=Paper=
{{Paper
|id=Vol-3149/paper8
|storemode=property
|title=IoT and E-Learning with the Impact of COVID-19 Pandemic Lockdown on the Undergraduate University Student Blood Pressure Levels
|pdfUrl=https://ceur-ws.org/Vol-3149/paper8.pdf
|volume=Vol-3149
|authors=Talib A. Al-Sharify,Zinah A. Alshrefy,Hussein Ali Hussein,Zainab T. Al-Sharify,Helen Onyeaka,Mushtaq T. Al-Sharify,Soumya Ghosh
|dblpUrl=https://dblp.org/rec/conf/ttsiit/Al-SharifyAHAOA22
}}
==IoT and E-Learning with the Impact of COVID-19 Pandemic Lockdown on the Undergraduate University Student Blood Pressure Levels==
https://ceur-ws.org/Vol-3149/paper8.pdf
IoT and E-learning with the Impact of COVID 19 Pandemic Lockdown
on the Undergraduate University Student Blood Pressure Levels
Talib A. Al-Sharifya, Zinah A. Alshrefyb, Hussein Ali Husseinc, Zainab T. Al-Sharifyd,e,
Helen Onyeakae, Mushtaq T. Al-Sharifyf, and Soumya Ghoshg
a
Al Rafidain University College, College of computer communications Engineering, Hay Al-Mustansiriyah, P. O.
Box 46036, Baghdad, Iraq
b
Quality Assurance and University Performance Department, University Presidency, Northern Technical
University, Mosul/Iraq
c
University of technology, production Engineering and Metallurgy, Baghdad, Iraq
d
School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT, UK
e
Environmental Engineering, College of Engineering, University of Mustansiriyah, Baghdad, Iraq
f
Taras Shevchenko National University of Kyiv, 03127, Kyiv, Ukraine
g
Department of Genetics, Faculty Natural and Agricultural Sciences, University of the Free State, Bloemfontein
9301, South Africa
Abstract
Since December 2019, Millions of people around the world suffer from the effects of
hypertension due to COVID 19 pandemic and all the stressed caused by this new virus. Around
40-50% of people worldwide can be assumed to have some form of hypertension especially
after the pandemic lockdown. However, the advancement of using the new technologies, IoT
and the E-learning during this lockdown period can support the education performance of the
university students and continue their study without spreading the virus due to the direct contact
with infected patients. This paper will study and compare the factors that contribute to
hypertension which are caused by changes in systolic and diastolic blood pressure during this
lockdown period. many students were surveyed and their blood pressures (BP)were monitored
using automatic devices. The BP of undergraduate students during the lockdown period were
identified as having higher systolic and diastolic readings however the results reflected no
direct causation between stress and blood pressure, and rather were representative of the factors
which will be studied further in this paper. The readings are compared with the definitions of
hypertension according to the American Heart Association (AHA). A thorough understanding
of the factors is important in the field of Internet of medical things (IoMT) medicine and
therapy to help patients suffering from hypertension and to monitor this situation.
Keywords 1
COVID 19, E-learning, hypertension, blood pressure, IoT, IoMT
1. Introduction and Literature Review
Globally, all of us around the world open our eyes on nightmare called coronavirus COVID-19 in
December 2019 which was originate in China, Wuhan [1–8]. The raped increased of COVID 19 make
it a pandemic within few months [6–7], Studies on the 31st August 2020 reported that the number of
cases and deaths by COVID 19 is 850,673 deaths and 25.3 million cases and it even goes higher to
2,619,767 deaths and 118,094,348115 cases on 10th March 2021 [6-7]. In terms of education and in
order to continue the life during this hard period the E-learning during the COVID 19 pandemic
Emerging Technology Trends on the Smart Industry and the Internet of Things, January 19, 2022, Kyiv, Ukraine
EMAIL: talibalsharify1955@gmail.com (T. A. Al-Sharify); zena.alshrefy@ntu.edu.iq (Z. A. Alshrefy); 70008@uotechnology.edu.iq (H. A.
