Infectious Diseases

Based on the our October paper "A Generalized Viral Infection Mathematical Model Derived from Covid-19 Simulation", at a conceptual level higher than the classic SIR/SEIR model, we have established the 6 laws of infection regarding the final infection ratio within any given population without any artificial intervention and have shown the final infection ratio in a natural, non-interfered pandemic must fall within a specified lower and upper bound as 1 − 1 R 2 0 ≤ F R ≤ 2 (1 − 1 R 0). Whereas R 0 is the intrinsic R 0 value of the disease. In this paper, we show how human intervention strategies alter the previous assumptions based on 2 factors. First, artificial intervention with cycles of restricting measures and relaxations. Based on our May paper "The Predictions on Worldwide Covid-19 Pandemic Cases Based on Historical Data", we have already demonstrated the dynamic falling R 0 (t) curve during lock down measures. With more historical data and observation, we now expand the scope to include a dynamic rising R 0 (t) curve following the relaxation of measures, completing the cycle of restriction and relaxation. Second, the introduction of vaccination at a steady rate introduced a new variable into the existing infection model, we denote it as function V (t). We demonstrate the optimal strategies of vaccination interpreted within our existing established framework.

Καθόλη τη διάρκεια της ανθρώπινης ιστορίας, αναρίθμητες επιδημίες και πανδημίες έχουν αφανίσει τον ανθρώπινο πληθυσμό. Αν και στο παρελθόν τεχνολογικοί και επιστημονικοί περιορισμοί μειονεκτούσαν τον άνθρωπο, πρέπει να επισημανθεί πως πολλές από τις εξάρσεις διάφορων ασθενειών ήταν και είναι αποφευκτές. Το συγκεκριμένο άρθρο θα επιχειρήσει μια ιστορική ανάλυση κάποιων χαρακτηριστικών πανδημιών και θα προτείνει συστάσεις για τον καλύτερο και αποτελεσματικότερο έλεγχο και περιορισμό μελλοντικών πανδημιών.

The systematic review focused on the prognosis, mortality, medications, and promising vaccines for COVID-19. COVID-19 severity varies. Mild cases often recover within two weeks, while people with severe diseases may take 3 – 6 weeks to recover. Among people who died, the time from the onset of symptom to death ranged from 2 – 8 weeks. Children constitute a small percentage of reported cases, with around 1% of cases under 10 years and 4% aged 10 to 19 years. The risk of death is below 0.5% in those younger than 50 years, while more than 8% in those older than 70. Most of the people who die of COVID-19 have pre-existing conditions, including diabetes mellitus, cardiovascular disease, and hypertension. The impact of COVID-19 and its rate of mortality are different for both men and women; mortality rate is higher in men. As of May 2020, it is not known if past infection provides long-term and effective immunity in those who recover from the viral disease. Some of the infected people were reported to develop protective antibodies; the acquired immunity is presumed possible, based on other coronaviruses’ behaviour. The total infection fatality rate (IFR) is estimated to be 0.66%. No approved vaccine to treat the disease yet. International research on medicines and vaccines in COVID-19 is underway by academic groups, industry researchers, and government organizations. As of May 2020, there are over 300 active clinical trials underway. Many existing medications are under evaluation for COVID-19 treatment, including remdesivir, chloroquine, lopinavir/ritonavir, hydroxychloroquine, and lopinavir/ritonavir combined with interferon beta; as of May 2020, there is tentative evidence for remdesivir efficacy. Other candidates in trials are vasodilators, immune therapies, lipoic acid, corticosteroids, recombinant angiotensin-converting enzyme 2, bevacizumab, etc. Preliminary evidence suggests hydroxychloroquine might have anti-cytokine storm properties. Transferring concentrated and purified antibodies produced by immune systems of those who recovered from COVID-19 to those who need them is being investigated as non-vaccine method of passive immunization.

