SUMMARYPurpose: To assess the association between epilepsy and exposure to the parasites, Toxocara canis and Taenia solium in a slum-community in India. Methods: A door-to-door survey to determine the prevalence of epilepsy was carried out by trained field workers. For every case, one age-and gender-matched control was selected from the same community. Serologic evaluation was carried out to detect antibodies against T. canis and T. solium. Key Findings: The crude prevalence of active epilepsy was 7.2 per 1,000. We enrolled 114 people with active epilepsy and 114 controls. The prevalence of antibodies to T. canis was similar in people with active epilepsy (4.7%; 5 of 106 people) and in controls (5.7%; 6 of 106 people). The prevalence of antibodies to T. solium was 25.5% (27 of 106) in people with active epilepsy, significantly higher than in controls (12.3%; 13 of 106 cases; p = 0.02). Adjusted conditional (fixed-effects) logistic regression estimated an odds ratio of 2.8 (95% confidence interval 1.2-6.8) for detection of T. solium antibodies. Nineteen people with active epilepsy demonstrated evidence of neurocysticercosis (NCC) on magnetic resonance imaging (MRI), including 7 (36.5%) with solitary cysticercus granuloma. Significance: Our findings do not support an association between epilepsy and exposure to T. canis in the community studied. A significant association between T. solium exposure and epilepsy was observed. Of those with active epilepsy and evidence of NCC on MRI, a large proportion demonstrated solitary cysticercus granuloma.

Background: During recent years, fungal infections have risen exponentially and are a cause of significant morbidity and mortality in hospitalized patients, especially in the critical care setting. There is paucity of data from India on fungal pathogens. Methods:We prospectively studied patients admitted to medical and surgical critical care section of a tertiary care institute in northern India. The clinical samples of patients were processed in Department of Microbiology for isolation and identification of fungi by using standard protocols over a period of one year. The patients were categorized into fungal infection and colonization groups. The demographic data and risk factors for fungal infection and colonization were evaluated.Results: Ninety one (82.7%) of the 110 patients enrolled in the study, had fungal infection, whereas 19 (17.3%) had fungal colonization. Candida were isolated from 85/91 (93.4%) and 19/19 (100%) patients with fungal infection and colonization respectively. There was predominance of non-albicans Candida spp both in fungal infection 61/85 (71.7%) patients as well as fungal colonization group 16/19 (84.2% ). In non-albicans Candida spp., Candida tropicalis was the most common isolate observed in both fungal infection (85.3%) and fungal colonization (63.1%) groups. Overall, in patients with fungal infection, candiduria was detected in 68/91 (74.7%) whereas candidaemia was observed in 19/ 91 (20.8%) patients. The risk factors for fungal infections included urinary catheterization (85.7%), central line insertion (81.3%), mechanical ventilation (52.7%), use of corticosteroids (23.1%), total parentral nutrition (6.6%) and peritoneal dialysis (3.3%). Conclusions:The emergence of non-albicans Candida similar to the trends in the western countries should be a cause of concern in our country. Proper surveillance of fungal pathogens is important to improve quality of care in critical care setting and measures should be focussed to control these infections, especially in patients with these risk factors.

<p class="abstract"><strong>Background: </strong>Fungal rhino sinusitis is rampant in the North Indian state of Punjab. The demographic profile, presentation and comorbidities have been analysed.</p><p class="abstract"><strong>Methods: </strong>110 samples from the nasal cavity were collected in Oto-rhino-Laryngology services and processed in the Microbiology services of Dayanand Medical College and Hospital, Ludhiana. Nasal secretions and surgically excised tissue were processed and subjected to direct microscopy by potassium hydroxide (KOH) preparation as well as inoculated on Sabrouraud’s dextrose agar. Identification of fungal isolates was done as per standard procedures.</p><p class="abstract"><strong>Results:</strong> Fungal sinusitis was most common followed by acute invasive sinusitis, chronic invasive, granuloma (fungal ball) and granulomatous invasive fungal sinusitis. Males were affected more than females and the majority of the patients were from urban background. Allergic form of disease was commonly seen in younger age group as compared to the invasive form of the disease which was seen more in older patients. Nasal discharge was common presentation followed by nasal obstruction. Bronchial asthma and diabetes mellitus were co-morbidities. KOH positivity was 44.5% and fungal culture positivity was 33.6%. The common fungal isolate in this group was Aspergillus flavus (22.7%). The most common fungal isolate in the invasive group was Rhizopus spp. (4.5%) and Mucor spp. (3.6%).</p><p class="abstract"><strong>Conclusions: </strong>Elderly diabetic and asthmatic males are more susceptible to invasive fungal rhino sinusitis while the young males are vulnerable to the allergic fungal rhino sinusitis. Thereby control of diabetic status and appropriate allergy testing and desensitization is emphasised.</p>

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