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Coronavirus disease 2019 (COVID-19) pandemic emergence has re-evaluated the functionality of the notable convalescent plasma transfusion (CPT). It is a source of neutralising antibodies, which when transfused into severe acute respiratory syndrome coronavirus 2 infected patients are believed to employ an antiviral effect, suppressing the replication of virus before the patients regain their own effective humoral immune responses. The major accepted mode of action of the CPT therapy is viremia clearance, that happens mostly between 10 and 14 days after infection. Hence, CPT has been administered to the recipients typically after the emergence of early symptoms for anticipating maximize the efficacy of the therapy. CPT has been used in treating viral diseases including measles, mumps, poliomyelitis, and influenza in the pre-vaccine era. More recently, it has been used as a treatment approach for influenza, Ebola virus disease, and severe acute respiratory syndrome coronavirus epidemics, with varying success. The available evidence till date suggests that convalescent plasma which is collected from the COVID 19 survivors contains "receptor binding domain specific antibodies " possessing potent antiviral activity. Multicentred and well-designed clinical trial studies in establishing the efficacy of CPT among COVID-19 patients are being conducted globally. PubMed, EMBASE, and Medline databases were screened till November 01, 2020. This is an attempt to review studies of convalescent plasma on clinical outcomes in patients with COVID-19. From the outcomes of some of the completed studies, it is suggested that CPT therapy among COVID-19 patients seems to be safe and clinically efficacious to some extent.
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Disease management is a global challenge due to the immense scale of the microbiota and the lack of drugs and hospital resources. This paper aims to evaluate the hidden nutraceutical use of phytoestrogens (PEs), which have been scientifically shown to protect the host from various deadly diseases. In particular, coronavirus disease-19 (COVID-19) is caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus, fatal for vulnerable individuals. Natural products that attenuate the severity caused by various coronaviruses will also be presented. Special attention will be given to the mechanism of action of PEs that stabilize the renin-angiotensin-aldosterone system, which has been linked to the SARS-CoV-2 invasion of human cells. © 2023 Elsevier Inc. All rights reserved.
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Introduction and Objective: Telemedicine is an established modality to deliver health care to patients remotely. Its role in pediatric urology followup among middle-class semi-urban families is unknown. We conducted a prospective observational questionnaire-based study to assess the patient and provider(urologist) satisfaction and feasibility of teleconsultation across different socioeconomic strata in follow-up of paediatric urology patients during the COVID 19 pandemic. Method(s): The guardians of children treated earlier and due for follow-up were explained and the appointment for teleconsultation was fixed using a video conferencing app. After consultation, consenting caregivers were explained about study and the provider survey was filled by consulting urologist, while the patient questionnaire was filled by principal investigator telephonically. Result(s): A total of 77 virtual visits were completed over 10 months. Median age was 8 years(IQR= 4 to 12) and 82% were boys. The clinical conditions were posterior urethral valves(22%), hypospadias(18%), PUJ obstruction(18%), vesicoureteric reflux(12%) and others(30%). Clinicians found that virtual visits were effective(78%) in deliverance of the care equivalent to the inpatient visit. Patients were equally satisfied(75%). Technical difficulties due to internet connectivity were faced in 24 visits(31%). Video clarity and inability to examine were additional limitations faced(23%). Majority(90%) belonged to the middle socioeconomic strata as per modified Kuppuswamy scale. Families were estimated to have saved a mean of 26,934 rupees(SD +- 7998.06) and a median of 7 days(Range 1-15) of travel time. Conclusion(s): Telemedicine has potential for successful follow-up with cost and time savings. With improving internet connectivity, its potential is likely to increase in future.
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Critical circumstances, natural disasters or pandemics like COVID 19 gave rise to the wide applicability of E-learning into education system. Efficient and fair online assessment is very important to utilize the inevitable benefits of E-learning.. In order to make it efficient, the trend of assessment has shifted from the subjective type to the objective type assessments which is mainly based on Multiple Choice Questions (MCQs), generation of MCQs is a tedious, tiresome and time consuming task. To cater this dire need, this study proposes an automated Multiple Choice Question (MCQ) generation by utilizing state of the art transformer based model T5 for the task of question generation and a lexicon based approach Sense2vec for the task of distractor generation. It also presented a domain specific lecture text based test data for performing evaluation on the task of domain specific lecture text based MCQ generation. © 2022 IEEE.
