Evaluation of the Effect of Early-Onset Steroid Treatment in the COVID-19-Positive Pregnant Women on Pregnancy Outcomes.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Acute respiratory distress and preterm delivery are the two major complications induced by SARS-CoV-2 infection during pregnancy. In the presence of dyspnea, the use of systemic corticosteroids was recommended in pregnant and non-pregnant groups. Our primary aim was to investigate the effect of early-onset steroid treatment on mortality and adverse effects in pregnant women with COVID-19. Our secondary aim was to investigate the effect of steroid treatment on the length of hospital stay and intensive care unit (ICU) stay, and duration of treatment. The study also investigated infection, preterm birth, and ideal body weight (lbw) in newborns. METHODS: In this retrospective study, 253 patients were divided into three groups according to steroid administration. In Group 1 patients (n:112), treatment was started at the time of hospitalization. In Group 2 patients (n:90), treatment was started at least 24 h after hospitalization. Group 3 consisted of patients (n:51) who did not receive steroid treatment. Methylprednisolone (32 mg/day) was given to pregnant patients with a gestational age below 24 weeks or above 34 weeks, and dexametazone (6 mg/day) was given in four doses followed by 32 mg/day methylprednisolone for the others (whose baby was at a gestational age of 24 weeks and above but less than 34 weeks). RESULT: The hospital stay, ICU stay, and steroid administration time were significantly lower in the Group 1 when compared to the others (p < 0.05). The steroid treatment requirement was 4.4 days in Group 1 and 5.7 days in Group 2 (p < 0.05). While no death was observed in Group 1, one patient died in Group 2 and three patients died in Group 3. There was no difference between the groups in terms of complications, including preterm labor. CONCLUSIONS: No death was also observed with early-onset treatment. Early-onset treatment may be beneficial for fewer hospitalizations, fewer ICU stays, and less mechanical ventilation requirement in pregnant women with COVID-19. In addition, with early treatment, the total number of steroid administration days was reduced, which is important in terms of reducing the risk of side effects.

A mathematical model of mobility-related infection and vaccination in an epidemiological case.

In this study, we established a system of differential equations with piecewise constant arguments to explain the impact of epidemiological transmission between different locations. Our main goal is to look into the need for vaccines as well as the necessity of the lockdown period. We proved that keeping social distance was necessary during the pandemic spread to stop transmissions between different locations and that re-vaccinations, including screening tests, were crucial to avoid reinfections. Using the Routh-Hurwitz Criterion, we examined the model's local stability and demonstrated that the system could experience Stationary and Neimark-Sacker bifurcations depending on certain circumstances.

Modeling a SEIVRS dynamic behavior with transportation-related transmissionEstablishing a system of two urban as differential equations with piecewise constant argumentsStability analysis of disease-free and co-existing equilibrium pointsAnalyzing bifurcation types around the disease-free and co-existing equilibrium points.Illustrating numerical scenarios that were applied during the pandemic event.

Diagnostic approach of tuberculous lymphadenitis in a multicenter study.

INTRODUCTION: Tuberculous lymphadenitis (TBLN) is the most common infectious etiology of peripheral lymphadenopathy in adults, in Turkiye. This study aimed to identify the demographic, clinical, and laboratory variables that differentiate TBLN from non-tuberculous lymphadenitis (NTBLN), as well as the etiology of lymphadenopathy in adults. METHODOLOGY: Patients who were over 18 years old and were referred to the infectious disease outpatient clinics with complaints of swollen peripheral lymph nodes, and who underwent lymph node biopsy between 1 January 2010 and 1 March 2021, were included in this multicenter, nested case-control study. RESULTS: A total of 812 patients at 17 tertiary teaching and research hospitals in Turkiye were included in the study. TBLN was the most frequent diagnosis (53.69%). The proportion of patients diagnosed with TBLN was higher among females; and among those who had a higher erythrocyte sedimentation rate, positive purified protein derivative test, and positive interferon-gamma release test result (p < 0.05). However, TBLN was less frequent among patients with generalized lymphadenopathy, bilateral lymphadenopathy, axillary lymphadenopathy, inguinal lymphadenopathy, hepatomegaly, splenomegaly, leukocytosis, and moderately increased C reactive protein levels (p < 0.05). CONCLUSIONS: Identifying the variables that predict TBLN or discriminate TBLN from NTBLN will help clinicians establish optimal clinical strategies for the diagnosis of adult lymphadenopathy.

