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1.
Pakistan Journal of Medical and Health Sciences ; 16(10):559-561, 2022.
Article in English | EMBASE | ID: covidwho-2207080

ABSTRACT

Introduction: Pandemic coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 coronavirus has recently emerged. Objective(s): The main objective of the study is to find the outcome comparison between tocilizumab and pulse solumedrol in severe COVID disease among resource depleted areas. Material(s) and Method(s): This cross sectional study was conducted in Central Park Medical College and Teaching Hospital, Lahore and the duration of this study was from August 2021 to March 2022. The data was collected through non-probability consecutive sampling technique. The data was collected into two groups. Men and non-pregnant women over 18 years old COVID diagnosis confirmed by real time polymerase chain reaction (RT-PCR) Pao2 / FIO2 <200 Laboratory: high sensitivity C reactive protein> 5 mg / L;lactic dehydrogenase (LDH) > 245 U / l;Ferritin> 300;D-dimer> 1500;Interleukin-6> 7.0 pg / ml were included. Result(s): The data was collected from 300 patients, 150 in each group. There were 72.9% male aged 41-60 years 45.8% were female with a mean age of 55.4 +/- 10.6 years. Diabetes and hypertension was the most common comorbidity in selected patients. Tocilizumab group had more number of males (P = 0.017), with higher incidence of coronary artery disease (CAD, P = 0.008). Conclusion(s): It is concluded that Tocilizumab decreased the propensity of severe COVID-19 patients to require invasive mechanical ventilation when compared to high-dose solumedrol pulse, especially in those with severe ARDS, but this did not translate to improved 30-day survival in them. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

2.
Front Med (Lausanne) ; 9, 2022.
Article in English | PubMed Central | ID: covidwho-2163043

ABSTRACT

COVID-19 infection primarily targets the lungs, which in severe cases progresses to cytokine storm, acute respiratory distress syndrome, multiorgan dysfunction, and shock. Survivors are now presenting evidence of cardiopulmonary sequelae such as persistent right ventricular dysfunction, chronic thrombosis, lung fibrosis, and pulmonary hypertension. This review will summarize the current knowledge on long-term cardiopulmonary sequelae of COVID-19 and provide a framework for approaching the diagnosis and management of these entities. We will also identify research priorities to address areas of uncertainty and improve the quality of care provided to these patients.

3.
Pakistan Journal of Pharmaceutical Sciences ; 35(4):1269-1274, 2022.
Article in English | EMBASE | ID: covidwho-2156228

ABSTRACT

People around the globe rumored so many things about the safety and efficacy of initial two doses and booster dose of Covid-19 vaccine, which eventually affected the acceptance of the only tool available against the fight between humans and virus. The aim of current study is to evaluate the acceptance and reluctance level among the population specifically elderly diabetes patients. The cross-sectional study was conducted during a time period of 3 months i.e. from July 2021 until September 2021. A 16-item questionnaire was used to assess the acceptance, reluctance, and concerns of the Covid-19 vaccine booster dose among elderly diabetes patients. A 16-item questionnaire was used to assess the acceptance, reluctance, and concerns of the Covid-19 vaccine booster dose among elderly diabetes patients. A total of 497 responses were collected and analyzed. Approximately 32% of respondents believed that they need additional information about the Covid-19 vaccine booster dose will be ineffective due to not enough information about the potential side effects of the vaccine dose, while around 80% of respondents showed concerns about safety, efficacy, newness and not enough information about vaccine contents. Around 47.1% of respondents expressed robust concerns about possible side effects of the Covid-19 vaccine booster dose. Copyright © 2022 Pakistan Journal of Pharmaceutical Sciences. All rights reserved.

