covid-19 pandemic

Atheroembolic disease (AED), or Cholesterol Crystals Embolism, is a systemic disease presented as a complication of severe atherosclerosis [1], where older age, male sex, diabetes hypercholesterolemia, smoking and hypertension [2], are the main risk factors for the development of Atherosclerosis, it is known that spontaneous atherosclerotic renal disease is rare in the absence of any vascular intervention [3], and in the absence of anticoagulant [4], or the absence of calcified aorta, with the most common presentation of the disease is subacute kidney injury progress into renal dysfunction occurs in like a staircase pattern and the renal dysfunction is usually observed several weeks after a possible intervention, caused by dislodging the micro cholesterol plaques from a major artery, and start showering multiple organs causing micro and macro embolic phenomena. In our case, we report acute kidney injury on a previously stable kidney disease in a female with diabetes mellitus type 2 presented with severe anemia, dyspnea, massive fluid overload with bilateral pleural effusion, patient had a history of multiple IV contrast exposures, with peripheral vascular occlusive disease (PVOD), required amputation of right below the knee amputation, presented during the COVID-19 pandemic, found with nephrotic syndrome, a kidney biopsy has shown cholesterol crystal embolization compatible with Athero-embolic Disease with severe Diabetic Nephropathy.

A growing figure of data proposes that outcomes with Coronavirus Disease 2019 are worse in those suffering from obesity and that a significant proportion of those requiring intensive care suffers from overweight or obesity [1]. 

Solid tumor oncology treatments are primarily performed in the outpatient setting. However, hospitalizations are inevitable due to complications of cancer and treatment-related toxicities. With rising health care spending, the length of hospital stay (LOS) is increasingly considered a proxy for healthcare costs. There are several ongoing efforts to abbreviate the inpatient LOS and ensure a safe and timely discharge to the outpatient setting. In addition to the acute illness and the associated comorbidities, various factors affect the LOS: social determinants of health (SDOH), nutritional status in cancer patients, and end-of-life issues. Furthermore, it is unclear how the institutional policies on social distancing and visitation during the current coronavirus disease (COVID-19) pandemic may impact the LOS. The purpose of this article is to review various factors and barriers that lead to longer LOS for solid tumor patients during the COVID-19 pandemic, and identify the critical areas of quality improvement.

Considering the geographical complexity and adversity, online communication and consultation are viable method in Nepal. The COVID-19 pandemic has accelerated the already starting trend of use of these technologies in medicine. In BPKIHS, telemedicine efforts were already initiated; lockdown rather warranted its maximum use. Here is an account of the observation made in telepsychiatry service provided by a consultant psychiatrist of its department of psychiatry. It is an institute-based observation noted for all the telepsychiatry consultations in 9 random duty days of the COVID-19 pandemic. Basic necessary information was noted down in a semi-structured proforma, like: socio-demographic, clinical information and advice provided. There were 104 subjects; 73 follow-up and 31 new: 60 male and 44 female cases. Clients of multi-ethnic groups were the most from urban, then semi-urban and least from rural areas. More consultations were for young age-groups and from nearby districts of Sunsari. Mood, somatic (sleep), anxiety were the top presenting complaints and 8/104 clients had suicidal symptoms. Maximum follow-up cases were improving. The most common diagnoses were: Mood (Depression and Bipolar), Anxiety, Psychosis and Substance use disorders. Most common treatment advices included: Antidepressants, Antipsychotics, Benzodiazepines and Counseling/psycho-education. Telepsychiatry is a viable method of delivering service even during the pandemic. 

