ABSTRACT
Objective: In this case series, we aimed to examine the changes in lymphocyte subgroups in children diagnosed with the multisystem inflammatory syndrome (MIS-C) during the acute phase and in the first month after treatment. Material and Methods: Ethics committee approval was received for the study from the Ethics Committee of Ondokuz Mayis University patient data were analyzed from medical records in an electronic database. Initial immunological evaluations of our first five patients diagnosed with MIS-C were made, steroid and IVIG treatments were given to the patients, and lymphocyte subgroups were evaluated for the second time in the first month for control purposes. Results: In MIS-C cases, it was observed that lymphopenia was severe in the acute period, CD3 T cells decreased, the ratio of 2:1 between cytotoxic T cells and helper T cells was impaired, B cells increased proportionally, and NK cells were normal or decreased. When we evaluated MIS-C cases with the control lymphocyte subgroup in the first month, it was observed that lymphopenia improved and CD3 T cells increased proportionally, and active T cells decreased to normal values in the first month after treatment. On the other hand, while naive B cells decreased, non-switching and switching B cells increased and NK cells decreased. Conclusion: While COVID-19 is an acute infection, MIS-C is associated with cytokine storm induced by the acute infection. Immunologic assessment of MIS-C cases is considered important since the condition causes immune dysregulation in the host immune system. Lymphopenia, increased B cell count, reversal of the CD4/CD8 ratio, and increased active T cell count may be beneficial in the early diagnosis of MIS-C. Since it is thought that the cytokine storm causes complications in MIS-C, immediate administration of IVIG treatment is considered essential. Although it was demonstrated that the disease manifests with marked cellular changes, there is still a need for further studies.
ABSTRACT
In the context of so much uncertainty with coronavirus variants and official mandate based on seemingly exaggerated predictions of gloom from epidemiologists, it is appropriate to consider a revised model of relative simplicity, because there can be dangers in developing models which endeavour to account for too many variables. Predictions and projections from any such models have to be in the context of relevant contingencies. The model presented here is based on relatively simple second order difference equations. The context here is as important as the content in that in many Western counties where the narrative currently seems more important than the truth, and the results of empirical science are valued more as a shield for politicians than a sword for protection of citizens © 2022 by the authors. Licensee Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
ABSTRACT
Objective: In this case series, we aimed to examine the changes in lymphocyte subgroups in children diagnosed with the multisystem inflammatory syndrome (MIS-C) during the acute phase and in the first month after treatment. Material and Methods: Ethics committee approval was received for the study from the Ethics Committee of Ondokuz Mayis University patient data were analyzed from medical records in an electronic database. Initial immunological evaluations of our first five patients diagnosed with MIS-C were made, steroid and IVIG treatments were given to the patients, and lymphocyte subgroups were evaluated for the second time in the first month for control purposes.
ABSTRACT
Decisions in the health industry have a significant impact on human lives. With the COVID-19 pandemic, a global war is being waged. Vaccination is a critical component in this fight. The governments are attempting to offer their citizens the best vaccine for the public based on limitations. However, due to the unique characterizations of countries and the people who live in the country, the definition of "the ideal vaccination" is indefinite. Fuzzy set theory has been an ideal tool to cope with problems involving imprecise information such as the meaning of "ideal" in this case. In this study Interval Type-2 Fuzzy Sets (IT2FSs) will be used to describe uncertainty. This IT2FS structure will be the framework of the AHP (Analytic Hierarchy Process), to determine the criteria weights, and the VIKOR (VIseKriterijumska Optimizacija I Kompromisno Resenje), to generate a set of optimal choices. The main objective of this study is to sustain the necessary effect of uncertainty of fuzzy sets via the Interval Type-2 Fuzzy (IT2F) metric to the VIKOR method and thus propose an extended VIKOR. The presented new approach will be applied to the problem of vaccine selection for COVID-19. Hence, for the first time in the literature, an application with a multilevel hierarchy will be used in IT2FAHP-VIKOR. Also, obtained optimal solution set with this hybrid framework will be compared with fuzzy AHP-VIKOR and the rankings evaluated with the IT2FTOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) and sensitivity analysis will be performed.
ABSTRACT
We aimed to evaluate the admissions to the Pediatric Emergency Department (PED) due to seizures one year before and one year after the first COVID-19 case in Turkey. We divided the admission time into two: The prelockdown period (March 2019-February 2020) and the lockdown period (March 2020 - February 2021). We divided the seizures into six parts: First simple febrile convulsion (FK), first complex FK, recurrent simple FK, recurrent complex FK, first non-febrile seizure, and recurrent non-febrile seizure. We compared the prelockdown and lockdown periods in terms of demographic and clinical characteristics and monthly admission of patients. The total number of patients admitted to PED was 37.323 and 10.191 during the prelockdown and lockdown period, respectively. While seizure-related PED accesses were 918 during the prelockdown period, 508 patients were admitted to PED during the lockdown period. Monthly average admissions decreased in all seizure types during the lockdown period. The ratio of first simple febrile seizures to total seizures decreased from 22.4% (206/918) to 16.3% (83/508), while the ratio of first afebrile seizures to total seizures increased from 29.6% (272/918) to 36.8% (186/508). While the rate of first febrile seizures decreased, we observed a significant increase in the rate of first afebrile seizures. The findings suggested that risk factors such as depression/anxiety or screen exposure may have caused seizures in patients with a predisposition to seizures. Copyright © 2022 Ondokuz Mayis Universitesi. All rights reserved.
