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Progression of SARS-COV-2 Infection in Patients Requiring Hospital Admission During the Second COVID-19 Pandemic Wave
Ana María Haro-Pérez,
Vega Estíbaliz Benito-López,
Mar Jiménez-Rodríguez,
Saray Martín-Monteagudo
Issue:
Volume 6, Issue 4, December 2021
Pages:
119-125
Received:
26 June 2021
Accepted:
7 July 2021
Published:
5 October 2021
Abstract: Objective: Establish the characteristics and number of patients with a diagnosis of SARS-COV-2 who end up requiring hospital admission, and which of them require assistance in Intensive Care Units (ICU), and determine the time that passes from diagnosis to hospitalization. Compare our own health data between the different waves to see how the pandemic is evolving to manage healthcare resources. Methods: Retrospective observational epidemiological study of 517 COVID-19 patients, microbiologically confirmed, in a tertiary hospital, between June 1 and November 30, 2020. Results: The diagnosis of SARS-COV-2 infection was made by Reverse Transcription Polymerase Chain Reaction (RT-PCR) in 78% of the cases, and by Antigen (Ag) test in the rest. In patients who presented symptoms, an average of 3 days elapsed until diagnosis. In asymptomatic patients, the time from the positive test to the onset of symptoms was 8.4 days on average in the cases of screening and 1 day in the case of contact studies. The mean time from the onset of symptoms to hospital admission was 9 days, 15.3 days in the cases detected by screening and 7.8 days in contact studies. The average hospital stay was 10 days and there was an overall mortality of 13%. 10% of the positive patients needed intensive care, where the average stay was 21 days, the median age was 61 years, and the mortality was 21%. Conclusions: A high percentage of patients diagnosed with SARS-COV-2 infection in Primary Care will require hospitalization (70% according to our study). This information is essential to anticipate the need for hospital resources and the time frame in which they will be needed.
Abstract: Objective: Establish the characteristics and number of patients with a diagnosis of SARS-COV-2 who end up requiring hospital admission, and which of them require assistance in Intensive Care Units (ICU), and determine the time that passes from diagnosis to hospitalization. Compare our own health data between the different waves to see how the pande...
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Detrimental Effects of COVID-19 on Physical and Mental Health in Pakistan
Shifa Abbasi,
Zara Abbasi,
Muhammad Hassan Waseem,
Syed Murtaza Ali,
Aqsa Sajjad,
Muddasir Ansari
Issue:
Volume 6, Issue 4, December 2021
Pages:
126-131
Received:
25 August 2021
Accepted:
9 September 2021
Published:
12 October 2021
Abstract: Background: The novel COVID-19 first reported in Wuhan, china then rapidly spread via contact and droplet means and stated as a pandemic. Pakistan was predicted as the next epicenter of the pandemic and WHO Operational Planning Guidelines and country preparedness and response was implemented in the country. Physical and mental crisis were evident in previous pandemics so as in COVID-19. Material and Methods: This is an observatory study in which sample 385 was selected without randomization from all over Pakistan during the pandemic. Participant were smart phone users with the age limit between 13 to 17 years old. Data was collected via Google survey and was analyzed by SSPS. Results: The participants belong to different occupations with a mean age of 28±10.85. The trinity of questionnaire of general health, death anxiety and anxiety shows COVID have effects on physical and mental health with a significant value of 0.001. Conclusion: This study shows that COVID-19 has effects on mental and physical health and also increased death anxiety in overall population either they had COVID by their selves or by their beloved ones and effects of COVID were seen that physical and mental health both are at stack reveals increased anxiety, stress and negative thoughts, financial difficulties engaging people in harmful behavior.
Abstract: Background: The novel COVID-19 first reported in Wuhan, china then rapidly spread via contact and droplet means and stated as a pandemic. Pakistan was predicted as the next epicenter of the pandemic and WHO Operational Planning Guidelines and country preparedness and response was implemented in the country. Physical and mental crisis were evident i...
