The predictive role of biomarkers for mortality in COVID-19 patients

Many biomarkers are used in addition to radiologic examinations to determine the severity of COVID-19. This study aims to determine WBC, neutrophil, lymphocyte, platelet, D-dimer, CRP, AST, ALT, LDH, PT, APTT, INR, urea, creatinine, lactate, and ferritin levels in COVID-19 patients and the effect of their changes on mortality rate. The study was conducted between 11 March 2020 and 31 August 2020 (during the COVID-19 pandemic). A total of 502 patients older than 18 years who presented with suspected COVID-19 were included in the study. Of these 502 patients who applied to the hospital, 229(45.6%) were male and 273(54%) were female. 301(60%) patients were diagnosed with COVID-19 through computed tomography and PCR tests. 201(40%) patients with negative test results constituted the control group. Patients with positive test results 48.2% (n=145) were men, and 51.8% (n=156) were women. The median age of the patients was 51±25 years. The patients tested positive for COVID-19 were divided into three groups as outpatients (26.9%), inpatients (68.8%), and intensive care unit patients (4.3%). The mortality rate of the patients followed via the patient follow-up system after 30 days was determined as 2.7%. The biomarker values of patients examined in this study tested negative and positive for COVID-19 were compared. In the study, D-dimer, ferritin, Lactate, AST, ALT, LDH, Urea, Creatinine, APTT, and INR levels were found to be higher in the positive tested patients than the negative ones. In the study, it was concluded that neutrophil, lymphocyte, CRP, and ferritin ratios should also be followed in the follow-up phase of the disease. It is important that additional measures should be taken in cases when these biomarkers increase by following the values of the patients who started taking treatment. Also, the ratio of biomarkers is crucial in determining whether the treatment has been effective or not.

Factors influencing Helicobacter Pylori positivity in children

Background

Helicobacter pylori (H. pylori) is a common bacteria all over the world. The factors influencing the acquisition and prevalence of H. pylori infection are still poorly understood.

Aims

The aim of this study was to determine the factors that may affect H. pylori positivity in patients who presented to the pediatric clinic.

Subjects and Methods

The study included 374 children who attended the pediatric clinic with gastrointestinal complaints. The demographic characteristics of patients were recorded, and fecal samples were examined for H. pylori positivity with a prepared kit procedure. In addition, the samples were examined under microscope for the diagnosis of parasites in stool. The Chi-square analysis and binary logistic regression analysis were used for data analysis. The odds ratio was calculated as an estimate of the relative risk. Results: The study found the incidence of H. pylori positivity to be 18.7%. It was observed that in all H. pylori positive patients had growth retardation. H. pylori positivity had no significant relationship with the presence of parasites in the stool (p = 0.113). The results of the Chi-square test showed that H. pylori positivity was significantly changed age groups and educational levels. Logistic regression analysis showed that "age" and "educational status" are significant predictors of H. pylori positivity (p = 0.023 and 0.017, respectively). The risk of H. pylori positivity in the 11-18 age group patients was found about two times (OR: 2.024) higher than in the 6-10 age group patients. The risk of H. pylori positivity in those with education level of "Middle school and above" were found to be twice as high (OR: 2.126) than those with a primary education level (OR: 2.126).

Conclusion

In this study, adolescent age and middle school and above level were found to be risk factors for H. pylori. This suggests that there may be other conditions influencing H. pylori positivity. Also, since the frequency of H. pylori is high in those with growth retardation, H. pylori should be considered when evaluating children with growth retardation.

[Intestinal strongyloidiasis in a psoriasis patient with diabetes]

This case study underlined the importance of parasitological examination before starting immunosuppressive treatment since a heavy burden of strongyloidiasis could lead to fatal infections. It represents the first strongyloidiasis from a patient with psoriasis and diabetes mellitus in this country. In the case, 59 years old female subject had psoriasis for six years and during the treatment with topical corticosteroid and anti-psorial medication, psoriatic lesions flared up. The patient had constipation and foul smelling stool complaints. Blood tests showed an increase in eosinophil and a decrease of vitamin B12 level. Stool examination indicated the presence of abundant amount of S. stercoralis larvae. The patient was given albendazole for two weeks. After treatment, the symptoms decreased and S. stercoralis larvae were not detected in stool. In this case, it was emphasized that the clinicians planning immunosuppressive regimens should bear in mind that parasitic examination could be present in the subjects.

