Common Infectious Conditions Research Articles

A CASE STUDY ON AGNI KARMA WITH PIPPALI IN THE MANAGEMENT OF CHARMAKEELA W.S.R. TO WART

Warts are common viral infectious conditions having symptoms like small fleshy grainy bumps, white, pink or tan coloured, sprinkled with tiny black pinpoints, measuring about 1-10 mm and having clotted blood vessels seen in primary care and affected approximately 7% to 10% of the population. In day-to-day life, Charmakeela is a nonhazardous condition, but it causes pain, and cosmetically, it causes inconvenience and a lack of concentration in their work. In Ayurveda, warts are co-related with Charmakeela, mainly due to the vitiation of Vyana Vata & Kapha Dosha, which presents with pain, itching, swelling and roughness symptoms. Acharyas explained the different treatment principles for Charmakeela, such as Bheshaja, Shashtra, Kshara, and Agnikarma. As such, Bheshaja, Kshara and Shashtra Karma are done; there will be recurrence, but when treated with Agnikarma, there is no recurrence. So, Agnikarma is the choice of treatment in Charmakeela. It’s a simple procedure which can be carried out at the OPD level & complications are also less & it’s affordable. Dahanopakarana told in the classics are Pippali, Ajashakrit, Godanta, Shara, and Shalaka for Tvakagata yoga; this article highlights the case study for the management of Charmakeela with Pippali for Agnikarma, which showed good results and followed by Kumari Pulp local application.

Prevalence and spectrum of infectious and inflammatory dermatologic conditions occurring in pediatric heart transplant patients on a predominantly mTOR-based immune suppressive regimen: A retrospective chart review.

Pediatric heart transplant patients are routinely followed in dermatology clinics due to elevated risk of cutaneous malignancy. However, transplant patients may experience other, non-cancer-related dermatologic conditions including skin infections, inflammatory diseases, and drug eruptions that can cause significant medical and psychosocial comorbidity. A retrospective chart review of all pediatric heart transplant patients at Mayo Clinic Children's Center in Rochester, MN, was performed to determine the prevalence and spectrum of non-cancer dermatologic conditions. Statistical analysis was conducted to look for associations between episodes of rejection and skin condition development. Of the 65 patients who received heart transplants under the age of 18 and were followed at Mayo Clinic, 69% (N = 45) were diagnosed with at least one skin condition between transplant and the time of most recent follow-up. Sixty-two percent (N = 40) of patients were diagnosed with an inflammatory skin condition (most commonly acne and atopic dermatitis), 45% (N = 29) with an infectious skin condition (most commonly warts and dermatophyte infection), and 32% (N = 21) with a drug eruption (most commonly unspecified rash and urticaria). No association was found between presence of skin disease and number of rejection episodes. Non-cancer dermatologic conditions are prevalent within pediatric heart transplant recipients and may directly impact their medical needs and quality of life. Dermatologist involvement in the care of post-transplant pediatric patients is important, not only for cancer screening but also for diagnosis and treatment of common infectious and inflammatory skin conditions.

Efficacy of Tonsenorm Compound in the management of Tundikeri with special reference to Chronic Tonsillitis in Children

Introduction: Tonsillitis is one of the most common infectious conditions in the paediatric age group. Symptoms such as pain or tenderness in the throat, fever, tonsillar swelling with a white or yellow coating, painful blisters or ulcers on the throat, headache, loss of appetite, ear pain, trouble swallowing, bad breath, a scratchy or muffled voice, and a stiff neck mentioned in this disease. Ayurveda addresses the problem of Tundikeri, similar to chronic tonsillitis with internal medicines and external therapies. Tonsenorm compound is such a herbomineral formulation formulated with extract a set of nine drugs. Aim of the proposed study is to evaluate the efficacy of the Tonsenorm compound in Tundikeri. Material and Methods: The present study is planned to be conducted under the strict protocol of an open-label clinical trial, in 40 patients. Tonsenorm compound will be given for 60 days at 250 mg thrice a day. Assessment of the patients will be done on the basis of subjective parameters with a grading/scoring system on every 15th day during the study, with a post-intervention follow-up after 1 month. Results: The result will show the effectiveness of the trial drugs, which will be economical and safe for long-term use in the patients of Tundikeri. Discussion & Conclusion: The outcome of this herbomineral drug change in scoring/ grading of symptoms of Tundikeri /chronic tonsillitis (will be assess after the completion of the trial work).

