The opportunity for massage therapy development for relieving long COVID symptoms: a literature review

The COVID-19 pandemic situation affected population health and lifestyle not only for a short period but also long period. Long COVID symptoms is a long-term illness after COVID condition. Long COVID symptoms greatly affected to quality of life of patients. Massage is a unique treatment form of alternative medicine that can promote health in various dimensions. From the previous studies, massage has affected to Long COVID mechanism via anti-inflammatory process, immune system enhancing process, and hormone level balancing that related to Long COVID symptoms as well as being able to reduce the symptoms of the long COVID symptoms. The study about the efficacy and safety of massage against Long COVID symptoms is the essential approach to increase the value of massage and develop health services in the future.

Emergencies in dental surgery during the COVID-19 pandemic

Introduction: Patients' negligence and difficult access to healthcare have an impact on the worsening of emergency conditions, which require immediate treatment due to the possibility of exacerbation in a short period of time. Untreated intra- and extraoral abscesses can have serious consequences on the patient's health and in many cases are life-threatening conditions increasing risk of respiratory obstruction, thrombophlebitis, meningitis, mediastinitis and septicemia. Background: The aim of this study is to investigate the impact of the pandemic and the resulting impediments to accessing medical care on the incidence and type of emergencies in the Oral Surgery Department. Material and methods: This was a retrospective study of 85375 patients aged 2 months to 90 years old with diagnosed intra- and extraoral abscesses before COVID-19 pandemic (2018,2019), and during pandemic (2020, 2021) in the Department of Oral Surgery of the Medical University in Lublin. The obtained results were statistically analyzed with the use of a computer program. Conclusions: The fewest patients were admitted in 2020, and the most in 2021, where we can already see the effects of the pandemic. Emergencies occurred most frequently in people aged 21-30, then 31-40. In 365 cases, tooth extraction was performed, and only in 28 cases, root canal treatment was attempted. Conclusions. Oral health service provision has been significantly affected by COVID-19. Patients came to their appointments too late, which in most cases resulted in the necessity of tooth extraction without attempting root canal treatment.

A comprehensive overview on COVID-associated mucormycosis

In recent times, numerous reports of systemic fungal infections have been a major concern. The angioinvasive fungal infection, mucormycosis has surged in patients with COVID-19 due to various factors, mainly uncontrolled diabetes and inappropriate corticosteroid use. The prevalence of this acute and fatal fungal infection caused by Mucorales-related fungal species has been highest in the Indian population. COVID-associated mucormycosis (CAM) has a propensity for contiguous spread, and exhibits high morbidity as well as mortality. Unless promptly detected and treated, it is associated with a poor prognosis. A high index of suspicion, aggressive surgical debridement and use of systemic antifungal agents continue to be the standard of care for CAM. Moreover, there is an imperative need to address this public health issue by increasing public awareness and education. This article provides a comprehensive overview on the emergence of CAM during the pandemic, the current burden, pathophysiology, diagnostic interventions and management of CAM in Indian clinical practice.

Non-invasive mechanical ventilation in patients admitted to a provisional center for moderate COVID-19 patients

Introduction:Non-invasive mechanical ventilation is a ventilatory alternative for COVID-19 cases. Background:To describe the characteristics and evolution of non-invasive mechanical ventilation (NIMV) in patients discharged from Provisional Center for moderate COVID-19 patients in Figali, Panama. Methods:A descriptive, retrospective, longitudinal stu was carried out in all adult patients discharged from June to July 2021 and who received non-invasive mechanical ventilation. A questionnaire was used using the digital individual medical record as primary source. Descriptive statistics techniques were used. Results:35.9% of the patients (78/217) who were admitted required non-invasive mechanical ventilation on the ninth day of symptoms and the second day after admission. 62.8% (49/78) were obese and 29.5% (23/78) hypertensive. The respiratory rate 30 and the decrease in the PaO2/FiO2 ratio decided the begining of non-invasive mechanical ventilation in 56.4% (78/217) of those admitted. 62.8% (49/78) had moderate-severe acute respiratory distress syndrome, and the severity was related to ventilation failure out of the total number of ventilated patients. Ventilation was successful in 65.4% (51/78). PaO2/FiO2 <150 (62.9%), respiratory rate 30 (55.6%) and physical exhaustion (51.85%) decided ventilation failure. Conclusions:Non-invasive mechanical ventilation is an effective procedure in COVID-19 patients and moderate or severe respiratory distress;although its success is related to the less severe forms. Low PaO2/FiO2, together with symptoms, were key indicators to assess the begining, success or failure of NIMV;not so the values of PaO2, PaCO2 and SpO2.

