Ahmed Ibn Edriss Mohamed*, Wisam Mahjoub Sirelkhatim and Muhammed Elamin Osman
DOI: DOI: 10.37421/2470-6965.2022.11.180
Background: Malaria is the world's commonest and life threatening tropical diseases.It is one of the top three causes of child mortality in sub-Saharan Africa,including Sudan. If not treated within 24 hours, malaria can progress into fatal severe illness. Early diagnosis and treatment reduces disease, prevents deaths and can contribute to the reduction of malaria transmission.
Objectives: To assess the association between ages, tribe, clinical manifestation of severs malaria and outcome in ED-Dueim Teaching Hospital, Sudan.
Patients and Methods: This descriptive cross sectional, hospital based study conducted at ED-Dueim teaching hospital, during the period from September 2020 up to February 2021. Included all pediatric patients diagnosed with severe malaria admitted to the hospital during study period (n=177patients). Data collected by using questionnaire, then analyzed using the Statistical Package of Social Science (SPSS) computer program.
Results: Majority of patients 73.4% were with age group 0-5 years old , followed by 13.6% within age group 5-10 years old, 51% of patients were male and 49% were female, the most common tribes were Hassania represent 25.4% of patients, followed by Hawsa 14%, Dewahia 13%, Hassanat 6.8%, and 5.6% were Nuba. All patients presented with hyperpyrexia, 73.4% presented with hyperparacytemia, 39.5% with frequent vomiting, and 24.9% with severe anemia, then convulsion, hypoglycemia, jaundice, impaired consciousness, renal impairment and prostration. 51.4% of patients have normal plts count, 48.% have low Plts count while only 0.6% have high plts count. Among patients, 79.1% received Quinine, 12.4% were received Artesunate, while 6.8% received quinine then shifted to Artesunate.
Conclusion: Majority of patients were with age group 0-5 years old, Male, from Hassania and Hawsa tribes. The commonest criteria of severe malaria among patients were hyperpyrexia, hyperparacytemia, and frequent vomiting. Quinine was the first choice for severe malaria treatment.
Keerthi Aparanjitha
Natural product biodiversity provides a large supply of drug discovery leads. Natural products are thought to be more likely to produce therapeutic hits because they have a higher number of stereo centres, which increases scaffold diversity provided by organic structures with more fused, bridging, and Spiro carbocyclic rings. The effective separation of resveratrol from grapes has highlighted the benefits of red wine consumption in supporting metabolic health, implying medicinal promise as a therapy for metabolic disorders. Natural products or their semisynthetic derivatives account for over 40% of all pharmaceuticals, 60% of anticancer drugs, and 80% of antimicrobials in clinical use. The emerging trends in pharmaceutical development are synthetic forms of natural products.
Zlatko Dembic
Statement of the Problem: Heritable susceptibility to tuberculosis (TB) is complicated and polygenic in the nature. 5-10% of humans that come in exposure with the bacterium Mycobacterium tuberculosis (Mt) will get the disease, provided no acquired- or congenital immunodeficiency were present. We still lack a viable explanation for the observed epidemiologic fact.
Method: Activation of macrophages via proinflammatory cytokines IFN-v and interleukin (IL)-17 can kill intracellular bacteria such as Mt. Instead, macrophages stimulated by the Toll-like receptor (TLR)-10 agonists show an anti-inflammatory effect. The TLR-10 acts by inhibiting the TLR-2 signaling from the cell membrane. The TLR-2 is the Mt-binding protein by which activated macrophages can internalize (and finish) Mt. Inactivation of the TLR-2 protein might create a risk for acquiring the disease. This was supported by our finding that TLR2 gene polymorphisms, which either inactivate the TLR2 gene product or have a dominant negative role in TLR-2-signaling, associated with elevated risk for tuberculosis in the Croatian Caucasian population.
Findings: The genome-wide study found that three single nucleotide polymorphisms (SNPs) within the HLA class II loci were significantly related with TB; suggesting that adaptive immunity is of paramount importance for defense against TB. In our studied population, SNP in the TLR10 gene was associated with risk for Tuberculosis, analyzed by the dominant model of inheritance. However, this was contrasted by the fact that SNPs in the IL17A&F genes were not.
Conclusion & Significance: Studying genetic risk by association studies or genome-wide screening led us to propose that clinical manifestation of TB is a state above certain risk-threshold. Threshold is achieved by deposition of seemingly minor susceptibilities divided between the hallmarks of the disease. The model suggests that every human population has its own criteria’s of genetic risks for TB.