Do family medicine residents optimally prescribe antibiotics for common infectious conditions seen in a primary care setting?

Antimicrobial resistance is a worldwide phenomenon that leads to a significant number of unnecessary deaths and costly hospital admissions. More than 90% of antibiotic use happens in the community and of this, family physicians account for two-thirds of these prescriptions. Our study aims to determine whether family medicine residents are optimally trained in antibiotic prescribing for common infectious conditions seen in a primary care setting. This study is a secondary analysis of a prior study of antimicrobial stewardship in two urban primary care clinics in central Toronto, Ontario. A total of 1099 adult patient visits were included that involved family medicine resident trainees, seen between 2015 and 2016. The main outcome measures were resident antibiotic prescription rates for each condition and expert-recommended prescribing practices, the rate prescriptions were issued as delayed prescriptions, and the use of first-line recommended narrow-spectrum antibiotics. Compared to expert-recommended prescribing rates, family medicine residents overprescribed for uncomplicated upper respiratory tract infections (URI) (5.0% [95% CI 2.2% to 9.7%] versus 0% expert recommended) and sinusitis (44.2% [95% CI 32.8% to 55.9%] versus 11%-18% expert range), and under prescribed for pneumonia (53.5% [95% CI 37.7% to 68.8%] versus 100% expert range]). Prescribing rates were within expert recommended ranges for pharyngitis (28.6% [95% CI 16.6% to 43.3%]), bronchitis (3.6% [95% CI 0% to 18.4%]), and cystitis (79.4% [95% CI 70.6% to 86.6%]). The antibiotic prescribing practices of family medicine residents during their training programs indicated overprescribing of antibiotics for some common infection presentations. Further study of antibiotic prescribing in primary care training programs across Canada is recommended to determine if future family physicians are learning appropriate antibiotic prescribing practices.

Association of dermatological manifestations with CD4 count among people living with HIV attending tertiary care hospital of South Gujarat.

Dermatological manifestations are common manifestations of human immunodeficiency virus (HIV) disease, seen in 80% to 95% of HIV-infected patients. Dermatological manifestations are considered clinical indicators to predict and assess the underlying immune status. This study aims to document the dermatological manifestations in relation to CD4 count in people living with HIV (PLHIV). Cross-sectional study in 250 PLHIV fulfilling inclusion-exclusion criteria was conducted. Variables including sociodemographic profile, recent CD4 count (data from antiretroviral therapy center), and dermatological manifestation (physical examination) were collected. Clinical diagnosis was established, and patients were grouped according to the World Health Organization immunological staging. Majority of PLHIV (39.6%) were in the age group of 31-40 years. Males were affected more than females (1.6:1). A total of 364 dermatoses were observed; dermatological manifestation per patient ranged from 1 to 4. 32.80%. PLHIV had CD4 count >500 cells/mm3, 15.60% had CD4 count between 200-349 cells/mm3. Majority of dermatosis had infectious etiology (77.6%), out of which dermatophytosis (27.2%) was the most common infectious condition, whereas pruritic papular eruption was the most common (11.6%) noninfectious condition. A statistically significant association of CD4 count was found with dermatophytosis (P ≤ 0.001) and candidiasis (P = 0.001). The study showed a significant association between the number of dermatological manifestation and CD4 count as majority of study participants (67.2%) had CD4 <500 cells/mm3 at the time of episode of dermatosis.

