Background With increasing healthcare demands for acute illness in patients especially in the times of pandemic, healthcare organizations require modern solutions. Hospital at home (HaH) is one such tool that has the potential to solve these problems without compromising the care of the patients. Main body Hospitals have been the conventional setting for managing acute sickness patients; however, it could be a very challenging environment for a few patients, especially for the older population who are highly susceptible to hospital-acquired infections. Health care in a hospital setting can also be very expensive, as it often involves a lot of healthcare professionals providing care. HaH service can provide the same quality of care expected in traditional settings. Conclusions The median length of stay and the rate of readmissions were lower in people under HaH care. Compared with patients in a hospital setting, patients in HaH had better clinical outcomes. HaH unit provides an integrated, flexible, easy-to-scale platform that can be cost-effectively adapted to high-demand situations.

Coronavirus disease 2019 (COVID-19) has played a significant part in systematic damage, affecting lives and leading to significant mortality. The endocrine system is one of the systems affected by this pandemic outbreak. The relationship between them has been identified in previous and ongoing research. The mechanism through which severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) can achieve this is similar to that for organs that express angiotensin-converting enzyme 2 receptors, which is the primary binding site of the virus. Endocrine cells widely express angiotensin-converting enzyme 2 receptors and transmembrane serine protease 2, the primary mediators initiating the acute phase of the disease. This review aimed to identify and discuss the endocrine complications of COVID-19. This primary focus is on presenting thyroid disorders or newly diagnosed diabetes mellitus (DM). Thyroid dysfunction with subacute thyroiditis, Graves' disease, and hypothyroidism caused by primary autoimmune thyroiditis has been reported. Pancreatic damage leads to type 1 DM because of the autoimmune nature of the disease and type 2 DM because of postinflammatory insulin resistance. Because follow-up data on COVID-19 on the endocrine glands are limited, long-term investigations are needed to assess specific effects.

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A major advancement in the field of medicine has been the introduction and usage of direct oral anticoagulants (DOACs) such as dabigatran (Pradaxa), apixaban (Eliquis), and rivaroxaban (Xarelto). DOACs have been increasing in popularity for mainstay anticoagulation pharmacotherapy and are being preferred by physicians over warfarin due to their rapid onset, fewer drug and food interactions, and lack of frequent blood monitoring. DOACs have been indicated in the management of thromboembolic conditions and have been extensively researched in various medical trials and studies before the approval of dabigatran (Pradaxa) in 2010 by the FDA. DOACs, like warfarin, are associated with a risk of bleeding, requiring clearance of the drug from the bloodstream or administration of reversal agents. It is important for physicians to familiarize themselves with the various types of DOACs and their dosages, along with their advantages and disadvantages in comparison to other non-DAOC classes of medications before incorporating them into their patient management plans.

Background First implemented in the 1950s, telemedicine is a rapidly evolving tool for healthcare systems around the world. Technological advancement and increasing access to information technology have made the implementation of telemedicine more feasible. Recent provisions by healthcare governing bodies have increased reimbursement for and the use of telemedicine globally. We have done a literature review to find out the pros and cons of adopting telemedicine. Main body Telemedicine is found to offer many benefits to conventional, in-person healthcare encounters for both patients and providers: decreased travel cost and time, decreased time spent in waiting rooms, decreased risk of transmission of communicable diseases, decreased overall encounter time consumption, increased convenience, and more. Telemedicine also facilitates seamless transitions of care between healthcare teams, connects isolated people groups with healthcare providers, and helps address regional healthcare infrastructure and provider shortages by connecting patients with healthcare teams from any location. Drawbacks specific to telemedicine include the lack of accessibility and advancement of imaging technology required to replace in-person physical examinations, nonuniversal access to the required devices and networks across the general patient population, and the risk of technical difficulties such as network connection disruptions. Conclusion Telemedicine helps bridging the gap of distance by connecting patients in remote locations with the physicians. This has also become vital in the time pandemic.

<p class="abstract"><strong>Background: </strong>Fungal rhino sinusitis is rampant in the North Indian state of Punjab. The demographic profile, presentation and comorbidities have been analysed.</p><p class="abstract"><strong>Methods: </strong>110 samples from the nasal cavity were collected in Oto-rhino-Laryngology services and processed in the Microbiology services of Dayanand Medical College and Hospital, Ludhiana. Nasal secretions and surgically excised tissue were processed and subjected to direct microscopy by potassium hydroxide (KOH) preparation as well as inoculated on Sabrouraud’s dextrose agar. Identification of fungal isolates was done as per standard procedures.</p><p class="abstract"><strong>Results:</strong> Fungal sinusitis was most common followed by acute invasive sinusitis, chronic invasive, granuloma (fungal ball) and granulomatous invasive fungal sinusitis. Males were affected more than females and the majority of the patients were from urban background. Allergic form of disease was commonly seen in younger age group as compared to the invasive form of the disease which was seen more in older patients. Nasal discharge was common presentation followed by nasal obstruction. Bronchial asthma and diabetes mellitus were co-morbidities. KOH positivity was 44.5% and fungal culture positivity was 33.6%. The common fungal isolate in this group was Aspergillus flavus (22.7%). The most common fungal isolate in the invasive group was Rhizopus spp. (4.5%) and Mucor spp. (3.6%).</p><p class="abstract"><strong>Conclusions: </strong>Elderly diabetic and asthmatic males are more susceptible to invasive fungal rhino sinusitis while the young males are vulnerable to the allergic fungal rhino sinusitis. Thereby control of diabetic status and appropriate allergy testing and desensitization is emphasised.</p>

Coronary artery anomalies (CAA) are a diverse group of congenital anomalies and are the second most common cause of sudden cardiac death in the young population after Hypertrophic Cardiomyopathy (HCM). Symptoms range from chest pain, syncope, or sudden cardiac arrest to completely asymptomatic. The prevalence of congenital coronary artery anomalies in the general population is estimated to be between 1% and 2%. CAA often gets underdiagnosed due to the lack of knowledge of the disease process. Approximately 5% of patients with acute myocardial infarction do not have atherosclerotic coronary artery disease or luminal narrowing due to other causes. Congenital coronary artery anomalies account for 50-60% of this 5% of patients. Most patients are asymptomatic for most of their lives, and chest pain is the most common symptom in symptomatic patients when referred for coronary angiography, typically when the diagnosis is typically made. The malignant coronary artery is a rare presentation of a coronary anomaly when associated with atherosclerotic coronary artery disease or valvular heart disease. Patients with symptoms of an abnormal coronary artery origin will receive medical treatment/observation, exercise restriction, coronary angioplasty with stent deployment, or surgical repair.

Remdesivir, a viral RNA-dependent RNA polymerase inhibitor, found extensive use in coronavirus disease 2019-infected patients because it curbs the viral load expansion. Among patients hospitalized as a result of lower respiratory tract infection, remdesivir proved to improve recovery time; however, remdesivir also can induce significant cytotoxic effects on cardiac myocytes. In this narrative review, we discuss the pathophysiological mechanism of remdesivir-induced bradycardia and diagnostic and management strategies for these patients. We conclude that further research is necessary to understand better the mechanism of bradycardia in coronavirus disease 2019 patients with or without cardiovascular disorder treated with remdesivir.