Hussein); zta011@alumni.bham.ac.uk (Z. T. Al-Sharify); onyeakah@bham.ac.uk (H. Onyeaka); alsharify@univ.kiev.ua (M. T. Al-Sharify);
soumyaghosh@yahoo.com (S. Ghosh)
ORCID: 0000-0002-3657-5944 (T. A. Al-Sharify); 0000-0003-0884-9570 (Z. A. Alshrefy); 0000-0002-8841-2426 (H. A. Hussein); 0000-
0002-3870-3815 (Z. T. Al-Sharify); 0000-0003-3846-847X (H. Onyeaka); 0000-0002-9818-3612 (M. T. Al-Sharify); 0000-0002-4945-3516
(S. Ghosh)
©️ 2020 Copyright for this paper by its authors.
Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).
CEUR Workshop Proceedings (CEUR-WS.org)
73
lockdown period can support the education performance of the university students and continue the
study without spreading the virus due to the direct contact with infected patients [2, 3, 4, 9, 10, 11, 12].
[13] They proposed IoT-based method uses an Arduino Uno-based system, Then the results
achieved IoT smart application to saving humans live thru COVID-19 pandemic.
Blood creates a force on the blood vessel walls, which is known as blood pressure (BP). The correct
measurement of hypertension commences with the true measurement of elevated BP [14]. The range of
high BP among students during COVID 19 pandemic period is given as diastolic pressure greater than
90 mmHg while systolic greater than 140 mmHg. According to worldwide reports, approximately half
of the 17 million human deaths reported yearly are due to heard diseases and high blood pressures seem
to play a main role in these [15]. The most alarming diseases such as strokes, kidney failures, heart
failures and narrowing of arteries are due to an increase in the BP above 140/90 mmHg. It is hence very
important to supervise the issue of hypertension to overcome such deadly diseases. The number of
patients of high BP are increasing by 60% approximately and it is expected that increased hypertension
issues will affect around 1.6 billion individuals by 2025 [16].
The heart pumps the blood to the body at a known systolic reading of 140 mm Hg. Whereas, when
the heart relaxes and replenishes itself with blood, the diastolic reading is around 90 mmHg [5]. The
American Heart Association (AHA) explains the following ranges of blood pressure (in mmHg), as
shown in Table 1:
Table 1
A guide to different levels of Blood Pressures in a human body
Systolic Diastolic
Normal Blood Pressure 120 80
Pre-Hypertension Between 120 and 139 Between 80 and 89
Stage 1 Hypertension Between 140 and 159 Between 90 and 99
Stage 2 Hypertension 160 100
Hypertensive Crisis 180 110
It is not easy to control high BP as there are many obstacles in controlling hypertension. Firstly, the
development of hypertension is indirect and undefined. Awareness before failure is usually a big
challenge. Secondly, it is common that patients tend to not follow the doctor’s advices and thus their
careless behaviours in adopting healthy lifestyles and lack of punctuality in consuming the right
medicines is a huge danger. Therefore, the risk factors change, and anti-hypersensitive therapies are
usually recommended [17 – 18].
Thirdly, the treatments received by the high BP patients remains unreliable. Hence, a low range of
less than 130/80 mmHg is considered as a standard for recommendation to patients suffering from
increased CVDs or diabetes instead of the normal less than 140/80 mmHg range [19]. Even then,
uncertainty cannot be avoided in decreasing BP ranges [20].
Furthermore, there is a change in BP at different timings of the day. For instance, BP tends to
increase at the time when a person is awakening from a deep sleep and decreases during sleep. BP also
varies due to changes in behaviour and it is normal for an individual to have high BP for short periods
in a day, often as a response to several circumstances occurring in one’s life. Stress and heavy exercise
lifestyles can also result in a rise in the BP of a strong and fit individual as well. In such a situation, it
is preferred several illustrations of checks performed at different timings before the declaration of
hypertension in an individual.
2. Risk Factors
There are several risk factors associated to increased blood pressures in humans. For instance, age
is one of such risk factors. Age above 60 years is a common cause for increased BP. This is usual as
arteries are firmer and tend to become narrow at this age because of the development of plague in the
relevant passages. Even a person’s ethnicity has a huge role in developing BP as some cultural groups
are more susceptible to hypertension, depending on their surrounding influences. Obesity is one of the
74
main risk factors and overweight individuals tend to suffer more by increased BPs. In terms of the
genders, these also play a key role. While both, men and women have the same lifetime risk, males are
more likely to develop hypertension from a young age. Whereas, for women, this occurs at much older
ages. Existing health conditions such as the presence of CVDs or other chronic diseases may also be a
representative of developing hypertension, especially with growing ages [21].
