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  Citation statistics : Table of Contents
   2009| January-June  | Volume 1 | Issue 1  
    Online since June 29, 2009

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Association between hepatitis C and hepatocellular carcinoma
Luis Jesuino de Oliveira Andrade, Argemiro D'Oliveira, Rosangela Carvalho Melo, Emmanuel Conrado De Souza, Carolina Alves Costa Silva, Raymundo Parana
January-June 2009, 1(1):33-37
DOI:10.4103/0974-777X.52979  PMID:20300384
Hepatocellular carcinoma (HCC) is the fifth most common cancer, the third most common cause for cancer death in the world, a major cause of death in patients with chronic hepatitis C virus infection, and responsible for approximately one million deaths each year. Overwhelming lines of epidemiological evidence have indicated that persistent infection with hepatitis C virus (HCV) is a major risk for the development of HCC. The incidence of HCC is expected to increase in the next two decades, largely due to hepatitis C infection and secondary cirrhosis, and detection of HCC at an early stage is critical for a favorable clinical outcome. Potential preventive strategies in the development of HCC are being recognized. The natural history of HCC is highly variable and the clinical management choices for HCC can be complex, hence patient assessment and treatment planning have to take the severity of the nonmalignant liver disease into account. This review summarizes the inter-relationship between HCV and liver carcinogenesis.
  6 5,475 232
Histological diagnosis of madura foot (mycetoma): A must for definitive treatment
Kiran Alam, Veena Maheshwari, Shruti Bhargava, Anshu Jain, Uroos Fatima, Ershad ul Haq
January-June 2009, 1(1):64-67
DOI:10.4103/0974-777X.52985  PMID:20300390
Mycetoma, an uncommon chronic infection of skin and subcutaneous tissues in tropical countries is caused by true fungi (eumycetoma) or by filamentous bacteria (actinomycetoma). Since the treatment of these two etiologies is entirely different, a definite diagnosis after histopathological and microbiological examination is mandatory. We hereby present five cases of Madura foot.
  2 3,742 223
A case of endogenous trichosporon endophthalmitis treated with micafungin and voriconazole
Harpreet Walia, Veronica T Tucci, John N Greene, Jennifer Tordilla-Wadia, Patrick Kelty, Sandeep Walia
January-June 2009, 1(1):71-74
DOI:10.4103/0974-777X.52987  PMID:20300392
Invasive fungal infections are a significant cause of morbidity and mortality. Endogenous fungal endophthalmitis is a rare intraocular infection with potential vision threatening consequences. Our review of the literature revealed only one other case of Trichosporon endophthalmitis. Ocular fungal infections are difficult to eradicate because of the limited availability of systemic and intravitreal therapeutic agents and poor tissue penetration of current antifungals. Along with systemic antifungal agents, vitrectomy and intravitreal amphotericin B have been suggested as optimal treatments for fungal endophthalmitis. Other antifungals such as flucytosine and triazoles have recently received consideration. Although the current antifungal therapy is not highly successful, there remains a significant potential for more successful treatments in the future, based on the current studies. We report a case of endogenous trichosporon endophthalmitis that was successfully treated with micafungin and voriconazole. This combination has not been previously reported as a successful therapy in literature. More targeted research is required to uncover additional efficacious therapies to combat trichosporon.
