Introduction Au cours des pandmies, il faut maintenir des services appropris pour les populations vivantes avec maladies chroniques. Observation Patiente btathalassmique vivante Al Hoceima, suivie Rabat et connue avec anti-Jka et anti-S. Programme le 23 mars 2020 pour une transfusion mais ne pouvant sy rendre cause de linterdiction des dplacements inter-villes instaure le 21 mars par les autorits marocaines. Elle prsente une anmie avec hmoglobine 5,8g/dL. Le CNTSH organise sa prise en charge transfusionnelle Al Hoceima et elle fut transfuse le 25 mars avec deux CGR prpars par le Centre de transfusion dOujda et livrs par le Centre de transfusion dAl Hoceima. Le 6 avril, la NFS rapporte un taux dhmoglobine 6,2g/dL. Aprs intervention du CNTSH, la patiente fut transfuse par 3 CGR prpars par le Centre de transfusion dOujda et dlivrs par le Centre de transfusion dAl Hoceima. Le 28 avril devant une anmie 5,9g/dL avec suspicion dinefficacit transfusionnelle, le CNTSH contacte la responsable du service pdiatrique du CHU dOujda pour valuation et prise en charge. Elle fut hospitalise et mise sous corticothrapie. Le gnotypage rythrocytaire ralis au Centre de transfusion de Rabat rvle quelle est Fya-. Le Centre de transfusion dOujda prpare des CGR compatibles et elle fut transfuse avec 4 CGR Jka-, S- et Fya- avec bonne volution clinicobiologique. Depuis, elle est suivie Oujda selon un protocole bien tabli. Conclusion Pendant les pandmies, les systmes de sant doivent mettre en place des programmes appropris pour assurer la continuit des soins aux patients souffrant de maladies chroniques telles que les hmoglobinopathies.

Dispersal is simply defined as the movement of species across space and time. Despite this terse definition, dispersal is an essential process with direct ecological and evolutionary implications that modulate community assembly and turnover. Seminal ecological studies have shown that environmental context (e.g., local edaphic properties, resident community), dispersal timing and frequency, and species traits, collectively account for patterns of species distribution resulting in either their persistence or unsuccessful establishment within local communities. Despite the key importance of this process, relatively little is known about how dispersal operates in microbiomes across divergent systems and community types. Here, we discuss parallels of macro- and micro-organismal ecology with a focus on idiosyncrasies that may lead to novel mechanisms by which dispersal affects the structure and function of microbiomes. Within the context of ecological implications, we revise the importance of short- and long-distance microbial dispersal through active and passive mechanisms, species traits, and community coalescence, and how these align with recent advances in metacommunity theory. Conversely, we enumerate how microbial dispersal can affect diversification rates of species by promoting gene influxes within local communities and/or shifting genes and allele frequencies via migration or de novo changes (e.g., horizontal gene transfer). Finally, we synthesize how observed microbial assemblages are the dynamic outcome of both successful and unsuccessful dispersal events of taxa and discuss these concepts in line with the literature, thus enabling a richer appreciation of this process in microbiome research.

Several African swine fever (ASF) outbreaks in domestic pigs have been reported in Burundi and Malawi and whole-genome sequences of circulating outbreak viruses in these countries are limited. In the present study, complete genome sequences of ASF viruses (ASFV) that caused the 2018 outbreak in Burundi (BUR/18/Rutana) and the 2019 outbreak in Malawi (MAL/19/Karonga) were produced using Illumina next-generation sequencing (NGS) platform and compared with other previously described ASFV complete genomes. The complete nucleotide sequences of BUR/18/Rutana and MAL/19/Karonga were 176,564 and 183,325 base pairs long with GC content of 38.62 and 38.48%, respectively. The MAL/19/Karonga virus had a total of 186 open reading frames (ORFs) while the BUR/18/Rutana strain had 151 ORFs. After comparative genomic analysis, the MAL/19/Karonga virus showed greater than 99% nucleotide identity with other complete nucleotides sequences of p72 genotype II viruses previously described in Tanzania, Europe and Asia including the Georgia 2007/1 isolate. The Burundian ASFV BUR/18/Rutana exhibited 98.95 to 99.34% nucleotide identity with genotype X ASFV previously described in Kenya and in Democratic Republic of the Congo (DRC). The serotyping results classified the BUR/18/Rutana and MAL/19/Karonga ASFV strains in serogroups 7 and 8, respectively. The results of this study provide insight into the genetic structure and antigenic diversity of ASFV strains circulating in Burundi and Malawi. This is important in order to understand the transmission dynamics and genetic evolution of ASFV in eastern Africa, with an ultimate goal of designing an efficient risk management strategy against ASF transboundary spread.

