11^th Global Infections Conference November 12-13, 2018 Melbourne, Australia

Biography:

Abstract:

Objectives: HIV epidemiology has changed in the past decade and attitude towards the disease may also have changed. We conducted a survey to compare medical students’ attitudes towards HIV/AIDS in the recent years (2014-2017) to a decade ago (2007-2010).

Methods: From 2007-2010, we surveyed three cohorts of medical students at the end of clinical training to assess their attitudes towards HIV/AIDS. From 2014-2017, we surveyed another three cohorts of medical students finishing clinical training to compare changes in attitudes towards HIV/AIDS over a decade.

Results: From 2007-2010, 546 students were surveyed and from 2014-2017, 504 students were surveyed. All participants were included in the analysis. Significantly less students in recent years were exposed to HIV patients for the first time during their HIV clinic attachment (72% vs 39%, odds ratio (OR) 0.25, 95% CI 0.18-0.34). Significantly more students planned to specialize in HIV medicine (2% vs 11%, odds ratio (OR) 9.46, 95% CI 4.75-18.84), while significantly less students prefer not to work in a field involving HIV/AIDS (17% vs 11%, odds ratio (OR) 0.57, 95% CI 0.4-0.83). Willingness of students to provide HIV care remained the same, with 22% of students unwilling to provide care.

Conclusions: Despite more positive attitudes of future doctors towards HIV/AIDS in relation to career choice, the willingness of future doctors to provide HIV care has remained unchanged in the past decade.

Biography:

Mr.Arunkumar G has been completed his Pharmacy education from the College of Pharmaceutical Sciences, Gvt.Medical College, Trivandrum , India. He has done so many inventions in the field of modern medicine and mostly through microbiology. 

Abstract:

Mobile phone radiation exposure for long term is harmful to human beings and other living system. Nowadays antibiotic resistance is the common tragedy in our modern allopathic treatment especially in the case of Tuberculosis. This study was based on the effect of mobile phone radiation on the antibiotic sensitivity in Escherichia Coli. The difference in sensitivity of E.Coli that exposed to mobile phone radiation were studied. The mechanism of resistance of these pathogenic bacteria has to be found out as soon as possible for improved patient care. This study may be repeated with other type of micro organisms, both gram positive and gram negative with other antibiotics for further investigations. This study has found that, such radio frequency radiation exposed E.Coli shows decreased sensitivity than other non-radiatedE.Coli towards Gentamycin. Anyway this topic helps to take preventive measures to withstand our healthy living system and it is the gateway to conclude the relationships and changes of microorganisms due to our natural environmental Electromagnetic fields.

This study throws light in to resistance developed by micro organisms to normally used antibiotics. This research indicates that, the organisms achieve resistance not only due to the numerous commonly known reasons, patient’s non compliance, etc but also due to invitro exposure of RF waves. Now our world has been surrounded by numerous mobile phone towers & this may cause serious health

problems. All of them may know about some hazardous effects of mobile tower and mobile phone radiation but not known about this effects on drugs through micro organisms. Due to the single cell structure, the micro organisms absorb radiation through their entire surface, which were surrounded by mobile tower radiation. When a healthy individual infected with micro organisms which has previously developed resistance or any change in susceptibility from its environment, it may cause failure to response of the individual to the normally used drugs or its dose. On the basis of this study, further research should be necessary about the hazardous effects of the mobile phone radiation to the pathogenic gram positive & gram negative bacteria, virus and fungus. Then only this study will achieve the success in protection of human health. 

Biography:

Employed in Ethiopian Public Health Institute in 2007 GC

Educational Background: Biology (BSc) from Dilla University,Tropical and Infectious Disease (MSc) and PhDc in Addis Ababa University,Guest Researcher Fellowship at CDC lab Atlanta, USA for one and half months,Guest Researcher Fellowship at University of South Florida (USF) lab, USA for two months,

Work experience: Ten (10) years work experience at the Ethiopian Public Health Institute (EPHI) since 2007 GC until know Current Position: Malaria and Neglected tropical Diseases Team Leader, Head for Malaria RDT QA and Onchocerciasis Molecular Laboratory and Researcher 1

Abstract:

Ethiopia is among the sub-Saharan African countries successful in reducing malaria burden in the last decade. The Government of Ethiopia launched elimination strategy taking advantage of this reduction in line with the commitment of African leaders to attain malaria elimination in 2030. However, unlike other settings Ethiopia requires additional efforts to achieve this ambitious elimination plan in due to the co-existence of both P. falciparum and P. vivax. The current case management mainly target both species. Despite the previous reports of the existence of the other two human malaria parasites including P. ovale and P. malariae in the past, there is no adequate and current information in this regard. This is, therefore, to describe the existence of P. ovale and P. malariae using an advanced molecular technique that helps to investigate Plasmodium spp. in Limu Kossa District, Jimma Zone, and Southwestern Ethiopia. A total of 180 serum samples were collected from three villages located in Limu Kossa District, 400 Km southwestern Ethiopia during October 2016. Longitudinal follow up and monitoring performance malaria elimination program was underway for the last years in Arengama 1, Arengama 2 and Konche villages. Serum was prepared from whole blood collected from the residents to investigate the presence of human malaria parasite marker antibodies. The investigation was conducted using LUMINEX, which is an advanced technique as briefly described below. Serum samples (1µl) diluted with 399 µl of 30ml buffer B and 20µlof 6mg/ml E.coli extracts and incubated for 1 hrs at 37 oC and stored at 4oC overnight. Next morning the Luminex plate pre wetted with 200ul PBST buffer and empty with vacuum. The tubes with coupled beads solution with each of the 7 different malaria antigens (CSP (5), AMA1 (33), PfMSP1 (36), PvMSP1 (91), PmMSP1 (16), PoMSP1 (45), LSA1 (23)) were mixed with vortex and from each antigen coupled beads solution 15ul transferred to conical tube and mixed with 5ml buffer.  The antigen coupled beads and buffer-A solution poured to the tray and 50µl transferred to all wells of the Luminex plate using multichannel pipette and washed twice with 100ul of PBST, vacuumed and 50µl of sera dilution added in duplicate plate well followed by incubation for 1 hour and 30 minutes at room temperature on a shaker. After incubation the plate washed with PBST buffer, vacuumed and 50 µl of secondary antibody buffer A solution added to each well using multichannel pipette and incubated for 45 minutes at room temperature on a shaker.  The procedure followed by plate wash, vacuum and 50µl strepavidin-phycoerythrin and buffer A solution added to each well and incubated at room temperature for 1 hour on a shaker. The plate washed with 100µl of PBST, vacuumed and 50ul of buffer A added to each well and incubated for 30 min at room temperature on a shaker. The last step was the plate washed and 125µl of PBS-PH 7.2 added to each well, incubated for 2 minutes and followed by immediate load on the calibrated and programmed Luminex machine and run the experiments.

