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   2017| October-December  | Volume 9 | Issue 4  
    Online since December 12, 2017

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The forgotten plague: Psychiatric manifestations of ebola, zika, and emerging infectious diseases
Veronica Tucci, Nidal Moukaddam, Jonathan Meadows, Suhal Shah, Sagar C Galwankar, G Bobby Kapur
October-December 2017, 9(4):151-156
DOI:10.4103/jgid.jgid_66_17  PMID:29302150
The media and public health generally focus on the biological and physical ramifications of epidemics. Mental health issues that coincide with emerging diseases and epidemics are rarely examined and sometimes, even eschewed due to cultural considerations. Psychiatric manifestations of various infectious diseases, especially with a focus on Ebola Virus disease (EVD) and Zika Virus, are discussed in this commentary to illustrate the continued need of care after the resolution of the actual illness. Various infectious diseases have associations with mental illness, such as an increased risk of obsessive-compulsive disorders and Tourette syndrome in children with Group B streptococcal infection. Current EVD literature does not demonstrate a strong association of mental illness symptoms or diseases but there is a necessity of care that extends beyond the illness. Patients and their families experience depression, anxiety, trauma, suicidal ideation, panic and other manifestations. Zika virus has been associated neuronal injury, genetic alteration that affects fetal development and detrimental maternal mental health symptoms are being documented. While funding calls from the international community are present, there are no specific epidemiological data or fiscal estimates solely for mental health during or after infectious diseases epidemics or disasters that support health care providers and strengthen policies and procedures for responding to such situations. Therefore, those on the frontlines of epidemics including emergency physicians, primary care providers and infectious disease specialists should serve communicate this need and advocate for sustained and increased funding for mental health programs to heighten public awareness regarding acute psychiatric events during infectious diseases outbreaks and offer treatment and support when necessary.
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Association of risk factors and drug resistance pattern in tuberculosis patients in North India
Pallavi Sinha, GN Srivastava, Anamika Gupta, Shampa Anupurba
October-December 2017, 9(4):139-145
DOI:10.4103/jgid.jgid_167_16  PMID:29302148
Context: India is one of the high tuberculosis (TB) burden countries in the world. Improper implementation in the guidelines for the management of TB and high rate of defaults on the part of the patients are most important risk factors for the development of multi-drug resistant TB. Aims: This study examines the drug resistance profile and the effect of demographic, clinical and behavioral risk factors on the prevalence of TB and multidrug resistance (MDR) in north India. Settings and Design: This was a prospective, observational study carried out from May 2012 to February 2014 in tertiary care hospital of Varanasi. Subjects and Methods: The study was performed on 721 pulmonary and extrapulmonary specimens of suspected TB patients based on history, was subjected for the Ziehl–Neelsen staining and culture on Lowenstein–Jensen (LJ) media. Statistical Analysis: The features of groups were compared by Chi-square (χ2) and odds ratio. Results: Out of 721 clinically suspected pulmonary and extrapulmonary TB patients, 222 (30.8%) patients were smear positive for acid-fast bacilli and 244 (38.3%) were positive for Mycobacterium species cultured on LJ medium. The prevalence of resistance to at least one anti-TB drug was 71.1% and MDR was 53.5%. Age, gender, HIV status, nature of TB, smoking, and alcohol consumption risk factors were significantly associated with TB prevalence; while prior history of TB infection, pervious household exposure, smoking, and alcohol consumption were significantly associated with MDR. Conclusion: This study showed a high prevalence of drug resistance TB in this region. It also provides evidence in our circumstance, of the role of prior history of TB infection, alcohol and smoking in increasing the risk of developing TB and MDR-TB. Therefore, it is necessary for the public health community to incorporate and strengthen alcohol and smoking nonparticipation interference in TB control program.