BACKGROUND: Ocular candidiasis is a known complication of candidemia. Given the poor ocular penetration of echinocandins, there is some concern that the increasing use of echinocandins may portend an increased incidence of ophthalmic complications. We examined the changing trends in antifungal prescribing patterns and the incidence of ophthalmic complications after candidemia. METHODS: Patients with blood cultures positive for Candida species between January 2014 and June 2020 who underwent screening fundoscopic examination by an ophthalmologist were analyzed. The (2) analysis was used to compare antifungal prescriptions and ocular exam findings before and after 2016. Trend analysis was also performed to assess temporal changes in prescribing practices and eye exam findings. RESULTS: There were 226 candidemia cases during the study period, 129 (57.1%) of which underwent screening eye exams. From 2014 to 2015, 24 of 37 (64.5%) patients received eye-penetrating antifungals compared to 36 of 92 (39.1%) from 2016 to 2020 (P = .008). Overall, 30 of 129 (23.3%) patients had abnormal eye exams with the prevalence of abnormal findings being 7 of 37 (18.9%) before 2016 compared to 23 of 92 (25%, P = .46) thereafter. A trend analysis revealed an increase in abnormal eye findings over the study period (P = .008). Of the 30 patients who had abnormal eye exams, 9 (30%) had a change in systemic antifungal therapy from echinocandins to eye-penetrating antifungals. Echinocandin use was associated with abnormal eye findings. CONCLUSIONS: Prescription of eye-penetrating antifungals for candidemia has trended down since 2016. This was associated with a concomitant increase in abnormal findings on screening fundoscopy. Abnormal eye exams were not uncommon throughout our study period.

Introduction: Although the efforts at global and national levels have attempted to decrease the COVID-19 pandemic, the low level of preparedness among healthcare providers is a challenge mainly in developing countries. Hence, this study is aimed at assessing the level of preparedness for COVID-19 and its associated factors among frontline healthcare providers in South Gondar public hospitals, northwest Ethiopia. Methods and Materials: A hospital-based cross-sectional study was conducted among 207 selected healthcare providers who were working in South Gondar public hospital from July 08 to August 29, 2020. A pretested structured questionnaire was used to collect data. The healthcare providers were selected through simple random sampling techniques. Both bivariable and multivariable logistic regressions with a 95% confidence interval were fitted with 95% CI to establish the associated factors with a low level of preparedness. A p value < 0.05 was considered statistically significant. Results: The overall level of preparedness among healthcare providers for COVID-19 was found to be 41.3% (95% CI: 37.4, 44.7). Only 81 (40.1%) healthcare providers had prepared for telling their family and friends if they are infected with COVID-19. Besides, only 23.8% of healthcare providers obtained alcohol-based hand sanitizer in every patient room. Factors associated with a low level of preparedness include being male (AOR = 2.5, 95% CI: 1.22-4.94), unmarried (AOR = 3.4, 95% CI: 1.44-8.00), and working experience less than five years (AOR = 3.4, 95% CI: 1.29-9.09). Conclusion: The level of preparedness among frontline healthcare providers towards COVID-19 was found to be very low. In the future, more emphasis should be placed on healthcare providers who are male, unmarried, and had working experience of lower than five years to decrease the burden of the COVID-19 pandemic.

