Predicting Delayed Shock in Multisystem Inflammatory Disease in Children: A Multicenter Analysis From the New York City Tri-State Region.

OBJECTIVES: Patients with multisystem inflammatory disease in children (MIS-C) are at risk of developing shock. Our objectives were to determine independent predictors associated with development of delayed shock (≥3 hours from emergency department [ED] arrival) in patients with MIS-C and to derive a model predicting those at low risk for delayed shock. METHODS: We conducted a retrospective cross-sectional study of 22 pediatric EDs in the New York City tri-state area. We included patients meeting World Health Organization criteria for MIS-C and presented April 1 to June 30, 2020. Our main outcomes were to determine the association between clinical and laboratory factors to the development of delayed shock and to derive a laboratory-based prediction model based on identified independent predictors. RESULTS: Of 248 children with MIS-C, 87 (35%) had shock and 58 (66%) had delayed shock. A C-reactive protein (CRP) level greater than 20 mg/dL (adjusted odds ratio [aOR], 5.3; 95% confidence interval [CI], 2.4-12.1), lymphocyte percent less than 11% (aOR, 3.8; 95% CI, 1.7-8.6), and platelet count less than 220,000/uL (aOR, 4.2; 95% CI, 1.8-9.8) were independently associated with delayed shock. A prediction model including a CRP level less than 6 mg/dL, lymphocyte percent more than 20%, and platelet count more than 260,000/uL, categorized patients with MIS-C at low risk of developing delayed shock (sensitivity 93% [95% CI, 66-100], specificity 38% [95% CI, 22-55]). CONCLUSIONS: Serum CRP, lymphocyte percent, and platelet count differentiated children at higher and lower risk for developing delayed shock. Use of these data can stratify the risk of progression to shock in patients with MIS-C, providing situational awareness and helping guide their level of care.

The role of telehealth in pediatric emergency care

In 2006, the Institute of Medicine published a report titled "Emergency Care for Children: Growing Pains,” in which it described pediatric emergency care as uneven at best. Since then, telehealth has emerged as one of the great equalizers in care of children, particularly for those in rural and underresourced communities. Clinicians in these settings may lack pediatric‐specific specialization or experience in caring for critically ill or injured children. Telehealth consultation can provide timely and safe management for many medical problems in children and can prevent many unnecessary and often long transport to a pediatric center while avoiding delays in care, especially for time‐sensitive and acute interventions. Telehealth is an important component of pediatric readiness of hospitals and is a valuable tool in facilitating health care access in low resourced and critical access areas. This paper provides an overview of meaningful applications of telehealth programs in pediatric emergency medicine, discusses the impact of the COVID‐19 pandemic on these services, and highlights challenges in setting up, adopting, and maintaining telehealth services.

Towards a Deep Learning Pain-Level Detection Deployment at UAE for Patient-Centric-Pain Management and Diagnosis Support: Framework and Performance Evaluation.

The outbreak of the COVID-19 pandemic revealed the criticality of timely intervention in a situation exacerbated by a shortage in medical staff and equipment. Pain-level screening is the initial step toward identifying the severity of patient conditions. Automatic recognition of state and feelings help in identifying patient symptoms to take immediate adequate action and providing a patient-centric medical plan tailored to a patient's state. In this paper, we propose a framework for pain-level detection for deployment in the United Arab Emirates and assess its performance using the most used approaches in the literature. Our results show that a deployment of a pain-level deep learning detection framework is promising in identifying the pain level accurately.

Perceived Organizational Support and Reduced Job Performance During COVID-19.

