Medicine
Combating Cholera in Syria: A Comprehensive Approach to Clean Water, Sanitation, and Vaccination
This study presents a comprehensive strategy for combating cholera in Syria with a focus on clean water initiatives treatment surveillance and vaccination and the critical role of clean water in halting disease transmission.
The review design has involved a thorough research and review of existing literature and data on cholera outbreaks in Syria. It has also included an analysis of vaccination and treatment options as well as an exploration of cholera surveillance systems and clean water initiatives.
Key findings have indicated that prioritizing access to clean water through community water management plans and water purification technologies is essential for cholera prevention. Case studies supported by epidemiological data up to September 2023 have underscored the importance of clean water in stopping cholera spread.
The study has highlighted the urgent need for a comprehensive strategy to protect millions in Syria through enhanced water sanitation and vaccination measures. It has advocated for improved cholera surveillance and response systems along with continued efforts to ensure clean water access for all.
Cleaning and Disinfection of Surfaces in a COVID-19 Respiratory Syndrome Unit: A Quasi-Experimental Study
This study aimed to assess the impact of an educational intervention on the cleaning and disinfection processes within a respiratory syndrome unit serving as a designated facility for COVID-19 patients.
A quasi-experimental design was employed incorporating a pre-intervention and post-intervention assessment. The evaluation of surfaces involved various monitoring techniques including Adenosine Triphosphate (ATP) testing colony-forming unit analysis and visual inspections. All statistical analyses were conducted at a significance level of 5% (p < 0.05).
Following the implementation of the educational intervention a notable reduction in surface contamination rates was observed. Significant improvements were noted for specific surfaces when utilizing the ATP testing method including benchtops (p = 0.030) mattresses (p = 0.014) doorknobs (p = 0.014) and armchairs (p = 0.014). Furthermore a decrease in the total count of aerobic bacteria was observed for benchtops (p = 0.014) mattresses (p = 0.014) and doorknobs (p = 0.014). Visual inspection results also indicated enhancements with approval rates for benchtops armchairs and mattresses rising from 0% before the intervention to 37.5% afterward.
The findings of this study demonstrate substantial improvements in approval rates following the implementation of the educational intervention. Additionally this research provides valuable insights for the development of ongoing educational initiatives for the healthcare team incorporating evaluation and feedback mechanisms as well as updates to cleaning and disinfection protocols.
Antimicrobial Susceptibility Profile of Bacteria Isolated from Hemocultures of Patients Attended in a Campaign Hospital During COVID-19 Pandemic
Primary bloodstream infections are most commonly related to health care and are associated with intravascular devices increasing patient mortality length of stay and health care costs. Among the complications of hospitalizations for COVID-19 bloodstream infection is one of the most prevalent requiring prevention and early treatment. Due to the contingency of hospital resources during the pandemic understanding the prevalence and incidence of antimicrobial agents that cause bloodstream infections and using exams judiciously are essential public health measures avoiding the misuse of antimicrobials and being able to establish treatment.
This study aimed to determine the antimicrobial susceptibility profile and the prevalence of etiological agents of bloodstream infections in patients with COVID-19 at the field hospital in the city of São Bernardo do Campo - SP.
A descriptive observational and retrospective cross-sectional study was carried out on the results of blood cultures already collected for diagnostic purposes from patients from May to August 2020 at the same hospital.
Of the 300 blood cultures analyzed 73.7% of the samples showed no bacterial growth. Among the others the main bacteria found were Klebsiella pneumoniae sensitive to tigecycline present in 30 (10%) followed by Staphylococcus sp. (coagulase-negative non-lugdunensis) sensitive only to doxycycline gentamicin tetracycline and vancomycin in only 2 (14.3%) samples.
In this study a low rate of laboratory-confirmed bacterial coinfection was identified in patients with COVID-19.
Effects of COVID-19 on Food Supply: A Systematic Review
The COVID-19 outbreak has had a significant influence on several critical industries including agriculture education and the economy. This essay investigates these processes with a focus on agriculture where the repercussions have been particularly harsh for poor groups dealing with unpredictable food supplies and food safety.
