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Among all the countries, Yemen is free of corona virus, and no single case has been recorded till today. Yemen is characterized by its mother geographical location on the Red Sea and its population is approximately 30 million people and an area of ​​555,000 square kilometers.

Background: The development of COVID-19 having been set apart as the third presentation of an exceptionally pathogenic coronavirus into the human populace after the extreme intense SARS-COV and MERS-COV in the twenty-first century. The infection itself doesn’t make a crucial commitment to mortality, anyway “cytokine storm” created by the unreasonable invulnerable reaction activated by the virus can result in a hyperinflammatory response of lung tissues and deadly lung injury, and in this way increment death rate. In this manner, immunomodulatory medications ought to likewise be remembered for treatment of COVID-19. Presentation of the hypothesis: the virus particles invade the respiratory mucosa firstly and infect other cells, triggering a series of immune responses and the production of cytokine storm in the body, which may be associated with the critical condition of COVID-19 patients. Once a cytokine storm is formed, the immune system may not be able to kill the virus, but it will certainly kill many normal cells in the lung, which will seriously damage the of lung function. Patients will have respiratory failure until they die of hypoxia. It is not yet clear what the death rate of Covid-19 will be, though the best estimate right now is that it is around 1 percent, 10 times more lethal than seasonal flu due to cytokines storm which trigger a violent attack by the immune system to the body, cause acute respiratory distress syndrome (ARDS) and multiple organ failure, and finally lead to death in severe cases of COVID-19 infection. Therefore, inhibiting cytokine storm can significantly reduce inflammatory injury in lung tissues. Pyridostigmine (PDG), cholinergic anti-inflammatory pathway (CAP) is a neural mechanism that modulates inflammation through the release of acetylcholine (ACh), resulting in decreased synthesis of inflammatory cytokines such as TNF-α and IL-1. This finding emphasis, the nervous and immune systems work collaboratively during infection and inflammation. Implications of the hypothesis: Administrations of Pyridostigmine (PDG) as cholinergic agonist inhibits the inflammatory response and lower the mortality of COVID-19 patients. Likewise, activation of the CAP during systemic inflammation down-regulates the production and release of inflammatory cytokines. 

Background: The National Strategic Plan for HIV Prevention and Control 2014-2018 recognized the need for the utilization of research findings to guide the development of HIV policies, programs and interventions for the general population and key population groups and to inform the allocation of government resources to the areas of greatest impact and need. To this end, a Knowledge, Attitudes, Beliefs and Sexual Practices Survey (KABP) was conducted among adults’ ages 15 to 49 years. Objectives: To identify the sexual behaviors among adolescents and young adults that exposed them to the risks of HIV/STIs and to identify factors that may have to be addressed, in order to achieve further reduction in the spread of HIV in this population. Methods: This is a population based cross-sectional survey undertaken in 2016. Sample was taken from among persons’ ages 15 – 49 years using a multistage sampling methodology. The survey questionnaire was developed from Family Health International’s guidelines for repeated behavioral surveys in populations at risk of HIV. It was interviewer-administered and consisted of ninety-nine (99) closed-ended questions. The topics covered by the survey included sexual history; use of and access to condoms; and HIV testing. Participants were asked about their sexual behaviors over the last 12 months, and about their experience with their most recent partner. Results: Overall, 87.8% described themselves as heterosexual, 1.2% as bisexual and 0.5% as homosexual. By the age 16, 17 1nd 19 years 25%, 50% and 75% of respondents have had sex respectively. Among the 763 respondents reporting vaginal or anal sex over the past 12 months, 80.6 and 19.4% had a single and multiple sex partner respectively. Also, 94.4%, 13.3% and 1.6% reported to have regular, non-regular and commercial sex partners respectively. Overall, 54.6% used condom at the last sex, the corresponding figure for the regular and non-regular partners were 41.2% 80.8% respectively. Only 40.9% reported to have had a HIV test done over the past 12 months and of those who did not, 42.8% had never been tested for HIV. Conclusion: Inconsistent and infrequent condom use and low HIV testing especially among the adolescents and younger adults, in the setting of young ages at sexual debut and multiple sexual partners. Findings form this study strongly recommends for a much greater effort from the public health at promoting condom use and HIV testing especially targeting the younger persons who risk their own protection and that of their partners.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in December 2019 in Wuhan, China. To date, the virus has infected roughly 5,000,000 people and caused approximately 345,000 deaths worldwide, and these numbers are increasing rapidly. Because of the rapid spread and the rising disease burden, several antiviral drugs and immunomodulators are in clinical trials, but no drugs or vaccines have yet been approved against this deadly pandemic. At present, computed tomography scanning and reverse transcription (RT)-PCR are used to diagnose COVID-19, and nanotechnology is being used to develop drugs against COVID-19. Nanotechnology also plays a role in diagnosing COVID-19. In this article, we discuss the role of nanotechnology in diagnosing and potentially treating COVID-19.

