Journal of Ideas in Health (JIDHealth)
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The perception of biopsychosocial impacts of COVID-19 during lockdown restrictions over time in the UK – a mixed methods study
Get PDFBackground: The COVID-19 pandemic has profoundly impacted the health of individuals physically, mentally, and socially. This study aims to gain a deeper understanding of this impact across the pandemic from a biopsychosocial stance.
Methods: A survey created by the research team was employed between November 2020 and February 2021 across social media, relevant organizations, and networks. The survey incorporated 5-time points across the different stages of the pandemic, covering biological, psychological, and social. There were 5 items for each survey (Very Positive affect to Very Negative affect), and analysis was undertaken using SPSS version 16. Descriptive statistics and non-parametric Friedman and Wilcoxon Tests, as well as correlations between the three domains, were implemented.
Results: This study included 164 participants (77.0% female and 35.0% male) across 24 out of 38 counties in the UK. The impact of COVID-19 on biological domain was significant across the five data points χ2(4) = 63.99, p < 0.001, psychological χ2(4) = 118.939, p <0.001 and socially χ2(4) = 186.43, p <0.001. Between the 5 data points, 4 out of 5 had a negative impact, however between the first stage of lockdown and the easing of restrictions, findings for biological (Z=-2.35, p <0.05), psychological (Z=-6.61, p < 0.001), and socially (Z = -8.61, p <0.001) were positive. Negative correlations between the three domains across the pandemic are apparent, but in later stages, the biological domain had a positive correlation r = 0.52, p < 0.001.
Conclusion: The data shows a negative impact from the self-reported perception of wellbeing from a biopsychosocial stance over time, as well as perceiving the three domains to interact negatively. To address these biopsychosocial issues, the research implies a place-based integrated recovery effort is needed, addressing biological, psychological, and social issues simultaneously. Further research should investigate biopsychosocial health among a more generalizable population
Predictive accuracy of blood inflammatory markers on COVID-19 mortality
Get PDFBackground: The impact of COVID-19 may be more severe in developing countries. Our study aims to analyze the accuracy of several inflammatory biomarkers in predicting COVID-19 mortality, providing information about the most suitable markers for developing countries.
Methods: A retrospective cohort study was conducted at Dr. Soetomo General Hospital, Indonesia, from March to June 2020. White Blood Cells (WBC) count, Neutrophil-Lymphocyte Ratio (NLR), Procalcitonin (PCT), D-Dimer, and C-Reactive Protein (CRP) have been collected from the electronic medical records. We performed survival analysis to provide the hazard ratio and Receiver Operating Characteristic (ROC) curve analysis to test for accuracy for each parameter.
Results: A total of 423 patients who met the criteria for participating had a median age of 54 (IQR 45-61) years. Patients in the death group are characterized by older age and shorter length of hospitalization. The WBC, NLR, PCT, D-Dimer, and CRP are found significantly higher in the death group (P=0.000). The WBC, NLR, PCT, D-Dimer, and CRP have an Area Under the Curve (AUC) of 0.709, 0.773, 0.738, 0.721, and 0.769, respectively moderate accuracy in predicting COVID-19 patient mortality. We found that NLR is significantly more accurate than the age parameter (Z=3.527; P=0.000) but has equal accuracy with other laboratory parameters.
Conclusions: Since NLR obtained the highest accuracy, we still recommend routine complete blood count tests as prognostic biomarkers with the highest feasibility to be performed in developing countries
Evaluation of health system in Iraq from people\u27s point of view: a comparative study of two different eras
Get PDFBackground: Since the 2003 United States–British coalition military invasion, Iraq has been in a state of continuous deterioration at all levels, including the health sector. This study aimed to elicit the viewpoints of the Iraqi people on the current health system, focusing on many provided health services and assessing whether the public prefers the current health system or that was provided before the invasion.
Methods: A cross-sectional survey designed to explore the Iraqi people’s opinions on their health system. A self-administered questionnaire using a multi-stage sampling technique was distributed in five geographical regions in Iraq to collect the data from the head of household between 1st October and 31st of December 2019. Multiple logistic regressions were recruited to determine the significant contributing variables in this study.
Results: A total of 365 heads of households (response rate: 86.1%) with the mean age of 48.36 + 11.92 years (ranged 35-78) included in the study. Most of the respondents (61.4%) complained of healthcare inaccessibility, 59.7% believed that health resources were not available, 53.7% claimed a deterioration in the quality of care, and 62.2% believed that the political / media position did not contribute to positive changes during the past two decades. Indeed, most respondents (66.0%) believe that the current healthcare system is worse than before. In the multivariate analysis, there was a statistically significant relationship between the characteristics and opinions of the respondents. Old age group (p = 0.003), men (p = < 0.001), married (p = 0.001), low educated (p = < 0.001), rural resident (p = < 0.001), unemployed (p = 0.003), monthly income of less than USD 400 (p = < 0.001), consider themselves to be unhealthy (p = 0.001), and those who think that people are unhappy now than two decades ago (p = 0.012) have a more negative opinion of the health system.
