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   Table of Contents - Current issue
July 2020
Volume 13 | Issue 7
Page Nos. 285-332

Online since Wednesday, June 17, 2020

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Will Africa experience a spike in COVID-19 cases? p. 285
Terkuma Chia, Oluwatosin Imoleayo Oyeniran
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Biosimilars: A novel perspective in diabetes therapy p. 288
Muthu Thiruvengadam, Baskar Venkidasamy, Ill-Min Chung, Prabhu Thirupathi, Umadevi Subramanian
Diabetes mellitus, an endocrine disorder, has a wider reach among most of the world population. The incidence of diabetes is high not only among adults but wider-age groups are also becoming susceptible to this disease because of modified food habits and lifestyle changes that are alien to the physiological system. The control of blood glucose level would be the prime focus of all the therapeutic targets, which is achieved through drugs, modified lifestyle, and paleo-based diets. To find a solution to these problems, earlier humans have revolutionized the science with the discovery of insulin from the porcine pancreatic crude extract. Later, developments have been made with artificial recombinant insulin and even insulin analogs that would mimic the physiological basal insulin in controlling the blood sugar levels. Various factors such as cost and logistics for quality delivery to the end-user at various corners of the world have impeded the reach of the original product. Hence, biosimilar insulins that are original insulin analogs were designed to execute similar physiological functions. In the current situation, the use of biosimilars has been approved in various clinical conditions that are very promising in its functions. In the present review, the various developmental phases of biosimilar preparations and the regulations enforced ensuring a quality product in the market through the Food and Drug Administration and the European Medicines Agency have been discussed.
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Seroprotection after hepatitis B vaccination amongst infants aged between 12 and 24 months in Ho Chi Minh City, Vietnam p. 295
Giao Huynh, Quang Vinh Bui, Ngoc Lan Nguyen, Le An Pham
Objective: To assess levels of HBsAb amongst infants who received hepatitis B vaccine in the Expanded Program on Immunization in Vietnam. Methods: A cross-sectional study was carried out at 16 community health centers from February 2016 to July 2017. Eligible infants were tested for HBsAb and HBsAg. Structured questionnaires were used to collect relevant information about the demographics of the parents/caregivers and their infants after physical examination. Results: A total of 199 eligible infants were selected with a mean age of (17.3±4.5) months. Protective antibody levels with HBsAb ≥10 mIU/mL were detected in 68.3% of infants. Of these, antibody levels from 10 to 99 mIU/ mL were 48.5% of those tested and antibody levels ≥100 mlU/mL were recorded as 51.5%. No cases were recorded of being infected with hepatitis B virus. The rate of positive HBsAb level in those who were not wasting and 18 months old was less than that among those who were <18 months old (OR 0.49, 95% CI: 0.26-0.92, P<0.05) while the infants with wasting and <18 months were less likely to be positive HBsAb than those who were not wasting and of the same age group (OR 0.15, 95% CI: 0.04-0.55, P<0.05). Conclusions: Seroprotection against hepatitis B virus was low in the infants tested (at 68.3%), which suggests that the hepatitis B vaccine should be administered with one additional dose for infants between 12 and 24 months of age, particularly those with wasting.
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A cohort study of hospitalized adult dengue patients with fatality in Taiwan: The elderly and febrile characteristics matter for prognosis p. 301
Tsung-Hang Kuo, Chia-Chang Chuang, Chin-Chung Tseng, Ming-Yuan Hong, Sheng-Hsiang Lin
Objective: To identify the febrile characteristics and clinical presentations associated with fatality in hospitalized adult patients with dengue virus (DENV) infections. Methods: A total of 289 adult hospitalized patients with laboratory-confirmed DENV infections were examined, of which 22 were fatal and 267 were non-fatal. A comparison of the clinical and laboratory characteristics was retrospectively conducted of the deceased and surviving individuals. Multivariate logistic regression and receiver operating characteristic curve analysis were performed to identify predictors of fatality. Results: Fatal patients exhibited significantly more comorbidities, particularly renal and cardiac comorbidities, and they were, in general, older than control individuals (P<0.000 1). The results of logistic regression analysis showed that febrile duration of less than four days before arriving in the Emergency Department (OR=5.34; 95% CI: 1.39–20.6), episode of hypotension in the Emergency Department (OR=6.95; 95% CI: 2.40–20.1), and comorbidity with congestive heart failure (OR=11.26; 95% CI: 2.31–54.79) were all significantly associated with inpatient fatality due to DENV infection. The ROC curve analysis indicated that the final prognostic model yielded an area under the curve of 0.87 (95% CI: 0.79–0.97) for fatality. Conclusions: The aforementioned clinical findings may help clinicians predict fatality among adult inpatients with DENV infection.