Among 180 samples processed four human malaria parasites were detected using the state-of-the art technique. Plasmodium falciparum accounted most of the antibodies detected. More interestingly, antibodies of both P. ovale and P. malariae were identified in the present analysis. Details of the findings of laboratory analysis are presented in Table 1 below. The Cumulative exposure history over the last five years for Pf MSP1 and AMA was 39.4%(n=71) and the recent exposure history over the last 12 months for Pf CSP and Pf LSA antigens was 11.1% (n=20).

Our preliminary finding from the field demonstrated the significant exposure history of study participants to all plasmodium species using LUMINEX. The present result showing the existence of recent exposure to P. malariae and P. ovale remains a challenge for malaria control and elimination strategy.

This local findings call for performing large scale survey and redefining the Plasmodium species composition to well inform the National Malaria Control Program in improving malaria microscopy in the country.

Biography:

Abstract:

Statement of the Problem: To understand hepatitis B infection in Jinchang Cohort. To explore the influence factors of abnormal levels of ALT, AST, and GGT in the anti-HBs positive population without a history of hepatitis and provide the basic evidence for it´s prevention.     Methodology & Theoretical Orientation: In 44,169 objects from the Jinchang Cohort during June 2011 to December 2013, And to investigate the detection rates of abnormal levels of alaninetransaminase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) by analyzing various demographic characteristics, dietetic behaviors and living habits, occupational exposures, and lipid metabolic indexes in the anti-HBs positive population without a history of hepatitis within Jinchang Cohort.

Conclusion & Significance: The positive rates of HBsAg, HBeAg, HBcAb, and HBsAb were 4.66%, 0.42%, 15.64%, and 62.31%, respectively and HBV infection rate was 28.25%, which was higher among males than females,and it peaked in the 60-69 years age group (31.63%) and while with the education level increasing, the infection rate of HBV was gradually decreased. Monthly average family income was protective against abnormal levels of ALT, AST, and GGT.The positive rates of HbsAg+HbeAb+ HBcAb and HbsAg+HbeAg+HbcAb  were 3.74% and 0.41%, respectively. Detection rates of abnormal levels of ALT, AST, and GGT were 18.20%, 11.14%, and 16.64%, respectively, in the cohort, and 16.20%, 9.87%, and 14.86%, respectively, in the anti-HBs positive population without a history of hepatitis. Multivariate analysis showed that gender, age, smoking, alcohol drinking, BMI, TG, TC, UA, and LDL-C were correlated to abnormal levels of ALT, AST, and GGT in the anti-HBs positive population within Jinchang Cohort. The risk of abnormal levels of GGT increased with alcohol drinking index. The risk of abnormal levels of ALT was higher in the iron and sulfur dioxide exposure group than the unexposed group. The risk of abnormal levels of ALT, AST, and GGT was directly related to lipid metabolic indexes, and showed an obvious dose-response relationship with BMI, TG, TC, LDH-C, and UA,and while the high density lipoprotein cholesterol (HDL-C) increasing, the detection rates of abnormal levels of ALT, AST, and GGT was gradually decreased, which showing the obviously dose-response relationship.

Key word: Jinchang Cohort, Hepatitis B infection, Hepatic enzyme, Lipid,metabolic indexes, Multivariate analysis

Biography:

Abstract:

Statement of the Problem: To confirm high-risk population of cholecystitis and gallstone by calculating the prevalence and incidence of cholecystitis and gallstone in Jinchang cohort, and to reveal the relationship between hepatitis B virus (HBV) infection and cholecystitis gallstones, cholecystitis gallstones and diabetes mellitus (DM), in order to provide science basis for prevention and treatment of related diseases deeply in Jinchang cohort. Methodology & Theoretical Orientation: Populations in baseline and follow-up were selected as subjects for this study. Through descriptive study, we study the prevalence and incidence of cholecystitis and gallstone. Logistic and Cox regression were used to analyze the effects of different HBV infection status on cholecystitis and gallstone and different state of cholecystitis gallstone on DM by estimating the odds ratio (OR), hazard ratio (HR) and 95% confidence interval (95% CI), based on Jinchang cohort. Conclusion & Significance: The prevalence of cholecystitis in the Jinchang cohort was 10.20% overall, 13.40% in females, and 8.17% in males. The incidence of cholecystitis in the Jinchang cohort was 6.32% overall, 8.50% in females, and 5.50% in males. Compared with the non-infection HBV, HBV infection replication would increase the risk of cholecystitis, the OR (95%CI) were 1.27(1.11-1.46) overall, 1.40(1.16-1.67) in males. Compared with the control group, HBV carriers would increase the risk of incidence of gallstone and the HR (95%CI) was 1.30(1.07-1.57) in males. Compared with non-infection HBV, HBV infection replication would also increase the risk of incidence of cholecystitis and the HR (95%CI) were 1.54(1.26-1.87) overall, 1.81(1.41-2.32) in males. Compared with no gallstones group, gallstones also would increase the risk of incidence of DM. The HR (95%CI) were 1.46(1.22-1.76) in males, 2.81(2.25-3.51) in females, 1.83(1.59-2.10) overall. 

Biography:

My name is Lamin Ceesay a Gambian and a person living with HIV, I was diagnosed in October (1998). I joined Santa Yalla Support Society in January 1999. I declared my status during World AIDS Day December 2000. I started advocating for universal access to Prevention, treatment Care and Support for people living with HIV from December 2000 to date.

