ABSTRACT
OBJECTIVE: The main objectives of the current study were to find out the frequencies of Psychiatric disorders in the general population during COVID-19 and to compare the gender-based association between newly diagnosed patients during COVID-19 with already existing psychiatric patients in Peshawar to provide patient care on priority bases. METHODOLOGY: This Cross-sectional design study was carried out in the Department of Psychiatry and Behavioral Sciences, HMC/MTI, from May to August 2020. Those patients who approached psychiatry OPD through video/audio online calls and could understand and respond to suggestions were included. The bio-data was collected, and DSM-5 criteria were used for diagnosis. Descriptive statistics were used for statistical significance, and the statistical package of social sciences (SPSS-21) was used for analysis and results. RESULTS: The results findings of the current study revealed that 59.3% of the patients approached for telepsychiatry consultation were from the district of Peshawar. Among them, 54% were female, and most patients were young married females (50.7%) with no job outside the home. The finding further revealed that most of the sample affected by psychiatric illness were uneducated (31.3%) and unemployed (28%). Furthermore, in the present findings, 46% of patients were diagnosed with depression, and 12% had Dissociative disorders. CONCLUSION: It is concluded from the present study that in the Covid-19 Pandemic, primarily females who were married with no job description are more vulnerable to psychiatric illness. Furthermore, during Covid-19 mostly cases were reported with depression and dissociative disorders. © 2023, Liaquat University of Medical and Health Sciences.
ABSTRACT
Objective: To present a single-health system retrospective analysis of post-mRNA-based COVID-19 vaccination CNS autoimmunity conducted in the greater New York City area. Background: There have been rare reports associating mRNA-based COVID-19 vaccines with central nervous system (CNS) inflammation. We report a case series of five patients with newonset neurological disorders of immunological origin temporally associated with these vaccines. Design/Methods: Case-series. Results: Five cases of post-vaccination CNS disorders of immune origin were observed within two weeks of inoculation with either the first or second dose of mRNA-based COVID-19 vaccines (Moderna = 3, Pfizer = 2). This includes: Fatal ADEM (n = 1), new-onset NMO (n = 2), new-onset fulminant MS (n = 1), and meningoencephalitis (n = 1). The age of our patients ranged from 27 to 81, and three were female. None of the patients had pre-existing neurological illnesses and one had a pre-existing autoimmune condition (immune thrombocytopenia purpura). New-onset focal neurological symptoms were present in all five patients, including quadriparesis, numbness, diplopia, and encephalopathy. CSF pleocytosis was present in all patients, and three had elevated protein. All but one patient (meningoencephalitis) had contrastenhancing lesions involving either the cerebrum or spinal cord. Both NMO patients had longitudinally extensive transverse lesions involving the central thoracic cord. Aquaporin-4 serum antibody was present in one NMO patients and aquaporin-4 CSF antibody present in the other. All but one patient (fatal ADEM) clinically improved with pulse steroids or plasmapheresis. Conclusions: These are among the emerging cases of CNS immunological events temporally associated with mRNA-based COVID-19 vaccines. These findings should be interpreted with great caution as they neither prove a link nor imply a potential long-term increased risk in postvaccination CNS autoimmunity. Larger prospective studies are needed. The mRNA-based SARS-CoV-2 vaccines should continue to be strongly encouraged given their high efficacy in overcoming this pandemic.
ABSTRACT
BACKGROUND: Coronavirus disease (COVID-19) is an infectious disease caused by SARS COV-2 that has spread globally, the virus can cause different pathological alterations in many organs, such as the lung, kidney, and testis. The study aimed to determine the effect of COVID-19 on the seminal fluid parameters of infected infertile males compared with those who are noninfected. METHODS: The study was performed in Al-Hussein Teaching Hospital during the period from September to November, 2021 and it involved 318 patients. The patients' info included age, address, and vaccination. The sperm count, activity, and morphology were detected using Computer-assisted semen analysis CASA (Microptic-Spain) according to the WHO manual. RESULTS: There were high significant differences between the infertile males who were infected with COVID- 19 and those who were vaccinated (X2 = 12.509, p = 0.001). A high significant relation (p < 0.001) was recorded between types of infection severity and volume of semen (p < 0.001) and nonprogress life sperm (C) (p < 0.001). While significant differences were shown in the moderate progression sperm (B) (p = 0.012), and morphology (p = 0.02), respectively. High significant differences were reported between the types of infection severity (count of the sperm, presence of pus, B, C and D), (p < 0.001), while a significant difference was shown between severity types in relation to A and morphology of the sperms (p = 0.021 and 0.015), respectively. CONCLUSION: The severity of COVID-19 has a significant impact on infertility and sperm parameters, particularly progression and sperm morphology, despite the fact that these parameters are unrelated to vaccination.
