Assessment of Interleukin-13(rs20541) Genomic Polymorphism in Patients with Acute Respiratory Distress Syndrome in Relation to COVID19 Infection.

Elevated Interleukin-13 (IL-13) may play an important role in the pathophysiology of COVID-19, yet, the attenuated response did not notice across all severe cases. Susceptibility to asthma in specific populations is associated with several SNPs of multifunctional cytokines, such as IL-13, IL-31 and IL-33. This prospective case-control study is designed to investigate the extent of genetic susceptibility in subsets of Iraqi patients with COVID-19 by targeting the variants of interleukin IL-13rs20541 polymorphism in relation to disease susceptibility and severity of clinical presentation. One hundred samples were obtained from the throat, nasopharyngeal and nasal swabs enrolled in this study. Eighty samples of the throat, nasopharyngeal and nasal localization swabs were obtained from patients with acute respiratory distress syndrome (ARDS) (both COVID-19 and non-COVID19 patients), while other 20 nasopharyngeal swabs were included as a healthy control group (AHC). Detection of IL-13rs20541 polymorphism was done by ARMS technique. The frequencies of GG- genotype in ARDS- patients with COVID-19, non-COVID19-, and AHC groups were respectively 14%, 12% and 3%, where, and as compared to the control group, showed a significant increase in COVID-19 patients. The AA- genotype in patients with COVID-19 group, non- COVID-19 group and healthy control group documented the frequency of 9%, 7%, and 14%, respectively, where the frequency decreased in the patient's groups as compared to the AHC group. Finally, and among the studied groups, an increase of AG- genotype (as rate OR=1.89) was documented compared to genotype GG and A-. Genetic polymorphisms in the IL-13rs20541 gene might influence its functions in patients with SARS-associated respiratory tract infection and thus might involve the pathogenicity of patients with COVID-19.

Conceptual Framework of Factors Affecting Online Teaching

This study will add to the body of knowledge by creating a conceptual framework around fundamental concepts related to examining the factors that influence the efficiency of online teaching. The framework is based on an assessment of the online teaching literature found using Emerald, Institute of Electrical and Electronics Engineers (IEEE) Explore, ProQuest, and Google Scholar searches. A conceptual matrix is used to combine the findings into a framework of online instruction and effectiveness. A questionnaire was utilized and 81 respondents participated in the survey. We found that Google Meet is the most used platform for online teaching. In terms of stress level, teachers between the ages of 36 and 50 are the most stressed. As per time spent on online teaching, most teachers spent 3-5 hours a day and we also found that the more hours spent on online teaching, the more benefit the teachers and students will get. The study's findings can help the school and Malaysia's Ministry of Education understand the factors that affect how well teachers can conduct online teaching. © 2022 by the authors.

Complete Blood Count for COVID- 19 Patients Based on Age and Gender

Coronavirus infection (COVID-19), is now a worldwide pandemic. The researchers are trying to find more about this virus in term of diagnosis and management. Many researchers reported that the routine complete blood count is one of the main analysis to be perform for the patients as part of the confirmation test for the disease. Our aim is to find more about complete blood count (CBC) of patients infected with COVID-19 and to see whether the results would show any significant differences regarding age and gender. A group of 110 patients with a confirmed COVID-19 admitted to the Salah El- Deen Hospital in Tikrit City, Iraq. The cases were collected and analyzed from January to Decemper 2020. CBC analysis showed a significant differences in the levels of red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT), and C-reactive protein (CRP) based on gender, but no significant changes regarding age groups. more studies should be done in the future in this department. © 2022 American Institute of Physics Inc.. All rights reserved.

