Multisystem Inflammatory Syndrome in Children (MIS-C), representing a new entity in the spectrum of manifestations of COVID-19, bears symptomatic resemblance with Kawasaki Disease (KD). This review explores the possible associations between KD and the human coronaviruses and discusses the pathophysiological similarities between KD and MIS-C and proposes implications for the pathogenesis of MIS-C in COVID-19. Since 2005, when a case-control study demonstrated the association of a strain of human coronavirus with KD, several studies have provided evidence regarding the association of different strains of the human coronaviruses with KD. Thus, the emergence of the KD-like disease MIS-C in COVID-19 may not be an unprecedented phenomenon. KD and MIS-C share a range of similarities in pathophysiology and possibly even genetics. Both share features of a cytokine storm, leading to a systemic inflammatory response and oxidative stress that may cause vasculitis and precipitate multi-organ failure. Moreover, antibody-dependent enhancement, a phenomenon demonstrated in previous coronaviruses, and the possible superantigenic behavior of SARS-CoV-2, possibly may also contribute toward the pathogenesis of MIS-C. Lastly, there is some evidence of complement-mediated microvascular injury in COVID-19, as well as of endotheliitis. Genetics may also represent a possible link between MIS-C and KD, with variations in FcγRII and IL-6 genes potentially increasing susceptibility to both conditions. Early detection and treatment are essential for the management of MIS-C in COVID-19. By highlighting the potential pathophysiological mechanisms that contribute to MIS-C, our review holds important implications for diagnostics, management, and further research of this rare manifestation of COVID-19.
ABSTRACT: BACKGROUND & OBJECTIVE: Internet has swayed all aspects of human society and the exponential rise in global internet users indicates that internet & Social Networking sites (SNS) have become an essential part of the daily lives of people with potentially addictive effects of its overuse. This may lead to social isolation, depression & professional effects. This behavioral addictive pattern has also been observed in increasing trend among healthcare professionals worldwide. This study aims to assess prevalence of internet addiction and its behavioral patterns (BP) in Pakistani healthcare context, to determine the prevalence and intensity of Internet Addiction (IA) among Medical Doctors. METHODOLOGY: A Quantitative; Cross-sectional Survey was conducted at Shaikh Khalifa Bin Zayed/ Azad Kashmir Combined Military Hospital Rawalakot for 2 months.After calculating sample size with 95% Confidence Interval limit,100 medical and dental doctors were selected using convenience sampling. After IRB approval & informed consent data was collected using prevalidated “Young's Internet Addiction Scale”& “Behavioral Patterns scale”. The participants recorded their response on a 5-point Likert scale and dichotomous scale for each scale respectively. Data was summarized using descriptive statistics & inferential statistics in SPSS 23. Addiction was classified into 4 categories. The significant association between IA groups and BP groups was computed by Fisher's exact test with P-value <0.05 as significant. RESULTS: The Response rate was 87% with 54% males and 56% females. The prevalence of internet addiction was 79%(n=69). Out of them 36% (n=31) had mild, 41% (n=36) had moderate addiction while 2% (n=2) had severe addiction. Pattern of internet addiction symptomatology shows that prevalence of IA is higher in excessive use (87.35%) & lack of control (77.01%) while least in anticipation (35.63%) category. Statistically significant difference was seen in behavioral patterns among addicted and nonaddicted medical and dental doctors. CONCLUSION: Internet Addiction is a recognizable disorder from the spectrum of Problematic Internet Use. This study reports the prevalence of internet addiction among health care professionals and burden of multiple behavioral patterns in association with IA, which is an emerging mental health concern.
Background This study sought to determine the presence of SARS-CoV-2 virus on surfaces that trainees and faculty of an academic eye clinic came into contact with during daily life at the time of the COVID-19 pandemic in New York City. Methods This cross-sectional analysis involved collection of at least two samples by teams on four different days (November 9, 2020 – December 18, 2020) using sterile swabs (Puritan HydraFlock, Garden Grove, CA). Collection sites were grouped into four zones depending on proximity and amount of time personnel spent there. Samples were transported to the laboratory in transport medium and RNA was extracted using the QIAamp DSP Viral RNA Mini Kit (Qiagen, Germantown, MD). Presence of viral RNA was investigated using the Luna Universal Probe One-step RT–qPCR kit (New England Biolabs, Ipwsich, MA). Results 834 samples were submitted. Two were positive for SARS-CoV-2 RNA. The first was a sample from a patient bathroom sink handle in the main emergency department. The second was a nasal swab sample from a staff member who had been assigned to collect samples. Prior to this positive result, this asymptomatic staff member had tested positive for COVID-19, had quarantined for two weeks, and had received a negative test. Conclusion Though COVID-19 is currently widespread in the United States, this study shows that health care personnel working in New York City at the Columbia University Irving Medical Center have a low chance of encountering viral RNA on surfaces they are in close contact with during daily life.
Précis: Remote contrast sensitivity (CS) testing through a free downloadable home test correlates with glaucomatous macular damage measured by 10-2 visual field (VF) testing.Purpose: To assess the feasibility and validity of home CS monitoring as a measure of glaucomatous damage using a free downloadable smartphone application.Methods: Twenty-six participants were asked to remotely use the Berkeley Contrast Squares (BCS) application, a free downloadable tool that records the user's CS for varying degrees of visual acuity. An instructional video detailing how to download and use the application was sent to the participants. Subjects were asked to send logarithmic CS results with a minimum 8-week test-retest window, and test-retest reliability was measured. Results were validated against office-based CS testing that was collected within the previous 6 months. Validity analysis was also carried out to determine whether CS as measured by BCS is a good predictor of 10-2 and 24-2 VF mean deviation (MD).Results: There was a high BCS test-retest reliability with an intraclass correlation coefficient score of 0.91 and a significant correlation between repeat test results and baseline test scores (Pearson, 0.86, P < 0.0001). There was significant agreement between unilateral CS scores as measured by BCS and office-based CS testing (b = 0.94, P < 0.0001, 95% CI: 0.61 to 1.27). Unilateral CS as measured by BCS was significantly associated with 10-2 VF MD (r 2 = 0.27, P = 0.006, 95% CI: 3.7 to 20.6), but not with 24-2 VF MD (P = 0.151). Conclusion:This study suggests that a free, rapid home CS test correlates with glaucomatous macular damage as measured by 10-2 VF.
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