Asian Journal of Research in Infectious Diseases 2022-01-24T05:58:51+00:00 Asian Journal of Research in Infectious Diseases Open Journal Systems <p style="text-align: justify;"><strong>Asian Journal of Research in Infectious Diseases (ISSN: 2582-3221)&nbsp;</strong>aims to publish&nbsp;high-quality&nbsp;papers (<a href="/index.php/AJRID/general-guideline-for-authors">Click here for Types of paper</a>) in all aspects of&nbsp;‘Infectious Diseases’. This journal facilitates the research and wishes to publish papers as long as they are technically correct, scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled,&nbsp;OPEN&nbsp;peer-reviewed, open access INTERNATIONAL journal.</p> Malaria Co – Infection with Urinary Schistosomiasis, Typhoid Fever, Hepatitis B Virus, and Human Immunodeficiency (HIV) Virus among Students in Three Local Government Areas of Ekiti State, South Western Nigeria 2021-11-22T07:47:58+00:00 C. A. Ologunde F. T. Akinruli T. O. Layo-Akingbade <p><strong>Introduction: </strong>Malaria, Typhoid fever, urinary schistosomiasis, AIDS and hepatitis B virus disease are major public health problems in the tropical and subtropical countries; they exert a huge burden of morbidity, mortality and economic loss on the populace.</p> <p><strong>Aims: </strong>The study investigates the prevalence of co–infection of malaria, typhoid fever, urinary schistosomiasis, hepatitis B virus and HIV virus among 306 students between the ages of 10- 21 years in three local government areas of Ekiti – state Nigeria.</p> <p><strong>Methodology: </strong>Blood samples were randomly collected for the examination of malaria parasites, typhoid fever, hepatitis B virus and HIV virus while urine examination was done for urinary schistosomiasis by random sampling and survey for a period one week.</p> <p><strong>Results: </strong>The results show that the overall prevalence of malaria, typhoid fever, urinary schistosomiasis and hepatitis B virus were 42.2%, 2.9%, 2.9% and 2.9% respectively. The female students had the highest prevalence of single infection with malaria fever having the highest figure (42.2%). Malaria and Urinary schistosomiasis had the highest prevalence of double infection of 2.3 %, while schistosomiasis and hepatitis B had the lowest prevalence of 0.3%. Also, male students had the highest prevalence of double and triple infections. The co-infection rate of malaria, urinary Schistosomiasis and hepatitis B was 0.3% and this occurred in male between the ages of 19-21 years, none of the students tested positive for HIV virus and therefore no students was found in the quaternaries.</p> <p><strong>Conclusion: </strong>Co-infections is prevalent in this study area, therefore there should be integrated control approach directed against these diseases.</p> 2021-11-16T00:00:00+00:00 ##submission.copyrightStatement## Knowledge and Practices on Prevention of COVID-19 among Traditional Medical Practitioners in Sri Lanka 2021-12-01T03:55:52+00:00 A. B. Dharmarathna W. M. S. S. K. Kulathunga <p><strong>Introduction</strong><strong>:</strong> An outbreak of pneumonia of unknown reason was named as COVID-19 by WHO and declared as pandemic. It was observed as most people infected with the COVID-19 virus is mild to moderate respiratory illness and recover without getting treatment. Older people with chronic diseases are more likely to develop serious illness. There is no effective modern medicine available so far for the treatment of COVID-19.</p> <p><strong>Objectives:</strong> To assess the Knowledge on prevention of COVID-19 Epidemic in among the Traditional Doctors.</p> <p><strong>Methodology</strong><strong>:</strong> Descriptive study was conducted among the 20 Traditional Practitionerson Knowledge and prevention of Corona Epidemic by purposively selected, open ended questionnaire that used a 5-point Likert scale for the response option. Recoding in to different variable and Analysis each question. According to that frequency distribution as 1-3 responses in to1 - Inadequate knowledge 4-5 responses in to 2- Adequate knowledge. The questionnaire included socio demographic characteristics, questions regarding the Knowledge and prevention of Corona Epidemic (Q1 toQ10). SPSS Software (16 version) used for Statistical analyzing. Descriptive statistics such as frequencies, mean mode, Slandered deviation and percentage were used to describe variables.