Self-Sovereignty Identity Management Model for Smart Healthcare System.

An identity management system is essential in any organisation to provide quality services to each authenticated user. The smart healthcare system should use reliable identity management to ensure timely service to authorised users. Traditional healthcare uses a paper-based identity system which is converted into centralised identity management in a smart healthcare system. Centralised identity management has security issues such as denial of service attacks, single-point failure, information breaches of patients, and many privacy issues. Decentralisedidentity management can be a robust solution to these security and privacy issues. We proposed a Self-Sovereign identity management system for the smart healthcare system (SSI-SHS), which manages the identity of each stakeholder, including medical devices or sensors, in a decentralisedmanner in the Internet of Medical Things (IoMT) Environment. The proposed system gives the user complete control of their data at each point. Further, we analysed the proposed identity management system against Allen and Cameron's identity management guidelines. We also present the performance analysis of SSI as compared to the state-of-the-art techniques.

Long-Term Symptoms of COVID-19: One-Year Follow-Up Study.

INTRODUCTION:  Persistent and prolonged symptoms, termed as long COVID (coronavirus disease), have been reported in several patients who recovered from the acute phase at different intervals. However, there has been largely unclear data regarding the full range of long-term sequelae of coronavirus disease 2019 (COVID-19) patients. This study aims to evaluate the prevalence of long COVID syndrome. METHODS: A long-term research was conducted in the COVID-19 unit of a tertiary care hospital in Pakistan from July 2020 to December 2021 in which 2,000 patients who had recovered from COVID-19 and had been discharged were included in the study. Symptoms were noted at the time of discharge and at follow-up after 12 months. Data were analyzed using Statistical Package for the Social Sciences (SPSS) v. 22.0 (IBM Corporation, Armonk, New York, United States). RESULTS: The mean age of the participants was 43 ± 10 years, 801 (53.8%) males and 688 (46.2%) females. At the time of discharge, the most common symptom was fatigue (26.93%), followed by dyspnea (20.34%) and muscle pain (8.86%). The most common symptom on follow-up was fatigue (6.78%). CONCLUSION: We strongly emphasize discussing and exploring further knowledge on the post-infection syndrome, with an aim to bring healthcare professionals' attention to the importance of handling COVID patients, their counseling, warning for alarming signs, and a long-term follow-up with necessary investigations and treatment.

Evaluation of Serum Electrolyte Levels in Patients With Anemia.

INTRODUCTION: Anemia is one of the most prevalent diseases globally. Various diseases have linked anemia with electrolyte disturbance. However, the local data are limited. In this study, we will determine the prevalence of electrolyte imbalance in anemic patients. METHODS: This case-control study was conducted in a tertiary care hospital from January 2021 to July 2021. A total of 500 anemic patients were enrolled in the study after informed consent. Another 500 non-anemic patients were enrolled as the control group. Blood was taken from both groups and send for assessment of electrolytes. RESULTS: Sodium levels were significantly lower in anemic patients compared to non-anemic patients (131.42 ± 0.82 meq/L vs. 135.57 ± 0.42 meq/L; p-value: <0.0001). Potassium levels were significantly higher in anemic patients compared to non-anemic participants (4.37 ± 0.12 meq/L vs. 4.09 ± 0.11 meq/L; p-value: <0.0001). Chloride levels were significantly higher in participants with anemia compared to non-anemic participants (103.92 ± 0.46 meq/L vs. 100.99 ± 0.41 meq/L). CONCLUSION: Our study indicates that sodium levels and potassium levels are impacted in patients with anemia compared to patients without anemia. Close monitoring of serum electrolytes is suggested in patients with anemia to avoid complications and life-threatening conditions.

Gastrointestinal Manifestation of COVID-19 in Hospitalized Patients.

INTRODUCTION: During the initial phase of the pandemic, gastrointestinal (GI) symptoms were less frequent but during the later stages, GI manifestations have become more frequent. This study aims to explore the prevalence of GI symptoms in COVID-19 patients, and also focuses on the frequency of these symptoms. METHODS: This longitudinal study was conducted in a COVID-19 unit of a tertiary care hospital, Pakistan. Data of patients hospitalized with COVID-19 infection between June 2021 and July 2021 was included in the study. A total of 412 participants were enrolled in the study via consecutive convenient non-probability sampling. Participants' symptoms and demographics were noted in a self-structured questionnaire. The collected data were analyzed using Statistical Package for Social Sciences (SPSS), version 23.0 (IBM Corp., Armonk, NY). RESULTS: A total of 261 (63.3%) participants had a minimum of one GI symptom. The most common symptom was anorexia (43.9%), followed by diarrhea (24.7%) and nausea/vomiting (17.9%). CONCLUSION:  Our study indicates high frequency of COVID-19 patients reporting GI symptoms. Anorexia, diarrhea, nausea, and vomiting were commonly reported symptoms. Therefore, COVID 19 testing should be considered with patients presenting with GI symptoms.

Association Between Rheumatoid Arthritis and Serum Vitamin D Levels.

Introduction Vitamin D is responsible for regulating innate and adaptive immune responses and for boosting the immune system; hence, a decline in its levels results in autoimmunity. Current studies have linked the deficiency of vitamin D to different autoimmune diseases, including rheumatoid arthritis (RA). In this study, we will determine the association between vitamin D level and RA. Methods This is a case-control study, conducted in a tertiary care hospital in Pakistan from January 2021 to May 2021. Three hundred patients with a confirmed recent diagnosis of RA were enrolled as the study group. Another 300 participants without RA, matched for age and gender, were enrolled in the study as a control group. RA was diagnosed on the basis of clinical symptoms, radiological features on X-ray, and anti-citrullinated protein levels of more than 20 u/mL. Results The mean vitamin D level in participants with RA was significantly lower than in the placebo group (30.18 ± 6.27 vs. 38.29 ± 7.98; p-value: <0.0001). The mean vitamin D level in participants with positive RF patients was significantly lower compared to rheumatoid factor (RF)-negative RA patients (29.21 ± 5.16 vs. 32.26 ± 7.02; p-value: <0.0001). There were more participants with hypovitaminosis D in RF-positive participants as compared to RF negative (88.6% vs. 44.3%; p-value: 0.00001). Conclusion There is a high prevalence of vitamin D deficiency in patients with RA and there is a link with disease severity. Therefore, a high index of suspicion is required while evaluating the at-risk patients, especially women, with complaints of vitamin D deficiency. Vitamin D supplementation may be needed for the prevention or avoidance of the progression of the disease.