Biomedical subjects
Publications and source records attributed to S C Parija.
A thirty two years man, heterosexually promiscuous presented with amoebic liver abscess, proven by ultrasonography, aspiration and culture of organism. He was human immunodeficiency virus (HIV) seropositive and had low CD4+ lymphocyte count. He responded to anti-amoebic treatment.
A 45 year old lady presented with history of recent surgery for uterovaginal prolapse and retained vaginal tampons following which she developed chronic meningitis due to acanthameba infection. Patient responded to a regimen containing albendazole. She was left with hydrocephalus as a sequelae.
The influence of methimazole-induced hypothyroidism on spontaneous rhythmic contractions and Ca2+ channel function of rat uterus was examined. Hypothyroidism significantly reduced the amplitude and frequency of spontaneous rhythmic contractions. Nifedipine (10(-12)-10(-6) M) and diltiazem (10(-9)-10(-4) M) caused concentration-related inhibition of the myogenic responses of the oestrogenised rat uterus obtained from both eu- and hypothyroid rats. However, nifedipine was less potent (IC(50); 5.4 x 10(-9) M; n=6) in hypothyroid rat uterus as compared to euthyroid controls (IC(50): 8.13 x 10(-12) M; n=9) to inhibit the rhythmic contractions. Similarly, diltiazem was less potent (IC(50): 4.57 x 10(-6) M; n=9) to inhibit the uterine spontaneous contractions in hypothyroid than in euthyroid rat uterus (IC(50): 6.4 x 10(-8) M; n=6). A similar decrease in the sensitivity to nifedipine and diltiazem for reversal of K+ (100 mM)-induced tonic contraction was observed in uterus obtained from hypothyroid rats compared to the controls. Both nifedipine and diltiazem were less potent for causing concentration-related inhibition of K+-stimulated 45Ca2+ influx in uterine strips taken from the hypothyroid rats. Thus, the IC(50) values of nifedipine (1.83 x 10(-8) M; n=12) and diltiazem (1.8 x 10(-6) M; n=9) were significantly greater in tissues obtained from hypothyroid rats compared to the controls (IC(50) of nifedipine, 1.15 x 10(-11) M; n=12, diltiazem, 8.1 x 10(-8) M; n=8). Nifedipine-sensitive influx of 45Ca2+ - stimulated either by K+ (100 mM) or Bay k8644 (1,4-dihydro-2,6-dimethyl-5-nitro-4-[2'-(trifluromethyl)phenyl]-3-pyridine carboxylic acid methyl ester) (10(-8) M) was significantly less in uterine strips from hypothyroid rats compared to the controls. The results of the present study suggest that the inhibition of uterine rhythmic contractions may be attributable to a reduction in rat myometrial Ca2+ channel function in the hypothyroid state.
Potassium hydroxide (KOH) is widely used in the wet mount preparation of various clinical specimens for demonstration of fungi and fungal elements. In the present study we have evaluated the use of KOH in the wet mount preparation of fresh stool specimens for the demonstration of intestinal parasites. The KOH wet mount of stool was compared with saline, iodine and lacto-phenol cotton blue (LPCB) wet mount preparations of stool. A total of 855 fresh stool specimens were examined in the study of which 419 specimens were found to be positive for either trophozoites, cysts, ova or larvae of different parasites by all these methods. A total of 309 stool specimens were positive by KOH preparation of stool, while 289, 245 and 208 stool specimens were positive by LPCB, iodine and saline preparations respectively. The KOH was found to be effective in lysing the faecal debris, faecal mass and other artifacts without affecting many of the parasitic ova, cysts and larvae in the stool smears. The parasitic ova, cysts and larvae were impacted by the use of 10% KOH and could be easily visualized, detected and identified against a clear background in the stool smear I hr after preparation of KOH wet mount. From these findings we recommend the routine use of KOH wet mount of stool for demonstration of intestinal parasites in a parasitology laboratory.
A clinico-mycological study of 100 cases of dermatophytosis was done in the B.P. Koirala Institute of Health Sciences in the eastern region of Nepal. The incidence of dermatophytoses in this study was 4.54% with a M: F ratio of 2.5: 1. The commonest age group was 11-20 years old. A single clinical type was found in 68%; 32% had two or more clinical types. The study revealed tinea corporis (43%) as the most common clinical type followed by tinea cruris (33%) and tinea pedis (20%). Positive culture was obtained in 94% of cases. A total of eight different species of dermatophytes were isolated with T. rubrum (45.74%) as the most common species followed by T. mentagrophytes (26.6%), T. tonsurans (11.7%), M. audouinii (8.36%), E. floccosum (4.26%), T. schoenlenii (2.13%), T. violaceum (2.13%) and T. verrucosum (1.06%).
A lacto-phenol cotton blue (LPCB) stain for detecting eggs of Enterobius vermicularis in perianal surface samples was evaluated prospectively. Two hundred children treated in the paediatrics ward and outpatients department of Jipmer Hospital in Pondicherry were studied. From each child two anal surface samples were collected by Scotch cellophane tape method. One cellophane tape containing anal surface samples was pressed against surface of the glass slide containing a drop of LPCB while another cellophane tape was placed on a clean glass slide without adding any LPCB. Both the specimens from each child were examined by microscopy for presence of the eggs of the parasite. The anal samples collected from 50 children were positive for the eggs of E. vermicularis--48 were detected by cellophane tape using LPCB and 36 by cellophane tape method without using any LPCB. Using LPCB stain, naturally transparent and colourless eggs of the parasites were stained deep blue which facilitated their easy detection and accurate identification in routine microscopy. We therefore recommend Scotch cellophane tape using LPCB as a simple, rapid, inexpensive and overall more sensitive method for detecting E. vermicularis eggs in anal surface samples for diagnosis of enterobiasis in children.
