Live With Stoma ? What Would it be ?

Live With Stoma ? What Would it be ?

Live with stoma – In Europe, approximately 700,000 people are living with a stoma, and in the USA, more than 1 million people have a stoma. In the United Kingdom (UK), a national audit shows that just under 11,500 patients diagnosed with rectal cancer each year have a stoma formed and a UK charity website indicates that each year, around 2000 people with inflammatory bowel disease (IBD) have a stoma formed.

It’s never been easy living your life with something hanging in your tummy, right? Even before you get that stoma, preparing the surgery itself was challenging for you both mentally or even physically. You might feel anxiety, fear or even loss of confidence. That’s okay, that’s normal for us who doesn’t know nothing about stoma.

Live with stoma pouch ? What would it be ? Some of you might feel depressed only by seeing your tummy, or maybe you are having problems with how to deal with that stoma thing. Stoma affect the patients’ quality of life although they help them to continue their lives

Both physically or mentally reasons, someone with stoma needs support to continuing their lives. As a person who have the stoma, or as a caregiver, or a family members who took care of it you must be understand and known many things that usually happen after you get the stoma.

Also Read Cajuput Essential (Melaleuca Cajuputi) Essential Oil Against Covid-19 Virus (SARS-CoV-2). Can It Really Inhibit Covid-19 Virus?

Here below the most common problems that effect of daily living activity on patients with stoma.

Daily Living Activities n%
Social LifeDifficulty in performing their religious duties2953.7
 Restricted their exercises2750.0
FoodingFeeding Time Arrangements2851.9
 Food/Beverage restriction1527.8
HygieneDifficulties in bathing3055.6
 Changed their clothing style2953.7
Problems of Stoma CarePlacement of stoma adapter in the skin627.3
 Skin Cleaning522.7
 Change of Stoma Bag418.2
 Apply Stoma Powder318.2
Stoma ProblemsDiarrhea2037.0
 Leakage1425.9
 Redness1425.9
 Odor1324.1
 Gas1222.2
Psychological problemsFear937.5
 Low self-esteem625.0
 Getting away from friends/family414.8

*This descriptive study was carried out in the general surgery clinic of an university hospital in İzmir between the 1 January 2016 and 1 June 2016. The sample of the study consisted of 54 patients who were in the general surgery clinic at the time of the study, who were over 18 years of age, who had a stoma duration of at least one month.

Beside all the problems above there are still many questions that commonly the stoma’s patient asked based on what they really concern about. I would love to share this information to you, and I hope it will help you.

1. My Skin is Itchy and Irritated, what can cause and what should I do then

This can be a problem for many people that live with stoma. Redness on the skin around the stoma can be from several sources. Some of the more common reasons can include irritation from stool, sensitivity/allergy to the products you are using, or yeast.

Most commonly with an ileostomy , redness to the skin around the stoma, accompanied by burning and itching, is the result of stool having direct contact with the skin. Stool from an ileostomy is corrosive and can cause damage to the skin within a short period of time. Damaged skin will often result in itchiness and burning, particularly when the stoma is functioning. You may also notice small amounts of bleeding from the skin if the irritation has been for a prolonged period of time.

There are several possible reasons why the skin may be exposed to the stool. The opening of the flange may be too large for the size of the stoma. You should ensure that the opening of the flange is the correct size. Most ostomy suppliers have measuring devices that can help you to determine the correct size of flange opening. You can also reserve the release paper from the back of your flange (usually paper or plastic), and place it over your stoma, making sure your stoma is centered in the middle of the opening. Look in a mirror and measure the gap between the base of your stoma and the inner edge of the release paper. If you are having difficulty measuring the gap or determining the correct size, contact your nurse to help you.

Skin exposure may also be the result of an inappropriate appliance. Different characteristics of the stoma, and different characteristics of the skin around the stoma may prevent you from obtaining a “good seal” with your appliance. If you don’t have a good seal, this can allow stool to leak under your flange and to come in contact with your skin. You may require an alternative type of appliance (e.g. perhaps switching from a flat flange to one with convexity) or the addition of another product (such as a barrier ring) to help prevent leakage and skin exposure. Sometimes, a light dusting of stoma powder can dry the skin enough to provide an adequate pouching surface. Many patients also report success with something as simple as a light coating of calamine lotion, another well-known drying agent. The most important course of action is to determine if the pouch in use is the best for that stoma and for that patient’s contours.

The redness and itchiness may also be the result of a yeast infection to the skin.  Yeast infections tend to be bright red (in the initial stages; the color will change as the infection resolves), have irregular borders or edges, and will likely have several smaller pink dots on the skin away from the main part of the redness /infection. These are called satellite lesions and are new areas of yeast growth. Yeast likes to grow in moist, dark, warm places, like under an ostomy appliance. Yeast will sometimes start after someone has been on antibiotics. It can also result from frequent soaks in hot-tubs or baths, or with excessive perspiration, like in warm weather or with exercise. Yeast is easily treated with a silver based powder. The powder is applied directly onto the skin, and must be “sealed” with a skin barrier wipe. If you don’t seal the powder, the flange will not adhere to your skin. Equally, you should not use a cream based anti-fungal preparation as this will also prevent the flange from adhering. You will need to apply the powder for about a two week period. Usually, you do not need to change your flange more often than normal while using the powder. You should also check other common body sites for signs of yeast, such as under breasts, in the groin, or axillae (underarms). If you notice yeast in these areas, you will need to treat as well (though here, a cream based preparation is okay) to prevent re-infection under your flange.

If all those problems persist, make sure contact your doctor.

2. I’m Having Leakage. What can I do now?

To help solve the issue, we would ask several questions including the current pouching system being used, and the frequency of it being changed. Other questions that would assist us in problem solving might be—How are you preparing your skin before putting on your pouch? If the products are not being properly applied, it could cause adherence issues. Are you cleaning out your pouch or do you put anything in it? Most important, where is the leakage occurring? If it’s always in the same area, evaluate the area for any creases or uneven surfaces such as scar tissue, incisions, or your belly button that may cause an uneven surface under the barrier. If this is the cause, you might try a barrier ring as a filler to even out the surface area. However, make sure that the stoma size is correct in the barrier. You’ll know it’s a correct fit when the barrier fits where the skin and the stoma meet. There should be no skin exposed between the stoma and the opening of the barrier.

