The increase in organisms transference and infectious pandemics across the globe have been accelerated by an increase in travel, international exchange and global changes in earth's climate. COVID-19, a virus caused by the novel coronavirus that was initially identified on December 2019, in Wuhan city of China is currently affecting 146 territories, states and countries raising distress, panic and increasing anxiety in individuals exposed to the (actual or supposed) peril of the virus across the globe. Fundamentally, these concerns ascend with all infections, including those of flu and other agents, and the same worldwide safeguards are compulsory and suggested for protection and the prevention of further diffusion. However, media has underlined COVID-19 as rather an exclusive threat, which has added to panic and stress in masses which can lead to several mental health issues like anxiety, obsessive compulsive disorder and post-traumatic stress disorder which should be contained immediately in its initial phases.

Background The mosquito-borne arboviral disease dengue has become a global public health concern. However, very few studies have reported atypical clinical features of dengue among children. Because an understanding of various spectrums of presentation of dengue is necessary for timely diagnosis and management, we aimed to document the typical and atypical clinical features along with predictors of severity among children with dengue during the largest outbreak in Bangladesh in 2019. Methods We conducted a cross-sectional study between August 15 and September 30, 2019. in eight tertiary level hospitals in Dhaka city. Children (aged < 15 years) with serologically confirmed dengue were conveniently selected for data collection through a structured questionnaire. Descriptive, inferential statistics, and multivariable logistic regression were used to analyze data. Results Among the 190 children (mean age 8.8 years, and male-female ratio 1.22:1) included in the analysis, respectively 71.1 and 28.9% children had non-severe and severe dengue. All children had fever with an average temperature of 103.3 ± 1.2 F (SD). Gastrointestinal symptoms were the most common associated feature, including mostly vomiting (80.4%), decreased appetite (79.5%), constipation (72.7%), and abdominal pain (64.9%). Mouth sore, a less reported feature besides constipation, was present in 28.3% of children. Atypical clinical features were mostly neurological, with confusion (21.3%) being the predominant symptom. Frequent laboratory abnormalities were thrombocytopenia (87.2%), leucopenia (40.4%), and increased hematocrit (13.4%). Age (AOR 0.86, 95%CI 0.75–0.98, p = 0.023), mouth sore (AOR 2.69, 95%CI 1.06–6.96, p = 0.038) and a decreased platelet count (< 50,000/mm3) with increased hematocrit (> 20%) (AOR 4.94, 95%CI 1.48–17.31, p = 0.01) were significant predictors of severity. Conclusions Dengue in children was characterized by a high severity, predominance of gastrointestinal symptoms, and atypical neurological presentations. Younger age, mouth sores, and a decreased platelet with increased hematocrit were significant predictors of severity. Our findings would contribute to the clinical management of dengue in children.

SummaryBrucellosis is one of the important zoonotic diseases among livestock. This study was carried out to estimate the prevalence of brucellosis and isolate Brucella spp. in sheep in Kassala State in the east of Sudan. Two thousand and five serum samples were randomly collected from nine different localities. All serum samples were examined by the Rose Bengal plate test (RBPT) and the modified RBPT (mRBPT). Forty-three (2.15%, 95% confidence interval [CI]: 1.6, 3.0) and 68 (3.4%, 95% CI: 2.6, 4.2) samples were positive with the RBPT and the mRBPT, respectively. According to a known diagnostic sensitivity of 86.6% and a known diagnostic specificity of 97.6% for the mRBPT, the true prevalence was estimated to be 1.2% (95% CI: 0.3, 2.2). Different tissue samples were collected from 41 mRBPT seropositive animals. Brucella abortus biovar 6 was isolated from a pyometra of a seropositive ewe. It is important to note that B. abortus biovar 6 cannot be differentiated from Brucella melitensis biovar 2 by routine bacteriology. Only phage typing performed in reference laboratories will allow accurate identification of the strain. The fact that B. abortus biovar 6 does not require CO 2 for growth, combined with the fact that it has been isolated from a small ruminant in this study, could easily have led to misidentification (as B. melitensis biovar 2), to wrong epidemiological inferences and to the implementation of inappropriate control measures. The results presented here suggest that sheep are spillover hosts, as previously described for camels, and that the actual reservoir of B. abortus biovar 6 is cattle in Kassala State, Eastern Sudan. This study highlights the importance of isolating and identifying Brucella spp. in different livestock species in order to accurately decipher brucellosis epidemiology in sub-Saharan Africa. KeywordsBrucella abortus biovar 6 -Brucella melitensis biovar 2 -Brucellosis -Eastern SudanEpidemiology -Livestock -Reservoir host -Spillover host -sub-Saharan Africa.

