The importance of Real-Time Polymerase Chain Reaction method in diagnosis of intestinal parasites in cases with diarrhea.

Diarrheal diseases cause significant morbidity in developing countries, and have a potential to cause severe complications. Stool samples collected from 272 patients with diarrhea in Adana, Turkey were screened using different laboratory methods such as the wet mount examination (WME), modified trichrome stain (MTS), modified acid-fast (MAF) stain, enzyme linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (realtime PCR) for intestinal parasites. Intestinal parasites were detected in 25.4% (69/272) of the patients. Of the parasites detected, Cryptosporidium spp. was the commonest 10.3% (28/272) followed by Blastocystis spp., 5.9% (16/272), Entamoeba dispar 2.6% (7/272), Giardia lamblia 2.6% (7/272), Entamoeba coli 1.8% (5/272), Entamoeba histolytica 0.7% (2/272), Isospora belli 0.7% (2/272), Trichuris trichiura 0.4% (1/272) and Strongyloides stercoralis 0.4% (1/272). Our study shows that there are differences in results obtained using different laboratory methods; 22.1% (60/272) with real time-PCR, 10.3% (28/272) with ELISA, 9.9% (27/272) with MTS, 6.6% (18/272) with WME, and 5.9% (16/272) with MAF stain. The differences in the level of positivity using different laboratory methods were sequenced in the diagnosis of intestinal parasites ranging from highest to lowest, as real-time PCR>ELISA>MTS> WME>MAF stain. Molecular techniques are recommended as diagnosis of choice especially in patients suffering from chronic diarrhea.

Entomological Survey for Sand Fly Fauna in Imamoglu Province (Cutaneous Leishmaniasis Endemic Region) of Adana, Turkey.

Leishmaniasis, presenting in two clinical forms, cutaneous and visceral in Turkey, is widespread in most of the countries in the Mediterranean Basin. An average of 10 to 13% of cases are reported from Adana every year. This paper presents the results of an entomological survey in an endemic focus of cutaneous leishmaniasis in Imamoglu province of Adana in Turkey.We collected 654 sand fly specimen using 100 light traps in 20 nights in August 2013 and July 2014. Several keys and previous drawings were used in the identification of the species. In total, six Phlebotomus species were identified; Phlebotomus tobbi (50.3%), Phlebotomus papatasi (34%), Phlebotomus perfiliewi (2.9%), Phlebotomus sergenti (0.4%), Phlebotomus neglectus/syriacus (0.8%), and Sergentomyia spp. (11.5%). In addition, the female/male rate was found to be 0.84.Collected sand flies (44 pools of 1-10 individuals) were analyzed microscopically, and no promastigotes were found in the midgut specimens. Using a genus specific real time-polymerase chain reaction (PCR) assay for simultaneous detection of Old Word Leishmania. We detected only 3 of the 44 pools with Leishmania by genus-specific real-time PCR assay.P. tobbi was found to be dominant species in spite of the differences in sand fly fauna composition. To the best of our knowledge, this is the first study for sand fly fauna including 15 villages where endemic focus of cutaneous leishmaniasis in Imamoglu, Adana Province, Turkey.

Prevalence of Dirofilaria immitis in dogs from Hatay province, Turkey.

The present study was conducted to determine the prevalence of canine dirofilariosis in Hatay province, south of Turkey. A total of 269 blood samples were collected from owned dogs in this multi-centre survey between March and July 2006. Blood samples were examined by modified Knott and enzyme-linked immunosorbent assay (ELISA) techniques to detect circulating microfilariae and antigens of Dirofilaria immitis, respectively. Seventy out of 269 dogs (26.0%) were positive for D. immitis. However, 61.4% of positive dogs had occult infection. The prevalence of canine dirofilariosis was heterogeneous in Hatay province, with higher values in shoreline (33.0%) and riverside (30.9%) areas followed by the lowland (25.5%) or mountainous (15.2%) areas. No statistically significant differences were observed in relation to sex (females, 33.3%; males, 24.4%, P>0.05). When evaluating the prevalence of D. immitis by age, the highest prevalence was observed in dogs older than 4 years of age. Large breeds (29.6%) and the dogs living outdoors (30.2%) showed a higher prevalence in comparison to small breeds (21.4%) and the dogs living indoors (10.5%), respectively. In conclusion, according to the results of this study canine dirofilariosis had a high prevalence in Hatay province. Therefore, prophylaxis against heartworm is advisable to decrease the incidence of canine dirofilariosis.

Pneumocephalus at the cerebellopontine angle secondary to chronic otitis media.

Intracranial air is usually asymptomatic but carries a potential risk of increased intracranial pressure or meningitis which require immediate therapy. Although pneumocephalus is quite common following trauma, especially with a fracture involving paranasal sinuses it is a rare manifestation of chronic otitis media. In this report, a case with a tension pneumocephalus at the cerebellopontine angle following a chronic mastoid infection is presented and the possible mechanism, diagnostic measures and the surgical management is discussed.