Etiology of tinea corporis in Karachi

To find out the demographic distribution and species of dermatophytes causing tinea corporis in Karachi, Pakistan. Design: Prospective study. Place And Duration: This study was conducted in the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi from September 2000 to August, 2001. Subjects and Ninety-nine patients having skin infections [clinically suspected cases of tinea corporis] were examined. The skin scraping were taken from active border of the lesions and subjected to direct microscopy and culture on mycobiotic agar [Difco] for isolation of dermatophytes. Various special media were used for species identification. Tinea corporis was generally predominantly seen in adult [74.8%] than in adolescent [14%] and children [11.1%]. Out of 99 cases 53 [53.5%] were males and 46 [46.5%] were females. Tinea corporis was relatively more common in males. 48 strains were recovered out of these 29 [60.4%] strains of Trichophyton rubrum, 09 [18.7%] strains of Epidermophyton [floccosum], 08 strains of Trichophyton violaecum and two strains of Trichophyton mentagrophytes. Tinea corporis was relatively more common in males. Trichophyton rubrum was the most frequently isolated dermatophytes. Species identification is necessary to prevent spread of infection and choice of appropriate antifungal agent

Frequency of cryptosporidium in childhood diaarrhoea-importance of modified acid fast technique

One of the important causes of childhood diarrhoea is cryptosporidium, a parasitic pathogen which is usually overlooked. This study was therefore designed to show the importance of modified acid fast stain in the diagnosis of cryptosporidium in childhood diarrhoea. Stool samples from 300 children with prolonged diarrhoea were examined by modified acid fast staining along with wet mounts in saline and iodine. Out of 300 samples five [1.7%] were diagnosed as positive for cryptosporidium. Results indicate that Cryptosporidiosis exists as a cause of diarrhoeal illness in our society. It was also noted that modified acid fast staining of stool samples is an important, non-invasive and useful diagnostic technique in identification of cryptosporidium

Study of hepatitis D in high risk population of hepatitis B

Hepatitis delta is a defective RNA virus which depends upon HBV for expression and replication. It may coinfect with HBV or super-infect an HBV infected individual. This study was conducted to evaluate the prevalence of antidelta in patients of hepatitis in blood bank donors in Karachi. Sera from 329 patients of hepatitis and healthy volunteers were tested for HBsAg by ELISA technique. Forty-two cases were processed further for delta antibody. HDV infection was detected in eight of the 22 patients [36.8%] of hepatitis and two [10%] of the 20 healthy carriers of HBV. The presence of HDV among our population emphasizes HBV and HDV screening prior to surgical and endoscopic procedures as well as before transfusion of blood and blood products.The use of disposable syringes in general practice should be made mandatory.There is a need to educate people for vaccination against HBV

Glandular toxoplasmosis

As lymphadenopathy is probably the most common finding in the acquired toxoplasmosis. To analyze the site and character of enlarged lymph nodes in seropositive cases of toxoplasmosis. SETTING: Department of microbiology, BMSI, JPMC, Karachi. MATERIAL AND METHODS: A total of 100 individuals of different age and sex groups having lymphadenopathy were included in the study for antitoxoplasma IgG and IgM antibody levels. Relevant information was recorded on a proforma. lymph nodes of the neck region were maximally involved i.e. 88.34%. Majority of the involved nodes were discrete, mobile, smooth in texture and firm in consistency. Half of the patients had tender lymph nodes. Among the other clinical features, fever was the most common presenting symptom [61.11%]. t 20[55.56%] of 36 positive cases were having contact with animals, contact with cats was maximum i.e. 75%

Acute and chronic toxoplasmosis; serological diagnosis in lymphadenopathy patients

Sera from 100 patients of lymphadenopathy were obtained and analyzed for antitoxoplasma IgG and IgM antibody by enzyme linked immunosorben assay [ELISA]. 36 patients were found to be seropositive, consisting of single sample of 26 patients and double samples of 10 patients. The antibody level showed that 10 patients were suffering from acute and 26 from chronic toxoplasmic infection. Regarding the analysis of seropositivity for age and sex distribution, it was found that in age group 2 1-30 years there was a significant difference [P<0.05] i.e. males dominated [61.53%] over the females [25%]

Antibodies to hepatitis C virus and alanine amino-transferase in chronic liver disease

