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Background and rationale: Coronavirus disease 2019 (COVID-19) infection is a respiratory tract infection because of a novel coronavirus. The clinical picture ranges from asymptomatic to severe manifestations mandating intensive care and respiratory support. We aimed to assess the serum level of iron, total iron binding capacity (TIBC), and transferrin saturation in COVID-19 patients and their relation to disease severity and outcome. Methodology: This observational cross-sectional analytical study was conducted on 100 confirmed cases of COVID-19 who were admitted to Kasr Al-Ainy hospitals between June and December 2020.Serum levels of iron, total iron binding capacity (TIBC), and transferrin saturation were measured for all study populations. Result: One hundred patients were involved in this research, 51males and 49 females, with a mean age of 51±14.9years. Regarding the disease severity,53% were moderate cases, 34% were mild, and 13% were severe cases. Fifty-two (54.2%) patients showed normal serum levels of iron, 38 patients (39.6%) showed high serum levels of iron, and 6 patients (6.3%) showed low serum levels of iron. The mean ±SD values of iron, TIBC, and transferrin saturation were 163.1±105 mcg/dL, 366 ± 162.6 mcg/dL, 44.4 ± 20.2 %, respectively. Iron, total iron binding capacity (TIBC) levels and transferrin saturation did not show a significant association as regards either COVID-19 severity or mortality. Mortality and deterioration were detected in 31.7% out of 60 patients with COVID-19. The results showed that obese patients showed a higher percentage of severe COVID-19,which was statistically significant (p=0.037).There was a statistically significant higher mortality rate in patients with severe COVID-19 (p=0.000).High mortality was observed significantly in patients with diabetes mellitus (p=0.041).Iron levels, total iron binding capacity (TIBC) levels and transferrin saturation did not show a significant association regarding either COVID-19 severity or mortality. Conclusion: In our study, COVID-19 severity was not related to iron metabolism but was affected by obesity and diabetes mellitus. COVID-19 mortality was significantly associated with diabetes. © 2020 The author (s). Published by Zagazig University.
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Cryptocurrencies have been widely used as financial instruments over the past decade. Given the development of the cryptocurrency market and the increasing awareness of greener and more energy-efficient tokens, their connection to the green economy has become a popular topic for understanding economic and policy issues. However, the literature still lacks clear evidence on how cryptocurrencies interact with green economy indicators. Therefore, this study examines the correlations and spillover relationships between green economy indices, five black cryptocurrencies, and five clean cryptocurrencies for the U.S., Euro, and Asian markets. To this end, it applies the novel quantile spillover index approach of Ando et al. (2018) to daily data from November 9, 2017, to April 4, 2022. The empirical results show that the overall linkage is stronger for green economy indices and clean cryptocurrencies than for dirty cryptocurrencies. Moreover, green economy indices show net receiving behavior, while cryptocurrencies' results differ across variables, quantiles, and time. In addition, a notable point for clean cryptocurrencies is 2020, which was the start of the COVID-19 pandemic. The overall spillover effect is very high for all quantiles for the three markets, especially for Asia. This outcome signifies the safe harbor property for diversification purposes of the green economy. The results presented in this study are important for investors, regulators and, policymakers, cryptocurrency founders as they seek to be financially integrated and develop a more sustainable business. © 2023
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Background and Aims Sarcopenia can be defined as loss of muscle mass, strength and function and has been shown to be associated with increased morbidity and mortality in the adult population. Sarcopenia has been assessed by decreased psoas muscle surface area (PMSA) on Computer tomography (CT) and has been validated in paediatric studies. The impact of Sarcopenia in children with end stage liver disease and oncological conditions is now being recognised. There is scarce literature on the effect of sarcopenia on motor function. CT imaging exposes children to radiation and hence is done in a select group of children at the time of transplant assessment. The aim of this audit was to assess the prevalence of Sarcopenia in children undergoing liver transplant assessment and its relationship on laboratory variables, functional activity and clinical outcomes. Methods Retrospective single centre case review of patients with liver disease undergoing transplant assessment and CT imaging between 2018-2020. Psoas muscle was analysed at the level of L4/L5. The z-Scores were calculated using ageand gender-specific reference values. Sarcopenia was defined as tPMA z score less than -2. We assessed the relationship of Sarcopenia to the biochemical parameters, nutritional status, effect on motor delay/physical abilities (assessed by a range of age appropriate standardised developmental and physical assessments due to COVID pandemic isolation restrictions) and post-transplant