Oral manifestations in COVID-19 patients among the Bangladeshi population: a cross-sectional study

Background: COVID-19 is a multi-system all-pervasive disease with protean manifestations, and its major signs and symptoms, such as incessant dry cough, fever, and pneumonia, are well known. Yet, its mucocutaneous manifestations, particularly those of the oral cavity, appear to be little recognized. This may be due either to the rarity of oral manifestations of COVID-19, or poor detection of such symptoms by attending physicians who may do only a cursory examination of the oral mucosa because of the overwhelming gravity of the other major systemic presentations. Nevertheless, there are now a considerable number of reports, including systematic reviews, on oral manifestations of COVID-19 in the literature. This observational study was performed to determine the oral manifestations among COVID-19 patients. Material & Methods: A cross-sectional study was carried out among COVID-19 recovered patients. 120 Covid 19 recovered patients were purposively selected as study samples. All the samples diagnosed as mild and moderate cases of COVID-19 disease were selected based on inclusion and exclusion criteria. Results: The study comprised the majority of males (68%) where females represent (32%) of the study population and the mean age was 39.3+or-12.4. Oral manifestations among study subjects during and after the disease illness including loss of taste being the commonest symptom (40%), followed by erythema and coated tongue (7.5%), mouth ulcerations (6.7%) and dry mouth (1.7%). The study revealed that the 41-60 age group subjects represented the highest (43%) oral manifestations. Conclusions: Early identification of oral symptoms in COVID-19 recovered or suspected cases can help a dentist or a general physician to diagnose high-risk groups, mitigate transmission, and promote overall health.

Post-COVID-19 Syndrome Clinical Manifestations: A Systematic Review.

BACKGROUND: Coronavirus disease-2019 (COVID-19) is a global pandemic health problem that causes a wide spectrum of clinical manifestations and considerable mortality rates. Unfortunately, recovered patients who survive COVID-19 may continue to report a wide variety of clinical manifestations of multisystem affection such as pulmonary embolism, deep vein thrombosis, acute myocardial infarction, depression, anxiety, myalgia, dyspnea, and fatigue. OBJECTIVE: We aimed to summarize the current literature regarding the prevalence of post-COVID- 19 manifestations. METHODS: We conducted a systematic review of post-COVID-19 manifestations by searching MEDLINE via PubMed, Scopus, Web of Science (WOS), EBSCO, Wily, and World health organization (WHO) databases. Screening, study selection, data extraction, data synthesis, and quality assessment were made by two independent reviewers. RESULTS: Of 1,371 references, 817 references remained after removing duplicates. Reviews, case reports, commentaries, and any article containing non-original information were excluded. According to the eligibility criteria for this systematic review, 12 studies were included for qualitative synthesis. The overall prevalence of post-COVID-19 manifestations ranged from 35% to 90.5%. Fatigue, dyspnea, neuropsychological disorders, and pain were the most frequent post-COVID-19 symptoms. CONCLUSION: This systematic review showed that 35% to 90.5% of recovered patients who survive COVID-19 continue to have a wide variety of clinical manifestations, including fatigue, dyspnea, neuropsychological disorders, and pain as the most frequent post-COVID-19 symptoms.

Exploring the Impact of Remuneration on Advertising Value & Attitudes: A Perspective During the Covid-19 Crises

The study investigates the impact of an unexplored motivational construct i.e., remuneration, on consumers' attitudes towards social media advertising (CATSMA). It proposes that this underlying relationship is mediated by perceived social media advertising value (PSMAV). The research takes under consideration the pandemic era of Covid-19, where the dependency on digital transactions has accelerated. Consumer responses are undertaken virtually by the young and dynamic audience of Pakistan, who consume social media as a way of life. The research deploys a variance-based structural equation modeling (SEM), by using a partial least squares (PLS) approach in the form of SmartPLS 3. The results show that remuneration plays an instrumental role in enhancing the value of advertising and also developing desirable consumers' attitudes on social media. The findings also reveal that advertising value exerts a significant impact on users' evaluative criteria and also mediates the relationship between remuneration and underlying attitudes. This empirical research is one of the embryonic social media investigations undertaken in a Pakistani context, transforming through the covid crisis.