In late 2019, a pandemic crisis started in Wuhan, China, swept the whole world. The disease is caused by the SARS-CoV-19 virus that belongs to the corona family of viruses. The virus mainly caused failure of respiration, and led to many deaths worldwide. The main focus of research and medicine is to find more about the virus, as well as the development of effective preventive and therapeutic measures. While many trials and opinions have been published, which might support or contradict each other, this article tries to provide a simplified viewpoint about the disease. We highly recommend the therapeutic strategies to include drug combinations that can target the pathogenesis at many levels. For example, a combination of an effective anti-viral Remdesivir, soulable ACE2, and an immune modulator.

The coronavirus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in Wuhan, China and spread around the world (WHO, 2020). The genome of the SARS-CoV-2 has been reported over 80% identical to the previous human coronavirus (SARS-like bat CoV) [1]. As of May 2020, more than 5 million people have been affected worldwide with deaths amounting to 333000, the numbers increasing at an alarming rate day by day.

Since December 2019, entire world is facing problem of corona-virus pandemics and its impact on the people and their social life has been phenomenal. Each part of the world is ‘almost’ hit by COVID-19 infection. Most of the COVID-19 victims were aged people followed by consequence of high death ratios as shown in data [1]. Not only aged people but people with some secondary diseases or disorder were of major concern. A special case comes across which are patients with intellectual disabilities (ID) are the most vulnerable group. They also have extra multiple disorders including respiratory diseases, diabetes, obesity, These individuals face more complications and stand at high risk of because, such people are usually mentally lethargic and have almost no literacy in to follow proper health care and access health facilities

Introduction - the perennial pandemic: It is being increasingly realised that the COVID-19 may have become the new reality associated with human existence world over and the mankind may have to live with it for years or even decades. Further, the grievous nature of the disease is evolving further with the genomic changes in the virus in form of mutations and evolution of variants, with enhanced infectivity and probably virulence. There are serious challenges posed by the SARS-CoV-2 virus and COVID-19 as the disease. COVID-19 as acute and chronic disease: On exposure to the SARS-CoV-2 virus, not all patients develop a disease. Further, for those who develop the disease, there is a large variation in disease severity. The known factors including the constituent factors and several still unknown factors influence the disease manifestations, its course, and later the convalescent phase as well. In fact, substantial continuing morbidity after resolution of the infection indicates persisting multisystem effects of COVID-19. The ‘long COVID-19’ or ‘long haulers’: The patients who continue to suffer with persisting symptoms have been described as long haulers and the clinical condition has been called post-COVID-19 or ‘long COVID-19’. The diagnosis should be entertained if various symptoms and signs linger well beyond the period of convalescence in COVID-19. With the chronicity, there occur inflammatory changes and damage in various organs, and the extent of organ damage determines the long-term effects. Management of ‘long COVID’ syndrome: The ‘long COVID’ syndrome has multi-system involvement, variable presentation, and unpredictable course. Following clinical and investigational assessment, the patients should be managed as per clinical manifestations, extent of organ damage and associated complications. The findings from various studies indicate that preventing further organ damage in ‘long COVID’ is crucial. The long COVID’s prognostic challenges: As apparent, the ‘long COVID’ afflictions are more common than realized earlier. The symptoms can escalate in patients with co-morbid conditions. The persistent symptoms among COVID-19 survivors pose new challenges to the healthcare providers and may be suitably managed with a combination of pharmacological and non-pharmacological treatments, and holistic healthcare. 

Corona Virus Disease-2019 (COVID-19) has become one of the most serious diseases in the history of mankind. It has captured the entire world and solutions are yet to be discovered to fight this global crisis. The outcomes of COVID-19 are influenced by a variety of pre-existing factors. The secondary microbial infections are one of the prominent ones that are major contributors for Antimicrobial Resistance (AMR) as they warrant the use of antimicrobial medications. The present review aimed at exploring the potential relationship between AMR under such circumstances and COVID-19 related outcomes. The published literature across the globe has delineated that the impact of COVID-19 may have worsened by a great degree due to the presence of secondary infections majorly bacterial ones. The consequences of COVID-19 have been fatal and a significant proportion can be a major attributor to AMR, either directly or indirectly. Although, there is a dearth of studies that can establish a very strong and direct relationship between AMR and negative COVID-19 outcomes so in-depth research on this topic is required to further explain this relationship in detail. 

