Asian Pacific Journal of Tropical Medicine

1-8

Authors: M-C Luan, D-Z Yu, L Tang, L-J Zhang

Objective: To identify members of genera of rickettsia and O. tsutsugamushi simultaneously. Methods: Rapid and duplex and nested PCR methods have been established by designing primers based on the conserved regions of heat shock protein GroEL gene. 345 mouse viscera samples including liver, spleen and kidney, 96 Xenopsylla cheopis and 32 chiggers collected from Hongta areas of Yuxi city, Yunnan province were tested by the new PCR methods. Results: The result of the study showed that the new PCR methods could identify most members of genera -Rickettsia and Orientia simultaneously with 100% specificity and its sensitivity could test one copy per microliter. The results of detection prevalence of rickettsioses in mouse, flea and mites DNA samples showed that the total rickettsia infection rate in mouse was 34.78% (120/345). The total infection rates in R. typhi, O.t Karp and R. sibirica of mouse samples were 28.12% (97/345), 19.71% (68/345) and 0.29% (1/345) respectively. Co-infection rates in R. typhi and O.t Karp of mouse samples were 13.33% (46/345). O.t Karp type has been the main epidemic strain in these areas. Conclusion: We concluded that this PCR method could be used to detect multi-genera rickettsia simultaneously. Molecular evidences provided in this and previous studies strongly support that Hongta areas of Yuxi city are a natural focus for typhus and scrub typhus with the common occurrence of their confection.

14-19

Authors: Maysaa El Sayed Zaki

Objective: The inefficiency of conventional laboratory methods for diagnosis of Pleural tuberculosis (TBP) and the reliance on pleural biopsy have motivated the evaluation of alternative diagnostic strategies. Our goal was to evaluate different laboratory techniques Ziehl Neelsen, Mantoux skin test, determination of interferon gamma in serum and pleural fluid, polymerase chain reaction and serological study of specific IgG, IgM and IgA beside bacteriological culture by BACTEC 460 TB for rapid and accurate diagnosis of tuberculosis pleurisy. Methods: Patients presented with pleural effusions were subjected to study by ZN, PCR, serological study By specific IgG, IgM and IgA for A60 of tuberculosis compared to culture by BACTEC460 TB. Interferon gamma was determined both in serum and pleural fluid. Results: Mantoux skin test was positive in 19 TBP patients and four patients with exudative pleural effusion. Z.N staining results of pleural biopsy specimens were positive in only 1 of 23 patients (4.3%) in the tuberculous pleural effusion group. PCR was positive in 20 cases of group 1 (87%). Serum and pleural fluid interferon had significantly elevated levels (P<0.000 1) in TBP and both measurements had significant correlation in TBP (P<0.000 1). The serum IgA ELISA test was positive in 7/23 (30.4%), IgM was positive in 17/23 (73.9%) patients and IgG was positive in 16/23 (69%) patients. Non of the non TBP had either ZN, PCR or positive serum IgA, IgG, or IgM. When the positive results for IgG and IgM were combined together the serological tests correctly identified 20/23 (87%) of patients. Conclusion: We suggest that in TBP serological diagnosis by combined use of IgG and IgM for A60 antigen with serum determination of interferon gamma can provide rapid and non invasive diagnostic tool that can justify the starting of chemotherapy while awaiting the results of culture.

24-27

Authors: Sharanabasappa M, Sudhakar Nayak

Objective: The study was conducted to evaluate the effect of liver diseases on serum Lp(a) levels and also to study the relationship between Lp(a) levels with other lipid parameters and liver function tests in 32 hyperbilirubinemia patients with total bilirubin>3mg/dL. The results were compared with 20 healthy age matched individuals. Methods: Serum obtained from venous blood sample are used for estimating total cholesterol (TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-c), low density lipoprotein cholesterol(LDL-c),very low density lipoprotein cholesterol(VLDL-c), total protein(TP), albumin(ALB), total bilirubin, direct bilirubin, aspartate amino tranferase(AST), alanine amino transferase(ALT), alkaline phosphatase(ALP), gamma glutamyl transferase (GGT), lipoprotein (a) ［Lp(a)］, serum phospholipids. Results: There was significant decrease in serum Lp(a) levels in liver disease patients and the decrease was directly correlated with reduced serum albumin levels and inversely with liver function parameters. Conclusion: Thus the present study indicates hepatic synthetic damage has possible biochemical basis for the reduction of serum Lp(a) levels

32-35

Authors: Banihashemi Kambiz, Naeeni K. Mohammad, Yasseri Mehdi, Ghasemi Saeed, Abutalebi Robabeh, Pourkhani Maryam

