Obesity and risk of severe COVID-19.

Obesity represents a higher risk of severe COVID-19 infection, which may lead to the requirement of a mechanical ventilation in intensive care units and premature death. The underlying mechanisms are multiple: alteration of the respiratory performance, presence of comorbidities such as diabetes, hypertension or obstructive sleep apnea, finally inadequate and excessive immunological responses, possibly aggravated by ectopic intrathoracic fat depots. Thus, COVID-19 may challenge the so-called <<obesity paradox>> commonly reported by intensivists in patients with acute respiratory distress syndrome. These findings require reinforced preventive and curative measures among obese patients to limit the risk of progression towards an unfavorable outcome in case of COVID-19.Copyright © 2020 Editions Medecine et Hygiene. All rights reserved.

Evaluation of Prevalence and Associated Factors of Dry Eye Syndrome among Medical Students Exposed to Visual Display Terminal in Health Campus, Universiti Sains Malaysia

Introduction: Dry eye syndrome (DES) has become a public health concern, especially during the COVID-19 pandemic. Medical students are at risk due to an increase in visual display terminal (VDT) exposure given the transition to full-time online lectures. The presence of reduced blink rate and tear film instability in VDT users causes an increase in tear evaporation leading to symptoms of DES. This study helps us to learn about the associated factors of VDT use and DES among the young generation. This study aims to determine the prevalence and associated factors of DES among medical students exposed to VDT at the health campus, Universiti Sains Malaysia (USM). Methods: A cross-sectional study involving 140 undergraduate medical students aged 22 to 29 years old who were VDT users. Factors analysed are age, gender, race and duration of VDT usage. Data collection included both subjective assessment (OSDI questionnaire) and objective assessment (TBUT and Schirmer's test). Statistical analysis was conducted using Statistical Package for the Social Science (SPSS Inc Version 24). Results were analysed using descriptive analysis and multivariate logistic regression. Results: Most of the medical student cohort was female and Malay. Most of the students use VDT for less than 8 hours. A high incidence of DES was noted among medical students (92.1%). None of the factors showed significant association with positive findings DES by subjective and objective assessment and duration of VDT usage. Conclusion: DES is common among VDT users. This study showed a high prevalence of DES among medical students in USM. The factors analysed did not show a significant association between DES and duration of VDT usage. This study may help to recognize the problem and will raise awareness of their daily practice and implement preventive measures to avoid VDT-related DES. [ FROM AUTHOR] Copyright of Malaysian Journal of Medicine & Health Sciences is the property of Universiti Putra Malaysia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Online Learning and Its Short-term Impact on Digital Engagement and Digital-related Health Symptoms Amongst University Students During the COVID-19 Pandemic

Introduction: The COVID-19 pandemic has precipitated a rapid shift of learning and education from traditional means to digital platforms. This paper aims to examine the impact of online learning on digital engagement and digital-related health symptoms among university students one year into the coronavirus pandemic. Methods: Data was collected through a self-administered online questionnaire after ethical approval. The questionnaire was adapted from the previously published Lifestyle Study in Youth Questionnaire. Through the questionnaire, the perception of students toward online learning was probed and recorded. Digital engagement and digital-related health symptoms were compared before and during the COVID-19 lockdown. Results: The majority (97.5%) of respondents preferred face-to-face learning. The time spent on digital devices was 1.8 times higher during COVID-19 than before the COVID-19 lockdown (t-test = -18.86, p<0.0001). The total hours of sleep were reduced during COVID-19 lockdown (0.6 hours lesser) (t-test = -3.92, p<0.0001). The Wilcoxon Signed Ranks Test revealed significant changes in digital-related health symptoms (15 out of 17) due to the COVID-19 lockdown. Digital eye strain, dry eye syndrome, carpal tunnel syndrome, and upper quadrant postural and muscle strain emerged (p<0.05). Conclusion: Most university students favoured face-to-face learning compared to online learning. There was a two-fold rise in digital engagement during the COVID-19 lockdown. As a result, it has seemed to translate into reduced sleeping hours. The short-term impact of the coronavirus pandemic on digital-related health symptoms amongst university students was apparent. The long-term effects require further investigations to facilitate fact-based decision-making. [ FROM AUTHOR] Copyright of Malaysian Journal of Medicine & Health Sciences is the property of Universiti Putra Malaysia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Fondaparinux Sodium: Recent Advances in the Management of Thrombosis.

