A Case of Budd-Chiari Syndrome Associated with Alveolar Echinococcosis

Although alveolar echinococcosis (AE) can cause a serious disease with high mortality and morbidity similar to malign neoplasms. A 62-year-old woman admitted to a hospital located in Sivas, Turkey, with the complaints of fatigue and right upper abdominal pain. On contrast abdominal CT, a 54x70x45 mm sized cystic lesion was detected in the left lobe of the liver that was seen to extend to the posterior mediastinum and invade the diaphragm, esophagus, and pericardium. The cystic lesion was seen to be occluding the inferior vena cava and left hepatic vein at the level where the hepatic veins poured into the inferior vena cava. Bilateral pleural effusion was also detected. We discussed this secondary Budd-Chiari Syndrome (BCS) case, resulting from the AE occlusion of the left hepatic vein and inferior vena cava, in light of the information in literature.

In vitro amoebicidal activity of Origanum syriacum and Origanum laevigatum on Acanthamoeba castellanii cysts and trophozoites.

In some patients, complete treatment of amoebic keratitis is difficult because of the resistance of cysts to therapeutic agents. The aim of this study was to evaluate the in vitro amoebicidal activity of methanolic extracts of Origanum syriacum and Origanum laevigatum. In the presence of methanolic extracts (ranging from 1.0 to 32.0mg/ml), numbers of the viable Acanthamoeba castellanii trophozoites and cysts were decreased. Both extracts showed a time and dose dependent amoebicidal action on the trophozoites and cysts. Of the extracts tested, O. syriacum showed the stronger amoebicidal effect on the trophozoites and cysts. In the presence of 32 mg/ml extract, no viable trophozoites were observed within third hour. The extract was also found effective against the cysts within 24th hour. In the case of O. laevigatum, no viable trophozoites were observed within 72nd hour at the concentrations of 16 and 32 mg/ml. As expected, cysts were found more resistant to the extracts than the trophozoites.

The prevalence of Pediculus humanus capitis and the coexistence of intestinal parasites in young children in boarding schools in Sivas, Turkey.

The aim of this study was to investigate the prevalence of Pediculus humanus capitis and the coexistence of intestinal parasites in boarding primary schools in Sivas, Turkey. Seven hundred seventy-two students (350 [45.3%] girls, 422 [54.7%] boys) were evaluated with combing for the presence of head lice, collection of fecal samples, and examination of the perianal region for intestinal parasites using the cellophane tape method. The overall infestation rate for head lice was 6% (n=46). Nine children had evidence of nits only (1.2%), whereas living lice and nits or eggs were found in 37 children (4.8%). Girls were significantly more commonly infested (12.9%) than boys (0.2%). Of the parameters evaluated, socioeconomic level, number of rooms per family, and size and weight of the children were statistically significantly different between the children with and without lice. Although the infestation rate of children with intestinal parasites was higher in the head louse-infested group (23.9%) than in the group of children without lice (17.6%), the differences were not statistically significant.

The investigation of Entamoeba histolytica prevalence in some villages of Sivas by ELISA method.

OBJECTIVE: Humans may be infected with three morphologically identical Entamoeba species; pathogenic E. histolytica, commensal E. moshkowskii and E. dispar. The aim of the present study was to determine the true prevalence of the E. histolytica using native lugol, trichrome staining and a monoclonal antigen detection kit (ELISA kit E. histolytica-II; Techlab, Inc., Blacksburg, VA) among primary school children living in the rural areas around Sivas. METHODS: A total of 1449 stool samples were examined by native lugol and Trichrome staining, and 312 (22%) samples were positive for one or more parasite species. Additionally, 22 (1.5%) stool samples were found to be positive for the presence of E. histolytica/dispar cysts, and these samples were further examined by E. histolytica specific antigen based ELISA. RESULTS: As a result, ELISA test gave negative reactions for all the samples. Also, there was no cross reaction with other luminal protozoa such as E. coli, G. intestinalis, B. hominis and I. butschlii. CONCLUSION: The data reveals that E. histolytica prevalence may be lower than estimated.

Primary hydatid disease of the pancreas mimicking pancreatic pseudo-cyst in a child: case report and review of the literature.

Primary hydatid disease of the pancreas is very rare. We report the case of a 7-year-old girl who presented with abdominal pain and an epigastric mass. The Casoni and indirect hemagglutination test for hydatid disease were negative. A diagnosis of a pancreatic pseudocyst was established by ultrasonography (US) and computed tomography scan before surgery. Ultrasound guided percutaneous drainage was planned as treatment. During the procedure, the cyst was perforated and as germinative membrane was seen by US, we arranged surgery. Hydatid disease should be considered in the differential diagnosis of all cystic masses in the pancreas, even if Casoni and indirect hemagglutination tests negative, especially in geographic regions like Turkey, where the disease is endemic.

Enterobiosis in Sivas, Turkey from past to present, effects on primary school children and potential risk factors.

The prevalence of Enterobius vermicularis and potential risk factors was investigated in 2,230 pupils in Sivas between November 2006 and June 2008. A total of ten primary schools in different regions (4 located in City center, 4 in districts and 2 in villages) were classified as Region 1, Region 2 and Region 3, respectively and children completed a questionnaire about the potential risk factors. The overall egg positivity rate for E. vermicularis was 8.2% in Region 1, and the prevalence in the other regions was 7.0% and 14.8%, respectively. Children, aged 10-14 years, didn't show a significantly higher egg positivity rate than younger children (chi(2): 0.10, p > 0.05) and the infection rate for boys was not statistically different than girls (chi(2):0.40, p > 0.05). The socio-economic status of the family and personal hygiene were found to be associated with enterobiosis, (chi(2):30.83, p < 0.05). Furthermore, it was found that there was a statistically important relation between parasite occurrence and school success (chi(2):39.52, p < 0.05).But there is no difference between the parasitic and non-parasitic groups in terms of weight and height (t: 1.75, p > 0.05, t: 1.43, p > 0.05; respectively). The frequency of enterobiosis is obviously decreased in our region when the previous studies are considered.

A Giant pulmonary hydatid cyst treated without lobectomy.

A 20 year-old woman was admitted to our clinic complaining of dyspnea, cough, chest pain and pleural effusion. The diagnosis of pulmonary hydatid cyst was made on the basis of parasitology laboratory findings, computed tomographic results and chest radiographic findings. A giant pulmonary hydatid cyst (33x14x12 cm) was located in the left lower lobe, which involved more than 90% of the lobe. The patient was treated surgically using cystotomy and capitonnage. This is a case of a giant pulmonary hydatid cyst published in the literature, which was surgically treated without a lobectomy, by preserving the lung parenchyma.

[Prevalence of cyst hydatic in slaughtered cattle between April and May 2005 in Sivas]. / Sivas'ta Nisan-Mayis 2005 tarihleri arasinda Kesilen Sigirlarda Kist Hidatik Yayginligi.

The present study was performed on 765 cattle obtained from three different slaughterhouses in Sivas, between April and May of 2005. Livers and lungs of those cattle were investigated for hydatid cysts. Out of 765 cattle, 273 (35.7%) were found to be hydatic cyst positive. On the other hand, 66 (8.6%) out of 765 cattle had hydatid cysts in their livers and 103 (13.5%) out of 765 were found to have cysts only in their lungs. It was found that there was a statistically significant difference in cystic hydatidosis according to gender and age group (p < 0.05). We compared and discussed our results from the point of human health and the loss of protein because of infected organs.

[The frequency of intestinal parasites in primary school children in urban and rural regions]. / Sehir, Ilçe ve Köy Ilkögretim Okulu Ogrencilerinde Bagirsak Parazitleri Görülme Sikligi.