A double-blinded randomized placebo-controlled non-inferiority trial protocol for postoperative infections associated with canine pyometra

BackgroundPyometra is a common infectious condition, especially in elderly bitches. In addition to an infected uterus, dogs may have concurrent urinary tract infection (UTI). The preferred treatment is surgical removal of the ovaries and uterus, whereupon the general prognosis is excellent. In addition, antimicrobial therapy is frequently prescribed for postoperative treatment. However, no research exists on the benefit of postoperative antimicrobial treatment in uncomplicated canine pyometra. Antimicrobial resistance has become a major challenge in treatment of bacterial infections. Diminishing overuse of antimicrobial agents is essential for controlling the development of antimicrobial resistance in both animals and humans.MethodsThis double-blinded, randomized, placebo-controlled two-arm clinical trial is designed to compare the incidence of postoperative infections associated with surgical treatment of uncomplicated pyometra followed by two different treatment protocols. For the study, 150 dogs presenting with an uncomplicated pyometra and that are to undergo surgical treatment will be recruited. Dogs with body weight < 3 or > 93 kg, complicated pyometra, primary disease increasing the risk of infection, or immunosuppressive medication will be excluded. All dogs will receive one dose of sulfadoxine-trimethoprim intravenously as an antimicrobial prophylaxis. Postoperatively, dogs will be randomized to receive either a five-day course of placebo or an active drug, sulfadiazine-trimethoprim orally. During the surgery microbiological samples will be taken from urine and uterine content. The follow-up includes a control visit in 12 days and an interview of the owner 30 days after surgery. If bacteriuria is detected at the time of surgery, a urinary sample will be cultured for bacterial growth at the control visit. The primary outcome is the incidence of a postoperative surgical site infection (SSI), and the secondary outcome is the occurrence of clinical UTI with bacteriuria. Intention-to-treat and per-protocol analyses will be performed to compare outcome incidences between the treatment groups.DiscussionResearch-based evidence is necessary to create treatment guidelines for judicious use of antimicrobials. The goals of this study are to provide evidence for reducing the use of antimicrobials and targeting the treatment to patients proven to benefit from it. Publishing the trial protocol will increase transparency and promote open science practices.

Editorial introductions.

Editorial introductions.

Identification of the Bacteria that causes Childhood Tonsillitis

Introduction: Tonsillitis is the most common infectious condition after viral nose and throat infections. Millions of new infections every year are recorded globally. Young people under the age of 15 are disproportionately affected by acute tonsillitis. This study aimed to isolate the bacteria causing tonsilitis in children. Methods: One hundred thirty throat swabs were taken from a variety of individuals who were clinically determined to have tonsillitis with purulent discharges at the ENT clinic at Kuthospital. Isolates were tested for their gram stain response and biochemical features after being promptly transported to the laboratory and streaked directly on blood agar, which was incubated aerobically for 24 hours at 37°C. The following antibiotics were tested on all isolates using the disc diffusion technique: penicillin (10 units), gentamicin (10 mcg), vancomycin (30 mcg), erythromycin (15 mcg), ciprofloxacin (10 mcg), cephalothin (30 mcg), and chloramphenicol (30 mcg). Isolates were classified as sensitive or resistant based on the widths of zones of inhibition. Results: Thirty-four strains of Streptococci, 14 strains of Staphylococcus epidermidis, 32 strains of Staphylococcus aureus, 15 strains of another Staphylococcus spp., and 9 strains of Haemophilus parainfluenzae were detected. The current results showed that most isolates were sensitive to ciprofloxacin, chloramphenicol, and vancomycin, while most isolates showed resistance to penicillin and gentamycin. Conclusion: Streptococci and S. aureus showed to be the most common bacterial causes of tonsilitis in children who were sensitive to ciprofloxacin, chloramphenicol, and vancomycin.

Neurosarcoidosis – A diagnostic challenge?

Background: Sarcoidosis is an inflammatory granulomatous multisystem disease with an unknown etiology. Neurosarcoidosis is a cryptogenic neuroinflammatory manifestation of sarcoidosis. Objective: This article aims at better understanding of one of the rarer diseases whose diagnosis may be difficult leading to delay in definitive management of the patient. Method: We describe a case of neurosarcoidosis with initial presentation similar to acute invasive fungal rhinosinusitis, whose diagnosis was challenging and delayed owing to the presenting symptoms. Conclusion: The diagnosis of neurosarcoidosis becomes challenging when it presents as isolated clinical neurological symptoms. We want to highlight the variable nature of neurosarcoidosis and its consideration as diagnosis after excluding other common infectious and inflammatory conditions.

Editorial introduction

Editorial introduction

Delayed diagnosis of oral lymphoma: a case series.