Current research aims to identify a framework to enhance the performance of employees in government sector healthcare during the COVID-19 pandemic. Perceived organizational support was identified to enhance employees' performance through the intervention of a psychological process containing 3 states, that is, psychological safety, felt obligation and organization-based self-esteem. Job performance is considered as planned behavior, and psychological links are developed on the basis of the theory of planned behavior. This study is quantitative and used an empirical survey. Respondents of the study were nursing staff of government hospitals in Pakistan. The data were collected during the first wave of COVID-19 in Pakistan through online distributed questionnaires, and the data were analyzed using Smart PLS. Results show that perceived organizational support positively affects job performance during the COVID-19 crisis, and all the psychological states mediate the relationship. The study results are helpful for decision-makers of public sector organizations dealing with the most common problem of performance reduction during COVID-19. Results are also helpful for policymakers to address reduced performance in most government hospitals. Future research should consider antecedents of the perception of organizational support in the context of government and private hospitals.

Internal Carotid Artery Dissection With Thrombosis in a Child With Prothrombin Gene Mutation.

Prothrombin gene mutation (prothrombin thrombophilia) is an inherited disorder that increases the risk of venous thrombosis. However, limited data exist on the risk of arterial stroke in an at-risk population. Several meta-analyses report slightly increased risk in specific populations. We report a 10-year-old Hispanic girl who presented to the emergency department with a seizure. This seizure occurred five days after she tripped and fell without any initial associated symptoms. She had left-sided hemiparesis on physical examination after the seizure. Imaging revealed internal carotid artery (ICA) dissection with thrombus, right caudate nucleus and putamen infarcts, and ischemic penumbra. She subsequently had an endovascular thrombectomy of the right ICA with reperfusion. Genetic testing showed a prothrombin gene mutation (G20210A). Prothrombin gene mutation was the most likely explanation for her stroke in the absence of a significant risk factor for arterial thrombosis or an underlying hypercoagulable disorder. Further investigations are required to determine the risks and evaluate the correlation between prothrombin gene mutation and ischemic stroke in children.

The Biological Causes and Consequences of COVID-19: ACE I/D Polymorphism and In-Silico Screening of Potential Bioactive Phytochemicals Against COVID-19.

The "Severe Acute Respiratory Syndrome" (SARS), which has relation to the coronavirus-2 considered to be a major cause of the disease addressed by COVID-19. COVID-19 requires the angiotensin converting enzyme 2 (ACE-2), which is considered to be the target receptor of the host cells. The intention of this practical research study was to observe ACE I/D polymorphism association with COVID-19 and also the in-silico screening of potential phytochemicals against COVID-19. This study incorporated total of 320 blood samples; of which 160 were collected from COVID-19 patients and 160 were collected from healthy controls. DNA extraction was conducted from whole genomic blood and afterward, the banding patterns of ACE polymorphism were identified by the application of a nested polymerase chain reaction. A significant discrepancy was recorded in the frequency of insertion/deletion (ID) and homozygous deletion (DD) between controls and patients. The frequency reported for ID was just 10% and that of DD (genetic constitution) was 90%. Predictably, a 100% DD genetic constitution was shown by all the controls. The inference of this study was that the DD genotype has a greater prevalence in COVID-19 as compared to II and ID. In-silico screening of potential phytochemicals against COVID-19 is very effective in its concentrated form showing no or fewer side effects and can be used as a drug against COVID-19 spike protein blockage to inhibit the interaction between ACE-2 receptors. The highest affinity and lowest binding energy were observed by Dictaminine.

Multisystem Inflammatory Syndrome in Children.

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a newly recognized condition affecting children with recent infection or exposure to coronavirus disease 2019 (COVID-19). MIS-C has symptoms that affect multiple organs systems, with some clinical features resembling Kawasaki disease (KD) and toxic shock syndrome (TSS). OBJECTIVE OF THE REVIEW: Our goal was to review the current literature and describe the evaluation and treatment algorithms for children suspected of having MIS-C who present to the emergency department. DISCUSSION: MIS-C has a wide clinical spectrum and diagnosis is based on a combination of both clinical and laboratory findings. The exact mechanism of immune dysregulation of MIS-C is not well understood. Physical findings may evolve and do not necessarily appear at the same time. Gastrointestinal, cardiac, inflammatory, and coagulopathy manifestations and dysfunction are seen frequently in MIS-C. CONCLUSIONS: The diagnosis of MIS-C is based on clinical presentation and specific laboratory findings. In the emergency setting, a high level of suspicion for MIS-C is required in patients exposed to COVID-19. Early diagnosis and prompt initiation of therapy offer the best chance for optimal outcomes.