The lockdown, implemented in response to the COVID-19 epidemic, restricted the operation of various sectors in the country and its highlights a good environmental outcome. Thus, a comparison of air pollutants in India before and after the imposed lockdown indicated an overall improvement air quality across major Indian cities. This was established by utilizing the Central Pollution Control Board’s database of air quality monitoring station statistics, such as air quality patterns. During the COVID-19 epidemic, India’s pre-to-post nationwide lockdown was examined. The air quality data was collected from 30-12-2019 to 28-04-2020 and synthesized using 231 Automatic air quality monitoring stations in a major Indian metropolis. Specifically, air pollutant concentrations, temperature, and relative humidity variation during COVID-19 pandemic pre-to-post lockdown variation in India were monitored. As an outcome, several cities around the country have reported improved air quality. Generally, the air quality, on a categorical scale was found to be ‘Good’. However, a few cities from the North-eastern part of India were categorized as ‘Moderate/Satisfactory’. Overall, the particulate matters reduction was in around 60% and other gaseous pollutants was in 40% reduction was observed during the lockdown period. The results of this study include an analysis of air quality data derived from continuous air quality monitoring stations from the pre-lockdown to post-lockdown period. Air quality in India improved following the national lockdown, the interpretation of trends for PM 2.5, PM 10, SO2, NO2, and the Air Quality Index has been provided in studies for major cities across India, including Delhi, Gurugram, Noida, Mumbai, Kolkata, Bengaluru, Patna, and others.

Background: For the prevention of respiratory infection similar to the current pandemic COVID-19, face masks are considered an effective method. Coronavirus disease (COVID-19) is a highly transmittable virus that continues to disrupt livelihoods, particularly those of low-income segments of society, around the world has poor knowledge towards facemask at the same time has huge gape towards attitude which affects the behaviors. Therefore this study was aimed to assess knowledge, attitude, and practice towards facemask use amid the COVID-19 pandemic among public transport drivers in Debre-Tabor town, Ethiopia, 2021.Methods: A cross-sectional study was conducted among 407 public transport drivers in Debre-Tabor town from July to August 2021. The study participants were selected using a simple random sampling technique after proportionally allocating the sample size from the total number of public transport drivers, and finally, study subjects were elected continuously working in Debre- Tabor Town public transport drivers. The data were collected by trained data collectors using a structured questionnaire with face-to-face interview administered questioners and an on-the-spot observational checklist. The collected data were checked, coded, and entered into SPSS version 23, and for data cleaning and analysis.Result: A total of 407 drivers responded to the questionnaire with a response rate of 96.4% were participated in this study. The mean age was 32.75 years (range: 19-45 years). Among them majority was male 383(94.1%) and the majority of 177(43.5%) were Bajaj drives. Among the responders, 114(28%) used radio to gather information, and 41(10.1%) drivers where were caught by COVID-19, but, only 30(7.4%) were vaccinated COVID-19 vaccine. Knowledge, attitude and practices regarding facemask use among these drivers were 368(90.4% [95% CI: 87.7-93.1]). 163(40% [95% CI: 37.5% - 43.2%]), and 23 ((5.6%) [95% CI: 3.7% - 8.3%]) Regarding facemask use against COVID-19 infection respectivelyConclusion and recommendation: The current study was able to demonstrate 90.4% of drivers had good knowledge. Positive attitude and practice levels of face mask use among drivers were less than half of them or 40%, and 5.6% respectively. There is a high supply of Surgical Face masks but poor attitude and practice. Almost all of the participants don’t wear a face mask despite having good knowledge about the transmission routes of COVID-19. The government COVID-19 prevention task force or health sector should be continued their awareness creation to bring behavioral change for the implementation of the COVID-19 prevention method, especially facemask.

