\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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Soundararajan",coverURL:"https://cdn.intechopen.com/books/images_new/3006.jpg",editedByType:"Edited by",editors:[{id:"145081",title:"Dr.",name:"R.P.",surname:"Soundararajan",slug:"r.p.-soundararajan",fullName:"R.P. Soundararajan"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},onlineFirst:{chapter:{type:"chapter",id:"73679",title:"Splenectomy in Liver Cirrhosis with Splenomegaly and Hypersplenism",doi:"10.5772/intechopen.94337",slug:"splenectomy-in-liver-cirrhosis-with-splenomegaly-and-hypersplenism",body:'The spleen is a unique organ with many functions, including its crosstalk with the liver in cirrhotic patients. This review aims to answer a clinical question “Should splenectomy be done in liver cirrhosis with hypersplenism and splenomegaly?”.
The spleen is an organ full of mystery, as stated by Galen. From the ancient times until the Renaissance, descriptions of the gross anatomy of the spleen were relatively accurate, yet the physiology of this organ remains incomplete and inaccurate. Even until today, much of spleen’s function are still yet to be discovered [1].
Spleen comprised of two distinct compartments, both functional and morphological, namely red pulp and white pulp. The red pulp filters blood to remove foreign material and damaged erythrocytes. It also serves as iron, erythrocytes and platelets storages. With one fourth of body’s lymphocytes stores in the spleen, it is the largest secondary organ which initiate immune response to blood-borne antigens [2]. It exerts important effects on local and systemic immune responses, which have the potential to affect different tissues and organs [3]. The white pulp, composed by periarteriolar lymphoid sheath (PALS), the follicles and the marginal zones, are the one responsible for this so called immune functions [2].
In addition, the spleen also produces opsonins, a substances that bind to the foreign antigen, which in turn enhance their uptake and phagocytosis by macrophages. Furthermore, the B-lymphocytes within the germinal centers of the spleen are also sites for the production of antibody activated by foreign antigen. The realization of this important immunological function has promoted the desire for splenic preservation [4].
The association between the liver and spleen are shown in three different categories. Both organ, anatomically important in the portal circulation. Histologically, they share similar possession of reticuloendothelial structures, participating in substance exchange and cellular migration. And immunologically, both organs plays essential roles in immune homeostasis and pathogen clearance [2].
The first recorded encounter between spleen and cirrhosis could be trace back to Carl Freiderich Quittenbaum (1793–1852) of Rostock, Germany, who removed the spleen of a woman with cirrhosis and ascites “more from the patient’s urgent entreaty rather than the surgeon’s judgment.” Unfortunately the woman lived only 6 h after the surgery [5].
The palpable spleen has long been considered as an obvious signs of liver cirrhosis, frequently occurs in parallel with hypersplenism, to be the major cause of cytopenia and thrombocytopenia. This condition are relatively sub-fatal, even in the absence of a bleeding varices. During the progression of liver cirrhosis, the spleen-derived immune cells and cytokines may travel into the injured liver via portal blood flow. Together with the portal hypertension and congestion, this will result in splenomegaly and hypersplenism. Furthermore, the chemokines, DAMPs like HMGB1, or exosomes, are also release into the circulation, which will trigger the activation and/or migration of splenocytes. This mechanism are known as the liver and spleen crosstalk pathways during liver cirrhosis [2].
Spleen size in patients with cirrhosis varies by the etiology of the disease. While in healthy adults, the size of the spleen in usually less than 12 cm, in cirrhotic patients it is relatively larger, as shown in the study by Kashani et al. This study revealed that the mean spleen size in the alcohol group (13.1 ± 2.5 cm) was significantly smaller than in the hepatitis C (15.0 ± 3.4 cm) and nonalcoholic steatohepatitis (15.2 ± 3.0 cm) groups (95% confidence intervals of the mean difference, 0.6 to 3.3 and 0.8 to 3.4 cm, respectively), sonographically [6].
Cirrhotic patients are generally considered as immunocompromised, mainly due to the development of bacterial infection and community-acquired infections. Since the spleen is the largest lymphoid organs with large amount of T and B cells, macrophages, and dendritic cells, splenectomy in cirrhotic patients has produced concern over decrease immunity and elevated risk of infection, namely overwhelming post splenectomy pneumococcal sepsis.
