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   2013| July-December  | Volume 3 | Issue 2  
    Online since November 26, 2013

 
 
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ORIGINAL ARTICLES
A study of prevalence of intestinal parasites and associated risk factors among the school children of Itahari, Eastern Region of Nepal
Ram Bilakshan Sah, Sailesh Bhattarai, Satish Yadav, Ratna Baral, Nilambar Jha, Paras Kumar Pokharel
July-December 2013, 3(2):140-144
DOI:10.4103/2229-5070.122143  PMID:24470999
Introduction: Intestinal parasitic infestation is a major public health problem in children of developing countries Because of poor socio-economic conditions and lack of good hygienic living. The aims of this study were to measure the prevalence of intestinal parasitic infestations and to identify risk factors associated with parasitic infestations among the school children of Itahari Municipality. Materials and Methods: The cross-sectional study was conducted in Grade VI, VII and VIII in Government and private schools of Itahari Municipality. Stratified random sampling method was applied to choose the schools and the study subjects. Semi-structured questionnaire was administered to the study subjects and microscopic examination of stool was done. The Chi-square test was used to measure the association of risk factors and parasitic infestation. Results: Overall intestinal parasitic infestation was found to be 31.5%. Around 13% of the study population was found to be infested with helminthes and 18.5% of the study population was protozoa infected. Not using soap after defecation, not wearing sandals, habit of nail biting and thumb sucking were found to be significantly associated with parasitic infection. Conclusions: The prevalence of intestinal parasitic infestation was found to be high in school children of Itahari. Poor sanitary condition, lack of clean drinking water supply and education is supposed to play an important role in establishing intestinal parasitic infections.
  7,968 267 12
SYMPOSIUMS
Laboratory diagnosis of Taenia asiatica in humans and animals
Subhash Chandra Parija, Dinoop Korol Ponnambath
July-December 2013, 3(2):120-124
DOI:10.4103/2229-5070.122127  PMID:24470995
Taenia asiatica is a recently described species known to cause intestinal teniasis in humans and cysticercosis in animals. This species has close morphological resemblance to Taenia saginata and has a life cycle resembling Taenia solium, hence has been posing diagnostic dilemma and had been the reason for its comparatively late discovery. Recent diagnostic tools such as serological and molecular techniques have thrown light on its exact prevalence in the endemic countries. Hence introduction of utilization of these techniques in addition to the routine morphological analysis would be helpful in diagnosis of T. asiatica infections and early implementation of preventive measures.
  7,156 117 -
REVIEW ARTICLE
Neurocysticercosis: A disease of neglect
Abhishek Mewara, Kapil Goyal, Rakesh Sehgal
July-December 2013, 3(2):106-113
DOI:10.4103/2229-5070.122111  PMID:24470993
Neurocysticercosis (NCC) is a neglected tropical disease caused by larval forms of the parasite Taenia solium lodging in central nervous system (CNS). There is a huge morbidity and debilitation due to CNS manifestations of NCC in developing and underdeveloped regions of the globe, mainly Asian, African and Latin American countries. It is the cause of epilepsy in about 1% of the population of endemic countries and is the underlying etiology in about 15-50% persons with epilepsy, depending upon the geographical region. There is no perfect diagnostic method and the diagnosis relies on a combination of clinical, radio-imaging, immunologic and epidemiologic data. Treatment includes anti-parasitic treatment by cysticidal drugs and management of associated symptoms and complications. The disease is eradicable and control depends on an integrated and coordinated involvement of international bodies like the World Health Organization along with scientific institutions and political and administrative strata of the endemic countries to provide the essential tools such as adequate sanitation, live-stock management, health education and improved socio-economic conditions.
