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Munir MZ, Khan AH, Khan TM. Healthcare professionals' understanding and perception of drug-related issues linked to off-label pharmacological medications used for COVID-19. Expert Rev Anti Infect Ther 2024; 22:487-493. [PMID: 38263904 DOI: 10.1080/14787210.2024.2310004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/30/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND To evaluate the opinions of healthcare workers regarding drug therapy problems linked to anti-infective medicines used for the treatment of COVID-19 infection in Pakistan. RESEARCH METHODOLOGY This cross-sectional study was conducted from January to October 2022 using a self-administered questionnaire developed by the authors, having three sections: demographics, knowledge, and perception. The study was validated by research experts and pilot-tested on 30 subjects. The study included medical doctors, nurses, pharmacists from Punjab's government and private medical institutes. RESULTS In this study, 382 of 400 participants replied. The mean knowledge score was 9.52 (SD 2.97), showing that participants had adequate knowledge of COVID-19 pharmacological interventions. The knowledge scores were significantly higher of those who treated COVID-19 patients and were from Lahore. Many doctors considered that elderly patients and those with blood disorders were at greater risk of experiencing drug-related problems. Most pharmacists support electronic prescription systems. Many doctors thought the lack of unified treatment guidelines, multiple prescribers, and self-medication were key obstacles in managing COVID-19 patients. CONCLUSION Most respondents had adequate knowledge. Older patients with comorbidities are at risk of adverse effects. Self-medication, polypharmacy, and multiple prescriptions can lead to misdiagnosis and complications. Electric prescriptions, team effort, and training programs can decrease these issues.
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Affiliation(s)
- Muhammad Zeeshan Munir
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, Malaysia
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, Malaysia
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- School of Pharmacy, Monash University Malaysia Sdn Bhd, Subang Jaya, Selangor, Malaysia
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Somani R, Muntaner C, Velonis AJ, Smith P, Hillan EM. Factors Contributing to Increased Workplace Violence Against Nurses During COVID-19 in the Healthcare Settings of a Lower Middle-income Country: A Qualitative Study. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:148-158. [PMID: 38697611 DOI: 10.1016/j.anr.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/17/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024] Open
Abstract
PURPOSE The aim of this study was to provide the perceptions of nurses, nursing supervisors, and nursing administrators about factors contributing to increased workplace violence (WPV) against nurses within the healthcare settings in Pakistan during the first wave of the COVID-19 pandemic. METHODS This study used a Descriptive Qualitative design, with a purposive sampling technique. From September to December 2021, In-depth interviews of 45 to 60 minutes, using a semistructured interview guide, we collected data from a private and a public healthcare setting in Pakistan. Given the travel restrictions during the COVID-19 pandemic, these interviews were conducted online, using Zoom audio features. Bedside nurses, nursing supervisors, and nursing administrators with at least six months of work experience participated in this study. RESULTS The qualitative data analysis steps suggested by Braun and Clarke (2013) were used for thematic analysis. The overarching theme emerging from the data was "Factors perceived by nurses that contributed to increased WPV in their work settings during the first wave of COVID-19, in a lower middle-income country" The subthemes from the participants' narrations were (a) highly stressed patients, attendants, and healthcare workers; (b) the financial burden on patients and their families; (c) lack of resources and shortage of staff; (d) restricted visiting policy and a weak security system; (e) lack of awareness about the seriousness of COVID-19; (f) misconceptions about COVID-19 vaccines and nurses' role in disseminating awareness. CONCLUSIONS The current pandemic increased the intensity of WPV against nurses in healthcare settings in Pakistan. Despite any supposed reasons for WPV, exposure to violence should never be an acceptable part of nursing. The healthcare system in Pakistan needs to pay equal attention to funding, resource provision, and ensuring a safe working environment for healthcare workers.
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Affiliation(s)
- Rozina Somani
- Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Canada.
| | - Carles Muntaner
- Lawrence S. Bloomberg, Faculty of Nursing and Dalla Lana School of Public Health, University of Toronto, Canada
| | - Alisa J Velonis
- School of Public Health, Division of Community Health Sciences, University of Illinois Chicago, USA
| | - Peter Smith
- Institute for Work & Health, Toronto, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Edith M Hillan
- Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Canada
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Iqbal S, Ali I. Routine Vaccination During COVID-19: A Case of Maternal Neonatal Tetanus From Pakistan. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 3:790647. [PMID: 36712913 PMCID: PMC9879008 DOI: 10.3389/frph.2021.790647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/17/2021] [Indexed: 01/15/2023] Open
Affiliation(s)
- Sehar Iqbal
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Inayat Ali
- Department of Public Health and Allied Sciences, Fatima Jinnah Women University, Rawalpindi, Pakistan,Department of Anthropology, Fatima Jinnah Women University, Rawalpindi, Pakistan,Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria,*Correspondence: Inayat Ali
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Saeidnia HR, Kozak M, Ausloos M, Herteliu C, Mohammadzadeh Z, Ghorbi A, Karajizadeh M, Hassanzadeh M. Development of a Mobile App for Self-Care Against COVID-19 Using the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) Model: Methodological Study. JMIR Form Res 2022; 6:e39718. [PMID: 36054441 PMCID: PMC9472509 DOI: 10.2196/39718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/13/2022] [Accepted: 08/10/2022] [Indexed: 12/23/2022] Open
Abstract
Background
Mobile apps have been shown to play an important role in the management, care, and prevention of infectious diseases. Thus, skills for self-care—one of the most effective ways to prevent illness—can be improved through mobile health apps.
Objective
This study aimed to design, develop, and evaluate an educational mobile-based self-care app in order to help the self-prevention of COVID-19 in underdeveloped countries. We intended the app to be easy to use, quick, and inexpensive.
