Lower Fatality Research Articles

A Study of Covid-19 Relative Fatalities of the Abrahamic Religion Populations

More than three years statistics of the Covid-19 pandemic shows great anomalies in relative fatalities of different countries. Computations show that Christian and Jewish populations, by a factor of 4 to 5, suffer greater relative fatalities compared to the Muslim populations. Ironically, most Muslim populations are developing or underdeveloped, deprived of health services available to the mostly-developed Christian and Jewish populations. Factors that may be contributing to the fatality discrepancies such as, development status, median ages, and alcohol consumption rates, have been discussed. A Quranic forbiddance of drinking alcohol has been suggested as an important factor in the lower fatalities of the Muslim populations in Covid-19 pandemic.

Obesity and 30-day case fatality after hyperglycemic crisis hospitalizations in Korea: a national cohort study

Background: We determined the case fatality rate associated with hospitalization due to hyperglycemic crises and investigated the relationship between obesity status and case fatality for hyperglycemic crises.Methods: From the Korean National Health Insurance Service-National Sample Cohort, 729 adults who visited the emergency room or were hospitalized due to hyperglycemic crises between January 1, 2010, and December 31, 2019, were included. Preobesity or obesity was defined as a body mass index ≥23.0 kg/m2. Case fatality rates are presented as the proportion of adults who died within 30 days of hospitalization. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for 30-day fatalities according to preobesity or obesity status.Results: The 30-day case fatality rate for hyperglycemic crises was 11.2%. In those aged ≥65 years, the fatality rate was twice as high as that in those aged 20 to 64 years (13.8% vs. 6.8%). Adults with preobesity or obesity had a lower fatality rate than those with normal weight (9.5% vs. 14.0%). After adjustment for confounding variables, preobesity or obesity was found to be significantly associated with a decreased risk for 30-day case fatality compared to normal weight (HR, 0.63; 95% CI, 0.40–0.98).Conclusions: In Korea, hyperglycemic crises had a high fatality rate. Management needs to be improved to prevent hyperglycemic crises and reduce mortality.

A review of analysis of biomarkers or detection method of biomarkers in cancer

In the last three decades, technological advancements in health services have notably enhanced the detection and treatment of diseases, including cancer. This progress is particularly evident in the research and application of cancer biomarkers for early detection and risk assessment, aiming to lower cancer fatalities. These biomarkers represent a cost-effective alternative to traditional diagnostic methods like CT scans, though they have yet to achieve the reliability needed for clinical use. This thesis explores the development, validation, and quality control of cancer biomarkers, examining market trends in genomics, proteomics, and diagnostic technologies. The potential for biomarkers to offer less invasive and more affordable diagnostic options could lead to significant healthcare savings. Highlighting this potential, the National Cancer Institute's Early Detection Research Network has initiated a project focused on enhancing cancer cell biomarker identification, driven by individual researchers' efforts. This initiative reflects the growing emphasis on prevention over treatment in the fight against cancer.

Outcomes of COVID-19 Omicron variant in patients with rheumatoid arthritis: a nationwide Greek cohort study.

Patients with RA were at increased risk for COVID-19-associated hospitalization and death during the first year of the pandemic in Greece. We aimed to examine their outcomes after the SARS-Cov-2 Omicron, a more contagious but with milder clinical impacts variant, prevailed. A retrospective, nationwide study was conducted between 1 January 2022 and 30 June 2022 in all RA patients under treatment and matched (1:5) on age, sex and region of domicile random general population comparators. Confirmed SARS-CoV-2 infections, hospitalizations and deaths, anti-rheumatic medications, prior COVID-19, vaccinations and anti-viral medications were recorded. Among 34 182 RA patients, infections (n = 5569, 16.29%), hospitalizations (n = 489, 1.43%) and deaths (n = 106, 0.31%) were more frequent than among comparators. Incidence rates per 1000 person/years of infection [IRR (95% CI):1.19 (1.16, 1.23)], hospitalization [IRR (95% CI):2.0 (1.82, 2.24)], and death [IRR (95% CI):1.81 (1.44, 2.27)] were increased in RA despite better vaccination coverage (89% vs 84%) and more frequent use of anti-viral medications (2.37% vs 1.08). Logistic regression analysis after correcting for age, sex, vaccinations, prior COVID-19, and anti-viral medications in SARS-CoV-2 infected RA patients and comparators revealed increased risk of hospitalization (OR: 2.02, 95% CI: 1.79, 2.27) and death [OR: 1.73, (95% CI: 1.36, 2.20)] in RA. Among infected RA patients, rituximab treatment conferred increased risks for hospitalization [OR: 6.12, (95% CI: 2.89, 12.92)] and death [OR: 12.06 (95% CI: 3.90, 37.31)], while JAK inhibitors increased only hospitalization risk [OR: 2.18 (95% CI: 1.56, 3.06)]. RA remains a risk factor for hospitalization and death in an era of a relatively low COVID-19 fatality rate, pointing to the need of perseverance in vaccination programs and wider use of anti-viral medications.

