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   2015| July-December  | Volume 5 | Issue 2  
    Online since August 10, 2015

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Morphology, epidemiology, and phylogeny of Babesia: An overview
Ramgopal Laha, M Das, A Sen
July-December 2015, 5(2):94-100
DOI:10.4103/2229-5070.162490  PMID:26629451
Babesiosis is a tick-borne hemoprotozoan disease of domestic and wild animals. The disease is caused by various species of Babesia and some species of Babesia have also zoonotic significance. The parasite in vertebrate hosts' remains in erythrocytes and the morphology of Babesia spp. is not uniform in all vertebrate hosts. With the advancement of science, particularly the use of molecular techniques made it easy to study the evolution of parasites and thereby reclassifying Babesia spp. as per their phylogeny and to establish the relation of one isolate of Babesia spp. with isolates throughout the world. An attempt also made in this communication to enlighten the readers regarding relationship of one isolate of Babesia spp. of a particular area to another isolate of Babesia spp. of that area or other parts of the world and phylogenetic classification of Babesia spp. was also discussed. It has been concluded that as the study on Babesia is complex in nature so monitoring of the infection with the use of modern techniques is very much needed to control the infection. Second, more research work on phylogenetic relationship of Babesia spp. isolated from different hosts is needed, particularly in India to know the evolution of Babesia spp. of a particular area, as it has great importance to study the trans boundary diseases of animals.
  19 13,794 26
Diagnosis and management of human babesiosis
Subhash Chandra Parija, KP Dinoop, Hrudya Venugopal
July-December 2015, 5(2):88-93
DOI:10.4103/2229-5070.162489  PMID:26629450
Babesiosis is a protozoan parasitic infection affecting humans and animals. These infections are commonly transmitted by various species of Ixodes ticks depending upon the geographical location. They can also be transmitted by packed cell transfusion and transplacental route from mother to child. Various species have been reported to cause human infections, of which Babesia microti is the most common species reported globally. Usually, Babesia infections are asymptomatic or mild, but can be severe/life-threatening in immunosuppressed or splenectomized individuals. A high index of clinical suspicion in residents of endemic areas or individuals who had a recent travel history to such areas, with laboratory confirmation can guide an early institution of appropriate antimicrobial therapy, thereby preventing complications and death.
  18 6,141 17
Visceral leishmaniasis
Shyam Sundar
July-December 2015, 5(2):83-85
DOI:10.4103/2229-5070.162487  PMID:26629448
  12 4,423 18
Babesiosis and other protists causing systemic infection
Subhash Chandra Parija
July-December 2015, 5(2):81-82
DOI:10.4103/2229-5070.162486  PMID:26629447
  6 3,193 21
Modified agar plate culture method for culture of Strongyloides stercoralis
Vinay Khanna, Kriti Tilak, Peralam Yegneswaran Prakash, Chiranjay Mukhopadhyay
July-December 2015, 5(2):136-138
DOI:10.4103/2229-5070.162535  PMID:26629461
  5 6,664 19
Microethics in medical education and practice
Jharna Mandal, KP Dinoop, Subhash Chandra Parija
July-December 2015, 5(2):86-87
DOI:10.4103/2229-5070.162488  PMID:26629449
"Microethics" is an avant-garde in the field of ethics. When the term "ethics" is brought into discussion in medical education or clinical practice, it customarily points to the traditional ethics, that is, biomedical ethics that deals with the ethical issues faced during unaccustomed or rare clinical circumstances. In contrast, microethics is a continuous ethical science existing in the physician-patient interaction that happens each day in every physician's clinical liaison. These ethical issues of everyday importance need to be introduced in the ethics training programs of medical institutions to provide insight and thereby promoting improvement in medical care and outcome.