  2 2,903 118
HIV infection, genital symptoms and sexual risk behavior among Indian truck drivers from a large transportation company in South India
Annie Dude, Ganesh Oruganti, Vinod Kumar, Kenneth H Mayer, Vijay Yeldandi, John A Schneider
January-June 2009, 1(1):21-28
DOI:10.4103/0974-777X.52977  PMID:20300382
Background: Sentinel surveillance conducted in the high Human Immuno-deficiency Virus (HIV) prevalent state of Andhra Pradesh includes sub-populations thought to be at high-risk for HIV, but has not included truck drivers. Novel HIV prevention programs targeting this population increasingly adopt public - private partnership models. There have been no targeted studies of HIV prevalence and risk behavior among truck drivers belonging to the private sector in India. Methods: A sample of 189 truck drivers, aged between 15 and 56, were recruited from Gati Limited's large trucking depot in Hyderabad, India. A quantitative survey instrument was conducted along with blood collection for HIV 1/2 testing. Multivariate regression models were utilized to determine predictors of HIV infection and risk behavior. Results: 2.1% of subjects were infected with HIV. Older age was protective against self-reported genital symptoms (OR = 0.77; P = 0.03), but these were more likely among those truck drivers with greater income (OR = 1.05; P = 0.02), and those who spent more time away from home (OR = 25.7; P = 0.001). Men with higher incomes also reported significantly more sex partners (OLS coefficient = 0.016 more partners / 100 rupees in monthly income, P = 0.04), as did men who spent a great deal of time away from home (OLS coefficient = 1.30, P = 0.002). Drivers were more likely to report condom use with regular partners if they had ever visited a female sex worker (OR = 6.26; P = 0.002), but married drivers exhibited decreased use of condoms with regular partners (OR = 0.14, P = 0.008). Men who had higher levels of knowledge regarding HIV and HIV preventative practices were also more likely to use condoms with regular partners (OR = 1.22, P = 0.03). Conclusion: Time away from home, urban residence, income, and marital status were the strongest correlates of genital symptoms for Sexually Transmitted Infections (STI) and risk behaviors, although none were consistent predictors of all outcomes. Low HIV prevalence might be explained by a cohort that was mostly married, and at home. Novel HIV prevention interventions may be most cost effective when focusing upon young, single, and long-haul truck drivers.
  2 3,576 188
Staphylococcal scalded skin syndrome in a newborn
D Jeyakumari, R Gopal, M Eswaran, C MaheshKumar
January-June 2009, 1(1):45-47
DOI:10.4103/0974-777X.52981  PMID:20300386
A six-day-old newborn was admitted with exfoliating erythematous lesions over the face, of two days duration. The lesions spread to the rest of the body during the next two days. A diagnosis of Staphylococcal Scalded Skin Syndrome (SSSS) was made clinically and confirmed by isolation of Staphylococcus aureus from a blood sample. The child responded to Injection vancomycin and no fresh lesions were seen after the next 48 hours. However the child developed severe pneumonia and left against medical advice.
  2 3,101 183
Approach to a patient with urosepsis
Om Prakash Kalra, Alpana Raizada
January-June 2009, 1(1):57-63
DOI:10.4103/0974-777X.52984  PMID:20300389
Urinary tract infections can occur in all age groups and produce an exceptionally broad range of clinical syndromes ranging from asymptomatic bacteriuria to acute pyelonephritis with Gram negative sepsis to septic shock. In approximately one-quarter of all patients with sepsis, the focus of infection is localized to the urogenital tract. This may lead to substantial morbidity and significant economic implications. We present a review of the current approaches to managing urospesis.
  2 12,953 480
Clinical significance of isolated anti-HBc positivity in cases of chronic liver disease in New Delhi, India
Manisha Jain, Anita Chakravarti, P Kar
January-June 2009, 1(1):29-32
DOI:10.4103/0974-777X.52978  PMID:20300383
Background: The presence of anti-HBc IgG in the absence of HBsAg is usually indicative of a past self-limiting HBV infection. But it is frequently associated with co-infection with HCV which can worsen the existing status of chronic liver disease (CLD). Objectives: The present study was planned to evaluate the significance of isolated HBc IgG positivity in patients of CLD and look for the presence of HCV co-infection in such patients. Methods: Clinical profiles and biochemical tests were done for all the 77 CLD cases included in the study. Blood samples were taken from these patients and tested by the commercially available EIA for the presence of HBsAg, anti-HBc IgG, anti-HBs and anti-HCV. HBV DNA was detected by amplifying the surface region in all the cases. Results: Isolated anti-HBc IgG positivity defined as the presence of anti-HBc IgG in absence of any other serological markers of HBV infection was detected in 28 patients . Out of 64 patients positive for anti-HBc IgG 36 had the markers of HBV, either HBsAg, HBV DNA or anti-HBs alone or in combination. There was a significant association between isolated anti-HBc IgG positivity and HCV co-infection. Conclusion: Anti-HBc IgG should be tested in all patients with CLD as it is frequently the only marker of HBV infection in such patients and they should be monitored closely as such patients can develop CLD. Presence of co-infection with HCV should be actively searched for in such patients.
