Knowledge and Acceptance of COVID-19 (SARS CoV2) Vaccination among Foundation students in a College in Kedah, Malaysia

@#Introduction: To combat the COVID-19 pandemic, Malaysia started vaccination of front-liners and adults in the community. The latter group might have insufficient knowledge to accept COVID-19 vaccination, therefore this research was to assess the knowledge and acceptance of COVID-19 vaccination among youths, specifically students in a Malaysian college. Methods: A cross-sectional study was conducted among 481 foundation students in Kolej MARA Kulim (KMKU). The minimum sample size, using Epi Info was 214. Students answered an online questionnaire using google form which included demographic data (age, gender) and ten questions on knowledge and acceptance of COVID-19 vaccination. For knowledge questions, students answered “yes”, “no” or “don’t know”, correct answer scoring 1. For acceptance questions, a 5-point Likert scale was used ranging from “strongly disagree” to “strongly agree”. EXCEL and SPSS version 23 were used for analysis with Chi-square test done to test association (significant for p-value <0.05). Results: The response rate was 65.1% with 313 students, (45.4% males, and 54.6% females) aged 18-19 years. The majority (83.7%) had satisfactory to excellent knowledge scores (mean = 6.66 (SD=2.299, 95% CI 6.40-6.91), median = 7 (± IQR =3), while 16.3% obtained poor scores (≤ 4). The majority (90%) accepted vaccination. Higher knowledge scores were associated with higher acceptance rates in both genders (p-value= 0.000). Significantly more females (90.6%) than males (80.3%) had positive attitude towards vaccination (p-value = 0.009). Conclusions: The majority of the foundation students in KMKU were knowledgeable on COVID-19 vaccination and willing to receive the vaccination against the novel coronavirus.

Effect of sildenafil citrate on fetal color doppler study and biophysical profile in cases of intrauterine growth restriction [iugr] in third trimester

Background: fetal growth restriction is an important cause of perinatal morbidity and mortality. The accurate assessment of fetal growth during pregnancy is difficult, but recent advances have improved this important aspect of obstetric care with positive implications for antenatal patients and their babies

Aim of the Work: to assess the effect of sildenafil citrate on color Doppler flow parameters in umbilical artery, Middle cerebral artery and Biophysical Profile in case of fetal growth restriction

Patients and Methods: this is a prospective cohort study of 100 pregnant females presenting for routine antenatal care at 28 + 0 weeks till delivery. A cohort of 100 pregnant females attending the antenatal care clinics at Al-Hussein university hospital and Bab El-Sharia university hospital during a period of 2 years from May 2016 to May 2018

Results: this study excluded the patients with undetermined gestational age, intrauterine infection, high risk for aneuploidy [e.g. maternal age >40 years, detected congenital fetal anomalies in the current or previous pregnancies]. All cases were followed regularly twice monthly during the seventh and eighth month and then once weekly till delivery, after the administration of 20mg of sildenafil citrate every 12 hourly starting from the 28 weeks of gestation until delivery

Conclusion: the current study conclude that, administration of Sildenafil 20 mg every 12 hourly in pregnant females with fetal growth restriction [FGR] improved the feto-placental Doppler indices [pulsatility index and resistance index] of umbilical artery, middle cerebral artery

Rheological properties of blood serum of rats after irradiation with different gamma radiation doses in vivo

The blood serum rheological properties open the door to find suitable radio-protectors and convenient therapy for many cases of radiation exposure. The present study aimed to investigate the rheological properties of rat blood serum at wide range of shear rates after whole body irradiation with different gamma radiation doses in vivo. Healthy male rats were divided into five groups; one control group and 4 irradiated groups. The irradiation process was carried out using Co60 source with dose rate of 0.883cG/sec. Several rheological parameters were measured using Brookfield LVDV-III Programmable rheometer. A significant increase in viscosity and shear stress was observed with 25 and 50Gy corresponding to each shear rate compared with the control; while a significant decrease observed with 75 and 100Gy. The viscosity exhibited a Non-Newtonian behaviour with the shear rate while shear stress values were linearly related with shear rate. The decrease in blood viscosity might be attributed to changes in molecular weight, pH sensitivity and protein structure. The changes in rheological properties of irradiated rats' blood serum might be attributed to destruction changes in the haematological and dimensional properties of rats' blood products

changes in serum and whole blood Theological properties of rabbits during the progression of atherosclerosis