The aim of this study was to determine the prevalence of intestinal parasites in primary school children in Sivas and to consider the changes in frequency and variety of intestinal parasites in the light of previous studies carried out since 1985. Specimens were examined by direct microscopy and staining. In addition, the relationship of intestinal parasites with physical development, success and socio-economic situation was investigated using surveys. Intestinal parasites were found in 191 (26.2%) of 730 stool specimens, 88 (12.9%) of cellophane tape specimens and parasites were found in both types of specimens obtained from 251 (37.1%) out of 677 students. The most common five parasite species were Giardia intestinalis (13.7%), Enterobius vermicularis (12.8%), Entamoeba coli (7.4%), Blastocystis hominis (2.2%) and Hymenolepis nana (1.2%). Intestinal parasites were most frequently detected in the Celtek Village Primary School (50.0%). This school was followed by Imranli YIBO School (45.7%), 60.Yil Primary School (36.3%) and Koyulhisar YIBO (21.3%) School. We found that there was no statistically important relationship between the occurrence of parasites with weight, length and success. It was related to the socioeconomic situation. Furthermore, in this region when the previous studies in similar age groups are considered, a decrease in intestinal parasites frequency and variety was revealed.

[Cystic echinococcosis: a study of consciousness and creating awareness]. / Kistik ekinokokkoz: Bir toplum bilgilendirme ve farkindalik yaratma çalismasi

Study was started in November 2005 and education practices and other activities have been realized between the dates of December 2005 and 5 January 2006. A wide group has been chosen from the students who are at the level of primary and secondary education to adults as a target mass to create awareness. Correspondences related to the subject have been done with Cumhuriyet University rector ship, Sivas governs ship, Sivas manager of education, Sivas mufti and essential otorizations got. Pictorial leaflets which introduce disease and explain infection and ways of protection are prepared and sent all province and county school by means of Manager of Education. Besides, lots of leaflet is distributed to tradesmen and public. Large sized posters are published about disease to make people aware of it. It is provided that these posters are distributed to all schools and mosques. Lectures are organized to introduce the disease and emphasize the ways of protection in five fixed center by two sessions. It is provided that 89 primary and secondary school students' attendance regularly with their teachers. Besides the working of society awareness, preparing executing and treating of control programs about cystic echinococcosis are other important and necessary stages.

[Comparison of the results of examination of fecal samples from students at six months intervals in the Alahaci village primary school in Sivas]. / Sivas merkez Alahaci köyü ilkögretim okulu ögrencilerinde alti ay arayla yapilan diski incelemesi sonuçlarinin karsilastirilmasi.

The aim of this study was to determine the distribution of intestinal parasites in primary school children in the Alahaci Central Village in the Sivas province, but owing to high prevalence of parasites in soil, new stool specimens were taken from the same subject group after 6 months. In the first stage of investigation, stool samples from a total of 189 children were taken and examined. It was found that the 110 (58.2%) out of 189 subjects were infected with parasites. The distribution of parasites was determined to be as follows: Giardia intestinalis in 33 (17.4%), Ascaris lumbricoides in 30 (15.8%), Entamoeba coli in 17 (8.9%), Entamoeba histolytica in 10 (5.3%), Hymenolepis nana in 9 (%4.8%), Endolimax nana in 8 (4.2%), Blastocystis hominis in 2 (1.1%) and Iodamoeba butschlii in 1(0.5%). In the second stage of the investigation (after a 6 months break), stool samples obtained from a total of 175 children were examined and 73 (41.7 %) were found to be infected with parasites. The distribution of parasites was as follows: Giardia intestinalis in 17 (9.7%), Ascaris lumbricoides in 17 (9.7%), Entamoeba coli in 29 (16.6%), Entamoeba histolytica in 1 (0.6%), Hymenolepis nana in 1 (0.6%), Blastocystis hominis in 1 (0.6%), Trichuris trichiura in 1(0.6%) and Iodamoeba butschlii in 6 (3.4%). The lower prevalence observed during the second investigation (p < 0.05), shows the importance of education and treatment of children in the control of parasitic infections.

Teniasis: effect on element status of children.

