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Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in China, in December 2019, and was declared a pandemic by WHO on March 11, 2020. The treatment is evolving and is mostly supportive in nature. Material and methods: This was a single-center retrospective study that included confirmed COVID-19 cases treated at our institute (a tertiary care hospital in Jammu and Kashmir, India), between March 2020 and December 2020. Patients with age more than 18 years were included in the study. Results: On evaluating the effect of various drug therapies used in management of COVID-19 patients of all severity, use of remdesivir and famotidine was associated with significantly higher odds of survival. In subgroup of patients with severe disease, use of systemic steroids was associated with significantly higher odds of survival in addition to remdesivir and famotidine. In patients with severe COVID-19 illness, likelihood of survival was significantly higher in those who received combination of systemic steroids plus remdesivir compared to steroids and remdesivir alone. Conclusion: Steroids were effective in severe COVID-19 illness and the combination of steroids and remdesivir was more effective in severe illness. There is a need to undertake more large scale prospective randomized trials to determine the most effective drug therapies to treat the sick patients and prevent worsening of mild cases.
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COPD is a growing global threat considering its increasing prevalence, morbidity and mortality. The only modality of treatment that has been proven to alter the late course of this disease is the long term oxygen therapy (LTOT). Considering that an increasing number of COPD patients are getting a prescription of LTOT, this study was done to recognize the common barriers that prevent its adequate compliance.METHODSA pre-set questionnaire was administered to patients and their caregivers regarding LTOT prescription, compliance to LTOT and reasons for their poor compliance to LTOT.RESULTS58 COPD patients included in the study completed the questionnaire. Only 12 (21.4%) patients used the recommended oxygen for more than 15 hours per day to give them the therapeutic benefit. 21 (37.5%) patients received recommended advice for the duration of using supplemental oxygen each day from their treating physicians. None of the patients received education about the correct use of using oxygen therapy at home.CONCLUSIONSOxygen usage among patients who have been prescribed home oxygen therapy is far from optimal, and both patient and physician related factors are responsible for it. Thus, the knowledge of major factors responsible for poor compliance of LTOT stresses upon the need for proper education of the treating physician and proper advice and counselling for this treatment modality at the time of prescription, for the patient.
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Introduction: Considerable degree of psychologicalmorbidity has been reported among medical students rangingfrom stress, interpersonal problems and suicidal ideationto psychiatric disorders. The objective of this study was todetermine the level of stress, anxiety and depression amongmedical undergraduate students of Government MedicalCollege Srinagar using DASS-21 scale.Material and methods: A cross-sectional study includingundergraduate medical students was conducted after approvalfrom instituitional ethical committee. Depression, Anxietyand Stress Scale (DASS-21) having 21 statements to assessthe level of stress, anxiety and depression among participantswas used. As there were no earlier estimates of prevalenceof stress among medical students in Kashmir, so prevalenceof 50% was assumed. With 95% confidence limits and 5 %non-response rate, sample size of 403 was calculated. Afterobtaining informed consent, 400 students were included inthe study. The data was entered into Microsoft Excel anddescriptive statistics were obtained.Results: Most of the students (55%) who participated in thestudy were females. About 67.5% were in the age-group of17-19 years, mostly belonging to rural areas(77.5%). Studentsfrom all academic years participated with majority from1st and 2nd years. Only 2.5% students had a single parent orwere orphans with majority (75%) satisfied with their sociallife. About 25% were not satisfied with their academicperformance. Prevalence of depression, anxiety and stresswas found to be 40%,50% and 37.5% respectively in medicalstudents.Conclusion: A substantial proportion of medical students aresuffering from stress, anxiety and depression revealing theirmental health issues which require urgent attention
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Background: Needle stick injury among health workers is regarded as an occupational hazard. Health care workers are at risk of having blood-borne diseases in case they are exposed to blood and other biological samples of the patients. Moreover, staff including doctors working in tertiary care hospitals has high work load which results in increased chances of getting these injuries. The aim and objectives of this study were to find out the prevalence of needle stick injury among different categories of health care workers. Authors also aimed to assess the knowledge, attitude and practices associated with it.Methods: A hospital based cross sectional study design to know the prevalence of needle stick injury among various health care workers of Karpagam Faculty of Medical Sciences and Research, a tertiary level care hospital in Coimbatore, Tamilnadu, India. A total of 250 health care workers were selected for the study purpose. A self-designed, semi-structured, pre-tested questionnaire was used to assess the prevalence of needle stick injuries and the factors associated with it.Results: A majority of health care workers (94%) knew about needle stick injury and 92% were aware that HIV can be transmitted through needle stick injury, 78.4% and 69.65% were aware of Hepatitis-B and Hepatitis-C transmission respectively. About 28.4% of subjects had encountered needle stick injury in their past. Furthermore, it was found that type of exposure and place of exposure was significantly associated with different categories of health care workers (p <0.001).Conclusions: Prevention of health workers against needle stick injury is the best possible way to prevent several bloods borne diseases. There should be a prevention programme which special focus on training of health care workers. Further strategies aiming at preventive measures and reporting of the Needle stick injuries accidents should be made compulsory among health care workers.
