Latent tuberculosis and COVID-19 disease

Since the start of the COVID-19 pandemic in 2020, there has been chaos in the world. With the COVID-19 cases rising, many other medical diseases have been ignored and not prioritized. One of these crucial diseases is Tuberculosis (TB). TB is a highly infectious bacterial respiratory disease. Every year there are millions of cases that are registered all around the world. TB is seen in two forms, an active and a latent form. In both of the states, the individual with TB is immunocompromised. This is of great importance, as COVID-19 is known to readily infect individuals in an immunocompromised state more than those with a healthy immune system. Although a little investigation about coexisting infections with COVID-19 and TB is conducted, it is important to consider many factors that can be beneficial to help treat these patients with both conditions effectively and promptly. A few of these factors are pathophysiological relation, diagnostic measurements, effects of each condition on the other, and approaches to treatment. Through a literature review of available information, we summarized the knowledge regarding the correlation between Latent TB infection and COVID-19 infection. The main objective of this publication is to provide a brief overview of how the two conditions overlap with one another. The article also provides a clinical review of how to approach these two conditions in a scenario where an individual is found to be infected with both Latent TB and COVID-19.

Transvaginal ultrasonography versus hysteroscopy in endometrial pathology diagnosis among women with abnormal uterine bleeding

Objective: Abnormal uterine bleeding is any deviation from a normal menstrual pattern. Transvaginal ultrasonography is useful in determining endometrial thickness but cannot conclusively exclude sessile and pedunculated lesions. Hysteroscopy is an invasive procedure that detects discrete lesions. This study was aimed to evaluate the diagnostic accuracy of 2-dimensional transvaginal ultrasonography and hysteroscopy in evaluating endometrial lesions in women with abnormal uterine bleeding, by determining the sensitivity and specificity of the two methods in diagnosing the lesions. Methods: Eighty-four cases of abnormal uterine bleeding were chosen based on inclusion criteria. The patients were subjected to routine investigations. The findings of transvaginal ultrasonography, hysteroscopy, and dilatation and curettage were compared and analyzed. Results: Maximum incidence of abnormal uterine bleeding was observed in women between 41 and 50 years of age (73.8%). The most common presenting complaint was menorrhagia (76.1%). 76% of patients experienced symptoms for less than six months. The sensitivity and specificity of transvaginal ultrasonography were 60% and 96.3%, respectively. The sensitivity and specificity of hysteroscopy were 80.4% and 93.1%, respectively. The accuracy of transvaginal ultrasonography was 60.3%, and that of hysteroscopy was 83.3%. Conclusion: Transvaginal ultrasonography and hysteroscopy can be used as first-line diagnostic modalities to rule out and find the causes of abnormal uterine bleeding, which can aid in instituting prompt and appropriate medical treatment.

COVID-19 and the Cardiovascular System: How the First PostModern Pandemic ‘Weakened’ our Hearts

The global spread of SARS-CoV-2 with its diverse signs and symptoms manifested in COVID-19 patients across different age groups and geographic locations perplexed the clinicians and public health experts. Emerging variants of SARS-CoV-2 through continuous mutation with a limited arsenal of treatment made the study of viral pathogenesis and factors associated with disease outcomes in a holistic approach inevitable, among which pre-existing cardiovascular complications were found to be significantly associated with adverse outcome of COVID-19. In addition, COVID-19 has already been reported to cause cardiac injury and different cardiovascular complications in patients irrespective of preexisting cardiovascular complications, which highlights the importance of recognizing the complications at the onset, although these arising complications might be an indirect effect of SARS-CoV-2 induced cytokine storm or hypoxia rather the virus itself. Also, the drugs used for the clinical management of the patients may have an impact on the induced cardiac complications. Thus, the effect of SARS-CoV-2 on the cardiovascular system needs to be investigated in order to predict the clinical outcome and to devise a proper treatment strategy. Besides, the interaction of vaccines or therapeutics to be approved with the cardiovascular system needs to be evaluated to avoid confounding effects leading to cardiovascular complications followed by post-approval retraction. However, potential biomarkers (eg. troponin, D-dimers, fibrin) associated with cardiac injury may be potentially useful in predicting life-threatening conditions early enough to save lives. In conclusion, this review summarizes the molecular pathogenesis of cardiovascular damage caused by SARS-CoV-2 in COVID-19 patients, as well as prescribed treatment and preventative measures.

SARS-CoV-2 and COVID-19: A Threat to Global Health

Since the outbreak of Coronavirus Disease 2019 (COVID-19) in China, in December 2019, scientists across the globe have been working relentlessly on the causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unfortunately, despite the ongoing research at the genomic level, as well as the immunological and the pathological aspects of SARS-CoV-2, our knowledge about SARS-CoV-2 is still in the primary stage, even after one year from the beginning of the outbreak. As a result, the world is adopting a public awareness-based prevention and control strategy, together with significant efforts in developing and distributing several vaccines. Thus, this review summarizes the understandings of this pandemic, which will in turn be helpful in dealing with SARS-CoV-2 and provide a reference for future studies.

