RESUMEN

OBJECTIVE: To study the frequency and diversity of fungi involved in onychomycosis. METHODS: The cross-sectional study was conducted from February 2018 to February 2019 at the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, and the University of Karachi. Specimens were taken from patients suffering with onychomycosis attending the Dermatology Department of Jinnah Postgraduate Medical Centre and were processed for the isolation of fungi. Specimens were processed for the diagnosis by potassium hydroxide mount for microscopic evaluation and mycological culture to determine the type of fungus involved in onychomycosis. Fungi were isolated using Sabouraud Dextrose Agar with antibiotics cycloheximide and chloramphenicol, and without antibiotics. Plates were observed for the growth periodically until 4th week. Appearance of any colony was studied further for identification on the basis of cultural characteristics and microscopy. Precise identification of Candida species was done. RESULTS: Of the 230 samples, 85(36.96%) were from males and 145(63.04%) from females. Potassium hydroxide mount showed fungal element in 134(58.26%) specimens, while in 111(48.26%) patients the fungal culture was positive. Nine (3.9%) cases were culture-positive but potassium hydroxide-negative, while among the 134(58.26%) potassium hydroxide-positive cases, 32(23.9%) were culture-negative.

Asunto(s)

RESUMEN

Emergence of novel coronavirus-2019 has become an international health concern. The objective of this review is to focus on 2019-nCoV emergence, prophylaxis and to predict the treatment approaches. The first case of 2019-nCoV was noted in Wuhan, China. The WHO has announced this epidemic as pandemic. The 2019-nCoV has +ve ssRNA (29903bp), lipid-bilayer envelope spiked with glycoprotein and bears genome sequences similar to bat coronavirus RaTG13. Antiviral agents like Interferon, Darunavir, Ribavirin, Lopinavir, Remdesivir, Chloroquine and Camostat mesylate may be considered for clinical trials. Chinese herbals may be effective against 2019-nCoV. These include Saikosaponins (triterpene glycosides), Amentoflavone, Scutellarein, Myricetin, extracts of Isatis indigotica, and Houttuynia cordata. Another treatment approach is to administer plasma from COVID-19 recovered patients. RNA vaccines, recombinant vector based vaccine and ACE-2 receptor like molecules may be employed for immunization against COVID-19. Moreover, immunity can be boosted against 2019-nCoV by regular exercise. We have checked Thymoquinone as ligand for various targets of 2019-nCoV (receptor binding domain of spike, RNA polymerase, protease, Nsp9 RNA binding protein, nucleocapsid phosphoprotein, endoribonuclease) by protein-ligand docking server SwissDoc. Thymoquinone can bind effectively to the targets of 2019-nCoV. Hence, it may be an effective candidate for the treatment of COVID-19.

Asunto(s)

RESUMEN

The interest in the synthesis of metallic complexes of different drugs to make them more efficient in biological environment of the human body is seen for the last few decades. Wide range of metal complexes are already used in clinical practice which encourages additional research for innovating new metal based drugs, such as metal-mediated antibiotics, anti-parasitic, antiviral, antibacterial, and anticancer compounds. Tuberculosis has been known as one of the most disastrous disease putting burden on health system worldwide. Though the therapeutic agents to combat the disease are well practiced, emergence of multi drug resistant strains makes the treatment strategies more difficult. The following work aims to synthesize copper, ferrous, ferric, cobalt and manganese complexes of renowned anti tuberculosis drug, pyrazinamide (PZ). These compounds were tested for anti-tuberculosis using five multidrug resistant strain of Mycobacterium tuberculosis. For this purpose BACTEC MGIT 960 system was used. The drug PZ was also screened with the synthesized complexes. The two complexes of cobalt and manganese proved potent among all of the compounds tested.

