COVID-19: Knowledge, attitude, and practice of health-care workers in tertiary care hospitals of Odisha – A cross-sectional survey

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a contagious viral pathogen, creating a public health emergency, and affecting lives and livelihood of millions of populations globally. Good knowledge, attitude, and practice are essential to prevent and stop the widespread transmission. Aims and Objectives: The aim of the study was to assess the knowledge, attitude, and practices regarding COVID-19 among health-care workers (HCWs) in tertiary care hospitals of Odisha. Materials and Methods: The present study is an observational, cross-sectional, and question-based online research. Questions were created on Google forms. Link was generated and given through social media apps. The questionnaire consists of four sections. First section comprised demographic characteristics. Second, third, and fourth sections contain questions on knowledge, attitude, and practice related to COVID-19, respectively. Descriptive and inferential statistical procedures were done through IBM SPSS statistics version 24.0. The research was granted approval by Institute Ethics Committee of IMS and SUM Hospital. Results: Data were analyzed in 430 subjects, 205 females and 225 males. The majority of HCWs have good knowledge score 86.5%, attitude score 80.9%, and practice score 91.2%. The mean knowledge score was 6.6 ± 0.84 and mean attitude score was 28.5 ± 1.89. Knowledge and attitude score was found to be significantly different among age groups and gender, p<0.001. Mean attitude score had a significant difference with working status, P = 0.025. Mean knowledge and attitude score was significantly higher across professions and work experience, P < 0.001. Good practice score varies significantly across professions, P < 0.001. Conclusions: The most of HCWs had good knowledge, positive attitude, and adopted appropriate practices regarding COVID-19. Periodic educational interventions are strongly recommended for HCWs to upgrade their knowledge, attitude, and practices regarding coronavirus diseases.

Attitude and practice of self-medication among 2nd-year dental students in a tertiary care teaching hospital: A questionnaire-based cross-sectional study

Background: It is a common believe that self medication prevails more in medical students. Dental students do believe in self medication. With this background, current study aimed to determine the attitude and practice of self medication among dental students. Aim and Objective: To know prevalence, attitude and practice of self medication among dental students in a dental college. Materials and Methods: A descriptive cross-sectional study was conducted among 2nd year dental students in a tertiary care teaching hospital to assess attitude and practice regarding self-medication. Data were collected from 90 students using a semi-structured self-administered questionnaire. Results: The study finding revealed that overall prevalence of self medication is 86.67% among the participants. There is an increase in prevalence of self medication from 58.97 to 86.67% after joining to professional course. Most common source of self medication is senior抯 advice (92.30%) followed by book reference (83.33%). Most common disease for which self medication is used are fever, headache/body ache, cold/flu (100%) followed by acid peptic disease (92.30%). The use of self medication is more in communicable/infectious disease (91.02%) than noncommunicable disease (62.82%). Most commonly used drug for self medication are analgesics, antiallergics and antipyretics (100%) followed by antacid/PPI (84.61%). The prevalence of use of antibiotics among the participants are 73.07%. 26.29% participants use herbal medication as self medication. Most of the participants use self medication as and when basis (52.57%). Only 25.64% participant took full course of the medication and 21.79% participants use self medication for long term. Most of the participants strongly agree or agree for self medication in community and among dental students. About 54% disagree saying medicine should be prescribed by licensed medical practitioner. Conclusion: Attitude and practice of the students towards self-medication was positive and reason being dental students and influence of seniors. Since they are in the initial year of course with inadequate knowledge, awareness must be created about appropriate use and adverse drug reaction arising from self-medication.

Spectrum of Eye Disease in Diabetes (SPEED) in India: A prospective facility-based study. Report # 3. Retinal vascular occlusion in patients with type 2 diabetes mellitus

Purpose: To determine the proportion of people with type 2 diabetes mellitus (T2DM) attending large eye care facilities across India who have retinal vascular occlusion (RVO). Methods: A 6-month descriptive, multicenter, observational hospital-based study of people was being presented to the 14 eye care facilities in India. The retina-specific component of comprehensive eye examination included stereoscopic biomicroscopy, binocular indirect ophthalmoscopy, and fundus fluorescein angiography, and optical coherence tomography was also available when needed. Data recording of the duration of diabetes, hypertension (HTN), stroke, and other variables was obtained from the medical history. The statistical analysis included frequencies, mean, and standard deviations for continuous variables. Odds ratio (OR) and multivariate analysis were undertaken to assess the associations between risk factors and RVO. Results: The study recruited 11,182 consecutive patients (22,364 eyes) with T2DM. About 59.0% (n = 6697) were male. The mean age was 58.2 ± 10.6 years. In this cohort, RVO was detected in 3.4% (n = 380) of patients; 67.6% (n = 257) of them had branch retinal vein occlusion (BRVO) and the remaining 32.4% (n = 123) had central retinal vein occlusion (CRVO). The frequency of unilateral BRVO (n = 220, 85.6%) and unilateral CRVO (n = 106, 86.18%) was much common. Unilateral RVO was more frequent (n = 326, 85.8%) than bilateral diseases (n = 54, 14.2%) (?2 = 126.95, P < 0.001). Ischemic CRVO was more common (n = 103, 73.6%) than nonischemic CRVO (n = 37, 26.4%). Macula-involving BRVO was found in 58.5% (n = 172) of cases, suggesting more than 50% of cases in RVO carries a risk of severe vision loss. The duration of diabetes apparently had no influence on the occurrence of RVO. On the multivariate analysis, a history of HTN [OR: 1.7; 95% confidence interval (CI): 1.3–2.1; P = 0.001) and stroke (OR: 5.1; 95% CI: 2.1–12.4; P < 0.001) was associated with RVO. Conclusion: RVO is a frequent finding in people with T2DM. History of stroke carries the highest risk followed by HTN. The management of people with T2DM and RVO must also include comanagement of all associated systemic conditions.

