Open Access Case Study

Treatment with CSE-1034 (Elores™) in the Management of Community Acquired Pneumonia Due to Multi Drug Resistant Pseudomonas aeruginosa

Atulya Atreja

International Journal of TROPICAL DISEASE & Health, Page 1-4
DOI: 10.9734/IJTDH/2016/28887

Introduction: Community acquired pneumonia (CAP) is one of the important cause of mortality and morbidity. CAP is defined as an infection of the lung parenchyma that is not acquired in a hospital, long-term care facility, or other recent contact with the health care system. Frequently, Pseudomonas aeruginosa (P. aeruginosa) is resistant to most antibiotics. This resistance is one of the main barriers in bacterial eradication and clinical cure of Pseudomonas infection. This delay in management of MDR P. aeruginosa with appropriate antibiotics, can lead to increased mortality and morbidity.

Case Presentation: Here we discuss a case of a CAP due to P. aeruginosa which clinically didn’t respond to piperacillin-tazobactam & meropenem and was resistant to both classes of antibiotics. This was successfully treated with CSE-1034 (Ceftriaxone/Sulbactam/Disodium-edetate).

Conclusion: CSE-1034 (Elores™) proved to be safe and efficacious in treatment of a hospitalized patient with CAP due to MDR P. aeruginosa.

Open Access Original Research Article

Ergonomics Workstation Assessment of Musculoskeletal Disorders in University of Port Harcourt

Ify L. Nwaogazie, Ken K. Umeadi, Oghenefejiri Bovwe

International Journal of TROPICAL DISEASE & Health, Page 1-14
DOI: 10.9734/IJTDH/2016/29675

This study examines the experiences of musculoskeletal discomfort among staff and students of the University of Port Harcourt as it relates to their workstations. Questionnaires were designed to extract information from respondents on their experience of musculoskeletal pains and other discomforts. A total of 320 questionnaires were distributed randomly to staff and students across the three campuses of the University of Port Harcourt. One hundred and forty (140) questionnaires were distributed to staff (academic, 60 and non-academic, 90) out of which 115 were retrieved. Similarly, 170 questionnaires were distributed to students out of which 163 were retrieved; altogether 278 out of 320 yielded a 86.9% response rate. The study revealed that there is a strong relationship between the workstation set up and development of musculoskeletal discomfort in classrooms and offices at the University of Port Harcourt. Most staff and students experienced low back and neck pains due to poor ergonomic practices. Furthermore, most of the students respondents spent their reasonable time sitting in class receiving lectures (47%) and studying/reading (18.3%), respectively. While a handful of students (9%) stood for most of the time receiving lectures; due to limited number of seats. A multiple regression analysis on workstation against MSDs (lower backaches, headaches, neck & upper backaches and neck & shoulder aches) yielded a coefficient of variance, R2 of 87%. The sensitivity analysis on the regression model gave the following results: R2 = 29.94, 1.23, 41.7, and 14.12% for workstation against i) lower backaches; ii) headaches; iii) neck & upper backaches; iv) neck & shoulder aches, respectively. The result of Kruskal-Walli’s test of significance on the questionnaire response to simple ergonomic workstation (the cause) and those of musculoskeletal disorder (the effect) showed not significant. This  confirmed the consistency of responses (that is, the samples were from the same distribution). Kendall’s w-statistic for staff and students level of agreement < 50% in all cases.

Open Access Original Research Article

Early Recognition of Malaria or Dengue Complicated with Thrombocytopenia

M. K. Bhatnagar, Rakesh Kumar Jagdish, Satender Kumar Yadav, Ritika Sud

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/IJTDH/2016/30257

Aim of the Study: To observed changes in clinical, haematological and biochemical parameters of dengue and malaria over a period of ten days in patients who presents with low platelet count.

Place and Duration of Study: Lady Harding Medical College, New Delhi, India, November 2013-to March 2015.

Study Design: Prospective observational study.

Sample Size: Total 134 cases of thrombocytopenia with fever were included in the study of which 90 cases were of dengue and 44 were of malaria.

Methodology: Patients of acute fever who were diagnosed as malaria or dengue by peripheral smear, rapid antigen testing or serology were included. Complete blood count including platelet count; liver function test and renal function tests were done in all cases on day 2, 4, 6, 8 and day 10 to see progressive changes. Results were analysed subsequently.

Results: The patients of dengue presented earlier (4.11 ± 1.42) around 4th day as compared to malaria. The skin rash, bleeding tendency, tourniquet test positivity and respiratory abnormalities were more frequent in dengue patients, while abdominal pain, diarrhoea, anaemia, jaundice, hepatomegaly and splenomegaly were more frequent in malaria patients.

White blood cells count showed initial rise in malaria and fall in dengue which gradually recovered by 10th day in both diseases. Fall in haemoglobin was seen only in malaria cases. There was continuous fall in platelet count till 6th day of illness in dengue patient while in malaria patient fall  appeared early on 2nd day of fever but was inconsistent, which gradually recovered. Platelet fall was more severe in dengue as compared to malaria, so was bleeding tendencies. Bleeding tendencies were more frequent when the platelet count was below 20,000/µL.

Transaminase levels were more severely deranged and manifested early in malaria, while serum creatinine and blood urea were more deranged in dengue. Both these biochemical abnormalities return to normal by 10th day of illness.