This study aimed to evaluate the role of zinc [Zn]-supplemented with high cholesterol diet [HCD] on the serum and whole blood rheological properties of rabbits fed a HCD. Twenty-four New Zealand white rabbits were divided into three groups. The HCD group was fed a diet with 1.0% cholesterol and 1.0% olive oil. The HCD + Zn group was fed a diet with 1.0% cholesterol, 1.0% olive oil, and Zn. Blood viscosity, shear stress, and torque [%] were measured at shear rates ranging from 225 to 1875 s-1 for serum and 75-900 s"1 for whole blood. Serum viscosity and shear stress in HCD rabbits were significantly higher at all shear rates compared to controls; while whole blood viscosity and shear stress in HCD rabbits were significantly lower at all shear rates compared to controls. Viscosity and shear stress in both serum and whole blood from rabbits in the HCD + Zn group returned to normal values at all shear rates. The Zn supplemented to HCD rabbits, delays the progression of atherosclerosis. Changes in blood serum viscosity could reflect changes in non-clotting proteins, glucose, nutrients and trace elements; while changes in whole blood viscosity could result from changes in hematocrit, hemoglobin, and erythrocyte count. One of the factors responsible for increasing the serum viscosity values of HCD rabbits might be attributed to increase in Fe and decrease in Zn levels in the blood serum

Ultraviolet-visible and fluorescence spectroscopy can be used as a diagnostic tool for gamma irradiation detection in vivo

The spectroscopic properties can indicate important features about the nature and severity of the disease. However, no earlier studies have been used the spectroscopic properties as a diagnostic tool for radiation detection. This study was aimed to use ultraviolet-visible and fluorescence spectroscopy as a diagnostic tool for gamma irradiation detection in rats in vivo. Adult male rats were exposed to 25, 50, 75 and 100 Gray as single dose, using Cobalt-60 [Co-60] source with a dose rate of 0.883 centi Gray/sec [cGy/s]. Ultraviolet and fluorescence spectroscopy of rat's blood serum were measured. After gamma irradiation of rats in vivo, the blood serum absorbance peaks for 25, 50, 75 and 100 Gray [Gy] decreased and shifted towards the ultra violet wavelength. A maximal change in fluorescence intensity of blood serum at 350 nm was obtained when exciting light at 194 nm after irradiation. The fluorescence intensity also decreased with the dose. The highest radiation gamma dose might be accompanied with the highest oxidative stress. This study suggests that at the above mentioned gamma radiation doses, the blood is highly fragmented; with low aggregation at 25 Gy and with high aggregation at 50-100 Gy

Effects of gamma-radiation on red blood cell corpuscles and dimensional properties in rats

In an attempt to understand the toxicity and the potential role of gamma-radiation as a therapeutic tool, the effects of different Gamma-radiation doses on haematological and dimensional properties of rats' blood were investigated in vivo. 60 healthy male Wistar-Kyoto rats were used, which were randomly divided into five groups, 4 Gamma-radiated rat groups [1St group was radiated with five Gamma-radiation dose, 2nd group 25Gy; 3rd group with 50Gy, 4th group with 100Gy, and 5th group was control]. Different haematological and dimensional parameters were measured using the standard haematological technique. A significant decrease in red blood cells [RBCs] count, haemoglobin [HGB], and haematocrit [HCT] was observed compared with the control. While a significant increase in mean corpuscular volume [MCV], mean corpuscular haemoglobin [MCH] and mean corpuscular haemoglobin concentration [MCHC], red distribution width [RDW] were observed compared with the control. This study suggested that low RBCs, HGB, and HCT might produce anemia and cessation of erythrocytes production in the bone marrow. Moreover, the RBCs size increase might be attributed to changes in the morphology and deformability of RBCs, which was confirmed by a slightly increase in RDW

Impacts on the third line of defense specialized against microbial infection as a result of exposure to gamma-radiation

To understand the toxicity and the potential role of gamma-radiation [GR] as a therapeutic tool, the effects of different GR doses on haematological and dimensional properties of rats' blood were investigated in vivo. 60 healthy male Wistar-Kyoto rats were used in this study, and were randomly divided into 5 groups, 4GR rat groups [1St group was radiated with 5GR, 2nd group 25Gy; 3rd group with 50Gy, 4th group with 100Gy and 5th group was the control]. Different haematological and dimensional parameters were measured using the standard haematological technique for complete blood count [CBC]. A significant decrease in white blood cells [WBCs] count and lymphocytes [LYM] was observed compared with the control. While a significant increase in monocytes [MON], neutrophils [NEU], basophils [BAS], and eosinophils [EOS] were observed. A non-significant decrease in platelets [PLTs] count was observed with GR compared with the control

Effect of incubating egg exposure to magnetic field on the biophysical blood properties of newly-hatched chicks

