Association between Covid-19 and Diabetes Mellitus

Aim: To determine the association between Covid-19 and diabetes mellitus. Study Design: Retrospective study. Place and Duration of Study: Department of Medicine & Respiratory Physiology, Independent Medical College Faisalabad from 1st July 2022 to 31st December 2022. Methodology: Fifty five patients received at outdoor patient department of Independent University Hospital with confirmed diagnosis for Covid-19 through naso-pharyngeal reverse transcription polymerase chain reaction (RT-PCR) and aged 13-65 years were included. The complete medical files of each confirmed Covid-19 case was completely studied in relevance to diabetes mellitus association and compared with normal matched controls that only visited the OPD against the suspicion of the disease and underwent complete biochemical profiling. The baseline levels of HbA1C and glucose monitoring in each patient and control was done and compared. Result(s): The mean age of the CoVid-19 cases was 39.5+/-5.3 years while of controls as 25.65+/-4.3 years. There was an obvious significant variance in the odds ratio of Covid-19 patients and those of controls in reference to diabetes mellitus. A significant increase was observed in Odds Ratio of Covid-19 cases within the age group of 51-65 years. The Elixhauser Comorbidity Index (ECI) categories also presented, ECI >5 to be higher in Covid-19 cases than controls. Conclusion(s): There is a higher risk of diabetes new onset in Covid-19 confirmed cases as compared to matched controls.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Fear of COVID-19 in dentistry students: an evaluation of their knowledge and practices

Background: This study's objective was to analyse the fear of COVID-19 among the dentistry student and the knowledge, attitude, and practices during the COVID-19 pandemic. Methods: It was a cross-sectional questionnaire-based study. An online survey form was designed and distributed to undergraduate dental students via google forms. A previously validated fear of coronavirus scale (FCV-19S) was used to analyse the fear. SPSS 21 was used for data entry and data analysis. Descriptive statistics were applied to calculate the frequencies of different variables. Independent t-test was executed to determine the difference of FCV-19S among gender and between public and private dental colleges. ANOVA was carried out to evaluate the difference in fear among different levels of BDS. Results: Data of 983 individuals from different dental colleges in Karachi, Pakistan, have been analysed. The majority of the students were females in 1st year and private sector dental colleges (P<0.001). The mean FCV-19S was 20.99 +or- 6.48, which is higher than the cut-off value 15. A highly significant difference in mean FCV-19S among the different variables has been observed (P<0.001). A significant difference has been observed among the gender (t (932) = -5.40, p<0.001) in all 4-years of BDS. Conclusion: Despite good knowledge and following the COVID-19 guidelines, fear is prevalent among the students.

Perception and Attitude of Medical and Dental Students Towards Covid-19 and its Vaccination in A Medical and Dental College of India

Background: Medical and dental students are among the frontline workers in the battle against COVID 19. As such their vaccination is mandatory. We conducted this study to assess perception and attitude of medical and dental students towards COVID-19 disease and its vaccination. Method(s): A total of 185 medical and 170 dental students were included in our study. A questionnaire based on previous studies was prepared. The respondents were interviewed telephonically and appropriate responses were recorded. Result(s): Among 355 students enrolled in our study, higher percentage of dental students were infected with COVID-19 (26%) as against only 20% medical students. 60% dental students had been tested for COVID-19 as against 70% medical students. Majority students in both the groups had done rapid antigen test (RAT). Academic loss was the major COVID-19 disease related concern among medical students, while in dental group there were two major concerns i.e academic loss and fear of passing the infection to family. Both the groups feared anaphylaxis the most as a sequel of vaccination. The other vaccination concerns in both the groups were fever, myalgias, infertility, thrombus formation while few female students feared that vaccination may disturb their menstrual cycles. The preferred vaccine in both the groups was Covishield. Conclusion(s): Our study concluded that there are many hurdles in the path of vaccination even among medical and dental students. It is important to address these hesitancies especially among health care workers since their opinion and recommendation is held supreme by common masses. Copyright © RJPT All right reserved.

