Plasmodium knowlesi is now added to the known four Plasmodium species (P.vivax, P.falciparum, P.malariae, P.ovale) as a cause of malaria in humans because of the recent increasing rate of cases reported from countries of southeastern Asia. P.knowlesi which infects macaque monkeys (Macaca fascicularis and M.nemestrina) is transmitted to humans especially by Anopheles leucosphyrus and An.hackeri mosquitos. First human cases of P.knowlesi malaria have been detected in Malaysia which have reached high numbers in recent years and also have been reported from countries of Southeast Asia such as Thailand, Philippines, Myanmar, Singapore and Vietnam. However the number of cases reported from western countries are rare and limited only within voyagers. This report is the first presentation of an imported case of P.knowlesi malaria in Turkey and aims to draw attention to the point that it could also be detected in future. A 33-year-old male patient from Myanmar who has migrated to Turkey as a refugee, was admitted to a health center with the complaints of fever with a periodicity of 24 hours, headache, fatigue, cough, sore throat, anorexia, myalgia and arthralgia. He was prediagnosed as upper respiratory tract infection, however because of his periodical fever and background in Myanmar, thick and thin blood films were prepared and sent to our laboratory for further examinations. Microscopic examination of the thin blood films revealed erythrocytic stages compatible with P.knowlesi (three large early trophozoites in an erythrocyte, three late trophozoites with compact view, and three late band-form trophozoites). Upon this, both real-time polymerase chain reaction (Rt-PCR) targeting the small subunit ribosomal RNA (SSU-rRNA) genes of Plasmodium genus and DNA sequence analysis targeting P.knowlesi rRNA gene were performed. As a result, the suspected identification of P.knowlesi by microscopy was confirmed by Rt-PCR and DNA sequencing. The patient was treated with chloroquine and primaquine combination and in the follow-up on the seventh day after the treatment, his parasitemia and symptoms had ceased. Although there were some previous reports concerning about imported patients infected with different Plasmodium species in our country, no cases of P.knowlesi have been reported. This first case presented here emphasizes the occurence of P.knowlesi malaria in Turkey hereinafter due to the increasing number of refugees.
The amended diagnosis of the genus Pratylenchoides and list of its valid species with synonyms are given. All the efficient diagnostic characters are listed. Modern taxonomic standard for the description of Pratylenchoides species is proposed; it may be used also in taxonomic databases. Tabular and text keys for all species of the genus are given. Five following groups are considered within the genus Pratylenchoides. The group arenicola differs from other groups in the primitive adanal bursa type; the groups magnicauda, crenicauda, ritteri, and megalobatus differ from each other in the position of cardium along the body axis in relation to the pharyngeal gland nuclei, pharynx types are named according to the stages of its evolution from the primitive tylenchoid pharynx (cardium situated posteriorly) to the advanced hoplolaimoid one (cardium situated anteriorly). Diagnoses and species compositions of the groups are given. Basing on the matrix of species characters, the dendrogram has been generated for all species of Pratylenchoides and for all characters (UPGMA, distance, mean character difference, random, characters ordered). Taking in view that the PAUP software gives equal weights to all characters, including the most important ones which define the prognostic species groups, the separate dendrograms for each prognostic species group were generated using the same above mentioned tree parameters. On the base of the records of Pratylenchoides species the matrices of plant host ranges, geographic distribution, and preferred soil-climatic conditions were developed. The dendrograms of the faunal similarities were generated using these matrices, with conclusions on a possible origin and evolution of the genus. The genus evolved from the flood lands with swampy soils and prevalence of dicotyledons (herbaceous Lamiaceae and woody Salicaceae families) to the forest mainland communities with balanced humidity and predominance of herbaceous Poaceae and Fabaceae with woody Fagaceae, Betulaceae, and Oleaceae. The leading factor of the evolutional adaptation to soil-climatic conditions was the factor of humidity, but its significance gradually decreased with the host change to more advanced plant taxa adapted to the communities with more dry balanced humidity. The genus took its origin on the south shores of Laurasia in the Cainozoe. Later, when Hindistant and Arabian Peninsula joined with Laurasia creating the Himalayas barrier, the Pratylenchoides spp. distributed by two branches: the northern one moved into Central Asia, East Europe and North America, and the south branch came into Indo-Malaya, West Asia and the north of Africa. The remnants of the ancient species groups remain in West Europe and East Asia. In the North America the genus gave an origin to its sister genus Apratylenchoides, which spread to the south up to Antarctica; another advanced branch spread in the North America reaching Alaska.
