The global response: How cities and provinces around the globe tackled Covid-19 outbreaks in 2021

Background: Tackling the spread of COVID-19 remains a crucial part of ending the pandemic. Its highly contagious nature and constant evolution coupled with a relative lack of immunity make the virus difficult to control. For this, various strategies have been proposed and adopted including limiting contact, social isolation, vaccination, contact tracing, etc. However, given the heterogeneity in the enforcement of these strategies and constant fluctuations in the strictness levels of these strategies, it becomes challenging to assess the true impact of these strategies in controlling the spread of COVID-19.Methods: In the present study, we evaluated various transmission control measures that were imposed in 10 global urban cities and provinces in 2021 Bangkok, Gauteng, Ho Chi Minh City, Jakarta, London, Manila City, New Delhi, New York City, Singapore, and Tokyo.Findings: Based on our analysis, we herein propose the population-level Swiss cheese model for the failures and pit-falls in various strategies that each of these cities and provinces had. Furthermore, whilst all the evaluated cities and provinces took a different personalized approach to managing the pandemic, what remained common was dynamic enforcement and monitoring of breaches of each barrier of protection. The measures taken to reinforce the barriers were adjusted continuously based on the evolving epidemiological situation.Interpretation: How an individual city or province handled the pandemic profoundly affected and determined how the entire country handled the pandemic since the chain of transmission needs to be broken at the very grassroot level to achieve nationwide control

Patient with multiple congenital disorders

PediatrijaVeselības aprūpePediatricsHealth CareIevads: 6 mēnešu vecs pacients ir iestājies BKUS 2019.gada septembrī sakarā ar galvas traumu. Neatliekamās palīdzības nodaļā tika veikta diagnostika, kuras rezultātā tika atklātas vairākas patoloģijas – sastrēgums MAL, periorālā cianoze, attīstības aizture, hipotonuss, galvas apkārtmēra palielināšanos, sirds trokšņi. Pacients tika nosūtīts un neiroloģijas un neiroķirurģijas klīnikā turpmākai izmeklēšanai un ārstēšanai. Tika plānota ģenētiskā testēšana kardioloģiskā izmeklēšana. Rezultātā- obstruktīva hidrocefālija suprasellārās cistas dēļ, sirds iedzimta patoloģija, aortas koarktācija. Ģenētiskā testēšana neatkāja nekādus sindromus. Multidisciplinārs konsīlijs nolēma veikt balona angioplastiju pirms ventrikupoleritoneālās šuntēšanas un tad, ķirurģisku aortas koarktācijas korekciju. Kā zināms no iepriekšējiem ierakstiem pacienta kartē, viņš tika ārstēts 2019. gada vasarā BKUS sakarā ar cirkšņa trūcēm. Darba hipotēze: Aortas koarktācija izraisīja germinālā matriksa asiņošanu, kas savukārt noveda pie suprasellārās arahnoidālās cistas veidošanās, līdz ar ko ir izveidojusies gan smadzeņu vēderiņu paplašināšanās, gan akvedukta stenoze, rezultātā sāka attīstīties obstruktīvā hidrocefālija un pieauga galvas apkārtmērs. Darba metode: literatūras izvērtēšana un analīze, patoloģiju rašanās mehānismu un ārstēšanas iespēju izpēte Secinājumi: Hipotēze ir daļēji pierādīta, pētījums ir jāturpina ar mērķi atrast līdzīgus gadījumus un aprakstīt tos  Introduction: A male patient, 6 months old, admitted to hospital in September 2019 due to a head trauma, with a frontal skull fracture. The emergency department examination showed cardiac murmur, congestion of the pulmonary circulation, perioral cyanosis, developmental retardation, hypotonus and an enlarged head. From previous history, earlier this year the patient was admitted to the same hospital for planned inguinal herniorrhaphy. The patient was further admitted to the neurology and Neurosurgery Clinic, and further neurologic, cardiologic and genetic examination was planned. Further examination revealed a dilated suprasellar arachnoideal cyst and obstructive hydrocephalus; cardiological examination showed congenital vitium cordis (CVC), aortal coarctation, necessitating surgical intervention for both (shunting, aortoplasty). Genetic testing did not show any known genetic syndromes. A multidisciplinary consilium was formed to decide further treatment options – it was decided to perform aortal balloon angioplasty as a temporary measure prior to ventricular shunting, to be followed by further aortal surgical correction. It is known that patient was previously administered to BKUS earlier that year due to inguinal hernias. Hypothesis: Coarctation of aorta triggered germinal matrix hemorrhage, which then led to suprasellar arachnoideal cyst, due to what obstructive hydrocephalus has developed Methods: literature review with aim to understand pathogenetical mechanism and treatment possibilities of described pathologies. Conclusion: Hypothesis is partially proved. Further investigation is needed in order to find similar cases and to describe them

The Global Response: How Cities and Provinces Around the Globe Tackled Covid-19 Outbreaks in 2021.

Background: Tackling the spread of COVID-19 remains a crucial part of ending the pandemic. Its highly contagious nature and constant evolution coupled with a relative lack of immunity make the virus difficult to control. For this, various strategies have been proposed and adopted including limiting contact, social isolation, vaccination, contact tracing, etc. However, given the heterogeneity in the enforcement of these strategies and constant fluctuations in the strictness levels of these strategies, it becomes challenging to assess the true impact of these strategies in controlling the spread of COVID-19. Methods: In the present study, we evaluated various transmission control measures that were imposed in 10 global urban cities and provinces in 2021- Bangkok, Gauteng, Ho Chi Minh City, Jakarta, London, Manila City, New Delhi, New York City, Singapore, and Tokyo. Findings: Based on our analysis, we herein propose the population-level Swiss cheese model for the failures and pitfalls in various strategies that each of these cities and provinces had. Furthermore, whilst all the evaluated cities and provinces took a different personalized approach to managing the pandemic, what remained common was dynamic enforcement and monitoring of breaches of each barrier of protection. The measures taken to reinforce the barriers were adjusted continuously based on the evolving epidemiological situation. Interpretation: How an individual city or province handled the pandemic profoundly affected and determined how the entire country handled the pandemic since the chain of transmission needs to be broken at the very grassroot level to achieve nationwide control. Funding: The present study did not receive any external funding