Additionally, the use of alcohol, smoking tobacco and the adoption of unhealthy lifestyles also plays
a vital role in developing hypertension. Other reasons include idleness and lack of exercise and physical
activities. It is also known that increased BP is more common in people using processed foods, junk
foods and foods with high input of salts. Family history also plays a chief role in the development of
hypertension, which is unintentional. Even the use of certain medicines can lead to such issues.
Vasoconstricting hormones are produced by the nervous systems, which can increase BP, and under
increased stress levels, which are due to elevated BP levels, one can have hypertension. It is well known
that the main factors for stress are employment issues and the stress incurred during an employment,
social and cultural pressures and family tensions. BP rates are multiplied when stress factors join with
risk factors [21].
Hypertension can be classified as primary, secondary and silent killer. Any other diseases do not
affect primary BP. It depends upon blood plasma volume and hormone secretion can change blood
volume along with the blood pressure [22]. Environmental reasons also regulate BP due to stress and
inactivity [23]. Secondary hypertension happens due to other conditions. For instance, these include
diabetes occurring because of kidney issues and nerve damages, other kidney diseases, cancers and
disorders of adrenal glands, over activity of thyroid glands, imbalances in calcium and phosphorous
levels along with the occurrence of pregnancy in females, obesity and sleep issues [24].
Silent killer is often referred to the type of hypertension in a person, which is mainly unnoticed, or
the symptoms are undetected. It can cause damages to the cardiovascular system and various vital
organs in the body [25]. Long term hypertension is responsible for issues occurring through
atherosclerosis [26], which can result in heart problems such as heart attacks and failures. Aneurysm
may also take place due to long term hypertension, which is mainly an irregular bulge in a wall of the
artery [27]. Such a burst can lead to serious bleeding and probably deaths in some circumstances. In
addition, it can also result in kidney failures, amputation and hypertensive retinopathies [28] leading to
loss of sight.
To avoid the serious problems arising from high BP levels, it is important to regulate BP levels by
testing each individual. It is worth mentioning that hypertension tends to be a permanent disorder, which
deserves to be treated. Hence, for an optimal regulation, a lasting binding is needed to the current and
future lifestyle patterns while making any necessary modifications. Also, continuous psychotherapies
along with awareness can assist in overcoming increased BP issues as well as reducing several CVD
risk factors.
Since youngsters are more prone to developing harmful diseases due to several reasons, and since
it is extremely important that youngsters are also monitored for their current blood pressure levels, this
study was aimed on estimating and comparing the Systolic and Diastolic Blood Pressure levels for
students before and after corona virus. One of the main motivations behind this study was to analyse
the effects of different educational types on the students’ BP levels as well and to comprehend the
students’ health conditions.
Section 1 provides a brief background on hypertension and the associated increased blood
pressure levels. It then introduces the scope of the current study performed. Section 2 provides
the research methodology adopted in this study whereas section 3 provides the results and the
useful discussion of such results relevant to the current study. The main conclusions drawn
from this research are provided in section 4.
3. Methodology
A prospective cross-sectional study was conducted over the period before and after COVID
19 pandemic. For this study, 335 students who fulfilled the inclusion criteria were enrolled.
Each student was provided a detailed questionnaire survey asking important questions relevant
to their health and lifestyle patterns. All of the data collected from these surveys is included in
75
this study. Some questions in the questionnaire included: recent measurement value of blood pressure,
date of birth, sex, ethnicity, weight, height, whether the student was consuming any antihypertensive
drugs, presence of diabetes, smoking status, whether the student had any heart attacks or strokes,
consumption of alcohol and preference of arm for measuring blood pressure.
The students were then directed to blood pressure measurements where the participating students
were asked to sit appropriately in a proper manner. Three readings were then taken of these students
and the relevant mean was calculated of the three readings taken. It was also ensured that the participants
had not smoked in the last 15 minutes. In addition, to prevent any influence of other factors, it was also
made sure that the students did not communicate to anyone during this time and the patients were not
in any type of anxiety.
