Clinical and Laboratory Evaluations of Patients Diagnosed as Having Multisystem Inflammatory Syndrome Associated with Coronavirus Disease 2019 in Children: A Single Center Experience from Konya

Objective Multisystem inflammatory syndrome in children (MIS-C), characterized by fever, inflammation, and multiorgan dysfunction, was newly defined after severe acute respiratory syndrome coronavirus 2 infection. The clinical spectrum of MIS-C can be classified as mild, moderate, and severe. We aimed to evaluate demographics, clinical presentations, laboratory findings, and treatment modalities of patients with MIS-C according to clinical severity. Methods We performed a retrospective study of patients who were diagnosed as having MIS-C between September 2020 and October 2021 in the Necmettin Erbakan University Meram Faculty of Medicine, Türkiye. Results A total of 48 patients (24 females and 24 males) with a median age at diagnosis of 10.3 years (range: 42 months-17 years) were enrolled, the most common clinical severity of MIS-C was moderate. The common presentations of patients were fever (97%), nonpurulent conjunctivitis (89.6%), rashes (81.3%), fatigue (81.3%), strawberry tongue (79.2%), and myalgia (68.8%). The most common laboratory findings were lymphopenia (81.2%), thrombocytopenia (54.1%), elevated D-dimer levels (89.5%), C-reactive protein (CRP;100%), procalcitonin (97%), erythrocyte sedimentation rate (87.5%), ferritin (95.8%), interleukin 6 (IL-6) (86.1%), and probrain natriuretic peptide (pro-BNP) (97%). High levels of CRP, procalcitonin, pro-BNP, and urea were associated with the severity of MIS-C (p < 0.05). Fifteen of the patients were found to have pulmonary involvement. Ascites were the most common finding on abdominal ultrasonography (11 patients) and were not seen in a mild form of the disease. During the study period, two patients died. Conclusion It is important to make patient-based decisions and apply a stepwise approach in treating patients with MIS-C due to the increased risk of complications and mortality. © 2022. Thieme. All rights reserved.

Nail ridging in rheumatoid arthritis patients and relation to disease activity: An integrated rheumatology-dermatology multi-centre study

Aim of the work: To evaluate the frequency of nail ridging (NR) in patients with rheumatoid arthritis (RA) and to study its relation to disease activity. Patients and methods: 230 RA patients and 97 matched controls from Helwan, Ain Shams and Mansoura university hospitals were studied. Disease activity score (DAS28) was assessed. NR has been searched for in all patients. The number of affected fingers was recorded. NR was determined by a magnifying lens, seen by naked eye or seen and felt. Dermoscopic photography of the NR using Dermalite DL4 3Gen dermatoscope has been recorded. Results: The median age of patients was 49 years (42–58 years);they were 221 females and 19 males (F:M 11.1:1) with a disease duration 9 years (5–11 years). Their DAS28 was 3.6 (2.9–4.6). NR was significantly increased in RA cases vs. control;73% vs 20%;p < 0.001. In patients, NR was detected by a magnifying lens in 32.6%, seen in 27% and seen and felt in 13.5%. Joint deformities were significantly higher in those with NR. DAS28 was a significant independent predictor of NR;for every one-point increase in DAS28, there was a 153 times higher odds to exhibit NR at a sensitivity of 93.5%, specificity 80.3% and at a diagnostic accuracy of 90%. Conclusion: NR is a frequent finding in RA. An integrated rheumatological- dermatological clinical evaluation may be helpful and further studies are required to prove the importance of this sign for follow up of RA patients.

Analysis of combined non-invasive respiratory support in the first six waves of the COVID-19 pandemic. Outcome according to the first respiratory support

