Compliance and Association of Ventilator Associated Pneumonia Bundle Strategy With Ventilator Associated Pneumonia rate: A Saudi Experience

Objectives: To evaluate the effectiveness and compliance of Ventilator Associated Pneumonia(VAP) care bundle in local setting at Erfan & Bagedo General hospital, Jeddah, KSA. Materials and Methods: The study was a Quasi experimental before and after observation type of study, in which VAP care bundle was implemented to the ventilated patients without any control group. It was conducted from February 2010 to January 2011. Results: Out of a total of 3011 patient ventilator days, 18 patient developed VAP. Number of VAP care bundle implementation increased from 42 (17.36%) in February 2010 to 315 (91.8%) in October 2010. However the implementation rate was 100% during November, December 2010 and January 2011. VAP rate dropped from 8.85/1000 ventilator days in February 2010 to 3.15 in January 2011. Conclusion: There was a strong negative correlation between proportion of implementation of VAP care bundle and VAP rate (r= - 0.534 p value=0.037 for one tailed test). Adopting VAP care bundle approach may help in reducing the morbidity and mortality in the ventilated patients

Diverse immunological factors influencing pathogenesis in patients with covid-19: A review on viral dissemination, immunotherapeutic options to counter cytokine storm and inflammatory responses

The pathogenesis of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still not fully unraveled. Though preventive vaccines and treatment methods are out on the market, a specific cure for the disease has not been discovered. Recent investigations and research studies primarily focus on the immunopathology of the disease. A healthy immune system responds immediately after viral entry, causing immediate viral annihilation and recovery. However, an impaired immune system causes extensive systemic damage due to an unregulated immune response characterized by the hypersecretion of chemokines and cytokines. The elevated levels of cytokine or hypercytokinemia leads to acute respiratory distress syndrome (ARDS) along with multiple organ damage. Moreover, the immune response against SARS-CoV-2 has been linked with race, gender, and age; hence, this viral infection’s outcome differs among the patients. Many therapeutic strategies focusing on immunomodulation have been tested out to assuage the cytokine storm in patients with severe COVID-19. A thorough understanding of the diverse signaling pathways triggered by the SARS-CoV-2 virus is essential before contemplating relief measures. This present review explains the interrelationships of hyperinflammatory response or cytokine storm with organ damage and the disease severity. Furthermore, we have thrown light on the diverse mechanisms and risk factors that influence pathogenesis and the molecular pathways that lead to severe SARS-CoV-2 infection and multiple organ damage. Recognition of altered pathways of a dysregulated immune system can be a loophole to identify potential target markers. Identifying biomarkers in the dysregulated pathway can aid in better clinical management for patients with severe COVID-19 disease. A special focus has also been given to potent inhibitors of proinflammatory cytokines, immunomodulatory and immunotherapeutic options to ameliorate cytokine storm and inflammatory responses in patients affected with COVID-19

Vaccine hesitancy and refusal among parents: An international ID-IRI survey

Introduction: Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale. Methodology: In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents' attitudes towards vaccination of their children. Results: Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p < 0.05 for all). Conclusions: Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR