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Background: COVID-19 accounts for more than half a billion deaths globally. The clinical manifestations may vary in due course. Despite several studies aimed at determining the extent to which the disease's severity and mortality remain high when combined with other comorbidities, more research is required. Therefore, this review aimed to measure the pooled prevalence of coronary artery disease (CAD) among COVID-19 patients, specifically those with a history of CAD. Additionally, we aim to assess the association between mortality due to CAD and the severity of COVID-19 among hospitalized patients. Method: A comprehensive search in PubMed, Web of Science, the Cochrane Library, and the WHO COVID-19 database was conducted. English studies with original data on CAD, mortality, and ARDS among COVID-19 patients were included. PRISMA guidelines were followed. Results: Among the 2007 identified articles, 76 studies met the inclusion criteria. The pooled prevalence of CAD among COVID-19 patients was 14.4%(95% CI: 12.7-16.2). The highest prevalence was observed in European studies at 18.2%(95% CI: 13.3-24.2), while the lowest was in Asian studies at 10.4% (95% CI: 6.4-16.3). Participants with concurrent CAD at the time of hospital admission had twice the odds of mortality due to COVID-19 (2.64 [95% CI: 2.30-3.04]) with moderate heterogeneity (I2 = 45%, p < 0.01). Hospitalized COVID-19 patients with CAD had a 50% higher risk of ARDS (95% CI: 0.62-3.66), but this difference was not statistically significant. Conclusion: Although our analysis revealed evidence for a relationship between concurrent CAD at the time of hospital admission and mortality from COVID-19, however, global variation in health infrastructure, limitations of data reporting, and the effects of emerging variants must be considered in future investigations.
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Background: Telemedicine, a part of Medical Informatics used to consult patients from remote places either via videoconferencing or transferring data and resources via the Store and Forward method, makes the quality of healthcare in low-and middle-income countries more efficient, cost-effective, and accessible. The objectives of this study were to determine its effects on the health of refugees and its efficacy in terms of referrals and cost reduction for healthcare service providers among Bhutanese refugees in eastern Nepal. Methods: This was a cross-sectional study done retrospectively from the records of patient data of Bhutanese refugees from AMDA, Damak, and prospectively by asking the questionnaire to the healthcare providers of Beldangi PHC of AMDA, Damak. Results: The total percentage of patients that were seen via teleconsultation in the primary center was 58% male and 42% females, whereas from the secondary center, males were 43% and females constituted 57%. The referral rate from those primary centers and secondary centers were decreased to 31% and 39%, respectively, from 72% and 61% from previous records. The budget expenditure was also decreased to 13.65% from 29.41%. Conclusions: Telemedicine is beneficial in those types of refugee camps where there are chains of referring patients from primary health centers to tertiary care centers via secondary healthcare centers. As it not only decreased the referral rate but also save the budget expenditure, which are needed when referring those patients to other centers.
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OBJECTIVES: This cross-sectional study was conducted to describe the socio-demographic characteristics, assess the utilization of HIV testing and counselling services, and to explore the reasons for the non-utilization of HIV testing and counselling services among the key populations at the Bhutanese refugee camps in eastern Nepal. RESULTS: The HIV testing and counselling services are utilized by less than a third (29%) of the key population among the Bhutanese Refugees. The prime source of information about the HIV testing and counselling sites has been health workers followed by peer/outreach educators and neighbors. Common self-reported barriers for utilization of HIV testing and counselling services by the Bhutanese refugees were self-perceived stigma about HIV, the fear of being discriminated and the lack of knowledge about HIV testing and counselling services. There is a need to analyze the gap between availability and utilization through more qualitative approaches in order to identify interventions to increase the uptake of the HIV testing and counselling services.