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There is increasing evidence of the post-COVID-19 suffering and decreased quality of life in the COVID-19 patients. This study aimed to assess the quality of life and associated factors of COVID-19 patients at one month after discharge from the hospital. This was a cross-sectional study that was conducted at the post-covid clinic of Dhaka Medical College Hospital (DMCH) where RT–PCR-confirmed adult COVID-19 recovered patients were enrolled one month after discharge from the same hospital. They were consecutively selected from January 01 to May 30. A pretested semi-structured questionnaire was used for the data collection for clinical variables. The generic multi-attributable utility instrument EQ-5D-5L was used for assessing health-related quality of life (HRQoL). A total of 563 patients were enrolled in the study. The patients had a mean age with standard deviation (±SD) of 51.18 (±13.49) years and 55.95% were male. The mean (SD) EQ-5D-5L index score and EQ-VAS scores were 0.78 (±0.19) and 70.26 (±11.13), respectively. Overall, 45.77%, 50.99%, 52.79%, 55.14% and 62.16% had problems (slight to extreme) in the mobility, self-care, usual activities, pain/discomfort and anxiety/depression dimensions, respectively. Patients aged ≥60 years had significant problem in mobility (odds ratio [OR] 3.24, 95% confidence interval [CI]: 1.07–9.77). Female participants were 5.50 times (95% CI: 2.22–13.62) more likely to have problems in their usual activities. In comparison to urban area, living in a peri-urban setting was significantly associated with problems in mobility (OR 1.89, 95% CI: 1.13–3.20), pain/discomfort (OR 1.82, 95% CI: 1.04–3.12) and anxiety/depression (OR 2.16, 95% CI: 1.22–3.84). Comorbid patients were 1.75 times (95% CI: 1.07–2.85) more likely to report problems in the pain/discomfort dimension. Presence of symptom(s) was associated with problems in self-care (OR 3.27, 95%CI: 1.31–8.18), usual-activity (OR 3.08, 95%CI: 1.21–7.87), pain/discomfort dimensions (OR 2.75, 95%CI: 1.09–6.96) and anxiety/depression (OR 3.35, 95%CI: 1.35–8.30). Specific management strategies should be planned to address the factors associated with low health-related quality of life in post-acute care of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: Post-coronavirus disease (COVID-19) syndrome includes persistence of symptoms beyond viral clearance and fresh development of symptoms or exaggeration of chronic diseases within a month after initial clinical and virological cure of the disease with a viral etiology. We aimed to determine the incidence, association, and risk factors associated with development of the post-COVID-19 syndrome. Methods: We conducted a prospective cohort study at Dhaka Medical College Hospital between June 01, 2020 and August 10, 2020. All the enrolled patients were followed up for a month after clinical improvement, which was defined according the World Health Organization and Bangladesh guidelines as normal body temperature for successive 3 days, significant improvement in respiratory symptoms (respiratory rate <25/breath/minute with no dyspnea), and oxygen saturation >93% without assisted oxygen inhalation. Findings: Among the 400 recruited patients, 355 patients were analyzed. In total, 46% patients developed post-COVID-19 symptoms, with post-viral fatigue being the most prevalent symptom in 70% cases. The post-COVID-19 syndrome was associated with female gender (relative risk [RR]: 1.2, 95% confidence interval [CI]: 1.02–1.48, p = 0.03), those who required a prolonged time for clinical improvement (p<0.001), and those showing COVID-19 positivity after 14 days (RR: 1.09, 95% CI: 1.00–1.19, p<0.001) of initial positivity. Patients with severe COVID-19 at presentation developed post-COVID-19 syndrome (p = 0.02). Patients with fever (RR: 1.5, 95% CI: 1.05–2.27, p = 0.03), cough (RR: 1.36, 95% CI: 1.02–1.81, p = 0.04), respiratory distress (RR: 1.3, 95% CI: 1.4–1.56, p = 0.001), and lethargy (RR: 1.2, 95% CI: 1.06–1.35, p = 0.003) as the presenting features were associated with the development of the more susceptible to develop post COVID-19 syndrome than the others. Logistic regression analysis revealed female sex, respiratory distress, lethargy, and long duration of the disease as risk factors. Conclusion: Female sex, respiratory distress, lethargy, and long disease duration are critical risk factors for the development of post-COVID-19 syndrome. [ABSTRACT FROM AUTHOR]

Background: Snakebite is a neglected public health problem in many countries of the world. Being a tropical country Bangladesh is also facing this problem. In this case series we have tried to focus the illiteracy, prejudice and mismanagement happen in snake bite cases from primary to tertiary level and how effective management can save life of snake bite victim. Case presentation: Among the 29 snake bite cases admitted in a medicine ward of tertiary care hospital four were venomous bites-two male and two female. Our patients came from around Dhaka city. Though victim failed to bring the snake, by studying clinical features and syndromic approaches we suspected Kraits as the culprit in three cases and Cobra in one case. Time period between bite and attend to hospital ranged from 4 hr to 16.30 hours. All victims had inappropriate application of tourniquet to their limbs as a first aid management. Most of them first visit OZHA (traditional healer). Two of them developed respiratory failure. All cases were managed in ICU with polyvalent ASV. One developed anaphylaxis which was managed with adrenaline. All patients recovered completely. Conclusion: Arrival to hospital without delay, facilities for management with trained physicians and proper supply of ASV may reduce death from snake bite and reduce financial burden to the patient. Developing public awareness to remove prejudice about snakes and identifying venomous snake bite is also necessary. [ABSTRACT FROM AUTHOR]