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Corona virus disease 2019 (COVID-19) is a global pandemic disease caused by novel corona virus called SARS-CoV-2. Over 213 countries as of July 15, 2020, 13.1 million people are affected by this deadly virus. More than 100 million women are pregnant worldwide and potentially all are at risk of exposure to SARS-CoV-2 infection. Coronaviruses cause illness ranging in severity from common cold and severe respiratory illness to death. Frequent manifestations of COVID-19 include fever, cough, myalgia, headache, and diarrhoea. Abnormal test result shows abnormalities on chest radiographic imaging, lymphopenia, leukopenia, and thrombocytopenia. Physiological changes during pregnancy like altered immunity, reduced functional residual volume, pressure on diaphragm by advanced gravid uterus may lead to adverse respiratory outcome in any viral disease. Maternal mortality was very high in other corona viruses like Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). No evidence of in utero transmission was seen in SARS or MERS. Coronavirus disease 2019 might increase the risk of vertical transmission and pregnancy complications. So, meticulous management is necessary for safe maternal and foetal outcome. Early isolation, aggressive infection control procedures, oxygen therapy are the key component of COVID-19 management. In pregnancy multidisciplinary approach should be taken for general and obstetrical management. At present there is no specific treatment for COVID-19. Based on results from observational studies empiric antibacterial and antiviral drugs are used. Very recently a few controlled trials were published that suggest few treatment options. On the basis of published data and recommendations of international health organizations, the aim of this review is to explore effective treatment and care of the pregnant women throughout pregnancy, during childbirth and afterwards in this novel SARS-CoV-2 crisis. J Bangladesh Coll Phys Surg 2020; 38(0): 91-108

Objective: The aim of this study was to explore the efficacy of low dose and high dose antioxidants for the treatment of idiopathic oligiospermia, asthenospermia and oligoasthenospermia. Materials and methods:This prospective quasi experimental study was conducted in Infertility Care and Research Center (ICRC) Ltd, Dhaka, Bangladesh between January 2013 and December 2014. Eighty four patients were the target population for this study. After thorough investigations those patients were diagnosed as idiopathic oligo, astheno and oligoasthenospermia were recruited for this study. Those patients whose female partner had infertility factor except PCOS were excluded from this study. For treatment patients were divided into two groups by lottery. Treatment for group A was Cap Doxycycline 100 mg twice daily for 1 month and tablet Oligocare, low dose antioxidant (Meyer Organic Pvt Ltd, India) 1 tab twice daily for 2 months. Group B was treated by Cap doxycycline 100 mg twice daily for 1 month and combination of micronutrients (High dose antioxidants) for 2 months. Ovulation induction was given to female partner of patient whose semen parameters improved. Results for pregnancy were observed for 6 ovulatory cycles. Data were expressed as mean standard deviation and percentage. Student's t test and χ 2 tests were done for test of significance where appropriate. A p value <0.05 was considered as significant. Results:In both treatment groups both count and motility were increased significantly after 2 months of treatment. Though mean semen parameter improved significantly in both treatment groups, there was significant difference in number of patient improvement between the groups. In high dose group 79% patients improved after two months of treatment whereas 48% patients improved in low dose group. Similarly pregnancy rate was also higher in high dose group 22% in comparison to 12% in low dose group. Conclusion:Antioxidants if can be used at a higher dose instead of low dose can give better result in terms of improvement of sperm count, motility and subsequently pregnancy rates.

In an effort to avert further Covid-19 transmission, the Bangladesh government took several initiatives which disrupted the routine food intake and exercise of diabetic patients. This study sought to examine the difference in dietary and exercise habits of diabetic patients between their pre-pandemic status and during COVID-19 which may be attributed to the observed poor health outcomes during the study period. This was a cross-sectional study that enrolled 604 diabetic patients using a convenience sampling technique who were attending outpatient clinics of the three selected hospitals in Bangladesh. A validated semi-structured questionnaire was used to collect information regarding eating habit and physical activity of the respondents pre- and during COVID-19 pandemic via direct interview. McNemar-Bowker test was used to assess the changes in dietary and physical activity behaviors. The current study reveals that 93.9% of the respondents were type-2 diabetic patients. During the pandemic, there was a decrease in the consumption of rice, bread, meat, fish, eggs, and dessert, while the consumption of cereals, milk, and potato/starchy vegetables increased. There was also a decrease in the frequency of drinking tea or coffee, while the consumption of soft drinks remained relatively stable. The level and duration of physical activity significantly decreased among the respondents during the pandemic. This study explored the changes in dietary habits and physical activity among the study population which not only disrupt the metabolic control of the diabetic patients but also pose a significant threat to their overall health. Therefore, it is critical to prioritize measures that support diabetic patients to maintain healthy dietary habit and to engage in regular physical activity during unprecedented times such as COVID-19 pandemic.