However, a study by Hirakawa et al., showed the possibility of reducing suppressive cell fractions and enhancement of the effector cell population and functions by means of splenectomy, thus ameliorate the impaired immune status of cirrhotic patients [7].
Yamada et al. demonstrated that splenectomy improved hepatic functional reserves and nutritional metabolism, together with improvement in thrombocytopenia and leukopenia in cirrhotic patients. Splenectomy is thought to induce a decrease in platelet pooling or breakdown in the spleen of thrombocytopenic patients, and as a result, increase blood platelet counts. Bilirubinemia secondary to hypersplenism, which is caused by an increase in bilirubin production, that overloads the capacity of the liver to metabolize bilirubin, are also reduced after splenectomy [8].
In a study by Ueda et al. of rats undergoing major liver resection with or without splenectomy, early stage splenic red pulp TGF-β1 production and secretion into the portal blood exert an inhibitory effect on liver regeneration. Splenectomy reversed this inhibition and enhanced the regeneration of hepatocytes [9].
Study by Huang et al., unveiled serum cytokine profiles in HBV-related cirrhosis patients with PH and hypersplenism, indicating a potential role of the hypertensive spleen in the progression of liver disease. Furthermore, the changes in cytokine levels following splenectomy maybe potential advantageous to reduce liver fibrosis and accelerate liver regeneration as well as reduce the risk of HCC [10].
Splenectomy also enhanced the repopulation of adoptively transferred bone marrow cell in cirrhotic liver and decreased collagen deposition through the upregulation of MM9 expression in transferred bone marrow cells, as suggested by Iwamoto et al. [11], and improved the efficiency of adipose tissue-derived mesenchymal cell transplant into the liver by enhancing liver SCF-1 and HGV expressions [12].
Considering all of the above mention mechanism, targeting spleen for the treatment of liver cirrhosis can be achieved through [2]:
amelioration of cirrhosis’ fatal complications such as bleeding esophageal or gastric varices
efficiently improving liver function and the prognosis of esophageal varices
increasing the efficacy of liver transplantation and improving the prognosis of HCC
supplementary treatment for anti-HCV therapy in combination with interferons and other pharmaceuticals.
Surgery in a patient with liver disease carries specific and higher risks, compare to those with normal populations. Perioperative care including assessment and optimalization is the key to a safe surgery. Many cirrhosis patients present themselves with a relative contraindications that preclude surgery.
The predictors for complications including Child-Pugh class B or C, ascites, etiology of cirrhosis other than PBC, elevated creatinine, preoperative infection, COPD, preoperative upper GI bleeding, invasiveness of surgical procedure, intraoperative hypotension, and ASA status 4–5. While the predictors of mortality including male gender, Child-Pugh class B or C, ascites, etiology of cirrhosis other than PBC, preoperative infection, ASA status 4–5 and respiratory surgery. The presence of 1 risk factors carries a 9.3% risk of complications, and this increase with the more numbers of risk factors. A total of 7–8 risk factors carries a 100% risk of complications [13].
Friedman proposed the following list of contraindication to elective surgery in patients with liver disease, including acute viral hepatitis, alcoholic hepatitis, acute liver failure, acute renal failure, severe coagulopathy, hypoxemia and cardiomyopathy [14].
Regarding the preferred method for splenectomy, recently laparoscopic has become technically feasible, safe and effective procedure for hypersplenism secondary to cirrhosis, and contributes to less blood loss, shorter length of stay and less impairment of liver function. However, this methods are generally more costly and might not readily available in every hospital. Thus the choice of splenectomy method must be personally selected for each patient, surgeon and hospital [15].
It is already a general consensus that liver transplantation is the preferred treatment options for patient with end stage liver disease. However, the waiting time for liver transplantation is also long due to the shortage of donor organs, even in living donor liver transplantation setting. Moreover, in some countries, liver transplantation still not a feasible option for all patients.
One among many alternatives is by doing a splenectomy prior to liver transplantation in patient with liver cirrhosis and subsequent splenomegaly-hypersplenism. A study by Kong et al., studied 833 patient patients underwent liver transplantation, of which 88 patients had splenectomy before liver transplantation. They found that postoperative infection and 90-days mortality in the splenectomy and non-splenectomy group were not statistically difference. Furthermore, the post-transplant thrombocytopenia and early allograft dysfunctions is significantly lower in splenectomy group compare to non-splenectomy group. They suggested that pre-transplantation splenectomy is recommended in cases with risky patients without appropriate source of liver for LT. Taking into consideration the possibility of more difficult operation due to adhesion when transplantation is being done. One thing to note is that as a “re-operation” the splenectomy is often as- sociated with more difficult dissection due to adhesions [16].
