SARS-CoV-2, most commonly known as Coronavirus, was emerged first in the Wuhan city of China in the late 2019 and proved to be an unprecedented threat to the whole world since then. It has truly imposed a restriction on human lives in many countries and has taught us a new way of living. Being the second-most populous country in the world and one of the top contenders in the hierarchy in terms of coronavirus infection, India is facing far extreme consequences of this unrestrained outbreak than many other countries in the same league. Apart from all the other challenges put forward by the existence of SARS-CoV-2, there is a need of proper management to handle the different types of solid waste especially Biomedical waste (BMW) emerging from different health care facilities, quarantine homes, and centers, that is appearing in a huge amount every day and the possible challenges we are facing while confronting the problem of this waste, that could be a source itself to spread this contagious virus, if not handled and treated properly. In this paper, we have discussed briefly the susceptibility of the virus due to Biomedical waste produced daily as a result of curing infected patients. This paper also put across the challenges and the solution to handle this waste in India before it is disposed of.
Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated acute appendicitis in pandemic situation. Study Design: Prospective interventional study. Setting & Duration of Study: CMH Lahore, a 700 bedded tertiary care hospital, for 4 months from 15th April 2020 to 15th august 2020. Methodology: A total of 110 cases meeting inclusion criteria, aged 13-65 years of both genders with suspicion of non-complicated appendicitis were included in the study, using probability sampling. They were divided in two groups on randomization basis. Group A for antibiotic therapy and Group B for appendectomy. Group A patients admitted in the ward 48 hours for IV antibiotics, were re-evaluated after 24 hours. If condition improves, the patient was discharged on oral antibiotics for next 10 days & if condition does not improve, antibiotics were prolonged for 48 hours. If deteriorating or patient. .chooses to change group, they underwent appendectomy. If condition improved, they were discharged on oral antibiotics for next 10 days. Group B patient were discharged after 2 post-operative doses of I/V antibiotics. Post-operative I/V antibiotics for 48 hours & 3 days oral antibiotics were given when appendix was gangrenous or perforated. Results: In a population of 110 patients, we studied the comparison of the groups having antibiotics and appendectomy as treatment for acute appendicitis. There is no significant difference in outcomes on basis of mean pain score and mean duration of hospital stay. Both ways of treatment can be adapted accordingly. Conclusion: Non-complicated acute appendicitis can be managed non-operatively in crisis situations like COVID-19 pandemic causing overburdening of hospitals. Keywords: Acute appendicitis, antibiotic therapy, appendectomy, pandemic.
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