Effects of Covid-19 Vaccines on Mental Health of an Individual A Cross-Sectional Clinical Study

Objective: The mains and objectives of the study was to evaluate the impact of Covid'19 vaccination on mental health status. Study Design: A Cross-Sectional Clinical Study. Place and Duration: It is a cross-sectional study which was conducted by the house officers and the faculty of Dow International Dental College from june2022 to January 2023. Methodology: This study was conducted by distributing the questionnaire among the patients coming to the Outpatient Department at Dow International Dental College. A total of 280 Questionnaires were filled among the Vaccinated Patients coming to the OPD. Questions were inquired related to demographics, dosage, history, last dose, and benefit of vaccine, depression, sleep deprivation, feeling low, trouble concentrating and suicidal thoughts. The consent to fill this questionnaire by the patient was taken by 'Implied Consent'. It was in English language but was translated in Urdu by the house officers whenever it was needed to ensure the comprehension of the questions to the patients. The filled questionnaire was collected by the house officers of the dental department. A total of more than 280 questionnaires were distributed among the participants out of which 250 questionnaires were filled correctly giving us a response rate of 89.2% and dropouts of 10.8%. Practical Implications: The results of this cross-sectional clinical study have practical implications for the wider community. Encouraging Covid-19 vaccination can have a positive impact on both physical and mental health, and promoting vaccine uptake may lead to improved mental health outcomes for individuals. Such benefits can reduce the overall burden of mental health issues during the pandemic, which is beneficial to the community. Thus, public health campaigns should focus on the potential positive effects of Covid-19 vaccines on mental health to improve community well-being and promote vaccine acceptance. Result(s): Approximately 48% women and 52% male have anxiety, depression or either disorder, respectively. Adults with anxiety and depression were more likely to have low educational attainment, low household income, lack of health insurance and either lack or delay medical care. The filled questionnaire was collected by the house officers of the dental department. A total of more than 280 questionnaires were distributed among the participants out of whom 250 questionnaires were filled correctly giving us a response rate of 89.2% and dropouts of 10.8%. There was a common mental impact that was noticed and brought about people's mental health at stake. Conclusion(s): Forceful vaccination has a potential to affect mental health of an individual. Further studies are required to extrapolate the findings of the present study.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Tocilizumab- a Treatment Option for Torsades De Pointes in Covid-19 Patients

Background The incidence of ventricular arrhythmias (VA) in Coronavirus disease 2019 (COVID-19) patients ranges from 1.6 to 5.9%. COVID-19 can trigger a systemic inflammatory response, which may unmask arrhythmias. Here we discuss a challenging case of COVID-19 that manifested as recurrent Torsades de Pointes (TdP). Case A 39-year-old female with no known past medical history presented with a complaint of multiple syncopal episodes in the last two days. Initial electrocardiograms (EKG) showed a heart rate of 62 with frequent premature ventricular contractions (PVCs) and a prolonged corrected QT(QTc) interval of 520ms. Frequent PVCs soon converted to TdP with loss of consciousness which was managed with successful direct current cardioversion (DCCV). However, the patient relapsed into TdP, warranting another successful DCCV. COVID-19 workup came back positive. Electrolytes were within normal limits;however, C-reactive protein (CRP) and troponin T levels were elevated. Decision-making The patient was started on intravenous (IV) magnesium for 24 hours. Following another episode of self-limiting TdP, IV isoproterenol was started, and tocilizumab was given. An echocardiogram showed no evidence of structural heart disease. During the hospital course, telemetry showed PVCs that decreased in frequency paralleled with a decrease in CRP and troponins. Repeat EKGs showed normalization of QTc interval. The patient declined implantable device placement or procedures and was eventually discharged with a heart monitor and a beta blocker. On follow-up, the patient denied any symptoms since the discharge, QTc remained normal, and the heart monitor did not show any VA. Conclusion Management of TdP generally involves magnesium, IV isoproterenol, and transvenous pacing. However, as described in this case, tocilizumab can cause QT interval shortening and a reduction in CRP and cytokine levels and may be beneficial for use in COVID-19 patients with QT prolongation and VA, including TdP. There are no strict guidelines for arrhythmias in COVID-19 patients. Accordingly, more studies need to be done to follow this patient population managed with tocilizumab for their eventual outcomes.Copyright © 2023 American College of Cardiology Foundation

Death caused by covid-19 in top ten countries in Asia affected by covid-19 pandemic with special reference to Pakistan.

