SARS-CoV-2 infection and vaccination in patients with pituitary diseases: the experience of a Brazilian reference center.

PURPOSE: To evaluate the prevalence and characteristics of SARS-CoV-2 infection, and the prevalence, efficacy, and safety of anti-SARS-CoV-2 vaccination in patients with pituitary diseases. METHODS: Observational, cross-sectional study of adult patients with pituitary diseases followed in a reference center. Clinical data were collected and a questionnaire about SARS-CoV-2 infection, vaccination and its possible adverse effects was applied. COVID-19 disease severity was defined as mild, moderate, and severe according to the WHO classification. RESULTS: 145 patients were studied (79 women; age 50 ± 15.8 years; duration of pituitary disease 16.8 ± 11.5 years), the cause of pituitary disease was tumoral in 74.5%, and 45.9% were on glucocorticoid replacement due to ACTH deficiency. SARS-CoV-2 infection was confirmed in 51 patients (35.2%; 32 women; age 53.8 ± 14.8 years, 22 before vaccination), with 28 (54.9%), 17 (33.3%) and 6 (11.8%) cases of mild, moderate, and severe disease, respectively, and hospitalization was indicated in 7 (14%) cases. One mild case presented pituitary apoplexy after SARS-CoV-2 infection. Advanced age was a risk factor for COVID-19. Patients with moderate and severe forms of COVID-19 had higher prevalence of dyslipidemia and duration of pituitary disease. All but one of the participants were vaccinated against COVID-19, and 60.4% had adverse events, the most common local pain (54.0%), fever (33.3%), and headache (18.4%), with one case of alopecia and two of persistent fatigue. CONCLUSION: The prevalence of SARS-CoV-2 infection in our cohort was 35.2%, including 14% of moderate and severe cases requiring hospitalization. The vaccination was universal and safe.

COVID-19 pandemic impacted internet use and anxiety among general public during COVID-19 pandemic in Pakistan.

Objective: To determine the association between internet use and anxiety among people during the coronavirus disease- 2019 pandemic. METHODS: The cross-sectional study was conducted across Pakistan from January 14 to February 21, 2021, which was the active phase of the coronavirus disease-2019 pandemic in Pakistan. The participants were aged at least 13 years having internet access regardless of gender or their location across Pakistan. The anonymous web-based survey was conducted using a questionnaire generated on Google Forms and disseminated through various social media platforms and WhatsApp groups. Anxiety symptoms were screened using the Depression, Anxiety and Stress Scale-21, while the Young Internet Addiction Test was used to evaluate symptoms of internet addiction. Data was analysed using STATA 16. RESULTS: Of the 1,145 subjects, 686(60%) were females and 459(40%) were males. A total of 257(22.5%) participants were found to have extremely severe anxiety and internet usage pattern was significantly associated with the level of anxiety (p<0.05). Age, gender, social class and marital status were not significantly different (p>0.05), while family income and area of living were significantly different (p<0.05) in terms of anxiety levels. The odd of addictive internet use was 10.2 (95% confidence interval: 5.7-18.5) times greater in extreme anxiety individuals compared to individuals having no anxiety after controlling for other sociodemographic, health-related, behavioural and environmental factors during the pandemic. Conclusion: A significant association of anxiety was found with internet addiction during the coronavirus disease-2019 pandemic.

O2 Saturation Predicted the ICU Stay of COVID-19 Patients in a Hospital at Altitude: A Low-Cost Tool for Post-Pandemic.

