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A 25-year-old woman, gravida 2, with no medical history of cardiovascular nor other chronic diseases, came to the gynaecologist and described symptoms of a flu-like disease, including very high fever. The gyneacologist prescribed her antibiotics and paracetamol to calm down the fever. At 37 week of gestation she was admitted to the provincial COVID-19 treatment center for isolation and health care in University Clinical Center of Kosovo in Gynecology/Obstetrics department. All bacteriological tests, including hemocultures and cultures of urines were negative. She received antipyretics (acetaminophen), antispasmodics trimethylphloroglucinol and antibiotics (oral azithromycin for 5 days and intravenous ceftriaxone). Despite this treatments, fever and uterine contractions persisted therefor the commission of doctors decided to deliver the baby via ceserean section. The peritoneal cavity and uterus were found to be very inflamed. Fetal appendages as well as the bladder were strewn with eruptive, vesicular lesions bleeding on contact. After few hours after the delivery her temperature (36.5 degreeC) and blood pressure (120/60 mmHg) were normal. The baby was healthy and tested negative on the COVD-19 tests performed. The patients after 2 weeks of treatment and a negative COVID-19 result she was released to go home and was counselled to eat healthy and prescribed multivitamins for her immune system and regular follow ups with the gynecologist. In a period of 8 months the patient became pregnant again and got infected with the COVID-19 again at 25 weeks pregnant. This time the symptoms were not severe and she was followed up at home. The delivery was planned with cesarean section and the baby was in healthy conditions. The patient got vaccinated with Astra Zeneca COVID-19 vaccine after the delivery. Because of their changed physiology, susceptibility to infections, and weakened mechanical and immunological processes, pregnant women are a particularly vulnerable group in any infectious disease outbreak. The requirement to protect the fetus adds to the difficulty of controlling their health. Keywords: COVID-19, pregnant women, cesarean section, Kosovo, astra-zeneca vaccineCopyright © 2023
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Functional movement disorders (FMDs) are a heterogenous group of movement abnormalities that greatly affect the quality of life of patients. They usually manifest as a result of underlying psychological or psychiatric illnesses without any known structural or neurochemical diseases. Various neurological disorders such as encephalitis, stroke, demyelination, seizures, and neuropathy have been reported by otherwise healthy individuals during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Here, we describe the case of a 27-year-old woman who presented to our outpatient department with episodes of deviation of angle of mouth with variability and distractibility. Following thorough clinical evaluation and appropriate investigation, the underlying etiology was identified as FMD secondary to the restrictions imposed during the COVID-19 pandemic to contain the transmission of the virus. The lockdown, isolation, financial strain, and other pandemic-related issues are stressors that may contribute to psychogenic disorders in people.Copyright © 2021 Annals of Movement Disorders Published by Wolters Kluwer - Medknow.
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Background: Total parenteral nutrition (TPN) is a life-saving therapy for patients with chronic intestinal failure. TPN typically consists of macronutrients (amino acids, dextrose, and lipids) as well as micronutrients (multi-vitamins [MVI] and trace elements) to meet fluid, calorie, and micronutrient needs. With the early years of PN administration, multiple deficiencies were noted leading to guidelines regarding need for daily use of essential trace element and MVI preparation for parenteral use. Unfortunately, during the last few years we have seen multiple shortages of PN related supplies including the most recent shortage of parenteral MVI preparation. Major organizations such as ASPEN have developed recommendations regarding management of shortages, however their clinical impact has not been fully evaluated. The current study evaluated the impact of MVI shortage on change in clinical practice and the prevalence of deficiency. Method(s): A retrospective review of electronic medical records for patients who received TPN during time of shortage in IV multivitamins supply due to COVID-19 crisis between January 2021 and June 2021. In our program, the shortage affected one TPN supplier. We included patients who received their TPN from affected supplier and who were tested for micronutrients including Vitamins A, B12, C, and D in the 6 months preceding the shortage in supply (period 1) as well as during the shortage period (period 2). Period 1 was defined as from July 1, 2020, to December 31, 2020, and period 2 was defined as from January 1, 2021, to June 30, 2021. In addition to baseline clinical characteristics, we captured changes in studied micronutrients. Result(s): Current retrospective analysis of a prospectively maintained database noted 21 patients (mean age of 63.3 +/- 13.8, 62% female) were impacted by MVI shortage during study period (Table 1). Most