Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and COVID-19 infection during pregnancy

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Home-based versus clinic-based care for patients starting antiretroviral therapy with low CD4⁺ cell counts: findings from a cluster-randomized trial.

OBJECTIVES: African health services have shortages of clinical staff. We showed previously, in a cluster-randomized trial, that a home-based strategy using trained lay-workers is as effective as a clinic-based strategy. It is not known whether home-based care is suitable for patients with advanced HIV disease. METHODS: The trial was conducted in Jinja, Uganda. One thousand, four hundred and fifty-three adults initiating ART between February 2005 and January 2009 were randomized to receive either home-based care or routine clinic-based care, and followed up for about 3 years. Trained lay workers, supervised by clinical staff based in a clinic, delivered the home-based care. In this sub-analysis, we compared survival between the two strategies for those who presented with CD4⁺ cell count less than 50 cells/μl and those who presented with higher CD4⁺ cell counts. We used Kaplan-Meier methods and Poisson regression. RESULTS: Four hundred and forty four of 1453 (31%) participants had baseline CD4⁺ cell count less than 50 cells/μl. Overall, 110 (25%) deaths occurred among participants with baseline CD4⁺ cell count less than 50  cells/μl and 87 (9%) in those with higher CD4⁺ cell count. Among participants with CD4 cell count less than 50  cells/μl, mortality rates were similar for the home and facility-based arms; adjusted mortality rate ratio 0.80 [95% confidence interval (CI) 0.53-1.18] compared with 1.22 (95% CI 0.78-1.89) for those who presented with higher CD4⁺ cell count. CONCLUSION: HIV home-based care, with lay workers playing a major role in the delivery of care including providing monthly adherence support, leads to similar survival rates as clinic-based care even among patients who present with very low CD4⁺ cell count. This emphasises the critical role of adherence to antiretroviral therapy

Sistem pendaftaran program latihan mengajar online : ORTep system

Sistem ORTeP adalah singkatan dari Online Registration for Teaching Practician System atau Sistem Pendaftaran Program Latihan Mengajar (LM). Ia adalah suatu sistem yang membolehkan pelajar membuat pendaftaran LM secara online. Sistem ORTeP ini dibina berasaskan kajian ke atas pelajar Sarjana Pendidikan Teknik dan Vokasional (PTV) di Kolej Universiti Teknologi Tun Hussein Onn (KUiTTHO). Rekod LM terkini akan dikemaskinikan oleh pentadbir sistem yang terdiri daripada Penyelaras LM. Satu kajian untuk menilai Sistem ORTeP telah dijalankan. Enam puluh orang pelajar Saijana PTV telah dipilih sebagai responden. Responden telah menggunakan Sistem ORTeP, dan memberi maklum balas melalui borang soal selidik. Hasil kajian mendapati, responden setuju jika Sistem ORTeP dapat dilaksanakan pada kadar segera kerana ia memudahkan pengumpulan dan pencapaian data di samping menjimatkan masa dan lebih efisien. Beberapa cadangan telah dikemukakan oleh responden untuk memperbaiki Sistem ORTeP. Sistem ORTeP yang telah dibaiki telah pun sedia diguna. Bagi memudahkan pengguna, manual penggunaan Sistem ORTeP telah disediakan. Sebagai kesimpulan, penggunaan Sistem ORTeP ini dapat melicinkan pentadbiran dan pendaftaran Program LM di samping menyediakan perkhidmatan yang terbaik kepada pelanggan

Emerging respiratory viral infections: MERS-CoV and influenza

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic

Drivers of MERS-CoV transmission: what do we know?

