ABSTRACT
OBJECTIVE: Recognizing the huge potential ramifications of COVID-19 pandemic, this study explores its impact on health professionals personally and professionally along with the associated challenges. METHODS: A descriptive cross-sectional qualitative survey was conducted from March-April 2020. Participants included health professionals from various disciplines in both public and private-sector institutions of Pakistan. The sample size was not predetermined, and an iterative approach of simultaneous data collection and analysis was taken until data and time saturation were reached. Thematic analysis of the qualitative data was carried out by two analysts. RESULTS: Two hundred and Ninety health professionals responded. They reported an impact on their mental, physical and social well-being. The clinicians mentioned facing an unprecedented workload in overstretched health facilities, while those in academia become engaged with planning/providing emergency remote teaching for the students affecting work-life balance. Some challenges associated with work-from-home and in the hospitals were identified. CONCLUSION: During COVID-19, the health professionals are anxious, overworked and financially unstable while planning, creating and caring for others and their families. We need to support them to do their jobs, be safe and stay alive. Future research should explore the fears and coping strategies of health professionals during pandemics.
ABSTRACT
Pneumorrhachis, the presence of air in the spinal canal, is an unusual and alarming radiographic finding. The etiology is most commonly traumatic or iatrogenic but it can occur as a spontaneous phenomenon in association with pneumomediastinum. We report the case of a 16 year old male who presented with throat discomfort and a feeling of altered voice after recreational drug use. Examination confirmed widespread subcutaneous emphysema above the clavicles and plain radiograph and computed tomography imaging confirmed the presence of extensive pneumomediastinum and pneumorrhachis. The patient was managed conservatively and made a full recovery. The clinical and imaging features of spontaneous pneumorrhachis are presented as well as a review of the literature with regard to pathogenesis, management and outcome. Knowledge and understanding of this unusual phenomenon is important to properly direct patient care.
Subject(s)
Illicit Drugs , Pneumorrhachis/chemically induced , Pneumorrhachis/diagnostic imaging , Tomography, X-Ray Computed , Adolescent , Conservative Treatment , Diagnosis, Differential , Humans , Male , Pneumorrhachis/therapy , Radiography, ThoracicABSTRACT
INTRODUCTION: Deaths following diagnosis of venous thromboembolism (VTE) often result from another concurrent illness. The specificity of mortality markers predicting death from pulmonary embolism is unknown. The aim of this analysis was to compare blood predictors of death in patients with confirmed VTE to patients with negative investigations for VTE. MATERIALS AND METHODS: Consecutive patients investigated for VTE were prospectively consented from a single hospital over 9months. VTE was diagnosed and excluded with a standard diagnostic algorithm. Blood was drawn for biomarker analysis and analyzed in batches for NT-proBNP, high sensitivity troponin T, C-reactive protein (CRP), fatty acid binding protein (FABP) and ischemia modified albumin (IMA). Participants were followed for 3months. The cohort was analyzed in two groups: those diagnosed with VTE and those who had thrombosis excluded. Regression analysis for 3-month mortality was performed for each group. RESULTS: 16/153 patients diagnosed with VTE died within three months (10.5%) as did 23/606 patients who had negative investigations for VTE (3.8%). Predictors for death following VTE included cancer, NT-proBNP, troponin T, FABP, and Hb<95g/L. NT-proBNP>500pg/ml in acute cancer associated VTE predicted death with C-statistic of 0.89 (0.80-0.99). Cancer, NT-proBNP and troponin T also predicted death in patients with negative investigations for VTE. CONCLUSION: Several blood markers are not specific for death from PE and may be surrogate markers of global declining health.