The population of developed countries is aging. Along with an increase in the proportion of people over 60 years of age among the population, their number is also increasing among patients with acute poisoning of chemical etiology. Analysis of the structure of acute poisoning in elderly and senile people for the period 2020-2022. It has been established that the proportion of patients of gerontological age in the overall structure of acute poisonings averages 13,5%, of which the largest group is persons aged 60-74 years (60,2%), women - 64,5%, men - 35,5%. It was found that in 61.5% of cases the cause of poisoning was suicide, 38,5% of poisonings were random. In the structure of acute poisoning in geriatric patients, psychopharmacological drugs are in the lead - 34,1%, corrosive substances - 15,9%, drugs acting on the cardiovascular system - 12,7%. These same toxicants are the main etiological cause of death. Patients over 60 years of age have a high mortality rate from 13,2 to 22,3%. Acute chemical poisoning in patients over 60 years of age is an urgent medical problem at the present stage, due to a significant incidence and high mortality, and require detailed study in order to improve the effectiveness of their treatment.
Running amok is considered a rare but dangerous act of violence which has been investigated predominantly on a case by case basis. German-wide data on amok cases covering the decades 1980 - 1989 and 1991 - 2000 were used to perform the first epidemiological study world-wide on the stability of socio-demographic, criminological and psychiatric variables of amok behaviour.
The medical-and-demographic processes as a starting point for the planning of means and resources for the short- and average-term future are forecasted in the paper on the basis of long-term peculiarities of the natural-science data and with respect for the social-and-economic crisis now underway in the country.
In order to analyze the relationship between the athletic qualification and syndrome of cardiac rhythm and conductivity disturbances in former athletes, a retrospective analysis of medical records of 39 male former athletes with cardiovascular complaints (mean age 61,6±11,3 years, mean duration of career in sports 23,9±17,3 years, mean duration of post-athletic period 20,1±9,9 years) was carried out. The patients were screened for cardiac arrhythmias and underwent echocardiography. The overall prevalence of sustained paroxysms of atrial fibrillation was 42%, increasing with the athletic qualification. Ryan grade 4b-5 premature ventricular contractions were found in 14% of patients. 3 parameters were found to be the independent predictors of arrhythmias in former athletes, i. e. athletic qualification, multifocal atherosclerosis (as an anti-risk factor), and age. The coefficient of determinance for the created prognostic model reached 43%. Further prospective studies are needed to validate an algorithm.
Description of the male Pterygodermatites nycticebi (Mönnig, 1920) unknown until the present study, and a study of the cephalic and cuticular structures of the female. This rictularid has a morphological evolution comparable to that of other males of the Rictulariidae parasitic in viverrid carnivores and in primates.
Description of a new species of Oxyurid: Syphacia (Syphatineria) callosciuri n. sp. parasite of a Sciurid rodent Callosciuris caniceps in Malaysia. In rodents belonging to the genus Callosciurus in Malaysia two species: S callosciuri n. sp. and S. owyangi Quentin, 1975, show morphological characteristics which are intermediate between the primitive Syphacia and two different lines of species parasite of recent rodents. These observations appear to indicate that the adaptation of Syphacia of Sciurids to the modern rodents has occured in South-East Asia.
