Pre-exposure and Post-exposure new prophylactic treatments against COVID-19 in healthcare workers

The Severe Acute Respiratory Syndrome-related Coronavirus 2 or novel coronavirus (COVID-19) infection pandemic continues to spread. Since the outbreak of the COVID-19 in Wuhan (China), healthcare workers have been infected and are considered at high risk of contamination. Moreover, in addition to the physical effects of COVID-19, the pandemic results in important mental health issues among healthcare workers such as anxiety, stress, depression, and further nervous or mental disorders. Despite the increasing number of clinical trials aiming to develop vaccines or test antiviral molecules, till now no efficient anti- SARS-CoV-2 drugs have been validated. The COVID-19 pandemic led us to call for an urgent nutritional intervention model that should be established to prevent and/or reduce the negative impact of COVID-19 on healthcare workers. In the present paper, we suggest a safe nutritional supplementation of MgZn- B vitamins (B1, B6, B9, and B12) in healthcare workers as pre-exposure and post-exposure new prophylactic treatments. Furthermore, the paper reports the scientific arguments and the possible mechanisms by which the Mg-Zn- B vitamins supplementation may exert its beneficial effects in the healthcare workers facing the COVID-19 pandemic. Overall, the Mg-Zn- B vitamins supplementation would enhance the immune response against SARS-CoV2, prevent inflammatory processes and oxidative stress, fight or alleviate the COVID-19-related mental health issues, or even reduce the replication. Each element of the supplementation possesses important and promising effects contributing to the possible efficiency of the suggested Mg-ZnB vitamins supplementation in healthcare workers

Multifocal Epithelial Hyperplasia: a case report and review of literature

Objective: Multifocal epithelial hyperplasia (MEH) or Heck's disease is a rare benign disorder caused by Human Papilloma Virus (HPV). It is characterized by multiple soft well demarcated nodules of the oral mucosa. They are commonly seen in buccal, labial and lingual mucosa. However, tonsilar and gingival lesions have also been reported. A detailed clinical history, examination and histopahological review is needed to arrive at a diagnosis. The aim of this report is to show the successful treatment of MEH using Salicylic acid and Zinc supplement. Case Report. Two cases of a 5year old Hausa girl and 7-year-old Hausa boy with a widespread oral lesion of 8 months and 1-year duration respectively. The diagnosis of the case reported were based on clinical evaluation and histopathological investigation. The presence of multiple painless pink nodules and papules on the lips, buccal mucosa and the gingiva as well as histological presence of koliocytes and mitosoid seen on hematoxylin and eosin slide led to the diagnosis of MultifocalEpithelial Hyperplasia. Conclusion: We reported 2 cases of MEH, a rare benign oral mucosa lesion in a 5-year-old Hausa female and a 7year old Hausa male in North-West Nigeria who presented with 8 months and 1-year history of widespread oral mucosa lesion respectively and was treated successfully using salicylic acid and zinc supplement

Serum zinc status in sickle cell anaemia children at the Jos University Teaching Hospital, Jos, Nigeria

Background: Several clinical manifestations of sickle cell anaemia (SCA) have been associated with zinc deficiency. Determining the zinc status of children with SCA in Nigeria, a country that accounts for the highest burden of the disease worldwide, will provide a template that could assist in critically appraising the need or otherwise for zinc supplementation or fortification programmes in these children. Methods: This was a cross-sectional comparative study conducted at the Jos University Teaching Hospital, Jos, Nigeria among 700 children (350 SCA patients and 350 age and sex matched hemoglobin AA controls). Serum zinc was analysed using the atomic absorption spectrophotometry. Results: The median serum zinc concentration of children with SCA was 6(3-7) µmol/l and it was significantly lower than that of the controls 8(4-9) µmol/l, p = 0.04. The prevalence of zinc deficiency in this study was 67% in children with SCA compared with 34% in the control group, (p<0.0001). The proportion of zinc deficient patients was more among children from lower socio economic class (68.5%, 35.5%) than in the upper socio economic class (38.5%, 16.3%) in both cases and controls groups respectively. Conclusion: There is a high prevalence of zinc deficiency in the study population especially among those with sickle cell anaemia. Zinc supplementation or fortification should be considered as part of intervention strategies to improve the zinc status of these children particularly those with sickle cell anaemia

Zinc Concentration during Pregnancy and Lactation in Enugu; South-East Nigeria

Background: There is no doubt that micronutrient deficiency is common in our environment. Replacements have thus been instituted without adequate information on specific and peculiar micronutrient needs of our people. Zinc is an essential micronutrient which is prone to maternal depletion during pregnancy and lactation. Unfortunately; studies in that regard in Nigeria has received diminutive interest. Objectives: To determine zinc concentration during pregnancy and lactation. Methods: This is a cohort study involving one hundred and twenty (120) pregnant women attending the antenatal clinic of one tertiary and two secondary health care institutions in Enugu. Thirty-five (35) apparently healthy; non pregnant women were used as control subjects. Atomic Absorption Spectrophotometer (AAS) was used to determine the zinc levels in the serum of the mothers during pregnancy; postpartum and in the breast milk. Results: Results showed that mean serum zinc levels were significantly decreased (P 0.0001) in pregnancy when compared with non-pregnant control subjects. The levels decreased as gestation progressed; with the lowest concentration of serum zinc obtained during the third trimester. It was also observed that serum zinc levels which decreased in pregnancy; increased non- significantly (P