Objective: To decrease or delay the major un-wanted clinical consequences to improve the quality of life in the involved patients. Methods: A retrospective case series study has been made on the forty five pediatric patients admitted to nephrology department of Ali-Asghar Hospital during a period of nearly 10 years. The patients have been divided into two groups of good and poor prognoses according to their clinical outcomes. The routine laboratory records and clinical manifestations extracted and statistically analyzed as independent variables both by univariate and multivariate methods. Results: Forty three patients have been managed successfully with only two deaths occurred. According to clinical findings, nineteen patients were classified as poor prognosis and the rest were categorized as good prognosis. Multivariate statistical analyses showed that lesser age at the time of admission (age < 46 months, P<0.015) and the higher initial WBC count (count > 15 000, P<0.226) were well-interrelated to ominous clinical consequences like convulsion, coma and peritonitis and statistically different between the two groups of patients. Conclusion: Despite the importance of predictive variables in the course of Hemolytic uremic syndrome(HUS) in children and their critical influence on the clinical outcome, many aspects of these parameters have been remained to be elucidated comprehensively. Our study showed that simultaneous low age of child at the time of admission with simultaneous high WBC count will result in the poorer prognoses of the patients. This may warn the clinicians to provide more supportive cares for this group of patients.

40-43

Authors: Madhukar Mallya H, Revathi P Shenoy, Sreejith Ramakrishnan, Linta Thampi, Rashmi Stevens, M Sethukumar Kamath, Anupama Nayak, Anjali Rao

Objective: In the Ayurvedic system of medicine, body constitution (prakruthi) is said to play a vital role in the disease process as well as in its progression. Free radical toxicity is also involved in the etiopathogenesis of many disorders. Hence, in the present study an attempt has been made to correlate the body constitution type and the antioxidant status of that prakruthi. Methods: Healthy volunteers from Manipal University Campus, South Karnataka, India were classified into three main human constitutions (prakruthi) and their possible combinations and their serum total antioxidant activity was determined. Results: There was a significant negative correlation of the total antioxidant status with the pitta prakruthi whereas vata and kapha constitutions showed no significant correlation with the total antioxidant status. Conclusion: Ayurveda classifies each individual based on his/her prakruthi into three categories of Doshas: Vata, Pitta and Kapha (collectively known as Tridoshas). The three Doshas are fundamental regulatory principles responsible for maintaining organism functioning and manifesting those characteristics typifying each individual, that is, in equilibrium Tridoshas signify health and an imbalance leads to disease. Thus, in this study a significantly decreased antioxidant status in the Pitta group would render them more susceptible to damage by oxidative stress. Hence, we suggest that supplementation with antioxidants of herbal (Ayurvedic) origin to such a group would prove to be beneficial - opening up the arena for pharmacogenomics and customized antioxidant drug administration based on the prakruthi of an individual.

49-60

Authors: Bharati P, Pal M, Bharati S

Objective: The aim of the paper is to see how educational and working status of the parents affect the nutritional and immunization status of preschool children in India. Methods: We have used data of more than 24 000 preschool children spread over different states in India. The data were collected by National Family Health Survey (NFHS-2) in 1998-99. For assessing the nutritional status, only the Z-scores of weight-for-height (WHZ) have been computed and for immunization status, it has been seen whether BCG, DPT3, Polio3 and measles have been administered. Children who fall below-2SD(-3SD) from median are considered to be moderately (severely) malnourished. Results: According to the NFHS-2 data, 70% of children are vaccinated by BCG, 50% receive the full course of DPT, 54% get all the three dozes of polio and only 42% are protected from measles by vaccination in India. The percentages of moderately and severely wasted children in India are 12.1 and 2.8, respectively. There is a marked regional variation of these percentages. Bivariate and multivariate analysis clearly points to the need of educational status of mothers rather than fathers for proper nutritional and immunization status of preschool children. Parents' occupation and working status also have some effect, but not so pronounced as parents' education. Conclusion: The Indian preschool children need particular attention for high risk of wasting and low immunization. The prevalence of malnutrition can be arrested more by improving the mother's education level rather than their fathers and by raising the standard of living of their house-holds.

67-71

Authors: Onwere S, Okoro O, Chigbu B, Kamanu C, Aluka C, Feyi-Waboso P

Central nervous system tuberculosis can have protean manifestations. We review the clinical and radiological findings in two cases of cerebral tuberculoma in immuoncompetent patients. These two cases represent the spectrum of variations of clinical and radiological features of cerebral tuberculoma and highlight the controversies in the approach to diagnosis and management.

76-82

Authors: Asad U Khan

Drug resistance is becoming a great problem in developing countries due to excessive use and misuse of antibiotics. The emergence of new pathogenic strains with resistance developed against most of the antibiotics which may cause, difficult to treat infection. To understand the current scenario in different mode of infection is most important for the clinicians and medical practitioners. This article summarized some common infections and antibiotic resistance pattern found among these pathogens.