Dengue’s increasing trends raise concerns over global health and pose a challenge to the Brazilian health system, highlighting the necessity of a strong surveillance system to reduce morbidity, mortality, and the economic burden of this disease. Although the Brazilian surveillance system reports more dengue cases than any other country, recent studies suggest that non-reported cases are the majority. The aim of the study is to explore the strengths and weaknesses of the Brazilian surveillance system, particularly looking at the functioning of data collection and reporting. This was done through qualitative semi-structured interviews with 17 experts in dengue surveillance, supported by quantitative data from the official notification system. To select the interviewees, purposive and theoretical sampling were used. Data were analyzed through thematic analysis. The research highlighted that a lack of human and technological resources in healthcare units and surveillance departments slo...

Author, shares series of cases to illustrate homoeopathic therapeutic strategies in acute viral hepatitis. The stage of disease, dominant miasm and assessment of susceptibility are some of the considerations in prescribing.

https://hpathy.com/homeopathy-papers/understanding-homoeopathic-therapeutic-strategyin-acute-viral-hepatitis/

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Majority samples are in the age group of 35 years to 50 years. Nearly 50 per cent of respondents are illiterates. 62.3 per cent (187 respondents) are male. Mostly samples are married people; their percentage is 84
(252 respondents). The respondents from both the selected districts are drastically high from the OBC community, with 48 per cent (144 respondents). The respondents with agriculture, agricultural allied activities and agricultural labourers as the primary occupation, is 60 per cent (182 respondents). Nearly 60 percent families are landless and from below poverty line. The study shows that Ortho-related diseases dominated by 33.3 per cent (103 respondents). This is followed by paralysis at 16 per cent (48 respondents). Uterus related disease is an account for 27 respondents (9 per cent), pulmonary diseases are account for 25 respondents (8.3 per cent). It can be found that there is a high positive correlation between age, education, occupation, possession of land, health problems.
Keywords: Health programme, Diseases, Insurance, BPL families.

The pharmacology of anti-SARS-CoV-2 drugs, Molnupiravir (M) and repurposed Ivermectin (IV) were compared. The IC 50 for the inhibition of viral replication were 0.3µM for M and 2.8µM for IV. Both drugs have good oral absorption, with M achieving peak plasma concentrations by 2 hours and IV by 5 hours. The plasma half life were 7 hours for M and 81-91 hours for IV. M inhibits viral replication inducing viral mutagenesis in RdRp, causing viral error catastrophe and viral extinction. IV affects viral cell entry, nuclear transport and inhibits replication via RdRp. IV has additional effect to suppress cytokine production through STAT-3 inhibition. M is a more potent antiviral drug and IV has a longer residence in the body. Their effects on RdRp and cytokine inhibition are potentially complimentary for anti-COVID-19 activity. Both IV and M should be compared in randomized controlled clinical trials, and the possibility of their combination for anti-SARS-CoV-2 antiviral actions, explored further.

Irresponsible failure of health authorities regarding need for protective goggles?- -Introduction References to COVID-19 infection via the eyes Comparison with research dismissal of HIV infection via mosquitoes Masks without Goggles or Masks with Goggles? Indication of range of full-face pandemic masks Convergence on face-covering norms in Muslim-majority countries?

Background: Blood culture contamination (BCC) increases length of stay (LOS) and leads to unnecessary anti-microbial therapy and/or hospital-acquired conditions (HACs).
Aim: We sought to quantify the magnitude of the additional LOS, costs to hospitals and society as well as the harm to patients attributable to BCC.
Methods: A retrospective matched survival analysis was performed involving hospitalized patients with septicaemia-compatible symptoms. BCC costs, hospital-acquired conditions (HACs), and potential savings were calculated based on the primary LOS data, a modified Delphi process, and published sources. The cost analysis compared standard care to interventions for reducing BCC, and estimated annual economic and clinical consequences for a typical hospital and for the entire U.S.
Findings: Patients with BCC experienced mean prolonged hospital stays of 2.35 days (p=0.0076). Avoiding BCCs would decrease costs by $6,463 ($4,818 from inpatient care, of which 53% was from reduced length of stay, and 26% was from reduced antibiotic use).
Annually, in a typical 250- to 400-bed hospital, employing phlebotomists would save $1.3 million and prevent 24 HACs (including 2 C. difficile cases); based on clinical efficacy evidence, using the studied Initial Specimen Diversion Device (ISDD) would save $ 1.9 million and prevent 34 HACs (including 3 C. difficile cases). In the United States, the respective strategies would prevent 69,300 and 102,900 HACs (including 6,000 and 8,900 C. difficile cases) and costs of $5 and $7.5 billion.
Conclusion: Costs and clinical burdens associated with false-positive cultures are substantial and can be reduced by available interventions, including phlebotomists and ISDD use.

