Clinico-pathological assessment of virulent Newcastle Disease Virus in ducks.

Newcastle disease (ND) is an infectious, highly contagious and lethal disease of avian species. It is considered that ducks are natural reservoir or carrier for Newcastle disease virus (NDV) and are resistant against different strains of NDV. Current study was designed to evaluate the pathogenesis of Newcastle disease in domestic ducks through histopathology, immunohistochemistry (IHC) and serum biochemical changes. For this purpose, eighty ducks were reared for 42 days and divided in two groups A and B. Ducks in group A were challenged with (NDV) at rate of 0.1 ml of ELD50 (virus titer 107.32/100µl) on second week of age, whereas Group B was control negative. Splenomegaly, atrophy of thymus and necrotic lesion in kidney were observed on 9th day of post infection. Hepatic degeneration and mononuclear cell infiltration were noticed in proventriculus and intestine in challenged ducks. Viral antigen detected in lungs, intestine, proventriculus and lymphoid organs of infected ducks through IHC. Albumin and total protein values were significantly low in infected groups A as compared to control group B. ALT, AST, and ALP values were significantly high in infected group A. On 5th and 7th day of post infection oropharyngeal swabs were negative for NDV and cloacal swabs were positive for NDV through Reverse transcriptase polymerase chain reaction. It is concluded that ducks are susceptible to NDV and virulent strain of NDV caused disease in ducks.

Establishment of public health security in Saudi Arabia for the 2009 Hajj in response to pandemic influenza A H1N1.

Mass gatherings of people challenge public health capacities at host locations and the visitors' places of origin. Hajj--the yearly pilgrimage by Muslims to Saudi Arabia--is one of the largest, most culturally and geographically diverse mass gatherings in the world. With the 2009 pandemic influenza A H1N1 and upcoming Hajj, the Saudi Arabian Ministry of Health (MoH) convened a preparedness consultation in June, 2009. Consultants from global public health agencies met in their official capacities with their Saudi Arabian counterparts. The MoH aimed to pool and share public health knowledge about mass gatherings, and review the country's preparedness plans, focusing on the prevention and control of pandemic influenza. This process resulted in several practical recommendations, many to be put into practice before the start of Hajj and the rest during Hajj. These preparedness plans should ensure the optimum provision of health services for pilgrims to Saudi Arabia, and minimum disease transmission on their return home. Review of the implementation of these recommendations and their effect will not only inform future mass gatherings in Saudi Arabia, but will also strengthen preparedness efforts in other settings.

Clinico-pathological assessment of virulent Newcastle Disease Virus in ducks

Abstract Newcastle disease (ND) is an infectious, highly contagious and lethal disease of avian species. It is considered that ducks are natural reservoir or carrier for Newcastle disease virus (NDV) and are resistant against different strains of NDV. Current study was designed to evaluate the pathogenesis of Newcastle disease in domestic ducks through histopathology, immunohistochemistry (IHC) and serum biochemical changes. For this purpose, eighty ducks were reared for 42 days and divided in two groups A and B. Ducks in group A were challenged with (NDV) at rate of 0.1 ml of ELD50 (virus titer 107.32/100µl) on second week of age, whereas Group B was control negative. Splenomegaly, atrophy of thymus and necrotic lesion in kidney were observed on 9th day of post infection. Hepatic degeneration and mononuclear cell infiltration were noticed in proventriculus and intestine in challenged ducks. Viral antigen detected in lungs, intestine, proventriculus and lymphoid organs of infected ducks through IHC. Albumin and total protein values were significantly low in infected groups A as compared to control group B. ALT, AST, and ALP values were significantly high in infected group A. On 5th and 7th day of post infection oropharyngeal swabs were negative for NDV and cloacal swabs were positive for NDV through Reverse transcriptase polymerase chain reaction. It is concluded that ducks are susceptible to NDV and virulent strain of NDV caused disease in ducks.

Resumo A doença de Newcastle (DN) é uma doença infecciosa, altamente contagiosa e letal de espécies aviárias. Considera-se que os patos são reservatórios ou portadores naturais do vírus da doença de Newcastle (VDN) e são resistentes a diferentes cepas de VDN. O presente estudo foi desenvolvido para avaliar a patogênese da DN em patos domésticos por meio de histopatologia, imuno-histoquímica (IHQ) e alterações bioquímicas séricas. Para este propósito, 80 patos foram criados por 42 dias e divididos em dois grupos A e B. Os patos do grupo A foram submetidos ao VDN a uma taxa de 0,1 ml de ELD50 (título viral de 107,32 / 100 µl) na segunda semana de idade, enquanto o Grupo B foi controle negativo. Esplenomegalia, atrofia do timo e lesão necrótica no rim foram observadas no 9º dia pós-infecção. Degeneração hepática e infiltração de células mononucleares foram observadas no proventrículo e intestino em patos infectados. Antígeno viral foi detectado em pulmões, intestino, proventrículo e órgãos linfoides de patos infectados por IHQ. Os valores de albumina e proteína total foram significativamente baixos no grupo A infectado em comparação com o grupo B. Os valores de ALT, AST e ALP foram significativamente altos no grupo A. No 5º e no 7º dia após a infecção, os esfregaços orofaríngeos foram negativos para VDN, enquanto os esfregaços cloacais foram positivos para VDN por meio da reação em cadeia da polimerase via transcriptase reversa. Conclui-se que os patos são suscetíveis ao VDN e à cepa virulenta de VDN que causou doenças em patos.