The aim of this study was to investigate the changes of level of the essential elements of copper, magnesium, and zinc status in cases of teniasis in children. Copper, magnesium, and zinc levels were measured in 40 children who were positive for intestinal parasite of Taenia saginata. Scores were obtained for the positives and their 30 age- and sex-matched T. saginata-negative healthy children. The mean concentration of copper, magnesium, and zinc in blood showed no statistically difference in T. saginata-positive children than in their controls both in females (p>0.05) and males (p>0.05). However, a clear numerically decrease was observed especially in magnesium and zinc levels compared to the controls both in females and males. The average magnesium concentration in T. saginata-positive female children and male children were 20+/-1.9 and 22+/-2.2 mg/L and it was 27+/-2.1 and 27+/-2.3 mg/L in controls, respectively. The mean values of the zinc in blood were 0.76+/-0.5 and 0.72+/-0.4 mg/L in T. saginata-positive female children and male children and 0.85+/-0.3 and 0.81+/-0.5 mg/L in female and male controls, respectively. No correlation could be demonstrated between age and mean values of copper, magnesium, and zinc in T. saginata-positive females and males and controls (p>0.05). No significant correlation could be found between blood copper, magnesium and zinc levels in T. saginata-positive female and male children and controls (p>0.05). Although there was no statistical correlation observed in copper, magnesium, and zinc levels between patients and controls, there seem to be, especially in magnesium and zinc levels, a decrease, whereas no change was seen in the zinc level in children infected with T. saginata compared to controls.

Effects of giardiasis on school success, weight and height indices of primary school children in Turkey.

BACKGROUND: Giardia intestinalis, the most common parasite in the world, causes several adverse effects on school children, with the prevalence rate ranging between 7.3% and 28% (mean 13.8%) in Turkey. The aim of the present study was to investigate possible adverse effects of G. intestinalis on success at school, and the mean weight and height of primary school children in Sivas, Turkey. METHODS: Five primary schools from central Sivas, Turkey, had a number of students from different socioeconomic conditions and regions. The stool specimens were examined by light microscopy for giardiasis using saline-Lugol and/or zinc sulfate flotation method. Three groups in the present study include the symptomatic giardiasis group (SG), which included children with giardiasis along with abdominal pain and/or diarrhea, the asymptomatic giardiasis group (ASG) without any symptom and the non-parasitic (NPG) group without any parasites. RESULTS: While 599 (34.6%) out of 1730 children were parasitic, 192 (11.1%) had only G. intestinalis. Ninety-eight (5.7%) of 192 were SG (with diarrhea and/or abdominal pain and 94 (5.4%) were ASG. The weights and heights were lower in the children with giardiasis than the children without any parasite. There was a significant difference between the giardiasis group and NPG when the numbers of persons living in the house were compared. While there were no significant difference between the giardiasis group and NPG when the sexes were compared, success at school and economical levels were found to be significantly different between these groups. CONCLUSION: There was a higher prevalence of giardiasis in primary school children and their physical and mental conditions were affected adversely. Giardia infections in particular have adverse effects on success at school.

The role of Casoni's skin test and indirect haemagglutination test in the diagnosis of hydatid disease.

Casoni's skin test and indirect haemagglutination test (IHA) are still used in Turkey. The preoperative IHA test or Casoni's skin test results of 120 patients with surgically confirmed hydatidosis were retrospectively studied during 1997-2004. At the same period, 306 patients with non-hydatid disease had serologic results for echinococcosis. The sensitivity of immediate intradermal reaction, delayed intradermal reaction, and IHA were 70, 62, and 56%, respectively. Casoni's skin test components had higher sensitivity than IHA (P < 0.01). The specificity of immediate intradermal reaction, delayed intradermal reaction, and IHA were 87, 85, and 84%, respectively. Cystic lesions in non-hydatid patients were localised commonly in the lungs. The occurrence of hydatid disease for pulmonary, hepatic, and renal cysts was 19, 54, and 5%, respectively. An immediate skin reaction to crude hydatid antigens is more useful than IHA.

Prevalence of intestinal parasites in three socioeconomically-different regions of Sivas, Turkey.