RESUMEN

The development and spreading of Multi Drug Resistant TB strains is hampering endeavours for the control and administration of tuberculosis (TB). The expansion episodes of multi-medication safe strains of Mycobacterium tuberculosis against first and second line antituberculosis drugs on one side and the unfavourable effects of these drugs on the other side has led the enthusiasm of researcher towards the synthesis of metal complexes of various medication. This approach is born with the expectation of finding new antituberculous operators without or least reactions as well as being active against the resistant strains of Mycobacterium tuberculosis. This study concentrates on the screening of five metal complexes of isoniazid (INH) against five Mycobacterium tuberculosis strains. These strains have been confirmed by WHO being active and even proliferating safely even in the presence of pyrazinamide, isoniazid (INH), ethambutol and rifampicin. In this work INH was taken as reference medication. All synthesized complexes and INH were subjected for a month and a half in BACTEC MGIT 960 technique. INH and its Fe (II) complex restrained the development of all bacterial strains for merely two weeks, while the Fe(III), Cu(II), Co (II) and Mn (II) complexes repressed the development five strains for three weeks. Conclusively, the strains utilized in this study were discovered to be more susceptible to the later four complexes than the ligand (INH) drug and its Fe (II) complex. Furthermore, elemental analysis and atomic absorption of all complexes were conducted for the determination of metal to ligand ratio.

Asunto(s)

RESUMEN

OBJECTIVE: To determine the pattern of polymicrobial isolates in blood cultures and antimicrobial susceptibility in a tertiary care hospital of Karachi. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan, from September to November 2014. METHODOLOGY: Blood culture samples were received from patients, which were processed by BACTEC 9240 system (Becton Dickinson). All positive blood samples were further analyzed. Susceptibility to antimicrobial agents was determined according to the Clinical and Laboratory Standards Institute (CLSI) criteria of the year. Identification of growth was based on Gram staining, colony morphology and appropriate biochemical tests. Antibiotic susceptibility was done as per Clinical and Laboratory Standards Institute (CLSI) recommendations. RESULTS: Out of the 7251 samples submitted, 2931 (40.42%) were positive for growth, 2389 (81.5%) samples were monomicrobial, whereas 542 (18.5%) samples were polymicrobial. Among the polymicrobial isolates, 468 (86.34%) blood culture samples yielded two, 66 (12.17%) yielded three, and 8 (1.47%) yielded four organisms. Gram positive isolates were 281 (51.84%) and Gram negative were 261 (48.15%). The most frequent isolates in polymicrobial blood stream infection were Acinetobacterspp. (51/542, 9.4%) and Coagulase negative Staphylococcus(84/542, 15.5%), respectively. Staphylococcus aureus isolates, which were resistant to Methicillin, accounted for 24.65%. Third generation Cephalosporins resistance in Klebsiella spp. and Eschericia (E.) coli was found to be 63.6% and 58%, respectively. Carbapenem resistance was seen in 5.9% of Pseudomonas aeruginosaand 17.6% Acinetobacter spp. CONCLUSION: Gram positive bacteria were more commonly involved in polymicrobial blood stream infections with Coagulase negative Staphylococcusbeing the most common Gram positive isolate. Methicillin-resistant Staphylococcus aureusaccounted for one-fourth of isolates. Higher resistance to third generation Cephalosporins was seen in Klebsiella spp. and E.coli isolates. Resistance of Pseudomonas aeruginosaand Acinetobacter species to Carbapenems was found out to be on the lower side.

Asunto(s)

Asunto(s)

RESUMEN

OBJECTIVE: To determine the frequency of Candida albicansin patients with funguria. STUDY DESIGN: Descriptive cross-sectional study. PLACE AND DURATION OF STUDY: Department of Microbiology, Sindh Institute of Urology and Transplantation, from July to December 2012. METHODOLOGY: Patients' urine samples with fungus/Candida were included. Candida albicans was identified by the production of tubular structures (germ tubes) on microscopy as per standard procedure followed by inoculation on Chrom agar (Oxoid) and Corn Meal-Tween 80 agar (Oxoid). The identification of other non-albicans Candidaspecies was also done both microscopically and macroscopically as per standard procedure. RESULTS: Out of the 289 isolates, 204 (70.6%) were male patients and 85 (29.4%) were female patients, with 165 (57.1%) from the out-patients and 124 (42.9%) from the in-patients. Five species of Candidawere found to be prevalent including 87 (30.1%) Candida albicans, 176 (60.9%) Candida tropicalis, 14 (4.8%) Candida parapsilosis, 8 (2.8%) Candida glabrata and 4 (1.4%) Candida lusitaniae. Majority of patients with funguria were aged above 50 years (60.2%). CONCLUSION: In the present study, 30.1% patients with funguria had Candida albicans. The most frequently isolated species was Candida tropicalis(60.9%), followed by other non-albicansCandida. This study has shown the emergence of non-albicans Candidaas a major cause of candiduria.