Methods
In 2020 and 2021, we conducted a methodological study. Using the ADDIE (analysis, design, development, implementation, and evaluation) educational model, we developed a self-care management mobile app. According to the ADDIE model, an effective training and performance support tool is built through the 5 phases that comprise its name. There were 27 participants who conducted 2 evaluations of the mobile app’s usability and impact using the mobile health app usability and self-care inventory scales. The study design included pre- and posttesting.
Results
An Android app called MyShield was developed. The results of pre- and posttests showed that on a scale from 0 to 5, MyShield scored a performance average of 4.17 in the physical health dimension and an average of 3.88 in the mental well-being dimension, thereby showing positive effects on self-care skills. MyShield scored highly on the “interface and satisfaction,” “ease of use,” and “usefulness” components.
Conclusions
MyShield facilitates learning self-care skills at home, even during quarantine, increasing acquisition of information. Given its low development cost and the ADDIE educational design on which it is based, the app can be helpful in underdeveloped countries. Thus, low-income countries—often lacking other tools—can use the app as an effective tool for fighting COVID-19, if it becomes a standard mobile app recommended by the government.
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Affiliation(s)
- Hamid Reza Saeidnia
- Department of Knowledge and Information Science, Tarbiat Modares University, Tehran, Iran
| | - Marcin Kozak
- Department of Media, Journalism and Social Communication, University of Information Technology and Management in Rzeszow, Rzeszow, Poland
| | - Marcel Ausloos
- School of Business, University of Leicester, Brookfield, Leicester, United Kingdom
| | - Claudiu Herteliu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Zahra Mohammadzadeh
- Department of Health Information Management and Technology, School of Allied Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali Ghorbi
- Department of Knowledge and Information Science, University of Tehran, Tehran, Iran
| | - Mehrdad Karajizadeh
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Mohammad Hassanzadeh
- Department of Knowledge and Information Science, Tarbiat Modares University, Tehran, Iran
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Daher-Nashif S, Al-Anany R, Ali M, Erradi K, Farag E, Abdallah AM, Emara MM. COVID-19 exit strategy during vaccine implementation: a balance between social distancing and herd immunity. Arch Virol 2022; 167:1773-1783. [PMID: 35723757 PMCID: PMC9208258 DOI: 10.1007/s00705-022-05495-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/05/2022] [Indexed: 11/09/2022]
Abstract
Currently, health authorities around the world are struggling to limit the spread of COVID-19. Since the beginning of the pandemic, social distancing has been the most important strategy used by most countries to control disease spread by flattening and elongating the epidemic curve. Another strategy, herd immunity, was also applied by some countries through relaxed control measures that allow the free spread of natural infection to build up solid immunity within the population. In 2021, COVID-19 vaccination was introduced with tremendous effort as a promising strategy for limiting the spread of disease. Therefore, in this review, we present the current knowledge about social distancing, herd immunity strategies, and aspects of their implementation to control the COVID-19 pandemic in the presence of the newly developed vaccines. Finally, we suggest a short-term option for controlling the pandemic during vaccine application.
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Affiliation(s)
- Suhad Daher-Nashif
- Population Medicine Department, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Rania Al-Anany
- Basic Medical Sciences Department, College of Medicine, QU Health, Qatar University, Doha, Qatar
- Public Health Department, Health Protection and Communicable Diseases, Ministry of Public Health, Doha, Qatar
| | - Menatalla Ali
- Basic Medical Sciences Department, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Khadija Erradi
- Basic Medical Sciences Department, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Elmoubasher Farag
- Public Health Department, Health Protection and Communicable Diseases, Ministry of Public Health, Doha, Qatar
| | - Abdallah M Abdallah
- Basic Medical Sciences Department, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Mohamed M Emara
- Basic Medical Sciences Department, College of Medicine, QU Health, Qatar University, Doha, Qatar.
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Beg BM, Hussain T, Ahmad M, Areej S, Majeed A, Rasheed MA, Ahmad MM, Shoaib QUA, Aroosa S. Perceived risk and perceptions of COVID-19 vaccine: A survey among general public in Pakistan. PLoS One 2022; 17:e0266028. [PMID: 35324978 PMCID: PMC8947088 DOI: 10.1371/journal.pone.0266028] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/11/2022] [Indexed: 01/09/2023] Open
Abstract
Background The coronavirus disease has become a global pandemic, and it continues to wreak havoc on global health and the economy. The development of vaccines may offer a potential eradication of COVID-19. This study evaluated the general knowledge, attitude, and perception of COVID-19 vaccines in the Pakistani population. Methods A self-reporting e-survey and questionnaire-based survey from vaccination centers of different cities of Pakistan among 502 participants were conducted. The questionnaire comprised four sections inquiring demographics, vaccination status, and perception or attitude towards the vaccine. Univariate logistic regression was applied to predict the knowledge, attitude and behavior of participants. Results The mean age of participants was 50.8±20.3 years. 53% of the participants have both doses of vaccine administered. Pain on the site of injection (49.8%) was the most common symptom, followed by asthenia (43.0%), muscle pain (29.5%), and swelling (24.5%) on the site of vaccine administration. Females complain of more symptoms than males. More severe symptoms were reported after the first dose of vaccine administration; these symptoms subsided within a week for most participants. Overall, the respondents have a positive attitude towards the vaccine. 47.4% are sure about the vaccine’s efficacy, 48.6% said getting vaccinated was their own decision, and 79.9% also recommended others to get vaccinated. Conclusion The study concluded that the Pakistani population has a positive attitude but inadequate knowledge towards COVID-19 vaccines. Immediate awareness and vaccination education programs should be conducted by the authorities to complete the mass vaccination schedule.
