Premenstrual Symptoms and Cycle Regularity: A Cross-sectional Study among Iraqi University Students during the COVID-19 Pandemic

Evidence suggests that the stressor factors faced by women of childbearing age during the COVID-19 pandemic are related to changes in menstrual cycles. The present study was conducted to explore the premenstrual symptoms (PMS), menstrual regularity, and their negative impact on academic performance and interpersonal relationships among Iraqi female university students during the COVID-19 pandemic. A cross-sectional study was conducted on 1270 Iraqi university students in Baghdad, Iraq. An online questionnaire was created to collect data about the menstrual cycle, PMS, and academic performance during the COVID 19 pandemic. The majority of the participants (76.6%) reported PMS. Depressed mood (69.6%) and flatulence (56.1%) were the most commonly reported PMS. The majority of participants (36.9%) suffered from moderate PMS. Moreover, (26.3%) and (18.3%) of the respondents reported worsening PMS and exacerbating menstrual pain, respectively. Among the respondents, (8.5%) reported a change in menstrual cycle length, and (50%) mentioned the lack of concentration. The study found that PMS was significantly (P<0.005) associated with the students’ age, age of menarche, and dysmenorrhea. Furthermore, PMS was highly significantly (P<0.001) associated with poor academic performance, poor interpersonal relationships, and COVID-19 infection. The findings of the present study reveal that during the COVID-19 pandemic, PMS was significantly increased in Iraqi university students and was associated with poorer academic performance and interpersonal relationships. © 2023 by SPC (Sami Publishing Company)

COVID-19 and liver diseases.

Coronavirus causes an outbreak of viral pneumonia that spread throughout the world. Liver injury is becoming more widely recognized as a component of the clinical picture of COVID-19 infection. Hepatitis with serum ALT elevation has been reported in up to half of patients. Patients with CLD were at a higher risk of decompensation with liver failure, hospitalization, and mortality. The percentage of acute liver injury (ALI) varied from 5 to 28%. COVID-19 hinders HCV elimination by 2030. It is recommended to continue treatment of chronic HCV and chronic HBV if already receiving treatment. Consider using antiviral therapy to prevent viral flare-ups in patients with occult or resolved HBV and COVID-19 who are receiving immunosuppressive agents. Patients with AIH do not have an increased risk of adverse outcomes even in high-risk areas. There is an association between MAFLD and disease progression. Patients with any type of cancer are at a higher risk of infection and are more likely to develop more severe clinical outcomes. Most societies advise against immunosuppressant modifications in patients with mild COVID-19, whereas in rare cases such as severe lymphopenia, worsening pneumonia, or bacterial or fungal superinfection, reduction or discontinuation of antiproliferative agents and lymphocyte-depleting therapies has been suggested.

The Role of Artificial Intelligence and Machine Learning During the Covid-19 Pandemic: A Review.

Covid-19 is one of the most significant infectious diseases that have faced humanity in the past century from clinical, economic, and social perspectives. Although the role of infectious diseases in human history has been vicious and is well known to humanity, Covid-19 is a special case since it is the first worldwide outbreak in the era of advanced computing and telecommunications. For this reason, it was only logical to see Artificial Intelligence (AI) and Machine Learning (ML) on the top of the list of controls to compact the spread of Covid-19. This paper goes through the applications of AI and ML that were reported in some of the major literature indexes and can be related to the main issues that face healthcare providers during the Covid-19 pandemic. This paper also discusses the applicability of these applications to healthcare organizations and points out the main prerequisites before they can be adopted.

COVID-19 Vaccine Hesitancy and Determinants of Acceptance among Healthcare Workers, Academics and Tertiary Students in Nigeria.

