Online education via media platforms and applications as an innovative teaching method.

Online teaching has globally become a part of the learning process and has been more well-established in developed countries. In developing countries, online teaching or e-Learning is not practiced or recognized officially by educational organizations and policymakers. On the other hand, it is well-known that computers and technology are the future; in such a case, the advancement of distance-learning or online learning is immensely remarkable. It has reduced teachers' and students' introversion concerning e-learning and technology and has provided a platform for learning new technologies and developing new skills. The recent COVID-19 lockdown impelled governments to start implementing E-learning in schools, which resulted in several challenges. This study attempts to analyze and interpret the challenges and potentials of implementing online learning by surveying through an online questionnaire using 'Google Forms' (N = 968) with responses from high school and primary school English teachers during the first week of March through the last week of April. The findings revealed that most teachers had negative perceptions of implementing e-learning for several reasons, including lack of essential facilities such as electricity, electronic devices, and the absence of required skills. The actual contributions of students and educators are also among the major obstacles. This research suggests introducing Information Communication Technology modules across media platforms and applications in the education departments, opening intensive courses for teachers, and developing educational facilities in the education departments and schools to overcome these limitations and challenges.

Public engagement in government officials' posts on social media during coronavirus lockdown.

BACKGROUND: Social media has been a common platform to disseminate health information by government officials during the COVID-19 pandemic. However, little is known about the determinants of public engagement in officials' posts on social media, especially during lockdown. OBJECTIVES: This study aims to investigate how the public engages in officials' posts about COVID-19 on social media and to identify factors influencing the levels of engagement. METHODS: A total of 511 adults aged 18 or over completed an online questionnaire during lockdown in Iraq. Levels of engagement in officials' posts on social media, trust in officials and compliance of government instructions were assessed. RESULTS: Fear of COVID-19 and trust in officials were positively associated with compliance of government instructions. Trust in officials was also associated with active engagement in officials' posts on social media, including commenting, posting and sharing of the posts. CONCLUSIONS: Trust in government has been established during the COVID-19 pandemic. Public engagement in officials' posts is crucial to reinforce health policies and disseminate health information.

Side effects and perceptions following Sinopharm COVID-19 vaccination.

OBJECTIVES: Vaccines are one of the best interventions developed for eradicating COVID-19. This study aimed to provide evidence on Sinopharm COVID-19 vaccine side effects. METHODS: A cross-sectional survey study was conducted between January and April 2021 to collect data on the effects of the COVID-19 vaccine among individuals in the United Arab Emirates. Demographic data, vaccination and the response of people unwilling to take the COVID-19 vaccine were reported. RESULTS: Side effects post first vaccine dose of normal injection site pain, fatigue and headache were more common in participants aged ≤49 years versus >49 years, while pain at the vaccination site, fatigue, lethargy, headache and tenderness were the most common side effects post second dose in both groups. All side effects for both doses were more prevalent among participants aged ≤49 years. Side effects were more common in females compared with males for both doses. The most common reason for being unwilling to take the COVID-19 vaccine was that vaccines are not effective. CONCLUSION: Post-vaccination side effects for the first and second doses were mild and predictable, and there were no hospitalization cases; this data will help reduce vaccine hesitancy.

Effects of COVID-19 home confinement on musculoskeletal health and physical performance in a cross-sectional study: results of the COVID-19 era online survey.

