A rare case report of short bowel anastomosis after acute mesenteric ischaemia in Covid-19 postive patient.

Acute mesenteric ischaemia is one of the serious abdominal surgical emergency, which has got very high morbidity and mortality. During the pandemic of COVID-19, besides respiratory complications, the virus was causing venous and arterial thromboembolism that can lead to acute mesenteric ischaemia in otherwise healthy individuals. Early diagnosis and suitable surgical procedures are the key to the better outcome of this disease. Surgical resection of gangrenous gut, leaving healthy gut is an important step of this operation. Leaving less than 200 cm of small intestine leads to short bowel syndrome which has got its own complication. This case report is on a healthy COVID-19 positive patient who presented with acute mesenteric ischaemia. After surgical resection only 1.5 feet small bowel (60 cm) was left behind and anastomosis was done with healthy transverse colon. He was later managed for complications of small bowel syndrome and was discharged successfully with dietary modifications.

Challenges in providing surgical procedures during the COVID-19 pandemic: Qualitative study among Operating Department Practitioners in Pakistan.

The surgical theatre is associated with the highest mortality rates since the onslaught of the COVID-19 pandemic. However, Operating Department Practitioners (ODPs) are neglected human resources for health in regards to both professional development and research for patient safety; even though they are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs during the pandemic. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. The public health sector, in Pakistan and other developing regions, needs to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.

The Toll it Takes: Mental Health Burden and Associated Factors During COVID-19 Outbreak among Healthcare Workers in Lahore, Pakistan

Objective: To assess psychological impact of COVID-19 pandemic among healthcare workers (HCWs) in a University Teaching Hospital, the main referral center for COVID-19 in Lahore Pakistan, by quantifying symptoms of acute stress disorder, depression, anxiety, insomnia and to explore their potential risk factors. Study Design: Descriptive Analytical study. Place and Duration of the Study: King Edward Medical University from March 30th-April 15th 2020. Methods: Following Institutional Review Board approval and informed consent, Demographic form, Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, and the stress reactions questionnaire were used for data collection. Descriptive statistics were computed. Binary logistic regression was done to determine potential risk factors for mental health outcomes. Results: Three hundred and thirty-seven healthcare workers participated with 79% physicians and 20% were nurses and paramedical staff. The prevalence of anxiety, depressive symptoms, acute stress disorder and insomnia was 36.2%, 30%, 27.9% &1.5% respectively. Women, frontline HCWs and junior staff had more anxiety, depression and insomnia symptoms with physicians reporting more acute stress symptoms compared to nurses. Binary logistic regression showed that being a junior staff member and a frontline worker appeared to be an independent risk factors for depression and anxiety (but not insomnia). Conclusion: High psychological distress among healthcare workers during COVID-19 reported in Pakistan. Failure to provide adequate psychosocial support can significantly impair their functioning and compromise patient care.

Significant other family members and their experiences of COVID-19 in Pakistan: A qualitative study with implications for social policy

To the best of our knowledge, there is no research about the challenges faced by significant others of coronavirus patients in Pakistan, including spouses, children, siblings, and parents. We aimed to discover through an open-ended semistructured questionnaire the main challenges and coping strategies of significant others since the time their relative have been tested positive for coronavirus and taken to quarantine or admitted to the hospital. Sampling was done using contact information from three hospitals of Lahore with the largest quarantine facilities for COVID-19 patients. We used NVIVO to analyze the interviews of 20 participants through content analysis approach. The findings included three broad themes of experiences of stigma, struggles, and strengths and a total of 9, 6, and 8 subthemes under each theme, respectively. We conclude with key social policy recommendations to support families of coronavirus-infected people through salient areas of criminalization laws, therapy and counseling, surveillance and monitoring, employee protection, and accountability of government, health workers, and police. (PsycInfo Database Record (c) 2020 APA, all rights reserved)