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Intro: Dexamethasone, a corticosteroid, was recently demonstrated to be the only medication capable of reducing mortality in severe COVID disease in the UK's Recovery Trial. There is a need to compare different steroids because it is well recognised that different corticosteroids have varied pharmacodynamic properties. The aim of our study was to compare outcomes in severe or critical COVID-19 when treated with Dexamethasone versus Methyl prednisolone. Method(s): We conducted a retrospective quasi-experimental, non-randomized study to determine whether intravenous or oral dexamethasone reduces mortality compared with intravenous methylprednisolone in patients with severe or critical COVID-19.The study was conducted on all patients aged 18 and over admitted at a 700-bedded academic medical center.The primary outcome was the mortality. The secondary outcome included length of stay. Finding(s): A total of 706 hospitalized patients with moderate to severe COVID- 19 were included in the study. There were n=217 patients in Dexamethasone group, n= 393 patients in Methylprednisolone group and n=96 patients who did not receive steroids.Among the baseline characteristics between the groups, there was no significant difference in median age (55 years in dexamethsone group vs 57 years in methyl prednisolone group p=0.09). There was male predominance in methylprednisolone group (74% versus 54% p<0.001) and a greater proportion of patients who required invasive mechanical ventilation (13.7% versus 3.2% p<0.001). Mortality was found to be significantly higher in methylprednisolone group compared to dexamethasone group on univariate logistic regression analysis (13.7% versus 3.2% p<0.001) and longer length of stay (7 days versus 4 days p<0.001). In multivariable model, dexamethsone was found to be associated with lower risk of mortality (aOR: 0.24;95% CI: (0.09- 0.62)(p=0.003) and lesser length of stay (aOR: 0.87;95% CI: (0.82-0.92) (p<0.001). Conclusion(s): Dexamethasone was associated with lower mortality and lesser length of stay when compared to Methyl prednisolone in moderate to critical COVID-19.Copyright © 2023
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The boom of the 4.0 industrial revolution and the Covid-19 pandemic have changed the teaching and learning process, where digital learning environments have become increasingly necessary and convenient. The application of game-based learning (GBL) provides many benefits, such as helping to improve the quality of the mathematics teaching and learning process. This paper describes digital GBL with the application of Learning Analytics (LA) in a primary school and how the LA approach can enhance learning with GBL. GBL allows students to have more practice in their learning, while LA allows the data on teaching and learning materials to be recorded. The recorded data allows the teachers to systematically analyze them to keep track of students' learning performance. The use of LA is also useful to researchers and game designers. This paper has also proven the importance of the cognitive load theory and its application in GBL. It allows the use of GBL-based application to present learning information to cater to students' cognitive needs. This study involved sixty-four students from a rural primary school who participated in a 10-week GBL-based intervention. The results show that digital GBL helped increase the students' achievement in mathematics. Moreover, the LA process could be used as a mathematics achievement prediction model. In this regard, data on login frequency, duration of use, and the score to predict could be used to predict the intervention's impact on mathematics achievements. The study concludes by discussing the findings and their implications towards GBL and LA-based research and practice in mathematics teaching and learning. © 2022,Pegem Egitim ve Ogretim Dergisi. All Rights Reserved.