Introduction: the global pandemic of COVID-19 is the unique health crisis, the populations were exposed to situations of unprecedented confinement, this represents a major public health challenge, with a high risk of developing musculoskeletal disorders. The objective of the present work is to identify the potential effects of sedentary behavior on musculoskeletal health and physical performance. Methods: after two months of confinement a survey was uploaded and shared on Google's online survey platform. Two research laboratories, University Moulay Ismail, University Ibn Tofail, promoted the survey which was developed on the basis of two questionnaires: the French version of the Nordic questionnaire musculoskeletal disorders and the French version of the Global Physical Activity Questionnaire (GPAQ). Results: out of 384 respondents, 209 (54.4%) were females 124 (32.3%) were between 30-49 years old (6.8%) and 123 (32%) had an underweight and overweight levels, respectively. One hundred and thirty-nine 139 (36.2%) reported sitting more than eight hours. The results of our survey show that many of our respondents had developed some sort of musculoskeletal pain during the confinement. One hundred and sixty two (42.2%) reported to have pain in the lower back region, 108 (28.1%) of participants reported to have pain in the neck region, 93 (28.2%) in the shoulder region, 97 (25.3) - in the upper back region and more women than men reported musculoskeletal pain in more than five regions. The results of our survey also show that 322 (83,9%) of the participants, after two months of confinement, were unable to do high intensity exercises for at least 10 min per day in their usual daytime activity, the prevalence of musculoskeletal pain differed across categories of body mass index (BMI) between males and females, (p<0.05). Conclusion: the results of this study show the existence of musculoskeletal disorders and deterioration in physical performance and strongly recommend the urgent implementation of prevention and remediation interventions.

Lenzilumab in hospitalised patients with COVID-19 pneumonia (LIVE-AIR): a phase 3, randomised, placebo-controlled trial.

BACKGROUND: The pathophysiology of COVID-19 includes immune-mediated hyperinflammation, which could potentially lead to respiratory failure and death. Granulocyte-macrophage colony-stimulating factor (GM-CSF) is among cytokines that contribute to the inflammatory processes. Lenzilumab, a GM-CSF neutralising monoclonal antibody, was investigated in the LIVE-AIR trial to assess its efficacy and safety in treating COVID-19 beyond available treatments. METHODS: In LIVE-AIR, a phase 3, randomised, double-blind, placebo-controlled trial, hospitalised adult patients with COVID-19 pneumonia not requiring invasive mechanical ventilation were recruited from 29 sites in the USA and Brazil and were randomly assigned (1:1) to receive three intravenous doses of lenzilumab (600 mg per dose) or placebo delivered 8 h apart. All patients received standard supportive care, including the use of remdesivir and corticosteroids. Patients were stratified at randomisation by age and disease severity. The primary endpoint was survival without invasive mechanical ventilation to day 28 in the modified intention-to-treat population (mITT), comprising all randomised participants who received at least one dose of study drug under the documented supervision of the principal investigator or sub-investigator. Adverse events were assessed in all patients who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, NCT04351152, and is completed. FINDINGS: Patients were enrolled from May 5, 2020, until Jan 27, 2021. 528 patients were screened, of whom 520 were randomly assigned and included in the intention-to-treat population. 479 of these patients (n=236, lenzilumab; n=243, placebo) were included in the mITT analysis for the primary outcome. Baseline demographics were similar between groups. 311 (65%) participants were males, mean age was 61 (SD 14) years at baseline, and median C-reactive protein concentration was 79 (IQR 41-137) mg/L. Steroids were administered to 449 (94%) patients and remdesivir to 347 (72%) patients; 331 (69%) patients received both treatments. Survival without invasive mechanical ventilation to day 28 was achieved in 198 (84%; 95% CI 79-89) participants in the lenzilumab group and in 190 (78%; 72-83) patients in the placebo group, and the likelihood of survival was greater with lenzilumab than placebo (hazard ratio 1·54; 95% CI 1·02-2·32; p=0·040). 68 (27%) of 255 patients in the lenzilumab group and 84 (33%) of 257 patients in the placebo group experienced at least one adverse event that was at least grade 3 in severity based on CTCAE criteria. The most common treatment-emergent adverse events of grade 3 or higher were related to respiratory disorders (26%) and cardiac disorders (6%) and none led to death. INTERPRETATION: Lenzilumab significantly improved survival without invasive mechanical ventilation in hospitalised patients with COVID-19, with a safety profile similar to that of placebo. The added value of lenzilumab beyond other immunomodulators used to treat COVID-19 alongside steroids remains unknown. FUNDING: Humanigen.

C reactive protein utilisation, a biomarker for early COVID-19 treatment, improves lenzilumab efficacy: results from the randomised phase 3 'LIVE-AIR' trial.

