International Journal of Infection
Volume:2 Issue: 2, Apr 2015

Context: Every year, millions of people travel around the world to attend a wide range of mass gatherings (MGs) such as sport events and religious festivals. These MGs increase the risk of infectious diseases outbreaks which is facilitated by large number of individuals staying in confined areas, sometimes for a short period of time..
Evidence Acquisition: Electronic medical databases including PubMed and EMBASE were searched from 1990 to 2014 on the subject of epidemiology of infectious diseases related to MGs. Keywords including "mass gathering", "crowding", "infectious diseases", "communicable diseases", "outbreak" and "surveillance" were used for retrieving the relevant articles. In this review article, we mainly focused on the epidemiology and surveillance systems related to infectious diseases control and management..
The spread of infectious diseases has been a major public health challenge related to MGs. Food-borne diseases and respiratory infections have been the most common outbreaks reported during MG. Preparedness and response plans to manage possible infectious diseases outbreaks requires enhancing infectious diseases surveillance, allocation of appropriate human and financial resources, and coordination among the various divisions of public health. Hajj is an example of good practice which involves millions of pilgrims, in which comprehensive infectious diseases surveillance is in place to monitor health risks and reinforce evidence-based planning for preventive measures..
Infectious disease surveillance for MGs should preferably be built via some modification and improvements, made to the existing surveillance and notification system to assist early detection and response to infectious diseases outbreaks..

Due to the increased resistance of pathogenic bacteria even towards new antibiotics, researchers have attempted to find herbal antimicrobial agents to replace chemical drugs..
The purpose of this study was to evaluate the effect of W. somnifera extracts on drug resistant E. coli strains isolated from clinical samples..
We studied all drug resistant strains of E. coli collected from patients with urinary tract infections hospitalized at Zabol hospitals from January 2010 to January 2012. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of plant extracts were determined by the dilution method with various concentrations of the bacteria. Sensitivity to multiple antibiotics was defined by the Kirby-Bauer disc diffusion test..
The results showed that the isolated E. coli strains were sensitive to these antibiotics: erythromycin (52.94%), tetracycline (76.47%), ceftazidime (41.17%), cefixime (35.29%), penicillin (76.47%), ampicillin (58.82%) and nalidixic acid (41.17%). Examination of the herbal extracts showed that the highest maximum inhibitory concentration (MIC) against drug resistant E. coli was 200 ppm. The lowest MIC was 50 ppm, where three strains of E. coli were inhibited at this concentration..
Our results indicated that Withania somnifera extracts had antibacterial effects on drug resistant E. coli strains isolated from clinical samples. Further studies are required to evaluate the effective compounds of this plant on microbial agents..

Iran is amongst endemic countries for Fasciola hepatica. Individuals can become infected by consumption of contaminated uncooked green vegetables. In the chronic cases, symptoms are fever, vague abdominal pain with eosinophilia. Patients sometimes have symptoms and signs of hepatobiliary involvements such as cholangitis and cholecystitis. .
Here we present a unique case of chronic cholecystitis due to Fasciola Hepatica..
Fascioliasis should be considered in any hepatobiliary system involvement, especially in endemic areas..

Many efforts have been made by researchers to find new antibiotics which are clinically useful against bacteria and drug resistant microorganisms..
We aimed to evaluate the antimicrobial effects of hydroalcoholic extracts of leaves and seeds of the Portulaca oleracea plant in traditional medicine of Sistan region, southeast of Iran..
In this cross-sectional and descriptive study, from January 2010 to January 2012, we studied the antibacterial activity of P. oleracea extract using nine bacteria (Gram-positive and Gram-negative bacterial strains) which were resistant to standard antibiotics such as erythromycin, cefixime, ceftazidime, tetracycline, ampicillin and amikacin. Bacterial strains were obtained from a standard laboratory. Broth microdilution method was used to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)..
The hydroalcoholic extract of P. oleracea L. leave and seed had antibacterial effects on selected drug resistant bacterial strains..
The leaves and seeds extract of P. oleracea has a remarkable antibacterial effect and it can be a good alternative when we are faced with drug resistance bacteria. However, more studies are required..

