Background and objectives: Reports comparing the characteristics of patients and their clinical outcomes between community-acquired (CA) and hospital-acquired (HA) COVID-19 have not yet been reported in the literature. We aimed to characterise and compare clinical, biochemical and haematological features, in addition to clinical outcomes, between these patients. Methods: This multi-centre, retrospective, observational study enrolled 488 SARS-CoV-2 positive patients -339 with CA infection and 149 with HA infection. All patients were admitted to a hospital within the University Hospitals of Morecambe Bay NHS Foundation Trust between March 7th and May 18th , 2020. Results: The CA cohort comprised of a significantly younger population, median age 75 years, versus 80 years in the HA cohort (P = 0⋅0002). Significantly less patients in the HA group experienced fever (P = 0⋅03) and breathlessness (P < 0⋅0001). Furthermore, significantly more patients had anaemia and hypoalbuminaemia in the HA group, compared to the CA group (P < 0⋅0001 for both). Hypertension and a lower median BMI were also significantly more pronounced in the HA cohort (P = 0⋅03 and P = 0⋅0001, respectively). The mortality rate was not significantly different between the two cohorts (34% in the CA group and 32% in the HA group, P = 0⋅64). However, the CA group required significantly greater ICU care (10% versus 3% in the HA group, P = 0⋅009). Conclusion: Hospital-acquired and community-acquired COVID-19 display similar rates of mortality despite significant differences in baseline characteristics of the respective patient populations. Delineation of community-and hospital-acquired COVID-19 in future studies on COVID-19 may allow for more accurate interpretation of results.

Key Clinical Message. Tension pneumothorax is an uncommon presentation in patients with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) or COVID-19 pneumonia. We present a case of tension pneumothorax in a patient with COVID-19 pneumonia and myocarditis. This was an unlikely diagnosis in a patient with no known underlying lung condition and no other precipitating factors such as barotrauma. In an acute deterioration of patients with SARS-CoV-2, it is important to always consider alternative diagnoses and repeat imaging.

This study aimed to evaluate the diagnostic performance of different imaging techniques for preoperative detection of pelvic fistula. Imaging and classification of female genital abnormalities considerably pelvic floor fistulas are significant. We conducted a systematic review of the available literature to highlight the effectiveness of different radiological imaging techniques (X-RAY,U/S,CT,MRI) for the diagnosis of different types of  pelvic fistulas to see the limitations of conventional scanning and testing over modern imaging techniques and to show the effectiveness of choosing  one imaging modality over other depending upon multiple dynamics e.g., site and types of fistula. The controlled and regular research cases (n= 9) available in English from 2011 to 2020 were included in criteria of research. The evidence databases were used for assessment of certain studies analytically by way of PEDro scale and explicated under decision guidelines. In all relevant articles were identified and included in this systematic review. The radiological techniques showed improved diagnostic performance that established the effectiveness of imaging advancement for administration and treatment of pelvic fistula. Conventional methods have less sensitivity and specificity as compared to modern techniques. X-RAY fistulography and ultrasonography has less sensitivity and specifity as compared to CT scan but still found beneficial in the diagnosis of colovaginal, uterovesical fistula and considered as the most basic clue about the existence of a malignant fistula respectively.it is verified that MDCT is the safer accurate and offered more detailed defects in diagnosis of urogenital, urethrorectal, lower urogenital tract fistulas, upper and middle vaginal fistulas colovesical fistulas(along with X-RAY) and prostate symphyseal fistula(along with MRI).It has been concluded that MRI can access colovesical fistulas inherited vaginal fistulas and prostate symphyseal fistulas(along with CT) more efficiently. It has been concluded that diagnostic imaging for all pelvic fistula is useful, to help the physicians, particularly radiologists, in diagnosis of pelvic fistulas. The choice of imaging technique is dependent upon multiple factors. Advanced medical imaging techniques XRAY,MDCT MRI)  are considered more recommended choices as compared to conventional imaging.

This qualitative research study aims at re-conceptualizing intimate co-creation on the basis of a qualitative data analysis. Hence, along with a latest conceptualization, theory of intimation co-creation has been empirically examined in this study. Based on the qualitative research approach of interpretive phenomenological analysis, qualitative data obtained from eight in-depth interviews was transcribed and coded in QDA Miner Lite software for analysis. Results found that five emerging themes represent the phenomenon of intimate co-creation. Furthermore, the contribution of this study was that a new research framework on intimate co-creation has been developed in which antecedents and potential outcomes of intimate co-creation have been identified. Propositions have been given as well to elaborate the relationship of antecedents and outcomes of intimate co-creation for future research direction.