OBJECTIVE: COVID-19 severity is correlated with granulocyte macrophage colony-stimulating factor (GM-CSF) and C reactive protein (CRP) levels. In the phase three LIVE-AIR trial, lenzilumab an anti-GM-CSF monoclonal antibody, improved the likelihood of survival without ventilation (SWOV) in COVID-19, with the greatest effect in participants having baseline CRP below a median of 79 mg/L. Herein, the utility of baseline CRP to guide lenzilumab treatment was assessed. DESIGN: A subanalysis of the randomised, blinded, controlled, LIVE-AIR trial in which lenzilumab or placebo was administered on day 0 and participants were followed through Day 28. PARTICIPANTS: Hospitalised COVID-19 participants (N=520) with SpO2 ≤94% on room air or requiring supplemental oxygen but not invasive mechanical ventilation. INTERVENTIONS: Lenzilumab (1800 mg; three divided doses, q8h, within 24 hours) or placebo infusion alongside corticosteroid and remdesivir treatments. MAIN OUTCOME MEASURES: The primary endpoint was the time-to-event analysis difference in SWOV through day 28 between lenzilumab and placebo treatments, stratified by baseline CRP. RESULTS: SWOV was achieved in 152 (90%; 95% CI 85 to 94) lenzilumab and 144 (79%; 72 to 84) placebo-treated participants with baseline CRP <150 mg/L (HR: 2.54; 95% CI 1.46 to 4.41; p=0.0009) but not with CRP ≥150 mg/L (HR: 1.04; 95% CI 0.51 to 2.14; p=0.9058). A statistically significant interaction between CRP and lenzilumab treatment was observed (p=0.044). Grade ≥3 adverse events with lenzilumab were comparable to placebo in both CRP strata. No treatment-emergent serious adverse events were attributed to lenzilumab. CONCLUSION: Hospitalised hypoxemic patients with COVID-19 with baseline CRP <150 mg/L derived the greatest clinical benefit from treatment with lenzilumab. TRIAL REGISTRATION NUMBER: NCT04351152; ClinicalTrials.gov.

A prediction system using AI techniques to predict Students’ learning difficulties using LMS for sustainable development at KFU (preprint)

With the emergence of the covid 19 pandemic, E-learning usage was the only way to solve the problem of study interruption in educational institutions and universities. Therefore, this field reserved significant attention in current times. In this paper, we used ten Machine Learning (ML) algorithms: Decision Tree(DT), Random Forest(RF), Logistic Regression(LR), SGD Classifier, Multinomial NB, K- Nearest Neighbors Classifier(KNN), Ridge Classifier, Nearest Centroid, Complement NB and Bernoulli NB) to build a prediction system based on artificial intelligence techniques to predict the difficulties students face in using the e-learning management system, to support related decision-making. Which, in turn, contributes supporting the sustainable development of technology at the university. From the results obtained, we detect the important factors that affect the use of E-learning to solve students' learning difficulties using LMS by building a prediction system based on AI techniques.

Efficacy of Sofosbuvir plus Ledipasvir in Egyptian patients with COVID-19 compared to standard treatment: a randomized controlled trial.

COVID-19 is a pandemic disease caused by SARS-CoV-2, which is an RNA virus similar to the hepatitis C virus (HCV) in the replication process. Sofosbuvir/ledipasvir is an approved drug to treat HCV infection. This study investigates the efficacy of Sofosbuvir/ledipasvir as a treatment for patients with moderate COVID-19 infection. This is a single-blinded parallel-randomized controlled trial. The participants were randomized equally into the intervention group that received Sofosbuvir/ledipasvir (S.L. group), and the control group received Oseltamivir, Hydroxychloroquine, and Azithromycin (OCH group). The primary outcomes were the cure rate over time and the incidence of serious adverse events. The secondary outcomes included the laboratory findings. 250 patients were divided equally into each group. Both groups were similar regarding gender, but age was higher in the S.L. group (p=0.001). In the S.L. group, 89 (71.2%) patients were cured, while only 51 (40.8%) patients were cured in the OCH group. The cure rate was significantly higher in the S.L. group (RR=1.75, p<0.001). Kaplan-Meir plot showed a considerably higher cure over time in the S.L. group (Log-rank test, p=0.032). There were no deaths in the S.L. group, but there were six deaths (4.8%) in the OCH group (RR=0.08, p=0.013). Seven patients (5.6%) in the S.L. group and six patients (4.8%) in the OCH group were admitted to the intensive care unit (ICU) (RR=1.17, P=0.776). There were no significant differences between treatment groups regarding total leukocyte and neutrophils count, lymph, and urea. Sofosbuvir/ledipasvir is suggestive of being effective in treating patients with moderate COVID-19 infection. Further studies are needed to compare Sofosbuvir/ledipasvir with new treatment protocols.