Hemodialysis is a necessary treatment for end-stage kidney disease patients. It imposes undergoing three sessions of dialysis per week in a specialized center. Amid the SARS-CoV-2 pandemic, precautionary measures were mandatory in all dialysis facilities and may have negatively impacted patients well-being. This study aimed to uncover the scale of this effect. We performed a cross-sectional study of all patients undergoing chronic hemodialysis in two dialysis units (one urban and another rural). Patients with Alzheimers disease were excluded. Patients filled a questionnaire including information on socio-demographics, factors related to the dialysis facility, and the impact of the COVID-19 epidemic on their mental health. A total of 72 patients responded. Their median age was 70 (60.79) years. Of them, 68% were males, 71% were married, and 10% were living alone. Following the pandemic, 35% felt more anxious, with a higher incidence of anxiety in the rural unit (p=0.021). Half of them felt very limited in their relationships, and 29% were isolated from their families. In total, 98% of patients were satisfied with the staff support. The imposed preventive measures were perceived as very strict in 27% of the surveyed patients. The majority of the urban group were bothered for not eating during the session, and they felt significantly more stress than the rural group (p=0.001). The SARS-CoV-2 pandemic increased anxiety among hemodialysis patients from a rural setting. Stress was more prevalent in the urban group and most probably related to limitations in eating during sessions. The majority were satisfied with staff support.

There is agreement that the pandemic has affected the healthcare system and behaviour of patients. This study aims to identify problems encountered by patients with phenylketonuria (PKU) and their parents/caregivers during the six-week pandemic lockdown in Poland (15 March to 30 April 2020). To determine the factors that influenced health and treatment-related issues, as well as the respondents' perception of the impact of the pandemic, study participants were asked to complete a non-validated online questionnaire comprising 31 questions (including 27 single-choice, two multiple-choice and two open-ended ones). A total of 571 patients or their parents completed the questionnaire, with 9.5% of respondents not performing any blood phenylalanine (Phe) test in the analysed period, 21.3% declaring a blood Phe increase, and 15.3% a decrease. Increased problems in contacting the doctor or dietitian were reported by 26.1% of subjects, whereas 39.3% of them felt restricted access to dietary products. Most (63.4%) participants were satisfied with remote contact with their PKU clinic. Better compliance was associated with higher odds of acceptance of remote contact and of reporting fewer problems with contacting the doctor, and with lower odds of missing Phe testing. Self-reported high stress was associated with higher odds of reporting the limited availability of low-Phe products and Phe-free formulas, as well as with increased Phe concentrations and non-PKU-related health problems. These patients also had poor dietary compliance and experienced more problems in contacting specialists. Health and treatment-related problems experienced during the pandemic lockdown were related to a higher intensity of stress in patient's family and worse therapy compliance before the pandemic. Previous experience of remote visits resulted in a better perception of this method of contact. It seems that this form of communication should be popularized and improved to increase therapy effectiveness in case of different limitations in the future. Special attention should be paid to vulnerable patients who may be at extra risk when the provision of standard care is affected.

OBJECTIVE: Global outbreak of the novel coronavirus disease 2019 (COVID-19) has forced healthcare systems worldwide to reshape their facilities and protocols. Although not considered the frontline specialty in managing COVID-19 patients, neurosurgical service and training were also significantly affected. This article focuses on the impact of the COVID-19 outbreak at a low- and/or middle-income country (LMIC) academic tertiary referral hospital, the university and hospital policies and actions for the neurosurgical service and training program during the outbreak, and the contingency plan for future reference on preparedness for service and education. METHODS: The authors collected data from several official databases, including the Indonesian Ministry of Health database, East Java provincial government database, hospital database, and neurosurgery operative case log. Policies and regulations information was obtained from stakeholders, including the Indonesian Society of Neurological Surgeons, the hospital board of directors, and the dean's office. RESULTS: The curve of confirmed COVID-19 cases in Indonesia had not flattened by the 2nd week of June 2020. Surabaya, the second-largest city in Indonesia, became the epicenter of the COVID-19 outbreak in Indonesia. The neurosurgical service experienced a significant drop in cases (50% of cases from normal days) along all lines (outpatient clinic, emergency room, and surgical ward). Despite a strict preadmission screening, postoperative COVID-19 infection cases were detected during the treatment course of neurosurgical patients, and those with a positive COVID-19 infection had a high mortality rate. The reduction in the overall number of cases treated in the neurosurgical service had an impact on the educational and training program. The digital environment found popularity in the educational term; however, digital resources could not replace direct exposure to real patients. The education stakeholders adjusted the undergraduate students' clinical postings and residents' working schemes for safety reasons. CONCLUSIONS: The neurosurgery service at an academic tertiary referral hospital in an LMIC experienced a significant reduction in cases. The university and program directors had to adapt to an off-campus and off-hospital policy for neurosurgical residents and undergraduate students. The hospital instituted a reorganization of residents for service. The digital environment found popularity during the outbreak to support the educational process.

