ABSTRACT
Enteric fever, predominantly caused by Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi, remains a significant global health challenge. This comprehensive review examines the evolving epidemiology and antibiotic resistance associated with enteric fever. We provide an overview of the disease's definition and historical context, highlighting the substantial impact of antibiotic resistance on treatment efficacy. The review details the global burden, incidence trends, and risk factors of enteric fever while elucidating the pathogenesis and clinical manifestations of the disease. A critical analysis of antibiotic resistance mechanisms reveals the alarming rise of multi-drug resistant (MDR) and extensively drug-resistant (XDR) strains, complicating treatment regimens and underscoring the need for novel therapeutic strategies. Current treatment protocols, the role of empirical therapy, and the rational use of antibiotics are discussed in depth. Additionally, we explore prevention and control strategies, emphasizing the importance of vaccination programs, sanitation improvements, and effective public health interventions. The review concludes with recommendations for future actions, including enhanced surveillance, research and development of new antibiotics, expansion of vaccination efforts, and improved public health infrastructure. The findings highlight the necessity for updated clinical guidelines and sustained global efforts to address the challenges of enteric fever and its evolving antibiotic resistance patterns. Through coordinated action and continued innovation, it is possible to mitigate the impact of this enduring public health threat.
ABSTRACT
Introduction: Obesity, defined on the basis of anthropometric measures is a global epidemic and threatening to healthy population worldwide. A research from China among young adults (20--44 years) recorded six and two times the risk of hypertension (HTN) in individuals who were obese and overweight, respectively, relative to normal weight individuals. This study highlights about anthropometric indices and its association with HTN among young medical students at rural medical college. Methods: In this cross-sectional study, 1,000 medical students had been enrolled. Anthropometric indices like body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), neck circumference (NC) as per South East Asian guidelines were measured in all students. Results: Among young medical students, the prevalence of obesity defined by BMI, WC, WHR, and NC was 46.5%, 32.4%, 57.3%, and 8.4%. Among males, there was significant positive correlation of BMI with SBP (P < 0.0001) and DBP (P < 0.0001), whereas WC (P < 0.0001) and WHR (P = 0.012) had positive and significant correlation with SBP but not with DBP. Correlation of NC with SBP and DBP was negative but did not reach statistical significance (P = 0.266 and P = 0.670, respectively). Among females, there was significant positive correlation of BMI with SBP (P < 0.0001) and DBP (P < 0.0001), WC had significant positive correlation with SBP (P < 0.0001,) and DBP (P < 0.0001). Correlation of WHR was significant with DBP (P = 0.002) but not with SBP (P = 0.055). Conclusion: The prevalence of HTN in this study was 9.8% in young medical students overall and varies according to anthropometric indices. The prevalence rate varies in males and females depending on the anthropometric measures.