Objective: Traditional denoising algorithms perform less due Limited Directional Selectivity problem and do not adequately capture directional information in pixels. Traditional algorithms' edge representation and texture details are insufficient for the earlier detection of DH. Limited Directional Selectivity leads to inaccurate diagnosis and classification of Disc Herniation (DH) stages. The DH stages are (i) Degeneration (ii) Prolapse (iii) Extrusion and (iv) Sequestration. Moreover, detection of DH size below 2mm using MR image is the major problem.

Methods: To solve the above problem, spinal cord MR images fed to the proposed Parrot optimization tuned Denoising Convolutional Neural Network (Po- DnCNN) algorithm for perspective enhancement of nucleus pulposus region in the spinal cord, vertebrae. The perspective enhancement of Spinal cord image led to the accurate classification of stages and earlier detection of DH by using the proposed Hippopotamus optimization- Fast Hybrid Vision Transformer (Ho–FastViT) algorithm. For this study, spinal cord MR images are obtained from the Grand Challenge website – SPIDER dataset.

Results: The proposed Po-DnCNN method and Ho-FastViT results are analysed quantitatively and qualitatively based on the edge, contrast, classification of the stage, and enhancement of the projected nucleus pulposus region in the spinal cord and vertebrae. The predicted DH results using the proposed method are compared with the manual Pfirrman Grade value of the spinal card method.

Conclusion: Proposed method is better than traditional methods for earlier detection of DH. Po-DnCNN and Ho-FastViat methods give high accuracy of about 98% and 97% compared to traditional methods.

Objectives: The shortcomings of various conventional treatments have prompted urgent efforts to discover safe, natural compounds that may be useful in combating COVID-19. This study aims to review research that has investigated the potential of traditional phytotherapies used by different populations for the prevention and symptomatic treatment of COVID-19 infection.

Methods: This paper reviewed scientific studies published through searching on search engines such as PubMed, Scopus, Google Scholar, ScienceDirect and Elsevier from May until October 2023.

Results: The preventive and anti-COVID-19 attributes of Traditional Chinese Medicine, Ayurvedic formulations and African medicinal plants have been substantiated in research. In Nepal, recommendations endorse the utilisation of medicinal plants for herbal teas and homemade sanitizers. Zingiber officinale, Curcuma longa L. and Curcuma xanthorriza Roxb., along with Camellia sinensis are crucial Indonesian medicinal plants with potential for treating COVID-19. Z. officinale was predominantly chosen for relieving coughs and sore throats associated with COVID-19 in Saudi Arabia.

Discussion: The immunomodulatory properties of medicinal plants, which may prove useful in combating COVID-19, have been verified via elevation of the level of peripheral WBCs, IgM, IgG; inhibition of leukotrienes and prostaglandins, maintenance of the integrity of intestinal mucosal barrier and regulation of HMGB1. The antiviral effects of herbs, including the inhibition of viral DNA and RNA replication, down-regulation of oxidative stress, and the impediment of SARS-CoV-2 access to vascular endothelial cells, suggest their potential to facilitate earlier recovery from COVID-19 infection.

Conclusion: Advancing scientific research in phytotherapy promises the possibility of novel approaches for effectively managing future infectious diseases and pandemics.

Methods: A quantitative, cross-sectional research design was used for the study.

Results: Most medical personnel agreed to get the COVID-19 vaccination (84%; n=384). Medical workers over 45 (90%) showed more readiness for vaccination. The main pushbacks against the vaccination included the development of a vaccine in a short period (n=56; 73.7%), fear of side effects (n=49; 64.5%), lack of reliable information about vaccination (n=35; 46.1%), negative information spread by the media (n=26, 34.2%). Recommendations by healthcare workers (63.9%), health authorities (73.1), media (70%), large number of people being vaccinated (72.6%), and provision of trustworthy information (71.3%) facilitate vaccination.

Conclusion: The high rate of COVID-19 vaccination among medical personnel shows that they have a high risk perception of infection. Among Health Belief Model components, cues to actions were most important in willingness to carry out vaccination. Recommendations of the WHO and scientists significantly influence the willingness to carry out vaccination. The regulatory responsibilities of the state and the public's trust in it play a crucial role in raising the population's awareness about the vaccine.

Methods: Studies in the English language between 2010 and 2021 were shortlisted using a structured search in electronic databases followed by an unstructured search using government websites and Google Scholar and anecdotal data from local professional experts. Synthesized data was subjected to weighted mean calculation, and an evidence gap map was charted.

Results: Varying prevalence of depression (5.1%-82.2%) was reported across different settings and population sample sizes in the UAE. One study reported that 13.0% of the UAE population was aware of their depressive condition. Screening rates of depression were reported to be relatively high (34.2%-90.5%), while depression was diagnosed in 0.5%-48.5% of patients. The treatment rate was 36.1%, while adherence rates were estimated to be low at 0.3%. No evidence of control or remission of depression could be gathered. The reviewed studies used only the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria for diagnosing depression.

The review also lacked large-scale research studies that may have limited the actual representation of the prevalence of depression across the country. Conclusion:

Addressing the gaps identified through evidence mapping methodology can shape a ‘model of care’ for depression. This model should aim to harmonize collaborations among the mental health stakeholders and advocate for the social reintegration of patients.

Methods: This investigation involved a cross-sectional design. The perceived severity, susceptibility, barriers, benefits, cues to action, and self-efficacy were the independent variables. The dependent variable was the adoption of the COVID-19 vaccine by the public. Mann-Whitney, Chi-square and Multivariate tests were used to present vaccine acceptance differences, relationships and impacts of each variable towards COVID-19 vaccine acceptance.

Results: There was a total of 461 participants in this study. For the majority of respondents (56.40%), COVID-19 vaccine acceptance among them remains modest. The difference between the low and high vaccination acceptance groups (p-value < 0.05) was revealed. Except for perceived severity, this study demonstrated that all HBM constructs had a significant relationship with vaccination acceptance (p-value < 0.05). In addition, the results of the logistic regression test indicated that the cues-to-action construct was the most influential factor in vaccine acceptance (OR= 7.156; CI, 95%= 4.107 – 12.469), followed by self-efficacy (OR=3.218; CI, 95%=1.819 – 5.694).

Conclusion: Thus, health policymakers should focus on cues-to-action and self-efficacy factors for developing a strategy to increase vaccine acceptance among the Indonesian population by using current study results among the Singkawang population as a model to start the persuasion techniques.

Methods: This was a cross-sectional study conducted in the United Arab Emirates that targeted residents above 18 years of age. A research questionnaire was developed and approved by three specialists in the field, along with the Patient Health Questionnaire-9 (PHQ9). The Chi-square test was used to assess the association between variables, and multiple logistic regression analysis was used to find the predictive risk factors for moderate to severe depressive symptoms.

Results: The study encompassed a group of 562 participants, achieving a response rate of 97.33%. Initially, a Google Form was distributed electronically to the entire participant pool; however, 15 individuals declined to participate, resulting in a final sample size of 547 (n). Amongst the variables that showed significant prevalence of moderate to severe depressive symptoms were age (P <0.001), sex (P <0.001), marital status (P <0.001), occupation classification (P <0.001), religiosity (P <0.001), education level (P <0.001), job stress (P <0.001), domicile and residence (P <0.001), responsibility towards family (P <0.001), post-traumatic stress disorder (PTSD) (P <0.001), consumption of alcohol (P <0.001), coronavirus disease pandemic (P <0.001), employment status (P = 0.002), family size (P = 0.001), and smoking (P = 0.004). Amongst the variables, the subgroups that showed significant predictive factors of moderate to severe depressive symptoms were the ages between 18 and 25 years old (P = 0.01), the female gender (P <0.001), and low levels of religiosity (P <0.001).

Conclusion: The prevalence of moderate-to-severe depressive symptoms was 48% (n=260). In our study on the prevalence of depression, we have investigated several predictive factors, including age, gender, religiosity, and a history of prior depression diagnosis. While numerous factors contribute to depression, additional research is imperative to identify and validate additional predictive factors.

Methods: The study was conducted as an online cross-sectional survey which was compared with historical data of antibody titers. The university female students who had participated in our previous study evaluating seroprevalence of measles, rubella and pertussis antibody titres were contacted online for the survey. The online questionnaire was sent to collect details on COVID-19 occurrence among all the participants. The measles, rubella and pertussis titers of all participants were correlated with the present questionnaire data. All volunteers participated in the survey after online informed consent.

Results: Among the 52 responders to the questionnaire, 18 participants had been reported to be suffering from COVID-related symptoms and 12 were reported to have confirmed RT-PCR positive for COVID-19. The unpaired “t” test comparing antibody titres of measles, rubella and pertussis between COVID-19 RT PCR positive and RT PCR negative subjects did not show statistical significance.

Conclusion: There was no statistical difference between antibody titers of measles, rubella and pertussis among self-reported COVID-19 RT PCR positive and RT PCR negative university female students.

Objectives: The pandemic revealed that COVID-19 affects a variety of organs in addition to the lungs, including the heart and brain, raising the risk of long-term health consequences. The illness can affect someone's health even after recovery in a variety of ways. The long-term effects of COVID-19 on locals are still being researched. The objective is to compile knowledge regarding the virus and the present Post pandemic complications in Long Haulers.

Methods: We reviewed the body of publicly available literature. To discover publications published between December 2019 and October 2020, we conducted a systematic search utilizing the keywords in online databases such as Pub Med, Scopus, Science Direct, Up to Date, and Web of Science. The review includes peer-reviewed original publications published that matched the qualifying requirements.

Results: Although the majority of patients recovered quickly after receiving COVID-19, the possibility of long-term issues induced by COVID-19 necessitates the search for and research of its late consequences. This article aims to provide a comprehensive assessment of COVID-19 late complications in order to determine how prevalent these symptoms are and who is most likely to be impacted.

Conclusion: There are a number of difficulties with the COVID-19 pandemic that has yet to be resolved. Review of the literature reported several long-lasting clinical problems that affect different phases of health, including chronic fatigue, reduced physical capacity, muscle weakness, increased depression, anxiety, post-traumatic stress disorder and sleep problems. A complete turndown in quality of life has been observed even one year after major Coronavirus outbreaks.