The COVID-19 pandemic has resulted in millions of human deaths, prompting the rapid development and regulatory approval of several vaccines. Although Nigeria implemented a COVID-19 vaccination program on 15 March 2021, low vaccine acceptance remains a major challenge. To provide insight on factors associated with COVID-19 vaccine hesitancy (VH), we conducted a national survey among healthcare workers, academics, and tertiary students, between 1 September 2021 and 31 December 2021. We fitted a logistic regression model to the data and examined factors associated with VH to support targeted health awareness campaigns to address public concerns and improve vaccination rates on par with global efforts. A total of 1525 respondents took part in the survey, composed of healthcare-workers (24.5%, 373/1525), academics (26.9%, 410/1525), and students (48.7%, 742/1525). Only 29% (446/1525) of the respondents were vaccinated at the time of this study. Of the 446 vaccinated respondents, 35.7% (159/446), 61.4% (274/446) and 2.9% (13/446) had one, two and three or more doses, respectively. Reasons for VH included: difficulty in the vaccination request/registration protocols (21.3%, 633/1079); bad feelings towards the vaccines due to negative social media reports/rumours (21.3%, 633/1079); personal ideology/religious beliefs against vaccination (16.7%, 495/1079); and poor confidence that preventive measures were enough to protect against COVID-19 (11%, 323/1079). Some health concerns that deterred unvaccinated respondents were: innate immunity issues (27.7%, 345/1079); allergic reaction concerns (24.6%, 307/1079); and blood clot problems in women (21.4%, 266/1079). In the multivariable model, location of respondents/geopolitical zones, level of education, testing for COVID-19, occupation/job description and religion were significantly associated with VH. Findings from this study underscore the need for targeted awareness creation to increase COVID-19 vaccination coverage in Nigeria and elsewhere. Besides professionals, similar studies are recommended in the general population to develop appropriate public health interventions to improve COVID-19 vaccine uptake.

The Argumentative Potential of Doubt: From Legitimate Concerns to Conspiracy Theories About COVID-19 Vaccines

Doubt is a double-edge sword. On the one hand, uncertainty is essential for epistemic progress, and yet, doubt can also make us vulnerable to deception, confused to the point of no longer knowing what is true. What distinguishes a doubt that is epistemologically beneficial from one which is deceptive, or even manufactured in the context of a conspiracy theory? In this chapter, we explore doubt, its role, and the way it is being handled in the context of the public controversy about the COVID-19 vaccine. We approach conspiracy theories as argumentative discourses and reconstruct the generic structure of a conspiracy theory macro argument. Through the structure, we look into the discourse of the twelve prominent anti-vaxxers known as the “Disinformation Dozen”, focusing on the argumentative potential that doubt can have in the public controversy about the COVID-19 vaccine. We suggest to distinguish ambivalence from scepticism and denialism as three argumentative potentials that a motivated doubt can have. We argue that ambivalent doubt ought to be acknowledged, addressed and incorporated into the public health narrative, in order to avoid that an unnecessarily broad interpretation of conspiracy theory dominates the public debate and leaves an uncertain public a prey to it. © 2022, The Author(s).

Adult-Onset Still's Disease After the ChAdOx1 nCoV-19 Vaccine.

Adult-onset Still's disease (AOSD) is a rare autoimmune disorder without clear etiology. It is known that genetic and infectious causes trigger diseases. AOSD cases have been reported after coronavirus disease 2019 (COVID-19) infection and post influenza vaccine. Here, we report this challenging case of adult-onset Still's disease in a patient who recently received the ChAdOx1 nCoV-19 vaccine (Oxford-AstraZeneca).

Clinical Practice and Barriers of Ventilatory Support Management in COVID-19 Patients in Saudi Arabia: A Survey of Respiratory Therapists.

OBJECTIVE: This study was conducted to determine the clinical practice and barriers of ventilatory support management in COVID-19 patients in Saudi Arabia among respiratory therapists. METHODS: A validated questionnaire comprising three parts was distributed to all critical care respiratory therapists registered with the Saudi Society for Respiratory Care through the official social networks. RESULTS: A total of 74 respiratory therapists completed the survey. The mean (±standard deviation) of intensive care unit beds was 67 ± 79. Clinical presentation (54%) and arterial blood gas (38%) were the two main diagnostic tools used to initiate ventilatory support. While protocols for the initiation of invasive mechanical ventilation (IMV; 81%) were widely available, participants had limited availability of protocols for the use of non-invasive ventilation (NIV; 34%) and high-flow nasal cannula (HFNC; 34%). In mild cases of COVID-19, most respondents used HFNC (57%), while IMV was mostly used in moderate (43%) and severe (93%) cases. Regular ventilator check was mostly done every 4 h (57%). BiPAP (47.3%) and full-face masks (45.9%) were the most used mode and interface, respectively, while pressure-regulated volume control (55.4%) and pressure control (27%) were the most used mechanical ventilation modes for COVID-19 patients. In terms of use of proning, 62% used it on IMV, while 26% reported using awake proning. Staff shortage (51.4%), personal protective equipment (PPE) shortage (51.4%), increased workload (45.9%), inadequate training (43.2%) and lack of available protocols and policies (37.8%) were the main barriers. CONCLUSION: Ventilatory support management of COVID-19 in Saudi Arabia was inconsistent with the global practice, lacked uniformity, and there was limited use of standard protocols/treatment guidelines. Shortage of staff and PPE, increased workload and insufficient training were the most prevalent barriers.