The clinical trial of patients improved from COVID-19: the effectiveness of mindfulness-based cognitive therapy on mental health and life expectancy (single-subject study)

Background & Aims: In early January 2020, a new corona virus called corona was identified as an infectious agent by the World Health Organization and caused a viral pneumonia outbreak, the first of which was reported in Wuhan, China in December 2019. The virus has so far infected most countries in the world and has become a global problem. By this time in December 2021, about 265 million people in the world have been infected with this virus and 5 million 270 thousand people have died from this disease. According to the World Health Organization, the incidence of this disease is still increasing and will become the third leading cause of death in the world by 2030. This disease has a special complexity and has multiple dimensions and consequences that have caused many problems in the field of health, social and economic as well as psychological for people. The emergence of this disease is now a public health crisis. According to this research, exposure to news and restrictions caused by this disease can lead to many mental health problems. In fact, one of the situations that puts a lot of stress on people during the outbreak of covid 19 disease is the inability to predict and uncertainty about the control and end of the disease. Mental health is defined as a harmonious and harmonious behavior with society, recognizing and accepting social realities, the power to adapt to them and meeting one's balanced needs and is an important factor for the health of society. The prevalence of the disease can also increase feelings of loneliness, decrease social support, feelings of fear and anxiety to clinical stress and anxiety, obsessive-compulsive disorder associated with the disease, and decreased life expectancy. One of the hopeful factors is health and the disease can cause despair, fear and even despair of the patient. The outbreak of a disease has a much deeper and wider impact and affects not only the affected community and relatives, but the entire community. Because everyone finds themselves at risk, and therefore people's feel of safe and healthy changes, and this situation causes people to despair. Hope is the capacity to imagine the ability to create paths to desirable goals and to imagine the motivation to move in those paths. Hope predicts physical and mental health such as positive response to medical interventions, mental health, effective getting along, and health-promoting behaviors. Covid 19 disease can also lead to psychological problems due to its infectious nature and unpredictable nature. In this regard, various researchers consider the implementation of public health policies, including areas related to individual and collective mental health in accordance with the different stages of the epidemic of this disease is very necessary. Mindfulness can be an effective tool for achieving peace of mind and body that helps people become aware of their current feelings. Mindfulness-based interventions are considered as one of the third generation or third wave cognitive-behavioral therapies. Mindfulness is a form of meditation rooted in Eastern religious teachings and rituals, especially Buddhism. Segal has defined mindfulness as paying attention to specific and purposeful ways, in the present time, without judgment or prejudice. Linhan stressed for the first time the need to pay attention to mindfulness as one of the essential components of psychological therapy. Mindfulness requires the development of three components: judgment avoidance, purposeful awareness, and focus on the present moment. Focusing on the present and processing all aspects of the above experience makes one aware of the daily activities and automatic functioning of the mind in the past and future world and he controls emotions, thoughts, and physical states through moment-to-moment awareness of thoughts. As a result, it is released from the everyday and automatic mind focused on the past and the future. Although general vaccination has reduced the virus in some countries, including Iran, and reduced the number of infected people, a large num

Spontaneous pneumomediastinum secondary to COVID-19 in Iran: a case series study: SPM secondary to COVID-19

BACKGROUND: Pneumomediastinum is defined as open-air in the mediastinum. Spontaneous pneumomediastinum (SPM) occurs when air leaks into the surrounding vascular sheath through small alveolar ruptures. CASE REPORT: We want to introduce 4 different cases with different outcomes. The first case was a 60-year-old man with a history of psychological disorders, the second case was a 41-year-old man with a history of hypertension (HTN) and asthma, the third case was a 50-year-old heavy smoker with no history of an underlying disease, and the fourth case was a 60-year-old man with a history of schizophrenia. They suddenly developed an exacerbation of cough, dyspnea, chest pain, and a severe decrease in oxygen saturation during hospitalization. Antibiotic therapy, corticosteroids, and high-dose oxygen therapy were administered to the patients. One of these patients died. CONCLUSION: All patients can potentially be at risk for this complication and have a good prognosis if diagnosed early and treated properly overall.