4.
International Journal of Engineering Education ; 38(5):1629-1642, 2022.
Article in English | Web of Science | ID: covidwho-2102185

ABSTRACT

In mid spring 2020, an unprecedented Covid-19 induced switch of learning mode, from face-to-face instruction to online learning, disrupted not only teachers, but also students, both cognitively and emotionally. This study seeks to understand how students felt about their capabilities to succeed in the online learning environment (OLE) and which online learning features (OLF), offered to them by their instructors, positively, negatively, or neutrally impacted their learning. Three research questions guided this study: (1) What online learning features did students perceive as contributing positively, negatively, or neutrally to their learning and how were these perceived contributions related to students' demographics?;(2) How did students feel about their capabilities to succeed in the OLE?;and (3) How did students' feelings change during their online learning experiences and how did these changes relate to students' gender, academic performance, and prior online experience? An online survey was designed and face-validated to solicit information about students' perceptions about online learning features and feelings about their capabilities to succeed in the OLE. The 13-item survey consisted of 10 multiple-choice/multiple-answer and 3 open-ended questions. One thousand two hundred and thirty-seven (N = 1237) students taking 27 different courses, from 6 different institutions participated in the study. Presentation of the qualitative analyses of open-ended survey responses is outside the scope of this paper. Findings suggest that the three most frequent OLFs provided to students were electronic homework submission, recorded video lectures, and electronic exams. While video lectures, homework electronics submission, and downloadable documents or files were reported to be the top three OLFs that contributed positively to students' learning, poor internet performance, online exams, and projects were the top three OLFs that were reported to have contributed negatively to student learning. Changes in students' feelings during the online learning experience were also reported.

5.
Pakistan Journal of Science ; 74(3):223, 2022.
Article in English | ProQuest Central | ID: covidwho-2083396

ABSTRACT

: The novel coronavirus has infected over 609,848,852 individuals throughout the world with a total death of over 6.5 million since its outbreak in December 2019. Since then many therapeutic options have been approached and tested in clinical trials as well to find a potential cure or preventive therapy for the COVID-19 disease. This review summarizes the potential therapeutic options currently available for the treatment of COVID-19 including lopinavir-ritonavir, Hydroxychloroquine, Remdesivir, Ribavirin, dexamethasone, interferon, antibodies, Tocilizumab, Azithromycin, Piperacillin-tazobactam, Moxifloxacin, Ivermectin, Nitazoxanide, Baricitinib, and Arbidol. This study briefly discusses the clinical trials and encompasses the dosage, efficacy, adverse drug reactions, and possible mechanism of action of the potential treatment candidate where applicable. The growing number of reported cases posits an exigent need for a suitable therapy for the prevention and cure of this disease. Therefore, the study aims to provide vital information on each drug to highlight the latest scientific research that could be helpful for better prevention/treatment of COVID-19 disease.

6.
129th ASEE Annual Conference and Exposition: Excellence Through Diversity, ASEE 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2045964

ABSTRACT

This paper describes a National Science Foundation-funded Research Experiences for Undergraduates (REU) Site program conducted through virtual working environment. Due to the Covid-19 pandemic, REU 2021 activities were conducted online through Canvas and Zoom communication platforms. The major aim of this program is to provide undergraduate students with experiences in engineering education research (i.e., education research in the context of engineering). This paper provides an overview of the program, and briefly describes the virtual working environment, and students' research experiences during the 10-week program. A total of 11 undergraduate students, seven graduate mentors, and seven faculty mentors have actively participated in the program. The program is conducted in two phases: Phases 1 (i.e., Weeks 1-2) and 2 (i.e., Weeks 3-10). Phase 1 consists of preparatory and foundational work that is delivered to participants and will allow them to begin Phase 2 with some educational research foundation already established. The results of the project evaluation show that the program has made a positive impact on increasing education research skills and communication skills of the participating REU students. The participating REU students reported that the research projects they worked on increased their motivation and confidence for continuing to engage in engineering education research. Four participants (i.e., 36.4% of the total participants) suggested that, if available, they would prefer face-to-face over a virtual REU program. Another four participants (i.e., 36.4%) felt that both face-to-face and virtual would offer the same quality of research experiences, and 3 participants (i.e., 27.2% of the total participants) voiced their preference of virtual over face-to-face REU program. © American Society for Engineering Education, 2022.

