2^nd World Congress on Infectious Diseases August 24-25, 2016 Pennsylvania, Philadelphia, USA

Biography:

Ashok Kapse is a consulting Pediatrician practicing in the city of Surat in the Gujarat state of India, besides owning a private pediatric hospital he is also Head of the Pediatric Department at a prestigious Mahavir Super Specialty Hospital. After finishing graduation (MBBS) he did MD in Pediatrics. Initially he has worked as a Professor of Pediatrics at Medical College Surat, later he opted out for private practice however pursued academic interest. He developed special interest and skill in infectious diseases. He is a recipient of many oration awards and delivered hundreds of lectures on dengue, malaria, typhoid and antibiotic uses across India. He has decorated many a posts in medical fields: President of Surat City Branch of Indian Academy of Pediatrics (IAP), President of Gujarat State Branch of IAP and National President of Infectious Diseases Branch of IAP are few of them. He is an avid Clinical Photographer; his photos figure into various books and atlases including the prestigious atlas of infectious diseases published by American Academy of Pediatrics. He has published umpteen articles in peer reviewed journals.

Abstract:

Right up to the mid twentieth century dengue was considered as a mild febrile illness; however in the mid 1950 image of dengue underwent a drastic change. South East Asian countries experienced epidemics of a serious dengue disease, later on termed as Dengue hemorrhagic fever-dengue shock syndrome. By the end of the last century the geographic distribution of dengue viruses which earlier was limited to South East Asian and South Asian countries, has tremendously expanded & engulfed almost whole of the world. Today dengue has emerged as an important threat to public health worldwide; it is estimated that over 50 million dengue virus (DENV) infections occur annually resulting in 500,000 hospitalizations and over 20,000 deaths. In 1974 World Health Organization (WHO) formulated case definition and classified dengue into DF/DHF/DSS. This classification remained in use for almost three decades however over the years dengue has expanded to different parts of the globe and to older age groups. Clinicians often observed deviations from the original description of dengue manifestations; several investigators have felt & reported various difficulties in using the old system of DF/DHF/DSS. With the realization that existing classification of the disease into DF, DHF and DSS may not always be universally applicable for clinical management; WHO convened a meet of global dengue experts in 2008 in Geneva. Committee recommended a new case classification for Dengue illnesses and put forward revised guidelines in 2009 for the management of dengue illnesses. As per new guidelines disease is now classified into three categories that are dengue, dengue with warning signs and severe dengue. This workshop proposes to acquaint audience with this newer classification and a simplified way of dengue case management. Workshop intends to impart hands on training in understanding staging of the disease and diagnosing various grades of dengue severity with the help of real clinical cases. Lastly it aims to impart a defined system of management as per the stage and severity of disease. The precise knowledge of newer diagnostic and management system would be of great help in reducing dengue ambiguity and thereby significantly alleviate the dengue related morbidity and mortality.

Biography:

Adriana Macedo Dell’Aquila has completed her PhD from Federal University of São Paulo, Brazil. She is the infectious disease Physician responsible for the control and treatment of osteoarticular infections, Department of Orthopedics and the control of infections in the Burns Unit of São Paulo Hospital, Federal University of São Paulo.

Abstract:

Background: The main objective in post-osteosynthesis surgical site infection (SSI) is to consolidate the fracture and prevent chronic osteomyelitis, the risk factors for SSI relapse in these patients, who were treated as per osteo-articular infection protocol were evaluated at the Federal University of São Paulo.

Methods: After retrospectively evaluating all SSI episodes occurring from December, 2004 to 2008 in patients undergoing osteosynthesis at the orthopedics department, 110 of them were included. SSIs were treated with at least 4-6 week antibiotic therapy cycles and followed up for one year with the results being analyzed using univariate and multivariate analysis models.

Results: Most patients were 18-89 year old (mean, 39.8 years) males (84.5%). In 37 patients, the causative agent was isolated with Staphylococcus being the most frequently observed (38.8%). In 83 (75.4%) patients, the antimicrobial treatment mostly with ciprofloxacin and clindamycin could be started within less than five days from the onset of symptoms. SSI relapses occurred in 34/110 (30.9%) patients. After one-year follow-up, 19 (17.3%) patients persisted with infection and only 10 (9.1%) did not have their fractures consolidated. The univariate analysis showed the performance of more than one surgery to stabilize the affected limb (OR 3.7 IC₉₅=1.1-12.7 p=0.045), presence of converting osteosynthesis (OR 3.6 IC₉₅=1.1-11.3 p=0.023), internal synthesis (OR 3.0 IC₉₅=0.99-9.2 p=0.043) and longer duration of surgery (OR 0.4 IC₉₅=0.1-1.6 p=0.029) as risk factors for SSI relapse. In the multivariate analysis, the only variable independently associated with SSI relapse was duration of surgery (OR 1.3 IC₉₅=1.1-1.7 p=0.015).

Conclusions: After one-year follow-up, using a specific protocol, most patients showed resolution of infection and only 9.1% had their fractures unconsolidated. The only independent risk factor associated with SSI relapse was prolonged surgery.

Biography:

Paul J Caesar has 25 years of experience in hygiene and infection control. He is presently working as an Expert in Medical Devices and Reprocessing Flexible Endoscopes in the Department of Medical Affairs, Quality and Safety of one of the largest university hospitals in the Netherlands. He has published papers on endoscope reprocessing, hand hygiene and other items on infection control. He has also developed teaching programs on reprocessing flexible endoscopes and cleaning, disinfection and sterilization of medical devices and a nationwide education program on hygiene and infection control for infection control practitioners in hospitals and public health. He is a chair of a Dutch Expert Group for reprocessing flexible endoscopes.

Abstract:

Although quality of reprocessing FES has improved over the past decades and permanent controls of process parameters in the automated endoscope washers (AEW) are continuously performed, improper or ineffective cleaning, disinfection, drying and storage (reprocessing) of reusable flexible endoscopes (FES) can pose a serious infection risk to patients. Despite of all quality improvements and a strong believe in validated process parameters of the AEW, in the UMCG FES with channels are still frequently and routinely microbiological (bacterial) sampled by retrograde flushing of all channels. For example, based on historical outcomes, each duodenoscope is sampled every week. Although FES safely passed the process in the AEW, a part of reprocessed FES showed to be positive in microbiological cultures, even with resistant bacteria. This additional screening of microbial quality of reprocessed FES could be regarded as an essential method to detect pitfalls in reprocessing or the state of art quality of FES especially in FES with channels. However, microbial screening is labor-intensive (and thus cost-expensive), takes a long time and only microbial (bacterial) contamination is verifiable. Based on literature and two short surveys in which we studied the use of ATP (adenosine triphosphate) bioluminescence as an alternative in checking the cleanliness of reprocessed ENT-endoscopes and duodenoscopes, we conclude that ATP is a quick, easy and reliable method for regularly monitoring the cleanliness of reprocessed FES. Because it’s broader spectrum including all possible organic contamination (e.g., tissue), it has a positive effect on the whole quality and safety process on reprocessing FES and a safe release and use for following patients. ATP can replace high frequent routine microbiological testing, which should only be indicated on clinical problems possible related with the use of FES or when outcomes on ATP indicates the need of further and more in-depth research.

Biography:

Jilei Zhang is currently a PhD candidate of Preventive Veterinary Medicine at College of Veterinary Medicine, Yangzhou University, China. He has published 12 papers in reputed SCI journals and was awarded 4 invention patents associated with vector-borne diseases. He was awarded with the National Scholarship for Graduate Students twice (2013 and 2015) and participated in one research program at The National Natural Science Foundation of China.

Abstract:

Infection caused by Rickettsia felis is an important tick-borne disease with natural foci, mainly transmitted through vertebrates (mouse and cat) and arthropods (fleas, ticks). The disease has been documented in more than 20 countries and is recognized as an emergent global threat to human health. Our preliminary report demonstrated that 5.83% (54/926) of the examined mosquitoes carried R. felis. In this study, we investigated whether the mosquito can transmit R. felis in a vertical fashion. We used a generic FRET-qPCR to detect R. felis in mosquitoes while a HMBS-gene based real-time PCR was applied to detect the level of blood meal in collected mosquitoes. During 2013-2015, 1984 mosquitoes were collected monthly in Jiangsu of China and PCRs on these mosquitoes demonstrated that mosquitoes with blood meal between summer months (10.0%) were significantly lower than in winter months (35.8%). In addition, R. felis positivity in collected mosquitoes was highest in December (20.8%) among the collected months (0.0-14.4%). Positivities of R. felis did not differ significantly between the mosquitoes with (n=29) and without (n=50) blood meal. Furthermore, testing on 23 pools of female mosquitoes showed that 2 pools were R. felis-positive and 5 were blood meal-positive. In contrast, 9 of 30 male pools were R. felis-positive and none of the male mosquitoes carried blood meal. This is the first report of detetcting Rickettsia spp. in male mosquito which is blood meal-free. Dynamic monitoring R. felis and blood meal in female and male mosquitoes provide here evidence that R. felis may be vertically transmitted in mosquitoes.

Biography:

Amanuel Ateweberhan Woldemariaman is an Assistant Lecturer in Orotta School of Medicine, Asmara, Eritrea. He has worked in different laboratories in Eritrea, East Africa. Currently, he is pursuing Masters in Immunology at Huazhong University of Science and Technology, Tongji Medical College, Wuhan, China.

Abstract:

Immune response to malaria and intestinal parasites is characterized by antibody production (IgE). Th2 immune response gives rise to antibody production and in this study the serum antibody level has been quantified in malaria patients with and without additional intestinal parasitic infection. The study was composed of 198 malaria positive and 217 malaria negative apparently healthy controls. Patients can be with or without additional intestinal parasitic infection. It was a cross sectional observational study conducted at Keren Hospital, Eritrea, Northeast Africa. A pre-designed structured format was utilized to collect socio-demographic and clinical data of the subjects. Detection and quantification of intestinal parasites, malaria parasites and quantification of serum antibody levels were done following standard procedures. Antibody levels of malaria-positive patients were significantly high as compared to that of malaria free apparently healthy controls (with and without intestinal parasitic infections). Malaria-positive patients with additional intestinal parasitic infection showed high level of antibody (2199 IU/ml) compared with those malaria patients without intestinal parasites (1669 IU/ml). The association between malaria parasitic density and level of antibody was highly significant (P=0.001) with 2048 IU/ml in high parasitaemia and 1779 IU/ml in low parasitaemia. Intestinal parasite egg loads were also significantly associated with level of antibody (P=0.003). It can be concluded that the level of antibody increases in response to malaria. It also increases in response to intestinal parasites. When compared, malaria infection is stronger than intestinal parasitic infection in driving the production of the antibody. Moreover, antibody level is correlated with malaria parasite density and intestinal parasite egg loads.

Biography:

Maria Luisa G Daroy is a Scientist at the Research and Biotechnology Division of St. Luke’s Medical Center and Assistant Professor in the MS Molecular Medicine Program of the St. Luke’s College of Medicine-WHQ Memorial. She has published more than 20 papers on dengue, Japanese encephalitis, chikungunya, eye infections, dementia, diabetes and coronary artery disease. She was the Chair of the Board of Examiners of the Philippine Academy for Microbiology from 2013-2015 and authored a book chapter on Philippine microbiology research. Researches include dengue, chikungunya, diarrhea, CNS infections, pathogen genomics, antimicrobial resistance, plant antivirals, molecular diagnostics and genetics of CVD, thyroid cancer and dementia.

Abstract:

Whole genome analysis of dengue virus strains isolated in the Philippines was performed using an Illumina MiSeq next generation sequencer and bioinformatics. Complete genome sequences of 24 DENV-2 isolated from 1995 to 2008 was mapped against a DENV-2 reference sequence (NC_001474) from Genbank. The Philippine DENV-2 isolates were highly similar to strains from Taiwan (AJ968413.1) and China (EF051521.1). The Chinese strain (EF051521.1) was isolated in 2001 yet similar strains could have been circulating in the Philippines as early as 1998. The isolates highly similar to the Taiwanese strain were of the Asian II genotype and the isolates highly similar to the Chinese strain were of the Cosmopolitan genotype. In total, 922 synonymous and non-synonymous substitutions were observed, of which 232 (25.2%) were in the NS5 gene, which had the most substitutions. This was followed by NS3 with 181 (19.6%) and the E gene with 144 (15.6%) and the 2K gene with only 6 (0.7%). Putative amino acid sequences from the coding regions revealed that majority (817, 88.6%) of the substitutions were synonymous or silent. Of the remaining 105 non-synonymous mutations, 22 (20.9%) were in the NS5 gene followed by the NS1 and E genes with 20 (19.0%) and 16 (15.2), respectively. When the clustered genetic variation profiles were identified based on the specific clinical diagnosis, all the DHF III cases belonged to a single cluster together with some DF cases and one SVI case. In contrast, all DHF I-II and most of the DF cases grouped together in another cluster. All DHF III cases were of the Cosmopolitan genotype. DENV circulating within the Philippines from 1995 to 1998 were of the Asian genotype, followed by a period from 1998 to 2001 in which both the Asian II and Cosmopolitan strains co-circulated and from 2000 to 2008 the circulating DENV was primarily cosmopolitan. This supports previous observations of a probable genotype shift in the Philippines. This is the first report of whole genome analyses of dengue virus isolates from the Philippines.