Abstract:

Introduction:As a Person living with HIV (PLHIV) I speak frequently in public about the challenges faced by PLHIV, especially Women and Girls who face serious problems of stigma and discrimination. We need to address stigma and discrimination by developing a stigma reduction strategy, demystify ignorance and the fear of AIDS.

I also believe that we PLHIV are best placed to stop the further spread of the Virus by disclosing our status and create more awareness among individuals and communities of the need for behavior change. We need to promote correct and consistent use of condoms to prevent the spread of the virus.

Santa Yalla organizes training workshops on HIV for our members to create awareness about positive living for PLHIV. People want to know if I am still having sex and if yes, with whom and they want to know whether my children know my HIV status.

We also conduct community HIV sensitizations meetings. We invite five villages in one forum. We meet with the village chiefs and elders and explain our mission and agreed with the chiefs that each Village should come with two elderly Men, two elderly Women, three boys and three girls, and they will all assemble in the bigger Village in that surrounding, and if the village chiefs agreed we select and agreed on a date for the meeting, and they should announce it to every-body in their communities. After all these we will do a follow up to see if the announcement have reached everyone to attend the meeting, and in the meeting we will invite an Imam and a Pastor to do the opening prayers to bless the occasion.

After the opening prayers, the introduction is done by the Program Manager, followed by presentation by a PLHIV during which we cover: HIV/AIDS and STIs, HIV counseling & testing, importance of PMTCT, HIV Stigma and Discrimination, Care and Support for PLHIV.

We provide counseling & testing with partners. We do the counseling and our partner provides testing services. Taking this approach, we have made a lot of progress; a high number of people now know their HIV status.

Follow up after testing is also conducted to those who tested positive to support them enrolls into care and into the HIV Support Groups.

Conclusion:For effective response to the HIV & AIDS epidemic, concerted efforts are required and PLHIVs actively participate in the planning, implementation and monitoring of the HIV program.

Biography:

Abstract:

Surveillance of healthcare associated infections in India: current gaps

In India, accurate estimates of the burden of healthcare associated infections are limited by the absence of reliable and routine standardized surveillance data. Published reports of healthcare associated infections are mostly from individual health facilities and include short term prospective studies and point prevalence surveys conducted in selected patient units of large hospitals. These indicate a prevalence of healthcare associated infections ranging from 7 to 18 per 100 patients, which is similar to that reported from other low and middle income countries. As in other settings, healthcare associated infections in India are associated with longer hospital stays, increased mortality, and added costs. The frequent use of indwelling devices is also reported, particularly in intensive care units, where one centre reported that over 70% of patients had indwelling devices in its intensive care unit for more than 48 hours. While microbiological confirmation of the healthcare associated infections was not a requirement in each of these reports, the data indicate that many of these infections were due to multidrug resistant pathogens, including meticillin resistant Staphylococcus aureus (MRSA) and extended spectrum β-lactamase producing and carbapenem resistant Enterobacteriaceae, Pseudomonas spp, and Acinetobacter spp.  Over the past several years, 40 private sector and academic hospitals in 20 cities in India have participated in surveillance through the International Nosocomial Infection Control Consortium, which uses a standardized method, and case definitions for surveillance of healthcare associated infections. Their recent publication gives pooled rates of healthcare associated infections at participating sites for the years 2004-13 and compares these rates with reported benchmarks.

Infection prevention and control in India:Although hospital accreditation is not mandatory in India, groups like the autonomous National Accreditation Board of Hospitals and the National Health Mission’s National Health Systems Resource Centre have incorporated programmes on infection prevention and control, including surveillance of healthcare associated infections, as a core part of the review and certification process. At the national level, there has been growing recognition of the need for policy and guidance documents, and in 2016 the Indian Council of Medical Research released guidelines on infection prevention and control. In addition, as part of the national Swacch Bharat Abhiyan (clean India mission) the National Health Mission launched Kayakalp (clean hospital initiative), which aims to promote and reward cleanliness, hygiene, and infection control practices in public healthcare facilities.

Despite these initiatives, the successful implementation of an infection prevention and control programme in Indian healthcare settings faces some important challenges, including insufficient funding and human resources, hospital overcrowding, and low nurse-to-patient ratios even in intensive care units. Nevertheless, there is clear interest among doctors and other providers in healthcare facilities to improve infection prevention and control. Many facilities have started hospital infection control committees, although with varying effectiveness. Some institutes have also begun targeted infection control interventions, such as the use of infection prevention and control bundles to prevent surgical site infections and infections from indwelling devices. Data from a few facilities in India suggest that the implementation of such bundles is feasible and can reduce infection rates. Long term implementation of recommended procedures will require concerted efforts to strengthen infection prevention and control capacity among staff in healthcare settings. Thus, it is important to find ways to support standardized surveillance of healthcare associated infections in India .

New initiatives to address gaps in India:As part of the national response to AMR, the Indian Council of Medical Research and the National Centre for Disease Control started AMR surveillance networks in 2013 and 2014, respectively. These surveillance efforts are an important part of the Indian Ministry of Health and Family Welfare’s recently launched five year national action plan on AMR. The networks currently comprise 25 public and private sector hospital laboratories across the country that report antibiotic susceptibility data on important resistant pathogens. In 2015 the Indian Council of Medical Research and the National Centre for Disease Control, with technical support from the US Centers for Disease Control and Prevention (CDC), helped their existing AMR networks begin programmes for the systematic assessment and improvement of infection prevention and control practices and the implementation of standardized surveillance of healthcare associated infection. The aim is to develop models that can serve as the basis for a sustainable Indian national network for standardised implementation, strengthening, and reporting of healthcare associated infections and infection prevention and control practices for the purposes of public health action.

In the current collaborations, a phased approach is being used to implement healthcare associated infection surveillance that is tied to strengthening related infection prevention and control practices and characterisation of resistance patterns among these infections. The expertise at facilities that are already conducting systematic surveillance of healthcare associated infections, such as the Jai Prakash Narayan Apex Trauma Centre of the All India Institute of Medical Sciences, has been used to develop protocols that will be applied across all network sites.