3. I’m not sure with My Food. What I should and What I shouldn’t Eat?

You are still having the possibility to taste your normal food or your favorite food even after you got a stoma. Although, you may get some advice from your doctor or your stoma nurse for maintaining your proper diet after your surgery.

Follow the guidelines below for the first few weeks after your surgery. This will help prevent discomfort while your colon heals. https://www.mskcc.org/cancer-care/patient-education/diet-guidelines-people-colostomy

  • Eat small, frequent meals. Try to have 6 small meals throughout the day instead of 3 large ones.
  • Eat slowly and chew your food well.
  • Drink 8 to 10 (8-ounce) glasses of liquids every day.
  • Eat mostly bland, low-fiber foods. Read the “Recommended foods” section for more information.
  • When you add foods back to your diet, introduce them one at a time.

It’s best to eat mostly bland, low-fiber foods for the first few weeks after your surgery. Bland foods are cooked, easy-to-digest foods that aren’t spicy, heavy, or fried. Eating bland foods will help you avoid uncomfortable symptoms such as diarrhea (loose or watery bowel movements), bloating, and gas.

Milk and Dairy
Foods to include in your dietFoods to limit
Non-fat (skim) or low-fat (1% or 2%)*Powdered milk*Non-dairy milks (such as soy milk and almond milk)Lactose-free dairy products (such as Lactaid products)Yogurt*Cheese*Low-fat ice cream or sherbetEggs*High-fat milk and dairy products, such as: Whole milkRegular Ice Cream or sherbetMilk and dairy products with lactose (if you have diarrhea after having them)

*If you have diarrhea after having these products, try non-dairy milks or lactose-free cheese or yogurt instead.

**When trying eggs, start with a small amount (such as 1 egg). Eggs may cause a bad odor (smell) when you open your pouch.

Meats and proteins
Foods to include in your dietFoods to limit
Lean animal proteins, such as:Meat without visible fatSkinless poultryFish*Nuts and nut butter (such as peanut)High-fat foods, such as fried meat, poultry, or fishHigh-fiber foods, such as dried or canned legumes (beans)

*When trying fish, nuts, and nut butter, start with small amounts. These foods may cuase odor when you open your pouch.

Grains
Foods to include in your dietFoods to limit
Low fiber food, such as: White bread, pasta, and riceBagels, rolls, and crackers made from white or refined flourCereals made from white or refined flour, such as Cream of Wheat, Rice Chex, and Rice KrispiesWhole grains, such as whole wheat bread, brown rice, bran cereal, quinoa, and buckwheat
Vegetables
Foods to include in your dietFoods to limit
Low-fiber foods, such as: Well-cooked vegetables without skins or seeds, such as peeled potatoes, peeled zucchini with the seeds removed, and peeled tomatoes with the seeds removedLettuceStrained vegetable juiceHigh-fiber foods, such as raw vegetables (except lettuce)
Fruits
Foods to include in your dietFoods to limit
Pulp-free fruit juice (except prune juice and grape juice)Peeled fruit (such as a peeled apple)Canned fruit (except pineapple)Fruits with thick skins. Examples include:Soft melons, such as watermelon and honeydewOrange without the membrane (the thin clear or white part around each orange section)Ripe bananaRaw fruits with the skin. Examples include:ApplesStrawberriesBlueberriesGrapesPrune juiceGrape juice

That’s it about live with stoma, hope this article will help you.

Also Read Corona Virus Transmission and The Phenomenon of False Informations Spread Related to COVID-19

REFERENCES

  1. Gill Hubbard, Claire Taylor, Angus J.M.Watson, Julie Munro.2020.A Physical Activity Intervention to Improve the Quality of Life of Patients with a Stoma: a Feasibility Study. Hubbard et al.Pilot and Feasibility Studies.6:12.
  2. Esma Özşaker, Tuğçe Yeşilyaprak.2018.The Problems of Patients with Stoma and its Effects on Daily Living Activities.Medical Science and Discovery.5(12):393-8. http://www.medscidiscovery.com
  3. Skin Irritation. Canadian Society ofIntestinal Research. https://badgut.org/information-centre/ostomies/skin-irritation/
  4. Peristomal Skin. Hollister. https://www.hollister.com/en/ostomycare/importanceofhealthyskin
  5. https://www.mskcc.org/cancer-care/patient-education/diet-guidelines-people-colostomy
  6. https://www.mskcc.org/cancer-care/patient-education/how-care-irritated-skin-around-your-stoma

live with stoma live with stoma live with stoma live with stoma live with stoma

What Stoma Really Is? Why Did I Have to Get Stoma?

What Stoma Really Is? Why Did I Have to Get Stoma?

What stoma really is? What it’s really look like? And why did I have to get that?

Maybe you kind of bit confusing about the term of stoma or maybe this is your first time hearing it. Here some information I would love to share with you about that.

The term of “stoma” or “ostomy” comes from the Greek and means “mouth”. In medicine, stoma/ostomy refers to surgically created opening of a hollow organ on the surface of the body to enable excretion of waste products.  

A stoma is a surgically created opening from an area inside the body to the outside. It looks like a small, pinkish, circular piece of flesh that is seen to your body.

Oh, no no wait? What ? there is a hole in my body? My tummy? Does it hurt ?

Actually, stoma-form through surgical by a surgeon, you will be under anesthesia and your stoma has no nerve endings so you should feel no pain from it.

Ostomy or stoma-forming surgery itself could be permanent or temporary, depending on the reason of the surgery.

Also Read What are the differences of these various COVID-19 vaccines?

Why Do I Need Stoma ?

A Stoma-forming surgery may be undertaken for a number of reasons, such as to eradicate a disease or improve the patient’s quality of life. But what kind of diseases that really need stoma surgery ?

