Impact of COVID-19 on clinical trials and clinical research: A systematic review.

Background: The World Health Organization has reported more than 31,186,000 confirmed cases of coronavirus disease-19 (COVID-19), including 962,343 deaths, worldwide as on September 21, 2020. The current COVID-19 pandemic is affecting clinical research activities in most parts of the world. The focus on developing a vaccine for SARS-CoV-2 and the treatment of COVID-19 is, in fact, disrupting many upcoming and/or ongoing clinical trials on other diseases around the globe. On March 18, 2020, the United States Food and Drug Administration (FDA) issued an updated guideline for the conduct of clinical trials during the current health emergency situation. The potential challenges, such as social distancing and quarantines, result in study participants' inaccessibility and trial personnel for in-person scheduled study visits and/or follow-up. Due to the sudden onset and wide-spread impact of COVID-19, its influence on the management of clinical trials and research necessitates urgent attention. Therefore, our systematic review of the literature aims to assess the impact of the COVID-19 pandemic on the conduction of clinical trials and research. The search for the relevant articles for review included the keywords "COVID-19" AND "clinical trial" in PubMed, MEDLINE, Embase, Google scholar and Google electronic databases. Key findings include: delaying subject enrollment and operational gaps in most ongoing clinical trials, which in turn has a negative impact on trial programmes and data integrity. Globally, most sites conducting clinical trials other than COVID-19 are experiencing a delay in timelines and a complete halt of operations in lieu of this pandemic, thus affecting clinical research outcomes.

Retroperitoneal liposarcoma in older person - a rare case report.

Retroperitoneal sarcoma is relatively uncommon, constituting only 10-15 percent of all soft tissue sarcomas. The most common histologic types of RPS are liposarcoma and leiomyosarcoma. Retroperitoneal sarcoma is classified based on the amount of lipid inside the cells, the mucoid lipid and the degree of cell differentiation. It is classified into the well-differentiated, myxoid, round cell, pleomorphic and dedifferentiated types and the commonest is the pleomorphic type. Dedifferentiated liposarcomas are defined by the presence of sharply demarcated regions of non-lipogenic sarcomatous tissue within a well-differentiated tumor. This type has a vague prognosis compared to other types of sarcoma and making the histological diagnosis can be difficult. Dedifferentiated liposarcoma commonly develops in the retroperitoneum, limbs, testis, and spermatic cord. Retro peritoneal sarcoma typically produces few symptoms until they are large enough to compress or invade surrounding structures. Most tumors are already large and locally advanced at the time they are first detected. Here, we reported a case that came to medical attention as an incidentally discovered large abdominal mass in an asymptomatic or minimally symptomatic, later the mass was successfully removed and free from symptoms.

Vitamin D deficiency among the elderly: insights from Qatar.

OBJECTIVES: Vitamin D (VitD) deficiency is associated with comorbidities in the elderly. The present study investigates the prevalence of VitD deficiency among the elderly in Qatar. RESEARCH DESIGN AND METHODS: A retrospective study conducted between April 2010 and April 2012 that involved chart reviews. All elderly patients of age ≥65 years in geriatrics facilities including Rumailah hospital, skilled nursing facility and home healthcare services in Qatar were included in the study. MEASUREMENTS: Patient characteristics and outcomes were analyzed and compared according to the severity of VitD deficiency. Correlation of VitD with comorbidities was analyzed. Mean follow-up period was 6 months. RESULTS: A total of 889 patients were enrolled; the majority (66%) were females and the mean age was 75 ± 8.7 years. Patient comorbidities included hypertension (76.5%), diabetes mellitus (63%), dyslipidemia, (47.5%), dementia (26%) coronary artery disease (24%) and cerebrovascular accident (24%). The mean baseline serum VitD level was 24.4 ± 13.5 ng/ml; 72% of patients had VitD deficiency: mild (31%), moderate (30%) and severe (11%). Patients with severe VitD deficiency had significantly higher HbA1c levels compared with patients with optimal VitD (P = 0.03). High density lipoprotein (HDL-C) levels were significantly lower in severe VitD deficiency patients compared with optimal VitD patients (P = 0.04). There was a positive correlation between HDL-C and VitD level (r = 0.17, P = 0.001), whereas HbA1c levels showed negative correlation with VitD (r = -0.15, P = 0.009). CONCLUSIONS: A high prevalence of VitD deficiency (72%) was observed among the elderly in Qatar. Lower VitD was associated with higher HbA1c and lower HDL-C levels. Further studies are warranted to evaluate whether VitD supplementation controls diabetes mellitus (DM) and low HDL-C levels among the elderly.