The pandemic revealed that COVID-19 affects a variety of organs in addition to the lungs, including the heart and brain, raising the risk of long-term health consequences even after years making them to be “Long Haulers”.

The causal agent, pathogenesis, immunological responses, epidemiology, diagnosis, therapy, and management of the disease, as well as control and preventive efforts, are all included in this review of the literature.

Methods: Our study included patients who were diagnosed with COVID-19 in our hospital at least 1 year ago, recovered, and then underwent coronary CT angiography with suspected coronary artery disease. The aim was to evaluate the burden of atherosclerotic plaque in the coronary arteries of these patients who underwent coronary CT angiography.

Results: Patients were assigned to 3 groups according to the results of the CT scan. Group 1 included patients in the control group with no history of COVID-19 (n=36), group 2 included those with mild to moderate pneumonia symptoms (n=43), and group 3 included those with severe pneumonia symptoms (n=29). The calcium scores were 23.25±36.8 in group 1, 27.65±33.4 in group 2, and 53.58±55.1 in group 3. The calcium score was found to be significantly higher in group 3 patients with severe pneumonia (group 1-2 p=0.885, group 1-3 p<0.05, group 2-3 p<0.05).

Conclusion: Although there is no conclusive evidence of a relationship between COVID-19 and atherosclerosis, our study suggests a possible relationship between them. Since this relationship was found especially in cases with severe disease in our study, we believe that the treatment should focus on preventing excessive inflammatory response, and such patients should be under control in terms of coronary artery disease.

Objective: The study aimed to analyze literature related to the application of MRI in COVID-19 using bibliometric tools, to explore the research status, hotspots, and developmental trends in this field, and to provide a reference for the application of MRI in the clinical diagnosis and evaluation of COVID-19.

Methods: We used the Web of Science Core Collection database to search and collect relevant literature on the use of MRI in COVID-19. The authors, institutes, countries, journals, and keyword modules of the bibliometric analysis software CiteSpace and VOSviewer were used to analyze and plot the network map.

Results: A total of 1506 relevant articles were shortlisted through the search; the earliest study was published in 2019, showing an overall upward trend every year. The research was mainly presented as published articles. Clinical neurology was found to be the primary discipline. The United States had the highest publication volume and influence in this field. Countries around the world cooperated more closely. The Cureus Journal of Medical Science was the main periodical to publish articles. Institutes, such as Harvard Medical School, Mayo Clinic, and Massachusetts General Hospital, have published a large number of papers. Some of the high-frequency keywords were “COVID-19”, “SARS-CoV-2”, “magnetic resonance”, “myocarditis”, and “cardiac magnetic resonance imaging”. The keyword clustering study showed that the current research mainly focuses on five “hot” directions.

Conclusion: There is a need to strengthen cross-teamwork and multidisciplinary collaboration in the future to completely explore the positive role of MRI in COVID-19 and to discover breakthroughs for the challenges in the clinical diagnosis and treatment of COVID-19.

Objective: The aim of this study was to determine whether there is a radiological difference in lung parenchymal involvement between infected vaccinated and unvaccinated patients. Additionally, we aimed to investigate whether vaccination has an impact on the course of illness and the need for intensive care.

Methods: This study includes all patients undergoing chest computed tomography (CT) or x-ray imaging in case of a proven SARS-CoV-2 infection between September and November 2021. Anonymized CT and x-ray images were reviewed retrospectively and in consensus by two radiologists, applying an internal severity score scheme for CT and x-ray as well as CARE and BRIXIA scores for x-ray. Radiological findings were compared to vaccination status, comorbidities, inpatient course of the patient’s illness and the subjective onset of symptoms.

Results: In total, 38 patients with acute SARS-CoV-2 infection underwent a CT scan, and 168 patients underwent an x-ray examination during the study period. Of these, 32% were vaccinated in the CT group, and 45% in the x-ray group. For the latter, vaccinated patients exhibited significantly more comorbidities (cardiovascular (p=0.002), haemato-oncological diseases (p=0.016), immunosuppression (p=0.004)), and a higher age (p<0.001). Vaccinated groups showed significantly lower extent of lung involvement (severity scores in CT cohort and x-ray cohort both p≤0.020; ARDS 42% in unvaccinated CT cohort vs. 8% in vaccinated CT cohort). Furthermore, vaccinated patients in the CT cohort had significantly less need for intensive care treatment (p=0.040).

Conclusion: Our data suggest that vaccination, in the case of breakthrough infection, favours a milder course of illness concerning lung parenchymal involvement and the need for intensive care, despite negative predictors, such as immunosuppression or other pre-existing conditions.

Aims: This study aims to assess the relationship between chest CT-extracted baseline bone mineral density (BMD) and body composition parameters and the length of hospital stay in these patients.

Methods: A retrospective analysis was performed in a cohort of 88 patients with COVID-19. Correlation analysis and a generalized linear model (GLM) were used to assess the associations between the length of hospital stay and covariates, including age, sex, body mass index (BMI), BMD and body composition variables.

Results: The mean length of hospital stay was 27.4±8.7 days. The length of hospital stay was significantly positively associated with age (r=0.202, p=0.046) and the paraspinal muscle fat ratio (r=0.246, p=0.021). The GLM involving age, sex, BMD, paraspinal muscle fat ratio, subcutaneous adipose tissue (SAT) area, visceral adipose tissue (VAT) area, and liver fat fraction (LFF) showed that the length of hospital stay was positively correlated with VAT area (β coefficients, 95% CI: 9.304, 1.141-17.478, p=0.025).

Conclusion: The musculoskeletal features extracted from chest CT correlated with the prognosis of COVID-19 patients. Factors including old age, a higher paraspinal muscle fat ratio and a larger VAT area in patients with COVID-19 were associated with longer hospital stays.

Methodology: The following research article elaborates on the surveys that were carried out in Maharishi Markandeshwar Deemed to be University Mullana, with 701 participants. Data were collected using the computer vision syndrome questionnaire and the ergonomics questionnaire for a duration of 6 months.

Results: The most prevalent symptom of CVS occasionally was found to be a headache (503 participants=71.7%), followed by eye heaviness and eye pain (483 participants=68.9%), burning sensation, itching and tearing (414 participants=59%), red eyes (361 participants=51.4%), foreign bodies (319 participants=45.5%), dryness (281 participants=40%), blurred and double vision (266 participants=37.9%), increased sensitivity to light and colored halos (249 participants=35.5%), and difficulty focusing (299 participants=42.6%).

Conclusion: All symptoms of CVS suffered by the participants were on an occasional basis, constituting the majority and the most common CVS symptom as headache. In assessing the ergonomics, all participants experienced pain at least in one extremity and the majority of participants had their back bent while working with electronics.

Methods: The survey was distributed online, and responses were collected from 173 participants nationwide. Data analysis was performed using SPSS Statistics (version 27).

Results: The participants scored an average of 1.7, 1.6, and 1.8 on a scale of 1–3 for attitudinal perspectives on clinical application and the positive and negative impact of integrating AI technology in diagnostic radiology. Lack of knowledge (43.9%) and perceived cyber threats (37.7%) were the most cited factors hindering AI implementation in Saudi Arabia.

Conclusion: The radiographers and radiologists in this study had a favorable attitude toward AI integration in diagnostic radiology; nonetheless, concerns were raised about data protection, cyber security, AI-related errors, and decision-making challenges.

Methods: In this study, we proposed a new model called Blend U-Net, which incorporates nested structures, redesigned long and short skip connections, and deep supervisions. The nested structures and the long and short skip connections combined characteristic information of different levels from feature maps in all scales, while the deep supervision learning hierarchical representations from all-scale concatenated feature maps. Additionally, we employed a mixed loss function to obtain more accurate results.

Results: We evaluated the performance of the Blend U-Net against other architectures on the publicly available Lung Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI) dataset. Moreover, the accuracy of the segmentation was verified by using the dice coefficient. Blend U-Net with a boost of 0.83 points produced the best outcome in a number of baselines.

Conclusion: Based on the results, our method achieves superior performance in terms of dice coefficient compared to other methods and demonstrates greater proficiency in segmenting lung nodules of varying sizes.

Introduction: The radiological changes in the lungs of critical people with coronavirus disease 2019 (COVID-19) pneumonia at different times have not been fully characterized. We aim to describe the computed tomography findings of patients with critical COVID-19 pneumonia at different disease stages.

Methods: Clinical and laboratory features of critical patients were assessed. CT scans were assigned to groups 1, 2, 3, or 4 based on the interval from symptom onset (within 2 weeks; ≥ 2-4 weeks; ≥ 4-6 weeks; or ≥ 6 weeks, respectively). Imaging features were analyzed and compared across the four groups. Total CT scores, corresponding periods of laboratory findings, and glucocorticoid dosages during the imaging intervals were longitudinally observed in five patients with complete data.

Results: All 11 critical patients (median age: 60 years [42-69]) underwent a total of 40 CT examinations, and the acquisition times ranged from 1-59 days after symptom onset. Median total CT scores were 18 (9-25.25); 445 (42.88-47.62); 4375 (38.62-49.38); and 42 (32.25-53.25) in groups 1, 2, 3, and 4, respectively. The observed lesions were mainly bilateral (37 [92.5%]). The median values of involved lung segments were 10.5 (4.5-13.5); 17 (16-18.5); 18 (18-19.5); and 18 (18-19) in groups 1-4, respectively. The predominant patterns of observed abnormalities were ground-glass opacities (GGO) (9 [90%]); GGO with reticulation and mixed patterns (3 [37.5%] for both); GGO with consolidation (3 [30%]); and GGO with reticulation (8 [66.7%]) in groups 1-4, respectively. Patients developed fibrotic manifestations at later stages.

Conclusion: Critical patients with COVID-19 infection generally presented with temporally changing abnormal CT features from focal unilateral to diffuse bilateral GGO and consolidation that progressed to or coexisted with reticulation in the long term after symptom onset. Low-dose glucocorticoids may be effective in patients with interstitial changes on CT findings.

Objective: The study aimed to characterize the global research landscape and trend of LUS with quantification and visualization approaches.

Methods: Documents related to LUS published between 2007 and 2023 were selected from the Web of Science Core Collection and identified. Visualization and statistical analysis were conducted with the VOSviewer 1.6.18, CiteSpace 5.7.R5, and Bibliometrix 4.1.0 Package, including analysis of the trend of global publications, prominent countries, active institutions, and funding agencies, key authors and journals, co-cited references, and keywords.

