ABSTRACT
Introduction: Autoimmune and inflammatory thyroid diseases have been reported following SARS-CoV-2 infection or vaccination, but thyroid eye disease (TED) post-COVID-19 infection is less common. We describe a case of TED following SAR-CoV-2 infection in a patient with a history of Graves' disease. Case Description: A 59-year-old female with history of Graves' disease status post radioiodine ablation therapy in 2002. She developed post-ablative hypothyroidism which has been stable on levothyroxine 88 mcg daily. In January 2021, the patient's husband and daughter were diagnosed with COVID-19 infection. A few days later, the patient developed an upper respiratory tract infection associated with loss of sense of smell and taste consistent with COVID-19 infection. Three days later, she developed bilateral watery eyes which progressed to eye redness, eyelid fullness, retraction, and pain with eye movement over 1-month duration. Her eye examination was significant for severe periocular soft tissue swelling, lagophthalmos and bilateral exophthalmos. The laboratory workup was consistent with normal TSH 0.388 mIU/L (0.358-3.740 mIU/L) and positive TSI 1.01 (0.0-0.55). The patient was referred to an Ophthalmologist for evaluation of TED. He noted bilateral exophthalmos, no restrictive ocular dysmotility or compressive optic neuropathy (clinical activity score 4/7 points). CT scan of orbit showed findings compatible with thyroid orbitopathy. Based on clinical activity score of 4, treatment with Teprotumumab was recommended pending insurance approval. Discussion(s): Many cases of new-onset Graves' hyperthyroidism have been reported after COVID-19, with only a few associated with TED. Our patient has been in remission for 20 years before she developed COVID-19 infection with occurence of TED.This suggests that COVID-19 infection may have played a role. SARS-CoV-2 may act through several mechanisms, including breakdown of central and peripheral tolerance, molecular mimicry between viral and self-antigens, stimulation of inflammasome with release of type I interferon. In our patient, treatment with Teprotumumab was indicated due to Graves' orbitopathy clinical activity score greater than or equal to 3. In conclusion, it is very uncommon for TED to present after COVID-19 infection. Our case reinforces the speculative hypothesis that SARS-CoV-2 virus could have triggered an autoimmune response against eye antigens. There is a need for increased awareness about the link between COVID-19 and autoimmunity to help better define the management of patients.Copyright © 2023
ABSTRACT
Students who receive literacy training tied to real-life assignments show greater improvement in literacy scores. The significance of this study revolves round the prominent role accorded social media in academic community for research, teaching and learning. In spite of the benefits associated with the use of social media for academic purposes, it is observed that many students, teachers/lecturers have not been fully exploring these advantages to improve the academic performance. The study investigated the awareness, access and social media challenges encountered by postgraduate students of Information Studies, University of KwaZulu-Natal (UKZN(during the lockdown caused by COVID-19 pandemics. The study employed a quantitative research design in form of an online questionnaire, using Google Forms. Fifty-five post-graduate students were sampled, of which 51 participated, giving a response rate of 93%. The findings revealed (Facebook, Instagram, Zoom, Twitter and WhatsApp) as major (100%) types of social media available for post graduate students for their academic purpose. The findings further revealed smartphone as a major tool for accessing social media by the respondents (96%), and the major challenges restraining students from effectively utilising social media for academic activities. The study underscores the importance of social media in academic environment and offers some recommendations that could lead to more informed and effective use of social media for academic purposes.
ABSTRACT
Background: Health care workers have been affected the most by coronavirus all over the world. Their knowledge and attitude toward caring for people with coronavirus have neither reduced their anxiety nor number of casualties from the pandemic. The aim of this study is on knowledge, attitude, and anxiety of Nigerian nurses toward coronavirus. Methods: A cross sectional, online quantitative survey of the six geopolitical zones in Nigeria was done using multistage sampling technique. Data were collected using Google Forms from 209 nurses, and the Statistical Package for the Social Science (SPSS) version 20 software was used for data analysis. Level of anxiety was determined using Generalized Anxiety Disorder Assessment. Descriptive data of participants were presented in tables, charts, percentages, means, and standard deviation, while the inferential data were tested with Chi square at a significance level of P = 0.05. Results: Mean age of the respondents was 41.01 +/- 8.21 years, with 13.1 +/- 8.44 years as mean for years of experience. Only 57% had good knowledge with mean of 10.67 +/- 1.197, while 70.8% had positive attitude toward nursing care during coronavirus pandemic. Anxiety level increased from 1.88 +/- 0.82 before to 2.33 +/- 0.96 during the pandemic. Association of knowledge and anxiety before and during was P = 0.79 and P = 0.27, respectively. Gender and age were significant with anxiety during the pandemic with P = 0.01 and P = 0.02, respectively. Conclusion: Adequate knowledge with positive attitude may not be enough to reduce the anxiety level of nurses, hence the need for adequate psychosocial support and provision of personal protective equipment for the nurses in other to keep them safe for optimum health workforce.