Asian Pacific Journal of Tropical Medicine

1-8

Authors: Braira Wahid, Amjad Ali, Muhammad Waqar, Muhammad Idrees

Objective: To determine the breadth of Zika virus (ZIKV)-associated brain anomalies in neonates and adults. Methods: Systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using electronic databases ScienceDirect, Pubmed, Medline, Scopus, and Global Health Library. Only those research articles, case studies, case-control studies, case-cohort studies, cross- sectional studies, and organizational survey reports were included in the study that reported any fetal outcomes for pregnant women who had infected with ZIKV during the gestational period and ZIKV-related neurological complications in adults as well. Results: Out of total 72 retrieved articles, 50 met the inclusion criteria. We estimated a significant increase in incidence of neural abnormalities such as Guillain–Barre syndrome and microcephaly in the regions that are experiencing ZIKV outbreaks. Other neurological malformations found in ZIKV patients include hydrancephaly/hydrops fetalis, myasthenia gravis, meningoencephalitis and myelitis. Conclusion: Our systematic analysis provides the broad spectrum of neurological malformations in ZIKV infected patients and these data further support the causal link of ZIKV with neurological disorders.

15-23

Authors: Muhammad Zubair Yousaf, Adeena Siddique, Usman Ali Ashfaq, Muhammad Ali

Dengue fever is one of the major health problems in tropical and subtropical areas throughout the world. The causative agent of dengue fever is the dengue virus which is an enveloped single stranded RNA virus belongs to the family Flaviviridae and has five distinct serotypes (DENV-1, DENV-2, DENV-3, DENV-4 and DENV-5). Dengue virus is transmitted to human via bite of Aedes aegypti and Aedes albopictus mosquitoes. The clinical symptoms of dengue fever ranging from mild to severe form as dengue hemorrhagic fever and dengue shock syndrome. Pakistan is dengue endemic since 1994 but from 2006, Pakistan faced the worst condition regarding dengue in which thousands of people affected by the disease and hundreds of people lost their lives. DENV-2, DENV-3 and DENV-1 are the prevalent serotypes in Pakistan. Common diagnostic techniques are being used in Pakistan such as enzyme-linked immunosorbent assay, polymerase chain reaction and rapid diagnostic tests, while differential diagnosis, limitations of diagnostic methods and poor health care system are the real challenges in dengue diagnosis. Favorable climatic conditions, unplanned urbanization, travelling etc., are major factors responsible for dengue epidemics in Pakistan. This presentation provides update about dengue circumstances in Pakistan and also describes the way how to improve dengue situation in Pakistan.

32-39

Authors: Dioxelis Lopez, Lilia Cherigo, Alejandro de Sedas, Carmenza Spadafora, Sergio Martinez-Luis

Objective: To investigate 33 organic extracts of mangrove plants for: antiparasitic, anticancer, and antibacterial activities, as well as their ability to inhibit the activity of the α-glucosidase enzyme. Methods: Leaves from all different plant mangrove species located in five mangrove zones of the Pacific coast of Panama were collected according to standard procedures. Qualitative phytochemical analysis of the organic extracts was performed by thin layer chromatography. The antiparasitic activity against Plasmodium falciparum, Trypanosoma cruzi and Leishmania donovani, toxicity against Artemia salina, anticancer activity in MCF-7 cell line, and antibacterial activity against Staphylococcus aureus, Bacillus subtilis, Escherichia coli and Pseudomonas aeruginosa of all organic extract were investigated according protocols stablished in our institution. Finally, the ability to inhibit the enzymatic activity of α-glucosidase was evaluated by monitoring the hydrolysis of p-nitrophenyl α-D- glucopyranoside. Results: Thirty-three different samples belonging to nine different species of vascular plants with seeds of true mangroves were collected. Triterpenoids, phenolics, and tannins were the main groups of compounds found in the sampled mangroves. Saponins, quinones, and coumarins were found in less than 50% of the samples. Laguncularia racemosa showed moderate activity against Plasmodium falciparum. None of the extracts presented anticancer activity. Rhizophora mangle exhibited potent activity against Staphylococcus aureus and Bacillus subtilis [(90.41±7.33)% and (96.02±6.14)% of inhibition]; Avicennia germinans and Conocarpus erectus had activity against Escherichia coli [(71.17±6.15)% and (60.60±5.13)% of inhibition, respectively]. About 60% of the mangroves showed α-glucosidase inhibitory activity. In particular, extracts from Laguncularia racemosa, Pelliciera rhizophorae, Conocarpus erectus, Mora oleifera, and Tabebuia palustris species showed α-glucosidase inhibitory potential, with IC50 values of (29.45±0.29), (20.60±0.70), (730.06±3.74), (25.59±0.37), and (853.39±5.30) μg/mL, respectively. Conclusions: Panamanian mangroves are mainly a promising potential source of hypoglycemic compounds, specifically α-glucosidase inhibitors. These results highlight the therapeutic virtues of extracts from American mangrove plants.

