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SARS-Cov-2 is the novel coronavirus with predominantly inflammatory pathogenesis. The inflammation can be initiated and finally aggravated through a number of interconnected inflammatory pathways such as NF-κB, JAK-STAT, MAPK TLRs, iNOS, COX, etc. In the current chapter, these signaling pathways which instigate inflammation in SARS-Cov-2 are discussed. Moreover, drugs inhibiting these pathways in other inflammatory conditions or diseases are either in clinical use as COVID-19 therapy, or have been proposed as potential future therapeutic interventions in this chapter. These repurposing strategies can halt the COVID-19 symptoms as well as disease progression. This was demonstrated by establishing a link between the regulatory actions of these molecules or drugs in the inflammatory pathway like cytokine release against the COVID-19-related inflammatory havoc. Hence, the chapter will provide profound insights in the inflammatory control pertaining to COVID-19 severity and complications. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
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The nervous system is a crucial part of the human body that is damaged by traumatic injury, stroke, and neurodegenerative diseases. Recent studies also have shown that neurodegenerative diseases are associated with a subsequently increased risk of COVID-19-related death. Presently used pharmacological and therapeutic strategies are only the symptomatic treatments that involve the disruption of axonal tracts and are unable to repair and regenerate damaged CNS tissue thereby leading to significant unmet clinical needs involved in neural degeneration. The use of stem cell based regenerative medicine approaches is also limited due to heavy cost, ethical concerns and graft rejection. To address all these limitations, the neural tissue engineering philosophy has been developed that focuses on exploring and developing smart biomaterials for neural tissue repair and regeneration. A scaffold based upon natural and synthetic polymers has meant a very potential role to mimic the extracellular matrix of cells and permit the growth of different types of cells thereby improving the biological behavior in vitro and in vivo effects. They treat neurological disorders without the classic drug delivery limitations. Among these biopolymers, the collagen-based hydrogel is successfully applied conduits for clinical trials that ultimately replicate the native physiological environment of the neural tissues and control cell behavior and favor the regeneration of the damaged nerve tissue. The main objective of this review is to investigate the recent approaches and applications of next-generation polymeric biomaterials useful in the management of neurodegenerative diseases. We also discuss the outlook of the polymeric scaffolds that could pave the way for successful clinical practices. © 2022 The Authors
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The demand for scalable, rapid and sensitive COVID-19 diagnostics is particularly pressing at present to help contain the spread of infection and prevent overwhelming the capacity of health systems. While high-income countries have managed to rapidly expand diagnostic capacities, such is not the case in resource-limited settings of low- to medium-income countries. We report the development of an integrated modular centrifugal microfluidic platform costing less than 250 USD to perform loop-mediated isothermal amplification (LAMP) of viral RNA directly from heat-inactivated nasopharyngeal swab samples. The platform was validated with a panel of 131 nasopharyngeal swab samples collected from symptomatic COVID-19 patients. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.
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BACKGROUND: Dual-consultant operating (DCO) has been introduced in a multitude of surgical specialities. This retrospective cohort comparison study seeks to delineate any benefits DCO may confer on list utilisation, patient safety and training opportunities. METHODS: A retrospective cohort comparison of all free-flap breast reconstruction cases conducted at a single centre by five consultant plastic surgeons in the period May 2016-May 2020. RESULTS: A total of 281 patient records were used for analysis; 146 cases were dual consultants compared with 135 single consultants, representing 186 and 158 free flaps, respectively. Patient demographics were near identical in terms of patient age, BMI and ASA grade. Operating times were significantly reduced for both unilateral (mean reduction 59.49 min) and bilateral cases (mean reduction 38.14 min) with the presence of dual consultants. The mean length of stay for dual-consultant cases was on average 0.35 days less than for single consultant cases (p = 0.04). Dual-consultant case complications were less severe than those of single consultant cases (mean Clavien-Dindo severity 1.35 vs 0.96, p = 0.05). The rates of trainee one-to-one consultant training were increased in dual-consultant cases when preparing vessels (0.08 vs 0.35, p=<0.01) and performing anastomosis (0.63 vs 0.77, p = 0.03). CONCLUSIONS: DCO for complex breast reconstruction confers significant benefits to operating time, list utility and patient safety whilst protecting training opportunities for trainees. Plastic surgery departments looking to redesign services in the post-SARS-CoV-19 era should consider its adoption into their enhanced recovery protocols.