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Current trends of drug resistance patterns of Acinetobacter baumannii infection in blood transfusion-dependent thalassemia patients
Suhail Ahmed Almani, Ali Naseer, Sanjay Kumar Maheshwari, Pir Maroof, Raza Naseer, Haji Khan Khoharo
October-December 2017, 9(4):135-138
DOI:10.4103/jgid.jgid_151_16  PMID:29302147
Objective: The present study aimed to evaluate the current trends of drug resistance patterns of Acinetobacter baumannii infection in blood transfusion-dependent thalassemia patients. Study Design: This study was a cross sectional study, conducted at the Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad, Sindh, Pakistan from October 2014 to January 2016. Subjects and Methods: Of 921 blood samples, A. baumannii strains were isolated from 100 blood samples. Blood samples were processed for the isolation, identification, and drugs sensitivity as per the Clinical and Laboratory Standards Institute. A. baumannii strains were identified by microbiological methods and Gram's staining. API 20 E kit (Biomeriuex, USA) was also used for identification. Data were analyzed on Statisti × 8.1 (USA). Results: Mean ± standard deviation age was 11.5 ± 2.8 years. Nearly 70% were male and 30% were female (P = 0.0001). Of 921 blood transfusion-dependent thalassemia patients, 100 (10.8%) patients showed growth of A. baumannii. Drug resistance was observed against the ceftazidime, cefixime, cefepime, imipenem, meropenem, amikacin, minocycline, tigecycline, and tazocin except for the colistin. Conclusion: The present study reports drug-resistant A. baumannii in blood transfusion-dependent thalassemia patients. National multicenter studies are recommended to estimate the size of the problem.
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Epidemiological trends of cutaneous leishmaniasis in Al-Madinah Al-Munawarah Province, Western Region of Saudi Arabia
Miskelyemen Abdelatti Elmekki, Mogahid M Elhassan, Hani A Ozbak, Ilham T Qattan, Satti M Saleh, Ali H Alharbi
October-December 2017, 9(4):146-150
DOI:10.4103/jgid.jgid_16_17  PMID:29302149
Objective: To investigate the epidemiological trends of cutaneous leishmaniasis (CL) in Al-Madinah Al-Munawarah, western region of KSA. Materials and Methods: Four hundred and sixty-seven parasitologically confirmed CL cases attending Al-Meeqat Hospital, Al-Madinah, during 2012–2015, were included in this study. Results: Both Saudi and non-Saudi nationals were infected, with the highest infection rate being among Saudis (68.7%). Males were more affected than females as 86.9% of the total CL cases were males. Moreover, CL was prevalent in all age groups with higher frequency among young adults and adolescents (23.1% and 22.7%, respectively). Interestingly, almost all the patients in the adolescent and child age groups were Saudis (96.2% and 93.5%, respectively). Considering geographical distribution, the highest percentage of the cases (40.5%) were from the northern parts of Al-Madinah province while the eastern parts reported the least infection rate (7.3%). Few cases (2.5%) were supposed to encounter the infection abroad. Additionally, the frequency of infection was found to follow a seasonal distribution. Regarding treatment, pentostam, ketoconazole, or cryotherapy were the treatment options usually used. Conclusion: CL is prevalent in Al-Madinah Al-Munawarah area and new foci are being introduced. Thus, detailed studies with large surveillances regarding vector and reservoir hosts in and around the area are needed.
