Post-COVID-19 Fatigue: Demographic Distribution and Relation to Chronic Illnesses

Objective: This retrospective study examined the relationship between post-COVID (PC) fatigue and the presence of chronic illnesses. Materials and Methods: Electronic health records of 122 Parkview PC Clinic patients were reviewed for demographics (age, gender, race), chronic illnesses (diabetes, hypothyroidism, hypertension, congestive heart failure, anemia, cancer, orthostatic hypotension), obesity (weight, BMI), complaint of fatigue, and activities affected by fatigue. Data was analyzed using Chi-square tests for categorical variables (or Fisher’s exact test for small cell sizes) and t-tests for continuous variables. Open thematic coding of activities most affected by PC fatigue was performed. Results: 95 out of 122 patients (77.9%) were found to have PC fatigue. Except for measures related to obesity, none of the chronic illnesses assessed were correlated with the presence of fatigue. The weight of PC fatigue patients was significantly higher than those without fatigue (p=0.04). Examination of BMI and obesity status also indicated significantly higher BMI (p=0.01) and levels of obesity (p= 0.004) in PC fatigue groups compared to the PC non-fatigue groups. No significant differences were observed between the groups in either PT test. Examination of patient described activities effected by PC fatigue found work (30.4%), daily stamina (28.6%) and ability to exercise (16.7%) most impacted by PC fatigue. Other activities affected by PC fatigue included housework (5.6%), hobbies (3.7%), shopping (1.9%) and driving (1.9%). Conclusion: 77.9% of our PC patients showed symptoms of fatigue. This is comparable with existing literature. None of the demographic variables and PT tests, or most of the chronic health conditions investigated, were correlated with the presence of fatigue in PC patients. In contrast, measures associated with obesity, including high BMI and weight, were significantly associated with increased PC fatigue presentation. Open thematic coding of qualitative variables indicated work, daily stamina, and exercise were most affected in PC patients.

Demographic Analysis of Mutations in Indian SARS-CoV-2 Isolates

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originally emerged from Hubei province, Wuhan, China, and has caused a worldwide pandemic with millions affected since December 2019. Since the first case of SARS-CoV-2 reported on 27th Jan 2020 in India, over 11 million people have been affected by the virus in the country in the past one year. To understand its demographic distribution, in this study we carried out the early distribution of clades and subclades state-wise based on the analysis of shared mutations in Indian SARS-CoV-2 isolates collected during the period 27th Jan – 27th May 2020. A total of 1279 mutations have been identified in 685 Indian isolates during this period. Principal component analysis on the mutational profile of Indian isolates revealed clusters corresponding to clades in Nextstrain and some state-specific clusters. Phylogenetic analysis of these isolates indicates multiple independent sources of introduction of the virus in the country. It is observed that clade 20A defining mutations C241T (ORF1ab: 5′ UTR), C3037T (ORF1ab: F924F), C14408T (ORF1ab: P4715L), and A23403G (S: D614G) are the predominant mutation set in Indian isolates during this period. Higher number of coronavirus cases were observed in certain states, viz., Delhi, Tamil Nadu, and Telangana. Genetic analysis of isolates from these states revealed a cluster with shared mutations, C6312A (ORF1ab: T2016K), C13730T (ORF1ab: A4489V), C23929T, and C28311T (N: P13L). Contact tracing led the spread of this cluster to a super spreader event, the Tablighi Jamaat religious congregation, and the efficacy of lockdown in containing it. Analysis of region-specific shared mutations carried out to understand the large number of deaths in Gujarat and Maharashtra identified shared mutations defining subclade, I/GJ-20A (C18877T, C22444T, G25563T (ORF3a: H57Q), C26735T, C28854T (N: S194L), C2836T) in Gujarat and two sets of co-occurring mutations C313T, C5700A (ORF1ab: A1812D) and A29827T, G29830T in Maharashtra. From the genetic analysis of mutation spectra of Indian isolates, the insights gained in its transmission, geographic distribution, containment, and impact are discussed.

Evaluation of cysts and odontogenic tumors over a period of 8 years in a reference medical hospital in Brazil

Objective: This study aimed to evaluate the relative prevalence, demographic distribution and clinical-pathological characteristics of the maxillary odontogenics cysts and tumors of the jaws in a pathology laboratory located in a university hospital in Northeastern Brazil. Methods: An observational and retrospective study was carried out, in which information was collected on histopathological diagnosis, age, gender and location of the lesion of patients who had been diagnosed with odontogenic cysts or odontogenic tumors between 2013 and 2020. Results: Among the 546 specimens, 57 were odontogenic cysts and 41 were odontogenic tumors. The most frequent odontogenic cysts were the odontogenic keratocyst 21 (21.4%) and the root cyst 19 (19.4%). The most frequent odontogenic tumors were ameloblastoma 27 (27.6%) and odontoma 6 (6.1%). Conclusion: The data found in this study are possibly associated with the service assistance profile.

