Early visual intervention, visual function analysis, and grating visual acuity outcomes in children with congenital Zika syndrome

ABSTRACT Purpose: This study aimed to assess grating visual acuity and functional vision in children with congenital Zika syndrome. Methods: Initial and final grating visual acuity was measured using Teller acuity cards. Cerebral vision impairment standardized tests were used to assess functional vision. Patients were referred to the early visual intervention program for visually disabled children. Neuroimaging was performed. Results: In this study, 10 children were included with an age range of 1-37 months. Eight patients presented with macular atrophic scars. Neuroimaging revealed microcephaly and cerebral abnormalities in all patients. Low vision and cerebral vision impairment characteristics were observed in all children. The final grating visual acuity in this group varied from 3.00 to 0.81 logMAR. Conclusions: The grating visual acuity test revealed low vision in all children with congenital Zika syndrome. Functional vision evaluation revealed cerebral vision impairment characteristics in all patients, who were referred to the early visual intervention program. Visual acuity improved in six children.

Optic disc edema and visual loss from paracentral acute middle maculopathy mimicking optic neuritis

ABSTRACT Optic neuritis is an important cause of unilateral and acute visual loss in young adults, but other differential diagnoses should be considered, especially when the disease has an atypical presentation. This report presents the case of a young woman with reduced visual acuity in her right eye, associated with optic disc edema and a relative afferent pupillary defect, that was initially misdiagnosed as optic neuritis and subsequently found to have paracentral acute middle maculopathy, possibly secondary to subtle impending central retinal vein occlusion. This case emphasizes the need to remember that retinal vascular diseases can occasionally mimic optic neuritis. Detailed anamnesis and ophthalmic examination can avoid unnecessary interventions.

Knowledge, attitudes and practices towards COVID-19 among Residence in Mombasa County, Kenya

Background: Infectious disease pandemic of COVID-19 continues to be a global & public health challenge. The knowledge, attitudes and practices of the people towards COVID-19 is critical to the understanding the epidemiological dynamics of the disease. This study sought to assess the awareness of Knowledge, attitudes and practices towards COVID-19. Methods: A cross-sectional quantitative survey was conducted in Mombasa between September-October, 2020. A validated questionnaire was used to collect data. Data collected were analysed using analysis of variance (ANOVA), and Pearson’s correlation and multivariate linear regression tests. A total of 422 participants completed the survey questionnaire. A p<0.05 was statistically significant. Results: The mean age was 29.55?years (SD: 10.7), 252 (59.72%) were female, and 170 (40.28%) were male. Majority 255 (60.4%) were aged between 18-29 years while 200 (47.38%) and 162 (38.39%) were educated up to secondary and university level respectively. Knowledge scores significantly differed across genders, age-groups, categories of marital status, education levels (p<0.05). The mean COVID-19 knowledge score was 7.45 (SD: 1.51), suggesting an overall 62% (7.45/12×100) correct rate on this knowledge test. The majority of the respondents agreed that COVID-19 will finally be successfully controlled (66.35%) and this was significant (p<0.05). The vast majority of the participants had not visited any crowded place (88.35%) and wore masks when going out (74.31%) in recent days. Conclusions: The knowledge about COVID-19 in the Mombasa County population during the outbreak was acceptable, attitudes have been mostly favourable and the practices are mostly adequate.

Co-trimoxazole induced Steven Johnson syndrome in HIV infected patient: things to consider

Co-trimoxazole is a sulfonamide fixed dose combination antibiotic which is effective and widely use in treatment and prevention of opportunistic infections in people living with HIV/AIDS, but can be potentially associated with adverse drug reactions including drug hypersensitivity reactions such as Steven Johnson syndrome. PLWHA individuals have up to a 1000-fold increased risk of drug hypersensitivity reaction compared to the general population, which is associated with drug exposure, immune dysregulation, and concurrent infections. Here we present a case report of a 59-year-old man with HIV who experienced Stevens-Johnson Syndrome after taking co-trimoxazole for 18 days. Therefore, we would like to remind you to be more careful when giving cotrimoxazole to PLWHA because it can take time for a hypersensitivity reaction to occur, also in a few cases, it can occur immediately.