Way forward:Tackling AMR requires a multipronged effort. Healthcare associated infections and infection control are linked with other factors associated with the emergence of AMR. Inadequate infection prevention and control practices provide greater opportunities for new drug resistant infections to emerge in healthcare settings. In turn, a high incidence of such infections results in an increased demand for broad spectrum and reserve antibiotics, which also contributes to increased drug resistance. This inter-relation highlights the importance of strengthening infection prevention and control systems to control AMR.

The newly introduced activities for surveillance of healthcare associated infection and strengthening infection prevention and control are currently being conducted in a limited number of referral hospitals. As the AMR networks of the National Centre for Disease Control and the Indian Council of Medical Research expand these activities will be the basis of more robust and representative national surveillance of healthcare associated infections in public and private sector healthcare facilities across India. The data can be used to develop benchmarks for healthcare associated infections for India and to promote standardized reporting of healthcare associated infections from more healthcare facilities. In addition, there is scope to adapt these measures to establish and implement infection prevention and control programmes in regional and district hospitals in semi-urban and rural settings, where it is equally important to understand the burden and pattern of AMR.

Surveillance of healthcare associated infections and infection prevention and control programmes not only help tackle AMR but also contribute to overall patient safety. Incorporating the initiatives started by the Indian Council of Medical Research and the National Centre for Disease Control within broader clinical care and patient safety initiatives—including accreditation and certification programmes implemented by the National Accreditation Board of Hospitals and the National Health Mission in India—provides a way to sustain surveillance of healthcare associated infections and infection prevention and control programmes as a routine part of clinical care. Data from many countries have shown that when governments and health system leaders take a leadership role in prioritizing healthcare associated infection surveillance and infection prevention and control efforts, major change can be achieved.  

Biography:

Abstract:

Zika, Ebola, Bird Flu, HIV, etc. are todays murderers. However, malaria is the ancient, todays and futures’ slaughterer. The main measures that are in action to minimize malarias distractions can be grouped into 3 options: prompting diagnoses and treatment with anti-malaria drugs; eliminating the vector by different measures; and preventing-vaccination.

By such measures the burden of malaria infection decreases, but yet not eradicated. Instead, may appear some genetically modified plasmodium and mosquito itself!

For postulating our new idea on minimizing such dangerous tendencies, since June 2016, through social media and seminar, we deal with stakeholders on the following: if anopheles couldn’t suck infected blood during its lifespan, it will die without transmitting the disease to a healthy person.

Hence, temporary dislocate the patient from the area, where the mosquito population is high, not only more effective than using only bed nets or killing the anopheles, but also gives extra dozens advantages. Half of them:

Controllable treatment

Skilling-training the patient for his futurity

Infectiously weakened person may have reliefs from his ridged situation - mostly a place where mosquito habitat is not suitable even for healthy people.

If dual strand phenomenon happens, patient’s condition will be worsening.

Consequences of plasmodium adaptation (modification) inside its host!

We should have to consider the right of non-infected people. They have also a right not to be infected by malaria!

Thus along with other methods of malaria control activities, we should try the mentioned new option.

During the presentation, we can show:

lack of sufficient awareness not only in developing countries but also of developed. 

Revealing the drawbacks of the above mentioned 3 options that world is using to eradicate  malaria

Drawbacks that are performed by NGOs (those who involve in malaria eradicating activities)

Detail plan of realizing our 4^th options project

propose 2-3 chemical agents, which may distract the life cycle of the vector

Biography:

Abstract:

Geohelmiths are mainly a health problem in developing    counties. Soil Transmitted Helminth well known of such  are Ascaris lumbricoides, Trichuris trichiura, Hookworm. The soil-transmitted helminths (STH) are the world’s most important causes of physical and intellectual growth retardation Ascaris lumbricoides infection is one of the most common intestinal worm infections. High prevalence ascariasis in Indonesia  in rural areas with poor sanitation about 80%. Anthelminthic Resistance is a common problem in STH. Most available alternative therapy is derived from plants. The purpose of this study was to analyse the anthelmintic effect and potency of Gandarusa LeavesI Infusion (GLI), Pomegranate Skin Infuson (PSI) and Papaya Leaves infusion (PLI) againts Ascaris suum  Female In Vitro. Methodology was a Real laboratory exprimental research design using  960  female worms of Ascaris suum which were divided into 8 groups. The anthelmintic effect tested in vitro. The data measured is the number of death worms after incubated for 3 hours at a temperature of 37⁰C. The data of death worm were analyzed using one-way ANOVA with α = 0.05, if there are differences continued by Tukey HSD test (p = 0.05). Results  The GLI, PLI and PSI were differed significantly when compared with negative control with p=0.000 and the Tukey HSD results showed GLI2, GLi3, PSI 2 were not significant when compared with positive control with the value of p >0.05). Conclusion All of GLI, PSI and PLI were have anthelmintic efectivity against Ascaris suum female in vitro and GLI2, GLi3, PSi2 were equivalent with positive control.

Biography:

Abstract:

Geohelmiths are mainly a health problem in developing    counties. Soil Transmitted Helminth well known of such  are Ascaris lumbricoides, Trichuris trichiura, Hookworm. The soil-transmitted helminths (STH) are the world’s most important causes of physical and intellectual growth retardation Ascaris lumbricoides infection is one of the most common intestinal worm infections. High prevalence ascariasis in Indonesia  in rural areas with poor sanitation about 80%. Anthelminthic Resistance is a common problem in STH. Most available alternative therapy is derived from plants. The purpose of this study was to analyse the anthelmintic effect and potency of Gandarusa LeavesI Infusion (GLI), Pomegranate Skin Infuson (PSI) and Papaya Leaves infusion (PLI) againts Ascaris suum  Female In Vitro. Methodology was a Real laboratory exprimental research design using  960  female worms of Ascaris suum which were divided into 8 groups. The anthelmintic effect tested in vitro. The data measured is the number of death worms after incubated for 3 hours at a temperature of 37⁰C. The data of death worm were analyzed using one-way ANOVA with α = 0.05, if there are differences continued by Tukey HSD test (p = 0.05). Results  The GLI, PLI and PSI were differed significantly when compared with negative control with p=0.000 and the Tukey HSD results showed GLI2, GLi3, PSI 2 were not significant when compared with positive control with the value of p >0.05). Conclusion All of GLI, PSI and PLI were have anthelmintic efectivity against Ascaris suum female in vitro and GLI2, GLi3, PSi2 were equivalent with positive control.

