Rationale

GeneXpert MTB/RIF (Mycobacterium tuberculosis/rifampicin) assay is a method for detecting rifampicin resistance (RR-MTB) in suspected samples in less than 2 hours with high sensitivity and specificity yield. This study aimed to use the GeneXpert MTB/RIF assay to determine the frequency of RR-MTB and to study the possible influencing correlates associated with positive results.

Subjects and methods

This is a retrospective cross-sectional study of patients who visited TB clinic in 5 years (2016–2021). According to the data sheet of the patients, all the collected specimens were divided into 2 parts one for diagnosis by Ziehl–Neelsen stain and the other part for GeneXpert analysis. GeneXpert was also used to look for evidence of RR.

Results

Out of the 2605 total samples screened, 718 (27.6%) tested positive for MTB on GeneXpert assay; of them 633 (88.4%) were sensitive to Rifampicin, 83 (11.6%) were resistant to Rifampicin and 2 cases were undetermined. Factors contributing to RR-MTB were: smoker/ex-smoker, with 2.5 times more risk (p = 0.013.0, p = 0.001); recurrence cases had a 4-fold increased risk (p < 0.001); patients with very low M. tuberculosis detected on the GeneXpert MTB/RIF test were 8 times more likely to have RR-TB (P = 0.004).

Conclusion

This study disclosed a high-rate MTB in Egyptian probable TB cases. Smoking, recurrence and cases with a very low M. tuberculosis burden noticed on the GeneXpert MTB/RIF test had augmented risk of RR-TB.

Method: Survey was done and validated to health care worker sectors, patients and judicial workers sectors, to evaluate the telemedicine according to their practice.

Results: about one thousand volunteers shared in this study, 616 (61.3%), 68 (6.8%) judicial workers, and 320 (31.9%) other jobs. Most of doctors 95% of them refuse to use telemedicine in the provisional diagnosis, 77.3% claim that it is very difficult to give accurate diagnosis through media, 75.6% of them convinced that telemedicine and increase the malpractice issues and medical responsibilities. In judicial workers 64.7% of them prove that there is increase in malpractice issues due to use of media. On the other side 55% of the other job sectors agree with the use of telemedicine especially in time of epidemics.

Conclusion: Telemedicine has many pros and cons. The main cons were that the inability to give the actual diagnosis and occurrence of medical errors, while the main pros was that the use of telemedicine to follow up already diagnosed patient. Governments should legalize the using of telemedicine by enacting law that prohibit the use of it except between doctors to take medical decision or exchange opinion.

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score.

Until now, there are more than two hundred million confirmed cases of COVID-19 including more than seven million deaths. Clinical trials of all three vaccines authorized for use in the UK (Pfizer–BioNTech, Oxford–AstraZeneca, and Moderna) have reported high vaccine efficacy. This rapid systematic review was initiated because no systematic review had been conducted to determine the safety and efficacy of AstraZeneca ChAdOx1 nCoV-19 vaccine.

Evidence acquisition

A systematic search in the following platforms: PubMed, Google Scholar, Scopus, WOS, and MEDLINE databases for all articles in the English language regarding safety and efficacy of SARS-CoV-2 vaccine ChAdOx1 nCoV-19 was performed. Papers published up to end of June were included.

Evidence synthesis

Out of 477 retrieved articles, fifteen are included. All the selected articles are concerned with evaluation of AstraZeneca ChAdOx1 

Background

This pilot study included 68 cases with post-COVID-19 persistent cough (> 8 weeks), randomly allocated into two groups; intervention group (32 patients) received standard cough therapy, and montelukast 10 mg/day for 14 days and control group (36 patients) received only cough sedatives.

Results

We found a significant improvement in the number of cough paroxysms/day, cough severity visual analog scale, cough severity index and cough quality of life, shorter duration improvement, and minimal side effects in the interventional group.

Conclusions

We suggest that montelukast may be effective to reduce the duration and severity of the persistent post-COVID-19 cough and further improve quality of life.