Regarding genetic predisposition to tuberculosis, we advice that the maximal risk for clinical manifestation requires complementation of sub-risks divided among the hallmarks of the disease. Clinical tuberculosis would only be known if at least one from each group of the genes encoding putative 5 (perhaps 7) hallmarks of the disease are mutated or changed epigenetically. These mutations/changes could be either sporadic (usually by the influence of the environment like other infection (HIV), nutrition, smoking, radiation etc.) or inherited. Ignorance of the immune attack is one of the hallmarks for TB that is shared with cancer. Perhaps, a similar immunotherapy as the recent one used in treating immunogenic types of cancer (anti-PD1, or/and anti-CTLA4) could be also successful in therapy of (multi-drug) resistant TB.
Consequently, we believe that it is important to study genetic risk factors for TB in every human subpopulation similarly as it is done for cancer, especially now that novel immunotherapies, have opened new ways to treatment of advanced cases
Active tuberculosis is a multi organ disease caused by primary infection or as a reactivation of hidden tuberculosis. Accordingly, active tuberculosis could be primary tuberculosis or reactivation tuberculosis. Primary tuberculosis occurs when the immune system is unable to protect against the Mycobacterium tuberculosis bacterium (MTB) infection. Reactivation tuberculosis, as the name suggests, is the reactivation of contained mycobacterial infection. Reactivation Tb is the most common form of active tuberculosis,revealing 90% of the cases. The lung is the most commonly known organ, other organ systems commonly affected include the gastrointestinal system, the musculoskeletal system, the lymphoreticular system, skin, liver, and the reproductive system.
The World Health Organization (WHO) estimates that, annually, around 8 million people get active tuberculosis globally, and nearly 2 million people die from this disease. Of every 10 people infected with M. tuberculosis, one may develop an active infection at any point of time in their lifetime. The WHO reported in 2017 that the estimated global incidence rate for tuberculosis has decreased by 1.5% each year since 2000. However, despite these substantial gains and drastic global efforts to eradicate tuberculosis, the disease still accounts for significant morbidity and mortality worldwide. Developing countries like India, Pakistan, the Philippines, China, South Africa, Indonesia, and Nigeria experience the highest morbidity and mortality rates. When combined, these countries accounted for 64% of all tuberculosis-related deaths in 2016, according to the WHO.
K. M. Yacob
According to the facts of physics, if temperature progresses, thermal expansion of an object is positive it will expand and with the decline in temperature, it will shrink. Pressure will increase due to an increase in temperature. On the contrary, during fever we can observe blood vessels and skin are shrunk, pressure decreases, body shivers, sleep increases, motion decreases, inflammation increases, body pain increases, blood circulation decreases, dislike cold things etc. In fever, the firing rate of Warm sensitive neurons declines, and the firing rate of cold-sensitive neuron increases. At the same time if we apply hotness from outside by thermal bag or if we drink hot water, our body responds according to the facts of physics: increase of temperature pressure will also increase, expands blood vessels and skin, body sweats, motion will increase, inflammation will decrease, body pain will decrease, blood circulation will increase, like cold substances etc. During fever, why do our body acts against facts of physics? When disease progresses, pressure and temperature will decline. Blood circulation will decrease due to a decrease of pressure. If the essential temperature of the body is going out, essential temperature and pressure will further decline. This will further endanger the life or action of the organ. When disease increases, it is the sensible and discreet action of the brain that tends to respond against facts of physics to sustain life or prevent organ. There is no way other than this for a sensible and discreet brain to prevent the life or organ. We will get a clear answer if we find out the purpose of fever, sensible and discreet action of the brain. No medical books clarify this. During fever, if the temperature of fever is not a surplus temperature or if it is not supposed to be eliminated from the body, the shrinking of skin and blood vessels, shivering of body, dislike towards cold substances etc., are a protective covering of the body to increase blood circulation to important organs of the body it is against the facts of physics.