1-6

Authors: H. Vatandoos, A. Khazani, J. Rafinejad, M. Khoobdel, A. KebriaiZadeh, MR. Abai, AA. Hanafi Bojd, AA. Akhavan, SM. Abtahi & F. Rafi

Malaria is one of the most important parasitic diseases in the world which is transmitted by the Anopheles mosquitoes. There are several methods for malaria control. One of them is application of repellents on skin in malarious area as an intergrated vectro management measures.This study evaluated two repellents of DMP as a synthtic and locally product of neem oil as a botanical repellent against Anopheles stephensi. The modified method of K & D was used for the tests. Probing/biting rates on the shaved belly of white rabbits were counted. ED50 and ED95 values were calculated by probit statistic software. Calculation of effective dose (ED50, ED90) on human volunteer and white rabbit was performed using regression line. Protection and failure time of DMP and neem oil was also determined. ED50 value of DMP and neem oil was determined as 0.0076 and 0.159 mg/cm2 respectively on white rabit. The figures of ED90 value of DMP and neem oil was determined as 0.046 and 1.388 mg/cm2 . DMP and neem oil showed repellency effects against An.stephensi on human volunteers with ED50 value of 0.0037 and 0.127 mg/cm2 respectively. ED90 value of DMP was determined as 0.032 mg/cm2 . neem oil exhibited a ED90 value of 1.066 mg/cm2 on human volunteer. The protection time of 6－7 hours for DMP and 31 minute for neem oil was determined. The failure times for DMP and Neem was 9 hours and 65 minutes rspectively on human bait. Our results exhibited that plant－based repellent is generally less effective than synthetic repellents. However, use of locally made botanical materials would be of great advantages for personal protection against mosquito biting.

13-19

Authors: Juma Khan Kakarsulemankhel

In the survey, the work was done to develop taxonomic record of sand fly Phlebotomus (paaphlebotomus) sergenti (Parrot) collected for the first time from new epidemic localities of cutaneous leishmaniasis in Dera Ghazi Khan (Pakistan). In view of the published reports about the detection of Leishmania major, the causative agent of cutaneous leishmaniasis from this species in many countries, the correct identification of this species becomes of significant value in the study of epidemiology of leishmaniasis. Therefore, in order to facilitate zoologists and medical researchers in its correct identification, taxonomic characters of P. sergenti (parrot) is studied in details with special reference to its mouth parts, male and female genitalia. A key is also given to P. sergentii (parrot) and its closest allies. In this light its relationships with its closest allies is also briefly discussed.

25-29

Authors: Hiroshi Nishiura

The purpose of the paper was to assess the frequency of secondary transmissions of primary pneumonic plague relative to the onset of fever. A simple backcalculation method was employed to estimate the frequency of secondary transmissions relative to disease－age. A likelihood－based procedure was taken using observed distributions of the serial interval (n = 177) and incubation period (n = 126). Furthermore, an extended model was developed to account for the survival probability of cases. The simple backcalculation suggested that 31.0% (95% confidence intervals (CI): 11.6, 50.4) and 28.0 % (95% CI: 10.2, 45.8) of the total number of secondary transmissions had occurred at second and third days of the disease, respectively, and more than four－fifths of the secondary transmission occurred before the end of third day of disease. The survivorship－adjusted frequency of secondary transmissions was obtained, demonstrating that the infectiousness in later stages of illness was not insignificant and indicates that the obtained frequencies were likely biased on underlying factors including isolation measures.In conclusion, the simple exercise suggests a need to implement countermeasures during pre－clinical stage or immediately after onset. Further information is needed to elucidate the finer details of the disease－age specific infectiousness.

36-41

Authors: Malak Shaheen and Ashraf Madkour

Bacille Calmette－Guérin (BCG) vaccine is one of the most widely used vaccines in children. In Egypt, it is a part of the national compulsory childhood immunization program. The most controversial aspect of BCG is the variable efficacy found in different studies.This study was to evaluate the efficacy status of the available BCG vaccine in Egypt within the last 10 years (BCG－Copenhagen).The pilot cross sectional study included 597 Egyptian children randomly selected. Their ages ranged from 6 months to 10 years old (mean_ 5 years, median: 3 years). All were assessed for history of BCG vaccine intake (primary at infancy and/or secondary at school age) and examined for the presence BCG scar. A group of the vaccinated children (62 children with BCG scar and 69 children without BCG scar) were further assessed with tuberculin skin test (TST). Prevalence of BCG vaccine intake in the studied children was 86.9% (519/597). Efficacy in term of BCG scar after vaccination was 66.6% (346/519). However, efficacy in term of post BCG vaccination tuberculin sensitization was only 3.8% (5/131). BCG vaccination program in Egypt seems to be widely prevalent; however, the immunological efficacy of the available strain is questionable.