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Free Tissue Flaps , Mammaplasty , Surgeons , Consultants , Humans , Mammaplasty/methods , Retrospective StudiesABSTRACT
The Coronavirus disease (COVID-19) most likely began in an animal species and subsequently transmitted to humans in Wuhan, China, a city of 11 million people, on December 29, 2019, when the first case was recorded. The Coronavirus then transmitted from person to person by infected droplets from a sick person's coughing, sneezing, or contaminated hands. Hence, the purpose of the study is to see the impact of the outbreak of COVID-19 daily tests on the Pakistani rupee against the US dollar exchange rate using Vector Autoregressive approach. The data is gathered from February 26, 2020 to March, 2021. This period was selected, because the pandemic expanded, and the first case was observed in Pakistan on Feb 26th 2020. To verify this effect, a Vector Autoregressive Model was developed. A generalized version of the Autoregressive Model is a Vector Autoregressive (VAR) model. As a result of the COVID-19 pandemic, the Pakistani rupee devalued against the US dollar throughout the abovementioned period. When analyzing the Pakistani rupee vs. the US dollar exchange rate using a Vector Autoregressive Model, the values of the lags (1, 4, 6, and 7) of the explanatory variable have a significant impact. Besides, under the VAR model, the IRF (Impulse Response Function) asserted the actual impact of the daily COVID-19 tests, as well as Decomposition of Variance was shown to provide for the daily COVID-19 tests just a small part in understanding the volatility of the Pakistani rupee against the US dollar exchange rate. The Granger Causality suggests that the short-term and long-term changes in the Pakistani rupee against the US dollar exchange rate are caused by daily COVID-19 tests. Copyright © 2022 Akhtar, Abiad, Mashwani, Aamir, Naeem and Khan.
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COVID-19 patients are known to have immunosuppression due to decreased lymphocytes and increased susceptibility to co-infections (Bacterial and fungal). We present a case of 61-year-old patient who had diabetes, hypertension and ischemic heart disease with COVID-19 infection admitted after RT-PCR positive result. He developed rhino-orbital Mucormycosis during treatment. He received Remdesivir with parenteral Methylprednisolone and Meropenem. While admitted in the ward, he developed signs of orbital cellulitis. Magnetic resonance imaging (MRI) of the brain, orbits, and paranasal sinuses revealed right frontal, ethmoidal, and maxillary sinusitis with the extension of the sinisuidal disease to the orbit. A nasal biopsy revealed broad a septate filamentous fungal hyphae suggestive of Mucormycosis. Long-term use of steroids/monoclonal antibodies/broad-spectrum antibiotics may contribute to the predisposition to fungal disease. Early diagnosis and prompt management are warranted to avoid morbidity. © 2022, Ophthalmological Society of Pakistan. All rights reserved.
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Purpose - This study was designed to specifically explore confirmation and perceived usefulness associated with mobile food ordering apps (MFOAs) in consideration of their impacts upon attitudes, satisfaction and intention to continuously use. Design/methodology/approach - The research utilized the convenience sampling to gather data from 250 respondents having prior experience with MFOAs during COVID-19 pandemic period in Bangladesh. The Structural Equation Modeling technique was applied to analyze the data using SmartPLS 3 software. Findings - This study's results showed that customers' perceived confirmation and usefulness were significant in determining their dinning attitudes. Besides, customers' dining attitudes were positively related to e-satisfaction. Finally, the customers' continuance intention to use MFOAs was significantly influenced by their e-satisfaction. Research limitations/implications - Restaurants managers should focus on online sales through MFOAs during the pandemic period since social distancing is a key strategy to manage COVID-19. Customers should be assured that the safety measures are undertaken while delivering the food. Originality/value - This study incorporated the expectation-confirmation theory and technology acceptance model and tested it in the context of MFOAs.