A mathematical model of COVID-19 and the multi fears of the community during the epidemiological stage.

Within two years, the world has experienced a pandemic phenomenon that changed almost everything in the macro and micro-environment; the economy, the community's social life, education, and many other fields. Governments started to collaborate with health institutions and the WHO to control the pandemic spread, followed by many regulations such as wearing masks, maintaining social distance, and home office work. While the virus has a high transmission rate and shows many mutated forms, another discussion appeared in the community: the fear of getting infected and the side effects of the produced vaccines. The community started to face uncertain information spread through some networks keeping the discussions of side effects on-trend. However, this pollution spread confused the community more and activated multi fears related to the virus and the vaccines. This paper establishes a mathematical model of COVID-19, including the community's fear of getting infected and the possible side effects of the vaccines. These fears appeared from uncertain information spread through some social sources. Our primary target is to show the psychological effect on the community during the pandemic stage. The theoretical study contains the existence and uniqueness of the IVP and, after that, the local stability analysis of both equilibrium points, the disease-free and the positive equilibrium point. Finally, we show the global asymptotic stability holds under specific conditions using a suitable Lyapunov function. In the end, we conclude our theoretical findings with some simulations.

Evaluation of clinical and laboratory findings in severe group COVID-19 pregnants without comorbidity.

BACKGROUND: COVID - 19 disease may be seen with different clinical presentations in pregnant women. Comorbid diseases are important factors affecting the progression of this disease. In this study, we aimed to evaluate the clinical and laboratory findings in pregnant women with COVID - 19 who had no comorbid disease. METHODS: This retrospective designed study included 217 patients with Covid PCR positive in typically COVID - 19 clinic. The patients were classified into asymptomatic, nonsevere, and severe disease groups. The symptoms, laboratory results, hospital followups and intensive care records of the patients and the findings of new borns are presented. RESULTS: Most of the patients (78%) were in the third trimester of pregnancy, and 103 patients in the study group had severe disease. Fever in the non-severe group and respiratory distress in the severe group were the most common symptoms in the patients. The severe clinical manifestations were specifically observed in the third trimester patients. In the severe group, neutrophil, lactat dehydrogenase, ferritin, CK - MB, IL - 6, and hospital stay were statistically higher than those in other groups (p < 0.05). Increase in BUN and creatine were the most predictive parameters in intensive care admission. While the intensive care unit (ICU) requirement was higher in patients in the severe group, premature birth was observed more frequently in the severe group (p < 0.05) .

A fractional-order model of COVID-19 considering the fear effect of the media and social networks on the community.

Since December 2019, the world has experienced from a virus, known as Covid-19, that is highly transmittable and is now spread worldwide. Many mathematical models and studies have been implemented to work on the infection and transmission risks. Besides the virus's transmission effect, another discussion appears in the community: the fear effect. People who have never heard about coronavirus, face every day uncertain and different information regarding the effect of the virus and the daily death rates from sources like the media, the medical institutions or organizations. Thus, the fear of the virus in the community can possibly reach the point that people become scared and confused about information polluted from different networks with long-term trend discussions. In this work, we use the Routh-Hurwitz Criteria to analyze the local stability of two essential critical points: the disease-free and the co-existing critical point. Using the discretization process, our analysis have shown that one should distinguish between the spread of "awareness" or "fear" in the community through the media and others to control the virus's transmission. Finally, we conclude our theoretical findings with numerical simulations.

Maternal deaths due to COVID-19 disease: The cases in a single center pandemic hospital in the south east of Turkey.

Coronavirus-19 disease is still a pandemic health problem and uncertainty in the management of severe or critically ill pregnant women confuses continually the obstetricians. The nationwide maternal mortality rate due to covid-19 still has not been presented in any study in Turkey. The study includes four maternal mortality cases in a referral single pandemic center in our country. Case 1, a 34-year-old, 34 weeks of gestation with moderate disease. The cesarean section was performed due to nonreassuring nonstress tests. She died on the postpartum seventh day. Case 2, a 37-year-old, at 36 weeks of gestation. The symptoms consisted of dry cough, shortness of breath and labor pain, and 3 cm cervical opening. Her second cesarean section was performed and she died at postpartum ninth day. Case 3, 33 years old, 33 weeks of gestation with moderate/severe stage of the disease. A few days after the treatment, CS was performed due to her severe condition and she died at postpartum 15th day. Case 4, 39 years old, 35 weeks of gestation, she was at a severe stage of the disease. On the second day after the treatment, CS was performed due to her severe condition and she died at postpartum seventh day. The postpartum period after cesarean section should be followed cautiously under the appropriate treatment of the COVID-19 disease. Unfortunately, the reason for this rapid deterioration which we observed in our cases is not well known and appropriate medications and algorithms should be established as soon as possible.

