A Mini Review on SARS-COVID-19-2 Omicron Variant (B.1.1.529)

The current world facing unpredictable problems with different variants of COVID-19; SARS-COV-19 is a significant lung infection caused by a coronavirus. Each type has one or more alterations to distinguish from each other. The viruses, including SARS-COV-19, continuously change the genetic code (mutations) during their genome replication. WHO labelled two variants in that we are experienced with delta (B.1.617.2) variant, now recently the omicron came (B.1.1.529) with highly mutatable strikes on it. So WHO predicted it is more dangerous than previous variants because of its mutatable capability. The mutatable strikes play an essential role in transmissibility. So there is a need to evaluate threatens raised with the new variant, so scientists are working on it. Till now, South Africa noticed major cases positive for the Omicron variant. Based on recent reports, the current paper summarized different properties of the omicron variant with others, including protein structure, diagnosis, spreadability, treatment, and potency of vaccines. Doi: 10.28991/SciMedJ-2021-0304-10 Full Text: PDF

Diagnostic Accuracy of COVID-19 Antibody Tests Authorized by FDA Philippines: A Systematic Review and Meta-Analysis

Introduction: Coronavirus Disease (COVID-19) is a highly infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which has infected many people all over the world. One of the best ways to lessen its spread is through early detection and diagnosis. Various serological tests are now being used as a surveillance tool in the detection of antibodies as a response to SARS-CoV-2. The aim of this study is to evaluate the diagnostic accuracy and performance of the available COVID-19 antibody tests authorized by the Food and Drug Administration (FDA) Philippines that make use of Enzyme-Linked Immunosorbent Assay (ELISA), Chemiluminescence Immunoassay (CLIA) and Lateral Flow Immunoassay (LFIA). Method: Complete published journal articles relevant to the diagnostic accuracy of the three antibody tests were collected using trusted medical journal search engines. The quality of journals was assessed using QUADAS-2 to determine the risk of bias and assess the applicability judgments of diagnostic accuracy studies. Forest plots were used to summarize the performance of LFIA, ELISA and CLIA according to their specificity and sensitivity in detecting various antibodies. Pooled sensitivity and specificity were also done using bivariate random-effects models with its log-likelihood, a corresponding chi-square test statistic, and area under the summary Receiver-Operating Characteristic curve to see the potential heterogeneity in the data and to assess the diagnostic accuracy of the COVID-19 antibody tests. Results: Bivariate random-effects model and areas under the sROC curve were used to evaluate the diagnostic accuracy of COVID-19 antibody tests. The pooled sensitivity in detecting IgG based on CLIA, ELISA, and LFIA were 81.7%, 58.7%, and 74.3% respectively, with an overall of 72.0%. For IgM detection, LFIA has a higher pooled sensitivity of 69.6% than CLIA with 61.0%. Overall, the pooled sensitivity is 68.5%. In IgA detection, only ELISA based test was included with a pooled sensitivity of 84.8%. Lastly, pooled sensitivities for combined antibodies based on ELISA and LFIA were 89.0% and 81.6% respectively, with an overall of 82.5%. On the other hand, all tests excluding ELISA-IgA displayed high pooled specificities with a range of 94.0% to 100.0%. Diagnostic accuracies of the test in detecting IgG, IgM, and combined antibodies were found out to be almost perfect based on the computed area under the sROC with values of 0.973, 0.953, and 0.966, respectively. Conclusion: In this systematic review and meta-analysis, existing evidence on the diagnostic accuracy of antibody tests for COVID-19 were found to be characterized by high risks of bias, consistency in the heterogeneity of sensitivities, and consistency in the homogeneity of high specificities except in IgA detection using ELISA. The bivariate random-effects models showed that there are no significant differences in terms of sensitivity among CLIA, ELISA and LFIA in detecting IgG, IgM, and combined antibodies at a 95% confidence interval. Nonetheless, CLIA, ELISA and LFIA were found to have excellent diagnostic accuracies in the detection of IgG, IgM and combined antibodies as reflected by their AUC values. Doi: 10.28991/SciMedJ-2021-0304-1 Full Text: PDF

