ABSTRACT
Background: Fever of unknown origin (FUO) continues to be a diagnostic dilemma for pediatricians because it is often difficult to distinguish clinically between benign and potentially life-threatening causes. The term is best reserved for children with persistent fever >38 ˚c for which a cause could not be identified for more than 1 week. Aim of work: to evaluate a four-stage investigative guideline for the detection of the causes of FUO among children. Methods: 70 children aged between 6weeeks to 15 years with FUO were enrolled for this study. Graded investigations were done ranging from routine to advanced and/or specific investigations were performed after revision of detailed history and thorough examination. Results: outpatient investigations were done in 8.6% of the cases. The duration of FUO in this study ranged from 12 days to 8 weeks. The causes of FUO were 31.4% bacterial infection and 11.4% viral infection including Covid-19 infection in 7.1% of them, herpes simplex, and glandular fever in 3.4% of them.ENT affection was present in 4.3%, and the cardiac cause was found in 4.3% of the cases. Malignancy was encountered in 10% of the cases. In 21.4% of the cases, the cause of FUO was not diagnosed. In 10% of the cases, connective tissue disease was detected, and auto-inflammatory disease was encountered in 7.1% of the cases. Conclusion: not all cases of FUO should be admitted to a hospital, as some of them can be diagnosed and treated on an outpatient basis,. © 2022, Ain Shams University Faculty of Medicine. All rights reserved.
ABSTRACT
BACKGROUND: The rapid worldwide spread of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) or COVID-19 pandemic from its epicenter;Wuhan was first reported in December 2019. Egypt reported its first COVID-19 case on February 14, 2020. Thereafter, Egypt scaled-up preventive measures, with a partial lockdown starting on March 25. Several therapeutic agents along with convalescent plasma transfusion (CPT) are under investigation and data from CPTs have been receiving a lot of attention, after Emergency approvals from the Food and Drug Administration suggesting that it may provide a clinical effect in the treatment of SARS-COV-2. IMPORTANCE: Early and effective treatment of COVID-19 is vital for control of SARS-CoV-2 infection. METHODS: Designs: An interventional, single-arm, and non-randomized clinical trial conducted in Egypt from April 15 to July 21, 2020. Settings: This was a multi-center study conducted in three hospitals in Egypt. Participants: A total of 94 COVID-19 laboratory-confirmed patients using quantitative real-time polymerase chain reaction were enrolled in the study. Intervention: All patients were administered with two plasma units (each unit is 200 cc). The volume of donated plasma was 800 cc. Main Outcome and measures: Primary measure was the degree of clinical improvement among the COVID-19 patients who received CPT within 7 days. RESULTS: A total of 94 patients were enrolled who received CPT either within 7 days or after 7 days of hospitalization. 82 were severely ill and 12 were critically ill. The average age remained 58 years (±standard deviation 15.1 years). Male were 69% and 49% patients got cured while 51% died with case fatality rate 51%. Seventy-five percent deaths were above 45 years of age. The symptoms were dyspnea (55%), fever (52%), cough (46%), and loss of taste and smell (21%), and cyanosis (15%). The most common co-morbidities among the <40 years remained diabetes mellitus (21%) and asthma (14%). Among 40–60 years hypertension (56%), diabetes mellitus (39%) and among >60 years age group hypertension (57%), and chronic heart disease (24%) were reported. CPT within 7 days remained significant as compared with the CPT after 7 days with the number of days to cure (p=0.007) and ICU stay (p = 0.008) among severely ill cured cases. CONCLUSIONS: Among patients with COVID-19 and severe or critical illness, the use of CPT along with routine standard therapy resulted in a statistically significant improvement when administered within seven days of hospital admission. However, plasma transfusion, irrespective of days to transfusion may not help treat critically ill patients. The overall mean time to cure in severely ill patients was 15 days if CPT provided within 7 days with 65% cure rate. TRIAL REGISTRATION: Clinical Intervention identifier: MOHP_COVID-19_Ver1.1 registered April 2020.
ABSTRACT
BACKGROUND: Mobile health projects have been implemented worldwide, using mobile phones for record keeping, data collection, or patient communication. Further, mobile health tools have been used to promote behavior change in health workers and/or patients. For example, text message reminders have been shown to increase health-care-seeking behavior or medication adherence in some patients, and mobile data collection and communication tools for health workers have improved follow-up of patients and data reporting. METHODS: This literature review was conducted through a keyword search of the following databases to identify relevant peer-reviewed articles: Google Scholar, PubMed, Embase, and EKB. Keywords used in these searches included mHealth, mobile health, mobile phone, coverage, usage, delivery, vaccination, immunization, and COVID-19. RESULTS: Eleven studies that satisfied the inclusion criteria were included. They examined awareness, applications, challenges, and strengths of Mobile-Health applications. All studies showed some evidence that mHealth intervention had a positive impact on increasing the coverage and use of the COVID-19 vaccine. Bad awareness of people was strongly associated with declines in vaccination intent. The use of mobile applications has made a great revolution in tracking and data gathering about vaccination status. The main limitations were reporting bias and malfunctioning of mobile applications. The main strengths were getting real-time data, improving surveillance, using geographic mapping to monitor populations. CONCLUSION: Growing usage of smartphones and Internet penetration in African countries opens the door to mHealth applications such as health literacy, vaccine supply and control, disease monitoring and intervention, and virtual consultations with health professionals worldwide.