Background Forgotten Joint Score (FJS) is a patient-reported outcome measurement that evaluates patients' ability to forget the replaced joint (knee or hip) in everyday activity. This study aimed to evaluate the validity and reliability of the Persian version of this questionnaire in Iranian patients who underwent total hip arthroplasty. Methods A team of specialists reviewed this questionnaire and voted for its clarity and content validity. Then, the FJS was filled out by 100 randomly selected total hip arthroplasty patients between 2019 and 2021 with at least 6 months of follow-up. The reliability coefficient (Cronbach's alpha) was calculated. Results A total of 95 patients who met the inclusion criteria, with the mean age 59.9 11.6 years and 26.6% being female, participated in the study. Patients had no difficulty with the content and linguistic format of the Persian FJS-12. The mean FJS for these patients was 50.8 4.6. The Cronbach's alpha was measured at 0.87. The mean content validity index was 0.93. Conclusion FJS-12 can discriminate even patients with eximious pain and functional outcomes after joint reconstruction surgery. The Persian format of FJS-12 showed acceptable internal consistency using Cronbach's alpha and acceptable content validity. Therefore, it can be utilized in the Iranian population for future research studies.

The sample collection procedure for SARS-Co-V2 identification has a strong impact on diagnostic capability, contact tracing approach, ultimately affecting the infection containment performance. This study demonstrates that self-collected nasal-swab has shown to be a valid and well tolerated procedure to Sars-CoV-2 surveillance in a healthcare system. More significantly, no performance adequacy difference was detected in self-administered swabs between HCW and non-HCW which allows to speculate that this procedure could be successfully extended to the entire population for mass screening.

Nurse-led research and innovation is key to improving health experiences and outcomes and reducing health inequalities. Clinical academic training programmes for nurses to develop research and innovation skills alongside continued development of their clinical practice are becoming increasingly established at national, regional and local levels. Though widely supported, geographical variation in the range and scope of opportunities available remains. It is imperative that clinical academic opportunities for nurses continue to grow to ensure equity of access and opportunity so that the potential of nurse-led clinical academic research to improve quality of care, health experience and health outcomes can be realised. In this paper we describe and report on clinical academic internship opportunities available to nurses to share internationally, a range of innovative programmes currently in operation across the UK. Examples of some of the tangible benefits for patients, professional development, clinical teams and NHS organisations resulting from these clinical academic internships are illustrated. Information from local evaluations of internship programmes were collated to report what has worked well alongside 'real-world' set-up and sustainability challenges faced in practice. Clinical academic internship schemes are often opportunistically developed, making use of hybrid models of delivery and funding responsive to local needs and available resources. Key enablers of successful clinical academic internship programmes for nurses were support from senior clinical leaders and established relationships with local universities and wider organisations committed to research capacity building.

Objectives: Music-based interventions have received growing attention to improve quality of life for people diagnosed with dementia. Results of randomized controlled trials and meta-analytic reviews to date, however, reveal a lack of conclusive evidence for or against the effectiveness of such interventions. Herein, we critically review the basic assumptions and methodological issues ingrained in the cultures of research and care as they relate to evaluating music-based treatments for people with dementia, and propose a shift in the methodology by which music interventions are empirically evaluated.Method: We begin by reviewing existing barriers to achieving clarity on the effectiveness of music interventions, and we highlight methodological and sociocultural constraints that have limited our ability to reach concrete conclusions in research studies to-date. We then consider several key factors that have demonstrated relevance in matching people to specific music-based interventions. Based on these key factors, we developed a person-centered framework integrating elements from precision-medicine methodology to guide intervention studies.Results: Our organizing framework systematically integrates the following factors to inform the design of intervention studies: 1) person-centered goals and desired outcomes; 2) differences among individuals in clinical, cognitive, and historical attributes; and 3) the context of intervention and access to resources.Conclusion: Integration of the proposed framework into empirical investigations of music interventions for people living with dementia will inform precise and tailored interventions that will bring clarity to this growing body of research. Another aim of this framework is to foster a more humane, person-centered approach to our culture of care.