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History of Epizootics, Epidemics and Evolution of Coronaviruses
Maminiaina Olivier Fridolin,
Razafindrafara Mirantsoa Suzanne
Issue:
Volume 6, Issue 4, December 2021
Pages:
132-145
Received:
3 September 2021
Accepted:
4 October 2021
Published:
15 October 2021
Abstract: Coronavirus (CoV), which causes animal diseases, has become a human health concern. Prior to 2003, CoV caused respiratory diseases and enteric disorders, but after 2003, CoV caused three acute respiratory syndromes, resulting in significant human deaths. Since then, research on CoV has multiplied, leading to a deeper knowledge of the species. It is in this context that this article reviews the history, the biological aspect, the evolution and the crossing of the CoV species barrier. This review shows that CoVs are formed by a large genome (27 to 33 kb) and by structural proteins (spike S, hemagglutinin esterase HE and membran protein M). Various coronaviruses have been described in a wide range of species including chickens (IBV-CoV), pigs (PHE-CoV, PED-CoV, TGE-CoV PR-CoV, PD-CoV, SADS-CoV), cattle (BCoV), cats (FCoV), dogs (CCoV), and humans (HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1, SARS-CoV, MERS-CoV, and SARS-CoV2). Birds and bats are the main reservoirs of CoVs, but due to the low fidelity of the replication complex, CoVs have the ability to adapt to various species. Due to the crossing of the species barrier, CoVs have a wide host range resulting in the emergence of various strains worldwide. This information can help researchers develop intervention strategies to prevent the re-emergence of CoVs in the future.
Abstract: Coronavirus (CoV), which causes animal diseases, has become a human health concern. Prior to 2003, CoV caused respiratory diseases and enteric disorders, but after 2003, CoV caused three acute respiratory syndromes, resulting in significant human deaths. Since then, research on CoV has multiplied, leading to a deeper knowledge of the species. It is...
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The Effect of Tocilizumab in the Treatment of COVID-19 Patients: A Propensity Score-Matched and a Stabilized Inverted Probability of Treatment Weight Study (SIPTW)
Jamal Wadi Al Ramahi,
Amal Matar,
Nour Hasan,
Ma'en Maher Al-Ali,
Lara Abdulhadi,
Dania Abu Kaf,
Waseem Saadeh,
Nour Hamdan,
Mohamed Gharaibeh,
Hanadi Hamadallah,
Ala'a Bader,
Mohammad Atout,
Sae’ed Moh Mar’I,
Tamer Alhamed
Issue:
Volume 6, Issue 4, December 2021
Pages:
146-152
Received:
28 September 2021
Accepted:
22 October 2021
Published:
30 October 2021
Abstract: Studies disputed the use of tocilizumab in the treatment of COVID-19 patients, retrospective studies and one interventional study from the RECOVER study supported tocilizumab use, however, many other interventional and a retrospective propensity score-matched studies did not find a benefit from its use, in contrast, increased mortality was demonstrated, this study aims to add knowledge on this topic. Records for 1124 COVID-19 admitted patients were reviewed. Patients were recruited from three participating hospitals. Characteristics of all-cohort and propensity score-adjusted (PS-adjusted) patients were described, data was analyzed as propensity score matching (PSM) and a stabilized inverted probability of treatment weighting (SIPTW). Management of patients was up to the treating physicians who varied in the treatment approach., the effect difference was estimated by χ2. Further, the study was analyzed as logistic regression to assure robustness of the inferred outcomes; recovery, need for home oxygen, and all-cause mortality. All-cause mortality for patients was 12.7% (143) and in ICU was 54.0% (128). In the all-cohort, there was an increase of patients’ recovery in controls; 39.6% versus tocilizumab 9.9% (P<0.000). The need for home oxygen was more in tocilizumab; 59.2%, controls 38.6% (P<0.000). Mortality was higher in tocilizumab than the controls (25.4% versus 10.9%, P<0.000). Analyses as PSM-adjustment and SIPTW continued to demonstrate significantly less recovery and more mortality with using tocilizumab (P ≤ 0.002), but tocilizumab and the control did not differ significantly for the need for home oxygen therapy (49.1% vs. 48.6% respectively, P=0.945). No benefit was seen for tocilizumab in the treatment of COVID-19 patients, quite the opposite, it showed no recovery benefit, increased mortality, and did not impact the need for home oxygen.
Abstract: Studies disputed the use of tocilizumab in the treatment of COVID-19 patients, retrospective studies and one interventional study from the RECOVER study supported tocilizumab use, however, many other interventional and a retrospective propensity score-matched studies did not find a benefit from its use, in contrast, increased mortality was demonstr...
