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"HOVHANNISYAN, HASMIK"
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Impact of the COVID-19 pandemic on the measles elimination status in Armenia
Introduction: The coronavirus disease 2019 (COVID-19) pandemic led to a decrease in immunization rates and measles surveillance, resulting in re-establishment of endemic measles transmission in many countries where measles was previously eliminated. Methodology: We conducted a retrospective study to evaluate the impact of the pandemic on the measles elimination status in Armenia. We studied the prevalence of measles from 2000 to May 2024 and predicted the trend for the coming months. We assessed trends in coverage levels of the mumps-measles-rubella (MMR)1 and MMR2 vaccines in Armenia between 2003 and 2023. The performance indicators of measles surveillance at the national and subnational levels before, after, and during the pandemic (2013-May 2024) were studied. Results: Endemic transmission of measles in Armenia was interrupted in 2008, and was sustained for many years; however, it was re-established in 2023. A total of 988 measles cases were recorded between February 2023 and May 2024. During the pandemic (2020–2022), MMR1 and MMR2 vaccine coverage decreased from the target level to 94%. Case-based measles surveillance was significantly weakened. Discarded case rate was 0.7 in 2020 and 2021, and 0.9 in 2022. After the pandemic, this indicator improved, reaching 33.3 in 2023 and 17.3 in 2024. The mean values of the numbers of discarded cases were 118 (95% CI, 73–163) in 2013–2019, and 23 (95% CI, 20–26) in 2020–2022 (p < 0.05). Conclusions: The measles elimination status of Armenia was lost due to immunity gaps and weakening of measles surveillance during the pandemic.
Journal Article
Impact of the COVID-19 pandemic on routine immunization services in Yerevan and vaccinations against COVID-19 in Armenia
Introduction: The coronavirus disease (COVID-19) has led to millions of deaths around the world. The indirect effects of the pandemic, include disruption of routine immunization services.
Methodology: We conducted a retrospective review to assess the impact of the pandemic on routine immunization in Yerevan and the vaccinations against COVID-19 in Armenia. We compared the number of administered doses of DPT/VHB/HIB/IPV1,2,3, Pneumococcal1,2,3, Rotarix1,2, and MMR1 vaccines in target groups in 2020 and 2021 and the total vaccination coverage in 2019, 2020, and 2021. We also analyzed the number of COVID-19 vaccines administered in Armenia from 17 May 2021 to 6 February 2022.
Results: There was a decline in the number of administered doses of vaccines at the beginning of the pandemic due to restrictive quarantine measures: 16 ± 4.5 (95% CI, 11.8-20.2), p < 0.05, during the second wave 18 ± 2.6 (95% CI, 15.6-20.4), p < 0.05 and during the interruption due to COVID-19 vaccine delivery 16 ± 7.4 (95% CI, 9.1-22.9), p < 0.05. There was no significant decrease in the number of vaccinations during the first, third, and fourth pandemic waves (p > 0.05) Overall, the COVID-19 vaccination process was slow and only 30% of the population were vaccinated.
Conclusions: The COVID-19 pandemic led to disruptions in the routine immunization process, but there was no significant decrease in the total vaccine coverage due to rapid scaling up of the vaccination services and catch-up vaccinations. Thus, the restrictions imposed during the pandemic did not affect the overall progress of vaccination.
Journal Article
Meta-Argumentation as An Argumentation Metatheory
This article shows that the Rhodian model of metatheory can be successfully applied to nonformal systems of a methodological rather than an axiological nature if the demands of the model are satisfied. This requires that we take into account the possible variations of Rhodian models of argumentation and choose the most effective of them. Plato's model of meta-argumentation is only applicable to fields of argumentation that are completely formalized and could be presented as whole general theories.
Journal Article
BUILDING A GENERAL THEORY OF META-ARGUMENTATION
This article presents a critical analysis of the main modern approaches to the problem of meta-argumentation and suggests a method for developing a general conception of meta-argumentation. A set of theoretical-methodological difficulties (aporias) along this path is revealed. Overcoming these aporias would constitute the main steps toward developing the body of a theory of meta-argumentation.
Journal Article
Right upper quadrant peritonectomy. Answering frequently asked questions
Correspondence to Professor Artem Stepanyan, Gynecologic Oncology, Nairi Medical Center, Yerevan 0015, Armenia; stepanyan.artem@gmail.com Removal of upper abdominal disease remains one of most challenging parts of surgery in advanced ovarian cancer. How do I safely avoid the supra-hepatic vena cava? A#4: (surgical video) The right coronary ligament is being incised over the supra-hepatic vena cava and the para-vascular space, located just laterally to the right hepatic vein, is entered. How do I safely avoid the infra-hepatic vena cava? A#5: (surgical video) For good access to the infra-hepatic inferior vena cava and Morrison’s pouch peritoneum the liver is manually retracted upwards and cephalad, the hepatic flexure of the colon is retracted caudad, and the duodenum is retracted medially.