Intraocular pressure (IOP) is the most important risk factor for glaucoma development and progression. Most anti-glaucoma treatments aim to lower IOP by enhancing aqueous humor drainage from the eye. Aqueous humor drainage occurs via well-characterized trabecular meshwork (TM) and uveoscleral (UVS) pathways, and recently described ciliary body lymphatics. The relative contribution of the lymphatic pathway to aqueous drainage is not known. We developed a sheep model to quantitatively assess lymphatic drainage along with TM and UVS outflows. This study describes that model and presents our initial findings. Following intracameral injection of (125)I-bovine serum albumin (BSA), lymph was continuously collected via cannulated cervical lymphatic vessels and the thoracic lymphatic duct over either a 3-h or 5-h time period. In the same animals, blood samples were collected from the right jugular vein every 15 min. Lymphatic and TM drainage were quantitatively assessed by measuring (125)I-BSA in lymph and plasma, respectively. Radioactive tracer levels were also measured in UVS and "other" ocular tissue, as well as periocular tissue harvested 3 and 5 h post-injection. Tracer recovered from UVS tissue was used to estimate UVS drainage. The amount of (125)I-BSA recovered from different fluid and tissue compartments was expressed as a percentage of total recovered tracer. Three hours after tracer injection, percentage of tracer recovered in lymph and plasma was 1.64% 0.89% and 68.86% 9.27%, respectively (n = 8). The percentage of tracer in UVS, other ocular and periocular tissues was 19.87% 5.59%, 4.30% 3.31% and 5.32% 2.46%, respectively. At 5 h (n = 2), lymphatic drainage was increased (6.40% and 4.96% vs. 1.64%). On the other hand, the percentage of tracer recovered from UVS and other ocular tissue had decreased, and the percentage from periocular tissue showed no change. Lymphatic drainage increased steadily over the 3 h post-injection period, while TM drainage increased rapidly - reaching a plateau at 30 min. This quantitative sheep model enables assessment of relative contributions of lymphatic drainage, TM and UVS outflows, and may help to better understand the effects of glaucoma agents on outflow pathways.

In recent decades, the prevalence of childhood depression and obesity has increased worldwide. African American (AA) children are more obese than White peers and experience many factors that can influence the onset of depressive symptoms. While depression and obesity have been examined in adolescents, there is a paucity of research in AA children. This study examined the relationships among depressive symptoms, obesity, and physical activity self-efficacy in AA children. A community sample of 65 AA children completed questionnaires for depressive symptoms and physical activity self-efficacy and also had body mass index (BMI) and BMI Z-scores calculated. Correlational statistics were used to examine associations between variables. Clinically significant total depression scores were present in 22% of children, while 48% were overweight or obese. Overall, children reported high physical activity self-efficacy. Higher depressive symptoms were associated with higher BMI Z-scores. Results also indicated significant correlations between the childrens physical activity self-efficacy and depressive symptoms. Findings suggest that the associations between depressive symptoms, BMI, and physical activity self-efficacy in AA children merit additional examination. Early identification of depression in children may inform future approaches to treatment of psychological and physiological problems within the clinical setting. Screening for childhood depressive symptoms in primary care settings, especially those that specifically treat childhood obesity, can be instrumental in early identification of children with depression. Healthcare providers should be knowledgeable of the clinical presentation of depression and engaged in depression screening.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) surveillance can be enhanced by collecting population-level data on individual prevention measures. We described the use of a state-based, population-level surveillance system on COVID-19 prevention and information-seeking behaviors in Florida during the first month of survey administration. METHODS: Beginning in April 2020, respondents of the Florida Behavioral Risk Factor Surveillance System were asked a series of 8 questions about sources of COVID-19 information and prevention behaviors. We analyzed the prevalence of information-seeking and prevention behaviors among respondents who answered at least 1 of the 8 questions (N = 1,004) overall, by demographic characteristics, and by the presence of chronic conditions. RESULTS: Most respondents reported engaging in prevention behaviors, including handwashing (98.2%), reducing or avoiding travel (96.6%), avoiding crowds and public events (96.5%), and keeping household members at home (87.5%); however, the prevalence of prevention behaviors varied significantly by age, sex, and education. The most frequently reported source of COVID-19 information was the Centers for Disease Control and Preventions website (40.8%) followed by the Florida Department of Healths website (32.9%). We found significant differences in information sources across all demographic and chronic condition subgroups. A larger proportion of respondents with chronic conditions (vs without chronic conditions) reported consulting their personal doctor for COVID-19 information. CONCLUSION: Understanding the uptake and characteristics associated with individual prevention and information-seeking behaviors at the population level facilitates COVID-19 response efforts. The rapid implementation of COVID-19Crelated questions in the Florida BRFSS provides a useful model for other population-based surveillance systems.

