Anesthesia Management in Cesarean Section for Close Contact Parturient with COVID-19 Patient: A Case Report

During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, which produced a disease that had been termed COVID-19, safely treating patients that have contracted COVID-19 has become a very challenging problem for both patients and healthcare workers alike. The case we will be dealing with concerns a surgery of a full-term parturient who tested negative for COVID-19 at the time of surgery but had been living with a husband who contracted COVID-19. The parturient was taken up for an elective caesarean section under spinal anesthesia in an isolated operating room. It is necessary to consider how to manage the patient who was a close contact even if their COVID-19 test result is negative and how to set up the protocols to protect healthcare workers themselves in such situation. Keywords ---- (COVID-19, Caesarean section, Parturient, Spinal anesthesia)

Correlation of Fischer’s Ratio with Liver Fibrosis in Naive Chronic Hepatitis B Patients without Comorbidities

Introduction: Hepatitis B virus infection is one of the most common health problems in the world. 20% Chronic hepatitis B can can change into liver fibrosis. The liver is the center of the body's Amino Acids metabolism. Amino acid changes can occur due to impaired liver function. Fisher's ratio (BCAA/AAA) has become one of the sign of liver fibrosis. This study wanted to find a relationship between Fischer Ratio values and liver fibrosis in naive chronic hepatitis B patients without comorbidities. Method: The research was conducted from October 2020-May 2021 at DR. Moewardi Hospital, Surakarta, Indonesia. Subjects were naive chronic hepatitis B patients without comorbidities with a minimum age of 30 years. The study used a cross-sectional method. Fischer Ratio values were assessed by spectrophotometry and liver fibrosis was assessed by transient elastography (fibroscan). A correlation test was conducted to determine the relationship between variables. Result: 20 patients were included in the study. The average age of the research subjects was 47 ± 10 years. The average Fisher's ratio value was 2.83 ± 1.16 and the average fibroscan value was 17.31 ± 18.50 kPa. Ratio Fischer had a correlation with liver fibrosis with r= - 0.571 (p=0.004). Conclusions: Ratio Fischer has a negative correlation with liver fibrosis in naive chronic hepatitis B patients without comorbidities.

Differences and Similarities between Coronaviruses: A Comparative Review

Today, humans fight powerful and active viruses that never take hold and do not know defeat, named coronaviruses. These viruses have start in 2002 and continued to grow and have changed their chains dramatically until now. They are known for having many similar features in common, and there are also structural differences between them. The most important reason that has turned coronaviruses into a pandemic is that this disease is easily transmitted by droplets near infected people, which leads to the spread of this virus faster worldwide. The more details known about coronaviruses that have profoundly affected humanity in the past and present and the diseases they cause, the more benefit in help designing an immune response or preventive vaccine to these viruses in the near future. In this article, coronaviruses, how they have been started and spread, and what differences and similarities are between them will be briefly covered here. The information of this investigation is taken from articles and the world health organization and are reviewed here. The goal is to document this information for future reference.

Anesthetic Consideration in Case of Large Lymphangioma in Right Atrioventricular Groove: A Case Report

Background Cardiac tumor is a rare disease but it causes various hemodynamic changes depending on location and size. Compression of the right sided heart can lead to impaired venous return and consequent systemic and coronary vascular collapse. Case A 62-year-old male who had cardiac lymphangioma on right atrio-ventricular groove. Upon entering the operating room, he was admitted to the tamponade physiology with tachycardia and hypotension. Opioid based anesthesia was performed to minimize myocardial depression, and myocardial function was continuously monitored through Transesophageal echocardiography and pulmonary artery catheter to safely wean the cardio pulmonary bypass (CPB) machine. Conclusion Anesthesiologists should be able to predict and respond appropriately to physiological hemodynamic changes according to the location and size of cardiac tumor.

Hypothyroidism and Pregnancy outcome

OBJECTIVE: To evaluate maternal and perinatal outcomes among ladies treated for hypothyroidism in pregnancy at antenatal clinics of King Hussein Medical Centre. METHODS: This study was conducted at antenatal clinics of King Hussein medical center during the period from April 2018 to April 2020. We studied 200 pregnant women with hypothyroidism as a study group (group I) who were compared to 200 euthyroid pregnant women as a control group (group II). RESULTS: The incidence of obstetric complications in group I vs group II found to be as the followings: Pre-eclampsia 12%(24) vs 9%(18), miscarriage 10%(20) vs 4%(8), while preterm labor was 20%(40) vs 22%(44), the antepartum hemorrhage 5%(10) vs 4%(8), Post-partum hemorrhage 7%(14) vs 5%(10) respectively. There were no significant statistical differences in these outcomes in both groups and preterm labor pain was the most frequent pregnancy complication encountered (20% vs, 22 %) CONCLUSION: Proper treatment of hypothyroid patients before pregnancy and throughout pregnancy would probably eliminate the potential risk of developing maternal and fetal complications, treated hypothyroid patients hold no significant differences in pregnancy-related complications once compared to euthyroid women. Keywords: Hypothyroidism, Pregnancy, Outcome

