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Introduction: The health workers are one of the most prone to becoming infected with COVID-19, due to their exposure during their relationship with patients. Background: To determine the clinical and epidemiological characteristics of COVID-19 in workers of the Pediatric Hospital of Camaguey in the period from January to December 2021. Methods: A descriptive and cross-sectional study was carried out in a universe of 238 workers with a polymerase chain reaction-confirmed diagnosis during the aforementioned period;registered in a database. The variables studied included age group, sex, occupational category, service of origin, clinical manifestations, quarter of the year, and possible source of infection. The data were processed using the statistical program SPSS (Statistical Package for Social Sciences), version 25.0, on a Pentium IV computer. Informed consent and the bioethical principles of confidentiality of information were taken into account in the research. Results: The female sex predominated (54.7%) at ages 50-59 years. They were mostly nursing staff (29.4%), infected during the third trimester (39.9%) in the community (59.3%), presenting symptoms such as nasal discharge (32.8%) and fever (17.6%), working in the pediatric medicine wards (28.2%). Conclusions: Despite the difficult epidemiological situation, the main source of infection was the community. There were no institutional transmission events and there were no deaths.
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Introduction: Acute recurrent purulent pericarditis is an uncommon pericardium infection that can be life-threatening due to pus production, leading to cardiac tamponade. Case presentation: We report a 36-year-old man referring to our hospital with impending cardiac tamponade who needed urgent pericardiocentesis. The patient's complaints were worsening dyspnea and palpitations in the last two days. The patient had been hospitalized for the same complaint and had pericardiocentesis due to cardiac tamponade approximately three weeks earlier. Physical exam, ECG, and CXR suggest impending cardiac tamponade. Echocardiography indicated massive right and left pericardial effusion and right atrial collapse. The Covid-19 screening test was positive;however, RT-PCR revealed a negative result. The patient was diagnosed with recurrent acute purulent pericarditis with impending cardiac tamponade requiring urgent pericardiocentesis. After the procedure, 1.5 million units of intrapericardial fibrinolytic were administered to patients. His improved hemodynamic and clinical symptoms indicate a successful procedure. Conclusion: This case highlights the challenges of managing an acute recurrent purulent pericarditis patient due to Staphylococcus A. infection in the current pandemic era, including distinguishing it from other contagious diseases due to nonspecific dyspnea, limited therapeutic options, and the effectiveness of intrapericardial fibrinolytic in improving the overall patient conditions, and reducing the mortality rate.
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Facing the unmet need for new, affordable medicines for public health crises, how should states' duty to ensure that everyone shares in the benefits of science be understood in relation to pandemic vaccine supply, and how has the United Nations Committee on Economic, Social and Cultural Rights monitored the implementation of this right? In this paper, we examine the contours and content of state obligations with regard to pandemic vaccine supply under the right to science (article 15(1)(b) of the International Covenant on Economic, Social and Cultural Rights), focusing on three aspects of state obligations: mobilizing public resources for developing and disseminating the benefits of scientific progress in areas of public health need;preventing unreasonably high medicines prices;and international cooperation, particularly in a globalized health emergency. The committee regularly assesses state parties' implementation of their obligations under the covenant, culminating in the issuing of concluding observations, which often serve as a basis for the next round of periodic reporting by states and can thereby direct future state action. Our analysis of the committee's concluding observations reveals that the committee has inconsistently applied its own guidance on the right to science regarding medicines and intellectual property in these monitoring exercises. These findings inform a rights-based response to medical innovation for health crises and advance the Sustainable Development Goal target on medicines research and development.
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Background: The COVID-19 pandemic has changed the world, especially at the community level. It has not only affected the way community members interact, but also how they relate. Objectives: To examine the role of community awareness in reducing the transmission of COVID-19;to investigate the effect of the engagement of Community Health Workers on the reduction of the transmission of COVID-19 positive cases;to examine the role of government restrictions in reducing COVID19 transmissions among the communities living and to analyse the measures put in place to address challenges facing the community-based responses in addressing COVID-19 transmission in Kisumu East Sub County. Methodology: The study adopted Descriptive Case Study Design. Data was collected using semi-structured questionnaires and interviews. Quantitative data was analysed using SPSS. Qualitative data was collected from the interviews and was analysed using the thematic content analysis technique. Findings: The study established that community awareness played a great role in reducing transmissions of COVID-19. It also established that the measures that the government put in place to reduce community transmissions were to a large extent successful. Lastly, the study established that the government stepped up measures to address the challenges of COVID-19 and these measures included screening and vaccinations. Recommendations: It recommends that the government puts emphasis on community-based response strategies when it comes to health interventions. It is expected that the findings of the study will be of benefit to policy makers, health planners as well as scholars in Development Studies.
