Online teaching at Fazaia Medical College, Islamabad: the students' perception

Objective: To evaluate the perception ofmedical students at a medical college in Islamabad, regarding the impact of online teaching due to the Corona virus-19 (COVID-19) pandemic. Methodology: This cohort online survey was conducted after developing a comprehensive online questionnaire on Google forms© by a three member faculty team in March 2022. All the students of Fazaia Medical College, first-year through the fifth year, were invited to join a class and the questionnaire was posted in it. There was no exclusion criteria. The aim was to achieve maximum participation and get an in-depth response. The data were analyzed using SPSS 21. Result(s): Almost 70% of the students responded to the online survey. Microsoft Power Point presentation accompanied by an online lecture was voted as the most effective method of teaching. Despite being the computer generation, majority (80%) of the students were in favor of a formal classroom setting. Conclusion(s): There is no denying thatonline teaching is the way forward and is here to stay. The faculty, as well as the students are adapting to it however the point to remember is that online teaching should augment and not replace the classic classroom setting, especially in developing countries with mundane limitations like electricity breakdown and signal coverage constraints. Copyright © 2022, Pakistan Medical Association. All rights reserved.

Level of General Stress in Doctors Community in Pre and Post Covid-19 Scenario in Different Hospitals of Pakistan

Objectives: To find out the level of stress among the doctor community before and during the COVID-19 pandemic in different public sector hospitals. Study Design: Cross-sectional study. Place and Duration of Study: Divisional Headquarters DHQ Teaching Hospital, Sahiwal Pakistan and two Public Sector Hospitals at Okara and Islamabad Pakistan, from Aug 2019 to Aug 2020. Methodology: A total of 320 doctors in two Groups were included in the study. Group-1 included 197 doctors in pre-COVID-19 time i-e from Aug 2019 to Jan 2020, while Group-2 included 123 doctors working in the COVID-19 scenario. The stress was assessed according to responses on a structured questionnaire and patient health questionnaire (PHQ-9) scores. Results: Three hundred and twenty doctors participated in the study, out of which 78(39.8%) doctors in the First Group and 49(40.4%) in Second Group developed depression during their duties. More female doctors participated in the study, most of whom were young doctors who were actively involved in COVID-19 patients. Conclusion: There is no significant rise in stress among the doctors working in the COVID-19 situation in public sector hospitals of Pakistan. © 2022, Army Medical College. All rights reserved.

How to avoid future "Covid-19 origins" questions?

Origins debates regarding Covid-19 are gaining momentum again. In light of the continued infections and deaths of Covid-19 seen in countries rich and poor, rather than focusing the approach with "whodunit", developing solutions that can help societies become better prepared for future pandemics might be a more meaningful way to move forward. In this paper, we propose a solution that could help society better predict and prevent future pandemics. A system could allow humans to anonymously report potential infectious disease outbreaks without fearing backlash or prejudice and could automatically surveil for potential disease transfers or virus leaks. The proposed autonomous and anonymous pandemic reporting and surveillance system has the potential to help health officials locate infectious disease outbreaks before they form into pandemics. And in turn, it better prevents future pandemics and avoids Covid-19 origins debates.

Synthesis of Potential Antiviral Agents for SARS-CoV-2 Using Molecular Hybridization Approach.

We synthesized a set of small molecules using a molecular hybridization approach with good yields. The antiviral properties of the synthesized conjugates against the SAR-CoV-2 virus were investigated and their cytotoxicity was also determined. Among all the synthesized conjugates, compound 9f showed potential against SARS-CoV-2 and low cytotoxicity. The conjugates' selectivity indexes (SIs) were determined to correlate the antiviral properties and cytotoxicity. The observed biological data were further validated using computational studies.