Biography:

Sion Jo has completed his Residency of Emergency Department from Seoul National University Hospital. He is an Assistant Professor of the Chonbuk National University Hospital. He has published more than 10 papers in reputed journals. He has designed the NEWS-L score and a Sion’s tube.

Abstract:

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is defined as a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. Clinically, sepsis is identified by suspected or documented infection and an acute increase of ≥ 2 SOFA points (a proxy for organ dysfunction). And in case of septic shock, sepsis and vasopressor therapy needed to elevate MAP ≥65 mmHg and serum lactate >2 mmol/L (18 mg/dL) despite adequate fluid resuscitation is used. In contrast to new sepsis which deals with multiple organs, definition of septic shock focuses on circulatory shock and cellular/metabolic shock, seeming not to consider other imperative organs such as CNS or lung. It is a big mistake of septic shock definition. If a sepsis refers to organ dysfunction caused by infection, likewise circulatory and cellular/metabolic shock, respiratory, neurologic and other organs shock should be included in the definition of septic shock. This suggestion is supported that hypoxia and unresponsiveness is associated with increased mortality in sepsis. One more problem is that septic shock definition includes failure of adequate fluid resuscitation in itself even though there is no prerequisite reason. Furthermore, assessment of volume status and adequate fluid resuscitation is still challenging in critical care era. So the separation of a shock and a failure in the clinical definition of septic shock was should be considered.

Biography:

Durgesh Sinha is an Adjunct Assistant Professor at five institutions; Temple University, Strayer University, Rowan College at Burlington County, Mercer County Community College and Community College of Philadelphia. She has received her Doctorate degree in Applied Mathematics from Vinoba Bhave University, India and Master’s degree in Environmental Engineering from Temple University, USA. Her recent publication is “Hydro-magnetic flow of rarefied gas between two parallel flat plates with external circuit, 1999” and “Delayed epidemic model on the attack of Computer virus in network” communicated to IJITCS. Her current research interest is on epidemic model applicable in human life, environment and cybercrime.

Abstract:

Avian influenza virus poses risks to both bird and human population. In primary strain, mutation increases the infectiousness of avian influenza. A mathematical model of avian influenza for both human and bird population is formulated. We have computed the basic reproduction number R^h₀ and R^b₀ for both human and bird population respectively and we prove that the model is locally and globally asymptotically stable for disease-free equilibrium point when R^h₀<1 and R^b₀<1. We also prove that the unique endemic equilibrium point is globally asymptotically stable in bird population when R^b₀>1. Extensive numerical simulations and sensitivity analysis for various parameters of the model are carried out. The effect of vaccination and quarantined class with recovered class are critically analyzed.

Biography:

Omotowo I Babatunde has obtained MBBS from University of Ilorin, Nigeria in 1987, MPH from University of Nigeria, Nsukka in 2006 and FWACP from West African College of Physicians in 2009. He has worked as a Medical Advisor for German Leprosy and Tuberculosis Relief Association from 2010 to 2012. He is a Lecturer at the Department of Community Medicine, College of Medicine, University of Nigeria, since August, 2012. He is the MBBS Coordinator in the department since then. He has published some papers in both local and international journals. His interests are in infectious and non-communicable diseases.

Abstract:

Introduction: Lassa fever is a hemorrhagic fever caused by an arena virus. Worldwide, an estimated 2 million people are infected each year resulting to 5,000 to 10,000 deaths. It is endemic in a few West African Countries. In 2012, Nigeria experienced the worst outbreak.

Objective: To assess the knowledge, attitude and practices of healthcare workers towards Lassa fever in Enugu, south-east, Nigeria.

Methods: This cross sectional study was conducted among 325 healthcare workers. Data was collected using a self reported questionnaire on the knowledge, attitude and practices towards Lassa fever. Data was analyzed using SPSS version 21 and statistical significance of association between variables was assessed using Chi-square test at p<0.05. Ethical clearance was obtained from the Research Ethics Committee of UNTH and informed written consent was obtained from the participants.

Results: Overall 325 respondents returned the completed questionnaire. 54.7% were males, 92.6% were aged between 18 to 45 years while their mean age was 32.4±12.6 years. Most of the participants 53.8% were single. Majority of the respondents were Doctors 46.2%, Nurses 23.4%, while Lab scientists, physiotherapists, pharmacists and radiographers were 12.9%, 8.6%, 4.3%, and 4.6% respectively. Also, 97.6% of respondents had tertiary education. Among the participants, only 2.8% have not heard about Lassa fever. Major sources of information are media 87.1%, radio 86.5%, and television 84.9%. Most of the participants knew correctly that Lassa fever can affect all age groups 91.7%, can cause death 92.3%, is a communicable disease 93.8% and transmitted by rats 96.6%. Most of them also knew correctly modes of transmission. However, about 20% of them did not know correctly prevention of Lassa fever. Majority of them believed that hand gloves were most useful personal protective measures while handling patients. Knowledge concerning burial practices and other preventive measures is poor. Only 46.5% of them regularly practiced barrier nursing and hand washing as means of containing the spread of infection. Knowledge on Lassa fever was found to be significantly associated with level of education (X² =105.680, df=4, p=0.000), but not significant to category of profession (X²=9.430, df=10, p=0.492).

Conclusion: Majority of health workers had good knowledge regarding Lassa fever. However, preventive practices were poor. Health education packages and training regarding Lassa fever should be introduced and sustained in all health facilities.

Biography:

Bimal Kumar Mishra is a full Professor in the Department of Mathematics at Birla Institute of Technology, India. Presently he is working in the area of non-linear dynamics, very specifically on Mathematical Models on infectious disease and has published more than 125 research journals of high repute. He has produced several PhDs’ and he is a Member of the Editorial Board of several international journals.

Abstract:

Ebola virus disease was first found in 1976 and thereafter it had emerged in different countries in different times, especially in 2014 in Liberia of West Africa and is now highly epidemic and is a great threat to human population. In this paper, we try to understand the spreading behavior of Ebola virus disease (EVD) in the human population. We have used the very close real parametric values as per the data released by ‘WHO’. To minimize the spread of EVD, critical analysis is performed both in the presence and absence of control measures. From the sensitivity analysis performed on the real data, we are able to say that the susceptible populations have a strong relation with the threshold number. Effect of quarantine is critically analyzed on the infectious population and it is observed that quarantining the infectious population may play a vital role in controlling the spread of EVD. Results are established both analytically and numerically. We hope that the results will definitely give a managerial insight for control of the spread of EVD.

Biography:

Jason A Thompson has been involved in public health since 1993, primarily revolving around the delivery of prehospital emergency medical care. He discovered his calling in the United States Navy as a hospital corpsman and has subsequently employed those skills as an emergency medical technician, healthcare administrator, medicolegal analyst and product development consultant. Jason has a passion for problem-solving and making the world a safer place, whether it is educating scouts in advanced first aid, instructing first responders on the use of lifesaving strategies, designing remote medical care programs and, of course, advocating for improvements in public health, specifically responsible hygienic practices.

Abstract:

In 2014, the world was concerned about the largest historical outbreak of the Ebola Virus happening in West Africa. This led to significant concerns about readiness to manage those who were potentially infected. In the United States, prehospital care providers were scrambling to prepare and desperate for directions they could rely on. This caught many decision makers by surprise and eager to understand why the public health community was seemingly unprepared. With some investigation, it quickly became apparent that the issue was directly correlated to the absence of a solid general understanding of infection prevention and control (IPC) practices among first responders and, surprisingly, public health officials. A rapid solution to this problem was essential, but there were no obvious leaders taking the charge, so a small team from Emergency Products & Research (EP+R), of Kent, Ohio, stepped forward. Working with other industry professionals and seeking advice from academia, EP+R launched an initiative that evolved into AMBUstat™, which is a program designed to introduce a common sense approach to IPC that can be easily and cost-effectively rolled out around the globe. The AMBUstat™ portable biological decontamination system, a key component of the AMBUstat™ program, was designed for ease-of-use, minimal training requirements and environmental consciousness. With the AMBUstat™ program, IPC is easy to understand and it provides the potential for a global platform that enables us to be ready for the next biological threat, with the most important aspect being a critical focus on proactive rather than reactive strategies.

Biography:

Ines Garcia-Garcia has completed her Medical Training at the University of Puerto Rico. She is Board Certified in Pediatrics Specialty and in the Neonatal-Perinatal Medicine Sub-specialty. She is a Professor at the University of Puerto Rico, School of Medicine. She has published in reputed journals and books, including articles related to intrauterine exposure to viral infections and congenital anomalies. She actively participates in Graduate Medical Education Programs. She is a Member of national and international research and academic associations. She has participated as a Speaker in multiple professional meetings in the United States, Latin-America and Europe.

Abstract:

The recent emergence in America of Chikungunya and Zika has added new febrile viral diseases which impact susceptible women in childbearing age and with a high rate of vertical transmission, which can occur in asymptomatic women. Both diseases are caused by viruses transmitted primarily by Aedes mosquitoes, found throughout much of the tropical and subtropical regions of the Americas. Some reports warn that climate change will worsen vector-borne disease threat. Chikungunya fever was first identified in Puerto Rico during an outbreak in 2014. 10 newborns where admitted from mothers with chikungunya-like symptoms within 5 days after delivery. The most prevalent symptoms in those babies were irritability and maculopapular rash. 3 babies were admitted from mothers with symptoms more than 5 days from delivery. Symptoms like fever, irritability and rash where not present, but they presented central nervous system lesions. At present, health officials reported that 1,726 people have been infected with Zika in Puerto Rico, including a total of 191 pregnant women. Only one case of microcephaly has been reported. These outbreaks prompted our Neonatal-Perinatal Service to characterize clinical manifestations of the diseases, develop guidelines for diagnosis and management of suspected intrauterine exposed fetuses. Health care professionals need to be familiar with the surveillance system, perform history taking focusing on febrile viral illnesses during pregnancy, recognize women at risk for chikungunya and Zika infections, and follow the protocols established by the local and state Health Authorities, including neurodevelopmental follow-up of affected offsprings.

Biography:

Natalia Isaza Brando is an Associate Neonatology Physician in Children’s National Health System, Washington DC. She had work experience as Neonatology Physician Associate, NICU attending, Adjunct Instructor in Pediatrics, Health and Wellbeing Program Director, Instructor, Health Educator, Pediatrician and Physician. She is interested in investigating the short and long-term impact of maternal depression on mother-infant behaviors.

Abstract:

I will intend to cover during the talk: The bioactive components in human milk that influence the immune status of newborns; the physiological and protective functions of the immune components in human milk: Anti-microbial substances and antibodies; the constituents in breast milk that promote tolerance and priming of the immune system in the newborn; how breastfeeding provides passive and long-lasting active immunity; how the use of oral immunotherapy with colostrum in the first days of life of sick newborns can improve their response to infections in the NICU; how human milk can improve the incidence of nosocomial infections in the NICU.

Biography:

Leena Bhattacharya Mithal is a Pediatric Infectious Diseases specialist at the Ann & Robert H. Lurie Children’s Hospital of Chicago and an Instructor at Northwestern University, Feinberg School of Medicine. She is pursuing her Master Degree in Clinical Investigation at the Northwestern Graduate School. Her research interests include neonatal infections, novel diagnostics for sepsis in preterm infants, study of the perinatal-neonatal microbiome, and vaccine awareness and delivery.

Abstract:

Early onset neonatal sepsis disproportionately affects preterm infants and remains a major cause of morbidity and mortality. Yet, diagnosis remains inadequate resulting in missed cases or prolonged empiric antibiotics with significant adverse consequences including necrotizing enterocolitis, antibiotic resistance, and death. Development of novel, more reliable methods to diagnose sepsis in preterm infants is essential to improve their outcomes. Biomarkers of infection, placental histopathology, and molecular methods of pathogen detection are among the tools being investigated for accurate identification of infants with sepsis. This presentation will review the conundrum of early onset sepsis in preterm infant and discuss both existing evidence and new research on novel diagnostics, including data on acute phase reactants and 16S rRNA PCR of cord blood in a large single-center cohort.

Biography:

Gabriela Sanchez Petitto has completed her MD from the Universidad Central de Venezuela, School of Medicine. She is currently a Postgraduate student of Internal Medicine at the University of Texas Health Science Center at Houston. She has worked in several projects with hematological malignancies and in the upcoming future with antibiotic resistance projects.