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Background: WHO has declared Coronavirus 2019 (COVID-19) as pandemic on 11th March 2020. Hydroxychloroquine (HCQ) chemoprophylaxis has been approved by the Indian Council of Medical Research (ICMR) for asymptomatic healthcare workers treating suspected or confirmed COVID-19 cases and asymptomatic household contacts of confirmed patients. However, there is a scarcity of data regarding the efficacy and safety of HCQ for COVID-19 prophylaxis and treatment. Background: The present study was designed to evaluate the adverse drug reaction (ADR) profile of HCQ prophylaxis among healthcare workers in a tertiary care teaching hospital in India. Methods: A Descriptive cross-sectional study was conducted in Kalpana Chawla Medical College and Hospital, Karnal for duration of 3 months (April-June 2020). The study was performed on the reported ADRs due to HCQ prophylaxis by the healthcare workers to the ADR monitoring centre of the institute during this period. Results: Gastrointestinal disturbance such as loose stool (16.4%) and hyperacidity (14.9%) were the most commonly reported ADRs during the study period. The incident rate of adverse drug reactions was 23.7%. The number of ADRs was found to be significantly (p<0.01) more in female as compared to male. We have observed that most of the reactions were reported following the 1st day loading dose. Conclusions: Our results showed that gastrointestinal system was most commonly affected. Loose stool and hyperacidity were most frequently reported ADRs due to HCQ prophylaxis. Larger studies are required to ensure the safety of the use of HCQ as prophylaxis for COVID 19.
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Aboriginal and Torres Strait Islander people living in rural and remote Australia have lower vaccine coverage rates and experience higher rates of notification and hospitalisations for vaccine preventable diseases than non-Aboriginal people. This paper explores important public health and research activities being undertaken in the Northern Territory to reduce this disparity in vaccine program performance, with a particular focus on rotavirus, meningococcal, human papilloma virus and COVID-19 vaccines.
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Objective: The Covid-19 viral pneumonia epidemic represents a major public health issue for all hospital structures, including hospital pharmacy, which has an essential role in dealing with this crisis. This study aims to explore the level of stress perceived by hospital pharmacy staff during this pandemic. Method: This is a cross-sectional study that evaluated 82 health professionals in hospital pharmacies in Morocco, using a snowball sampling technique. It evaluated their socio-demographic characteristics, working conditions, perceived stress scale (PSS), emotions and concerns during the epidemic. Statistical analysis was performed using statistical package for social science (SPSS). Results: The majority of participants were women (74.4%) and hospital pharmacists (67%). More than half of the participants showed moderate levels of stress (73.2%). Among the variables examined, only protective measures and information about the situation via the superiors showed a significant association with the PSS value (P = 0.036) and the level of stress according to the ANOVA test and the Chi-2 test respectively. Conclusion: In this study, hospital pharmacy staff showed moderate levels of stress at the beginning of the Covid-19 epidemic. It should be noted that socio-demographic traits had no impact on stress. Consideration of social and health conditions and stress management would help reduce professional stress among hospital pharmacy staff during the pandemic.
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Introduction: The SARS-CoV-2 pandemic put the health system in Mexico to the test. The rapid conversion to "COVID hospitals" and the difficulties already faced by public health institutions, such as the saturation of health services, lack of hospital structure and person-al protective equipment, had a negative impact on the working conditions and health of primary care physicians in COVID areas. Background: To identify the factors that affected the working conditions and health of physicians who worked in COVID areas in public health institutions in Mexico. Methods: A bibliographic review was carried out, six different databases were consulted, readings on the discussion of occupational health of physicians in COVID areas were included, and nine articles were selected. Results: The working conditions were described as precarious: lack of personal protective equipment, working hours of more than ten hours, and absence of a contract. In terms of health, this group of professionals was found to suffer from stress, anxiety, fear and anguish. Conclusions: The participation and cooperation of physicians, health authorities, governmental sectors, involved institutions and associations, the involvement of public policies, the health system and the society can join efforts to reduce the risk of COVID-19 infections, as well as the rate of contagion and comorbidities. All these actions will make it possible to re-duce the stress levels and work overload of health professionals.