Meningitis is an inflammation of the membranes, which surround the brain and spinal cord. Early treatment of bacterial meningitis can prevent serious complications. In the last two decades, three vaccines have been developed against the three main bacterial species implicated in meningitis of children in western countries and vaccine-preventable invasive bacterial meningitis has decreased substantially in the past few years. However, none of the developed vaccines are part of our childhood immunization schedule..
This study aimed to search the epidemiology of meningitis in Zahedan..
Patients and In this cross–sectional survey, we studied all patients with meningitis for ten years, from May 2004 to May 2014, who had been referred to our hospital. The patients were evaluated according to their sex, age, clinical features, risk factors, pathogenic microorganisms, form of infection (acute or chronic) and clinical outcome..
Among the 53 patients with meningitis (47% females; 53% males with mean age 36 years) 47 cases (83%) had acute meningitis and six cases (17%) had chronic meningitis (four cases of tuberculosis and two cases of brucellosis). From the 47 cases with acute meningitis, only one case had a positive cerebrospinal fluid (CSF) culture for meningococci and 46 patients had negative CSF culture. The most common clinical symptoms was fever and headache (90%) and the least was seizure (9%). Mortality rate was 7.5% (4 cases). There were no significant risk factors except for two patients with acute meningitis and two cases with chronic meningitis..
According to negative CSF cultures in acute meningitis, CSF culture using the BACTEC automated system and specific viral tests is recommended for detection of the etiological agents of viral and bacterial meningitis, particularly in the Iranian population where patients use antibiotics without prescription..

Meningitis is a life-threatening disease and can lead to significant sequelae. Pediatric bacterial meningitis leaves some survivors with more significant sequelae if not treated, promptly. The advent of vaccine has changed the incidence of pediatric bacterial meningitis but these vaccines have not been used in routine childhood immunization schedule..
The current study aimed to investigate the epidemiology, clinical features, etiologic agents and clinical outcome of meningencephalitis among the pediatric group in Zahedan, Iran. .
Patients and The current cross-sectional and descriptive study investigated the medical records of the patients with meningitis from May 2010 to May 2014. Then, the patients were evaluated according to sex, age, clinical feature, risk factor, etiologic agents, acute or chronic form, and clinical outcome. .
Among 55 patients with meningitis (42% girls and 58% boys; mean age of 8.5 months, age range of 45 days to nine years), 55 cases (98%) had acute meningoencephalitis and only one case (2%) had chronic tuberculous (TB) meningitis. Out of the 54 cases with acute disease, only six cases showed a positive test for etiologic agent. Forty-eight patients had negative CSF culture. The most common clinical symptom was fever (95%) and the least was seizure (16%). Mortality rate was 7.2% (four cases). There were no significant risk factors in children with illness, but there was a history of pulmonary TB in grandmother of the case with TB meningitis. .
According to the obtained results, and finding a high negative cerebro-spinal fluide (CSF) culture in acute meningitis, it is recommended to use systems to detect the bacteria more, particularly in the patients whose parents use antibiotics before referring to a physician. Also, more specific viral tests are needed to detect the etiologic agents of viral meningitis. .

Hepatotoxicity is one of the most frequent adverse events that occurs during tuberculosis treatment and is associated with mortality of 6% - 12% if drugs are continued after the appearance of symptoms. In most of the cases, hepatitis is evident within three months after induction of anti-tuberculosis treatment..
The current study aimed to define the pattern of changes in liver transaminases and the associated risk factors among the patients with anti-tuberculosis drug-induced hepatitis who admitted to Boo-Ali Hospital in Zahedan, Southeastern Iran..
Patients and The current descriptive cross-sectional study reviewed all files of the patients with anti-tuberculosis Drug-Induced Hepatitis (DIH) who referred to Boo-Ali Hospital in Zahedan, Southeastern Iran, in five years. All patients were above 14 years, and were treated with the standard regimen (a combination of isoniazid, rifampin, pyrazinamide, and ethambutol ± streptomycin). Hepatotoxicity was defined when the liver transaminases were more than five, the Upper Limit of Normal (ULN), or had clinical symptoms with an increase of liver transaminases ≥ 3 ULN..
Among the 946 patients with tuberculosis disease (44% men; 56% women), 52 (5.5%) cases had drug-induced hepatotoxicity. Only 25% of the patients with anti-tuberculosis drug-induced hepatitis were below 52; 50% of the cases occurred within the first two weeks after the treatment onset..
Anti-tuberculosis drugs-induced hepatotoxicity caused treatment interruption in 5.5% of the patients with tuberculosis. The majority of the patients with DIH were above fifty, and 50% the cases occurred during the first two weeks after treatment onset. Physicians must carefully and closely monitor such patients..