Alam, Md. Mashiul

Introduction: Anthracyclines are a first-line chemotherapeutic agent used in the treatment of lymphoma. Myocardial injury can occur with cumulative doses of 250 to 350 mg/m 2 . Echocardiography is the imaging modality for identifying cardiac dysfunction; however, identifying diastolic changes in patients who received anthracyclines is not well represented in the literature. Variables used to identify diastolic dysfunction include lateral e’, medial e’, mitral E velocity, mitral A velocity, E/A, E/e’, and left atrial volume index (LAVI). This study aims to identify if diastolic abnormalities develop in a prospective cohort of patients with HL or NHL who received anthracycline-based chemotherapy. Methods: Lymphoma patients treated with anthracyclines from 2013 to 2020 were prospectively enrolled. Echocardiography was obtained at 3-time points: before the start of chemotherapy (T1), at 3-6 months (T2), and 9-12 months (T3). Diastolic variables were measured and analyzed based on the total cumulative dose of Doxorubicin per body surface area. Those that received greater than 250 mg/m 2 and greater than 300 mg/m 2 of Doxorubicin were compared to those that did not. Statistical analysis was done using one-way ANOVA, adjusting for age and gender. Results: 151 total patients (90 males, mean age 61 + 16 years); 21 (14%) HL, 130 (85%) NHL. 114 and 66 patients received a total cumulative dose of Doxorubicin greater than 250 mg/m 2 and 300 mg/m 2 , respectively. There was no significant association with 250 mg/m2. Lateral e’ at T3 vs. T1, was lower in those that received greater than 300 mg/ m 2 compared to those received less (0.09 vs 0.10, p < 0.02) (Table 1). Conclusions: Lateral e’ decreased at 1-year follow-up in those that received higher doses of Doxorubicin. These changes in the lateral e’ could reflect early relaxation abnormalities related to anthracycline-based chemotherapy and suggest that changes in lateral e’ should be considered by itself since E/e’ was normal.

Abstract ObjectiveThis study aims to determine the role of personal protective measures in the prevention of COVID-19 spread among the physicians working at different health facilities in Bangladesh.MethodsThis hospital-based cross-sectional comparative was conducted from May to June 2020. A total of 98 COVID-19 positive physicians and 92 COVID-19 negative physicians (physicians having no symptoms of COVID-19 or tested negative), were enrolled. The questionnaire was adapted from a tool developed by the World Health Organization (WHO) for risk assessment and management of exposure of health care workers in the context of COVID-19. Data was collected from the respondents online using google forms.ResultsThere was no significant difference in baseline information between COVID-19 positive and COVID-19 negative physicians. The physicians, who were unaware of direct participation in COVID-19 patient care, had higher odds of being COVID-19 positive (OR= 4.018; CI: 1.532-10.535). Also, the physicians, who were unaware of the COVID-19 status while performing aerosol generated procedure (AGP), had a higher chance of being COVID-19 positive, had a higher chance of being COVID-19 positive (OR= 2.522; CI: 1.020-6.233). Using face shields/goggles (OR=0.437; CI:0.228-0.837), regular decontamination of the patient’s surroundings (OR=0.392; CI:0.176-0.873) while usual take care of patients and use of N95 masks while performing AGP (OR=0.372; CI:0.159-0.873) had protective roles against COVID-19 among the physicians. The physicians who had reused the medical gown had two times more chance of being tested positive for COVID-19 than those who had not reused it (OR= 2.3; CI:1.251-4.259).ConclusionThe use of face shield/goggles and N95 masks and decontamination of the patient’s surroundings may give protection against COVID-19. Also, reusing medical gown should be avoided as much as possible.