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Background: We present our early experience of introducing state-of-the-art endoscopic vessel harvesting (EVH) into a hospital in Scotland. Coronary arteries bypass grafting (CABG) is the most frequently performed adult cardiac surgical operation and circa. 1200 cases were performed across Scotland in 2019/20, prior to the COVID-19 pandemic. Although internal thoracic artery (ITA) is the preferred conduit, most CABG operations require long saphenous vein (LSV) to be harvested from one or both legs. The radial artery (RA) is also used less frequently. Conduits are currently harvested by open technique, representing one of the longest incisions in surgery. Even when expertly performed, this is a major source of morbidity and delayed hospital discharge. Known risk factors for wound complications include age > 75 years, female sex, BMI > 28, history of smoking, diabetes mellitus and peripheral vascular disease. Both LSV and RA can be successfully harvested endoscopically via 2 cm incision with expected reduction in post-operative morbidity. In our quest to make CABG less invasive, we decided to embark upon a programme of EVH and hereby present our early clinical experience and vision for future roll-out across centres routinely performing cardiac surgery in Scotland. Methods: Consecutive patients undergoing isolated elective CABG surgery at one institution were consented for endoscopic vessel harvesting (EVH). We used a novel on-screen imaging (CoreVista, CardioPrecision), along with latest EVH harvesting tools (HemoPro 2, Getinge) and standard imaging/CO2 insufflation (Stryker). Data on risk factors, wound complications, patient satisfaction and length of stay were collected. Results: A short video will be used to demonstrate key steps of the procedure. Nine patients were recruited into the study. The mean age was 61 years [95% CI 53-69 years]. Six out of 9 (66%) patients had one or more risk factors for post-operative wound complications. LSV was harvested endoscopically in 6 patients (66%) and RA in 3 (33%) patients. The median number of grafts was 3 [range 2-5]. There were no immediate wound complications. All patients expressed a high level of satisfaction with the surgical result. Median post-operative length of stay was 5 days [range 5-6 days]. At a median follow-up of 2 months there were no late wound complication or adverse events reported. Conclusions: EVH was successfully delivered without complications in our series with high degree of patient satisfaction and consistently short length of stay. The combination of devices was easy to use and integrate into the standard CABG theatre footprint and procedure. Plans are now being made to implement EVH more widely across Scotland.
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Background: It's more than 2 years since the strike of a COVID-19 pandemic caused by severe acute respiratory syndrome Coronavirus 2. It had infected nearly 400 million populations globally and affected several important sectors worldwide such as the economy, social and healthcare services. To date, Malaysia recorded more than 3 million confirmed cases of COVID-19. The first nationwide Movement Control Order (MCO) started on 18th March 2020 then followed by multiple series of targeted MCOs on several states with a high surge up of cases. The National Blood Center (NBC) and State Blood Transfusion Services (SBTS) experienced significant reduction of blood collection, the shortage of blood availability and supply. The total blood collection in the year 2020 was 655,069 units, showing a 12% reduction compared with the year 2019. Blood supply management requires an integrated and holistic planning from all stakeholders to ensure the judicious use of blood and blood components in the normal situations, pandemics, crises, or during blood shortages. Aims: This study was to determine the characteristic of blood components mobilized during the COVID-19 Pandemic and to assess the coordination of inter-regional blood availability, supply, and transportation between the blood inventory of NBC, SBTS, or Hospital Blood Bank. Methods: A retrospective study was conducted from 18th March 2020 until 18th August 2021 where multiple series of MCOs were instated. Data from the blood inventory during the 18 months were analysed. All data were retrieved from Blood Bank Information System from NBC and SBTS. Results: A total of 17,144 units of blood components have been mobilized and distributed, comprised of 15,591 units of red cell, 1107 units of platelet concentrates, 299 units of Fresh Frozen Plasma, 125 units of Cryoprecipitate and 22 units of Convalescent Plasma. Overall, there were 20 blood collection centers comprised of NBC, state hospitals, and major hospitals involve as blood providers to the (Table Presented) several affected blood collection centers, beyond the state border. The states with major contributions for blood component mobilization were Kuala Lumpur, Sarawak and Johor while the collection centres that provided the most blood were National Blood Centre (4542 bags), Sultanah Aminah Hospital in Johor (1714 bags) and Malacca Hospital (1630 bags). The blood products have been shipped via hospitals' land transportation, air transportation by courier service and collaborative mercy flight by the Malaysian Air Force to the Malaysia East. The validated blood packaging and transportation procedure have been implemented to preserve the blood cold chain during blood mobilization through the air or by land transportation. Summary/Conclusions: The challenges during a pandemic are to deliver adequate, safe, and quality blood to the patient who needs blood transfusion for life-saving. Dynamic inter-state blood availability, supply and mobilization are essential to overcome the shortfall during a pandemic. Effective communication among NBC, SBTS, interagencies, governmental organizations, and postal service companies were among the great factors of success in transporting blood beyond borders to ensure blood availability. The plan was designed in response to the threat to the national blood supply from any untoward events that lead to blood shortages in a state, regional, or nationwide in Malaysia.