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Objective: To provide an insight into the frequency of cutaneous manifestations in patients with Corona Virus Disease of 2019 (COVID-19), along with an association of these findings with the severity of the disease. Study Design: Cross-sectional study. Place and Duration of Study: Tertiary care hospital, Rawalpindi Pakistan, from May to Jul 2020. Methodology: We collected data from 412 confirmed cases of COVID-19 patients directly who were >12 years of age. The data included names of patients, their genders, ages, dates of admission, severity category, presence or absence of symptoms and cutaneous findings along with description of cutaneous findings if present. The data was evaluated using Statistical Package for the Social Sciences (SPSS) version 23. Results: Eleven out of the total 412 patients with COVID-19 included in our study were found to have cutaneous findings. The frequency of cutaneous manifestations associated with COVID-19 was calculated to be 11 (2.7%). Increasing age proved to be positively correlated with increasing severity of the disease whereas no association was found between gender and severity of the disease. Conclusion: Infection with COVID-19 may result in dermatological manifestations with various clinical presentations, which may aid in better understanding and management of the disease. © 2021, Army Medical College. All rights reserved.
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Objective: To assess the frequency of smokers in patients who are confirmed to have COVID-19 through PCR testing and to determine the association of cigarette and windpipe smoking with the disease severity Study Design: Cross-sectional study Place and Duration of Study: This study was conducted at the Department of Medicines, Shaikh Zayed Hospital, Services Hospital and Ittefaq Hospital Lahore, Pakistan from 13th June 2020 to 15th March 2021. Materials and Methods: Three hundred and sixty seven patients were taken from different hospitals of Lahore, Pakistan. Only COVID-19 PCR positive patients with age over 25 were selected to be part of the study. The COVID- 19 case was defined as mild moderate and severe based on the severity of symptoms. History of current and former smoking, mode of smoking whether windpipe or cigarette and the no. of pack years smoked was asked from each patient or next of kin in severe disease. Results: There were 39.5% females and 60.5% males. The smoking population was fairly low to about 12.53% among which 46 were cigarette smokers, 4 used windpipe and the other 4 had used both cigarette and windpipe. The no. of years smoked are divided into three groups and their relation with the severity of disease observed in this study. Conclusion: There was no significant association found between the disease severity in COVID-19 infection and smoking habit. Also, it was found that the intensity of smoking was unrelated to the severity of symptoms in COVID-19.
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A 50 years old woman was referred to hospital with complaints of bluish black discoloration of skin or multiple ecchymosis since 6 days and skin rashes, pink changes or petechiae changes since 1 week, dark color stools since 3 days. She had a history of COVID-19 positive on past "3 months" back and she received the corticosteroids, antiviral drugs, broad spectrum antibiotics, anticoagulants, and vitamin B and C supplements. Now patient is admitted and investigated for further management. Her bone marrow examination reveals marrow cytological features are compatible with immune thrombocytopenic Purpura and peripheral examination reveals red cells are microcytic hypochromic with elongation forms, platelets are markedly reduced and elevation of CRP, reduction of the Hb, PCV, MCH, MCV, MCHC, APTT, Serum vitamin B12, Lymphocytes and her HRCT-Chest shows CORADS 5, Rapid antigen test shows positive. A review on introduction of the disease, etiology, pathogenesis, pathophysiology, mechanism of thrombocytopenia in COVID-19 patients and grading is explained in literature review.
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In times where all other companies are on the verge of shutting down, app-based companies have found new meaning to their businesses through helping people. They have risen from the ashes like a phoenix and have set a marvellous example for all other companies about the meaning of life and how the goat of every company should be set. There is a saying that everything has a bright side, even a life-threatening pandemic like COVID-19 has a bright side to it. And one of those is the new definition of business and partnership. The outbreak of Coronavirus, countrywide lockdown and people in need has taught companies that making profit is not the only goal of business and partnerships. Helping people in times of crisis is even bigger than profit. You go after doing good for the people, profit will follow you anyway, and that trend has been initiated by app-based companies in Bangladesh. Copyright © 2021 Inderscience Enterprises Ltd.