7.
Risk Management and Healthcare Policy ; 15:1421-1431, 2022.
Article in English | EMBASE | ID: covidwho-1968921

ABSTRACT

This study aims to identify the impact of the COVID-19 pandemic on the psychological health and dental practice of oral health-care workers (OHCWs). The search for relevant literature was carried out online using PubMed, Web of science, and science direct databases from January 2020 to February 2021. Those articles were included that provided complete information about the impact of the COVID-19 pandemic on oral health-care workers during covid-19 and were original articles and reviews. Those articles were excluded from the current study that was not in English Language and involved case reports/book chapters/short communica-tions. Finally, only 8 articles were selected for the scoping review considering that complete information regarding the provision of dental care in the time of COVID-19 was provided. Increased psychological distress (especially those with existing comorbidities) was noted among the OHCWs during this pandemic. They had enough knowledge about COVID-19 and showed concern regarding the future of dentistry. Either complete or partial closure of dental clinics had introduced financial constraints among them. However, the majority of them did not switch their profession. The institutions were not prepared for any such situation and no training was conducted to control the spread of COVID-19 infection. OHCWs are fully aware of the knowledge regarding COVID-19 and showed concerns for dentistry and dental health-care workers during this pandemic. Complete or partial closure of dental clinics has had adverse effects on the future of dentistry, economically as well as psychologically. Institutions need to upgrade and strengthen their systems to cater to any such situation efficiently. Proper counseling sessions should be conducted for the OHCWs to monitor, identify and treat the cases found.

8.
Diseases of the Colon and Rectum ; 65(5):203, 2022.
Article in English | EMBASE | ID: covidwho-1894234

ABSTRACT

Purpose/Background: Quality improvement (QI) and enhanced recovery after surgery (ERAS) protocols are effective in reducing length of stay and complications after colorectal surgery. The COVID-19 pandemic's strain on hospital personnel and resources called into question the feasibility of implementation of QI studies. Hypothesis/Aim: We aimed to successfully implement of a novel, structured postoperative ambulation protocol in colorectal surgery patients and determine its effect on patient outcomes in a time of strained personnel. Methods/Interventions: This prospective non-randomized study included all patient who underwent elective inpatient abdominal colorectal procedures at a single quaternary care center. All patients were already undergoing a standard ERAS protocol at baseline. A structured, aggressive postoperative ambulation protocol was developed. An erasable poster (Figure) was placed in patient rooms which allowed the nursing staff and patient to track progress towards specific ambulation goals. The protocol measured specific metrics such as out-of-bed to chair and the number and extent of daily ambulation relative to postoperative day. The protocol was initiated on post-operative day 0, and increased in duration and distance daily. Nursing staff was educated on the protocol prior to initiation and a standard process was created to outline the documentation requirements. The primary outcome measured was hospital length of stay. Secondary outcomes were return of bowel function, 30-day postoperative DVT/PE rate, and 30-day readmission rate. A change in these outcomes metrics over time compared to historical controls was noted. Results/Outcome(s): The protocol was implemented in February 2020, with improvements in outcomes beginning in July 2020 following extensive re-education for nursing staff. Adherence to the post-operative ambulation regimen increased from 36% at baseline to 75%. This was associated with an improvement in postoperative return of bowel function (2.13 days vs 1.44 days), post-operative length of stay (6.36 days vs 3.33 days), postop VTE/PE rates (1.64% vs 0%) and readmission rate (6.56% vs 0%) over a period of 12 months. Limitations: The outcomes of this study may have been influenced by other uncontrolled measures during the COVID crisis but most if not all led to decreased personnel and resources making success of such a project difficult. A standard ERAS protocol was in place with good compliance (>95%) for over 2 years prior to the initiation of this study. Conclusions/Discussion: A novel, structured, aggressive early postoperative ambulation protocol is feasible during times of strained personnel resources such as the COVID-19 pandemic, and leads to improvement in postoperative outcomes such as postoperative length of hospital stay, return of bowel function, VTE/PE rates, and postoperative ambulation without an increase in the readmission rate.

