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The coronavirus Covid-19 has sent reverberations in all aspects of healthcare, where its spread in 2019 has impacted multiple National Health Services, including the head and neck cancer clinics. Early diagnosis combined with the appropriate treatment plays an unquestionable significant role in the survival rates and prognosis for head and neck cancer patients. King's College Hospital sits in the heart of south-east London, serving a population of 700,000;however also acts as a tertiary care centre receiving referrals for a multitude of specialties from across the South of England. A retrospective review was conducted of 365 cases referred for suspected head and neck cancer to the Oral and Maxillofacial Surgery and Oral Medicine two-week-wait clinic at King's College Hospital during the first coronavirus wave (1st of March 2020 to 31st of September 2020) and the same time period in 2019. A total of 233 suspected head and neck cancer referrals were made via the Pan London referral pathway during the first wave in 2020, compared to 132 referrals made in 2019. A total of 3.4% (n = 8) of the patients referred during the first wave were diagnosed with a subtype of head and neck cancer, compared with 9.8%(n = 13) in 2019. Of these referrals, the proportion of patients not seen within the required 14-day period only slightly increased from 3.03% (n = 4) in 2019 to 3.86% (n = 9) in 2020. There was a significant impact from the government-enforced lockdown where reduced face-to-face examinations impacted the quantity of referrals and their diagnosis via the two-week-wait pathway. This study allows reflection of the impact of the first coronavirus wave on the two-week-wait head and neck cancer referrals and gives valuable insight for service implementation and staff reallocation in the event of future periods of waves to prevent overburdening of services.Copyright © 2021
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Early detection of the COVID-19 infection is the key to avoiding fatalities. Chest radiography has proven to be an effective and low-cost solution for detecting the virus. It is important to evaluate the potential of deep learning models for COVID-19 detection from the x-ray images for quick and early detection of COVID-19 with high accuracy. We conducted a study that evaluates the potential and performance of various Convolutional Neural Networks (CNN) architectures for detecting the COVID-19 on a dataset consisting of 5902 chest X-ray images having 2276 instances of X-ray images of COVID-19 patients and 3626 images of healthy and non-COVID-19 pneumonia X-rays. The performance of the models is assessed using metrics like accuracy, specificity, sensitivity, F1 Score, ROC curve, etc. The results suggest that the DenseNet-121 model proved to be the better choice among evaluated architectures for COVID-19 detection from X-ray images in terms of overall performance with an accuracy of 98.2%, sensitivity of 97.6%, and specificity of 98.4%. We conclude that there is a need for further evaluation of the CNN architectures on large, real-world, and diverse datasets for obtaining generalizable results for a reliable diagnosis.Copyright © 2022 Informa UK Limited, trading as Taylor & Francis Group.
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Pakistan is in a terrifying and devastating energy crisis. Recently, the prediction for energy consumption has intensified compared to its production capacity, which is problematic for Pakistan's social and economic stability. Hence, it is vital to examine the link between power consumption, power prices, urban transition, other electricity use, and economic expansion from 1970 to 2018 in Pakistan. For analysis, the second-generation econometric technique of Lee and Strazicich (2013), novel Augmented Autoregressive Distributed Lag (AARDL), and Frequency Domain Causality (FDC) is useful to detect the long-medium and short-run association among the variables. The results show that power consumption stimulates economic expansion in the short and long-run, though the rise in power prices declines economic activity in the short and long-run. Also, urban transition and other electricity use are a substantial positive and negative impact on economic expansion in the short and long-run. The outcome suggests that efficient energy supply, low-cost power prices, proper urban transition management, and other energy use could be useful for policymakers to achieve SDGs 7 and 11 in Pakistan.
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Background: The aftershocks of COVID-19 pandemic are still emanating in different regions of the world in term of increasing number of cases and deaths due to mutation in the virulence and pathogenicity of the virus. The pandemic affected almost every part of our lives including health, economy, employment, and social interactions. This study surveyed the Indonesian public to better understand their health, employment, and economic deterioration during the early stages of the COVID-19 outbreak. Methods: An online cross-sectional survey of 200 participants was conducted from eight different regions (Jawa Timur, DKI Jakarta, Kalimantan Tengah, Yogyakarta, Bali, Sulawesi Selatan, Jawa Tengah) of Indonesia who speak Bahasa. A standardized questionnaire was used to obtain information about COVID-19 impacts on health, employment, the economy, and social life from the respondents. Descriptive statistics and Chi-square tests were conducted to analyze the data. Results: According to the findings, out of 200 participants, 40% stated that the impact of COVID-19 did not affect their salary. People under the age of 20 with an intermediate education who worked in government sectors were more likely to lose their jobs (p-value 0.05), which would result in a loss in salary that would have an impact on the education of their children. Only the "use of hand sanitizers" indicated a statistically significant difference between the practices of male and female respondents (p-value = 0.038), which is one of the activities that helps to prevent fever and respiratory difficulties during the present pandemic. Conclusion: The finding of the study depicted that COVID-19 has no immediate collateral effects on the economy of the study participants. However, the pandemic has a negative impact on the employment, health, and social life of the people. To mitigate the negative effects of this pandemic on health, employment, economy, and social life, a complete evaluation of COVID-19 impacts, as well as public health interventions, should be conducted. © 2022, The Running Line. All rights reserved.
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Objective: To assess acceptance of vaccination against Coronavirus by nursing students of Mosul City. Methodology: This quantitative cross-sectional study collected data by using questionnaires from 215 students of College of Nursing, University of Mosul, Iraq from September 20 to December 20, 2021. All respondents were 18 – 30 years old. Results: Age of students was 20 to 26 years, (mean22.34 1.76). Almost two-thirds of respondents (70%) agreed that the nursing student should be vaccinated against Covid 19. Conclusion: The acceptability rate was significantly high among females. Higher acceptability of COVID-19 vaccination among nursing students was related with their age group and stage of study.
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Introduction: The COVID-19 pandemic has prompted the consideration of alternative methods to provide consultations such as telephone, e-mail, and video conferencing. Sidra Diabetes Team developed remote pump training program using video conferencing. Objectives: The aim of the study was to evaluate glycemic control between Remote Initiation and In Clinic Initiation of Advanced Hybrid Closed Loop (AHCL) System MiniMed 780G (Medtronic, Northridge, US) in patients with Type 1 Diabetes (T1D). Methods: Prospective observational study of children aged 7 to 18 years with T1D who were offered to start the MiniMed 780G system either following the remote initiation program (Remote group) or the traditional in clinic initiation program (In Clinic group). Both programs followed same structured education protocol over four consecutive days, two hours per days. Remote program was performed using Skype “Meet Now” or Zoom Conferencing, while in clinic program was performed at the hospital. HbA1c, Time in Range, AHCL system characteristics were analyzed three months after AHCL initiation. Results: 13 patients (age 12.6±2.8 years, female:7) were included in the Remote group and 34 patients (age 11.7±2.1 years, female:18) in the In Clinic group. HbA1c of the Remote group decreased from 8.5 ±1.2% (69±13.1 mmol/mol) at baseline to 7.1±0.9% (54±9.8 mmol/ mol) at the end of the study (p=0.002), compared to the In Clinic group for which HbA1c decreased from 8.6±1.3% (70±14.2 mmol/ mol) to 7.0±1.1% (53±12.0 mmol/mol), (p=0.001), respectively). No significant difference of HbA1c levels, TIRs and SmartGuard use between groups was found at the end of the study. No DKA events and severe hypoglycemia in both groups was observed during the study. No severe hypoglycemia was observed in both groups. Conclusions: Remote Initiation Program for AHCL system should be offered to people with T1D as alternative to In-Clinic Initiation Program. Both programs can improve glycemic control in a safe manner without severe hypoglycemia and hyperglycemia.
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Vaccine development using different platforms is one of the important strategies to address coronavirus disease pandemic. The global need for vaccines requires effective vaccine approaches and collaboration between pharmaceutical and biotechnological companies, governments and the industrial and academic sectors. About 72% of the vaccine candidates are being developed by the private sector, while 28% are carried out by the public sector and different non-profit organizations. COVID-19 vaccines are based on complete viruses (inactivated or attenuated), viral vectors (replicating or not), antigenic subunits (proteins or peptides), nucleic acids (RNA or DNA) or virus-like particles. Important aspects of vaccine development include manufacturing flexibility, speed, cost, safety, cellular and humoral immunogenicity, vaccine stability and cold chain maintenance. Vaccines can be prepared using different manufacturing platforms, computational biology, gene synthesis, structure-based antigen design and protein engineering. Individual confidence, convenience and complacency are factors that affect the attitude towards acceptance of COVID-19 vaccination. This could be complicated by socio-demographic, psychologic, cognitive and cultural factors. © 2021, Finlay Ediciones. All rights reserved.