Results: A total of 3010 publications, including 2434 articles and 576 reviews, were retrieved. The output of LUS-related research has increased steadily over the years, especially after 2018. Italy (n=756; 25.12%) has shown the highest output, being the country with the highest total citations (23423 times). The most influential author was Gargani Luna with 52 documents, who worked at the Consiglio Nazionale delle Ricerche. Chest and Intensive Care Medicine with high citations and impact factor scores were the most influential journals. Besides “lung ultrasonography”, the keywords developed included “coronavirus disease 2019 (COVID-19)”, “acute respiratory distress syndrome”, and “acute heart failure”.

Conclusion: Research output on LUS has increased steadily, especially after 2018. Italy and the United States are staying ahead in this field. Research collaboration still needs to be strengthened. This comprehensive analysis has presented the global research landscape and trends of LUS-related research, providing valuable information for researchers to pursue further exploration.

Objective: In this article, we aim to present a new AI model that solves this challenge by allowing the differentiation, diagnosis and classification of three distinct diseases, whose symptoms are very similar. The fundamental contribution is to reduce the number of parameters used while maintaining the same level of precision for use in embedded systems.

Methods: Our proposed model combines the power of the neural network using the SqueezeNet architecture with a set of machine learning algorithms as classifiers, including logistic regression, support vector machine (SVM), k-nearest neighbors (KNN), decision tree, and naive Bayes. The chest Xray dataset used in the proposed model consists of CXR images that are classified into four categories: pneumonia, tuberculosis, COVID-19, and normal cases.

Results: Our proposed model demonstrated remarkable accuracy (97,32%), precision (97,33), F1 score (97,31%), recall (97,30%), and AUC (99,40), which is close to the best model. Whereas, the number of parameters used by our model (4,6 M) is very small compared to the best model in the literature (47M).

Conclusion: The model demonstrated good classification accuracy. In addition, the proposed model has the ability to use fewer parameters, which means it requires less internal memory and computing resources.

Objective: The objective of this study is to validate the results of our previous study.

Design: A retrospective study was conducted in two hospitals in the Netherlands.

Patients: All patients that were referred to the internal medicine emergency department between May 2018 and May 2019 with a suspected infection defined as fever (temperature ≥38°C) or hypothermia (temperature <36°C) or CRP ≥100μg/mL.

Main Measures: We defined our primary outcome as the number of newly diagnosed pneumonia by CXR in cases of suspected infection with no obvious site of infection and nor localizing symptoms or signs.

Key Results: We included 1052 patients, of which 106 did not have respiratory signs or symptoms. In this group, none of the CXRs (95% CI 0-2.36%) showed an infiltrate. Combined with our previous study, 176 CXRs were performed in patients with no respiratory signs or symptoms. None (95% CI 0-1.42%) showed an infiltrate.

Conclusion: Our results confirm that a CXR has no diagnostic value in the workup of fever without localizing signs or symptoms.

Case Presentation: A 44-year-old woman underwent ultrasound-guided FNA in other hospitals after thyroid ultrasound revealed a solid lesion in the left lobe classified as TI-RADS 4. Two days later, this female presented to our hospital for an excision of a thyroid mass. Pre- and post-contrast CT scans of the thyroid showed extensive accumulation of gas in the thyroid gland and the retropharyngeal and retrotracheal space. A CT scan of the thyroid two days later revealed obvious absorption of thyroid gas and faint low-density nodules in the left lobe of the thyroid. The lesion was histopathologically confirmed as papillary carcinoma of the thyroid.

Conclusion: We thought the aforementioned issues originating from the limited imaging capacity of ultrasound in the context of thyroid biopsy. To avoid these limitations, we highlight the need to thoroughly examine the location of a lesion prior to thyroid biopsy to understand in detail the relationship between the lesion and the adjacent tissues, especially the proximity of the lesion to the trachea, the occurrence of coughing during a biopsy (indicating puncture of the trachea) is what operators need to be aware of so that they can manage such cases. On the other hand, we recommend that pre-operative use of CT before thyroid biopsy and especially if CT is needed anyway later for nodules evaluation before surgery to ensure the CT image quality.

Aims: In this study, we propose a hybrid architecture that combines Convolutional Neural Networks (CNNs) with Recurrent Neural Networks (RNNs) and leverages transfer learning to enhance the accuracy of COVID-19 detection from X-ray images.

Methods: The proposed work utilizes 4 pre-trained CNN architectures, namely, InceptionnetV3, Densenet121, Inception-ResNet V2, and VGG19, to extract high-level features from the input X-ray images. These features are then fed into the second component, an RNN-based network, which captures the temporal dependencies within the extracted features. To evaluate the performance of the proposed architecture, a comprehensive dataset consisting of X-ray images from COVID-19 positive cases, non-COVID-19 pneumonia cases, and healthy individuals is used. Gradient class activation map (Grad-CAM) analysis has been applied to the obtained results to provide heat-map pictures specific to each class and coloured visualizations of the COVID-19-infected areas in CXR images.

Results: : Experimental results demonstrate that the proposed hybrid CNN-RNN architecture achieves promising results in COVID-19 detection from X-ray images. The model exhibits high accuracy, precision, recall, area under the receiver operating characteristics (ROC) curve (AUC), and F1-score, outperforming other state-of-the-art methods.

Conclusion: The combination of CNNs and RNNs enables the model to effectively capture spatial and temporal information, leading to improved performance in COVID-19 detection. The proposed hybrid architecture with transfer learning from X-ray images provides a robust and efficient solution for COVID-19 detection. The model can potentially assist healthcare professionals in making accurate and timely diagnoses, thereby contributing to the global efforts to combat the COVID-19 pandemic. In the present work, VGG19-RNN architecture outperformed all other networks in terms of accuracy. The most effective training and validation accuracy for the VGG19-RNN architecture is 99% & 97.70%, respectively, and the loss was 0.02 & 0.09 at epoch 100.

Methods: The retrospective study included 52 patients who tested positive for SARS-CoV-2. All patients had two chest CT exams. Lung involvement measurements were calculated by using an artificial intelligence tool. Visceral and subcutaneous fat tissue was measured at the level of the first lumbar vertebra on chest CT. Additionally, demographic and laboratory data were collected.

Results: 52 patients were included (36.5% female, mean age 50). Visceral fat area and visceral fat thickness changes were significantly positive predictors of total lung involvement changes (p=0.033, p=0.00024). Subcutaneous fat area and subcutaneous fat thickness changes were not associated with lung involvement change (p>0.05). CRP, IL-6, d-dimer, and ferritin levels were higher in patients who need intensive care units.

Conclusion: Visceral adipose tissue changes may indicate that it can have a role as a reservoir of virus involvement.

Methods: COVID-19 crisis has also galvanized researchers to adopt various machine learning as well as deep learning techniques in order to combat the pandemic. Lung images can be used in the diagnosis of COVID-19.

Results: In this paper, we have analysed the COVID-19 chest CT image classification efficiency using multilayer perceptron with different imaging filters, like edge histogram filter, colour histogram equalization filter, color-layout filter, and Garbo filter in the WEKA environment.

Conclusion: The performance of CT image classification has also been compared comprehensively with the deep learning classifier Dl4jMlp. It was observed that the multilayer perceptron with edge histogram filter outperformed other classifiers compared in this paper with 89.6% of correctly classified instances.

Methods: 10,000 participants (5428 males, and 4,572 females, mean age 50+/-13.5 years [SD] years; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. Following that, the reconstructed images were interpreted to identify and categorize various bronchial patterns in the RSL. Cross-tabulation analysis and the Pearson chi-square test (χ2) were used to calculate the component ratios of bronchial branch types and determine their relevance between male and female groups.

Results: Our results revealed mainly six types for the RSL bronchial tree, i.e., (B1, B2, B3, 60.70%); (B1+2, B3, 18.72%); (B2+3, B1, 6.68%); (B1+3, B2, 7.57%); (B1, B2, B3, B*, 3.19%); (B1a+B3, B1b+B2, 3.14%). There were significant sex-related differences in the proportion of bronchial branches in the RSL (P< 0.05).

Conclusion: The current study has validated the presence of segmental bronchial variations in the RSL. These findings may have significant implications for diagnosing symptomatic patients and performing particular procedures, including bronchoscopy, endotracheal intubation, and lung resection.

]]> https://www.benthamscience.comarticle/131211Aims: COVID-19 has become a worldwide epidemic disease and a new challenge for all mankind. The potential advantages of chest X-ray images on COVID-19 were discovered. We proposed a lightweight and effective Convolution Neural Network framework based on chest X-ray images for the diagnosis of COVID-19, named AMResNet.

Background: COVID-19 has become a worldwide epidemic disease and a new challenge for all mankind. The potential advantages of chest X-ray images on COVID-19 were discovered.

Objective: A lightweight and effective Convolution Neural Network framework based on chest X-ray images for the diagnosis of COVID-19.

Methods: By introducing the channel attention mechanism and image spatial information attention mechanism, a better level can be achieved without increasing the number of model parameters.

Results: In the collected data sets, we achieved an average accuracy rate of more than 92%, and the sensitivity and specificity of specific disease categories were also above 90%.

Conclusion: The convolution neural network framework can be used as a novel method for artificial intelligence to diagnose COVID-19 or other diseases based on medical images.

Objectives: This study aimed to characterize the clinical, laboratory, and high-resolution computed tomography (HRCT) findings in patients with mild or moderate infection from SARS-CoV-2 Omicron subvariant BA.2.

Methods: We performed a retrospective study on patients infected with SARS-CoV-2 Omicron subvariant BA.2 between April 4th and April 17th, 2022. The clinical characteristics, laboratory features, and HRCT images were reviewed.