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A Rare Case of Recurrent Pancreatitis Secondary to Rifampicin in a Patient with Disseminated Tuberculosis
Jeat Thong Tang,
Azmad Kareem Anwardeen,
Nur Hidayah Mohd Makhatar,
James Emmanuel,
Kunji Kannan Sivaraman Kannan
Issue:
Volume 6, Issue 4, December 2021
Pages:
153-156
Received:
6 October 2021
Accepted:
25 October 2021
Published:
30 October 2021
Abstract: Background: Anti-tuberculous drug (ATD) induced pancreatitis is a rare complication of ATDs, but it has serious consequences if it is not managed promptly. Early recognition of ATD induced pancreatitis and identification of the culprit ATD are important approach with subsequent causative drug withdrawal, while at the same time, not impeding the ATD treatment of tuberculosis infection are unquestionably challenging. The objective of this clinical case report is to highlight an unusual case of Rifampicin induced pancreatitis to avoid future delayed diagnosis and management. Case Report: A 38 year-old male presented with acute dyspnea and cough. He was diagnosed to have smear positive disseminated tuberculosis infection with pulmonary and urinary system involvement. The intensive regime of ATDs (Rifampicin, Isoniazid, Pyrazinamide and Ethambutol) was started immediately. Nonetheless, he developed acute pancreatitis with severe abdominal pain after 1 week of ATDs therapy initiation. Usual etiologies of pancreatitis were eliminated. He demonstrated clinical improvement and his serum amylase reduced after his ATD regimen was withheld. Once his pancreatitis resolved, he was re-challenged with individual ATD one at a time in order to form an effective ATD regime. However, he developed another 3 episodes of pancreatitis in the following weeks with failed attempts to re-challenge with Rifampicin, which is an important core drug of ATD. Eventually, he succumbed to his severe tuberculosis illness. Conclusion: This clinical case is a rare case of Rifampicin induced pancreatitis with an unfavourable outcome. It is essential for clinicians to have a high index of suspicion for ATD induced acute pancreatitis in the patients with active tuberculosis infection and to identify the offending agent promptly without compromising the intensive phase of ATD treatment.
Abstract: Background: Anti-tuberculous drug (ATD) induced pancreatitis is a rare complication of ATDs, but it has serious consequences if it is not managed promptly. Early recognition of ATD induced pancreatitis and identification of the culprit ATD are important approach with subsequent causative drug withdrawal, while at the same time, not impeding the ATD...
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The Isenheim Altar in Colmar Depicts Syphilis maligna
Issue:
Volume 6, Issue 4, December 2021
Pages:
157-160
Received:
8 September 2021
Accepted:
19 November 2021
Published:
29 November 2021
Abstract: The Isenheim altarpiece was painted for the Isenheim monastry in 1512-16 by the German artist Mathis Grünewald (1475-1528). In the frontal part of the altar, the Crucifixion is illustrated. In the second part, the Annunciation with Virgin Mary’s meeting with the Archangel Gabriel is depicted. The back part of the altar has a large golden stature of Saint Anthony. The right sidepanel has created debate about the disease of the shabby monk with widespread sores. Traditionally, he is believed to suffer from ergotism, but there are no signs of gangrene. Most likely he had Syphilis maligna, called “Böse blattern” or Variola major, which at Grünewald’s time plagued all Europe. Today, knowledge of malignant syphilis is practically non-existing. Textbooks about a hundred years ago described the characteristical bullous and pox-like, sometimes ulcerative lesions like those of the monk. In the Crucification Jesus Christ´body is covered with multiple sores resembling woodcuts of petitions and of a young man with “the French disease” attributed to Albrecht Dürer. Woodcuts of flyleaves and Albrecht Dürer´s reproduction may have inspired Grünewald to depict syphilis as a warning and rememberance of the plague.
Abstract: The Isenheim altarpiece was painted for the Isenheim monastry in 1512-16 by the German artist Mathis Grünewald (1475-1528). In the frontal part of the altar, the Crucifixion is illustrated. In the second part, the Annunciation with Virgin Mary’s meeting with the Archangel Gabriel is depicted. The back part of the altar has a large golden stature of...