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Affiliation(s)
- Bilal Mahmood Beg
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences Lahore, Lahore, Pakistan
| | - Tariq Hussain
- Department of Basic Sciences, College of Veterinary and Animal Science Jhang, Jhang, Pakistan
| | - Mehmood Ahmad
- Department of Pharmacology, Riphah International University Lahore, Lahore, Pakistan
- * E-mail:
| | - Sadaf Areej
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences Lahore, Lahore, Pakistan
| | - Arfa Majeed
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences Lahore, Lahore, Pakistan
| | - Muhammad Adil Rasheed
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences Lahore, Lahore, Pakistan
| | - Muhammad Moin Ahmad
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Qurat-ul-Ain Shoaib
- Department of Pharmaceutics, Akhtar Saeed College of Pharmaceutical Science Lahore, Lahore, Pakistan
| | - Sadaf Aroosa
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences Lahore, Lahore, Pakistan
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Abstract
Although coronavirus disease 2019 (COVID-19) is a pandemic, it has several specificities influencing its outcomes due to the entwinement of several factors, which anthropologists have called "syndemics". Drawing upon Singer and Clair's syndemics model, I focus on synergistic interaction among chronic kidney disease (CKD), diabetes, and COVID-19 in Pakistan. I argue that over 36 million people in Pakistan are standing at a higher risk of contracting COVID-19, developing severe complications, and losing their lives. These two diseases, but several other socio-cultural, economic, and political factors contributing to structured vulnerabilities, would function as confounders. To deal with the critical effects of these syndemics the government needs appropriate policies and their implementation during the pandemic and post-pandemic. To eliminate or at least minimize various vulnerabilities, Pakistan needs drastic changes, especially to overcome (formal) illiteracy, unemployment, poverty, gender difference, and rural and urban difference.
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Affiliation(s)
- Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria
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8
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COVID-19 in Pakistan and Papua New Guinea: reflections on mass testing and challenges. Prim Health Care Res Dev 2021; 22:e71. [PMID: 34796827 PMCID: PMC8628555 DOI: 10.1017/s1463423621000724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The 2020 COVID-19 pandemic continues during 2021. Some countries are revisiting their containment measures to be eased or re-imposed after massive testing programs. Yet is testing itself a solution? Testing may be an important containment step, yet in low-income countries (LICs), it may be substantially challenging to carry out. This is because the situation in LICs is complexified by inadequate and corrupt economic, political, and healthcare systems in which testing is often beyond reach. Focusing on Pakistan and Papua New Guinea (PNG), we contend that the sparse number of recorded COVID-19 infections may demonstrate that both countries lack the required resources to conduct effective testing and deal with the pandemic. To appropriately tackle the pandemic, such countries need focus on implementing the measures they can and on public education about how viruses work and why it is so important to seek to contain their spread. Furthermore, we invite thorough studies to examine and analyze massive testing from various perspectives.
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Noorali AAA, Thobani H, Hashmi S, Iqbal S, Merchant AA, Haroon MA, Chauhan SSB, Mallick S, Zahid N, Khan Y, Faheem O, Fatimi SH. Comparative Trends in Ischemic Heart Disease Admissions, Presentation and Outcomes Due to the COVID-19 Pandemic: First Insights From a Tertiary Medical Center in Pakistan. Cureus 2021; 13:e17558. [PMID: 34646615 PMCID: PMC8480226 DOI: 10.7759/cureus.17558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction COVID-19 has manifested a striking disarray in healthcare access and provision, particularly amongst patients presenting with life-threatening ischemic heart disease (IHD). The paucity of data from low-middle income countries has limited our understanding of the consequential burden in the developing world. We aim to compare volumes, presentations, management strategies, and outcomes of IHD amongst patients presenting in the same calendar months before and during the COVID-19 pandemic. Methods We conducted a retrospective cross-sectional analysis at the Aga Khan University Hospital, one of the premier tertiary care centres in Pakistan. Data were collected on all adult patients (>18 years) who were admitted with IHD (acute coronary syndrome (ACS) and stable angina) from March 1 to June 30, 2019 (pre-COVID) and March 1 to June 30, 2020 (during-COVID), respectively. Group differences for continuous variables were evaluated using student t-test or Mann-Whitney U test. The chi-squared test or Fisher test was used for categorical variables. Values of p less than 0.05 were considered statistically significant. P-value trend calculation and graphical visualization were done using STATA (StataCorp, College Station, TX). Results Data were assimilated on 1019 patients, with 706 (69.3%) and 313 (30.7%) patients presenting in each respective group (pre-COVID and during-COVID). Current smoking status (p=0.019), admission source (p<0.001), month of admission (p<0.001), proportions ACS (p<0.001), non-ST-elevation-myocardial-infarction (NSTEMI; p<0.001), unstable angina (p=0.025) and medical management (p=0.002) showed significant differences between the two groups, with a sharp decline in the during-COVID group. Monthly trend analysis of ACS patients showed the most significant differences in admissions (p=0.001), geographic region (intra-district vs intracity vs outside city) (p<0.001), time of admission (p=0.038), NSTEMI (p=0.002) and medical management (p=0.001). Conclusion These data showcase stark declines in ACS admissions, diagnostic procedures (angiography) and revascularization interventions (angioplasty and coronary artery bypass graft surgery, CABG) in a developing country where resources and research are already inadequate. This study paves the way for further investigations downstream on the short- and long-term consequences of untreated IHD and reluctance in health-seeking behaviour.
