Background: Coronavirus illness (COVID-19) reached the level of a significant public health emergency in 2019, with an estimated worldwide death toll of more than 1,00,000 people 2019. Coronavirus illness (COVID-19). This survey was conducted to identify the factors influencing COVID-19 practice among undergraduate nursing students at the University of Nizwa, Sultanate of Oman. Methods: A quantitative cross-sectional online survey of sixty-four undergraduate nursing students chosen from the school of Nursing at the University of Nizwa in Sultanate of Oman took part from July 30 to August 5, 2021. Results: Participants’ average age was 22.27 ± 1.04, and the male-to-female ratio was 31.8% (n=64). Nursing students had adequate knowledge (13.67 ± 3.46), a positive attitude (48.14 ± 12.29), and good practices (32.6 ± 6.12), according to the results of a survey. Female students, compared to males (0.006, p<0.05), were more likely to follow better practices. Significant positive associations were found between age (0.025, p<0.05), gender (0.006, P<0.05), living areas (0.031, p<0.05), grade (0.000, p<0.05), Clinical practice experienced (0.016, p<0.05) and practice on COVID -19. Conclusions The study findings exhibited the essential elements that affected COVID-19 precautionary practices, knowledge, and a positive attitude, which were the most critical variables to consider. Male students and students who reside in rural regions should be targeted for further health education, and efforts should be made to ensure these groups have access to reliable and effective online tools to assist them.

Introduction: Distal radial fracture is a commonly encountered fracture. This study aims to study the epidemiology of distal radial fracture and factors affecting the patients’ functional outcome one to two years after the injury. Materials and methods: This is a retrospective cohort study. The records of patients, fulfilling the radiographical diagnosis of distal radial fracture, and aged 18 and above, who presented to our Emergency Department from 1st January 2018 to 31st December 2018 were retrieved. According to AO classification, we grouped our patients into A (extra-articular), B (partial articular) and C (complete articular). Patients with congenital abnormalities were excluded. Epidemiological data and relevant medical history were obtained and tabulated. A Malaysian language translation of Disability of the Arm, Shoulder and Hand (DASH) questionnaire was used to assess the functional outcome. Results: Out of 168 patients’ data retrieved, only 110 patients’ data were found complete for purposes of this study. The mean DASH score was 13.7 ± 7.87 approximately one to two years post-injury regardless of treatment method. Increasing age was associated with higher DASH score with r=0.407(p<0.001). Several variables had significantly better functional outcome: male gender (p=0.01), Type A fracture configuration (p=0.007) and non-operational treatment (p=0.03). There was no significant difference between treatment modalities in Type A fracture (p=0.094), but Type B (p=0.043) and Type C (p=0.007) had better outcome without surgery. There was no significant difference between different ethnic groups, open or closed fracture and mechanism of injury. Conclusion: Better functional outcome after sustaining distal radial fracture was associated with young age, male gender, type A fracture and treated non-operatively. Interestingly, more complex fracture pattern had better functionality were observed without surgery.

The objectives of this study were to investigate the prevalence and associated risk factors for gastrointestinal (GI) parasites in buffaloes from various areas of Sarawak, and to assess current management practices of GI parasites among farmers. Faecal samples were collected from 15 farms and 129 animals, as well as data on farm and animal-based characteristics. A total of 129 faecal samples were examined for GI parasites using a modified McMaster and sedimentation. Association between potential risk factors and the prevalence of GI parasites was investigated using Chi-square statistic. The prevalence of Paramphistomum sp., strongyles, and coccidia were 75.2% (95% CI±7.5), 52.7% (95% CI±8.6) and 48.1% (95% CI±8.6), respectively. Farms which had a grazing area less than 50 acres in size had significantly higher prevalence of strongyles (70.5%, χ² = 8.34, P = 0.004) and paramphistomes (88.6%, χ² = 6.46, P = 0.01) relative to farms with a larger grazing area (43.5% and 68.2%, respectively). Prevalence of strongyles was lower in farms that did not implement a cut- and-carry system (45.6%, χ² = 4.17, P = 0.04) in comparison to those that did (64%). The prevalence of paramphistomes was higher on farms with more than 40 animals (80.6%, χ² = 3.18, P = 0.05) relative to farms with fewer animals. The majority of farmers surveyed (67.9%) showed awareness of GI parasite infection and reported that they recognized the associated symptoms. Most farmers practised deworming, and ivermectin was the most commonly used anthelminthic (60.4%); only 1.9% of farmers used albendazole. Overall this study revealed a high prevalence of GI parasites in buffalo in Sarawak. Although farmers report they are aware of parasitic diseases, further education is still required. This could include how they can successfully implement on-farm changes to reduce the prevalence of GI parasites in their herds.

