Impact of The Covid-19 Pandemic On the Activities of the Gynecology-Obstetrics Department of the Ignace DEEN National Hospital of the Conakry CHU

2021 ◽  
Vol 5 (1) ◽  

The novel coronavirus pandemic (COVID-19) is the main global health crisis of our time and the greatest threat we have faced in this century. According to the National Agency for Health Security (ANSS), which is the national body for the management of epidemics and pandemics, 12,516 cases of COVID-19 have been confirmed out of 153,609 people tested with 10,879 cured and 74 deaths as of November 11, 2020. The objective of this study was to assess the impact of the COVID-19 pandemic on the activities of the GynecologyObstetrics department of the Ignace Deen National Hospital of the Conakry University Hospital. This was a retrospective, descriptive study from September 13, 2019 to September 12, 2020 on consultation, delivery and hospitalization activities. The study consisted of assessing the impact of the pandemic on the use of the service by patients during the first six (6) months of the pandemic. We recorded the frequency of consultations, deliveries and hospitalizations from September 13, 2019 to March 12, 2020 that we compared to the figures of the same data from March 13, 2020 to September 12, 2020. During the period from September 13, 2019 to March 12, 2020 we recorded 2,732 consultations against 1,358 for the period from March 13 to September 12, 2020 (first six months following the official declaration of the pandemic in Guinea), a decrease of 34.59% (1374 patients). The same remark with a lower proportion this time was made with the deliveries (3,119 during the 6 months preceding the official declaration of the pandemic in Guinea against 2,630 during the first 6 months of the pandemic, ie a decrease of 8.51%) and hospitalization (1,748 patients hospitalized during the 6 months preceding the official declaration of the pandemic in Guinea versus 1501 patients hospitalized during the first 6 of the pandemic, ie a decrease of 7.6%). In this period of the COVID-19 pandemic, we have to recognize a rapid and significant drop in the activities of the gynecology and obstetrics department. 748 patients hospitalized during the 6 months preceding the official declaration of the pandemic in Guinea versus 1501 patients hospitalized during the first 6 of the pandemic, ie a decrease of 7.6%). In this period of the COVID-19 pandemic, we have to recognize a rapid and significant drop in the activities of the gynecology and obstetrics department. 748 patients hospitalized during the 6 months preceding the official declaration of the pandemic in Guinea versus 1501 patients hospitalized during the first 6 of the pandemic, ie a decrease of 7.6%). In this period of the COVID-19 pandemic, we have to recognize a rapid and significant drop in the activities of the gynecology and obstetrics department.

Author(s):  
Martin Simko ◽  
Adrian Totka ◽  
Diana Vondrova ◽  
Martin Samohyl ◽  
Jana Jurkovicova ◽  
...  

This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013–2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7122 women. Our results suggest a statistically significant, higher risk for the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio (AOR) = 15.3; 95% CI 9.0−25.8 for obesity), preeclampsia (AOR = 3.4; 95% CI 1.9−6.0 for overweight and AOR = 13.2; 95% CI 7.7−22.5 for obesity), and gestational diabetes mellitus (AOR = 1.9; 95% CI 1.2−2.9 for overweight and AOR = 2.4; 95% CI 1.4−4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above IOM (Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR = 1.2; 95% CI 1.0−1.3), gestational hypertension (AOR = 1.7; 95% CI 1.0−2.7), and infant macrosomia (AOR = 1.7; 95% CI 1.3−2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through prepregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.


Author(s):  
Martin Simko ◽  
Adrian Totka ◽  
Diana Vondrova ◽  
Martin Samohyl ◽  
Jana Jurkovicova ◽  
...  

This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013–2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7,122 women. Our results indicate a positive statistical dependency of the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio [AOR]=15.3; 95% CI 9.0−25.8 for obesity), preeclampsia (AOR=3.4; 95% CI 1.9−6.0 for overweight and AOR=13.2; 95% CI 7.7−22.5 for obesity), and gestational diabetes mellitus (AOR=1.9; 95% CI 1.2−2.9 for overweight and AOR=2.4; 95% CI 1.4−4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above the IOM (the Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR=1.2; 95% CI 1.0−1.3), gestational hypertension (AOR=1.7; 95% CI 1.0−2.7), and infant macrosomia (AOR=1.7; 95% CI 1.3−2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through pre-pregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.