common primary diagnosis was Crohn's disease (33.3%) followed by enterocutaneous fistula (19%), and gastrointestinal dysmotility (14.3%). In 19/21 (90%) patients, MVI was administered 3 days per week in PN. In the remaining two patients who had short bowel,MVI was continued 7 days per week. Additionally, 19/21 (90%) patients also were supplemented orally with Vitamin D (17/21), Vitamin B12 (5/21), MVI (3/21), Vitamin C (1/21). There was a decline in average Vitamin C levels between the two study periods (Table 2) with a trend towards a decline in average 25-hydroxy vitamin D levels, while mean vitamin A and B12 levels did not change significantly. There was a significant increase in Vitamin D and C deficiencies, while no increase in deficiencies in Vitamin E, A, and B12 levels was noted (Figure 1). Conclusion(s): Unfortunately, shortages of key PN related supplies have become commonplace in the last few years. The most recent shortage affected MVI supplies. Our group managed the shortage through a combination of reduction of parenteral MVI administration to 3 days per week along with additional supplementation of specific micronutrients orally. Although with this strategy, there was an increase in Vitamin D and C levels falling below reference range, no significant deficiencies were noted. (Table Presented).
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Background: It is well knowledge that various viral illnesses may interfere with a man's ability to father children. Through the angiotensin-converting enzyme-2 receptor, which is highly concentrated in testicular tissue, the corona virus illness known as COVID-19 may cause harm to several organs. On the other hand, there is a paucity of data about the transmission of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) in sperm, as well as the virus's influence on spermatogenesis and the capacity for fertility. We intended to look into whether or not COVID-19 guys' sperm contained SARS-CoV-2 as well as examine how COVID-19 affected the overall quality of the sperm and the degree to which it's DNA was fragmented. Material(s) and Method(s): The survey was conducted between May 2022 to October 2022, with the participation of 40 male COVID-19 patients who were between the ages of 19 and 45 and enrolled at the RSDKS, Government Medical College, Ambikapur, Chhattisgarh. We tested each sample of sperm with a real-time reverse transcriptase and found no abnormalities. At the time of the initial sample, which took place during COVID-19, a comprehensive examination of the sperm was carried out. This analysis included the calculation of the sperm DNA Fragmentation Index. After 74 days had passed since the first sample, we were able to get the second specimen and carried out the aforementioned tests once again. Result(s): All of the sperm samples that were examined using real-time reverse transcription-polymerase chain reaction (RT-PCR) came back negative for SARS-CoV-2. These samples were taken during the first and second sampling. The initial sample had considerably lower levels of fructose, semen volume, vitality, total motility, sperm concentration, total sperm count, percentage of normal morphology, and cytoplasmic droplet percentage than the subsequent samples. On the other hand, the agglutination of the semen, the percentage of head defects, the DNA Fragmentation Index, the liquefaction time, the viscosity of the semen, and the number of leukocytes all rose. At the second sample, these results were inverted, but not to the level that would be considered optimal. These results all had a p-value less than 0.05, meaning they were statistically significant. As a result, COVID-19 has a detrimental impact on the characteristics of the sperm, including the sperm DNA fragmentation index. Conclusion(s): The quality of the semen remained low up until the second time it was sampled, despite the fact that we were unable to discover SARS-CoV-2 in the sample. It is recommended that assisted reproductive technology (ART) clinics and sperm banking facilities evaluate the quality of the sperm produced by males infected with COVID-19 and exclude men who have a history of being infected with SARS-CoV-2 until the men's sperm quality recovers to normal.Copyright © 2023 Ubiquity Press. All rights reserved.
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Spontaneous pneumomediastinum (SPM) is a decisive complication reported to be associated with COVID-19. Here, we present a case of SPM in a COVID-19positive patient that was not caused by any iatrogenic or known reasons. At the time of admission, the patient was COVID-positive and distressed. He was immediately subjected to hematological and radiological investigations (chest X-ray, HRCT), which confirmed pneumomediastinum. The patient was hypoxic and hypotensive even after receiving ionotropic support. Considering the patient's critical condition, a mediastinal pigtail catheterization was performed instead of a thoracotomy, and the catheter was in situ for nine days. Arterial blood gas was monitored during the hospital stay, and supplementary oxygen therapy was provided accordingly. The patient subsequently recovered and was discharged. Hence, SPM in this COVID patient was treated by pigtail catheterization, and major surgical interventions were avoided.Copyright © 2023 LookUs Scientific. All rights reserved.