Spinal Anesthesia of a Patient with Central Core Disease for Caesarean Section: A Case Report

Central core disease is an autosomal dominant congenital myopathy. It typically manifests as muscle weakness and developmental delay. Central core disease is also associated with malignant hyperthermia which can be developed by volatile agent or succinylcholine. Here, we are reporting a case of a 34-year-old primigravida with central core disease who underwent an emergency cesarean section under spinal anesthesia without complications.

Reflections on Communication Difficulties Related to Covid-19

This paper describes some of the concept which are often miscommunicated between scientists, politicians and laypeople. Scientists are advised to take a more active role in explaining relevant concepts so that they can be understood by laypeople and thus facilitate better discussions.

Epidemiological Profile of COVID-19 in Brazil and Worldwide

Introduction: COVID-19, caused by the new coronavirus or SARSCoV-2, has a high capacity for dissemination, which brings about an emergency scenario in public health. It manifests itself in a multifaceted manner, with a great variability in the profile of the affected population, which may be associated with biological, social and economic factors. Objective: To know the epidemiological profile of the population affected by COVID-19, in order to promote better assistance. Methods: This is a literature review, starting in 2020, using the SciELO, PubMed, Google Scholar, DATASUS databases and the website of the Brazilian Institute of Geography and Statistics (IBGE). Results: Studies show a higher prevalence of SARS-CoV-2 infection in men, in the age group after the fourth decade of life and among whites. Discussion: The first studies showed a prevalence of coronavirus infection in males. One of the hypotheses drawn was that men present more cardiopulmonary diseases and smoke more. Another study shows that women's lower susceptibility to infection is due to the X chromosome and sex hormones, which are essential for the innate and adaptive immune response. As for the age group, most studies show a higher prevalence after the fourth decade of life, due to increased expression of angiotensin 2 receptors (ACE2), hormonal changes in aging and associated comorbidities. Conclusion: Studies show with greater assertiveness a predominance of involvement by COVID-19 in males, individuals from the fourth decade of life and in whites. However, it is important to investigate the epidemiological profile in order to offer better assistance and prevention.

Curvilinear Moderation of Perceived Co-Worker Support on Bullied Health Professionals: Timelag Study

Objectives. The research highlights the role of co-worker’s support in bullied health professionals. Investigating the extend of support, firstly, how it helps the bullied professionals not to quit their jobs. Secondly, how the continued constant and increased support from co-workers drastically change it to higher turnover intention. Material and Methods. Data was gathered from 300 health professionals working in different hospitals in two time-lags with the lapse of almost 6 weeks using convenience sampling technique. Results. Data analysis revealed the strong positive connection between workplace bullying and turn over intention posing alarming challenge for health professionals and organizations as well. Further the research proved the strong impact of lower and higher levels of perceived co-worker support in manipulating the decision of bullied professionals to turnover. Conclusion. Workplace bullying is on alarmingly rise affecting the health sector as well and it is the worst type of social stress being evident at workplaces causing serious medical errors and list goes on. This Research helps to understand the role of co-worker’s support on victims opening new avenues, adding new variable for future research on bulling culture.

Brain Tumor Radiotherapy Role and Variation

Objectives: We report our experiences of brain tumors management by surgery and radiotherapyWhether It has been used as adjuvant, radical or palliative therapy belonging to benign or malignant tumors over 2 years period at ENT, neurosurgery and radiotherapy departments royal medical services. Methods: We used a retrospective study design to review all brain tumor patients(benign, malignant or metastatic) operated in neurosurgical department and referred to radiotherapy after discussing each case in multidisciplinary clinic in 2018 and 2019. Patient files, radiological images computed tomography (CT) or magnetic resonance imaging (MRI) scans), histo-pathological reports and radiotherapy management plan were reviewed for patients. Results: In total, 137 patients with brain tumor managed byradiotherapy 64 patients were metastatic, 37 patients high grad glioma, 12 patients atypical meningioma, 7 patients medulloblastoma, rest of cases discussed in the study . Conclusions: Radiotherapy has been fulfilling crucial part in the treatment of CNS tumors, where it has been implemented as adjuvant therapy or even being the solitary resort where surgery is inapplicable or used as palliative therapy in different regimens according to histopathology, performance status and different sites.