Special Issue: Supplement of rhinology and anterior skull base - laryngology and head and neck surgery - Covid-19 in Ent and mucormycosis. (Special Issue: Supplement of rhinology and anterior skull base - laryngology and head and neck surgery - Covid-19 in Ent and mucormycosis.)

This special issue contains 491 featuring clinical reports, clinical studies, research articles in basic and applied Otolaryngology, short communications, clinical records reporting unusual presentations or lesions and new surgical techniques in laryngology and head and neck surgery in COVID-19 and mucormycosis.

Assessing critical care nurses' knowledge on oxygen therapy in COVID-19 patient care in Turkiye, a multicenter study

Objective: Oxygen therapy for individuals with COVID-19 includes best practices for supportive management of acute respiratory syndrome. The aim of this study was to determine critical care nurses' levels of knowledge on oxygen therapy during the COVID-19. Method: This was a descriptive study. The study was conducted with COVID-19 critical care nurses (N=446) in a total of 16 hospitals affiliated with a healthcare group in Turkey. A total of 322 nurses were included in the study. The data were collected via the Oxygen Therapy Information Form prepared based on the literature through Google survey. Results: According to the oxygen therapy subscales, the mean score of the nurses varied from 40.77 to 86.21, and their total mean score was 72.99 (fairly). The nurses' knowledge on oxygen therapy was strongly correlated with their educational level and manner of work (p < 0.05). Conclusions: It can be asserted that in oxygen therapy, their knowledge on nursing interventions was adequate;however, their knowledge on oxygen therapy definitions and concepts was inadequate. In order to develop patient safety concerning oxygen therapy in COVID-19 patients, it is recommended that training programs be planned and competencies of nurses be assessed. In order to qualify legal competence about the safe oxygen therapy, clear protocols and professional guidelines are recommended.

Non-invasive ventilation an alternative to invasive ventilation in COVID-19 patients

Objectives: To study the role of non-invasive ventilation (NIV) in the treatment of COVID-19 patients with mild to moderate acute respiratory distress syndrome (ARDS).

Influence of perioperative oral nutritional supplementation on short-term efficacy of laparoscopic sleeve gastrectomy for obesity patients: a prospective study

Objective: To investigate the effect of perioperative oral nutritional supplementation on the short-term curative effect of obese patients after laparoscopic sleeve gastrectomy (LSG). Methods: A prospective research method was adopted. The clinical data of 218 obese patients who underwent LSG in Ningxia Medical University General Hospital from January 2018 to December 2021 were selected. The patients who received oral nutritional supplement therapy during the perioperative period were set as the experimental group, and those who received conventional treatment were set as the control group. Observation indicators: (1) Grouping of enrolled patients. (2) Postoperative and follow-up situation. (3) Nutrition-related indicators. (4) Diet compliance. (5) Status of weight loss-related indicators. Follow-up visits were conducted by telephone, We Chat and outpatient visits. The patients were followed up once 30 days after discharge, including albumin (Alb), hemoglobin (Hb), dietary compliance and weight loss-related indicators. The follow-up time will end in February 2022. The measurement data with normal distribution were expressed as x+or-s, and the comparison between groups was performed by independent sample t test. The measurement data is represented by M (range), and the comparison between groups is performed by Mann?Whitney U test. Enumeration data were expressed as absolute numbers or percentages, and the X2 test was used for comparison between groups. Repeated measures data were analyzed by repeated measures analysis of variance. The rank sum test was used to compare the rank data. Results (1) Grouping of the enrolled patients. Screened 218 eligible patients;42 males and 176 females;age (32+or-9) years;body mass index (BMI) (39+or-7) kg/m2. Among the 218 patients, there were 109 cases in the test group and 109 cases in the control group. Gender (male, female), age, BMI, preoperative Alb, and preoperative Hb of patients in the test group were 17 and 92 cases, (33+or-9) years old, (39+or-7) kg/m2, (40.6+or-4.8) g /L, (141.7+or-13.9) g/L;the above indicators in the control group were 25 and 84 cases, (31+or-8) years old, (39+or-8) kg/m2, (40.9+or-4.2) g/L, (142.9+or-9.7) g/L;there was no significant difference in the above (X2=1.89, t=-1.52, 0.51, 0.40, 0.71, P > 0.05). (2) Postoperative and follow-up situation. The first hospitalization time and first hospitalization expenses of the patients in the experimental group were (9.1+or-2.9) d and (3.6+or-0.5) ten thousand yuan respectively;the above indicators of the patients in the control group were (4.9+or-1.0) ten thousand yuan respectively;There were statistically significant differences in the above indicators between the two groups (t=5.58, 12.38, P < 0.05). Among the 218 patients, 119 were followed up, including 62 in the experimental group and 57 in the control group. The 119 patients were followed up for 31.0 (25.0-38.0) days. Among the 218 patients, 14 cases had postoperative complications and led to rehospitalization, including 2 cases in the experimental group, 1 case of nausea and vomiting and 1 case of intestinal obstruction;12 cases in the control group, 10 cases of nausea and vomiting, gastric fistula 2 cases;there was a statistically significant difference between the two groups in hospital readmission (X2=7.63, P < 0.05). The time interval between re-admission and first discharge of 14 patients was (22.0+or-6.7) days. (3) Nutrition-related indicators. The Alb and Hb levels of 62 patients in the experimental group who were followed up before operation, before the first discharge, and 1 month after operation were (40.4+or-5.5) g/L, (35.9+or-3.8) g/L, (45.4+or-2.9) g/L, respectively and (140.8+or-13.9) g/L, (130.5+or-16.9) g/L, (147.8+or-17.2) g/L;the above indicators of 57 patients in the control group were (41.2+or-3.9) g/L, (34.2 +or-3.9) g/L, (42.7+or-5.3) g/L and (143.0+or-9.7) g/L, (122.9+or-12.8) g/L, (139.0+or-11.4) g/L;There was a statistically significant difference between the Alb and Hb groups from preoperative to postoperative 1 mont