48-54

Authors: E. O. Omeje, P.O. Osadebe, F. B. C. Okoye, A.K. Agwu, C.O.Esimone

Loranthus micranthus is the species of mistletoe peculiar to the eastern province of Nigeria. It has been shown to possess anti－diabetic, antimotility, antimicrobial and antihypertensive activities which are host－tree dependent. The antimicrobial activity was found to vary with the season during which the plant was harvested. We are of the opinion that this species should possess immunomodulating potentials as have been reported for the European species, Viscum album. In our efforts to establish the bio－activities and active principles in our local mistletoe, the immunomodulatory activity of n－hexane and methanol extracts from Loranthus micranthus parasitic on Persea americana was assessed at three dose levels ranging from 100 to 400 mg/kg body weight using delayed type hypersensitivity reaction (DTHR) and cyclophosphamide－induced myelosuppression models in mice. This was compared with responses from a standard immunostimulatory drug, levamisole. Preliminary phytochemical analysis of the plant showed the presence of tannins, flavonoids, alkaloids, terpenoids, carbohydrates and saponins. Regression analysis indicated a dose－dependent response relationship in the parameters measured with over 170 % increase for both extracts at the highest dose level. The one way ANOVA test showed significant variation in the parameters between the controls and the different dose levels. However, at 95 % confidence level, (P<0.05), there was no statistically significant difference between the two extracts, an indication that the active immunomodulant(s) could be both in the polar and non－polar crude extract. In conclusion, the present results have established some immune stimulating actions of the Eastern Nigeria mistletoe, Loranthus micranthus thus indicating that this variant of the semi parasitic plant holds a strong promise as an immunostimulatory candidate. There is therefore, a basis for further detailed investigation on the fractions and specific constituents. Thus, these extracts from Loranthus micranthus possess pronounced immune stimulating action comparable to Levamisole in mouse－based models.

60-64

Authors: Abdulqadir Maghded Zangana, Bashar Hanna Saqat

To understand the socio－psychological aspects of HIV transmission and gender and caste based AIDS care in India, 100 HIV positive patients and their spouses or sexual partners were included in this study. The individuals were interviewed for their pre－or extramarital sexual exposure with suspected HIV positive persons. They were also interviewed about the barriers, if any, they used, and change in their sexual behaviour with their spouses after they were tested HIV positive. All except three were males who were first detected HIV positive, while 3 women were found HIV positive first and subsequently their male partners were included in the study. Eighty of 97 (82.4%) males admittedly acquired HIV through heterosexual route. Of the 80 males, 60 (75%) acquired HIV infection from organised CSWs and 20 from casual sex partners. Many of these acquired the infection just before their marriages. More than half of these males were infected during only one or two sexual encounters. Sixty out of 75 (80%) married males continued to have sex even after knowing their HIV positive status. One male and six female spouses did not get infected even after multiple insertive unprotected sex. The average life span after the diagnosis of HIV infection in Indian males without specific treatment was 4.5 ± 3.5 yr while in women it was 3.5 ± 2.0 yr, indicating fast progression of AIDS in females, most probably due to gender bias in access to treatment, nutrition, care and also due to hormonal differences. Pulmonary tuberculosis was most common and first clinical presentation of HIV associated opportunistic infection. The study also showed that due to ignorance majority of husbands do not share their HIV positive status with their wives and continue to have unsafe sex.

69-71

Authors: Onwere S, Okoro O, Chigbu B, Kamanu C, Aluka C, Feyi-Waboso P

The purpose of the study was to assess pregnant women's knowledge of perinatal human immunodeficiency virus (HIV) infection.A descriptive study involving 100 consecutive and consenting patients at the antenatal clinic of Abia State University Teaching Hospital (ABSUTH), Aba, South Eastern Nigeria, over the period 1st November, 2007 to 15th January, 2008 was done. Using a structured questionnaire, the respondents' sociodemographic data were recorded as well as their knowledge of perinatal HIV infection. Although 85% of the pregnant women were aware of perinatal HIV transmission, only 69% knew that if a baby tested positive to HIV at delivery, it meant that the mother is infected with HIV. Fifty one percent of the pregnant women wrongly thought that all babies born to mothers with HIV also get infected whilst 83% knew that HIV can be transmitted through breast feeding. The pregnant women demonstrated an incomplete knowledge of perinatal HIV transmission. The findings of this study underscore the continued need for intensified health education about prevention of perinatal HIV infection in our community in order to reduce the impact of HIV, especially in children

79-82

Authors: Majid Avijgan,Mandana Moghni, Seyyed Kamyar Mostafavi Zadeh

This paper reports two seronegative cases of parotid swelling following MMR vaccination, which contains Hoshino strain of mumps virus. This study showed a high, (5%) potential reactogenicity induced by Hoshino strain of current MMR vaccine administered in Iranian EPI. The rate of complication of parotid swelling following national immunization against mumps is more than natural infection. Based on the results of this report, there is the first report of occurrence of parotid swelling 31 days following MMR vaccination. This reaction or complication may not be dependent on the vaccine dose, because one of cases presented parotid swelling following taking one fifth of conventional dose of vaccine. It must be considered this strain may be with high rate of complication and be the subject of change of mumps strain of this vaccine in national immunization program of Iran.

