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Kawasaki disease (KD) is an acute vasculitis leading to coronary artery dilation and aneurysm in untreated patients. Etiology includes infectious triggers, autoimmune response, genetically susceptible host response, windborne agents. Diagnosis of classical KD is made based on the presence of ≥5 days of fever and presence of ≥4 of the 5 principal clinical features, which include conjunctival injection, oropharynx changes, peripheral extremity changes, diffuse erythematous rash, cervical lymphadenopathy. In addition, serum markers of acute inflammation such CRP and ESR are also elevated. Patients without sufficient clinical findings are known to have incomplete or atypical KD. Prompt diagnosis is essential, and treatment should be initiated with intravenous Immunoglobulin (IVIG). Early detection and follow-up of evolving coronary artery changes should be performed by serial echocardiograms and appropriate thromboprophylaxis should be initiated in a timely fashion. Risk stratification for long-term management is based primarily on coronary changes. Patients with coronary aneurysms require lifelong cardiology follow-up. In the current COVID-19 pandemic caused by SARS-CoV-2 virus, pediatric patients may present with atypical KD or acute toxic shock like features called Multisystem Inflammatory Syndrome in Children (MIS-C). Most of them present with myocardial dysfunction and gastrointestinal symptoms in addition to atypical KD features. Although, the true mechanism is not completely understood, the proposed hypothesis for myocardial injury is due to "cytokine storm" from the proinflammatory and regulatory T cells. Early recognition and initiation of IVIG is crucial in addition to ongoing intensive care management. Long-term outcomes are yet to be determined. © Springer Nature Switzerland AG 2021.
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Purpose: The global COVID-19 pandemic has rapidly overwhelmed our societies, shocked the global economy and disturbed normal business operations. While such impacts of COVID-19 are becoming clearer, the effects of the disease on business operations are more common. This study mainly focuses on identifying the factors that affect the smooth operation of businesses during a pandemic situation. Design/methodology/approach: Analytical hierarchy process (AHP) method was used to rate the result index. A total of 40 professionals and experts of different businesses were listed on stock exchanges, and asked to rank the key variables with relative indices and weighting methods. Findings: The results of the AHP successfully assigned weighting scores to all key important factors during the COVID-19 pandemic situation that businesses should focus on, with economic factors receiving the highest score of 60%. Likewise, the other factors that impact values for business operations are reported as social (22%), legal (12.2%), technological (5.16%) and political (0.57%). The results of this study also match with the current policies adopted by different government and nongovernment agencies like the guidelines of the World Health Organization and some most recent research results. Originality/value: In the hectic and growing environment under COVID-19 pandemic, more contributions are not enough, and it is helpful for the whole business industry and society by stipulating more views. This study aims to overview the global impacts and challenges of COVID-19 pandemic on business operations. © 2023, Emerald Publishing Limited.
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The outbreak of the Coronavirus 2019 pandemic presented a challenge for every Faculty of pharmacy that conducts objective structured clinical examinations throughout the academic year. It is necessary to ensure that pharmacy students are welltrained and prepared to enter the clinical workforce during the crisis caused by this pandemic. Due to the pandemic, the Faculty of Pharmacy at King Abdulaziz University embraces the challenge of ensuring that the upcoming pharmacy students will complete their academic year requirements, including the objective structured clinical examination. This paper provides details of how the objective structured clinical examination was designed and managed during the coexisting Coronavirus 2019 pandemic. It also assists other faculties of pharmacy that need to plan objective structured clinical examinations to ensure the validity and reliability of performance assessments while protecting the safety of all participants.
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In this chapter, we develop the mathematical model of four compartments including classes of susceptible, infected, recovered, and death of infected ones for the recent outbreak of a coronavirus infectious disease (COVID-19). The model is investigated for both integer-order and fractional-order derivatives. The integer-order model is analyzed for an approximate solution using the Taylor's series method along with the numerical simulation showing the validity of the obtained scheme. The fractional-order model is evaluated numerically by Euler's iterative techniques and its results are compared to that of the Taylor's series scheme. The numerical simulation is drawn against the available data at different fractional orders. The fractional-order model is also investigated for qualitative analysis using the well-known theorems of fixed-point theory. The said model is also checked for feasibility and stability by using the techniques of basic reproduction number. © 2022 Elsevier Inc. All rights reserved.