Subject(s)
COVID-19 , Infertility, Male , Humans , Infertility, Male/etiology , Male , SARS-CoV-2 , Semen , Semen AnalysisABSTRACT
Introduction: Coronavirus disease 2019 (COVID-19) has resulted in dramatic changes to health-care delivery. Endoscopic activity has had frequent disruptions during this pandemic. The objective of the study was to see the influence of pandemic over the endoscopic activity. Methods: This retrospective analysis of endoscopic activity was undertaken at Nishtar Hospital Multan. Procedural analysis was done in the three months immediately after covid lockdown (1st April till 30th June 2020) and was compared to a similar period one year back. Results: Five hundred and fifty-four (68.5%) patients underwent endoscopic procedures during the three months of pre-COVID era, while this number reduced to half (n=255, 31.5%) patients during the covid pandemic. Even though the absolute number of Esophagogastroduodenoscopies (EGDs) reduced during the pandemic, patients were more likely to undergo EGDs during the COVID pandemic in contrast to the era before the pandemic (79% versus 66%, p = 0.002). The most common indication for EGD was upper gastrointestinal bleeding (UGIB). The percentage of EGDs done for UGIB rose from almost 60% to 80% during the covid pandemic (p < 0.001). The most common findings were esophageal varices and portal gastropathy (non-significant difference during and before the pandemic). Percentage of ERCPs done for obstructive jaundice doubled during the COVID pandemic (33% versus 65%, p = 0.002).The most common indication for sigmoidoscopy or colonoscopy was lower gastrointestinal bleeding. However, no significant difference was found before and during the covid pandemic (41.7% and 45.8% respectively, p=0.72). Internal hemorrhoids were the most common endoscopic finding. Colon cancer diagnosis reduced from 10% to undetected during the pandemic period. Conclusion: COVID pandemic resulted in considerable reduction in all type of endoscopic procedures. Majority of procedures were done for emergency indications like gastrointestinal bleeding. Rates of cancer detection was significantly reduced.
ABSTRACT
Purpose: This paper aims to investigate the impact of business process reengineering on organizational performance in the Malaysian electronics manufacturing industry during the coronavirus pandemic. It also studied the moderating effect of strategic thinking on the relationship between these two concepts. Design/methodology/approach: Data of 103 samples are obtained from a survey of the electronics manufacturing companies listed in the Federation of Malaysia Manufacturers’ directory. Data is analysed using partial least squares structural equation modelling. Findings: The results show that business process reengineering dimensions, i.e. top management commitment, organizational readiness for change, information technology capabilities and people management have significant positive impacts on organizational performance;whereas organizational structure and other abovementioned dimensions were found to have a much stronger impact on organizational performance whilst strategic thinking exists in the organization. Practical implications: As the studied firms have been affected by the pandemic, the results will be useful for managers of the firms in the Malaysian electronics manufacturing industry by highlighting the dimensions of business process reengineering that can have a positive and significant impact on the organizational performance and by advising them to incorporate strategic thinking. Originality/value: The results extend the literature on business process reengineering dimensions, which impact organizational performance by empirically testing the relationship of those dimensions on the performance, with strategic thinking as a moderating variable in Malaysian electronics manufacturing companies. From the knowledge, studying strategic thinking as a moderator in the relationship between business process reengineering and organizational performance in electronics manufacturing companies in Malaysia is unique, especially during a global crisis, i.e. the pandemic. © 2021, Emerald Publishing Limited.
ABSTRACT
Introduction: We aim to evaluate the surgical outcome of cavity obliteration with bioactive glass in patients with cholesteatoma undergoing canal wall-down mastoidectomy with reconstruction of canal wall;recognize the presence of postoperative complications such as wound infection, posterior canal wall bulge, and residual perforation;and evaluate the safety of bioglass. This is a prospective study carried out over 3 years;due to COVID-19, we could not enroll enough patients and follow them up for an adequate period of time. Methods: A prospective study was conducted over a period of 3 years on 25 patients who underwent mastoid obliteration with bioactive glass following canal wall-down mastoidectomy for cholesteatoma. The primary outcome measure was the presence of a dry, low-maintainance mastoid cavity that was free of infection, assessed and graded according to the grading system by Merchant et al at the end of 1 month and 6 months, postoperatively. Secondary outcome measures included presence of postoperative complications sucha s wound infection, posterior canal wall bulge, and residual perforation. Results: Of the 25 patients included in this study, at the end of 1 month, 60% had a completely dry ear and 28% had grade 1 and 12% had grade 2 otorrhea. At the end of 6 months, 72% had a completely dry ear, while 20% had grade 1 and 8% had grade 2 otorrhoea. There were no cases with grade 3 otorrhoea during the entire follow-up period. Postoperative complication of a posterior canal bulge was noted in 2 patients (8%), and only 1 patient (4%) had a residual perforation. Conclusion: Mastoid cavity obliteration with bioactive glass is an effective technique to avoid cavity problems.
