Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey

<p>Abstract</p> <p>Background</p> <p>Dimeticone 4% lotion was shown to be an effective treatment for head louse infestation in two randomised controlled trials in England. It is not affected by insecticide resistance but efficacy obtained (70-75%) was lower than expected. This study was designed to evaluate efficacy of dimeticone 4% lotion in a geographically, socially, and culturally different setting, in rural Turkey and, in order to achieve blinding, it was compared with a potential alternative formulation.</p> <p>Methods</p> <p>Children from two village schools were screened for head lice by detection combing. All infested students and family members could participate, giving access to treatment for the whole community. Two investigator applied treatments were given 7 days apart. Outcome was assessed by detection combing three times between treatments and twice the week following second treatment.</p> <p>Results</p> <p>In the intention to treat group 35/36 treated using dimeticone 4% had no lice after the second treatment but there were two protocol violators giving 91.7% treatment success. The alternative product gave 30/36 (83.3%) treatment success, a difference of 8.4% (95% CI -9.8% to 26.2%). The cure rates per-protocol were 33/34 (97.1%) and 30/35 (85.7%) respectively. We were unable to find any newly emerged louse nymphs on 77.8% of dimeticone 4% treated participants or on 66.7% of those treated with the alternative formulation. No adverse events were identified.</p> <p>Conclusion</p> <p>Our results confirm the efficacy of dimeticone 4% lotion against lice and eggs and we found no detectable difference between this product and dimeticone 4% lotion with nerolidol 2% added. We believe that the high cure rate was related to the lower intensity of infestation in Turkey, together with the level of community engagement, compared with previous studies in the UK.</p> <p>Trial Registration</p> <p>Current Controlled Trials ISRCTN10431107</p

Health inequities: lower socio-economic conditions and higher incidences of intestinal parasites

<p>Abstract</p> <p>Background</p> <p>Intestinal parasitic infections affect child health and development and slow down growth, while reducing adults' productivity and work capacity. The aim of the present study was to determine and compare the incidences of intestinal parasitic infections and the socio-economic status of two near primary school children in Manisa, a western city of Turkey.</p> <p>Methods</p> <p>A total of 352 children were involved a questionnaire study from a private school (Ülkem Primary School – ÜPS, 116 children) and a community-based school (Şehzadeler Primary School – ŞPS, 236 children). Of these, stool samples could be obtained from a total of 294 students; 97 (83.6%) from ÜPS, and 197 (83.5%) from ŞPS. The wet mount preparations of the stool samples were examined; samples were also fixed in polyvinyl alcohol and examined with modified formalin ethyl acetate sedimentation and trichrome staining techniques. Data were analyzed using SPSS for Windows version 10.0. The chi-squared test was used for the analytic assessment.</p> <p>Results</p> <p>The percentages of the students found to be infected with intestinal parasites, were 78 (39.6%) and 13 (13.4%) in ŞPS and ÜPS, respectively. Totally 91 (31.0%) of the students from both schools were found to be infected with at least one intestinal parasite. <it>Giardia lamblia </it>was found to be the most common pathogenic intestinal parasite and <it>Blastocystis hominis </it>was prevalent independently from the hygienic conditions. The factors which significantly (<it>p </it>< 0.05) increase the incidence of intestinal parasites were uneducated and unemployed mother, lower social status of father, living in crowded houses with insufficient indoor spaces, using the tap water as drinking water, and living at shanty areas.</p> <p>Conclusion</p> <p>Intestinal parasitic infections in school children were found to be a public health problem that increased due to lower socio-economic conditions. We conclude that organization of education seminars including the topics such as prevention of the infectious diseases, improving general hygienic conditions, and application of supportive programs for the parents may be suggested not only to reduce intestinal parasitic infections, but also to elevate the socio-cultural levels.</p

Is serum essential for in vitro culture of Trichomonas vaginalis?