2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Saghar Samimi Sadeh ◽  
Elham Hashemi ◽  
Reza Aminnejad ◽  
Ehsan Bastanhagh

Background: Following surgery, patients frequently suffer from shivering, and this can lead to postoperative complications and discomfort. Objectives: This study aimed to compare the effect of ketamine on patients’ shivering following an elective abdominal hysterectomy. Patients were given either Ketamine (0.25 mg or 0.5 mg/kg) or a placebo. The study and surgery took place in a subspecialty University Hospital for Gynecology and Obstetrics. Methods: This study was an interventional, randomized, controlled clinical trial. Ninety-six women who underwent elective abdominal hysterectomy were randomly assigned to three groups. Ketamine was administered to all participants 20 min prior to the end of surgery. The first group received 0.25 mg/kg of intravenous ketamine. The second group received 0.5 mg/kg intravenous ketamine. The third group received a placebo of intravenous saline. Postoperative shivering, sedation grade, hallucination, nausea, vomiting, and nystagmus were measured for each patient up to 30 minutes. Results: The study showed that patients suffered from less shivering in the two groups that received ketamine. The reduced shivering was seen 5, 10, and 20 min following surgery in the two groups that were given two doses of 0.25 and 0.5 mg/kg ketamine compared to the control group (P value < 0.05). There was a significant difference between patients receiving normal saline and those having 0.25 and 0.5 mg/kg of ketamine in the rate of sedation grade, nausea, vomiting, and nystagmus (P value < 0.05). The main differences in patients receiving ketamine were the sedation grade at zero time and postoperative hallucination experienced by those patients who received 0.5 mg/kg of ketamine. Conclusions: Ketamine reduced shivering in all patients following elective abdominal hysterectomy. This was regardless of dose. Patients were less likely to suffer from hallucinations and sedation grade with a lower dose of ketamine (0.25 mg/kg compared to 0.50 mg/kg).


2020 ◽  
Vol 12 ◽  
Author(s):  
Sai Akilesh M ◽  
Ashish Wadhwani

: Infectious diseases have been prevalent since many decades and viral pathogens have caused global health crisis and economic meltdown on a devastating scale. High occurrence of newer viral infections in the recent years, in spite of the progress achieved in the field of pharmaceutical sciences defines the critical need for newer and more effective antiviral therapies and diagnostics. The incidence of multi-drug resistance and adverse effects due to the prolonged use of anti-viral therapy is also a major concern. Nanotechnology offers a cutting edge platform for the development of novel compounds and formulations for biomedical applications. The unique properties of nano-based materials can be attributed to the multi-fold increase in the surface to volume ratio at the nano-scale, tunable surface properties of charge and chemical moieties. Idealistic pharmaceutical properties such as increased bioavailability and retention times, lower toxicity profiles, sustained release formulations, lower dosage forms and most importantly, targeted drug delivery can be achieved through the approach of nanotechnology. The extensively researched nano-based materials are metal and polymeric nanoparticles, dendrimers and micelles, nano-drug delivery vesicles, liposomes and lipid based nanoparticles. In this review article, the impact of nanotechnology on the treatment of Human Immunodeficiency Virus (HIV) and Herpes Simplex Virus (HSV) viral infections during the last decade are outlined.


2020 ◽  
Vol 9 (11) ◽  
pp. 3472 ◽  
Author(s):  
Elena-Mihaela Cordeanu ◽  
Lucas Jambert ◽  
Francois Severac ◽  
Hélène Lambach ◽  
Jonathan Tousch ◽  
...  