</p> <p><strong>Results:</strong> According to the present study mean age was 49.6<u>+</u>1.2737(SD). Considering all the questions Q1 to Q10 Adequate knowledge vary in 50 -80% and Inadequate knowledge vary in 15-50%. In our study 80% of them were mentioned that corona infection was mainly affected to the respiratory tract, most common symptoms were sore throat in 70%, transmission of the Corona infection through air 50%, reduce social distance less than one meter 80% was the main cause for the infection transmission through the society, the precautions for prevent the corona infection through the society that Keeping social distance more than one meter in 85%, The advises given by them in the management lived separately from others until cure the diseases in 45%,The treatment protocol followed them in the treatment Administration of immunity enhancement drugs 30%, wholesome foods and behaviors suitable for corona infection were reducing Kaphadosha (one of the body humor) 35%.</p> <p><strong>Conclusion</strong><strong>:</strong> In the present study Considering all the questions Q1 to Q10 most of them have adequate knowledge. Although they were not expressed much details of the treatment protocol in the management. It is recommended that further large scale studies are needed to confirm the knowledge and Prevention of Corona epidemic.</p> 2021-11-27T00:00:00+00:00 ##submission.copyrightStatement## Polio Vaccination and Chronic Fatigue Syndrome 2021-12-15T06:29:05+00:00 Andrew P. Smith Marie Thomas <p><strong>Background: </strong>Previous research has suggested that enteroviruses may be implicated in the development and persistence of Chronic Fatigue Syndrome (CFS). One method of investigating this topic has been to use a polio vaccination challenge, and a previous study showed that CFS patients had more shedding than healthy controls. There was no effect of the vaccination on the clinical condition or wellbeing of the CFS patients.</p> <p><strong>Methods: </strong>In the previous study, the control group were more likely to have had a recent booster vaccination. This was controlled in the present study, where 18 CFS patients were randomly assigned to vaccination or placebo conditions. Nine healthy volunteers were also given the polio vaccination.</p> <p><strong>Results: </strong>The results confirmed that vaccination had no negative effects on the CFS group. Although there was more virus shedding in the CFS polio group than in the control polio group, this difference was not significant.</p> <p><strong>Conclusion: </strong>This study confirms that polio vaccination is not contraindicated in CFS patients but could not confirm that they are more susceptible to enterovirus infection.</p> 2021-12-11T00:00:00+00:00 ##submission.copyrightStatement## Usefulness of Nested PCR Assay for the Molecular Diagnosis of Human Rickettsial Infection: A Study in Bangladesh 2021-12-20T08:23:37+00:00 Mahfuja Begam Shaira Akter Shampa Aleya Farzana Abu Taher MD Zabed Hasan Shirin Tarafder <p><strong>Background:</strong> Rickettsial infections are re-emerging arthropods born worldwide zoonotic disease caused by Rickettsia, which is responsible for spotted fever and typhus fever. The diagnosis of a rickettsial illness is important for appropriate antibiotic treatment.</p> <p><strong>Aims:</strong> The study aimed to determine the diagnostic accuracy and clinical usefulness of using nested polymerase chain reaction (PCR) by comparing nested PCR, ELISA, and Weil-Felix (WF) tests. <strong>&nbsp;</strong></p> <p><strong>Methodology:</strong> This was a prospective type of cross-sectional study. A total of 135 clinically suspected rickettsial infection cases were enrolled. Peripheral blood was taken to detect gltA, 17 kDa lipoprotein antigen gene (17 kDa), ompA, and ompB gene of Rickettsia by nested PCR. ELISA and Weil-Felix tests were done to compare with nested PCR.</p> <p><strong>Results:</strong> Out of 135 cases, we detected Rickettsia in 70(51.85%) cases by nested PCR assay (p&lt;0.01), 33((24.4%) by Weil- Felix test, 34 (25.18%) by ELISA. Only 26.66% of cases were PCR positive, which were negative by both ELISA and Weil-Felix test. Fifteen (11.11%) cases were positive by all three tests. Among 70 PCR positive rickettsia cases most frequently detected gene was ompB 42(60%), followed by 17kDa 34(48.58%); gltA 21(30%), and ompA 3(4.28%).&nbsp; Multiple gene combinations (ompB, 17kDa and gltA) detected in 98.57 % cases.</p> <p><strong>Conclusion:</strong> Nested PCR assays showed the highest rate of detection of rickettsia cases than ELISA and Weil-Felix test. Multiple gene combinations (ompB, 17kDa, and gltA) showed the highest positivity. Therefore, diagnosis of rickettsial infection can be confirmed by PCR assay, and clinicians can plan appropriate treatment for these patients.