Introduction: COVID-19 can lead to acute respiratory failure (ARF) requiring admission to intensive care unit (ICU). This study analyzes COVID-19 patients admitted to the ICU, according to the initial respiratory support. Its main aim is to determine if the use of combination therapy: high-flow oxygen system with nasal cannula (HFNC) and non-invasive ventilation (NIV), is effective and safe in the treatment of these patients. Methods: Retrospective observational study with a prospective database. All COVID-19 patients, admitted to the ICU, between March 11, 2020, and February 12, 2022, and who required HFNC, NIV, or endotracheal intubation with invasive mechanical ventilation (ETI-IMV) were analyzed. HFNC failure was defined as therapeutic escalation to NIV, and NIV failure as the need for ETI-IMV or death in the ICU. The management of patients with non-invasive respiratory support included the use of combined therapy with different devices. The study period included the first six waves of the pandemic in Spain. Results: 424 patients were analyzed, of whom 12 (2.8%) received HFNC, 397 (93.7%) NIV and 15 (3.5%) ETI-IMV as first respiratory support. PaO2/FiO2 was 145 ± 30, 119 ± 26 and 117 ± 29 mmHg, respectively (p = 0.003). HFNC failed in 11 patients (91.7%), who then received NIV. Of the 408 patients treated with NIV, 353 (86.5%) received combination therapy with HFNC. In patients treated with NIV, there were 114 failures (27.9%). Only the value of SAPS II index (p = 0.001) and PaO2/FiO2 (p < 0.001) differed between the six analyzed waves, being the most altered values in the 3rd and 6th waves. Hospital mortality was 18.7%, not differing between the different waves (p = 0.713). Conclusions: Severe COVID-19 ARF can be effectively and safely treated with NIV combined with HFNC. The clinical characteristics of the patients did not change between the different waves, only showing a slight increase in severity in the 3rd and 6th waves, with no difference in the outcome. © 2022 Elsevier Ltd

Examining virtual research recruitment and participant diversity in a multi-center birth cohort, Childhood Allergy and the NeOnatal Environment" (CANOE)

Rationale: Recruitment for a NIH/ECHO-supported multi-center birth cohort, "Childhood Allergy and the NeOnatal Environment” (CANOE) stopped due to the COVID-19 pandemic. Redesign of study procedures emphasized virtual and socially distanced activities. We hypothesized that "virtual” recruitment methods (social media, websites, email) would surpass "traditional” methods (in-clinic, telephone, flyers/print materials) and increase enrollment of families from diverse backgrounds and communities. Methods: Pregnant women (n=439, target 500) were recruited from four academic medical centers in Detroit MI, Madison WI, Nashville TN, and St. Louis MO. We collected demographic and social information by questionnaires and examined race, ethnicity, age, parity, and employment status in relation to recruitment method using chi-square tests. Results: In-clinic and telephone recruitment comprised 55% of enrollment, followed by print materials (17%), and social media and email (15%). The cohort includes families self-identifying as Caucasian/White (63%), African American/Black (27%), Hispanic/Latino (3.3%), Asian (3.5%), and mixed races (1.2%). This reflects site demographics for White and Black patients, while other populations are not as well recruited into this cohort. Recruitment method success did not vary by race, ethnicity, maternal age, or employment status (p=ns for each comparison). Most (63%) multigravida mothers (9.1% of participants) were recruited in clinic, while primigravida participants were recruited more evenly via all methods. Conclusions: "Virtual” recruitment methods comprised a smaller proportion of cohort enrollment than hypothesized and study recruitment method did not vary by race/ethnicity;however, consideration of combined, varied, and novel recruitment methods may add to the development of best practices for more representative research study recruitment.