Conclusion: Most Iraqis surveyed expressed disappointment from the health system after the 2003 United States–British Coalition military invasion. The current health system is faltering at all levels and does not meet the citizens\u27 basic needs. Health Transformation Program (HTP) has become inevitable to develop an accessible, affordable, high-quality, efficient, and effective health system
Prioritization of resource allocation amid the COVID-19 outbreak response in Nigeria
Get PDFThe COVID-19 pandemic has revealed the massive shortcomings of health systems globally, particularly in Nigeria with weak healthcare infrastructure, high population, and chronic high morbidity and mortality from the double burden of infectious and non-infectious causes. Many routine and elective services were suspended or withdrawn, and existing delivery approaches adapted to the evolving COVID-19 pandemic across all the states in Nigeria. Preventive programs such as screening were completely suspended. The vaccination schedules were missed for many children due to the closure of the immunization clinics. Many Nigerian children being liable to infections, alongside a reduction in the possibility of child survival. Funds to manage the COVID-19 pandemic were donated from internal organizations and corporate agencies. However, the modalities involved in the disbursement of these funds were not publicly revealed by the Nigerian government. Therefore, we recommend optimal allocation of inadequate health resources in ways that maximize health care delivery benefits to the greatest number of people, give priority to the worst off, ensure equality and promote continued care provision for non-COVID-19 conditions, including pregnancy and chronic conditions. To ensure the improved trust of Nigerians and donor agencies and organizations, accountability on all funds should be ensured by the Nigerian government. For this cause, such funds should be committed into the hands of trustworthy and expert finance managers and infectious disease experts
Renin-angiotensin-aldosterone system inhibitors – a realm of confusion in COVID-19
Get PDFCurrently, there is a persisting dispute regarding the renin-angiotensin-aldosterone-system (RAAS) inhibitors\u27 safety of use in COVID-19 pandemics. On one side, RAAS inhibitors appear to determine an overexpression of ACE2, the receptor of SARS-CoV-2. Therefore, they could increase the risk of SARS-CoV-2 infection and its degree of severity. On the other side, the discontinuation of RAAS leads to cardiovascular decompensation and has been discouraged by the major medical societies. Also, large-cohort studies report beneficial or at least neutral effects for the RAAS inhibitors in COVID-19 patients. Worldwide, millions of patients receive RAAS inhibitors for the treatment of hypertension and other important comorbidities. In this context, knowledge of the exact effect of these medications becomes of crucial significance. This paper aims to fill in a gap in the current knowledge and presents a putative mechanism by which RAAS inhibitor administration\u27s beneficial results can be explained better. RAAS inhibitors can be beneficial, as they counteract the excessive detrimental activation of the classical angiotensin-converting enzyme (ACE) axis, decreasing the angiotensin II levels. The angiotensin receptor blockers (ARBs) increase the angiotensin II levels, while the angiotensin-converting enzyme inhibitors (ACEI) increase the angiotensin I levels; these substrates will compete with the SARS-CoV-2 for the ACE2 binding, decreasing the viral infectivity. In addition, following the RAAS inhibitors treatment, the up-regulated ACE2 will cleave these substrates (angiotensin I and II), particularly to angiotensin 1-7 that possesses vasodilator, protective effects
Assumption of heparin-induced thrombocytopenia in mucopolysaccharidoses
Get PDFBackground: Mucopolysaccharidoses (MPSs) are a group of lysosomal storage diseases, resulted from glycosaminoglycans’ breakdown failure (GAGs). The study aims to determine the presence of thrombocytopenia, its prevalence, clinical implication, and correlation with the types of MPSs and with the types of glycosaminoglycans storage.
Methods: A retrospective cross-sectional study of complete blood count data was conducted among 108 children with a confirmed diagnosis of MPS in the National Medical Research Center for Children\u27s Health, Moscow, Russian Federation. STATISTICA 10 (Stat Soft, Inc. 1984-2011) was used for statistical analysis. A p-value of ≤0.05 was considered significant.
Results: The median age of children was 65 [IQR: 41; 102] months, range: 3 – 102 months. The male to female ratio was 3:1. The prevalence of fluctuating or persistent thrombocytopenia in all children with MPS was 19.0%. Thrombocytopenia occurred in patients with MPS I (14.0%), II (19.0%), and III (31.0%). Neither of the patients with MPS IV nor VI demonstrated low platelet count. There was a non-significant predominance (P=0.068) of thrombocytopenia frequency in patients with heparan sulfate storage (22.0%) compared with patients without heparan sulfate burden (0%).
Conclusion: Routine checkups of patients with MPSs must include complete blood count with platelet measurement. Cases of thrombocytopenia that requiring treatment, immunomodulatory/ immunosuppressive therapy should be considered. Further research is needed to look for the laboratory confirmation of autoimmune variants of HIT in patients with MPS I, II, III
Prevalence and correlates of geriatric depression in a rural community in Kerala, India
Get PDFBackground: Elderly constitutes a vulnerable group for depression, as they are especially prone to suffer adverse consequences of a depressive episode and have greater rates of completed suicides. This study aims to estimate the prevalence and determinants of geriatric depression.
