Asian Pacific Journal of Tropical Medicine

1-7

Authors: Mariana A, Ho TM, Lau TY, Heah SK, Wong AL

Objective:To determine distribution of arthropods in rice grains obtained from different sources. Methods:Rice samples were randomly collected from public in urban areas, farmers in rice field areas, aborigines in undeveloped areas and retailers in commercial premises. Random samples of rice were taken out from each sample for isolation of arthropods using a modified Berlese Tullgren Funnel Method. Mites were mounted prior to identification; weevils were directly identified.Results:Samples of rice from retailers in commercial premises had the highest infestation by arthropods followed by samples from urbanites, aborigines and rice farmers. Two species of weevils, Sitophilus oryzae( S. oryzae)and Sitophilus granarius(S. granarius), were found. Samples from commercial premises had the least percentage of weevils compared to those collected from domestic premises. Depending on the source of samples, densities of S. granarius and S. oryzae ranges from 11-103 weevils/kg and 7- 80 weevils/kg, respectively. Important species of mites in stored rice identified were mainly members of the families Cheyletidae, Echimyopodidae, Pyroglyphidae, Saproglyphidae and Tenuipalpidae. Among the species of mites identified were Austroglycyphagus malaysiensis, Cheyletus fortis, Cheyletus malaccensis, Dermatophagoides pteronyssinus, Grammolichus malukuensis and Suidasia pontifica. Average density of most of the mites was less than 40 mites/kg of rice grains. In this study, the highest number of mites in rice samples was recovered from commercial premises, followed by samples from urbanites. Samples from farmers and aborigines contained lesser mites.Conclusion: This study demonstrated the presence of 3 allergenic mite species in rice, i.e A. malaysiensis, D. pteronyssinus and S. pontifica. Weevils, S. oryzae and S. granarius that are known to be allergenic, were also found.

14-19

Authors: Apichart Nontprasert, Cheeraratana Cheeramakara, Sasithon Pukrittayakamee, David AB Dance, Ty L Pitt, Michael D Smith, Sirivan Vanijanonta, Nicholas J White

Objective: To investigate the banding patterns of whole cell protein (WCP) and outer membrane protein (OMP) of Burkholderia pseudomallei (B. pseudomallei) in clinical isolates from patients with melioidosis. Methods: WCP and OMP of of B.pseudomallei in 50 clinical isolates, from 47 patients with melioidosis were prepared and separated by polyacrylamide gel electrophoresis (SDS PAGE) using 10% gels and stained with Coomassie brilliant blue. The banding patterns were compared by using a laser densitometer and dendrogram.Results: There were 6 different banding patterns of WCP and 2 types of OMP. Type 15 WCP had 8 common protein bands at 19.0 - 45.0 kDa with identical OMP pattern. The banding patterns of WCP in type 6 were distinct from the others and also its OMP profile. The majority of clinical isolates (37/50, 74%) were in type 1 WCP. Of the remaining isolates, 8 were in type 2, 2 in type 3, and one each was in type 4 to 6. There was no significant association between the WCP typing and the demographic or clinical features of the investigated patients.Conclusion: Despite the wide variation of clinical features of melioidosis, the results of this study show that B. pseudomallei had a few differences in the WCP and OMP profiles. Therefore typing of WCP and OMP, using SDSPAGE analysis, could be an alternative method for phenotypic differentiation in clinical isolates of B. pseudomallei.

26-29

Authors: Uche FI, Okunna BU

Objective: To investigate the analgesic and antiinflammatory effects of the methanolic extract of the leaves of Triumfetta rhomboidea on mice and rats respectively. And to screen the phytochemical constituent of the extract.Methods: The analgesic effect was determined by acetic acidinduced writhing test in mice. While the antiinflammatory activity was determined by egg albumininduced oedema of the rat paw. Phytochemical screening was done by standard procedures. Results: Triumfetta rhomboidea leaf extract (50-400 mg/kg) caused a statistically significant inhibition on the egg albumininduced eodema or inflammation in Wister albino rats with P < 0.001 (ANOVA). This effect was higher than the observed effect with Piroxicam (0.5 mg/kg) which was used as a standard. The effect was also dosedependent. Furthermore, Triumfetta rhomboidea extract caused a statistically significant reduction in the number of acetic acidinduced writhing in mice, with P < 0.001 (ANOVA). These effects were also doesdependent and greater than the analgesic effects by paracetamol which was used as a reference drug. Phytochemical screening revealed the presence of flavonoids, steroids, triterpenoids alkaloids, tannins and saponins in Truimfetta rhomboidea leaf extract. Conclusion:Triumfetta rhomboidea can be recommended for acute inflammatory disorders and diseases associated with pains. This also supports its traditional use as an antisnake bite and anticancer or antitumor agent. Further study is on the way to find out the mechanism of its action and also to isolate, identify and characterize the active principle responsible for these effects in this plant.

