Excess Mortality during the First Ten Months of Covid-19 Epidemic at Jakarta, Indonesia

Excess mortality during the COVID-19 epidemic is a crucial indicator of the health effects. We examined mortality records from government sources in Jakarta, Indonesia, from January 2015 to October 2020: 1) burials in public cemeteries;2) civil registration of deaths;and 3) registration of deaths by health authorities. During 2015-2019, there were an average of 26,342 burials per year between January and October. During the same time frame in 2020, there were 42,460 burials, a 61% increase. Two months before the first official laboratory confirmation of SARS-CoV-2 infection in Indonesia in March 2020, a surge in burials began in early January 2020. In 2020, an examination of civil death registrations or health authority death registrations revealed insensitive trends. Both the characterization and management of the health crisis in Jakarta are clouded by insufficient laboratory diagnostic and death surveillance capabilities. The public burials data described may serve as a useful indicator of mortality impacts and the efficacy of epidemic interventions.Copyright © 2023

A Surge in Malaria Cases in the Eastern Health Region of Saudi Arabia During the COVID-19 Pandemic.

Background Malaria transmission was stopped on most of the vast area of the Kingdom of Saudi Arabia. However, the pandemic of coronavirus disease (COVID-19) has negatively affected the efforts to control malaria. For instance, COVID-19 was reported to induce a relapse of malaria that is caused by Plasmodium vivax. Furthermore, physicians' attention toward COVID-19 can only result in neglect and delayed diagnosis of complicated malaria cases. These factors, among others, might have contributed to an increase of malaria cases in Dammam, Saudi Arabia. Thus, this study was conducted to examine the effects of COVID-19 on malarial cases. Methods The medical records of all patients who were treated at Dammam Medical Complex for malaria between July 1, 2018, and June 30, 2022, were reviewed. Malaria cases were compared between the pre-COVID-19 period (between July 1, 2018, and June 30, 2020) and the COVID-19 period (between July 1, 2020, and June 30, 2022). Results A total of 92 malaria cases occurred in the total study period. There were 60 cases of malaria in the COVID-19 period as opposed to only 32 cases in the pre-COVID-19 period. All the cases were imported from the endemic Saudi southern areas or from outside the country. Eighty-two patients (89.1%) were males. Most of them were Sundaneses (39 patients, 42.4%), Saudis (21 patients, 22.8%), and tribal peoples (14 patients, 15.2%). Fifty-four patients (58.7%) were infected with Plasmodium falciparum. Seventeen patients (18.5%) were infected with Plasmodium vivax. Another 17 patients (18.5%) had a mixed infection with both Plasmodium falciparum and Plasmodium vivax. A trend toward more infected stateless tribal patients was observed in the COVID-19 period compared to the pre-COVID-19 period (21.7% vs 3.1%). A similar trend was noticed for mixed malarial infections with both Plasmodium falciparum and Plasmodium vivax (29.8% vs 0%) with a P value of less than 0.01. Conclusion Malaria cases were almost doubled during the COVID-19 pandemic as compared to the pre-pandemic era signifying the negative effects of the pandemic on malaria epidemiology. The cases increased for a variety of causes that include alternation of health-seeking behaviors, changes in healthcare structures and regulations, and the interruption of malaria preventive services. Future research is needed to study the long-term effects of the changes imposed by the COVID-19 pandemic and to mitigate the effects of any future pandemic on malaria control. As two patients from our cohort were diagnosed with malaria based on blood smears, although they had negative rapid detection tests (RDTs), we recommend testing all the patients who are suspected to have malaria with both RDTs and peripheral blood smears.

Dynamics of Online Learning during COVID-19 in Indonesia: Bibliometric Analysis and Future Research Agenda

Indonesia implemented the online learning system during COVID-19. These changes were associated with the country's vast and archipelago-shaped area. Therefore, this research aimed to examine online learning publication trend during the pandemic using bibliometric analysis. The results showed that 2021 had the most publications on online learning during the pandemic, with 259. The frequently used keywords included online learning (n = 95), COVID-19 (n = 71), and e-learning (n = 70). Santoso HB had the most publications with 14 documents, while Junus K and Sulisworo D had 7. Jakarta State University had the most publications, including 8 documents, 8 citations, and 23 link strengths. Ahmad Dahlan University had 6 documents, 9 citations, and 1 link strength. Indonesia and Malaysia had the most collaborations with 29 publications. Future research can be developed using motivational learning and the post-COVID-19 school system as keywords. Furthermore, this research provided a thematic trend visualization map for future research to develop educational concepts and policies on online learning, specifically in archipelagic countries such Indonesia. © 2022 IEEE.

