The current pandemic of Corona Virus Disease-2019 (COVID-19) which is caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) has resulted in lockdown in many countries culminating in a major socio-economic crisis globally. COVID-19 can remain asymptomatic and so is crucial for early diagnosis to prevent further spread of this pandemic. Here we highlight the importance of screening asymptomatic patients prior to elective surgery, procedure or scheduled hospital admission. This analysis was done for the month of July 2020 during which 261 asymptomatic people were screened for COVID-19. Out of this, 6 patients (2.29%) were diagnosed to have COVID-19 on nasopharyngeal/ oropharyngeal swabs and subsequently had to delay their elective procedure or surgery. This clearly shows how important it is to screen this cohort of asymptomatic people who could potentially have spread the virus to other patients as well as healthcare professionals.
Asymptomatic Trasmission, the Achilles'Heel of Current Strategies to Control ...Valentina Corona
The editorial discusses an outbreak of COVID-19 at a skilled nursing facility in Washington where asymptomatic transmission played a major role in spreading the virus. Over half of the residents who tested positive were asymptomatic at the time of testing, and live virus was detected in samples from presymptomatic residents days before they developed symptoms. Current strategies relying on symptom screening alone are inadequate for controlling transmission. The authors argue for expanded testing of asymptomatic individuals in high-risk settings like nursing homes to allow for proper isolation and prevent further outbreaks.
Clinical course and risk factors for mortality of adult inpatients with covid...BARRY STANLEY 2 fasd
Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help
clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale
for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
The document provides recommendations from the Saudi Oncology Pharmacy Assembly (SOPA) on managing cancer patients during the COVID-19 pandemic. It discusses 8 recommendations, including delaying adjuvant chemotherapy within recommended timeframes, using extended dosing schedules for certain therapies, and switching intravenous chemotherapy to oral or subcutaneous routes when possible. The recommendations aim to reduce cancer patients' exposure to COVID-19 while continuing essential cancer treatment.
The document discusses the novel coronavirus SARS-CoV-2 (COVID-19) that has become a worldwide threat. It provides an overview of the virus for emergency clinicians, including its epidemiology, prevention, and treatment. Key points are that the case fatality rate is approximately 4% but sampling error may be large, 29% of confirmed cases in China are healthcare workers suggesting alarming nosocomial spread, and gastrointestinal symptoms like diarrhea are common and associated with worse outcomes. Lessons can be learned from early outbreak centers in preparing local healthcare systems for high patient volumes requiring respiratory support.
This document provides a comprehensive review of potential COVID-19 therapeutics and the possibility of repurposing drugs that were candidates for treating SARS-CoV-1. It summarizes the current management strategies for COVID-19 and discusses the pathogenesis and clinical manifestations. The review evaluates similarities between SARS-CoV-1 and SARS-CoV-2 to identify drug candidates from SARS-CoV-1 that may be effective against SARS-CoV-2. It aims to provide insight for developing safe and effective drugs to treat COVID-19.
Coronavirus disease (COVID-19) is a pandemic disease, which has already caused
thousands of causalities and infected several millions of people worldwide. Any technological tool
enabling rapid screening of the COVID-19 infection with high accuracy can be crucially helpful to the
healthcare professionals. The main clinical tool currently in use for the diagnosis of COVID-19 is the
Reverse transcription polymerase chain reaction (RT-PCR), which is expensive, less-sensitive and requires
specialized medical personnel. X-ray imaging is an easily accessible tool that can be an excellent alternative
in the COVID-19 diagnosis. This research was taken to investigate the utility of artificial intelligence (AI)
in the rapid and accurate detection of COVID-19 from chest X-ray images
The document provides guidelines for COVID-19 surveillance and response in Punjab, Pakistan. It outlines case definitions, epidemiology of COVID-19, alert thresholds, and surveillance protocols. It describes laboratory diagnosis, contact tracing, and the roles and responsibilities of the Provincial Disease Surveillance and Response Unit. Guidelines are provided for clinical management, laboratory sample collection and transport, and infection prevention and control.
Asymptomatic Trasmission, the Achilles'Heel of Current Strategies to Control ...Valentina Corona
The editorial discusses an outbreak of COVID-19 at a skilled nursing facility in Washington where asymptomatic transmission played a major role in spreading the virus. Over half of the residents who tested positive were asymptomatic at the time of testing, and live virus was detected in samples from presymptomatic residents days before they developed symptoms. Current strategies relying on symptom screening alone are inadequate for controlling transmission. The authors argue for expanded testing of asymptomatic individuals in high-risk settings like nursing homes to allow for proper isolation and prevent further outbreaks.
Clinical course and risk factors for mortality of adult inpatients with covid...BARRY STANLEY 2 fasd
Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help
clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale
for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
The document provides recommendations from the Saudi Oncology Pharmacy Assembly (SOPA) on managing cancer patients during the COVID-19 pandemic. It discusses 8 recommendations, including delaying adjuvant chemotherapy within recommended timeframes, using extended dosing schedules for certain therapies, and switching intravenous chemotherapy to oral or subcutaneous routes when possible. The recommendations aim to reduce cancer patients' exposure to COVID-19 while continuing essential cancer treatment.
The document discusses the novel coronavirus SARS-CoV-2 (COVID-19) that has become a worldwide threat. It provides an overview of the virus for emergency clinicians, including its epidemiology, prevention, and treatment. Key points are that the case fatality rate is approximately 4% but sampling error may be large, 29% of confirmed cases in China are healthcare workers suggesting alarming nosocomial spread, and gastrointestinal symptoms like diarrhea are common and associated with worse outcomes. Lessons can be learned from early outbreak centers in preparing local healthcare systems for high patient volumes requiring respiratory support.
This document provides a comprehensive review of potential COVID-19 therapeutics and the possibility of repurposing drugs that were candidates for treating SARS-CoV-1. It summarizes the current management strategies for COVID-19 and discusses the pathogenesis and clinical manifestations. The review evaluates similarities between SARS-CoV-1 and SARS-CoV-2 to identify drug candidates from SARS-CoV-1 that may be effective against SARS-CoV-2. It aims to provide insight for developing safe and effective drugs to treat COVID-19.