complications. Results Thirty one children that met the inclusion criteria were included. Sarcopenia was prevalent in 17 children (6 males: 11 females), with a median age of 3.5 years (SD = 4.9). The common conditions were biliary atresia (n= 11, 35%), hepatoblastoma (n=6, 19%), Autoimmune hepatitis (n=3) etc. Twenty- four patients required additional nutritional support (77% nasogastric feeding, 13% PN and 6% oral supplementation). Mean tPMA z-score was -2.27. Data for the assessment of physical abilities/functional activity was available in 21 children. Impairment of motor skills/physical abilities was overall noted in 14/21 children (67%);9/13 (69%) in the sarcopenic group (6 significant impairment) vs 5/8 (63%) in non sarcopenic group (4 significant impairment). Sarcopenia was associated with increased complications (27 vs 7, p = 0.005) and hypoalbuminaemia (p=0.01), but was not statistically significant (p> 0.05) for the overall length of stay (total and intensive care). Discussion Sarcopenia was commonly identified in children with liver diseases undergoing transplant assessment. Reduction in physical abilities/functional activity was observed in both groups which may be a consequence of loss of muscle mass in children secondary to liver diseases or underlying oncological conditions leading to delay in gross motor skills. Although there was no statistical difference in the duration of stay or impairment of motor skills, complications were higher in the sarcopenic group. Conclusion In this pilot study, sarcopenia is prevalent in children being assessed for liver transplantation and was associated with increased complications. Better non-invasive methods (aside from CT scan) of assessing sarcopenia needs to be developed and validated for the paediatric age group, which would help to better characterise the true incidence and prevalence of sarcopenia in children with chronic liver disease. There is a need to offer nutritional support and assess physical function early in the pre transplant period in order to initiate appropriate physiotherapy interventions to halt and even reverse the progression of sarcopenia.
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Background During the COVID-19 pandemic, online education and entertainment have increased significantly due to strict isolation and frequent lockdowns. This study intended to explore the prevalence and potential factors associated with computer vision syndrome (CVS) among the postsecondary students of Bangladesh pursuing online education. Methods In total, there were 917 postsecondary students participated in this study. Information on sociodemographic variables, and CVS symptom-related variables were collected using a prevalidated self-administered questionnaire. The CVS questionnaire was used to assess an individual's CVS status. The bivariate association between CVS and other categorical variables was obtained using a chi 2 test. A multivariable logistic regression model was used to explore variables associated with the CVS. Results The overall prevalence of CVS was 68.16%. Most common symptoms were headache (42.4%), feeling of worsening eyesight (23.2%), and eye pain (23.2%). CVS was associated with educational status (p=0.03), family history of eye-related problems (p<0.001), personal history of eye-related problems (p<0.001), usage of eye accessories (p<0.001), type of device used for online education (p<0.01), average daily use (p<0.01), and usage pattern (p=0.02). After adjusting for confounders, CVS was significantly related to the use of mobile or tablet (adjusted OR, AOR 8.954, 95% CI 1.57 to 51.063), continuing online education for more than 12 hours/day without any break or insufficient break (AOR 7.654, 95% CI 1.625 to 36.053), and previous family (AOR 3.189, 95% CI 1.751 to 5.811) or personal history of eye problems or headaches, or insomnia (AOR 6.214, 95% CI 2.783 to 13.878). Conclusion A high prevalence of CVS was observed among the post-secondary students in Bangladesh. Since an extensive use of digital screens is somewhat unavoidable during unprecedented times, such as COVID-19, educators should include CVS awareness and prevention in their curricula. Copyright © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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Prior work has studied the interaction experiences of screen-reader users with simple online data visualizations (e.g., bar charts, line graphs, scatter plots), highlighting the disenfranchisement of screen-reader users in accessing information from these visualizations. However, the interactions of screen-reader users with online geospatial data visualizations, commonly used by visualization creators to represent geospatial data (e.g., COVID-19 cases per US state), remain unexplored. In this work, we study the interactions of and information extraction by screen-reader users from online geospatial data visualizations. Specifically, we conducted a user study with 12 screen-reader users to understand the information they seek from online geospatial data visualizations and the questions they ask to extract that information. We utilized our findings to generate a taxonomy of information sought from our participants' interactions. Additionally, we extended the functionalities of VoxLens-an open-source multi-modal solution that improves data visualization accessibility-to enable screen-reader users to extract information from online geospatial data visualizations. © 2022 Owner/Author.
