Clinical aspects of Ebola virus disease: a review.

Ebola Virus Disease (EVD), also known as Ebola Hemorrhagic Fever (EHF), initially emerged over 40 years ago in the Democratic Republic of Congo. Endemic to Africa, outbreaks have been recorded in six African countries since its detection in 1976. Fruit bats are believed to be the natural hosts of Ebola viruses (EBoV), with humans and other mammals serving as accidental hosts. Transmission of EBoV has been reported in various ways, including human to human transmission through close contact with blood and bodily fluids. The virus has an incubation period ranging from two to twenty-one days, followed by a multitude of clinical manifestations such as the sudden onset of high fever, chills and myalgia depicting a flu-like syndrome. It is usually diagnosed based on several clinical symptoms such as the sudden onset of illness, high fevers for less than three weeks, and at least two hemorrhagic symptoms despite no predisposing factors. This generally provides enough evidence for clinicians to consider EHF and begin supportive treatment until the virus is confirmed through laboratory findings. Management of patients involves supportive care such as maintaining fluid along with electrolyte balance, blood pressure and oxygen saturation. This also includes treating complications arising from secondary infections. The main options include: prophylactic strategies, anti-viral therapy for EVD, immunotherapies, vaccines, and ZMapp. Finally, the key to managing EBoV epidemics is to stop the transmission of disease in the most severely affected population, as prevention has become of utmost importance to alleviate the significant physical and economic burden.

Knowledge, attitude and practice of medical students towards HIV patients in their pre-clinical and post-clinical years in Karachi, Pakistan: a dual-center cross-sectional study.

The human immunodeficiency virus (HIV) is currently a global threat with an estimated 38.6 million people affected with HIV worldwide. According to the Joint United Nations Program on HIV/AIDS (UNAIDS), since 2004 the total number of cases of HIV in Pakistan has risen from 2700 to 130,000. In light of the rising burden of HIV/AIDS across the country, it is essential that medical students possess appropriate knowledge regarding the subject. Therefore, we aimed to assess the knowledge, attitude and practice of medical students towards HIV patients in their pre-clinical and post-clinical years in Karachi, Pakistan. A cross-sectional study was conducted among 518 pre-clinical (year 1 and 2) and post-clinical (year 3, 4, and 5) medical students from two medical schools in Karachi during the months of October - December 2019. Similar numbers of participants were taken from each year. Data were analyzed using SPSS. Descriptive statistics were used to report frequencies and proportions for categorical responses. Chi-square and Kruskal-Wallis tests were used as the primary statistical tests. About 55% of participants were female, and most belonged to the Islamic faith. More than half of the participants learned about HIV from books (315/518), followed by medical personnel (287/518). A quarter (134/518) of the participants believed HIV could be transmitted by sharing saliva, more than half of whom consisted of pre-clinical year students. Over half the participants (60.4%) knew that there was a difference between HIV and AIDs, most of whom belonged to the 5th year group. When detecting HIV, only about 30% of participants knew about indirect fluorescent antibody. Regarding attitudes, one-third would not be friends with a person diagnosed with HIV/AIDS. As a medical officer, a large majority (76.6%; n=397/518) of the participants would be anxious or somewhat anxious. Two-thirds believed that treating an HIV patient can make them contract HIV, and a majority of participants (333/518) did not feel adequately prepared to deal with the psycho-social problems of an HIV/AIDS patient. Finally, regarding practice, only one-third of the participants were willing to treat an HIV/AIDS patient, most of whom belonged to the pre-clinical 2nd year group and fewer to the post-clinical 3rd year group. Knowledge amongst medical students regarding HIV/AIDS was generally high, although there are some knowledge inadequacies which require more emphasis in the medical school curriculum. However, contrasting with the level of knowledge, in terms of attitude the majority were anxious or somewhat anxious when treating an HIV patient, and only one-third were willing to treat a patient with HIV.