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Objective: To find out the effects of remdesivir on the body weight of treated albino rats and its testes Study Design: Experimental Place & Duration of study: At the Anatomy Department of Baqai Medical University Karachi, from August 2021-February 2022 Material & Method: The research was undertaken to record the body weight and its testes in Albino Wistar rats treated by antiviral agent remdesivir. This drug is also recommended for the treatment of Covid-19. The albino rats were divided into 4 groups as A, B, C & D. In each group having 6 Albino Wistar rats. Group A was untreated i.e. control group while group B, C & D were treated by intraperitoneal injection with low, Intermediate and high doses of Remdesivir respectively for 10 consecutive days. A paired sample t-test was performed to determine changes in body weights before and after provision of drugs. The one-way ANOVA was conducted to compare the difference of body weight and relative weight of testes amongst all four groups. Results: The mean body weight of group A before giving any treatment was 173.10±3.42 g & after sterile saline injection intraperitoneally without the drug was 173.48±3.46 g & the difference between the two was insignificant. The mean body weight albino rats before giving any treatment to group B was 178.24±1.78 g, in group C was 174.33±2.49 g & in group D was 173.76±3.22 g. After treatment with intraperitoneal remdesivir with low, intermediate and high doses given to the rats, the mean body weight of group B, C & D was 179.88±1.87 g,177.17±2.41 g and 176.44±3.15 g respectively and the difference between the two means was highly significant (p=0.0001). The mean relative weight of tetes of rat in group A=0.713 ± 8.56 g, B=0.717 ± 15.83 g, C=0.716 ± 14.18 g and D=0.705 ± 4.15 g. There was no statistically significant difference found in the overall relative weight changes of testes amongst four groups (p=0.876). Conclusion: It has been concluded from this study that the mean body weight of animal treated with remdesivir increased significantly while weight of the testes did not affect significantly but in high dose the relative weight of testes decreases. In high dose this drug should be used cautiously as it can affect germ cells present in the testes.
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Coronavirus is one of the major viruses that mainly attack human respiratory system . there are similarities in symptoms between COVID – 19 and earlier Coronavirus infections such as fever, dry cough, however, COVID – 19 showed unique clinical feature, that involve the targeting of the lower airways as evident by upper respiratory tract symptoms such as rhinorrhea, sneezing and sore throat . The severity of COVID- 19 as indicated by hospitalization, admission to intensive care unit, has been greater in men than women . Many hypotheses have been found to explain this difference in susceptibility and severity of the disease . The difference in immune response between sex is consider the main factor in outcomes of viral infection . Estrogen has immunoenhancing effect on the immune system, while testosterone has immunosuppressive role, also progesterone inhibits inflammatory innate immune response . In this review, its concluded that sex hormones have relation with COVID-19 severity .It was concluded that estrogen and progesterone reduce disease severity in contrast, testosterone increase the severity and susceptibility for COVID-19 .
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Introduction: The incidence of acute kidney injury (AKI) associated with hospitalized corona virus disease -19(Covid-19) patients and associated outcomes are not well determined. This study describes the presentation, risk factors and outcomes of AKI in patients hospitalized with Covid-19. Material & Methods: In this cross sectional study, we reviewed the health records for all conveniently selected patients hospitalized with Covid-19 irrespective of co morbidity from 1st May to 31st July, 2020, at combined military hospital Dhaka, Bangladesh. Patients younger than 18 years, end stage kidney disease or with a kidney transplant recipient were excluded from the study. AKI was deûned according to kidney disease improving global outcome (KDIGO) criteria. Results: A total of 470 Covid-19 patients were recruited in this current study, out of them 67.02% were male and 32.98% of were female;with male to female ratio was 2:1. The mean age of the study population was 54.71(±14.31) years. AKI developed among 106 (22.55%) patients of whom 50 patients had CKD. The peak stages of AKI were stage 3 in 58(12.34%), followed by stage 1 in 37(7.87%), and stage 2 in 11(2.34%) patients. Renal replacement therapy was required (RRT) for 37(7.87%) patients. Risk factors included older age, hypertension, diabetes mellitus, cardiovascular disease, and chronic kidney disease and those who presented with prolong fever and breathlessness.AKI was commonly seen in patients with severe disease. Considerable number of patient had proteinuria 222(47.23%) and haematuria in 63 (13.40%) and were significantly associated with AKI. Elevated level of ferritin, D-dimer and procalcitonin were observed among 249(52.98%), 179(38.08%) and 138(35, 88%) patients respectively which were substantially correlated with AKI. COVID-19 patients complicated to acute kidney injury were strongly associated with higher mortality19 of 23 (82.60%). Conclusion: Renal involvement in COVID-19 (Corona virus-nephropathy) has a complex etiology. It is closely associated with severity of disease and indicating poor prognosis. Further study will be needed for better understanding the causes of AKI and patient outcomes. [ FROM AUTHOR] Copyright of Journal of Bangladesh College of Physicians & Surgeons is the