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Helicobacter pylori in dyspepsia: Phenotypic and genotypic methods of diagnosis
Vignesh Shetty, Mamatha Ballal, Girisha Balaraju, Shiran Shetty, Ganesh C Pai, Ramachandra Lingadakai
October-December 2017, 9(4):131-134
DOI:10.4103/jgid.jgid_52_17  PMID:29302146
Background: Helicobacter pylori affects almost half of the world's population and therefore is one of the most frequent and persistent bacterial infections worldwide. H. pylori is associated with chronic gastritis, ulcer disease (gastric and duodenal), mucosa-associated lymphoid tissue lymphoma, and gastric cancer. Several diagnostic methods exist to detect infection and the option of one method or another depends on various genes, such as availability, advantages and disadvantages of each method, monetary value, and the age of patients. Materials and Methods: Patients with complaints of abdominal pain, discomfort, acidity, and loss of appetite were chosen for endoscopy, detailed history was contained, and a physical examination was conducted before endoscopy. Biopsies (antrum + body) were received from each patient and subjected to rapid urease test (RUT), histopathological examination (HPE), polymerase chain reaction (PCR), and culture. Results: Of the total 223 biopsy specimens obtained from dyspeptic patients, 122 (54.7%) were positive for H. pylori for HPE, 109 (48.9%) by RUT, 65 (29.1%) by culture, and 117 (52.5%) by PCR. The specificity and sensitivity were as follows: RUT (99% and 88.5%), phosphoglucosamine mutase PCR assay (100% and 95.9%), and culture (100% and 53.3%), respectively. Conclusion: In this study, we compared the various diagnostic methods used to identify H. pylori infection indicating that, in comparison with histology as gold standard for detection of H. pylori infection, culture and PCR showed 100% specificity whereas RUT and PCR showed 99% and 100% sensitivity, respectively.
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Cryptococcal meningitis masquerading as normal pressure hydrocephalus in an immune-competent adult
Hitesh Raheja, Ankur Sinha, Pavan Kumar Irukulla, Yizhak Kupfer
October-December 2017, 9(4):157-159
DOI:10.4103/jgid.jgid_2_17  PMID:29302151
We report a case of acute cryptococcal meningitis (CM) masquerading as normal pressure hydrocephalus (NPH) in an immune-competent female. An 85-year-old human immunodeficiency virus-negative female presented to the emergency room for altered mental status and difficulty walking. She was increasingly lethargic, with urinary incontinence and gait instability. A previous computed tomography was reported to have ventricular dilatation out of proportion to the degree of cortical atrophy. Magnetic resonance scan of the brain revealed ventricular dilatation and subtle debris layering the occipital horns of the lateral ventricles. A working diagnosis of NPH had been made considering the clinical symptoms and imaging. She became febrile to 103°F. Lumbar puncture was then performed which showed increased protein, decreased glucose, and mononuclear pleocytosis. India ink preparation of the cerebrospinal fluid was positive for Cryptococcus along with a positive cryptococcal antigen test. The patient was started on treatment for CM, but the patient continued to deteriorate further and died on the same day. Blood cultures subsequently grew Cryptococcus neoformans as well.
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State of the globe: The global battle for survival against Mycobacterium tuberculosis
Vivek Chauhan, Suman Thakur
October-December 2017, 9(4):129-130
DOI:10.4103/jgid.jgid_150_17  PMID:29302145
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Spinal mucormycosis
Kunal Shah, Abhay Nene
October-December 2017, 9(4):160-161
DOI:10.4103/jgid.jgid_107_16  PMID:29302152
Spinal mucormycosis is a rare and fatal condition. High degree of suspicion is required for early diagnosis and treatment.
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Empyema necessitans: An unexpected infectious presentation of multiple myeloma
Aaysha Kapila, Christine Ann Moore, Guha Krishnaswamy, Kailash Bajaj
October-December 2017, 9(4):163-164
DOI:10.4103/jgid.jgid_35_17  PMID:29302154
  1,554 16 -
Enterococcal empyema and trapped lung in systemic lupus erythematosus
Satish Maharaj, Simone Chang, Karan Seegobin, Christian Abrahim
October-December 2017, 9(4):162-163
DOI:10.4103/jgid.jgid_34_17  PMID:29302153
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Dual infection with dengue virus serotype 1 and 2 in a patient in Western Mexico
Francisco Espinoza-Gómez, Iván Delgado-Enciso, Salvador Valle-Reyes, Clemente Vásquez, Uriel A López-Lemus
October-December 2017, 9(4):164-165
DOI:10.4103/jgid.jgid_42_17  PMID:29302155
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