Results: A total of 805 patients were included (411 males and 394 females, median age 33 years old). The infection was mild, moderate, severe, and asymptomatic in 490 (60.9%), 37 (4.6%), 0 (0.0%), and 278 (34.5%) patients, respectively. Notably, 186 (23.1%), 96 (11.9%), 265 (32.9%), 11 (3.4%), 7 (0.9%), and 398 (49.4%) patients had fever, cough, throat discomfort, stuffy or runny nose, fatigue, and no complaint, respectively. Furthermore, 162 (20.1%), 332 (41.2%), and 289 (35.9%) patients had decreased white blood cell counts, reduced lymphocytes, and elevated Creactive protein levels, respectively. HRCT revealed pneumonia in 53 (6.6%) patients. The majority of the lung involvements were ground-glass opacity (50, 94.3%) mostly in the subpleural area. The grade of lung injury was mainly mild (90.6%). Short-term follow-ups showed that most patients with pneumonia recovered.

Conclusion: Most patients with mild or moderate infection from SARS-CoV-2 Omicron subvariant BA.2 were adults, with fever and upper respiratory symptoms as the main clinical presentations. Lower respiratory infection was mild, with ground-glass opacity in the subpleural area as the main finding.

Methods: Between May 2021 and January 2022, 397 patients with COVID-19 were included in this retrospective cohort study. All demographic, clinical and laboratory data and chest CT images of patients were retrospectively reviewed. RM-S, V-CAC-S, HS-S, PS-S and C-CT-SS scores were calculated, and their performance in predicting mortality and ICU requirement were evaluated by univariate and multivariable analyses.

Results: A total of 32 (8.1%) patients died, and 77 (19.4%) patients required ICU admission. Mortality and ICU admission were both associated with older age (p < 0.001). Sex distribution was similar in the deceased vs. survivor and ICU vs. non-ICU comparisons (p = 0.974 and p = 0.626, respectively). Multiple logistic regression revealed that mortality was independently associated with having a C-CT-SS score of ≥ 14 (p < 0.001) and severe RM-S category (p = 0.010), while ICU requirement was independently associated with having a C-CT-SS score of ≥ 14 (p < 0.001) and severe V-CAC-S category (p = 0.010).

Conclusion: RM-S, C-CT-SS, and V-CAC-S are useful tools that can be used to predict patients with poor prognoses for COVID-19. Long-term prospective follow-up of patients with high RM-S scores can be useful for predicting long COVID.

Discussion: No doubt there are many conventional drug delivery systems to treat ocular keratitis, yet it is the fifth leading cause of blindness globally. This is the result of the eye's complex anatomy and barrier system, which restricts the total ocular contact time of the conventional formulations resulting in underdosing. The widely used traditional formulations to treat keratitis, like antibiotic eye drops and ointments, are rendered useless due to less ocular contact time and low therapeutic drug levels at the target ocular site. The main requirement of the present time is to develop novel drug delivery-backed stratagems to overcome the shortcomings of conventional formulations, which will reduce the morbidity associated with infectious keratitis and improve clinical outcomes. It is worth mentioning that there are documented incidents of Herpetic keratitis of the cornea followed by COVID-19 infection and vaccination.

Conclusion: This paper is a rigorous review of all the novel drug delivery strategies to combat ocular keratitis. These future drug delivery strategies will pave the way for the present time researcher and formulation chemists to develop multi-dimensional novel formulations that are safe, patient-compliant, and surpass the ocular barriers to maintain therapeutic drug levels in ocular tissues.

With an emphasis on lung illnesses, this article will offer an in-depth understanding of dextran-based delivery systems in respiratory illnesses.

The primary focus of nanomedicine is to engineer and utilize nanoscale materials, such as nanoparticles and nanostructures, to improve the effectiveness and precision of medical interventions. Nano-sized drug delivery systems can target specific cells or tissues, enhancing therapeutic outcomes and reducing side effects. These nanocarriers can penetrate biological barriers and accumulate at disease sites, enabling more efficient drug delivery and increasing the bioavailability of therapeutic agents. Furthermore, nanotechnology has opened new horizons in medical imaging. Nanoparticles can be engineered to be responsive to certain diseases or conditions, providing valuable information for early detection and precise diagnosis. Novel contrast agents based on nanomaterials have the potential to revolutionize imaging techniques, offering higher sensitivity and specificity, ultimately leading to improved patient outcomes.

Beyond diagnostics and drug delivery, nanotechnology is fostering breakthroughs in regenerative medicine. Nanomaterials can act as scaffolds, guiding tissue repair and promoting cellular regeneration. By harnessing the unique properties of nanoscale materials, tissue engineering, and organ transplantation may witness unparalleled advancements, bringing hope to countless patients awaiting life-saving treatments. However, the unprecedented potential of nanomedicine also raises ethical concerns that demand careful consideration. As nanotechnology progresses, concerns about the safety of nanomaterials, potential toxicity, and long-term effects must be addressed to ensure responsible and sustainable development.

Methods: This cross-sectional, descriptive research study collected essential data, encompassing personal characteristics and inquiries concerning the use of personal protective equipment, the extent of their utilization, training regarding proper equipment use, and adherence to health guidelines, including hand hygiene and disinfectant usage. Data were gathered through a questionnaire developed in accordance with international standards, specifically the PPE Safe Survey. The questionnaire was administered to medical staff, including physicians, nurses, and medical students, working in healthcare facilities that admitted COVID-19 patients within the Lorestan University of Medical Sciences, situated in Khorramabad.

Results: Our investigation involved a total of 201 participants, comprising 82 (40.8%) males and 119 (59.2%) females. The average age of the participants was 32 years, with an average daily duration of personal protective equipment utilization amounting to 8.9 hours. Notably, 44 (21.9%) participants worked in emergency wards, 63 (31.3%) in general medical wards, 12 (6.0%) in administrative departments, 14 (7.0%) in surgical units, 11 (5.5%) in anesthesiology, 17 (8.5%) in intensive care units, and 40 (19.9%) in miscellaneous contexts.

Conclusion: The study findings underscore the imperative need for healthcare professionals to consistently employ suitable personal protective equipment, encompassing face masks, eye protection, gowns, and eye shields. Furthermore, our study highlights the significance of appropriate training and rigorous adherence to equipment utilization protocols during healthcare tasks, coupled with consistent hand hygiene practices in healthcare facilities.

Aims: The study aimed to assess the role of baseline anamnestic information, clinical parameters, instrumental examination, and serum biomarkers in predicting adverse outcomes of COVID-19 in a hospital setting of Internal Medicine.

Methods: Fifty-two inpatients consecutively admitted to the Unit of Internal Medicine “Baccelli,” Azienda Ospedaliero – Universitaria Policlinico of Bari (February 1 - May 31, 2021) due to confirmed COVID-19 were grouped into two categories based on the specific outcome: good prognosis (n=44), patients discharged at home after the acute phase of the infection; poor prognosis, a composite outcome of deaths and intensive care requirements (n=8). Data were extracted from medical records of patients who provided written informed consent to participate.

Results: The two study groups had similar demographic, anthropometric, clinical, and radiological characteristics. Higher interleukin 6 (IL-6) levels and leucocyte count, and lower free triiodothyronine (fT₃) levels were found in patients with poor than those with good prognosis. Higher IL-6 levels and leucocyte count, lower fT₃ concentration, and pre-existing hypercholesterolemia were independent risk factors of poor outcomes in our study population. A predicting risk score, built by assigning one point if fT₃ < 2 pg/mL, IL-6 >25 pg/mL, and leucocyte count >7,000 n/mm³, revealed that patients totalizing at least 2 points by applying the predicting score had a considerably higher risk of poor prognosis than those scoring <2 points (OR 24.35 (1.32; 448), p = 0.03). The weight of pre-existing hypercholesterolemia did not change the risk estimation.

Conclusion: Four specific baseline variables, one anamnestic (pre-existing hypercholesterolemia) and three laboratory parameters (leucocyte count, IL-6, and fT3), were significantly associated with poor prognosis as independent risk factors. To prevent adverse outcomes, the updated 4-point score could be useful in identifying at-risk patients, highlighting the need for specific trials to estimate the safety and efficacy of targeted treatments.

Objective: This study aimed to authenticate the outcomes of prior research employing the HM and GEP algorithms, endeavoring to expedite the formulation of efficacious therapeutics for osteosarcoma.

Methods: A robust quantitative constitutive relationship model was engineered to prognosticate the IC₅₀ values of innovative synthetic compounds, harnessing the power of gene expression programming. A total of 39 natural products underwent optimization via heuristic methodologies within the CODESSA software, resulting in the establishment of a linear model. Subsequent to this phase, a mere quintet of descriptors was curated for the generation of non-linear models through gene expression programming.

Results: The squared correlation coefficients and s2 values derived from the heuristics stood at 0.5516 and 0.0195, respectively. Gene expression programming yielded squared correlation coefficients and mean square errors for the training set at 0.78 and 0.0085, respectively. For the test set, these values were determined to be 0.71 and 0.0121, respectively. The s2 of the heuristics for the training set was discerned to be 0.0085.

Conclusion: The analytic scrutiny of both algorithms underscores their commendable reliability in forecasting the efficacy of nascent compounds. A juxtaposition based on correlation coefficients elucidates that the GEP algorithm exhibits superior predictive prowess relative to the HM algorithm for novel synthetic compounds.

Materials and Methods: To answer the study question, a comprehensive search was carried out in databases, such as PubMed, Web of Science Core Collection, and Scopus, using keywords, including cancer, gynecologic cancer, breast cancer, treatment, delay, and modification. Full-texted, English language and original articles were included in this study.

Results: In total, 27 articles were selected for the study. The findings of this study revealed that COVID-19 greatly affects the treatment of gynecology and breast cancer. These patients experience delay or modification of cancer treatment. Increased time between diagnosis and treatment, delay, change or cancellation of surgery and change in treatment plan are the most important changes in cancer treatment during the COVID-19 pandemic.

Conclusion: The COVID-19 pandemic has had a significant impact on various aspects of gynecology and breast cancer care worldwide. In the current pandemic, there has been a significant delay in the diagnosis and treatment of gynecological and breast cancer, which, due to its higher morbidity and mortality, has made the condition more difficult for cancer patients and treatment teams.

Methods: In this study, we comprehensively review data resources and predictors related to ACVPs published over the past two decades. In addition, we analyze the influence of various factors on model performance.

Results: We have reviewed nine ACVP-containing databases, which integrate detailed information on protein fragments effective against coronaviruses, providing crucial references for the development of antiviral drugs and vaccines. Additionally, we have assessed 15 peptide predictors for antiviral or specifically anticoronavirus activity. These predictors employ computational models to swiftly screen potential antiviral candidates, offering an efficient pathway for drug development.