All BP measurements were performed with properly calibrated automatic pressure measurement
devices. These measurements were taken in the morning in suitable surrounding conditions and the
readings were based on the JNC 8 Guidelines. The students considered for this study had to pass the
inclusion criteria, as mentioned previously. This inclusion criteria involved students having a normal
body weight and age above 18 years for both colleges investigated. Whereas, the exclusion criteria for
this study involved the following factors: any history of hypertension, obesity, secondary causes of
hypertension and the presence of any chronic medical therapies such as NSAID or steroid along with
anti-hypertensive drugs.
For the statistical analysis, the statistical assessment was achieved using the SPSS package, Version
20. The unpaired t-test was used when comparing the mean values between groups. A significance level
of P values less than 0.05 was selected.
Internet of Medical Things- (IoMT) based health monitoring systems are attention on staying
healthy by knowing your body mass index (BMI) immensely among students from the students during
COVID 19 and before COVID 19. This study presents an IoMT-based system that is a real-time health
monitoring system utilizing the measured heart rate, systolic and diastolic blood pressure and blood
pressure for the students.
Figure 1; shows the flow chart of the IoMT. When the statistical analysis (BMI, heart rate, blood
pressure and blood temperature) is measured for each student, it starts measuring values, determined
levels and sends it to the main controller then comparing receiving the measured value to prevention
programs and strengthening protective factors. The IoMT will displays health rate and sends an alert to
both the doctor and the student patient.
76
Start IoMT
Application
Statistical analysis (BMI, heart rate, blood
pressure and blood temperature)
Determined levels of Blood
Pressures in a human body
Control of high blood pressure
Body analyses and Measuring SpO2 & body
doctor’s examinations temperature
Comparing the
Doctor advised systolic and
diastolic blood
pressure levels
Synchronization among E-learning
and the impact of COVID 19
unpaired t-test
Prevention programs and promotion
End of protective factors in society
Figure 1: Flow chart of IoMT application system
4. Results
The total number of students in this work were 335. Amongst the students, there are 26 (19.5%)
smokers, 107 (80.5%) non-smokers; as shown in table 2.
Table 2
Demographic distribution of students in the Colleges of Arts and Medicines
77
Groups
Before COVID After COVID Total
N % N % N %
The mean of the systolic BP in the students associated to the College of Medicine was 121.8, while
the mean of the diastolic BP in these students was 79.6. The Heart Rate (HR) was 99.8 and the BMI
was 22.4. On the contrary, the students from the College of Arts had a mean of systolic BP as 120.23.
For them, the mean diastolic BP was 75.4, HR was 91.9 and BMI was 22.4. Hence, there was no
statistical significance between the students from the two types of colleges. Table 3 details the data
results in terms of the systolic BP (P value of 0.37), diastolic BP (P value of 0.227) and HR (P value
0.316).
Table 3
Mean, SD, SE among students during COVID 19 and before it.
Groups N Mean Std. Deviation Std. Error mean P value
Age After COVID 19 133 21.0675 1.8878 1.8878 0.005
Before COVID 19 96 21.8439 2.2384 2.2384
Systolic After COVID 19 133 121.823 13.2848 1.1519 0.37
Before COVID 19 96 120.234 13.0585 1.3328
Diastolic After COVID 19 133 79.6368 55.3025 4.7953 0.468
Before COVID 19 96 75.4792 10.3053 1.0518
Weight After COVID 19 133 64.015 12.9545 1.12329 0.89
Before COVID 19 96 63.7708 13.4567 1.37342
Height After COVID 19 133 168.323 9.8493 0.8541 0.84
Before COVID 19 96 168.052 10.2571 1.0469
HR After COVID 19 133 99.8226 76.0304 6.5927 0.316
Before COVID 19 96 91.9417 13.2844 1.3558
BMI After COVID 19 133 22.4284 3.05476 0.26488 0.98
Before COVID 19 96 22.4393 3.40393 0.34741
As mentioned previously, both types of students after COVID 19 were investigated, the ones
studying normal leering and the E-learning with IoMT ones. Hence, for the students studying the normal
learning (before covid 19), the mean systolic BP was 122.38, the mean diastolic BP was 81.61, HR was
94.18 and BMI was 22.22. Whereas, for the students studying the E-learning, the mean of systolic BP
was 23.80, the diastolic BP was 73.39, HR was 117.60 and BMI was 23.07. Also, there was no statistical
significance between the normal learning (i.e in person education before COVID 19) and E-learning
78
students with the systolic BP (P value 0.391), diastolic BP (P value 0.466) and HR (P value 0.129), as
detailed in table 4.
