Effect of COVID-19 Pandemic on the Diagnosis of Breast Lesions Compared with Breast Lesions in the Previous Five Years

Background: Covid-19 pandemic caused havoc in both people, the health care system and more so in patients with malignancies. Breast malignancies being one of the most common and relatively curable malignancies got hit a lot due to the impact of the Covid-19 pandemic. The multistep impact of pandemic delayed the diagnosis as also the treatment of this multidisciplinary approach disease. Objective(s): To determine the effect of the Covid-19 pandemic on the diagnosis of breast lesions. Method(s): This is a descriptive type of histopathological study in which we have collected and studied the data of Breast lesions over the Five years (Jan 2015-Dec 2019) and compared it with the data of Breast lesions in the Covid-19 year (the year 2020). Result(s): The number of cases of breast specimens received for histopathology per year declined from an average of 224/year to 124/year in the Covid-19 year of 2020. Conclusion(s): The decrease in the number of cases alludes to the downfall in the number of patients coming for diagnosis and in turn getting treatment. This study also highlights the importance of anticipation of various cases which will cluster shortly.

Prevalence of psychological stress among health care workers during COVID-19 pandemic - A cross-sectional questionnaire-based survey in a tertiary care teaching hospital

Background: Health care workers (HCWs) exposed to COVID-19 are at increased risk of developing mental health problems. This study aims to access the prevalence of psychological stress among HCWs during COVID-19 pandemic. Aims and Objectives: The aim of the study was to assess the prevalence of psychological stress among HCWs during COVID-19 pandemic. Material(s) and Method(s): A cross-sectional study was conducted among HCWs working in a tertiary care teaching hospital. A total of about 100 HCWs who participated in the study were randomly distributed pre-structured questionnaire pertaining to sociodemographic parameters and variables related to psychological stress and their responses were graded accordingly. Result(s): It was found that HCWs showed significant rise in psychological distress with moderate-to-severe elevated levels of anxiety (69%), depression (21%), and insomnia (41%). Nurses were significantly more likely to experience anxiety than other HCWs in our present study and the most of the participants were engaged in some form of stress reduction activities. Conclusion(s): The high levels of psychological distress were reported in HCWs in hospital dealing with COVID-19 patients. Increase efforts are needed for promotion of mental health well-being of HCWs exposed to COVID-19.Copyright © 2023 Shamiya Sadiq, et al.

Assessment of Risk to Healthcare Workers During the COVID-19 Pandemic: A Tertiary Care Facility Based Cross-sectional Study in Pakistan

Objective: To assess the risk of COVID-19 to healthcare workers (HCWs) in Tertiary care hospitals and its association with demographic factors. Study Design: Cross-sectional analytical study. Place and Duration of Study: Tertiary Care Hospital, Rawalpindi Pakistan, from May to Dec 2020. Methodology: Healthcare workers working in a designated COVID-19 Tertiary care hospital were included in the study. A modified "Risk assessment and management of exposure of HCWs in the context of COVID-19 tool" was distributed. HCWs were categorized as "high risk" and "low risk" of COVID-19 infection. Frequency and percentages were computed for demographic variables. Results: A total of 182 healthcare workers were included, and 167(91.7%) returned the study questionnaire. Most of them were nurses (n=65, 40.1%) working in the medical unit (n=99, 61.1%). Low risk HCWs were 73.5%( n=119) and only 26.5%( n=43) were high risk. Gender (p-value: .02) and type of HCWs (p-value: .01) were significantly associated with the risk of COVID-19. Conclusion: One-fourth of HCWs were at high risk of COVID-19 virus infection. Female gender and nurses were more likely to acquire COVID-19 infection. © 2023, Army Medical College. All rights reserved.

AI-Enabled Wearable Medical Internet of Things in Healthcare System: A Survey

Technology has played a vital part in improving quality of life, especially in healthcare. Artificial intelligence (AI) and the Internet of Things (IoT) are extensively employed to link accessible medical resources and deliver dependable and effective intelligent healthcare. Body wearable devices have garnered attention as powerful devices for healthcare applications, leading to various commercially available devices for multiple purposes, including individual healthcare, activity alerts, and fitness. The paper aims to cover all the advancements made in the wearable Medical Internet of Things (IoMT) for healthcare systems, which have been scrutinized from the perceptions of their efficacy in detecting, preventing, and monitoring diseases in healthcare. The latest healthcare issues are also included, such as COVID-19 and monkeypox. This paper thoroughly discusses all the directions proposed by the researchers to improve healthcare through wearable devices and artificial intelligence. The approaches adopted by the researchers to improve the overall accuracy, efficiency, and security of the healthcare system are discussed in detail. This paper also highlights all the constraints and opportunities of developing AI enabled IoT-based healthcare systems. © 2023 by the authors.