Conclusion: Our study provides conclusive results and insights into the performance of different computational methods, and sheds light on the future trajectory of bioinformatics tools for ACVPs. This work offers a representative overview of contributions to the field, with an emphasis on the crucial role of ACVPs in combating COVID-19.

Objective: In this paper, we propose a new deep learning method that can effectively identify SARSCoV- 2 Variant sequences, called SCVfilter, which is a deep hybrid model with embedding, attention residual network, and long short-term memory as components.

Methods: Deep learning is effective in extracting rich features from sequence data, which has significant implications for the study of Coronavirus Disease 2019 (COVID-19), which has become prevalent in recent years. In this paper, we propose a new deep learning method that can effectively identify SARS-CoV-2 Variant sequences, called SCVfilter, which is a deep hybrid model with embedding, attention residual network, and long short-term memory as components.

Results: The accuracy of the SCVfilter is 93.833% on Dataset-I consisting of different variant strains; 90.367% on Dataset-II consisting of data collected from China, Taiwan, and Hong Kong; and 79.701% on Dataset-III consisting of data collected from six continents (Africa, Asia, Europe, North America, Oceania, and South America).

Conclusion: When using the SCV filter to process lengthy and high-homology SARS-CoV-2 data, it can automatically select features and accurately detect different variant strains of SARS-CoV-2. In addition, the SCV filter is sufficiently robust to handle the problems caused by sample imbalance and sequence incompleteness.

Other: The SCVfilter is an open-source method available at https://github.com/deconvolutionw/ SCVfilter.

Methods: We conducted this scoping review to collect evidence related to the antimicrobial potential of diverse natural compounds from Zingiberaceae plants and their synthetic derivatives. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews guidelines. The literature search was conducted using PubMed, Web of Science and Scopus electronic databases for relevant studies published from 2012 to 2023. A total of 28 scientific studies fulfilled the inclusion criteria. The authors of these studies implemented in vitro and in silico methods to examine the antimicrobial potency and underlying mechanisms of the investigated compounds.

Result: The evidence elucidates the antimicrobial activity of natural secondary metabolites from Zingiberaceae species and their synthetic derivatives against a broad panel of gram-positive and gram-negative bacteria, fungi and viruses.

Conclusion: To date, researchers have proposed the application of bioactive compounds derived from Zingiberaceae plants and their synthetic analogues as antimicrobial agents. Nevertheless, more investigations are required to ascertain their efficacy and to broaden their commercial applicability.

Methods: This systematic review investigated new variants of Omicron SARS-CoV-2 based on current studies. Online databases were searched for English articles as of January 03, 2023. Selection of publications was a two-step process of title/abstract and full-text assessment against eligibility criteria. The relevant data from the included articles were systematically collected and organized in a designed table for analysis. To ensure the quality of the review, the PRISMA checklist and Newcastle- Ottawa Scale (NOS) of quality assessment were utilized.

Results: The data extracted from 58 articles were analyzed, including 10003 pieces of evidence. Lower risk of hospitalization, ICU admission, and mortality after vaccination were reported in the Omicron variant compared to the Delta variant. Additionally, the Delta variant led to more severe clinical symptoms in comparison to the Omicron variant.

Conclusion: The Omicron variant of SARS-CoV-2 results in less severe disease outcomes as compared to Delta. Nevertheless, it remains crucial to maintain ongoing monitoring, implement containment measures, and adapt vaccination protocols to effectively address the evolving variants.

Materials and Methods: Data were collected from hospitalized patients (May to June 2020), and COVID-19 was confirmed in patients by real-time polymerase chain reaction (PCR). The patient group was classified into survivor and deceased groups. The chi-square and the independent t-test with Statistical Package for the Social Sciences (SPSS) software program, version 18, were used for analysis.

Results: Mean age, hemoglobin, serum C-reactive protein (CRP), alkaline phosphatase (ALP), white blood cells, and level of procalcitonin in non-survivors were significantly higher than in survivors. Serum tumour necrosis factor-alpha (TNF-a) had a significant relationship with Ddimer (p = 0.0006). The risk of mortality in patients with serum CRP ≥ 100 mg/dl was significantly higher than those with CRP < 100 mg/dl (odds ratio (OR) = 4.8 (95% CI, 1.33-12.44, p = 0.01).

Conclusion: COVID-19 has different clinical features and can be an asymptomatic, mild, or severe disease. Thus, findings about the disease and the consequent outcomes differ in patients. Further studies are needed to evaluate the clinical features and consequences of COVID-19 infection.

Methods: In the present review article, we have collected all scientific information on galuteolin from different scientific databases and analyzed it to know the biological importance and therapeutic benefit of galuteolin in medicine against human disorders. Scientific data on galuteolin were collected from numerous literature databases, such as Google, Google Scholar, PubMed, Scopus and Science Direct. Detailed pharmacological data on galuteolin were collected from these scientific sources and analyzed in the present work to know the health-beneficial aspects of galuteolin in medicine. In addition, scientific data on analytical techniques of galuteolin were also collected and analyzed in the present work to know their importance in the separation, isolation, and identification of galuteolin in different plant materials.

Results: The present work signified the biological importance of galuteolin in medicine and other allied health sectors. Pharmacological data analysis revealed the health-beneficial aspects of galuteolin on rheumatoid arthritis, cerebral ischemia, carcinoma, COVID-19, Atherosclerosis, and melanin biosynthesis. Further, intestinal absorption and pharmacokinetic parameters of galuteolin were also discussed in the present work. Analytical data signified the importance of newer and modern analytical techniques in medicine for the qualitative and quantitative analysis of galuteolin in different biological samples.

Conclusion: Scientific data analysis of galuteolin revealed its biological importance and therapeutic benefit in medicine.

Methods: Traditional Chinese Medicine Systems Pharmacology database (TCMSP), DrugBanks database, and Chinese Knowledge Infrastructure Project (CNKI) were used to retrieve the active ingredients of QBD. Drug and disease targets were collected using UniProt and Online Mendelian Inheritance in Man databases (OMIM). The core targets of QBD for pneumonia were analyzed by the Protein-Protein Interaction Network (PPI), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) to reveal the underlying molecular mechanisms. The analysis of key targets using molecular docking and animal experiments was also validated.

Results: A compound-direct-acting target network mainly containing 171 compounds and 110 corresponding direct targets was constructed. The key targets included STAT3, c-JUN, TNF-α, MAPK3, MAPK1, FOS, PPARG, MAPK8, IFNG, NFκB1, etc. Moreover, 117 signaling pathways mainly involved in cytokine storm, inflammatory response, immune stress, oxidative stress and glucose metabolism were found by KEGG. The molecular docking results showed that the quercetin, alanine, and kaempferol in QBD demonstrated the strongest affinity to STAT3, c- JUN, and TNF-α. Experimental results displayed that QBD could effectively reduce the pathological damage to lung tissue by LPS and significantly alleviate the expression levels of the three key targets, thus playing a potential therapeutic role in COVID-19.

Conclusion: QBD might be a promising therapeutic agent for COVID-19 via ameliorating STAT3-related signals.

Methods: Focus group discussions and interviews were used to examine the unique perspectives of social work interns, program leaders, and Boys and Girls Clubs of America (BGCA) staff.

Results: Results emphasized the importance of trust, clear communication, and shared decisionmaking as a foundation for successful program site integration. Additionally, several unanticipated barriers to implementation arose, including difficulty obtaining informed parental consent to work individually with youth, challenges aligning internship schedules with the fluid structure of after-school programs, and the need for a private welcoming space to work.

Conclusion: In conclusion, the SYR program successfully integrated within BGCA sites and was able to provide support to youth. BGCA sites expressed great satisfaction with the program and were eager to continue and expand upon their collaboration with the local university.

Objectives: In this study, we performed computational and cell-based assays to investigate the anti- COVID-19 potential of Withaferin-A and Caffeic acid phenethyl ester, natural compounds from Withania somnifera and honeybee propolis, respectively.

Methods: Structure-based computational approach was adopted to predict binding stability, interactions, and dynamics of the two test compounds to three target proteins (androgen receptor, ACE2, and TMPRSS2). Further, in vitro, cell-based experimental approaches were used to investigate the effect of compounds on target protein expression and SARS-CoV-2 replication.

Results: Computation and experimental analyses revealed that (i) CAPE, but not Wi-A, can act as androgen antagonist and hence inhibit the transcriptional activation function of androgen receptor, (ii) while both Wi-A and CAPE could interact with ACE2 and TMPRSS2, Wi-A showed higher binding affinity, and (iii) combination of Wi-A and CAPE (Wi-ACAPE) caused strong downregulation of ACE2 and TMPRSS2 expression and inhibition of virus infection.

Conclusion: Wi-A and CAPE possess multimodal anti-COVID-19 potential, and their combination (Wi-ACAPE) is expected to provide better activity and hence warrant further attention in the laboratory and clinic.

Objective: The current investigation involves the preparation of polyherbal syrup containing various medicinal plants such as ephedra, diascorea, ginger, echinacea, garlic, rhubarb, and glycyrrhiza for the effective control of the COVID-19 infection.

Methods: All varieties of the individual plant powders (200 g) were treated to a 7 day maceration in aqueous ethanol (70:30) in a percolator at room temperature with intermittent vigorous shaking at room temperature and storage of the extract in a dark room. The mixture was run through a muslin cloth and then a Whatman qualitative grade 1 filter paper to produce the filtrate. The filtrate was evaporated to a thick paste-like consistency at 370°C under decreased pressure in a rota evaporator connected to a vacuum pump. After that, each individual extract was collected and kept in airtight jars at 4°C. According to the Indian Pharmacopoeia, simple syrup (66.67% w/v) of polyherbal extract was prepared. The oral administration of polyherbal syrup was carried out at varied doses of 0.5 ml, 1 ml, and 1.5 ml to infected golden Syrian hamsters from the 7th day for one week after infection reached its peak.

Results: When compared to the infection control group, the results revealed that the viral load was significantly reduced by 79.1% when treated with polyherbal syrup. A histological examination of the infected hamster lung on days 7, 10, and 13 demonstrated that polyherbal syrup significantly decreased viral load in a dose-dependent manner.

