Real-World Single-Centre Experience of Jak Inhibitor Use in Ra

Background/Aims The use of Janus Kinase Inhibitors (JAKi) has been gradually increasing overtime in the management of rheumatoid arthritis (RA) and other inflammatory arthritis and these appeal to patients. being oral agents. Nevertheless, rheumatologists have become cautious about their use since recent trials have shown safety concerns about VTEs, MACE and malignancies. Methods We decided to study use of JAKi at our centre in Princess of Wales Hospital Bridgend. The aim was to assess whether appropriate patients were selected (considering cautions about MACE, VTEs and malignancies). We also wanted to see whether all patients had required pretreatment safety testing and post-treatment monitoring performed. Results These were 70 patients;59 were females and 11 were males. All of them were diagnosed as RA. Average age was 61.1 years (20-85), average duration of disease 129.9 months (16-340) and average duration of treatment was 58.1 weeks. The most common JAKi being used was baricitinib (84%) followed by tofacitinib (12%) and upadacitinib (4%). 50% patient were on concomitant csDMARDs among whom two-thirds were on methotrexate. Looking at previous biologic use, 9 patients were biologic naive, 22 had one biologic, 15 had two biologics used in the past. All patients were appropriately selected (severe RA and no significant risk factors for MACE, VTEs and malignancies). All patients had pre-treatment Hepatitis B, Hepatitis C, latent TB, FBC and LFTs checked. All patients had FBC and LFTs monitored post treatment. No patient developed VTE, MACE or cancer on treatment. 84.2% patients had lipids tested before starting JAKi. 22.8% patients had abnormal lipids before Rx initiation and 62.5% of these were on lipid lowering Rx. All patients had lipids tested post treatment, but the timing was quite variable and only 62.5% of patients had lipids tested on the recommended time. There were 2 deaths recorded in this cohort. One of those was an 80-year-old RA patient on baricitinib 2mg OD, who died due to chest infection on the background of ILD. He was not on steroids or csDMARDs. The second patient was 63 years' old (on baricitinib 4mg OD), and died due to respiratory sepsis, and was also on azathioprine. She had RA with advanced ILD. The reasons for discontinuing JAKi were inefficacy (46%), side effects (39%) and both inefficacy and side effects (15%). 41.4%of patient experienced side effects due to JAKi. These included infection 28%, deranged lipids 17%, cytopenia 14%, deranged LFTs 14%, GI side effects 10%, skin rash 7% and varicella zoster 3%. Conclusion There has been steady increase in the use of tsDMARDs for RA and other rheumatic conditions. Due to short half-life, these drugs became a popular choice during COVID-19 pandemic but on the other hand safety monitoring became extremely challenging during this time.

Does Gender and Locality Impact Dysfunctional Anxiety Caused by the Coronavirus Pandemic? A Cross-Sectional Study of the Residents of Hyderabad, Pakistan

Background/objectives: COVID-19 has affected 521 million people worldwide since March 2020. Disease outbreaks increase fear and anxiety. Stress, anxiety, and other mental illnesses. Various tools have been created to assess the psychological impact of COVID-19. Corona Anxiety Scale is among the reliable tools. This study examined the relationship between gender and location (urban/rural) and corona anxiety. Methodology: This cross-sectional study was conducted at the Physiology department university of Sindh Jamshoro from December 2020 to January 2021. After informed consent, a total of 479 participants completed 5 item corona anxiety scale questionnaire. Result(s): Among 479 individuals 10.2% (49) were suffering from corona anxiety. 12% (43) females were suffering from corona anxiety as compared to 5% (6) males. 10.2% of residents of both urban and rural areas were suffering from corona anxiety. Pearson's chi-square correlation revealed a positive association between the female gender and corona anxiety p-value (.016). Conclusion(s): Corona Anxiety is more prevalent among the female gender. Residence in rural or urban areas has no association with corona anxiety.Copyright © 2023 Japan University of Health Sciences & Japan International Cultural Exchange Foundation.

