ABSTRACT
Trace the timeline of a pandemic such as Ebola, SARS, and SARS-CoV-2. All these extremely infectious viruses led to a worldwide pandemic starting in 2002. All these three viruses are transmitted to humans by animals from the jungle. The novel human coronavirus COVID-19 is now the fifth documented pandemic since the 1918 influenza pandemic. Questions about pandemics are on the rise these days, and it is widely discussed in the media. Recently, awareness about urban green spaces is rising in this era, and numerous researchers claim that appropriate landscape planning and design with the conception of sustainability able to produce a beneficial and responsive environment for healthy urban improvement in relation to pandemic crises. Therefore, this paper aims to investigate the effectiveness of urban green spaces for sustainable environmental health. The result shows that the role of urban green spaces improves immune system function, increases social capital and cohesion, reduces mortality, and increases life expectancy, reduces potential negative health impacts, and makes urban beautification healthier. In addition, the finding shows the benefits of urban green spaces in pandemics, for example improving mental health and stress reduction, improving physical health, decreasing the risk of disease transmission, and improving social cohesion.
ABSTRACT
The unrelenting protraction of Coronavirus Disease 2019 (COVID-19), inflicted by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is tending to craft havoc all over the world for the past few months. Considering the looming repercussions due to this deadly virus worldwide, there is an impending necessity to comprehend this newfangled contagion. To develop an effective eradication measure and preventive strategy, knowledge about the virus structure, life cycle, and metabolism is imperative. Better insight into the virus life cycle helps us to identify and design drugs that can hit crucial targets of this dreadful virus. The close genetic similarity between SARS-CoV-2 and SARS-CoV, which triggered an outbreak in the year 2003, could be of great strategic importance in designing effective drug formulations. This will also help in the development of leveraging immunological measures to develop an effective vaccine against SARS-CoV-2. This eventually will help us to progress our strategies related to the virus. Not on the positive side, there is some misinformation going all around the world despite the strict regulations from the WHO and other government agencies to inform the citizens to abstain from the rumour-mongering regarding COVID-19. Further, evidence needs to be gathered on vaccine strategies to cure the patients suffering from COVID-19. This information will also help us in designing both drug inhibi-tors as well as prophylactic measures against SARS-CoV-2.Copyright © 2021 Bentham Science Publishers.
ABSTRACT
The pandemic issue is frequently discussed in the news or mass media. In 2002, Ebola, SARS, and SARS-CoV-2 were highly infective viruses that caused a global pandemic, according to the pandemic chronology. Animals in the forest spread each of these viruses to people. Since the 1918 influenza pandemic, the unique human coronavirus COVID-19 has caused the fifth documented pandemic. In this era, there has been an increase in public awareness about urban green spaces. Many studies suggest that proper landscape planning and design with a sustainable mindset may provide a helpful and responsive environment for healthy urban improvement during pandemic crises. Thus, this study aims to look into the functions of urban green spaces for long-term environmental health, especially during pandemic crises. The research revealed that urban green spaces improve immune system performance, promote social capital and cohesiveness, reduce mortality, lengthen life expectancy, and potential adverse health impacts. The findings also emphasised various advantages of urban green spaces during pandemics, such as enhanced mental and physical well-being, less risk of disease transmission, and enhanced social cohesion. In summary, urban green space sustainability may support a healthy environment and lifestyle in metropolitan areas amid pandemic crises. © 2023 Institute of Physics Publishing. All rights reserved.
ABSTRACT
Objective: The objective of the study is to determine the prevalence of common mental disorders among high school students and their online education satisfaction levels in Pakistan. Study Design: It was an observational, cross sectional study. Place and Duration of Study: The study took place among students registered across various high schools at different cities in Pakistan. The duration of the study was about six months from January 2021 to June 2021. Material and Methods: A cross sectional study was conducted across different high schools in Pakistan. For a total of 275 selected study participants, structured and validated questionnaires were used to determine the common mental disorders such as anxiety, depression, and Psychosis. Chi square was used to determine the association between the satisfaction levels of online learning with mental disorders. Results: Among students 28% and 34. 7% and 32%, suffered from severe anxiety, depression and Psychotic disorder respectively. The relationship of severe depression (r=0.7 (p=0.001)), severe anxiety (r=0.6 (p=0.036)) and severe psychotic (r=0.8 (p=0.002)) disorder had significant strong relationship with student's satisfaction with online classes. Conclusion: High levels of mental disorders among students during the pandemic and low satisfaction with online learning were common among students due to stress. It is recommended that the mental level of students should be monitored, and counseling services should be provided.