Objectives: The COVID-19 pandemic has made a major impact on hospital services globally, including the care of persons with diabetes and endocrine disorders. The aim of this study is to describe the epidemiology of COVID-19 in the ASEAN Federation of Endocrine Societies (AFES) member countries; to describe challenges, changes and opportunities in caring for patients with endocrine diseases, as well as in fellowship training programs, and endocrine-related research in the AFES countries. Methodology: The AFES ASEAN Survey Of Needs in Endocrinology (AFES A.S.-O.N.E.) was an open-ended questionnaire that was sent to the presidents and representatives of the AFES member countries by email. Responses from Societies were collated and synthesized to obtain perspectives on the emergent issues in endocrinology in the Southeast Asian region during this pandemic. Results: The burden of COVID-19 cases varied widely across the AFES member countries, with the least number of cases in Vietnam and Myanmar, and the greatest number of cases in either the most populous countries (Indonesia and the Philippines), or a country with the highest capability for testing (Singapore). The case fatality rate was also the highest for Indonesia and the Philippines at around 6%, and lowest for Vietnam at no fatalities. The percentage with diabetes among patients with COVID-19 ranged from 5% in Indonesia to 20% in Singapore, approximating the reported percentages in China and the United States. The major challenges in managing patients with endocrine diseases involved inaccessibility of health care providers, clinics and hospitals due to the implementation of lockdowns, community quarantines or movement control among the member countries. This led to disruptions in the continuity of care, testing and monitoring, and for some, provision of both preventive care and active management including surgery for thyroid cancer or pituitary and adrenal tumors, and radioactive iodine therapy. Major disruptions in the endocrine fellowship training programs were also noted across the region, so that some countries have had to freeze hiring of new trainees or to revise both program requirements and approaches to training due to the closure of outpatient endocrine clinics. The same observations are seen for endocrine-related researches, as most research papers have focused on the pandemic. Finally, the report ends by describing innovative approaches to fill in the gap in training and in improving patient access to endocrine services by Telemedicine. Conclusion The burden of COVID-19 cases and its case fatality rate varies across the AFES member countries but its impact is almost uniform: it has disrupted the provision of care for patients with endocrine diseases, and has also disrupted endocrine fellowship training and endocrine-related research across the region. Telemedicine and innovations in training have been operationalized across the AFES countries in an attempt to cope with the disruptions from COVID-19, but its over-all impact on the practice of endocrinology across the region will only become apparent once we conquer this pandemic.
Surveys and Questionnaires ; Asia, Southeastern ; COVID-19 ; SARS-CoV-2

The role and efficacy of exclusive enteral nutrition (EEN) in the treatment of luminal Crohn's disease (CD) has been well established over the last 2 decades. Consequently, in many centers nutritional therapy is now considered first line therapy in the induction of remission of active CD. However, the use of nutritional therapy in complicated CD has yet to be fully determined. This article aimed to review case reports and clinical trials published in the last decade that have considered and evaluated nutritional therapy in the setting of complicated CD in children and adults. Published literature focusing upon the use of nutritional therapy as part of medical therapy in the management of complicated CD were identified and reviewed. Although there continue to be various interventions utilized for complicated CD, the currently available literature demonstrates that nutritional therapies, especially EEN, have important roles in the management of these complex scenarios. Further assessments, involving large numbers of patients managed with consistent approaches, are required to further substantiate these roles.
Adult ; Child ; Crohn Disease ; Enteral Nutrition ; Humans ; Intestinal Fistula ; Intestinal Obstruction ; Phenobarbital ; Remission Induction

During the past two decades, management of blunt solid organ injuries had shifted from conventional surgery to more conservative approach, namely nonoperative management (NOM).[1] The non-operative approach mainly depends on the trauma experience of surgeons and the institution, quality of radiographic imaging and its interpretation.[2-5] If the surgeon decides to observe the patients by NOM, close monitoring of vital signs and frequent physical examinations must be done accordingly with radiological evaluations if needed.

AIM:To determine whether there was a significant relationship between eye iris color with axial length, intraocular pressure, retinal nerve fiber layer (RNFL) thickness, macular thickness and choroidal thickness.METHODS:A prospective cross-sectional study involving 92 eyes of 92 healthy volunteers.These were divided into dark colored-eye (DCE) and light-colored eye (LCE) groups according to iris color.The RNFL and macular thicknesses were analysed with standard optical coherence tomography (OCT) protocol while choroidal thickness was analysed with electronic data interchange (EDI) protocol in all subjects.Choroidal thickness was measured at the fovea, 1500 μm nasal and 1500 μm temporal to the fovea in a horizontal section.RESULTS:Of the 92 eyes included, 62 (67.4%) were dark-colored while 30 (32.6%) were light-colored.The mean age was 29.22±5.86y in the subjects with DCE and 28.86±6.50y in those with LCE.No significant difference was detected in mean age, axial length, macular thickness, choroidal thickness and intraocular pressure (IOP) between the groups (P>0.05).However, RNFL thicknesses varied depending on the quadrant measured, and were lower in both global and the nasal and temporal quadrants for individuals with LCE (P≤0.022).CONCLUSION:No significant differences were found in IOP, macular thickness and choroid thickness between individuals with DCE and LCE.Meanwhile, the RNFL thickness is lower.