Asunto(s)

RESUMEN

OBJECTIVE: To document the prevalence of Helicobacter pylori (H. pylori), Hepatitis A virus (HAV), Hepatitis C virus (HCV), Hepatitis E virus (HEV) antibodies and Hepatitis B virus surface antigen (HBsAg), in the pediatric age group of low socioeconomic urban communities of Karachi and to identify risk factors associated with these infections. DESIGN: Cross-sectional survey. PLACE AND DURATION OF STUDY: Three selected squatter settlements of Karachi during April 2002 to December 2004. PATIENTS AND METHODS: Three hundred and eighty children, ages 5 months to 15 years were investigated. Venous blood samples were collected and questionnaire filled on sociodemographic characteristics (family income, number of dependents in the family, area of living, number of people per room per house, and number of children sharing bed with parents and siblings). Gastrointestinal symptoms were recorded. Anti-HAV IgG (Hepatitis A virus IgG antibody), anti-HCV (Hepatitis C virus antibody), anti-HEV (Hepatitis E antibodies) and HBsAg, were analyzed by enzyme immunoassays (EIAs). Samples were also screened for anti-HIV1/2 (human immunodeficiency virus 1 and 2 antibodies by EIA. IgG antibodies against H. pylori were detected by immunochromatography. RESULTS: A correlation between increasing age and seroconversion was seen for hepatotropic viruses. At 14 years and above,100% of the children were found to be positive for anti-HAV, 26% for anti-HEV, and 1.4%, for anti-HCV while HBsAg was positive in 1.9%. H. pylori infection did not show a significant increase with age. Both anti-HAV and anti-H. pylori were present simultaneously in 30% of the population investigated. CONCLUSION: With age, increasing number of children acquired antibodies against hepatotropic viruses and H. pylori. Occurrence of HBsAg and anti-HEV at a later age suggests horizontal, rather than vertical transmission.

RESUMEN

OBJECTIVE: To see the frequency of formation of interferon antibodies in patients receiving alpha interferon and evaluate their role in treatment response. METHODS: Patients with chronic Hepatitis C receiving alpha interferon three times a week along with daily ribavarin in two gastroeneterolgy departments of public hospitals, running hepatology clinics were studied. Blood for interferon antibodies in most (71) cases was collected around 5th month of therapy, sera were stored and analyzed in batches. Sera of 134 patients was analyzed, of whom 44 were taking Interferon 2a and 90 were taking 2b. RESULTS: Of 134 cases, 17 showed the presence of antibodies in titers of over 50 units and 5 of these showed no response to interferon treatment (6%). Majority (78) of the cases had antibody levels of less than 20 followed by 39 cases whose levels ranged between 20-50 units. CONCLUSIONS: Interferon antibodies are formed in a small percentage of cases receiving interferon and that too are in such low titers that they are not hampering the treatment. Serial antibody levels may be done to see if they remain stationary or increase with the continuation of the therapy.

Asunto(s)

RESUMEN

Healthcare in developing countries less funded than developed nations (0.8 to 4% vs. 10 to 15%, respectively), and must contend against approximately 1/3 of the population living below the poverty line ($1US/day), poor literacy (58% males/29% females), and less access to potable water and basic sanitation. Cultural and societal constraints combine with these economic obstacles to translate into poor transplantation activity. Donor shortage is a universal problem. Paid donation comprises 50% of all transplants in Pakistan. Post-transplant infections are a major problem in developing countries, with 15% developing tuberculosis, 30% cytomegalovirus, and nearly 50% bacterial infections. The solutions to these problems may seem simplistic: alleviate poverty, educate the general population, and expand the transplant programs in public sector hospitals where commerce is less likely to play a major role. The SIUT model of funding in a community-government partnership has increased the number of transplantations and patient and organ survival substantially. Over the last 15 years, it has operated by complete financial transparency, public audit and accountability. The scheme has proven effective and currently 110 transplants/year are performed, with free after care and immunosuppressive drugs. Confidence has been built in the community, with strong donations of money, equipment and medicines. We believe this model could be sustained in other developing nations.

Asunto(s)