Fondaparinux sodium is a chemically synthesized selective factor Xa inhibitor approved for the prevention and treatment of venous thromboembolic events, that is, deep vein thrombosis, pulmonary embolism, and superficial vein thrombosis, in acutely ill (including those affected by COVID-19 or cancer patients) and those undergoing surgeries. Since its approval in 2002, the efficacy and safety of fondaparinux is well demonstrated by many clinical studies, establishing the value of fondaparinux in clinical practice. Some of the advantages with fondaparinux are its chemical nature of synthesis, minimal risk of contamination, 100% absolute bioavailability subcutaneously, instant onset of action, a long half-life, direct renal excretion, fewer adverse reactions when compared with direct oral anticoagulants, and being an ideal alternative in conditions where oral anticoagulants are not approved for use or in patients intolerant to low molecular weight heparins (LMWH). In the last decade, the real-world use of fondaparinux has been explored in other conditions such as acute coronary syndromes, bariatric surgery, in patients developing vaccine-induced immune thrombotic thrombocytopenia (VITT) and in pregnant women with heparin-induced thrombocytopenia (HIT), or those intolerant to LMWH. The emerging data from these studies have culminated in recent updates in the guidelines that recommend the use of fondaparinux under various conditions. This paper aims to review the recent data and the subsequent updates in the recommendations of various guidelines on the use of fondaparinux sodium.

First year students enrolled in university during the COVID-19 disaster and online classes: physical and mental health and desire for Hikikomori

The purpose of this study was to quantitatively clarify the physical and mental health of first year university students whose classes were conducted online due to COVID-19. The checklist of Visual Display Terminal (VDT) syndrome suggested that physical stress was placed mainly on the eyes, shoulders, neck, and head. In addition, from the results of the Kessler Psychological Distress Scale (K6) scale, higher values were obtained than those of previous studies, which indicated the poor mental health of first year university students. Consequently, university academics who conduct online classes must consider the physical and mental fatigue of the students. In contrast, there was a correlation between university students who had desire for Hikikomori and students who preferred on line classes. In other words, for students who experienced difficulties with existing face-to-face classes, it is suggested that online classes are one of the potential solution. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

MULTIFOCAL OSTEONECROSIS AS A CONSEQUENCE OF A NEW CORONAVIRUS INFECTION.

The impact of the transferred coronavirus infection on the musculoskeletal system still remains an urgent problem. Arthralgia, myalgia, arthritis, autoimmune disorders and also osteonecrosis are may be development of the post-COVID period. This article discusses the case of the debut of multifocal osteonecrosis after a coronavirus infection.Copyright © 2023 Ima-Press Publishing House. All rights reserved.

Malignant peripheral nerve sheath tumor on a patient with a maternally inherited novel NF1 gene pathogenic germline variant: Case report.

INTRODUCTION: Neurofibromatosis type 1 (NF1) is an autosomal dominant cancer predisposition syndrome caused by pathogenic variants in NF1, which negatively regulates the RAS pathway. Knowledge of the genotype-phenotype correlation in this disease is an important tool for prognostic evaluation and early detection of malignant peripheral nerve sheath tumors (MPNST), present in approximately 10% of these patients. We present the case of a teenager with a left jaw MPNST and a previously unreported germline pathogenic variant on NF1. CASE PRESENTATION: An 11-year-old female with a NF1 clinical diagnosis was referred to our hospital with a MPNST in an advanced state. A previously unreported NF1 pathogenic variant was obtained (GRCh37: NM_182493.2 c.3299C>G, p.Ser1100*). Despite great efforts from the surgical and medical teams, the tumor progression couldn't be halted, resulting in the patient's death. DISCUSSION: As MPNSTs are refractory to current treatment regimens, early diagnosis, and development of new therapies, such as MEK inhibitors, is necessary for reducing morbidity and mortality within NF1 patients. This increases the importance of a more widespread genetic testing strategy. CONCLUSION: The report of a novel NF1 pathogenic variant in a patient with maternally inherited neurofibromatosis type 1 and a MPNST increases the knowledge of the genotype-phenotype correlation in the disease.

Bilateral Ampiginous Choroiditis following Confirmed SARS-CoV-2 Infection.

