Few studies provide data on the global morbidity and mortality caused by infection with Shigella spp.; such estimates are needed, however, to plan strategies of prevention and treatment. Here we report the results of a review of the literature published between 1966 and 1997 on Shigella infection. The data obtained permit calculation of the number of cases of Shigella infection and the associated mortality occurring worldwide each year, by age, and (as a proxy for disease severity) by clinical category, i.e. mild cases remaining at home, moderate cases requiring outpatient care, and severe cases demanding hospitalization. A sensitivity analysis was performed to estimate the high and low range of morbid and fatal cases in each category. Finally, the frequency distribution of Shigella infection, by serogroup and serotype and by region of the world, was determined. The annual number of Shigella episodes throughout the world was estimated to be 164.7 million, of which 163.2 million were in developing countries (with 1.1 million deaths) and 1.5 million in industrialized countries. A total of 69% of all episodes and 61% of all deaths attributable to shigellosis involved children under 5 years of age. The median percentages of isolates of S. flexneri, S. sonnei, S. boydii, and S. dysenteriae were, respectively, 60%, 15%, 6%, and 6% (30% of S. dysenteriae cases were type 1) in developing countries; and 16%, 77%, 2%, and 1% in industrialized countries. In developing countries, the predominant serotype of S. flexneri is 2a, followed by 1b, 3a, 4a, and 6. In industrialized countries, most isolates are S. flexneri 2a or other unspecified type 2 strains. Shigellosis, which continues to have an important global impact, cannot be adequately controlled with the existing prevention and treatment measures. Innovative strategies, including development of vaccines against the most common serotypes, could provide substantial benefits.

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Global Burden of Shigella Infections: Implications for Vaccine Development and Implementation of Control Strategies

Background Young infants and pregnant women are at increased risk for serious consequences of influenza infection. Inactivated influenza vaccine is recommended for pregnant women but is not licensed for infants younger than 6 months of age. We assessed the clinical effectiveness of inactivated influenza vaccine administered during pregnancy in Bangladesh. Methods In this randomized study, we assigned 340 mothers to receive either inactivated influenza vaccine (influenza-vaccine group) or the 23-valent pneumococcal polysaccharide vaccine (control group). Mothers were interviewed weekly to assess illnesses until 24 weeks after birth. Subjects with febrile respiratory illness were assessed clinically, and ill infants were tested for influenza antigens. We estimated the incidence of illness, incidence rate ratios, and vaccine effectiveness. Results Mothers and infants were observed from August 2004 through December 2005. Among infants of mothers who received influenza vaccine, there were fewer cases of laboratory-confirmed influenza than among infants in the control group (6 cases and 16 cases, respectively), with a vaccine effectiveness of 63% (95% confidence interval [CI], 5 to 85). Respiratory illness with fever occurred in 110 infants in the influenza-vaccine group and 153 infants in the control group, with a vaccine effectiveness of 29% (95% CI, 7 to 46). Among the mothers, there was a reduction in the rate of respiratory illness with fever of 36% (95% CI, 4 to 57). Conclusions Inactivated influenza vaccine reduced proven influenza illness by 63% in infants up to 6 months of age and averted approximately a third of all febrile respiratory illnesses in mothers and young infants. Maternal influenza immunization is a strategy with substantial benefits for both mothers and infants. (ClinicalTrials.gov number, NCT00142389.)

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Effectiveness of maternal influenza immunization in mothers and infants.

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

The global problem of antimicrobial resistance is particularly pressing in developing countries, where the infectious disease burden is high and cost constraints prevent the widespread application of newer, more expensive agents. Gastrointestinal, respiratory, sexually transmitted, and nosocomial infections are leading causes of disease and death in the developing world, and management of all these conditions has been critically compromised by the appearance and rapid spread of resistance. In this first part of the review, we have summarised the present state of resistance in these infections from the available data. Even though surveillance of resistance in many developing countries is suboptimal, the general picture is one of accelerating rates of resistance spurred by antimicrobial misuse and shortfalls in infection control and public health. Reservoirs for resistance may be present in healthy human and animal populations. Considerable economic and health burdens emanate from bacterial resistance, and research is needed to accurately quantify the problem and propose and evaluate practicable solutions. In part II, to be published next month, we will review potential containment strategies that could address this burgeoning problem.

https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(05)70189-4.pdf

Antimicrobial resistance in developing countries. Part I: recent trends and current status

Doing research in Business and Management: An Introduction to process and method

Antimicrobial resistance is becoming increasingly important in the treatment of enteric infections, particularly those due to Shigella, Vibrio cholerae, enterotoxigenic Escherichia coli (associated with traveler's diarrhea), and Salmonella typhi. The rate of antimicrobial resistance is highest in the developing world, where the use of antimicrobial drugs is relatively unrestricted. Of greatest immediate concern is the need for an effective, inexpensive antimicrobial that can be used safely as treatment for small children with dysentery due to Shigella, primarily Shigella dysenteriae type 1.