Abstract:

A 67-year-old post-menopausal woman with advanced stage histiocytic sarcoma of the pelvis, presented with 4-day history of abdominal pain and fever. She had local tumor invasion to bladder and cervix requiring bilateral percutaneous nephrostomy tubes. She received chemotherapy and radiotherapy with partial tumor regression. On examination she had an enlarged suprapubic mass and foul-smelling vaginal discharge. A computed tomography (CT) scan demonstrated a large cervical mass occluding the cervical os, causing dilatation of the endometrial cavity, doubling its size compared to one month prior. The patient was started in broad spectrum antibiotics and a cervical catheterization was intended unsuccessfully. A CT guided percutaneous uterine drain was placed in her abdomen and purulent drainage grew Prevotella loescheii. Blood and urine cultures were negative. She was discharged under oral sulfamethoxazole/trimethoprim and metronidazole with clinical improvement. In the subsequent months she underwent chemotherapy and radiotherapy and required long-term percutaneous drainage. Pyometra is defined as the accumulation of pus in the uterine cavity and thought to be a result of interference with the natural drainage of the uterus. Symptoms are non-specific and easily misdiagnosed. Diagnosis can be made clinically by drainage of pus from the uterine cavity and with imaging. Treatment includes drainage along with antibiotics to cover microorganisms such as Lactobacillus iners, Prevotella spp., and Lactobacillus crispatus. Vague abdominal symptoms in a post-menopausal woman with pelvic malignancy should raise concern for pyometra and prompt treatment has to be instituted to prevent the development of the most catastrophic complication; uterine perforation.

Biography:

Gabriela Sanchez Petitto has completed her MD from the Universidad Central de Venezuela, School of Medicine. She is currently a Postgraduate student of Internal Medicine at the University of Texas Health Science Center at Houston. She has worked in several projects with hematological malignancies and in the upcoming future with antibiotic resistance projects.

Abstract:

A 36-year-old woman with newly diagnosed nephrotic syndrome presented with a 10-day history of progressive vision loss. On ophthalmological exam, visual acuity was 20/800 in both eyes. The left eye showed grade 4 disc edema and both retina had vitreous and intraretinal hemorrhages. HIV serology was positive, CD4 count of 17/ul and viral load of 375000 copies/ml, newly diagnosed. CT head was normal. Cerebrospinal fluid analysis is unremarkable. Serum and CSF immunoglobulins against Toxoplasma spp., PCR for herpes simplex virus 1 and 2, varicella-zoster (VZV) and Cytomegalovirus (CMV) were negative. Empirical ganciclovir, trimethoprim-sulfamethoxazole and prednisolone were started. Vitreal fluid extracted by paracentesis was positive for toxoplasma antigen and negative for CMV and VZV in both eyes. The diagnosis of toxoplasma retinochoroiditis was confirmed. The patient continued a 6-week course of antibiotics with clinical improvement at 4 weeks. In immunocompromised patients is difficult to establish a diagnosis of ocular toxoplasmosis based upon the lesions’ appearance, since atypical lesions are common and obtaining reliable results for immunodiagnostic assays is more difficult. The best clue to diagnosis is recognition of the clinical presentation and the detection of the agent in ocular samples by molecular biology. Confirmation of diagnosis is higher for PCR of vitreous samples compared to aqueous humor; this due to the fact that, anatomically the vitreous humor is closest to the necrotic lesions, leading to a better sampling of the parasitic DNA. In summary, a positive PCR study for T. gondii became a dependable alternative to diagnose retinochoroiditis in an immunocompromised patient.

Biography:

Jose Gonzales Zamora has obtained his MD degree at Universidad Nacional Federico Villarreal in Lima, Peru. He has completed his Internal Medicine Residency at John H. Stroger Hospital and Infectious Disease Fellowship at Rush University Medical Center in Chicago, Illinois, USA. He is currently an Assistant Professor of the Infectious Disease Division at Augusta University in Augusta, Georgia, USA.

Abstract:

Introduction: HIV has changed the epidemiology of tuberculosis and is now considered the main risk factor for extra-pulmonary involvement. In recent years, molecular techniques have emerged as promising diagnostic tools. Only Xpert MTB/Rif assay has been advocated by the WHO for diagnosis of extra-pulmonary TB. Scarce data is available on its utility in gastrointestinal tuberculosis. We report a case of an HIV patient with intestinal tuberculosis diagnosed by XpertMTB/Rif.

Description: A 31 year-old HIV patient presented with diarrhea, fever, diffuse abdominal pain and weight loss for the last month. Bilateral crackles and right lower quadrant pain were found on physical exam. His CD4 count was 172 cells per ml and his HIV-1 viral load was 2026 copies/ml. Bilateral alveolar infiltrates were seen on the chest X-ray. Ultrasound showed enlarged peritoneal lymph nodes and thickening of the ileocecal region. Smear and Xpert MTB/Rif from sputum were negative. Patient underwent a colonoscopy which showed irregular congested ulcers in ileum, sigmoid and rectum. Xpert MTB/Rif from biopsy was positive for TB. Standard 4 drug therapy was started and patient improved significantly.

Discussion: The majority of experience with Xpert MTB/Rif has been on sputum samples, but it has also been used in a variety of fluid and tissue samples. It has a sensitivity of 89% and specificity of 74% for the diagnosis of extra-pulmonary tuberculosis. To our knowledge, there are no reports on the use of Xpert MTB/Rif in intestinal biopsies. Our case is a precedent for the use of this assay in the future.

Biography:

Tania M Kohal was graduated from the University of California Berkeley with Bachelor’s degrees in Molecular and Cellular Biology and Latin.

Abstract:

Introduction: Advances in pharmacological therapy have changed the narrative of individuals diagnosed with HIV, prolonging quality and length of life, however, prevention remains key in preventing transmission. Our project aims to assess how individuals obtain HIV information and testing services in the hope to better inform how resources for prevention can be effectively allocated.

Methods: Our study involved designing a flyer to be placed in two clinics, Affirmations and American Indian Health Family Services (AIFHS) in a general information area and a testing area. The flyers contained different web addresses directing individuals to the same web module. This web module contained information about HIV and a survey querying prior testing, risk assessment and demographic factors. A link was provided from the web module to a website where testing resources were available. We designed a method of tracking web traffic to ascertain the initiative individuals were taking in seeking further information. A focus group was done to evaluate how individuals obtain HIV information for which a qualitative analysis was done.
 

Results: Individuals do not readily engage in paper-media based information sources and are more likely to seek out web-based information on their own or respond to directed intervention by peers, physicians, etc.

Conclusion: Our study indicates that resources may be better directed towards web-based information sources and that a directed approach involving healthcare providers, peers, etc. is most effective in encouraging prevention-seeking behaviors.

Biography:

Luis Del Carpio Orantes is a Medical Specialist in Internal Medicine and also an Internist in Mexican Social Security Institute. He is assigned to ICU Internist, D'Maria Hospital and he is also an Expert Columnist for the Iberoamerican Society of Scientific Information with the theme of emerging viruses. He has published articles related to intensive care (negative pressure pulmonary edema and disseminated intravascular coagulation in the ICU) and epidemiology, regarding dengue, zika, chikungunya and influenza which can be referred in PubMed and other index. He is an Independent Researcher, projects a research on the treatment of dengue.

Abstract:

Case Report: Male patient 36 years old with no history of importance except filing burn in your hands by electricity, admitted with symptoms 20 days of evolution characterized by fever, cough and yellowish expectoration, being treated with common antimicrobials previously, developed persistent fever so as right pleuritic pain, so entered, diagnosis protocol which only evinced leukocytosis of 13500/mm³ without respiratory, kidney or liver involvement starts. Smears are performed in series of 3 being negative, a first scan, which reports pneumonic process 70% with diffuse cavitary lesions in addition to air bronchograms (March 14), started treatment with imipenem and vancomycin is performed. The report cultivation expectoration was Staphylococcus epidermidis coagulase negative resistant to vancomycin handling adjusted with linezolid, a second tomography was performed which demonstrated increased cavitary, extended zones into the pleural cavity with multiple septums and fluid levels, so as destruction of lung parenchyma in middle and lower lobe of the right lung (March 20); by poor evolution of painting it was decided to send chest surgery but was managed conservatively, died after 5 days in the service management.

Conclusion: This case has clinical significance, since it illustrates the severity of necrotizing pneumonia, also aggressiveness with coagulase-negative germs, referred to as nosocomial pathogens emergency epidemiological displayed. The importance of pulmonary tomography for the diagnosis and therapeutic decisions also emphasized that in this case was fully indicated the surgical management, primodial mainstay of treatment of necrotizing pneumonia, combined with the antimicrobial medical treatment.

Biography:

Muhanad Ali is currently pursuing his Bachelor of Science in Health Science, Critical Development Studies and Anthropology from the University of Toronto Scarborough Campus. His focus is on how factors such as colonialism, globalization and socio-cultural or even socio-ecological factors play into the origin, maintenance and emergence of old and new infectious diseases. He is currently the Co-Director for the University of Toronto International Health Program (UTIHP-UTSC) and serves as YHAN (Youth Health Action Network) Member for the City of Toronto Public Health in Toronto, Canada.

Abstract:

Middle East Respiratory Syndrome (MERS) is a severe viral respiratory illness that is caused by a new strain from the beta group of coronavirus (CoV). At both the global and national level within Saudi Arabia, men are at a greater risk of contracting the virus (68%) in comparison to women, which fosters an interesting question: What accounts for these gender based differences in the MERS infection rates between men and women? This study seeks to challenge the assumption that biological differences in vulnerability (genetic disposition) are the primary drivers for the disparate male infection rates and shift towards a framework of analysis that embraces the unique dynamics of gender roles. To demonstrate this analytical framework, this paper will consider several gender based risk factors such as gender segregation, religious and cultural practices and social roles pertaining to livestock management within Saudi Arabia. The literature review examined for this study found that gender based risk factors (gender segregation, religious and cultural practice and social roles pertaining livestock management) may lead to varying rates of exposure to MERS-CoV. Moreover, it illustrated a gap in our current knowledge and understanding of how gender dynamics affect infectious diseases, especially concerning the issue of containment of and protection from MERS.

Biography:

Andre Ricardo Araujo Da Silva has completed his PhD from FIOCRUZ-National Institute of Infectology, Brazil. He is an Associate Professor of Neonatology at Federal Fluminense University, Brazil, Coordinator of Scientific Program of Medicine Course and also leads the Laboratory of Teaching of Prevention and Control of Healthcare associated infections. He has published more than 15 papers in reputed journals and is a Member of International Federation of Infection Control.

Abstract:

Multidrug-resistance is a global concern. This is a major problem within intensive care units (ICU), where usually doctors have few options to treat healthcare associated infections (HAI). The aim of our work is to describe profile of Gram-negative resistance in cases of HAI occurred in a Pediatric Intensive Care Unit (PICU) of reference. We did a prospective study of all HAI reported in PICU of Prontobaby-Children’s Hospital, with focus in infections due to Gram-negative bacteria. We used National Healthcare Safety Network (NHSN) criteria to define HAI. Gram-negative resistance was defined according Magiorakis criteria. In seven-years of follow-up (from January 2009 to December 2015), we reported 224 HAI. 65 cases were due to Gram-negative and global rates of resistance reported were 47.7%. HAI rates ranges from 9.4 to 15.1 per 1000 patient-days in PICU, during the study. In five of seven years, Gram-negative resistance was higher than 50%. During this period only two HAI due to Enterobacteriaceae resistant to carbapenem were reported (0.9% of all HAI). The main agents founded are Enterobacteriaceae ESBL producers and P. aeruginosa resistant to carbapenem. In our casuistic, we found higher rates of Gram-negative bacterial resistance in cases of HAI. To avoid this problem, it is necessary to develop strategies to reduce incidence of HAI, even in critical ill children. Also, new treatment options are urgently needed.

Biography:

Luis Del Carpio Orantes is a Medical Specialist in Internal Medicine and also an Internist in Mexican Social Security Institute. He is assigned to ICU Internist, D'Maria Hospital and he is also an Expert Columnist for the Iberoamerican Society of Scientific Information with the theme of emerging viruses. He has published articles related to intensive care (negative pressure pulmonary edema and disseminated intravascular coagulation in the ICU) and epidemiology, regarding dengue, zika, chikungunya and influenza which can be referred in PubMed and other index. He is an Independent Researcher, projects a research on the treatment of dengue.

Abstract:

Objective: Casuistry of invasive candidiasis is reviewed on an intensive care unit, applying the candida score to assess their potential predictor of HIV infection.

Design: Retrospective, observational and descriptive study.

Methods: The Candida score is applied retrospectively all identified cases of invasive candidiasis to evaluate its effect predictor of the disease; also the most common strains and their risk factors identified in this population are identified.