ABSTRACT
Background: We recently reported that in United States, 388 organs from SARSCoV- 2 nucleic acid test (NAT) positive 150 donors were procured between Aug 2020 to Sep 2021. Nearly 1 million deaths have been attributed to SARS-CoV-2 pandemic however only selected group of donor organs were assessed for transplantation. Even after procurement, 28% (of 388) organs were discarded. For kidney transplants (KT), commonest reason for relatively high-quality organ discards (35%) was 'exhaustion of wait list', indicating reluctance to accept these organs. Method(s): We investigated potential risk of donor transmission of SARS-CoV-2 by a prospective study including 23 KT recipients with prior SARS-CoV-2 vaccination. Donor serum and pre-implantation kidney biopsy tissue were assessed for detection of SARSCoV- 2 via a validated commercially available real-time reverse transcription polymerase chain reaction (RT-PCR) (threshold 73 copies/mL). All recipients had SARS-CoV-2 RTPCR on plasma and nasopharyngeal swab at Day-7 post-KT. Result(s): A total of 23 KT were performed from 22 SARS-CoV-2 NAT positive donors between Nov 2021 and Feb 2022. All 22-donor serum samples and 23 procurement biopsies were negative for SARS-CoV-2, including those from 8 donors with symptomatic disease. Six (of 22 donors;27%) had death attributable to SARS-CoV-2 complications. Three recipients with asymptomatic donors were diagnosed with clinical SARS-CoV-2 disease at 10, 14, and 23 days post-KT during 4th pandemic surge. Both graft and patient survival rate was 100% at a median 3 month followup. Collation with national 'Organ Procurement and Transplant Network' registry showed that majority of other organs from these donors were not procured [zero pancreata, zero lungs, 11 (50%) livers, 19 (86%) hearts]. Among 42 KT [55% (23/42) performed at our center], 10 transplanted livers, and 3 hearts;no graft loss or death was reported. Conclusion(s): In this single-center study we report an absence of detectable SARSCoV- 2 virus in donor kidney tissue and plasma from SARS-CoV-2 positive donors.and absence of recipient viremia and nasopharyngeal detectable virus immediately after KT indicating a lack of donor transmission. Our results of excellent graft and patient survival favor utilization of SARS-CoV-2 infected donors.
ABSTRACT
Purpose: Expansion of the donor pool remains a major unmet need for solid organ transplants (SOT). Early data suggests that at least some severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID) nucleic acid test positive (NAT+) organs could be transplanted safely although there is substantial controversy about this topic. Method(s): A retrospective analysis of the national United States Organ Procurement and Transplantation Network database was performed, demonstrating initial experience with COVID NAT+ deceased donor organs with a focus on kidney transplants, from August 8, 2020, to Sep 29, 2021. Result(s): During this time period, 17,143 COVID NAT negative (NAT-) deceased donors and 150 COVID NAT+ deceased donors were assessed for organ donation (Figure 1) (Table 1). When compared to COVID NAT- donors, there was a higher (p<0.001 for all) non-recovery rate for COVID NAT+ hearts (35% vs 87%), lungs (71% vs 99%), livers (24% vs 53%), and pancreas (89% vs 98 %). Of a total of 385 recovered organs from 150 COVID NAT+ donors, 276 (72%) organs were transplanted into 262 recipients. Majority of donors had a COVID NAT+ <=7 days prior to procurement (94;62.7%). While only a minority of pancreases, hearts, lungs, and livers were procured, almost all were transplanted post-procurement. In contrast, there was a high discard rate for kidneys post-procurement (102/295;34.6%) with the most common reason (~70%) for discards being 'exhaustion of the wait list'. Presumably superior quality COVID NAT+ kidneys were discarded compared with COVID NAT- kidneys (mean KDPI: 67% vs 76%;p=0.04). Limited outcome data was available with a median post-transplant follow-up of 75 days (range: 23-243 days). Three kidney allograft losses (2 due to allograft thrombosis) and five deaths (2 kidneys, 3 livers) were reported, of which, one was due to respiratory failure and one due to sepsis. Conclusion(s): These data provide early reassuring evidence on the utilization of non-lung COVID NAT+ organs. However, a substantially lower procurement rate for non-kidney transplantable organs and a high discard rate for kidneys were noted. (Table Presented).