The COVID-19 is a contagious viral disease, was first emerged in Wuhan, China in December 2019 and became the whole world on alert. The mortality rate in top most countries in Asia with special reference to Pakistan has been focused. Since February 26 to September 2020 the total confirmed cases and mortality rate was measured through Wikipedia and the notable journals. Iran is the only country having highest number of deaths (5.73%) followed by Indonesia (3.77%) while Saudi Arabia shows the lowest number of deaths as 1.39%. In Pakistan the first case was confirmed in 26th February, 2020. The nCov-19 has closely related to severe acute respiratory syndrome (SARS) hence SARS COV-2 was named. This virus is responsible for more than 33.9 million deaths in over all the world as of 20th September, 2020. The number of new cases is increasing time to time. Sindh province of Pakistan has reported the highest number of cases till September, 20, 2020 as compared to other parts of the country and has the highest number of death followed by Khyber Pakhtunkhwa. Because of the person to person contact the disease is spreading rapidly. The individuals who has already infected with other diseases like cancer or diabetic etc. are vulnerable. The nCOV-19 is the most contagious due to its mode of transmission. There is still no vaccine is available for the treatment of disease caused by nCoV-2019. It is therefore the only option to control this pandemic is to adopt effective preventive measures.

Empathy of Healthcare Professionals During Covid-19 Crisis

Background: Empathy is one of the most vital parts of medical ethics that is a prerequisite for good clinical practice, yet the level of empathy of the doctors has not been up to the mark. Objective(s): To measure empathy of healthcare professionals during COVID-19 crisis Material(s) and Method(s): This was a cross Sectional Study done in almost all public and private tertiary care hospitals of Peshawar. The study duration was 6 months (10 September 2021-10 Febuary 2022) after the approval of research proposal. The sampling method was non probability convenient sampling. The inclusion criteria were health professionals involved in the care of the COVID 19 patients like pulmonogists, physicians, trainee doctors, nurses and chest physiotherapists. Exclusion criteria were the doctors from other specialties who were not taking in the management of such patients. Empathy scale was used to collect responses of the participants.The data was analyzed using SPSS latest version Results: Significant association was seen between Consultants, Nurses and PGRs with that they were not interested in patient's personal matters as these are not relevant to medical treatment. i.e. p-value <0.001. Significant association was seen between Consultants, Nurses and PGRs they Viewed things from patient' perspectives might confuse me and make me too distracted to take the right clinical decision (cognitive). I.e. p-value=0. 026 Conclusion(s): The level of empathy did get affected to a colossal extent during the COVID-19 pandemic as reflected by the above results. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Frequency of Inactivated COVID-19 Vaccine Side Effects in a Tertiary Care Hospital of Karachi

Objective: to determine the frequency of the possible side effects of the COVID-19 inactivated vaccine. Study Design: Cross-sectional survey. Place and Duration of Study: Pakistan Naval Ship Shifa Hospital, Karachi Pakistan from Jan to Apr 2021. Methodology: A total of 305 recipients of inactivated COVID-19 vaccine were asked to fill out a questionnaire themselves or by the health care worker via telephonic conversation. The questionnaire comprised queries regarding general and local side effects that the participants experienced after getting vaccinated for COVID-19. Results: Out of 305 recipients, 270(88.5%) were men, and 35(11.5%) were women. Participants' age ranged from 18-60 years. After the first dose, 83(27.2%) cases [male 63(23.3%) vs. female 20(57.1%)], were reported with side effects, while 75(24.5%) recipients, [male: 54(19.9%) vs. female: 21(58.8%)], had side effects after the second dose. Generalized symptoms were fever, headache, dizziness, and body aches, while local side effects were pain, itching, swelling and rash at the injection site. 259(84.9%) recipients reported spontaneous recovery after the first dose. After the second dose, 286(93.8%) recipients recovered spontaneously. The remaining 44(13%) of the recipients' required symptomatic treatment. After the second dose, only 19(6%) recipients needed symptomatic treatment. Conclusion: It is important to document the possible side effects of COVID vaccine so that public awareness and education can be made to minimize public fear of vaccine side effects. Inactivated vaccine for COVID-19 has minimal reported side effects and hence has a good safety profile. © 2022, Army Medical College. All rights reserved.

