Asian Pacific Journal of Tropical Disease

85-92

Authors: Prashant Tiwari, Rajnikant Panik, Arin Bhattacharya, Dheeraj Ahirwar, Anish Chandy

Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a rare, life-threatening dermatological condition that is usually induced by reaction to medications. It is characterized by the detachment of the top layer of skin (the epidermis) from the lower layers of the skin (the dermis) all over the body. There is broad agreement in medical literature that TEN can be considered a more severe form of Stevens Johnson syndrome, and debate whether it falls on a spectrum of disease that includes erythema multiforme. Some authors consider that there is an overlap between the two syndromes (usually between 10% and 30% of skin detachment). This article deals with history, epidemiology, diagnosis, pathophysiology treatment and management of TEN.

103-110

Authors: Usharani Veerabadran, Anuradha Venkatraman, Aroumougame Souprayane, Mathivanan Narayanasamy, Dhanalakshmi, Perumal, Sagadevan Elumalai, Sindhu Sivalingam, Vadivelu Devaraj, Arumugam Perumal

Objective: To investigate the antioxidant and antiproliferative potential of Leonotis nepetifolia (L. nepetifolia) leaves. Methods: The leaves of L. nepetifolia were subjected to extraction using three different solvents and the antioxidant potential of those extracts were tested by using various in vitro assays. Further, the best screened extract was analyzed for its phytochemical profile by both qualitative and quantitative assays. In order to determine its anti-proliferative activity, the best screened extract was treated with breast and laryngeal cancer cell lines such as MCF-7 cells and Hep2 cells, respectively. The cytotoxicity of the extract was also studied using MTT assay. The inhibitory effect of the extract of leaves of L. nepetifolia on the selected cell-line DNA was determined by DNA fragmentation assay. Also, the extract was subjected to TLC and bioautography analysis. Results: The DPPH assay showed methanol extract of L. nepetifolia leaves to be more significant in scavenging free radicals with inhibition percentage of 60.57%. From the data obtained, the methanol extract proved to be significant in all anti-oxidant assays and this effect was well comparable with the standard used in the study. The predominant phytochemicals such as phenols and flavonoids were further quantified as 0.107% and 0.089%. The cytotoxicity assay showed that the cell viability increased with increasing concentration of methanol extract. In addition, the extract caused dose dependent damage to the cancer cell lines MCF-7 and Hep2. Conclusions: Our study suggests that the leaves of L. nepetifolia were significant in scavenging fr ee radicals and causing damage to proliferative cells. Further mechanistic studies would help in proving the efficiency of the selected plant under in vivo conditions.

119-126

Authors: Chellamuthu Vasugi, Siva Kamalakannan, Kadarkarai Murugan

Objective: To evaluate the toxicity, predatory efficiency of Delonix elata (D. elata) and Mesocyclops aspericornis (M. aspericornis) against dengue vector, Aedes aegypti (Ae. aegypti). Methods: A mosquitocidal bioassay was conducted at different concentration of plant extract followed by WHO standard method. The probit analysis of each tested concentration and control were observed by using software SPSS 11 version package. The each tested concentration variable was assessed by DMRT method. The predatory efficiency of copepod was followed by Deo et al., 1988. The predator, M. aspericornis was observed for mortality, abnormalities, survival and swimming activity after 24 h treatment of plant and also predation on the mosquito larvae were observed. Results: D. elata were tested for biological activity against the larvae, and pupae of Ae. aegypti. Significant mortality effects were observed in each life stage. The percentage of mortality was 100% in first and second instars whereas 96%, 92% in third and fourth instars. Fitted probit-mortality curves for larvae indicated the median and 90% lethal concentrations of D. elata for instars 1-4 to be 4.91 (8.13), 5.16 (8.44), 5.95 (7.76) and 6.87 (11.23), respectively. The results indicate that leaf extract exhibits significant biological activity against life stages. The present study revealed that D. elata is potentially important in the control of Ae. aegypti. Similar studies were conducted for predatory efficiency of Copepod, M. aspericornis against mosquito vector Ae. Aegypti. This study reported that the predatory copepod fed on 39% and 25% in I and III instar larvae of mosquito and in combined treatment of D. elata and copepod maximum control of mosquito larval states and at 83%, 80%, 75% and 53% in I, II, III and IV instars, respectively. Conclusions: The combined action of plant extract and predatory copepod to effectively control mosquito population and reduce the dengue transmitting diseases.