Effects of harmful gases emitted from poultry houses on productive and health performance

Air pollution in the environment in which poultry is raised is one of the most serious problems facing the poultry sector across various aspects of production. Perhaps the most dangerous gas emitted from poultry houses is ammonia. The high concentrations of this gas in the air above the permissible limits (15 ppm) will have disastrous consequences. Ammonia directly affects the health and safety of birds, as it is a cause of ammonia blindness in birds accompanied by many respiratory diseases that destroy production and increase breeding costs. In addition, high concentrations of ammonia (above 20 ppm) contribute to enhancing the infection of birds with Newcastle and the bronchitis virus. In general, the greenhouse gases emitted from poultry houses included four main gases (carbon dioxide, nitrous oxide, methane and hydrogen sulphide). Studies regarding their direct effects on the health and productivity of birds have been insufficient. In the direct form, as the concentrations of greenhouse gases rise to very high limits, they cause suffocation and death., the behaviour of the greenhouse gases in the indirect effect is reflected being a source of nutritional stress and a group of diseases and parasites which lead to a decrease in productivity levels. The intensity and concentrations of gas emissions are directly related to many factors such as geographic location, the season of the year, ventilation technologies, humidity, litter quality, nutritional status and stocking density. The advances in ventilation technologies have played a key role in expelling all harmful gases, especially those that depend on negative pressure. However, greenhouse gases remain a real threat to the poultry industry in particular and to the planet's environment in general.

Dysmenorrhea among Female University Students during the COVID-19 Pandemic

Dysmenorrhea is the most common gynecological symptom among adolescent girls and young women. It can have a significant impact on females' quality of life. The study aims to investigate the prevalence and impact of dysmenorrhea among Iraqi university students during the COVID-19 pandemic. A cross-sectional study was conducted across different universities, including (College of Medicine, Pharmacy, and Dentistry) in Baghdad/Iraq, from March to May 2021. The data was collected through a self-questionnaire of 1312 Iraqi female university students. Dysmenorrhea was reported by (51.5%) of university students. Nearly one-third (32.1%) of participants rating dysmenorrhea as mild, (13.3%) moderate, and (6.1%) severe. Approximately (18.1%) of participants reported worsening of their menstrual pain, (21.3%) reported irregular menstrual cycles, (35.5%) reported increasing in learning difficulties, and (13.4%) reported increasing in the medication used to treat dysmenorrhea during the pandemic. The results revealed that there was a significant relationship between dysmenorrhea and the age of students, menstrual irregularity, medication use, and students who had Covid-19 infection (p-value <0.005). In addition, there was a highly significantly relationship between dysmenorrhea and learning disabilities as well as poor interpersonal relationships among Iraqi university students during the COVID-19 pandemic (p-value <0.001). According to the findings, dysmenorrhea has a negative impact on students' attendance, academic performance, and their interpersonal interactions during the COVID 19 pandemic. Future studies need to focus on improving pain management strategies to reduce the effects of dysmenorrhea so that young women can optimize their educational and future life opportunities. © 2022 Sami Publishing Company. All rights reserved.

The Paradoxical Relationship Between Nicotine and SARS-CoV-2 Infection: A Systematic Review

Across the board, smoking is considered to be negative toward our health. While this information has been known for a relatively long time, the COVID19 pandemic has stirred up a controversial idea: that smokers are protected from severe COVID-19 relative to non-smokers. This suggests that smoking is a helpful agent in the evolving fight against SARS-CoV-2, and impressionable individuals are at risk of starting to smoke as a means of protecting themselves from the virus. To address the validity of this claim, a systematic review was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed was searched for relevant articles and the results were screened according to inclusion criteria. Our search yielded a total of 81 results and after removal of duplicates, non-English papers, and a quality appraisal a total of 16 papers were included in this review. We found that while smokers were more likely present with a less severe disease due to downregulation of severe cytokine storm, they were overall more likely to contract COVID-19 due to upregulation of ACE-2 receptors which SARS-CoV-2 uses to enter the cells of the respiratory epithelium. Also, long time smokers who develop COPD are more likely to have fatal outcomes from COVID-19 infection. Further, these results were due to the effects of nicotine and not cigarettes themselves. Since cigarettes contain numerous carcinogens, they are not recommended as a prophylaxis for COVID-19. However, we recommend that nicotine should be a topic for further research as potential therapy.