ABSTRACT
SESSION TITLE: Rare Cases with Masquerading Pulmonary Symptoms SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/18/2022 01:35 pm - 02:35 pm INTRODUCTION: COVID vaccinations have been encouraged by many healthcare providers but many adverse effects have also been reported. The adverse effects of the vaccine can vary based on each individual. Common adverse effects of the vaccine included fatigue, fever, chills, sore throat, muscle pain, headache, rash at injection site. Pleurodynia, also known as Devil's Grip, is a viral myalgia which causes sharp chest pain or the sensation of a grip around one's chest. Pleurodynia treatment is mostly supportive like anti-inflammatories (NSAIDS), pain management, and antibiotics (if bacterial inflammation is suspected). CASE PRESENTATION: We present a case report of a 63-year-old female who presented with complaints of pleuritic chest pain worse with inspiration. She had a history of atrial fibrillation and HTN. Patient had received the Pfizer COVID booster vaccine a few days prior to onset of the pleuritic chest pain. She was obese and had a 40 pack year smoking history. She was on room air saturating 92% with no increased work of breathing. Lung sounds were diminished due to body habitus but clear. Chest x-ray showed low lung volumes with no evidence of acute pulmonary disease. Computed Tomography Angiography (CTA) chest showed no pulmonary embolism and small left partially loculated pleural effusion with peripheral airspace opacities abutting the pleura. Acute coronary syndrome was ruled out and other cardiac workup was negative. COVID PCR was negative. Patient was treated empirically for bacterial infection with ceftriaxone and azithromycin. She was given NSAIDS to decrease inflammation and pain. Patient's symptoms improved significantly with treatment. She was discharged on NSAIDS and advised to follow up outpatient with her primary care and pulmonology. DISCUSSION: Research studies have indicated that the COVID vaccines (like Pfizer) can cause exacerbation of inflammatory or autoimmune conditions. Multiple mechanisms may be responsible for myocarditis, pericarditis, and other inflammatory conditions post vaccines. One mechanism describes that lipid particles of SARS mRNA vaccines can induce inflammation by activating the NLR pyrin domain containing 3 inflammasome of mRNA which are recognized by toll like receptors and cytosolic inflammasome components leading to inflammation. Another mechanism explains that viral proteins can cause immune cross reactivity with self-antigens expressed in the myocardium leading to an inflammatory process. CONCLUSIONS: As per current literature review there are no case reports about pleurodynia post COVID vaccination but pericarditis and myocarditis have been described. Further research studies are indicated to assess the cause and pathophysiology of pleurodynia post COVID vaccine. Physicians should have a high index of clinical suspicion for pleurodynia when assessing a patient with pleuritic chest pain with a recent history of COVID vaccination. Reference #1: 1. Analysis of COVID 19 Vaccine Type and Adverse Effects Following Vaccination. Beatthy, A;Peyser, N;Butcher, X. AMA Netw Open. 2021;4(12):e2140364. doi:10.1001/jamanetworkopen.2021.40364 Reference #2: 1. Association of Group B Coxsackieviruses with Cases of Pericarditis Myocarditis, or Pleurodynia by Demonstration of Immunoglobulin M Antibody. Schmidt, N;Magoffin, R;& Lennette, E. Infection and Immunty Journal. 1973 Sep;8(3): 341–348. PMCID: PMC422854 Reference #3: 3. Autoimmune phenomena following SARS-CoV-2 vaccination. Ishay, Y;Kenig, A;Toren, T;Amer, R;et. al. International Journal of Immuno-pharmacology. 2021 Oct;99: 107970. DISCLOSURES: No relevant relationships by Olufunmilola Ajala No relevant relationships by Arij Azhar No relevant relationships by Louis Gerolemou No relevant relationships by Wael Kalaji No relevant relationships by Steven Miller No relevant relationships by Kunal Nangrani No relevant relationships by Gaurav Parhar No relevant relationships by iran Zaman
ABSTRACT
