A study on intestinal parasitic infections among school children in Karaikal.

INTRODUCTION: Intestinal parasitic infections (IPIs) play a major role in global disease burden with significant morbidity. The most vulnerable age group was school going children and is transmitted through soil. About 90% of infected individuals remain asymptomatic. The present study was designed to screen for IPI among school children in Karaikal, to identify the asymptomatic infections and to assess the type and occurrence of IPIs. METHODOLOGY: A cross-sectional study was carried out from July to September 2018 among school children in the age group of 6-14 years after getting ethical clearance. A total of 335 single stool samples were collected. The samples were subjected to macroscopic examination, microscopic examination and subjected to concentration techniques such as salt floatation and formal ether sedimentation technique. Two separate fresh stool smears were made on the microscopic slides for trichrome and modified acid-fast staining. The results were calculated as percentage, frequency/proportion, and Chi-square test using IBM SPSS software version 19. RESULTS: Only 90 (28%) out of 324 stool samples were positive for the presence of intestinal parasites. The sensitivity of formal ether sedimentation technique (58%) was higher than other techniques. None of the ova of helminths detected. Modified acid-fast staining was negative for coccidian parasites. CONCLUSIONS: The low prevalence of protozoan parasites and total absence of helminths in the study revealed the effective role of nationwide deworming program and Swachh Bharat Abhiyan program. However, anthelminthic does not cover the protozoan parasites and it exists among asymptomatic healthy population.

In vitro antifungal activity of cassia fistula extracts against fluconazole resistant strains of Candida species from HIV patients.

BACKGROUND: Candida species is the fourth common cause of blood stream infections all over the world which is life threatening. Invasive candidiasis leads to increased mortality and morbidity especially in immunosuppressed. The antifungal resistance pattern in high-risk patients is major concern. PURPOSE: The present study was to access the anticandidal activity of leaves, bark and seeds of Cassia fistula against fluconazole resistant Candida species, C. albicans, C. glabrata, C. krusei, C. tropicalis, C. kefyr and C. parapsilosis isolated from HIV patients. The predominant phytochemical component responsible for fungicidal activity was to be accessed. MATERIAL AND METHODS: Ethanol, chloroform, petroleum ether and aqueous extracts of leaves, bark and seeds of C. fistula linn. was evaluated against Microbial type culture collection (MTCC) Candida strains and 21 fluconazole resistant clinical isolates. Antifungal activity was evaluated by agar diffusion and broth dilution techniques. The active phytochemical component present in the ethanol extract of seeds was accessed by high performance thin layer chromatography. The docking study was done with lanosterol 14-alpha demethylase, the azole drug target with the predominant phytochemical from the extract having antifungal activity. RESULTS: All the extracts of C. fistula showed excellent anticandidal activity. Ethanol extract of C. fistula seed exhibited the most inhibitory activity. C. krusei and C. parapsilosis were the most inhibited and C. kefyr was the least inhibited species. The predominant phytochemical active component of the ethanol extract of seed was gallic acid. Gallic acid showed excellent binding with lanosterol 14-alpha demethylase. CONCLUSION: The present study reports the antifungal activity of various extracts of Cassia fistula for the first time against fluconazole resistant Candida isolates. We can conclude that the polyphenolic compound gallic acid is a potent natural antifungal agent. Further research is needed to assess the pharmacokinetic property.

Hyperinfection with Strongyloides in a HIV-negative elderly male.

Strongyloides stercoralis is an intestinal nematode producing mild infection in the immunocompetent and fatal hyperinfection syndrome in the immunocompromised. An elderly HIV-negative male presented with symptoms of chronic respiratory disease and vague abdominal symptoms. Examination of sputum and stools showed larvae of S. stercoralis. Bacterial and fungal causes of respiratory infections were ruled out. The patient responded to oral ivermectin.

Staphylococcal scalded skin syndrome in a newborn.

A six-day-old newborn was admitted with exfoliating erythematous lesions over the face, of two days duration. The lesions spread to the rest of the body during the next two days. A diagnosis of Staphylococcal Scalded Skin Syndrome (SSSS) was made clinically and confirmed by isolation of Staphylococcus aureus from a blood sample. The child responded to Injection vancomycin and no fresh lesions were seen after the next 48 hours. However the child developed severe pneumonia and left against medical advice.