  5,392 315 11
ORIGINAL ARTICLES
Spectrum of vaginal discharge in a tertiary care setting
R Sivaranjini, TJ Jaisankar, Devinder Mohan Thappa, Rashmi Kumari, Laxmisha Chandrasekhar, M Malathi, SC Parija, S Habeebullah
July-December 2013, 3(2):135-139
DOI:10.4103/2229-5070.122140  PMID:24470998
Introduction: Vaginal discharge is one of the common reasons for gynecological consultation. Many of the causes of vaginitis have a disturbed vaginal microbial ecosystem associated with them. Effective treatment of vaginal discharge requires that the etiologic diagnosis be established and identifying the same offers a precious input to syndromic management and provides an additional strategy for human immunodeficiency virus prevention. The present study was thus carried out to determine the various causes of vaginal discharge in a tertiary care setting. Materials and Methods: A total of 400 women presenting with vaginal discharge of age between 20 and 50 years, irrespective of marital status were included in this study and women who had used antibiotics or vaginal medication in the previous 14 days and pregnant women were excluded. Results: Of the 400 women with vaginal discharge studied, a diagnosis was established in 303 women. Infectious causes of vaginal discharge were observed in 207 (51.75%) women. Among them, bacterial vaginosis was the most common cause seen in 105 (26.25%) women. The other infections observed were candidiasis alone (61, 15.25%), trichomoniasis alone (12, 3%), mixed infections (22, 5.5%) and mucopurulent cervicitis (7 of the 130 cases looked for, 8.46%). Among the non-infectious causes, 72 (18%) women had physiological vaginal discharge and 13 (3.3%) women had cervical in situ cancers/carcinoma cervix. Conclusion: The pattern of infectious causes of vaginal discharge observed in our study was comparable with the other studies in India. Our study emphasizes the need for including Papanicolaou smear in the algorithm for evaluation of vaginal discharge, as it helps establish the etiology of vaginal discharge reliably and provides a valuable opportunity to screen for cervical malignancies.
  5,529 152 4
DISPATCHES
Intraluminal cecal hydatid cyst presented as chronic intestinal obstruction
Smita B Pawar, Nandkumar V Dravid, Dhananjay V Newadkar, Nilam D Ahire
July-December 2013, 3(2):158-160
DOI:10.4103/2229-5070.122149  PMID:24471004
A 70-year-old male presenting with abdominal pain was clinically diagnosed to have chronic intestinal obstruction due to lesion in ileo-cecal junction based on barium meal follow through. He underwent right hemicolectomy and the lesion was ascertained to be an intraluminal hydatid cyst in the caecum. Intraluminal cecal hydatid cysts can mimic malignancy on radiological investigations. It should be considered as a differential diagnosis in patients presenting with intestinal obstruction in endemic regions for hydatid disease.
  3,819 55 -
A case of Hymenolepis diminuta in a young male from Odisha
T Karuna, Sagar Khadanga
July-December 2013, 3(2):145-147
DOI:10.4103/2229-5070.122145  PMID:24471000
Hymenolepis diminuta also known as rat tapeworm rarely causes hymenolepiasis in humans. We report a case of H. diminuta infection in an 18-year-old male farmer who presented with intermittent pruritic maculopaular rashes and dull aching left iliac fossa pain for 6 months. Patient was cured with 2 doses of praziquantel 20 mg/kg on day 0 and 7.
  3,656 99 5
GUEST COMMENTARY
Human cysticercosis (Taenia solium)
Oscar H. Del Brutto
July-December 2013, 3(2):100-103
DOI:10.4103/2229-5070.122103  PMID:24470991
  3,468 195 5
ORIGINAL ARTICLES
Evaluation of a newly designed sandwich enzyme linked immunosorbent assay for the detection of hydatid antigen in serum, urine and cyst fluid for diagnosis of cystic echinococcosis
DR Chaya, Subhash Chandra Parija
July-December 2013, 3(2):125-131
DOI:10.4103/2229-5070.122131  PMID:24470996
Introduction: Cystic echinococcosis (CE) is a zoonotic disease of humans with variable clinical manifestations. Imaging and immunological methods are currently the mainstay of diagnosis of this disease. Although the immunological tests for detection of anti-echinococcal antibodies have several disadvantages, they are widely being used. Antigen is far more superior than antibody detection test as they can provide a specific parasitic diagnosis. Materials and Methods: A sandwich enzyme linked immunosorbent assay (ELISA) was designed using antibodies to 24 kDa urinary hydatid antigen for the detection of hydatid antigens in urine, serum and cyst fluid specimens. The performance of this novel test was compared with that of other hydatid antibody detection ELISA and enzyme immune transfer blot (EITB) using radiological and surgical confirmation as the gold standard. Results: The antigen detection ELISA showed 100% sensitivity and specificity when tested with cyst fluid. On testing urine and serum, the antigen detection ELISA was found to be more specific than antibody detection ELISA. EITB was found to be the most sensitive and specific test. Conclusions: ELISA using polyclonal antibodies against 24 kDa urinary hydatid protein was moderately sensitive to detect hydatid antigen in serum and urine. Hence polyclonal antibodies to 24 kDa urinary hydatid antigen can be used as an alternative source of antibody to detect hydatid antigen in serum, urine and cyst fluid. In the present study, EITB was found to be highly specific test for detection of hydatid antibodiesin serum. 24 kDa protein was found to be specific and of diagnostic value in CE.