Background: The novel coronavirus is a rapidly spreading respiratory disease that has been declared a pandemic by the World Health Organization (WHO) and a global public health emergency. The use of face masks has been recommended by the WHO and the Centers for Disease Control (CDC) as a standard prevention method for transmission of COVID-19.Objective: The objective of this study is to determine face mask utilization and associated factors in combating the COVID-19 pandemic among government employees in Akaki district administration offices in Akaki District, Oromia, Ethiopia, 2022Methods: A quantitative cross-sectional study was conducted from December 1, 2021, to February 15, 2022, on 385 government employees working in Akaki district administration offices. After obtaining consent from the study participants, data were collected using pretested, self-administered, and standardized questionnaires adapted from other studies. After the data was collected, it was entered into Epi info version 7.2.6, cleaned, and analyzed using SPSS version 26. A logistic regression model was computed to measure the association between the predictor and outcome variables. A p - value of.05 with a 95% CI was used as the cut-off point to declare the level of statistical significance. Results: The study showed that the magnitude of good practice for facemask utilization was 213 (53.5%) (95% CI: 1.50, 1.60) for preventing COVID-19. In the multivariate logistic regression analysis, the odds of using face masks among male employees (AOR = 0.275; 95% CI: 0.137, 0.555), employees aged 20-29 (AOR = 0.17; 95% CI: 0.065, 0.481 ), employees aged 30-39 (AOR = 0.260, 95% CI: 0.109, 0.623), employees of less than five family size (AOR = 0.549, 95% CI: 0.303, 0.995), work experience at 6-12 (AOR = 0, 32, 95 CI: 0.120, 0.450), poor knowledge about face mask use (AOR = 0.504, 95% CI: 0.302, 0.844), and employees with a negative attitude (AOR = 0.430, 95% CI: 0.256, 0.721) were factors significantly associated with face mask utilization.Conclusion: The magnitude of facemask utilization was low (53.5%) compared to other studies. The results of the study showed that age, sex, household family size, work experience, poor knowledge, and the negative attitude of employees toward facemask utilization were among the factors significantly associated with facemask utilization.

For over two years, COVID-19 pandemic has been a major global health concern and threat to human life. In the SARS-CoV2 macromolecules, the 3-chymotrypsin like protease (3CLpro or main protease) has been identified to be crucial and essential for viral survival, processing of the viral polyproteins and has been explored as a target in COVID-19 drug discovery. Although vaccines and other various inhibitors have been designed and launched, the emergence of the variant of this virus has put an unrelenting effort of researchers to this end. Also, the high cost of manufacturing these molecules coupled with the occurrence of drug resistance is a concern.Herein, Pefloxacin and its derivative for the first time were screened for their inhibitory activity against the SARS-CoV2 main protease through in silico analysis and their pharmacokinetic properties were evaluated. Interestingly, from the docking results, they both bind with high affinity at the active site of the protein. Moreover, they showed excellent pharmacokinetic and drug - likeness properties. Derivatization of Pefloxacin at the C7 position prevents its blood-brain barrier permeability. Overall, the dual antibacterial and potential antiviral activities of these two molecules make them promising drug candidates for COVID-19 management.

The COVID-19 pandemic resulted in public health measures and fewer viral infections, which trigger the nephrotic syndrome. Our objectives were to characterize the effect of the COVID-19 pandemic on children with nephrotic syndrome. This single-center retrospective chart review compared children with nephrotic syndrome one year before the pandemic with the first wave of the pandemic. Epidemiologic events, clinical characteristics, and health care utilization were compared using paired t-tests, Fisher’s exact tests and Wilcoxon Rank Sum tests. Among 96 children the mean age was 10.7 ± 5.28 years. The distribution was minimal change disease (16.7%), focal segmental glomerulosclerosis (12.5%), membranous nephropathy (1%) and not biopsied (69.8%). Medication responsiveness was steroid-sensitive (25%), frequently relapsed (54%) and steroid-resistant (20.8%). There were 14 new diagnoses of nephrotic syndrome pre-pandemic and 18 during the pandemic. Fewer relapses during the pandemic were likely due to fewer viral illnesses from public health measures during the pandemic.

The use of complementary and alternative medicine (CAM) applications increased by 39.3% of individuals with chronic diseases during the pandemic process in Turkey. For this reason, this descriptive study was conducted to determine the use of integrative and integrated medicine practices in hemodialysis patients during the COVID-19 pandemic. The population of the study consisted of individuals who were treated in a hemodialysis unit in the city center (n = 235). It was planned to include whole of the population by using the whole number method, but patients, who did not agree to participate in the study and did not meet the inclusion criteria of the study, were excluded from the sample and the study was conducted with 160 patients between 1 June and 1 September 2021. As a data collection tool, a questionnaire consisting of 30 questions including socio-demographic and disease characteristics of the patients was prepared by the researcher upon review of related literature. Considering the distribution of phytotherapy method (herbal treatment) usage frequency of integrative and integrated medicine applications of individuals before the COVID-19 pandemic and during the COVID-19 pandemic period, the most vitamins (21.8%), prebiotics (12.5%), and honey (%) 10.6), their use was found to be high. During the COVID-19 pandemic, the use of massage (40%), breathing exercises (30.0%) and spiritual therapy (28.7%) applications increased. As a result, it is seen that integrative and integrated applications are considered in the process of dealing with hemodialysis patients. Physicians need to be aware of and ask patients about their use of integrated and integrated health practices.