1-6

Authors: Simpore J, Zeba B, Karou D, Ilboudo D, Pignatelli S, Nacoulma OG, Musumeci S

Burkina Faso (West Africa) is a tropical country with a high incidence of infectious diseases. The uncontrolled use of antibiotics against bacterial pathogens has given rise to the emergence of antibiotic resistance in this country. The aims of this study were. i) to determine the prevalences of the most important pathogenic bacteria, isolated in the town of Ouagadougou. ii) to identify the bacterial species which have acquired resistance as a result of antibiotic selection. iii) to compare antibiotic-resistances of Escherichia coli isolated from stool culture in the present study, with results obtained in 2002 from strains collected in the same structure in Burkina Faso. iv) to determine the trend of antibiotic resistance in Burkina Faso in order to give local advice on the most appropriate empiric antibiotic therapy. Six thousand two hundred and sixty four samples of blood, stools, urine, sputum, pus and vaginal secretion were collected and analyzed in Saint Camille Medical Center (SCMC) laboratory from May 2001 to May 2006. Out of the 6264 samples tested no pathogen was identified in 1583 (25.31%), whilst 4681 (74.73%) were positive, with the incidence of the microrganisms isolated being as follows: Escherichia coli 1291 (27.6%),Staphylococcus aureus 922 (19.7%),Salmonella spp 561 (12.0%), Streptococcus spp 499 (10.7%), Klebsiella spp 359 (7.7%), Shigella spp (6.3%), Acinetobacter spp 266 (5.7%) and others 783 (16.7%). Among the isolated pathogens, the highest resistance was found to Amoxycillin: Proteus spp 95.6%, Escherichia coli 78.2%, Salmonella spp 62.2%, Shigella spp 73.4% and Klebsiella spp 89.9%, followed by resistance to Ampicillin and cotrimoxazole. Comparing the prevalence of antibiotic resistance of Escherichia coli from stool cultures isolated during 1999-2000 to that of 2001-2006, a significant reduction was found, which could be due to the improved use of antibiotics in recent years. The reduced antibiotic-resistance observed in pathogens isolated in Burkina Faso during this study as compared to previous data, could be the result of setting up microbiological epidemiological monitoring centres, in tropical countries, to better control the emergence of bacterial antibiotic-resistance.

12-15

Authors: Asad U Khan, Saeedut Zafar Ali, Mohammed S Zaman

This study was to investigate the current trends of multiple drug resistance in bacteria against antibiotics for the proper empirical treatmen. Clinical isolates were collected from community-acquired infection of urinary tract patients in Aligarh India from March 1999 to August 1999. Antibiotic susceptibility test was performed, using the disc diffusion method followed by plasmid isolation by the method of Kado and Liu. Transfer experiments were performed by the method of Lederberg and Cohen. Clinical study revealed that this infection was more common in young women. Various strains of E. coli isolated during the course of study were found to show multiple antibiotic resistance which was further characterized as plasmid-borne drug resistance. This study shows that E. coli may be one of the important causative agents of urinary tract infection(UTI) in young women.

21-27

Authors: Arun Kumar，Ramiah Sivakanesan

Dyslipidemia the major cause of atherosclerosis are suggested to act synergistically with non-lipid risk factors to increase atherogenesis. Low-density lipoprotein cholesterol (LDL-C) is the main therapeutic target in the prevention of CVD. Increased triglycerides (TG) and decreased high-density lipoprotein (LDL-C) are considered to be a major risk factor for the development of insulin resistant and metabolic syndrome. Although the TG/HDL-C ratio has been used in recent studies as a clinical indicator for insulin resistance, results were inconsistent. The TG/HDL-C ratio is also widely used to assess the lipid atherogenesis. How ever the utility of this rate for predicting coronary heart disease (CHD) risk is not clear. We encountered myocardial infarct patients with normal serum lipid concentration so this study was undertaken to evaluate the usefulness of these lipid ratios in predicting CHD risk in normolipidemic AMI patients and to compare the results with healthy subjects. The aim of the present study was to evaluate serum TC/HDL-C, TG/HDL-C and LDL-C/HDL-C in myocardial infarct subjects with normal lipid profile.To study this, lipid profile was determined in 165 normolipidemic acute myocardial infarction patients and 165 age/sex-matched controls. Total cholesterol, triglycerides, and HDL-cholesterol were analyzed enzymatically using kits obtained from Randox Laboratories Limited, Crumlin, UK. Plasma LDL-cholesterol was determined from the values of total cholesterol and HDL- cholesterol using the friedwalds formula. The values were expressed as means ± standard deviation (SD) and data from patients and controls was compared using students 't'-test.The results and conclusion of the study were: Total cholesterol, TC: HDL-C ratio, triglycerides, LDL-cholesterol, LDL: HDL-C ratio were higher in MI patients (p<0.001). HDL-C concentration was significantly lower in MI patients than controls (p<0.001). Higher ratio of TC/HDL-C, TG/HDL-C and LDL-C/HDL-C was observed in AMI patients compared to controls.