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Affiliation(s)
| | - Humza Thobani
- Cardiothoracic Surgery, Aga Khan University, Karachi, PAK
| | - Shiraz Hashmi
- Cardiothoracic Surgery, Aga Khan University, Karachi, PAK
| | - Sara Iqbal
- Cardiothoracic Surgery, Aga Khan University, Karachi, PAK
| | | | | | | | | | - Nida Zahid
- Cardiothoracic Surgery, Aga Khan University, Karachi, PAK
| | - Yasir Khan
- Cardiothoracic Surgery, Aga Khan University, Karachi, PAK
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Fleitas PE, Paz JA, Simoy MI, Vargas C, Cimino RO, Krolewiecki AJ, Aparicio JP. Clinical diagnosis of COVID-19. A multivariate logistic regression analysis of symptoms of COVID-19 at presentation. Germs 2021; 11:221-237. [PMID: 34422694 DOI: 10.18683/germs.2021.1259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023]
Abstract
Introduction The objective of this cross-sectional study was to describe the main symptoms associated with COVID-19, and their diagnostic characteristics, to aid in the clinical diagnosis. Methods An analysis of all patients diagnosed by RT-PCR for SARS-CoV-2 between April and May 2020 in Argentina was conducted. The data includes clinical and demographic information from all subjects at the time of presentation (n=67318, where 12% were positive for SARS-CoV-2). The study population was divided into four age groups: pediatric (0-17 years), young adults (18-44 years), adults (45-64 years), and elderly (65-103 years). Multivariate logistic regression was used to measure the association of all symptoms and to create a diagnostic model based on symptoms. Results Symptoms associated with COVID-19 were anosmia, dysgeusia, headache, low-grade fever, odynophagia, and malaise. However, the presentation of these symptoms was different between the different age groups. In turn, at the time of presentation, the symptoms associated with respiratory problems (chest pain, abdominal pain, and dyspnea) had a negative association with COVID-19 or did not present statistical relevance. On the other hand, the model based on 16 symptoms, age and sex, presented a sensitivity of 80% and a specificity of 46%. Conclusions There were significant differences between the different age groups. Additionally, there were interactions between different symptoms that were highly associated with COVID-19. Finally, our findings showed that a regression model based on multiple factors (age, sex, interaction between symptoms) can be used as an accessory diagnostic method or a rapid screening of suspected COVID-19 cases.
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Affiliation(s)
- Pedro E Fleitas
- MSc, Instituto de Investigaciones de Enfermedades Tropicales (IIET-CONICET), Universidad Nacional de Salta, Alvarado 751, San Ramon de la Nueva Oran, zip code A4530, Salta, Argentina, Cátedra de Química Biología, Facultad de Ciencias Naturales, Universidad Nacional de Salta, Av. Bolivia 5150, zip code A4400, Salta, Argentina
| | - Jorge A Paz
- PhD, Instituto de Estudios Laborales y del Desarrollo Económico (IELDE), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Salta, Av. Bolivia 5150, zip code A4400, Salta, Argentina
| | - Mario I Simoy
- PhD, Instituto de Investigaciones en Energía no Convencional (INENCO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Salta, Av. Bolivia 5150, zip code A4400, Salta, Argentina, Instituto Multidisciplinario sobre Ecosistemas y Desarrollo Sustentable, Universidad Nacional del Centro de la Provincia de Buenos Aires, Pinto 399, zip code B7000, Tandil, Buenos Aires, Argentina
| | - Carlos Vargas
- MSc, Instituto de Investigaciones de Enfermedades Tropicales (IIET-CONICET), Universidad Nacional de Salta, Alvarado 751, San Ramon de la Nueva Oran, zip code A4530, Salta, Argentina
| | - Rubén O Cimino
- PhD, Instituto de Investigaciones de Enfermedades Tropicales (IIET-CONICET), Universidad Nacional de Salta, Alvarado 751, San Ramon de la Nueva Oran, zip code A4530, Salta, Argentina, Cátedra de Química Biología, Facultad de Ciencias Naturales, Universidad Nacional de Salta, Av. Bolivia 5150, zip code A4400, Salta, Argentina
| | - Alejandro J Krolewiecki
- MD, PhD, Instituto de Investigaciones de Enfermedades Tropicales (IIET-CONICET), Universidad Nacional de Salta, Alvarado 751, San Ramon de la Nueva Oran, zip code A4530, Salta, Argentina
| | - Juan P Aparicio
- PhD, Instituto de Investigaciones en Energía no Convencional (INENCO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Salta, Av. Bolivia 5150, zip code A4400, Salta, Argentina, Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, P.O. Box 873901, Tempe, AZ 85287-3901, USA
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Rauf N, Zulfiqar S, Mumtaz S, Maryam H, Shoukat R, Malik A, Rowther AA, Rahman A, Surkan PJ, Atif N. The Impact of the COVID-19 Pandemic on Pregnant Women with Perinatal Anxiety Symptoms in Pakistan: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8237. [PMID: 34443987 PMCID: PMC8394090 DOI: 10.3390/ijerph18168237] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 12/12/2022]
Abstract
The impact of coronavirus disease 2019 (COVID-19) on people with existing mental health conditions is likely to be high. We explored the consequences of the pandemic on women of lower socioeconomic status with prenatal anxiety symptoms living in urban Rawalpindi, Pakistan. This qualitative study was embedded within an ongoing randomized controlled trial of psychosocial intervention for prenatal anxiety at a public hospital in Rawalpindi. The participants were women with symptoms of anxiety who had received or were receiving the intervention. In total, 27 interviews were conducted; 13 women were in their third trimester of pregnancy, and 14 were in their postnatal period. The data were collected through in-depth interviews and analyzed using framework analysis. Key findings were that during the pandemic, women experienced increased perinatal anxiety that was linked to greater financial problems, uncertainties over availability of appropriate obstetric healthcare, and a lack of trust in health professionals. Women experienced increased levels of fear for their own and their baby's health and safety, especially due to fear of infection. COVID-19 appears to have contributed to symptoms of anxiety in women already predisposed to anxiety in the prenatal period. Efforts to address women's heightened anxiety due to the pandemic are likely to have public health benefits.