A stoma-forming surgery can be done by some techniques and types, due to where the main location of the diseases are held.

Small bowel ostomies (ileostomies) can be distinguished from large-bowel ostomies (colostomies), end ostomies from loop ostomies. Ileostomy are preferentially created in the right tummy, colostomies mostly in the left tummy.

A colostomy is a stoma created from a part of the colon. For this surgery, the surgeon brings the colon through the abdominal wall and makes a stoma. A colostomy may be temporary or permanent depend on what is the underlying diseases are.

Figure II
Figure III

In end (terminal) ostomies, the bowel is divided and the proximal stump is brought out (figure 2). In the case of a loop ostomy, the intestine is not transected; rather the anterior wall is opened to create the ostomy (figure 3)

The location of the colostomy or ileostomy will affect the type and consistency of stool (poop). Your colon normally absorbs water so when some or all of the colon is removed or bypassed, water may not be absorbed from stool as usual. For example, the stool from an ileostomy is mostly liquid because it doesn’t travel through the colon, which would normally remove most of the water. If you have a descending or sigmoid colostomy, your stool will be formed and solid as usual.

REFERENCES :

  1. Ostomy surgery of the bowel : https://www.niddk.nih.gov/health-information/digestive-diseases/ostomy-surgery-bowel#stoma
  2. Peter C. Ambe, Nadja Rebecca Kurz, Claudia Nitschke, Siad F.Odeh; 2018; Intestinal Ostomy: Classification, Indications, Ostomy Care and Complication Management. Deutsches Ärzteblatt International.
  3. National Cancer Institute Dictionary : https://www.cancer.gov/publications/dictionaries/cancer-terms/def/stoma
  4. Types and Indications of Colostomy and Determinants of Outcomes of Patients After Surgery : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864340/
  5. Colostomy and Ileostomy : https://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/tests-and-procedures/colostomy-and-ileostomy/?region=on

Indonesia COVID vaccination to start Wednesday using Sinovac drug

Indonesia COVID vaccination to start Wednesday using Sinovac drug

Indonesia Covid Vaccination – Country is first, outside China, to greenlight those vaccines for emergency use.

JAKARTA — Indonesia’s food and drugs agency on Monday approved the COVID-19 vaccine developed by China’s Sinovac Biotech for emergency use, paving the way for the archipelago to begin its planned mass vaccination program.

Indonesia is the first country outside of China to green light the Sinovac vaccine.

Interim data from a late-stage human trial in Indonesia showed the jabs to be 65.3% effective, said Penny Lukito, head of the agency, BPOM. That is lower than the 78% efficacy rate reported in a similar trial in Brazil, and the 91.25% efficacy rate shown in tests in Turkey.

But the figure is above the World Health Organization’s recommended 50% efficacy rate.

“Safety data for the [Sinovac’s] vaccine were obtained from phase three clinical studies in Indonesia, Turkey, and Brazil,” said Lukito, explaining the decision. “Overall, it shows that the [Sinovac] vaccine is safe with the incidence of side effects being mild to moderate in the form of pain, irritation, swelling, muscle aches, fatigue, and fever.”

The Indonesian Ulema Council — the country’s top Islamic body — gave the Sinovac vaccine halal status last week. That move together with BPOM’s decision clear the way for the Indonesian government to start mass vaccination as planned from Wednesday, offering a beacon of hope to a country still struggling to contain the spread of the virus.

Indonesia added another 8,692 new cases on Monday, taking its total to 836,718. It also reported that another 214 people had died of the disease over the last 24 hours, taking its death toll to 24,343. The government on Monday extended its existing ban on foreign visitors for two more weeks. The initial ban was set to end on Jan. 14.

The country had received 3 million vaccine doses from Sinovac, and as of last week, 1.2 million doses had been distributed to 34 provinces. Health Minister Budi Gunadi Sadikin said Monday that the country is set to receive 15 million doses of bulk vaccines from Sinovac on Tuesday.

President Joko Widodo will receive the first shot, followed by 1.3 million health care workers.

Unlike other countries that have begun vaccinating its vulnerable, elderly population first, Indonesia is prioritizing its working-age population, or those in the 18 to 59 age group, in the hope of kick-starting economic activity.

The president is 59. Vice President Ma’ruf Amin, who is 77, will not be receiving the vaccination for now, according to his spokesperson.

The health ministry has set a target of vaccinating 181 million of Indonesia’s 270 million people in 12 months. The country has so far managed to secure 229 million doses of COVID-19 vaccines from Sinovac, Novavax and global vaccine program COVAX. It is in talks to secure 50 million doses each from AstraZeneca and Pfizer.

BPOM as well as the Indonesian Ulema Council will need to authorize the use of the other vaccines when they become available.

So what do you think about Indonesia Covid Vaccination ?

What are the differences of these various COVID-19 vaccines?

What are the differences of these various COVID-19 vaccines?

Sinovac

Various COVID 19 vaccines in Beijing-based biopharmaceutical company Sinovac is behind the CoronaVac, an inactivated vaccine.

It works by using killed viral particles to expose the body’s immune system to the virus without risking a serious disease response.

By comparison the Moderna and Pfizer vaccines being developed in the West are mRNA vaccines. This means part of the coronavirus’ genetic code is injected into the body, triggering the body to begin making viral proteins, but not the whole virus, which is enough to train the immune system to attack.

On paper, one of Sinovac’s main advantages is that it can be stored in a standard refrigerator at 2-8 degrees Celsius, like the Oxford vaccine, which is made from a genetically engineered virus that causes the common cold in chimpanzees.1

While the three COVID-19 vaccines – from Pfizer/BioNtech, Moderna and Oxford/AstraZeneca – look set to be the most common ones for Europeans.

While they all have the same goal, there are substantial differences between the jabs, from their composition and reported effectiveness, to their price and ease of conservation and distribution.

It means that both Sinovac and the Oxford-AstraZeneca vaccine are a lot more useful to developing countries that might not be able to store large amounts of vaccine at such low temperatures.