202. A Mixed Method Investigation of Parent-Adolescent Communication about Mental Health

Purpose: The purpose of this study is to explore how adolescents and their parents/guardians communicate about mental health in order to generate ideas for potential interventions that seek to improve parent-adolescent communication. Methods: Twenty adolescents aged 12 to 19 with a history of depression and/or anxiety were recruited from an adolescent and young adult medical clinic affiliated with an academic medical center in Pittsburgh, PA. Adolescent participants were asked to enroll in the study alongside one parent or guardian. Following enrollment, both adolescents and their parents/guardians completed a survey including a Barriers to Adolescents Seeking Help Scale and Parent-Adolescent Communication Scale. Two sample t-tests were performed to determine if a significant difference existed between overall adolescent and parent/guardian scores. Separate, semi-structured interviews were conducted in person and via Zoom for both adolescents and parents/guardians. Interviews were transcribed verbatim and separate, data-driven codebooks for adolescents and parents/guardians were developed based upon themes that emerged after initial read-through of interview transcripts. Qualitative data was analyzed via template analysis. Double coding was utilized for half of the adolescent and parent/guardian interviews and Cohen's Kappa scores were calculated for each code;the average score was 0.90, indicating substantial agreement. The rest of the interviews were coded by one coder. Results: Qualitative analysis revealed themes concerning adolescents' reluctance to communicate with parents about mental health, including fear of judgement, apprehension about parents' dismissal or misinterpretation of mental health symptoms, and worry about burdening parents. Additionally, a theme of adolescents' preference for communicating with peers was identified, often due to shared experiences. Several themes were identified that promoted parent-adolescent communication, including the disclosure of familial mental health conditions, which led to greater mutual understanding, as well as reduced mental health stigma: "She [mother] talks to me about her own mental health, which makes me feel comfortable talking to her about mine”. Psychotherapy was described by both parents and adolescents as promoting the development of more effective communication strategies. A theme of increased communication about mental health during the COVID-19 pandemic was found, many times due to a greater amount of family time. Both parents and adolescents indicated that an established, trusting relationship was critical to the success of a conversation about mental health. Quantitative analysis revealed that parents reported a significantly higher quality of communication with their child (79.80, p = 0.04) than adolescents reported with their parent (71.75). Additionally, parents reported significantly lower barriers to help seeking (18.60, p = 0.002) than adolescents (24.00). Conclusions: The themes identified in this study lend insight into how communication between parents and adolescents about mental health might be improved and provide targets for potential educational interventions. Anti-stigma campaigns directed at parents may assist in disclosure of familial mental health history and assist in diminishing adolescents' apprehension of parents' dismissal or misinterpretation of mental health symptoms. For parents and adolescents with poor communication, targeted combined psychotherapy sessions can be encouraged as a means to facilitate conversation about mental health and establish trust. Sources of Support: National Institute of Mental Health K23MH111922

Back to the First Days of the Pandemic: How Well Have We Done to Diagnose COVID-19 in Healthcare Workers?

Introduction: Healthcare workers (HCWs) are one of the most vulnerable groups for COVID-19. SARS-CoV-2 PCR was offered to HCWs who had symptoms compatible with COVID-19 or who had a close contact with COVID-19 patient. A rapid antibody test was used to identify the risk of exposure of the HCWs who worked at high-risk units in our hospital during the first month of the pandemic. Herein, we aimed to evaluate the usefulness of this approach. Materials and Methods: The records of the HCWs from a university hospital who were tested by SARS-CoV-2 PCR or rapid antibody test between March 12, 2020 and April 04, 2020 were reviewed retrospectively. Demographic and clinical characteristics of HCWs were extracted from the electronic database. Wards or outpatient clinics that served COVID-19 patients were defined as high-risk units. Results: A total of 599 HCWs were tested for SARS-CoV-2 by PCR and 409 by rapid antibody test. Thirty-seven (6.2%) were found to be PCR positive. Eleven (29.7%) out of 37 HCWs were asymptomatic when they were tested. There was no statistically significant relationship between PCR positivity and occupation or working unit. A positive PCR result was detected in 24 HCWs during the first admission. Eleven out of 114 HCWs who were tested by a second PCR were found to be positive and two out of 17 HCWs who were tested by a third test were reported as PCR positive. Median interval between the first and second PCR was seven days (IQR= 8.5 days) and median interval between second and third PCR test was 4.5 days for the HCWs who were reported as positive at repeated PCR tests. Rapid antibody test was positive in one HCW who did not have a history of COVID-19. Conclusion: Approximately, one third of the SARS-CoV-2 PCR positive HCWs were asymptomatic. In case of increasing incidence of COVID-19 in the community, a regular screening policy for the HCWs regardless of their occupation and contact tracing might help to have a safe environment in hospitals. Screening policy should be based on well validated tests.

