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Background: Various digestive symptoms caused by COVID-19 are frequently reported. This study aims to describe the most frequent digestive signs in patients with COVID-19, the relationship between the severity of digestive symptoms and some serological markers associated with liver manifestation, the detection of SARS-CoV-2 in a stool sample, and the mortality rate of those patients. Material(s) and Method(s): A descriptive cross-sectional study on 100 confirmed COVID-19 cases with digestive and hepatic manifestation in one center (Fallujah Teaching Hospital), Anbar governorate, Iraq, during a period of study. Questioner's data were formed for all patients regarding age, sex, and comorbidities such as diabetes and hypertension. Liver function enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase, total bilirubin (TBIL), and direct bilirubin and haematological parameters such as ferritin D-dimer, C-reactive protein (CRP), albumin, amylase, leukocyte count, and prothrombin time were used. SARS-CoV-2 prevalence in stool is determined using reverse transcription polymerase chain reaction according to manufacturer's instructions. The mortality rate of patients with COVID-19 was also determined. Data were followed up until April 22, 2022. Result(s): Patients with digestive symptoms who had COVID-19 had an average age of 45.03 (SD 20.078), 52 (52%) were men, and 48 (48%) were women. No statistically significant variances were observed in the severity of digestive symptoms among age groups. The three digestive symptoms that patients with COVID-19 experienced most frequently were fatigue, fever, and abdominal colic. SARS-CoV-2 was detected in the stool of 11% of the patients with COVID-19 with digestive signs. The COVID-19 mortality rate was 9%. Statistically, significant variance was observed in ALT (P value 0.01) and TBIL (P value 0.0027) levels between mild, moderate, and severe gastrointestinal (GI) diseases. The levels of CRP varied considerably among those with mild, moderate, and severe GI conditions (P value 0.0182, according to the findings). In mild, moderate, and severe GI disorders, ferritin levels differed considerably (P value 0.05). Conclusion(s): The faecal sample with a nasopharyngeal swab is needed to confirm COVID-19 diagnosis;hepatic manifestations are connected with increased COVID-19 mortality in individuals with digestive symptoms.Copyright © 2022 Wahab, Khalil, Majeed, licensee HBKU Press.
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Background: Abnormalities in liver function tests (LFTs) are found in 14%-53% of hospitalized COVID-19 patients. These could occur in patients with or without previous chronic liver diseases. Knowing the risk factor of liver manifestations in COVID-19 subjects is crucial for the proper management of these patients. Objective(s): We aimed to identify the risk factors for liver manifestations as well as other risk factors in COVID-19 subjects who complained of digestive manifestations. Material(s) and Method(s): COVID-19 patients with and without liver manifestations at the Emergency Department of Al Fallujah Teaching Hospital were enrolled in this study. This study covered a period from September 15, 2022, to April 22, 2022. Comparisons between patients with or without abnormal LFTs were made. The possible risk variables connected to abnormal LFTs and hepatic manifestation were investigated using univariable and multivariable logistic regression analysis. Result(s): Out of 100 COVID-19 patients, there were 64 suffering from mild gastrointestinal (GI) symptoms. There were 26 mild cases with abnormal LFTs (40.6%). Although there were nine (total number 22) and seven (total number 14) of the moderate and severe cases with liver involvement, there was no statistically significant difference between the digestive manifestations severity and liver involvement. Increased alanine aminotransferase (ALT) levels were linked to a greater incidence of LFTs, according to multivariable analysis (odds ratio [OR]: 45.05;P < 0.0001), elevated aspartate aminotransferase (AST;OR: 3.462;P = 0.00041), elevated direct bilirubin (DBIL) (OR: 3.643;P < 0.001), and elevated d-dimer levels [OR]: 2.690;P < 0.0137) in liver involvement group compared with non-involvement patients. Conclusion(s): Elevated ALT, AST, DBIL, and d-dimer are potential risk factors for liver manifestations in COVID-19 patients with digestive symptoms.