Due to widespread of human exposure to electromagnetic fields, there has been increasing public concern about the potential health risks from low-frequency electromagnetic fields; ELF-EMF. The magnetic fields [MFs] affects functions of the living organisms, such as DNA synthesis and ion transportation through the cell membranes. In the present work, the effects of short-term exposure to magnetic fields [MFs] prior to incubation were investigated on the ancliaysical blood properties of chicks hatched from layer-type breeder eggs. The eggs were exposed to a MF of 0.75mT at 50 Hz for 20, 40 and 60min before incubation. This study was performed by measuring the dielectric relaxation of hemoglobin [Hb] molecules and the membrane solubility of red blood cells [RBCs] using the non-ionic detergent octylglucoside. Exposure of the eggs to a MF increased the conductivity of the Hb molecules. The pronounced increase is the conductivity of the exposed eggs might be attributed to an increase in the surface charge of the Hb macromolecules, resulted from the formation of highly active molecular species. This speculation can be supported link increase in the relaxation time of the exposed groups. The solubilization process of the RBC membrane indicates a lass in the mobility of RBCs in the blood of hatching chicks

Recent concepts in the pathophysiology and treatment of pseudotumor cerebri [PTC]

Study the role of intracranial venous system in the pathophysiology of Pseudotumor cereberi. Twenty patients diagnosed as PTC according to Dandy diagnostic criteria. All underwent general and neurological assessment. Full ophthalmologic assessment. Full Laboratory investigations were done. Radiological assessment included CT scan brain +/- MRI brain without contrast, MRV of the intracranial venous system. All underwent digital subtraction cerebral Angiography [DSA] [venous phase] to confirm the validity of filing gaps seen at the level of MRV whether they are true stenosis or not. Menstrual irregularity documented in 2 patients [10%]. Sixteen patients [80%] considered to be overweight or obese. MRV brain showed that 14 patients [70%] showed filling gaps suggestive of sinus stenosis. However, digital subtraction cerebral angiography [venous phase] gave different data that only 5 patients [25%] had stenosis in their dural sinuses. MRV showed to be a good screening tool since it had 100% sensitivity and negative predictive value. Therefore, if MRV is normal no further investigations are needed. However, since it has a moderate specificity [62%] with a positive predictive value [PPV] of only 35%, then lesions detected should be confirmed with digital subtraction cerebral angiography [venous phase] particularly those involving the transverse and sigmoid sinus. In our study most of the cases having venous sinus stenosis occurred among patients with age between 22-30 y old [p<0.05] and among those with BMI>30 [p<0.05]. Significant association was found between visual symptoms and stenosis since 80% of cases with stenosis had diplopia, TVO's, grade 3 papilledema and in grade 3 field defect [p<0.05]. By logistic regression model, diplopia and TVO's were considered as independent predictors of occurrence of stenosis among the studied cases. Studying the intracranial venous system in patients with PTC is and important step in understanding the pathophysiology of the disease. Detection of venous sinus stenosis opens the way to a novel therapeutic option for refractory patients like venous sinus stenting

Endoscopic septoplasty

The aim of this study was to compare the efficacy of endoscopic septoplasty with traditional septoplasty in treating cases having septal deviations. The study included 60 patients complaining mainly of nasal obstruction due to significant septal deviations. They were divided into two groups: Group A 30 patients who had endoscopic septoplasty performed in order to correct their deviated septum and group B 30 patients who had a traditional septoplasty performed as a method of treatment of their septal deviation. Each patient was subjected to a preoperative assessment protocol that included a thorough history taking, general and local examination, nasal endoscopic examination and active anterior rhinomanometry. Postoperatively, the patients were subjected to an assessment protocol similar to the preoperative one

Congenital dislocation of the knee surgical management

This paper reported 12 complete congenital dislocations of the knee in 8 children. The average age at presentation was 9 months. The patient's age at the time of surgery ranged between three months and three years with an average of nine months. It was not possible in any case to flex the knee beyond 0 degree of extension. A deep anterior transverse skin fold at the level of the joint was found in all cases. Surgery was generally required for congenital pathologic subluxation and dislocation. The essential abnormality needing operative correction was severe fibrosis of the distal quadriceps with subsequent shortness and contracture. The operation was performed with the patient in the supine position without a tourniquet. The incision was a long anterior incision that extended from the distal half of the thigh to the proximal part of the tibia to expose the distal two thirds of the quadriceps mechanism and the knee joint. The patients were followed up from 1-5 years following operation, with a mean follow up of 3 years. All patients were able to walk freely without an external aid. Several series in the literature reported a spectrum of hyperextension deformities of the knee, varying from simple or physiologic hyperextension to complete pathologic dislocation. It is difficult to correct the equinovarus deformity of the foot caused by tension on the gastrocnemius when the knee cannot be flexed sufficiently. Thus, a reduction of the knee joint first is considered to be essential for producing the correct alignment of the lower limb