10.
Rawal Medical Journal ; 47(1):45-48, 2022.
Article in English | Scopus | ID: covidwho-1728318

ABSTRACT

Objective: To find the impact of Covid-19 pandemic on routine immunization of children. Methodology: This cross sectional study was done at the New City Teaching Hospitaland Divisional Head Quarter Teaching Hospital, Mirpur, Azad Kashmir from March to September 2021. Data about routine immunization of children from parents was collected by using predesigned questionnaire. All data were analysed using SPSS version 20. Results: The study included 1200 parents. We found that 80% parents had scheduled vaccination for their children, 18% had delayed vaccination while 2% missed vaccination during Covid – 19 pandemic. Major reason for delayed vaccination was fear of contracting Covid – 19 in 65% respondents. We found that 80% parents feared that their children have chance to get Covid – 19 infection, 78% responded that their children might transmit this infection while 74% reported that their children have chance to get hospitalized due to Covid-19. Majority of the respondent had positive attitude towards vaccination. Conclusion: Covid-19 pandemic had major impact on the timing of routine immunization of children in Pakistan. © 2022, Pakistan Medical Association. All rights reserved.

11.
3rd International Sustainability and Resilience Conference: Climate Change, ISRC 2021 ; : 264-269, 2021.
Article in English | Scopus | ID: covidwho-1714065

ABSTRACT

In this study, game theory is used to determine the effect of vaccination and booster shots in containing COVID-19 in Bahrain. The study is divided into three parts and in each part, the payoff matrix and the biometric is generated. The Nash equilibrium points are determined by marking the maximum value in the first entry of each column and the maximum value in the second entry of each row. The results show that the vaccination and the booster shots significantly reduce the number of infected individuals, the number of patients reaching the ICU, and the number of deaths due to COVID-19. © 2021 IEEE.

12.
24th International Conference on Computer and Information Technology, ICCIT 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1714047

ABSTRACT

An automated means for predicting the virus is of utmost importance to help the medical personnel to detect patients, prepare reports and produce results fast and impeccably so that people can get early treatment and prevent future transmissions. In this work, we proposed a COVID19 detection method using chest x-ray images by training and testing pre-trained deep neural network models, such as VGG19, InceptionV3, and Densenet201 individually, and got an accuracy of 96.9%, 95.2%, and 96.7% respectively. Then to bolster the performance of each model, we proposed an average weighted based ensemble approach and got an accuracy of 97.5%, which surpassed the performance of each separate model. © 2021 IEEE.

13.
Pakistan Journal of Medical and Health Sciences ; 16(1):256-258, 2022.
Article in English | EMBASE | ID: covidwho-1677849

ABSTRACT

Objective: To compare the patient outcome in severe COVID-19 pneumonia between the non-invasive ventilation and invasive mechanical ventilation. Study design: Prospective, observational study Study Setting and Duration: Department of Pulmonology, Bahawal Victoria Hospital, Bahawalpur from January 2021 to June 2021. Methodology: We analyzed 660 patients of severe covid pneumonia. Conscious proning was done in those requiring ≥ 21 L oxygen and oxygen saturation < 90%. We defined typical ARDS according to Berlin criteria. Atypical ARDS did not fulfill set criteria. We divided ARDS into 2 types i-e H and L type. We managed ARDS with either NIV, invasive mechanical ventilation or both. We used multiple regression analysis to predict ICU stay. Results: Out of 660 patients, 285 (43.18%) developed biPAP failure and were subsequently intubated. We observed 273 (41.4%) overall mortality, 175 (64.1%) in IMV and 98 (35.9%) in the NIV group (p<0.0001). invasive mechanical ventilation had statistically significant correlation with mortality and also predicted ICU stay. (p=< 0.001, OR 3.2, p=0.001). Conclusion: NIV therapy is superior to invasive mechanical ventilation in terms of ICU stay and outcome.