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Purpose: Gallstone related pathology (GRP) accounts for a significant proportion of general surgery admissions. The aim of this study is to investigate if seasonal variation for GRP admissions exist in England allowing improved resource allocation and planning. No other study has addressed this. Methods: This multicentre retrospective cohort study included only emergency adult (≥18 years old) admissions to acute secondary care with ICD-10 codes associated with gallstones between 01/01/2010 to 31/12/2019 in England using Hospital Episode Statistics data. Seasons were defined according to United Kingdom Met Office. Results: A total of 396 879 GRP related admissions were recorded during the specified period, accounting for 1.44% of all emergency admissions. Cholecystitis accounted for 49.1% (n=195 058) of admissions. The modal age of admission was 75 - 84 years old. There was a progressive increase in the number of admissions throughout the data collection period. Our study suggests a significant seasonal peak in Summer (n=102 620) based cumulative admissions per season and a linear regression model (p<0.001), followed by Autumn (n=102 267), then Spring (n=97 807) and finally Winter (n=94 185). When considering GRP admissions as a proportion of all emergency admissions, Autumn and then Summer see the highest proportions at 1.47% (102 267/6 961 395) and 1.46% (102 620/7 011 001) respectively which are significant when compared to the lower Spring, 1.42% (97 807/6 904 013) and Winter, 1.40% (94 185/6 742 228) months using X2 (p<0.05). This is clearly depicted in Figure 1. Spectral analysis confirmed there is seasonality in the emergency GRP admissions every 12 months. A forecasting model was shown to be reliable;all observed admissions for 2019 were within the 95% prediction intervals for each month for the proportion of emergency GRP admissions. Discussion: Resource allocation towards the Summer and Autumn months to target seasonal peaks in GRP should be considered. Given the steady rise in GRP admissions with the added strain of COVID-19 delaying elective operations perhaps there needs to be greater emphasis on resource allocation towards public health campaigns for gallstone disease, whilst training and hiring more doctors who can treat GRP. This includes surgeons, endoscopists and radiologists. This will allow safe and timely intervention for patients vulnerable to the risks that GRP can pose, particularly in the elderly. [Formula presented]
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In this article, we present a new fractional integral with a non-singular kernel and by using Laplace transform, we derived the corresponding fractional derivative. By composition between our fractional integration operator with classical Caputo and Riemann-Liouville fractional operators, we establish a new fractional derivative which is interpolated between the generalized fractional derivatives in a sense Riemann-Liouville and Caputo-Fabrizio with non-singular kernels. Additionally, we introduce the fundamental properties of these fractional operators with applications and simulations. Finally, a model of Coronavirus (COVID-19) transmission is presented as an application. © 2021, Semnan University, Center of Excellence in Nonlinear Analysis and Applications. All rights reserved.
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Depression become the most health problem especially after COVID-19 pandemic in Iraq by increased the psychiatric disorder, the present study focused on the Mitochondrial Genes (ND1, ATP6c) in Depression patients using PCR-SSCP technique, samples collection with patients data were collected from psychiatric clinic, then DNA isolation and genes polymorphisms were detected, the results show that patients recorded in age more than 40 years and in married than single individuals in significant differences, non-significant differences were observed in occupational status, the genotyping found tow haplotypes in ATP6c gene (A and B) in significant differences between for B haplotype frequent in patients, the ND1 polymorphisms show three haplotypes (A, B and C) that varied in non-significant differences between patients and control, the present results concluded association between ATP6c and depression disease but didn’t found linked with ND1 polymorphism.
Subject(s)
BNT162 Vaccine/adverse effects , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Immune Checkpoint Inhibitors/adverse effects , Ipilimumab/adverse effects , Nivolumab/adverse effects , Anti-Bacterial Agents/adverse effects , COVID-19/prevention & control , Female , Humans , Melanoma/drug therapy , Middle Aged , Trimethoprim, Sulfamethoxazole Drug Combination/adverse effectsABSTRACT
COVID-19 pandemic has increased the generalized anxiety among nursing staff. This cross-sectional questionnaire-based study aimed to determine the generalized anxiety disorders among the nursing staff working in secondary and tertiary care hospitals in Punjab province, Pakistan. A GAD-7 scale was used to assess anxiety. Non-parametric statistics were applied to estimate the difference among the groups. Multiple regression model was adopted to explore the impact of covariates on the GAD-7 score. A total of 133 nurses responded to this survey. It was revealed that being female (7.38 +/- 4.20, p=0.032) and having an age of >= 31 years (7.68 +/- 5.14) might lead to a higher GAD-7 score. 19.6% of the respondents had a high level of generalized anxiety (GAD-7 score >= 10), and about 49.6% were falling in the range of mild anxiety. Female nursing staff have the probability of higher GAD-7 score up to 15% [0.148(-0.450 - 4.697), p= 0.049]. Job experience, especially being new to the field (<= 3 years) might increase the likelihood of having a higher GAD-7 score by 14%. In conclusion, 19.6% of the respondents were meeting the GAD-7 criteria of moderate-severe level of generalized anxiety and depressive disorder. Being female, having less job experience, and no training on how to handle COVID patients were revealed to the main factors influencing the GAD-7 score. Risk of getting COVID, transmission of COVID to family members through them, and uncertainty about the consequence of COVID in Pakistan were some of the common stressors reported by the nurses who participated in this study.