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Affiliation(s)
- Nida Rauf
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan; (N.R.); (S.Z.); (S.M.); (H.M.); (R.S.); (A.M.)
| | - Shaffaq Zulfiqar
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan; (N.R.); (S.Z.); (S.M.); (H.M.); (R.S.); (A.M.)
| | - Sidra Mumtaz
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan; (N.R.); (S.Z.); (S.M.); (H.M.); (R.S.); (A.M.)
| | - Hadia Maryam
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan; (N.R.); (S.Z.); (S.M.); (H.M.); (R.S.); (A.M.)
| | - Rabail Shoukat
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan; (N.R.); (S.Z.); (S.M.); (H.M.); (R.S.); (A.M.)
| | - Abid Malik
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan; (N.R.); (S.Z.); (S.M.); (H.M.); (R.S.); (A.M.)
- Department of Research, Rawalpindi Medical University, Tipu Rd, Chamanzar Colony, Rawalpindi 46000, Pakistan
| | - Armaan A. Rowther
- Department of International Health, Johns Hopkins Bloomberg School of Public Health 615 N. Wolfe St., Baltimore, MD 21205, USA; (A.A.R.); (P.J.S.)
| | - Atif Rahman
- Institute of Population Health, University of Liverpool, Liverpool L12 2AP, UK;
| | - Pamela J. Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health 615 N. Wolfe St., Baltimore, MD 21205, USA; (A.A.R.); (P.J.S.)
| | - Najia Atif
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan; (N.R.); (S.Z.); (S.M.); (H.M.); (R.S.); (A.M.)
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Ali I, Ali S, Iqbal S. COVID-19 Vaccination: Concerns About Its Accessibility, Affordability, and Acceptability. Front Med (Lausanne) 2021; 8:647294. [PMID: 34336872 PMCID: PMC8323868 DOI: 10.3389/fmed.2021.647294] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/02/2021] [Indexed: 01/09/2023] Open
Abstract
By the mid of June 2021, after an almost 1.5-year-long COVID-19 pandemic that has significantly affected the world in multiple ways, various vaccines against COVID-19 have arrived and started worldwide. Yet, economic, (geo)political, and socio-cultural factors may influence its uptake at individual and country levels. Several issues will (and already have been reported in media) revolve around this vaccination regarding its accessibility, affordability, and acceptability at an individual level and a country level. Given that in this commentary, we provoke a discussion: Who—a country as well as the individuals—would have access to it, and who would economically afford it, and who would accept it? Centering these intriguing questions, we revisit the body of literature that explicates vaccine hesitancy, refusal, and resistance, and we also draw on the current literature and media reports about vaccination against COVID-19. We suggest that these backdrops need essential attention so that everyone can afford, accept, and have access to it. Otherwise, the current risk in the face of a year-old pandemic will continue.
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Affiliation(s)
- Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria
| | | | - Sehar Iqbal
- Department of Nutrition and Dietetics, National University of Medical Sciences, Rawalpindi, Pakistan
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Cypro A, McGuire WC, Rolfsen M, Jones N, Shah NG, Cribbs SK, Kaul V, Bojanowski CM, Pedraza I, Lynch L, Guzman L, Larsson E, Crotty Alexander LE. An International Virtual COVID-19 Critical Care Training Forum for Healthcare Workers. ATS Sch 2021; 2:278-286. [PMID: 34409421 PMCID: PMC8362763 DOI: 10.34197/ats-scholar.2020-0154in] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/11/2021] [Indexed: 11/18/2022] Open
Abstract
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic resulted in redeployment of non-critical care-trained providers to intensive care units across the world. Concurrently, traditional venues for delivery of medical education faced major disruptions. The need for a virtual forum to fill knowledge gaps for healthcare workers caring for patients with coronavirus disease (COVID-19) was apparent in the early stages of the pandemic. Objective: The weekly, open-access COVID-19 Critical Care Training Forum (CCCTF) organized by the American Thoracic Society (ATS) provided a global audience access to timely content relevant to their learning needs. The goals of the forum were threefold: to aid healthcare providers in assessment and treatment of patients with COVID-19, to reduce provider anxiety, and to disseminate best practices. Methods: The first 13 ATS CCCTF sessions streamed live from April to July 2020. Structured debriefs followed each session and participant feedback was evaluated in planning of subsequent sessions. A second set of 14 sessions streamed from August to November 2020. Content experts were recruited from academic institutions across the United States. Results: As of July 2020, the ATS CCCTF had 2,494 live participants and 7,687 downloads for a total of 10,181 views. The majority of participants had both completed training (58.6%) and trained in critical care (53.8%). Physicians made up a majority (82.2%) of the audience that spanned the globe (61% were international attendees). Conclusion: We describe the rapid and successful implementation of an open-access medical education forum to address training and knowledge gaps among healthcare personnel caring for patients with COVID-19.