Results: The casuistry of the intensive care unit were reviewed, which had 102 patients in the period 1 January to 31 December 2014, of which Candida infection in 14 patients (13.7%) was reported. Being the most affected female gender with 10 patients (71.4%), also the most affected age group was 81-90 years, followed by 71-80 years. The stay in the ICU, at the beginning of candidiasis averaged 8 days. Infection of an anatomical site was identified in 9 patients and in 5 patients in two anatomical sites with predominant involvement in the lungs (10 isolates), the urinary tract 2^nd highest incidence (7 cases), it is noteworthy that no cases of candidemia and there was only one isolate in a central catheter, which was classified as catheter colonization; other cases invasive pulmonary candidiasis and urinary level (the latter probably bladder colonization, favored by use of urinary catheters) were considered. The most frequent isolates were Candida albicans (10 patients) followed by C. krusei (4 patients), C. tropicalis and Candida sp., in 3 patients, respectively. The score Candida was positive in 7 patients (50% score >2.5) but did not correlate with mortality as these patients, only 3 of them were fatal, C. albicans being the most deadly. In this casuistry 8 patients had a good outcome. The presence of a central venous catheter (14 patients), the long stay in the unit (12 patients) and the use of broad spectrum antimicrobials as prior (10 patients) were identified as predisposing factors. Risk factors being the bearer of chronic lung disease, sepsis and cardiovascular disease in 8 patients respectively were identified. Candidiasis appeared after a common course of broad spectrum antimicrobials (3^rd generation cephalosporins basically) in 10 patients and only 4 had begun with an antimicrobial greater spectrum (carbapenem, glycopeptide or fluoroquinolone); once identified candidiasis, management began with triazolido (fluconazole in 9 cases and voriconazole in 1 case), meriting a second antifungal adjustment scheme with an echinocandin or voriconazole in 4 cases by persistent candidiasis. Of the 6 deaths, 4 had started operation with fluconazole and despite having given a second scheme with an echinocandin or voriconazole, the prognosis is not improved.

Conclusion: We conclude that the Candida score is a predictive indicator and signals to patients who are at risk for infection with Candida (score >2.5), but does not predict the mortality rate of each case. Risk factors and predisposing factors are similar to those reported in other series, only highlighting in this series, the presence of chronic lung disease, as correlational would explain the higher incidence of lung isolation level and in elderly patients. Also regarding the treatment employed, it is recommended that a positive Candida score, antifungal management spectrum starts, primarily an echinocandin or voriconazole, to try to improve the survival rate of these patients, who are often elderly patients, anergic, diseases chronic degenerative and high rate of morbidity and mortality and can be considered as neutropenic patients. In this series, chronic lung disease served as a major risk factor, which has not been previously reported, since in the literature to Aspergillus is mentioned as the leading pioneer in these patients which was not confirmed.

Biography:

Leila Vali has completed her PhD from Edinburgh University and Postdoctoral studies from Medical College of Wisconsin, Milwaukee and Edinburgh University. She has been a Lecturer in Strathclyde University, UK and is currently an Assistant Professor in Kuwait University. He has published more than 25 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

It is essential to reduce the bacterial load and ensure the effectiveness of hygienic conditions in hospitals. Chlorhexidine is one of the most widely used biocides. Since resistance genes to quaternary ammonium compounds have appeared more frequently in staphylococci, we aimed to identify S. aureus with reduced sensitivity to Chlorhexidine in Kuwaiti hospitals. We collected 97 methicillin-resistant (MRSA) and 100 methicillin-sensitive (MSSA) S. aureus. We amplified mecA, blaZ, qac A/B, qacH, qacH2, qacG, smr, norA, PVL and agr genes. Antibiotic sensitivity testing for 10 antibiotics and MIC/MBC of chlorhexidine were determined. MLST, spa typing and PFGE were used to identify genetic variations. The predominant genes were mecA, blaZ, norA, qacA/B, smr, while qacG, qacH, qacH2 were not detected. All isolates were sensitive to vancomycin, teicoplanin and tigecycline. The range of MIC for chlorhexidine for qacA/B positive isolates was 4-30 mg/l, however the MBC (0.94-60 mg/l) was statistically greater than MIC (p˂0.0001). Typing methods showed all the isolates with reduced sensitivity to chlorhexidine containing qacA were ST239-III-t945-PVL˗. The presence of qac genes does not necessarily imply increased resistance to chlorhexidine or any other antimicrobial agents. However MBC of chlorhexidine was higher for the isolates containing qacA/B compared to those without. We observed clonality among the qacA/B positive isolates with reduced sensitivity to chlorhexidine (HA-MRSA-ST239-III-t945 PVL˗). Reduced sensitivity may be a contributing factor to survival of this clone in hospitals. It is crucial to strictly monitor dilution standards to avoid low level exposure of HA-MRSA-ST239-III to biocides, specifically in the developing countries.

Biography:

Luis Del Carpio Orantes is a Medical Specialist in Internal Medicine and also an Internist in Mexican Social Security Institute. He is assigned as ICU Internist at D'Maria Hospital and he is also an Expert Columnist for the Iberoamerican Society of Scientific Information. He has published articles related to intensive care (negative pressure pulmonary edema and disseminated intravascular coagulation in the ICU) and epidemiology, regarding dengue, zika, chikungunya and influenza.

Abstract:

Case: Woman 24 years old with no history of importance except being operated caesarean operation two months and a half without incident, resulting in macrosomia product. Enter a room trauma shock seizures witnessed at home and during transportation to the hospital, clouding, state initial shock, hypoglycemia, fever, with a history of non-specific prodrome 7 days prior characterized by fatigue and weakness, adding fever 72 hours previous and also presenting with behavioral disorders disorientation 24 hrs prior to admission, the previous night generalized purpuric dermatosis is added. Upon initial review apparently glasgow of 14, but disorientated and psychomotor agitation, presenting shock unresponsive to water resuscitation initial, feverish with suspected neuroinfection, so she underwent cranial tomography which is reported only discrete brain edema; passes intensive therapy for management of shock, after endotracheal intubation seizures and involvement of consciousness. Upon arrival even with persistent hypotension despite double scheme amines (dopamine, norepinephrine) and fluid resuscitation, also high ventilatory requirements with data from acute lung injury, in frank anuria and acute renal injury, severe metabolic acidemia that warrants management bicarbonate, hematologic data franca fails with disseminated intravascular coagulation and purpura generalized data. The antimicrobial management that had been initially with ceftriaxone-vancomycin, leaving vancomycin-meropenem also dose intravenous hydrocortisone (500 mg) is given for suspected acute adrenal insufficiency (manifested by shock, tendency to hypoglycemia, hyponatremia, hypokalemia) is set, is it gives renal support with loop diuretic infusion as well as bicarbonate infusion. He remains in the intensive care unit for 10 hrs, no response to management, a refractory shock, severe sepsis and multiple organ dysfunctions were considered. Since studied with neurological, metabolic and hematological disorders, kidney damage, lung damage, criteria for disseminated intravascular coagulation coupled with widespread purpura, Waterhouse-Friderich sensyndrome was considered, which was devastating for the patient. A 5-day incubation of blood cultures growth coagulase-negative staphylococci were reported, being sensitive to Vancomycin, definitive bacteriological diagnosis, staphylococcus haemolyticus. Negative serology for dengue and leptospirosis were reported, requested by endemic area meet such conditions. First case reported in adults Waterhouse-Friderichsen syndrome secondary to staphylococcus haemolyticus is concluded.

Biography:

Jamshaid Iqbal is a consultant at Mubarak Al-Kabir Teaching Hospital, Kuwait and he is the director at center for medical education and faculty of medicine at Kuwait University, Kuwait.

Abstract:

Background: Prostate cancer and benign prostatic hyperplasia (BPH) represents the most common urologic disease among the elderly males resulting in more than 2 million visits per year. BPH affects about one-quarter of men in their 50s. The pathogenesis of BPH is not yet completely understood however, the role of chronic inflammation is emerging as an important factor in BPH development and progression. Recently, the studies have found that T. vaginalis may be associated with asymptomatic infections in 50-75% of infected men. In this study we investigated the possibility of asymptomatic persistence of T. vaginalis in the prostate gland using benign hyperplastic prostate tissue as prostate condition other than clinical prostatitis.

Materials & Methods: We investigated the occurrence of T. vaginalis in prostate tissue of 75 men of >50 years of age suspected and treated for BPH by transurethral resection of the prostate at the Mubarak Al-Kabir Teaching Hospital, Kuwait. The presence of T. vaginalis infection in the prostate tissue was determined by PCR analysis of the DNA extracted from the tissue and Immunocytochemistry of the tissue sections of the prostate tissue. In addition, P16 antigen was also detected in the tissue sections. The antibodies to T. vaginalis were also determined in blood.

Results: We detected T. vaginalis DNA in 18 of 75 (24%) and P16 antigen in 16/75 (21%) of BPH tissue samples, of which only 7 (39%) BPH tissues were positive by immunocytochemistry. In addition, three T. vaginalis DNA-negative prostate tissues were also positive immunochemistry. T. vaginalis-specific antibodies with predominantly IgG4 antibodies were detected in 23 (31%) cases.

Conclusion: Our preliminary study suggests a direct evidence of T. vaginalis in BPH tissues with no clinical signs of prostatitis. We hypothesize that chronic T. vaginalis infection of prostate tissue may lead to BPH in elderly people.

Biography:

Sakly Mouna has completed her Medicine studies from El Manar University, Faculty of Medicine of Tunisia. She has submitted her Doctoral thesis in Medicine in 2002, completed Master of Advanced Studies in Economy Health and Hospital Management from the Faculty of Medicine of Tunisia in 2009, Master of Advanced Studies in Tobacco from the Faculty of Medicine of Tunisia in 2010 and Certification Green Belt Lean Manufacturing and Management L2M in 2016. She is the Coordinator of child health programs and primary health care quality program in Tunisia and she is also the Tunisian focal point on disability and deafness and a National Trainer in the counseling and HIV screening among pregnant women. She has published some papers in reputed journals. She is a Reviewer of Public Health Review, France since 2016 and a Teacher of the national maternal and newborn health program in the University Mohamed El Matri at Tunisia.

Abstract:

Introduction: the Influenza is an acute viral infection transmitted by air. It`s a highly contagious disease that can cause serious complications, especially among vulnerable people, it presents a major public health issue with a considerable socio-economic impact.

Purpose: Review the epidemiological situation of influenza in Tunisia in The 2015-2016 season. Determine if the A (H1N1) virus has a particular virulence in Tunisia during the 2015-2016 season. Make recommendations to overcome challenges.

Methods: This retrospective study is based on data issued by the National influenza surveillance unit; it relies on a descriptive analysis of influenza surveillance data provided by the network of sentinel sites and national influenza center (NIC).

Results & Discussion: Influenza surveillance in Tunisia has been in established since 1999 with the creation of network sentinel sites, but it significantly developed on March 2014, by the enhancement of the national influenza surveillance system. In Tunisia, clinical, epidemiological and virological surveillance of influenza began in week 40/2015 (1^st of October 2015) and ended in week 18/2016 (30^th of April 2016). During the period of study: 96,240 cases ILI (Influenza-like illness) were collected from a total of 1,394,782 patients seen at sentinel ILI sites, representing 6.9% of total patients versus 7.7% during the 2014-2015 season. The epidemiological surveillance of influenza on the Tunisian territory showed that the influenza epidemic was spreading in the winter season 2015/2016 during fourteen weeks from the 25^th of January 2016 (2016 / W4) to the 29^th of April 2016 (2016/ W18) with an incidence rate of 10.3%. It started a little later than it did during the previous season and lasted relatively longer (14 weeks versus 8 weeks). During the 2014-2015 season, influenza reached its peak during the coldest weeks (S6 to S9) and there was an inverse trend of the monthly average temperature. This correlation has not been observed during this season having regard to the shift of the cold season. In fact, this flu season peaked during the week of 14 to 20 March 2016 (2016/S12), later than usual. These findings were also observed in Europe and in USA. All of the 24 governorates of Tunisia have been affected by the influenza and the incidence is higher in the most populated regions. Children 5 to 16 years are the most affected. Among the visits for influenza-like illness (ILI), 190 severe cases were hospitalized representing a comparable proportion to the previous season (0.19% vs 0.2%) and were mainly infected with A (H1N1) pmd09 virus (57% of cases). The average age for these severe cases was 46.5 years, with extreme ages varying between 6 months and 73 years. Their lethality was significantly higher than that observed during the previous season (20% vs 3%) and was H1N1 associated in 73.7% of cases. During Week 12, there was an increased circulation of influenza viruses in Tunisia and subsequently there were the highest number of deaths (10 deaths representing 26.3% of all influenza deaths). 37.1% of influenza deaths had no risk factors. The co-circulation of the three influenza viruses began in late January (W4) with a gradual increase in the circulation of the type A (H1N1) pmd09 virus. During the week W12, the type A (H1N1) pmd09 virus was more common than the type B. The seasonal distribution of three types of influenza viruses was: Virus A (H1N1) pmd09 (57.4%), Virus A (H3N2) (38.5%) and Virus B (3.5%). The positivity rate for influenza was 24.4% vs 28.4% during the previous season.

