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Botulism is the disease caused by botulinum neurotoxins. It is produced by an obligate anaerobic bacteria called Clostridium botulinum. There is no immuno-detection system available in the world for the detection of C. botulinum. Secretory proteins of cooked meat media grown C. botulinum type B were extracted by TCA precipitation method. Polyclonal antibodies were generated against secretory proteins. Cytokine profiling of secretory proteins were done. An immunodetection system was developed to detect the C. botulinum type B using Secretory proteins of C. botulinum type B.

The problems of guaranteeing the best possible social and health services in every part of the world to combat any form of disability and limitation of participation for all, as indicated by international ethical-political documents, are still very great. A critical point that could favour this progress is to enhance the integration between the growing potential of rehabilitation science (medical and clinical evidence, technologies, and training of numerous operators..) and the ability of communities as a whole to stimulate, support and qualify these interventions with the participation of citizens (families, neighbours and associations) who can voluntarily actively carry out important synergistic actions in many fields. This could develop in any socio-economic condition; in developed ones supporting and finalizing any treatment in common life and in developing countries offering competencies and knowledge to the strong funding actions of community projects aimed at populations with disabilities in this part of the World. The community of rehabilitation professionals, national governments and rulers, and international institutions (UN, WHO..) must well understand this aspect and make it their own in training, in the definition of care protocols, in the definition of the organization of socio-health and rehabilitation systems in each country in relation to the different local economic and cultural conditions.

The human immune system consists of innate and adaptive immune responses which both provide protective immunity to microbial infection. The adaptive immune system consists of T and B cell which act as second line defense through production of neutralizing antibody by B cells and cytotoxic activity of CD8+ T cells. The CD4+ T-cell performs a central role in the immune responses. These cells also known as T4 or helper/inducer T lymphocytes recognize antigens presented by antigen presenting cells (APC) such as macrophages and monocytes. Once antigens such as bacteria and viruses are presented, CD4+ T lymphocytes orchestrate the body’s antigen-specific immune response by Coordinating B-lymphocyte production of antibodies to these antigens, producing cytokines and induction of cytotoxic T-lymphocytes. The paper was aimed to review the role of T-helper cells (CD4+ T cells) in human immune system against some microbial infections.

The introduction of a new class of drugs known as direct acting antiviral (DAA) agents represents a revolution in the treatment of hepatitis C virus (HCV) in the general population, as these regimens are associated with higher sustained virological response (SVR) rates and fewer side effects. However, for patients with advanced chronic kidney disease suffering from HVC infection, treatment options including DAA remain limited. The aim of this study is to report our experience on Sofosbuvir (SOF) based regimen in the treatment of HCV in hemodialysis patients.In this observational study, we included all patients with chronic HCV infection on hemodialysis who were treated with SOF in our Hospital between April 2016 and March 2018. All patients were treated with a combination of 400 mg of SOF three times a week after hemodialysis and of 60 mg of Daclatasvir daily for a total of 12 to 24 weeks.A total of 20 hemodialysis patients were included in this study. 12 were females and the mean age was 52.1 ± 15.5 years. 11 patients were infected with HCV genotypes 1b. All patients achieved SVR. Clinical and biological tolerance was very good for all patients and none of them had to discontinue treatment because of side effects or developed hepatobiliary and cardiac toxicity. Two patients reported fatigue and another patient reported headaches. However, these symptoms were spontaneously resolved after the end of the treatment.In Morocco, despite the absence of new DAA combination treatment regimens which are not renally eliminated, our study concludes that SOF based treatment without Ribavirin or Peginterferon was effective and safe with minimal side effects. However, larger studies are still needed in order to validate these results.

