ABSTRACT
ABSTRACT: We investigated whether the number of pediatric patients with congenital clubfoot treated with the Ponseti method decreased during the Covid-19 pandemic or not in a rural area. So we aimed to guide orthopedic surgeons and health infrastructure for future pandemics to be prepared in hospitals of rural areas for the treatment of children with congenital clubfoot.One hundred and fifty-four patients with clubfoot who were admitted to our clinic were evaluated retrospectively from March 2017 to December 2020. Institutional hospital electronic database was used to detect the number of weeks between the birth and first cast performed in clinic and the number of casts been applied and unilaterality or bilaterality. Patients were divided into four groups, which included pandemic period and three previous years. Recorded data were analyzed statistically to detect if there is a difference between the numbers of the patients in pandemic period and three previous years.The number of patients with clubfoot admitted to our hospital between March 2020 and December 2020 increased by 140% compared to previous year. There was a statistically significant difference between the average number of cast applications of Group 4 and other groups (P <.001). Achilles tenotomy was performed in 44 (61.1%) of 72 patients admitted during the pandemic period. Only 4 (13.3%) out of 30 patients admitted between March 2019 and December 2019 were performed Achilles tenotomy.We detected an increase in the number of clubfoot cases admitted to our rural-based hospital during the Covid-19 pandemic, treated with casting or surgically. We think this is because of preventive measures during the pandemic, which caused parents could not reach urban for treatment.
Subject(s)
COVID-19/prevention & control , Casts, Surgical/statistics & numerical data , Clubfoot/therapy , Health Services Accessibility/statistics & numerical data , Tenotomy/statistics & numerical data , Achilles Tendon/surgery , COVID-19/epidemiology , COVID-19/transmission , Clubfoot/diagnosis , Communicable Disease Control/standards , Cross-Sectional Studies , Health Services Accessibility/standards , Hospitals, Rural/standards , Hospitals, Rural/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Orthopedic Surgeons/statistics & numerical data , Outpatient Clinics, Hospital/standards , Outpatient Clinics, Hospital/statistics & numerical data , Pandemics/prevention & control , Retrospective Studies , Tenotomy/standards , Treatment OutcomeABSTRACT
BACKGROUND: The coronavirus disease 2019 (COVID 19) is a zoonotic viral infection that originated in Wuhan, China, in December 2019. It was declared a pandemic by the World Health Organization shortly thereafter. This pandemic is going to have a lasting impact on the functioning of pathology laboratories due to the frequent handling of potentially infectious samples by the laboratory personnel. To deal with this unprecedented situation, various national and international guidelines have been put forward outlining the precautions to be taken during sample processing from a potentially infectious patient. PURPOSE: Most of these guidelines are centered around laboratories that are a part of designated COVID 19 hospitals. However, proper protocols need to be in place in all laboratories, irrespective of whether they are a part of COVID 19 hospital or not as this would greatly reduce the risk of exposure of laboratory/hospital personnel. As part of a laboratory associated with a rural cancer hospital which is not a dedicated COVID 19 hospital, we aim to present our institute's experience in handling pathology specimens during the COVID 19 era. CONCLUSION: We hope this will address the concerns of small to medium sized laboratories and help them build an effective strategy required for protecting the laboratory personnel from risk of exposure and also ensure smooth and optimum functioning of the laboratory services.
Subject(s)
COVID-19/diagnosis , Clinical Laboratory Services/organization & administration , Infection Control/organization & administration , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Tertiary Care Centers/organization & administration , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Clinical Laboratory Services/standards , Decontamination/methods , Decontamination/standards , Developing Countries , Disinfection/methods , Disinfection/organization & administration , Disinfection/standards , Hospitals, Rural/organization & administration , Hospitals, Rural/standards , Humans , India/epidemiology , Infection Control/standards , Medical Laboratory Personnel/organization & administration , Medical Laboratory Personnel/standards , Pandemics/prevention & control , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Specimen Handling/standards , Tertiary Care Centers/standards , Workforce/organization & administration , Workforce/standardsABSTRACT
Nine surgeons from rural and remote communities in the United States share early experiences preparing for the COVID-19 pandemic. Relating experiences remarkably different from health care providers in urban areas in America most affected by the first stages of the outbreak, they tell the challenges of organizing resources in facilities already struggling with poverty-stricken communities far from established health care resources and supplies. From Alaska to Appalachia and the Navajo Nation to the rural midwest, they show the leadership and professionalism that exemplify rural surgery.