Student Performance Prediction Using Machine Learning Techniques (preprint)

With the emergence of the covid 19 pandemic, E-learning usage was the only way to solve the problem of study interruption in educational institutions and universities. Therefore, this field has garnered significant attention in recent times. In this paper, we used ten machine-learning algorithms (Logistic Regression, Decision Tree, Random Forest, SGD Classifier, Multinomial NB, K-Neighbors Classifier, Ridge Classifier, Nearest Centroid, Complement NB and Bernoulli NB) to build a prediction system based on artificial intelligence techniques to predict the difficulties students face in using the e-learning management system, and support related decision-making. Which, in turn, contributes to supporting the sustainable development of technology at the university. From the results obtained, we found the important factors that affect the use of E-learning to solve students' learning difficulties by using LMS.

Epidemiological Features of COVID-19 in Makkah City: A Retrospective Data Analysis.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is continuing to circulate and change, affecting billions of people worldwide and leading to increased mortality rates, especially in the Holy City of Makkah, Kingdom of Saudi Arabia (KSA). This study was aimed at investigating the epidemiological features of COVID-19 in Makkah City, KSA. METHODS: A retrospective analysis was conducted to investigate the prevalence of COVID-19 and the association between the severity and mortality of COVID-19 with demographic factors and comorbidities. RESULTS: Among 4,742 COVID-19 patients, the incidence rate observed in males was 66.7%, and 69.7% were from Al-Noor Specialized Hospital. The highest incidence rate (25.2%) was found in the age group > 60 years old, followed by the age group 51-60 years (21.8%). Furthermore, the highest frequency was observed in patients from Saudi Arabia (36.8%), followed by patients from Myanmar (14.7%) and Bangladesh (9.4%). The overall frequency of COVID-19 severity and death was 20.3% and 11.6%, respectively. Body mass index analysis showed that 1% of the patients were underweight, while 9.2% were overweight and 4.4% were obese. In addition, 9.6% had diabetes, 6.9% had hypertension, 1.1% had heart disease, and 2.2% had other chronic diseases. CONCLUSION: The study concluded that the overall percentages of severe COVID-19 (intensive care unit) cases and deaths in Makkah City, KSA, were 20.3% and 11.6%, respectively, and there was a higher incidence in male patients. The severity of infection was shown to have a strong significant correlation with different chronic diseases, nationality, body mass index, death rate (mortality), heart disease, and length of hospital stay (P < 0.05). Despite these findings, more studies are needed to explain the underlying mechanisms that influence the overall health status of patients with specific characteristics and comorbidities.

Assessment of supplied water quality during mass gatherings in arid environments.

Mass gathering events commonly encounter environmental challenges that necessitate assurance of water quality and food security. The current outbreak of the coronavirus disease 2019 (COVID-19) call for maintaining safe drinking water supply and providing assessment tools of drinking water quality to avoid contamination in water sources or distribution networks. Arid environmental conditions also add more stress on supplied water to mass gathering events. Herein, we assess the quality of the water supply (desalinated 95% and groundwater 5%) in Makkah city, Saudi Arabia during a mass gathering event in 2019 (9.6 million people) for religious purposes. Fifty five samples were randomly collected from nine different districts of Makkah city, analyzed for TDS, turbidity, pH, EC, free Cl2, Al, Cd, Pb, Cr, F, major ions, coliform and E.coli bacteria and were finally used to estimate the water quality index (WQI). Major ions, trace elements and heavy metals analyses show values below permissible limits in most of the samples, while a few samples show slightly higher values. No bacterial count found in any sample. WQI values of all fifty-five samples were below 50 and were identified as "excellent water". The WQI variations could be attributed to the distribution network conditions rather than a direct impact of adding groundwater with uncontrolled chemical composition. The use of WQI to report the quality of water during mass gathering events to governmental authorities has been proved to be beneficial and should be applied for further mass gathering events worldwide.