Higher Education Response to The COVID-19: Do Students Feel Comfortable Studying With Distance Learning?

This article aims to describe student responses when implementing SFH and provide an outline of six recommendations for the implementation of online learning during COVID-19, with the expectancy that learning under any conditions will continue to run benevolently. This study had a total of 693 participants with 416 (60%) women and 277 (40%) men, with a vulnerable age 17-24 years. In total, 34 universities across Indonesia participated in this study. This study uses online surveys as a method of collecting qualitative research. In this situation, the state, to respond to instruction on integrating online learning during the epidemic in universities, was given recommendations. In order to make conclusions easily understood by researchers and readers, data is organized into categories and described as units. During COVID-19, the Ministry of Education and Culture prepares educational regulations that are socialized via digital media. Online learning rose by 10.3% between COVID-19 and prior. WhatsApp is utilized 38.2% and Google Classroom 34.92%. This article also discusses some student feedback and complaints. The education office and school have strong communication. However, it is vital to adopt national rules connected to online learning that do not burden schools, students, teachers, or parents. Aside from that, the government should work with local and international online education software developers. Ensuring that education continues to run ideally in Indonesia, despite its limitations and issues, by developing a standard operating process for online learning evaluation. © 2022 IEEE.

Chronic Kidney Disease Patients: Collateral Damage Due to Suspension of Vascular Access Services

This study was conducted at the Department of Vascular Surgery at Combined Military Hospital Lahore from December 2019 to June 2020. The mortality of patients on the waiting list for vascular access in our institution three months after implementing strict policies for elective surgeries (30th March 2020 to 29th June 2020) was compared with the preceding three months. The mortality of patients in the pre-COVID-19 periods on the waiting list for HD was 11 (7.9%) in the pre-COVID-19 period, while this increased to 5 (12.5%) in the post-COVID-19 period. COVID-19 related suspension of vascular access services negatively influences CKD patients waiting for permanent vascular access. © 2022, Army Medical College. All rights reserved.

Distribution of Suicides in India: A Decadal Data Analysis (2011-2020) : Areiba Arif

Background India accounts for a significant proportion of suicide deaths globally. As per the Global Burden of Disease Study, India’s share of global suicides from 1990 to 2016 increased from 25·3% to 36·6% among women and 18·7% to 24·3% among men. However, medical factors are not the sole contributors to the suicide burden. Methods I analyze decadal data (2011-2020) on suicides in India provided by National Crime Records Bureau. This data contains the distribution of suicidal deaths based on age groups, causes, professions, gender, and residence zones. Results The analysis suggests that individuals aged ‘15-29 years’ were most affected (35.05%) by suicides, followed by those aged ‘30-44 years’ (32.61%). Family problems contribute to the highest burden of suicides among both these age groups. Such deaths can be attributed to personal reasons. Suicides due to dowry disputes are exclusive to women. Also, women report the highest instances of suicides due to marriage-related issues. While suicides due to drug abuse, bankruptcy, unemployment, poverty, and property disputes were mainly reported among males. In 2020, the rise in annual suicide rate was found to be highest among business persons (29.43%), especially tradesmen (49.9%) and vendors (26.11%) against other businesses (12.13%). Other professions which witnessed a steep rise in annual suicide rates in 2020 were agricultural laborers (17.90%) and daily wage earners (15.76%). This increase in suicide rates may be linked to economic reasons post lockdown imposition during the Covid-19 outbreak in 2020. Conclusions Women commit suicide mainly due to marriage-related causes, while men are more vulnerable to suicide due to economic factors. Not all suicides can be traced back to diagnosed mental illnesses. A significant proportion of suicides are attributed to personal, economic, and social problems. The insights generated from this analysis can help identify the vulnerable groups and target the much-needed interventions. Key messages • Suicide is a multifaceted problem involving various personal, economic, cultural, and social factors, besides medical reasons. • Multidimensional strategies targeted at vulnerable groups could be potentially effective in curbing suicide rate.

