Bariatric surgery provision in response to the COVID-19 pandemic: retrospective cohort study of a national registry.

BACKGROUND: When surgery resumed following the outbreak of the COVID-19 pandemic, guidelines recommended the prioritization of patients with greater obesity-related co-morbidities and/or higher body mass index. OBJECTIVE: The aim of this study was to record the effect of the pandemic on total number, patient demographics, and perioperative outcomes of elective bariatric surgery patients in the United Kingdom. SETTING AND METHODS: The United Kingdom National Bariatric Surgical Registry was used to identify patients who underwent elective bariatric surgery during the pandemic (1 yr from April 1, 2020). Characteristics of this group were compared with those of a pre-pandemic cohort. Primary outcomes were case volume, case mix, and providers. National Health Service cases were analyzed for baseline health status and perioperative outcomes. Fisher exact, χ2, and Student t tests were used as appropriate. RESULTS: The total number of cases decreased to one third of pre-pandemic volume (8615 to 2930). The decrease in operating volume varied, with 36 hospitals (45%) experiencing a 75%-100% reduction. Cases performed in the National Health Service fell from 74% to 53% (P < .0001). There was no change in baseline body mass index (45.2 ± 8.3 kg/m2 from 45.5 ± 8.3 kg/m2; P = .23) or prevalence of type 2 diabetes (26% from 26%; P = .99). Length of stay (median 2 d) and surgical complication rate (1.4% from 2.0%; relative risk = .71; 95% CI .45-1.12; P = .13) were unchanged. CONCLUSIONS: In the context of a dramatic reduction in elective bariatric surgery due to the COVID-19 pandemic, patients with more severe co-morbidities were not prioritized for surgery. These findings should inform preparation for future crises.

Emergence of a genotype I lineage 1 variant avian infectious bronchitis virus in Assam, India

Background: Infectious bronchitis (IB) is an acute and highly contagious viral disease of poultry affecting chicken of all ages. The causative agent IB virus (IBV) is a Gammacoronavirus within the family Coronaviridae. Viral genetic mutations and recombination events particularly in the spike protein (S1) of IBV constantly give rise to emerging IBV variants. Vaccination is considered as the most reliable approach for IBV control, but current vaccines have been found to be ineffective due to constant emergence of new variant viruses. Objective(s): The objective of our study was to detect IBV genotypes prevalent in Assam, India. Material(s) and Method(s): Oro-pharyngeal swabs and tissue samples from unvaccinated broiler chickens showing respiratory symptoms were tested using RT-PCR targeting the N gene of IBV. The virus was isolated from infected swab/tissue samples in 9 days old specific pathogen free embryonated chicken eggs through allantoic cavity route. Phylogenetic studies were done based on the S1 gene of IBV. Results and Conclusion(s): Clinically, the birds showed gasping and tracheal rales. Necropsy revealed distended ureters. Virus was isolated and identified by curling and dwarfing of the dead embryos and further confirmed by RT-PCR. Positive PCR amplicons were sequenced and phylogenetic analysis clustered the IBV isolate from Assam with genotype I lineage 1 IBV prototype sequence belonging to Beaudette and Mass 41 strains but the isolate exhibited a relatively high degree of sequence divergence with reference strains. Our findings suggest that the IBV isolate might have emerged from recombination with the local circulating virus or vaccine strains. This will have important implications for IB prevention strategies.