Was lockdown worth it? community perspectives and experiences of the Covid-19 pandemic in remote southwestern Haiti

Public experiences of COVID-19 pandemic lockdown differed dramatically between countries and socio-economic groups. Low-income countries raise unique empirical and ethical concerns about (1) the balance between benefits and social harms and (2) how explanatory disease models and everyday life realities influenced the experience and interpretation of lockdown itself. In this paper, we present qualitative data on community perceptions and experiences of the pandemic from a remote area of Haiti, with a focus on the 2020 lockdown. We conducted in-depth interviews with 30 community leaders in Grand’Anse Department, southwest Haiti, at two time periods: May 2020 and October–December 2021. We divide our results into five sections. First, our analysis showed that lockdown was widely considered ineffective at controlling COVID-19. Despite the lack of testing, community leaders believed most of the local population had caught COVID-19 in the first half of 2020, with limited reported mortality. Public concern about the pandemic largely ended at this time, overtaken by other socio-economic and political crises. Second, we found that popular explanations for the low fatality rate were related to various coping strategies: the strength of people's immune systems, use of natural prophylactic folk teas, beliefs about the virus, spiritual protections and the tropical weather. Third, we found that lockdown was widely seen to have not been appropriate for the Haitian context due to various challenges with compliance in the face of socio-economic vulnerability. Fourth, we found strong negative feelings about the social consequences of lockdown measures, which lasted from March–August 2020, including adverse effects on: food security, household income, education, health, and psychosocial well-being. Finally, these perceptions and experiences reinforced popular ideas that lockdown had been imposed by elites for financial and/or political gain, something that was also reflected in the discourse about the low vaccine acceptance rate. Our study showed that pandemic respiratory virus response in Haiti should better balance restrictive non-pharmaceutical interventions (NPIs) with existing socio-economic vulnerability. Local socio-behavioral dynamics and risk perceptions decrease the overall effectiveness of NPIs in fragile states and alternatives to lockdown, such as shielding the most vulnerable, are likely to be a more appropriate strategy.

The Impact of Periodic Passenger Vehicle Safety Inspection Programs on Roadway Fatalities: Evidence from US States Using Panel Data

Presently, 15 US states require that passenger vehicles undergo periodic safety inspections. Past studies estimating the effectiveness of these safety inspection and maintenance programs (I/M programs) in their stated aim of mitigating road accidents and fatalities have tended to rely on outdated data sets or to focus on specific geographic regions. Since inspection program effectiveness continues to be deliberated in legislative bodies across the country, this paper aims to present a replicable and data-driven quantification of the effects of I/M programs on road fatalities, applying the largest available data set, covering all 50 US states over a 44-year period. Numerous panel data regressions showed a negative correlation between the presence of state I/M programs and the fleet size–adjusted roadway fatality rate. Fixed-effects (FE) estimates suggest that states with I/M programs had 5.5% fewer roadway fatalities per 100,000 registered passenger vehicles—95% confidence interval (CI): 0.4% to 10.6%—nationwide based on nearly exhaustive data for fatal passenger vehicle accidents from 1980 to 2015. These results are complemented by an additional FE specification with fewer variables, but over a longer period. A two-stage least-squares specification is also presented that not only supports this finding but also implies a causal relationship between the presence of I/M programs and lower road fatality rates. The convergent results of the regressions presented in this paper provide compelling evidence that jurisdictions experience lower roadway fatality rates due to the presence of an active safety I/M program for passenger vehicles.

A one-health approach to design an mRNA-based vaccine candidate against the lumpy skin disease virus as an alternative to live-attenuated vaccines.

