Epidemiology of Cyclospora Species in Humans in Malatya Province in Turkey.

BACKGROUND: Cyclospora species are rare among other Coccidia parasites and can cause recurrent gastroenteritis. Cyclospora spp. can infect reptiles, insects, rodents, and mammals. OBJECTIVES: The present study aimed to determine the epidemiology of Cyclospora spp. in Malatya province and its neighboring provinces. PATIENTS AND METHODS: Totally, 2281 stool samples taken from patients with digestive system complaints who referred to the polyclinics affiliated with Inonu University, Faculty of Medicine in Malatya Province and its neighboring provinces, in 2006, and whose stool specimens were submitted to the parasitology department were examined. A questionnaire was developed to determine the epidemiology of Cyclospora spp. in the patients as the dependent variable of the study. All the participants signed an informed written consent. The samples were coated with Entellan™ after staining via acid-fast staining and were examined on an immersion microscope objective. The data are presented as mean, standard deviation, or number/percentage. The chi-square test was used for the statistical analyses. Statistically, a P value < 0.05 was accepted as meaningful. RESULTS: The stool samples were examined via direct microscopic examination and acid-fast staining. Positivity was determined in 129 (5.7%) cases. In the overall assessment of the patients with respect to general body itching, rectal itching, allergy, immunosuppression plus cancer, shortness of breath, ulcerative colitis, diarrhea, abdominal pain, salivation, constipation, nausea, vomiting, growth retardation, and anemia, there was no significant relationship. However, in the statistical evaluations among the positive cases, the difference was found to be significant. CONCLUSIONS: The study was conducted in Malatya Province, but patients from the neighboring provinces were also included in the evaluation during the study. Of all the positive cases, 5.6% were those from Malatya Province and its surrounding areas. Additionally, Cyclospora spp. were observed among the patients referring to the polyclinics with digestive system complaints in 8.1% of those from the Adiyaman province and in 6.9% of those from the Kahramanmaras region. The incidence of Cyclospora cayetanensis may be higher in these regions if an epidemiological study is performed. Consequently, we suggest that Cyclospora spp. be investigated in digestive system disorders, especially in immunosuppressed patients.

[The clinical, serological and morphological analysis of 91 patients with cystic echinococcosis following surgery]. / Kistik ekinokokkozis nedeniyle opere edilmis 91 olguda klinik, morfolojik ve serolojik irdelemeler.

Cystic echinococcocis (CE) is a zoonotic infection caused by metacestod form of Echinococcus granulosus. In this study, 91 patients with CE were revealed according to their gender, age, symptoms, cyst localization and size, and also to their preoperative serologic analysis results. These patients were recruited in Pathology Department of Inonu University, School of Medicine, Turgut Ozal Medical Center between January 2002 and December 2005. They had already undergone surgery following the preliminary diagnosis of CE and were diagnosed definitively after histopathological analysis. Thirty-seven of them were female (41%) and the rest were male (n=54, 59%). Mean age was 36.24 ± 20.35 (range: 4-80 years). Lung and liver were the most common localizations for CE cysts (n=67, 73.63%). Fifty patients' preoperative serological analysis (IHA) were already available (55%) and 46 of them (92%) were positive. Since histopathological definitive diagnosis was CE, false negative result rate was assessed as 8%. Intraabdominal CE cyst localization was found related with bigger cyst size and multiple organ involvement. Symptom duration was correlated with cyst size (p < 0.05; r < sup > 2 < /sup > =0.09). IHA results were failed to be found related with clinical features of the cysts.

[Malondialdehyde, glutathione and nitric oxide levels in patients with Enterobius vermicularis infection]. / Enterobius vermicularis ile enfekte hastalarda malondialdehid, glutatyon ve nitrik oksit düzeyleri.

The aim of this study was to investigate the levels of malondialdehyde (MDA) and nitric oxide (NO) which are indicators of oxidative stress and also the level of glutathione (GSH) which is an antioxidant molecule, in patients with Enterobius vermicularis infection. A total of 41 patients (mean age: 36.4 years; 31 were male) and 40 healthy controls (mean age: 40.2 years; 28 were male) were included to the study. None of the patients and controls have had history of hormone/steroid drug use, smoking and alcoholism. The mean level of GSH in patient and control groups were found 1.17 +/- 0.02 micromol/l and 2.49 +/- 0.10 micromol/l; MDA 26.97 +/- 2.06 micromol/l and 19.47 +/- 2.25 micromol/l; NO 20.74 +/- 0.60 micromol/dl and 17.83 +/- 0.50 micromol/dl, respectively. The mean GSH level in patient group was statistically significantly lower (p < 0.05) than controls, while the mean MDA and NO levels were statistically significantly higher (p < 0.05). These results indicated that the consumption of GSH was increased due to the severity of oxidative stress in patients infected with E. vermicularis. Detailed experimental and clinical studies are required to enlighten the relation of GSH in the pathogenesis of E. vermicularis infection. Since oxidative stress is increased during enterobiosis, the use of antioxidant agents (e.g. vitamins C and E) for the supportive treatment deserves evaluation.

