Bringing health information exchange to the Middle East and North Africa: the case of Malaffi in Abu Dhabi

Launched in 2019, Malaffi is the first health information exchange (HIE) platform in the Middle East and North Africa region. It safely and securely connects public and private healthcare providers in the Emirate of Abu Dhabi. Malaffi allows for meaningful, real-time exchange of patient health information between the providers, establishing a centralized database of unified patient records, thus improving healthcare quality and patient outcomes. Now that the foundation has been firmly established by collating 99% of all patient episodes in the Emirate, Malaffi is implementing tools to support population health. Recently these activities were focused on COVID-19 response. In the future, these population health services will offer insights to improve care delivery. This case study demonstrates the HIE status in the UAE and focuses on the establishment of Malaffi in Abu Dhabi. © 2023 Elsevier Inc. All rights reserved.

Repositioning of Drugs as a Promising Strategy to Fight COVID-19

Background and Objective: With the initial case of corona reported in Wuhan, China on 31st December 2020, there has been an unprecedented rise in the coronavirus disease (COVID-19), with over 200 countries all across the world in less than 3 months. By the October 2020, about 40 million population of the world got infected and over one million deaths occurred. Since no WHO and FDA approved medications or vaccines for COVID-19 were available, there was an impatient bustling need to develop a drug for the treatment. Drug repurposing emerged as the easiest and fast emerging strategy to get medicine for COVID-19 with rapid approvals for the clinical trials. The purpose of this study was to evaluate the status of drug repurposing under the clinical and its impact on the development of medicine for COVID-19. Method(s): The study was undertaken to review various clinical trials from the website. www.clinicaltrials.gov. We evaluated 220 ongoing clinical trials with the strategy of 'drug repur-posing' against COVID-19, analyzed them as per their chemical structure and possible biological targets. Result(s): It was noticed that some of the early repurposed drugs like chloroquine, hydroxychloro-quine, ACE inhibitors and ARBs, did not succeed and remained controversial. While many of the antiviral drugs like remdesivir, favipiravir, lopinavir, ritonavir, oseltamivir could be taken for the clinical trials in various countries, remdesivir could succeed to a great extent as compared to other drugs. WHO has come up with an initiative known as multi-country 'Solidarity Trial' for developing a potential drug or therapy against COVID-19.However, the most preferred drugs used for re-purposing like hydroxychloroquine and remdesivir have not shown predictable results in solidarity trials. Conclusion(s): The analyses of several ongoing and partially concluded clinical trials suggest that drug repurposing can be one of the major strategies for the treatment of COVID-19. Further, guidelines framed by the WHO through Infection Prevention and Control for monitoring the widespread of this COVID-19 across the world is another aggressive attempt to find the solution for the treatment for COVID-19.Copyright © 2021 Bentham Science Publishers.

Electronic Health Literacy: A Key Determinant in Televisit Acceptance in Inner-City Patients With CKD

Background: Televisits have become a more widely used since the COVID pandemic in 2020. However, pts in underserved populations may not be as knowledgable about electronic health resources and may not be able to access this type of health care visit, worsening health care disparities. We examined the relationship between electronic health literacy and acceptance of televisits in an underserved inner-City population of pts with CKD. Method(s): 38 randomly selected CKD pts were surveyed in a face to face fashion including a demographics section, the eHEALS electronic health literacy assessment (scored from 8 to 40), and additional sections on televisit history. eHEALS is a validated 8 question survey that characterizes the subjective ability to find and use electronic health resources. Result(s): Mean age of the pts. was 67+/-15 yrs. 66% were female, 74% did not attend any college, 60% make less than $25,000 per year. 21% did not have any Internet access, 5.3% did not own a cell phone, and 5.3% of cell phone owners did not own a smart phone. 61% need help using the internet. The mean eHEALS of those who need help using the internet is 21.1+/-6.0 vs 27.5+/-8.6 (p=<0.05) for those who do not need help.76% of pts. had a televisit before the survey, of which 76% were telephone only and 24% had visits by both telephone and video. No participant had only used video. Those who had televisits did not differ based on age, education, gender and income from those who did not. Of the 24% of participants who did not have televisits, 100% need help using the internet vs 48% who had televisits (p=0.006). Mean eHEALS score of those who had a televisit was 25.1+/-7.9 vs 18.9+/-4.9 for those who did not (p=0.01). Conclusion(s): In our population of older inner-city CKD patients, 1. Almost one quarter had no home internet access, and over half needed help using it 2. Pts who needed help had lower eHealth literacy and were less likely to have televisits. 3. Televisit use related to eHealth literacy rather than age, education or income. 4. Administering eHEALS may identify people who would benefit most from in person visits, directed educational materials to help with televisits or for whom support should be provided 5. The rise in use of telehealth may further health resource inequities if eHealth literacy is not recognized as a potential negative social determinant in vulnerable populations.

