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The coronavirus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in Wuhan, China and spread around the world. Genomic analysis revealed that SARS-CoV-2 is phylogenetically related to severe acute respiratory syndrome-like (SARS-like) bat viruses, therefore bats could be the possible primary reservoir. The intermediate source of origin and transfer to humans is not known, however, the rapid human to human transfer has been confirmed widely. In our current study, the genotoxicity of Coronavirus was evaluated in epithelial cells by Micronucleus assay, 30 samples were taken from the patients of corona in samraa hospital and 20 samples as control. The results of this study showed that the average of the affected cells the mean micronuclei (2.000 ± 8.000),the average of d-dimer is (272.697 ± 35.992), in the crp was(17.254 ± 14.871 ) and Ferritin was (26.765± 79.202). These results indicate that the micronucleus assay in corona patients causes cytogenetic damage in epithelial cells.
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Background: COVID-19 disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This infectious disease was previously known as Novel Coronavirus-Infected Pneumonia (NCIP) by the WHO, and the virus was dubbed 2019 novel coronavirus (2019-nCoV). Abnormal levels of thyroid hormones alter metabolism, and thyroid hormones are significant determinants of glucose homeostasis, and affect fasting glucose levels by antagonizing insulin action. Aim;The aim of the study is to evaluate of thyroid hormones in diabetic patients who affected with COVID-19. Patients and methods;A total of 120 subjects participated in the present study. patients distributed as follows: Group1(30 patient with COVID-19), Group2 (30 patient with COVID-19 and DM), Group3 (30 patient with DM type2 without COVID-19), Group4 (30 control (apparently healthy subjects)). Their age ranged from 23-70 years old and was investigated for the determination of FBS, HbA1c, CRP, IL-6, T3, T4, and TSH. Results: In our study, there were no significant differences between control and all patients. However, regarding T3, There is a highly significant elevation in T3 concentration of patients with COVID-19 associated with DM, (4.2 ± 0.7ng/ml) as compared with control healthy subjects, (2.3 ± 0.2;P ≤ 0.01). Moreover, there is a significant elevation in the concentration of serum T3 in patients with COVID-19, (3.8 ± 0.4 ng/ml), as compared with control healthy subjects, (2.3 ± 0.2 ng/ml;P≤0.05. Also there is a significant elevation in the concentration of serum T3 of patients with DM type 2 without COVID-19, (3.6 ± 0.4 ng/ml)، as compared with control healthy subjects, (2.3 ± 0.2 ng/ml;P ≤ 0.05). According to T4, there is a highly significant elevation in the concentration of serum T4 of patients with COVID-19 associated with DM, (209.8 ± 34.7 nmol/l) as compared with control healthy subjects, (156.2 ± 11.4;P ≤ 0.01). While, there is no significant elevation in the concentration of serum T4 of patients with COVID-19, (155.6 ± 21.1 nmol/l), as compared with control healthy subjects, (156.2 ± 11.4), but there is a significant elevation in the concentration of serum T4 of patients with DM type 2 only, (181.9 ± 19.7), as compared with control healthy subjects, (156.2 ± 11.4;P ≤ 0.05). TSH in our result shows there are no significant differences in the concentration of serum TSH of patients with COVID-19 associated with DM group and a group of patients of DM without COVID-19 (0.88 ± 0.21), (0.97 ± 0.22) as compared with control healthy subjects (0.84 ± 0.14;P ≤ 0.05). However, there is a significant elevation in the concentration of serum TSH of patients with COVID-19 only, (1.23 ± 0.3), as compared with control healthy subjects, (0.84 ± 0.14;P ≤ 0.05). Regarding FBS and HbA1c, our result presents that there is a significant increase in serum FBS, (P≤ 0.01) in patients with COVID-19 associated with DM, (259.8 ± 90.7) as compared with control subjects, (95.1± 6.7). Also, there is a significant increase in serum FBS, (P≤ 0.01) in patients with COVID-19 associated with DM, (259.8 ± 90.7 mg/dl) as compared with patients with COVID-19 only, (156.4± 40.7 mg/dl). While in HbA1c %, there is significant increase in serum HbA1c %, (P ≤ 0.05) in patients with COVID-19 associated with DM, (9.3 ± 1.7%) as compared with control subjects (1.1 ± 0.6 %). Also, there were significant differences in HbA1c % in patients with COVID-19 associated with DM, and COVID-19 patients as compared with control subjects, (P ≤ 0.01). With regard to Interleukin-6, a highly significant