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Background: Coronavirus, a common infectious disease in the 21st century, has not been studied enough in children. Therefore, this study aimed to investigate the clinical manifestations, laboratory findings, and outcomes of children with Covid-19 admitted to Shahid Beheshti Hospital in Kashan during 2020-2022.Method: In this retrospective cohort study, the medical records of children with covid-19 referred to Shahid Beheshti hospital in Kashan between February 2020 and March 2022 were reviewed. The information extracted from the patient's medical records included demographic variables, clinical characteristics, laboratory findings, and the outcome of covid-19. The collected data were analyzed through SPSS 16, using descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (chi-square test and ANOVA).Result: The findings of 271 children (159 boys;52% of the age group <= 5 years) showed that fever (57.6%), cough (39.9%), nausea-vomiting (31.7%), and diarrhea were the most common clinical symptoms. Also, the majority of patients were in the abnormal range in terms of Monocyte (89.3%), PTT (84.7%), Lymphocyte (83.6%), Neutrophil (80.4%), and LDH (74.5%). Pulmonary involvement was present in 12.5% of children. Finally, four children (1.5%) died. Conclusion: Severity of lung involvement and the outcome of the covid-19 disease (admission to the ICU and death) among children were at a low level, and in fact, it shows the better condition of children than adults in relation to this disease.
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The motivation behind conducting this research is to study the association between oil prices and Islamic and conventional stock indexes’ performance in the Malaysian market during COVID-19 using the wavelet analysis technique. The daily data on selected variables were collected from 1 January 2020, to 10 June 2021. Empirical investigation was made with wavelet analysis along with the Toda-Yamamoto test. The results revealed the significant response of both indexes to the oil price. Such response was negative for the short- and medium terms;however, it became positive in the long run. Our research has several important implications and recommendations for asset managers and policymakers. Policymakers and regulators should promote awareness and adopt effective action plans to minimize the risk of change in oil prices during the COVID-19 period. This research will enable investors, scholars, and policymakers to improve their current structure and prepare them for any potential future crisis. Copyright © 2022 Khan, Sharif, Islam, Ali, Fareed and Zulfaqar.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has numerous effects on different systemic organs other than the lungs. In this case report, we look at the presentation of a young female who was diagnosed with autoimmune hemolytic anemia (AIHA), kidney injury and thrombocytopenia during coronavirus disease 2019 (COVID-19) infection. She recovered well without the need for steroids. As demonstrated by this case, COVID-19 infection can be associated with the development of AIHA. The purpose of this report is to indicate that COVID-19 can present unusually with different clinical manifestations enough to require hospitalization.
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We aimed to determine the prevalence, characteristics, and risk factors associated with asymptomatic COVID-19 cases in a district setting in Malaysia. We included all confirmed COVID-19 cases within the district from inception to March 2021. Out of 3,051 confirmed COVID-19 cases, 1,862 (61.0%) were asymptomatic. Asymptomatic cases were mostly men, younger, non-Malaysians and had fewer comorbidities. The highest prevalence of asymptomatic cases was from prisons and factories. Male gender (adjusted OR 2.02;95%CI 1.69 – 2.43), non-Malaysians (adjusted OR 20.00;95%CI 14.75 – 27.64), current smoking status (adjusted OR 12.06;95%CI 6.74 – 23.94), prisoners (adjusted OR 19.02;95%CI 12.30 – 30.57), and higher CT values were significantly associated with asymptomatic COVID-19 infection. To ensure more targeted public health prevention and infection containment strategies, authorities and employers should be more aware of their local population's heterogeneity, risk factors, and unique conditions. © 2022. Malaysian Journal of Public Health Medicine. All Rights Reserved.
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The purpose of this systematic literature review is to review the major studies about misinformation and fake news during COVID-19 on social media. A total of 144 articles studies were retrieved from ScienceDirect, Scopus, and Web of Science databases and 20 relevant articles were selected using the PRISMA technique. It was found that altruism, instant news sharing, self-promotion, and socialization are predictors of fake news sharing. Furthermore, the human mind plays a significant role in spreading misinformation while the role of critical thinking of individuals is very much important in controlling the flow of misinformation. © 2020 Tahir Mumtaz Awan et al., published by De Gruyter.