Utilization of chest imaging in COVID 19 pandemic

Introduction and Aim: Coronavirus disease (COVID-19) is a viral infection that can lead to severe respiratory disease. Radiological examinations mainly computed tomography (CT) and Chest x-ray (CXR) play a role in diagnosis, follow-up, and management of COVID-19 infection. The purpose of this study was to look into the extent of using chest imaging in COVID-19 infection, as well to see if chest imaging in COVID-19 infections is justified and guided by clinical recommendation in Mosul, Iraq. Material(s) and Method(s): This cross-sectional study involved 245 people (93 males and 152 females), infected previously with COVID-19 infection in Mosul, Iraq. The participants were asked to self-complete an anonymous questionnaire. Data obtained was subjected to statistical analysis. Result(s): The 245 participants had an average age of 25.7 +/-8.44 years. The study sample included 57 (23.2%) with low education and 188 (76.7%) with moderate to high education. Among the radiological examinations undergone by these participants, chest X-ray (CXR) was the most common followed by chest computed tomography scan (CT scan). The CXR and the CT scan were done during the patient's illness either for diagnosis or follow-up of the disease. Non-clinically recommended examinations were reported by 64% and 20% of patients who undertook CXR and CT scan respectively, during COVID-19 illness. Higher education status was associated with a tendency to do non-recommended CXR examination during COVID-19 infection. Conclusion(s): CXR and CT imaging are the most commonly used radiological examinations in the diagnosis and follow-up in COVID-19 infection. However, a non-clinically recommended utilization of these examinations was noted in Mosul, Iraq during the pandemic. Therefore, educating people of this region about the limitation of non-justified uses of imaging is essential for healthy maintenance of individuals, environment, and resources.Copyright © 2023, Indian Association of Biomedical Scientists. All rights reserved.

Predictors of COVID-19 Vaccine Uptake and Reasons for Vaccine Hesitancy Among New York State Refugees

Purpose: Resettled refugees in the U.S. face a disproportionately high risk of COVID-19 exposure, infection, and death. This study examines COVID-19 vaccination status among adult participants and their minor children, reasons for vaccine hesitancy, and predictors of vaccine uptake, as well as sources of COVID-19 news and information and trust in those sources. Method: The data in this study were drawn from the Telehealth and COVID-19 Knowledge, Attitudes, and Practices in New York Refugee Communities Survey (N = 353), conducted March-May, 2022. Results: The multivariate results indicate that in this sample of resettled refugees, those who reported higher levels of educational attainment, were from Afghanistan, and those who had fewer concerns about the vaccine were more likely to accept vaccination. The participants in this study identified local health workers, clinics, and community organizations–places where social workers are present–as both the largest source of nonsocial media COVID-19 news and information and the most trusted source of COVID-19 news and information. Discussion: The implications from this study provide social workers with an understanding of the social and behavioral factors impacting vaccine uptake in refugee communities. Conclusion: According to the NASW Code of Ethics, social workers must challenge inequalities that persist against marginalized groups, such as racial and ethnic health disparities. Social work practitioners can play an essential role in decreasing unjust health disparities by providing accurate, culturally appropriate information on public health concerns such as COVID-19 to their refugee clients and within interprofessional collaboration. © 2023 Taylor & Francis.

Predicting the need for Continuous Positive Airway Pressure (CPAP) or High-flow nasal oxygen (HFNO) in COVID-19 and patient outcome

Background: Patients admitted with COVID-19 pneumonia often have severe hypoxemic respiratory failure which requires additional support with CPAP/HFNO. It is not known which clinical variable best predicts the need for CPAP/HFNO. Aim(s): We reviewed consecutive patients admitted with COVID-19 to an acute respiratory care unit (ARCU) to assess, if any clinical or demographic data could help predict the need for CPAP/HFNO in a high risk group of patients, and also assessed their outcome. Method(s): Data collected from patients admitted to our ARCU with COVID-19 pneumonia between 28th November 2020 and 16th February 2021 was retrospectively reviewed. Clinical and demographic data was collected. The 4C mortality score for COVID-19 and chest x-ray scoring was performed. Result(s): 271 people were included in the study, CPAP/HFNO was initiated in 187 (73%). A CRP >100 (OR: 3.12, CI:1.8-5.4), or a respiratory rate >=30 (OR: 9.54, CI:3.9-26) at admission were associated with requiring CPAP/HFNO. A severe degree of zonal involvement on chest x-ray (OR: 3.65, CI:1.8-7.6) predicted the need for CPAP/HFNO. The 4C mortality score showed a step wise increase in the odds of needing CPAP/HFNO. 144 patients were commenced on CPAP/HFNO who were for escalation to invasive ventilation, 45% required escalation to invasive ventilation. 43 patients underwent CPAP/HFNO as a ceiling of care, 35 of which died resulting in an 81% mortality. Discussion(s): It is possible to predict which patients may require CPAP/HFNO using easily available clinic data. CPAP/HFNO as a ceiling of care in severe COVID-19 can be associated with a very high risk of mortality and should be carefully considered.