Conclusion: It is inferred that the polyherbal syrup formulation demonstrates efficacy in the prevention of COVID-19 infection during its first stages and may serve as a potential contender for SARSCoV- 2 due to its immunomodulatory properties.

Case Report: We presented a patient receiving the COVID-19 vaccine Sputnik V two weeks before progressive flaccid tetraparesis and dysautonomia. He was first diagnosed with Guillain- Barre Syndrome (GBS). Two episodes of worsening the weakness occurred within 8 weeks from the onset of the disease, and the treatment was repeated as GBS-Treatment-related Fluctuations (TRF) and relapse. Also, a few relapses happened eight weeks after the disease's onset. Hence, he was diagnosed with “acute-onset CIDP”. The patient received several intravenous immunoglobulin (IVIG) courses as maintenance therapy. No further deterioration was reported during the follow-up.

Conclusion: Post-vaccination GBS is a known phenomenon. However, there are several reports of vaccine-induced-CIDP. This is the first reported case of acute-onset CIDP associated with the Sputnik V vaccine in Iran. Subsequent studies are required to determine the definite relationship between COVID-19 vaccination and CIDP.

Objective: This study aimed to explore Iranian midwives' perceptions and experiences of the COVID- 19 pandemic.

Methods: This qualitative description was carried out between March and May 2020 in Mashhad, Northeast Iran. Through purposive sampling, 15 midwives were selected from Corona Care-Centers. Semi-structured face-to-face interviews were used for data collection. Graneheim & Lundman's conventional content analysis approach was used to analyze the data. The data organization was performed using MAXQDA 12 software. Guba and Lincoln's elements of rigor, including credibility, dependability, confirmability, and transferability were considered.

Results: Four overarching categories emerged based on the analysis of midwives' perceptions and experiences including \"Facing challenges in confrontation with pregnant women\", \"Inefficiency of crisis management\", \"providing solutions and strategies to improve the current situation \", and \"being affected by the pandemic in all aspects of life\".

Conclusion: Midwives faced different challenges since all aspects of pregnancy and childbirth care were influenced by the COVID-19 outbreak. Like other medical staff, midwives were on the frontline of health care during the COVID-19 pandemic, and it made problems for their personal feelings and professional responsibilities. Comprehensive support, promoting working status, and motivating midwives are vital in maintaining high-quality midwifery care.

Objective: To uncover the effect and mechanisms of XCHD on psoriasis by integrating network pharmacology, molecular docking, and in vivo experiments.

Methods: The active ingredients and corresponding targets of XCHD were screened through Traditional Chinese Medicine Systems Pharmacology Database and Analysis (TCMSP) and Traditional Chinese Medicine Integrated Database (TCMID). Differentially expressed genes (DEGs) of psoriasis were obtained from the gene expression omnibus (GEO) database. The XCHD-psoriasis intersection targets were obtained by intersecting XCHD targets, and DEGs were used to establish the “herb-active ingredient-target” network and Protein-Protein Interaction (PPI) Network. The hub targets were identified based on the PPI network by Cytoscape software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed next. Molecular docking was executed via AutoDockTools-1.5.6. Finally, in vivo experiments were carried out further to validate the therapeutic effects of XCHD on psoriasis.

Results: 58 active components and 219 targets of XCHD were screened. 4 top-active components (quercetin, baicalein, wogonin and kaempferol) and 7 hub targets (IL1B, CXCL8, CCND1, FOS, MMP9, STAT1 and CCL2) were identified. GO and KEGG pathway enrichment analyses indicated that the TNF signaling pathway, IL-17 signaling pathway and several pathways were involved. Molecular docking results indicated that hub genes had a good affinity to the corresponding key compounds. In imiquimod (IMQ)-induced psoriasis mouse models, XCHD could significantly improve psoriasis-like skin lesions, downregulate KRT17 and Ki67, and inhibit inflammation cytokines and VEGF.

Conclusion: XCHD showed the therapeutic effect on psoriasis by regulating keratinocyte differentiation, and suppressing inflammation and angiogenesis, which provided a theoretical basis for further experiments and clinical research.

Objectives: This study aimed to investigate the effects of Ang-(1-7) on high glucose-induced islet β-cell dedifferentiation by activating the phosphatidylinositol-3-kinase/Protein kinase B/ Forkhead box transcription factor O1 (PI3K/Akt/FoxO1) signaling pathway.

Methods: The mouse islet β-cell line MIN6 cells were passaged and cultured and randomly divided into five groups: control (Con) group, high glucose (HG) group, HG with Ang-(1-7) group, HG with Ang-(1-7) and specific MasR antagonist A-779 group, and HG with Ang-(1-7) and PI3K inhibitor LY294002 group. After 48 hours, glucose-stimulated insulin secretion (GSIS) was detected by Enzyme-Linked Immunosorbent Assay (ELISA). The mRNA and protein expression levels of β-cell-specific factors (Pancreatic duodenal homeobox-1 (Pdx1), v-maf musculoaponeurotic fibrosarcoma oncogene homolog A(MafA)) and endocrine progenitor cell-specific factors (Octamer binding transcription factor 4(Oct4), Nanog) were measured by Real Time-PCR and Western blot. The factors of protein expression levels of PI3K/Akt/FoxO1 signaling pathway (Akt, p-Akt, Fox- O1, p-FoxO1) were determined by Western blot.

Results: We observed for the first time that high glucotoxicity can induce dedifferentiation of pancreatic islet β-cell, causing a decrease in insulin secretion levels and expression of Pdx1, MafA, p-- FoxO1, and p-Akt and an increase in expression of Oct4 and Nanog. After Ang-(1-7) intervention, insulin secretion levels and expression of Pdx1, MafA, p-FoxO1 and p-Akt were increased, and the levels of Oct4 and Nanog were reduced. However, A-779 and LY294002 could reverse this effect. During these processes, the total Akt and total FoxO1 expression did not change significantly.

Conclusion: Ang-(1-7) may prevent high glucose-induced pathological dedifferentiation of pancreatic β-cell by activating the PI3K/Akt/FoxO1 signaling pathway.

Methods: Non-synonymous single nucleotide polymorphisms (nsSNPs) in the ACE2 gene may have an impact on the protein's stability and its function. The deleterious or harmful nsSNPs of the ACE2 gene that can change the strength as well as the pattern of interaction with the RBD of S protein were selected for this study.

Results: The ACE2:RBD interactions were analyzed by protein-protein docking study. The missense mutations A242V, R708W, G405E, D292N, Y633C, F308L, and G405E in ACE2 receptor were found to interact with RBD of Omicron subvariants with stronger binding affinity. Among the other selected nsSNPs of human ACE2 (hACE2), R768W, Y654S, F588S, R710C, R710C, A191P, and R710C were found to have lower binding affinity for RBD of Omicron subvariants.

Conclusion: The findings of this study suggest that the nsSNPs present in the human ACE2 gene alter the structure and function of the protein and, consequently, the susceptibility to Omicron subvariants.

Objective: Due to the insufficient evidence regarding the reluctance to accept COVID-19 vaccination in Iran, the current study was designed to evaluate barrier and motivator factors in receiving COVID-19 vaccination among the healthcare workers of Tehran military hospitals.

Methods: In this descriptive cross-sectional study, 272 healthcare workers of Tehran military hospitals were enrolled. Their demographic, as well as barrier and motivating factors, were prospectively recorded and analyzed. The chi-square test and Fisher's exact test were used to compare the qualitative variables between groups. Also, the Kolmogorov-Smirnov test was used to evaluate the normal distribution of all quantitative parameters.

Results: We found that 11% had a history of vaccination against COVID-19, and 89.3% were willing to be vaccinated if the COVID vaccine was available. As obtained, the highest scores for barrier factors in receiving COVID-19 vaccine among the healthcare workers of Tehran military hospitals were belief in having a sufficient immune system (93.4%), limitation to the number of vaccines (71%), enough knowledge about all types of available vaccines (70.2%), and the side effects of the vaccine (44.5%), respectively. Furthermore, the highest scores for motivator factors in receiving COVID-19 vaccination were believing in the effect of vaccination (89%) and the free vaccine available for staff (72.8%), respectively.

Conclusion: In conclusion, our study suggests that early on in a vaccination campaign, most healthcare workers prefer to be vaccinated with an available vaccine, whether in the present or in the future and also identifies several reasons underlying vaccine acceptance and hesitancy. These results could be used in the future to promote campaigns to increase vaccine acceptance. Thus, increasing healthcare workers’ knowledge and consultations are strictly recommended for preventing vaccine hesitancy. In this study, the healthcare workers of military hospitals were more willing to use vaccines for emerging diseases due to their awareness and the higher risk of deadly infectious diseases.

Methods: From December, 2019, to May, 2022, all clinical trials using AI approaches listed on clinicaltrials. gov and ctri.gov.in were examined and analysed.

Results: Out of 8072 studies on COVID-19 listed on ClinicalTrials.gov and 674 studies on the CTRI website, 53 studies were related to AI. Ten (18.9%) of the 53 studies were interventional, while the remaining 43 (81.1%) were observational.

Conclusion: With limited medical resources and growing healthcare strain, the introduction of AI approaches will increase human efficiency and capacity to combat the COVID-19 pandemic. In this review, artificial intelligence was proven to be more accurate than human specialists in COVID-19 diagnosis and medication discovery.

Aim: To clarify the SARS-CoV-2 immune status in the general population.

Methods: A cross-sectional study was conducted in Kirkuk province during the period from 15 May 2022 to 11 September 2022. The samples were collected from voluntary subjects and informed consent was taken from each participant before their enrolment in the study. SARS-CoV-2 IgG, SARSCoV- 2 IgM, 25-OH Vitamin D, Vitamin B12, and Folate were determined using the Electrochemiluminescence Immunoassay (eCLIA) technique with the instrument NIPIGON-Robot R1Automated ECL Analyzer (Canada).