UWB Radar Sensing for Respiratory Monitoring Exploiting Time- Frequency Spectrograms

Regarding the health-related applications in infectious respiratory/breathing diseases including COVID-19, wireless (or non-invasive) technology plays a vital role in the monitoring of breathing abnormalities. Wireless techniques are particularly important during the COVID-19 pandemic since they require the minimum level of interaction between infected individuals and medical staff. Based on recent medical research studies, COVID-19 infected individuals with the novel COVID-19-Delta variant went through rapid respiratory rate due to widespread disease in the lungs. These unpleasant circumstances necessitate instantaneous monitoring of respiratory patterns. The XeThru X4M200 ultra-wideband radar sensor is used in this study to extract vital breathing patterns. This radar sensor functions in the high and low-frequency ranges (6.0-8.5 GHz and 7.25-10.20 GHz). By performing eupnea (regular/normal) and tachypnea (irregular/rapid) breathing patterns, the data were acquired from healthy subjects in the form of spectrograms. A cutting-edge deep learning algorithm known as Residual Neural Network (ResNet) is utilised to train, validate, and test the acquired spectrograms. The confusion matrix, precision, recall, F1-score, and accuracy are exploited to evaluate the ResNet model's performance. ResNet's unique skip-connection technique minimises the underfitting/overfitting problem, providing an accuracy rate of up to 97.5%. © 2022 IEEE.

LIVER INJURY ASSOCIATED WITH TURMERIC&≤x2013;A GROWING PROBLEM: NINE CASES FROM THE DRUG-INDUCED LIVER INJURY NETWORK [DILIN]

BACKGROUND: Turmeric (curcumin) is a commonly used over-the-counter herbal product whose uses include diarrhea, arthritis, cancer and even COVID-19. Recently turmeric has been implicated in cases of clinically apparent liver injury with jaundice. The aim of this case series is to describe the clinical, histologic and human leukocyte antigen (HLA) associations of turmeric-associated hepatotoxicity as seen in the U.S. Drug Induced Liver Injury Network (DILIN) Prospective Study. METHODS: All adjudicated cases enrolled in DILIN between 2003-2020 with turmeric as an implicated product were reviewed. Causality was assessed using a 5-point expert opinion score. Available products were collected and analyzed for the presence of turmeric using ultra-high-performance liquid chromatography. Genetic analyses included HLA sequencing. RESULTS: Of 1697 cases of drug-induced liver injury judged to be definite, highly likely or probable (high confidence), nine (0.5%) were attributed to turmeric, all of which were enrolled since 2012, and 6 since 2017 (Figure). The 9 cases included 7 women, 8 whites, with a mean age of 51 years (range, 35-62 years) and BMI 25 kg/m2 (range, 15-40). Seven patients used alcohol, but none to excess, and none had underlying liver disease. Turmeric was used for an average of 102 days before onset of injury (range, 30-425 days). Initial mean ALT was 1179 U/L (range, 328-2245), ALP 211 U/L (41-441), total bilirubin 5.9 mg/dL (1.2-10.8), and INR 1.0 (0.9-1.2). Six patients developed jaundice, and serum bilirubin peaked at 9.6 mg/dL (0.8-26), and INR 2.3 (1.0- 9.7). Liver injury was hepatocellular in 8 patients (mean R = 22). Five patients had elevated antinuclear antibody (ANA) titer and two anti-smooth muscle (ASM) antibody, but none were treated with corticosteroids. Liver biopsy in 5 patients showed portal and lobular mixed inflammatory infiltrates with lymphocytes and eosinophils typical of drug-induced liver injury. Five patients were hospitalized, and one patient died of acute liver failure. Chemical analysis confirmed the presence of turmeric in all 7 products analyzed;3 also contained piperine (black pepper), and none contained green tea. Of 7 patients with HLA typing available, 4 carried HLA-B*35:01, a class I HLA allele previously implicated in both green tea and Polygonum multiflorum hepatotoxicity. CONCLUSION: Liver injury due to turmeric appears to be increasing, perhaps, reflecting usage patterns or increased combination with black pepper, which increases its absorption. Turmeric liver injury, similar to that caused by other polyphenolic herbal products, is typically hepatocellular, with a latency of 1 to 6 months, and is linked to HLA-B*35:01. While most cases are self-limited, the injury can be severe and result in death or liver transplantation.