AIM:To evaluate the potential posterior segment effects of topical application of brimonidine-purite 0.15％ through measurement of choroidal thickness (CT) in healthy eyes using enhanced depth imaging spectraldomain optical coherence tomography (EDI-SD-OCT).METHODS:Thirty-two eyes of 32 healthy subjects were included in this prospective,placebo controlled interventional clinical trial.They received one drop of topical preservative-free artificial tears as placebo for the first day and one drop of brimonidine-purite 0.15％ for the second day.Intraocular pressure,ocular perfusion pressure (OPP),and EDI-SD-OCT were performed at baseline,at 1,3 and 5h after the treatments.RESULTS:Compared to the measurements obtained at baseline,the CT measurements obtained after the topical application of brimonidine-purite 0.15％ significantly increased at the sub-fovea (P=0.001),at temporal 1500 μm to the fovea (P=0.003) and at nasal 1500 μm to the fovea (P=0.003).Choroidal thickness was unchanged in placebo group during the study (P ＞0.05).There was no significant reduction in the OPP in both groups (P ＞0.05).There were no adverse events during the study.CONCLUSIONS:Contrary to expectations,topical administration of brimonidine-purite 0.15％ resulted with thickening of sub-foveal,temporal and nasal CT.This might be related to altered auto-regulation mechanisms in choroidal vessels.

We evaluated the activity of methanolic extracts of Melaleuca cajuputi flowers against the filarial worm Brugia pahangi and its bacterial endosymbiont Wolbachia. Anti-Wolbachia activity was measured in worms and in Aedes albopictus Aa23 cells by PCR, electron microscopy, and other biological assays. In particular, microfilarial release, worm motility, and viability were determined. M. cajuputi flower extracts were found to significantly reduce Wolbachia endosymbionts in Aa23 cells, Wolbachia surface protein, and microfilarial release, as well as the viability and motility of adult worms. Anti-Wolbachia activity was further confirmed by observation of degraded and phagocytized Wolbachia in worms treated with the flower extracts. The data provided in vitro and in vivo evidence that M. cajuputi flower extracts inhibit Wolbachia, an activity that may be exploited as an alternative strategy to treat human lymphatic filariasis.
Adult ; Aedes ; Biological Assay ; Brugia pahangi ; Elephantiasis, Filarial ; Flowers* ; Humans ; In Vitro Techniques ; Melaleuca* ; Methanol* ; Microscopy, Electron ; Polymerase Chain Reaction ; Wolbachia

Malaria is still a leading cause of morbidity and mortality. The increase in lipid peroxidation reported in malaria infection and antioxidant status may be a useful marker of oxidative stress during malaria infection. The aim of this study was to investigate the role of antioxidant enzymes against toxic reactive oxygen species in patients infected with Plasmodium vivax and healthy controls. Malondialdehyde levels, superoxide dismutase, and glutathione peroxidase activities were determined in 91 P. vivax patients and compared with 52 controls. Malondialdehyde levels, superoxide dismutase, and glutathione peroxidase activities were 8.07+/-2.29 nM/ml, 2.69+/-0.33 U/ml, and 49.6+/-3.2 U/g Hb in the patient group and 2.72+/-0.50 nM/ml, 3.71+/-0.47 U/ml, and 62.3+/-4.3 U/g Hb in the control group, respectively. Malondialdehyde levels were found statistically significant in patients with vivax malaria higher than in healthy controls (P<0.001). On the other hand, superoxide dismutase and glutathione peroxidase activities were found to be significantly lower in vivax malaria patients than in controls (P<0.05). There was an increase in oxidative stress in vivax malaria. The results suggested that antioxidant defense mechanisms may play an important role in the pathogenesis of P. vivax.
Adult ; Animals ; Antioxidants/*metabolism ; Biological Markers/metabolism ; Female ; Glutathione Peroxidase/metabolism ; Humans ; Lipid Peroxidation ; Malaria, Vivax/*metabolism/parasitology ; Male ; Malondialdehyde/metabolism ; *Oxidative Stress ; Plasmodium vivax/*metabolism ; Reactive Oxygen Species/*metabolism ; Superoxide Dismutase/metabolism ; Young Adult