ABSTRACT
Smart health is a relatively new paradigm where information and communication technology is utilized to improve health care and medical services. In this article, we provide a literature-based overview of smart health systems, their components, architecture, technologies, benefits, applications, challenges, and opportunities. In addition, we discuss the potential benefits of big data, data analytics, artificial intelligence (AI), and machine learning (ML) in smart health systems. Moreover, we discuss the challenges as well as the open research issues that need further investigation to facilitate the implementation of smart health systems.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) has a remarkable impact on healthcare systems globally, and it has challenged patients, healthcare personnel, healthcare systems, and the general population under serious threats. Aim: The aim was to determine the effect of the COVID-19 pandemic on catheterization laboratory activity in Azadi Heart Center, Duhok, Iraq. Materials and Methods: All data of consecutive patients visiting Azadi Heart Center for Cardiac Intervention (coronary angiography, congenital intervention, and cardiac device implantation) in two calendar years period (2019 and 2020) were collected, compared, and studied to explore the effect of the pandemic on catheterization laboratories activity during the peak of the pandemic in our region. Results: A significant decrease in all cardiac procedures and interventions was detected except for emergency percutaneous coronary intervention, and the total number of procedures performed between January 1 and December 31, 2020 reduced by one-third as compared with the same period in 2019. Conclusion: During the peak of disease, the COVID-19 pandemic had reduced all catheterization laboratories activity by one-third except for emergency percutaneous coronary intervention. © 2022 Medical Journal of Babylon ;Published by Wolters Kluwer - Medknow
ABSTRACT
BACKGROUND: COVID-19 coagulopathy manifests by elevation of certain marker of active coagulation as fibrinogen and this increment associated with increased markers of inflammations. AIM: To measure protein C (PC) level in hospitalized patients with COVID-19 and to find a possible correlation with hematological and inflammatory markers. PATIENTS AND METHODS: Seventy-five hospitalized Iraqi adult patients with COVID-19 were included in a descriptive cross-sectional research. PC, D-dimer, and erythrocyte sedimentation rate (ESR) blood samples were collected, and further information was received from patient’s records. Statistical analysis was conducted using SPSS version 23 and Microsoft Office Excel 2019. RESULTS: Mean age of 75 patients included in the study was 60.13 ± 14.65 years. Sixty-two (62.7%) of patients exhibited neutrophilia, whereas 41 had lymphopenia (54.7%). High ratio of neutrophil/lymphocyte (N/L) was seen in 66 (88.0%), eosinopenia was seen in 46 (61.3%), high lactate dehydrogenase level was seen 68 (90.7%), serum ferritin was high in 66 (88.0%), and high level of C-reactive protein was seen in 68 (90.7%), increased ESR was seen in 69 (92.0%) and high level of D-dimer was seen in 56 (74.7%), while low level of PC was seen in 12 (16.0%) patients. PC had significant negative correlation with prothrombin and partial thromboplastin time but no significant correlation with hematological and inflammatory parameters. CONCLUSION: COVID-19 coagulopathy is common in majority of patients which include significant changes in WBCs counts, inflammatory markers, PC, and D-dimer levels. Such changes may have a great impact on morbidity and mortality and thus need to be monitored throughout treatment and convalescence.