EDU_INSIGHTS: The Analytic Tools to Assess Students' Satisfaction Level in Open and Distance Learning (ODL)

Open and distance learning (ODL) has become a new norm in higher institutions due to the Covid-19 outbreak. The implementation of ODL is grounded in an internet-based teaching system that enables university students to learn through a virtual platform. However, to date, the tool to assess the ODL performance from the students' perspectives is insufficient to improve the service quality. In this regard, the objective of this study is to develop an analytic tool using sentiment analysis techniques in evaluating the ODL performance from the students' perspective. To fulfill that, a new innovative sentiment tool namely EDU_INSIGHTS was developed and tested among the students from Universiti Teknologi MARA (UiTM) Kedah, Malaysia. A sample of questions was distributed to capture, analyze and visualize the real-time data on students' perspectives towards ODL. Subsequently, the sentiments were visualized in terms of the chart and word clouds. Consequently, this beneficial tool assists the top management of the university in assessing the performance of ODL for a better learning experience in the future.

The Emergence of SARS-CoV-2 Variants With a Lower Antibody Response: A Genomic and Clinical Perspective.

The emergence of several novel SARS-CoV-2 variants regarded as variants of concern (VOCs) has exacerbated pathogenic and immunologic prominences, as well as reduced diagnostic sensitivity due to phenotype modification-capable mutations. Furthermore, latent and more virulent strains that have arisen as a result of unique mutations with increased evolutionary potential represent a threat to vaccine effectiveness in terms of incoming and existing variants. As a result, resisting natural immunity, which leads to higher reinfection rates, and avoiding vaccination-induced immunization, which leads to a lack of vaccine effectiveness, has become a crucial problem for public health around the world. This study attempts to review the genomic variation and pandemic impact of emerging variations of concern based on clinical characteristics management and immunization effectiveness. The goal of this study is to gain a better understanding of the link between genome level polymorphism, clinical symptom manifestation, and current vaccination in the instance of VOCs.

Immunoinformatics-guided design of a multi-epitope vaccine based on the structural proteins of severe acute respiratory syndrome coronavirus 2† † Electronic supplementary information (ESI) available. See DOI: 10.1039/d1ra02885e

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulting in a contagious respiratory tract infection that has become a global burden since the end of 2019. Notably, fewer patients infected with SARS-CoV-2 progress from acute disease onset to death compared with the progression rate associated with two other coronaviruses, SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV). Several research organizations and pharmaceutical industries have attempted to develop successful vaccine candidates for the prevention of COVID-19. However, increasing evidence indicates that the SARS-CoV-2 genome undergoes frequent mutation;thus, an adequate analysis of the viral strain remains necessary to construct effective vaccines. The current study attempted to design a multi-epitope vaccine by utilizing an approach based on the SARS-CoV-2 structural proteins. We predicted the antigenic T- and B-lymphocyte responses to four structural proteins after screening all structural proteins according to specific characteristics. The predicted epitopes were combined using suitable adjuvants and linkers, and a secondary structure profile indicated that the vaccine shared similar properties with the native protein. Importantly, the molecular docking analysis and molecular dynamics simulations revealed that the constructed vaccine possessed a high affinity for toll-like receptor 4 (TLR4). In addition, multiple descriptors were obtained from the simulation trajectories, including the root-mean-square deviation (RMSD), root-mean-square fluctuation (RMSF), solvent-accessible surface area (SASA), and radius of gyration (Rg), demonstrating the rigid nature and inflexibility of the vaccine and receptor molecules. In addition, codon optimization, based on Escherichia coli K12, was used to determine the GC content and the codon adaptation index (CAI) value, which further followed for the incorporation into the cloning vector pET28+(a). Collectively, these findings suggested that the constructed vaccine could be used to modulate the immune reaction against SARS-CoV-2. COVID-19 is caused by SARS-CoV-2, resulting in a contagious respiratory tract infection. For designing a multi-epitope vaccine, we utilized the four structural proteins from the SARS-CoV-2 by using bioinformatics and immunoinformatics analysis.

