Global Access to Cardiac Surgery Centers: Distribution, Disparities, and Targets

BACKGROUND

Global data on cardiac surgery centers are outdated and survey-based. In 1995, there were 0.7 centers per million population, ranging from one per 120,000 in North America to one per 33 million in sub-Saharan Africa. This study analyzes the contemporary distribution of cardiac surgery centers and proposes targets relative to countries' cardiovascular disease (CVD) burdens.

METHODS

Medical databases, gray literature, and governmental reports were used to identify the most recent post-2010 data that describe the number of centers performing cardiac surgery in each nation. The 2019 Institute for Health Metrics and Evaluation Global Burden of Disease Results Tool provided national CVD burdens. One-third of the CVD burden was assumed to be surgical. Center targets were proposed as the average or half of the average of centers per million surgical CVD patients in high-income countries.

RESULTS

5,111 cardiac surgery centers were identified across 230 nations and territories with available data, equaling 0.73 centers per million population. The median (interquartile range) number of centers ranged from 0 (0-0.06) per million in low-income countries to 0.75 (0-1.44) in high-income countries. Targets were 612.2 (optimistic) or 306.1 (conservative) centers per million surgical CVD incidence. In 2019, low-income, lower-middle-income, and upper-middle-income countries possessed 34.8, 149.0, and 271.9 centers per million surgical CVD incidence.

CONCLUSION

Little progress has been made to increase cardiac surgery centers per population despite growing CVD burdens. Today's global cardiac surgical capacity remains insufficient, disproportionately affecting the world's poorest regions.

Severe Gastrointestinal Hemorrhage due to Monkeypox Virus-Associated Proctocolitis

Monkeypox is primarily a painful cutaneous disease with occasional systemic manifestations. Monkeypox is transmitted predominantly through close physical contact and occasionally sexual contact. The first case was reported in the United States on May 17, 2022, in a recent monkeypox worldwide outbreak. We present a case of severe gastrointestinal bleeding as an atypical manifestation of monkeypox infection in a 40-year-old male with HIV. In our case, monkeypox-induced proctocolitis progressed to severe rectal bleeding requiring one unit of packed red blood cells transfusion despite one week of tecovirimat (TPOXX) therapy. So, patients should be educated about the possibility of unusual complications of monkeypox infection, i.e., bleeding in immunocompromised hosts.

Seeing COVID-19 through a Health care professional’s eye

Background: The world is in a state of war. The health care professionals are the front line soldiers who are fighting this war against COVID-19. The modification in human behavior to a specific stimulus (say the Corona epidemic) is the single most important determinant of the fate of that stimulus.  On 26th February 2020, Pakistan reported its first corona positive cases. Till Mid-March, the number raised to a significantly critical level. As the outbreak was unexpected in Pakistan, the situation created chaos and panic among the public as well as among health care workers. The current study analyzed COVID-19 thorough a healthcare professional's eye. There has been no previous study according to the PubMed database. Using the keywords, "Coronavirus, Health care professionals, Pakistan, COVID-19", for any sort of previous cases reported or literature reported relating to coronavirus, our team could not find any article, case report or publication of any sort. So this study is the first from Pakistan Methods: In this cross-sectional study, a self-administrated online questionnaire was circulated through emails and social media to the whole country. The questionnaire comprised of assessing knowledge about the cause and symptoms of COVID-19. A total of 146 responses were scrutinized to include in the survey, in the time period of 1 week (March 23-30, 2020). The participants belonged to private and government institutions from all provinces of Pakistan. Results: The mean values of all items depicted that all health care professionals were well aware of the knowledge, symptoms and transmissibility of COVID-19. Conclusion:  The study concluded that the healthcare professionals were fully aware of the transmission of COVID-19 and its symptoms. However, it is recommended that the government should provide full support to health care professionals, who are at the front line.     Key words: COVID-19, Health care professionals, Transmissibility, Pakistan

Vascular Surgery Research in the Coronavirus Disease 2019 Pandemic: A Sex-Based Bibliometric Analysis

INTRODUCTION

The COVID-19 pandemic has disrupted vascular surgery services globally and its impact on researchers has illustrated disproportionate barriers for female researchers. We assessed the pandemic's consequences on bibliometric trends in vascular surgery and vascular medicine throughout the pandemic.

METHODS

A scoping review was performed using the PubMed/MEDLINE, Scopus, and EMBASE databases from January to December 2020 to identify articles related to COVID-19 and vascular surgery or vascular medicine. Articles only describing cardiac or neurovascular care were excluded. The scoping review was performed according to the PRISMA-ScR guidelines. Bibliometric data were extracted and analyzed.

