suresh, Ivor Peter D'sa, Shobha S Shetty, S Ganesh Kumar
April-June 2013, 5(2):54-59
DOI:10.4103/0974-777X.112277  PMID:23853432
Background and Objectives: There has been a rapid expansion of the directly observed treatment short-term (DOTS) under the revised national tuberculosis control program throughout India in the last decade. Few reports exist detailing individual DOTS centers' experiences with regard to extrapulmonary tuberculosis (EPTB) in a medical college hospital setting. Materials and Methods: This is a retrospective, record-based study of patients with the diagnosis of EPTB, in all age groups. Data on all consecutive EPTB cases diagnosed at the K. S. Hegde Medical College and Hospital, Deralakatte, Mangalore from 1 January 2005 to 31 December 2011 at the DOTS centre attached to this hospital were collected, analyzed by Mantel-Haenszel Chi square for linear trend and described in proportion or percentages. Results: Among 1267 cases registered for treatment of all forms of tuberculosis, 528 (41.67%) had EPTB. Around half of the cases of EPTB (269, 51%) were among adult age groups and the majority of cases (342, 64.77%) received Category-I treatment. Pleural TB was the commonest type of EPTB (n = 148, 28.03%), followed by lymph node TB (n = 131, 24.81%). Involvement of lymph nodes was the commonest manifestation among the less than 14 years' age group (27, 58.7%), while involvement of pleura was more common among > 65 years' age group (23, 45.1%). The difference in the occurrence of EPTB by site between males and females is statistically significant with a P value of <0.005. There is a significant increase in the number of cases of tuberculosis affecting bones and joints, and other forms of tuberculosis over the years. Conclusion: The burden of EPTB is more among the productive age group. Increase in the trend of bone and joint tuberculosis, and other rare forms of EPTB is a point of concern highlighting the importance of strengthening the services towards this group.
  21 4,711 117
Assessment of risk factors of helicobacter pylori infection and peptic ulcer disease
Rahul S Mhaskar, Izurieta Ricardo, Azizan Azliyati, Rajaram Laxminarayan, Bapaye Amol, Walujkar Santosh, Kwa Boo
April-June 2013, 5(2):60-67
DOI:10.4103/0974-777X.112288  PMID:23853433
Background: Helicobacter pylori (H. pylori) infection is a risk factor for peptic ulcer. There have been no studies addressing environmental and dietary risk factors in western India. We conducted a case control study enrolling peptic ulcer patients in Pune, India. Materials and Methods: Risk factors for peptic ulcer and H. pylori infection were assessed in a participant interview. H. pylori status was assessed from stool by monoclonal antigen detection. Results: We enrolled 190 peptic ulcer, 35 stomach cancer patients, and 125 controls. Fifty-one percent (180/350) of the participants were infected with H. pylori. Lower socioeconomic status (SES) [odds ratio (OR): 1.10, 95% confidence interval (CI): 1.02-1.39], meat consumption (OR: 2.35, 95% CI: 1.30-4.23), smoking (OR: 2.23, 95% CI: 1.24-4.02), eating restaurant food (OR: 3.77, 95% CI: 1.39-10.23), and drinking nonfiltered or nonboiled water (OR: 1.05, 95% CI: 1.01-1.23) were risk factors for H. pylori infection. H. pylori infection (OR: 1.70, 95% CI: 1.03-2.89), meat (OR: 1.10, 95% CI: 1.02-1.75), fish (OR: 1.05, 95% CI: 1.02-1.89) consumption, and a family history of ulcer (OR: 1.20, 95% CI: 1.08-1.60) were risk factors for peptic ulcer. Consumption of chili peppers (OR: 0.20, 95% CI: 0.10-0.37) and parasite infestation (OR: 0.44, 95% CI: 0.24-0.80) were protective against H. pylori infection. Conclusion: H. pylori infection is associated with peptic ulcer. Lower SES, consumption of restaurant food, meat, nonfiltered water, and smoking are risk factors for H. pylori. Consumption of meat, fish, and a family history of peptic ulcer are risk factors for peptic ulcer. Consumption of chili peppers and concurrent parasite infestation appear to be protective against H. pylori.
