Journal of Ideas in Health (JIDHealth)
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Evaluation of the knowledge, attitudes, vaccine hesitancy, and behaviors of anesthesia technicians on adult vaccination
Background: Anesthesia technicians work in places with a high risk of infectious diseases. Vaccination is one of the most essential methods that protect society and healthcare workers against infectious diseases. This study aims to determine anesthesia technicians\u27 knowledge, behavior, attitude, and vaccine hesitancy.
Methods: A cross-sectional web-based study was conducted between October 2021 and February 2022 at the Ankara Yildirim Beyazit University, Turkiye. A semi-structured and self-reported online survey was recruited to collect data from the Turkish anesthesia technicians’ community. Data of 1600 participants have undergone descriptive and univariate analyses to evaluate the differences in mean scores on knowledge, attitudes, and vaccine hesitancy.
Results: The mean age of respondents was 24 years (±6.15). More than two-thirds (79.2%) were females, single (84.9%), aged less than 30 years (88.4%), and unemployed (61.1%); however, 12.4% had chronic diseases. The mean knowledge, attitude, and vaccine hesitancy score were 13.24± 3.22 (range: 0-21), 11.19 ± 3.19 (range: 0-15), and 28.67± 6.64, range: 12–60), respectively. Most respondents had information (1458, 91.1%) about COVID-19 vaccines, and 1247(77.9%) had been vaccinated. However, 240 (16.3%) did not receive vaccines at all compared to 59 (3.7%) who completed the thirteen recommended vaccines in Turkiye. The mean of vaccine hesitancy was significantly higher among females (P=0.001), unemployed (P=0.007), residents in Southeast Anatolia (P=0.001), and those who did not use medication continuously (P=0.016). However, participants aged 40 years and above (P=0.013) showed the lowest mean of vaccine hesitancy than the other age groups.
Conclusion: Appropriate training and guidance might increase the vaccination information and enhance the vaccination rates among anesthesia technicians
Monkeypox in the COVID-19 era
Currently, in addition to the COVID-19 waves, the world is confronting an additional threat: the global monkeypox infection outbreak, already regarded as a “public health emergency of international concern” by the World Health Organization. According to the most recently published reports, more than 21000 monkeypox infection cases have been confirmed in 78 countries, with 5 African deaths and more than three deaths outside endemic Africa while the numbers are still increasing. Too little is currently known about the monkeypox virus, although it does not appear as a recently emerged pathogen, being probably as ancient as the smallpox virus. The major fear in regards to the current international monkeypox infection spread has multiple causes: monkeypox\u27s similarity to smallpox, the deadliest pathogen in the history of humanity; lack of knowledge of the virus\u27s natural occurrence, animal reservoir, mechanisms of transmission, pathogenicity, host immune response; lack of effective specific treatment and vaccine; unusually rapid geographic spread and atypical clinical presentation; increase in the mutation rate outside the standard, mathematically anticipated rates; putative complications and sequelae of the infection; potential use as a biological weapon. Actually, with such characteristics, the monkeypox virus has the potential to occupy/replicate the place of the much-feared smallpox virus. In the near future, due to the high registry of viral mutagenesis, limitations in the preventive strategies, and lack of an efficient vaccine, several viruses, including SARS-CoV-2 and monkeypox, could continue their worldwide spread and generate flu-like subsequent infective bursts. Therefore, dedicated research and detailed knowledge of the viral pathogenic mechanisms and transmission routes are required to design efficient therapies and limit/stop future pandemics: until the emergence of a new virus
Detection of stem cells in human endometrium: immune-histochemical study
In this work, we recruited CD105 and CD90 markers to identify the endometrial stem cells (EnSCs) in the human uterine endometrium. Fifty endometrial specimens have been extracted from twenty-five deceased women. All specimens have been embedded in paraffin block and prepared for immune-histochemical processing. The expression of CD105 and CD90 was counted per high power field (HPF). Paired sample t-test was used to compare the means between groups and age variables. The Statistical analysis was conducted using “SPSS16 software" The statistical significance was considered at less than 0.05. Results of paired sample t-test showed that the expression count (EC) at the Basalis layer (with CD105) was 5.26 points higher than the Functionalis layer (95% CI [3.43, 7.09]) and the correlation was strongly and positively related (r = 0.829, P < 0.001). The EC at Basalis layer (with CD90) was 4.96 points higher than Functionalis layer (95% CI [3.02, 6.89]) and the correlation was strongly and positively related (r = 0.746, P= < 0.001). The EC at Functionalis layer (with CD105) was 0.9 points higher than the Stroma layer (95% CI [2.27, 4.11]); however, the correlation was weak and positively related (r = 0.429, P = 0.032). The EC at Functionalis layer (with CD90) was 1.4 points higher than the Stroma layer (95% CI [2.1, 4.2]), but the correlation was moderately and positively related r = 0.547, P = 0.005). Findings of an independent-sample t-test showed that the EC of stem cells at the Functionalis, Basalis, and Stroma layers (with CD105 and CD90 markers) was more among patients of reproductive age (<50 years) than patients who were at non-reproductive age (50 years and above), a statistically significant difference [(m = 9.6, 95% CI (5.3, 14.6), t (19.630) = 4.413, P < 0.001)], [(m = 10.2, 95% CI (5.2, 15.2), t (20.714) = 4.202, P < 0.001)] and [(m = 8.4, 95% CI (3.5, 13.4), t (12.313) = 3.523, P = 0.002)], respectively. In conclusion, the EC of the stem cells in the endometrium decreases with age
Calculation of 95% confidence interval of the median lethal dose determined by the up-and-down procedure: a letter to editor
Acute toxicity of chemicals can be determined by the up-and-down procedure (UDP) to measure the median lethal dose (LD50) in laboratory animals. An improved UPD was introduced to calculate the 95% confidence intervals (CI) for LD50 values:
95% confidence interval = LD50 + the standard error (SE)
SE = SD x √2/N (SD= standard deviation of all dosages in N trials in animals).
