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   2020| April  | Volume 13 | Issue 4  
    Online since March 25, 2020

 
 
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REVIEW ARTICLE
Crimean-Congo hemorrhagic fever: etiology, diagnosis, management and potential alternative therapy
Mohammad Saleem, Muiz Tanvir, Muhammad Furqan Akhtar, Ammara Saleem
April 2020, 13(4):143-151
DOI:10.4103/1995-7645.280221  
Crimean-Congo hemorrhagic fever (CCHF) virus belongs to the genus Nairovirus and family Bunyaviridae. CCHF is a tickborne disease that has mostly been reported from Asia, Africa and Europe. Early diagnosis of CCHF is essential for patient care and preventing its spread to normal individuals. Treatment of CCHF is mostly limited to the use of ribavirin and palliative care. The practice of using interferon and vaccines has also been proved to be ineffective and unsafe. A search for an effective alternative treatment of the CCHF still continues. Therefore, the current review focusses on the cause, prevalence, mode of transmission, pathophysiology, signs, symptoms, diagnostic features and treatment options of CCHF. This review also highlights the possible alternative therapy in the form of antiviral medicinal plants which are effective against viral hemorrhagic fever. These medicinal plants have shown convincing evidence for their activities against different viral hemorrhagic fevers and may be used alone or in combination with existing therapies to achieve an optimum therapeutic response.
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GUIDELINES
Expert consensus guidelines on clinical use of Xiyanping injection for acute infectious diseases
Banghan Ding, Bangjiang Fang, Jun Li, Qingquan Liu, Chuanzhu Lv, Xuezhong Yu, Xiaodong Zhao
April 2020, 13(4):152-161
DOI:10.4103/1995-7645.280222  
Xiyanping injection, a traditional Chinese medicine injection made of andrographolide sulfonate, consisting of well-defined ingredients with antiviral, antibacterial, anti-inflammatory and antipyretic efficacy, has been widely used for treating infectious diseases of respiratory and digestive systems. However, its wide applications may easily lead to unreasonable clinical medication. In order to guide the precise clinical application and rational use of Xiyanping injection, experts in related fields conducted systematically literature review, evaluated and deliberated the application of Xiyanping injection in treating acute infectious diseases using evidence-based medicine method, and jointly drafted the consensus to summarize types of acute infectious diseases in children and adults that can be treated with Xiyanping injection, and recommend the intervention time, usage and dosage, course of treatment and combined medication of the injection. Besides, the consensus elucidates the safety, precautions and contraindications of the injection, so as to provide guidance for clinical use.
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ORIGINAL ARTICLES
Provincial clustering of malaria in Iran between 2005 and 2014
Vahid Moqarabzadeh, Ahmad Ali Enayati, Ahmad Raeisi, Fatemeh Nikpour, Jamshid Yazdani Charati
April 2020, 13(4):162-168
DOI:10.4103/1995-7645.280223  
Objective: To reveal the provincial clustering of malaria in Iran between 2005 and 2014 based on the epidemiologic factors and the climatic indicators affecting the disease. Methods: This was a descriptive-analytical study using malaria and meteorological data from the Malaria Elimination Programme of the Ministry of Health and Medical Education and National Meteorological Organization. After standardization, the aggregate data was used to produce 10-year means for each province. The data analysis included grouping the provinces with respect to factors using hierarchical clustering method and Kruskal-Wallis test to examine the difference between clusters using SPSS ver.23. Results: The hierarchical clustering stratified the provinces’ in 5 clusters. Kruskal-Wallis H test revealed a significant difference in the incidence rate per 100 000 population (P=0.001), male gender (P=0.001), Iranian nationality (P=0.001), Afghan nationality (P=0.003), Pakistani nationality (P=0.001), urban residence (P=0.006), rural residence (P=0.004), autochthonous cases (P=0.007), average minimum temperature (P=0.001), average maximum temperature (P=0.007), average relative humidity (P=0.011), average pressure level (P=0.038), prevailing wind direction (P=0.023), average wind speed (P=0.031) and average precipitation sum (P=0.002) among the clusters. Conclusions: The results of this study and stratification of the provinces could help health policy makers to better manage malaria by allocating resources accordingly.