More than 200 countries have been devastated by the SARS-CoV-2 pandemic. The health workers exposed to SARS patients have been confirmed to be infected with coronavirus (SARS-CoV-2), regardless of the degree of their exposure. The increasing complexity of virus existence and heterogeneity has cast doubt on disinfectants as a viable choice. Hence, the present systematic review aims to achieve the comparative analysis of established disinfectants against enveloped and non-enveloped viruses including SARS-CoV and MERS-CoV. Three databases (Pubmed, Google scholar, and Medline) were searched to frame the systematic review. Our comparative analyses with 34 studies have found that 85% ethanol-based hand sanitizers and 7.5% Povidine Iodine based soaps/surgical scrub could be used to deter the SARS-CoV-2 virus as preferred hand sanitizers. For surface eradication, 0.5% sodium hypochlorite or a mixture of glutaraldehyde, Quaternary Ammonium Compounds (QAC), and isopropanol could have more efficacies as compared to hydrogen peroxide, phenol, and QAC alone. Moreover, the accelerated hydrogen peroxide as an active ingredient in the automatic quick surface disinfectant (tunnel system), maybe a positive indication for quick whole-body sanitation. Additionally, the alternative method for avoiding the rapidly increasing chain of infection with SARS and restarting regular life has been exclusively discussed.

Background: Azithromycin (AZM) is a macrolide antibiotic with distinct pharmacokinetic properties and is increasingly used as maintenance treatment in patients with bronchiectasis in order to reduce infectious exacerbations and improve pulmonary symptoms. The exact mechanism of action is not known and the relation between azithromycin dose level, local and systemic drug levels and clinical effect however, has not been extensively studied yet. Objectives: To explore the relation between AZM serum and sputum concentrations, clinical effect parameters and side effects. Methods: Azithromycin concentrations were measured in serum and sputum samples of bronchiectasis patients receiving one year of AZM treatment (250mg OD) enrolled in the Bronchiectasis and Azithromycin Treatment (BAT) trial, a double blind, randomised placebo-controlled trial. Results were correlated with data on AZM dose level, exacerbation frequency, lung function (forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), quality of life and symptoms collected within the same year. Results: 83 sputum samples from 31 patients and 151 serum samples from 43 patients were available for analysis. Mean AZM dose-level ranged from 18.8 to 39.8 mg/kg body weight/ week, generating mean AZM concentrations of 7.57 mg/L (SD 9.49) in sputum and 0.11 mg/L (SD 0.085) in serum. No correlation was found between side effects and AZM dose level, sputum- or serum concentrations. Significant correlation was found between AZM sputum concentration and CRP-level (r= -0.6). Conclusion: High and stable AZM sputum levels were reached during long term treatment, as opposed to low AZM levels in serum. Apart from CRP-levels to AZM sputum concentration, no other outcome parameter showed significant correlation to AZM serum- or sputum levels. AZM dose- or exposure levels were not predictive for the occurrence of side effects.

For last decades diabetes type 2, blood’s pressure (especially hypertension) and relating diseases are most serious problems for much people over the world. These diseases are not like other different diseases then for studying them very accuracy, this research choose sample from different societies a small city called “Al-Mejar Al-Kabeer” in south of Iraq. People of this city do same activities than other Iraqi cities and during the last twenty years the only change happened in this city is; they changed them drinking water from tap water to commercial water called it R.O. Population of this city is about 70000 persons and about 20000 from them have diabetes that means more than 28% from all people of this city have this disease, this ratio or may be more for hypertension. Results of this research show that the main reason for diabetes type 2, blood’s pressure and relating diseases is civilization. It shows according good evidences that the right treatment for diabetes, hypertension and relating diseases is about 5g/day potassium ions (K+) with less amounts from sodium ions such as 2:1. In fact, insulin forming from known amino acids so each body need sufficient amounts from these acids therefore the right treatment for diabetes type 2 is not only potassium it must there sufficient amounts from proteins each day or each three days. References of this research indicated; Diabetes and hypertension are well understood but this research find that these diseases need a chemist touch to be fully understood.