[Tuboovarian abscess caused by hydatid cyst: a rare case]

Primary lesions of hydatid cysts caused by Echinococcus granulosus, are frequently localized in liver, followed by lungs, muscles, kidneys, spleen and bones. Pelvic inoculations are rare and usually occur as a secondary infection. In this report, a case of primary hydatid cyst in the abdomen, spleen and pelvic organs, clinically mimicking tuboovarian abscess, was presented. A nineteen-years-old female patient was admitted to the gynecology outpatient clinic with the complaint of abdominal pain for two days. The case was considered as tuboovarian abscess according to the initial examination findings and hospitalized for treatment and follow-up. In transabdominal ultrasound examination, 44 x 43 mm thin-walled septated cysts in the left ovary and 65 x 65 mm thin-walled multiloculated cysts in the spleen were detected. Abdominal computerized tomography also yielded multivesicular cystic masses in spleen, front abdominal wall and the left ovary. Since the clinical and vital findings worsened, she initially underwent ovarian cystectomy by laparoscopy, then abdominal cystectomy and splenectomy. The operation material examined macroscopically was compatible with hydatid cyst with the characteristics of a germinative membrane and hydatid sand. The diagnosis was confirmed by histopathological examination. The patient was discharged without complication on post-operative sixth day, with a recommendation of albendezol (15 mg/kg/day, 3 months) treatment. Since the patient had undergone emergency surgery, indirect hemaglutination (IHA) test had not been performed pre-operatively. However, post-operative third month serum sample revealed a positive (1/32) IHA titer. In conclusion, hydatid cyst should be kept in mind in the differential diagnosis of patients with abdominal pain, in response to the high prevalence of the parasite in our country.

[Frequency of intestinal parasites among administrators and workers in sanitary and non-sanitary institutions]

OBJECTIVE

Transmission of parasites generally occurs through fecal-oral means directly from human to human or through receiving eggs and cysts by means of nourishment. The aim of the study was to investigate the frequency of intestinal parasites among administrators and workers in sanitary and non-sanitary institutions.

METHODS

Stool specimens were examined using native-lugol, Trichrome and acid-fast stains methods.

RESULTS

23.7% of the 2443 fecal specimens were found to be positive. The frequencies of parasites were found to be 9.8% for Entamoeba coli, 7.2% for Blastocystis hominis, 7.2% for Iodamoeba butschlii, 3.4% for Giardia intestinalis, 0.9% for Dientamoeba fragilis, 0.13% for Entamoeba histolytica, 0.08% for Chilomastix mesnilii, 0.04% for Trichomonas intestinalis, 0.04% for Entamoeba hartmanni, 0.04% for Hymenolepis nana, 0.04% for Taenia spp. and 0.04% for Enterobius vermicularis.

CONCLUSION

This rate of parasite positivity among healthy subjects visiting hospital for porter examination suggests that intestinal parasites still constitute a public health problem in the region. Moreover, it can be considered that one important factor in the frequency of the parasite can be both the nature of the jobs of administrators and workers in sanitary and non-sanitary institutions and their interaction with people during sales.

[The rates of seropositivity and seroconversion of toxoplasma infection in pregnant women]

Infections caused by Toxoplasma gondii are frequently asymptomatic in healthy adults, however they may be serious in pregnant women and immunocompromised patients. The aims of this study were to investigate the rates of seropositivity and seroconversion in pregnant women and newborn cord blood samples, and to evaluate those data in the view of relation to lifestyle and nutrition. A total of 312 pregnant women (mean age: 28.1 ± 5.2 years) who were admitted to and followed by gynecology clinics of Inonu University Medical School Hospital, Malatya, Turkey were included in this observational and cross-sectional study. Anti-toxoplasma IgG and IgM antibodies in pregnants and newborn cord sera were screened by commercial ELISA and immunofluorescence antibody (BioTek; USA) methods. A total of 312 sera from pregnant women and 312 cord blood samples during delivery were collected. IgG seropositivity rate in pregnants was found as 37.5% (117/312), seroconversion was not determined in restrained pregnants and T.gondii IgM was found negative in all pregnants. Also in all newborns IgM was negative and IgG seropositivity was determined as 33.3% (104/312) in cord blood. There was a statistically significant relationship between IgG seropositivity and raw meat consumption (p< 0.001) and being engaged in agriculture (p< 0.005). It was concluded that toxoplasma antibodies should routinely be searched on the first visit of the pregnants and the seronegative cases should be trained about the preventive measures related to toxoplasmosis. The follow-up of toxoplasma seronegative cases during pregnancy can be achieved by only detecting the IgM class antibodies and this will also reduce the cost of screen test.