Evaluation of the Effectiveness of Some Detergents and Disinfectants Against Staphylococcus Aureus Isolated from Kirkuk Schools

The present study aimed to evaluate the effectiveness of some detergents and disinfectants against Staphyloccocus aureus, As (60) swabs were collected for a period of one month, and from various school environmental sources, which included the hands of students during their academic performance of their duties and age groups (13-19) years and after they underwent a corona virus examination and from health units for the school environment and student desks in the city of Kirkuk, The efficiency of the detergents and detergents used for hand washing and health institutions available in the local market was evaluated, which included: liquid soap (Fax), Bleach 6%, Flash, Dettol (EIFFEL), Hand santizer gel, Hand sanitizer spray.The results of the study showed that the detergents and disinfectants under study have inhibitory efficacy against Staphylococcus aureus according to the prepared concentrations (50,25,12.5)%,Flash and Hand sanitizer spray are among the most effective disinfectants and detergents, followed by Bleach, then Dettol and liquid soap, and Hand santizer gel was less effective against bacteria. © 2022 American Institute of Physics Inc.. All rights reserved.

Acute STEMI During the COVID-19 Pandemic at a Regional Hospital: Incidence, Clinical Characteristics, and Outcomes

Objectives: The aim of this study was to describe the characteristics and in-hospital outcomes of patients with acute ST-segment elevation myocardial infarction (STEMI) during the early COVID-19 pandemic at Piedmont Athens Regional (PAR), a 330-bed tertiary referral center in Northeast Georgia. Method(s): A retrospective study was conducted at PAR to evaluate patients with acute STEMI admitted over an 8-week period during the initial COVID-19 outbreak. This study group was compared to patients admitted during the corresponding period in 2019. The primary endpoint of this study was defined as a composite of sustained ventricular arrhythmia, congestive heart failure (CHF) with pulmonary congestion, and/or in-hospital mortality. Result(s): This study cohort was composed of 64 patients with acute STEMI;30 patients (46.9%) were hospitalized during the COVID-19 pandemic. Patients with STEMI in both the COVID-19 and control groups had similar comorbidities, Killip classification score, and clinical presentations. The median (interquartile range) time from symptom onset to reperfusion (total ischemic time) increased from 99.5 minutes (84.8-132) in 2019 to 149 minutes (96.3-231.8;P= .032) in 2020. Hospitalization during the COVID-19 period was associated with an increased risk for combined in-hospital outcome (odds ratio, 3.96;P= .046). Conclusion(s): Patients with STEMI admitted during the first wave of the COVID-19 outbreak experienced longer total ischemic time and increased risk for combined in-hospital outcomes compared to patients admitted during the corresponding period in 2019. Copyright © 2022 Turner White Communications Inc.. All rights reserved.

INCIDENCE, CLINICAL CHARACTERISTICS, AND OUTCOMES OF ACUTE STEMI DURING THE COVID-19 PANDEMIC AT A TERTIARY REFERRAL CENTER

BACKGROUND: The aim of this study was to describe the characteristics and in-hospital outcomes of acute ST- segment elevationmyocardial infarction (STEMI) patients during the COVID-19 pandemic at Piedmont Athens Regional (PAR), a 330-bed tertiary referral center in Northeast Georgia. METHODS: We conducted a retrospective study involving patients admitted at PAR to evaluate consecutive STEMI patients admitted throughout an 8- week period during the COVID-19 outbreak. These patients were compared with consecutive STEMI patients admitted during the corresponding period in 2019. The primary endpoint was defined as a composite of malignant arrhythmia, congestive heart failure, and in-hospital mortality. Secondary outcomes included individual components of primary outcome, cardiogenic shock, mechanical complications, electrical complications, re- infarction, stroke, and pericarditis. RESULTS: This study cohort was comprised of 64 consecutive acute STEMI patients, of whom 30 (46.9%) were hospitalized during the COVID-19 outbreak. STEMI patients in both the COVID-19 and control groups had similar comorbidities, Killip classification score, and clinical presentations. The median time from symptom onset to reperfusion (total ischemic time) was lengthened from 99.5 minutes (IQR 84.8-132) in 2019 to 149 minutes (IQR 96.3- 231.8, p-value = 0.032) in 2020. Hospitalization during the COVID-19 era was independently associated with an increased risk for combined inhospital outcome (OR 3.96, p-value = .046). CONCLUSIONS: STEMI patients admitted during the first wave of COVID- 19 outbreak experienced longer total ischemic time and increased risk for combined in-hospital outcomes compared to the corresponding period in 2019 at PAR.