  1 2,798 179
Seasonal influenza: Waiting for the next pandemic
Angela Clem, Sagar Galwankar
January-June 2009, 1(1):51-56
DOI:10.4103/0974-777X.52983  PMID:20300388
With the ongoing cases of H1N1 influenza (aka Swine Flu) occurring around the globe, seasonal influenza has a tendency to be overlooked by the media and general population as a source of illness and death. Yet, these pandemic influenza viruses arise from these seasonal influenza viruses. This article will provide an overview of seasonal influenza, its prevention and treatment, and the global surveillance system in place, used to detect the next influenza pandemic.
  1 2,401 173
Cholera outbreaks in Iran and duration time of outbreaks
Ali Tavana
January-June 2009, 1(1):75-76
DOI:10.4103/0974-777X.52988  PMID:20300393
  1 1,703 115
Herpes labialis manifesting as recurrent erythema multiforme and solitary ulcer on face
Biju Vasudevan, Ashish Bahal, Vinod Raghav
January-June 2009, 1(1):48-50
DOI:10.4103/0974-777X.52982  PMID:20300387
A 65-year-old lady presented with recurrent crusting of lips and ulceration on face since the last three weeks. History revealed recurrent herpes labialis during the previous three years. Examination showed hemorrhagic crusting of lips and a solitary crusted ulcer on the right cheek. The patient showed partial improvement with antiviral therapy. On withdrawal of initial therapy, the patient developed classical lesions of herpes labialis and erythema multiforme. Investigations confirmed herpes simplex infection and erythema multiforme. All the lesions including the ulcer on the face responded to maintenance therapy with antivirals. Though herpes infection has been found to cause ulcers especially in the peri-anal region in immunosuppressed individuals, it is the first time in literature that a facial ulcer has been ascribed to herpes simplex virus that too in an immunocompetent individual.
  1 2,644 139
Two highly immunized hilly areas versus double measles outbreak investigations in district Kangra, Himachal Pradesh, India, in 2006
Surender N Gupta, Naveen Gupta
January-June 2009, 1(1):14-20
DOI:10.4103/0974-777X.52976  PMID:20300381
Background: We investigated two sequential outbreaks of measles in seven villages of Kangra, to confirm the diagnosis and to formulate recommendations for prevention and control. Methods: We defined a case of measles as occurrence of fever with rash in a child aged six months to 17 years during the period 3 rd September to 23 rd November 2006. We collected information on age, sex, residence, date of onset, symptoms, signs, treatment taken, traveling history and vaccination status. We described the outbreak by time, place and person. We estimated vaccine coverage and efficacy in the affected villages. We confirmed diagnosis clinically, serologically and through genotyping of the virus. Results: We identified 69 cases. Overall attack rates ranged between 4.2% and 6%. All case patients were between 6 years to 11 years of age. Age-specific attack rate in double outbreaks ranged in between 1.7% and 21.6%, the highest being in the age range 11-17 years. No deaths or complications were reported. The epidemic curve was suggestive of typical propagated pattern. The first outbreak imported virus after an interschool game competition (relative risk, 6.44%; 95% confidence interval, 3.81-10.91); followed by the second outbreak, in which people exchanged foods in the festival in one infected village of the first outbreak (relative risk, 5.3; 95% confidence interval, 1.90-14.77; P <.001). The calculated immunization coverage (93%) coincided nearly with administrative claims. The vaccine efficacies were estimated to be 85% and 81% in the first and second outbreaks respectively. Eleven of the 16 case patients were tested for measles IgM antibodies, while two nasopharyngeal swabs were positive by polymerase chain reaction (PCR) and are genotyped D4 measles strain. Vitamin A supplementations were only given in four villages. Conclusion: Measles outbreaks were confirmed in high-immunization-coverage areas. We recommended (i) second dose opportunity for measles in Himachal Pradesh and (ii) vitamin A supplementation to all the case patients.
  1 6,486 526
Fatal postoperative Candida glabrata septicemia in a child with congenital heart disease
Vasant Baradkar, Shripad Taklikar, Simit Kumar
January-June 2009, 1(1):68-70
DOI:10.4103/0974-777X.52986  PMID:20300391
The incidence of candidemia has been reported to be high in some cardiovascular surgery units. Congenital heart disease has been considered a risk factor for acquisition of candidemia. This present case is a postoperative Candida glabrata in a child with congenital heart disease. A 3-year-old child, a previously diagnosed case of situs-solitus D loop situs with double outlet right ventricle, ventricular septal defect, pulmonary stenosis and large ostium secundum atrial septal defect, was admitted with history of effort intolerance. A left modified Blalock-Taussig shunt was performed and then the child underwent closure of the ventricular septal defect and the atrial septal defect. On the third day the patient developed fever. Klebsiella pneumoniae was isolated from blood which responded to piperacillin + tazobactam but on the twelfth day, the patient again developed fever spikes. The blood cultures performed at this time showed repeated isolation of Candida glabrata. Amphotericin B was started but still the patient deteriorated and died on the 22 nd day after operation. The antifungal susceptibility of the isolate performed showed that the isolate was resistant to Amphotericin B.
