Efficacy of Paracetamol or Ibuprofen in The Management of COVID-19 Fever: A SystematicReview

The Global outbreak of COVID-19 pandemic affected almost all countries and territories worldwide. The outbreak was first identified from Wuhan, China, in December 2019 and was declared a pandemic in March 2020. Virus incubation time is usually 7 days and initial symptoms includes fever, cough, flu, muscle fatigue and difficulty in breathing. Ibuprofen and paracetamol are the two most commonly used over the counter (OTC) drugs to treat fever due to COVID-19. Some researchers discouraged the use of ibuprofen initially due to possible adverse effects related with longevity of infection, increased morbidity, and mortality rate. This study aimed to compare the effectiveness of paracetamol and ibuprofen as anti-pyretic drugs to treat fever caused in COVID-19 infection. A systematic review of major databases i.e., PubMed, Cochrane library, Web of Science, Google scholar and ClinicalTrials.gov was performed, to screen the studies conducted on managing fever using paracetamol and ibuprofen. Review of the selected articles based on the inclusion/exclusion criteria was performed by two independent researchers. The titles of selected publications were screened for relevance to the preset criteria followed by review of the s. Finally, the full-length articles were evaluated for the final selection of studies to be included. Outcomes of use of ibuprofen and paracetamol were estimated by analyzing selected case control and cohort studies. Overall, eleven observational studies were selected for the compilation of systematic review, based upon the preset inclusion/exclusion criteria. All studies included adult COVID-19 patients both male and female from different age groups. Paracetamol users were compared with ibuprofen users and no adverse effects of ibuprofen were found related to longevity of infection, complications, increased mortality rate and ventilation support requirement, when treating fever or pain caused by COVID-19. However, further studies and randomized control trials need to be conducted to assess and compare the effectiveness of these drugs to manage fever caused by coronavirus disease. © The Author(s) 2023.

Study the Pattern of D-Dimers, HS CRP and Ferritin in Covid-19 Patients

Background: Corona virus disease is caused by SARS-CoV-2. This pandemic has affected over 200 countries. Most of the patients are asymptomatic. The disease is usually mild but in approximately 14% of patients it worsens to severe respiratory impairment and admission to ICU. Different tests in laboratories have been used to assess severity and prognosis of severely sick Covid-19 patients in addition to clinical and radiological findings. Aim(s): To study pattern of Hs- CRP, Ferritin and D-Dimers in Covid-19 patients admitted in Mayo Hospital/ KEMU Duration: June 2020 to October, 2020. Method(s): It was a descriptive study conducted in Central Diagnostic Laboratory (CDL) of Mayo Hospital/ KEMU, Lahore on 1474 Covid-19 patients. All samples of the Covid-19 patients sent to CDL of Mayo hospital/ KEMU Lahore for D-Dimers, Hs CRP and Ferritin levels were included in the study. The results and other relevant information were recorded on proforma. The collected data was analyzed by SPSS 23.Quantitative variables like age was presented as mean +/- SD. Qualitative variables like gender, single, double or triple parameter abnormalities were presented as frequency and percentage. Result(s): Out of total 1474, 958(65%) samples were of male and 516(35%) were of female patients. Mean age+/- SD was50.6+/-4.2 years. The percentage of abnormal Hs CRP, D Dimers and ferritin was 1386(94%), 1312(89%) and 1135(77%) respectively. The mean+/-SD value for HsCRP, D-Dimers and ferritin was 56.8+/-16.9mg/L, 4.4+/-1.5microg/ml FEU and 770+/-180 ng/ml respectively. The patients having 3, 2 and 1 abnormal parameter were 988(67%), 456(31%) and 29(2%). Conclusion(s): Males were more affected with Covid-19 as compared to females. HsCRP is the most frequently raised biomarker in Covid-19 patients and both inflammatory (HsCRP and Ferritin) and coagulopathy marker (D Dimers) were raised in severely sick Covid-19 patients. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Using smart glasses for monitoring cyber threat intelligence feeds