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Introduction/Aim: Ludwig's angina is potentially life-threatening, polymicrobial infection of bilateral submandibular and sublingual spaces. Most common organisms isolated from deep neck infections are viridans streptococci, streptococcus anginosus group of oral flora. We describe a previously un-reported case of Ludwig's angina associated with an unusual fungus, Candida Krusei. Case Description: 35-year-old, fit and healthy, non-smoking male patient presented with ludwig's angina and sepsis, previously diagnosed with parotitis following telephone consultation with his GP due to the COVID-19 pandemic. CT scan showed periapical pathology of both carious lower third molars with involvement of deep neck tissue spaces including the prevertebral space. The patient underwent multiple theatre visits for neck exploration and had prolonged hospital stay and subsequently recovered and discharged. Tissue samples grew Candida Krusei on multiple occasions. Discussion(s): This is a rare and previously unreported case of Ludwig's angina related to Candida Krusei. Literature search was carried out using MeSH terms Candida krusei, dental infection, neck infection, cervicofacial infection and Ludwig's angina using EMBASE, Medline, PubMed and Google Scholar. Candida Krusei has low disease-causing potential when compared to commonly found candida, with poor adhesive properties to oral cavity. It is not well-studied with regards to its virulence but has high resistance to azoles and other antifungal medications. Conclusion/Clinical Relevance: This report emphasises keeping an open mind when considering potential pathogens in cervico-dentofacial infections, to test tissue for fungi as well as bacteria, and to seek timely advice from microbiologists. The authors also counsel caution when carrying out telephone consultations during the ongoing COVID-19 pandemic. Copyright © 2022
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SESSION TITLE: Lung Cancer Imaging Case Report Posters 1 SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: Pulmonary alveolar proteinosis (PAP) is a lung condition that is caused by a build-up of proteins, fats, and other substances (collectively called surfactants) in the alveoli of the lungs. Here we describe a case of a 47-year-old female diagnosed with PAP, with radiologic features conflicting with Coronavirus Disease 19 (COVID-19) pneumonia. CASE PRESENTATION: The patient is a 47-year-old female with no significant medical history who presents to the outpatient pulmonology clinic for shortness of breath evaluation. She reported that for the past 3-4 months she has been having progressively worsening shortness of breath (SOB) associated with dry cough, and nasal congestion. She reports no recent illness, no history of COVID or COVID exposure, no second-hand smoke exposure, no toxin/chemical exposure, no pets/birds at home. Her SOB has been impacting her lifestyle. Pulmonary function tests showed no obstruction, moderate restriction, mildly decreased diffusion capacity. Computed tomography (CT) of the chest showed multiple ground-glass opacities with septal wall thickening (appears crazy paving pattern) - suggestive of infection or inflammatory process. Infectious/inflammatory work up with HIV, COVID-19, hypersensitivity pneumonitis (HP) panel, autoimmune panel, immunoglobulins, QuantiFERON gold, IgM mycoplasma antibodies was negative. Repeat CT chest in 6 weeks as per patient request, was unchanged from prior. A bronchoscopy was done, bronchoalveolar lavage (BAL) negative for infection - fungal, acid-fast bacilli, Mycobacterium tuberculosis;GMS (Grocott's methenamine silver) stain negative for fungus;negative PCP (Pneumocystis pneumonia);left upper lobe and left lung biopsy showed lung parenchyma with scant amorphous eosinophilic material in alveolar sacs, Periodic Acid-Schiff stain (PAS) stain was positive confirming PAP diagnosis. DISCUSSION: PAP is a rare disease, affecting about 1 person in 100,000 people worldwide, with fewer than 10,000 of them in the United States. The "crazy paving pattern" is characteristic of PAP but recently it has appeared in the list of radiologic findings for COVID 19 pneumonia1,2,3. In these COVID times, these kinds of interactions might make the decision tougher, often leading to misdiagnosis. The decision of diagnosis/treatment should be based on symptoms and their duration, medical history, previous tests, response to treatment. Given our patient never had a COVID infection in the past or