Splenectomy is beneficial in reversal of the pathologic process through live regeneration and pre-transplant splenectomy could be an alternative in patients without appropriate source of liver for liver transplantation. However, perioperative considerations should be thoroughly assessed to allow a safe surgery.
“The authors declare no conflict of interest.”
Part of this article was presented in APASL Congress, Bali, March 2020.
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\n\nMetadata for all publications is also automatically deposited in IntechOpen's OAI repository, making them available through the Open Access Infrastructure for Research in Europe's (OpenAIRE) search interface further establishing our compliance.
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MS pathogenesis is not clear. Destruction of myelin by inflammation caused by autoimmune reactions has been proposed. Interestingly, healthy humans usually do not develop abzymes (Abzs). It was shown that DNase and MBP-hydrolyzing Abzs are easily detectable at the beginning of autoimmune diseases (ADs) including MS, when concentrations of antibodies to autoantigens are not yet significantly increased and correspond to levels in healthy donors. In addition, the relative enzymatic activity of antibodies from cerebrospinal fluid (CSF) is ~50-fold higher than that from the sera of the same MS patients. Experimental autoimmune encephalomyelitis (EAE) in C57BL/6 mice, a model mimicking relevant aspects of human MS was used. During development of spontaneous and MOG35-55-induced EAE in C57BL/6 mice, a specific reorganization of the immune system of mice was observed. It leads to a condition which was associated with the generation of catalytically active IgGs-hydrolyzing DNA, myelin basic protein (MBP), and MOG. Production of Abzs was associated with increased proteinuria, leading changes in differentiation of mice bone marrow hematopoietic stem cells (HSCs) and an increase in proliferation of lymphocytes in bone marrow, spleen, and thymus as well as a significant suppression of cell apoptosis in these organs. Treatment of control non-autoimmune CBA mice with MOG led to the different differentiation and proliferation of HSCs comparing with EAE C57BL/6 mice. The treatment of EAE mice with cuprizone inducing demyelination lead to a significant decrease in the size of the brain corpus callosum, but do not significantly change the differentiation profile of HSCs differentiation when compared with untreated mice. It indicates that cuprizone treatment is associated with demyelination, but not autoimmune reactivity. The possible differences in immune system reorganizations during preclinical phases of the disease, acute and late EAE, leading to production of different autoantibodies and Abzs as well other changes are discussed.",book:{id:"5156",slug:"trending-topics-in-multiple-sclerosis",title:"Trending Topics in Multiple Sclerosis",fullTitle:"Trending Topics in Multiple Sclerosis"},signatures:"Georgy A. Nevinsky",authors:[{id:"47119",title:"Dr.",name:"Georgy",middleName:null,surname:"Nevinsky",slug:"georgy-nevinsky",fullName:"Georgy Nevinsky"}]},{id:"21744",doi:"10.5772/19010",title:"Hallmarks in the History of Epilepsy: From Antiquity Till the Twentieth Century",slug:"hallmarks-in-the-history-of-epilepsy-from-antiquity-till-the-twentieth-century",totalDownloads:9300,totalCrossrefCites:6,totalDimensionsCites:27,abstract:null,book:{id:"627",slug:"novel-aspects-on-epilepsy",title:"Novel Aspects on Epilepsy",fullTitle:"Novel Aspects on Epilepsy"},signatures:"Emmanouil Magiorkinis, Kalliopi Sidiropoulou and Aristidis Diamantis",authors:[{id:"33300",title:"Dr.",name:"Emmanouil",middleName:null,surname:"Magiorkinis",slug:"emmanouil-magiorkinis",fullName:"Emmanouil Magiorkinis"},{id:"33563",title:"Ms.",name:"Kalliopi",middleName:null,surname:"Sidiropoulou",slug:"kalliopi-sidiropoulou",fullName:"Kalliopi Sidiropoulou"},{id:"33564",title:"Dr.",name:"Aristidis",middleName:null,surname:"Diamantis",slug:"aristidis-diamantis",fullName:"Aristidis Diamantis"}]},{id:"24857",doi:"10.5772/28930",title:"Hormonal Signaling Systems of the Brain in Diabetes