High-Grade Atrioventricular Nodal Block: An Unusual Presentation of COVID-19 Infection

While respiratory system disease, including pneumonia, remains the principal clinical presentation, several cardiovascular complications of coronavirus disease 2019 (COVID-19) including myocardial infarction, myocarditis, and tachyarrhythmias were reported. We present an unusual case of fatal high-grade atrioventricular nodal block in a young adult male with COVID-19 infection in the occurrence of normal coronary arteries. Marked inflammatory response and myocarditis are the most likely contributing factors to electrical conduction system disturbance. It is appropriate for the clinicians to be aware of the fact that COVID-19 can atypically present as bradyarrhythmia and conduction abnormalities.

Pursed lips breathing education for asthma patients in Kebonsari Village, Pekalongan Regency, Indonesia

Asthma is a respiratory system disease characterized by symptoms of coughing, shortness of breath and wheezing. Pursed lips breathing is one of the non-pharmacological measures used to treat asthma recurrence. The patients who followed were 10 people. This community service method was in the form of education using leaflets and power points and was attended by 10 asthma patients. The activity began with a pre-test, delivery of material, and ends with a post-test. The results of this activity revealed an increase in knowledge of asthma patients with good criteria as much as 70% and quite as much as 30%. Thus, Pursed lips breathing can effectively prevent the risk of recurrence in asthma patients.

Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam

Background: Our study was conducted to determine the prevalence of drug-related problems (DRPs) in outpatient prescriptions, the impact of DRPs on treatment efficacy, safety, and cost, and the determinants of DRPs in prescribing for pediatric outpatients in Vietnam. Methods: A retrospective cross-sectional study was conducted on pediatric outpatients at a pediatric hospital in Can Tho, Vietnam. DRPs were classified according to the Pharmaceutical Care Network Europe classification (PCNE) of 2020. The study determined prevalence of DRPs and their impacts on efficacy, safety, and cost. Multivariate regression was used to identify the determinants of DRPs. Results: The study included 4339 patients (mean age 4.3, 55.8% male), with a total of 3994 DRPs, averaging 0.92 DRP/prescription. The proportion of prescriptions with at least one DRP was 65.7%. DRPs included inappropriate drug selection (35.6%), wrong time of dosing relative to meals (35.6%), inappropriate dosage form (9.3%), inappropriate indication (7.1%), and drug-drug interactions (0.3%). The consensus of experts was average when evaluating each aspect of efficiency reduction, safety reduction, and treatment cost increase, with Fleiss’ coefficients of 0.558, 0.511, and 0.541, respectively (p < 0.001). Regarding prescriptions, 50.1% were assessed as reducing safety. The figures for increased costs and decreased treatment effectiveness were 29.0% and 23.9%, respectively. Patients who were ≤ 2 years old were more likely to have DRPs than patients aged 2 to 6 years old (OR = 0.696; 95% CI = 0.599–0.809) and patients aged over 6 years old (OR = 0.801; 95% CI = 0.672–0.955). Patients who had respiratory system disease were more likely to have DRPs than patients suffering from other diseases (OR = 0.715; 95% CI = 0.607–0.843). Patients with comorbidities were less likely to have DRPs than patients with no comorbidities (OR = 1.421; 95% CI = 1.219–1.655). Patients prescribed ≥ 5 drugs were more likely to have DRPs than patients who took fewer drugs (OR = 3.677; 95% CI = 2.907–4.650). Conclusion: The proportion of prescriptions in at least one DRP was quite high. Further studies should evaluate clinical significance and appropriate interventions, such as providing drug information and consulting doctors about DRPs.

Clinical Characteristics of Patients Infected with Coronavirus Disease 2019 (COVID-19) in Iran: A Retrospective Cohort Study

Background: Coronavirus disease 2019 (COVID-19) was introduced by the World Health Organization as a pandemic and emergency for human health. This study aimed to investigate the clinical characteristics of patients infected with COVID-19 in Guilan Province, Iran. Methods: This retrospective study was conducted on 1,000 patients with a definitive diagnosis of COVID-19 pneumonia admitted to six hospitals in Guilan Province, Iran, from April 13 to June 14, 2020. This study evaluated the patients' clinical information, demographic characteristics, laboratory results, and chest computed tomography scans. Findings: The mean age of the patients was obtained at 55±1.3 years, and the majority (n=800; 80%) of the cases were male. Furthermore, most patients had underlying diseases, including respiratory system disease (n=173; 17.3%), cardiovascular disease (n=711; 71.1%), and malignancy (n=146; 14.6%). The most common causes of the infection with COVID-19 included the presence in crowded places (n=733; 73.3%), close contact with the infected person (n=370; 82.2%), possession of pets (n=107; 23.2%), and family gathering (n=822; 82.2%). In addition, the most common clinical symptoms in patients included fever (n=911; 91.1%), cough (n=900; 90%), and dyspnea or shortness of breath (n=889; 88.9%). Other less common symptoms were diarrhea (n=160; 16%), vomiting (n=168; 16.8%), and headache (n=217; 21.7%). Dyspnea developed in 889 (88.9%) patients, and 660 (66%) cases had increased leucocytes. Conclusion: COVID-19 causes mild to fatal pneumonia in patients. Therefore, early detection and treatment of these patients are of utmost importance. Timely treatment of the disease can reduce the severity of symptoms and prevent the further spread of the disease.