  4 3,623 16
Comparative evaluation of staining techniques and polymerase chain reaction for diagnosis of intestinal microsporidiosis in immunocompromised patients
Ujjala Ghoshal, Sonali Khanduja, Vikas Agarwal, Tapan N Dhole, Uday C Ghoshal
July-December 2015, 5(2):101-105
DOI:10.4103/2229-5070.162491  PMID:26629452
Context: Microsporidia, which causes chronic diarrhoea in immunocompromised hosts, are often missed. The commonest diagnostic techniques include modified trichrome (MT) stain; however, it requires expertise and does not identify the species, which is important therapeutically. Other diagnostic techniques include Calcoflour white staining and polymerase chain reaction (PCR). Data on comparative utility of different diagnostic techniques are scanty. Aim: Comparison of Calcoflour white, MT staining and PCR for the diagnosis of intestinal microsporidiosis. Subjects and Methods: Fecal samples of consecutive immunocompromised patients were evaluated for Microsporidia using Calcoflour white, MT stain and PCR. Species were identified by restriction fragment length polymorphism using HindIII and HinfI. Presence of Microsporidia by two or more techniques was considered true positive. Absence of Microsporidia by all three techniques was taken as true negative. Results: Of 730 patients, Microsporidia was detected in 28 (3.8%), 250 (34.2%) and 30 (4.1%) patients by MT, Calcoflour white stains and PCR, respectively. Enterocytozoon bieneusi was identified in all 30 (4.1%) patients. 30 (4.1%) and 479 (65.6%) patients were true positive and true negative, respectively. Sensitivity and specificity of Calcoflour white, MT stains and PCR were 100%, 93.8%, 96.8% and 68.5%, 100% and 99.8%, respectively. Diagnostic accuracy of MT stain and PCR was superior to Calcoflour white (99.6% vs. 69.8%; P < 0.05). Conclusions: Though Calcoflour white stain is a highly sensitive, but it is nonspecific technique. MT stain and PCR with high sensitivity, specificity and diagnostic accuracy are useful diagnostic techniques. Furthermore, PCR is useful for species identification, which has therapeutic implications.
  4 4,013 16
Acute pancreatitis, ascites, and acute renal failure in Plasmodium vivax malaria infection, a rare complication
Manoj Lakhotia, Hans Raj Pahadiya, Harish Kumar, Jagdish Singh, Jainapur Ravi Sangappa, Prakash Kumar Choudhary
July-December 2015, 5(2):120-122
DOI:10.4103/2229-5070.162525  PMID:26629455
A 22-year-old male presented with 6 days history of intermittent fever with chills, 2 days history of upper abdomen pain, distension of abdomen, and decreased urine output. He was diagnosed to have Plasmodium vivax malaria, acute pancreatitis, ascites, and acute renal failure. These constellations of complications in P. vivax infection have never been reported in the past. The patient responded to intravenous chloroquine and supportive treatment. For renal failure, he required hemodialysis. Acute pancreatitis, ascites, and acute renal failure form an unusual combination in P. vivax infection.
  3 3,517 18
Pathogenicity of Leishmania donovani is associated with the high expression of a group low molecular weight proteins
Partha Mitra
July-December 2015, 5(2):106-117
DOI:10.4103/2229-5070.162521  PMID:26629453
Background: With few exceptions, members of the Leishmania donovani complex such as L. donovani, L. infantum and L. chagashi are the etiological agents of visceral leishmaniasis or kala-azar. Promastigotes of Leishmania spp. lose their Pathogenicity; the ability to establish infection in a susceptible host, after prolonged culture. The molecular basis of this evolution of pathogenic to nonpathogenic culture has not been very well understood. It has been proposed that the loss of pathogenicity is associated with the gradual disappearance of selective parasite proteins. An alternative hypothesis is that during prolonged culture, the pathogenic clonal population of the parasite is deleted from the mixed population due to their selection pressure. This clonal deletion is proposed to be responsible for the emergence of the nonpathogenic population. Study Methodology and Results: We have a done a series of two-dimensional polyacrylamide gel electrophoresis followed by western blot experiments to study the antigenic profile of few L. donovani isolates of Indian origin. We observed a gradual and significant downregulation of expression of a group of low molecular weight proteins (LMW, molecular weight 20-30 kDa) which are associated with loss of pathogenicity. These proteins are recognized only by antiserum raised against the whole cell extract of one of the pathogenic Indian L.donovani isolates, Ag83, and remained undetected by antiserum raised against the nonpathogenic AG83 isolates. These LMW proteins were also present in the nonpathogenic extract in very low levels and remained undetected by the virulent serum, indicating a phenomenon of simultaneous downregulation of the expression and altered immunogenicity. LMW proteins were universally expressed in all early passage Indian isolate we tested and also detected in two clones obtained from pathogenic parasite culture. The antigenic patterns of none of the eight clones obtained from nonpathogenic culture were not exactly similar with the pathogenic clones. Conclusion: Therefore, our data strongly support the hypothesis that the loss of pathogenicity of L. donovani is associated with a change in antigenic profile, but not due the selective deletion of pathogenic clones.