SESSION TITLE: Extraordinary Cardiovascular Reports SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/18/2022 01:35 pm - 02:35 pm INTRODUCTION: The incidence of acute pericarditis is 3.32 per 100,000 person-years (11). Patone et. Al, found that 0.001% had acute pericarditis after a dose of the COVID-19 vaccine, while 11.9% were COVID-19 positive (11). 1.5% of patients with COVID- 19 developed new onset pericarditis and six-month all-cause mortality was 15.5% (2). CASE PRESENTATION: 48-year-old male with no known past medical history who presented with acute onset of sharp, left-sided chest pain and associated with dyspnea on exertion. He was not vaccinated for COVID-19 and denied being around any sick contacts. On physical examination he was afebrile, normotensive and saturating 99% on room air. EKG initially showed diffuse ST elevations in leads II,III, aVF, V2-V6. Initial high sensitivity trop was <6. He was incidentally found to be COVID positive. Initial echocardiogram was not suggestive of wall motion abnormalities or pericardial effusions. He was not initiated on management for COVID-19 pneumonia as he was asymptomatic and on room air. He was started on colchicine 0.6 mg BID and ibuprofen 400 TID for pericarditis treatment and symptoms resolved on follow up. DISCUSSION: COVID-19 causing pericarditis is relatively rare and our patient presented with pericarditis and no associated respiratory symptoms. The clinical signs of pericarditis include: a pleuritic or sharp chest pain relieved by leaning forwards, a pericardial friction rub auscultated near the left sternal border and EKG changes including diffuse ST elevations or PR depressions seen in the leads I,II,III, aVL, aVF and the precordial leads V2-V6 (3). The common complications seen with pericarditis are pericardial effusion, cardiac tamponade, and constrictive pericarditis (1). A common etiology for pericarditis is a viral illness which can be seen to precede the cardiac symptoms and be seen as flu-like symptoms or as gastrointestinal symptoms. Treatment is with colchicine and NSAIDs. Aspirin has been the drug of choice in patient's who present with pericarditis following a myocardial infarction, solely because the other NSAIDs have been studied and shown to interfere with myocardial healing (3)(4). NSAIDs were believed to be harmful in patient's diagnosed with COVID, due to upregulation of ACE2 receptors in multiple sites which is used by SARS-COV-2 as a point of entry into cells (9). Drake et. Al, looked at patients with COVID-19 pneumonia, and found use of NSAIDs did not play any significant role in mortality (10). First-line therapy for pericarditis is NSAIDs and colchicine. Second line therapy can be with corticosteroids and refractory therapy is generally with intravenous human immunoglobulins, Azathioprine or anti-IL1 agents such as Anakinra (12). CONCLUSIONS: COVID 19 continues to present with varying levels of comorbidities. Timely diagnosis and intervention of pericarditis precipitated by COVID-19 can lead to near complete recovery and prevent fatal outcomes. Reference #1: Dababneh E, Siddique MS. Pericarditis. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431080/ Reference #2: Buckley BJR, Harrison SL, Fazio-Eynullayeva E, Underhill P, Lane DA, Lip GYH. Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients. Eur J Clin Invest. 2021 Nov;51(11):e13679. doi: 10.1111/eci.13679. Epub 2021 Sep 18. PMID: 34516657;PMCID: PMC8646627.1 Reference #3: Little WC, Freeman GL. Pericardial disease. Circulation. 2006 Mar 28;113(12):1622-32. doi: 10.1161/CIRCULATIONAHA.105.561514. Erratum in: Circulation. 2007 Apr 17;115(15):e406. Dosage error in article text. PMID: 16567581. DISCLOSURES: No relevant relationships by Atika Azhar No relevant relationships by Berty Baskaran No relevant relationships by Andres Cordova Sanchez No relevant relationships by Harvir Gambhir No relevant relationships by Hanish Jai
ABSTRACT
SESSION TITLE: Look again: Infections and Mimics SESSION TYPE: Case Reports PRESENTED ON: 10/18/2022 11:15 am - 12:15 pm INTRODUCTION: Phlegmasia Cerulea Dolens (PCD) is a rare and critical condition caused by venous thrombosis requiring emergent treatment to prevent limb ischemia. COVID 19 has been widely reported to cause venous thromboembolism and compromise of tissue perfusion. We report a case of PCD in a patient with asymptomatic COVID-19 infection. CASE PRESENTATION: A 60 year-old female with no known medical history, unvaccinated for COVID-19 presented with sudden onset left lower extremity pain and swelling associated with numbness. Physical examination was remarkable for left lower extremity swelling with bluish discoloration, poikilothermia, and paraesthesia. Computed tomography angiogram (CTA) chest, abdomen and pelvis revealed left lower extremity deep vein thrombosis with compromised blood flow with focal thrombosis of the IVC extending inferiorly to the great saphenous and popliteal vein, along