ABSTRACT
Background: COVID shelters and many emergency centers were established as a countermeasure to control this pandemic that hit the word by the end of 2019. Due to unavailability of medical care, along with physical health is-sues, these patients suffer with mental health related issues. Aims: This study aimed to explore the both, physical and psychological impacts upon the patients diagnosed with COVID-19 and admitted in intensive care units of hospitals of Pakistan during the third wave. Methods: This cross-sectional survey was performed during the peak time of COVID-19 for the duration of two months i.e. April & May 2021. After getting ethical approval from Shifa International Hopsital (Ref# 070-021), permission was sorted from public and private hospitals of Pakistan. 183 conscious patients diagnosed with COVID and currently admitted in intensive care units were randomly selected from hospitals of Islamabad and Rawal-pindi. Written consent was taken from patients and their caregivers after they were briefed regarding the importance of the study. PHQ-15 was used to assess somatic symptoms related to COVID-19 whereas DASS-21 was used to assess level of depression, anxiety and stress among patients. Results: Of 183 hospitalized patients of COVID-19 in intensive care units, 170 (92.9%) participants showed mild to severe level of somatic symptoms on PHQ-15. Shortness of breath, feeling hearth race, back pain, stomach pain, low energy and sleeping difficulties were the most common somatic complaints reported by patients. The statistics of DASS-21 showed that 51 (27.86%) participants had mild to severe level of depres-sion, 74 (40.4%) had mild to profound level of anxiety and 96 (52.45%) reported mild to profound level of stress. Conclu-sion: This study portrayed a better understanding and confirms the physical and psychological impacts upon hospitalized COVID-19 patients, therefore highlighting the need of both physical and mental health interventions to minimize these impacts.
ABSTRACT
The COVID-19 virus spread around the globe very rapidly during early 2020. Identification of the evolution pattern, and genome scale mutations in SARS-CoV-2 is essential to study the dynamics of this disease. The genomic sequences of thousands of SARS-CoV-2 infected patients from different countries are publicly available for sequence based in-depth analysis. In this study, the DNA sequences of SARS-CoV-2 from the COVID-19 infected patients (having or lacking a travel history) from Pakistan and India, the two highest populous neighboring countries in South Asia, have been analyzed by using computational tools of phylogenetics. These analyses revealed that the SARS-CoV-2 strain in Pakistani traveler COVID-19 patients is closely related to Iranian strains, the strain in non-traveler patients is related to the strain of Wuhan, China. Likewise, in India, the SARS-CoV-2 strains in travelers and non-travelers are closely related to Italy, Germany, and Mexico. The selected approach has also been utilized to find out the identical genomic regions and similar strains around the world. Collectively, our study suggested distinct strains and routes of viral transmission in Pakistan and India. These differences may infer partially the reason for the decline phase in viral propagation in Pakistan two months after the peak COVID-19 load, and rapid viral propagation in India making it the second worst-hit country in the world after the USA.
ABSTRACT
Summary Originating with unexplained symptoms from Wuhan, city of China, COVID-19 being a global pandemic causing tremendous morbidity and mortality, has proved to be the biggest challenge of the 20th century. This study aimed to explore the functional impacts of COVID-19 upon those patients who were diagnosed with this disease and were admitted in hospitals. This cross-sectional survey included 183 COVID-19 diagnosed patients from COVID-19 isolation wards of public and private hospitals of Islamabad and Rawalpindi. After getting ethical permission from Institutional Review Board of Shifa International Hospital (Ref # 070-21), this survey was conducted for the time period of 6 months from December 2020 to May 2021. Through convenient sampling, 183 patients with the age range of 25 to 55 years with no already diagnosed psychological complaints were assessed for eligibility briefed regarding the study purpose and then were asked for their voluntary participation. The Functional Status Scale for the Intensive Care Unit (FSS-ICU) was used to assess the functional status impacted due to COVID-19 during hospitalization. Frequencies and percentages were calculated through SPSS-21. On FSS-ICU, out of 183 COVID-19, 11 (6%) patients reported that they were dependent, 18 (9.8%) required maximum assistance, 32 (17.5%) required moderate assistance, 27 (14.8%) required minimal, 24 (13.1%) required supervision to complete their tasks, 28 (15.3%) required assistive devices, whereas 43 (23.5%) were totally independent. Results indicated a temporal impact of COVID-19 upon functional status of hospitalized patients in intensive care units, therefore highlighting the need of physiotherapeutic and psychotherapeutic interventions.
ABSTRACT
Introduction: Hypofractionated radiotherapy (HF-RT) has been used in the UK as a non-surgical treatment for locally advanced laryngeal cancer (LALC) in the past. HF-RT has been readopted in some departments during the COVID-19 pandemic due to having a shorter overall treatment time and fewer attendances. This study explores the outcomes of a cohort of patients treated from 2003 to 2012 at Aberdeen Royal Infirmary (Scotland, UK). Materials and Methods: 36 patients received HF-RT (55 Gy in 20 fractions) through 2D or 3D conformal radiotherapy, 7 of them received concurrent cisplatin (CRT). Overall survival (OS), locoregional recurrence free survival (LRFS), progression free survival (PFS), laryngectomy free survival (LFS), disease specific survival (DSS) and late toxicity data were analysed in patients treated with HF-RT at 1-year (1Y), 2-year (2Y) and 5-year (5Y). The same outcomes were measured between the RT and CRT group for any differences. Results: The mean follow-up durationwas 43.0 months. OS at 1Y, 2Y and 5Y was 69.4%, 52.8% and 30.6%. LRFS at 1Y, 2Y and 5Y was 63.9%, 47.2% and 25.0%. PFS at 1Y, 2Y and 5Y was 63.9%, 44.4% and 25.0%. LFS at 1Y, 2Y and 5Y was 69.4%, 50.0% and 27.8%. DSS at 1Y, 2Y and 5Y was 63.9%, 52.8% and 30.6%. During the period of treatment and up to 5Y follow up, 41.7% of patients required an NG tube for feeding and 25% required a PEG tube at any point. 22.2% of patients required long term enteral feeding via PEG tube beyond 5Y. No significant differences were found in the survival outcomes or alternative feeding route outcomes between patients treated by RT alone or CRT. Conclusions: HF-RT constitutes an alternative for the treatment of LALC with acceptable local control and toxicity. Further investigation is needed in the comparison of this regime with standard fractionation and its application with modern radiotherapy techniques
ABSTRACT
In the context of pandemic, COVID-19, recognition of masked face images is a challenging problem, as most of the facial components become invisible. By utilizing prior information that mask-occlusion is located in the lower half of the face, we propose a dual-branch training strategy to guide the model to focus on the upper half of the face to extract robust features for Masked face recognition (MFR). During training, the features learned at the intermediate layers of the global branch are fed to our proposed attention module, named Upper Patch Attention (UPA), which acts as a local branch. Both branches are jointly optimized to enhance the feature extraction from non-occluded regions. We also propose a self-attention module, which integrates into the backbone network to enhance the interaction between the channels and spatial locations in the learning process. Extensive experiments on synthetic and real-masked face datasets demonstrate the effectiveness of our method. © 2022 Elsevier Ltd