High-altitude cerebral edema manifesting as T2/FLAIR hyperintensity and microbleeds in the white matter on MRI brain.

High-altitude cerebral edema is a rare type of acute mountain illness characterized by consciousness disruption and truncal ataxia. Here we discuss a 40-year-old nondiabetic, nonsmoker male who went on a tour to Nanga Parbat. On returning home, the patient developed symptoms of headache, nausea, and vomiting. His symptoms worsened with time and he developed lower limb weakness and shortness of breath. Later, he underwent a computerized tomography chest scan. On the basis of CT scan findings, the doctors decided that the patient was suffering from COVID-19 Pneumonia despite having negative COVID-19 PCR tests multiple times. Later, the patient presented to our hospital with similar complaints. MRI of the brain revealed T2/fluid-attenuated inversion recovery hyperintense and T1 hypointense signals in the bilateral semioval centrum, posterior periventricular white matter, and corpus callosum genu, body, and splenium. These abnormal signals were discovered to be more evident in the corpus callosum's splenium. Moreover, susceptibility-weighted imaging revealed micro hemorrhages in the corpus callosum. This verified the diagnosis that the patient is suffering from high-altitude cerebral edema. Within 5 days, his symptoms resolved and he was discharged with full recovery.

The Impact of Hospitality Work Environment on Employees' Turnover Intentions During COVID-19 Pandemic: The Mediating Role of Work-Family Conflict.

Employees' turnover intentions and work-family conflict as a result of the hospitality work environment are considered the major global challenges confronted by hospitality organizations, especially in the era of COVID-19. This study aims at identifying the impact of the hospitality work environment on work-family conflict (WFC), as well as turnover intentions and examining the potential mediating role of WFC in the relationship between work environment and turnover intentions, during the COVID-19 pandemic in a sample of three- and four-star resorts in Egypt. A total of 413 resorts employees from Egyptian destinations (Sharm El-Sheikh and Hurghada) participated in the study. The findings of the Structural Equation Modeling (SEM) revealed that the hospitality work environment significantly and positively affects employees' turnover intentions and WFC. In the context of the mediating role of WFC, results illustrated that WFC significantly partially mediates the relationship between the hospitality work environment and turnover intentions. Upon these findings, the study suggests that to prevent WFC and eliminate turnover intentions among resorts' employees, an urgent need to create a better work environment is vitally important. limitations and future research directions have been discussed.

Implementation of Covid-19 protection protocols and its implication on learning & teaching in public schools.

This study aimed to investigate the implementation of COVID-19 protection protocols and its implication on teaching -learning process in schools of Werabe administrative town. A concurrent embedded research design and mixed approach were used to carry out the current study and collect data in that order. To conduct the study, 140 teachers, 12 principals, and 6 supervisors were selected by simple random, purposive, and availability sampling techniques respectively. To gather the data, a questionnaire, semi-structured interview, observation checklist, focus group discussion, and document analysis were used. The analysis of quantitative data was carried out by using mean and multiple regressions, while qualitative data was analysed through thematic description and word narration. The results showed that COVID-19 protection protocols were not strictly implemented as per the standards set by both Ministry of Education and the World Health Organization. In addition, the study exposed school community-related factors like reluctance in keeping physical distancing (mean = 4.28, Beta = 0.29, p < 0.05) and resource-related factors like shortage of thermometer (mean = 2.85, Beta = 0.25, p < 0.05) are significantly affecting the implementation of COVID-19 protection protocols. The findings further indicated that the school-community related and the resource-related factors directly affected the classroom teaching-learning process, render students' families and education sectors for additional financial expenses. Therefore, encouraging communication and coordination among education actors, families, learners, and health communities need to be re-strengthened, and the implementation of protection protocols has to be enforced.

Quarantine-related traumatic stress, views, and experiences during the first wave of Coronavirus pandemic: A mixed-methods study among adults in Saudi Arabia.

