Atypical presentation of COVID-19 in a diabetic patient with malaria-like symptoms: case report

Since the emergence of the coronavirus (COVID-19) pandemic beginning in China in 2019, all health workers have faced a difficult  challenge. One challenge is a clinical picture in some cases, where the presenting symptoms do not fit with the usual pattern. In this report, we present a case whose initial symptoms were headache, dizziness, and vomiting suggesting malaria bearing in mind that the patient was from Sudan, where there is a high incidence of malaria. These unusual symptoms may be attributed to the presence of the receptor ACE2, in various body systems. The mild pathological course may be related to the patient’s age and the fact that diabetic patients are less likely to develop lung injury, hence the absence of respiratory symptoms. We recommend that physicians are alert to the variety of different presenting features of COVID-19 and test with Polymerase Chain Reaction (PCR) whenever there is doubt

Challenges of living with a mental health condition as a registered healthcare professional: exploring experiences of organisational support and stigma

\ua9 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.The prevalence of serious mental illness is higher in healthcare professionals than in the general population. Mental health issues are associated with more lost workdays than any other chronic condition within the NHS. For healthcare professionals, disclosure of mental health condition can lead to stigmatisation and devaluation as a professional. The aim of this study was to investigate the experiences of living with a mental health condition as a healthcare professional and access to support. The study used qualitative methods combining data from semi-structured interviews (n = 10) and textual data from Twitter threads (n = 51). Purposeful sampling was used to achieve maximum variation in terms of serious mental illness experience, health care professions, and location of work. Search criteria for identifying relevant twitter threads followed the same sampling criteria. The data was analysed using thematic analysis. Three themes were identified: importance of support and advice, need to tackle stigmatisation, and challenges to improve mental well-being. Emotional validation of living with a mental health condition as a health care professional was an important factor for feeling supported. Organisational mismanagement and negative attitudes about mental illnesses were considered as key reasons for persistent stigmatisation. Challenges included disparities in support between the professions, high expectations by self and others, and fearing to disclose suicidal thoughts and ideation. Organisational changes are needed to better support healthcare professionals living with serious mental health conditions. Barriers to seeking support could be addressed by providing better training and toolkits for managers and colleagues

GIVING TWO ANSWERS TO THE SAME QUESTION: APPLYING SURVEY RE-INTERVIEWING TECHNIQUES IN QATAR.

In order to evaluate the quality of its survey data, SESRI implemented since 2010 a system of re-interviewing a sub-sample of respondents. These re-interviews usually take place not more than six days from the date of the first interview for the original survey production. Results from these interviews are used as an instrument to analyze non-sampling error and to estimate response inconsistencies, to identify reasons for discrepancies for selected questions for the same respondents, as well as to determine interviewer cheating. Applying the Gross Difference Rate (GDR), Index of Inconsistency (IOI) and Reliability Rate (RR) to estimate variances in respondents’ answers, this paper presents the results of the re-interviewing study of the 2012 Qataris’ Attitudes Towards the Foreign Workers in Qatar. The results are intended for researchers and data collection organizations to improve the quality of data they collect and use

Clostridium difficile modulates host innate immunity via toxin-independent and dependent mechanism(s)

Clostridium difficile infection (CDI) is the leading cause of hospital and community-acquired antibiotic-associated diarrhoea and currently represents a significant health burden. Although the role and contribution of C. difficile toxins to disease pathogenesis is being increasingly understood, at present other facets of C. difficile-host interactions, in particular, bacterial-driven effects on host immunity remain less studied. Using an ex-vivo model of infection, we report that the human gastrointestinal mucosa elicits a rapid and significant cytokine response to C. difficile. Marked increase in IFN-γ with modest increase in IL-22 and IL-17A was noted. Significant increase in IL-8 suggested potential for neutrophil influx while presence of IL-12, IL-23, IL-1β and IL-6 was indicative of a cytokine milieu that may modulate subsequent T cell immunity. Majority of C. difficile-driven effects on murine bone-marrow-derived dendritic cell (BMDC) activation were toxin-independent; the toxins were however responsible for BMDC inflammasome activation. In contrast, human monocyte-derived DCs (mDCs) released IL-1β even in the absence of toxins suggesting host-specific mediation. Infected DC-T cell crosstalk revealed the ability of R20291 and 630 WT strains to elicit a differential DC IL-12 family cytokine milieu which culminated in significantly greater Th1 immunity in response to R20291. Interestingly, both strains induced a similar Th17 response. Elicitation of mucosal IFN-γ/IL-17A and Th1/Th17 immunity to C. difficile indicates a central role for this dual cytokine axis in establishing antimicrobial immunity to CDI