Stability analysis and simulation of the novel Corornavirus mathematical model via the Caputo fractional-order derivative: A case study of Algeria.

The novel coronavirus infectious disease (or COVID-19) almost spread widely around the world and causes a huge panic in the human population. To explore the complex dynamics of this novel infection, several mathematical epidemic models have been adopted and simulated using the statistical data of COVID-19 in various regions. In this paper, we present a new nonlinear fractional order model in the Caputo sense to analyze and simulate the dynamics of this viral disease with a case study of Algeria. Initially, after the model formulation, we utilize the well-known least square approach to estimate the model parameters from the reported COVID-19 cases in Algeria for a selected period of time. We perform the existence and uniqueness of the model solution which are proved via the Picard-Lindelöf method. We further compute the basic reproduction numbers and equilibrium points, then we explore the local and global stability of both the disease-free equilibrium point and the endemic equilibrium point. Finally, numerical results and graphical simulation are given to demonstrate the impact of various model parameters and fractional order on the disease dynamics and control.

Serum TNF-α, IL-1ß, and IL-6 levels in chronic HBV-infected patients.

BACKGROUND: The objective of the study was to evaluate the serum levels of tumour necrosis factor (TNF)-α, interleukin (IL)-1ß and IL-6 in chronic HBV-infected patients. METHODS: The present study was a single centre, prospective and randomised controlled trial. Twenty healthy volunteers and thirty HBeAg-negative patients with planned liver biopsy and treatment-naive diagnosed with chronic hepatitis B (CHB) were included in the study. TNF-α, IL-1ß and IL-6 levels were measured in the serum of CHB patient and control groups using an ELISA. Results were compared statistically using a Mann-Whitney U test. RESULTS: The mean age of the CHB group (20 men, 10 women) and the control group (10 men, 10 women) was 33.3 ± 9.7 (17-55) and 26.1 ± 12.3 (16-57), respectively. When the two groups were compared with the Mann-Whitney U-test, TNF-α and IL-6 levels were found to be significantly higher in the CHB group compared to the control group (P = .003, P < .0001, respectively). Although IL-1ß levels were not statistically significant, they were higher in the CHB group compared to the controls (P = .07). CONCLUSIONS: The results of our study showed that serum levels of TNF-α and IL-6 are increased in CHB patients.

Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case-control study including 1401 patients from Turkey.

Peripheral lymphadenopathy (LAP) is an important and common abnormal finding of the physical exam in general medical practice. We aimed to reveal the LAP etiology and demographic, clinical and laboratory variables that may be useful in the differential evaluation of LAP. This multicenter, nested case-control study including 1401 patients between 2014 and 2019 was conducted in 19 tertiary teaching and research hospitals from different regions in Turkey. The ratio of infectious, malign and autoimmune/inflammatory diseases was 31.3%, 5% and 0.3%, respectively. In 870 (62%) of patients had nonspecific etiology. Extrapulmonary tuberculosis (n: 235, 16.8%) was the most frequent cause of LAP. The ratio of infective etiology of LAP was significantly lower in patients older than 65 years-old compared to younger patients with the rate of 66.67% and 83.84%, respectively (p 0.016, OR 0.386, 95% Cl 0.186-0.803). The probability of malign etiology was higher both in patients who are older than 45 years-old (p < 0.001, OR 3.23, 95% Cl 1.99-5.26) and older than 65 years-old (p 0.002, OR 3.36, 95% Cl 1.69-6.68). Age, localization and duration of LAP, leukocytosis, anemia, thrombocytopenia, CRP and sedimentation rate were important parameters to differentiate infections. Size of lymph node and splenomegaly in addition to the parameters above were useful parameters for differentiating malign from benign etiology. Despite the improvements in diagnostic tools, reaching a definite differential diagnosis of lymphadenopathy is still challenging. Our results may help clinicians to decide in which cases they need an aggressive workup and set strategies on optimizing the diagnostic approach of adulthood lymphadenopathy.