Lymphomas are the second most common neoplasm in the head and neck. The clinical and radiographic presentation of non-Hodgkin lymphoma in the oral cavity is non-specific and can be hard to differentiate from other common infectious or inflammatory conditions. We report four cases of lymphoma of the head and neck, which presented as odontogenic infection, osteomyelitis, or cutaneous infection, and subsequently led to a delay in provision of appropriate treatment. Correlation between clinical, radiographic and histological findings is essential in reaching an accurate diagnosis. It is important for clinicians to consider malignant lesions, such as lymphoma, in the differential diagnosis of pain, swelling, tooth mobility or radiographic radiolucencies. Clinicians should maintain a high level of suspicion for malignancy when inflammatory lesions fail to respond to normal modes of treatment.

Editorial introductions.

Editorial introductions.

Oxygen-enriched oleic matrix (NovoX) for wound healing in pediatric patients undergoing open surgical treatment for pilonidal disease: Preliminary experience.

Pilonidal disease (PD) is a common infectious and inflammatory condition affecting the gluteal cleft and sacrococcygeal region. The optimal treatment for PD remains controversial. While the open technique reduces the number of relapses compared to minimally invasive approaches, it is associated with a longer healing time. Reactive oxygen species are a key part of the normal wound-healing process. Herein, we reported our preliminary experience using a new oxygen-enriched oil-based product called NovoX for wound healing after open surgery for PD. We used a new oxygen-enriched product for wound healing in three pediatric patients undergoing open surgical repair for PD between December 2021 and April 2022. During postoperative follow-up, healing time and the aesthetic result were evaluated. Our preliminary study included three patients with chronic PD. The average follow-up time was 5 weeks, corresponding to the end of the healing process and the resumption of normal daily activities. Only one mild complication occurred during the study period. No short-term side effects were reported. The cosmetic result was reported as satisfactory. NovoX is easy to apply, safe, and effective for treating pediatric patients undergoing open surgical treatment for PD, leading to slightly faster wound healing with good aesthetic outcomes.

Editorial introductions

Editorial introductions

Editorial introductions.

Editorial introductions.

Common infectious disease conditions and antibiotic resistance in pediatric population

Bacterial cells are multiple times (at least 10 times) more abundant than human cells in our bodies. The majority of agents that cause sickness in human beings are viruses or bacteria. Microbes in the human gastrointestinal tract have around 10 trillion living beings, addressing every 1,000 species. Microbes produce nutrients, separate food into nutrients that can be absorbed, and boost our immune system. Infectious diseases are a main source of death around the world, notably in low-income countries, particularly in pediatric populations. Resistance to antibiotics is one of the very best challenges to public health today. There are numerous approaches to prevent drug-resistant infections. Immunization may be a prospering and efficient public strategy that saves millions of lives annually. This review aims to highlight the infectious conditions within the pediatric population and the antibiotic resistance in pediatrics. Keywords: Antibiotics, Global epidemiology, India, Infectious disease, Prevention, Pediatrics.

Inflammatory Disease Affecting the Central Nervous System in Dogs: A Retrospective Study in England (2010-2019).

The epidemiology of inflammatory diseases affecting the central nervous system (CNS) in dogs is largely unknown. We aimed to report the relative proportion of different causes of inflammatory disease affecting the CNS in dogs and identify predictors for infectious vs. immune-mediated conditions and predictors for the most common diseases affecting the brain and the spinal cord. This was a retrospective cohort study over a 10-year period in 2 referral institutions using multivariable and multinomial logistic regression for identification of risk factors. In total, 1,140 client-owned dogs diagnosed with inflammatory disease affecting the CNS were included. Fifteen different diagnoses were identified, with immune-mediated (83.6%) disease being more common than infectious conditions (16.4%). The most common immune-mediated conditions diagnosed were meningoencephalitis of unknown origin (47.5%) and steroid-responsive meningitis–arteritis (30.7%), and the most common infectious conditions were discospondylitis (9.3%) and otogenic intracranial infection (2.2%). Older age (p < 0.001, OR = 1.019, 95% CI: 1.014–1.024), higher body weight (p < 0.001, OR = 1.049, 95% CI: 1.025–1.074), male sex (p = 0.009, OR = 1.685, 95% CI: 1.141–2.488), longer duration of the clinical signs before presentation (p < 0.001, OR = 1.011, 95% CI: 1.006–1.017), progressive nature of the clinical signs (p < 0.001, OR = 2.295, 95% CI: 1.463–3.599), identification of a possibly associated preceding event (p = 0.0012, OR = 1.93, 95% CI: 1.159–3.213), and hyperesthesia on presentation (p < 0.001, OR = 2.303, 95% CI: 1.528–3.473) were associated with a diagnosis of infectious diseases. Our data shows that immune-mediated diseases are more common than infectious conditions as a cause for inflammatory CNS disease in dogs. The risk factors for the most common diagnoses were identified from signalment, history, and findings of the physical and neurological examinations to give valuable information that can guide clinicians with their investigations.

