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Aim: To determine the intraoperative Ramsay sedation score after dexmedetomidine infusion in patients undergoing perineal surgery. Study design: Descriptive study. Place and duration of study: Department of Anaesthesia, JPMC, Karachi from 13th February 2021 to 13th August 2021. Methodology: One hundred and seventy four patients who met the diagnostic criteria were enrolled. Result(s): The mean age was 46.51 years with the standard deviation of +/-10.87. 66 (37.9%) were male and 108 (62.1%) were female. Whereas, mean duration of surgery, Ramsay sedation score at 5 minutes, 15 minutes, 30 minutes, height, weight and BMI in our study was 1.41+/-0.40 hours, 1.72+/-0.44, 3.51+/-0.60, 4.57+/-0.62, 165.62+/-8.23 cm, 68.34+/-8.23 kg and 24.85+/-3.34 kg/m2 respectively. Conclusion(s): Intraoperative dexmedetomidine proved beneficial in perineal surgeries and could be served as a potent sedative drug.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Background: The 2020 COVID- 19 pandemic had various effects on local healthcare. The aim of this study was to assess the extent to which local healthcare and healthcare workers were affected by the COVID- 19 pandemic. Method(s): In this observational study we examined and compared intensive care units (ICUs) before (2019) and during (2020) the COVID- 19 pandemic to assess its effects. Emergency patient data were obtained from the Saitama Prefecture Emergency Medical Information System. The effect of COVID- 19 on emergency care responses was compared with the admission and refusal of patients in 2019 and 2020. We also examined the number of patients who were admitted to ICUs and required surgery. The effect on ICUs was examined with the number of Nurses' incident reports and severity percentages calculated from the integrated team medical care and safety system. We also compared the overtime hours of physicians on the basis of employment records. Result(s): In 2019, 2,136 emergency requests were made to admit patients, and 1,811 patients (85%) were admitted. In contrast, in 2020, 2,371 emergency requests were made, and 1,822 patients (76%) were admitted, representing a decrease to 76% (p = 0.931). The percentage of patients for whom admission was refused was significantly greater in 2020 (506 patients, 21.3%) than in 2019 (303 patients, 14.1%;p = 0.0004). In 2020, the number of neurosurgical, cardiac, and vascular operations increased and, over time, the number of operations increased for all surgical units. The number of incidents reported in ICUs increased significantly from 396 in 2019 to 510 in 2020 (p = 0.001). Conclusion(s): Although intensive care management was restricted, the numbers of patients and physician overtime hours were greater during the COVID- 19 pandemic than before, and the resulting environment led to an increase in the number of incidents. The ICU environments must be proactively improved to prepare for more severe situations in the future.Copyright © 2022 Jikei University School of Medicine. All rights reserved.
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The military commissariat requests information characterizing their state of health in order to study the state of health of citizens subject to conscription before the next conscription of citizens for military service. An interdepartmental request for this information's provision to medical organizations and institutions of medical and social expertise is encouraging to be issued in the form of an electronic document using a unified system of interdepartmental electronic interaction, taking into account the trends in the development of the public administration system. Interdepartmental interaction optimization through creation of an electronic interaction mechanism will allow military commissariats to promptly exchange information in real-time characterizing the citizens' state of health subject to conscription for military service with medical organizations of the state and municipal health care system, and federal state institutions of medical and social expertise. The direct connection of the military commissariat to the state information system in the field of healthcare of the subject of the Russian Federation by means of cryptographic protection of information will contribute to improving the quality as well as deceasing the medical examination time of citizens subject to conscription, thus improving the efficiency of providing medical services to citizens in medical organizations. The public administration system was successfully reoriented to provide state and municipal services in a remote format during the unstable epidemiological situation caused by the pandemic of a new coronavirus infection. Optimization of interdepartmental electronic interaction will allow military commissariats to take additional preventive measures to avoid infection and avert the spread of a new coronavirus infection during the recruitment campaign. Modern digital technologies and solutions are able to provide a qualitative leap in the organization of conscription of citizens for military service, which can be implemented without significant financial costs in the short term. However, there is a growing need to involve a proper number of participants of the military command and other state authorities in solving this complex problem. All rights reserved © Eco-Vector, 2022.