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Robotics and Artificial Intelligence (A.I.), applications have played an essential role in managing and controlling COVID-19 pandemic specifically in hospitals, hotels, restaurants, airports, transportation systems, schools, and others community levels. Artificial intelligence technologies, autonomous vehicles, drones, mobile robots, humanoid robots, manipulator robots and other intelligent robots are used potentially during the outbreak to control the transmission network from person to person. Due to the highly uses, we consider A.I. and robotics in health will likely continue after the COVID-19 pandemic and development of these technologies is needed for fighting against infectious diseases. Furthermore, the uses of these systems in different fields like industry, sports, ergonomics, distribution of goods, and social life will keep going in the coming years. In this article, the artificial intelligent devices and robots helped in fighting, and managing covid19 are explored, including the new trends. These new trends are led by artificial intelligence, autonomous driving, network communication, cooperative work, nanorobotics, friendly human-robot interfaces, safe human-robot interaction, and emotion expression and perception. Furthermore, these news trends are applied to different fields such as medicine, health care, sports, ergonomics, industry, distribution of goods, and service robot. These tendencies will keep going their evolution in the coming years.
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A novel coronavirus was identified at the end of December 2019 as the cause of a cluster of pneumonia cases in Wuhan, China. The virus that causes Coronavirus diseases-19 ( COVID-19) is designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical manifestations of COVID -19 and complications are evolving. Cardiac, renal, neurologic complication and coagulopathy has been reported in the literature. Here we present a case of spontaneous pneumomediastinum who tested positive for COVID -19 . A 45 years old female who was admitted after a reverse transcriptase-polymerase chain reaction (RT-PCR) test-confirmed COVID-19. She was experiencing worsening dyspnea. Initial laboratory investigation showed white blood cells of 7.49 [differential: 80.5% neutrophils and 13.6% lymphocytes]. Procalcitonin was 0.12, lactate dehydrogenase was 701, ferritin was 586, fibrinogen was more than 600, D-dimer was 0.56, CRP was 9.9. Arterial blood gas showed pH 7.44, PCO2 54 mmHg, and PO2 85.7 mmHg on 85% FiO2 heated high flow nasal cannula oxygen. A chest x-ray showed bilateral interstitial and alveolar opacities. A diagnosis of acute respiratory distress syndrome (ARDS) was made. Despite maximum high flow oxygen patient continues to desaturate and the patient was started on BiPAP with 100% FiO2 with the improvement of hypoxia. The patient continued on Covid specific therapy including dexamethasone. The patient remained BiPAP dependent with intermittent heated high flow nasal cannula with positive pressure support. On the 15-day of hospitalization, the patient noted to have worsening hypoxia, emergent computed tomography angiogram(CTA) of the chest was done which revealed extensive pneumomediastinum. Esophagogram was obtained and esophageal rupture was ruled out. The patient was treated conservatively and monitored for any further complications. On day 43 patient was discharged on 2liter nasal cannula oxygen. Spontaneous pneumomediastinum (SPM) is a rare clinical entity. SPM occurs when the air leak through the small alveolar ruptures into the surrounding bronchovascular sheath. SPM also could result from air leaks from the esophageal or endobronchial rupture. The exact mechanism is unknown but the proposed mechanism is likely via the differential pressure gradient that develops between the Alveoli and lung interstitium. Barotrauma from mechanical ventilation accounts for one-third of the cases of pneumomediastinum. In our case patient was not on mechanical ventilation and esophageal rupture was ruled out by esophagogram, so we believe it is a spontaneous pneumomediastinum. We believe prolonged positive pressure ventilation could lead to rupture of the alveoli in COVID-19 pneumonia, leading to spontaneous pneumomediastinum.
