ABSTRACT
BACKGROUND: This survey was designed and conducted during the lockdown period to assess its effect on urology practice dealing with patients with voiding dysfunction and their care in the Gulf Cooperation Council (GCC) region. METHODS: An online survey was sent across to urologists managing patients with voiding dysfunction in countries of the GCC region through various social media platforms. All valid responses were tabulated and analyzed. RESULTS: A total of 202 responses were received. Higher proportion of urologists in private sector (98.2%) were treating patients in comparison to those in public or governmental hospitals (82.7%); (P = 0.007). Telemedicine was used by 72% of the respondents. Telephone calls were preferred With regard to perception of risk while examining patients, 65% of the respondents felt that their risk was equal to other specialties. Their preferred prevention strategy would be pre-operative screening. Financial impact affected only 10% claimed major catastrophic effect. There was a significant difference between private and public government urology services provided, with a higher proportion of patients seen, operations performed, fees charged for telemedicine, and financial effect in the private sector with P = 0.012, P = 0.037, P = 0.004, and P = 0.001, respectively. CONCLUSION: Our survey showed that majority of urologists in the GCC region were seeing patients during COVID-19 lockdown. Emergency services were prioritized. A large proportion of urologists had switched over to telephonic communication. Most of the responding urologists were uncertain about when and how to resume surgical procedures upon easing of the COVID-19-related restrictions.
ABSTRACT
Introduction: COVID-19 has a wide range of clinical manifestations involving multiple organ systems. There have been a few cases in the literature that demonstrate the association between COVID-19 and hypertriglyceridemia in the setting of treatment with tocilizumab. We report, to our knowledge, the first known series of patients with critical illness resulting from COVID-19, who developed severe hypertriglyceridemia in the absence of treatment with tocilizumab. Description: Case 1: A 57-year-old male with end-stage renal disease, diabetes mellitus, and hypertension was admitted to the hospital with worsening shortness of breath due to COVID-19. He was initially managed with conservative measures including supplemental oxygen on the medical floor but required transfer to the ICU for worsening hypoxemia necessitating invasive mechanical ventilation. The patient developed a lipemic serum on hospital day 8. His triglyceride level was noted to be 3160mg/dl, with a baseline level of 224mg/dl 1-year prior. Patient deteriorated rapidly and expired before appropriate treatment measures for his hypertriglyceridemia could be implemented. Case 2: A 73-year-old male with pulmonary fibrosis and coronary artery disease was admitted to the hospital with shortness of breath due to COVID-19. He was managed with remdesivir and dexamethasone on the medical floor, but deteriorated further and required invasive mechanical ventilation and continuous renal replacement therapy. Patient developed lipemic serum on hospital day 19 and was found to have a triglyceride level of 1757mg/dl, with a baseline level of 173mg/dl 1-year prior. Patient was started on an insulin infusion but continued to deteriorate and expired on hospital day 20. Case 3: A 47-year-old hypertensive male patient was admitted with worsening shortness of breath due to COVID-19. He was initially treated with dexamethasone and supplemental oxygen but deteriorated and required invasive mechanical ventilation as well as continuous renal replacement therapy. He was noted to have a lipemic serum on hospital day 14 and was found to have a triglyceride level of 945mg/dl. Patient was managed with an insulin infusion with subsequent improvement in his levels. Patient had a prolonged hospitalization and required tracheostomy but has since made a full recovery including the recovery of his renal function, and has returned to work. Image below shows the lipemic serum of our patient: Discussion: These cases suggest an association between severe COVID-19 and hypertriglyceridemia in the absence of treatment with tocilizumab. Further studies are needed to determine whether this association truly exists, its implications on prognosis, and to determine optimal management strategies.
ABSTRACT
BACKGROUND: During the current COVID-19 pandemic, prevention is the key to limiting the spread of this disease. The frequent handwashing and use of sanitizers resulted in notable skin changes among some individuals. The aim of the study was to determine the prevalence and determinants of the new onset of dermatitis during the COVID-19 pandemic in a university population from Saudi Arabia. METHODS: A cross-sectional study was conducted using a self-administered online questionnaire by sending an invitation link to students and employees of Prince Sattam Bin Abdulaziz University in June 2020. A chi-squared test was used to note differences regarding hand and face dermatitis. RESULTS: Of the total 2356 participants, 34.8% reported skin changes or symptoms over hands, and 15.3% reported skin changes on their face during this pandemic. 88.7% of the participants reported a change in handwashing habits during the COVID-19 pandemic, and 62.2% of participants were not using any hand sanitizers before COVID-19 but began using them during the pandemic. There were significantly higher percentage of skin conditions in females (on hands (ScH): 42.6% and face (ScF):19.2%), individuals working in environments requiring frequent handwashing (ScH: 40.3% vs. ScF: 17.2%), those working in facilities where they have to interact with people during the pandemic (ScH: 41.1% vs. ScF: 18.7%), those encountering COVID-19 patients (ScH: 48.6% vs. ScF: 24.8%), those exposed to chemicals (ScH: 48.6% vs. ScF: 24.8%), and healthcare workers (ScH: 51.3% vs. ScF: 24.3%). CONCLUSION: It was found that during the pandemic, skin changes were common among the general population as well as among healthcare workers. The frequency of handwashing and the use of alcohol-based sanitizers were contributing factors for dermatitis. Although hygiene is an extremely important preventive measure in this pandemic, maintaining skin integrity is also vital. Appropriate knowledge and good practice can prevent dermatitis in this pandemic, with regular hydration of the skin being a key factor.