property of Bangladesh College of Physicians & Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Hospitals and healthcare systems are instrumental in the formulation and delivery of a coordinated response to disaster management especially epidemics. In healthcare policy and strategy formation, there are only trade-offs, which with uncertainty are akin to gambles. National organizations play a key role in pandemics through the expression of physician motivation. Effective strategies can facilitate physician action through economies of scale that lower the costs for physicians to meet both community and patients' needs. Moreover, no matter how well clinicians are motivated and positioned to act, their collective actions are likely to fall short without complementary systems for populationbased care that require the operational support of an organization. This review of institutional policy implementation and frameworks intends to highlight how a nodal-designated COVID-19 center in Qatar managed to control the menace by altering its procedural sets and work arrangements to augment an integrated, intrinsic response to a briskly emerging, conceivably complex situation. This outcome was achieved under the guidance of a national leadership team, effectively adapted to its specific challenges by building on current medical evidence, management routines, proficiencies, and health system capacity. This ambitious drive started with the cohesion of services and implementation of evidence-based protocols by assigning a physician-led team to research, strategize and organize improved patient flow and information by arranging analytical compliance and preparedness. Through these service approaches and ongoing efforts, HMGH has realized significant outcome improvements, such as increasing capacity building, reducing healthcare waste, and increasing patient satisfaction rates whilst successfully achieving significantly lower COVID-19 mortality both in terms of absolute numbers and as percent population compared to many developed countries in the world. The strategies outlined in this article might not be all-inclusive or fit other healthcare system models, but they generate a veritable interest to pursue and be subjected to further rigorous study.
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COVID-19 or the Coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a great pandemic. At the time of writing this (29th March 2021), more than 127 M people had affected and 2.78 M had died across the world. Due to the lack of specific treatment against COVID-19, antiviral agents and effective medicines are critically needed to prevent the COVID-19 pandemic. Revised drugs such as remdesivir have revealed a favourable clinical efficacy against COVID-19. This review provides an overview of the origin of coronavirus, the role of nanomedicine in coronavirus, nanomedicine vaccines, diagnosis, and therapy against coronavirus. This information may cause any effect in the disease outbreak. Taking all this under consideration, an effort has been made to teach readers the easiest method of the role of nanomedicine, which may play a pivotal role in the management of diseases.
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The current research work is focused on awareness and bio-management of COVID-19 through four selected natural medicinal herbs (MHs) in District Bhimber, Azad Jammu, and Kashmir (AJK), Pakistan. It was observed that the mortality rate is extremely high in people having weak immune systems, especially with pre-existing health problems. We have conducted questionnaire surveys protocol in different societies about COVID-19 assessment. After the field survey of the coronavirus, we used extracts of selected herbs against the patients of COVID-19 in a local hospital. In these preliminary experimental trials, we have tried to compile the effects of different MHs and their bioactive components that have the potential to combat the infection of COVID-19. The treatment of MHs can also be improved the immune system of the patients and future risk of viral attack can be minimized. The extracts of selected MHs (Allium sativum L, Zingiber officinale Roscoe, Piper nigrum L., and Vitex negundo L.) were given to already symptomatic patients with COVID-19 in the District Headquarter (DHQ) hospital Bhimber, AJK. The crude extracts of MHs showed 90 % positive results against COVID-19 patients in the preliminary experimental trials. The ‘Allium sativum and Zingiber officinale’ were showed the best recovery rate with 95 % and 87 % respectively. Thus, it was proved that MPHs can help in the reduction of the mortality rate. Therefore, it is concluded that the MHs have also been considered as the best healing agents against this epidemic virus as well as boost-up the immune system of human beings. This article will help research laboratories and industries in the identification and scrutinization of potential medicinal herbs against COVID-19 and other viruses as well in the future. © Pakistan Academy of Sciences.
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Cardiovascular data of 8 patients with Multisystem Inflammatory Syndrome in Children (MIS-C), caused by an aberrant reaction of immune system to the SARS-CoV-2 coronarovirus, were retrospectively analyzed by using patient-specific biomechanical modeling. The first goal was to increase the understanding of the pathophysiology of the cardiovascular involvement in MIS-C, during the inpatient stay at Intensive Care Unit and after discharge from the hospital. Secondly, hypothetical action of various types of pharmacological therapy was tested in silico using the created patient-specific models, aiming to contribute into the optimal pharmacological management during the acute stage of MIS-C. © 2021, Springer Nature Switzerland AG.