  3,158 149 3
DISPATCHES
Cutaneous fistula of liver echinococcal cyst previously misdiagnosed as fistulizated rib osteomyelitis
Kirien T Kjossev, Ivan L Teodosiev
July-December 2013, 3(2):161-165
DOI:10.4103/2229-5070.122150  PMID:24471005
External fistulization or subcutaneous rupture of liver echinococcal cyst (EC) is found occasionally with total of 15 cases reported in the literature. We report a case of 60-year-old female previously misdiagnosed as fistulizated osteomyelitis of the 11 th rib. At computed tomography scan, non-vital EC was noted in the third liver segment. Under suspicion of external fistulization of perforated EC the patient underwent one-stage operation-pericystectomy and complete fistula excision. A retrospective analysis of the reported cases in the literature was performed with special references to classifying this rare entity. The main purpose of this report is to highlight the possibility of such a diagnosis when cutaneous fistula occurs in a same anatomic area with hydatid EC, even that cyst is proven to be calcified. We emphasize the role of a swift and radical surgical procedure including complete fistula excision to prevent secondary dissemination and post-operative complications.
  3,213 72 5
ETHICS IN SERIES
Ethics of authorship in scientific publications
Jharna Mandal, Subhash Chandra Parija
July-December 2013, 3(2):104-105
DOI:10.4103/2229-5070.122108  PMID:24470992
Authorship should be based on the contribution provided by each author who has made a significant scientific contribution to a study. Credit of authorship has important academic, social and financial implications and is bound by guidelines, which aid in preserving transparency during writing and publication of research material so as to prevent violation of ethics.
  2,909 166 1
DISPATCHES
Cysticercosis of breast
Narendra Kumar Gupta, Ashok Panchonia, Dinesh Jain
July-December 2013, 3(2):148-150
DOI:10.4103/2229-5070.122146  PMID:24471001
Human cysticercosis, a parasitic infection caused by cysticercus cellulosae. This results from ova being swallowed or getting asses to human stomach by regurgitation from own adult worm. The larvae are liberated in stomach, penetrate the intestinal mucosa and carried to many parts of the body where they form cysterci, 0.5-1 cm cyst that contain the head of young worm. They do not grow further or migrate. The common sites are skeletal muscle, subcutaneous tissue, brain and eye. Breast is an uncommon site.
  2,838 82 3
Primary pancreatic echinococcosis
Padmaja Yarlagadda, Bindu Madhav Yenigalla, Uma Penmethsa, Ramesh Babu Myneni
July-December 2013, 3(2):151-154
DOI:10.4103/2229-5070.122147  PMID:24471002
Hydatid disease is an endemic and common zoonosis in India. Liver is the most common site of infection. However, extra hepatic primary pancreatic hydatid cyst is rare. We report a case of primary hydatid cyst in the tail of pancreas compressing the adjacent organs in a 43-year-old male who presented with abdominal mass and was diagnosed as pancreatic cyst/splenic cyst by ultrasonography. Computed tomography of abdomen revealed a large cystic lesion in the tail of pancreas suggestive of a pseudocyst of pancreas. The case was managed surgically by splenectomy and distal pancreatectomy with albendazole therapy. Microbiological Investigations of aspirated fluid revealed free hooklets and invaginated scolices of Echinococcus granulosus, which was correlated with histopathological findings.
