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Background Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery and can lead to increased risk of postoperative adverse events. However, atrial fibrillation and postoperative adverse events are preventable. In this study, a risk index was developed to predict atrial fibrillation after cardiac surgery. Methods A prospective cohort study of 405 patients who had undergone adult cardiac surgery from 2015 September to 2016 August at Heart Institute of HCMC and Cho Ray Hospital were obtained. In order to predict POAF, a logistic regression model was developed, and a risk score was derived and validated by bootstrap. Results In our study, 98 patients developed POAF (24.2%). The risk score included three significant risk factors (age ≥ 60, left atrial diameter > 41 mm, Coronary Artery Bypass Graft with concomitant mitral valve replacement or repair) that were consistent with other reports. Each of these risk factors was assigned one point. The total risk score ranges from 0 to 3 (AUC = 0.69, 95% CI: 0.63–0.75) with the best cutoff point at 1. According to this scoring system, the incidences of POAF in patients associated with each score of 0, 1, 2, and 3 were 8.6%, 30.1%, 40.8%, and 58.3% respectively. Bootstrapping with 5000 samples confirmed the final model provided was consistent with predictions. Conclusions We developed and validated a simple risk score based on clinical variables that can be obtained before surgery in order to accurately predict the risk of POAF in patients undergoing cardiac surgery.

Introduction: In poor countries, due to the limited resources, mostly they prescribe medications without proper diagnosis. The aim of this report is to show diagnostic bias of COVID-19 case. Case presentation: A 17-year-old male patient was presented to the Hospital with a fever up to 39°C associated with rigor, sweating, generalized body pain, myalgia, fatigue, loss of appetite, headache, and multiple joint pain with no swelling and redness. The vital signs were steady on physical examination, except temperature which was 39°C. The chest was clear, and the pulse rate was 90 beats per minute. The heart rate relative bradycardia and lungs were normal. Both a PCR test for COVID-19, and a viral assay ELISA were negative. After further investigations, the culture findings revealed the strong development of Gram-negative coccobacilli (Salmonella serotype Typhi) bacteria under the microscope, which was confirmed by using VITEK 2 to identify it. and treated with ciprofloxacin tab, two times per day for five days and amikacin ampule 500 mg IV every 24 hours for 10 days. Discussion: Fever is a well-known sign of COVID-19 infection which has been observed in 83%–98% of patients with COVID19. As a result, it may be difficult to tell the difference between COVID-19 and other febrile infections, causing delays in diagnosis and treatment and may blind the physician from considering other febrile illnesses. Conclusion: Physicians should construct more comprehensive differential diagnoses for people who experience fever, headache, or myalgia symptoms that are linked to a pandemic. COVID-19., Annals of Medicine and Surgery, 74, art. no. 103282; 2022

Background: Atrial fibrillation is the most common complication after cardiac surgery and is associated with an increased risk of postoperative adverse events. The objective of this study was to develop a risk index to predict atrial fibrillation after cardiac surgery. Methods: We performed a prospective cohort study. A total of 405 patients who had undergone adult cardiac surgery from 2015 September to 2016 August at Heart Institute of HCMC and Cho Ray Hospital. Results: In the overall, 98 patients developed POAF (24.2%). The risk score included three significant risk factors (age, left atrial diameter > 41mm, Coronary Artery Bypass Graft with concomitant mitral valve replacement or repair). The point values for were 1 for the age  60, 1 for CABG with concomitant mitral valve replacement or repair and 1 for left atrial diameter > 41mm, and the total risk score ranges from 0 to 3 (AUC = 0.69, 95% CI: 0.63 – 0.75), the best cutoff point was 1 The incidences of POAF associated with scores were: patient with a score of 0, predicted probabilities of POAF was 8.6%; a score of 1: 30.1%; a score of 2: 40.8%; a score of 3: 58.3%. Bootstrapping with 5,000 samples confirmed the final model provided consistent predictions. Conclusions: We developed a simple risk score based on clinical variables and these variables can be collected easily before surgery. This risk score may help accurately stratifies the risk of POAF to identify patients at high risk of POAF before cardiac surgery.