Background and Objectives: Patients at high altitudes with COVID-19 may experience a decrease in their partial oxygen saturation (PO2S) levels. The objective was to assess the association between PO2S and intensive care unit (ICU) stay in patients at high altitudes with COVID-19. Materials and Methods: Clinical records of 69 COVID-19 patients (36% women) admitted to the ICU were analyzed. Median values were considered for intra-group categories ("≤11 days" and ">11 days" in the ICU) and for PO2S height categories ("<90%" and "≥90%"). Logistic regression and linear regression models adjusted for confounding variables were used. Results: Patients with >11 days in the ICU had 84% lower odds of having a PO2S ≥ 90% (OR: 0.16 [CI: 0.02, 0.69], p = 0.005) compared to those with ≤11 days in the ICU. An increase in PO2S by 1% reduced ICU stay by 0.22 days (ß: -0.22 [CI: -0.33, -0.11], p < 0.001), potentially leading to a reduction of up to 1.44 days. Conclusions: PO2S is a crucial factor in estimating ICU stays for COVID-19 patients at high altitudes and serves as an accessible and cost-effective measure. It should be used in infected patients to complement the prognosis of post-pandemic ICU stay.

[Social factors of mental health and well-being of older Russians.]

The article highlights social factors of mental health and well-being of older Russians based on the results of wave sociological studies of the perceived quality of life for 2002-2019 and the author's representative survey of older Russians in 2022. Age, gender and employment are the most significant determinants not only of social activity, but also of mental health and emotional well-being. At the same time, the study shows that the pandemic had a multidirectional impact on perceived quality of life among older Russians. Compared to the pre-pandemic situation, after the relaxation of restrictive measures, the parameter of social activity increased significantly, the parameter of mental health remained virtually unchanged, but the emotional problems of elderly Russians became more acute. Due to the severe restrictions for older people, the long period of isolation, and for working pensioners - also due to the need to restructure their work remotely - stress, anxiety and worry have affected everyday life.

Health aspects of the behaviour of the Czech population during the COVID-19 pandemic from a public health perspective.

The paper presents the outcomes of the WHO European Region research project, Ministry of Health of the Czech Republic and the First Faculty of Medicine, Charles University which concerned Czech population behaviour during the COVID-19 pandemic. In the Czech Republic the research was carried out in three waves on a representative sample of respondents using methodology of a questionnaire survey. The results showed that the risk perception in connection with the pandemic was low in the Czech environment, regardless of the growing number of infected and deceased. Optimism persisted about the perception of personal susceptibility to infection and self-efficacy. General wellbeing was above average after successfully coping with the first wave, but it decreased slightly in connection with the worsening of the pandemic situation. Compliance with preventive measures has been relatively low for a long time and the trend has been rather declining. By the time, it became increasingly difficult to understand the communication of state authorities regarding the measures being implemented, and trust in the media decreased. A positive finding was the increase in the proportion of those who tried to improve the lifestyle in connection with the pandemic.

[Medication reconciliation on admission: One year of practice in health care institutions during the COVID-19 pandemic]. / Conciliation médicamenteuse à l'admission : bilan d'une année d'activité en établissement de santé durant la crise COVID-19.

OBJECTIVES: Medication reconciliation is a key point of the v2020 certification. The main objective of this study was to evaluate this activity over one year, including the first epidemic wave at COVID-19. The secondary objectives were to identify the obstacles and levers and to evaluate doctor satisfaction. METHODS: This was a retrospective study of drug reconciliations performed on admission during 12 months of the emergence of COVID-19. Patients aged 65 years and older from orthopedic and visceral surgery, acute hospitalization and conventional medicine units were included. Unintentional discrepancies were analyzed. The obstacles and levers were identified by means of a focus group. Doctors' satisfaction was collected using online quiz. RESULTS: A total of 760 patients were conciliated, of which 27% (n=208) by hospital pharmacy technicians. A decrease in activity was observed during the first epidemic wave. An unintentional discrepancy was found in 77% of patients, and only 48% were corrected by the prescriber. These results were impacted by the pandemic. The pharmaceutical team was mobilized in the logistical management of the crisis, but it was able to adapt in order to perpetuate the activity. Doctors are satisfied with the process. CONCLUSIONS: Medication reconciliation on admission is essential for the prevention of iatrogeny, particularly with the impact of the COVID-19 pandemic in healthcare institutions.

Managing the COVID-19 pandemic in people with mental disorders: An exploratory telephone interview study in a psychiatric outpatient department.

