Infectious Diseases

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

Background and Objective: Soil transmitted helminthes (STH) infection affects more than two billion people worldwide with Nigeria having the highest burden in Sub-Saharan Africa. This study examined the spatial and potential distribution of STHs in Nigeria. Materials and Methods: Secondary data were assessed from 98 journals and the prevalence of Ascaris lumbricoides, Trichuris trichiura and hookworms were extracted from them. The spatial distribution of the parasites was performed using DIVA-GIS software. The climatic variables (temperature and precipitation) and elevation variable (altitude) were used in the modeling of the parasites using Maximum Entropy

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

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

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

Mycoplasma genitalium has been proposed as a suitable model for an in-depth understanding of the biology of a free-living organism. This paper reports that the expression of the aminoglycoside resistance gene aac(69)-aph(20), the only selectable marker hitherto available for M. genitalium genetic studies, correlates with a growth impairment of the resistant strains. In light of this finding, a tetM438 construction based on the tetracycline resistance gene tetM was developed; it can be used efficiently in M. genitalium and confers multiple advantages when compared to aac(69)-aph(20). The use of tetM438 significantly improves transformation efficiency and generates visible colonies faster. Finally, the improvements in the pMTnTetM438 construction made it possible to obtain insertions in genes which have not been previously considered to be dispensable under laboratory growth conditions.

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

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

Introduction: Coronavirus disease-2019 (COVID-19) is a disease caused by Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) that emerged in China in late 2019. The rapid viral spread has made the disease a public health emergency of worldwide concern. The gold standard for diagnosing SARS-CoV-2 is reverse transcription followed by qualitative real-time polymerase chain reaction (RT-qPCR); however, the role of viral load quantification has not been thoroughly investigated yet. Objective: The aim of this study was to develop a high-precision quantitative one-step RT-qPCR reaction using the association of the viral target and the human target in the same reaction. Methods: The assay standardization involved the absolute quantification method, with serial dilutions of a plasmid with the N gene in a biological matrix to build a standard curve. Results and Discussion: The results demonstrated the possibility of quantifying as few as 2.5 copies/ reaction and an analysis of 244 patients with known results selected by cross-section that revealed 100% agreement with a qualitative RT-qPCR assay registered by Anvisa. In this population, it was possible to quantify patients with between 2.59 and 3.5 Â 10 7 copies per reaction and negative patients continued to indicate the same result. Conclusion: This assay can be a useful tool for a proper patient management, because the level and duration of viral replication are important factors to assess the risk of transmission and to guide decisions regarding the isolation and release of patients; an accurate diagnosis is critical information, whereas the current COVID-19 pandemic represents the biggest current global health problem.

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Organisms being S.pneumoniae-83%, K.pneumoniae-12%, H.influenzae-5%. COPD Is the commonest risk factor associated with RTI in our patients In both UTI and RTI, incidence increased with age. Enteric fever was diagnosed in 5.5% cases (63% male). Fever,headache with prominent GI symptoms and splenomegaly are the common presenting symptoms in those diagnosed with enteric fever. Leucopenia and raised liver enzymes are common findings.

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

Epidermal changes caused by a chytridiomycete fungus (Chytridiomycota; Chytridiales) were found in sick and dead adult anurans collected from montane rain forests in Queensland (Australia) and Panama during mass mortality events associated with significant population declines. We also have found this new disease associated with morbidity and mortality in wild and captive anurans from additional locations in Australia and Central America. This is the first report of parasitism of a vertebrate by a member of the phylum Chytridiomycota. Experimental data support the conclusion that cutaneous chytridiomycosis is a fatal disease of anurans, and we hypothesize that it is the proximate cause of these recent amphibian declines.

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

Case Report:A 38 years old patient was scheduled for fetal MMC in utero repair. The fetus presented a lumbosacral MMC and Arnold Chiari type II malformation. Magnesium sulfate was administered for fetal neuroprotection. We provided a latex free environment (LFE). Uterine relaxation (UR) was achieved by indomethacin, atosiban, nitroglycerin and sevoflurane. Rapid sequence intubation was performed using fentanyl, propofol and rocuronium. Anesthesia maintenance was achieved by target controlled infusion (TCI) of remifentanil, sevoflurane and fentanyl. Bispectral Index (BIS) was used to monitor depth of anesthesia. As there is a known risk of pulmonary edema 1 , we decided to maintain a goal directed fluid management, using EV1000® to estimate systolic volume variation and cardiac output. Norepinephrine was used to maintain maternal blood pressure. Fentanyl, atropine and vecuronium were administered intramuscularly to the fetus. Fetal heart rate was registered by echocardiography. Surgery was completed without any maternal or fetal complications.

Previously we have shown that resistance to Eimeria acervulina (EA) infection in broiler chickens was enhanced by a probiotic treatment. In the present studies, we examined cytokine and oocyst production under similar conditions using a commercial Lactobacillus-based probiotic. Day-old male broiler chicks were fed control or probiotic diets and were orally challenged with either 2!10 4 (Experiment 1) or 1!10 4 (Experiment 2) oocysts of EA at 3 weeks of age. For the first experiment, fecal oocyst shedding and IFN-g levels in the culture supernatants of ConA-stimulated spleen lymphocytes were evaluated. Humoral and local cell-mediated immunity in the second experiment were assessed by evaluating antibody and cytokine (IFN-g and IL-2) levels in sera and intestinal secretions on a 3-day interval post inoculation. Results showed small but significant (P!0.05) differences in cytokine levels and oocyst production but not antibody levels between the probiotictreated and control groups. Collectively, these data suggest a positive impact of the probiotic on cellular immune responses of infected broilers as compared to control chickens resulting in enhanced resistance to EA as shown in reduced fecal oocyst shedding. The results showed an immunoregulatory effect of probiotic diets on the local cell-mediated immunity in poultry and

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

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

Methods. This randomized, double-blind, placebo-controlled study was designed to compare humoral responses to licensed trivalent influenza vaccine given concomitantly with 1 of 2 RSV vaccine formulations in persons 65 years old with cardiopulmonary disease. Hemagglutinin-inhibition assays and neutralization assays were used to measure levels of antibody to influenza and RSV, respectively. Subjects with respiratory illnesses during subsequent winters were tested for RSV and influenza by reverse-transcriptase polymerase chain reaction and serologic analysis.