Table 4
Mean, SD, SE among students during COVID 19 studying the Normal learning and E- learning.
Std. Std. Error P
Category Type of study N Mean
Deviation mean value
Normal 101 20.2006 1.10492 0.10994
Age 0
E-learning 32 23.8039 1.02869 0.18185
Normal 101 122.3812 13.67505 1.36072
Systolic 0.391
E-learning 32 120.0594 12.00056 2.12142
Normal 101 81.6149 63.23916 6.29253
Diastolic 0.466
E-learning 32 73.3937 8.31341 1.46962
Normal 101 63.7426 13.01895 1.29543
Weight 0.668
E-learning 32 64.875 12.91598 2.28324
Normal 101 168.7327 9.94373 0.98944
Height 0.397
E-learning 32 167.0313 9.5832 1.69409
Normal 101 94.1871 14.20965 1.41391
HR 0.129
E-learning 32 117.6094 153.40432 27.11831
Normal 101 22.2234 3.08736 0.3072
BMI 0.17
E-learning 32 23.0753 2.90135 0.51289
The following Fig. 2 that’s depend on IoMT application shows that there is no difference in the
BMI between the students before and after COVID 19.
25.00
Mean BMI (Kg/m2)
20.00
15.00
22.43 22.44
10.00
5.00
During Before
Covid 19 Covid 19
0.00
Situation
Figure 2: Distribution of BMI among students from the students during and before COVID 19
Fig. 3 shows the mean of HR of during Covid students is 99.8 which is higher than the mean of art
students which is 91.9.
79
200.00
180.00
160.00
Mean HR (Beats/min) 140.00
120.00
100.00
80.00
60.00
99.82 91.94
40.00
During Before
20.00 Covid 19 Covid 19
0.00
Situation
Figure 3: Mean of HR among students during COVID 19 and before COVID 19
Fig. 4 shows the mean age in each college which is 21.8 for art students and 21.1 for during COVID
19.
30.00
25.00
20.00
Mean Age
15.00
10.00 21.07 21.84
5.00 During Before
Covid 19 Covid 19
0.00
Situation
Figure 4: Mean age among students during COVID 19 and before COVID 19
After measuring the blood pressure in both cases students, i.e. during COVID 19 and before COVID
19, it was discovered that systolic and diastolic blood pressure of student during the covid in comparison
with students before it was slightly elevated. After further analysis this elevation was deemed as
insignificant. The results are shown in Fig. 5 and 6, below:
80
160.00
140.00
Mean Systolic BP (mmHg)
120.00
100.00
80.00
60.00 121.82 120.23
40.00
20.00 During Before
Covid 19 Covid 19
0.00
Situation
Figure 5: Mean systolic BP (in mmHg) among students during COVID 19 and before COVID 19
160.00
140.00
Mean Diastolic BP (mmHg)
120.00
100.00
80.00
60.00
40.00 79.64 75.48
20.00 During Before
Covid 19 Covid 19
0.00
Situation
Figure 6: Mean diastolic BP (in mm Hg) students during COVID 19 and before COVID 19
A further comparison was undertaken within students. This comparison was between the normal
and the E-learning studies by use IoMT application as shown in Fig. 7, where the graph indicates that
BMI is higher in normal (23.1) than E-learning (22.2).
81
25.00
Mean BMI (Kg/m2) 20.00
15.00
22.22 23.08
10.00
normal E-learning
5.00
0.00
After COVID 19
Figure 7: Mean BMI (in kg/m2) among students using normal and E-learning, respectively
Figure8 shows the mean of age of students After COVID 19 in both normal and IoT with E-
learning. The mean age is 23.8 in normal learning and 20.2 in E-learning.