THE EFFECT OF COMMON SURGICAL MASKS ON UNATTENDED BLOOD PRESSURE CHANGES IN DRUG TREATED HYPERTENSIVE PATIENTS

Objective: While there are several studies that have focused on the role of face masks in preventing airborne transmission of SARS-CoV-2, few data are available on their effects on physiological measures, and no study has examined their effects on blood pressure (BP). The purpose of our study was to investigate the effect of surgical masks on BP in drug-treated hypertensive patients who had a routine follow-up visit to a university hospital outpatient hypertension clinic. Design and method: The study included already treated hypertensive patients aged > 18 years, while the exclusion criteria were atrial fibrillation or any other arrhythmia affecting the BP measurement, an arm circumference > 42 cm, mental disorders, Parkinson disease, pregnancy, intolerance to the BP measurement method, or unwillingness to participate. A new surgical mask was provided to all participants to replace the face mask that was already in use. After the routine mask-on office BP measurement, patients were left alone and randomized to automated office BP measurement, with measurements taken after first wearing a mask for 10 min, then without wearing the mask for 10 min, and vice versa. Results: A total number of 265 patients were included in the study. Among the participants, 115 were women (43.4%), the mean age was 62 ± 12 years, and the mean office BP was 134 ± 15 / 81 ± 12 mmHg. There was no significant difference between mask-on unattended systolic BP (133 ± 15 mmHg) and mask-off unattended systolic BP (132 ± 15 mmHg) (P = 0.13) or between mask-on unattended diastolic BP (77 ± 13 mmHg) and mask-off unattended diastolic BP (76 ± 13 mmHg) (P = 0.32). Moreover, there was no difference in the heart rate (mask-on first, 69 ± 11 bpm;mask-off first, 69 ± 11 bpm, P = 0.7). Conclusions: Common surgical masks do not affect systolic/diastolic BP levels during unattended BP measurements in treated hypertensive patients.

POSTAL MEDICINE DELIVERY FOR STAGE-2 HYPERTENSIVE PATIENTS IN COVID-19 SITUATION: TURNING CRISIS TO OPPORTUNITY

Introduction: The COVID-19 pandemic has influenced healthcare systems, particularly in the areas of non-communicable diseases, such as hypertension, where the majority of patients require medication therapy and frequent visits. The postal medicine delivery (PMD) approach was an innovative solution to keep antihypertensive drugs accessible under the social distance regulation. Objective: We aimed to investigate the effectiveness of the PMD in terms of blood pressure (BP) control (< 140/90 mmHg), and target organ damage (TOD) including myocardial infarction, heart failure, acute stroke, and progression of chronic kidney disease) during the use of PMD. Design and method: This was a cross-sectional study in a university hospital, conducted between 11th March to 27th May 2020 when the hospital policy stated that outpatient departments' service would be reduced, and physicians were encouraged to use PMD. Patients without a history of TOD and who had a history of well BP control (< 140/90 mmHg) for the last 2 weeks, were enrolled. All of the patients used smartphones and LINE® applications for contacting the nurse coordinator every 3 months to report their home BP. After 6 months of PMD, patients were assigned to have a follow-up visit at the hospital for office BP measurement and having metabolic panel checked. Results: Thirty-eight patients met the inclusion criteria, and 68% were women. Most of the patients (97.4%) had used home BP monitoring (HPBM). The rate of BP control in goal was 64.2%. There was no TOD during the PMD approach. The medication boxes were sent successfully via postal service within 5-10 days, with no loss or damage recorded. All of the patients reported that they had been taking their antihypertensive medications. More than two-thirds (68.4%) continued to follow a low-sodium diet, while 76.3 percent continued to exercise regularly. Conclusions: In the COVID-19 epidemic, the PMD method could be another effective and safe strategy to enhance medicine access, if suitable enrolment criteria and communication between healthcare practitioners and patients are maintained. (Figure Presented).

Examining the association between vaccine reactogenicity and antibody titer dynamics after the third dose of BNT162b2 vaccine using a mixed-effects model

Background: To mitigate the COVID-19 pandemic, many countries have recommended the use of booster vaccinations. The relationship between the degree of adverse vaccine reactions and elevated antibody titers is of interest;however, no studies have investigated the temporal changes in antibody titers based on repeated measurements after a third dose of the BNT162b2 vaccine. Methods: This prospective longitudinal cohort study was conducted with 62 healthcare workers who received a third dose of the BNT162b2 at Okayama University Hospital, Japan. Venous blood draw and fingertip whole blood test sample collection were conducted at the early (3–13 days) and 1-month time points;only FWT sample collection was conducted at the 2-month time point. Information on adverse reactions within 1 week after vaccination was also obtained. The association between fever of 37.5 °C or higher and antibody titers after the third dose of BNT162b2 was examined using a mixed-effects model and Poisson regression with robust variance. Results: A trend toward higher antibody titers in the early period after vaccination was observed in the febrile individuals, but the differences were not significant at 1 and 2 months post-vaccination (the partial regression coefficient for fever was 8094.3 [-1910.2, 18,098.8] at 1 month after vaccination, and 1764.1 [-4133.9, 7662.1] at 2 months after vaccination in the adjusted models). Conclusion: The findings suggest that the presence of fever after the third vaccine does not predict a sustained elevation in serum antibody titers. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases

Evaluating equity in participation within a comprehensive school based wellness initiative amongst schools from different resource settings

Purpose of Study: It is well documented that the school environment can foster students' health through modification of social, nutritional, and physical activity factors. Schools often employed wellness programs prior to the COVID-19 pandemic to comprehensively address these different factors. However, one factor predicted to have negative health impacts on children during the pandemic involved schools shutting down and transitioning to virtual learning. Schools from lower resource settings like Title 1 schools likely experienced challenges addressing these health impacts during the pandemic through wellness programs, such as lack of access to technology and challenges within the home setting. The purpose of this study is to examine participation in an academic medical center supported K-12 school-based wellness initiative amongst schools from different resource settings during the COVID-19 pandemic. Methods Used: This was a retrospective cohort study of 68 schools within the longest participating county school district during the school years of 2017 + 2018, 2019, and 2020 respectively, with schools being separated by Title 1 status (Title 1 n = 36, non-Title 1 n = 32). The mean percentage of points earned on the wellness initiative's School Wellness Checklist was stratified by Title 1 status and compared utilizing two-sample T-tests between the study years. As well, within each study year, points earned on the checklist were compared between Title 1 and non- Title 1 schools utilizing two-sample T-tests. The change in number of participating Title 1 schools across the study years was analyzed using the Cochrane-Armitage Trend Test. Summary of Results: Non-Title 1 schools decreased significantly more in mean percent of earned checklist points from pre-pandemic to the 2020 pandemic study year compared to Title 1 Schools during that same period (mean decreas -1.24% non-Title 1, mean increase 0.796% Title 1, p = 0.0018). Non-Title 1 schools implemented checklist items significantly more compared to Title 1 schools during all study years except for the 2020 pandemic study year (p < 0.05). The number of participating Title 1 schools did not significantly change across the study years (p < 0.05). Conclusion(s): These results demonstrate the resiliency of schools from lower resource settings to equitably participate in this wellness initiative despite the challenges faced during the pandemic. Non-Title 1 schools demonstrated significantly higher performance within the initiative prior to the pandemic, but significantly declined as the pandemic was in full effect. In contrast, Title 1 schools sustained participation in the wellness initiative across all study years and performed similarly to non-Title 1 schools during the pandemic study year. This study supports how schools from different resource settings can equitably utilize this comprehensive school wellness initiative as a framework for their wellness programs, even during challenging times such as the COVID-19 Pandemic. Copyright © 2023 Southern Society for Clinical Investigation.

Commonwealth Pharmacist Partnership develops antimicrobial stewardship and infection control in Zambia

Background: Misuse of antimicrobials combined with poor infection prevention and control (IPC) can result in antimicrobial resistance (AMR). Health partnerships are ideally placed to enhance antimicrobial stewardship (AMS) through sharing up-to-date evidence and implementing best practice. Purpose(s): Brighton Lusaka Pharmacy Link (BLPL) was awarded a Commonwealth Partnerships for Antimicrobial Stewardships Scheme (CwPAMS) grant to implement AMS at University Teaching Hospital (UTH) (THET, 2020). Pharmacists-led AMS prescribing and monitoring activities aim to implement a robust data collection system and measure the impact of interventions reducing misuse and overuse of antibiotics while increasing knowledge about on IPC and AMS. Method(s): BLPL conducted a three-day workshop in Zambia for pharmacists, physicians, nurses and allied healthcare professionals at UTH to enhance AMS and point prevalence surveillance (PPS). IPC training was provided by the experienced Ndola IPC team. Train the trainer workshops enables UTH to disseminate AMS, PPS, IPC and data collection standards. Result(s): Proactive MDT committee to manage AMS and IPC activities at UTH was established Specialist AMS pharmacist appointed Two Global-PPS undertaken Modified antibiotic prescribing chart introduced and audited-UTH antimicrobial guidelines updated AMS modular training programme for health care accredited by UNZAforCPD recognition-34 IPC trainers trained Bare-below-the-elbow dress code (BBE) adopted nationally by HOPAZ WHO hand-rub production expanded Conclusion(s): This model of pharmacist-led AMS demonstrates sustainability in locally driven AMS knowledge and seeded national IPC capacity-building whilst instigating behavioural change pertinent during the COVID-19 pandemic.