INTRODUCTION: Ampiginous Choroiditis is a rare posterior uveitis that combines clinical features of Acute Multifocal Posterior Placoid Pigment Epitheliopathy and Serpiginous Chorioretinitis. Its pathophysiology is poorly understood and further studies are necessary to understand which mechanisms start the immunologic reaction. CASE REPORT: The purpose of this article is to report a well-documented case of Ampiginous Choroiditis following in seven days a RT-PCR confirmed SARS-CoV-2 infection, suggesting that the infection might have contributed as a trigger. CONCLUSION: Timely diagnosis and correct treatment are paramount to improve the visual outcomes, and the patient had successful response to systemic steroids.

Deadly Synergy: between Postcovid & Posttrauma Stress Syndrome in Areas of Armed Conflicts in COVID-I9 Era (Note)

Postcovid syndrome affects 5-20% of all patients with symp-tomatic Covid-I9 infection, resulting in temporary or perma-nent disability for next weeks or months. The commonest syn-dromes after long Covid-I9, (or chronic fatigue syndrome after Covid, or as synonymum postcovid syndrome) are psychic or psychosomatic disorders known under the name Depression and Anxiety Syndrome. After the unrest and armed conflicts during the Covid era, clients or patients, mainly migrants of war, are also exposed to chronic post trauma syndrome related to previous or recent de-struction of infrastructure, temporary homelesness and escape from affected regions/country. Cumulation of those 2 syndro-mes may have devastating consequences to both, individual health and economic losses due to permanent working and eco-nomy disabilities and consumption of health and social funds. After the unrest and armed conflicts during Covid era,clients or patients, mainly migrants of war, are also exposed to chronic post trauma syndrome related to previous or recent destruction of infrastructure, temporary homelesness and escape from af-fected regions/country.

Yoke between COVID-19 infection and cardiovascular diseases: Evidence briefing from Indian studies

Globally, cardiovascular diseases (CVDs) are of major concern. The current pandemic situation of Coronavirus Disease 19 (COVID-19) infection has further hiked the burden of cardiovascular problems. Since India has a large number of cases with cardiovascular problems the interlink between the COVID-19 infection and CVDs has greatly challenged the field of medicine. The interaction between the drugs used in the management of COVID infection and cardiovascular problems is another major area of concern. With the variant nature of the Coronavirus, cases have surged leading to increased mortality and one of the major causes for mortality is cardiovascular complications. This article aims to reflect on the effect of cardiovascular morbidity on COVID-19 infection and the cardiovascular outcome of COVID-19 positive patients in India. The relevant articles for the review were searched using the three databases: CINHAL, Scopus, and PubMed and the search was limited to the studies conducted from January 2020 till May 2021. The review highlighted that Diabetes and Hypertension were the most common comorbidity and were the major contributing factors for the mortality among patients diagnosed with COVID-19 in India.

Cerebral venous sinus thrombosis following ChAdOx1 nCoV-19 AstraZeneca COVID-19 vaccine.

A woman in her mid-twenties was admitted with headache, ultimately leading to a diagnosis of cerebral venous sinus thrombosis 10 days after receiving a first dose of the AstraZeneca ChAdOx1 nCoV-19 vaccine (Vaxzevria). We report this case from clinical investigations to outcomes and discuss the issues raised by it regarding the ChAdOx1 nCoV-19 vaccine.

Acute Visual Disturbances and Ataxia Secondary to Attempted COVID-19 Prophylaxis With Ivermectin in a Nine-Year-Old.

Ivermectin is an antiparasitic agent listed as an essential medication by the World Health Organization. Ivermectin utilization has increased due to the popular, though inaccurate, perception of its use in COVID-19 management. Poison Control Central calls regarding ivermectin toxicity have increased 245% since pre-pandemic baselines. This case study illustrates the clinical presentation of ivermectin toxicity in a nine-year-old child with acute vision changes and ataxia. The child was given 60 mg (1 mg/kg) of veterinary-grade ivermectin by a parent, 10 times the clinically recommended dose of 0.1 mg/kg, as prophylaxis after household exposure to COVID-19. Ten hours later, the child developed new-onset blurry vision, a perception of red dots in the peripheral vision, dizziness, and balance issues. Physical examination was notable for pulsating pupils, ataxia, and dysmetria. Symptoms resolved completely after 10 hours. Ivermectin ingestion is an important diagnostic consideration in children presenting with similar symptoms. We hope our case aids in the identification of ivermectin toxicity and hastens necessary supportive measures.