Out of a group of 12 M. nemestrina (originating from Malaysia), 9 adults had shown clinical signs induced by ILS at 25 c/sec. Six of them (3 males, 3 females) were very photosensitive; however, only 2 presented eyelid and/or head jerks after the end of ILS (level 4), but never a generalized seizure. Tactile periorbital stimuli favoured myoclonus. In all but the two of level 4, the intensity of clinical signs varied from one day to the next. In all implanted adult macaques, spontaneous paroxysmal EEG activities were seen during slow sleep in mostly anterior areas, but also during waking and REM sleep in some of them; however, their occurrence depended upon the individual and were not in all cases related to their level of photosensitivity. During ILS, paroxysmal discharges (spikes and waves and/or polyspikes and waves), isolated or in bursts at 3-4/sec were bilateral and symmetrical. They started in fronto-rolandic regions, then became generalized. This observation constitutes a new fact since the discovery, in 1966, of the photomyoclonic syndrome of Papio papio, Macaca nemestrina being another species of subhuman primates with a marked predisposition to photosensitive epilepsy.
Scrub typhus is caused by the mite-borne bacterium Orientia tsutsugamushi. Imported cases have been suspected in Denmark but no diagnostic method has yet been available to confirm the diagnosis. This is a case report of a 38-year-old male admitted to hospital with high fever, severe malaise and headache after returning from Malaysia. Scrub typhus was suspected and the patient recovered after one week of doxycycline treatment. The pathogen was identified by use of microbiome 16S/18S rRNA next-generation sequencing on ethylenediamine tetraacetic acid (EDTA) blood, which in the future may serve an important role in the investigation of travel-associated infections.
Description of Trichospirura willmottae n. sp. parasite of the salivary ducts of Tupaia glis and T. sp. (single virgin female) parasite of the intestine of Myotis mystacinus in Malaysia. The two species are very closely related to the type species, a parasite of the pancreatic ducts of brasilian Primates, and can be differentiated mainly by the mensurations of the posterior extremities of the bodies. While the genus Rhabdochoma, parasite of the intestine of fresh-water fishes, underwent a very similar, but more or less pronounced, morphological evolution, it became adapted to many different hosts: Sea-fishes, Saurians, Mammals and to many locations. This evolutionary line includes six genera; Trichospirura, the only parasite in Mammals, is one of the more evolved. Some remarks are made on the host-distribution of Trichospirura, on the relationships between Rabdochonidae and Cystidicolidae and on the osmo-excretory apparatus of Trichospirura. The hypertrophy of this apparatus, which could be the consequence of the passage during the course of evolution from aquatic to terrestrial life, is comparable to that of the Pneumospirurinae.
Morphological study of two Spirura parasites of the oesophageal and the gastric wall of Tupaia and Nycticebus in Malaysia. -- Spirura malayensis n. sp. is found both in Tupaia in the District of Selangor (West Malaysia) and in Nycticebus coucang in Borneo. Its very primitive characteristics relate it to S. diplocyphos Chabaud, Brygoo and Petter, 1965, parasite of lemurs from Madagascar. Its larval development was obtained experimentally in Blatella germanica. -- Spirura aurangabadensis (Ali and Lovekar, 1966) described from a microchiroptera in India is found in west Malaysia in a Nycticebus coucang, and in a Tupaia glis. -- The distribution of the different species and the comparative study of the larval and adult cephalic structures show that the genus Spirura arose and became diversified in the old world in very primitive hosts according to two main evolutive lines.
