The COVID-19 pandemic has threatening features: High infectivity, divergent presentations – 5–10% severe; 10–15% moderate; and 70–80% mild; but low mortality. The main challenge so far has been the extremely high risks experienced by the medical carers and close contacts. While the absolute effectiveness of vaccines is yet uncertain, other means to boost up the immunological defense could be explored. Materials and Methods: A close look at the pulmonary responses to invading pathogens and how the related innate immunity system reacts would be the first step towards the planning. Various means of immune boosting agents have been studied and practically used. Vitamin D could be a good example which has been studied in detail of how a natural product could offer immune boosting effects. While herbal products have been popular in Chinese Medicine as preventive agents against different forms of infection their real value could be explored through the modern approach of drug development.
Procalcitonin is an excellent biomarker for antibiotic use in bacterial infections alone. POCT guided PCT levels can help decide whether to add antibiotics or not in opd settings for respiratory tract infection.
Rational Use of Antibiotics. Infection was a major cause of morbidity and mortality, before the development of antibiotics.
The treatment of infections faced a great challenge during those periods.
Later in 1928, the discovery of Penicillin, a beta-lactam antibiotic, by Alexander Fleming opened up the golden era of antibiotics.
It marked a revolution in the treatment of infectious diseases and stimulated new efforts to synthesize newer antibiotics.
The period between the 1950s and 1970s is considered the golden era of discovery of novel antibiotic classes, with very few classes discovered since then.
Overuse of antibiotics in both human medicine and agriculture has contributed to the emergence of antibiotic resistance. In medicine, antibiotics are often prescribed unnecessarily due to pressure on doctors to treat potential infections and patient demand. Patients also frequently fail to complete antibiotic treatment courses. Agricultural use of antibiotics for growth promotion and disease prevention in healthy animals allows antibiotic resistant bacteria to spread to humans. Poor infection control and lack of rapid diagnostic tests have also facilitated the spread of resistant pathogens in healthcare settings. Addressing these factors through improved prescribing practices, public education, infection control, and testing can help slow the development of antibiotic resistance.
This study reviewed antibiotic use in the neonatal intensive care unit (NICU) of Misurata Medical Center from January to February 2018. It found that 97.3% of the 37 babies treated received penicillin alone or with gentamicin, for durations mostly between 3-7 days. Most treatment was based on clinical suspicion of infection rather than confirmed diagnosis, as only 2 cases underwent full sepsis workup. The main reasons for admission and initiating antibiotics empirically were preterm birth, caesarean delivery, low birth weight, and prolonged rupture of membranes - highlighting overuse and misuse of antibiotics without microbiological justification in the NICU.
The document discusses antibiotic stewardship and strategies to combat antibiotic resistance. It outlines how inappropriate antibiotic use has led to increased antibiotic resistant organisms and how antimicrobial stewardship aims to optimize antibiotic use and minimize unintended consequences. The document provides numerous examples of antibiotic stewardship strategies including obtaining cultures before prescribing antibiotics, using local antibiotic resistance data to guide treatment, reviewing culture results to modify prescriptions, restricting broad-spectrum antibiotics, and monitoring treatment response and duration. It stresses the importance of education, guidelines, surveillance, and metrics to evaluate antibiotic stewardship programs.
This presentation is made for school health awareness programme on antibiotic resistance. This includes introduction to antibiotics, antibiotic save lives, side effect of antibiotic, and detail about antibiotic resistance. This presentation is mostly focus on antibiotic resistance prevention.
This document outlines the principles of antibiotic therapy, including determining when antibiotic treatment is necessary based on the presence of infection and state of the patient's defenses. It discusses choosing the appropriate antibiotic based on identifying the causative organism and determining antibiotic sensitivity. Broad-spectrum antibiotics are not preferred, and narrow-spectrum antibiotics with a proven history of effectiveness against the identified bacteria are recommended. Proper dosing, timing, route of administration, and use of combination therapy are also important principles for antibiotic administration and treatment.
Antibiotic Resistance: Medical and Public Health DirectionsNational Pork Board
This document summarizes a presentation on antibiotic resistance given by Dr. Steven Solomon. It makes four key points:
1. Antibiotic resistance is a serious global public health problem that spreads rapidly through travel and is worsening as antibiotic use continues to rise in all settings.
2. All antibiotic use, whether in humans, animals, or the environment, contributes to the development of resistance. Antibiotics have been overused in many contexts, and disrupt the human microbiome in ways that aid the spread of resistance.
3. Changing antibiotic usage will require changing perceptions and thinking about antibiotics through improved education and communication. New data systems and genomic analysis can help optimize prescribing and prevent infections.
4.
Procalcitonin is an excellent biomarker for antibiotic use in bacterial infections alone. POCT guided PCT levels can help decide whether to add antibiotics or not in opd settings for respiratory tract infection.
Rational Use of Antibiotics. Infection was a major cause of morbidity and mortality, before the development of antibiotics.
The treatment of infections faced a great challenge during those periods.
Later in 1928, the discovery of Penicillin, a beta-lactam antibiotic, by Alexander Fleming opened up the golden era of antibiotics.
It marked a revolution in the treatment of infectious diseases and stimulated new efforts to synthesize newer antibiotics.
The period between the 1950s and 1970s is considered the golden era of discovery of novel antibiotic classes, with very few classes discovered since then.
Overuse of antibiotics in both human medicine and agriculture has contributed to the emergence of antibiotic resistance. In medicine, antibiotics are often prescribed unnecessarily due to pressure on doctors to treat potential infections and patient demand. Patients also frequently fail to complete antibiotic treatment courses. Agricultural use of antibiotics for growth promotion and disease prevention in healthy animals allows antibiotic resistant bacteria to spread to humans. Poor infection control and lack of rapid diagnostic tests have also facilitated the spread of resistant pathogens in healthcare settings. Addressing these factors through improved prescribing practices, public education, infection control, and testing can help slow the development of antibiotic resistance.
This study reviewed antibiotic use in the neonatal intensive care unit (NICU) of Misurata Medical Center from January to February 2018. It found that 97.3% of the 37 babies treated received penicillin alone or with gentamicin, for durations mostly between 3-7 days. Most treatment was based on clinical suspicion of infection rather than confirmed diagnosis, as only 2 cases underwent full sepsis workup. The main reasons for admission and initiating antibiotics empirically were preterm birth, caesarean delivery, low birth weight, and prolonged rupture of membranes - highlighting overuse and misuse of antibiotics without microbiological justification in the NICU.
The document discusses antibiotic stewardship and strategies to combat antibiotic resistance. It outlines how inappropriate antibiotic use has led to increased antibiotic resistant organisms and how antimicrobial stewardship aims to optimize antibiotic use and minimize unintended consequences. The document provides numerous examples of antibiotic stewardship strategies including obtaining cultures before prescribing antibiotics, using local antibiotic resistance data to guide treatment, reviewing culture results to modify prescriptions, restricting broad-spectrum antibiotics, and monitoring treatment response and duration. It stresses the importance of education, guidelines, surveillance, and metrics to evaluate antibiotic stewardship programs.
This presentation is made for school health awareness programme on antibiotic resistance. This includes introduction to antibiotics, antibiotic save lives, side effect of antibiotic, and detail about antibiotic resistance. This presentation is mostly focus on antibiotic resistance prevention.
This document outlines the principles of antibiotic therapy, including determining when antibiotic treatment is necessary based on the presence of infection and state of the patient's defenses. It discusses choosing the appropriate antibiotic based on identifying the causative organism and determining antibiotic sensitivity. Broad-spectrum antibiotics are not preferred, and narrow-spectrum antibiotics with a proven history of effectiveness against the identified bacteria are recommended. Proper dosing, timing, route of administration, and use of combination therapy are also important principles for antibiotic administration and treatment.
Antibiotic Resistance: Medical and Public Health DirectionsNational Pork Board
This document summarizes a presentation on antibiotic resistance given by Dr. Steven Solomon. It makes four key points:
1. Antibiotic resistance is a serious global public health problem that spreads rapidly through travel and is worsening as antibiotic use continues to rise in all settings.
2. All antibiotic use, whether in humans, animals, or the environment, contributes to the development of resistance. Antibiotics have been overused in many contexts, and disrupt the human microbiome in ways that aid the spread of resistance.
3. Changing antibiotic usage will require changing perceptions and thinking about antibiotics through improved education and communication. New data systems and genomic analysis can help optimize prescribing and prevent infections.
4.
The document discusses antibiotic stewardship programs (ASPs) and the growing problem of antibiotic resistance. It notes that approximately 50% of antibiotic use is inappropriate, contributing to the development of resistance. ASPs aim to optimize antibiotic use and prevent resistance through coordinated interventions. The document emphasizes the importance of local antibiotic resistance data to inform treatment decisions and highlights challenges around compliance with standards for tracking resistance patterns. It also explores opportunities to leverage electronic health records and decision support software to enhance ASPs.
Factors behind emergence of resistancekatefranklyn
Overuse of antibiotics in human medicine, agriculture, and livestock has contributed to the emergence of antibiotic resistance. Inappropriate use stems from over-prescription by doctors, patients not completing treatment courses, and mass administration to farm animals. Lack of public knowledge about antibiotic use and resistance also drives unnecessary consumption. Weak infection control in hospitals and limited diagnostic testing further enable the spread of resistant bacteria. Addressing these interconnected factors through improved prescribing practices, public education, infection prevention, and testing is needed to curb the global rise of antibiotic resistance.