Pfizer/BioNtech and Moderna

The Pfizer vaccine, like the Moderna one, use innovative messenger RNA technology. In short, this technology teaches our cells how to produce a protein, which is what makes the immune system react.

It is claimed their efficiency in successfully fighting COVID-19, at up to 95%, is higher than that of AstraZeneca.

Both, however, are more expensive.

The big drawback of Pfizer’s jab is that it needs to be stored in the extreme cold, at temperatures as low as -70C to -80C. Moderna’s can remain stable for 30 days at a temperature of between 2C and 8C, but for longer periods it will have to be frozen at -20C.

Oxford/AstraZeneca

Compared to Pfizer and Moderna, AstraZeneca’s jab uses a more traditional vaccine technique, using an attenuated version of the virus that causes the common cold in chimpanzees.

This virus has been genetically altered with a gene for a coronavirus protein to provoke the body’s immune reaction.

Its efficiency rate is lower at around 70%. But, under certain conditions, this can be as high as 90%.

But it is a lot cheaper and easier to store than Pfizer’s vaccine. The AstraZeneca vaccine can survive in a standard refrigerator for up to six months, whereas the Pfizer one needs temperatures of up to -80℃.2

That’s all for the various covid 19 vaccines hope this article help you!

Also Read Indonesia COVID vaccination to start Wednesday using Sinovac drug

RESOURCE:

  1. https://www.bbc.com/news/world-asia-china-55212787
  2. Carmen Menéndez  & Lucía Riera. 
  3. https://www.euronews.com/2020/12/31/what-are-the-differences-between-the-three-main-covid-19-vaccines
Cajuput Essential (Melaleuca Cajuputi) Essential Oil Against Covid-19 Virus (SARS-CoV-2). Can It Really Inhibit Covid-19 Virus?

Cajuput Essential (Melaleuca Cajuputi) Essential Oil Against Covid-19 Virus (SARS-CoV-2). Can It Really Inhibit Covid-19 Virus?

The SARS-CoV-2 pandemic, or we often hear covid-19 has been the hottest issue all over the world currently. The number of newly infected and died patients has been increasing day by day. This blog content about cajuput (Melaleuca cajuputi) Essential Oil Against Covid-19 Anti Virus. Can It Really Inhibit Covid-19 Virus?

The Agriculture Ministry of Indonesia has developed a cajuput based treatment that it claims has been shown to reduce the transmission of COVID-19. The ministry expects it to play a role in the fight against the virus.1

Cajuput Essential oil is extracted from the twigs and leaves of Cajuput tree. The scientific name of Cajuput tree is Melaleuca Cajuputi. Chief components of Cajuput Oil are Caryophyllene, Alpha Pinene, Beta Pinene, Limonene, Alpha Terpinene, Alpha Terpineol, Gamma Terpinene, Terpinolene, Terpineol, Cineole, Cymene, Linalool, Myrcene etc. The process of extraction of Cajuput Oil involves steam distillation of its twigs and leaves.2 Cajuputi (Melaleuca cajuputi) is one of hundreds species of Melaleuca genus (Myrtaceae family) that is commonly grown in Vietnam, Indonesia, and Thailand.3

Many pharmacological studies have shown that the major constituents of the Melaleuca cajuputi essential oil are 1,8cineol and α-terpineo.4 Which have antibacterial, antifungal and antiparasitic activities. Furthermore, there were also reports on the antiviral properties of essential oil from Melaleuca species.5,6  That the major monoterpenes and their derivatives of the essential oil from tea tree (Melaleuca alternifolia) including α-terpinene, γ-terpinene, α-pinene, p-cymene, 1,4terpineol, α-terpineol, thymol, citral, and 1,8-cineol had an antiviral activity against herpes simplex virus type 1 (HSV-1) in vitro.7 The other results showed that tea tree oil and a few of its compounds (e.g. 1,4-terpinenol, terpinolene and αterpineol) possessed an inhibitory effect on influenza A/PR/ 8virus subtype H1 N1 replication at non-cytotoxic concentrations.8 The literature review indicated that cajeput oil might be a promising medicine in preventing the infection of SARS-CoV-2. The docking simulation to predict the capability of molecular structure in the cajeput oil in inhibiting Angiotensin-converting enzyme 2 (ACE2) protein in human body, causing SARS-CoV-2 to lose its host receptor and destroy its protein (PDB6LU7) at the same time. Noticeably, the ACE2 protein is the host receptor of the SARS-CoV-2 and SARS-CoV.9,10,11 therefore, if the ACE2 protein is inhibited, the SARS-CoV-2 could be prevented and treated. Further information of the ACE2 and PDB6LU7 proteins can be found at UniProtKB.12

We got from a journal that the cajeput essential oil, determined the ability to inhibit ACE2 protein in human body and PDB6LU7 protein of SARS-CoV-2. This is important in discovering medicinal herbs and developing treatments to prevent the SARS-CoV-2 pandemic.13

Interestingly, the synergistic interactions of these 10 substances of the TA exhibit excellent inhibition into the ACE2 and PDB6LU7 proteins. The docking results orient that the natural Melaleuca cajuput essential oil is considered as a valuable resource for preventing SARS-CoV-2 invasion into human body.The three substances Terpineol (TA2), Guaiol (TA5), and Linalool (TA19) have the strongest inhibitory effects on ACE2 and PDB6LU7 proteins. The order of the active compounds inhibiting the ACE2 and PDB6LU7 proteins is: TA2  TA5  TA19 > TA1 > TA3 > TA4 > TA7 > TA10 > TA18 > TA17. Interestingly, the docking simulation results also indicate the synergistic interactions of 10 substances in the Melaleuca cajuputi essential oil exhibit the significant inhibition into the ACE2 and PDB6LU7 proteins.14

Melaleuca cajuputi essential oil are capable of inhibiting ACE2 and resisting PDB6LU7 protein in SARS-CoV-2. So that, after read this blog today we know the trusted source that prove cajuput essensial oil capable inhibiting covid-19. Not only to make warm the respiratory cajuput essensial oil also can inhibiting protein in SARS-CoV-2 as we know the virus of Covid-19 disease. Stay safe all.

