ABSTRACT
Mucormycosis is a life-threatening infection. Mucormycetes causes a wide range of diseases, including pneumonia, rhinosinusitis, internal organ spread, gastrointestinal tract involvement, and skin and soft tissue infection. It infects predominantly with hematological malignancies, transplantation, immunocompromised, and diabetes mellitus patients. The most severe type of the disease is a disseminated disease, which is linked to significant immunosuppression. Currently, this disease is more prevalent in the COVID-19 pandemic because of erroneous steroid use and untreated diabetes. However, there is a scarcity of study and information on the COVID-19 and mucormycosis connection. According to the latest research, mucormycosis cases are rising in developed and developing nations, and only a few therapies are available. The exact burden of mucormycosis is unclear;however, it is likely to be greater than recorded instances due to mucormycosis epidemiological changes. As a result of the delay in identifying this severe illness, appropriate antifungal medications are delayed, resulting in significant morbidity and death. A few drugs are underclinical trials for their efficacy. Other obstacles to treat patients are lack of reliable diagnostic non-invasive tests. This review article draws the attention of its readers and clinicians towards the agents of mucormycosis and discuss the various cases to manage this fungal infection.
ABSTRACT
West Bengal, a conventional state for migrant workers in India since the colonial era, mutated to a net sender of migrants as its economy failed to keep pace while new centres of growth emerged i.e., southern Indian states in post-reform era. Owing to squeeze on farm incomes, migration towards urban centres within the state as well as outside the state has seen a quantum jump. Consistent decline of job opportunities in conventional centres like Kolkata, Asansol, Durgapur and others have started pushing away the inter-state migrants to other states. On top of this, Bengalis themselves have begun venturing out of the state to find jobs. Saturation of opportunities in old urban centres such as Delhi and Mumbai and rising sub-nationalism has given way to new centres where migrants from Eastern Indian states including West Bengal, are increasingly moving to. Southern Indian states have begun to emerge as new destination for migrant workers, as they feel more included and secure vis-à-vis rich states of north and western India. The supportive role of government towards migrant workers among South Indian states during Corona pandemic is one example of inclusiveness. The paper utilises information from three Indian Censuses (1991, 2001 and 2011) in exploratory manner to substantiate the arguments. Copyright © Rabiul Ansary and Md Zakaria Siddiqui.
ABSTRACT
Introduction: COVID-19 resulted in Regional tiered restrictions being introduced across the UK with subsequent implications for planned and emergency care. Specific to Merseyside Tier 4 and Tier 2 restrictions were introduced in late 2020. At the onset of the pandemic in the Spring, elective work ceased, and emergency admissions were minimal. The purpose of this study was to examine the volume and nature of all emergency admissions to a Urology unit in Merseyside in the 2nd wave of the pandemic during two different tiers of national restrictions. Method: A prospective audit examining all emergency urological activity was conducted in Whiston Hospital from October 2020 when the Tier 4 restrictions were introduced to Tier 2 was introduced. Data was obtained by identifying patients using the electronic theatre listing system. Results: A total of 52 emergency cases were performed (24 in November Tier 4, 28 in December Tier 2). A total of 12 different procedures were performed. The commonest procedure performed was stent insertion (26), followed by scrotal exploration (7). One patient required transfer to a different hospital. In total 4 calls were made by general surgery and 2 by gynaecology for urological assistance in theatre. Two urology patients returned to theatre. Direct Consultant involvement occurred in 19 cases (37%). Conclusions: Unlike the Spring lockdown acute urology operations presented despite regional restrictions. A total of 52 cases were performed with more occurring in Tier 2. Stent insertion was the commonest procedure with the majority of the cases performed by registrars.
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Purpose: Monoclonal antibody (mAB) infusion (bamlanivimab or casirivimab/ imdevimab) for symptomatic, non-hypoxemic, high-risk outpatients with COVID-19 infection, is an available early intervention for COVID-19+ SOT recipients. We aimed to assess efficiency in time from diagnosis to treatment, and outcomes in a retrospective cohort of SOT recipients with COVID-19 who received mAB. Methods: We developed a Nurse Coordinator-led initiative to screen, refer, and facilitate mAB infusion for COVID-19+ SOT recipients within 10 days of symptom onset. SOT recipients received electronic messaging to promptly report potential COVID-19 symptoms to the transplant team. Data were collected on time from symptom onset to diagnosis, mAB infusion, and follow-up > 21 days, and hospital admissions, disease severity, mortality, and rejection. Results: 34 out of 36 referred SOT recipients with symptomatic COVID-19 disease without hypoxia received mAB therapy (3 heart, 8 lung, 16 kidney, 2 Liver-Kidney, 2 Pancreas-Kidney, 3 Kidney-Heart). Median time from symptom onset to diagnosis was 2 days and from date of diagnosis to mAB infusion was 4 days. Of those 34, 88% did not require hospitalization and recovered uneventfully. 12% required hospitalization for COVID disease progression, two on the same day as mAB infusion, and the other 2, more than 26 days post infusion. Of these, 2 patients had mild-moderate hypoxia, and 2 had critical disease. Only 1 patient died from COVID-19 complications and no episodes of rejection or graft loss were observed. Conclusions: The Nurse Coordinator-led initiative efficiently facilitated mAB therapy for COVID-19+ SOT recipients and was associated with excellent outcomes. Compared to prior published COVID-19 outcomes in SOT recipients, patients who received mAB may have reduce hospitalization and low mortality. As mAB therapy may be underutilized in the general population, these results support efforts to educate transplant centers to implement efficient interventions for the screening and referral of COVID+ SOT recipients for mAB therapy.