Aims Statin-related myopathy (SRM), which includes rhabdomyolysis, is an uncommon but important adverse drug reaction because the number of people prescribed statins world-wide is large. Previous association studies of common genetic variants have had limited success in identifying a genetic basis for this adverse drug reaction. We conducted a multi-site whole-exome sequencing study to investigate whether rare coding variants confer an increased risk of SRM. Methods and results SRM 3–5 cases (N = 505) and statin treatment-tolerant controls (N = 2047) were recruited from multiple sites in North America and Europe. SRM 3–5 was defined as symptoms consistent with muscle injury and an elevated creatine phosphokinase level >4 times upper limit of normal without another likely cause of muscle injury. Whole-exome sequencing and variant calling was coordinated from two analysis centres, and results of single-variant and gene-based burden tests were meta-analysed. No genome-wide significant associations were identified. Given the large number of cases, we had 80% power to identify a variant with minor allele frequency of 0.01 that increases the risk of SRM 6-fold at genome-wide significance. Conclusions In this large whole-exome sequencing study of severe statin-related muscle injury conducted to date, we did not find evidence that rare coding variants are responsible for this adverse drug reaction. Larger sample sizes would be required to identify rare variants with small effects, but it is unclear whether such findings would be clinically actionable.

With the continued spread of COVID-19 across the world, rapid diagnostic tools, readily available respurposable drugs, and prompt containment measures to control the SARS-CoV-2 infection are of paramount importance. Examples of recent advances in diagnostic tests are CRISPR technology, IgG assay, spike protein detection, and use of artificial intelligence. The gold standard reverse transcription polymerase chain (RT-PCR) has also been upgraded with point-of-care rapid tests. Supportive treatment, mechanical ventilation, and extracorporeal membrane oxygenation (ECMO) remain the primary choice, while therapeutic options include antivirals, antiparasitics, anti-inflammatories, interferon, convalescent plasma, monoclonal antibody, hyperimmunoglobulin, RNAi, and mesenchymal stem cell therapy. Different types of vaccines such as RNA, DNA, and lentiviral, inactivated, and viral vector are in clinical trials. Moreover, rapidly deployable and easy-to-transport innovative vaccine delivery systems are also in development. As countries have started easing down on the lockdown measures, the chance for a second wave of infection demands strict and rational control policies to keep fatalities minimized. An improved understanding of the advances in diagnostic tools, treatments, vaccines, and control measures for COVID-19 can provide references for further research and aid better containment strategies.

Background and ObjectivesTinnitus is characterized as a perception of numerous auditory sounds in absence of external stimulus. Tinnitus can have a considerable consequence on a person’s quality of life, and is considered to be very complicated to quantify. The aim of this study was to investigate the reliability and validity of Urdu translation of the Tinnitus Handicap Inventory (THI) in Pakistan. It was designed to assess the presence of various auditory sounds without the external stimulus. Scale consisted of 25 items having three subscales functional, emotional, and catastrophic.Subjects and MethodsThe study comprised into two stages, preliminary and main studies. The results of preliminary study revealed that the overall scale had high internal consistency [alpha coefficient of Urdu version of THI (THI-U)= 0.99, alpha coefficient of English version of THI=0.98]. The overall scale had test-retest correlation over a fifteen days period of interval (0.99). Main study was performed on 110 tinnitus patients. The results of main study showed that the internal consistency and reliability of Urdu version was (α=0.93). The THI-U and its subscales demonstrated good internal consistency reliability ( α =0.81 to 0.86).ResultsHigh to moderate correlations were noted between tinnitus symptom ratings. A confirmatory factor analysis was used to validate the three subscales of THI-U, and high inter-correlations were found between the subscales also results revealed that a three-factor model for the THI-U was most tenable. The results displayed that the confirmatory factor analysis confirmed to validate the three subscales of THI-U.ConclusionTHI-U might present important information about precise facets of tinnitus distress along with diagnostic interviews in clinical practice.