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The corona virus disease 2019 (COVID-19) pandemic has increased the interest in self-care strategies, including self-medication. Medical students, as future health practitioners, learn more about medications than other students. This study aimed to describe self-medication practices for preventing COVID-19 among medical students at Universitas Islam Indonesia. This observational study used a cross-sectional design and was undertaken in November- December 2020. The study sample included 336 undergraduate medical students determined using a consecutive sampling technique based on inclusion and exclusion criteria. Data were collected using an online questionnaire about self-medication practices in the preceding 3 months. Among a total of 336 students, 137 (41%) reported using self-medication intending to prevent COVID-19, and 126 (92%) of these 137 took preventive supplements, mainly vitamins C, D, and E, and omega-3. Seven students reported the use of zinc, mainly in combination with other vitamins. Students who practiced self-medication lived closer to people confirmed with COVID-19, washed their hands more often, and desinfected their belongings more frequently than their counterparts (p<0.05). The mean duration for consuming vitamins was 11-16 days. Forty students (29%) used herbal medicine to prevent COVID-19;ginger, turmeric, honey, black seed, cutcherry, and Curcuma were the most often consumed herbal remedies. Fourteen students (10%) reported taking over-the-counter medications to relieve symptoms related to COVID-19, including antipyretic, analgesic, antiseptic, antihistamine, decongestant, antitussive, and expectorant medications. Most respondents (82%) purchased their medications at pharmacies, and 11 (9%) obtained them from online shops. These findings show the high rate of self-medication using vitamins and herbal remedies for COVID-19 prevention among university medical students. Further studies are needed to explore students' knowledge about the risks of self-medication including the use of herbal medicines.Copyright © 2022 Marmara University Press.
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December 2019 has become one of the most surprising days in the whole world in light of the flare-up of a most infectious sickness brought about by novel Covid or Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV-2). This study is conducted to assess the benefits of the use of home remedies to prevent the cause of Covid-19 and evaluate the assessment of dietary changes and physical activity in the prevention of Covid-19. A questionnaire-based online survey is conducted using Google forms consisting of multiple-choice questions about home remedies, lifestyle and dietary changes made by the people during this pandemic. These home remedies included using different types of herbal preparations, steam inhalation, physical exercise and OTC medications for prophylaxis. Questions likewise included about being infected by Coronavirus-19(during first wave or second) and their recovery period, additionally collected their viewpoint for changes made, for example how much they are useful in the prevention of the attack and whenever encountered any undesirable impacts. Total responses were 210, among which 121(57.6%) responses were from females and 89(42.4%) from males. 65 people tested Covid positive (42 during the first wave and 23 during the second wave). 118(56.2%) of people think these changes are very beneficial. (Rated 4 and 5 out of 5 points). From our survey, we concluded that different herbal preparations of their composition, which they thought are helpful, and steam inhalations have been used. Rating regarding the use and effectiveness was also found to be average. Further studies are needed to prove and provide clear evidence about adverse and side effects associated with the use of herbal products.Copyright © 2022 Society of Pharmaceutical Sciences and Research. All rights reserved.
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Objective: During COVID-19 pandemic, people have practiced one or more self-medication (SM) for prevention of the disease. This requires monitoring and evaluation to see the pattern of medicine used. Hence, in this study, we evaluated the prevalence and pattern of SM in various group of people. Method(s): A cross-sectional study was conducted as an online survey on individuals who were in contact through mobile phone from October 2020 to March 2021. A pre-structured questionnaire-based Google form that contain questions related to SM practiced was prepared and circulated on social media application and email. Submitted forms were analyzed using Microsoft excel. Result(s): Out of 779 forms, 775 (99.4%) filled completely were considered in result. Majority (52%) of participants were in the age group of 20-40 year. Six hundred and fifty-two (84%) participants had taken medication, out of which 40% were modern medicine users and rest 44% had used other than modern medicine. In modern medicine, Vitamin C was taken by 72% and in other group, lemon water was taken by 99% of participants. The prevalence of SM was highest among urban population (43%) with education up to postgraduation (53%). Health worker (57%) were highest among users. SM advice was received by doctors in 60% participants with belief of effectiveness against COVID-19 infection. Conclusion(s): SM was practiced by half of the participants that includes modern as well as other than modern medicine. It was mainly seen among people with higher education and who are associated with health-care system.Copyright © 2023 The Authors.
