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2015| July-December | Volume 8 | Issue 2
Online since
January 27, 2016
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CASE REPORT
A case report of
Strongyloides stercoralis
duodenitis in an immunocompromised patient
Archana Randale, Aarti Dani, Sanjay Chawhan, Saroj Meshram, Shilpa Tathe, Dinkar Kumbhalkar
July-December 2015, 8(2):127-129
DOI
:10.4103/1687-7942.175011
Strongyloides stercoralis
can cause hyperinfection syndrome and disseminated disease with high mortality, particularly in an immunocompromised patient. With the low diagnostic rate of
S. stercoralis
on stool examination, early endoscopic biopsy and histopathologic diagnosis of strongyloidiasis must be taken into consideration when examining duodenal biopsies from immunocompromised patients, to avoid the development of life-threatening infection.
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ORIGINAL ARTICLES
Identification of parasitic infections in appendectomy specimens using histopathological and faecolith examinations
Manal Z.M. Abdellatif, Ekhlas H Abdel-Hafeez, Usama S Belal, Rabie M Mohamed, Noha H Abdelgelil, Nissreen Abdel-Tawab, Ahmed M Atiya
July-December 2015, 8(2):101-106
DOI
:10.4103/1687-7942.175007
Background
Appendicitis is the most common acute surgical condition of the abdomen, and appendectomy constitutes one of the most common surgical operations worldwide. Gender, age, seasonal variation and leucocytic count have been investigated in many studies, however, causative parasitic agents of appendicitis are the most important. They differ from country to country.
Objective
The present study aimed to investigate parasitic infections as causes of appendicitis among patients attending Minia University Hospital, Minia Governorate, EL Minia, Egypt.
Methodology
This descriptive study was carried out during the period between October 2013 and March 2014. Among 100 patients treated by appendectomy with a prediagnosis of appendicitis, 55 were males and 45 were females. All patients with clinically prediagnosed appendicitis were subjected to an open appendectomy, in which a right Macberny incision was made, followed by delivery of the caecum, devascularisation of the appendix, base ligation and appendectomy. Removed appendices were preserved in 10% formalin, fixed, sectioned, stained with H & E and examined for histopathological changes and presence of parasites. The faecolith contents of the remaining portions of appendices were evacuated. A wet mount preparation from each specimen was subjected to light microscopic examination for detection of parasites.
Results
Parasitic infection was detected in nine appendectomy specimens. The presence of
Enterobius vermicularis
worms was confirmed in three cases by both histopathological and faecolith examinations. Eggs of
Ascaris lumbricoides
,
Ancylostoma duodenale
and
Hymenolepis nana
were detected in one case each by faecolith examination. Bilharzial granulomas were detected in three cases by histopathology. Interestingly,
E. vermicularis
and the eggs of
A. lumbricoides
,
A. duodenale
and
H. nana
were found to be associated with obstructive acute appendicitis, whereas bilharzial granulomas were observed in chronic appendicitis.
Conclusion
The study concluded that parasitic infections constitute only 9% of the surgically removed appendices.
Schistosoma
spp
.
and
E. vermicularis
were the most common parasitic recorded. The association of
H. nana
with acute appendicitis appears to be a novel finding. A combination of histopathology and faecolith examinations is necessary for detection of parasitic causes of appendicitis.
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Effect of nitroxynil (fasciolid) on adult
Fasciola gigantica
and
Fasciola hepatica
in infected cows
Eman K Omran, Noha S Ahmad
July-December 2015, 8(2):107-114
DOI
:10.4103/1687-7942.175008
Background
Drug resistance to treatment of fascioliasis with triclabendazole (TCBZ) has emerged in Sohag Governorate, Egypt. Nitroxynil belongs to the halogenated phenol group of fasciolicides. It is highly active against adult liver flukes. A nitroxynil metabolite is produced in the liver parenchyma adding to its flukicidal activity and augmenting its efficacy against late immature flukes that migrate through the liver tissues. Treatment with nitroxynil may be an effective replacement for therapy with TCBZ in cases of resistance.