Knowledge of Breast Self-Examination, Breast and Cervical Cancer Screening among Indian Women

The burden of breast and cervical cancer in terms of incidence and mortality in low- and mid-income countries is increasing daily due to late diagnosis, unhealthy lifestyle choices, late presentation, and poor attitude to screening. Early detection increases the chances of survival. This present study assessed Assam women’s breast and cervical cancer screening (CCS) awareness, the practice of breast self-examination (BSE), and uptake of human papillomavirus vaccines. An internet-based cross-sectional questionnaire was utilized to obtain 251 consenting respondents. The mean age of respondents was 27.8 ± 6.91. Only 205 (81.7%) and 110 (43.8%) respondents have satisfactory levels of BCS, and CCS knowledge, respectively. While only 76 (30.3%) respondents had satisfactory BSE practice. Age range (26 – 32 years), tertiary education, and being single were demographic characteristics that influenced knowledge and practice. Though the respondents had a satisfactory knowledge level, screening uptake among respondents is very poor as only 32 (12.7 %) had ever been screened and only 19 (7.6 %) ever been vaccinated. The major reasons for poor screening uptake were “no symptoms” and “not aware of screening location”. Most respondents (227, 90.4 %) are willing to go for screening if well oriented. This presents an opportunity to enhance awareness about screening and vaccination among Assam women. The media/internet and health practitioners can be leveraged to promote the uptake and utilization of screening services and BSE practice. Doi: 10.28991/SciMedJ-2021-0304-5 Full Text: PDF

Suitability System of Microbiological Method for Nystatin Potency Determination in the Routine Analysis Using Agar Diffusion Method

Nystatin is a polyene macrolide antifungal active which is used for the treatment of candidiasis and obtained from some species of Streptomycesbacteria. The present work describes the statistical suitability analysis for regular monitoring of the agar diffusion bioassay in a simple, inexpensive and time-saving process before potency determination. A balanced (symmetrical) two-dose parallel line assay model was applied using the agar well diffusion method for quantification of Nystatin in raw material and finished medicinal dosage form. The routine inspection methodology yielded good results and included calculations by the linear parallel model and by means of regression analysis and verified using analysis of variance (ANOVA). The assay is based on the inhibitory effect of Nystatin upon a standard strain as described in the United States Pharmacopeia (USP). The results of the post validation regular assays were treated statistically by ANOVA and the deviations (expressed as average ± standard deviation) from both raw and column totals were 0.702 ± 0.476 and 0.865 ± 0.468, respectively. The mean value of the variance ratio for regression and parallelism squares were 534.349 ± 212.546 and 0.596 ± 0.345, respectively. The study of Nystatin's ongoing analysis showed that the microbiological assay design is satisfactory with respect to the limiting values for the determination of the potency. The established balanced parallel line assay is reasonably stable and suitable and can be used for the regular drug analysis in routine quality control testing and the quantitation of Nystatin in pharmaceutical dosage form and raw material. Doi: 10.28991/SciMedJ-2021-0304-2 Full Text: PDF

Are Avoidance Goals the Right Prescription For a Pandemic? A COVID-19 Case Study

Background: Motivation scientists study goals, self-regulatory tools that are used to help people approach or avoid objects of desire or disdain. Purpose: Using these tools, motivation science can offer insights to guide behaviour and help individuals maintain optimal health and well-being during pandemics, including COVID-19. Results: Avoidance goals help guide behaviour away from negative objects like COVID-19, and are necessary in situations where survival is at stake. Formulating the goal of avoiding COVID-19 is therefore recommended during the pandemic. However, avoidance goals have inherent limitations, in that they tax one’s energy and well-being. To minimize these costs, the pursuit of approach sub-goals may be recommended, such as increasing social connection online or exercising outdoors (particularly prior to widespread vaccination). Conclusion: Adhering to the goal of avoiding COVID-19 prevents infection and saves lives when safe and effective vaccines and treatments are lacking. But avoidance goals have known costs that must be acknowledged and addressed. One solution is to pair avoidance goals with approach sub-goals to bolster mental and physical health while adhering to the ultimate goal of avoiding COVID-19, viral variants, and future contagions. Doi: 10.28991/SciMedJ-2021-0304-7 Full Text: PDF

