Retraction Note: A new emergency response of spherical intelligent fuzzy decision process to diagnose of COVID19 (Soft Computing, (2023), 27, 3, (1809-1825), 10.1007/s00500-020-05287-8)

The Editor-in-Chief and the publisher have retracted this article. The article was submitted to be part of a guest-edited issue. An investigation by the publisher found a number of articles, including this one, with a number of concerns, including but not limited to compromised editorial handling and peer review process, inappropriate or irrelevant references or not being in scope of the journal or guest-edited issue. Based on the investigation's findings the Editor-in-Chief therefore no longer has confidence in the results and conclusions of this article. Author Shahzaib Ashraf disagrees with the retraction. Authors Saleem Abdullah and Alaa O. Almagrabi have not responded to correspondence regarding this retraction. © 2023, Springer-Verlag GmbH Germany, part of Springer Nature.

Kawasaki Disease in the Time of COVID-19 and MIS-C - The International Kawasaki Disease Registry.

BACKGROUND: Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki disease (KD) have overlapping clinical features. We compared demographics/clinical presentation, management, and outcomes of patients by evidence of prior SARS-CoV-2 infection. METHODS: The International KD Registry (IKDR) enrolled KD and MIS-C patients from sites from North, Central and South America, Europe, Asia and Middle East. Evidence of prior infection was defined as: Positive (+ve household contact or positive PCR/serology), Possible (suggestive clinical features of MIS-C and/or KD with negative PCR or serology but not both), Negative (negative PCR and serology and no known exposure), and Unknown (incomplete testing and no known exposure). RESULTS: Of 2345 enrolled patients SARS-CoV-2 status was Positive for 1541 (66%) patients, Possible 89 (4%), Negative 404 (17%) and Unknown for 311 (13%) patients. Clinical outcomes varied significantly between the groups, with more patients in the Positive/Possible groups presenting with shock, having admission to Intensive Care, receiving inotropic support, and having longer hospital stays. Regarding cardiac abnormalities, patients in the Positive/Possible groups had a higher prevalence of left ventricular dysfunction, while patients in the Negative and Unknown groups had more severe coronary artery abnormalities. results CONCLUSION: : There appears to be a spectrum of clinical features from MIS-C to KD with a great deal of heterogeneity, and one primary differentiating factor is evidence for prior acute SARS CoV2 infection/exposure. SARS-CoV-2 Positive/Possible patients had more severe presentations and required more intensive management, with a greater likelihood of ventricular dysfunction but less severe coronary artery adverse outcomes, in keeping with MIS-C.

COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA).

OBJECTIVE: To find out differences in the presentation, management and outcomes of COVID-19 infected STEMI patients compared to age and sex-matched non-infected STEMI patients treated during the same period. METHODS: This was a retrospective multicentre observational registry in which we collected data of COVID-19 positive STEMI patients from selected tertiary care hospitals across India. For every COVID-19 positive STEMI patient, two age and sex-matched COVID-19 negative STEMI patients were enrolled as control. The primary endpoint was a composite of in-hospital mortality, re-infarction, heart failure, and stroke. RESULTS: 410 COVID-19 positive STEMI cases were compared with 799 COVID-19 negative STEMI cases. The composite of death/reinfarction/stroke/heart failure was significantly higher among the COVID-19 positive STEMI patients compared with COVID-19 negative STEMI cases (27.1% vs 20.7% p value = 0.01); though mortality rate did not differ significantly (8.0% vs 5.8% p value = 0.13). Significantly lower proportion of COVID-19 positive STEMI patients received reperfusion treatment and primary PCI (60.7% vs 71.1% p value=< 0.001 and 15.4% vs 23.4% p value = 0.001 respectively). Rate of systematic early PCI (pharmaco-invasive treatment) was significantly lower in the COVID-19 positive group compared with COVID-19 negative group. There was no difference in the prevalence of high thrombus burden (14.5% and 12.0% p value = 0.55 among COVID-19 positive and negative patients respectively) CONCLUSIONS: In this large registry of STEMI patients, we did not find significant excess in in-hospital mortality among COVID-19 co-infected patients compared with non-infected patients despite lower rate of primary PCI and reperfusion treatment, though composite of in-hospital mortality, re-infarction, stroke and heart failure was higher.

Examining the Association Between MIS-C and the Child Opportunity Index at a Single Center.

