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Objective: To find out the side effects of vaccines of COVID-19 and its association with sociodemographic factors among students of medical colleges of Rawalpindi. Study Design: Cross sectional analytic study. Place and Duration of Study: A cross-sectional analytical study was carried out from May to Aug 2022 among medical students of three Medical Colleges (AMC, FUMC, RMC) in Rawalpindi Pakistan. Methodology: There were 200 participants that were conveniently selected with the Rao soft sample size calculator. A validated questionnaire was used to collect data. SPSS (v:26) was used to analyze the data. Chi square analysis was used to assess the relationship between side effects and demographic characteristics and a p-value of 0.05 was taken as significant. Results: Majority of the participants were male 126(63%) and unmarried 182(94%). The mean age of the participants was 20 years (SD=1.4). Almost all were vaccinated 197(98.5%) with two doses 195(97.5%). The side effects after the first dose were more profound as compared to the second dose, like normal pain 133(66.5%), tenderness at injection site 69(34.5%), fever 65(32.5%) and fatigue 80(40%). Muscular pains were also documented to be pronounced after the administration of first dose 58(29%). Association analysis showed significant association between first dose side effects, normal pain(p=0.001), tenderness (p=0.004), redness (p=0.02) and fatigue (p=0.02) with gender variable. Whereas age and degree socio demographic variables reported significant association with first dose side effects, normal pain (p=0.04) and muscle pain (p=0.01), respectively. Conclusion: It was conclusive that adverse effects were more common and more severe after the first dose than after the second. The most frequent side effect was normal pain at the injection site, found more frequently in men, with muscular pain being noticeably worse after the first dosage and surprisingly minimal following the second dose of the COVID-19 vaccination. © 2022, Army Medical College. All rights reserved.
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Background: The treatment landscape of metastatic renal cell carcinoma (mRCC) has evolved over recent years with several systemic anti-cancer therapies (SACT) licensed across different lines of treatment. There is ongoing discussion amongst oncology professionals about how best to optimise treatments in terms of sequencing to maximise the potential number of lines or to give the best treatments first. A previous south-west UK audit was completed in 2021 reviewing the drop off rates across 5 UK sites identifying that 69% of patients were able to receive second line therapy and 34% were able to receive third line therapy. Method(s): In this study we conducted retrospective analysis of all patients who commenced treatment with SACT for mRCC between 1st January 2018 and 30th June 2021 in 18 centres across the 4 nations of the United Kingdom. All NHS reimbursed treatment options including the COVID interim treatment guideline options were included. Patients who received SACT as part of a clinical trial were also included. Patients who continued on their respective lines of treatment were censored. We also identified patients who had been on a period of active surveillance before staring SACT in this cohort. Result(s): 1549 patients (71% male: 29% female) were included. IMDC subgroup patients included 21.6%favourable, 52.3% intermediate, 25.1%poor and 1% unavailable. 9.1% of patients had been on active surveillance before starting SACT - defined as a period of longer than 3 months from mRCC diagnosis to starting SACT. Of those patients that started SACT 60.5% of eligible patients had 2nd line therapy, 25.3% had 3rd line, 7.2% received 4th line therapy and only 1% had 5th line therapy. In the 1st line setting 58.9% received single agent VEGF TKI, 24.5% received combination ipilimumab and nivolumab (IO-IO) immunotherapy, 14 % received IO/ VEGF TKI combination and 2.6% received other/trial treatment. The single agent VEGF TKI ratio for 1st line SACT declined year by year with rising IO-IO and IO/VEGF TKI combination ratios seen. In the secondand third-line settings cabozantinib (33.2% 2nd line and 44.4% 3rd line) and nivolumab (32.8% 2nd line and 22.6% 3rd line) were the most common options. Disease progression or death was the most common cause of SACT discontinuation amounting to 57.4%, 62.5% and 79% of SACT cessation in the 1st, 2nd and 3rd lines respectively. Treatment toxicity SACT discontinuation rates were 22.8%, 21.4% and 10.9% for 1st, 2nd and 3rd lines respectively. Conclusion(s): These results suggest that with more treatment options available, including combination/immunotherapy therapies, more patients are able to receive second- and third-line therapies. That said there remains significant drop off rates mostly driven by disease progression that would support the use of our most effective therapies in the upfront setting.