34-37

Authors: Idogun E. S, Airauhi L. U

Objective:To assess the plasma electrolyte status of patients with diagnosis of malaria but without the symptoms of diarrhea, vomiting or altered sensorium and correlation of the plasma electrolyte changes and the degree of parasitaemia.Methods: All the participants were adults, who met the clinical case definition of malaria but without the symptoms of diarrhea, vomiting or other medical illness. Blood slides were screened microscopically for malaria parasite and the parasite positive patients were grouped into A (mild), B (moderate) and C (heavy) malaria parasiteamia, depending on the malaria parasite count per high power microscopic field. Plasma sodium, potassium and chloride were estimated using the ion selective electrode method, while bicarbonate ions were determined by simple titration method.Results: A total of 200 subjects were studied which comprised of 150 patients and 50 controls. The mean plasma sodium was significantly lower in patients with heavy parasitaemia［group C, (128.8±1.2) mmol/L］compared to those with mild and moderate parasitemia［(133.5± 2.8) mmol/L and (133.5± 3.5) mmol/L, P<0.0001］. The mean plasma chloride was lowest in those patients with heavy parasitaemia (group C) than those patients of group A and B (P<0.0001). Patients in group C also had significant hypokalaemia［(3.2± 0.5) mmol/L］ when compared to those in groups A and B［(3.6±0.3) mmol/L and (4.1±0.6) mmol/L respectively, P<0.0001］. Conclusion: A disorder of plasma electrolytes in malaria patients that had no symptoms of diarrhea and vomiting was reported. And the severity of hyponatraemia and hypokalaemia correlate with the severity of the patients′ malaria parasitaemia. This data should alert clinicians on the need to assess electrolytes status of patients with malaria even without the symptoms of fluid loss, especially when malaria parasitaemia is heavy.

44-48

Authors: Ghaleb Adwan, Bassam Abu Shanab, Marwan Odeh

Objective:This study was conducted to update the prevalence of methicillinresistant Staphylococcus aureus (MRSA) isolates among human clinical S. aureus isolates recovered from Northern Palestine, to evaluate the possible presence of vancomycinResistant S. aureus (VRSA) and vancomycin intermediate resistant S. aureus strains (VISA) and to determine the antimicrobial susceptibilities of these clinical isolates.Methods:The in vitro activities of 11 antibiotics against 204 nonduplicate S. aureus isolates from clinical samples in North of Palestine were determined by the diskdiffusion method. These samples were isolated between June 2006 and December 2007. The minimum inhibitory concentration (MIC) of vancomycin for 115 methicillin resistant Staphylococcus aureus (MRSA) strains was carried out using the agar dilution method.Results:One hundred and fifteen (56.4 %) of these isolates were MRSA and according to their antibiotic profile these are multidrug resistant (resistant to three or more nonβlactam antibiotics). Ninety nine (43.6 %) isolates were methicillin sensitive S. aureus (MSSA), forty four of MSSA isolates (44.4 %) were multidrug resistant, while forty five (45.6 %) were non multidrug resistant. Our results showed that the most common resistance (95.6 %) was to penicillin. Two strains of MRSA have shown to be vancomycin intermediate resistant, had MIC of 4 μg/mL and 8 μg/mL and these vancomycin intermediate resistant S. aureus strains (VISA) are resistant to all antibiotics tested.Conclusion:According to our information this is the first study report about VISA in Palestine.

54-57

Authors: Azikiwe CCA, Amuzu LU, Unekwe PC, Nwosu PJC, Ezeani MC, Siminialayi MI, Obidiya SO, Arute JE

