A review on the advancements in the development of vaccines to combat coronavirus disease 2019

Coronavirus disease 2019 (COVID-19), the deadly disease caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a global pandemic that has severely affected lives and economies around the globe. The spread of this virus will be very difficult to contain if no vaccine is ready for implementation. This is because of the high human-to-human transmission rate of this virus and the fact that the virus is in the community spread stage. As of 31st August 2020, 25.3 million individuals have been affected by this deadly virus resulting in about 850,673 deaths. To combat the spread of COVID-19, more than 100 applicant immunizations are being developed around the world. Among them, eight have begun or will be soon beginning preliminary clinical trials. This paper provides a review of the current developments of potential COVID-19 vaccines around the world. It specifically discusses the recombinant vaccine produced by the University of Oxford and AstraZeneca (Cambridge, UK), the use of novel selfamplifying RNA technique to create a vaccine and the progress made by UNAID (US National Institute of Allergy and Infectious Diseases) and World Health Organization (WHO). Furthermore, this review demonstrates the pharmaceutical prophylaxis and treatment protocols for COVID-19 by analysing the documentation set up by the WHO for up to date data with respect to the novel coronavirus of 2019–2020.

Nurse-led HIV services and quality of care at health facilities in Kenya

Objective:To develop a novel measure to characterize human immunodeficiency virus (HIV) programme quality at health facilities in Kenya and explore its associations with patient- and facility-level characteristics.Methods:We developed a composite indicator to measure quality of HIV care, comprising: assessment of eligibility for antiretroviral therapy(ART); initiation of ART; and retention on ART or in care, if ineligible for ART, for 12 months. We applied the comprehensive retention indicator to routinely collected clinical data from 13 331 patients enrolled in HIV care and treatment at 63 health facilities in the Eastern and Nyanza regions of Kenya from 1 January 2014 to 31 March 2016. We explored the association between facility- andpatient-level characteristics and the primary outcome: appropriate staging and management of HIV, and retention in care over 12 months.Findings:Of the enrolled patients, 8404 (63%) achieved comprehensive retention 12 months after enrolment in care. In univariate analyses, patients at facilities where nurses delivered HIV treatment services (including eligibility assessment, initiation and follow up of ART) had significantly higher comprehensive retention rates at 12 months. In multivariate analyses, after adjusting for both facility- and patient-level characteristics, patients at facilities where nurses initiated ART had significantly higher comprehensive retention in care at 12 months (relative risk, RR: 1.22; 95% confidence interval, CI: 1.00­1.48).Conclusion:Nurse-led HIV services were significantly associated with quality of care, confirming the central role of nurses in the achievement of global health goals, and the need for further investment in nursing education, training and mentoring

Granulosa cell tumour a clinico pathologic study

19 granulosa cell tumour [GCT] were reviewed and re-evaluated clinically and histologically. The age range between 18-53 years. Patients were divided into two age groups. They young age group [younger than 40 years] which Consisted of eight patients, and the old age group [older than 40] which consisted of eleven patients. The usual clinical presentation of those patients was generally vaginal bleeding in the older age group, or-post-menopausal bleeding, and/or abdominal mass. while the young age group presented with amenorrhea, vaginal bleeding and abdominal mass in order of frequency. Juvenile G C T. has distinctive clinical and pathological subtype and is associated with better prognosis. The operative and histologica findings are of great importance in the assessment of the outcome. Patients with juvenile G.C.T. carry better outcome even with the presence of cytological atypia and mitotic divisions. The operative finding of a tumour that invades the surface of the ovary with Local and omental metastasis needs more aggressive treatment. Since a large group of our patients are of the child bearing age, the critical decision of treatment for young women with stage la disease [whether conservative or to chose more radical treatment] is the responsibility of both the pathologist and the clinician

Endemic goiter in the Lemanak and Ai river villages of Sarawak.

In a survey of 974 villagers (408 males, 566 females; ages = 11-82 years) of the Ai (n = 496; 212 males, 284 females) and Lemanak (n = 478; 196 males, 282 females) rivers in the district of Lubuk Antu in Sarawak's Sri Aman Division during July 1993, goiter was found in 31.8% of the subjects. The goiter prevalence was higher in the more interior Ai river area than in the Lemanak river area (36.9% vs 26.5%). In females aged 15 years and above, the goiter prevalence was 75.4% and 49.1%, respectively, in the Ai and Lemanak river areas. The difference in goiter prevalence between the two areas was related to the degree of iodine deficiency in the two areas. The median urinary iodine excretion in the Ai river villagers was 22.1 micrograms/l compared to 72.9 micrograms/l in the Lemanak river villagers (p < 0.0001). Goitrous subjects tended to have lower urinary iodine concentration than non-goitrous subjects. In the males, smoking of tobacco was associated with a two-fold increase in goiter frequency. Despite on-going distribution of iodized salt by the medical and health services in the State, only 23% of the 135 salt samples obtained from the households in the areas contained detectable iodine.

Current practice pregnancy and delivery in renal transplant recipients in Iraq

With the advent of kidney transplantation as main method for renal replacement therapy in chronic terminal renal failure, female- patients are having better chances to mother children. Here in nine patients are presented with a number of pregnancies ranging from one to three. The antenatal, delivery,and postnatal problems are presented and discussed as well as the well being of the neonate. Some observations and recommendations were made

importance of cytological study of cervical smears

Cervical smears stained by papanicolou technique were examined in 1000 patients referred from the Gynaecology outpatient Department in the Medical City Teaching Hospital Inflammatory cells were found in 615[61.5%] patients, different grades of dysplasis in 169 [16.9%] patients, malignant cells in 11 [1.1%] patients; whereas no abnormal cells were found in 205 [20.5%] patients. Routine pap smear can be performed to detect high risk group of patients for further detailed diagnostic means of cervical cancer