Perception of faculty towards e-learning vs. traditional learning in a public sector medical college

Objective: To evaluate the perception of medical teaching faculty of a public sector medical college in Pakistan and the barriers in e-learning methodologies according to faculty's opinion. Study Design: Analytical Cross-Sectional Study. Setting: Department of Medical Education, Sahiwal Medical College Sahiwal. Study Period: 1st April 2020 to 30th April 2020. Material & Methods: The questionnaire was sent to all the faculty members through Whatsapp due to COVID-19 pandemic in Pakistan. Mean scores were calculated by using SPSS-26. Results: A total of sixty six faculty members responded to the questionnaire while it was sent to all 72. So the response rate of our study is 91.66%. According to our results, external sources barrier questions were found to be of highest mean value of 10.64 with standard deviation of 4.64. Internal source barriers were found to have least of the means value of 5.39 with standard deviation of 2.41. Motivation related to e-learning was with highest mean score of 2.67 and with standard deviation of 0.591. Lack of central policy was found to be of major concern by the respondents with mean value of 1.15 and standard deviation of 0.361. Conclusion: This study found that motivation towards e-learning as the most dominant factor. Also external sources barriers were predominately revealed in the college such arrangements are required to speedily guarantee that fast web get to and dependable systems are accessible at the higher education institutions. [ FROM AUTHOR] Copyright of Professional Medical Journal is the property of Professional Medical Journal 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.)

A Cross-sectional Study of Antecedents and Consequence of Panic Buying Behavior: The Moderating Effect of COVID-19 Rumors.

The novel corona virus pandemic has influenced people buying behaviors. Due to the significant psychological and behavioral impact of COVID-19 on society, this study aimed to examine the determinants of panic buying behavior and a resultant psychological outcome in the form of a sense of security. The purpose of this study is to investigate the effect of COVID-19 caller ringback tone (CRT) experiences, that is, informational and stimulation experience, on the panic buying behavior and how rumors moderate this relationship. This research is quantitative and uses a purposive sampling method to collect the survey-based data from 264 respondents. The researchers analyzed the data using Partial Least Square Structural Equation Modeling (PLS-SEM). The results of data analysis indicated that the informational and stimulation experience of COVID-19 CRT had a significant influence on panic buying behavior which further resulted in a sense of security in public. This study could not find evidence of the moderating role of rumors in the relationship between COVID-19 CRT experiences and panic buying behavior. The findings highlight the role of the COVID-19 CRT in causing panic buying behavior and resultant psychological outcome and thus provide implications for policymakers on the control of panic buying under COVID-19.

Multisystem Inflammatory Syndrome in Children.

Multisystem inflammatory syndrome in children (MIS-C) is an uncommon but emerging syndrome related to SARS-CoV-2 infection. While the presentation of MIS-C is generally delayed after exposure to the virus that causes coronavirus 2019, both MIS-C and Kawasaki disease (KD) share similar clinical features. Multisystem inflammatory syndrome in children poses a diagnostic and therapeutic challenge given the lack of definitive diagnostic tests and a paucity of evidence regarding treatment modalities. We review the clinical presentation, diagnostic evaluations, and management of MIS-C and compare its clinical features to those of KD.

