A case of primary cutaneous actinomycosis was diagnosed on clinical and bacteriological grounds. A fifty-five year woman presented with multiple discharging sinuses on both legs since 9 years with slowly progressive course; from rural area in Kurdistan Region-Iraq. Bacteriological study including macroscopical and cultural examination of the discharge and crust taken deep from the lesions revealed actinomyces as the causative organism. Good response with complete healing was noticed after 4 months of treatment with benzathine penicillin. Primary cutaneous actinomycosis is a rare variety of actinomycosis and this is the first case reported in Iraq. Good awareness of the full clinical spectrum of the disease aided by bacteriological study is needed to minimize the misdiagnosis of the case.

Introduction:Antiphospholipid syndrome (APS), may manifest itself as primary (PAPS) or secondary (SAPS).  Repeated thromboses are the most frequent clinical manifestation of APS in the presence of antiphospholipid antibodies (aPL).  APS patients suffer from various non-thrombotic manifestations, including thrombocitopenia. Methods: Our prospective study comprises of 468 patients: 318 with primary, 132 with secondary APS. Results:Thrombosis was diagnosed in 46.5% patients, with higher prevalence in PAPS compared to SAPS patients. There was similar prevalence of arterial thrombosis in PAPS and SAPS groups (34.6% and 34%, respectively, p=0.932) although venous thrombosis was more frequent in PAPS (25.9% and 8.5%, respectively, p=0.001). Thrombosis was observed in 92 (55.8%) patients who had more than one type of antibodies (category I), in 13 (41.9%) patients with category IIa, in 19 (46.3%) patients with category IIb, and in 73 (44.2%) patients with category IIc (p=0.10). The patients with thrombosis were older than those without thrombosis (49.8 and 39.8 years, respectively, p=0.001). Overall, older age was a risk factor for thrombosis. The prevalence of venous thrombosis was higher in the PAPS group, but with lower frequency than in literature data. Any aPL type and level is a risk factor for thrombosis. Thrombocytopenia more likely occurs in patients with both high aCL IgG and ß₂GPI IgG levels.

Orphan drugs are medicines or vaccines intended to treat, prevent or diagnose a rare disease (viz., Huntington's disease, myoclonus disease, Tourette syndrome, etc.). The definition of rare diseases varies across jurisdictions but typically considers disease prevalence, severity, and existence of alternative therapeutic options. A rare disease is not universal and depends on the legislation and policies adopted by each region or country. In the last 35 years, ODA (Orphan Drug Act, 1983) has been adopted in several countries worldwide (USA, Australia, European Union, Japan, etc.) and has successfully promoted R and D investments to develop new pharmaceutical products for the treatment of rare diseases. The incidences of such diseases have been increasing at a greater pace than the speed with which drugs are researched and developed to treat such diseases. One of the major reasons is that the pharmaceutical industry is not very keen to research the development of orphan drugs as these drugs do not capture a bigger market. This is the current scenario in-spite of the various incentives provided in the orphan drug act. However, in this article, we have tried to focus on existing regulations and policies utilized by various countries namely USA, EU, Canada and Australia. It has been noted, most importantly that the two largest populated countries- China and India, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases.

Abstract

Introduction:

Our study focused on the value of TCD8 cytotoxicity in susceptibility to severe malaria in endemic areas.

The global purpose of the work hereby was to evaluate adaptive cellular immunity during Plasmodium falciparum malaria through TCD8 + cytotoxic lymphocytes.

Patients and methods :

It was a prospective study, with analytical purpose that took place over a period of 8 months in the Pediatric Department of Hôpital Général d’Abobo and in the Immunology and Hematology Laboratory of CHU de Cocody. The study focused on 50 children (under 15 years of age) selected on the basis of WHO definition criteria for malaria infections (40 children with simple malaria and 10 severe malaria) a fact sheet and 10 witness persons.

The samples carried were sent and processed in the said-laboratory.

RESULTS:

Among these 50 children, those under 5 and over 5 years accounted for 52% and 48% of the size respectively. Most of them were boys with a sex ration of 1, 77. In children under 5 years, the average rate of TCD8 was higher in simple malaria (6098.16 cells / ml) than in severe malaria (3915 cells / ml) with a statically significant difference. On the other hand, in children over 5-year-olds, the difference noticed was not significant despite relatively higher TCD8 rates.

However, regardless of the age of the child, the rate of TCD8 cells was higher in malaria than in witness.