P158 A nurse-led model for tuberculosis services delivers safe and effective care

P158 Table 1 2018–2019 2020–2021 No: of patients 33 38 Disease site Pulmonary Extra-pulmonary Pulmonary Extra-pulmonary 45.5% 55.5% 23.6% 76.4% Single site Multi-Site Single Site Multi-Site 87.9% 12.1% 78.9% 21.1% Sensitivity Sensitive Drug Resistant Sensitive Drug Resistant 62.5% 37.5% 81.2% 18.8% Treatment started by: Doctor Nurse Doctor Nurse Inpatient Outpatient Inpatient Outpatient 24.1% 75.9% 0% 7.9% 71.1% 21% Days from symptom onset to treatment(median) 73 65 Total clinic appointments Face to face Virtual Face to face Virtual 503 1 339 11 Clinic appointments per patient (median) 13 13 Follow-up appointments led by Doctor Nurse Doctor Nurse 52% 48% 28% 72% Patients lost to follow-up 3 1 Hospital admissions 7 1 Patient deaths 0 1 ConclusionA nurse-led model for TB services provides safe, effective, and timely care.An expanded TBSN role with the support of a proactive, easily-accessible consultant may present a good model for TB service provision going forward.Further research is needed to test this model outside of the pandemic context.ReferencesBritish Thoracic society. Tuberculosis services during the Covid-19 pandemic. Available at https://www.brit-thoracic.org.uk/covid-19/covid-19-information-for-the-respiratory-community/

Earth-friendly-assessed silver-nanoparticles spectrophotometric method for rapid and sensitive analysis of Molnupiravir, an FDA-approved candidate for COVID-19: application on pharmaceutical formulation and dissolution test.

Molnupiravir is the first oral direct-acting antiviral prodrug recently approved for the COVID-19 pandemic. Here and for the first time, we present a novel, sensitive, robust, and simple silver-nanoparticles spectrophotometric technique for molnupiravir analysis in its capsules and dissolution media. This spectrophotometric technique involved silver-nanoparticles synthesis through a redox reaction between the reducing agent (molnupiravir) and the oxidizing agent (silver nitrate) in presence of polyvinylpyrrolidone as a stabilizing agent. The produced silver-nanoparticles have an intense surface plasmon resonance peak at 416 nm where the measured absorbance values were utilized for the quantitative analysis of molnupiravir. The produced silver-nanoparticles were recognized by using the transmission electron microscope. Under optimal conditions, a good linear rapport was accomplished between molnupiravir concentrations and the corresponding absorbance values in a range of (100-2000) ng/mL with a detection limit of 30 ng/mL. Greenness assessment was implemented using eco-scale scoring and GAPI disclosing the excellent greenness of the suggested technique. The suggested silver-nanoparticles technique was authenticated according to recommendations of the ICH and statistically assessed with the reported liquid chromatographic method without significant differences regarding accuracy or precision. Accordingly, the suggested technique is deemed a green and cheap alternative for assaying molnupiravir due to its reliance primarily on water. Furthermore, the suggested technique's high sensitivity can be employed for investigating molnupiravir bioequivalence in future studies.

Comparative study of four innovative earth-friendly platforms for rapid analysis of daclatasvir dihydrochloride: Application on different matrices.

BACKGROUND: Daclatasvir dihydrochloride has important roles not only in the management of COVID-19 pandemic symptoms but also in the treatment of chronic hepatitis C infection. OBJECTIVE: The current research presents four novel and simple platforms including silver-nanoparticles spectrophotometric technique and three electrochemical conductometric ones for daclatasvir analysis in its tablet, biological fluids, and dissolution media. METHODS: The spectrophotometric platform involved the synthesis of silvernanoparticles through a redox reaction between the reducing agent (daclatasvir) and the oxidizing agent (silver nitrate) in presence of polyvinylpyrrolidone as a stabilizing agent. The produced silver-nanoparticles have an intense surface plasmon resonance peak at 421 nm where the measured absorbance values were utilized for quantitative spectrophotometric determination of daclatasvir. While the electrochemical conductometric platforms involved the reaction of daclatasvir with three different precipitating reagents (silver nitrate, phosphomolybdic acid, and ammonium reineckate) to form ion associates between these reagents and daclatasvir in the aqueous system. RESULTS: All proposed platforms were validated in line with recommendations of the international conference on harmonization producing satisfactory outcomes within the agreed boundaries. CONCLUSION: The proposed platforms are green alternatives for routine rapid assay of daclatasvir at the cheapest cost because their results were observed to be nearly similar to those of the reported platform. Moreover, the suggested spectrophotometric platform's sensitivity can be employed for investigating daclatasvir bioequivalence.