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Introduction: Splenectomy addresses the role of the spleen in hematological disorders particularly those ofcellular sequestration and destruction and antibody production. Splenectomy is indicated in specific cases ofanemia.Material and methods: The study was conducted in the department of General and Minimal Invasive Surgery incollaboration with the department of Clinical Hematology, Sher-I-Kashmir Institute of Medical Sciences, Srinagarfrom Jan 2012 to Jan 2016.The study included 33 patients The patients were studied in regards to thevariables1.clinical and demographic information. 2.surgical findings.3.preoperative and post operativehaematological profile.4.immediate and late complications.5.hospital stay6.persistence of disease.Result: In our study, out of 33 patients, laparascopic splenectomy(LS) was performed on 19 patients(57.6%) and14 underwent open splenectomy(OS).. Mean age was 28.89 years in LS group.and 36 years in OS group. Malefemale ratio was 4/15 in LS and 3/11 in OS. Mean operation time was 107.5 minutes in LS and 80.7 minutes in OS(pvalue <.001). Mean intraoperative blood loss was significantly lower for LS vs OS (76.43 mL vs 133.57 mL; P =.003). There was no statistical significant difference in complications between the two groups. Also, There wasno significant difference between LS and OS in terms of remission rates.Conclusion: Laparoscopic splenectomy is a safe and effective procedure in experienced hands. It is superior withregard to hospital stay, operative blood loss, postoperative pain and cosmesis as compared to Open Splenectomy.
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Background: Acute Myeloid Leukemia (AML) is a malignancy of the cells of myeloid series characterized by the rapid growth of Myeloblasts. The diagnosis of AML is established by demonstration of more than 20% of the blood and/or bone marrow by leukemic myeloblasts. Immunophenotyping is one of the most useful tool for the confirmation, lineage assignment and subtyping of leukemias. This study was aimed to phenotype and classify acute leukemias by flow cytometry using commonly used markers for leukemia diagnosis and to establish whether CD 117 can be considered as a lineage specific marker in diagnosis and subclassification of AML.Methods: Flow Cytometric Immunophenotyping was employed for the study. The myeloid antibodies employed in AML in our study included - CD117, CD11c, CD13, CD15, CD33, CD34, CD36, CD41, CD65 and MPO.Results: In our study AMLs constituted 46% of all acute leukemias. CD117 positivity was seen in 86.56% of the French American British (FAB) category of AML. The blasts gated using CD45 v/s SSC revealed variable expression of CD34, CD13 and CD33. The expression of CD117 was consistent particularly in AML-M0, AML-M1 and AML M2.Conclusions: CD117 is virtually a myeloid blast marker with a high sensitivity, specificity and positive predictive value. Among the various myeloid markers like cMPO, CD13, CD33 and CD117, it is just CD117 that has got a tremendous reproducibility in AMLs. Besides CD117 is a surface marker unlike MPO thus easier to process, time saving and less prone to nonspecific binding.
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Background: Plasma cell dyscrasia (PCD) is the term used to describe the disorders characterized by neoplastic proliferation of plasma cells with the abnormal production of immunoglobulins (Ig). Patients with multiple myeloma frequently have abnormal coagulation tests. Aim of the present study were to correlate prothrombin time (PT) and Activated Partial Thromboplastin time (aPTT) with Ig concentrations in patients with newly diagnosed with PCD and to compare PT and aPTT values in untreated and treated patients diagnosed with PCDMethods: This study was conducted in the department of clinical hematology of SKIMS, a tertiary care hospital in northern India from 2015 to 2016. Patients diagnosed with PCD were advised for coagulogram (PT, aPTT) as a base line investigation. A total of 72 patients were included in the study.Results: 37% of multiple myeloma cases (newly diagnosed) and 22% of light chain disease patients presented with prolonged PT whereas none of the patients in treated cases of PCD had prolonged PT. The mean Ig concentration was significantly higher in patients with prolonged PT and aPTT compared to that of patients with normal PT and aPTT values. In IgA myeloma, the mean immunoglobulin concentration was 3643 mg/dL with a mean PT and aPTT values of 18.8s and 36.6 (p value: 0.006). The mean free light chain concentration in kappa (k) light chain myeloma was 1727 mg/L with a mean PT value of 20.5 s, mean aPTT value of 37.4 s (p-value: 0.026).Conclusions: Patients with newly diagnosed myeloma presented with prolonged PT as compared to the treated cases. Also, mean Ig concentration was significantly higher in patients with prolonged PT and aPTT compared to that of patients with normal PT and aPTT values.
