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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.

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Background: The outbreak of Coronavirus disease (COVID-19) caused by a novel coronavirus (named SARS-CoV-2) has gained attention globally and has been recognized as a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO) due to the rapidly increasing number of deaths and confirmed cases. Health care workers (HCWs) are vulnerable to this crisis as they are the first frontline to receive and manage COVID-19 patients. In this multicenter multinational survey, we aim to assess the level of awareness and preparedness of hospital staff regarding COVID-19 all over the world. Methods: From February to March 2020, the web-based or paper-based survey to gather information about the hospital staff's awareness and preparedness in the participants' countries will be carried out using a structured questionnaire based on the United States Centers for Disease Control and Prevention (CDC) checklist and delivered to participants by the local collaborators for each hospital. As of March 2020, we recruited 374 hospitals from 58 countries that could adhere to this protocol as approved by their Institutional Review Boards (IRB) or Ethics Committees (EC). Discussion: The awareness and preparedness of HCWs against COVID-19 are of utmost importance not only to protect themselves from infection, but also to control the virus transmission in healthcare facilities and to manage the disease, especially in the context of manpower lacking and hospital overload during the pandemic. The results of this survey can be used to inform hospitals about the awareness and preparedness of their health staff regarding COVID-19, so appropriate policies and practice guidelines can be implemented to improve their capabilities of facing this crisis and other future pandemic-prone diseases.

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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.

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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 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. Results: Of 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. Discussion: Studies 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 number: CRD42018091088.

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