Recently, lumpy skin disease (LSD) has been spread over the Asian, European, and Middle Eastern regions making it a significant hazard to the chain of cattle production, milk production, and human milk consumption, requiring prompt attention. Lumpy skin disease virus has high morbidity and low fatality rates, but its infections have led to terrible economic and agricultural consequences. Although live-attenuated vaccines have been commercialized, farmers in different regions have not taken them well because of the allergic responses against the vaccines. The study aims to develop an mRNA-based vaccine candidate for LSDV, using immunoinformatic approaches to minimize allergenicity and homology while maximizing immunogenic potential. The study used extensive immunoinformatic approaches to shortlist five proteins from the LSDV genome that belong to the transmembrane region and are crucial in early viral interaction with host cells. The B-cell and T-cell-specific epitopes were chosen based on non-allergenicity, antigenicity, non-homology, surface accessibility, and lower IC50 inhibition values. The construct's stability, hydrophilicity, and antigenic potential were analyzed using the instability index, Grand Average of Hydropathicity (GRAVY) index, and antigenicity, respectively. We selected a total of 34 epitopes, consisting of 12 B-cell-specific epitopes and 22 T-cell-specific epitopes. These epitopes were chosen based on their characteristics such as non-allergenicity, antigenicity, non-homology, surface accessibility, and lower IC50 inhibition values. Specifically, 11 epitopes were selected for Major Histocompatibility Complex-I, and another 11 epitopes were chosen for Major Histocompatibility Complex-II. The inclusion of the RS09 adjuvant enhanced the immunogenic potential of the vaccine. The instability index was found to be 38.60. Additionally, the GRAVY index, indicating hydrophilicity, was calculated as -0.151. Furthermore, the antigenicity value of 0.6073 confirmed its potential to elicit an immune response. Further supporting its immunogenic potential, strong immune stimulation was observed, with IgM+IgG titers reaching 6,000 (arbitrary units) and IFNg titers measuring 400,000 ng/mL. These results provide additional evidence of the vaccine's ability to stimulate a robust immune response. The study results indicate that the developed mRNA-based vaccine candidate for LSDV has high immunogenic potential and could serve as an effective alternative to live-attenuated vaccines. Further experimental validations are required to test its efficacy. The study also highlights the potential of the One-Health approach to tackle non-zoonotic diseases that have significant consequences for the environment and humanity.

COVID-19 progression towards ARDS: a genome wide study reveals host factors underlying critical COVID-19.

Coronavirus disease 2019 (COVID-19) is a viral infection produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus epidemic, which was declared a global pandemic in March 2020. The World Health Organization has recorded around 43.3 billion cases and 59.4 million casualties to date, posing a severe threat to global health. Severe COVID-19 indicates viral pneumonia caused by the SARS-CoV-2 infections, which can induce fatal consequences, including acute respiratory distress syndrome (ARDS). The purpose of this research is to better understand the COVID-19 and ARDS pathways, as well as to find targeted single nucleotide polymorphism. To accomplish this, we retrieved over 100 patients' samples from the Sequence Read Archive, National Center for Biotechnology Information. These sequences were processed through the Galaxy server next generation sequencing pipeline for variant analysis and then visualized in the Integrative Genomics Viewer, and performed statistical analysis using t-tests and Bonferroni correction, where six major genes were identified as DNAH7, CLUAP1, PPA2, PAPSS1, TLR4, and IFITM3. Furthermore, a complete understanding of the genomes of COVID-19-related ARDS will aid in the early identification and treatment of target proteins. Finally, the discovery of novel therapeutics based on discovered proteins can assist to slow the progression of ARDS and lower fatality rates.

Maternal mortality and morbidity amongst antenatal patients with and without COVID-19 infection

Background: The aim of our study is to compare the maternal mortality between those who are infected with COVID-19 infection and those who are not. Our study was done at Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, which included 2 groups: group 1- pregnant women with COVID-19 infection, and group 2- pregnant women without COVID-19 infection. Methods: Our study is prospective and comparative study, done over 250 antenatal patients admitted at our centre, with COVID-19 infection status confirmed either by rapid antigen testing, or by reverse transcription polymerase chain reaction (RT-PCR)/TruNaat testing who had signs and symptoms of COVID-19 infection along with those who needed obstetric intervention or had a high-risk pregnancy status. Results: Preterm labor accounted for the maternal complication with a majority in COVID-19 infected maternal group. Maternal mortality did not increase amongst patients affected with COVID-19 infection within our study duration. Conclusions: Maternal mortality thus did not seem to be affected much by the COVID-19 pandemic probably due to the low infectivity and fatality of third wave was low.