This document discusses the classification and determinants of disease. It identifies three main ways to classify determinants: primary vs secondary, intrinsic vs extrinsic, and those associated with the host, agent, or environment. Primary determinants have a major effect in inducing disease, while secondary determinants are predisposing or enabling factors. Intrinsic determinants are internal to the host, while extrinsic determinants are external. Virulence refers to an agent's ability to cause disease severity, while pathogenicity is an agent's ability to induce disease. Pathogenicity and virulence can be conditioned intrinsically by an agent's characteristics or extrinsically by environmental factors.
The document summarizes key aspects of epidemic processes and infectious disease transmission. It describes the three main links that are required for an epidemic process - a source of infection, a transmission mechanism, and a susceptible population. It also outlines various forms an epidemic can take based on incidence levels, such as endemic, epidemic, or pandemic. Factors like periods of disease progression, clinical forms, and mechanisms of transmission determine the epidemiological importance of the infection source.
The document discusses a directed student learning session on vaccines and immunity. The objectives are to understand immunity, vaccination, and the Malaysian immunization schedule. Students are advised to visit several websites to learn about herd immunity, different vaccine types, and the cold chain system for maintaining vaccine integrity.
Antibiotics are most common therapeutic agents used in hospitals across world, however, microbial world is becoming resistant day by day, posing special challenges to clinicians specially working in ICU set ups. There are multiple ways to curb this menace, if approached together in antibiotic stewardship way, can bring about wonders and retain therapeutic potentials of these drugs.
Future impacts of antibiotic resistance
Antibiotic resistance poses serious risks to global public health in the future, including the potential for 10 million deaths per year by 2050 from currently treatable infections and diseases becoming deadly again without effective treatments. Recognition of these future impacts is important for emphasizing the urgent need to change antibiotic prescription and usage. If antibiotic resistance continues to grow, global health systems will lose control over infectious diseases and see increased rates of severe infection, hospitalization, disability and death. Many medical procedures may also become riskier as common postoperative infections become difficult or impossible to treat.
The document discusses the epidemiological triad of agent, host, and environment. It describes disease agents as substances or forces that can initiate or perpetuate disease. Agents can be biological like viruses, bacteria, protozoa, or fungus. They can also be physical, chemical, mechanical, or nutritional. The host refers to humans and factors like demographics, biology, socioeconomics, lifestyle, and environment that influence susceptibility. The environment encompasses physical, biological, and psychosocial external factors that interact with host and agent.
This document provides information about bioterrorism, including:
- Defining bioterrorism as the deliberate release of biological agents to cause illness or death.
- Discussing the history of bioterrorism dating back to ancient times and examples from the 20th-21st centuries.
- Categorizing biological agents into 3 categories based on their ability to threaten public health and safety.
Vaccines are designed to elicit an immune response against the particular microbe or bits of the microbe from which the vaccine is made. This idea dates back several centuries, when British surgeon, Edward Jenner developed the first vaccine against a lethal infectious disease, small pox. Between the 18th century and now, more than 65 products have been approved which, together with public health and other developments, have contributed to the tapering and, in some cases, eradication of infectious diseases that used to kill millions. The problem is that the design is based on the physical attributes of the microbe. So, one person might be infected with virus x, which mutates rapidly to become 10 or more different strains. So, between approval and reaching the public, effectiveness may drop or wane over time. The sheer logistics of designing a trial means that follow-up periods are not long enough to account for every possible safety issue. Nevertheless, they remain our go-to defense for lethal infections, such as Ebola, and ones that reduce productivity. In other cases, timely inoculations may protect against the risk of developing specific cancers later in life. They have also contributed to the fact that most people are not at home sick with polio or some of the other ancient plagues.
However, anti-infective vaccines are typically given to healthy children and people on the basis that it will not make them sick or that it will reduce the risk of premature death. Because vaccines need to be preserved, properly stored and kept free of other contamination before it reaches many distribution sites, other ingredients are added to the mix. And some people, especially those with weakened immune systems, may have severe/life-threatening allergies to additives or a contaminated batch.
So, one in a million complications/deaths is one in a million too many. To this end, I have compiled a summary culled from various sources, to foster a positive dialogue towards improvements.
This document discusses strategies for preventing and controlling infectious diseases in low and middle income countries. It outlines approaches like preventing exposure to infectious agents, increasing resistance, and treatment to reduce transmission. General strategies mentioned include vector control, vaccination, mass chemotherapy, improved sanitation, access to potable water, behavior change programs, and addressing biological and genetic factors. The document also discusses components of effective community control like diagnostic accuracy, intervention efficacy, provider compliance, and recipient compliance. It defines terms like control, elimination, eradication, and extinction.
The use of antimicrobial in humans and animals, the consequences of this use, the political and economic barriers to improve prudent use and possible solutions for this problem.
Structure of the epidemiological processJasmine John
This document outlines basic principles for preventing infectious diseases, including measures targeting the source of infection, transmission mechanisms, and population susceptibility. It discusses eliminating or decontaminating sources through measures like exterminating infected animals or isolating sick individuals. It covers stopping transmission by improving sanitation, ventilation, and health education. It also addresses stimulating population immunity through vaccines, immunization programs, and developing herd immunity. The three approaches work best together to effectively fight infectious diseases according to their specific characteristics and the situation.
Please find the power point on Antimicrobial resistance. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
The document discusses antimicrobial stewardship and the need to curb antibiotic overuse and misuse. It notes that nearly half of hospitalized patients receive antimicrobial agents. While antibiotics have been life-saving, there has been too much use for trivial infections and without understanding principles of therapy. This has contributed to the rise of antibiotic resistance, which the CDC calls a "major public health crisis." The document outlines strategies for antimicrobial stewardship programs, including prospective audits, formulary restrictions, education, guidelines, and streamlining therapy based on culture results. The goal is to optimize outcomes while minimizing resistance by ensuring appropriate antibiotic use.
Are we running out of antibiotics? - Slideset by Professor EspositoWAidid
How does antibiotic resistance happen?
This work, edited by the professor Susanna Esposito, tries to answer this question underlining the importance of prescribing the right drug with the right dose and duration, to avoid any kind of abuse that may cause or increase antibiotic resistance.
To learn more please visit www.waidid.org
Isoniazid (INH), a first-line tuberculosis drug, commonly causes peripheral neuropathy through inhibition of vitamin B6 synthesis. The risk of INH-induced neuropathy is dose-dependent, with 2-12% of patients on standard doses and 44% on higher doses developing neuropathy. Symptoms are predominantly sensory and can develop within 3-5 weeks for higher doses or after 16 weeks for standard doses. Neuropathy is reversible by supplementing with pyridoxine (vitamin B6), which is recommended to be given concomitantly with INH in both prophylactic and therapeutic doses.
Threats and preventions of bioterrorismNida Sajjad
This document discusses threats, impacts, and preparedness for bioterrorism. It outlines various threats including threats to the economy from spreading animal and plant diseases, threats to wildlife and biodiversity, and psycho-social impacts on the population during a bioterrorism attack. It also discusses key elements of bioterrorism threats including the actor, agent, target, and mode of attack. The document then covers impacts on the population size and environment. Finally, it discusses various aspects of bioterrorism preparedness including prevention, detection, response, and the roles of clinicians, laboratories, and surveillance systems.
Omicron XBB.1.5 and BQ.1/BQ.1.1 subvariants are driving increased COVID cases in some areas due to high transmissibility. Updated bivalent boosters target the original strain and BA.5, reducing severe outcomes. While new antivirals treat COVID, long COVID causes persistent symptoms. Monkeypox cases have been reported in over 100 countries primarily among men who have sex with men. Antibiotic resistance poses a threat if overuse and misuse continue, requiring improved stewardship, sanitation, and new drug development.
Emergence of Drug resistant microbes PPT By DR.C.P.PrinceDR.PRINCE C P
Antimicrobial resistance is resistance of a microorganism to an antimicrobial drug that was originally effective for treatment of infections caused by it.
Resistant microorganisms (including bacteria, fungi, viruses and parasites) are able to withstand attack by antimicrobial drugs, such as antibacterial drugs (e.g. antibiotics), antifungals, antivirals, and antimalarials, so that standard treatments become ineffective and infections persist, increasing the risk of spread to others.
The document discusses antibiotic stewardship programs (ASPs) and the growing problem of antibiotic resistance. It notes that approximately 50% of antibiotic use is inappropriate, contributing to the development of resistance. ASPs aim to optimize antibiotic use and prevent resistance through coordinated interventions. The document emphasizes the importance of local antibiotic resistance data to inform treatment decisions and highlights challenges around compliance with standards for tracking resistance patterns. It also explores opportunities to leverage electronic health records and decision support software to enhance ASPs.
Factors behind emergence of resistancekatefranklyn
Overuse of antibiotics in human medicine, agriculture, and livestock has contributed to the emergence of antibiotic resistance. Inappropriate use stems from over-prescription by doctors, patients not completing treatment courses, and mass administration to farm animals. Lack of public knowledge about antibiotic use and resistance also drives unnecessary consumption. Weak infection control in hospitals and limited diagnostic testing further enable the spread of resistant bacteria. Addressing these interconnected factors through improved prescribing practices, public education, infection prevention, and testing is needed to curb the global rise of antibiotic resistance.
