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Introduction: Chronic respiratory diseases (CRDs) are growing problems worldwide. Pulmonary rehabilitation (PR) has proven benefits for patients with CRDs, but programmes need to be adapted to low resource settings, in the context of the recent COVID-19, to home-based delivery. Aim(s): To evaluate the feasibility of delivering home-based PR for patients with CRDs in Malaysia. Method(s): We recruited people with CRD from two hospitals in Klang Valley, Malaysia to home-based PR programme. Patients were provided education sessions, and assessments [functional exercise capacity {6-Minutes walking test (6MWT)}] and [Health-Related Quality of Life (HRQOL) {COPD Assessment Test (CAT)}] were made at centres prior to the start of programme. They performed exercise at least 5 sessions per week for 8 weeks at home and were supervised weekly via phone calls. Post PR, we assessed the attendance and retention rate and measured 6MWT and CAT at centre. Result(s): We recruited 30 patients. The retention rate was 93.3%;2 dropped out due to hospitalization. However, only 11(36.7%) attended post PR assessment at centres, of these 9 (81.8%) had performed all 40 sessions of home exercises. The attendance for post- PR assessment was limited due to COVD-19 restrictions that forbade travel in Malaysia at that time. Data from the 11 patients showed significant change in CAT scores, 5.09;pre: 22.45, post: 17.36(95% confidence interval (CI) 1.48, 8.70, p=0.01) but no significant change in 6MWT distance -24.36;pre: 276.36, post: 300.72(95% CI -80.52,-31.79, p=0.356). Conclusion(s): Home-based PR is feasible and can be a valuable method to deliver PR remotely.
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Case Report: Pulmonary embolism (PE) is a form of venous thromboembolism (VTE) which causes an obstruction of the pulmonary vasculature. Massive PE can be a fatal, accounting for over 100,000 death/year in the US. Incidence of PEs is increased in COVID-19 infections, due to a hypercoagulable state resulting from endothelial injury, stasis and increase in prothrombic factors. We report a case of a 48-year-old male with past medical history of mild form of COVID-19 infection approx. 6 months back. He was brought to the ED after cardiac arrest resuscitated in the ambulance. 3 days prior to the cardiac arrest he presented in the ED for nonspecific upper respiratory tract symptoms, for which he received symptomatic treatment. During that visit all the workup was negative except for sinus tachycardia. The cause of patient's cardiac arrest was found to be massive bilateral PE leading to right ventricular strain, shock, and HFrEF (20%). Our patient received thrombolytic, ECMO, thrombectomy, anticoagulation, and required complex treatment for several complication during hospitalization. Was eventually discharged home recovered. COVID-19 pandemic has been one of the worst in human history, causing millions of deaths. Symptoms of COVID-19 infection vary from mild upper respiratory disease to respiratory failure or severe VTEs. Multiple studies including a large national study in Sweden reported COVID-19 being an independent risk factor for VTEs, risk extending up to 180 days after COVID-19 infection, especially in unvaccinated population as seen in our patient. New variants of SARS-Cov 2 pose a challenge to control the spread of COVID-19 infection. As more studies support COVID-19 infection association with hypercoagulability status, varied nonspecific symptomology of PE remains a diagnostic and treatment dilemma. Physicians should have low threshold for investigating PEs in patients with unexplained sinus tachycardia or non-specific respiratory distress, especially in an unvaccinated post-COVID-19 patient, including historical mild forms of infection. Many studies have arguably advocated "treatment to prevent thrombotic events” in post COVID- 19 infection, however, vaccination remains the corner stone to reduce morbidity and mortality associated with serious thrombotic events like massive PEs in patients exposed to COVID1-19.