Renaissance of small diameter partial portacaval shunt: experience, outcome and survival in Egyptian schistosomal portal hypertensive bleeders

The objective of this work was to evaluate specifically the surgical experience, portal haemodynamics, clinical outcome and survival in Egyptian schistosomal portal hypertensive bleeders after the small diameter partial portacaval shunts [SDPPCS]. This prospective study included fifty-six patients out of two hundred and fifty-four patients with schistosomal hepatic fibrosis, portal hypertension, and splenomegaly and complicated by bleeding oesophageal varices. All patients belonged to class A or B of Pugh modification of Child-Turcotte classification of cirrhosis. All patients were studied preoperatively with endoscopy and color duplex. All patients showed a preoperative haemodynamics pattern with hepatopedal flow. The fifty-six patients were prepared for elective small diameter partial portacaval shunt, SDPPCS, using the 8 mm, non-compressible polytetrafluoroethylene [PTFE] graft, Gore-Tex, W. L. Gore and Associates, Inc., Elkton, Md.].Postoperative duplex study was repeated one month, six months, and one year after operation. The portal flow cephalad and caudal to shunt site were measured, shunt patency was directly visualized, and flow in IVC cephalic to shunt in the intrahepatic portion was measured. Postoperative endoscopic evaluation, every three months during the first year, then every six months afterwards, to assess the downgrading of varices. One-three years of follow-up were the time allowed before reporting the final results. The episodes of variceal bleeding, ascites and encephalopathy were recorded for all patients. Twenty-one cases [37.5%] belonged to child s class A, and thirty-five cases [62.5%] were class B. SDPPCS was abandoned in 5/56 [8.9%]. Causes of operative failure in graft replacement were: adhesions due to previous cholecystectomy in 1/56 [1.8%], very thin walled PV in 1/56 [1.8%], very small PV < 10 mm in 3/56 [5.35%], extensive collaterals around the PV in 2/56 [3.58%], and medially displaced PV with inability to dissect a sufficient segment in 1/56 [1.8%]. Complications: were in the form of PV thrombosis in 1/56 [1.8%], IVC thrombosis in 1/56 [1.8%], shunt thrombosis in 2/56 [3.58%], and transected CBD in 1/56 [1.8%]. SDPPCS permitted sufficient volume of prograde flow of portal blood to the liver leading to maintenance of liver functions and low incidence of encephalopathy. SDPPCS resulted in progressive diminution of the size and grade of esophageal and gastric varices, as well as, disappearance of risk signs, thus guarding against rebleeding. There was statistically significant difference in downgrading of esophageal and gastric varices and improvement of gastropathy. SDPPCS resulted in improvement in hematological abnormalities with significant increase of blood elements, especially for thrombocytopenia. SDPPCS resulted in significant decrease in splenic size and splenic congestion. There was no operative mortality. Survival after SDPPCS was 91.07%. Shunt was patent in 49/51 patients [96%]. Three patients [5.357%] complained of mild encephalopathy after SDPPCS. Small diameter partial portacaval shunt [SDPPCS], using 8 mm PTFE graft, is feasible technically and is effective in controlling bleeding esophageal bleeding with preservation of a prograde hepatic portal flow, that preclude encephalopathy, in Egyptian schistosomal portal hypertensive bleeders. It could be considered as an alternative to difficult cases meant for DSRS, or shunt procedures in splenectomized patients

Assessment of the correlation between some haemostatic disturbances caused by cardiopulmonary bypass [CPB] and the pathogenesis of post operative blood loss

This work was performed on 20 patients [11 females and 9 males] with age ranged between 9 and 50 years with a mean value of 23.6 +/- 10.2 years underwent elective open heart surgery aiming to study the effect of cardiopulmonary bypass on some hemostatic parameters and to correlate these changes with post bypass bleeding. The results obtained showed that platelet count, mean platelet volume, platelet aggregation with ADP and bleeding time were significantly affected with CPB procedure and the degree of affection was correlated statistically with the time of bypass which had a mean value of 139.8 +/- 43.8 minutes. In addition, the postoperative blood loss was correlated with all post bypass platelet parameters. However, in the second postoperative day, all the hemostatic parameters tested showed statistically significant improvement

Diagnosis of human toxoplasmosis by a dot enzyme-linked immunosorbent assay

O Dot-ELISA foi padronizado e avaliado para o imunodiagnostico da toxoplasmose humana. Entre 538 amostras testadas pela reacao de Imunofluorescencia Indireta (teste de referencia) 183 foram positivas considerando-se os soros reagentes nas diluicoes >= 1:16 (34 por cento). Utilizando-se a diluicao 1:256 como titulo discriminante para o Dot-ELISA, foram observados 192 soros positivos (36 por cento)...

