Molecular epidemiology of Cryptosporidium in HIV/AIDS patients in Malaysia

Cryptosporidiosis is a particular concern in immunocompromised individuals where symptoms may be severe. The aim of this study was to examine the epidemiological and molecular characteristics of Cryptosporidium infections in HIV/AIDS patients in Malaysia in order to identify risk factors and facilitate control measures. A modified Ziehl-Neelsen acid fast staining method was used to test for the presence of Cryptosporidium oocysts in the stools of 346 HIV/AIDS patients in Malaysia. Standard coproscopical methods were used to identify infections with other protozoan or helminths parasites. To identify the species of Cryptosporidium, DNA was extracted and nested-PCR was used to amplify a portion of the SSU rRNA gene. A total of 43 (12.4%) HIV-infected patients were found to be infected with Cryptosporidium spp. Of the 43 Cryptosporidium-positive HIV patients, 10 (23.3%) also harboured other protozoa, and 15 (34.9%) had both protozoa and helminths. The highest rates of cryptosporidiosis were found in adult males of Malay background, intravenous drug users, and those with low CD4 T cell counts (i.e., < 200 cells/mm3). Most were asymptomatic and had concurrent opportunistic infections mainly with Mycobacterium tuberculosis. DNA sequence analysis of 32 Cryptosporidium isolates identified C. parvum (84.3%), C. hominis (6.3%), C. meleagridis (6.3%), and C. felis (3.1%). The results of the present study revealed a high prevalence of Cryptosporidium infection in hospitalized HIV/AIDS patients. The results also confirmed the potential significance of zoonotic transmission of C. parvum in HIVinfected patients, as it was the predominant species found in this study. However, these patients were found to be susceptible to a wide range of Cryptosporidium species. Epidemiological and molecular characterization of Cryptosporidium isolates provides clinicians and researchers with further information regarding the origin of the infection, and may enhance treatment and control strategies.

Association of bacterial vaginosis with preterm delivery

Preterm delivery is the leading cause of infant morbidity and mortality. Preterm labor and premature rupture of membranes and low birth weight have been associated with either specific maternal genital tract infections or an altered microflora in pregnancy. Bacterial vaginosis is one of the implicating factors for preterm labor and preterm delivery. Objective of the study is to study the frequency of Bacterial vaginosis in preterm labor. By identifying and observing the frequency of Bacterial vaginosis as a causative factor in preterm labor, we can reduce its frequency by taking certain measures and indirectly we would be able to overcome the problem of infant mortality and morbidity due to prematurity. Observational study. Fifty patients.Obstetric and Gynecology department unit II of Abbasi Shaheed Hospital and Karachi Medical and Dental College Karachi, From Jan 2003 to Jan 2004. Patients included were presented with established labor after 24[th] weeks and before 37[th] weeks of gestations. Patients with singleton pregnancy were with or without rupture of membranes. Patients excluded were multiple pregnancies, current pregnancy with sepsis, cervical incompetence, and antepartum bleeding. Patients presented with chorioamnionitis, diabetes, mellitus, hypertension, cardiac disease, renal disease and urinary tract infection were also excluded. Patients presented with effective uterine contractions after 24[th] weeks and before 37[th] weeks of gestation were admitted. Full history and examination were recorded on a given proforma. Full base line investigations, including complete blood picture, random blood sugar, and urine detailed report, blood group and Rh factor were done. High vaginal swab was taken and sent for culture/sensitivity and microscopy for clue cells. Vaginal pH was determined by using Nitrazine paper and change in color of Nitrazine paper was recorded. Whiff test was performed by taking some secretion by disposable syringe on glass slide and fishy odor was observed after adding a drop of KOH on slide. Amsel's criteria were applied to all cases preterm labor and results was analyzed on SPSS 10. Results were based on Amsel's criteria. Fifty patients were enrolled in this study. Out of fifty patients only 2[4%] patients fulfilled all four criteria, while 29[58%] patients fulfilled three criteria, 4[8%] patients fulfilled 2 criteria and 15[13%] patients fulfilled 1 criterion. Hence Bacterial vaginosis was found in 35[70%] patients. Bacterial vaginosis was associated with majority of patients presented with preterm labor and responsible for perinatal morbidity and morbidity

Epidemiologic triad of dog bite [a study of 81 cases]

Dog bite accounts for a significant number of traumatic injuries, which often needs medical treatment .Although agent, host and environment characteristics of dog bite have been well documented internationally but it is not done in Pakistan. A study was planed to find Agent, host and environment characteristics of dog bite in local population.The study setting was Emergency Department of Abbasi Shaheed Hospital. Patients were enrolled in July 2004,on a Performa designed to get different features of epidemiologic triad. Performa contain features of agents [type of animal, nature of attack and vaccination status of animal]host features [Age .gender, body part involved in bite and vaccination] environmental features [Time of bite and site of accident].Performa was filled by Doctors after interviewing each patient individually. Total 81 cases were registered in this study. Male were dominating with 80% [66] cases .Children and adolescent were the main target 65% [53] of the dog bite victims were less than 15 year of age .Mostly lower limbs were involved in the accident and it accounted for 68 % [55] cases.The highest frequency of dog bite were reported from Orangi town 31 % [25], a thickly populated area belonging to very low socioeconomic group