Along with a critical examination of the shift to digital education systems the report highlights the major obstacles that lie ahead for regions lacking adequate digital infrastructure and digital literacy. There have been notable disruptions in the economy as well. Manufacturing the financial markets and tourism have all seen major downturns.
The study emphasizes the crucial part that following safety measures and boosting immunization campaigns play in mitigating these negative consequences while supporting economic recovery. Also new technical solutions have emerged throughout this time. The application of drone technology to contactless food delivery is a notable illustration of how creativity can overcome the challenges posed by the pandemic.
Finally the report recommends the development of specific and rigorous methods to strengthen recovery efforts in these critical areas.
Evaluation of the Effect of Vaccination Status on Lung Involvement and Hospitalization in COVID-19 Patients
The spectrum of COVID-19 in adults ranges from asymptomatic infection to mild respiratory tract symptoms to severe pneumonia with acute respiratory distress syndrome (ARDS) and multiorgan dysfunction. In our study it was aimed to investigate the effects of COVID-19 vaccine on lung involvement and hospitalization.
Cases over the age of 18 who had a history of contact with cases infected with COVID-19 or had clinical findings suggestive of COVID-19 who applied to the emergency department and who were diagnosed with COVID-19 by reverse-transcriptase-polymerase chain reaction (RT-PCR) were included in the study. Age gender comorbid diseases hospitalization status thorax tomography findings and vaccination status in the last 3 months of the patients included in the study were obtained by examining the hospital information system and patient files.
Our study included 496 patients. One hundred eighty-three of the cases were vaccinated and 42.6% (n = 78) of the vaccinated patients were male. Of the 313 unvaccinated patients 36% (n = 113) were male. Comorbid disease was observed in 55.2% (n = 101) of the vaccinated patients and 38.7% (n = 121) of the unvaccinated patients. Of the 313 unvaccinated patients 72.2% (n = 226) were discharged from the emergency department 19.8% (n = 62) were admitted to the service and 8% (n = 25) were admitted to the intensive care unit. Of the 183 vaccinated patients 78.1% (n = 143) were discharged from the emergency department 16.4% (n = 30) were admitted to the service and 5.5% (n = 10) were admitted to the intensive care unit. In the vaccinated patient group both the service admission rate and the intensive care hospitalization rate were found to be significantly lower than the non-vaccinated patient group (p < 0.05). Thoracic tomography findings of 32.9% (n = 103) of 313 unvaccinated patients were reported as CORADS 1-2-3 and thoracic tomography of the remaining 210 patients was reported as CORADS 4-5. The number of patients whose thorax tomography report was CORADS 4-5 was found to be significantly higher in the unvaccinated group than in the vaccinated group (p < 0.05).
In our study it was found that vaccination significantly reduced hospitalization in COVID-19 patients. Although the mean age was higher in the vaccinated patient group both the service admission rate and the intensive care admission rate were found to be lower.
The XEC COVID-19 Variant: A Global Threat Demanding Immediate Action
The new XEC variant that has recently been described a recombinant strain originated from the Omicron sub-lineages KS1.1 and KP3.3 (also known as FLuQE; it is descended from the FLiRT lineage) has since early July 2024 been confirmed in more than 15 EU countries as well as North America and Asia. Currently the XEC variant is reported in 27 countries including America Britain and China with T22N and Q493E in the spike that gives it a transmission advantage meaning that it may be the dominant strain in this coming winter season. Like past COVID-19 strains XEC has caused flu-like signs including fever sore throat and body aches. Thus the high efficacy of vaccines in preventing severe disease and hospitalization cannot negate the necessity to pay attention to XEC increase public health measures and improve genomic surveillance due to the high transmissibility of the virus and slight advantage in transmission. This letter urges people worldwide to pay attention to how XEC is spreading and to act quickly to stop new cases from rising especially among the susceptible groups.
Revealing the Unseen: Post COVID-19 Biomarkers, Severity, and Outcome Mysteries
Although the COVID-19 pandemic has passed some patients still experience post-COVID-19 symptoms. It has been reported that COVID-19 symptoms can persist for more than three months after recovery.
This study aims to analyze biomarkers severity and outcome factors associated with post-COVID-19 symptoms.