Clinico-pathological assessment of virulent Newcastle Disease Virus in ducks / Avaliação clínico-patológica do Vírus da Doença de Newcastle em patos

Abstract Newcastle disease (ND) is an infectious, highly contagious and lethal disease of avian species. It is considered that ducks are natural reservoir or carrier for Newcastle disease virus (NDV) and are resistant against different strains of NDV. Current study was designed to evaluate the pathogenesis of Newcastle disease in domestic ducks through histopathology, immunohistochemistry (IHC) and serum biochemical changes. For this purpose, eighty ducks were reared for 42 days and divided in two groups A and B. Ducks in group A were challenged with (NDV) at rate of 0.1 ml of ELD50 (virus titer 107.32/100µl) on second week of age, whereas Group B was control negative. Splenomegaly, atrophy of thymus and necrotic lesion in kidney were observed on 9th day of post infection. Hepatic degeneration and mononuclear cell infiltration were noticed in proventriculus and intestine in challenged ducks. Viral antigen detected in lungs, intestine, proventriculus and lymphoid organs of infected ducks through IHC. Albumin and total protein values were significantly low in infected groups A as compared to control group B. ALT, AST, and ALP values were significantly high in infected group A. On 5th and 7th day of post infection oropharyngeal swabs were negative for NDV and cloacal swabs were positive for NDV through Reverse transcriptase polymerase chain reaction. It is concluded that ducks are susceptible to NDV and virulent strain of NDV caused disease in ducks.

Resumo A doença de Newcastle (DN) é uma doença infecciosa, altamente contagiosa e letal de espécies aviárias. Considera-se que os patos são reservatórios ou portadores naturais do vírus da doença de Newcastle (VDN) e são resistentes a diferentes cepas de VDN. O presente estudo foi desenvolvido para avaliar a patogênese da DN em patos domésticos por meio de histopatologia, imuno-histoquímica (IHQ) e alterações bioquímicas séricas. Para este propósito, 80 patos foram criados por 42 dias e divididos em dois grupos A e B. Os patos do grupo A foram submetidos ao VDN a uma taxa de 0,1 ml de ELD50 (título viral de 107,32 / 100 µl) na segunda semana de idade, enquanto o Grupo B foi controle negativo. Esplenomegalia, atrofia do timo e lesão necrótica no rim foram observadas no 9º dia pós-infecção. Degeneração hepática e infiltração de células mononucleares foram observadas no proventrículo e intestino em patos infectados. Antígeno viral foi detectado em pulmões, intestino, proventrículo e órgãos linfoides de patos infectados por IHQ. Os valores de albumina e proteína total foram significativamente baixos no grupo A infectado em comparação com o grupo B. Os valores de ALT, AST e ALP foram significativamente altos no grupo A. No 5º e no 7º dia após a infecção, os esfregaços orofaríngeos foram negativos para VDN, enquanto os esfregaços cloacais foram positivos para VDN por meio da reação em cadeia da polimerase via transcriptase reversa. Conclui-se que os patos são suscetíveis ao VDN e à cepa virulenta de VDN que causou doenças em patos.

Respiratory infection in the chronically critically ill patient. Ventilator-associated pneumonia and tracheobronchitis.

The long-term ventilated patient is at high risk for developing nosocomial pneumonia or tracheobronchitis. In general, the frequency of infection increases with the duration of mechanical ventilation, but the risk appears to be greatest in the first week of intubation. Although these types of infection are common and may have morbidity and mortality impact, the daily risk is less in the long-term ventilated patient than in the acutely ill intubated patient. This reduced daily risk may reflect a "survivor effect," with less healthy patients dying early in the hospital stay and not surviving long enough to undergo tracheostomy and long-term ventilation. A number of factors predispose these patients to infection, including host defense impairment and exposure to large numbers of bacteria. This exposure can occur through the airway, and proper care of respiratory therapy devices is essential to minimize the risk for infection. Most infections of the lower respiratory tract are preceded by airway colonization with EGN bacteria and, with improvement in host defenses and nutrition, infection in the face of colonization is less likely. In some patients, colonization can be eliminated. When the long-term ventilated patient does develop infection, it generally involves highly resistant gram-negative or gram-positive organisms and therapy should be prompt and appropriate. Not all such patients respond to systemic antibiotics, and the use of adjunctive aerosol therapy may have benefit for those with either tracheobronchitis or pneumonia, especially if highly resistant pathogens are present.