Recurrence of COVID-19 Infection in Healthcare Workers after complete Vaccination

Background: COVID-19 is a novel infection. Since its first case report in 2019, it has affected population globally. Healthcare workers are at most risk as they are in direct contact with patients. Aim(s): To record recurrence of symptomatic COVID 19 after complete doses of Sinopharm vaccine among healthcare workers. Study design: Descriptive case series Place and duration of study: Department of Gastroenterology, Holy Family Hospital, Rawalpindi from 12th December 2021 to 11th June 2022. Methodology: Twenty four healthcare workers and between 20-60 years who had COVID-19 infection previously and despite receiving two doses of Sinopharm vaccine, again developed symptomatic COVID-19 diseases were enrolled. The severity was graded as per guidelines provided by CEAG. The extent of exposure during work was documented. Result(s): No significant association was found with any of the healthcare workers with duration and extent of vaccination. Upto 66% of the front line workers got COVID at 5th month and no considerable variation was noticed in other months of the vaccination. Similarly, three PGs also got COVID at 5th month and at 5th month highest number of frontline workers got COVID-19. Conclusion(s): COVID-19 reinfection can occur even after vaccination though symptoms remain relatively mild and Sinopharm provides protection against severe infection for prevention of COVID-19. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Regorafenib in patients (pts) with unresectable hepatocellular carcinoma (uHCC) in real-world practice in Asia: Final analysis of the prospective, observational REFINE study

