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Bivalent COVID-19 vaccines that contain two mRNAs encoding Wuhan-1 and Omicron BA.4/5 spike proteins are successful in preventing infection from the original strain and Omicron variants, but the quality of adaptive immune responses is still not well documented. This study aims at characterizing adaptive immune responses to the bivalent booster vaccination in 46 healthy participants. Plasma and PBMC were collected prior and three weeks after bivalent booster. We measured anti-N, anti-S, and RBD IgM, IgA, IgG plasma titers against original, Omicron BA.1, and BA.5 variants (pending) as well as total anti-S IgG titers and surrogate Virus Neutralization capacity against the Alpha, Delta, and BA.1 variant. With spectral flow-cytometry we identified peripheral blood B-cells specific for the RBD of the S-protein of the original and BA.1 variants. T-cell-specific responses were assessed by cytokine release assay after stimulation with SARS-CoV-2 peptides from the original, BA.1, BA.4, and BA.5 variants (pending). Finally, we performed TRB and IGH repertoire studies on sorted CD4+, CD8+, CD19+ lymphocytes, to study breadth of SARS-CoV-2 specific clonotypes (pending). 27/46 participants were analyzed;9 had SARS-CoV-2 infection (COVID+), while 18 are infection naive (COVID-). In both groups, median time since last dose of SARS-CoV-2 vaccine (3rd or 4th) was 11 months. All subjects were positive for anti-S IgG prior to bivalent booster. The COVID + group displayed anti-S IgG pre-booster levels and neutralization against BA.1 higher than the COVID- group. Significant increase post-boost of total anti-S IgG and BA.1 neutralizing activity was detected in the COVID- but not in the COVID+ group;however, no difference in neutralization activity post-boost was detected between the two groups. Furthermore, the COVIDgroup showed significant increase in the frequency of CD19+ and CD27+ switched memory B-cells specific for BA.1 RBD in post-boost compared to pre-boost samples. However, post-boost frequencies of the same B-cells were higher in the COVID+ compared to the COVID- group. These preliminary findings confirm that among individual immunized with the original COVID-19 mRNAvaccine, prior COVID infection provides increased protection against SARS-CoV-2 variants. They also demonstrate that booster immunization with the bivalent vaccine induces robust adaptive immune responses against Omicron variant.[Formula presented][Formula presented]Copyright © 2023 Elsevier Inc.
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Introduction: The onset and rise of COVID-19 and its sudden progression to a worldwide pandemic lead medical and dental institutes to change their way of teaching and conducting assessments to distance learning as compared to the previously applied conventional approaches. Teaching and assessment during this era have changed vastly, earlier it was solely traditional/live Objective Structured Clinical Examination (OSCE) but due to the current circumstances electronic/online OSCE (E-OSCE) method was introduced. In Pakistan also, Pakistan Medical Council (PMC) and the College of Physicians and Surgeons of Pakistan (CPSP) conducted online exams so that the scheduled exams do not get delayed. Aim(s): The main objective of this paper is to measure the reliability of an E-OSCE and to compare it with the traditional OSCE. Methodology: This was a cross-sectional study which got conducted at the Rawal Institute of Health Sciences, Islamabad. Traditional OSCEs and E-OSCEs were conducted with 71 participants including final year students and house officers. Each OSCEs had 10 stations, including one interactive station in traditional OSCE. Students' scores in both the OSCEs were collected and paired t-test was used to compare the mean scores at p<0.05. Result(s): Total number of house officers were 27 and final year students were 44. The scores of 71 participants were collected. The difference between mean scores of house officers' traditional OSCE and E-OSCE was statistically significant (p=0.000). The difference between final year students traditional OSCE and E-OSCE was also statistically significant (p=0.020). Finally, the overall difference between traditional OSCE and E-OSCE was also statistically significant (p=0.000) Practical implication: The main objective of this study was to assess the reliability of an E-OSCE and to compare whether the electronic method of conducting OSCE is more reliable than the traditional method of conducting OSCE. Conclusion(s): Despite limitations and the biases, the results of E-OSCE proved to be better than traditional OSCE. Further research needs to be conducted on E-OSCE to control the factors causing biases and limitations.