Journal Article
Monitoring therapy outcomes in idiopathic scoliosis patients: case series and a proposed model
Introduction: Current treatment options for idiopathic scoliosis include three main strategies: physiotherapy, bracing and surgery, which are used combined or successively, but in many cases are not efficient. This study aimed to develop a targeted, efficient, and appropriately calibrated approach for continuously monitoring of scoliosis therapy. Methods: Six patients with idiopathic scoliosis (IS) participated in this consecutive sample study. The study group (n = 6) underwent a physical rehabilitation program that utilized motion capture and myometry for control.Both before and after program completion, all patients underwent X-ray revaluations. Repeated assessments of muscle thickness were conducted to establish a correlation between biomechanical spine remodeling and paraspinal muscle development. Results. Results of M°Cap spinal curvature assessment correlate positively with the x-ray measurements (f2 >0.35). The same ratio of difference in x-ray angle measurement results was revealed after the study completion (PO.OOl). Both the muscle thickness and the body muscle mass measurements showed negative correlation with the changes in Cobb's angle measurements (the angle was decreased in all measurements, whereas the muscle thickness and mass were increased). Correlation for the SMI (R=-0.88) was close to -1.0. For the measurements in the study group the minimum R value was - 0.92 and for paraspinal muscles L3-L4 and SMM (%) the correlation index was -0.96. These results indicate that the improved muscle thickness and muscle mass (particularly the SMM (%)) support the posture correction and assist in spinal stability. Conclusion. The M°Cap and myometry controlled assessment is an efficient, safe and reliable monitoring model to control the outcomes of scoliosis rehabilitation.
Journal Article
Assessment of pathomorphological characteristics of the oral mucosa in patients with HBV, HCV and HIV
Introduction: Oral clinical manifestations in HBV HCV and HIV patients indicate a deterioration in general health status. The aim of the study was to assess pathomorphologic features of oral mucosa observed in patients with these diseases.
Methodology: The study was conducted in N1 Dental Clinic of YSMU after M. Heratsi. The total number of patients taking part in the research was 120, including HBV (n = 40), HCV (n = 40) and HIV (n = 40). After biopsy and subsequent histological examination of the oral mucosa, statistical analysis was carried out using Excel 2013 and R software.
Results: Pathomorphological examination revealed inflammatory infiltrations in all samples collected from HBV, HCV and HIV patients. These changes included microcirculatory disorders in 98.3% of samples: fibrinous-like deposits lining the surface of erosions and ulcers on the oral mucosa (1.67%), fibrosis of the mucous membrane (70%), dystrophy of squamous epithelium (93.3%) and bone sequestration (3.3%). Comparative analysis of pathomorphological characteristics revealed distinct content of infiltrates: lymphoplasmacytic infiltration in patients with HBV and HCV, while HIV patients showed neutrophils infiltration and lack of plasmocytes.
Conclusions: There are common abnormal morphological changes in the oral mucosa typical of all patients with HBV, HCV and HIV, as well as liver diseases specific to each of them. Inflammation in the patients with HIV indicated impairment of the humoral immune system. Understanding the distinct characteristic of inflammation in the oral cavity could be useful for early differential diagnosis and management of patients with HIV, HBV and HCV.
Journal Article
Species identification of osseous museum artefacts through peptide mass fingerprinting illustrated by a study on objects from Neolithic to Iron Age Armenia
Identifying animal species used in osseous industry production is crucial for reconstructing human-animal interactions in ancient societies. However, bone artefact manufacture often involves intensive modifications to raw materials that hamper taxonomic identifications. Here, for the first time in central Eurasia, we taxonomically assess bone objects stored in museum collections, recovered from Late Neolithic to Iron Age contexts in Armenia, using a minimally invasive peptide mass fingerprinting technique, also known as Zooarchaeology by Mass Spectrometry (ZooMS). Our pilot study shows remarkable collagen preservation in the bone artefacts, demonstrating the rich potential of ZooMS for examining legacy collections. The successful ZooMS screening provided taxonomic identification for 86% of the artefacts, offering insights into species selection for bone manufacturing, as well as broader socioeconomic developments and interregional links. Our study underscores the utility of minimally invasive proteomic techniques, enabling the preservation of cultural and historical artefacts while addressing limitations of studying museum collections.
Journal Article