Difference in presentation, outcomes, and hospital epidemiologic trend of COVID-19 among first, second, and third waves in Dhaka Medical College

BackgroundThis study aimed to examine the differences in epidemiologic and disease aspects among patients with COVID-19 MethodsWe reviewed the hospital records between April 2020 and September 2021 and followed up on the patients for post-COVID complications. FindingsOlder adult patients were predominantly affected during the first and second waves, followed by middle-aged patients. Men were predominantly admitted, considering the three waves; although more women were admitted in the second wave. Cough was more common in the second and third waves than in the first wave 522 (59.7%). Respiratory distress was the most common in the third wave, 251(67.1%), and least common in the first wave 403 (46.1%). Anosmia was more common in the third wave 116 (31.2%). In the third wave, patients presenting in a critical state 23 (6.2%) and severe disease 152 (40.8%) were more common. The hospital admission median (IQR) was longer in the first wave, 12 (8-20), than in other waves. More patients were admitted in the first wave (52%) than in the other waves, and patients received more oxygen in the third wave (75%) than in the other waves. Death occurred more commonly in the first wave (51%) than in the other waves. Patients were investigated more commonly in the first and third waves than in the second wave. The positivity rate was high in the third wave (22.8%) than in other waves. In the third wave, the positivity rate was higher in women (24.3%) than in men. Post-covid cough increased in the second wave and fatigue was higher in the third wave than in other waves. Tiredness and memory loss was greater during the second wave than in other waves. ConclusionThis study revealed that the presenting symptoms, outcomes, and epidemiologic trends differed during the COVID-19 waves.

Experiences of the physicians in the largest COVID-19 dedicated hospital of Bangladesh about COVID-19 and its aftermath

BackgroundThe doctors and the other health care workers are the first-line fighters against COVID-19. This study aims to identify the prevalence, risk factors, clinical severity of COVID-19 infection among the doctors working in the COVID unit. We also analyzed the hospital data for admission and RT-PCR positivity among the physicians. MethodsIt was a cross-sectional survey and review of the hospital database. We surveyed from September 2021 to October 2021 and explored the hospital data from march 2020 to September 2021.We included 342 physicians for analysis in the survey. We reviewed hospital data of 1578 total admitted patients and 336 RT-PCR test positive physicians for analyzing the hospital admission rate, the positivity rate for COVID-19 among the physicians and the other patients in the different COVID-19 surges. FindingsIn this study, we demonstrated the physicians sufferings during the pandemic era. We have observed four surges in the hospital admission and RT-PCR for COVID-19 positivity rate among the physicians and the general population. The physicians experienced a similar surge in the hospital admission and positivity rate to the general population. The hospital admission was lower in the fourth surge among the physicians than the general population. The positivity rate was higher in the first, second and third surge among the physicians. In the survey, a total of 146(42%) respondents had COVID-19 infection, and among them, 50(34.2%) had re-detectable positive SARS-CoV-2 infection. Most of them experienced mild (77[52.7%]) to moderate (41[28.1%]) symptoms. Increasing age (OR, 95%CI, p-value; 1.15, 1.05-1.25, 0.002), male sex (OR, 95%CI, p-value; 5.8, 3.2-9.8, <0.001), and diabetes (OR, 95%CI, p-value; 25.6, 2-327.2, 0.01) were the risk factor of having COVID-19. Female sex and diabetes were the risk factors for re-detectable positive SARS-CoV-2 infection. (OR, 95%CI, p-value; 0.24, 0.09-0.67, 0.006; 44, 8.9-218.7, <0.001 respectively). Most respondents suffered for 7-14 days. Total 98(67%) suffered from post-COVID fatigue. ConclusionsThe physicians observed four surges in hospital admission and COVID-19 positivity rate. A significant number of the COVID-warrior became positive for SARS-CoV-2, had re-detectable positive SARS-CoV-2 infection, and suffered in the post-COVID-19 state.

Difficulties to enter the left ventricle during percutaneous transvenous mitral commissurotomy (PTMC)- our experiences of 80 cases with modified techniques.

BACKGROUND: Percutaneous transvenous mitral commissurotomy (PTMC) is the standard of treatment for symptomatic severe rheumatic mitral stenosis (MS). PTMC has the standard Inoue technique, but we have to modify the procedure in many technically challenging cases, especially to cross the mitral valve. METHODOLOGY: Two over-the-wire strategies to enter the LV were taken in 80 complex cases of PTMC. The first one was done by exchanging the J-shaped wire from the balloon, introducing the spring wire into it, and pushing it into LV. The second one-removal of balloon keeping the spring wire in LA and the Mullin's sheath was introduced, and the tip of the wire was pushed into LV, and the balloon was introduced over the wire. We also changed the left atrium (LA) graphy in the RAO view instead of the AP view to facilitating entry into LV. RESULTS: We succeeded in 76 (95 %) cases. Strategy one was applied to all but successful in only 25 cases (31 %), and strategy 2 was applied in the remaining. Strategy 1 required less procedural time and fluoroscopic time in comparison to strategy 2 (40 ± 10 vs 60 ± 16 min, 25 ± 7 vs 35 ± 8 min). After modification of taking the LA graphy in RAO view, our rate of facing the difficulties decreased from 21 % to 9 %. Critical MS (31 %) and the giant LA (30 %) were the topmost causes of difficulties. No major complications were recorded. CONCLUSION: Over-the-wire entry into LV is cost-effective, requiring no new equipment and is safe and can be used in complex cases.

Synthesis, Characterization, and Optimization of Magnetoelectric BaTiO3-Iron Oxide Core-Shell Nanoparticles.

Improvement of magnetic, electronic, optical, and catalytic properties in cutting-edge technologies including drug delivery, energy storage, magnetic transistor, and spintronics requires novel nanomaterials. This article discusses the unique, clean, and homogeneous physiochemical synthesis of BaTiO3/iron oxide core-shell nanoparticles with interfaces between ferroelectric and ferromagnetic materials. High-resolution transmission electron microscopy displayed the distinguished disparity between the core and shell of the synthesized nanoparticles. Elemental mapping and line scan confirmed the formation of the core-shell structure. Energy-dispersive X-ray spectroscopy and X-ray photoelectron spectroscopy detected the surface iron oxide phase as maghemite. Rietveld analysis of the X-ray diffraction data labeled the crystallinity and phase purity. This study provides a promising platform for the desirable property development of the futuristic multifunctional nanodevices.