48-52

Authors: Abdullatif Azab, Ahmad Nassar, Jacob Kaplanski, Reem Mahajneh, Galila Agam, Abed N. Azab

Objective: To investigate the effects of a dry aqueous extract of Notobasis syriaca (N. syriaca) on lipopolysaccharide (LPS)-induced inflammation in rats. Methods: Rats were fed the dried extract [500 mg/(kg•d)] for three consecutive days and then were intraperitoneally injected with LPS (1 mg/kg). Two hours after LPS injection, rats were sacrificed and blood and brain regions were collected. Inflammatory mediators' levels in plasma and homogenates of brain regions were determined by ELISA. Results: Pretreatment with the N. syriaca extract resulted in significant anti-inflammatory effects (P<0.05), including: i) attenuated LPS-induced hypothermia; ii) decreased hypothalamus and hippocampus prostaglandin E2 levels in the LPS- treated rats; and, iii) reduced hypothalamus and hippocampus interleukin-6 and tumor necrosis factor-α levels in the LPS-treated rats. Conclusions: These results suggest that N. syriaca possesses anti-inflammatory properties. Thus, it is possible that long-term consumption of this plant may result in beneficial pharmacological effects.

58-62

Authors: Naser Nazari, Arezoo Bozorgomid, Alireza Janbakhsh, Farshid Bashiri

Objective: To determine Toxoplasma gondii (T. gondii) as a cause of morbidity and mortality in human immunodeficiency virus (HIV) infected patients by ELISA method and to investigate toxoplasmosis-associated risk factors. Methods: This cross sectional study was conducted with 385 patients with HIV/AIDS referred to the behavior disease consultation center in Kermanshah, Iran between May 2012 and June 2013. Anti-Toxoplasma IgG and IgM antibodies were measured by using the ELISA method. Also, the relationship between the infection and age, gender, education, occupation, antiretroviral status, CD4+ cell counts and some other factors of the patients were assessed. P<0.05 was considered statistically significant. Results: Among the HIV-positive patients, 40.8% (157/358) and 2.6% (10/358) patients were positive for anti-T. gondii IgG and IgM antibodies, respectively. The mean CD4+ count in the patients with HIV was 327 cells/μL. A significant correlation was observed between the toxoplasmosis infections with the age group (P<0.05). Nevertheless, no statistically significant difference was found between gender, living area, educational level, occupational, marital status, antiretroviral status, prophylaxis, CD4+ cell count and toxoplasmosis. Conclusions: This study revealed that the patients with HIV infection were at the high risk of developing toxoplasmosis disease especially those patients who do not receive antiretroviral therapy and prophylaxis. The development and use of the effectiveness-based guidelines for controlling and the prevention reactivation of the latent T. gondii infection is required.

68-72

Authors: Ru-Cui Yu, Ping-Sheng Fan, Wei Wang, Wei Jia

Objective: To identify potential tumor markers for the development and recurrence of hepatocelullar carcinoma (HCC), this research studied the relationship between the expression of the tumor necrosis factor receptor-associated factor 4 (TRAF4) and tumor angiogenesis together with its survival time of HCC patients. Methods: The expressions of TRAF4, vascular endothelial growth factor and CD34 were performed upon 90 patients with curative liver resection between August 2006 and November 2009 by immunohistochemical method in locally advanced HCC and adjacent non-tumoral liver. The expression of TRAF4 was determined by the Spearman rank correlation. Their prognostic factors on disease free survival (DFS) and overall survival (OS) were guaranteed by Kaplan-Meier and Cox regression analyses. The detection of the levels of vascular endothelial growth factor and CD34 was fulfilled in 90 cases of HCC. Results: TRAF4 expression was both significantly higher in HCC than in surrounding non-tumor tissues (57.8% vs. 22.2 %; P<0.001) and significantly correlated with tumor size and tumor staging. High TRAF4 was correlated with reduced DFS rate (P=0.001) and overall OS rate (P<0.001) and were displayed in Kaplan-Meier survival analysis. Conclusions: TRAF4 is involved with multifarious clinicopathologic features. TRAF4 expression, as an independent adverse prognostic factor, DFS and OS in HCC, is associated with increased tumor angiogenesis. The combined detection of TRAF4 in locally advanced HCC is a trustworthy predictive factor for the tumor development and recurrence.

78-81

Authors: Jun-Ling Zhu, Jian-Yao Zhou, Tao Hou, Jian-Zhi Zhao,Guo-Fang Wang, Xiao-Wei Han

Objective: To observe the expression and significance of fibronectin and metalloproteinase-3 (MMP-3) in patients with ankylosing spondylitis (AS). Methods: A total of 30 AS patients in our hospital and 30 healthy volunteers were selected in our study. Fibronectin and MMP-3 were measured and compared between these two groups. The AS group received sulfasalazine 2 g daily for 3 months. Bath ankylosing spondylitis disease activity index, bath ankylosing spondylitis functional index, bath ankylosing spondylitis metrology index, erythrocyte sedimentation rate and C-reactive protein were compared before and after treatment. Pearson's linear-correlation analysis was used to determine relationships between parameters. Results: Totally 28 patients in the AS group completed the study. Fibronectin and MMP-3 in peripheral blood of AS patients were evidently higher than that in the normal control group (P<0.05). After treated by sulfasalazine, the level of expressing Fibronectin and MMP-3 significantly decreased compared with baseline values (P<0.05). Pearson's linear-correlation analysis showed that serum fibronectin and MMP-3 level had a positive correlation with bath ankylosing spondylitis disease activity index global assessment, spine pain, night pain, general pain, erythrocyte sedimentation rate and C-reactive protein (P<0.05). Conclusions: The expression of fibronectin and MMP-3 in AS patients were significantly higher than that in the normal control group, and they all decreased significantly after treatment. It indicated that both fibronectin and MMP-3 were correlated closely with the onset of AS.