Background: Measles outbreaks under high coverage of measles vaccination in Indonesia is gaining a necessary evaluation of factors associated with measles-vaccine immune responses.
Objctive: The purposes of recent study were to evaluate the association of sociodemographic and anthropometric parameters and specific immune responses towards first dose Edmonston-Zagreb (EZ) measles vaccine in Indonesian infants.
Methods: A total of 35 infants were enrolled in this cohort study. Measles immune responses were followed up at one and six months after vaccination then analyzed for its association with sociodemographic, anthropometric, and nutritional parameters.
The plaque-reduction microneutralization assay was conducted to measure the titer of measles specific IgG antibody.
The level of CD4+ and CD8+ T-cells that exhibiting gamma interferon (IFN-γ) secretion were analyzed by flow cytometry.
The association between variable was analyzed by linear regression. The difference immune response among variable were analyzed with Mann-Whitney test.
Results: Vitamin A supplementation and breastfeeding were predicted as associated factor for humoral and cellular immune response after one month and six months measles vaccination among Indonesia Infants.
Conclusion: Nutritional factor is associated with measles vaccination immune response in Indonesian infants.
Keywords: Age; Breastfeeding; Immune; Measles; Vitamin A.
Purification and Optimization of Extracellular Lipase from a Novel Strain Kocuria flava Y4
The exogenous lipolytic activities of Kocuria sp. have been recognized earlier but the genus further contains many more unexplored strains.
In this study, the extracellular lipase activity of Kocuria flava Y4 (GenBank accession no. MT773277), isolated from Dioscorea villosa during our previous study, was regulated by different physicochemical parameters, such as pH, temperature, shaking speed, and incubation time.
For efficient immobilization of the extracellular lipase, 4% sodium alginate, 50 mL of 25 nM CaCl2.2H2O solution, and 15 min. Hardening time of gel beads in calcium chloride was used.
For the first time, K. flava Y4 lipase was purified using ammonium sulphate precipitation followed by dialysis and DEAE-Sepharose anion exchange chromatography with Sepharose-6B gel filtration chromatography, yielding ∼15-fold purified lipase with a final yield of 96 U/mL. The SDS-PAGE of purified lipase displayed a single strong band, indicating a monomeric protein of 45 kDa.
At a temperature of 35°C and pH 8, the purified lipase showed maximum hydrolytic activity. Using p-nitrophenyl acetate (p-NPA) as the hydrolysis substrate, the values of K m and V max derived from the Lineweaver-Burk plot were 4.625 mM and 125 mol/min-1mg-1, respectively.
Evaluating the Current Practice of Post Cesarean Thromboprophylaxis and Enhancing Guideline Adherence in Al-Najaf Hospitals
Background: Venous thromboembolism (VTE) is one of the most common cardiovascular disorders in the United States and is manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE) which represented as the most important cause of death in pregnant women after cesarean section.
Venous thromboembolism (VTE) is representing the second direct cause of death which is accounting for 13.8% of all mother’s death in the world. The most common risk factor of venous thromboembolism (VTE) is cesarean section.
Objective: The study aims to study the current practice of post-cesarean thromboprophylaxis in dosing calculation and duration of therapy.
Methods: Between September 2020 and January 2021, an observational- interventional prospective pre and post-study, was conducted in all hospital of Najaf in the City center and the suburbs that contain gynecology and obstetric ward to assess the current practice of post-cesarean thromboprophylaxis and to evaluate the impact of pharmacist intervention program to improve guideline adherence then after intervention. Another 102 patients were enrolled to analyze the change thromboprophylaxis according to the guideline.
Results: From patient data, the rate of adherence to guidelines raised significantly among the post-intervention patients’ group by thromboprophylaxis dose according to body weight was increase significantly (p<0.001) from 56.9% in the observation phase to 83.3% after intervention and about the duration of thromboprophylaxis is significantly (p<0.001) from 18.6% in the observation phase to 52.0% after the intervention.
