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   2015| January-June  | Volume 5 | Issue 1  
    Online since January 22, 2015

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Laboratory diagnosis of Blastocystis spp. in diarrheic patients
Azza S Elghareeb, Mohamed S Younis, Amany F El Fakahany, Ibrahim M Nagaty, Marwa M Nagib
January-June 2015, 5(1):36-41
DOI:10.4103/2229-5070.149919  PMID:25709951
Background: Many laboratories currently diagnose Blastocystis spp. infections by looking for the presence of vacuolar forms in faeces and the amoeboid form in diarrheal stools. Objectives: To investigate the best direct method in diagnosis of Blastocystis spp. and to study different morphological forms of the parasite. Materials and Methods: The study was carried out on one thousand and two hundred diarrheic stool samples. All samples were examined using direct smear, iodine stained smear, formalin-ether concentration techniques, trichrome stained smear and in vitro cultivation using Jones' medium. Results: Using direct smear, Blastocystis spp was detected in 42 cases (3.5%) with a sensitivity (28.4%) and specificity (100%). Iodine stained smear detected 72 positive cases (6%) with a sensitivity (48.7%), specificity (100%). Formol ether concentration technique detected 120 positive cases (10%) with a sensitivity (81.1%) and specificity (100%). Trichrome stained smear detected 148 positive cases (12.3%). In vitro cultivation using Joni's medium detected 274 positive cases (22.8%) which was the highest number among all different diagnostic methods with a sensitivity (100%) ,specificity (88%), PPV (54.1%) and NPV (100%). It was found that, 49 blastocystosis cases had mixed infection with other intestinal parasites. Giardia lamblia was the most frequently associated parasite with Blastocystis spp. Conclusion: In vitro cultivation is more sensitive in detection of B. hominis than simple smear and concentration technique. Blastocystis spp. vacuolar form was the most common form that was found by all methods used in this study G. lamblia was the most frequent parasite associated with Blastocystis spp .
  7,808 27 5
Balamuthia mandrillaris: Morphology, biology, and virulence
Ruqaiyyah Siddiqui, Naveed Ahmed Khan
January-June 2015, 5(1):15-22
DOI:10.4103/2229-5070.149888  PMID:25709948
Balamuthia mandrillaris is a protist pathogen that can cause encephalitis with a fatality rate of >95%. This is due to our incomplete understanding of the pathogenesis and pathophysiology of B. mandrillaris encephalitis. B. mandrillaris has two stages in its life cycle, an active trophozoite stage during which it divides mitotically. However, under unfavorable conditions, the trophozoite transforms into a dormant cyst stage. A major concern during the course of therapy is that B. mandrillaris can transform into cysts. Cysts are highly resistant to physical and chemical conditions and present a problem in successful antimicrobial chemotherapy. Several lines of evidence suggest that B. mandrillaris encephalitis develops as a result of hematogenous spread, but it is unclear how circulating amoebae enter the central nervous system and cause inflammation, blood-brain barrier disruption, and neuronal injury. Recent studies have identified several parasite-host determinants for B. mandrillaris translocation of the blood-brain barrier, and host inflammatory markers that may be associated with neuronal injury. These determinants may provide important targets for the prevention and treatment of this devastating infection. Here, we present a brief overview of the current understanding of the morphology, biology, pathogenesis, and pathophysiology of B. mandrillaris encephalitis.
  7,490 22 7
Vulval myiasis: An unusual presentation of a rare entity in an adolescent female
Divya Pandey, Pragati Divedi, Prashant Kumar Mishra, Pallav Mishra
January-June 2015, 5(1):58-60
DOI:10.4103/2229-5070.149924  PMID:25709955
Human myiasis refers to parasitic infestation of body tissues by larvae of several fly species. The entity has a simple management. Human myiasis is well-documented in the literature however genital myiasis in females is scarcely reported in the literature. We hereby report this entity in an adolescent female who presented with urinary retention and concomitant urinary tract infection.