Introduction: Allergen immunotherapy is the only targeted therapy that can modify the natural course of allergic diseases. In pediatric patients, SCIT with aeroallergens is an effective treatment and should be considered as a preventive strategy in the treatment of allergic diseases, even though one of the major concerns about it is its safety. The main purposes of this study were to assess the safety of SCIT ultra-rush schedules with polymerized extracts in a pediatric population and to determine the impact of the COVID-19 pandemic on the safety and time of administration of subcutaneous immunotherapy among pediatric patients.Methods: A retrospective medical records review of patients under 18 years of age undergoing SCIT was made and re-scheduling due to restrictions imposed by the COVID-19 pandemic was recorded. Results: A total of 192 pediatric patients were included. Fifty-nine (31%) had local reactions and systemic reactions were not reported. In March 2020, the first case of COVID-19 was diagnosed in Portugal and all non-urgent appointments and procedures were postponed. In our group of pediatric patients, 43 (22%) were referred to primary care, 38 (20%) stopped AIT definitively and 111 (58%) maintained administrations in the hospital. Only 2 (2%) of them had reactions upon reinitiation. Conclusion: In this study, the ultra-rush protocol using polymerized extracts was safe in pediatric patients. Although the effectiveness of AIT may be compromised due to prolonged suspension of the treatment, it is important to note that despite longer interruptions, administrations may continue without compromising safety, maintaining shorter visits and a lower number of injections.

Viruses becoming day by day dominate over humans, as a covid-19 pandemic is not jet over, new monkeypox virus infection cases emerged in the month of May 2020. On 13th May 2020 WHO reported monkeypox virus cases from 12 member states that are epidemic for this virus. In the past monkeypox virus are rarely seen outside of west and central Africa. Investigations are going to establish a travel link between reported cases and epidemic areas. There are very little data regarding viral mechanism or time of shading and still, we have no licensed treatment. Two smallpox-approved drugs brincidofovir and tecovirimat have efficacy against monkeypox shown in animals. Now two smallpox-recommended vaccinations JYNNEOS and ACAM2000 are also available and are efficient to prevent the monkeypox virus. Two second- and third-generation Vaccinations are recommended by WHO for people that are immunocompromised and children’s MVA-BN, LC16. This article aims to raise awareness of virus spread, providing information regarding virus detail, severity, precautions, and detection.

SARS-CoV-2 is the virus associated with the disease called COVID-19 and become a global pandemic. The only way to prevent its severe scenarios is through timely and rapid testing. In comparison to more time taking gold-standard RT-PCR testing, rapid diagnostic kits are used. For better prevention and diagnosis of SARS-CoV-2, the analysis of rapid diagnostic kits' accuracy and specificity is necessary. This study is meant to assess and examine the viability, responsiveness, and explicitness of quick antigen distinguishing nasopharyngeal swabs (NPS), and saliva-based units. The study was conducted on 200 suspected COVID-19 patients from Islamabad, 100 of which were RT-PCR positive while 100 were RT-PCR negative. For the analysis of Rapid diagnostic COVID-19 kits (RDT), nasopharyngeal swabs (NPS) and saliva samples were taken from the RT-PCR positive and negative patients. Among 100 RT-PCR positive patients, 62% were males (19 - 91 years), 34% were females (20 - 78 years) and 4% were children (6 - 17 years). False-negative results were significantly more observed in saliva-based RDTs of the sample (49%) as compared to nasopharyngeal swab RDT (38%). There were 2% invalid results in saliva-based RDT and 3% invalid results in Nasopharyngeal swab RDT. While among 100 RT-PCR negative patients 69% were males (19 - 80 yrs), 27% were females (18 - 77 yrs) and 4% were children (12 - 16 yrs.). False positive results were significantly more in saliva-based RDT (22%) as compared to Nasopharyngeal swab RDT (13%). The sensitivity and specificity of saliva-based RDT were 67% and 87% respectively while that of Nasopharyngeal swab (NPS) was 72% and 82% respectively, both of which were less than the gold standard RT-PCR sensitivity demanding the introduction of more sensitive RDT kits in Pakistan for accurate detection of COVID-19.

