Nilgün Daldal

Cerebral malaria owing to Plasmodium vivax: case report.

Abstract Cerebral malaria is a diffuse encephalopathy associated with seizures and status epilepticus which can occur in up to one-third of children with severe malaria, particularly that caused by Plasmodium falciparum. We report a unique case of P. vivax infection complicated by status epilepticus. A 4-year-old boy was admitted to the emergency outpatient clinic with intractable seizures for the previous hour. During resuscitation, two episodes of left-focal tonic convulsions occurred and he received phenytoin. Because of a history of P. vivax infection in the family 3 months previously, a blood slide for malaria was undertaken. Thin blood smears demonstrated P. vivax. He was treated with chloroquine and primaquine. An initial EEG was normal but after 3 months of follow-up a second EEG showed generalised epileptic activity. Rarely, cerebral malaria is a presenting complication or occurs during the course of P. vivax infection. In endemic areas such as Turkey, the possibility of cerebral malaria should be considered.

Malondialdehyde, Glutathione, and Nitric Oxide Levels in Toxoplasma gondii Seropositive Patients

The aim of this study was to investigate the difference in the serum malondialdehyde (MDA), glutathione (GSH), and nitric oxide (NO) levels between normal and T. gondii-infected patients. To this end, MDA, GSH, and NO levels in the sera of 37 seropositive patients and 40 participants in the control group were evaluated. In Toxoplasma ELISA, IgG results of the patient group were 1,013.0 +/- 543.8 in optical density (mean +/- SD). A statistically significant difference was found between patients and the control group in terms of MDA, GSH, and NO levels. A decrease in GSH activity was detected, while MDA and NO levels increased significantly. Consequently, it is suggested that the use of antioxidant vitamins in addition to a parasite treatment shall prove useful. The high infection vs control ratio of MDA and NO levels probably suggests the occurrence as a mechanism of tissue damage in cases of chronic toxoplasmosis. Moreover, it is recommended that the patient levels of MDA, GSH, and NO should be evaluated in toxoplasmosis.

Can the Requirement of a Diversion Procedure Be Predicted after an Uncomplicated Intracranial Hydatid Cyst Surgery

Intracranial hydatidosis is mainly a pediatric disease. Surgical evacuation of the mass in toto is the gold standard of therapy. No concise data related to the requirement of diversion procedures after uncomplicated hydatid cyst removal is encountered in the literature. The aim of this report is to focus on this idea and estimate the necessity of a diversion procedure beforehand. A 6-year-old girl both with intracranial and renal involvement of hydatidosis underwent surgery. Intact removal of the intracranial cyst harboring daughter vesicles was achieved. A persistent porencephalic cyst at the operative site required a shunt 6 months after surgery. Thick pericyst formation was blamed for this specific progress and the pathophysiology is discussed.

Correlation of environmental mite levels & the symptoms of allergic rhinitis regarding the efficacy of preventive education

Allergic rhinitis is still a commonly investigated disease all over the world. Allergens are usually in the nature of glycoprotein or protein which interact with antibodies resulting in the formation of specific Ig E in the body 1. It is presumed that some environmental factors play an important role in their clinics. In allergic rhinitis, symptoms usually occur after the interaction of nasal mucosa with allergens. Allergens may be indoors, outdoors or in both environments. House-dust contains most of the indoor allergens. Mites are the most egregious allergen in house dust. D. pteronyssinus is commonly seen in European countries, D. farinae is mostly seen in North America. House-dust mites play an important role in allergic sensitization of individuals in Turkey. Perennial allergic rhinitis is a common chronic disorder that results most frequently from sensitivity to house-dust mites. National and international guidelines for the management of allergic rhinitis recommend that house and dust mite avoidance measures be considered for all patients with house-dust mite provoked rhinitis. Symptoms of allergic rhinitis are related to the environmental mite level in which patients live. The aim of this study is to show the relationship between mite levels and symptoms of allergic rhinitis diagnosed patients and the change of mite levels in the environment after appropriate education.

Epidemiology of Cyclospora Species in Humans in Malatya Province in Turkey

Background: Cyclospora species are rare among other Coccidia parasites and can cause recurrent gastroenteritis. Cyclospora spp. can infect reptiles, insects, rodents, and mammals. Objectives: The present study aimed to determine the epidemiology of Cyclospora spp. in Malatya province and its neighboring provinces. Patients and Methods: Totally, 2281 stool samples taken from patients with digestive system complaints who referred to the polyclinics affiliated with Inonu University, Faculty of Medicine in Malatya Province and its neighboring provinces, in 2006, and whose stool specimens were submitted to the parasitology department were examined. A questionnaire was developed to determine the epidemiology of Cyclospora spp. in the patients as the dependent variable of the study. All the participants signed an informed written consent. The samples were coated with Entellan™ after staining via acid-fast staining and were examined on an immersion microscope objective. The data are presented as mean, standard deviation, or number/percentage. The chi-square test was used for the statistical analyses. Statistically, a P value < 0.05 was accepted as meaningful. Results: The stool samples were examined via direct microscopic examination and acid-fast staining. Positivity was determined in 129 (5.7%) cases. In the overall assessment of the patients with respect to general body itching, rectal itching, allergy, immunosuppression plus cancer, shortness of breath, ulcerative colitis, diarrhea, abdominal pain, salivation, constipation, nausea, vomiting, growth retardation, and anemia, there was no significant relationship. However, in the statistical evaluations among the positive cases, the difference was found to be significant. Conclusions: The study was conducted in Malatya Province, but patients from the neighboring provinces were also included in the evaluation during the study. Of all the positive cases, 5.6% were those from Malatya Province and its surrounding areas. Additionally, Cyclospora spp. were observed among the patients referring to the polyclinics with digestive system complaints in 8.1% of those from the Adiyaman province and in 6.9% of those from the Kahramanmaraş region. The incidence of Cyclospora cayetanensis may be higher in these regions if an epidemiological study is performed. Consequently, we suggest that Cyclospora spp. be investigated in digestive system disorders, especially in immunosuppressed patients.

Assessment of the levels of nitric oxide (NO) in chronic diarrhea patients infected with Giardia intestinalis

Department of Parasitology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Department of Parasitology, Faculty of Medicine, Inonu University, Malatya, Turkey. Department of Microbiology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Department of Biochemistry, Faculty of Medicine, Inonu University, Malatya, Turkey. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Department of Biochemistry, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Department of Internal Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.