Antifungal susceptibility testing: Application in cases of oculomycosis

We studied a total of 52 cases of fungal ocular infections in Saudi Arabia. Mycotic keratitis predominates the cases [84.6%]. History of trauma was given in 55.7% of cases, previous use of antibiotics in 40%., and use of steroids in only 9.6%. Majority of patients are middle-aged males [67.3%]. The most frequent cause of oculomycosis was found to be Aspergillus Spp. [53.8%]. Other etiologic organisms includes: Fusarium Spp. [23%]., yeast [9.6%], and dematecious molds [9.6%] Our disc microbroth antifungal susceptibility test was found to be comparable with the standardized National Committee of Clinical Laboratory Standardization [NCCLS] method. Azole group of drugs: Ketoconazole, Miconazole, and itraconazole showed excellent activity against yeasts and Aspergillus Spp. as 92-100% of strains are susceptible. 75% of Fusarium Spp. are also susceptible to itraconazole. 5-FIuorocytosin, on the other hand, showed poor activity against molds but active against Candida. Amphotericin-B showed variable activities but its high toxicity remains as a limiting factor

Anaesthesia and intensive care for patients with morbid obesity

Fifty major surgical procedures were carried out on 48 morbidly obese patients in king Fahd Hospital -Jeddah and Jubail Hospital, Eastern Province, from year 1407 to year 1414. There were 44 females and 4 males. The age range was 14-52 Years [mean 31.8, S.D. 8.08]. The weights ranged from 97-183 kg [mean 126.97 kg, S.D 17.86]. All patients received general anaesthesia and they were all admitted to the Intensive Care Unit after operation. Fourteen patients needed prolonged endotracheal intubation with assisted ventilation after operation for an average of 9.7 hours. While the average stay in I. C. U. was 39.5 hours. No special anaesthesia tevhnique was recommended, the only emphasis was on careful monitoring during anaesthesia of all the vital signs, the arterial blood gases and acid base balance and on the necessity of having a central venous line and arterial line. In the I. C. U., hypoxaemnia occurred in 14 patients [simple in 9, severe and recurrent in 5]. Other metabolic changes included hyperglycaemia in [35 cases], hypocalcaemia [13 cases], elevation of the liver enzymes in [32 cases] and acidosis in [4 cases] We recommend post-operative extubation as early as possible and we reserve I. C. U. beds only for patients who have additional medical problems

Effect of beta blocker versus alpha combined alpha and beta blocker on blood pressure response under static exercise and cold pressor test

The effect of a single oral dose of beta-1 blocker [Metoprolol] versus combined alpha- and beta-blocker [Labetalol] was evaluated in two groups of patients: Control [C] normotensive and hypertensive [H] groups with mild to moderate elevation of blood pressure. Each group consisted of 10 subjects. The study comprised monitoring the heart rate [HR] and blood pressure [BP] response to two tests: Hand grip test [HCT] and cold pressor test [CPT]. These tests were performed before and after the drugs on separate sittings. The BP and HR response to HGT before administration of drugs was linear for the two groups, while the CPT showed insignificant rise of HR. The results at rest before and after medications in both groups showed a decrease in HR and BP. It was statistically insignificant in C group only after Labetalol used. In C group Metoprolol was more effective in lowering the pressor response than Labetalol, while in the H group Labetalol was potent in reducing BP, specially during CPT

Road traffic injuries admitted to Jubail hospital: a study of site, severity and outcome

The present work showed that road traffic injuries admitted to Jubail Hospital were mainly at the head and neck followed by multiple injuries. Injury severity score proved to be a good predictor to assess outcome of cases but it has to be applied also at pre-hospital level and it has to be tried and tested in other areas of Saudi Arabia. Most of the admitted injured victims suffered from mild to moderate injuries. Age, nationality, victim status proved to be important predictors of injury outcome. Improvement in the emergency medical care system is required with special emphasis on causes of case referrql to other hospitals. Careful supervision of children is required to avoid playing at streets, and use of safety measures inside cars, especially safety belts is highly bene ficial as demonstrated in other studies to lower rates of head and neck injuries