ABSTRACT
The MD-PhD programme allows medical students to be trained in one programme and obtain two degrees, one in medicine and the other in research. In America, some countries in Europe and the far East, the MBBS is always referred to as MD. However, in UK, Australia, some countries in the Indian subcontinent and Africa, including Sudan, the MD is a postgraduate degree. The main goal is to produce physicians-scientist who can conduct clinical work with a researcher mindset. Other benefits are to provide research leaders, mentors and supervisors for the next generations of doctors. We searched Medline (PubMed) and Google Scholar for scientific publications published in English since 1950. We used the keywords MBBS-PhD OR MD-PhD programme AND academic medicine AND Sudan AND research OR barriers of research OR epidemiology. The Sudan Medical specialization board (SMSB) is the only postgraduate body in Sudan for training of medical doctors at postgraduate level and candidate will receive MDs in different clinical specialities after competing four years of training (research dissertation is expected to be completed in year four). In this review, we proposed that SMSB offer an MD-PhD programme at the postgraduate level with a duration of 6–7 years, with PhD in clinical epidemiology. Notably, the pandemic of COVID-19 brought immense recognition and light for the importance of epidemiology in managing the infectious disease and the management of the high prevalence of non-communicable diseases (diabetes and hypertension). In addition, clinical epidemiological research requires relatively less funding than molecular or cellular research. The databases for population studies will allow: how the illness develops, analysing data with understanding of the social and ethical conditions in Sudan, so researchers can produce solutions based on innovations with a practical ability to communicate these solutions to different teams. Therefore, a candidate like this needs to be trained in advanced understanding of statistics, logic, critical thinking, planning and strategizing skills and the ability to use broad clinical and research knowledge to understand the link between diseases and traditions and customs of different tribes in Sudan. Therefore, the MD-PhD programme in Sudan will lead to the establishment of new generations of clinical scientists who will be able to shed light on the behaviour of different diseases in Sudan including COVID-19 and how to apply appropriate strategies in management and prevention. © 2022 Journal of Public Health and Emergency. All rights reserved.
ABSTRACT
Academic medicine is vital for Sudan as it reflects progress in diseases prevention and management, and it enhances both medical practice and academic environment. The academic medicine can be defined as interrelationships among teaching, research, and clinical service. For this reason, all the medical colleges in Sudan recommended that all staff should be involved in research practice, teaching beside clinical services. Importantly, many universities in Sudan are offering a master degree in medical education, which prove to be very popular among doctors. During the pandemic of COVID-19, the appreciation and enthusiasm for research and medical teaching increased not only in Sudan but worldwide. In addition, research output is of a significant value in increasing the chance of success in accreditation of medical schools and the ability to attract national and international funds. Importantly, several studies showed that more than 90% of doctors in Africa and Sudan are interested in participation in research. In this article, we will try to highlight the challenges and solutions that influence the chance for men and women to participate in academic medicine in Sudan. Some of these factors are also shared worldwide and represent common challenges for doctors in developing and developed countries. We have also tried to reflect on barriers that related to the culture and customs of Sudan, which can also decrease chance of participation in academic medicine. We have also presented an attempt for how to overcome all these problems and suggested possible solutions. © 2022 AME Publishing Company. All Rights Reserved.
Subject(s)
COVID-19 , Emergency Medicine , Internship and Residency , Emergency Medicine/education , Humans , SARS-CoV-2ABSTRACT
Favipiravir (Fav) is an antiviral drug administered for the treatment of pulmonary infection and is also among the approved drugs for the treatment of lung inflammation in humans infected with COVID-19. Here we introduce the electrochemical behavior of Fav at ionic liquid crystals (ILCs)-carbon nanotubes (CNTs) modified electrode. The proposed electrode is ready for use in a one-step preparation protocol, is employed with low-cost instrumentation, and is distinctly sensitive and selective for the determination of the drug both in human serum and in commercially available medications. Ionic liquid crystals allow ionic interaction with the drug to realize its surface preconcentration. The limits of detection and quantification for the determination of Fav in blood-serum within the concentration range 0.9 to 150 mu mol l(-1) are 0.0161 and 0.119 mu mol l(-1), respectively. The sensor proved effective in the concurrent determination of several drugs used as prescribed "add-on" medication for the virus or for the treatment of other chronic diseases of some patients.