Background: In an interim analysis of Asian pts with uHCC in the observational REFINE study of regorafenib (NCT03289273), treatment-emergent adverse events (TEAEs) were consistent with those reported in the global, phase 3 RESORCE trial. Here, we present the final analysis of Asian pts with uHCC in REFINE. Method(s): REFINE is an international, prospective, multicenter study that enrolled pts with uHCC for whom a decision to treat with regorafenib was made by the treating physician prior to enrollment, according to the local health authority approved label. The primary objective is safety, including the incidences of TEAEs and dose modifications due to TEAEs (NCI-CTCAE v4.03). Secondary endpoints include overall survival, progression-free survival, and treatment duration. Result(s): Of the 1005 evaluable pts, 557 (55%) were from Asia (Korea [31%], Japan [26%], Taiwan [24%], China [18%], Thailand [1%]) and 82% were male. At baseline, median age was 65 years (range 21-94) and the most common HCC etiology in Asian pts was hepatitis B (60%) and in non-Asian pts was alcohol use (36%;Table). More Asian pts (71%) had received prior transarterial chemoembolization vs non-Asian pts (42%). The initial daily regorafenib dose was 160/120/80/40 mg in 51%/12%/35%/3% of Asian pts and 42%/9%/45%/4% of non-Asian pts. The median treatment duration was 3.7 months (range 0-34.4) in Asian pts and 3.6 months (range 0-38.9) in non-Asian pts. The most common TEAEs in Asian pts were hand-foot skin reaction (40%), diarrhea (27%), and decreased appetite (17%). TEAEs led to dose modification in 44% of Asian pts. [Formula presented]. Conclusion(s): These final data from REFINE confirm the safety and effectiveness of regorafenib in Asian pts with uHCC from a broad population in real-world practice. Final analyses from REFINE are ongoing and will be presented at the conference. Clinical trial identification: NCT03289273. Editorial acknowledgement: Editorial assistance in the preparation of this manuscript was provided by Matthew Reynolds of OPEN Health Communications (London, UK), with financial support from Bayer. Legal entity responsible for the study: Bayer. Funding(s): Bayer. Disclosure: Y.J. Kim: Financial Interests, Personal, Advisory Role: Bayer, Bristol Myers Squibb, Samil, PharmaKing, Celltrion, Bukwang;Financial Interests, Personal, Invited Speaker: Roche, AbbVie, Eisai, Ipsen, Boston Scientific, Bristol Myers Squibb, BTG, Bayer, MSD, Gilead Sciences, Novo Nordisk, Green Cross Cell, Boehringer Ingelheim, AstraZeneca;Financial Interests, Personal, Funding: BTG, Bayer, Boston Scientific, AstraZeneca, Gilead Sciences, Samjin, BL&H. M. Kurosaki: Financial Interests, Personal, Speaker's Bureau: Gilead Sciences, AbbVie, Eisai, Chugai, Lilly, Takeda. H.Y. Lim: Financial Interests, Personal, Advisory Role: Bayer, Eisai, Roche, Ipsen. M. Ikeda: Financial Interests, Personal, Advisory Board: AstraZeneca, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Ono, Takeda, GlaxoSmithKline;Financial Interests, Personal, Invited Speaker: AstraZeneca, Bayer, Bristol Myers Squibb, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Taiho, Yakult, Teijin Pharma, AbbVie, Abbott Japan, Fujifilm Toyama Chemical, Incyte Biosciences Japan, ASLAN, Chugai, Nihon Servier, Takeda;Financial Interests, Institutional, Invited Speaker: Bayer, Bristol Myers Squibb, Eisai, AstraZeneca, Eli Lilly Japan, Chugai Pharmaceutical, Merck Serono, MSD, Ono, Yakult, Novartis, Takeda, J-Pharma, Pfizer, Chiome Bioscience, Nihon Servier, Delta-Fly Pharma, Syneos Health, Merus.N.V. M. Kudo: Financial Interests, Personal, Invited Speaker: Eisai, Chugai, Eli Liiy, Bayer, Takeda, MSD;Financial Interests, Institutional, Research Grant: Otsuka, Sumitomo Dainippon Pharma, EA Pharma, Taiho, Eisai, AbbVie, Gilead Sciences, Takeda, GE Healthcare, Chugai. Y. Huang: Financial Interests, Personal, Advisory Role: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Personal, Invited Speaker: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Inte ests, Personal, Speaker's Bureau: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Institutional, Funding: Gilead. N. Kato: Financial Interests, Personal, Invited Speaker: Gilead Sciences Inc., AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Olympus Corporation, Eisai Co., Ltd., Aska Pharmaceutical Co., Ltd., Tsumura & Co., Mochida Pharmaceutical Co., Ltd., Miyarisan Pharmaceutical Co., Ltd., Covidien Japan Inc., Eli Lilly Japan K.K., Nobelpharma Co., Ltd., Kowa Company, Ltd., Incyte Biosciences Japan GK, Yakult Honsha Co.,Ltd., Olympus Marketing, Inc., Taisho Pharmaceutical Co.,Ltd., Janssen Pharmaceutical K.K.;Financial Interests, Institutional, Research Grant: AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., Shionogi & Co., Ltd., Eisai Co., Ltd., Tsumura & Co., Nippon Kayaku Co., Ltd., JIMRO Co., Ltd., Kowa Company, Ltd. C. Hsu: Financial Interests, Personal, Speaker's Bureau: Bristol Myers Squibb, Ono Pharmaceutical, Merck Sharp & Dohme, Roche, Eisai;Financial Interests, Institutional, Funding: Ono Pharmaceutical, AstraZeneca, MSD, Merck Serono, Taiho Pharmaceutical, Bristol Myers Squibb, BeiGene, NuCana BioMed, Johnson & Johnson, Roche/Genentech, BeiGene;Financial Interests, Personal, Advisory Role: Ono Pharmaceutical, MSD, Bristol Myers Squibb, Merck Serono, Roche/Genentech. B. Chewaskulyong: Financial Interests, Personal, Advisory Role: Pfizer, STADA;Financial Interests, Personal, Invited Speaker: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Personal, Speaker's Bureau: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Institutional, Funding: Bayer. J. Khan: Financial Interests, Institutional, Full or part-time Employment: Bayer. K. Ozgurdal: Financial Interests, Institutional, Full or part-time Employment: Bayer;Financial Interests, Personal, Stocks/Shares: Bayer. All other authors have declared no conflicts of interest. Copyright © 2022

