Management of Acute Appendicitis in Children: Takeaway from Coronavirus Disease-2019, a Perspective of Pediatric Surgeons from South Asia

BackgroundNon-operative treatment (NOT) of pediatric appendicitis as opposed to surgery elicits great debate and is potentially influenced by physician preferences. Owing to the effects of the COVID pandemic on healthcare, the practice of NOT has generally increased by necessity and may, in a post-COVID world, change surgeons perceptions of NOT. ObjectiveThe objective was to determine whether the use of NOT has increased in usage in South Asia and whether these levels of practice would be sustained after the pandemic subside. MethodsA survey was conducted by pediatric surgeons regarding their position, institute, country, number of appendicitis cases managed, and their mode of treatment between identical time periods in 2019 and 2020 (April 1 to August 31). It also directly posed the question as to whether they would continue with the COVID imposed level of NOT after the effect of pandemic diminishes. ResultsA total of 134 responses were collected. A significant increase in the practice of NOT was observed for the entire cohort, although no effect was observed when grouped by country or institute. When grouped by position, seniors increased the practice of NOT the most, while juniors reported the least change. The data suggests that only professors would be inclined to maintain the COVID level of NOT practice after the pandemic. ConclusionsIncreased practice of NOT during the COVID pandemic was observed in South Asia, particularly by senior surgeons. Only professors appear inclined to consider maintaining this increased level of practice in the post-COVID world.

Pediatric surgical services in Bangladesh during the COVID 19 pandemic: How they are affected and how to overcome the backlog, keeping healthcare professionals safe.

BackgroundSevere Acute Respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan, China, has turned into a pandemic. All countries have implemented multiple strategies to try mitigating the losses caused by this virus. To stop the rapid spread of the disease and in compliance with the World Health Organizations social distancing policy, the government of Bangladesh has implemented a number of strategies, one of which is to limit the spread of the virus in hospitals by postponing elective procedures and providing only emergency services in the hospitals. The objective of this survey was to assess the current status of pediatric surgical procedures in different hospitals in Bangladesh and assess the effects of the current restrictions along with their implications in the long run. Materials and MethodsA survey was performed among doctors from public and private hospitals in Bangladesh to evaluate the status on pediatric surgery. ResultsThe results clearly revealed the lack of a significant reduction in doctors exposure to SARS-CoV-2 by postponing elective procedures. ConclusionKeeping in mind the socioeconomic and health care conditions of the country, the author recommend resuming elective surgical procedures.