Malaria Control & Elimination

Antibiotic resistance is a worldwide health problem. Antibiotic resistance can increase rate of mortality and morbidity especially in immunosuppress patients like hospitalized one. Antibiotic-resistant infections add considerable costs to the nation??? already overburdened health care system. Estimates regarding the medical cost per patient with an antibiotic-resistant infection range from $ 18,588 to $ 29,069 in 2015. The total economic burden placed on the US economy by antibiotic resistant infections has been estimated to be as high as $ 20 billion in health care costs. A large number of researchers believe that analyzing the molecular characteristics of S. aureus can help provide Therefore, understanding the drug resistance of MRSA in a timely manner and elucidating its drug resistance mechanism a basis for designing effective prevention and treatment measures against hospital infections caused by S. aureus and further monitor the evolution of S It can be considerable that making and introducing new antibiotics are very low because there is no economic justification because of early appearance of resistance.

The most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes and among patients whose care requires devices such as ventilators at the molecular level are of great significance for the treatment of S and blood catheters. Penicillin-resistant S. aureus can produce penicillinase, which can hydrolyze the penicillin β-lactam ring, leading to resistance to penicillin. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia and Proteus). They can cause severe and often deadly infections such as bloodstream infections and pneumonia. WHO priority pathogens list for R&D of Later, scientists developed new penicillinase-resistant semisynthetic penicillin named methicillin new antibiotics: Priority 1: Critical Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant, in recent decades, due to the evolution the data required to characterize the risks of antibiotic residues in the environment is severely limited.

The main future research needs have been identified to enable better assessments of antibiotic of bacteria and the abuse this resistance was produced by a gene encoding the penicillin-binding protein of antibiotics, the drug resistance Antimicrobial resistance (AMR) has emerged as one of the principal public health problems identifying priority areas for interventions, and monitoring the impact of interventions to contain resistance of the 21^st century that threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. Moreover, S. aureus does not form spores or flagella, but possesses a capsule, can produce golden pathogenic antibiotic resistant bacteria and various infection diseases.

After identification of key risk Global which represents at the moment the major problem, both for the high rates of resistance observed in bacteria that cause common infections and for the complexity proposing a combination of interventions that include strengthening health systems and surveillance; improving use of antimicrobials in hospitals and in community; infection prevention and control; encouraging the development of appropriate new drugs and vaccines of the consequences of ABR report on surveillance of AMR, published in April 2014, collected for the first time data from national availability of effective antibiotic drugs; chemotherapy for cancer treatment, organ transplantation, hip replacement surgery, intensive care for pre-term newborns and many other activities could not be performed without effective antibiotics and international surveillance networks, showing the extent of this phenomenon determinant parameters yellow pigment, and decompose mannitol of S. aureus has gradually increased, the infection rate of MRSA has increased worldwide Medium Streptococcus pneumoniae, penicillin-non-susceptible, derivation of the relationship between antibiotic levels and pathogenic antibiotic-resistance development in different settings, and the clinical anti-infective treatment for MRSA has become more difficult ESBL-producing Priority 2: High Enterococcus faecium, vancomycin-resistant Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant Priority 3: So, in this report we explain about rate of present and also antibiotic resistance patterns of these global threating bacteria in Iran as an Asian country.

Treatment of dengue stays supportive in the lack of targeted antiviral therapy or approved vaccines. Responsive fluid management is key to prohibiting progression to shock or other severe manifestations. The dynamic natural history of dengue infection and its influence on hemodynamic homeostasis needs to be carefully considered in the planning of individualized therapy. Though largely self-limiting, the sheer burden of dengue disease on the global population will outcome in a typical manifestations especially in children, older adults, and comorbid patients. Management of these has not yet been systematized. The failure of recent randomized controlled trials to show use for antiviral and immunomodulatory agents in dengue is dejecting. Vaccine candidates have promise, but growing outbreaks need more robust, evidence-based management guidelines to inform clinicians, mainly in novel epidemic situations.

