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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a major health concern globally. Genomic epidemiology is an important tool to assess the pandemic of coronavirus disease 2019 (COVID-19). Several mutations have been reported by genome analysis of the SARS-CoV-2. In the present study, we investigated the mutational and phylogenetic analysis of 30 whole-genome sequences for the virus's genomic characteristics in the specimens collected in the early phase of the pandemic (March–June, 2020) and the sudden surge of local transmission (August–September, 2020). The four samples in the early phase of infection were B.6 lineage and located within a clade of the samples collected at the same time in Singapore and Malaysia, while five returnees by rescue flights showed the lineage B. 1.36.1 (three from India), B.1.1 (one from India) and B.1.80 (one from China). However, there was no evidence of local spread from these returnees. Further, all 19 whole-genome sequences collected in the sudden surge of local transmission showed lineage B.1.36. The surge of the second wave on SARS-CoV-2 infection was linked to the single-introduction of a variant (B.1.36) that may result from the strict restriction of international travel and containment efforts. These genomic data provides the useful information to disease control and prevention strategy.

The Russell’s viper (Daboia siamensis) is a medically important venomous snake in Myanmar. Next-generation sequencing (NGS) shows potential to investigate the venom complexity, giving deeper insights into snakebite pathogenesis and possible drug discoveries. mRNA from venom gland tissue was extracted and sequenced on the Illumina HiSeq platform and de novo assembled by Trinity. The candidate toxin genes were identified via the Venomix pipeline. Protein sequences of identified toxin candidates were compared with the previously described venom proteins using Clustal Omega to assess the positional homology among candidates. Candidate venom transcripts were classified into 23 toxin gene families including 53 unique full-length transcripts. C-type lectins (CTLs) were the most highly expressed, followed by Kunitz-type serine protease inhibitors, disintegrins and Bradykinin potentiating peptide/C-type natriuretic peptide (BPP-CNP) precursors. Phospholipase A2, snake venom serine proteases, metalloproteinases, vascular endothelial growth factors, L-amino acid oxidases and cysteine-rich secretory proteins were under-represented within the transcriptomes. Several isoforms of transcripts which had not been previously reported in this species were discovered and described. Myanmar Russell’s viper venom glands displayed unique sex-specific transcriptome profiles which were correlated with clinical manifestation of envenoming. Our results show that NGS is a useful tool to comprehensively examine understudied venomous snakes.

Snakebite, classified by World Health Organization as a neglected tropical disease, causes more than 100,000 deaths and 2 million injuries per year. Currently, available antivenoms do not bind with strong specificity to target toxins, which means that severe complications can still occur despite treatment. Moreover, the cost of antivenom is expensive. Knowledge of venom compositions is fundamental for producing a specific antivenom that has high effectiveness, low side effects, and ease of manufacture. With advances in mass spectrometry techniques, venom proteomes can now be analyzed in great depth at high efficiency. However, these techniques require genomic and transcriptomic data for interpreting mass spectrometry data. This study aims to establish and incorporate genomics, transcriptomics, and proteomics data to study venomics of a venomous snake, Daboia siamensis . Multiple proteins that have not been reported as venom components of this snake such as hyaluronidase-1, phospholipase B, and waprin were discovered. Thus, multi-omics data are advantageous for venomics studies. These findings will be valuable not only for antivenom production but also for the development of novel therapeutics.

Introduction: The World Health Organization Safe Childbirth Checklist is a supporting tool for safe delivery that is essential for maternal and perinatal care practices. It has to be well mentored with its accurate implications to the health care providers who attend the deliveries so that they can protect delivering mothers from major causes of maternal death such as haemorrhage, infection, obstructed labour, hypertensive disorders, intrapartum-related stillbirths, and neonatal deaths. Purpose: The purpose of the study is to determine the level of awareness about the Safe Childbirth Checklist and its accurate application among the health care providers who attend the childbirth delivery procedures. Methodology: This study is a qualitative study on knowledge and practises regarding the World Health Organization Safe Childbirth Checklist among obstetrics and gynaecology professionals. The secondary data is collected from the literature search from various electronic databases such as PubMed, Google scholar, and PubMed Central. Results: the study intellectualizes and advances the knowledge concerning the use of world health organization safe child birth checklist among nurses and other health care providers who are the attenders of child delivery procedures. Conclusion: The study brings out better awareness concerning knowledge and practise concerning the World Health Organization safe childbirth checklist that indicates safe practise concerning maternal and child safety. This suggests training programmes to enhance the quality of practise among staff nurses and other health providers among child birth professionals.

In Myanmar, Russell's viper ( ) bite is a significant public health problem. In this study, we expend upon our previous RNA-sequencing approach to characterize candidate toxin genes encoding toxins. The mRNA was extracted from Myanmar Russell's viper venom glands. The RNAseq was performed using Illumina next-generation sequencing. Subsequently, candidate toxin transcripts were recognized by the Venomix pipeline. This study focused on 29 unique cDNA sequences representing eight newly identified venom gene families with low-to-moderate expression levels. These transcripts represented 0.088% of the total number of transcripts in the dataset. The translated protein sequences were analyzed for their conserved motifs and domains to predict their functions. They were neprilysins (bioactive peptide inactivators), cystatins (protease inhibitors with anti-metastatic activities), waprin and vipericidin (antimicrobial peptides), veficolin (platelet and complement activation), vespryns and three-finger toxins (elapid toxin homologs causing neurotoxic activity and tissue damage), and endothelial lipases (unknown function). Their functional activities should be further investigated for potential therapeutic applications, for example, in cancer or antibiotic-resistant infections.