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Background: Various digestive symptoms caused by COVID-19 are frequently reported. This study aims to describe the most frequent digestive signs in patients with COVID-19, the relationship between the severity of digestive symptoms and some serological markers associated with liver manifestation, the detection of SARS-CoV-2 in a stool sample, and the mortality rate of those patients. Material(s) and Method(s): A descriptive cross-sectional study on 100 confirmed COVID-19 cases with digestive and hepatic manifestation in one center (Fallujah Teaching Hospital), Anbar governorate, Iraq, during a period of study. Questioner's data were formed for all patients regarding age, sex, and comorbidities such as diabetes and hypertension. Liver function enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase, total bilirubin (TBIL), and direct bilirubin and haematological parameters such as ferritin D-dimer, Creactive protein (CRP), albumin, amylase, leukocyte count, and prothrombin time were used. SARS-CoV-2 prevalence in stool is determined using reverse transcription polymerase chain reaction according to manufacturer's instructions. The mortality rate of patients with COVID-19 was also determined. Data were followed up until April 22, 2022. Result(s): Patients with digestive symptoms who had COVID-19 had an average age of 45.03 (SD 20.078), 52 (52%) were men, and 48 (48%) were women. No statistically significant variances were observed in the severity of digestive symptoms among age groups. The three digestive symptoms that patients with COVID-19 experienced most frequently were fatigue, fever, and abdominal colic. SARS-CoV-2 was detected in the stool of 11% of the patients with COVID-19 with digestive signs. The COVID-19 mortality rate was 9%. Statistically, significant variance was observed in ALT (P value 0.01) and TBIL (P value 0.0027) levels between mild, moderate, and severe gastrointestinal (GI) diseases. The levels of CRP varied considerably among those with mild, moderate, and severe GI conditions (P value 0.0182, according to the findings). In mild, moderate, and severe GI disorders, ferritin levels differed considerably (P value 0.05). Conclusion(s): The faecal sample with a nasopharyngeal swab is needed to confirm COVID-19 diagnosis;hepatic manifestations are connected with increased COVID-19 mortality in individuals with digestive symptoms.
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In a case-control study, fifty two subjects with COVID-19 were included in the study and 30 gender and age matched apparently healthy individuals were included as control. Vitamin D serum level determined by Mini Vidus, WBC, Lymphocytes and PCV by Swelab. CRP determined manually. SPSS package used for statistical analysis. Vitamin D mean serum level in COVID-19 subjects was significantly lower [P=0.007] than that in control group. Vitamin D mean serum value was lower than normal recommended value in patients with COVID-19. Additionally, the frequency of < 10 ng/ml was 30% in controls, while it was 42% in patients group. When the results stratified on < 20 ng/ml strata, controls show 70%, while patients corresponding value was 81%. The mean serum levels of vitamin D were higher in male compared to female, in smoker as compared to non-smoker and in patients with age of ≥ 50 years. However, the differences not reach significant values. There was inverse correlation between Vitamin D low serum levels and CRP levels indicating a significant association between disease severity and vitamin D serum levels. Serum vitamin D was higher in patients with chronic diseases than that in patients without chronic diseases history, however, the difference not reach significant level. © 2022 American Institute of Physics Inc.. All rights reserved.
