Day 2 :
Bazarganan Hospital, IRAN
Dr. Reza Nejat is a board certified Anesthesiologist, FCCM and ECFMG certified. He was graduated from Tehran University of Medical Sciences (TUMS) as a GP and achieved his expertise in Anesthesiology from Iran University of Medical Sciences. Fellowship in Critical Care Medicine at Sina Hospital, TUMS, made him fascinated to molecular medicine with inclination to sepsis and acute heart failure. IVIg has been one of his field of interests and experience for the past 4 years.
In addition to his positions as the chief of few hospitals and as an associate professor in Shahid Beheshti University of Medical Sciences for 8 years, he has 4 published books in the fields of cardiology, nephrology, fluid and electrolyte, nutrition, metabolism and endocrinology. He has established his website on which he publishes his articles. Dr. Nejat has presented a few articles in different conferences.
Statement of the problem: Intravenous immunoglobulins (IVIG) contains immunoglobulins pooled from the plasma of 3000 to 10000 individual blood-donors. This preparation was developed originally in 1952 as a therapeutic milestone in primary hypo-gamma-globulinemia. IVIG has subsequently been proved to have therapeutic efficacy for an ever-growing number of conditions in diverse fields of medicine. Presuming the protective characteristic of its pluripotent antibody content, IVIg is expected to have explicit impact in sepsis, yet FDA has not approved and Surviving Sepsis Campaign Guidelines (SSCG) 2012 discouraged its administration in adult sepsis.
Methodology: By reviewing of relevant articles searched through internet from 1990 to 2016, the efficacy of IVIg as an adjuvant treatment in improving the outcome in systemic inflammatory response syndrome (SIRS) and sepsis was surveyed. Based on the literature it is discernible that SIRS and sepsis with high rate of mortality in ICUs are actually detrimental much more owing to dysregulated immune system responses overwhelmed by disarray of cytokines and chemokines, declining of endogenous immunoglobulins and even deranged activation or suppression of relevant gene domains. According to the latest definition of sepsis in 2016, this dysregulated host response to infection renders the scene toward organ dysfunction.
IVIg was given to three highly critically ill patients of 95, 37 and 11 years of age, with severe sepsis due to iatrogenic sigmoid perforation, post-ERCP necrotizing pancreatitis and severe multiple trauma following collision with a truck, respectively. Before administration of IVIg the patients was given intensive care with administration of appropriate antibiotics and keeping the energy, fluid and electrolytes in a balance mode. They all recovered from sepsis and were discharged in good health.
Conclusion: Based on this review article and case report, immune-modulatory characteristic of IVIG may restore the pathobiological host responses to normal and improve the outcome in sepsis.
Baqiyatallah University of Medical Sciences,Iran
Ali Karami is Molecular biologist, Medical Biotechnologist and expert in Genetic Engineering working on Molecular detection of infectious diseases, cloning, expression and purification and characterization of recombinant proteins for medical applications. I also have been working for long time on Recombinant vaccines, DNA vaccines, Bioinformatics, microarray and other eras of molecular Biotechnology.
Background and Objective: Biological weapons like other weapons of mass destruction, including nuclear and radiological weapons are very dangerous in recent years due to characteristics such as the ability to create extensive injury , having incubation period , creating long illness , the ability to spread and epidemic and most importantly non-specific symptoms and difficulty in detection of bioterrorism attacks are increasingly used by some countries . One of the most important steps to deal with the Bioterrorism threat is microbiological detection of biological agents that can be done in the Microbiology laboratory.
Methods: This study aimed to review the role and actions of microbiology laboratories and specialists needed in passive defense against biological threats. In this study databases like CDC, Medline, Google scholar, PubMed and the World Health Organization (WHO) and other national and international sources have been used.
Results: The basic principle of control bioterrorism attacks is based on the ability to rapidly deliver health services . Microbiology laboratories play a critical role in the rapid and accurate detection of biological agents due to the lack of features such as odor, color and other physical characteristics, diagnosis is difficult and sometimes impossible.Therefore Microbiology Laboratories should be equipped with advanced detection and diagnosis methods along with rapid development of Novel biological Agents and Personnel should be trained with current detection methods and protocols and further with biosafety and biosecurity guidelines for working with bio agents.
Conclusion: With rapid Development in detection systems and methods specially molecular detection protocols and instruments for Biological Agents it will be nesecary for nationas Microbilogy laboratoryies and personel to be trained and equiped and redy for detection of any possible biological incidents.