Temporal trends in the incidence of opportunistic diseases (ODs) related to acquired immunodeficiency syndrome (AIDS) were studied during 1989-1997 in 1115 outpatients infected with human immunodeficiency virus (331 of whom had AIDS) in a hospital in Madrid, Spain. We analyzed the effect of adherence to antiretroviral therapy and Pneumocystis carinii pneumonia (PCP) prophylaxis on the incidence of OD. Diseases that showed a significant decreasing trend were esophageal candidiasis, pulmonary and extrapulmonary tuberculosis, and cerebral toxoplasmosis. Patients who adhered to antiretroviral therapy had a smaller risk of OD. Patients who adhered to PCP prophylaxis had a reduced risk of cerebral toxoplasmosis and PCP. A reduction in the incidence of AIDS-related ODs was observed, mainly in patients who underwent prophylaxis. Adherence to antiretroviral treatment and PCP prophylaxis was associated with a reduction in the risk of disease.

A multicenter effort was begun in 1994 to characterize the pathophysiology of dengue using a study design that minimized patient selection bias by offering enrollment to all children with undifferentiated fever for õ72 h. In the first year, 189 children were enrolled (age range, 8 months to 14 years). Thirty-two percent of these children had dengue infections (60 volunteers). The percentage of children with a secondary dengue infection was 93%, with only 4 (7%) having a primary dengue infection. The virus isolation rate from the plasma of children with dengue was 98%. Viremia correlated highly with temperature. All four dengue virus serotypes were isolated at both study sites. This study demonstrates that all four serotypes of dengue virus can cause dengue hemorrhagic fever, that all dengue patients as defined by serology experience viremia during the febrile phase, and that as fever subsides, so does viremia.

Introduction. LC16m8 is an attenuated cell culture-adapted Lister vaccinia smallpox vaccine missing the B5R protein and licensed for use in Japan. Methods. We conducted a phase I/II clinical trial that compared the safety and immunogenicity of LC16m8 with Dryvax in vaccinia-naive participants. Adverse events were assessed, as were electrocardiography and laboratory testing for cardiotoxicity and viral culturing of the vaccination sites. Neutralization titers to vaccinia, monkeypox, and variola major were assessed and cell-mediated immune responses were measured by interferon (IFN)-c enzyme-linked immunosorbent spot and lymphoproliferation assays. Results. Local and systemic reactions after vaccination with LC16m8 were similar to those reported after Dryvax. No clinically significant abnormalities consistent with cardiac toxicity were seen for either vaccine. Both vaccines achieved antivaccinia, antivariola, and antimonkeypox neutralizing antibody titers .1:40, although the mean plaque reduction neutralization titer of LC16m8 at day 30 after vaccination was significantly lower than Dryvax for anti-NYCBH vaccinia (P , .01), antimonkeypox (P , .001), and antivariola (P , .001). LC16m8 produced robust cellular immune responses that trended higher than Dryvax for lymphoproliferation (P 5 .06), but lower for IFN-c ELISPOT (P 5 .02). Conclusions. LC16m8 generates neutralizing antibody titers to multiple poxviruses, including vaccinia, monkeypox, and variola major, and broad T-cell responses, indicating that LC16m8 may have efficacy in protecting individuals from smallpox. Clinical Trials Registration. NCT00103584.

Subsequent BSI developed in 6 (20%) of 30 episodes in which empiric antibiotic treatment were inappropriate while but in 3 (4%) of 82 episodes in which empiric antibiotic treatment were appropriate (P = .01). Conclusion: In patients with isolated positive HC-drawn blood cultures, the overall incidence of subsequent BSI was 8.0%. Isolation of Candida species and inappropriate empiric treatment were associated with development of subsequent BSI.

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

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

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

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

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

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

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

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

A French nurse presented Plasmodium falciparum malaria 10 d after a needlestick while sampling blood in a source patient with malaria. As did the source patient, the nurse recovered fully although diagnosis was delayed and her malaria severe. We proceeded to a thorough description of the transmission profile of P. falciparum following occupational needlestick. A review of the literature found 21 published reports of occupational malaria including our own, documenting 22 P. falciparum infections. One of these was lethal. The mean incubation time to fever onset was documented in 21 reports including our own and is 11.609/3.38 d (median 12.0, range 4 Á/17 d). The incubation period was comparable to that found in experimental anopheline bites or transfusion malaria. The transmission profile cites a pathogen which may be more easily transmissible by occupational exposure to blood than human immunodeficiency virus (HIV) or hepatitis C virus (HCV). Undiagnosed malaria in non-immune health care workers can be lethal. Presumptive treatment of malaria is widely available and well tolerated. Clinicians should consider P. falciparum malaria when faced with a febrile patient who has or may have been exposed to biological fluids. Further research is needed in the field of P. falciparum prophylaxis following accidental exposure to a malaria patient's blood.