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Purpose - The study aims to gain insights into the management of COVID-19 in Bangladesh to identify the factors that are relevant to managing the pandemic in a developing country. Design/methodology/approach - The study was carried out by pursuing the archival method. The information was collected from credible newspaper reports over the previous months, as well as articles published on the subject of COVID-19. Findings - The research revealed important and relevant dimensions of the health sector in managing the COVID-19 pandemic. The major factors were doctors, nurses (health service providers), patients, (customers) and society. This is a pioneering paper, which documents the major lessons learned from the management of COVID-19 in Bangladesh concerning three stakeholders of the health-care system, i.e. providers, patients and society. This paper covers the situation regarding the ongoing pandemic from three perspectives - provider, customers and society, and thus, may help to develop future research regarding the development of health-care management models for addressing the pandemic. Research limitations/implications - The major limitations of this paper is its over dependence on secondary sources for collecting the information. Practical implications - This paper presents the learnings from the pandemic in health-care management in different categories (e.g. social, doctor/nurse, patients), which can help the managers in understanding different dimensions of the health-care sector from different perspectives. The problems as well as the learnings stated in the paper can help the policy makers implement such strategies to ensure better delivery of the medical healthcare service during a pandemic. Social implications - This paper clearly reveals the social dimensions of the COVID-19 by assessing the social aspects of COVID-19 management. Both social stigma and support are traced out during evaluating the situation. Thus, the social forces will be able to rethink about their role in addressing the social costs of pandemic. Originality/value - This is a commentary piece.
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Online learning systems owing to their nature are free of restrictions of time or place and can prove to be a useful platform for students where they can continue their studies when it is not possible for them to go to a university in person owing to different reasons. Such systems have also been used in Pakistan, particularly in private sector, for university and school education. This paper attempts to highlight various issues that the students are facing and the factors that have a significant effect on their online learning experience. We collected data through online questionnaires distributed to 1200 students enrolled in six private universities in Pakistan. This study employed the Structure Equation Modelling (SEM) to examine factors that influenced online learning. The results showed that teaching and professional behaviour, course instructional planning and methodology and online connectivity were significantly positively associated with online learning. With the identification of key factors that affects online learning of students, it will be more helpful to provide improved services for effective student leaning. Other crucial implications and a way forward are also discussed in the paper.
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Problem Management Plus (PM+) is used to address mental health needs in humanitarian emergencies, including in response to COVID-19. Because PM+ is designed for non-specialist facilitators, one challenge is ensuring that trainees have the necessary competencies to effectively deliver the intervention and not cause unintended harm. Traditional approaches to evaluating knowledge of an intervention, such as written tests, may not capture the ability to demonstrate PM+ skills. As part of the World Health Organization Ensuring Quality in Psychological Support (EQUIP) initiative, we developed a structured competency rating tool to be used with observed standardised role plays. The role plays were designed to elicit demonstration of the key mechanisms of action for PM+. These role plays can be objectively rated by trainers, supervisors or other evaluators to determine facilitators' competency levels in PM+. These competency assessments can highlight what skills require additional attention during training and supervision, thus supporting facilitators to fill gaps in competencies. The integration of role plays in training and supervision also allows organisations to establish quality control metrics for competency standards to deliver PM+. We describe lessons learned from piloting the PM+ competency role plays with the Center for Victims of Torture programme with Eritrean refugees in Ethiopia. © 2021 Lippincott Williams and Wilkins. All rights reserved.
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Purpose: The outbreak of the new coronavirus has caused tremendous concerns to public health, which are impacting human lives both physically and psychologically. The rise in coronavirus cases has led to the propagation of control measures for its prevention. This study aims to investigate the factors enhancing the coronavirus preventive behavior among the respondents. Design/methodology/approach: To understand the coronavirus preventive behavior, the study is based on the value–belief–norm (VBN) theory. Data for the study has been collected through a survey of 319 respondents in New Delhi, India. The study uses structural equation modeling (SEM) to understand the factors impacting preventive behavior. For analysis, the study uses SEM to examine direct and indirect relationships and Hayes’ PROCESS macro SPSS module for moderating effects. Findings: The results show that egoistic values have a negative impact on belief while altruistic values have a positive impact on the belief about the coronavirus outbreak. Belief is recorded to have a positive and significant impact on preventive behavior. Also, personal norms positively mediate the relationship between belief and preventive behavior. Additionally, the impact of awareness of preventive behavior is positively moderated by the symptomatic profile. Furthermore, the interaction effect is found to be conditioned positively with age and level of education. Originality/value: To the best of the authors’ knowledge, no other work in the existing literature was found to apply the VBN theory to determine coronavirus preventive behavior. Further, the extensive moderation analysis done in this study is expected to be a significant contribution to the literature. © 2020, Emerald Publishing Limited.
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