Effect of mutation and vaccination on spread, severity, and mortality of COVID-19 disease

Coronavirus disease 2019 (COVID-19) has had different waves within the same country. The spread rate and severity showed different properties within the COVID-19 different waves. The present work aims to compare the spread and the severity of the different waves using the available data of confirmed COVID-19 cases and death cases. Real-data sets collected from the Johns Hopkins University Center for Systems Science were used to perform a comparative study between COVID-19 different waves in 12 countries with the highest total performed tests for severe acute respiratory syndrome coronavirus 2 detection in the world (Italy, Brazil, Japan, Germany, Spain, India, USA, UAE, Poland, Colombia, Turkey, and Switzerland). The total number of confirmed cases and death cases in different waves of COVID-19 were compared to that of the previous one for equivalent periods. The total number of death cases in each wave was presented as a percentage of the total number of confirmed cases for the same periods. In all the selected 12 countries, Wave 2 had a much higher number of confirmed cases than that in Wave 1. However, the death cases increase was not comparable with that of the confirmed cases to the extent that some countries had lower death cases than in Wave 1, UAE, and Spain. The death cases as a percentage of the total number of confirmed cases in Wave 1 were much higher than that in Wave 2. Some countries have had Waves 3 and 4. Waves 3 and 4 have had lower confirmed cases than Wave 2, however, the death cases were variable in different countries. The death cases in Waves 3 and 4 were similar to or higher than Wave 2 in most countries. Wave 2 of COVID-19 had a much higher spread rate but much lower severity resulting in a lower death rate in Wave 2 compared with that of the first wave. Waves 3 and 4 have had lower confirmed cases than Wave 2; that could be due to the presence of appropriate treatment and vaccination. However, that was not reflected in the death cases, which were similar to or higher than Wave 2 in most countries. Further studies are needed to explain these findings

Non-invasive ventilation in patients with an altered level of consciousness. A clinical review and practical insights

Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respira-tory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preserva-tion of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation.Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed

The efficacy of oral versus parentral vitamin D in treatment of nutritional rickets

Rickets is the most common form of metabolic bone disease in children. Vitamin D deficiency rickets is clearly a problem in breast-fed infants who do not receive enough vitamin D or adequate sunshine exposure. The study was carried out on 30 patients who had clinical evidence of rickets. Patients were divided into three equal groups. Group A received 600,000U IM once; group B received 20,000U IM three times a week for two weeks and group C received 2000U/day orally for a month. The aim of this study was to compare the effect of different doses of ergocalciferol on serum calcium, phosphorous and alkaline phosphatase. Results show that the serum alkaline phosphatase concentration significantly decreased more in the group B compared to group A and group B (p=0.013 and p=0.001, respectively). Patients who received the intramuscular dose responded promptly, whereas infants who received the oral dosages had less response. [Med-Science 2012; 1(4.000): 244-53

Comparison Between Nitazoxanide and Metronidazole in the Treatment of Protozoal Diarrhea in Children

Diarrheal disease is a leading cause of illness and death in children worldwide. Diarrhea is caused by a blend of bacterial, viral and parasitic pathogens. Enteric protozoal infections such as giardiasis, amebiasis and cryptosporidiosis are among the most common and most prevalent forms of gastrointestinal parasitic infections worldwide. Both nitazoxanide and metronidazole are used in treatment of protozoal diarrhea. Nitazoxanide was found to have a very broad spectrum of activity against many forms of parasites. Metronidazole also produces good results when it is used for treatment of parasitic infections. The aim in this study was to evaluate and compare the effect of nitazoxanide and metronidazole in treatment of protozoal diarrhea in children. This study was carried out on 160 diarrheic patients (83 males and 77 females), aged from 1-11 years old collected from the-clinics of pediatric department at Beni suef University Hospital. Patients were divided into two groups. Group A received Nitazoxanide 100 mg in 1-4 years aged patients and 200 mg in 4-11 years aged patients twice daily for 3 days respectively, Group B received Metronidazole 50 mg/Kg/body weight daily for 7 days. Patients were represented to full history taking, physical examination, laboratory investigations in the form of stool analysis, culture and complete blood count (CBC). There was a significant increase in the number of cases resolved by Nitazoxanide compared to Metronidazole group in both amebiasis and giardiasis (p-value < 0.05) with similar clinical improvement when using Nitazoxanide for 3 days and Metronidazole for 7 days. This study confirms the efficacy and safety of nitazoxanide as a 3-day treatment of diarrhea due to giardiasis & amebiasis in children. A 3-day course of nitazoxanide could replace much longer regimens of metronidazole [Med-Science 2014; 3(2.000): 1162-73

