ABSTRACT
Objective: To analyze the effect of Critical Incident Stress Management on the mental health of nurses during COVID-19. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Jhelum Pakistan from Mar to Jun 2020. Methodology: Forty-six nurses were consecutively recruited and evaluated regarding Knowledge about COVID-19, thoughts regarding its origin, emotional reactions, and coping mechanisms. The evaluation was followed by the provision of Critical Incident Stress Management sessions in March. Finally, in the second phase conducted in June, the participants were evaluated again to assess the effect of intervention regarding the above parameters. Results: Results indicated a statistically significant shift in Knowledge from Social Media to Academic Resources (p<0.001). Thoughts regarding the origin of COVID-19 showed that ‘Religious Causes' and belief in ‘Religious and Biological Causes both” significantly reduced (p=0.001 and p=0.003, respectively), while opinions regarding ‘Biological Causes' increased in frequency (p< 0.001). Emotionally a significant reduction was seen in Confusion (p<0.001). A significant reduction was observed in Religious Rituals (p=0.002) for Coping Mechanisms. However, observing Safety Precautions and Distraction Strategies were insignificantly affected (p=0.668 and p=1, respectively). Conclusion: Critical Incident Stress Management helped healthcare workers sublimate their emotional reactions and helped them cope with a productive mindset for better management of the pandemic.
ABSTRACT
Objective: To determine the role of Methylprednisolone in managing COVID-19 patients. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Emirates Military Hospital (PEMH), Rawalpindi Pakistan, from Jan to Feb 2021. Methodology: This study was carried out at the Department of Medicine. Medical records of all moderate, severe and critical COVID-19 patients admitted and receiving Methylprednisolone were reviewed. Methylprednisolone was used in all patients at doses 0.-2 mg per kg. Results: A total of 200 cases were included. The most common presenting symptoms were cough (77.5%), fever (67.5%) and shortness of breath (63.5%). Most patients (85%) presented within the first week of their illness. One or more comorbidities were present in 75% of patients. Most common being hypertension in 70(35%) and diabetes mellitus in 63(31.5%). Complications seen in the study were Cytokine release storm 92(46%) and acute respiratory distress syndrome 44(22%). The median time for initiation of corticosteroid therapy was 4 hours (range 1-96 hours). Overall survival (OS) in the study was 83.5%. OS for patients with moderate, severe and critical diseases was 97.8%, 86.2% and 62%, respectively (p<0.001). Conclusion: Corticosteroids are useful in COVID-19-admitted patients and provide excellent survival outcomes.