A Comparison of Low Dose with Standard Dose Chest CT Scan in Diagnosis of COVID-19

Aim: Comparison of safety profile of low dose CT scan chest with standard dose CT scan in Covid 19. Study design: Prospective study Place and duration of study: Department of Radiology, Benazir Bhutto Hospital, Rawalpindi from -01-09-2020 to 31-03-2021. Methods After approval from ERB, 45 COVID-19 positive patients diagnosed by PCR, aged 55 years and above were selected. In the prospective study, these patients with normal CXR were advised for same day chest CT scan. Initially, a standard dose of chest CT scan of 150mAs was applied. After assessing the chest signs of Covid on scan, a low-dose CT of 30mAs was performed instantly. A comparison was made to check the diagnostic accuracy of standard-dose and low-dose CT for the identification of features of typical COVID19 pneumonia. Results: The mean age of patients was 58.27±7.23. An admirable intra-reader agreement was found between low- and standard-dose CT in identifying typical findings of COVID pneumonia (intraclass correlation coefficient [ICC] = 0.98–0.99 with A p value of less than 0.001 of all readers). Mean effective dose values of low and standard dose groups were 1.69±0.38 mSv and 7.21±1.23, correspondingly. Values of absolute cancer risk per mean cumulative effective dose of low & standard dose chest CT examinations were 0.68 × 10−4 and 2.41×10−4 respectively. Conclusions: The low dose CT chest protocol is better than standard dose for the identification of typical COVID-19 pneumonia features in routine practice with substantial decrease in dose of radiation as well as estimated cancer risk.

Sentiment Analysis for Twitter Chatter during the Early Outbreak Period of COVID-19

This study presents the findings of applying sentiment analysis on a corpus of seven million unique English tweets collected from March 26, 2020 to April 9, 2020 about the COVID-19 outbreak. First, an off-the-shelf lexicon-based sentiment analysis tool was used to determine sentiment polarity in each tweet. Then, an off-the-shelf text visualization tool was used to visualize the most frequent emotions and topics that showed positive and negative sentiments. The study revealed meaningful insights about which positive and negative emotion types were most prominent on Twitter chatter during the early period of the COVID-19 pandemic, and which topics garnered the most positive and negative emotional reactions. This work shows that analyzing social media chatter using sentiment analysis and text visualization tools is an effective approach for tracking people's concerns and mental health during pandemics and infectious diseases outbreaks. © 2021 IEEE.

Fear and Perception of People to Visit Dentists during COVID-19 Pandemic and Their Suggestions

Objectives This study was performed to determine patients' fear and perception of visiting dentists during the COVID-19 pandemic. Materials and Methods This cross-sectional study was performed online using Google forms. Participants included individuals who had been to dental clinics for treatment. The data of 407 participants were analyzed. SPSS 21 was used for data entry and analysis. Demographic variables were expressed in numbers and percentages. The Chi-squared test was applied to analyze the difference between the demographic variables and fear among genders, age, and level of education. Results Due to the coronavirus's contagious nature, fear is prevalent among a significant number of patients (χ 2= 31.373, p < 0.001). Females are more afraid to visit the dentist than males (χ 2= 7.065, p = 0.008). The majority of the patients are not willing to go for dental treatment other than an emergency. Around two-thirds of the participants reported that their visit to the dentist during the current pandemic was reduced. Conclusion Due to the fear of COVID-19, patients are not willing to visit dentists for treatments. Therefore, dentists should build confidence by ensuring cross-infection control. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.