Investigation and analysis of effective approaches, opportunities, bottlenecks and future potential capabilities for digitalization of energy systems and sustainable development goals

Taking into consideration of substantial role of energy system and sustainable development goals (SDGs) in modern society, it is critical to analyse current situation and forthcoming renewable energy development strategies under the impact of COVID-19. For this purpose, this paper provides significant new insights to assess effective approaches, opportunities, challenges and future potential capabilities for the development of energy systems and SDGs under on-going pandemic and in case of a future global crisis. The digital energy systems with Industry 4.0 (I4.0), which provide noteworthy solutions such as enhancing energy efficiency policy, providing clean, secure and efficient energy and achieving SDG targets, has been discussed and evaluated. Integration of the smart grid (SG) architecture with blockchain-Internet of Things (IoT)-based technologies is also offered. Alongside the various discussions, short-term, mid-term and long-term plans have been suggested in determining the well-defined renewable energy development and SDGs targets, struggling with climate change, transition to a more sustainable energy future and reaching global net-zero emissions. To achieve SDGs and provide more strong and sustainable energy systems under the continuing pandemic and in case of potential risk of forthcoming global crisis, this paper reveals significant perceptions that inform politicians and legislators in performing successful policy decisions.

Addition of Midthigh Circumference Improves Predictive Ability of Broselow Tape Weight Estimation.

OBJECTIVES: This study aimed to improve the accuracy of Broselow tape (BT) weight prediction by adding midthigh circumference (MTC) and to compare and standardize the methods for measuring MTC. METHODS: This prospective, observational study was conducted in a pediatric emergency department of a tertiary care children's hospital. Children up to 12 years of age presenting to emergency department were included. Children were excluded if obtaining the data would interfere with their acute management. The data collected included MTC, height, BT weight, and actual weight. Three models were built. Broselow tape-only model and MTC plus BT model used 2 methods for MTC measurements: visual approximation of thigh midpoint (visual MTC1) and Centers for Disease Control and Prevention (CDC)-defined method (CDC MTC2). RESULTS: A total of 430 children were enrolled during pre-coronavirus disease era. Of these, 234 were boys (54.4%) and 196 (45.6%) were girls. Data were categorized into children younger than 2 years (224 [52.1%]) and older than 2 years (206 [47.9%]). African American constituted 250 (58%); White, 136 (31%); and unspecified, 27 (6%). For the entire cohort, both models that included MTC were significantly better at weight prediction with larger adjusted R2 (visual MTC1, 0.921; CDC MTC2, 0.928) and smaller root mean squared (RMSE) (visual MTC1, 2.70; CDC MTC2, 2.56) compared with BT-only model (adjusted R2 = 0.843; RMSE, 3.80). Midthigh circumference plus BT models performed even better in children older than 2 years compared with BT-only model with adjusted R2 (visual MTC1, 0.859; CDC MTC2, 0.872 vs 0.616) and RMSE (visual MTC1, 3.18; CDC MTC2, 3.03 vs 5.27). CONCLUSIONS: The inclusion of MTC with BT resulted in a more accurate weight prediction in children especially greater than 2 years old. Midthigh circumference model using CDC-defined method was slightly better predictor of actual weight than visual approximation.

The progress, impact analysis, challenges and new perceptions for electric power and energy sectors in the light of the COVID-19 pandemic

Understanding the COVID-19 crisis that arose in 2019 is a significant important case study to prepare scenarios and meet electrical energy consumption and high renewable energy production (REP), especially in the context of the power systems. Although many researchers have investigated the medical field and electric power sectors associated with the COVID-19 pandemic, critical factors affecting the development of the REP like electric demand, power system, electric markets, economy, and environment have are still not studied in great detail. In this perspective, this paper analyses the impact of the COVID-19 outbreak on the development of the REP, electrical energy consumption, power system maintenance, electric markets, energy demand, ongoing investment projects/investment plans, economy and renewable energy sectors. Estimation of energy demand based on cooling degree days (CDDs) and heating degree days (HDDs) methods has been examined and contrasted with the same period in prior years to observe electricity consumption Besides, climate change and energy efficiency or energy intensity related to the energy demand have been investigated and analysed before and following the pandemic. Some important energy statistical data is addressed and examined in detail. In addition to these, various critical factors such as driver and barrier forces affecting the REP has been discussed during lockdown restrictions of the COVID-19. These findings will help researchers and academicians to analyse the far-reaching implications of the COVID-19 outbreak on the energy demand and contribute to figuring out and plan higher renewables share scenarios and power system management issues.