25.00
20.00
Mean Age
15.00 normal E-learning
23.80
10.00 20.20
5.00
0.00
After COVID 19
Figure 8: Mean age among students studying in normal and E-learning.
The blood pressure measurements of students after COVID 19 in both systems included last two
grades from the normal system and first four grades were included form the E-learning system. An
elevation in both systolic and diastolic blood pressure was noticed in the new system when compared
to the normal learning. As this elevation was not significant, no further analysis was undertaken. The
mean systolic and diastolic blood pressures are shown in the Figure 9 and 10, respectively.
82
160.00
140.00
Mean Systolic BP (mmHg)
120.00
100.00
80.00
60.00 122.38 120.06
40.00
normal E-learning
20.00
0.00
After COVID 19
Figure 9: Mean systolic BP (in mm Hg) among students after and before covid 19 using normal
learning and E-learning with IoMT, respectively
160.00
140.00
Mean Diastolic BP (mmHg)
120.00
100.00
80.00
60.00
normal E-learning
40.00 81.61 73.39
20.00
0.00
After COVID 19
Figure 10: Mean systolic BP (in mm Hg) among students after and before covid 19 using normal
learning and E-learning, respectively
5. Discussion
Hypertension is a worldwide problem, which is estimated to cause 7.5 million deaths yearly. This
accounts for about 12.8 % of the total of all deaths occurring in the world. Raised blood pressure levels
are a major risk for coronary heart diseases, ischemic and haemorrhagic strokes. Hypertension is caused
by multiple key factors, where one of these key factors is stress. This study focuses on stress and its
effect on blood pressure levels. Whilst conducting this study the IoMT focus was to determine any
difference in blood pressure measurements (systolic & diastolic) and heart rate between students.
The aim of this study was to correlate between stress and elevation of blood pressure levels. A very
detailed analysis of the results was undertaken to determine any correlation. It was discovered that after
COVID 19 students had slightly elevated blood pressure levels and heart rates when compared with the
83
students before the pandemic. Within the students after COVID 19, a further deviation was noticed
between Normal and IoMT with E-learning studies. Even though a difference was noticed, the results
were not significantly different which resulted in a low probability “P” value.
A definite conclusion can not be determined due to the assumptions and limitations of the study.
Some of these limitations are listed as follows:
1- A small sample size;
2- Period during which measurements were taken. As no exams were being undertaken hence
stress levels were low;
3- No analysis or records were noted on high risk factors such as smoking and alcohol consump-
tion;
4- The participants were only subjected to one measurement. A single measurement is not enough
to detect any hypertension. A better prospect would have been to take multiple measurements from the
same test subject over the period of few days.
Previous studies undertaken indicate a greater level of stress in students after COVID 19 which
leads to elevated blood pressures [29 – 30].
A study conducted in India on 18 to 21-year-old individuals concluded that the prehypertension and
hypertension percentage was 67% among students after COVID 19, where it is also noted that the
prevalence is high among males compared to females and the difference is statistically significant [31].
A similar study undertaken in Ethiopia demonstrated that college students showed a prevalence of
hypertension of 7.7%. Higher rates of hypertension were observed among males, overweight people
and participants who suffered sleep deprivation or slept for less than 5 hours [32].
6. Conclusions
Young people are more prone to developing harmful diseases due to several reasons. Hence, it is
extremely important that youngsters are also monitored for their blood pressure levels. This study was
aimed on estimating and comparing the Systolic and Diastolic Blood Pressure levels in undergraduate
students before and after COVID 19. One of the main motivations behind this study was to analyse the
effects of different educational types on the students’ BP levels as well and to comprehend the students’
health conditions.
The main conclusions drawn from this research show that there was a significant association
between stress and blood pressure elevation (both systolic and diastolic) when comparing BP students
from both after and before COVID 19. The HR and BP were also not statistically significant in
comparing normal and E-learning.
Further recommendations for this study are as follows:
Additional research on the topic is required;
Increase in knowledge and education of people about the complications of hypertension is needed
People need to be advised to measure their blood pressure regularly
Prevention programs can strengthen protective factors among people
Larger samples should be tested where students from several colleges and universities must be
scrutinised
IoMT applications were used to improve readings and to know the exact health details of each
student, depending on a flowchart adopted by researchers.