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Big data is a very large size of datasets which come from many different sources and are in a wide variety of forms. Due to its enormous potential, big data has gained popularity in recent years. Big data enables us to investigate and reinvent numerous fields, including the healthcare industry, education, and others. Big data specifically in the healthcare sector comes from a variety of sources, including patient medical information, hospital records, findings from physical exams, and the outcomes of medical devices. Covid19 recently, one of the most neglected areas to concentrate on has come under scrutiny due to the pandemic: healthcare management. Patient duration of stay in a hospital is one crucial statistic to monitor and forecast if one wishes to increase the effectiveness of healthcare management in a hospital, even if there are many use cases for data science in healthcare management. At the time of admission, this metric aids hospitals in identifying patients who are at high Length of Stay namely LS risk (patients who will stay longer). Once identified, patients at high risk for LS can have their treatment plans improved to reduce LS and reduce the risk of infection in staff or visitors. Additionally, prior awareness of LS might help with planning logistics like room and bed allotment. The aim of the suggested system is to precisely anticipate the length of stay for each patient on an individual basis so that hospitals can use this knowledge for better functioning and resource allocation using data analytics. This would contribute to improving treatments and services. © 2023 IEEE.
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Lack of access to cancer prevention education, early screening, and timely treatment, particularly in low socioeconomic, underserved communities, are cited as substantial barriers to improving survivorship. Outreach educational efforts with on-site screenings offered in partnership with community groups are known to be valuable in encouraging community members' uptake of healthy behaviors and adherence to screening recommendation. To create more engaging events, a community-academic partnership, We Engage 4 Health (WE4H), co-created 11 unique 4-panel comic-style stories designed to be read aloud together as attendees visit each event table. These colorful stories are shared on boards that stand on each table and are offered in both English and Spanish at this time. Many tables also have an accompanying hands-on activity. Together, they lead to meaningful "low stakes" discussions which support understanding of seemingly complex health information. Story topics include the cause of cancer (Cells Gone Wrong), cancer risk factors (Reducing Your Risk), the role of primary care in cancer screening (Primary Care for Prevention), the purpose of research (short Research Ready) and details about specific cancer types (Combatting Colon Cancer, Blocking Breast Cancer, Looking for Lung Cancer, Silencing Skin Cancer, Hindering HPV, and Professional Prostate Protection) and COVID-19 (Take Your Best Shot FAQs). A health passport is used to facilitate table visitation and survey collection at each table enables meaningful evaluation of the event as well as provides the community hosts and their partners baseline cancer data to inform future programing. In 2022, WE4H and the University of Cincinnati Cancer Center partnered with three different communities to co-host pilot events that served over 100 adult residents. Community, research interns and university students volunteered to work the tables at the event and received training prior. Post event surveys and discussions indicated that community partners appreciated the different take on a health fair event. Most volunteers indicated that they would enjoy volunteering again. Attendees indicated that they liked the graphic-style story format used and most preferred it to text and text with graphics approaches. Taken together, the data indicates that Reducing Your Risk events are useful in meaningfully engaging hard to reach, at risk attendees. Additional in-person and virtual events are being planned for 2023 as an approach to reach the medically underserved throughout our region.
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Background: Since the coronavirus disease 2019 outbreak, telemedicine has become an important means of providing medical care worldwide. This study aims to highlight the implications of establishing telemedicine policies in Korea. Japan's telemedicine policies were reviewed from the time of the first trial to the present official allowance. Current Concepts: Since telemedicine demonstration work began in 1971, telemedicine in Japan has advanced in four stages. The first stage was the operation of a remote regional comprehensive medical information system from 1971 to 1997. The second stage was when telemedicine was officially institutionalized from 1997 to 2018. The third stage was the time of expansion of telemedicine, from the announcement of the "Guidelines for the Implementation of Proper Online Care" in 2018 to when online first-time examinations were temporarily allowed in 2020. The fourth stage began in 2021 when the "Permanent Establishment of Special Cases for Online Care" was announced, and telemedicine has been officially allowed to supplement face-to-face care. Telemedicine usage was estimated to be about 53.65 million in 2021, and the total number of treatments in Japan in 2021 was estimated to be about 1.32 billion, accounting for about 4.1% of medical care. Discussion and Conclusion(s): For the Korean government to establish telemedicine, it needs to be promoted step by step through discussions with the medical community. Also, an appropriate medical remuneration system needs to be prepared along with guidelines reflecting the opinions of the medical community to secure the safety of telemedicine.Copyright © Korean Medical Association.