Covid the Board System

The dark cloud of the vigorously spreading pandemic is still seen hovering over our heads. Though the situation presently seems under control, a continuation of the same is not guaranteed. The massive disturbance to the environmental assets leading to the melting of polar ice caps, ozone depletion, global warming, etc., poses a towering threat to every surviving species. The most recently faced devastation by the people is the 'Corona' virus;a ginormous pandemic, which has affected people living in almost every nook and corner of the world. For which the primary steps were to wear a mask, maintain social distancing and sanitize almost every single thing that comes in physical contact with more than one human. This brings in a crucial technical catastrophe, the physical barrier to be maintained, and the face masks covering the face, making fingerprint and face recognition systems totally impractical. This demands a grave need for a situation-friendly technical solution. © 2022 IEEE.

District Level Covid Case Prediction using LSTM Models

Covid-19 has had an adverse effect on the world, with more than 440 million cases recorded so far. The outbreak has hampered the country's healthcare and economy. This calls for an accurate prediction model for the prediction of Covid Cases, so that it gives some time to the hospitals and administration, to make the necessary arrangement. For population-dense countries like India, the covid case dynamics of every district is different, hence this requires a district-wise case prediction of Covid Cases. In this paper, we perform prediction of covid cases across all districts of India using different architectures of Long short-term memory (LSTM) and performed a comparative analysis between them. To the best of our knowledge, this is the first such attempt at the district level. Bidirectional LSTM encoder-decoder outperformed other LSTM-based models and, gave a test set MAPE of 15.44, followed by LSTM Encoder Decoder, giving a MAPE of 19.72. © 2022 IEEE.

Co-F I N D: LSTM Based Adaptive Recurrent Neural Network for CoVID-19 Fraud Index Detection

On March 8, 2020, the IEDCR reported three cases of the first corona infection in Bangladesh, and there was a lot of fake news surrounding the virus, which the WHO Director-General called “infodemic”. Infodemic, additional information about any problem that is usually unbelievable, spreads quickly and makes that problem difficult to solve and it is even more dangerous than the Corona epidemic. The misinformation provided by the media, false information, religious discrimination, miraculous remedies, and vague instructions of the government have created panic among the people of Bangladesh. Many news portals are intentionally or accidentally publishing fake news about the covid vaccine, the rate of infection and survival, the situation in other countries, the symptoms, and what to do after being infected. The most widely reported controversy is China’s involvement in the creation and spread of the coronavirus. This article has been proposed in the context of identifying, sorting most of the fake news and misinformation about coronal infodemics in Bangladesh so that the people can take necessary steps accordingly. LSTM-Recurrent Neural Networks have been applied for classification and detection of fake news because RNN can easily detect complex sentences from textual data and LSTM is called a memory network that can easily perform detection work by remembering the sequence of the sentences. RNN has provided the most accuracy between LSTM and RNN models but LSTM has been able to perform the prediction work more accurately than RNN. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Digital Twinning remote laboratories for online practical learning

The COVID19 pandemic has demonstrated a need for remote learning and virtual learning applications such as virtual reality (VR) and tablet-based solutions. Creating complex learning scenarios by developers is highly time-consuming and can take over a year. It is also costly to employ teams of system analysts, developers and 3D artists. There is a requirement to provide a simple method to enable lecturers to create their own content for their laboratory tutorials. Research has been undertaken into developing generic models to enable the semi-automatic creation of virtual learning tools for subjects that require practical interactions with the lab resources. In addition to the system for creating digital twins, a case study describing the creation of a virtual learning application for an electrical laboratory tutorial is presented, demonstrating the feasibility of this approach. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Neurological Deficits of Coronavirus Disease-19: A Systematic Literature Review

