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Intro: The spike protein of the SARS-CoV-2 virus targets the human cell receptor of angiotensin-converting enzyme (ACE2), including the myocardium and heart's conduction system. Patients diagnosed with COVID-19 have also been found to exhibit cardiac arrhythmia. Here, a whole-genome sequencing analysis using long-read sequencing was proposed to evaluate the virus genome in a patient who presented with AVNRT as a main presentation of COVID-19. Method(s): The sample was recovered from nasopharyngeal and oropharyngeal swab specimens of a 46-year-old female with no comorbidities who presented with palpitation, and ECG showed typical AVNRT features. The RT-qPCR of SARS- CoV-2 was confirmed positive with a CT-value of 15.82. The total RNAs were extracted and proceeded for RT-qPCR and proceeded with Oxford Nanopore Flongle sequencing. The genomics data of the virus was deposited in GISAID (EPI_ISL_3241561) and further analysed using online bioinformatics tools such as Nextclade CLI 2.3.0. Ethical approval (IREC 2021-080) for the study was obtained from IIUM Research Ethics Committee. Finding(s): Here, we reported a total of 29,775 bp near-complete whole-genome belonging to clade 21J (Delta) of AY.79 lineage (also known as B.1.617.2.79), which formed a dominant variant in Malaysia during the time of sampling. Discussion(s): While a previous study showed an association between Delta variant infection with fulminant myocarditis, the present study reported the benign AVNRT as the main presentation of SARS-CoV-2 infection. Furthermore, we observed the presence of the C3037T mutation previously described in the endomyocardial biopsy of a patient with persistent arrhythmia. Conclusion(s): Even though SARS-CoV-2 targets the respiratory tract, the present study supports the evidence that the ACE2 receptors are present in the heart. In addition, COVID19 is causing more and more damage to heart tissue, and viral transcription has been confirmed on cardiomyocytes. Further functional studies are needed to explore the associated mutations and their relation to cardiac manifestation.Copyright © 2023
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In this paper, the effect of contaminated objects on a SIRS Model with vaccination and hospitalization compartments is modeled. Positivity and boundedness properties of the solutions of model are proved, basic reproduction number of the model is founded through criteria which make the eigenvalues of the Jacobean matrix at the disease-free equilibrium point, negative. Globally stability analysis of the disease-free equilibrium point is proved when the basic reproduction number is less than unity. The existence, uniqueness of the endemic equilibrium point is investigated when the basic reproduction number is greater than unity. Parameter values regarding to spreading covid-19 in Kurdistan region are estimated. Finally, sensitivity analysis of the reproduction number is carried out. © 2022 Production by the University of Garmian. This is an open access article under the LICENSE.
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Background: The aim of the present investigation is to prepare baricitinib (BAR)-loaded diphenyl carbonate (DPC) ß-cyclodextrin (ßCD) based nanosponges (NSs) to improve the oral bioavailability. Methods: BAR-loaded DPC-crosslinked ßCD NSs (B-DCNs) were prepared prepared by varying the molar ratio of ßCD: DPC (1:1.5 to 1:6). The developed B-DCNs loaded with BAR were characterized for particle size, polydispersity index (PDI), zeta potential (ZP), % yield and percent entrapment efficiency (%EE). Results: Based on the above evaluations, BAR-loaded DPC ßCD NSs (B-CDN3) was optimized with mean size (345.8±4.7 nm), PDI (0.335±0.005), Yield (91.46±7.4%) and EE (79.1±1.6%). The optimized NSs (B-CDN3) was further confirmed by SEM, spectral analysis, BET analysis, in vitro release and pharmacokinetic studies. The optimized NSs (B-CDN3) showed 2.13 times enhancement in bioavailability in comparison to pure BAR suspension. Conclusion: It could be anticipated that NSs loaded with BAR as a promising tool for release and bioavailability for the treatment of rheumatic arthritis and Covid-19.