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The coronavirus disease 2019 (COVID-19) rapidly spread worldwide. Although several vaccines have been developed to control the spread of the disease, the safety and efficacy of the vaccine to patients with autoimmune liver disease are uncertain. However, subjects need to decide whether to receive the vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study found that 29 of 40 patients with autoimmune liver disease experienced anxiety to receive the SARS-CoV-2 vaccine. After providing information about COVID-19 and the vaccines, the number of patients with vaccination anxiety was reduced from 40 to 14 (p=0.000685). Appropriate provision of the information of COVID-19 and the vaccine improved vaccine anxiety in patients with autoimmune liver disease.Copyright © 2021 The Japan Society of Hepatology.
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Background: During covid-19 period not only general public was victim of anxiety besides all medical professional also face anxiety and change their Information seeking behaviour according their personality. Curiosity is in human nature with the easy access to internet the new horizon to information has been opened. People searching trends have shown that they are interested in health risk to health treatment for their health related problems. Aim(s): In this study examined the influences of anxiety (ISA) and Personality traits (PT) on health information seeking behaviour (HISB) among the Doctor, paraprofessional and final year medical students who are frontline worker during pandemic situation. Methodology: The study adopted survey method with non-probability convenience sampling to collect statistical. Questionnaires werefiled from 313 participants by utilizing convenient sampling and analyzing the data through SPSS. Result(s): The result showed that significant relation between personality traits, information seeking anxiety and health information seeking behaviour. In medical library user PT has significant impact on HISB (p<.05), (AVG_PT=.002) and ISA has impact on HISB but it is not significant in medical professional (beta -.070) value shows ISA has negative impact on HISB. Practical implication: This study will be beneficial for information professionals, health care workers, policy makers and administrators to access of information resources in hybrid format. Conclusion(s): Medical professional's plays an important role in our society. They work hard and served the nation during pandemic situation. Anxiety is natural phenomena to every person. So medical professional also feel anxietybut the medical profession demands its professionals to stay cool, calm and free of anxiety by having analytical and cognitive skills, in order to fulfill the needs of their profession. This research helps to understand that ISA has no significant impact on HISB while PT has significant impact on HISB.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Background: Non-communicable diseases (NCDs) are rising in low middle income countries (LMICs) mainly driven by cardiometabolic disease (cardiovascular disease, diabetes, and hypertension). Aim(s): To develop a model of care, based on the chronic care model and collaborative care model, to improve care, outcomes and risk factor control for adults with cardio metabolic disease in LMICs in the Covid-19 era. This will contribute to the sustainable development goals of promoting good health, well-being and reducing inequalities. Method(s): Using an iterative consultative approach with healthcare workers, clients, and community leaders in Kenya, Ghana and Mozambique, we developed a model of care, which includes core features from chronic care models: self-management support;decision support;clinical information systems;delivery system design;and community linkages. Result(s): We produced a culturally adapted self-management education programme, a training package for educators delivering the programme, as well as a training package for community and healthcare professional leaders to increase awareness and self-care for cardiometabolic disease. Given the lack of a robust health information system, we are offering a global registry to provide real world data on patient management and quality of care for people with type 2 diabetes, hypertension, heart failure and chronic kidney disease. Conclusion(s): This intervention will be tested in a mixed-methods single-arm feasibility study in five sites across three African countries: Kenya, Ghana, Mozambique.
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Background: Stroke is the leading cause of death and disability worldwide. In COVID-19 pandemic, stroke remains to be a medical emergency. To treat patients with acute ischemic stroke [AIS], early intravenous thrombolysis is highly time sensitive. This research investigated the impact of regionally imposed social and healthcare restrictions of COVID-19 on the time metrics in the management of AIS patients admitted at the stroke unit center in Srinagarind Hospital. Objective(s): Comparison of door to needle time for intravenous thrombolysis for AIS patients before and after the COVID-19 outbreak. Material(s) and Method(s): The present study is a retrospective analysis of patients with AIS who received intravenous tissue plasminogen activator [tPA] from 1 January 2019 to 31 December 2020 in Srinagarind Hospital, Khon Kaen. The patients admitted before and after the COVID-19 outbreak [January 13, 2020, as officially announced by the World Health Organization] were screened to collect sociodemographic data, medical history information, and symptom onset status from clinical medical records and to compared door-to-needle time (DNT) for intravenous thrombolysis before and after the outbreak. Result(s): A total of 239 patients were included, of which 113 were enrolled before and 126 after the COVID-19 outbreak. According to the findings, DNT is 35.3 minutes before the pandemic and 35.8 minutes after the epidemic. Conclusion(s): COVID-19 has remarkable impacts on the management of AIS. However, DNT for before and after COVID-19 outbreak is nearly identical. It was established that administering intravenous thrombolysis to patients in the emergency room rather than the stroke unit allowed for speedier access. Therefore, a policy which provides quick AIS treatments in COVID-19 situations should be implemented.Copyright © 2023 Journal of the Medical Association of Thailand.