  2,743 144 -
Primary hydatid cyst of broad ligament
Aruna Bhattacharya, Rama Saha, Sudipan Mitra, Pamela Nayak
July-December 2013, 3(2):155-157
DOI:10.4103/2229-5070.122148  PMID:24471003
Cystic lesions of the female pelvis are common. Clinically, symptomatic lesions are mostly ovarian in origin and neoplastic in nature. Considerable diagnostic dilemma may be encountered if clinical, radiological, and estimation of serum markers failed to classify the origin and nature of such cysts. One such exceptional case is being described where a 35-year-old female presented with a rapidly growing cystic mass in lower abdomen, clinically suspicious of malignancy. Investigations failed to identify the nature. On laparotomy, excision of the mass was done. Suprisingly histopathological examination identified the lesion as hydatid cyst arising from the broad ligament. Female genital tract hydatidosis is uncommon and in most cases the involvement is secondary. Primary hydatid disease of female genital tract is even very rarer and generates considerable diagnostic difficulty. A significant clinical suspicion is necessary in the differential diagnosis of pelvic cystic diseases to identify such a rare entity.
  2,766 91 1
ORIGINAL ARTICLES
Cysticercosis: The day to day public health problem and the various sites affected by it - A one year study
S Srikanth, G Anandam
July-December 2013, 3(2):132-134
DOI:10.4103/2229-5070.122133  PMID:24470997
Introduction: The present study is done to highlight the various regions in the body affected by cysticercosis and to educate the people about the personal hygiene and prevention of the parasite. Materials and Methods: This is a study done on patients who were referred for swelling in the body, which were diagnosed as cysticercosis in one of their differential diagnosis clinically. Results: During the 1 year study (from October 2011 to September 2012) we diagnosed seven cases of cysticercosis involving the various sites in the body. Our cases highlight the rare presentation of cysticercus infestation as cause of treatablelymphadenopathy. Conclusions: Cysticercosis should be included in the differential diagnosis of cervical swellings especially in endemic regions. Timely diagnosis and intervention help in preventing fatal complications.
  2,480 81 -
SYMPOSIUMS
Lights and shadows of the Taenia asiatica life cycle and pathogenicity
Maria Teresa Galán-Puchades, Mŕrius Vicent Fuentes
July-December 2013, 3(2):114-119
DOI:10.4103/2229-5070.122114  PMID:24470994
Humans are definitive hosts of two well-known species of the Taenia genus, Taenia solium (the pig tapeworm) and Taenia saginata (the cattle tapeworm). In the 1990s, a third species, Taenia asiatica, was discovered, sharing features with the other two since the adult morphology is similar to that of T. saginata, but its life cycle is like that of T. solium. Human taeniasis usually is asymptomatic or displays mild symptoms, and only T. solium can cause other sometimes serious disorders when humans accidentally ingest the eggs and develop the larval stage in different organs (cysticercosis). In this review, we expose what we currently know (lights) and what we do not yet know (shadows) about the life cycle and pathogenicity of T. asiatica. Concerning its life cycle, the main uncertainty is whether humans can act as intermediate hosts of this species. We also suggest that due to its small size and location in pigs, the cysticerci probably escape veterinary inspection becoming a silent parasite. Concerning pathogenicity, it is still not known if T. asiatica can cause human liver cysticercosis, taking into account its principal hepatic tropism in pigs. To answer all these questions it would be essential to perform sensitive as well as specific diagnostic techniques for T. asiatica in humans and pigs. Currently, only molecular methods are able to determine the Taenia species, since morphology and immunology are useless, but unfortunately although largely used in research those methods are not employed in routine diagnosis.
  2,393 89 8
LETTERS TO EDITOR
Latex agglutination test for the detection of cysticercus antigen in the urine for the diagnosis of neurocysticercosis
Rakhi Biswas, Subhash Chandra Parija
July-December 2013, 3(2):168-169
DOI:10.4103/2229-5070.122152  PMID:24471007
  2,089 99 1
Occipital neurocysticercosis presenting as monocular visual hallucinations and transient blurring of vision
KJN Siva Charan, Ch Madhavi, G Hanumantha Rao
July-December 2013, 3(2):166-167
DOI:10.4103/2229-5070.122151  PMID:24471006
  2,114 63 -
EDITORIAL
Cestode infections: A brief insight
Subhash Chandra Parija
July-December 2013, 3(2):99-99
DOI:10.4103/2229-5070.122100  PMID:24470990
  2,003 165 -
FACE TO FACE
An interview with Dr. Magda Azab

July-December 2013, 3(2):170-174
DOI:10.4103/2229-5070.122153  PMID:24471008
  2,080 58 -
SYMPOSIUMS
Cysticercosis of the Human Nervous System
Subhash Chandra Parija
July-December 2013, 3(2):175-176
  1,900 115 -
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