ABSTRACT
Objective: To find out an association between covid and sleep and how covid lockdown has affected the sleeping habits of the youth in Pakistan compared to pre-lockdown sleeping patterns. Study Design: Cross-sectional study. Place and Duration: Current research was conducted at HITEC (IMS-HITEC) Institute of Medical Sciences, Taxila Cantt Pakistan from 5th may to 15th may 2020). Material(s) and Method(s): It was a quantitative study in which participants filled out an online survey form. The data was collected on Google forms shared through social media focusing on undergraduate individuals from 16 to 24 years of age to acquire a homogenous example of responders, since youth are more liable to digital media use and their routine is more prone to be affected by the lockdown. The participation rate was 98.2%. SPSS was used for the data entry and analysis purpose. The data obtained was compiled, tabulated and analysed statistically. Chi square test was used to check whether the variables yielded significant or insignificant results. Result(s): Out of a total of 100 participants, 60 (60%) were females and 40 (40%) were males. The mean age was 21 years and the participants were mostly university students. A set of questions were also asked to determine which social media apps the participants were increasingly using, most of the participants spent time on Instagram (68%) and YouTube (64%), while modest people spent time on Netflix (41%), Snapchat (30%) and Facebook (33%). Lesser participants spent time on TikTok (11%) and Skype/Zoom (25%). Practical Implications: The use of e-learning and other forms of social interaction are becoming increasingly significant in the education of our young people. The findings of the current research make it possible for us to evaluate the influence of lockdown measures on Pakistani population in light of previously published studies that were carried out during the same time period in other countries and continents. Conclusion(s): Participants in the lockdown reported spending more time in front of screens and suffering delayed sleep habits. It was found that risky behaviours were associated with increased screen screen time.. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
ABSTRACT
INTRODUCTION: As the surge of COVID-19 continues, low resource settings such as Pakistan have encountered an acute shortage of ICU facilities and trained intensivists. The dearth of resources is apparent in the remote region of Northern Pakistan. Therefore, we established a tele-ICU consultation service model to address these concerns and leverage critical care capacity in these remote settings. METHODOLOGY: This study was conducted in Gilgit and Chitral secondary care hospital in Northern Pakistan. Gilgit is a 46-bedded hospital with 6 ventilators, and Chitral is a 25-bedded hospital with 3 ventilators in their ICU. The study duration is 1 year from July 2020 till June 2021. This is a centralised and decentralised hub-and-spoke tele-ICU model. The main hub is located in Aga Khan University Hospital (AKUH) in the metropolitan city Karachi. The distance from the main hub to the remote facilities is approximately 1800km. The tele-ICU followed a 24/7 Scheduled Care Model (periodic consultations on a predetermined time) and Responsive Care Model (unscheduled teleconsultations prompted by an alert) to provide care. The mode of communication is teleconference calls, video calls, and text messaging. This service is provided by 24/7 AKUH trained intensivists. Patient information such as demographics, clinical course, teleconsultation interventions, and management were obtained from these remote ICUs. RESULTS: A total of 157 patients presented to the tele-ICU from Pakistan's remote regions of Gilgit and Chitral. Of these, 60% were male (n=95). 86% (n=135) patients presented with COVID-19. 64% (n=97) patients had comorbidities with hypertension (47%, n=46) being the most common. Invasive mechanical ventilation was provided to 12% (n=18) of the tele-ICU patients, while 62% patients (n=98) received noninvasive mechanical ventilation interventions. Average length of stay of patients in the tele-ICU was 9 days with a range of 1-41 days. 72% (n=113) patients were discharged home from the hospital. Tele-ICU mortality was 29% (n=44). CONCLUSION: We utilized a peer-to-peer tele-consult model to support critical care services in Northern Pakistan. The survival rate achieved by this model is comparable to national and international hospital published data. This was possible through use of multimodal information technology in Pakistan.
ABSTRACT
Background: Since February 2020, there have been 825,519 confirmed COVID-19 cases and 17,957 fatalities across Pakistan. The number of ICU beds in Pakistan is approximately 2166, a ratio of 0.7 beds per 100,000 population. Critical care resources are concentrated in metropolitan cities with limited availability in rural areas. These gross shortages have escalated during the COVID-19 pandemic, leaving large parts of the country without access to skilled personnel or ICU beds. The Aga Khan University established a free 24/7 teleICU consultation service to rapidly increase access to trained personnel during the COVID-19 pandemic. Methods: The tele-ICU service adheres to a Scheduled and Responsive Care Model delivered through a centralized and decentralized structure. Using two-way audio-visual technology, the tele-ICU leverages critical care expertise and connects to clinical teams in rural and remote hospital settings. Endto- end encrypted Zoom and WhatsApp applications or telephone calls are utilized. Initially, only COVID-19 patients were consulted;however, coverage was broadened to include surgical and medical patients requiring intensive care. Results: Between June 2020 and April 2021, 1709 teleconsultations have been conducted on 404 patients. These include 339 COVID-19 patients, 231 of which were severe and critically ill. An estimated 20,394 minutes of consultative services have been provided covering 26 hospitals across 4 provinces. The mean call duration of each teleconsultation was 13.29 (1-60) minutes. The major mode of communication was Zoom (45.58%) followed by Telephone (43.30%) and WhatsApp (11.12%). The overall hospital discharge outcome for the teleICU is 58.27% with a mortality rate of 29.13%. The remaining patients (12.60%) were transferred or left against medical advice. Conclusion: To combat the insufficient critical care capacity, Aga Khan University implemented a novel tele-ICU service to provide an innovative solution for coordination of care and increase availability of intensivists in remote settings across Pakistan.