Aim: To review neurological aspects of patients infected with COVID-19 including neurological dysfunctions and possible pathophysiology. Methods: A systematic review of articlesfrom PubMed, Ovid MEDLIN, DOAJ databases and grey literature included the WHO-COVID-19 database, and medRxiv.Articles published from January 2020 until June 2020 were included in the review. Out of the226 titles and s, 213 were identified after the removing duplicates. With a screening of 119 studies carried by all authors, 83 full-text articles were assessed based on inclusion criteria of the neurological perspectives with COVID-19. Subsequently, 45 texts were removed. A total of 38 studies were included in the last scrutiny.Specifically, case reports, cohort studies, and case series were included Results: Reviewed evidence was presented in textual and tabulated format, which includes methodology, characteristics of included studies and summary of findings. Correlational evidence of COVID-19 disease and neurological dysfunctions with possible pathophysiology isreviewed. Conclusion:The findings provide evidence for physicians and neurologists working with COVID-19 patients about the possible probable complications and clinical presentations due to the SARS-CoV-2 infection.

Behavioral trends of medical institution employees in adhering to covid-19 preventive strategies

Objective: To evaluate behavioral attitude and compliance of employees in adhering to COVID-19 preventive strategies. Methodology: This descriptive study was conducted in CMH Kharian Medical College in the month of September 2020. Convenient sampling was used 442 employees of CMH Kharian Medical College, including faculty, students and administrative/technical staff were included in the study. Prochaska model of behavior change (PMBC) was used to access behavior pattern. Questions were asked about adhering to WHO advised COVID-19 preventive strategies. Data were analyzed using SPSS version 25. Results: Out of 442 participants, 9.7%, 6.8% and 6.6% belonged to a category that didn't see any benefit of using face mask, washing hands for 20 seconds and keeping advised social distancing of minimum 3-6 feet in preventing COVID-19, and they did not have any intention to use these p r e v e n t i v e s t r a t e g i e s (b e l o n g t o P r e-contemplation phase of PMBC). Almost 1.3%, 1.8% and 0.8% of staff belonged to contemplation phase and were of opinion that they were enjoying their own way of life, and they were little concerned that if they continue like this, it might be hazardous to their health. Still they did not adhere to preventive strategies, owing to lack of motivation-hall mark of contemplation phase of PMBC. Conclusion: Majority of personnel (70%) of our medical school were found in maintenance phase once it comes to compliance of preventive strategies. There is dire need to work on remaining 30% of individuals so that those pertaining to pre-contemplation and other three phases do realize the significance of above mentioned preventive strategies in halting the prevention of COVID-19. (Rawal Med J 202;46:698-701).

The Impact of Covid-19 Lockdown on Metamemory among Medical Students: An Experimental Study

Background: The lockdown due to Covid-19 has impacted certain aspects of cognition among medical students. Aim: To explore the impact of the Covid-19 lockdown on metamemory among medical students studying in a private medical college in Pakistan. Study design: Experimental study. Methodology: This study with enrolled students (n=233) was carried out after ethical review committee's (ERC) approval at CMH Kharian Medical College (CKMC), Physiology Department, Kharian-Pakistan. Both male and female medical students were enrolled. In phase 1, the students reported to the Physiology laboratory where age and gender were recorded. Metamemory was measured using the Multi-factorial Memory Questionnaire (MMQ)Satisfaction scale using the Baycrest Centre protocols for its administration and scoring. Data was analyzed by SPSS software, version 21. MMQ-Satisfaction score was presented as mean +/- SD. Statistical significance was taken at p value <0.05. Results: Among males mean +/- SD for Pre Covid-19 MMQ was 43.24 +/- 9.58 while mean +/- SD for Post Covid-19 MMQ males was 55.32 +/- 6.01. Significant difference was seen between Pre & Post Covid-19 MMQ scores with p-value of <0.000. Conclusion: We concluded that significant difference was seen between Pre & Post Covid-19 MMQ scores with p-value of <0.000. However, means among all age groups were significantly equal with the others in Pre & Post COVID-19 MMQ. Similarly, means were significantly equal among both genders for Pre & Post COVID19 MMQ.

