A global review of racial, ethnic and socio-economic disparities in multisystem inflammatory syndrome in children related to COVID-19.

With over 500 million confirmed cases and 6.2 million deaths worldwide, the novel coronavirus has highlighted the underlying disparities in healthcare, unpreparedness to deal with a new disease and the need for monitoring and surveillance for a post-infectious syndrome as well as complicated diseases. Initially, children were thought to be spared but reports of a new phenomenon manifesting as Kawasaki-like disease, toxic shock syndrome, and multi-system inflammatory syndrome, which developed after a few weeks of severe COVID-19 infection, emerged in the pediatric population. As the pandemic progressed, increased prevalence of multi-system inflammatory syndrome in children (MIS-C) related to COVID-19 was seen in non-Hispanic blacks, Asians, and Latinos as compared to the white population drawing attention to a possible role of ethnicity and socio-economic disparities. The CDC currently reports that 31% of MIS-C cases were seen in Black Non-Hispanics and 26% in Latinos, who were historically more affected in previous pandemics. Furthermore, MIS-C cases in developing countries showed higher mortality as compared to high-income countries, which points toward the role of social determinants of health and limitations in a low-resource set up in increasing the disease burden of MIS-C, which should be treated as a public health emergency. Our review highlights the role of ethnicity, socio-economic factors, comorbidities, and differences in populations affected by MIS-C in high-income vs. low- and middle-income countries.

SARS-CoV-2 vaccine-associated-tinnitus: A review.

The global vaccination drive against severe acute respiratory syndrome coronavirus-2 is being pursued at a historic pace. Unexpected adverse effects have been reported following vaccination, including thrombotic thrombocytopenia, myocarditis, amongst others. More recently, some cases of tinnitus are reported post-vaccination. According to the Vaccine Adverse Events Reporting System (VAERS), 12,247 cases of coronavirus post-vaccination tinnitus have been reported till September 14, 2021. To the best of our knowledge, this is the first review evaluating any otologic manifestation following vaccine administration and aims to evaluate the potential pathophysiology, clinical approach, and treatment. Although the incidence is infrequent, there is a need to understand the precise mechanisms and treatment for vaccine-associated-tinnitus.

Hematological and biochemical parameters as diagnostic and prognostic markers in SARS-COV-2 infected patients of Pakistan: a retrospective comparative analysis.

Objectives: This study was conducted to investigate alteration in blood parameters and their association with the presence, severity, and mortality of COVID-19 patients as the data on hematological abnormalities associated with the Pakistani COVID-19 patients is limited.Methodology: A double-centered, hospital-based comparative retrospective case study was conducted, to include all the admitted patients (n = 317) having COVID-19 Polymerase chain reaction (PCR) positive. The control group (n = 157) tested negative for COVID-19.Results: Of 317 admitted cases, the majority were males n = 198 (62.5%). Associated comorbidities, lower lymphocytes, platelets, and higher White blood cells, neutrophil, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were found in COVID-19 cases as compared to healthy controls (p < 0.001 for all). The biochemical parameters of cases including Ferritin, D-Dimer, CRP, IL-6, LDH, ALT, AST, and APTT also showed a statistically significant difference compared with standard values (p < 0.001 for all). However, their comparison with a severity level of the severe and non-severe groups showed significance for WBCs, neutrophils, NLR (p < 0.001 for all), and PLR (p = 0.06) only. Receiver operating characteristic curve analysis showed that NLR had the highest area under curve (0.84) followed by 1/lymphocyte (0.82), neutrophils (0.74), PLR (0.67),1/platelets (0.68) and WBC's (0.65). Comparison of cases and controls with recommended cut-off values derived from sensitivity and 1-specificity was also done (p < 0.001).Conclusion: Monitoring all the hematological and biochemical parameters including novel hemograms NLR, PLR can aid clinicians to identify potentially severe cases at early stages and initiate effective management in time which may reduce the overall mortality of COVID-19 patients.

Implementasi Model Kesuksesan Sistem Informasi Delone And Mclean Terhadap Sistem Pembelajaran Berbasis Aplikasi Zoom Di Saat Pandemi COVID-19

Investasi dalam sistem informasi saat ini memiliki dampak yang signifikan terhadap aspek yang multidimensional dalam artian mencakup berbagai aspek dalam kehidupan berbisnis seperti perbankan, pendidikan, kepariwisataan dan lainnya karena sistem informasi memainkan peran penting dalam memberikan pelayanan yang lebih baik dan keunggulan kompetitif. Tidak terlepas pada dunia pendidikan dimasa saat ini kondisi dunia dan Indonesia mengalami pendemi COVID-19 sehingga himbauan pemerintah yang menyatakan bekerja dari rumah (work from home), social distancing serta penyesuaian sistem kerja bukan berarti pelayan public dan pembelajaran dihentikan, namun semua aktivitas dilakukan dengan bantuan teknologi informasi atau secara online. Salah satu media atau aplikasi yang biasa digunakan untuk sistem pembelajaran adalah aplikasi zoom. Peningkatan penggunaan aplikasi yang pesat menarik peneliti untuk melihat implementasi dari model yang diterapkan oleh DeLone dan McLean dimana model kesuksesan sistem dapat dilihat dari sisi kualitas sistem, kualitas informasi dan kualitas pelayanan serta kebutuhan dan kepuasan dari pengguna informasi. Penelitian ini merupakan explanatory research, lokasi penelitian ini dilakukan di kota Malang Jawa Timur. Populasi dalam penelitian ini adalah semua orang yang pernah menggunakan aplikasi zoom dalam beraktivitas terutama bidang pendidikan dengan jumlah sampel 180 responden. Pengumpulan data dengan penyebaran kuesioner, karena kondisi pandemic COVID-19 dengan pentingnya menerapkan Social Distancing maka penyebaran kuesioner dilakukan secara online. Teknik analisis data menggunakan Analisis Statistik Deskriptif, Analisis data menggunakan SEM dan Pengujian Hipotesis. Hasil dari penelitian ini system quality berpengaruh positif terhadap User Satisfaction, Information Quality berpengaruh positif terhadap User Satisfaction, Service Quality berpengaruh positif terhadap User Satisfaction dan User Satisfaction berpengaruh positif terhadap Net Benefit. 