EDU_INSIGHTS: The Analytic Tools to Assess Students' Satisfaction Level in Open and Distance Learning (ODL)

Open and distance learning (ODL) has become a new norm in higher institutions due to the Covid-19 outbreak. The implementation of ODL is grounded in an internet-based teaching system that enables university students to learn through a virtual platform. However, to date, the tool to assess the ODL performance from the students' perspectives is insufficient to improve the service quality. In this regard, the objective of this study is to develop an analytic tool using sentiment analysis techniques in evaluating the ODL performance from the students' perspective. To fulfill that, a new innovative sentiment tool namely EDU_INSIGHTS was developed and tested among the students from Universiti Teknologi MARA (UiTM) Kedah, Malaysia. A sample of questions was distributed to capture, analyze and visualize the real-time data on students' perspectives towards ODL. Subsequently, the sentiments were visualized in terms of the chart and word clouds. Consequently, this beneficial tool assists the top management of the university in assessing the performance of ODL for a better learning experience in the future. © 2021 IEEE.

Molecular Docking and Dynamics Studies to Explore Effective Inhibitory Peptides Against the Spike Receptor Binding Domain of SARS-CoV-2.

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a pandemic due to the high transmission and mortality rate of this virus. The world health and economic sectors have been severely affected by this deadly virus, exacerbated by the lack of sufficient efficient vaccines. The design of effective drug candidates and their rapid development is necessary to combat this virus. In this study, we selected 23 antimicrobial peptides from the literature and predicted their structure using PEP-FOLD 3.5. In addition, we docked them to the SARS-CoV-2 spike protein receptor-binding domain (RBD) to study their capability to inhibit the RBD, which plays a significant role in virus binding, fusion and entry into the host cell. We used several docking programs including HDOCK, HPEPDOCK, ClusPro, and HawkDock to calculate the binding energy of the protein-peptide complexes. We identified four peptides with high binding free energy and docking scores. The docking results were further verified by molecular dynamics (MD) simulations to characterize the protein-peptide complexes in terms of their root-mean-square fluctuation (RMSF), root-mean-square deviation (RMSD), radius of gyration (Rg), solvent-accessible surface area (SASA), and hydrogen bond formation. Allergenicity and toxicity predictions suggested that the peptides we identified were non-allergenic and non-toxic. This study suggests that these four antimicrobial peptides could inhibit the RBD of SARS-CoV-2. Future in vitro and in vivo studies are necessary to confirm this.

Maternal Transmission of SARS-CoV-2: Safety of Breastfeeding in Infants Born to Infected Mothers.

Coronavirus disease 2019 (COVID-19) is a recent epidemic disease caused by severe acute respiratory syndrome virus type 2 (SARS-CoV-2). In pregnancy, SARS-Cov-2 infection creates additional alarm due to concerns regarding the potential for transmission from the mother to the baby during both the antenatal and postpartum times. In general, breastfeeding is seldom disallowed because of infection of the mother. However, there are few exceptions with regards to certain infectious organisms with established transmission evidence from mother to infant and the link of infection of a newborn with significant morbidity and mortality. It is confirmed that pregnant women can become infected with SARS-CoV-2, although the debate on the possible vertical transmission of SARS-CoV-2 infection during pregnancy is still open. In this regard, the literature is still poor. On the contrary, the information on the safety of breastfeeding even during infections seems reassuring when the mother takes the necessary precautions. However, there are still answered questions regarding the precautions to be taken during breastfeeding by COVID-19 patients. This paper reviews the existing answers to these and many other questions. This review therefore presents a summary of the present-day understanding of infection with SARS-CoV-2 and discusses the answers around the maternal transmission of COVID-19 and the potential threat of breastfeeding to babies born to infected pregnant mothers. In conclusion, intrauterine transmission of SARS-CoV-2 infection is less likely to occur during pregnancy. Most studies suggest that COVID-19 is not transmitted through breast milk. Correspondingly, COVID-19-infected neonates might acquire the infection via the respiratory route because of the postnatal contact with the mother rather than during the prenatal period. International organizations encourage breastfeeding regardless of the COVID-19 status of the mother or child as long as proper hygienic and safety measures are adhered to so as to minimize the chance of infant infection by droplets and direct contact with the infected mother. Pasteurized donor human milk or infant formula as supplemental feeding can be quite beneficial in the case of mother-infant separation till breastfeeding is safe.