BACKGROUND: Coronavirus disease-19 (COVID-19) disease affects all age groups, especially the elderly, and regarding the high mortality rate among the elderly, preventive measures are needed to reduce mortality in the elderly AIM: This study was conducted to investigate the causes of in elderly people leaving home in time of COVID-19 epidemic METHODS: The present study is a descriptive-analytical study performed on 1656 elderly people in Urmia, Iran, by simple random sampling method The data collection tool in this study was a researcher-made questionnaire that included demographic characteristics, a questionnaire on the causes of the elderly leaving home during the COVID-19 epidemic Data were analyzed using Chi-square and Fisher tests using SPSS 23 software RESULTS: The results revealed that the highest concern of the elderly to leave home was to receive health services (45 89%) such as visiting the doctor or the caregiver, receiving medication, and so on As the second priority, buying daily necessities such as bread, food, clothes (42 75%) was one of the reasons for the elderly to leave home Furthermore, education, gender, age, underlying diseases, occupation, and living conditions of the elderly were related to the needs of health services and living necessities and this relationship was statistically significant (p &lt; 0 05) CONCLUSION: Effective interventions should be designed based on the causes of the elderly leaving home, including the use of home distance care and health ambassadors to estimate the needs and causes of leaving home Therefore, the elderly would be protected from this disease and its mortality ? 2020 Morad Ali Zareipour, Ali Sadaghianifar, Najaf Ahmadi Aghziyarat, Mina Tasouji Azari, Monireh Rezaee Moradali

BACKGROUND Clinically meaningful pain reduction with respect to severity and the adverse events of drugs used in prehospital pain management for children are areas that have not received sufficient attention. The present systematic review therefore aims to perform a comprehensive search of databases to examine the preferable drugs for prehospital pain relief in paediatric patients with acute pain, irrespective of aetiology. METHODS The systematic review includes studies from 2000 and up to 2020 that focus on children's prehospital pain management. The study protocol is registered in PROSPERO with registration no. CRD42019126699. Pharmacological pain management using any type of analgesic drug and in all routes of administration was included. The main outcomes were (1) measurable pain reduction (effectiveness) and (2) no occurrence of any serious adverse events. Searches were conducted in PubMed, Medline, Embase, CINAHL, Epistemonikos and Cochrane library. Finally, the risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist and a textual narrative analysis was performed due to the heterogeneity of the results. RESULTS The present systematic review on the effectiveness and safety of analgesic drugs in prehospital pain relief in children identified a total of eight articles. Most of the articles reviewed identified analgesic drugs such as fentanyl (intranasal/IV), morphine (IV), methoxyflurane (inhalational) and ketamine (IV/IM). The effects of fentanyl, morphine and methoxyflurane were examined and all of the included analgesic drugs were evaluated as effective. Adverse events of fentanyl, methoxyflurane and ketamine were also reported, although none of these were considered serious. CONCLUSION The systematic review revealed that fentanyl, morphine, methoxyflurane and combination drugs are effective analgesic drugs for children in prehospital settings. No serious adverse events were reported following the administration of fentanyl, methoxyflurane and ketamine. Intranasal fentanyl and inhalational methoxyflurane seem to be the preferred drugs for children in pre-hospital settings due to their ease of administration, similar effect and safety profile when compared to other analgesic drugs. However, the level of evidence (LOE) in the included studies was only three or four, and further studies are therefore necessary.