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The outbreak of novel corona virus had led the entire world to make severe changes. A secured healthcare data transmission has been proposed through Telecare Medical Information System (TMIS) based on metaheuristic salp swarm. Patients need proper medical remote treatments in this Post-COVID-19 time from their quarantines. Secured transmission of medical data is a significant challenge of digitally overwhelmed environment. The objective is to impart the patients' data by encryption with confidentiality and integrity. Eavesdroppers can carry sniffing and spoofing in order to deluge the data. In this paper, a novel scheme on metaheuristic salp swarm based intelligence has been sculptured to encrypt electrocardiograms (ECG) for data privacy. Metaheuristic approach has been blended in cryptographic engineering to address the TMIS security issues. Session key has been derived from the weight vector of the fittest salp from the salp population. The exploration and exploitation control the movements of the salps. The proposed technique baffles the eavesdroppers by the key strength and other robustness factors. The results, thus obtained, were compared with some existing classical techniques with benchmark results. The proposed MSE and RMSE were 28,967.85, and 81.17 respectively. The time needed to decode 128 bits proposed session key was 8.66 × 1052 years. The proposed cryptographic time was 8.8 s.
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Medical Information in the pharmaceutical industry involves the creation and dissemination of evidence-based scientific medical content in response to questions about medicines and therapy areas for patients and healthcare professionals. Health information equity can be broadly defined as the distribution of health information in a way that is accessible and understandable to all users, allowing them to benefit and reach their full potential for health. Ideally, this information would be made available to all those in need across the globe. However, as demonstrated by the COVID-19 pandemic, widespread health discrepancies exist. The World Health Organization defines health inequity as differences in health status or in the distribution of health resources between different population groups. Health inequities are influenced by the social conditions in which people are born, grow, live, work and age. This article explains select key factors influencing health information inequity and addresses opportunities where Medical Information departments can make a difference to improve global public health.
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COVID-19 , Health Equity , Humans , Pandemics , Global Health , Health ResourcesABSTRACT
Intro: Dysregulated inflammation plays a key role in the development of severe SARS-CoV-2 infection. One of the key cellular signaling pathway involved in the inflammatory response is JAK/STAT signaling. Among the hospitalized Covid patients with hypoxia to reduce the progression to ARDS, immunomodulators have a definite role. Baricitinib is an oral selective Janus kinase 1/2 inhibitor with anti-inflammatory properties. This study evaluates the efficacy and all-cause mortality among moderate to severe Covid patients who received Baricitinib. Method(s): A retrospective case-control study was carried out among moderate to severe Covid patients who had received Baricitinib. COVID severity matched group from the same time period was selected as the control. We evaluated the efficacy (based on WHO-ordinal scale) and difference in all-cause mortality among case and control groups. Baseline characteristics and outcome variables were retrospectively captured from the hospital health information system. Finding(s): During our study period, 2547 active Covid patients have admitted, out of which 105 patients received Baricitinib. Based on the retrospective analysis 75 patients were selected as the case group and 75 covidpositive patients of similar age and sex were identified by a simple random selection technique to serve as a control group. The age group of the baricitinib group 60.82 (+/- 13) and the Control group 62.34 (+/-13). Among the participants, 62.66% were severe (58% Baricitinib group & 66% control), 36% were with moderate severity (40% Baricitinib group & 33.33% control). The all-cause mortality of cohort was 43% (n=64), 36% (n=27) of cases as compared to 49.3% (n=37) of control group, (P Value= 0.06). Improvement in WOS score by at least 1-point cases 47% and 37.3 % in controls, (P Value= 0.09). Conclusion(s): Baricitinib when combined with standard of care, among hospitalized patients with moderate to severe Covid infection, showed a trend towards clinical improvement and decreased all-cause mortality.Copyright © 2023