[Investigation of Microsporidia prevalence by different staining methods in cases of diarrhea]

Microsporidia, depending on their different species, generally lead to self-limited, sporadic and mild infections such as diarrhea, corneal ulcer and myositis. They are considered as opportunistic pathogens in HIV-positive patients however in recent years Microsporidia have been detected also in immunocompetent individuals as a cause of diarrhea. Diagnosis of Microsporidia depends on the detection of spores or different developmental stages of protozoon in stool, urine, sinus aspirates, nasal discharge, bronchoalveolar lavage or tissue biopsies. Diagnosis of Microsporidia infections is usually achieved by the use of different staining methods, serological tests, polymerase chain reaction, and electron microscopic methods. The aims of this study were to detect the incidence of microsporidia in patients with diarrhea by using three different staining methods and to compare the performance of these methods. A total of 225 stool samples from diarrheal patients (84 were children, 141 were adults; 103 were female, 122 were male) admitted to Gazi University Medical Faculty Hospital between March-June 2009, have been evaluated in the laboratory of Medical Microbiology Department. Stool samples were examined in terms of the presence of Microsporidia spores by Weber's modified trichrom staining (MTS), calcofluor (CF) and acridine orange (AO) staining methods. Microsporidia positivity rate was 9.8% (22/225) in the diarrheal patients, the rate being 9.5% (8/84) in children and 9.9% (14/141) in adults. There was no statistically significant difference between age and gender groups (p> 0.05) regarding Microsporidia detection. When MTS was considered as the reference method, sensitivity, specifity and consistency of AO staining were estimated as 100%, 91.6% and 92%, respectively, while those rates for CF staining were 95.4%, 99.5% and 99%, respectively. There was very strong and significant correlation (r= 0.950, p< 0.001) between CF staining and MTS, while there was strong and significant (r= 0.719, p< 0.001) correlation between AO staining and MTS. Although AO staining is rapid and convenient, the positive predictive value was measured very low (56.4%) and the interpretation of stained slides was very difficult since background of the slides was stained orange and there were a lot of dye artefacts. In conclusion, screening Microsporidia in all diarrheal stool samples is of diagnostic value. To increase sensitivity and reliability in the detection of Microsporidia spores in diarrheal samples, initial application of calcofluor staining should be followed by the confirmatory MTS method.

[Investigation of microsporidia in patients with acute and chronic urticaria]

Microsporidia species are one of the major causes of severe diarrhea especially in immunocompromised patients, however they also cause infections in immunocompetent subjects. Urticaria, which is a common dermatologic disease may be triggered by drugs, infections, foods or food additives, psychogenic factors and autoimmune, metabolic and malignant diseases. While the etiologic grounds of acute urticaria are generally identified, the etiology remains unknown in most of the chronic urticaria cases. The studies on the roles of parasitic infections in the etiology of urticaria have indicated that the most responsible protozoa are Giardia intestinalis and Blastocystis hominis. However, no data have been found in the literature concerning the relationship between Microsporidia and urticaria. The aim of this study was to investigate the presence of Microsporidia spores in the stool samples of patients diagnosed as acute or chronic urticaria in dermatology clinics and to determine the rates of positivity. All of the samples stained with modified trichrome and calcofluor staining methods were examined microscopically. The samples were accepted as positive when the spores of Microsporidia were detected by both of the staining methods. Microsporidia were detected in 26 (19.7%) of the patients and in 1 (2.8%) of the control subjects. Thus the total rate of positivity was 16% (27/168). In cases with acute/chronic urticaria, microsporidia positivity rate was found significantly higher than the control group (p= 0.028; p< 0.05). No statistically significant difference was detected between Microsporidia positivity and age or gender (p= 0.27 and p= 0.99, respectively; p> 0.05). In conclusion, Microsporidia should be taken into consideration in patients with unknown origin of urticaria. However, advanced studies are needed for supporting the relation between Microsporidia and acute/chronic urticaria.