Conclusion: The 2015-2016 influenza epidemic started little later than the previous season, marked by the co-circulation of three influenza viruses and the predominance of the virulent type A (H1N1) pmd09 virus, the impact of the epidemic in terms of ILI consultations and hospitalizations was comparable to the previous season, but the lethality of severe cases was significantly higher. Viruses know no borders, control and fight against the influenza require a global vision of the dynamics of the disease in our country, as well as around the Mediterranean in order to better contain any unusual event.

Biography:

Samer M Al-Hulu is an Assistant Professor of Microbiology. He has completed his PhD from College of Science, Babylon University. He has published more than 14 papers in microbiology field. He has trained at Ministry of Health at Laboratory of Babylon Maternity and Children Hospital. Presently, he is working at College of Food Science, Al-Qasim Green University.

Abstract:

Superbugs is the term which used for describing of multidrug-resistant organisms that evolved and developed resistance to at least one type of antimicrobial drug or antibiotic. MRSA, VRE, ESBLs are some examples on superbugs. The combating of superbugs can be achieved by proper hand washing and using of good hand hygiene. DNA Sequencing of superbugs playing an important role in combating of spread such as DNA sequencing from patient and compared with database for determining source of infection. Using of Nano-based therapy for combating of superbug such as using of nano metals and metallic oxides which having high activity against board spectrum antibiotic resistant bacteria such as AgNPs which having high activity against MRSA and silver resistant E. coli, also using of Nano-enabled antibiotics such as using drug delivery system and using of other methods such as cellulose nano crystals-porphyrin, CNTs and others. Other solution for combating of superbugs is prevent of antibiotic misuse and overuse which due to developing of resistant for antibiotics via one or more mechanisms of DNA alteration. Essential oil having a new weapon for combating of superbugs, oil is derived from variety of natural sources including plants or component of plants such as flowers, leaves and others, these oil having complex mixtures of chemicals which having antimicrobial activity. Phage therapy is plays an important role for fighting of drug-resistant pathogens.

Biography:

Zharov Vladimir P is the Director of the Arkansas Nanomedicine Center at the University of Arkansas for Medical Sciences, USA. He has received his PhD and DSc degrees from the Bauman Moscow State Technical University (BMSTU) and completed his Postdoctoral Fellowship at Lawrence Berkeley National Laboratory at the University of California. He has served as the Chairman of Biomedical Engineering Department at the BMSTU and his record of innovative achievements include more than 200 publications (5 in Nature journals), 54 patents and 5 books. He pioneered photoacoustic and photothermal medical technologies, laser pulse nanotherapy of infections and cancer, laser-ultrasonic microsurgery and in vivo flow cytometry. He is the State Prize Winner, the most prestigious national award in Russia and the first recipient of the US Maiman Award, named after the inventor of the first laser.

Abstract:

Infections remain one of the main causes of death in the worldwide. The diagnosis of infections and other diseases begins with a common medical procedure: The examination of blood samples. The sensitivity of current blood tests is limited by the small volume of blood collected, in which no less than one disease-specific biomarker (e.g., pathogen) can be detected. This can miss many thousands of abnormal cells and biomarkers in the whole blood volume (~5 liter in adults), which can be sufficient for disease progression to difficult-to-treat if not already incurable complications (e.g., sepsis). This report summarizes our novel concept of early disease diagnosis with ~1000-fold improved sensitivity using in vivo non-invasive photoacoustic (PA) flow cytometry (PAFC) platform for identification and enumeration of rare circulating disease-associated biomarkers with intrinsic PA contrasts (e.g., hemozoinin malaria) or molecularly targeted with the functionalized gold nanoparticles. The principle of PAFC is based on the irradiation of the superficial blood vessels with near-infrared laser pulses followed by detection of laser-induced acoustic waves from single biomarkers with small ultrasound transducer attached to skin. In addition, the integration in real-time diagnosis and therapy (called theranostics) can eradicate circulating bacteria and viruses and thus can potentially prevent or at least inhibit deadly complications. Recent advances of this label-free theranostics platform is presented with focus on its pre-clinical and clinical trials associated with malaria, S. aureus and bacteremia.

Biography:

Shantanu Bhatt is affiliated to the Saint Joseph’s University, USA.

Abstract:

Enteropathogenic Escherichia coli (EPEC) is responsible for considerable disease and death amongst infants in developing countries. EPEC belongs to the attaching and effacing (A/E) family of bacterial pathogens, which are aptly named because they adhere intimately to intestinal cells and destroy cellular microvilli to form characteristic pathomorphological A/E lesions, which lead to diarrhea and dehydration. The ability to form A/E lesions resides within the virulence module locus of enterocyte effacement (LEE), which encodes a type III secretion system (T3SS). To date, over fifty non-LEE encoded regulators have been identified in EPEC. The vast majority of these regulators affect the expression of the LEE-encoded transcription factors, Ler, GrlR and GrlA. Intriguingly, every regulator of the LEE that has been identified to date in EPEC is a proteinaceous factor. Thus far, not a single regulatory small RNA (sRNA) has been implicated in its virulence. We set out to identify and characterize sRNA regulators of the LEE in EPEC. Our preliminary data suggest that Hfq globally represses gene expression from all the LEE-encoded genes including the grlRA operon. Because Hfq and Hfq-dependent sRNAs typically target the 5’ region of the first gene in an operon, we constructed a reporter E. coli strain in which only the 5’ UTR and 45 nucleotides of the grlR ORF were fused to a chromosomal N-terminally truncated lacZ gene driven by the heterologous P_araBAD promoter (P_araBAD-grlR-lacZ). Inactivation of hfq resulted in elevated β-galactosidase activity from the grlR’-‘lacZ fusion suggesting that the cloned 5’ region of grlR was sufficient to elicit Hfq-dependent repression. These results also suggest that one or more Hfq-dependent sRNAs, conserved between EPEC and E. coli, regulate grlRA. To identify these sRNAs, each of the 27 conserved Hfq-dependent sRNAs was individually overproduced in the grlR-lacZ reporter strain. Three sRNAs-MgrR, RyhB and McaS reproducibly repressed the grlR-lacZ fusion. Using IntaRNA we aligned each of the 3 sRNAs to the cloned 5’ region of grlR. Bioinformatic analysis revealed that MgrR exhibited the most extensive and contiguous region of complementarity (~10 bp) with the grlR leader region. The predicted base-pairing region in MgrR was substituted with a scrambled oligonucleotide sequence that lacks complementarity to grlR. Predictably, mutation of the base-pairing region abolished the ability of MgrR to pair to and repress the grlR-lacZ fusion, thereby providing genetic evidence for direct base-pairing between grlR and MgrR. Subsequent experiments revealed that MgrR binds to the same region on the grlRA transcript as CsrA and counteracts its stimulatory effect. Meanwhile, RyhB appeared to form a relatively shorter (~6 bp) duplex with the ribosome-binding site of grlR. An oligonucleotide substitution in the base-pairing region of RyhB also prevented the sRNA from repressing the grlR-lacZ fusion, suggesting that RyhB, like MgrR, base pairs to the 5’ region of grlR. In contrast to MgrR and RyhB, McaS did not possess any regions of complementarity to grlR and presumably exerts its effect by sequestering CsrA. In summary, our results provide the first piece of evidence to implicate multiple Hfq-dependent sRNAs in controlling the LEE-encoded virulence of EPEC. Future studies are aimed at elucidating the molecular mechanism by which MgrR, RyhB and McaS regulate the LEE and the ensuing A/E lesion formation.

Biography:

Kartikeya Makker is an Assistant Professor in Nenatology at University of Florida College of Medicine and is the Quality Initiative Director of the Neonatal Intensive Care Unit (NICU) at UF Health. He is also a candidate for Master of Public Health at Johns Hopkins Bloomberg School of Public Health. He has several publications, national presentations and has been awarded for Medical Education on numerous occasions.

Abstract:

Ventilator-associated pneumonia (VAP) is a serious complication related to mechanical ventilation in the neonatal period. However, lack of a specific definition and difficulties obtaining noncontaminated samples of the lower respiratory airway render microbiological diagnosis and etiological treatment extremely difficult. Thus far, only few studies have approached VAP using accepted Centers for Disease Control and Prevention criteria and reliable sampling techniques. In recent years, however, the blind-protected bronchoalveolar lavage technique with protected specimen brush and the development of validated biomarkers have attempted to overcome the diagnostic difficulties and assess the response to therapy. This presentation on neonatal VAP aims to stimulate neonatologists’ interest in this subtle but serious complication of mechanical ventilation.

Biography:

Ashok Kapse is a consulting Pediatrician practicing in the city of Surat in the Gujarat state of India, besides owning a private pediatric hospital he is also the Head of the Pediatric Department at a prestigious Mahavir Super Specialty Hospital. After completing graduation (MBBS) he did MD in Pediatrics. Initially he has worked as a Professor of Pediatrics at Medical College Surat, later he opted out for private practice however pursued academic interest. He has developed special interest and skills in infectious diseases. He is a recipient of many oration awards and delivered hundreds of lectures on dengue, malaria, typhoid and antibiotic uses across India. He has decorated many posts in medical fields: President of Surat City Branch of Indian Academy of Pediatrics (IAP), President of Gujarat State Branch of IAP and National President of Infectious Diseases Branch of IAP are few of them. He is an avid Clinical Photographer; his photos figure into various books and atlases including the prestigious atlas of infectious diseases published by American Academy of Pediatrics. He has published umpteen articles in peer reviewed journals.

Abstract:

Child presenting with rash is common occurrence in pediatrics. Rash presenting with fever provides you material for microbiological evaluation, offers you unique opportunity to make clinical diagnosis and gives clinician vital leads towards severity markers. A case could be approached in different ways however rash based approach is the easiest way for clinical evaluation. Classification and evaluation of rash as erythematous, maculopapular, papulovesicular, petechial, blisterous and so on leads clinician to correct diagnosis and proper management. Correct typing of rash directs clinician towards a careful wait and watch approach in certain clinical situation while dictates him to act emergently in others. I intend to provide an easy clinico-pictorial approach for a case presenting with rash in day to day practice.

Biography:

Maria Del Rosario Davalos Gamboa has acquired her Pharmaceutical Biochemistry degree from the University of San Simon. She has started working at the University of San Simon in the Faculty of Medicine at the Laboratory of Nuclear Medicine and later from August 1992 continued working as a Teaching Research Assistant till 1998. From 2009 to 2010, she was the Director of the Research Institute of the Faculty of Dentistry UMSS and in 1997 won a competency exam at the Faculty of Dentistry UMSS in Biochemistry and appointed as a Professor. She is currently a Legal Representative and owner partner (in a greater proportion than 51% of shares) of the International Associated Factory oils and coals SRL ACECAB, in the city of Santa Cruz, Bolivia, whose principal activity is to generate cosmetic oils and charcoal.

Abstract:

Introduction: In Bolivia there is no research to identify the effect of socioeconomic status, diet and physical activity in cancer in children and adolescents.

Objectives: The aim of this study was to identify the predominant types of cancer in children and adolescents attending the Children's Hospital Manuel Ascencio Villarroel in Cochabamba (Bolivia) and the effect it had on these socioeconomic status, diet and physical activity.

Methods: Cross sectional study conducted in January 2016 in children and adolescents with cancer (n=36) between zero and 16 years old who attend the Hospital Manuel Ascencio Villarroel child of Cochabamba (Bolivia), involving 21 male and 15 female. Parents or guardians of the participants were surveyed. It has been made a descriptive and explanatory analysis.

Results: The prevalent cancer in this population was leukemia. In a proportion of 72.22%, cancerous tumors in various parts of the body were 11.11% and other cancers were 16.7%. In the socioeconomic status of the parents, lived in urban areas 66.66%, 50% lived in a rented house, 66.6% had a house built of brick and 52.77% lived in two rooms of 47.22 parents had secondary school and 36.11% of primary school. In the type of feeding natural products before the diagnosis of cancer, 41.66% used to eat natural carbohydrates, 61.11% natural protein, natural fats 61.11%, 63.88% natural fruit, 55.55% natural fiber, drank plenty of water 27.77%. The type of food not suitable before diagnosis of cancer, ate deli meats 33.33%, 75% drank carbonated soft drinks, 83.3% ate junk food sugar and refined flour and 77.77% ate junk food. No statistical significant differences in physical activity were detected.

Conclusions: This study identified that leukemia is the prevalent type of cancer in children and adolescents who regularly attend child Hospital Manuel Ascencio Villarroel in Cochabamba. That most children and adolescents with cancer live in urban areas and are economically disadvantaged. The feeding they received before the cancer diagnosis was a varied diet based on natural products and not suitable that facilitate the development of cancer and almost all the children and teens commonly consumed soft drinks, refined sugar, refined flour and junk food products; Foods that are related to the origin of cancer.

Biography:

Muhamad Ali K Shakhatreh has completed his PhD. from University of Dayton- USA.  Currently, he is an Assistant Professor in Jordan University of Science and Technology (Jordan) in the field of Microbiology.  His research experience and interests are in bacteriology with focusing on medical microbiology.  He has 6 publications.