However, not all studies using the UDP report the 95% CI. Using the above mentioned equations, it is possible to calculate the 95% CI of LD50 determined by using the table of Dixon for UDP- section of the standard error 0.61. For demonstration, recalculations were done on selected LD50 values with standard deviation, standard error and 95% CI from published literature by using the above mentioned equations. These included the LD50 values of propofol and diazinon in chicks, as well as cadmium and tetramisole in mice.
The use of anesthetics for cesarean section delivery in women in Duhok, Kurdistan region, Iraq
Background: Limited information is available on anesthetics that are preferred or used by anesthesiologists for cesarean section (CS) delivery in Kurdistan region, Iraq. This study aims to document general or regional anesthesia use in elective CS deliveries in four major hospitals in Duhok province, Northern Iraq.
Methods: A retrospective cross-sectional study was conducted from February 2019 to February 2020. The general and regional anesthetics types were recorded for each CS delivery case within the selected hospitals. Any adjuvants and medications used with the anesthetics were also recorded. Univariate and bivariate analyses were undertaken. The statistically significant was considered at less than 0.05.
Results: A total of 3420 elective CS deliveries were reported. The mean age ± SD of the pregnant women was 29.6 ± 5.8 years. The anesthetics used in the four hospitals were propofol as a general anesthetic (53.0%) and bupivacaine as a spinal anesthetic (47.0%). The combination of propofol and bupivacaine was used only in 0.3%. The three most frequently and concurrently used adjuvants and medications with propofol or bupivacaine were metoclopramide (90.0%), dexamethasone (80.0%), and ephedrine (73.0%).
Conclusion: Propofol and bupivacaine were the general and spinal anesthesia of choice, respectively, for elective CS delivery in Duhok province, northern Iraq. Some adjuvants and medications were supplemented to improve the quality of anesthesia and the outcome of CS delivery
Attitude and intention of Iraqi healthcare providers to get vaccinated against COVID-19: a cross-sectional study
Background: International efforts to confront the COVID-19 pandemic are joining forces by accelerating the pace of vaccination. This study aims to explore the attitude and the intent to get vaccinated against COVID-19 among healthcare providers (HCPs) in Iraq.
Methods: A cross-sectional survey was conducted in January 2021 using web-based facilities to access the respondents. The data were collected through a semi-structured and self-administered questionnaire, including sociodemographic and close-ended questions related to attitude and intention toward COVID-19 vaccination. Bivariate and multivariate logistic regression were recruited to predict variables. The statistical significance is considered at less than 0.05.
Results: Data of 209 HCPs with a mean age of 45.12 (± 6.37) years have undergone final analysis. Most of the HCPs were males (112, 53.6%) and nurses (110, 52.6%), who had close contact (64.6%) with COVID-19 patients, and forty percent have been infected with COVID-19. Overall, 115 HCPs (58.0%) reported intention to get vaccinated compared to 94 (42.0%) who declined vaccination. Variables associated with intention to get vaccinated among HCPs were high attitude toward COVID-19 vaccination (odds ratio (OR) = 1.740, 95% confidence interval (CI): 0.799, 3.786), aged less than 45 years (OR = 3.713; 95% CI: 1.647, 8.367), married (OR = 2.155; 95% CI: 0.984, 4.720), highly educated (OR = 2.657; 95% CI: 1.202, 5.871), doctors (OR = 3.153; 95% CI: 1.428, 6.963), contracted with COVID-19 (OR = 4.119; 95% CI: 1.623, 10.455), directly engaged in management of COVID-19 patients (OR = 3.962; 95% CI: 1.569, 10.005), and had lost a close relative due to COVID-19 (OR = 5.698; 95% CI: 1.506, 12.564).