COVID-19 clinical presentations: the modern mimic of other conditions

The coronavirus pandemic (COVID-19) has placed enormous challenges on the health sector. Diagnosis is one of these challenges, where a clinical presentation may suggest a disease other than COVID-19. In this review we describe many presentations unrelated to the respiratory system. The ACE2 receptor is present in a wide variety of body tissues and it appears that this may be a link with the clinical pathology. To find these data we searched the major academic research engines, Google Scholar, and Pubmed, as well as the most recent case reports and original research published in specialized journals. An awareness of these uncommon presentations helps health workers to recognize and treat the disease early and appropriately. Keywords: COVID-19, coronavirus, pandemic, ACE2, unusual symptoms, revie

Improving influenza vaccination rate among primary healthcareworkers in Qatar

The purpose of this study was to improve influenza vaccination, and determine factors influencing vaccine declination among health care workers (HCW) in Qatar. We launched an influenza vaccination campaign to vaccinate around 4700 HCW in 22 Primary Health Care Corporation (PHCC) centers in Qatar between 1st and 15th of November, 2015. Our target was to vaccinate 60% of all HCW. Vaccine was offered free of charge at all centers, and information about the campaign and the importance of influenza vaccination was provided to employees through direct communication, emails, and social media networks. Staff were reported as vaccinated or non-vaccinated using a declination form that included their occupation, place of work and reasons for declining the vaccine. Survey responses were summarized as proportional outcomes. We exceeded our goal, and vaccinated 77% of the target population. Only 9% declined to take the vaccine, and the remaining 14% were either on leave or had already been vaccinated. Vaccine uptake was highest among aides (98.1%), followed by technicians (95.2%), and was lowest amongst pharmacists (73.2%), preceded by physicians (84%). Of those that declined the vaccine, 34% provided no reason, 18% declined it due to behavioral issues, and 21% declined it due to medical reasons. Uptake of influenza vaccine significantly increased during the 2015 immunization campaign. This is attributed to good planning, preparation, a high level of communication, and providing awareness and training to HCW with proper supervision and monitoring. 1 2017 by the authors. Licensee MDPI, Basel, Switzerland.Acknowledgments: We would like to thank all staff for participation in the 2015 influenza vaccination campaign at the PHCC. Members of the Health protection at MoPH and PHCC communicable disease control team are highly acknowledged for assistance with implementation. This Study was funded by the Ministry of Public Health.Scopu

In situ PCR for detection and differentiation of Newcastle disease virus strains in Leghorn chickens

In experiment 1, six specific pathogen free (SPF) chickens were intra-nasally infected with velogenic (v) NDV strain with titre of 10⁵ EID50/0.1 mL and 6 non-infected birds were used as controls. Chickens were sacrificed at different times and tissue samples were collected for In situ PCR and immunoperoxidase staining (IPS). In situ PCR was more sensitive (P < 0.05) than IPS for detection of NDV. In a 2nd experiment, In situ PCR was done to differentiate NDV strains. Groups of 5 SPF chickens each, were infected with velogenic (10⁵EID50/0.1 mL) or lentogenic (l) NDV (103.0 EID50/0.1 mL) strains. Non-infected birds were used as controls. After sampling of tissues, an In situ PCR was developed using specific velogenic and lentogenic strain probes. In situ PCR velogenic probe was positive only to tissues infected by velogenic strain whereas lentogenic probe only with lentogenic infected-tissues. The findings suggested that the In situ PCR differentiated lentogenic from velogenic NDV virus strains

In situ PCR for detection and differentiation of infectious bursal disease virus strains in chickens

An In situ PCR method for detection and differentiation of infectious bursal disease virus (IBDV) strains is described. In one study, 15 specific pathogen free (SPF) 14 day old chickens were infected orally with very virulent (vv) IBDV strain with a titre of 107.5 EID50/0.1 mL. Six non-infected chickens were used as controls. Chickens were sacrificed at various intervals and tissue samples taken for histological examination. Immunoperoxidase staining (IPS) was done, and an In situ PCR was developed using a specific probe for IBDV’s VP1 gene. The In situ PCR was significantly (p < 0.05) more sensitive than IPS. In another study todifferentiate strains by In situ PCR, ten, 42 day old SPF chickens were infected with virulent (104.83 EID50/0.1 mL) or classical (ca) NDV strains (103.0 EID50/0.1 mL) with 5 non-infected controls. Tissue samples infected with virulent, classic and controls tested with a virulent specific probe were positive only in tissues infected by the virulent strain whereas classical strain probe were positive only to tissue infected by classical strain. These results suggest that our In situ PCR differentiated virulent from classical NDV strains

Real-Life Anti-Tumour Necrosis Factor Experience in > 500 Paediatric United Kingdom Inflammatory Bowel Disease Patients.