Also Read Things People With Diabetes Must Know About the COVID-19 Vaccines

  • https://www.thejakartapost.com/news/2020/05/09/agriculture-ministry-claims-to-have-developed-eucalyptus-based-covid-19-treatment
  • https://www.quinessence.com/cajuput-oil-essential-oil
  • Yoon, Y. Sornnuwat, J. H. Kim, K. H. Liu, T. Kitirattrakarn, C. Anantachoke. Essential leaf oils from Melaleuca cajuputi. In III WOCMAP Congress on Medicinal Aromatic Plants-Volume 6: Traditional Medicine Nutraceuticals 2003, p. 65–72.
  • J. C. Doran, J. W. Turnbull, Trees and shrubs: species for land rehabilitation and farm planting, ACIAR Monograph, Australian Centre for International Agricultural Research, Canberra, Australia, 1997, 24.
  • L. P. A. Oyen, N. X. Dung, Plant resources of South-East AsiaI: Essential Oil Plants. Backhuys Publ. Leiden, the Netherlands 1999, 19.
  • S. Tariq, S. Wani, W. Rasool, M. A. Bhat, A. Prabhakar, A. H. Shalla, M. A. Rather, Microb. Pathog. 2019, 103580.
  • A. Astani, J. Reichling, P. Schnitzler, Phytother. Res. 2010, 24, 673–679.
  • A. Garozzo, R. Timpanaro, B. Bisignano, P. Furneri, G. Bisignano, A. Castro, Lett. Appl. Microbiol. 2009, 49, 806–808.
  • A. Roberts, D. Deming, C. D. Paddock, A. Cheng, B. Yount, L. Vogel, B. D. Herman, T. Sheahan, M. Heise, G. L. Genrich, PLOS Pathog. 2007, 3.
  • L. E. Gralinski, V. D. Menachery, Viruses 2020, 12, 135.
  • D. Paraskevis, E. G. Kostaki, G. Magiorkinis, G. Panayiotakopoulos, G. Sourvinos, S. Tsiodras, Infect. Genet. Evol. 2020, 104212.
  • A. D. Amis, R. Prakash, in Proceedings 3rd IEEE Symposium on ApplicationSpecific Systems and Software Engineering Technology, IEEE, 2000, pp. 25–32.
  • Z. Guo, L. Cupples, A. Kurz, S. Auerbach, L. Volicer, H. Chui, R. Green, A. Sadovnick, R. Duara, C. DeCarli, Neurology 2000, 54, 1316–1323. J. Sharifi-Rad, B. Salehi, E. M. Varoni, F. Sharopov, Z. Yousaf, S. A. Ayatollahi, F. Kobarfard, M. Sharifi-Rad, M. H. Afdjei, M. Sharifi-Rad, Phytother. Res. 2017, 31, 1475–1494.
  • My. Tran Thi A., Loan. Huynh T. P., et al. Evaluation of the Inhibitory Activities of COVID-19 of Melaleuca cajuputi Oil Using Docking Simulation. ChemistrySelect 2020, S, 6312-6320.
That Chemical Agents Called A Disinfectant

That Chemical Agents Called A Disinfectant

Chemical Agents Disinfectant is extensively used in healthcare settings and now getting popular used for household appliances.  A wide variety of active chemical agents (or “biocides”) are found in these products, many of which have been used for hundreds of years for antisepsis, disinfection, and preservation.1 Different countries have different desinfection protocols. Health-care facilities with limited resources may not have access to a variety of hospital disinfectants, however, alcohol and bleach are acceptable chemical agents disinfectant if used appropriately. As with any other disinfectants, soiled surfaces need to be cleaned with water and detergent first.2

Now, the question is which desinfectant can kill corona virus? Coronavirus or known as Covid-19 has become a great reason now that desinfectant has become popular not only in health care settings. There are various desinfection  agents are used but which one is more effective killing viruses.

 The COVID-19 virus is transmitted mainly through close physical contact and respiratory droplets, while airborne transmission is possible during aerosol generating medical procedures.3

Also Read What are the differences of these various COVID-19 vaccines?

All disinfectants were found to be active against SARS-CoV regardless of the type of organic load. Against other enveloped viruses, an ethanol-based hand rub was also described to be effective under different types of organic load.24 Against the feline calicivirus (FCV), however, there was a significant influence of the type of organic load on the efficacy of 70% ethanol and 70% iso-propanol; FCS did not impair the efficacy against FCV but the presence of albumin or sheep erythrocytes significantly reduced the efficacy of the alcohols.4

Eight commercial products were tested, all manufactured by and obtained from Bode Chemie GmbH & Co., Hamburg, Germany. Four were alcohol-based hand disinfectants: Sterillium, based on 45% iso-propanol, 30% n-propanol and 0.2% mecetronium etilsulphate; Sterillium Rub, based on 80% ethanol; Sterillium Gel, based on 85% ethanol; and Sterillium Virugard, based on 95% ethanol. All alcohol-based hand rubs were tested without dilution. Three products were surface disinfectants: Mikrobac forte, based on benzalkonium chloride and laurylamine; Korsolin FF, based on benzalkonium chloride, glutaraldehyde and didecyldimonium chloride; and Dismozon pur, based on magnesium monoperphthalate.4

Alcohols have been described to have immediate, very good activityagainst many different enveloped viruses such as orthopoxvirus, influenza A virus, herpes simplex virus type 1 and 2, Newcastle disease virus, togavirus, hepatitis B virus and human immunodeficiency virus.3,4

Most of the health websites and resources on their journals mentioned about Chlorine (bleach) can effectively kill viruses but handling it can be hazardous for humans. So Use a safer alternative, where possible, and always follow manufacturer’s instructions are always advisable.5