Purpose The monetary and psycho-social ramifications of the COVID-19 pandemic have been extensive and unimaginable around the globe. The purpose of this study was to have a psycho-social analysis of people confronting this situation and its impact in the situation of a health crisis on them. Design/methodology/approach In the current study, participants were divided according to their different backgrounds and professions based on the types of measures taken by the Pakistani government to limit the spread of the virus and people who are not disturbed by any of the measurement categories but are troubled by the coronavirus. The interviews based on five open-ended questions were conducted with the eight participants, comprising questions that helped participants in remembering and realizing the purpose of the interview in the mode of an open questioning. Phenomenological interpretative analysis was used to understand how participants make meaning of the phenomenon being studied, an in-depth analysis of the human subject was considered in its singularity, and personal accounts and experiences were noted regarding this pandemic. Findings The results indicated that the participant’s experiences were marked by stress, insecurity, anger, fear, anxiety, traces of painful emotions and a feeling of weakness. Also the prevalence of unknown precariousness and vulnerability of coronavirus aggravated the psychological frailness among people existing in an anxiety-prone situation created by the novel coronavirus. Confronted with these painful experiences, the participants however, used a variety of cognitive and behavioral efforts which needs to be strengthened by psychological care. Research limitations/implications This study based on qualitative method was performed on diverse socio-professional levels, giving an insight to what they are undergoing, their current fears, desires and their feeling. The outcome of this study reveals traces of uncertainty, anxiety, fears, insecurity and hidden imminent death from coronavirus, therefore highlighting a need for immediate psychological interventions. Originality/value This study explores the individual understanding regarding current coronavirus pandemic situation on subjective lived experiences and psychological health in an anxiety-prone context manifested by the health crisis created by the novel corona virus.

Purpose Fear of COVID-19 is one of the pivotal components that have generated higher levels of stress, obsessions and anxiety among the adult population, thus creating numerous mental health issues. The purpose of this study was to evaluate psychological well-being based on COVID-19-related fear, obsessions and anxiety during the pandemic situation. Design/methodology/approach The current study aimed to evaluate the relationship between COVID-19-related fear, obsessions, anxiety, stress and well-being among adult populations. Additionally, the aim was to see the impact of COVID-19-related fear, obsessions, anxiety and stress on well-being. This was a cross-sectional study based on nonclinical sample of (n = 250) adults; data was obtained via online questionnaire survey method and analysis was performed by using the statistical package for social sciences (SPSS-22). Findings The authors’ findings based on descriptive statistics showed that COVID-19-related fear and obsessions were positively associated with COVID anxiety and stress and negatively associated with well-being. COVID anxiety was positively associated with stress and negatively associated with well-being. Moreover, perceived stress is negatively associated with well-being. The results additionally provide the outcome/conclusion that COVID-related anxiety significantly negatively predicted the psychological well-being. Overall the model explained 24% of the variance in psychological well-being. Females scored significantly high in COVID-19-related anxiety and obsessions as compared to males. Research limitations/implications A distinctive feature of this study is the understanding of COVID-19-related fear, obsessions, anxiety, stress and well-being among adult populations, and the findings are highlighting the need for psychological and social interventions for this specific population; therefore, immediate attention is needed by the clinical health professionals dealing with mental health issues. Originality/value There is a vital need to explore and develop psychological interventions aiming at the negative consequences being faced by the adult populations due to the COVID-19 pandemic and the impending second wave that will expose individuals to various mental health issues evolving because of the health crisis.