This document discusses the classification and determinants of disease. It identifies three main ways to classify determinants: primary vs secondary, intrinsic vs extrinsic, and those associated with the host, agent, or environment. Primary determinants have a major effect in inducing disease, while secondary determinants are predisposing or enabling factors. Intrinsic determinants are internal to the host, while extrinsic determinants are external. Virulence refers to an agent's ability to cause disease severity, while pathogenicity is an agent's ability to induce disease. Pathogenicity and virulence can be conditioned intrinsically by an agent's characteristics or extrinsically by environmental factors.
The document summarizes key aspects of epidemic processes and infectious disease transmission. It describes the three main links that are required for an epidemic process - a source of infection, a transmission mechanism, and a susceptible population. It also outlines various forms an epidemic can take based on incidence levels, such as endemic, epidemic, or pandemic. Factors like periods of disease progression, clinical forms, and mechanisms of transmission determine the epidemiological importance of the infection source.
The document discusses a directed student learning session on vaccines and immunity. The objectives are to understand immunity, vaccination, and the Malaysian immunization schedule. Students are advised to visit several websites to learn about herd immunity, different vaccine types, and the cold chain system for maintaining vaccine integrity.
Antibiotics are most common therapeutic agents used in hospitals across world, however, microbial world is becoming resistant day by day, posing special challenges to clinicians specially working in ICU set ups. There are multiple ways to curb this menace, if approached together in antibiotic stewardship way, can bring about wonders and retain therapeutic potentials of these drugs.
Future impacts of antibiotic resistance
Antibiotic resistance poses serious risks to global public health in the future, including the potential for 10 million deaths per year by 2050 from currently treatable infections and diseases becoming deadly again without effective treatments. Recognition of these future impacts is important for emphasizing the urgent need to change antibiotic prescription and usage. If antibiotic resistance continues to grow, global health systems will lose control over infectious diseases and see increased rates of severe infection, hospitalization, disability and death. Many medical procedures may also become riskier as common postoperative infections become difficult or impossible to treat.
The document discusses the epidemiological triad of agent, host, and environment. It describes disease agents as substances or forces that can initiate or perpetuate disease. Agents can be biological like viruses, bacteria, protozoa, or fungus. They can also be physical, chemical, mechanical, or nutritional. The host refers to humans and factors like demographics, biology, socioeconomics, lifestyle, and environment that influence susceptibility. The environment encompasses physical, biological, and psychosocial external factors that interact with host and agent.
This document provides information about bioterrorism, including:
- Defining bioterrorism as the deliberate release of biological agents to cause illness or death.
- Discussing the history of bioterrorism dating back to ancient times and examples from the 20th-21st centuries.
- Categorizing biological agents into 3 categories based on their ability to threaten public health and safety.
Vaccines are designed to elicit an immune response against the particular microbe or bits of the microbe from which the vaccine is made. This idea dates back several centuries, when British surgeon, Edward Jenner developed the first vaccine against a lethal infectious disease, small pox. Between the 18th century and now, more than 65 products have been approved which, together with public health and other developments, have contributed to the tapering and, in some cases, eradication of infectious diseases that used to kill millions. The problem is that the design is based on the physical attributes of the microbe. So, one person might be infected with virus x, which mutates rapidly to become 10 or more different strains. So, between approval and reaching the public, effectiveness may drop or wane over time. The sheer logistics of designing a trial means that follow-up periods are not long enough to account for every possible safety issue. Nevertheless, they remain our go-to defense for lethal infections, such as Ebola, and ones that reduce productivity. In other cases, timely inoculations may protect against the risk of developing specific cancers later in life. They have also contributed to the fact that most people are not at home sick with polio or some of the other ancient plagues.
However, anti-infective vaccines are typically given to healthy children and people on the basis that it will not make them sick or that it will reduce the risk of premature death. Because vaccines need to be preserved, properly stored and kept free of other contamination before it reaches many distribution sites, other ingredients are added to the mix. And some people, especially those with weakened immune systems, may have severe/life-threatening allergies to additives or a contaminated batch.
So, one in a million complications/deaths is one in a million too many. To this end, I have compiled a summary culled from various sources, to foster a positive dialogue towards improvements.
This document discusses strategies for preventing and controlling infectious diseases in low and middle income countries. It outlines approaches like preventing exposure to infectious agents, increasing resistance, and treatment to reduce transmission. General strategies mentioned include vector control, vaccination, mass chemotherapy, improved sanitation, access to potable water, behavior change programs, and addressing biological and genetic factors. The document also discusses components of effective community control like diagnostic accuracy, intervention efficacy, provider compliance, and recipient compliance. It defines terms like control, elimination, eradication, and extinction.
The use of antimicrobial in humans and animals, the consequences of this use, the political and economic barriers to improve prudent use and possible solutions for this problem.
Structure of the epidemiological processJasmine John
This document outlines basic principles for preventing infectious diseases, including measures targeting the source of infection, transmission mechanisms, and population susceptibility. It discusses eliminating or decontaminating sources through measures like exterminating infected animals or isolating sick individuals. It covers stopping transmission by improving sanitation, ventilation, and health education. It also addresses stimulating population immunity through vaccines, immunization programs, and developing herd immunity. The three approaches work best together to effectively fight infectious diseases according to their specific characteristics and the situation.
Please find the power point on Antimicrobial resistance. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
The document discusses antimicrobial stewardship and the need to curb antibiotic overuse and misuse. It notes that nearly half of hospitalized patients receive antimicrobial agents. While antibiotics have been life-saving, there has been too much use for trivial infections and without understanding principles of therapy. This has contributed to the rise of antibiotic resistance, which the CDC calls a "major public health crisis." The document outlines strategies for antimicrobial stewardship programs, including prospective audits, formulary restrictions, education, guidelines, and streamlining therapy based on culture results. The goal is to optimize outcomes while minimizing resistance by ensuring appropriate antibiotic use.
Are we running out of antibiotics? - Slideset by Professor EspositoWAidid
How does antibiotic resistance happen?
This work, edited by the professor Susanna Esposito, tries to answer this question underlining the importance of prescribing the right drug with the right dose and duration, to avoid any kind of abuse that may cause or increase antibiotic resistance.
To learn more please visit www.waidid.org
Isoniazid (INH), a first-line tuberculosis drug, commonly causes peripheral neuropathy through inhibition of vitamin B6 synthesis. The risk of INH-induced neuropathy is dose-dependent, with 2-12% of patients on standard doses and 44% on higher doses developing neuropathy. Symptoms are predominantly sensory and can develop within 3-5 weeks for higher doses or after 16 weeks for standard doses. Neuropathy is reversible by supplementing with pyridoxine (vitamin B6), which is recommended to be given concomitantly with INH in both prophylactic and therapeutic doses.
Threats and preventions of bioterrorismNida Sajjad
This document discusses threats, impacts, and preparedness for bioterrorism. It outlines various threats including threats to the economy from spreading animal and plant diseases, threats to wildlife and biodiversity, and psycho-social impacts on the population during a bioterrorism attack. It also discusses key elements of bioterrorism threats including the actor, agent, target, and mode of attack. The document then covers impacts on the population size and environment. Finally, it discusses various aspects of bioterrorism preparedness including prevention, detection, response, and the roles of clinicians, laboratories, and surveillance systems.
Omicron XBB.1.5 and BQ.1/BQ.1.1 subvariants are driving increased COVID cases in some areas due to high transmissibility. Updated bivalent boosters target the original strain and BA.5, reducing severe outcomes. While new antivirals treat COVID, long COVID causes persistent symptoms. Monkeypox cases have been reported in over 100 countries primarily among men who have sex with men. Antibiotic resistance poses a threat if overuse and misuse continue, requiring improved stewardship, sanitation, and new drug development.
Emergence of Drug resistant microbes PPT By DR.C.P.PrinceDR.PRINCE C P
Antimicrobial resistance is resistance of a microorganism to an antimicrobial drug that was originally effective for treatment of infections caused by it.
Resistant microorganisms (including bacteria, fungi, viruses and parasites) are able to withstand attack by antimicrobial drugs, such as antibacterial drugs (e.g. antibiotics), antifungals, antivirals, and antimalarials, so that standard treatments become ineffective and infections persist, increasing the risk of spread to others.
This document provides information about malaria vaccines. It discusses the context of malaria globally and the need for a vaccine. Several potential vaccine candidates target different stages of the malaria parasite's lifecycle, including sporozoites, infected hepatocytes, and erythrocytic stages. Developing an effective vaccine is challenging due to the parasite's diversity and complexity. The most promising current candidate is RTS,S, which provides some protection against malaria in clinical trials but is not fully effective.
Antibiotic Resistance for children with febrilerasel64
This document discusses the growing problem of antibiotic resistance. It provides background on the discovery and mechanisms of antibiotics, and explains how overuse and misuse has led to increased resistance. Some key points made include:
- Antibiotic resistance occurs when bacteria evolve and become resistant to antibiotic treatments. Factors like overprescribing, incomplete treatment courses, and overuse in animals contribute to resistance.
- Resistant bacteria spread rapidly and are becoming more common, while few new antibiotics are being developed. Developing new drugs is also very expensive.