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Introduction: Covid 19 is a disease caused by a virus belonging to SARS Co V2 family of viruses. It primarily effects the lungs resulting in inflammation and pneumonia. Objective(s): The main objective of the study is to compare the outcomes and efficacy of solumedrol and dexamethasone in moderate to severe COVID disease. Material(s) and Method(s): This cross sectional study was conducted in Central Park Medical College and Teaching Hospital, Lahore and the duration of this study was from August 2021 to March 2022. The data was collected from 100 COVID-19 patients diagnosed with moderate to severe condition of the diseases. The data was collected through non-probability consecutive sampling technique. Result(s): The data was collected from 100 patients of moderate to severe COVID-19 condition. There were 35 patients in group I and 65 patients' group II. The mean age for dexamethasone (group II) was 55.41 +/- 10.4 years and solumedrol (group I) was 56.86 +/- 9.3 years. Conclusion(s): It is concluded that both drugs dexamethasone and solumedrol are effective in improving clinical and biochemical parameters of moderate to severe covid 19 disease. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Reservoir surveillance and production optimization will remain at the forefront of company strategies in the new post-COVID19 environment. We anticipate that companies will focus more on producing assets and go the route of production enhancement rather than exploration. Accordingly, production logging will remain an important surveillance method in evaluating and strategizing production-optimization schemes pertaining to flow-characterization from reservoir-to-wellbore. This work is culmination of operational and technical excellence that enabled the revival of a loaded-up well through simultaneous lifting-and-logging technique. Conventionally, wireline is the preferred mode of conveyance for production-logging;however, well must be continuously flowing throughout acquisition timeframe. Kicking-off the well using nitrogen-lift and then bringing in wireline-unit for production-logging in Well A-4 was not feasible as previous attempts confirmed well to load-up in few hours post-offloading. Therefore, success of this project was heavily dependent on initial planning stage, which accounted for all available data including production-history, well-events, intervention-details, fluid analysis and well load-up behavior. Next, a multi-domain approach was adopted while bringing-out each domain from its silos and strategize collectively to simultaneously kickoff the well with nitrogen and acquire real-time downhole production-logging data through smart-coiled-tubing (CT). This was first implementation of concurrent lifting and logging operation in Pakistan. By deploying the approach mentioned above through smart CT (using optical-telemetry-link inside the CT-string coupled with downhole-assembly), synchronized lifting-and-logging operation was carried-out successfully. Well was observed to swiftly go back to load-up conditions post-kickoff;however, continuous well dynamics monitoring downhole enabled us to log perforated interval across multiple time domains. Well was activated through CT nitrogen-injection but depicted continuous loading tendency, which was captured downhole in form of flow-transients. Real-time job optimization ensured vigilant monitoring and selection of right-time to acquire meaningful zonal-contribution data for evaluation and diagnostic solutions. Finally, operational excellence was complemented through technical data analysis and interpretation, integrating passes data with transients and stationary measurements. Ultimately, acquired data analyzed using an integrated lens involving fluid velocities, downhole density, temperature, and water hold up data. Consequently, enabling us to decipher gas and water-entries on a zonal-basis across perforated sandstone reservoir. Copyright © 2022, Society of Petroleum Engineers.
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Background: Corona virus disease 2019 (COVID-19) was first reported in China and became the global pandemic. This pandemic has proven fatal for the world and lasts drastic effects on the whole world. To combat with this hilarious pandemic, the whole world has adopted the strategy of social distancing and precautionary measures. Aim: To compare trends of social anxiety and avoidance during covid wave 1 and covid wave 2. Methodology: A cross-sectional study was conducted at Central Park Medical College from October 2020 and January 2021. To assess social avoidance and anxiety LIEBOWITZ Social Anxiety and avoidance Scale was employed. Paired sample t test and correlation was used to compare mean differences. A p value less than 0.05 were considered significant. Results: There was a reduction of score of social anxiety from covid wave 1 and wave 2 (26.73±4.65. 17.86±3.81) with p value of .001 and similarly there was a reduction of score of social avoidance (25.31±0.597 v/s 15.±0.3390) as well from wave 1 to wave 2 with p value of .001 Conclusion: There is a continuous decline in social avoidance and social anxiety which can cause an increase in covid 19 infection rate in order to combat that there's need of prompt vaccination along with the precautionary measures to combat covid pandemic.