Carence acquise en zinc chez un nourrisson béninois

La carence acquise en zinc est rare chez les nourrissons ayant une alimentation diversifiee. Nous en rapportons un cas chez un nourrisson de 2 ans. Observation : Un nourrisson de 2 ans est amene par sa mere pour des lesions erythemateuses et erosives de la sphere genitale et du pourtour des orifices du visage evoluant depuis l'age de 9 mois. Sevre a l'age de 3 mois; il a ete nourri par des bouillies a base de mais. Les lesions cutanees; faites de plaques maculeuses erosives erythemateuses et suintantes periorificielles du visage et du perinee ont fait evoque le diagnostic de carence acquise en zinc. La supplementation en zinc a faible dose (0;950 mg/jour) a entraine la cicatrisation des lesions en deux semaines. Discussion : Les hypozincemies acquises sont tres souvent rapportees chez les prematures nourris exclusivement au sein et chez les enfants nes a terme. Elles sont plus rares chez les nourrissons dont l'alimentation est diversifiee. La chelation du zinc par certaines cereales utilisees dans l'alimentation du nourrisson pourrait expliquer la carence en zinc

Effect of Zinc Supplementation in Treatment of Acute Diarrhoea among 2-59 Months Children Treated in Black Lion Hospital; Addis Ababa; Ethiopia

Background: Diarrhoeal disease is one of the major causes of morbidity and mortality in under five children.Worldwide; there are about 1.3 million under five children deaths attributable to diarrhea. Health status in Ethiopia is one of the lowest in the world with estimated health service coverage of 60; and diarrhoeal disease remains one of the major causes of under five morbidity and mortality. Treatment with ORS does not affect the duration and severity of diarrhoea; hence acceptance of ORS is low and diarrhoea still remains the major cause of child morbidity and mortality. Diarrhoea is a commonly associated problem in children with Zinc deficiency and also leads to excess zinc losses. Objective: To assess variations in the usage of antimicrobial and/or antidiarreals in children with acute watery diarrhoea randomized to receive zinc supplementation as compared to those who do not receive it; and assess the adherence to zinc supplementation given with ORS in the management of an episode of acute watery diarrhoea. Methodology: This is part of a multicentre; multi-disciplinary; randomized and open effectiveness trial conducted in out-patient settings in Addis Ababa; Black Lion Hospital at the Department of Paediatrics. The sample size has been calculated for a two-tailed alpha of 0.05 and power of 0.2. Children aged 2-59 months and who presented with acute watery diarrhoea for less than 7 days were recruited. Results: There were 188 children randomized to the Zinc plus ORS arm and 226 children to the ORS arm. There were 193 (46.6) females and 221 (53.4) males. Fifty two percent of the cases were between 2-11 months of age and decreasing trend of proportion of older children was observed in the study population (P=0.0001). Zinc adherence rate was 95. Seventy three (39.3) patients from Zinc + ORS group and 71 (32.3) patients from ORS group took ORS when they came for the first follow up visit (P-value=0.115). From the total study subjects 16.1took antibiotic or antidiarhael tablets before randomization which was significantly higher than the second follow up visit observation with only 1.7(P=0.0001). Only 3 (1.7) patients from Zinc arm and 4 (1.8) patients from ORS arms took antibiotic/anti diarrhoeal on the second follow up visits. Conclusion: Proper counselling of care takers significantly reduces unnecessary use of antibiotic/anti diarrhoea drugs in the treatment of childhood diarrhoea. Zinc supplementation in the treatment of childhood diarrhoea is well tolerated by patients and there is good compliance of care takers. However; we could not observe any significant difference in antibiotic/antidiarheal drug use between ORS and ORS plus Zinc groups

Contributions of dietary protein and zinc deficiencies to protein energy malnutrition

Some degree of zinc deficiency seems present in all cases of Protein-Energy malnutrition. Protein Energy Malnutrition (PEM) was induced in male Wistar rats fed either adequate (30ppm) or moderately deficient levels of zinc (6ppm) in diets containing either 0.4 or 20 per cent spray-dried egg white. The protein-deficient rats developed PEM with oedema in 4 - 5 weeks regardless of their dietary zinc level. Except for disorders of the brain; protein deficiency was the major cause of most PEM signs - loss of appetite; growth failure; oedema; water accumulation in the liver; hypoalbuminaemia and mortality. Dietary zinc deficiency aggravated some of these to a small extent. Dietary zinc alone accounted for elevations of brain iron and sodium in both PEM and non-PEM rats. This suggests that zinc deficiency may significantly contribute to some of the symptoms of PEM