ABSTRACT
Introduction: Traditionally the management of nonmuscle invasive bladder cancer (NMIBC) involves rigid cystoscopy and bladder biopsies/tumour resection under general/regional anaesthesia. The COVID-19 pandemic forced hospitals to reduce operating lists and increase bed availability. An outpatient TULA service was recently started at our trust. TULA is performed via a flexible cystoscopy without the need for anaesthetic. Anticoagulation/ anti-platelets can continue and antibiotics are not routinely administered. We present a case series of our first 4 months data. Patients and Methods: All TULA cases (n=39) performed between Aug-Dec 2020 were included. Data was gathered prospectively including: patient demographics, co-morbidities, medications, initial cancer diagnosis grading/ staging and number of subsequent recurrences, histopathological data, post-procedural complications and patient procedural satisfaction. Results: Median age was 82 years (range 34-96) and median Charleston score was 7 (range 2-12). Previous bladder cancer diagnosis was present for 85% with the most common initial stage G2pTa (n=11). Median number of recurrences was 1 (range 1-5). Median patient perceived pain score was 3 (range 1-7) with 100% of patients preferring TULA over TURBT. Reasons included reduced procedural time (n=18) and enhanced recovery (n=15). One grade-1 Clavien-Dindo classification complication was noted. Conclusion: TULA is safe for all low risk NMIBC, particularly for frail patients. It is well tolerated and facilitates improved patient experience. It also alleviates demand on theatre capacity and inpatient beds, allowing these patients to continue to be treated despite the pressures exerted on the NHS during the pandemic. Further audit of clinical outcomes should continue as recommended by NICE.
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Objective: To evaluate the psychological fear (anxiety) of dental patients while visiting a dentist in the period of the present coronavirus disease (COVID-19) pandemic. Methodology: This online cross-sectional survey used a self-administered questionnaire to analyze the anxiety, knowledge, and perception of 461 dental patients. A p<0.05 was considered significant. Results: Data from 461 participants revealed significant differences among genders (X-2 = 14.944, p<0.001), age (X-2= 142.915, p<0.001), and between the educational levels of the participants (X-2= 410.399, p<0.001). We found that 63.6% patients were afraid of visiting dentists due to the fear of COVID-19, and 66.2% patients thought that they will get the disease from the dentist or dental office. We observed that females were found to be more anxious than men (p<0.05). Conclusion: There was high anxiety among the patients to visit dentists because of the current pandemic. Aanxiety regarding COVID-19 is prevalent in the society that may lead to a monetary crisis for dentists.
ABSTRACT
Coronavirus disease (COVID-19) is an acute respiratory illness caused by a highly contagious novel coronavirus creating catastrophe globally. With no specific treatment and approved vaccine for COVID-19 till date, the practice of social distancing, preferably called physical distancing and staying home has been adopted as a part of the prevention and control strategy against the spread of 2019 -nCoV infection-causing COVID-19. But the implementation, extension and repetition of the lockdowns creates various threats not only on the economy but also on the psychosocial and behavioural changes in general. This article critically discusses the positive effects of lockdown along with its adverse possible outcomes or effects. The adverse effects experienced are multidimensional like psychosocial, mental and economical. The recent insurgence of COVID-19 cases, shortage of intensive care ventilators, quarantine, and ill effects of lockdown have led to depression, anxiety, insomnia, fear and insecurity in the common man. Worst ever economic recession has been noticed after COVID-19 lockdown. Consumer spending and buying power have also reduced significantly in all sectors. The looming crisis in developing nations is predicted to devastate economies disproportionately and ramp up inequality in such nations. This lockdown has pushed millions of people in various countries to no work, no income and hunger. The positive effects like reduction in air pollution, better lifestyle are also observed. The reduction in soil, water and air pollution is eventually helpful to live a healthy life. People are following proper hand washing practices, practicing respiratory etiquettes and maintaining proper personal hygiene and have embraced health promotion and disease prevention measures seriously. Traffic volume and street crimes have also been reported going down. Education has become digitalized and affordable. Family members are spending time with each other and developing gratitude towards their loved ones. Food waste control is critical. This lockdown has improved the food shopping performances in some places and a positive behavioural change for the prevention of food wastage is expected in other countries also. Lockdown reduces the reproduction of coronavirus, i.e., to reduce people having confirmed infection and treated as a case. The goal is to keep the reproduction number 'R' below one (R < 1), through mitigation & suppression. Embracing health promotion measures and practicing social responsibility is the need of the hour. However, policymakers should strive for maintaining a balance in measures in order to reduce the devastation of economies apart from safeguarding the health of the people.