BACKGROUND: The COVID-19 pandemic and associated lockdown measures reduced well-being in the general population significantly and led to an increase in anxiety and depression symptoms, however, results on the impact on people with mental disorders are heterogeneous to date. The aim of this study was to investigate the mental health status, social support, perceived stress, and the medical care provision of people with mental disorders during the time period immediately after the first COVID-19 lockdown in spring 2020 in Germany. METHODS: Participants were people with mental disorders currently receiving treatment in the psychiatric outpatient department of the University Hospital Leipzig, Germany. Structured telephone interviews were administered to assess depressive symptoms, self-rated medical care provision, attitudes and social and emotional aspects of the pandemic (social support, perceived stress, loneliness, resilience, and agreeableness). RESULTS: A total of N = 106 people completed the telephone interview. The most frequent clinician-rated diagnoses were attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD; n = 29, 27.4%) and obsessive-compulsive disorder (OCD; n = 24, 22.6%). The mean Patient Health Questionnaire-9 sum score was 10.91 (SD = 5.71) and the majority of participants (n = 56, 52.8%) reported clinically relevant depressive symptoms. A low self-rated medical care provision was significantly associated with higher depressive symptom load. In a regression analysis, higher perceived stress levels and low medical care provision significantly predicted depressive symptoms. Furthermore, 38.1% (n = 40) reported to feel relieved as a result of the restrictions and, due to previous experience in dealing with crisis, half of the participants (n = 53, 50.5%) stated they were better able to deal with the current situation than the general population. CONCLUSIONS: This study emphasizes the importance of maintenance of medical care provision for people with mental disorders, as cancelled or postponed treatment appointments and perceived stress were associated with higher depressive symptoms. Regular treatment services showed to have a protective effect. In addition, a majority of people with mental disorders felt prepared for managing the COVID pandemic due to existing crisis management abilities. These resources should also be taken into account for further future treatment considerations. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00022071).

Nurses' experiences of emergency department triage during the COVID-19 pandemic in Indonesia.

PURPOSE: To explore the experiences of nurses working in emergency departments in selecting and triaging patients during the COVID-19 pandemic. DESIGN: Descriptive phenomenology was applied in this study. METHODS: Data were collected from nurses working at hospitals in Indonesia using snowball sampling and telephone interviews. A total of 10 emergency nurses participated, and Colaizzi's method of data analysis was applied. FINDINGS: Six themes and 10 subthemes emerged. The main themes were "extreme challenges in triage," "feeling of responsibility under uncontrolled spread and infection," "physical and psychological exhaustion," "discovering strategies under difficult circumstances," "looking for positive reinforcement," and "optimism in togetherness." Nurses had to deal with the challenge of COVID-19 in the ED triage, interestingly so, the nurses they have shown the development of professional responsibility. Nurses are also experienced in finding patient selection and triage strategies and the sense of optimism that may influence strategy and practice during the COVID-19 pandemic. CONCLUSIONS: This findings identify nurses' experiences in dealing with the extreme challenges of emergency department triage as well as their associated strategies and optimism. CLINICAL RELEVANCE: Providing support to emergency nurses, improving emergency department triage, and community empowerment are suggested as strategies to improve nursing care during the COVID-19 pandemic.

Dietary supplements, vitamins and minerals as potential interventions against viruses: Perspectives for COVID-19.

The novel coronavirus (SARS-CoV-2) causing COVID-19 disease pandemic has infected millions of people and caused more than thousands of deaths in many countries across the world. The number of infected cases is increasing day by day. Unfortunately, we do not have a vaccine and specific treatment for it. Along with the protective measures, respiratory and/or circulatory supports and some antiviral and retroviral drugs have been used against SARS-CoV-2, but there are no more extensive studies proving their efficacy. In this study, the latest publications in the field have been reviewed, focusing on the modulatory effects on the immunity of some natural antiviral dietary supplements, vitamins and minerals. Findings suggest that several dietary supplements, including black seeds, garlic, ginger, cranberry, orange, omega-3 and -6 polyunsaturated fatty acids, vitamins (e.g., A, B vitamins, C, D, E), and minerals (e.g., Cu, Fe, Mg, Mn, Na, Se, Zn) have anti-viral effects. Many of them act against various species of respiratory viruses, including severe acute respiratory syndrome-related coronaviruses. Therefore, dietary supplements, including vitamins and minerals, probiotics as well as individual nutritional behaviour can be used as adjuvant therapy together with antiviral medicines in the management of COVID-19 disease.