- Antibiotic resistance poses a major threat to human and animal health worldwide and could result in significant healthcare costs and economic losses if not addressed. Coordinated global surveillance and
This document discusses the use of subtractive genomics to identify potential drug targets for pathogenic organisms. Subtractive genomics involves subtracting the sequences between a host and pathogen's proteome to identify proteins essential to the pathogen but not present in the host. This approach has been applied to identify drug targets for multi-drug resistant pathogens like Salmonella typhi and Listeria monocytogenes, as well as pathogens with no existing effective drugs like Leishmania donovani and Clostridium botulinum. Identifying novel drug targets through subtractive genomics can help develop new defenses against antibiotic-resistant pathogens and treat diseases currently lacking effective treatments.
1) Vaccines are biological preparations that help improve immunity against specific diseases. They contain weakened or killed forms of pathogens that stimulate immune system memory without causing illness.
2) Edward Jenner developed the first vaccine in 1796 using cowpox to provide immunity to smallpox. There are several types of vaccines including live attenuated, inactivated, subunit, toxoid, and recombinant vector vaccines.
3) Vaccines work by exposing the immune system to antigens from pathogens. This triggers production of antibodies and memory cells that can fight the pathogen if exposed in the future, providing immunity. While vaccines have many benefits like disease prevention and eradication, some risks also exist.
Antibiotics are commonly used but also contribute to growing antibiotic resistance, a major public health problem. When antibiotics become ineffective, infections are harder to treat and can lead to worse health outcomes like longer illnesses or death. Overuse and misuse of antibiotics, including taking incomplete courses or using them for viral infections, promotes the spread of resistant bacteria. Physicians should follow best practices like only prescribing antibiotics appropriately and narrowing treatment based on test results. Improving antibiotic stewardship through more responsible use can help reduce growing resistance and protect individuals as well as communities.
In this topic take about public health microbiology because of people are not aware about virus or disease vaccine is more essential for human being save our lives from the virus it is major requirements for people
Impact of antimicrobial resistance (AMR) in developing countries.Robin Barmon
This document is a research paper submitted by Parth Protim Barmon to Professor Tahera Ahmed on antimicrobial resistance in developing countries. It provides background information on antimicrobial resistance as resistance of microorganisms to antimicrobial medicines. It discusses how antimicrobial resistance is a growing global problem, but has a greater impact in developing countries due to factors like poverty and limited access to healthcare. The paper aims to study the risk factors for antimicrobial resistance in developing countries, including socio-demographic factors, why developing countries are more vulnerable, the role of poverty, and the disease burden.
1. Vaccines are among the safest medical tools but require strict safety monitoring due to their administration to healthy populations including children.
2. Pharmacovigilance for vaccines differs from drugs in that adverse events are more complex due to multiple components, immunological actions, and difficulty determining causality for delayed events.
3. Reporting and evaluation of vaccine safety also differs in that vaccines are administered by primary care physicians who may lack technology and training in pharmacovigilance compared to drug oversight.
‘Antibiotic Ireland’ Antimicrobial Resistance A Major Cause for ConcernImproper Prescribing or Patient’s Misconceptions, Expectation and Pressure on Dr’s to prescribe ?
Combating Drug Resistance in The Intensive Care Unit (ICU)Apollo Hospitals
Drug resistance of microbes has become a major challenge in treating ICU patients successfully. There are many factors that contribute to the development of drug resistance, including irrational antibiotic use, lack of antibiotic stewardship programs, and poor infection control practices. Implementing strict antibiotic policies, having responsive microbiology departments, and educating healthcare providers on following clinical guidelines are important first steps to prevent drug resistance. It is also essential to monitor antibiotic use, tailor therapies based on culture results, and withdraw antibiotics appropriately once infections have resolved. A multifaceted approach involving hospitals, healthcare workers, and communities is needed to curb the growing issue of antimicrobial resistance.
This document discusses the need for new antibiotics to combat the growing threat of antibiotic resistance in pathogenic bacteria. It notes that while current technologies have improved our ability to identify potential drug targets, significant challenges remain in developing new antimicrobial drugs and bringing them to market. The document outlines factors contributing to the need for new antibiotics, such as emerging infectious diseases, increasing antibiotic resistance, and the impact of bacterial diseases. It argues that without active support of antibiotic research and development, we may face a potential public health crisis as antibiotic-resistant bacteria proliferate and treatment options dwindle.
This document summarizes research on the immunological and toxicological implications of COVID-19, focusing on the innate immune response and immune evasion. It discusses how the virus can trigger a "cytokine storm" through overactivation of the innate immune system and proinflammatory cytokines like IL-6. This storm can lead to widespread inflammation and multi-organ failure. The document also explores potential therapeutic strategies aimed at modulating the cytokine response, such as using corticosteroids or chloroquine to reduce IL-6 levels and calm the storm. Understanding the immune dysregulation and identifying key signaling pathways may help develop new clinical management approaches and prevent progression to severe illness.
Developing Therapeutic Strategies & Current Knowledge on Drugs For Treatment ...LaraV1
This document discusses developing therapeutic strategies for COVID-19. It outlines three main approaches: targeting the virus's binding to host cells, targeting viral replication inside cells, and repurposing approved drugs. Several drugs are discussed, including remdesivir, chloroquine, hydroxychloroquine, and azithromycin. While no consensus treatment has been found, repurposed drugs have shown promise. Continued research efforts provide hope that an effective treatment can be developed to combat this pandemic.
Handbook on adult_immunization_2009_(contents)raissa_09
The document provides information on vaccines for adult Filipinos. It includes general principles of vaccination, descriptions of various vaccine-preventable diseases, and information on 13 different vaccines. The committee members and table of contents are listed, and there are sections on vaccine storage, side effects, contraindications, and an appendix with disease trend graphs and vaccine information tables.
醫藥人 楊幽幽 Physician Pharmacist People Health Magazine Cecilia Young Tau Yau - ...ceciliayoungyau
Patient Perception from Internet on Adverse Effects vs Benefits of Vaccination written by Dental Consultant Physician Pharmacist People 醫藥人 楊幽幽 (Cecilia Young Tau Yau)
Specific prophylaxis and therapy of infectious diseases. Vaccines & toxoidesEneutron
Vaccines provide protection against infectious diseases by exposing individuals to antigens from pathogens in a way that does not cause disease. There are several types of vaccines, including live attenuated vaccines which use weakened live pathogens, and inactivated vaccines which use killed pathogens. Live vaccines typically produce stronger and longer-lasting immunity but carry some risk, while inactivated vaccines are safer but may require booster doses to maintain protection. Both vaccine types aim to stimulate the immune system's memory response to future pathogens, protecting individuals and populations through herd immunity when widely adopted.
Epidemiology is the study of the distribution and determinants of health-related states or events in populations and the application of this study to control health problems. The epidemiological triad consists of an agent, host, and environment. Communicable diseases are transmitted from one host to another through various modes of transmission. Key aspects of epidemiology include reservoirs, portals of exit, modes of transmission, incubation periods, and susceptible hosts. Prevention strategies include primordial, primary, secondary, and tertiary prevention to promote health and prevent disease at different stages.
Similar to Therapeutic Protection against COVID-19 Infection While Waiting for Herd Immunity (20)
Convalescent Plasma and COVID-19: Ancient Therapy Re-emergedasclepiuspdfs
Convalescent plasma has been used as a treatment for infectious diseases for over a century. It involves transfusing plasma from patients who have recovered from an infection into patients who are currently ill with that same infection. Clinical trials are now investigating its use for COVID-19. While some early studies showed promising results, larger randomized controlled trials found no significant benefit of convalescent plasma for severe COVID-19. Further research is still needed to determine whether certain patient populations or plasma dosages may be more effective.
The Negative Clinical Consequences Due to the Lack of the Elaboration of a Sc...asclepiuspdfs
Until a few years ago, the immune system was considered as responsible for the only defense against microbial infections and other external agents. On the contrary, the immune cells have been proven to be linked not only through cell-cell contact but also by releasing proteins capable of influencing the immune-inflammatory response, the so-called cytokines or interleukins. Moreover, the cytokines have appeared to play not only immune activities but also metabolic and systemic effects influencing the overall biological systems, including the nervous, the endocrine, and the cardiovascular systems, by representing the main endogenous molecules responsible for the maintenance of the unity of the biological life. Therefore, only the systematic clinical consideration of cytokine effects may allow the generation of real future holistic medicine.
The great benefit of blood/blood constitutes therapy is the ability to provide transfusion support for patients with many unique hematologic conditions. For some patients, such as patients with sickle cell disease, thalassemia major, immune hemolytic anemia, anemia of kidney disease, and aplastic anemia may need for this consolidation extends throughout their life. By knowing the alteration mechanisms of these conditions, we can appreciate the stationary, urgency, and the value of the transfused red blood cell (RBC).
Decreasing or Increasing Role of Autologous Stem Cell Transplantation in Mult...asclepiuspdfs
During the past four decades, autologous stem cell transplantation (ASCT) has been the first choice and the standard option for the treatment of newly diagnosed patients with multiple myeloma. The introduction of new agents such as thalidomide, lenalidomide, and bortezomib has led to a clear improvement in basic approach and those agents became the standard of care in the induction phase; however, they were not able to play the role of ASCT in term of progression-free survival and overall survival. Debate continues about the best induction, consolidation, and maintenance taking into account the toxicities of these new agents. The new monoclonal antibody (anti CD38) starts to take its place in the induction setting and it seems to be a promising agent in the high-risk group. Until recently, ASCT is the standard treatment for newly diagnosed patients.
