The enduring impact of COVID-19 on patients has been examined in recent studies, leading to the description of Long-COVID. We report the lasting symptom burden of COVID-19 patients from the first wave of the pandemic. All patients with COVID-19 pneumonia discharged from a large teaching hospital trust were offered follow-up. We assessed symptom burden at follow-up using a standardised data collection technique during virtual outpatient clinic appointments. Eighty-six percent of patients reported at least one residual symptom at follow-up. No patients had persistent radiographic abnormalities. The presence of symptoms at follow-up was not associated with the severity of the acute COVID-19 illness. Females were significantly more likely to report residual symptoms including anxiety ( p = 0.001), fatigue ( p = 0.004), and myalgia ( p = 0.022). The presence of long-lasting symptoms is common in COVID-19 patients. We suggest that the phenomenon of Long-COVID may not be directly attributable to the effect of SARS-CoV-2, and believe the biopsychosocial effects of COVID-19 may play a greater role in its aetiology. Supplementary Information The online version contains supplementary material available at 10.1007/s00408-021-00423-z.

The enduring impact of COVID-19 on patients has been examined in recent studies, leading to the description of Long-COVID. We report the lasting symptom burden of COVID-19 patients from the first wave of the pandemic. All patients with COVID-19 pneumonia discharged from a large teaching hospital trust were offered follow-up. We assessed symptom burden at follow-up using a standardised data collection technique during virtual outpatient clinic appointments. Eighty-six percent of patients reported at least one residual symptom at follow-up. No patients had persistent radiographic abnormalities. The presence of symptoms at follow-up was not associated with the severity of the acute COVID-19 illness. Females were significantly more likely to report residual symptoms including anxiety (p=0.001), fatigue (p=0.004), and myalgia (p=0.022). The presence of long-lasting symptoms is common in COVID-19 patients. We suggest that the phenomenon of Long-COVID may not be directly attributable to the effect of SARS-CoV-2, and believe the biopsychosocial effects of COVID-19 may play a greater role in its aetiology.

Endovascular aneurysm repair is a minimally invasive technique for the treatment of abdominal aortic aneurysms. Patients who undergo endovascular aneurysm repair are potentially at risk of developing problems related to the graft such as the development of endoleaks. Endoleaks can cause expansion of the aneurysmal sac, which can potentially lead to rupture. It is for this reason that lifelong surveillance of patients is required to assess the graft and the aneurysmal sac. This article discusses the role of contrast-enhanced ultrasound in the follow-up of patients post-endovascular aneurysm repair. Contrast-enhanced ultrasound is rapidly becoming a powerful, accurate and cost-effective tool to complement computed tomography in the follow-up of endovascular aneurysm repair patients. Real-time imaging of contrast filling into the arterial system means that contrast-enhanced ultrasound is an excellent problem-solving tool, particularly when assessing for the type and anatomy of endoleaks. In some instances, contrast-enhanced ultrasound can detect endoleaks when other modalities are equivocal.

Tuberculous meningitis (TBM) is associated with significant complications of central nervous system. It is accompanied by nonspecific and heterogeneous clinical symptoms. We focused on the significance of early diagnosis and prompt treatment. We describe a case of TBM in a 19-year-old Asian female. She had a progressive motor weakness with no sensory findings. She was started on antituberculous therapy. Her magnetic resonance imaging (MRI) contrast of dorsolumbar spine showed syringomyelia. Her culture and sensitivity for Mycobacterium tuberculosis (MTB) came negative. She was given a therapeutic trial of quinolones and Steroids. She had an uneventful recovery and was followed up for the past one year.

Aim: To determine the factors associated with persistent sputum positivity at the end of two months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi.Setting: A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi over six months.Methods:A sample of 73 consenting, newly diagnosed, smear positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, body mass index (BMI), socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at two months of treatment with a sputum smear. Data analysis was done on SPSS-20.0.Results:Rate of sputum positivity after two months of treatment was 17.8%. None of the factors was associated with persistence of sputum positivity except for the presence of chest radiograph (CXR) cavities; which made it 5.5 times more likely that the patient would remain smear-positive at two months (p=0.035).Conclusion:The finding of CXR cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavourable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and pay particular attention in terms of stringent monitoring and Directly Observed Treatment Short-course (DOTS) provision.

To compare the precision of DECAF (Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation) and CURB-65 scoring systems in prediction of mortality among patients presenting with an acute exacerbation of chronic obstructive pulmonary disease (COPD).

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Objective: To find the frequency of depression, anxiety and stress among Gynae residents during covid pandemic. Methodology: This Cross-sectional survey was carried out in different Teaching Hospitals of Khyber Pakhtunkhwa during the period of six months i.e from August 2020 to January 2021. After the ethical approval from the research community, data was collected from Post Graduate Gynae Residents of Teaching Hospitals. Sample size for the study was 405 participants. Depression, anxiety and gross scale shorten version DASS-21 containing 21 items was standard research to use in study i.e. depression, anxiety and stress was identified on the basis of their cutoff scores i.e. normal scores were ≥10, ≥8 and ≥15 for depression, anxiety and stress respectively. Result: In depression, 136 (34%) participants were normal followed by moderate level having frequency 121 (30.25%). In the anxiety category, 116 (29%) participants were normal followed by moderate level having frequency 101 (25.5). In the category of stress, 179 (44.75%) participants were normal followed by mild levels having frequency 106 (26.50%). Only COVID positive status was statistically significant with depression, anxiety and stress as their P-valve was 0.02 less than 0.05. Conclusion: Considerable number of post graduate Gynae trainees working in different tertiary care hospitals have varying degrees of depression, anxiety and stress due to COVID-19 pandemic. Keywords: COVID-19, Pandemic, Post graduate, Psychological impact, Trainee doctors, Gynae residents, Mental health, Obstetrics, Gynaecology.