Mellitus",slug:"hormonal-signaling-systems-of-the-brain-in-diabetes-mellitus",totalDownloads:1990,totalCrossrefCites:3,totalDimensionsCites:25,abstract:null,book:{id:"745",slug:"neurodegenerative-diseases-processes-prevention-protection-and-monitoring",title:"Neurodegenerative Diseases",fullTitle:"Neurodegenerative Diseases - Processes, Prevention, Protection and Monitoring"},signatures:"Alexander Shpakov, Oksana Chistyakova, Kira Derkach and Vera Bondareva",authors:[{id:"75886",title:"Dr",name:"Vera",middleName:null,surname:"Bondareva",slug:"vera-bondareva",fullName:"Vera Bondareva"},{id:"75888",title:"Dr.",name:"Alexander",middleName:null,surname:"Shpakov",slug:"alexander-shpakov",fullName:"Alexander Shpakov"},{id:"81684",title:"Dr",name:"Oksana",middleName:null,surname:"Chistyakova",slug:"oksana-chistyakova",fullName:"Oksana Chistyakova"},{id:"81685",title:"Dr.",name:"Kira",middleName:null,surname:"Derkach",slug:"kira-derkach",fullName:"Kira Derkach"}]},{id:"19739",doi:"10.5772/18469",title:"Antiepileptic Medicinal Plants used in Traditional Medicine to Treat Epilepsy",slug:"antiepileptic-medicinal-plants-used-in-traditional-medicine-to-treat-epilepsy",totalDownloads:9698,totalCrossrefCites:7,totalDimensionsCites:23,abstract:null,book:{id:"628",slug:"clinical-and-genetic-aspects-of-epilepsy",title:"Clinical and Genetic Aspects of Epilepsy",fullTitle:"Clinical and Genetic Aspects of Epilepsy"},signatures:"E. Ngo Bum, G.S. Taiwe, F.C.O. Moto, G.T. Ngoupaye, R.R.N. Vougat, V.D. Sakoue, C. Gwa, E.R. Ayissi, C. Dong, A. Rakotonirina and S.V. Rakotonirina",authors:[{id:"31580",title:"Prof.",name:"Elisabeth",middleName:null,surname:"Ngo Bum",slug:"elisabeth-ngo-bum",fullName:"Elisabeth Ngo Bum"},{id:"46671",title:"Dr.",name:"Germain",middleName:"Sotoing",surname:"Taïwe",slug:"germain-taiwe",fullName:"Germain Taïwe"},{id:"46672",title:"MSc.",name:"Fleur",middleName:null,surname:"Moto",slug:"fleur-moto",fullName:"Fleur Moto"},{id:"46673",title:"Prof.",name:"Gwladys",middleName:"Temkou",surname:"Ngoupaye",slug:"gwladys-ngoupaye",fullName:"Gwladys Ngoupaye"},{id:"46674",title:"MSc.",name:"Espoir",middleName:null,surname:"Ayissi",slug:"espoir-ayissi",fullName:"Espoir Ayissi"},{id:"46675",title:"MSc.",name:"Christian",middleName:null,surname:"Dong",slug:"christian-dong",fullName:"Christian Dong"},{id:"46676",title:"MSc.",name:"Frédéric",middleName:null,surname:"Maidawa",slug:"frederic-maidawa",fullName:"Frédéric Maidawa"},{id:"46677",title:"MSc.",name:"Gildas",middleName:null,surname:"Djafsia",slug:"gildas-djafsia",fullName:"Gildas Djafsia"},{id:"46678",title:"MSc.",name:"Leopold",middleName:null,surname:"Nanga",slug:"leopold-nanga",fullName:"Leopold Nanga"},{id:"46679",title:"MSc.",name:"Saleh",middleName:null,surname:"Soudi",slug:"saleh-soudi",fullName:"Saleh Soudi"},{id:"46680",title:"Dr.",name:"Alice",middleName:null,surname:"Rakotonirina",slug:"alice-rakotonirina",fullName:"Alice Rakotonirina"},{id:"46681",title:"Dr.",name:"Silvère",middleName:null,surname:"Rakotonirina",slug:"silvere-rakotonirina",fullName:"Silvère Rakotonirina"}]},{id:"44546",doi:"10.5772/54305",title:"Astrocytes Role in Parkinson: A Double-Edged Sword",slug:"astrocytes-role-in-parkinson-a-double-edged-sword",totalDownloads:4358,totalCrossrefCites:11,totalDimensionsCites:18,abstract:null,book:{id:"3278",slug:"neurodegenerative-diseases",title:"Neurodegenerative Diseases",fullTitle:"Neurodegenerative Diseases"},signatures:"Ricardo Cabezas, Marco Fidel Avila, Daniel Torrente, Ramon Santos\nEl-Bachá, Ludis Morales, Janneth Gonzalez and George E. Barreto",authors:[{id:"85869",title:"Prof.",name:"George",middleName:"E.",surname:"Barreto",slug:"george-barreto",fullName:"George Barreto"},{id:"88549",title:"Dr.",name:"Ludis",middleName:null,surname:"Morales",slug:"ludis-morales",fullName:"Ludis Morales"},{id:"97601",title:"Dr.",name:"Janneth",middleName:null,surname:"Gonzalez",slug:"janneth-gonzalez",fullName:"Janneth Gonzalez"},{id:"157020",title:"MSc.",name:"Ricardo",middleName:null,surname:"Cabezas",slug:"ricardo-cabezas",fullName:"Ricardo Cabezas"},{id:"157021",title:"MSc.",name:"Marco Fidel",middleName:null,surname:"Ávila",slug:"marco-fidel-avila",fullName:"Marco