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Klinefelter's syndrome is the most common chromosomal abnormality seen in men, affecting 1 in 650 men. It is a group of chromosomal disorders with at least one extra X chromosome (47, XXY) occurring due to non-disjunction at the time of gametogenesis. Most adult men are diagnosed at the time of fertility investigations. However, the syndrome has an array of clinical presentations which patients require input from numerous medical specialities during their lifetime. The setting up of a national-access Klinefelter Syndrome multidisciplinary clinic (KSMDT) approach comprising Urology, Endocrinology, Genetics, Reproductive medicine, Radiology, Psychosexual medicine, a specialist pharmacist as well as a patient representative has led to improvements in fertility and long- term management and waiting times. Here we describe the patient-reported outcomes and clinician perspectives of the clinic as it approached its 1st year. Between 2019 and 2020, 72 patients were seen in the adult KS MDT clinic. To assess the quality of care received in the clinic, an 8 -point feedback questionnaire was given to each patient attending the clinic to fill out at the end of the clinic. The form included a space for feedback for each speciality involved. The feedback forms were reviewed by 2 individual researchers and entries were assessed using an adapted Likert scale (0 – 5). Clinicians involved in the clinic were also encouraged to attend and rate the other specialties, the effectiveness of the pre and post clinic MDTs and to describe achievements derived from KSMDT clinic team-working. All the patients (n = 72) took the questionnaire reported that the clinic was beneficial to their understanding of KS & its management and had enough time during consultations. In terms of scoring 86% were very satisfied (score = 5) about genetic consultation compared to 92%, 82%, 82% and 88% in endocrine, fertility, psychosexual and urology consultation, respectively. Key factors influencing these positive results included the presence of an MDT, the access to a patient liaison and knowledge of support groups during the consult, digitized patient information sheets and a cohesive approach between endocrine and fertility teams. Clinician feedback was positive with all members agreeing that the pre and post clinic MDTs allowed effective pinpointing of often missed issues (e.g. hormone induction, social issues). Key milestones for the clinic included the reduction in waiting times by almost 80%, securing funding for costly hormone medication and assisted reproduction, improving sperm retrieval rates (from 11 – 29%) and a thrombo-embolism awareness programme. The overall patient and clinician feedback for the adult KSMDT clinic was uniformly positive, with the multispecialty approach allowing communication with and between all relevant specialities on the same day, avoiding the need to come for multiple separate appointments across different sites (especially relevant during the COVID-19 era). The feedback has also been useful in developing patient information tools such as digital resources and has led to the development of a supportive community group for newly diagnosed KS men. More research is underway to investigate the complex issues affecting KS men long term, after fertility management. Work supported by industry: no. [ FROM AUTHOR] Copyright of Journal of Sexual Medicine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Most children are diagnosed with Klinefelter's as part of investigating learning and behavioural difficulties or during prenatal screening. Klinefelter's is the most common chromosomal abnormality affecting men (1 in 650) and is associated with a large spectrum of clinical manifestations including learning, behavioural and developmental delays. The optimal management of this condition involves many different specialties, as seen in the development of adult Klinefelter multidisciplinary team (KSMDT) clinics. Unfortunately, young patients are often outside the remit of these adult clinics, and often experience major gaps and delays to the patient pathway, with a lack of coordination in areas such as hormone replacement therapy, psychological & educational support and fertility counselling. Based on this, a national survey was carried out to assess the needs of young (16-20) Klinefelter Syndrome patients which led to the setting up a young person's KSMDT clinic model for KS. We report on the patient and clinician reported feedback in the first 6 months of this clinic. The structure of the pilot young person's KSMDT clinic included input from endocrinologists, a fertility team of urologists & reproductive medicine doctors, a psychology team involving both clinical and educational psychology, a neurodisability team, genetics specialists as well as a specialist pharmacist and a patient liaison. Each consult was specifically structured to the patient's priorities, with both the patient and parent invited to attend and to separately indicate these priorities. Ten patients (mean age 17, range 16 – 20) were seen in the first clinic. To assess the quality of care received in the clinic, an 8 -point feedback questionnaire was given to each patient & parent attending the clinic to fill out at the end of the clinic. The form included a space for feedback for each speciality involved. The feedback forms were reviewed by 2 individual researchers and entries were assessed using an adapted Likert scale (0 – 5). Clinicians involved in the clinic were also encouraged to attend and rate the other specialties, the effectiveness of MDT clinic. All patients & parents were satisfied about the structure of clinic, the provision and management plans. 