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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The available drugs against coronavirus disease 2019 (COVOD-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are limited. This study aimed to identify ginger-derived compounds that might neutralize SARS-CoV-2 and prevent its entry into host cells. Ring compounds of ginger were screened against spike (S) protein of alpha, beta, gamma, and delta variants of SARS-CoV-2. The S protein FASTA sequence was retrieved from Global Initiative on Sharing Avian Influenza Data (GISAID) and converted into ".pdb” format using Open Babel tool. A total of 306 compounds were identified from ginger through food and phyto-databases. Out of those, 38 ring compounds were subjected to docking analysis using CB Dock online program which implies AutoDock Vina for docking. The Vina score was recorded, which reflects the affinity between ligands and receptors. Further, the Protein Ligand Interaction Profiler (PLIP) program for detecting the type of interaction between ligand-receptor was used. SwissADME was used to compute druglikeness parameters and pharmacokinetics characteristics. Furthermore, energy minimization was performed by using Swiss PDB Viewer (SPDBV) and energy after minimization was recorded. Molecular dynamic simulation was performed to find the stability of protein-ligand complex and root-mean-square deviation (RMSD) as well as root-mean-square fluctuation (RMSF) were calculated and recorded by using myPresto v5.0. Our study suggested that 17 out of 38 ring compounds of ginger were very likely to bind the S protein of SARS-CoV-2. Seventeen out of 38 ring compounds showed high affinity of binding with S protein of alpha, beta, gamma, and delta variants of SARS-CoV-2. The RMSD showed the stability of the complex was parallel to the S protein monomer. These computer-aided predictions give an insight into the possibility of ginger ring compounds as potential anti-SARS-CoV-2 worthy of in vitro investigations. © 2023, School of Medicine, Universitas Syiah Kuala. All rights reserved.
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This study explores the association of novel COVID-19 with the dominant financial assets, global uncertainty, commodity prices, and stock markets of the top ten corona-affected countries. We employ a wavelet coherence technique to unearth this linkage using daily data of COVID-19 deaths and reported cases from 1 January 2020 until 26 February 2021. The study finds a weak coherence between COVID-19 and global uncertainty variables in the short and medium term, while a strong positive correlation has been witnessed in the long run. The COVID-19 cases impact the stock markets in the short and medium term, while no significant impact is reported in the long run. On the other hand, a substantial impact of the COVID-19 outbreak has also been found on the exchange rate. In addition, the real asset market, such as gold, remains more stable during the COVID-19 outbreak. Thus, the study recommends that investors and portfolio managers should add such assets to their investment options to safeguard the excessive risk and downside momentum of the equity market. The study also has implications for regulators who are concerned with the neutrality of the COVID-19 effect and market stability. © 2023 by the authors.
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Individuals with comorbidities (i.e., Diabetes Mellitus, hypertension, heart diseases) are more likely to develop a more severe form of coronavirus disease 2019 (COVID-19), thus, they should take necessary precautions to avoid infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its emerging variants and subvariants by getting COVID-19 vaccination and booster doses. In this regard, we used text analytics techniques, specifically Natural Language Processing (NLP), to understand the perception of Twitter users having comorbidities (diabetes, hypertension, and heart diseases) towards the COVID-19 vaccine booster doses. Understanding and identifying Twitter users' perceptions and perspectives will help the members of medical fraternities, governments, and policymakers to frame and implement a suitable public health policy for promoting the uptake of booster shots by such vulnerable people. A total of 176,540 tweets were identified through the scrapping process to understand the perception of individuals with the mentioned comorbidities regarding the COVID-19 booster dose. From sentiment analysis, it was revealed that 57.6% out of 176,540 tweets expressed negative sentiments about the COVID-19 vaccine booster doses. The reasons for negative expressions have been found using the topic modeling approach (i.e., risk factors, fear of myocardial fibrosis, stroke, or death, and using vaccines as bio-weapons). Of note, enhancing the COVID-19 vaccination drive by administering its booster doses to more and more people is of paramount importance for rendering higher protective immunity under the current threats of recently emerging newer Omicron subvariants which are presently causing a rise in cases in a few countries, such as China and others, and might lead to a feasible new wave of the pandemic with the surge in cases at the global level. Copyright © The Author(s) 2023.