Pediatric emergency care in New York City during the COVID-19 pandemic shutdown and reopening periods.

OBJECTIVE: New York City (NYC) is home to the largest public healthcare system in the United States and was an early epicenter of coronavirus disease 2019 (COVID-19) infections. This system serves as the safety net for underserved and marginalized communities disproportionately affected by the pandemic. Prior studies reported substantial declines in pediatric emergency department (ED) volume during the initial pandemic surge, but few describe the ongoing impact of COVID-19 throughout the year. We evaluated the characteristics of pediatric ED visits to NYC public hospitals during the pandemic lockdown and reopening periods of 2020 compared to the prior year. METHODS: Retrospective cross-sectional analysis of pediatric ED visits from 11 NYC public hospitals from January 2019-December 2020. Visit demographics, throughput times, and diagnosis information during the early (3/7/20-6/7/20) and late (6/8/20-12/31/20) pandemic periods coinciding with the New York State of emergency declaration (3/7/20) and the first reopening date (6/7/20) were compared to similar time periods in 2019. Findings were correlated with key pandemic shutdown and reopening events. RESULTS: There was a 47% decrease in ED volume in 2020 compared to 2019 (125,649 versus 238,024 visits). After reopening orders began in June 2020, volumes increased but peaked at <60% of 2019 volumes. Admission rates, triage acuity, and risk of presenting with a serious medical illness were significantly higher in 2020 versus 2019 (P < 0.001). Time-to-provider times decreased however provider-to-disposition times increased during the pandemic (P < 0.001). Infectious and asthma diagnoses declined >70% during the pandemic in contrast to the year prior. After reopening periods began, penetrating traumatic injuries significantly increased compared to 2019 [+34%, Relative Risk: 3.2 (2.6, 3.8)]. CONCLUSIONS: NYC public hospitals experienced a sharp decrease in pediatric volume but an increase in patient acuity during both the initial pandemic surge and through the reopening periods. As COVID-19 variants emerge, the threat of the current pandemic expanding remains. Understanding its influence on pediatric ED utilization can optimize resource allocation and ensure equitable care for future surge events.

Impact of COVID-19 on Emergency Medicine Residency Programs: A Cross-Sectional Study in New York State.

INTRODUCTION: The 2019 novel coronavirus pandemic has caused significant disruptions in the clinical operations of hospitals as well as clinical education, training, and research at academic centers. New York State was among the first and largest epicenters of the pandemic, resulting in significant disruptions across its 29 emergency medicine (EM) residency programs. We conducted a cross-sectional observational study of EM residency programs in New York State to assess the impact of the pandemic on resident education and training programs. METHODS: We surveyed a cross-sectional sample of residency programs throughout New York State in June 2020, in the timeframe immediately after the state's first "wave" of the pandemic. The survey was distributed to program leadership and elicited information on pandemic-prompted curricular modifications and other educational changes. The survey covered topics related to disruptions in medical education and sought details on solutions to educational issues encountered by programs. RESULTS: Of the 29 accredited EM residency programs in New York State, leadership from 22 (76%) responded. Of these participating programs, 11 (50%) experienced high pandemic impact on clinical services, 21 (95%) canceled their own trainees' off-service rotations, 22 (100%) canceled or postponed visiting medical student rotations, 22 (100%) adopted virtual conference formats (most within the first week of the pandemic wave), and 11 (50%) stopped all prospective research (excluding COVID-19 research), while most programs continued retrospective research. CONCLUSION: This study highlights the profound educational impact of the pandemic on residency programs in one of the hardest- and earliest-hit regions in the United States. Specifically, it highlights the ubiquity of virtual conferencing, the significant impact on research, and the concerns about canceled rotations and missed training opportunities for residents, as well as prehospital and non-physician practitioner trainees. This data should be used to prompt discussion regarding the necessity of alternate educational modalities for pandemic times and the sequelae of implementing these plans.

Computational modelling of potentially emerging SARS-CoV-2 spike protein RBDs mutations with higher binding affinity towards ACE2: A structural modelling study.