Despite decades of global and country commitments towards eradicating malaria, malaria remains the most hazardous parasitic disease and the most common cause of fever for humans, especially in tropical countries. Plasmodium falciparum causes 90% of malaria cases. Coma [Cerebral Malaria (CM)], acidosis, hypoglycemia, severe anemia, renal dysfunction, and pulmonary edema are the most common complications of malaria caused by Plasmodium falciparum and the most common cause of death related to malaria. People from less prevalent malaria areas are at high risk of developing these complications. A 16-year-old male from a low malaria transmission area was diagnosed with CM. Prior to developing CM, he was treated with Coartem. CM is a medical emergency and one of the forms of severe malaria. CM has high mortality and morbidity rates. Yet, international health-related agencies, funders, and policy-makers are unfamiliar with it. The continuous occurrence of CM validates the considerable need for global investment in malaria control and elimination programs. Early administration of Artesunate to all patients suspected of having severe malaria would reduce global malaria-related mortality and morbidity. Simple tests, such as the determination of malaria parasitic density either with thin or thick blood smears, may influence the proper management of all severe malaria cases. However, in clinical practice, the determination of malaria parasitic density is not routinely done. Further commitments are needed to ensure routine determination of malaria parasitic density for all suspected severe malaria cases. Moreover, further commitments are needed to guarantee the proper management of CM because it is a major cause of reversible encephalopathy in tropical countries.

Background: There is a huge global loss of lives due to COVID-19 pandemic, the primary epicentre of which is China, where the causative agent of the disease, SARS-CoV-2 was first emerged in December 2019. This study aims to explore the severity, in terms of case fatality rate (CFR), of COVID-19 pandemic. Methods: Data of ongoing COVID-19 global pandemic were retrieved from website of the WHO, and processed for the estimation of global (both including and excluding China) CFRs of COVID-19. CFRs were explored following the naive estimates, 14-day delay estimates, and linear regression model analysis, during January 25, 2020 to April 25, 2020, on weekly basis. To explore the current situation, in terms of CFR, data for the next 13 weeks (May 2, 2020 through July 25, 2020), were processed by naive and linear regression model analysis. Results: Mean CFRs, in naive estimates, were 4.59% for the world including China, and 3.62% for the world excluding China. The 14-day delay estimates of CFRs were 15.6% globally, and 21.65% in countries outside China. Following statistical model, global (both including and excluding China) CFRs were 6.81%, by naive estimates, and ~13%, by 14-day delay estimates. Global CFRs of COVID-19 during May 2, 2020 to July 25, 2020, ranged 4.1% – 7.04%, by naive estimates, and by statistical regression analysis the CFR was 3.19%. Conclusion and recommendations: The CFR might help estimate the need of up-to-date hospital supplies and other mitigation measures for COVID-19 ongoing pandemic, and therefore, instantaneous CFR estimations are recommended.

Background: The National Strategic Plan for HIV Prevention and Control 2014-2018 recognized the need for the utilization of research findings to guide the development of HIV policies, programs and interventions for the general population and key population groups and to inform the allocation of government resources to the areas of greatest impact and need. To this end, a Knowledge, Attitudes, Beliefs and Sexual Practices Survey (KABP) was conducted among adults’ ages 15 to 49 years. Objectives: To identify the sexual behaviors among adolescents and young adults that exposed them to the risks of HIV/STIs and to identify factors that may have to be addressed, in order to achieve further reduction in the spread of HIV in this population. Methods: This is a population based cross-sectional survey undertaken in 2016. Sample was taken from among persons’ ages 15 – 49 years using a multistage sampling methodology. The survey questionnaire was developed from Family Health International’s guidelines for repeated behavioral surveys in populations at risk of HIV. It was interviewer-administered and consisted of ninety-nine (99) closed-ended questions. The topics covered by the survey included sexual history; use of and access to condoms; and HIV testing. Participants were asked about their sexual behaviors over the last 12 months, and about their experience with their most recent partner. Results: Overall, 87.8% described themselves as heterosexual, 1.2% as bisexual and 0.5% as homosexual. By the age 16, 17 1nd 19 years 25%, 50% and 75% of respondents have had sex respectively. Among the 763 respondents reporting vaginal or anal sex over the past 12 months, 80.6 and 19.4% had a single and multiple sex partner respectively. Also, 94.4%, 13.3% and 1.6% reported to have regular, non-regular and commercial sex partners respectively. Overall, 54.6% used condom at the last sex, the corresponding figure for the regular and non-regular partners were 41.2% 80.8% respectively. Only 40.9% reported to have had a HIV test done over the past 12 months and of those who did not, 42.8% had never been tested for HIV. Conclusion: Inconsistent and infrequent condom use and low HIV testing especially among the adolescents and younger adults, in the setting of young ages at sexual debut and multiple sexual partners. Findings form this study strongly recommends for a much greater effort from the public health at promoting condom use and HIV testing especially targeting the younger persons who risk their own protection and that of their partners.

