I first read Davidson 30 years ago: at that time it was already in its 5th edition. A brief comparison shows that it then contained about 440,000 words in 1,100 pages: the current edition has compressed 625,000 words into 800 pages. I think I bought it as a student because it was cheap: but also because it seemed to be comprehensive and straightforward, and I have used it as a basis for my medical knowledge ever since. So I miss some of the old pictures of the acute skin rashes such as scarlet fever: in fact infectious disease has been transferred to the back and genetic factors take the first chapters. But careful linguistic comparison will still uncover the old phrases which some of us know by heart-there are minor changes such as 'alarming reactions to intravenous iron are uncommon, but have occasionally been noted', which becomes 'alarming systemic anaphyllactic reactions can occur'. Sir Stanley Davidson made 'no attempt to describe every rare disease or syndrome, but devoted most of the space available to those disorders most commonly encountered in practice'. I have grown up with successive editions, and have gradually come to appreciate the problems of the authors in the compression of knowledge. Having got to know many of them personally as real people rather than as names I can still recommend the book. It is the essential starting point for the study of internal medicine and for many doctors will remain their base reference work. The present editors have kept up-to-date and been prepared to prune the dead wood. There are many competitors in the market, and the publishers must take care with layout and illustration, although Davidson is still the best value for money. I will continue to recommend it to my clinical students: they will need to read it and know it to pass final MB. Postgraduates will need to remember the facts, but also to be able to place them in a broader perspective. The older consultant will still happily read it, and to get to know the authors themselves is really to complete your medical education. Dr John Macleod and his team have successfully kept alive the primary objective 'to provide a rational and easily comprehensible basis for the practice of medicine'. The book is economical in price and compact in size, but still contains the essential truths for the practice of good medicine.

Davidson's Principles and Practice of Medicine

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Anthrax as a Biological Weapon: Medical and Public Health Management

Clinical evaluation of CpG oligonucleotides as adjuvants for vaccines targeting infectious diseases and cancer.

Most humans are in contact with animals in a way or another. A zoonotic disease is a disease or infection that can be transmitted naturally from vertebrate animals to humans or from humans to vertebrate animals. More than 60% of human pathogens are zoonotic in origin. This includes a wide variety of bacteria, viruses, fungi, protozoa, parasites, and other pathogens. Factors such as climate change, urbanization, animal migration and trade, travel and tourism, vector biology, anthropogenic factors, and natural factors have greatly influenced the emergence, re-emergence, distribution, and patterns of zoonoses. As time goes on, there are more emerging and re-emerging zoonotic diseases. In this review, we reviewed the etiology of major zoonotic diseases, their impact on human health, and control measures for better management. We also highlighted COVID-19, a newly emerging zoonotic disease of likely bat origin that has affected millions of humans along with devastating global consequences. The implementation of One Health measures is highly recommended for the effective prevention and control of possible zoonosis.

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Zoonotic diseases: etiology, impact, and control

As the Ebola outbreak in West Africa wanes, it is time for the international scientific community to reflect on how to improve the detection of and coordinated response to future epidemics. Our interdisciplinary team identified key lessons learned from the Ebola outbreak that can be clustered into three areas: environmental conditions related to early warning systems, host characteristics related to public health, and agent issues that can be addressed through the laboratory sciences. In particular, we need to increase zoonotic surveillance activities, implement more effective ecological health interventions, expand prediction modeling, support medical and public health systems in order to improve local and international responses to epidemics, improve risk communication, better understand the role of social media in outbreak awareness and response, produce better diagnostic tools, create better therapeutic medications, and design better vaccines. This list highlights research priorities and policy actions the global community can take now to be better prepared for future emerging infectious disease outbreaks that threaten global public health and security.

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Lessons from the Ebola Outbreak: Action Items for Emerging Infectious Disease Preparedness and Response