Comparison of the Hypocalcemic Effects of Erythropoietin and U-74389Gasclepiuspdfs
Aim: This study calculated the effects on serum calcium (Ca) levels, after treatment with either of two drugs: The erythropoietin (Epo) and the antioxidant lazaroid (L) drug U-74389G. The calculation was based on the results of two preliminary studies, each one of which estimated the certain influence, after the respective drug usage in an induced ischemia-reperfusion animal experiment. Materials and Methods: The two main experimental endpoints at which the serum Ca levels were evaluated were the 60th reperfusion min (for the Groups A, C, and E) and the 120th reperfusion min (for the Groups B, D, and F). Especially, the Groups A and B were processed without drugs, Groups C and D after Epo administration, whereas Groups E and F after the L administration. Results: The first preliminary study of Epo presented a non-significant hypocalcemic effect by 0.34% ± 0.68% (P = 0.6095). However, the second preliminary study of U-74389G presented a non-significant hypercalcemic effect by 0.14% ± 0.66% (P = 0.8245). These two studies were coevaluated since they came from the same experimental setting. The outcome of the coevaluation was that L is 2.3623042-fold (2.3482723–2.3764196) more hypercalcemic than Epo (P = 0.0000). Conclusions: The antioxidant capacities of U-74389G ascribe 2.3623042-fold more hypercalcemic effects than Epo (P = 0.0000).
The term refractory anemia (RA) may be confusing to those who are not hematologists. RA should be well defined because it means more than what it says. RA is defined as anemia that is not responsive to therapy except transfusion.[1] The term RA is used to rule out those types of anemia with a known cause such as anemia of systemic diseases (liver and kidney) and anemia of inflammation even though they are considered refractory to therapy.[2] RA with cellular or hypercellular bone marrow was formerly used to exclude aplastic anemia.
Management of Immunogenic Heparin-induced Thrombocytopeniaasclepiuspdfs
Immunogenic heparin-induced thrombocytopenia (HIT) is an immune response to heparin associated with significant morbidity and mortality in hospitalized patients if unidentified as soon as possible, due to thromboembolic complications involving both arterial and venous systems. Early diagnoses based on a comprehensive interpretation of clinical and laboratory information improve clinical outcomes. Management principles of strongly suspected HIT should not be delayed for laboratory result confirmation. Treatment strategies have been introduced including new, safe, and effective agents. This review summarizes the clinical therapeutic options for HIT addressing the use of parenteral direct thrombin inhibitors and indirect factor Xa inhibitors as well as the potential non-Vitamin K antagonist oral anticoagulants.
A 73-year-old woman presented with fever and linearly arranged erythema on her chest, back, and abdomen. She was initially diagnosed with drug-related scratch dermatitis due to antibiotic use. However, her fever persisted and lab work showed abnormal liver enzymes and very high ferritin levels. Biopsies ruled out infection and malignancy. She was ultimately diagnosed with adult Still's disease (ASD) based on her symptoms and lab results. Treatment with prednisolone resolved her symptoms within a week. This case demonstrates that ASD can present with various skin lesions, and a high index of suspicion is needed for diagnosis.
Bone Marrow Histology is a Pathognomonic Clue to Each of the JAK2V617F, MPL,5...asclepiuspdfs
According to the World Health Organization and Clinical Laboratory Molecular and Pathological criteria bone marrow pathology in JAK2V617F mutated trilinear myeloproliferative neoplasm (MPN) patients essential thrombocythemia (ET) and polycythemia vera are indistinguishably featured by clustered medium to large pleomorphic megakaryocytes and increased cellularity (60–90%) due to increased erythropoiesis and megakaryopoiesis. MPL515 mutated ET is the second distinct clonal MPN characterized by thrombocythemia in a normocellular bone marrow showing clustered increased large to giant mature megakaryocytes with staghorn-like hyperlobulated nuclei. Calreticulin (CALR) mutated hypercellular thrombocythemia associated with prefibrotic megakaryocytic, granulocytic myeloproliferation (MGM) recently became the third distinct MPN featured by dense clusters of immature megakaryocytes with cloud-like nuclei. Bone marrow pathology in newly diagnosed MPN patients appears to be a pathognomonic clue for diagnostic differentiation between JAK2V617F mutated trilinear MPN, MPL515 normocellular thrombocythemia, and CALR thrombocythemia with MGM characteristics followed by secondary reticulin fibrosis. Their natural histories clearly differ featured by an increase of erythro/granulopoiesis and cellularity in JAK2V617F, decrease of erythropoiesis and cellularity in MPL515 and increase of dual megakaryo/granulopoiesis and cellularity in CALR mutated MPN.
Helicobacter pylori Frequency in Polycythemia Vera Patients without Dyspeptic...asclepiuspdfs
Introduction: In polycythemia vera (PV) patients, peptic ulcer and gastroduodenal erosions are more common than the general population, but there are insufficient data on the frequency of Helicobacter pylori (HP) and its role in etiopathogenesis. In this study, we aimed to compare the prevalence of HP infection in PV patients without dyspeptic complaints with a healthy control group without dyspeptic complaints. Materials and Methods: Fifty patients with PV without dyspeptic complaints and 50 controls without dyspeptic complaints were enrolled in this study after informed consent obtained. Stool samples of selected patients were analyzed using HP stool antigen test (True Line®). Results: There was surprisingly striking difference between HP prevalence in PV patients without dyspeptic complaints and asymptomatic healthy controls (64% vs. 2%) (P < 0.05). There was no significant relationship found between HP presence and age, gender, treatment modalities, complete blood count, positivity of JAK2 V617F, serum erythropoietin level, and splenomegaly in PV patients (P > 0.05). Conclusion: As the susceptibility of HP infections in PV patients are higher, it is recommended to have close surveillance of these patients by screening HP presence. In addition, when HP positivity is determined, the eradication of HP is essential to prevent possible future gastrointestinal lesions in patients with PV.
Lymphoma of the Tonsil in a Developing Communityasclepiuspdfs
The lymphoma of the tonsil is a rarity. Single case reports have appeared in countries as disparate as China, Greece, India, Japan, and Turkey. Therefore, this paper presents cases found in Nigeria among the Ibo ethnic group. The epidemiological comparisons are deemed to be worthy of documentation such as age ranges and sides of involvement.
Should Metformin Be Continued after Hospital Admission in Patients with Coron...asclepiuspdfs
Background: In most patients with diabetes, guidelines recommend discontinuation of oral anti-diabetic agents. Preliminary data suggest that pre-admission metformin use may have a mortality benefit in patients with coronavirus disease (COVID)-19 admitted to the hospital. Objective: The objective of the study was to review the impact of metformin on morbidity and mortality among hospitalized patients with COVID-19. Methods: Review of English literature by PUBMED search until November 10, 2020. Search terms included diabetes, COVID-19, metformin, retrospective studies, meta-analyses, pertinent reviews, pre-print articles, and consensus guidelines are reviewed.
Clinical Significance of Hypocalcemia in COVID-19asclepiuspdfs
- Several retrospective studies found that hypocalcemia is common in hospitalized patients with COVID-19, occurring in 62-78% of patients.
- Hypocalcemia is associated with more severe disease and worse outcomes, including increased risk of hospitalization, longer hospital stays, multi-organ failure, acute respiratory distress syndrome, and death.
- The cause of hypocalcemia in COVID-19 patients is unclear but may involve consumption of calcium for viral entry into cells or reflect severity of illness. Further study is needed.
Excess of Maternal Transmission of Type 2 Diabetes: Is there a Role of Bioche...asclepiuspdfs
Objective: An excess of maternal transmission of Type 2 diabetes (T2D) has been reported in some populations but not confirmed in other studies. Mitochondrial inheritance has been proposed to explain such excess. In the present paper, we have considered the presence of T2D in the mother and/or in the father in relation to the risk of T2D and to age at onset of the disease in the offspring. The distribution of two genetic polymorphisms involved in glucose metabolism in relation to the presence of T2D in the mother has been also considered. Materials and Methods: Two hundred and seventy-nine participants with T2D were studied in the population of Penne, a small rural town in the eastern side of central Italy. Adenosine deaminase locus 1 (ADA1) and phosphoglucomutase locus 1 (PGM1) phenotypes were determined by starch gel electrophoresis. Statistical analyses were carried out using commercial software (SPSS). Results: The proportion of patients from T2D mothers is much greater as compared to the proportion of the patients from T2D fathers (P < 0.0001). Age at onset of the disease in patients in whom one or both parents are T2D is lower as compared to other patients. The distribution of ADA1 and PGM1 phenotypes in participants with T2D depends on the presence of diabetes in the mother. Conclusions: About the transmission of T2D, our data confirm the high proportion of maternal T2D and show the role of two common biochemical polymorphisms involved in glucose metabolism.
