ABSTRACT
The novel coronavirus disease (COVID-19) caused by SARS-CoV-2 has turned the world topsy-turvy since its emergence. Although COVID-19 is mostly associated with respiratory pathology, it can also result in several extrapulmonary manifestations. Multisystem Inflammatory Syndrome in Adults (MIS-A) seems to be a new addition to the ever expanding COVID-19 puzzle and warrants extensive research to familiarize the phenotype, formulate a definitive treatment and prognosticate accordingly. This article highlights the case definition, pathogenesis, clinical features and treatment modalities of this new entity with a concise review of available literature at present.
ABSTRACT
Introduction: Metabolic syndrome is a constellation of interrelated risk factors that increase the risk of cardiovascular diseases (CVD) and diabetes mellitus. The increase in prevalence of hyperuricemia was considered to be directly related to increasing incidence of obesity and Metabolic Syndrome in developing and developed countries. Hyperuricemia is defined as serum uric acid of 6.0mg/dl and 7.0mg/dl for females and males respectively. Aims and Objectives: To study correlation of hyperuricemia with metabolic syndrome or its components. Materials and Methods: An observational, cross sectional single centre study with 316 patients fulfilling inclusion and exclusion criteria was carried out. Results: Out of 316 patients, 202 (63.9%) were males and 114 (36.1%) were females. 138(43.7%) were from rural areas and 178 (56.3%) were from urban areas. 126 (39.9%) patients had an active lifestyle and 190 (60.1%) had a sedentary lifestyle. Mean waist circumference among114 females was 82.10 cm and among men was 87.07cm. 113 patients fulfilled the criteria for central obesity with the mean uric acid level of 8.14 mg/dl (p=0.001); Mean uric acid level of patients without central obesity was 7.36 mg/dl. 99 (31.33%) fulfilled the criteria for hypertriglyceridemia with mean s.uric acid level 8.24mg/dl (p=0.0440). 124 had elevated blood pressure with mean s.uric acid 8.28 mg/dl (p=0.004). Patients with normal blood pressure had a mean value of s. uric acid 7.86 mg/dl. 33.44% fulfilled the criteria for metabolic syndrome (41.23%of total females and 32.10% of total males). Odds ratio was 1.28 and 0.864 for females and males respectively. Conclusion: Prevalence of metabolic syndrome in patients with hyperuricemia was 35.4%. More common in females than males. Hyperuricemia is more prevalent in patients with a sedentary lifestyle. Hyperuricemia positively correlates with central obesity, blood pressure, hypertriglyceridemia and hyperglycemia. Hence, it is of utmost importance to screen patients of hyperuricemia for metabolic syndrome or its components to prevent mortality and morbidity associated with CVDs.
ABSTRACT
Background : Clinically-based Medical Education is the principal source of learning and this has been profoundly impacted by restrictions due to COVID-19. Methods : A cross-sectional observational study was conducted to assess the impact of COVID-19 on the different aspects of the Postgraduate curriculum among the residents of Internal Medicine and its Allied sub/super-specialties across India. An online semi-structured English language questionnaire was prepared using Google-form platform and the link was shared among the residents through various social media outlets. The questionnaire comprised of seven sections: demographic characteristics, burden of COVID duties, hospital service utilization, academic activity, procedural training, research activity and recommendations for improvement of academic activities. Appropriate statistical tests were carried out to analyze the data obtained. Results: A total of 1857 responses were taken into consideration. A significant reduction in both out-patient and In-patient Department (IPD) attendance was reported by 47% and 35.3% participants respectively. Most of the residents (69.8%) claimed that their magnitude of self-study was less than usual. Bulk of the respondents (75.4%) felt that their clinical training was being grossly hampered. Three-fourths of the participants were involved in online studies. Procedural training was severely affected as opined by 75.9% of respondents. Majority (55.6%) respondents reported their thesis work was severely affected during pandemic. Conclusion : The findings of this study highlight the grave implications of the current pandemic on various aspects of the Postgraduate Residency Curriculum. Learning methods applying modern emerging online digital technologies will improve our teaching paradigms