[Time perspective, sleep and wellbeing of the elderly during COVID-19 pandemic.]

The purpose of this study was to analyze the association between the time perspective and the psychophysiological state of the elderly during the pandemic COVID-19. 433 residents from 11 Russian cities aged 60,8±9,8 years (range - 50-94 years, women - 78,7%) took part in the study. During the online survey, each participant of the study provided personal data (place of residence, sex, age, height, and weight) and completed the Zimbardo Time Perspective Inventory, the Munich Chronotype Questionnaire, the Beck Depression Inventory and the Yale Food Addiction Scale. It was found that elderly people with a balanced time perspective had the lowest level of depression during the pandemic COVID-19 and less expressed sleep inertia at work days, while those with a past negative time perspective had the highest level of depression, high frequency of detection of food addiction and low sleep efficiency. The other types of time perspective (past positive, present hedonistic, present fatalistic and future) had intermediate values of indicators between these two extreme options. Thus, the conducted studies have shown that elderly people with a balanced time perspective showed the highest level of resistance to psychoemotional stress caused by the pandemic COVID-19.

Evaluating the effects of responsive design on the usability of academic websites in the pandemic.

Responsive design allows users to benefit from the web page without having to worry about screen size and resolution. The aim of this study is to investigate the effect of responsive design on usability. For this purpose, a questionnaire consisting of a five-point Likert was applied to university students. According to the results, it was seen that 99.2% of university students had smart phones and used smart phones to connect to internet with a rate of 91.3%. It was observed that the participants' attitudes towards responsive design did not differ according to gender, and students in the 24-26 age group had more desire to use responsive design. And, university students' attitudes towards responsive design did not differ according to the Internet access method. It was found that 38% of the participants had a daily internet usage rate of 4-5 h and they used social media the most. Ease of use has been identified as the most preferred feature (Avg = 3.67/5, 73.4%) of usability in responsive design by evaluating dimensions central tendency measures. With regression analysis, responsive design explains 74.7% of the change in effectiveness (R2 = 0.747) among the usability dimensions. With regression analysis, 91.5% of usability can be explained with the responsive design (R2 = 0.915). Usability and responsive design (r = 0.92, p < 0.01) were both found to be positively correlated. It can be said that the academic university websites developed with responsive design are preferred by university students in the pandemic and this has increased usability and effectiveness.

Predictors of COVID-19 vaccine hesitancy among Egyptian healthcare workers: a cross-sectional study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccination has raised concerns about vaccine hesitancy in general and COVID-19 vaccine hesitancy in particular. Understanding the factors driving the uncertainty regarding vaccination against COVID-19 is crucial. METHODS: This cross-sectional study was designed to identify the perceptions and attitudes of healthcare workers (HCWs) towards COVID-19 vaccines and determine the predictive factors that affect their willingness to receive the COVID-19 vaccine. An online survey was distributed among HCWs to collect data assessing demographic and general characteristics of the participants and vaccine-related characteristics, including source of information about the vaccine. In addition to items assessing the perception of COVID-19, there were items on COVID-19 vaccines and attitude towards vaccination in general and towards COVID-19 vaccines in particular. RESULTS: The participants were classified according to their willingness to take the COVID-19 vaccine as follows: hesitant (41.9%), refusing (32.1%), and willing (26%). Statistically significant differences were observed among the three groups for the perception of COVID-19 vaccines, attitude towards vaccination in general, and COVID-19 vaccines in particular (p < 0.01). CONCLUSIONS: Although the participants adequately perceived COVID-19 severity, prevention, and COVID-19 vaccine safety, they were widely hesitant or refused to be vaccinated. A multidimensional approach is required to increase the vaccine acceptability rate. Higher income and increased years of work experience are positive predictors of willingness to receive a vaccine. Thus, further studies addressing the scope of COVID-19 vaccine hesitancy are warranted as an initial step to build trust in COVID-19 vaccination efforts with continuous monitoring of attitudes and practices of HCWs towards COVID-19 vaccines in the future.