This prospective cohort study involves hospitalised COVID-19 patients who were followed for up to 3 months after discharge. Clinical examinations and laboratory tests for MMP-9 TIMP-1 and IL-6 were conducted during hospitalisation and after three months.
We enrolled 76 COVID-19 patients with a mortality rate of 30.26%. Among them 55 individuals (30.91%) had no residual symptoms 54.5% had acute COVID-19 9.09% had ongoing COVID-19 and 5.45% had long-term COVID-19. Symptomatic post-COVID-19 had oxygen demand and respiratory rates higher than no-symptoms groups. Early IL-6 IL-10 MMP-9 and TIMP-1 were lower in symptomatic post-COVID-19 compared to dead and asymptomatic post-COVID-19 groups. IL-6 and MMP-9 decrease and TIMP-1 increases after cure. IL-6 significantly still increases in post-COVID-19 symptoms compared to no-symptoms (p=0.01). Patients more than 50 years old and critically ventilated patients are prone to have symptoms post-COVID-19.
More than half of patients suffer from post-COVID-19 symptoms with various related factors. Even though IL-6 decreases after recovery IL-6 levels are still higher in symptomatic post-COVID-19 patients.
Unraveling the Effects of SARS-CoV-2 on Dementia: A Comprehensive Study
Since late 2019 a pandemic caused by SARS-CoV-2 a highly contagious coronavirus has jeopardized human and public health. Neurodegeneration and structural brain diseases produce dementia which is developing rapidly. Strong evidence of COVID-19 brain abnormalities as neurotrophic viruses impair neurological systems. Neuron and glial cell degeneration can affect nerve transmission and brain function. Damage to these brain components raises dementia risk. Multiple studies linked SARS-CoV-2 to dementia. This manuscript contains selective data. This study aims to review the findings and suggest strategies to improve SARS-COVID dementia management. The study makes use of medical research databases like Google Scholar PubMed Medline and Embase. Furthermore information is also collected by recognized health organizations and government agencies. COVID-19 can produce neuropsychological deficits agitation confusion inattention and disorientation. Thus SARS can worsen dementia and neurodegeneration. This article summarizes COVID-19's effects on dementia patients from several sources. The focus on existing treatments for affected patients ties the two.
Mucormycosis: Current Perspectives on Treatment, Diagnosis, and Advancements
This review study examines mucormycosis treatment challenges gaps in medicines and COVID-19-related effects. This paper examines diagnostic and drug development advances while addressing safety and specificity.
This review study searches PubMed Web Science and Scopus for relevant material. Keywords associated with mucormycosis therapy diagnosis medication advancement and COVID-19 are used to identify pertinent articles. Data extraction summarizes therapeutic obstacles diagnostic advances and innovative drug options.
This review article covers mucormycosis therapy diagnostics and drug development. It reveals limitations in present medicines such as selectivity safety and resistance mechanisms. Diagnostic advances and mucormycosis in COVID-19 have also been explored.
This review emphasizes the need for more secure specific mucormycosis therapies. It discusses therapy obstacles diagnostic advances and new drug techniques. Overall this research emphasizes improving mucormycosis therapy to enhance patient outcomes.
Antibodies as Promising Molecules to Block Spike Glycoprotein from SARS-CoV-2
COVID-19 is caused by a new SARS-CoV-2 virus from the Coronaviridae family responsible for developing severe acute respiratory syndrome (SARS-CoV). Its emergence in 2019 presented several challenges to global health. The virus can infect host cells using the ACE2 receptor and after infection several clinical manifestations appear ranging from mild symptoms to death. One approach that has shown promising results is convalescent plasma since convalescent plasma (CP) consists of a concentrate of immunoglobulins in the blood of patients recently infected with the coronavirus for those currently infected. Therefore this therapy uses antibodies in the plasma to neutralize the virus. This literature review aims to evaluate the efficacy of CP therapy in symptomatic COVID-19 patients by analyzing clinical trials and studies published between 2020 and 2023. Therefore the search identified studies in which the majority reported the efficacy of using convalescent plasma to treat and alleviate the clinical condition of patients diagnosed with COVID-19. Important factors influence the efficacy of CP therapy such as the timing of administration and the severity of the disease. Early administration in mild and moderate cases has shown promise. Furthermore molecular docking analysis suggests that antibodies can cause conformational changes in the SARS-CoV-2 spike protein raising the hypothesis that using CP may interfere with viral entry into host cells.