Case Report: Neurologic Presentation of West Nile Virus: Difficult Diagnosis.

West Nile virus infections have surged across the globe. South Texas, located on the path of bird migration, with Culex quinquefasciatus and other Culex species, and biotic primers that predispose the area to epidemics (floods, amplifying hosts, and lack of mosquito control and prevention) remains a highly endemic area for arbovirus spread. West Nile virus infection ranges from mild febrile illness to severe central nervous system involvement. The purpose of this report is to highlight complex presentations of WNV and how confounding presenting symptoms delay diagnosis. The secondary goal is to describe how pandemics, such as SARS-CoV-2, can overwhelm the system and result in medical decision bias errors.

An Epidemiological Study of COVID-19 Cases in Al-Leith, Saudi Arabia.

Background and objective Ever since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in December 2019, more than 0.550 million cases of coronavirus disease 2019 (COVID-19) have been reported in the kingdom of Saudi Arabia (KSA) and the number is on the rise. In this study, we aimed to perform an epidemiological analysis of COVID-19 cases in Al-Leith, KSA. Methods A community-based descriptive study was carried out to assess the epidemiology of COVID-19 in Al-Leith, KSA. The relevant data were collected using a questionnaire designed for this study, which included questions on basic information and characteristics in addition to data on COVID-19. Data were analyzed using the SPSS Statistics software (IBM, Armonk, NY). Results The significant findings were as follows: people aged between 26-40 years were more affected (55.7%) than other age groups, and more than half (74.1%) of COVID-19 patients were female; most of them were employed (85, 48,9%), and most of those got infected through direct contact (137, 78.7%) with other infected people. About 163 (93.7%) cases were asymptomatic, and 168 (96.6%) cases were notified to the health authorities. The findings also illustrated that 78 (44.8%) COVID-19 cases suffered from psychological impact due to infection; 83 (47.7%) cases had at least one case in the family before they became infected. The majority of cases (93.7%) suffered from symptomatic COVID-19. A considerable number of COVID-19 patients did not follow precautions before and after infection. Conclusions The study concluded that various age groups were susceptible to developing COVID-19, and direct contact was the main mode of transmission. Moreover, a considerable number of infected people did not adhere to precautionary measures.

Medical image processing and COVID-19: A literature review and bibliometric analysis.

COVID-19 crisis has placed medical systems over the world under unprecedented and growing pressure. Medical imaging processing can help in the diagnosis, treatment, and early detection of diseases. It has been considered as one of the modern technologies applied to fight against the COVID-19 crisis. Although several artificial intelligence, machine learning, and deep learning techniques have been deployed in medical image processing in the context of COVID-19 disease, there is a lack of research considering systematic literature review and categorization of published studies in this field. A systematic review locates, assesses, and interprets research outcomes to address a predetermined research goal to present evidence-based practical and theoretical insights. The main goal of this study is to present a literature review of the deployed methods of medical image processing in the context of the COVID-19 crisis. With this in mind, the studies available in reliable databases were retrieved, studied, evaluated, and synthesized. Based on the in-depth review of literature, this study structured a conceptual map that outlined three multi-layered folds: data gathering and description, main steps of image processing, and evaluation metrics. The main research themes were elaborated in each fold, allowing the authors to recommend upcoming research paths for scholars. The outcomes of this review highlighted that several methods have been adopted to classify the images related to the diagnosis and detection of COVID-19. The adopted methods have presented promising outcomes in terms of accuracy, cost, and detection speed.