Comparative evaluation of the efficacy and safety of ormeloxifene and norethisterone in abnormal uterine bleeding

Background: Abnormal uterine bleeding is a typical condition for women of reproductive age. It can be painful and uncomfortable, create social disgrace, and have a considerable impact on health-related quality of life. Several studies have shown that ormeloxifene and norethisterone are useful in the treatment of abnormal uterine bleeding, however there is a scarcity of data comparing the efficacy and safety of these medicines. Methods: A prospective comparative study was conducted over 100 women, age group of 30-50 years, attending the gynecology outpatient department with subjective complaints of heavy menstrual bleeding at a tertiary care hospital, in Hyderabad. Group A (n=50) received 60 mg of ormeloxifene and Group B (n=50) received 5mg of norethisterone, respectively. Ethical approval was taken from the institutional ethical committee. Results: 38% aged 41-45, 86% had irregular cycles, 76% reported subjective improvement in group A, and 38% in group B. Group A showed a mean difference of 80.22 in decreasing PBAC score, 0.70 in hemoglobin rise, and 3.5 in decreasing ET, while group B showed 53.70 in PBAC decrease, 0.28 in hemoglobin rise, and 1.76 in endometrial thickness reduction. Both groups have no notable side effects and no significant p value. Conclusions: Reducing PBAC score, subjective improvement, hemoglobin, and endometrial thickness with ormeloxifene and norethisterone works. Ormeloxifene has a far greater effect than norethisterone and has fewer adverse effects.

Acute coronary syndrome in very young adults (<35 years of age) - time to awake and act! A prospective analytical study from South India

Background: Acute coronary syndrome in very young adults (<35 yrs) was considered as an uncommon entity, recently shows rising incidence especially in India. Hence we planned this study with the aim, to investigate the incidence, clinical, angiographic profile and outcome of ACS in this population. Methods: This is a prospective analytical study included patient <35 yrs with ACS admitted to cardiology department in a tertiary hospital of South India. Risk factors, clinical, angiographic profile and follow up data were recorded and analyzed. Results: Among the total 2180 patients with ACS, 5.8% (n=127) were very young adults. Youngest one was 11 yrs old with coronary anomaly. Median age was 30yrs (SD� and only 8.6% (n=10) were obese. Smoking, male sex were the major conventional risk factors followed by low HDL (52%). Family history of premature coronary event seen in 12.9%, hyperhomocysteinemia, elevated LPA and high fibrinogen were observed in 15%, 20% and 3.5% respectively. Anterior wall MI with LAD occlusion was the commonest type (66.3%). Angiographically 31.4% (36/116) had recanalised vessels, coronary anomaly was seen in 3 (2.5%) patients and pure ectasia in 4 (3.4%) patients. Only 2 were undergone primary PCI (1.7%), 61% (n=71) received thrombolytic therapy. Median delay for angiogram was 72 hrs (3 days). In-hospital mortality was 3.4% and 4.5% (n=5) during follow up. Conclusions: The incidence of ACS among very young adults is on the rising trend (5.8%). Obstructive CAD in 56.9% patients implies the rapid progression of atherosclerosis. With little contribution of novel risk markers of atherosclerosis, smoking and dyslipidemia accelerate the process of premature vascular aging in Indian subcontinent.