Objective:Aim of present study is to scientifically, verify the antidiabetic activity/potency of Vernonia amygdalina in human diabetes.Methods:A search was made at Nnewi, South-East Nigeria for known diabetes who use Vernonia amygdalina either as their sole or supplementary antidiabetic. A total of ten volunteers comprising, eight females and two males were recruited. They were all of age range of 3650 and average weight of 78 kg and suffering from non-insulin form of diabetes. The purpose of the study was explained to them and their consent obtained. They were asked not to take any other antidiabetic outside Vernonia amygdalina throughout the four weeks study period. There was however, no form of restrictions to their choice of diet or life style. They were requested to abstain from any drugs a week prior to commencement of study. Their prescriber′s dosage range was followed and minimum daily dose of 210 mL (approximately 220 mg of dry extract) was administered in Week1, followed by daily dose of 420 mL (440 mg) in Week2. In Week3 they received 630 mL (660 mg) daily dose and in Week4, they received daily dose of 840 mL (880 mg). Their fasting blood sugar were estimated precrude drug administration and on weekly basis for the four week study period. Their weekly weights were measured to check for possible weight gain or loss. Results were subjected to statistical analysis and Students TTest was used to calculate Pvalue. Pvalue ≤0.05 were considered significant. Results: It was observed that all the volunteers in the study group were taking Vernonia amygdalina only as supplementary. Two volunteers dropped out of the study at the end of Week3 leaving us with 8 in Week4. There was no significant bodyweight change within the four week study. The starting mean fasting blood sugar which was 133.3 mg/dL(7.41 mmol/L) rose to 136.6 mg/dL(7.59 mmol/L) in Week1, to 149.5 mg/dL(8.31 mmol/L) in Week2 and to 166.5 mg/dL(9.30 mmol/L) in Week3. Week4 had us left with 8 volunteers with a mean of 190.6 mg/dL(10.59 mmol/L). There was significant differences in increase in sugar levels between the precrude extract administration and treatment period with Vernonia amygdalina (P≤0.05 for Week1, P≤0.02 for Week2, P≤0.01 for Week3 and P≤0.001 for Week4). Conclusion:Claims of antidiabetic efficacy of Vernonia amygdalina in human diabetes are scientifically non verifiable based on our work hence these claims are false. We also feel bold to state that we could not demonstrate any antidiabetic activity of Vernonia amygdalina in human subjects. We recommend that NAFDAC and all relevant agencies must sit up and control all forms advertorial on Medicinal plants until such are well studied and proven.

66-70

Authors: Yap Felix Boon Bin

Objective: To assess the efficacy of ADA isoenzyme estimation over that of total ADA level in pleural fluid and serum as a more efficient diagnostic indicator in tuberculous pleural effusions in high prevalence country like India.Methods:The efficacy was analysed in total thirty four patients of pleural effusions. Total ADA was estimated by Guitsi and Galanti Calorimetric method and ADA isoenzymes with and without EHNA［Erythro-9(2-hydroxy 3-nonyl) adenine］ a potent ADA1 inhibitor using the same method. Results:The results demonstrated a statistically significant values of ADA2 in serum (P< 0.001), pleural fluid (P=0.000) and significant value for the ratio of pleural fluid ADA2／serum ADA2 (P<0.001) and pleural fluid ADA1／ADA2 (P<0.005). The sensitivity and specificity values of pleural fluid ADA2 is 81.8 % and 91.6 % (cut off value 60 IU／L for Tuberculous effusions), serum ADA2 95.4 % and 66 % (cut off value 70 IU／L for tuberculous effusions). ADA2 is an isoenzyme, which is significantly raised in tuberculous pleural effusions both in the serum and pleural fluid. Conclusion: Estimation of ADA isoenzymes is redundant as a diagnostic aid over total ADA estimation in view of the limited improvements both in specificity and sensitivity patterns and also in term of costbenefit ratio.

77-79

Authors: Siti Suraiya Md Noor, Zaidah Abdul Rahman, Sarimah Abdullah ,Zakuan Zainy Deris，Che Wan Aminuddin

Objective: To investigate the prevalence, clinical and bacteriological features and outcome of extrapulmonary tuberculosis in patients attending a tertiary care hospital at Kota Bharu, Kelantan. Methods: All culture positive tuberculosis cases recorded in Hospital Universiti Sains Malaysia at Kota Bharu during five years period from 20032007 were included in the study. Mycobacterium detected in samples originating from sites other than lungs was considered as a case of extrapulmonary tuberculosis. Age, site of infection, bacteriological findings and outcomes were analyzed. Results: Out of 437 tuberculosis cases recorded from 20022006, 59 cases had culture positive extrapulmonary tuberculosis. Their mean age was 37 years and 44% were between the ages of 2040 years. About 63% were negative for acidfast bacilli by ZN stain. Of the 59, 97% was Mycobacterium tuberculosisc (M. tuberculosis) while two (3%) were atypical Mycobacterium Runyon GroupIV. Only 3 (5%) were isoniazid resistant. Extrapulmonary sites involved were lymph nodes 19 (31%), central nervous system 12 (20%), pleural 11(19%) spine 8 (14%), renal 3 (5.1%) and others 6 (10.2%). In this series, 11(18%) were positive for HIV. There was no significant association between extrapulmonary tuberculosis and HIV status. The outcome of CNS tuberculosis was the poorest with a mortality rate of 25%.Conclusion: M. tuberculosis is the predominant organism in extrapulmonary tuberculosis and culture is the most effective method for its diagnosis.