RESULTS

Four hundred and fourteen articles were identified, including 125 (30.2%) original articles, 42 (10.1%) review papers, 105 (25.4%) case reports, 27 (6.5%) editorials and commentaries, 94 (22.7%) letters and correspondences, and 21 (5.1%) conference abstracts. The 5 most common countries of study or discussion were all high-income countries. English was the predominant (n = 393, 94.9%) language. Funding was reported for 5.1% (n = 21) of articles. In the first 6 months, 17.6% (n = 30) of first authors and 10.6% (n = 18) of last authors were female, while the last 6 months saw an increase in representation to 30.6% (n = 74) and 15.6% (n = 38) for first and last author, respectively.

CONCLUSION

The pandemic caused a rapid surge in vascular publications related to COVID-19. Female authors remain underrepresented in vascular research and the share in female authorship has dropped early in the pandemic, but rose after the end of the first wave. High-income countries remain overrepresented in research productivity, alluding to important disparities in COVID-19-related literature.

Clinical characteristics and outcomes of cancer patients and their hospital course during the COVID-19 pandemic in a developing country

In the new Coronavirus Disease 2019 (COVID-19) pandemic, cancer patients are considered a particularly susceptible population. We compared the type and magnitude of COVID-19 clinical manifestations among cancer patients in our center to non-cancer COVID-19 affected patients including 99 patients (28 cancer patients and 71 non-cancer patients). Hepatocellular carcinoma, breast carcinoma, and leukemia were the most common cancers. Diabetes and hypertension were prevalent comorbidities. Dyspnea, cough, fatigue, myalgia and diarrhea were statistically indifferent in both groups. Fatigue was more pronounced in cancer patients [OR: 2.573(1.025–6.460), p = 0.041] along with early onset of bilateral patchy consolidation [HR: 3.127(1.197–5.851), p = 0.032].

Implications of social media misinformation on COVID-19 vaccine confidence among pregnant women in Africa

It has been over a year since the World Health Organization (WHO) declared the outbreak of COVID-19 as a Public Health Emergency of International Concern and subsequently a global pandemic. The world has experienced a lot of uncertainty since then as we all get used to this new ‘normal’ with social distancing measures, lockdowns, the emergence of new variants, and an array of hope with the development of vaccines. Having an abstract understanding of vaccine delivery, public perceptions of vaccines, and promoting acceptance of vaccines are critical to tackling the pandemic. The advent of the pandemic has led to the emergence of an ‘infodemic’ or rampant misinformation surrounding the virus, treatment, and vaccines. This poses a critical threat to global health as it has the potential to lead to a public health crisis by exacerbating disease spread and overwhelming healthcare systems. This ‘infodemic’ has led to rising vaccine hesitancy which is of paramount concern with the WHO even identifying it as one of the ten main threats to Global health almost 2 years before the approval of COVID-19 vaccines. Pregnant African women are one of the most vulnerable population groups in a region with an already burdened healthcare system. Currently, there isn’t ample research in the literature that explores vaccine hesitancy in this subpopulation and the impact of social media misinformation surrounding it. The aim of this paper is to highlight the implications of this ‘infodemic’ on the pregnant African population and suggest key recommendations for improved healthcare strategies.

Global impact of vaccine nationalism during COVID-19 pandemic

Vaccines are the best chance to control the pandemic-unless leaders succumb to vaccine nationalism. Vaccine nationalism is a frequent recurrence, especially during a brand-new market distribution. The development of safe and effective COVID-19 vaccines in such a short space of time is a testament to modern scientific abilities. It will also test the world's political will and moral commitment to end this pandemic. As desperate as the COVID-19 pandemic, vaccine nationalism is already setting a foundation for itself and is considered socially and economically counterproductive. Vaccine equity is not just a theoretical slogan, and it protects people worldwide from new vaccine-resistant variants. Understanding and anticipating the consequences is vital, and creating a global solution approach to avoid them. This article evaluates the common issues previously faced and the plausible ones during this pandemic. A few recommendations are made to warn and accentuate the reality of this dire matter.

Foreign workers in the Middle East during COVID-19

The COVID-19 pandemic is having an unprecedented and consequential impact on global economies, businesses, and workforces. Foreign nationals account for the majority of the population in the Middle East. Throughout this article, the authors address the negative ramifications the COVID-19 pandemic has had on the migrant workforce in the Middle East. This pandemic has intensified various socio-economic and public health crises such as unemployment, income cuts, depletion of savings, repatriation difficulties, inadequate living conditions, and associated burden on healthcare facilities by the COVID-19 infection.

