Abstract Introduction Disease phobia may impose distressing manifestations along with compromised quality of life, particularly in young age. COVID-19 caused substantial psychological concerns in general population which required the attention of health authorities to address the issue as soon as possible. Objective This study was aimed to determine COVID-19 phobia in Pakistani youth during the current pandemic. Method A cross-sectional study was conducted to ascertain the extent of fear of COVID-19 among university students in Lahore, Pakistan using the COVID-19 Phobia Scale (C19P-S). Psychological, somatic, social, and economic factors were ascertained among students. The relationship of demographics with the phobia score was determined through appropriate statistical tests. Result This study included 374 students with a male preponderance (64.7%). The mean C19P-S score was 59.08 ± 14.44 (IQR: 50 - 70), with no significant difference among demographics except gender (male 57.65 ± 14.77 vs female 61.70 ± 13.47; p = .009). The mean psychological, psycho-somatic, economic, and social subscale scores were 19.59 ± 5.00 (25th percentile = 16 and 75th percentile = 24), 12.29 ± 4.56 (25th percentile = 10 and 75th percentile = 15), 11.22 ± 3.67 (25th percentile = 8 and 75th percentile = 14) and 15.97 ± 4.04 (25th percentile = 13.75 and 75th percentile = 19), respectively. Male students had a significantly lower score on social and psychological subscales than females (p< .05). Discussion and conclusion One fourth of the students achieved a fear score > 70 on C19P-S. These results indicate the need of dire maneuvers for reducing corona-phobia among university students.

Resumen Introducción La fobia a las enfermedades puede imponer malestar psicológico y comprometer la calidad de vida, particularmente en edades tempranas. El COVID-19 causó serias preocupaciones psicológicas en la población en general y éstas requieren la atención de las autoridades de salud para abordar el problema cuanto antes. Objetivo Este estudio buscó determinar la fobia al COVID-19 en jóvenes paquistaníes durante la pandemia actual. Método Se realizó un estudio transversal basado en la web para evaluar el miedo al COVID-19 entre los estudiantes universitarios en Lahore; para esto se utilizó la Escala de Fobia COVID-19 (C19P-S). Se evaluaron factores psicológicos, somáticos, sociales y económicos entre los estudiantes. La relación de la demografía con la puntuación de fobia se determinó mediante pruebas estadísticas apropiadas. Resultados Este estudio incluyó a 374 estudiantes con preponderancia masculina (64.7%). La puntuación media de C19P-S fue 59.08 ± 14.44 (IQR: 50 - 70), sin diferencias significativas entre los datos demográficos, excepto el género (hombres 57.65 ± 14.77 versus mujeres 61.70 ± 13.47; p = .009). Las puntuaciones medias de las subescalas psicológicas, psicosomáticas, económicas y sociales fueron 19.59 ± 5.00 (percentil 25 = 16 y percentil 75 = 24), 12.29 ± 4.56 (percentil 25 = 10 y percentil 75 = 15), 11.22 ± 3.67 (percentil 25) = percentil 8 y 75 = 14) y 15.97 ± 4.04 (percentil 25 = 13.75 y percentil 75 = 19), respectivamente. Los estudiantes varones obtuvieron una puntuación significativamente menor en las subescalas sociales y psicológicas que las mujeres (p< .05). Discusión y conclusión Una cuarta parte de los estudiantes obtuvo una puntuación de miedo > 70 en la C19P-S. Estos resultados indican la necesidad de aplicar medidas extremas para reducir la fobia al Coronavirus entre los estudiantes universitarios.

ABSTRACT Vaccine development using different platforms is one of the important strategies to address coronavirus disease pandemic. The global need for vaccines requires effective vaccine approaches and collaboration between pharmaceutical and biotechnological companies, governments and the industrial and academic sectors. About 72% of the vaccine candidates are being developed by the private sector, while 28% are carried out by the public sector and different non-profit organizations. COVID-19 vaccines are based on complete viruses (inactivated or attenuated), viral vectors (replicating or not), antigenic subunits (proteins or peptides), nucleic acids (RNA or DNA) or virus-like particles. Important aspects of vaccine development include manufacturing flexibility, speed, cost, safety, cellular and humoral immunogenicity, vaccine stability and cold chain maintenance. Vaccines can be prepared using different manufacturing platforms, computational biology, gene synthesis, structure-based antigen design and protein engineering. Individual confidence, convenience and complacency are factors that affect the attitude towards acceptance of COVID-19 vaccination. This could be complicated by socio-demographic, psychologic, cognitive and cultural factors.

RESUMEN El desarrollo de vacunas utilizando diferentes plataformas es una de las estrategias importantes para abordar la pandemia de COVID-19. La necesidad mundial de vacunas requiere enfoques de vacunas eficaces y la colaboración entre las empresas farmacéuticas y biotecnológicas, los gobiernos y los sectores industrial y académico. Alrededor del 72% de los candidatos vacunales están siendo desarrolladas por el sector privado, mientras que el 28%, por el sector público y diferentes organizaciones sin fines de lucro. Las vacunas contra la COVID-19 se basan en virus completos (inactivados o atenuados), vectores virales (replicantes o no), subunidades antigénicas (proteínas o péptidos), ácidos nucleicos (ARN o ADN) o partículas similares a virus. Aspectos importantes del desarrollo de vacunas incluyen la flexibilidad de fabricación, la velocidad, el costo, la seguridad, la inmunogenicidad celular y humoral, la estabilidad de la vacuna y el mantenimiento de la cadena de frío. Las vacunas se pueden preparar con precisión utilizando diferentes plataformas de fabricación, biología computacional, síntesis de genes, diseño de antígenos basado en estructuras e ingeniería de proteínas. La confianza individual, la conveniencia y la complacencia son factores que afectan la actitud hacia la aceptación de la vacunación contra la COVID-19. Esto podría complicarse por factores sociodemográficos, psicológicos, cognitivos y culturales.