current infection, CT chest was typical for PAP with a crazy-paving pattern, no significant subjective/radiological improvement lead us to the diagnosis of PAP with eventual work up with bronchoscopy. CONCLUSIONS: A high index of suspicion is needed for the diagnosis of such rare diseases as PAP, which can be misdiagnosed as COVID-19 pneumonia, given radiological similarities. Early diagnosis and treatment can improve morbidity and mortality of PAP. Reference #1: PAP with COVID-19 Radiology - Differential Diagnosis Discussion, PMID: 33646114 Reference #2: Proteinaceous Lung With COVID-19: The Mimicker, PMID: 34703683 Reference #3: COVID-19 pneumonia: the great radiological mimicker - https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00933-z DISCLOSURES: No relevant relationships by Ahmad Al-Alwan No relevant relationships by Arundhati Chandini Arjun No relevant relationships by Farhan Khalid no disclosure submitted for Boning Li;No relevant relationships by Rana Prathap Padappayil No relevant relationships by Raghu Tiperneni
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Background: COVID-19 Pandemic has impacted the diagnosis and treatment of breast cancer and has been shown to increase the late stage cancer at presentation. Most of studies has made year-wise comparison with 2019 for this conclusion. Same studies have also concluded that there was no difference in treatment duration after the diagnosis. Methods: We conducted an IRB-approved retrospective chart review of 505 (255 in 2018 and 250 in 2019) patients diagnosed with Breast Cancer from January 2018 to December 2019 for pre-COVID era and 206 patients diagnosed from March to December 2020 i.e. COVID era. We compared the race, histology, and stage at presentation. Patients from COVID era were compared with newly diagnosed breast cancer in 2018, 2019 patients individually and together. All the above characteristics. were compared between COVID and Pre-COVID era. Continuous variable was compared by T-test and Categorical variable were compared with details were recorded. Descriptive statistics were used in the analysis. Results: Median age of diagnosis for 2018, 2019, and COVID era was 62 (38-83), 59 (37-80) and 64(39-97) respectively. The proportion of white Race during pre-COVID era was 87.52% compared to 89.32% during the COVID era without any significant difference between all 3 years. For Histology, there was significant difference between proportion of histology between 2019 and 2020 (p-value 0.003) whereas no difference between 2018 and 2020 (p-value - 0.21) or combined pre-COVID and COVID era. Incase of staging, significantly more late stage cancer was seen in the COVID era compared to 2019 but there was no significant difference (pvalue - 0.225). Same finding was seen between combined pre-COVID and COVID era (p-value -0.94). Conclusions: Findings from our study suggest that a longer-term trend analysis is required for to find out the accurate impact of COVID-19 pandemic on breast cancer and cancer in general. A populationbased study incorporating data from multicenter and multiple year should be done to assess the real effect of COVDI pandemic.
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Background: Fever, myalgia or fatigue, pneumonia, and complicated dyspnea are all signs of COVID-19. Chest physiotherapy can be utilized in these situations to minimize the time of stay on a mechanical ventilator and in the ICU, as well as to prevent ventilator-associated pneumonia. Aim: To determine the psychological distress and anxiety among physiotherapists in intensive care unit while performing chest physiotherapy in covid-19 patients. Methods: 176 physiotherapists were enrolled in this study, Data collected by purposive sampling technique through an online survey from physiotherapist in Lahore. The Scoring GAD-7 Anxiety Severity and Kessler Psychological Distress Scale(K10) were used. Data entered to SPSS for further statistical analysis. Results: Among 176 participants, 143(81.25%) were males and 33 (18.75%) were females.meanagewas35.11±3.752years. Psychological Distress, moderate disorder was among 26(14.6%), server disorder was among 150(85.2%). Anxiety was mild among 9(5.1%) moderate 43(24.4%) and severe 124(70.5%). P value was<0.05. Conclusion: Psychological distress and anxiety were present among physiotherapists in ICU while performing chest physiotherapy in covid-19 patients. Covid-19 affects their mental health. Most of the Physiotherapists were feeling severe anxiety and have a severe psychological Distress.