Dynamic model of infected population due to spreading of pandemic COVID-19 considering both intra and inter zone mobilization factors with rate of detection.

Most of the widely populated countries across the globe have been observing vicious spread and detrimental effects of pandemic COVID-19 since its inception on December 19. Therefore to restrict the spreading of pandemic COVID-19, various researches are going on in both medical and administrative sectors. The focus has been given in this research keeping an administrative point of view in mind. In this paper a dynamic model of infected population due to spreading of pandemic COVID-19 considering both intra and inter zone mobilization factors with rate of detection has been proposed. Few factors related to intra zone mobilization; inter zone mobilization and rate of detection are the key points in the proposed model. Various remedial steps are taken into consideration in the form of operating procedures. Further such operating procedures are applied over the model in standalone or hybridized mode and responses are reported in this paper in a case-studies manner. Further zone-wise increase in infected population due to the spreading of pandemic COVID-19 has been studied and reported in this paper. Also the proposed model has been applied over the real world data considering three states of India and the predicted responses are compared with real data and reported with bar chart representation in this paper.

Air quality changes in cities during the COVID-19 lockdown: A critical review.

In response to the rapid spread of coronavirus disease-2019 (COVID-19) within and across countries and the need to protect public health, governments worldwide introduced unprecedented measures such as restricted road and air travel and reduced human mobility in 2020. The curtailment of personal travel and economic activity provided a unique opportunity for researchers to assess the interplay between anthropogenic emissions of primary air pollutants, their physical transport, chemical transformation, ultimate fate and potential health impacts. In general, reductions in the atmospheric levels of outdoor air pollutants such as particulate matter (PM), nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), and volatile organic compounds (VOCs) were observed in many countries during the lockdowns. However, the levels of ozone (O3), a secondary air pollutant linked to asthma and respiratory ailments, and secondary PM were frequently reported to remain unchanged or even increase. An increase in O3 can enhance the formation of secondary PM2.5, especially secondary organic aerosols, through the atmospheric oxidation of VOCs. Given that the gaseous precursors of O3 (VOCs and NOx) are also involved in the formation of secondary PM2.5, an integrated control strategy should focus on reducing the emission of the common precursors for the co-mitigation of PM2.5 and O3 with an emphasis on their complex photochemical interactions. Compared to outdoor air quality, comprehensive investigations of indoor air quality (IAQ) are relatively sparse. People spend more than 80% of their time indoors with exposure to air pollutants of both outdoor and indoor origins. Consequently, an integrated assessment of exposure to air pollutants in both outdoor and indoor microenvironments is needed for effective urban air quality management and for mitigation of health risk. To provide further insights into air quality, we do a critical review of scientific articles, published from January 2020 to December 2020 across the globe. Finally, we discuss policy implications of our review in the context of global air quality improvement.

Selection of healthcare waste disposal firms using a multi-method approach.

The aim of this study is to propose a hybrid multi criteria decision making model with a linear programming (LP) model to tackle the issue of safe disposal of hazardous and infectious healthcare waste. For this, ten criteria in this study have been identified from literature and field surveys which are modelled using Decision making trial and evaluation (DEMATEL) and Analytic network process (ANP) methods to select the best disposal firm i.e. single sourcing for a hospital. We found that Experience of the firm, Technology for disposal, and Waste collection infrastructure acts as the most vital criteria in selecting a healthcare waste disposal firm for single sourcing. Furthermore, to optimize the total value of disposal and mitigating the risk involved in disposing waste through single sourcing; the LP model considering constraints such as waste lose constraint and waste processing constraint etc. Is solved for multiple sourcing using Lingo 18.0. The solution to LP results into allocation of 500, 500, and 1000 (kg/day) disposables to healthcare waste disposal firms D1, D2 and D3, respectively. The multi-method approach proposed in this study helps the hospital management in selecting economically, socially, and environmentally sustainable healthcare waste disposal firm.