Evaluation of Mental Health Status of Obstetrics and Gynecology Assistants during the COVID-19 Pandemic in Iran - A Cross-sectional Study
Some evidence shows that the COVID-19 pandemic has had negative effects on the mental health status of different sections of society including the medical staff.
The current study was conducted with the aim of investigating the mental health status of obstetrics and gynecology (OB-GYN) assistants during the COVID-19 pandemic in Iran.
The present cross-sectional study was conducted in 23 hospitals across Iran in 2021 (January-March). Four hundred OB-GYN assistants were randomly and voluntarily enrolled in the study. The instrument used in this study was the 28-item General Health Questionnaire (GHQ-28) which had four subscales including somatic symptoms anxiety/insomnia social dysfunction and severe depression. To collect data and to reach respondents in distant areas the questionnaires were provided to the OB-GYN assistants by the online platform.
The mean age of the OB-GYN assistants was 32.3±2.6 years and all were female. Of 400 OB-GYN assistants 132 (33%) had no distress and 268 (67%) had psychiatric distress. According to subscales scoring 72 (18%) 68 (17%) 92 (23%) and 64 (16%) had severe distress in somatic symptoms anxiety/insomnia social dysfunction and severe depression respectively.
Considering that more than half of the Iranian OB-GYN assistants had poor mental health it seems that the COVID-19 pandemic has had a negative and destructive effect on the mental health of OB-GYN assistants. In this situation they need psychological support and appropriate intervention.
Assessing the Efficacy and Challenges of Tofacitinib in the Management of COVID-19: A Systematic Review and Meta-analysis of Cohort Studies
Global healthcare faces challenges in combating COVID-19 with rising cases despite widespread vaccination. Severe COVID-19 cases marked by acute respiratory distress and cytokine release syndrome highlight the importance of managing cytokine storms. Janus kinase (JAK) inhibitors such as tofacitinib show promise in this regard. While tofacitinib is recommended for severe cases challenges include adverse effects conflicting studies and the need for further investigation of new virus strains. Overcoming these hurdles is crucial for developing an effective treatment protocol and reducing COVID-19 mortality.
This study conducted a comprehensive search across PubMed Scopus and ISI Web of Science for observational studies on tofacitinib treatment in human adults with COVID-19. The search covered a specified period up to 2024. Data extraction including study characteristics and quality assessment employed the Newcastle Ottawa Scale and a modified Cochrane tool. Statistical analysis conducted with Comprehensive Meta-Analysis Software assessed heterogeneity and significance levels.
The meta-analysis of the three studies showed a significant reduction in mortality (Risk Ratio: 0.372 95% CI: 0.213–0.649 p-value = 0.001) with low heterogeneity (Cochrane p-value = 0.793) while no significant reduction in the need for mechanical ventilation was observed (Cochrane p-value = 0.194).
Tofacitinib administration shows a significant reduction in COVID-19 mortality. However the limited studies on its efficacy highlight the need for cautious interpretation in clinical assessments.
The Relationship of Self-Care Knowledge Towards COVID-19 Crisis with Anxiety and Quality of Life in Infertile Women
Self-care is any activity that establishes and maintains one’s own health and prevents and deals with illnesses. According to the evidence epidemiological crises affect individuals' mental health. Also dealing with infertility can lead to mental health issues. The present study aimed to investigate the relationship of self-care knowledge towards the COVID-19 crisis with anxiety and quality of life among infertile women.
A cross-sectional online survey via the social media platform WhatsApp based on convenience sampling of infertile women active in the virtual network was conducted from April to December 2019 during the COVID-19 pandemic in Infertility centers of Shiraz a metropolis in the South of Iran. Data was collected by demographic and infertility-related questionnaire self-structured questionnaire of self-care knowledge towards the COVID-19 crisis Spielberger state anxiety and Fertility Quality of Life questionnaire using Porsline software on a self-report basis. SPSS software IBM company version 20 was used for data analysis.
