BackgroundThis cross-sectional study aims to evaluate pain management's success in limiting admissions and assesses remote care's effectiveness for optimal pain relief. By utilizing data from severe ...COVID-19 inpatients in Prishtina, Kosovo, this study offers insights into the challenges posed by the pandemic and innovative care approaches aimed at improving patient well-being.MethodologyThis cross-sectional study includes 55 patients with severe COVID-19 after hospital discharge. All study participants completed the questionnaire in the presence of a clinical pharmacologist. The questionnaire of this study consisted of three parts: sociodemographic data (first part), the Intensity and Characteristics of Toothache (IaCofT) and headache (second part), and pharmacological treatment of headache and dental pain (third part). The questionnaire on IaCofT and headache was created with some modifications of the Modified Dental Pain Screening Questionnaire (M-DePaQ).Descriptive statistics were conducted using Prism version 10.0.1 (Windows and Mac).ResultsAccording to the study data, 89.1% (n = 49) of the participants experienced pain during hospitalization with COVID-19, while 72.72% (n = 40) of them experienced pain after hospital discharge. Of the participants, 32.7% (n = 18) experienced dental pain, whereas 60% (n = 33) reported having headaches. Regarding the pain scale, more than two-thirds (n = 40, 72.72%) of the participants had moderate to moderately severe pain, and in 70.9% (n = 39) of the cases, the pain occurred episodically. The absolute majority (n = 53, 96.4%) of study participants reported the use of analgesics for pain management. Paracetamol (n = 46, 83.6%) and ibuprofen (n = 14, 25.5%) were the most commonly used analgesics for pain management.ConclusionsThis study highlighted the prevalence of headache and acute dental pain in these patients. The majority of the study participants were convinced by the healthcare system and were highly dependent on pharmacological treatment for headaches and acute toothache during the COVID-19 peak. The study results showed that the pain was proven to be successfully treated pharmacologically with analgesics such as paracetamol, ibuprofen, and diclofenac. Telemedicine is expected to become an important healthcare practice in the post-COVID-19 era. Therefore, the introduction of this service could be considered.
Background and Aims
Extended hospitalization due to coronavirus disease 2019 (COVID‐19) is associated with residual musculoskeletal and functional deficits lasting even 6 months after discharge; ...therefore, it is crucial that post‐hospitalized patients are promptly assessed. The aim of this study was to identify post‐COVID‐19 patients' functional status and quality of life, as well as to investigate their inter‐relatedness 2–3 weeks after hospital discharge.
Methods
The study included 39 post‐COVID‐19 patients previously hospitalized in the Clinic for Infectious Diseases at the University Clinical Center of Kosovo (UCCK) from August to December 2021. Physiotherapeutic assessment encompassed socio‐demographic and clinical data including Short Physical Performance Battery (SPPB) for physical functional performance, hand grip strength, 6‐min Walk Test (6MWT) for aerobic capacity and endurance, EuroQol 5‐Dimension 5‐Level (EQ‐5D‐5L) for quality of life, Visual Analogue Scale (VAS) for pain, Borg CR10 for dyspnea, peripheral oxygen saturation and heart rate. Descriptive statistics, Pearson correlation, and multiple linear regression analysis were utilized for data processing.
Results
The median (interquartile range IQR) for Borg CR10, VAS pain scale, total SPPB, grip strength, and 6MWT were 1 (0–3), 3 (1–6), 9 (8–10), 30.5 (23.2–43.5) kg, 344.5 (312.7–381.7) m respectively, while the mean (SD) for EQ‐5D‐5L index value was 0.7 (0.2). The strongest and most significant correlation was depicted between SPPB total score and its subscales, followed by correlation with EQ‐5D‐5L (r = 0.719, p < 0.001), grip strength (r = 0.612 p < 0.001), Borg CR10 (r = −0.515, p = 0.001), 6MWT (r = 0.416, p = 0.02), and VAS scale (r = −0.343, p = 0.03). Using the multiple regression analysis, the grip strength, Borg‐CR10, and 6MWT were found to be strongly predictive of SPPB total score.
Conclusion
In post‐COVID‐19 patients' functional status and quality of life were impaired 2–3 weeks following hospitalization. SPPB showed the most frequent and significant correlation with other variables, hence it should be considered as one of the primary screening tools.
Keypoints
Based on the heterogeneity of symptom presentation and clinical course, there is a need to carefully monitor for signs and symptoms in individuals with postcoronavirus disease 2019 (COVID‐19) conditions, especially in previously hospitalized patients.
There are no established core outcome measures to be applied in the framework of physical therapy for post‐COVID‐19 conditions.
In our study, post‐COVID‐19 patients had impaired functional status and quality of life, as early as two weeks following hospitalization.
We recommend that the Short Physical Performance Battery (SPPB) be used in the future as one of the primary screening tools for post‐COVID‐19 patients following hospitalization.