31-33

Authors: Seyedeh Atefeh Emadi, Marzieh Akbarpour, r. Shahram Azhdari

Lymphomas form a heterogenous group of clonal(neoplastic) diseases. Primary renal lymphoma(PRL) is rare. Diagnosis of primary renal lymphoma is important for the patients to receive appropriate therapy. Laparoscopic nephrectomy should be the standard procedure in most cases of both malignant and benign, renal tumors with the possible exception of tumor >10cm. Probably this case report of laparoscopic surgery of primary renal lymphoma is the first report of this kind and may be useful for the other laparoscopic surgeons. A 53 years-old man with unilateral primary renal lymphoma who had a history of renal colic and ESWL(Extracorporeal Shock Wave Lithotripsy) of the left kidney stone 3 years ago, he underwent laparoscopic radical left nephrectomy and chemotherapy. The patient was monitored for follow up for 4 months and had a significant improvement. Although treatment of lymphoma is now guided by phenotype of tumor, we found that appropriate treatment is possible after radical nephrectomy and assessment of pathology. Renal lesions may compeletly regress by appropriate treatment. There was not any report of laparoscopic surgery of PRL in our literature. We are reporting the first case of successful laparoscopic surgery of PRL successfully.

36-37

Authors: Bava Javier, Troncoso Alcides

41-60

Authors: Cristóbal S. Berry-Cabá

Schistosomiasis is an infection with one of a series of related trematode parasites that are endemic to at least 76 tropical and subtropical countries. Schistosomiasis affects over 200 million people in tropical and subtropical regions of South America, Africa and Asia. This paper reported more than 1500 soldiers of US troops and 560 men of Australian Air Force were affected schistosomiasis japonicum in the Leyte of the Philippines during the liberation of the Philippines from Octorber 1944 to the early months of 1945. Many troops there were affected by contaminated water with snail hosts. At first, the medical corps knew little about the situations of the schistosomiasis japonica in the Leyte, no preventive measure was adopted. On December 23, 1944 CPT morris Goldberg discovered schistosomes first from the hospitalized soldiers while conducting a liver biopsy. Some soldiers with markedly signs and symptoms were admitted to hospital for treatment. Preventive measure was taken since. The US sent a lot of experts to Philippines for the research of schistosomiasis japonicum, including epidemiology, prevention, diagnosis, treatment and so on. Nineteen chemicals were used to control snail hosts. In clinical, schistosomiasis has acute and chronic stages, the manifestations are plenty and various, the liver, intestine, veins, spleen and skin etc are common sites of impingement. An extensive educational program was carried out in the troops through different means, which yielded remarkable effect, the new incidence of schistosomiasis dropped. Though hospitalized soldiers were a few, but there were scare and some morale and psychological problems among them and the other affected victims, they worried about their prognoses or being infected. Some patients were evacuated to United States for treatment after diagnosis, some patients were treated in Leyte. Before World War II, schistosomiasis was treated generally with trivalent antimony compounds, Fuadin and tartar emetic. In this event, no case died, relapses were rare. It was a successful campaign against schistosomiasis in the army.

65-70

Authors: Shikha Baisakhiya DOMS, FGO

As the number of HIV infected patients is multiplying exponentially day by day so are the associated ocular complications. The increasing longevity of individuals with HIV disease has resulted in greater numbers of patients with ocular opportunistic infection. By the means of this article we describe various opportunistic ocular infections in AIDS and their clinical manifestations, discussed under four headings; 1) adnexal manifestation; 2) anterior segment manifestation; 3) posterior segment manifestation; 4) neuro ophthalmic manifestation . Herpes zoster ophthalmicus, molluscum contagiosum and Kaposi sarcoma are common adnexal manifestations. Molluscum contagiosum being the commonest. Varicella Zoster Virus (VZV) and herpes simplex virus (HSV) most commonly cause infectious keratitis in HIV-positive patients . As compared to the immunocompetent individuals the frequency of bacterial and fungal keratitis is not more in HIV patients, but it tends to be more severe. Posterior segment structures involved in HIV-positive patients include the retina, choroid, and optic nerve head. The herpesvirus family is implicated most commonly in infections of the retina and choroid in HIV positive patients. CMV is the most common cause of retinitis and the commonest intraocular infection in AIDS. Atypical presentations resistance to conventional treatment and higher rate of recurrence make the diagnosis and therapeutic intervention more difficult and challenging. In addition, in one eye, several infections may occur at the same time, rendering the situation more difficult.