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Background: many studies reported the association between NTDs and maternal fever, infection like toxoplasma, rubella and cytomegalovirus, this study aimed to give the trend of the NTDs in Zakho and find if it was related to new epidemic of COVID19. Patient and method: This is study have two lines 1st studying the trend of the prevalence of NTDs depending on the health directorate statistics from Jan. 2013 to December 2021. The 2nd is a case series of 18 case of NTDs with COVID19 infection that reported in Zakho Maternity hospital labour unit. Results: The prevalence of NTD ranged from 32 during 2013 to 35 during 2017 per 10000 births, with sudden n increase to 53 per 10000 births during 2021. The case series study of 18 patient with NTDs and COVID19 infection done to uncover our doubt about the relation of COVID19 infection and NTDs. The general characteristics of mothers had baby with NTDs show that mean age of mothers was (30.5 ± 7.5) most of them from Zakho 12 (66.7%), followed by Shingar 4(22.2%). Only 2(11.1%) they married their consanguinity. Female sex of the affected baby was the common 10(55.6%), the male: female ratio was 0.8:1. Fever during the 1st trimester reported among 15(83.3%) of the patients, most of the mothers had mild COVID19 infection 14(77.8%), and 4(22.2%) had moderate severity, the antibiotics and vitamin supplement was reported among 13(72.2%). Conclusions There were increased prevalence of the NTDs in Iraq during the new epidemic COVID19 period.
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Educators worldwide are facing challenges to continue providing quality learning design remotely, digitally and in virtual settings. Although teaching and learning activities are almost relatively easy to be translated to online platforms, education is missing active learning and social presence, both of which can promote effective learning. When digital education ensues, mobile technologies are widely optimized for learning. The Malaysian Communications and Multimedia Commission report shows that smartphones have become the most popular devices to access the Internet, reaching a near saturation usage level at 98.7% in 2020, due to the pandemic. In the aftermath of the COVID-19 pandemic, more education institutions will continue to conduct virtual lessons, and the trend is set to grow exponentially. The XploreRAFE+ mock-up mobile apps was developed with the aim of gamifying learning and foster active learning, framed by the Interest-Driven Creator Theory. In general, people who play games may experience positive activating emotions. Positive activating emotions such as enjoyment and pride are found to be positively correlated with cognitive regulations (Yeo & Frederiks, 2011). This is what XploreRAFE+ aims for its users to achieve - able to internalize the knowledge through game play and therefore, enhance their cognition. As such, this apps was designed to allow instructors who do not have the technological know-how of gamification and Augmented Reality (AR), to be able to embrace both for their learning design. Rather than spending time and effort laboriously on designing a gamified lesson with virtual contents, instructors are now able to save their time and create a gamified lesson by plugging in their content into this apps, choosing AR overlays, selecting game mechanics and eliciting students' learning feedback through ePortfolio. XploreRAFE+ would be able to add value by adding in the affective aspects, virtual extended reality elements, supporting social presence and intimacy, and immediacy of feedback. This study invites further research on the apps' evaluation after its development is fully completed.
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BACKGROUND: COVID-19 has caused profound socio-economic changes worldwide. However, internationally comparative data regarding the financial impact on individuals is sparse. Therefore, we conducted a survey of the financial impact of the pandemic on individuals, using an international cohort that has been well-characterized prior to the pandemic. METHODS: Between August 2020 and September 2021, we surveyed 24,506 community-dwelling participants from the Prospective Urban-Rural Epidemiology (PURE) study across high (HIC), upper middle (UMIC)-and lower middle (LMIC)-income countries. We collected information regarding the impact of the pandemic on their self-reported personal finances and sources of income. FINDINGS: Overall, 32.4% of participants had suffered an adverse financial impact, defined as job loss, inability to meet financial obligations or essential needs, or using savings to meet financial obligations. 