Cancer Morbidity and Computed Tomography: “After” and “Due to” Challenge

The article discusses the problem of carcinogenic risk assessment in the context of relationship with diagnostic radiation resulted from Computed Tomography (CT). The study aimed to evaluate the possible long-term carcinogenic effects after the exposure to a low dose of diagnostic radiation, appeared within a decade after the 1st CT scan. Information on patients examined using CT in the District Hospital of Kasli (KDH) has been derived from the CT archives since 2009 when the first CT examinations has been performed in the KDH. The data were linked to local Cancer registry, the Death registry, and the “CT Registry” database (CTDB) to obtain the information on vital status, the cause of death, cancer morbidity and CT examinations outside KDH, respectively. 275 CT examinations of 246 patients have been recorded to the data file (KDH cluster). To the end of the study, 46 cases of malignant tumours (MT) have been accumulated in the study group. The average observation time was 6.5 years (90% CI 6.2-6.8). The distribution of cancers among patients exposed to CT has been shown retrospectively through the date of birth of patient to December, 31, 2018. The cases of MT diagnosed prior to 1st CT examination have been excluded from the analyses. Cancer-related conditions stated before the date of 1stCT examination have been accounted. The cumulative cancer incidence after the exposure to CT, adjusted for predisposed conditions in the study group was 4.8%. The study results have been compared with the results of the LSS cohort study to assess the expected excess cancer morbidity. The data obtained in the study provide the information for a comprehensive epidemiological assessment of long-term effects related to diagnostic radiation exposure in the Ozyorsk Computed Tomography Cohort (OCTC study). Doi: 10.28991/SciMedJ-2021-0304-3 Full Text: PDF

An Overview of Central Nervous System Tumours

Central nervous system (CNS) tumours refer to tumours that occur in the tissues of the brain and/or spinal cord. These tumours arise as a result of abnormal growth of cells and may begin in different parts of the brain or spinal cord. There are many types of CNS tumours, which are further divided into subtypes. Despite decades of research conducted, CNS tumours remain among the deadliest of all cancers. It is most often challenging to treat these tumours, due to the risks involved, and biological characteristics associated with them. The classification, grading, and characterisation of CNS tumour plays a pivotal role in the management thereof. The current review provides an overview of CNS tumours, classification, grading and treatment, as well as their characterisation with specific focus on gliomas, ependymomas, oligodendrogliomas, meningiomas, medulloblastomas, schwannomas, gangliogliomas, and craniopharyngiomas. Doi: 10.28991/SciMedJ-2021-0304-8 Full Text: PDF

COVID-19 Perceptions: Applying the Health Belief Model

This study aimed to explore the Sudanese COVID-19-related perceptions on preventive measures using the Health Belief Model, a psychosocial frame that explains and predicts health-related behaviours. A cross-sectional using an online-questionnaire through social media platforms, or channels. A snowball sampling technique was used. Descriptive analyses using frequencies and percentages for categorical variables, mean (±SD) for numerical variables. Bivariate relationships between the variables were assessed using a t-test. We conducted multiple variable analysis using the correlation between HBM constructs. Eight hundred seventy-seven participants with a mean age 37.8 (SD±11.94), primarily males, had a university education, employed and residing in Khartoum. Scores of 69% self-efficacy prevent COVID-19, 60% perceived severity if infected with COVID-19, 54% perceived susceptibility to COVID-19. Furthermore, high scores reported for hand hygiene barriers 50 and 53% social distancing. Self-efficacy correlated negatively with susceptibility (r=-0.084), positively with severity, benefits of and barriers to hand hygiene, benefits and barriers to social distancing (r=0.117, r=0.347, r=0.202, r=0.396, r=0.276), respectively. The lack of self-efficacy and low perception of severity and susceptibility, and increased perception of barriers to social distancing and hand hygiene among a considerable portion of the public hindered the compliance with the preventive measures. Doi: 10.28991/SciMedJ-2021-0304-4 Full Text: PDF