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Diagnostic and Therapeutic Difficulties of Chronic Diarrhea with Cystoisospora belli Inaugural Infection by the HIV at the NTHC-HKM of Cotonou: Literature Review
Angèle Azon Kouanou,
Yolande Sissinto Savi De Tovè,
Agbodandé Kouessi Anthelme,
Adélakoun Ange Géoffroy Falade,
Yves Morel Sokadjo,
Mahoutin Semassa Ghislain Missiho,
Olamidé Gloria Marlene Marie Dénise Kouanou,
Marcelle Vodounou,
Richard Oba,
Djimon Marcel Zannou
Issue:
Volume 6, Issue 4, December 2021
Pages:
161-164
Received:
22 November 2021
Accepted:
17 December 2021
Published:
29 December 2021
Abstract: Isosporosis is an opportunistic parasitosis caused by Cystoisospora belli. It was more or less frequently found during HIV immunodepression. Its prevalence has considerably decreased since the democratization of antiretroviral treatments and the implementation of a strategy of systematic global management of People Living with HIV (PLWH) and opportunistic infections. We report the case of a 49-year-old PLHIV patient discovered during the exploration of recurrent diarrhea. This diarrhea was found to be due to Cystoisospora belli. The patient was allergic to cotrimoxazole and was therefore initially treated with ciprofloxacin and tinidazole with poor evolution. The other treatments selected are limited by the lack of access to drugs, both geographically and financially. In view of the persistence of the clinical picture and the continuous presence of the parasite in the stools, several hypotheses have been put forward. That of an under-dosage of the molecule used, of a lack of therapeutic compliance, or of the resistance of the germ to the prescribed molecule. Although the coproculture and antibiogram revealed the sensitivity of the germ to the Ciprofloxacin already prescribed, and to the Cotrimoxazole to which the patient is very allergic, and which can therefore no longer be prescribed. After a second opinion and a review of the literature, the patient was put on Pyrimethamine tablets and Albendazole with folic acid. The evolution was favorable with a significant regression of stools, resumption of appetite, and weight gain after one month. A last coproculture of control did not find any more oocysts of cystoisospora belli. In the face of chronic diarrhea, the systematic search for opportunistic germs in PLWHIV is essential. Management is possible.
Abstract: Isosporosis is an opportunistic parasitosis caused by Cystoisospora belli. It was more or less frequently found during HIV immunodepression. Its prevalence has considerably decreased since the democratization of antiretroviral treatments and the implementation of a strategy of systematic global management of People Living with HIV (PLWH) and opport...
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Epidemiological, Diagnostic, and Therapeutic Facies of Malaria in Outpatient Medicine at NTHC-HKM
Angèle Azon Kouanou,
Yolande Sissinto Savi De Tovè,
Kouessi Anthelme Agbodande,
Mahoutin Semassa Ghislain Missiho,
Yves Morel Sokadjo,
Adélakoun Ange Geoffroy Falade,
Olamidé Gloria Marlene Marie Dénise Kouanou,
Delphin Murhula Katabana,
Houénoudé Mickaël Arnaud Assogba,
Richard Oba,
Djimon Marcel Zannou
Issue:
Volume 6, Issue 4, December 2021
Pages:
165-169
Received:
22 November 2021
Accepted:
17 December 2021
Published:
29 December 2021
Abstract: Malaria is an endemic parasitosis caused by plasmodium. The objective was to evaluate the epidemiological, diagnostic, and therapeutic profile of malaria in outpatient medicine at the NTHC-HKM of Cotonou. This is a cross-sectional and descriptive study, having covered a period of 11 years and 3 months (1/01/2010 to 31/03/2021). Patients who consulted the outpatient clinic of the NTHC-HKM of Cotonou during the study period were included. The diagnosis of malaria was made on the basis of a positive parasite density thick drop. Over 41,960 patients consulted during the period, 95 had malaria, a hospital incidence of 0.2%. Forty-seven patients (49.5%) were male. The mean age was 36.8±14.3 years. The main symptoms were fever in 81 patients (85.2%), asthenia in 45 patients (47.3%) and arthromyalgia in 42 patients (44.2%). Clinically, the general condition was preserved in 61 patients (64.2%), pallor was noted in 4 patients (4.2%) and icterus in 2 patients (2.1%). Hepatomegaly was found in 2 patients (2.1%) and splenomegaly in 1 (1.0%). Biologically, anemia was found in 11 patients (11.6%). CRP was elevated in 10 patients (10.5%). Parasite density varied between 1,200-75,000 red blood cells per microliter. Therapeutically, 45 patients (47.3%) had taken self-medication before diagnosis. All diagnosed patients had been treated. Simple malaria is a pathology rarely encountered in adults in outpatient clinics.
Abstract: Malaria is an endemic parasitosis caused by plasmodium. The objective was to evaluate the epidemiological, diagnostic, and therapeutic profile of malaria in outpatient medicine at the NTHC-HKM of Cotonou. This is a cross-sectional and descriptive study, having covered a period of 11 years and 3 months (1/01/2010 to 31/03/2021). Patients who consult...
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