Hypochlorite-based products include liquid (sodium hypochlorite), solid or powdered (calcium hypochlorite) formulations. These formulations dissolve in water to create a dilute aqueous chlorine solution in which undissociated hypochlorous acid (HOCl) is active as the antimicrobial compound. Hypochlorite displays a broad spectrum of antimicrobial activity and is effective against several common pathogens at various concentrations. For example, hypochlorite is effective against rotavirus at a concentration of 0.05% (500 ppm), however, higher concentrations of 0.5% (5000 ppm) are required for some highly resistant pathogens in the health-care setting such as C. auris and C. Difficil.3,4

Resources:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88911/
  2. https://www.ncbi.nlm.nih.gov/books/NBK214356/
  3. https://apps.who.int/iris/rest/bitstreams/1277966/retrieve
  4. H.F. Rabenaua,*, G. Kampfb,c, J. Cinatla , H.W. Doerra. Efficacy of various disinfectants against SARS coronavirus. Elsevier. Journal of Hospital Infection (2005) 61, 107–111
  5. https://www.health.gov.au/sites/default/files/documents/2020/03/coronavirus-covid-19-environmental-cleaning-and-disinfection-principles-for-health-and-residential-care-facilities.pdf
Covid-19 Vaccine Updates

Covid-19 Vaccine Updates

It is not a lie that everyone hopes we can overcome the Covid-19 by expecting a vaccine, but since the disease is new, WHO even mentioned no vaccine is developed until now and it can take a number of years for a new vaccine to be developed.1 According to the news in New York Times, they mentioned that The first vaccine safety trials in humans started in March, but the road ahead remains uncertain. Some trials will fail, and others may end without a clear result. But a few may succeed in stimulating the immune system to produce effective antibodies against the virus.2 Some Countries have started this vaccine trial and researches and it becomes a Global Competition. In the three months since the virus began its deadly spread, China, Europe, and the United States have all set off at a sprint to become the first to produce a vaccine.3

Also Read Indonesia COVID vaccination to start Wednesday using Sinovac drug

China as the first place where Covid-19 firstly spread, with China’s CanSino Biologics Inc , the company behind one of the few coronavirus vaccine candidates already in clinical trials, is collaborating with Canada’s National Research Council to “pave the way” for future trials in Canada, the research council said. The CanSino vaccine is in early trials, and there is no way to know whether it will work. But if it does, the collaboration could help ensure that Canadians have access to it. Local trial data could reassure Health Canada that the vaccine is safe, and local manufacturing could ensure some doses are at hand.4

A vaccine that protects people from the coronavirus could eventually end the pandemic, but finding one that works and manufacturing enough doses is a huge challenge.4 “The first country to the finish line will be first to restore its economy and global influence,” said Dr. Scott Gottlieb, former commissioner of the Food and Drug Administration. The priority for any country is to protect its own citizens, and governments may reserve supplies produced within their borders for their own use and stockpile doses for future outbreaks.5

These researches and trial would definitely a great hope and how soon people expect it done very soon. Every news, updates are always demanded and waited although it may take a long time. What do you think? Do you think the vacccine will be available very soon?

Resources :

  1. http://www.emro.who.int/health-topics/corona-virus/questions-and-answers.html#:~:text=When%20a%20disease%20is%20new,vaccine%20to%20be%20developed.
  2. https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html
  3. https://www.nytimes.com/2020/03/19/us/politics/coronavirus-vaccine-competition.html
  4. https://www.thejakartapost.com/news/2020/05/13/chinese-coronavirus-vaccine-could-be-tested-manufactured-in-canada.html

https://www.voanews.com/covid-19-pandemic/coronavirus-vaccine-hunt-race-be-first

Take A Look At How The  Coronavirus Swab Test Done : What You Should Know

Take A Look At How The Coronavirus Swab Test Done : What You Should Know

Coronavirus Swab Test ? What would you think when we heard about a swab test? Painful Test? Scary one because your nose would be put into by a long stick? The more accurate result? Well, there are so many thoughts for sure running in our mind by seeing how the Swab Test (PCR) done.

A nasal (or nasopharyngeal) swab is used to diagnose upper respiratory tract infections, such as whooping cough and COVID-19. It is a quick test that may feel a little uncomfortable but should not be painful.1 Mainly based on typical symptoms, bilateral involvement on chest radiographs, and exposure to infected patients, and confirmed by positive nucleic acid test of SARS-CoV-2 from numerous types of specimens. Reverse-transcriptase-polymerase-chain-reaction (RT-PCR) is the most common method for SARS-CoV-2 detection by targeting the ORF1ab, N, or E genes. Oropharyngeal and nasopharyngeal swabs were most frequently used samples.3

Reverse Transcription-Polymerase Chain Reaction (RT-PCR). RT-PCR relies on its ability to amplify a tiny amount of viral genetic material in a sample and is considered to be the gold standard for identification of SARS-CoV-2 virus.4

Should we get covid-19 Test? Your health care provider will provide you guidance on the need for being tested for novel coronavirus (COVID-19). As the numbers of cases decline and testing become less challenging, public health officials will again try to contain the virus through contact tracing and early isolation. That will require appropriate testing of individuals who may be infected with coronavirus.

Currently, COVID-19 tests are prioritized for the following groups:

  • Hospitalized and symptomatic individuals
  • Health care workers
  • First responders and other social service employees
  • People exposed to infected individuals in places where COVID-19 risk is high

Asymptomatic (non-ill) residents or employees of group-living facilities, either after a positive case has been identified or before readmission5

The novel coronavirus swab testing specimens shall be collected by qualified technicians who have received biosafety training (who have passed the training) and are equipped with the corresponding laboratory skills.2

Testing for COVID-19 involves inserting a 6-inch long swab (like a long Q-tip) into the cavity between the nose and mouth (nasopharyngeal swab) for 15 seconds and rotating it several times. World Health Organization (WHO) recommends that providers use a sterile dacron or rayon swab with a flexible, plastic shaft for deep nasal sampling. Cotton, calcium alginate swabs, or swabs with wooden sticks may contain such compounds that can inactivate some viruses and inhibit the diagnostic polymerase chain reaction (PCR). The swabbing is then repeated on the other side of the nose to make sure enough material is collected. The coronavirus swab test is then inserted into a container and sent to a lab for testing.3,6

After that how they store this specimen and shipped to a laboratory?