Side Effects and Perceptions Following Sinopharm COVID-19 Vaccination (preprint)

Objectives Vaccines are one of the best interventions developed for eradicating COVID-19 the rapid creation of vaccinations was increased the risk of vaccine safety problems. The aim of this study to provide evidence on Sinopharm COVID-19 vaccine side effects. Methods A cross-sectional survey study was conducted between January and April 2021 to collect data on the effects of COVID-19 vaccine among individuals in the UAE. Demographic data chronic conditions side effects of the 1st and 2nd dose toward the vaccination, and the response of unwilling taking COVID-19 vaccine were reported. Results The most common side effects of post 1st dose (less than 49 years old vs >49 years) were normal injection site pain, fatigue, and headache while pain at the vaccination site fatigue lethargy headache and tenderness were the most side effects of the post 2nd dose in both groups. All the side effects in both doses were more prevalent among the participants less than 49-year-old group. Among females vs males side effects were more common in females compared with males in both doses in both doses. The most common adverse reactions of 1st dose in (females vs males) were fatigue lethargy headache while in 2nd dose were fatigue sever injection site pain. The most common reason of not willing to take the COVID-19 vaccine were the vaccines are not effective and they were not authorized to take vaccine. Conclusion The 1st and 2nd dose post-vaccination side effects were mild predictable and there were no hospitalization cases this data will help to reduce the vaccine hesitancy.

Increasing frequency of Aminoglycoside-Resistant Klebsiella pneumoniae during the era of pandemic COVID-19.

The emergence of multidrug resistance to aminoglycosides in K. pneumoniae isolates is a growing concern, especially during pandemic Coronavirus disease 2019 (COVID-19). The study identifies antibiotic resistance in K. pneumoniae isolated from tertiary hospitals during pandemic COVID-19. Among 220 clinical isolates, the total rate of K. pneumoniae was found to be 89 (40.5%). Phenotyping results confirmed the resistance of aminoglycoside antibiotics in 51 (23.2%) of K. pneumoniae isolates. PCR results confirmed the existence of one or more aminoglycoside genes in 82.3% of the 51 isolates. The rmtD gene was the highest-detected gene (66.7%), followed by aac(6')-Ib (45.1%), aph(3')-Ia (45.1%), rmtB (29.4%), armA (21.6%), aac(3)-II (7.8%), and rmtA (3) (11.8%). Significantly, higher resistance strains showed a higher prevalence (61.5%) of aminoglycoside genes (p < 0.05). During COVID-19, there is a higher risk of acquiring MDR bacterial infections, so the monitoring of multidrug resistant bacteria must be continuously undertaken to implement effective measures in infection control and prevention.

Efficacy of Sofosbuvir plus Ledipasvir in Egyptian patients with COVID-19 compared to standard treatment: Randomized controlled trial (preprint)

Background: COVID-19 is a pandemic disease caused by SARS-CoV-2, which is an RNA virus similar to HCV in the replication process. Sofosbuvir/ledipasvir is an approved drug by the FDA to treat HCV infection. This study investigates the efficacy of Sofosbuvir/ledipasvir as a treatment for patients with moderate COVID-19 infection.. Methods: This is a single-blinded parallel-randomized controlled trial. The participants were randomized equally into the intervention group received Sofosbuvir/ledipasvir (S.L. group), and the control group received Oseltamivir, Hydroxychloroquine, and Azithromycin (OCH group). The primary outcomes were the cure rate over time and the incidence of serious adverse events. The secondary outcomes included the laboratory findings. Results: Two hundred and fifty patients were divided equally into each group. Both groups were similar regarding gender, but age was higher in the S.L. group (p=0.001). In the S.L. group, 89 (71.2%) patients were cured, while only 51 (40.8%) patients were cured in the OCH group. The cure rate was significantly higher in the S.L. group (RR=1.75, p<0.001). Kaplan-Meir plot showed a considerably higher cure over time in the S.L. group (Log-rank test, p=0.032). There were no deaths in the S.L. group, but there were six deaths (4.8%) in the OCH group (RR=0.08, p=0.013). Seven patients (5.6%) in the S.L. group and six patients (4.8%) in the OCH group were admitted to ICU (RR=1.17, P=0.776). There was no significant difference between treatment groups regarding Total Leukocyte Count, Neutrophils count, Lymph, Alanine transaminase, and Urea. Conclusion: Sofosbuvir/ledipasvir is suggestive of being effective in treating patients with moderate COVID-19 infection. Further studies are needed to compare Sofosbuvir/ledipasvir with the new treatment protocols.

