Pub Date : 2021-06-06DOI: 10.54112/pjicm.v2021i1.4
M. Rana, R. Pervaiz, B. Arif, F. Tariq, S. Tabassum, M. Siddiqui, S. Raza, MM Hafeez
Introduction: Coronavirus disease (COVID-19) is a leading cause of acute hypoxemic respiratory failure which can progress to acute respiratory distress syndrome (ARDS). These patients are deeply sedated, paralyzed and ventilated and prone positioning is known to help in these cases. Prone positioning has been known to help in ARDS cases, but they are ventilated deeply sedated and paralyzed. The aim of the current study was to assess the safety and potential benefits of awake prone positioning in COVID-19 patients with moderate to severe hypoxemic respiratory failure. Methods: This is a retrospective cohort study, performed at Bahira International Hospital Lahore. Record of confirmed COVID-19 patients with hypoxic respiratory failure was reviewed thoroughly to collect data. The duration, timing, frequency, tolerability, beneficial effects and adverse events during prone positioning were recorded from the medical records before and after self-prone positioning. Results: The current analysis showed that prone positioning is supportive to maintain good saturation (92%) as compared to keeping patients in spine position (82%). Conclusion: It can be concluded from the current study that prone position is helpful to maintain normal oxygen saturation even on low oxygen supply, helping in quick recovery and preventing oxygen induced damage to the lungs.
{"title":"BENEFICIAL EFFECTS OF AWAKE PRONE POSITIONING IN COVID-19 PATIENTS WITH MODERATE TO SEVERE HYPOXEMIC RESPIRATORY FAILURE","authors":"M. Rana, R. Pervaiz, B. Arif, F. Tariq, S. Tabassum, M. Siddiqui, S. Raza, MM Hafeez","doi":"10.54112/pjicm.v2021i1.4","DOIUrl":"https://doi.org/10.54112/pjicm.v2021i1.4","url":null,"abstract":"Introduction: Coronavirus disease (COVID-19) is a leading cause of acute hypoxemic respiratory failure which can progress to acute respiratory distress syndrome (ARDS). These patients are deeply sedated, paralyzed and ventilated and prone positioning is known to help in these cases. Prone positioning has been known to help in ARDS cases, but they are ventilated deeply sedated and paralyzed. The aim of the current study was to assess the safety and potential benefits of awake prone positioning in COVID-19 patients with moderate to severe hypoxemic respiratory failure. Methods: This is a retrospective cohort study, performed at Bahira International Hospital Lahore. Record of confirmed COVID-19 patients with hypoxic respiratory failure was reviewed thoroughly to collect data. The duration, timing, frequency, tolerability, beneficial effects and adverse events during prone positioning were recorded from the medical records before and after self-prone positioning. Results: The current analysis showed that prone positioning is supportive to maintain good saturation (92%) as compared to keeping patients in spine position (82%). Conclusion: It can be concluded from the current study that prone position is helpful to maintain normal oxygen saturation even on low oxygen supply, helping in quick recovery and preventing oxygen induced damage to the lungs.","PeriodicalId":353986,"journal":{"name":"Pakistan Journal of Intensive Care Medicine","volume":"11 suppl_1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122532012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-18DOI: 10.54112/pjicm.v2021i1.3
M. Rana, A. Qayyum, M. Hashmi, M. Saif, M. Munir, R. Pervaiz, S. Iqbal, MM Hafeez
Background: Since SARS CoV-2 infection began in China and has evolved into a pandemic, mortality associated with this illness has been under discussion and hypercoagubility, severe acute respiratory syndrome and septicemia with multiple organ insufficiency have been cursed as potential causes of death in cases infected with the novel coronavirus. We did a retrospective analysis of cases admitted to our highly dependent and intensive care unit, and we tried to identify the leading cause of death in our cases. Methods: This is a single center retrospective study carried out at Bahria International Hospital Lahore over a 3-month period (May 10th to July 10th 2020) in which we analyzed the clinical and biochemical profiles of the COVID-19 patients who died during this period. Results: A total of 108 patients were admitted during this period out of which 11 patients died. 7 of them were men and 4 women. Majority of them had sudden cardiac arrest due to acute coronary syndrome followed by multiorgan dysfunction syndrome and acute respiratory distress syndrome. Conclusion: Acute coronary syndrome due to hypercoagubility was the leading cause of death in our patients.
