The role of social media in safe fasting ramadan for children and adolescents: Kuwait experience

Introduction: Fasting in Ramadan poses a risk for children with type 1 diabetes (T1D) who insist on fasting. This project was caried out during Ramadan 2021 for older children and adolescents with T1D to ensure safe fasting during the COVID -19 pandemic Objectives: Using the social media platform to ensure safe fasting during Ramadan among children and adolescents with T1D. Methods: A total of23 older children and adolescents (mean age was14.4 ± 2.95) who chose to fast during Ramadan2021 were successfully close-monitored. Among 11(52.17%) of them, insulin was administered by MDI and12(47.8%)were on IPT. Prior to starting this project, a pre-Ramadan education webinar was conducted to educate children and their family members on how to fast safely in Ramadan. The webinar was focused on the following: fasting eligibility, dose adjustment, carbohydrate counting, hypoglycemia and hyperglycemia management and glucose monitoring timing. Due to COVID-19 pandemic, the progress of the participants was tracked via a welldeveloped daily online questionnaire shared via WhatsApp to adjust the insulin doses when required. All these instructions were given to the patients in the presence of their guardians. Results: Of the total fasting days (30 days), the children were able to fast 14.57± 5.59 days, whereas 15.43±5.72 of these days were not fasted. The most common cause of breaking the fast was mild hypoglycemia events (9.2%, of all cases), followed by hyperglycemia (23.08% before Iftar) for both groups. No events of severe hypoglycemia, DKA, or hospitalization occurred. Furthermore, there was no significant difference in the average of blood glucose levels between two groups (Table 1). Conclusions: Despite the COVID-19 situation, the pediatric team managed to use the social media to deliver pre-education webinar and provided daily supervision to participants who fasted Ramadan, with the main aim of preventing severe hypoglycemia and hospitalization. (Table Presented).

Trial of 3-day kids in control of food (KICk OFF) format in Kuwait

Introduction: Kids In Control Of Food (KICk OFF) has been conducted in Kuwait since 2015. The Kuwait team adapted and modified the course to a 3-day format instead of a 5- day, due to the attendees preferences. Objectives: To pilot a modified educational program KICk-OFF for children and adolescents (11-16 years old) with T1D and to evaluate the HbA1C and weight change, when compared with usual care Methods: The team successfully conducted 4 modified courses from July- September 2019 at Damsan diabetes institute (DDI). Prior to the trial courses that were conducted;the team responded to the requests of the previous graduates by piloting a shorter format (3-day). Also, the following modifications were made: 1)Ongoing follow up individual sessions, 2) Group booster sessions 4 weeks post course,3) Sending biweekly text messages, 4) Fasting Ramadan sessions and 5) Flash glucose monitoring devices were distributed throughout the courses instead of the classical SMBG. Glycaemic control measured by HbA1c and body weight calculated by body mass index (BMI) were taken at baseline, 6, and 12 months for intervention groups and compared with controls. Results: Due to the Covid-19 pandemic, the trail outcomes were tracked up to 6months instead of 12months. For the intervention group, there was a significant reduction in mean HbA1c (n =22, pre: 9.6 ± 2.0%vs. post 8.6 ± 0.9%;P = 0.01), whereas, there was no significant BMI differences (n=22, pre 23.52±4.6 vs. post-I 23.74±4.2;P =0.8). Moreover, no episodes of severe hypoglycemia, DKA, or hospitalization occurred after 6 months for all graduates. In addition, three graduates started insulin pump therapy. Finally, there were no changes in HbA1c (n=21, pre: 9.6 ±1.9% vs. post 9.2 ±1.2%;P= 0.19) and BMI (n=21 pre22.7 ±5.6 vs. post23.1 ±5.9, P=0.37) in the control group. Conclusions: Joining a 3-day KICk-OFF Kuwait format was associated with significantly improved in Glycaemic control at 6 months compared with control group. These outcomes need to be confirmed in a study with a longer duration.

Biochemical Dynamics and Clinical Features of Novel Corona Virus (2019-nCoV)

Context . The novel Corona Virus (nCoV-19) was initially reported in Wuhan, China during December 2019, and later people with nCoV-19 were identified in different parts of the world. Infected people had shown symptoms resembling pneumonia, but about 50% of patients were asymptomatic. Objective . The study intended to examine the data from studies on nCoV-19. Design . The research team performed a literature review, searching relevant literature databases. The sources of data included bioRxiv, medRxiv, Google Scholar, Embase, PsychINFO, WanFang Data and PubMed. The search terms were novel Corona Virus, and nCoV-19 structure. Setting . The study took place in the main library of the University of Sargodha, Sargodha, Pakistan. Results . The study identified 22 studies that had reported and confirmed over 2000 cases of nCoV-19 by January 26, 2020. The studies found that the virus was transmitted through respiratory droplets. The virus has two serotypes, OC43 and 229E. Conclusions . No specific curative therapy is available for CoVid-19. However, certain precautionary measures may potentially reduce the transmission, including washing hands, using sanitizers frequently, avoiding public gatherings, and quarantining or isolating patients. This virus has spread globally and immunocompromised individuals, and especially older individuals, are at significant risk. Community and healthcare professionals have a positive role to play in controlling the spread of the disease.

The battle against Covid-19: the experience of an Egyptian radiology department in a university setting

Background: The current COVID-19 pandemic has resulted in marked and rapid changes to the standing policies of radiology departments globally. The aim of this review article is to describe the various processes implemented by a radiology department in an educational institution in a resource limited country during the COVID-19 crisis, giving insights into the adopted strategies in other institutions in developed countries. Main body: Our preparedness strategy was directed into five main domains: protection and wellness of radiology faculty and staff, radiological examinations and patients’ safety, education, research, and financial support. By implementing new strategies, we found that work reorganization through the use of home PACS provided safe and effective reporting service, low infection rate with zero mortality, and online lectures and theses defense were successful. Furthermore, governmental support and donations were helpful in facing financial challenges during the pandemic. A comprehensive literature review search for policies adopted by other radiology departments in the world was performed. The adopted strategies of various centers are generally similar to ours aiming for mitigating the spread of the virus, keeping good patients’ care, and maintaining the educational process. Few policy differences across institutions were found in the reporting strategy of COVID-19 pneumonia and according to the availability of resources. Conclusion: Covid-19 pandemic has opened the door for changes in the radiology department policies with renewed focus on educational, clinical, and scientific strategies. Documentation of the dynamic modifications of everyday practices and lessons learned are important as a reference for preparedness for possible second surge or future crisis.