COVID-19 pandemic effects on the distribution of healthcare services in India: A systematic review

Meta-analysis and systematic review of factors predicting conversion to radical nephrectomy following robotic-assisted partial nephrectomy in renal cancer patients

Evaluating the risk factors for the conversion from robotic-assisted partial nephrectomy (RAPN) to radical nephrectomy (RN). Through a comprehensive database search encompassing PubMed, Web of Science, Embase, and the Cochrane Library, we identified pertinent English-language research published by June 2024. We utilized the NOS scale for quality assessment. The aggregate effect was quantified via the odds ratio (OR), alongside a 95% confidence interval (CI). Sensitivity analyses were conducted using both fixed-effects and random-effects models to evaluate reliability. The meta-analytical process was facilitated by the Stata 18 software suite. Our meta-analysis encompassed a total of 8 retrospective studies and 3 prospective studies, totaling 4056 patients. We found that increasing patient age (OR: 1.04; 95% CI 1.00-1.08; P = 0.005), higher American Society of Anesthesiologists (ASA) scores (3 or above) (OR: 2.74; 95% CI 1.52-4.93; P = 0.001), elevated R.E.N.A.L. scores (7 or above) (OR: 2.49; 95% CI 1.57-3.95; P < 0.001), and the use of off-clamp RAPN (OR: 7.21; 95% CI 2.60-19.93; P < 0.001) significantly raised the odds of surgical conversion. On the other hand, male sex (OR: 1.04; 95% CI 0.67-1.62; P = 0.858), the side of the tumor (OR: 0.97; 95% CI 0.48-1.95; P = 0.936), tumor size (OR: 3.43; 95% CI 0.57-20.55; P = 0.177), body mass index (BMI) (OR: 1.03; 95% CI 0.96-1.11; P = 0.426), clinical stage (OR: 3.78; 95% CI 0.46-30.70; P = 0.214), and the use of single-port RAPN (OR: 0.54; 95% CI 0.16-1.78; P = 0.31) did not show a statistically significant link to an increased conversion risk. This meta-analysis elucidates the critical risk factors for the conversion from robotic-assisted partial nephrectomy to radical nephrectomy, providing significant guidance for preoperative risk assessment and clinical decision-making. However, our findings necessitate validation through studies with larger sample sizes.

How COVID-19 has changed the utilization of different health care services in Poland

BACKGROUND

The COVID-19 pandemic has affected health care systems in many ways, including access to and the use of non-COVID services. The aim of the study was to assess the impact of the pandemic on the utilization of different public health care services in Poland.

METHODS

The aggregated data on health care users and provided services for the years 2015/2016-2021 were used to analyse the changes in health care utilization during the pandemic and deviations from pre-pandemic utilization trends. Quantitative analysis was complemented with qualitative descriptions of the changes in principles of health care provision during the pandemic.

RESULTS

The results show a considerable drop in the provision of most health care services in 2020 that in some cases disturbed pre-pandemic utilization trends and was not made up for in 2021. The most significant decrease has been observed in the field of preventive and public health services, as well as rehabilitation. The provision of these services was put on hold during the pandemic.

CONCLUSIONS

The accumulated COVID-19-related "health debt" urgently calls for government actions to strengthen disease prevention and health promotion in Poland.

All That Glitters Is Not Gold: The Indian Healthcare System

Healthcare is the most essential requirement for a better quality of life. Governments throughout the world ensure the establishment of improved healthcare systems that are on par with global healthcare systems for people, irrespective of their socioeconomic situation. It is crucial to understand the status of healthcare establishments existing in a country. The coronavirus disease 2019 (COVID-19) pandemic posed an imminent challenge concerning the quality of healthcare in various countries throughout the world. There were different types of problems faced by most nations irrespective of their socioeconomic status and financial capabilities. India also struggled to cope with the initial times of the COVID-19 pandemic wherein the hospitals were overwhelmed with patients and limited infrastructural capabilities, resulting in considerable morbidity and mortality. The greatest achievement of the Indian healthcare system was to increase access to healthcare by encouraging private players and boosting public-private partnerships to deliver better healthcare to people. Moreover, the Indian government ensured healthcare access to people from rural areas by establishing teaching hospitals. However, the major drawback in the Indian healthcare system appears to be illiteracy among people and exploitation by healthcare stakeholders that include physicians, surgeons, pharmacists, and capitalists, including hospital management and pharmaceutical industries. Nevertheless, like two sides to a coin, the Indian healthcare system has both pros and cons. The limitations in the healthcare system need to be addressed to improve the quality of healthcare provided to people in general and especially during disease outbreaks similar to the COVID-19 pandemic.

Effect of the pandemic on rehabilitation healthcare services in India: Breaking barriers

We would like to highlight the rehabilitation medicine perspective from India. Difficulties are impacted by the pandemic during this time, especially for people with disabilities. Awareness building among the public regarding the need for rehabilitation along with improvement in infrastructure is the key unmet need.

Effectiveness of massage therapy on anxiety and depression of COVID-19 convalescent: A protocol for systematic review and meta-analysis

BACKGROUND

Novel coronavirus pneumonia was first detected in Wuhan, China, in late December 2019. Its widespread infectivity and strong pathogenicity has posed a great threat to public health, seriously affecting social production and life. The disease caused by this virus has been officially named COVID-19 (coronavirus disease 2019) by the World Health Organization (WHO). Tuina (massage) therapy is 1 of the widely employed complementary and alternative medicine interventions in the world. As a useful therapy implemented on human's skin, muscles and joints, tuina (massage) has unique advantages in the field of medicine. This systematic review and meta-analysis will summarize the current evidence of tuina (massage) used as an intervention for COVID-19.

METHODS

We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating all patients recovering from COVID-19: Wanfang and Pubmed Database, china national knowledge infrastructure database, cochrane central register of controlled trials, cumulative index of nursing and allied health literature and excerpta medica database. Each database will be searched from inception to October 2022. The entire process will include study selection, data extraction, risk of bias assessment and meta-analyses.

RESULTS

This proposed study will evaluate the effectiveness and safety of massage therapy for patients recovering from COVID-19.

CONCLUSIONS

This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients recovering from COVID-19.