Introduction: In Pakistan, a wave of coronavirus has started in February which was first reported in Wahun City China. Abnormal calcium blood level is considered one of the important and common electrolyte disturbances in patients with severe infection. The effect of blood calcium level on the severity of COVID-19 and the possible immune regulation mechanism is considered to be an important factor related to severity of disease. Aim of the Study: To find out the correlation of blood calcium levels and related risk factors of patients suffering from COVID-19 and provide a basis for early intervention in patients with relevant clinical characteristics and further reduce the incidence of critical illness and mortality in COVID-19 patients. Method: 180 COVID-19 patients were admitted to Gulab Devi Teaching Hospital, Lahore between February to July 2020. Subject index were tested on real-time fluorescent RT-PCR test. On the basis of the result of RT-PCR, they were divided into two groups according to clinical symptoms as mild (control/placebo group) and critical (experimental group). The patient with the mild symptom were included in the placebo group, whereas patient with the severe symptoms were included in the experimental group. Exclusion criteria: The patients who do not show the detection level of viral infection with the RT-PCR are excluded from the study. Results: The comparison has been carried out between the placebo group and the experimental group on the basis of various parameters. The patients serum calcium level was tested and the value for hypocalcemia was declared as per universal recommendation which is < 2.13mmol/L. According to the corrected serum total calcium level, COVID-19 patients can be divided into hypocalcemia group and normal blood calcium group. The result showed that hypocalcemia and immune dysfunction was found high in experimental group as compare to control group which shows a strong correlation between hypocalcemia and COVID-19 disease. Conclusion: It has been concluded from the study that patients with COVID-19 have obvious hypocalcemia and immune dysfunction, especially in experimental group patients. In this study, it is easy to be combined with multiple infections caused by pathogenic bacteria under certain conditions. Close monitoring of blood calcium levels can predict the severity of the disease more effectively.
Introduction: Hyperemesis Gravidarum (HG) is a common early pregnancy syndrome that usually occurs around 6 weeks of pregnancy. The patient may cause dehydration, electrolyte metabolism disorders and abnormal fat metabolism, causing increased risk of pregnancy-induced. Objective: The effects of vitamin B and acupressure application combined with psychological adjuvant therapy on vomiting symptoms and mental health in pregnant women with severe vomiting. Methods: Study Type: Randomized Control Trial Duration of Study: Twelve Months from January 2019 to December 2019 Sampling Technique: The data has been collected from the subject index coming to the gynecology OPD of Gulab Devi Teaching Hospital, Lahore, Pakistan. Control group: aged 20 to 37 years, with an average of (26.12±2.44) years; 8 to 17 weeks of gestation, with an average of (9.18±1.77) weeks. Sample Selection Inclusion Criteria: All persons who have 1) meet the diagnostic criteria for HG; 2) 20 to 40 years of age; 3) both signed informed consent. Exclusion Criteria: vomiting caused by medical diseases such as hydatidiform mole, gastrointestinal disease, viral hepatitis, cholecystitis. This study was approved by the Medical Ethics Committee of Gulab Devi Teaching hospital. Pregnant women who were enrolled were divided into control group and experimental group according to the random number table method, with 48 cases in each group. Study Tools: Questionnaire and Interview Sample size (n)=96. Results: After 7 days of treatment the effective percentage rate in the experimental group was higher as compare to the control group in terms of clinical efficacy, SAS and SDS scores, antiemetic and hospitalization time and cost was much lower and within limits in the experimental group as compare to control group. Discussion: In addition to physiological treatment such as fluid replacement, psychological treatment should not be ignored. Conclusion: vitamin B6 and acupressure application combined with psychological adjunctive treatment of HG had a significant effect and could significantly relieve pregnant women Anxiety, depression and promote the recovery of pregnant women.
In Low and Middle-Income Countries (LMIC) almost all cancer patients and their close relatives face some form of financial deprivation during the phases of diagnostic workup and treatment of cancer. The term financial toxicity (FT) refers to the detrimental effects of the excess financial burden caused by the diagnosis of cancer on the well-being of patients, their families, and society.1 In cancer management this phenomenon of financial constraint becomes extremely important for both patient and the healthcare provider. In LMIC, like in Pakistan, the affordability of patients plays a pivotal role in access to healthcare. Financial toxicity leads to multifaceted challenges for the patients. At each step, the patient and his or her family members face various forms of psychological distress.Patients undergoing cancer treatment are likely to experience financial toxicity due to the longer timeframe between diagnosis and treatment. Multiple modalities are available for treatment, e.g. surgery, radiation therapy, chemotherapy, hormones, etc. Overall costs also include out-of-pocket costs like transportation, residence, childcare, loss of income etc. To address these issues effective patient screening, transparent pricing, and commitment to providing evidence-based high--quality care are important.2 Multidisciplinary approaches provided by a team of experts will be required to provide solutions to this perpetual problem which demands expert mature input from disciplines involved in the overall comprehensive care of the cancer patients. As the problem is multifaceted, therefore its solution will also require multipronged coping strategies. All the stakeholders have to play their roles in their domains. The list of stakeholders of the Financial Toxicity Tumor Board is healthcare providers, patients, policymakers, fund providers, and financial councillors. 3
The doctors who are going through our postgraduate residency training programs are tomorrow’s specialists who will be playing pivotal roles as healthcare policy decision-makers. To establish site-specific multidisciplinary tumor boards, we have to rely on our present-day resident’s leadership skills. We intend to provide meaningful specific patient-centered goals to our postgraduate students who are our future specialist healthcare providers. We are witnessing a slow positive change towards shared care and the implementation of multidisciplinary culture. This is high time to develop modules with a specific learning objective of providing high-quality leadership skills to all our postgraduate trainees. Effective and efficient team-building skills will enable them to initiate and maintain multidisciplinary professional processes complying with international standards [1].
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