Association of plasma fibrinogen level with the severity of obstructive sleep apnoea patients in a tertiary care hospital

Background: Obstructive sleep apnoea syndrome (OSAS) is a common sleep-related breathing disorder of multi-risk factorial pathogenesis and is characterized by recurrent, partial or complete upper airway obstruction resulting in intermittent hypoxia during sleep. It has been implicated in both cardiovascular and cerebrovascular diseases. Objective of the study was to determine the association of Plasma Fibrinogen levels with the severity of OSA patients in a tertiary care hospital. Methods: This cross-sectional observational study with group comparison was conducted among all the patients attending in the Department of Respiratory Medicine, BSMMU with suspicion of OSA within one year after the clearance of institutional review board (IRB) using STOP-BANG questionnaire and Epworth sleepiness scale (ESS) and confirmed by polysomnography. Plasma fibrinogen was measured in all OSA and non-OSA patients. Data were analyzed with the help of statistical package for the social sciences (SPSS) version 26. Results: Sociodemographic analysis found no significant differences in age, gender, area, occupation, or smoking between OSA and non-OSA groups (p>0.05). However, witnessed apnoea (p=0.002), breathlessness (p=0.005), higher ESS (p<0.001), and STOP-Bang scores (p<0.001) were associated with OSA. Plasma fibrinogen levels were significantly higher in OSA (319.2±63.7 mg/dl versus 242.5±20.33 mg/dl, p<0.001), positively correlating with AHI (r=+0.876, p=0.001). Positive correlations were also found between fibrinogen levels and daytime sleepiness (r= +0.393, p=0.002), waist circumference (r =+0.346, p=0.007), and BMI (r =+0.297, p=0.021) in OSA patients. Conclusions: In conclusion, this study establishes a notable connection between plasma fibrinogen levels and the severity of OSA. Elevated fibrinogen levels correlate with increased OSA severity, indicating a link between OSA, inflammation and coagulation.

Retinopathy of prematurity: screening programme for preterm infants in Ondo State, South-West, Nigeria

Background: Retinopathy of prematurity (ROP) is one of the avoidable causes of childhood blindness in the whole world. The disease can be mild, it can resolve spontaneously, and it could also have a grave consequence of blindness. As such, all extreme and very preterm babies at risk for ROP and having additional systemic co-morbidities and risk factors must be screened. Methods: Preterm babies with gestational age up to 32 weeks and birth weight less than 1500 g were prospectively recruited into the study. Retinal examination using binocular indirect ophthalmoscope with +20DS lens was done at 4 to 6 weeks post-delivery and were subsequently followed up. Data were analyzed using the software package for social science (SPSS) version 20.0 Categorized data were presented as percentages, p value <0.05 was considered significant. Results: Fifty-two preterm babies with birth weight ranging between 900-1500 g and gestational age ranging between 26-32 weeks were examined. ROP was detected in 7 babies (13.5%), Four (57.1%) babies had stage 1 ROP, 3 (42.9%) had stage 2 disease and none had stage 3 disease. ROP was commoner in the female babies 6 (86%). Neonatal sepsis and use of up to 3-days supplemental oxygen therapy (p=0.024) were the only risk factors associated with all the babies with ROP in the study. Conclusions: Prevalence of ROP was 13.5% in the current study with risk factors of neonatal sepsis and use of supplemental oxygen of up to 72 hours post-natal life.

Association of serum alpha-1 antitrypsin level with the severity of COPD

Background: Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder linked to early onset COPD, notably the emphysema variety, but often goes undetected. Low serum AAT levels may impact lung function and correlate with COPD severity. The aim of the study was to detect possible associations of serum AAT level with the severity of COPD patients on the basis of post bronchodilator FEV1 in Bangabandhu Sheikh Mujib Medical University (BSMMU). Methods: A cross-sectional study was conducted at the Department of Respiratory Medicine, BSMMU, Dhaka, from October 2022 to September 2023. Adult patients (?18 years) of both genders diagnosed with COPD based on spirometry were included. COPD was defined per GOLD guidelines, with a post-bronchodilator FEV1/FVC ratio <70%. Severity was categorized based on post-bronchodilator FEV1% predicted. Association between serum AAT level and COPD severity was analyzed using SPSS version 26, with significance set at p <0.05. Results: The study involved 80 COPD patients, with 1.25% showing low serum AAT levels and 98.75% normal. No significant differences in age, sex, or smoking status were observed among severity groups. Mean serum AAT levels varied across severity groups but were not statistically significant (p=0.377). Smoking was prevalent (66.3%), with common comorbidities like hypertension (26.3%), IHD (16.3%), and diabetes mellitus (15.0%). Shortness of breath (95.0%) and cough (92.5%) were common symptoms, with most patients having moderate disease severity (42.5%). Conclusions: The study indicates a weak association between serum AAT levels and COPD severity, with only 1.25% of 80 patients exhibiting low AAT levels.