Anxiety and Obsession among the Dentists after Covid-19 Vaccination - A Cross-Sectional Study

Aim: To assess dentists' COVID-19 anxiety and obsession following vaccination and their impressions of the COVID-19 vaccine. Methods: It was a cross-sectional study performed in July 2021. Two previously validated, standardized, self-reported scales were used: the COVID-19 anxiety scale (CAS) and the Obsession with COVID-19 scale (OCS).COVID-19 scales. The survey form was circulated through the convenience snowball technique. Data were analyzed with the help of SPSS-21. Independent sample T-Test and ANOVA were executed. Results: Data of 124 dentists were analyzed. Mean anxiety and obsession score was recorded as 5.29±4.238 and 1.87±3.34, respectively. 83.06% (n=103) of the dentists agree that the vaccine's anxiety has been reduced. Female dentists showed significantly higher anxiety (t= -2.606, P=0.011) and obsession scores (t=-3.309, P=0.02). Dysfunctional anxiety was found in 21.77% of the dentists, and obsession was observed in 9.67%. Conclusion: The majority of dentists stated that COVID-19 vaccination had lessened their anxiety related to COVID-19, and Coronavirus vaccination has greatly reduced dysfunctional anxiety and obsession.

The Psychological Impact of COVID-19 on Sindh and Baluchistan's Bachelors of Dental Surgery (BDS) Students and Their Stress Management Strategies During the Current Pandemic

Objective: The objective of this study was to evaluate the anxiety among the bachelors of dental surgery (BDS) students of Sindh and Baluchistan during COVID-19 pandemic. The secondary objective of this study was to evaluate the stress management strategies. Methods: In this web-based cross-sectional study, data of eight hundred and nine bachelors of dental surgery (BDS) students of Sindh and Baluchistan were analyzed using SPSS version 21. A validated e-questionnaire created using Google form was distributed among the dental college students pursuing bachelors of dental surgery (BDS) through social media. A P-value of less than 0.05 was considered significant. Results: The majority of the respondents were females (n=596, 73.7%) and studied in private dental colleges (n = 543, 67.15). Most of the students were dissatisfied with online education, and no significant difference was found among private and public sector dental college (p>0.05). Moderate to severe level of anxiety among both genders was prevalent. Praying and reciting the Holy Book is the most common coping strategy, followed by sleeping and talking to friends and family. Conclusion: We conclude that the BDS students of Sindh and Baluchistan are suffering from anxiety. The majority of the students are not happy with the quality of online education.

The psychology of coronavirus fear: are dentists of Pakistan suffering from corona-phobia?

OBJECTIVE: The objective of this study is to evaluate the level of anxiety and fear among Pakistani dentists due to COVID-19. METHODOLOGY: Data of 386 dentists evaluated who responded to the questionnaire sent via social media. Fear of coronavirus scale (FCV-19S) was used for evaluation of fear among Pakistani dentists. Data was entered and analyzed using SPSS version 21. One way ANOVA, chi-square and independent t-test were used for statistical analysis. P-value <0.05 was considered as significant. RESULTS: The overall mean FCV-19S score was 26.22 +or- 4.907, which is on the higher end. Females showed higher fear scores as compared to males (p<0.001). A statistically significant difference between the scores of General Dental Practitioners (GDP) and specialists was also observed (p<0.001), Statistically, a significant difference was observed between all 4 age groups of dentists, young and elderly dentists demonstrating higher scores (F (3,382) = 8.618, p< 0.001). CONCLUSION: We conclude that due to the current COVID-19 crisis, majority of the dentists of Pakistan are afraid and among them, females, GDPs, young and elderly dentists are found to be more anxious and have a greater fear of getting infected by coronavirus during COVID 19 Pandemic.

Clinical characteristics and outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C): A national multicenter cohort in Saudi Arabia