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Introduction: Dietary supplement use is continuously increasing in the world and it seems to be more common among women. Data on supplement habits of women in Turkey are still limited. The purpose of this study is to determine dietary supplement use and to evaluate associated factors in Turkish women in the pre-COVID-19 period. Methodology: A total of 727 Turkish women (33.4[10.3] years;25.9[4.57] kg/m2;162.9[6.81] cm) participated in this cross-sectional study. After piloting, the participants completed a six-part questionnaire form that was administered either face-to-face or over the phone by a trained dietitian. The questionnaire intended to collect data about demographic characteristics, use of dietary supplements and factors influencing supplement choices such as eating habits, physical activity and lifestyle habits. Result(s): A total of 307 participants (42.2%) used at least one dietary supplement within the previous year. The most commonly used was iron (30.6%) followed by vitamin D (30.6%), vitamin B12 (26.7%), multivitamins (18.2%), and calcium (11.4%). Supplement use decreased with higher physical activity (p=0.002). Furthermore, it was significantly higher among women who consume meals at regular times (p=0.001) and those that avoid fast food consumption (p=0.014). However, the use of dietary supplements was not associated with lower BMI, older age or higher academic level (p>0.05). Conclusion(s): More than 40% of women were reported using dietary supplements. The use of supplements was not associated with lower BMI, higher physical activity, older age, higher academic level smoking or drinking. Turkish women seem to show a different consumer profile from typical dietary supplement users.Copyright © 2022 Asociacion Espanola de Dietistas-Nutricionistas. All rights reserved.
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Background: Isolated tracheobronchial mucormycosis (ITBM) is an uncommonly reported entity. Herein, we report a case of ITBM following coronavirus disease 2019 (COVID-19) and perform a systematic review of the literature. Case description and systematic review: A 45-year-old gentleman with poorly controlled diabetes mellitus presented with cough, streaky haemoptysis, and hoarseness of voice 2 weeks after mild COVID-19 illness. Computed tomography and flexible bronchoscopy suggested the presence of a tracheal mass, which was spontaneously expectorated. Histopathological examination of the mass confirmed invasive ITBM. The patient had complete clinical and radiological resolution with glycaemic control, posaconazole, and inhaled amphotericin B (8 weeks). Our systematic review of the literature identified 25 additional cases of isolated airway invasive mucormycosis. The median age of the 26 subjects (58.3% men) was 46 years. Diabetes mellitus (79.2%) was the most common risk factor. Uncommon conditions such as anastomosis site mucormycosis (in two lung transplant recipients), post-viral illness (post-COVID-19 [n = 3], and influenza [n = 1]), and post-intubation mucormycosis (n = 1) were noted in a few. Three patients died before treatment initiation. Systemic antifungals were used in most patients (commonly amphotericin B). Inhalation (5/26;19.2%) or bronchoscopic instillation (1/26;3.8%) of amphotericin B and surgery (6/26;23.1%) were performed in some patients. The case-fatality rate was 50%, primarily attributed to massive haemoptysis. Conclusion: Isolated tracheobronchial mucormycosis is a rare disease. Bronchoscopy helps in early diagnosis. Management with antifungals and control of risk factors is required since surgery may not be feasible. © 2022 Wiley-VCH GmbH.