WHO also wrote several trusted resources how the virus is stored and checked in the laboratory. Specimens for virus detection should reach the laboratory as soon as possible after collection. Correct handling of specimens during transportation is essential. Specimens that can be delivered promptly to the laboratory can be stored and shipped at 2-8°C for up to 72 hours after collection. When there is likely to be a delay in specimens reaching the laboratory, the use of viral transport medium is strongly recommended. Specimens may be frozen to – 20°C or ideally -70°C and shipped on dry ice if further delays are expected. It is important to avoid repeated freezing and thawing of specimens.7,8

So here’s the following protocol describes the proper procedure the patient get a nasopharyngeal swab sample for swab test (PCR) :

Figure 1. Image for the Surveillance of Vacine-Preventable Disease
(https://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection.html#swab-testing)
  1. The patient escort into the examination room area
  2. The patient will be explained the process and obtain their consent to process
  3. Provider open the swab package of a sterile swab and take out the swab
  4. The provider tilt the patient’s head back slightly (about 70o) to straighten the passage from the front of the nose to the nasopharynx. Instruct the patient to close his or her eyes, then gently insert the swab along the nasal septum until resistance. (see Figure 1).
  5. The coronavirus swab test rotates several times for 10-15 sec to collect the sample material.
  6. Remove swab and the sample insert into a collection vial containing 1 – 3 mL of viral transport media.
  7. The swab handle break at the marked breakpoint and close the vial.
  8. Label the vial with the following information: Collection date, Onset date, Patient age and sex, Specimen type (e.g.: nasal swab), Unique identifiers, Other pertinent information
  9. Repeat the same procedure with the other nostril.
  10. Follow the manufacturer’s instructions to store the sample and transport it to an FDA approved diagnostic laboratory.4

After that, the vial brings to the diagnostic laboratorium. Than labrorian will mix the sample with reagents. The process like in following figure 2.

Figure 2. RT-PCR Laboratorium Method for detecting SARS-CoV-2 Infections.
(Carter, L.J; Garner L.V., et al. Assay Techniques and Test Development for Covid-19 Diagnostic. ACS Cent. Sci. 2020, 6, 591-605.)
  • Step 1: At the 3′-end of the viral RNA, reverse transcriptase and BIP primer initiate conversion of RNA to cDNA.
  • Step 2: At the same end, DNA polymerase and B3 primer continue to generate the second cDNA strand to displace and release the first cDNA strand.
  • Step 3: The FIP primer binds to the released cDNA strand and DNA polymerase generates the complementary strand. Step 4: F3 primer binds to the 3′ end, and DNA polymerase then generates a new strand while displacing the old strand. LAMP cycling produces various sized double-stranded looped DNA structures containing alternately inverted repeats of the target sequence as detected by a DNA indicator dye. Reagents*: Primers and master mix containing reverse transcriptase, DNA polymerase with strand displacing activity, dNTPs, and buffers.

Although RT-PCR is the most widely used method for detecting SARS-CoV-2 infections, it has the disadvantage of requiring expensive laboratory instrumentation highly skilled laboratory personnel, and can take days to generate results. As a result, a number of companies and laboratories around the globe are working to further improve the efficiency and timeliness of the RT-PCR technologies and develop various other techniques.

In addition, a few studies have also been done using serum, stool, or ocular secretions.1 Recently, the Rutgers Clinical Genomics Laboratory developed an RT-PCR assay (TaqPath COVID-19 Combo kit) that uses self-collected saliva samples, which is quicker and less painful than other sample collection methods, lowers the risks to healthcare providers, and may enable higher volume testing.9,10

In Bali itself, the hospitals give various price to do this swab test. It is from 350K – 6000K in 24 hrs – 72 hrs

Resources:

  1. https://www.healthnavigator.org.nz/health-a-z/n/nasal-swab-test/
  2. http://www.chinacdc.cn/en/COVID19/202003/P020200308322036088669.pdf
  3. https://health.ucdavis.edu/coronavirus/coronavirus-testing.html
  4. Carter, L.J; Garner L.V., et al. Assay Techniques and Test Development for Covid-19 Diagnostic. ACS Cent. Sci. 2020, 6, 591-605
  5. Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020, http://dx.doi.org/10.1001/jama.2020.3786.
  6. Petrova Elena V., Xu Huan, et al. COVID-19 / Coronavirus Outbreak: Performing a Nasal Swab Test on Patients inside a Rapidly Deployable Facility Optimized for Epidemics. Journal of Visualized Experiment. March 2020
  7. https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html
  8. https://apps.who.int/iris/rest/bitstreams/1272454/retrieve
  9. Rutgers University; New Rutgers Saliva Test for Coronavirus Gets FDA Approval: Emergency Use Authorization Granted for New Biomaterial Collection Approach. Rutgers Today, April 2020. www. rutgers.edu/news/new-rutgers-saliva-test-coronavirus-gets-fdaapproval.
  10. U.S. Food & Drug Administration. Accelerated emergency use authorization (EUA) summary SARS-CoV-2 ASSAY (Rutgers Clinical Genomics Laboratory). April 10, 2020, pp 1−8. www.fda. gov/media/136875/download.
It Is Why Washing Hand is Effective preventing Corona Virus than a Hand Sanitizer

It Is Why Washing Hand is Effective preventing Corona Virus than a Hand Sanitizer

Preventing Corona Virus with Washing Hands and soap has been a common campaign everywhere now to kill the coronavirus and preventing corona virus from entering our body. The Perspective of Microorganisms, soap is destructive. A drop of ordinary soap diluted in water is sufficient to rupture and kill many types of bacteria and viruses, including the new Coronavirus that is currently circling the globe. The secret to soap’s impressive might is its hybrid structure.1