Subject(s)
COVID-19 , Cyclodextrins , Humans , COVID-19 Drug TreatmentABSTRACT
BACKGROUND: The availability of COVID-19 vaccines worldwide necessitates measuring healthcare workers' (HCWs') willingness to recommend or receive these vaccines. Therefore, we conducted a local study in Jordan to assess HCWs' willingness to recommend or receive a third dose of a COVID-19 vaccine and the predictors of such a decision. A cross-sectional study investigated Jordanian HCWs' willingness regarding a third dose of a COVID-19 vaccine using a self-administered online questionnaire through WhatsApp, a mobile phone application. A total of 300 HCWs participated in the current study. Of these HCWs, 65.3% were physicians, 25.3% were nurses, and 9.3% were pharmacists. HCWs' overall willingness regarding a third vaccine dose was 68.4% (49.4% certainly and 19.0% probably), whereas the overall willingness of HCWs to recommend a third dose to their patients was 73.3% (49.0% certainly and 24.3% probably). Males had significantly higher willingness than females (82.1% vs. 60.1%, p < 0.05). Physicians reported more willingness than nurses and pharmacists. HCWs' willingness was not significantly affected by direct contact with a patient infected with COVID-19 or by a personal history of COVID-19 infection. Only 31% of HCWs were certainly willing to recommend the vaccine to their patients with chronic diseases, and only 28% of the participants were certainly willing to recommend it to people aged 65 or older. HCWs' willingness to receive a third dose of a COVID-19 vaccine is limited in Jordan. This has affected their certainty in recommending this vaccine to their patients or people older than 60. Decision-makers and health-promotion programs in Jordan should focus on addressing this public health problem.
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The COVID-19 pandemic has accelerated the growth of telemedicine. Advantages include patient convenience, reduced waiting time, minimising hospital commute and the risk of virus transmission and healthcare cost-savings [1]. Compared with other specialties, anaesthesiology is less engaged with telemedicine- based clinical work and challenges in implementation exist [2]. To align with the Ministry of Health, Singapore COVID-19-safe management measures, pre-anaesthetic assessment via video consultation (VC) workflow was implemented in Sengkang General Hospital, Singapore, in December 2020;however, the referral rate amongst our surgical colleagues remained low. Therefore the aim was to increase the number of VCs by 50% within 12 months (from June 2021) and evaluate patients' experiences. Methods Eligibility criteria included low-risk surgeries (duration < 4 h) with minimal expected blood loss, patients aged 21-65 years, ASA status 1 or 2, body mass index < 35 and the patient's ability to use the Zoom video-conferencing application. Post-consultation, patients were invited to complete an electronic patient satisfaction survey. The main reasons for the low VC referral rate were identified based on ground engagement and feedback. Two plan-do-study-act (PDSA) cycles were conducted to address these issues. PDSA cycle 1 (June 2021): to increase awareness amongst surgeons, surgical champions were engaged to promote VC within their departments;however, the VC referral rate remained low. Therefore, a second PDSA cycle was undertaken. PDSA cycle 2 (October 2021): to increase patient and staff awareness by placing posters publicising VC and enlisting the help of Patient Service Associates (PSAs) to screen for patient eligibility. This led to a significant increase in VC referrals. The current workflow will be evaluated for sustainability. Results Pre-intervention, the average number of monthly VCs was 3, and remained unchanged during PDSA cycle 1. This was increased to 14 during PDSA cycle 2. Discussion VC referrals have increased after the modified workflow, achieving high patient satisfaction and no surgical cancellations. Future work includes developing an automated VC workflow for low-risk surgeries. (Figure Presented).
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United States (U.S.) mariners continued sailing throughout COVID-19. Many aspects of their work could make them prone to adverse mental health outcomes but research on workplace determinants of their mental health during COVID-19 is limited. Between January and July 2021 an online survey assessed the outcomes of increased depressive symptoms, increased anxiety symptoms, and increased perceived stress in addition to concerns, worries, and experiences when sailing during COVID-19, job satisfaction, and safety climate in n = 1384 U.S. mariners. Demographic measures were also collected. Logistic regression models (for depression and anxiety) and a linear regression model (for stress) were developed. We found that increased COVID-19 concerns and poor self-reported mental health were related to increased odds of likely depression and anxiety and higher stress. Mariners who experienced more adverse experiences aboard a vessel had increased stress and increased odds of depression. Poor sleep quality was also related to increased odds of depression, and poor vessel support/safety culture was related to higher stress. Differences in outcomes were seen by vessel type, age, and credential in regression analyses. Results from this study will help to prioritize interventions to minimize the mental health impacts of COVID-19, and influence evidence-based recommendations to improve the mental health of mariners going forward.