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Background: Gall stone and alcohol are the two most common causes of pancreatitis. Other etiologies include trauma, post endoscopic retrograde cholangiopancreatography (ERCP), bacterial, viral, fungal, and parasitic infections, hypertriglyceridemia, medications, and scorpion bite to name a few. Hypercalcemia is a rare cause of acute pancreatitis. Hypercalcemia can be due to primary hyperparathyroidism (PHPT) manifested by raised parathyroid hormone and serum calcium level. In addition acute pancreatitis is a rare presenting complain of PHPT. PHPT can be asymptomatic or present with symptoms of bone pain, kidney stones, nephrocalcinosis, renal failure, peptic ulcer disease, accelerated atherosclerotic heart disease, hypertension and proximal muscle weakness. Osteitis fibrosa cystica is the term for radiologically visible characteristic feature of skeletal involvement. Case presentation: We report a case of 20 years old male with chief complaint of epigastric and left hypochondrium pain associated with vomiting for two months. Abdominal pain was gradual in onset, radiating to back, and progressive. He also had complains of constipation, blood tinged feces and pain during defecation. Initial lab tests were significant for increased amylase, lipase and a diagnosis of acute pancreatitis was made which was confirmed by CT scan. After ruling out the common etiologies of acute pancreatitis, further investigations for uncommon etiologies revealed increased IgG-4 values suggesting autoimmune pancreatitis. However further investigations were done and it did not meet the diagnostic criteria for autoimmune pancreatitis. Covid-19 IgG antibodies were positive, however patient did not have any other symptoms of Covid-19 and PCR Covid-19 test was negative. Although Covid-19 can cause pancreatitis, given the ongoing pandemic, he might have been asymptomatically infected with Covid-19 and developed immunity. Therefore we did not believe Covid-19 to be the cause of his pancreatitis. Thus a search for other rare etiologies was initiated which revealed serum calcium of 15 mg/dL. Serum parathyroid hormone and urinary calcium were increased several times suggesting primary hyperparathyroidism. DEXA scan revealed osteoporosis. Conclusion: Hypercalcemia is one of the rare etiologies of pancreatitis. Thus it should be considered as one of the etiologies of acute pancreatitis after ruling out the more common ones. Secondly, this Case report highlights acute pancreatitis as one of the rare presenting complain of primary hyperparathyroidism which may be associated with several times increased IgG-4 values. Covid-19 has been associated with a number of presenting complains and can cause acute pancreatitis, amid the ongoing pandemic physicians should exercise caution to avoid spurious association of Covid-19 with acute pancreatitis or other presenting complains.
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Background: An emergent COVID-19 outbreak originated in Wuhan City, in December 2019. The COVID-19 contamination has swiftly unfold from Wuhan to maximum different provinces and different 24 countries. WHO declared a public health emergency of global concern over this worldwide COVID-19 outbreak on 30th January 2020. Manifold research has been intensely initiated for immunization and drug development for COVID-19 till date no specific vaccine or approved drugs are accessible for COVID-19. Alternatively, therapy consists of supportive care and non-specific anti-viral, anti-malarial, and antibiotics are being testedas drugs for COVID-19. Though, novel approaches could play a crucial role to combat mortality rate and patient recovery in the treatment of COVID-19. Objective: To reveal the epidemiology, pathophysiology, and comparison of promising synthetic and natural drug targets to avert and cure of COVID-19. Method: This article sets a brief understanding of the viral characteristics, its life cycle, infection to humans, and the pathophysiology of the disease. It also throws light on the currently used synthetic medicines. we have reviewed the effect of natural products to prevent or treat COVID-19 infection. Their mechanisms of action have been elaborately discussed. literature research was undertaken using PubMed, Google Scholar, Scopus, and WHO website. The different herbal products (extracts) and their moieties which are promising as anti-SARS- CoV-2 by direct inhibition of the virus replication or entry has also been discussed. Results and Conclusion: In conclusion we have highlighted that natural therapeutics either alone or in combinationcould be used as alternative medicines to treat/prevent COVID-19 infection. Moreover, their structures may offer clues for the development of anti-SARS-CoV-2 drugs.The integration of nanocarriers for effectively delivering the conventional as well as the herbal drugs becomes a key point for their efficacy and safety.
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At the end of 2019, in December, the Huanan Seafood Wholesale Market appeared to be linked with the massive outbreak of pneumonia in Wuhan. It was identified that a virus later called the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was responsible for this condition. The disease was named COVID-19 and declared a pandemic as it affected the entire world and claimed many lives. News pertaining to the spread of COVID-19 became the hot talk in all forms of media ranging from print and television to social media platforms. This study aims to provide an analysis of the role of all types of media in the crisis and emergency that has arisen worldwide due to the outbreak of COVID-19. The role of media in disseminating information, particularly within Pakistan, is discussed in detail regarding the spread of coronavirus and the media's active part in sensationalizing or controlling the situation.