Willingness to vaccinate against COVID-19 among healthcare workers: an online survey in 10 countries in the eastern Mediterranean region

BACKGROUND: Willingness of healthcare workers to be vaccinated is an important factor to be considered for a successful COVID-19 vaccination programme. This study aims to understand the willingness of health workers to receive a COVID-19 vaccine and its associated concerns across 10 countries in the Eastern Mediterranean Region (EMR). METHOD: A cross-sectional study was conducted in January 2021 among healthcare workers in EMR using an online survey. Data were analyzed using IBM SPSS software package version 20.0. RESULTS: A total of 2806 health workers (physicians, nurses and pharmacists) completed and returned the informed consent along with the questionnaire electronically. More than half of the respondents (58.0%) were willing to receive a COVID-19 vaccine, even if the vaccination is not mandatory for them. On the other hand, 25.7% of respondents were not willing to take COVID-19 vaccine while 16.3 % were undecided. The top three reasons for not willing to be vaccinated were unreliability of COVID-19 vaccine clinical trials (62.0%), fear of the side effects of the vaccine (45.3%), and that COVID-19 vaccine will not give immunity for a long period of time (23.1%). CONCLUSION: Overall, the study revealed suboptimal acceptance of COVID-19 vaccine among the respondents in the EMR. Significant refusal of COVID-19 vaccine among healthcare professionals can reverse hard-won progress in building public trust in vaccination program. The findings suggest the need to develop tailored strategies to address concerns identified in the study in order to ensure optimal vaccine acceptance among healthcare workers in the EMR

Evaluation of the Sensitivity and Specificity of Immunohistochemical Markers in the Differential Diagnosis of Effusion Cytology

Objective: To evaluate the sensitivity and specificity of Calretinin and Carcinoembryonic antigen as immunocytochemical markers in distinguishing mesothelial cells from metastatic adenocarcinoma cells in effusion cytology.Methods: This study included 50 patients who presented with effusions (26 pleural and 24 peritoneal), at Al-Kadhimya Teaching Hospital who were selected according to their preliminary diagnosis from 1st December 2010 to 30th June 2011. Effusion fluids were aspirated and processed for both conventional cytological methods using Papanicolaou-stain and immunocytochemical staining with anti Calretinin and Carcinoembryonic antigen.Results: The sensitivity of cytology for detection of malignant cells was 77%, with 100% specificity and 86% accuracy. Calretinin was observed to be a specific (100%) and sensitive (90%) marker for mesothelial cells (of benign etiology). Carcinoembryonic antigen exhibited 70% sensitivity and 100% specificity for adenocarcinoma cells. When the results of both cytology and immunocytochemistry were considered in conjunction, the sensitivity for the detection of malignancy increased to 97%, with 100% specificity and 98% accuracy.Conclusion: Calretinin and Carcinoembryonic antigen were found to be useful markers for differentiating reactive mesothelial cells from metastatic adenocarcinoma cells in smears prepared from body fluids. Also, the combination of both cytology and immunocytochemical studies using the two markers can greatly enhance the diagnostic accuracy, sensitivity and specificity in malignant effusions

COVID-19 Treatment Guidelines: Do They Really Reflect Best Medical Practices to Manage the Pandemic?

SARS-CoV-2 (COVID-19) has been changing the world since December 2019. A comprehensive search into many COVID-19 treatment guidelines was conducted and reported in this article. This is a review paper to probe differences in COVID-19 managing strategies and explore the most common treatment plans among countries. Published guidelines from 23 countries and three references guidelines—until the end of 2020—were included in this article. The majority of COVID-19 treatment options were reported in this review and it includes antiviral drugs, antimalarial drugs, antibiotics, corticosteroids, immunotherapy, anticoagulants, and other pharmacological treatment. The presence of such information from different countries in a single comprehensive review article could help in understanding and speculation of variation in the recommended treatment in each country. This might be related to the cost of medications, the access to the medications, availability of medication that could potentially be useful in managing COVID-19 cases, and the availability/capacity of healthcare facilities. Finally, although there are various treatment groups listed in the published therapeutic guidelines worldwide, unfortunately, there is no evidence for effectiveness of most of these medications in reducing the COVID-19 mortality curve over more than one year of this global pandemic

Dynamic analysis of thick plates reinforced with agglomerated GNPs

In this work, the quasi-3D hyperbolic shear deformation theory (quasi-3D HSDT) is utilized to examine the dynamics of thick rectangular plates reinforced with rectangular nanofillers known as graphene nanoplatelets (GNPs). Agglomeration of the GNPs is incorporated and the mechanical characteristics like shear, elastic, and bulk moduli, Poisson's ratio, and density are analysed according to the mixture along with the Eshelby-Mori-Tanaka approach. Hamilton's principle is hired to derive the solving equations, the Navier approach is hired to present an analytical solution in the spatial domain, and the Newmark method is hired to provide an approximate solution in the time domain. The relevance of the dynamic response and the natural frequencies of the plate on several parameters are explored such as dispersion pattern and the GNPs percentage and agglomeration parameters. It is discovered that for a specific GNPs percentage, growth in the amount of agglomerated GNPs leads to lower natural frequencies and higher dynamic deflection. Meanwhile, for a specific mass fraction of the agglomerated GNPs, growth in the volume of clusters brings about higher natural frequencies and lower dynamic deflection