ABSTRACT
A good number of patients experience post-Covid complications. Doctors and nurses are the front liners who are at greater risk of having this disease. Neurological symptoms are frequent in patients with post-COVID-19 infection. The study aims to observe the post-acute neurological symptoms among doctors and nurses of Mymensingh Medical College Hospital, a tertiary care hospital in Bangladesh, after they recover from initial infection or among the asymptomatic cases. It was a retrospective observational study among the doctors and nurses who became RT PCR positive from late April to mid-September 2020. A total of 100 subjects were interviewed over the phone for the presence or absence of neurological symptoms four weeks post Covid-19 infection. Total 54 doctors and 46 nurses were evaluated;the male-female ratio was 1:1.77, the mean age was 35.6+/-7.6 years. Post-acute COVID neurological symptoms (PACNS) were present in 60% of respondents. Fatigue (51%) was the most common symptom, followed by sleep disturbance, headache, myalgia, loss of taste and smell. PACNS were more in symptomatic patients at the initial Covid infection than asymptomatic cases.
ABSTRACT
Recently, mucormycosis, extremely rare fungal infections are emerging as a matter of concern in COVID-19. The saprophytic fungi of Mucorales species cause the disease, Mucormycosis, only in immunocompromised hosts. Clinical presentation of mucormycosis is related to the underlying conditions;rhino-cerebral disease is the most common form, especially in patients with diabetes mellitus;pulmonary, cutaneous, or gastrointestinal infections can also occur. Severe COVID-19 itself is a life-threatening disease and various factors, including diabetes, especially when complicated by ketoacidosis, previous respiratory pathology, immunosuppressive therapy, nosocomial infection sources and systemic immune alterations of COVID-19 itself predispose to mucormycosis. No specific biomarkers are available to diagnose mucormycosis;imaging of the involved area and histopathological examination of the biopsied tissue are most important in diagnosis. The underlying medical conditions must be corrected;these include good glycemic control, tapering of steroids, and reducing or stopping immunosuppressive medications. Systemic antifungal therapy with liposomal Amphotericin B is the medical treatment of choice though drug resistance is not uncommon. Surgical debridement of devitalized tissue is often required. Severe COVID-19 patients with secondary co-infections require longer hospitalization and had higher risks of death. The mortality rate is almost 50% despite timely adequate treatment. The judicious use of systemic glucocorticoids and immunosuppressive agents for treating severe disease and hyperglycemia control seems vital for preventing and managing mucormycosis.
ABSTRACT
BACKGROUND: The year 2020 witnessed a largely unprecedented pandemic of coronavirus disease (COVID-19), caused by SARS COV-2. Many people with COVID-19 have comorbidities, including diabetes, hypertension and cardiovascular diseases, which are significantly associated with worse outcomes. Moreover, COVID-19 itself is allied with deteriorating hyperglycemia. Therefore, Bangladesh Endocrine Society has formulated some practical recommendations for management of diabetes and other endocrine diseases in patients with COVID-19 for use in both primary and specialist care settings. OBJECTIVE: The objective of the article is to develop a guideline to protect the vulnerable group with utmost preference - the elderly and those with comorbid conditions. Therefore, to ensure the adequate protective measures and timely treatment for COVID-19 patients with diabetes, other endocrine diseases or any other comorbidities. CONSIDERING AND MONITORING ISSUES: The risk of a fatal outcome from COVID-19 may be up to 50% higher in patients with diabetes than in non-diabetics.Patients with diabetes and COVID had CFR 7.3-9.2%, compared with 0.9-1.4% in patients without comorbidities.Diabetic ketoacidosis may be one of the causes of mortality in COVID-19.There is wide fluctuation of blood glucose in these patients, probably due to irregular diet, reduced exercise, increased glucocorticoids secretion, and use of glucocorticoids. HbA1c should be <7.0% for the majority of the patients, this target may be relaxed in appropriate clinical settings.More emphasis should be given on day-to-day blood glucose levels. Hypoglycemia (<3.9 mmol/l) must be avoided.Frequent monitoring of blood glucose is needed in critically ill patients. CONCLUSION: The fight against COVID-19 has been proven to be a challenging one. Therefore, all healthcare personnel should make the best use of updated knowledge and skills to ensure adequate protective measures and timely treatment for COVID-19 patients with diabetes, other endocrine diseases or any other comorbidities.
ABSTRACT
Not Available.