Marburg virus disease outbreak amidst COVID-19 in the Republic of Guinea: A point of contention for the fragile health system?

In August 2021, the Marburg virus disease (MVD) outbreak was confirmed amid the coronavirus disease 2019 (COVID-19) pandemic in the Republic of Guinea. This is the first time it is detected in Guinea and West Africa. Marburg virus is one of the world's most threatening diseases, causing severe haemorrhagic fever, with a case fatality rate of 90%. Currently, there are no vaccines and specific antiviral drugs for MVD. Technical teams and community health care workers that were set up as part of the recent Ebola virus disease (EVD) outbreak that was declared over on June 19, 2021, are now redeployed to support governments response activities of the MVD outbreak in the country. The MVD is an added burden to the fragile healthcare systems that are already overburdened with multiple reoccurring epidemics and the COVID-19 pandemic. Previous epidermic strategies are needed to contain the spread of the disease, amid the COVID-19 pandemic, so the health care systems are not overwhelmed. This commentary discusses the available evidence regarding the epidemic of MVD in Guinea amid the COVID-19 pandemic, and highlights the efforts, challenges to be prioritized, and provides evidence-based recommendations.

Food Security, Conflict, and COVID-19: Perspective from Afghanistan

Afghanistan, a country challenged by war and conflicts, has been in a state of turmoil for several years. The prolonged suffering has brought many challenges to the country's inhabitants. Among these, food security is one important cause for concern. Food security occurs when people continuously have physical and economic access to adequate, safe, and nutritious food to meet their dietary requirements and food preferences for a functional and healthy life. Amid the pandemic, Afghanistan has witnessed a large increase in food shortages due to its dependence on neighboring countries. In light of current circumstances, food insecurity, coupled with political instability and the third wave of the COVID-19, have made it extremely hard for people to access daily provisions. Hence, people are left to navigate the COVID-19 pandemic with economic recession and poverty as the backdrop of the other health crises. To mitigate food security, international attempts are the required at this critical juncture. The aim of this article is to understand the causes leading to food insecurity and its implications in Afghanistan and to propose solutions that will improve the overall food security at the policy and implementation levels.

Acceptance Rates and Beliefs toward COVID-19 Vaccination among the General Population of Pakistan: A Cross-Sectional Survey

Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.

The Hajj and COVID-19: How the Pandemic Shaped the World's Largest Religious Gathering

The Hajj pilgrimage, one of the five pillars of Islam, is held in Saudi Arabia in the second week of Dhu’l-Hijjah, the last month of the Islamic calendar. It is one of the world’s largest mass gatherings, constituting more than 2.5 million Muslim pilgrims from more than 180 countries. The COVID-19 pandemic posed a significant public health threat for such mass gatherings. Thus, a health risk assessment for the 2020 Hajj was held by the Saudi Arabia Ministry of Health and the WHO Collaborating Centre for Mass Gatherings Medicine, which concluded that foreign pilgrims should be excluded from the 2020 Hajj and that the number of pilgrims should be significantly reduced. Timely decisions allowed the Saudi government to conduct the Hajj, despite an initial postponement. However, the number of pilgrims was significantly downscaled, and extensive new protocols were set in place because of the pandemic. This article aims to shed light on the challenges faced and efforts made by Saudi Arabia to mitigate the spread of COVID-19 during the religious proceedings of the Hajj.

Polio Amidst COVID-19 in Pakistan: What are the Efforts Being Made and Challenges at Hand?

Poliomyelitis, a crippling viral disease, has been affecting many children in Pakistan despite the numerous efforts that have been taken to curb its spread. The COVID-19 pandemic has halted mass polio vaccination campaigns globally, including Pakistan, resulting in a resurgence of new cases. Pakistan managed to flatten the COVID-19 curve from July to October that made three immunization drives possible, but the COVID-19 cases are on the rise again which can again complicate the polio situation in the country if left unmonitored. The efforts of Pakistan have been effective with no significant rise in polio cases in 2020 as compared with 2019. We discuss the numerous challenges faced by the polio eradication program in Pakistan. To help eliminate polio, Pakistan needs to enhance its efforts in the struggle against polio with the same zeal and stringency used to flatten the curve of COVID-19 in these challenging times.