[Histopathology of strobilocercosis found in the livers of white mouse.]. / Beyaz Farelerde Karaciger Yerlesimli Strobilocercosis Histopatolojisi.

The adult form of Taenia taeniaeformis is found in the intestine of the cat and cheetah. The larva form is called Strobilocercus fasciolaris and is found in rodents such as mice and rats. Our objective was to draw attention to that rare zoonosis, since it has already been reported in the literature as strobilocercosis in humans. During an experimental animal study conducted at Inonu University, some unexpected cystic formations were found in the livers of nine 6-8-month-old healthy white mice, which affected the conducted study negatively. These cystic formations were examined histopathologically. Prepared sections were stained with haemotoxylin eosin, periodic acid-Schiff and Masson trichrome stains, and examined by light microscopy. Strobilocercus fasciolaris larvae that curled towards cyst cavity and their hooks were seen. Plasma cells, macrophage, focus of eosinophilic infiltration and fibroblastic connective tissue were simultaneous found. In this paper, histopathological changes in intermediate hosts caused by Strobilocercus fasciolaris and other cestod larvae have been discussed.

What is the importance of Demodex folliculorum in Behçet's disease?

Demodex folliculorum is an obligate parasite and commonly detected in patients with immune system deprivation. This study is planned to document the Demodex folliculorum prevalence among patients with Behçet's disease (BD). The patients who referred to the ophthalmology clinic were included in the study. Fourty patients with BD and 131 patients with refractive errors without any ocular and systemic disease were included. For parasite detection, 3 eyelashes from each inferior eyelid were epilated. Standardized skin surface biopsy (SSSB) was performed for detection of parasite at cheeks of patients. Samples were prepared with Hoyer's solution and investigated under the light microscope. There were 15 female and 25 male in BD group and 61 female and 70 male patients ine control group. Mean ages were 37.62 and 38.38 for BD and control groups, respectively. Demodex folliculorum prevalence at eyelashes was 65% for BD and 10% for control group. SSSB of cheek revealed 7.5% positivity for BD and 10% for control group patients. Statistical analysis documented a significant difference for eyelashes (p < 0.05) which could not be detected for skin results. Investigation of Demodex folliculorum in BD may be useful, even in patients without any complaint, for the treatment of ocular and eyelid discomforts of these patients.

[The prevalence of Microsporidium among patients given a diagnosis of cancer]. / Kanser Tanisi Almis Hastalarda Microsporidium Görülme Sikligi.

The aim of this study was to determine the frequency of Microsporidium among patients given a diagnosis of cancer. For this purpose fecal samples from 320 patients aged 23.60+/-23.00 years were examined using native-Lugol and sedimentation methods and evaluated with modified trichrome, trichrome, and calcofluor dyes. Moreover a control group of 320 non-cancer patients was set up. While 10.9% of the patient group was found to have Microsporidium, only 5.6% of the control group did. Comparison between the control and patient groups in terms of presence of Microsporidium revealed a statistically significant difference. The analysis of a possible relation between intestinal parasites and the presence of Microsporidium revealed a statistically significant correlation between Microsporidium and Blastocystis hominis (P < 0.05). The frequencies of intestinal parasites in the control group and the patient group were found to be 17.8% and 18.1%, respectively. From the findings it was concluded that presence of intestinal parasites and Microsporidium in cancer patients can cause critical problems and adversely affect the therapy. Moreover it was suggested that cancer patients should be informed about regular feces examination and protection against parasites in order to improve their life standards and protect them against parasite infections during treatment.

[The prevalence of Microsporidium among adult patients admitted to the parasitology laboratory at the Inonu University Turgut Ozal Medical Center]. / Inönü Universitesi Turgut Ozal Tip Merkezi Parazitoloji Laboratuvarina Gelen Eriskin Hastalarda Microsporidium Görülme Sikligi.