Agility leadership and its effect on motivation and discipline: A review of learning supervision during Covid-19

Increased work motivation and work discipline are still seeing as a significant problem in the work system of the State Civil Apparatus in Indonesia. This problem needs to be resolving immediately so that public services are in line with expectations. This research focuses on the application of agility leadership and its influence on work motivation and work discipline of the State Civil Apparatus. Several studies have been conducting to measure the effect of work motivation on the work discipline of the State Civil Apparatus. However, only a few studies have tried to scientifically identify agility leadership approaches concerning work motivation and work discipline. The study population was 122 teachers in Enrekang Regency, Indonesia, who lived in mountainous areas that were not reached by the internet during Covid-19. They carry out "teach from home"learning with communication information technology that requires an internet network. The results of this study found that agility leadership has been very well implemented, and the effect is very significant on the work motivation and work discipline of teachers through the supervision of the principal. To ensure the continuity of work motivation and work discipline of teachers still very well implemented, the leadership of the principal's agility is significant. Further research is expected to apply qualitative methods and approaches to meet the needs of reward and punishment. © 2021 Author(s).

Exposures and risk factors of corona virus among health care workers and need for preventive measures in combined military hospital Rawalpindi

Objective: Prospective To determine the various risk factors and exposures for spread of Corona Virus Disease 2019 (COVID19) among health care workers working at Combined Military Hospital Rawalpindi. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital, Rawalpindi, from Apr to Jul 2020. Methodology: A total of 134 health care workers who were infected with COVID-19, were included in study. A structured questionnaire was attained after informed consent and approval from hospital ethical committee. Data was analyzed using SPSS-19 statistical software. Results: Overall, 134 of 2591 Health care workers (Health care workers) in Combined Military Hospital Rawalpindi tested positive for COVID-19 during the study period. The infection rate was 5.17%. Among them 25 (18.7%) were women and 109 (81.3%) were men. There was not statistical difference in infection rate between male and female health care workers p=0.156). The infection rate in clinical category was significantly higher than non-clinical category (p<0.001. The infection rate in nursing assistants was significantly higher than the doctors (p=0.021). Personal protective equipment was optimally provided to health care workers except for goggles and face shields whose provision and use were both lacking. Conclusion: Health care workers are at high risk of developing COVID-19. There is need for extensive training, easy availability of personal protective equipment and strict compliance to infection control policies. © 2021, Army Medical College. All rights reserved.

Academic Library Resources and Services at Higher Education Institutions during COVID-19 Pandemic: A Case of Students’ Satisfaction

This study has been designed to inspect the library resources and services at higher education institutions during the covid-19 pandemic in terms of students' satisfaction. A quantitative study design to conduct an online survey from the students of public sector universities of Pakistan. A sample of 1823 respondents had been sampled through a proportionate random sampling technique. Moreover, a well-structured questionnaire was opted to measure the response of the respondents using an attitudinal scale of (dis)agreement. Further, frequency distribution, descriptive statistics, correlation statistical tests, and regression analysis had been used to draw results and conclusions. The study findings present that provision of required documents and available library resources have not been predicting students' satisfaction. However, other variables including access to library resources, access to library services, available library services, response to online queries, and online research support have favorable effects on students' satisfaction towards online library access and resources in public sector universities. © 2021, Library Philosophy and Practice. All rights reserved.