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Middle East Respiratory Syndrome coronavirus (MERS-CoV) emerged in 2012 has since resulted in sporadic cases, intra-familial transmission and major outbreaks in healthcare settings. The clinical picture of MERS-CoV includes asymptomatic infections, mild or moderately symptomatic cases and fatal disease. Transmissions of MERS-CoV within healthcare settings are facilitated by overcrowding, poor compliance with basic infection control measures, unrecognized infections, the superspreaders phenomenon and poor triage systems. The actual contributing factors to the spread of MERS-CoV are yet to be systematically studied, but data to date suggest viral, host and environmental factors play a major role. Here, we summarize the known factors for the diverse transmission of MERS-CoV

The Hajj 2019 Vaccine Requirements and Possible New Challenges

Each year millions of pilgrims perform the annual Hajj from more than 180 countries around the world. This is one of the largest mass gathering events and may result in the occurrence and spread of infectious diseases. As such, there are mandatory vaccinations for the pilgrims such as meningococcal vaccines. The 2019 annual Hajj will take place during August 8–13, 2019. Thus, we review the recommended and mandated vaccinations for the 2019 Hajj and Umrah. The mandatory vaccines required to secure the visa include the quadrivalent meningococcal vaccine for all pilgrims, while yellow fever, and poliomyelitis vaccines are required for pilgrims coming from countries endemic or with disease activity. The recommended vaccines are influenza, pneumococcal, in addition to full compliance with basic vaccines for all pilgrims against diphtheria, tetanus, pertussis, polio, measles, and mumps. It is imperative to continue surveillance for the spread of antimicrobial resistance and occurrence of all infectious diseases causing outbreaks across the globe in the last year, like Zika virus, MDR-Typhoid, Nipah, Ebola, cholera, chikungunya and Middle East Respiratory Syndrome Coronavirus

Crystallization and flow in active patch systems

Based upon recent experiments in which Janus particles are made into active swimmers by illuminating them with laser light, we explore the effect of applying a light pattern on the sample, thereby creating activity inducing zones or active patches. We simulate a system of interacting Brownian diffusers that become active swimmers when moving inside an active patch and analyze the structure and dynamics of the ensuing stationary state. We find that, in some respects, the effect of spatially inhomogeneous activity is qualitatively similar to a temperature gradient. For asymmetric patches, however, this analogy breaks down because the ensuing stationary state is specific to partial active motion.Comment: Version published in Soft Matter is significantly improve

Empiric Antibiotic Therapy in the Treatment of Community-acquired Pneumonia in a General Hospital in Saudi Arabia

Background: Guideline-based empiric antimicrobial therapy is recommended for the treatment of community-acquired pneumonia (CAP). In this study, we evaluate the pattern of empiric antibiotics of CAP patients. Materials and Methods: Patients with CAP were retrieved from the health information unit using the International Classification of Diseases, Ninth Revision. The electronic pharmacy database was used to retrieve prescribed antibiotics and the duration of therapy for each antibiotic. Results: A total of 1672 adult patients were included in the study and 868 (52%) were male. Of all the patients, 47 (2.8%) were admitted to the intensive care unit (ICU). The most frequently used antibiotics were levofloxacin (68.12%), ceftriaxone (37.7%), imipenem-cilastatin (32.5%), and azithromycin (20.6%). The mean days of therapy of each of these antibiotics were 3.2, 2.8, 4.4, and 2.9, respectively. A combination therapy of levofloxacin and imipenem-cilastatin was prescribed for 355 (21.8%) of non-ICU patients versus 20 (60.6%) of ICU patients (P = 0.0007). Imipenem-cilastatin was prescribed for 518 (31.8%) of non-ICU patients versus 25 (56.8%) of ICU patients (P = 0.0009). Levofloxacin was prescribed for 1106 (68%) of non-ICU patients versus 33 (75%) of ICU patients (P = 0.412). Ceftriaxone use decreased significantly from 40.9% in 2013 to 25.9% in 2016 (P = 0.034). In addition, levofloxacin use increased from 63.7% to 75% (P = 0.63). Conclusion: The most commonly used antibiotics were levofloxacin, ceftriaxone, imipenem-cilastatin, and azithromycin. The data call for further refinement and prospective audit of antibiotic use in CAP, especially in non-ICU settings