[Malondialdehyde, glutathione and nitric oxide levels in patients with Enterobius vermicularis infection]

The aim of this study was to investigate the levels of malondialdehyde (MDA) and nitric oxide (NO) which are indicators of oxidative stress and also the level of glutathione (GSH) which is an antioxidant molecule, in patients with Enterobius vermicularis infection. A total of 41 patients (mean age: 36.4 years; 31 were male) and 40 healthy controls (mean age: 40.2 years; 28 were male) were included to the study. None of the patients and controls have had history of hormone/steroid drug use, smoking and alcoholism. The mean level of GSH in patient and control groups were found 1.17 +/- 0.02 micromol/l and 2.49 +/- 0.10 micromol/l; MDA 26.97 +/- 2.06 micromol/l and 19.47 +/- 2.25 micromol/l; NO 20.74 +/- 0.60 micromol/dl and 17.83 +/- 0.50 micromol/dl, respectively. The mean GSH level in patient group was statistically significantly lower (p < 0.05) than controls, while the mean MDA and NO levels were statistically significantly higher (p < 0.05). These results indicated that the consumption of GSH was increased due to the severity of oxidative stress in patients infected with E. vermicularis. Detailed experimental and clinical studies are required to enlighten the relation of GSH in the pathogenesis of E. vermicularis infection. Since oxidative stress is increased during enterobiosis, the use of antioxidant agents (e.g. vitamins C and E) for the supportive treatment deserves evaluation.

[Case report: primary renal hydatic cyst]

Hydatic cyst is a prevalent parasitic disease in Mediterranean region, Middle East and Australia. Its diagnosis is sometimes problematic because of nonspecific complaints and unavailability of any positive result in a routine laboratory analysis. In this study, an primary right renal hydatic cyst which was found in a young female has been presented. The multilocular cyst was completely removed by total nephrectomia surgery. A late diagnosis due to unclear clinic manifestations was considered to be the main reason for the loss of the organ. It will be beneficial to consider a renal hydatic cyst when the patients with blurred flank pain are encountered.

[The prevalence of Microsporidium among patients given a diagnosis of cancer]

The aim of this study was to determine the frequency of Microsporidium among patients given a diagnosis of cancer. For this purpose fecal samples from 320 patients aged 23.60+/-23.00 years were examined using native-Lugol and sedimentation methods and evaluated with modified trichrome, trichrome, and calcofluor dyes. Moreover a control group of 320 non-cancer patients was set up. While 10.9% of the patient group was found to have Microsporidium, only 5.6% of the control group did. Comparison between the control and patient groups in terms of presence of Microsporidium revealed a statistically significant difference. The analysis of a possible relation between intestinal parasites and the presence of Microsporidium revealed a statistically significant correlation between Microsporidium and Blastocystis hominis (P < 0.05). The frequencies of intestinal parasites in the control group and the patient group were found to be 17.8% and 18.1%, respectively. From the findings it was concluded that presence of intestinal parasites and Microsporidium in cancer patients can cause critical problems and adversely affect the therapy. Moreover it was suggested that cancer patients should be informed about regular feces examination and protection against parasites in order to improve their life standards and protect them against parasite infections during treatment.

[Demodex spp. in hairy skin biopsy specimens]

It has been reported that Demodex mites play a role in the pathogenesis of rosacea, acne vulgaris, perioral dermatitis, seborrhoeic dermatitis, micropapular-pruritic dermatitis, and blepharitis. Methods used for diagnostic purposes included cyanoacrylic adhesives, comedone extractor, cellophane tape preparations, skin scraping, punch biopsy and standardized surface skin biopsy. This study is a retrospective work. The aim of the present retrospective study was the investigation of the incidence of Demodex mites using histopathological examination of skin biopsy specimens of keratinized cysts, fungal spores, tricholemmal cysts, nevi, dermatitis, fibrosis, carcinoma and inflammation of the scalp. Fifty-nine biopsy specimens were examined histologically after staining with hematoxylen-eosin. Demodex mites (i.e., tricholemmal cyst, dermatitis, sebaceous cyst, carcinoma, keratose cysts, nevi, fungal spores) were found in 9 (15.3%) of them. It was concluded that since this parasite is found in pathological cases of the scalp, the possible role of Demodex in the pathogenesis of such diseases should also be evaluated.

[A case of alveolar echinococcosis in Malatya province]

The disease resulting from being infected with the larval stage of Echinococcus multilocularis is called alveolar echinococcosis (AE). In our country AE is seen in eastern and southeastern regions of Anatolia. Previously no case of AE had been reported by any hospital in Malatya. In this one case, a 70 year-old woman who presented at the Inönü University Turgut Ozal Medical Center with a right upper quadrant abdominal pain was given a diagnosis of cystic echinococcosis (CE) by dynamic liver computed tomography. The pathological examination following the cystectomy revealed the presence of AE. This is a report of the first AE case detected in Malatya province.

A comparison of cytological and parasitological methods in the diagnosis of Trichomonas vaginalis

Trichomonas vaginalis (T. vaginalis), which causes urogenital system infections in humans, develops symptomatically and asymptomatically. T. vaginalis in females is diagnosed using direct microscopy, Giemsa staining, and cultivation methods for examination of samples derived from the vaginal posterior fornix. Serologic methods can also be employed. In cytological diagnosis, the ectocervical smear is examined using the Papanicolaou (PAPS) stain. The aim of the present study was to compare the efficacy of the methods used in cytological and parasitological diagnosis. For this purpose, 506 female patients who visited the Obstetrics and Gynecology policlinic of the Academic Hospital of the Faculty of Medicine, Inönü University during a course of six years were involved in this study. The samples derived from the vaginal posterior fornix were examined in the parasitology laboratory, while the ectocervical samples were examined in the cytology laboratory. T. vaginalis was detected in 4.6% of the samples examined in parasitology laboratory, while parasites were found in only 0.9% of the samples taken to the cytology laboratory. The statistical analysis revealed a significant difference (P<0.05). It was concluded that parasitological methods are more sensitive than cytological methods in the diagnosis of T. vaginalis.

[The prevalence of Microsporidium among adult patients admitted to the parasitology laboratory at the Inonu University Turgut Ozal Medical Center]

Microsporidium can cause acute and self-restricted diarrhea cases among immunocompetent patients. The aim of this study was to investigate the presence of intestinal parasites and Microsporidium in patients presenting at the internal diseases polyclinic with some digestive system complaints but no immune suppressive problems, and to detect whether it has anything to do with the complaints. A total of 781 fecal samples were investigated for intestinal parasites and Microsporidium. Intestinal parasites were found in 16.11% and Microsporidium in 6.5%. A significant correlation was observed between the presence of intestinal parasites other than Microsporidium and dyspepsia, while in the case of Microsporidium, a significant frequency of dyspepsia and fatigue was observed. It was found that the presence of Microsporidium does not differ by age and gender. From the findings, it was concluded that patients with digestive system complaints should be examined for Microsporidium in addition to intestinal parasites, and the symptoms of dyspepsia and a lack of appetite should especially be given more careful attention.

[Malaria cases in Malatya during the past seven years]

Malaria can be seen in every region inhabited by human blood-sucking Anopheles and species of disease-causing Plasmodium. Since the region is on the crossroads of other cities where malaria is more widespread and it has a population of seasonal workers and an increasing number of tourists during the summer, additional imported cases may also be detected in the Malatya region. The aim of this study was to determine the state of malaria for the past seven years in Malatya. According to the records of the Malaria Control Unit of the Health Directorate of the Malatya province, 189 positive patients were reported during the seven years from 1999-2005. Of these cases, 186 (98.4%) were P. vivax, while 3 (1.6%) were imported cases of P. falciparum malaria. The rate of positivity was found to be 58.2% in male patients and 41.8% in female patients. Consequently, malaria can be said to persist as a health problem in Malatya region. It was concluded that people in the region should be informed about malaria and the ways to protect themselves.

[The frequency of intestinal parasites and head lice among students of the Akşemsettin Primary School for Deaf Students]

Parasitic infections especially affect those children in critical phases of growing and development. They can lead to malnutrition, malabsorption, mental and social adaptation problems, and critical illnesses that hinder productivity. This is an important health problem in Turkey, and intestinal parasites are quite frequently found in boarding school and care centers for children. The aim of this study was to discover and treat the parasitological agents found in the students of the Primary School for Deaf Students. A total of 117 fecal specimens and material from the perianal region (using the cellophane tape method) were collected from deaf students and examined during 2003-2004 school season. Also the students were scanned for adult head lice and their eggs. As a result, 53 (45.3%) children with intestinal parasites and 6 (5.1%) with head lice were detected in the study. The patients were treated and informed about means of protection. The same children were examined again after six months: Only 24 (20.5%) children had intestinal parasites and 2 (1.7%), head lice. Thus, the decrease in parasitic infections was found to be significant (qui-square test in dependent samples P < 0.05). Therefore it was concluded that the schools should be scanned for intestinal parasites and head lice, and both treatment and training in the subject should be given the necessary importance.