Evaluate the efficacy of Simvastatin and Fluvastatin in patients with hypercholesterolemia and their effect on liver functions

The study was aimed to evaluate Simvastatin and Fluvastatin effects on patients with hypercholesterolemia. For 6 months, 141 patients administered Simvastatin (GpA), 100 administered Fluvastatin (GpB) and 100 fluctuated between them (GpC). Post treatment, in GpA, Triglycerides, total Bilirubin (T.BIL), Cholesterol and Low Density Lipoprotein (LDL) were significantly reduced. Alkaline Phosphatase (ALP) and Alanine Aminotransferase (ALT) elevated reduced in females and elevated in males. T.BIL reduced in both males and females. In GpB, Glutamyltransferase elevated and Cholesterol and LDL reduced. Albumin elevated in females and reduced in males and the opposite in Triglycerides. Significant difference between age groups in Albumin, Globulin, and ALT was found. In GpC, Asprtate Aminotransferase (AST) elevated and ALT, Cholesterol, Triglycerides and LDL reduced in all patients. Albumin and ALT elevated in males and reduced in females. Significant difference between age groups in Albumin, T.BIL and AST was found. Fluvastatin or simvastatin had variable effects on lipid parameters in patients with hypercholesterolemia and associated with mild effect on liver. Simvastatin was more effective to reach antihypercholesterolemic goal. Effects were related to gender, age and continuation on the same medication. Patients lab data periodic monitoring during therapy is useful to reach antihypercholesterolemic goal and observe any serious liver parameters elevation. [Med-Science 2017; 6(4.000): 724-728

The Efficacy of Elemental Zinc on Acute Diarrhea in Egyptian Infant and Children

Diarrhea is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and electrolyte imbalances. Hence, the aim in the present study was to evaluate the effect of elemental zinc in treatment of diarrhea in children. 100 diarrheic patients (50 females) aged from 1-12 years old collected from the-clinics of pediatric department at Beni suef University Hospital, were divided into two equal groups. Group A received elemental Zinc in the form of Zinc Sulphate (10 mg elemental Zinc daily for infants and 20 mg for children) with the normal diarrhea treatment. Group B received the normal anti-diarrhea treatment only. There was no significant difference between the two groups regarding most of the parameters studied. However, the mean±SD recovery time in group A was significantly higher (p-value=0.019) than in group B. However, when antibiotic alone was used as anti-diarrheal treatment the recovery time in days in group A was less than in group B but with no significant difference. The expected beneficial efficacy of elemental Zinc in the form of Zinc Sulphate on the duration and severity of acute diarrhea was not observed. However, the study showed that Zinc may be effective in diarrhea due to bacterial infections. [Med-Science 2015; 4(1.000): 1788-95

Prevalence of Congenital Heart Diseases in Children with Congenital Hypothyroidism

The aim of the work was to assess the prevalence of cardiac anomalies in primary congenital hypothyroidism (PCH) patients. Fifty patients with PCH recruited after diagnosis by ultrasonography or scintigraphy (64% Dysgenesis, 36% Dyshormonogenesis). The prevalence of cardiac anomalies was 18%, with renal anomalies being 8%. There was no significant difference in the longitudinal follow-up of growth and sexual maturation between a hypothyroid with and without anomalies. Statistically significant difference was found with replacement therapy of both groups. Hence, echocardiography should be done to screen this birth defect as soon as possible so as to prevent or delay the possible complications. [Arch Clin Exp Surg 2013; 2(2.000): 85-91

Effect of DPI's training-device on inhalation technique and clinical efficacy in asthmatics