PILLARS OF INDIAN ECONOMY IN COVID-19: COMPREHENSIVE STUDY OF FARMING & AGRO BASED INDUSTRY

The country was under lockdown from more than two months due to COVID-19. In this crisis, the farmers have not allowed food security to be endangered. Moreover, they have increased food production despite all the obstacles. Right now, farmers are facing many obvious and climatic problems. Prime Minister of India has said that we have to convert this crisis into opportunity. The solution to farmer's problems is necessary, to make the country Atmanirbhar Bharat and to take it rapid fast on the path of progress. The outbreak of this epidemic has come at a time when the harvesting of Rabi crops had already started. However, taking necessary steps, Ministry of Agriculture has worked with all agencies of selling and buying agricultural products, units notified by the state governments, farmers and agricultural labourers along with machines used in harvesting and sowing and agro-horticulture exempted from and out of state. In addition, the All India Transport Call Centre was launched to remove bottlenecks in the movement of seeds, pesticides, fertilizers and fruits, vegetables, milk, eggs, fish and other perishable agricultural products. © 2022 University of Stockholm. All rights reserved.

Clinical Profile of COVID-19 Positive Obstetric Patients Admitted to a Tertiary Care Hospital during the Two Waves of COVID-19

Background: Coronavirus disease 2019 (COVID-19), a global pandemic which undoubtedly hit the whole world so hard. There have been multiple waves across the globe of varying time, duration, and intensity, India has also witnessed two waves sweeping the entire nation. The second wave had startling intensity with massively increased oxygen requirement, intensive care unit (ICU) admissions. The effect was even more pronounced in the pregnant women as there was increased maternal morbidity and mortality. However, there are limited reports on the impact of COVID-19 during pregnancy. Objective: This study is aimed at highlighting the variance in clinical profile of pregnant patients in first and second wave of COVID-19 in India. Materials and methods: A retrospective observational comparative hospital-based study was conducted in a tertiary care hospital in Delhi during the two waves of COVID-19. The first wave in India lasted from May 2020 to October 2020, and the second wave lasted from April 2021 to June 2021.We obtained the medical records and compiled clinical and outcome data for all pregnant patients, who were admitted in the Department of Obstetrics and Gynaecology of our Hospital during the first and second wave of pandemic with a laboratory-confirmed report of SARS-CoV-2. Results and conclusion: The second wave definitely saw more number of symptomatic patients, an increase in symptom of shortness of breath, increase in oxygen requirement, ICU admissions, marginally increase lower segment cesarean section (LSCS) rates and associated comorbidity such as hypertensive disease of pregnancy.

Bronchoscopic management of bronchopleural fistula due to COVID-19 a nonsurgical option

Background: COVID-19 has become a dreadful pandemic. One of the important complication is the development of pneumothorax/ pneumomediastinum which gets further complicated by bronchopleural fistula. Case Study: A 44year male patient with severe COVID pneumonia developed Left sided pneumothorax and treated conservatively with ICD and negative suctioning for 2 months and referred to us with persistent pneumothorax with BPF. As patient was unfit for surgery, bronchoscopic management was planned. With flexible bronchoscope, 6F Fogarty balloon was passed and inflated, leak site was identified in left upper lobe upper division. A Watanabe spigot size 5 was deposited at the opening of upper division and manipulated to apical segment. Other small openings were sealed with cyanoacrylate glue and autologous blood patch. After procedure negative suction was reapplied. Repeat Xray showed resolution of pneumothorax. Pleurodesis was done with talc slurry, post pleurodesis showed no pneumothorax and ICD was removed. Patient was discharged, follow up X ray after 4weeks showed no evidence of pneumothorax. Discussion: In most cases of BPF, leak seals after tube thoracostomy, only 3-5% will continue to have persistent leak. For medically inoperable cases, bronchoscopic balloon occlusion of site and subsequent injection with fibrin glue, liquid bioadhesive or blood patch can be done. For large leak;Amplatzer device, stents, spigots, coils are used. Conclusion: Bronchoscopic treatment can work well for a medically inoperable, complicated pneumothorax in COVID-19 disease.