Passive Order Auditing Associated with Reductions in Red Blood Cell Utilization. National Blood Shortage Experience

Background/Case Studies: Decreased blood collection during the COVID-19 pandemic resulted in long-term red blood cell (RBC) shortages in the United States. To conserve RBCs, an existing passive alert system for auditing transfusions was modified to activate at a lower hemoglobin (HGB) threshold (6.5g/dL for stable nonbleeding inpatients) during a 9-month shortage at a 400-bed academic medical center. Study Design/Methods: This retrospective study compared the number of single unit RBC transfusions and pre-transfusion HGB levels among inpatients during 9 months of the intervention (Period 2, 06/01/2021- 2/28/2022) to the same period of the previous year (Period 1, 06/01/2020-2/28/2021) to determine whether RBC utilization changed during the intervention. Results/Findings: Overall full unit RBC transfusions to inpatients decreased by 15%. The incidence rate difference and incidence rate ratio of units transfused per 1000 patient-days significantly decreased (p = 0.029). The average pre-transfusion HGB level significantly decreased (p = 0.0002), largely due to significant decreases in HGB transfusion triggers for adult inpatient ward transfusions. Conclusion(s): Modification of the passive alert system was associated with significantly decreased RBC utilization during a long-term RBC shortage at a single center. Modification of transfusion criteria recommended by passive alerts may be a feasible option to decrease RBC utilization during long-term RBC shortages.

Significance and importance of fruits in strengthening immune system during COVID-19

The outbreak of COVID-19 in 2019 followed by its new variants till now in 2021, made it more necessary to find more identify effective antiviral agents to be included in daily life to combat SARS-CoV-2 and support vaccines and their effect. Fruits are always considered good for health and many studies are trying to find the solution and different compounds with antiviral properties in fruits. Recently, many in vivo and docking studies found many phytochemical compounds effective against COVID-19. In this review, we tried to collect data from different studies. We found that fruits are most valuable gift with great healing property.

Myth surrounding the FDA disapproval of hydroxychloroquine sulfate and chloroquine phosphate as drugs for coronavirus disease 2019

Chloroquine (CQ) and its analog hydroxychloroquine (HCQ) are popular antimalarial drugs that also exhibit wide range of activities against other diseases such as cancer, diabetes, HIV, and microbial infections, among others. They are also reported to possess antioxidant properties. The popularity of these drugs skyrocketed with the emergence of coronavirus disease 2019 (COVID-19) that has caused the deaths of over 600,000,000 people worldwide just within 7 months. Due to the urgency of the time in discovering or repurposing new drugs that will be active against SARS-CoV-2, the causative agent of COVID-19, some initial in vitro studies found prospects in CQ and HCQ against SARS-CoV-2. HCQ instantly became a drug of choice over CQ for the treatment of COVID-19 patients because it is readily absorbed and less toxic. However, clinical studies found no positive indices to support the continued use of HCQ. This chapter looks into this by consulting current literatures in order to unravel the myth surrounding the approval and disapproval of the use of HCQ. © 2022 Elsevier Inc. All rights reserved.

Angiotensin converting enzyme 2 in the gastrointestinal tract: binding with coronavirus and its consequences

Introduction: Angiotensin converting enzyme 2 (ACE2) is expressed in several cell types in the body including the gastrointestinal (GI) epithelium. Objective:To provide an overview of the normal distribution of ACE2 in the GI tract, altered ACE2 expression notably in coronavirus infection and its consequences. Materials and Methods: Pubmed and google scholar were searched using the key words ACE2 paired with GI tract, intestinal permeabilty, gut microbiota, inflammatory bowel disease. Results and Discussion: ACE2 is highly expressed in the ileum and colon in human being as well as in rodents. In this current situation of COVID-19 pandemic, downregulation of ACE2 has been reported due to internalization of the ACE2-virus complex within the cells. Although researches are still in infancy in this topic, altered luminal microbiota, increased intestinal permeability, higher level of inflammatory markers and deficient nutrient transport has been reported due to altered ACE2 expression. Conclusion:Altered expression of ACE2 has the possibility to hamper normal physiological function of the GI tract and might affect GI disease progression and prognosis.

