MATERIALS AND METHODS: The authors conducted literature search in three databases (PubMed, Cochrane, and Clinical Key) on July 15th, 2020. The keywords were ("Head and Neck Mucosal Malignancy" OR "Head and Neck Cancer") AND ("Management" OR "Head and Neck Surgery") AND ("COVID-19" OR "Pandemic"). The inclusion criteria were cancer in adult patients, published from 2020 in English, and with available access to full text. The exclusion criteria were comments, letters, and case reports. The articles were critically appraised using the Centre of Evidence-based Medicine (CEBM), University of Oxford and Duke University. The literature search strategy is illustrated using Preferred Reporting Items for Systematic review and meta-analysis (PRISMA) flow diagram.

RESULTS: A total of 150 articles were identified; 21 articles were gathered from Clinical Key, 33 from Cochrane, and 96 from Pubmed. After screening abstracts and reviewing the full text, the authors determined five articles met the inclusion criteria. There are several key points of head and neck cancer management in the COVID-19 pandemic. Head and neck cancer management is considered a high-risk procedure; the clinician should use proper personal protective equipment. Before operative treatment, all patients should undergo a PCR test 14 days before surgery. In diagnosing head and neck cancer, laryngoscopy should be considered carefully; and cytology should be preferred instead. Medically Necessary, Time-sensitive (MeNTS) score is recommended for risk stratification and surgery prioritization; it has three domains: procedure, disease, and patient. However, it is not specified to head and neck cancer; therefore, it should be combined with other references. Stanford University Head and Neck Surgery Division Department of Otolaryngology made surgery prioritization into three groups, urgent (should be operated immediately), can be postponed for 30 days, and can be postponed for 30- 90 days. Some urgent cases and should be operated on immediately include cancers involving the airways, decreased renal function, and metastases. For chemoradiation decision to delay or continue should refer to the goal of treatment, current oncologic status, and tolerance to radiation. In terms of patient's follow up, telephone consultation should be maximized.

RESULTS: Of the 27 patients, 77.8% were female. Their ages group ranged from 18 to 35 years, and all patients had skin type III or IV. There were 14 mild acne patients and 13 moderate ones. There was a statistically significant improvement in mean acne severity score from 18.1± 4.3 at baseline to 14.3 ± 4.6 after two weeks post-IPL and 12.3 ± 4.9 after four weeks post-IPL. The result on satisfaction level of patients showed 'satisfied' in 3 patients, "very satisfied" in 5 patients; and, half of the patients (11) answered "fair" at the end of the study. Most patients tolerated well the procedure, and only 5 patients developed either post-inflammatory hyperpigmentation or skin hyperpigmentation.

MATERIALS AND METHODS: This is a retrospective study looking at data collected during office hours on 79 working days, excluding weekends and public holidays in Hospital Melaka, Malaysia. Details on all medical access block cases that were reviewed were recorded including their locations, diagnosis, disposition decisions and if they received specialist input at the time of their initial assessment by the medical team in ED. The aim is to revolutionise patient admission flow by offering early specialist care with rapid assessment, investigation and treatment. Hence, improving the overall treatment efficiency and reduce medical access block.

RESULTS: There were 1321 admissions. A total of 82% of the patients were admitted to the medical wards while 13% of them were given acute treatment in ED and discharged home with appropriate follow ups. We managed to resolve 18% of medical access block by re-triaging our cases and offering timely acute medical treatment. Nearly 90% of patients received first hand medical specialist input during the initial assessment by the Acute Internal Medicine (AIM) team in ED.