COVID-19's impact on family medicine resident training and wellness.

Background: The COVID-19 global pandemic has raised many challenges in training family medicine residents. Family medicine is at the frontline for treating and managing patients with COVID-19. Attention is needed on the critical issue of the effect of the pandemic on resident training, the safety of those performing needed medical services, and the psychological well-being of trainees. Methods: We performed a cross-sectional, 25-question survey-based study to evaluate the perceived effect of the COVID-19 pandemic on family medicine residents' training and residents' well-being in the state of Texas. Results: A total of 250 Texas-based family medicine residents were surveyed with a response rate of 12.8% (n = 32). After the pandemic began, all residents worried about exposing their loved ones to COVID-19, and 65% felt like the COVID-19 pandemic negatively impacted their training overall. Respondents indicated that changes occurred in their respective residency curricula that altered training such as canceling of scheduled lectures (84.3%) and more telemedicine visits (56.25%). There was a significant difference for postgraduate year level and the effect on rotation assignments, with more disruption to the first- and third-year residents (P = 0.03). Conclusions: The COVID-19 pandemic has had a notable impact on the perception of quality of training and mental health within family medicine. Our findings may guide programs in how to proactively target pandemic-related training challenges.

Comparison of sleep quality among COVID-19 patients and non-COVID-19 population in Pakistan: A cross sectional study during the COVID-19 pandemic.

Background: Adverse effects on the health and well-being changes may also express as a decreased sleep quality in COVID-19 patients. This study aimed to assess sleep quality among confirmed COVID-19 patients and the non-COVID-19 Pakistani population. Methods: An online cross-sectional survey was conducted between April and September 2020 in Punjab province, Pakistan. Information about demographic characteristics, COVID-19 diseased status, prior knowledge about COVID-19, and sleep quality using the Pittsburgh Sleep Quality Index (PSQI) was collected. Results: A total of 597 participants were included in this study, 296 (49.6%) COVID-19 patients and 301(50.4%) non-COVID-19 population. The PQSI was used to measure seven distinct sleep components; subjective quality, latency, duration, efficiency, disturbances, medication, and daytime dysfunction. Where mean ± standard deviation (SD) were 0.96 ± 0.743, 1.47 ± 1.032, 0.97 ± 1.006, 0.61 ± 0.995, 1.13 ± 0.649, 0.23 ± 0.651, 1.02 ± 0.861 respectively in total population (N = 597). Sleep latency, sleep duration, and sleep efficiency did not show a significant difference in the T-Test. While sleep quality, sleep disturbances, sleep medication, and daytime dysfunction showed a significant difference between both populations. Conclusion: In conclusion, we highlighted the poor sleep quality in COVID-19 patients as compared to the non-COVID-19 population.

Forecasting COVID19 parameters using time-series: KSA, USA, Spain, and Brazil comparative case study.

Many countries are suffering from the COVID19 pandemic. The number of confirmed cases, recovered, and deaths are of concern to the countries having a high number of infected patients. Forecasting these parameters is a crucial way to control the spread of the disease and struggle with the pandemic. This study aimed at forecasting the number of cases and deaths in KSA using time-series and well-known statistical forecasting techniques including Exponential Smoothing and Linear Regression. The study is extended to forecast the number of cases in the main countries such that the US, Spain, and Brazil (having a large number of contamination) to validate the proposed models (Drift, SES, Holt, and ETS). The forecast results were validated using four evaluation measures. The results showed that the proposed ETS (resp. Drift) model is efficient to forecast the number of cases (resp. deaths). The comparison study, using the number of cases in KSA, showed that ETS (with RMSE reaching 18.44) outperforms the state-of-the art studies (with RMSE equal to 107.54). The proposed forecasting model can be used as a benchmark to tackle this pandemic in any country.

The impact of COVID-related economic shocks on household mental health in Pakistan.

We combine data collected just prior to the unfolding of COVID-19 with follow-up data from July 2020 to document the adverse economic effects of the pandemic and resulting impact on parental and child mental well-being in peri-urban Pakistan. 22% of the households in our sample are affected by job loss, with monthly income down 38% on average. Our difference-in-difference results show that job loss is associated with a 0.88 standard deviation (SD) increase in adult mental distress scores (K10), a 0.43 SD reduction in a Hope index of children's aspirations, agency and future pathways, and a 0.39 SD increase in children's depression symptoms. In addition, we observe higher levels of parental stress and anger reported by children, as well as an increase in reported prevalence of domestic violence. Overall, we document that the pandemic has disproportionately and negatively affected the economic and mental well-being of the most vulnerable households in our sample.

