ABSTRACT
The COVID-19 disease, caused by SARS-CoV-2 virus, has been one of the worst pandemics ever to hit the human mankind. Undoubtedly the start of the second wave of COVID-19 has literally ripped apart the hearts of millions of people. Cancer patients have been left of the beaten track to their fate, with no access to treatments. Intravesical BCG instillation is the standard of care for patients with non-muscle invasive bladder cancer (NMIBC). Several patients were in the middle of their treatment regimen when this pandemic struck. As slowly the word is recuperating from concussion effect of this pandemic and routine health services are being restored, uro-oncologist will face a unique scenario with respect to intravesical BCG therapy i.e., whether to restart the course of BCG therapy or to continue course from where it was interrupted. There are no studies in literature to directly answer this peculiar question and to resolve this dilemma. So, we in this review article propose to explore the literature for the most appropriate therapeutic regimen for these patients with interruption of intravesical BCG therapy. We plan to divide the patients with interruption to BCG therapy into the following three groups:Group 1: Patients who had interruption during the induction period.Group 2: Patients who completed the induction course but maintenance course could not be started.Group 3: Patients who had interruption during maintenance phase of BCG therapy. We will compile the recent recommendations by NCCN, AUA, and EAU for the administration of intravesical BCG in non-muscle invasive bladder cancer. We herein want to review the literature to propose the most appropriate strategy, its safety profile for these subsets of patients. Supplementary Information: The online version contains supplementary material available at 10.1007/s13193-023-01742-8.
ABSTRACT
BACKGROUND: The COVID-19 pandemic with its plenitude of hardships has been a challenge for residents in training. Besides the fear of contracting the disease, the complete reconfiguration of hospital services has severely affected the surgical residency programs across India. The current study highlights the lacunae that have arisen in the residency programs and design appropriate solutions to reframe the remaining part of the surgical training. MATERIALS AND METHODS: The present study is an observational study based on a questionnaire survey done in November 2020 aimed at gauging the mood and perspective of residents across India pursuing surgical residency programs on how the pandemic has impacted various domains of their residency namely surgical training, clinical skills, research, academic curriculum, and mental health. The analysis was performed using an Internet-based program. RESULTS: Seventy-eight percent of residents felt that they have lost crucial months of surgical training. Impact on clinical skills was reported by 73.9% of residents. Almost half of the residents (49.1%) believed that there has been a definite increase in research activities and 81.7% believed that the academic curriculum was affected during the past 6 months. Furthermore, 86% of respondents admitted to have had a profound impact on their mental health as a result of the pandemic. CONCLUSION: Formulating reform policies in the current residency programs is paramount to train the current and future generation of surgeons. Whereas personal safety and wellness of the residents is paramount during these times, residency training via digital medical education and various other innovative ways needs to continue.