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In December 2019, a novel coronavirus (now named COVID-19) was identified as a causative agent for a cluster of pneumonia cases in Wuhan, China.1 Till March 2020, India was one among 50 countries which identified patients tested positive for COVID-19.2 One day curfew was imposed in the country on March 22, 2020 to forewarn the people about the danger the country was going to face. The government of India announced a nationwide lockdown for 21 days from March 25, 2020 with subsequent second, third and fourth lockdowns. This was done to reduce the transmission of disease and flatten the curve. The preparations to manage COVID-19 pandemic crisis began in Jawaharlal Nehru Medical College Hospital Aligarh, a tertiary care centre in western Uttar Pradesh by 15th of March 2020. In April 2020, it was declared as Level 2 COVID care hospital to deal with complicated and critical cases. The establishment of flu clinic, exclusive COVID-19 isolation ward, teleconsultation and widespread screening of patients by Reverse transcriptase polymerase chain reaction (RT PCR) were some measures undertaken to deal with the crisis. The increased burden of patients presenting with bronchopneumonia necessitated augmentation of the existent infrastructure and better utilization of resources. Emergency and trauma centre, JNMCH, AMU Aligarh was also no exception and reorganising emergency trauma ICU as COVID-19 suspect ICU made the functioning of the entire hospital a lot smoother during this unsustainable crisis situation. However, there were several challenges to overcome while designating an emergency and trauma ICU as COVID-19 suspect ICU. There is ample amount of literature available discussing the strategies for preparing a dedicated COVID ICU, however there is relative scarcity of literature on the challenges in managing an emergency and trauma ICU (ETC – ICU) during the pandemic. In this review, we discuss the strategies and planning for converting an emergency and trauma ICU into a COVID suspect ICU in a tertiary care centre in western Uttar Pradesh (India) during the pandemic and the challenges faced. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.26-31

Background Naphthalene is widely used in households as an insect repellent, but its poisoning is rare, especially in adults. Naphthalene is a strong oxidant with a pungent smell. Case Report We report a case of a 16-year-old female who ingested three naphthalene mothballs 3 days prior to admission and presented with history of recurrent vomiting, severe pallor, jaundice, and hemoglobinuria. Investigation found severe hemolytic anemia, indirect hyperbilirubinemia, acute kidney injury, and evidence of intravascular hemolysis. Her urine output was normal throughout the course of illness. She was managed conservatively with i.v. fluid, oral ascorbic acid, and blood transfusion. With treatment our patient improved completely and was discharged in hemodynamically stable condition. She is doing fine after further follow-up. Why Should an Emergency Physician Be Aware of This? Emergency physician should keep the possibility of poisoning by an oxidizing agent, such as naphthalene, when a patient presents to the emergency department with rapid onset pallor, jaundice, and hemoglobinuria.