elevation in the concentration of serum IL-6 in patients with COVID-19 associated with DM has been shown, (20.8 ± 7.5 pg/ml) as compared with control healthy subjects, (3.9 ± 0.8;P ≤ 0.01). Moreover, there is a significant elevation in the concentration of serum IL-6 in patients with COVID-19, (14.6 ± 3.5), as compared with control healthy subjects, (3.9 ± 0.8;P ≤ 0.01). However, there is a significant elevation in the concentration of serum IL 6 in patients with DM type 2 without COVID-19, (11.5 ± 0.8), as compared with control healthy subjects, (3.9 ± 0.8;P ≤ 0.05). While CRP has shown a highly significant elevation in its concentration in patients with COVID-19 associated with DM, (53.2 ± 21.6 mg/l) as compared with control healthy subjects, (2.1 ± 0.8;p≤ 0.01). Moreover, there is a significant elevation in the concentration of serum CRP of patients with COVID-19 only, (39.1 ± 10.6), as compared with control healthy subjects, (2.1 ± 0.8;P ≤ 0.01). Also, there is a significant elevation in the concentration of serum CRP of patients with DM type 2 without COVID-19, (4.7 ± 0.9), as compared with control healthy subjects, (2.1 ± 0.8;P ≤ 0.05).
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E-learning allows the students to access, repeat and use the scientific materials wherever and whenever the users want. Both academics and learners are the leading and essential actors in the process of the learning process. Moreover, the acceptance of a technology is the positive react for users by using such technology. Due to the COVID-19 pandemic, e-learning has become mandatory over the world, thus, there is a necessity to investigate the determinants of e-learning adoption in higher education institutions (HEIs) in Iraq. Consequently, this paper aims to investigate elearning adoption and identify the determinants of e-learning in HEIs. An instrument was developed with eight dimensions based on technology organization and environmental (TOE) elements. The sample selection was of 580 students and 130 university lecturers who spread over several colleges. A clustering sampling method was used in the sampling selection process. Some hypotheses were proposed and tested via the paired T-test tool. To evaluate the relationship between the TOE variables and e-learning adoption, a regression analysis was carried out. The study findings classified into two categories, first, it helps to determine to what extent e-learning be adopted. Second, it provides meaningful guidance for higher education institutions that should follow as a pre-requested before adopting e-learning. © 2022. All Rights Reserved.
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Background: Health care workers (HCWs) are crucial to maintaining healthcare services during COVID-19 pandemic. One of the greatest risks to healthcare system is the potentially high rate of infections due to COVID-19 among HCWs. Objective: To summarize the epidemiologic characteristics, clinical features, radiologic findings, laboratory data, and outcomes of health care workers diagnosed with coronavirus disease 2019 (COVID-19) in Sohag University Hospitals. Patients and methods: A retrospective study included 101 HCWs who were proved to have COVID-19. HCWs with COVID-19 were categorized to asymptomatic cases, mild cases which included patients with mild clinical symptoms and normal lung computed tomography (CT), and moderate cases which included patients with mild or moderate clinical features and abnormal lung CT. Results: 89.11% of infected HCWs had no definite history of contact with a confirmed case of COVID-19. A considerable percent of the patients presented with non-respiratory symptoms such as GIT, and neurological symptoms. Patients who had a moderate respiratory illness were significantly older than those who had a mild respiratory illness and were more likely to have diabetes. Home isolation was recommended in most cases (n=73). Several cases (n=24) preferred isolation in university undergraduate houses, and 4 patients were treated at isolation hospital, 2 of them needed oxygen therapy. Conclusion: COVID-19 in HCWs exhibited a wide spectrum of disease severity. Symptom-based screening for COVID-19 in HCWs may underestimate the affected number as there is a considerable percent of asymptomatic cases. For HCWs’ safety, the use of protective personal equipment and adherence to proper hand-hygiene practice are important protective tools during this pandemic. Also, there is a growing need for educational and training programs for all levels of HCWs. © 2021, Ain Shams University Faculty of Medicine. All rights reserved.