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LETTERS TO EDITOR
Epitope finding in 2019 novel coronavirus (2019-nCoV): The first world report
Beuy Joob, Viroj Wiwanitkit
April 2020, 13(4):187-188
DOI:10.4103/1995-7645.277515  
  830 259 -
ORIGINAL ARTICLES
Epidemiological, molecular characterization and risk factors of human brucellosis in Iran
Afshar Etemadi, Rezvan Moniri, Mahmood Saffari, Hossein Akbari, Saeed Alamian, Ali Mohammad Behrozikhah
April 2020, 13(4):169-175
DOI:10.4103/1995-7645.280224  
Objective: To determine epidemiological, molecular characterization, and potential risk factors of human brucellosis. Methods: This descriptive study was carried out in the clinical setting in Iran between 2017 and 2018. A total of 297 participants enrolled in the study. The sample size was calculated based on the occurrence rate of brucellosis in different areas. Patients were assessed using serological tests and conventional culture methods. Phage and multiplex PCR methods typed all of Brucella isolates. Potential risk factors of disease were determined. Results: A total of 141 of 297 (47.5%) Brucella strains were isolated and all of them were detected as Brucella melitensis biovar 1. Based on serologic titers, high culture positivity was recorded at 1/640 titer (P<0.006). The risk factors for brucellosis were patients older than 40 years (OR=2.23, 95%CI: 1.4-3.55, P=0.001), animal keeper (OR=7, 95%CI: 1.51-32.41, P=0.005), housewife (OR=8.76, 95%CI: 1.85-41.37, P=0.002), farmer (OR=6.42, 95%CI: 1.21-33.97, P=0.019), and contact with animal (OR=1.31, 95%CI: 0.60-2.85, P=0.005). Conclusions: To the best of our knowledge, this is the first comprehensive report from Iran presenting the detection of Brucella species by the multiplex PCR. Brucella melitensis biovar 1 is still the dominant causative agent in Iran. The consumption of unpasteurized dairy products, living in rural areas, and animal contact were risk factors of brucellosis.
  801 226 -
LETTERS TO EDITOR
COVID-19 international outbreak and the need for a suitable estimation model: A second-order polynomial equation with constant coefficients based on imported infected cases seems inadequate
Hamid Reza Niazkar, Majid Niazkar
April 2020, 13(4):185-186
DOI:10.4103/1995-7645.280234  
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EDITORIAL
Call for accurate statistical data to solve snakebite conundrum in India
Saurabh Bhargava, Kiran Kumari, RK Sarin, Rajvinder Singh
April 2020, 13(4):141-142
DOI:10.4103/1995-7645.280235  
  687 213 -
ORIGINAL ARTICLES
Antimalarial activity of the aqueous extract of Euphorbia cordifolia Elliot in Plasmodium berghei-infected mice
Raceline Gounoue Kamkumo, Jaures Marius Tsakem Nangap, Lauve Rachel Tchokouaha Yamthe, Florence Ngueguim Tsofack, Patrick Valère Tsouh Fokou, Mariscal Brice Tchatat Tali, Théophile Dimo, Fabrice Fekam Boyom
April 2020, 13(4):176-184
DOI:10.4103/1995-7645.280239  
Objective: To evaluate the antimalarial activity of the aqueous extract of Euphorbia (E.) cordifolia Elliot against Plasmodium (P.) berghei-infected mice. Methods: Thirty healthy Swiss mice were intraperitoneally inoculated with 200 μL of P. berghei parasitized-erythrocytes and divided into five groups, and then daily treated for 5 d with single dose of 10 mL/kg of distilled water for malaria control, 10 mg/kg of chloroquine for the chloroquine control and 100, 200 and 400 mg/kg of the aqueous extract of E. cordifolia for the three test groups. Parasitaemia was monitored by Giemsa-staining. At the end of the treatment, animals were sacrificed, and blood was collected for haematological and biochemical analyses. Organs were collected for biochemical and histopathological analyses. Statistical significance (P<0.05) was evaluated by analysis of variance followed by the Tukey post-test using Graphpad prism 7.0. Results: E. cordifolia extract decreased the parasite load to 2.46%, with an effective dose (ED50) of 113.07 mg/kg compared to the malaria group where the parasite load increased to (46.46±10.28)%. E. cordifolia extract prevented hypoglycaemia, anaemia, leucocytosis and thrombocytopenia, attenuated the increase of transaminases activities, bilirubin and creatinine rate, and improved catalase and superoxide dismutase activities, while reducing malondialdehyde contents in the liver and kidney. E. cordifolia extract significantly prevented histological damages observed in the malaria control group. No acute toxicity sign was observed in mice with plant extract at the dose up to 5 000 mg/kg. Conclusions: E. cordifolia extract at 200 and 400 mg/kg showed significant antimalarial effects. This results support its traditional use in the treatment of malaria.
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