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Though supply chain management (SCM) is widely researched in several application domains, SCM literature concentrates more on the production industry, the service sector, and, far less so, SCM academics. In articulating SCM theory and development, this chapter highlights its chronological services/manufacturing business perspectives. While standard supply chain, from raw material to finished products, for service and manufacturing industries, includes various intermediate parties/organizations, what this paper concentrates on is the evolutionary SCM timeline and the essential SCM principles of the ready-made garments (RMG) industry. Such an analysis illustrates the COVID-19 pandemic impacts on localizing the global RMG production network industry inside Bangladesh. Various effective ways of short-term and mid-to-long-term action factors to operate supply chain stand out, as too the need for reshaping the future supply chain. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Though supply chain management (SCM) is widely researched in several application domains, SCM literature concentrates more on the production industry, the service sector, and, far less so, SCM academics. In articulating SCM theory and development, this chapter highlights its chronological services/manufacturing business perspectives. While standard supply chain, from raw material to finished products, for service and manufacturing industries, includes various intermediate parties/organizations, what this paper concentrates on is the evolutionary SCM timeline and the essential SCM principles of the ready-made garments (RMG) industry. Such an analysis illustrates the COVID-19 pandemic impacts on localizing the global RMG production network industry inside Bangladesh. Various effective ways of short-term and mid-to-long-term action factors to operate supply chain stand out, as too the need for reshaping the future supply chain. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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With nine weeks remaining in the term, COVID-19 necessitated emergency remote learning and remote online exams. This required a series of software trainings for administrators, faculty and students at Howard University College of Pharmacy, USA. The experiential department also had to look beyond normal clerkship placements. The described telemedicine and virtual experiences were used to supplement face-to-face experiences. Assessments for both learning innovations were successful, based on faculty and student feedback. Student reflections describe how COVID-19 helped advance the use of telehealth and indicate their learning of clinical decision-making skills, effective communication, and the digital health industry. A formal evaluation of outcomes from the implemented pandemic innovations is being planned. The use of online proctoring with artificial intelligence during the emergency remote learning was successful. With software training, this type of service can be adopted to ensure the integrity of assessments. The cost of the service and the reporting time should be considered in academic planning. Copyright © 2020 FIP.
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An outbreak of Covid-19 occurred in Wuhan, China initially in December 2019. Over the next few months, the wide spread of SARS-CoV-2 had been reported in all continents and the transmission in utero from an infected mother to fetus debating yet was observed.1,9Objectives: To determine risk of vertical transmission of corona virus in neonates of SARS COVID-2 positive mothers. Study Design: A Cross-Sectional study. Place and Duration of Study: Pediatric department of Pakistan Air Force (PAF) Hospital, Islamabad, Pakistan. The study conducted during 01-03-2020 to 31-08-2020. Methodology: After taking informed consent, Nasopharyngeal swab for PCR for SARS-CoV-2 was taken one week before delivery. Confirmed COVID positive pregnant ladies were included irrespective of symptoms of COVID-19 infection and any other medical illness. Neonates born to COVID-19 positive mothers were admitted in NICU, and Performa was filled for neonates after PCR done 24 and 48 hours respectively. Result(s): Total 14(87.5%) out of 16 COVID positive mothers were asymptomatic. 16(100%) neonates were negative for Sars- COV-2 at 24 hours and 48 hours. Conclusion(s): This study concluded with no evidence of transmission of COVID-19 from infected mothers. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Contamination of surfaces has long been identified as a significant factor in viral transmission. Therefore, sustained efforts are required to address this issue. This work aims to build a scientific database on nano-sized metal oxides as intelligent materials for surface disinfection against corona viruses, synthesize and characterize nano-sized MgO, and discuss the possibility of using it in virus eradication. The MgO nanoparticle was prepared through the heating method. Meanwhile, XRD diffractometer, Scan electron microscope, and nitrogen adsorption were used to characterize the MgO nanoparticle. The synthesized MgO nanoparticle showed an average crystallite size of 18.55nm, lattice strain 0.0053, surface area 27.56 m(2)/g and d-spacing 2.1092. The outcomes of this review highlight the advantage and challenges of AgO, CuO, ZnO, TiO2 and MgO nanoparticles and their utilization for surface disinfection against coronaviruses.
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A pandemic of coronavirus infection is causing a significant public health hazard globally, putting millions of people at risk in an increasing amount of countries. Nanostructured materials have been recognized to be highly efficient against coronaviruses. ZnO nanoparticles possess unique features that enable to act as anti-bacterial and anti-viral. Hence, the aim of the current investigation is to produce zinc oxide nanoparticles and utilized as surface coating materials against COVID-19. Thermal decomposition has been utilized in this investigation to fabricate ZnO nanoparticles with crystallite of 41 and 55 nm. The study outcomes demonstrated that Zinc nanoparticles is a favorable material for future usage as an anti-coronavirus surface due to their ecologically friendly features and exceptional physical and chemical functionality.