</p> 2021-12-13T00:00:00+00:00 ##submission.copyrightStatement## Acceptance of COVID-19 Vaccine in the University of Port Harcourt Community 2021-12-23T07:21:01+00:00 Lekpa Kingdom David Chigozie Njoku John Nwolim Paul <p><strong>Background:</strong> Vaccine acceptance is one thing that must be achieved before the masses can volunteer to be vaccinated. Vaccine acceptance is defined as the individual or group's decision to accept or refuse when presented with an opportunity to vaccinate. Acceptance can be active (adherence by an informed public that perceives the benefit of and needs for a vaccine) or passive (compliance by a public that defers to recommendations and social pressure). It will not be out of place to state that the University of Port Harcourt will not be spared in the distribution of the cases as such if no drastic action for vaccination is taken. Therefore, vaccine acceptance is essential. Hence, this study was done to survey the acceptance of the covid-19 vaccine amongst the lecturers and teachers in the University community.&nbsp;</p> <p><strong>Materials and Methods</strong><strong>:</strong> The study was cross-sectional carried out at the University of Port Harcourt in Rivers State. The study population was the public tertiary institutions in Rivers State which comprised only the teaching staff. The sample size used for the study was four hundred and sixty persons calculated using the Taro Yamane formula for a population less than ten thousand; the sampling technique used was simple random sampling. The data collection tool used for the study was a self-structured closed-ended questionnaire.&nbsp;</p> <p><strong>Results and Discussions:&nbsp;</strong>The results of the study showed that<strong>&nbsp;</strong>the acceptance rate of COVID 19 vaccine by the UPWA staff members was 7.4%, UNIPORT lecturers was 8.7%, and UDSS staff members were 9.1%. The UDSS staff members had the highest level of acceptance. The total acceptance rate for COVID 19 vaccine in this population was 25.2%. The difference in the proportion is statistically significant at p&lt;0.001.&nbsp;</p> <p><strong>Conclusions:</strong>&nbsp;The comparison of the variables showed that age category, occupation, sex, marital status, educational level, and insurance were all statistically significant (p=0.001) with the acceptance COVID 19 vaccine by UPWA staff, UNIPORT staff members and UDSS staff. The result showed that about a quarter of the sampled population was willing to take the vaccine. This study recommends the intensification of a&nbsp;campaign that is geared towards enhancing COVID 19 vaccine acceptance and uptake.&nbsp;</p> 2021-12-13T00:00:00+00:00 ##submission.copyrightStatement## A Time Series Model on the Occurrence of COVID-19 Pandemic in Nigeria 2021-12-24T05:58:24+00:00 David Adugh Kuhe Jonathan Atsua Ikughur <p>Coronaviruses belong to a large family of viruses which affect the hepatic, gastrointestinal, neurological and respiratory systems. The increase in the daily number of COVID-19 confirmed and deaths cases from different countries of the world has brought social, economic and political activities to a standstill, affecting individuals, government, public and private sectors. In this study, autoregressive integrated moving average (ARIMA) time series model for modeling and forecasting daily confirmed, recovered, and deaths cases of COVID-19 in Nigeria was used with data on daily cases of confirmed, recovered and deaths due to COVID-19 in Nigeria from 27/02/2020-31/07/2020 obtained from Nigeria Centre for Disease Control (NCDC) website. The data from 27/02/2020-16/07/2020 were used for model building while 15 observations from 17/07/2020-31/07/2020 were used for training and forecast evaluations. Time plots and Dickey-Fuller Generalized Least Squares unit root test were used to investigate the stationarity properties of the data. Schwarz Information Criterion (SIC) in conjunction with log likelihood were used to search for optimal ARIMA models while Mean Absolute Percentage Error (MAPE) was used for forecast evaluation.&nbsp; Results showed that all the study variables were differenced stationary and hence integrated of order one, I (1). ARIMA (2,1,4), ARIMA (2,1,2) and ARIMA (2,1,3) models were selected as the best candidates for modeling and forecasting the confirmed, recovered and deaths cases of COVID-19 in Nigeria respectively. The study found an approximate COVID-19 life cycle of 12 days among the infected population. The 15 days’ forecasts from ARIMA (2,1,4) and ARIMA (2,1,2) models showed increases in the daily number of confirmed and recovered cases of COVID-19 in Nigeria. The forecasts from ARIMA (2,1,3) model however showed fluctuating trend with decline in the number of deaths cases due to the disease. The result of the study further showed that improving on the present approach to treatment will further decrease the number of casualties due to COVID-19 in Nigeria.