Mild Androgen Insensitivity Syndrome presenting in male with infertility and sexual difficulties

Androgen insensitivity syndrome has a wide spectrum of presentations. It results from a mutation in androgen receptor (AR) gene. It ranges from mild androgen insensitivity syndrome (MAIS) which is the mildest form to complete androgen insensitivity syndrome (CAIS). In case of MAIS, the abnormality that can be observed appears to be male infertility and sexual difficulties including premature ejaculation and erectile dysfunction. In this case report, we discuss a case of MAIS in a 37-year-old male who presented with infertility, premature ejaculation, and secondary erectile dysfunction.Copyright © 2023, Ibn Sina Trust. All rights reserved.

Impacts and Response Strategies of the COVID-19 Pandemic on the Construction Industry Using Structural Equation Modeling

The COVID-19 pandemic is one of the most serious global health crises. It has had a massive impact on the global workforce and workplaces, causing enormous changes in the working environment and raising concerns among organizations. Due to the pandemic, the construction industry has faced more challenges in delivering projects on time and within budget. This study aims to determine the relationship between the impacts and response strategies of COVID-19 in Sri Lankan construction projects. A systematic literature review and semi-structured interviews with industry professionals identified twelve COVID-19 impacts and twenty-two response strategies needed to mitigate the impacts. A structured questionnaire survey was then conducted with Sri Lankan construction professionals. The gathered data were analyzed using the Kruskal-Wallis test, exploratory factor analysis (EFA), and partial least-squares structural equation modeling (PLS-SEM). A model and six hypotheses were developed to explain the impact and strategy. The results revealed that it is necessary to focus on the impacts related to the project, develop the necessary strategies from a financial point of view, and supply the necessary materials and equipment. During COVID-19, organizational management and information exchange should be enhanced, along with a project's workforce and its provision. The study findings could aid industry professionals and policymakers in comprehending the pandemic and developing strategies to mitigate the effects of COVID-19 on Sri Lankan construction projects.

Knowledge and Awareness of Medical Students for Protective Measures against COVID-19

Objective: Our study aimed to assess the knowledge and awareness of medical students for preventive and protective measures towards Covid-19. Study Design: descriptive observational cross sectional study Place and Duration of Study: This study was conducted at the institutes of southern Punjab including Nishtar Medical University, Multan, Bakhtawer Amin Medical College, Multan and Quade Azam Medical College, Bahawalpur from June, 2020 to September, 2020. Materials and Methods: A structured questionnaire based on demographic, COVID-19 related information and practice for preventive measures was distributed online among medical students of southern Punjab, Pakistan. The response of students was recorded and result was analyzed. Results: Out of 736 students 287 (39%) were males and 449 (61%) were females. Over all 85% students showed appreciable awareness for predisposing factors, virology, preventive and protective measures Clinical students were more aware as compare to pre-clinical students. Awareness was better among male students as compare to females one. The most common source of gaining knowledge was social media. Clinical students were in good practice of preventive and protective measures. Direct dealing or contact with Corona patients in wards might be the cardinal reason for good awareness and preventive practice in clinical students. Observation of the intensive treatment required for symptomatic patients and poor outcome in some patients is another fundamental ground that increases the Covid fear or anxiety and the thirst for gaining more information and knowledge. Conclusion: Medical students are asset of a nation, being the future frontline worriers against these kinds of pandemics. Overall, the Covid Related knowledge was deficit among pre-clinical and female medical students. Awareness for covid-19 pandemic is the one and only key to protect our medical students and its associated mental and physical impact but unfortunately is an ignored aspect in developing countries. There is need of intervention by public health department for designing awareness and education plans.

Online Teaching, a Big Challenge for Developing Countries during the Era of Covid 19, A Survey Conducted in Medical Students of Southern Punjab, Pakistan

Objective: To find out perception of medical students and scope versus limitations of online teaching in field of medical education during the course of Covid-19 pandemic when schools, colleges and universities were shut down in emergency and online teaching was initiated with intention to fill the stopgap with little to no preparation, inadequate resources and scarce training of teachers Study Design: Observational study Place and Duration of Study: This study was conducted at the different medical colleges of southern Punjab from January 2021 to December 2021 for a period of one year. Materials and Methods: Self designed online questionnaire was circulated among medical students of south Punjab. Response of students was collected, recorded and analyzed for. Results: Number of total participants was 485. Satisfaction level of students was not optimum being less than 35%. Ground reasons behind were deficiency in pertinent resources and materials, technical problems, lack of favorable home environment for online learning, non-availability of internet facilities to most of students living in remote areas. 68.5 % students rebuffed continuation of online classes with main reason of being unable to learn without one to one classes and to maintain daily routine. Conclusion: Online teaching is a big challenge for education department especially in highly specialized field of medical education and might lower not the standard of education but also skills and competency of front line soldiers of future. There is utmost need for strategic planning to uplift our online medical education system to strengthen, secure and accomplish our health care system.