76-82

Authors: Asad U. Khan and Shahper N. Khan

The discovery that RNA can act as an enzyme led Thomas Cech to win the Nobel Prize in Chemistry and led immediately to the next wave of attempts to find an effective RNA-based therapy. The tantalizing idea that RNA enzymes called trans-cleaving ribozymes enables them to act as potential antiviral and powerful tool for functional genomic studies. The efficacy of ribozyme function in a complex intracellular environment is dependent on the intracellular fate of the RNA that is being targeted. Recently, ribozymes have been used successfully to inhibit gene expression in a variety of biological systems in vitro and in vivo. Ribozyme has also been used successfully to combat many cases of viral infection, as clinical trial. Despite it needs to be investigated and explored as far as its structural and functional aspects are concern. In view of the significance of ribozyme in modern medicine, we reviewed the recent literature on general approach to control viral infection.

1-6

Authors: Tienboon P, Wangpakapattanawong P, Thomas DE, Kimmins JP

Malnutrition results from insufficient intakes of food including micronutrients such as vitamin A, iron, iodine, zinc, and folic acid. This paper reported the results from a study of dietary intakes of Karen hill tribe children aged 16 years in the north of Thailand. All children aged 16 years (n=158; 83 boys, 75 girls) from the three Karen villages (Mae Hae Tai, Mae Yot, Mae Raek) of Mae Chaem district in the north of Thailand were studied. All children were examined by a qualified medical doctor and were assessed for their nutrient intakes using 24 hours dietary recall. All families had income lower than the Thailand poverty line (US $ 1000/year). For children aged 13 years, the nutrients generally consumed were much less than the Thai RDA. Compared with the Thai RDA, all children consumed much less energy (28%-40.5% RDA) than protein (55.8%-96.1% RDA). Interestingly, all boys and only girls from Mae Raek village consumed vitamin A more than the Thai RDA but girls from Mae Hae Tai village and Mae Yot village consumed vitamin A less than the Thai RDA. For children aged 46 years, boys from Mae Raek village consumed protein (128.4% RDA) and vitamin C (143.1% RDA) above the Thai RDA. Girls from Mae Yot village also consumed vitamin C (132.9% RDA) above the Thai RDA. Both boys and girls from Mae Raek village and also girls from Mae Yot village consumed vitamin A more than the Thai RDA. Other nutrients were consumed much less than the Thai RDA by all children. All children consumed protein more than 10% of the total energy consumption per day. Most of the energy consumed by children came from carbohydrate. Nearly all children consumed carbohydrate more than 50% of the total energy consumption per day except boys aged 13 years from Mae Raek village (consumed 45%). All children from Mae Hae Tai village and boys aged 46 years from Mae Yot village (consumed 27%) consumed fat less than 30% of the total energy consumption per day. It appeared that the priority recommendations for improving nutrition in Karen villages in Mae Chaem would be increase energy consumption such as fat and oil. More general work is needed on how children's diets might be improved in a culturally acceptable manner, so as to bring consumption patterns closer to recommended allowance levels.

14-18

Authors: Gupta AD, Dhundasi SA, Dhara PC , Das KK

We studied the effect of the simultaneous treatment with α-tocopherol (100 mg/kg; im) and nickel sulfate (20 mg/kg , ip) on nickel-induced changes in serum lipid profiles. Nickel-treated rats showed a significant increase in serum LDL cholesterol, total cholesterol, triglycerides, and a significant decrease in serum HDL cholesterol. Simultaneous administration of α-tocopherol with nickel sulfate improved LDL-cholesterol and HDL-cholesterol level when compared with rats receiving nickel sulfate alone. The results indicate that α-tocopherol is beneficial in preventing nickel-induced lipid profile alterations.