</p> 2021-12-14T00:00:00+00:00 ##submission.copyrightStatement## Knowledge, Practices and Attitude of Health Care Support Personnel on COVID-19: A Comparative Study Bhutan and Sri Lanka 2022-01-04T04:31:38+00:00 Priyamali Jayasekera Diki Dolkar Tharindu Dissanayake <p><strong>Background:</strong> Health care support personnel are more vulnerable to COVID-19 due to the nature of their work. Their comparatively lower education qualifications, the important service they provide and associated risks of infection to themselves and others are high. <strong>&nbsp;</strong>This study attempts to explore and compare the knowledge, practices, and attitude of health care support personnel in Bhutan and Sri Lanka.</p> <p><strong>Methods: </strong>A descriptive cross-sectional study using a purposive stratified sampling method with a questionnaire administered on knowledge, practices, and attitude was conducted from September 2020 to June 2021. The analysis was run using SPSS 21.</p> <p><strong>Results: </strong>There were 775 (383 Sri Lankans, 392 Bhutanese) respondents. They consist of attendants (204), health care assistants (labourers) (355), cleaners (140), ambulance drivers (35) and security guards (41). Their levels of education were Grade 12 (24.5%), Grade 10 (41.2%), Grade 8-5(22.2%), and no formal education (12.1%).&nbsp; The majority (66.3%) had a ‘good’ knowledge level of COVID-19. Sri Lankan and Bhutanese mean knowledge score is 7.55 and 7.44 respectively (p&lt;0.05). Overall, not much difference is observed in Practice related to COIVD-19 in both countries. Sri Lankans reported less fear of contact with COVID patients than Bhutanese (p&lt;0.05), but more Bhutanese feel safe at work than Sri Lankans (p&lt;0.05). More Bhutanese (90.8%) report satisfaction with measures taken by their hospital compared to Sri Lankans (49.3%).</p> <p><strong>Conclusion: </strong>Sri Lanka reports slightly higher knowledge test means compared to Bhutan. While more Bhutanese report fear of contact with COVID-19 patients, more Bhutanese report satisfaction with measures taken by their hospitals for their safety, comparatively. It is important to explore the low levels of appreciation perceived, fears reported, and study ways to improve the psychological well-being of healthcare support staff.</p> 2021-12-15T00:00:00+00:00 ##submission.copyrightStatement## Measles Neutralization Antibodies and Some Related Factors in Women of Reproductive-age in Hanoi, Vietnam 2022-01-10T05:03:00+00:00 Than Huu Dao Loan Phuong Do Anh Kieu Thi Nguyen Satoshi Inoue Katsuhiro Komase Hanh Duc Hoang Hien Tran Nguyen <p><strong>Aims: </strong>Our study aimed to determine neutralization antibodies against measles virus and some related factors in women of childbearing-age from 18 to 30 years old, in Hanoi, Vietnam.</p> <p><strong>Methodology:</strong> In 2018, a cross-sectional study was conducted on 1,235 childbearing-age women from 18-30 years old in Bavi district, Hanoi, Vietnam. The study participants were interviewed by using a structured questionnaire which included demographic information, and history of measles. The measles neutralization antibodies (MNA) of these participants were quantified by a plaque reduction neutralization test (PRNT). The data were analyzed using the Epidata 3.1 and Stata 14.2 software.</p> <p><strong>Results:</strong> The results showed that only 58.5% had MNA at sufficient protective levels (≥120mIU/ml), up to 12.5% were negative for MNA, and 358 women (29%) had MNA at insufficient protective levels. In addition, we found that the participants’ working as public employees, having two children, and being ≥ 25 years of age were all positively associated with the sufficient protective antibody levels (<em>P</em>&lt;0.05). A weak positive correlation between age and MNA titers was determined (r= 0.26).</p> <p><strong>Conclusion:</strong> Approximately half (41.5%) of the women of childbearing age in this study did not have sufficient protective antibodies against measles virus. The study results suggest that it is necessary to boost measles vaccine to prevent the sporadic measles infection in women of childbearing age in Hanoi and to quantify the dynamics of maternal measles antibody levels in infants born from these women, so as to provide evidences to control measles incidence in children up to 9 months of age in the future.