The aim of this work was to study the effect of using training device (In-Check DIAL) along with traditional dry powder inhaler (DPI) counseling on inhalation technique and pulmonary functions test (PFT) in asthmatics.Adult asthmatics >18 years old were recruited in 3months study of investigation and training. They were divided into control and investigation groups.DPI inhalation technique was checked and mistakes were noted and corrected at every monthly visit. Their peak expiratory flow and forced expiratory volume in 1second as percentage of forced vital capacity were checked at each visit followed by showing patients the correct inhalation technique and how to use In-Check DIAL (investigation group).29 patients (14 females) and 57 patients (30 females) in control and investigation groups respectively completed the study. Mean number of mistakes was significantly decreased (p < .001) as the counseling session increased in both groups. Significant decrease in crucial mistake (inhalation quickly and forcefully until complete filling up of the lungs) that was very hard to be learned via only verbal counseling was noticed after the addition of In-Check DIAL. The improvement of the PFT results were significant from the second visit in the investigation group (p < .05) and from the third visit in the control group (p < .001). The decrease in the rate of rescue medication consumption was faster in investigation group than control group.Using training device along with verbal counseling has proven a beneficial role in inhalation technique resulting in optimum dosage delivery and yielding reasonable improvement in PFT. Keywords: DPI, In-Check DIAL, Dose delivery, Traditional verbal counseling, Pulmonary function

Effect of DPI's training-device on inhalation technique and clinical efficacy in asthmatics

The aim of this work was to study the effect of using training device (In-Check DIAL) along with traditional dry powder inhaler (DPI) counseling on inhalation technique and pulmonary functions test (PFT) in asthmatics.Adult asthmatics >18 years old were recruited in 3months study of investigation and training. They were divided into control and investigation groups.DPI inhalation technique was checked and mistakes were noted and corrected at every monthly visit. Their peak expiratory flow and forced expiratory volume in 1second as percentage of forced vital capacity were checked at each visit followed by showing patients the correct inhalation technique and how to use In-Check DIAL (investigation group).29 patients (14 females) and 57 patients (30 females) in control and investigation groups respectively completed the study. Mean number of mistakes was significantly decreased (p < .001) as the counseling session increased in both groups. Significant decrease in crucial mistake (inhalation quickly and forcefully until complete filling up of the lungs) that was very hard to be learned via only verbal counseling was noticed after the addition of In-Check DIAL. The improvement of the PFT results were significant from the second visit in the investigation group (p < .05) and from the third visit in the control group (p < .001). The decrease in the rate of rescue medication consumption was faster in investigation group than control group.Using training device along with verbal counseling has proven a beneficial role in inhalation technique resulting in optimum dosage delivery and yielding reasonable improvement in PFT. Keywords: DPI, In-Check DIAL, Dose delivery, Traditional verbal counseling, Pulmonary function

The Effect of Gentamicin on the Action of Atracurium in Adult Patients

The aim of the trial was to study the effect of Gentamicin as an aminoglycoside on Atracurium as a neuromuscular blocker. Forty patients (20-60 years old) who had minor surgical procedures were enrolled in the study. All the patients were with the American Society of Anaesthesiologists (ASA) physical status I-II with elective surgery in supine position. Patients were represented to full history, clinical examination and laboratory tests at Beni suef University Hospital to be sure that they met the criteria. Patients were divided into two equal groups. Group I (Atracurium-Gentamicin) and Group II (Atracurium alone). Group I received Gentamicin at dose of 2 mg/kg 5 minutes before starting the general anesthesia. The degree of muscle relaxation was monitored by using peripheral nerve stimulator with recording of Train of Four (TOF) ratio every 10 minutes. Clinical duration, onset time, time to spontaneous recovery T4/T1 ratio and occurrence of recurrence of the neuromuscular blockade were assessed. At the end of anesthesia it was noticed that there was no significant difference according to onset time, clinical duration or time to spontaneous recovery. Hence, there was no effect of using Gentamicin preoperatively on the action of the Atracurium. [Med-Science 2014; 3(2.000): 1174-82