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Background: The COVID-19 pandemic affected health commodities due to disrupted supply chains, increased demand, and price increases. Jazia Prime Vendor System (Jazia PVS) is a Public Private Partnership for procuring health commodities when not available at Medical Stores Department (MSD). The system has been operational since 2018. Objective(s): This study highlights the resilience and contribution of Jazia PVS during the pandemic in mitigating health supply challenges including price increases. Methodology: Routine data from regional monitoring of the Jazia PVS were analyzed between March 2020 and June 2021. Prices of selected health products were compared with baseline prices. Data were collected using monitoring checklists and secondary information from 7 (27%) regions and 5 (37%) contracted regional vendors. Analysis used Microsoft office excel. Result(s): Despite the spike in demand, PVS managed to supply commodities to public health facilities, complementing MSD during the pandemic. Facilities recorded availability of medicines of 75% and 85% in April 2020 and April 2021, respectively. Initially, Jazia PVS continued supply of health commodities at original contract prices. As stock depleted and demand increased, vendors and their clients (regions) initiated market price reviews and contract negotiation leading to price adaption. Price increase of 244.83% in June 2020 for examination gloves reduced to 201.72% in June 2021. The baseline price increase for surgical gloves of 122.22% reduced to 77.78%. Paracetamol price increase of 51.72% reduced to 37.93%. The price for azithromycin tablets increased by 69.23% up to June 2021. Multivitamins tablets increased by 157.14%. Conclusion(s): The COVID-19 pandemic disrupted health supply chains. The complementary Jazia PVS demonstrated resilience and was able to mitigate supply challenges. Vendors and clients agreed to amend commodities prices as a measure to maintain operations and to sustain supply of health commodities. The system proved flexibility in response to a public health and economic crisis.
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(1) Background: During the COVID-19 pandemic, the use of Dietary Supplements (DSs) has increased for health promotion purposes. Few data records were found on the safe use of DSs among university students in Saudi Arabia, during COVID-19. This study aimed to assess the perceptions and patterns of DSs during COVID-19 among students at a selected female university. (2) Methods: A descriptive cross-section design was used. A convenient sample of undergraduate students (n = 651) were recruited via email, to fill in an online validated questionnaire: The nutrition and intake of DSs during COVID-19. Data were analyzed using descriptive and inferential statistics. (3) Results: Among the 509 students who did not have chronic diseases, 85% of them had taken DSs. About 35.5% of the students had not changed their dietary habits since the beginning of COVID-19, but 78.6% thought that they needed to improve their immunity by taking DSs. Half of the students 51.2% believed that healthy habits may reduce the chance of being infected with COVID-19. The most used DSs were vitamin C (84.3%), followed by honey (65.3%), and vitamin D (47.7%). At the top of students' references for DSs was personal judgment or previous knowledge of the benefits (27.3%). (4) Conclusion: The usage and patterns of DSs were impacted by the COVID-19 pandemic. Taking DSs without a doctor's prescription may lead to several complications. DSs users should be educated effectively about the proper use of DSs as an external supplementation.
Subject(s)
COVID-19 , Ascorbic Acid , COVID-19/epidemiology , Cross-Sectional Studies , Dietary Supplements , Female , Humans , Pandemics , Saudi Arabia/epidemiology , Students , Vitamin D , VitaminsABSTRACT
Background: The new coronavirus disease 2019 (COVID-19) is a worldwide pandemic. Concerns have been raised about the influence of SARS-CoV-2 infections on pregnant mothers and their fetuses, and patient care in the setting of COVID-19 is difficult. As a result, the current study was conducted to determine the outcomes of pregnant females with COVID-19 infection and their obstetric care of COVID-19. Materials and methods: The study enrolled 8622 pregnant women from April 1st, 2020 to September 30th, 2020 at Lokmanya Tilak Medical College and Sion Hospital, a tertiary care hospital. There were 455 women who tested positive for COVID, whereas the remaining 8167 patients tested negative for COVID. The results obtained were compared in both groups. Results: The percentage of pregnant women who tested positive for COVID was determined to be 5.27%. Most patients were delivered by LSCS in the COVID-positive group (49.45%) than in the COVID-negative group (43.95%) (p >0.05). Among 455 COVID-positive women, 401 were asymptomatic, whereas 54 patients showed COVID-19 symptoms like fever and cough (12%). All patients with mild symptoms were adequately handled with a multivitamin supplement, high-protein diet, fluid-electrolyte balance, regular vitals monitoring, and prophylactic antibiotic therapy. In total, 23 women were admitted to the intensive care unit after developing severe COVID-19 pneumonia with ARDS. The risk of maternal mortality in COVID-positive patients was somewhat higher 16 (3.51%) than in COVID-negative pregnant women 39 (0.47%) (p <0.05). In the majority of neonates in both the COVID-positive and-negative women, Apgar score was normal 7–10, and birth weight between 2.6 and 3 kg. Low Apgar scores (0–3) were seen in 6 (1.43%) of COVID-positive mothers’ neonates and 197 (2.60%) of COVID-negative mothers’ neonates. Overall, the majority of the newborns were healthy. Swabs from seven neonates were first determined to be positive, but were retested on day five and proved to be negative. Conclusions: In times of global pandemic, quick and judicious management of COVID-19 positive pregnant women is a critical notion for safe motherhood and healthy children. However, our findings reveal that COVID infection has no substantial influence on maternal and fetal outcomes in pregnancy, and there is no indication of vertical transmission of the COVID-19 infection, but long-term monitoring of these newborns is suggested.
