Reduction of MERS-CoV Transmission among Healthcare Workers and Patients in Saudi Arabian Healthcare Settings: A Scoping Review

Background No review consolidating available evidence of the various interventions for preventing MERS-CoV transmission in healthcare settings has been published to inform practice. The MERS-CoV outbreak in Saudi Arabia led to wide-scale hospitalisations and, among other individuals at risk, healthcare workers (HCW) were one of the most affected groups. This study evaluates the effectiveness of various interventions implemented to prevent MERS-CoV transmission to HCW and MERS-negative patients in Saudi Arabian healthcare settings. Methods This review summarises and evaluates the effectiveness of MERS-CoV infection prevention and control (IPC) measures in Saudi Arabian hospital settings. Instead of using ‘best quality/evidence’ studies, the review has included as many relevant studies as possible. Results Various IPC measures were deemed effective. However, since no analysis of their effectiveness had been undertaken, it was not possible to determine the interventions’ level of effectiveness as applied in hospital settings. The studies appeared to rely on the assumption that the extent of MERS-CoV transmission control observed was a direct reflection of the implemented IPC measures. Conclusions Robust studies, using empirical methods, should be conducted to measure the effectiveness of the various IPC measures developed and implemented to control MERS-CoV transmission

Toxic Effects of Insecticides Malathion and Cypermethrin on Biochemical, Hematological and Hormonal Parameters in Blood of Male Rabbit Oryctolagus Cuniculus