COVID-19 Vaccines: Community Myths Vs Facts

Objective: To determine the reasons for hesitancy regarding COVID-19 vaccines. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Feb to Jun 2021. Methodology: After Ethical Committee approval, 100 respondents were recruited, regardless of vaccination status, and requested to respond to 27 different myths and queries circulating about COVID-19 vaccines. Results: Mean age of participants was 36.25 ± 5.77 years, ranging from 15-80 years. Fifty-three were males and 47 females. 41% of subjects trusted the Sino-pharm vaccine, and 25% preferred Pfizer Bio N Tech, while 34% could not answer due to the lack of knowledge. 55% subjects showed concern about catching the infection from Vaccination. 54% considered vaccines unsafe for pregnant and breastfeeding women. 29% believed it unsafe for the elderly and those with comorbidities. 14% believed it could cause autism in children and infertility in adults. 62% individuals acknowledged that vaccines have no nano chips to track patients. 46% opined that vaccines were rushed through trials and had doubtful efficacy. 11% individuals thought vaccines could alter DNA, while most were aware of this false concept. 28% considered that vaccines were needless because recovery from COVID-19 was excellent, while 63% emphasised the need for Vaccination. 23% deemed the side effects of vaccines more dangerous than the disease itself. 85% individuals favoured use of mask and social distancing after getting the vaccine. Conclusion: Strong efforts are needed to support the COVID-19 vaccine and to eliminate negative propaganda on media outlets. © 2022, Army Medical College. All rights reserved.

Medicinal plants with antimalarial activity and antiviral potential: A source of active compounds for the treatment of COVID-19? A review

CoVID-19 is a devastating disease that affects different organs and systems in the human body and is caused by the SARS-CoV-2 virus. This disease had its beginnings in China and has raged around the world, characterizing a pandemic that is difficult to control due to the high transmission capacity of the virus between people. Studies with plants with anti-protozoan activity have been the object of studies for the treatment of CoVID-19, since some of these plants have an antiviral effect. The aim of this study was to conduct a review of the literature on the use of medicinal plants with antimalarial activity as a possible strategy in CoVID-19 therapy. Dozens of plants with antimalarial activity stood out for having antivirals and, considering the diversity of active compounds present in these plants, it is possible to think of these plants as a potential source of new biologically active compounds that could potentially be applicable in therapy against CoVID-19. © 2022 International Scientific Organization. All Rights Reserved.

Psychological Impact of Covid-19 on Orthodontic Patients

Background: Unexpected postponement or delay in various treatment protocols during peak time of COVID-19 cause serious psychological trauma and obstacle to orthodontists and orthodontic patients as well. Objective: To evaluate depression and anxiety level of orthodontic patients during this chaos regarding their treatment even when the treatment was resumed. Study Design: Questionnaire-based cross-sectional study. Place and Duration of Study: Department of Orthodontics, Bacha Khan College of Dentistry, Mardan from 1st July 2021 to 31st December 2021. Methods: One hundred and sixty-six orthodontic patients were enrolled after taking informed consent from the patients. Data were taken in hard form and then later verbally translated into native language of this area. Numerical rating scale was used for psychological assessment and for the determination of anxiety level where 0 refers to no anxiety and 10 interprets extreme anxiety. Results: Ninety-three females and seventy-three males were present in this study. Conclusion: Severe anxiety level was reported and patients were greatly concerned about their health.

CARDIAC INVOLVEMENT IN PATIENTS SUFFERING FROM COVID-19 AND ITS ASSOCIATION WITH DISEASES SEVERITY AND PROGNOSIS

Objective: To determine frequency of cardiac involvement in patients of COVID-19. Secondary objective was to determine association of cardiac involvement with prognosis. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Apr to Jul 2020. Methodology: We prospectively assessed the laboratory data, Electrocardiogram and transthoracic echocardiography of all the COVID-19 patients admitted to our institute. Outcomes of interest included length of hospital stay, admission to Intensive Care Unit and mortality. Acute myocardial injury was defined by a value of high-sensitivity troponin I (hs-TnI) above the 99th percentile upper reference limit. Statistical Package for the Social Sciences (SPSS) version 23 was used for all the analysis. Results: Our study included 1015 patients, mean age 50.34 (SD 13.71) years, 887 (87.3%) males and 128 (12.6%) females. Three hundred and thirty (n=330, 32.5%) patients had evidence of acute cardiac injury as shown by raised cardiac troponins, but 50, 4.92% had left ventricle dysfunction. Raised cardiac enzymes were associated with marginally prolonged hospital stay (10.03 versus 9.32 days, p-value 0.07) and higher mortality (OR 2.634, confidence interval 1.252-5.543, p-value 0.01). Conclusion: Cardiac involvement is quite common among patients suffering from COVID-19 and predicts worse prognosis. © 2021, Army Medical College. All rights reserved.

Post-vaccination (COVID-19) impacts in healthcare personnel

The COVID-19 pandemic has brought attention back to its spread in medical staff. A survey-based study was conducted to combine general information related to COVID-19 exposures, acceptances, vaccines received, and side effects. The majority (62.3%) of healthcare professionals had acquired COVID-19 infection from hospital environment (51.5%) mainly who treated (64%) COVID-19 patients. 54% healthcare respondents expressed 'high acceptance' towards COVID-19 vaccines. 88% received COVID-19 vaccination. The majority of healthcare personnel received SinoPharm (65%). 82.3% did not acquire COVID-19 post-vaccination. 38% mild side effects were observed from vaccination. Following were the general side-effects: myalgia (18.2%), the feeling of sickness (16%), fever (15.6%), dizziness (7.8%), joint pain (7.4%), chills (4.8%), and flu (4.8%). Following were the common neurological side-effects reported: headache (18.2%), fatigue (16.5%), muscle pain (16%), numbness/tingling (3%), and migraine (2.6%). Nausea and diarrhoea were reported in only 3.5% of respondents. Bad taste was reported in only 3% of respondents. The 1.7% reported rash and itching. The majority of the healthcare professionals did not report significant side effects related to neurological, gastroenterological, skin and oral categories. To assess the vaccines' potential for substantial and long-term or chronic effects, more study with a larger sample size and a longer follow-up time is required.

Covid-19 vaccine breakthrough infections among health care workers in military institutes of Pakistan – Till 30th june 2021

Objective: To measure incidence of COVID-19 vaccine breakthrough infections among health care workers vaccinated with both doses of Sinopharm Vaccine. Study Design: Prospective cohort study. Place and Duration of Study: All Military Institutes of Pakistan, from Feb to Jun 2021. Methodology: Detailed surveillance mechanism was developed before the start of Health Care Workers vaccination in Pakistan Military to report any PCR positive COVID-19 infection post vaccination. Among 39512 health care workers vaccine-ted with both doses of COVID-19 vaccine;those who developed COVID-19 infection ≥14 days post 2nd dose were included in the study. Total 124 participants till 30 Jun 2021 fulfilled the criteria of COVID-19 vaccine breakthrough infection and were analyzed. Results: Mean age of the participants was 38.8 ± 11 years. Males were 69.4% while females were 30.6%. Median duration from 2nd dose to development of COVID-19 vaccine breakthrough infection was 36.5 days (IQR, 26-62). Asymptomatic/mild infections were reported among 94.4% and only 5.6% had moderate disease. No severe/critical disease requiring oxygen supplementation or ventilator support was observed. Recovery rate was 100% with no mortality. There was no significant statistical association of age, gender, job category with COVID-19 vaccine breakthrough infection (p>0.05). Conclusion: Vaccines remain an important weapon in the battle against COVID-19. No vaccine is 100% effective against all strains of COVID-19;however among the completely vaccinated health care workers less severe disease was observed. There was no mortality. © 2021, Army Medical College. All rights reserved.

Comparison of High Resolution Computed Tomography Features in Covid-19 and Other Viral Pneumonia- A Systematic Review

Aim: To compare the high resolution computed tomography features in Covid and other viral pneumonia presented in recent literature. Methodology: For this study, total 25 studies were included which follow the Preferred Reporting Items guideline for conducting this systematic review analysis (PRISMA). Electronic articles of Covid from January 2020 to April 2020 were searched on PUB Med, online Willey library, and Science Direct site by using keywords related to CT imaging and Corona virus. For pneumonia related studies articles from year 2010 to year 2017 were included for better comparison. Results: After pooling data, it was observed that bilateral involvement was found in 76.8% of studies, 68.4% GGO, and 62.2% ratio was occupied by peripheral distribution in different studies. Total 48.7% of studies were concerned about the ground glass opacity (GGO) consolidation, 33.2% observed consolidation, 27.7% look for crazy paving pattern, and 25% of studies observed mixed central and peripheral distribution. Conclusion: Study concludes that the chest CT finding results of selected studies for Covid and pneumonia cases were overlapping. Only high prevalence related to upper and lower lobe involvement and peripheral distribution was relatively high in Covid studies.

Facts and myths regarding covid-19 in athletes

After the rise of the Coronavirus infection from the country of China in the year-end of 2019, brought about by the Novel Coronavirus, a total of approx-imately 45 million cases all around the world with deaths of more than 1.17 million individuals and 29.8 million recoveries. The SARS-COV2, also known as the coronavirus, usually presents as an asymptomatic carrier state with respiratory illness and pneumonia-like symptoms. Grown-ups speak to the populace with the largest rate of infection;in any case, youngsters, kids, and old patients can likewise be affected by the virus. The most widely seen abnormal-ity on chest x-ray amongst individuals with lung infection was ground-glass opacity, with B/L findings. Serious cases are bound to be found in patients with other illnesses contrasted with other non-serious cases. In reality, age and illness seriousness might be corresponded with the results of the coro-navirus disease. Until this point, viable treatment is missing;notwithstand-ing, clinical preliminaries researching the viability of a few drugs, including remdesivir and chloroquine, are in progress. Right now, viable contamination control poses the best method to forestall the outbreak of the virus.

Variations In Spectrum Of Covid-19 Ct Findings And Its Severity Scoring In A Tertiary Care Hospital Of Bahawalpur, Southern Punjab Pakistan

BACKGROUND: Recently the Coronavirus pandemic presented with different manifestations in different parts of the world, both on clinical examinations and on imaging. CT Scanning (CT Scan) chest is used for detailed evaluation of the different characteristic patterns determining the depth of disease. The study is aimed to assess the variations in spectrum of Covid-19 CT findings and relating severity (CT Severity Score) with the Clinical Symptoms in Bahawal Victoria Hospital, Bahawalpur. METHODS: In this cross-sectional study, patients referred to radiology department from outdoor for COVID screening were included from 1st May to 30th June 2020. Mean age range of patients was calculated, while presenting complaints and co-morbidities were tabulated in frequencies and percentages after analysis. Severity of symptoms and CT findings were correlated with biochemical and haematological tests. RESULTS: Patients' age range from 25 to 85 years with 62% males and 38% females. Statistically no significant difference was observed in CTSS on gender basis. As sensitivity of RT PCR is about 70%, negative cases cannot be considered disease free and this is seen in this study as CT findings suggestive of COVID are seen in these patients. Using 40-point CT-SS, 11 patients had a score of >19 with severe diseases, while 14 patients had common disease with a score range of 11-18 and 35 patients had <10 score with mild or no symptoms. CONCLUSIONS: In this study, a spectrum of patchy ground glass opacities, bilateral peripheral predominantly lower lung consolidations were observed. Quantitative analysis of inflammatory process as occurring in lungs in Coronavirus Disease 2019, using 40-point CTSS scoring on Imaging could provide a timely and objective approach towards identifying patients requiring intensive care and hospitalisation.

The impact of COVID-19 on medical education: Our students perception on practice of online education

Background: The emergence of COVID-19 has severely disrupted medical education throughout the world and its effects may forever change the way future doctors and physicians are educated and trained. Social distancing is the most effective strategy to prevent this disease from spreading so medical faculty have transitioned from traditional lectures to online education1. Aim: To measure the impact of COVID-19 on medical education by asking students perception on practice of online education. Methods: The study was conducted in Quaid-e-Azam Medical College, Bahawalpur from 15th to 30th June, 2020 after getting approval from Ethical committee of the college. This was a simple survey based cross-sectional study using an electronic questionnaire which was based on findings of previously conducted in-depth interviews with the students. The e-questionnaire was sent via WhatsApp to all students of first and second year. All the data collected was entered on excel datasheets and then analyzed using SPSS version 21. Results: Our study showed that out of 688 students enrolled for first professional, 427(62%) responded to the survey through WhatsApp. The effect of COVID-19 on student's education showed both supportive and inhibitory factors. Conclusion: Students perception on practicing online education can be a valuable input to the faculty and teachers to improve medical education in future. © 2020 Lahore Medical And Dental College. All rights reserved.

A Privacy Preserved and Cost Efficient Control Scheme for Coronavirus Outbreak Using Call Data Record and Contact Tracing

Coronavirus or COVID-19, which has been declared pandemic by the World Health Organization, has incurred huge losses to the lives of people throughout the world. Although, the scientists, researchers and doctors are working round the clock to develop a vaccine for COVID-19, it may take a year or two to make a safe and effective vaccine available for the world. In current circumstances, a solution must be developed to control or stop the spread of the virus. For this purpose, a novel technique based on call data record analysis (CDRA) and contact tracing is proposed that can effectively control the coronavirus outbreak. A positive coronavirus patient can be traced through CDRA and contact tracing. The technique can track the path traversed by the patient and collect the cell numbers of all those people who have met with the patient. Keeping in tact the privacy of this group of people, when a test result of a person comes positive among the group, then he/she must be isolated and same CDRA and contact tracing procedures are adopted for that person. A COVID- 19 patient is geo tagged and alerts are sent if any violation of isolation is done by the patient. Moreover, the general public is informed in advance to avoid the path followed by the patients. This privacy preserved and cost effective mechanism is not only capable to control the coronavirus outbreak but also helps in isolating the patient in his/her house. IEEE