Coronavirus disease (COVID-19) is a pandemic disease, which has already caused
thousands of causalities and infected several millions of people worldwide. Any technological tool
enabling rapid screening of the COVID-19 infection with high accuracy can be crucially helpful to the
healthcare professionals. The main clinical tool currently in use for the diagnosis of COVID-19 is the
Reverse transcription polymerase chain reaction (RT-PCR), which is expensive, less-sensitive and requires
specialized medical personnel. X-ray imaging is an easily accessible tool that can be an excellent alternative
in the COVID-19 diagnosis. This research was taken to investigate the utility of artificial intelligence (AI)
in the rapid and accurate detection of COVID-19 from chest X-ray images
The document provides guidelines for COVID-19 surveillance and response in Punjab, Pakistan. It outlines case definitions, epidemiology of COVID-19, alert thresholds, and surveillance protocols. It describes laboratory diagnosis, contact tracing, and the roles and responsibilities of the Provincial Disease Surveillance and Response Unit. Guidelines are provided for clinical management, laboratory sample collection and transport, and infection prevention and control.
BJS commission on surgery and perioperative care post covid-19Ahmad Ozair
Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues’ experiences and published evidence. Methods: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.
This document discusses the importance of defining the epidemiology of COVID-19 through various studies and surveillance methods. It outlines key questions about the virus that need answers, such as its full disease severity spectrum, transmissibility, most infectious individuals, and risk factors for severe illness. It recommends approaches like syndromic surveillance, household studies, and community studies. Conducting these simultaneously can help characterize the trajectory and severity of the epidemic to inform response efforts. Early investment in such studies will improve understanding and control of the outbreak.
1) The study assessed predictors of death in severe COVID-19 patients admitted to a care center in Ethiopia by comparing characteristics of patients who died (cases) to those discharged alive (controls).
2) Significant predictors of death were found to be having diabetes, fever at admission, and shortness of breath, while having a fever was associated with being discharged alive.
3) Patients who were older (≥70 years), had pre-existing comorbidities, diabetes, or hypertension were more likely to die from severe COVID-19.
The editorial discusses the Covid-19 outbreak caused by a novel coronavirus. It summarizes a study describing the first 425 cases in Wuhan, China, noting the median age was 59 and higher mortality in the elderly and those with preexisting conditions. While the current fatality rate is around 2%, it may ultimately be closer to seasonal flu if asymptomatic cases are accounted for. The virus has an estimated reproduction number of 2.2, indicating rapid spread. Countries have implemented travel restrictions and should prepare for broader community spread, potentially using social distancing and isolation measures. Research efforts are underway to develop treatments and a vaccine.
This document summarizes a review article on using deep learning techniques to detect and diagnose COVID-19 using radiology images. The review analyzed 37 studies published between November 2019 and July 2020. The studies used deep learning models on CT scans and X-rays to improve the detection and diagnosis of COVID-19 compared to traditional methods. Deep learning was shown to increase sensitivity and specificity by extracting hidden features from radiology images. The models helped address limitations of current diagnostic methods by providing fast, low-cost analysis of images to help identify COVID-19 cases.
This document discusses coronavirus disease 2019 (COVID-19) and its implications for dental practice and infection control. It provides an overview of COVID-19, including its viral etiology, epidemiological characteristics like modes of transmission and incubation period, clinical manifestations, diagnosis and treatment. It notes the risk of cross-infection in dental settings and the need for strict infection control protocols.
Guidance isth _management_of_coagulopathy_in_covid-19 Dr. Freddy Flores Malpa...Freddy Flores Malpartida
1) This document provides interim guidance from the International Society on Thrombosis and Haemostasis (ISTH) on recognizing and managing coagulopathy in COVID-19.
2) It recommends measuring D-dimers, prothrombin time, and platelet count in all COVID-19 patients to help stratify risk, with increased D-dimers indicating a higher risk of severe illness.
3) For hospitalized COVID-19 patients, the guidance suggests regular monitoring of D-dimers, prothrombin time, platelet count, and fibrinogen to identify worsening coagulopathy, which correlates with poorer outcomes. More aggressive care may be warranted for patients with worsening markers.
This document provides an overview of the 2019 novel coronavirus (2019-nCoV) outbreak that began in Wuhan, China in December 2019. It describes the clinical presentation and management of 2019-nCoV, compares it to other coronaviruses like SARS and MERS, and outlines current WHO guidance on case definitions, investigations and infection control.
This document discusses the COVID-19 pandemic and potential treatments for the disease. It notes that COVID-19 has led to a national emergency in the US with significant health and economic impacts. Currently, there is no cure for COVID-19 and the disease spectrum varies from asymptomatic to severe cases requiring ICU care. The document explores the pathogenesis of the virus and notes that a "cytokine storm" may be a key driver of organ damage. It reviews several potential treatments under investigation including vaccines, antiviral medications, and stem cell therapies. It highlights reports from China and Italy using expanded umbilical cord mesenchymal stem cells (UC-MSCs) to treat COVID-19 and argues they may be considered for compassionate
This document discusses the impact of the COVID-19 pandemic on cancer care and management based on data from Asia and Europe. Key points include:
1) Cancer care has been modified to protect patients and health care workers from COVID-19, while attempting to maintain cancer diagnosis, therapy, and research.
2) Diagnosing COVID-19 in cancer patients is challenging due to overlapping symptoms, and PCR testing and chest CT are recommended.
3) Early data from China found cancer patients with COVID-19 had worse outcomes, especially those receiving recent anticancer treatments or with lung abnormalities on CT scans.
4) Both the direct effects of COVID-19 infection and indirect impacts of health system breakdown on cancer care
Knowledge and Attitude of Prosthodontic Post Graduates on COVID 19: A Qualita...DrHeena tiwari
This document summarizes a study that surveyed 60 prosthodontic post-graduate students regarding their knowledge and attitudes about COVID-19. The results found that 80% felt they received adequate training on COVID-19 prevention and control, while over 60% were confident in managing patients with required precautions. However, only around 63% knew who to contact if they encountered a suspected COVID-19 patient. Nearly all (96.6%) agreed that the pandemic has affected their academic activities. The study concludes that understanding aerosol transmission in dentistry can help identify risks and improve practices to prevent disease spread.