The Effect of Demographic Data and Hemoglobin A 1c on Treatment Outcomes in P...asclepiuspdfs
Objective: Diabetes mellitus, the most common cause of non-traumatic foot amputations, is a life-threatening condition due to its high mortality and morbidity. In our study, we retrospectively evaluated our patients with diabetic foot syndrome in our clinic. Materials and Methods: The demographic data, duration of diabetes, Wagner classification, haemoglobin A 1c (HbA1c) levels, white blood cell, C-reactive protein sedimentation levels, hospital stay, and treatment results were evaluated retrospectively in 14 patients with diabetic foot between January 2017 and December 2018. Results: The mean age of the patients was 62.43 ± 7.7 years. Of the 14 patients, 3 were females and 11 were males. All 14 patients were type 2 diabetes mellitus. When diabetic foot Wagner classification was performed, 6 patients were evaluated as Wagner 2, five patients were Wagner 3, and three patients were evaluated as Wagner 4. Nine patients had complete amputation and 3 had vascular surgery. Conclusion: Although the level of HbA1c is below the target level, the risk of diabetic foot is increased when there is no adequate diabetes mellitus foot training. Inadequate diabetic patient education and hospitalization of patients after infection progress the amputation rate.
Self-efficacy Impact Adherence in Diabetes Mellitusasclepiuspdfs
The aim of the paper is to explore how self-efficacy (SE) is associated with adherence among adults with diabetes mellitus (DM). Methods: The search of electronic databases identified 564 records from 2007 to 2017 on SE and adherence from different perspectives and its effect on adults with DM. Discussions: SE increases the confidence in adults in their self-care behaviors. Non-adherence continues to be a significant barrier to SE. SE and adherence should be informed by an understanding of theoretical frameworks and the individual characteristics. Conclusion: Adherence is likely among adults with better SE to empower them to make valid decisions about their health. Interventions to improve SE should be tailored based on different types of non-adherence such as intentional and unintentional non-adherence. Implications: An intercollaborative professional practice approach is crucial to improve SE and adherence for sound judgment and valid decision-making.
Uncoiling the Tightening Obesity Spiralasclepiuspdfs
While an underweight prevalence was once more than twice that of obesity, now more people are obese than underweight. Obesity is one of the leading causes of preventable death in the world. There are an estimated 2,100,000,000 obese people worldwide and that number is forecast to grow to 51% of the world’s population by 2030. Escalating obesity-related disease costs threaten to bankrupt the world’s health-care systems.
Prevalence of Chronic Kidney disease in Patients with Metabolic Syndrome in S...asclepiuspdfs
Background and Objective: Chronic kidney disease (CKD) which is an increasingly important clinical and public health issue is associated with cardiovascular disease. Epidemiologic studies have also linked metabolic syndrome (MetS) with an increased risk of incident CKD. Therefore, the present study was designed retrospectively to find the prevalence and potential risk factors of CKD in patients with MetS in Saudi Arabia.
Management Of Hypoglycemia In Patients With Type 2 Diabetesasclepiuspdfs
Hypoglycemia is the rate-limiting step of intensive management in patients with diabetes. Lowering one’s A1C to a prescribed target is expected to mitigate one’s risk of developing long- and short-term diabetes-related complications. Several of the less expensive and commonly prescribed glucose lowering agents favored by practitioners result in weight gain, hypoglycemia, and even an increased risk of cardiovascular (CV) mortality. Although achieving a targeted A1C of <7 % is the standard of care, clinicians often fail to evaluate patients for glycemic variability which can increase oxidative stress driving long-term diabetes-related complications including CV death. The use of concentrated insulins and glucagon-like peptide-1 receptor agonists separately or in combination with each other reduces glycemic variability and one’s risk of hypoglycemia. Pharmaceutical agents which allow patients to safely achieve their targeted A1C without weight gain and hypoglycemia should be preferred in patients with type 2 diabetes.
Predictive and Preventive Care: Metabolic Diseasesasclepiuspdfs
South Asians have a very high incidence of ischemic heart disease and stroke. In addition, they also have a very high incidence of metabolic diseases such as prehypertension, hypertension, visceral obesity, metabolic syndrome, prediabetes, type-2 diabetes, and its clinical complications. Currently, there are over 75 million diabetic subjects in India and an equal number of prediabetics. Republic of China has taken over India as the diabetes capital of the world, with over 115 million diabetics. Modern medicine is disease focused and has failed to address the prevention of these chronic diseases. According to the reports from the United Nations (Millennium Development Goals [MDGs], the World Health Organization, Global Health Initiatives, and the non-communicable disease risk task force), obesity has increased by 2-fold and type-2 diabetes by 4-fold worldwide. Experts in this field predict that chances of meeting the MDGs set by the UN members of reducing the incidence of these diseases at 2025 to the level of 2020 are very little. Western medicine has failed to reduce or reverse the trend in the incidence of these diseases. We feel that an integrated approach to health care may be a better option, to reduce the disease burden in developing and resource-poor countries. Having said that, one cannot prevent something that one is not aware of, as such it is the need of the hour for us, to develop a robust predictive and preventive health-care platform. In an earlier article, we presented our views on reducing or reversing cardiometabolic diseases. There is great enthusiasm among the health-care providers and professional bodies that integration of emerging technologies will help develop personalized, precision medicine, as well as reduce the cost of health-care worldwide.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
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8 Journal of Community and Preventive Medicine • Vol 4 • Issue 1 • 2021
socio-distancing, home-binding etc. Not much discussion has
been put on personal protections apart from the use of face-
masks and testing’s related to the viral infection. Nutritional
supplements like the use of Vitamin D might have convincing
evidence of protection against influenza,[5]
but people might
consider it a belated message and only vaccines aiming at
specific prevention with immediate responses is worth
consideration.
We all agree that an effective vaccine is the common goal.
Is it really true once, we get the effective vaccine, nothing
needs be done? In any epidemic outbreak, apart from the
chronically ill and aged people being more vulnerable,
many others are apparently more resistant. In leprosy and
tuberculosis, one or two members of the family might be
infected while the other close members remain healthy. In
this pandemic, only about 15–20% of infected people develop
severe symptoms, while the rest recover rather smoothly.[1]
A lot of them did not receive specific treatment.[2]
There
must be a defense system within the individual capable of
resisting the infection effectively. We realize this is related
to the innate immunodefensive system which could be
effective or defective.
Hence, in this COVID-19 pandemic, while distributing and
receiving the new vaccines, there could be explorations on
the ways to effectively boost up the innate immunodefense
of individuals, particularly those at high risk like medical
personnel’s and affected family members, before they have
vaccination and even after.[6,7]
The innate immunodefense system protects mainly through
activities of T cells which produce suitable environments of
defense through the production of complicated enzymatic
materials: The chemokines, cytokines, and interferons (IFN).
Boosting of the defense ability refers to a quantitative increase
in the cellular components and a qualitative enhancement
of their related activities.[8]
Since inflammation is always
involved, control of inflammation forms an important part.
METHODS AND RESULTS
Pulmonary innate immunity
Pathogens entering the respiratory tract need to go through
defense barriers before gaining access to the human body.
Epithelial cells produce seroussecretions (commonly
known as sputum) which contain lysozymes, lactoferrins,
and defensins[5,8,9]
which have direct lytic effects on the
peptidoglycans of organisms.
After breaking through this defense, pathogens have to face
the complements, a major component of innate immunity
generating cytolytic activities. Then they need to face
immunoglobulins created by the B lymphocytes after being
introduced by the T cells. The successful entry of pathogens
then faces a complicated environment of interplay between
cytokines and IFNs. They could possibly be eliminated
through this non-specific, antigen-independent immune
network.
Protective immune therapeutics may act by neutralizing
or inducing the direct lysis of pathogens, by interfering
with microbial gene expression and growth, by enhancing
and activating immune cells or a combination thereof.[10,11]
When there is an urgent need, compounds of endogenous
origin like cytokines could be used as nonspecific activating
agents. Other non-specific immune modulators include
attenuated or dead microbial products, natural compounds,
plant fractions, glucans, synthetic compounds, antibiotics,
and probiotics.[12]
Immunoboosting agents for clinical use
For wide coverage to be offered to large circles of need, that
is, the at risk, close or near contacts, artificially prepared
agents need to be used instead of endogenous mediators
like convalescent serum. The best known substances with
immunotherapeutic effects are related to plants which
own long histories of preventive applications, long before
the full knowledge of infections, their causative agents
and the course of events. Many of them have attracted
bioscientists’ attention and gained early evidences of
therapeutic value.
Some examples of herbal origin are given as follows:
1. Extracts from tea leaves to control protease release from
the severe acute respiratory syndrome (SARS) virus
2. The natural polyphenols in tea-leaves have been found to
contain a compound 3-isotheaflavin-3-gallate capable of
inhibiting the activities of 3C protease which is required
for the viral replication.[13,14]
3. Herbal extracts promoted T cell activities and increase
CD4/CD8 ratio
4. Peripheral blood samples taken before and after
consumption showed increased total lymphocyte counts
and helper/suppressor (CD4/CD8) ratio, indicating
immune-boosting effects.[15,16]
5. Herbal material had been used as adjuvant component to
enhance the immunogenicity of vaccines
6. One approach was to coadminister cytokines, sterile
constituents of bacteria, or polysaccharides to influence
the antigen-presenting cells, especially the dendritic
cells.[17,18]
7. Potential gene-related targets like Mannose-Binding-
Lectin (MBL)
8. MBL could be an important constituent of the human
innate immune system. Studies have shown the
association between MBL mutations and increased
susceptibility to infections and autoimmune diseases.