Methods: A cross-sectional study was done among 250 elderlies from 1st January 2019 to 1st January 2020 in the different rural blocks of Ernakulam district, India. The multistage sampling technique and the Geriatric Depression Scale (GDS-30) were used to collect the data. A score of 0 9 is considered "normal", 10 19 is labeled as "mildly depressed", and 20 30 as "severely depressed". Statistical analysis was performed using the IBM SPSS software. The Chi-square test /Fisher\u27s exact test was used to study the association between the socio-demographic and behavioral variables with depression.
Results: The mean age was 69.33 ± 7.41years and male: female ratio was 0.55: 1.The overall prevalence of depression was 52.4%. Advanced age over 70years [OR=2.04;95% CI, 1.227 – 3.394; P=0.006], female gender[OR=2.844;95% CI,1.663-4.865; P =<0.001], lack of gainful employment [OR=3.504; 95% CI, 1.833–6.699; P =<0.001], physical dependence [OR=0.365;95% CI,0.162–0.821; P =0.012], financial dependence [OR=0.388; 95% CI, 0.219–0.687; P =<0.001], presence of medical co morbidities [OR=0.428; 95% CI, 0.212–0.866; P =0.016],poor lifestyle including the lack of regular exercise [OR =2.020; 95% CI,1.174–3.473; P =0.010], addiction to alcohol [OR=4.932;95%CI,1.600-15.208; P =0.004] and addiction to tobacco smoking [OR=2.905;95%CI,1.273-6.628; P =0.009] and poor family support [OR= 5.180;95% CI,716–15.636; P = 0.002] were found to be significantly associated with depression.
Conclusion: The prevalence of depression among the elderlies was high, and hence early diagnosis and prompt treatment are essential to reduce its burden in the community
Laboratory manifestations of COVID-19 associated with hemostatic abnormalities
Get PDFHemostatic abnormalities had been reported in COVID-19 patients, which may include disseminated intravascular coagulation (DIC), hypercoagulability, and alterations in platelets parameters. Articles that investigate the alterations of hemostatic abnormalities during the COVID-19 disease (2020-2021) and their predictive value of disease outcome have been thoroughly reviewed. Among the reviewed articles, thrombocytopenia is observed in 5.0-41.7% of COVID-19 patients, which is related to disease severity. Moreover, other platelets parameters, including Platelets/lymphocytes ratio (PLR), Mean platelets volume (MPV), and aggregation, may also be affected. On the other hand, findings of coagulation tests such as D dimer; fibrinogen, Antithrombin (AT), and Fibrin degradation products (FDP) are significantly elevated in COVID-19 patients, while in a single study, most of the patients had positive Lupus anticoagulants (LA) and normal protein C (PC). In the same perspective, these alterations showed significant correlations with disease severity. Overall, hemostatic laboratory markers are significant predictors of COVID-19 disease outcome as indicated by the increased risk of venous and arterial thrombotic events, especially in ICU patients.
 
Nutraceutical management of male infertility-towards new generation therapeutics
Get PDFInfertility is one of the most significant public health-related concerns globally. Both male and female factors can cause it. Male factors include poor sperm quality, idiopathic oligospermia, asthenozoospermia, and isolated asthenozoospermia. Many substances, collectively known as nutraceuticals, have been studied for their capacity to enhance hormonal state and sperm parameters through different mechanisms. Nutraceuticals are components in dietary supplements prescribed to prevent or treat a wide range of diseases. This article aims to highlight certain nutrients that can help improve male fertility based on recent advancements in the management of male infertility
On revisiting vital signs IoT sensors for COVID-19 and long COVID-19 monitoring: a condensed updated review and future directions
Get PDFBackground: Although the world has been facing the COVID-19 pandemic for over a year, we understand that there are still some challenges in using Internet of Things (IoT) devices as allies in this fight. Among the main difficulties, we can mention the selection of appropriate devices and the correct measurement and subsequent analysis of previously obtained vital signs.
Methods: In this context, we present a condensed compilation of IoT devices to monitor the vital signs often used to monitor COVID-19. We focus on easy-to-use devices currently available on the market to the general user. Also, the presented analysis is helpful for long COVID-19 monitoring, which is particularly useful to governments and hospitals to analyze eventual sequels on those citizens who tested positive beforehand.
Results: The review resulted in 148 heterogeneous devices offering different capabilities. Our first contribution resides in detailing several aspects of each IoT device, indicating which are the most suitable for particular use-case situations. Moreover, our article introduces some challenges and insights into assembling a smart city composed of IoT devices.
Conclusion: Here, technological trends such as Serverless computing, homomorphic cryptography, Federated Learning, Elixir programming language, Web Assembly, and vertical elasticity are discussed towards enabling vital sign-driven data capturing and processing. Although there are several IoT devices for health monitoring, there is still work to standardize data formats and APIs for data extraction