Investigating Distorted Thinking Patterns and Psychological Distress in Students taking Online Education during COVID-19 Outbreak

Purpose: The objective of this study was to assess the predictive association between distorted thinking patterns and psychological distress (depression, stress, anxiety) in university e-learners during COVID-19 outbreak. Methodology: In this correlational study, 643 participants between age18 to 29 years (M= 21.27, SD+4.06) participated online through convenient sampling technique. They were sent an online google questionnaire, including the informed consent form, the depression, anxiety, stress scale (DASS-21), and cognitive distortions scale in Urdu, which assessed the distorted thinking patterns of adults. Findings: Analysis through Pearson product moment correlation revealed that the distorted thinking patterns of predictive thinking, rigid thinking and stress-creating thinking pattern had a strong positive association with depression, stress, and anxiety. The distorted thinking pattern of self-criticism/selfblame also had a strong positive association with depression and stress, and a moderate positive association with anxiety. Multiple stepwise regression was performed to calculate the predictive association between distorted thinking patterns and psychological distress of university students seeking digital education during the COVID-19 outbreak. Analysis revealed that distorted thinking patterns of stress-creating thinking, self-criticism/self-blame, and predictive thinking are predictors of depression. However, stress-creating thinking was the strongest predictor of depression. Stress-creating thinking, predictive thinking, and rigid thinking were predictors of anxiety in university students during online education and stress-creating thinking is the strongest predictor of anxiety as well. Moreover, the distorted thinking patterns of stress creating thinking, self-criticism/self-blame, and rigid thinking strongly predicted stress in university students engaged in distant education during the COVID-19 outbreak. Implications to Research and Practice: The study's findings emphasize the role of distorted thinking patterns in the stress experience of students during COVID and encourage teachers and universities to consider the findings while developing an online education system for the students. (C) 2022 Ani Publishing Ltd. All rights reserved.

To Use Face Masks or Not After COVID-19 Vaccination? An Impact Analysis Using Mathematical Modeling

The question of whether to drop or to continue wearing face masks especially after being vaccinated among the public is controversial. This is sourced from the efficacy levels of COVID-19 vaccines developed, approved, and in use. We develop a deterministic mathematical model that factors in a combination of the COVID-19 vaccination program and the wearing of face masks as intervention strategies to curb the spread of the COVID-19 epidemic. We use the model specifically to assess the potential impact of wearing face masks, especially by the vaccinated individuals in combating further contraction of COVID-19 infections. Validation of the model is achieved by performing its goodness of fit to the Republic of South Africa's reported COVID-19 positive cases data using the Maximum Likelihood Estimation algorithm implemented in the fitR package. We first consider a scenario where the uptake of the vaccines and wearing of the face masks, especially by the vaccinated individuals is extremely low. Second, we consider a scenario where the uptake of the vaccines and wearing of the face masks by people who are vaccinated is relatively high. Third, we consider a scenario where the uptake of the vaccines and wearing of the face masks by the vaccinated individuals is on an upward trajectory. Findings from scenario one and scenario two, respectively, indicate a highly surging number of infections and a low recorded number of infections. For scenario three, it shows that the increased extent of wearing of the face masks by the vaccinated individuals at increasing levels of vaccine and face mask average protection results in a highly accelerated decrease in COVID-19 infections. However, wearing face masks alone also results in the reduction of the peak number of infections at increasing levels of face mask efficacy though the infections delay clearing.

Innovative Nanotechnology a Boon for Fight Against Pandemic COVID–19

COVID – 19 is a contagious disease caused by severe acute respiratory syndrome (SARS-CoV2). The rate at which COVID – 19-virus spread from epidemic to pandemic within a short period is quite alarming. As of July 2020, the Dashboard of the World Health Organization (WHO) recorded over 15 million COVID – 19 cases across 213 countries, with mortality of over 620,000. The governments and healthcare agencies responsible for mitigating the virus's spread have adopted several strategies to end the pandemic. However, all hands were on deck to establish the standard treatment modalities of SARS-CoV-2 through inventing new drugs, vaccine candidates, or repurposing the existing medicines and robust diagnostic tools, in addition to other technological innovations. Therefore, nanotechnology’s employment would play a vital role in bringing multidisciplinary ways of developing affordable, reliable, and powerful tools for diagnosis, in addition to personal protection and effective medicines. Additionally, nanosensors' application would significantly aid the diagnoses of the COVID–19 even on asymptomatic patients, and thus would be an essential means for determining its prevalence. Likewise, nanoscale fibers can optimize personal equipment protection and allow their reusability for medical and economic benefits. Accordingly, the literature was intensively reviewed by searching for the combinations of the research keywords in the official scientific databases such as Science Direct, PubMed, and Google Scholar. Hence, this research highlighted the perspective contributions of nanotechnology in the war against the COVID-19 pandemic. Copyright © 2021 Shehu, Auwal, Musa, Mukhtar, Yusuf, Yau, Muhammad, Baba Dala, Sani, Ahmad and Islam.