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Background: The most well-known classification of the cost of diseases is direct medical cost. The aim of this study is to investigate and analyze direct treatment costs of patients with Covid-19 by hospitals affiliated with Ilam University of Medical Sciences. Methods: This was a descriptive-analytical, cross-sectional study performed retrospectively. The hospital expenditure information in Ilam province from March to October 2020 was used. Cost information related to all patients was collected and classified and reviewed using Excel 2016 software. The average direct treatment costs of hospitalized patients were also determined. Results: The direct costs of treatment in hospitalized patients in Ilam were estimated at $ 2349272.094 (98669427959 billion Rials). The per capita direct medical costs were calculated to be $ 1228.056 (51578373 million Rials). The largest share of the cost related to pharmaceutical services and the share of basic insurance was equal to $ 934.570 (39,252,109 million Rials). Conclusion: Results of the study indicated that the treatment costs of patients entering Ilam province are high, and the highest cost concerns pharmaceutical services. Taking necessary measures to prevent and control the spread of coronary artery, using the most cost-effective drug interventions and reducing unnecessary hospital stays of patients can increase the efficiency of financial resources and reduce direct medical costs in Ilam province.
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INTRODUCTION: The aim of this study was to investigate the patients treated for COVID -19 in pandemic hospitals in northwestern Syria. METHODS: The study evaluated all patients hospitalized for COVID -19 by the pandemic emergency departments of hospitals in northwestern Syria between July 1, 2020 and December 01, 2020. Demographic, clinical, laboratory, and imaging characteristics, 4C mortality index scores treatments, and progressions of all patients hospitalized for COVID -19 were retrospectively reviewed. RESULTS: A total of 991 patients admitted to hospitals in northwestern Syria by pandemic emergency services for treatment and follow-up were included. 114 patients from Afrin Hospital, 251 from Al-Bab Hospital, 527 from Azez Vatan Hospital, and 99 from Jarablus Hospital were included in the study. When comparing the mortality and hospitalization rates of the patients according to the 4C Mortality Score, it was found that the patients with high-risk score in Azez and Jarabulus hospitals and those with very high-risk score in El Bab hospital had significantly higher mortality and hospitalization rates in the ICU (p<0.05). DISCUSSION AND CONCLUSION: The data that can be obtained from studies evaluating the approach to the COVID -19 epidemic in this and similar regions are important for the development of health services in disadvantaged regions. We believe that our study will make an important contribution to the literature, as it is the first and only data reflecting hospitalized patients with COVID -19 in this region.
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Background: The COVID-19 pandemic has caused many economic problems worldwide, in Iran as well, causing Hospitals to face many financial problems. Objectives: Based on documented data on pharmacotherapy, costs, and its effectiveness, this study aimed to analyze the costs and outcomes of hospitalized patients with COVID-19 under pharmacotherapy in Iran. Methods: This research was a retrospective analytical descriptive study. Relevant data of the COVID-19 hospitalized patients' were extracted from the Hospital's Medical Records Department. All items of direct medical costs, such as visits, nursing services, consuming materials, laboratories, imaging, medical operations, medications, and beds, were extracted by reviewing COVID-19 hospitalized patients' files in different wards of the Shohada Ashayer Hospital in Khorramabad city in 2021. Results: A total of 399 patients were examined in this study. The total direct medical costs per patient was 338.63 US$. Of note, the highest cost was related to medicine (32.56%), more than the cost of bed (22.77%). The most commonly used drugs were Lopinavir (95%) and Azithromycin (90%), and the highest medicine cost per patient was related to Immunoglobulin (64.32 US$) and Remdesivir (46.91 US$). Conclusion: Medicine and hospitalization costs accounted for the largest share of the total treatment costs of patients. Therefore, reducing bed costs requires home treatments and outpatient injections. Furthermore, due to rising drug costs, prescriptions should be based on standard treatment protocols.
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Patients do not usually have the skills or knowledge to assess the provider's technical competence, but they do know how they feel, how they have been treated, and whether their expectations have been met. Viewed by specialists, patient satisfaction is an element of psychological health that influences the outcome of care. A satisfied and informed patient tends to cooperate with the doctor and more easily accept his recommendations. The purpose of this study is to assess the degree of satisfaction of Covid hospitalized patients regarding the quality of care and treatment. Objectives of the study: identifying the main existing problems and finding solutions to improve the quality of "health care". Materials and methods: a retrospective, descriptive study, using the patient's medical records and a qualitative study, measuring the degree of Covid-19 patient's satisfaction, according to the quality of nursing care and medical treatment during hospitalization. Conclusions: Covid-19 patients were mostly elderly with associated morbidity, from urban areas, especially men. 95.02% of patients were discharged from the hospital with improved condition, and 4.98% died, most of them being unvaccinated.