The surge of COVID-19 has introduced a new threat surface as malevolent actors are trying to benefit from the pandemic. Because of this, new information sources and visualization tools about COVID-19 have been introduced into the workflow of frontline practitioners. As a result, analysts are increasingly required to shift their focus between different visual displays to monitor pandemic related data, security threats, and incidents. Augmented reality (AR) smart glasses can overlay digital data to the physical environment in a comprehensible manner. However, the real-life use situations are often complex and require fast knowledge acquisition from multiple sources. In this study we report results from an experiment with six subjects using an AR overlaid information interface coupled with traditional computer monitors. Our goal was to evaluate a multi tasking setup with traditional monitors and an AR headset where notifications from the new COVID-19 MISP instance were visualized. Our results indicate that better situational awareness does translate to increased task performance, but at the cost of a gender gap that requires further attention. © 2021 ACM.

Causes of Alarmingly High Frequency of Covid 19 Infection in Health Care Workers: A Third World Perspective

Background: Covid 19 infection is spreading like a wild fire world wide. More worrisome thing is that it has spread in health workers too which are the sole care takers of affected patients, despite of use of personal protective equipments and taking other precautions. Aim: To conduct a study at local level to see causes of high frequency of Covid 19 infection in health care workers. Methods: We conducted a cross sectional observational study in which we enrolled 195 doctors, nurses and paramedics from different hospitals of punjab, who were affected from covid 19 infection and gave them a questionnaire to fill regarding use of mask, (surgical, cloth, n=95)/duration of its use, use of surgical cap, goggles, soap or hand sanitizer use/frequency, technique of donning/doffing of PPE etc, to find out that where is the fault. Results: Out of total 195 participants 148 were doctors from various specialties, departments and with different work experience.47 were nurses and other paramedical staff including lab workers, pharmacists, ward boys and others. Out of 195 participants 42(21.5%) did not use PPE (cover-all with surgical apron, mask KN-95 or N-95, goggles/face shield) whereas 153(78.5%) used it. Conclusion: We concluded at the end of our study that improper doffing techniques, overuse of masks for more than 3 days, and infrequent hand washing may be the reasons for increased rate of infection and need to be dealt promptly.

Acute Respiratory Distress Syndrome in Confirmed and Suspected Cases of Covid-19: A Cross Sectional Study

Aim: To observe the frequency, severity and susceptibility to develop the severe symptoms of acute respiratory distress syndrome in confirmed and suspected cases of COVID-19. Study design: Cross sectional observational study. Place and duration of study: Lahore General Hospital, Lahore. Methodology: After Ethical Committee approval in 164 patients of confirmed or suspected COVID-19 who underwent the complication of ARDS were enrolled, admitted in department of Medicine and Intensive Care Unit at Lahore General Hospital, Lahore. After taking consent we studied different features in these patients like age, gender, comorbidities, symptoms, their radiological findings, SATS, PO2/FIO2 ratio, serum ferritin, CRP, LDH and d-dimer levels, and results were analyzed. Result: Out of 164 patients, 103 were COVID-19 positive. Mostly middle aged to old males developed the complications of ARDS. The most common symptoms observed were fever, cough and shortness of breath. Most common comorbidities present in the patients were diabetes and hypertension. HRCT was done in severe cases and 25 out of 35 patients had either unilateral or bilateral lung opacities. On chest X-ray 76% patients had bilateral lung infiltrates and 12% patients were having unilateral infiltrates. Inflammatory markers such as CRP, serum LDH, serum Ferritin, D-dimers were raised in most of the patients who developed moderate to severe ARDS. Conclusion: We concluded that the middle aged to old males with comorbidities like diabetes and hypertension are more likely to undergo ARDS. They can present with shortness of breath alone or in combination with fever and cough. Their X-ray usually showed bilateral patchy infiltrates and their ferritin, CRP, LDH and d- dimer levels are usually high.