Audit of Surgical Practice and Performance in COVID Crisis - Lessons for future

Aim: To evaluate the pattern of surgical emergencies and surgical care provided during COIVD 19 pandemic. Study design: Cross-sectional Study Place and duration of study: Department of Surgery, CMH, Lahore from 15th March - 15 June 2020. Methodology: Data was collected retrospectively, of all the patients who were admitted in department of surgery over the duration of 3 months. Demographic variables, diagnosis, work up related to COVID-19, specialty of admission and surgical vs conservative management was recorded. Results: A total of 312 patients were included. Majority were male 216(69.2%). Most of the patients 191(61.2%) were admitted via clinic, predominantly in month of May 148(41%). COVID-19 PCR was done on 210 patients (67.3%), chest x-ray was done on 271(87.9%), HRCT chest was done on 113 patients (29.20%). Although general surgery was the busiest service line with a total patient admission of 89(43.1%), Orthopedic surgery top the operative interventions list with 85.1% of admissions underwent operative management. Conclusion: The current local guidelines about patient flow and management of patients in COVID crisis are practical and can be implemented. In the wake of the later waves of COVID 19 hospitals should prepare to divert their resources to high volume specialties like General and orthopedic surgery. Simple, but important procedures like arteriovenous fistula creation should only be stopped it there is shortage of manpower.

Molecular modelling on multiepitope-based vaccine against SARS-CoV-2 using immunoinformatics, molecular docking, and molecular dynamics simulation.

The pandemic of COVID-19 caused by SARS-CoV-2 has made a worldwide health emergency. Despite the fact that current vaccines are readily available, several SARSCoV-2 variants affecting the existing vaccine are to be less effective due to the mutations in the structural proteins. Furthermore, the appearance of the new variants cannot be easily predicted in the future. Therefore, the attempts to construct new vaccines or to modify the current vaccines are still pivotal works for preventing the spread of the virus. In the present investigation, the computational analysis through immunoinformatics, molecular docking, and molecular dynamics (MD) simulation is employed to construct an effective vaccine against SARS-CoV2. The structural proteins of SARS-CoV2 are utilized to create a multiepitope-based vaccine (MEV). According to our findings presented by systematic procedures in the current investigation, the MEV construct may be able to trigger a strong immunological response against the virus. Therefore, the designed MEV could be a potential vaccine candidate against SARS-CoV-2, and also it is expected to be effective for other variants.

Analysis of rule-based and shallow statistical models for COVID-19 cough detection for a preliminary diagnosis

Coronavirus pandemic that has spread all over the world, is one of its kind in the recent past, that has mobilized researchers in areas such as (not limited to) pre-screening solutions, contact tracing, vaccine developments, and crowd estimation. Pre-screening using symptoms identification, cough classification, and contact tracing mobile applications gained significant popularity during the initial outbreak of the pandemic. Audio recordings of coughing individuals are one of the sources that can help in the pre-screening of COVID-19 patients. This research focuses on quantitative analysis of covid cough classification using audio recordings of coughing individuals. For analysis, we used three different publicly available datasets i.e., COUGHVID, NoCoCoDa, and a self-collected dataset through a web application. We observed that wet cough has more correlation with covid cough as opposed to dry cough. However, the classification model trained with wet and dry coughs, both, has similar test performance as that of the model trained with wet cough samples only. We conclude that audio-signal recordings of coughing individuals have the potential as a pre-screening test for COVID-19. © 2022 ACA.