According to the facts of physics, if temperature increases, thermal expansion of an object if positive it will expand and with decrease of temperature it will shrink. Pressure will increase due to increase of temperature. On the contrary, during fever we can see the following situations - blood vessels and skin are shrunk, pressure decreases, body shivers, sleep increases, motion decreases, inflammation increases, body pain increases, blood circulation decreases, dislike to have cold substances etc. The temperature increasing and decreasing controlled by brain. Disease or cause of diseases signals the brain to create fever and shivering. In temperature increasing hyperthermia, the firing rate of warm sensitive neurons increases, and inhibit cold sensitive neurons. Contrary to this during fever the firing rate of warm sensitive neurons decreases and the firing rate of cold sensitive neurons increases. In temperature decreasing hypothermia, as in fever the firing rate of warm sensitive neurons decreases and the firing rate of cold sensitive neurons increases. If the aim of cold sensitive neurons increasing their firing rates in hypothermia is to increase blood circulation, then the aim of cold sensitive neurons increasing their firing rates during fever is also to increase blood circulation. If the aim of shivering in hypothermia is to increase blood circulation, then the aim of shivering during fever is also to increase blood circulation. If set point is below there is no necessary of shivering to increase temperature. At the same time, if we apply heat from outside by thermal bag or if we drink hot water, our body acts according to the Facts of Physics -which means, if temperature increases pressure will also increase, expands blood vessels and skin, body sweats, motion will increase, inflammation will decrease, body pain will decrease, blood circulation will increase, like to have cold substances etc. We will get a clear answer if we discover the purpose of fever, sensible and discreet action of brain. No medical books have ever clarified this till date. When disease progresses, pressure and temperature will decline. Blood circulation will decrease due to decrease of pressure. If the essential temperature of the body is going out, essential temperature and pressure will further decrease. This will further endanger the life or action of organs. When disease increases, it is the sensible and discreet action of brain that tends to act against facts of physics to sustain life or protect organs. There is no way other than this for a sensible and discreet brain to preserve the life or organ. During fever, if the temperature of fever is not a surplus temperature or if it is not supposed to be eliminated from the body, the contraction of skin and blood vessels, shivering of body, an aversion towards cold substances etc. are a protective covering of the body to increase essential blood circulation to important organs of the body and this action is against the facts of physics. In all diseases, which decreases essential blood circulation, our body will acts against the facts of physics to increase essential blood circulation.
Francesca J Torriani
Prevention of Healthcare related Infections has been the focus of Infection Prevention and Quality Initiatives for more than two decades, and multidrug resistant organisms are responsible for many of these infections, further messing up their diagnosis. In addition to strengthening antimicrobial stewardship practices, and improving adherence to standard precautions (including hand hygiene), contact precautions for patients colonized or infected with multidrug resistant organisms have been advised and broadly adopted to prohibit horizontal transmission in the acute care healthcare setting. However, the data firming these recommendations derives predominantly from epidemic rather than endemic settings, where the burden of transmission as well as the transmission rate is by definition high. Guidelines underscore the cruciality of a basic multiprong step that includes education around epidemiologically important organisms, hand hygiene, contact precautions, environmental cleaning and antimicrobial stewardship. Additional measures recommended in the outbreak setting, such as active screening for MDR GNR, MRSA and VRE, alerts for previous positives with pre-emptive CP, and cohorting of patients and staff, etc have also been presented on occasion. The presenter will discuss the strengths and weaknesses of these steps when used alone or in conjunction, and will argue that the focus on the primacy of contact precautions in acute care settings is misplaced for most MDR organisms. Alternative focus and practices will be presented.
The occurrence and undesirable complications from health care–associated infections (HAIs) have been well recognized in the literature for the last several decades. The occurrence of HAIs continues to rise at a dramatic rate. HAIs originally referred to those infections related with admission in an acute-care hospital (formerly called a nosocomial infection), but the term now applies to infections acquired in the continuum of settings where persons get health care (e.g., long-term care, home care, ambulatory care). These unanticipated infections happen during the course of health care treatment and result in significant patient illnesses and deaths (morbidity and mortality); prolong the duration of hospital stays; and necessitate additional diagnostic and therapeutic interventions, which generate added costs to those already incurred by the patient’s underlying disease. HAIs are considered an undesirable outcome, and as some are preventable, they are considered an indicator of the quality of patient care, an adverse event, and a patient’s safety issue.