  3 4,660 17
Plasmodium vivax induced hemolytic uremic syndrome: An uncommon manifestation that leads to a grave complication and treated successfully with renal transplantation
Rajesh Jhorawat, Pankaj Beniwal, Vinay Malhotra
July-December 2015, 5(2):127-129
DOI:10.4103/2229-5070.162528  PMID:26629457
We are reporting a case of hemolytic uremic syndrome, a rare manifestation of Plasmodium vivax malaria. A young driver was admitted with acute febrile illness, decreased urine output, anemia, thrombocytopenia, jaundice, and increased serum lactate dehydrogenase. He showed a partial response to antimalarial drugs. However, he was readmitted with worsening renal parameters. His kidney biopsy revealed chronic thrombotic microangiopathy. He remained dialysis dependent and later underwent renal transplantation successfully, with excellent graft function at 1-year.
  2 3,236 17
Pulmonary hydatidosis from Southern Argentina
Claudia Irene Menghi, Liliana Eugenia Arias, Carla Pia Puzzio, Claudia Liliana Gatta
July-December 2015, 5(2):118-119
DOI:10.4103/2229-5070.162523  PMID:26629454
Hydatidosis or cystic echinococcosis is a zoonosis caused by the larval stage of the cestode Echinococcus. Even though different measures are taken including the use of a vaccine in livestock to stop transmission, the continuous diagnoses of cases, mainly of liver and pulmonary hydatidosis, show the failure of the control programs for hydatidosis in our country. A clinical case of pulmonary hydatidosis in a patient from a rural endemic area in Southern Argentina is described.
  1 3,212 17
Acute abdomen: An uncommon presentation of a common intestinal nematode
Ghazala Rizvi, Vinita Rawat, Hari Shankar Pandey, Mukesh Kumar
July-December 2015, 5(2):123-126
DOI:10.4103/2229-5070.162526  PMID:26629456
Enterobius vermicularis is a common parasitic infection of the intestine which is rarely symptomatic. It is unusual to find it in the wall or outside the gastrointestinal tract. We encountered five such cases where we observed the worm outside the lumen of the intestine. The pathological findings and the clinical features are discussed. This case series highlight that E. vermicularis can be the cause of pathology within the abdomen and should be considered in the differential diagnosis of some commonly encountered abdominal conditions.
  1 3,869 17
Comparison of hematological aspects: Visceral leishmaniasis and healthy children
Ali Fattahi Bafghi, Seyed Hossein Shahcheraghi, Sedigheh Nematollahi
July-December 2015, 5(2):133-135
DOI:10.4103/2229-5070.145597  PMID:26629459
  1 3,320 40
Calendar of Upcoming Events for the Year 2015-2016

July-December 2015, 5(2):144-145
  - 2,545 17
Symmetrical peripheral gangrene: A rare complication of plasmodium falciparum malaria
Atul Rana, DP Singh, Gurdeep Kaur, SK Verma, Hemant Mahur
July-December 2015, 5(2):130-132
DOI:10.4103/2229-5070.145592  PMID:26629458
Malaria, the most important of the parasitic diseases of humans, is transmitted in 108 countries containing 3 billion people and causes nearly 1 million deaths each year. With the re-emergence of malaria various life-threatening complications of malaria have been observed. Unarousable coma/cerebral malaria, severe normochromic, normocytic anemia, renal failure, pulmonary edema/adult respiratory distress syndrome, hypoglycemia, hypotension/shock, bleeding/disseminated intravascular coagulation (DIC), hemoglobinuria and jaundice are few of the common complications of severe malaria. Symmetrical peripheral gangrene (SPG) has been reported as a rare complication of malaria. We report a rare and unique case of Plasmodium falciparum malaria complicated by DIC, severe normocytic normochromic anemia, and SPG.
  - 4,368 35
An E-mail interview with Prof. Jeremy S. Gray

July-December 2015, 5(2):139-141
  - 2,975 17
Protozoa and Human Disease
Subhash Chandra Parija, Shashiraja Padukone
July-December 2015, 5(2):142-143
  - 2,554 19
Case of hemophagocytic lymphohistiocytosis with leishmaniasis
Harish Chandra, Smita Chandra
July-December 2015, 5(2):135-136
DOI:10.4103/2229-5070.162534  PMID:26629460
  - 2,737 17