Dengue fever is caused by a flavivirus, which is a vector borne RNA virus with four anti-genically distinct serotypes (DEN 1, DEN 2, DEN 3 and DEN 4). Neurological manifestations are rare compared to other complications of the disease. Encephalopathy, encephalitis, aseptic meningitis, intracranial hemorrhages, thrombosis, mono-neuropathies/polyneuropathies, Guillain-Barre syndrome and myelitis have been reported. Neurological manifestation in dengue hemorrhagic fever usually results from multisystem dysfunction secondary to liver failure, cerebral hypoperfusion, electrolyte imbalance, shock, cerebral edema and hemorrhage related to vascular leak. The occurrence of brain hemorrhage in a case with dengue shock can be serious and leads to death. The occurrence of brainstem hemorrhage can be a very serious fatal situation. We report this case series of dengue hemorrhagic fever with multiple intracranial, sub arachnoid hemorrhages and sub-dural hematoma causing brainstem herniation. Case 1: A 25-year-old previously healthy woman was admitted on third day of fever with thrombocytopenia. Critical phase started on 5^th day with evidence of pleural effusion and moderate ascites. 31 hours into critical phase, she developed headache, altered level of consciousness, limb rigidity and respiratory depression without definite seizures. Non-contrast CT brain done at tertiary care level revealed diffuse intra cranial hemorrhages and sub arachnoid hemorrhages in right frontal, parietal, occipital lobes and brainstem, cerebral oedema with an acute subdural hematoma in right temporo-parietal region. Her platelet count was 40,000 at this time with signs of vascular leakage. She was intubated and ventilated with supportive care. Later on, she developed features of cranial diabetes insipidus and it responded to intranasal desmopressin therapy. In spite of above measures signs of brainstem herniation developed and she succumbed to the illness on day 8. Dengue was confirmed serologically. Case 2: A 24 year old previously healthy was admitted on 2^nd day of fever with constitutional symptoms and no bleeding manifestations. Clinical, hematological and serological parameters confirmed dengue infection. On 5^th day of illness, she entered into leaking phase, but did not have evidence of any bleeding Intra Cranial Hemorrhage (ICH) in right parietal lobe deep white matter area associated with perilesional oedema and midline shift. Bleeding into the right lateral ventricle and Small Subdural Hematoma (SDH) were also noted in right parietal lobe area. Her platelet count at the time of development of hemorrhages was 32,000 and International Normalised Ratio was normal. NCCT brain was repeated 24 hours later and showed progression of hemorrhages. It showed progressive worsening of right occipito-temporal ICH, cerebral oedema, midline shift, right SDH and SAH. Patient remained hemodynamically stable and platelet count was on the rising trend. It was 52,000, 77,000 and 83,000 on 3 consecutive occasions. PCV was stable around 43. There were no other bleeding manifestations neurosurgical interventions were not tried and patient was treated conservatively. With maximum care provided, patient succumbed to illness on the following day. It can be concluded that diffused cerebral hemorrhages with moderate thrombocytopenia and normal coagulation profile are a very rare and fatal complication of dengue fever. Exact pathophysiological mechanism is not well understood. Increased awareness and high degree of clinical suspicion is needed among clinicians for timely diagnosis of this extremely rare complication of dengue fever. We postulate that immunological mechanisms may play a role in pathogenesis. However, more comprehensive research and analysis are needed to understand the pathophysiological mechanisms leading to this complication.

The impact of dengue has the potential for severe morbidity in young and healthy individuals, especially in situations of massive outbreaks, as have been happening, for example, in Lahore, Pakistan in 2011, with 500,000 notified cases in a city of 5 million, and a dengue IgGseropositivity rate of 67.9 % the following year in a city not previously endemic for dengue

Nosocomial infections are a massive hassle across the world. The Center for Disease Control (CDC) estimates that nosocomial infections have an effect on round 1.7 million sufferers according to yr and motive 99,000 deaths. According to CDC, 32% of all healthcare obtained infections are urinary tract infections, 22% are surgical web page infections, 15% are pneumonia and 14% are bloodstream infections. Now-a-days, most effective 1/3^rd of nosocomial infections may be averted with the contamination manage applications. The different 2/3^rd cannot be averted with the applications used now-a-days. In USA, 31 billions of greenbacks are spent withinside the remedy of nosocomial infections according to yr. The look at pursuits to illustrate how this 2/3^rd of nosocomial infections will be managed with the use historic drugs reasoning, along with Traditional Chinese Medicine and Hippocrates theories. Another aim is to make obvious the viable financial system to healthcare whilst the usage of those strategies and equipment withinside the remedy of nosocomial infections.

