ABSTRACT
A doctor of any specialty in his practice is faced with an infectious pathology, in connection with which the early diagnosis of infectious diseases is important both from a clinical and epidemiological standpoint. The aim - design and development of a unified practical guide to infectious diseases with elements of digitalization of content on pharmacotherapy. Material and methods. When developing the structure of the practical guide "Tactics of an infectious disease doctor", prototypes of educational and methodological materials were worked out. The structure of the practical guide included socially significant infectious diseases of viral, bacterial etiology, the most important helminthiases and protozoses, which practitioners of various specialties may encounter, both in inpatient and outpatient settings. Results and discussion. In the practical guide "Tactics of an infectious disease doctor" all nosologies are presented in a unified form: a brief definition of nosologies, characteristics of the etiological agent, epidemic process, clinical classification, examples of the formulation of a diagnosis, diagnosis, organization of medical care, treatment, pharmacotherapy, approximate terms of temporary disability, criteria recovery, rehabilitation, dispensary observation, recommendations for treatment and prevention. The practical guide contains a short guide to medicines. An innovation is the presentation of medicines via a QR code. Also, by means of a QR code, it is possible to switch to the electronic version of the practical guide. Recommendations for the prevention of infectious diseases are given in the form of pictographic diagrams. Conclusion. The practical guide "Tactics of an infectious disease doctor" allows primary care physicians and general practitioners in a short time period to make the optimal decision on the tactics of managing patients with infectious diseases, within the framework of modern clinical guidelines and approaches set out in national guidelines.Copyright © 2021 Infectious Diseases: News, Opinions, Training. All rights reserved.
ABSTRACT
The occurrence of Cryptosporidium species infection and its risk factors in neonatal goats is less explored. Also it is due to the fact that diseases like colibacillosis and neonatal viral enteritis complex caused by Group A rotaviruses and Bovine corona viruses can co-exist with Cryptosporidium and can lead to mixed infections and the latter is often overlooked. Therefore, in the current research we explored the cryptosporidial occurrence in neonatal goats of Mathura district of Uttar Pradesh, India. In this study, a total of 644 faecal samples were collected from neonatal goats at different villages and certain organized farms of Mathura district age-wise, season-wise and breed-wise, and were examined for Cryptosporidium based on modified Ziehl-Neelsen technique, conventional 18SSU rRNA nested PCR assay. The overall prevalence of Cryptosporidium infection in goats based on microscopy was 36.80% (237/644;p value <0.0001) and 18SSU rRNA nested PCR 52.95% (341/644;p value <0.0001) respectively. Cryptosporidium species typing was also done using 18SSU rRNA nested PCR-RFLP product using enzymes Mbo-II, Ssp-I and Vsp-I, which revealed species including C. parvum C. bovis, C. ryanae, C. hominis and C. andersoni. Also the infection was clinically associated based on age, gender and seasons to identify the causal relationships that precipitate the cryptosporidial infection in goat kids. Since mZN microscopy based screening requires expertise and may sometimes be confuse with other weak acid fast bodies and also due to low sensitivity, combination of diagnostic tests are used in this study to identify the best test combination that yields best statistical fit in terms of kappa-agreement and McNemar's test. Cryptosporidiosis is caused by an enteric protozoan parasite and the first report in sheep and goat was observed in early 1980s, with other important etiological agents for neonatal diarrhoea, mortality and morbidity in neonatal kids and lambs, responsible for economic losses.Copyright © 2023 Indian Veterinary Assocaition. All rights reserved.