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Introduction/Background Saccharomyces cerevisiae is a yeast of the phylum Ascomycota which can be used in food production. It has rarely been mentioned in the literature as a cause of human disease. Various types of infections have been reported, primarily bloodstream infections. Whether Saccharomyces is a cause of true infection in other sites as compared to a culture contaminant is controversial, as it is considered a normal part of the gastrointestinal (GI), vaginal, and respiratory mucosal flora. The main risk factors for infection with Saccharomyces are immunodeficiency including chemotherapy, history of a central venous catheter, gastroenterological surgery, and use of antibiotics or probiotics. We present the case of an 80-year-old woman who, after five days of dexamethasone treatment for COVID-19 pneumonia, presented with worsening abdominal pain. The patient was diagnosed with perforated diverticulitis, complicated by Saccharomyces cerevisiae fungemia. We will discuss the management of Saccharomyces cerevisiae fungemia and other infections to highlight the difficulty in management and high mortality risk associated with similar infections. Case Presentation An 80-year-old woman with no known medical history was admitted for COVID-19 pneumonia and hypoxia, for which she required four liters of oxygen. She was initially treated with dexamethasone, remdesivir, cefepime, and azithromycin. On the fifth day of hospitalization, she developed acute generalized abdominal pain. Computed tomography of the abdomen and pelvis (figure 2) showed pneumoperitoneum, sigmoid versus terminal ileum perforation, and two abscesses (measuring 5.5 cm and 8 cm in the largest diameters) in the pelvis. Surgical team recommended non-operative management. On days eight and ten of illness, blood cultures were obtained and grew Saccharomyces cerevisiae. Piperacillin-tazobactam was started for empiric GI coverage. Micafungin was started when yeast was identified in blood cultures and was subsequently switched to oral voriconazole once the yeast was identified as Saccharomyces. Blood cultures cleared four days after first positive. Due to persistently worsening leukocytosis, an exploratory laparotomy with sigmoidectomy and end colostomy was performed on day twelve of hospitalization. Intraoperative diagnosis of Hinchey stage IV diverticulitis (diverticulitis with generalized fecal peritonitis) was made. A drain was placed, and cultures from the abscess fluid grew Saccharomyces cerevisiae. In addition to the Saccharomyces isolate, a Mucor species grew in the abscess culture after four days, and the patient was transitioned to liposomal amphotericin B. Two days after amphotericin was started, the patient developed acute encephalopathy to the point where she was non-responsive to pain, believed to be secondary to amphotericin B neurotoxicity. She required transfer to a surgical intensive care unit. Liposomal amphotericin B was changed to intravenous posaconazole. Within 48 hours of stopping amphotericin, the patient's mental status showed moderate improvement and she was disoriented but conversive. She then developed refractory hypoxia and progressive kidney dysfunction, and ultimately required intubation and continuous renal replacement therapy. Surgical team questioned posaconazole as a cause for her worsening renal function, and she was subsequently switched to intravenous Isavuconazole. The patient continued to decline, requiring vasopressor support. She developed refractory metabolic acidosis and lactic acidosis, and hypoxia uncorrected with maximum ventilatory support. The patient's family requested to transition to comfort measures, and the patient expired on day 21 after initial COVID-19 admission. Discussion In one study, Saccharomyces cerevisiae was considered one of the nosocomially acquired infections. It has been reported to cause an average of 1.7% of all fungal cases. Our patient developed Saccharomyces cerevisiae after evidence of diverticulitis complicated by bowel perforation in the setting of being treated with broad-spectr m antibiotics and while not being known to use probiotics. Various types of GI infections have been reported in Saccharomyces cerevisiae, including esophagitis, peritonitis, liver abscess and a link to Crohn's disease, where antibodies to Saccharomyces cerevisiae are a sensitive and specific test. A key element in the management of Saccharomyces cerevisiae is the removal of the infected foreign bodies and the purification of the source. There are no guidelines for dealing with Saccharomyces cerevisiae infections, it is well known that it is susceptible to amphotericin B. Several different types of azole drugs have been investigated, resistance to itraconazole and fluconazole have been reported. Better susceptibility Results were observed with voriconazole and posaconazole. The mortality rate of Saccharomyces cerevisiae fungemia remains high and was reported in one study as 29.5%. Saccharomyces cerevisiae fungemia is a rare, lifethreatening disease with no clearly defined treatment guidelines. Further studies are needed to better understand the therapeutic antifungals options. (Table Presented).