Hydroxychloroquine desensitization improves the retention rate for patients with Systemic lupus erythematosus, 356 cases analysis in Japan Impact of the COVID-19 pandemic on patients with rheumatological disorders: A single centre study in Sri Lanka

Background: The COVID-19 pandemic has affected patient populations all over the world and majority are being directly or indirectly affected by the virus. Many had to encounter logistical problems related to clinic attendance due to lockdowns, cancellation of clinics, unavailability of safe transport, quarantine process and multiple other factors. Therefore, the morbidity and mortality during the pandemic was also related to the co-morbidities of the patients, including rheumatological disorders. Thus, it is worthwhile investigating the impact of the pandemic on their disease, to guide a more structured approach to their care, particularly if similar situations occur in the future. Method(s): This was a cross sectional observational study done on 325 of Rheumatology clinic follow-up patients at University Hospital, Kothelawala Defence University (UH-KDU), Sri Lanka. After obtaining informed verbal consent, data was collected by the investigator by telephone interviewing and recorded in a questionnaire. The questionnaire included details on the diagnosis, duration of clinic follow-up, the routine medication, disruption of clinic visits with reasons, availability of medication and disease flares during this pandemic. Data was analysed using SPSS version 23. Result(s): The mean age of the study population was 57.1 years and a majority of 42.2% had degenerative arthritis while 20.6% and 24.3% had inflammatory arthritis and soft tissue rheumatism respectively. Sixty six percent of the patients has been followed up in the clinic for more than a year. Out of the study population 23.4% was on disease modifying drugs (DMARDs). Routine clinic follow-up was disrupted in 79.1%. Out of which 42.4% did not attend due to fear of contracting COVID during the clinic visit, 15.2% due to transport difficulties, 21% due to cancellation of clinics by hospital and 21.4% due to other reasons. Forty two percent experienced disease flare during the pandemic, while for 47.7% routine medicine was unavailable. Disease flare was found to be a correlated with disruption of clinic visits (P = 0.000) and availability of medicine. (P = 0.000) Conclusion(s): A significant proportion of regular clinic attendees had their clinic follow-up disrupted due to COVID pandemic. The main reason for clinic absence was fear of contracting COVID during the clinic visit. More than one third of the study population experienced a disease flare related to disruption of clinic attendance and unavailability of medicine. Therefore, it is recommended that telemedicine services be made available to patients with chronic rheumatological disorders, should they fail to attend follow-up visits to ensure the patient wellbeing.

Rhino-Orbital Mucormycosis in a COVID-19 Patient: A Dreadful Challenge

Coronavirus disease 2019 (COVID-19) is a pandemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). COVID-19 infections may be associated with a wide range of bacterial and fungal co-infections. Recent studies are reporting invasive fungal infection associated with severe COVID-19. Herein, we report a case of COVID-19 rhino-orbital mucormycosis infection caused by Rhizopus sps in a 32 year old diabetic patient who was successfully managed with early aggressive debridement of infected tissue endoscopically with extended ethmoidectomy by modified Denker's approach along with orbital decompression and antifungal therapy with Liposomal Amphotericin B and Posaconazole. Serial diagnostic nasal endoscopy showed no evidence of progression of the infection. The patient was discharged on 21st day of hospitalization still on oral Posaconazole for a total of 3 months. Copyright © 2022, Kathmandu University. All rights reserved.