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Introduction: Due to the COVID-19 restrictions in providing regular diabetes services at Sidra Medicine in Qatar, the traditional training and education was postponed, as the service was not considered critical in the current situation. Diabetes team developed an innovative “virtual pump training program”, using video conferencing Skype “Meet Now”. Aim: The aim of this study was to evaluate effectiveness of this program on glycemic control patients transiting to HCL system. Methods: Prospective observational study of children aged 7 to 18 years with Type 1 Diabetes (T1D) on Multiple Daily Injections (MDI), starting the MiniMed 670G system using Skype Meet Now with the following program: prerequisite technical session, patient's criteria for the program and pre-course requirements;pump training, one face to face practical session for sensor insertion and four consecutive online sessions: Day 1- Manual Mode, bolus wizard use, basal rates, Auto Mode and readiness;Day 2- Infusion set and reservoir change;Day 3- hypoglycemia, hyperglycemia, exercise and travel management;Day 4- Evaluation to initiate HCL system. Time in Range, Sensor Glucose, HCL system characteristics were analyzed in the first month of HCL initiation. Results: A total of 12 patients (Age 7-18 years) and their parents commenced MiniMed 670G using the virtual program and used the system for one month. Sensor wear of 91.2 ± 4.5% and Auto Mode usage of 88.5 ± 6.8% was noted in the first month HCL initiation. Time in Range (70-180 mg/dL) increased from 42.1 ± 10.2% at baseline to 74.2 ± 7.3% at the end of the study (p < 0.001). There was no severe hypoglycemia nor DKA during the study. The patients will be followed for the next 3 months. Conclusions: Virtual Pump Training Program in people with T1D on MDI, can be an effective tool to initiate an HCL system and to improve glycemic control in a safe manner without severe hypoglycemia and hyperglycemia.
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SESSION TITLE: Medical Student/Resident Chest Infections Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: An outbreak of novel coronavirus (COVID-19) infection began in December 2019 in Wuhan, China.(1) Widespread human-to-human transmission has resulted in over 4.6 million cases in 216 countries and territories with 312,009 confirmed deaths as of May 18, 2020.(2-6) On March 11, 2020, the World Health Organization declared COVID-19 outbreak a global pandemic.(7) We report the first confirmed case of COVID-19 in our county which is notable for its atypical clinical and radiographic presentation. Our case highlights the importance of clinical awareness regarding this novel disease and the importance of close coordination between providers and public health authorities. CASE PRESENTATION: A 42-year-old male with no known past medical history presented due to worsening productive cough with white sputum, shortness of breath, nausea, myalgias, diarrhea, and decreased appetite for two weeks. He reported being in contact with his co-worker at a restaurant about two weeks ago who had similar symptoms. He also reported recent travel to Philadelphia a month prior to admission. Presenting vital signs were notable for temperature of 102F, respiratory rate of 39, and oxygen saturation of 85% on room air while rest of the vital signs were within normal limits. Physical exam was notable for inspiratory crackles and diffuse rhonchi in bilateral lung fields. He was placed on high flow nasal cannula at 80% FiO2 and 40L/min flow. Lab workup revealed mild hyponatremia and mild hypokalemia while rest of the labs including CBC, lactic acid, procalcitonin, and troponin was unremarkable. Chest CTA was notable for diffuse patchy consolidation and was negative for pulmonary embolism. (Image 1) He was started on broad spectrum antibiotics and COVID-19 testing was sent out to department of health which resulted positive. He was gradually weaned off oxygen. He was discharged home with self-quarantine for 14 days. DISCUSSION: Currently, our understanding of the clinical spectrum of COVID-19 infection is still limited. Complications such as severe pneumonia, acute respiratory distress syndrome, and cardiac injury have been reported.(1, 3, 8) Chest CT is a vital component in the diagnostic algorithm for patients with suspected COVID-19 infection. The hallmarks of COVID-19 infection on imaging include bilateral and peripheral ground-glass and consolidative opacities.(9) Other CT findings include smooth or irregular interlobular septa thickening, air bronchogram, crazy-paving pattern, bronchiectasis, pleural effusion, linear opacities, and the reverse halo sign.(9, 10) Our case is unique as the patient’s CT scan displayed bilateral consolidation without ground-glass opacities which is only reported in 2% of the patients.(9) CONCLUSIONS: Our case highlights the importance of early recognition of various clinical and radiographic presentation of COVID-19. Reference #1: Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33 Reference #2: Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-23 Reference #3: Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506 DISCLOSURES: No relevant relationships by Krishna Akella, source=Web Response No relevant relationships by Kashif Hussain, source=Web Response No relevant relationships by Gunjan Joshi, source=Web Response No relevant relationships by Howard Sklarek, source=Web Response No relevant relationships by Liana Tatarian, source=Web Response No relevant relationships by Daisy Young, source=Web Response