Introduction: HIV infection leads to metabolic disorders. The objective of this work was to study the lipid profile of HIV + patients followed at the University Teaching Hospital of Kinshasa (UTHK). Methods: This study analyzes the lipid profile of HIV + patients, aged at least 18 years, followed at the UTHK from January 1, 2008 to December 31, 2014. The medians of different types of lipids, the frequency of lipid disorders, the general clinical characteristics of patients and factors associated with dyslipidaemia were studied. Haemoglobin (Hb), White Blood Cells (WBC), Leukocyte Formula (LF), Blood Sugar, Urea, Creatinine, Transaminases, Uric Acid, CD4s+ count were analyzed. Results: The lipid balance was performed in 38.8% of patients; 38.1% of them had dyslipidaemia. Total hypercholesterolaemia (28.6%), elevated LDL-C (19%), hypertriglyceridemia (23.8%) and HDL hypocholesterolaemia (42.9%) were observed. The medians of TG (128 mg / dL), HDL-C (51 mg/dL) and LDL-C (78 mg/dL) were high. Risk factors associated with dyslipidaemia were represented by WHO stage 4, tuberculosis (TB) and hyperglycaemia. The highest levels of LDL-C and TG and the lowest HDL-C were seen when CD4s+ were below 200 elements/µL. Conclusion: The HIV/AIDS dyslipidaemia characterized in this study by HDL-C hypocholesterolaemia, hypertriglyceridemia and total and LDL hypercholesterolemia can be considered as an indicator of the progression of HIV infection.

The outbreaks and resurgence: The disease which reportedly began in the Chinese city Wuhan in November-December 2019, soon spread to various parts of the world, and was named and declared a pandemic disease by WHO. While the European countries were recovering from the epidemic, the disease took hold in the USA, the South American countries, Arabian countries, and South Asian countries, predominantly affecting Brazil, Peru, Iran, and India. Presently, many European countries are witnessing a resurgence and recurrent outbreaks of COVID-19. Spread and evolving new insights: Whereas there is workplace-related infection rise as people are returning to their offices, in other places the outbreaks are related to the people crowding and meeting care-freely and trying to resort back to their earlier way of life. The reopening of the educational facilities across the continents may make matters worse. Impact on health and healthcare: Most cases of COVID-19 infections go unnoticed and are followed by self-recovery. But what may appear good from the clinical perspective, appears to complicate epidemiological efforts to contain the outbreak. With the evolving information about the disease, there seem to be certain possible outcomes such as control and containment, or the persistence of the disease as global endemic accompanied with outbreaks and resurgent episodes. Gnetic factors linked to disease severity: With the COVID-19 pandemic, not all infected patients develop a severe respiratory illness. Further, there is a large variation in disease severity, which may be due to the genetic factors underlying the variable response to the virus. It is becoming clear that apart from the advanced age and pre-existing conditions, certain genetic constituent factors render some patients more vulnerable to the more severe forms of the diseases. Integration of virus into human genome: A significant part of the human genome is derived from viruses especially the RNA viruses. In fact, about 8 percent of the human genome is made up of endogenous retroviruses (ERVs), which are viral gene sequences that have become a permanent part of the human lineage after they infected our ancient ancestors. With this background, a novel concept emerging that if COVID-19 persists for several generations, its genetic material is projected to be integrated or assimilated into human genome. The involved mechanisms are conceptualized through the transposons or transposable elements of the SARS-CoV-2.

Summary: Exercise is recommended for the treatment and prevention of type 2 diabetes. Also, to control and reduce glucose fluctuations in people with type 1 diabetes. However, the most appropriate time and the most effective intensity of exercise is still unknown, and various studies provide different results and different recommendations, and none of the studies provide a comprehensive and practical result. We conducted our studies to examine the results and determine the effect of time and intensity of exercise on blood sugar control and glucose fluctuations during the day. Methods: search in PubMed and Google Scholar with keywords morning, evening, type 1 and 2 diabetes, exercise, interval, periodic, aerobic, and glucose and blood sugar fluctuations were performed. A total of 31 articles were reviewed and finally, 10 articles that were most related to each other or had complementary information were selected. Conclusion: HIIT exercises are useful for type 2 diabetes, but they are recommended for type 1 diabetes with less pressure. Morning exercise increases glucose and evening exercise is applicable for type 1 and 2 diabetes.