Introduction: Patients following the acute stage of Severe Acute Respiratory Syndrome Coronavirus 2 were shown to present with persisting symptoms including fatigue, dyspnea, joint pain, and chest ...pain. The aim of this study was to investigate the effect of a 6-week home physiotherapy program on the psychological and physical symptoms, as well as the physical abilities to perform activities of daily living in post-COVID-19 patients. Methods: The subjects were 39 adult patients who had been diagnosed with COVID-19 and had been hospitalized at the University Clinical Center of Kosovo. Patients initially underwent a physiotherapy assessment 2-3 weeks after discharge from the hospital, including sociodemographic data, psychological and physical symptoms, and functional performance in daily activities using the Patient-Specific Functional Scale (PSFS). Based on their functional capacity, the patients received two types of brochures for a home physiotherapy program that was carried out over the next 6 weeks. Upon the completion of the physiotherapy program, 23 patients reported for the second physiotherapy assessment. The Mann–Whitney Wilcoxon test was used for comparison of the variables obtained during the first and second assessments. Results: Pre–post analysis showed that the symptoms including excessive fatigue, difficulty breathing, and insomnia were significantly less present following the home physiotherapy program (p = 0.005; p = 0.008; p = 0.034). On the PSFS scale, the mean score increased from 5.2 (2.1) to 7.8 (0.5) for stair climbing, from 5.5 (1.8) to 8.8 (1.6) for walking longer distances, and from 3.7 (3.2) to 4.0 (5.6) for running. Conclusion: Although limited by the absence of a control group, the findings from this study indicate that home physiotherapy intervention can be feasible and effective in enhancing psychological and physical symptoms, as well as activities of daily living in post-COVID-19 patients following hospitalization.
Multiple myeloma (MM) is a disease that causes significant morbidity and mortality in the population. It is a common hematological malignancy in Kosovo, and the diagnosis and treatment of the disease ...in Kosovo has some significant challenges. With this study we want to share our experience in the treatment of MM with the CyBorD chemotherapy protocol.
Cross sectional retrospective epidemiological study. The data was collected from the patients treated with this protocol.
The data was collected from the chemotherapy treatment protocol books in the hematology clinic of the University Clinical Center of Kosovo.
Adults, age 18 and older, both genders with MM, in the hematology clinic of Kosovo treated with the CyBorD chemotherapy protocol.
Of the 34 patients treated with this protocol, 20 of them were women and 14 were men; 2 were aged 43; 2 were aged 48; and the rest were over the age of 60. Twenty-two of the patients had immunoglobulin G (IgG) and kappa light chain paraproteinemia, and 6 of them had IgA paraproteinemia. All patients had anemia and a high erythrocyte sedimentation rate (ESR); 16 had osteolytic lesions; and 8 of the patients had renal failure. Fourteen patients had more than 50% plasma cells in bone marrow aspiration, 10 had above 40%, and 8 had more than 30%. All the patients were treated with the CyBorD chemotherapy protocol.
Side effects reported during the treatment were peripheral neuropathy (12 patients); cytopenias (all patients); hyperglycemia (14 patients); dyspepsia (all). CyBord produced a very rapid response based on the results of 14 patients. The anemia improved, the ESR, and IgG levels decreased, and the percentage of plasma cells in the bone marrow was reduced. Six patients had disease progression with renal failure and increased plasma cells in the bone marrow. Eighteen patients had complete remission, 10 partial remission, and 6 died because of disease progression.
Interindividual variability in drug metabolism is an important cause of adverse drug reactions and variability in drug efficiency. Polymorphisms of cytochrome P450 (CYPs) genes have a significant ...effect on drug metabolism and toxicity. This review brings an update about how genetic polymorphisms of CYP2C8 and CYP2C9 enzymes affect the disposition and clinical outcomes of ibuprofen and diclofenac, two of the most common pain relievers. The most common side effects associated with the influence of CYP2C8*3 and CYP2C9*2*3 variants on ibuprofen and diclofenac pharmacokinetics are hepatotoxicity and gastrointestinal bleeding. CYP genotyping may therefore identify patients at increased risk of these adverse reactions, and these patients could have their doses adjusted or start receiving another NSAID that does not share the same metabolic pathways with ibuprofen or diclofenac. However, before genotyping is introduced into regular clinical practice, more research is needed to evaluate the effectiveness of this strategy in improving treatment with ibuprofen and diclofenac.
Interindividual variability in drug metabolism is an important cause of adverse drug reactions and variability in drug efficiency. Polymorphisms of cytochrome P450 (CYPs) genes have a significant ...effect on drug metabolism and toxicity. This review brings an update about how genetic polymorphisms of CYP2C8 and CYP2C9 enzymes affect the disposition and clinical outcomes of ibuprofen and diclofenac, two of the most common pain relievers. The most common side effects associated with the influence of CYP2C8*3 and CYP2C9*2*3 variants on ibuprofen and diclofenac pharmacokinetics are hepatotoxicity and gastrointestinal bleeding. CYP genotyping may therefore identify patients at increased risk of these adverse reactions, and these patients could have their doses adjusted or start receiving another NSAID that does not share the same metabolic pathways with ibuprofen or diclofenac. However, before genotyping is introduced into regular clinical practice, more research is needed to evaluate the effectiveness of this strategy in improving treatment with ibuprofen and diclofenac.
Cytochrome P450 genetic polymorphisms are responsible for individual variations in drug metabolism and drug-drug interactions. They are very important for pharmacogenetics, and their frequency varies ...across different populations. There is a big gap in the knowledge about the CYP gene family polymorphisms in the population of Kosovo, and the aim of our study was to fill that gap by determining the frequency of the most important variant alleles of CYP2C9, CYP2C19, and CYP3A5 in 234 nonrelated Kosovars. The allele frequencies of CYP2C9*2 and 2C9*3 were 17.52 %, and 10.89 %, respectively. Sixteen participants (6.81 %) were CYP2C9 poor metabolisers. The CYP2C19*2 and *17 variant frequencies were 13.03 % and 19.01 %, respectively. There were 2.13 % CYP2C19 poor and 4.27 % ultra-rapid metabolisers (homozygous carriers of the *17 allele). With regard to CYP3A5, the frequency of the *3 variant allele was 98.29 % (non-expressors), while the remaining participants (1.70 %) were expressors of CYP3A5. These findings are comparable with other European ethnicities, specifically those of Southeast Europe.
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