Prevalence of malaria reported during summer and winter at a tertiary care hospital in Karachi, Pakistan

This study was designed to determine the prevalence and type of malaria cases that presented throughout the year 2014 in a tertiary care hospital in Karachi, Pakistan. A total of 1099 cases, (377 females, 722 males) were reported. Plasmodium vivax (P. vivax) was discovered in 93.7% cases compared to 6.3% Plasmodium falciparum (P. falciparum). Based on the highest and lowest weather temperatures, in summer (June, July and August) and in winter (December, January and February) were differentiated. The number of cases were greater during summer months compared to winter. Interestingly, the ratio of P. falciparum to P. vivax during winter was greater compared to summer. Finally, there was a strong correlation between increasing humidity and number of malaria cases. These findings show that even though the incidence of malaria is higher in summer, malaria cases are still reported in winter. Furthermore, the probability of finding P. falciparum (which causes cerebral malaria ) is higher in winter

Prevalences of giardia lamblia and cryptosporidium parvum infection in adults presenting with chronic diarrhoea

iardia lamblia and Cryptosporidium parvum are both waterborne pathogens associated with diarrhoea in developing countries. In a recent study based at the Aga Khan University in Karachi, 334 adults aged 16–83 years (178 patients with chronic diarrhoea and 156 diarrhoea-free volunteers who acted as controls) were checked for infection with these parasites, using stool microscopy and/or PCR. Overall, 21 (6.3%) and 29 (8.7%) of the subjects were found positive for G. lamblia by microscopy and PCR, respectively, while the corresponding values for C. parvum were 13 (3.9%) and 14 (4.2%). Although, compared with the diarrhoea-free controls, the patients with diarrhoea were not significantly more likely to be found infected with Giardia, either by microscopy [15 (8.4%) v. six (3.8%); P=0.085] or PCR [19 (10.7%) v. 10 (6.4%); P=0.167], they were significantly more likely to be found infected with C. parvum, both by microscopy [11 (6.2%) v. two (1.3%); P=0.024] and by PCR [12 (6.7%) v. two (1.3%); P=0.014]. The 19 patients found PCR-positive for Giardia comprised 10 (67%) of the 15 found smear-positive for the same parasite but only nine (5%) of the 163 found smear-negative (k=0.545; PCryptosporidium comprised all 11 (100%) patients found smear-positive for the same parasite but only one (0.6%) of the 167 found smear-negative (k=0.954; P\u3c0.001). Although C. parvum was associated with chronic diarrhoea in the present study, the carriage of G. lamblia often appeared asymptomatic

Irritable bowel syndrome: in search of an etiology: role of Blastocystis hominis.

This study was designed to examine stool specimens of irritable bowel syndrome (IBS) patients for Blastocystis hominis, a common intestinal parasite. One hundred fifty patients were enrolled, 95 IBS cases and 55 controls. These patients provided a medical history, and underwent physical and laboratory evaluations that included stool microscopy and culture for B. hominis and colonoscopy. The 95 cases (51 males and 44 females) had a mean +/- SD age of 37.8 +/- 13.2 years. Stool microscopy was positive for B. hominis in 32% (30 of 95) of the cases and 7% (4 of 55) of the controls (P = 0.001). Stool culture was positive in 46% (44 of 95) of the cases and 7% (4 of 55) of the controls (P \u3c 0.001). Stool culture for B. hominis in IBS was more sensitive than microscopy (P \u3c 0.001). Blastocystis hominis was frequently demonstrated in the stool samples of IBS patients; however, its significance in IBS still needs to be investigated. Stool culture has a higher positive yield for B. hominis than stool microscopy

Frequency of G6PD mediterranean in individuals with and without malaria in southern Pakistan