{"title":"MORTALITY AND COVID-19: A SNAPSHOT OF A TERTIARY CARE FACILITY IN PAKISTAN","authors":"M. Rana, A. Qayyum, M. Hashmi, M. Saif, M. Munir, R. Pervaiz, S. Iqbal, MM Hafeez","doi":"10.54112/pjicm.v2021i1.3","DOIUrl":"https://doi.org/10.54112/pjicm.v2021i1.3","url":null,"abstract":"Background: Since SARS CoV-2 infection began in China and has evolved into a pandemic, mortality associated with this illness has been under discussion and hypercoagubility, severe acute respiratory syndrome and septicemia with multiple organ insufficiency have been cursed as potential causes of death in cases infected with the novel coronavirus. We did a retrospective analysis of cases admitted to our highly dependent and intensive care unit, and we tried to identify the leading cause of death in our cases. Methods: This is a single center retrospective study carried out at Bahria International Hospital Lahore over a 3-month period (May 10th to July 10th 2020) in which we analyzed the clinical and biochemical profiles of the COVID-19 patients who died during this period. Results: A total of 108 patients were admitted during this period out of which 11 patients died. 7 of them were men and 4 women. Majority of them had sudden cardiac arrest due to acute coronary syndrome followed by multiorgan dysfunction syndrome and acute respiratory distress syndrome. Conclusion: Acute coronary syndrome due to hypercoagubility was the leading cause of death in our patients.","PeriodicalId":353986,"journal":{"name":"Pakistan Journal of Intensive Care Medicine","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124671743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-12DOI: 10.1101/2020.11.06.20223040
M. M. Hafeez, Mohammad-Reza Azhar, Hafiz Rizwan Zafar Chudhary, M. A. Rana, Arif Malik
During the novel coronavirus pandemic, also known as SARS-CoV-2 or COVID-19 pandemic, frontline healthcare professionals suffered psychological as well as pathological trauma due to the lack of preparation to cope with this unforeseen situation. The protocols to prevent the spread of this disease proved to be less effective than anticipated. In these circumstances, improvement of the existing triage system was felt and an AUDIO-VISUAL TRIAGE (AVT) system was introduced to enhance confidence as well as increase the safety of frontline healthcare professionals. The current analysis was performed from March 21, 2020, to April 28, 2020, until the completion of sixty response forms, at Bahria Town International Hospital, Lahore. Thirty participants (Group A) deployed on visual triage and other thirty (Group B) on AVT for screening suspected cases of COVID-19 infection. Anxiety levels were measured by using the GAD-7 scoring system and the participants of both groups were periodically tested for COVID-19 infection by PCR. Independent t-test was used to evaluate the significance of different variables at a confidence level of 95%. The result of the current study revealed the effectiveness of AVT for the screening of COVID-19 patients. There was a statistically significant increase in anxiety levels and SARS-CoV-2 infection rate in group A as compared to group B. Almost all participants in group A wanted to shift their place of work or ready to quit the job if they were forced to perform their duties at the same visual triage. AVT system for COVID-19 screening is proved to be better than visual triage. It is not only a simple and effective way to prevent the spread of diseases but also boosted the confidence of frontline healthcare professionals to fight against coronavirus spread.
