Increased psychological distress after the lifting of COVID-19 lockdown in the Saudi population: a cross-sectional study

Background Amid the ongoing COVID-19 pandemic and its global health and socioeconomic aftereffects, the enduring state of crisis is increasingly impacting the coping capacity of the populations. In this study, we aimed to characterize the levels of psychological distress after the lifting of COVID-19 lockdown. Results The Impact of Event Scale (IES-R) and Depression, Anxiety, and Stress Scales-21 items (DASS-21) were used to screen for post-traumatic stress syndrome (PTSD), depression, anxiety, and stress. The prevalence of PTSD was 41.6% and was associated with severe or extremely severe stress (27.8%), anxiety (31.4%), and depression (39.0%). All disorders were strongly correlated with one another. The risk of developing PTSD was independently associated with residence in high COVID-19 prevalence region (OR = 2.25, p = 0.004), poor (OR = 3.98, p = 0.002), or moderate (OR = 1.63, p = 0.048) self-assessed overall physical health, psychiatric comorbidity (OR = 1.87, p = 0.036), number of COVID-19-like symptoms (OR = 1.94, p = 0.039), and severe COVID-19 morbidity in the acquaintances (OR = 1.54, p = 0.026). Four theories were proposed to explain these high figures, with a discussion of their practical implications. Conclusions The lifting of lockdown measures was associated with a substantial increase in psychological distress among the Saudi population, referring to figures reported during the lockdown. This may indicate a decline in the overall population's coping capacity with the enduring crisis.

“Pre-Ramadan” Telemedicine: Effect on Fasting Experience & Glycemic Control during Ramadan in People with Type 1 Diabetes

Objective: People with type 1 diabetes (T1D) are advised to have a “pre-Ramadan” clinic visit to receive the appropriate assessment and education needed to safely fast during the holy month of Ramadan. The COVID-19 lockdown has interrupted this standard of care, particularly in Muslim-majority countries where telemedicine is not well-established. Here, we examined the effect of virtual “pre-Ramadan” visits, as an alternative to the traditional (in-person) visit, on fasting experience and glycemic control during Ramadan in people with T1D. Method: 151 individuals with T1D were categorized into 3 groups according to the type of “pre-Ramadan” visit that they had in 2020: virtual (n=50), in-person (n=56), and no visit (n=45). Number of days fast was broken due to diabetes-related issues and CGM metrics were retrospectively compared across the 3 groups. Result: Patients who had a virtual “pre-Ramadan” visit were more likely to be women (60%) and use CGM during Ramadan (61.7%) than those who had no visit (37.8% and 38.6%, respectively, both p<0.05). Similarly, patients who had an in-person “pre-Ramadan” visit were more likely to use CGM (70.9%) than those who had no visit. Attending a virtual “pre-Ramadan” visit was associated with the least number of days fast was broken compared to those who had no visit (p<0.01) or in-person visit (p=0.02). The virtual group had the highest time in range (TIR) during Ramadan (59%) compared to the no visit group (44%, p<0.01) and in-person group (47%, p<0.01). After adjusting for age, gender, pre-Ramadan A1c, and use of CGM, the odds ratios of fasting most days of Ramadan (i.e., breaking the fast ≤2 days) were the highest in the virtual group [OR (CI): 9.13 (1.43, 58.22)] followed by the in-person group [3.02 (0.54,16.68)] compared to the no visit group. Conclusion: A virtual “pre-Ramadan” visit is an effective alternative to in-person visits when managing people with T1D who plan to fast during Ramadan.

Colorectal cancer screening during covid-19 pandemic;A systematic review

The pandemic of COVID 19 has led to the postponement of all elective procedures including screening colonoscopy due to the rising risk of infection with covid-19. Routine use of screening tests for colorectal cancer is not applicable during covid 19 pandemic including colonoscopy, computed tomographic colonography, colon capsule endoscopy, and fecal immunochemical test. Focused reviewing of the impact of covid-19 on the various diagnostic modalities for colorectal cancer screening is the objective of this review. Databases of PubMed, Embase, and Cochrane Library were searched for literature published before June 2020. This narrative review was created from a conscious dissection of different data obtained from the related articles. Careful categorical writing of the recommendations was done in an easy simple manner. The risk of the spread of COVID 19 infection could be higher after using aerosol-generating procedures such as upper and lower GIT endoscopy. Also, CT might raise the risk of infection. Colon capsule endoscopy may be considered a potentially valuable procedure for colorectal cancer screening during the pandemic of COVID 19. During the post-COVID-19 recovery phase, it is expected to have a high demand for colonoscopy services as waiting lists will grow in that time. Colon capsule endoscopy may be considered a valuable diagnostic modality for prioritizing those who will need screening colonoscopy. Colon capsule endoscopy seems to be superior to other modalities for the screening of colorectal cancer during the pandemic of COVID 19 while postponement of colonoscopy service. Colon capsule endoscopy can be used for triaging those requiring further endoscopic procedures. © 2021 Teikyo University School of Medicine. All rights reserved.

A Systematic Review of the Potential Implication of Salivary Secretions in Covid-19 Patients

As reported on 23rd May 2021, there are a total of 167,313,629 confirmed cases of Covid-19 all across the world with a mortality of about 3,473,851 whereas in Saudi Arabia 439,847 were registered cases of covid-19 and 7,237 deaths. According to the World Health Organization (WHO) a total of 12,244,264 people were vaccinated with Covid-19 vaccination. Covid-19 is a respiratory infectious disease. More recent researches on SARS-COV-2 suggests the entry of the virus into the host cell using the host entry factors like TMPRSS-2, TMPRSS-4 and ACE-2 in the oral tissues. The spike proteins of the SARS COV-2 attaches to the ACE-2 and TMPRSS2 of the salivary gland. Saliva provides the lubrication of the oral cavity, initiation of digestion and provides immunity in host. A complete research of all the articles was done using databases like: SCOPUS, PUBMED, EMBASE and WEB OF SCIENCE. In case of SARS CoV-2, the salivary glands act as reservoir for the virus. Intake of these viruses present in infectious saliva droplets found in the air would lead to the transmission of infection to an individual. Saliva is more efficient when compared to the blood as it doesn't clot. A reduced secretion of saliva is observed in patients post the covid 19 disease.