Antimicrobial Resistance in Organisms Causing Diarrheal Disease

Folk medicinal practitioners (Kavirajes) are possibly the most ancient practitioners of traditional medicine in Bangladesh and in general are the primary health-care providers to a majority of the rural population and a substantial segment of the urban population in the country. The major characteristic that separates the folk medicinal practitioners from other systems of existing medicinal practices is their almost exclusive use of simple preparations of medicinal plants for treatment of various ailments. Since the population of Bangladesh is primarily rural, village Kavirajes form the major unit from whom ethnomedicinal data can be obtained. The objective of the present study was to conduct a randomized ethnomedicinal survey among the Kavirajes of four villages, Kalakandi, Gorashal, Kadamtoli, and Gunjar, all villages being situated in Daudkandi sub-district of Comilla district in Bangladesh. Informed consent was obtained from the Kavirajes and surveys were carried out with the help of a semi-structured questionnaire and the guided field-walk method, where the Kavirajes took the interviewers to places from where they collected their medicinal plants, pointed out the plants and described their uses. All plant specimens were collected and identified at the Bangladesh National Herbarium. It was observed that the Kavirajes of the four villages surveyed used 44 plant species distributed into 32 families. The Lamiaceae family contributed 4 plants, followed by the Leguminosae, Rutaceae, and Solanaceae families with 3 plants each. Leaves constituted the major plant part used (45.3%), followed by roots (13.2%), and whole plants, fruits, and seeds (7.5% each). The various ailments treated included respiratory tract problems, gastrointestinal disorders, sexual problems, fever, cardiovascular disorders, mental disease, diabetes, loss of hair, vomiting, menstrual problems, skin disorders, hepatic disorders, piles, leprosy, calcium deficiency, dental diseases, cracked foot, bleeding, insect bites, mumps, rabies, chicken pox, body ache, and bone fracture. Cumulatively, the plants obtained in the present survey present considerable potential for further scientific research towards discovery of lead compounds and more efficacious drugs.

A Randomized Survey of Medicinal plants used by Folk Medicinal Practitioners in Daudkandi sub-district of Comilla district, Bangladesh

Hepatitis C virus is a significant healthcare problem, affecting more than 170 million people worldwide and as many as 4 million new infections occur annually. Incidence rates across the world fluctuate and are difficult to calculate given the asymptomatic, often latent nature of the disease prior to clinical presentation. Of those exposed to HCV, 80% become chronically infected, and at least 30% of carriers develop chronic liver disease, including cirrhosis and hepatocellular carcinoma. HCV infection also increases the number of complications in persons who are co-infected with HIV. This article reviews an overview of the prevalence, genotype data, transmission risk and prevention. DOI:10.3329/jbcps.v27i3.4294 J Bangladesh Coll Phys Surg 2009; 27: 160-165

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Epidemiology of Hepatitis C Virus (HCV) Infection

A survey of medicinal plants used by folk medicinal practitioners of Station Purbo Para village of Jamalpur Sadar Upazila in Jamalpur district, Bangladesh.

Computer-aided drug screening by molecular docking, molecular dynamics (MD) and structural–activity relationship (SAR) can offer an efficient approach to identify promising drug repurposing candida...

Mahbubur Rahman

Papers

Antimicrobial Resistance in Organisms Causing Diarrheal Disease

A Randomized Survey of Medicinal plants used by Folk Medicinal Practitioners in Daudkandi sub-district of Comilla district, Bangladesh

Epidemiology of Hepatitis C Virus (HCV) Infection

A survey of medicinal plants used by folk medicinal practitioners of Station Purbo Para village of Jamalpur Sadar Upazila in Jamalpur district, Bangladesh.

Virtual screening, molecular dynamics and structure-activity relationship studies to identify potent approved drugs for Covid-19 treatment.