Long COVID in Pakistan: a cross-sectional analysis of health and psychosocial outcomes.

According to the World Health Organization-led Delphi consensus, long COVID corresponds to the occurrence of symptoms beyond twelve weeks after the onset of acute COVID-19 illness that cannot be explained by alternate diagnosis. This cross-sectional study aimed to analyse the impacts of long COVID on general health and psychosocial well-being. For this study, the participants were interviewed either face to face or via telephone, and their responses were recorded on a questionnaire capturing information on demographics, COVID-19 status, duration of symptoms and long COVID symptoms. The psychosocial impacts of the pandemic were assessed using scales like Short Mood and feeling questionnaire (sMFQ), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), Generalized Anxiety Disorder Assessment (GAD-7) and Perceived Stress Scale (PSS). Regression analysis was conducted to analyse the predictors of long COVID. A total of 300 participants were interviewed, of which 155 (52%) had COVID-19 illness. Of these 54 (35%) had persistent symptoms for a period of more than 12 weeks classified as long COVID. Muscle problems and fatigue were the most frequent (14.7%) symptoms encountered, followed by breathing problems (12.6%) and cognitive issues (12.6%). The symptoms of decrease in appetite and confusion or disorientation during the initial phase of the infection were associated with long COVID. The majority of the participants (83.3%) had moderate level of perceived stress, while moderate to severe levels of stress were observed in 17.3% of the individuals. Moreover, a high level of positive mental well-being was also observed. This study highlights the need for further research into the clinical aspects and implications of long COVID in Pakistan and emphasizes the importance of ongoing support for affected individuals.

Extensive intraoperative peritoneal lavage with surgery, compared to surgery alone, for patients diagnosed with gastric cancer: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Gastric cancer ranks as the fifth most frequently diagnosed cancer and the seventh most prevalent overall. The lifetime risk of developing gastric cancer is 1.87% for males and 0.79% for females worldwide. AIM: This systematic review and meta-analysis aimed to determine whether Extensive Intraoperative Peritoneal Lavage (EIPL) provides short-term benefits or improved survival outcomes for patients undergoing gastrectomy. METHODS: A comprehensive search spanned PubMed, Embase, Cochrane Library, clinicaltrials.gov, and Web of Science, from their inception up to October 2023, adhering to predefined inclusion and exclusion criteria. The quality of the studies was analyzed using the Cochrane Collaboration Risk of Bias Tool. Data analysis was done using Review Manager 5.3, utilizing a random-effects model. RESULTS: Our analysis incorporated seven randomized controlled trials with 2602 patients. The follow-up time for all outcomes varied from 30-60 months. For our primary outcomes, EIPL demonstrated a significant benefit over surgery alone in terms of recurrence (RR=0.73; 95% CI: 0.65 to 0.83, P<0.00001) and postoperative complications (RR=0.67; 95% CI: 0.51 to 0.87, P=0.003). For our secondary outcomes, postoperative hospital stay (MD=-0.35; 95% CI: -1.11 to 0.41; P-value=0.37), 3-year overall survival (OR=1.44; 95% CI 0.84 to 2.47; P-value=0.19), 3-year disease-free survival (HR=0.93; 95% CI: 0.78 to 1.13; P-value=0.48), and time to first flatus (MD=-0.17; 95% CI: -0.35 to 0.01; P-value=0.06), no statistically significant differences were observed between the EIPL and control groups. CONCLUSION: While there is a marginal difference in survival outcomes, EIPL holds promise in significantly reducing overall cancer recurrence and suggests an enhancement in postoperative recovery.