The COVID-19 pandemic appeared in late 2019 and became a major health concern with rapid transmission and very high mortality rates across the globe. Although precautionary, preventive, protective and therapeutic measures have been adopted against COVID-19, still the disease has drastically affected people. In order to overcome the challenges of the pandemic, the understanding of the route of transmission, its fusion with receptors and invasion into the human body and hacking the immune system, the viral genome was sequenced. The viral genome keeps on mutating and altering its original form into its subtypes. Moreover, age and comorbid conditions had their impact on developing the disease differing from individual to individual due to interaction varying between the host genome and virus. Considering the pathogenesis of the virus, neutralizing antibodies reduced the viral impact and severity. This review is focused on highlighting the COVID-19 genome, host genetic factors, the pathogenesis of the disease and available therapeutic measures to overcome the pandemic.

The impact of vitamin D on the musculoskeletal system is well known. The diverse role of vitamin D is well supported by the functionality of vitamin D receptors and vitamin D activating enzymes (hydroxylase) present in tissues and cells. Hypovitaminosis D causes rickets, osteomalacia, hyperparathyroidism, and an increased risk of bone fracture. Vitamin D has immune-stimulatory effects on both the innate and adaptive immune systems. Vitamin D induces antimicrobial peptide cathelicidin and defensin that can inhibit viral replication of pro-inflammatory cytokines that regulate inflammatory encasement. Moreover, several studies on vitamin D have shown its interdictory role in the immune and respiratory systems. This global crisis, the COVID-19 pandemic condition has increased the risk of acute respiratory tract infection by immune dysregulation along with cytokine storm, which further progress into acute respiratory distress syndrome. Vitamin D has immunomodulatory and anti-inflammatory properties which are effective against respiratory viral infections. Vitamin D supplementation has shown a compatible effect on viral infection. This review article discusses the role of vitamin D in reducing the risk of respiratory infections including the severity of COVID-19 infections. This review focuses on the therapeutic role of vitamin D to improve clinical outcome during COVID-19 infection and suggest its possible role in the prevention and treatment of respiratory infections.

Disruption to contrast agent supply chains for radiology investigations has become an additional consequence of the COVID-19 pandemic. Various recommendations, including dose reductions and choices of alternative agents, have been made to help account for this limited availability. This case demonstrated how two separate CT venograms with different contrast agents, undertaken on the same day for the same patient, yielded different results; venous thromboses were more prominent in the subsequent scan. Although there was some evidence of venous sinus thrombosis on the first scan, repeat imaging was required to further characterize the lesions identified. The case exemplifies the notion that diagnostic imaging should always be guided by a detailed history and examination. It also raises the discussion point of whether more strict or uniform protocols should be developed to facilitate contrast administration for radiology investigations. It is important that appropriate doses are always administered to maximize diagnostic yield.

The COVID-19 Pandemic, which began in March 2020, and its associated surges, had an immense impact on our medical staff and their ability to perform their daily duties.The COVID-19 Pandemic necessitated hospital modifications, including the expansion of the Emergency Department, ICU, and Isolation units. The overwhelmed staff and overburdened ER and ICU required adjustments to deal with the Inpatient impasse. For example, temporary patient care rooms needed to be set up for the overflow of patients. The tsunami of the Pandemic almost overwhelmed our hospital.With the challenges presented to our hospital during the Pandemic, we needed a fresh perspective to our multi-disciplinary approach. Thus, we fathomed that the use and cost-effectiveness of both Dalbavancin, a long-acting lipoglycopeptide antibiotic combined with the diagnostic Moleculight Imaging Device would be a sound decision.We hypothesized that with the use of this cost-effective antibiotic in conjunction with the use of the Moleculight Imaging Device, with its fluorescent imaging, we could detect the presence of bacteria and assist our wound treatment and decision-making.A shift in patients from the Emergency Room/Inpatient Department to the Outpatient Department/Wound Care Center was made possible with the use of these two novel products.

