Psychological impact of the COVID-19 pandemic in children with autism spectrum disorder - a literature review.

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases: PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs.

Assessment of parental satisfaction with paediatric health services in public sector tertiary hospitals within a low-income setting using Patient Satisfaction Questionnaire (PSQ-18).

INTRODUCTION: Patient satisfaction is an integral part of healthcare quality, impacting treatment adherence, patient loyalty and healthcare utilisation. Parental satisfaction is particularly crucial as parents influence decision-making for their child's healthcare. OBJECTIVE: The objective was to assess parental satisfaction levels (as measured by Patient Satisfaction Questionnaire-18 (PSQ-18)) related to paediatric healthcare services and identify specific factors significantly influencing parental satisfaction with paediatric healthcare services. METHODOLOGY: This is a descriptive cross-sectional study that used a structured questionnaire based on the PSQ-18. The study was conducted in Faisalabad, Islamabad, Peshawar and Swat. Seven subscales measured satisfaction across various dimensions. RESULTS: We found 882 suitable responses indicating a diverse participant demographic, with the largest group in the 6-12 years age category. The overall mean parental satisfaction score was 2.0±0.5 (40.0%). Notably, financial aspects scored highest at 2.8 (55%), followed by accessibility and convenience at 2.0 (40.5%). However, lower satisfaction scores in the interpersonal relationship (1.8±0.5) and technical quality (1.8±0.5) domains were recorded. Sociodemographic analysis indicated age, education and occupation significantly influenced satisfaction. Conversely, factors such as gender, residence and the presence of chronic disease did not significantly impact satisfaction levels. CONCLUSION: The study offers valuable insights into paediatric patient satisfaction in Pakistan, emphasising the need for targeted interventions and improvements in specific domains to enhance overall healthcare quality.

Proteome level analysis of drug-resistant Prevotella melaninogenica for the identification of novel therapeutic candidates.

The management of infectious diseases has become more critical due to the development of novel pathogenic strains with enhanced resistance. Prevotella melaninogenica, a gram-negative bacterium, was found to be involved in various infections of the respiratory tract, aerodigestive tract, and gastrointestinal tract. The need to explore novel drug and vaccine targets against this pathogen was triggered by the emergence of antimicrobial resistance against reported antibiotics to combat P. melaninogenica infections. The study involves core genes acquired from 14 complete P. melaninogenica strain genome sequences, where promiscuous drug and vaccine candidates were explored by state-of-the-art subtractive proteomics and reverse vaccinology approaches. A stringent bioinformatics analysis enlisted 18 targets as novel, essential, and non-homologous to humans and having druggability potential. Moreover, the extracellular and outer membrane proteins were subjected to antigenicity, allergenicity, and physicochemical analysis for the identification of the candidate proteins to design multi-epitope vaccines. Two candidate proteins (ADK95685.1 and ADK97014.1) were selected as the best target for the designing of a vaccine construct. Lead B- and T-cell overlapped epitopes were joined to generate potential chimeric vaccine constructs in combination with adjuvants and linkers. Finally, a prioritized vaccine construct was found to have stable interactions with the human immune cell receptors as confirmed by molecular docking and MD simulation studies. The vaccine construct was found to have cloning and expression ability in the bacterial cloning system. Immune simulation ensured the elicitation of significant immune responses against the designed vaccine. In conclusion, our study reported novel drug and vaccine targets and designed a multi-epitope vaccine against the P. melaninogenica infection. Further experimental validation will help open new avenues in the treatment of this multi-drug-resistant pathogen.