Monkeypox: A current emergency global health threat.

Monkeypox (MPXV) is an emerging zoonotic disease carrying a global health threat. Using a multi-disciplinary approach, we review the current MPXV virus infection outbreak including virology, prevention, clinical presentation, and disaster management. MPXV is caused by a double-stranded deoxyribonucleic acid virus. Despite its clinical similarities with smallpox, it is less severe with low mortality. Human-to-human transmission occurs through prolonged direct or close contact, or through blood, body fluids, or mucosal lesions. Risk groups include frontline health workers who care for MPXV patients, household members of an infected patient, and men who have sex with men. Skin lesions are usually, but not always, at the same stage. They may affect the face followed by the distal extremities with fewer lesions on the trunk (centrifugal distribution). Lesions may involve the mouth, genitalia, conjunctiva, and rectum. The majority of cases are mild. Nevertheless, the disease may have long-term effects on the skin, the neurological system, and the eye. Vaccination against MPXV is available but meanwhile should be limited to those who are at high risk. Those vaccinated against smallpox (usually older than 40 years) might be immune against MPXV. Infectious diseases are without borders. If proper action is not taken, there is considerable risk that MPXV will be entrenched worldwide. Our world has a delicate balance between animals, environment, and humans reflecting the need for a "one globe, one health approach" to address this risk. Following the principles of disaster management and using the lessons we have learned from the COVID-19 pandemic will reduce the impact of the MPXV outbreak.

Evaluation of post-vaccination immunoglobulin G antibodies and T-cell immune response after inoculation with different types and doses of SARS-CoV-2 vaccines: A retrospective cohort study.

Introduction: The induction and speed of production of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) immune biomarkers may vary by type and number of inoculated vaccine doses. This study aimed to explore variations in SARS-CoV-2 anti-spike (anti-S), anti-nucleocapsid (anti-N), and neutralizing immunoglobulin G (IgG) antibodies, and T-cell response by type and number of SARS-CoV-2 vaccine doses received. Methods: In a naturally exposed and SARS-CoV-2-vaccinated population, we quantified the anti-S, anti-N, and neutralizing IgG antibody concentration and assessed T-cell response. Data on socio-demographics, medical history, and history of SARS-CoV-2 infection and vaccination were collected. Furthermore, nasal swabs were collected to test for SARS-CoV-2 infection. Confounder-adjusted association between having equal or more than a median concentration of the three IgG antibodies and T-cell response by number and type of the inoculated vaccines was quantified. Results: We surveyed 952 male participants with a mean age of 35.5 years ± 8.4 standard deviations. Of them, 52.6% were overweight/obese, and 11.7% had at least one chronic comorbidity. Of the participants, 1.4, 0.9, 20.2, 75.2, and 2.2% were never vaccinated, primed with only one dose, primed with two doses, boosted with only one dose, and boosted with two doses, respectively. All were polymerase chain reaction-negative to SARS-CoV-2. BBIBP-CorV (Sinopharm) was the most commonly used vaccine (92.1%), followed by rAd26-S + rAd5-S (Sputnik V Gam-COVID-Vac) (1.5%) and BNT162b2 (Pfizer-BioNTech) (0.3%). Seropositivity to anti-S, anti-N, and neutralizing IgG antibodies was detected in 99.7, 99.9, and 99.3% of the study participants, respectively. The T-cell response was detected in 38.2% of 925 study participants. Every additional vaccine dose was significantly associated with increased odds of having ≥median concentration of anti-S [adjusted odds ratio (aOR), 1.34; 95% confidence interval (CI): 1.02-1.76], anti-N (aOR, 1.35; 95% CI: 1.03-1.75), neutralizing IgG antibodies (aOR, 1.29; 95% CI: 1.00-1.66), and a T-cell response (aOR, 1.48; 95% CI: 1.12-1.95). Compared with boosting with only one dose, boosting with two doses was significantly associated with increased odds of having ≥median concentration of anti-S (aOR, 13.8; 95% CI: 1.78-106.5), neutralizing IgG antibodies (aOR, 13.2; 95% CI: 1.71-101.9), and T-cell response (aOR, 7.22; 95% CI: 1.99-26.5) although not with anti-N (aOR, 0.41; 95% CI: 0.16-1.08). Compared with priming and subsequently boosting with BBIBP-CorV, all participants who were primed with BBIBP-CorV and subsequently boosted with BNT162b2 had ≥median concentration of anti-S and neutralizing IgG antibodies and 14.6-time increased odds of having a T-cell response (aOR, 14.63; 95% CI: 1.78-120.5). Compared with priming with two doses, boosting with the third dose was not associated, whereas boosting with two doses was significantly associated with having ≥median concentration of anti-S (aOR, 14.20; 95% CI: 1.85-109.4), neutralizing IgG (aOR, 13.6; 95% CI: 1.77-104.3), and T-cell response (aOR, 7.62; 95% CI: 2.09-27.8). Conclusion: Achieving and maintaining a high blood concentration of protective immune biomarkers that predict vaccine effectiveness is very critical to limit transmission and contain outbreaks. In this study, boosting with only one dose or with only BBIBP-CorV after priming with BBIBP-CorV was insufficient, whereas boosting with two doses, particularly boosting with the mRNA-based vaccine, was shown to be associated with having a high concentration of anti-S, anti-N, and neutralizing IgG antibodies and producing an efficient T-cell response.