Resumo Objetivo: anemia é uma complicação comum de doenças renais crônicas (DRC) e está significativamente envolvida na morbidade cardiovascular. O objetivo de nosso estudo foi investigar a prevalência e a gravidade da anemia em pacientes adultos pré-diálise, bem como determinar fatores preditores da terapia antianêmica. Método: estudo retrospectivo observacional foi realizado em pacientes pré-diálise adultos que recebiam tratamento no Hospital Universiti Sains Malaysia de janeiro de 2009 a dezembro de 2013. Resultados: ao todo, 615 casos elegíveis foram incluídos. A idade média dos pacientes foi de 64,1±12,0 anos. A prevalência de anemia foi de 75,8%, e a gravidade da anemia foi considerada leve em 47,7%, moderada em 32,2% e grave em 20% dos pacientes. Com base nas características morfológicas da anemia, os pacientes foram classificados em anemia normocrômica normocítica (76,9%), anemia hipocrômica microcítica (21,8%) e anemia macrocítica (1,3%). Suplementos de ferro oral foram prescritos para 38% dos pacientes e a nenhum dos pacientes foram dados eritropoietina, agentes estabilizadores (ESA) e preparações de ferro por via intravenosa. Na regressão logística, os preditores significativos de utilização da preparação antianêmica foram diminuição da hemoglobina e do hematócrito e estágios avançados da DRC. Conclusão: os resultados do presente estudo sugerem que a prevalência de anemia em pacientes pré-diálise é maior do que o atualmente aceito e está associado com a função renal; a prevalência aumenta com a diminuição da função renal. A identificação precoce e o manejo adequado da anemia não só terão um impacto positivo na qualidade de vida, mas também reduzirão internações de pacientes com DRC decorrentes de eventos cardiovasculares.

Summary Objective: Anemia, a common complication of chronic kidney diseases (CKD), is involved in significant cardiovascular morbidity. Therefore, the objective of our study was to investigate the prevalence and severity of anemia in pre-dialysis patients, as well as to determine the predictors of anti-anemic therapy. Method: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013. Results: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD. Conclusion: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.

RESUMO CONTEXTO E OBJETIVO: Doença renal crônica (DRC) é um problema médico e socioeconômico crescente. As informações relativas às causas da DRC são pré-requisito para reduzir a carga da doença, e são escassas na Malásia. Este estudo tem como objetivo avaliar as causas atribuíveis à DRC na população adulta de um hospital de referência terciária. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo realizado no Hospital Universiti Sains Malaysia (HUSM). MÉTODOS: Análise de prontuários de pacientes adultos de HUSM. Foram obtidos dados demográficos, exames laboratoriais, causas atribuíveis e estágio da DRC. RESULTADOS: Um total de 851 casos elegíveis foi incluído. A idade média dos pacientes foi de 61,18 ± 13,37 anos. DRC fase V foi contabilizada em 333 casos (39,1%), enquanto casos de estágio IV, IIIb, IIIa e II foram 240 (28,2%), 186 (21,9%), 74 (8,7%) e 18 (2,1%), respectivamente. A porcentagem de pacientes com DRC estágio V recebendo a terapia de substituição renal foi 15,6%. As causas atribuíveis mais importantes da DRC foram nefropatia diabética (ND) (44,9%), hipertensão (24,2%) e uropatia obstrutiva (9,2%). A diferença na prevalência da DRC devido à ND, hipertensão e glomerulonefrite entre pacientes ≤ 50 anos e > 50 anos de idade foi estatisticamente significativa. CONCLUSÃO: Nossos resultados sugerem que a ND e a hipertensão são as principais causas atribuíveis da DRC em pacientes sob cuidados terciários na Malásia. Os resultados apontam para a possibilidade de maior ênfase na prevenção primária da diabetes e hipertensão como impactante na redução das internações hospitalares devidas a DRC na Malásia.

ABSTRACT CONTEXT AND OBJECTIVE: Chronic kidney disease (CKD) is an escalating medical and socioeconomic problem worldwide. Information concerning the causes of CKD, which is a prerequisite for reducing the disease burden, is sparse in Malaysia. Therefore, this study aimed to evaluate the attributable causes of CKD in an adult population at a tertiary referral hospital. DESIGN AND SETTING: Retrospective study at Hospital Universiti Sains Malaysia (HUSM). METHODS: This was an analysis based on medical records of adult patients at HUSM. Data regarding demographics, laboratory investigations, attributable causes and CKD stage were gathered. RESULTS: A total of 851 eligible cases were included. The patients' mean age was 61.18 ± 13.37 years. CKD stage V was found in 333 cases (39.1%) whereas stages IV, IIIb, IIIa, and II were seen in 240 (28.2%), 186 (21.9%), 74 (8.7%) and 18 (2.1%), respectively. The percentage of CKD stage V patients receiving renal replacement therapy was 15.6%. The foremost attributable causes of CKD were diabetic nephropathy (DN) (44.9%), hypertension (HPT) (24.2%) and obstructive uropathy (9.2%). The difference in the prevalence of CKD due to DN, HPT and glomerulonephritis between patients ≤ 50 and > 50 years old was statistically significant. CONCLUSION: Our results suggest that DN and HPT are the major attributable causes of CKD among patients at a Malaysian tertiary-care hospital. Furthermore, the results draw attention to the possibility that greater emphasis on primary prevention of diabetes and hypertension will have a great impact on reduction of hospital admissions due to CKD in Malaysia.