Abstract:

Waterpipe tobacco smoking (WTS) has significantly increased worldwide. It has become a global public health problem (threat) and a serious global concern. This type of smoking is not a safe alternative to cigarette smoking which is a potential risk factor. The effects of waterpipe tobacco smoking on health outcomes remain unknown. However, few studies investigated and reported the relationship between waterpipe tobacco smoking and adverse health effects (deleterious health effects associated with waterpipe tobacco smoking). Little is known about effects of waterpipe tobacco smoking on oral health (if it can cause oral health problems). The objective of the current investigation is to determine the effect of waterpipe tobacco smoking on the changes in oral microbial flora which is still under investigation. Samples were taken aseptically from the oral cavity and subgingival regions of healthy participants (waterpipe smokers and waterpipe non-smokers). To identify types, frequency and mean number of microorganisms in cultures from the oral cavity and subgingival regions, standard bacterial culture methods were used. The present study provides a preliminary proof (evidence) indicating that oral microbial flora is significantly changed (altered) by waterpipe tobacco smoking (linking between waterpipe tobacco smoking and alteration in oral microflora).

Biography:

Thambarasi Sundaram has completed her MBBS and Post graduation studies from Sri Ramchandra University, India.

Abstract:

Objectives: To determine the usefulness of Typhidot M in rapid diagnosis of typhoid fever in children and to determine the sensitivity and specificity of Typhidot M with blood culture as gold standard.

Methods: Blood samples were collected from 130 children who were clinically diagnosed as typhoid fever. Typhidot-M is a dot enzyme immunoassay for detection of specific IgM to Salmonella Typhi. Samples were serologically tested with Typhidot assay as per the kit instruction (Typhipoint M/s AB diagnopath Mfg. Pvt. Ltd). For analysis purpose study group was divided into four; Confirmed Typhoid fever: Diagnosis of typhoid fever as confirmed by positive culture of S. Typhi; Probable typhoid fever: Children with fever and with a positive serodiagnosis (WIDAL) or antigen detection test but without S. Typhi isolation; Clinical enteric fever: Patient’s whose clinical course is compatible with typhoid fever but without S. Typhi isolation; and Non-typhoid fever: Children with definitive alternative diagnosis and in whom blood culture is negative for Salmonella Typhi.

Results: Of the 130 blood samples, 31 (23.8%) were positive of Salmonella Typhi infection and remaining 99 were negative for Salmonella Typhi. 54 (41.5%) were typhidot IgM positive. There were no cases in which culture was positive and typhidot negative. But there was false positive in 23 patients (17.6%). Of these 5 were probable typhoid fever, 2 were clinical typhoid fever, 3 had infection with S. Paratyphi A and 13 patients in non-typhoid group. The sensitivity, specificity, positive and negative predictive value of Typhidot test in comparison with blood culture were 100%, 76.7%, 57.4%, 100%, respectively.

Conclusions: After analyzing the present study, it was concluded that blood culture remains the gold standard for the diagnosis of typhoid fever. Typhidot M may be an alternative in early and rapid diagnosis of typhoid fever where facility of blood culture is not available.

Biography:

Otache A E is affiliated to the University of Nigeria, Nigeria.

Abstract:

Introduction: Leprosy is a chronic infectious disease that is associated with serious morbidity and is a disease of public health concern because of the social stigma. Knowledge, attitudes and practices of medical practitioners is vital in the control.

Objective: The aim of the study was to assess the knowledge, attitudes and practices of medical officers and interns regarding leprosy disease.

Methods: This cross sectional study was conducted among medical officers and interns in University of Nigeria teaching Hospital and Enugu State University Teaching Hospital, both in Enugu. Data was collected using a self reported questionnaire on the knowledge, attitude and practices towards Leprosy. Data was analyzed using SPSS version 21 and statistical significance of association between variables was assessed using Chi-square test at p<0.05. Ethical clearance was obtained from the Research Ethics Committees of both health facilities.

Results: All the 26 medical officers and 262 interns returned the completed questionnaires. In the study, interns showed higher knowledge 78.2% than medical officers 60.4%. Knowledge of the respondents on diagnosis, management and prevention of leprosy was adequate. However, their overall attitudes and practices towards leprosy were poor. 50% of them would not eat, 79.9% would not marry and 34.7% of them would not agree to perform cardio-pulmonary resuscitation (CPR) to persons affected by leprosy. Only 33.3% would like to work in any leprosy referral hospital, while 5.1% would not agree to be admitted in the same hospital with persons affected by leprosy and 31.3% would like to isolate people affected with leprosy from the general community. Agree to perform CPR and category of profession relationship was not statistically significant (X²=8.296, df=4, p=0.081), but the relationship with the age of the participants was significant (X²=17.111, df=8, p=0.029).

Conclusion: The study revealed there is adequate knowledge among medical officers and interns with regards to leprosy in the two hospitals. However, their attitudes and practices are poor. There is need to organize training programs at regular intervals for interns and medical officers in out-patients departments.

Biography:

Marisa Egan is affiliated to the Saint Joseph’s University, USA.

Abstract:

Enteropathogenic Escherichia coli, commonly known as EPEC is a diarrheal pathogen that infects infants in developing countries. The bacterium belongs to the attaching and effacing (A/E) morphotype of pathogenic E. coli, since it infects infants by directly binding to intestinal epithelial cells and destroying the microvilli. The virulence of EPEC is attributed to its major pathogenicity island: The locus of enterocyte effacement (LEE). Treatment of EPEC infections is particularly challenging, because currently there are no vaccines against this bacterium. The problem is only exacerbated by the emergence of multi-drug resistant strains of EPEC. Thus, understanding the regulatory pathways that govern the LEE is critical towards the development of effective measures to combat EPEC infections. The LEE is responsive to a myriad of environmental cues with the majority of them targeting three LEE-encoded transcription factors: Ler, GrlR, and GrlA. Whereas transcriptional regulation of the LEE has been widely characterized, post transcriptional regulation including regulation by trans-encoded regulatory small RNAs (sRNAs), remains understudied. Most sRNAs exert their effects by directly base-pairing to their target mRNAs to influence the translation and/or stability of the target mRNA. A subset of these sRNAs requires Hfq, a chaperone protein that assists in the finding and base-pairing of sRNAs to their target mRNAs. One such sRNA is RyhB. Preliminary results suggest that Hfq and RyhB core press the grlRA mRNA that encodes GrlR and GrlA. To better understand the mechanism of action of RyhB on the grlRA mRNA, we preformed in silico alignment analysis. By using IntaRNA, we identified regions of complementarity between RyhB and the ribosomal binding site, in the 5’ untranslated region (UTR), of the upstream gene grlR in the grlRA mRNA. In order to confirm this prediction of direct base-pairing between RyhB and grlRA, we constructed a polynucleotide mutation in the seed region of RyhB; this mutation completely abolished the ability of the mutant RyhB to base pair to and represses the grlR-lacZ fusion. Thus, collectively, our results suggest that RyhB represses the LEE by directing base-pairing to the leader segment of the grlRA mRNA and preventing the expression of both GrlR and GrlA. Future studies are aimed at further understanding the RyhB-mediated regulation of the LEE by genetic, biochemical and phenotypic assays to with the goal of developing efficacious and potent pharmacological targets against EPEC.

Biography:

Moamen AL Zoubi is affiliated to Advocate Illinois Masonic Medical Center, USA.

Abstract:

Cardiac tamponade is a life threatening condition often requiring urgent or emergent pericardiocentesis and close monitoring in the ICU. We report a 51 year-old spanish speaking female with a history of hypothyroidism who presented with facial swelling, SOB and orthopnea for 3 weeks. She denies joint pain, rash, fever, chills, weight loss. She had travelled to Mexico 6 years ago but did not remember exposure to TB patients. She had not received BCG vaccine as a child. In the ER her vitals were stable. Labs were remarkable for Alk phos 230, AST 63 and ALT 102. Otherwise, unremarkable including normal thyroid function test. ANA comprehensive panel and HIV test were negative. The ECG showed sinus rhythm and low QRS amplitude. Chest X-ray demonstrated bilateral pleural effusion. Echocardiogram showed large pericardial effusion with features consistent with tamponade physiology. Urgent pericardiocentesis was done with 450 ml fluid withdrawn. Thoracentesis was done as well and samples were sent for analysis. The fluids was an exudate.AFB smears and fungal culture came back negative. Repeated Echo showed complete resolution of pericardial effusion. Patient was discharged on colchicine 0.6 mg by mouth twice a day x2 weeks. Two weeks later the patient presented again with dyspnea and found to have cardiac tamponade after performing Echocardiography. Patient was taken to the operating room and a pericardial window was performed. TB quantiferon test found to be positive from the previous admission and she was started empirically on anti-TB medication as recommended by infectious diseases service. The results of pericardial biopsy showed no evidence of TB or sarcoidosis. No granulomas or malignant cells were seen. AFB smear was negative in three consecutive samples and Anti-TB medication were discontinued. Viral serology sent and came back elevated as high as 320:1 for coxsackie B type 4. Repeated Echocardiogram showed no pericardial effusion and patient reported improvement of her symptoms. The patient was discharged on indomethacin 50 mg BID with a cardiology follow up in 2 weeks. To the best of our knowledge, this is the first reported case of cardiac tamponade secondary to group B coxsackieviruses. We encourage considering viral causes as a probable etiology for cardiac tamponade of unknown etiology.

Biography:

Anamika Gupta has completed her PhD from Banaras Hindu University, India and Postdoctoral studies from National AIDS Research Institute, India. Currently, she is working with Boston University School of Medicine as a Visiting Researcher. She has published 13 papers in peer reviewed journals and 5 manuscripts are in process. She has also published 3 chapters in the books of international repute.

Abstract:

Beijing genotype of Mycobacterium tuberculosis has attracted special attention due to its association with multi drug resistance and rapid transmission. The present study was undertaken to investigate the prevalence of Beijing genotype of M. tuberculosis and their association with drug resistance and clinical characteristics of TB patients. A total of 381 clinical isolates were cultured from more than 4000 TB patients’ sputum samples from 2008 to 2014, of which the genetic profile was determined by using multiplex-PCR and Spoligotyping methods and the drug susceptibility testing to first-line anti-TB drugs was performed by using proportion method and MGIT960. Detection of mutations at rpoB codons (516, 526 and 531), katG codon 315 and embB codon 306 in Beijing and non-Beijing-strains were determined by MAS-PCR and DNA-sequencing. We also characterized a collection of M. tuberculosis isolates to see if Beijing strains had a higher rate of mutations in katG315, rpoB-RRDR region and embB306 gene. Multidrug-resistance was observed to be significantly associated with Beijing strains (p=0.03) and a strong correlation between Beijing strains and specific resistance mutations in katG315, rpoB531 and embB306 gene segments was also found (p=<0.0001, <0.0001 & 0.0014 respectively). These findings will help to understand the transmission and drug resistance related genetic characteristics of the Beijing/W genotype of M. tuberculosis and may provide a scientific basis for the development of new TB diagnostic tool for effective management and control of TB in countries with higher prevalence of Beijing strains.

Biography:

Mojdeh Habibi Zoham has completed General Medicine from Tehran University of Medical Sciences in 2009. She continued her work with graduation in Pediatrics from Tehran University of Medical Sciences in 2012. After her graduation, she has started working as an Associate Professor of Tehran University of Medical Sciences. She has been working in Pediatric ICU ward of Bahrami Children Hospital for at least 3 years and has 6 published articles in reputed journals.

Abstract:

Basidiobolomycosis is a rare fungal disease caused by Basidiobolus ranarum which is an environmental saprophyte. It is a chronic inflammatory disease that is generally restricted to the subcutaneous tissue and rarely involves gastrointestinal tract. With the intent to spread the awareness of this potentially life threatening and rare infection, we report a 4 years old boy presenting with abdominal pain and fever with eventual diagnosis of gastrointestinal basidiobolomycosis. We discuss the non-specific and confusing of symptoms of this rare infection and treatment options in detail.

Biography:

Hammad A is affiliated to National Ribat University, Sudan.

Abstract:

Background: Humans infected with schistosoma parasite demonstrate substantial immune responses against both adult worms and eggs. This response can be studied in different age group in both males and females in exposed and infected population. The study aimed to determine the humoral immune responses of Sudanese residents in an endemic area of Schistosoma haematobium.

Methods: Syringe filtration techniques were used to detect Schistosoma haematobium eggs. To rule out Schistosoma mansoni and other helminths infection, Kato Katz technique for the examination of stool was used. One hundred twenty eight individuals were included in the study. Twenty one subjects who were Schistosoma haematobium negative participated in the study as a control group. Different ELISA techniques were used to detect different anti-Schistosoma haematobium antibodies.

Results: The mean infection intensity was 61.92 eggs per 10 ml urine. Peak infections were found among the age group of 3-13 year. 53.1% had light infection and 46.9% had heavy infection. High levels of anti-soluble egg antigen (SEA) IgE was detected in infected individuals in the age group range (13-23 years) while low levels were observed in individual of ˃23 year of age. The highest anti- (SEA) IgA level was detected in old patients. The highest anti-SEA IgM levels were found in children aged 3-13 year. Females produced high levels of anti-SEA IgE, IgM and IgG, while males produced high levels of IgA.