The value of real-world evidence for clinicians and clinical researchers in t...Arete-Zoe, LLC
In the midst of a rapidly spreading global pandemic, real-world evidence can offer invaluable insight into the most promising treatments, risk factors, and not only predict but suggest how to improve outcomes. Despite overwhelming news coverage, significant knowledge gaps regarding COVID-19 persist. The current uncertainties regarding incidence and the case fatality rate can only be addressed by widespread testing. But the paucity of testing, and diversity of approaches implemented in different countries, particularly among the general asymptomatic public, perpetuates a lack of understanding about spread and infectivity. The essential indicators that would describe the pandemic more accurately can be obtained using real-world data (RWD). To that purpose, we designed a data collection tool to collect data from hospitals that treat COVID-19 patients. The captured data will enhance our understanding of the COVID-19 pandemic, identify risk factors relevant for triage, relate to other similar seasonal infections and gain insight into the safety and efficacy of experimental and off-label therapies. Knowledge derived from a focused data collection effort will enable clinicians to adjust rapidly clinical protocols and discontinue interventions that turn out to be ineffective or harmful. By deploying our elegantly designed survey to capture routine clinical indicators, we avoid placing an additional burden on practitioners. Systematically generating real-world evidence can decrease the time to insight compared to randomized clinical trials, improving the odds for patients in rapidly changing conditions.
Slide deck cancer care during covid 19 pandemicmadurai
This document provides guidance for cancer care during the COVID-19 pandemic from several medical organizations. It discusses that cancer patients may be more susceptible to COVID-19 and have poorer outcomes. It recommends postponing non-urgent visits and elective surgeries, continuing critical cancer treatments when possible, and increasing telehealth to reduce infections. Safety measures like PPE and social distancing are crucial to protect staff and patients. Treatment should be individualized based on risk factors.
The Efficacy and Safety of Convalescent Plasma for COVID-19 Patients: A Meta-...semualkaira
Convalescent plasma (CP) was demonstrated
promising benefit for clinical practice involved in efficacy and
safety in previous coronavirus pandemics, however, the efficacy of
CP from COVID-19 sufferers are still controversial and unascertainable based on current randomized controlled trials (RCTs). The
urgent needs for affirmative replies on the efficacy and safety of
CP for COVID-19 patients must be developed as soon as possible.
Review of advisories and contingency plan for covid 19 pandemic in radiothera...Anil Gupta
The document reviews advisories and contingency plans for radiotherapy facilities during the COVID-19 pandemic. It summarizes guidelines from various radiation oncology societies on risk stratification of cancer patients, prioritization of treatments, and treatment modifications. It also discusses specific recommendations for tumor sites like head and neck, breast, and gynecological cancers. Screening of patients and staff, treatment scheduling and coordination between departments is emphasized. Treatment principles of remote, avoid, defer, and shorten treatments are recommended to balance cancer and COVID-19 risks.
Application of ordinal logistic=China.pdfHenokBuno
This study aimed to identify determinants of illness severity for COVID-19 patients in China. Medical records from 598 COVID-19 patients admitted to four hospitals in China between January and March 2020 were analyzed. Patients were divided into moderate (n=400), severe (n=85), and critical (n=113) illness groups based on their condition. Ordinal logistic regression was used to identify predictors of more severe illness. The analysis found that older age, hypertension, abnormal liver enzymes and cardiac markers, longer time from illness onset to diagnosis and admission were associated with increased risk of more severe illness.
Factores de riesgo para reingreso temprano despues de hospitalizacion por cov...MelendiNavarro
The study assessed the incidence and risk factors for early readmission (within 60 days) in patients hospitalized for COVID-19. Of the 629 patients followed, 34 (5.4%) were readmitted, with a median time to readmission of 12 days. Main reasons for readmission were respiratory worsening (38.2%), decompensation of a previous disease (35.3%), or infectious complications (17.6%). Prior diagnosis of heart failure, length of stay over 13 days, treatment with corticosteroids, and developing pulmonary thromboembolism were identified as risk factors statistically associated with early readmission.
• Much is still unknown regarding the markers of disease and recovery process for SARS-CoV-2, including if and what immunity arises and which tests or markers can be useful in assessing immunity status
• A multi-phased plan is required to reopen the economy post-COVID-19, with significantly daily testing capacity (millions) required at all stages
o Challenges with scientific validation, regulatory, manufacturing, and ongoing logistics must be overcome to successfully ramp up testing capacities in the US
o Hundreds of molecular and serology tests are now available, but many have limited accuracy (high false positive/negative rates) due to the rapid development and lack of validation of these tests
• In this edition of Demystifying COVID-19 Testing, we highlight what is required now and in the future to move to a “new normal” and why it is challenging to get this testing up and running at volumes needed in the US
The document discusses the risks of COVID-19 infection in pregnant women based on a study of nine cases in China. It finds that the clinical characteristics and outcomes for pregnant women with COVID-19 were less severe than those seen in pregnant women with SARS. However, more research is still needed given the small number of cases. It recommends pregnant women and newborns be considered at-risk populations and that prevention and management strategies be strengthened.
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...suppubs1pubs1
This study aimed to determine if the extent of lung involvement on CT scans can predict short-term outcomes in COVID-19 patients. The study analyzed 253 COVID-19 patients in China, 63 of whom died in the hospital. Non-survivors were older, more often male, and had more preexisting health conditions compared to survivors. On CT scans, non-survivors had higher lung involvement scores, and were more likely to have findings like bronchial dilation and diffuse opacity. Higher lung involvement scores, lower oxygen levels, bacterial coinfection, and preexisting conditions were associated with higher odds of death based on statistical analysis. The study suggests that thoroughly assessing CT scans together with patient details may help predict outcomes and optimize COVID
Features of Radiation-Induced Thyroid Cancersuppubs1pubs1
A significant part of research on Thyroid Cancer (TC) incidence changes after nuclear disasters concerns mainly the dose effects on this oncopathology, as well as radiation epidemiology. Meanwhile, the features of this disease like gender characteristics of the stages and histological forms of cancer are of particular interest. The incidence and risks of various stages and forms of TC were analyzed in the present study
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BJS commission on surgery and perioperative care post covid-19Ahmad Ozair
Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues’ experiences and published evidence. Methods: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.