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RATIONALE & OBJECTIVE: Children with kidney disease and primary hypertension may be more vulnerable to COVID-19. We examined COVID-19 vaccine hesitancy among parents of children with chronic kidney disease or hypertension. STUDY DESIGN: Sequential explanatory mixed-methods design; survey followed by in-depth interviews. SETTING & PARTICIPANTS: Parents of children aged <18 years with kidney disease or primary hypertension within a large pediatric practice. EXPOSURE: Parental attitudes toward general childhood and influenza vaccines assessed by the Vaccine Hesitancy Scale. Kidney disease classification, demographic and socioeconomic factors, experiences with COVID-19, COVID-19 mitigation activities and self-efficacy, and sources of vaccine information. OUTCOME: Willingness to vaccinate child against COVID-19. ANALYTICAL APPROACH: Analysis of variance (ANOVA) test to compare parental attitudes toward general childhood and influenza vaccination with attitudes toward COVID-19 vaccination. Multinomial logistic regression to assess predictors of willingness to vaccinate against COVID-19. Thematic analysis of interview data to characterize influences on parental attitudes. RESULTS: Of the participants, 207 parents completed the survey (39% of approached): 75 (36%) were willing, 80 (39%) unsure, and 52 (25%) unwilling to vaccinate their child against COVID-19. Hesitancy toward general childhood and influenza vaccines was highest among the unwilling group (P < 0.001). More highly educated parents more likely to be willing to vaccinate their children, while Black race was associated with being more likely to be unwilling. Rushed COVID-19 vaccine development as well as fear of serious and unknown long-term side effects were themes that differed across the parental groups that were willing, unsure, or unwilling to vaccinate their children. Although doctors and health care teams are trusted sources of vaccine information, perceptions of benefit versus harm and experiences with doctors differed among these 3 groups. The need for additional information on COVID-19 vaccines was greatest among those unwilling or unsure about vaccinating. LIMITATIONS: Generalizability may be limited. CONCLUSIONS: Two-thirds of parents of children with kidney disease or hypertension were unsure or unwilling to vaccinate their child against COVID-19. Higher hesitancy toward routine childhood and influenza vaccination was associated with hesitancy toward COVID-19 vaccines. Enhanced communication of vaccine information relevant to kidney patients in an accessible manner should be examined as a means to reduce vaccine hesitancy. PLAIN-LANGUAGE SUMMARY: Children with kidney disease or hypertension may do worse with COVID-19. As there are now effective vaccines to protect children from COVID-19, we wanted to find out what parents think about COVID-19 vaccines and what influences their attitudes. We surveyed and then interviewed parents of children who had received a kidney transplant, were receiving maintenance dialysis, had chronic kidney disease, or had hypertension. We found that two-thirds of parents were hesitant to vaccinate their children. Their reasons varied, but the key issues included the need for information pertinent to their child and a consistent message from doctors and other health care providers. These findings may inform an effective vaccine campaign to protect children with kidney disease and hypertension.