A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South Africa

Data on antimicrobial consumption among the paediatric population in public hospitals in South Africa are limited. This needs to be addressed to improve future antimicrobial use and reduce antimicrobial resistance rates. This study aimed to quantify antimicrobial usage and to identify and classify which antimicrobials are used in the paediatric population in public sector hospitals in South Africa according to the World Health Organization (WHO) AWaRe list of antimicrobials. A point prevalence survey was conducted among 18 public sector hospitals from nine provinces using a newly developed web-based application. Data were analysed according to the WHO AWaRe list to guide future quality improvement programmes. A total of 1261 paediatric patient files were reviewed, with 49.7% (627/1261) receiving at least one antimicrobial and with 1013 antimicrobial prescriptions overall. The top five antimicrobials included ampicillin (16.4%), gentamicin (10.0%), amoxicillin/enzyme inhibitor (9.6%), ceftriaxone (7.4%) and amikacin (6.3%). Antimicrobials from the 'Access' classification were the most used (55.9%), with only 3.1% being from the 'Reserve' classification. The most common infectious conditions for which an antimicrobial was prescribed were pneumonia (14.6%; 148/1013) and clinical sepsis (11.0%; 111/1013). Parenteral administration (75.6%; 766/1013) and prolonged surgical prophylaxis (66.7%; 10/15) were common concerns. Only 28.0% (284/1013) of prescribed antimicrobials had cultures requested; of which only 38.7% (110/284) of culture results were available in the files. Overall, antimicrobial prescribing is common among paediatric patients in South Africa. Interventions should be targeted at improving antimicrobial prescribing, including surgical prophylaxis, and encouraging greater use of oral antibiotics.

Laboratory investigations of herpes simplex virus-1 and -2 clinical samples in Korea.

ObjectivesHerpes simplex virus (HSV) infections have been reported in 60% to 95% of the adult population worldwide, making them one of the most common infectious conditions globally. HSV-1 and HSV-2 cause severe disease in immunocompromised patients. Therefore, the aim of this study was to provide information that could be used to reduce the incidence of genital herpes caused by HSV-1 and HSV-2.MethodsFrom September 2018 to December 2020, 59,381 specimens were collected from outpatients across primary and secondary hospitals in Korea who requested U2Bio (Korea) to conduct molecular biological testing of their samples for sexually transmitted infections. In this study, the positivity rates of HSV-1 and HSV-2 were analyzed according to age, sex, and specimen type.ResultsIn the age-specific analysis of HSV-1, the highest positivity rate (0.58%) was observed in patients under 19 years of age, whereas the lowest positivity rate (0.08%) was observed in patients aged over 70 years. In the age-specific analysis of HSV-2, the highest positivity rate (2.53%) was likewise observed in patients under 19 years of age.ConclusionOur study identified differences in the infection rates of HSV-1 and HSV-2 depending on patients’ sex and age. These differences will be useful for improving disease prevention and control measures for HSV-1 and HSV-2.

276 Emergency Department Visits for Pediatric Infectious Conditions Decrease After COVID-19

Following the arrival of COVID-19 in the New York metropolitan area in March 2020, pediatric ED visits markedly decreased. Possible reasons for this include parental reluctance to bring their children to the ED due to fear of exposure and mandates to socially isolate (which may have also decreased infectious disease transmission) and increasing use of telemedicine. Our goal was to determine whether ED visits for some common pediatric infectious conditions changed following the arrival of COVID-19 in our area.