Spontaneous mid-trimester uterine rupture associated with fetal death in a young patient during COVID-19 pandemic: A case report.

Uterine rupture mostly occurs in the third trimester. However, it may occur at an earlier time with the same catastrophic consequences. The authors present a case report of uterine rupture occurring in the second trimester at 18 weeks gestation.

Assessment of COVID-19 related preventive measures in medical students across a lower-middle-income country: A cross-sectional study from Pakistan.

Objectives: This study aims to identify the effect of having COVID-19 positive close contact on practices and evaluate practices regarding COVID-19 prevention among medical students and the differences among clinical and preclinical students. Study design: The cross-sectional study included medical students from the Micro-fest++ event held on 30th May 2020. Methods: Participants filled a questionnaire of 15 questions regarding COVID preventive measures practices having satisfactory reliability (Cronbach's alpha = 0.715) and validity. The Statistical Package for Social Sciences (IBM SPSS) 26.0 was used for data analysis. Out of 1342 medical students, the majority were female (N = 881, 65.6%). Greater proportion (47%) of students had good practices (>85.7%) (p < 0.05). Results: Having COVID-19 positive relatives resulted in higher positive responses for practices with 11.86 ± 1.94 (out of 14) compared to 11.78 ± 2.38 for the COVID-19 negative group. Clinical year students compared to preclinical students responded positively to all questions, except one, and had a better score of 11.90 ± 2.28 (out of 14) compared to 11.61 ± 2.37 (p < 0.05). A significant difference was noted for "Information on preventive measures" (p < 0.01), "Avoiding crowds and staying home" (p < 0.05), "Social distancing (maintain 3 feet)" (p < 0.01), and "Practices of disinfection after going outside" (p < 0.05). Conclusions: Overall, medical students showed good practices, but a lack of knowledge in certain areas requires addressing infection during clinical rotations. A greater proportion of clinical students and those having a COVID-19 positive relative showed better adherence to practices.

Food Insecurity during COVID-19 in Yemen.

The United Nations has declared Yemen as the world's worst humanitarian crisis with 21 million people in need of humanitarian assistance. Due to the convergence of severe economic instability exacerbated by the COVID-19 pandemic, stifling war, and spiking food prices, the Yemeni people are at the brink of famine with women and children especially malnourished. Desperate to feed their families, civilians are forced to resort to begging, participate in child marriages, or plunge into debt. An inflated currency has significantly diminished the purchasing power of the Yemeni population, and COVID-19 restrictions have made acquisition of food and essential commodity imports arduous. Immediate action by global and local governments is essential to prevent the deaths of thousands of people in the wake of severe food scarcity.

Mental Health Effects of COVID-19 Within the Socioeconomic Crisis and After the Beirut Blast Among Health Care Workers and Medical Students in Lebanon.

Objective: To measure the mental health effects (perceived stress, anxiety, and depression) among health care workers and medical students in Lebanon during the coronavirus disease 2019 (COVID-19) pandemic and subsequent to the Beirut blast.Methods: In this cross-sectional study, a self-administered online questionnaire was developed and distributed between late December 2020 and early February 2021 among health care workers and medical students via social media. The 10-item Perceived Stress Scale (PSS-10) and the 4-item Patient Health Questionnaire for Depression and Anxiety (PHQ-4) were administered. P values between variables were calculated using χ2 test.Results: Overall, 98% of the respondents had a low PSS-10 score and 89% had a low PHQ-4 score. About 58.1% of health care workers and 69.0% of student respondents had moderate to severe stress on the PSS-10, and 48.7% and 46.8%, respectively, reported moderate to severe anxiety and depression on the PHQ-4. Prevalence of depression and anxiety was relatively higher among health care workers with monthly incomes < LBP 4 million (57.1%) and higher in women (39.9%) compared to men (17.2%). Furthermore, the prevalence of depression and anxiety was higher among health care workers traveling between different districts (63.0%) compared to those with residence and work location within the same district and was higher among females (65.4%) compared to males (34.6%).Conclusions: The resilience of the Lebanese people as well as their ability to adapt in the face of trauma, tragedy, threats, or any significant source of stress is remarkable and seen in their everyday lives, especially subsequent to the Beirut blast. However, the psychological well-being and mental health of health care workers and medical students in Lebanon should be carefully surveilled and recorded during the COVID-19 pandemic, especially within the ongoing socioeconomic crisis.

Drug supply shortage in Nigeria during COVID-19: efforts and challenges.