Assessment of industrial effluent and its impact on soil and plants.

The present study deals with the assessment of industrial water of an electronic component manufacturing unit with electroplating and its subsequent effects on soil and plants receiving the effluent. The physico-chemical parameters of the effluent samples showed higher value than that of ground water. The treated effluent was within the permissible limit. Microtox test was conducted and determined the degree of toxicity of untreated, treated effluents as well as the water sample collected at effluent discharge point of receiving river (confluence point). The physico- mechanical parameters of the soil samples were not changed due to irrigation of the treated effluent, but the concentration of metals were comparatively higher than the control soil. Higher accumulation of metals was found in the plant parts in naturally growing weeds and cultivated crop plant irrigated with treated effluent. Elevated accumulation of metals in Eichhornia crassipes and Marsilea sp. growing along the effluent channel has been identified as a potential source of biomonitoring of metals particularly for Cu and Ca and can be utilised for the removal of heavy metal from wastewater.

Factors regulating the metastatic potential of benign giant cell tumour of bone--study of an unusual case with short review of literature.

Benign giant cell tumour of bone with metastases to other bones and lungs is extremely rare. Benign metastasising giant cell tumour is distinctly separate from multicentric giant cell tumour, primary and secondary malignant giant cell tumour. Factors regulating the local recurrence and metastatic potential of this benign tumour depend on its aggressiveness which can be better assessed by clinical and radiological parameters rather than the histopathological appearance. A benign giant cell tumour of ischium with metastasis to vertebra and lung over an eleven year period is discussed. Extreme paucity of literature prompted to publish the article. A short review of factors determining the recurrence and metastatic spread of benign giant cell tumour of bone is highlighted.

Bilateral Wilms tumor: an eleven year experience.

Over the last 11 years, 101 patients of Wilms tumor were treated at our hospital. Of these, 7 had bilateral Wilms tumors (BWT). The first two patients were referred in terminal stages and died. Of the latter five, three have survived while one is on treatment. One patient succumbed to liver metastasis, he had stage III disease on one side and was irregular in his chemotherapy protocol. Remarkably, one of the survivors was cured even after developing vertebral metastasis, retroperitoneal recurrence and bilateral lung metastasis. Part of the success was due to "salvage chemotherapy regimens" using Cis-plantinum, ifosphamide and VP-16. Flow cytometric analysis of DNA ploidy performed on only three of the five patients showed that two tumors were aneuploid and one was diploid. Spectacular cure rates can be achieved in BWT by renal conservation surgeries and effective chemotherapy. The use of "salvage chemotherapeutic regimes" and the study of DNA ploidy is being highlighted.

Ewing's sarcoma of bone--a study of 71 cases by fine needle aspiration cytology.

Fine needle aspiration cytology (FNAC) plays immense diagnostic role in Ewing's sarcoma of bone. As clinically and sometimes radiologically Ewing's sarcoma mimics osteomyelitis of bone, FNAC is of great help to distinguish these 2 lesions and can avoid unnecessary incisional biopsies in most of the cases. At present limb salvage therapy is replaced by chemotherapy and radiotherapy. Moreover most of the patients present with gross soft tissue involvement where exact categorisation of malignant bone tumour is not possible by radiological means. FNAC is of great benefit to the clinicians and the patients as it provides a quick and accurate report and surgical interventions can be avoided in most of the cases. This paper highlights the cytological appearance of Ewing's sarcoma of bone in 71 cases. A conclusive diagnosis can be made with the help of special stains and cell block study. The diagnostic accuracy was 100% without any complication.

Management of metastatic Wilms tumor: an eleven year experience.

During the last 11 years, 101 patients of Wilms tumor were seen. Of these, 13 patients had metastatic disease at onset while 24 patients presented with relapse at a latter date. Seven patients have been cured, all had favourable histology. The risk factors associated with relapse were found to be unfavourable histology, lymph node involvement, age more than 6 years, diffuse spill, capsular and vascular invasion, and aneuploidy. Of the 18 patients who had relapsed, 14 were found to be aneuploid. Judicious use of various therapeutic options like radiotherapy to metastatic sites, second look surgery, resection of pulmonary metastasis and use of cis-platinum, VP-16 and Ifosfamide as "alternative chemotherapy protocols" were used to achieve cure in these advance cases.