Fidel Ávila"},{id:"165566",title:"Dr.",name:"Ramon",middleName:null,surname:"El-Bachá",slug:"ramon-el-bacha",fullName:"Ramon El-Bachá"},{id:"167253",title:"Mr.",name:"Daniel",middleName:null,surname:"Torrente",slug:"daniel-torrente",fullName:"Daniel Torrente"}]}],mostDownloadedChaptersLast30Days:[{id:"44555",title:"Pharmacological Treatment of Acute Ischemic Stroke",slug:"pharmacological-treatment-of-acute-ischemic-stroke",totalDownloads:3665,totalCrossrefCites:6,totalDimensionsCites:8,abstract:null,book:{id:"3278",slug:"neurodegenerative-diseases",title:"Neurodegenerative Diseases",fullTitle:"Neurodegenerative Diseases"},signatures:"Humberto Mestre, Yael Cohen-Minian, Daniel Zajarias-Fainsod and\nAntonio Ibarra",authors:[{id:"72488",title:"Dr.",name:"José Juan Antonio",middleName:null,surname:"Ibarra Arias",slug:"jose-juan-antonio-ibarra-arias",fullName:"José Juan Antonio Ibarra Arias"},{id:"120571",title:"Mr.",name:"Humberto",middleName:null,surname:"Mestre",slug:"humberto-mestre",fullName:"Humberto Mestre"},{id:"165904",title:"Dr.",name:"Daniel",middleName:null,surname:"Zajarias-Fainsod",slug:"daniel-zajarias-fainsod",fullName:"Daniel Zajarias-Fainsod"},{id:"165905",title:"Mrs.",name:"Yael",middleName:null,surname:"Cohen-Minian",slug:"yael-cohen-minian",fullName:"Yael Cohen-Minian"}]},{id:"60608",title:"Mucuna and Parkinson’s Disease: Treatment with Natural Levodopa",slug:"mucuna-and-parkinson-s-disease-treatment-with-natural-levodopa",totalDownloads:4647,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Mucuna pruriens is a tropical bean containing large amounts of levodopa and is the most important natural remedy for Parkinson’s disease. Famous neurologists have patented methods of extraction for its advantages over the synthetic forms, Sinemet and Madopar. This natural levodopa is less toxic and has a faster and more lasting effect and can delay the need for pharmaceuticals and combination therapies. Currently, there are many patients with Parkinson’s disease who take Mucuna and spontaneously reduce the dose of conventional drugs and do so behind their doctors’ backs. Mucuna should always be taken under medical supervision.",book:{id:"6406",slug:"parkinson-s-disease-understanding-pathophysiology-and-developing-therapeutic-strategies",title:"Parkinson's Disease",fullTitle:"Parkinson's Disease - Understanding Pathophysiology and Developing Therapeutic Strategies"},signatures:"Rafael González Maldonado",authors:[{id:"214658",title:"Dr.",name:"Rafael",middleName:null,surname:"Gonzalez-Maldonado",slug:"rafael-gonzalez-maldonado",fullName:"Rafael Gonzalez-Maldonado"}]},{id:"19700",title:"Physiotherapy for Children with Cerebral Palsy",slug:"physiotherapy-for-children-with-cerebral-palsy",totalDownloads:21763,totalCrossrefCites:1,totalDimensionsCites:3,abstract:null,book:{id:"630",slug:"epilepsy-in-children-clinical-and-social-aspects",title:"Epilepsy in Children",fullTitle:"Epilepsy in Children - Clinical and Social Aspects"},signatures:"Mintaze Kerem Günel",authors:[{id:"38412",title:"Prof.",name:"Mintaze",middleName:null,surname:"Kerem Günel",slug:"mintaze-kerem-gunel",fullName:"Mintaze Kerem Günel"}]},{id:"51151",title:"Association Between Multiple Sclerosis Risk and Human Immunodeficiency Virus Infection: Insights and Challenges",slug:"association-between-multiple-sclerosis-risk-and-human-immunodeficiency-virus-infection-insights-and-",totalDownloads:2034,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Multiple sclerosis (MS) is a convoluted autoimmune and inflammatory disease of the central nervous system (CNS) in which the protective myelin sheath is eroded and the underlying nerve fibers are damaged. There is no conclusive knowledge on the role played by different etiological factors in its development, and studies have shown that it primarily results due to complex interactions between the genetic, geographic and infectious components. Among the risk factors reported to have a possible role in MS development, retroviruses also appear to influence it. Studies suggest human immunodeficiency virus (HIV) infection to be inversely related to MS risk, but to date, the association