Complicated sinusitis with sphenopalatine artery thrombosis in a COVID-19 patient: a case report.

COVID-19 has been a mystery against healthcare professionals. We herein report a rare presentation of complicated sinusitis with pre-septal cellulitis and hard palatal necrosis in a COVID-19 patient. A 52-year-old male was admitted to the hospital with typical COVID manifestations where he had two successive COVID-19 positive swabs. During his admission, he developed symptoms of right orbital complications of sinusitis along with both clinical and radiological evidence of ipsilateral hard palatal necrosis. Imaging confirmed a diagnosis of right pan-sinusitis complicated with right pre-septal infection and hard palatal bony defect on the same side. Our case focuses on the possible association between these manifestations and the known thromboembolic complications of COVID-19. Ongoing management of such complicated rare cases should be through multidisciplinary team.

Hand Hygiene Knowledge, Perception, and Practices among Domestic Visitors to the Prophet's Mosque in Al Madinah City Amid the COVID-19 Pandemic: A Cross-Sectional Study.

This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet's Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic residents, who visited the mosque between 31 July and 3 August 2020. Participants' demographic data, hand hygiene knowledge, perception, and practices were collected. Four hundred participants aged 18-65 (median 36) years completed the survey, of which 215 (53.8%) were female. The visitors' mean knowledge score about hand hygiene was 6.4 (± standard deviation (SD) 1.35) of total 12. Most participants (392, 98%) were aware of the role of hand hygiene in preventing Coronavirus Disease 2019 (COVID-19); nevertheless, 384 (96%) said hand hygiene lowers body immunity and 316 (79%) thought <60% alcohol is sufficient for hand disinfection. Males had a higher knowledge score than females (6.46 (±1.41) vs. 6.14 (±1.27), p = 0.02) and, visitors who had no formal education scored higher than those with post-graduate education (6.88 (±1.45) vs 5.73 (±1.12), p = 0.01). Washing hands with soap and water was the predominant method practiced after a meal (365, 91.7%), after toilet visit (354, 88.5%), after touching a surface (262, 65.7%), after waste disposal (332, 83.2%), and when hands were visibly dirty (357, 89.5%). Al Madinah visitors had moderate knowledge about hand hygiene, but demonstrated some knowledge gaps and negligence in practice that are crucial to curb the spread of COVID-19.

Assessment of burnout among primary teachers in confinement during the COVID-19 period in Morocco: case of the Kenitra.

INTRODUCTION: Confinement, because of the COVID-19 pandemic, could have problems on the mental health of the population. Teachers responsible for giving distance courses during this period could be psychologically stressed. The aim is to assess the magnitude results of burnout and associated factors among primary school teachers in Kenitra in Morocco during this confinement period. METHODS: This is a cross-sectional study, which was conducted during the two months of April and May 2020. Burnout was evaluated by the Maslach Burnout Inventory MBI with 16 items, specific to the context of Moroccan teachers and the factors of stress were assessed using a questionnaire developed by the research team. We used the Chi-square test to determine the association between two qualitative variables anda logistic regression for an overall statistical analysis. RESULTS: The average age was 38.6 ± 9.9 years. The MBI revealed that 68 teachers (54%) were victims of burnout, of which 47 (38%) had a low level; 15 (12%) had a moderate level and six (5%) had a severe burnout. Logistic regression analysis has shown that the risk factors for burnout during this confinement period are: the use and development of skills in new information and communication technologies (p<0,05); work/family conflict (p<0,05); social support (p<0,05); and the workload related to distance education (p≤0,05). CONCLUSION: In light of these results, interventions aimed at promoting mental well-being teachers during and after confinement should be implemented immediately.