  10 9,591 253
Multiplex PCR for rapid diagnosis of gastrointestinal tuberculosis
Kusum Sharma, Saroj Kant Sinha, Aman Sharma, Ritambra Nada, Kaushal K Prasad, Kapil Goyal, Surinder Singh Rana, Deepak Kumar Bhasin, Meera Sharma
April-June 2013, 5(2):49-53
DOI:10.4103/0974-777X.112272  PMID:23853431
Background: Rapid and specific diagnosis of gastrointestinal tuberculosis (GITB) is of utmost importance. Aim: To evaluate Multiplex PCR (MPCR) using MPB64 and IS6110 primers specific for M. tuberculosis for rapid diagnosis of GITB. Materials and Methods: MPCR was performed on colonoscopy biopsy specimens on 11 GITB confirmed (culture/AFB/histopathology was positive), 29 GITB suspected and 30 Non GITB (control group) patients. Results: MPB64 PCR had sensitivity and specificity of 90% and 100% for confirmed GITB cases. In 29 clinically diagnosed but unconfirmed GITB cases, MPCR was positive in 72.41%. MPCR was negative in all control group patients. The overall sensitivity and specificity of microscopy, culture, histopathology and MPCR was 5%, 2% 20% and 77.5% and 100%, 100%, 100% and 100% respectively. Conclusion: MPCR has good sensitivity and specificity in diagnosing gastrointestinal tuberculosis.
  9 4,206 72
Community-Acquired urinary tract infection by pseudomonas oryzihabitans
Sunita M Bhatawadekar
April-June 2013, 5(2):82-84
DOI:10.4103/0974-777X.112274  PMID:23853437
Pseudomonas oryzihabitans and Chrysomonas luteola has been placed in CDC group Ve2 and Ve1 respectively. These bacteria appear to be emerging pathogens. P. oryzihabitans was isolated from cases of bacteremia, CNS infections, wound infections, peritonitis, sinusitis, catheter associated infections in AIDS patient, and pneumonia. Most of the reports of P. oryzihabitans infection were of nosocomial origin in individuals with some predisposing factors. We report here a case of community acquired UTI by P. oryzihabitans in an immune-competent patient with stricture of urethra.
  4 4,123 44
The pattern and impact of infectious diseases consultation on antimicrobial prescription
Jaffar A Al-Tawfiq
April-June 2013, 5(2):45-48
DOI:10.4103/0974-777X.112266  PMID:23853430
Objectives: Inclusion of infectious disease (ID) physicians in the care of patients with possible infection can favorably affect antibiotic usage. The aim of this study was to evaluate the role of the ID consultations in reducing inappropriate antibiotic usage. Materials and Methods: This is a prospective study evaluating all adult ID consultations from January 2006 to December 2009. A total of 1444 consultation requests were recorded during the 4-year period. Results: The most frequent consultations were from cardiology (23.1%), orthopedics (8.2%), general medicine (7.8%), hematology-oncology (7.8%), gastroenterology (7.3%), and pulmonary/critical care (7.1%). The main reason for consultation was for the choice of antibiotics (75%). The commonest diagnoses prior to consultation were fever (14.7%), bacteremia (9.1%), and urinary tract infection (8.4%). Bacteremia was documented in 21.4% of cases and 12.9% were found to have no identifiable focus of infection. Antimicrobial therapy was changed in 58.7% and antimicrobials were discontinued in 14.7% of cases. The number of antimicrobial therapy was one (49.7% and 49.9%) and two (24% and 17.6%, P = 0.0001) before and after the consultation, respectively. In addition, 17.3% and 26.9% ( P = 0.0001) received no antimicrobial agents before and after ID consultation. Conclusion: ID consultation is important to reduce inappropriate antimicrobial therapy and to limit the number of dual therapy.
  4 3,454 49
Data from the world health organization (WHO) national network laboratory for japanese encephalitis
AK Borthakur, Nibedita Das, BJ Bora
April-June 2013, 5(2):76-79
DOI:10.4103/0974-777X.112294  PMID:23853435
Aim: Japanese encephalitis (JE) virus is the leading cause of viral neurologic disease and disability in Asia. In the present study JE virus-specific IgM in serum and CSF from acute encephalitis syndrome (AES) patients, attending Assam Medical College and Hospital (AMC and H), Dibrugarh, Assam from 2007 to 2009 were detected and different epidemiological parameters namely age, season and vaccination campaign were enumerated. Materials and Methods: A cross-sectional study on patients with AES admitted in AMC and H, Dibrugarh, Assam was done during 2007 to 2009. The different epidemiological features were characterized depending on a pretested structured questionnaire called the clinical information form (CIF). Serum and CSF obtained were tested by a Panbio JE-Dengue IgM Combo ELISA kit and JEV Chex kit (Xycton). Statistical Analysis: A z-test was used for the statistical analytic assessment. Results: Detection rate of JE was 39.4%, 51.1%, and 51.3% in the years 2007, 2008, and 2009 respectively. Cases of JE increased in the age group more than 15 years in the district where the vaccination program was undertaken. This increase of cases from pediatric to adults is also statistically significant by the z-test (P<0.05). Conclusion: There was an increase in AES cases and also JE cases from 2007 to 2009. JE also showed a seasonal variation with maximum cases in the months of July and August. Although vaccination campaigns with the live attenuated vaccine SA-14-14-2 have started and are protecting the under-15 children, there is a shift of disease pattern in the older population.