between the two remains enigmatic. This protective inverse association has become an area of active research and the most plausible explanations for this may be immune suppression and/or antiretroviral medications. The purpose of writing this chapter is to provide background information on the unfathomable relationship between HIV infection and the risk of developing MS while at the same time providing description of the insights garnered from recent studies. While highlighting the application of ART (antiretroviral therapy) as budding future alternative for MS management, this chapter provides momentum for further studies.",book:{id:"5156",slug:"trending-topics-in-multiple-sclerosis",title:"Trending Topics in Multiple Sclerosis",fullTitle:"Trending Topics in Multiple Sclerosis"},signatures:"Ehtishamul Haq, Insha Zahoor and Mushfiquddin Khan",authors:[{id:"181077",title:"Dr.",name:"Ehtishamul",middleName:null,surname:"Haq",slug:"ehtishamul-haq",fullName:"Ehtishamul Haq"},{id:"185233",title:"Dr.",name:"Insha",middleName:null,surname:"Zahoor",slug:"insha-zahoor",fullName:"Insha Zahoor"},{id:"185234",title:"Dr.",name:"Mushfiquddin",middleName:null,surname:"Khan",slug:"mushfiquddin-khan",fullName:"Mushfiquddin Khan"}]},{id:"63824",title:"Plasmapheresis in Treatment of Myasthenia Gravis",slug:"plasmapheresis-in-treatment-of-myasthenia-gravis",totalDownloads:1346,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Treatment of myasthenia gravis is still a rather difficult task, since there is no single tactic to use different drugs (corticosteroids, rituximab, immunoglobulins), especially since it is associated with a number of side effects. They are not able to remove the accumulating autoantibodies and immune complexes, the large size of which does not allow them to be excreted by the kidneys as well. Special problems of treatment arise when myasthenic crises develop associated with respiratory failure requiring artificial lungs ventilation. Plasmapheresis can help to solve this for it is possible to remove antibodies and other pathological metabolites. In addition, regular plasmapheresis is able not only to prevent exacerbations but also to reduce doses of the maintenance therapy with less risk of their side effects, which is confirmed by our own experience.",book:{id:"7160",slug:"selected-topics-in-myasthenia-gravis",title:"Selected Topics in Myasthenia Gravis",fullTitle:"Selected Topics in Myasthenia Gravis"},signatures:"Valerii Voinov",authors:null}],onlineFirstChaptersFilter:{topicId:"1056",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"81721",title:"Atrial Fibrillation and Stroke",slug:"atrial-fibrillation-and-stroke",totalDownloads:5,totalDimensionsCites:0,doi:"10.5772/intechopen.104619",abstract:"Atrial fibrillation (AF) represents a major cause of morbidity and mortality in adults, especially for its strong association with thromboembolism and stroke. In this chapter, we aim to provide an overview on this cardiac arrhythmia, addressing several important questions. Particularly, we faced the possible mechanisms leading to an increased risk of embolism in AF, emphasizing how Virchow’s triad for thrombogenesis is unable to fully explain this risk. Disentangling the risk of stroke caused by AF and by other associated vascular conditions is extremely challenging, and risk stratification of patients with AF into those at high and low risk of thromboembolism has become a crucial determinant of optimal antithrombotic prophylaxis. Moreover, we discuss the typical clinical and radiological characteristics of cardioembolic strokes, addressing acute, time-dependent reperfusional therapies in case of ischemic stroke. The role of anticoagulation in AF is also fully analyzed; the benefit of oral anticoagulation generally outweighs the risk of bleeding in AF patients, and a variety of scoring systems have been developed to improve clinical decision-making when initiating anticoagulation. With their predictable pharmacokinetic profiles, wide therapeutic windows, fewer drug–drug and drug-food interactions, and the non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have changed the landscape of thromboprophylaxis