Radiographic repeat rate data in diagnostic radiology in King Fahad Hospital (KFH), King Abdulaziz Hospital (KAH), and Maternity and Children Hospital (MCH) in Jeddah, Saudi Arabia, have been studied. The study provided valuable information to suggest preventive measures to reduce repeats. The variables included in the study are exposure techniques, examination types, total number of films used, number of films repeated, the film sizes, gender, the age groups of the patients, and reason for repetition. The total number of examinations in all three hospitals is 6001 using 8887 films on 5412 patients. The average repeat rate was 7.93%, where the individual hospital repeat rates were 9.57% in the MCH, 7.84% in KAH, and 7.44% in KFH. The repeat rate for children and infants was found to be undesirable. The quality assurance (QA) programme can effectively reduce the unnecessary exposure and can identify the cause of the exposure. The overexposure, underexposure, and position fault were the foremost contributors for repeats and constitute 32.91%, 28.94%, and 22.98% of the total respectively. The QA study identified that human error and equipment malfunction are the major contributors to these causes of repeats. The highest repetition rate was for pelvis, 13.64%, followed by skull, 11.59%, and abdomen, 10.41%. It is estimated that the total area of wasted film in all three hospitals is 74.3 m2. As per the average repeat rate, the cost of repeat films in the entire kingdom per year has been projected to be about 1.82 million US dollars (SR 6.83 million) in the government hospitals only. Based on the findings of this study a set of recommendations have been prescribed for the radiology department to reduce the repeat rate and to improve the safety culture.
Background: Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in mild to moderate COVID-19 patients. As it is highly contagious, health care workers including physicians are high risk of being infected in hospital care. Case Report: A 37 years old Bangladeshi physician working in a paediatric unit of a medical college hospital with multiple co-morbidities, hypertension, diagnosed axial spondyloarthropathy (ankylosing spondylitis) taking disease modifying anti rheumatic drugs-DMARDs (Salfasalazine) from 2016 till now, chronic persistent bronchial asthma on medication developed sore throat, increasing breathlessness and cough admitted to his own hospital on 22 April, 2020. He had a history of contact with a relapse nephrotic syndrome (glomerulonephritis) patient admitted with severe respiratory distress later confirmed as COVID-19 following RT PCR test on 14 April, 2020. After 3 days of contact with the patient, the physician also developed the symptoms mentioned above. The RT PCR test result of the physician came positive on 18 April, 2020. The physician primarily taken only azithromycin 500 mg once daily along with other regular drugs. On 5, 12 and 18 May, 2020, his sample was taken for re-test and came positive subsequently. After that he started Ivermectin (0.15 mg/kg) once daily for 3 days and doxycycline 100 mg BD for 7 days. He gave samples again on 27 and 29 May, 2020 which were came negative after 39 days. On full recovery he was discharged from hospital on day 40. We choose the patient because presence of co-morbidities may be associated with delayed viral clearance and physicians with co-morbidities working in a hospital have high risk of being infected.
Background: Since 2019, the pandemic of Coronavirus disease 2019 (COVID-19) has spread very rapidly in China and Worldwide. COVID-19 is a highly contagious, infectious and rapidly spreading viral disease with an alarming case fatality rate up to 5%. Case Report: In this article, we report a case of 60 years old non diabetic, hypertensive woman infected with COVID-19 who has end stage renal disease (ESRD) on hemodialysis for last 18 months. COVID-19 patients with ESRD need isolation dialysis but most of them cannot be handled properly due to limited hemodialysis machine. With these unavailability and risk, we continue the treatment along with hemodialysis for controlling uraemia and fluid balance. With all effort this patient ended with an uneventful course with clinical improvement, improvement of all laboratory parameters and resolution of radiological findings but follow up RT-PCR cannot done due to changing guideline of discharge criteria of COVID-19 patient in Bangladesh. He positively responded to meropenem, clarithromycin, favipiravir, thromboprophylaxis with enoxaparin along with supplemental oxygen therapy. After that she was discharged with an advice of 14 days home isolation with regular hemodialysis and a follow up visit after 14 days in the outpatient department. Conclusion: An ESRD patient on regular hemodialysis suffering from severe pneumonia has high risk of mortality. Combined effort from the health care workers are needed to decrease the mortality of COVID-19 infected ESRD patients.