133-142

Authors: Debasmita Dubey, Shakti Rath, Mahesh C. Sahu, Lolly Pattnaik, Nagen K. Debata, Rabindra N. Padhy

Objective: To access nosocomial and community accounts of multidrug resistant strains of Staphylococcus aureus (S. aureus) isolated by surveillance in a teaching hospital, over a period of 30 months. Methods: Clinical samples from nosocomial sources, i.e., wards and cabins, intensive care unit (ICU) and neonatal intensive care unit (NICU) sources, as well as community or outpatient department (OPD) sources of a hospital were used for isolating strains of S. aureus resistant to methicillin/oxacillin and vancomycin, over a period, November 2009-April 2012. Results: Of a total of 1 507 S. aureus isolates, 485 strains from community and 1 022 isolates were fr om nosocomial sources; Out of 485 (100%) OPD S. aureus isolates, 390 (80.41%) were MRSA strains. Similarly, from wards and cabins of 564 (100%) isolates, 461 (81.73%) strains were MRSA; whereas of 458 (100%) isolates obtained from ICU and NICU, 363 (79.25%) strains were MRSA. It was ascertained with χ2-tests of independence that MRSA strains were equally distributed in "community" or "wards and cabins" or "ICU and NICU" sources, alike rest other drug-resistant S. aureus strains. Antibiotic sensitivity patterns of isolated strains with 16 antibiotics were ascertained. Out of 390 (100%) MRSA strains isolated from OPD, 80 (20.51%) were vancomycin resistant (VRSA) and 173 (44.35%) strains were moderately sensitive to vancomycin or called, vancomycin intermediate strains (VISA). Similarly, from nosocomial sources, out of 461 (100%) MRSA isolates obtained from wards and cabins, 110 (23.86%) strains were VRSA and 208 (45.11%) were VISA strains, whereas out of 363 MRSA isolates obtained from ICU and NICU, 61 (16.8%) VRSA strains and 164 (45.17%) VISA strains were found. A progressive increase of percent values of drug resistance to 16 antibiotics used for antibiotic profiling revealed its subtle infection dynamics. Conclusions: This study revealed the appalling state of occurrence of MRSA and VRSA in a resource-limited setting. A progressive increase of percent values of drug resistance to 16 antibiotics used revealed its subtle infection dynamics.

146-149

Authors: Mohammed Said Al- Balushi, Juma Z Al- Busaidi, Muna S Al- Daihani, Mohammed O Shafeeq, Sidgi S Hasson

Objective: To investigate the prevalence of Helicobacter pylori (H. pylori) infection, a crosssectional epidemiological study, based on the age and gender-specific seroprevalence of H. pylori antibodies in asymptomatic healthy Omani blood donors attending the SQUH blood bank. Methods: Analysis of the sera from 133 apparently healthy subjects, based on the serological determination of the IgM, IgG and IgA antibodies against H. pylori, was carried out using a commercially available kit ELISA (NovaLisa, NovaTec, Germany). While the presence of H. pylorispecific IgG antibodies is the marker for a "chronic" infection with this pathogen. Therefore, there was no indicator of the time of acquisition of the infection. However, the H. pylori-specific IgM antibody was a more specific marker for a recently acquired infection with H. pylori. Results: Of the 133 subjects, there were 100 (74%) males and 33 (26%) females. The age range was 15 to 50 years with a mean of 25.75依3.75 years. The overall prevalence of H. pylori infection in our study was 69.5%. The overall seroprevalence was found to be increased 69%-86% with age. Subjects between 15-20 years of age showed 71% seroprevalence, while those between 21-40 years showed gradual increase (63%-70%) with age and reached up to 87% in subjects between 41-50 years of age. A significant inverse association was found between sex and age groups. This is when each age group was examined individually; a higher positive percentage of H. pylori antibodies increasing with age was seen in males between 21-40 years of age group in comparison to the females of the same age group. Male subjects with age group between 21 to 40 years were found to have a significant seropositivity compared to the female subjects within the same group. This may reflect how frequent were the male subjects being exposed to the outer environment and their conduct than the females in this society like Oman. Conclusions: The seropositivity of H. pylori is moderately higher between ages of 21 to 30 more than any other age group.

155-157

Authors: Mahmoud Bahmani, Maryam Rasouli, Pouya Parsaei, Ebrahimkhalil Bahnihabib, Koroosh Saki, Fereidon Ghotbian

Leech infestation can cause various clinical symptoms in human and animals. There are a few reports about this infestation in the world. In this report, we represented two cases of leech infestation of Limnatis nilotica in domestic kid and ram with anorexia, little respiratory disorders and restlessness in Dehloran city, Ilam province, west of Iran. Based on author’s knowledge, there is no report of leech infestation on ram and kid and the present case is the first report of internal hirudiniasis of ram and kid due to Limnatis niloticain in literature.

161-163

Authors: Deepinder Chhina, Rama Gupta, Bishav Mohan

Patients with tuberculosis sometimes may present with atypical, unusual features. The reported case is of 57 years male admitted with chief complaint of fever and breathlessness. Spiral CT chest revealed significant pericardial effusion all around heart, bilateral pleural effusion and multiple ill defined alveolar nodules scattered in both the lungs, more so in upper lobes. No significant mediastinal lymphadenopathy was seen. Pericardial fluid on Ziehl-Neelsen staining revealed acid fast bacilli. Subsequently sputum examination also showed acid fast bacilli. Hence pericardial fluid examination is helpful in the diagnosis of tubercular pericarditis. Tuberculosis can have protean manifestations as in this case with bilateral pleural effusion, pericardial effusion and mottling of lungs. Therefore clinician needs to keep complex presentation of tuberculosis in mind to manage the case at its earlier stage to avoid residual complications.

167-168

Authors: Utpal Adhikari, Anupam Ghosh, Goutam Chandra

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