Journal of Medical Science and Technology

1 -2

Authors: Dr N Mallikarjuna Rao PhD

Swine flu has made its mark in Hyderabad. It is spreading in its favorable winter season throughout the Telugu speaking states of India from the common capital. So it’s time to know more about this disease and protect our self from this infection. A brief description of swine flu, its spread and preventive measures has been explained in this article for the benefit of nursing staff, lab technicians and other health care professionals.

19 – 25.

Authors: Samutela MT, Mwansa JCL, Kalonda A, et.,al.

Staphylococcus aureus is implicated in nosocomial infections worldwide and is associated with a variety of infections such as endocarditis, food poisoning, toxic shock syndrome, septicaemia, skin and soft tissue infections, and bone infections. The emergence and spread of multi-drug resistant strains of S. aureus, particularly methicillin-resistant strains, is worrisome as they are resistant to many antibiotics. However, there is sparse information on the burden of methicillin-resistant Staphylococcus aureus in Zambia. Knowledge of antimicrobial susceptibility patterns of bacterial pathogens is crucial for optimal treatment of patients. It is also important for monitoring the spread of resistant organisms in hospitals and communities. The objective of this study was to identify and determine the antimicrobial susceptibility patterns of methicillin-resistant Staphylococcus aureus at the University Teaching Hospital in Lusaka, Zambia. A total of 95 stored isolates of suspected methicillin-resistant Staphylococcus aureus from pus and blood specimens collected from June 2009 to December 2012 at the University Teaching Hospital were analysed. Conventional microbiological methods and Clinical Laboratory Standards Institute criteria were used to identify and determine the antimicrobial susceptibility of isolates. Of the 95 S. aureus isolates, 43% were identified as methicillin-resistant Staphylococcus aureus strains. These methicillin-resistant Staphylococcus aureus strains were resistant to trimethoprim/sulfamethoxazole (100%), ciprofloxacin (95%), penicillin (95%), erythromycin (79%), tetracycline (76%) and gentamicin (67%). Multi-drug resistance to a combination of, four, five, six and seven antibiotics was observed in 17.5%, 27.5%, 35%, and 17.5% of the methicillin resistant Staphylococcus aureus isolates, respectively. The prevalence of multi-drug resistant methicillin resistant Staphylococcus aureus at the University Teaching Hospital was found to be high. Regular surveillance for multi-drug infections is recommended for infection control and to guide treatment.

30 – 35.

Authors: Mushabati F, Goma FM, Lwiindi L, Siulapwa NJ, Siziya S.

Central arterial stiffness is a strong and independent predictor of cardiovascular events and mortality including hypertension in any given population. A few studies have found that being black could be associated with elevated arterial stiffness thereby accounting for the high prevalence of hypertension in them. The present study sought to determine and compare central arterial stiffness using Carotid femoral PWV (cfPWV) in a population of Zambian normotensive (NT) participants and hypertensive (HT) participants (both treated hypertensives (HTC) and untreated hypertensives (HTN)) between 30 – 65 years of age. CF PWV was measured in 146 participants. A Complior® Analyse device (Version 1.9 Beta 2013; ALAM-Medical, France) was used. Superficial pulses were accessed noninvasively over the carotid– femoral segment. The cfPWV values in HTN participants (N=23) were significantly higher than in NT (N=64) participants (11.4±4.2 vs 9.1±3.2, p=0.009). In HTC participants (N=59), their cfPWV values (10.4±5.6) tended to approach those in HTN participants, with no statistical differences between them (p > 0.500). Furthermore, the mean cfPWV found in NT participants was considerably higher than any found in previous studies. Carotid femoral PWV did not show significant age – related increase in all three blood pressure categories (r2 < 0.03, p > 0.100). These findings show that central elastic arteries of HT participants are stiffer and thus less compliant than those in NT participants adding to their burden of hypertension. Regrettably, HTC participants showed poor BP control inferring from their considerably high cfPWV values.

40 – 45

Authors: Lwiindi L, Goma F, Chongo K, Prashar L, Mushabati F.