Purpose: The purpose of this study is to present a better understanding of the specialized telehealth service in Bangladesh from the service provider and service recipients by aged people Method: Both quantitative and qualitative methods were used to collect data from Diabetes Mellitus (DM) patients. Data were collected by online telephone interviewing with an interview schedule. A total of 100 aged people with diabetes were selected purposively for a quantitative interview and 10 In-depth Interviews (IDIs) & Key Informant Interviews (KIIs) were conducted. Result: The majority of patients aged was between 61 to 68 years with a mean age of 63.6 ± 7.01years. The difference of age of DM patients by sex was found statistically significant (x2 = 39.49, df = 31; Cramer’s V = .032; P=<.003). The main source of information about digital health was: relatives (55%), neighbors (31%), television (12%), newspaper (10%), social media (9%), and healthcare providers (6%). Strong relationship was found between age of respondents and sources of information (x2= 77.08; Cramer’s V= .032, df = 13; Sig; P= < .009). About 59% of DM patients were benefited from telehealth services during COVID-19, however; they encountered some difficulties like effective access to digital technology, cost, and diagnosis facilities. About 83% of respondents suggest formalizing community engagement programs to extend the digital health services during a health emergency. The common barriers to the engagement of community people in digital health care are lack of social awareness, lack of peer group support, and gender disparities. Poor counseling, language barrier, bad internet signal, and lack of family members' support were the key barriers during teleconsultation services. Conclusion: Telehealth has the potential to address critical health issues of aged people and effective community engagement may be the best option to reach older people with diabetes in Bangladesh during any health emergency.
COVID-19(Corona virus disease 2019), which starts from Wuhan, China on December, 2019 spread rapidly to different countries of the world including Bangladesh. It affects huge impact on health care system. It’s a new disease with multisystem involvement. Physicians are experiencing new presentation of different cases and rare complication including arterial thrombosis. Few data is available regarding arterial thrombosis in SARS-CoV-2 infected patients. We are currently fighting with a 60 year old lady suffering from COVID-19 pneumonia with other co-morbidities developed severe arterial occlusion of right leg despite of taking anti platelet for long time for another cause. Patient developed irreversible right lower limb ischemia not improving with continuous infusion of unfractionated heparin followed by severe pulmonary embolism. So further study and recommendations will need to evaluate the cases and treatment in COVID-19 Patients with rare presentation. Bangladesh Journal of Infectious Diseases, October 2020;7(suppl_2):S50-S56
pneumonia), severe (severe pneumonia), critical (ARDS, Sepsis/septic shock) [5].Corona virus disease 2019 produces multisystem involvement and complications including acute respiratory distress syndrome (29%), anaemia (15%), acute cardiac injury (12%), and secondary infection (10%) [6]. Evidence also suggests that coronavirus also produce neurologic symptoms including dizziness, headache, ataxia and seizure, anosmia and taste impairment. Ischemic stroke may develop in 0.9% to 2.3% of patients suffering from . Focal neurological deficit may present in the early onset of the disease or in association with respiratory symptoms [8].
Globally, millions of documented SARS-CoV-2 infections with hundreds of thousands of deaths already reported. The majority of the fatal events have been reported in adults older than 70 years and those who have multiple co-morbidities. Despite the misery fatality of the virus, a significant number of peoples recovered from critical conditions also. Mild cases improved significantly with symptomatic management with strict maintenance of isolation. Therefore, many people believed that COVID-19 is a short-term illness, mild cases recovered completely within 2 weeks and severe or critical illness may require 3-6 weeks for complete recovery. However, the latest issue coming forward is delayed recovery in the surviving patients from severe or moderate COVID presenting with multisystem complications. We reported two cases of post COVID complications, newly named as “long COVID syndrome”. We described the common symptoms two patients experienced following recovery from acute phase of COVID-19 and how they were managed. We also discussed on the pathogenesis and management plan of common symptoms persisting after recovery of COVID-19. Bangladesh Journal of Infectious Diseases 2021;8(1): 42-49
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