Most of the participants (62.2%) had average self-care knowledge about COVID-19. There was an inverse and significant relationship between self-care knowledge of COVID-19 and anxiety of infertile women i.e. the lower level of self-care knowledge of infertile women towards COVID-19 crisis was associated with a higher level of anxiety (p < 0.05). No significant relationship was found between the level of self-care knowledge of COVID-19 and infertile women’s quality of life (p > 0.05).
Increasing self-care knowledge of COVID-19 among infertile women could affect their mental health. Education and increasing self-care knowledge during pandemics are recommended to manage the anxiety of infertile women and as a consequence promoting fertility.
Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19-PIMS-grade 3: A Case Report
In the face of the rise of COVID-19 the multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 has been reported and an increase in MIS-C cases has been observed throughout the world. The majority of these cases were similar to Kawasaki disease concerning clinical presentation.
Despite similarities MIS-C cases present clinical and laboratory differentiation which makes it essential to portray similar cases worldwide to have a better consensus in the future. A 7-year-old male child visited the hospital with the chief complaints of fever associated with chills rigors and excessive myalgia for 3 days. He had a history of elevated high C-reactive protein (CRP) of 42.7 mg/L. He was diagnosed with Paediatric inflammatory multisystem syndrome (PIMS)-grade 3. Here for the first time we bring an Indian MIS-C case with COVID-19-associated Paediatric inflammatory multisystem syndrome (PIMS)-grade 3.
PIMS-TS infection in paediatrics is associated with a wider range of complications and the importance of musculoskeletal complications in PIMS-TS has been discussed.
Thrombocytopenia and Other Hematological Features in COVID-19 Patients Referred to Shahid Mostafa Khomeini Hospital
COVID-19 is a deadly virus but there is still no appropriate cure for it. Hence the target of this study was to estimate the clinical value of thrombocytopenia and other blood parameters in COVID-19 patients referred to Ilam Shahid Mostafa Khomeini Hospital from April and September 2020.
In this cross-sectional study patients with thrombocytopenia associated with COVID-19 diagnosed at the Shahid Mostafa Khomeini Hospital in Ilam City during the spring and summer of 2020 were included. A checklist was used to record the hematological indicators of the patients. Further an analysis of data using SPSS V20 software was performed.
Overall 66 thrombocytopenic patients were studied. Among patients who succumbed to the disease complications 40 (67.8%) were male and 19 (32.2%) were female. Mortality and survival rates were 90% and 10% respectively.
Due to the high mortality rate of COVID-19 patients with thrombocytopenia platelet count can be considered a major risk factor as well as a prognostic and diagnostic indicator in these patients.
Nasal Vaccine: A Special Prominence on SARS-CoV-2
Nasal administration of mucosal medications and vaccines is an alternate and promising method of drug and vaccine delivery. Mucosal pathways can be used selectively for various disorders due to many benefits. Many initiatives are now being made to yield effective medications and cutting-edge nasal delivery systems. The structure of the nasal cavity and key features were discussed in this review. With a focus on vaccine distribution the benefits successes and difficulties of using the nasal route for medical purposes were examined. The strong result supports the benefits and security of the safety of nasal medication and vaccination administration. This alternate path may help many unmet medical needs and may also make big vaccination drives or expensive protracted chronic therapies possible. Today despite some lingering criticism the area of nasal medicine and vaccine delivery is expanding quickly supported by recent advancements in nanotechnology imaging and administration devices. The variety of drugs that have been licensed for nasal delivery is expected to increase significantly.