Effectiveness of Online Teaching Methodology on Students' Learning During Pandemic: The Mediating Role of Online Learning Space Design

This study is aimed to analyze the effectiveness of online teaching on students' learning during the current pandemic. The novelty lies in analyzing the mediating role of online learning space design during an unprecedented situation of a pandemic. The effect of online teaching methodology (instructional design, assessment design, and online teaching platform and online learning space design) on student learning (dependent variable) is studied. Furthermore, the mediating role of online learning space design is investigated by correlating factors that influence student learning. A total of837student responses and 86 teacher responses have been recorded using two questionnaires. The results fully support the proposed hypotheses.

Performing Hybridity or Deflecting Islamophobia? Adaptable Identity Management amongst Young British Pakistani Muslims

This article engages with issues of identity construction and maintenance as expressed by a group of young British Pakistanis living in the North-West of England. Drawing on primary data from a qualitative study, we examine the ways in which Muslim identities are maintained, negotiated, and protected in relation to everyday situated cultural experiences. Nested within a context in which Islamophobia is pervasive, we discuss four salient processes of identity management articulated by participants: cherry picking;strategic adaption;ambassadorship and active resistance. Whilst these processes are to be considered as porous rather than mutually exclusive, our analysis elucidates evidence of both nimble and creative individual identity management and also an entrenchment of collective pride. We posit that, for the participants in this study, such practices constitute a grounded, pragmatic response to living in an environment in which their religious beliefs, political values and cultural commitments are frequently questioned within public life, the media and the political sphere.

Floods, landslides and COVID-19 in the Uttarakhand State, India: Impact of Ongoing Crises on Public Health.

The Uttarakhand State, known for its Himalayan Mountains, is a territory in Northern India that is extremely vulnerable to earthquakes, landslides, and floods. Currently, due to the COVID-19 outbreak, India is facing the dual challenge of containing a pandemic and responding to natural disasters. This situation can have a negative impact on the health and the economic development of the region, leading to a long-lasting humanitarian crisis that can disrupt even more, the already overburdened health service. In addition, it can pose serious threats to the wellbeing of the population as it complicates physical distancing and other COVID-19 prevention measures. It is of utmost importance to analyse the impact of floods, landslides, and COVID-19 pandemic on the health system of the Uttarakhand State, and how these crises interact with each other.

Structure-guided design of multi-epitopes vaccine against variants of concern (VOCs) of SARS-CoV-2 and validation through In silico cloning and immune simulations.

Severe Acute Respiratory Syndrome Corovirus2 (SARS-CoV-2) has been determined to be the cause of the current pandemic. Typical symptoms of patient having COVID-19 are fever, runny nose, cough (dry or not) and dyspnea. Several vaccines are available in markets that are tackling current pandemic. Many different strains of SAR-CoV-2 have been evolved with the passage of time. The emergence of VOCs particularly the B.1.351 ("South African") variant of SARS-CoV-2 has been reported to be more resistant than other SARS-CoV-2 strains to the current vaccines. Thus, the current research is focused to design multi-epitope subunit Vaccine (MEV) using structural vaccinology techniques. As a result, the designed MEV exhibit antigenic properties and possess therapeutic features that can trigger an immunological response against COVID-19. Furthermore, validation of the MEV using immune simulation and in silico cloning revealed that the proposed vaccine candidate effectively triggered the immune response. Conclusively, the developed MEV needs further wet lab exploration and could be a viable vaccine to manage and prevent COVID-19.

A Review of Platelet-Activating Factor As a Potential Contributor to Morbidity and Mortality Associated with Severe COVID-19.

The precise mechanisms of pathology in severe COVID-19 remains elusive. Current evidence suggests that inflammatory mediators are responsible for the manifestation of clinical symptoms that precedes a fatal response to infection. This review examines the nature of platelet activating factor and emphasizes the similarities between the physiological effects of platelet activating factor and the clinical complications of severe COVID-19.

Rationalistic approach in COVID-19 prevention through intervention of Unani medicine prevalent in epidemic - A review.