Biography:

Abstract:

Parkinson's disease (PD) is a progressive neurodegenerative disorder that primarily presents with features of bradykinesia, rigidity and tremor, and has, as part of its core pathology, the degeneration of dopaminergic neurons in the substantia nigra pars compacta. There is a great need for the development of a reliable diagnostic tool to improve promptness of diagnosis, definition of disease subtypes, and to monitor disease progression and demonstrate treatment efficacy in the case of disease modifying therapies. Biomarkers are characteristics that can be measured as an indicator of a normal biological process, and they have special relevance in Parkinson’s disease. We currently have no definitive diagnostic test, and thus for the clinician there is hope that biomarkers will help diagnose symptomatic and presymptomatic disease or provide surrogate end-points to demonstrate clinical efficacy of new treatments, such as neuroprotective therapies, and help stratify this heterogeneous disease. No biomarker is likely to fulfill all these functions, so we need to know how each has been validated in order to understand their uses and limitations, and be aware of potential pitfalls. In this review we discuss the current potential biomarkers for Parkinson’s disease, highlight the problems with their use, and conclude with a discussion of future alternatives. Current biomarkers range from objective clinical tools, to neuroimaging, to 'wet' markers involving blood and cerebrospinal fluid. To date, all candidate biomarkers for PD have failed to be developed into a clinically useful tool. Ideally, a combination of sensitive markers will be needed, not only to predict the onset of PD, but also to help in subtype classification and to follow progression. Here, we critically review various PD biomarker studies.

Biography:

Abstract:

Gastrointestinal basidiobolomycosis is an emerging infection, with fewer than 80 cases reported in the English literature. Case Presentation: Also, a few cases of gastrointestinal basidiobolomycosis, accompanied by liver involvement as part of a disseminated disease, have been reported. Conclusions: This is the first case report of an isolated liver involvement of this fungal infection in a 2-year-old girl, who presented with a liver mass resembling a hepatic abscess.

Zygomycosis includes 2 orders, one of which causes fungal infections in an immunocompromised host (Mucorales) and the other in an immunocompetent host (Entomophthorales) (1).

Basidiobolus ranarum belongs to the second group and is a saprophyte found mostly in soil and decaying vegetable material (2). It is a low virulent fungus, and the first human case of this fungal infection was reported in 1956 in subcutaneous tissue (3). Since then, many cases of subcutaneous basidiobolomycosis have been reported. However, the gastrointestinal (GI) involvement of this fungus is an emerging infection and has rarely been reported (4). Recently, a few cases of GI basidiobolomycosis, accompanied by liver involvement as part of a disseminated disease, have been reported (5).

To the best of our knowledge, no case has been reported in the English literature with an isolated liver mass caused by basidiobolomycosis without the involvement of any other organ. Accordingly, herein we report our experience with a 2-year-old girl, who presented with a liver mass subsequently identified as basidiobolomycosis.

Case Presentation

A 2-year-old well-nourished and well-developed girl from the Iranian city of Kangan (Bushehr province) presented with vague and generalized abdominal pain. She was the first child of the family, born via normal vaginal

delivery without any specific disorder. She had had a normal infancy until 2 months prior to her referral, when she developed abdominal pain with no response to routine treatment.

Physical examination was normal, except for mild hepatomegaly. Laboratory tests showed microcytic hypochromic anemia (hemoglobin level = 7.8 gr/dl). White blood cell count was high (about 11-12000/cc) with significant eosinophilia (25%-35%). Immunoserology tests revealed high C-reactive protein (CRP = 13 mg/L, normal < 6) and erythrocyte sedimentation rate (ESR = 83, normal for the patient's age<10). Liver function tests showed high aspartate aminotransferase and alanine aminotransferase (57 and 45 IU/L respectively, normal <31) and alkaline phosphatase (4030 IU/L, normal<300). Stool occult blood was performed 3 times, and the results were all negative.

Abdominal ultrasonography demonstrated a prominent liver with a well-defined mass lesion measuring 40 x 35 cm. Another mass was detected in the hilar area. The other parts of the GI tract, including the stomach and intestine walls, were normal. Upper abdominal magnetic resonance imaging (MRI) showed normal thickness of the GI tract with no mass, but there were multiple masses in the liver. The first impression of both sonography and computed tomography scan was liver or biliary abscesses (Figure 1). TruCut needle biopsy displayed a mainly normal liver with foci of eosinophilic infiltration, which was nondiagnostic.

Therefore, the patient underwent surgery, which showed multiple nonencapsulated liver masses with illdefined borders, the main one in the parenchyma and the other in the hilar area. During surgery, precise search was made to find any accompanied GI mass, but no mass was identified. Also, the omentum was completely free of any tumor or mass lesion. The masses were resected and sent for culture and pathologic studies. The pathology sections showed Splendore-Hoeppli bodies and many eosinophils as well as radiating eosinophilic granular material surrounding the fungal elements within the liver parenchyma and in the hilar mass within the lymph node tissue (Figures 2A and2B). The fungal elements exhibited broad hyphae with thin walls with no septae or sparse septation.

According to the characteristic pathologic features, the diagnosis of hepatic basidiobolomycosis was made. However, all the cultures including fungal and bacterial were negative. The immune system, cellular and humoral, of the patient was thoroughly investigated, even for the possibility of chronic granulomatous disease. All of the studies regarding the immune system were normal.

Figure 1. A, B: Magnetic Resonance Imaging of the Abdomen Shows Multiple Low-Signal Masses in the Liver Associated With Biliary Dilatation

Figure 2. A, B: Degenerated Fungal Hyphae Surrounded by Granulomatous Reaction and Many Eosinophils in the Liver (2a: Low Power, 2b: High Power)

Subsequently, antifungal therapy was started, mainly composed of amphotericin B (1 mg/kg/d) for at least 6 months. Now after 3 months, the patient is well, the abdominal pain has been relieved, and also ESR and eosinophil counts have returned to normal level. She is still under treatment and follow-up.Basidiobolomycosis is an uncommon fungal infection caused by Basidiobolus ranarum, which is an environmental saprophyte (6). It causes human fungal infection in immunocompetent hosts. The most common reported site of involvement is subcutaneous tissue, caused by insect bite or contamination of wounds by soil and dust (7). However, GI involvement of this fungus is rare and seems to be secondary to the ingestion of contaminated food and water(8).