[Time perspective perception specific and maladaptation in elderly under uncertainty conditions during pandemic emergency.]

The purpose of the study - to determine the specifics of experiencing psychological stress, the time perspective and symptoms of adaptation disorders in older people in a pandemic emergency compared to the active adult population. At the first stage, 587 people were examined using the PSM-25 scale, then 100 respondents with maladaptive stress levels (sum ≥155 points) were selected. The main group consisted of 50 people aged 60 to 74 years (average age 65±2,7 years), 50 people aged 18 to 44 years (average age 32±3,8 years) were included in comparison group, who were examined with using the SCL-90-R questionnaire for assessing psychopathological symptoms and the ZTPI questionnaire for assessing the perception of time perspective. The presence of adaptation disorders in both groups was revealed. In the elderly group, the activation of the perception of the positive past was established, which can be an adaptive resource, and the greater severity of the fatalistic perception of the present, which causes passive overcoming with stress and narrows the adaptive capabilities of the elderly. The results of the study make it possible to identify potential «targets¼ of psychotherapeutic work with the population in conditions of pandemic stress, taking into account the age factor.

PSYCHOLOGICAL FACTORS AND CONSEQUENCES OF PSYCHOSOCIAL STRESS DURING THE PANDEMIC.

OBJECTIVE: The aim: Study of psychological factors and consequences of psychosocial stress which is formed during the COVID-19 pandemic. PATIENTS AND METHODS: Materials and methods: In the research, we used methods: developed a common, assessment of psychosocial stress L. Reeder scale, assessment of distress R.Kessler, assessment of the presence of manifestations of anxiety-depressive response GAD-7, depression self-assessment scale PHQ-9, method of assessing neuropsychological adaptation I. Gurvich, assessment of psychosocial support D. Ziemet, the scale of assessment of family anxiety E. Eidemiller, W. Justickis, strategies for stress-coping behavior E. Heim, methods of assessing the quality of life A.A. Pushkarev, N.G. Arinchina (2000). The current factors of the impact of coronavirus on the mental state of the population have been investigated. The study involved 823 citizens of Ukraine, who filled out the developed Google form. RESULTS: Results: Threats of coronavirus disease, violation of the usual life stereotype, restriction of leisure activity, harmful interest in news about the pandemic, usage of tobacco plays an important role in the mechanisms of distress formation. These conditions raise the risk of increased stress, anxiety and depression. CONCLUSION: Conclusions: The investigations carried out suggested that the quarantine restrictions could be predisposing factors for mental health impairments. Under these conditions, risks of increased stress pressure, anxiety, and depression are rising. Measures on psycho-prevention should be performed on the base of the regularities identified.

[Working conditions among Mental Healthcare workers at the beginning of COVID-19 pandemic in Argentina]. / Condiciones laborales del personal de salud mental al comienzo de la pandemia por COVID-19 en Argentina.

INTRODUCTION: The current COVID-19 pandemic highlights the different difficulties that healthcare workers have to face in this context. In order to quantify some aspects of the current working situation, the Asociación de Psiquiatras Argentinos (APSA) designed a survey for Mental Healthcare workers. The goal was to: measure and know what are the working conditions of those working in Mental Health in Argentina, in this pandemic context. METHODS: Cross sectional descriptive study. Convenience sample. The survey was designed and sent in a digital format, thru APSA means of communication. The survey had 27 questions and one comments option. Questions explored sociodemographic variables, worked related aspects and discrimination suffered by participants. RESULTS: The survey, in its digital format, was answered by 710 participants. 32% of those in the public sector pointed out that people needed to bring their own personal protective equipment, compared to 56% in the private sector. For protocols in place, nearly 82% of public sector responses said there is a protocol for COVID-19 compatible symptoms in patients, compared to 58% in the private sector. And for new patients in an inpatient facility, responses showed that more than 50% had a protocol in the public sector, vs less than half in the private setting. CONCLUSIONS: This survey and the results allows to know and have evidence on which were the working conditions at the beginning of the pandemic. Having a plan considering what is known and what is available, allows a more appropriate approach, for both the workers and those who depend on them for care.