[Frequency of the appearance of Demodex sp. in various patient and age groups]

Demodex folliculorum and Demodex brevis are acari that can be found in hair follicles and sebaceous glands of the skin, especially on face of humans. In this study, Demodex sp was investigated in regard to allergic diseases, age and gender. A total of 197 patients (117 with rosacea, 29 with akne vulgaris, and 51 with allergic diseases) were examined using the standardized skin surface biopsy (SSSB) and 97 out of 197 (49.23%) cases were found to be positive by the Inonu University Medical Faculty Department of Parasitology. There was no significant difference between mite positivity and negativity between the genders, while a higher rate of Demodex sp. was found in patients with rosacea and a lower rate in patients under 20 years old (p0,005). As a result, patients over 20 years old, especially those with rosacea, must be investigated for Demodex sp.

[The relationship between the skin allergy test and house dust mites]

Since 1960 it has been known that house dust mites are related to allergy and that they cause pulmonary tract diseases. There are various house dust mites and among these Dermatophagoides pteronyssinus (Trouessart, 1897) and Dermatophagoides farinae (Hughes, 1961) are best known with regard to their medical importance and morphological characteristics. Skin tests are used to determine the role of mites in allergic diseases. The tests are performed by using D. pteronyssinus and D. farinae antigens. In order to study, the concordance between the skin test results and the presence of house dust mites, dust samples from the houses of 49 patients diagnosed with allergic diseases who underwent skin tests were taken to investigate the presence of mites in dust. House dust mites were determined in 23 (46.3%) of the houses. Mites were found in the houses of 15 (50.0%) of 30 patients with positive skin test results and 8 (42.0%) of 19 patients with negative skin test results. There was no significant difference between the skin test positivity and negativity in the presence of house dust mites (P>0,005). In conclusion, we thought that it was necessary to evaluate the presence of mites in the houses of people who have allergic symptoms even if they had negative skin test results.

[Malaria cases detected by active surveillance in Malatya]

Malaria continues to be an important health problem in and around Malatya. Although the disease can be kept under control thanks to the regular work of the Centre for the Struggle against Malaria, it can not be eradicated fully due to the socio-economic conditions in the region. The aim of this study was to determine the prevalence of the disease through active surveillance in those regions where it is most common. From 2003, until 2004, 8856 blood samples were collected at one month intervals and 66 patients were found to be positive. Sixty three of the patients were Plasmodium vivax positive and 3 patients, P. falciparum, positive. The questionnaire administered to the positive patients (ranging from 02-70 years of age) revealed that 8 of the cases originated from extra-provincial sources. Men constitute 43% of all patients and women, 23%. Consequently it was concluded in this study that malaria threatens the people in the region. Therefore it was considered important for the Malatya Centre for the Struggle against Malaria and the local university to cooperate in the struggle against malaria by offering planned training programs in public health.

[Incidence of intestinal parasites among primary school children in Malatya]

The aim of this study was to determine the incidence of intestinal parasites among primary school children in the central region of Malatya and to educate the children about parasitic diseases. During the study, cellophane tape preparations and stool samples that had been prepared using direct mounting methods were examined. In addition the students were informed about intestinal parasites. Parasitic infection was observed in 415 (22.5%) out of 1838 students and the highest rate of 10.6% was that of Enterobius vermicularis. The rates of Giardia intestinalis, Entamoeba coli, Blastocystis hominis, Taenia sp., Hymenolepis nana, Trichomonas hominis, Ascaris lumbricoides and Iodamoeba butschlii were found to be 8.5%, 1.9%, 1.4%, 0.3%, 0.1%, 0.1%, 0.05%, and 0.05%, respectively. Thus, intestinal parasites are important among primary school children in Malatya and it seems that there is a relationship between socioeconomic conditions and the rate of intestinal parasites.

