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nThe present study is to identify the perceived stress and coping strategies among parents of hospitalized patient withacute lymphoblastic leukemia in the Covid pandemic situation at IMS & SUM hospital of Bhubaneswar, Odisha, A non-experimental which was descriptive in nature was selected for purpose to assess the perceived stress and coping strategies among parents of hospitalized patient with acute lymphoblastic leukaemia in the Covid pandemic situation at IMS and SUM hospital With a sample size of 100 Parents, Non-Probability purposive sampling technique was used for the study. Developed tools are social demographic data Performa, perceived stress scale and f-cope were used for the data collection. A questionnaire was used to collect data from parents who visited the hematology ward. The investigators observed that among all participants 82% having moderately stress and 18% having severe stress. The same participants were interviewed to know their coping abilities, the results reveals that majority (96%) participants having good coping strategies, (4%) participants having average coping strategies. Parent’s life is usually under lots of responsibility, at time it can also be under much pressure and stress. In this study the result we found that there is significant between stresses among parents of hospitalized patient with acute lymphoblastic leukemia. The present study is to identify the perceived stress and coping strategies among parents of hospitalized patient withacute lymphoblastic leukemia in the Covid pandemic situation at IMS & SUM hospital of Bhubaneswar, Odisha, A non-experimental which was descriptive in nature was selected for purpose to assess the perceived stress and coping strategies among parents of hospitalized patient with acute lymphoblastic leukaemian

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1. American Cancer Society, Cancer Facts & Figures. 2012. [Last Retrieved On 2017 Dec06]. AvailableFrom:Https://Www.Cancer.Org/Cancer/Cancer-In-Children/Key-Statistics.Html
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nHuman Papillomavirus is the most common sexually transmitted infection. While the virus can cause many negative health effects in both males and females, the most concerning and common of these is cervical cancer in females. Immunization is not effective in clearing HPV infection that is already present. Therefore, there is a need for therapeutic vaccines that work to combat the virus in an individual who has already been exposed and has a persistent infection causing cervical cancer. This paper reviews the literature on DNA vaccines and the success in eliminating cervical cancer cells by examining the route of administration. The most successful methods stimulated innate immune responses required to trigger strong and lasting adaptive immune responses. Currently, the best studies focus on gene gun, electroporation, tattooing, and microspheres/nanodelivery. Electroporation has the best results and is slightly more efficacious than the gene gun due to a small advantage in tumor reduction and the presence of larger human sample sizes. Microspheres show promise as well but require more research. The most common limitation of these methods is lack of human trials. The data that has been gathered so far is promising, though, and in the future, it could be groundbreaking in the treatment of cervical cancer due to persistent oncogenic HPV infection.n

