ABSTRACT
Scrub typhus is a form of bacterial Zoonosis caused by Orintia tsutsugamushi usually presents as Acute febrile illness with multiorgan involvement as a complication and is associated with significant mortality. This study aims to document the clinico-demographic profile, laboratory parameters and complication of Scrub Typhus in North Eastern Hilly State of Tripura with background of tropical climate. This retrospective study was conducted at Tripura Medical College, including 42 patients admitted with acute febrile illness between June, 2020 to December, 2021 during the era of COVID-19 Pandemic. The diagnosis was established by Rapid card test, Lateral Flow Metry Assay (LFA) followed by confirmation through IgM, ELISA test and pathognomic Eschar where feasible. The clinlical, demographic and laboratory profile were documented and analysed. Post rainy season and people from rural area with farming background were mostly affected population. Apart from Fever and Flu like symptom, respiratory and Gastrointestinal (GI) symptoms were more prominent feature. Pathognomic skin lesion eschar was found in maximum cases followed by shortness of breath, GI involvement and Renal failure. Acute Respiratory Distress Syndrome (ARDS), Acute Kidney Injury (AKI), Hepatic encephalopathy and meningitis were the serious complications. While evaluating cases of acute febrile illness with multiorgan involvement clinician should have high index of suspicion for Scrub typhus specially resource poor areas of North Eastern (NE) state of India so that early detection and time bound intervention may help to reduce the mortality.Copyright © 2022 Indian Medical Association. All rights reserved.
ABSTRACT
Introduction: Incarcerated populations with HCV are at high risk of contracting COVID-19 disease and COVID-19-induced liver injury, causing significant morbidity and mortality. Despite the availability of vaccines, vaccine hesitancy among these populations remains a problem. Unfortunately, few studies discussed COVID-19 vaccination rates among HCV-positive prisoners. To identify subgroups that will require more interventions to prevent COVID-19, this study will assess the association between COVID-19 vaccination rates and the degree of hepatic impairment among HCV-positive prisoners. Research Question or Hypothesis: HCV-positive prisoners are more likely to receive COVID-19 vaccine if they have advanced liver disease compared to HCV-positive prisoners without hepatic impairment. Study Design: Retrospective chart review at the Illinois Department of Corrections (IDOC) HCV Clinic. Method(s): Patients seen between 12/11/2020 to 1/10/2022 were evaluated. Eligible IDOC patients included if >18 years old, had a documented COVID-19 vaccination status, and were eligible for HCV treatment. Vaccination status, FibroScan scores, abdominal ultrasound, and APRI were collected to determine if there is an association between COVID-19 vaccination rates and degree of hepatic impairment. Estimates and odds ratios were assessed using continuous and categorical variables, respectively. P-values determined statistical significance. Result(s): This IRB approved study including 336 patients showed no significant associations between the degree of hepatic impairment and COVID-19 vaccination rates using the regression model for analysis. The odds of one receiving the COVID-19 vaccine are 1.24 times more likely for someone with ultrasound evidence of cirrhosis compared to one without a documented ultrasound, and 1.01 times more likely for someone with advanced fibrosis compared to one with mild fibrosis. Conclusion(s): There was a trend showing that HCV-positive prisoners with advanced liver disease were more likely to be vaccinated against COVID-19. While an association cannot be made given statistically non-significant results, education about the importance of COVID-19 vaccination among all HCV-positive prisoners, including those with minor hepatic impairment, is imperative.
ABSTRACT
Background: The current COVID-19 pandemic is one of the greatest public health challenges. The spread of COVID-19 infection continues unabated despite vaccination. Adherence to COVID-19 appropriate behavior is critical to prevent COVID-19 infection. Aim and Objectives: To find out the pattern of COVID-19 appropriate behavior among vaccinated medical students and to estimate the incidence of COVID-19 infection after vaccination. Materials and Methods: A cross-sectional observational study using a questionnaire was carried out for a period of 3 months. The questionnaire was prepared based on the guidelines of Ministry of Health and Family Welfare Government of India. The data were collected using a pretested Google Form (online digital questionnaire) by means of a web-based survey. Results: About 96.5% of the participants wear face cover or mask while meeting someone or during visit to public places and 91.6% maintain respiratory hygiene, whereas 11.6% spit in the open, 16.1% travel unnecessarily, and 36.8% do not discourage crowd. There is significant (P < 0.05) increase in COVID-19 infection after vaccination. Conclusion: This study suggests that more emphasis should be given on sensitizing the medical students about the standard COVID appropriate behaviors because strict adherence to COVID-19 appropriate behavior is the key to the long-term management of this pandemic.