Antiplatelet Therapy and Kidney Function in Non-Dialysis Chronic Kidney Disease: A Two-Centre Observational Study in Nigeria

Antiplatelet therapy used in preventing cardiovascular events in chronic kidney disease may be associated with higher risks of bleeding, low efficacy from fewer occlusive atherosclerotic disease), attenuation of the inflammatory process, and changes in the haemogram. We prospectively determined the kidney function, the haemogram, and the lipid profile of participants with and without antiplatelet therapy. The population with a mean age of 69.21 ± 11.73 years, had more women (65.88%), p=0.001. Participants' age was positively correlated with the CKD stage, p<0.001. Bleeding was more common with clopidogrel than aspirin and, less common with advancing CKD. Cardiovascular events were more common in CKD stage 5. The men had higher eGFR but lower platelet count and platelet neutrophil ratio (PNR) than the women, p=0.004, p<0.001, and p<0.001 respectively. The eGFR, bicarbonate, and HDL cholesterol were higher with versus without antiplatelets, p=0.04, p<0.001, and p=0.001 respectively. The platelet count and PNR were higher with antiplatelet therapy and with higher CKD stage, p<0.001 and p<0.001 and, p<0.001 and p<0.001 respectively. Higher platelet count (OR-0.410, 95% CI-0.02-1.04), lower uric acid levels (OR-0.550, 95% CI-0.271-0.948), higher HDL-C (OR-0.486, 95% CI-0.093-1.013), lower LDL-C (OR-0.572, 95% CI-0.082-1.002) and lower triglycerides (OR-1.274, 95% CI-0.755-1.493) were independently associated with antiplatelet therapy. The benefits of antiplatelet therapy in CKD are anchored on its anti-inflammatory, lipid-lowering, and kidney function-improving effects, these synergistically lead to lower cardiovascular events. The increased risk and consequences of bleeding, and reductions in leucocytes and erythrocytes population should be borne in mind to prevent heightening morbidity and mortality rates.

Red de formación y de cuidados para la transición de adolescentes con inmunodeficiencias primarias / Care and training network for the transition of adolescents with primary immunodeficiencies

En este escrito nos proponemos relatar y sistematizar los aspectos centrales de la estrategia de gestión, formación y atención diseñada por el Servicio de Inmunología y Psicología Institucional del Hospital Garrahan junto a los Hospitales Durand y Posadas para la transición de adolescentes con inmunodeficiencias primarias a la atención de adultos. La formalización de las primeras transiciones comenzó en 2007 con el Hospital Durand y progresivamente se fueron complejizando y expandiendo los procesos y actores participantes, sumándose el Hospital Posadas y otros centros de atención que reciben un porcentaje menor de pacientes. El eje central de la estrategia fue la implementación de un sistema de rotaciones para los residentes del último año de la especialidad de adultos por el servicio de pediatría. La formalización de la estrategia también readecuó de manera gradual aspectos internos de la atención de los adolescentes en el hospital pediátrico. En una etapa posterior se implementaron encuentros por videoconferencia con centros de adultos para redefinir acuerdos entre los servicios. Además, la asociación civil de pacientes (Asociación de Ayuda al Paciente con Inmunodeficiencias Primarias - AAPIDP) cumplió un rol relevante desde los primeros años de la estrategia. Estas acciones propiciaron la creación de una red de formación y cuidados en inmunodeficiencias primarias para la transición (AU)