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Introduction: The severity of COVID-19 is determined by the presence of pneumonia, severe ARDS, cytokine storms, and small vessels thrombosis, all involves underlying inflammation. Vitamin D is a fat-soluble vitamin with immuno-modulating and anti-inflammatory properties. The high prevalence of vitamin D deficiency is usually due to inadequate sunlight exposure, sedentary lifestyle, diet poor in vitamin D, and traditional clothing. Vitamin D deficiency is a modifiable risk factor their identification and management can improve outcomes. Materials and methods: This was a prospective observational single centre study of moderatelysevere COVID-19 patients. All consecutive, moderately-severe COVID-19 patients with ICU stay >48 hours were included. Exclusion criteria: consent refusal, pregnant and lactating mothers, Age <18 years, post-cardiac arrest resuscitated patient before ICU admission, patient on multivitamin or Neutraceuticals supplements, chronic diarrhea, and cancer patients. Based on vitamin D levels on ICU admission, patients were stratified into two groups, i.e., ≤20 ng/mL deficient and >20 ng/mL non-deficient group. After demographic data, we collected data of underlying disease;cause of admission;APACHE II on admission and daily SOFA scoring, various morbidities during ICU stay (mechanical ventilation, inotropes/vasopressor, nosocomial infections, etc.), length of ICU stay, ICU mortality and 30 days mortality. Results and discussion: A total of 88 patients were studied, 73 (82.9%) patients had vitamin D deficiency. Median [IQ range] vitamin D levels of the deficient and non-deficient group were 11 [5-17] and 27 [22-35]. Groups did not differ in demographic or clinical characteristics except for age. The elderly age group had a higher prevalence of deficiency and was statistically significant, mean (±SD) age of the deficient vs non-deficient group was 54.78 (±13.30) vs 46.47 (±5.75), p value 0.02. The overall mortality rate of the cohort was 42.05%. Percentage mortality in the deficient group (46.5%) was lower than the non-deficient group (20%) but failed to show statistical significance p value 0.058. In continuous data, deficient group had a poor association with ICU morbidities vs nondeficient group as mean (±SD) duration of mechanical ventilation 4.59 (±2.78) vs 4.07 (±3.21) p value 0.521, and length of ICU stay 8.04 (±2.82) vs 8.53 (±3.04) p value 0.545. In categorical data, deficient group showed increased ICU morbidities vs non-deficient group but were not statistically significant, inotropes/vasopressor requirement 60.3% vs 53.3% p value 0.619, hospital-acquired infection incidence 45.2% vs 40% p value 0.712 and 30 days mortality 75.6% vs 24.4% p value 0.059. In severity scoring, deficient group had higher severity vs non-deficient group but statistical significance was not demonstrated APACHE II 10.74 (±4.42) vs 8.73 (±3.39) p value 0.101 and mean SOFA score 4.17 (±3.33) vs 2.51 (±2.68) p value 0.074. Mean (±SD) levels of vitamin D in survivor vs non-survivors were 11.54 (±5.76) vs 15.45 (±6.92) p value 0.006 showed a correlation between mortality and low vitamin D deficiency levels. However, vitamin D levels failed as an independent risk factor for mortality in multivariate analysis OR (95% C.I.) 1.198 (0.732-1.672), p value 0.296. Conclusion: In moderately-severe COVID-19, vitamin D deficiency was associated with a greater incidence of mortality and morbidity, although the relationship was not statistically significant. Vitamin D deficiency was not found to be an independent risk factor for mortality.