Raising awareness of recurrent cystitis among women

Background: Recurrent cystitis is a common condition affecting women, often causing discomfort and negatively impacting their quality of life. Despite the high level of morbidity, this condition is frequently overlooked due to relatively low fatality rate. This lack of adequate awareness about recurrent cystitis has led to increased healthcare costs, inappropriate utilization of medical resources, and growing antibiotic resistance. Therefore, there is an urgent need to raise awareness and improve the strategies employed for managing recurrent cystitis.Current Concepts: The socioeconomic burden imposed by recurrent cystitis is substantial, with billions of dollars spent worldwide every year on its diagnosis and treatment. Unnecessary emergency room visits and loss of labor due to illness further exacerbate the costs. Additionally, recurrent cystitis significantly diminishes patients’ quality of life, leading to psychological challenges such as anxiety and depression. Recent research has highlighted the importance of identifying underlying conditions and modifying lifestyle behaviors, in addition to actual treatment, to improve patients’ quality of life.Discussion and Conclusion: It is important to implement various strategies to raise awareness and foster interest in recurrent cystitis. These include patient education, public awareness campaigns, healthcare professional training, online resources, and research collaboration. By increasing awareness and adopting a proactive approach to managing recurrent cystitis, we can improve patient outcomes and enhance the overall efficiency of the healthcare system, ultimately benefiting patients, medical staff, and society as a whole.

Explaining Why Africa had Much Lower COVID-19 Fatalities Per Million than Europe and North America

Abstract: This letter aims to explain the observed difference between COVID-19 fatalities in Europe and America compared to Africa. At present (May 3, 2023), the cumulative number of COVID-19 fatalities per million people has been 3,093 in South America, 2,761 in Europe, and 2,662 in North America. In particular, the United States and the United Kingdom had 3,323 and 3,320, respectively. With fewer opportunities to practice social distancing or hygiene and much more limited access to health care, Africa only had 181 fatalities per million. The better performances of Africa have been ascribed to the positive effects of reduced hygiene, increased biome diversity, lack of masking mandates and restrictions, better access to antivirals, a younger population, and lower vaccination rates, which all may have contributed to the better performances of Africa compared to Europe and North America against COVID-19.

Constructing a Learning Curve to Discuss the Medical Treatments and the Effect of Vaccination of COVID-19.

Acknowledging the extreme risk COVID-19 poses to humans, this paper attempted to analyze and compare case fatality rates, identify the existence of learning curves for COVID-19 medical treatments, and examine the impact of vaccination on fatality rate reduction. Confirmed cases and deaths were extracted from the "Daily Situation Report" provided by the World Health Organization. The results showed that low registration and low viral test rates resulted in low fatality rates, and the learning curve was significant for all countries except China. Treatment for COVID-19 can be improved through repeated experience. Vaccinations in the U.K. and U.S.A. are highly effective in reducing fatality rates, but not in other countries. The positive impact of vaccines may be attributed to higher vaccination rates. In addition to China, this study identified the existence of learning curves for the medical treatment of COVID-19 that can explain the effect of vaccination rates on fatalities.

Accidental poison exposure among children in a regional hospital in northern KwaZulu-Natal before and during the COVID-19 pandemic

Background. Poisoning has been reported as the fifth most common cause of injury-related deaths in children younger than five years worldwide. Little is known about accidental poison exposure among children at regional hospital level. Regional hospitals generally provide more specialised support to primary care facilities over a larger area. During the COVID-19 pandemic, lockdown measures may have increased home-based unintentional poisoning. Objectives. To determine the frequency, outcome and type of accidental poison exposure in children admitted to a regional hospital and compare cases before and during the COVID-19 pandemic. Methods. A review of admissions to Queen Nandi Regional Hospital in Empangeni was performed to document cases of accidental poison exposure over two years. Equal periods during 2019 and 2020 (April to December) were then compared. Children <13 years of age were included. Age, sex, date of admission, death or survival and type of poisoning were collected. Results. Cases of accidental poison exposure made up a small proportion of the total admissions over two years (n=252/5 071, 4.97%) with a low case fatality rate (0.40%). Boys made up the majority (n=132/252, 52.38%). Most were <five years old (n=220/252, 87.30%). Medicines (n=114/252, 45.24%), hydrocarbons (n=59/252, 23.41%) and pesticides (n=26/252, 10.32%) were the main types of poison. Domestic cleaner-, sanitiser- and disinfectant-related admissions were significantly increased during the pandemic (p=0.020). Conclusion. Accidental poison exposure occurs commonly in younger children. Medicines, hydrocarbons and pesticides made up the majority of cases. Domestic cleaner, hand sanitiser and disinfectant ingestion increased in the pandemic. Future research should involve primary care facilities, and risk factors as well as clinical severity should be investigated.

Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals [Letter

Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals [Letter

Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals.

The lack of feasible therapies and comorbidities aggravate the COVID-19 case-fatality rate (CFR). However, reports examining CFR associations with diabetes, concomitant cardiovascular diseases, chronic kidney disease, and chronic liver disease (CLD) are limited. More studies assessing hydroxychloroquine (Hcq) and antivirals are needed. To examine associations of COVID-19 CFR in comorbid patient groups each with single comorbidities and after treatment with Hcq, favipiravir, and dexamethasone (Dex), either alone or in combination versus standard care. Using statistical analysis, we descriptively determined these associations among 750 COVID-19 patient groups during the last quarter of 2021. A diabetes comorbidity (40%, n=299) showed twice the fatality (CFR 14%) of the others (CFR 7%; P=0.001). Hypertension (Htn) was the second-commonest comorbidity (29.5%, n=221), with similar CFR to diabetes (15% and 7% for Htn and non-Htn, respectively), but with higher significance (P=0.0006167). Although only 4% (n=30) heart failure (HF) was reported, the CFR (40%) was much higher than in those without it (8%). A similar rate (4%) for chronic kidney disease was reported, with CFRs of 33% and 9% among those with and without it, respectively (P=0.00048). Ischemic heart disease was 11% (n=74), followed by chronic liver disease (0.4%) and history of smoking (1%); however, these were not significant due to the sample sizes. Treatment indicated standard care and Hcq alone or in combination were superior (CFR of 4% and 0.5%, respectively) compared to favipiravir (25%) or Dex (38.5%) independently or in combination (35.4%). Furthermore, Hcq performed well (CFR 9%) when combined with Dex (9%; P=4.28-26). The dominance of diabetes and other comorbidities with significant association with CFR implied existence of a common virulence mechanism. The superiority of low-dose Hcq and standard care over antivirals warrants further studies.

An assessment of the relationship between national rates of Covid-19 incidence and mortality as reported to an international comparison database: An ecological study.

Making a judgment only based on formal national reports can be misleading. We aimed to assess the relationship between countries' development indicators and reported coronavirus disease 2019 (Covid-19)-related incidences and death. Covid-19 related incidence and death cases were extracted from the updated Humanitarian Data Exchange Website on October 8, 2021. Univariable and multivariable negative binomial regression were utilized to investigate the relationship between development indicator and incidence and mortality from Covid-19 by calculating the Incidence rate ratio (IRR), mortality rate ratio (MRR), and fatality risk ratio (FRR). Very high human development index (HDI) compared with low HDI (IRR:3.56; MRR:9.04), the proportion of physicians (IRR:1.20; MRR:1.16), besides extreme poverty (IRR:1.01; MRR:1.01) were independently correlated with the mortality and incidence rate of Covid-19. Very high HDI and population density were inversely correlated with the fatality risk (FRRs of 0.54 and 0.99). The cross-continental comparison shows Europe and the North Americas, had significantly higher incidence and mortality rates with IRR of 3.56 and 1.84 as well as MRRs of 6.65 and 3.62, respectively. Also, they inversely correlated with the fatality (FRR:0.84 and 0.91, respectively). A positive correlation between the fatality rate ratio based on countries' development indicators and the reverse for the incidence and mortality rate was found. Developed countries with sensitive healthcare systems can diagnose infected cases as soon as possible. Also, the mortality rate of Covid-19 will be accurately registered and reported. Due to more access to diagnostic tests, patients are diagnosed at the initial stages and will have a better opportunity to receive treatment. This leads to higher reports of incidence/and/or mortality rates and lower fatality of COVID-19. In conclusion, more Covid-19 incidence and mortality cases in developed countries can result from a more comprehensive care system and a more accurate recording procedure.

Time perspective and working memory impairments among persons diagnosed with schizophrenia

Cognitive deficits are recognized as one of the critical aspects of schizophrenia, and psychological processes play an essential role in understanding these cognitive impairments. In the current study, we examined the role of Time Perspective (TP) in predicting working memory functioning among persons diagnosed with schizophrenia (N = 88) and healthy individuals (N = 91). First, we replicated previous findings on a clinical sample by showing that performance in working memory tasks correlates with lower Present Fatalism, higher Future Positive, and lower unbalanced TP. Second, the clinical group reported higher levels of Past Negative, Present Fatalism, and Future Negative, lower levels of Past Positive, and more unbalanced TP than the control group. Moreover, we found a moderating effect between unbalanced TP and working memory. Specifically, the relationship between unbalanced TP and working memory was more pronounced in the clinical group. The study deepens our understanding of the role of different dimensions of TP and cognitive functioning in schizophrenia.