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Prevalence and genotype distribution of Enterobius vermicularis among kindergarteners in Shiraz and Khorramabad cities, Iran p. 308
Atefeh Tavan, Fattaneh Mikaeili, Seyed Mahmoud Sadjjadi, Sara Bajelan, Hossein Mahmoudvand, Meysam Sharifdini
Objective: To study the prevalence and genotype of Enterobius (E.) vermicularis from adhesive tape samples in the cities of Shiraz and Khorramabad, Iran. Methods: A total of 1 000 adhesive tape samples from kindergartens in Shiraz (500 samples) and Khorramabad (500 samples) were collected and tested using a microscope to find E. vermicularis egg/s. A questionnaire was filled out for each sample. In order to characterize the genotype of E. vermicularis, the PCR-sequencing method of the mitochondrial cytochrome C oxidase subunit 1 (cox1) gene was used. Genomic DNA was extracted from the positive scotch tape samples of E. vermicularis. The cox1 gene was amplified by the polymerase chain reaction and sequenced. The sequence data were aligned using the BioEdit software and compared with the published sequences in GenBank. Phylogenetic analysis was performed using the maximum likelihood method. Results: The parasitological method showed that 15 out of the 500 samples from Shiraz (3.00%) and 12 out of the 500 samples from Khorramabad (2.40%) were infected with E. vermicularis eggs. BLAST analysis indicated that the sequenced isolates belonged to E. vermicularis genotype B while three different haplotypes were also identified. Conclusions: This is the first study on genotyping E. vermicularis in the cities of Shiraz and Khorramabad. Considering the public health importance of the disease, further studies are necessary to characterize the genotype of E. vermicularis in human populations from other regions of Iran.
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Predicting factors contributing to knowledge, attitudes and practices relating to Zika virus infection among the general public in Malaysia p. 314
Kingston Rajiah, Mari Kannan Maharajan, May Yee Woo, Yew Wing Yee, Shi Mun Cheah, Mai Ya Zhe
Objective: To identify the predicting factors that contribute to knowledge, attitude and practices relating to Zika virus infection among the general public in Malaysia. Methods: A cross-sectional study was conducted using a validated self-administered questionnaire. Descriptive analysis was done for participants’ socio-demographic profile. Contingency table analysis was done to analyse the associations between knowledge, attitudes, and practices (KAP) scores and socio-demographic profile. A Bonferroni-corrected P-value was used to find the significance of the associations and multiple comparisons were performed in a single data set. To determine the linear relationship between each independent variable and the dependent variable, Spearman rank correlation was performed. Cohen’s correlation coefficient was evaluated to determine the strength of the effect size. Multiple correlations and regression analyses were performed to identify independent variables that predicts the dependent variable. Results: Multiple correlation analyses were conducted between respondents’ KAP score and independent variables (Age >60 years; Female gender; Selangor state; At least 1 pregnant woman per household). The independent variables such as ‘Female gender’, ‘Selangor state’ and ‘At least 1 pregnant woman per household’ were positively and significantly correlated with KAP score whereas, age >60 years was negatively and significantly correlated with the KAP scores. Conclusions: There were associations between four independent factors and the KAP scores, while only three factors contributed to changes in KAP scores among the public. Among these contributing factors, respondents’ age group was the strongest predictor.
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Leishmania donovani infection in Eastern Sudan: Comparing direct agglutination and rK39 rapid test for diagnosis-a retrospective study p. 322
Elfadil Abass
Objective: To compare diagnostic accuracy and agreement between direct agglutination test and rK39 rapid tests for diagnosis of visceral leishmaniasis in an endemic area, the Doka area in Eastern Sudan. Methods: Stored sera of confirmed visceral leishmaniasis cases, unconfirmed visceral leishmaniasis-suspects and negative controls were tested by direct agglutination test and rK39 rapid test. The sera were collected from the Doka area in Eastern Sudan. Diagnostic accuracy of direct agglutination test and rK39 rapid test was assessed in terms of sensitivity, specificity, positive predictive value and negative predictive value, estimated at 95% confidence interval (CI). Agreement between the two tests was determined by the kappa (κ) value. Results: Taking lymph node aspiration of Leishmania as a gold standard, direct agglutination test showed 91.0% sensitivity, 99.3% specificity, resulting in a positive and negative predictive value of 99.3% and 91.0%, respectively. In contrast, the sensitivity of rK39 rapid test was 85.2% and specificity 98.6%, resulting in a positive and negative predictive value of 98.5% and 85.9%, respectively. Most (81.3%) of the confirmed visceral leishmaniasis sera revealed strong antibody titers (≥1:6 400). Some sera (n=5) that were positively tested with rK39 rapid test were negative in direct agglutination test (≤1:800); in contrast, direct agglutination test was positive in 12 confirmed visceral leishmaniasis sera that were negatively tested with rK39 rapid test. There was moderate to good agreement between direct agglutination test and rK39 rapid test for confirmed visceral leishmaniasis patients (κ=0.42, 95% CI=0.21-0.63) and control sera (κ=0.80, 95% CI=0.41-1.00). Conclusions: Both direct agglutination test and rK39 rapid test are satisfactory test systems for visceral leishmaniasis diagnosis in East Sudan. Their simplicity makes them ideal for first healthcare in rural areas. These data are relevant also for other East African endemic countries because of the geographical and overlapping distribution of the Leishmania parasite.
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Case fatality rate of coronavirus disease 2019 (COVID-19) in Iran-a term of caution p. 328
Vahid Rahmanian, Mohammad Hasan Rabiee, Hamid Sharifi
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Effect of the Songkran festival on COVID-19 transmission in Thailand p. 331
Natcha C Jitsuk, Pikkanet Suttirat, Charin Modchang
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