Management of the Surgical Patient during the First and Second Wave of COVID-19 Pandemic: Experience of a Tertiary Care Centre

Objective: Due to the COVID 19 pandemic healthcare providers all over the world had brought some changes in the management of surgical patients. This study is aimed to estimate the impact of pandemic on surgical practices. Material(s) and Method(s): We conducted a retrospective review of the medical records of all patients admitted to the department of general surgery (both elective & emergency), SCB Medical College and Hospital, Odisha, India from April 1 to July 31, 2020, and 2021 and the records were those of patients who were admitted in the same period in 2019. Data collection includes the number of admissions, the reason for admission, the age & gender of the patients admitted patients and type of management. Result(s): There was a 57.5% reduction in total admission during first COVID in pandemic 2020 and 58.7% reduction during second wave of pandemic in 2021. The proportion of patient presenting to emergency department was more in 2020 and 2021 than 2019. Number of emergency admission decreased by 46.54% in 2020 and 46% in 2021. There was a 79.5% drop in the number of out-patients admission in 2020 and 84% in 2021. Furthermore a 79.8% reduction in elective surgical intervention noticed in 2020 and 80% in 2021. Conservative management was preferred over surgical management during the COVID era. Conclusion(s): COVID-19 has led to a drastic reduction in outpatient and elective surgical practices. Hence creating a major concern for all surgeons about the critical situation.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Clinical profile and outcomes of COVID 19 patients having acute kidney injury: an experience from a tertiary care centre Eastern India

Introduction: SARS COVID 19 is the third corona virus affecting all over the world in last 20 years following SARS COV and MERS COV. Multiple complications and death usually occurs in 6.4 % cases. In the beginning reports, incidence of AKI was negligible. Various data shows AKI occurs is >20% hospitalized patients and >50% of ICU patients. Methods: The study was a cross sectional study, carried out in the department of nephrology, of IMS and SUM Hospital, Bhubaneswar for a period of 1.2 years (April 2020-June 2021). The patients data was obtained from the hospital information system (HIS). It included the individuals of at least 18 years old, with a laboratory confirmed SARS-COV2 infection, and were hospitalised for the same. It excluded the known ESKD prior to admission and patients who were hospitalised for less than 48 hours. Results: It was observed that most patients were in their 6th decade, 40 % were Female. Patients with AKI, have low Hb%,high TLC count, low platelet count, high potassium level and low albumin, bicarbonate level,lymphocyte count, and higher creatinine values. Out of 3993 patients, 46% 1 developed AKI. In ICU 76% developed AKI. Peak Serum Creatinine was 2.2(IQR 1.5-3.6) in non dialysis patients and 8.2 in dialysis requiring patients (IQR 6.1-11). Conclusion: It is not uncommon to come across AKI patients in patients suffering from COVID-19 also associated with high death rate. Meticulous clinical observation and instillation of therapy helps to render better patient care.

Mental health concerns in outpatients during COVID-19 pandemic: Comparison between psychiatric and general hospital clinics in an Indian population

We intended to compare mental health concerns in patients attending a general hospital clinic with that of patients attending a psychiatric clinic during the coronavirus disease 2019 (COVID-19) pandemic. We specially wished to know about the perceived stress, worries, possibility of anxiety and depression, and the quality of life (QOL) of the patients. In a cross-sectional study, we used two screening questions for depression, Generalised Anxiety Disorder-2 (GAD-2) scale for anxiety, Perceived Stress Scale (PSS) for stress, nature and degree of worries in a 0–10 scale, and QOL in a 1–10 scale. Majority (75.5 percent) of outpatients had moderate to high level of stress, 76.5 percent were screen positive for depression, and 42 percent for anxiety. Psychiatric patients had significantly higher perceived stress, level of worry, and lower QOL to those with physical illness and were screen positive for depression (99 percent v 54 percent) and anxiety (68 percent v 16 percent), respectively. Patients with major physical illnesses had significantly higher stress levels and anxiety compared with those without. Fear of getting the infection, loss of job, and financial issues were the major worries along with social stigma. The results highlighted the need for screening mental health concerns in general hospital and psychiatric outpatients during the COVID-19 pandemic and facilitate appropriate interventions. © 2022 Weston Medical Publishing. All rights reserved.