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The dreaded coronavirus (COVID-19) disease traceable to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) has killed thousands of people worldwide, and the World Health Organization (WHO) has proclaimed the viral respiratory disease a human pandemic. The adverse flare of COVID-19 and its variants has triggered collaborative research interests across all disciplines, especially in medicine and healthcare delivery. Complex healthcare data collected from patients via sensors and devices are transmitted to the cloud for analysis and sharing. However, it is pretty difficult to achieve rapid and intelligent decisions on the processed information due to the heterogeneity and complexity of the data. Artificial intelligence (AI) has recently appeared as a promising paradigm to address this issue. The introduction of AI to the Internet of Medical Things (IoMT) births the era of AI of Medical Things (AIoMT). The AIoMT enables the autonomous operation of sensors and devices to provide a favourable and secure environmental landscape to healthcare personnel and patients. AIoMT finds successful applications in natural language processing (NLP), speech recognition, and computer vision. In the current emergency, medical-related records comprising blood pressure, heart rate, oxygen level, temperature, and more are collected to examine the medical conditions of patients. However, the power usage of the low-power sensor nodes employed for data transmission to the remote data centres poses significant limitations. Currently, sensitive medical information is transmitted over open wireless channels, which are highly susceptible to malicious attacks, posing a significant security risk. An insightful privacy-aware energy-efficient architecture using AIoMT for COVID-19 pandemic data handling is presented in this chapter. The goal is to secure sensitive medical records of patients and other stakeholders in the healthcare domain. Additionally, this chapter presents an elaborate discussion on improving energy efficiency and minimizing the communication cost to improve healthcare information security. Finally, the chapter highlights the open research issues and possible lines of future research in AIoMT.
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AIM: There is a discussion about COVID-19 vaccination rates among healthcare workers (HCW), especially nurses. The primary question for this review was: "What are the attitudes of nurses, compared to other HCW, towards COVID-19 vaccination?" The secondary questions included the proportion of nurses with intention to get vaccinated, what prevents the nurses from accepting the vaccine and what enables them to accept the vaccine. METHODS: The PRISMA-ScR format for scoping reviews was chosen to respect the novelty of COVID-19 vaccines. Database search (PubMed/MEDLINE, PROquest and EBSCO) was performed for original studies in English language, from all geographies, with most recent search on March 20, 2022. Vaccination acceptance rates were charted for nurses and nursing students in one category, and HCW other than nurses in the other category. The evolution in time of the nurses attitude to vaccine acceptance relative to that of HCW other than nurses was charted post hoc. The factors associated with COVID-19 vaccination intention according to the WHO categories (contextual influences, individual/ group influences, and vaccine/vaccination specific issues) were reviewed as narrative summary. RESULTS: Total 58 eligible studies were selected, all with cross-sectional study design, including 95418 healthcare workers of whom 33130 were nurses and 7391 were nursing students, from 44 countries in Europe, Americas, Africa and Asia. Trust in science, in doctors, in experts and in governments were the main contextual factors increasing vaccination acceptance mentioned in the studies, while altruism and collective protection, or protecting a person at risk at home was mentioned only few times. The nurses were less likely to accept vaccination compared to doctors and other HCWs at the onset, eg. before vaccine rollout, and this difference decreased with time (p = 0.022). Being older (n = 25 studies), being male (n = 23), having higher degree of education (n = 7), and having more years of clinical practice (n = 4) were associated with higher vaccination acceptance. Percieved individual risk of having severe COVID-19 (n = 14) or working in a COVID-19 dedicated units (n = 5) was mentioned in a minority of studies. The main vaccine-releated factors associated with higher vaccination intention were trust in the vaccine and its efficacy and safety, general vaccinatoin acceptance and specifically having had influenza vaccination in previous years (n = 21 studies). A significant factor associated with higher vaccine acceptance was high "vaccine knowledge", "vaccine literacy", "understanding the vaccine" or "understanding benefits and barriers of vaccination" (n = 17 studies). CONCLUSIONS: Nurses have been more hesitant to accept COVID-19 vaccination than other healthcare professions at the beginning, but with time this difference disappeared. This general nurse attitude of wait-and-see reported in the studies corresponds with real-life data from practicing healthcare workers as reported by the Czech Institute of Health Information and Statistics on vaccination against COVID-19. Trust in scientific structures and vaccine makers increases the vaccine acceptance. The acceptance increases also with higher age, increasing level of education, longer clinical experience, and also with being a male. Vaccine literacy and having participated in previous vaccination programmes, especially influenza vaccine, were identified as independent modifiable factors increasing vaccination acceptance.