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Background: The COVID-19 pandemic is caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus, which causes life-threatening illness and mortality. One of the most critical risk factors for severe COVID-19 and COVID-19 mortality is cardiovascular disease (CVD) that develops during infection. Objective: To determine the most common CVD that occurred during infection with COVID-19 patients and the link between CVD and Fate. Material and methods: A descriptive cross-sectional study was conducted between July 22 and April 10 2022 to describe the frequency of CVD among 100 COVID-19 patients, as well as to detect the serological cardiovascular markers with mortality rates of those patients who attended Al-Karama Teaching Hospital in Baghdad governorate, Al-Shafaa Hospital, and Al-Ramadi Teaching Hospital in Al-Anbar governorate. Blood samples from all of the patients were taken for cardiovascular serological markers, as per the manufacturer's instructions. Results: The mean age of the COVID-19 patients with CVD was 65 23.83.83 (83.0%). Thrombosis, heart failure, myocarditis, myocardial infarction or acute coronary syndrome, hypertension, myocardial injury, angina, and pulmonary embolism were found in 83 (83.0%) of the 100 confirmed COVID-19 cases using IgM antibodies against SARS-CoV-2 by ELIZA in the following frequencies: 21, 9, 9, 7, 10, 11, 8, 5, and 3 respectively. ELIZA discovered COVID-19 patients with CVD utilizing IgG antibodies against SARS-CoV-2 in the remaining 17 cases (17.0%). Troponin-T, Ferritin, D-dimer, Leukocyte, B Urea, CRP LDH were 58.60 ±40.70, 368.36±265.75, 2523.05±1727.60, 15.00±7.67, 103.49±60.74, 33.13±35.74, 525.40±459.86, 4.11±2.13, respectively, among COVID-19 heart failure patients. Troponin-T, Ferritin, D-dimer, Leukocyte, B Urea, CRP LDH were 33.61±34.70, 481.20±181.89, 3361.15±14.26, 20.08±10.54, 76.71±28.02, 22.76±19.73, 536.35±798.14, 3.61±2.11, respectively among COVID-19 Myocarditis patients. Conclusion: There was no significant variation in mortality across the various CVD of COVID-19 cases, There were no significant differences in cardiovascular serological markers in different age groups of among CVD of COVID-19 cases. © 2022, ResearchTrentz Academy Publishing Education Services. All rights reserved.
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Recent years and especially the coronavirus pandemic have been very challenging for the oil industry, resulting in a significant reduction in investment, forcing companies to review budgets and search for more efficient and economical technologies to achieve the target level of hydrocarbon production and revenue generation. In PDO, one of the most challenging fields is "AS", where extreme downhole conditions require a very well-engineered approach to become economical. This field has already seen some of the most advanced technology trials in PDO that are also covered in multiple SPE papers. Based on the new approaches and techniques that were successfully implemented on recently drilled wells, it was decided to review the older, previously fractured wells in the area and assess them for a refracturing opportunity. The main challenge in this project was that these older wells were previously hydraulically fractured in multiple target intervals, therefore both zonal isolation and successful placement of the new fracs were becoming the major concerns. As the planned coverage by the new fractures was to ensure no bypassed pay, the only applicable technology on the market was a pinpoint fracturing process, whereby the targeted placement is achieved through limited entry perforations and focused energy of the injected fluid. The subject pinpoint technology anticipates that the limited entry sandblasting perforation is created and then proppant laden fluid is pumped through a sandblasting nozzle which is part of either a coiled tubing (CT) or a jointed pipe (JP) Bottom Hole Assembly (BHA), and the backside (or the annulus of the injection path) is used to maintain the positive backpressure from the top. This technology allows for choosing a desirable order of target interval selection inside the well, unlike conventional plug and perf or a simplified multistage completion, where the treatments must be placed only in order from bottom to top. Another advantage of this approach is a faster frac cycle through the elimination of wellbore cleanout requirement. Being a unique and first-ever application in the Middle East, using CT for placing frac treatments through a jetting nozzle demonstrates the full scale potential of this approach not only in conventional wells but also in complex, sour and High Pressure (HP) environments that are often found in the Sultanate of Oman and in the Middle East. This paper will cover the advantages and disadvantages, complexity and requirements, opportunities and lessons learnt in relation to this approach. © 2022, Society of Petroleum Engineers
