Heavy metal resistant of E. coli isolated from wastewater sites in Assiut City, Egypt.

Twelve isolates of E. coli were isolated from wastewater of El-Malah canal located in Assiut, Egypt and were checked for their heavy metal tolerance. One isolate has tested for its multiple metal resistances and found to be plasmid mediated with molecular weights 27 and 65 kb for hexa- and trivalent chromium. It was identified as E. coli ASU 7. Its minimal inhibitory concentration (MIC) for Cu(2+), Co(2+), Ni(2+), Zn(2+), Cr(6+), Cr(3+), Cd(2+) and Pb(2+) were 1.57, 2.55, 1.7, 9.17, 0.48, 7.69, 4.4 and 3.1 mM, respectively. Growth kinetics was determined under Cr(6+) and Cr(3+) stress. SDS-PAGE of protein profile shows that 10 ppm (0.19 mM) of Cr(6+) induces new protein with molecular weight 23 kDa.

Isolation, characterization of heavy metal resistant strain of Pseudomonas aeruginosa isolated from polluted sites in Assiut city, Egypt.

Sixty six isolates of Pseudomonas spp. were isolated from wastewater of El-Malah canal located in Assiut, Egypt and were checked for their heavy metal tolerance. One isolate has tested for its multiple metal resistances and found to be plasmid mediated with molecular weight 27 Kb for nickel and lead. It was identified as Pseudomonas aeruginosa ASU 6a. Its minimal inhibitory concentration (MIC) for Cu(2+), Co(2+), Ni(2+), Zn(2+), Cr(3+), Cd(2+)and Pb(2+) were 6.3, 5.9, 6.8, 9.2, 5.8, 4.4, and 3.1 mM, respectively. Growth kinetics and the maximum adsorption capacities were determined under Ni(2+) and Pb(2+) stress. The latter heavy metals induced potassium efflux and were used as indicator for plasma membrane permeabilization.

Human immunodeficiency virus-associated disorders in Pakistan.

We have documented evidence of the human immunodeficiency virus (HIV) infection in four individuals including a blood donor and three members of a family (husband, wife, and a child) in Karachi, Pakistan. Our data indicate that HIV has been transmitted to the wife of the seropositive male, a drug abuser, in the recent past and that she has passed the virus to her newborn child perinatally/ transplacentally. The two seropositive males (blood donor and drug abuser) were diagnosed clinically as having persistent generalized lymphadenopathy, an AIDS-related condition (ARC), and the child presented with developmental disorders and neurologic manifestations. This is the first report of AIDS/ARC cases from Pakistan that can be directly related to HIV infection and its heterosexual transmission.

Changing spectrum of typhoid.

To determine the changing spectrum of typhoid fever, a study was conducted on 240 cases of typhoid fever, admitted over a period of 4 years. The classical 'Stepladder fever' and 'relative bradycardia' were less commonly seen. Presentation as hepatitis, psychosis, meningism, myocarditis, polyneuropathy and diarrhea were encountered in a small number of patients. Reversible proximal myopathy occurred in four patients and all of them recovered completely over a period of 2-3 weeks. The total leukocyte counts were within normal range in most of the cases. Bone marrow cultures were positive in all untreated and partially treated patients. All strains of Salmonella typhi in this study were sensitive to ofloxacin ceftriaxone and ciprofloxacin.

Falciparum malaria or fulminant hepatic failure?

Six cases of severe jaundice and encephalopathy due to falciparum hepatitis initially diagnosed as fulminant hepatic failure are reported. This rare presentation of falciparum malaria should be suspected in patients with persistent fever, jaundice, encephalopathy and hepatomegaly. The diagnosis should be further suspected when the liver function tests show a predominantly conjugated hyperbilirubinemia with only modest elevation of liver enzymes and alkaline phosphatase. Liver biopsy is valuable in establishing the diagnosis at all stages of the disease.

Sickle cell anaemia in Pakistan.

The sickle cell gene is found predominantly in Equatorial Africa and amongst the negro population in the United States. It has also been reported in Saudi Arabia, the Middle East, Southern India and Iran. Despite human migration from the Middle East, Iran and India to Pakistan, there have to date been no reported cases of sickle cell disease in Pakistan to the best of our knowledge. But unfortunately there has been no population screening to find out the true incidence of the disease. Our study demonstrates that the disease is not totally non-existent in Pakistan: over a two-year period we have collected eight cases in our department. Electrophoretic screening is obviously needed to find out the true incidence of the disease/trait.

AIDS and HIV associated disorders in Karachi.

In a seroepidemiological study for the prevalence of HIV infection in Pakistan, individuals from different groups were tested for HIV antibodies using ELISA. Positive results were confirmed by western blot. Out of 413 individuals screened four were found positive by ELISA, of these three were confirmed by western blot. Two cases were foreign nationals visiting Pakistan, one of them died of full blown AIDS, the other did not show any AIDS related condition. The third case was a Pakistani national who presented with full blown AIDS with toxoplasmosis. To our knowledge this is the first case of full blown AIDS reported in a Pakistani national. The fourth case was an asymptomatic promiscuous lady who could not be traced further. Blood transfusions abroad and sexual contacts were responsible for HIV infection in these cases.

Transverse myelitis and hepatitis in varicella.

We describe a case with several grave complications of varicella rarely encountered in previously healthy young individuals.

Primary hepatic actinomycosis: a diagnostic problem.

A fatal case of hepatic actinomycosis in an immuno-compromised host is described. Diagnosis was delayed because of the rarity of this disease and because amoebic liver abscess, common in the tropics, has a similar presentation.