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Objectives: To find the effect of information channels on Covid-19 acceptance among university students of Rawalpindi/ Islamabad. Study Design: Cross sectional analytic study. Place and Duration of Study: Study was conducted in four imminent Universities in Rawalpindi/Islamabad, Air University, Rawalpindi Medical University, Riphah University and Quaid-e-Azam University, Rawalpindi, from May to Aug 2022. Methodology: Participants from four universities in Rawalpindi/Islamabad Pakistan, were recruited for this current research from May to August 2022. A sample size of 377±14 was computed using the Rao soft sample size calculator, maintaining a 5% margin of error and a 95% confidence interval a population proportion (50%). Non-probability convenient sampling was used. Data was analysed using SPSS version 26. Results: There were 377 students recruited, out of which majority 207(55%) were female. Most of the students were in the Medicine and allied fields 227(60.2%). Almost, half of the respondents (44.56%) received information about the COVID-19 vaccine from mobile networks. The level of trust in vaccine information was also highest for Mobile Networks (31.30%). Participants' perceptions of the covid 19 risk, 156(41%) revealed high concerns for infecting family and friends with the virus. There was a significant association of female gender (p<0.05) and being from the Medicine and allied fields (p=p<0.05) with vaccine acceptance. Conclusion: In our study the mobile and traditional media were reported as the main sources of information about the COVID-19 vaccination however they were not significantly associated with vaccine acceptance. Female gender, education level and being from the Medicine and allied fields was associated with intention to be vaccinated. © 2022, Army Medical College. All rights reserved.
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Ventricular tachycardia (VT) is a type of broad complex tachycardia originating from a focus in the ventricle. It is one of the four important rhythms which can lead to cardiac arrest. Accurate and timely diagnosis of true VT is the cornerstone for proper management in the emergency department (ED). We present an interesting case of an electrocardiographic artifact mimicking VT, which led to a diagnostic dilemma in the ED.Copyright © 2023 Rehman, Albaroudi, Akram, Ahmad, licensee HBKU Press.
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This study examines the predictive power of oil shocks for the green bond markets. In line with this aim, we investigated the extent to which oil shocks could be used to accurately make in- and out-of-sample forecasts for green bond returns. Three striking findings emanated from our results: First, the three types of oil shock are reliable predictors for green bond indices. Second, the performances of the predictive models were consistent across the different forecasting horizons (i.e. H = 1 to H = 24). Third, our findings were sensitive to classifying the dataset into pre-COVID and COVID eras. For instance, the results confirmed that the predictive power of oil shocks declined during the crisis period. We also discuss some policy implications of this study's findings. © 2022 The Author(s)
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The publication of this article unfortunately contained mistakes. The funding note was not correct. The corrected funding note is given below. Funding The current study was funded by;The National Key Research and Development Program of China [Grant No. 2019QY(Y)0502];The Key Research and Development Program of Shaanxi Province [Grant No. 2020ZDLSF04- 07];The National Natural Science Foundation of China [Grant No. 51905438];The Fundamental Research Funds for the Central Universities [Grant No. 31020190502009];The Innovation Platform of Bio fabrication [Grant No. 17SF0002];and China postdoctoral Science Foundation [Grant No. 2020M673471]. The original article has been corrected. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023.