2019 Novel Coronavirus Disease (Covid-19): Toward a Novel Design for Nasopharyngeal and Oropharyngeal Swabbing Robot

The world still suffers from the global pandemic of corona virus. The COVID 19 is a disease that majorly influence the patient's respiratory system and degrade the performance of the immune system. The Polymerase Chain Reactions (PCRs) is commonly used method to assist the health care service in detection the viral disease. It permits identifying the defined chains of the virus genetic code in sputum samples. The front-line staffs are susceptible to infection by COVID 19 during direct swab test that unfortunately subjects them to a high level of risk. To remedy this problem, this paper introduces a flexible swabbing robot for oropharyngeal and nasopharyngeal. This robot is teleworked-based to perform swab sampling with consisting of a flexible manipulator, an integrated endoscope monitor, and the main device. The additional components incorporate a passive locating arm, an active end effector, and a detachable swab handles capable to sense forces. The achieved results revealed the capability of the proposed system in the detection COVID 19 of PCRs specimens based on little data acquired from the clinicians. © 2022 IEEE.

COVID-19 Associated Hypercalcemia, A Rare Yet Interesting Case

Introduction: Hypercalcemia is a common clinical diagnosis. Hyperparathyroidism is one of the most common etiologies. Rarely hypercalcemia is associated with intense inflammation secondary to IL-6 production. Herein we present an interesting case of hypercalcemia associated with COVID-19. Case Description: 36-year-old woman with history of Cirrhosis secondary to hepatitis C and alcohol abuse initially admitted for COVID/ARDS and cryptococcemia without CNS involvement. She was initially treated with amphotericin B and continued on fluconazole. Patient was re-admitted after 2 weeks with abdominal pain, constipation and hypercalcemia (Ca 14.2 mg/dl (normal range 8.7-10.1mg/dl). Her ionized calcium was 1.78 mmol/L (normal range 1.12-1.32 mmol/L). Serum phosphorus was 2.5 mg/dl (normal range 2.5-4.5mg/dl). Intact PTH level was 6.7 pg/ml (normal range 6-48pg/ml). Vitamin D 25-OH level was 26.8 ng/ml (sufficient range 32-100 ng/ml);Vitamin D 1,25-OH level was 7.4 pg/ml (normal 19.9-79.3pg/ml). PTH-rp was unmeasurable (< 2pmol/l). CRP was elevated at 31.7mg/L (normal range 0.2-8 mg/L). She was not on calcium, Vitamin D supplementation or thiazide diuretics. Her renal functions were normal. She was given Intravenous fluids & Intravenous pamidronate. Steroids were not used due to an ongoing fungal infection. It was proposed that the patient had Interleukin-induced hypercalcemia secondary to COVID-19 infection. Her serum calcium normalized with improvement in clinical status Discussion: Recent literature suggests COVID-19 is associated with inflammatory response with cytokines & interleukins production. IL-6 production is significantly upregulated especially in severe cases of COVID-19 known as “Cytokine storm”. IL-6 is produced by bronchial epithelial cells. High levels of IL-6 are associated with worse outcomes and much more severe disease. IL-6 in turn causes osteoclast activation, bone resorption & hypercalcemia. In our patient other potential causes of hypercalcemia were ruled out. The proposed mechanism of her hypercalcemia is an intense inflammatory response associated with COVID-19 infection. Conclusion: We present a rare sequelae of COVID-19 infection which presents a teaching point for clinicians to consider while managing such novel disease

WHEN ANCA-ASSOCIATED VASCULITIS MET COVID-19: A CASE REPORT

The ANCA-associated vasculitis (AAV) shares similar pathophysiological pathways with SARS-CoV-2 infection such as neutrophil extracellular traps, complement cascades, and IL-6. Patients with AAV have a higher risk for SARS-CoV-2 infection. In turn, the viral infection could trigger the relapse of AAV. We are presenting a case of a SARS-CoV-2 infection who developed relapsing AAV and discussion about management. A 25-year-old Hispanic male who was recently diagnosed with X-ANCA vasculitis with diffuse alveolar hemorrhage (DAH), AKI treated with pulse steroids, plasmapheresis (PLEX), two doses of rituximab (375mg/kg) was admitted with fever, hemoptysis, hypoxemia, and positive COVID-19 nasopharyngeal swab. Due to DAH and worsening oxygen requirements by day 3, IV pulse methylprednisolone 1000mg x3, rituximab 1g x2 and PLEX x 5 given, and on day 6 convalescent plasma was given. He developed non-oliguric AKI on CKD due to acute tubular injury superimposed on biopsy proven pauci-immune necrotizing crescentic glomerulonephritis needing hemodialysis from day 8 to 18. On day 9, patient developed ARDS requiring BiPAP and increased inflammatory markers, secondary to cytokine storm and got two dose of tocilizumab (8mg/kg). After this patient improved clinically and was discharged on room air with improving serum creatinine from peak 5.98mg/dL to 3.94mg/dL with oral prednisone of 60mg daily. The treatment for the AAV in the setting of COVID-19 has been controversial. Though the risk of infection increases with Rituximab use, current literature supports cautious use of the B-cell depleting agents for AAV indications during the pandemic with favorable riskbenefit ratio. Tocilizumab may also have dual beneficial effects in treating the AAV flare and managing the cytokine storm of COVID infection. Our case study showed this presumed dual benefit. Large scale studies are required to both prove the safety of Rituximab use in the setting of risk of COVID infection and Tocilizumab use for AAV flare with COVID infection. Clinicians should not shy away from using the Rituximab in AAV treatment due to the ongoing pandemic as the risk of not using may be much worse where it is clinically indicated. Tocilizumab may have dual beneficial effects of treating the Cytokine storm and AAV flare as we saw in our case.