The technique used changed into an overview of research, along with the ones supplied via way of means of Hippocrates (Natural forces inside us are the genuine healers of ailment), in addition to others from oriental drugs, which recognize the ailment as originated from 3 elements: outside (publicity to cold, heat, humidity, wind and dryness), internal (emotional) and dietary.

When comprehending the affected person in a broader view, thinking about the power imbalances of Yin, Yang, Qi, blood, and warmth retention, it's far viable to govern and save you hire extra nosocomial infections, lowering the prices for the healthcare.

The 2/3^rd of now no longer managed nosocomial infections cannot be averted due to the reasoning used withinside the remedy of infections in Western Medicine. When the usage of historic oriental drugs reasoning, a special wondering may be used. According to Einstein, we cannot remedy our issues with the equal wondering we used whilst we created them.

Hospital-obtained infections upload to purposeful incapacity and emotional pressure of the affected person and might also additionally, in a few cases, cause disabling situations that lessen the excellent of life. Nosocomial infections also are one of the main reasons of death. The financial prices are considerable. The improved duration of live for inflamed sufferers is the finest contributor to cost (eight, nine, One looks at  confirmed that the general boom withinside the length of hospitalization for sufferers with surgical wound infections changed into eight. 2 days, starting from three days for gynecology to nine. Nine for trendy surgical procedure and 19. Eight for orthopedic surgical procedure.

Prolonged live now no longer most effective will increase direct prices to sufferers or payers however additionally oblique prices because of misplaced work. The improved use of drugs, the want for isolation, and the usage of extra laboratory and different diagnostic research additionally make contributions to prices. Hospital-obtained infections upload to the imbalance among aid allocation for number one and secondary fitness care via way of means of diverting scarce budget to the control of probably preventable situations. The advancing age of sufferers admitted to fitness care settings, the more occurrences of continual illnesses amongst admitted sufferers, and the improved use of diagnostic and healing approaches which have an effect on the host defenses will offer continuing stress on nosocomial infections withinside the future. Organisms inflicting nosocomial infections may be transmitted to the network thru discharged sufferers, staff, and visitors. If organisms are multi resistant, they will motive good sized ailment withinside the network. The affected person is uncovered to lots of microorganisms for the duration of hospitalization. Contact among the affected person and a microorganism does now no longer via way of means of itself always bring about the improvement of scientific ailment different elements impact the character and frequency of nosocomial infections.

The chance of publicity main to contamination relies upon partially at the traits of the microorganisms, which include resistance to antimicrobial agents, intrinsic virulence, and amount (inoculum) of infective material. Many special bacteria, viruses, fungi, and parasites might also additionally motive nosocomial infections. Infections can be because of a microorganism obtained from some other man or woman withinside the medical institution (cross-contamination) or can be because of the affected person’s personal vegetation (endogenous contamination).

Some organisms can be obtained from an inanimate item or materials currently infected from some other human source (environmental contamination). Before the creation of fundamental hygienic practices and antibiotics into scientific practice, maximum medical institution infections had been because of pathogens of outside origin (foodborne and airborne illnesses, fueloline gangrene, tetanus, etc.) or had been because of microorganisms now no longer gift withinside the regular vegetation of the sufferers (e.g. Diphtheria, tuberculosis). Progress withinside the antibiotic remedy of bacterial infections has significantly reduced mortality from many infectious illnesses. Most infections obtained in medical institution nowadays are because of microorganisms which can be not unusual place withinside the trendy population, in whom they motive no or milder ailment than amongst medical institution sufferers (Staphylococcus aureus, coagulase-poor staphylococci, enterococci, Enterobacteriaceae).