ABSTRACT
Introduction COVID-19 has disrupted pathways of care for over 12 months. Primary care has transformed dramatically with much care being provided remotely. The COVID surges and vaccination programme have reduced capacity further. People with conditions such as hypertension, cardiovascular disease and diabetes depend on regular review and treatment optimisation to keep them well. There is a high risk that continued disruption to proactive care will drive an increase in exacerbations and complications. It is likely this will drive further waves of demand for urgent care over the coming months in primary care, in emergency departments and in hospital admissions. Methods The team of GPs & pharmacists at UCLPartners, with patient and public support, developed proactive care frameworks for six conditions including atrial fibrillation, hypertension, high cholesterol and type 2 diabetes mellitus. The frameworks focus on the 'how to' of delivering care in the new world of primary care post COVID-19. They are built on 4 principles: virtual where appropriate, use of the wider workforce, step change in self-management, and use of digital resources. For each condition, the frameworks include: risk stratification tools;pathways that support remote care and deploy staff such as healthcare assistants and social prescribers to systematically support education, self-management and lifestyle change;scripts, protocols and training to guide these staff in consultations;digital tools;and resources to support treatment optimisation. The frameworks include clinical and project management support for local pathway adaptation and implementation. Results The frameworks have gained wide traction in primary care across England. There have been over 2,700 downloads of the search/stratification tools with evidence of implementation in several regions. In the UCLP geography, North East London and North Central London have adopted the frameworks for roll out across 475 GP practices and 2.8 million people. NHSEngland has now adopted the Frameworks as a key part of the NHS@Home programme with plans to support at scale national roll out. Evaluation is being commissioned. Conclusions The UCLPartners Proactive Care Frameworks provide systematic, evidence-based support to restore services post COVID: stratifying so that higher risk patients can be prioritised and workload managed;maximising remote care;optimising personalisation and support for self-care. By using a population health management approach together with comprehensive resources to support clinical management in real world primary care, the frameworks provide a platform not just to restore services but to optimise treatment and outcomes in the high-risk conditions for CVD. The widespread national traction the frameworks are gaining suggests that despite the pandemic, this brings an opportunity to deliver the NHS Long Term Plan ambitions for CVD prevention and prevent 150,000 heart attacks, strokes and cases of dementia.
ABSTRACT
BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic has extraordinarily impacted global healthcare. Neuro-oncological surgery units have peculiar features that make them highly relevant in the strategic reaction to the pandemic. In this Chinese Society of Neuro-Oncology (CSNO) initiated survey, we appraise the changes implemented in neuro-oncological surgery hospitals across different Asian countries and provide expert recommendations for responses at different stages of the pandemic. METHODS: We performed a 42-question survey of the early experience of neuro-oncological surgery practice in hospitals across different Asian countries on April 1, 2020, with responses closed on April 18, 2020. RESULTS: 144 hospitals completed the questionnaire. Most were in WHO post-peak phase of the pandemic and reported a median reduction in neuro-oncological surgery volume of 25-50%. Most (67.4%) resumed elective surgery in only COVID-19 negative patients;11.1% performed only emergency cases irrespective of COVID-19 status;2.1% suspended all surgical activity. Ninety-one (63.2%) relocated personnel from neurosurgery to other departments. Fifty-two (36.1%) hospitals suspended post-operative adjuvant therapy and 94 (65.2%) instituted different measures to administer post-operative adjuvant therapy. Majority (59.0%) of the hospitals suspended research activity. Most (70%) respondents anticipate that current neurosurgery restrictions will continue to remain for > 1 month. CONCLUSIONS: Majority of the respondents to our survey reported reduced neuro-oncological surgery activity, policy modification, personnel reallocation, and curtailment of educational/research activities in response to the COVID-19 pandemic. The persistent widespread interruption of surgical neuro-oncology in even post-peak phases of the pandemic raises serious concerns about the long-term impact of the pandemic on neuro-oncological patients and highlights the essence of timely measures for pandemic preparedness, patient triage, and workforce protection.
Subject(s)
COVID-19 , Neurosurgery , Neurosurgical Procedures , Pandemics , Elective Surgical Procedures , Humans , SARS-CoV-2ABSTRACT
Under the covid-19 pandemic, the profitability of the hotels will decrease, and the costs of the buffets will increase. It is essential to implement more efficient processes, while ensuring the safety of guests. The purpose of this study is to understand the future of hotel buffets amidst the COVID-19 pandemic. Four professionals from the Accor group were interviewed. They were purposefully chosen, due to their know-how in the F&B department. These professionals provided key recommendations and predictions on how hotels can adjust the buffet to a new reality. Their recommendations range from the transformation of the traditional buffet into an assisted buffet, to the implementation of new techniques to enhance the customer experience, and the growth of a healthy trend. The implementation of more efficient processes will also be essential for economic recovery. According to these professionals, the main challenge will be to generate a feeling of trust among customers.