Objective
The aim of this study was to evaluate the efficacy of nitroxynil in the treatment of fascioliasis by assessing its effect on teguments and durability of adult
Fasciola gigantica
and
Fasciola hepatica
worms.
Materials and methods
Infected cows were selected on the basis of clinical signs, and infection was confirmed by detection of
Fasciola
eggs in their stools. Nitroxynil was administered as recommended in two doses 15 days apart, and the animals were slaughtered 15 days after treatment.
Fasciola
worms collected from the bile ducts were identified and prepared for electron microscopy. Tegument changes were examined with scanning electron microscopy.
Results
The removed adult flukes of both species were moving sluggishly and appeared pale with no evidence of gut content. Scanning electron microscopy examination of these flukes revealed evidence of swelling of the tegument that showed regional variation in its severity. Loss of spines was also observed.
Conclusion
The present study demonstrated the flukicidal properties of nitroxynil, proving that the tegument is an important target for its action. Disruption of the fluke's main line of defense allowed the drug access to other internal tissues, leading to more widespread damage. Nitroxynil may be successfully used for treatment in case of resistance to TCBZ.
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Genotyping of Blastocystis hominis symptomatic isolates and kinetics of associated local CD3 and CD20 cell infiltrate
Nora I Abu El-Fetouh, Eman S Abdelmegeed, Raifa A Attia, Ibrahim El-Dosoky, Manar S Azab
July-December 2015, 8(2):115-122
DOI
:10.4103/1687-7942.175009
Background
Pathogenicity of the protozoan parasite
Blastocystis hominis
is a subject of debate. It has been suggested that the pathogenic outcome may be linked to specific subtypes of
Blastocystis
spp. Studies on experimental infection in animals have reported varying degrees of illness depending on the used genotype.
Objective
This study was designed to identify a possible link between
Blastocystis
genotypes and gastrointestinal illness. In addition, the CD3 and CD20 local immune response to infection using symptomatic isolates was experimentally evaluated.
Patients and methods
Blastocystis-
infected symptomatic (
n
= 51) and asymptomatic (
n
= 19) patients and irritable bowel syndrome patients (
n
= 32) were enrolled in the study, after exclusion of individuals who had other possible fecal pathogens. Restriction fragment length polymorphism was used for genotyping of isolates. Isolates from symptomatic cases were used for experimental infection, and immunohistochemical characterization of local CD3 and CD20 response was evaluated at two time intervals (groups A and B) after infection.
Results
Genotype 3 was the most common, being detected in 55.9% of all studied participants, and genotype 4 was the least common (9.8%). Symptomatic cases constituted 90% of genotype 1, 45.6% of genotype 3, 40% of genotype 4, and 20% of genotype 2. Genotype 2 was detected in 14.7% of all studied patients, with asymptomatic patients accounting for 60% of this isolate. Twenty-four isolates of genotype 3 occurred in 42.1% of irritable bowel syndrome patients. Rats euthanized after 7 (group A) and 14 days (group B) had higher CD3 and CD20 mean cell counts compared with control rats. The mean cell count of CD3 cells was statistically significantly higher in group A compared with group B, whereas CD20 cells in group B showed statistically significantly higher mean count compared with group A.
Conclusion
We suggest that both host and pathogen factors cooperate to express the pathogenic behavior of the parasite.
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Soil contamination with
Cryptosporidium
spp. in the west of Iran
Mohsen Ghomashlooyan, Mohammad R Vafaei, Hamed Kalani, Farzaneh Mirzaei, Mehdi Azami, Rasool Jafari, Mohammad Falahati, Ahmad Hosseini Safa, Mohammad A Mohaghegh
July-December 2015, 8(2):123-126
DOI
:10.4103/1687-7942.175010
Background
Cryptosporidium
spp. is a coccidian protozoan parasite that causes gastrointestinal disorders in human and animals. Several studies have demonstrated that the soil of public parks and schools presents an important source of infection which has a significant impact on public health. Children are the main group affected by accidentally ingesting contaminated soil.