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Affiliation(s)
- Alexander Cypro
- Pulmonary and Critical Care Section, VA
San Diego Healthcare System, San Diego, California, and Pulmonary, Critical Care
and Sleep Division, University of California San Diego, San Diego,
California
| | - W. Cameron McGuire
- Pulmonary and Critical Care Section, VA
San Diego Healthcare System, San Diego, California, and Pulmonary, Critical Care
and Sleep Division, University of California San Diego, San Diego,
California
| | - Mark Rolfsen
- Pulmonary and Critical Care Section, VA
San Diego Healthcare System, San Diego, California, and Pulmonary, Critical Care
and Sleep Division, University of California San Diego, San Diego,
California
| | - Neal Jones
- Pulmonary and Critical Care Section, VA
San Diego Healthcare System, San Diego, California, and Pulmonary, Critical Care
and Sleep Division, University of California San Diego, San Diego,
California
| | - Nirav G. Shah
- Division of Pulmonary and Critical Care
Medicine, University of Maryland, Baltimore, Maryland
| | - Sushma K. Cribbs
- Pulmonary and Critical Care Section,
Atlanta VA Healthcare System, Atlanta, Georgia, and Division of Pulmonary,
Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta,
Georgia
| | - Viren Kaul
- Division of Pulmonary and Critical Care
Medicine, Crouse Health/SUNY Upstate Medical University, Syracuse, New
York
| | - Christine M. Bojanowski
- Section of Pulmonary Diseases, Critical
Care and Environmental Medicine, Tulane University, New Orleans, Louisiana
| | - Isabel Pedraza
- Division of Pulmonary and Critical Care
Medicine, Cedars Sinai, Los Angeles, California; and
| | | | - Liz Guzman
- American Thoracic Society, New York, New
York
| | | | - Laura E. Crotty Alexander
- Pulmonary and Critical Care Section, VA
San Diego Healthcare System, San Diego, California, and Pulmonary, Critical Care
and Sleep Division, University of California San Diego, San Diego,
California
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14
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Yánez Benítez C, Ribeiro MAF, Alexandrino H, Koleda P, Baptista SF, Azfar M, Di Saverio S, Ponchietti L, Güemes A, Blas JL, Mesquita C. International cooperation group of emergency surgery during the COVID-19 pandemic. Eur J Trauma Emerg Surg 2021; 47:621-629. [PMID: 33047158 PMCID: PMC7550249 DOI: 10.1007/s00068-020-01521-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/26/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE The COVID-19 pandemic has changed working conditions for emergency surgical teams around the world. International surgical societies have issued clinical recommendations to optimize surgical management. This international study aimed to assess the degree of emergency surgical teams' adoption of recommendations during the pandemic. METHODS Emergency surgical team members from over 30 countries were invited to answer an anonymous, prospective, online survey to assess team organization, PPE-related aspects, OR preparations, anesthesiologic considerations, and surgical management for emergency surgery during the pandemic. RESULTS One-hundred-and-thirty-four questionnaires were returned (N = 134) from 26 countries, of which 88% were surgeons, 7% surgical trainees, 4% anesthetists. 81% of the respondents got involved with COVID-19 crisis management. Social media were used by 91% of the respondents to access the recommendations, and 66% used videoconference tools for team communication. 51% had not received PPE training before the pandemic, 73% reported equipment shortage, and 55% informed about re-use of N95/FPP2/3 respirators. Dedicated COVID operating areas were cited by 77% of the respondents, 44% had performed emergency surgical procedures on COVID-19 patients, and over half (52%), favored performing laparoscopic over open surgical procedures. CONCLUSION Surgical team members have responded with leadership to the COVID-19 pandemic, with crisis management principles. Social media and videoconference have been used by the vast majority to access guidelines or to communicate during social distancing. The level of adoption of current recommendations is high for organizational aspects and surgical management, but not so for PPE training and availability, and anesthesiologic considerations.
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Affiliation(s)
- Carlos Yánez Benítez
- General and GI Surgery Department, Royo Villanova Hospital, SALUD, Av. de San Gregorio s/n. 50015, Zaragoza, Spain
| | - Marcelo A. F. Ribeiro
- Department of General Surgery and Trauma Surgery, Catholic University of São Paulo PUC-Sorocaba and Hospital Moriah, Avenida Victor Civita, Sao Paulo, 235 Brazil
| | - Henrique Alexandrino
- Department of General Surgery, Faculty of Medicine, Coimbra University Hospital Center, University of Coimbra, Praceta Mota Pinto, 3000-045 Coimbra, Portugal
| | - Piotr Koleda
- Department of Medical Simulation, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | | | - Mohammad Azfar
- Department of General Surgery, Al Rahba Hospital, Abu Dhabi, UAE
| | - Salomone Di Saverio
- Department of General Surgery, Varese University Hospital, ASST Sette Laghi, University of Insubria, Regione Lombardia, Varese, Italy
| | - Luca Ponchietti
- Department of General Surgery, San Jorge University Hospital, Av. Martínez de Velasco, 36, 22004 Huesca, Spain
| | - Antonio Güemes
- Department of General Surgery, Lozano Blesa University Hospital, Av. San Juan Bosco, 15, 50009 Zaragoza, Spain
| | - Juan L. Blas
- General and GI Surgery Department, Royo Villanova Hospital, SALUD, Av. de San Gregorio s/n. 50015, Zaragoza, Spain
| | - Carlos Mesquita
- Department of General Surgery, Faculty of Medicine, Coimbra University Hospital Center, University of Coimbra, Praceta Mota Pinto, 3000-045 Coimbra, Portugal
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15
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Singhal S, Kumar P, Singh S, Saha S, Dey AB. Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis. BMC Geriatr 2021; 21:321. [PMID: 34011269 PMCID: PMC8133052 DOI: 10.1186/s12877-021-02261-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 05/05/2021] [Indexed: 12/20/2022] Open
Abstract
Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02261-3.
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Affiliation(s)
- Sunny Singhal
- Department of Geriatric Medicine, All India Institute of Medical Sciences, Ansari Nagar, Delhi, 110029, India
| | - Pramod Kumar
- Department of Geriatric Medicine, All India Institute of Medical Sciences, Ansari Nagar, Delhi, 110029, India
| | - Sumitabh Singh
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Srishti Saha
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Aparajit Ballav Dey
- Department of Geriatric Medicine, All India Institute of Medical Sciences, Ansari Nagar, Delhi, 110029, India.