25-29

Authors: Nwodo NJ, Omeje EO, Brun R

Objective: Aqueous extracts of Zapoteca portoricensis are used traditionally as antidiarrhea agent and in the treatment of diverse gastrointestinal disorders here in Nigeria specifically, the southern part. Similarly, the aqueous extract of the plant is also used traditionally as anticonvulsant, antispasmodic and in the treatment of tonsillitis. Recently too, the antiinflammatory and antimicrobial activities of the methanol extracts of the root of Zapoteca portoricensis was reported. In this research, we are set to investigate the trypanocidal activity of Zapoteca portoricensis. Methods: The methanol extract of the root of Zapoteca portoricensis was investigated for both in vitro and in vivo trypanocidal activity following established models. In summary, phytochemical analysis was carried out on both the crude powdered root and on the methanol extract following standard procedures. The oral acute toxicity test (LD 50) of the crude methanol extract was determined according to the method described by Lorke (1983). Albino mice (17g-21g) of either sex were used. The methanol extract was suspended in 3 % v/v tween 85 and administered orally at doses of 10 mg/kg, 100 mg/kg and 1 000 mg/kg to three groups of mice (n=3). The animals were observed for 24 hours. Based on the result obtained in this initial test, doses of 4 mg/kg, 6 mg/kg, and 8 mg/kg were administered to three different mice. The LD 50 was calculated as the geometric mean of the lowest dose killing a mouse and the highest dose showing no death. The in vivo/ in vitro anti-trypanosomal evaluations were carried out in experimental animals and tissue cell culture respectively. Results: The result of the in vitro studies shows the inhibitive concentration 50(IC50) against Trypanosoma brucei rhodesiense (T.b. rhodesiense) to be 0.372 mg/kg, while the control drug melarsoprol was 0.006 mg/kg. On Trypanosoma brucei brucei (T. cruzi), the IC50 is 6.42 mg/kg against 0.87 of the reference drug Benznidazole. The cyctotoxicity on L6 cells exhibited an IC50 of 0.039 6 mg/kg against the reference drug, podophyllotoxin of 0.01 mg/kg. However, the in vivo study shows that the extract, at the administered doses, could not exhibit appreciable reduction of parasitemia and hence resulted to the death of test animals. Conclusion: The present data suggests that Zapoteca portoricensis could yield useful leads for the development of potentially potent antitrypanocides.

29-30

Authors: Meunier Y.A.

Strongyloidiasis is endemic to the entire inter-tropical zone. Newly infected people are the most prone to experience the symptoms of this intestinal nematodosis. In this article, a 38-year old German citizen consulted for bowel movement disturbances and dyspepsia as well as diffuse and erratic pruritus, and was finally diagnosed with to have strongylodiasis is presented and discussed.

50-55

Authors: Li F, DeWolfe Miller F

Staphylococcus aureus (S. aureus) is one of the most common human pathogens, causing a wide range of afflictions from minor infections of the skin to serious wound infections, bacteraemia, pneumonia and endocarditis. Methicillin, the first semisynthetic derivative of penicillin, was a new hope to treat penicillin resistant S. aureus in the early 1960s. Nevertheless, only one year after its introduction, the first methicillin-resistant S. aureus (MRSA) strains were detected. There is no golden rule in the control of MRSA. Nevertheless, using surveillance cultures of patients and healthcare personnel, strictly enforced contact precautions, and judicious use of broad-spectrum antibiotics have helped several countries, including Finland, Denmark, and the Netherlands to keep MRSA at a very low level. Conversely, countries including China, Japan, US, Italy, Greece, UK, where stringent counter-measure were not able to be installed, MRSA have become hyper-endemic. Control of MRSA in those countries were obliged to concentrate available resources to prevent MRSA infections only at patients at high risk of serious morbidity and mortality.

60-62

Authors: Wiwanitkit V

All human beings have to ingest food to get the nutrition. The epidemiology of nutritional problem is quite different in different part of the world. Most of the problematic cases come from the underdeveloped tropical countries. Of several methods, nutritional surveillane adding to the standard nutritional promotion should be used. Not only the basic medical and nutritional science but also other sciences should be integrated into a complete nutritional surveillance. Applied new technology especailly for the medical informatics should be used. The multidisciplinary project between medical science workers and other non -medical science workers is also recommended.

69-82

Authors: Tyagi P, Biswas S

The research scenario for malaria has improved in the last three decades to understand the epidemiology and host immune responses to plasmodial infection. Due to the augmented episodes of resistance development against the commonly used antimalarials in plasmodium parasites, especially in Plasmodium falciparum, neutralization of infection through effective vaccine(s) remains the feasible alternative in malaria control. In this direction, lot of attention was paid towards the identification of stage specific malaria antigens targeted by host's immune system. Preparation of synthetic or recombinant peptides and evaluation of their immunogenecity in naturally occurring antibody response were also given much importance, as these studies could help in finding potential candidates for future malaria vaccine(s). Attention was also paid on the pathogenic consequences of antibody formation in malaria infection as polyclonal activation of B cells, which is a very prominent feature in malaria infection. Formation of circulating immune complexes in chronic malaria infection was also viewed as pathogenic parameter of severe malaria. The present survey focuses mainly on protective and pathogenic aspects of malaria antibodies (eliciting against various stage specific antigens), and future research plan in antibody-mediated immune response.