RESUMEN
Background: Implementation of vaccination programmes has had a transformational impact on control of the SARS-CoV-2 pandemic, but the need for effective antiviral drugs remains. Molnupiravir (MPV) targets viral RNA polymerase inhibiting replication via lethal mutagenesis and nirmatrelvir (NTV) is a protease inhibitor boosted with ritonavir when given clinically. This study aimed to assess the virological efficacy of NTV and MPV individually and in combination against the SARS-CoV-2 BA.1 Omicron variant in a K18-hACE2 mouse model. Method(s): K18-hACE2 mice were inoculated intranasally with 103 PFU of SARSCoV-2 BA.1 Omicron (B.1.1.529). After 24 hours, mice were orally dosed q12H, as outlined in Figure 1. At 2, 3, and 4-days post infection mice were sacrificed, and lung samples harvested. Animals were weighed and monitored daily throughout. Subsequently, viral replication in the lung was quantified using qRT-PCR to measure total (N-gene) and sub-genomic (E-gene) viral RNA. Data were normalized to 18S for quantitation. Viral exposures expressed as Areas Under viral load Curves (AUCs) were calculated by the trapezoidal method using mean values at each timepoint. Separate studies in Syrian golden hamsters using individual drugs were also conducted, and total serum IgG was measured by ELISA at 4-days post infection. Result(s): Mice gained weight in all groups post-treatment, with no significant difference between groups. A reduction in lung viral exposure was evident in all treatment groups compared to the vehicle control dosed mice (Figure 1). Coadministration of NTV with MPV displayed a trend towards lower lung viral exposure compared to the vehicle control with ~40-and ~45-fold reduction in AUC for N-and SgE-gene assays, respectively. Dosed individually, NTV and MPV reduced viral exposure 5.7-and 7.7-fold for the N-gene assay, respectively. Differences in total serum IgG concentrations were evident between vehicle and NTV-(34-fold reduction, P=0.018), and MPV-(4.2-fold reduction, P=0.053) treated hamsters. Conclusion(s): These data show virological efficacy of NTV and MPV against the SARS-CoV-2 BA.1 Omicron variant. The combination of NTV and MPV demonstrated a lower viral RNA exposure in the lung than either drug alone, albeit not statistically significant. Initial data indicate potential immune alterations in NTV and MPV dosed hamsters. Studies to clarify the utility of NTV/ MPV combinations and further characterize the impact of antiviral therapy on IgG are warranted.
RESUMEN
Background: Maternal depression and anxiety can predispose the women to higher risk of complications. The COVID-19 pandemic is a unique stressor which may affect the mental and psychological well-being of pregnant women. Aim(s): To determine prevalence of depression and anxiety and related factors in pregnant women during COVID-19. Method(s): This multicenter analytical cross-sectional study was carried out from August 2021 to December 2021 in six cities of Pakistan. Two stage sampling technique was used to include sample of 400 pregnant women. Patient Health Questionnaire-9 (PHQ-9) and Corona virus Anxiety Scale (CAS) were used to measure depression and anxiety level along with self-constructed questionnaire to record socio-demographic profile. Data entry and analysis was done in SPSS version 23. Association between variables was assessed by applying Chi square test and strength of association was measured by binary logistic regression. p-value <= 0.05 was taken as statistically significant. Result(s): Mean age of participants was 27.25+/-5.22 years. The mean gestational age was 23.5+/-9.6 weeks. About 37.1% had mild depression. Moderate depression was found in 7.8% and moderately severe depression in 0.5% participants. Significant association was found between depression and no physical activity (p value=0.02), not having spouse support (p value=0.03), perceived vulnerability to get COVID (p value=0.004) and fear of infection to baby (p value=0.05). Only 3.25% participants had dysfunctional anxiety. Conclusion(s): Findings of the study would be helpful for policy makers to launch health awareness campaigns about regular physical activity, role of social support and seeking medical advice for mental well-being during pregnancy. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
RESUMEN
Background: COVID-19 was announced as a pandemic issue globally on 11th March, 2020. In response to this situation, all educational activities including medical and clinical education in various colleges across the country were suspended on the 15th of March. So, online education emerged as an alternative method of teaching & learning to maintain continuity of education Aim: To evaluate the use of online learning modalities and to find their feasibility and usability in medical education. Method(s): A cross-sectional study was performed across the government and private medical colleges of Lahore. Eligible participants were undergraduate medical students from 10 medical colleges of Lahore. A questionnaire linked to a Google form was distributed to the medical students across 10 government and private medical colleges through different social platforms. Result(s): A total of 439 valid questionnaires were collected. 31.7% of students disagreed that interaction between students and teachers was possible through online teaching. Only 7.7% of students agreed that online learning can be used for clinical teaching of medical sciences, as compared to 35.8% who disagreed with this answer and 12.8% who were neutral. 23% of the students agreed that online learning was more convenient and flexible than traditional learning, while 24% disagreed and 21.4% were neutral in this regard. Only 19.8% of students had problems with poor internet services. Conclusion(s): As Pakistan has faced four waves of the COVID-19 which is not over yet due to the emergence of new strains. Due to vaccination of medical students medical education is back to conventional physical learning but online learning has gained importance as an effective alternate to continue learning processes in exceptional situations like COVID-19 pandemic. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.