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The coronavirus disease 2019 (Covid-19) has devastated the entire globe in a short period of time and was declared a global pandemic by the World Health Organization (WHO) on March 11th, 2020. It rapidly increased in fatality rate and has become an international public health crisis, culminating in social and economic calamity. However, mobile applications are being introduced globally to minimize the coronavirus's continuous spread by tracing people's circulation or mobility using digital software and smartphones. There is no digitally equipped tool that monitors the movement of the people, particularly in the public places. This work on Smarter Movement Control Application (SMCApp) aims to develop methods that will assist Malaysian people to move around with the aid of mobile tracing application. Therefore, the SMCApp was designed and developed as a mobile application software which stands to improve compliance with the mandated SOP measures across the country, as well as to provide digital support to those who wish to travel to various parts of the country. As a result, it is concluded that the usage of Smarter Movement Control Application (SMCApp) is hoped to bring about safe and effective movement of people throughout these two regions, as it will constantly alert individuals of any suspicious close-contact or the state of the location. Once the application is in effect, with at least 90% of users installing the App on their smartphones, it is projected to increase tranquility and elevate compliance with SOP measures. © 2022 IEEE.
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Background: previous studies showed that nurses reported inadequate knowledge of the risks and protective strategies in dealing with infectious diseases. Additionally, nurses reported a lack of willingness to care for patients with infectious diseases. Purpose: To examine Jordanian nurses’ knowledge and attitudes and their willingness to provide care for patients with COVID-19. Design and Methods: Correlational cross-sectional design with convenience sampling was used to collect data through an online self-administered questionnaire from 347 Jordanian nurses working at hospitals. Results: The study results showed that about 56% of the nurses reported having the experience of treating or providing care to confirmed or suspected COVID-19 patients, and 71.8% expressed their willingness to provide care for them. Only 55% of the nurses reported finishing a training program about COVID-19. Job title, type of hospital, and experience in treating or caring for patients with COVID-19 were predictors of nurses’ willingness to provide care. Conclusion: Jordanian nurses reported gaps in their knowledge about COVID-19 related to using personal protective equipment and fear of transmitting the disease to family members. Nurses also reported a moderate level of attitude toward hand hygiene and the use of personal protective equipment;however, most of the nurses reported willingness to provide care for COVID-19 patients. © 2022 Hamdan et al.
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Background: Alcohol-related hepatitis (AH) is the most severe form of alcohol-related liver disease, with rising incidence. Stay-at-home orders for the COVID-19 pandemic were associated with increased alcohol consumption. Online sales reported a 262% increase from March 2019 to 2020. Aims: The purpose of this study was to track the epidemiology of hospitalizations for AH by sex before and after the COVID-19 pandemic. We hypothesized that AH would be more severe in females and younger individuals during the pandemic. Methods: Using the Discharge Database, we identified all hospitalizations in Alberta with international classification of disease-10 codes for AH between March 2018 and September 2020. We merged this dataset with provincial laboratory data to identify all inpatient lab values. We calculated Model for End-Stage Liver Disease (MELD) and Maddrey scores and validated a laboratory-based algorithm for AH. Severe AH was defined as Maddrey score > 32. Onset of the pandemic was defined as March 2020. Stratified by pandemic onset, descriptive statistics were done with Chi-squared and Kruskal Wallis tests. Inpatient mortality was assessed as a primary outcome. Binomial regression was used to assess changes in frequency of admission for AH with the denominator as all cirrhosis-related admissions over the same time-period. Results: We identified 991 hospitalizations for AH prior to the pandemic (n=381, 38.5% female) and 417 during the pandemic (n=144, 34.5% female). Hospitalizations for AH significantly increased during the pandemic (p = 0.04) (Figure 1). Median Maddrey score for females (30.5) before the pandemic was significantly higher than for males (22.9), p < 0.01. During the pandemic, median Maddrey for females (28.7) was higher than males 21.4, p = 0.07. Median age at admission was significantly lower for both males and females during the pandemic (age 44 and 41, respectively) as compared to prior (age 47 and 45, respectively) p < 0.05. There was no significant difference in MELD between sexes before (13.5 for females, 14.0 for males, p = 0.15) and during the pandemic (13.3 for females, 13.0 for males, p = 0.75). Additionally, there was no significant difference in mortality between sexes before (10.4% in females, 11.5% in males, p = 0.22) and after the pandemic (9.2% in females, 9.9% in males, p = 0.67). Conclusions: Hospitalizations for AH rose during the pandemic and occurred at younger ages. There was no significant difference in disease severity or mortality before and during the pandemic. Overall, females have more severe AH than males. Public health efforts should continue to be made to educate about the harms of alcohol excess and offer community support. Future studies will expand the trend through multiple pandemic waves. (Figure Presented).