8.4% of participants had lost a job (temporarily or permanently); 14.6% of participants were unable to meet financial obligations or essential needs at the time of the survey and 16.3% were using their savings to meet financial obligations. Participants with a post-secondary education were least likely to be adversely impacted (19.6%), compared with 33.4% of those with secondary education and 33.5% of those with pre-secondary education. Similarly, those in the highest wealth tertile were least likely to be financially impacted (26.7%), compared with 32.5% in the middle tertile and 30.4% in the bottom tertile participants. Compared with HICs, financial impact was greater in UMIC [odds ratio of 2.09 (1.88-2.33)] and greatest in LMIC [odds ratio of 16.88 (14.69-19.39)]. HIC participants with the lowest educational attainment suffered less financial impact (15.1% of participants affected) than those with the highest education in UMIC (22.0% of participants affected). Similarly, participants with the lowest education in UMIC experienced less financial impact (28.3%) than those with the highest education in LMIC (45.9%). A similar gradient was seen across country income categories when compared by pre-pandemic wealth status. INTERPRETATION: The financial impact of the pandemic differs more between HIC, UMIC, and LMIC than between socio-economic categories within a country income level. The most disadvantaged socio-economic subgroups in HIC had a lower financial impact from the pandemic than the most advantaged subgroup in UMIC, with a similar disparity seen between UMIC and LMIC. Continued high levels of infection will exacerbate financial inequity between countries and hinder progress towards the sustainable development goals, emphasising the importance of effective measures to control COVID-19 and, especially, ensuring high vaccine coverage in all countries. FUNDING: Funding for this study was provided by the Canadian Institutes of Health Research and the International Development Research Centre.
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The novel Corona Virus Disease 2019 (COVID-19) has been spread from the Wuhan city of China has now affected many countries;it is still circulating worldwide. Consecutive studies of finding the RNA of this virus in sewage systems increase renewed interest about COVID-19 faucal transmission and its pathogenic issue on sanitation and wastewater systems. Municipal wastewater is typically remarked as one of the major end routes of different types of emerging contaminants such as pharmaceuticals, endocrine disruptors, antibiotics, micro plastics, pesticide and heavy metal residues associated with antimicrobial resistance. Currently all available, antibodies based and molecular base testing have some limitations for this purpose: whole coronavirus particles instead of pure antigen proteins need to be tested in a short time and take control of the pandemic of COVID-19. The current study helped in understanding, concept and demonstrated the potential of graphene Field Effect Transistor (FET) technology for sensitive and rapid detection of corona viruses. Therefore, extra trustworthy, quick response, economical and broadly accessible analytical devices or diagnostic approaches are crucially required. We have critically reviewed and argued the biomarkers and indicators used for COVID-19 diagnostics or SARS-CoV-2 detection. In this regard, ultrasensitive graphene FET biosensors are powerful tools in early diagnosis of COVID-19 infection via targeting virus S1 protein to assess the clinical progress and offer awareness on severity and critical trends of infection.
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INTRODUCTION Convalescent plasma therapy (CPT) has been proposed as a mechanism of passive immunization against COVID-19. Current guidelines on the efficacy of its use is not well delineated with limited studies analyzing the risk of thromboembolic events during treatment. The goal of this systematic review and meta-analysis was to assess the risk of arterial and venous thromboembolisms from CPT in patients with COVID-19. METHODS We conducted a comprehensive literature review of Ovid MEDLINE, Cochrane Central Registry of Controlled Trials (CENTRAL), and EMBASE from inception to June 2021. Title and screening and full-text screening was done in duplicate by two independent reviewers. All randomized controlled trials and cohort studies that analyzed adult COVID-19 patients undergoing CPT were included for analysis. Editorials, conference s, narrative reviews, case series, containing less than 100 patients were excluded. The primary outcome analyzed was the risk of thrombotic events in CPT + standard therapy vs standard therapy alone. Meta-analysis was done using a random-effects model using the Revman 5 software. RESULTS Of 1774 studies identified from our search, three randomized (n= 660 patients), and one non-randomized matched cohort study) (n = 96 patients) were included for analysis. The risk ratio for thrombotic events was 2.33, favoring the CPT group (95% CI, [0.70, 7.72], P = 0.17, I2 = 29%). Subgroup analyses showed that CPT + standard therapy was associated with a decreased risk of in-hospital mortality (RR = 0.70 [0.49, 0.98], P = 0.04, I2 = 0%). No significant difference in cardiovascular events (RR = 0.90 [0.67, 1.20], P = 0.48, I2 = 0%), hypertension (RR = 1.67 [0.56, 4.98], P = 0.35, I2 = 0%), and septic shock (RR = 0.97 [0.40, 2.35], P = 0.94, I2 = 41%) was found between CPT + standard therapy and standard therapy alone. CONCLUSION We found treatment of COVID-19 with standard therapy + CPT was not associated with an increase in the risk of thromboembolic events. CPT was associated with a decreased risk of in-hospital mortality but not of MACE, hypertension, or septic shock. Disclosures: Crowther: Hemostasis reference laboratories: Honoraria;Bayer: Speakers Bureau;CSL Behring: Speakers Bureau;Precision Biologicals: Honoraria;Pfizer: Speakers Bureau;Syneos Health: Honoraria.