Microsporidium can cause acute and self-restricted diarrhea cases among immunocompetent patients. The aim of this study was to investigate the presence of intestinal parasites and Microsporidium in patients presenting at the internal diseases polyclinic with some digestive system complaints but no immune suppressive problems, and to detect whether it has anything to do with the complaints. A total of 781 fecal samples were investigated for intestinal parasites and Microsporidium. Intestinal parasites were found in 16.11% and Microsporidium in 6.5%. A significant correlation was observed between the presence of intestinal parasites other than Microsporidium and dyspepsia, while in the case of Microsporidium, a significant frequency of dyspepsia and fatigue was observed. It was found that the presence of Microsporidium does not differ by age and gender. From the findings, it was concluded that patients with digestive system complaints should be examined for Microsporidium in addition to intestinal parasites, and the symptoms of dyspepsia and a lack of appetite should especially be given more careful attention.

[Determination of house dust mites in Eskisehir]. / Eskisehir'de Ev Tozu Akari Görülme Durumu.

House dust contains various organic and inorganic materials. The most important parts of the house dust are dust mites causing allergic diseases such as allergic rhinitis, asthma, atopic dermatitis and seasonal keratoconjunctivitis. In this study, a total of 72 random house dust samples collected from various regions of Eskisehir were examined. The dust samples were examined by the lactic acid precipitation method which was modified from the Spieksma-Boezaman's method. The mite positive house dust rate was 16.67% including Dermatophagoides pteronyssinus, Chortoglyphus arcuatus and Tyrophagus sp. It was concluded that investigation of a greater number of samples would lead to more precise rate of detection of mite positive dust and also that more mite species would be found.

[A case of alveolar echinococcosis in Malatya province]. / Malatya'da Alveolar Echinococcosis Olgusu.

The disease resulting from being infected with the larval stage of Echinococcus multilocularis is called alveolar echinococcosis (AE). In our country AE is seen in eastern and southeastern regions of Anatolia. Previously no case of AE had been reported by any hospital in Malatya. In this one case, a 70 year-old woman who presented at the Inönü University Turgut Ozal Medical Center with a right upper quadrant abdominal pain was given a diagnosis of cystic echinococcosis (CE) by dynamic liver computed tomography. The pathological examination following the cystectomy revealed the presence of AE. This is a report of the first AE case detected in Malatya province.

Glutathione and malondialdehyde levels in patients with hydatid cyst.

OBJECTIVE: To investigate the levels of glutathione (GSH), and malondialdehide (MDA) in the sera of patients diagnosed with cyst hydatid. METHODS: Forty-six hydatid cyst patients who were indirect hemaglutination (IHA) and indirect fluorescence antibody (IFA) test positive constituted our study group in 2007. Patients diagnosed with hydatid cyst in the Inonu University School of Medicine, Department of Parasitology were re-called for the study. Forty healthy subjects who were negative for hydatid cyst by IHA and IFA methods, and who did not have any parasites on stool inspection formed the control group. The MDA level was analyzed in the sera by Uchiyama and Mihara method. The GSH activity was measured by the Ellman method. RESULTS: The GSH level was 11.31 -/+ 3.80 micromol/L and the MDA level was 67.94 -/+ 106.70 micromol/L in the study group, while they were 24.95 -/+ 6.55 micromol/L and 26.52 -/+ 19.42 micromol/L in the control group. CONCLUSION: An increase in MDA levels and a decrease in GSH activity in patients with hydatid cyst was observed.

Malondialdehyde, glutathione, and nitric oxide levels in Toxoplasma gondii seropositive patients.

The aim of this study was to investigate the difference in the serum malondialdehyde (MDA), glutathione (GSH), and nitric oxide (NO) levels between normal and T. gondii-infected patients. To this end, MDA, GSH, and NO levels in the sera of 37 seropositive patients and 40 participants in the control group were evaluated. In Toxoplasma ELISA, IgG results of the patient group were 1,013.0 +/- 543.8 in optical density (mean +/- SD). A statistically significant difference was found between patients and the control group in terms of MDA, GSH, and NO levels. A decrease in GSH activity was detected, while MDA and NO levels increased significantly. Consequently, it is suggested that the use of antioxidant vitamins in addition to a parasite treatment shall prove useful. The high infection vs control ratio of MDA and NO levels probably suggests the occurrence as a mechanism of tissue damage in cases of chronic toxoplasmosis. Moreover, it is recommended that the patient levels of MDA, GSH, and NO should be evaluated in toxoplasmosis.

A comparison of cytological and parasitological methods in the diagnosis of Trichomonas vaginalis.