Covid-19 (SARS-CoV-2) spreads through the air in the form of small particles that an infected person near you breathed, sneezed, coughed, or let loose while talking. They can enter your body through the eyes, mouth, or nose. Recent findings suggest that those germs can also survive hours, even days, when they land on objects made of plastic, metal, and cardboard.2

Some bacteria and viruses have lipid membranes that resemble double-layered micelles with two bands of hydrophobic tails sandwiched between two rings of hydrophilic heads. These membranes are studded with important proteins that allow viruses to infect cells and perform vital tasks that keep bacteria alive. Pathogens wrapped in lipid membranes include Coronaviruses, HIV, the viruses that cause hepatitis B and C, herpes, Ebola, Zika, dengue, and numerous bacteria that attack the intestines and respiratory tract. When you wash your hands with soap and water, you surround any microorganisms on your skin with soap molecules. The hydrophobic tails of the free-floating soap molecules attempt to evade water; in the process, they wedge themselves into the lipid envelopes of certain microbes and viruses, prying them apart.1

But it has to be done the right way. The gold standard involves scrubbing your hands thoroughly with soap and clean water for at least 20 seconds. Since our hands have many parts to clean individually and the lather needs to cover all of them to capture the germs which make 20 seconds allows for enough time to be thorough, and for soap molecules to do their job on the entire hand.2

In this blog we are not encouraging people not to use hand sanitizer at all, but according to me, we just need to know when we can use the hand sanitizer and how it works compared to washing our hands by water and soap.

Even CDC recommends washing hands with soap and water whenever possible because handwashing reduces the amounts of all types of germs and chemicals on hands. But if soap and water are not available, using a hand sanitizer with at least 60% alcohol can help you avoid getting sick and spreading germs to others.3

Hand sanitizers might not remove harmful chemicals, like pesticides and heavy metals, from hands.3 Disrupting and sequestering viruses and other contaminations with soap and water is different than using disinfectants and sanitizers, which are designed to kill germs but not remove them from your skin.2

Based on what we wrote above, we would like to encourage everyone to wash their hands if possible and use a hand sanitizer for emergency case when you can’t find soap and water. Scrub your hands for at least 20 seconds. Need a timer? The “Happy Birthday” song from beginning to end twice. Stay Safe.

Resources:

  1. https://globalhandwashing.org/how-washing-hands-with-soap-destroys-the-coronavirus/
  2. https://medicalxpress.com/news/2020-03-soap-seconds-covid-.html

https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html

The Differences of SARS, MERS and COVID-19 and How to Compare Them

The Differences of SARS, MERS and COVID-19 and How to Compare Them

It still stays in our mind about SARS and MERS which infected a lot of people and how it became a serious issue in the world. Although they are from same virus group (coronavirus), but there are differences in their transmission speed and the treatment. Incubation for MERS is 2-14 days (average 5 days), SARS is 1-14 days (Average 4-5 days), while for COVID-19 is 1-14 days (Average 5 days).1

Most of the time, human coronaviruses cause mild respiratory illnesses like the common cold. In fact, four types of human coronaviruses cause 10 to 30 percent of upper respiratory tract infections in adults.2

COVID-19 seems not to be very different from SARS regarding its clinical features. However, it has a fatality rate of 2.3%, lower than that of SARS (9.5%) and much lower than that of MERS (34.4%). The possibility cannot be excluded that because of the less severe clinical picture of COVID-19 it can spread in the community more easily than MERS and SARS.3 Sometimes very hard to compare the SARS, MERS, and COVID-19 because it is basically has similar symptoms.

Research has identified horseshoe bats as the natural reservoir of SARS-CoV. Civets and animals in wet markets also likely contributed to the virus crossing from animals into humans. According to the WHO, direct or indirect contact with dromedary camels is the most common route of infection. The MERS-CoV virus has similarities to European bat coronaviruses. SARS , MERS have significantly higher case fatality rates than COVID-19. Yet COVID-19 is more infectious — the underlying SARS-CoV-2 virus spreads more easily among people, leading to greater case numbers.4

Coronavirus disease (COVID-19) is the clinical syndrome associated with SARS-CoV-2 infection; it is characterized by a respiratory syndrome with a variable degree of severity, ranging from a mild upper respiratory tract illness to severe interstitial pneumonia and acute respiratory distress syndrome (ARDS) [2e4]. Although SARS-CoV-2 belongs to the same Betacoronavirus genus as the coronaviruses responsible for the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) (SARS-CoV and MERS-CoV, respectively), this novel virus seems to be associated with milder infections. Moreover, SARS, MERS were associated mainly with nosocomial spread (A nosocomial infection is contracted because of an infection or toxin that exists in a certain location, such as a hospital)5, whereas SARS-CoV-2 is much more widely transmitted in the community.6 Scientists are still trying to determine how Covid spread from an animal to reservoir to people.7 Although so far Bat is suspected as the reservoir.

Overall, the symptoms of COVID-19 and SARS are similar. But there are some subtle differences.8

SymptomsCOVID-19SARS
Common symptomsfever,
cough,
fatigue,
shortness of breath
fever,
cough,
malaise,
body aches and pains,
headache,
shortness of breath
Less common symptomsrunny or stuffy nose,
headache,
muscle aches and pains,
sore throat,
nausea,
diarrhea,
chills (with or without repeated shaking),
loss of taste,
loss of smell
diarrhea,
chills

Resources:

  1. https://www.alodokter.com/ketahui-perbedaan-covid-19-dengan-sars-dan-mers
  2. https://www.healthline.com/health/coronavirus-vs-sars#whats-a-coronavirus
  3. https://www.sciencedirect.com/science/article/pii/S1198743X20301713
  4. https://www.medicalnewstoday.com/articles/
  5. https://www.healthline.com/health/hospital-acquired-nosocomial-infections
  6. https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(20)30171-3/pdf
  7. https://www.niaid.nih.gov/diseases-conditions/covid-19
  8. https://www.healthline.com/health/coronavirus-vs-sars#symptoms