Pid-based with odometry for trajectory tracking control on four-wheel omnidirectional COVID-19 aromatherapy robot

Inhalation therapy is one of the most popular treatments for many pulmonary conditions. The proposed Covid-19 aromatherapy robot is a type of Unmanned Ground Vehicle (UGV) mobile robot that delivers therapeutic vaporized essential oils or drugs needed to prevent or treat Covid-19 infections. It uses four omnidirectional wheels with a controlled speed to possibly move in all directions according to its trajectory. All motors for straight, left, or right directions need to be controlled, or the robot will be off-target. The paper presents omnidirectional four-wheeled robot trajectory tracking control based on PID and odometry. The odometry was used to obtain the robot's position and orientation, creating the global map. PID-based controls are used for three purposes: motor speed control, heading control, and position control. The omnidirectional robot had successfully controlled the movement of its four wheels at low speed on the trajectory tracking with a performance criterion value of 0.1 for the IAEH, 4.0 for MAEH, 0.01 for RMSEH, 0.00 for RMSEXY, and 0.06 for REBS. According to the experiment results, the robot's linear velocity error rate is 2%, with an average test value of 1.3 percent. The robot heading effective error value on all trajectories is 0.6%. The robot's direction can be monitored and be maintained at the planned trajectory. © 2021 by the authors.

Effect of covid-19 pandemic on non-covid illness in the general population of pakistan

Aim: The goal of this study was to examine the influence of the Covid-19 pandemic 2020 on the health-seeking behavior of the general public in a lower-middle-income nation like Pakistan by looking at the availability, accessibility, and usage of health infrastructure. Methodology: In this cross-sectional study, 394 Pakistani patients completed an online questionnaire measuring their willingness to seek medical treatment, reporting for follow-up visits, and the ease of getting medical care about their medical condition, both before and after the pandemic. The information was then examined. Results: During the pandemic, 21.8 percent of patients visited a health center for follow-up. Fear of infection from the health institution kept 20.3 percent of patients from showing up for follow-up. 17.5 percent of patients had significant symptoms from their underlying sickness but delayed going to the doctor due to the fear of the virus. Patients' appointments were canceled or rescheduled in 20.1 percent of cases, while 54.1 percent did not feel the need to visit a health center. Conclusion: Fear of the virus, lockdowns, limitations, and other reasons have resulted in a substantial proportion of the population avoiding ER/health facility visits while suffering symptoms that necessitate medical attention. The long-term impact on a developing country's healthcare system, such as Pakistan, will be negative unless extraordinary steps are made to provide safe, accessible, and cheap health care during the epidemic.