INTRODUCTION: A novel coronavirus virus (2019-nCoV) emerged in China in December 2019 and achieved a high-risk category by the World Health Organization (WHO). The initial symptoms included fever, cough, dyspnea, and sore throat. The present review aims to evaluate the available evidence for the safety and efficacy of Unani herbal drugs and formulations in the prevention of Wabai Amraz (epidemic diseases) having resemblance to SARS-CoV-2. METHODS: Sources of data for this paper are classical Unani textbooks, Unani pharmacopeia of India, Indian Medicinal Plants-An Illustrated Dictionary, and published articles in various reputed peer-reviewed journals. Collected information was then critically analyzed. RESULTS: Despite great efforts, no specific treatment has been discovered for coronavirus yet. The best choices, therefore, are prevention and management. The Unani system of medicine offers health protection during epidemics. Three important interventions practised during an outbreak are (i) purification of the environment by using certain herbal drugs as fumigants which include vinegar (acetic acid) alone or combined with Ferula foetida Regel; (ii) promotion of health and immune modulation by using the pharmacopoeial preparations Khamira-e-Khashkhash and Khamira-e-Marwareed. CONCLUSION: Several single drugs, as well as compound formulations, have been recommended in Unani medicine for the prevention and treatment of infectious diseases. The pharmacopoeial preparation Tiryaq-e-Nazla has been used for respiratory catarrhal inflammations and influenza by Hakims of the medieval period. Scientific research on these drugs reveals the presence of many pharmacologically active substances possessing significant antiviral, antipyretic, anti-tussive, and immune-modulatory properties, which can give new insight into infection and epidemic management.

Viral hepatitis amidst COVID-19 in Africa: Implications and Recommendations

Abstract Hepatitis, a significant cause of mortality worldwide, results in around 1.34 million deaths each year globally. Africa is not exempt from the plague of Hepatitis. Around 100 million estimated individuals are infected with Hepatitis B (HBV) or C (HCV). Egypt has the highest prevalence cases of Hepatitis followed by Cameroon and Burundi. The continent is severly affected by the onset of the COVID-19 pandemic, as the virus has added additional burden on the already fragile continent. With the pandemic, it is presumable that Hepatitis like other viral diseases will pose a threat to collapsing healthcare system. Therefore, for Africa to become more resilient in the face of such menaces, including Hepatitis, further prevention policies are required to be implemented This article is protected by copyright. All rights reserved.

The risk of cutaneous mucormycosis associated with COVID-19: A perspective from Pakistan.

As a developing country, Pakistan reports a high burden of fungal diseases, of which cutaneous mucormycosis remains a prominent infection, presenting as a highly invasive disease with significant mortality. Apart from a high population of at-risk individuals, multiple factors have precipitated an increment in mucormycosis cases in the country following the COVID-19 pandemic. These include increased use of corticosteroids, immunosuppression following the viral infection, prolonged stays in the intensive care unit and sub-optimal laboratory testing available in the country. This article aims to assess the potential implications of a mucormycosis epidemic on a healthcare system already strained under the COVID-19 pandemic, and provides subsequent recommendations to weather the dual challenge of two deadly pathogens.

Ebola and COVID-19 in Democratic Republic of Congo: grappling with two plagues at once.

In February 2021, a new Ebola virus disease outbreak was confirmed amid the COVID-19 pandemic in the Democratic Republic of Congo. Although the country has successfully contained the outbreak amid its fight against the COVID-19 pandemic, the epidemiological situation is still concerning, primarily due to the risk of an increase in the number of COVID-19 cases. The coexistence of both outbreaks increased the burden on the country's health system mainly because Ebola response programs were redirected to the COVID-19 national response. Strategies adopted and lessons learned from previous Ebola outbreaks were crucial to developing the COVID-19 national response. To tackle the challenges of combating both the viruses, it is essential to adopt multidisciplinary measures such as prevention, education, and vaccination campaigns, promoting hygiene and social distancing practices, and improving diagnostic and management protocols. This paper discusses the efforts, challenges, and possible solutions to grapple with Ebola amid the COVID-19 crisis in DRC successfully.

Resurgence of tuberculosis amid COVID-19 in Peru: Associated risk factors and recommendations.

Peru is one of the countries with the highest incidence of tuberculosis and multidrug-resistant tuberculosis in the world. Although public health measures adopted in the country have improved the care, diagnosis and management of patients with tuberculosis, there are still failures in the control of the disease in the country, especially of multidrug-resistant tuberculosis and among the prison population or people living with HIV. The COVID-19 pandemic has added a great burden to the Peruvian public health system, negatively impacting tuberculosis-focused health programs due to the diversion of resources to control the pandemic. Consequently, combat measures, epidemiological surveillance of tuberculosis cases were affected, and data point to an increase in the number of cases, especially of multidrug-resistant tuberculosis, and to the underdiagnosis of the disease. To deal with this problem and avoid a future catastrophe for the country's health system, multidisciplinary measures involving the population, health professionals and government bodies are needed. It is essential that education, diagnosis, contact screening and treatment programs are prioritised and given greater financial support. Furthermore, it is necessary to raise awareness in the population about the need for isolation and maintenance of treatment, especially among the most vulnerable populations.