Avicenna - Volume 2023, Issue 1

The COVID-19 pandemic has presented significant challenges to healthcare systems worldwide, necessitating a proactive and strategic approach to navigate the post-COVID healthcare landscape. This editorial delves into the multifaceted challenges that healthcare systems face in the aftermath of the pandemic and emphasizes the importance of equitable, sustainable, and ethical policy making. The editorial highlights the persisting mental health burdens, the long-term effects of COVID-19, the threat of antimicrobial resistance, strained healthcare infrastructure, health disparities, climate change impacts, inflation’s influence on healthcare, the integration of artificial intelligence, and the specific challenges related to aging populations. To address these challenges effectively, policymakers must focus on developing policies that ensure equitable access to healthcare services, facilitate sustainable healthcare practices, and uphold ethical standards. Collaborative efforts among policymakers, healthcare providers, researchers, and communities are essential for successfully navigating these post-COVID healthcare challenges. By adopting a comprehensive and proactive approach, healthcare systems can work towards achieving a resilient, inclusive, and ethically-driven healthcare landscape.

Introduction

In order to attain Sustainable Development Goal 2 (SDG-II) of eradicating malnutrition among children by 2030, Pakistan has initiated a Community-based Management of Severely Acute Malnutrition (CMAM) program. This program has been established at the public level to detect and treat uncomplicated Severely Acute Malnourished (SAM) children at an early stage. However, during the outbreak of COVID-19, very poor compliance with the CMAM program was observed. Consequently, the nutritional quality of children’s diets has deteriorated, with malnutrition rates expected to rise. Therefore, this study has been set up to evaluate the effect of the COVID-19 lockdown on the health of SAM children and compliance with the CMAM program.

Methodology

This study used a multicenter cross-sectional design in District Dera Ghazi Khan’s rural areas located in the Southern Province of Punjab. Data were collected from the parents/guardians of SAM children through the researcher-administrated questionnaire. The sample size was 196, and data were analyzed through SPSS version 25.

Results

The majority of the children enrolled were males (52.5%), had fathers aged between 41 and 50 years (52.0%), mothers aged between 21 and 30 years (52.5%), had illiterate fathers (40.1%), illiterate mothers (73.8%) and had a monthly household income of PKR <15,000 (91.1%). All of the respondents mentioned that COVID-19 affected them in one way or the other (100.0%), with a majority of them did not visit the hospital during COVID-19 for their SAM child (52.5%) as they were afraid of COVID-19 (63.2%) and/or they lacked access to transport for visiting a hospital (93.4%). Bivariate analysis revealed that the father’s age (P = 0.02) and income (P = 0.00) is associated with the perceived effect of COVID-19 on income. In contrast, only the gender of the child (P = 0.00) is related to the visit to the hospital, and the gender of the child (P = 0.01) and mother’s literacy (P = 0.00) is associated with the choice of treatment from any other setup, including Hakeem and Peer.

Conclusion

This study concludes that health emergencies like the COVID-19 pandemic pose a significant barrier to access to healthcare services and subject a more vulnerable state to already vulnerable groups like SAM children. To lessen their vulnerability, initiatives like mobile health care services should be introduced, especially for socially disadvantaged communities, localities, and groups on regular basis and for future emergencies.

Background: The gallbladder is an essential organ in the human body that functions as an antioxidant. Cholangitis and pyogenic cholecystitis are two significant reasons for cholecystectomy. The significance of establishing microbial cultures and antibiotic susceptibility is that suitable antibiotics can be supplied because the infection can lead to severe consequences and death if not treated properly. However, very limited data is available on this matter. Therefore, this study is an attempt to investigate the presence of bacterial pathogens causing gallbladder disease and antibacterial susceptibility patterns to assess the choice of antibiotic. Moreover, both gallbladder’s wall and bile samples were investigated for accurate results. None of the past studies have worked on the gallbladder and the bile simultaneously.

Objective: A prospective analytical study was conducted from July to December 2014. Blood, MacConkey agar, and Robertson cooked medium were used to culture all the clinical samples. After 24 and 48 hours of incubation, culture plates were examined for evident growth. Standard microbiological procedures were used to identify the isolated species. Antibiotic susceptibility tests were performed, and the isolated bacteria were also examined for extended-spectrum beta-lactamase (ESBL) development.