Clinical severity of patients with COVID-19 presenting to Nepal armed police force hospital: a descriptive cross-sectional study

Introduction: Coronavirus Disease 2019 (COVID-19), since its emergence, has spread rapidly as a pandemic causing massive loss of human life. This study aims to describe clinical severity of the disease in relation to age, mode of oxygen delivery and clinical outcome of patients admitted to a tertiary care center in Nepal. Methods: This was a descriptive cross-sectional study of data records of 130 COVID-19 patients 18 years and above admitted in Nepal Armed Police Force Hospital from April 2021 to June 2021 with Severe Acute Respiratory syndrome SARS-CoV-2 Reverse Transcriptase Polymerase Chain Reaction positive status. Ethical approval was obtained from Nepal Health research Council. Data were collected using structured proforma and analyzed using SPSS version 23. Results: Patients with severe illness (52/130) constituted 40% of the bulk of COVID-19 patients, 48 of them requiring intensive care. Among them, 38.5% required non-invasive ventilation and 32.7% were intubated during treatment. Severity of illness was variable among different age groups but mortality was high among severely ill patients, 19/52 (36.5%) and with increasing age. The overall mortality was 19/130 (14%) over the study period, all of which were among severely ill patients. Conclusions: Most of the clinically severe cases required Intensive Care Unit admission, the majority receiving oxygen therapy via non-invasive or invasive mechanical ventilation, with a high mortality rate. The number of severely ill COVID-19 patients was variable in different age groups. Mortality, however, was observed in severely ill patients only and proportionately increased in COVID-19 patients with advancing age.

Vitamin-D deficiency, the hidden pandemic in sunshine sufficient countries, exacerbating hypocalcaemia in a health worker undergoing thyroidectomy - a global perspective and review of literature

Introduction: Vitamin D deficiency (VDD) is common in young adults even in sunlight sufficient countries. It manifests with subtle and trivial symptoms that are often ignored. Nutritional deficiency due to improper dietary habits, poverty, long hours at work and study are factors. The lockdown during COVID has exacerbated the incidence. We had a patient with VDD who became symptomatic after routine thyroidectomy prompting our review into literature on the global health perspective of VDD. Material and method: - A 21-year-old nursing student developed hypocalcaemia within 24 hours after a routine thyroidectomy. VDD was detected and patient improved after supplementation. Literature was reviewed from Pubmed database for the medical aspects of the problem, from Government archives like the Scientific Advisory Committee on Nutrition, ICMR etc for cause and medical archives including those of paediatric and general health for the impact of disease at the state, national and global level. A global health problem list was prepared and data was reviewed. Discussion: Vitamin D is protective against respiratory infections due to viral aetiology including COVID. However, complete lockdown to prevent spread of COVID, online learning, and work from home culture has reduced sunlight exposure and increased incidence of VDD. Post thyroidectomy hypocalcaemia is common in VDD. Conclusion: Since there is a high prevalence of asymptomatic VDD even in sunshine sufficient countries, it is recommended to screen all patients especially young adults for VDD during routine preoperative work up.