[Investigation of the prevalence of Trichomonas vaginalis with respect to diverse social variables in women (Malatya, Turkey)]

Trichomonas vaginalis is a monoxen parasite and its definitive host is human. It is known that the way of life is an important factor affecting incidence because of sexual transmission. In the present study, the incidence of T. vaginalis has been investigated with direct microscopy, Giemsa staining and culture (cysteine-peptone-liver-maltose (CPLM)). The study included 675 females with complaints of vaginal discharge who presented at different health departments or hospitals in the Malatya region during 2000-2001. T. vaginalis was seen in 55 (8.1%) patients. In addition, during period of presentation, a questionnaire was used to determine the relationship between the sociocultural status of the women and the incidence of T. vaginalis. Some of the questions in this questionnaire showed statistically significant differences in T. vaginalis infections related to the women's sociocultural status. These are as follows: type of toilet used; method and frequency of bathing; type, color, odor and frequency of vaginal discharge, level of knowledge of common sexually transmitted diseases and trichomoniasis; employment or non-employment of herself and her husband; life style in home; and educational level of husband. However, there was no statistical difference seen between other questions in the questionnaire and the existence of T. vaginalis infection.

[Incidence of intestinal parasites in municipal sanitary workers in Malatya]

The incidence of intestinal parasites is closely related to such factors as the socio-economic level of the society, nutritional and hygienic habits, climate, environmental conditions, infrastructure and degree of literacy. In this study, the municipal sanitary workers who are regarded as a high risk group in Malatya were examined for intestinal parasites. Cellophane slides and fecal samples from 241 workers were examined and intestinal parasites were found in 93 (39.0%). The most common parasite was Entamoeba coli (34). Other parasites detected include Enterobius vermicularis (32), Giardia intestinalis (22), Blastocystis hominis (8), Iodamoeba butschlii (5), Entamoeba histolytica (2), Taenia sp. (2), Chilomastix mesnili (2), Dientamoeba fragilis (2), Entamoeba hartmanni (1), Trichomonas intestinalis (1) Hymenolepis nana (1), and Ascaris lumbricoides (1). A training seminary was conducted in order to inform all the workers about means of protection. The workers were given suitable treatment and were called for control after a month. The examinations revealed a significant decrease in the incidence rate of parasites (qui-square test in dependent samples P<0.05). It was concluded that offering training seminaries for certain occupational groups under risk is efficient in terms of protection.

[The first appearance in Malatya of Falciparum malaria originating in Uganda: Two cases.]

Malaria that is usually seen in tropical and subtropical areas and presents with acute paroxysmal febrile attacks is a parasitic infection caused by Plasmodium species. P. vivax malaria is usually seen in our country, but P. falciparum malaria is rare. Since P. falciparum malaria may cause fatal complications, urgent therapy is necessary. Two patients with a history of travel to Uganda where falciparum malaria is endemic were found to have the first falciparum malaria infection seen in Malatya.

[Analysis of anti-echinococcus antibodies in garbage men in Malatya.]

It has been reported that some occupation groups constitute a higher risk group with regard to hydatid cyst disease. Municipal garbage men also are under this risk especially in those places where untamed dogs are abundant. The aim of this study was to analyze the anti-Echinococcus antibodies in garbage men in Malatya who are regarded as high risk-group with regard to hydatid cysts. Two hundred and forty serum specimens were collected and were later analyzed with the manual indirect hemagglutination technique (IHAT) and indirect immunofluorescent technique (IFAT). Of these sera 17 (7.08%) were found to be seropositive. Garbage men who were found to be seropositive were examined for intestinal parasites using the cellophane type technique, native Lugol and sedimentation methods. It was found that the group members giving seropositive results were free of parasites such as Taenia saginata and Hymenolepis nana which may lead to cross reaction with Echinococcus granulosus. The garbage men were informed about the results of the examination and were oriented for further examinations. The seropositive rate of 7.08% found in this study is supports the view that the garbage men should be regarded as a risk group. In order to inform all garbage men about means of protection, training seminar were organized.

[Hydatid cyst prevalence in the region of Kars.]

It has been reported that hydatid cysts are more common in societies that breed animals. Although there have been epidemiologic studies in various regions of our country, there has been no previous study related to this issue in the province of Kars where stockbreeding is quite common. In this study in order to determine the seroprevalence in the city of Kars and villages of the province of Kars, 511 serums were obtained and the specimens were analyzed by the indirect hemagglutination technique (IHAT) and indirect immunofluorescent technique (IFAT). The seropositive rate of 34.6% (177) found in this study, leads to the conclusion that hydatid cysts may be an important health problem in the region, and it was concluded that it would be suitable to carry out more comprehensive studies in the region.