the most frequent types of adverse events affecting hospitalized patients are bad drug events, nosocomial infections, and surgical complexities.1, 2 From these and other studies, the Institute of Medicine reported that adverse events affect approximately 2 million patients each year in the United States, resulting in 90,000 deaths and an estimated $4.5–5.7 billion per year in additional costs for patient care.3 Recent modification in medical management settings have shifted more medical diagnosis and services to outpatient settings; fewer patients are accepted into hospitals. The disappointing fact is that the average duration of inpatient admissions has declined while the frequency of HAIs has increased.4, 5 The true incidence of HAIs is likely to be underestimated as hospital stays may be shorter than the incubation period of the infecting microorganism (a developing infection), and symptoms may not come up until days after patient gets discharged. For example, between 12 percent and 84 percent of surgical site infections are detected after patients are released from the hospital, and most become evident within 21 days after the surgical operation.6, 7 Patients receiving follow up care or routine care after a hospitalization may seek care in a non acute care facility. The reporting systems are not as well networked as those in acute care facilities, and reporting mechanisms are not directly connected back to the acute care setting to document the suspected origin of some infections.
HAI surveillance has monitored continous trends of infection in health care facilities.8 With the application of published evidence-based infection control strategies, a decreasing trend in certain intensive care unit (ICU) health care-associated infections has been reported through national infection control surveillance9 over the last 10 years, although there has also been an alarming increase of microorganism isolates with antimicrobial resistance. These modifying trends can be affected by factors such as increasing inpatient acuity of illness, inadequate nurse-patient staffing ratios, unavailability of system resources, and other demands that have challenged health care providers to continuosly apply evidence-based recommendations to maximize prevention efforts. Despite these demands on health care workers and resources, reducing preventable HAIs remains an imperative mission and is a contagious opportunity to improve and broaden patient safety.
Liana Monica Deac
Foodborne illness afflicts people throughout the world. The CDC defines a foodborne disease outbreak as the occurrence of two or more similar illnesses resulting from intake of a common food. Each year, in USA, one in 10 people experiences a foodborne illness, 128,000 are hospitalized, 3,000 die, and 33 million healthy life-years are lost. While few patients with foodborne illness are alive with life-threatening symptoms, there are a number of foodborne infectious diseases and toxins that the emergency physician or other health care provider must consider in the reports of these patients. Given the frequency of international travel, as well as the risk relation with recurrent outbreaks of foodborne illness from commercial food sources, it is important to recognize various syndromes of foodborne illness, including those which may require specific analysis and management steps. Foodborne illness shows a significant public health threat to the United States. The disease is defined as any ailment associated with the ingestion of contaminated food and is most oft en associated with gastrointestinal symptoms, including diarrhea, nausea, and/or vomiting. Individuals who are aged less than 5 years or more than 60 years or who are immune compromised are at greatest risk for acquiring a foodborne illness. The most common cause of gastroenteritis is Salmonella infection. Annually, nontyphoidal Salmonella causes 1.2 million cases of foodborne illness and 450 deaths. Most Salmonella presence was attributed to seeded vegetables (6.9%), pork (4%), or vegetable row crops (1.7%).
Adults older than 65 years, people with weakened immune systems, and nonbreastfed infants are more likely to have severe infections. Approximately 8% of patients with nontyphoidal salmonellosis will develop bacteremia and require treatment with antibiotics, including ceftriaxone or azithromycin in children and a fluoroquinolone (commonly levofloxacin) or azithromycin in adults. The summer months (peaking in July or August) had the highest percentage of cases. The use of certain medications to reduce stomach acidity can increase the risk of Salmonella infection. The food safety systems in some countries does better consumer protection than others. This situation, combined with differing climates and ecologies, results in the association of different types of foodborne illness with different regions of the world. In a global economy, both people and food travel the world. Clinicians must consider foreign travel as well as the consumption of food from other parts of the world when determining the cause of foodborne disease. The point to decline the incidence of foodborne illness is prevention. Proper food storage, refrigeration, handling, and cooking are vital. Patients should be aware enough to avoid high-risk items such as unpasteurized milk and milk products, as well as raw or undercooked items like oysters, meat, poultry, and eggs. The use of more meals in the home may also decrease the risk of foodborne illness.
CDC defines a foodborne disease outbreak as the occurrence of two or more similar illnesses resulting from ingestion of a common food. The disease is defined as any filament associated with the ingestion of contaminated food and is most often associated with gastrointestinal symptoms, including diarrhea, nausea, and/or vomiting. It is important to identify various syndromes of foodborne illness, including those, which may require specific evaluation and management strategies. The food safety systems in some countries afford better consumer protection than others. This situation, combined with differing climates and ecologies, results in the association of different types of foodborne illness with different regions of the world. In a global economy, both people and food travel the world and can offer foodborne morbidity everywhere.