with small bilateral segmental and subsegmental pulmonary emboli. Diffuse Ground glass opacities suspicious for COVID-19 pneumonia. COVID-19 PCR was positive. Anticoagulation with heparin drip was initiated, and the patient underwent successful left iliocaval to popliteal vein thrombectomy and venoplasty by interventional radiology with successful restoration of circulation to the affected extremity. She was eventually transitioned to apixaban. She experienced marked improvement in her symptoms post procedure. DISCUSSION: Patients with COVID 19 develop venous thromboembolisms at an alarming rate despite thromboprophylaxis. The mechanism is likely explained by the virchow's triad (venous stasis, hypercoagulable state, vessel wall injury) in the setting of increased pro-inflammatory markers. We report the first case at our institution of PCD in the setting of COVID-19.We noted that our patient had a similar presentation as those reported in literature, which include acute leg swelling associated with pain and cyanosis. Complications include venous outflow obstruction, which can result in compartment syndrome with arterial ischemia, eventually progressing to gangrene of the affected limb. PCD is a very rare but life-threatening complication caused by extensive clot burden associated with acute limb ischemia and increased mortality rates. This condition requires emergent initiation of intravenous anticoagulation and thrombectomy with or without tissue plasminogen activator (tPA). If this condition is not treated in a timely fashion, it can result in acute limb ischemia and gangrene requiring amputation. CONCLUSIONS: Physicians should recognize PCD in patients who have been exposed to COVID-19 as it is a life-threatening condition which requires emergent initiation of anticoagulation and treatment. Diagnosis is usually made with clinical examination and ultrasonography or CT imaging. Management options include open thrombectomy with leg fasciotomy or catheter directed thrombolysis or percutaneous transluminal angioplasty. Reference #1: Chun TT, Jimenez JC, Pantoja JL, Moriarty JM, Freeman S. Phlegmasia cerulea dolens associated with acute coronavirus disease 2019 pneumonia despite supratherapeutic warfarin anticoagulation. J Vasc Surg Cases Innov Tech. 2020;6(4):653-656. doi:10.1016/j.jvscit.2020.10.002 Reference #2: Gutierrez JR, Volteas P, Skripochnik E, Tassiopoulos AK, Bannazadeh M. A Case of Phlegmasia Cerulea Dolens in a Patient With COVID-19, Effectively Ttreated With Fasciotomy and Mechanical Thrombectomy. Ann Vasc Surg. 2022 Feb;79:122-126. doi: 10.1016/j.avsg.2021.07.034. Epub 2021 Oct 10. PMID: 34644637;PMCID: PMC8502248 Reference #3: : Morales MH, Leigh CL, Simon EL. COVID-19 infection with extensive thrombosis: A case of phlegmasia cerulea dolens. Am J Emerg Med. 2020;38(9):1978.e1-1978.e3. doi:10.1016/j.ajem.2020.05.022 DISCLOSURES: No relevant relationships by Arij Azhar No relevant relationships by Louis Gerolemou No relevant relationships by Wael Kalaji No relevant relationships by Steven Miller N relevant relationships by jasparit minhas No relevant relationships by houman mirtorabi No relevant relationships by Kunal Nangrani No relevant relationships by Gaurav Parhar No relevant relationships by Kiran Zaman
ABSTRACT
This study analyses return volatility for Malaysia and China's stock markets during the SARS and COVID-19 pandemics. Stock return volatility is estimated using GARCH family models (GARCH (1,1), TGARCH and EGARCH). Generally, GARCH (1,1) estimates symmetric conditions, whereas TGARCH and EGARCH estimate the asymmetric condition or leverage effect of return volatility. Stock return volatility in China and Malaysia are then compared to assess the severity of pandemic cases during the study period. Post pandemic, Malaysia is seen to experience higher decrements in leverage effect when using the TGARCH model. Conversely, the effect is higher for China when using the EGARCH model for the SARS pandemic. To aid in predicting future return volatility after the COVID-19 pandemic, return volatility after the SARS pandemic is forecast, with the forecast value serving as the basis for evaluating the error using the mean absolute error (MAE), root mean square error (RMSE) and Theil inequality coefficient (TIC) approaches. The forecast error performance is ranked to identify outperforming GARCH family models for the pandemic period: the TGARCH model for China's stock market but the GARCH model for Malaysia's stock market. © 2022 Author(s).
