Background: The recent pandemic condition developed from the Coronavirus Disease 2019 (COVID-19) outbreak, have a profound effect on almost all the aspects of society. This outbreak has greatly compromised both the mental and physical health of the frontline healthcare workers and supporting hospital staff since they are responsible for the diagnosis and treatment of infected individuals with COVID-19. This study aimed to investigate the psychological impacts and factors causing stress among the healthcare workers & supporting hospital staff during the COVID-19 outbreak and also to identify the preferred coping strategies. Methodology: This cross-sectional survey-based study was conducted from 1st to 30th February 2020. The sample comprised of frontline healthcare workers & hospital staff providing supporting services like laboratory personnel & administrative workers. The data was collected using a structured self-administered online questionnaire focusing on the impacts of COVID-19, factors causing stress and the coping strategies used by frontline medical workers to deal with the psychological impacts of such pandemics. Results: A total of 127 frontline medical workers completed the survey. The findings from the present study suggested that frontline healthcare workers & hospital staff experience both psychological as well as emotional impacts due to COVID-19. The mean Impact of Event Scale (IES) score was 24.44±19.41 indicating partial PTSD or at least a few symptoms of PTSD. The major factor causing stress among these health workers was their fear of inflicting COVID-19 on family (33.1%). Among the coping strategies, emotion-focused coping techniques and positive thinking were found to be the most preferred strategies among the frontline medical workers and hospital staff in coping stress associated with the COVID-19 outbreak. Conclusion: The current study emphasizes the significance of the psychological impacts of COVID-19 among healthcare workers and the importance of psychiatric help for these long-term traumatic influences.
Amaç: Bu çalışmanın amacı retrospektif bir olgu kontrol çalışmasında supin perkütan nefrolitotomi (PCNL) ve pron PCNL'yi taşsızlık oranı, operasyon süresi, anestezi süresi ve kan kaybı bakımından karşılaştırmaktır. Gereç ve Yöntem: Çalışma süresince 22 hastaya supin PCNL yapıldı (grup A). Aynı dönemde benzer demografik ve klinik özellikleri olan ve pron pozisyonda PCNL uygulanan eşit sayıda hasta kontrol grubu (grup B) olarak çalışmaya dahil edildi. İki grup arasında cinsiyet, yaş, vücut kitle indeksi, taş boyutu, taş yeri ve taş lateralitesi gibi demografik detaylar benzerdi. Her iki gruptaki hastaların ameliyat öncesi ve sonrası hemoglobin (Hb)
Objective: To assess the immunisation status, frequency of complications and the outcome in chil- dren admitted with measles in public and private sector hospitals of Karachi. Methods: In this cross-sectional study a total of 382 patients admitted with measles, of either sex from 3 months to 13 years, who presented from March 2016 to March 2017 were included. A total of 265 (69.3%) children were from Ziauddin University Hospital (ZU) and 117 (30.6%) from Abbasi Shaheed Hospital (AS). Non-probability convenient sampling technique was used. Those with con- genital anomalies and chronic medical illnesses were excluded from the study. Detailed history and physical examination was done, and findings entered in a Proforma. Immunisation status of the pa- tients was recorded. All the patients were observed for complications like encephalitis, pneumonia, diarrhea, otitis media, epiglottis, febrile fits and corneal ulcers. Statistical analysis was done using SPSS version 22. Categorical values were compared by chi-square test, p-value of <0.05 was con- sidered significant. Results: A total of 382 were patients admitted with measles, 265 (69.3%) from Ziauddin University hospital and 117 (30.6%) from Abbasi Shaheed Hospital. Overall, 57.4% were completely vaccinated in ZU vs. 32.5% in AS. Despite being completely vaccinated, children in ZU; 152/265 (80%) and in AS; 38/117 (30.6%) had complications with a statistically significant (p<0.0001) difference between private and government sector hospitals. Predominantly, in both hospitals pneumonia was common followed by gastroenteritis. Overall mortality was 13/382 (3.4%) in both hospitals combined. Conclusion: A sizeable number of children admitted with measles in both private and government hospitals were unvaccinated. A significant number developed measles despite receiving two doses of vaccine. Frequency of complications was higher in private versus government hospitals. Mortality from measles was high (3.4%) especially in the unvaccinated.
Background: Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large or complex renal stones. The upper pole (supra-costal access) is associated with pulmonary and cardiac complications post-operatively, owing to its proximity to the diaphragm. The prone position also causes restricted chest expansion and decreased pulmonary compliance. In this study, we aim to evaluate pulmonary complications after percutaneous nephrolithotomy by reducing the tidal volume intra-operatively and to assess the appropriate tidal volume for patients undergoing PCNL. Methodology: A retrospective chart review was performed over a period of one year (2019-2020). All patients who underwent PCNL and fulfilled the inclusion criteria were included in the study. They were divided into two groups: low tidal volume (Cases), and normal tidal volume (Controls). The records were evaluated for any pulmonary complications post-operatively, and this was compared between the two groups. Results: A total of 114 patients were included in the study. When patients with low tidal volume were compared to patients with normal tidal volume, no significant difference in pulmonary complications was observed (p-value < 0.05). Conclusion: There was no significant difference between the two groups, in terms of post-PCNL pulmonary complications, with respect to the tidal volume. Further multicenter studies can better elucidate these findings.
Öz Amaç: Transüretral prostat rezeksiyonu (TURP) sonrası, hastalarda postoperatif hemoglobin ve elektrolit izleminin önemini değerlendirmek ve izlem için dikkate alınması gereken parametreleri belirlemektir. Objective: To evaluate the importance of post-operative hemoglobin and electrolyte monitoring after transurethral resection of the prostate (TURP) and establish the parameters to be considered for monitoring. Materials and Methods: Data of patients who underwent TURP between 2007 and 2017 were reviewed. Data regarding prostate size, irrigation fluid volume, resection time, pre-and post-operative electrolytes, hemoglobin levels taken within 48 hours before and after surgery, and blood transfusion information were collected. In order to establish parameters for post-operative laboratory monitoring, we categorized prostate size, resection time, and irrigation fluid into groups i.e. (<45 g, 45-60 g, 61-80 g and >80 g), (<30 min, 31-60 and >60 min) and (<20 L, 21-40 L and >40 L) respectively. Results: A total of 1.000 patients were included. The median age was 66 years with the minimum of 46 years and maximum of 98 years. The median prostate size was 54.26 g. Among all pre-and post-operative laboratory parameters, only hemoglobin and sodium showed a significant change, which were analyzed further. Drop in hemoglobin was significantly associated with increasing prostate size and volume of irrigation fluid. Patients with a prostate size of >80 g had 27.3 times higher chance of significant (>2 g) drop in hemoglobin while 5.1 times higher when irrigation volume exceeded 40 liters. Low levels of sodium were strongly associated with prostate size, irrigation fluid volume, and resection time. However, all these factors become insignificant (p≥0.05) for their effect on low sodium, when these variables were adjusted with each other. Blood transfusion was performed in 27 patients. All these patients belonged to a group of patients with prostate size of more than 80 g with high resection time and irrigation fluid volume. Three patients had TUR syndrome. Post-operative hemoglobin and electrolytes monitoring contributed to a change in the management of only 14% of patients. Conclusion: Routine post-operative hemoglobin and electrolyte measurement is not required in every patient undergoing TURP. Use of risk stratification approach will help us to decide which patient needs post-operative lab testing.
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