Evaluation of hematological parameters as an indicator of disease severity in Covid-19 patients: Pakistan's experience.

BACKGROUND: The severity of COVID-19 could be evaluated by examining several blood parameters mainly white blood cell (WBC) count, granulocytes, platelet, and novel hemocytometric markers neutrophils to lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), and lymphocyte to monocyte ratio (LMR). The current study was conducted to investigate alteration in blood parameters and their association with the severity and mortality of COVID-19 patients. METHODOLOGY: An observational cross-sectional study was conducted retrospectively, a total of 101 COVID-19 positive patients were examined: 52 were mild, 24 were moderate, 09 were severe, and 16 were critically diseased patients. We also recorded 16 deaths associated with the critical group. The overall mean age observed in our study was 48.94 years, where the mean age for critical individuals was 62.12 ± 14.35 years. RESULTS: A significant association between the disease severity and elevation in blood parameters were observed. The WBC's and granulocyte count were significantly increased (p value <0.001) while the mean platelet count (165.0 × 109 /L) and red blood cell volume distribution width (RDW) were decreased in the critical group (57.86%) compared to mild group's patients (177.3%) (p = 0.83). The lymphocytes count was decreased in critical patients (1.40 × 109 /L) compared to mild patients (1.92 × 109 /L) (p = 0.28). A significant association was observed in platelet-lymphocyte ratio (p < 0.001), Neutrophil-Lymphocyte ratio (p = <0.001), and Lymphocyte-Monocyte ratio (0.011). CONCLUSION: These blood parameters could be used as a suitable biomarker for the prognosis and severity of COVID-19. Evaluating novel hemograms NLR, PLR, and LMR can aid clinicians to identify potentially severe cases at early stages, initiate effective management in time, and conduct early triage which may reduce the overall mortality of COVID-19 patients.

The COVID-19 ratio in Pakistan: A Gender Disparity

The COVID-19 outbreak, which was first experienced in China and rapidly spread in 212 countries/regions of the world including Pakistan. It affected both males and females, but the ratio of males is higher than females worldwide. According to the Ministry of National Health Services, Regulation and Coordination of Pakistan, the female ratio is much lower than male in Pakistan (3.6% vs 6.7%). The study mainly focused on the main reasons and possibilities that COVID-19 affected men more than women worldwide, especially in Pakistan. The biological, social, professional, religious, and cultural aspects make a gender disparity in the COVID-19 ratio in Pakistan.

COVID-19 Incidence in Pakistan: Gender Disparity

Context: The COVID-19 outbreak was first experienced in China and rapidly spread to 212 countries/regions of the world, including Pakistan. It has affected both males and females, but the incidence is higher in males than in females worldwide. Evidence Acquisition: According to the Ministry of National Health Services, Regulation, and Coordination of Pakistan, the female infection rate is much lower than the male infection rate in Pakistan (3.6% vs. 6.7%, respectively). What are the main possible reasons that created gender disparity in COVID-19 incidence in Pakistan? We reviewed different factors that created gender disparity in COVID-19 Incidence in Pakistan. Results: The biological differences, social, professional, religious, psychological factors, cultural, and lifestyle aspects have created a gender disparity in COVID-19 incidence in Pakistan. Conclusion: This study mainly focused on the main possible reasons (mentioned above) that COVID-19 has affected men more than women worldwide, especially in Pakistan.

Impact of COVID-19 on polio vaccination in Pakistan: a concise overview.

The pandemic of coronavirus disease 2019 (COVID-19) has disrupted immunization programs around the globe, potentially increasing life-threatening vaccine-preventable diseases. Pakistan and Afghanistan are the only countries, which are still struggling to eradicate wild poliovirus. All vaccination campaigns in Pakistan were suspended in April due to the COVID-19 outbreak, leading 40 million children to miss out on polio vaccination. Like the climate crisis, the COVID-19 pandemic could be regarded as a child-rights crisis because it could have life-threatening impact over children, who need immunization, now and in the long-term. Delays in polio vaccination programs might not have immediate impact but, in the long-term, the increase in polio cases in Pakistan could result in the global export of infections. Therefore, healthcare authorities must intensify their efforts to track and vaccinate unvaccinated children in countries like Pakistan and Afghanistan. Polio vaccination campaigns need to resume immediately, so we suggest applying social distancing measures along with standard operating procedure to flatten the transmission curve of COVID-19. Furthermore, the concurrent emergence of cVDPV2 means that tOPV should temporarily be used for primary immunization. In the current review, we have discussed delays in polio vaccination, surveillance of polio viruses, reported cases in Pakistan along with recommendations to overcome interrupted immunization.