OBJECTIVES: To measure the effectiveness, safety and use of anti-Tumour necrosis Factor (TNF) therapy in paediatric inflammatory bowel disease (PIBD) in the United Kingdom (UK). METHODS: Prospective UK audit of patients newly starting anti-TNF therapy. Disease severity was assessed using Physician Global Assessment (PGA) +/or the Paediatric Crohn's Disease Activity Index (PCDAI). RESULTS: 37 centres participated (23 of 25 specialist PIBD sites). 524 patients were included; 429 Crohn's disease (CD), 76 ulcerative colitis (UC), 19 IBD unclassified (IBDU). 87% (488/562) anti-TNF was infliximab; commonest indication was active luminal CD 77% (330/429) or chronic refractory UC/IBDU 56% (53/95); 79% (445/562) had concomitant co-immunosuppression. In CD (267/429 male), median time from diagnosis to treatment was 1.42 years (IQR 0.63-2.97). Disease (at initiation) was moderate or severe in 91% (156/171) by PGA compared to 41% (88/217) by PCDAI; Kappa (Κ) 0.28 = only 'fair agreement' (p < 0.001).Where documented, 77% (53/69) of CD patients responded to induction; and 65% (46/71) entered remission. 2287 infusions and 301.96 years of patient follow-up (n = 385) are represented; adverse events affected 3% (49/1587) infliximab and 2% (2/98) adalimumab infusions (no deaths or malignancies). Perianal abscess drainage was less common after anti-TNF initiation (CD): 26% (27/102) before, 7% (3/42) after (p = 0.01); however pre and post anti-TNF data collection was not over equal time periods. CONCLUSION: Anti-TNFs are effective treatments, usually given with thiopurine co-immunosuppression. This study highlights deficiencies in formal documentation of effect and disparity between disease severity scoring tools which need to be addressed to improve ongoing patient care

Scoring system for lesions induced by different strains of Newcastle disease virus in chicken

Newcastle disease virus strains are velogenic, mesogenic, and lentogenic. This study aims to design a scoring system for lesions induced by different strains of Newcastle disease virus in chicken. Three experiments were conducted. In experiments 1 and 2, chickens were divided into infected and control groups. Infected groups of experiments 1 and 2 consisted of 6 and 24 specific pathogen-free (SPF) chickens, respectively. Control groups in experiments 1 and 2 consisted of 6 and 15 SPF chickens, respectively. In infected groups, infection was induced by intranasal administration of 105 50% EID50/0.1 mL of velogenic Newcastle disease virus strain (vNDV). Infected chickens in experiment 1 were euthanised by cervical dislocation on days 3, 6, and 7 postinoculation (pi). Infected chickens in experiment 2 were euthanised at hours (hrs) 2, 4, 6, 12 and days 1, 2, 4, and 6 pi. Chickens of the control group in experiment 1 were euthanised on days 3 and 7 pi, whereas control group chickens in experiment 2 were euthanised on days 0, 1, 2, 4, and 6 pi. Then in experiment 3, 15 SPF chickens were divided into three groups; in the first group, 5 SPF chickens were infected with vNDV, in the second group, 5 SPF chickens were infected with lentogenic NDV (lNDV) (103.0 EID50/0.1 mL), and the third group was kept without infection as a control group. Chickens were euthanised on day 5 pi. In all previous experiments, tissues of brain, trachea, lung, caecal tonsil, liver, kidney, spleen, heart, proventriculus, intestine, and thymus were collected, fixed in 10% buffered formalin, embedded in paraffin, and sectioned. HS staining was applied. Tissues were examined under light microscope and changes were recorded. A scoring system was designed for lesions induced by different strains of NDV and, accordingly, lesions were scored. The scoring system was found helpful in the evaluation of disease severity