A decision making tool and protocol for early cuff deflation and one way valve inline for patients who are ventilated with a tracheostomy - A case series report

Introduction: Early cuff deflation and one way valve placement inline for patients who are ventilated with a tracheostomy allows for the restoration of verbal communication with concomitant psychological benefits, and enables assessment of bulbar function, delirium, pain, airway patency and speech and language problems.1,2 Such an approach has not been shown to impact respiratory or ventilatory outcomes.3-5 Whilst the benefits may seem obvious, the practice of using one way valves inline has not been widely documented and there are a few published patient selection criteria or protocols, but no national guidelines. Our multidisciplinary team designed a novel decision making tool and protocol to improve specialist service provision. Objectives: This was a retrospective audit of i) our decision making tool and ii) our protocol for early cuff deflation, one way valve inline placement and ventilator adjustments in a specialist tertiary referral neuroscience intensive care unit. Methods: The decision making tool and protocol guides the selection of patients and the approach to early cuff deflation. We performed a retrospective analysis of medical and therapy electronic patient records on consecutive patients with whom we had used this tool and protocol over a two year period from December 2018 -December 2020. Data included diagnosis, primary mode of ventilation, aim of first cuff deflation, time tolerated for first cuff deflation (minutes), and number of days between first cuff deflation and decannulation. Results: Eighteen consecutive patients were selected for early cuff deflation using the decision making tool with the following diagnoses: Encephalitis (5), COVID pneumonitis (5), Guillain Barre Syndrome (4), Intracerebral haemorrhage (1), Posterior communicating artery aneurysm (1), Motor Neurone Disease (1), Syringomyelia (1). At the time of the initial assessment, the ventilation status was: 10 patients on CPAP/PS, 4 on SIMV, 2 on High Flow Oxygen Therapy and 2 on a period of self-ventilation. The decision making tool defined the aim of the initial trial as laryngeal wean for 10 patients and to facilitate communication for 8. The median time for one way valve use for the initial trial was 10 minutes (range 4-25). There were no deleterious effects from following the protocol. All patients received further one way valve inline trials, and seventeen were weaned from the ventilator without respiratory compromise. One patient with Motor Neurone Disease remained ventilator dependent. Seventeen patients were subsequently decannulated (median 26.5 days after initial cuff deflation, range 12-209). Conclusions: Eighteen neurointensive care patients were successfully able to use a one way valve inline in accordance with our decision making tool and protocol. It is hoped that our practice will prompt a wider discussion amongst different intensive care multidisciplinary teams about careful patient selection and judicious use of a one way valve inline. We plan to collect patient's experience of the practice and to update our protocol with emerging evidence around optimal ventilator settings for using one way valves inline.

Privacy-Preserving Adaptive Trajectory Storage on Blockchain for COVID-19 Contact Tracing

Privacy preservation in various contact tracing approaches for the COVID-19 or SARS-CoV-2 virus is challenging, as such applications tend to reveal users' points of interest (POIs) and other sensitive data shared together with their location information. This paper proposes COVID-19 eavesdropping resistant tracing (COVERT)-Blockchain, a novel distributed-ledger-based platform to facilitate contact tracing without invading users' privacy. COVERT-Blockchain enables infected users to share only their anonymized location traces on the Blockchain with a sliding window of the previous 15 days, thereby avoiding constant location information sharing with third party users. To further reduce the chances of revealing the corresponding users' trajectories, in COVERT-Blockchain we employ an adaptive logging mechanism to store trajectory data for contact tracing only if the users stayed in a location where there is significant presence of other humans around them for a relatively long duration of time. This ensures anonymity where the trajectory is generated differently each time for each user, and such infrequent and random trajectory generation enables us to generate unidentifiable trajectories for each user and thus preserve their privacy. COVERT-Blockchain is evaluated for scalability and robustness in relation to overhead and delays in storing and retrieving data from the Blockchain. Results show it to efficiently achieve contact tracing without any breaches of privacy.