ABSTRACT
BACKGROUND: Despite the rapidly expanding data on clinical, epidemiological and radiological aspects of coronavirus disease 2019 (COVID-19), little is known about the disease's pathological aspects. The scarcity of pathological data on COVID-19 can be explained by the limited autopsy procedures performed on deceased patients. AIM: This work aims to review and summarize the pulmonary pathological findings observed in COIVD-19 deceased individuals based on recent case series reports published in English up to September 2020. METHODS: A search in Google Scholar, PubMed(Ò), MEDLINE(Ò), and Scopus was performed using the keywords "autopsy and COVID-19," "postmortem and COVID-19," and "pulmonary/lung pathology and COVID-19." RESULTS: Pulmonary autopsy hallmark findings of COVID-19 cases demonstrate the presence of diffuse alveolar damage. The presence of pulmonary thrombi was reported in the majority of patients. Cellular alterations included type 2 pneumocyte hyperplasia, inflammatory cell infiltrates predominantly by lymphocytes, other mononuclear cells, and neutrophils as evident by their specific immunohistochemical markers. Electron microscopy confirmed the presence of virus particles in different cell types, including types 1 and 2 pneumocytes. CONCLUSION: The few emerging autopsy reports have substantially contributed towards our understanding of COVID-19 pulmonary histopathological aspects. COVID-19 caused acute severe respiratory manifestations that are the leading cause of morbidity and mortality in infected patients. More studies and research are needed to understand the inflammatory processes and histopathological changes associated with COVID-19 in African populations. RELEVANCE FOR PATIENTS: Postmortem investigations advance important mechanistic knowledge on COVID-19 pathophysiology and clinical outcomes and could facilitate provisions for targeted therapies.
ABSTRACT
Social accountability is an essential component for all medical schools as it deals with education, research and services. In this mini-review, we have discussed why the Faculty of Medicine, University of Gezira (FMUG), Sudan, can lead in social accountability in Africa and the Middle East. This critical analysis is based on searching the literature published in PubMed, Medline, Scopus and Google scholar. We added sections about reflection on opportunities and future direction for FMUG on social accountability. Many unique features in the curriculum that led to excellence in teaching, research and service, will qualify FMUG to lead in social accountability. The location in the heart of Sudan and being community-oriented medical education meant that FMUG, over the last 45 years, gained and mastered the art of social accountability. FMUG continues to be a leader in medical education and has a pioneer master's program in medical education. The majority of the graduates who are not staff members continued to support the medical school many years after their graduation (teaching, research and donation) and promote the concept of social accountability at the national and international level. The curriculum meets all of the competencies of social medicine. Hence, graduates are influential leaders in all medical specialties, and most importantly, in addressing the priority health concerns of the community in rural and urban areas. Therefore, through research and innovations, FMUG can establish social accountability alliance for medical schools and consider adding more unique components to the concept of social accountability (promotion of concept health made at home, especially during COVID-19 pandemic). For instance, retention and recruitment of doctors (training and promotion) and brain drain are main challenges to many health authorities in African and Middle East countries. Another area of innovation, is environmental social accountability of medical schools in order to develop environmentally sustainable solutions to address health concerns especially during the COVID-19 pandemic. This of considerable importance as Gezira state has one of the largest irrigation agriculture schemes in the world. We believe that medical schools' concept of social accountability will continue to evolve, likely depending on the community's needs. © Journal of Public Health and Emergency. All rights reserved.