SARS-CoV-2 Delta Variant Spike Protein: Structure, Mechanism, and Docking Interaction with Antiviral Ligands from the Plants of the Phyllanthus Genus
An abrupt outbreak of “Severe Acute Respiratory Syndrome Coronavirus 2” was first identified in Wuhan City Hubei Province China in December 2019 which was later disseminated globally. Individuals afflicted with this highly transmissible virus contribute to a significant public health crisis. The lack of specific vaccinations and antiviral medications for nCoV-2019 together with the emergence of mutations in the genome of the virus necessitates a multifaceted approach to drug design and discovery for COVID-19. A comprehensive worldwide supervision plan is essential for the accurate forecast and prevention of viral infections. The SARS-CoV-2 spike (S) protein plays a crucial role in viral binding fusion and entrance hence influencing the generation and evolution of antibodies and vaccines. The receptor binding domain (RBD) of the SARS-CoV-2 spike protein exhibits a significant affinity for human angiotensin-converting enzyme 2 (ACE2) receptors. It encompasses diverse mutations in the N-terminal domain (NTD) and the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein enhancing immunological efficacy. The B.1.617.2 mutant also known as the Delta variation is expected to spread more rapidly than earlier versions. Thus in this study we have evaluated the structural characteristics of the SARS-CoV-2 spike protein and the human ACE2 protein and their interactions and examined putative SPIKE-ACE2 protein-protein inhibitors derived from the phytocompounds of Phyllanthus species. This is the crucial aspect for the advancement of economical clinical trials of individual plant components for the treatment of viral diseases.
Investigating the Relationship Between Postpartum Depression, Antenatal Depression, Corona Disease Anxiety, and Personality Traits During the COVID-19 Pandemic
Postpartum depression has a profound impact both physically and psychologically on both the mother and her newborn. With a focus on the prevalent psychological complications following the onset of this condition this study aimed to explore the correlation between antenatal depression and corona disease anxiety personality traits and postpartum depression during the COVID-19 pandemic.
This cross-sectional descriptive-analytical study investigated women receiving care at health centers affiliated with Kerman University of Medical Sciences during the last month of their pregnancy and the postpartum period in 2022. Following the acquisition of informed consent participants were assessed using various measures including demographic and obstetric information the Edinburgh Postnatal Depression Scale the Corona Disease Anxiety Scale (CDAS) and the NEO Personality Inventory-Revised during their third trimester of pregnancy. The same group of participants completed the Edinburgh Depression Scale and the Corona Disease Anxiety Scale (CDAS) 4-6 weeks after childbirth.
There was a significant correlation between family income unwanted pregnancy as perceived by both the mother and father and antenatal depression. Additionally marital satisfaction played a significant role in postpartum depression. Furthermore antenatal depression was significantly associated with neuroticism agreeableness and physical symptoms related to corona disease anxiety. Personality traits with the exception of extroversion and conscientiousness and various domains of corona disease anxiety excluding psychological symptoms were also significantly associated with postpartum depression.
During pandemics or epidemics such as the COVID-19 outbreak experiencing mental distress during pregnancy can contribute to mental health issues during the postpartum period. This risk is particularly true in individuals with unique personality traits emphasizing the need for increased focus on mental health within prenatal care during these crises.
Investigating the Relationship Between the Levels of Hematological and Biochemical Parameters of COVID-19 Patients with the Length of Hospitalization
Identifying and treating patients with COVID-19 requires the use of quick and precise laboratory diagnostic techniques that assess the patient's health and identify the illness.
This study was conducted to determine the relationship between hematological and biochemical parameters and length of hospitalization in patients with COVID-19.
This is a cross-sectional study of a descriptive-analytical type which was conducted by census method on 360 medical records of patients with COVID-19 in Imam Khomeini Hospital in Jiroft in 2022. Data were analyzed using descriptive and inferential statistics tests.
The average number of days of hospitalization in the present study was 4 days. The rate of COVID-19 was higher in men than in women. The most common underlying diseases in the patients were heart pulmonary and diabetes. Among the biochemical parameters only lactate dehydrogenase (LDH) blood urea nitrogen (BUN) aspartate aminotransferase (AST) alanine transaminase (ALT) platelet (PLT) and erythrocyte sedimentation rate (ESR) parameters had a statistically significant relationship with the total length of hospitalization (p-value<0.001). LDH AST ALT creatinine (Cr) creatine phosphokinase (CPK) blood sugar (BS) total bilirubin and direct bilirubin parameters were higher than normal in hospitalized patients.
The results showed that there is a relationship between LDH BUN AST ALT PLT and ESR parameters and the length of hospitalization of patients. The levels of LDH AST ALT Cr CPK BS total bilirubin and direct bilirubin parameters in patients were higher than normal.