Measurements carried on students must be made during a longer period of time, perhaps for the
full academic term in order to comprehend their overall health conditions.
7. Acknowledgment
The authors gratefully Acknowledge the support from Al-Rafidin University, Northern Technical
University, University of technology, University of Birmingham and also the authors gratefully
Acknowledge the support from Mustansiriyah University (www.uomustansiriyah.edu.iq), and Taras
Shevchenko National University of Kyiv, Kyiv, Ukraine, and University of the Free State, South Africa
for its support in the present work.
84
8. References
[1] Al-Mashhadani, S.H.; Al-Sharify, Z.T.; Kariem, N.O. Investigating the spread of coronavirus
(covid-19) at airports and methods of protection. Journal of engineering and sustainable
development 2020, 38-44.
[2] Al-Sharify, N.T.; Al-Sharify, Z.T.; Al-Sharify, T.A.; Al-Sharify, M.T.; Al-Sharify, A.T. A technical
overview and comparison between pet and mri scanning. Systematic Reviews in Pharmacy 2020,
11, 35-41.
[3] Al-Sharify, N.T.; Rzaij, D.R.; Nahi, Z.M.; Al-Sharify, Z.T. An experimental investigation to
redesign a pacemaker training board for educational purposes. In IOP Conference Series: Materials
Science and Engineering, 2020; Vol. 870.
[4] Al-Sharify, Z.T.; Al-Sharify, T.A.; Al-Sharify, N.T.; H.Y., N. A critical review on medical imaging
techniques (ct and pet scans) in the medical field. In Conference Series: Materials Science and
Engineering, IOP Publishing: 2020; Vol. 870, p 012043.
[5] Al-Sharify, Z.T.; Nussrat, H.H.; Al-Najjar, S.Z.; Onyeaka, H.; Al-Sharify, N.T. The emergence of
covid-19 and its pandemic potentialas a global health security threat and its effect on future life
strategy. Systematic Reviews in Pharmacy 2021, 12 259-269.
[6] Onyeaka, H.; Al-Sharify, Z.T.; Ghadhban, M.Y.; Al-Najjar, S.Z. A review on the advancements in
the development of vaccines to combat coronavirus disease 2019. Clin Exp Vaccine Res 2021, 10,
6-12.
[7] Onyeaka, H.; Anumudu, C.K.; Al-Sharify, Z.T.; Egele-Godswill, E.; Mbaegbu, P. Covid-19
pandemic: A review of the global lockdown and its far-reaching effects. Sci Prog 2021, 104,
368504211019854.
[8] Rushdi, S.; Hameed, K.K.; Jana, H.; Al-Sharify, Z.T. Investigation on production of sustainable
activated carbon from walnuts shell to be used in protection from covid-19 disease. Journal of
Green Engineering 2020, 10, 7517-7526.
[9] Adetona, Z. A., Ogunyemi, J., & Oduntan, O. E. (2021). Investigating E-Learning Utilisation during
COVID-19 Pandemic Lockdown in Southwestern Nigeria. International Journal of Scientific &
Engineering Research, 12(5), 893-899.
[10] Anwar, A., Mansoor, H., Faisal, D., & Khan, H. S. (2021). E-Learning amid the COVID-19
Lockdown: Standpoint of Medical and Dental Undergraduates. Pakistan Journal of Medical
Sciences, 37(1), 217.
[11] Kapasia, N., Paul, P., Roy, A., Saha, J., Zaveri, A., Mallick, R., ... & Chouhan, P. (2020). Impact
of lockdown on learning status of undergraduate and postgraduate students during COVID-19
pandemic in West Bengal, India. Children and Youth Services Review, 116, 105194.
[12] Radha, R., Mahalakshmi, K., Kumar, V. S., & Saravanakumar, A. R. (2020). E-Learning during
lockdown of Covid-19 pandemic: A global perspective. International journal of control and
automation, 13(4), 1088-1099.
