Malaria remains the most serious infectious disease and is one of the leading causes of death among children in malaria endemic areas. The development of malaria vaccines has been underway since 1960s. Significant progress in the development of vaccine has been made in the last decade. On 6 October 2021, World Health Organization recommended widespread use of the RTS, S/AS01 malaria vaccine. The level of acceptance of RTS, S/AS01 malaria vaccine is relatively low in middle-income countries. This might be because of lack of information regarding vaccine implementation in such countries. The proper and efficient execution of the malaria vaccination program necessitates careful consideration of each community's socio-cultural setting. The most prominent RTS, S/AS01 vaccine trial was conducted from 2009 to 2011 in which eleven sites in seven African countries participated. Results of the trial, published in 2015, provided a promising advance in the development of a malaria vaccine for African children. As of 2019, large-scale pilot studies of the vaccine have been conducted in Ghana, Kenya, and Malawi, involving several hundreds of thousands of infants. The RTS, S/AS01 vaccine shows modest efficacy against malaria and has a feasible mode of administration. Although there is increased risk of meningitis, cerebral malaria, pneumonia, anemia, febrile convulsions and gastroenteritis, the vaccine still has a feasible mode of administration and high cost effectiveness and can be easily implemented in resource-limited settings.

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There is considerable evidence from a wide range of sources, including written texts, preserved monuments, and natural plant medicines, that demonstrate the long history of humankind's search for medicinal substances in the natural world. The purpose of this article was to compare the performance of medicinal plant Thuja (T.) occidentalis in a variety of disease-relieving conditions. The current review draws on the work of nearly two hundred original research papers indexed in Google Scholar, ScienceDirect, and the NCBI Library. The authors gatherd all the accessible data on the therapeutic effects of T. occidentalis. Although there are no published randomized controlled trials of T. occidentalis alone so far, multiple clinical investigations have validated the therapeutic efficacy of a combination herbal medication including the extract of T. occidentalis and additional immune stimulants. T. occidentalis is a plant with great potential as it is widely used in both traditional homoeopathy and modern, evidence-based phytotherapy. In vitro and in vivo models have shown its immunopharmacological potential, including its immunostimulatory, anti-cancer, anti-bacterial, anti-fungal, and antiviral activities. More researches into these plants might be done to find out if any of them have the potential to be implemented as a novel drug to treat a wide range of conditions.

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Objective: To evaluate early efficacy of sputum conversion within 6 months of individual regimens containing bedaquiline in patients with drug resistant tuberculosis. Methods: We conducted a retrospective study among patients with drug resistant tuberculosis who were receiving individual regimens containing bedaquiline. The primary outcome was sputum conversion of both smear and culture within 6 months of treatment. We used medical records of drug resistant tuberculosis patients from January 2020 to December 2021. The study was conducted at Dr. Soetomo Hospital, Indonesia from August to October 2022. Results: In this study, 44 eligible drug resistant tuberculosis patients were initiated on regimens containing bedaquiline. There were 52.3% males and the median age was 45.5 years. The rates of previous treatment (70.5%) and lung cavity (36.4%) were high. The most common companion drugs included clofazimine, cycloserine, levofloxacin, and linezolid. Sputum smear and culture conversion was seen in 79.4% and 82.1% at the 2nd month, respectively. More than 97% patients had smear and culture conversion at the end of 6 months. Conclusions: Among drug resistant tuberculosis patients, individual regimens containing bedaquiline were associated with high rates of smear and culture conversion at the end of 6 months. Early efficacy of regimens containing bedaquiline can be used to predict cure rate at the end of treatment.

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Objective: To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China. Methods: An online cross-sectional study was conducted among parents of teenagers in Zhejiang, China from May 1 to 31, 2022. Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences (SPSS) program. Results: A total of 11115 (96.11%) participants and 11449 (99.00%) of their children in Zhejiang, China had been vaccinated against COVID-19. Children whose parents did not receive COVID-19 vaccination were 19 times (aOR 18.96, 95%CI 12.36-29.08) more likely to be unvaccinated than their counterparts. In addition, children with no previous influenza vaccination, those whose parents doubted the COVID-19 vaccine’s safety or effectiveness, were 6.11 times (aOR 6.11, 95%CI 2.80-13.34), 8.27 times (aOR 8.27, 95%CI 5.33-12.83), and 2.69 times (aOR 2.69, 95%CI 1.11-6.50) more likely to be unvaccinated than their counterparts, respectively. COVID-19 vaccine uptake varied between different sociodemographic groups. However, the odds of receiving the COVID-19 vaccine decreased as age and education level increased. The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination (53.78%), followed by safety concerns about the vaccine (13.56%), not knowing where to get vaccinated (6.44%), and concerns about fertility issues (5.56%). Conclusions: Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang, China, the elderly and highly educated people had lower COVID-19 vaccine uptake. It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups. Furthermore, with vaccination rates at such a high level, the pandemic is still ongoing, and public confidence in vaccines may decline. Thus, sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public.

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Rationale: Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management. Scrub typhus associated myositis with rhabdomyolysis is rare. Patient concerns: A 36-year-old female presented with intermittent fever up to 38.6 °C, jaundice and progressive weakness of all four limbs. Diagnosis: Scrub typhus associated myositis and rhabdomyolysis. Intervention: Doxycycline 100 mg twice daily and injection of ceftriaxone 1 gm twice daily along with continuous intravenous fluids. Outcome: Fever resolved with normalization of liver function and recovery of muscle power. Lessons: Presence of myositis and rhabdomyolysis is uncommon in scrub typhus; high clinical suspicion should be kept in patients with atypical manifestations of scrub typhus.

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