From eating contaminated food, anyone can get food-borninfection, which as case definition, includes specific criteria for person, place, time, and clinical aspects.
• Every country around the world, get medical social and economic sufferings from foodborne illnesses, which became a possible active today medical emergency everywhere.
• The population must be educated for good Hygiene uses, to avoid the illnesses.
• For protecting people from the disease, there is needed tosurvive correct each chain of food production: processing, transportation, handling, and all correct food preparation steps.
• To prevent a Food-born infection, there is necessary to washregular hands and surfaces, as more often possible.
• A useful prevent and control activity in Food born disease, is to put together: epidemiologists, environmental health specialists, laboratory specialists, clinicians, as all other specialists with possible enteric disease outbreak connections and therapy responsibilities.
Samer M Al-Hulu
Bio-surfactants are amphiphilic biological compounds made extracellular or cell membrane part bacteria, yeast and filamentous fungi. Bio-surfactants are made up of a hydrophilic moiety, may be acid, peptide, action, anion, mono, di or polysaccharides and a hydrophobic moiety, which may be unsaturated or saturated hydrocarbon chains or fatty acids. Many advantages for bio-surfactants comprise biodegradability, low toxicity, biocompatibility and digestivity, presence of raw materials and specificity. The bio-surfactant production was known by many methods includes, hemolytic activity, oil displacement test emulsification index, surface tension reduction, blue agar plate or CTAB agar plate method, hydrocarbon overlay agar method. There are many medial applications for bio-surfactant which includes antimicrobial activity. Biosurfactants having capacity to be toxic on cell membrane permeability in similar method to detergent effect, anti-cancer activity, the neuronal differentiation in PC 12 cells induced by MEL and get ready the ground work for the use of microbial extracellular glycolipids as novel reagents for cancer cell treatment, antiviral activity, the sophorolipids surfactants produce by C. bombicola having structural analogues such as the sophorolipiddiacetate ethyl ester which is powerful spermicidal and virucidal agent and its virucidal activity similar to nonoxynol-9 against the human semen. Anti-adhesive agents, bio-surfactants having capability for adhesion residing for pathogenic organisms to solid surfaces or infection site, anti-fungal activity, flocculosin is a glycolipid produced by yeast like fungus P. flocculosa having antifungal activity against pathogenic yeasts and human mycoses. Immunological adjuvants, bacterial lipo-peptides when mix with classic antigens having active nontoxic, nonpyrogenic immunological adjuvants. Gene delivery, the liposomes based on bio-surfactants having increasing efficiency for gene transfection than cationic liposomes trading use.
Microbial compounds that possess pronounced surface and emulsifying activities are categorized as biosurfactants. Biosurfactants include a wide range of chemical structures, such as glycolipids, lipopeptides, polysaccharide–protein complexes, phospholipids, fatty acids and neutral lipids. For instance, Cooper and Goldenberg described different bio emulsifiers produced by two Bacillus species in water-soluble substrates with different emulsifying and surface activities. It is, therefore, reasonable to expect different properties and physiological functions for unique groups of biosurfactants. Moreover, these molecules can be tailor-made to suit different applications by modifying the growth substrate or growth conditions. Although most biosurfactants are regarded to be secondary metabolites, some may play crucial roles for the survival of biosurfactants-producing microorganisms through facilitating nutrient transport or microbe–host interactions or by acting as biocide agents. Biosurfactant roles include increasing the surface area and bioavailability of hydrophobic water-insoluble substrates, heavy metal binding, bacterial pathogenesis, and quorum sensing and biofilm formation. Biosurfactants are amphipathic molecules with both hydrophilic and hydrophobic moieties that partition preferentially at the interface between fluid phases that have different polarity and hydrogen bonding, such as oil and water or air and water interfaces. This property elaborates their wide use in environmental applications. Most work on biosurfactant applications has been focused on their use in environmental applications owing to their diversity, environmentally friendly nature, suitability for large-scale production and selectivity. Despite their potential and biological origin only a few studies have been carried out on applications related to the biomedical field. Some biosurfactants are suitable alternatives to synthetic medicines and antimicrobial agents and may be used as safe and effective therapeutic agents
Synthetic surfactants are becoming increasingly unpopular in many areas and applications due to previously disregarded effects on biological systems and this has led to a new focus on replacing such products with biosurfactants that are biodegradable and created from renewal resources. Microbially derived biosurfactants have been investigated in numerous studies in areas including: increasing feed digestibility in an agricultural context, improving seed protection and fertility, plant pathogen control, antimicrobial activity, ant biofilm activity, wound healing and dermatological care, improved oral cavity care, drug delivery systems and anticancer treatments. The development of the potential of biosurfactants has been stopped somewhat by the myriad of steps taken in their investigations, the focus on pathogens as source species and the costs associated with largeâ?scale production. Here, we focus on various microbial sources of biosurfactants and the current trends in terms of agricultural and biomedical applications.