94% of patients indicated they were very satisfied (score = 5) about endocrine consultation compared to 100%, 90% and 88% in genetic, neurodisability/psychology and fertility consultations respectively. Key factors influencing these positive results included the presence of detailed fertility counseling, access to patient support groups and having a transition plan to the adult KSMDT clinic. Clinician feedback was positive with all members agreeing that the pre and post clinic MDTs allowed effective discussion of complex issues such as hormone initiation, future fertility as well as socio-educational factors affecting the well-being of the patient. The overall patient and clinician feedback for the young person's KSMDT clinic was uniformly positive, with the multispecialty approach allowing communication with and between all relevant specialities on the same day, avoiding the need to come for multiple separate appointments across different sites (especially relevant during the Covid era). A fully fledged clinic is now running based on the feedback and insight provided from the pilot process, with a seamless transition of these young patients to our adult KSMDT clinic to continue to support them. Work supported by industry: no. [ FROM AUTHOR] Copyright of Journal of Sexual Medicine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Background: Multisystem Inflammatory Syndrome in Children (MISC) is a phenomenon that appeared in children infected with or exposed to SARS-CoV-2. The typical onset of MISC is 4-6 weeks following SARS-CoV-2 infection and is formulated to be due to an immune response. Methods: : Our study retrospectively analyzed data from a tertiary center in UAE of MISC patients who were admitted to either general pediatric wards or pediatric intensive care (PICU) or who came exclusively for follow-up (post PICU admission) from May 2020 to August 2021. Results: : The total sample size is 50 patients and the study included a comparison of PICU admissions with none PICU admissions. The PICU sample size was 18 patients, 50% females, with mean age of 8.3 years all were previously healthy. PICU patients had deranged blood counts with a lower hemoglobin count, a more pronounced lymphopenia and thrombocytopenia along with hypoalbuminemia. PICU patients presented with relatively higher inflammatory markers: CRP, PCT, ferritin and D-dimer. Immunological studies were significantly higher for IL-6 levels in PICU patients. On echocardiography, higher myocardial dysfunction was more notable in patients admitted to PICU. Children admitted in PICU were provided with more extensive therapy. As part of our study course, we re-evaluated our PICU patients twice, once at 48 hours post PICU admission and again 4-6 weeks after discharge from the hospital. No deaths have been recorded in the cohort. Conclusion: This study evaluated risk factors of MISC and potential severity features. Follow up of patients on discharge showed improvement across all domains.
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Cryopyrin-Associated Periodic Syndromes , Thrombocytopenia , Hypoalbuminemia , COVID-19 , Cardiomyopathies , LymphopeniaABSTRACT
This study investigates the impact of uncertainty and volatility on ten Islamic stock returns using monthly data for from 2011:M5 to 2021:M5. We rely on the continuous wavelet transform and wavelet coherence ratios, which allows decomposition of time series across time scales to investigate the causal relationship between stock market returns, economic policy uncertainty and volatility. Our results provide some interesting insights. First, economic policy uncertainty, in general, has a negative effect on the majority of Islamic stock returns, except for the Dow Jones Islamic Market (DJIM). Second, volatility has a significant positive impact on most of the Islamic stock returns in various countries. Third, both economic policy uncertainty and volatility have a greater impact on the Islamic stock returns post-COVID-19 outbreak. These results should assist investors to re-evaluate their portfolios to fully maximize the potentials of these Islamic stock markets. Policymakers could use these results to design policies to reduce economic policy uncertainty as well as to cushion the impact of externally generated uncertainties. © 2022 AESS Publications.