Comparative study of feto-maternal outcome of ante-natal cases as per the standard WHO guidelines vs revised antenatal visit schedule during COVID19 pandemic

Background: Good antenatal care helps a woman face labour in good health and optimum conditions. The National Institute for Health and Care Excellence (NICE) and WHO guidelines suggest 15 visits in the whole pregnancy. Keeping in view the COVID-19 pandemic to reduce the exposure of pregnant ladies the number of antenatal visits was reduced to 7 milestone visits and outcome was noted. This study aimed to do a comparative study of feto-maternal outcome in antenatal cases at our centre using standard WHO protocol vs. revised antenatal protocol during COVID-19 pandemic. Subjects and Method: This was an observational study done at a tertiary care center of an Armed forces hospital with target population as pregnant ladies attending antenatal care Out patient department of the hospital during COVID19 pandemic Vs Antenatal cases in previous 1 year. A comparative analysis of pregnancy outcome, maternal variables during pregnancy and delivery along with neonatal variables was done. Results: There were lesser deliveries by 41.7% as compared to non-COVID times. There was an increase in the caesarean delivery rate and instrumental delivery rate during COVID times by 11% and 53% respectively. There was increase in Vaginal birth after caesarean (VBAC) by 26.6%. The incidence of fetal growth restriction, placental abruption, maternal anaemia and gestational diabetes mellitus, oligohydramnios and polyhydramnios was low. The incidence of spontaneous abortions was also low in our study. In contrast, the incidence of pre-term deliveries doubled from 7.4% to 13.4%. Neonatal morbidity and mortality indicators like Neonatal Intensive care unit (NICU) admissions showed a rising trend of 1.7% during the COVID (14.6% to 16.3%) with a minimal rise in early neonatal deaths by 0.2%. Conclusion: Our model doesn't show an increase in maternal, neonatal morbidity, and mortality. This model can be used as a standard of care for Antenatal patients during Pandemics. It reduces the risk exposure of the gravid mother without any significant increase in maternal and neonatal morbidity and mortality.

Identification of obstetric risks in COVID-19 times in a community health area, Ecuador

Introduction: risk factors associated with complications in the mother-child pair include: history of hypertensive disorders, adolescent pregnancy, drug use, unfavorable obstetric history with a background of miscarriages or abortions, sexually transmitted diseases and urinary tract infections. Background: to identify the obstetric risk in times of COVID-19 pandemic at the "Bastion Popular" health area, Guayaquil, Ecuador, from January to June 2021. Method: a descriptive-transversal field research was carried out, with a quantitative approach, which favored the analysis of the obstetric risk categories recorded in the medical history of 117 pregnant women, who signed an informed consent, for the collection of data through home visits, using the obstetric risk scale or score. Results: outcomes assessment showed, as main result, that the most frequent obstetric risk group was the age group 20 to 24 and the high risk factor was the main category identified. Obstetric risk increased proportionally when the interpregnancy interval was reduce. Conclusions: young women between 20 and 24 years of age are those who presented the highest obstetric risk, which is correlate with a higher number of gestations, abortions, deliveries and cesarean sections. Therefore, it is necessary to provide women with information about pregnancy and its complications, so that they are able to identify risk factors during pregnancy, delivery and the puerperium.

The effect of COVID-19 on the blood supply to the gums and the appearance of caries

The biological system of the oral cavity provides a number of protective mechanisms that fight pathogenic factors that arise due to a decrease in local immunity. This problem is found in patients after Covid-19. There is a violation of the blood supply to all organs and systems, including the mucous membrane of the oral cavity. As a result, patients have an increased risk of ulcers, plaques, fungal infections of the oral cavity, cracks, and spot hemorrhages. Due to a decrease in immune reactions in the oral cavity, the risk of caries in all groups of teeth increases, the permeability of enamel increases, and mineral substances exit from the hard tissues of the tooth.