80 patients of chronic liver disease with 10 healthy controls were studied in the Microbiology Department, Basic Sciences Medical Institute, Jinnah Postgraduate Medical Center [BMSI, JPMC], Karachi. All patients were suffering from chronic liver disease i.e. chronic persistent hepatitis, chronic active hepatitis, cirrhosis of liver and hepatocellular carcinoma for more than six months duration. The alanine aminotransferase [ALT] was persistent / fluctuating raised [>40 IU/L for males and > 35 IU/L for females] for more than three months. Samples were collected from admitted patients of various hospitals of Karachi. Ten healthy individuals with normal ALT were also included in the study. The prevalence among chronic liver disease was found to be 40%. The prevalence with history of blood transfusion, parentral therapies, hemodialysis and with no known history of possible contact with the virus was found 45%, 45.6%, 100% and 28.7% respectively

Latex agglutination method, its comparison with elisa [enzyme linked immuno sorbant assay] for HBsAg detection

OBJECTIVE: To compare the methods for the detection of HBsAg, as regards their sensitivity, specificity, practicability and cost effectiveness. SETTING: Basic Medical Science Institute, JPMC, Karachi. PERIOD: 15th Feb 1995 to 30th April 1995. SUBJECTS: 32 blood samples [22 positive and 10 negative for HBsAg] were taken from blood donors and tested in different dilutions. METHODS: All the samples were tested for HBsAg by LA method, using HUMAN [Germany] Kit and by ELISA, ABBOTT [USA] Kit. Latex agglutination method was 57% sensitive and 100% specific as compared ELISA. CONCLUSIONS: ELISA was found to be more sensitive, while both the test procedures were equally specific. On the other hand, ELISA was very technical and time consuming [2-3 hours], while LA method was very simple and rapid to perform [5-10 minutes]. Moreover cost per test for ELISA was many times more as compared to LA method. Therefore, LA method appeared to be more suitable for screening the HBsAg carriers while ELISA for HBsAg detection in early diagnosis of hepatitis and its prognosis

activity of sodium stibogluconate rifampicin and metronidazole against leishmania tropicin growth in vivo [embryonated eggs]

To delermine the anti-leishmanial activity of sodium stibogluconate, rifampicin and metronidazole in vivo. Design: Six to eight days chick embryo for in vivo anti leishmania activity. Settings: Department of Microbiology, BMSI, JPMC and Dr. Ehsanullah's Laboratory Karachi. Subjects: Locally isolated strain of Leishmania tropica. Main outcome measures: Inhibition of growth by the drugs used in the study. Sodium stibogluconate, rifampicin and metronidazole were used in different concentrations. There was complete inhibition of organisms observed with 100ug/gm for three days of sodium stibogluconate and of metronidazole. No toxic effects on chick embryos were observed. Chick embryo proved successful model for in vivo growth of leishmania tropica by yolk sac route. Base line sensitivity was determined. It was found that activity of metronidazole was comparable to sodium stibogluconate. Organisms were inhibited by administration of either drug in 100ug/mg for three days in yolk sac. Metronidazole may be used in the trial study for the treatment of Cutaneous leishmaiasis

Antibiotic sensitivity pattern of staphylococcus aureus strains isolated from patients at Karachi

To see the antibiotic sensitivity pattern of Staphylococcus aureus strains. Design: The susceptibility of Staph. aureus strains to oxacillin, six other beta lactam antibiotics and ten non-beta lactam antimicrobial agents was determined on Mueller Hinton agar by disc diffusion method. Staph. aureus strain ATCC 25923 was used as standard strain for quality control. Settings: Patients from five large public and private sector hospitals of Karachi. Subjects: Prospective study involving 200 strains of Staph. aureus isolated from patients suffering from hospital acquired or community acquired infections. Main outcome measures: Antibiograms of Staphlococcus aureus strains against beta lactam and non-beta lactam antimicrobial agents. The strains were found highly resistant to penicillin [92%]. All the strains were sensitive to vancomycin, 91% were sensitive to fusidic acid and to rifampicin, 88% to chloraphenicol, 86% to clindamycin and to ofloxacin, 75% to gentamicin, 61% to erythromycin, 41% to tetracycline and 45% to trimethoprim-sulfamethoxazole. About 25% strains were resistant to oxacillin [MRSA]. Almost the same number were resistant to amoxicillin-clavulanic acid combination and to cephalosporins. Most of the MRSA strains were also resistant to the non-beta lactam antimicrobials while MSSA strains were mostly sensitive to the beta lactam and non-beta lactam antimicrobials. Antibiotic resistance in Staphlococcus aureus is very high. Most of the MRSA strains are multiply resistant towards the commonly used antibacterials and their prevalence in community is alarmingly high. The situation calls for restrication calls for restriction in the use of antibiotics and adoption of adequate infection control measures