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Objectives: The aims of this study were to collect sociodemographic, clinical data regarding practice of self-medication and to assess quality of life in healthcare workers involved taking care of COVID-19 patients. Methods: The study population consisted of 104 healthcare workers from Gauhati Medical College and Hospital directly involved in management and control of COVID-19 Pandemic. It was a cross-sectional observational study using non-probability sampling. Data were collected in a questionnaire developed by the investigators which included age, sex, and occupation, COVID-19 such as symptoms, medicines used, contraction and confirmation of COVID-19 positive, and self-medication when COVID positive, symptomatic relief, and adverse effects and usefulness of self-medication. The data for mental health were obtained in a questionnaire based on the Professional Quality of Life Scale (Compassion Satisfaction and Compassion Fatigue Version 5) with responses rated on a five-point Likert scale. Results: The study consisted of 104 participants. Males were n=42 (40%) and females were n=62 (60%). Doctors n=20 (19%), Laboratory Technicians n=22 (21%), Nurses n=44 (42%), Pharmacists n=13 (13%), Ward boys n=3 (3%), and Ward girls n=2 (2%) took part. Eighty-four (97.7%) respondents took paracetamol, 39 (45.3%) took cough syrup, 30 (34.9%) used nasal decongestants, 25 (29.1%) utilized throat gargle, 24 (27.9%) used azithromycin, 22 (25.6%) used cefixime, 13 (15.1%) took amoxyclav, 27 (31.4%) took ORS, 3 (3.5%) took Doxycycline, 4 (4.8%) used Ivermectin, 1 (1.2%) took Dexamethasone, and 1 (1.2%) used Multivitamin. About 68% (n=51) of COVID Positive respondents self-medicated with Azithromycin, 24% (n=18) with Ivermectin, 41.3% (n=31) with Doxycycline, 20% (n=15) with Dexamethasone, and 4% (n=3) with Levocetrizine and Paracetamol. The Mental Health Assessment Scores were obtained as the sum total of scores of answers to the 30 questions provided per respondent. About 7% (n=7) respondents with total score between 60 and 69, 12% (n=13) from 70 to 79, 29% (n=30) from 80 to 89, 22% (n=23) from 90 to 99, 16% (n=17) from 100 to 109, 13% (n=13) from 110 to 119, and 1% (n=1) between 120 and 129. This indicates that some participants had mild burnout, most had moderate burnout, and a few had severe burnout. Conclusion: Self-medication practices common among healthcare workers, increased during the COVID-19 Pandemic which must be appropriately managed to stay away from the ill effects. Providing adequate mental health resources and education to the affected health workers will motivate them increasing their productivity during the pandemic.
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The insufficient provision of micronutrients (vitamins A, D, E, C, and B-group, the minerals zinc, iron, selenium, magnesium, copper, and phosphorus) weakens the immune response, which can increase the risk of infection, contribute to disease severity and COVID-19 complications. The population of Russia, both adults and children, has deficiencies of multiple micronutrients (vitamins D, B-group, calcium, magnesium, zinc, and iodine), their simultaneous deficiency is experienced by about one third of the surveyed population. The micronutrients in the body are interconnected to form metabolic networks. A lack of one or more vitamins can disrupt the conversion of other vitamins to their biologically active forms, causing a functional vitamin deficiency. The percentage of vitamins and minerals in the diet of the population is a modifiable risk factor for infectious diseases. This implies replenishing the insufficient dietary intake of micronutrients not only to cover the needs of the body, but also to achieve their optimal provision. We are not dealing with therapy with and use of vitamins in pharmacological dosages. The intake of multivitamins provides protection against COVID-19, a decrease in the severity of the disease, a reduction in the manifestations of post-COVID sequels, and an increase in the efficiency of vaccination. Optimization of the vitamin status in all population groups through the intake of vitamin and mineral supplements (VMS) containing a complete set of vitamins and immunotropic elements is an underestimated important preventive factor in protecting from viral infections. Conclusion: The relevance of taking VMS in pregnancy and lactation during the pandemic is becoming even more important. During the pandemic, the use of VMS by pregnant and lactating women will not only improve their own micronutrient status and subsequently optimize the percentage of vitamins and minerals in breast milk, and thus the micronutrient status of the baby, but will also contribute to the body's resistance to disease.
