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- Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. [1]
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What COVID-19 has taught the world
Background: A novel coronavirus (SARS-CoV-2) has captured global recognition in a short period of time by dramatically impacting people's everyday lives and emerged as a public health emergency. Undoubtedly it shows that lessons learned from past coronavirus epidemics such as the Middle East Respiratory Syndrome (MERS) and the Serious Acute Respiratory Syndrome (SARS) were not adequate and thus left us ill-prepared to deal with the challenges presently raised by the COVID-19 pandemic12. Methods: COVID-19 adds to the list of previous outbreaks of infectious disease epidemics that try to remind us that we live in an ecosystem where the relationship between human and animal life and the environment must be respected in order to survive and prosper. Rapid urbanization and our forestland invasion have created a new interface between humans and wildlife and have exposed humans to unfamiliar species frequently involving unfamiliar organisms and exotic wildlife23. Findings: Every pandemic is nature’s way of reminding us that the interrelationship between all forms of existence needs to be recognized. To limit new infectious outbreaks the transdisciplinary ‘One Health’ solution incorporating ‘Health in All Policy’ involving all stakeholders especially environmental health and social sciences is being advocated (Figure 1). Conclusion: Savings and investments should be made by everyone to meet the unexpected. Stigmatization and prejudice among individuals in the world should be discouraged. Special attention should be paid to the elderly as their immune system is weak. Health and safety precautions such as physical distancing and health hygiene etiquettes should be considered as part of life. Global experience teaches that containment steps and active tracing of contacts are effective to minimize the economic burden of disease and enhance knowledge of disease processes health issues disease emergence and re-emergence. These lessons will help us to battle future pandemics.
Embracing healthcare delivery challenges during a pandemic. review from a nodal designated COVID-19 center in qatar
Hospitals and healthcare systems are instrumental in the formulation and delivery of a coordinated response to disaster management especially epidemics. In healthcare policy and strategy formation there are only trade-offs which with uncertainty are akin to gambles. National organizations play a key role in pandemics through the expression of physician motivation. Effective strategies can facilitate physician action through economies of scale that lower the costs for physicians to meet both community and patients' needs. Moreover no matter how well clinicians are motivated and positioned to act their collective actions are likely to fall short without complementary systems for population-based care that require the operational support of an organization. This review of institutional policy implementation and frameworks intends to highlight how a nodal-designated COVID-19 center in Qatar managed to control the menace by altering its procedural sets and work arrangements to augment an integrated intrinsic response to a briskly emerging conceivably complex situation. This outcome was achieved under the guidance of a national leadership team effectively adapted to its specific challenges by building on current medical evidence management routines proficiencies and health system capacity. This ambitious drive started with the cohesion of services and implementation of evidence-based protocols by assigning a physician-led team to research strategize and organize improved patient flow and information by arranging analytical compliance and preparedness. Through these service approaches and ongoing efforts HMGH has realized significant outcome improvements such as increasing capacity building reducing healthcare waste and increasing patient satisfaction rates whilst successfully achieving significantly lower COVID-19 mortality both in terms of absolute numbers and as percent population compared to many developed countries in the world. The strategies outlined in this article might not be all-inclusive or fit other healthcare system models but they generate a veritable interest to pursue and be subjected to further rigorous study.
Ceftriaxone-induced hepatotoxicity in patients with common medical infections in Qatar: A retrospective study
Introduction: Ceftriaxone a third-generation cephalosporin is frequently used for the treatment of various bacterial infections as a broad-spectrum antibiotic for many decades. Although ceftriaxone is a well-tolerated drug in most cases it can lead to serious liver injury which can be a real challenge to the treating physician. Given the potentially serious adverse effects that can vary from mild biochemical abnormalities to complete liver failure we intend to assess the spectrum of liver injury based on biochemical criteria for patients treated with ceftriaxone for common bacterial infections in Qatar.Objectives: This study aimed to explore the incidence of ceftriaxone-induced liver injury at Hazm Mebaireek General Hospital Qatar and to evaluate the relationship of the ceftriaxone dose if any with liver dysfunction.Methods: This retrospective study included hospitalized adult patients treated with ceftriaxone at our hospital from January 2019 to December 2019 and analyzed demographic and clinical data obtained from electronic medical records. This study determined the incidence of liver injury (primary outcome) in patients treated with ceftriaxone (2 g/day) for ≥ 2 consecutive days by reviewing liver function test results until the day of discharge and at the first outpatient follow-up.
Results: The final data analysis included a total of 634 patients admitted and treated with ceftriaxone from January 2019 to December 2019.In the multivariate analysis with propensity score adjustment ceftriaxone was independently associated with liver injury especially when combined with other agents utilizing hepatic metabolism.Conclusions: Ceftriaxone was associated with a significantly higher incidence of liver injury (19.7%) when used along with other medications that are metabolized in the liver as found in the present study compared with other similar studies (approximately 2.9%–13.9%). Furthermore the incidence was too high to be ignored in clinical practice.