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Background: COVID-19 pandemic has created numerous psycho-social issues throughout the world. Aim: The current study is aimed at identifying and validating the psychosocial reactions of university students to current pandemic COVID-19. Methods: Mixed-methods research design was used. Initially, the presenting problems of 39 university students were collated and a list of 28 items was finalized and presented to 15 experienced clinical psychologists for the frequency of occurrence for Psychosocial Reaction Scale (PRS). An online survey was conducted on 510 university students with an age range of 17-26 (M=21.86;SD=2.94) and presented Psychosocial Reaction Scale (PRS) and Depression Anxiety Stress Scale (DASS) for construct validity. Results: Results of both exploratory and confirmatory factor analyses revealed a two-factor model depressive symptoms and apprehension. The PRS shown a satisfactory internal consistency and construct validity. Conclusion: The findings are further discussed in the continual significance and counseling plans to handle adverse reactions of COVID-19 in Pakistani university students.
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The Research Aims To Study How To Build An Efficient Portfolio By Using The Weighted Moving Average In The Light Of The Global Pandemic And Compare It With The Efficient Portfolio For The Previous Period Before The Global Pandemic. The Rapid Spread Of Corona Virus (Covid-19) Is Having Major Impacts On The Financial Markets Around The World. However, The Global Pandemic Caused A Great Risk, Which Led The Investors To Suffer Huge Losses In A Very Short Period Of Time, In Addition, To The Global Covid-19 Pandemic, The Economic Recession And The Drop In Oil Prices Led To A Drop In The Share Prices Of Companies, As Well As Most Of The Companies Listed In The Iraq Stock Market (Iraq Stock Exchange), Trading In Their Shares Decreased After The Appearance Of The First Case In Iraq In 25/2/2019. The Weighted Moving Average Is One Of The Technical Analysis Tools, And This Technical And Mathematical Tool Has Been Used To Build A Portfolio Consists Of (24 Companies). The First Ten Companies That Have The Highest Weighted Moving Average Have Been Selected And The Research Period Is Divided Into The Period Before The Global Pandemic Which Started From 25/2/2019 To 24/2/2020 And The Concurrent Period Of The Global Pandemic From 25/2/2020 To 2/24/2021 And The Researcher Used The Statistical Program [Microsoft Excel 10]. It Has Been Concluded From The Research That The Sharpe Ratio For The Technical Portfolio For The Concurrent Period Of The Global Pandemic Was Higher Than The Sharpe Ratio For The Previous Technical Portfolio Before The Global Pandemic, Although The Sharpe Ratio For Both Portfolios Is Negative, Meaning That The Returns Of The Portfolio Are Less Than The Risk-Free Return, But The Sharpe Ratio For The Technical Portfolio For The Concurrent Period Is Better Than The Technical Portfolio For The Previous Period, Which Confirms That The Decrease In The Number Of Trading Sessions And The Volume Of Trading Have Affected The Performance Of The Investment Portfolio, The Smaller The Number Of Trading Volume, The Better The Performance Of The Portfolio. The Researcher Recommends With Using Other Technical And Mathematical Tools To Build An Efficient Investment Portfolio In The Light Of The Global Pandemic © The Author 2021. This Work Is Licensed Under A Creative Commons Attribution License (Https://Creativecommons.Org/Licenses/By/4.0/) That Allows Others To Share And Adapt The Material For Any Purpose (Even Commercially), In Any Medium With An Acknowledgment Of The Work's Authorship And Initial Publication In This Journal
ABSTRACT
Coronavirus disease 2019 (COVID-19) is a systemic disease with a substantial impact on the hematopoietic system and hemostasis. Neutrophilia is an early indicator of SARS-CoV-2 infection, while lymphopenia acts as a biomarker of the severity of infection, and the neutrophil-to-lymphocyte ratio (NLR) is the main indicator of cytokine storms. Thus, this study aimed to provide local data about hematological parameters among COVID-19 patients and estimate their correlation with viral load and other factors in severe cases. A total of 99 nasopharyngeal swabs and whole blood specimens were collected from individuals suspected with COVID-19 between October and December 2020. Samples were tested by real time reverse transcriptase polymerase chain reaction (rRT-PCR) assay, COVID-19 IgG and IgM antibody tests, beside hematological analysis. The results showed a significant increase in neutrophils count and NLR, correlated with the severity of the disease Patients at older ages who are suffering from some comorbidity like hypertension and diabetes are at elevated risk to develop more severe disease outcome. The findings demonstrated a higher neutrophils count and higher death ratio in older ages. Also, the results suggest that NLR could be employed as a useful biomarker and potential prognostic tool supporting the importance of laboratory records in assessing case severity and disease progression. © 2021 University of Baghdad-College of Science. All rights reserved.