Low hemoglobin as a biomarker for paediatric sinus thrombosis

Background : Cerebral venous sinus thrombosis (CVST) is rare in children. Its risk factors and outcome are largely unknown in low-middle income countries. Some case reports have shown presence of anemia in pediatric CVST as a probable risk factor. Aims : This study was done to determine the frequency of anemia in patients having pediatric CVST and to observe its association with the severity of disease. Methods : Patients between age 0 to 18 years of both genders diagnosed with sinus thrombosis during 2011 to 2020 were identified through international classification of diseases (ICD 9). Data was collected through in-house computerized system and SPSS version 19 was used for analysis. Results : Of 143492 patients who were admitted, 32 (21 males and 11 females) with a median (IQR) age of 4.5 years (0-16) had CVST. This is equivalent to 2.2 CVST events /10,000 pediatric admissions. Overall mortality was 3.4%. Primary underlying disorders were infections (59%), hematological neoplasms (12.5%), thrombotic thrombocytopenic purpura (3%) and antiphospholipid syndrome (3%). Significant laboratory findings were anemia (65%), low protein S (19%), low protein C (19%), low antithrombin III (6%) and activated protein C resistance (25%). Mean(±SD) hemoglobin in anemic patients was 9.0 g/dL (±2.3). SARS-COV2 was negative in patients tested in 2020. Regression analysis showed a positive association of anemia with multiple sinus involvement ( P 0.009) but anemia had no association with the duration of symptoms ( P 0.344), hospital stay ( P 0.466), age ( P 0.863) or gender ( P 0.542) of the patients. Conclusions : Low hemoglobin was observed in a significant proportion of patients with pediatric CVST. Anemia may be an important biomarker along with other clinical variables in the risk assessment of sinus thrombosis in children. Future studies may unveil the role of anemia in coagulopathy and more specifically in pediatric CVST.

Knowledge, attitude and practices of Pakistani doctors about COVID-19 Pandemic

Objective: To assess the knowledge, attitude and practices (KAP) of Pakistani doctors in the early period of COVID-19 Pandemic. Methodology: This KAP survey was conducted from 29th March to 6th April 2020. The questionnaires were disseminated using Google Forms, which utilized electronic consent. Physicians and surgeons of frontline involved in the care of COVID-19 patients including house officers, postgraduate trainees of all specialties, and consultants were included in study. Results: Out of 112 participants, 52.7% were female. Mean age was 29.93 +/- 7.3 years. There were 46 (41.3%) house officer. Twenty five (22.3%) participants were daily exposed to COVID-19. Residents who had maximum exposure on a daily basis, none had access of full personal protective equipment. Only 13.4% had correct knowledge about time of maximum disease transmission and 70% health care workers had greatest concern about their family's health. Conclusion: There was poor level of knowledge and worrisome practice and discrepancies in the perceptions about COVID-19 among our study participants.

Distance Education in Higher Education in Saudi Arabia in the Post-COVID-19 Era

COVID-19 has changed the field of education. This paper aimed to re-envision the post-pandemic higher education landscape in Saudi Arabia. This study employed descriptive-qualitative research design. Twenty postgraduates completed a journal task at a public university in the Eastern Province of Saudi Arabia. The responses revealed their first-hand experience of multi-sectorial communities caused by the COVID-19 lockdown, including students, parents and teachers. Results showed that there are seven positive and eight negative impacts of emergency distance education caused by the pandemic lockdown and various themes have emerged, including Social and Educational. To succeed in the post-pandemic era, teachers need to acquire online pedagogical content knowledge and teaching strategies, conduct effective student evaluation and engage students in both virtual and in-person labs and classrooms. This study contributes to quality access of students toward online learning in countries, where distance education is still in its infant stage, such as Saudi Arabia.

2019 Novel Coronavirus Disease (Covid-19): Toward a Novel Design for Disinfection Robot to Combat Coronavirus (Covid-19) Using IoT Based Technology

Coronavirus Disease 19 or well known as Covid-19 is infectious disease that attack human respirator system. This virus is contagious due to its fast transmission from small droplets that come to people that sneezing, coughing, or even talking. This virus can stay in air for long time and it also can survive on the inanimate surface things. During this time, some places like hospital, mall, and station are places where crowds gathered. People in those places have possibility to spread the virus not only through close contact but also due to touching the infected surfaces. That is why device that able to clean the infected surfaces needed. The Internet of Things based robots may give big impact in combating the coronavirus that stay on inanimate surfaces. The proposed system is the robot that able to disinfect the surfaces of things using UV-C lights. The implementation of UV disinfectant robot will indeed help health authorities in reducing the transmission. © 2021 IEEE.