MBL may therefore be used as a target in the innate
immunity when immunotherapy is being planned.[19,20]
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Journal of Community and Preventive Medicine • Vol 4 • Issue 1 • 2021 9
9. Clinical studies using herbal extracts as a preventive
agent against getting infected among the high-risk
medical workers during an epidemic. One good example
was provided n Hong Kong during the SARS crisis in
2003.[21]
When medical workers were found resistant to
SARS infection.[15]
Vitamin D as another example
Historically Vitamin D deficiency has been linked with
respiratory ailments such as common cold and influenza
because of their seasonal variations. The prevalence is related
to the cold cloudy months of the year with the least amount
of sunlight which seriously affect the normal production of
Vitamin D under the skin. Clinical studies have confirmed
the correlation.[5]
Subsequently, laboratory studies have worked out the
molecular mechanisms behind Vitamin D’s preventive effects
against respiratory viral infections.
Activities of Vitamin D rely totally on the presence of the
Vitamin D receptors (VDR) which are found in most tissues
throughout the body. Through the VDR Vitamin D modulates
the innate and adaptive immune systems.[21]
On the cellular
level, it activates T and B cells, regulates anti-microbial
peptides (AMP), upregulates toll like receptors (TLRs),
and induces destruction of pathogens through autophagy.[22]
Vitamin D facilitates adaptive responses through the T cells
and B cells.Among the different types of cytokines produced,
it particularly regulates the inflammation related groups such
as Tumor necrosis factor α and IFN. The immunomodulatory
effects of Vitamin D are related both to the early as well as
the late phases of pathogen invasion.[23,24]
Vitamin D does not have the vaccine effect. It is nonspecific
to the invading organism, and there is yet no recommended
time frame with which it could claim the best efficacies. It
acts like an endogenous antibiotic, stimulating the production
of AMP’s and at the same time putting inflammation under
control.[25]
Before the very early days of the COVID-19 pandemic Mc
Greevey in Harvard University called to the World’s attention
about the potential use of Vitamin D as a personal protective
agent against respiratory epidemic.[26,27]
Developing an evidence based immunobooster
The encouraging result of our 2003 SARS experience: Using
a modified classical “anti-flu” formula for the personal
protection of at risk medical workers against the infections
is currently giving us much encouragement to get engaged
in further research to get more evidence on its efficacy, with
the aim of producing an herbal booster for immunological
defense.[28-30]
Corona virus is an enveloped positive-sense RNA virus,
which is characterized by club-like spikes projecting
from its surface.[31]
Macrophages, the major effector cells
in the innate immune system, recognize viral attacks
through Pattern Recognition Receptors such as TLRs and
RIG-I-like receptor (RLRs) which identify the conserved
microbial components called pathogen-associated
molecular patterns. During the infection, TLR and RLR
are essential for the recognition of microbial pathogens,
followed by the activation of intracellular signaling
pathways with distinct pattern of gene expression. The
innate immune response against microbial infections is
thus developed.[32]
TLR3 is therefore involved in antiviral
responses by triggering the production of antiviral
cytokines such as IFN and other Th1 cytokines. RIG-1-like
receptors (RLRs) constitute a family of cytoplasmic RNA
helicases which are important to initiate the host antiviral
responses. For example, RIG-I/retinoic-acid-inducible
gene 1 has been shown to detect viral RNA, leading to
production of type I IFNs.[33]
In our previous studies on
adults hospitalized with viral infection, we confirmed that
TLRs played an important role for innate viral inhibition
in naturally occurring influenza.[34]
The research protocol under planning includes Macrophage
Studies,’ cytokines and chemokines studies; cell adhesion
studies; luciferase reporter assay for NF-kβ activities; and
special animal studies.[16,35-38]
Since Vitamin D has gone
through thorough platform studies of its immune-boosting
effects[21]
and although the clinical results of prevention have
not been conclusive, the development of an evidence based
preventive agent could include Vitamin D to form a combined
Herbal-Vitamin D twin supplement.
Once the preclinical tests are completed, the immunoboosting
agent could be put under clinical trials following the strict
rules of drug development.
DISCUSSION
In the 100 years following the “Spanish Pandemic”
of Influenza, variants of the influenza virus had been
responsible for three other serious epidemics in China and
Hong Kong; and at least 8 more regional epidemics in the
world.[39]
Every time when China experienced the epidemic,
herbal medicine in different formulations would be used for
treatment. Zhang in 2006 reported 117 published articles
discussing about the value of Chinese Medicine in influenza
treatment.[29]
In spite of the popular use of herbal formulae specific for the
prevention of seasonal influenza attacks throughout China,
yet in the past 10 years only four very brief published reports
on clinical trials for treatment and prevention are available.
The target populations were medical staff; people in close
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10 Journal of Community and Preventive Medicine • Vol 4 • Issue 1 • 2021
contact; and students. The sample size varied from a few
cases to over 20,000. The low quality of the trials is very
obvious. Only general impressions were given about the
preventive effects.[40-44]
During the SARS outbreak, Traditional Chinese Medicine
was included into many of the treatment programs.
After the epidemic WHO held a special meeting with
international participations to evaluate the effects of
Chinese Medicine in the combat against SARS. Many
reports gave convincing observations about the value of
symptom controls such as improving dyspnea and fatigue;
improving oxygenation, lessening steroid dependence, and
hastening rehabilitation.[45]
No report on prevention was
available.
During the SARS epidemic, Lau and Leung reported a
clinical trial at the peak of the crisis in Hong Kong aiming at
the prevention of getting infected among the at risk medical
workers serving SARS patients. An innovative formula
combining two popular patent Chinese Medicines: one from
Northern China, the other from the South, with the aim of
achieving better harmony was used. 3160 workers were given
2 weeks’ consumption after which infection rate and adverse
effects were studied. Other hospital workers not consuming
the formula were used as controls. The results showed that
none of the herbal group contracted the infection, compared
to 0.4% infection rate among the control group. Adverse
effects were minimal.[46]
In the current COVID-19 Crisis the Commission of Health
of the People’s Republic of China issued “Guidelines on the
Diagnosis and treatment of coronavirus disease 2019.” In
the sections related to the use of Chinese Medicine: 14 types
of Chinese Patent Medicine were officially recommended
for the treatment of the disease. 11 on-going clinical trials
with divergent inclusions: From mild, moderate, to critically
ill patients had been arranged in different cities in China,
registered under the Chinese Clinical Trial Registry.[46]
These trials were organized for confirmed cases receiving
conventional treatment in hospital settings, while herbal
medicine was also used.
The overwhelming enthusiasm on vaccine production is
challenged by other known facts: The effectiveness of
antiviral vaccines might not match expectations because of
the frequent dynamic changes of the RNA sequencing of the
corona virus leading to variants. In addition, elderly people
and chronically ill patients might not be suitable for vaccine
administration.[47,48]
CONCLUSION
While we are waiting for reliable detail reports about the
efficacy of the emergency vaccinations to stop the pandemic
we could take a more open view on additional ways to
protect people exposed to the viral threat: They are the
medical attendants taking care of the infected patients, their
family members and other close contacts. At the height of
an epidemic large numbers of people would be at risk.
Specific supplements might serve the purpose of protecting
these high-risk groups through the boostering of their innate
immunological defense. Vitamin D research enthusiasts
have worked out the laboratory evidences of this vitamin
in the boosting of innate and adaptive immunological
responses of the individual against external biological
invasions.[31]
Reports on Vitamin D’s clinical effects against
cold and influenza-like infections are also plentiful.[32,33]
As
we witness good results with herbal treatment in China, the
formulae used in mild cases for the control of deterioration,
could be considered also suitable for prevention against
the viral attack.[49-51]
Development of an evidence-based
immunoboosting agent from selected, simplified classical
herbal formulae for the prevention of viral infections would
be very much desired, possibly together with Vitamin D to
achieve synergistic effects.
ACKNOWLEDGMENTS
This work was supported by the State Key Laboratory Fund
provided by the Innovation and Technology Commission of
Hong Kong.
REFERENCES
1. World Health Organization. A Joint after an International
Inspection on COVID-19 Epidemic in China. China, Geneva:
World Health Organization; 2020.
2. Guan WJ, Ni ZY, Zhong WS, Hu Y, Liang WH, Ou CQ, et al.
Clinical Characteristics of 2019 Novel Coronavirus Infection
in China, MedRxiv; 2020.
3. National Health Commission of the People’s Republic of
China.The guideline on diagnosis and treatment of Coronavirus
infection 2019. Tianjin J Tradit Chin Med 2020;37:1-5.
4. Zhu FC, Li YH, Guan XH, Hou LH, Wang WJ, Li JX, et al.
Safety, tolerability, and immunogenicity of a recombinant
adenovirus Type-5 vectored COVID-19 vaccine: A dose-
escalation, open-label, non-randomised, first-in-human trial.
Lancet 2020;395:1845-54.
5. Martineau AR, Jolliffe DA, Greenberg L. Vitamin D
supplementation to prevent acute respiratory tract infections:
Systematic review and meta-analysis of individual participant
data. BMJ 2017;356:i6583.