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Aim: There is a discussion about COVID-19 vaccination rates among healthcare workers (HCW), especially nurses. The primary question for this review was: "What are the attitudes of nurses, compared to other HCW, towards COVID-19 vaccination?" The secondary questions included the proportion of nurses with intention to get vaccinated, what prevents the nurses from accepting the vaccine and what enables them to accept the vaccine. Method(s): The PRISMA-ScR format for scoping reviews was chosen to respect the novelty of COVID-19 vaccines. Database search (PubMed/MEDLINE, PROquest and EBSCO) was performed for original studies in English language, from all geographies, with most recent search on March 20, 2022. Vaccination acceptance rates were charted for nurses and nursing students in one category, and HCW other than nurses in the other category. The evolution in time of the nurses attitude to vaccine acceptance relative to that of HCW other than nurses was charted post hoc. The factors associated with COVID-19 vaccination intention according to the WHO categories (contextual influences, individual/ group influences, and vaccine/vaccination specific issues) were reviewed as narrative summary. Result(s): Total 58 eligible studies were selected, all with cross-sectional study design, including 95418 healthcare workers of whom 33130 were nurses and 7391 were nursing students, from 44 countries in Europe, Americas, Africa and Asia. Trust in science, in doctors, in experts and in governments were the main contextual factors increasing vaccination acceptance mentioned in the studies, while altruism and collective protection, or protecting a person at risk at home was mentioned only few times. The nurses were less likely to accept vaccination compared to doctors and other HCWs at the onset, eg. before vaccine rollout, and this difference decreased with time (p = 0.022). Being older (n = 25 studies), being male (n = 23), having higher degree of education (n = 7), and having more years of clinical practice (n = 4) were associated with higher vaccination acceptance. Percieved individual risk of having severe COVID-19 (n = 14) or working in a COVID-19 dedicated units (n = 5) was mentioned in a minority of studies. The main vaccine-releated factors associated with higher vaccination intention were trust in the vaccine and its efficacy and safety, general vaccinatoin acceptance and specifically having had influenza vaccination in previous years (n = 21 studies). A significant factor associated with higher vaccine acceptance was high "vaccine knowledge", "vaccine literacy", understanding the vaccine" or "understanding benefits and barriers of vaccination" (n = 17 studies). Conclusion(s): Nurses have been more hesitant to accept COVID-19 vaccination than other healthcare professions at the beginning, but with time this difference disappeared. This general nurse attitude of wait-and-see reported in the studies corresponds with real-life data from practicing healthcare workers as reported by the Czech Institute of Health Information and Statistics on vaccination against COVID-19. Trust in scientific structures and vaccine makers increases the vaccine acceptance. The acceptance increases also with higher age, increasing level of education, longer clinical experience, and also with being a male. Vaccine literacy and having participated in previous vaccination programmes, especially influenza vaccine, were identified as independent modifiable factors increasing vaccination acceptance.Copyright © 2023, Czech Medical Association J.E. Purkyne. All rights reserved.
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Aim: Therapeutic plasma exchange (TPE) is a frequently discussed treatment modality in severe coronavirus disease 2019 (COVID-19) patients. It requires an apheresis device and experienced personnel for the application. In this study, we aimed to reveal the characteristics and clinical outcomes of adult patients with COVID-19 who experienced TPE. Material(s) and Method(s): Adult patients who had undergone TPE in our apheresis unit were retrospectively analyzed and COVID-19-positive cases were included in the study. All the medical information about the cases was obtained from the electronic database and technical details of the procedures were gathered from apheresis unit records. Result(s): A total of 80 patients with a median age of 60 (19-85) years were included in the study. Severe pneumonia was present in 98.8% (n=79) of the cases. More than three-quarters of the patients had lymphopenia, critically elevated C-reactive protein (CRP), and D-dimer, and 41.0% (n=32) had high ferritin. The median length of stay in the intensive care unit was 26 (5-124) days. The mortality rate observed on the 14th and 28th days following the TPE procedure was 51.3% (n=41) and 75.0% (n=60), respectively. High ferritin level, multiple organ failure (MOF), and intubation were parameters found to be associated with mortality in the multivariate analysis. Conclusion(s): The mortality rate observed in patients with COVID-19 who underwent TPE in our study was similar to the cases in the literature without the procedure, while it has been shown that high ferritin levels, intubation, and the presence of MOF increase the risk of mortality.Copyright © 2023, Duzce University Medical School. All rights reserved.