{"title":"Innovation of Audio-Visual Triage system in Combating the Spread of COVID-19 Infection and its efficacy: A Novel Strategy","authors":"M. M. Hafeez, Mohammad-Reza Azhar, Hafiz Rizwan Zafar Chudhary, M. A. Rana, Arif Malik","doi":"10.1101/2020.11.06.20223040","DOIUrl":"https://doi.org/10.1101/2020.11.06.20223040","url":null,"abstract":"During the novel coronavirus pandemic, also known as SARS-CoV-2 or COVID-19 pandemic, frontline healthcare professionals suffered psychological as well as pathological trauma due to the lack of preparation to cope with this unforeseen situation. The protocols to prevent the spread of this disease proved to be less effective than anticipated. In these circumstances, improvement of the existing triage system was felt and an AUDIO-VISUAL TRIAGE (AVT) system was introduced to enhance confidence as well as increase the safety of frontline healthcare professionals. The current analysis was performed from March 21, 2020, to April 28, 2020, until the completion of sixty response forms, at Bahria Town International Hospital, Lahore. Thirty participants (Group A) deployed on visual triage and other thirty (Group B) on AVT for screening suspected cases of COVID-19 infection. Anxiety levels were measured by using the GAD-7 scoring system and the participants of both groups were periodically tested for COVID-19 infection by PCR. Independent t-test was used to evaluate the significance of different variables at a confidence level of 95%. The result of the current study revealed the effectiveness of AVT for the screening of COVID-19 patients. There was a statistically significant increase in anxiety levels and SARS-CoV-2 infection rate in group A as compared to group B. Almost all participants in group A wanted to shift their place of work or ready to quit the job if they were forced to perform their duties at the same visual triage. AVT system for COVID-19 screening is proved to be better than visual triage. It is not only a simple and effective way to prevent the spread of diseases but also boosted the confidence of frontline healthcare professionals to fight against coronavirus spread.","PeriodicalId":353986,"journal":{"name":"Pakistan Journal of Intensive Care Medicine","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133113635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.54112/pjicm.v2021i1.5
B. Amir, Y. Javed, S. Hanif, M. Tahir, M. Rana, MM Hafeez
The development of low-cost, fast, and reliable methods for detecting Mycobacterium tuberculosis (MTB) infection and drug susceptibility is critical for tuberculosis control. The new microscopic examination of liquid drug susceptibility assay (MODS) examines early MTB colonies in a liquid medium, which permits for more convenient diagnosis and testing of drug susceptibility. The sensitivity of MODS (91%) was superior as compared to the sensitivity of different culture methods (92%). The MGIT and MODS were used to monitor tuberculosis-positive sputum samples for isoniazid and rifampin susceptibility. Concordance between MODS and MGIT was found in 89 percent of cases. MODS are the fastest method used for diagnostic and susceptibility testing (median, 10.0 or 9 days). MODS is a fast, low-cost, responsive, and particular method for detecting and testing MTB susceptibility; it is specifically well-suited utilize in growing countries with high infection rates and a growing number of multidrug-resistant cases.
{"title":"CULTURING, IDENTIFICATION AND DRUG RESISTANCE OF MYCOBACTERIUM TUBERCULOSIS IN SPUTUM SPECIMEN","authors":"B. Amir, Y. Javed, S. Hanif, M. Tahir, M. Rana, MM Hafeez","doi":"10.54112/pjicm.v2021i1.5","DOIUrl":"https://doi.org/10.54112/pjicm.v2021i1.5","url":null,"abstract":"The development of low-cost, fast, and reliable methods for detecting Mycobacterium tuberculosis (MTB) infection and drug susceptibility is critical for tuberculosis control. The new microscopic examination of liquid drug susceptibility assay (MODS) examines early MTB colonies in a liquid medium, which permits for more convenient diagnosis and testing of drug susceptibility. The sensitivity of MODS (91%) was superior as compared to the sensitivity of different culture methods (92%). The MGIT and MODS were used to monitor tuberculosis-positive sputum samples for isoniazid and rifampin susceptibility. Concordance between MODS and MGIT was found in 89 percent of cases. MODS are the fastest method used for diagnostic and susceptibility testing (median, 10.0 or 9 days). MODS is a fast, low-cost, responsive, and particular method for detecting and testing MTB susceptibility; it is specifically well-suited utilize in growing countries with high infection rates and a growing number of multidrug-resistant cases.","PeriodicalId":353986,"journal":{"name":"Pakistan Journal of Intensive Care Medicine","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114696421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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