Evaluation of Bohicon cotton ginning factory workers respiratory health using chest radiography

Background: Chest radiography is widely used to monitoring the occupational lung disease caused by the inhalation or ingestion of dust particles. Our goal was to explore the respiratory system disease among cotton ginning workers at Bohicon using radiography.Methods: We performed cross-sectional descriptive from February 25 to June 11, 2015. It included 110 cotton ginners selected from the 416 workers of ginning factory. The study participant underwent a survey and a postero-anterior chest X-ray, respectively. Radiographic examinations were performed with a conventional radiographic device. The radiograms were acquired on analog and were developed with automatic processor. The interpretation has been performed by a radiologist. We performed the data analysis with Epi Info 6.5 software.Results: The mean age of our sample is 33.96±4.22 years with a minimum age of 19 and a maximum of 56 years. Also, it should be noted that 89.1% of workers had between one year and 10 years of work experience. Chest tightness and cough are the most respiratory symptoms raised among its workers. 78.18% of workers said they had cough and 55.45 admitted to having chest tightness. Bronchial lesion was the most observed (70.90%) followed by plural lesion (07.26%). Only seven (07) over 110 (7.28%) participants had a lung lesion.Conclusions: In according our result, chest radiography could be used to respiratory health monitoring for the highlighting bronchial, lung and pleural lesion. A large case-control study will be performed to confirm our findings about this population.

TRANSMISSION AND PATHOGENESIS OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2

Coronavirus disease 2019 (COVID-19) is a respiratory system disease that results in flu-like symptoms. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) which was initially transmitted from either sea animals, wild animals like bats, or pet animals like dogs, and cats to humans. Since the occurrence of the first human COVID-19 case in China in 2019, the disease uses a trans-human transmission pathway. Its pathogenesis is almost similar to other respiratory diseases.

Value of blood IFN-I levels in COVID-19 management

Coronavirus disease 2019 (COVID-19) which is a respiratory system disease has created inevitable pandemic. In the course of disease; the uncontrolled inflammatory response may cause tissue damage. 80–90% of patients undergo mild-to-moderate disease symptoms, the rest of the patients proceeds to critical or severe disease. Type I Interferons (IFN–I) are crucial immune mediators in order to host responses to viral infection likewise those are major components of the innate immune system moreover serve as critical antiviral molecules. IFN-I are within the first cytokines secreted during a viral infection. Until now, IFN-I response has been evaluated in patients with COVID-19 in a few publications and its contribution to the viral load control and inflammation is very little known. In those studies, the researchers have found that IFN-I deficiency which characterized by no IFN- β and low IFN- α production and activity is a hallmark of severe and critical COVID-19. Until recently, measurement of circulating serum levels of IFN-α have been limited owing to the limits of conventional immunoassay technology. Limit of detection problems of immunoassays has started to figure out thanks to SIMOA. On the top of that, generally the platforms that use SIMOA technology is 10–100 fold more sensitive than most conventional immunoassays. We should strive to do research that includes IFN-I with using platforms that include SIMOA technology, especially in severe COVID-19.

Investigation of Formaldehyde Adsorption on Carbon Nanotubes by Density Functional Theory

Background: Formaldehyde (HCOH) is the most abundant airborne carbonyl indoor volatile organic compound (VOC), which is well-known to cause serious health effects such as respiratory system disease, immune system disorders, and central nervous system damage. Methods: The interaction between HCOH and intrinsic, congeners of Au, Ag, Cu-doped SWCNTs were investigated by density functional theory (DFT) to evaluate the detection of formaldehyde. Results: The results demonstrated that the less adsorption on the surface of intrinsic SWCNT, an HCOH molecule tended to be chemisorbed to the Au, Ag, and Cu atoms of doped SWCNT with larger binding energy of 0.4-0.8 eV and smaller binding distance of 1.9-2.3 Å. Furthermore, charge transfer and density of state studies indicated tha t the electronic properties changed evidently in the most stable HCOH-doped SWCNT systems, mainly at the region of -5.5 to -4.5 eV and Fermi level. Conclusion: More importantly, the adsorption of HCOH affected the electronic conductance of doped SWCNT. It is expected that the results obtained in this study could provide a useful theoretical guidance for the investigation of molecular films interface bonding and design of HCOH sensing devices.

Early famine exposure and adult disease risk based on a 10-year prospective study of Chinese adults

ObjectiveTo comprehensively examine the potential impacts of prenatal experience of the Chinese Great Famine on chronic disease risks in the middle age.MethodsThis study included 92 284 participants aged 39–51 years from China Kadoorie Biobank born around the famine period and without major chronic diseases at baseline. We categorised participants into non-famine births (born between 1 October 1956 and 30 September 1958, and 1 October 1962 and 30 September 1964) and famine births (born between 1 October 1959 and 30 September 1961). The outcomes were incident cardiovascular disease, cancer and respiratory system disease. Cox regression was used to estimate adjusted HR and 95% CI for famine exposure. Subgroup analyses were performed according to baseline characteristics.ResultsDuring a median 10.1 years of follow-up, we identified 4626 incident ischaemic heart disease (IHD) cases, 7332 cerebrovascular disease cases, 3111 cancer cases and 16 081 respiratory system disease cases. In the whole population, prenatal famine exposure was not statistically associated with the risks of developing any chronic diseases in adulthood. However, for urban participants, compared with non-famine births, famine births had a higher risk of cerebrovascular disease (HR 1.18; 95% CI 1.09 to 1.28); such association was not shown for rural participants (p for interaction <0.001). Also, we observed the associations of prenatal famine exposure with IHD (HR 1.15; 95% CI 1.05 to 1.26) and cerebrovascular disease (HR 1.13; 95% CI 1.05 to 1.21) in participants with lower physical activity level, but not in those with higher ones (all p for interaction=0.003).ConclusionOur findings indicate that prenatal exposure to the Chinese famine might be associated with an increased cardiovascular risk and such risk may be modified by adult lifestyle.