This document discusses the importance of defining the epidemiology of COVID-19 through various studies and surveillance methods. It outlines key questions about the virus that need answers, such as its full disease severity spectrum, transmissibility, most infectious individuals, and risk factors for severe illness. It recommends approaches like syndromic surveillance, household studies, and community studies. Conducting these simultaneously can help characterize the trajectory and severity of the epidemic to inform response efforts. Early investment in such studies will improve understanding and control of the outbreak.
1) The study assessed predictors of death in severe COVID-19 patients admitted to a care center in Ethiopia by comparing characteristics of patients who died (cases) to those discharged alive (controls).
2) Significant predictors of death were found to be having diabetes, fever at admission, and shortness of breath, while having a fever was associated with being discharged alive.
3) Patients who were older (≥70 years), had pre-existing comorbidities, diabetes, or hypertension were more likely to die from severe COVID-19.
The editorial discusses the Covid-19 outbreak caused by a novel coronavirus. It summarizes a study describing the first 425 cases in Wuhan, China, noting the median age was 59 and higher mortality in the elderly and those with preexisting conditions. While the current fatality rate is around 2%, it may ultimately be closer to seasonal flu if asymptomatic cases are accounted for. The virus has an estimated reproduction number of 2.2, indicating rapid spread. Countries have implemented travel restrictions and should prepare for broader community spread, potentially using social distancing and isolation measures. Research efforts are underway to develop treatments and a vaccine.
This document summarizes a review article on using deep learning techniques to detect and diagnose COVID-19 using radiology images. The review analyzed 37 studies published between November 2019 and July 2020. The studies used deep learning models on CT scans and X-rays to improve the detection and diagnosis of COVID-19 compared to traditional methods. Deep learning was shown to increase sensitivity and specificity by extracting hidden features from radiology images. The models helped address limitations of current diagnostic methods by providing fast, low-cost analysis of images to help identify COVID-19 cases.
This document discusses coronavirus disease 2019 (COVID-19) and its implications for dental practice and infection control. It provides an overview of COVID-19, including its viral etiology, epidemiological characteristics like modes of transmission and incubation period, clinical manifestations, diagnosis and treatment. It notes the risk of cross-infection in dental settings and the need for strict infection control protocols.
Guidance isth _management_of_coagulopathy_in_covid-19 Dr. Freddy Flores Malpa...Freddy Flores Malpartida
1) This document provides interim guidance from the International Society on Thrombosis and Haemostasis (ISTH) on recognizing and managing coagulopathy in COVID-19.
2) It recommends measuring D-dimers, prothrombin time, and platelet count in all COVID-19 patients to help stratify risk, with increased D-dimers indicating a higher risk of severe illness.
3) For hospitalized COVID-19 patients, the guidance suggests regular monitoring of D-dimers, prothrombin time, platelet count, and fibrinogen to identify worsening coagulopathy, which correlates with poorer outcomes. More aggressive care may be warranted for patients with worsening markers.
This document provides an overview of the 2019 novel coronavirus (2019-nCoV) outbreak that began in Wuhan, China in December 2019. It describes the clinical presentation and management of 2019-nCoV, compares it to other coronaviruses like SARS and MERS, and outlines current WHO guidance on case definitions, investigations and infection control.
This document discusses the COVID-19 pandemic and potential treatments for the disease. It notes that COVID-19 has led to a national emergency in the US with significant health and economic impacts. Currently, there is no cure for COVID-19 and the disease spectrum varies from asymptomatic to severe cases requiring ICU care. The document explores the pathogenesis of the virus and notes that a "cytokine storm" may be a key driver of organ damage. It reviews several potential treatments under investigation including vaccines, antiviral medications, and stem cell therapies. It highlights reports from China and Italy using expanded umbilical cord mesenchymal stem cells (UC-MSCs) to treat COVID-19 and argues they may be considered for compassionate
This document discusses the impact of the COVID-19 pandemic on cancer care and management based on data from Asia and Europe. Key points include:
1) Cancer care has been modified to protect patients and health care workers from COVID-19, while attempting to maintain cancer diagnosis, therapy, and research.
2) Diagnosing COVID-19 in cancer patients is challenging due to overlapping symptoms, and PCR testing and chest CT are recommended.
3) Early data from China found cancer patients with COVID-19 had worse outcomes, especially those receiving recent anticancer treatments or with lung abnormalities on CT scans.
4) Both the direct effects of COVID-19 infection and indirect impacts of health system breakdown on cancer care
Knowledge and Attitude of Prosthodontic Post Graduates on COVID 19: A Qualita...DrHeena tiwari
This document summarizes a study that surveyed 60 prosthodontic post-graduate students regarding their knowledge and attitudes about COVID-19. The results found that 80% felt they received adequate training on COVID-19 prevention and control, while over 60% were confident in managing patients with required precautions. However, only around 63% knew who to contact if they encountered a suspected COVID-19 patient. Nearly all (96.6%) agreed that the pandemic has affected their academic activities. The study concludes that understanding aerosol transmission in dentistry can help identify risks and improve practices to prevent disease spread.
The value of real-world evidence for clinicians and clinical researchers in t...Arete-Zoe, LLC
In the midst of a rapidly spreading global pandemic, real-world evidence can offer invaluable insight into the most promising treatments, risk factors, and not only predict but suggest how to improve outcomes. Despite overwhelming news coverage, significant knowledge gaps regarding COVID-19 persist. The current uncertainties regarding incidence and the case fatality rate can only be addressed by widespread testing. But the paucity of testing, and diversity of approaches implemented in different countries, particularly among the general asymptomatic public, perpetuates a lack of understanding about spread and infectivity. The essential indicators that would describe the pandemic more accurately can be obtained using real-world data (RWD). To that purpose, we designed a data collection tool to collect data from hospitals that treat COVID-19 patients. The captured data will enhance our understanding of the COVID-19 pandemic, identify risk factors relevant for triage, relate to other similar seasonal infections and gain insight into the safety and efficacy of experimental and off-label therapies. Knowledge derived from a focused data collection effort will enable clinicians to adjust rapidly clinical protocols and discontinue interventions that turn out to be ineffective or harmful. By deploying our elegantly designed survey to capture routine clinical indicators, we avoid placing an additional burden on practitioners. Systematically generating real-world evidence can decrease the time to insight compared to randomized clinical trials, improving the odds for patients in rapidly changing conditions.
