ABSTRACT
Immunosuppressant drugs like Etanercept, Mycophenolate mofetil, Sirolimus, Cyclos-porine, and Rituximab can weaken the immune system and make patients susceptible to SARS nCoV-2 virus. These drugs make immunocompromised persons more vulnerable to complications associated with COVID-19. Moreover, it can also increase mortality and morbidity, as a weakened immune system can lead to a longer duration of infection. This study discusses the guidelines on immunosuppressant drugs and their associated risk factors with COVID-19, issued by the U.S CDC (Centers for Disease Control and Prevention), WHO (World Health Organization), U.S FDA (Food and Drug Administration), and other accredited global health organizations. Moreover, it also includes information about pharmaceutical properties, mechanism of action, COVID-19 associated risk factors, adverse drug reactions, contraindications, and drug-drug interactions. Our study will help government partners and international health organizations to understand COVID-19 health risks associated with immunosuppressants. Increased public awareness about effective drug therapy for autoimmune diseases, cancer treatment, immunocompromised, and organ transplant patients will help lower the mortality and morbidity associated with the disease amid the COVID-19 pandemic.Copyright © 2021 Bentham Science Publishers.
ABSTRACT
Introduction: The anaesthetic management for surgeries during the COVID-19 pandemic has posed unique challenges. Safety of all healthcare workers is an additional concern along with heightened risk to patients during General Anesthesia (GA). COVID-19 pneumonia and aerosol generation may be exacerbated during airway intervention and GA. We aimed to assess the change in the mode of anaesthesia due to the pandemic. Methods: A research consortium led by WHO Collaboration Centre for Research in Surgical Care Delivery in Low and Middle Income countries, India, conducted this retrospective cross-sectional study in 12 hospitals across the country.We compared the anaesthesia preferences during pandemic (April 2020) to a corresponding pre pandemic period (April 2019) Results: A total of 636 out of 2,162 (29.4%) and 156 out of 927 (16.8%) surgeries were performed under GA in April 2019 and April 2020 respectively, leading to a fall of 13% in usage of GA. A 5% reduction in GA and a 12% increase in the usage of regional anaesthesia was observed for cesarean sections. There was no significant change in anesthesia for laparotomies and fracture surgeries. However, 14% increase in GA usage was observed in surgeries for local soft tissue infections and necrotic tissues. Conclusion: Though overall usage of GA reduced marginally, the change was mainly contributed by anesthesia for caesarean births. The insignificant change in anaesthesia for other surgeries may be attributed to the lack of facilities for spinal anaesthesia and may reflect the risk taking behaviour of healthcare professionals in COVID-19 pandemic.
ABSTRACT
The emergence and global spread of COVID-19 has disrupted the traditional mechanisms of education throughout the world. Institutions of learning were caught unprepared and this jeopardised the face-to-face method of curriculum delivery and assessment. Teaching institutions have shifted to an asynchronous mode whilst attempting to preserve the principles of integrity, equity, inclusiveness, fairness, ethics, and safety. A framework of assessment that enables educators to utilise appropriate methods in measuring a student's progress is crucial for the success of teaching and learning, especially in health education that demands high standards and comprises consistent scientific content. Within such a framework, this paper aims to present a narrative review of the currently utilised methods of assessment in health education and recommend selected modalities that could be administered in an asynchronous mode during the COVID-19 pandemic. Assessment methods such as open-ended short answer questions, problem-based questions, oral exams, and recorded objective structured clinical exams (OSCE) would be appropriate for use in an asynchronous environment to assess the knowledge and competence of health professional students during COVID-19. Fairness and integrity can be ensured by using technological tools such as video and audio recording surveillance.