A 3-month-old girl presented to the surgical consultation room with bilateral cleft lip incomplete. A girl weighing 4205 g, was born at term after an uneventful pregnancy with a birth weight of 2500 g. There was no family history. On examination, a congenital, linear, erythematous cutaneous anomaly on the left side of her neck was highlighted with ocular anomalies (strabismus and the eyes are widely spaced) and a broad nose with a flattened tip. The examination of the other systems was unremarkable. In front of the association of these different anomalies BOFS was suspected but molecular diagnosis has not been made. The child benefited surgery to correct cleft lip with tennisson procedure with a good postoperative result.

Child neglect is a global problem that involves large costs for both the individual and for society. This article is based on published reviews and meta-analyses in the field of child neglect between 1980 and 2018. Of a total of 433 articles, 13 was included, main Data bases has been PubMed, Scopus, Web of Science, Psych Info, ERIC, CINAHL. The prevalence in the normal population was found to be between 16% and 26%, while the prevalence in clinical groups seem to be significantly higher. For example, was the prevalence of neglect 50% among patients with eating disorder. It is especially important to know who is reporting neglect. Research shows that neglect is strongly associated with among other things, depression, one of the most common illnesses among the general public. The theoretical models that are used are ecological. Risk factors can be found at all levels when using ecological models. Research shows that factors involving the relationship parent-child are among the most important. Neglect is more common in low-income countries than in high income countries. Most studies point to the importance of prevention. Existing preventive programs are most often of family and parental character. More research is needed, especially as concerns the development of preventive programs that can identify specific types of neglect and present suitable preventive measures, both at the societal and family level. Key points 1. Neglect is a global problem. 2. Prevalence depends on the measurement method and can vary between about 16% and 76%. 3. Prevalence is higher when negligence is self-reported than when reported by professionals. 4. The most common and most serious risk factors are present in the microsystem. Parenting and interactions between child and parent are considered important. 5. There is a link between neglect and, above all, depression, but also anxiety, self-harm and eating disorders.

Premature ovarian insufficiency (POI) is a rare disease, especially in children and adolescents. It was previously called premature ovarian failure (POF). It can be manifested as delayed puberty, primary or secondary amenorrhea that occurred before the age of 40 years with no less than two abnormal serum sex hormones (low estrogen and high gonadotropin). It is reported that the incidence rate is 1% at the age of 40 years and 0.01% at the age of 20 years. Although the disease usually occurs in middle-aged and elderly women, clinical practice in recent years has shown that it has also been found in adolescents and even children. It is generally believed that the etiology of POI includes genetic factors, immune factors, and iatrogenic factors. So far, several genetic mutations that may cause POI have been found clinically, but the etiology of 90% of POI is still unknown. In recent years, the incidence of POI in children and adolescents has increased, and there are more urgent requirements for its early diagnosis, treatment, and clinical management. Based on this, this article will mainly review the research progress of the etiology, treatment, and clinical management of POI in children and adolescents.

Shellfish are extensively consumed worldwide because of their nutritional value. In general they are good sources of low-fat protein rich in several essential vitamins and minerals as well as in the essential nutrients omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs) [1]. Shellfish belongs to “The Big 8” food groups causing allergy, which often does not outgrow during childhood. However, increase in IgE – mediated sea food allergy has been linked to shellfish. Seafood- associated shellfish include crustaceans & molluskans [2]. These may cause mild local symptoms & lead to severe systemic anaphylactic reactions by ingestion, inhalation, or contact. Globally, the prevalence of shellfish allergy estimated to be 0.5% to 2.5% of the general population [3]. There are limited data showing the prevalence of shellfish allergy in children. A study on US pediatric population showed 1.3% of shellfish allergy. Children were more allergic to crustacean (1.2%) than mollusks (0.5%) [4]. Tropomyosin is the major allergen.

Background: School nurses possess an essential role in treating and helping children maintain health. However, the full scope of their role has not been identified by parents. Therefore, the purpose of this study was to explore parents’ perceptions of the role of the school nurse. Methods: Descriptive statistics were used to analyze the data. One hundred eighty parents participated in the study. The perception of the roles of school nurses was assessed by a 16-item questionnaire, which was adapted from a study by Kirchofer, et al. 2007. Results: The four most important school nurses’ roles perceived by the parents were providing first aid and emergency care to children, communicating with parents and health care providers in the presence of a problem, providing medical treatment, and preventing and controlling diseases. Conclusion: School nurses have many important roles, and while parents identified some essential roles, they did not recognize other vital roles as being very important. Increasing awareness of school nurses’ multifaceted roles among parents is essential so that they can utilize nurses’ expertise in maintaining their student’s health as well as tap into a key resource in the coordination of care for their child.