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16
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Ali I, Sadique S, Ali S, Davis-Floyd R. Birthing Between the "Traditional" and the "Modern": DāĪ Practices and Childbearing Women's Choices During COVID-19 in Pakistan. FRONTIERS IN SOCIOLOGY 2021; 6:622223. [PMID: 34026899 PMCID: PMC8138426 DOI: 10.3389/fsoc.2021.622223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/15/2021] [Indexed: 05/05/2023]
Abstract
Pregnancy and birth are biological phenomena that carry heavy cultural overlays, and pregnant and birthing women need care and attention during both ordinary and extraordinary times. Most Pakistani pregnant women now go to doctors and hospitals for their perinatal care. Yet traditional community midwives, called DāĪ in the singular and Dāyūn in the plural, still attend 24% of all Pakistani births, primarily in rural areas. In this article, via data collected from 16 interviews-5 with Dāyūn and 11 with mothers, we explore a maternity care system in tension between the past and the present, the DāĪ and the doctor. We ask, what does the maternity care provided by the Dāyūn look like during times of normalcy, and how does it differ during COVID-19? We look at the roles the DāĪ has traditionally performed and how these roles have been changing, both in ordinary and in Covidian circumstances. Presenting the words of the Dāyūn we interviewed, all from Pakistan's Sindh Province, we demonstrate their practices and show that these have not changed during this present pandemic, as these Dāyūn, like many others in Sindh Province, do not believe that COVID-19 is real-or are at least suspect that it is not. To contextualize the Dāyūn, we also briefly present local mother's perceptions of the Dāyūn in their regions, which vary between extremely positive and extremely negative. Employing the theoretical frameworks of "authoritative knowledge" and of critical medical anthropology, we highlight the dominance of "modern" biomedicine over "traditional" healthcare systems and its effects on the Dāyūn and their roles within their communities. Positioning this article within Pakistan's national profile, we propose formally training and institutionalizing the Dāyūn in order to alleviate the overwhelming burdens that pandemics-present and future-place on this country's fragile maternity care system, to give mothers more-and more viable-options at all times, and to counterbalance the rising tide of biomedical hegemony over pregnancy and birth.
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Affiliation(s)
- Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, VIE, Austria
| | - Salma Sadique
- Department of Community Health Sciences, Peoples University of Medical and Health Sciences for Women (PUMHSW), Sindh, Pakistan
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Ali I, Sadique S, Ali S. COVID-19 and Vaccination Campaigns as "Western Plots" in Pakistan: Government Policies, (Geo-)politics, Local Perceptions, and Beliefs. FRONTIERS IN SOCIOLOGY 2021; 6:608979. [PMID: 33969047 PMCID: PMC8102740 DOI: 10.3389/fsoc.2021.608979] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/22/2021] [Indexed: 05/04/2023]
Abstract
Vaccination encounters multiple context-specific challenges-socio-cultural, economic, and political-that substantially affect its uptake. Likewise, natural disasters and health emergencies considerably impact immunization endeavors, such as the coronaviurs 2019 (COVID-19) pandemic that has overwhelmed the entire world. It was already anticipated that the pandemic would severely affect Pakistan's vaccination programs due to interruptions in routine vaccination and the overstretching of healthcare systems. Consequently, there are anticipations of outbreaks of other vaccine-preventable diseases (VPDs). Yet empirical evidence is missing. Drawing on qualitative research, this article focuses on the impact of COVID-19 on routine vaccination programs in Pakistan. Our data come from a small village located in Pakistan's Sindh province where local people refused the routine polio vaccine that was stopped for a while, then resumed in July 2020. They suspected both the vaccine and COVID-19 to be a "Western plot." We argue that these perceptions and practices can be seen against the backdrop of economic, socio-cultural, and (geo)political forces, which are encoded in "societal memory." Not only is there a need to reverse the significant impacts of COVID-19 on routine vaccination by arranging supplementary immunization activities (SIAs), but also the government must deal with other pressing issues that affect the vaccination programs in the country.
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Affiliation(s)
- Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria
| | - Salma Sadique
- Community Health Sciences, Peoples University of Medical and Health Science Women, Nawabshah, Pakistan
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18
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Ali I. From Normal to Viral Body: Death Rituals During Ordinary and Extraordinary Covidian Times in Pakistan. FRONTIERS IN SOCIOLOGY 2021; 5:619913. [PMID: 33869536 PMCID: PMC8022599 DOI: 10.3389/fsoc.2020.619913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 12/17/2020] [Indexed: 05/02/2023]
Abstract
Death is far from being simply a physiologic event; it is a complex phenomenon with sociocultural and politicoeconomic aspects. During extraordinary times such as the 2020 coronavirus pandemic, death becomes a contested site. I argue that the Pakistani government's dealings with the bodies of people who die from COVID-19 have shifted the meaning of a normal dead body to a viral body that poses particular challenges to cultures and people, including the government. This article is both autoethnographic and ethnographic. It concurrently draws on my observations and participation in death rituals in a Pakistani village in Sindh province as a member of that society, and on a recent experience that I faced after the death of a gentle lady of my acquaintance due to COVID-19. I also build on my previous long-term ethnographic research in Pakistan and my ongoing research on COVID-19 in that country. I discuss the death rituals and ceremonies performed during "ordinary" situations as background information; and the changes in these rituals that have resulted from the coronavirus pandemic. My data demonstrate significant differences between usual and customary death rituals and those performed during Covidian times by government mandate, which have severely and negatively affected people's mental health. I show the government's "symbolic ownership" of the viral body, in that the government can control how people deal with their viral dead.