6. Horton R. The plight of essential workers during the COVID-
19 pandemic. Lancet 2020;395:1587.
7. Treibel TA, Manisty C, Burton M, McKnight A, Lambourne J,
Augusto JB, et al. COVID-19: PCR screening of
asymptomatic health-care workers at London hospital. Lancet
2020;395:1608-10.
8. Fearon DT, Locksley RM. The instructive role of innate
immunity in the acquired immune response. Science
1996;272:50-3.
5. Ping-chung et al.: Protection against COVID-19 while waiting for herd immunity
Journal of Community and Preventive Medicine • Vol 4 • Issue 1 • 2021 11
9. Beutler B. Innate immunity: An overview. Mol Immunol
2004;40:845-59.
10. Medzhitor R, Janeway CA. An ancient system of host defense.
Curr Opin Immunol 1998;10:12-5.
11. Lee SH, Webb JR, Vidal SM. Innate immunity to
cytomegalovirus: The Cmv1 locus and its role in natural killer
cell function. Microbes Infect 2002;4:1491-503.
12. Bassel C, Holton J, O’Mahony R, Roitt I. Innate immunity and
pathogen-host interaction. Vaccine 2003;21 Suppl 2:S12-23.
13. Chen CN, Lin PC, Huang KK, Chen WC, Hsu TA. Inhibition
of SARS-CoV 3C-like protease activity by theaflavin-3,
3’-digallate (TF3). Evid Based Complement Alternat Med
2005;2:209-15.
14. Clark KJ, Grant PG, Sarr AB, Belakere JR, Swaggerty CL,
Phillips TD, et al. An in vitro study of theaflavins extracted
from black tea to neutralize bovine rotavirus and bovine
Coronavirus infections. Vet Microbiol 1998;63:147-57.
15. Fung KP, Leung PC, Tsui KW, Wan CC, Wong KB, Waye MY,
et al. Immunomodulatory activities of the herbal formula Kwan
Du Bu Fei Dang in healthy subjects: A randomised, double-
blind, placebo-controlled study. Hong Kong Med J 2011;17
Suppl 2:41-3.
16. Poon PM, Wong CK, Fung KP, Fong CY, Wong EL, Lau JT,
et al. Immunomodulatory effects of a traditional Chinese
medicine with potential antiviral activity: A self-control study.
Am J Chin Med 2006;34:13-21.
17. Audibert FM, Lise LD. Adjuvants: Current status, clinical
perspectives and future prospects. Immunol Today
1993;14:281-4.
18. Vogel FR. Immunologic adjuvants for modern vaccine
formulations. Ann N Y Acad Sci 1995;754:153-60.
19. Kuhlman M, Joiner K, Ezekawitz RA. The human mannose-
binding protein functions as an opsonin. J Exp Med
1989;169:1733-45.
20. Super M, Thiel S, Lu J, Levinsky RJ, Turner MW. Association
of low levels of mannan-binding protein with a common defect
of opsonisation. Lancet 1989;2:1236-9.
21. Greiller CL, Martineau AR. Modulation of the immune
response to respiratory viruses by Vitamin D. Nutrients
2015;7:4240-70.
22. Abdelsalam A, Rashed L, Salman T, Hammad L, Sabry D.
Molecular assessment of Vitamin D receptor polymorphism as
a valid predictor to the response of interferon/ribavirin-based
therapy in Egyptian patients with chronic hepatitis C. J Dig Dis
2016;17:547-53.
23. Szymezak I, Pawliczak R. The active metabolite of Vitamin
D3 as a potential immunomodulator. Scand J Immunol
2016;83:83-91.
24. Chun RF, Liu PT, Modlin RL, Adams JS, Hewison M. Impact
of Vitamin D on immune function: Lessons learned from
genome-wide analysis. Front Physiol 2014;5:151.
25. Jeffery LE, Wood AM, Qureshi OS, Hou TZ, Gardner D,
Briggs Z, et al.Availability of 25-hydroxyvitamin D(3) toAPCs
controls the balance between regulatory and inflammatory T
cell responses. J Immunol 2012;189:5155-64.
26. McGreevey S, Morrison M. Study Confirms Vitamin D
Protects Against Colds and Flu, The Harvard Gazette; 2017.
27. Gruber-Bzura BM. Vitamin D and Influenza-Prevention or
Therapy? Int J Mol Sci 2018;19:2419.
28. LeungPC.Methodologyforthedevelopmentofevidence-based
herbal tonics for preventive purposes. J Altern Complement
Integr Med 2015;1:004.
29. Zhang JH, Su TM, Fan WY. Analysis of Chinese medicine
formulae for the treatment of influenza. J Chin Med Inform
2006;13:103-5.
30. Lau J, Ko WM, Tam CW, Leung PC. Using herbal medicine as
a means of prevention experience during the SARS crisis. Am
J Chin Med 2003;33:345-56.
31. Phan T. Novel Coronavirus: From discovery to clinical
diagnostics. Infect Genet Evol 2020;79:104211.
32. Hopkins PA, Sriskandan S. Mammalian toll-like receptors: To
immunity and beyond. Clin Exp Immunol 2005;140:395-407.
33. Loo YM, Gale M Jr. Immune signaling by RIG-I-like receptors.
Immunity 2011;34:680-92.
34. Lee N, Wong CK, Hui DS, Lee SK, Wong RY, Ngai KL,
et al. Role of human toll-like receptors in naturally occurring
influenza A infections. Influenza Other Respir Viruses
2013;7:666-75.
35. Wong CK, Dong J, Lam CW. Molecular mechanisms regulating
the synergism between IL-32γ and NOD for the activation of
eosinophils. J Leukoc Biol 2014;95:631-42.
36. Wong CK, Cheung PF, Ip WK, Lam CW. Intracellular signaling
mechanisms regulating toll-like receptor-mediated activation
of eosinophils. Am J Respir Cell Mol Biol 2007;37:85-96.
37. Wong CK, Hu S, Leung KM, Dong J, He L, ChuYJ, et al. NOD-
like receptors mediated activation of eosinophils interacting
with bronchial epithelial cells: A link between innate immunity
and allergic asthma. Cell Mol Immunol 2013;10:317-29.
38. Qiu HN, Wong CK, Chu IM, Hu S, Lam CW. Muramyl
dipeptide mediated activation of human bronchial epithelial
cells interacting with basophils: A novel mechanism of airway
inflammation. Clin Exp Immunol 2013;172:81-94.
39. Lui SP, Lin L, Juo JL. Prevention and Treatment for Influenza-
Modern and Traditional Treatment in Chinese. Beijing, China:
China Publisher for Traditional Chinese Medicine; 2010.
Available from: https://www.www.cptcm.com. [Last accessed
on 2020 May 29].
40. Protocol for the Treatment and Prevention of H1N1 Influenza,
GuangDong Centre for the Prevention and Control of Diseases;
2009.
41. Song Y, Wang X, Liu H, Gao K, Liang H, Liu L. Clinical
observation of prevention of influenza A (H1N10 using
QingjieFanggan granules. Shoanxi J Tradit Chin Med
2019;40:886-9.
42. LiuL,XuG,XuX.Preliminaryobservationonthepreventionof
influenzas A (H1N1). Beijing J Tradit Chin Med 2013;32:91-2.
43. Leung PC. The efficacy of Chinese medicine for SARS: A
review of Chinese publications after the crisis. Am J Chin Med
2017;35:575-81.
44. Zhang L, Chen B, Zeng H. Analysis of fandu decoction on
SARS and zero infection in hospital. Chin J Hosp Pharm
2005;25:59-60.
45. World Health Organization. Clinical Trials on Treatment Using
a Combination of Traditional Chinese Medicine and Western
Medicine. Geneva: World Health Organization; 2004. p. 1-194.
46. Lau TF, Leung PC, Wong EL, Fong C, Cheng KF, Zhang SC,
et al.Usingherbalmedicineasameansofpreventionexperience
during the SARS crisis. Am J Chin Med 2005;33:345-56.
47. Clereq ED, Neyts J. Avian influenza A (H5N1) infection:
Targets and strategies for chemotherapeutic intervention.
6. Ping-chung et al.: Protection against COVID-19 while waiting for herd immunity
12 Journal of Community and Preventive Medicine • Vol 4 • Issue 1 • 2021
Trends Pharmacol Sci 2007;28:280-5.
48. Oxford JS, Lambkin R, Elliot A, Daniels R, Sefton A, Gill D.
Scientific lessons from the first influenza pandemic of the 20th
century. Vaccine 2006;124:6742-6.
49. Chan B, Wong CK, Leung PC. What can we do for the
personal protection against the COVID-19 infection? Immuno-
boostering specific supplement could be the answer. J Emerg
Med Trauma Surg 2020;2:007.
50. Ren JL, ZhangAH, Wang XJ. Traditional Chinese medicine for
COVID-19 treatment. Pharmacol Res 2020;155:104743.
51. Liu B. Clinical observation on the prevention of influenza A
(H1N1) with prevention theory of TCM. Tradit Chin Med Res
2010;23:46-7.
How to cite this article: Ping-Chung L, Chun-Kwok W,
Ben CC. Therapeutic Protection against COVID-19
Infection While Waiting for Herd Immunity. J Community
Prev Med 2021;4(1):7-12.