Open Access Case Study

Biliary Ascariasis: Our Experience and Review of Literature

Suhani Suhani, Lalit Aggarwal, Shadan Ali, Kartikeya Sharma, Shaji Thomas

International Journal of TROPICAL DISEASE & Health, Page 102-107
DOI: 10.9734/IJTDH/2015/14665

Background/Aim: Ascariasis is endemic in the tropics especially amongst those living in poor sanitary conditions. Although most commonly it infests the small intestine, it can sometimes migrate to the biliary tract. We herein aimed to study the clinical manifestations, complications, diagnostic modalities and the most appropriate treatment modality for this condition.
Materials and Methods: Fifteen cases of hepatobiliary ascariasis presenting over a period of 1.5 years were studied. All the patients were adults and presented to the emergency with acute biliary symptoms.
Results: In this study, biliary ascariasis was found to be more common in middle aged females. The common presentations included upper abdominal pain and jaundice. Complications observed included acute pancreatitis and cholangitis. Ultrasonography could establish the diagnosis in 86.67% cases. Medical management could successfully treat 86.67 % patients with ERCP being required in the remainder.
Conclusion: In endemic countries, ascariasis should be considered as a differential diagnosis in patients presenting with acute biliary symptoms. Ultrasonography is a useful non invasive test to diagnose the condition and medical management remains a reasonable first line treatment option.

Open Access Original Research Article

Bioprospection for Repellent Effect of Natural Volatiles from Ocimum suave Willd Growing in Dar es Salaam, Tanzania against Anopheles Mosquitoes

Wilson Leonidas, Judith Kagondi Shipili; Josephat A. Saria; Yohana Lawi, Eliningaya J. Kweka, Frank Magogo, William N. Kisinza, Hamisi M. Malebo

International Journal of TROPICAL DISEASE & Health, Page 73-79
DOI: 10.9734/IJTDH/2015/14710

Essential oil was extracted from Ocimum suave Willd leaves by water distillation and tested for repellency effectiveness against Anopheles gambiae adult mosquitoes. The percentage yield of the essential oil was 0.2%. Six concentrations of O. suave essential oil were applied on human skin of four volunteers, and the repellency effectiveness which was analyzed by PoloPlus (LeOra software version 1.0, 2002-2014), revealed promising RC50, RC75, RC90 and RC99 with their confidence limits as 0.1161 mg/cm(0.02067 - 0.1767 mg/cm2), 0.2823 mg/cm2 (0.22328 - 0.3654 mg/cm2), 0.4319 mg/cm2 (0.35226 - 0.58862 mg/cm2) and 0.98934 mg/cm2 (0.54731 - 0.99972 mg/cm2), respectively. O. suave essential oil exhibited high Anopheles mosquitos’ repellency effectiveness which merits further scientific attention for the development of natural repellents for the control of malaria and other mosquito borne diseases. These findings provides a scientific evidence and base for formulation for further mosquito repellency semi-field and field trials for the development of cheaper and affordable new mosquito repellent product(s) to meet human healthcare needs in the prevention and control of malaria and other mosquito transmitted infections.

Open Access Original Research Article

Anti-plasmodial Activity of Bee Sting in Plasmodium berghei Infected Mice

Oluwatosin Kudirat Shittu, Musili Eyihuri Abubakar

International Journal of TROPICAL DISEASE & Health, Page 80-85
DOI: 10.9734/IJTDH/2015/14660

Aim: Based on traditional claims and practice, the antiplasmodial activity of bee stings and its effect on haematological indices was investigated in P. berghei infected mice.
Methodology: Sixteen albino mice were intraperitoneally infected with chloroquine sensitive P. berghei strain and divided into four groups each consisted of four animals. Group I was set up as negative control of 0.2 ml normal Saline/kg body weight, group II as 5 mg chloroquine/kg body weight, group III had suppressive treatment and group IV was administered curative treatment. The thin blood smear was used to determine the parasiteamia counts and the haematological parameters were estimated on day 7.
Results: The result of percentage chemosuppression shows that bee stings suppress the parasitaemia to 56.6%. Also, the suppressive and curative groups show longer mean survival period of 15.0 and 20.0 respectively. The haematological studies show that the level of packed cell volume (PCV) and haemoglobin concentration (HB) of infected untreated group was significantly (p<0.05) lower when compare with all other experimental groups, where as chloroquine treated group shows significant increase compared to the bee treated groups. The Red blood cell (R.B.C.) counts was significantly (p<0.05) lowered in infected untreated group when compare with suppressive and chloroquine treated groups. However the white blood cell (WBC) counts was significantly (p<0.05) higher in infected bee sting treated when compare to the infected untreated and infected chloroquine treated groups.
Conclusion: Based on the result obtained, this study confirms the antiplasmodial activity of bee stings and suggests its potential as drug agent or lead against malaria.