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Objectives: A pandemic is a health disaster that can lead to the disruption of hospital's health care activities. The objective of this work is the presentation of a health emergency plan model applicable to the hospital pharmacy in times of crisis, and the description of the Moroccan National Institute of Oncology's pharmacy experience in fighting COVID-19 pandemic. Method: Establishment of a set of procedures for pharmaceutical organization as a part of a health emergency plan, the creation of a device whose endowment allows the rapid management of 25 simultaneous patient's health care, and a system for managing the risks of shortages. In addition, all the missions carried out by the pharmacy during the COVID-19 pandemic were presented and discussed. Results: Three medical endowment lists of essential therapeutic products were created, with a total of 125 references. The terms of supplies are defined by a procedure for deploying health emergency plan's pharmacy. An interhospital pharmaceutical inventory monitoring system was also put in place during the COVID-19 pandemic. Conclusion: In time of crisis, supply systems are severely disrupted and shortages in therapeutic products are common. An emergency plan is an organization of multidisciplinary actions to deal with a health disasters in which the hospital pharmacy plays a decisive role.
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Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Background: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 +or- 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.
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Objective: Healthcare workers are at high risk of exposure to SARS-CoV-2. Attitudes of healthcare workers towards vaccines also affect the approach of society to vaccines. In this study, it was aimed to evaluate the attitudes of healthcare workers in Erzurum towards the COVID-19 vaccine and the factors affecting vaccine hesitations. Methods: This cross-sectional study was applied to healthcare workers in Erzurum between January and May 2021 with an online questionnaire. SPSS v25 program was used in data analysis. Results: The mean age of 235 healthcare workers participating in the study was 36.3..9.2 years and 56.2% were women. 69.4% of the participants were physicians, 20% were nurses and 10.6% were support personnel. The rate of vaccine hesitancy/rejection among the participants was 27.6%. 32.3% of the participants who have COVID-19 vaccine hesitancy/rejection, stated that they were worried about side effects and 26.1% stated that they did not have enough information about the vaccine. Male gender and increase in working time were factors that positively affected attitudes towards vaccination. The approach to the COVID-19 vaccine was more positive in the participants who had the seasonal influenza vaccine regularly (p < 0.001). The rate of recommending the COVID-19 vaccine by physicians participating in the study was higher than other healthcare workers (p=0.025). Conclusion: Vaccine hesitancy is an increasing problem in society and it's also high among healthcare workers. In general, the reason for this situation is the lack of information. It is necessary to eliminate the concerns and lack of knowledge on this subject with regular vocational training.
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The aim of the study was to understand older Chinese migrants' perceptions of social cohesion and access to health to manage chronic diseases during the COVID-19 pandemic in Australia. This study employed a qualitative descriptive study design. Participants were recruited from a Chinese community organisation in an Australian state. Data were collected via online interviews with participants using Zoom and WeChat Apps. A semistructured interview guide informed by the social determinants of health framework was used in the interview. The data collection period was between August and October, 2020. Thematic analysis was used in data analysis. In total, 24 participants including 17 older Chinese migrants with noncommunicable chronic diseases and seven family carers participated in the study. Of the 17 older Chinese migrants, 10 were male and seven were female. Their mean age was 76 years (ranging from 65 to 86) and they spoke little English. All seven carers were females with a mean age of 61 years (ranging from 35 to 76). Three main themes were identified in the study and described as: increased loneliness, anxiety, and depression;increased difficulties in accessing healthcare services;and various experiences in telehealth. In conclusion, older Chinese-Australians who spoke little English and lived with chronic diseases experienced the loss of their only social capital during the COVID-19 pandemic. They faced language barriers for accessing and utilising primary care to manage their chronic diseases when these care services were changed into telehealth during the COVID-19 pandemic. Findings provide a clear direction for stakeholders to take actions to address the lack of social cohesion and health inequalities for the most vulnerable populations in the community during the COVID-19 pandemic and beyond.
