Parvez Anwar Khan

In Vitro Chloroquine Resistance in Plasmodium falciparum Isolates from Tertiary Care Hospital.

Chloroquine (CQ) has been the mainstay of treatment of malaria for decades. This cost-effective and safe drug has become ineffective for treatment of falciparum malaria in many parts of the world due to development of resistance by the parasite. In addition CQ is not gametocytocidal for P. falciparum and thus cannot block transmission. The extent of problem of chloroquine resistance in P. falciparum is increasing every year. The study was done in period of 2 years. A total of 5653 specimens were examined for malarial infection by employing different diagnostic modalities. Four hundred and thirty-five were found to be positive for P. falciparum by using different diagnostic techniques. All positive specimens were cultured on RPMI 1640 medium; only 108 were found to be culture positive. Sensitivity of isolates to chloroquine was done using Mark III WHO sensitivity plates. The prevalence of malaria infection was found 9.54% in 2010. There were schizont formation at 8 pmol/liter or more of chloroquine concentration in 26 isolates. The emergence of chloroquine (CQ) resistance pattern in Aligarh isolates increases. Antimalarial agents should be used with caution; monotherapies should be avoided.

IgG Avidity Antibodies against Toxoplasma gondii in High Risk Females of Reproductive Age Group in India

Toxoplasma gondii is an obligate intracellular protozoan that is distributed worldwide. Recently, several tests for avidity of Toxoplasma IgG antibodies have been introduced to help discriminate between recently acquired and distant infections. The study was conducted in Jawaharlal Nehru Medical College and Hospital, India from February 2011 to September 2012. Serum specimens were subjected to Toxoplasma IgM ELISA and IgG avidity ELISA test. Out of 48 patients with abortions, 17 (35.4%) were positive for IgM ELISA, and 8 (16.6%) had low IgG avidity antibodies. Out of 48 patients with other obstetric problems, 23 (47.9%) were positive for IgM ELISA, and 17 (35.4%) had low IgG avidity antibodies. Combining both groups on avidity test, only 25 of 40 (62.5%) IgM-positive women had low-avidity IgG antibodies suggesting a recent T. gondii infection in these women. More importantly, 15 (37.5%) of the IgM-positive women had high-avidity antibodies suggesting that the infection was acquired before gestation The relation of IgM seropositivity with the following risk factors was not found to be statistically significant; contact with cats (0.13), non-vegetarian food habits (0.05), and low socio-economic status (0.49). While, for IgG avidity ELISA, only contact with cats (0.01) was significantly associated with seropositivity. All other risk factors have P-values of >0.05 (not significant). IgG avidity test when used in combination with IgM test was a valuable assay for diagnosis of ongoing or recently acquired T. gondii infection in India.

Profile of Fungal Lower Respiratory Tract Infections and CD4 Counts in HIV Positive Patients

One hundred and sixty symptomatic confirmed human immunodeficiency virus (HIV)-positive patients, of both sexes with lower respiratory tract infection were taken as a study population, and the clinicomycological profile was correlated with the immunological status of the patients with particular reference to CD4 counts. Relevant samples were collected and subjected to direct microscopy, fungal culture and antigen detection.

Intestinal Protozoa in Immunosuppression: A Medical Hassle

Introduction: Immunity forms the backbone of our very existence and opportunistic infections have plagued the immunosuppressed since long. A significant morbidity and mortality is attributable to intestinal parasitosis in the immunocompromised population. Objectives: This study aims to study the prevalence of intestinal protozoa in various immunosuppressed groups and to correlate degree of immunosuppression with protozoal infections. Material and Methods: The study was conducted on 400 patients divided into 4 groups: Group I (HIV patients), Group II (patients on chemotherapy/chemotherapy and radiotherapy for various malignancies), and Group III (diabetes patients) and Group IV included children presenting with diarrhea. Group I, II and III included patients with and without gastrointestinal symptoms. Stool samples were investigated microscopically for cysts/trophozoites after concentration with formol-ether method. Iodine wet mount and Modified acid fast staining methods were used. Result: Intestinal protozoa were detected in 40.75% (163/400); more commonly in patients with higher degree of immunosuppression (CD4 count 7: 95.3% in diabetics and moderate to severe malnutrition: 61.8%. Most common protozoa associated was Cryptosporidium in 66 patients (40.5%) followed by, Entamoeba histolytica in 48 (29.4%), Giardia lamblia in 35 (21.5%), Isosporabelliin 9 (5.5%), Blastocystis hominis in 4 (2.5%), Cyclospora cayetenensis in 1 (0.61%). Conclusion: High prevalence of intestinal protozoa was seen in all groups of immunosuppressed patients and a significant association seen between degree of immune suppression and protozoal infection. Focus needs to be on routine screening of all immunosuppressed patients and their immune reconstitution.

Rapid development of IRIS in the form of cryptococcal meningitis after beginning ART

Around one fourth of patients infected with human immunodeficiency virus (HIV) and given antiretroviral therapy (ART) experience inflammatory or cellular proliferative disease associated with a preexisting opportunistic infection. Many such infections are subclinical or quiescent before the patient begins ART. Cryptococcal immune reconstitution inflammatory syndrome may present as a clinical deterioration or new presentation of cryptococcal disease following initiation of antiretroviral therapy (ART) and is believed to be caused by recovery of Cryptococcus-specific immune responses. In the following report we present a case of expeditious developed IRIS in the form of cryptococcal meningitis.

A Clinico-Mycological Study of Superficial Mycoses from a Tertiary Care Hospital of a North Indian Town

Introduction: Superficial mycoses refer to the diseases of skin and its appendages caused by fungi. Aims & Objectives: The present study was undertaken to find out the prevalence of different clinical types of Dermatomycoses including Dermatophytes, candida spp. and dermatomycotic mold infections of skin and its appendages and their etiological agents in and around Aligarh region of Northern India. Material and Methods: The study was conducted at the Department of Microbiology, JNMC,AMU, Aligarh, during the period of July 2011-July 2013. A total of 425 samples were collected including skin, nail and hair for a period of 5 years. Skin, nail scraping and clippings of infected hair from patients were collected. The samples were subjected to direct microscopy and culture. Results: Out of 425 samples, Dermatophytoses was manifested clinically more in the males between the age of 11-30 years. In our study, KOH positivity rate was 61.2% and culture positivity rate was 58.8%. 18.8% of samples were culture positive alone; while, 21.2% of specimens were positive on direct microscopy alone. Dermatophytoses was the commonest superficial fungal infection in 123 cases 28 (9.5%), followed by Dermatomycotic molds in 32 (7.2%) and candidiasis in 15 (3.5%). T.rubrum was the predominant pathogen followed by T. mentagrophytes. Conclusions: It is concluded that along with Dermatophytes, non-dermatophytic fungi are also emerging as an important cause of superficial mycoses.

Role of toxplasma gondii serology in patients with habitual abortions.

Objective To study the prevalence of toxoplasmosis in pregnant females with history of habitual abortions.