Slide deck cancer care during covid 19 pandemicmadurai
This document provides guidance for cancer care during the COVID-19 pandemic from several medical organizations. It discusses that cancer patients may be more susceptible to COVID-19 and have poorer outcomes. It recommends postponing non-urgent visits and elective surgeries, continuing critical cancer treatments when possible, and increasing telehealth to reduce infections. Safety measures like PPE and social distancing are crucial to protect staff and patients. Treatment should be individualized based on risk factors.
The Efficacy and Safety of Convalescent Plasma for COVID-19 Patients: A Meta-...semualkaira
Convalescent plasma (CP) was demonstrated
promising benefit for clinical practice involved in efficacy and
safety in previous coronavirus pandemics, however, the efficacy of
CP from COVID-19 sufferers are still controversial and unascertainable based on current randomized controlled trials (RCTs). The
urgent needs for affirmative replies on the efficacy and safety of
CP for COVID-19 patients must be developed as soon as possible.
Review of advisories and contingency plan for covid 19 pandemic in radiothera...Anil Gupta
The document reviews advisories and contingency plans for radiotherapy facilities during the COVID-19 pandemic. It summarizes guidelines from various radiation oncology societies on risk stratification of cancer patients, prioritization of treatments, and treatment modifications. It also discusses specific recommendations for tumor sites like head and neck, breast, and gynecological cancers. Screening of patients and staff, treatment scheduling and coordination between departments is emphasized. Treatment principles of remote, avoid, defer, and shorten treatments are recommended to balance cancer and COVID-19 risks.
Application of ordinal logistic=China.pdfHenokBuno
This study aimed to identify determinants of illness severity for COVID-19 patients in China. Medical records from 598 COVID-19 patients admitted to four hospitals in China between January and March 2020 were analyzed. Patients were divided into moderate (n=400), severe (n=85), and critical (n=113) illness groups based on their condition. Ordinal logistic regression was used to identify predictors of more severe illness. The analysis found that older age, hypertension, abnormal liver enzymes and cardiac markers, longer time from illness onset to diagnosis and admission were associated with increased risk of more severe illness.
Factores de riesgo para reingreso temprano despues de hospitalizacion por cov...MelendiNavarro
The study assessed the incidence and risk factors for early readmission (within 60 days) in patients hospitalized for COVID-19. Of the 629 patients followed, 34 (5.4%) were readmitted, with a median time to readmission of 12 days. Main reasons for readmission were respiratory worsening (38.2%), decompensation of a previous disease (35.3%), or infectious complications (17.6%). Prior diagnosis of heart failure, length of stay over 13 days, treatment with corticosteroids, and developing pulmonary thromboembolism were identified as risk factors statistically associated with early readmission.
• Much is still unknown regarding the markers of disease and recovery process for SARS-CoV-2, including if and what immunity arises and which tests or markers can be useful in assessing immunity status
• A multi-phased plan is required to reopen the economy post-COVID-19, with significantly daily testing capacity (millions) required at all stages
o Challenges with scientific validation, regulatory, manufacturing, and ongoing logistics must be overcome to successfully ramp up testing capacities in the US
o Hundreds of molecular and serology tests are now available, but many have limited accuracy (high false positive/negative rates) due to the rapid development and lack of validation of these tests
• In this edition of Demystifying COVID-19 Testing, we highlight what is required now and in the future to move to a “new normal” and why it is challenging to get this testing up and running at volumes needed in the US
The document discusses the risks of COVID-19 infection in pregnant women based on a study of nine cases in China. It finds that the clinical characteristics and outcomes for pregnant women with COVID-19 were less severe than those seen in pregnant women with SARS. However, more research is still needed given the small number of cases. It recommends pregnant women and newborns be considered at-risk populations and that prevention and management strategies be strengthened.
Similar to Should All Patients Having Planned Procedures or Surgeries Be Tested for COVID-19? (20)
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...suppubs1pubs1
This study aimed to determine if the extent of lung involvement on CT scans can predict short-term outcomes in COVID-19 patients. The study analyzed 253 COVID-19 patients in China, 63 of whom died in the hospital. Non-survivors were older, more often male, and had more preexisting health conditions compared to survivors. On CT scans, non-survivors had higher lung involvement scores, and were more likely to have findings like bronchial dilation and diffuse opacity. Higher lung involvement scores, lower oxygen levels, bacterial coinfection, and preexisting conditions were associated with higher odds of death based on statistical analysis. The study suggests that thoroughly assessing CT scans together with patient details may help predict outcomes and optimize COVID
Features of Radiation-Induced Thyroid Cancersuppubs1pubs1
A significant part of research on Thyroid Cancer (TC) incidence changes after nuclear disasters concerns mainly the dose effects on this oncopathology, as well as radiation epidemiology. Meanwhile, the features of this disease like gender characteristics of the stages and histological forms of cancer are of particular interest. The incidence and risks of various stages and forms of TC were analyzed in the present study
Case of Rare Entity - Parry-Romberg Syndromesuppubs1pubs1
Parry-Romberg syndrome (PRS), also known as progressive facial hemyatrophy is a rare clinical entity with prevalence of 1 case on 250 000 of general population [1-3]. It was first described by C.Parry in 1825 and – later – by M.Romberg in 1846 [1,2]. Course of this syndrome ends in atrophy of subcutaneous fat with skin changes, en coupe de sabre sign, in some cases facial muscles wasting, ophthalmic and nervous systems involvement [4-9].