</p> 2021-12-18T00:00:00+00:00 ##submission.copyrightStatement## Treatment Outcome of Pulmonary and Extra Pulmonary Tuberculosis Patients Registered at DOTS Centre in a Tertiary Care Hospital, Mysuru, Karnataka, India 2022-01-18T04:25:36+00:00 Anitha Victoria Noronha B. Madhu B. S. Jayaraj <p><strong>Aim:</strong> To compare the personal variables, clinical characteristics and treatment outcome of Pulmonary and Extra Pulmonary Tuberculosis (EPTB) patients.</p> <p><strong>Settings and Design</strong><strong>:</strong> A Retrospective observational study was conducted in Directly Observed Treatment Short term (DOTS) centre of teaching hospital, Mysuru, Karnataka state in India from December 2019 to December 2020.</p> <p><strong>Methods and Materials</strong><strong>:</strong> All newly diagnosed patients were registered and followed up during their course of treatment to assess treatment outcome. Data is collected by using personal variable proforma and clinical characteristic form.</p> <p><strong>Results:</strong> Among 197 tuberculosis (TB) patients’ 120(60.91%) were suffering with EPTB and the remaining 77(39.08%) have the PTB. Majority 101(51.26%) patients were diagnosed by microbiological confirmation and remaining 96(48.73%) were clinically diagnosed. Even though majority 140 (71.06%) completed the treatment only 10(5.07%) were cured. About 16(8.12%) TB patients have treatment failure and were lost to follow up. The treatment success rate was (0.5%). Confirming the presence of TB by microbiologically and clinically is having influence in diagnosis of EPTB, as well as consumption of alcohol was having statistical significance inferring these clinical characteristics having influence in developing EPTB. Residence of the patient is a risk factor for the treatment outcome as per calculated odds ratio</p> <p><strong>Conclusion</strong><strong>:</strong> The mean treatment success rate of PTB patients was 80.59% and in EPTB was 73.33%. The treatment success rate was not significantly affected by gender, age and type of TB. .</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Radiological Features of COVID-19 Patients in Hodeidah, Yemen 2022-01-24T05:58:51+00:00 Fahd Ahmed Suhail Mohammed Amood Al Kamarany <p><strong>Background</strong><strong>:</strong> The radiological techniques namely chest radiography (chest X-ray) and computerized tomography (CT) scan play a major role not only in the early detection and diagnosis, especially for false negative Real Time-Polymerase Reaction (RT-PCR) tests and in admission criteria, monitoring the clinical course and the disease severity.</p> <p><strong>Objective</strong><strong>:</strong> The study aimed to describe the radiological features of chest X-ray and CT scan in coronavirus diseases 2019 (COVID-19) patients, Hodeidah, Yemen.</p> <p><strong>Methodology</strong><strong>:</strong> A descriptive study (a case series) included 49 patients with COVID-19 , confirmed by RT-PCR who were admitted in isolation department of COVID-19, Center of Tropical Medicine and Infectious Diseases (CTMID), AL Thawara Public Hospital Authority, Hodeidah, Yemen who underwent serial chest X-ray and CT scan, from 1<sup>st</sup> June to 31<sup>st</sup> December 2021. The cases reports of patients from 3 to 80 years old. Image features and their distribution were &nbsp;analyzed and the COVID-19 Reporting and Data System (CO-RADS) for level of suspicion of COVID-19 infection was applied.</p> <p><strong>Results</strong><strong>:</strong> The results showed that 21 /49 patients (42.86 %) of CO-RAD 4 and 28 /49 patients (57.14 %) of CO-RAD 5. The most patterns were 42/49 patients (85.71 %) of ground glass opacification (GGO), 40/49 patients (81.63%) of bilateral involvement , 41/49 patients (83.67 %) of multi-lobar involvement, 37/49 patients (75,51 %) of peripheral distribution , 15/49 patients (30.61 %) of consolidation pattern and 3/49 patients (6.12%) of crazy paving pattern. On the other hand , in the youngest patients less than 50 year,79 % had GGO, and 21 % had lung consolidations ,while in the patients over 50 year ,GGO were presented in 56 % and consolidations in 44 %. In addition, the lung involvement range of patients was from 40 to 95 % and the median was 60 %. The lung involvement was represented in the patients more than 50 year as 60 – 95 % while in the patients less than 50 years was represented as 40 – 55 %. The lung involvement of death patients was 85 to 95 % of non-chronic diseases and 60 to 70 % of comorbidity and coinfection.