Hematological and morphological changes in the peripheral blood smear of patients with covid-19

Background: The novel coronavirus is responsible for a widespread pandemic, causing multiple clinical manifestations. Peripheral blood films have shown changes in white blood cell (WBC) morphology and counts, as well as platelet abnormalities. Atypical and reactive lymphocytes may also be observed in the blood film, which suggests mild leukoerythroblastosis. Objectives: The present study aimed to evaluate the hematological and morphological changes in the peripheral blood smear of patients with COVID-19. Methods: This study was conducted on 175 patients diagnosed with COVID-19 infection. Blood samples were collected from the patients and examined for the estimation of blood parameters, differential cell count, and presence of atypical lymphocytes. Results: The mean age of the patients was 53.73 years, and males constituted 52.6% of the patients. The majority had normal hemoglobin levels. WBC count was normal in 60.6% of the patients, while 74.3% had normal platelet count, and thrombocytope-nia was detected in 23.4%. In addition, differential WBC count indicated that 56.6% of the patients had normal neutrophils, while lymphopenia was detected in 28 and 77.7% had a low eosinophil count. The peripheral blood smears showed atypical lymphocytes with deeply basophilic cytoplasm in 21.14% of the patients. Conclusions: Blood film examination may show multiple abnormal findings in patients with COVID-19 infection. Neutrophilia and lymphopenia with the presence of atypical lymphocytes are frequently observed as well. Low eosinophil count is also highly common. Although platelets showed changes, they were normal or reduced in most cases.

Lumbosciatalgia as the first manifestation of COVID-19 infection

Background and aims: The clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-COV-19) ranges from asymptomatic infection to severe acute respiratory failure with multi-organ involvement. The disease can cause extra pulmonary complications such as neurological disorders which are increasingly reported in the literature. Methods: We included in our retrospective study five patients, three women and 2 men. Clinical ,biologicall and radiological data were analyzed. Results: The mean age of the beginning of symptoms was 44.6 years old. All of them had lumbosciatalgia as the first manifestation. Lumbosciatalgia was isolated in one case and associated with other signs in four cases. The SARSCOV- 19 infection was confirmed by real-time reverse transcription (PCR). Spinal cord MRI was normal in all cases. All patients received symptomatic treatment with positive outcome. Conclusion: Lumbosciatalgia can be the inaugural symptom of SARS-COV-19. This diagnosis should be considered in patient with lumbosciatalgia in our epidemiologic context.

Analysis and Prediction of COVID-19 Outbreak by a Numerical Modelling

Pandemic COVID-19 is a contagious disease affecting more than 200 countries, territories, and regions. Recently, Iraq is one of the countries that have immensely suffered from this outbreak. The Kurdistan Region of Iraq (KRI) is also prone to the disease. Until now, more than 23,000 confirmed cases have been recorded in the region. Since the onset of the COVID-19 in Wuhan, based on epidemiological modelling, researchers have used various models to predict the future of the epidemic and the time of peak, yielding diverse numbers in different countries. This study aims to estimate the basic reproductive number [R0] for COVID-19 in KRI, using the standard SIR (Susceptible-Infected-Removed) epidemic model. A system of nonlinear differential equations was formulated and solved numerically by the 4th order Runge-Kutta method. The reproductive numbers R0 was estimated by the method of fitting the curves between the actual daily data and numerical solution by applying the least square method. For the analysis, data were taken for the duration of 165 days, from 1st of March to 12th August 2020, in a population of 5.2 million. It is concluded that the R0 value was fluctuating during the outbreak, with an average of 1.33, predicting that infection cases will reach their maximum value of around 540,000 on the 5th of November 2020. Then, the spread of the disease will die out since the number of susceptible people will decrease to about 3.2 million. While the number of removed individuals will reach approximately to 1.5 million. © 2021 University of Baghdad-College of Science. All rights reserved.