Conclusion: This study showed that the clinical pharmacist’s multifaceted intervention has resulted in encouraging guideline implementations as reflected by improving the proper use of thromboprophylaxis the duration anddosing calculations according to body weight.
Keywords: Venous thromboembolism; deep vein thrombosis; pulmonary embolism.
Therapeutic Modalities in the Treatment of Persistent Ductus Arteriosus in Premature Babies: Report of Two Cases
Background: Persistent Ductus Arteriosus (PDA) is a vascular structure that connects the pulmonary artery and the descending aorta. It plays an important role in the fetal blood flow pattern.
Objective: The aim of this paper is to present two cases from Neonatology of Cantonal hospital in Bihac, with hemodynamically significant ductus, different “timing” of treatment and different therapeutic options.
Results and discussion: The ductus closes functionally within the first 72 to 96 hours after the birth. Its anatomical closure follows in the next 14 days.
If it remains open after the third month of life, it is treated as a congenital heart anomaly with a left-right shunt. Approximately 10% of all congenital heart defects are PDA with an incidence of 2-4 per 1000 live births.
It has been clinically proven that PDA is present in 45% of premature babies with a birth weight of less than 1750 g and in about 80% of premature babies with a birth weight below 1200 g.
As criteria for the application of drug therapy (in this case we use Paracetamol) for ductal closure, we took into account clinical parameters and echo parameters that indicated that it was a hemodynamically significant ductal shunt.]
Prerequisites for treatment were normal liver function confirmed by laboratory tests, normal platelet count, no intracranial hemorrhage, normal gastrointestinal function, normal coagulation parameters, normal renal function, calm parameters of inflammation.
Conclusion: The diagnosis of PDA in the early, asymptomatic phase, in premature babies, is made by early echocardiographic examination. The decision on treatment should be based on clinical and echocardiographic criteria. Paracetamol is an alternative in the treatment of this cardiac problem of premature infants and could be more effective if used in early, presymptomatic phase.
Keywords: persistent ductus arteriousus; premature babies.
Smoking and COVID-19 in ICU Patients
Background: Case studies revealed an astonishingly low number of current among patients suffering from symptomatic COVID-19 compared to general population, leading to the conclusion that smoking/nicotine uptake might have a preventive effect.
Objective: This study aims to show the relation between smoking habits, present and past, and severity and outcome in COVID-19 patients hospitalized in the ICU of the University Hospital in Pristina.
Methods: This paper reports the results of possible association between smoking habits and severity and outcome of COVID-19. Data on smoking habits, present and past, among 73 patients with severe COVID-19 hospitalized at ICU are analysed and presented.
Results: Smokers (active and ex-smokers) in total were 16 (21.9%) cases (P<0.0001); active smokers were 5 (6.8%) cases (P<0.0001), ex-smokers 11 (15.1%) cases (P<0.0001), and non-smokers were 57 (78.1%) of the cases. From 16 cases (21.92%) identified as active smoker and ex-smoker, 8 of them ended with death, and other 8 cases survived; while 40 cases (54.79%) from the non-smoker group died, while 17 cases (23.29%) from this group survived (95% CI: 0.2881 to 1.5430, P=0.3792).
Out of 5 (6.85%) cases of active smokers, 3 (4.11%) of them ended with death (95% CI: 0.1692 to 2.6846, P=0.855); while from 11 (15.07%) of ex-smokers, 5 (6.85%) died (95% CI: 0.1995 to 1.6412, P=0.3561). OR for death among smoker group of cases (active and ex-smokers) was 0.4250 (95% CI: 0.1370 to 1.3189, P=0.1386); for active smokers 0.2550 (95% CI: 0.0547 to 1.1892, p=0.0820), and 0.3542 (95% CI: 0.0950 to 1.3199, P=0.1220) for ex-smokers. Data on the influence of smoking on incidence and severity of COVID-19 ICU cases are conflicting.
Conclusion: A protective effect of smoking in COVID-19 should not be inferred.