Polyps and Polyposis Syndromes in Children: Novel Endoscopic Considerations.

Polypectomy is the most common therapeutic endoscopic intervention in children. Management of sporadic juvenile polyps is limited to polypectomy to resolve symptoms, whereas polyposis syndromes pose a multidisciplinary challenge with broader ramifications. In preparation for polypectomy, there are key patient, polyp, endoscopy unit, and provider characteristics that factor into the likelihood of success. Younger age and multiple medical comorbidities increase the risk of adverse outcomes, classified as intraoperative, immediate postoperative, and delayed postoperative complications. Novel techniques, including cold snare polypectomy, can significantly decrease adverse events but a more structured training process for polypectomy in pediatric gastroenterology is needed.

Use of cardiac imaging in chronic coronary syndromes: the EURECA Imaging registry.

BACKGROUND: The prospective, multicentre EURECA registry assessed the use of imaging and adoption of the European Society of Cardiology (ESC) Guidelines (GL) in patients with chronic coronary syndromes (CCS). METHODS: Between May 2019 and March 2020, 5156 patients were recruited in 73 centres from 24 ESC member countries. The adoption of GL recommendations was evaluated according to clinical presentation and pre-test probability (PTP) of obstructive coronary artery disease (CAD). RESULTS: The mean age of the population was 64 ± 11 years, 60% of patients were males, 42% had PTP >15%, 27% had previous CAD, and ejection fraction was <50% in 5%. Exercise ECG was performed in 32% of patients, stress imaging as the first choice in 40%, and computed tomography coronary angiography (CTCA) in 22%. Invasive coronary angiography (ICA) was the first or downstream test in 17% and 11%, respectively. Obstructive CAD was documented in 24% of patients, inducible ischaemia in 19%, and 13% of patients underwent revascularization. In 44% of patients, the overall diagnostic process did not adopt the GL. In these patients, referral to stress imaging (21% vs. 58%; P < 0.001) or CTCA (17% vs. 30%; P < 0.001) was less frequent, while exercise ECG (43% vs. 22%; P < 0.001) and ICA (48% vs. 15%; P < 0.001) were more frequently performed. The adoption of GL was associated with fewer ICA, higher proportion of diagnosis of obstructive CAD (60% vs. 39%, P < 0.001) and revascularization (54% vs. 37%, P < 0.001), higher quality of life, fewer additional testing, and longer times to late revascularization. CONCLUSIONS: In patients with CCS, current clinical practice does not adopt GL recommendations on the use of diagnostic tests in a significant proportion of patients. When the diagnostic approach adopts GL recommendations, invasive procedures are less frequently used and the diagnostic yield and therapeutic utility are superior.

The Current Outbreak of COVID-19 with Reference to India

This review summarizes the outbreak of viruses causing the fatal disease, which is highly pathogenic and efficiently transmitted from human to human. This first began in Wuhan, China, and now turned into an epidemic situation worldwide. A novel coronavirus (2019-nCoV) or severe acute respiratory syndrome coronavirus(SARS-CoV)-2 belongs to beta-coronavirus genera originated in bats due to highly identical genome which leads to bat coronavirus. This review highlights the study of Indian Council of Medical Research, India, which determined the detection of pathogenic coronavirus in two different species of Indian bats. Indian Council of Medical Research, India, has successfully isolated the COVID-19 virus strain which was the first step towards diagnosis and the development of vaccines in the country. The outbreaks of coronavirus received worldwide attention for overcoming the challenges faced during this current pandemic as there is no clinically approved antiviral drug or vaccine available yet. However, preventive measures and different treatments were taken to cope with this viral outbreak. In response to this global outbreak, this review tries to explain the Virology, Epidemiology and pathogenesis, and discusses the diagnosis and treatment strategies of COVID-19. This review emphasizes the current update of COVID-19.Copyright © 2021 Bentham Science Publishers.