The most influential COVID-19 articles: A systematic review.

Background: Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),causative pathogen of coronavirus disease 2019 (COVID-19), has triggered a pandemic with challenges for health care systems around the world. Researchers have studied and published on the subject of SARS-CoV-2 and the disease extensively. What is the significance of articles published, shared and cited in the early stages of such a pandemic? Materials and methods: A systematic literature search in a time frame of 12 months and analysis rating using Principle Component Analysis (PCA) and Multiple Factor Analysis (MFA) were performed. Results: The 100 most cited COVID-19 articles were identified. The majority of these articles were from China (n = 54), followed by United States of America (USA) (n = 21) and United Kingdom (UK) (n = 8). All articles were published in high-ranked, peer-reviewed journals, with research focusing onthe the diagnosis, transmission and therapy of COVID-19. The level of evidence of the 100 most cited COVID-19 articles on average was low. Conclusion: In the early stages of a pandemic, new and innovative research can emerge and be highly cited, regardless of the level of evidence.

Evaluation of post-vaccination immunoglobulin G antibodies and T-cell immune response after inoculation with different types and doses of SARS-CoV-2 vaccines: A retrospective cohort study

Introduction The induction and speed of production of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) immune biomarkers may vary by type and number of inoculated vaccine doses. This study aimed to explore variations in SARS-CoV-2 anti-spike (anti-S), anti-nucleocapsid (anti-N), and neutralizing immunoglobulin G (IgG) antibodies, and T-cell response by type and number of SARS-CoV-2 vaccine doses received. Methods In a naturally exposed and SARS-CoV-2–vaccinated population, we quantified the anti-S, anti-N, and neutralizing IgG antibody concentration and assessed T-cell response. Data on socio-demographics, medical history, and history of SARS-CoV-2 infection and vaccination were collected. Furthermore, nasal swabs were collected to test for SARS-CoV-2 infection. Confounder-adjusted association between having equal or more than a median concentration of the three IgG antibodies and T-cell response by number and type of the inoculated vaccines was quantified. Results We surveyed 952 male participants with a mean age of 35.5 years ± 8.4 standard deviations. Of them, 52.6% were overweight/obese, and 11.7% had at least one chronic comorbidity. Of the participants, 1.4, 0.9, 20.2, 75.2, and 2.2% were never vaccinated, primed with only one dose, primed with two doses, boosted with only one dose, and boosted with two doses, respectively. All were polymerase chain reaction-negative to SARS-CoV-2. BBIBP-CorV (Sinopharm) was the most commonly used vaccine (92.1%), followed by rAd26-S + rAd5-S (Sputnik V Gam-COVID-Vac) (1.5%) and BNT162b2 (Pfizer-BioNTech) (0.3%). Seropositivity to anti-S, anti-N, and neutralizing IgG antibodies was detected in 99.7, 99.9, and 99.3% of the study participants, respectively. The T-cell response was detected in 38.2% of 925 study participants. Every additional vaccine dose was significantly associated with increased odds of having ≥median concentration of anti-S [adjusted