Varicella pneumonia: another 'steroid responsive' pneumonia?

Varicella-zoster virus (VZV) pneumonitis remains an often-fatal complication of VZV infection. Antiviral agents and supportive care are widely accepted therapies. Cautious use of corticosteroids in life-threatening VZV pneumonitis may be justified. Appropriate patient selection factors are as yet unidentified and the decision to commence corticosteroid therapy in this setting is clinical.

Cancer of male breast. (A report on incidence).

During a retrospective study of 1843 patients with malignant lesions, 83 were identified as breast cancer. Of these, 4 turned out to be male breast cancer showing a male to female ratio of this neoplasms to be 1:19.7.

Cancer morbidity.

In the present study, 1736 cases of cancer has been analysed by major sites, sub-sites and mortality trend. The most common cancerous lesion in the male was in the lungs and in the female in the uterine cervix. The second common lesion in male and female were larynx and breast respectively. In children, retinoblastoma was the commonest type of cancer.

Rationale for producing evidence-based guidelines for community-acquired pneumonia in the Gulf Corporation Council.

World-wide community-acquired pneumonia (CAP) is a common respiratory tract infection and is now a growing public health concern in the GCC region. Practice guidelines are derived statements which lead to informed clinical decision making. National and regional guidelines have been developed in North America, South America, South Africa and Western Europe to assist practitioners managing patients with CAP and have demonstrated to improve patients outcome. Four years have elapsed since the publication of the Saudi Arabian CAP guideline and notable changes in the area of CAP demand revision of this earlier document. We expanded previous guidelines to a regional level in a number of ways: by incorporating changes in antimicrobial resistance profiles in the region, by considering the regional availability of antibiotics and diagnostic procedures, by including emerging data on new advancements in diagnosis and treatment of CAP and, finally, by adopting an evidence-based approach in grading relevant data. The current document seeks to target primary care physicians who manage most patients with CAP in the GCC region. All available and relevant peer reviewed studies published until June 2007 were considered in the literature review. Based on the strength of the evidence, we graded our recommendations to high-level (Level I), moderate-level (Level II), and low-level (Level III) evidence.

Microbiology of community-acquired pneumonia in the Gulf Corporation Council states.

In spite of advances in microbiological and serological investigations over the last two decades, etiological attribution remains difficult in community-acquired pneumonia (CAP). Even after exhaustive investigation, the etiology of CAP remains unknown in up to 50% of patients. Common pathogens include Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. In addition, several investigators document the importance of atypical pathogens including Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila in the etiology of CAP in the GCC region. Increasingly, other etiologies, particularly influenza viruses, varicella zoster virus and Mycobacterium tuberculosis, have been recognized as causative pathogens of CAP within the region. Rates of antimicrobial resistance of S. pneumoniae and other pathogens are rising in the Gulf Corporation Council (GCC) region and susceptibility profiles of antibiotics against intracellular pathogens such as Chlamydophila pneumoniae and Mycoplasma pneumoniae are not routinely performed. Injudicious prescribing and over-use of antibiotics drive much resistance. The GCC CAPWG calls for urgent governmental regulations to limit and monitor antibiotic prescription in the GCC region.

Management and prevention strategies for community-acquired pneumonia in the Gulf Corporation Council.

Risk factors identify likelihood and severity of community-acquired pneumonia (CAP) and may allow prognostication. Prognostic factors can focus resources and efforts on those who may need special observation. Several risk assessment tools are used to estimate the severity of CAP and whether these tools can be used to predict outcomes, to determine disposition or even used to determine ICU level of care is hotly under debate. Treating CAP depends on age and comorbidities, as well as local epidemiology and disease severity. The current guidelines for managing CAP categorize patients with CAP into the healthy outpatient, the outpatient with modifying factors or comorbidities, the inpatient with CAP and patients requiring intensive care unit admission. These guidelines took into account regional bacteriology, antibiotic resistance data and available antibiotics to formulate recommendations. Preventive strategies for CAP include the administration of pneumococcal and influenza vaccine in selected populations at risk.

Clinical presentation and diagnostic workup for community-acquired pneumonia: the Gulf Corporation Council CAP Working Group consensus statement.

Community-acquired pneumonia (CAP) is diagnosed on the basis of a suggestive history and compatible physical findings and new infiltrates on a chest radiograph. No criteria or combination of criteria based on history and physical examination have been found to be gold standard. With the rise in elderly Gulf Cooperation Council (GCC) residents, CAP is likely to present with non-classical manifestations such as somnolence, new anorexia, and confusion and carries a worse outcome than CAP in their younger counterparts. Tuberculosis should be considered in the differential diagnosis of unresolving CAP in the GCC region. Diagnostic work up depends on severity of CAP, clinical course and underlying risk factors.