  - 3,713 115
The laboratorial diagnosis of dengue: Applications and implications
Nina Rocha Dutra, Marilia Barbosa de Paula, Michelle Dias de Oliveira, Leandro Licursi de Oliveira, Sergio Oliveira de Paula
January-June 2009, 1(1):38-44
DOI:10.4103/0974-777X.52980  PMID:20300385
The diagnosis of infection by the dengue virus relies, in most cases, on the clinical judgment of the patient, since only a few major centers have clinical laboratories that offer diagnostic tests to confirm the clinical impressions of an infection. At present, routine laboratory diagnosis is done by different kinds of testing. Among them are the methods of serological research, virus isolation, detection of viral antigens, and detection of viral genomes. The continued development of diagnostic tests, which are cheap, sensitive, specific, easy to perform, and capable of giving early diagnosis of the dengue virus infection is still a need. There are also other obstacles that are not specifically related to the technological development of diagnostic methods. For instance, infrastructure of the laboratories, the training of personnel, and the capacity of research of these laboratories are still limited in many parts of Brazil and the world, where dengue is endemic. Clinical laboratories, especially the ones that serve regions with a high incidence of dengue, should be aware of all the diagnostic methods available for routine these days, and choose the one that best suit their working conditions and populations served, in order to save lives.
  - 6,544 646
State of the globe: Yellow fever is still around and active!
Dilip Mathai, A George Vasanthan
January-June 2009, 1(1):4-6
DOI:10.4103/0974-777X.52975  PMID:20300379
  - 3,003 188
The philosophy we believe and the principles we practice
Editors, Publisher and Supporters of JGID
January-June 2009, 1(1):1-3
DOI:10.4103/0974-777X.52974  PMID:20300378
  - 1,584 202
Inducible clindamycin resistance in Staphylococcus aureus: Reason for treatment failure
KE Vandana, Jyothsana Singh, M Chiranjay, Indira Bairy
January-June 2009, 1(1):76-77
DOI:10.4103/0974-777X.52989  PMID:20300394
  - 2,814 187
Cytomegalovirus infection and unusual early graft dysfunction in a renal transplant recipient
Suzan Sanavi, Ahad Ghods, Reza Afshar
January-June 2009, 1(1):77-78
DOI:10.4103/0974-777X.52990  PMID:20300395
  - 1,918 92
Assessing yellow fever risk in the Ecuadorian Amazon
Ricardo O Izurieta, Maurizio Macaluso, Douglas M Watts, Robert B Tesh, Bolivar Guerra, Ligia M Cruz, Sagar Galwankar, Sten H Vermund
January-June 2009, 1(1):7-13
DOI:10.4103/0974-777X.49188  PMID:20300380
This study reports results of a cross-sectional study based on interviews and seroepidemiological methods to identify risk factors for yellow fever infection among personnel of a military garrison in the Amazonian rainforest. Clinical symptoms and signs observed among yellow fever cases are also described. Humoral immune response to yellow fever, Mayaro, Venezuelan equine encephalitis, Oropouche, and dengue 2 infection was assessed by evaluating IgM and IgG specific antibodies. A yellow fever attack rate of 13% (44/341, with 3 fatal cases) was observed among military personnel. Signs of digestive track bleeding (14.6%) and hematuria (4.9%) were observed among the yellow fever cases. In 32.2% of the cases, we measured high levels of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase with maximum levels of 6,830 and 3,500, respectively. Signs of bleeding or jaundice were observed in some cases, and high levels of transaminases were seen. The epidemiological and laboratory investigations demonstrated that the military personnel were affected by a yellow fever outbreak. The association between clearing the rainforest and also being at the detachments with yellow fever infection confirms that clearing is the main factor in the jungle model of transmission, which takes place deep in the Amazonian rainforest.
  - 4,077 221
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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008