Results: The overall IgG mean concentration was 37.75 ± 23.18 COI, with a median of 39.99 COI and a range of 0.25 - 87.23 COI. Additionally, 93% of tested samples were with concentrations of more than 1 COI. The highest frequency (18.2%) was for the IgG concentration of 51 to 60 COI, while the lowest frequency (1.3%) was for the concentration of 81 - 90 COI. The IgG was significantly higher (P = 0.046) in males (39.87 ± 24.04 COI) than that in females (35.12 ± 21.89 COI). The IgM overall concentration was 0.569 ± 0.456 COI, with a median of 0.489 COI and a range of 0.17 - 6.40 COI. The mean serum level of folic acid concentration was 9.03 ± 5.72 ng/ml, with a median of 7.476 ng/ml and a range of 0.60 - 20.00 ng/ml. The mean serum concentration of vitamin B12 was 462.65 ± 349.18 pg/ml, with a median of 353 pg/ml and a range of 13.05 - 2000 pg/ml. The mean serum concentration of vitamin D was 18.29 ± 18.42 ng/ml with a median of 12.44 ng/ml and a range of 3 - 100 ng/ml. IgG and IgM serum levels did not show a significant correlation with serum levels of folic acid, vitamin D, and vitamin B12. However, there was a significant correlation between folic acid and vitamin D (r = 0.197; P = 0.012); vitamin B12 and vitamin D (r = 0.253, P = 0.001). While there was a non-significant correlation between folic acid and vitamin D serum levels (r = 0.129, P = 0.10).

Conclusion: General population IgG antibody concentration reflects a high rate of herd immunity. Folic acid was with a mean value of about half of the upper normal limit and only 17.7% were with low values. Vitamin B12, only 6.3% of the population had values lower than normal. However, the range of vitamin B12 was wide. While vitamin D values were lower than the normal limit at 82.6%. However, a large scale well designed was warranted to evaluate COVID-19 national immune response.

Methods: A systematic search of the literature published from November 1, 2019 to May 1, 2021, was conducted on PubMed/MEDLINE, Embase, and Web of Science databases. Afterwards, an observational study was designed based on the electronic health records of COVID-19 patients hospitalized in a tertiary referral hospital during the same period. A total of 179 COVID-19 cases were divided into two groups: cases with a history of CAD and percutaneous coronary intervention (CAD/PCI⁺, n = 89) and controls (n = 90). Clinical data were extracted from the electronic database of the hospital and statistically analyzed.

Results: After the application of inclusion/exclusion criteria, only three studies were deemed eligible, one of which was concerned with the impact of CAD on the all-cause mortality of COVID-19. Results from our observational study indicated that the cases were older (median age: 74 vs. 45) and more likely to develop hypoxemia (25.8% vs. 8.8%) than the controls. CAD/PCI+ was correlated with a more severe COVID-19 (11% vs. 1%). Age was a moderately significant independent predictor of increased COVID-19 severity, while hypoxemia was not.

Conclusion: Considering the negative impact of hypoxemia on the prognosis of COVID-19 and its higher prevalence among COVID-19 patients with underlying CAD, further research is warranted to unravel the negative effects of COVID-19 on the mechanisms of gas exchange and delivery in patients with pre-existing CAD.

This mini-review aims to substantiate the possibilities of using the cardiomarkers (CSTnI and CSTnT) to assess the prognosis of patients suffering from hypertension and to discuss potential mechanisms that cause injury to myocardial cells and increase serum levels of CSTnI and CSTnT.

This is a narrative mini-review, which was prepared using the following databases: Pubmed/Medline, PubMed Central, Embase, Scopus, and Web of Science. The following keywords were used in the literature search: “myocardial cells”, “injury”, “damage”, and “hypertension” in combination with the terms “mechanisms of injury” “predictive significance”, “cardiac troponins”, or “cardiospecific troponins”.

Methods: The Detection System includes Direct one-step Reverse Transcription PCR (RT-PCR) reagents (Qexp-MDx kit), a portable thermal cycler (Qampmini) with a preprogrammed chip and a simple-to-use Capillary Gel Electrophoresis system (Qsep Series Bio-Fragment Analyzer) with high fluorescence detection sensitivity to solve the problems associated with traditional real-time PCR (qPCR) systems which produces high false positive results.

Results: The proposed simple-to-use detection platform can provide high detection sensitivity (identify less than 20 copies) and fast results (less than 120 minutes), which would be suitable for field testing applications.

Conclusion: Our high detection sensitivity platform provides fast and accurate results in 120 minutes without doing DNA/RNA extraction.

Materials and Methods: For the present review, the materials were collected from the Ayurvedic literature, including the three major classical texts Brihatrayees Charaka Samhita, Sushruta Samhita, Ashtanga Samgraha and Ashtanga Hridaya, and their important commentaries by Chakrapani, Arunadutta, Hemadri, Indu, and Dalhana. Information from the current scientific literature, articles published in PubMed, and authentic webpages has also been incorporated into this study. Subsequently, an independent analysis of immunology from Ayurvedic classical texts is presented in this review.

Discussion: Ayurvedic compendia have vividly described the perspectives and practices of immunity and the promotion of disease-resisting factors. In addition to being the repository of age-old medical practices and the treasure trove of herbal drugs, the immunomodulatory effects of these disease-resisting factors hold up even when bridging with new models based on modern science and technology.

Conclusion: Rather than being a complementary science, Ayurveda is enriched with the concepts and practices of immunology. In order to free humanity from the grip of infections, it is important to explore the standalone and integrative aspects of science now.

Methods: In this retrospective single-center cross-sectional study, we used hospital records of all consecutive patients aged 18 years or older admitted to the hospital from July 23rd to September 23rd, 2021. All patients included in the study had confirmed SARS-CoV-2 infection using polymerase chain reaction (PCR) testing and required hospitalization. Demographic and clinical information, as well as patient outcomes, were collected. Treatment details, including the type(s), cumulative doses, and duration of administered corticosteroids, were also recorded. CS pulse therapy was defined as the daily administration of 24 mg or more of dexamethasone or its equivalents.

Results: A total of 500 patients with COVID-19 were included in this study, comprising 122 patients who received CS pulse therapy and 378 patients who did not. A higher mortality rate was observed in patients receiving CS pulse therapy (42.6%) compared to the other group (28%) (p =0.04). Additionally, logistic regression analysis showed an increased mortality risk in patients receiving CS pulse therapy in the crude model (OR=1.54, 95% CI: 1.01-2.27, p <0.01). However, after adjusting for confounding factors, such as mechanical ventilation and ICU admission, the results were reversed (OR=0.21, 95% CI: 0.07-0.62, p <0.01).

Conclusion: In the findings of the current study, treatment with CS pulses was shown to significantly enhance recovery in patients with non-severe COVID-19.

Objective: The current study aims to investigate the role of lncRNA GAS5, miRNA-200, and ACE2 as new COVID-19 diagnostic markers capable of predicting the severity of SARS-CoV-2 complications.

Methods: A total of 280 subjects were classified into three groups: COVID-19-negative controls (n = 80), and COVID-19 patients (n=200) who required hospitalization were classified into two groups: group (2) moderate cases (n = 112) and group (3) severe cases (n = 88).

Results: The results showed that the serum GAS5 expression was significantly down-expressed in COVID-19 patients; as a consequence, the expression of miR-200 was reported to be overexpressed and its targeted ACE2 was down-regulated. The ROC curve was drawn to examine the diagnostic abilities of GAS5, miR-200, and ACE2, yielding high diagnostic accuracy with high sensitivity and specificity.

Conclusion: lncRNA-GAS5, miRNA-200, and ACE2 panels presented great diagnostic potential as they demonstrated the highest diagnostic accuracy for discriminating moderate COVID-19 and severe COVID-19 cases.

Methodology: Unfortunately, twitter was also used to spread myths and misinformation about the illness and its preventative immunization. So, it is crucial to identify false information before its spread gets out of hand. In this research, we look into the efficacy of several different types of deep neural networks in automatically classifying and identifying fake news content posted on social media platforms in relation to the COVID-19 pandemic. These networks include long short-term memory (LSTM), bi-directional LSTM, convolutional-neural-networks (CNN), and a hybrid of CNN-LSTM networks.

Results: The \"COVID-19 Fake News\" dataset includes 42,280, actual and fake news cases for the COVID-19 pandemic and associated vaccines and has been used to train and test these deep neural networks.

Conclusion: The proposed models are executed and compared to other deep neural networks, the CNN model was found to have the highest accuracy at 95.6%.

Objective: We aimed to determine whether ascorbic acid, which can be used as a drug and antioxidant food supplement, is a glutathione S-transferase isozyme inhibitor.

Methods: For this purpose, glutathione S-transferase was first purified from human erythrocytes and the in vitro effect of ascorbic acid on enzyme activity was investigated. Then, kinetic studies were performed to evaluate the inhibition potential of ascorbic acid, which was determined to be an inhibitor of the enzyme.

Results: The enzyme was purified 1286-fold with a yield of 81% and specific activity of 18.00 U/mg protein. The effects of ascorbic acid were tested on the in vitro enzyme activity of glutathione Stransferase and detected to be an inhibitor for the enzyme with 10 mM of IC₅₀ value. K_i constants and inhibition type were also determined for the enzyme.

Conclusion: This finding indicates that ascorbic acid can be an effective inhibitor of some GST isozymes increased in cancer cells. Abundant ascorbic acid intake may prevent cancer formation by strengthening the antioxidant defense system, on the other hand, it may increase the effectiveness of cancer treatment by inhibiting the chemotherapy-resistant GST enzyme.

Objective: This study aimed to evaluate the symptoms of SARS-Cov-2 syndrome in children with SARS-Cov-2 in Afzalipour Hospital in Kerman.

Methods: The present descriptive cross-sectional study was performed on 122 children with SARSCov- 2 in 2020-2021. A checklist including information on age, sex, duration of hospitalization, need for admission in intensive care units, clinical symptoms, mortality during or after discharge, underlying illness, and need for readmission was completed by reviewing patient records and interviews. The collected information was entered into SPSS software version 26 for statistical analysis.

Results: The mean age of patients was 46.64±40.39 months. 49.2% of patients were female and 50.8% were male. The most common symptoms were fever (84.4%), weakness (49.2%), cough (34.4%), nausea/vomiting (34.4%), dyspnea (27%), and diarrhea (26.2%). In 122 children, 115 children (94.3%) had symptoms for less than one month, one child had symptoms for one to two months, and 6 children (4.9%) had symptoms for a long duration (more than two months). The most common clinical signs in children with post-SARS-Cov-2 syndrome were weakness (33.3%) and dyspnea (33.3%).