  2 3,204 44
Salmonella typhi rib osteomyelitis with abscess mimicking a 'cold abscess'
Alice Mathuram, Rianne Van Rijn, George M Varghese
April-June 2013, 5(2):80-81
DOI:10.4103/0974-777X.112271  PMID:23853436
Salmonella enterica serovar typhi (Salmonella typhi) causing typhoid fever is common in many parts of the world particularly in developing countries. Extra-intestinal manifestations such as osteomyelitis are rare in immunocompetent individuals. We report a case of Salmonella typhi osteomyelitis of a rib with overlying abscess mimicking a 'cold abscess', treatment outcomes and discuss relevant literature.
  1 2,999 34
State of the Globe: Antimicrobial stewardship guides rationale use of antimicrobials to enable faster cure and prevent drug resistance
Dhanashree Kelkar, Sagar Galwankar
April-June 2013, 5(2):43-44
DOI:10.4103/0974-777X.112261  PMID:23853429
  1 2,734 40
Seropositivity for Brucellosis in veterinarians
Niranjan B Patil, Ajit S Damle, Jayashree B Bhakare, Jyoti A Iravane, Mukta N Khaparkhuntikar, Pradnya S Gajbhiye
April-June 2013, 5(2):87-88
DOI:10.4103/0974-777X.112285  PMID:23853440
  1 2,114 29
Intractable hiccups in an elderly diabetic: An unusual presentation of ascaris lumbricoides
Ramesh Aggarwal, Shridhar Dwivedi, Anupam Dey, Shamim Ullah Khan, Meenakshi Aggarwal
April-June 2013, 5(2):88-88
DOI:10.4103/0974-777X.112287  PMID:23853441
  - 2,579 30
Not all vaccines are cost-beneficial in developing countries
Ashish Garg, Zainab Golwala
April-June 2013, 5(2):89-90
DOI:10.4103/0974-777X.112291  PMID:23853442
  - 2,003 30
Nontuberculous mycobacterial arthritis of the first metatarsophalangeal joint in a young immunocompetent adult: An interesting case report
Annam Vamseedhar, Ashok Kumar Padmanabhan, Nalini Mohan Chakkirala, Rajgopalrao Suresh Darbur
April-June 2013, 5(2):85-86
DOI:10.4103/0974-777X.112280  PMID:23853438
  - 2,052 28
Diagnosis of extrapulmonary tuberculosis by polymerase chain reaction for mpb64 gene: An evaluation in a hospital based study
Sushma Pednekar, Arvind V Bhore, Vrishali A Muley, Dnyaneshwari P Ghadage
April-June 2013, 5(2):86-87
DOI:10.4103/0974-777X.112283  PMID:23853439
  - 1,909 25
Detection of invasive aspergillosis in bone marrow transplant recipients using real-time PCR
Mojtaba Nabili, Tahereh Shokohi, Ghasem Janbabaie, Mohammad Bagher Hashemi-Soteh, Kamran Ali-Moghaddam, Seyed Reza Aghili
April-June 2013, 5(2):68-75
Objective: The invasive aspergillosis (IA) is a serious opportunistic infection caused by various species of Aspergillus in immunocompromised individuals. Basically, rapid and early diagnosis prevents IA progression. In this study we performed a Real Time PCR/ Fluorescence Resonance Energy Transfer (FRET) for diagnosis of IA in hematologic malignancies and bone marrow transplant recipients. Materials and Methods: Sixty two patients with hematologic malignancies and marrow transplant recipients were evaluated for IA in Sari and Tehran from 2009 to 2010. The primer and hybridization probe were designed to amplify the specific sequence of 18S rRNA genes using Light Cycler system and FRET. Galactomannan (GM) assay was performed on serums which obtained from selected patients using the Platelia Aspergillus kit. Results: According to the criteria defined by the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) for IA, 18 (29%) patients out of 62 patients were stratified into probable and possible groups. The female-to-male ratio was 1:2; the mean age of the patients was 36 years. The most common malignancies in these patients were acute lymphoblastic leukemia (38.9%). The minimum detection limit was 10 conidia (10 1 CFU/ml) equivalents (100 fg) per PCR reaction. GM assay was positive in 20.9% and real-time PCR probe set assay were positive in 17.7% patients who had clinical signs and host factor according to the mentioned criteria. Conclusion: Using the Real-Time PCR/FRET assay in whole blood specimens seems to be a promising method for diagnosis of IA, especially when used in combination with the GM detection test.
  - 4,688 76
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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008