In this article, we aim to describe and systematize the central aspects of the management, training, and care strategy designed by the Departments of Immunology and Institutional Psychology of the Garrahan Hospital, in collaboration with the Durand and Posadas Hospitals, for the transition of adolescents with primary immunodeficiencies to adult care. The first transitions were formalized in 2007 with the Durand Hospital. Over time, the processes and actors involved have become more complex and expanded, incorporating the Posadas Hospital and other care centers that receive a smaller percentage of patients. The central axis of the strategy was the implementation of a rotation system for residents in their final year of the adult specialty in the Department of Pediatrics. The formalization of the strategy also led to gradual readjustments in the internal aspects of adolescent care within the pediatric hospital. In a later stage, videoconference meetings with adult centers were implemented to redefine agreements between departments. Additionally, the patient association (Asociación de Ayuda al Paciente con Inmunodeficiencias Primarias - AAPIDP) has played a significant role since the early years of the strategy. These actions have led to the creation of a network for training and care in primary immunodeficiencies for the transition (AU)

Conservative management of traumatic brachial plexus injury: a case report

Brachial plexus injury (BPI) is one of the devastating conditions for patients, which has a negative impact on patients' quality of life. It renders patients with an inability to achieve functional independence. With advancements in surgeries and rehabilitation, improvement in these domains is possible. This case report describes the rehabilitation of a 28-year-old male patient. Being a driver by occupation and the only earning member in the family, upper limb function was essential for functional independence and resume work. After examination, problems were identified, goals were set, and intervention was planned. The patient took 2 months of inpatient rehabilitation six days a week. After completion of treatment, the patient was independent in basic and instrumental activities of daily living. The study concludes that structured, evidence-based physiotherapy treatment is effective in achieving functional independence and reducing disability in patients with traumatic BPI.

Study of depression among patients with type 2 diabetes mellitus at a tertiary care hospital

Background: Diabetes and depression are two major issues related to community health. Diabetes patients frequently co-occur with depression. Diabetes patients frequently co-occur with depression, which calls for serious attention because delayed diagnosis and treatment can worsen the patients' complications. Assessing the prevalence of depression in diabetic patients and identifying the various factors associated with it were the objectives of this research study. Methods: In this study 70 adult patients suffering from type 2 DM participated in this 6-month prospective study. Sociodemographic data and clinical features of the participants were collected. The presence and severity of depressive symptoms in patients have been assessed by a PHQ9 questionnaire. Ethical approval was taken before the commencement of the study. SPSS (Version 20) was used for data analysis. Results: The majority of the patients were from 41-50 years of age group (32.9%) with a female predominance (58.6%), with no symptoms of depression before type 2 DM (92.9%). Most of them had primary education (32.9%) and majority were homemakers (44.3%) residing in urban are (65.7%) living joint family setup (68.6%). Most of them had 11 to 20 years of type 2 DM duration (745.8%) with a high family history of type 2 DM (75.7%). Majority of them were on Oral therapy (47.1%) with ophthalmic complications (32.9%). The majority of them had mild depression (5-9) i.e. 67.1%. Conclusions: Due to patient-specific diabetes management and inappropriate diabetes treatment, the majority of cases were found to have depressive disorders. This article focused on a few common factors and their relationships that lead to depression in people with diabetes.

Hepatitis B virus total core antibody status in unvaccinated general population in a community of Bangladesh

