Prevalence and Etiological Agents of Onychomycosis.

Onychomycosis is a common nail infection caused by dermatophytes, yeast or other non-dermatophyte molds and have been known to be associated with significant physical and psychological morbidity. This study was performed to determine the prevalence and the etiologic agents of onychomycosis in patients attending RIMS, Imphal, Manipur for a period of two years (January 2010 to December 2012). Nail samples of 347 clinically suspected cases of onycomycosis attending dermatology OPD RIMS, Manipur were collected and were subjected to potassium hydroxide (KOH) mounts for direct microscopy and fungal culture on Sabouraud’s dextrose agar (SDA). The male female ratio of the participants was 1:1.81 (165 male and 302 female). Out of 467, 399 (85.44.%) were positive by culture and KOH mount. Young adults in the age group of 21-30 years were commonly affected. In female patients finger nail infection was more common than toe nail infection. Both toe and finger nails involvement were noticed in nine patients of which two were male and seven were female. The most frequently isolated fungus was dermatophytes, in 107 (40.38%) patients followed by Aspergillus spp in 101 (38.11%) and Candida spp in 17 (6.4%). This study demonstrated that dermatophytes, as well as moulds especially Aspergillus spp are commonly isolated from onychomycosis patients in our region.

Pattern of Onychomycosis - A RIMS Study.

Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts or non-dermatophytes moulds. In this study, 500 patients suspected of having onychomycosis reffered from the out patient department (OPD), Dermatology, Regional Institute of Medical Sciences(RIMS) Hospital Imphal Manipur during the period from January 2007 to December 2008 were processed in the Department of Microbiology RIMS. Nail clippings or scrapings depending on the variety of onychomycosis were collected with sterile blades under all aseptic measures. Specimens were put up for 10% KOH mount, fungal cultures on two sets of SDA (Sabouraud‘s dextrose agar) incorporated with antibiotics and lactophenol cotton blue preparation (LCB) from the cultures and examined microscopically. Slide cultures were also put up if necessary. Out of 500 samples processed, a total of 444(88.8%) were positive for the various fungi. The positive fungi were dermatophytes 258(58.1%), non-dermatophytes 139(31.3%), yeasts and yeast-like 17(3.8%) and mixed fungal isolates 30 (6.7%). Of the 230 males and 270 females studied,193(83.9%) males and 251(92.9%) females respectively were positive for various fungi causing onychomycosis. Maximum number of suspected cases were in the age group of 21-30 years.Among the dermatophytes, Trichophyton species (spp.) 250(50%) was the commonest isolate followed by Epidermophyton spp. 8(1.6%). Among the non-dermatophytes, Aspergillus spp. 70(14%) was the commonest followed by Penicillium spp. 24(4.8%), Acremonium spp. 9(1.8%), Fusarium spp. 8(1.6%), Curvularia spp. 7(1.4%), Alternaria spp. 5(1%), Scopulariopsis spp. 4(0.8%), Cladosporium spp. 4(0.8%), Nigrospora spp. 2(0.4%), Mucor spp. 1(0.2%), Paecilomyces spp. 1(0.2%), Pseudallescheria spp. (0.2%), Rhizopus spp. 1(0.2%), Verticillium spp. 1(0.2%), Exophiala jeanselmei 1(0.2%). Among the yeast and yeast-like i.e. Candida spp. 15, Geotrichum spp. 1, Rhodotorula spp. 1 were 17(3.8%), mixed fungal isolates 30(6.7%), respectively. Reports were given to the patient for follow up and treatment. Health awareness and suggestions were given for prevention and further spread of onychomycosis.

Strongyloides stercoralis infection in an HIV positive patient – A Case Report from RIMS, Imphal, Manipur.

Strongyloides stercoralis, a nematode parasite in human with free living and autoinfective cycles, is often an asymptomatic infection of the upper small intestine. If the host becomes immunocompromised, autoinfection may increase the intestinal worm burden and lead to disseminated strongyloidiasis. We report a case of a 33 year old male HIV positive patient admitted on 2/6/08 in male medical ward, Regional Institute of Medical Sciences, Imphal, Manipur with complaints of loose stools,pain abdomen, nausea, vomiting, generalized weakness, loss of appetite and loss of weight for past one month with fever off and on. Stool examination reveals larvae of Strongyloides stercoralis. The patient was successfully treated with Ivermectin 200 μgm/kg daily for 2 days.

Pattern of hepatitis C virus genotypes in HIV infected patients in RIMS, Hospital, Imphal, Manipur.

The present study was carried out to find the pattern of genotype distribution of Hepatitis C virus. Twenty-three Hepatitis C virus positive serum samples in various age-groups of both sexes attending, Microbiology Department, RIMS during the period from September 2002 to December 2004 were studied for Hepatitis C genotype. These HCV positive serum samples were sent to National Institute of Cholera and Enteric Diseases, Kolkata. The serum samples were tested for HCV-RNA by qualitative RT-PCR test and then genotyped by type specific RT-PCR. Out of 23 serum samples, 22 were males. All the 23 HCV positive serum samples were also tested positive for HCV-RNA by qualitative RT-PCR. Majority of the cases belonged to the age group of 31-40 years. Higher percentage of Hepatitis C cases were Injecting Drug Users and next to it were patients with multiple sexual contacts. Among the IDUs, Hepatitis C virus 3a type was the commonest genotype (61.1%) followed by 1b (22.2%) and 3b (16.7%) respectively. Hepatitis C genotype 3a was predominant (52.2%) followed by 1b (26%) and 3b (21.8%). HCV genotype 3a occurred most commonly in the age group of 21-40 years.