The Prevalence of blaNDM-1 in Clinical Isolates of Carbapenem-resistant Pseudomonas Aeruginosa: A Systematic Review

Background: Pseudomonas aeruginosa (P. aeruginosa) is a gram negative bacteria that is known to cause nosocomial infections. Carbapenem is used to treat the damage caused by P. aeruginosa, however it is becoming resistant to carbapenems because of the production of β-lactamases. The objectives of the study were to systematically review the prevalence of blaNDM-1 in carbapenem-resistant Pseudomonas aeruginosa (CRPA) and to review and analyze the clinical sources as well as the antibiotic resistance profile of CRPA carrying blaNDM-1. Methods: The researchers systematically searched PubMed, ScienceDirect, and Google Scholar. Studies that met the inclusion criteria were included in the review. In assessing the methodological quality of the included studies, the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data and the JBI Critical Appraisal Checklist for Case Reports were used. Results: A total of nine studies were included in which eight were cross-sectional studies and one was a case report. The highest prevalence rate reported was 54.55% in blaNDM-1 positive CRPA isolates among the cross-sectional studies. The three most frequent sources of clinical isolates of CRPA carrying blaNDM-1 include urine, wound discharge, and tissue, among the included studies. Lastly, this review showed that among the included studies, CRPA isolates carrying blaNDM-1 were most resistant to ceftazidime and gentamicin. Conclusions: There is varying prevalence of blaNDM-1 in CRPA in different countries. Urine, wound discharge, and tissue specimens being the most frequent sources of CRPA isolates carrying blaNDM-1 poses a challenge that must be given attention by the infection control committee, thus the need for proper handling and processing of clinical specimens. Resistance to ceftazidime and gentamicin among the CRPA isolates carrying blaNDM-1highlights the growing challenge of successfully treating infections caused by this bacteria. This challenge reminds us of the importance and purpose of antibiotic stewardship that emphasizes the improvement of proper antibiotic prescription by the physicians and proper antibiotic use by the patients that can help in preventing harm and antibiotic resistance. Doi: 10.28991/SciMedJ-2021-0304-9 Full Text: PDF

Diabetic Foot Ulcer Risk with Diabetic Kidney Disease and Renal Failure among 10,680 Patients

Objectives: Patients with Diabetic Kidney Disease (DKD) and foot ulcer have poor prognosis. However, no study have found association of diabetic foot ulcer (DFU) with diabetic kidney dysfunction and their co-existing risk factors. Materials and Methods: This cross sectional study collected the data for 10,680 patients for 15 years. All variables were analyzed biochemically and statistically by standardized methodology. Results: Levels of HbA1c, creatinine, systolic and diastolic blood pressures, microalbuminuria, spot urine protein, and spot urine protein to creatinine ratio were higher among the groups with foot ulcers (p-value < 0.0001 for all). Average ABI was observed to be lower among the groups demonstrating nephropathy and DKD (p=0.025 and 0.022 respectively. DFU was significantly associated with HTN (odds ratio 2.2; 95% CI 1.66 to 2.9; p < 0.0001), nephropathy (odds ratio 4.77; 95% CI 3.53 to 6.5; p < 0.0001) and DKD (odds ratio 4.77 and 6.83; 95% CI 4.6 to 10.2; p < 0.0001). HbA1c of 7.8% was 60% sensitive and 52% specific for the development of DFU. Creatinine of 1.2 mg/dl was 75% sensitive and 48% specific for DFU. Spot urine protein excretion from nephrons of 35 mg/dl was 88% sensitive and 90% specific for the development of DFU. Conclusion: Nephropathy/DKD are risk factors for the development of DFU. With optimal diabetes control, regular and routine assessment of the feet and early screening of diabetic patients for neuropathy, nephropathy, hypertension, dyslipidaemia and other diabetic complications are essential. Doi: 10.28991/SciMedJ-2021-0304-6 Full Text: PDF