Primary Epithelioid Hemangioendothelioma of the Kidney Pelvissuppubs1pubs1
Epithelioid hemangioendothelioma is a rare type of angiogenic tumor composed of Epithelioid endothelial cells, which is characterized by potentially malignancy and metastasis potential. It is mainly seen in adults, while very rare in children. Tumor can be found in soft tissue or other parts,such as liver and lung, however it is rare in the kidneys.
Non-Operative Management in Oesophagic Tear Due to Sengstaken Tubesuppubs1pubs1
This case report describes the non-operative management of a large oesophageal tear in a 79-year-old man. After a Sengstaken tube was inserted to treat upper gastrointestinal bleeding, a CT scan showed the gastric balloon inflated in the oesophagus. Endoscopy then revealed a 10 cm oesophageal tear. Due to the early diagnosis, the patient's general condition, and limited contamination, endoscopic stenting was used instead of surgery. Two metal stents were placed and removed after two weeks with complete healing of the tear. The patient was discharged four days later with no signs of perforation, demonstrating that selected cases of large oesophageal tears can be successfully treated with non-operative management including endoscopic
miRNAs: Role of Post-Transcriptional Regulation of NLRP3 Inflammasomes in The...suppubs1pubs1
Inflammasomes are multiprotein complexes consist of having nucleotide binding domain and leucine rich repeat with the pyrin and HIN domain family. The NLRP3 inflammasome one of these members of family. It is activated upon sensing microbes or danger associated molecular pattern. NLRP3 inflammasome activation leads to activation of caspase 1 which is in turn activate proinflmmatory cytokines/chemomokines.
Bowel Perforation in COVID-19 Patient Treated With Dexamethasonesuppubs1pubs1
The treatment and management for COVID-19 continues to evolve as we have gained more experience with infected patients over the past year of this pandemic. The goal of the medical team is to optimize the care and balance the risk and benefits of each intervention and treatment. Currently, guidelines include starting dexamethasone therapy for patients requiring supplemental oxygen or mechanical ventilation. However, each treatment and intervention comes with risks. Here, we discuss the case of a 76-year old male who presented to the ED with dyspnea and cough after being diagnosed with COVID-19 three days prior.
Megacalycosis with Ipsilateral Segmental Mega-Ureter - A Rare Entitysuppubs1pubs1
Congenital megacalycosis of Pugivert is a rare clinical entity which denotes presence of dilated calyces most often without any functional abnormality and Segmental mega-ureter implies large, focal segmental ureteral dilatation producing a distorted ureter. Megacalycosis with an ipsilateral segmental mega-ureter is a rarer association of which only a few cases have been reported after its original description. It is diagnosed incidentally or the patient might present with urinary tract infection or calculus formation and usually respond to conservative management.
Advances Perspectives in Syncytin-1 From Biology to Clinical Practicessuppubs1pubs1
Syncytin-1 serves as an enveloped membrane glycoprotein encoded from env gene and expressed in placenta specifically as HERV-W member product of human genome playing an essential role in cell fusion process of from trophoblast to syncytiotrophoblast during each individual pregnancy. It is widely maintained that unusual expressive levels of syncytin-1 have close relationships to obstetrical syndromes such as pre-eclampsia as a typical gestational hypertension symptom. In this review, correlations between syncytin-1 and related diseases are in detailed discussions.
Benign Metastasizing Leiomyoma: A Case Reportsuppubs1pubs1
Metastasizing benign leiomyoma is an extrauterine smooth muscle tumour. Leiomyoma in spine is extremely rare. We report a case of a 47-year-old female with benign leiomyoma metastasizing to the spine. To our knowledge no case of benign leiomyoma metastasizing to the spine has been reported before. Magnetic Resonance Imaging (MRI) revealed C6, C7 vertebral involvement, T2, T4, T7, T8, T11, L2, L3, L4, L5 moderate spinal canal stenosis and cord impingement and cord compression at T12 level. She also presented with growth over her right elbow and psoas muscle.
Clinical Features and general Symptoms of COVID-19 Illness and Influenza: Dif...suppubs1pubs1
The document summarizes the clinical features and symptoms of COVID-19 and influenza. While the viruses have similarities, there are differentiating factors. COVID-19 is caused by SARS-CoV-2 and has an incubation period of up to 14 days, with symptoms like fever, dry cough, and loss of taste and smell. Influenza is caused by influenza viruses and has a shorter incubation period of 5 days, with symptoms like fever, fatigue, and dry cough but no loss of taste or smell. Pneumonia is a common complication of both but presents differently based on the causing virus. Laboratory tests are needed to definitively diagnose the infection.
Meigs syndrome is characterized by the presence of hydrothorax and ascites in the presence of solid, benign ovarian tumors that resolve after tumor removal. Pseudo-Meigs syndrome is defined as hydrothorax and ascites associated with pelvic tumors other than those identified in Meigs syndrome.
The Prevalence of Tuberculosis Among Internal Displaced Persons In Alsalam Ca...suppubs1pubs1
Tuberculosis (TB) continues to be one of the leading causes of death worldwide, and the largest prevalence of this disease is in Asia (59%) and Africa (26%).
Zeehan Hospital, Zeehan, Tasmania. The First Forty Years, During The Mining B...suppubs1pubs1
The clinical details of the patients admitted to the Zeehan Hospital in Tasmania, Australia from the opening date of the hospital in 1894 for the subsequent forty years during the peak of the mining period in Zeehan are presented. Major features are the frequent but uncompensated industrial fatalities and accidents, outbreaks of infectious diseases in the pre-antibiotic era and the damage to individuals and the environment from severe metal pollution, yet an apparent silence about the issue of clinical lead poisoning.
Zeehan Hospital, Zeehan, Tasmania. The First Forty Years, During The Mining B...suppubs1pubs1
The clinical details of the patients admitted to the Zeehan Hospital in Tasmania, Australia from the opening date of the hospital in 1894 for the subsequent forty years during the peak of the mining period in Zeehan are presented. Major features are the frequent but uncompensated industrial fatalities and accidents, outbreaks of infectious diseases in the pre-antibiotic era and the damage to individuals and the environment from severe metal pollution, yet an apparent silence about the issue of clinical lead poisoning.