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Affiliation(s)
- Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria
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19
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Halsey R, Priftakis D, Mackenzie S, Wan S, Davis LM, Lilburn D, Thornton A, Papathanasiou N, Gnanasegaran G, Bomanji J. COVID-19 in the act: incidental 18F-FDG PET/CT findings in asymptomatic patients and those with symptoms not primarily correlated with COVID-19 during the United Kingdom coronavirus lockdown. Eur J Nucl Med Mol Imaging 2021; 48:269-281. [PMID: 32761260 PMCID: PMC7406218 DOI: 10.1007/s00259-020-04972-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/23/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE The emergence of the novel SARS-CoV-2 pathogen and lethal COVID-19 disease pandemic poses major diagnostic challenges. The study aims to describe the spectrum and prevalence of thoracic and extrathoracic incidental findings in patients who have undergone 18F-FDG PET/CT during the first 3 weeks of the COVID-19 UK lockdown. METHODS This is a single-centre retrospective controlled observational study. 18F-FDG PET/CT scans (n = 160) acquired from 23/3/2020 to 9/4/2020 were retrospectively reviewed for incidental findings in the lungs and extrapulmonary sites (heart, nasal sinuses, parotid and salivary glands, colon, large vessels, renal cortex, brain, spleen and testes). A date-matched control group (n = 205) of patients from 2019 was used for comparison. RESULTS The total prevalence of suspicious findings was 26/160 (16.25%). Fifteen patients presented with incidental findings in the lungs, while eleven patients had only non-pulmonary incidental findings. There was a significant increase in the appearance of incidental 18F-FDG PET/CT findings during the 2nd week (OR = 3.8) and 3rd week (OR = 7.6) in relation to the 1st week. There was a significant increase in the average maximum standardised uptake values (SUVmax) in the parotid/salivary glands of patients scanned during week 2 in relation to week 1 (p = 0.036). There was no significant difference in the prevalence of incidental findings compared to the control group, but the number of pulmonary vs. extrathoracic findings was different between the two populations. CONCLUSION The study provides a novel base of evidence to identify asymptomatic patients and those without symptoms strongly associated with COVID-19 with incidental 18F-FDG PET/CT findings suspicious of SARS-CoV-2 infection during the initial stages of the pandemic.
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Affiliation(s)
- Richard Halsey
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Dimitrios Priftakis
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Strachan Mackenzie
- Department Haematology, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Simon Wan
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Laura M. Davis
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - David Lilburn
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Andrew Thornton
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Nikolaos Papathanasiou
- Nuclear Medicine and PET/CT Department, University Hospital of Patras, Rio, 265 04 Patras, Greece
| | - Gopinath Gnanasegaran
- Department of Nuclear Medicine, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG UK
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
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20
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Ali I, Sadique S, Ali S. COVID-19 Significantly Affects Maternal Health: A Rapid-Response Investigation from Pakistan. Front Glob Womens Health 2020; 1:591809. [PMID: 34816166 PMCID: PMC8594032 DOI: 10.3389/fgwh.2020.591809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/22/2020] [Indexed: 12/26/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) is still unfolding. Its several implications are visible, yet more of them we have to observe and witness in future. Dealing with these impacts, this rapid-response article aims to situate the COVID-19 pandemic within Pakistan's overall sociocultural and politico-economic context; next to investigate the impacts of COVID-19 particularly the psychological ones on pregnant women in Pakistan via five case. One case history of Haleema (pseudonym) revealed how the pandemic exerted a substantial amount of mental pressure due to “arranging someone to accompany her to the hospital, finding a blood donor for her, and insecurity of convenience to hospital.” In this article, we show that Pakistan's geographical division into urban with an appropriate healthcare system, infrastructure and economic status, and more impoverished rural areas may show different impacts on people in general and the pregnant women in particular. This difference of facilities may contribute to disease transmission in the more deprived areas, that also due to cultural norms and mores such as shaking hands, cheek-kissing, and hugging that spread the virus are being overturned and that pregnant women are particularly vulnerable to psychological effects of the pandemic.
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Affiliation(s)
- Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria
- *Correspondence: Inayat Ali
| | - Salma Sadique
- Department of Community Health Sciences, Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan
| | - Shahbaz Ali
- Department of Anthropology, Pir Mehr Ali Shah (PMAS)-Arid Agriculture University Rawalpindi, Rawalpindi, Pakistan
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21
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Obara S. Anesthesiologist behavior and anesthesia machine use in the operating room during the COVID-19 pandemic: awareness and changes to cope with the risk of infection transmission. J Anesth 2020; 35:351-355. [PMID: 32856167 PMCID: PMC7453066 DOI: 10.1007/s00540-020-02846-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/14/2020] [Indexed: 12/12/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease [coronavirus disease 2019 (COVID-19) infection] first appeared in December 2019 in China and is now spreading worldwide. Because SARS-CoV-2 can be transmitted via aerosols and surface contaminations of the environment, appropriate use of anesthesia machines and appropriate behavior in the operation room (OR) are required specifically in relation to this disease. The use of high-performance hydrophobic filters with a high rate of virus rejection is recommended as the type of viral filter, and surgical team behaviors that result in aerosol splashes should be avoided. Appropriate hand hygiene by the anesthesiologist is crucial to prevent unexpected environmental contamination. When the anesthesia machine is used instead of an intensive care unit ventilator, it is important to keep the fresh gas flow at least equal to the minute ventilation to prevent excessive humidity in the circuit and to monitor condensation in the circuit and inspiratory carbon dioxide pressure. In addition, both the surgical smoke inherent in thermal tissue destruction and the surgical team's shoe soles may be factors for the presence of SARS-CoV-2 in the operating room. Ensuring social distancing-even with a mask in the OR-may be beneficial because healthcare providers may be asymptomatic carriers. After the acute crisis period of COVID-19, the number of cases of essential but nonurgent surgeries for waiting patients is likely to increase; therefore, optimization of OR scheduling will be an important topic. Anesthesiologists will benefit from new standard practices focusing on the prevention of COVID-19 infection.
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Affiliation(s)
- Shinju Obara
- Surgical Operation Department, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.
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