Psychological status of nurses providing care for patients with covid-19 at baqubah teaching hospital

Objectives: The present study aims to assess the psychological status of nurses providing care for patients with COVID 19. Methodology: a descriptive correlation design used in the present study established was for a period from October 10th, 2020 to March 20th, 2021. The study was conducted on a probability (convenient) sample of 100 nurses who providing care for patients with COVID-19 which were selected from isolation wards. The instruments of the study are adopted and modified for the purpose of this study, patients health questionnaire(PHQ), fear of COVID19 scale(FCS), general anxiety disorder scale(GAD). The data were analyzed through the application of descriptive and inferential statistical approaches which are applied by using SPSS version 22.0. Results: The majority of the study (43 percent) of nurses had minimal depression, (52 percent) had minimal anxiety, and (55percent) had minimal fear. Conclusions: The study concluded that minimal depression was prevalent among nurses who were male gender, married, and had small family. Minimal fear was significant with nurses who were not infected with COVID-19, did not have a history of psychological disorders, and highly significant among nurses who did not use any tobacco, alcohol drinking, and substance abuse. Recommendations: Emphasis should be focused on increasing the awareness through educational role of psychological misfortune COVID19 pandemic among nurses who work in isolation wards. Psychological care counselling and guidance are nessecary to increase nurses’ vulnerability and strengthen their mental health which helps to encounter any psychological burden caused by COVID 19 pandemic. © 2021 Universitatea de Vest Vasile Goldis din Arad. All rights reserved.

An update on the pharmacological treatments of covid-19

Researchers have tried many therapeutic agents in their experimental studies since the first pandemic time of COVID-19;these studies have been virus-based or host-based. Major therapeutics agent’s regimens evaluated in this review. Antiviral agents such as remdesivir, and Umifenovir should be used before the viral peak of replication to obtain the best clinical outcome. Dexamethasone is FDA approved in the treatment of certain cases of Covid-19. Immunoglobulin, and Interferon effectiveness in the treatment of this pandemic disease is not clear due to inconsistent outcomes data obtained in many studies. Several studies that used chloroquine and hydroxychloroquine as a therapeutic agent in COVID-19 showed that these agents have in vitro inhibitory activity against SARS-CoV-2, but failed to show a significant effect in many clinical studies. For patients who develop cytokine storm the interleukine-6 inhibitors like Tocilizumab could be effective.

Global Current Practices of Ventilatory Support Management in COVID-19 Patients: An International Survey.

BACKGROUND: As the global outbreak of COVID-19 continues to ravage the world, it is important to understand how frontline clinicians manage ventilatory support and the various limiting factors. METHODS: An online survey composed of 32 questions was developed and validated by an international expert panel. RESULTS: Overall, 502 respondents from 40 countries across six continents completed the survey. The mean number (±SD) of ICU beds was 64 ± 84. The most popular initial diagnostic tools used for treatment initiation were arterial blood gas (48%) and clinical presentation (37.5%), while the national COVID-19 guidelines were the most used (61.2%). High flow nasal cannula (HFNC) (53.8%), non-invasive ventilation (NIV) (47%), and invasive mechanical ventilation (IMV) (92%) were mostly used for mild, moderate, and severe COVID-19 cases, respectively. However, only 38.8%, 56.6% and 82.9% of the respondents had standard protocols for HFNC, NIV, and IMV, respectively. The most frequently used modes of IMV and NIV were volume control (VC) (36.1%) and continuous positive airway pressure/pressure support (CPAP/PS) (40.6%). About 54% of the respondents did not adhere to the recommended, regular ventilator check interval. The majority of the respondents (85.7%) used proning with IMV, with 48.4% using it for 12-16 hours, and 46.2% had tried awake proning in combination with HFNC or NIV. Increased staff workload (45.02%), lack of trained staff (44.22%) and shortage of personal protective equipment (PPE) (42.63%) were the main barriers to COVID-19 management. CONCLUSION: Our results show that general clinical practices involving ventilatory support were highly heterogeneous, with limited use of standard protocols and most frontline clinicians depending on isolated and varied management guidelines. We found increased staff workload, lack of trained staff and shortage of PPE to be the main limiting factors affecting global COVID-19 ventilatory support management.