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Pandemic of a new coronavirus infection is accompanied by advanced need for emergency medical care in Russia. However, this process is hampered by state of roads and no electricity sources in some cases. Mobile medical complexes are able to compensate this need. These ones include feldsher obstetric stations, complexes for medical examination, specialized medical complexes (Thyromobil, Mammography, mobile Diabetes Center and others), as well as convoys with diagnostic equipment (mammography, magnetic resonance imaging, computed tomography) and fully equipped offices of various specialists (therapist, urologist, gynecologist, ophthalmologist, endocrinologist). However, spread of such medical complexes is currently difficult in Russia. The manuscript is based on the author's analysis of publicly available documents on the state and number of mobile medical complexes in Russia. Mobile hospitals are not used in all Russian regions. Nevertheless, there is a need for qualified preventive and therapeutic services, especially in the northern and mountainous regions of our country (Pskov, Arkhangelsk regions, the republics of Komi, Karelia, Dagestan and others). The authors analyzed current situation and experience of mobile medical complexes in the Novgorod, Rostov regions and the Republic of Tatarstan. Introduction of mobile hospitals in all Russian regions within the national health strategy will improve population health including working age people and reduce costs in health care system. Medical organizations cooperate with mobile hospitals to qualifiedly meet the needs of patients in diagnosis and treatment. However, projects of mobile medical complexes and their routine implementation in each region of our country are required. This is a priority task for the state and local health authorities of the Russian Federation.Copyright © R.N. ABDULLABEKOV, V.E. FEDORCHUK, T.V. MINNIKOVA.
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BACKGROUND: The COVID-19 pandemic condition limits pregnant women from getting health services, especially continuum care-based health services. Pregnant women need access to antenatal care services to get screening and assistance related to efforts to get good pregnancy outcomes. AIM: The purpose of this study is to identify factors related to information exposure and the role of health volunteers in providing health education to pregnant women. METHOD(S): This study also applies the preparation of health volunteers in conducting online education practices during the COVID-19 pandemic for pregnant women. Pregnant women who have been given education by the health volunteers are asked to assess their acceptance of the health volunteer's educational practices. Collect data about need assessment online education in pregnant women. Health volunteers who attended debriefing related to online education practices and pregnant, women who were given online education by health volunteers. The number of samples of health volunteers and pregnant women in this study was 32 health volunteers and then 32 pregnant women giving assessment about online education practices by health volunteers. RESULT(S): The results of the intervention on the application of online education by health volunteers are quite good, according to pregnant women, namely, screening and mentoring, health volunteers have provided information. Submission of information is done through WhatsApp by 76% and pregnant women understand the health information of pregnant women delivered by health volunteers. CONCLUSION(S): It is necessary to strengthen the role of health volunteers in providing online assistance and education so that it can continue to be carried out optimally.Copyright © 2023 Colti Sistiarani, Erna Kusuma Wati, Setiyowati Rahardjo.
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Intro: COVID-19 Vaccination has proven to be very effective in preventing infection and progression to severity and death. However, there were concerns about very rare but potentially fatal adverse reactions after vaccination;myocarditis/pericarditis, TTS/VITT et al. It suggested that the evaluation of the two values of personal safety and public benefit is necessary. Method(s): The benefit of vaccination was measured by the number of critically ill patients prevented from vaccination. The number of critically ill patients predicted in the future was measured through two Methods: based on a fixed scenario, and using a mathematical model. Damage through vaccination was calculated as the occurrence of TTS/VITT, Myocarditis/Pericarditis, and of severe cases. Finding(s): The evaluation results on vaccine safety and effectiveness were made in the form of age restrictions for vaccination by each vaccine platform. As a result of the evaluation, the AstraZeneca vaccine was limited to those under the age of 30 but there was no restriction on the age of mRNA vaccination. In addition, the risks and benefits of vaccination for children aged 5-11 years and 12-17 years of age were evaluated respectively, and it was confirmed that the benefits of vaccination outweigh the potential harm in children and adolescents. Conclusion(s): Our nation has the own policy for COVID 19 vaccination from the results. The pandemic situation has presented a new approach to the benefits and risks of large-scale vaccination. In particular, the method of comparing the risks and benefits of vaccination was considered as a useful method for health communication.Copyright © 2023