The spike protein of SARS-CoV-2 and the host ACE2 receptor plays a vital role in the entry to the cell. Among which the hotspot residue 501 is continuously subjected to positive selection pressure and induces unusual virulence. Keeping in view the importance of the hot spot residue 501, we predicted the potentially emerging structural variants of 501 residue. We analyzed the binding pattern of wild type and mutants (Spike RBD) to the ACE2 receptor by deciphering variations in the amino acids' interaction networks by graph kernels along with evolutionary, network metrics, and energetic information. Our analysis revealed that N501I, N501T, and N501V increase the binding affinity and alter the intra and inter-residue bonding networks. The N501T has shown strong positive selection and fitness in other animals. Docking results and repeated simulations (three times) confirmed the structural stability and tighter binding of these three variants, correlated with the previous results following the global stability trend. Consequently, we reported three variants N501I, N501T, and N501V could worsen the situation further if they emerged. The relations between the viral fitness and binding affinity is a complicated game thus the emergence of high affinity mutations in the SARS-CoV-2 RBD brings up the question of whether or not positive selection favours these mutations or not?

Annotation of Potential Vaccine Targets and Design of a Multi-Epitope Subunit Vaccine against Yersinia pestis through Reverse Vaccinology and Validation through an Agent-Based Modeling Approach.

Yersinia pestis is responsible for plague and major pandemics in Asia and Europe. This bacterium has shown resistance to an array of drugs commonly used for the treatment of plague. Therefore, effective therapeutics measurements, such as designing a vaccine that can effectively and safely prevent Y. pestis infection, are of high interest. To fast-track vaccine development against Yersinia pestis, herein, proteome-wide vaccine target annotation was performed, and structural vaccinology-assisted epitopes were predicted. Among the total 3909 proteins, only 5 (rstB, YPO2385, hmuR, flaA1a, and psaB) were shortlisted as essential vaccine targets. These targets were then subjected to multi-epitope vaccine design using different linkers. EAAK, AAY, and GPGPG as linkers were used to link CTL, HTL, and B-cell epitopes, and an adjuvant (beta defensin) was also added at the N-terminal of the MEVC. Physiochemical characterization, such as determination of the instability index, theoretical pI, half-life, aliphatic index, stability profiling, antigenicity, allergenicity, and hydropathy of the ensemble, showed that the vaccine is highly stable, antigenic, and non-allergenic and produces multiple interactions with immune receptors upon docking. In addition, molecular dynamics simulation confirmed the stable binding and good dynamic properties of the vaccine-TLR complex. Furthermore, in silico and immune simulation of the developed MEVC for Y. pestis showed that the vaccine triggered strong immune response after several doses at different intervals. Neutralization of the antigen was observed at the third day of injection. Conclusively, the vaccine designed here for Y. pestis produces an immune response; however, further immunological testing is needed to unveil its real efficacy.

Bioinformatics analysis of the differences in the binding profile of the wild-type and mutants of the SARS-CoV-2 spike protein variants with the ACE2 receptor.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). Reports of new variants that potentially increase virulence and viral transmission, as well as reduce the efficacy of available vaccines, have recently emerged. In this study, we computationally analyzed the N439K, S477 N, and T478K variants for their ability to bind Angiotensin-converting enzyme 2 (ACE2). We used the protein-protein docking approach to explore whether the three variants displayed a higher binding affinity to the ACE2 receptor than the wild type. We found that these variants alter the hydrogen bonding network and the cluster of interactions. Additional salt bridges, hydrogen bonds, and a high number of non-bonded contacts (i.e., non-bonded interactions between atoms in the same molecule and those in other molecules) were observed only in the mutant complexes, allowing efficient binding to the ACE2 receptor. Furthermore, we used a 2.0-µs all-atoms simulation approach to detect differences in the structural dynamic features of the resulting protein complexes. Our findings revealed that the mutant complexes possessed stable dynamics, consistent with the global trend of mutations yielding variants with improved stability and enhanced affinity. Binding energy calculations based on molecular mechanics/generalized Born surface area (MM/GBSA) further revealed that electrostatic interactions principally increased net binding energies. The stability and binding energies of N439K, S477 N, and T478K variants were enhanced compared to the wild-type-ACE2 complex. The net binding energy of the systems was -31.86 kcal/mol for the wild-type-ACE2 complex, -67.85 kcal/mol for N439K, -69.82 kcal/mol for S477 N, and -69.64 kcal/mol for T478K. The current study provides a basis for exploring the enhanced binding abilities and structural features of SARS-CoV-2 variants to design novel therapeutics against the virus.