Otolaryngology consultations for COVID-19: Determining occupational exposure and inpatient interventions

Introduction: The novel coronavirus SARS-CoV-2 has ravaged the United States and transformed the way medical care is delivered. As specialists in upper airway anatomy, otolaryngology (ENT) services may be called upon to manage various head-and-neck complaints for patients with COVID-19. While ear, nose, and throat (ENT) consults may benefit critically ill patients, they also expose physicians to the transmission of COVID-19. We sought to identify the reasons for ENT intervention and examine trends in testing through the pandemic. Method: Records for all ENT consults from May 1 to September 29, 2020, were retrospectively reviewed. Demographic information, admission diagnoses, length of stay, COVID status, and ENT interventions were recorded. Univariate analysis was performed. Results: Of 1343 distinct consults, 965 (72%) were tested for COVID-19, with 62 (4.6%) positive. In May 200 (70%) of 287 consults were tested with 2 (0.7%) positive, while in September, 251 (78.5%) of 320 consults were tested with 22 (6.9%) positive. The most common ENT consultation for COVID-positive patients was nasal and oropharyngeal bleeding (n = 19, 30.6%), followed by facial trauma (n = 15, 24.2%). Other reasons included respiratory distress, tracheostomy, and foreign body (retained COVID swab). Of 96 interventions for patients with COVID-19, 49 (51%) were for management of bleeding, 24 (25%) were for upper airway evaluation (UAE), and 8 (8.3%) were for tracheostomy or trach management. Conclusion: Although patients with COVID-19 necessitated various otolaryngologic interventions, management of bleeding was the most common complaint, which may be associated with therapeutic anticoagulation as well as coagulopathy from the disease process. Bleeding control was followed by UAE and trach management, 2 aerosol-generating procedures that may increase the risk of COVID transmission. The proportion of consults tested and confirmed positive for COVID- 19 at our institution increased from May to September, possibly assisting otolaryngologists to take appropriate preventive precautions.

Public Library Online Information Resources to Library Patrons during COVID-19 Pandemic: A Case of Higher Education Institutions

The main purpose of this paper is to examine online library resources during the COVID-19 pandemic situation at higher educational institutions in Pakistan. During the current pandemic situations, all the educational activities have been postponed and transformed into online latterly. A cross-sectional study consisting of a sample of 2378 from library patrons of public sector universities in Pakistan. A structured questionnaire has been administered based on different parts using an attitudinal scale of (dis)agreement has been used and pre-tested randomly with the reliability value ranging from .03 to .842. It is pertinent here to mention that during the COVID-19 pandemic, all the educational activities were shifted to online mode and it was not possible to collect information physically. Hence, an online method was opted and the questionnaire was shared through emails and WhatsApp numbers of public sector university library users. The study findings reveal that COVID-19 outbreak, fear of infection, and social distancing have favorable effects on online library information resources. Similarly, the results also support the argument that accessibility of manuscripts, accessibility of periodicals, and accessibility of books have favorable effects on online library resources. The study suggested that similar nature of the study may be conducted using mixed-method research and a different set of variables in the future. © 2021

An overview of novel Coronavirus SARS-CoV-2 spanning around the past, present and future perspectives. (Special Issue: Coronaviruses and COVID-19- Past, Present, and Future.)

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a new enveloped RNA virus known as Coronavirus (COVID-19) are most prevalent in humans and wild animals. All four species that is alpha, beta, delta and theta have been identified till date and are responsible for human disease;causing influenza like illness (ILI). This virus has similar lineage of Middle East Respiratory Syndrome coronavirus (MERS-CoV) and related Coronavirus (SARS-CoV). This outbreak initially presented as pneumonia-like illness in a group of people in Wuhan, China. The infection was said to be caused by seafood and unusual animals in the wholesale markets of this city. SARS-CoV-2 is highly infectious and has resulted in a rapid pandemic. As of now it has spread to 197 countries with total no of cases in the world being 3.76 million as of early march. The mortality till now is 7.11%. The cases have been increasing since its first discovery in China. In India also the number has been increased. Till now India has total of 39,980 cases and mortality is attributed to be 3.26%. As per data from Ministry of health and family welfare (MoHFW) death is more commonly seen in males with age > 60 years. Among these most of the deaths were related to other co-morbid conditions. This article will help the readers with an overview of novel Coronavirus spanning around the clinical features, diagnostic modalities, treatment strategies and infection control measures. It will also help in raising awareness among healthcare workers regarding COVID-19 and aid in early recognition of these patients. Moreover, this review will also focus on the most recent information for the effective management, prevention, and treatment of patients worldwide.