Conclusion: There are certain differences between clinical, haematological and biochemical parameters in malaria and dengue for early diagnosis. We suggest that our observations can be used in remote areas where facilities for specific test are not available or limited by financial constrains or in epidemics.

Open Access Original Research Article

Alterations in Renal Functions of Market Gardeners Occupationally Exposed to Pesticides in West Cameroon

M. G. Tanga, P. B. Telefo, D. N. Tarla

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2016/28185

Despite the tremendous advantages of pesticides in sustainable agriculture, their excessive misuse causes environmental and health hazards.

Objective: Assessment of the effects of pesticides on renal functions of market gardeners in the western highlands of Cameroon.

Design and Methods: A total of 124 male market gardeners in Foumbot, Massangam and Bantoum were questioned on their health status, attitudes and behaviour with respect to agricultural practices. Thereafter, their blood samples were collected for assessment of renal function biomarkers including serum urea and creatinine. Urine samples were also analysed using 11-parameter urinalysis test strips. Sixty men with no history of pesticide exposure were recruited as control group.

Results: Fifty six pesticides containing 25 active ingredients were currently used by market gardeners enrolled in our study, and most of their symptoms (headache, fatigue, skin rashes, eye irritation and nausea) were related to spread/use of these chemicals. Compared to the control subjects market gardeners’ urea and creatinine serum levels were significantly increased (11.4 ± 1.59 mgdL-1 vs. 12.61 ± 1.94 mgdL-1; P< 0.05) and (12.5 ± 3.0 mgdL-1vs. 29.41 ± 12.98 mgdL-1 P < 0.001), respectively. Though some positive cases were identified, no significant difference was recorded in urine nitrites, ketones and protein levels.

Conclusion: Our results suggest that market gardeners in West Cameroon are exposed to pesticides, and that this exposure could impair their renal functions. Despite the infancy of biomonitoring of effects of pesticides in Cameroon, a crucial need arises to increase awareness of market gardeners on the adverse effects of pesticides on kidney functions and increase government subventions on Personal Protective Equipments.

Open Access Original Research Article

Risk Factors for Concurrent Malaria and Arbovirus Infections in Handeni, Northeastern Tanzania

Rogathe Ndosi, Edith Kwigizile, Upendo Ibrahim, Ummehani Dossajee, Justus Rwiza, Claudia Kabanyana, Arnold Ndaro, Jaffu Chilongola

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/30632

Aim: We aimed to understand risk factors associated with seropositivity to chikungunya and dengue infections in an area endemic for malaria in a cross sectional analytical study.

Study Design: A structured questionnaire was used for interview to study risk factors for CHK and DEN exposure whereas serology (ELISA) for anti-Chikungunya and Dengue virus immunoglobulin M detection was used to determine exposure to the arboviruses. Microscopy was used for malaria parasites detection to understand the extent of interaction between arboviruses and malaria.

Results: A total of 448 participants were screened for anti- chikungunya/dengue IgM and malaria. A seroprevalence of 15.6% and 0.2% was found for Chikungunya and Dengue respectively. Age, less than 16 years (p=0.011) and malaria positivity (p=0.001) were found to be significant risk factors for Chikungunya IgM seropositivity. Female gender, not keeping livestock, using bed net and travelling outside the study area were associated with reduced risk for CHIKV seropositivity by 28%, 24%, 29% and 37%, respectively. Not using a bed net was twice as much more likely to be malaria-Chikungunya IgM positive compared to bed net use (OR= 2.19; p= 0.198).

Conclusion: There is ongoing, transmission of arboviruses in the study region. Chikungunya virus and its co-occurrence with malaria was found to be common in the study population but not Dengue virus. Surveillance of arbovirus transmission in malaria endemic areas should be strengthened to be able to predict fatal outbreaks before they occur.

Open Access Review Article

Otogenic Tetanus in Children – A Systematic Review and Analytical Study

Shibu George, George Mullonkal Varghese, Sandeep Suresh

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2016/30700

Background: Otogenic tetanus may follow ear suppuration or ear injury. Straightforward diagnosis may not be possible if the otolaryngologist is not familiar with the entity; infrequently it may masquerade complications of otitis media as well. Practical difficulty in evaluation and management of otogenic tetanus due to the paucity of available literature prompted us to undertake this systematic review.

Aims: To compile the available data on otogenic tetanus by literature review; to encompass and analyze the varied perspectives of this enigmatic condition.

Methodology: PubMed/MEDLINE database supplemented with relevant search in world wide web using Google/ Google scholar were used as data sources for obtaining relevent articles on the topic; duplicate publications and studies on tetanus other than otogenic origin were excluded. Extracted and shortlisted articles were abstracted, analyzed and collated.

Results: Otogenic tetanus is commoner in children; it is the commonest sub type of tetanus in post-neonatal age group. Chronic otitis media is the major suppurative ear disease predisposing to otogenic tetanus though acute ear suppuration has also been implicated. Tetanus resulting from ear trauma runs a more severe course. Mortality in otogenic tetanus was found to be significantly lower compared to generalized tetanus.

Conclusions: Being aware of the condition is primarily important in diagnosis and management of otogenic tetanus. Immunization history need be elicited in all children developing otitis media. Prompt primary immunization, appropriate booster doses, meticulous care of the discharging ear and proper treatment ear injury are essential preventive strategies.