14.
Pakistan Journal of Medical & Health Sciences ; 15(8):1838-1841, 2021.
Article in English | Web of Science | ID: covidwho-1594318

ABSTRACT

Background: The outbreak of COVID-19 in Pakistan started from February 2020 and over the next few months it affected around a million people, leaving thousands dead in an already burdened healthcare infrastructure. Rising to the challenge of COVID 19 airway management, we adopted components of 'Consensus guidelines for managing airways in patients with COVID 19 to improve success of first pass intubation alongwith minimising risk of infection to self and others. Aim: To analyse the techniques of airway management and complications of suspected or confirmed COVID status at time of their airway management. Methodology: After ethical approval by the institutional review board, data is collected from the Hospital Information System (HIS) for cases fulfilling inclusion criteria, from April to September 2020 in a tertiary care cancer hospital, Pakistan. Results: In our centre, forty-five intubations were performed, 71% of these intubations were out of hours and 43% performed by consultants. It had a high 1st attempt success rate of 84.4%, using Videolaryngoscope (64.4%) and 55.6% confirmed use of capnography. In all cases (100%) PPE was available and used. Minimum number of personnel in room during intubation was kept to four to five in 55.6% of cases. Conclusion: Dedicated airway team used Personal Protective Equipment in all cases (100%) and restricted the number of personnel during the procedure. A high success rate of 1st attempt intubation, widely used videolaryngoscope, single agent induction and consultant intubators were salient features of our practice.

15.
British Journal of Surgery ; 108(SUPPL 6):vi204, 2021.
Article in English | EMBASE | ID: covidwho-1569622

ABSTRACT

Aim: We assessed patient perceptions of hand trauma management through a plastic surgery trauma clinic. We also assessed effects of educating patients about outcomes of their condition on their desire to have prompt surgery. Method: A prospective survey review was conducted at our plastic surgery trauma clinic. Patients included were those referred due to simple hand trauma. Any patients needing urgent admissions were excluded. An anonymous survey assessing patient perceptions before and after education about delay in surgery was distributed. Results: Of 100 patients, there were mixed expectations regarding trauma clinic;38% (n=38) expect an operation, 32% (n=32) expect no operation and 30% (n=30) expect either option. 90% (n=90) expect surgery within a week (50% n=50) or within a day (40% n=40);10% expect it (n=10) within a few weeks. After educating patients about no negative effects on their condition from surgical delay, 43% (n=17) fewer patients desired surgery within a day, and 8% (n=3) fewer patients desired surgery within a week. 190% (n=19) more patients were willing to have surgery within a few weeks. 79% (n=79) would rather come back at a guaranteed surgical slot than stay in hospital until a slot is available. 72% (n=72) considered knowledge about long-term outcomes associated with surgical delay to influence their decision more than anaesthetic type (12% n=12) and personal circumstances (16% n=16). Conclusions: If appropriate patients are assured that their condition will not be affected by surgical delay, fewer patients may stay in hospital with financial benefits of reduced bed occupancy and reduced covid risks.