ABSTRACT
The spreading of Covid-19 in Indonesia caused changes in the learning process from conventional to distance learning, including higher education. The implementation of online learning at university has been accomplishing for approximately one year. This research focused on the perceptions of students toward physics learning online. As many as 198 students from three departments in the FMIPA UNP act as respondents. The data was obtained from an online survey using the Google Form. The results showed that most students had negative perceptions about the implementation of physics learning online. Although students thought online learning was the best solution during the Covid-19 pandemic. However, most of the students complained about the workload given by the lecturers and the limited feedback given regarding assignments. Lack of readiness, effectiveness, and difficulties during one year of online learning implementation could act as positive feedback for the university to improve the quality of online learning in the future. Therefore, online learning is more beneficial for students.
ABSTRACT
This paper is based on an ongoing study titled "Social Based-Crowd Funding in Battling Covid-19 and Maqasid Shariah: Some Legal and Shariah Observations in Malaysia and Indonesia." The COVID-19 pandemic has been one of the most serious health crises since the turn of the century. The corona pandemic has presented Islamic banks with significant challenges in dealing with this pandemic, taking into account, on the one hand, its impact on various economic sectors and regulatory authorities' decisions. However, it appears that Islamic financial institutions are at odds over how to handle Islamic banking transactions, particularly a moratorium between the bank and their clients during the pandemic, as well as the use of social-based crowdfunding activities. This investigation begins with a historical pandemic that afflicted the entire world. The purpose of this paper is to examine the position of Islamic banking transactions and social-based crowdfunding during the pandemic from a Shariah standpoint. This paper also highlights Malaysia's Islamic banking approach to social based financing and social based crowd funding by financial and non-financial institutions during the pandemic. The qualitative research method was used in this paper, which included a library-based research method. A descriptive content analysis method will be used to analyse the data. This paper is significant in that it will add to the body of knowledge and literature on the subject while also providing Shariah's perspective on the status of Shariah's commercial and socially based crowdfunding contracts. The principles of adl and Ihsan appear to have been applied, affecting Islamic banking commercial transactions and social-based crowdfunding contracts. During a pandemic, however, there is a need to strike a balance between the financial stability of the financial institution and the needs of society as a whole. As a result, Shariah parameters must be developed in such a way that financial institutions understand how Islamic commercial transactions and socially based crowdfunding should be treated, particularly during a pandemic. © 2021, CA and C Press AB. All rights reserved.
ABSTRACT
Objectives: To determine the safety of Sinopharm Covid-19 vaccine among health care workers of Khyber Teaching Hospital (KTH, Peshawar). Material and Methods: This observational study was carried out to assess the side effects associated with the first dose of Sinopharm vaccine among health care workers in KTH Peshawar, Pakistan. Data was collected using a close ended questionnaire which was filled by the health care workers above 18 years of age. The participants were asked to monitor any side effects up to 1 week after the first dose of Sinopharm vaccine administered to them. Data was analyzed using SPSS version 23 for macbook. Results: A total of 400 health workers were included in the study but only 155 participants responded by completing the questionnaire. It was observed that 63.9% of the participants who were vaccinated experienced at least one symptom after vaccination. The most common symptom was pain at injection site (36.8%) experienced during 15 – 30 minutes after vaccination followed by fatigue (21.3%), headache (18.7%), lightheadedness (12.3%), myalgia (10.3%). Percentage of other symptoms was less than 10%. The occurrence of symptoms after vaccination was greater in age group 24-42 years which was 60.6% while in age group 43-60 years it was 39.4%. Conclusion: Our study concludes that Sinopharm vaccine has no or mild side effects and therefore safe for public use.