  6,885 24 1
Entamoeba dispar: Could it be pathogenic
FabrÍcio Marcus Silva Oliveira, Elisabeth Neumann, Maria Aparecida Gomes, Marcelo Vidigal Caliari
January-June 2015, 5(1):9-14
DOI:10.4103/2229-5070.149887  PMID:25709947
Amebiasis is a disease caused by the protozoan parasite Entamoeba histolytica. This ameba can colonize the human intestine and persist as a commensal parasite, similar to Entamoeba dispar, an ameba considered to be non-pathogenic. The similarities between E. histolytica and E. dispar make the latter an attractive model for studies aimed at clarifying the pathogenesis of amebiasis. However, in addition to being an interesting experimental model, this relative of E. histolytica remains poorly understood. In the 1990, it was believed that E. dispar was unable to produce significant experimental lesions. This scenario began to change in 1996, when E. dispar strains were isolated from symptomatic patients in Brazil. These strains were able to produce liver and intestinal lesions that were occasionally indistinguishable from those produced by E. histolytica. These and other findings, such as the detection of E. dispar DNA sequences in samples from patients with amebic liver abscess, have revived the possibility that this species can produce lesions in humans. The present paper presents a series of studies on E. dispar that begin to reveal a new facet of this protozoan.
  6,072 30 13
Effect of enteric parasitic infection on serum trace elements and nutritional status in upper Egyptian children
Doaa A Yones, Lamia A Galal, Alameldin M Abdallah, Khaled S Zaghlol
January-June 2015, 5(1):29-35
DOI:10.4103/2229-5070.145581  PMID:25709950
Introduction: Enteric parasitic infections still the cause of major health problems among Egyptian children as they have great morbid effect on their physical and cognitive development. Malnutrition makes children more prone to micronutrient deficiency and subsequently more vulnerable to parasitic infection. The present study aimed to identify the effect of intestinal parasitism on micronutrient serum level and children nutritional status. Materials and Methods: A case control study was carried out on children from 1 to 6 years old who were attending the Assiut University Children Hospital outpatient clinic, after parasitological stool examination they were divided into Group 1 (G1, n: 60) positive with enteric parasite and Group 2 (G2, n: 60) age and sex matched and free of parasites. Anthropometric measurements were expressed as weight for age (WFA), height for age (HFA), and weight for height (WFH) parameters. Serum zinc (Zn) and copper (Cu) were determined by atomic absorption spectrophotometer. Results: Intestinal parasitic infection rate was 55.7%; more commonly detected parasites were Giardia lamblia 28%, Cryptosporidium sp. 20%, and polyparasitism 18%. All children (G1 and G2) were underweight (WFA) while 63% of G1 were malnourished, either in the form of wasting (WFH) or stunting (HFA) or both aspects. Stunting and wasting were more dominant among children infected with G. lamblia and Cryptosporidium sp. and most of them were below 2 years old. Conclusions: Coincident decrease in serum Zn level and an increase of serum Cu was more prominent among G. lamblia and Cryptosporidium sp. patients. G. lamblia and Cryptosporidium sp. were found to be more associated with nonstandard children nutritional status beside to an altered micronutrient level.
  5,069 32 6
Management of granulomatous amebic encephalitis: Laboratory diagnosis and treatment
Subhash Chandra Parija, Dinoop KP, Hrudya Venugopal
January-June 2015, 5(1):23-28
DOI:10.4103/2229-5070.149889  PMID:25709949
Granulomatous amebic encephalitis is a life-threatening central nervous system (CNS) infection caused by the free-living amoebae Acanthamoeba spp., Balamuthia mandrillaris and Sappinia pedata. The disease has a subacute to chronic onset affecting commonly the immunocompromised population with high mortality rate. The diagnosis of this disease entity requires high suspicion with appropriate sample collection and testing by the laboratory experts. Radiological investigations are nonspecific and commonly confused with CNS tuberculosis, neurocysticercosis, disseminated encephalomyelitis, viral encephalitis etc., delaying the accurate diagnosis of these cases. Early diagnosis plays a crucial role in the survival of these cases since appropriate management can be initiated. No single drug is effective; hence multiple antibiotics targeting various proteins or receptors are required for successful treatment. A combination of surgical and medical interventions involving multiple specialty experts is required to prevent death and morbidity in survivors.