Conclusion: These results showed high production of IgE which may protect the host until development of other immune responses and may also protect the host from re-infection.

Biography:

Musa H A is affiliated to National Ribat University, Sudan.

Abstract:

Background: Schistosome-specific acquired immunity capable of reducing levels of infection or re-infection develops slowly. The nature of these protective immune responses suggesting that anti-helminths immune responses fall into a Th1 (pro-inflammatory) and Th2 (anti-inflammatory).

Objective: The aim of this study was the detection and quantification of pro-inflammatory cytokines in both sera and urine of patients with urinary schistosomiasis.

Methodology: One hundred and thirty sera and urine were collected from patients with urinary schistosomiasis in two villages south Elduiem (Sudan). The disease was confirmed by finding Schistosoma haematobium eggs in urine using syringe filtration techniques. To rule out Schistosoma mansoni and other helminths infection Kato Katz technique for stool examination was used. Sera and urine of seventy subjects who were Schistosoma haematobium negative included in the study as controls. Samples were examined for IFNγ and IL-2, cytokines level using ELISA techniques.

Results: The prevalence of Schistosoma haematobium infection in the study population showed that the peak of infection was in childhood (3-13 years) followed by a sharp decline in infection intensity. Males infected more than females 62% and 38% respectively. Measurements of parasite specific cytokine responses showed high levels of both cytokine productions before treatment then after treatment. There are significant differences in cytokine production in infected groups and control one. Females produce high levels of IFNγ and IL-2 than males. Aged people produce high levels of both cytokine than young people. There are a positive association between the production of cytokine and intensity of the infection.

Conclusion: The conclusion drawn from the study is that pro-inflammatory cytokines were produced in large amount before treatment with significant difference between males and females.

Biography:

Nurul Azmawati Mohamed has completed her Bachelor of Medicine and Surgery in 2002 from University of Sheffield, United Kingdom and Masters of Pathology (Medical Microbiology) in 2012 from National University of Malaysia. She is a Clinical Microbiologist and Senior Medical Lecturer at Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia. Her interest is in bacteriology, particularly on antibiotic resistant organisms. She has published 10 articles in journals and presented in conferences locally and internationally.

Abstract:

Background: Taking honey with citrus juice (lemon/lime/calamansi) to soothe sore throat has been practiced in many parts of the world for decades. Various combinations of honey with different types of citrus juice (lime, lemon and calamansi to name a few) have been traditionally used by the Egyptians, Assyrians, Greeks, Romans, Chinese, Indians and Malays for the treatment of sore throat. The amount of honey and citrus juice used also varies from different cultures and places.

Objective: To systematically review the antibacterial effect of honey and citrus juice on Streptococcus pyogenes.

Methodology: Using the keywords honey, manuka, tualang, citrus, lime and Streptococcus pyogenes, we systematically searched EBSCOhost, Ovid, Scopus and WEB OF SCIENCE databases for reports of studies investigating the antibacterial effect of honey and citrus juice on Streptococcus pyogenes.

Results: A total of 415 abstracts were initially identified. 26 abstracts were finally chosen and reviewed by looking at the title, abstracts and full paper using pre-determined inclusion and exclusion criteria in relation to honey (n=22) and citrus (n=4). None of the articles studied the effect of both honey and citrus juice on the organism. Majority of the studies showed that both honey and citrus have significant antimicrobial effect on Streptococcus pyogenes.

Conclusions: There is no available data on the combined effect of honey and citrus on Streptococcus pyogenes. This knowledge gap offers an opportunity to investigate those effects with the purpose to support traditional practice with scientific evidences.

Biography:

Nurul Azira Binti Mohd Shah has completed her degree in Bachelor of Medicine and Bachelor of Surgery (MBBS) from University of Malaya, Malaysia. She was also awarded Master of Pathology (MPath) in Clinical Microbiology from Universiti Sains Malaysia. She is a Clinical Microbiologist and Medical Lecturer in Universiti Teknologi MARA, Malaysia.

Abstract:

Background: Amoebiasis is a parasitic disease caused by Entamoeba histolytica that causes death in developing country. The gold standard treatment for amoebiasis is metronidazole. However, the emergence of resistant against metronidazole has been increasingly reported. Thus, it is important to search for other alternative control measure which is safe and effective. Medium chain triglyceride (MCT), an active compound in natural products is widely available as a nutrient supplement and has been shown to have anti-protozoal properties.

Objective: Therefore the objective of this study is to investigate the potential effect of medium chain triglycerides (MCT) against amoebic infections.

Methods: The trophozoites of Entamoeba histolytica HM1: IMSS strain were axenically cultivated in TYI-S-33 medium in culture flasks and incubated anaerobically by using Anaerocult A (Merck). The anti-amoebic effect was determined by measuring the minimum inhibitory concentration (MIC) of E. histolytica against MCT active compounds which include lauric acid, capric acid, caprylic acid and caproic acid were based on scoring of trophozoites growth using the standard method.

Results: Lauric acid and capric acid exhibited anti-amoebic effect with minimum inhibitory concentration (MIC) of 400 μg per ml and 800 μg per ml respectively.

Conclusion: In conclusion, MCTs was active against E. histolytica in vitro and should be considered as a probable anti-amoebic compound in amoebiasis.

Biography:

Veeraraghavan Meyyur Aravamudan is senior resident in advanced internal medicine at National University Hospital, Singapore.

Abstract:

A 46 year old Malay male with past surgical history of mastoidectomy in 2007 for cholesteatoma was admitted with sudden onset of headache, altered level of consciousness and lethargy for 1 day. Associated symptoms included multiple episodes of non-projectile vomiting and photophobia. He denied blurring of vision, otalgia and otorrhea. Physical examination revealed a lethargic looking male patient with a GCS of 3. His temperature was 38.5 ^oC. Neck rigidity was present on movement in all directions. Cranial nerve and fundoscopic examination was unremarkable. He had skew deviation of eyes to right. Rest of the neurological examination did not reveal any motor deficits. He was started on empirical intravenous ceftriaxone, vancomycin, acyclovir and ampicillin for clinically suspected meningitis while awaiting lumbar puncture results. Computerized tomography (CT) of brain was normal. Cerebrospinal fluid (CSF) obtained from lumbar puncture showed cell count of 900 units per mm³ with 80% lymphocytes and 20% neutrophils, protein of 0.92 gram per liter and glucose was 1.7 mmol per liter. Gram stain did not reveal any organism and cultures were negative. Polymerase chain reaction (PCR) for neurotropic viruses i.e., HSV, measles, mumps and enterovirus were negative. Cerebrospinal fluid acid fast bacillus (AFB) smear was negative. Computerized tomography (CT) temporal bone with contrast showed right middle ear and mastoid cholesteatoma with surrounding infected granulation tissue which extended into the inner ear and intracranially. He was subsequently referred to ENT and underwent right modified radical mastoidectomy. He made a good clinical recovery. Cholesteatoma is a destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process. Because of their erosive and expansile properties they can destroy the ossicles and can potentially spread into the base of the skull into the brain causing meningitis. Even though the incidence of cholesteatoma causing meningitis is rare, these are still potential life threatening complications. Cholesteatoma is still considered a surgical disease requiring either the complete removal of its squamous lined matrix or its exteriorization for continued aural toilet and ventilation. In the pre-antibiotic era, the mortality rate from intracranial complications following the otologic diseases was approximately 75%. In the post-antibiotic era, mortality was around 34%. Meningitis is the most common intracranial complication. There are three dissemination passages for the occurrence of otogenic meningitis which are hematogenous, congenital dehiscence (such as Hyrtl’s fissures) or preformed (osseous erosion). Every patient with suspicion of complication needs to be followed up by several medical specialties and must be submitted to full physical exam and computerized tomography with contrast. The treatment must be aggressive with early initiation of intravenous antibiotic and early drainage of the infectious focus in order to reduce the morbidity and mortality rate. Early recognition and computerized tomography of temporal bone were important in diagnosis of meningitis secondary to cholesteatoma and prompt referral to ENT surgeon for early surgery should be considered to avoid long-term complications.

Biography:

Onyinye Jane Onyemaechi is a 5th year medical student at First Moscow State Medical University I.M Sechenov, Russia. She is a member of Build Africa Capacity and also she is the president of Association of Nigerian Scholarship students in Russia. In 2011, she was awarded scholarship for her astounding academic excellence to study medicine in Russia. Her interest in tropical medicine grew with her increasing desire to help eradicate malaria. She has been a part of research programs, one of which resulted in the abstract “Evaluating the prevalence of drug resistance in intermittent preventive treatment for malaria during pregnancy”. She understands how to successfully fight for malaria eradication and collective efforts are vital and hopes made people to get inspired to make contributions towards achieving malaria eradication.

Abstract:

Background & Objective: Due to the poor patient compliance with prophylaxis and increasing resistance of parasite strains to chloroquine, administration of intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine/pyrimethamine is now recommended for all pregnant women living in areas with stable malaria transmission. However, resistance to sulfadoxine/pyrimethamine is on the increase which risks the drug being compromised. Thus, an urgent need exists to assess alternative drug regimens for IPTp.

Design & Method: Numerous molecular epidemiologic studies showed that resistance to pyrimethamine is associated with the acquisition of mutations in Plasmodium spp. dihydrofolatereductase (dhfr) genes while resistance to sulfadoxine is associated with 3 mutations in dihydropteroate synthase (dhps gene). Each mutation leads to a decrease in sensitivity to pyrimethamine (dhfr gene) and sulfadoxine (dhps gene).

Results: On a systematic review, results indicated that 2 doses of IPTp with sulfadoxine/pyrimethamine retained activity to reduce placental malaria and low birth weight amongst pregnant that visited the clinic. About >60% of the pregnant women that visited the clinic benefited with 2 doses of IPTp in the proportional reduction of peripheral parasitaemia at delivery compared with that at enrolment while the rate of resistance was at <39% and the proportion of placental infection was reduced by 75% compared with the efficacy of chloroquine prophylaxis administered the previous year.

Conclusion: An alternative approach involves systematic detection of placental infection at delivery by using blood smear, rapid diagnostic test or PCR with placental blood. Conversely, placental infection prevalence may change with time because of changes in sulfadoxine/pyrimethamine efficacy (likely to decrease) and quality of IPTp implementation (likely to increase). Such an approach would also provide baseline data to assess efficacy of all preventive measures against pregnancy-associated malaria, including IPTp and use of insecticide-impregnated bed nets and will enable assessment of these effects in a specific population.

Biography:

Leticia Gely has completed her MD from University of Puerto Rico, School of Medicine. She has completed Pediatric Residency at the University of Puerto Rico in the year 2013 and is a Board Certified Pediatrician. She is currently a 2^nd year Fellow in the Neonatal-Perinatal Medicine Program at the University of Puerto Rico. She is a Member of National Academic Associations.

Abstract:

Zika virus (ZV) is a mosquito-borne Flavivirus primarily transmitted by Aedes aegypti mosquitoes found in tropical regions. ZV infection may occur by vertical transmission to the fetus or by intrapartum transmission from a viremic mother to the newborn, and may have severe implications to the newborn health including microcephaly. The World Health Organization and the Centers for Disease Control and Prevention (CDC) activated their respective emergency operations centers to better coordinate response to the ZV outbreak. The Neonatology Section, University of Puerto Rico provides services in a Level 3 Neonatal Intensive Care Unit. A protocol was design based on the CDC and the Puerto Rico Health Department guidelines. The specific aim is to identify, evaluate and treat appropriately all fetus/newborns with possible intrauterine ZV exposure. The protocol included a quality improvement strategy with process mapping for all deliveries with documented prenatal ZV exposure. All interventions will follow the standard evaluations and procedures based on the infant’s needs as recommended by the American Academy of Pediatrics and the CDC recommendations. Review of the process map with local managers and frontline health professionals revealed multiple areas which require improvement, such as including new questions of events occurring during prenatal period and accessibility to prenatal laboratory and fetal ultrasounds for appropriate identification of cases and avoid adding steps that do not add value to the process, will dramatically increase the cost of interventions in a time of decreased funding and may interfere with the standard newborn care and the promotion of breastfeeding practices.

Biography:

Mansour Amin has completed his PhD from Pune University, India in Microbiology. He is an academic member of 1Health Research Institute, Infectious and Tropical Diseases Research Center, Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. He has published more than 40 papers in different academic journals.

Abstract:

Introduction: Bacterial Meningitis (BM) is a medical emergency and is a life threatening condition in the populations of infants and children. The most common etiologic agents of acute BM are Haemophilus influenzae type b (Hib), Streptococcus pneumoniae and Neisseria meningitides.