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Introduction: Handwashing practice is an effective way to minimize severe infectious diseases such as COVID-19, diarrhea, and pneumonia. The study aimed to explore the prevalence of handwashing behavior and associated determinants in rural and urban areas of Bangladesh. Methods: The research was performed using cross-sectional survey data from the 2019 Bangladesh Multiple Indicator Cluster Survey, and 61,242 household members were the sample for this study. The Chi-square test was applied for the bivariate analysis. A generalized linear mixed-effects model was used to identify the risk factors of practicing handwashing in both urban and rural areas of Bangladesh. Results: Only 65% of the country's households had access to handwashing facilities (place, water, and materials). While urban dwellers were more likely to wash their hands, rural dwellers were only 63% likely to do so. The level of education of household heads, wealth status, division, number of family members, sanitation facilities, and water source were the key factors associated with handwashing behavior. This study revealed that the odds were significantly lower among illiterate respondents compared to those with secondary and above-secondary education in both areas of Bangladesh, and a positive association was found between wealth status and handwashing behavior practiced in both urban and rural areas. In this study, the size of the family was statistically significant for both rural and urban areas of Bangladesh. Conclusion: Handwashing is the most prominent consideration for controlling COVID-19. Policymakers are striving to improve handwashing facilities by increasing awareness-raising programs, especially among rural residents of Bangladesh. © 2022 Asian Journal of Social Health and Behavior ;Published by Wolters Kluwer - Medknow.
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Background: The COVID-19 global pandemic has shed light on the importance of testing to stop the spread of disease. For a developing country with a large population of over 200 million inhabitants such as Pakistan, widespread testing can be difficult. To date, 957,371 cases have been confirmed and over 14 million tests have been performed in Pakistan, with only 1% of the population vaccinated. In a country already burdened by health disparities with little to no resources, the challenges became ever apparent as case numbers grew. According to the WHO, complacency among the population in cooperating with public protective measures is a rising challenge. Several violent incidents have occurred in hospital wards in Pakistan, prompting medical staff to fear for their lives and demand extra security not only from the virus, but from volatile patients and families. The incidents are thought to be rooted in a mix of anger at a lack of resources, and mistrust of the medical system. The objective of this study was to survey Pediatric emergency medicine (PEM) physicians in Pakistan on their ability to test for COVID-19 and their limitations experienced. Methods: An anonymous prospective survey was performed from February to March 2021 in association with the ChildLife Foundation, a nonprofit organization that operates and manages Pediatric EDs in 10 government teaching hospitals in the province of Sindh. 170 PEM providers were surveyed on their experiences with COVID-19 testing, reasoning for why testing was not performed when infection was suspected and reasoning for patient refusals. Results: 68% of respondents had COVID-19 on their differential for patients under their care in the week prior to survey. However, 49% of respondents did not order any COVID-19 testing. 37% of those providers had at least one patient in whom COVID-19 was on the differential. 81% of providers claimed to collect COVID-19 testing every time when suspected. When surveying reasoning for not acquiring COVID-19 testing, providers listed patient refusal as the top reason, followed by limited availability and cost, mild presentation of disease, patient leaving AMA, fear of violence against healthcare professionals, social stigma/fear from patients of being labelled as COVID-19 positive and denial of the diagnosis. Conclusion: According to this survey, PEM providers in Pakistan were not always able to send COVID-19 testing, when indicated, due to a variety of factors. Testing limitations despite suspicion for disease can be a major hurdle in identifying cases and limiting spread in unvaccinated populations.
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The world is now in an extremely precarious situation due to the COVID-19 pandemic. People devote a lot of time to social media sites these days. Just as social media has stood by people during this pandemic, it has also caused trouble in some cases. Excessive use of social media harms mental as well as physical well-being. In our research project, the use of social media by Bangladeshi people throughout the year 2021 has been examined to anticipate their level of addiction in this COVID-19 circumstance. The data has been gathered from people of various age ranges, occupations, and the levels of addiction have been analyzed. Using several methods and machine learning classifiers, their addiction to social media has been predicted in which the levels are categorized into four labels. Different feature selection techniques and machine learning classifiers have been employed and found the maximum accuracy, 94.05% in logistic regression. © 2022 IEEE.
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This study combines an epidemiological model (Susceptible-Infected-Recovered, S-I-R) with the Shorter-term Decisions Simulator (SDS), an activity-based microsimulation model developed for Halifax, Canada. The decision support tool assesses infected individuals' travel behavior during the COVID-19 pandemic. The results of the S-I-R model reveal the rate of infection, p=0.39, the rate of recovery, q=0.34, and the reproduction number, R0=1.15 in Halifax region. In terms of activity participation, most infected individuals are found to participate in two activities (53%) followed by three activities (25%). Infected individuals share a similar type of proportion for work, shopping, and recreational type of activity (23%, 20% and 19%, respectively). In response to travel distance and travel duration for the infected individuals, the age group of 30 to 40 shows a higher density than others. This paper's findings will help policymakers to develop policy interventions to deal with ongoing, emerging COVID-19 public health crisis. © 2022 Elsevier B.V.. All rights reserved.