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1. Cheng, M.A., Farmer, E., Huang, C., Lin, J., Hung, C.F., & Wu, T.C. (2018). Therapeutic DNA Vaccines for Human Papillomavirus and Associated Diseases. Hum Gene Ther, 29(9),971-996. doi:10.1089/hum.2017.197
2. Pokorna, D., Rubio I., & Muller M. DNA-vaccination via tattooing induces stronger humoral and cellular immune responses than intramuscular delivery supported by molecular adjuvants. Genet Vaccines Ther, 2008;6(4).
3. Gopee, N.V., Cui Y., Olson G., et al. Response of mouse skin to tattooing: use of SKH-1 mice as a surrogate model for human tattooing. Toxicology and Applied Pharmacology. 2005;209(2):145-158
4. Pokorna D., Polakova I., Kindlova, M., et al. Vaccination with human papillomavirus type 16-derived peptides using a tattoo device. Vaccine. 2009;27(27),3519-3529
5. Van den Berg J.H., Nujien B., Beijnen J.H., et al. Optimization of intradermal vaccination by DNA tattooing in human skin. Hum Gene Ther.2009; 20(3): 181-189
6. Van de Wall S., Walczak M., van Rooij N., et al. Tattoo Delivery of a Semliki Forest Virus-Based Vaccine Encoding Human Papillomavirus E6 and E7. Vaccines (Basel). 2015;3(2):221-238.
7. Chen C.H., Ji H., Suh K.W., et al. Gene gun-mediated DNA vaccination induces antitumor immunity against human papillomavirus type 16 E7-expressing murine tumor metastases in the liver and lungs. Gene Ther. 1999;6(12):1972-1981.
8. Gurunathan S., Klinman D.M., & Seder R. A. DNA vaccines: immunology, application, and optimization. Annu Rev Immunol.2000;18: 927-974.
9. Trimble C., Lin C.T., Hung C.F., et al. Comparison of the CD8+ T cell responses and antitumor effects generated by DNA vaccine administered through gene gun, biojector, and syringe. Vaccine.2003;21(25-26):4036-4042
10. Garza-Morales R., Perez-Trujillo J.J., Martinez-Jaramillo E., et al. A DNA Vaccine Encoding SA-4-1BBL Fused to HPV-16 E7 Antigen Has Prophylactic and Therapeutic Efficacy in a Cervical Cancer Mouse Model. Cancers (Basel).2019;11(1).
11. Alvarez R.D., Huh W.K., Bae S., et al. A pilot study of pNGVL4a-CRT/E7(detox) for the treatment of patients with HPV16+ cervical intraepithelial neoplasia 2/3 (CIN2/3). Gynecol Oncol.2016;140(2):245-252.
12. Smahel M., Polakova I., Duskova M., et al. The effect of helper epitopes and cellular localization of an antigen on the outcome of gene gun DNA immunization. Gene Ther.2014;21(2):225-232
13. Best S.R., Peng S., Juang C.M., et al. Administration of HPV DNA vaccine via electroporation elicits the strongest CD8+ T cell immune responses compared to intramuscular injection and intradermal gene gun delivery. Vaccine.2009; 27(40):5450-5459
14. Gothelf A., Gehl J. What you always needed to know about electroporation based DNA vaccines. Hum Vaccin Immunother.2012;8(11):1694-1702.
15. Sales N.S., Silva J.R., Aps L., et al. In vivo electroporation enhances vaccine-mediated therapeutic control of human papilloma virus-associated tumors by the activation of multifunctional and effector memory CD8(+) T cells. Vaccine.2017;35(52):7240-7249.
16. Best S.R., Peng S., Juang C.M., et al. Administration of HPV DNA vaccine via electroporation elicits the strongest CD8+ T cell immune responses compared to intramuscular injection and intradermal gene gun delivery. Vaccine.2009;27(40):5450-5459.
17. Kim T.J., Jin H.T., Hur S.Y., et al. Clearance of persistent HPV infection and cervical lesion by therapeutic DNA vaccine in CIN3 patients. Nat Commun.2014;5:5317
18. Bagarazzi M.L., Yan J., Morrow M.P., et al. Immunotherapy against HPV16/18 generates potent TH1 and cytotoxic cellular immune responses. Sci Transl Med. 2012;4(155):155ra138.
19. Trimble C.L., Morrow M.P., Kraynyak K.A., et al. Safety, efficacy, and immunogenicity of VGX-3100, a therapeutic synthetic DNA vaccine targeting human papillomavirus 16 and 18 E6 and E7 proteins for cervical intraepithelial neoplasia 2/3: a randomised, double-blind, placebo-controlled phase 2b trial. Lancet.2015;386(10008):2078-2088
20. Suschak J.J., Williams J.A., Schmaljohn C.S. Advancements in DNA vaccine vectors, non-mechanical delivery methods, and molecular adjuvants to increase immunogenicity. Hum Vaccin Immunother.2017;13(12):2837-2848. doi:10.1080/21645515.2017.1330236
21. Saade, F., Petrovsky, N. Technologies for enhanced efficacy of DNA vaccines. Expert Rev Vaccines.2012;11(2):189-209
22. Morrow M.P., Kraynyak K.A., Sylvester A.J., et al. Clinical and Immunologic Biomarkers for Histologic Regression of High-Grade Cervical Dysplasia and Clearance of HPV16 and HPV18 after Immunotherapy. Clin Cancer Res.2018;24(2):276-294
23. Vici P., Mariani L., Pizzuti L., et al. Immunologic treatments for precancerous lesions and uterine cervical cancer. J Exp Clin Cancer Res.2014;33(29).