Background: Pakistan has an estimated annual burden of 1.5 million malaria cases. The current situation calls for an efective malaria control and eradication programme in this country. Currently, primaquine is an attractive option for eliminating reservoirs of Plasmodium vivax hypnozoites and killing gametocytes of Plasmodium falciparum. However, this drug causes haemolysis in individuals who are glucose-6-phosphate (G6PD) defcient. It is important to map G6PD defciency and malaria distribution in Pakistan to design an efective malaria eradication regimen. Frequency of G6PD defciency (G6PDd) in malaria patients has not been reported from Pakistan in any meaningful way. The purpose of this study was to evaluate the frequency of G6PD c.563C\u3eT (G6PD Mediterranean) in male individuals with and without falciparum malaria.Methods: Two hundred and ten archived DNA samples from males (110 from falciparum malaria patients and 100 from healthy individuals) were utilized in this study. Healthy blood donors were selected based on stringent predefned criteria. Patients were confrmed for malaria parasites on microscopy and or immune chromatographic assay detecting P. falciparum histidine-rich protein 2. Parasitaemia was also computed. DNA samples were tested for G6PD c.563C\u3eT mutation through PCR–RFLP according to the previously defned protocol and its allelic frequency was computed.Results: G6PD c.563C\u3eT was observed in four of 110 patients with falciparum malaria and in two of 100 healthy donors. Mean (± SD) haemoglobin, median (IQR) platelet and median (IQR) parasite count in G6PD-defcient malariapatients were 8.9 ± 0.9 g/dL, 124 × 109/L (IQR 32, 171) and 57,920/μL of blood (IQR 12,920, 540,000) respectively.Conclusions: Cumulative allelic frequency for G6PD 563c.C\u3eT was 0.0285 detected in 6 of 210 X-chromosomes in Southern Pakistan. Frequency for this G6PD allele was 0.0364 in malaria-patients and 0.0200 in healthy individuals. Large studies including females are needed to elucidate the true burden of G6PDd in malaria-endemic areas. The information will enable local health policy makers to design efective strategies for eliminating malaria form this region

Spectrum of complications and mortality of bacterial meningitis: an experience from a developing country

Objective: The aim of this study was to obtain data on predisposing factors, causative organisms and their associated mortality and complications related to acute bacterial meningitis. Methods: The chart review of all patients in whom acute bacterial meningitis was diagnosed at The Aga Khan University Hospital from January 1995 through December 2001. Results: One hundred ninety-four patients were included in study. There were 146 males and 48 females. The mean age of our study population was 41±12.3 years. One hundred and ninety (97.9%) patients had community acquired meningitis; only 4 (2.0%) patients developed meningitis nosocomially. The two most common predisposing factors were diabetes mellitus (13.9%) and otitis media (7.7%) among all 194 patients. A significant proportion of patients with complications had diabetes mellitus (24.6%, p Conclusion: Bacterial Meningitis remains a serious disease associated with substantial morbidity and mortality. Most cases are community acquired with S. Pneumoniae being the most common pathogen. Old age, diabetes mellitus, a positive culture, seizures as a complication and late stage in the disease are the important predictors of a poor outcome (JPMA 53:580;2003)

A collaborative healthcare framework for shared healthcare plan with ambient intelligence

The fast propagation of the Internet of Things (IoT) devices has driven to the development of collaborative healthcare frameworks to support the next generation healthcare industry for quality medical healthcare. This paper presents a generalized collaborative framework named collaborative shared healthcare plan (CSHCP) for cognitive health and fitness assessment of people using ambient intelligent application and machine learning techniques. CSHCP provides support for daily physical activity recognition, monitoring, assessment and generate a shared healthcare plan based on collaboration among different stakeholders: doctors, patient guardians, as well as close community circles. The proposed framework shows promising outcomes compared to the existing studies. Furthermore, the proposed framework enhances team communication, coordination, long-term plan management of healthcare information to provide a more efficient and reliable shared healthcare plans to people

Efficacy and safety of quinine loading dose in patients with severe falciparum malaria at a tertiary care hospital in Pakistan

OBJECTIVE: To compare the clinical outcomes of a loading dose regimen of quinine with a uniform dose regimen in patients with severe falciparum malaria. METHODS: A retrospective chart review of 315 patients admitted with severe falciparum malaria and treated with quinine at a tertiary care teaching hospital of Karachi, Pakistan during 1999-2006 was conducted. Group A with 103 patients (32.7%) was given an initial loading dose of quinine while group B with 212 patients (67.3%) did not receive the loading dose. The two groups were compared in terms of reduction of parasite load, resolution of fever, recovery of consciousness and incidence of adverse effects. Outcome parameters were measured on the third day of therapy. RESULTS: More individuals in group A (62.1%) were afebrile as compared to group B (54.7%) at day 3 of therapy. Patients in group B showed greater reduction in parasitaemia (47.2% at baseline to 4.7% on day 3) as compared to group A (56.3 % at baseline to 9.7% on day 3). Following therapy, fewer patients in group B had altered consciousness (7.1% at baseline to 4.7% on day 3) as compared to patients in group A (7.8% at baseline to 5.8% on day 3). However, these associations were not statistically significant. The incidence of thrombocytopenia was higher in Group A (5.8%) as compared to Group B (0.9%). CONCLUSION: Although quinine loading dose may be more effective than uniform dose in rapid fever clearance; it also appears to be associated with higher toxicity. Uniform dose of quinine may be prescribed in severe falciparum malaria in view of its better safety profile