The bark root of Steganotaenia araliacea Hochst (Umbelliferae) nicknamed “herbal pitocin” is used by traditional circle in Zambia to induce labour in pregnant women. This work was aimed at investigating the contractile stimulatory effects of the aqueous extracts of Steganotaenia araliacea (SAEª) on isolated smooth muscle preparations of the rat uterus to explain its reported local use. Objective of the study was to determine the physiological effect of SAEª root extract (nicknamed “herbal Pitocin’’) on pregnant and non-pregnant uterine muscle. This work examined the effect of the aqueous extract of SAEª extract on rat uterus pre-treated with 1 mg/kg stilboesterol for 24 h and also on the pregnant rat uterus. The effects of reference agonists like oxytocin (OT) and Acetylcholine (Ach) were used and also antagonists like atropine (AT), indomethacin (Indo) and Salbutamol (SBM) on the uterine contractile effect of the extract were investigated. In vitro studies of SAEª on uterine tissue showed contractile activity which was dose dependant similar to OT and Ach while pre-treating the tissue with atropine, indomethacin or Salbutamol before administering the extract showed the inhibitory effects of the drug Salbutamol on the activity of the extract. The inhibition of contractile effect of the crude aqueous extract of Steganotaenia araliacea shown by Salbutamol (p < 0.05) suggests the probable stimulation of the Oxytocin-like receptors of the uterus by the extract. These physiological finding justify the traditional use of the plant for its uterotonic properties.

55 – 57

Authors: Pravinkumar P, Pillai S, Michael M et. al.,

Pharmacological analysis of medicinal plants remains a challenging issue for analytical chemists as medicinal plants are a complicated system of mixtures. Many highly sophisticated separation techniques, for example, high performance liquid chromatography (HPLC), gas chromatography (GC) and mass spectrometry (MS) are amongst the most popular methods of choice used for quality control of raw material and finished herbal product. Comparatively, the application of, Fourier Transform Infra Red (FT-IR) spectroscopy in herbal research is limited. The present study was carried out to characterize the bioactive constituents present in the novel antiobesity Polyherbal formulation (PHF) using FT-IR spectroscopy. An aqueous extract of PHF consisting of the following plants Commiphora mukul (Stocks) Hook, Garcinia gummi-gutta(L.) Roxb, Plantago ovata Forrsk was prepared and supplied by Lanson Biotech, Chennai, subjected to FT-IR analysis. The results showed the detection of bands of various bio molecules, which has a variety of pharmacological effects on the living system.

62 – 68

Authors: Anthony Kodzo-Grey Venyo

Malakoplakia of the testis / epididymis is uncommon therefore most clinicians globally would be unfamiliar with the disease. Malakoplakia is an extremely rare chronic inflammatory disease which usually affects the genitourinary tract and it is often associated with Escherichia coli infection. Malakoplakia characterized by the observation of Von Hansemann cells and intracytoplasmic inclusion bodies called “Michaelis-Gutmann Bodies (M-G bodies).” The testes are affected in 12% of cases of malakoplakia and isolated malakoplakia of the epididymis is even rarer. To the knowledge of the author, less than 50 cases of malakoplakia of the testis and less than 15 cases of malakoplakia of the epididymis have been reported so far world-wide. Malakoplakia of the testis / epididymis may present with pain in the testicular area, fever, chills and or a hemi-scrotal mass. Malakoplakia of testis / epididymis is usually seen in middle aged men and they tend to appear clinically as epididymo-orchitis or testicular enlargement with fibrous consistency and some soft areas. Ultrasound scan findings of the testis are non-specific revealing hypo-echogenic or hyper-echogenicity with increased vascularity on Doppler scanning. A number of cases of malakoplakia of the testis and epididymis are associated with immunosuppression, renal transplantation and diabetes. Treatment of malakoplakia includes medical and surgical treatment. The quinolones and trimethoprim-sulfamethoxazole have been most commonly used. Orchidectomy has been the only way to differentiate malakoplakia from other malignant and infective processes. If a patient with malakoplakia of testis is immunosuppressed then a period of withdrawal may perhaps be beneficial to speed up the recovery process. With the knowledge that malakoplakia of the testis is more common in middle aged men and the fact that testicular tumours are uncommon in the middle aged group perhaps ultrasound guided biopsy of a hypo-echoic or hyper-echogenic testicular lesion with increased vascularity could be undertaken to establish the diagnosis if there is evidence of coliform urinary tract infection and a clinical diagnosis of epididymoorchitis has been made but the lesion has not resolved. In that case perhaps prolonged antibiotic treatment with quinolones may help the lesion to resolve and thus avoiding orchidectomy. Malakoplakia involving the testis and or epididymis is an uncommon chronic inflammatory condition which clinicians should consider in the differential diagnosis of testicular swellings. The disease tends to be associated with gram negative infections especially coliform infections.