Subdermal contraceptive implants are one method of long-acting reversible contraception. Implanon NXT provides contraception for 3 years, and Jadelle (Levonorgestrel-releasing implant) for 5 years. The implants are easy to remove through a small opening in the skin. In a small proportion of women the implant will not be palpable or, very rarely, may have migrated. Non-palpable and migrated implants can be removed in an outpatient setting, by doctors who are specially trained and have access to ultrasound and special instruments. In this case report authors share their experience using C-arm machine which resulted in successful removal of Implanon non-palpable contraceptive implant that had become misplaced. A 26-year-old woman was referred to the hospital for lost Implanon after using Implanon as a long-acting contraceptive. GP's attempt to remove it in the clinic was unsuccessful. It appeared to be embedded in the muscle and after taking the X-ray elbow standard view, it was found to be located 15.6 cm from the dorsal surface of the olecranon process. It was successfully removed with the aid of C-arm machine.

The case study discussed patient oriented quality care can enhance patient safety and increase the competency of healthcare professionals, even when they follow standard operating procedures and deal with unforeseen complications in performing LLETZ. This case report aims at validating the qualitative routine procedures against rare and complicated cases of LLETZ. The case concludes that every surgery should be performed carefully and properly to avoid unnecessary aftereffects in order to maintain efficient quality control. Simple and normal procedures were carried out by surgeons performing to the best of their abilities, competently, and with careful attention to patient safety. Though complications arose and were difficult and uncommon, the trained professional successfully navigated the procedure in such circumstantial emergencies.

Russell’s viper bites are potentially fatal from severe bleeding, renal failure and capillary leakage. Snake venom metalloproteinases (SVMPs) are attributed to these effects. In addition to specific antivenom therapy, endogenous inhibitors from snakes are of interest in studies of new treatment modalities for neutralization of the effect of toxins. Two major snake venom metalloproteinases (SVMPs): RVV-X and Daborhagin were purified from Myanmar Russell’s viper venom using a new purification strategy. Using the Next Generation Sequencing (NGS) approach to explore the Myanmar RV venom gland transcriptome, mRNAs of novel tripeptide SVMP inhibitors (SVMPIs) were discovered. Two novel endogenous tripeptides, pERW and pEKW were identified and isolated from the crude venom. Both purified SVMPs showed caseinolytic activity. Additionally, RVV-X displayed specific proteolytic activity towards gelatin and Daborhagin showed potent fibrinogenolytic activity. These activities were inhibited by metal chelators. Notably, the synthetic peptide inhibitors, pERW and pEKW, completely inhibit the gelatinolytic and fibrinogenolytic activities of respective SVMPs at 5 mM concentration. These complete inhibitory effects suggest that these tripeptides deserve further study for development of a therapeutic candidate for Russell’s viper envenomation.

Introduction: Piper betle Linn is one of the most commonly used compounding plants for ethno-medical purposes, with its extract generally used in modern products to enrich their functional efficacy. The extraction methods always lead to differences in the antimicrobial efficacy of methanol extracts of bioactive compounds. Purpose: The study was conducted to screen for bioactive compounds and determine their antimicrobial efficacy in a methanol extract of Piper betle and Murraya koenigi leaves from five different regions. Methodology: The phytochemical screening done according to the procedure that is implied in from Patil, et.al, with minor modifications by the researchers of the current study. Antimicrobial activity was determined; efficacy was measured by disc diffusion analysis. Results: Phytochemical screening revealed the presence of saponin, tannin, terpenoids, alkaloids and flavonoids in the extracts. The methanolic extract of betel leaves from all the selected regions except from Bau exhibited antimicrobial activities. Among them, extract from Kuching and Simunjan have no effect on E. coli. The methanolic extract of curry leaves from Kuching, Balai ringai and Bau have antimicrobial activities against Staph aureus and those from Balai ringai is also active against E.coli. Conclusion: Although there were previous reports of phytochemical screening and antimicrobial activities from the extract of these plants, there were still lack of research conducted on the specimens especially from our local community (Sarawak). The outcome of this study will help us to identify the bioactive compounds of the local samples and give us some pictures of their activities on how to ensure these plants can be brought forward based on the origin of the sample.

Anencephaly means simply no brain or acrania. To be precise, it is a congenital absence of the skull, scalp, and forebrain (cerebral hemispheres). It was categorized under neural tube defects (NTD). As a whole, NTD is the second most common fatal anomaly after cardiac defects. The neural tube defects are a group of central nervous system ailments, which result from the failure of normal primary neurulation, an embryologic process completes in humans by almost day 26-28 the post-conception. In this case, the normal closure of the anterior neuropore fails, which results in anencephaly. The case report demonstrates the clinical experience that would broaden our knowledge of this uncommon but distressing and dilemmatic event. We highlighted the ultrasound features to recognize the condition by first and second-trimester scans and the role of folic acid in the prevention of further occurrence. The diagnosis was confirmed anencephaly with formal ultrasound from the radiologist, who reported no definite brain parenchyma noted, the head was small in size, and the patient was informed about the condition and its prognosis. The reported case was found to be rare and clinicians emphasized the contribution of professional guidance for its management since the case is critical and the ethical concerns need careful handling to avoid adverse psychosocial outcomes such as grief, guilt, anxiety, and loss of self-confidence.