ABSTRACT
Objective: Multisystem inflammatory syndrome (MIS-C) in children is a newly defined and serious health problem that develops after SARS-CoV-2 infection. Our aim is to report epidemiological, clinical, laboratory and radiological features of children with MIS-C. Material and Methods: Forty patients who applied to our hospital from October 2020 to February 2021 and met the MIS-C criteria were included in the study. Patients with gastrointestinal involvement (GIS), cardiac involvement and Kawasaki Disease (KD)-like MIS-C were examined clini-cally and laboratory. Results: The mean age of the patients was 8.2 ± 4.2 years and male patients were in the majority (70%). The most common symptoms were fe-ver (100%) and fatigue (90%). Gastrointestinal symptoms were present in 71%, cardiac involvement in %40, Kawasaki-like patients in %52.5, shock symptoms in 59%. Elevated levels of C-reactive protein, D-dimer, and ferritin were found in 100%, 97.5%, and 67.5% of the patients, respec-tively. Patients with cardiac involvement had higher mean age and lower lymphocyte levels. Shock findings were higher in patients with KD-like MIS-C. Also, INR and ferritin levels were higher in KD-like MIS-C patients (p= 0.028). The mean platelet count (p= 0.004) and albumin levels were lower (p= 0.048) in shock group. Conclusion: MIS-C is a hyperinflammatory syndrome with cardiac, GIS, and lung involvement. Cardiac findings were not common in patients presenting with KD-like MIS-C, but a poor prognosis was observed in KD-like MIS-C patients. Patients with cardiac involvement were older and their lymphocyte count was lower.
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Mindfulness-based interventions (MBIs) have been applied in many contexts, including educational sectors of K-12 and various graduate schools, such as medical and law schools. Research shows that highly competitive students are likely to benefit from mindfulness practices. However, few STEM-focused colleges have been able to assess its value and apply mindfulness practices. This study presents a case report of an MBI course offered by the Korea Advanced Institute of Science and Technology (KAIST). We devised eight questions in three categories to investigate how each individual experiences the MBI course, how they enjoy the academic course, and the suitability of the MBI curriculum in STEM education. Qualitative assessments of feedback featuring questions and answers were analyzed using grounded theory. The results demonstrate three central phenomena: a) gradual changes and development in students’ emotional intelligence, b) development in physical awareness, and c) enhanced sense of joy during the session. These results imply that even during the COVID-19 pandemic, international students—being isolated in their home countries and taking the course online—would likely still benefit from the intrinsic effect of MBIs. It also implies that MBI courses could be recommended as mandatory classes for all KAIST students, where feasible. Nevertheless, further research is needed to fully explore the impact of such programs, both online and in-person, including the use of self-report scales of common measures of mental health to contribute empirical data to the literature. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Since December 2019, 2019 outbreak of coronavirus (Covid-19) spread all over the world as well as in Turkey. In this study, we aimed to investigate the clinical and laboratory effects of covid 19 disease on children. The epidemiological, laboratory, radiological, and treatment features of the 30 pediatric patients with covid-19 evaluated retrospectively. The median age of the patients was 10 years, boys and girls ratio was 1.5 (18/12). Of the patients, 80.7% had family contact and 11.5% had comorbidity. The most common symptom was fever (84.6%), and cough was the second frequency (57.7%). All patients except 1 patient had a mild course, 5 were asymptomatic. One patient needed intensive care who had underlying chronic disease. Neutropenia was the most common laboratory anomaly (36.6%). Increased D-dimer levels were observed in 9 patients (30%), decreased leukocyte was in 7 patients (23.3%) and increasedlactate dehydrogenaz level was in 8 patients (26.6%). Chest computed tomography was taken 14 patients who had an abnormal chest X-rays, and ground-glass opacities were seen in 6 patients (20%). Hydroxychlorachine, azithromycin and other antibiotic treatments were given to the necessary patients. The mean PCR negative time in the treated symptomatic group was 8.8 +5.34 day, while in the untreated asymptomatic group 12 + 5.19 day and there was no statistically significant difference (p=0.154). The correlation between PCR negative time and clinical, laboratory, and radiological findings was examined and no correlation was found. In conclusion, pediatric covid 19 is mostly transmitted by family contact and has a mild course if there is no underlying disease. The most common symptoms are fever and cough. Ground glass densities on lung tomography are similar to adult. More conservative approaches may be preferred in children.