Anthrax is a zoonotic disease caused by Bacillus anthracis. It is potentially fatal and highly contagious disease. Herbivores are the natural host. Human acquire the disease incidentally by contact with infected animal or animal products. In the 18th century an epidemic destroyed approximately half of the sheep in Europe. In 1900 human inhalational anthrax occured sporadically in the United States. In 1979 an outbreak of human anthrax occured in Sverdlovsk of Soviet Union. Anthrax continued to represent a world wide presence. The incidence of the disease has decreased in developed countries as a result of vaccination and improved industrial hygiene. Human anthrax clinically presents in three forms, i.e. cutaneous, gastrointestinal and inhalational. About 95% of human anthrax is cutaneous and 5% is inhalational. Gastrointestinal anthrax is very rare (less than 1%). Inhalational form is used as a biological warefare agent. Penicillin, ciprofloxacin (and other quinolones), doxicyclin, ampicillin, imipenem, clindamycin, clarithromycin, vancomycin, chloramphenicol, rifampicin are effective antimicrobials. Antimicrobial therapy for 60 days is recommended. Human anthrax vaccine is available. Administration of anti-protective antigen (PA) antibody in combination with ciprofloxacin produced 90%-100% survival. The combination of CPG-adjuvanted anthrax vaccine adsorbed (AVA) plus dalbavancin significantly improved survival.

Anthrax: an update.

Objective: Acute poisoning is a common medical emergency in paediatric unit. This was a retrospective study to see the seasonal variation of acute poisoning in children in a tertiary hospital. Conclusion: Poisoning was common during the summer season and kerosene was found to be most common ingredient. It was possibly due to easy availability of kerosene and during the summer months thirsty children took this substance which was sometimes kept in the discarded container of soft drinks and mineral water bottles etc. People should be warned not to keep these toxic ingredients in such containers and within reach of the children.

Seasonal variation of childhood acute poisoning

Summary Visceral leishmaniasis (Kala-azar) is endemic in many countries including Bangladesh. Clinical presentation of visceral leishmaniasis in children and adult may vary and at time may simulate many tropical and hepatobilliary diseases. Jaundice and ascites is not common in some patients. In this series of eleven cases Jaundice, splenomegaly, hepatomegaly and ascites are present in 55%, 100%, 91%, 27% of cases respectively. So, Kala-azar should be kept in mind while dealing with cases of many such clinical findings.

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Jaundice in Pediatric Visceral Leishmaniasis (Kala-azar) Patients

Objective To compare intestinal parasitoses between urban and rural children in developing countries and its related factors. Methods Children of 1-6 years old in the urban and rural areas who had not taken antihelmenthic drugs in the last 6 months were randomly selected. Various factors were taken as variables in a preformed questionnaire. Results Among the total 52 children, 24 were in urban and 28 were in rural group. Male/female ratio of the rural group was 1:1 and that of the urban group was 1.4:1. Average income was 12 000 taka and 4 000 taka per month in urban and rural areas, respectively. None of the rural group used sanitary latrine, whereas every one in urban group used sanitary latrine. Majority (71%) of the mothers in rural group were below the primary level of education. Majority (75%) of fathers were educated above higher secondary level in urban group. In the rural group 18 (64%) fathers had not received any education. Enterobius vermicularis was observed only in 1 (4%) stool samples of urban children but in rural group it was found in 7 (25%) of the stool samples. Enterobius vermicularis was the main parasite isolated from both groups. Exclusive breast feeding practice of less than 6 months was observed in 20 (83%) children of urban group but in rural group that of less than one year was found in 22 (78%) children. Conclusions Intestinal parasitic infestation is mostly found in rural children. Urban children almost have no intestinal parasitoses. It has the relation with the poor sanitation, low standard of living, less parental income and education, and early weaning. Unnecessary universal deworming of the urban and rural children in developing countries should be discouraged in order to use the money economically and effectively. It can be carried out in rural children and their living standard should be improved.

Prevalence of intestinal parasitoses in urban and rural children of a developing country.

SUMMARY Clinical presentations of kala-azar (visceral leishmaniasis) are varied in children and adults. This may at least initially mimic many tropical and hepatobilliary diseases. This paper is an attempt to see the clinical presentations of kala-azar in children. Eleven cases are analyzed, retrospectively admitted in a pediatric unit of a tertiary care hospital in the southern part of Bangladesh. Fever 91%, Jaundice 55%, splenomegaly 100%, hepatomegaly 91% are common findings. Presence of jaundice and ascites may mimic chronic liver disease which is suspected in 36% in this series. Awareness regarding these uncommon features will help in diagnosis.

Akm Mamunur Rashid

Papers

Anthrax: an update.

Seasonal variation of childhood acute poisoning

Jaundice in Pediatric Visceral Leishmaniasis (Kala-azar) Patients

Prevalence of intestinal parasitoses in urban and rural children of a developing country.

Kala-azar (visceral leishmaniasis) in children