Feedback Artificial Tree-Anti Corona Virus Optimization enabled deep learning for detecting autism spectrum disorder

Autism spectrum disorder (ASD) is an umbrella term for a number of neurodevelopmental conditions with many heterogeneous behavioural indications. Recent medical imaging approaches use functional Magnetic Resonance Imaging (fMRI) for human recognition of the various neurological syndromes. However, these traditional techniques are time consuming and expensive. Thus, in this research, an optimization assisted deep learning technique, named Feedback Artificial Virus Optimization (FAVO)-based deep residual network (DRN), is developed. FAVO-based DRN is designed to incorporate the Feedback Artificial Tree (FAT) algorithm with Anti Corona Virus Optimization (ACVO). First, Region-Of-Interest extraction is carried out using thresholding techniques with nub region extraction completed using the proposed FAVO algorithm. ASD classification is then carried out using a DRN classifier. Evaluation of the proposal uses the ABIDE-1 and ABIDE-2 datasets. The developed FAVO algorithm attains better accuracy, sensitivity, and specificity of 0.9214, 0.9365, and 0.9142, respectively, by considering ABIDE-2 dataset. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

COVID-19 and the hyperferritinemic syndromes

The hyperferritinemic syndromes include macrophage activation syndrome, adult onset Still's disease, catastrophic antiphospholipid syndrome, and septic shock. The syndrome is characterized by life-threatening disease due to the development of a cytokine storm, multiorgan damage, elevated ferritin levels, and the response to similar therapies. In the third phase of SARS-COV2 infection, the hyperinflammatory phase, elevated ferritin levels and the development of a cytokine storm are present. A new entity, multisystem inflammatory syndrome, described predominantly in pediatric patients, mimics MAS, yet develops without a previous symptomatic disease. In these patients, hyperferritinemia is prominent. Elevated ferritin levels in COVID-19 intensive care unit patients predict mortality. Ferritin levels in nonsurvivors are much higher than those who survive. Consecutive measurements of a rising ferritin level may predict the need for assisted ventilation. Treatments such as corticosteroids, biologics, and IVIG may also be beneficial for COVID-19 as they are for the other hyperferritinemic syndromes. In this review, we present proof of concept for COVID-19 to be included with the other entities in the hyperferritinemic syndrome. © 2023 Elsevier Inc. All rights reserved.

Historical perspectives, including chronic fatigue syndrome/Myalgic Encephalomyelitis and Fibromyalgia

The illnesses that most resemble long-COVID syndrome are Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) and fibromyalgia. This chapter describes the similar symptoms of these conditions to long-COVID syndrome. It discusses what is termed chronic Lyme disease, or post-treatment Lyme disease syndrome, as an example of an analogous, unexplained syndrome following an infection. CFS/ME are diagnostic labels used to describe a syndrome characterized by chronic fatigue, post-exertional malaise, muscle pain, and cognitive disturbances often attributed to a possible infection but without a defined cause or pathology. Fibromyalgia, like CFS/ME, has been around for centuries in various guises. Abnormalities of the central and autonomic nervous system are prominent in fibromyalgia and CFS/ME. CFS/ME and fibromyalgia are sometimes referred to as functional, somatic syndromes. Patients with CFS/ME and fibromyalgia often express frustration with medical professionals' approach to their illness. © 2023 John Wiley & Sons Ltd. All rights reserved.

SARS-CoV-2 and microbiome: pathology, implications and therapeutic options

A multidisciplinary approach in the treatment of COVID-19 warrants close attention to the role of the intestinal microbiome in terms of disease pathology, disruption of local and systemic homeostasis, and possible treatment strategies. Dysbiotic disorders affect the immune system on the level of postvaccination immunity, influencing the likelihood and severity of SARS-CoV-2 infection, indicating the importance of intestinal microbiota in the prevention of complications and risk reduction. The fundamental factor in the stability of the intestinal microflora is a diet that includes regular consumption of probiotic foods, which support healthy microbiota. Restoration of damaged intestinal microbiota in cases of dysbiosis requires specific supplements and foods, which vary significantly for each symbiont. In clinical practice, the most appropriate approach is a differentiated one, taking into account the severity of the dysbiotic condition, comorbidities, and the age of the patients. A bacteria consortium of the human microbiome is the basis for a bioprobiotics complex with targeted action. The translational benefits of such therapy in most common COVID-19 syndromes are in detail presented in this chapter. We discuss the role of SARS-CoV-2 infection on the microbiota, as well as pathogenetic mechanisms of microbiota disruption, local and systemic influencing factors, and treatment strategies. © 2023 Elsevier Inc. All rights reserved.