Conclusion: Persistent symptoms of post-SARS-Cov-2 syndrome are less common in children with SARS-Cov-2 disease in Iran.

Methods: In this retrospective study, all adult patients with severe Covid-19 pneumonia who undergone NIV and suffered from any form of barotrauma from July to September 2021 in Afzalipour Hospital, Kerman, Iran were evaluated. Laboratory tests and NIV machine settings were collected from patients' files. A chi-square test and an independent t-test were used for analytical statistics.

Results: Twenty patients with barotrauma secondary to severe Covid-19 pneumonia were enrolled. The most common manifestation of barotrauma was pneumomediastinum in 19 patients (95%). No significant relationship was seen between the occurrence of barotrauma and Laboratory tests. The mean ± SD Inspiratory Positive Airway Pressure (IPAP) level in passed-away patients (17.8 ± 1.1) was significantly higher than in recovered patients (13.5 ± 0.5) (p = 0.04).

Conclusion: According to the results of the study, using a low level of IPAP in the ventilator machine settings of patients with barotrauma secondary to severe Covid-19 pneumonia will reduce the mortality rate.

Objective: The aim of the present study was to explore the perceptions of women with breast cancer about the support they received during the COVID-19 pandemic.

Methods: This study was qualitative in nature. Semi-structured interviews were conducted with Iranian women with breast cancer. The interviews were transcribed verbatim and analysed via conventional content analysis.

Results: Participants (n = 33) were Iranian women aged 29-58 years. All women included were married and were working in the role of a housewife. Women's perceptions of breast cancer during the COVID-19 pandemic of support were identified under two main categories; Constructive support and Lack of support. Sub-categories related to constructive support included receiving support from family, peers, and nurses. Sub-categories related to lack of support included a perceived lack of spousal and sociocultural support.

Conclusion: Anti-stigma interventions (AS interventions) are suggested to increase both spousal and sociocultural support in this context. Further studies may usefully be conducted with the participation of Iranian women's family members in order to gain a deeper understanding of the support received and required by Iranian women with breast cancer during the COVID-19 pandemic and beyond.

Methods: This study was based on a cross-sectional design. The target population was parents of children with ADHD aged 6-18 years who were evaluated in a tertiary care hospital in Dubai, United Arab Emirates (UAE) from January 2018 to August 2021. Participants completed a survey, which gathered information on the child’s personal characteristics and medical history as well as the parents’ and family characteristics. Additionally, the parents stress level was evaluated using the English and Arabic-translated versions of the Perceived Stress Scale (PSS).

Results: Parents of 103 children diagnosed with ADHD participated in this study. Most children were males (74.8%), and their mean age was 10.0 ± 3.4 years. Most children had ADHD as a primary diagnosis (87.4%), with ADHD subtypes being mainly combined presentation (60.2%), followed by a predominately inattentive presentation (35.9%). Psychiatric morbidity was present in 87.4% of the children, mainly learning disorders (41.7%), conduct disorder (34%), or autism spectrum disorder (24.3%). On the other hand, physical disorders were present in 68.9% of the children. Parents’ perceived stress levels differed significantly according to their children’s ADHD subtypes (p=0.002), with the highest stress levels among parents of children with predominately hyperactive/impulsive ADHD. PSS scores were moderate in 62.1% of the sample and high in 32% of the sample. Significant associations with elevated PSS scores was found in the presence of comorbid tic disorders (p<0.001) as well as in comorbid autism spectrum disorder (p=0.029). The most frequently reported items on the PSS were: being upset because of something that happened unexpectedly; feeling nervous and stressed; being angered because of things that were outside of your control; feeling unable to control important things in life; and feeling that difficulties were piling up so high that could not be overcome. Various changes were reported during the COVID-19 pandemic, which included a significant decrease in social activities (31.1%), time spent with friends (26.2%), conflicts between the child and siblings (18.5%), and conflicts between parents (25.3%). Furthermore, a significant increase was reported in children’s average screen time (28.2%), the quality of the child’s relationship with parents (19.4%), and the overall stresses faced by the family (16.5%).

Conclusion: ADHD is commonly associated with high levels of parental stress. Factors associated with an increased level of stress include ADHD predominantly hyperactive/ impulsive subtype as well as comorbidity with tic disorders or autism spectrum disorder. Furthermore, the COVID-19 pandemic had a marked impact on children with ADHD and their families’ social functioning.

Aim: The study aimed to assess the proportion of associated complications with COVID-19 and the underlying pathophysiology in pregnant women.

Methods: The MedLine and Embase databases were searched for studies relevant to the study topic.

Results: Preterm delivery and C-section have been found to be the most frequently reported complications. Approximately, 28.55% of pregnant women with symptomatic COVID-19 have been reported to require a C-section and 8.8% preterm delivery. In addition, anxiety and depression have also been frequently reported in 57% and 37% of pregnant women, respectively.

Conclusion: Symptomatic pregnant women with COVID-19 have a high risk of preterm labor, mortality and morbidity rates, and C-section requirements. The underlying pathophysiology of COVID-19-associated complications during pregnancy includes homeostatic disturbances of the immune system, pulmonary system, and hemostatic system. In addition to endothelial dysfunction, excessive immune response, coagulopathy, hypoxemia, and hypotension are involved in the pathogenesis that negatively affects neonates' health outcomes.

Methods: We included patients admitted to two tertiary hospitals from October 2020 to July 2022. Patients were categorized into non-vaccinated, partiallyvaccinated, and fully-vaccinated groups.

Results: A total of 2277 cases were included, with 27.49% being non-vaccinated. The monthly trend of admitted patients dropped from 1264 (56.50%) cases in the first half of 2021 to 194 (8.67%) cases in the first half of 2022, with a reduction rate of 84.65%. The trend of ICU admission followed the overall hospital admission rate, with an overall CFR of 0.88%, 95% CI (0.54% to 1.35%), and a virulence rate of 1.76%, 95% CI (1.26% to 2.38%). The incidence of ICU admission in the unvaccinated group was 4.79%, compared to 0% and 0.97% in the partially-vaccinated and fullyvaccinated groups, respectively (p <0.001). The CFR was significantly (p <0.001) higher in the unvaccinated group 2.88%, 95% CI (1.71 to 4.51) than in the partially-vaccinated 0%, 95% CI (0% to 0.59%) and fully-vaccinated groups 0.19%, 95% CI (0.02% to 0.70%).

Conclusion: Among the study population, COVID-19 vaccines showed promising efficacy in reducing the trend of COVID-19-related hospitalization, ICU admission, and mortality. Full vaccination might reduce the burden of COVID-19 on healthcare.

Aims and Objectives: This study aimed to investigate pancytopenia in COVID-19 and its correlation with severity and to explore the detailed clinical and biochemical information in COVID-19- associated pancytopenia. This study also highlights pancytopenia's rarity and prognostic value among COVID-19 patients.

Materials and Methods: This was a retrospective observational study conducted in a tertiary care centre at a level 3 COVID care facility that included adults of either sex having positive RT PCR for COVID-19 from October 2020 to May 2021. Data were collected from the online outpatient department and hospitalized patients.

Results: A total of 18 cases were included in the study; 13 were males (72.2%). The mean age was calculated as 48.56 years. Cases were categorized as severe 13 (72.2%) and non-severe 5 (27.8%) disease on the first day of pancytopenia. The most common presentations were fever 18 (100%) and cough 18 (100%), followed by generalized weakness 16 (88.9%), breathlessness 15 (83.3%), and diarrhoea 10 (55.6%). One case died in the severe disease group. The mean of haemoglobin, leukocyte count, and platelets in severe vs non-severe disease were calculated as 8.59 vs 8.74, 2339 vs 2578, and 77769 vs 88600, respectively.

Conclusion: Pancytopenia was more prevalent in severe disease and age group 40-60 years. CAP was most likely due to secondary bone marrow suppression. It has no prognostic value for disease outcomes.]]> https://www.benthamscience.comarticle/131072Background: Borrelia burgdorferi is regarded as an extremely dangerous bacteria causing infectious disease in humans, resulting in musculoskeletal pain, fatigue, fever and cardiac symptom. Because of all alarming concerns, no such prophylaxis setup has been available against Borrelia burgdorferi till now. In fact, vaccine construction using traditional methods is so expensive and time-consuming. Therefore, considering all concerns, we designed a multi-epitope-based vaccine design against Borrelia burgdorferi using in silico approaches.

Objective: To design an effective and safe vaccine that can activate cell-mediated and humoral immunity against Borrelia burgdorferi by using various bioinformatics tools.

Methods: The present study utilized different computational methodologies, covering different ideas and elements in bioinformatics tools. The protein sequence of Borrelia burgdorferi was retrieved from the NCBI database. Different B and T cell epitopes were predicated using the IEDB tool. Efficient B and T cell epitopes were further assessed for vaccine construction using linkers AAY, EAAAK and GPGPG, respectively. Furthermore, the tertiary structure of constructed vaccine was predicated, and its interaction was determined with TLR9 using ClusPro software. In addition, further atomic level detail of docked complex and their immune response were further determined by MD simulation and C-ImmSim tool, respectively.

Results: A protein with immunogenic potential and good vaccine properties (candidate) was identified based on high binding scores, low percentile rank, non-allergenicity and good immunological properties, which were further used to calculate epitopes. Additionally, molecular docking possesses strong interaction; seventeen H-bonds interactions were reported, such as THR101-GLU264, THR185-THR270, ARG 257-ASP210, ARG 257-ASP 210, ASP259-LYS 174, ASN263-GLU237, CYS 265-GLU 233, CYS 265-TYR 197, GLU267- THR202, GLN 270-THR202, TYR345-ASP 210, TYR345-THR 213, ARG 346-ASN209, SER350- GLU141, SER350-GLU141, ASP 424-ARG220 and ARG426-THR216 with TLR-9. Finally, high expression was determined in E. coli (CAI = (0.9045), and GC content = (72%)). Using the IMOD server, all-atom MD simulations of docked complex affirmed its significant stability. The outcomes of immune simulation indicate that both T and B cells represent a strong response to the vaccination component.

Conclusion: This type of in-silico technique may precisely decrease valuable time and expenses in vaccine designing against Borrelia burgdorferi for experimental planning in laboratories. Currently, scientists frequently utilize bioinformatics approaches that speed up their vaccine-based lab work.