Open Access Original Research Article

Misconceptions to Primary Pyomyositis in Post-conflict Northern Uganda

Kitara Lagoro David, Bwangamoi Paul Okot, Wabinga Henry, Odida Michael

International Journal of TROPICAL DISEASE & Health, Page 86-93
DOI: 10.9734/IJTDH/2015/14725

Aims: To assess the perceptions and views of the community to the possible causes and the factors responsible for the high prevalence of primary pyomyositis in the region.
Study Design: A cross-sectional study design
Place and Duration of Study: Gulu Regional Referral Hospital and 4 other Hospitals in Northern Uganda from September 2011 to September 2013.
Methodology: A cross-sectional study was conducted on primary pyomyositis patients, their relatives, health workers and managers of hospitals. Qualitative research methods such as Focus Group Discussions, Key Informant Interviews, and In-Depth Interviews were used to obtain the information on the possible causes, experiences and socio-economic effects of the disease to their family, community, health facility and the patients. The information obtained was triangulated before transcribing to an electronic text. Ethical approval for the study was obtained from the IRB of Gulu University Medical School and Uganda National Council of Science and Technology (UNCS&T). Thematic content analysis was used for data analysis.
Results: There was a wide and varying view about pyomyositis, its causes, and its socio-economic effects to the patient, family, health facilities and communities. The knowledge of the community on the disease is completely at variant with that of health workers and this may present with lack of compliant of patients to the western medical treatment in health facilities. The community beliefs that it is caused by witchcraft and that traditional methods by use of red hot arrow was the best method of management of the disease which should take place in the villages and not health facilities.
Conclusion: Pyomyositis is a common surgical disease and highly prevalent in Northern Uganda but there are misconceptions about its aetiology and approach to management.

Open Access Original Research Article

Association between Albumin Creatinine Ratio and e-GFR in Type 2 Diabetes Mellitus Patients in Oredo Local Government Area, Benin City, South-South Nigeria

O. F. Adewolu, K. Atoe

International Journal of TROPICAL DISEASE & Health, Page 94-101
DOI: 10.9734/IJTDH/2015/14282

Background: Diabetes mellitus is the commonest endocrine disease in Nigeria. Nephropathy is one of the complications of type 2 diabetes mellitus that could lead to end stage renal disease. Persistent microalbuminuria is a predictor of high risk of developing diabetic nephropathy. Early detection of kidney disease and intervention will prevent progression to end stage renal disease.
Objective: To determine the association between albumin creatinine ratio and eGFR in type 2 diabetic patients, their usefulness as early predictors of diabetic nephropathy and progression of disease.
Materials and Methods: This was a cross sectional study conducted in the State Specialist Hospital, Benin City, Edo State, Nigeria. Forty six type 2 diabetes mellitus patients, both male and female within the age range of 30 – 85 years were recruited for the study, after meeting the inclusion criteria. Twenty age and gender matched healthy subjects were selected as controls. Fasting plasma glucose, glycated haemoglobin, C-Reactive protein, serum creatinine were assayed. Urine albumin was estimated and albumin creatinine ratio determined, eGFR was estimated according to the Modification of Diet in Renal Disease (MDRD) formula.
Results: There was a significant difference between means of glycated haemoglobin, C – Reactive protein, Albumin creatinine ratio, eGFR of subjects which was (8.3±2.1%, 17.9±1.3 mg/l, 247.7±22.2 mg/g, 88±5.9 ml/min) respectively and that of controls which was (4.5±1.1%, 10.2±2 mg/l, 22.7±5.1 mg/g, 93.1±2.3 ml/min) p<0.05. ACR showed a strong and linear negative correlation with eGFR (r=-.682, p<0.05). A higher percentage of patients (64.7%) with e-GFR<60 ml/min had microalbuminuria, compared with (57.7%) with microalbuminuria in the subjects with eGFR>60 ml/min. Albuminuria worsened with increased duration of disease, as 55.6% of patients with diabetes mellitus of 5 years and above had macro albuminuria compared with 25% of patients with disease less than 5 years. Decline in eGFR increased with increasing duration of disease, 55.6% with disease duration of 5 years and above had eGFR<60 ml/min, compared with 45.5% in those with disease less than 5 years.
Conclusion: Albumin creatinine ratio and eGFR had a significant and linear negative correlation in this study. Therefore, they could be useful as predictors of early kidney disease in type 2 diabetes mellitus in this local government area. Increase in severity of albuminuria, coupled with higher prevalence of decline in eGFR with increasing duration of disease may be suggestive of their usefulness as predictors of disease progression.