Trichomonas vaginalis (T. vaginalis), which causes urogenital system infections in humans, develops symptomatically and asymptomatically. T. vaginalis in females is diagnosed using direct microscopy, Giemsa staining, and cultivation methods for examination of samples derived from the vaginal posterior fornix. Serologic methods can also be employed. In cytological diagnosis, the ectocervical smear is examined using the Papanicolaou (PAPS) stain. The aim of the present study was to compare the efficacy of the methods used in cytological and parasitological diagnosis. For this purpose, 506 female patients who visited the Obstetrics and Gynecology policlinic of the Academic Hospital of the Faculty of Medicine, Inönü University during a course of six years were involved in this study. The samples derived from the vaginal posterior fornix were examined in the parasitology laboratory, while the ectocervical samples were examined in the cytology laboratory. T. vaginalis was detected in 4.6% of the samples examined in parasitology laboratory, while parasites were found in only 0.9% of the samples taken to the cytology laboratory. The statistical analysis revealed a significant difference (P<0.05). It was concluded that parasitological methods are more sensitive than cytological methods in the diagnosis of T. vaginalis.

[Frequency of the appearance of Demodex sp. in various patient and age groups]. / Cesitli hasta ve yas gruplarinda Demodex sp. görülme sikligi.

Demodex folliculorum and Demodex brevis are acari that can be found in hair follicles and sebaceous glands of the skin, especially on face of humans. In this study, Demodex sp was investigated in regard to allergic diseases, age and gender. A total of 197 patients (117 with rosacea, 29 with akne vulgaris, and 51 with allergic diseases) were examined using the standardized skin surface biopsy (SSSB) and 97 out of 197 (49.23%) cases were found to be positive by the Inonu University Medical Faculty Department of Parasitology. There was no significant difference between mite positivity and negativity between the genders, while a higher rate of Demodex sp. was found in patients with rosacea and a lower rate in patients under 20 years old (p0,005). As a result, patients over 20 years old, especially those with rosacea, must be investigated for Demodex sp.

[Serum zinc (Zn) levels in patients with giardiosis]. / Giardiosisli hastalarda serum Cinko (Zn) düzeyleri.

A decrease may occur in the levels of trace elements due to absorption deficiency resulting from giardiosis. This study was designed in order to reveal the difference in serum zinc levels between patients with giardiosis and healthy controls. Thirty one patients who were diagnosed as having giardiosis after detection of G. intestinalis and 31 healthy controls participated in the study. A significant decrease was observed in serum zinc levels of patients with giardiosis compared to those of controls (p < 0.0001). In conclusion, we suggest that parasitic diseases should also kept in mind in the differential diagnosis of cases characterized by low serum zinc levels.

[The frequency of intestinal parasites and head lice among students of the Aksemsettin Primary School for Deaf Students]. / Aksemseddin Isitme Engelliler Ilkögretim Okulu ögrencilerinde bagirsak parazitleri ve bas biti görülme sikligi.

Parasitic infections especially affect those children in critical phases of growing and development. They can lead to malnutrition, malabsorption, mental and social adaptation problems, and critical illnesses that hinder productivity. This is an important health problem in Turkey, and intestinal parasites are quite frequently found in boarding school and care centers for children. The aim of this study was to discover and treat the parasitological agents found in the students of the Primary School for Deaf Students. A total of 117 fecal specimens and material from the perianal region (using the cellophane tape method) were collected from deaf students and examined during 2003-2004 school season. Also the students were scanned for adult head lice and their eggs. As a result, 53 (45.3%) children with intestinal parasites and 6 (5.1%) with head lice were detected in the study. The patients were treated and informed about means of protection. The same children were examined again after six months: Only 24 (20.5%) children had intestinal parasites and 2 (1.7%), head lice. Thus, the decrease in parasitic infections was found to be significant (qui-square test in dependent samples P < 0.05). Therefore it was concluded that the schools should be scanned for intestinal parasites and head lice, and both treatment and training in the subject should be given the necessary importance.

[Malaria cases in Malatya during the past seven years]. / Malatya'da son yedi yil içindeki sitma olgulari

Malaria can be seen in every region inhabited by human blood-sucking Anopheles and species of disease-causing Plasmodium. Since the region is on the crossroads of other cities where malaria is more widespread and it has a population of seasonal workers and an increasing number of tourists during the summer, additional imported cases may also be detected in the Malatya region. The aim of this study was to determine the state of malaria for the past seven years in Malatya. According to the records of the Malaria Control Unit of the Health Directorate of the Malatya province, 189 positive patients were reported during the seven years from 1999-2005. Of these cases, 186 (98.4%) were P. vivax, while 3 (1.6%) were imported cases of P. falciparum malaria. The rate of positivity was found to be 58.2% in male patients and 41.8% in female patients. Consequently, malaria can be said to persist as a health problem in Malatya region. It was concluded that people in the region should be informed about malaria and the ways to protect themselves.