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Background: Alcohol-associated hepatitis (AH) is the most severe form of alcohol-related liver disease, with rising incidence. Stay-at-home orders for the COVID-19 pandemic were associated with increased alcohol consumption. Online sales reported a 262% increase from March 2019 to 2020. Aims: The purpose of this study was to track the epidemiology of hospitalizations for AH by sex before and after the COVID-19 pandemic. We hypothesized that AH would be more severe in females and younger individuals during the pandemic. Methods: Using the Discharge Database, we identified all hospitalizations for adults > 18-years-old in Alberta with international classification of disease-10 codes for AH between March 2018 and September 2020. We merged this dataset with provincial laboratory data to identify all inpatient lab values. We calculated Model for End-Stage Liver Disease (MELD) and Maddrey scores and validated a laboratory-based algorithm for AH. Severe AH was defined as Maddrey score > 32. Onset of the pandemic was defined as March 2020. Stratified by pandemic onset, descriptive statistics were done with Chi-squared and Kruskal Wallis tests. Inpatient mortality was assessed as a primary outcome. Binomial regression was used to assess changes in frequency of admission for AH with the denominator as all cirrhosisrelated admissions over the same time-period. Results: We identified 991 hospitalizations for AH prior to the pandemic (n=381, 38.5% female) and 417 during the pandemic (n= 144, 34.5% female). Hospitalizations for AH significantly increased during the pandemic (p = 0.04) (Figure 1). Median Maddrey score for females (30.5) before the pandemic was significantly higher than for males (22.9), p < 0.01. During the pandemic, median Maddrey for females (28.7) was higher than males 21.4, p = 0.07. Median age at admission was significantly lower for both males and females during the pandemic (age 44 and 41, respectively) as compared to prior (age 47 and 45, respectively) p < 0.05. There was no significant difference in MELD between sexes before (13.5 for females, 14.0 for males, p = 0.15) and during the pandemic (13.3 for females, 13.0 for males, p = 0.75). Additionally, there was no significant difference in mortality between sexes before (10.4% in females, 11.5% in males, p = 0.22) and after the pandemic (9.2% in females, 9.9% in males, p = 0.67). Conclusions: Hospitalizations for AH rose during the pandemic and occurred at younger ages. There was no significant difference in disease severity or mortality before and during the pandemic. Females have more severe AH by Maddrey score, but not by MELD than males. Public health efforts should continue to be made to educate about the harms of alcohol excess and offer community support. Future studies will expand the trend through multiple pandemic waves. (Figure Presented)
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Background: There was a difficult time of COVID-19 pandemic and lockdown. People around the country were forced to stay home. Hospitals were deeply concerned about managing the exposure to COVID-19 virus. Aim of the study: To evaluate the cellphone based remote consultation in reproductive endocrinology and infertility. Material & Methods: The observational cross sectional study was carried out in the Department of Reproductive Endocrinology & Infertility for about 6 months from July 2020 to December 2020. Following approval of Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, we decided to call the patients who had attended our consultation from 1st January 2020. The Department of Reproductive Endocrinology & Infertility attends every working day approximately 50-60 new patients of infertility and related problems of reproductive endocrinology in outdoor. The COVID-19 pandemic halted the interaction of the patients with us for indefinite period. Remote consultation with cell phone was applied to maintain the continuity of care of the patients. Statistical Package of Social Sciences (SPSS) version 22 was used for quantitative analysis.