Introduction: Child Protection Services (CPSs) are dedicated to providing protection and responding to any threats a child could face as children worldwide could be abused. Recently, the COVID-19 pandemic affected all aspects of life. Procedures implemented to restrict the spread of the disease (such as reduced access to services, school closure, and social distancing measures) had an impact on child life and maltreatment. Therefore, it is important to know the impact of this pandemic on child abuse and protection. Aim and rationales: This study aimed to assess the impact of COVID-19 on CPSs in Oman by studying the change in the number of reported cases of child abuse and the change in the reporting procedure at the Ministry of Social Development (MOSD). In addition, know the impact of the restriction measures on child rights and risk factors of child maltreatment based on CPSs workers’ opinions and experience. To understand the adaptation of the CPSs to the change in work and life environment imposed by COVID-19. Method: A cross-section study was conducted using a semi-structured questionnaire, that was distributed to the workers involved in the CPSs at the MOSD in Oman. Data also were collected from the statistical bulletins on the Ministry’s website. Results: COVID-19 pandemic was not found associated with a significant change in the number and type of child abuse cases reported to the MOSD. The reporting procedures also did not change. In addition, the pattern of child abuse types did not change before and during the pandemic, as neglect cases were the most. The participants judged the restriction measures affecting family life through separation, cyber abuse, and reduced educational support. With regard to intervention and follow-up procedures, the main difference was in the communication processes by using online communication methods and reducing the fieldwork for mild cases.Conclusion: CPSs in Oman were not much affected by the COVID-19 pandemic, which may reflect the success of this system in dealing with the restriction measures. However, more solutions should be developed to adapt to these circumstances in the future altogether.

Background: In light of the COVID-19 pandemic and the health crisis left in its wake, our goal is to develop extensive machine-learning techniques to provide a clear picture of the treatment, and possible mistreatment, of specific patient demographics during hospital triaging.Objective: We aim to reveal whether a patient’s treatment and hospital disposition is related to the following attributes - Emergency Severity Index (ESI), gender, employment status, insurance status, race, or ethnicity which our 100 MB dataset included.Materials and methods: Our work is separated into two parts - the classification task and data analysis. As part of the classification task, we used the k-Nearest-Neighbor classifier, the F1-score, and a random forest. We then analyze the data using SHapley Additive exPlanations (SHAP) values to determine the importance of each attribute.Results: Our findings show that significance varies for each attribute. Notably, we found that patients with private insurance programs receive better treatment compared to patients with federal-run healthcare programs (e.g. Medicaid, Medicare). Furthermore, a patient’s ethnicity has a greater impact on treatment for patients under 40 years of age for any given ESI level. Surprisingly, our findings show language is not a barrier during treatment.Discussion and conclusion: We, therefore, conclude that although hospitals may not be doing so intentionally, there is a systemic bias in hospital triaging for specific patient demographics. For future works, we hope to aggregate additional patient data from hospitals to find whether specific demographics of patients receive better healthcare in different parts of the United States.

The 2019 COVID-19 pandemic caused by SARS-CoV-2 has resulted in many fatalities worldwide. Despite various types of supportive care, mortality rates for patients with comorbidities remain high. To explore alternative treatment options, interferons (IFNs) have emerged as promising therapeutic drugs for SARS-CoV-2. This review aims to investigate the potential of IFNs as a drug with details on their mechanisms of action, and available data on their use with ongoing clinical trials, results, potential limitations, and challenges.  Recently published research articles, which are systematically searched through online databases, have been selected and found that IFNs have colossal potential in treating SARS-CoV-2 infection by modulating the host’s immune response and inhibiting viral replication and decreasing the severity of disease and hospitalization (p = 0.03, ± 0.05) and (p = 0.04, ± 0.05) respectively. However, due to less available data, more controlled and randomized trials are needed to confirm the efficacy and safety of IFN therapy.  The optimal dosing and duration of IFN therapy also remain to be determined. Although further research is needed the wait for ongoing clinical trial results under investigation is also important for a better understanding of IFN therapy.