Bullying and its Effect on Mental Wellbeing of the Students: A Case Study in Two Different Schools

Background: Bullying can be a major problem for many children at most schools. Traditionally, bullying is associated with lower academic achievements and generally lower life satisfaction in a child’s primary years of life. Previous studies exploring the effects of bullying on positive psychological constructs of a child have shown varying results. Objectives: This study is aimed to analyze the degree of bullying in two different schools of Lahore and evaluate its effect on the positive mental wellbeing of the students of each institution. Methods: 381 participants were selected from two schools of Lahore, Pakistan: Sacred Heart Convent and Ibne Sina College. The students selected were from grades 6 to 10. The severity of bullying was analyzed by using a questionnaire designed using the Victimization Scale and the WHO-5 Scale. The scores were calculated for each school and the results were compared for victimization and positive mental wellbeing. Results: The mean score for victimization was 8.90 at the Ibne Sina College and 5.89 at the Sacred Heart Convent, which means the incidence of bullying was higher at Ibne Sina College. According to WHO Wellbeing Index, the mental wellbeing was also higher at Ibne Sina College, with 60.7% of students reporting a score higher than 13, as compared to 48.6% from Sacred Heart Convent. Conclusion: These results suggest that in Pakistan, the rate of traditional bullying is higher among students of co-educational school i.e., students of both genders in the same school or college, however, they also report higher general happiness and lower risk for depression. Irrespectively, there is a need to incorporate the promotion of anti-bullying programs and promote positive health as an integral part of the curriculums in school.

A Population Based Study on the Healthcare Seeking Behaviour During the COVID-19 Outbreak

Amidst a time when there is the global pandemic of COVID-19 and high levels of stress and anxiety among people, it was pertinent to study if people have modified their health-seeking behavior. A questionnaire-based cross-sectional study was performed in Lahore to assess the change in behaviors of people before and during the pandemic. The results show that the health seeking behavior of the people has changed during the pandemic, resulting in an increased trend of self-medication and a decreased number of people visiting the hospital for their ailments. People preferred private health providers over the government facilities. This might be due to the misinformation, panic, and uncertainties spread by the social media. Governmental health care providers should consider these aspects while addressing the polices related to the pandemic.

Frequency and Distribution of Rifampicin Resistance in Mycobacterium Tuberculosis Clinical Isolates Using Gene Xpert MTB/RIF in Delta State, South-South Nigeria

The emergence and spread of multi-drug resistant-tuberculosis is a threat, which has complicated the diagnosis, management and control of tuberculosis. In addition to the simultaneous detection of Mycobacterium tuberculosis bacilli and rifampicin resistance, the Gene Xpert assay can also highlight the point of mutation if it occurs around the rifampicin resistance determination region (RRDR) of the rpoB gene, which is responsible for 95% of rifampicin resistance. This study seeks to estimate the prevalence of rifampicin resistance, determine the frequency and distribution of mutations along the rifampicin resistance determination region, and assay for the relationship that exists between these mutations and basic epidemiological variables.

Prevalence of Polycystic Ovary Syndrome Awareness Among Female Medical Students

Background: Polycystic ovary syndrome is one of the most common causes of infertility in woman, affecting 4-18% of reproductive aged women worldwide. It is characterized by hormonal imbalance leading to reproductive, metabolic and psychological dysfunction. It is a multi-organ syndrome affecting both female gonads and the pituitary gland. Polycystic ovary syndrome is idiopathic in occurrence. However, recent studies suggest that it can be caused by inherent abnormalities of ovarian steroidogenesis, follicular development, excessive gonadotropin-releasing hormone (GnRH) and luteinizing hormone (LH), and reduced follicle stimulating hormone (FSH) secretion. Objectives: To evaluate the knowledge and level of awareness of female students about polycystic ovary syndrome. To determine the prevalence of the symptoms of polycystic ovary syndrome. Methods: A cross sectional type of quantitative study was conducted following the approval from the Ethical Review Committee. The study was carried out on a sample of medical students, with a calculated sample size of 278 individuals according to the World Health Organization (WHO) formula. A questionnaire-based survey was implemented. Results: The most important question was regarding the awareness of polycystic ovary syndrome and to our interest 74.5% of the participants were aware of the disease. 42.2% of the participants gained knowledge of the disease from social media and the internet. The diagnosed cases of polycystic ovary syndrome in the sample was 11.2%, among which 41.9 % are receiving the treatment. Conclusion: The majority of the female medical students (74.5%) were aware of polycystic ovary syndrome in female medical students. 33.8% of the participants had a normal menstrual cycle of 28 days. A noticeable percentage of students had polycystic ovary syndrome and were under treatment. Our study can be further used to determine relations between polycystic ovary syndrome and a variety of factors, such as the duration of menstrual cycle, body mass index (BMI) or symptoms of this syndrome, such as the weight gain and acne.

An Interesting Case of Blood Group Switch after Breast Cancer Therapy

Blood groups are determined by specific antigens attached to red blood cells that are either carbohydrate or protein in nature. Changes in gene expression encoding for various blood types are rare, with the ABO blood group antigen most commonly altered. We report a female patient whose blood group changed from A, Rh positive to A, Rh negative, over the period of 10 years (1999-2009). During this time period, she was diagnosed with breast carcinoma and a lumpectomy was performed, followed by chemotherapy (with anthracycline and docetaxel) along with local irradiation. There has been no remission after recovery. It was noticed that the patient’s blood group had changed. A possible reason may be Rh mosaicism and a mutation in the Rh gene, resulting in the alteration of Rh antigen expression. The reason causing this mutation is unclear. However, in some cases changes in blood groups are related to patients’ chemotherapy treatment and their remission status.