  4,988 28 4
Laboratory diagnosis of Blastocystis spp
Christen Rune Stensvold
January-June 2015, 5(1):3-5
DOI:10.4103/2229-5070.149885  PMID:25709945
  4,825 25 4
Identification of Leishmania species by kinetoplast DNA-polymerase chain reaction for the first time in Khaf district, Khorasan-e-Razavi province, Iran
Fata Abdolmajid, Salehi Sangani Ghodratollah, Rafatpanah Hushang, Mousavi Bazzaz Mojtaba, Mohaghegh Mohammad Ali, Movahedi Abdolghayoum
January-June 2015, 5(1):50-54
DOI:10.4103/2229-5070.145587  PMID:25709953
Context: Cutaneous leishmaniasis (CL) is an endemic parasitic skin disease in many parts of Iran including Khorasan province. Both clinical forms of the disease, anthroponotic cutaneous leishmaniasis (ACL) and zoonotic cutaneous leishmaniasis (ZCL) are present in this province. However, leishmaniasis molecular map is determined in four cities of Khorasan, but several foci still are remained unknown. Aim: The aim was to identify the species of Leishmania causing CL in Khaf, a District in Khorasan-e-Razavi province. Materials and Methods: Slide smears obtained from skin lesions of 120 patients suspected to leishmaniasis. Direct microscopy and polymerase chain reaction (PCR) performed using specific kinetoplast DNA primers. Data were analyzed with the use of SPSS. Results: Among 120 persons with skin ulcers suspected to CL, the results of direct smear of 54 (45%) samples were positive. PCR band were observed in 66 (55%) of examined samples in which 46 bands identified for Leishmania tropica and 20 for Leishmania major. Conclusion: Both ACL and ZCL are present in Khaf. L. tropica is the dominant causative species for ACL. Further study is recommended to discover probable reservoir and vector for L. major in Khaf.
  4,675 28 3
Is the coverage of mass-drug-administration adequate for elimination of Bancroftian filariasis? An experience from West Bengal, India
Dibakar Haldar, Debkumar Ghosh, Dhruba Mandal, Abhik Sinha, Gautam Narayan Sarkar, Sucharita Sarkar
January-June 2015, 5(1):42-49
DOI:10.4103/2229-5070.149921  PMID:25709952
Background: Bancroftian filariasis is the second most common mosquito-borne disease in India. Government of India adopted mass-drug-administration (MDA) since 2004 for its elimination by 2015 AD. Objective: The aim was to assess the coverage, compliance, factors-related to noncompliance to MDA. Materials and Methods: A cross-sectional survey of 1 week was conducted within 2 weeks after completion of MDA for 2012 in three villages and two municipal wards of North 24 Parganas district of West Bengal, India selected as clusters by multistage random sampling. Information was collected via interview of inhabitants of the clusters selected by systematic random sampling and drug administrators of the selected clusters along with verifying left over medicines, if any. Results: Both appropriate medicine distribution (83.4%) and 61.28% of people who received drug reported consumption and effective consumption rate (48.01%) fell short of the target. The lowest consumption (38.15%) was noted in one of the rural cluster (villages), followed by municipal wards (43.14%). Consumption was significantly higher among rural residents and Hindu community. Fear of the adverse reaction was the commonest (63.02%) cause of noncompliance. Contrary to the requirement, almost all consumptions were unsupervised by drug administrators. Only 10.71% of the respondents reportedly were paid house to house campaign of forthcoming MDA. About 64% participants had heard about filariasis out of which 71% & 47% mentioned swelling of legs as symptoms and mosquito bite as mode of spread, respectively. About one-third opined mosquito control and MDA each as means of prevention. Approximately, 60% participants had heard about MDA. Information education and communication related to MDA program was conspicuously inadequate in the last round. Conclusion: Mass mobilization as in intensive pulse polio immunization with effective monitoring and supervision is the need of the hour for universal coverage of MDA with supervised on the spot consumption of tablets.