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Objective: COVID-19 pandemic pushed unprepared educational institutes towards online sessions. Though equivalence of online sessions proved already in many studies before pandemic, unplanned sessions and inexperienced teachers with networking issues and novice software for online sessions could not meet the standard of teaching that was expected or experienced during these sessions. We planned this study to know perspective of learners to measure quality of online sessions and to find out factors which could improve these sessions in future. Design: Prospective questionnaire based study Place & duration of study: Hitec IMS Dental College, from 10th Feb 2022 to 10th March 2022 Methodology: Questionnaire was distributed to 150 students of BDS who has attended online session during COVID-19 pandemic. Results: 85% of the responders appreciated online sessions happening during pandemic to avoid wastage of time but as high as 50% students were of the opinion that teachers could not maintain standard of teaching as in on campus session. Factors for this dis-satisfaction of students included issues like connectivity issues, gadgets of students as well as teachers, novelty to softwares to attend online class, and psychological issues like depression. So at the end 83% of students preferred on-campus sessions on on-line sessions. Conclusion: On the basis of findings of this study, it is recommended that we should continue activity of online teaching with improvement in resources and train our staff and students even in the absence of such emergency.
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Artificial intelligence has radically altered the world, and it continues to progress at an alarming rate as time passes. AI applications include healthcare and medical solutions, illness diagnostics, agriculture, constructing security infrastructures, autonomous cars, intelligent systems, industrial production, robotics, and much more. COVID19 is a deadly virus that first appeared in China in 2019 and soon spread over the world. By 2020, the globe had witnessed a tremendous epidemic, with countless lives lost as a result of this dreadful virus, which has now become a severe health danger. Furthermore, in 2021, several nations will be infected with new Covid19 forms that are more deadly and spread quicker. The research describes the proposed methodology for diagnosing covid-19 and pneumonia from human chest X-ray images using transfer learning with Resnet-18 and VGG-16 neural networks. The focal loss function was also used to homogenize the imbalanced dataset, which included X-ray images of normal, pneumonia, and Covid-19 patients. The purpose is to assess the performance and accuracy of fine-tuned neural networks after including Binary Cross-Entropy (BCE) and Focal Loss (FL) functions. However, when we used our Resnet-18 and VGG-16 neural networks with BCE and FL functions, the VGG-16 with FL function outperformed all other models, with training and validation accuracy of 98.37 percent and 97.37 percent, correspondingly.
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The educational system in Pakistan relies on traditional methods of learning. Notably, only few institutions are prioritizing technological advancements and its implementation in education system. However, majority of the institutions adhere to conventional methods and ignoring its negative impacts. A sudden outbreak of the Covid-19 pandemic is challenging for everyone. Specifically, the fear of pandemic particularly affected those students who were indulged in physical classes. This study presents a comprehensive analysis of already available studies discussing the challenges and role of Information Technology (IT) in the educational domain. The study mainly incorporated an online questionnaire-based survey among 400 university-going students of Punjab, Pakistan. Additionally, the study highlights the key challenges and essential IT platforms that helped students continue their education. Moreover, we analyzed the incorporated constructs with the assistance of using SPSS and AMOS. Besides, our results confirm that Information Technology (IT) played an essential role in students' lives in their education. Our research shows that the role of IT in our education system is highly essential to be implemented. Although there are innumerable challenges, yet IT has core importance in the education sector during the pandemic. Moreover, the research intends to safeguard the education budget for better learning outcomes in Pakistan Punjab's educational level COVID-19 pandemic. Institutions and students are encouraged to adopt IT, seeing its inevitable role in education.
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Objective: To ascertain the immunogenicity and short-term safety of inactivated SARS-CoV-2 Vaccine (Vero Cell), BBIBP-CorV (Sinopharm) in our setup. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital Sialkot Pakistan, from Feb to Apr 2021. Methodology: A total of 227 health care workers (HCWs) between 18 to 59 years of age were included in the study. Two doses of Inactivated SARS-CoV-2 Vaccine (Vero Cell), BBIBP-CorV were administered to all individuals 21 days apart and they were monitored for any vaccine-related adverse reactions for 7 days after each dose. Neutralizing antibodies (NAbs) in study subjects were detected in three samples i.e. before 1st dose of vaccine, 21 days after 1st dose and 14 days after 2nd dose by Elecsys Anti- SARS-CoV-2 S (Roche Diagnostics). Results: Mean age of individuals in the study was 36.70 ± 18.08 years and most individuals were in the 31-45 years age group. Fatigue and drowsiness were the most common adverse effects experienced by study subjects after 1st and 2nd dose of the vaccine followed by malaise and headache. Only 42 (39%) individuals developed positive neutralizing antibody titers in a sample taken 21 days after 1st dose while all individuals except one (99%) developed positive neutralizing antibody titers in a sample taken 2 weeks after 2nd vaccine dose. Conclusion: Inactivated SARS-CoV-2 Vaccine (Vero Cell), BBIBP-CorV is safe and well-tolerated with very few adverse reactions. Immunogenicity was well achieved as the seroconversion rate was 99% two weeks after 2nd dose of the vaccine. © 2021, Army Medical College. All rights reserved.