To evaluate the toxicity of the pesticides Malathion and Cypermethrin on the blood hematological, biochemical and hormonal indices of male New Zealand white rabbits. thirty six rabbits were classified into twelve equivalent groups A (1, 2, 3, 4) B, C, D, E, F, G, H and I. Group A was kept as control without any intoxication and each experiment was having its own control group i.e A1, A2, A3 and A4 while group B, C, D, E, F, G, H and I were treated as the experimental tests groups. Each group was having 3-5 rabbits. The rabbits were retained in cages with appropriate housing, conditions and requirements and fed with different concentrations of Malathion and Cypermethrin. Hematological parameters A 75 mg/kg body weight dose of both Malathion and Cypermethrin were fed to male rabbits for seven days. After the stipulated time period Malathion in comparison with control group exhibited a significant increase of 95% while Cypermethrin showed a more significant increase of 142% in white blood cells count. Hematocrit showed a significant increase of 3.34% in Malathion intoxicated group. Mean corpuscular hemoglobin concentration in Cypermethrin fed group revealed a significant increase of 4.21%. A dose of 50 mg/kg body weight dose of both Malathion and Cypermethrin was given to another set of rabbits for fourteen days. Red blood cells showed a significant increase of 19.64% in Malathion fed group while in Cypermethrin intoxicated group a more significant increase of 23.1% was found. Hematocrit was more significantly increased up to 30.72% in Malathion fed group while Cypermethrin test group exhibited a more significant increase of 26.12% in hematocrit level. xiii With a dose of 20mg/kg body weight for thirty days of both pesticides Malathion in comparison with control group showed that hematocrit was significantly decreased up to 2.37 % in Malathion fed group. Mean corpuscular volume due to Malathion administration revealed a more significant increase of 7.17%. Mean corpuscular hemoglobin showed highly significant increase of 46.32% in Malathion treated group. Mean corpuscular hemoglobin concentration showed a highly significant increase of 36.35 % in Malathion fed group. Platelets values were significantly increased up to 7.01 % in Malathion intoxicated group. With 5mg/kg body weight dose for three months, Malathion fed group in comparison with control group, hemoglobin level displayed a significant decrease of 17.53 % in Malathion fed group but was more significantly decreased in Cypermethrin served group i.e. 29.97 %. Hematocrit showed a significant decrease of 14.07% in Malathion fed group while in Cypermethrin fed group there was a more significant decrease of 16.85% in hematocrit level. Biochemical parameters A 75 mg/kg body weight dose of Cypermethrin in seven days exhibited a significant increase of 113% in alkaline phosphatase level. Cholesterol level in Cypermethrin intoxicated group showed a significant decrease of 38.71%. Creatinine phosphokinase showed a highly significant decrease of 64.33% in Malathion administered group. High density lipoprotein in Cypermethrin fed group showed a more significant increase of 672.8%. Lactate dehydrogenase showed a more significant decrease of 53.33% in Malathion fed group while Cypermethrin fed group also indicated a highly significant decrease of 30.09% in lactate dehydrogenase level. Bilirubin total level in Cypermethrin administered group displayed a significant increase of 72.75%. xiv Glutamate oxaloacetate transaminase exhibited a significant increase of 33.26 % in Malathion fed group. Glutamate pyruvate transaminase revealed a highly significant decrease of 85.6% in Malathion fed group while Cypermethrin intoxicated group exhibited a more significant decrease of 56.39 % in glutamate pyruvate transaminase level. Triglyceride showed a more significant decrease of 38.86% in Malathion intoxicated group while Cypermethrin fed group exhibited a significant decrease of 33.68 % in triglyceride level. Total protein showed a more significant decrease of 30.76% in Malathion test group in comparison with control group. With a dose of 50 mg/kg body weight Malathion and Cypermethrin, alkaline phosphatase exhibited a highly significant rise of 106.61% in Malathion intoxicated set of rabbits. High density lipoprotein in Cypermethrin fed set presented a significant rise of 190.11 %. Lactate dehydrogenase showed more significant increase of 9.25% in Malathion served group. Glutamate oxaloacetate transaminase in Cypermethrin fed group exhibited a significant increase of 50.02 %. With 20 mg/kg body weight dose Malathion and Cypermethrin alkaline phosphatase displayed a highly significant rise of 145.15 % in Malathion served group. Cholesterol level in Cypermethrin fed group disclosed a significant increase of 171.16 %. High density lipoprotein exposed a highly significant decrease of 88.74% in Malathion intoxicated group while Cypermethrin fed group showed a more significant increase of 816.03% in high density lipoprotein level. Bilirubin total showed a significant increase of 60.15% and 100 % both in Malathion and Cypermethrin administered groups respectively. Glutamate pyruvate transaminase activity showed a significant increase of 482.04% in Malathion fed group. xv With 5 mg/kg body weight dose for three months of Malathion and Cypermethrin, acid phosphatase concentration in Cypermethrin test group was significantly raised. Alkaline phosphatase exhibited a more significant increase of 88.24% in Malathion fed group. Cholesterol level in Cypermethrin intoxicated group exhibited a significant increase of 147.5 %. Creatinine phosphokinase exhibited a significant decline of 44.24% in Malathion served group while Cypermethrin served group also exhibited a significant reduction of 51.02% in creatinine phosphokinase level. High density lipoprotein showed a significant increase of 437.99 % in Malathion fed group while Cypermethrin administered group exhibited a highly significant increase of 499.99 % in high density lipoprotein level. Bilirubin total exhibited a more significant increase of 116.8% and 91.8% both in Malathion and Cypermethrin groups respectively. Glutamate oxaloacetate transaminase activity exhibited a more significant increase of 108.73% and 104.56% in Malathion and Cypermethrin intoxicated groups respectively. Glucose level in Cypermethrin treated group exhibited a more significant raise of 248.67 %. Total protein in Cypermethrin fed group exhibited a significant increase of 34.76 %. Hormonal parameters A dose concentration of 50 mg/kg body weight of Malathion and Cypermethrin, luteinizing hormone in Cypermethrin intoxicated group displayed a significant decline of 26.17% in comparison with control group. With 20 mg/kg body weight dose of Malathion and Cypermethrin, triiodothyronine exhibited a more significant decline of 37.23% in Malathion administered group. With 5mg/kg body weight dose of Malathion and Cypermethrin, estrogen level displayed a significant increase of 41.92% in Malathion fed group.