Many trichostrongyloid species parasitizing rodents in Malaysia were described in 1967 in a thesis that was never published. Some of these species have since been redescribed sometimes with, sometimes without reference to the thesis. The remaining species are redescribed using information given in the thesis and certain additional morphological data (in particular, the synlophe) taken from study of the paratypes. The species are reclassified according to criteria established in the most recent classification. The following genera are proposed: Brevistriatinae: - Macrostrongylus n. gen. characterized by a caudal bursa of Calypsostrongylus type and absence of synlophe. Nippostrongylinae: - Malaistrongylus n. gen. characterized by a synlophe of Heligmonoides type but with a larger number of ridges and by the fusion of rays 4 and 5 in the caudal bursa. - Rattus strongylus n. gen. characterized by small, subequal dorsal left ridges and a total number of ridges less than 20. - Sabanema n. gen. characterized by small subequal dorsal left ridges and a total number of ridges greater than 30. The species under consideration are the following: Hepatojarakus malayae Yeh, 1955; Pithecostrongylus bicapitatus n. sp. (= P. bicapitatus Ow Yang, 1967, in litt); Macrostrongylus ratti n. gen., n. sp. (= Macrostrongylus ratti Ow Yang, 1967, in litt.); Calypsostrongylus malayensis Durette-Desset, 1976 (= Brevistriata malayensis Ow Yang, 1967, in litt); Fissicauda callosciuri (Supperer et Kutzer, 1964); Fissicauda brevispicula n. sp. (= Brevistriata brevispicula Ow Yang, 1967, in litt.); Nippostrongylus brasiliensis (Travassos, 1914); Orientostrongylus tenorai Durette-Desset, 1970 (= Longistriata selangora Ow Yang, 1967, in litt.); O. krishnansamyi Durette-Desset et Lim-Boo-Liat, 1974 (= Longistriata malaccae Ow Yang, 1967, in litt.); Heligmonoides bulbosus n. sp. (= Heligmonina (Heligmonoides) bulbosa Ow Yang, 1967, in litt.); Heligmonoides lanceolatus n. sp. (= Heligmonina (Heligmonoides) lanceolata Ow Yang 1967, in litt.); Malaistrongylus odontospicularis n. gen., n. sp. (= Malaistrongylus odontospicularis Ow Yang, 1967, in litt.); Paraheligmonelloides triangulus n. sp. (= Longistriata triangulum Ow Yang, 1967, in litt.); P. annandalei n. sp. (= Longistriata annandalei Ow Yang, 1967, in litt.); P. rajah n. sp. (= Heligmonina (Heligmonoides) rajah Ow Yang, 1967, in litt.); Rattustrongylus odontoconus n. gen., n. sp. (= Longistriata odontocona Ow Yang, 1967, in litt.); R. rotundoconus n. sp. (= Longistriata rotundocona Ow Yang, 1967, in litt.); Sabanema sabana n. gen., n. sp. (= Longistriata sabana Ow Yang, 1967, in litt.); S. kepongi n. sp. (= Longistriata kepongi Ow Yang,
The prevalence of mycobacterial infection in AIDS patients has increased in Japan. This report describes details of the clinical and radiological features of eight AIDS patients with mycobacterial disease (6 with M. tuberculosis infection and 2 with M. kansasii infection) in our hospital during the period from October 1995 through February 1997. Six of the 8 were men, and two were women. The mean age was 36.5 years. Six were Japanese, one was from Myanmar, and one was Malaysian. The median CD4 positive T lymphocyte counts (CD4 count) at the time of diagnosis of the M. tuberculosis was 75.5 (range 14-569/microliter, and the M. kansasii was 21.5 (range 19-24)/microliter. Clinical findings and symptoms of all patients were non-specific, but almost all patients had a cough and fever. In the radiographic findings, the patients of the M. tuberculosis group presented multiple hilar and mediastinal lymphadenopathy, miliary shadow, and obstructive pneumonia. Both M. kansasii patients showed a multiple infiltration shadow. There were no drug resistant strains in M. tuberculosis except on isolate with moderate resistant. to Streptomycin. These observations suggest that AIDS-associated mycobacterial disease shows atypical clinical and radiological features in some cases, especially in advanced stages of AIDS. Therefore, we need to recognize the characteristics of the clinical and radiological features of the patients with mycobacterial diseases and AIDS.
Since 2011, about 100 travellers to the island of Tioman, Malaysia, have been diagnosed worldwide with suspected muscular sarcocystosis, a previously only sporadically observed parasitic disease. Source of infection and therapy remain unclear. Final diagnosis requires microscopic identification of cysts in muscle biopsies. The study objective was a systematic description of characteristic symptoms, laboratory investigations and treatment response.
Melioidosis, an important diagnosis in the severely ill traveler Melioidosis is a common tropical infection in Southeast Asia and is caused by the highly pathogenic soil bacterium Burkholderia pseudomallei. Diagnosis and treatment is often challenging due to variations in clinical presentation, limited antibiotic susceptibility and high risk of recurring infection. In this report, three cases with different clinical presentations are described.