Prevalence and Factors Associated with Intestinal Parasitic Infection among Children in an Urban Slum of Karachi

Background:Intestinal parasitic infections are endemic worldwide and have been described as constituting the greatest single worldwide cause of illness and disease. Poverty, illiteracy, poor hygiene, lack of access to potable water and hot and humid tropical climate are the factors associated with intestinal parasitic infections. The study aimed to estimate prevalence and identify factors associated with intestinal parasitic infections among 1 to 5 years old children residing in an urban slum of Karachi Pakistan. Methods And PrincipalFindings:A cross sectional survey was conducted from February to June 2006 in Ghosia Colony Gulshan Town Karachi, Pakistan. A simple random sample of 350 children aged 1-5 years was collected. The study used structured pre-tested questionnaire, anthropometric tools and stool tests to obtain epidemiological and disease data. Data were analyzed using appropriate descriptive, univariate and multivariable logistic regression methods. The mean age of participants was 2.8 years and 53% were male. The proportions of wasted, stunted and underweight children were 10.4%, 58.9% and 32.7% respectively. The prevalence of Intestinal parasitic infections was estimated to be 52.8% (95% CI: 46.1, 59.4). Giardia lamblia was the most common parasite followed by Ascaris lumbricoides, Blastocystis hominis and Hymenolepis nana. About 43% children were infected with single parasite and 10% with multiple parasites. Age {Adjusted Odds Ratio (aOR) = 1.5, 95% CI: 1.1, 1.9}, living in rented households (aOR = 2.0, 95% CI: 1.0, 3.9) and history of excessive crying (aOR = 1.9, 95% CI: 1.0, 3.4) were significantly associated with intestinal parasitic infections.Conclusion:Intestinal parasites are highly prevalent in this setting and poverty was implicated as an important risk factor for infection. Effective poverty reduction programmes and promotion of deworming could reduce intestinal parasite carriage. There is a need for mass scale campaigns to create awareness about health and hygiene

Laccase Application in Medium Density Fibreboard to prepare a Bio-composite

Laccase efficacy as a biological tool for the removal of lignin in pulp industries is evident and has a scope for a wider application. In this research study, rubber wood (Hevea brasiliensis) fibres were treated with laccase enzyme to study its effect on the fibre surface and the enzyme hydrolysis lignin (EHL) was collected as a byproduct. Collected EHL was concentrated (con) till the solution reached a 3% solid content. Fibre surface modification was studied by FESEM, FTIR and XRD. A distinct fibre surface with an improved crystallinity index was observed. EHL and Con-EHL were analyzed on viscometer, FTIR, DSC, and TGA. Con- EHL exhibits a lower stretching energy at the benzene range as compared to EHL and a curing pattern similar to UF was reported. To evaluate the capability of modified fibre and Con-EHL, 6 mm medium density fibreboard (MDF) of 810 kg/m3 were prepared by using 10% Con-EHL solution (by weight of Page 1 of 31 RSC Advances RSC Advances Accepted Manuscript Published on 14 January 2014. Downloaded by RSC Internal on 03/02/2014 12:49:07. View Article Online DOI: 10.1039/C3RA40593Afibre). The MDF boards exhibit higher mechanical strength and have passed the ASTM D1037 standard for internal bonding and modulus of rupture

AplhaLogger: Detecting Motion-based Side-Channel Attack Using Smartphone Keystrokes

Due to the advancement in technologies and excessive usability of smartphones in various domains (e.g., mobile banking), smartphones became more prone to malicious attacks.Typing on the soft keyboard of a smartphone produces different vibrations, which can be abused to recognize the keys being pressed, hence, facilitating side-channel attacks. In this work, we develop and evaluate AlphaLogger - an Android-based application that infers the alphabet keys being typed on a soft keyboard. AlphaLogger runs in the background and collects data at a frequency of 10Hz/sec from the smartphone hardware sensors (accelerometer, gyroscope and magnetometer ) to accurately infer the keystrokes being typed on the soft keyboard of all other applications running in the foreground. We show a performance analysis of the different combinations of sensors. A thorough evaluation demonstrates that keystrokes can be inferred with an accuracy of 90.2% using accelerometer, gyroscope, and magnetometer