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nCOVID-19 began so suddenly that no one imagined that it could be for such a long stretch. A tiny virus locked down the whole world within very short notice. Life just turned to a much-unexpected patch. Is it to be taken seriously knowing the reality of the happenings? Having been objective to this scenario, it has left one in a very indefinite condition. The authorities globally are taking adequate and desired moves to provide people sufficient information and guidelines in order to encounter the dreaded pandemic COVID-19. With the people’s co-operation, many countries have fought the pandemic by abiding with the advice given by the Ministry of Health and Family Welfare. Realities OF COVID-19: The eruption of pandemic COVID-19 all over the world has disrupted the political, social, economic, religious, and financial layout of the whole world. What to look for if infected with coronavirus? Check for signs of an itchy throat, dry throat, dry cough, high temperature, shortness of breath, loss of smell. Stages OF COVID: COVID in nose—recovery time is half a day. (Steam inhalation), Vitamin C. Usually no fever. Asymptomatic. COVID in the throat—sore throat, recovery time 1 day (hot water gargle, warm water to drink, if temperature, then paracetamol. Vitamin C, B complex. If severe, then antibiotic. COVID in lungs—cough and breathing difficulty 4 to 5 days. (Vitamin C, B-complex, warm water gargle, oximeter, paracetamol, oxygen cylinder if severe, lot of fluids required, deep breathingexercises. Management: Protect yourself and others from the spread of COVID-19, safe use of alcoholbased hand sanitizers; Alert: when to approach the hospital, tips to boost the immune system, COVID medical kit required at home.n

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1. Government of India. (2020, June.) India fights corona COVID-19. [Online] Available from https://www.mygov.in/covid-19
2. World Health Organization. (2020, Nov.) Coronavirus disease (COVID-19) advice for the public. [Online] Available from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
3. BBC News. (2020, May.) Mumbai: how Covid-19 has ravaged India’s richest city. [Online] Available from https://www.bbc.com/news/world-asia-india-52798740
4. TATA Health. Insta Doc. [Online] Available from https://www.tatahealth.com/online-doctor-consultation/general-physician
5. WIRE. (2020, May.) Politics and COVID-19: will the pandemic result in state power expanding? [Online] Available from https://thewire.in/politics/india-politics-coronavirus-state-power
6. Priyanka Bajaj. (2020, June.) The silver lining behind the COVID-19 cloud. Outlook poshak. [Online] Available from https://poshan.outlookindia.com/story/poshan-news-the-silver-lining-behind-the-covid-19-cloud/353991
7. Brand South Africa. (2020, May.) The importance of your immune system in fighting COVID-19 and how to keep it healthy. [Online] Available from https://www.brandsouthafrica.com/covid19/ the-importance-of-your-immune-system-in-fighting-covid-19-and-how-to-keep-ithealthy?gclid=EAIaIQobChMI8aj549DJ6gIV2RwrCh0LSQQsEAAYAiAAEgJe9vD_BwE
8. Centers for Disease Control and Prevention. (2020, Nov.) Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). [Online] Available from https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
9. Medscape. (2020, July.) Symptoms and management of coronavirus disease 2019 (COVID-19) [Online] Available from https://emedicine.medscape.com/article/2500122-overview
10. Johns Hopkins Medicine. What is coronavirus? [Online] Available from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus

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nVaccines are especially important for older adults. As they get older, their immune system weakens and it can be more difficult to fight off infections. Vaccines can protect from serious diseases. Vaccines are crucial to prevent mortality. This study was aimed to asses the effectiveness of health awareness program upon adult vaccination among visually challenged. Methods: The study was conducted using pre-experimental research design among visually challenged at National Institute for the Visually Handicapped, Chennai among 70 samples who were selected using total enumerative sampling technique. Data was collected using 10 items MCQ questionnaire on knowledge regarding adult immunization using interview method. Results: The study findings revealed that there was significant improvement in the knowledge score in posttest (8.26/10, SD.18) than pretest (4.14/10, SD. 1.68) (p<0.001). Conclusion: The study findings revealed that, the health awareness program is effective in enhancing the knowledge regarding adult immunization among the visually challenged.n