Material & Methods: In this study, 196 cerebrospinal fluid samples (CSF) were taken from the infants and children under 5 years of age suspected to BM. Three milliliter of CSF was collected in three sterile tubes. The first tube was used for blood cell count, protein and glucose detection, the second tube was used for bacterial culture and direct smear and the tertiary was used for DNA extraction and PCR.

Results: Out of 196 cases, BM was confirmed by PCR in 9 samples and bacterial culture in 3 samples. The frequency of Hib was 8 cases. Furthermore, Hib was detected in 3 cases by both of the bacterial culture and PCR but in the five other cases, this bacterium was recognized only by PCR. S .pneumoniae was detected in one case only by PCR. In this study, any N. meningitides was not found in the based on the culture or PCR.

Conclusion: The frequency of Hib in Iran is more than other bacterial meningitis agents in Iran. The introducing of Hib vaccine has been started from December 2014 in Iran and the samples of this study were taken before this time. We wish the immunization protect the children and decries the rate of Hib in next studies.

Biography:

Roland N Ndip has obtained his PhD in 1994 from the Edo State University, Nigeria. He has worked as a Professional Microbiologist for over 20 years successively at Edo State University, Nigeria; University of Fort Hare, South Africa and the University of Buea, Cameroon rising to the rank of Professor of Microbiology. His research has concentrated in the areas of microbiology, molecular biology, antimicrobial chemotherapy and alternative and complementary medicine. He has published over 100 articles in international peer reviewed journals of repute. He currently serves as a Registrar at the University of Buea, Cameroon.

Abstract:

The aim of this study was to isolate and identify phytochemicals with anti-Helicobacter pylori activity from the stem bark of Sclerocarya birrea. The plant crude extract was fractionated by silica gel column and thin layer chromatography techniques; initially with ethyl acetate (EA) and subsequently with a combination of ethyl acetate/methanol/water (EMW). Further fractionation and identification of the phyto-constituents was achieved by gas chromatography and mass spectrometry (GC/MS) analysis. The antimicrobial activity of the fractions and compounds was evaluated against 5 metronidazole and clarythromycin-resistant strains of H. pylori and a reference strain ATCC 43526 using micro-broth dilution technique. Amoxicillin was included in these experiments as a positive control antibiotic. Sixteen of the 18 fractions collected demonstrated anti-H. pylori activity with minimum inhibitory concentration (MIC₅₀) values ranging from 310-2500 µg/mL. Two of the fractions; EMW fraction 6 and EA fraction 1 revealed the presence of 5 and 24 compounds respectively representing 40.5% and 86.57% of the total composition. Most of the compounds were essential oils with terpinen-4-ol being the most abundant agent (35.83 %), followed by pyrrolidine (32.15 %), aromadendrene (13.63%) and α-gujunene (8.77%). MIC₅₀ values for amoxicillin, terpinen-4-ol and pyrrolidine ranged from 0.0003-0.06 µg/mL, 0.004-0.06 µg/mL and 0.005-6.3 µg/mL respectively. The inhibitory activities of terpinen-4-ol and pyrrolidine were similar to amoxicillin (P>0.05). Most of these compounds are being reported in this plant for the first time and may represent new sources of therapeutically useful compounds against H. pylori.

Biography:

Neeraj Kumar Tulara has completed his Post graduate Diploma in Infectious Disease from South Wales University, Australia. He is a Diplomate at National Board-Internal Medicine, India. He is an MBBS (Bachelor of Medicine and Surgery), India. He is a Member of IDSA, USA. He is an Editor for SM Tropical Medicine Journal, USA and a Reviewer of Biomedical Sciences, USA.

Abstract:

Background: Fever is most common presentation of any disease of any etiology. For children many fever protocol has been practiced in developed and also developing world but for fever in adult patients there are paucity of literature about how to investigate and treat the adult patient presenting first time with the fever in emergency care.

Objective: Objective of this study is to devise standard care pathway for all adults who presents with fever with no localizing signs in order to avoid unnecessary investigation and unwanted antibiotics. After devising fever protocol, pilot study was performed to see its effectiveness.

Methods: A protocol was formulated for all adults presenting with fever without any signs of SIRS and no localizing signs to suggest the clear etiology of the fever. Initial investigations were based on duration of fever, type of fever and associated symptoms along with fever. Treatment was based on the results of investigations. A pilot study was conducted wherein all adults with fever were included and data were analyzed.

Results: During the 3 month study period 1109 adult patients were presented with fever in emergency department, out of them 876 were fitting in the parameters of devised protocol with 659 patients were presented within the first 48 hours of the onset of fever. All patients experienced the defervescence of the fever. Of the patients presented within 48 hours, 69.8% (460/659) defervesced without the need of any investigations and 63.2% (416/659) defervesced without the need of any antibiotic therapy.

Conclusion: Implementation of fever protocol in emergency care department helped to reduce the unnecessary investigation and antibiotics. Thus reducing the cost of the management of fever and also the most important is to help in reducing the antimicrobial resistance by reducing the unwanted used of antimicrobials.

Biography:

Ashraf Osman Abdellatif Mohamed is currently a PhD student at Faculty of Pharmacy, Cairo University, Egypt. He has published five papers in reputed journals.

Abstract:

Combining and incorporating of the natural antimicrobials with metal nanoparticles is a growing research area because of their potential applications in nanomedicines to enhance and synergize their activity as well as to minimize unwanted side effects by using lower concentrations. The aim of the present study was to investigate the feasibility of using tea tree oil (TTO) and greenly synthesized silver nanoparticles (AgNPs) alone and in micro emulsion combination formula against representative wound infecting pathogens namely; Staphylococcus aureus, methicillin resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and Candida albicans. The result of the bioassay showed that both TTO-AgNPs combination possesses a potential antimicrobial property. Based on the minimum lethal concentration (MLC), the fractional lethal concentration index (FLCI) showed that treatment with combinations of TTO and AgNPs exerted a synergistic effect against MRSA (FLCI=0.233) followed by P. aeruginosa (FLCI=0.263) and indifferent effects against S. aureus and C. albicans (0.53 and 0.73, respectively). As well, analysis of the morphological changes in S. aureus cells by transmission electron microscope (TEM) revealed that, AgNPs aggregated and located non-specifically on the cell wall, also, AgNPs were seen within the cell wall or the cell of bacteria. The cells became severely distorted and disrupted showing a bactericidal action when compared to untreated cells. In conclusion, these results showed the potential of using TTO and AgNPs in form of micro-emulsion combination and this could be developed into a broad spectrum pharmaceutical product for treating wound infections.

Biography:

Ahmad Shah Farhat assistant professor of neonatology has completed neonatology subspecialty Mashhad University of Medical Sciences, Iran. I am vice chancellor of Neonatal Research Center in this university since 2006 and consultant neonatologist of neonatal intensive care unit since 1992 up to now. I have published 66 papers locally and international journal, 19 books, 71 supervision of thesis in general medicine, pediatric, and neonatology, 120 participation in national and international congress with lecture and poster presentation. I was member of 50 national scientific organs during last 23 years. I have 10 scientific honors in pediatric and neonatology.

Abstract:

Introduction: Infection is a common cause of neonatal death, nosocomial infection may increase neonatal death at NICU, as we know the nosocomial infection is more than 11% at NICU, we decide to study the result of contamination of devices solutions and personal hands at NICU and based on the type of bacteria and the device which is contaminated we take the serious steps for prevention of contaminating and its disinfection.

Method: All devices and solutions which were related to neonates studied with culture during Jan 2014-Jan 2015 at NICU of Emam Reza Hospital, Mashhad, Iran. Two samples were taken by head nurse weekly. If the culture was positive after disinfection of devices another's culture was taken.

Result: From155 samples, 66 samples were sterile (42/6%) and 89 (57/4%) contaminated. Common organisms were gram positive non pathogen (25/8%), Staphylococcus coagulase negative (12/9%) and Staphylococcus aureus (6/5%).

Conclusion: This study shows that the common contaminable organisms are same as nosocomial organisms at our NICU and common contaminated places are incubator and personal hands.

Recommendation: Attention to disinfection of incubators and hands washing at NICU will be very important factors for contamination control.

Biography:

Mohammad Reza Hashempour has completed his Doctorate from Army University of Medical Sciences and Postdoctoral studies in Surgery from Golestan University School of Medicine. He has published papers in reputed journals.

Abstract:

Background: Nowadays, routine invasive techniques to diagnose the causes of exudative pleural effusion are going to be replaced by new non-invasive methods such as biomarkers which with the same diagnostic accuracy can confirm malignant situations at least in a group of cases who do not need more invasive means.

Aim: To evaluate concentration of calprotectin in pleural fluid with causes of exudative pleural effusion

Materials & Methods: In this descriptive-analytical and case-control study, the calprotectin concentrations in pleural fluid was evaluated in 90 patients with exudative pleural effusion and compared among two groups including 34 patients with malignant pleural effusion (MPE) and 56 patients with benign pleural effusion (BPE) in Sayyad Shirazi Hospital in Gorgan of Iran in 2014. All patients underwent examination and the necessary laboratory tests were done and closed pleural biopsy was performed if necessary. Collected data were analyzed by SPSS-21 statistical software and chi-square, t-test, ANOVA and logistic regression analysis.

Results: Calprotectin concentration was (107.72±10.59) in patients with malignant causes and (114.42±23.95) in others. Calprotectin concentration was (122.34±27.03) in patient with TB. The results showed that this difference was statistically significant (p=0.05) and calprotectin rate is lower in the malignant pleural effusion. Especially, when the results were compared with patients with TB, this difference was more prominent (p=0.01).

Discussion & Conclusion: According to higher levels of calprotectin in tuberculous pleural effusions, maybe we can achieve important results in differentiating between malignant and non-malignant pleural exudate, without the need for invasive procedures, by putting together the clinical symptoms, the calprotectin concentration in pleural fluid and pleural fluid cytology results.

Biography:

Syed Ali M is now currently working as the Head of the department and Research Department of Biotechnology at Mohamed Sathak College of Arts and Science (Affiliated to University of Madras), Chennai, India. He had completed Phd in Oceanography – Marine Biotechnology 2011 (Title: Screening of various biological resources from Gulf of Mannar for the management of Dengue fever) and also Master of Philosophy and Master of Science in Marine Biotechnolgy, 2006. He had published 4238 international publication in peer reviewed journals and also contributed three book chapter. He is the member of five scientific committee to all over the world especially European Society of Clinical Microbiology and Infectious Disease, Europe (Member ID: 123822) and Advisory Board Member of all of the world.

Abstract:

Malaria is one of the most prevalent infectious diseases in the world. Treatment for malaria is commonly inadequate due to the lack of quality assured effective drugs. The effectiveness of these drugs is declining at an ever accelerating rate with consequent increase in malaria related morbidity and mortality. The newest antiplasmodial drug from plants is needed to overcome this problem. The seaweeds species are a good source of bioactive entities which exhibits many therapeutic properties. The present study was carried out to test the antiplasmodial activity of three seaweeds species distributed along the South East coast of India. Biosynthesis silver nanoparticles from Sargassum sps Caulerpa taxifolia and Dictyota dichotoma plant exhibited in vitro antiplasmodial activity against Plasmodium falciparum. Of which, the nanoparticles of D. dichotoma exhibited high antiplasmodial activity (IC50=60.11 μg.ml−1). Statistical analysis reveals that, significant antiplasmodial activity (P<0.05) was observed between the concentrations and time of exposure. The chemical injury to erythrocytes was also carried out and it shows that no morphological differences in erythrocytes by the synthesized nanoparticles of seaweeds after 48 hours of incubation. The FTIR results of most potent leaf extract-synthesized silver nanoparticles showed the prominent peaks (range between 620.967 to 2,854.14) Further, the results of XRD analysis showed the 2 hours intense values (38.11 and 70.57) within the ranges of Bragg’s reflection. In addition, the SEM analysis showed the results of particle sizes (50-100 nm). This study shows that the biosynthesized silver nanoparticles had a source of lead compounds for the development of new drugs for the treatment of malaria.

Biography:

Say-yed Hesameddin Tafreshi is affiliate to Pasteur Institute of Iran, Iran.

Abstract:

Objectives: Despite the positive effects of vaccines on control of many infectious diseases, they are not completely safe. The purpose of this article is to draw attention to the problems associated with newborns and infants immunization.

Methods: For each subject, a review of electronic sources was carried out in the PubMed and Google Scholar using appropriate key words.

Results: For different reasons including the differences between the immune systems of newborns/children and adults, severe adverse events and inefficacy of vaccines, deceptive advertising and inadequate parental awareness about vaccines and vaccination; newborns and children are at risk and a decline in public confidence is observed.

Conclusions: The revision of vaccination age changing (at least for some vaccines) in order to maintain newborns/children's health and to prevent the return of infectious diseases is required. To achieve this goal, new retrospective and prospective studies to reassess the safety, efficacy, quality and protection duration of vaccines, proper implementation of good clinical practice, establishment of a network vaccine safety database by collaboration of international organizations, vaccine manufacturers and academic centers for sharing of information and enhancement of awareness of healthcare professionals and people about immunization at global level are needed.