ABSTRACT
The purpose of this study was to examine and visualize lecturers' writings submitted to the Mataram State Islamic University's institutional repository during the COVID-19 pandemic. The study used bibliometric analysis with the total number of publications was 166 documents in various types. The results indicated that journal articles accounted for 42.16 percent (n=70) of all publications and more than half (65.66%) of total publications were authored in Indonesian language. Additionally, it was discovered that the terms pendidikan (education) and pembelajaran (learning) were the two most frequent terms in all type of publications, appearing 10,714 and 9,834 times respectively. Furthermore, this study discovered that Abdul Wahid was the most prolific author, while Abdul Quddus was the most collaborative one. This research also found that the terms covid-19 and pendidikan (education) were the most frequently occurring words combined in a single document with at least three co-occurrences. This study was expected to encourage lecturers to have publications and deposited into the institutional repository. It will benefit both lecturers and university in national and international scale © 2021. Library Philosophy and Practice. All Rights Reserved.
ABSTRACT
Introduction: Recent data demonstrates a strong correlation between COVID-19 and hypercoagulability with the spectrum of thromboembolic manifestations, including deep vein thrombosis and pulmonary embolism (PE). Here we present a unique case of COVID-19 associated hypercoagulability manifesting as both PE and apical left ventricular (LV) thrombosis in the absence of underlying coronary artery disease (CAD). Case: A 71-year-old female with a diagnosis of mild COVID-19 pneumonia presented with worsening fatigue, cough, shortness of breath, and chest heaviness on the thirteenth day of her illness. The patient was hypoxic on presentation requiring 3 L supplemental oxygen. Laboratory analysis showed an extremely high D-dimer level (greater than 20,000 ng/mL). Hence, computed tomography angiography of the chest was performed, showing evidence of right lower lobe segmental and subsegmental PE along with bilateral multifocal consolidation. Incidentally, the imaging demonstrated a filling defect within the apex of LV, transcending into further cardiac workup. Initial troponin was elevated at 0.04 ng/mL, and electrocardiogram showed sinus rhythm without any acute ST-T wave changes. Transthoracic echocardiography confirmed the presence of large, sessile, mobile, 1.3 x 2.1 cm LV thrombus but normal LV systolic function, ejection fraction, and no evidence of regional wall motion abnormalities. However, due to ongoing chest heaviness, the decision was made to perform a diagnostic left heart catheterization, which showed insignificant CAD. The patient received treatment with convalescent plasma, Remdesivir, and dexamethasone as per our institutional protocol and started on unfractionated heparin for anticoagulation. She was discharged on enoxaparin as per the patient's preference on a stable condition with close cardiology follow up. DiscussionLV thrombosis is a well-known complication of LV dysfunction associated with ischemic cardiomyopathy. While PE is an established phenomenon of COVID- 19 induced hypercoagulability, thrombus formation within the cardiac chamber is rarely reported. As cardiovascular complications such as acute myocardial injury, myocarditis, and cardiomyopathy are substantially reported in COVID-19, through this case report, we highlight the rare presentation of COVID 19 hypercoagulability with LV thrombus in the absence of predisposing cardiac conditions such as myocardial infarction or atrial fibrillation. Although the mechanism remains unclear, endothelial dysfunction eliciting local myocardial inflammation and blood stasis is a plausible explanation. Early recognition of LV thrombus and treatment with anticoagulation is of paramount importance to reducing stroke risk and systemic embolization. The detection of LV thrombus mandates anticoagulation with warfarin or heparin due to insufficient evidence to support the use of direct oral anticoagulants.
ABSTRACT
Coronavirus Disease 2019 (COVID-19) predominantly involves the respiratory system and shows a wide range of severity. There is a growing body of evidence about the occurrence of thromboembolic events in COVID-19. Case Report: We report the case of a 48-year-old female patient who presented with sudden-onset abdominal pain. Physical examination revealed ascites and tender hepatomegaly. Subsequently, abdominal computed tomography was performed which revealed thrombosis in the hepatic vein and inferior vena cava in keeping with Budd-Chiari Syndrome. The patient was started on low-molecular-weight heparin and supportive care. Clinical improvement was observed over the course of the treatment and the patient was discharged after 10 days from the presentation. Thromboembolic events could be the first manifestation of COVID-19. Early recognition of these complications is crucial for prompt management.