Resuming Business in A COVID Normal Environmentsuppubs1pubs1
Although pandemics of its scale and geographical coverage are not unprecedented as widely claimed, coronavirus continues to pose novel and complex challenges to governments, businesses, and individuals. Governments had and continue to have obligations to respond speedily with both health and economic policies to prevent irrevocable damages to their respective economies and sovereignties-some more successful than others.
Reconstruction of The Hand in Congenital Polydactylysuppubs1pubs1
This document describes a new surgical method for treating congenital polydactyly (extra fingers) of the hand in a 1.5 year old child. The method involves removing an underdeveloped extra finger but preserving its skin. The bones of a more functional extra finger are then transposed to the distal metacarpal bone and fixed with wiring. The preserved skin from the removed finger is used to form the full volume of the new thumb, ensuring good hand function and appearance. The results were an effective grip and aesthetically pleasing thumb reconstruction using tissues from the removed finger.
Adenylosuccinate Lyase Deficiency (ADSL) and Report the First Case from Iransuppubs1pubs1
Adenylosuccinate lyase deficiency is a neurometabolic disorder associated by accumulation of succinylpurines in body fluids that causes encephalopathy. It’s a rare neurological dysfunction with psychomotor retardation and epilepsy. We introduce here a five-and-a-half-year-old patient who was referred to the Neurology Department, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
It was Kepler who first asked whether contra-globally bounded homomorphisms can be classified. Hence unfortunately, we cannot assume that M is differentiable and pointwise generic. Therefore this reduces the results of [9] to a well-known result of Sylvester [32, 21]. Now it would be interesting to apply the techniques of [31] to associative, naturally Euclid elements. Thus a central problem in elliptic calculus is the derivation of countable monoids.
A New Radically Improved Model of the Circulation with Important Clinical Imp...suppubs1pubs1
Blood flow is normally controlled by individual tissues, providing the appropriate rate of oxygen delivery (DO2 ). Cardiac output is the result of the addition of all tissue blood flows. Cardiac output is therefore controlled at the tissues, not heart or brain. Complications in anesthesia are from lowered DO2 due to venous relaxation lowering arterial pressure. Arterial blood pressure depends on arterial volume, in turn depending on total blood volume and venous volume control. The usual idea, arterial pressure is controlled by arteriolar tone in therefore incorrect. The bases of these assertions, are outlined in sections 1 and 2, and implications in section 3. Further interesting surgical phenomena receive attention, including carotid endarterectomy effects on hypertension, and potential improvement in treatment of myocardial ischemia.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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2. After a formal approval by the institutional review board at
Primary Health Care Corporation (PHCC - Ref No. PHCC/
DCR/2020/08/091), a retrospective observational data study was
conducted at Rawdat-Al-Khail Health Centre (RAK-HC), which
is a government designated COVID centre in Qatar, for the month
of July 2020. We analyzed the medical e-records of a cohort of
asymptomatic people who had a screening Reverse-Transcrip-
tion-Polymerase-Chain-Reaction (RT-PCR) test for COVID-19 as
a mandatory requirement prior to any planned procedures, sur-
gery or scheduled hospital admissions. Demographic and clinical
data were obtained from the medical e-records of this cohort of
people after all identifiable variables were removed as per the re-
search-study requirements.
Patients were instructed by hospitals to get a COVID-19 RT-PCR
Negative Report, 72 hours prior to the procedure or planned sur-
gery. During this one-month period, 261 asymptomatic people
were screened for COVID-19 by RT-PCR testing of samples ob-
tained from nasopharyngeal and oropharyngeal swabs by trained
medical staff as per international standards of testing. The sam-
ples were processed at the testing laboratory in Hamad Hospital in
Doha, Qatar, which is a tertiary level hospital.
4. Results
Amongst the tested population, 103 patients (39.47%) were males
and 158 patients (60.53%) were females. The results showed that
6 patients (2.29 %) were found to be Covid positive, and hence
had to cancel their planned procedure or elective surgery. Of the
6 positive patients, the distribution of positive patients was equal
amongst males and females- 50% each of males and females (Fig-
ure1). 245 people were fortunately Covid negative and went ahead
as planned for their procedure or elective surgery (Table1). 10 pa-
tients (3.83%) had inconclusive results and were instructed to re-
peat the test as per protocol. These patients could be potentially
positive which could then probably increase the number of positive
patients to 16 (6.13%).
Table 1: Gender based analysis of results of asymptomatic people prior to
elective procedure or surgery
Gender
Total
Male Female
Positive
Actual number of patients 3 3 6
% within Diagnostic 50% 50% 100.00%
% within Gender 3.03% 2.05% 2.29%
% of Total 1.14% 1.14% 2.29%
Negative
Actual number of patients 99 146 245
% within Diagnostic 40.41% 59.59% 100.00%
% within Gender 96.11% 92.40% 93.86%
% of Total 37.93% 55.93% 93.86%
Inconclusive
Actual number of patients 4 6 10
% within Diagnostic 40% 60% 100.00%
% within Gender 3.88% 3.79% 3.83%
% of Total 1.53% 2.29% 3.83%
Figure1: Graph showing male and female distribution of patients
5. Discussion
COVID-19 is a global pandemic which can result in severe infec-
tion leading to respiratory failure and is associated with significant
morbidity and mortality. COVID-19 has features of rapid trans-
mission, high infectivity, insidious onset and prolonged incubation
period of up to 14 days on average. Therefore, timely diagnosis of
this potentially life-threatening condition is crucial. RT-PCR test-
ing is considered as the “gold standard” for clinical diagnosis of
COVID-19 [2]. The case fatality rate for COVID-19 tends to be
much higher than the typical influenza seasonal viral illness, and
disproportionately affects the elderly population and patients with
major cardiac or pulmonary co-morbidities [3].
During initial days of COVID-19 pandemic, screening patients
prior to surgery or procedures was done by contact history and
symptom-based screening questionnaires. However, as communi-
ty spread of this virus is well recognized and established, relying
purely on contact history and symptoms to screen asymptomatic
pre-procedural and surgical patients is no longer adequate and is
in fact unsafe too.