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Objectives: To assess and compare the admission rates of medical complications (MC) after Bariatric and metabolic surgery (BMS) over a period of 6 years prior to and during the pandemic. Bariatric and metabolic surgery could be associated with MC, including malnutrition and neuromuscular complications (NC). Methods: Retrospective study of all patients admitted to Hamad General Hospital, Qatar, with post-BMS MC before (n=12, January 2014-December 2019) and during the pandemic (n=36, January 2020-31 May 2021). We assessed 17 nutrients, nerve conduction/electromyography diagnosed NC, and we explored whether patients had clustering of gastrointestinal symptoms, barium meal findings, excess weight loss percentage (EWL%), or non-compliance with post-BMS clinic visits and multivitamin supplements. Results: The sample comprised 95.8% sleeve gastrectomies, mean age was 26.62 years, and 54.2% were women. Admissions increased from pre-pandemic 0.29 per 100 BMS to 11.04 during the pandemic (p<0.0001), despite no significant differences in patients' demographic/surgical profiles, nutrient deficiencies, or MC characteristics. Across the sample, the most frequent neuropathies were mixed sensory/motor/axonal;albumin and total protein deficiencies were observed in 54.2% and 29.2% of patients, respectively (no pre-pandemic/ pandemic differences). Most frequent micronutrient and trace element deficiencies were potassium, vitamin D, and zinc (no pre-pandemic/pandemic differences). Admitted patients had high non-compliance with multivitamins supplementation (87.5%), high post-BMS nausea/vomiting (66.7%, 62.6%, respectively), high EWL% (mean=74.19±27.84%), no post-BMS outpatient follow up (75% during pre-pandemic, 88.9% during pandemic) (no pre-pandemic/pandemic differences for all), and gastroesophageal reflux (higher during the pandemic, p=0.016). Conclusion: Despite the reduced number of BMS during the pandemic, hospital admissions of MC significantly increased.
ABSTRACT
Background: Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS) has been associated to Epstein Bar Virus (EBV), Coxsakie virus and Ross River virus infections. Recently a similar condition to ME/CFS has been described as 'Long Covid' associated to SARS-CoV-2. Patients with positive EBV serology and ME/CFS may be carriers of a chronic latent infection that translates in a chronic systemic inflammation with neuroinflammation. The activation of the immunologic cascade after a viral infection or vaccination can trigger the formation of Anti-idiotype antibodies (Ab2) and an activation of pyrin domain containing protein3 (NRLP3) inflammasome. The NRLP3 inflammasome is the pattern of activation for interleukin (IL1-beta) cytokine complex which is activated in inflammatory conditions (1). Colchicine is postulated to work by inhibiting tubulin polymerization and microtubule formation blocking inflammasome activation (2). Spironolactone increased the activity and number of macrophage angiotensin converting enzyme 2 (ACE2) receptors. In the microglia this effect may represent a reduction of neuro-inflammation (3). In this we present ME/CFS patients treated with the synergetic effect of Colchicine and Spironolactone to inhibit Inflammasome and decrease inflammation. Population and Method: 23 patients (19 females) with positive serology for EBV infection and ME/CFS were included. All the patients were treated with multivitamins. Patients were educated about benefit and adverse effects of spironolactone and colchicine before treatment. The starting dose of Spironolactone was 12.5 mg a day increased to 25 mg a day (during years 2019 to 2021). The introduction of Colchicine 0.5 mg/day on treatment plan was during year 2021. Patient follow-up was in the outpatient clinic and GP clinic. Results: Total 23 Patients 19 were Females age 37.3+28 and 4 were Males age 61+9. Two patients stop colchicine after 4 weeks. Improvement in cognitive skills was the early manifestation of spironolactone benefit. Patients reported to be less brain foggy, more alert, and they found it easier to focus when doing normal everyday activities. They were also less irritable by noise and light and described themselves to be able to multi-task again. There was an improvement in general condition and everyday activities four weeks after Colchicine started. Conclusion: Patients with ME/CFS improve their cognitive skills and everyday physical activity tolerance when treated with Colchicine and Spironolactone.