The risk of occupational contact dermatitis in COVID-19 isolation ward setting

Background The preventive measures of coronavirus disease-19 (COVID-19) transmissions require the healthcare workers (HCWs) to be more cautious. Irritants or allergens exposure from these measures might induce adverse skin reactions and lead to the development of occupational contact dermatitis (OCD). Methods Questionnaires were distributed to HCWs in COVID-19 isolation ward of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. The questionnaire consisted of personal and work characteristics, clinical history, skin complaints, and occupational exposures. Results Fifty-three completed questionnaires were gathered from eligible subjects. History of atopic dermatitis (AD) was found on 8 subject (15.09%). Many of the subjects had complained of dry skin (28.30%), itchy skin (26.41%), and redness of skin (20.75%) on the hands in the last 12 months. As many as 50.94% of the subjects washed their hands with water and soap at least 6-10 times a day and 49.06% used hand sanitizers 6-10 times a day. The use of PPE were mostly 4 hours a day or less. There were associations between history of AD with complaints related to hand dermatitis (p=0.004) and history of AD with incidence of OCD assessed with Mathias criteria (p=0.016). It was also found that the use of gloves for 2 or more hours a day was associated with skin complaints after gloves use (p=0.021) and the use of hand sanitizer for more than 10 times a day was associated with complaints related to hand dermatitis (p=0.041). Conclusion The repeated and prolonged exposure to irritative or allergenic substances contained in PPE and hand hygiene products is related to OCD, particularly hand dermatitis, among HCWs in COVID-19 isolation ward. Copyright © 2023 Pakistan Association of Dermatologists. All rights reserved.

Retrospective and comparative study about the impact of the health crisis on the activity of a pedopsychiatric emergency unit

Objectives: The aim of this retrospective study was to question the psychological consequences of the health crisis in a pediatric population, through an analysis of the variations in the activity data of a pedopsychiatric emergency consultation service. Material(s) and Method(s): The present study is a retrospective and comparative epidemiological study based on an analysis of activity data from a pedopsychiatric emergency consultation at the Lille University Hospital center collected over the period contemporary of the social restriction measures of March 17th, 2020 to May 19th, 2021 as well as those collected after the lifting of these measures from May 19th, 2021 to May 31st, 2022 by comparing them to the activity on this same service over the equivalent periods between January 1st, 2017 and March 17th, 2020. Comparisons centered around the three confinement periods were also carried out. Any patient between 0 and 18 years old taken care of in this emergency consultation was included in this study. Result(s): A significant increase in drug prescriptions and consultations for suicidal ideations was observed during, but also at a distance from social restriction measures. The first confinement was marked by a significant drop in the number of consultations and a significant increase in the drafting of child protection documents. Discussion(s): These results were therefore in favor of an increase in suicidality in the pediatric population during and after the lifting of social restriction measures, as well as an increase in situations relating to child protection during the first confinement. The significant increase in discordant discharge drug prescriptions with the more modest increase in hospitalizations foreshadowed a mismatch between needs and hospitalization capacity. Conclusion(s): An impact of the health crisis could therefore be observed on the activity of a pedopsychiatric emergency consultation during, but also after the lifting of social restriction measures. This raises the importance of not limiting research to periods of confinement, as well as the question of the reversibility of the variations observed for the generation considered. Copyright © 2022 Elsevier Masson SAS

COVID-19 Transmission in Healthcare Professionals in the First Period of the Pandemic.

Objective: We aimed to evaluate the spread of COVID-19 among healthcare workers diagnosed with COVID-19 at the beginning of the COVID-19 epidemic and to draw attention to the importance of the correct and effective use of personal protective equipment. Method(s): This is a descriptive, cross-sectional, retrospective study. The research universe consisted of healthcare workers and administrative and technical personnel working at a university hospital who were diagnosed with COVID-19 at the beginning of the pandemic. The sample consisted of 100 healthcare workers diagnosed with COVID-19 and agreed to participate in the study. Data were collected between 10 June-30 July 2020. The "Evaluation of the Transmission Status of Healthcare Workers Diagnosed with COVID-19 Questionnaire" questionnaire, which included questions about demographic and disease information, COVID-19 transmission, and personal protective equipment usage parameters, was used as the data collection tool. The questionnaire was filled face to face or by telephone calls by the researchers. Result(s): Of the participants, 41% stated that they had never worked in the COVID unit, 33% worked only on duty in the COVID unit, and 26% stated that they constantly worked in the COVID unit;32% had contact with a patient diagnosed with COVID-19 in the last 14 days. Regarding the use of personal protective equip-ment, 51% stated that they did not have any problems, and 52% stated that they had not received any training. Conclusion(s): Frontline healthcare workers can be infected during the pandemic. Inadequacies in the use of personal protective equipment, omissions, failure to carry out systematic training and practices, and neglecting the use of protective equipment in social environments increase the risk of transmission. Copyright © 2022, DOC Design and Informatics Co. Ltd. All rights reserved.