16.
15th ACM/IEEE International Symposium on Empirical Software Engineering and Measurement, ESEM 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1501792

ABSTRACT

Background. Studies on developer productivity and well-being find that the perceptions of productivity in a software team can be a socio-Technical problem. Intuitively, problems and challenges can be better handled by managing expectations in software teams. Aim. Our goal is to understand whether the expectations of software developers vary towards diverse stakeholders in software teams. Method. We surveyed 181 professional software developers to understand their expectations from five different stakeholders: (1) organizations, (2) managers, (3) peers, (4) new hires, and (5) government and educational institutions. The five stakeholders are determined by conducting semi-formal interviews of software developers. We ask open-ended survey questions and analyze the responses using open coding. Results. We observed 18 multi-faceted expectations types. While some expectations are more specific to a stakeholder, other expectations are cross-cutting. For example, developers expect work-benefits from their organizations, but expect the adoption of standard software engineering (SE) practices from their organizations, peers, and new hires. Conclusion. Out of the 18 categories, three categories are related to career growth. This observation supports previous research that happiness cannot be assured by simply offering more money or a promotion. Among the most number of responses, we find expectations from educational institutions to offer relevant teaching and from governments to improve job stability, which indicate the increasingly important roles of these organizations to help software developers. This observation can be especially true during the COVID-19 pandemic. © 2021 IEEE Computer Society. All rights reserved.

17.
Journal of Ayub Medical College ; 33(3):519-522, 2021.
Article in English | GIM | ID: covidwho-1490301

ABSTRACT

Background: Protection against SARS-CoV-2 in infected individuals of COVID-19 is lacking. We report a case series of repeated infections of SARS-CoV-2.

18.
American Journal of Respiratory and Critical Care Medicine ; 203(9):2, 2021.
Article in English | Web of Science | ID: covidwho-1407235
19.
Pakistan Journal of Medical and Health Sciences ; 15(8):1838-1841, 2021.
Article in English | EMBASE | ID: covidwho-1395906

ABSTRACT

Background: The outbreak of COVID-19 in Pakistan started from February 2020 and over the next few months it affected around a million people, leaving thousands dead in an already burdened healthcare infrastructure. Rising to the challenge of COVID 19 airway management, we adopted components of Consensus guidelines for managing airways in patients with COVID 19 to improve success of first pass intubation alongwith minimising risk of infection to self and others. Aim: To analyse the techniques of airway management and complications of suspected or confirmed COVID status at time of their airway management. Methodology: After ethical approval by the institutional review board, data is collected from the Hospital Information System (HIS) for cases fulfilling inclusion criteria, from April to September 2020 in a tertiary care cancer hospital, Pakistan. Results: In our centre, forty-five intubations were performed, 71% of these intubations were out of hours and 43% performed by consultants. It had a high 1st attempt success rate of 84.4%, using Videolaryngoscope (64.4%) and 55.6% confirmed use of capnography. In all cases (100%) PPE was available and used. Minimum number of personnel in room during intubation was kept to four to five in 55.6% of cases. Conclusion: Dedicated airway team used Personal Protective Equipment in all cases (100%) and restricted the number of personnel during the procedure. A high success rate of 1st attempt intubation, widely used videolaryngoscope, single agent induction and consultant intubators were salient features of our practice.

20.
J Ayub Med Coll Abbottabad ; 33(3):519-522, 2021.
Article in English | PubMed | ID: covidwho-1391163

ABSTRACT

BACKGROUND: Protection against SARS-CoV-2 in infected individuals of COVID-19 is lacking. We report a case series of repeated infections of SARS-CoV-2. METHODS: A total of 12 patients were identified with repeated infections for SARS-CoV-2 from 25 April 2020 to 16 March 2021 from Pakistan. Repeated infection was defined as diagnosis of the SARS-CoV-2 with real-time reverse transcriptase-polymerase chain reaction (RT-PCR) tests in the first and second phase of infection after complete recovery from the first phase of infection with a negative RT-PCR. RESULTS: Of the 12 participants, 75% (n=9) were male and mean age of the participants were 40.1±9.7 years. Mean duration between the first and second phase of infection was 184±68.9 days. Patients presenting with mild infection in the first phase largely developed moderate to severe infection in the second phase. None of them were vaccinated. CONCLUSION: The pandemic of COVID-19 is on the rise and repeated infection from SARS-CoV-2 is occurring.

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