for AF patients, offering the opportunity to use effective anticoagulants without the need for intensive therapeutic drug monitoring.",book:{id:"10782",title:"Cerebrovascular Diseases - Elucidating Key Principles",coverURL:"https://cdn.intechopen.com/books/images_new/10782.jpg"},signatures:"Francesca Spagnolo, Vincenza Pinto and Augusto Maria Rini"},{id:"81639",title:"Atrial Cardiopathy and Cryptogenic Stroke",slug:"atrial-cardiopathy-and-cryptogenic-stroke",totalDownloads:24,totalDimensionsCites:0,doi:"10.5772/intechopen.103736",abstract:"Cryptogenic stroke (CS) is defined as the presence of cerebral infarcts, the cause which has not been identified despite an appropriate diagnostic evaluation, and it accounts for approximately 30–40% of all ischemic strokes. There is a certain subgroup of CS with embolic characteristics on neuroimaging studies and no evidence of atrial fibrillation alternative or any alternative cause. Recent data suggest that disorders of the atrium, even without atrial fibrillation, could increase thromboembolic risk. The pathological atrial substrate, or atrial cardiopathy (AC), may be an important and underrecognized cause of cryptogenic strokes. This chapter will review the information on the rationale and data behind the concept of atrial cardiopathy, its pathophysiology, proposed biomarkers of atrial cardiopathy, and therapeutic implications.",book:{id:"10782",title:"Cerebrovascular Diseases - Elucidating Key Principles",coverURL:"https://cdn.intechopen.com/books/images_new/10782.jpg"},signatures:"Marianela López Armaretti, Natalia Romina Balian and María Cristina Zurrú"},{id:"81011",title:"Amino Acids as Neurotransmitters. The Balance between Excitation and Inhibition as a Background for Future Clinical Applications",slug:"amino-acids-as-neurotransmitters-the-balance-between-excitation-and-inhibition-as-a-background-for-f",totalDownloads:31,totalDimensionsCites:0,doi:"10.5772/intechopen.103760",abstract:"For more than 30 years, amino acids have been well-known (and essential) participants in neurotransmission. They act as both neuromediators and metabolites in nervous tissue. Glycine and glutamic acid (glutamate) are prominent examples. These amino acids are agonists of inhibitory and excitatory membrane receptors, respectively. Moreover, they play essential roles in metabolic pathways and energy transformation in neurons and astrocytes. Despite their obvious effects on the brain, their potential role in therapeutic methods remains uncertain in clinical practice. In the current chapter, a comparison of the crosstalk between these two systems, which are responsible for excitation and inhibition in neurons, is presented. The interactions are discussed at the metabolic, receptor, and transport levels. Reaction-diffusion and a convectional flow into the interstitial fluid create a balanced distribution of glycine and glutamate. Indeed, the neurons’ final physiological state is a result of a balance between the excitatory and inhibitory influences. However, changes to the glycine and/or glutamate pools under pathological conditions can alter the state of nervous tissue. Thus, new therapies for various diseases may be developed on the basis of amino acid medication.",book:{id:"10890",title:"COVID-19, Neuroimmunology and Neural Function",coverURL:"https://cdn.intechopen.com/books/images_new/10890.jpg"},signatures:"Yaroslav R. Nartsissov"},{id:"80821",title:"Neuroimmunology and Neurological Manifestations of COVID-19",slug:"neuroimmunology-and-neurological-manifestations-of-covid-19",totalDownloads:58,totalDimensionsCites:0,doi:"10.5772/intechopen.103026",abstract:"Infection with SARS-CoV-2 is causing coronavirus disease in 2019 (COVID-19). Besides respiratory symptoms due to an attack on the broncho-alveolar system, COVID-19, among others, can be accompanied by neurological symptoms because of the affection of the nervous system. These can be caused by intrusion by SARS-CoV-2 of the central nervous system (CNS) and peripheral nervous system (PNS) and direct infection of local cells. In addition, neurological deterioration mediated by molecular mimicry to virus antigens or bystander