Construction Industry from Perspective of Force Majeure and Environmental Risk Compared to the COVID-19 Outbreak: A Systematic Literature Review

The COVID-19 pandemic represents a type of force majeure that significantly and unexpectedly affected all human lifestyles. This study includes an integrative review of articles published across Scopus and Web of Science journals and compiled using the systematic review methodology based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement and VOSreview (visualization of similarities) software by defining keywords that include “construction industry”and “force majeure”and “environmental risks”as a starting point. Moreover, the research years and the countries covered by this research were determined in a second stage. Finally, the s of selected studies were reviewed in order to extract factors similar to the pandemic conditions of COVID-19 along with the brief results of the research. Out of 6384 publications identified and 56 publications reporting, 20 studies fulfilled the inclusion criteria with full text. Based on our findings, there has been a continuous growth of publications on construction risk and environmental research since 2010. Malaysia had the greatest contribution to the research topic of the countries covered by the study, followed by Egypt. The Engineering, Construction and Architectural Management journal published the greatest number of publications related to the research topic. In this review, the most important previous studies are classified according to their handling of force majeure and environmental risks and the most important factors mentioned in these studies are identified. In addition, recommendations are made for dealing with the COVID-19 pandemic and for mitigating its effects on the construction industry in the Arab world and Malaysia. The results of this review will benefit researchers and construction companies alike in furthering research on reducing the risks of COVID-19 to construction projects and avoiding the significant economic loss that results from stopping these projects.

Assessing the Impact of Vaccination on COVID-19 in South Africa Using Mathematical Modeling

The unexpected continuing mushrooming tendency of the COVID-19 epidemic calls for alarm in the entire globe especially with the cropping up of more divergent contagious variants being witnessed. On top of the many non-pharmaceutical measures put in place for containment of the pandemic, pharmacological measures have been incorporated in the battle against the SARS-CoV-2 especially with the commencement of vaccination in the early December 2020. This study develops a deterministic compartmental model that incorporates vaccination as a measure to combat the spread of COVID-19 epidemic. We use the model particularly to assess the potential impact of vaccination in shattering the chain of transmission of the virus in South Africa. Verification of the model is carried out by performing its best fit to cumulative COVID-19 positive cases data as reported by the government of the Republic of South Africa utilizing the maximum likelihood estimation algorithm implemented in fitR package. With some vaccines already being under utility while other are being developed, we consider two major vaccine efficacy scenarios. One scenario accounts for general hypothetical vaccines with 20%,50%,65% and 85% case efficacy. The other scenario considers the Johnson and Johnson’s Janssen vaccine with its distinctive efficacy levels as reported to act against the 501Y.V2 variant. The sensitivity analysis and simulations for the model reveal that the cumulative infections decline drastically with increased extent of vaccination at each level of the vaccine efficacy.The study fundamentally discovers that vaccinating approximately 20% of the population with a vaccine of at least 60% efficacy would be sufficient in elimination of the pandemic over relatively shorter time. Moreover, with J&J vaccine maintaining its efficacious level against the 501Y.V2 variant, it would be the best vaccine to shortly eradicate the COVID-19 epidemic in South Africa © 2021 NSP Natural Sciences Publishing Cor.

Comparison of Nigella sativa and Trachyspermum ammi via experimental investigation and biotechnological potential

Trachyspermum ammi and Nigella sativa are mostly used as traditional medicinal plants to cure different diseases. It was observed that both extracts showed significant antibacterial activity against gram-negative bacteria and which may be extended to the SARS-CoV-2, leading to the absence of the peptidoglycan layer. T. ammi showed the highest percentage inhibition in the antifungal assay compared to N. sativa against Aspergillus flavus. The antioxidant assay was performed. It was observed that T. ammi has more free radical scavenging activity as indicated by low IC50. The cytotoxic assay was performed by following brine shrimp lethality assay, and it was observed that T. ammi has more cytotoxicity. The results are that both N. sativa and T. ammi are the origins of active pharmaceutical ingredients and have several pharmacological effects. Furthermore, both essential antibacterial agents were identified and can, therefore, be used as an antibiotic. They have now shown important antioxidant and cytotoxic potential, such that their potential in herbal medicine and cancer genetics can now unravel. In the future, the bioactive molecules responsible for biological processes will be separated. Besides, the nano-formulations in nano-biotechnology may also be analyzed with these extracts. © 2021 Elsevier B.V.

Successful treatment of acute heart failure in COVID-19-induced cytokine storm with tocilizumab: a case report.

BACKGROUND: SARS-CoV-2 is known to induce a cytokine storm, a hyperinflammatory state driven by up-regulation of interleukin 6 (IL-6) and immunomodulatory chemokines that may result in acute heart failure. CASE SUMMARY: A 65-year-old woman with confirmed SARS-CoV-2 developed shock with multiorgan system failure, including acute biventricular heart failure, 2 weeks after the initial onset of fever, cough, and shortness of breath. The patient experienced myocardial recovery within 48 h after administration of tocilizumab, a humanized monoclonal anti-IL-6 receptor antibody, and multiple supportive vasoactive medications. DISCUSSION: The differential diagnosis of acute heart failure in critically ill patients with COVID-19 infection is broad, including sepsis-induced cardiomyopathy, Takotsubo syndrome, viral lymphocytic myocarditis, and acute coronary syndrome. Immunomodulatory treatment with tocilizumab may benefit patients who develop cardiogenic shock associated with SARS-CoV-2-induced cytokine storm.