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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron versions have been the sole one circulating for quite some time. Subvariants BA.1, BA.2, BA.3, BA.4, and BA.5 of the Omicron emerged over time and through mutation, with BA.1 responsible for the most severe global pandemic between December 2021 and January 2022. Other Omicron subvariants such as BQ.1, BQ.1.1, BA.4.6, BF.7, BA.2.75.2, XBB.1 appeared recently and could cause a new wave of increased cases amid the ongoing COVID-19 pandemic. There is evidence that certain Omicron subvariants have increased transmissibility, extra spike mutations, and ability to overcome protective effects of COVID-19 neutralizing antibodies through immunological evasion. In recent months, the Omicron BF.7 subvariant has been in the news due to its spread in China and a small number of other countries, raising concerns about a possible rebound in COVID-19 cases. More recently, the Omicron XBB.1.5 subvariant has captured international attention due to an increase in cases in the United States. As a highly transmissible sublineage of Omicron BA.5, as well as having a shorter incubation time and the potential to reinfect or infect immune population, BF.7 has stronger infection ability. It appears that the regional immunological landscape is affected by the amount and timing of previous Omicron waves, as well as the COVID-19 vaccination coverage, which in turn determines whether the increased immune escape of BF.7 and XBB.1.5 subvariants is sufficient to drive new infection waves. Expanding our understanding of the transmission and efficacy of vaccines, immunotherapeutics, and antiviral drugs against newly emerging Omicron subvariants and lineages, as well as bolstering genomic facilities for tracking their spread and maintaining a constant vigilance, and shedding more light on their evolution and mutational events, would help in the development of effective mitigation strategies. Importantly, reducing the occurrence of mutations and recombination in the virus can be aided by bolstering One health approach and emphasizing its significance in combating zoonosis and reversal zoonosis linked with COVID-19. This article provides a brief overview on Omicron variant, its recently emerging lineages and subvairants with a special focus on BF.7 and XBB.1.5 as much more infectious and highly transmissible variations that may once again threaten a sharp increase in COVID-19 cases globally amid the currently ongoing pandemic, along with presenting salient mitigation measures. © 2022, Editorial board of Journal of Experimental Biology and Agricultural Sciences. All rights reserved.
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Clinical Applications of Immunogenetics: Immunogenetics: a Molecular and Clinical Overview, Volume II provides readers with an exclusive, updated overview of scientific knowledge, achievements and findings in the field of immunogenetics. In thirteen chapters, the book gives insights in new advancements and approaches in viral and autoimmune diseases. Specific chapters are dedicated to immunogenetic mechanisms in the treatment of immune disorders, cancer, neurological and neurodegenerative disorders. In addition, other chapters cover immunogenomics in precision medicine, clinical medicine and transplantation. Finally, a special chapter, COVID-19: A novel challenge to human immune-genetic machinery, updates on thoughts surrounding the pandemic. © 2022 Elsevier Inc. All rights reserved.
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The exponential rise of healthcare problems like human aging and road traffic accidents have developed an intrinsic challenge to biomedical sectors concerning the arrangement of patient-specific biomedical products. The additively manufactured implants and scaffolds have captured global attention over the last two decades concerning their printing quality and ease of manufacturing. However, the inherent challenges associated with additive manufacturing (AM) technologies, namely process selection, level of complexity, printing speed, resolution, biomaterial choice, and consumed energy, still pose several limitations on their use. Recently, the whole world has faced severe supply chain disruptions of personal protective equipment and basic medical facilities due to a respiratory disease known as the coronavirus (COVID-19). In this regard, local and global AM manufacturers have printed biomedical products to level the supply-demand equation. The potential of AM technologies for biomedical applications before, during, and post-COVID-19 pandemic alongwith its relation to the industry 4.0 (I4.0) concept is discussed herein. Moreover, additive manufacturing technologies are studied in this work concerning their working principle, classification, materials, processing variables, output responses, merits, challenges, and biomedical applications. Different factors affecting the sustainable performance in AM for biomedical applications are discussed with more focus on the comparative examination of consumed energy to determine which process is more sustainable. The recent advancements in the field like 4D printing and 5D printing are useful for the successful implementation of I4.0 to combat any future pandemic scenario. The potential of hybrid printing, multi-materials printing, and printing with smart materials, has been identified as hot research areas to produce scaffolds and implants in regenerative medicine, tissue engineering, and orthopedic implants.
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Rationale: SARS-CoV-2 has been identified as a highly infective and contagious viral infection. The SARS-CoV-2 pandemic has been spread worldwide and affected more than 210 countries. Globally, the fast spread of novel SARS-CoV-2 variants has been mostly attributed to international travel. Patient concerns: We are reporting the genomic evidence of SARS-CoV-2 Eta VOI among two international travelers. Both travelers were males from Nigeria aged 24 and 34 years and both were asymptomatic. Diagnosis: The nasopharyngeal swab samples were in both travelers positive by real-time RT-PCR followed by COVIDSeq-NGS. Interventions: Paracetamol 3 times daily for 5 days. Outcomes: Patient recovered completely within 10 days and discharged after 14 days of quarantine duration. Lessons: This report highlights genomic variation of SARS-CoV-2 among the travelers. For managing the present health crisis, molecular identification of viral variants present in different geographical locations will be very helpful.