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Background: Substance abuse disorder is among the leading public health problems in modern day world as they cause enormous human suffering in terms of morbidity, mortality and economic loss; and threatens the very social fabric of almost all communities around the world and as such is a great threat to the global health, economy and peace. Like most social behaviours the etiology of substance abuse is complex, varying through time, geographical regions and by demographic characteristics. Among young people, students are the most vulnerable group as the initiation into substance abuse first starts during this period. Aims & Objective: To find out the prevalence and pattern of substance abuse and its association with various sociocultural and demographic variables. Material and Methods: Multi-stage random sampling method was adopted to select the study subjects. The study subjects were asked about the substance abuse and related socio-demographic variables by means of WHO model core questionnaire format and results were subjected to statistical analysis. Results: The overall life-time prevalence of for substance abuse among college students was found to be 31.3%. Male students had significantly higher prevalence of substance abuse as compared to female counterparts(37.5% versus 19.6% respectively).The most common substance being abused was Tobacco products(22.5%) followed by solvents (10.0%), alcohol (6.2%), sedatives (5.9%), cannabis (4.4%), amphetamine products (2.1%), hallucinogens (0.5%) and cocaine (0.3%). Age, gender and family type were found to be strongly associated with substance abuse (p<0.001). Conclusion: Prevalence of substance abuse among college students is high and causes significant problems in this population; therefore there is necessity of targeted interventions to reduce this huge burden.
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Background: Population ageing is a recognized international reality, both in developed and developing countries. The number of elderly in the developing world is increasing due to demographic transition, whereas their condition is deteriorating as a result of fast eroding traditional family system coupled with rapid modernization and urbanization. Current statistics for the elderly gives a prelude to a new set of medical, social and economic problems that could arise if a timely initiative in this direction is not taken. Aims & Objective: To determine the pattern of physical morbidity in rural elderly population and to study health related quality of life and utilization of health services among them. Material and Methods: A community based cross-sectional design was adopted for studying the health problems of elderly and their health related quality of life, using WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. Simple random sampling technique was used for sample collection. A total of 660 individual ≥ 60 years of age were taken up for the study purpose. Results: An overwhelming majority (68.2%) of elderly enjoyed a good quality of life, while those having a fair/poor quality of life were ≤ 15%. Quality of life was better in males in physical, psychological, social and environmental domains. It was more in subjects who had graduated and currently married, belonged to non-scheduled cast and living in extended families (p<0.001). Majority of the subjects were anaemic (64.5%), suffering from dental problems (62.2%) and joint pains (51.4%). Maximum numbers of subjects (92.7%) were utilizing non-government health care facility due to long distance from their houses (33.3%). Conclusion: There is a need to highlight the medical and psychosocial problems that are being faced by the elderly people in India and strategies for bringing about an improvement in their quality of life.
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Organisms are exposed to a variety of stressful condition that damage important cellular structures and interfere with essential functions. In response to heat and other insults, cells activate an ancient signalling pathway leading to the transient expression of heat shock or heat stress proteins (HSPs). HSPs exhibit sophisticated protection mechanisms that protect the damaged cells. HSPs assist in protein folding, translocation and assembly of newly synthesized polypeptides. They also stabilize proteins during heat shock and other stresses, thus contributing to cell survival after injury. The elevated expression of stress proteins is considered to be a universal response to adverse conditions. In this Review we summarize the concepts of the HSPs protective mechanism.
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Background: Substance abuse among children has become an issue of concern throughout the world. Increasing substance abuse and its impact on physical and psychosocial health is a worldwide public health concern affecting the early youth and subsequently the whole life of the individuals. Particularly disturbing fact is that the age of initiation of abuse is progressively falling. To plan effective interventions, it is essential to have information on the extent and type of substance abuse among school children and their attitude towards its control. Aims & Objective: To find out the prevalence and pattern of substance abuse among school children and the associated risk factors. Material and Methods: A descriptive cross-sectional survey was conducted among students (13-19 years) studying in classes 7th-12th in rural and urban areas of district Ambala, using the Self-Administered WHO Model Core Questionnaire. Stratified random sampling technique was used to select the respondents. A total of 1500 students studying in various government and private schools were taken for the study purpose. Results: Overall prevalence of substance abuse was 60.0% for ever users and 34.93% for regular users. Substance abuse was more among male urban students belonging to nuclear families (p<0.001). Among ever users, alcohol (44.49%) was the most common substance abused while tobacco (14.42%) was mostly consumed by regular users. Substance abuse was more in age group of 17-19 years. Overall 42% were using more than one drug combination. Conclusion: Prevalence of substance use among school children in Northern India is high and causes significant physical and psychosocial problems in this population. A large proportion of those using drugs reported serious adverse effects, raising the necessity of targeted interventions to reduce the risk of subsequent substance dependence and other deleterious consequences.