Maxillofacial emergency's care during the COVID-19 pandemic, Granma 2021

Introduction: during the COVID-19 pandemic, new safety measures were implemented in all sectors. However, the Maxillofacial Surgery specialty kept on, where emergency patients were not left unattended. Background: to characterize the maxillofacial emergencies attended at the Hospital Clinico Quirurgico Docente "Celia Sanchez Manduley" in Manzanillo, during the COVID-19 related epidemiological situation. Methods: an observational, descriptive, and cross-sectional study was applied on 358 patients in the period between September 2020 and April 2021. The variables studied were as follow: age groups, sex, month when patients were attended, maxillofacial emergency's motive, therapeutic behavior and patients with COVID-19 related symptoms. Results: the most affected age group was 60 (22.6%), with predominance in male sex (54.2%). Most patients were attended in November and December (20.3%), the predominated maxillofacial emergencies were those associated to maxillofacial trauma (31.8%), followed by facial cellulitis (23.7%). In terms of treatment, the highest percentage of conservative treatment was associated with the medicamentation (88.3%), while wound suturing practice predominated in surgical treatment (18.2%). The symptom with the highest incidence was fever (3.4%). The 61.5% of the maxillofacial surgeons were infected with COVID-19. Conclusions: maxillofacial emergencies are more frequent in males;maxillofacial trauma and facial cellulitis predominate. The maxillofacial surgery service is vulnerable to the coronavirus infection.

Challenges faced by anesthesiologists during the cesarean section of COVID-19 patients - an observational study

Background: The health-care system has encountered exceptional circumstances, experiencing unique challenges, and manifesting as acute challenges in health-care services due to the spread of COVID-19. Aims and Objectives: The present study aimed to report the difficulties faced by the anesthetists while performing a cesarean section under the subarachnoid block (SAB) in COVID-19 patients at a dedicated COVID Level 3 hospital. Materials and Methods: Twenty healthy anesthetists (six consultants and 14 postgraduate) aged 20-40 years performed 60 elective or emergency cesarean sections of known COVID-19-positive gravida patients aged 20-35 years with no comorbidity and no spine abnormality under the SAB. Anesthetist;s responses to the challenges faced while performing procedures wearing the Level 3 personal protective equipment were recorded using a pre-structure self-administered questionnaire. To quantify the intensity of these problems, all the physical and psychological difficulties were graded as mild, moderate, and severe. Results: In the present study, 75% experienced moderate-to-severe sweating, and 60% experienced moderate-to-severe headaches. A total of 45% experienced moderate-to-severe breathlessness. Though there was little difficulty in communication among doctors and staff, almost 75% of anesthetists faced it. The fear of contracting the disease and spreading it to the family members was expressed by 75-80% of anesthetists. Conclusion: The present scenario has increased physical stress and other psychological problems among health workers. Therefore, hospital support with regular psychological counseling sessions is needed for healthcare workers to cope with the current situation.

Use of alternative medicine to treat COVID-19 symptoms

The use of alternative medicine helps to prevent the symptoms generated by Covid-19, among the methods is phytotherapy or herbal therapy, homeopathy acupuncture, among others, all with different functions such as moxibustion, for coughs, flu, lungs, pain body, breathing, etc. Although some people do not use it due to the few results in improving their health. In this article, the use of alternative medicine to treat symptoms of Covid-19 was analyzed through a quantitative exploratory approach, the population was taken through a simple random non-probabilistic sampling of 40 people from the Banos parish of Ulba between 30 At 60 years as results it was obtained that, among the most frequently used methods was phytotherapy with 65%, followed by homeopathy with 15% and acupuncture with 12,5%. It was concluded that it is important to know the benefits that contributes to health using alternative medicine such as medicinal plants to improve health and in this case to a virus that has affected and caused the death of countless people.

Successful intrapericardial fibrinolysis on acute recurrent purulent pericarditis with impending cardiac tamponade during pandemic situation: a rare case report

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.

The right to science as a guidepost for fair access to COVID-19 vaccines: investigating the interpretive role of the united nations committee on economic, social and cultural rights. (Special Issue: COVID-19 vaccine equity and human rights.)

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.