  4,550 23 -
Ocular sparganosis from Assam
Reema Nath, Rajendra Nath Gogoi
January-June 2015, 5(1):64-67
DOI:10.4103/2229-5070.149930  PMID:25709957
Sparganosis is caused by plerocercoid larvae of the Pseudophyllidea tapeworms of the genus Spirometra. Though prevalent in East Asian and south east Asian countries like China, Japan, Korea, Taiwan, Vietnam, Thailand; yet very few cases are reported from India. We report a case of migrating sub-conjunctival ocular sparganosis mimicking scleritis which later on developed into orbital cellulitis from Dibrugarh, Assam, North-eastern part of India. This case is reported for its rarity.
  4,315 22 -
Pancreatic ascariasis with periampullary carcinoma
S Arulprakash, Manoj Kumar Sahu, Amit Kumar Dutta, A Joseph, George M Chandy
January-June 2015, 5(1):55-57
DOI:10.4103/2229-5070.145590  PMID:25709954
Ascarias lumbricoides infestation is endemic in tropical countries. Most infections are asymptomatic, but it can produce a wide spectrum of manifestations including hepatobiliary and pancreatic complications. There are reports of association of biliary ascariasis with bilary malignancies in the past, but same is not known for pancreatic ascariasis. We report a case of association of periampullary malignancy with pancreatic ascariasis.
  4,259 30 -
Ethics of international collaboration
Jharna Mandal, KP Dinoop, Subhash Chandra Parija
January-June 2015, 5(1):6-8
DOI:10.4103/2229-5070.149886  PMID:25709946
Education and research together are vital components of academic institutions and globalization has improved health care education and research in numerous ways, one of which is multinational/transnational research/international collaboration. Usually academic institutions of high-income countries and institutions in low-income countries participate in collaboration. These collaborative research are guided by international ethics codes proposed by the international ethics committee to avoid stringent follow/unethical practices.
  4,171 28 -
Calendar of upcoming events in parasitology for the Year 2015

January-June 2015, 5(1):75-77
  3,985 23 -
Uncommon neurological manifestations of a common tropical vector borne disease
Saikat Ghosh, Somak Kumar Das, Anand Sharma
January-June 2015, 5(1):61-63
DOI:10.4103/2229-5070.149928  PMID:25709956
Malaria poses a major public health problem in India, where it is endemic, especially severe malaria caused by Plasmodium falciparum infestation. There have been great changes in the clinical manifestation of severe falciparum malaria over the past couple of decades, with a shift from cerebral malaria to fever with jaundice, renal failure, bleeding diathesis, and multi-organ dysfunction syndrome. Here, we discuss two cases of severe falciparum malaria which presented with extremely uncommon neurological manifestations.
  3,953 21 -
Finding of an unusual ova - Schistosoma mansoni
Dhivyalakshmi Shanmugam, Anupma J Kindo, S Shanmughanathan
January-June 2015, 5(1):68-69
DOI:10.4103/2229-5070.145595  PMID:25709958
  3,892 24 -
Intestinal and free living amoebae: Lesser known facts
Subhash Chandra Parija
January-June 2015, 5(1):1-2
DOI:10.4103/2229-5070.149884  PMID:25709944
  3,850 30 -
Hypothesis: The potential application of doxorubicin against cutaneous leishmaniasis
Masoud Keighobadi, Mahdi Fakhar, Saeed Emami
January-June 2015, 5(1):69-70
DOI:10.4103/2229-5070.145594  PMID:25709959
  3,625 28 2
An E-mail interview with Prof. John Horton

January-June 2015, 5(1):71-74
  3,191 20 -