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The coronavirus disease 2019 (COVID-19) pandemic caused by the coronavirus strain has had massive global impact, and has interrupted economic and social activity. The daily confirmed COVID-19 cases in Saudi Arabia are shown to be affected by some explanatory variables that are recorded daily: recovered COVID-19 cases, critical cases, daily active cases, tests per million, curfew hours, maximal temperatures, maximal relative humidity, maximal wind speed, and maximal pressure. Restrictions applied by the Saudi Arabia government due to the COVID-19 outbreak, from the suspension of Umrah and flights, and the lockdown of some cities with a curfew are based on information about COVID-15. The aim of the paper is to propose some predictive regression models similar to generalized linear models (GLMs) for fitting COVID-19 data in Saudi Arabia to analyze, forecast, and extract meaningful information that helps decision makers. In this direction, we propose some regression models on the basis of inverted exponential distribution (IE-Reg), Bayesian (BReg) and empirical Bayesian regression (EBReg) models for use in conjunction with inverted exponential distribution (IE-BReg and IE-EBReg). In all approaches, we use the logarithm (log) link function, gamma prior and two loss functions in the Bayesian approach, namely, the zero-one and LINEX loss functions. To deal with the outliers in the proposed models, we apply Huber and Tukey's bisquare (biweight) functions. In addition, we use the iteratively reweighted least squares (IRLS) algorithm to estimate Bayesian regression coefficients. Further, we compare IE-Reg, IE-BReg, and IE-EBReg using some criteria, such as Akaike's information criterion (AIC), Bayesian information criterion (BIC), deviance (D), and mean squared error (MSE). Finally, we apply the collected data of the daily confirmed from March 23 - June 21, 2020 with the corresponding explanatory variables to the theoretical findings. IE-EBReg shows good model for the COVID-19 cases in Saudi Arabia compared with the other models.
Subject(s)
COVID-19 , Bayes Theorem , Cities , Communicable Disease Control , Humans , SARS-CoV-2 , Saudi Arabia/epidemiologyABSTRACT
This retrospective study aimed to characterize comorbidities and associated with mortality among hospitalized adults with Covid-19 managed as perthe Saudi Ministry of Health protocol in a specialized tertiary hospital in Riyadh, Saudi Arabia. Medical records of 300 adult patients with PCR-confirmed SARS-CoV2 infection and admitted in King Salman Hospital (KSH) from May 1 to July 31, 2020 were included. Medical history, management and outcomes were noted. Males significantly outnumber females (259 versus 41). South Asians comprise 41% of all admitted patients. Mortality rate was 10% and highest among Saudi males (28.9%). Type 2 diabetes mellitus (T2DM) was the most common comorbidity (45.7%). Almost all patients (99%) had pneumonia. Patients > 50 years were three times more likely to die (confidence interval, CI 1.3-6.9; p = 0.01) from Covid-19. Congestive heart failure (odds ratio OR 19.4, CI-1.5-260.0; p = 0.02) and acute kidney injury (OR 11.7, CI-4.7-28.6; p < 0.001) were significantly associated with higher mortality. Dexamethasone use significantly improved the final outcome based on net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (p < 0.05). In this single-center study, T2DM was very common among hospitalized Covid-19 patients. Patients > 50 years, those with congestive heart failure and acute kidney injury are at higher risk for worse Covid-19 outcome.