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Introduction: SARS-COV-2, causing the COVID-19 pandemic, had a disease spectrum affecting multiple organs since its emergence in 2019. There is an association between COVID-19 and thyroid disease. Multiple vaccines had been approved for SARS-COV-2. Despite their safety profile, adverse effects have been reported. An association between thyrotoxicosis after the vaccine has been reported. But COVID-19 vaccine is very rare to precipitate a thyroid storm. Case Description: 29-year-old gentleman, presented to Emergency Department (ED) complaining of shortness of breath for 5 days, increasing in severity. He had a cough with whitish sputum, no fever or chest pain. He had palpitations and 10 kg weight loss, for 6 months. Five days prior to the presentation he received the second dose of the BNT162b2 vaccine (Pfizer-BioNTech COVID -19 vaccine) Physical examination: the vital signs showed tachycardia 175 beat/minute with an irregular pulse, otherwise unremarkable, he was conscious alert and oriented to time place and person, there was bilateral mild exophthalmos and diffuse soft goiter. Chest exam showed bilateral coarse basal crackles. He has bilateral pitting edema of the lower limbs. Blood investigation was remarkable for TSH < 0.01 (0.3-4.5 mIU/L), FT3 12.6 (3.6-7.4 pmol/L), FT4 48.5 (11-23.5 pmol/L) and TSH receptor antibodies (TRAB) 34, Positive > 1.75 IU/L. Electrocardiography showed atrial fibrillation with a rapid ventricular response. Echocardiography showed reduced ejection fraction (40%) with moderate global hypokinesia. The patient was admitted under MICU care as thyroid storm (Bursh-Wartosfsky score 50/140) secondary to Graves’s disease and precipitated by COVID 19 vaccine. He was started on Propylthiouracil 200 mg every 4 hours, hydrocortisone 100 mg every 8 hours, Lugol’s solution 10 drops every 8 hours, cholestyramine 4 gm every 6 hours, and metoprolol 12.5 mg every 12 hours, the dose of metoprolol increased gradually to avoid worsening of heart failure. The patient’s condition was improving, he was switched from propylthiouracil to carbimazole 20 mg twice daily, and after a few days, he was stable and discharged home on carbimazole and metoprolol. The patient didn’t attend the endocrine clinic for follow-up as he traveled back to his home country. Discussion: The association between thyrotoxicosis and the COVID-19 vaccine is reported in the literature. Very rarely COVID-19 vaccine can precipitate thyroid storm in a patient with Graves’s disease. The immune system activation after the vaccine possibly leads to a decompensated state in this patient with existing hyperthyroidism.
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Silver nanoparticles have a wide range of anti-bacterial, anti-fungal, and anti-viral effects due to their unique properties. In this work, citrate reduction has been employed to fabricate silver colloidal nanoparticles with 12 nm. The plasmon resonance spectra of nanoscopic silver particles adsorbed onto transparent electrodes in contact with various electrolyte solutions and concentrations of NaClO4, KPF6, and NaCl were studied. Potentials were controlled with a galvanostat, and UV/visible spectrophotometer was employed to obtain the optical spectra. The results showed the electrolyte identity, potential-induced redshifts, and damping is most pronounced for NaCl, whereas spectral changes are weaker in the cases of NaClO4 and KPF6 solutions. Hence, due to the noble physical and biological properties of silver colloid nanoparticles, it becomes a great candidate and promising in the future to be used as an anti-coronavirus surface.
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BACKGROUND: In January, 2020 COVID-19 infection was declared a public health emergency characterized as pandemic by the World Health Organization (WHO). In March 2020, special guidelines were issued to address mental and psychological aspects of the disease survivors and community at large. This study was conducted with the aim to evaluate the psychological impact of COVID-19 on mothers in the postpartum period. METHODS: It was cross-sectional study of six months duration on COVID-19 positive deliveries and Covid negative mothers. A total of 84 women (42 Covid Positive and 42 Covid negative) were included through non-probability quota with consecutive sampling technique. Mothers with pre-existing mental health issues, those who had been on medication for any psychological issues or those who suffered from obstetrical and neonatal complications or required transfer to High Dependency Unit (HDU) were excluded from the study. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen the women for postpartum depression. Independent sample t test was used for continuous variables and Fisher exact test was used for qualitative variables. RESULTS: Mean EPDS score was 9.48+/-6.33 in COVID-19 positive group. The sub-scale analysis showed mean scores 1.6+/-1.76 and 4.86+/-2.94 for Anhedonia and Anxiety with statistically significant difference. CONCLUSIONS: Women experiencing COVID-19 infection during pregnancy were found to have greater anxiety and nervousness in post-natal period compared to their COVID-19 negative counterparts.