BackgroundWe systematically reviewed the evidence on how primary healthcare workers obtain information during consultations to support decision-making for prescribing in low and lower middle-income countries.MethodsWe searched electronic databases, consulted the Healthcare Information For All network, hand searched reference lists, ran citation searches of included studies and emailed authors of identified papers. Two reviewers extracted data and appraised quality with relevant tools.ResultsOf 60 497 records found, 23 studies met our inclusion criteria. Fourteen studies were observational and nine were interventional. Frequently mentioned sources of information were books, leaflets, guidelines, aids and the internet. These sources were sometimes out of date and health workers reported being confused which to use. Internet access varied and even when it was available, use was limited by technical issues. Of the five electronic tools that were assessed, four had positive outcomes. Tools assisted prescribers with medicine selection and dosage calculations, which increased prescribing accuracy. The quality of reporting varied but was overall low.DiscussionStudies indicated a lack of up-to-date and relevant medicine information in low and lower middle-income settings. Internet-based sources appeared to be useful when it is possible to download content for offline use and to update when there is internet access. Electronic tools showed promise, but their accuracy needs to be validated and they should focus on giving actionable advice to guide prescribers.PROSPERO registration numberCRD42018091088.

The recent outbreak of respiratory illness caused by a novel coronavirus (named “COVID-2019”) has gained attention globally and has been recognized as a serious public health threat by US Centers for Disease Control and Prevention (CDC). The first case was detected in Wuhan City, Hubei Province, China and since then, the disease has spread rapidly. As of February 28, 2020, the World Health Organization (WHO) declared that the outbreak of COVID-2019 as a Public Health Emergency of International Concern (PHEIC) with 62 countries now reporting 85,176 confirmed cases (79,250 of which have been in mainland China) and 2,919 deaths to date. However, information about the health systems and health professionals’ preparedness for combating the 2019-nCoV is not known. Therefore, their awareness and preparedness in managing the 2019-nCoV infection are important to prevent the further spread of the disease. This is a multicenter multinational survey aiming to assess the level of preparedness of hospital staff and practices regarding COVID-2019 all over the world and their preparedness to deal with the outbreak. It will also measure the level of awareness of hospital staff about the crisis and how will they react to limit and prevent further transmission.

Background: We systematically reviewed the evidence on how primary healthcare workers obtain information during consultations to support decision-making for prescribing in low- and lower-middle-income countries. Methods: We searched electronic databases, consulted the Healthcare Information For All (HIFA) network, hand-searched reference lists, ran citation searches of included studies and emailed authors of identified papers. Two reviewers extracted data and appraised quality with relevant tools. Findings: Of 60,497 records found, 23 studies met our inclusion criteria. Fourteen studies were bservational and nine were interventional. Frequently mentioned sources of information were books, leaflets, guidelines, aids, and the internet. These sources were sometimes out of date and health workers reported being confused which to use. Internet access varied and even when it was available, use was limited by technical issues. Of the five electronic tools that were assessed, four had positive outcomes. Tools assisted prescribers with medicine selection and dosage calculations, which increased prescribing accuracy. The quality of reporting varied but was overall low. Interpretation: Studies indicated a lack of up-to-date and relevant medicines information in low- and lower-middle-income settings. Internet-based sources appeared to be useful when it is possible to download content for offline use and to update when there is internet access. Electronic tools showed promise, but their accuracy needs to be validated and they should focus on giving actionable advice to guide prescribers. Clinical Registration Number: PROSPERO registration number: PROSPERO 2018 CRD42018091088. Funding Statement: This work was supported by Nagasaki University and the Japanese Society for the Promotion of Science (JSPS). Declaration of Interests: The author(s) declared the following potential competing interests with respect to the research, authorship, and/or publication of this article: None. Ethical Approval Statement: No ethics approval was required. The review will inform efforts that aim to improve the prescribing practices of healthcare workers in low- and middle-income countries. Findings were disseminated through the Healthcare Information For All network.