Background: In children, Coronavirus Disease 2019 (COVID-19) is usually mild. However, children can be seriously impacted in rare situations, and clinical manifestations may differ from those seen in adults. One rare consequence associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in children is a Multisystem Inflammatory Syndrome (MIS-C). We sought to describe the clinical, laboratory and radiological characteristics, as well as the outcomes of children with MISC. Methods: A multicenter, retrospective cohort study was conducted in seven pediatric intensive care units spanning four regions in Saudi Arabia, from April to December 2020. Patients under 14 years of age who met MIS-C diagnostic criteria were included consecutively. Results: Among 54 patients, 55.6% were boys, 40.7% were 2-5 years old, and 75.9% were Arab. Only four (7.4%) had some comorbidity. The median BMI was 15.6 kg/m2. Contact with another COVID-19 case was reported by 31.5%, and 87% had recent SARS-CoV-2 infection confirmed by RTPCR. Serology was performed in 53.7%, but only positive in three patients (5.3%). Gastrointestinal symptoms were present in 63%. Severe respiratory symptoms were apparent in 48%, but 92.6% of the patients had an abnormal chest X-ray and 83.3% had abnormal echocardiographic findings. Almost all patients (92.6%) received immunoglobulin, but only 37% needed invasive mechanical ventilation, with a median duration of ventilation-free days of 28 days (IQR 9.75-28). The median duration of the PICU stay was seven days, during which nine deaths occurred (16.7%). Conclusion: Most of the current MIS-C patients had characteristics similar to other, previously reported cohorts. Several factors, we believe, played a role in the higher than expected rate of mortality, including high PRISM scores and presentation with acute COVID19 symptoms in many patients, and most being under five years old. There also is no standardized national protocol for MISC therapy in Saudi Arabia.

COVID-19 and dental education in Pakistan

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 6 million people globally;and changed the dynamics of the entire world. In March 2020, novel coronavirus disease 2019 (COVID-19) was declared as a pandemic by the World Health Organization (WHO). In Pakistan, the first case of COVID-19 was reported on 26th February, 2020. The virus is highly contagious and spreads mainly by aerosols. Its major symptoms include sore throat, cough, high-grade fever, anosmia, etc. Like other countries, it has also affected all fields of life in Pakistan, but its impact on dental education and dentistry has been particularly devastating. Dental institutes are at particularly high risk for infection transmission through their aerosol-generating dental procedures. In the scenario of a lockdown, dental students are suffering a lot and the dental colleges and faculties must try their best to overcome this situation. This article aims to review the challenges faced by dental community to carryout teaching and training in dental education during the COVID-19 pandemic.

Psychological barriers among dental patients during the COVID-19 crisis

Objective: To evaluate the psychological fear (anxiety) of dental patients while visiting a dentist in the period of the present coronavirus disease (COVID-19) pandemic. Methodology: This online cross-sectional survey used a self-administered questionnaire to analyze the anxiety, knowledge, and perception of 461 dental patients. A p<0.05 was considered significant. Results: Data from 461 participants revealed significant differences among genders (X-2 = 14.944, p<0.001), age (X-2= 142.915, p<0.001), and between the educational levels of the participants (X-2= 410.399, p<0.001). We found that 63.6% patients were afraid of visiting dentists due to the fear of COVID-19, and 66.2% patients thought that they will get the disease from the dentist or dental office. We observed that females were found to be more anxious than men (p<0.05). Conclusion: There was high anxiety among the patients to visit dentists because of the current pandemic. Aanxiety regarding COVID-19 is prevalent in the society that may lead to a monetary crisis for dentists.

The emergence of covid-19 and its pandemic potentialas a global health security threat and its effect on future life strategy

The novel Wuhan coronavirus, known as SARS-CoV-2, and the disease it causes, COVID-19, are declared as a global pandemic thus breaking havoc on lives and economies around the world.The extent of the outbreak of COVID-2019, which was discovered quite recently, and its massive impact on lives, societies as well as the economies of the affected countries is unprecedented. Cases of COVID -19 infection have so far been reported in 212 countries and territories where more than 71.2 million individuals have been affected till December 2020, resulting in more than 1.6 million deaths. Both, outside and inside China all around the world, COVID-19 is transmitted via human-to-human transmission,which has resulted in such a global outcome. To decrease the cases all the affected countries were under lockdown and eventhoug the cases were incresed dramaticlly. However, all the dailly activiets were moved to a virtual reality which adds more impact to investigate the future of the virtual reallity and its great impact during this hard time. This paper presents a critical study on the outbreak of COVID-19 by providing an analysis on the confirmed cases at Corona's first wave along with discussing the impact of the disease on social lives and economies all around the world.