[13] Staessen, J., Li, Y., Hara, A., Asayama, K., Dolan, E. and O’Brien, E. (2017). Blood Pressure
Measurement Anno 2016. American Journal of Hypertension, 30 (5), pp. 453-463.
[14] Mohammad Monirujjaman Khan, Safia Mehnaz, Antu Shaha, Mohammed Nayem, Sami
Bourouis. "IoT-Based Smart Health Monitoring System for COVID-19 Patients". Computational
and Mathematical Methods in Medicine, vol. 2021, Article ID 8591036, 11 pages, 2021.
https://doi.org/10.1155/2021/8591036.
[15] Lim, S. S. et al. (2012). A comparative risk assessment of burden of disease and injury attributable
to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the
Global Burden of Disease Study. Lancet. 380:2224–2260.
[16] Kearney, P. M. et al. (2005). Global burden of hypertension: analysis of worldwide data. Lancet.
365:217–223.
[17] Ghadhban F, A. H., & Habib S., O. (2011). A study on the distribution of blood pressure
measurements among university students. The Medical Journal of Basrah University, 29(1), 43-
50.
[18] Chen, R. et al. (2013). Most Important Outcomes Research Papers on Hypertension. Circulation:
Cardiovascular Quality and Outcomes. American Heart Association. 6:4.
85
[19] Chobanian, A. V et al. (2003). National Heart, Lung, and Blood Institute Joint National Committee
on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood
Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National
Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC
7 report. JAMA. 289:2560–2572.
[20] Bangalore, S. et al. (2011). Blood pressure targets in subjects with type 2 diabetes mellitus/impaired
fasting glucose: observations from traditional and bayesian random-effects meta-analyses of
randomized trials. Circulation. 123:2799–2810.
[21] Pinto, E. (2007). Blood pressure and ageing. Postgraduate medical journal. 83(976), 109–114.
[22] Ganzevoort, W., Rep, A., Bonsel, G., de Vries, J. and Wolf, H. (2004). Plasma volume and blood
pressure regulation in hypertensive pregnancy. Journal of Hypertension, 22(7), pp.1235-1242.
[23] Diaz, K. M., and Shimbo, D. (2013). Physical activity and the prevention of hypertension. Current
hypertension reports, 15(6), 659–668.
[24] Puar, T. H., Mok, Y., Debajyoti, R., Khoo, J., How, C. H., & Ng, A. K. (2016). Secondary
hypertension in adults. Singapore medical journal, 57(5), 228–232.
[25] Bennett, V. (2017). Combating the ‘silent killer’ that is hypertension. Nursing Standard, 31(25),
pp.28-28.
[26] Rafieian-Kopaei, M., Setorki, M., Doudi, M., Baradaran, A., & Nasri, H. (2014). Atherosclerosis:
process, indicators, risk factors and new hopes. International journal of preventive medicine, 5(8),
927–946.
[27] Tada, Y., Wada, K., Shimada, K., Makino, H., Liang, E., Murakami, S., Kudo, M., Kitazato, K.,
Nagahiro, S. and Hashimoto, T. (2014). Roles of Hypertension in the Rupture of Intracranial
Aneurysms. Stroke, 45(2), pp.579-586.
[28] Lee, W., Park, J., Won, Y., Lee, M., Shin, Y., Jo, Y. and Kim, J. (2019). Retinal Micro-vascular
Change in Hypertension as measured by Optical Coherence Tomography Angiography. Scientific
Reports, 9(1).
[29] Dahlin, M., Joneborg, N. and Runeson, B. (2005). Stress and depression among medical students:
a cross-sectional study. Medical Education, 39(6), pp.594-604.
[30] Aamir, I. (2017). Stress Level Comparison of Medical and Nonmedical Students: A Cross
Sectional Study done at Various Professional Colleges in Karachi, Pakistan. Acta
Psychopathological, 03(02).
[31] Patnaik, A. and Choudhury, K. (2015). Assessment of risk factors associated with hypertension
among undergraduate medical students in a medical college in Odisha. Advanced Biomedical
Research, 4(1), p.38.
[32] Tadesse, T. and Alemu, H. (2014). Hypertension and associated factors among university students
in Gondar, Ethiopia: a cross-sectional study. BMC Public Health, 14(1).
86