ABSTRACT
Sudan is a country with huge natural resources and this may provide a potential for a rich and diverse health research economy especially in medicine. It is important that both basic and applied medical research will be directed and prioritized according to the need of Sudanese communities based on experiments tested in the lab and can be implemented in bedside practice. This can help in facing the health challenges associated with communicable and non-communicable disease. Research in medical education is also needed especially with an increase in the numbers of medical schools. Research for everyone involved in medical education and practice should be adopted as a way forward in Sudan. In other words, research engaged medical force will improve the medical care in Sudan. For instance, doctors can develop expertise, deep learning in their specialties and enhance their chance of developing theories and proposal (satisfy the need for doctors inquiring minds). University hospitals and patients will benefit from recent advancements in medicine in term of diagnostic and treatment. Importantly, research is bringing satisfaction, dynamism and opportunity for doctors to leave a legacy for the next generations of doctors in Sudan. During the pandemic of COVID-19, it is clear that more research is needed in Sudan. Importantly, diabetes, obesity and hypertension are known to have a high prevalence in Sudan and also risk factors for COVID-19. This is a challenging time for the health system in Sudan, and perhaps investing in research will help in keeping people well and open new venues for health service in Sudan. We very much hope that this article will increase understanding and enthusiasm about research in communicable, non-communicable diseases, medical education and social medicine. Therefore, we feel that every doctor in Sudan should engage in research activities so that current and future patients can benefit from the outcomes of these research activities. © Journal of Public Health and Emergency. All rights reserved.
ABSTRACT
Establishing the diagnosis of viral diseases often needs sophisticated settings, equipment, expertise, and strict laboratory methods. In Sudan, as in most developing countries, viral diseases are mostly diagnosed by clinical presentation. As most viral infections are self-limiting and there is no specific treatment for most of them, laboratory diagnosis has not been a focus for improvement, particularly in public sector until the current pandemic of COVID-19. During this pandemic, the vital need for well-equipped clinical virology laboratories is urged. The aim of this work is to highlight the various diagnostic methods and to describe the current situation of clinical virology diagnostics in Sudan. [ABSTRACT FROM AUTHOR] Copyright of Sudan Journal of Medical Sciences is the property of Knowledge E DMCC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
ABSTRACT
Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that has spread to almost all countries worldwide. Diabetes mellitus (DM) has been shown to increase the risk of COVID-19 disease severity. In this review, we provide a summary of the impact of COIVD-19 on diabetes management and related services. We searched the literature using the following databases: PubMed, Medline, Scopus and Google Scholar. These databases were searched using the keywords: COV-ID-19, diabetes type 1 and type 2. Lockdown causing social isolation and psychological issues, showed an influence on poor glycemic control amongst people with diabetes. Hence, the use of telemedicine and various technologies in the management of diabetes has substantially increased. In individuals with COVID-19, the current practice is not in favor of using sodium-glucose cotransporter 2 (SGLT2) inhibitors. Furthermore, insulin is recommended for the management of diabetes in critically ill patients. The COVID-19 pandemic was associated with many changes in diabetes management and the delivery of diabetes services. © The authors.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is highly transmittable through contact with respiratory droplets. The virus is also shed in fecal matter. Some patients may present with effects in more than one system;however, there are no defined biomarkers that can accurately predict the course or progression of the disease. The present study aimed to estimate the severity of the disease, to correlate the severity of the disease with biochemical predictors, to identify valuable biomarkers indicative of gastrointestinal disease, and to determine the cutoff values. A cross-sectional study was conducted on COVID-19 patients admitted to the Kafrelsheikh University Hospital (isolation unit) between July 10, 2020, and October 30, 2020. The diagnosis of COVID-19 was confirmed via reverse transcription-polymerase chain reaction (RT-PCR), which was employed for the detection of the viral RNA. We conclude that lymphopenia, elevated C-reactive protein (CRP) level, and liver enzymes were among the most important laboratory findings in COVID-19 patients. Statistically significant differences in platelet count, neutrophil count, D-dimer level, and fecal calprotectin levels were observed among patients presenting with chest symptoms only and patients with both chest and gastrointestinal symptoms (p = 0.004;< 0.001;0.010;0.003;and < 0.001, respectively). C-reactive protein, D-dimer, and fecal calprotectin levels positively correlated with disease severity. The cutoff value for fecal calprotectin that can predict gastrointestinal involvement in COVID-19 was 165.0, with a sensitivity of 88.1% and a specificity of 76.5%. © 2021 Elsevier Editora Ltda. All rights reserved.