OBJECTIVE: To describe associations between the Child Opportunity Index (COI) and multisystem inflammatory syndrome of childhood (MIS-C) diagnosis among hospitalized children. METHODS: We used a retrospective case control study design to examine children ≤21 years hospitalized at a single, tertiary care children's hospital between March 2020 and June 2021. Our study population included children diagnosed with MIS-C (n = 111) and a control group of children hospitalized for MIS-C evaluation who had an alternative diagnosis (n = 61). Census tract COI was the exposure variable, determined using the patient's home address mapped to the census tract. Our outcome measure was MIS-C diagnosis. Odds ratios measured associations between COI and MIS-C diagnosis. RESULTS: Our study population included 111 children diagnosed with MIS-C and 61 children evaluated but ruled out for MIS-C. The distribution of census tract overall COI differed significantly between children diagnosed with MIS-C compared with children with an alternate diagnosis (P = .03). Children residing in census tracts with very low to low overall COI (2.82, 95% confidence interval [CI]: 1.29-6.17) and very low to low health/environment COI (4.69, 95% CI 2.21-9.97) had significantly higher odds of being diagnosed with MIS-C compared with children living in moderate and high to very high COI census tracts, respectively. CONCLUSION: Census tract child opportunity is associated with MIS-C diagnosis among hospitalized children suggesting an important contribution of place-based determinants in the development of MIS-C.

Financial Constraints and Their Impact on University Students of Different Nationalities in the United Arab Emirates

Financial constraints caused by the economic slowdown in 2020 and COVID-19 that followed, affecting the student motivation for academic achievements, are of strategic importance to the global higher education (HE) sectors. This study aims to examine the effects of financial constraints on the motivation and academic performance of students of different nationalities in the United Arab Emirates (UAE) during the pandemic. This study will help us recognize the challenges among students from different backgrounds and nationalities and develop remedial strategies with a global perspective. We used a Likert scale-based questionnaire to collect data on motivation level, and associated variables from a sample of 371 students enrolled in different colleges in the UAE. Statistical techniques such as t-test, F-test, and chi-square test were used to explore the relationship between the variables in the data. The findings of the study revealed that financial constraints during the pandemic did not significantly affect academic motivation, regardless of gender, nationality, and age. The participants expressed that they were prepared and aware of the sunk costs involved in education. However, as the financial impact of the pandemic extended beyond 2020, unemployment increased, and parents were less prepared to bear their children's education costs. This inevitably increased the responsibilities of the universities to provide financial support to deserving students. © 2023, Association for Social Studies Educa. All rights reserved.

Comparing the effect of strict versus routine awake prone positioning among patients hospitalized with COVID-19

Background: In patients with moderate to severe coronavirus disease 2019 (COVID-19), awake prone positioning improves oxygenation and clinical outcome. Despite prone positioning incorporated in the protocol, it's not followed in true letter and spirit. Aims and objectives: The objective of this study was to compare the effect of strict versus routine awake proning among patients hospitalized with Covid-19. Method(s): PCR positive COVID-19 patients admitted to the Khyber Teaching Hospital Peshawar's isolation unit were randomly allocated to 2 groups, Group A prone positioning (PP) was ensured for at least 12 hours by helping proning during rounds by the respiratory therapists and nurses. Further, prone positioning was ensured by the use of telemedicine, whereas Group B just followed the standard care in which awake proning was emphasized on a routine basis without doing any intervention. Their biochemical and clinical parameters, outcomes related to oxygen requirement, intubation, and mortality were followed weekly for two weeks or till discharge. Result(s): Out of the 58 patients, 29 patients with PP had a better outcome in terms of oxygenation (p<0.01), respiratory rate (P<0.05), and inflammatory markers such as serum ferritin (p<0.02) and C reactive protein (p<0.03). Additionally, ventilatory support (18% VS 42%, p<0.05) and mortality rate 21.4% Vs 64.3%) were significantly lower in the PP group. Conclusion(s): Strict compliance of awake prone positioning improved oxygenation in COVID-19 patients, resulting in a clinically better outcome.

Emerging Insights Into the Pathophysiology of Multisystem Inflammatory Syndrome Associated With COVID-19 in Children.