A Demographic Analysis of Craniomaxillofacial Trauma in the Era of COVID-19

Study Design: Retrospective cohort study. Objective: The challenges of COVID-19 could magnify socioeconomic vulnerability for craniomaxillofacial (CMF) trauma. This study compares subjects who presented with CMF fractures to a regional healthcare system during the pandemic with those in 2019. We hypothesized societal circumstances of 2020 would correlate with disproportionately more CMF fractures in vulnerable patients compared to pre-pandemic trends. Methods: An IRB approved retrospective study of CMF fracture presentations in 2019 and 2020 was performed. Demographics, injury details, and management details were collected. A residence-based poverty index was calculated for each subject utilizing census data. Pre-pandemic and pandemic cases were compared to identify differences between cohorts. Results: A large decrease in presentations was noted between pre-pandemic and pandemic cohorts. There was significantly greater poverty the pre-pandemic cohort as compared to the pandemic cohort ( P = .026). Overall, there was a significant correlation between higher poverty and violent MOI ( P < .001). This association was maintained pre-pandemic, ( P = .001) but was insignificant in the pandemic cohort ( P = .108). Difference between cohorts with respect to violent injury was non-significant ( P = .559) with non-significant difference in demographics including age ( P = .390), place of injury ( P = .136), employment status ( P = .905), insurance status ( P = .580), marital status ( P = .711), ethnicity ( P = .068), and gender ( P = .656). Management was not significantly different between cohorts including percent hospital admission ( P = .396), surgical intervention ( P = .120), and time to operation ( P = .109). Conclusions: Contrary to our hypothesis, this analysis indicates that the societal changes brought on by the COVID-19 pandemic did not magnify vulnerable populations. Some changes were noted including in volume of presentation, demographic distribution, and injury detail.

Tubulointerstitial nephritis and uveitis in Northern Ireland

Objectives This paper looks at patients with a diagnosis of tubulointerstitial nephritis and uveitis (TINU) presenting to the Northern Ireland regional adult and paediatric uveitis service in the Belfast Health and Social Care Trust. The demographic distribution, treatment required and the visual and renal outcomes of these patients are documented. Methods Data were collected retrospectively on 24 patients with TINU using the Northern Ireland Electronic Care Record, central pathology records alongside the adult and paediatric uveitis databases from 2011 to 2021. Patients were categorised into two groups using the Mandeville classification system. Standard Uveitis Nomenclature (SUN) was used to classify the uveitis. Results The population prevalence is at least 12.6 cases per million based on a population of 1.9 million. Nineteen of 24 cases were definite TINU and five of 24 probable. Seventeen out of 24 had biopsy-positive TIN, all of which met all of the Mandeville clinical diagnostic features required for a definite diagnosis. All but one presented with acute bilateral anterior uveitis. The paediatric cases ranged from age 12 to 18 at age of onset with a mean age of 14. Of the 18 adult onset cases, the age ranged from 20 to 76 years. The mean age of onset for the adult cases was 53 years. Of these patients 71% were female; 42% required second-line immunosuppression for ocular disease. Visual acuity was maintained. Follow-up time ranged from 3 months to 16 years. No patient developed long-term renal impairment. Conclusions TINU is a cause of uveitis in both the paediatric and adult populations. In Northern Ireland average age with TINU was older than much of the published literature. Long-term immunosuppression for uveitis may be required as ongoing ocular, rather than renal inflammation seemed to require treatment.

Organising National Socialism: Nazi Organisation in Sweden and the Netherlands, 1931–1939

This article compares the party apparatuses of the National Socialist Movement of the Netherlands and the National Socialist Workers’ Party of Sweden. These two parties, founded in the 1930s, both to some extent mimicked the organisational model of Hitler's party in Germany. While this has been frequently noted, the deployment of this model in practice has not been analysed in any detail. The article explores the specific characters of the Swedish and Dutch fascist party organisations diachronically vis-à-vis propaganda, member activism and internal cohesion, highlighting their changes, successes and failures. The comparison reveals that the party apparatus was highly dependent on the specifics of national infrastructure, demographic distribution and urbanisation and the physical landscape, with notable consequences for internal party cohesion and morale. In the final analysis the relative appeal and popularity of the parties is shown party be the result of how the Nazi organisational model was deployed in practice within each national context.

DEMOGRAPHIC PROFILE OF ACUTE FEBRILE ENCEPHALOPATHY CASES IN PEDIATRIC AGE GROUP PATIENTS: A STUDY FROM WESTERN RAJASTHAN

Acute Febrile Encephalopathy is a clinical term used to describe patients presenting with short febrile illnesses with altered mental states. Demographic distribution plays an essential role in the diagnosis of viral etiologies. One hundred ve suspected AFE cases were enrolled in the study. A detailed history by predesigned performa and laboratory investigations was obtained for data collection. Viral etiology was diagnosed in 32 (30.48%) cases. The male to female ratio was 1.39:1. Total 56.25% of positive cases were from the lower class, 28.13% from the middle class, and 15.63% from the upper class. 24 (75%) cases from rural, while only 8 (25%) of the urban population showed viral etiologies. In 19 (59.4%) cases were either history of incomplete vaccination or not vaccinated, 13 (40.6%) cases had a history of complete immunization among positive cases. The predominant clinical feature was fever (100%) followed by seizures 66(62.86%), vomiting 37(35.24%), headache 14(13.33%), paresis in 16(15.24%) and altered sensorium in 29(27.62%), respectively. To conclude, the etiologic panorama of AFE varies with several factors such as time and demographical location, age, and immunization status. There is an urgent need to conduct more studies to prole the viral etiologies according to their prevalence in geographical areas so the treatment can be tailored accordingly and prophylaxis treatment or immunization can be boosted in the population at risk of getting the disease.