RESUMO
This study evaluated the relationship between the traditional indicators of faecal pollution, total coliforms (TC), faecal coliforms (FC) and Faecal streptococci (FS), and the presence of few potentially pathogenic enteric bacteria, Vibrio cholerae (VC), Vibrio parahaemolyticus (VP), Shigella spp. (SH) and Salmonella spp. (SL) in coastal sea water. The distributional statuses of these bacteria were also studied along the Southern Kerala coast. Cluster analyses were done to identify similar groups of indicator as well as enteric pathogenic bacteria. Kochi was found to be highly polluted with enteric pathogens and indicator bacteria (TC of 4700, VC of 820, FC of 920 and FS of 410 CFU ml-1). Percentage incidence of VC (97.42%) was comparatively higher than the traditional indicator bacteria (TC 95.04%, FC of 63.64% and FS of 47.64%). VC found to be rather stable and showed significant relationship with all the traditional indicator bacteria (R² > 0.370), suggests that both quantitatively and qualitatively the abundance of Vibrio cholerae can determine faecal pollution, could be used as a faecal pollution indicator bacterium, especially in the marine environment where traditional indicator bacteria failed to survive. It would be advisable to always perform the detection of SH and VP beside the traditional indicators as no significant relationship (R²<0.076, p>0.05) exists among them.
RESUMO
BACKGROUND: Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. AIM: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal failure (CRF) undergoing hemodialysis. METHODS: One hundred patients with CRF on hemodialysis were examined for cutaneous changes. RESULTS: Eighty-two per cent patients complained of some skin problem. However, on examination, all patients had at least one skin lesion attributable to CRF. The most prevalent finding was xerosis (79%), followed by pallor (60%), pruritus (53%) and cutaneous pigmentation (43%). Other cutaneous manifestations included Kyrle's disease (21%); fungal (30%), bacterial (13%) and viral (12%) infections; uremic frost (3%); purpura (9%); gynecomastia (1%); and dermatitis (2%). The nail changes included half and half nail (21%), koilonychia (18%), onychomycosis (19%), subungual hyperkeratosis (12%), onycholysis (10%), splinter hemorrhages (5%), Mees' lines (7%), Muehrcke's lines (5%) and Beau's lines (2%). Hair changes included sparse body hair (30%), sparse scalp hair (11%) and brittle and lusterless hair (16%). Oral changes included macroglossia with teeth markings (35%), xerostomia (31%), ulcerative stomatitis (29%), angular cheilitis (12%) and uremic breath (8%). Some rare manifestations of CRF like uremic frost, gynecomastia and pseudo-Kaposi's sarcoma were also observed. CONCLUSIONS: CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.