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TOPIC: Critical Care TYPE: Fellow Case Reports INTRODUCTION: Mechanical ventilation for Covid-19 – acute respiratory distress syndrome (ARDS) is challenging due to poor lung compliance and high airway pressures for a prolonged period. Under these circumstances, physicians have limited means to control air leaks when they occur. We discuss a case of severe Covid-19 ARDS complicated by early air-leak which was attributed to idiopathic tracheomegaly, and the associated challenges in the patients' care. CASE PRESENTATION: 60-year-old African American man with polymyositis and diabetes mellitus was intubated with a size 8.0 endotracheal tube (ET) for hypoxemic respiratory failure due to Covid-19 infection. Lung protective ventilation was utilized. He was extubated on day three, but he required re-intubation the following day for worsening mental status and hypoxemia. A significant cuff leak (> 400 ml) on a PEEP of 5 cm H2O was noted. Ppeak and Pplat were 42cm H20 and 39 cm H2O respectively. Arterial blood gas: pH 7.129, PCO2 79.6, PaO2 72. The air leak only resolved when cuff pressures exceeded 70 cm H2O. A chest x-ray confirmed adequate ET tube positioning. Tube exchange with another size 8.0 tube was performed, but the balloon was found to be intact. The ET tube was upsized to size 9.0, yet cuff-pressures as high as 70-80 cm H2O were needed to maintain a leak of < 200ml. Considering focal tracheomalacia, the ET tube was bronchoscopically repositioned at different lengths of the airway, without effect. Extended tracheostomy was technically unfeasible due to the severity of the respiratory failure. A computed tomography (CT) of the neck was pursued for airway injury following re-intubation. Image review suggested tracheomegaly with a tracheal diameter of 29 mm (average 21-25 mm in men);Left and Right mainstem measured 18.11 mm and 21mm respectively. (Figure 1). Size 9.0 ET tube failed to prevent air-leak and lung de-recruitment. In the absence of alternative adult airway products, and with the reassurance obtained from the CT neck, the cuff pressure was deliberately kept at 80 mm Hg to maintain adequate ventilation. DISCUSSION: Risk factors for tracheomalacia include prolonged ventilation, high cuff pressure(>35cm H2O) and airway pressures, steroid use, connective tissue diseases, and systemic shock. Our patient had a history of polymyositis but no other risk factors for early tracheomalacia. This case highlights the challenge of overcoming a life-threatening air leak that was likely exacerbated by elevated airway pressures in a patient with idiopathic tracheomegaly. The cuff leak improved after one week with the recovery of lung compliance. After 45 days in the medical intensive care unit, the patient was discharged to an LTACH with a size 8.0 Shiley tube. CONCLUSIONS: Developing alternative endotracheal airway products should be considered to account for these rare patients. REFERENCE #1: Everson DM. Tracheobronchomegaly causing endotracheal tube cuff leak. Trends in Anaesthesia and Critical Care. 2019;25:46-7. DISCLOSURES: No relevant relationships by Enambir Josan, source=Web Response No relevant relationships by Faiza Khalid, source=Web Response No relevant relationships by Ismini Kourouni, source=Web Response No relevant relationships by Yasir Tarabichi, source=Web Response