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BACKGROUND: The UK began delivering its COVID-19 vaccination programme on 8 December 2020, with health and social care workers (H&SCWs) given high priority for vaccination. Despite well-documented occupational exposure risks, however, there is evidence of lower uptake among some H&SCW groups. METHODS: We used a mixed-methods approach-involving an online cross-sectional survey and semi-structured interviews-to gain insight into COVID-19 vaccination beliefs, attitudes, and behaviours amongst H&SCWs in the UK by socio-demographic and employment variables. 1917 people were surveyed- 1656 healthcare workers (HCWs) and 261 social care workers (SCWs). Twenty participants were interviewed. FINDINGS: Workplace factors contributed to vaccination access and uptake. SCWs were more likely to not be offered COVID-19 vaccination than HCWs (OR:1.453, 95%CI: 1.244-1.696). SCWs specifically reported uncertainties around how to access COVID-19 vaccination. Participants who indicated stronger agreement with the statement 'I would recommend my organisation as a place to work' were more likely to have been offered COVID-19 vaccination (OR:1.285, 95%CI: 1.056-1.563). Those who agreed more strongly with the statement 'I feel/felt under pressure from my employer to get a COVID-19 vaccine' were more likely to have declined vaccination (OR:1.751, 95%CI: 1.271-2.413). Interviewees that experienced employer pressure to get vaccinated felt this exacerbated their vaccine concerns and increased distrust. In comparison to White British and White Irish participants, Black African and Mixed Black African participants were more likely to not be offered (OR:2.011, 95%CI: 1.026-3.943) and more likely to have declined COVID-19 vaccination (OR:5.550, 95%CI: 2.294-13.428). Reasons for declining vaccination among Black African participants included distrust in COVID-19 vaccination, healthcare providers, and policymakers. CONCLUSION: H&SCW employers are in a pivotal position to facilitate COVID-19 vaccination access, by ensuring staff are aware of how to get vaccinated and promoting a workplace environment in which vaccination decisions are informed and voluntary.
Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Caregivers/psychology , Health Personnel/psychology , Vaccination Refusal/psychology , Vaccination/psychology , Adult , COVID-19/epidemiology , COVID-19/immunology , COVID-19 Vaccines/supply & distribution , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , United Kingdom/epidemiology , Vaccination Coverage/organization & administration , Vaccination Coverage/statistics & numerical data , Vaccination Refusal/statistics & numerical dataABSTRACT
Purpose The use of social media has increased during the COVID-19 pandemic. Social media platforms provide opportunities to share news, ideas and personal stories. Twitter is used by citizens in Pakistan to respond and comment on emerging news stories and events. However, it is not known whether Twitter played a positive or negative role in spreading updates and preventive messages during the COVID-19 pandemic. The purpose of this study is to analyse content from Twitter during the pandemic. Design/methodology/approach NodeXL was used to retrieve data using the keyword (written in Urdu and which translates to Coronavirus). The first data set (Case Study 1) was based on 10,284 Twitter users from the end of March. The second data set (Case Study 2) was based on 10,644 Twitter users from the start of April. The theoretical lens of effective message framing was used to classify the most retweeted content on Twitter. Findings Twitter was used for personal and professional projections and included certain tweets included political motives even during the unfolding health crisis. There appeared to be very few successful attempts to use Twitter as a tool for health awareness and risk communication. The empirical findings indicate that the most retweeted messages were gain-framed and can be classified as personal, informative and political in nature. Originality/value The present study provides insights likely to be of interest to researchers, health organizations, citizens, government and politicians that are interested in making more effective use of social media for the purposes of health promotion. The authors also provide novel insights into the key topics of discussions, websites and hashtags used by Pakistani Twitter users during the COVID-19 pandemic.
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Introduction: Since mid-April 2020, infection with coronavirus disease of 2019 (COVID-19) has affected more than 2 million people worldwide. Little is known about the effects of COVID-19 infection on kidney transplant patients treated with immunosuppressive (IS) drugs. Case Presentation: Here, we report three Iranian pediatric kidney transplantation cases who acquired COVID-19 infection and were admitted to Hazrat Ali Asghar Hospital in Tehran, Iran, in March-April 2020 (first wave). They were treated with prednisolone, cy-closporine, and cellcept. All of them had gastrointestinal symptoms, and one patient also had respiratory symptoms. In two patients who had only gastrointestinal symptoms, chest radiographies were considered normal. They did not need the intensive care unit (ICU), ventilator respiratory support, and dialysis due to a temporary increase in serum creatinine and no change in urine volume. Cellcept was stopped and other medications continued. The patient, who had pulmonary and gastrointestinal symptoms, expressed more severe manifestations that led to ICU admission and dialysis. Prednisolone was increased to a stress dose and the other drugs were discontinued. Conclusions: Pulmonary manifestations significantly worsen the prognosis compared to gastrointestinal manifestations in pediatric kidney transplants with COVID-19.
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Pilonidal sinus is a skin lesion comprising of a cavity at the attachment of hairs in inter gluteal cleft. The sinus gets filled with air, dirt, moisture and debris. The condition is painful, discomforting and disgracing. The victims are young and obese individual with history of trauma and a hairy body. The condition can reoccur with conservative treatment. Here we present case report of two young adolescent boy and girl who are first cousins too. Both of them are of same age, but were given two different treatments to avoid reoccurrence.