odds ratio (aOR), 1.34;95% confidence interval (CI): 1.02–1.76], anti-N (aOR, 1.35;95% CI: 1.03–1.75), neutralizing IgG antibodies (aOR, 1.29;95% CI: 1.00–1.66), and a T-cell response (aOR, 1.48;95% CI: 1.12–1.95). Compared with boosting with only one dose, boosting with two doses was significantly associated with increased odds of having ≥median concentration of anti-S (aOR, 13.8;95% CI: 1.78–106.5), neutralizing IgG antibodies (aOR, 13.2;95% CI: 1.71–101.9), and T-cell response (aOR, 7.22;95% CI: 1.99–26.5) although not with anti-N (aOR, 0.41;95% CI: 0.16–1.08). Compared with priming and subsequently boosting with BBIBP-CorV, all participants who were primed with BBIBP-CorV and subsequently boosted with BNT162b2 had ≥median concentration of anti-S and neutralizing IgG antibodies and 14.6-time increased odds of having a T-cell response (aOR, 14.63;95% CI: 1.78–120.5). Compared with priming with two doses, boosting with the third dose was not associated, whereas boosting with two doses was significantly associated with having ≥median concentration of anti-S (aOR, 14.20;95% CI: 1.85–109.4), neutralizing IgG (aOR, 13.6;95% CI: 1.77–104.3), and T-cell response (aOR, 7.62;95% CI: 2.09–27.8). Conclusion Achieving and maintaining a high blood concentration of protective immune biomarkers that predict vaccine effectiveness is very critical to limit transmission and contain outbreaks. In this study, boosting with only one dose or with only BBIBP-CorV after priming with BBIBP-CorV was insufficient, whereas boosting with two doses, particularly boosting with the mRNA-based vaccine, was shown to be associated with having a high concentration of anti-S, anti-N, and neutralizing IgG antibodies and producing an efficient T-cell response.

Topical niacinamide (Nicotinamide) treatment for discoid lupus erythematosus (DLE): A prospective pilot study.

BACKGROUND: Cutaneous lupus erythematosus is an umbrella term for a group of autoimmune connective tissue disorders affecting the skin. Discoid lupus erythematosus (DLE) is the chronic condition and most common form of cutaneous lupus erythematosus. AIMS: Current therapies of DLE are challenging and not completely satisfactory, highly expensive, off-label, or poorly available (like antimalarials due to COVID-19 outbreaks). Nicotinamide, also called niacinamide, is a water-soluble form of vitamin B3 (niacin). Its multiple effects let us think that nicotinamide could be a therapy for lupus-associated skin lesions. METHODS: We performed a prospective randomized double-blind clinical trial on 60 subjects diagnosed with Discoid lupus erythematosus using topical Nicotinamide 2% and 4% preparations in form of cream and gel on skin and scalp lesions. Control group was included using only cream/gel base as placebo control. RESULTS: Obtained data showed that topical Nicotinamide can be used for the treatment of DLE as adjuvant to other treatment regimens with good cosmetic results and minimal side effects. Topical 4% Nicotinamide is superior to 2% preparation in response but associated with a higher incidence of irritation. CONCLUSION: Topical Nicotinamide can be used for the treatment of DLE as an adjuvant to other treatment regimens with good cosmetic results and minimal side effects. Further trials with long-term therapy, follow-up period, and bigger sample sizes are required.

