ABSTRACT
Pandemics are well-known as epidemics that spread globally and cause many illnesses and mortality. Because of globalization, the accelerated occurrence and circulation of new microbes, the infection has emerged and the incidence and movement of new microbes have sped up. Using technological devices to minimize the visit durations, specifying days for handling chronic diseases, subsidy for the staff are the alternatives that can help prevent healthcare systems from collapsing during pandemics. The study aims to define the efficient usage of optimization tools during pandemics to prevent healthcare systems from collapsing. In this study, a new integrated framework with fuzzy information is developed, which attempts to prioritize these alternatives for policymakers. First, rating data are assigned respective fuzzy values using the standard singleton grades. Later, criteria weights are determined by extending Cronbach´s measure to fuzzy context. The measure not only understands data consistency comprehensively, but also takes into consideration the attitudinal characteristics of experts. By this approach, a rational weight vector is obtained for decision-making. Further, an improved Weighted Aggregated Sum Product Assessment (WASPAS) algorithm is put forward for ranking alternatives, which is flexibly considering criteria along with personalized ordering and holistic ordering alternatives. The usefulness of the developed framework is tested with the help of a real case study. Rank values of alternatives when unbiased weights are used is given by 0.741, 0.582, 0.640 with ordering as R 1 â» R 3 â» R 2 . The sensitivity/comparative analysis reveals the impact of the proposed model as useful in selecting the best alternative for the healthcare systems during pandemics.
ABSTRACT
Acute leukemia in children may present with hyperleukocytosis. Symptomatic hyperleukocytosis is a medical emergency that necessitates rapid stabilization of the patient and prompt lowering of the leukocyte count. We report on a patient with intracranial hemorrhage associated with T-cell acute lymphoblastic leukemia with hyperleukocytosis, which is a rare occurrence. A 16-year-old boy with hyperleukocytosis (total white cell count; 398×103/µL) underwent repeated leukapheresis and received supportive treatment until a definite diagnosis of T-cell acute lymphoblastic leukemia was made and chemotherapy was started at 10% of the usual dose. On day 2 of treatment, he had headache, vomiting, and was agitated. Brain magnetic resonance imaging showed bilateral extensive hemispheric and cerebellar punctate areas of hemorrhage and perilesional edema. Chemotherapy intensified to a maximum dose on day 3. If supportive care for tumor lysis syndrome can be promptly provided, initial chemotherapy regimen can immediately be begun at an optimal dose.