Background: Hepatitis B virus (HBV) infection poses a significant health challenge in Bangladesh, with the hepatitis B core antibody (anti-HBc) being a crucial marker due to its lifelong presence in the bloodstream. This study aimed to evaluate the prevalence of anti-HBc (total) positivity among unvaccinated adults in Northeastern Bangladesh. Methods: This cross-sectional observational study was conducted in the Sobhanighat area of Sylhet, Bangladesh, in collaboration with the department of gastroenterology, Sylhet MAG Osmani Medical College, from November 2022 to August 2023. A total of 216 participants were selected using consecutive sampling. HBsAg, anti-HBs, and anti-HBc (total) were tested for all subjects, and data were collected using a pre-formed questionnaire and analyzed using statistical package for the social sciences (SPSS) version 24. Results: Among the participants, 16 (7.4%) tested positive for anti-HBc (total), while HBsAg was positive in 6 (2.77%) individuals. Anti-HBs was detectable in 23 (10.6%) participants, with 3 (1.38%) showing isolated anti-HBc positivity. Notably, 20% of HBsAg-positive cases exhibited heterotypic anti-HBs. Moreover, 56.25% of respondents with anti-HBc (total) positivity had detectable anti-HBs (p<0.001). Gender did not show significant associations with HBsAg, anti-HBc (total), anti-HBs, or isolated anti-HBc (p>0.05). Conclusions: The study underscores a notable prevalence of anti-HBc (total) positivity among unvaccinated individuals in Bangladesh, indicative of past HBV exposure. It underscores the necessity for enhanced vaccination coverage and robust infection control measures to mitigate HBV transmission in this demographic.

Effects of the use of contraceptives: a case of women in the Greater Accra and Ashanti regions of Ghana

Background: Contraceptive use during a woman's reproductive years can help prevent unintended pregnancies, maternal deaths, and other non-reproductive problems. However, there is also a risk of running into various health challenges. The study aimed at finding out if women in the Greater Accra and Ashanti regions of Ghana encounter health issues during and after use of contraceptives was conducted. Methods: Questionnaires were administered to 600 women out of which 401 responses were carefully gleaned for analysis using SPSS version 25. The questionnaire probed side and adverse effects women encountered in their use of contraceptives as well as the types of contraceptives they preferred. Results: The study revealed that the use of contraceptives was widely prevalent, especially amongst women aged 21-30 years (61.8%). The preferred types of contraceptives were the oral-progestin only (42.9%) and combined oral contraceptives (31.4%). Spotting or bleeding between periods (menstrual-related) was the highest reported side effect (33.2%), followed by weight gain (metabolic-related), 21.7%. Pearson’s Chi squared test showed an association between the age of respondents and the choice of contraceptive type at p<0.01. Hypertension and deep vein thrombosis (DVT) were the highest reported adverse effect (10.2% and 9.2% respectively). Conclusions: It was concluded that contraceptive use (especially the oral type) may cause discomfort with the side effects reported in women of reproductive age and it may be a contributing factor to other health conditions in susceptible women.

Prevalence of pre-diabetes and its associated risk factors among people in rural field practice area of Vydehi Institute of Medical Sciences and Research Centre, Bangalore

Background: India harbours a significant diabetic population, with over 60 million adults affected, a substantial proportion of whom remain undiagnosed or untreated, elevating the risk of complications and premature mortality. Identifying prediabetes and advocating lifestyle modifications become imperative in such a scenario. This research aimed to gauge the prevalence of prediabetes and associated factors among adults in the rural field practice area of Vydehi institute of medical sciences and research centre, Bengaluru. Methods: A cross-sectional study targeted individuals above 30 years in Vydehi institute of medical sciences and research centre's rural field practice area. A house-to-house survey screened for prediabetes. Results: Among 895 subjects, 128 (14.3%) exhibited prediabetic conditions. Prediabetes was notably prevalent in the 36-40 age group (18.8%), with 52.3% being males. A majority (77.4%) lacked a family history of diabetes, and 62.5% belonged to the lower-middle class. Sedentary lifestyles were prevalent (83.6%), with 83.6% consuming mixed diets. Elevated BMI was common, and a statistically significant association existed between BMI, waist circumference, and prediabetes (p<0.05). Similarly, education level significantly correlated with blood glucose control (p<0.01). Merely 7.0% of subjects were aware of prediabetes, mainly through health personnel. Conclusions: The study highlights a high prediabetes prevalence, coupled with low awareness and knowledge of blood sugar control. It underscores the necessity for strategic screening and intervention programs in the community to forestall prediabetes progression to diabetes.