The COVID-19 pandemic has resulted in massive disruptions in global supply chains. Nigeria is particularly vulnerable with respect to pharmaceuticals since there is reduced local production and about 70% of the drug supply is imported creating a huge supply-demand disparity particularly in times like COVID-19. Nigeria is in need of huge quantities of quality-assured health commodities to effectively respond to the pandemic. Significant shortages of other essential medicines and medical products across the country could be imminent. Drug scarcity in Nigeria during the COVID-19 pandemic period is because of several accumulated factors, majorly as a result of global lockdown, decreased manufacturing, unaddressed regulatory affairs, poor access to resources by the population, lack of buffer stocks, security instability, and poor funding of the healthcare system. This situation if left unattended, could cause serious drawbacks to the health of the populace as well as the quality of life of Nigerians amid the COVID-19 Pandemic. Appropriate measures should be directed to ensure ethical processes on drug production, importation, pricing, and distribution to avoid such events during unavoidable scenarios, like the COVID-19 pandemic and other public health emergencies.

Yemen's triple emergency: Food crisis amid a civil war and COVID-19 pandemic.

Yemen has been termed as the world's worst humanitarian crisis by the United Nations. About 20.1 million (more than 50% of population) Yemenis are facing hunger and 10 million are severely food insecure according to reports by the World Food Programme. With the spread of COVID-19, the situation in Yemen has worsened and humanitarian aid from other countries has become the basis of life for hundreds of thousands of Yemenis after the threat of famine. Yemen is practically one of the poorest countries in the world. It has structural vulnerabilities that have developed over a protracted period of conflict and poor governance and more than 50% live in starving, they suffer for getting one meal a day. To prevent a total collapse of Yemen's food crises, the government and the international community should act now more decisively.

Drug supply situation in Rwanda during COVID-19: issues, efforts and challenges.

COVID-19 is a threat to health systems around the world and Rwanda is not an exception. The impact of the pandemic is far-reaching and access to health commodities is not spared. Proper drug supply is critical for a robust healthcare system. It determines the extent at which the population are likely to have access to essential medicines and treatments. In Rwanda, the pharmaceutical sector heavily relies on imports. With the emergence of COVID-19 pandemic, the drug supply system was interrupted leaving many stores from small local pharmacies to the big medical stores running out of stock. The reasons were limited importation of goods from abroad, and the panic buying practice among the customers and some institutions when responding to the pandemic. Drug and medicines accessibility, availability and affordability should be the core of any drug management policy. It is with no doubt that, Rwanda has made a tremendous work to mitigate the effect of COVID-19 on the country's drug supply; however, efforts are still needed to invest in local pharmaceutical production as a way to minimize import expenses in the country. Good policy on drug importation, production and distribution should be enforced to avoid any drug shortage that may be encountered in the Rwandan drug market.

The Hajj and COVID-19: How the Pandemic Shaped the World's Largest Religious Gathering.

The Hajj pilgrimage, one of the five pillars of Islam, is held in Saudi Arabia in the second week of Dhu'l-Hijjah, the last month of the Islamic calendar. It is one of the world's largest mass gatherings, constituting more than 2.5 million Muslim pilgrims from more than 180 countries. The COVID-19 pandemic posed a significant public health threat for such mass gatherings. Thus, a health risk assessment for the 2020 Hajj was held by the Saudi Arabia Ministry of Health and the WHO Collaborating Centre for Mass Gatherings Medicine, which concluded that foreign pilgrims should be excluded from the 2020 Hajj and that the number of pilgrims should be significantly reduced. Timely decisions allowed the Saudi government to conduct the Hajj, despite an initial postponement. However, the number of pilgrims was significantly downscaled, and extensive new protocols were set in place because of the pandemic. This article aims to shed light on the challenges faced and efforts made by Saudi Arabia to mitigate the spread of COVID-19 during the religious proceedings of the Hajj.

Association Between Frequent Urination and Prolonged Staying at Home.

BACKGROUND: Due to the coronavirus 2019 (COVID-19) pandemic, many activities have stopped and individuals have been forced to stay at home for prolonged periods, which can have a negative impact on overall health and trigger stress and psychological disorders such as depression and anxiety. The objective of this study was to highlight 25 cases of unusual frequent urination associated with abnormal sleep and their relation to staying at home for a prolonged period due to the COVID-19 crisis. METHODS: This retrospective cross-sectional study included 25 patients who complained of frequent urination (> 3 times/hour) and abnormal sleep during the last 4 months (January-April 2020). These patients were evaluated for all possible differential diagnoses. RESULTS: All of the patients had frequent urination > 10 times/day and abnormal sleep but had normal kidney function tests and other investigations. None of the patients had been doing any physical activity at home. All of the patients said that both sleep and urination frequency improved after leaving home for a while (eg, to visit friends, walk, or play sports). This improvement occurred within 2 nights of leaving the home; however, the majority of patients improved after the first night. CONCLUSIONS: "Home staying syndrome" is an undefined syndrome of unusual symptoms of abnormal sleep (altering sleep time and duration) and frequent urination > 3 times/hour. This syndrome is associated with staying at home for a long period of time and is easily resolved by doing any activity such as sports or visiting friends. While this syndrome is rare, it may be more prevalent now due to the COVID-19 pandemic, which forces people to stay home for infection prevention.