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“1. Verma R, Khanna P, Chawla S. Adult immunization in India: Importance and recommendations. Hum VaccinImmunother. 2015;11(9):2180-2.
2. Alexander Muacevic, John R Adler Samar Zaki, et al.Frequency and Factors Associated with Adult Immunization in Patients Visiting Family Medicine Clinics at a Tertiary Care Hospital, Karachi Cureus. 2018; 10(1): e2083.
3. Centers for Disease Control and Prevention. 2012. Recommended adult immunization schedule—United States –2012. (Online) Available from www.cdc.gov/vaccines/schedules/downloads/adult/adultschedule.pdf. 12.
4. Ministry of Health and Family Welfare. 2010. Operational Guide Japanese Encephalitis Vaccination in India. (Online) Available from: http://www.iapcoi.com/hp/Dec%2025th/Guidelines-Japanese-Encephalitis,%20MoHFW,%20September%202010[2].pdf
5. Sharadha K. (2014, Feb) The Grown-ups Vaccines. (Online) Available from http://www.newindianexpress.com/cities/bangalore/The-Grown-ups%E2%80%99-Vaccines/2014/02/05/article2038944.ece
6. Whitley RJ, J. Larry Jameson, Anthony S. Fauci. Harrison’s Principles of Internal Medicine. 20 ed.New York, USA: McGraw-Hill publisher.2011
7. Elderly in India. 2016. Available from http://mospi.nic.in/sites/default/files/publication_reports/ElderlyinIndia_2016
8. Granados R et al. Efficacy of High dose versus standard dose influenza vaccine in older adult. The New England Journal a phase of Medicine. 2014;371(1):635-648.
9. Polit, D.F, Beck, C.T. Nursing Research, Generating and Assessing Evidence for Nursing Practice. 9th ed. New Delhi, Lippincott Williams and Wilkins. 2017.
10. K. Park. Park Textbook of Preventive and Social Medicine. 24th ed. page no 2015.

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nHuman body is affected by direct entry of pathogen and its collateral damage of immune response by pathogen. Cytokines are specific type of proteins which are secreted by the immune system. It encodes the molecules which help in building immunity, inflammation and hematopoiesis. Cytokines are important for stimulating the immune system to fight a foreign pathogen or attack tumors. Effects include reduction of an immune response, for example interferon beta reduction of neuron inflammation in patients with multiple sclerosis. It affects the growth of all blood cells and other cells that help the body’s immune and inflammation response. There is a specific type of cytokine named as chemokine.n

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1. The National Academics of Science Engineering Medicine. Learining from SARS Preparing for the
Next Disease Outbreak: Workshop Summary. Washington DC: The National Academics Press;
2004. Available from: https://www.nap.edu/catalog/10915/learning-from-sars-preparing-for-the-
next-disease-outbreak-workshop
2. Doremalen N, Bushmaker T, Morris DH, Gamble A, Williamson BN, Tamin A, Harcourt JL,
Thornburg NJ, Gerber SI, Witt DE, et al. Aerosal and surface stability of HCov (SARS-CoV-2)
compared to SARS-CoV-1. N Engl J Med. 2020; 382(16): 1564–1567p.
3. Matthay MA, Aldrich JM, Gotts JE. Treatment for severe acute respiratory distress syndrome from
COVID-19. Lancet Respir Med. 2020; 8(5): 433–434p.
4. Elsevier. Elsevier’s free health and medical research on novel coronavirus. Elsevier [Online]; 2020
Mar. Available from: https://www.elsevier.com/connect/coronavirus-information-center
5. National Institutes of Health. Communities Fighting COVID! NIH [Online]; 2020 Mar Available
from: https://covid19.nih.gov/
6. Hickman RJ. What is cytokine storm syndrome: An exaggrerated and dangerous immune response.
Verywell health [Online]; 2020 Apr 23. Available from: https://www.verywellhealth.com/cytokine-
storm-syndrome-4842383
7. Caricchio R, Gallucci M, Dass C, Zhang X, Gallucci S, Fleece D, Bromberg M, Criner GJ, Temple
University COVID-19 Research Group. Preliminary predictive criteria for COVID-19 cytokine
storm. Ann Rheum Dis. 2020; 80(1): 3–5p.
8. Tisoncik JR, Korth MJ, Simmons CP, Farrar J, Martin TR, Katze MG. Into the Eye of the Cytokine
Storm. Microbiol Mol Biol Rev. 2012; 76(1): 16–32p.
9. Song P, Li W, Xie J, Hou Y, You C. Cytokine Storm Induced by SARS-CoV-2. Clin Chim Act.
2020; 509: 280–287p.
10. Coperchini F, Chiovato L, Croce L, Magri F, Rotondi M. The cytokine storm in COVID-19: An
overview of the involvement of the chemokine/chemokine receptor system. Cytokine Growth
Factor Rev. 2020; 53: 25–32p.

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