The Myth of Air Purifier in Mitigating the Transmission Risk of SARS-CoV-2 Virus

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious disease that emerged in December of 2019, threatening human health and leading to global public health crises. Airborne transmission via droplets and aerosol has been recently recognized as one of the infection modes for the SARS-CoV-2 virus. Hospitals have deployed/incorporated indoor air purifiers with the hope to minimize the transmission risk of SARS-CoV-2 virus. Nevertheless, the effectiveness of the indoor air purifier in reducing the transmission risk remained unknown. This study uses computational fluid dynamics to model the dispersion of the aerosol particles exhaled from the patient under the influence of an air conditioner, exhaust fans and air purifier. The numerical model showed that airflow from the diffusers, exhaust fans and placement of the air purifier significantly influenced the dispersion pattern of the aerosol particles in the common ward. Multiple air purifiers placed at 1 meter above the floor and next to a patient can increase the total efficiency from 37.14 to 59.91% for weak exhalation and from 36.44% to 48.81% for medium exhalation. No aerosol particles flew out from the door for weak and medium exhalation when multiple air purifiers were deployed in the common ward. Location and matching the clean air delivery rate with the size of the room are the important factors that affect the performance of the air purifier. © The Author(s).

Medical errors during covid-19 pandemic: The role of emergency medicine

Objective: Nowadays, many countries all over the world are involved with COVID-19 and the number of new cases and deaths are on a rise. The role of emergency medicine and physician-led triage is important in this period. We report some near missed cases in our academic center related to this pandemic. Case Presentation: We report 5 cases that missed triage or received delayed diagnosis because of COVID-19 suspicion. Some cases are life threatening. Conclusion: Although COVID-19 is the main health concern these days, other critical conditions should be considered. Stabilizing patients before transferring them between hospitals should be the essential goal of emergency department whether the patient is Corona virus infected or not. And before any intervention, the safety of healthcare workers must be ensured. © 2021 The Author(s).

Monitoring and evaluation of tropospheric NO2 columns density and Ultraviolet Aerosol Index (UVAI) over Iraq during the Outbreak of COVID-19 Using Remote Sensing and GIS

Since the discovery of COVID 19 coronavirus in January 2020 and the researchers everywhere try to find a reason behind spreading of coronavirus over the world. The important question here is, does air pollution can be a good medium to increase the infection rate and spread of COVID-19. In present work, ESA remote sensing data, specifically, Sentinel 5p Level 2 data to study the air pollutants with high spatial-temporal resolution was analyzed. We used the tropospheric NO2 vertical column density, along with UV Aerosol Index (UVAI) were used to investigate the role of changing in the air pollutants on the spread of COVID-19. The continuous decrease in the in tropospheric nitrogen dioxide NO amounts in all cities in Iraq during the lockdown measures. At the same time, the results illustrate a significant increase in 2 UV Aerosol Index in all cities in Iraq. More specifically, the cities that have the highest levels of air pollution are Baghdad and Basra. The maximum declination in NO2 was 43% lower than that from 1-31 January 2020. On the other hand, we found a significantly large increase ratio in UVAI and the largest increase is 239.8 and 221.2% in June and July respectively. In the end, we concluded that the implementation control actions in Iraq have been effectively contributed to reducing the current air pollution situation and increasing the air quality but unfortunately, the effectiveness of the actions didn't help to reduce the spread of the COVID-19 pandemic and decrease the number of cases of coronavirus in Iraq. © 2021 Ecological Society of India. All rights reserved.

