A Case of Spontaneous Multiple Abdominal Wall Hematomas in a COVID-19 Patient.

Despite being relatively uncommon, abdominal wall hematomas can occur due to blunt trauma, post-percutaneous procedures, anticoagulation, and even spontaneous bleeding. It can present with varying symptoms from acute abdominal pain to life-threatening bleeding causing hypovolemia and shock. With the coronavirus disease 2019 (COVID-19) pandemic, affected patients developed coagulopathy putting patients at risk of venous thromboembolism or excessive bleeding. Herein, we report a case of spontaneous multiple abdominal wall hematomas in a patient after a COVID-19 infection, which was managed conservatively.

Evidence based medicine--where do articles published in local indexed journals stand?

OBJECTIVE: The recent emphasis on using "evidence based medicine" for decision-making in patient care issues has prompted many publishers to mention the level of evidence of articles in their journals. The "quality" of a journal may thus be reflected by the proportion of articles with high levels of evidence, apart from other criteria. We aimed to determine the level of evidence of articles in indexed Pakistani medical journals. METHODS: Two journals were selected: Journal of Pakistan Medical Association (JPMA) and Journal of College of Physician and Surgeons, Pakistan (JCPSP). Based on the information in the abstracts, all articles from 2003 and 2006 were categorized according to guidelines of Center for Evidence Based Medicine, Oxford, UK. RESULTS: 882 items/articles were reviewed. Of these, 270 (31%) were scientific articles within which 51% belonged to the "Therapeutic" and 25% to the "Prognostic" type. Only 27% had a high level of evidence (1 and 2) while a majority of 55% had level 4 evidence. Although there was a higher proportion of scientific research articles in JCPSP than JPMA (36% vs. 25%). no major difference in the levels of evidence was noted between the two journals, nor between 2003 and 2006. Moreover, the results were quite comparable to similar international studies. CONCLUSION: The level of evidence in articles in our leading local journals compares favourably with international literature. We recommend that levels of evidence be stated with abstracts in local journals not only to help the clinicians in making decisions on the best available evidence, but also to elevate the "quality" of these journals.