OSPE (Objective structured practical examination): Perception of the faculty and students at A Public Sector Medical College in Pakistan

Objective: Objective Structured Practical Examination (OSPE) is a growing way of assessing the students of medical universities particularly. This study is targeted to compare and assess different perceptions of the faculty and the students towards OSPE at a public sector medical college. Study Design: Cross Sectional Survey. Setting: Sahiwal Medical College Sahiwal. Period: 1st July 2020 to 15th July 2020. Material & Methods: The questionnaire was sent to all the participants by Whatsapp because of COVID-19 pandemic. All the undergrad students of MBBS (500) and all the faculty members (65) of clinical and basic medical sciences were included in the study. Results: The response rate of faculty members was 78.46% and that of undergraduate students was 70.80%. Out of 51 members who responded, 23 (45.10%) were males while 28 (54.90%) were female. Female students were having majority of participation (71.20%). Most of the faculty and students agreed with the fact that ‘The questions asked in the OSPE stations were appropriate and related to the curriculum’ (60.10% and 45.10% respectively). Response to a question ‘OSPE is more transparent, fair and objective as compared to traditional practical examination’ got a nod from faculty members (49%). Almost 76% of the students (strongly agreed and agreed) thought that OSPE was tiring and stressful for them but their respected faculty members thought the opposite. Conclusion: Our study concludes that there is satisfaction of both students and the faculty regarding their perceptions of OSPE at public sector medical college. In our study while comparing, the majority of both the groups were having almost same opinions. [ABSTRACT FROM AUTHOR] Copyright of Professional Medical Journal is the property of Professional Medical Journal 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Factors contributing to distress among school and college-going adolescents during COVID-19 Lockdown: A cross-sectional study conducted in Sibi Balochistan, Pakistan.

BACKGROUND: Due to the COVID-19 pandemic, many countries have implemented nationwide lockdowns. While this leads to a decrease in disease transmission, there is a concurrent increase in the levels of psychological distress. To estimate the levels of psychological distress in school- and college-going adolescents currently under lockdown and to determine the factors associated with this psychological distress. MATERIALS AND METHODS: A cross-sectional study conducted in Army Public School and College (APSAC) Sibi, Balochistan province of Pakistan between March and May 2020. Students of APSAC Sibi were enrolled in this research. Modified Kuppuswamy Socioeconomic Scale, Godin Leisure-Time Exercise Questionnaire, and Kessler-10 were used for data acquisition. Chi-square and t-tests and univariate analysis (nonparametric test) were performed using the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM, Armonk, US). RESULTS: Out of 225 participants, 57.4% were studying at school. Sixty-four percent of the participants were likely to be suffering from psychological distress. There is a significant effect of physical activity, sleep duration, bedtime at night, screen-time duration, and COVID-19 positive family member on the levels of distress. A moderate positive correlation was between psychological distress and bed-time at night (rho[223] = 0.328, P < 0.001) and screen time duration (rho[223] = 0.541, P < 0.001). A moderate negative correlation of physical activity (rho[223] = -0.340, P < 0.001) and a weak negative correlation of sleep duration hours (rho[225] = -0.158, P = 0.018) was found with psychological distress levels. CONCLUSIONS: The COVID-19 lockdown and pandemic have had a considerable psychological impact on both school-going and college-going students, showing increased level of stress. A strong public health campaign along with mental and physical and social support programs are the need of the hour.