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Background: COVID-19 was announced as a pandemic issue globally on 11th March, 2020. In response to this situation, all educational activities including medical and clinical education in various colleges across the country were suspended on the 15th of March. So, online education emerged as an alternative method of teaching & learning to maintain continuity of education Aim: To evaluate the use of online learning modalities and to find their feasibility and usability in medical education. Method(s): A cross-sectional study was performed across the government and private medical colleges of Lahore. Eligible participants were undergraduate medical students from 10 medical colleges of Lahore. A questionnaire linked to a Google form was distributed to the medical students across 10 government and private medical colleges through different social platforms. Result(s): A total of 439 valid questionnaires were collected. 31.7% of students disagreed that interaction between students and teachers was possible through online teaching. Only 7.7% of students agreed that online learning can be used for clinical teaching of medical sciences, as compared to 35.8% who disagreed with this answer and 12.8% who were neutral. 23% of the students agreed that online learning was more convenient and flexible than traditional learning, while 24% disagreed and 21.4% were neutral in this regard. Only 19.8% of students had problems with poor internet services. Conclusion(s): As Pakistan has faced four waves of the COVID-19 which is not over yet due to the emergence of new strains. Due to vaccination of medical students medical education is back to conventional physical learning but online learning has gained importance as an effective alternate to continue learning processes in exceptional situations like COVID-19 pandemic. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Aim: To assess the neurological and mental health responses to pandemic Covid-19. Study design: Cohort study Place and duration of study: Department of Medicine, Chandka Medical College Hospital Larkana and Department of Medicine, Khairpur Medical College Hospital Khairpur Mir's from 1st October 2021 to 31st March 2022. Methodology: Two hundred patients who suffered Covid-19 infection and 200 who had any other life event except Covid-19 were enrolled. All patients who were above 18 years of age and were positive for Covid-19 through reverse transcriptase PCR were included in the study.Global Psych trauma Screening was done by enlisting twenty-two items which assessed trauma related symptoms while five items only assessed the factors increasing risks. Result(s): There were 112 (56%) females and 88 (44%) males in Covid-19 patients and 150 (75%) females and 50 (25%) males in non-Covid patients. The mean age of the Covid-19 patients was 49.65+/-15.5 year while of non Covid patients was 39.02+/-12.01 years. A significant increase in post-traumatic stress disorder (PTSD) cases probability was noted in the Covid-19 cases than non Covid-19 related events. Neurological responses showed that patients who had suffered from Covid 19 infections had a generalized weakness with hyposmia formation. Conclusion(s): Covid-19 is related with high level of depression, anxiety, hyposmia and other mental and neurological responses. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Objective: To determine the frequency of patient compliance with universal face mask policy during COVID-19 pandemic using simple observable criteria. Study Design: Cross sectional study Place and Duration of Study: Pakistan Railway Hospital, Rawalpindi during the third wave of COVID-19 pandemic over a period of one month from 15 March 2021 to 15 April 2021. Materials and Methods: A total of 266 patients were recruited from the general population of patients visiting our hospital after undergoing screening for COVID-19 at the filter clinic. Face mask compliance was defined as the wearing of a disposable surgical mask while employing correct techniques as per the World Health Organization and National Institute of Health guidelines for hospital settings. Results: Majority of the patients (79.9%) wore a surgical face mask as recommended for hospital settings. However, only 41% employed the correct mask wearing technique. Patients under strict supervision in outdoor clinics were more likely to wear mask as compared to their indoor counterparts (76.79% vs 51.76%). Correlation was significant at a level of 0.492. One third (34.2%) of the patients did not cover their face, nose, and chin completely. An overwhelming majority (129/183 or 70.49%) admitted reusing the mask multiple times. Conclusion: The study findings indicate that while majority of the general population of patients visiting our hospital wore a face mask, compliance with correct mask wearing technique as per recommended guidelines was poor. Our results support strict implementation of universal masking policies for hospitals in Pakistan as part of a multifaceted strategy to minimize transmission of infection in health care settings. © 2022 Journal of Islamic International Medical College. All rights reserved.