SUMMARY Neonatal tetanus is still prevalent in
developing countries such as India. Generally, neonatal
tetanus is seen in babies of unimmunized mothers beyond
the second day of life. A neonate presented to us on the
4th hour of birth with a periumbilical ulcer.The baby’s
antenatal and birth history was uneventful.The mother
had been immunized against tetanus. At presentation, the
baby was active, alert and sucking normally. Avery small
ulcer was noted below the umbilicus. Subsequently, the
baby developed rigidity and a tonic spasm of its body with
recurrent seizures from the 18th hour of its birth and by
21st hour. It also had a full blown clinical picture of neonatal
tetanus including: masseter spasm; generalized rigidity; a
high pitched cry: and intermittent opisthotonos posturing.
An ulcer gradually enlarged to 5  4 cm and a swab from
ulcer showed Clostridium tetani (both on Gram staining
and culture). A review of the published literature did not
reveal any case that had presented so early.Therefore, this
is probably the first case of neonatal tetanus being
reported within the 21st hour of birth.

Performing routine lumbar punctures in children with febrile seizures has been controversial. This study aimed to determine the positive yield of lumbar punctures in a setting where routine lumbar puncture is routinely carried out and to determine if any other parameter could ...

Objective: Vivax malaria is common in Pakistan. We carried out this study to determine the effects of this infection on blood counts and the impact of splenomegaly on these results.
Methods: This was a retrospective observational study carried out at 1 Mountain Medical Battalion, Bagh, Azad Kashmir. Old medical records of all patients admitted with vivax malaria from Jan 2010 to Oct 2012 were scrutinized. The presence or absence of a palpable spleen and the results of complete blood counts and platelet counts measured at the time of admission were noted down. Anaemia was defined as Hb<13g/dl in men, leukopenia as total leukocyte count (TLC)<4000/µl and thrombocytopenia as platelets count <150000/µl. Data was analysed with STATA version 12.1. The results of haematology parameters were compared amongst patients with splenomegaly and the rest.
Results: Anaemia was seen in 22.15%, neutropenia in 23.49% and thrombocytopenia in 90.60% of the 149 male patients having a mean age of 27.54±5.11 years. The differences in mean blood counts and the number of patients with haematological abnormalities in the two groups were statistically insignificant.
Conclusion: Since the blood counts are not affected by presence or absence of splenomegaly, mechanisms other than hypersplenism are important.

Francis ZEUKING , Rousseau DJOUAKA, Jude BIGOGA , Razack ADEOTI, Manuele TAMO, Wilfred F. MBACHAM, Anthony ABLORDEY 1 AgroEcoHealth Platform, International Institute of Tropical Agriculture (IITA), 08 P.O.Box 0932, Tri-Postal Cotonou, Cotonou, Bénin. 2 Faculty of Science, Department of Biochemistry, University of Yaoundé I, P.O.Box., 812, Yaoundé, Cameroon. 3 Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O.Box., 581, Legon, Accra, Ghana.

Nipah virus (NiV) is a newly detected highly pathogenic virus with ability to cause devastating morbidity and mortality (an estimated 100% in some cases) rate among the human populations. This emerging infectious disease has become one of the most alarming threats of the public healths in Bangladesh mainly due to its periodic outbreaks (as it strikes almost every year) and the highly devastating mortality rate. In this paper, we propose a mathematical model describing the host-pathogen interactions in terms of ordinary differential equations (ODEs). The main aim is to investigate the disease propagation and control strategy of NiV infections. The behaviour of the dynamics of NiV infections has been illustrated by the numerical simulations.