The R0
value represents the average number of people infected by
one infectious individual and shows how quickly the virus can
spread. The R0
value of COVID-19 is between 2-3 which is very
high and therefore it is vital to mitigate further spread of this virus
and reduce case fatality rate [4]. If the number of COVID-19 posi-
tive patients picked up in this cohort were extrapolated taking into
consideration the R0
value, one positive patient could have possi-
bly infected 406 people in a month’s duration which would have
equated to 2436 positive cases from the 6 cases who were initial-
COVID-19 confirmed patients in this cohort [5], and regrettably
the majority of them could potentially have been health care pro-
fessionals treating those COVID positive patients.
Our goal as clinicians is to not only help control the pandemic
in the general population but also to prevent infection amongst
Volume 2 | Issue 2
ajsccr.org 2
3. healthcare professionals who provide essential services to patients.
The testing of patients for SARS-CoV-2 has been proposed as a
mechanism for protecting patients and healthcare workers during
the current COVID-19 pandemic [6]. Performing surgery or any
other procedure without excluding COVID-19 increases the risk
of COVID-19 contamination in the hospital exposing patients and
healthcare staff and putting them at high risk of contracting the
virus [6].
A recent publication from the international Covid Surg Collab-
orative found that surgical patients already infected with SARS-
CoV-2 infection had a postoperative pulmonary complication rate
of 51.2%, which was further associated with a much higher mor-
tality [7]. Isolation is almost impossible to practice in the operating
room because an anesthetist has to stand very close to the patient
during intubation procedure, which can exponentially increase the
risk of exposure to aerosols containing COVID-19. The virus can
also spread through biological fluids which can compromise the
safety of all the healthcare professionals in the surgical environ-
ment [8].
During this COVID-19 pandemic, it is advisable to postpone
non-urgent procedures and promote non-operative treatments in
order to delay or avoid the need for surgery although this might
not always be possible [9]. Confirmed and suspected patients of
COVID-19 carry a higher risk of severe events needing admission
to the critical care unit, mechanical ventilation support and even
death [10].
6. Limitations
A systematic review of 39 studies has revealed that 29 of those have
suggested screening for all surgical patients prior to surgery to rule
out COVID-19 [11]. However, it is important to remember that
there is the possibility of false negative results with RT-PCR tests
[12]. In addition, the test detects presence of virus at a single point
in time, and if a patient is still in the early phase of incubation, the
virus may not be detected. Both of these factors may falsely reas-
sure healthcare workers by a negative RT-PCR test result. Despite
this, it is now mandatory in most places to screen patients prior to
any procedure, surgery or elective hospital admission. Several In-
ternational reputed healthcare organizations including the Amer-
ican College of Surgeons have recommended screening patients
before surgery [13].
7. Conclusion
Though there are several reports which claim efficacy of different
drugs and vaccines against COVID-19, none are effective and com-
pletely safe yet, to receive approval by regulatory authorities [14].
With rising number of COVID-19 cases all over the world, this
is a desperate time for infection prevention and control, both for
the safety of patients and healthcare professionals alike. Hence we
propose that the identification of infected individuals is extremely
important to prevent the spread of this virus not only to protect
healthcare professionals and other people but also to identify those
who are likely to be at risk from disease-associated complications.
References:
1. Chau NVV, Lam VT, Dung NT, Yen LM, Minh NNQ, Ngoc NM, et
al. The natural history and transmission potential of asymptomatic
SARS-CoV-2 infection. medRxiv. 2020; ciaa711.
2. Esbin MN, Whitney ON, Chong S, Maurer A, Darzacq X, Tjian R.
2020. Overcoming the bottleneck to widespread testing: A rapid
review of nucleic acid testing approaches for COVID-19 detection.
RNA. 2020; 26: 771-83.
3. Kharasch ED, Jiang Y. Novel coronavirus 2019 and anesthesiology.
Anesthesiology: The Journal of the American Society of Anesthesi-
ologists. 2020; 132: pp.1289-91.
4. Viceconte, G. and Petrosillo, N. COVID-19 R0: Magic number or
conundrum?. Infectious disease reports. 2020; 12: 8516.
5. Abbasi K. The scandals of covid-19. 2020.
6. Schlosser M, Signorelli H, Gregg W, Korwek K, Sands K. COVID-19
testing processes and patient protections for resumption of elective
surgery. The American Journal of Surgery. 2020; S0002-9610: 30438-
4.
7. Nepogodiev D, Glasbey JC, Li E, Omar OM, Simoes JF, Abbott TE,
et al. Mortality and pulmonary complications in patients undergoing
surgery with perioperative SARS-CoV-2 infection: an international
cohort study. The Lancet. 2020; 396: 27-38.
8. Xu K, Lai XQ, Liu Z. Suggestions for prevention of 2019 novel coro-
navirus infection in otolaryngology head and neck surgery medical
staff. Zhonghua er bi yan houtoujingwaike za zhi= Chinese journal
of otorhinolaryngology head and neck surgery. 2020; 55: E001.
9. Jean WC, Ironside NT, Sack KD, Felbaum DR, Syed HR. The im-
pact of COVID-19 on neurosurgeons and the strategy for triaging
non-emergent operations: a global neurosurgery study. Acta neuro-
chirurgica. 2020; 162: 1229-40.
10. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients
in SARS-CoV-2 infection: a nationwide analysis in China. The Lan-
cet Oncology. 2020; 21: 335-7.
11. Hojaij FC, Chinelatto LA, Boog GHP, Kasmirski JA, Lopes JVZ, Sac-
ramento FM. Surgical Practice in the Current COVID-19 Pandemic:
A Rapid Systematic Review. Clinics. 2020; 75: e1923.
12. Woloshin S, Patel N, Kesselheim AS. False Negative Tests for SARS-
CoV-2 Infection—Challenges and Implications. New England Jour-
nal of Medicine. 2020; 383: e38.
13. American College of Surgeons. Local Resumption of Elective Sur-
gery Guidance. Available. (accessed April 17, 2020).
14. Shanmugam C, Mohammed AR, Ravuri S, Luthra V, Rajagopal N,
Karre S. COVID-2019–A comprehensive pathology insight. Pathol-
ogy-Research and Practice. 2020; 216: 153222.
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