</p> <p><strong>Conclusion</strong><strong>:</strong> The study concluded that different radiological patterns and features were reported in elderly patients with COVID-19 infection associated with risk factors (comorbidity and coinfection). The radiological techniques have good predictive values on severity and mortality. Also can support the clinicians staff in early detection, early triage, criteria admission, and effective management of COVID-19 infection.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Vaccine Hesitancy: In the Age of the COVID-19 Pandemic 2021-11-22T07:46:59+00:00 Mohammad Jahidur Rahman Khan Samshad Jahan Shumu Farzana Mim Md. Selim Reza <p>Vaccines are one of the most significant innovations of modern science. Worldwide, millions of lives are saved each year by the vaccine. Vaccine hesitancy, which represents the refusal to receive vaccines when vaccination services are available and reachable, is a major obstacle to global health. While vaccine hesitancy has been present for many years, its damaging effects are likely to be more evident during the COVID-19 pandemic than ever before. This study aimed to find out common causes of vaccine hesitancy, assess COVID-19 vaccination acceptance rates worldwide, and present the approaches by which vaccine hesitancy rate can be reduced. This study revealed though vaccine hesitancy is a worldwide phenomenon, the causes differ from country to country or reign. More studies are needed to address COVID-19 vaccine hesitancy, especially in the Middle and South America, the Middle East and North Africa, Central Asia, Sub-Saharan Africa, Eastern Europe. The leading causes of COVID-19 vaccine hesitancy are found lack of confidence towards the government or pharmaceutical companies, less concern about the outcome of SARS-CoV-2 infection, and shortage of supply of different types of COVID-19 vaccines. Healthcare personnel and social media play an essential role in addressing vaccine hesitancy. Convincing the general population about the safety and effectiveness of COVID-19 vaccines, the consequence of being unvaccinated, and the delivery of free vaccines in an easily accessible way can reduce vaccine hesitancy rate.</p> 2021-11-18T00:00:00+00:00 ##submission.copyrightStatement## An Opinion on Mosquitoes’ Role in HIV Transmission 2021-12-11T05:14:02+00:00 Jiman He <p>The concept that mosquitos do not transmit HIV was established in the 1980s. The present paper examined the early studies used in formulating the concept, and showed there were significant problems with the studies. The present paper demonstrates a consistent correlation between mosquitoes and HIV over a broad range of data worldwide, and suggested that, mosquitoes are a significant risk factor in HIV transmission.</p> 2021-12-06T00:00:00+00:00 ##submission.copyrightStatement## Giant Bilateral Angiomyolipoma Associated with Tuberous Sclerosis of Bourneville: Exceptional Case and Therapeutic Dilemma 2021-11-22T15:41:37+00:00 Benatta Mahmoud <p>Angiomyolipoma (AML) is a mesenchymal tumour composed of variable proportions of adipose tissue and vascular and smooth muscle elements. It can cause potentially life-threatening complications.</p> <p>This report aims to describe a bilateral angiomyolipoma associated with tuberous sclerosis of Bourneville; the second aim is to discuss the treatment modalities of this disease.</p> <p>A 51-year-old woman with abdominal mass and characteristic triad: Epilepsy, mental retardation and skin lesions (adenoma) (Fig. 1), with no notion of hematuria or abdominal pain, abdominal ultrasonography and computed tomography showing bilateral renal masses of 28.4×17 cm on the left kidney and 22× 11.7 cm on the right, respectively (Fig. 2-3). Serum creatinine was 13.4g/l.</p> <p>Body-scan imaging finds cardiac rhabdomyoma (Fig. 4) and brain calcifications (Fig. 5). the patient underwent surveillance with scan imaging every month, and at the last control, she was asymptomatic, serum creatinine was still normal. The management of giant bilateral AML is a complex and multifactorial decision. Patients can knowingly choose an active surveillance program, even with giant AML, but the economic situation and mental status can limit the therapeutic choice.</p> 2021-11-19T00:00:00+00:00 ##submission.copyrightStatement## Routine Use of Condom as an Ultrasound Probe Cover to Prevent Cross Infection in COVID-19 Intensive Care Unit 2022-01-17T07:31:18+00:00 Mohd Mustahsin Amit Srivastava Krochi Pal Puspraj Singh <p>.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement##