An overview of severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2): Pathophysiology, diagnosis, and management tactics

The World Health Organization (WHO) declared an international public health concern on January 30, 2020, in response to the idiopathic Coronavirus disease 2019 (COVID-19) pandemic outbreak. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of the disease being identified as the third human Coronavirus, was discovered in Wuhan, Hubei Province, China. Coronavirus belongs to the Coronaviridae family, Coronavirinae subfamily which according to their genetic structures, are grouped into alphaCoronavirus (aCoV), betaCoronavirus (bCoV), gamma Corona¬virus (yCoV) and deltaCoronavirus (dCoV) of order Nidovirales. Coronaviruses are enveloped, positive-sense, single-stranded RNA viruses invading a wide variety of host species. SARS-CoV-2 belongs to extensively. Angiotensin¬converting enzyme 2 (ACE2) is imperative for Novel SARS-CoV-2 to enter host cells as a substrate receptor. With a high mortality rate in the elderly, immune-compromised, diabetic, and patients with cardiovascular and respiratory diseases, COVID-19 is an extremely contagious disease. Patients who are afflicted experience fever, a nonproductive cough, lethargy, dyspnea, and occasionally diarrhoea as well as radiographic signs of pneumonia. A cytokine storm is a result of the immune system's aggressive response to a virus that has propagated inside the body. Genetic recombination and mutation are the main drivers of the emergence of novel SARS-CoV-2 variants. Variants of concern (VOCs) are used to describe some variants having significant virulence and transmission rates, such as the Omicron variants now. RT-LAMP, RT- qPCR, and High-Resolution Computed Tomography, among other new cutting-edge techniques, are effective at diagnosing SARS-CoV-2 infected patients. Standard treatments involving compounds like Lopinavir/Ritonavir, paxlovid, and molnupiravir have shown to be efficacious to some extent against even the newly emerging strains when it comes to treatment approaches. Additionally, immunization is a crucial strategy for preventing the disease or lessening its impact. Live attenuated vaccines, DNA- and RNA-based vaccines, protein subunit vaccines, and amplifying viral vector vaccines are among the molecular frameworks used in the production of vaccines against SARS-CoV-2. Comirnaty by Pfizer-BioNTech, SpikeVax by Moderna, and Vaxzevria by Oxford- AstraZeneca are three extensively incorporated and validated COVID-19 vaccines. In a similar vein, a variety of vaccinations have been created with varying degrees of potency against VOCs. Nanotechnology and artificial intelligence (AI) advancements may help in the provision of an effective and dependable remedy for the eradication of SARS-CoV-2. Definitive diagnosis, community engagements, and united scientific approaches have effectively addressed public health issues amid the pandemic. Although COVID-19 has presented a significant challenge to the healthcare system, it has also provided a chance for the development of novel and creative roles that could have significant effects on the healthcare system. This pandemic has highlighted the value of prompt diagnosis, the value of universal healthcare as well as the need for cutting-edge methods to contain pandemics around the world. © 2023 Nova Science Publishers, Inc. All rights reserved.

Aggregate, asymmetric and frequency-based spillover among equity, precious metals, and cryptocurrency

This study evaluates the portfolio diversification potential of different classes of assets-equity, cryptocurrency and precious metals-using total, asymmetric and frequency-based spillover transmission framework. The VARbased generalized variance decomposition method is used to analyse the daily prices of S&P 500, bitcoin, gold, silver and platinum between April 2011 through January 2021. The results of aggregate spillover support bitcoin as a potential diversifier due to its isolation from other sets of assets. The decomposition of overall spillover into downside and upside spillover reveals a higher downside connectedness than the upside, suggesting an asymmetric interdependence amongst these markets. Moreover, the frequency based aggregate spillovers suggest the connectedness is driven mostly by the shorter time-horizons. The study provides important policy implications for market participants with distinct investment objectives.

Third International Conference on Medical Education and Medical writing, University of Karbala College of Medicine, Karbala, Iraq

University of Karbala College of Medicine (UKCM), Iraq, conducted a three days' workshop on Medical Education and medical writing. The UKCM is now transforming to conform with the latest trends of modern education. This will help to re-shape the future of medical education and produce capable doctors. This requires a strong faculty, which is sound in teaching, training, learning improvement, research capacity building, and leadership development. The capacity building of faculty at UKCM has been initiated in collaboration with Medics International at a local and government level and includes a series of workshops and online symposia. This educational activity was conducted after a delay of three years due to COVID-19. A three-day refresher course was conducted in the first week of August, 2022. Medical writing is another important feature which has been continuously covered by UKMM since many years with the collaboration of Al-Sadiq International Virtual University (SIVU) and Imamia Medics International (IMI).

Isolation, Identification, Speciation, and Antibiogram of Enterococcus species by conventional methods and Assessment of the Prevalence of vana genotype among VRE

Enterococci are Gram-positive, ovoid cocci that can be found as diplococci or in short chains. These species are found in the typical microbiota of the intestine, oral cavity, vagina, and other areas. Despite being commensals with moderate virulence, these species have lately emerged as important nosocomial infections with increasing drug resistance particularly to vancomycin. This has resulted in their changing patterns of infection that are resistant to conventional antimicrobial therapy. The main objective of this study was to assess the frequency of the VanA genotype among Vancomycin Resistant Enterococci, as well as the isolation, identification, speciation, and antibiotic sensitivity pattern of Enterococci from various clinical specimens. In this six-month study, 500 different clinical specimens such as urine, blood, and pus were collected aseptically from patients suffering from urinary tract infection (UTI), septicemia, and pyogenic illnesses, and a total of 94 Enterococci strains were identified. These isolates were identified and speciated using traditional tests and biochemical processes. Following culture, the disc diffusion technique was used to determine their antibiotic susceptibility pattern, as suggested for common antibiotics. RCR was also used to evaluate the prevalence of the vanA gene among VRE isolates. 88.29% were E. faecalis, 7.88% were E. faecium, 2.12% were E. durans, 1.06 % was E. casseliflavus, and 1.06 % was E. gallinarum, out of a total of 94 isolates. Urine (70.21 %) yielded the most isolates, followed by blood (17.02 %) and pus (17.02 %). Female patients had a higher isolation rate of 73.40 % (69/94) than male patients, who had a rate of 26.59 % (25/94), and the majority of the Enterococcal isolates were from inpatients (62.77 %) rather than outpatients (37.23 %). 30 % of the isolates were hemolytic, whereas 70% were non-hemolytic. The isolates sensitivity patterns revealed that they were resistant to antibiotics such as ampicillin, ciprofloxacin, and gentamicin. The susceptibility test also included 30g discs of vancomycin. Vancomycin resistance is greatest in E. faecium (28 %) 6/83, followed by E. faecalis (8 %) 2\7. All other isolates were vancomycin-susceptible. Vancomycin-resistant isolates made up 8.51 % of the total. Barely urine isolates were tested for nitrofurantoin resistance, which was found to be only 5%. Linezolid sensitivity was found in all of the Enterococci. According to the PCR test for the vanA gene, among total VRE isolates 5 E. faecalis and 1 E. faecium isolates had vanA genotypes with bands of 473bp. A number of studies have revealed an increment in the infection rate and antimicrobial resistance of Enterococci. Elevated isolation rate of VRE has posed threat to therapeutic strategies as now only few antibiotics are susceptible to such isolates. It is thus imperative to execute measures that could stable the VRE augmentation lest a normal commensal would get the status of SARS-CoV-2. © MEDIC SCIENTIFIC, All rights reserved.

Electrolysis Study Effect on Electrolyzed Water as Disinfectant and Sanitizer

The use of harmful alcohol-based disinfectants and sanitizers was a major concern throughout the CoVID-19 era. Frequent use of alcohol-based sanitizer can dry up the skin, and the effect is worsening for individuals with sensitive skin. Alcohol-based disinfectants are flammable and can ignite if used near a flame, spark, or other source of ignition. Using the electrolysis of sodium chloride (NaCl) aqueous solution method, this study aims to make Hypochlorous Acid (HOCl), a safe disinfectant and sanitizer. Two critical parameters were tested on the electrolysis effect of producing HOCl. The first is the amount of sodium chloride (NaCl) present, while the second is the type of electrode used, which are carbon, graphite, and titanium. The results showed that 10 grams of NaCl produces 50-200 ppm of HOCl, which is good for sanitizing purposes, and 30 grams of NaCl produces 500-800 ppm of HOCl, which is good for disinfecting purposes. The graphite electrode was also demonstrated to be capable of producing a clean HOCl solution. Using a UV-vis spectrophotometer, the effectiveness of the HOCl produced was determined, and it was discovered that HOCl is capable of killing bacteria. As a result, HOCl can be applied as a safe disinfectant and sanitizer in the fight against COVID-19.

Mental well-being during COVID-19 pandemic: the role of fear, social isolation and psychological resilience

Emergence of any pandemic raises serious concerns toward the psychological well-being of an individual and overall society. Although, the magnitude and intensity of the novelwellb coronavirus (COVID-19) pandemic are not precisely known yet, however, this pandemic has predominantly reshaped the global scenario. Scholars have begun to unfold the reality of this traumatic situation, but empirical research that focuses on the identification of key factors that could have a notable impact on mental wellbeing of the general population is limited. To fill this gap, this research endeavors to analyze the impact of fear of getting infected and social isolation on mental well-being during the pandemic. In addition, psychological resilience is used as a moderator between social isolation and mental well-being. A total of 714 responses were received through an online survey from university students across all provinces of Pakistan. The findings demonstrate that people who fear of being infected tend to engage in social isolation, and social isolation brings negative repercussions toward mental well-being. Interestingly, the study findings reveal that psychological resilience could mitigate the negative impact of social isolation on mental well-being. This study calls for creating and promoting awareness concerning psychological resilience in order to cope with the psychological challenges during this COVID-19 pandemic.

Evaluation of large-scale rapid antigen testing of incoming passengers at a dynamic point of care setting carried out by dental students for COVID-19 screening - a field report

BACKGROUND: Assessment of the results of large-scale rapid antigen diagnostic (RAD) testing for detection of SARS-CoV-2 amongst incoming passengers was carried out by Ahmedabad Municipal Corporation (AMC) Dental College Students at the Central Railway Station of Ahmedabad city. We wanted to determine the sensitivity and specificity of RAD testing for detection of Covid-19 amongst passengers disembarking from scheduled trains arriving at the Central Railway Terminus of Ahmedabad city. METHODS: Under the campaign "Chase the Virus" launched by Ahmedabad Municipal Corporation (AMC), Interns & Final Year students of AMC Dental College were trained to carry out rapid antigen testing of scheduled trains running on special routes starting from 07/09/2020 to 05/10/2020.14 dental teams were deputed at a temporary testing facility formulated for day-to-day testing at the Central Station using the standalone Standard - Q Covid-19 Ag testing kit (SD Biosensor, South Korea). RESULTS: In total, 18901 travellers were tested in a span of 26 days out of which 324 tested positive with an overall percentage positivity of 1.71%. An average number of 727 (+or- 182) tests were performed with an overall sensitivity of 66.01% and specificity of 99.71%. CONCLUSIONS: In response to the growing Covid-19 pandemic and complexity of laboratory-based molecular tests, rapid antigen detection tests have proved to be efficient in the easier and faster diagnosis of the passengers in such point of care settings.

The impact of sars-cov2 infection in children with liver disease: An international observational registry study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) on children with underlying liver disease (LD) is unknown. We aim to report outcomes for pediatric patients with LD from the joint North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the Society of Pediatric Liver Transplantation (SPLIT) SARS-CoV2 registry Methods: We collected data from patients younger than 21 years with LD from 6 countries and laboratory-confirmed SARS-CoV2 infection reported to a multicenter observational cohort study between April 2020 and May 2021. Results: Seventy-three (59% male,55% white, 23% Hispanic) children with a median age of 9 years were reported in the registry. The most common causes of LD were biliary atresia (22%) followed by autoimmune hepatitis (16%) and non-alcoholic fatty liver disease (16%). Five patients (7%) presented in acute liver failure (ALF);all recovered without the need for a liver transplant. Four patients presented with multisystem inflammatory syndrome in children (2 with ALF, 2 without ALF) with one death reported. The most common presenting symptoms were constitutional (49%) including fever and fatigue followed by respiratory symptoms (47%). Twenty two percent (n=16) of patients were asymptomatic at the time of diagnosis. Twentythree percent had radiologic evidence of pneumonia and 14% reported co-infections. Median peak INR was 1.4, peak total bilirubin 2.9 (mg/dl), peak ALT 129 (IU/l) and nadir albumin 3.1 (g/dl). Sixty-four percent of patients required hospitalization;40% (n=19) in the ICU and 60% (n=28) non-ICU for a median of 6 and 7 days, respectively. Twenty-two percent of patients required respiratory support including mechanical ventilation (n=6), high-frequency oscillatory ventilation (n=3), highflow nasal cannula (n=5) and regular nasal cannula (n=2) for a median of 6 days. Nine patients required vasoactive agents, 3 required renal replacement therapy and 2 patients required ECMO. Sixty-six percent did not receive any SARSCoV2 directed treatment. Twelve (16%) patients developed new liver-related complications including ascites (n=9), GI bleeding (n=2), encephalopathy (n=3), progression of endstage liver disease (n=2) and infection (n=1). There were a total of 3 (4.1%) deaths (20yr, 17yr and 6month of age at time of death) reported secondary to acute on chronic liver failure with respiratory failure and multiorgan failure Conclusion: Contrary to healthy children, almost 2/3rd pediatric patients with LD testing positive for SARS-CoV2 required hospitalization with death reported in 4% of cases. Acute liver failure is rare with SARS-CoV2 infection with recovery reported without the need for liver transplantation. Close monitoring is needed due to an increased risk of underlying liver disease complications and death, particularly in children with end-stage liver disease awaiting transplantation.

Infection control practices in orthodontics during COVID-19

Aim: To find out infection control practices among orthodontists in Punjab, Pakistan during COVID-19 pandemic. Methods: This cross sectional study was conceived from 1.6.2020 to 1.1.2021. A pre-designed proforma was used to find out the infection control practices in orthodontics. Each pre-designed proforma consisted of 10 questions about infection control. The pre-designed proforma was distributed among 50 orthodontists. The response rate was 100%. Results: The results showed that most of the orthodontists were up-dated and in practice of using proper infection control measures while COVID-19. Gloves, PPE, Protective eye wears and face shields were worn by most of the respondents. Most of them were using proper disinfection and sterilization measures. Conclusion: The knowledge and practices of infection control in orthodontics was appropriate and up to standards during COVID-19.

Challenging COVID-19 and its outbreak in Pakistan and across the borders

The pandemic of COVID-19 has covered almost all the globe, due to the rapid transmission of the virus. Drastic effects have been observed in Europe 1707946 confirmed cases and 155552 deaths in America, there are 1655378 confirmed cases and 98723 deaths, in Eastern Mediterranean 255728 confirmed cases 8878 deaths, Western Pacific 159662 confirmed cases and 6470 deaths, in South-East Asia 95314 confirmed cases and 3356 deaths and in Africa 42626 cases are confirmed and 1369 deaths. New cases are being reported meanwhile government has increased its testing capacity to more than 10000 per day and up to date, 283,517 total tests for corona has been performed and 30,062 confirmed cases are reported with 659 deaths however 8,063 patients get recovered which is a hopeful situation as compared to the international scenario. Pakistan has only travel history and there was no evidence of any natural outbreak and the first case was reported quite late as compared to the globe hence its spread was not as violent as that of other countries. The timely lockdown has shown its positive results and fewer cases are reported as were expected despite the rapid transmission.

Should I be Concerned? Surgical Training in the Time of COVID19

As the US healthcare system restructured to deal with the COVID-19 pandemic, medical training was significantly disrupted. During the peak of the crisis, three surgical trainees in different stages of their residency shared their experiences and concerns on how this pandemic affected their training. The article is intended to generate discussion on the concerns of derailment and stagnation of surgical training and difficulties faced at all levels of surgical training to perform clinical duties and fulfill academic responsibilities during the early months of the COVID pandemic.

An overview of immunological response, anti-viral therapy and vaccine development against severe acute respiratory syndrome coronavirus (Sars-cov)-2

SARS-CoV-2, the causative agent of COVID-19 disease belongs to the group beta-coronavirus, which have infected around 120 million people so far with a 2.65 million death toll worldwide. Coronaviruses are enveloped viruses having positive sense, single-stranded RNA genome (26-32 kb size). This paper mainly reviews/focuses on the existing development on the vaccination and drugs developed against severe acute respiratory syndrome coronavirus (SARS-CoV). SARS-CoV, Middle East respiratory syndrome coronavirus (MERS-CoV), and the novel SARS-CoV-2 have come out as highly fatal strains of coronavirus for human beings. Novel SARS-CoV-2 requires angiotensin-converting enzyme 2 (ACE2) as its foothold receptor to gain entry into the host cells. Infected patients develop symptoms of fever, nonproductive cough, fatigue, dyspnea, sometimes diarrhoea and radiographic evidence of pneumonia. The immune system reacts violently against the virus spread inside the body which gives rise to a condition known as a cytokine storm. The potential anti-viral medicines suggested for COVID-19 treatment were hydroxychlo-roquine, Lopinavir/Ritonavir etc. which showed some combined effects, positive and negative. Many vaccines candidates are under different phases of trials all over the world against SARS-CoV-2. The main cause which enabled the quick development of vaccine technologies against SARS-CoV-2 was that an already established knowledge of the structure and function of its close associates namely SARS and MESRS was present. Molecular platforms used in vaccine development against SARS-CoV-2 are live attenuated vaccines, DNA based vaccines, RNA based vaccines, protein subunits and replicating viral vector vaccines. © IJCRR.

Online learning during the COVID-19 pandemic: Applying the self-determination theory in the ‘new normal’

The COVID-19 pandemic has introduced the notion of the “new normal” in daily life through profoundly influencing the way we used to live, study and work. During these unprecedented times, the rapid transition from traditional face-to-face learning to online learning has been viewed as a paradigm shift in higher education. Drawing impetus from the self-determination theoretical framework, the present study aims to examine the impact of the online learning climate on student's engagement. It also hypothesizes the mediating role of basic psychological needs on the nexus between online learning and students’ engagement. Total 689 students taking online classes in ten (five publics and five private) universities of Pakistan responded to the web-based survey. The present study findings do not support the direct influence of the online learning climate on student engagement, nevertheless, this relationship was mediated by students’ perceptions concerning the extent to which their basic psychological needs were satisfied/ dissatisfied. This study theoretically and empirically contributes to both the psychology and higher education literature, pertaining to the developing field of online learning. The practical implications from this study inform policy-makers in academia to reflect on the students’ psychological needs within virtual teaching environment. © 2021 Universidad de País Vasco

Pakistani perspective, preparation and response to COVID-19: A review

The recent 2020 emerging infection of COVID-19 was initiated from Wuhan China. At first, it spread around China and now reached more than 213 countries around the globe including Pakistan. The nurses and doctors play an important role before and during the pandemics, nursing plays a leading role in preparation for the outbreak. The clinical symptoms of COVID-19 are very similar to respiratory diseases. Every day the number of laboratory-confirmed cases associated with deaths increasing regularly in different countries around the world. Natural infections of coronavirus are seven (229E, NL63, OC43, HKUI, SARS, MERS and COVID-19). Out of seven four are mild upper respiratory infection, and SARS-CoV, MERS-CoV and COVID-19 are known for their high mortality rate. Among them, COVID-19 is an emerging viral infection responsible for pandemics. Fortunately, the mortality rate of COVID-19 is low as compared to SARS and MERS, the majority of cases are recovered in almost all the countries. The death rate toll of COVID-19 is high even after its mortality because COVID-19 causes a pandemic, while the other can't. Currently, COVID-19 influenced a large segment of the world population, which let to public health emergencies around the world, and an international concern, putting all the health organizations to high alert. The present review is on preparation, response, general continent, virology, epidemiology, clinical presentations, diagnosis, treatment and control of COVID-19 regarding Pakistan.

Convalescent plasma therapy: A promising approach in the treatment of Covid-19

At present, the whole world fronting a very challenging situation of the pandemic, severe acute respiratory syndrome due to coronavirus (COVID-19). Today, COVID-19 is spreading rapidly in every part of the world;these pandemic affected billions of people. This virus is found as a new human pathogen. However, currently, there is no hasty therapy available, which will provide fruitful results in this regard. As per previously reported data, human convalescent serum (plasma) will be a great choice for the rescue patients from COVID-19 infection, and it will be readily available if there are adequate numbers of people who have recovered and can donate immunoglobulin consisting serum. It includes the administration of antibodies against a given agent to an affected individual for the cause of treating an infectious disease due to the virus. In disparity, active vaccination involves the induction of an immune response that takes time to develop and varies depending on the vaccine recipient. The plasma therapy has a storied history going back and founds as well reported to treat multiple types of viral diseases. In the current review, we tried to explore and systematically discussed how plasma therapy will create a boon for humans to fight against the novel coronavirus disease.