Results: Among 60 patients, 66% were positive for bacteria in the gallbladder wall or bile, or both. Gramnegative bacteria were the most commonly isolated ones. Due to ESBL production, bacteria were mainly resistant to all cephalosporins and Augmentin. However, aminoglycosides, carbapenem, and antibiotics combination were the most effective.

Conclusion: It can be concluded that organisms are more resistant now due to ESBL production, so the old regimen of antibiotics might not be effective in treating them. The considerable culture-positive rate highlights the significance of acquiring bile and gallbladder wall bacterial cultures to administer the proper antibiotics at cholecystectomy. To avoid major complications like gram-negative septicemias, necessary adjustments must be made by the results of antibiotic sensitivity tests.

This paper presents a proposed system for cloud-based and Internet o Things (IoT)-based electronic health records (EHRs) that utilize wearable body biosensors to collect biometric data in real time and analyze it to provide personalized therapy recommendations. The study aims to ensure the confidentiality and integrity of patient data through security authorizations, device authentication, and encrypted communication channels. The research method involves describing the proposed system’s communication environment and trust boundary and illustrating the communication mechanisms, including the “starting” and “authentication” procedures. The proposed communication protocols are also explained in detail, and a complete illustration of the symbols and abbreviations used throughout the work is provided. The initialization process involves contacting a body sensor network (BSN) server to register, generating a secret key, and assigning a track sequence number. The proposed systematic verification involves a dependable authentication solution to maintain secure communication between the biosensors, local processing unit (LPU), and BSN server. The verification process involves figuring out the values and generating a random integer, establishing communication with the receiver, and validating the data by searching for a corresponding tuple in the required database. The study emphasizes the importance of a robust IoT communication architecture to ensure secure data transfer between devices, networks, and individuals.

BACKGROUND: Nurses in the Intensive Care Units (ICUs) routinely provide care to patients and their families nearing the end of their lives. ICU nurses encounter numerous barriers while caring for ICU patients.

STUDY AIMS: This study aims to assess the barriers faced by the nurses working in intensive care units while performing their duties.

METHODOLOGY: A descriptive cross-sectional study was conducted among intensive care unit nurses at four hospitals. A total of 289 nurses were enrolled in the current investigation. An adapted and modified questionnaire was utilized to collect data. The questionnaire includes demographic information about nurses and questions about nursing care barriers. A five-point Likert scale was used for each aspect, with 1 signifying strong disagreement and 5 denoting strong agreement.

RESULTS: In this study, among 289 participants, most of the study participants 176 (60.9%) were in the age group 20–30 years. Most ICU nurses reported the family barrier as the major perceived barrier, with a mean score of 4.01 ± 0.50. The other related barriers include task, environmental, technological, and organizational barriers.

CONCLUSION: The current study concluded that ICU nurses faced various perceived barriers while caring for ICU patients. The family barrier was the most prevalent perceived barrier among ICU nurses (mean score 4.01 ± 0.50). Most of the nurses agreed that spending time on explanation to family members (87.9%) was the most common family barrier. Nursing administrators and healthcare policymakers can use the current study findings to improve the healthcare system’s performance.

Open Access (OA) initiatives are pivotal in democratizing knowledge, fostering research, and encouraging global collaboration. This paper highlights the progress of OA initiatives in Eastern Mediterranean Region (EMR) countries, as designated by the World Health Organization. EMR countries have embraced OA to bridge the gap between high-income and lower-middle-income countries (LMICs), especially in healthcare and medicine. This is exemplified by initiatives like the Egyptian Knowledge Bank (EKB), which provides Egyptians free access to extensive scientific publications, e-books, and multimedia resources from international publishers. EKB aims to democratize knowledge and cultivate learning, research, and innovation in Egypt. Qatar National Library (QNL) is another prime example, investing considerably in OA by providing access to international resources and databases. Through the Open Access Author Fund (OAAF), QNL covers Article Processing Charges (APC) for Qatar-based researchers publishing in OA journals and supports the development of a knowledge-based society in Qatar. In the United Arab Emirates, the national policy on Open Educational Resources (OER) facilitates access to knowledge by encouraging the use and sharing of OER in education and research. However, despite these strides, challenges still need to be addressed, including limited funding, lack of infrastructure, and low OA awareness among researchers and institutions. Moreover, a unified regional strategy is necessary to ensure effective OA implementation.