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Objective: To determine the prevalence of depression and anxiety in patients with corona virus disease and without corona virus disease. Study Design: Cross-sectional/observational Place and Duration: Psychiatry department of KMC Teaching Hospital Khairpur Mirs for four months duration from 1st July, 2020 to 30th October, 2020. Methods: Two hundred and twenty patients of both genders were presented in this study. Patients detailed demographics were recorded after taking written consent. Patients were ages between 20-70 years. Among all the patients, 110 patients (group I) with covid-19 disease taken as cases and 110 non-covid 19 patients (group II) were taken as control. Prevalence of depression and anxiety were measured by DASS-21. Complete data was analyzed by SPSS 27.0 version. Results: Mean age of the patients in group I and II was 42.38 ±12.44 years and 41.22±12.85 years. Mean BMI in group I was 23.46±1.52 kg/m2 and in group II it was 24.33±1.58 kg/m2. 76 (69.10%) and 70 (63.64%) patients were males while 34 (30.91%) and 40 (36.36%) were females in cases and control. Frequency of depression and anxiety was significantly among patients with covid-19 disease as compared to without covid-19 disease patients (p-value <0.05). Conclusion: Anxiety and depression was significantly associated with COVID-19 disease. Medically ill patients should develop techniques for rapid diagnosis and treatment of depression and anxiety.
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Since the early spring of 2020, the coronavirus pandemic (COVID-19) outbreak has hindered traditional face-to-face teaching and hands-on, traditional delivery of laboratory courses, forcing universities to migrate from the traditional way of teaching to a remote online approach. Although few studies addressed the pandemic's impact on educational outcomes, no studies are found to investigate the impact of the remote online teaching approach on laboratory courses. This paper highlights the impact of the online teaching approach, coupled with flipped learning pedagogy, as a substitute for traditional laboratories. The course learning outcomes and assessment tools are analyzed and discussed for 46 students enrolled in the Unit Operations Laboratory course in the chemical engineering program at Qatar University. Results show that the course learning outcomes are achieved effectively using the hybrid online-flipped learning pedagogy, which can be considered for computerized traditional laboratories as a moderation solution to alleviate pandemic COVID-19 confinement on learning outcome. This methodology can also be sustained in the future to facilitate the teaching of such lab courses, even in normal conditions, to optimize the resources and avail the delivery of such courses to a larger audience who may have various obstacles to attending traditional lab courses.
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This research aims to explore and investigates which project management methodology is recommended for artificial intelligence (AI) transformation projects. Aligning projects with strategic business goals is necessary to achieve the desired outcomes for any digital transformation program. Project management methodology helps standardize studies of an ongoing project that might have a continuous effect on the organization. It also helps secure the standard practices, language, and processes that ensure the smooth flow of a project and are vital for project management. The current research will evaluate the most widely used project management methodologies and to which extent they support the sudden transformation witnessed due to Covid-19, including AI technologies. © 2021 IEEE.
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Purpose: This study aimed to investigate Jordanian university students' interaction, Internet self-efficacy, self-regulation and satisfaction regarding online education during the COVID-19 pandemic. Design/methodology/approach: A correlational cross-sectional design was utilized using convenience sampling to include 702 undergraduate students from Jordanian universities using an online self-administered questionnaire. Descriptive statistics, T-tests, one-way ANOVA and multiple regression analyses were used to analyze the data. Findings: The mean score of students' satisfaction was low (m = 45.14, SD = 25.62). Regarding student's interaction, learner-instructor interaction had the highest total mean score (m = 58.53, SD = 24.51), followed by learner-learner interaction (m = 47.50, SD = 22.64). Learner-content interaction had the lowest total mean score (m = 45.80, SD = 24.60). Significant differences in students' satisfaction were identified according to the level of education, university type and marital status. Significant predictors of students' satisfaction with online education were self-regulated learning, Internet self-efficacy, learner-content interaction, learner-learner interaction and the number of e-learning theoretical courses. Originality/value: Online education is not well-established in developing countries. This study contributed to the limited knowledge of university students’ preparedness and satisfaction with online education during the early stage of COVID-19 pandemic. © 2021, Emerald Publishing Limited.