A Retrospective Study Assessing the Effect of Diabetes on Mortality in Patients With COVID-19 at a Teaching Hospital in the United Kingdom.

Aim The aim of the study was to compare the clinical characteristics and outcomes (mortality, intensive care admission, mechanical ventilation, and length of stay, LoS) of patients with and without diabetes with confirmed COVID-19.  Methods This retrospective study evaluated clinical and laboratory variables in adult inpatients from Brighton and Sussex University Hospitals NHS Trust with laboratory-confirmed COVID-19 between March 10, 2020, and June 30, 2020. Univariate and multivariate analyses were performed to compare the outcomes of patients with and without diabetes.  Results Over 457 patients were included in this study (140 with diabetes and 317 without diabetes), of which 143 (31.9%) died. The median age was 80 years and were predominantly males (59.1%). Baseline characteristics at the time of COVID-19 diagnosis demonstrated that the patients with diabetes were younger than those without diabetes (p=0.008). Mortality increased with age. There was no difference in adverse outcomes in those with and without diabetes. However, subgroup analysis of patients aged ≤60 years demonstrated a significantly increased mortality in those with diabetes (p=0.016). Patients with diabetes had an increased length-of-stay compared to those without diabetes, which was more evident in those aged ≤60 years. Conclusion Age is the most important predictor of mortality. Patients with diabetes did not have increased mortality from COVID-19, which is likely due to their younger age in our cohort. More patients with diabetes stayed in the hospital longer than seven days than those without diabetes.

Attenuation of 7-ketocholesterol- and 7ß-hydroxycholesterol-induced oxiapoptophagy by nutrients, synthetic molecules and oils: Potential for the prevention of age-related diseases.

Age-related diseases for which there are no effective treatments include cardiovascular diseases; neurodegenerative diseases such as Alzheimer's disease; eye disorders such as cataract and age-related macular degeneration; and, more recently, Severe Acute Respiratory Syndrome (SARS-CoV-2). These diseases are associated with plasma and/or tissue increases in cholesterol derivatives mainly formed by auto-oxidation: 7-ketocholesterol, also known as 7-oxo-cholesterol, and 7ß-hydroxycholesterol. The formation of these oxysterols can be considered as a consequence of mitochondrial and peroxisomal dysfunction, leading to increased in oxidative stress, which is accentuated with age. 7-ketocholesterol and 7ß-hydroxycholesterol cause a specific form of cytotoxic activity defined as oxiapoptophagy, including oxidative stress and induction of death by apoptosis associated with autophagic criteria. Oxiaptophagy is associated with organelle dysfunction and in particular with mitochondrial and peroxisomal alterations involved in the induction of cell death and in the rupture of redox balance. As the criteria characterizing 7-ketocholesterol- and 7ß-hydroxycholesterol-induced cytotoxicity are often simultaneously observed in major age-related diseases (cardiovascular diseases, age-related macular degeneration, Alzheimer's disease) the involvement of these oxysterols in the pathophysiology of the latter seems increasingly likely. It is therefore important to better understand the signalling pathways associated with the toxicity of 7-ketocholesterol and 7ß-hydroxycholesterol in order to identify pharmacological targets, nutrients and synthetic molecules attenuating or inhibiting the cytotoxic activities of these oxysterols. Numerous natural cytoprotective compounds have been identified: vitamins, fatty acids, polyphenols, terpenes, vegetal pigments, antioxidants, mixtures of compounds (oils, plant extracts) and bacterial enzymes. However, few synthetic molecules are able to prevent 7-ketocholesterol- and/or 7ß-hydroxycholesterol-induced cytotoxicity: dimethyl fumarate, monomethyl fumarate, the tyrosine kinase inhibitor AG126, memantine, simvastatine, Trolox, dimethylsufoxide, mangafodipir and mitochondrial permeability transition pore (MPTP) inhibitors. The effectiveness of these compounds, several of which are already in use in humans, makes it possible to consider using them for the treatment of certain age-related diseases associated with increased plasma and/or tissue levels of 7-ketocholesterol and/or 7ß-hydroxycholesterol.