Impact of Covid-19 on Mental Health and Treatment Compliance in Psoriasis Patients

Objective: This study was designed to determine the impact of COVID-19 on treatment compliance and mental health (anxiety and depression) in psoriasis patients. Methods: A descriptive cross-sectional study was undertaken in the Department of Dermatology at York teaching Hospital from April to August 2020. One hundred and eleven patients diagnosed with psoriasis were asked to complete a questionnaire (HADS). Patients were also asked about their compliance or self-modifications in their treatment regime due to fear of Covid-19. Using SPSS version 26.0 all of the collected data was analysed together. Results: 40 patients (36.03%) had depression and 52 patients (46.84%) anxiety on the basis of their HADS score. Twenty patients (18.01%) stopped treatment due to concerns regarding COVID-19. Prevalence of anxiety was more in female patients and those on traditional immuno-suppressants as compared to biological treatment or those receiving topical treatment only. Conclusion: Depression and anxiety are common in patients with psoriasis. Female patients and those on systemic medications are worse affected compared to patients on topical treatment or those receiving phototherapy. Fear of COVID-19 has led to 18% of patients self-stopping their treatment altogether.

Artificial Intelligence and Internet of Things (AI-IoT) Technologies in Response to COVID-19 Pandemic: A Systematic Review

The origin of the COVID-19 pandemic has given overture to redirection, as well as innovation to many digital technologies. Even after the progression of vaccination efforts across the globe, total eradication of this pandemic is still a distant future due to the evolution of new variants. To proactively deal with the pandemic, the health care service providers and the caretaker organizations require new technologies, alongside improvements in existing related technologies, Internet of Things (IoT), Artificial Intelligence (AI), and Machine Learning in terms of infrastructure, efficiency, privacy, and security. This paper provides an overview of current theoretical and application prospects of IoT, AI, cloud computing, edge computing, deep learning techniques, blockchain technologies, social networks, robots, machines, privacy, and security techniques. In consideration of these prospects in intersection with the COVID-19 pandemic, we reviewed the technologies within the broad umbrella of AI-IoT technologies in the most concise classification scheme. In this review, we illustrated that AI-IoT technological applications and innovations have most impacted the field of healthcare. The essential AI-IoT technologies found for healthcare were fog computing in IoT, deep learning, and blockchain. Furthermore, we highlighted several aspects of these technologies and their future impact with a novel methodology of using techniques from image processing, machine learning, and differential system modeling.

Deep Learning Approach for COVID-19 Identification

Accurate diagnostic system is significantly important for timely COVID-19 identification. Diagnosing COVID-19 from chest x-ray images employing the CNN model is recommended for accurate recognition of COVID-19. The existing diagnosis techniques of COVID-19 still lack high accuracy. To handle this problem in this work, we have proposed accurate detection method for COVID-19. In the proposed method, a CNN is incorporated for the diagnosis of COVID-19 using chest x-ray images data. The experimental results illustrate that our technique is good for COVID-19 accurate diagnosis and can be easily implemented in health care systems. © 2021 IEEE.

A close loop audit to assess awareness among non-consultant hospital doctors re use of personal protective equipment

Introduction: Personal protective equipments (PPEs) are like war uniforms in the fight against Corona Pandemic. The limited supply of PPEs warrant their proper use not only to avoid shortage of supplies but also to prevent any infectious spread to healthcare workers. This study aimed at analyzing awareness among non-consultant hospital doctors re proper use of PPEs Method: A questionnaire was devised using local available guidelines published by university Hospital Limerick. The study was done in 2 phases. In 1st phase 100 questionnaires were distributed to non-consultant hospital doctors(NCHDs). Results were analysed and after 1st phase and emails were sent with results and local guidelines and a zoom educational session was organized. In 2nd phase, questionnaire was redistributed in a week's time and results were re analysed to close the loop. Results: 200 NCHDs participated in the study,100 in each phase. Most common age group in two phases was 21-30 yrs. Awareness about PPEs use for Covid 19 increased significantly in 2nd phase across all domains (what is included in PPEs (100% from 91%), Sequence for putting on PPEs (52% to 88% p<0.05), steps for FIT test (57% to 74% p=0.247) and sequence for removing PPEs (47% to 81% p<0.05). Conclusions: Though PPEs donning and doffing sessions were organized by the hospital officially, Awareness about effective use of PPEs among NCHDs further improved after organizing a Zoom educational session and auditing.