Phylogenomic analysis of SARS-CoV-2 from third wave clusters in Malaysia reveals dominant local lineage B.1.524 and persistent spike mutation A701V

@#The emergence of a third wave of COVID-19 infection in Malaysia since September 2020 has led to imminent changes in public health prevention and control measures. As high as 96.2% of registered COVID-19 cases and 88.5% of confirmed deaths in Malaysia occurred during this third wave of infection. A phylogenomic study on 258 SARS-CoV-2 full genomes from February 2020-February 2021 has led to the discovery of a novel Malaysian lineage B.1.524. This lineage contains another spike mutation A701V that co-exists with the D614G spike mutation that was predominant in most of the third-wave clusters. The study provides vital genomic insights on the rapid spread of the SARS-CoV-2 variants in Malaysia in conjunction with the presence of a dominant SARS-CoV-2 lineage during the third wave of COVID-19 infection.

COVID-19 Death and BCG Vaccination Programs Worldwide / 결핵및호흡기질환

Several clinical trials are being conducted worldwide to investigate the protective effect of the bacillus Calmette-Guérin (BCG) vaccine against death in healthcare providers who are working directly with coronavirus disease 2019 (COVID-19) patients. Clinical studies suggested that certain live vaccines, particularly the BCG vaccine, could reduce the mortality due to other diseases caused by non-targeted pathogens, most probably through the nonspecific effects (heterologous effects). By the end of May 2020, the available information on the COVID-19 pandemic indicated the great effect of the BCG vaccine in reducing the number of COVID-19 death cases. The occurrence of death due to COVID-19 was found to be 21-fold lower in countries with a national BCG vaccination policy than in countries without such a policy, based on the medians of COVID-19 death case per 1 million of the population in these two groups of countries (p<0.001, MannWhitney test). Therefore, it can be concluded that the early establishment of a BCG vaccination policy in any country is a key element in reducing the number of COVID-19 and tuberculosis death cases.

Embolized amplatzer duct occluder to aorta: retrieval technique

A 4-year-old girl had an Amplatzer duct occluder embolized to the descending aorta immediately after closure of patent ductus arteriosus: a novel technique of retrieval

Spontaneous intracranial hypotension with magnetic resonance localisation of spinal cerebrospinal fluid leak

To increase the awareness of spontaneous intracranial hypotension [SIH], we report in this paper a middle-aged woman who presented with an intractable headache that worsened in sitting and standing positions [a postural headache]. Magnetic resonance imaging [MRI] of the spine demonstrated a cerebrospinal fluid [CSF] leak at the level of the cervical spine, in addition to typical features in a brain MRI, including symmetrical subdural collections, circumferential dural enhancement and features of midbrain sagging. The patient underwent a surgical repair of the cervical CSF leak which resulted in a dramatic symptomatic improvement that was confirmed by follow-up imaging

investigation of different RGP lens fitting in a keratoconic population at assir central hospital

To assess the effect of rigid contact lens design and keratoconus severity when selecting initial lens back optic zone radius [BOZR] for keratoconus contact lens fitting. Seventy new keratoconus patients [56 female, 14 male; mean age 19.5 [SD 5.0] years; range 11-28 years] were recruited from referrals to the Department of Ophthalmology, Assir Central Hospital. Patients were classified for keratoconus severity according to keratometry reading, and then fitted with multicurve [McGuire Steep or Regular], tricurve or Percon continuous curve rigid lens designs, visual acuity check and slit-lamp examination were also performed for all Patients. [i] Percon lens is suitable for early corneal curvature changes; [ii] The tricurve lens is able to fit a wide range of corneal shapes from mild to severe keratoconus; [iii] The McGuire lenses are better suited for the moderate to severe forms of keratoconus, and the different lens diameters do not appear to influence the lens choice. BOZR correlated strongly with the keratometry readings [p< 0.001], but not with corneal eccentricity [p= 0.203]. Severity of keratoconus strongly influences the optimum lens design and BOZR. Tricurve or multicurve lens designs are better suited for advanced keratoconus, while Percon curve lenses are only suitable for very early stages of the disease

Acute Lympoblastic Leukaemia in seventy Iraqi adults: clinical and haematological findings and outcome of therapy.

Studies on acute Leukaemia from developing and Asian countries are scarce, and generally reflect poorer outcomes of therapy compared to their Western counterparts. This study was undertaken to address the latter issue in Iraqi adults with Acute Lymphoblastic Leukaemia (ALL). It included seventy unselected Iraqi adults (aged 14-60years), diagnosed as ALL in Baghdad Teaching Hospital, Baghdad, during the period between May 1991 and June 1994. The clinical and haematological findings in the included patients were generally comparable with those reported from the West, except for the lower median age. The patients were scheduled to receive a modified intensive chemotherapy protocol, and had an overall complete remission rate of 84.3%, and all overall median survival of 24 months. Nineteen patients were still alive in complete remission after a median follow-up of 67 months, and the estimated five year disease free survival was 27.2%. The above finding compare favourably with Western studies and are among the more favourable reports from Asian countries. The study also includes a discussion of the problems facing haematologists in the management of ALL in this part of the world.

Shock wave lithotripsy: Al-Adan experience

The use of the Wolf lithotripter for treatment of 574 upper urinary calculi was evaluated. Patients and Ninety-two caliceal, 319 renal pelvic, and 163 upper ureteric calculi were treated. The overall success rate was 41%. The majority of patients had haematuria after treatment. Renal colic and stone aggregation in the ureter were seen in some cases. No serious complications were encountered. Shock wave is a safe method for treatment of upper urinary stones

Incidence of glaucoma capsulare in 100 consecutive patients with pseudoexfoliation syndrome

Purpose The aims of this prospective study were to determine the incidence of glaucoma in patients with pseudoexfoliation syndrome and to compare the age and sex distribution in unilateral and bilateral cases. Methods One hundred consecutive patients with pseudoexfoliation syndrome detected during routine examination were studied. Patients with a known history of glaucoma as well as patients with uveitis or history of ocular trauma were excluded from the study. All patients underwent complete ophthalmic examination including applanation tonometry, gonioscopy and ophthalmoscopy. Results Of the 100 patients [51 males and 49 females] found to have pseudoexfoliation syndrome 26 [13 males and 13 females] had unilateral involvement and 74 [38 males and 36 females] had bilateral involvement. A total of 174 eyes were found to have pseudoexfoliation syndrome; 73.4% had normal intraoccular pressure, 2.2% had ocular hypertension [intraoccular pressure greater than 22 mm Hg but no cupping or field loss] and 24.4% had glaucoma. Conclusion This study found the incidence of glaucoma capsulare in the 100 consecutive patients [174 eyes] to be 24.1% Males with glaucoma outnumbered females at 36% versus 11.8%. The bilateral cases occurred in the older age group and shoowed a higher perrcentage of glaucoma than in unilateral cases but there was no statistical significance found

Acute haemolytic episodes & fava bean consumption in G6PD deficient Iraqis.

The relation between fava bean ingestion and the occurrence of a haemolytic episode was studied in 102 glucose-6-phosphate dehydrogenate (G6PD) deficient Iraqi patients. None of the patients (mean age 12.8 yr) had a documented similar illness earlier, although all of them gave history of reported regular fava bean ingestion in the past. Further, none of the three patients who were rechallenged (2-3 months later) by the beans developed any clinical or laboratory evidence of haemolysis. The incidence of the haemolytic episodes was found to peak in April, while the fava bean season extends from February to June. This study thus does not support a causal relation between the bean ingestion and the haemolytic episodes in G6PD deficient Iraqis. Possibly, some other factor such as a viral infection may be involved.