POSB193 COVID-19 Vaccine Development Pipeline: 2021

Objectives: The COVID-19 pandemic caused by the novel coronavirus strain SARS-CoV-2 had a catastrophic consequence in global physical and psychological health, as well as economic recession. Development of vaccines can be the most prominent approach to prevent the virus to cause COVID-19 and hence will play a vital role in controlling the spread of the virus and reducing mortality. This study was conducted to review the current pipeline of vaccines in clinical trials for the COVID-19. Methods: We conducted a review of clinical trials of vaccines for COVID-19 using trial data obtained from the and World Health Organisation (WHO) registries and performed an analysis. We also assessed active vaccine development projects that had completed one clinical phase but were yet to start the next. Results: A total of 125 vaccines in 365 trials assessing the efficacy and safety for COVID-19: 36 vaccines in phase III, 49 in phase II, and 35 in phase I. As of June, 2021, there were 18 vaccines approved for COVID-19. Of these, seven approved by WHO, three by US FDA, and four by EMA. Among the approved vaccines, eight were inactivated, five were non-replicating viral vector, three were RNA, and two were protein subunit. Among the top five vaccines approved in most number of countries, Oxford/AstraZeneca AZD1222 approved in 115 countries, followed by Pfizer/BioNTech BNT162b2 in 89 countries, Gamaleya Sputnik V in 68 countries, Moderna mRNA-1273 in 53 countries), Janssen (Johnson & Johnson) Ad26.COV2.S in 52 countries, and Sinopharm (Beijing) BBIBP-CorV in 53 countries. Conclusions: Emerging COVID-19 will continue to pose significant challenges to the global community. This pipeline analysis shows that we have a strong pipeline of new vaccines in late stage development. Till date, 18 received approval and several additional promising vaccines are being evaluated in later stage clinical trials.

Unmasking of obsessive compulsive disorder in a vulnerable preadolescent girl due to covid-19 related stress: A case report

Coronavirus Disease 2019 (COVID-19) pandemic has been especially hard for children and adolescent's mental health due to their inherent vulnerabilities and added stress of lockdown, mobility restrictions, school closure, absence of peer interaction. The case report highlights the unmasking of obsessive compulsive symptoms due to the COVID-19 pandemic stress and the role of inherent vulnerabilities in a 11-year-old female. The management of the index case emphasised upon age appropriate strategies for intervention. Although, Obsessive Compulsive Disorders (OCD) is not a stress disorder per se but the index case highlights the role of stress in manifestation of mental illness in vulnerable individuals favouring the biopsychosocial model for mental illness.

Entreprenuership in covid-19: Resilience and rebuild

According this paper, discussion is held on the effectiveness of strategies and entrepreneurship in relation with the situation of COVID-19. Also, about the adverse effect of the corona virus on worldwide economy along with the support of government for small businesses for boosting the economy again as well as new business ideas transformational opportunities for people to overcome these implications of COVID-19.

Board Members’ Religious Affiliations and Corporate Governance Practice: An Exploratory Study

The deleterious effects of a black-swan event, COVID-19, on companies and their governance are likely to be wide-ranging and unprecedented. To survive a potentially existential crisis that organizations are currently facing and remain sustainable, they may have to look beyond the standard governance models, leadership styles, and leaders’ attributes. So far, the usual suspects of effective corporate governance have been the sound principles of management and law. The impact of corporate elites’ religious background on their decision-making is seldom explored in the existing literature. However, the Upper Echelon perspective suggests that when faced with uncertain and complex situations, corporate elites turn to their background and experiences. This is done in order to interpret available information and make decisions. This chapter explores if corporate elites’ religious background influences their decision. We conduct the inquiry by interviewing 42 board members of listed companies in the UK. The study’s findings suggest that corporate elites’ religious beliefs shape their value-sets, decisions, and organizations’ strategic aspirations. The findings are explained with the help of interdisciplinary literature. The study’s contribution to theory, literature, and praxis is also discussed. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Assessing COVID-19 Impacts on College Students via Automated Processing of Free-form Text