PURPOSE: Mental health is a significant problem following exposure to a traumatic event. This study aimed to examine quarantine-related experiences, traumatic stress, and coping strategies among adults quarantined in Saudi Arabia due to coronavirus disease 2019 (COVID-19) exposure or travel history. METHODS: Individuals aged ≥ 18 years who were quarantined in Saudi Arabia due to COVID-19 exposure or travel history were included. We used a sequential mixed methods design, using an online survey followed by in-depth individual telephonic interviews. The Impact of Event Scale-Revised (IES-R) was used to measure post-traumatic stress disorder (PTSD) symptoms after the quarantine. To identify factors associated with significant symptoms (IES-R score ≥ 33), prevalence ratios (PR) with 95% confidence intervals were computed using Poisson regression with robust error variance. In the next phase, a subset of the participants (n = 26) were interviewed to elicit their quarantine-related experiences and coping responses. Major themes and subthemes were identified. RESULTS: Of the 111 adults who completed the survey, 32 (28.8% [95% CI, 21.1-38.0%]) had significant PTSD symptoms (IES-R score ≥ 33) and 27 (24.3% [95% CI, 17.2-33.3%]) had severe symptoms (IES-R score > 37). Marital status was the only variable that was significantly associated with significant PTSD symptoms (P = 0.028). Significant symptoms were twice as prevalent in married adults than among other marital groups (PR 2.00, 95% CI, 1.08-3.72). Participants reported negative emotions such as overwhelming fear, helplessness, anxiety, and disgust. Participants utilized both problem-centered coping (e.g., use of social support) and emotion-centered coping (e.g., use of positive diversionary activities) during the quarantine period. CONCLUSION: PTSD symptoms were present in one out of every four quarantined persons. The quarantine experience is viewed negatively. These findings highlight the need for increased awareness about stress-related disorders among quarantined individuals. Efforts are needed to detect and manage these symptoms early while making the quarantine experience more satisfying for the involved individuals and groups.

Emergence of deadly severe acute respiratory syndrome coronavirus-2 during 2019-2020.

Wuhan, the city in Hubei province in China is in the focus of global community due to the outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), formerly known as 2019-nCoV. The virus emerged in humans from Wuhan seafood market probably via zoonotic transmission. Within a few days the virus spread its tentacles rapidly to neighboring cities in China and to different geographical regions through travelers and to some extent by human to human transmission leading to significant disease burden globally. More than 2,00,000 people (including more than 8000 deaths) have been infected with this respiratory illness across 167 countries and territories worldwide leading to a pandemic. The present review provides an outline about emergence and spread of SARS-CoV-2 from Wuhan, China in 2019-2020. We have also provided information about the classification, genome, proteins, clinical presentation of COVID-19, type of clinical specimens to be collected and diagnostic methods adopted to identify the respiratory illness. In addition we have also provided information about transmission dynamics, prevention measures and treatment options that are available at the present. Subsequently, we have given a comprehensive overview of the spread of this infection from China to the other parts of the globe. Management of the ongoing outbreak of SARS-CoV-2 encompassing surveillance, clinical, immunological, genetic and evolutionary investigations are likely to provide the desired results. Joint efforts of global scientific community are needed at this hour in terms of enhancement of research on development of accurate diagnostics, antiviral therapeutics and finally into formation of an effective vaccine against the emerging novel coronavirus.

Climate factors and incidence of Middle East respiratory syndrome coronavirus.

BACKGROUND: Our understanding of climate factors and their links to the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreaks is incomplete. This study aimed to estimate the monthly incidence of MERS-CoV cases and to investigate their correlation to climate factors. METHODS: The study used aggregated monthly MERS-CoV cases that reported to the Saudi Center for Disease Prevention and Control from the Riyadh Region between November 1, 2012 and December 31, 2018. Data on the meteorological situation throughout the study period was calculated based on Google reports on the Riyadh Region (24.7136°N, 46.6753°E). The Poisson regression was used to estimate the incidence rate ratio (IRR) and its 95% confidence intervals (CI) for each climate factor. RESULTS: A total of 712 MERS-CoV cases were included in the analysis (mean age 54.2±9.9 years), and more than half (404) (56.1%) MERS-CoV cases were diagnosed during a five-month period from April to August. The highest peak timing positioned in August 2015, followed by April 2014, June 2017, March 2015, and June 2016. High temperatures (IRR=1.054, 95% CI: 1.043-1.065) and a high ultraviolet index (IRR=1.401, 95% CI: 1.331-1.475) were correlated with a higher incidence of MERS-CoV cases. However, low relative humidity (IRR=0.956, 95% CI: 0.948-0.964) and low wind speed (IRR=0.945, 95% CI: 0.912-0.979) were correlated with a lower incidence of MERS-CoV cases. CONCLUSION: The novel coronavirus, MERS-CoV, is influenced by climate conditions with increasing incidence between April and August. High temperature, high ultraviolet index, low wind speed, and low relative humidity are contributors to increased MERS-CoV cases. The climate factors must be evaluated in hospitals and community settings and integrated into guidelines to serve as source of control measures to prevent and eliminate the risk of infection.