Experiences of Patients with Tuberculosis Who Underwent Completed TB Treatment during the COVID-19 Pandemic in Indonesia: A Qualitative Study

Background

The scope of tuberculosis (TB) elimination programs, such as case detection, rapid diagnostics, and treatment success, has dramatically worsened because of the COVID-19 pandemic. Therefore, this study aimed to explore the experiences of patients with TB who had completed their treatment during the COVID-19 pandemic.

Methods

This qualitative study was performed using content analysis approach between May-July 2022. A total of 14 patients with TB who agreed to participate in this study were selected using purposive sampling. In-depth interviews were conducted using semi-structured interview guidelines, and the interviews ended after information saturation occurred. Data analysis was carried out concurrently to identify the main themes. The NVIVO software application version 12 was utilized to analyze the data.

Results

Several key themes emerged from the study, shedding light on various aspects of the experiences of TB patients during the COVID-19 pandemic. These themes encompass (1) Barriers to TB Diagnosis during the COVID-19 Pandemic; (2) Challenges in TB Treatment during the COVID-19 Pandemic; and (3) Support Resources during TB Treatment in pandemic era.

Conclusion

Patients have difficulty receiving healthcare because of changes in TB health services brought on by the pandemic. This research advances our knowledge of the effects of the COVID-19 pandemic on patients with TB and lays the groundwork for improved patient support and interventions.

The incidence and causes of acute hospitalizations and emergency room visits in adolescents with type 1 diabetes mellitus prior to and during the COVID-19 pandemic: a single-centre experience

INTRODUCTION

Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in childhood. Because acute glycaemic com-plications account for most concerns in the management of T1DM in children, special attention during the challenging time of the global COVID-19 pandemic is required to prevent deteriorations resulting in acute hospitalization.

AIM OF THE STUDY

is to assess how the COVID-19 pandemic influenced the incidence and causes of acute hospitalizations and emergency room visits in adolescents with established type 1 diabetes mellitus, and to characterize the admitted population.

MATERIAL AND METHODS

The study was conducted as a retrospective evaluation of acute hospitalizations of 39 T1DM patients between 15 and 17 years of age in the period 2018-2021.

RESULTS

No difference was noted in the incidence of acute hospitalizations and DKA or the biochemical parameters of adolescents with T1DM between the pre-COVID (23 patients in 2018-2019) and COVID period (16 patients in 2020-2021). It is, howev-er, worth underlying that 6/11 (55%) patients hospitalised in 2021 experienced diabetes deterioration as a result of emo-tional distress - a phenomenon that was not present in the pre-COVID era. After excluding of the hospitalizations due to psy-chosocial causes, a significant decrease in the number of acute hospitalizations in the COVID period was observed.

CONCLUSIONS

We suppose that increased parental supervision during the pandemic might have prevented some of the episodes of severe disease decompensation, but this was masked by the sharp increase in hospitalizations due to emotional distress. Our data confirmed that psycho-emotional status is an important factor in the treatment of T1DM.

Are we ready to manage an opioid epidemic in the intensive care unit?

The current opioid epidemic has had a massive impact on the critical care sector. This is due to an increase in the number of acute opioid overdose-related admissions and the number of opioid-dependent and opioid-tolerant patients admitted to intensive care units (ICUs). This review discusses the challenges that intensive care physicians face when caring for patients suffering from opioid-related disorders and analyses existing solutions. Preference for non-opioid analgesics, treatment of acute pain in the ICUs to avoid chronic pain syndrome, and education of patients and caregivers are critical to preventing this pandemic.

The Impact of Isolation During COVID-19 on Chronic Musculoskeletal Pain in the Geriatric Population: A Narrative Review

BACKGROUND

During the COVID-19 pandemic, social distancing has been employed to decrease the spread of COVID-19, especially within the geriatric population; however, the resulting loneliness and isolation carry their own detrimental effects. Loneliness resulting from the COVID-19 pandemic may also have negative implications on those with chronic musculoskeletal pain.

OBJECTIVES

The aim of this review was to identify the role of loneliness specific to the recent COVID-19 pandemic as it relates to the prevalence and severity of chronic pain in the geriatric population and to provide an overview for clinicians.

STUDY DESIGN

Narrative review.

METHODS

A literature search was conducted using combinations of relevant search terms. Databases included PubMed and relevant grey literature sources. Reference lists of selected articles were also searched for additional relevant literature.

RESULTS

Recent literature supports that social isolation and loneliness stemming from the COVID-19 pandemic have negative implications on chronic musculoskeletal pain. Loneliness has been well documented to have deleterious effects on physical and mental health, and it is increasingly linked to worsening debility and pain interference for those with chronic musculoskeletal pain. This has been found to be most prominent in the geriatric population, who are at the greatest risk for social decline and loneliness. Loneliness has also been found to have negative effects on cardiovascular disease, infectious disease, and mental health, as well as cognitive decline.

LIMITATIONS

Potential selection bias due to the narrative review design. Some included studies required the use of online questionnaires, which may not be accessible for the geriatric population, those without technology literacy, or low socioeconomic status populations. Future studies should emphasize screening patients for access to technological devices and reliable internet while partnering with community programs focused on digital literacy and resource access.