Thoracic computerised tomography scans in one hundred eighteen orthopaedic patients during the COVID-19 pandemic: identification of chest lesions; added values; help in managing patients; burden on the computerised tomography scan department.

PURPOSE: Based on the recent literature, chest computed tomography (CT) examination could aid for management of patients during COVID-19 pandemic. However, the role of chest CT in management of COVID-19 patients is not exactly the same for medical or surgical specialties. In orthopaedic or trauma emergency, abdomen, pelvis, cervical, dorsal, and lumbar spine CT are performed to investigate patients; the result is a thoracic CT scan incorporating usually the thorax; however, information about lung parenchyma can be obtained on this thorax CT, and manifestations of COVID-19 can be diagnosed. The objective of our study was to evaluate this role in orthopedic patients to familiarize orthopaedists with the value and limits of thoracic CT in orthopaedic surgery. MATERIALS AND METHODS: Among the 1397 chest CT scans performed during the pandemic period from 1 March 2020 to 10 May 2020, in two centres with orthopaedic surgery, we selected all the 118 thoracic or chest CT performed for patients who presented to the Emergency Department of the hospital with a diagnosis of trauma for orthopaedic surgical treatment. Thirty-nine of these 118 patients were tested with PCR for the diagnosis of COVID-19 infection. Depending on clinical status (symptomatic or non-symptomatic), the information useful for the orthopaedist surgeon and obtained from the Chest CT scan according to the result of the PCR (gold standard) was graded from 0 (no or low value) to 3 (high value). The potential risks of chest CT as exposure to radiation, and specific pathway were analyzed and discussed. A group of patients treated during a previous similar period (1 March 2018 to 15 April 2018) was used as control for evaluation of the increase of CT scanning during the COVID-19 pandemic. RESULTS: Among the 118 patients with chest CT, there were 16 patients with positive COVID-19 chest CT findings, and 102 patients with negative chest CT scan. With PCR results as reference, the sensitivity, specificity, positive predictive value of chest CT in indicating COVID-19 infection were 81%, 93%, and 86%, respectively (p = 0.001). A useful information for the orthopaedic surgeon (graded as 1 for 71 cases, as 2 for 5 cases, and as 3 for 11 cases) was obtained from 118 chest CT scans for 87 (74%) patients, while the CT was no value in 30 (25%) cases, and negative value in one (1%) case. Roughly 20% of the total number of CT scanner performed over the pandemic period was dedicated to COVID-19, but only 2% were for orthopaedic or trauma patients. However, this was ten times higher than during the previous control period of comparison. CONCLUSION: Although extremely valuable for surgery management, these results should not be overstated. The CT findings studied are not specific for COVID-19, and the positive predictive value of CT will be low unless disease prevalence is high, which was the case during this period.

Fighting pandemics: Inspiration from Islam.

Infectious disease has killed more people than any other cause throughout history. The current pandemic of coronavirus disease (COVID-19) has again revealed how vulnerable we remain. Muslims constitute the world's second-largest religious group, making up about a quarter of the world population. They have distinctive faith and culture, pertaining to their religious beliefs and practices that need special attention, in situations such as current COVID-19 pandemic. Congregational prayers are an indispensable part of Islamic culture. Performance of obligatory prayers in congregation is compulsory and mandatory for every Muslim adult male who has no excuse for not doing so. But, doing so during a pandemic can help in the spread of the COVID-19. Muslims look up to the Holy Qur'an and teachings of Prophet (PBUH) (Hadiths) for guidance under all the circumstances. In this review we will cover how Islamic teaching can guide us to manage pandemics like COVID-19.