Sociobehavioural Factors Associated With Child Oral Health During COVID-19.

OBJECTIVES: The aim of this study was to identify the sociobehavioural factors that influenced children's oral health during the COVID-19 pandemic. METHODS: The online cross-sectional study was conducted in Al Jouf Province in the northern region of Saudi Arabia. A total of 960 parents of children aged 5 to 14 years were invited by multistage stratified random sampling. Descriptive, multinomial, and multiple logistic regression analyses were performed to estimate odds ratios and determine the relationship between independent and dependent variables. P < .05 was considered statistically significant. RESULTS: Of the 960 participants, 693 (72.1%) reported that their child had 1 or more untreated dental decay. The children of uneducated parents were 1.6-fold more likely to have 1 or more untreated dental decay (adjusted odds ratio [AOR], 1.66; 95% CI, 0.74-3.73; P < .001). The children of unemployed parents were 4.3-fold more likely to have a financial burden for a child dental visit (AOR, 4.34; 95% CI, 2.73-6.89; P < .001). Parents from a rural area were 26.3-fold more likely to have spent a lag period of over 2 years since their child's last dental visit (AOR, 26.34; 95% CI, 7.48-92.79; P < .001). Nursery-level children were 5.4-fold more likely to need immediate care (AOR, 5.38; 95% CI, 3.01-9.60; P < .001). CONCLUSIONS: The present study demonstrated a very high prevalence of 1 or more untreated dental decay in our cohort. Children of rural areas, uneducated, unemployed, widow/divorced, low- and middle-income parents and nursery school children were linked to poorly predictive outcomes of child oral health during the pandemic.

Neurosurgical Outcomes, Protocols, and Resource Management During Lockdown: Early Institutional Experience from One of the World's Largest COVID 19 Hotspots.

BACKGROUND: As the COVID-19 pandemic surpasses 1 year, it is prudent to reflect on the challenges faced and the management strategies employed to tackle this overwhelming health care crisis. We undertook this study to validate our institutional protocols, which were formulated to cater to the change in volume and pattern of neurosurgical cases during the raging pandemic. METHODS: All admitted patients scheduled to undergo major neurosurgical intervention during the lockdown period (15 March 2020 to 15 September 2020) were included in the study. The data involving surgery outcomes, disease pattern, anesthesia techniques, patient demographics, as well as COVID-19 status, were analyzed and compared with similar retrospective data of neurosurgical patients operated during the same time period in the previous year (15 March 2019 to 15 September 2019). RESULTS: Barring significant increase in surgery for stroke (P = 0.008) and hydrocephalus (P <0.001), the overall case load of neurosurgery during the study period in 2020 was 42.75% of that in 2019 (P < 0.001), attributable to a significant reduction in elective spine surgeries (P < 0.001). However, no significant difference was observed in the overall incidence of emergency and essential surgeries undertaken during the 2 time periods (P = 0.482). There was an increased incidence in the use of monitored anesthesia care techniques during emergency and essential neurosurgical procedures by the anesthesia team in 2020 (P < 0.001). COVID-19 patients had overall poor outcomes (P = 0.003), with significant increase in mortality among those subjected to general anesthesia vis-a-vis monitored anesthesia care (P = 0.014). CONCLUSIONS: Despite a significant decrease in neurosurgical workload during the COVID-19 lockdown period in 2020, the volume of emergency and essential surgeries did not change much compared with the previous year. Surgery in COVID-19 patients is best avoided, unless critical, as the outcome in these patients is not favorable. The employment of monitored anesthesia care techniques like awake craniotomy and regional anesthesia facilitate a better outcome in the ongoing COVID-19 era.

Bilateral Acute Lower Limb Ischemia Secondary to COVID-19.

COVID-19 has to date affected over 5 million people worldwide and caused in excess of 300000 deaths. One of the principal finding is that of a thrombotic tendency within the lungs leading to high mortality. There have been increasing number of reports of peripheral arterial thrombosis as well. Most cases of arterial thrombosis is noted in patient in intensive care setting. Here-in we report a case of acute bilateral lower limb arterial thrombosis in a patient recovering at home with mild COVID-19 symptoms, highlighting that patients with milder symptoms may also suffer from prothrombotic state resulting in acute arterial occlusions. Arterial thrombosis should be suspected in these patients despite the absence of predisposing factors.