CONCLUSIONS

A myriad of deleterious effects stemming from social isolation and loneliness have been documented, of which geriatric populations are especially susceptible. Both early identification of at-risk patients and safe interventions are essential to mitigate loneliness and stop the progression of debility. Further resources and research are necessary to illuminate how best to proceed, both in the setting of the ongoing pandemic and how interventions can be applied to alleviate suffering in those with limited ability to receive hospital or clinic-based care.

The potential use of Drosophila as an in vivo model organism for COVID-19-related research: a review

The world urgently needs effective antiviral approaches against emerging viruses, as shown by the coronavirus disease 2019 (COVID-19) pandemic, which has become an exponentially growing health crisis. Scientists from diverse backgrounds have directed their efforts towards identifying key features of SARS-CoV-2 and clinical manifestations of COVID-19 infection. Reports of more transmissible variants of SARS-CoV-2 also raise concerns over the possibility of an explosive trajectory of the pandemic, so scientific attention should focus on developing new weapons to help win the fight against coronaviruses that may undergo further mutations in the future. Drosophila melanogaster offers a powerful and potential in vivo model that can significantly increase the efficiency of drug screening for viral and bacterial infections. Thanks to its genes with functional human homologs, Drosophila could play a significant role in such gene-editing studies geared towards designing vaccines and antiviral drugs for COVID-19. It can also help rectify current drawbacks of CRISPR-based therapeutics like off-target effects and delivery issues, representing another momentous step forward in healthcare. Here I present an overview of recent literature and the current state of knowledge, explaining how it can open up new avenues for Drosophila in our battle against infectious diseases.

Skin Exposures, Hand Eczema and Facial Skin Disease in Healthcare Workers During the COVID-19 Pandemic: A Cross-sectional Study

The COVID-19 pandemic has led to enhanced hygiene procedures and use of personal protective equipment, but also to increased attention to occupational skin disease in healthcare workers. The occurrence of hand and facial skin disease in > 5,000 Swedish healthcare workers was investigated in a questionnaire survey. Levels of skin exposure related to hygiene procedures and personal protective equipment were recorded. Caring for patients with COVID-19 entailed higher levels of wet work and face mask exposures, and was associated with higher 1-year prevalence of both hand eczema (36%) and facial skin disease (32%) compared with not being directly engaged in COVID-19 care (28% and 22%, respectively). Acne and eczema were the most common facial skin diseases; for both, a dose-dependent association with face mask use was found. Dose-dependent associations could be shown between hand eczema and exposure to soap and gloves, but not to alcohol-based hand disinfectants.

PROTECTION OF THE RIGHTS OF CHILDREN BORN BY SURROGATE MOTHERS DURING THE COVID-19 PANDEMIC

OBJECTIVE

The aim: Analyze the practice of resolving the problems of protecting the rights of children born to surrogate mothers in the context of the COVID-19 pandemic.

PATIENTS AND METHODS

Materials and methods: In carrying out the study, an interdisciplinary approach was applied to the analysis of the problem of protecting the rights of children born to surrogate mothers in the context of the COVID-19 pandemic. This approach includes dialectical, comparative-legal, statistical, and systemic methods. The research used scientific developments in the field of problems of protecting the rights of children born to surrogate mothers, international acts, legislation, statistical data. It has been established that although the understanding of surrogacy is the same for all states, there is a rather different approach to the possibility of its application. The issue of providing a child born to a surrogate mother with data on his genetic origin (in the absence of a genetic link with legal parents) should be resolved on the basis of this approach: maintaining a balance of interests between parents and the child, taking into account the principle of the best interests of the child.

CONCLUSION

Conclusions: It was concluded that the inadmissibility of closing borders and restricting the entry of foreigners to reunite with children born of surrogate mothers. It is proposed to create a register of persons those wishing to apply the surrogacy procedure, as well as the register of children born from surrogate mothers in Ukraine.

Professionally responsible counseling about birth location during the COVID-19 pandemic

If the worries about the coronavirus disease 2019 (COVID-19) pandemic are not already enough, some pregnant women have been questioning whether the hospital is a safe or safe enough place to deliver their babies and therefore whether they should deliver out-of-hospital during the pandemic. In the United States, planned out-of-hospital births are associated with significantly increased risks of neonatal morbidity and death. In addition, there are obstetric emergencies during out-of-hospital births that can lead to adverse outcomes, partly because of the delay in transporting the woman to the hospital. In other countries with well-integrated obstetric services and well-trained midwives, the differences in outcomes of planned hospital birth and planned home birth are smaller. Women are empowered to make informed decisions when the obstetrician makes ethically justified recommendations, which is known as directive counseling. Recommendations are ethically justified when the outcomes of one form of management is clinically superior to another. The outcomes of morbidity and mortality and of infection control and prevention of planned hospital birth are clinically superior to those of out-of-hospital birth. The obstetrician therefore should recommend planned hospital birth and recommend against planned out-of-hospital birth during the COVID-19 pandemic. The COVID-19 pandemic has increased stress levels for all patients and even more so for pregnant patients and their families. The response in this difficult time should be to mitigate this stress and empower women to make informed decisions by routinely providing counseling that is evidence-based and directive.