OBJECTIVE: Guillain-Barr syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy that is often related to a previous infectious exposure. GBS emerged as a potentially serious complication of coronavirus disease 2019 (COVID-19) since its declaration as a global pandemic. We report the first case from Kuwait, to the best of our knowledge. CLINICAL PRESENTATION: A 72-year-old male presented with 3 weeks history of acute progressive and ascending lower limbs weakness. He developed these symptoms 3 weeks after testing positive to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Electrophysiological studies showed acute demyelinating polyradiculoneuropathy and cerebrospinal fluid showed protein-cell dissociation. He was successfully treated with intravenous immunoglobulins (IVIGs). CONCLUSION: Neurologists should be aware of GBS as a potentially serious complication associated with CO-VID-19. Our patient had a favorable outcome with IVIG with no autonomic or respiratory affection.

OBJECTIVE: To detect association of lymphopenia with disease severity and mortality. METHODS: Total 874 COVID RT-PCR positive patients admitted to KRL Hospital Islamabad from April 2020 to August 2020 were included in this cross-sectional study. Lymphopenia was defined as <1100 cells/microCL. WHO categories for disease severity were used. Demographic profile, absolute lymphocyte counts and co-morbidities were recorded. Pearsons Chi Square test was used to see association between lymphopenia and disease severity as well as disease outcome. Regression analysis was used to see whether lymphopenia would predict disease severity. Comparison of means of absolute lymphocyte count in different disease categories was done by ANOVA. Tukeys test range was then used to find the means different from each other. P-value 0.05 was considered statistically significant RESULTS: The mean age of patients was 40 12.3 years. Majority patients (73.9%) were asymptomatic. Lymphopenia was present in 6.9% of total patients. Significant association was found between lymphopenia and disease severity as well as lymphopenia and mortality (< 0.001). Lymphopenia was found to be a predictor of disease severity using regression analysis (< 0.001). Comparison of mean absolute lymphocyte count was significant among disease severity categories (< 0.001). On post-hoc analysis, difference in absolute lymphocyte count was significant moving from asymptomatic to mild and then moderate disease category. However no significant difference was seen in absolute lymphocyte count between moderate and severe categories. CONCLUSION: Results are compatible with worldwide studies and lymphopenia is valid as a marker of disease severity and mortality.

BACKGROUND: Web-based research allows cognitive psychologists to collect high-quality data from a diverse pool of participants with fewer resources. However, web-based testing presents unique challenges for researchers and clinicians working with aging populations. Older adults may be less familiar with computer usage than their younger peers, leading to differences in performance when completing web-based tasks in their home versus in the laboratory under the supervision of an experimenter. OBJECTIVE: This study aimed to use a within-subjects design to compare the performance of healthy older adults on computerized cognitive tasks completed at home and in the laboratory. Familiarity and attitudes surrounding computer use were also examined. METHODS: In total, 32 community-dwelling healthy adults aged above 65 years completed computerized versions of the word-color Stroop task, paired associates learning, and verbal and matrix reasoning in 2 testing environments: at home (unsupervised) and in the laboratory (supervised). The paper-and-pencil neuropsychological versions of these tasks were also administered, along with questionnaires examining computer attitudes and familiarity. The order of testing environments was counterbalanced across participants. RESULTS: Analyses of variance conducted on scores from the computerized cognitive tasks revealed no significant effect of the testing environment and no correlation with computer familiarity or attitudes. These null effects were confirmed with follow-up Bayesian analyses. Moreover, performance on the computerized tasks correlated positively with performance on their paper-and-pencil equivalents. CONCLUSIONS: Our findings show comparable performance on computerized cognitive tasks in at-home and laboratory testing environments. These findings have implications for researchers and clinicians wishing to harness web-based testing to collect meaningful data from older adult populations.