[Incidence of intestinal parasites in municipal sanitary workers in Malatya]. / Malatya temizlik isçilerinde bagirsak parazitlerinin görülme orani

The incidence of intestinal parasites is closely related to such factors as the socio-economic level of the society, nutritional and hygienic habits, climate, environmental conditions, infrastructure and degree of literacy. In this study, the municipal sanitary workers who are regarded as a high risk group in Malatya were examined for intestinal parasites. Cellophane slides and fecal samples from 241 workers were examined and intestinal parasites were found in 93 (39.0%). The most common parasite was Entamoeba coli (34). Other parasites detected include Enterobius vermicularis (32), Giardia intestinalis (22), Blastocystis hominis (8), Iodamoeba butschlii (5), Entamoeba histolytica (2), Taenia sp. (2), Chilomastix mesnili (2), Dientamoeba fragilis (2), Entamoeba hartmanni (1), Trichomonas intestinalis (1) Hymenolepis nana (1), and Ascaris lumbricoides (1). A training seminary was conducted in order to inform all the workers about means of protection. The workers were given suitable treatment and were called for control after a month. The examinations revealed a significant decrease in the incidence rate of parasites (qui-square test in dependent samples P<0.05). It was concluded that offering training seminaries for certain occupational groups under risk is efficient in terms of protection.

[House dust mite fauna in Malatya]. / Malatya'da ev tozu akar faunasi

The organisms in the Acarina order of the Arachnida class that form an important group of the Arthropoda are called mites. Dermatophagoides pteronyssinus (Trouessart, 1897) and D. farinae (Hughes, 1961) are known to be the most common mites found in house dust. The aim of this study was to determine the house dust mite fauna in Malatya that had not been investigated previously. In this study, a total of 303 house dust samples collected from various districts of Malatya between June 1, 2000 and November 20, 2001 were examined. The dust samples were examined by the lactic acid precipitation method which was modified from the Spieksma-Boezaman's method. The rate of mites was found to be 23.1%. In conclusion, the rate of mites detected in this study was considered to be high considering the altitude and humidity of Malatya.

[Investigation of the prevalence of Trichomonas vaginalis with respect to diverse social variables in women (Malatya, Turkey)]. / Kadinlarda Trichomonas vaginalis'in çesitli sosyal degiskenler açisindan yayginliginin incelenmesi (Malatya ili Ornegi).

Trichomonas vaginalis is a monoxen parasite and its definitive host is human. It is known that the way of life is an important factor affecting incidence because of sexual transmission. In the present study, the incidence of T. vaginalis has been investigated with direct microscopy, Giemsa staining and culture (cysteine-peptone-liver-maltose (CPLM)). The study included 675 females with complaints of vaginal discharge who presented at different health departments or hospitals in the Malatya region during 2000-2001. T. vaginalis was seen in 55 (8.1%) patients. In addition, during period of presentation, a questionnaire was used to determine the relationship between the sociocultural status of the women and the incidence of T. vaginalis. Some of the questions in this questionnaire showed statistically significant differences in T. vaginalis infections related to the women's sociocultural status. These are as follows: type of toilet used; method and frequency of bathing; type, color, odor and frequency of vaginal discharge, level of knowledge of common sexually transmitted diseases and trichomoniasis; employment or non-employment of herself and her husband; life style in home; and educational level of husband. However, there was no statistical difference seen between other questions in the questionnaire and the existence of T. vaginalis infection.

[Incidence of intestinal parasites among primary school children in Malatya]. / Malatya ili merkezinde üç ilkögretim okulu çocuklarinda bagirsak parazitlerinin dagilimi.

The aim of this study was to determine the incidence of intestinal parasites among primary school children in the central region of Malatya and to educate the children about parasitic diseases. During the study, cellophane tape preparations and stool samples that had been prepared using direct mounting methods were examined. In addition the students were informed about intestinal parasites. Parasitic infection was observed in 415 (22.5%) out of 1838 students and the highest rate of 10.6% was that of Enterobius vermicularis. The rates of Giardia intestinalis, Entamoeba coli, Blastocystis hominis, Taenia sp., Hymenolepis nana, Trichomonas hominis, Ascaris lumbricoides and Iodamoeba butschlii were found to be 8.5%, 1.9%, 1.4%, 0.3%, 0.1%, 0.1%, 0.05%, and 0.05%, respectively. Thus, intestinal parasites are important among primary school children in Malatya and it seems that there is a relationship between socioeconomic conditions and the rate of intestinal parasites.