Conclusion: The urgent need to improve the COVID-19 vaccine uptake rates among Iraqis requires a positive attitude and a high vaccination rate among HCPs
Artificial intelligence-enabled rapid and symptom-based medication recommendation system (COV-MED) for the COVID-19 patients
In a general COVID-19 population in Cox’s Bazar, Bangladesh, we developed a medication recommendation system based on clinical information from the electronic medical record (EMR). Our goal was also to enable deep learning (DL) strategies to quickly assist physicians and COVID-19 patients by recommending necessary medications. The general demographic data, clinical symptoms, basic clinical tests, and drug information of 8953 patients were used to create a dataset. The learning model in this COVID-MED model was created using Keras (an open-source artificial neural network library) to solve regression problems. In this study, a sequential model was adopted. In order to improve the prediction capability and achieve global minima quickly and smoothly, the COVID-MED model incorporates an adaptive optimizer dubbed Adam. The model calculated a mean absolute error of 0.0037, a mean squared error of 0.000035, and a root mean squared error of 0.0059. The model predicts the output medications, such as injections or other oral medications, with around 99% accuracy. These findings show that medication can be predicted using information from the EMR. Similar models allow for patient-specific decision support to help prevent medication errors in diseases other than COVID-19
Human cytomegalovirus and relationship with abortion among Iraqi females: a systematic review
Background: Human cytomegalovirus (HCMV) seroprevalence is a significant health problem, especially among pregnant women in lower socioeconomic societies. This study aims to explore the prevalence of HCMV infections among women in Iraq.
Methods: A systematic review was designed to collect and summarize articles concerning the relationship between HCMV infection and abortion in Iraq. We identified the titles and abstracts of the publications from 2008 to 2022. A pre-defined keyword was recruited to recognize the publications and filter the articles to eliminate duplication and remove irrelevant articles. In the reviewed studies, the HCMV was detected using diagnostic methods such as enzyme-linked immunosorbent assay and immunochromatography (rapid test) or molecular methods such as polymerase chain reaction.
Results: Twenty-four eligible articles have been included in this review sourced data from about 5442 patients covering 15 of 18 provinces in Iraq. The prevalence of HCMV IgG and IgM was (0%-100%) and (0%-93%), respectively. Many factors influenced the varied results, including the design of the study and sociodemographic and clinical aspects.
Conclusion: The high prevalence of HCMV infection indicates a causative relationship with repeated abortion among Iraqi females
IVF laboratory management in COVID-19 pandemic
Background: Since the first report of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), widely known as COVID-19, in late December 2019, it has spread worldwide. The eventual return of new normal has started to happen in most countries where the COVID-19 curve has flattened, and Assisted reproduction technology (ART) services are eventually resuming. Well-organized ART (embryology/andrology) laboratories safeguard the wellbeing of all staff, patients, and their gametes/embryos.
Main body: A well-organized pandemic management plan must be implemented in anticipation of possible subsequent COVID-19 waves. Apart from local and national guidelines, some mandatory changes need to be taken into considerations that will allow us to overcome the fear of this deadly pandemic, work smoothly and stop any possible transmission without comprising the quality control for successful treatment. These mandatory changes include conserving different supplies, reducing manpower needs, and various protective measures for non-clinical and clinical staff, patients, and gametes/embryos.
Conclusion: The current pandemic of COVID-19 suggests a well-organized action-oriented emergency plan to assure the wellbeing of all stakeholders
The use of mHealth solutions in active and healthy ageing promotion: an explorative scoping review
The global population aged 60 years and over is expected to almost double between 2015 and 2050 from 12.0% to 22.0%, which will directly impact countries\u27 labor market composition and increase the economic pressure on their healthcare systems. One way to address these challenges is to promote Active and Healthy Ageing (AHA) using mobile Health (mHealth). This research aims to provide an initial overview of the width and the depth of contemporary preventive mHealth solutions that promote AHA among healthy, independent older adults (individuals aged 60 years and over). To do so, an explorative scoping review was applied to search online databases for recent studies (March 2015 - March 2020) addressing the promotion of mHealth solutions targeting healthy and independent older adults. We identified 31 publications that met the inclusion criteria. Most of them utilized either mobile (n=25) and/or wearable (n=11) devices. mHealth solutions mostly promoted AHA by targeting older adults’ active lifestyles or independence. Most of the studies (n=27) did not apply a theoretical framework on which the mHealth promotion was based. User-experience was positive (n=12) when the solution was easy to use but negative (n=11) when the participants were resistant or faced challenges using the device and/or technology. The review concludes that mHealth offers the opportunity to combat the issues faced by an unhealthy and dependent aging population by promoting AHA through focusing on older adults’ Lifestyle, Daily functioning, and Participation. Future research should use multidisciplinary integrated approaches and strong theoretical and methodological foundations to investigate mHealth solutions\u27 impact on AHA behavioral change