Fewer than 80 cases of GI basidiobolomycosis have been reported in the English literature (9), and a small number of them have been accompanied by a liver mass. These cases were reported from United States, Kuwait, Iraq, and Iran. The cases reported from Iran were from Shiraz, Tehran, and Mashhad (9). In our previous 14 cases, there was a wide variation of lifestyles, both from rural and urban areas (10). It means that the reported liver masses caused by basidiobolomycosis have always been part of a disseminated disease (10-13). To the best of our knowledge, there has been no report of an isolated liver mass caused by this pathogen without the involvement of the GI tract.

The probable theory for the pathogenesis in isolated liver involvement can be the acquisition of this infection after the ingestion of contaminated material and dissemination of the fungus through small lymphatics in the GI tract without creating a mass in the intestine (11). The clinical presentation of hepatic basidiobolomycosis is very similar to tubular GI inasmuch as abdominal pain is the most common presenting symptom in the GI tract. Our patient also presented with abdominal pain (9).

Our patient underwent liver biopsy and then laparotomy with the clinical impression of malignancy, which is the exact usual preoperative diagnosis of GI basidiobolomycosis in the previous reports (13). The most important laboratory findings in our case were high ESR and CRP, with significant eosinophilia. Also aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase were significantly high, which were all indicative of parenchymal liver injury most probably secondary to an inflammatory or neoplastic process. The usual paraclinical findings in GI basidiobolomycosis are also the same (9).

Imaging studies play a key role in the diagnosis of liver masses before surgery or biopsy. All masses in the solid organs such as liver and kidney tend to show an inflammatory component with adjacent soft tissue stranding, with or without abscess formation (14). In this case, sonography and MRI were in favor of a liver mass; however, the possibility of a hepatic abscess was also considered.

In most of the previous cases of GI basidiobolomycosis. the final diagnosis was made after surgery and resection of the liver mass (9). Nonetheless, the gold standard for the diagnosis of every fungal infection is culture. In the majority of the previously reported cases of GI basidiobolomycosis, culture was either negative or was not performed because of the unavailability of the proper tissue (5). In our case, cultures turned out to be negative. The pathologic characteristics of this fungal infection are the presence of Splendore-Hoeppli bodies with many eosinophils and degenerated fungal hyphae (13). It can cause liver granuloma with heavy infiltration of eosinophilic liver granuloma and should be considered in the differential diagnosis of hepatic granulomas (15).

The best treatment in this pathogen is the resection of the mass, accompanied by antifungal therapy including itraconazole or amphotericin B. Our patient showed a dramatic response to amphotericin B. In less than a week, eosinophilia disappeared and ESR returned to normal and within 2 weeks, she resumed weight gain and her abdominal pain subsided. She is still under treatment, and the plan is to continue the antifungal therapy for at least 6 months, because our previous experience showed the high possibility of recurrence after an early discontinuance of the treatment.

In conclusion, basidiobolomycosis should be considered as a differential diagnosis of hepatic abscess with or without GI involvement to prevent delayed treatment.

Biography:

Abstract:

Prostate cancer is the most frequently diagnosed malignancy in Indian men. The therapeutic success rate for prostate cancer can be tremendously improved if the disease is diagnosed early. Prostate cancer generally does not present any symptoms until it becomes locally advanced or metastatic disease. Therefore, in the past, efforts at screening and early detection have used all available tools for diagnosis in asymptomatic patients before the presentation of symptoms. A successful therapy for this disease depends heavily on the clinical indicators (biomarkers) for early detection of the presence and progression of the disease, as well as the prediction after the clinical intervention. However, the current clinical biomarkers for prostate cancer are not ideal as there remains a lack of reliable biomarkers that can specifically distinguish between those patients who should be treated adequately to stop the aggressive form of the disease and those who should avoid overtreatment of the indolent form. A biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes, or pharmacologic responses to a therapeutic  intervention. A biomarker reveals further information to presently existing clinical and pathological analysis. It facilitates screening and detecting the cancer, monitoring the progression of the disease, and predicting the prognosis and survival after clinical intervention. A biomarker can also be used to evaluate the process of drug development, and, optimally, to improve the efficacy and safety of cancer treatment by enabling physicians to tailor treatment for individual patients. The form of the prostate cancer biomarkers can vary from metabolites and chemical products present in body fluid to genes and proteins in the prostate tissues. Current advances in molecular techniques have provided new tools facilitating the discovery of new biomarkers for prostate cancer. These emerging biomarkers will be beneficial and critical in developing new and clinically reliable indicators that will have a high specificity for the diagnosis and prognosis of prostate cancer. The purpose of this review is to examine the current status of prostate cancer biomarkers, with special emphasis on emerging markers, by evaluating their diagnostic and prognostic potentials. Along with the discovery of prostate cancer biomarkers, the criteria used when selecting potential biomarkers for further development towards clinical use is very important.. In addition, how to appraise and validate candidate markers for prostate cancer and some relevant issues involved in these processes’ debatable. The new concept of the biomarkers, existing challenges, and perspectives of biomarker development are worth exploring.

Biography:

A practicing physician in the field of healthcare in the state of Kerala in India for the last 29 years and very much interested in basic research. My interest is spread across the fever , inflammation and  back pain,. I am a writer. I already printed and published nine books in these subjects. I wrote hundreds of articles in various magazines.

I presented 9 research papers in Indian Science Congress 2008 to 2017.And 2 papers selected for the coming 2018 Indian science congress. I presented 2 papers in kerala science congress2014and 2017.