Background

The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality.

Methods and analysis

Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the “PROVENT-C19 Registry”, endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care…’(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice.

Conclusions

This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed …

Background

Adherence to preventive control measures is influenced by perception, attitudes, and practices toward the disease prevention.

Aim

To assess the perceptions, attitude, and practices of university students in three health sector faculties (Medicine, Nursing, and Pharmacy) from six Egyptian universities towards COVID-19 pandemic prevention.

Methods

An electronic online survey was distributed to students of 3 faculties (Medicine, Pharmacy, and Nursing) in six Egyptian universities from March to July 2021. The questionnaire consists of the following parts: socio-demographic data of participants, student perception and attitude towards the COVID-19 pandemic and its consequences, as well as practices of preventive measures in the community.

Results

The study included 1990 participants. Most respondents perceived the seriousness of the COVID-19 pandemic (88.2%). The rates of practicing precautionary 

Introduction

Bronchiectasis was considered as an uncommon radiological feature of corona virus disease 2019 (COVID-19) infection. The clinical course and outcome of COVID-19 bronchiectasis overlap is still a point for research. The aim of this study was to evaluate the prevalence, course, and outcome of bronchiectasis as an atypical presentation of COVID-19 infection.

Methods

A cross-sectional study has been conducted from July 2021 to February 2022 and included 425 COVID-19 swab-positive patients who were examined by high resolution computed tomography of the chest during acute phase (4 weeks) of the infection.

Results

Fourteen (3.3%) patients newly developed bronchiectasis-de novo. Patients with de novo bronchiectasis had significantly higher cough score, frequency of colored sputum and mMRC score, respiratory distress (p < 0.001) and respiratory failure (p = 0.02) than patients with no bronchiectasis. They also had the higher frequency of ICU’s admission (p = 0.02), need to non-invasive (p = 0.01), and invasive mechanical ventilation (p = < 0.001), duration of mechanical ventilation, ICU’s stay and overall hospital stay (p < 0.001). As for the outcome, death rate was also statistically significantly higher among those with De novo bronchiectasis than those without bronchiectasis (p = 0.04).

Conclusion

Bronchiectasis is an uncommon presentation among COVID-19 patients. However, bronchiectasis increases disease burden in COVID-19 patients. It may have a negative impact on the outcome.

Frailty is a clinical syndrome characterized by decreased reserve and resilience [1]. Identifying frailty in critically ill patients can help to guide management, including the selection of appropriate interventions and the development of care plans such as time-limited trials in patients with an unclear benefit from critical care. The Clinical Frailty Scale (CFS) and the FRAIL checklist (1) are both tools proposed to assess frailty in older adults, but they have some key differences. The CFS is a simple, ordinal scale that assigns a score of 1 to 9 based on an assessment of the patient’s level of frailty. It takes into account various physical and functional characteristics. It is quick and easy to use, and it has been validated in multiple settings [2–4]. The FRAIL checklist assesses five domains of frailty: functional impairment, recurrent hospitalizations, advanced malignancy and chronic diseases, irreversible organ failure, and long …

We would like to express our sincere gratitude for the thoughtful comments made by Cheung et al. in their response to our letter [1]. We evaluated the distribution and prognostic relevance of previously proposed surrogate parameters for frailty, Clinical Frailty Scale (CFS)[2–4] and the FRAIL checklist [5], in our database and found that in the univariate analysis, both were associated with 90-day mortality. However, after multivariable adjustment for age, gender, SOFA score, and the presence of therapy goal limitations, only the CFS, but not the FRAIL checklist, was still associated with mortality. We concluded that the CFS has added value compared to the FRAIL checklist. Cheung et al. pointed out that the rate of patients with CFS> 4 was higher than those with

FRAIL> 0. We agree with Cheung et al.’s assessment that the items of the FRAIL checklist are less concrete than the pictograms of the CFS, and this could be a …