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Background: Coronavirus Disease 2019 (COVID19) was declared a pandemic on March 11, 2020. COVID-19 has caused over 100 million infections and over 2 million deaths globally. Patients who have received a hematogenic stem cell transplant or cellular therapy (HCT) have a high risk of mortality and morbidity with COVID-19 due to severe immune dysregulation. We conducted a systematic review and metaanalysis aimed to evaluate the outcomes of COVID-19 in HCT patients. Methods: A literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA) guidelines was performed on 3 databases (PubMed, Cochrane, and Clinical trials.gov) from the date of inception to Jan 2021. MeSH terms included 'hematological malignancies', 'hematopoietic stem cell transplantation', 'SARS-CoV-2', and 'COVID 19'. We screened 99 articles and 6 studies (4 retrospective studies, 2 prospective) were included after excluding review, duplicate, and non-relevant articles. Quality evaluation was done using the NIH quality assessment tool. The Inter-study heterogeneity among the studies was assessed using the Q statistic proposed by Cochrane and the I2 index introduced by Higgins and Thompson. Pooled analysis was done using the 'metaXL', and the random effects model was used to estimate the pooled prevalence with 95% CI. Results: Of 1619 patients in 6studies, 646 HCT patients were analyzed (Table ). The median age of patients was 63 years and 59% were males. Median days since HCT for autologous (auto) HCT and allogeneic (allo) HCT patients were 690 and 450 days respectively. The average follow-up duration after COVID-19 was 24 days. COVID-19 mortality in HCT patients was 20% (95%CI 0.17 to 0.23, I2=0). Roedl et al (n=6) reported a mortality of 83% and was excluded from the pooled analysis. The mortality rate was 19% (95% CI 0.15 to 0.24, I2=0%) in auto HCT patients and 21% (95% CI 0.17 to 0.25, I2=0%) in allo HCT patients. Conclusions: The HCT patients are at significant risk of increased mortality and morbidity due to COVID-19. There is a need to prioritize HCT patients for COVID-19 vaccination, close surveillance, and aggressive management. (Table Presented).
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BACKGROUND: The educational process in different medical schools has been negatively affected by the COVID-19 pandemic worldwide. As a part of the Saudi government's attempts to contain the spread of the virus, schools' and universities' educational activities and face-to-face lectures have been modified to virtual classrooms. The purpose of this study was to explore the perceptions of the faculty and the students of an electronic objective structured clinical examination (E-OSCE) activity that took place during the COVID-19 pandemic in the oldest medical school in Saudi Arabia. METHODS: An e-OSCE style examination was designed for the final-year medical students by the pediatrics department, College of Medicine at King Saud University in Riyadh, Saudi Arabia. The examination was administered by Zoom™ video conferencing where both students and faculty participated through their laptop or desktop computers. In order to explore the students' and the faculty's perceptions about this experience, a newly designed 13-item online questionnaire was administered at the end of the e-OSCE. RESULTS: Out of 136 participants (23 faculty and 112 students), 73 respondents (e.g., 54% response rate) filled out the questionnaire. Most of the respondents (69.8%) were very comfortable with this new virtual experience. Most participants (53.4%) preferred the e-OSCE compared to the classic face-to-face clinical OSCE during the pandemic. Regarding the e-OSCE assessment student tool, 46.6% reported that it is similar to the classic face-to-face OSCE; however, 38.4% felt it was worse. CONCLUSIONS: The e-OSCE can be a very effective alternative to the classic face-to-face OSCE due to the current circumstances that still pose a significant risk of infection transmission. Future studies should examine different virtual strategies to ensure effective OSCE delivery from the perspective of both faculty and students.