AIDS-diagnosis and management

HIV infection is universal with an ever increasing number of HIV infected people. However the pattern of infection varies depending on the region involved. In Pakistan, 960 HIV positive cases were detected, of which 52 were AIDS cases. HIV is transmitted more commonly in individuals who are involved in risk activities or who belong to the high risk group. The disease has varied presentations and needs a high degree of suspicion from the health care providers. Two different types are identified; HIV [widest distribution] and HIV-2 [mostly in West Africa]. Most of HIV-1 individuals have antibodies detectable in all assasy, excepting those who have been recently exposed. No patient with suggestive symptoms or signs should be dismissed on the basis of a single negative test results and no patient should be informed definitely about a positive finding without confirmed positive results. ELISA, PCR and virus culturing are methods for diagnosis the disease

Anti-HCV in chonic liver disease reflux disease

A study of 52 patients with chronic liver disease due to hepatitis C virus [HCV] following blood transfusion and parenteral therapies was conducted at the Department of Microbiology. Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre. Karachi. The patients were suffering from chronic liver disease i.e. chronic hepatitis, cirrhosis of liver and hepatocellular carcinoma for more than six months with history of blood transfusion and parenteral injections [with non-disposable syringe] for therapeutic reasons at least for three months prior to the development of the symptoms of liver disease. All these patients had persistant/fluctuating raised level of alanine aminotransferase for more than 3 months. The mean ALT was 65.1 IU/L with a range of 43-165 IU/L. The prevalence of anti-HCV was found to be 47.6% among post-transfusion cases and 45.16% in multiple parenteral therapy cases. Ten samples from healthy individuals were also included in the study, their mean ALT was 18.9 IU/L with a range of 12.1 to 30.01 IU/L. No case was found positive for anti-HCV in ten control cases

Surveillance of toxoplasmosis in different groups

Two hundred and twenty three serum samples were screened for the antitoxoplasma antibodies of IgG type by a direct agglutination method, of these 78 [34.9%] were sero-positive. In high risk groups 71 [40.1%] of 177 cases were positive, while in the low risk groups 7[15.2%] out of 46 cases were positive. Seropositive males were more than females, and the disease increased steadily with age. Of the high risk group the prevalence of toxoplasmosis was 53.7% in immunocompromised group, 44.7% in animal handlers, 39.8% in pregnancy wastage group and 25.8% in a congenitally abnormal children. A high percentage prevalence of toxoplasmosis was noticed in high risk groups as compared with low risk group

Toxoplasmosis in children with congenital anomalies

Toxoplasma gondii sero-surveillance study was conducted in a total number of 48 children with or without congenital anomalies, out of which 9 [18.8%] were sero-positive. In children with congenital anomalies, out of 31 cases 8 [25.8%] were sero-positive, while only one [5.9%] seropositive case was noticed out of 17 normal children. All cases were tested for the presence of immunoglobulin of IgG type, specific for toxoplasma gondii by direct agglutination

In vivo antibacterial activity of berberis asiatica

Antibacterial activity of the extract of roots of berberis asiatica was tested in white mice against pneumococcal infection. A dose of 6 mg given intraperitonealy at 6 hour interval over a period of 24 hours, protected 57% of the infected mice from pneumococcal infection and subsequent death. Ampicillin in a total dose of 2 mg over a period of 24 hours protected 100% of the infected mice from pneumococcal infection and death

seroepidemiology of hepatitis B in haemodialysis units

A seroepidemiologic study for hepatitis-B virus [HBV] markers in 64 chronic renal failure patients from four haemodialysis units of Karachi was conducted. Hepatitis-B surface antigen [HBsAg] was detected in 17.2% of patients and 5.4% of controls, while antibody to hepatitis N surface antigen [anti-HBs] was dected in 21.9% of patients as compared to 3.6% of the control group [p < .OS]. Eight of the 39 HBV seronegative patients became HBsAg positive during study period of 10 months. Sample collected from dialysis machines demonstrated about 11% positive, while 40% of the samples from units floors were found to be positive for HBsAg. One of the staff members developed HBsAg during study period while two had anti IIBs. The prevalence of HBsAg among family contacts of the patients was 7.4%, however, spouses seemed to be at higher risk

open study of tioconzole 1 dermal cream in patients with pityriasis versicolor dermal cream in patients with pityriasis versicolor / dermal cream in patients with pityriasis versicolor

Sixty five cases of pityriasis versicolor were treated with 1% Tioconazole dermal cream twice daily for three weeks in an open study to determine its efficacy. They were assessed before treatment and at one, two, three and six weeks after initiation of therapy. Fifty three patients [81.5%] were completely cured while twelve patients [18.5%] had recurrence on discontinuation of therapy. Five patients [7.5%] had side effects in the form of itching and burning which however, did not necessitate interruption of treatment