After scientific studies for a long time, we have developed a theory, Which proves the temperature of fever is to increase blood circulation. we have developed 8000 affirmative cross checking questions. It  can explain all queries related with fever and  it considers the messages of the  body and the facts of physics

Abstract:

When the disease becomes threat to life or organs blood circulation decreases, Temperature of fever will emerges to increase prevailing blood circulation. And it acts as a protective covering of the body to sustain life.

When blood flow decrease to brain, the patient becomes fainted-delirious .If we try to decreases temperature of fever, the blood circulation will further reduced. Blood circulation never increases without temperature increase. Delirious can never be cured without increase in blood circulation.

The temperature of fever is not a surplus temperature or it is not to be eliminated from the body. During fever, our body temperature increases like a brooding hen`s increased body temperature.

The actual treatment to fever is to increase blood circulation.Two ways to increase blood circulation.                                          

1. Never allow body temperature to lose                    

2. Apply heat from outside to the body. When the temperature produced by body due to fever and heat which we applied on the body combines together, the blood circulation increases.

Then body will stop to produce heat to increase blood circulation. And body will get extra heat from outside without any usage of energy.

How can we prove that the temperature of fever is to increase blood circulation?

If we ask any type of question related to fever by assuming that the temperature of fever is to increase blood circulation  we will get a clear answer. If avoid or evade from this definition we will never get proper answer to even a single question

If we do any type of treatment  by assuming  that the temperature of fever is to increase blood circulation , the body will accept, at the same time body will resist whatever treatment to decrease blood circulation.

No further evidence is required to prove the temperature of fever  is to increase blood  circulation. 

Biography:

A practicing physician in the field of healthcare in the state of Kerala in India for the last 29 years and very much interested in basic research. My interest is spread across the fever , inflammation and  back pain,. I am a writer. I already printed and published nine books in these subjects. I wrote hundreds of articles in various magazines.

I presented 9 research papers in Indian Science Congress 2008 to 2017.And 2 papers selected for the coming 2018 Indian science congress. I presented 2 papers in kerala science congress2014and 2017.

After scientific studies for a long time, we have developed a theory, Which proves the temperature of fever is to increase blood circulation. we have developed 8000 affirmative cross checking questions. It  can explain all queries related with fever and  it considers the messages of the  body and the facts of physics

Abstract:

According to the facts of physics, if temperature increases, thermal expansion of an object is positive it will expand and with decrease of temperature it will shrink. Pressure will increase due to increase of temperature.

On the contrary, during fever we can see blood vessels and skin are shrunk, pressure decreases, body shivers,   sleep increases, motion decreases, inflammation increases,   body pain increases, blood circulation decreases, dislike cold substances etc...

In fever, the firing rate of Warm sensitive neurons decreases, and the firing rate of

Cold sensitive neurons increases.

At the same time if we apply hotness from outside by thermal bag or if we drink hot water, our body acts according to the Facts of Physics- increase of temperature  pressure will also increase,  expands blood vessels and skin, body sweats, motion will increase ,  inflammation will decrease , body pain will decrease, blood circulation will increase,  like cold substances etc..

During fever, why our body acts against Facts of Physics? when disease increases, pressure and temperature will decrease. Blood circulation will decrease due to decrease of pressure. If the essential temperature of the  body is going out, essential temperature and  pressure will further decrease. This will further endanger the life or action of organ.

when  disease  increase, it is the sensible and discreet action of brain  that tends to act against facts of physics  to sustain life or protect organ .There is no  way other than this for a sensible and discreet  brain to protect the  life or organ.                       

We will get a clear answer if we find out the purpose of fever,  sensible and discreet action of brain . No medical books clarify this¹

During fever, if the temperature of fever is not a surplus temperature or if it is not suppose to be eliminated from the body, the shrinking of skin and blood vessels, shivering of body, dislike towards cold substances etc are a protective covering of the body to increase blood circulation to important organs of the body it is against the facts of physics.

Biography:

Abstract:

Streptococcus pneumoniae is a human pathogen of major importance. It causes both mucosal and invasive diseases including pneumonia, otitis media, arthritis, septicemia, and meningitis. This bacterium is considered as not only an aggressive pathogen but a normal part of the human respiratory microbiome. Although S. pneumoniae can be detected by microscopy and culturing, currently PCR are increasingly being used in the etiological diagnosis of microbial infections. In this study, a total number of 93 nasopharyngeal samples were collected from patients with acute respiratory infection. Isolates of S. pneumoniae were confirmed by α-hemolysis of colonies appeared, optochin sensitivity, and bile solubility. The presence of ply gene was also discovered by PCR. 7 (7.53%) isolates among 93 nasopharyngeal samples were confirmed as S. pneumoniae by all of phenotypic tests, while the PCR assay revealed that 19 isolates (20.43%) were positive for virulence gene, ply. The present study found out the identification of Streptococcus pneumoniae should be based on phenotypic tests and at least a molecular method such as PCR. 

Biography:

Dr, ayoola samuel abati completed is mbbs in 2004 at obafemi awolowo university teaching hospital ile –ife nigeria, he was trained at the department of inectious diseases during is residency. And he was able to provide several superior care and consultaion that resulted in overall improvement of department patient’s satisfation quotient.

Dr ayoola focused on patient’s treatment and re-evaluated several methods of   therapy management dependant on infection types tailored to patient’s individual patient history and efficacy of previous treatments  and completed is master degree in public health at the same institution.

Dr ayoola has then been practicing in department of infectious disease at lagos university teaching hospital one of the top tree infection disease hospital in nigeriaand also doing his phd at the moment.

Dr, ayoola  currently holds a certification from nigerian board of internal medicine for internal medicine ,hematology and infectious disease  and  also awarded the ward of the developing leader in medicine from nigerian medical association in 2010 for his excellent contribution in general treatment and towards the reduction of infectious disease in nigeria .

Abstract:

Aims: in nigeria, hepatitis c virus (hcv) infection is primarily spread through injection drug use. There is an urgent need to improve access to care for hcv among persons with opioid use disorders who inject drugs. The purpose of our study was to determine the prevalence of hcv, patient characteristics, and receipt of appropriate care in a sample of patients treated with buprenorphine for their opioid use disorders in a primary care setting.