Ülkemizde cinsel ilişki ile bulaşan hastalık etkenleri arasında sık görülen Trichomonas vaginalis'in tanısı, taze preparatların mikroskop altında incelenmesi ve alınan materyalin besiyeri ortamına ekilerek değerlendirilmesi ile konulmaktadır. Parazitin üretilmesi için serumun gerekli olup olmadığını saptamak amacı ile bu çalışma yapılmıştır. Trichomonas vaginalis'in in vitro üretilmesinde Beyin-Kalp (BH) ve modifiye Tiyoglikolat (NaT) besiyerleri serum ile ve serumsuz olarak hazırlanmış, üretme kapasiteleri ve tanısal etkinlikleri TYM (Trypticase-yeast extact-maltose) besiyeri ile karşılaştırmıştır. Besiyerlerine 1X10 5 canlı T. vaginalis trofozoitleri ekilmiş, 24 saat ara ile dokuz gün boyunca üreme fazları ve canlılıkları değerlendirilmiştir. Trofozoitlerin üreme durumu incelendiğinde, en fazla üremenin 72. saatte serum içermeyen BH besiyerinde olduğu (35x105 tane/ml) görülmüştür. Sonraki günlerde serum içermeyen besiyerlerindeki üremenin TYM besiyeri ile eşdeğer düzeyde olduğu, sekizinci günde ise sadece serum içermeyen besiyerlerinde trofozoitlerin canlı kaldığı saptanmıştır. Serum içermeyen besiyerleri laboratuvarlarda rahatlıkla bulunan malzemeler kullanılarak kolay hazırlanabilmekte, ayrıca serum ilave edilirken oluşabilecek kontaminasyon riski en aza indirilmektedir. Bu bulgular ışığında, serum içermeyen besiyerlerinin T. vaginalis kültüründe ve pasajların sürekliliğinde rahatlıkla kullanılabileceği, hem laboratuvarlarda hem alan çalışmalarında avantaj sağlayabileceği kanısına varılmıştır.The definitive diagnosis of Trichomonas vaginalis, one of the common causes of sexually transmitted diseases in Turkey, relies both the microscopic examination and culture of frash varinal swabs. The aim of the study was to investigate the efficacies of Brain-Heart (BH) medium and modified tioglycolate medium (NaT) and without serum, for the culture of T. vaginalis in vitro, in comparison to TYM (tripticase-yeast extract-maltose) medium. Both media were prepared according to their original formulas and inactivated serum was then added to the half of the test tubes. Trichomonas vaginalis trophozoites were inoculated in an amount of 1x105 in all tubes, and their viabilities and growth rates were examined everyday for 9 days. The growth rates of all study groups were compared with TYM medium. The highest rate of growth (35x105) was found in serum-free BH medium at the end of 72 hours. The number of trophozoites in serum-free BH and modified NaT media was found to be equivalent to that in TYM medium on the following days. In addition, T. vaginalis trophozoites were detected only in serum-free BH and NaT media on the 8th day. Serum-free culture media are easy-to-prepare and have lower risk of contamination. The findings indicate that they could be useful in the culture of T. vaginalis for both routine diagnosis and field studies

Türkiye’deki Bazı Endemik Bitkilerin Uçucu Yağ Komponentlerinin Pedikülosidal Aktivitelerinin in vitro İncelenmesi

Objective: The human head louse Pediculus capitis has recently acquired resistance to commercially available insecticides, which has expanded the search concerning the pediculicidal activities of some herbal products. The present study aimed to assess the in vitro pediculicidal activities of volatile oils extracted from 10 medical plants raised in Turkey: Rosa damascena (red provins rose), Pelargonium graveolens (geranium), Lavandula angustifolia (lavender), Salvia triloba (salvia), Rosmarinus officinalis (rosemary; two different chemotypes), Citrus bergamia (citrus tree), Cymbopogon nardus (citronella), Citrus limonum (lemon), and Cymbopogon flexuosus (lemongrass).Methods: Head lice obtained from school children in Manisa Province were initially grouped as adults and nymphs and were then kept under optimal conditions (temperature of 27°C and humidity of 50%). A pinch of hair and filter paper were placed in Petri dishes and seven adults and seven nymphs were separately put in Petri dishes. The extracts obtained from each volatile oil were dropped on the lice specimens. Results: The active movement of the external (antenna and legs) and internal (midgut and intestine) organs of the lice was monitored and recorded starting from 5th min for 24 hours by 10 to 30 minutes intervals. The time of death was defined as the loss of active movement and cessation of intestinal activities of lice. The results were analyzed using Statistical Packages for the Social Sciences (SPSS) versiyon 15.Conclusion: The results showed that the volatile oil of Rosmarinus officinalis (two different chemotypes) was more effective than the other oilsAmaç: Baş biti enfestasyonuna neden olan Pediculus capitis'in, piyasada bulunan kimyasal insektisitlere karşı direnç kazanması ve bu insektisitlerin sık tekrarlayan kullanımlarında oluşabilecek toksisite nedeniyle bitkisel ürünlerin pedikülosidal etkilerine ilişkin araştırmalar giderek artmaktadır. Bu çalışmada, Türkiye'de yetiştirilen Türk Gülü (Rosa damascena), Itır (Pelargonium graveolens), Lavanta (Lavandula angustifolia), Adaçayı (Salvia triloba), iki farklı tür kuşdili (Rosmarinum officinalis), Bergamot (Citrus bergamia), Citronella (Cymbopogon nardus), Limon (Citrus limonum) ve Hint limonu (Cymbopogon flexuosus) olmak üzere toplam 10 tıbbi bitkiden elde edilen uçucu yağların in vitro pedikülosidal etkinliğini değerlendirmek amaçlanmıştır.Yöntemler: Okul çocuklarından canlı olarak toplanan baş bitleri başlangıçta yetişkinler ve nimfler olarak gruplandırılmış ve en uygun koşullarda (27°C, %50 nem) muhafaza edilmiştir. Her uçucu yağ için yedi erişkin ve yedi nimf bir petri kutusuna bir tutam saç ve filtre kağıdı ile birlikte ayrı ayrı konulmuş ve daha sonra bu ekstratlar bit üzerine damlatılmıştır.Bulgular: Bitin dış (anten, bacaklar) ve iç (orta bağırsak, bağırsak) organlarının aktif hareketleri takip edilmiş ve 5 dakikadan başlanarak 24 saat boyunca canlılıkları kontrol edilmiştir. Ölüm zamanı aktif hareketlerin kaybedilmesi ve bitlerin bağırsak faaliyetlerinin durdurulması olarak tanımlandı. Sonuçlar Statistical Packages for the Social Sciences (SPSS) istatistik programı versiyon 15 ile analiz edildi.Sonuç: Rosmarinus officinalis'in (kuşdili, 2 farklı kemotipin) uçucu yağının diğer yağlardan daha etkili olduğu gözlend