ABSTRACT
Background: The World Health Organization had declared the release of COVID-19 vaccines in September 2020 and after. mRNA vaccine "Pfizer Biotech” and the adenoviral vector vaccine CoV-19 (AstraZeneca-Oxford) were granted emergency use. Researchers found that effectiveness of AstraZeneca and Pfizer vaccine is (70% and 95%) respectively. While the inactivated SARS-CoV-2 vaccine (Sinopharm) is safe, effective (effectiveness more than 50%) as WHO's declared. Sinopharm was the first vaccine that had been administered to Iraqi population. Only 2% of population had been vaccinated despite the efficacy and acceptability of it. Several studies conducted in different countries to assess the effectiveness of Covid-19 vaccines and its safety. Aim: This study done to assess the frequency of post vaccination infection with COVID-19 and accompanying signs and symptoms in different vaccine companies that are available in Iraq (Sinopharm, AstraZeneca-Oxford and Pfizer-BioNTech). Patients and methods: The study is a cross-sectional study conducted from 11th November 2021 to 15th March 2022 that included 500 Iraqi persons vaccinated with COVID-19 vaccine with either Pfizer, AstraZeneca or Sinopharm, Patients were chosen by Convenient sampling from different Iraqi governorate. All data management and analysis done by manual statistical methods. Results: From total 500 patients participated in the study with full doses vaccination (2 doses as recommended) there were (25%) person get covid-19 infection. Majority of infection occurred after 6 months of 2nd dose. Majority of postvaccination infections with Pfizer vaccine were with mild to moderate symptoms without need hospitalizations in comparison to (5.56%), (3.13%) hospitalizations rate and severe infection post AstraZeneca and Sinopharm vaccines respectively. Conclusion: Full vaccination of two doses of (Pfizer, AstraZeneca, Sinopharm) are highly effective in decrease the severity of COVID-19 infection signs and symptoms, decrease rate of hospitalizations. High efficacy of Pfizer vaccine than AstraZeneca and Sinopharm vaccines. © 2023,ournal for ReAttach Therapy and Developmental Diversities. All Rights Reserved.
ABSTRACT
Background: Malignant bowel obstruction (MBO) is common in advanced ovarian cancer (AOC). Treatment options are limited as majority of cases present with widespread, multilevel peritoneal dissemination and platinum-resistant disease. The benefit of Parenteral Nutrition (PN) in MBO is debated, given the limited overall survival (OS) of this patient group. Aim: to identify which clinical features correlate with improved survival in AOC and MBO, to support clinical decision-making. Methods: Retrospective review of patients admitted with MBO between April 2019 and October 2021 to a single tertiary cancer centre. Those with AOC established on PN with the aim to discharge home on PN were included. Univariate analysis for survival after commencing PN was performed using log-rank test. Results: 103 patients with MBO were identified with 33 patients excluded (PN not initiated, 15;PN withdrawn: covid service constraint, 5, acute medical event, 13). 70 patients were successfully established on PN and 49 discharged on PN;16 patients clinically deteriorated;5 returned to enteral diet. Median OS of patients that did not receive PN was 19 days, PN stopped due to general deterioration 39 days and 100 days (range 18-807) for those established on PN (p<0.0001). Clinical features associated with improved OS: no prior systemic therapy (p=0.0067), platinum sensitivity (p=0.043), ECOG performance status (PS) 1 vs 2-3 (p=0.004), falling modified Glasgow Prognostic Score (mGPS) during admission (p=0.0027). In the treatment naïve group, chemotherapy resolved MBO in 6/9 cases. In the pre-treated group, 60% of patients received subsequent chemotherapy (median duration 8 weeks), with early cessation due to toxicity and no clinical benefit. Only 1 patient achieved resolution of MBO on chemotherapy. Conclusions: PN may improve survival of patients with AOC in MBO. ECOG PS, platinum sensitivity and mGPS trend may be useful to select patients for PN. In those presenting with MBO at AOC diagnosis, PN can enable safe delivery of chemotherapy, which usually will resolve MBO. In pre-treated patients, PN is a life-long commitment and chemotherapy is largely ineffective in resolving MBO. Further research should focus on quality of life in patients receiving PN. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.