Background: Although illegal, Ghana has a long history of cannabis use. With changing perceptions, advocacy for legalization has increased globally. This study exams pharmacological evidence on the prospects and challenges of decriminalization and /or legalization of cannabis in Ghana. Results: Cannabis and cannabinoids are a “pharmacological enigma” with unique ability to activate at least 3 of the 4 drug receptor super families. This include; inotropic Transient Receptor Potential Vanilloid 1 (TRPV1), metabotropic Cannabinoid Receptors (CB) and nuclear Peroxisome Proliferator Activator Receptors (PPAR). Cannabinoid receptors also dimerize with other receptors creating distinctly new signaling pathways. Cannabis and cannabinoids show good anti- nociceptive, anti-inflammatory, immunosuppressant anti-emetogenic activity and variable anticonvulsant activity. It can play important role in palliative care, some rare intractable epilepsy, multiple sclerosis, cachexia and Opioid Use Disorder. Cannabis precipitates psychosis in individuals with underlying genetic susceptibility. Chronic cannabis use alter the neurobiology of adolescent brain, predisposing them to amotivational syndrome characterized by depersonalization and inhibited motivation for goal directed behavior. Cannabis is also a “gateway drug”; ushering users to “harder” substances of abuse and reinstating extinguished drug seeking behaviours. The recent tramadol abuse in Ghana may have been precipitated by previous and concurrent cannabis use. Furthermore, Ghana’s cannabis may have a higher propensity to induce detrimental effects because of preferential accumulation the psychotropic delta-9-Tetrathydrocannabinol as a result of the high tropical temperature and humidity. Conclusion: There is not sufficient pharmacological evidence supporting criminalization of medical cannabis in Ghana. However, the same evidence does not support legalization of recreational cannabis.

In this manuscript it has been described a novel synthesis of mercury doped hydroxyapatite (Hap) and its application on human liver carcinoma cell line (Hep G2) and human lung fibroblast carcinoma cell line (MRC 5). Nano-sized hydroxyapatite doped with Hg2+ was synthesized by a solution based chemical method along with mercury ion. The surface of nanoparticle of mercury doped hydroxyapatite (MHAp) was functionalized by using phosphonomethyl iminodiacetic acid (PMIDA) for making it stable as dispersed phase with negative zeta potential. Surface functionalization was confirmed by FTIR measurements. Crystalline nature, morphology and surface topology were studied by powder XRD, FESEM and AFM measurements. Particle size of the well dispersed sample was obtained by HRTEM image. The studies on cell viability of Hep G2 and MRC 5 cell in presence of mercury doped HAp nanoparticle (MHAp) were determined through WST assay. It was observed that nanocomposite exhibited a site specific action towards MRC 5 cell lines along with reduction of toxicity toward normal cells.

Introduction: In Madagascar, plague is a highly contagious acute endemic infectious disease. The diagnosis of the most severe form of pneumonic plague remains difficult in children, hence the objectives of the present study; which is to identify the clinical signs of this clinical form in children and to describe its epidemiological and evolutionary profile. Methods: A retrospective case-control study was conducted in four pediatric wards in Antananarivo during the urban pneumonic plague outbreak from September 2017 to January 2018. Those cases were defined as children aged 0-15 years old suspected of having plague with positive RDT and PCR, and they were defined as children aged 0-15 years old with negative RDT and PCR. Results: Fifty-two cases of pneumonic plague were identified, half of which (50%) were under 24 months of age. A male predominance was noted with a sex ratio of 1.23 and 86.54% of the patients were from urban areas. Several clinical signs were found but none was specific for pneumonic plague: cough (59.62% p: 0.5), dyspnea (3.85% p: 0.16), chest pain (3.85% p: 0.26%), hemoptysis (7.69% p: 0.17), vomiting (9.62% p: 0.14), diarrhea (11.54% p: 0.45), altered general condition (38.46% p: 0.24%). Two deaths were noted (3.8%). Conclusion: No specific clinical warning signs have been identified in childhood pneumonic plague. In the event of an epidemic of urban pneumonic plague, any bacterial pneumonia should at least initially include active treatment against Yersinia pestis.