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Background: The coronavirus disease 2019 (COVID-19) pandemic has had a massive impact worldwide. Clinical symptoms vary in different countries. In addition, a wide range of symptoms involve most of the body systems including the respiratory system. However, COVID-19 has no classical presenting signs. Objective: This study aimed to describe the sociodemographic and clinical characteristics of hospitalized and nonhospitalized COVID-19 patients in Anbar Governorate, Iraq. Patients and Methods: This retrospective study was conducted in Anbar Governorate, Iraq. The study covered the period from May 1 to June 30, 2020. All cases were confirmed by real-time polymerase chain reaction. Data concerning the age, gender, residence, occupation, clinical symptoms, smoking, history of systemic diseases, and disease fate were collected from patients' records. Results: Of 481 patients, 259 (53.8%) were male. The patient age ranged from 12 to 104 years with a mean age of 45.7
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This book considers the impact of the COVID-19 pandemic on international diplomacy, and the challenges and opportunities it presents for the future of multilateralism. Global cooperation and solidarity are central to responding to and mitigating the health and socio-economic effects of the COVID-19 pandemic, yet, to many, this was slow to mobilize and lacking in political leadership. This book takes a practical look at the lessons learned from the period spanning the World Health Organization's first declaration of a public health emergency of international concern in January 2020, to the commemoration of the 75th Anniversary of the United Nations in October 2020. This timespan covers a critical period in which to consider key areas of diplomacy, covering a range of tools of global cooperation: multilateral diplomacy, the rule of law, sustainable development, economics and financing, digital governance, and peace and security. Each chapter in this book introduces readers to the current situation in their respective areas, followed by a constructive consideration of lessons learned from the pandemic's impact on that field, and key recommendations for the future. The practical focus and future orientation is particularly important as the book injects pragmatism and guidance that will facilitate 'building back better' in COVID response plans, while creating space for continued focus on global commitments around sustainable development and the future of the UN. Written by a team of authors who have worked directly in International Public Policy and the establishment of global agendas at the United Nations, this book will be essential reading for professionals and policymakers involved in diplomatic roles, as well as students and scholars interested in the future of international relations, global governance and sustainable development. © 2021 selection and editorial matter, Hana Alhashimi, Andres Fiallo, Toni-Shae Freckleton, Mona Ali Khalil, Vahd Mulachela and Jonathan Viera. All rights reserved.
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Background: Chest CT scan has a great sensitivity with rapid diagnoses of COVID-19 infection in the community. Nevertheless,the specificity of this test for diagnosis of this disease are believed to be low. Objective: To evaluate role, effectiveness and diagnostic accuracy of chest CT scan with main imaging manifestations and hematological appearances for screening COVID-19 cases through comparing results of those with other NON-COVID-19 pneumonia. Patients and Method: Twenty COVID–19 & 28NON–COVID–19pneumoniaIraqi patients in Yarmouk teaching hospital, Baghdad, Iraq from 1 march to 1 may 2020, at the beginning of the outbreak in Iraq COVID–19 had been included in current research. Confirmed COVID–19 together with NON–COVID-19 patients to be infected or not with SARS-CoV-2 using RT-PCR were included in current research. Socio-demographic,hematological and chest CT scan finding were examined to compare the variance between COVID-19 and NON-COVID-19 patients. Result: “COVID-19” patients mean age was 62.10 ±14.308SDrangedbetween 35-90 years whereas “non-COVID-19” patients mean was 61.07± 13.638 SD.There was a significant difference between WBC average number of COVID-19 compared to its average number of “NON-COVID-19” patients (P<0.001). A significant differences between Neutrophils, lymphocytes, Monocytes, Eosinophil and Basophils low counts and MCV, MCH, PDW of COVID-19 compared to its counts or levels in “NON-COVID-19” patients (P<0.001). A significantly different of CT scanImages ‘Ground glass opacity, Crazy paving alteration’, ‘Vascular dilatations, Traction Bronchiectasis alteration’, ‘Sub pleural –bands’ & Architectura) between “COVID-19” & ”NON-COVID-19 cases (P less than 0.001), whereas Consolidation was non-significant. Conclusion: A chest CT scan might be a dependabletool for COVID-19 cases diagnosis. Hematological features that include WBC, Neutrophils, Lymphocytes, Monocytes, Eosinophil, Basophils, MCV, MCH, PDW might be substantial indications for COVID-19 appraisal.