In this paper, we report experimental results on assessing the impact of COVID-19 on college students by processing free-form texts generated by them. By free-form texts, we mean textual entries posted by college students (enrolled in a four year US college) via an app specifically designed to assess and improve their mental health. Using a dataset comprising of more than 9000 textual entries from 1451 students collected over four months (split between pre and post COVID-19), and established NLP techniques, a) we assess how topics of most interest to student change between pre and post COVID-19, and b) we assess the sentiments that students exhibit in each topic between pre and post COVID-19. Our analysis reveals that topics like Education became noticeably less important to students post COVID-19, while Health became much more trending. We also found that across all topics, negative sentiment among students post COVID-19 was much higher compared to pre-COVID-19. We expect our study to have an impact on policy-makers in higher education across several spectra, including college administrators, teachers, parents, and mental health counselors.

Pediatric COVID: How is it different from adults?

COVID 19 pandemic has affected the world for more than one year now. It has had impact on children as well, but the numbers have been fewer than adults, with lesser morbidity. Children have been commonly asymptomatic and are suspected to be the spreaders to the more susceptible part of the community. Nasopharyngeal swab testing is difficult and challenging in smaller children, and therefore their results should be interpreted with caution. Multisystem involvement has been seen in some children who required ICU admission. Most centers treated these cases as a multisystem inflammatory syndrome and used vasoactive agents for support. Overall, children showed lower morbidity and mortality all over the world.

Covid-19: Group testing and digital technology “aarogya setu”-the need of the hour

The importance of group testing, efficient utilization of the diagnostic tests and its applications are highlighted. Though it has advantages, the challenges and constraints and the need for the policy from the concerned authorities to implement group testing in a reliable manner with competent persons were brought out. Thus, with group testing and the use of digital technology “Aarogya Setu” in India, we are confident that we will be able to diagnose cases and implement surveillance activities successfully. Popularization of “Aarogya Setu” by all categories of healthcare workers, teachers, women self help groups and other users of android mobile phones in the interest of the Nation and community at large, towards disease containment were cited. However, the ethical aspects of deployment of such kind of approach as part of a multidimensional public health response, and its usefulness in infectious disease outbreaks have to be monitored. © 2020, Indian Association of Preventive and Social Medicine. All rights reserved.

PIN42 Current Trends in Covid-19 Testing Rates and Unmet NEEDS

Objectives: To analyze the current rate of COVID-19 testing in select countries and what India can learn Methods: Number of tests per million people and case doubling time was collected through tracking websites and analyzed for 1 Feb – 6 Apr 2020 for 11 countries. Results: South Korea, with a very high testing rate, reported 380 cases per million for as early as Feb 22, a rate matched by the UK two weeks later. Germany also steeply increased its testing rate starting Mar 10. The total number of samples tested in Germany was 918,460, as of Mar 29 and the case doubling time was 9 days. S. Korea had tested 443, 273 (1% of the total population) cases as of Apr 3 and the case doubling time was 33 days. In contrast, test numbers in India were negligible, and doubling time was 4 days1,2. Importantly, testing capacity globally is currently limited. S. Korea, at number three after US and China in terms of testing kit production, can only support a capacity of 1,35,000 tests per day at present3. Additionally, ICMR guidelines such as “Laboratory test should only be offered when prescribed by a qualified physician” and 48 hours of turnaround time for test results further delay case identification and isolation4. Conclusions: If India was to mirror the testing rate of S. Korea, ∼15 million individuals may have to be tested within coming few weeks to be able to bend the curve of the COVID-19 cases. A balance of both the strategies – exponentially increasing testing and social distancing will be crucial. Sources: 1. https://ourworldindata.org/coronavirus” l "testing-for-covid-19, accessed on Apr 6, 2020 2. Statista,, accessed on Apr 6, 2020 3. News: 4. MoHFW website,, accessed on Ap 7, 2020