CT-guided needle aspiration cytology (FNAC) of 112 vertebral lesions.

Aspiration cytology under CT-guidance was utilised as a diagnostic device in 112 lesions of vertebrae from January, 1985 till August, 1992. The age of the patients ranged from 6 years to 82 years. The materials were spread on glass slides, air-dried and stained by May-Grunwald and Giemsa method. In few cases part of the aspirated material was utilised for special stain and cell block preparation. Analysis of results showed metastatic tumours in 61 cases, Tuberculous lesions in 24 cases, Plasmacytoma in 6 cases, Giant cell lesion in 6 cases, Eosinophilic Granuloma in 3 cases, Chordoma in 3 cases, Ewing's sarcoma in 2 cases, Hodgkin's disease in 2 cases, Chondrosarcoma in 1 case and no definite diagnosis was given in 4 cases. These 4 cases on exploration and biopsy proved to be osteoblastoma (2), haemangioma (1) and undifferentiated sarcoma in the other. The giant cell lesions on histopathology proved to be aneuryamal bone cysts in 4 cases while osteoclastoma in 2 cases. The diagnostic accuracy was 96.4%. No complication was encountered in the present study. Early diagnosis by needle aspiration cytology (NAC) prevented unnecessary surgical exploration in majority of the cases and treatment could be started at the earliest.

Incidence of Nelson's syndrome and residual adrenocortical function in patients of Cushing's disease after bilateral adrenalectomy.

Eighteen patients of Cushing's Disease, who had undergone bilateral "total" adrenalectomy 2 to 10 years back, were evaluated for residual adrenocortical function and for any evidence of Nelson's Syndrome. Surprisingly, all patients were discovered to have measurable plasma cortisol, albeit in the subnormal range. The standard criteria for accepting "completeness of adrenalectomy" were fulfilled in 16 patients. It was possible to wean one patient off replacement therapy. Thus, the dose of replacement steroids needs to be regulated according to the blood steroid levels in order to avoid unnecessary hypercortisolism. Radiological evidence of pituitary tumor diagnosed Nelson's Syndrome in 2 patients. Nelson's Syndrome was further suspected in 8 others who showed pigmentation. One of these had an enlarged sella and an erosion of the dorsum sellae, but had a normal CT scan. Another patient had evidence of incidental pituitary pathology (incidentaloma) which resolved spontaneously. Contrast enhanced CT scans of the sella are necessary for early detection of Nelson's Syndrome.

Effect of post-hypoxic acclimatization on extremity temperature during exposure to acute cold stress in man.

Twelve male volunteers aged 20-28 yr, who were physically fit for high altitude duties were studied. Recordings of oral temperature, mean skin temperature, extremity temperature, O2 consumption and heart rate were taken in a thermoneutral room (26 degrees +/- 2 degrees C) and cold room (6 degrees-8 degrees C) initially; after 4 wk stay at 3353 m (502 mm Hg); again after 4 wk at 4115 m (455 mm Hg); and finally after return to Delhi (740 mm Hg). The oral temperature, mean skin temperature, oxygen consumption and heart rate did not show any significant difference from their initial sea level values recorded in the thermoneutral room or the cold room. It may be concluded that our subjects did not exhibit any degree cold acclimatization when retested at sea level. A significant elevation (P less than 0.001) of extremity temperature observed during retest in cold might be due to some degree of vasodilatation through relaxation of constrictor tone that might have taken place during exposure to hypoxia at high altitude.

Septum and adrenocortical function.

Dorsal septum is an intermediary centre in between the hippocampus and hypothalamus and it has got inhibitory influence over the hypothalamo-pituitary-adrenal axis. Stimulation of the dorsal septum manifested with fall in adrenocortical output whereas its lesion has opposite response. Ventral septum is a facilitatory area regarding activation of the hypothalamo-pituitary-adrenal axis. It is a balancing centre lying in between the higher central nervous system structures and the hypothalamus. Stimulation and lesion of the ventral septum led to rise and fall in adrenal venous 17-OHCS output respectively. Adrenocortical response to stress of burn was not blocked or inhibited following lesion of the dorsal as well as ventall septum.

Changes in brain acetylcholine of rats after dermal application of fenitrothion (Sumithion).

Fenitrothion (Sumithion), and organophosphorous insectide, was applied dermally to rats. Cholinesterase activity was measured in blood and brain. The concentration of the pesticide in blood plasma and acetylcholine in brain were estimated at different intervals. The maximum concentration of Fenitrothion in the plasma was found at 4 hrs while significantly elevated levels of acetylcholine were present in the brain till 24 hrs. The results suggest that the compound was readily absorbed by dermal route to produce inhibition of cholinesterase and a consequent persistent increase in brain acetylcholine.