The study was carried out to determine the prevalence of parasites in three socioeconomically-different regions (Alibaba, Esentepe, and Cayboyu) of Sivas, Turkey, to determine the most accurate method for the diagnosis of taeniasis and enterobiasis, to determine the importance of household visits in primary healthcare to control parasitic diseases, and to treat intestinal parasitic diseases in those regions. Both stool specimens and cellophane tape (CT) samples were taken from 1,864 participants during 641 household visits in the three regions. The age groups included were pre-school [(0-6 year(s)], primary school (7-15 years), and the upper age group (16 years and above). The total prevalence of intestinal parasites in the three regions was 37.2%. Eleven intestinal parasite species were detected in both stool specimens and CT samples. Giardia intestinalis and Enterobius vermicularis were the most frequent species identified in all the three regions. Region I (Alibaba) had a higher prevalence of parasites compared to the other two regions. There was no significant difference between Region II (Esentepe) and Region III (Cayboyu) in isolation of intestinal parasites. There were statistically significant differences between the age groups when the rates of parasitic infection were compared. The highest prevalence of parasitosis was observed among the age group of 7-15 years and in the socioeconomically lowest one of the three regions. While the most accurate way of diagnosis for taeniasis was the combined usage of the CT and direct preparation methods, the CT method was the best method for the diagnosis of enterobiasis. Thus, the local administrators in cities need to pay more attention to the prevention of parasitic infections along with improvements in educational, environmental and sanitary conditions.

Egg positive rate of Enterobius vermicularis and Taenia spp. by cellophane tape method in primary school children in Sivas, Turkey.

The aim of the present study was to find out the number of students with enterobiasis and/or taeniasis in primary schools of Sivas. Among the 2,029 students in 6 primary schools, 316 (15.6%) were positive to Enterobius vermicularis eggs and 32 (1.6%) were positive to Taenia spp. eggs by the cellophane tape method. The egg positive rates of E. vermicularis and Taenia spp. ranged from 9.4% to 27.2% and from 0.8% to 2.6% respectively among six schools. The egg positive rate of E. vermicularis was found to be significantly different among these schools (chi2 = 31.96, P < 0.05), whereas there was no significant difference between the schools for Taenia spp. (chi2 = 4.37; P > 0.05). The rate (18.7%) of E. vermicularis in the urban slum regions was higher than the rate (11.5%) in the urban central regions (chi2 = 19.20; P < 0.05). Above results demonstrate that the egg positive rate of E. vermicularis and Taenia spp. was still prevalent among primary school children.

[The distribution of intestinal parasites in patients presenting at the Parasitology Laboratory of the Cumhuriyet University.]. / Cumhuriyet Üniversitesi Tip Fakültesi Parazitoloji Laboratuvarina basvuran hastalarda bagirsak parazitlerinin dagilimi

This study is concerned with the distribution of intestinal parasites detected in patients who presented at the routine Parasitology Laboratory of the Cumhuriyet University Faculty of Medicine from May 2002-November 2004. A total of 5057 stool specimens from 2305 (45.6%) males and 2752 (54.4%) females were examined for intestinal parasites using direct examination and flotation methods. Intestinal parasites were found in 231 (4.5%) females and 301(5.9%) males. A total of 1313 cellophane tape specimens from 646 (49.2%) females and 667 (50.8%) males were examined. Parasites were detected in 34 (2.6%) female and 48 (3.6%) male patients. The distribution of intestinal parasites detected in stool specimens was as follows: 189 (3.7%) Giardia intestinalis, 124 (2.4%) E. histolytica/dispar, 128 (2.5%) Entamoeba coli, 29 (0.6%) Iodamoeba butschlii, 21(0.4%) Blastocystis hominis, 2 (0.03%) Chilomastix mesnili, 1 (0.01%) Trichomonas hominis, 1 (0.01%) Hymenolepis nana, 33 (0.6%) Taenia saginata, 3 (0.05%) Ascaris lumbricoides, and 1 (0.01%) Trichuris trichiura. Parasites detected in cellophane tape specimens included 71 (5.4%) Enterobius vermicularis and 11 (0.8%) Taenia saginata.