Pandemic-Driven Technology during COVID-19: Experiences of Older Adults

Pandemic-driven technology and mobile health (mHealth) applications become more apparent with the COVID-19 pandemic. Older adults are facing major issues using these applications due to their lack of understanding of the technology and hesitation to adopt them, reducing the benefits of such applications. To further explore these issues, we conducted an online survey with older adults' families (n = 397), preformed online interviews with older adults (n = 5), and undertook observations focused on their experiences. We found that older users of such social pandemic tracking technologies suffered with using these applications by themselves, which resulted in an increased dependence on others to help them with their basic daily social activities, increasing their chances of physically interacting and contracting the coronavirus. Such results make us question the level of technology literacy we reached within our communities, especially with the increased integration of digital technology into all areas of our lives. © 2021 ACM.

Viral and Bacterial Causes of Labyrinthitis

Labyrinthitis is a known inflammation of the membranous structure of the inner ear. Affected patients usually present with nausea and vomiting, vertigo, hearing loss/impairment, and tinnitus. Many etiologies have been proposed to lead to the development of labyrinthitis, including bacterial, viral, systemic, and iatrogenic causes and the most commonly reported causes include viral and bacterial infections. Not many investigations have elaborated on the viral and bacterial etiologies, and the evidence seems to be scattered across the different studies. In the present study, we have reviewed the literature to discuss the current evidence regarding the viral and bacterial causes of labyrinthitis. Many viruses and bacteria were reported in the literature to cause the condition. However, the most common pathogen includes cytomegalovirus and maternal rubella infections, leading to congenital hearing loss. Other viruses as measles and mumps might also lead to developing post-natal labyrinthitis. Studies also indicates that COVID-19 can be a recent cause of the disease. However, evidence regarding this information, similar to the case with other viral and bacterial etiologies, still needs further validation and reporting before making solid conclusions. Accordingly, we encourage researchers to furtherly report about similar cases and conduct epidemiological investigations to better understand the etiology of the disease.

Systemic Steroids and Mortality Rate in Severe COVID-19 Infection: A Systematic Review and Meta-analysis

Background: Evaluation of posted statistics including on this issue suggests that therapy with corticosteroids in the range of 6 mg of dexamethasone (or equivalent) in keeping with day possibly has an advantageous effect in patients requiring assisted ventilation but there remains considerable doubt in sufferers over the age of 70, in patients with diabetes and patients with milder sickness. Aim: This work aims to determine the safety of systemic steroids and mortality rate in severe COVID-19 patients. Materials and Methods: A systematic search was performed over different medical databases to identify Internal Medicine studies, which studied the outcome of the Steroid group versus the Non-steroid group of COVID-19 patients. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on 28-day mortality rate as a primary outcome, and Serious Adverse Events (SAE rate) as a secondary outcome. Results: Seven studies were identified involving 2583 patients, with 1218 patients in the Steroid group, and 1365 patients in the Nonsteroid group. The meta-analysis process revealed a highly significant decrease in the 28-day mortality rate and SAE rate in the Steroid group compared to the Non-steroid group (p<0.001 respectively). Conclusion: To conclude, steroids have shown their usefulness in critically ill COVID-19 patients. However, the efficacy of steroids and steroid dosage remains a matter of argument due to a lack of solid evidence and wide-ranging worries about benefits and harms. Further studies are needed to determine the optimal dosage and duration of steroid therapy which can reduce the mortality rate.

Reliability and Validity of Arabic Translation of the Impact of Event Scale-Revised for COVID-19 Pandemic

Objective: This study aims to translate and validate the Impact of Event Scale-Revised (IES-R) into the Arabic language with a population of medical students at two different universities in Saudi Arabia. Method: Fifty-six male and female medical students were tested during different periods of quarantine due to the COVID-19 pandemic using both original and translated versions of the IESR. Results: The Arabic IES-R has acceptable internal consistency, with the following alpha coefficients: Intrusion (Cronbach's a= 0.85), Avoidance (Cronbach's a= 0.75), Hyperarousal (Cronbach's a= 0.74), and total IES-R score (Cronbach's alpha= 0.88), all of which were significant (p-value< 0.01). The test-retest reliability of the Arabic scale examined with the same sample is high, with correlation coefficients ranging from 0.75 to 0.81 (p-value< 0.01) for the three subscales and total score. The reliability-parallel form method of the Arabic IES-R with the original IES-R indicates excellent consistency between the two scales, with significant (p-value< 0.01) intraclass correlation ranging from 0.80 to 0.89 for its three subclasses and total score. Finally, a principal components analysis using Varimax rotation was performed with the 3-factor forced solution explains 50.5% of the variance and generated an intrusion factor (items 1,3,6,9,14,15), avoidance factor (items 5,8,11,17,22), and hyperarousal factor (items 2,4,10,12,16,18,19). Conclusion: The Arabic IES-R has proven to be a reliable and valid measure for posttraumatic stress symptoms in our sample of medical students in quarantine during the COVID-19 pandemic. Category: Psychiatry, psychometry, community.