Introduction: A bacterial infection by Borrelia burgdorferi referred to as Lyme disease (LD) or borreliosis is transmitted mostly by a bite of the tick Ixodes scapularis in the USA and Ixodes ricinus in Europe. Various tests are used for the diagnosis of LD, but their results are often unreliable. We compiled a list of clinically visible and patient-reported symptoms that are associated with LD. Based on this list, we developed a novel scoring system. Methodology: Nutech functional Score (NFS), which is a 43 point positional (every symptom is subgraded and each alternative gets some points according to its position) and directional (moves in direction bad to good) scoring system that assesses the patient's condition. Results: The grades of the scoring system have been converted into numeric values for conducting probability based studies. Each symptom is graded from 1 to 5 that runs in direction BAD → GOOD. Conclusion: NFS is a unique tool that can be used universally to assess the condition of patients with LD.

Background: Burkholderia pseudomallei is a Gram-negative saprophytic soil bacterium that causes melioidosis, a potentially fatal disease endemic in wet tropical areas. The currently available biochemical identification systems can misidentify some strains of B. pseudomallei. The aim of the present study was to identify the biochemical features of B. pseudomallei, which can affect its correct identification by Vitek 2 system. Materials and Methods: The biochemical patterns of 40 B. pseudomallei strains were obtained using Vitek 2 GN cards. The average contribution of biochemical tests in overall dissimilarities between correctly and incorrectly identified strains was assessed using nonmetric multidimensional scaling. Results: It was found (R statistic of 0.836, P = 0.001) that a combination of negative N-acetyl galactosaminidase, β-N-acetyl glucosaminidase, phosphatase, and positive D-cellobiase (dCEL), tyrosine arylamidase (TyrA), and L-proline arylamidase (ProA) tests leads to low discrimination of B. pseudomallei, whereas a set of positive dCEL and negative N-acetyl galactosaminidase, TyrA, and ProA determines the wrong identification of B. pseudomallei as Burkholderia cepacia complex. Conclusion: The further expansion of the Vitek 2 identification keys is needed for correct identification of atypical or regionally distributed biochemical profiles of B. pseudomallei.

Background: Head lice, a common social and health problem among all age groups, is especially widespread among school-aged children. Aims: This study aimed to assess the prevalence of pediculosis capitis among governmental primary school students in Southern Jordan and its related risk factors. Settings and Design: A sample of 500 primary schools students aged 6–12 from two male and two female public primary schools in four educational directorates were selected randomly in this cross-sectional study. Materials and Methods: Data were collected using a modified questionnaire that was completed by the students with the help of their parents. Students were then asked to return the questionnaire a day ahead of the examination date with a signed consent from the parents. Statistical Analysis: SPSS software was used with Chi-square testing to study the significant relationship between lice infestation prevalence and the independent variables. Statistical significance was set at P < 0.05. Results and Conclusion: The overall prevalence of lice infestation was 20.4% and was significantly higher among girls than boys. The prevalence rate was higher among rural residents, those living in shared rooms, families with a monthly income of <200 Jordanian Dinar, illiterate father and mother, those living in families with more than five members, houses with fewer than three rooms, students with longer hair, those with a history of infestation in the previous year, and students who share home articles with other family members. Female gender, low socioeconomic status, a history of contact, inadequate hygiene practices, and sharing articles were the major risk factors.

Laboratory confirmation of chlamydial antigen in clinically suspected cases of chlamydial eye infections is important, as similar clinical picture can be presented by different infective or noninfective causes. We retrospectively analyzed the presence of Chlamydia trachomatis antigen in 690 clinically suspected patients over the last 8 years (2009–2016). The chlamydial antigen was detected using direct immunofluorescence assay. Overall, Chlamydia-specific antigen positivity was 45.5%. The highest positivity was seen in 2014 (68.6%) and the least in 2016 (9.4%). The antigen positivity in years 2015 (13.4%) and 2016 (9.4%) was significantly less than in all the previous study years (P < 0.0001). Antigen positivity in patients having clinical diagnosis of trachoma was significantly higher than those having other eye manifestations suggestive of chlamydial infections (P = 0.0274). Stringent surveillance both at community level and in hospital attendees is required to know the actual load of this pathogen.

Urinary tract infection (UTI) is a common and painful human illness that, unfortunately not responsive to commonly used antibiotics in current practice. The role of fosfomycin and nitrofurantoin in the era of growing bacteria resistance has been widely discussed. In this study, we aimed to know the local antimicrobial susceptibilities, fosfomycin and nitrofurantoin susceptibility in particular, for urinary extended-spectrum-beta-lactamase-producing Escherichia coli and Escherichia pneumoniae (ESBL-EC and ESBL-KP) isolates in our hospital. We collected 464 urine isolates, including 384 ESBL-EC and 80 ESBL-KP isolates. Of 464 urine isolates culture positive ESBL-UTIs, EC caused 384 (82.75%), followed by Klebsiella in 80 (17.24%). Carbapenems and Colistin seems to remain as the first line therapy for the majority of ESBL-UTIs in the local setting. Colistin and fosfomycin remains the most sensitive antibiotic while nitrofurantoin still preserves the good sensitivity against ESBL and found to be an only oral sensitive antibiotic.

Among hantaviruses (HTNV), 22 are known as pathogenic for humans. HTNV can cause two clinical entities: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome or hantavirus cardiopulmonary syndrome (HCPS). In most countries of Eastern Europe as well as in Kosovo, HTNV infection is presented mainly as HFRS. Here, we report a 20-year-old man with HFRS and HCPS caused by Dobrava hantavirus strain, successfully treated in Intensive Care Unit of Infectious Diseases Clinic, University Clinical Center of Kosovo. In HFRS endemic areas, patients with acute respiratory distress syndrome need to be evaluated for Dobrava hantavirus strain as a possible causative agent.

We report four cases of complicated malaria in Andhra Pradesh-Orissa border between July 2016 and December 2016, with apparent treatment failure with artemisinin drugs, and all showing parasitological clearance after quinine and adjuvant clindamycin therapy. However, one case died due to complications of malaria. We highlight the need for increased monitoring and surveillance to identify artemisinin combination therapy resistance in other parts of India apart from Northeastern states. It is also essential to ensure rationale use of the existing antimalarial drugs.