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Background: In covid-19 related ARDS patients, early approach to proper health care facility and non-invasive ventilation lead to better outcome. Objective: To determine the outcome of covid-19 related ARDS patients at a tertiary care hospital, Rahim Yar Khan. Methodology: This retrospective study was carried out at department of ICU & anesthesiology in collaboration with department of Pulmonology, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. A total of 74 (confirmed positive PCR) covid-19 ARDS patients with age of 18-90 years of either sex were admitted in covid ICU from June – December 2020. Patients with negative PCR for covid-19 or who presented in gasping condition or received dead were excluded from the study. Outcomes were labelled as recovered (survivors) or died (non-survivors) and treatment outcome was observed in both groups those who were on non-invasive ventilation (NIV) and on invasive mechanical ventilation (IMV). Data was analyzed by using SPSS version 23.0 Results: Out of 74 patients, 60 (81.08%) were male and 14 (18.02%) were female. Middle and old age patients were more affected as compared to young age group (p-value 0.01) and more than half 41 (55.40%) patients went in to severe ARDS. Regarding treatment outcome 44 (59.5%) patients received NIV and 30 (40.5%) patients received IMV. Survival rate better (35.4%) among the patients on NIV as compared to those on IMV (6.7%) respectively. Conclusion: Survival was better among the covid-19 ARDS patients who received NIV as compared to those on IMV. Keeping an eye on respiratory rate and SpO2 is the main factor for the early recognition of ARDS development and severity.
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Introduction - Since Belt and Road Initiative (BRI) was proposed by the Chinese government, Malaysia, as a vital link in Asia, has actively responded to the initiative. Thus, China has increased foreign direct investment (FDI) in Malaysia and has become the largest investor. Due to the spreading of Covid-19, the progress of Belt and Road projects has been dragged down, which has caused Malaysian government treasury deficits and an increase of credit risk to the bank. In order to control costs and compliance with government policy to prevent the spread of the Covid-19, Malaysia international commercial banking industry service has shifted their work and tasks from office to home. Purpose - The research focused on discovering the direct and indirect relationship among transformational leadership, self-efficacy, and employee performance in the international commercial banking industry in Malaysian. Design/methodology/approach - Quantitative Approach Findings - In this study, 450 survey questionnaires were distributed to international commercial banks in Malaysian, and after data cleaning and screening, 302 questionnaires were valid. By analysing with SmartPLS, the result illustrated that all four hypotheses were supported, where self-efficacy significantly mediated the relationship between transformational leadership and employee performance. Conclusion - The research investigated the improvement methods of employee' performance to maintain the bank's services, in which excellent leadership plays a vital role in managing employees to reach higher performance. Thus, positive changes in transformational leadership in the banking industry should be promoted. Moreover, employees should strive to maintain their innovation at work, which will be beneficial to the smooth operation of the banking industry and maintain the economic chain services of BRI during the Covid-19 period.
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Objective: To determine sensitivity and specificity of Roche SARs-cov-2 antibodies assay using real time poly-marase chain reaction (RT-PCR) Covid-19 as standard in Pakistani population. Methodology: It was a cross-sectional study conducted in Rehman Medical Institute Peshawar from 1st January 2021 till 15th February 2021. This study include 192 suspected Covid-19 patients. Serum samples set consisted of 122 symptomatic RT-PCR positive patients and 70 negative RT-PCR were used for qualitative detection of Antibodies (CoVID-19 IgG, IgM). Overall and period wise (Post RT-PCR) diagnostic accuracy was determined by comparing results of antibodies assay to Rt-PCR. Chi square test was applied to assess the correlation between post-PCR duration and Anti-SARS-Cov-2. A p-value of <0.05 was considered significant.
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Background: Covid-19 is a very contagious and quickly spreading viral infection, caused by a corona virus SARS-COV-2 which was originally reported in China on December 5, 2019. It was confirmed as pandemic by WHO on March 11, 2020. This disease is yet under research. It has variable severity which includes no symptoms to pneumonia. This can cause death of the patient. Aim: To evaluate the association of Lymphopenia with severity of COVID 19 in COVID-19 patients Methods: It was a retrospective observational study conducted in COVID wards of Ghurki hospital Lahore. Record of 100 COVID-19 patients that were admitted between March and July 2021 fulfilling the inclusion criteria was included in the study. A pre-structured pro forma was filled to collect the data. Results: Out of 100 patients, 30 patients were included in Non-severe group while severe group had 70 patients. The mean age of study population was 52.5±10.38 with 60% male and 40% female. 70% patients in severe group had some co-existent comorbidity. The most commonly reported symptoms were fever and cough in both groups while shortness of breath was more commonly reported in severe group. Conclusion: Lymphopenia is associated with severe Coronavirus disease 2019 (COVID-19) infections. Lymphocytes count can be used to assess the severity of COVID 19.