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SESSION TITLE: Critical Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: We sought to perform a meta-analysis using retrospective studies comparing non-sedation with traditional sedation methods in the ICU. Traditional sedation methods have risk of side effects that may prolong time on the ventilator and in the ICU. The clinical utility of non-sedation as an alternative remains unknown. In the current climate of COVID-19 where there is a finite supply of sedatives, non-sedation can prove to be a non-inferior alternative. METHODS: We performed a comprehensive literature search using Pubmed and Google Scholar for studies comparing non-sedation and traditional sedation methods between January 1, 2010 and April 14, 2020. Outcomes included hospital LOS, ICU LOS, ICU mortality, ventilator days, overall mortality, and self extubation. Results were reported as an odds ratio (OR) with 95% CI. A total of 3 retrospective and prospective studies were included comparing non-sedation and sedation in the ICU. A total of 904 patients were enrolled (average age 66.08 +/- 7.04 years, 45.8% males). These patients were divided into two groups: a sedation group (n=437) and non-sedation group (n=467). RESULTS: Reduction was found with non-sedation in Hospital LOS (3 studies), ICU LOS (2 studies), ICU mortality (2 studies), and ventilator days (3 studies). Non-sedation was non-inferior in overall mortality and self-extubation. CONCLUSIONS: Non-sedation appears to be a superior alternative to traditional sedation methods in the ICU. CLINICAL IMPLICATIONS: Non-sedation appears to be a superior alternative to traditional sedation methods and can minimize medication side effects, hospital LOS, ICU LOS, ICU mortality, and ventilator days. DISCLOSURES: No relevant relationships by Krishna Akella, source=Web Response No relevant relationships by Charles Arcoleo, source=Web Response No relevant relationships by Akella Chendrasekhar, source=Web Response No relevant relationships by Priscilla Chow, source=Web Response No relevant relationships by Kashif Hussain, source=Web Response No relevant relationships by Samer Ibrahim, source=Web Response No relevant relationships by Gunjan Joshi, source=Web Response No relevant relationships by Ghulam Mujtaba, source=Web Response No relevant relationships by Haaris Naji, source=Web Response No relevant relationships by Heidi Roppelt, source=Web Response No relevant relationships by Nandini Seshan, source=Web Response No relevant relationships by Howard Sklarek, source=Web Response No relevant relationships by Liana Tatarian, source=Web Response No relevant relationships by Daisy Young, source=Web Response
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Since the first recorded case of SARS-CoV-2 in Bangladesh on 8th March 2020, COVID-19 has spread widely through different regions of the country, resulting in a necessity to re-evaluate the delivery of cardiovascular services, particularly procedures pertaining to interventional cardiology in resource-limited settings. Given its robust capacity for human-to-human transmission and potential of being a nosocomial source of infection, the disease has specific implications on healthcare systems and health care professionals faced with performing essential cardiac procedures in patients with a suspected or confirmed diagnosis of COVID-19. The limited resources in terms of cardiac catheterization laboratories that can be designated to treat only COVID positive patients are further compounded by the additional challenges of unavailability of widespread rapid testing on-site at tertiary cardiac hospitals in Bangladesh. This document prepared for our nation by the Bangladesh Society of Cardiovascular Interventions (BSCI) is intended to serve as a clinical practice guideline for cardiovascular health care professionals, with a focus on modifying standard practice of care during the COVID-19 pandemic, in order to ensure continuation of adequate and timely treatment of cardiovascular emergencies avoiding hospital-based transmission of SARS-COV-2 among healthcare professionals and the patients. This is an evolving document based on currently available global data and is tailored to healthcare systems in Bangladesh with particular focus on, but not limited to, invasive cardiology facilities (cardiac catheterization, electrophysiology & pacing labs). This guideline is limited to the provision of cardiovascular care, and it is expected that specific targeted pharmaco-therapeutics against SARS-CoV-2 be prescribed as stipulated by the National Guidelines on Clinical Management of Corona virus Disease 2019 (COVID-19) published by the Director General of Health Services, Ministry of Health and Family Welfare of Bangladesh.