Evaluation of a Year During the COVID-19 Pandemic in a Private Healthcare Facility: Retrospective Cross-Sectional Study.

AIMS AND OBJECTIVES: To examine the impact of the workforce crisis on healthcare service delivery for a year during the coronavirus disease 2019 (COVID-19) pandemic on healthcare service delivery and hospital economy in a healthcare facility. MATERIALS AND METHODS: An examination was conducted of employees who were issued with a report for incapacity to work due to the pandemic between March 2020 and March 2021. A record was made of the employees' ages, genders, fields of work and lost workdays. The employees were classified as physicians, nursing services, guest services, hotel services, and support services. Diagnoses were made of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on computed tomography (CT) and polymerase chain reaction (PCR) test results. Employees diagnosed with SARS-CoV-2 infection were put into isolation in the hospital during the first months of the pandemic, and treatment was initiated in accordance with the protocols. By contrast, during the last eight months, our personnel who were not indicated for hospitalization completed their treatment in a home isolation setting. According to the Turkish Ministry of Health COVID-19 (SARS-CoV-2 Infection) Scientific Advisory Board Study Guide, the isolation period was initially 14 days, before being reduced to 7-10 days, in line with the revised guide. Employees with at least one negative PCR test result following isolation were allowed to return to work. RESULTS: The study included 575 individuals who were employed at our hospital between March 2020, when the first case was identified in Turkey, and March 2021. Among these employees, 257 were issued with a report for incapacity to work due to COVID-19. Of these, 239 had a positive PCR test result. There were 11 individuals who just had symptoms and/or positive CT findings but a negative PCR test result. There were only seven individuals who were put into isolation due to high-risk contact. The combined lost workdays of the employees totaled 3792. The highest lost workday rate (52%) was in nursing services (1973 days, n = 126). There was no mortality.  Conclusion: Lost workdays due to the pandemic in the midsize healthcare facility severely affected the morale and motivation of both the diagnosed and the remaining employees. Hospital administrations also had difficulties in maintaining the quality and continuity of the services provided.

Polyarteritis nodosa presenting with necrotising appendicitis and hepatic aneurysm rupture.

Polyarteritis nodosa is a necrotizing vasculitis which affects small and medium-sized arteries. The clinical features of the disease vary according to the site and extent of involvement. Aneurysmal dilatation and thrombosis in the arteries of the liver and gastrointestinal tract have been reported in polyarteritis nodosa. However, rupture of the hepatic aneurysm and necrotizing appendicitis due to polyarteritis nodosa are uncommon; indeed a case in which these have occurred together has not been reported to date. In this case report, a patient with necrotizing appendicitis and hepatic aneurysm rupture due to underlying poliarteritis nodasa is presented. Extensive intraabdominal hematoma and appendicitis were treated surgically and complete recovery was achieved.