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INTRODUCTION: There are several clinical outcomes associated with coronavirus disease 2019 (COVID-19) infection, including pneumonia, acute respiratory distress syndrome, and death. The aim of this study is to evaluate whether serum cortisol levels affect COVID-19 prognosis. METHODS: A retrospective study was conducted with COVID-19 pneumonia patients hospitalized in an internal medicine clinic at the Haseki Training and Research Hospital in Istanbul from March 13 to May 31, 2020. Demographics, laboratory test results, and clinical outcomes of the patients were recorded. The patients were divided into two groups based on whether they were hospitalized for 1-9 days or 10 days. Both groups were classified according to their average age and duration of hospitalization/discharge, and laboratory parameters were analyzed. RESULTS: This study was conducted on 129 COVID-19 pneumonia patients, 13 of whom died during the study period. The mean age was 68.7+or-10.9 years for nonsurvivors and 55.7+or-15.9 years for survivors (p=0.001). Serum cortisol levels were significantly elevated in patients with a long hospital stay. While there was no significant difference in the hemogram or biochemical parameters of the two groups, correlation analysis showed a close relationship between serum cortisol levels and length of hospitalization. DISCUSSION AND CONCLUSION: Cortisol is a reliable predictor of the length of hospital stay and prognosis of COVID-19 patients.
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The COVID-19 pandemic has led to a public health crisis, with increases in the number of deaths. As a result, the number of bereaved people has increased significantly. In addition, the measures adopted to control the spread of virus have triggered changes in the subjective and collective bereavement experiences. This systematic literature review aims to summarize and reinterpret the results of qualitative studies on the experience of losing family members during the pandemic by a thematic synthesis. The searches were performed in the Web of Science, Scopus, PubMed/MEDLINE, CINAHL, PsycINFO, and LILACS databases. Among 602 articles identified, 14 were included. Evidence was assessed using the Critical Appraisal Skills Programme tool. Two descriptive themes related to the objective were elaborated in addition to one analytical theme, namely: "Pandemic grief: lonely and unresolved". These themes proved to be interrelated and indicate that experiences of loss in this context were negatively impacted by the imperatives of physical distance, restriction of hospital visits, technology-mediated communication, and prohibition or restriction of funerals. These changes resulted in experiences marked by feelings of loneliness and helplessness, which should be considered when planning intervention strategies that favor communication between family members with the afflicted loved one and with the health care team, enabling welcoming and creating alternatives for farewell rituals. The findings may support further research to test intervention protocols, especially to guide public policies and promote psychological support to bereaved family members after their loss.
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Background: Chest X-rays are important for tracking the progression of lung abnormalities, particularly in critically ill COVID-19 patients in the intensive care units (ICU). We aimed to assess correlation of chest X-ray findings with the COVID-19 disease severity and outcome. Methods: This prospective observational study was conducted at B & C Teaching Hospital, Birtamode from 15 March to 15 July 2021. All diagnosed COVID-19 patients admitted in the ICU for respiratory distress with oxygen saturation < 90% and evaluated by portable X-rays were enrolled. The radiographic findings were evaluated for the distribution and patterns of affection, and the total severity score was calculated using RALE scales of 0 - 8 and Brixia scales of 0 - 18. The scores were then compared between the expired and improved patients. Results: The age of patients (mean +or- SD) was 48.2 +or- 13.84 years. During the first four days of hospitalization, there was no significant difference in Brixia score (p = 0.793) or RALE score (p = 0.842) between expired and improved patients. The differences in both (Brixia and RALE) scores grew with each passing day (p < 0.05). The Brixia and RALE severity scores had a strong positive correlation at various stages of disease in both expired and improved patients. (r > 0.75, p < 0.001). Conclusion: In resource limited setting, the severity scores (RALE or Brixia) can be used as a quantitative method of the extent of COVID-19 pneumonia, correlating with an increased risk of ICU admission.
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This progress report provides an update on the progress made towards eliminating nnchocerciasis (river blindness) by the World Health Organization (WHO) as part of its road map on neglected tropical diseases for 2021-2030. The report highlights that the goal is to eliminate the need for mass drug administration of ivermectin in at least one focus in 34 countries by 2030, in more than 50% of the population in at least 16 countries and in the entire endemic population in at least 12 countries. However, challenges remain in achieving these goals, including incomplete mapping of all transmission zones, co-endemicity of onchocerciasis and loiasis, a potential decrease in sensitivity to ivermectin, uncoordinated cross-border work, suboptimal programme implementation and inadequate technical and financial resources. COVID-19 has also delayed national programmes, with millions of doses of preventive chemotherapy that should have been distributed expiring. The report also provides regional highlights, including that in 2021, 23 countries reported having treated a total of 142.3 million people for onchocerciasis, representing 58.1% of global coverage, and that the African region faces the greatest challenge with 99% of the global burden of the disease in this region.