Introduction: tetanus is a disease caused by a toxin produced by the bacterium Clostridium tetani. It is characterized clinically by generalized stiffness and muscle spasms capable of causing respiratory arrest and death. The high-risk population includes older adults, diabetics, injection drug users, and the unvaccinated. The diagnosis of tetanus is increasingly rare, with the implementation of compulsory vaccination programs it has been possible to reduce the incidence of this disease worldwide; however, it continues to have significant morbidity and mortality.
Objective: to describe the case of a male patient with generalized tetanus in order to reinforce the relevance of vaccination, prophylaxis, early diagnosis and timely treatment.
Clinic case: 18-year-old male patient admitted to the emergency department of a primary care center 10 days after wounding his lower right limb, which progressed to fever, trismus, hypertonia and generalized muscle contractions. His immunization schedule was unknown and he lacked tetanus prophylaxis; Therefore, based on the history and the clinical picture, a diagnosis of accidental generalized tetanus was made, treatment was instituted, and the patient was admitted to the Intensive Care Unit. The neurological manifestations were graves; however, he progressed satisfactorily until complete resolution of the condition and was subsequently discharged.
Conclusions: despite the fact that tetanus is a pathology that doctors do not usually see in their clinical practice, it is a serious infection that still represents an important diagnostic and therapeutic challenge. The disease can be completely prevented by vaccination and proper wound care.

RESUMEN
Introducción: el tétanos es una enfermedad causada por una toxina producida por la bacteria Clostridium tetani. Se caracteriza clínicamente por rigidez generalizada y espasmos musculares capaces de causar paro respiratorio y muerte. La población de alto riesgo incluye a los adultos mayores, los diabéticos, los usuarios de drogas inyectables y las personas no vacunadas. El diagnóstico de tétanos es cada vez más raro, con la implementación de programas de vacunación obligatoria se ha logrado disminuir la incidencia de esta enfermedad a nivel mundial; no obstante, sigue teniendo una morbimortalidad significativa.
Objetivo: describir el caso de un paciente masculino con tétanos generalizado con el fin de reforzar la relevancia de la vacunación, profilaxis, su diagnóstico precoz y tratamiento oportuno.
Caso clínico: paciente masculino de 18 años de edad que ingresa al servicio de urgencias remitido centro de atención primaria 10 días después de hacerse herida en miembro inferior derecho, que evolucionó hasta presentar fiebre, trismo, hipertonía y contracciones musculares generalizadas. Su esquema de inmunizaciones era desconocido y carecía de profilaxis antitetánica; por lo tanto, con base a los antecedentes y el cuadro clínico se hizo diagnóstico de tétanos generalizado accidental, se instauró tratamiento y se trasladó a la Unidad de Cuidados Intensivos. Las manifestaciones neurológicas fueron graves; sin embargo, evolucionó satisfactoriamente hasta la resolución completa del cuadro y fue dado de alta posteriormente.
Conclusión: a pesar de que el tétanos es una patología que los médicos no ven usualmente en su práctica clínica, es una infección grave que todavía representa un importante desafío diagnóstico y terapéutico. La enfermedad se puede prevenir completamente mediante la vacunación y el cuidado adecuado de las heridas.

Introduction: Chronic gastritis is inflammation of the gastric mucosa. It can be non-atrophic and atrophic. Atrophy is defined as the loss of appropriate glands. It is frequently located in antral mucosa as consequence of Helicobacter pylori infection and it is associated with intestinal gastric cancer. Goal: Describe histopathological and demographic characteristics of atrophic gastritis. Matherial and methods: We assessed the pathological reports of 100 patients with atrophic gastritis whose characteristics were evaluated by using a semiquantitative scale of Sidney system of classification of gastritis. To assess the significance between the incidence of various parametres we used χ 2 test. Results: We found that the difference in frequency of atrophic gastritis between men and women was not statistically significant. The difference in distribution is statistically significant in favor of the antrum. Among patients who have atrophy with Helicobacter pylori infection and intestinal metaplasia and those who do not have metaplasia, it was found that the difference is highly statistically significant. Conclusion: The most frequent localisation of atrophic gastritis is antral mucosa. There is no difference between men and women in frequency of atrophic gastritis, while the aging is related with more often occurrence of atrophic gastritis.