Cytopenias in Hospitalized Patients of Covid-19 during First and Other Waves

Introduction: COVID -19 emerged in December 2019 in china and till date this virus has mutated into different strains which are somewhat different in their presentation and severity. Pakistan has faced five waves of COVID-19 till date. This study was aimed to compare Haematological parameters and outcomes of hospitalized patients during First and other waves (second and third) of COVID-19. Method(s): Demographic, Clinical and laboratory data as well as outcome of total 202 COVID-19 PCR positive patients admitted in Fatima memorial Hospital, Lahore, Pakistan was collected during first and other waves. Data of First wave is from May 2020 to July 2020, second wave from early November to Mid December 2020 and third wave from Mid march to June 2021. We compared the data on basis of SII as well hematological parameters of First Wave were compared with other waves (second & third) of COVID-19. Result(s): There were 54(26.7%) patients with SII< 600 and 148(73.2%) patients with SII>600. Neutrophilia (p-< 0.001), leukocytosis (p-< 0.001), lymphocytopenia(p-< 0.001), Raised NLR(p-< 0.001), PLR(p-< 0.001) and MLR(p-< 0.001) had direct association with SII. Raised SII was directly related to increased requirement of ventilator support (p-0.2) and Mortality (p-0.001). There were total 90(44.5%) patients in first wave and 112(55.4%) patients in other waves of COVID-19. More Females (33.3% Vs 57.1%) than Males (66.7% Vs 42.9%) were infected during other waves (p- 0.001). Anemia (27.8% vs 37.5%) (p-0.09), leucopenia (1.1% vs 8.9%) (p-< 0.001), Lymphocytopenia (20% Vs 39.3%) (p-0.003) and thrombocytopenia (3.3% Vs 25%) (p-< 0.001) were more prevalent in other waves of COVID-19 when compared to first wave. Requirement of Ventilator Support (7.7% vs 22%) and mortality (10% vs 33.9%) were also increased in other waves of COVID-19 Conclusion(s): Systemic immune Inflammation Index (SII) is a good predicting tool in COVID -19 patients for prognosis and is directly associated with severity of disease as well as outcome. Patients with cytopenias like anemia, leucopenia, lymphocytopenia thrombocytopenia, requirement of Ventilator Support and mortality were noted to be more in other waves of COVID-19. Haematological parameters like ANC, AMC NLR, PLR, MLR and SII show no significant difference between first and subsequent waves of COVID-19.

Online Teaching during Covid-19 Pandemic-Perceptions of Undergraduate Medical Students in Uttar Pradesh, India

Background: The suspension of regular face to face teaching during Covid Pandemic lead to emergence of e learning with full swing in every field of education including Medical Colleges. Students perceived this unplanned shift differently. So, this study was planned to explore the perceptions of medical students in a private medical university, UP, India. Method(s): A questionnaire was designed on google form with close ended questions & likert scale questions. Link was shared with medical students who have attended online classes during Covid pandemic. Respondents were 140 medical undergraduates from 1st Professional, regular & supple batch. Responses were analyzed & results obtained Results: Majority of students (76%) used smart phones to attend online classes & Google meet was the preferred platform (45.35%). Duration of online classes preferred by students was 30-45min (54.28%). Usefulness of online teaching by most of the students perceived as passable (Likert scale, LS-2.84). Extent of understanding the topic was not equivalent to face to face (LS-2.9) & internet connectivity posed problems (LS-3.77) that is why most of the students demanded for reconduction of classes after resumption of regular offline classes (LS-3.91) Most of them agreed that medical learning is suffering as practical classes cannot be conducted online (LS-3.98). Most of the students (45%) confessed that self-study was less at homes as compared to their hostels. Both students & their parents were worried about quality of studies & their future performance in exams (LS 4.02 &3.66). Students were not in favour of online teaching in future (LS-2.31) Conclusion(s): Online teaching was well received by medical students but they faced several challenges like sometimes internet connectivity issues, less student teacher interaction, methodology barriers, less development of practical skills. Despite all the hassles, chain of learning did not break due to online teaching. Efforts should be done to address the problems faced by students at individual faculty level as well as Institute level. Copyright © 2022, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Dentist's Knowledge and Behavior on the Use of Smart Phones in Clinical Environment and their association with Cross Infections