Multisystem inflammatory syndrome in children (MIS-C) has emerged as a rare delayed hyperinflammatory response to SARS-CoV-2 infection and causes severe morbidity in the pediatric age group. Although MIS-C shares many clinical similarities to Kawasaki disease (KD), important differences in epidemiologic, clinical, immunologic, and potentially genetic factors exist and suggest potential differences in pathophysiology and points to be explored and explained. Epidemiologic features include male predominance, peak age of 6 to12 years, and specific racial or ethnicity predilections. MIS-C is characterized by fever, prominent gastrointestinal symptoms, mucocutaneous manifestations, respiratory symptoms, and neurologic complaints, and patients often present with shock. Cardiac complications are frequent and include ventricular dysfunction, valvular regurgitation, pericardial effusion, coronary artery dilation and aneurysms, conduction abnormalities, and arrhythmias. Emerging evidence regarding potential immunologic mechanisms suggest that an exaggerated T-cell response to a superantigen on the SARS-CoV-2 spike glycoprotein-as well as the formation of autoantibodies against cardiovascular, gastrointestinal, and endothelial antigens-are major contributors to the inflammatory milieu of MIS-C. Further studies are needed to determine both shared and distinct immunologic pathway(s) that underlie the pathogenesis of MIS-C vs both acute SARS-CoV-2 infection and KD. There is evidence to suggest that the rare risk of more benign mRNA vaccine-associated myopericarditis is outweighed by a reduced risk of more severe MIS-C. In the current review, we synthesize the published literature to describe associated factors and potential mechanisms regarding an increased risk of MIS-C and cardiac complications, provide insights into the underlying immunologic pathophysiology, and define similarities and differences with KD.

Researching COVID to enhance recovery (RECOVER) pediatric study protocol: Rationale, objectives and design (preprint)

Importance: The prevalence, pathophysiology, and long-term outcomes of COVID-19 (post-acute sequelae of SARS-CoV-2 [PASC] or "Long COVID") in children and young adults remain unknown. Studies must address the urgent need to define PASC, its mechanisms, and potential treatment targets in children and young adults. Observations: We describe the protocol for the Pediatric Observational Cohort Study of the NIHs REsearching COVID to Enhance Recovery (RECOVER) Initiative. RECOVER-Pediatrics is an observational meta-cohort study of caregiver-child pairs (birth through 17 years) and young adults (18 through 25 years), recruited from more than 100 sites across the US. This report focuses on two of five cohorts that comprise RECOVER-Pediatrics: 1) a de novo RECOVER prospective cohort of children and young adults with and without previous or current infection; and 2) an extant cohort derived from the Adolescent Brain Cognitive Development (ABCD) study (n=10,000). The de novo cohort incorporates three tiers of data collection: 1) remote baseline assessments (Tier 1, n=6000); 2) longitudinal follow-up for up to 4 years (Tier 2, n=6000); and 3) a subset of participants, primarily the most severely affected by PASC, who will undergo deep phenotyping to explore PASC pathophysiology (Tier 3, n=600). Youth enrolled in the ABCD study participate in Tier 1. The pediatric protocol was developed as a collaborative partnership of investigators, patients, researchers, clinicians, community partners, and federal partners, intentionally promoting inclusivity and diversity. The protocol is adaptive to facilitate responses to emerging science. Conclusions and Relevance: RECOVER-Pediatrics seeks to characterize the clinical course, underlying mechanisms, and long-term effects of PASC from birth through 25 years old. RECOVER-Pediatrics is designed to elucidate the epidemiology, four-year clinical course, and sociodemographic correlates of pediatric PASC. The data and biosamples will allow examination of mechanistic hypotheses and biomarkers, thus providing insights into potential therapeutic interventions.

COVID-19 associated rhino-orbital-cerebral mucormycosis: Clinical features, antifungal susceptibility, management and outcome in a tertiary hospital in Iran (preprint)

Background: Despite the unprecedented surge in the incidence of mucormycosis in the COVID-19 era, the antifungal susceptibility patterns (ASPs) of COVID-19 associated mucormycosis (CAM) isolates have not been investigated so far and it is unclear if the high mortality rate associated with CAM is driven by decreased susceptibility of Mucorales to antifungal drugs.  Objectives: To describe the clinical, mycological, outcome and in vitro ASPs of CAM cases and their etiologies from Iran.  Patients/Methods: A prospective study from January 2020 to January 2022 at a referral tertiary hospital in Tehran, Iran was conducted for screening mucormycosis through histopathology and mycological methods. The identity of Mucorales isolates was revealed with ITS-panfungal PCR& sequencing and MALDI-TOF. The AS for amphotericin B, itraconazole, voriconazole, posaconazole and caspofungin was cleared according to the EUCAST antifungal susceptibility testing protocol.  Result: A total of 150 individuals were diagnosed with CAM. Males constituted 60.7% of the population. The mean age was 54.9 years. Diabetes was the leading risk factor (74.7%). The median interval between diagnosis of COVID-19 and CAM was 31 days. The recovery rate of culture was as low as 41.3% with Rhizopus arrhizus being identified as the dominant (60; 96.7%) agent. Amphotericin B (MIC50= 0.5µg/ml) demonstrated the highest potency against Mucorales.  Conclusion: Majority of the cases had either diabetes, history of corticosteroid therapy or simultaneously both conditions. Accordingly, close monitoring of blood glucose should be considered. The indications for corticosteroids therapy are recommended to be optimized. Also, an anti Mucorales prophylaxis may be necessitated to be administrated in high risk individuals. Although amphotericin B was the most active agent, a higher rate of resistance to this antifungal was noted here in comparison with earlier studies on mucormycetes from non-CAM cases.

COVID-19 Positive Versus Negative Complete Kawasaki Disease: A Study from the International Kawasaki Disease Registry.

To determine clinical differences for children with complete Kawasaki disease (KD) with and without evidence of preceding SARS-CoV-2 infection. From January 2020, contemporaneous patients with complete KD criteria were classified as either SARS-CoV-2 positive (KDCOVID+; confirmed household exposure, positive PCR and/or serology) or SARS-CoV-2 negative (KDCOVID-; negative testing and no exposure) and compared. Of 744 patients in the International Kawasaki Disease Registry, 52 were KDCOVID- and 61 were KDCOVID+. KDCOVID+ patients were older (median 5.5 vs. 3.7 years; p < 0.001), and all additionally met diagnostic criteria for multisystem inflammatory syndrome in children (MIS-C). They were more likely to have abdominal pain (60% vs. 35%; p = 0.008) and headache (38% vs. 10%; p < 0.001) and had significantly higher CRP, troponin, and BUN/creatinine, and lower hemoglobin, platelets, and lymphocytes. KDCOVID+ patients were more likely to have shock (41% vs. 6%; p < 0.001), ICU admission (62% vs. 10%; p < 0.001), lower left ventricular ejection fraction (mean lowest LVEF 53% vs. 60%; p < 0.001), and to have received inotropic support (60% vs. 10%; p < 0.001). Both groups received IVIG (2 doses in 22% vs. 18%; p = 0.63), but KDCOVID+ were more likely to have received steroids (85% vs. 35%; p < 0.001) and anakinra (60% vs. 10%; p = 0.002). KDCOVID- patients were more likely to have medium/large coronary artery aneurysms (CAA, 12% vs. 0%; p = 0.01). KDCOVID+ patients differ from KDCOVID-, have more severe disease, and greater evidence of myocardial involvement and cardiovascular dysfunction rather than CAA. These patients may be a distinct KD phenotype in the presence of a prevalent specific trigger.

Novel Decision Making Methodology under Pythagorean Probabilistic Hesitant Fuzzy Einstein Aggregation Information

This research proposes multicriteria decision-making (MCDM)-based real-time Mesenchymal stem cells (MSC) transfusion framework. The testing phase of the methodology denotes the ability to stick to plastic surfaces, the upregulation and downregulation of certain surface protein markers, and lastly, the ability to differentiate into various cell types. First, two scenarios of an enhanced dataset based on a medical perspective were created in the development phase to produce varying levels of emergency. Second, for real-time monitoring of COVID-19 patients with different emergency levels (i.e., mild, moderate, severe, and critical), an automated triage algorithm based on a formal medical guideline is proposed, taking into account the improvement and deterioration procedures from one level to the next. For this strategy, Einstein aggregation information under the Pythagorean probabilistic hesitant fuzzy environment (PyPHFE) is developed. Einstein operations on PyPHFE such as Einstein sum, product, scalar multiplication, and their properties are investigated. Then, several Pythagorean probabilistic hesitant fuzzy Einstein aggregation operators, namely the Pythagorean probabilistic hesitant fuzzy weighted average (PyPHFWA) operator, Pythagorean probabilistic hesitant fuzzy Einstein weighted geometric (PyPHFEWG) operator, Pythagorean probabilistic hesitant fuzzy Einstein ordered weighted average (PyPHFEOWA) operator, Pythagorean probabilistic hesitant fuzzy Einstein ordered weighted geometric (PyPHFEOWG) operator, Pythagorean probabilistic hesitant fuzzy Einstein hybrid average (PyPHFEHA) operator and Pythagorean probabilistic hesitant fuzzy Einstein hybrid geometric (PyPHFEHG) operator are investigated. All the above-mentioned operators are helpful in design the algorithm to tackle uncertainty in decision making problems. In last, a numerical case study of decision making is presented to demonstrate the applicability and validity of the proposed technique. Besides, the comparison of the existing and the proposed technique is established to show the effectiveness and validity of the established technique.

Management of MIS-C (Multi-system Inflammatory Syndrome in Children): Decision-making regarding a new condition in the absence of clinical trial data.

Multisystem inflammatory syndrome in children (MIS-C) is a new illness that evolved during the COVID-19 pandemic with initial reports of severe disease including use of extracorporeal membrane oxygenation and death. Institutions rapidly assembled task forces to develop treatment algorithms. At the national/international levels, collaboratives and associations assembled consensus writing groups to draft guidelines. These guidelines and algorithms were initially based on expert opinion and small case series. Some groups utilized the Delphi approach, and the resultant guidelines often mimicked those for other conditions that resembled MIS-C, like Kawasaki disease (KD). For instance, intravenous immunoglobulin (IVIG), a known effective treatment in KD, was recommended for MIS-C. Early in the pandemic many favored IVIG over steroids as first line therapy. As evidence evolved so did some guidelines which now endorse the dual use of IVIG plus steroids as first line therapy. In contrast, withholding immunotherapy became an option for some MIS-C patients with mild symptoms. Here, we review guidelines and discuss the evidence informing early recommendations, how this has evolved, the role and limitations of expert opinion and observational data, and the importance of leveraging existing research infrastructures, such as the intensive care unit collaborative (Overcoming COVID-19 surveillance registry), and the International KD Registry. Finally, we discuss strategies to rapidly develop, deploy and adapt clinical trials evaluating the treatment of such rare conditions in children, which may include alternatives to conventional clinical trial design. The emergence of MIS-C during the COVID-19 pandemic has highlighted unmet needs regarding research of a new condition.

Protective Efficacy of Anti-Hyr1p Monoclonal Antibody against Systemic Candidiasis Due to Multi-Drug-Resistant Candida auris.

Candida auris is a multi-drug-resistant fungal pathogen that can survive outside the host and can easily spread and colonize the healthcare environment, medical devices, and human skin. C. auris causes serious life-threatening infections (up to 60% mortality) in immunosuppressed patients staying in such contaminated healthcare facilities. Some isolates of C. auris are resistant to virtually all clinically available antifungal drugs. Therefore, alternative therapeutic approaches are urgently needed. Using in silico protein modeling and analysis, we identified a highly immunogenic and surface-exposed epitope that is conserved between C. albicans hyphal-regulated protein (Cal-Hyr1p) and Hyr1p/Iff-like proteins in C. auris (Cau-HILp). We generated monoclonal antibodies (MAb) against this Cal-Hyr1p epitope, which recognized several clinical isolates of C. auris representing all four clades. An anti-Hyr1p MAb prevented biofilm formation and enhanced opsonophagocytic killing of C. auris by macrophages. When tested for in vivo efficacy, anti-Hyr1p MAb protected 55% of mice against lethal systemic C. auris infection and showed significantly less fungal burden. Our study is highly clinically relevant and provides an effective alternative therapeutic option to treat infections due to MDR C. auris.

Impact of Topical v/s Systemic Steroids on Regaining Olfaction in Post Covid-19 Patients, A Randomized Controlled Trail

Background: Covid-19 is a spectrum of infection not only causing fever and respiratory changes but including alteration in chemosensory functions including;olfactory dysfunction and gustatory dysfunction. In covid-19, olfactory dysregulation could be treated with either systemic steroids or with topical steroids. Objective(s): To assess and compare role of systemic and topical steroids in regaining normal olfactory functions. Material(s) and Method(s): A Randomized control trial was conducted at Central Park Teaching Hospital Lahore after getting ethical approval and prior written informed consent from participants. A total of 35 patients were recruited were segregated into two groups;Group 1 who were treated with topical steroids (n=17) and Group 2 who were given and treated with systemic steroids (n=18). Time frame of regain of olfaction was compared between the groups using Mann Whitney U test. A p value less than 0.05 was considered as significant. Result(s): A total of 35 participants participated in this randomized controlled trial who were segregated into two groups with the mean ages of 47.12 + 11.94 and 43.72 + 13.74 with no significant mean difference. On appliance of Mann-Whitney U test in Group 1 and group 2 (52 + 39 v/s 4 + 2) it was observed that systemic steroid patients regain olfaction earlier as compared to group 1 (topical steroids) with the p value of .0001. Practical implication: Systemic Steroids will help in prompt regaining of normal olfaction and should be part of COVID-19 infection management. Conclusion(s): Olfaction management till the regaining of normal olfactory functions should be part of covid-19 management and role of steroids in crucial yet unavoidable. Systemic steroids play a key role in early regain of normal olfactory response so should be encouraged under the physician observation. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Irritability in Preschool Children: A Predictor of Adolescent Psychopathology

Objectives: Adolescents are vulnerable populations at risk for mental health disorders due to physical, social, and educational transitions and need to be assessed seriously, especially after the recent COVID-19 pandemic. We aim to understand and identify irritability at a preschool age as a predictor of developing psychopathology later in adolescence. Method(s): A literature search was conducted using relevant Medical Subject Headings (MeSH) keywords in PubMed, MEDLINE, and PubMed Central databases. We identified all relevant published articles from inception until March 31, 2021. Out of 99 studies applied, 19 studies were chosen for full-text review when inclusion and exclusion criteria were applied. After a full-text review, we included 6 relevant studies in our final qualitative synthesis review. Result(s): The results of the studies showed an association between preschool irritability and mental health outcomes later in life. A 2019 study showed that irritability in preschoolers predicted later diagnosis of mood and externalizing disorders when controlled for social adversity, maternal history of mood disorders, and externalizing diagnoses at baseline. Irritability early in childhood predicted mania later in life (OR = 1.99;95% CI, 1.19-3.37;p =.009), and the OR of later being diagnosed with depression was 3.11 (95% CI, 1.32-3.27;p =.002) for each point increase in irritability factor score. Results further indicated that high stable irritability in early childhood is a predictor of irritability at age 12 (r =.35;p <.001). A 2021 study reproduced the results showing that preschool irritability predicted internalizing and externalizing comorbidity (OR = 1.67;95% CI, 1.22-2.28;p =.001). Conclusion(s): The findings show that irritability in preschool children is a predictor of internalizing, externalizing, and other behaviors later in life. It indicates an association between preschool irritability and psychopathology later in adolescence. A large-scale well-structured randomized controlled trial is recommended to unearth the potential benefit of identifying irritability in early life. ADOL, IMD, PSC Copyright © 2022

Influence of Pedagogy on the Epistemological Estimation of Electrical Engineering Subject

COVID-19 pandemic has brought sudden changes in teaching and learning process compared to conventional face to face mode of education all around the globe. During social distancing in pandemic environment, the most common change that has been introduced was to opt online and hybrid mode of learning using e-resources by students and faculty at several organizations. In our organization, the BlackboardTM platform has been used to teach the course either in e-learning or blended mode. The present work is an epistemic case study of an electrical engineering subject taught in blended mode to undergraduate students. The performances of the students have been analysed in continuous assessment as well as in final assignment. The analysis criteria was based on expected “course learning outcomes” taken from ABET guidelines which was planned before the commencement of academic semester. In this case study, a specific part of the final assignment in which a questionnaire was framed to assess the “Understanding”, “Apply”, “Analyzed”, “Evaluate” and “Create” levels of Bloom's Taxonomy by determining the correlation factor among various parameters. It was observed that students had felt the difficulty in achieving the satisfactory response in “Evaluate” and “Create” while performed well in first three levels of Bloom's Taxonomy. Based on analysis and results, it is concluded that to achieve satisfactory response of the students, continuous hands-on-experience of laboratory experiments and instruments are essential. In the coming months when it is difficult to start the face to face mode of teaching and learning, an alternate method for laboratory could be catered by introducing virtual laboratory and simulations. In addition a remedial plan has to be prepared to enhance the critical thinking of the students to improve the “Evaluate” and “Create” levels of students. © 2022, Rajarambapu Institute Of Technology. All rights reserved.

General and Covid Anxiety: Observing the Outcome under Same Umbrella of Vaccination

Background: Despite of our strong want, the datum is that the Covid-19 pandemic is still not over. Its physical and mental sufferings are well known. Mass vaccination is the true hope to eradicate this virus. Despite of large scale efforts, vaccination including boosters still needs optimization Aim: To see the effect of vaccination against covid-19 on general and covid-19 related anxiety so to endorse the continuation of vaccination until the virus is completely eradicated. Study Design: Observational, cross-sectional study Place and Duration of Study: Shifa International Hospital Islamabad from 1st October 2021 to 31st March 2022. Methodology: Three hundred and thirteen subjects with recent history of Covid-19 vaccination were enrolled and 281 subjects completed the survey, asked to fill out CAS (covid-19 anxiety scale) and GAD-7 (general anxiety disorder) scale based on the recall of their feelings before vaccination and then about after vaccination. Result(s):. Majority were females (61.1%), had education graduation and above (71.2%), belonged to non-medical profession (71.4%). 47.3% had Covid-19 cases in family while 13.2% had covid-19 related deaths in family. Means of CAS were higher than the means of GAD-7 (p<0.001). Drop in anxiety level was statistically significant for both Covid related anxiety and general anxiety after vaccination (p<0.05). Conclusion(s): Vaccination against covid-19 is crucial to manage Covid related and general anxieties because, future covid waves hence the anxiety waves are still expected. Bereaved families need further psychiatric support beyond vaccination to deal with their anxieties. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Cardiac Effects of COVID-19 Infection, MIS-C, and the Vaccine in Infants and Children: What Is Known and Future Implications.

The cardiac effects of novel coronavirus disease 2019 (COVID-19) infection on the pediatric heart has become an area of particular interest as elevated cardiac enzymes and abnormalities on echocardiogram and electrocardiogram were seen in a portion of children affected by the virus. In this article, we review the cardiac manifestations of acute COVID-19 infection, multisystem inflammatory syndrome in children, and postvaccine myocarditis. The limited research on the effects of COVID-19 on neonates and infants is also reported. KEY POINTS: · Cardiac involvement from MIS-C is much higher than the risk of COVID-19 vaccine-induced myocarditis.. · Neonates and infants have overall been less affected by COVID-19 than adults and older children.. · At this point in time, there is limited research on the cardiac effects of COVID-19 in neonates..

Colchicine anti-inflammatory therapy for non-intensive care unit hospitalized COVID-19 patients: results from a pilot open-label, randomized controlled clinical trial.

Systemic inflammation is a hallmark of severe coronavirus disease-19 (COVID-19). Anti-inflammatory therapy is considered crucial to modulate the hyperinflammatory response (cytokine storm) in hospitalized COVID-19 patients. There is currently no specific, conclusively proven, cost-efficient, and worldwide available anti-inflammatory therapy available to treat COVID-19 patients with cytokine storm. The present study aimed to investigate the treatment benefit of oral colchicine for hospitalized COVID-19 patients with suspected cytokine storm. Colchicine is an approved drug and possesses multiple anti-inflammatory mechanisms. This was a pilot, open-label randomized controlled clinical trial comparing standard of care (SOC) plus oral colchicine (colchicine arm) vs. SOC alone (control arm) in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. Colchicine treatment was initiated within first 48 hours of admission delivered at 1.5 mg loading dose, followed by 0.5 mg b.i.d. for next 6 days and 0.5 mg q.d. for the second week. A total of 96 patients were randomly allocated to the colchicine (n=48) and control groups (n=48). Both colchicine and control group patients experienced similar clinical outcomes by day 14 of hospitalization. Treatment outcome by day 14 in colchicine vs control arm: recovered and discharged alive: 36 (75.0%) vs. 37 (77.1%), remain admitted after 14-days: 4 (8.3%) vs. 5 (10.4%), ICU transferred: 4 (8.3%) vs. 3 (6.3%), and mortality: 4 (8.3%) vs. 3 (6.3%). The speed of improvement of COVID-19 acute symptoms including shortness of breath, fever, cough, the need of supplementary oxygen, and oxygen saturation level, was almost identical in the two groups. Length of hospitalization was on average 1.5 day shorter in the colchicine group. There was no evidence for a difference between the two groups in the follow-up serum levels of inflammatory biomarkers including C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), ferritin, interleukin-6 (IL-6), high-sensitivity troponin T (hs-TnT) and N-terminal pro b-type natriuretic peptide (NT pro-BNP). According to the results of our study, oral colchicine does not appear to show clinical benefits in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. It is possible that the anti-inflammatory pathways of colchicine are not crucially involved in the pathogenesis of COVID-19.