ABSTRACT
Aims: During the pandemic of COVID-19, the sudden change in traditional health-care providing systems, clinicians experience some positive and negative aspects of the approach. This study evaluates the clinician's satisfaction and experience with the use of teleconsultation provided during the pandemic of novel coronavirus and their willingness to continue telehealth after the pandemic. Materials and Methods: A cross-sectional survey was conducted online during the peak pandemic of COVID-19 in Pakistan through Google Forms questionnaire from 115 health consultants on different disciplines and recruited through social media. The questionnaire contains 15 questions regarding clinician's satisfaction, quality of treatment, and intention to continue providing telehealth services after the pandemic. Descriptive and inferential statistics were obtained by analyzing the data using SPSS software version 20, USA. Results: One hundred and fifteen consultants, 28 males and 87 females participated in the study, in which 62% were found to have an average and 34% at a high level of satisfaction. The Kruskal-Wallis test showed a significant difference among different medical specialists in the continuation of telehealth services after the pandemic of COVID-19 (P = 0.003) and its recommendation to friends and family (P = 0.02) with high mean rank in endocrinologist and dermatologist. Conclusions: A great number of participants reported a good response for the continuation in telemedicine services in their daily routine even after the pandemic situation. However, there is an urgent need to find the solution for the difficulties and drawbacks faced by health-care providers.
ABSTRACT
Background: COVID-19 has caused a pandemic since the end of the year 2019. Controversy regarding the presence of the SARS-CoV-2 in tears and conjunctival sac has created suspense throughout. Moderate to severe dry eye has been observed in the patients infected with COVID-19. Material and Method: We conducted a descriptive, prospective observational study. We enrolled 16 patients fulfilling the inclusion criteria for our study. Patients affected with acute COVID-19 from 28-9-2020 to 9-10-2020 registered at our hospital and willing to participate were included. Tears and conjunctival swabs were taken at the interval of 24 h;consecutively three samples were taken from one COVID-19 infected patient. In total, 48 samples were analyzed by qRT-PCR. Result: We had 16 participants, 47% were females and 53% were males;2/16 [12.5%] patients showed the presence of SARS-CoV-2 in tears and conjunctival swabs. Both the infected patients were females, and they did not have any obvious abnormal ocular conditions. Schirmer strip reading, however, showed a severe dry eye in both the patients. Conclusion: We identified dry eye ranging from mild to moderate to severe [Schirmer 1 reading ranged from 2 to 8 mm] in all our patients admitted to the COVID-19 ward. The SARS-CoV-2 gene seems to be mutating. More work needs to be done to find the viral load in the tears and any abnormalities in the eyes accordingly. © Medical Journal of Dr. D.Y. Patil Vidyapeeth 2022.
ABSTRACT
Sepsis is a life-threatening organ dysfunction due to a dysregulated host response to infection. The infection triggers a host response with an early hyperinflammatory and subsequent anti-inflammatory phase, both regulated by homeostatic mechanisms. A breakdown of these regulatory mechanisms can result in an exaggerated immune response which leads to complications. The vagus nerve plays a central role in regulating inflammation and the balance between the sympathetic and parasympathetic arms of the autonomic nervous system through the "cholinergic anti-inflammatory pathway". Several experimental models support the notion that external stimulation of the vagus nerve can modulate inflammation and restore the sympatho-vagal balance which may translate to improved outcomes in sepsis. Here, we review the pathophysiologic basis and evidence behind vagus nerve stimulation in sepsis.