Mini geriatric medicine clerkship for MS3

Background: The ongoing COVID-19 pandemic has adversely affected face-to-face time for teaching and learning of geriatric concepts in undergraduate medical education. To augment learning experiences in older adult healthcare the Geriatrics Department at the North Dakota School of Medicine and Health Sciences developed a case-based curriculum for a 2-week geriatrics elective designed for third year medical students. Method: Older adult patient cases were developed from multiple sources. Learning objectives were tailored toward undergraduate medical education and mapped to ACGME Core Competencies. Case reports were supplemented with evidence-based medicine from PubMed® citations and made available as reading material. Pre- and post-clerkship assessment multiple-choice questions were developed to cover fundamental core concepts. Result: Curriculum was implemented using Blackboard® and Zoom® technology. Feedback on the curriculum from both learners and teachers was generally positive. Pre test results showed 70% knowledge of Geriatrics that improved by 8-10% after the mini- clerkship. We did not track trainee engagement of the cited medical literature, thus offering a new round of project analysis regarding how many students are stimulated by case reviews to delve deeper into the Geriatrics clinical research. Conclusion: An online, case-driven geriatrics elective can be implemented successfully to strengthen 3rd year student's Geriatrics knowledge sans face to face clinical encounters. It remains to be seen if this type of learning augments face to face experiential learning.

Cities and COVID-19: Navigating the new normal

Non-technical summary Urban density is erroneously regarded as the main factor in the spread of COVID-19 in cities. A review of extant literature and findings from our case study of Karachi, Pakistan indicate that inequalities in income, healthcare, and living conditions play a key role in the spread of contagions along with government responsiveness to the pandemic. Moving forward, urban policies need to address these inequalities through changes in housing policies and decentralized governance systems. Cities must adapt to sustainable modes of travel, reduce digital inequalities, and encourage people friendly urban planning to become resilient in the face of pandemics. Technical summary COVID-19 has changed how urban residents relate to their cities. Urban centers have become epicenters of disease, which has raised questions about the long-term sustainability of high-density settlements and public transport usage. However, the spread of COVID-19 in cities is incorrectly attributed to urban density. Using the case study of Karachi, Pakistan, we find that inequality of income, healthcare, and living conditions is a major contributing factor to the spread of COVID-19. Data on positive COVID-19 cases, density, and socioeconomic status were obtained at the Union Council level from administrative districts of Karachi, Pakistan between March 2020, and July 2020. Despite low population densities, low-to-middle income neighborhoods in Karachi had a higher proportion of positive cases. Further, the experience of dense cities such as Hanoi in Vietnam and New York in the US differs regarding the spread of COVID-19. Hence, the government's response to the pandemic is also a major factor in containing the outbreak. Our findings suggest that a crisis in a city is exacerbated by its inability to take advantage of its density, inequality in the distribution of resources, lack of inclusiveness, and centralized governance mechanisms that make it difficult to respond quickly to situations. Thus, urban planning scholarship and practice should take an interdisciplinary approach to make cities equitable, inclusive, and adaptive. Social media summary Cities in the developing world have an opportunity for more resilient renewal in the post-COVID world. Copyright © The Author(s), 2021. Published by Cambridge University Press.

Serum phosphate, serum calcium and serum iPTH levels in patients with CKD and risk of cardiovascular events

Objective: To determine the association between serum phosphorus, serum calcium, and serum iPTH and the occurrence of cardiovascular events in patients with diagnosed chronic kidney disease. Methodology: A prospective cohort study was conducted at Pir Abdul Qadir Shah Jeelani Institute Of Medical Sciences Gambat, Khairpur Mirs and Jinnah Postgraduate Medical Centre between August 2019 and July 2020. All patients over 18 years of age were eligible to participate in the study. Patients with incomplete data or those who were lost to follow-up were excluded from the study. Mineral metabolism parameters including, serum calcium, Phosphorus, and intact iPTH (iPTH), levels were recorded for all patients. Patients were followed up till the start of August 2020 to record any cardiovascular event. Patients were sub stratified into two groups i.e. with or without a CV event. Results: The study reported that with the exception of serum calcium, both iPTH and serum phosphorus were significantly associated with occurrence of CV events. iPTH levels had a direct association with CV events with a mean iPTH of 157.34±106.95 pg/ml in patients with CV events versus 108.98±85.63 pg/ml in patients without any CV event (P=0.0005). The mean serum phosphorus for the group with CV event was 3.57±0.73 mg/dl which was significantly higher than those without CV events (P=0.03). Conclusion: The current study indicated that serum phosphorus and intact iPTH levels were significantly associated with CV events in patients with CKD.