(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates respiratory epithelium through angiotensin-converting enzyme-2 binding, raising concerns about the potentially harmful effects of renin–angiotensin system inhibitors (RASi) on Human Coronavirus Disease 2019 (COVID-19) evolution. This study aimed to provide insight into the impact of RASi on SARS-CoV-2 outcomes in patients hospitalized for COVID-19. (2) Methods: This was a retrospective analysis of hospitalized adult patients with SARS-CoV-2 infection admitted to a university hospital in France. The observation period ended at hospital discharge. (3) Results: During the study period, 943 COVID-19 patients were admitted to our institution, of whom 772 were included in this analysis. Among them, 431 (55.8%) had previously known hypertension. The median age was 68 (56–79) years. Overall, 220 (28.5%) patients were placed under mechanical ventilation and 173 (22.4%) died. According to previous exposure to RASi, we defined two groups, namely, “RASi” (n = 282) and “RASi-free” (n = 490). Severe pneumonia (defined as leading to death and/or requiring intubation, high-flow nasal oxygen, noninvasive ventilation, and/or oxygen flow at a rate of ≥5 L/min) and death occurred more frequently in RASi-treated patients (64% versus 53% and 29% versus 19%, respectively). However, in a propensity score-matched cohort derived from the overall population, neither death (hazard ratio (HR) 0.93 (95% confidence interval (CI) 0.57–1.50), p = 0.76) nor severe pneumonia (HR 1.03 (95%CI 0.73–1.44), p = 0.85) were associated with RASi therapy. (4) Conclusion: Our study showed no correlation between previous RASi treatment and death or severe COVID-19 pneumonia after adjustment for confounders.


2020 ◽  
Vol 13 (1) ◽  
pp. 271
Author(s):  
Carmen Valentina Radulescu ◽  
Georgiana-Raluca Ladaru ◽  
Sorin Burlacu ◽  
Florentina Constantin ◽  
Corina Ioanăș ◽  
...  

The present research aims to establish the impact that the current crisis situation the planet is facing, namely the COVID-19 pandemic, has had so far on the Romanian labor force market. In this context, given the lack of information and information regarding this pandemic and its effects, the administration of a questionnaire among the population was considered to identify the research results. The method of semantic differential and the method of ordering the ranks were used for the interpretation of the results. With the help of this questionnaire, it will be possible to answer the question of the research in this study: What are the main effects of the COVID-19 pandemic on the Romanian labor market? The main results showed that the COVID-19 pandemic affected the Romanian workforce; the respondents of the applied questionnaire claimed that they obtained better results and maintained a similar income, but the health crisis also influenced the mentality of employees, with respondents stating that in the event of changing jobs, they would consider it very important for the new employer to ensure the conditions for preventing and combating COVID-19, as well as complex health insurance. However, analyzing at the macroeconomic level, it was found that the COVID-19 pandemic induced an increase in the number of unemployed people in the Romanian labor market.


Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Diletta Onorato ◽  
Giovanni Carpenè ◽  
Giuseppe Lippi ◽  
Mairi Pucci

AbstractThe worldwide spread of coronavirus disease 2019 (COVID-19) has generated a global health crisis and more than a million deaths so far. Epidemiological and clinical characteristics of COVID-19 are increasingly reported, along with its potential relationship with overweight and/or obesity. Therefore, we aim here to review the current scientific literature on the impact of overweight and/or obesity among hospitalized patients who have developed severe or critical forms of COVID-19. Following PRISMA guidelines, our literature search identified over 300 scientific articles using the keywords “obesity” and “COVID-19”, 22 of which were finally selected for reporting useful information on the association between overweight/obesity and disease severity. In particular, in 11 out of the 14 studies (79%) which evaluated the association between obesity and disease severity providing also a risk estimate (i.e., the odd ratio; OR), the OR value was constantly >2. Although the studies were found to be heterogeneous in terms of design, population, sample size and endpoints, in most cases a significant association was found between obesity and the risk of progressing to severe COVID-19 illness, intensive care unit admission and/or death. We can hence conclude that an increased body mass index shall be considered a negative prognostic factor in patients with COVID-19, and more aggressive prevention or treatment shall hence be reserved to overweight and/or obese patients.


2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199607 ◽  
Author(s):  
Chia-Lung Shih ◽  
Peng-Ju Huang ◽  
Hsuan-Ti Huang ◽  
Chung-Hwan Chen ◽  
Tien-Ching Lee ◽  
...  

