Parasitic coinfections among selected smallholder goat flocks in Malaysia

@#This paper describes the occurrence of multiple parasitic infection with special reference to emerging haemotropic Mycoplasma ovis. A cross-sectional survey of four selected goat flocks was conducted to collect samples and management information. Blood samples were processed using microhaematocrit centrifugation to determine the packed cell volume (PCV). Detection and morphological identification of blood protozoa and haemotropic Mycoplasma ovis from Giemsa-stained smears were done microscopically. M. ovis infection was classified mild (1-29% infected cells), moderate (30-59% infected cells), or severe (above 60% infected cells). Faecal floatation and McMaster faecal egg count were used to detect and classify strongyle infections as negative (no eggs/oocysts), light (< 500 epg), Moderate (500 – 1000 epg), or severe (>1000 epg) and coccidia infection as light (<1800 opg), moderate (1800 – 6000 opg), or severe (>6000 opg). There were 149 goats with blood protozoa (57.98%; 95% CI: 51.87 – 63.85) and 204 goats with GI parasites (79.38%; 95% CI: 74.02 - 83.87) involved in single (15.8%; 95% CI: 11.7 – 21.0) or multiple (84.2%; 95% CI: 79.0 – 88.3) infections. The risk of Strongyles increases by 2.49 (95% CI: 1.24 – 4.99) in females versus males and 6.79 (95% CI: 3.25 – 14.18, p =0.000) in adults versus young. The risk of Eimeria species increases by 7.32 (95% CI: 3.45 – 15.50, p =0.000) in adults versus young, while M. ovis coinfection risk increases by 4.51 (95% CI: 1.40 – 14.50, p =0.000) in female versus males. Thin animals had a significantly higher (p<0.05) mean burden of Strongyle (1370.37 ± 345.49) and Eimeria (1594.12 ± 695.26) than the moderate and fat goats. The PCV was negatively associated with mean faecal egg count (FEC) (p<0.05) such that a lower PCV was recorded in animals with a higher Strongyle epg output. A severe burden of M. ovis was accompanied by an increased nematode FEC and decreased haematocrit (p<0.05). Coinfections of Strongyles, or Eimeria species involving M. ovis were associated with a higher parasitaemia compared with single infections (p<0.05). This study highlights the importance of M. ovis and Strongyle or Eimeria species coinfections among goat flocks and provides valuable data for developing and implementing an integrated herd health management program for parasite control among low-input smallholder flocks.

Funny turns in an elderly man

A 74-year old man presented with recurrent attacks of altered sensorium, sometimes with abrupt falls, against the background of a long history of chronic obstructive airways disease and ischaemic heart disease. Investigations revealed evidence of significant cardiac conduction abnormalities and this led to the insertion of a permanent pacemaker. However, he continued to have recurrent 'syncopal'attacks. He was hospitalized to clarify the nature and aetiology of these attacks. Multiple stereotyped events were observed by different medical personnel, lasting up to two hours in duration. An attack was terminated by the administration of intravenous diazepam. Subsequent initiation of anti-epileptic drugs led to the complete abolition of these episodes. He has remained event-free since then ie two years. Because of multiple co-morbidities, the elderly present a greater diagnostic challenge in the evaluation of paroxysmal alterations in sensorium. It is essential that epilepsy, particularly with non-convulsive seizures, be included in the differential diagnosis whenever evaluating these patients.

Intracoronary stent implantation in Jamaica. The initial experience

Intracoronary stent implantation resulted in the complete or near complete dilatation of high grade occlusions of the left anterior descending coronary arteries in the four patients in whom it was undertaken. Intracoronary stent implantation is a useful adjunct to Percutaneous Transluminal Angioplasty (PTCA) and is applicable in selected patients with symptomatic ischaemic heart disease in a developing country with limited health resources like Jamaica. This is so since financial data presented here document the significant savings this technique (when appropriately utilised) could realise compared to the use of balloon angioplasty alone.

Percutaneous balloon mitral valvuloplasty for severe rheumatic mitral stenosis in Jamaica: the initial experience

Although percutaneous balloon mitral valvuloplasty has been performed in the Caribbean before, there has not been any detailed description in the English-speaking West Indian Medical literature hitherto. This report provides a description of the first four cases of percutaneous balloon mitral valvuloplasty performed in Jamaica.

Percutaneous transluminal coronary angioplasty (PTCA) in Jamaica. Preliminary results

This is the first detailed report from the Anglophone Caribbean of percutaneous transluminal coronary angioplasty (PTCA). The procedure resulted in complete dilatation of the occluded vessels in the five patients in whom it was undertaken, with significant improvement in exercise duration in the Bruce protocol (p < 0.001; 95CI 2.5 to 4.1 minutes) in the four patients who were studied. PTCA can be undertaken in developing countries with limited resources, and should be offered to selected patients with symptomatic coronary artery disease who need a revascularisation procedure.