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Purpose: The aim of this study is to investigate the serially mediating effect of knowledge management (KM) practices (namely, knowledge creation, storage and sharing) on the organizational learning (OL) and organizational performance (OP) relationships during a crisis. Design/methodology/approach: Based on theories-of-action, knowledge-based and resource-based theories, this study proposed a sequential mediation model where OL underlying mechanisms through which KM practices have facilitated OP during the crisis. The sample dataset contains 440 responses collected from the managers of the software development companies in Pakistan. The authors used Hayes Process macro with SPSS to test the study hypotheses. Findings: The results of the study reveal that knowledge creation, storage and sharing serially mediate the relationships between OL and OP. These findings strengthen the argument suggesting that OL plays the key role in KM that helps software companies to mend their performance in times of crisis. Originality/value: This study contributes to the KM literature in two ways: (1) grounded on the study's proposed framework, organizations can improve and manage their businesses in times of crisis and (2) learn how to generate new knowledge in response to business crises. © 2021, Usman Ahmad Qadri, Mazuri Binti abd Ghani, Shumaila Bibi, Abdul Haseeb Tahir, Muhammad Imran Farooq and Abdul Rauf Kashif.
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Domestic violence is a worldwide epidemic, and the UN lists it as the worst human rights violation before the Covid-19 outbreak. A large rise in domestic violence incidents occurred when governments adopted emergency lockdown measures due to a worldwide Covid-19 epidemic. The unprecedented rise in domestic violence cases under Covid-19 serves as a wake-up call for the states. This study aims to examine the reasons for the increase in domestic violence and the methods used by stakeholders to address the issue in South Asian and Far Eastern countries, specifically the Maldives, Pakistan, and Malaysia. This paper adopted the qualitative research method in collecting data. The statistics indicate an alarming surge in domestic violence cases during Covid-19, and clear links exist between Covid-19 and domestic violence, impacting the economic and social crisis. This study confirmes that the state interventions to deal with this social problem are inadequate. Domestic violence has been worsened by growing unemployment, financial stress, anxiety and lack of community services. Furthermore, states have significant difficulties in addressing such issues due to a lack of cooperation across government agencies and stakeholders. Finally, this research recommends policy initiatives and legislative reforms to decrease domestic violence during this crucial period. © 2021 Estudios de Economia Aplicada. All rights reserved.
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Purpose: Anticoagulation during extracorporeal membrane oxygenation (ECMO) for COVID-19 can be carried out by direct or indirect thrombin inhibition. The former agent obviates monitoring of antithrombin III but differences in outcomes with either approach are uncertain. Methods: A retrospective, multi-center study was conducted. Adult patients (≥18 years old) placed on ECMO for severe respiratory or circulatory failure due to COVID-19 between March 1, 2020, to April 30, 2021, in the United States were included. Patient were divided in 2 groups based on the utilized anticoagulation agent during ECMO support: 1) direct thrombin inhibitor (DTi, e.g. bivalirudin and argatroban) and 2) indirect thrombin inhibitor (IDTi, e.g. unfractionated heparin). The primary outcome was in-hospital mortality after ECMO placement assessed by a time-to-event analysis. Results: Overall, 455 patients from 17 centers were placed on ECMO, of whom 44 were excluded due to no reported anticoagulation agent. DTi was used in 160 (age: 47±11, 28% female) cases and 251 patients received IDTi (age 47±12, 29% female). At 90 days, in-hospital mortality was 50% (DTi) and 61% (IDTi), p=0.08, (Figure). After adjustment for clinical covariates, the likelihood of in-hospital mortality was similar with DTi (aHR: 0.79, 95%CI 0.57-1.10, p=0.16) compared to IDTi. Noted prevalence of deep vein thrombosis (DTi 14%, IDHi 12%), ischemic stroke (DTi 2%, IDHi 3%), intracranial hemorrhage (DTi 11%, IDHi 10%) and bleeding requiring transfusion (DTi 71%, IDHi 83%) was comparable between groups. Conclusion: Anticoagulants that directly or indirectly inhibit thrombin are associated with similar outcomes during ECMO for COVID-19.