Aim: Taiwan’s response to the coronavirus disease 2019 (COVID-19) differed in that it successfully prevented the spread without having to shutdown or overburden medical services. Patients’ fear regarding the pandemic would be the only reason to reduce surgeries, so Taiwan could be the most suitable place for research on the influence of psychological factors. This study aimed to assess the impact of patients’ fear on orthopedic surgeries in Taiwan amid the peak period of the COVID-19 pandemic. Patients and Methods: The investigation period included the COVID-19 pandemic (March 2020 to April 2020) and the corresponding period in the previous year. The following data on patients with orthopedic diseases were collected: outpatient visits, hospital admission, and surgical modalities. Results: The COVID-19 pandemic led to a 22%–29% and 20%–26% reduction in outpatients, 22%–27% and 25%–37% reduction in admissions, and 26%–35% and 18%–34% reduction in surgeries, respectively, at both hospitals. The weekly mean number of patients was significantly smaller during the COVID-19 pandemic for all types of surgery and elective surgeries at the university hospital, and for all types of surgery, elective surgeries, and total knee arthroplasties at the community hospital. Further, patients visiting the community hospital during the pandemic were significantly younger, for all types of surgery, elective surgeries, and total knee arthroplasties. Conclusions: The reduction in orthopedic surgeries in Taiwan’s hospitals during COVID-19 could be attributed to patients’ fear. Even without restriction, the pandemic inevitably led to a reduction of about 20%–30% of the operation volume.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 767.2-768
Author(s):  
S. Lahrichi ◽  
K. Nassar ◽  
S. Janani

Background:Spondyloarthropathies (SpA) are a group of chronic and progressive diseases, characterized in particular by a progressive stiffening of the spine, spreading to neighboring joints or to certain tissues, which could lead in the long term to progressive stiffening and functional impairment. This conditioncancauseinsomnia problems and impaired sleep quality.Objectives:To assess the impact of SpA on the quality of sleep.Methods:This is a retrospective study over a period of 4 years from January 2015 to December 2019, including all the medical records of patients with SpA followed in the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. We evaluated for each patient two validated scores: the Epworth somnolence scale rated from 0 to 24, and the Pittsburgh sleep score rated from 0 to 21 with 7 components. Patients with a psychiatric history or who were followed up for neurological pathologies were excluded.Results:178 patients were included. 60.67% were men with an average age of 36.32 years (14-68 years). 45.01% had axial SpA, 29.77% had psoriatic arthritis, and 25.22% were followed for SpA associated with inflammatory bowel disease. 45% had associated comorbidities: there were 18 diabetics and 34 hypertensive, 16.58% were smokers. Clinically, 85.42% presented a back pain initially on examination, 55% presented a polyarthralgia, and 39.88% an oligoarthritis. 63% had radiological sacroiliitis, and 35.14% had bilateral coxitis. 13.48% had a positive HLA B27 and 58.89% had a positive inflammatory assessment with very high activity indices,with a mean of 4.6. 64.66% of the patients received NSAIDs,of which 11% responded well. 57% were treated with csDMARDs, and 17.86% were treated with biologics. At the time of our study, the mean visual analog scale was 5.84 ± 1.7 out of 10 (2-9). The mean Epworth score was 8.38 ± 5.2 (0-21). 56.1% of patients had no sleep debt, 33.3% had a sleep deficit, and only 10.6% had signs of drowsiness. For the overall Pittsburgh score, the mean was 7.02 ± 3.6 (1-18). The mean of “subjective quality of sleep” was 1.12, “sleep latency” was 1.22, “duration of sleep” was 1.06, “usual sleep efficiency” was 0.74, “Sleep disturbance” of 1.28, “use of a sleep medication” of 0.54, and the average of the component concerning “poor shape during the day” was 1.03 out of 3. The LEQUESNE index went from an average of 6 to 8, which corresponds to an average handicap (P = 0.2) over a period of 3 years. 68% of the patients had an alteration in the quality of sleep, starting on average three years after the onset of symptoms. 11% reported having experiencedanxiety and depressive symptoms, and reported having used antidepressants or anxiolytics in the past 5 years.Conclusion:Our study showed the negative impact of SpA on the duration and overall quality of sleep. The degree of pain as well as functional impairment can cause and worsen sleep disturbances in SpA. We have shown that the Pittsburg score increases significantly with the increase of pain.The Lequesne score and that the Epworth score increase with disease activity[1].References:[1]StolwijkC,vanTubergenA,Castillo-OrtizJD,BoonenA.Prevalenceofextra-articularmanifestationsinpatientswithankylosingspondylitis:asystematicreviewandmeta-analysis.AnnRheumDis2015;74:65—73.Disclosure of Interests:None declared.


Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 798
Author(s):  
Ignacio Martin-Loeches ◽  
Adrian Ceccato ◽  
Marco Carbonara ◽  
Gianluigi li Bassi ◽  
Pierluigi di Natale ◽  
...  

Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (>3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa02/FiO2 improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. Conclusions: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes.


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