activation in the context of immunological anti-virus defense can lead to tissue damage in the CNS and PNS. In addition, cytokine storm caused by SARS-CoV-2 infection in COVID-19 can lead to nervous system related symptoms. Endotheliitis of CNS vessels can lead to vessel occlusion and stroke. COVID-19 can also result in cerebral hemorrhage and sinus thrombosis possibly related to changes in clotting behavior. Vaccination is most important to prevent COVID-19 in the nervous system. There are symptomatic or/and curative therapeutic approaches to combat COVID-19 related nervous system damage that are partly still under study.",book:{id:"10890",title:"COVID-19, Neuroimmunology and Neural Function",coverURL:"https://cdn.intechopen.com/books/images_new/10890.jpg"},signatures:"Robert Weissert"},{id:"80005",title:"Infarct Stroke and Blood Glucose Associated with Food Consumption in Indonesia",slug:"infarct-stroke-and-blood-glucose-associated-with-food-consumption-in-indonesia",totalDownloads:62,totalDimensionsCites:0,doi:"10.5772/intechopen.101548",abstract:"Stroke is the primary cause of death in adults. It is predicted that the death caused by stroke will increase twice in the next 30 years. In Indonesia, stroke is one of the diseases of the circulatory system, which has been taking the first place of causing death since 2007. Indonesia has rice as the main type of daily food consumed, which has higher glycemic index than other sources. This study aims to find the risk of blood glucose level that determines the incidence of infarct stroke. There were 164 patients enrolled in this study, 82 patients in each stroke and not stroke group. The blood examination is using the enzymatic method, which is the hexokinase method. The results of research revealed that indicators of high blood glucose level were found in infract stroke incidence, including casual blood glucose, fasting blood glucose, 2-h postprandial blood glucose, and glycated hemoglobin. These four indicators were found in a higher level in the infarct stroke than the non-stroke group. Other epidemiological studies have shown that diabetes is a risk factor for stroke. Therefore, education about food selection should be a priority in the effort to prevent infarct stroke and diabetes mellitus in Indonesia.",book:{id:"10782",title:"Cerebrovascular Diseases - Elucidating Key Principles",coverURL:"https://cdn.intechopen.com/books/images_new/10782.jpg"},signatures:"Santi Martini, Hermina Novida and Kuntoro"},{id:"80391",title:"COVID-19 and Seizures",slug:"covid-19-and-seizures",totalDownloads:59,totalDimensionsCites:0,doi:"10.5772/intechopen.102540",abstract:"The past two years were deeply marked by the emergence of a global pandemic caused by the worldwide spread of the virus severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection. The plethora of repercussions on the health of those affected is extensive, ranging from asymptomatic individuals, mild flu-like disease, and severe respiratory failure, eventually leading to death. Despite this predilection for the respiratory system, the virus is responsible for multisystemic manifestations and soon became clear that neurological involvement was a frequent issue of coronavirus disease 2019 (COVID-19). Much have been pointed out about the neurotropic nature of the virus, the ways by which it invades and targets specific structures of the central nervous system, and the physiopathology behind the neurologic manifestations associated with it (namely encephalomyelitis, Guillain-Barré syndrome, lacunar infarcts, and vascular dysfunction, just to list a few). 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He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. Gonzalez-Sanchez",slug:"juan-a.-gonzalez-sanchez",fullName:"Juan A. Gonzalez-Sanchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico System",country:{name:"United States of America"}}},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}}]}},subseries:{item:{id:"3",type:"subseries",title:"Bacterial Infectious Diseases",keywords:"Antibiotics, Biofilm, Antibiotic Resistance, Host-microbiota Relationship, Treatment, Diagnostic Tools",scope:"