Aim of the work
The aim of this study was to detect the presence of
Cryptosporidium
spp. oocysts in soil collected from primary schools and parks in Kermanshah city, west of Iran.
Materials and methods
The survey was conducted from August to December 2014 in Kermanshah city. Altogether 192 randomly selected soil samples were collected from 24 parks and 24 primary schools in six regions. The samples were screened for
Cryptosporidium
spp. oocysts using Sheather's flotation method and modified Ziehl-Neelsen staining.
Results
Out of 192 samples, 49 (25.5%) were found to contain
Cryptosporidium
spp. oocysts. Data analysis using χ
2
-test revealed that there was no significance among parks and primary schools in terms of the contamination rate (
P
= 0.24). Furthermore, there was no significant difference between the contamination rate and different regions of Kermanshah (
P
= 0.36). Regions 3 and 4 had the highest contamination rate (34.4%) and the lowest was for region 6 (15.6%).
Conclusion
Considering human infection with different
Cryptosporidium
spp. and the increase in numbers of immunocompromised patients, high contamination of soil with this parasite in Kermanshah stands as a serious problem. Consequently, health promotions, public education, improving sanitation conditions, especially for the underprivileged, are the keys to success in preventing the spread of
Cryptosporidium
spp. infection. In this regard, findings of this study can be used as a basis for preventive programs and development strategies targeting groups for the prevention of greater risk of cryptosporidiosis.
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REVIEW ARTICLES
Helminthiases: a neglected cause for reproductive ill-health and social stigma
Mulambalah Chrispinus Siteti, Siteti Darwin Injete, Wekesa Antony Wanyonyi
July-December 2015, 8(2):87-94
DOI
:10.4103/1687-7942.175003
Helminthic infections cause severe diseases (helminthiases) associated with significant morbidity and mortality worldwide. Many individuals are not aware of the risks and complications of helminthiases in reproductive health; hence, the infections are often neglected, leading to severe outcomes. These infections are often misdiagnosed and result in miscarriages, infertility, ectopic pregnancy, and increased risk of other conditions. Infected women of reproductive age often pass infections to their fetus during pregnancy and childbirth, which consequently affects their growth and development. In addition, the resultant morbidity affects the economic productivity and quality of life of individuals and communities. For the present review, both electronic (PubMed, Medline, EBSCO host, Science Direct) and manual literature were searched for relevant articles. The review highlights emerging issues on clinical manifestations, risks, and complications. Besides impairment of reproductive health in developing countries, helminthiases increase the transmission of viral, fungal, and bacterial infections, and promote stigma and sex inequality. The clinical and social impact of these neglected, forgotten infections largely considered to be of low public health importance is discussed. Because of the immense and increasing impact on global health and development, health professionals are encouraged to confer high priority to helminthiases.
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PARASITOLOGICAL RESOURCES
Parasitological resources
Khalifa E Khalifa
July-December 2015, 8(2):134-135
DOI
:10.4103/1687-7942.175013
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REVIEW ARTICLES
Heat shock proteins: Part III. Arthropods
Sherif M Abaza
July-December 2015, 8(2):95-100
DOI
:10.4103/1687-7942.175005
Contents Introduction
Different aspects of HSPs in arthropods 1.1. Effects of expression in response to blood meal 1.2. Effects of expression in response to temperature, water dehydration and hypoxia 1.3. Effects of expression on developmental stages 1.4. Effects of expression on oogenesis and embryonic development
Other aspects related to HSPs in arthropods
Applications
Concluding remarks References
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SPOTLIGHTS ON NEW PUBLICATIONS
Spotlights on new publications
Sherif M Abaza
July-December 2015, 8(2):130-133
DOI
:10.4103/1687-7942.175012
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