Background: The use of smart phones inside hospitals especially in clinically sensitive areas is a subject of debate because it may improve the quality of healthcare but can also be a vehicle of hospital acquired infections. Aim: To determine dentist's knowledge and behavior related to the use of smart phones in clinical environment and to determine the presence of microbial growth on these devices. Methods: This is a cross-sectional study in which validated survey tool was used to collect data about knowledge and behavior of 397 dental graduates from 8 dental colleges of Pakistan, regarding their usage of smart phones in clinical environment. Bacterial isolates were collected from the smart phones of 45 participants from Fatima Memorial Dental Hospital, Lahore. Results: The SPTC Scale was used to divide the participants into 3 categories;low, moderate and high users. The behavior related to smart phone usage in clinical environment was significantly different among the participants. Moderate users had significantly higher average behavior score of 3.7 (p-value = 0.034). The growth of pathogenic bacterial flora was greater on high users of smart phones (95%,) whereas those participants who were low users the percentage was 37%. Conclusion: Hospital-acquired infections (HAIs) are increasing significantly in number of patients and these can be prevented by adhering to proper hand hygiene practices and if hand hygiene is improved the amount of bacterial load will be less and disinfection of smart phone devices will not be required.

Coagulation profile in COVID-19

Objective: To evaluate the coagulation profile in COVID-19 patients and to correlate disease severity with the coagulation parameters. Methodology: This retrospective study was conducted at Pathology and medicine departments, FMH College of Medicine and Dentistry. It included 101 confirmed cases of COVID-19 disease of both genders between 17 and 75-year age. Coagulation profile was compared between survivor and non-survivor groups. Results: Out of 101 patients, 93 (92.1%) patients were in the survivor group and eight (7.8%) in the non-survivor group. Mean APTT (p = 0.02) in non-survivor group showed relatively higher values than survivor group. Mean D-Dimers (p = 0.007) in non-survivors showed a significantly raised values. However other parameters of coagulation like Platelets, MPV, PT and INR showed no significant association statistically. Conclusion: High D-dimers and prolonged APTT were associated with mortality in COVID-19 Patients.

Role of hematological parameters in stratification of COVID-19 disease severity

Background : Covid-19 disease involves respiratory as well as other body systems including cardiovascular, gastrointestinal, neurological, immunological and hematopoietic system. Patient of covid-19 pneumonia presents with wide range of hemostatic abnormalities. These hemostatic abnormalities in COVID-19 are related with disease progression, severity and mortality. Aims : The aim of our study is to evaluate the role of hematological parameters in determination of COVID-19 disease severity. Methods : This was a retrospective study, conducted in Department of Pathology and Department of medicine, FMH college of Medicine and Dentistry from May 2020 to July 2020. Total of 101, confirmed cases of covid-19 disease, both genders between 17 and 75-year age were included. Hematological parameters were compared in mild, moderate, severe and critical disease group. Continuous variables were analyzed by using non parametric, Kruskal Wallis test while categorical variables were analyzed by chi-square test. Results : Out of 101 patients, 20.8%, 51.8%,19.8% and 7.9% were in mild, moderate, severe and critical group respectively. Median (IQR) values of WBCs ( P -value 0.004), ANC ( P -value 0.002), NLR ( P -value 0.001), D-dimer level ( P -value 0.001), ferritin (0.0001), LDH (0.0001) were significantly increased in patients with critical disease. Median (IQR) values of APTT ( P -value 0.003) and CRP ( P -value 0.0001) were suggestively higher in patients with severe disease. Other parameters like Hemoglobin, MCV, HCT, ALC, Platelet count, prothrombin time did not show statistically significant association with severity of disease. Conclusions : The study concluded that Leukocytosis, neutrophilia, elevated Neutrophil to lymphocyte ratio, APTT, D-dimer, LDH, serum ferritin and CRP are associated with severity of covid-19 disease.