ABSTRACT
Pakistan is at the verge of polio eradication but isolation of non-polio enteroviruses (NPEVs) from acute flaccid paralysis (AFP) cases may result in serious or even fatal outcome. Many enteroviruses share similar symptoms and epidemiology as is the case with poliovirus and coxsackievirus (CV). The present study was designed to genetically characterize coxsackievirus B (CV-B) serotypes isolated from non-polio acute flaccid paralytic children, as well as to understand their probable role in paralysis. A total of 63 (20·1%) out of 313 stool samples during 2013 were found positive for NPEVs in rhabdomyosarcoma cells. Only 24 (38·0%) NPEVs were typed as CV-B by microneutralization assay and were further characterized by sequencing of the viral protein 1 (VP1) gene. Molecular phylogenetic analyses classified the study strains into six coxsackievirus B serotypes (coxsackievirus B1 to B6) with their respective prototype strains with evidence of epidemiological linkage and distinct clusters. Moreover, four major differences were found within the amino acid sequences of BC-loop in VP1 of CV-B strains. In conclusion, this study presented the molecular evolutionary genetic overview and distinct phylogenetic pattern of CV-B isolates from AFP cases in Pakistan, and explored the possible link between CV-B infections and AFP cases. Furthermore, our data reveal that these viruses might contribute to the incidence of paralysis in population and there is need of time to establish an enterovirus surveillance system for better understanding of epidemiological and virological characteristics of NPEV infections associated with AFP cases in the country.
Subject(s)
Capsid Proteins/genetics , Coxsackievirus Infections/epidemiology , Enterovirus B, Human/genetics , Paralysis/epidemiology , Child , Child, Preschool , Coxsackievirus Infections/virology , Disease Eradication , Enterovirus B, Human/classification , Feces/virology , Female , Humans , Infant , Male , Pakistan/epidemiology , Paralysis/virology , Phylogeny , Poliomyelitis/prevention & control , Sequence Analysis, RNAABSTRACT
OBJECTIVE: To ascertain the current approach to screen for developmental dysplasia of the hip in the Republic of Ireland. METHODS: Two-pronged prospective and retrospective study. (1) Postal questionnaire to consultant paediatricians responsible for the routine neonatal care of infants in the Irish Republic in June 2006. (2) Retrospective database review to identify infants undergoing radiological follow-up and their outcome. RESULTS: All maternity units surveyed responded. Most units (84%) were dependent on radiographs at 4-6 months for imaging hips, only two units primarily used ultrasound (10.5%). We estimate that neonatal hip examination is performed by an experienced examiner in less than 30% of routine newborn examinations. On retrospective analysis, 94% of radiographs performed were normal. CONCLUSIONS: The most effective interventions, selective ultrasound and examination by an experienced clinician are not widely practiced. There is a need for the development of national guidelines based on available resources.
Subject(s)
Hip Dislocation, Congenital/diagnosis , Hip Injuries/diagnosis , Hip Joint/pathology , Neonatal Screening , Female , Health Care Surveys/statistics & numerical data , Hip Dislocation, Congenital/diagnostic imaging , Hip Dislocation, Congenital/pathology , Hip Injuries/diagnostic imaging , Hip Injuries/pathology , Humans , Infant, Newborn , Ireland , Male , Pediatrics , Prospective Studies , Radiography , Retrospective Studies , Risk Factors , Surveys and Questionnaires , UltrasonographyABSTRACT
OBJECTIVE: To identify the Leishmania species being responsible for cutaneous leishmaniasis in Multan. METHOD: Parasites were isolated from clinically and parasitologically confirmed lesions of cutaneous leishmaniasis from 30 patients by fine needle aspiration (FNA). The bioptical materials were then cultured in Evans Tobie's medium and parasites isolated were identified by isoenzyme electrophoresis technique. RESULTS: Successful Leishmania isolates were obtained from 16 patients. All strains were identified by biochemical techniques as belonging to Leishmania tropica zimodeme MON7 variant PGD. CONCLUSION: The causative species was identified as Leishmania tropica.
Subject(s)
Leishmania tropica/isolation & purification , Leishmaniasis, Cutaneous/parasitology , Adolescent , Adult , Animals , Child , Female , Humans , Leishmania tropica/classification , Leishmania tropica/enzymology , Male , PakistanABSTRACT
OBJECTIVE: Cutaneous leishmaniasis is endemic in Multan. Therefore this study was undertaken to elucidate the epidemiological features with main emphasis on the geographical distribution of the infection in Multan. SETTINGS: Multan city. Dermatology Outpatient Department, Nishtar Medical College. METHOD: Records of 173 diagnosed patients of cutaneous leishmaniasis were retrospectively reviewed according to the age, sex, number and site of lesions, results of the smear for LD bodies and residential area. RESULTS: The disease was more common in the children and young adults, with male to female ratio of 3:2. The maximum number of lesions were on the lower legs. Sixty five percent of the patients were from the interior old city. CONCLUSION: The main focus of infection is in old interior part of the city with microfoci of the disease scattered throughout the city.
Subject(s)
Leishmaniasis, Cutaneous/epidemiology , Adolescent , Adult , Age Factors , Child , Female , Humans , Leishmaniasis, Cutaneous/parasitology , Leishmaniasis, Cutaneous/prevention & control , Male , Pakistan/epidemiology , Retrospective Studies , Skin/parasitology , Skin/pathologySubject(s)
Antiprotozoal Agents/administration & dosage , Leishmaniasis, Cutaneous/drug therapy , Meglumine/administration & dosage , Organometallic Compounds/administration & dosage , Adolescent , Adult , Child , Child, Preschool , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Infant , Injections, Intralesional , Leishmaniasis, Cutaneous/diagnosis , Male , Meglumine Antimoniate , Treatment OutcomeABSTRACT
BACKGROUND: Cutaneous leishmaniasis (CL) is endemic in certain areas of Pakistan. This study was carried out to determine the incidence and clinical pattern of the disease in Pakistan. METHODS: CL patients presenting in the out-patient clinic of the Department of Dermatology, Nishtar Hospital, Multan from January 1995 to June 1997 were included in the study. The patients were diagnosed clinically and confirmed by laboratory demonstration of the parasite in a Giemsa-stained smear from the lesion. All important clinical details were recorded on specially designed forms. RESULTS: Three hundred and five patients with 681 lesions were seen during 30 months. All the lesions were of the dry type. Most of the lesions (97%) were present on exposed areas of the body. One hundred and thirty-four (44%) patients had one and 75 (24%) had two lesions. Eight five per cent of the sufferers were less than 30 years of age. The disease was slightly more preponderant in males (60%). Most cases presented during winter. CONCLUSIONS: Lack of wet type lesions may be due to complete absence of Leishmania major in this area. This is in contrast to other areas of Pakistan where both dry and wet types of CL are present.