Yoshinori Hayakawa
Universal influenza vaccine is proposed and under development. Universal vaccine seems not to be payable for many people in developing countries, (dangerous pandemics usually start at developing countries from bird influenza). Artificial pandemics by infectious attenuated live vaccine are proposed. Ferret nasal mucosa is carcinized using carcinogen for easiness of incubation. Bird influenza virus is attenuated by reverse genetics. The virus is marked by green fluorescent protein. This attenuated virus is sprayed to many cultured cancer cell specimen incubated. In some specimen attenuated virus will mutate to increase in cancer cells, checked by green fluorescence. Then the virus is tested to infect ferret and then human volunteers without serious syndrome. Virus with strongest virus titer to infect ferret is selected as seed virus of infectious attenuated live vaccine. The seed virus will be increased in incubated cancer cells by bioreactors all over the world and sprayed to vulnerable people, e.g. soldiers, students, people in slams, medical staffs and people engaged in lifeline. Artificial pandemics of dangerous virus as H7N9, H5N1 etc. are to be created serially with few years interval. Artificial pandemic should be initiated before wild type pandemic starts. One reason is to avoid reassortment (mixture) of virus RNA and another is to avoid clinical confusion. It should not overlap with influenza season. All inclusive flu immunization is proposed and being worked on. All inclusive antibody appears not to be payable for some individuals in creating nations, (risky pandemics typically start at creating nations from winged animal flu). Fake pandemics by irresistible constricted live immunization are proposed. Ferret nasal mucosa is carcinized utilizing cancer-causing agent for ease of hatching. Winged creature flu infection is weakened by invert hereditary qualities. The infection is set apart by green fluorescent protein. This constricted infection is splashed to many refined malignancy cell example brooded.
In some example weakened infection will transform to increment in malignancy cells, checked by green fluorescence. At that point the infection is tried to taint ferret and afterward human volunteers without genuine condition. Infection with most grounded infection titer to taint ferret is chosen as seed infection of irresistible lessened live antibody. The seed infection will be expanded in hatched malignant growth cells by bioreactors everywhere throughout the world and showered to weak individuals, for example officers, understudies, individuals in pummels, clinical staffs and individuals occupied with help. Fake pandemics of perilous infection as H7N9, H5N1 and so on are to be made sequentially with not many years stretch. Counterfeit pandemic ought to be started before wild sort pandemic beginnings. One explanation is to maintain a strategic distance from reassortment (blend) of infection RNA and another is to keep away from clinical disarray. It ought not to cover with flu season.
Infectious attenuated live influenza vaccine of candidate virus of new influenza pandemic is to be distributed to many people. Artificial pandemic happens as people have no immunity against it. Resultantly, they will obtain basic immunity to the virus. So wild type outbreak of pandemic does not occur. Even if wild type human to human transfer occurs, the scale is of seasonal influenza and number of victims are much less. It should be started as it is ready. If artificial pandemic overlaps with wild type pandemic, reassortation (mixture) of RNA may happen in patients’ cell infected to both of them simultaneously. It should avoid influenza season of winter as well by the same reason. If infection is done intensively, artificial pandemic will be finished within 2 month all over the world (initiate on April or September). It will not increase virulence as 1918 Spanish influenza did during long period of transmission. Especially vulnerable people, e.g., soldiers, students, people in slums, medical staffs, and people engaged in lifelines, policemen, firemen, and officials of politics are to be eagerly infected by spray of live vaccine virus on the nose. As infectious live attenuated vaccine is incubated in nasal mucosal cancer, airborne transmission seems to be dominant and strongly infectious between people. Method to increase infectious attenuated vaccine and to distribute all over the world. Quality of Infectious attenuated live influenza vaccine should be kept assured concerning its infectivity, effectiveness against wild bird influenza, and minimal virulence. If once low quality infectious vaccine were infected to men, it will result pandemic with miserable result.
Malaria Control & Elimination received 1187 citations as per Google Scholar report
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