Correlation between atopy and Covid-19: A cross sectional study

The whole world is facing one of the biggest health related disasters of the century. As a novel disease, Covid-19 has so many parameters yet to explore. Objectives: To explore any correlation between atopy and Covid-19 among residents of Gujrat and Kharian, Punjab, Pakistan. Study Design: Cross-sectional study. Methodology: This study with enrolled subjects (n=206) was carried out after ethical review committee’s (ERC) approval at Life Diabetes Centre, Gujrat and CMH Kharian Medical College (CKMC), over a period of 3 months, Kharian-Pakistan. Both male and female medical subjects were enrolled. Statistical analysis: Data was analyzed by SPSS software, version 17. Parameters like gender, allergy and treatment taken were presented as frequency and percentage. Chi square was applied to see the correlation with p-value <0.05 as significant. Results: Total 206 patients were randomly selected, 89 male and 117 females. Among 206, only 13 patients had allergy from different allergens. Only 2 patients required hospitalization and injectable treatment. Conclusion: We concluded that there is strong affiliation between atopy and Covid-19 presentations.

The Influence of Covid-19 Lockdown on Body Mass Index, Depression, Anxiety and Stress among Medical Students

The Covid-19 pandemic has wreaked havoc throughout the world, with 150 million cases to date and over 3 million lives claimed worldwide. Objectives: To explore the impact of the Covid-19 lockdown on psychological health parameters i.e. depression, anxiety and stress as well as on body mass index among medical students studying in a private medical college in Pakistan. Study Design: Experimental study. Methodology: This study with enrolled students (n=233) was carried out after ethical review committee’s (ERC) approval at CMH Kharian Medical College (CKMC), Physiology Department, Kharian-Pakistan. Both male and female medical students were enrolled. In phase 1, the students reported to the Physiology laboratory where age and gender were recorded. The pre-lockdown readings of BMI and DASS-21(Depression, Anxiety, Stress) scale were taken. In phase-2, the post-lockdown readings of BMI and DASS-21 scale were taken once the students returned to campus. Statistical analysis: Data was analyzed by SPSS software, version 21. BMI and DASS-21 score were presented as mean + SD. Statistical significance was taken at p value <0.05. Results: In present study, results showed that there was a decrease in level of depression post-Covid-19-lockdown among enrolled subjects with significant p-values (0.019*) in the pre and post covid-19-lockdown comparison. Conclusion: We concluded that significant difference was seen between Pre & Post Covid-19-lockdown depression with p-value of <0.019. However, insignificant difference was seen between Pre & Post Covid-19-lockdown anxiety and stress with p-value of >0.05. Key Words: Covid-19 lockdown, Medical students, Depression, BMI and Anxiety.

COVID-19: Journey so far and Deep Insight Using Crowdsourced Data in India

The aim of this study is to assemble the data and reflect the epidemiological statistics required as well as apply mathematical prototypical approach of the new outbreak that cover all perspectives of the facts and figures as of August 08, 2020, and thereby suggest the direction of the forthcoming epidemic situation in India for all policy makers. The outburst of the new fatal strain of coronavirus from an animal-to-human fall over in China has infected at least 204 countries as well as territories throughout the world. As of April 03, 2020, almost 972,303 confirmed cases and 50,321 deaths have been reported across the world due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that attained a huge elevation to 19.3 × 106 confirmed cases on August 08, 2020, of which India contributes a major part of 2.09 × 106 confirmed cases. It is the first neoliberal virus that easily encompasses its danger chiefly to easily susceptible including the malnutrition, the ill, and old people. As the world struggles with pandemic, India with its second largest population of more than 1.3 billion people in the world is likely to have many more cases than the numbers currently being reported. This has put numerous thousand individuals under observation in the country due to clinical symptoms, recent travel to China, Italy, Iran, and concordant entries in the relevant tailing surveys. The novelty of this approach is to rely on the exclusive source of official data, for social media and daily tracking of news reports in India that collected and curated the pertinent information. © 2021, Metrology Society of India.