Acanthamoeba keratitis is a potentially devastating infection of the cornea caused by the free-living amoebae, Acanthamoeba species. During the period from 1997 to 2000, a total of 136 corneal scrapings from clinically suspected cases were screened and examined for the presence of the Acanthamoeba. On examination of the direct smear by microscopy, 11 out of 136 cases were positive for Acanthamoeba. Eight patients were males and 3 were females. The age of these patients ranged from 15 to 57 years. All of these cases were agricultural workers who did not use contact lens. Four cases gave a history of injury to the eye and 1 patient gave a history of applying cow dung on the eye after the injury. Rest of the patients did not give any history of trauma or wearing contact lenses. The patients were treated with topical application of neosporin ointment. Many of our cases had complications such as poor vision (all 11 cases had 6/60 or less), scar formation (3 cases), opacity (5 cases) and corneal perforation (2 cases). This report documents for the first time the cases of Acanthamoeba keratitis in Pondicherry.
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We describe here coagglutination (Co-A), a rapid slide agglutination test for the detection of hydatid antigen in the urine for the diagnosis of cystic echinococcosis (CE). Paired urine and serum samples were collected from 16 patients with surgically confirmed CE, 10 patients with ultrasound-proven CE, 14 patients with clinically diagnosed CE, 24 patients with various parasitic diseases other than CE, and 25 healthy control subjects. Co-A detected excreted hydatid antigen in the concentrated urine of 7 of 16 (43.75%) surgically confirmed cases, 6 of 10 (60%) ultrasound-proven cases, and 8 of 14 (57.14%) clinically diagnosed cases of CE. A false-positive reaction was observed with 12.50% of control urine specimens from patients with parasitic diseases other than CE and 12% of urine samples from healthy controls. The circulating antigen was detected in the serum in 13 of 16 (81.25%) surgically confirmed cases, 6 of 10 (60%) ultrasound-proven cases, and 13 of 14 (92.86%) clinically diagnosed cases of CE. False-positive reactions were observed with three sera (12.5%) from controls with other parasitic diseases. The low sensitivity of Co-A for detection of antigen in the urine of a patient whose serum was positive for the antigen is possibly due to low levels of antigen in the urine. Unlike the collection of blood for serum, which is an invasive procedure and also requires technical expertise and disposable syringes, urine can be collected easily and frequently without causing any inconvenience to the patient. Urine as a clinical specimen alternative to serum would be immensely useful in the diagnosis of CE, particularly in a rural or field setting. In such situations as well as in poorly equipped laboratories, Co-A has the potential to be used as a simple, rapid, and economical slide agglutination test for detection of urinary hydatid antigen in the diagnosis of CE.
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Reports are scanty regarding kala-azar in children in Nepal. In this communication we document 20 children diagnosed to have kala-azar who were admitted and treated at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. The children were between 2 and 14 years old. The duration of illness varied between 12 days and 24 months with a majority (65 per cent) of children being ill for less than 6 months. Hepatomegaly and splenomegaly were seen in 95 and 90 per cent of cases respectively. Splenomegaly was not found in two (10 per cent) children. Anaemia, leucopenia, and thrombocytopenia were seen in 95, 60, and 75 per cent of children respectively. Amastigotes of Leishmania donovani (LD bodies) were demonstrated in Giemsa-stained smears of bone marrow aspirates in 16 (80 per cent) children. All the children responded to treatment with sodium stibogluconate. No mortality was observed. This study emphasizes the importance of kala-azar in children in endemic areas of eastern Nepal.
Fifty serum samples from patients with amoebic liver abscess and 50 from subjects who had not suffered from the disease (25 from patients with other, chiefly parasitic, infections and 25 from healthy blood donors, staff or students) were tested for circulating amoebic antigen by counter-current immuno-electrophoresis (CIEP). Amoebic antigen was detected in 38 sera (76%) from cases of amoebic liver abscess, but in none of the other sera. Although CIEP is only moderately sensitive, the high specificity suggests that this simple test may be useful in the diagnosis of amoebic liver abscess.
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We report here a simple and economical slide agglutination test, the co-agglutination (Co-A) test, for the detection of circulating amebic antigen in sera for the diagnosis of amebic liver abscess. Fifty serum specimens from cases of amebic liver abscess, 25 from other individuals with parasitic and miscellaneous infections, and 25 from healthy controls were tested for the presence of serum antigen by the Co-A test. Forty-five (90%) amebic liver abscess sera were found to be amebic-antigen positive by the Co-A test. None of 25 sera from healthy controls were positive for the antigen. However, false-positive results were seen with two sera from those with other parasitic and miscellaneous infection controls. These results show that the Co-A test can be used as a sensitive and specific rapid slide agglutination test for the detection of amebic antigen in the sera for diagnosis of cases of amebic liver abscess in a routine parasitology laboratory.