Methods :this study used retrospective clinical data from the electronic medical record. The study population included patients receiving buprenorphine in the office based opioid treatment (obot) clinic within the adult primary medicine clinic at lagos medical center between october 2008 and august 2015 who received a conclusive hcv antibody ab test within a year of clinic entry. We compared characteristics by hcv serostatus using pearson's chi-square and provided numbers/percentages receiving appropriate care.

Results :the sample comprised 300 patients. Slightly less than half of all patients (n = 134, 27.7%) were hcv ab positive, and were significantly more likely to be older hausas and yoruba’s, have diagnoses of post- traumatic stress disorder (ptsd) and bipolar disorder, have prior heroin or cocaine use, and be hi v- infected. Among the 134 hcv ab positive patients, 126 (67.7%) had detectable hcv ribonucleic acid (rna) indicating chronic hcv infection; only 8 patients (2.21%) with chronic hcv infection ever initiated treatment.

Conclusions :nearly half of patients (47.7%) receiving office-based treatment with buprenorphine for their opioid use disorder had a positive hepatitis c virus antibody screening test , although initiation of hcv treatment was nearly non- existent (2.21%).

Biography:

Michael Skutek, MD gathered expertise as an orthopedic surgeon in prevention and detection of surgical site infections both during his fellowship (Canada) and in daily life practice in an academic orthopedic center (Germany). His viewpoint combines the academic angle as well as experience as a practicing surgeon with >200 joint replacements per year. His research focuses on optimizing treatment and preventing of complications. Knowledge of potential risk factors and straight forward performance is a key to reduce SSI in obese and morbidly obese patients.

Abstract:

Statement of the problem: There is an increasing number of both total hip replacement and related SSI, especially in obese and morbidly obese patients. We examined our experience and, in particular, complications associated with total hip arthroplasty in this entity. We prospectively gathered 50 patients in a matched control series including 25 obese and morbidly obese patients. All patients were operated using the direct lateral approach using an iodized foil following skin disinfection and generous irrigation using a water lavage during the procedure. Standard postoperative protocols were applied. Operating room time, incidence of infections as well as other potential complications, dislocations, blood loss, cup position and clinical parameters using the Harris Hip Score and the Western Ontario and McMaster Universities Arthritis Index results were compared. Although there were some significant differences in clinical outcomes, the applied procedures yielded good overall results and an acceptable rate of complications. Details approaching this patient entity in terms of prevention of surgical site infections are being discussed.

Biography:

Abstract:

Background: The control of tuberculosis infection in PLHIVs has now become more complicated due to emerging of multidrug resistant TB (MDR-TB). It takes longer time; at least 6-8weeks for diagnosis of MDR-TB by culture and conventional DST. The aim of this study was to early diagnosis of MDR-TB by rapid molecular method directly from positive sputum specimens to decrease the mortality of PLHIVs.

Method: A total of 25 smear positive sputum specimens of PLHIVs were used for the detection of RIF and INH resistant mutation by genotypic assay (Genotype MTBDR plus kit, Hain Life science GmbH, Nehren, Germany) and compared with phenotypic DST from the same specimens.

Result: Out of the 25 specimens, an interpretable result of MDR-TB (RIF^r+INH^r), were obtained from 7/23(30.4%), by Genotypic method and 8/23(34.7%) from phenotypic method. The majority of common mutation regions were seen in MUT3 64.3% (Ser531lue) in rpoB gene, MUT1 24.5% (Ser315Ile) in katG gene and MUT1 5.6% (Cys-15Thr) in inhA gene.

Conclusion:This method is suitable for rapid diagnosis of MDR-TB, directly on smear positive sputum specimens in PLHIVs because it is equally sensitive and specific and takes less time as compared with conventional DST.

Biography:

I completed my Bachelor degree in Clinical Laboratory Science from University of Asmara, Eritrea on September 2007. In the last ten years of my tenure I worked as a senior medical technologist in clinical chemistry and clinical bacteriology department and as a teaching assistant at Asmara College of Health Sciences, Asmara, Eritrea. Currently I am doing my masters at Huazhong University of Science and Technology, China. I has published two papers in reputed journals. I have also guided three undergraduate research projects as supervisor which are nearing publication internationally

Abstract:

Background: Cholesterol has been shown to have an intimate link with both our immunity and Mycobacterium tuberculosis. This project was to investigate the association of dietary and serum cholesterol levels with active tuberculosis.

Methodology:  A hospital based matched case control study was done. Blood collected for TC, LDL-C, HDL-C and TG along with albumin levels were measured. Levels of dietary cholesterol intake were assessed by a validated food frequency questionnaire (FFQ) for all participants. Sputum samples were collected from the newly diagnosed cases. The extent of bacterial load in the sputum samples was assessed by grading the smear for AFB after ZN staining. Statistical analysis was done by SPSS version 20. 

Results:  levels of serum TC, LDL-C, HDL-C, TG and albumin were significantly lower in the newly diagnosed cases when compared with the controls (p<0.000) and the cases under treatment (p<0.000). The levels of serum lipids and albumin levels appear to normalize with treatment. There was significant inter group difference with categories of smear grades at p<0.05 for TC, HDL-C and cholesterol intakes. Serum lipid levels appeared to negatively correlate with the smear grading of sputum samples with Spear man rho of -0.514, -0.398 and -0.424 for TC, HDLC and LDL-C respectively at p<0.05.

There was also a significant positive correlation between the reported pre-disease habitual intake of cholesterol and smear grading of sputum sample (r=0.561 for new cases at p<0.05). The OR adjusted for several confounders was 8.57 (95%CI 1.58-46.3) for the highest quartile of intake.  There was a significant positive trend between quartiles of cholesterol intake and the risk of developing active disease with P= 0.008 which remained even after the exclusion of the cases under treatment P= 0.004. 

Discussion and Conclusion: Serum cholesterol was low in the new cases with a negative correlation with smear grading. This may be due to high oxidative stress and elevated cytokines seen with the onset of active ;disease. The normalization of serum lipids with treatment suggests that the lower levels seen in the new cases are due to the disease. Reported pre-disease levels of dietary cholesterol seem to have negative effects as they were positively associated with the smear grading and risk of developing active disease.