ABSTRACT
The human body is inhabited by trillions of diverse microorganisms collectively called "microbiome" or "microbiota". Microbiota consists of bacteria, viruses, fungi, protozoa, and archaea. Microbiome demonstrates multi-faceted effects on human physical and mental health. Per evidence there is a multi-functional interplay between the whole-body microbiome composition on the epithelial surfaces including skin, nasal and oral cavities, airway, gastro-intestinal and urogenital tracts on one hand and on the other hand, the individual health status. Microbiota composition as well as an option to modulate it - together create a highly attractive operation area for the translational bio/medical research with multi-professional expertise and healthcare-relevant output in the framework of predictive, preventive and personalised medicine (PPPM/3 PM). Advanced PPPM strategies implemented in the microbiome area are expected to significantly improve individual outcomes and overall cost-efficacy of healthcare. According to the accumulated research data, corresponding diagnostic and treatment approaches are applicable to primary care (health risk assessment in individuals with sub-optimal health conditions and prevention of a disease development), secondary care (personalised treatment of clinically manifested disorders preventing a disease progression) and tertiary care (making palliation to an optimal management of non-curable diseases). In the current book, we do highlight the implementation potential of the microbiome-relevant research in the framework of predictive diagnostics, targeted prevention and treatments tailored to the individualised patient profile.Copyright © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Context: Amelioration of olfactory and gustatory dysfunction (OGD) disorders has become a common requirement due to COVID-19. Although it's hardly exclusive to COVID-19, OGD's prevalence requires exploration of therapeutic and restorative modalities, on the broadest scale possible. No specific medication or treatment of any noteworthy efficacy exists for OGD. Objective(s): As Part 1 of a three-part article, a narrative review intended to examine the known causes of OGD, not restricted to COVID-19, and frame their relevance for development of new treatments or the repurposing of existing ones. Design(s): The researcher performed a narrative review by searching databases including PubMed, Sciencedirect, Google Scholar, Old Dominion University Libraries, and the websites of various medical journals. Searches included numerous combinations of keywords accompanied by the phrases, loss of sense of smell and taste, olfactory and gustatory dysfunction disorders, as well as the terms anosmia, parosmia, ageusia, and parageusia. Such keywords included viruses, bacteria, fungi, protozoa, parasites, infection, COVID-19, treatments, medications, steroids, supplements, nutrients, alternative medicine, acupuncture, olfactory training, clinical trials, cranial nerves, pathogenesis, pathophysiology, and etiology. Setting(s): The Liebell Clinic, Virginia Beach, VA, USA. Result(s): Scientific investigation into mechanisms and treatment of OGD appears to be historically limited and unremarkable. Medical literature spanning decades reports a bleak clinical outlook with an abundance of speculation and hypotheses. Limited evidence of effective or reliable treatment exists, especially for chronic cases. Conclusion(s): With a dismal lack of medical support for a suddenly prevalent, but hardly novel set of maladies of taste and smell perception;the imperative for multifaceted and broad investigations across all medical disciplines is without question. Global urgency for the development of any treatment capable of reducing or resolving OGD triggered by COVID-19 is unprecedented. Part 2 of the current author's three-part series will address the details of current and past treatment approaches and clinical trials.
ABSTRACT
STATEMENT OF PROBLEM/QUESTION: Chagas disease (CD) is a lifelong protozoan parasitic infection that if left untreated can result in cardiomyopathy in a third of cases;a screening program can identify individuals with chronic asymptomatic disease. DESCRIPTION OF PROGRAM/INTERVENTION: Elmhurst Hospital is a public safety net hospital in Queens serving a diverse community with many immigrants from Mexico, Central and South America. An estimated 8 million people in Latin America and 300,000 in the US are living with CD. We implemented a Chagas screening program in the Elmhurst adult primary care clinic. Our electronic health record (EHR), Epic, captures patient diversity by including 200 ethnic background options;we used this field to identify at-risk patients. Patients waiting for their appointment were brought into a private area and educated about CD by a Spanish-speaking volunteer. They were asked their country of origin, their ability to recognize the Reduviid bug, and the type of house they grew up in. Written educational materials about CD in Spanish provided by CDC website were given to patients. Once a patient accepted screening the provider received a secure chat in the EHR instructing them to order the Chagas serology. All patients have been kept on a secure list, and all are called for follow-up regardless of their results. Patients who test positive receive a follow-up plan that includes cardiac testing and referral to the Infectious Diseases (ID) clinic. Education about immigrant health and CD was provided to faculty, nurses and residents by ID specialists. MEASURES OF SUCCESS: The number of patients accepted and screened for CD. FINDINGS TO DATE: From June to November 2021, 340 patients in the Elmhurst medicine clinic were approached about their risk for CD. Of these migrants 36% were from Mexico, 51% were from S. America and 13% were from Central America. 23% of these patients grew up in an adobe house and 26% recognized the reduviid bug from a picture. Of 324 at-risk individuals asked about previous Chagas knowledge, only 7% were familiar with CD. 203 patients were tested with final results, 18 refused testing, 37 tests are pending for the next visit, and 82 were not ordered. 2 were positive on the screening ELISA with confirmation pending;CDC has suspended testing during the COVID-19 pandemic. Family members will be screened if confirmatory testing is positive. KEY LESSONS FOR DISSEMINATION: For practices serving large atrisk populations, a Chagas screening program can help to address a healthcare disparity. Partnership with ID specialists is essential for this process to succeed. Having an EHR that captures diverse demographic information identifies atrisk patients and is critical to the success of such a program. Challenges include having to obtain confirmatory testing at CDC which involves a patient returning for a follow-up visit and another blood draw. PCP champions can be a useful resource to sustain CD screening in the future. Low awareness of CD in our patient population suggests that community outreach to at-risk individuals is needed to increase awareness.