The reduction of SARS-Cov-2 S1-RBD IgG after four months of covid-19 infection of the medical staff at the Neurosurgery Teaching in Baghdad

Background The SARS-CoV-2 pandemic continues to negatively impact the healthcare system globally despite the availability of vaccination since late 2020.Until July 2022, Iraq registered 2,438,101 million COVID-19 cases and 25,304 deaths putting Iraq in third place among the Eastern Mediterranean Sea countries. Methods This study included ninety volunteered medical staff whois working in the Neurosurgery Teaching Hospital and were diagnosed with COVID-19 by PCR and accepted to give 5 ml of their blood.The medical staff was categorized into two groups and every group containforty-five, we collected bloodfrom the first group after one month (30 days) from the day of COVID-19 infection diagnosis while the second group after 4 months (120 days).We used an ELISA kit (Diacino R: cat.No. DS 207704, china) which is an indirect ELISAto estimate Cov-19 -SI-RBD(anti-spike). Results the independent two-sample Mann-Whitney test was used which showed that there was a significant decrease (P<0.05) in the SARS Cov-2 S1-RBD serum levels of the volunteered medical staff after 4 months compared to the one month. Conclusion SARS - CoV-2 S1- RBD IgGsignificantly decreasedafter 4 months (120 days).

The Effects of Hydroxychloroquine on Electrocardiogram Intervals

Background: Hydroxychloroquine (HCQ) was widely used as a potential therapy for COVID-19 infection. We studied the effects of HCQ on electrocardiogram (ECG) intervals. Method(s): We conducted a large-scale retrospective study of COVID-19 patients treated with HCQ admitted between March 1, 2020 and June 1, 2020. Extensive medical chart review was performed. Baseline and on treatment ECG intervals were manually measured by 3 electrophysiologists. The QT interval was corrected using Bazett formula (QTc). The paired t-test was used for the main analysis. Result(s): Paired ECG data from 1890 patients were analyzed. The mean age was 47.0 (+/-12.6) years with a strong male prevalence (85.6%). The commonest comorbidities were hypertension (39.6%) and diabetes mellitus (36.8%). The average duration of HCQ therapy was 6.3 (+/-2.3) days. 404 patients (21.4%) had severe COVID-19 infection and the mortality rate was 3.86%. Intensive care admission and mechanical ventilation was required in 209 (11.1%) and 166 (8.8%) patients, respectively. During therapy, heart rate (HR) decreased from 87.2 +/- 16.8 bpm to 80.6 +/- 14.7 bpm (P<0.001). The mean PR interval increased from 153.2 +/- 21.9 ms to 162.9 +/- 22.8 ms (P<0.001). The mean QRS duration increased from 92.8 +/- 12.6 ms to 97.4 +/- 13 ms (P <0.001). The average QTc increased from 427.4 +/- 25.4 ms to 438.4 +/- 29.9 ms (P<0.001). Conclusion(s): HCQ caused a modest but statistically significant prolongation in PR, QRS and QTc intervals. A reduction in HR was also noted mainly due to clinical improvement. (Figure Presented).

Impact of COVID-19 pandemic on mental health and quality of life of the physiotherapists of Islamabad and Rawalpindi: A cross-sectional study

A global pandemic of Coronavirus appeared in December 2019 in Wuhan and spread globally. The objective behind the study was to find out the impact of COVID-19 on mental status and quality of life of physical therapists of Pakistan. This cross-sectional survey was carried out from August 2020 to January 2021. Data was collected online and personally from teaching and practicing physiotherapists working in universities and in departments of rehabilitation sciences of hospitals of Islamabad and Rawalpindi. A sample of 110 physiotherapists was selected through non-probability convenience sampling. Standardized questionnaires including Depression Anxiety and Stress Scale (DASS-21), World Health Organization-Quality of Life Questionnaire (WHOQOL-BREF) and Impact of Event Scale-Revised (IES-R) were used to assess depression, anxiety, stress, fear and quality of life. Out of 110 physiotherapists, 48 were males and 62 were females. Through DASS-21, it was assessed that the prevalence of psychological distress was 40.0%, anxiety was 57.3% and depression was 40%. Scores on all four sub-scales of WHOQOL depicted that COVID-19 also impacted the quality of life of physiotherapists including physical, psychological, social and environmental health related quality of life. Similarly, through IES-R, it was assess that 35.5% physiotherapists were having mild to severe level of fear regarding COVID-19. This study concludes us that COVID-19 has a great impact on mental health and quality of life of physiotherapists during this pandemic. Copyright © Nova Science Publishers, Inc.

