Clinico-Epidemiological Patterns of Cutaneous Leishmaniasis Patients Attending the Anuradhapura Teaching Hospital, Sri Lanka

Cutaneous leishmaniasis (CL) caused by Leishmania donovani is an endemic vector-borne disease in Sri Lanka. Over 2,500 cases have been reported since 2000 and the number of CL cases has dramatically increased annually. Total 57 clinically suspected CL patients attending the dermatology clinic in Anuradhapura Teaching Hospital were recruited from January to June 2015. Slit skin smears and skin biopsies were taken from each of the subjects. Clinical and epidemiological data were obtained using interviewer administered questionnaire. Forty-three (75.4%) patients among 57 were confirmed positive for L. donovani. The majority of infected patients was males (P=0.005), and the most affected age group was 21–40 years. Soldiers in security forces, farmers, and housewives were identified as high risk groups. The presence of scrub jungles around the residence or places of occupation (P=0.003), the presence of sandflies (P=0.021), and working outsides more than 6 hr per day (P=0.001) were significantly associated with CL. The number of lesions ranged from 1–3, and the majority (76%) of the patients had a single lesion. Upper and lower extremities were the prominent places of lesions, while the wet type of lesions were more prevalent in females (P=0.022). A nodular-ulcerative type lesion was common in both sexes. The presence of sandflies, scrub jungles, and outdoor activities contributed to spread of Leishmania parasites in an endemic pattern. Implementation of vector control programs together with health education with regard to transmission and prevention of CL are necessary to control the spread of this infection.

Epidemiological pattern and outcome of head injuries during festive and non-festive periods in a tertiary hospital, Nnewi, Nigeria.

Background: Head injury is trauma to the brain and/or its coverings as a result of an externally applied mechanical force. Study of epidemiological pattern of head injuries is essential in developing necessary preventive strategies and control. To compare the prevalence and pattern of head injuries during the non-festive (February – September) and the festive (October – January) periods in our environment. Methods: Patients’ case files at the Accidents and Emergency unit of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, were reviewed. Results: Two hundred and sixty-six out of 4,846 met the inclusion criteria for traumatic head injury and were recruited for the study, giving a prevalence of 5.5%. About 77.4% of these presentations were males while 22.6% were females. Both males and females were affected more in the festive period (52.4% and 48.3%) than in the non-festive period (51.7% and 47.6%). The >20 – 30 year group recorded the highest presentation at 30.5%. Traders and Commercial Motorcyclists were the most affected occupations with 25.9% and 24.1% respectively, with the most common causes of head injury during both the festive and non – periods being motorcycle and motor vehicle accidents (68% and 18% respectively). About 63% presented with mild head injury, 14% with moderate and 23% with severe head injuries. About 11.4% were discharged, 83.9% were transferred to the ward for further evaluation and monitoring while 4.7% died at the Accident and Emergency department. Conclusions: Traumatic head injury is one of the major causes of mortality and morbidity in our environment especially in the festive periods. Aggressive and sustained traffic safety education is recommended for all stakeholders in the broad field of accidentology.

Study on the epiemiological patterns of HIV infection in HongKong by a mathematic model / 中国艾滋病性病

Objective To study the epidemiological patterns of HIV infection prevalent in HongKong.Method The epidemiological patterns of HIV infection in HongKong were analyzed with a mathematic model SI by changing its initial condition,which was used to test the related data.Results The changeable patterns of susceptible accumulative numbers of HIV infection in HongKong and the epidemiological curves and the curve of infection velocity were obtained.Conclusion The epidemic pattern of HIV infection in Hongkong and local infection velocity from 1987 to 2004 were well described using the epidemic model SI.An accumulation of 2 733 cases of HIV infection will be predicted in the year of 2005.The epidemic peak occurred in 2002 to 2004 and the overall HIV epidemic will last for 50 years approximately.

Epidemiological pattern of renal injuries and their evaluation and management.

To determine the epidemiological pattern of renal injuries and to define appropriate methods for their evaluation and management. Material and Methods: We reviewed retrospectively the medical records of 65 patients who were admitted to Siriraj Hospital, between September 1996 and February 2000. Details of patients, mechanism of injury, chief complaint, hematuria, associated injuries, radiographic assessment, management and complications of renal injury were analysed. Results: The study group consisted of 54 men and 11 women with a mean age of 31 years. Blunt and penetrating trauma occurred in 55 (85%) and 10 (15%) patients, respectively. Hematuria was present in 62 patients (95%) and absent in 3 patients (5%). Associated organ injuries were present in 37 patients (57%) and mostly occurred in blunt trauma patients. Chest injuries were the most common cause of associated injuries. Associated abdominal injuries in 17 patients (26%) involved primarily the liver and spleen. In hemodynamically stable patients, preoperative staging was performed in 47 patients (72.3%) with an intravenous pyelogram (IVP). Of 55 patients with blunt renal injuries, 32 (58%) were managed nonoperatively and 23 (42%) underwent exploratory laparotomy. In patient with blunt trauma requiring laparotomy, 6 (26%) underwent renal exploration while the remaining 17 (74%) were treated with expec-tant management and 3 (17.6%) of them had renal complications. Nine out of 10 penetrating trauma patients required laparotomy with renal exploration, but none of them had renal complications. Conclusion: In the evaluation of renal injuries and the accurate staging of these, it is important to define the full extent of the injury in order to decide on the most appropriate management. This will avoid unnecessary surgery in patients with minor injuries and these with limited major injuries, and will avoid the risk of secondary surgery, renal loss and other complications in patients with extensive injuries treated by operation.