Evolution of SARS-CoV-2 Variants: Implications on Immune Escape, Vaccination, Therapeutic and Diagnostic Strategies.

The COVID-19 pandemic caused by SARS-CoV-2 is associated with a lower fatality rate than its SARS and MERS counterparts. However, the rapid evolution of SARS-CoV-2 has given rise to multiple variants with varying pathogenicity and transmissibility, such as the Delta and Omicron variants. Individuals with advanced age or underlying comorbidities, including hypertension, diabetes and cardiovascular diseases, are at a higher risk of increased disease severity. Hence, this has resulted in an urgent need for the development of better therapeutic and preventive approaches. This review describes the origin and evolution of human coronaviruses, particularly SARS-CoV-2 and its variants as well as sub-variants. Risk factors that contribute to disease severity and the implications of co-infections are also considered. In addition, various antiviral strategies against COVID-19, including novel and repurposed antiviral drugs targeting viral and host proteins, as well as immunotherapeutic strategies, are discussed. We critically evaluate strategies of current and emerging vaccines against SARS-CoV-2 and their efficacy, including immune evasion by new variants and sub-variants. The impact of SARS-CoV-2 evolution on COVID-19 diagnostic testing is also examined. Collectively, global research and public health authorities, along with all sectors of society, need to better prepare against upcoming variants and future coronavirus outbreaks.

Re-emergence of human monkeypox 2022: its ecology and public health significance-short review article

Monkeypox virus (MPXV) is one of Orthopoxvirus subfamily, it’s refers to a zoonotic disease caused by MPXV. Human monkeypox, on the other hand, has a much lower morbidity and fatality rate than smallpox. Reference to the current resurgence, monkeypox outbreaks have been reported over the past 5 decades, 10 countries in Africa was initially discovered to be affected by the outbreak and subsequently 4 countries apart from Africa. Additionally, re-emergence of monkeypox in African countries, especially Nigeria about forty 40 years of the initial outbreak, midst 2010-2019. Climate change, deforestation, lack of proper health and research advance infrastructure among the society and uncontrol intake of bush meat in the African countries could have been the reason for the recent re-emergence of monkeypox within the communities. Public health significance of monkeypox outbreak could be the factors related to the vulnerability of the population towards MPXV when smallpox vaccination was stopped. Due to the rapid global outreach of monkeypox endemic, it should be therefore considered as a very serious re-surging pathogen in the world. However, detail and proper observational research could bring more light on the influence of MPXV on overall human population, together with the advancement in qualitative and quantitative of outbreak data collection, research in the current situation is crucial and need an emergency treat in order to encourage the researchers to improve more findings on the monkeypox outbreak, which will subsequently enhances appropriate case management and public health response.

Case Report: Non-Cirrhotic Hepatoma BCLC-C With Vertebrae Metastasis

Background: Hepatocellular carcinoma (HCC) can arise from either cirrhosis or non-cirrhosis of the liver. HCC in non-cirrhotic livers is still uncommon and can present insidiously in patients. HCC may develop in people with non-cirrhotic chronic liver illness, such as chronic hepatitis B virus infection and chronic HCV infection. More than half of non-cirrhotic individuals with HCC may not exhibit any symptoms, and the disease is frequently detected when it is advanced and incurable. Case Report: Here we presented a 47-year-old man went to the emergency room complaining of upper right side abdominal discomfort that suddenly arose and spread to the back and right shoulder. He also experiencing upper right abdominal fullness for the past two months, along with a sense of a lump growing larger and harder. Hepatic stigmata were not discovered, whole blood revealed a thrombocytosis and significant rising AFP from the expected result of 71,000 ng/dL, with hepatitis B testing was positive. Abdominal ultrasound revealed hepatomegaly and several hypo-hyperechoic nodules. CT scan revealed multiple solid lesions and lytic lesions of the vertebrae bodies. The patient recieved palliative treatment.. Conclusion: This case study demonstrates a non-cirrhotic hepatoma that came at an80 tan advanced stage and was more likely to be asymptomatic than a cirrhotic hepatoma that showed signs of liver failure, such as hepatic stigmata and other physiologic abnormalities. This case report demonstrates the This case study demonstrates the importance of strengthening general HHC preventative measures in order to lower non-cirrhotic HHC's incidence and fatality rate.