The interplay between severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) and the hypothalamic and endocrinal disorders: A Mini-review

The worldwide medical systems are still being severely impacted by the coronavirus disease-2019 (COVID-19) pandemic, which is responsible for catastrophic mortality and morbidity. It becomes more and more obvious that this unique respiratory virus's impacts go beyond the respiratory system as time goes on and our comprehension of it deepens. The transmembrane serine protease 2 (TMPRSS2) protein is necessary for the severe acute respiratory syndrome coronavirus 2, which is the cause of COVID-19, to gain cellular entry through the angiotensin-converting enzyme 2 (ACE2) receptor. Most endocrine glands exhibit high levels of expression for ACE2 and TMPRSS2. This pays the attention to the effect of COVID-19 on the endocrine system. Besides its capability to pass to the central nervous system especially the hypothalamus inducing a lot of functional disorders in COVID-19 individuals. Although effective vaccines became widely available, and mortality declined but attention is shifting more and more to the lengthy health impacts on COVID-19 survivors. To inform suitable research and effective management, this review provides an overview of the data examining the impacts of COVID-19 on the endocrine glands besides the hypothalamus. In addition, we reported if the endocrinal and thalamic disorders could affect the incidence and progress of COVID-19. Copyright© by the Egyptian Association of Immunologists.

Inhibition of SARS-CoV2 viral infection with natural antiviral plants constituents: An in-silico approach.

Background and Objective: In 2019, a novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) was declared pandemic. Advancement in computational technology has provided rapid and cost-effective techniques to test the efficacy of newer therapeutic agents. This study evaluated some of the potent phytochemicals obtained from AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homeopathy)-listed medicinal plants against SARS-CoV-2 proteins using computational techniques. Materials and methods: The potential SARS-CoV-2 protein targets were utilized to study the ligand-protein binding characteristics. The bioactive agents were obtained from ashwagandha, liquorice, amla, neem, tinospora, pepper, and stevia. Ivermectin was utilized as a reference agent to compare its efficacy with phytochemicals. Results: The computational analysis suggested that all the bioactive components from the selected plants possessed negative docking scores (ranging from -6.24 to -10.53). The phytoconstituents were well absorbed, distributed in the body except for the CNS, metabolized by liver enzymes, well cleared from the body, and well tolerated. The data suggest that AYUSH-recommended plants demonstrated therapeutic efficacy against SARS CoV-2 virus infection with significantly reduced toxicity. Conclusion: The phytoconstituents were found to hinder the early stages of infection, such as absorption and penetration, while ivermectin prevented the passage of genetic material from the cytoplasm to the nucleus. Additional research involving living tissues and clinical trials are suggested to corroborate the computational findings.

Addressing Long Term Support Needs in Wales - Community Steps Project

Background and Aims: Through feedback and conversations with stroke survivors, carers and staff, we identified gaps in long term support across Wales. There was need for more localised peer support and to work with people to help them feel confident and empowered to participate in activities. In response, the National Lottery funded, Community Steps project was implemented between April 2018 and March 2022. Method(s): We worked with partners to offer bespoke activities including: Wales Golf, Bowls Wales, Sailability, Parkinsons UK, Headway and other neurological organisations. In response to the COVID-19 pandemic, the team developed new and innovative ways of delivering services. We worked closely with partners to set up sessions on-line. Ability Net worked with stroke survivors and carers to address digital exclusion issues. The project also included a campaign forum working with decision makers within health boards. Result(s): 767 stroke survivors and carers referred to the project New groups, clubs and cafes established 1563 stroke survivors and carers recorded as attending group sessions, face to face and virtual. 7043 attendances recorded at our activities 556 volunteer hours recorded with the monetary value of 7241 Conclusion(s): The success of Community Steps is due to its ability to flex to needs of stroke survivors and adapt to challenges. Truly listening to stroke survivors and carers ensures they have been able to receive support they need throughout the project. Going forward we'll be running a new, three-year project called Next Steps. The project will build on learnings from Community Steps and stroke survivors' feedback.