Introduction. The most common form of leishmaniasis is cutaneous leishmaniasis. It presents with cutaneous lesions of the unprotected parts of the skin which leave scars later on. The causative agents are protozoae from the Leishmania species , and there are more than 20 of them. Clinical presentation and therapy depend on the type of leishmaniasis. The vectors of leishmaniosis are flies from the Phlebotomus species, and the source of infection is people and animals. Case report. A patient used to work in Iraq. Due to skin lesions that persisted for three months and suspicion of cutaneous leishmaniosis, he was sent by an infectious disease specialist from General hospital, Pancevo to the Public Health Institute of Serbia - PHIS. Lesions were localized on the hands, in the form of plaques with central ulcerations. There were similar cases among his colleagues. Microscopic examination of the skin samples, Giemza stained, showed intracellular amastigote Leishmania. The patient spent two months in the Clinic for infectious and tropical diseases. He was treated with fluconazole and liposomal amphotericin B and discharged with crusts on his hands. Clinical presentation, epidemiologic data, and microbiological diagnosis are very important for the diagnosis of cutaneous leishmaniasis.
Nadežda Petrović belongs to the constellation of masterful human beings who are the pride of their national histories, dominating their era and radiating above and beyond it, surpassing both their immediate environment and the age they live in. These persons are instrumental in the development and growth of their people, tracing the path to be followed in their work, to catch up to future times and other cultures. A member of this constellation of extraordinary persons, Nadežda Petrović has overcome the boundaries of time, historical development, humanist ideas and local culture in her short, prematurely ended life. Superior, self-confident and tenacious, she had an unusual intelligence that was able to perceive the entire vast expanse of the world. With her love for her people, she rushed to illuminate and broaden the views of her contemporaries and clear the path for future generations with her vision, her ideals and her sacrifice. Patriotism was the deepest of Nadežda's passions. At the time of Balkan wars, Nadežda recognised her desire and her capability to help her homeland as her mission in life, staying true to her positions from 1903 and annexation crisis of 1908. She went where the situation was the direst, she worked and helped on the front lines, because her fighting spirit would not let her stay in the rear. As a volunteer nurse, Nadežda followed the soldiers from battlefield to battlefield, suffering all types of weather without complaint. She would walk and she would ride, her hospital or ambulance reaching all the places she was needed. She also dressed the wounds of captured enemy soldiers. The wounded and the sick blessed her, doctors praised and admired her. The work was too hard and in tending to others, caught in a typhoid outbreak, Nadežda fell ill and recovered slowly. The beginning of World War I was yet another summons for Nadežda, to put down her paintbrush and continue with her humanitarian work. She immediately reported to the High Command to get her marching orders. Many women tended to the wounded, but only a few were accepted into the real military medical service by the Surgeon General of the High Command. Nadežda Petrović was one of them. She was assigned to the field hospital of the Danube division. In letters written during this time, Nadežda's words are impressive, touching in their profound honesty of experiencing human helplessness in the face of the tragedy of mass deaths. Soldiers knew Nadežda from the moments that transcended the strength of ordinary humans. She was highly appreciated, her courage and self-sacrifice earned her great respect. During the periods of cease-fire, after the victory of the Serbian army in the battles of Cer and Kolubara, at the beginning of 1915, Nadežda went to Skopje where her family was located. Already in February that year, Nadežda resumed her war duties. The High Command offered her a choice of several proposed positions, and told her that she didn't have to go back to Valjevo. Without a second thought, she picked the most difficult post - her hospital in Valjevo. Following the battle of Suvobor near Valjevo, an outbreak of spotted typhus fever claimed the lives of soldiers, civilians, doctors and medics in terrifying numbers. Nadežda arrived to Valjevo from a field hospital as aid sent to the small medical team. At the end of March, Nadežda was infected with typhoid. When the infection finally caught up to her, she was completely exhausted: she would only be a patient in the Valjevo hospital for a week. Volunteer nurse of the 1st Reserve Hospital in Valjevo, Nadežda Petrović, died on 3 April 1915.
Diphtheria is an infection of the respiratory tract or skin with systemic intoxication caused by aerobic gram-positive bacteria, Corynebacterium diphtheriae. Epidemiology of infection and clinical manifestations of the disease vary in different parts of the world. In the past, this disease was among the leading causes of child mortality and occurred in massive outbreaks. Developed at the end of the 19th century, diphtheria antitoxin (DAT) played a key role in the history of public health and vaccinology prior to the diphtheria-tetanus toxoid and combined vaccines against diphtheria, tetanus and pertussis with the acellular pertussis component (DTaP). One of the more significant events from the past that showcase the importance of DAT was the dire need for its use during the diphtheria outbreak in the town of Nome, Alaska. It was January, 1925, when Doctor Curtis Welch declared a diphtheria outbreak and sent a radio telegram to all major cities in Alaska, as well as to the US Public Health Service in Washington, D.C., begging for help. Despite the quarantine, the disease spread, and the only available serum supplies were discovered at a hospital in the small town of Anchorage, hundreds of kilometres away from Nome. The serum was delivered from Anchorage by train to the Nenana village, where the nearest railway station was located, and from there teams of sledding dogs were organised to take the serum to Nome in a relay dash. They needed to cross 1085 kilometers as fast as possible, in dire weather conditions. The teams took over from each other, pushing the limits of their endurance. The musher, the dog sled driver, had to be prepared for these conditions. All the dogs on the team had significant roles, but the lead dog was the key, and he had to be resourceful, strong and well trained. It took five and a half days (127 and a half hours), 20 people and more than 150 dogs for the so-called "Great race of mercy". A coordinated emergency delivery of this serum, thanks to the sled relay accomplished by Alaskan malamutes and Siberian huskies and their mushers in extreme weather conditions in order to save lives, left a great legacy in the history of vaccinology and public health. The most difficult parts of the relay were led by Siberian huskies, Balto and Togo and their mushers, Gunnar Kaasen and Leonhard Seppala, but it should be noted that most of the mushers were native Alaskans, Athabascans. This race, where the dogs pulled the sleds carrying the precious serum represents a dynamic illustration of the contribution of a non-human species to mass immunization in the history of vaccinology. Many dogs died during this relay, while their mushers suffered severe frostbite due to extremely low temperatures. Every single individual on our planet (both human and animal) plays a part, the significance of which should not be forgotten, in the historical chain of survival and not giving up the goal of improving the life of every living creature, while at the same time trying not to harm another living being. This unique example of cooperation between human and animal species emphasizes the importance of a human-animal relationship in the one health approach initiative.
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