Evaluation of orphan drug therapies and associated monitoring guidelines

Orphan drugs, designed for the treatment and prevention of rare medical conditions known as orphan diseases, are infrequently accessible due to their high costs and limited research. The prevalence of rare diseases varies across countries based on population demographics. The Food and Drug Administration (FDA) has approved over 770 drugs with 77 designations for orphan status. Some of these drugs, often discovered by the pharmaceutical industry, are both highly valuable and expensive. When using orphan drugs, specific parameters need to be monitored. Therapeutic monitoring should align with the patient's physical condition and the severity of the disease. This article aims to comprehensively examine the development of orphan drugs and their monitoring protocols.

The flip side of social media: unveiling the effects of social media on mental health

Mental health, commonly known as behavioral health, is the psychological, emotional, and social well-being of an individual. It mostly affects a person’s ideas, emotions, behaviors, and relationships with other people. The idea that social media use and mental health are inextricably related appears to be the most intricate and varied. The effect of social media on mental health is a complicated topic with many moving parts. According to a countrywide survey carried out in India, as of 2023, approximately 67.5% of adults in the country utilize at least one social networking site; this percentage may be steadily increasing over time. Despite its numerous benefits, social media has also been connected to problems in society and poor mental health outcomes. People need to be aware of the potential risks of social media like disinformation, addiction, cyberbullying, data security and privacy concerns, and its possible effects on mental health. This review offers a thorough analysis of social media’s effects on mental health, and it demonstrates how crucial it is to develop a thoughtful and balanced relationship with our digital life to ensure that the advantages of connection do not come at the expense of our mental health.

An outline on the global insights of implementation and challenges in primary healthcare telemedicine

Background: The utilization of telephone consultation (TC) has seen a significant increase of up to 86% since the start of the COVID-19 pandemic. In order to bridge the existing knowledge gap by examining the usage and efficacy of telephone or virtual consultations in a clinical setting during the COVID-19 lockdown, the objective of the current review is to gain a comprehensive understanding of the advantages and limitations of TC in the light of physicians and familial perspectives to enlighten future healthcare planning and decision-making. Methods: The data utilized in this research spanning the period of COVID-19 and other studies related to TC that occurred before the onset of the pandemic were gathered from a variety of reputable sources, such as Pubmed, Pubmed Central, Google Scholar, Research Gate, and Science Direct with the pre-established eligibility criteria and relevant keywords. Results: Studies revealed that the incorporation of teleconsultation has demonstrated numerous benefits for patients, including effective handling of data, fair accessibility, and adherence to standardized care protocols. Nonetheless, the implementation of TC also presents obstacles such as insufficiently trained staff, technical hurdles like connectivity issues and unreliable internet connections, and the possibility of erroneous diagnoses. Conclusions: During the COVID-19 phase, TC has proven effective with fewer limitations that can be minimized by training the healthcare staff and overcoming technical issues.

Association of liver function tests with severity of disease in patients with COVID-19

Background: We aimed to investigate the association of liver function tests with disease severity at admission and during hospitalization in patients with coronavirus disease 2019 (COVID-19). Methods: Blood tests of patients who were hospitalized due to COVID-19 were retrospectively analyzed. Liver tests included serum aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, total bilirubin, and albumin. Besides these, C-reactive protein and ferritin were also analyzed in the study. Levels of these tests at admission and peak levels during hospitalization were then recorded. Severe COVID-19 infection was defined as the reason for ICU admission. Both the associations of the levels of liver tests at admission and peak levels during hospitalization with severe disease were evaluated. Results: The study included a total of 602 patients, and 127 (21.1%) of the patients were hospitalized in the ICU. In our study, only albumin level abnormality was significantly associated with severe disease in COVID-19 patients at admission. However, during hospitalization, a significant association was found between severe disease and abnormal AST, ALT, GGT, T.BIL, albumin, and ferritin levels. During hospitalization, it was also observed that the rates of severe disease cases increased as AST, ALT, GGT, and T.BIL levels increased. Conclusions: Abnormal liver function tests may be a predictor for severe disease in patients with COVID-19. It is therefore important to monitor liver function tests in hospitalized patients.