Redefining Clinical Skills in History Taking in Association With Epidemiological Assessment of Risk Factors, and Diagnosis of Patients With Cardiovascular Diseases With a Special Emphasis on COVID-19.

Cardiovascular diseases were the leading cause of death in the world prior to the COVID-19 pandemic. A wide range of risk factors may precipitate a cardiovascular disease and therefore multiple aspects of the patient's history may lend a hand in the diagnosis of the specific stage of cardiovascular disease that is presented by the patient. This article will give a general review of the knowledge and skillsets needed by a clinician to distinguish and at the same time correlate the different presenting symptoms and the potential cardiac issue associated with them. History taking is a very essential and critical clinical skill that is of paramount assistance in diagnosing and treating the patient with the right management therapies to find a cure for the disease. Basic approaches in the evaluation of the physical condition and cardiac assessment are important skills in healthcare that help decrease mortality in everyday life and therefore are needed to be learned efficiently. Lifestyle changes and modern standard of living especially in a developing country like India contribute majorly to the evolution of this disease in the population as well as the eating habits and addictions which play a vital role in the progression of the disease. The aim of this article is also to give an outline of various risk factors and recent etiological agents by analyzing the epidemiological variation and patterns that can be ruled out or considered associated with the cardiovascular related-symptomatology and relevant history of the patient to confirm a diagnosis by investigations which will direct the clinician towards specific treatments and recovery of the patient. A special topic of understanding would be the COVID-19-associated cardiovascular complications which have been recently discovered and studied as a result of the pandemic.

Role of Telemedicine and Digital Technology in Public Health in India: A Narrative Review.

There are still many areas of India without proper medical facilities. In such a setting, technology can play a facilitating role, particularly in reaching out to remote locations and offering a greater standard of care at a lower cost. The method of treating and diagnosing patients remotely through communication networks is known as telemedicine. When more patients get access to telemedicine, payers take more notice of how much less expensive it is than traditional medicine, and doctors are aware of its benefits. Telemedicine is a more beneficial technology that can expand access to preventive treatment and may lead to long-term health. Telemedicine has the potential to greatly affect public health. This paper reviews the current state of the art of telemedicine in India. Nearly 50 years ago, telemedicine was shrugged off as a complicated, expensive, and inefficient technology. Because of how quickly the information technology and telecommunications disciplines are advancing, telemedicine is today a viable, dependable, and useful technique. Practitioners and medical experts from a variety of fields have experienced success with telemedicine. The COVID-19 pandemic highlighted the need for strong primary healthcare networks for a more effective public health response during health emergencies and exposed the fragmentation of healthcare delivery systems. Although primary care is the first point of contact between the general public and the healthcare system, it has not recently grown much focus or funding. Even in the post-COVID-19 environment, telemedicine offers the potential to get through enduring barriers to primary care in India, such as a shortage of qualified medical professionals, issues with access, and the cost of in-person care. Telemedicine has the power to speed up the delivery of universal health coverage while strengthening primary care. There is a widening gap between people and those who offer basic health services as the population in India has grown, and the average lifespan has increased. Telemedicine helps with palliative care, early identification, a better cure, prevention, and rehabilitation in the treatment of cancer. Due to a shortage of primary care delivery networks and referral units, secondary and tertiary care facilities' health systems are overworked. To successfully use telemedicine, proper planning and operating processes are required. Thus, the development and implementation of telemedicine will improve patient care and India's primary healthcare system in the future. Finally, telemedicine's cost-effectiveness will likely be its most significant outcome.

Impact of COVID-19 on Pregnancy and Maternal-Neonatal Outcomes: A Narrative Review.

The pandemic coronavirus disease (COVID-19) has caused an unprecedented worldwide health emergency. The pandemic increased the susceptibility of pregnant women to maternal and fetal complications. Elderly and patients with comorbidities were also at high risk during the pandemic times. Further evidence supports that COVID-19 is not only a respiratory infection but possibly affects other organ systems, including the placenta. The key objective of this review is to explore the literature on COVID-19-affected pregnancies and study the pandemic's impacts on maternal, perinatal, and neonatal outcomes. We used Google Scholar and PubMed (Medline) for relevant literature searches. The clinical manifestations in pregnant women, fetus outcome, vertical transmission, and early and late pregnancy impacts are combined in database studies. Women should receive special attention for COVID even though most of the COVID-19-positive pregnant women had no symptoms or had minor ones. It was found that most pregnant women with COVID-19 had mild and few symptoms and that the effect on the fetus was insignificant. However, in some women, miscarriage and fetal growth retardation were seen as a consequence of the infection.

Comparison of Public Health Investments of Various Countries Amid a Need for Greater Transparency: A Narrative Review.

A robust health system demands investments in public health and healthcare as they aid in closing the health protection gap. They are primarily responsible for longer life expectancies, disease prevention, and protection. Loopholes in the public health system were formed due to a lack of transparency and have only worsened throughout COVID-19. Spending more on public health is associated with fewer deaths, fewer food-borne illnesses, better sanitation, food safety, clean air and water, increased immunizations to stave against infectious diseases, and a decline in low birth weight. A comprehensive literature and data search was conducted using web-based search engines like PubMed, National Center for Biotechnology Information (NCBI), Google Scholar, Science Direct, and the New England Journal of Medicine. The review study standpoints healthcare spending, out-of-pocket expenditures, and other monetary use in various low-to-high-income countries, and the results are graphically represented. Countries with a strong public health system provide all the necessary aid to protect their citizens. They have cost-effective, readily available resources with fewer out-of-pocket expenditures (OOPs), government schemes, and health insurance to help their people. During our research, it was found how little the Indian government spends on healthcare as a percentage of gross domestic product (GDP) as compared to 'thought-to-be' poor countries like Bhutan.

Redefining Clinical Skills in History Taking in Association With Epidemiological Assessment of Risk Factors, and Diagnosis of Patients With Cardiovascular Diseases With a Special Emphasis on COVID-19

Cardiovascular diseases were the leading cause of death in the world prior to the COVID-19 pandemic. A wide range of risk factors may precipitate a cardiovascular disease and therefore multiple aspects of the patient's history may lend a hand in the diagnosis of the specific stage of cardiovascular disease that is presented by the patient. This article will give a general review of the knowledge and skillsets needed by a clinician to distinguish and at the same time correlate the different presenting symptoms and the potential cardiac issue associated with them. History taking is a very essential and critical clinical skill that is of paramount assistance in diagnosing and treating the patient with the right management therapies to find a cure for the disease. Basic approaches in the evaluation of the physical condition and cardiac assessment are important skills in healthcare that help decrease mortality in everyday life and therefore are needed to be learned efficiently. Lifestyle changes and modern standard of living especially in a developing country like India contribute majorly to the evolution of this disease in the population as well as the eating habits and addictions which play a vital role in the progression of the disease. The aim of this article is also to give an outline of various risk factors and recent etiological agents by analyzing the epidemiological variation and patterns that can be ruled out or considered associated with the cardiovascular related-symptomatology and relevant history of the patient to confirm a diagnosis by investigations which will direct the clinician towards specific treatments and recovery of the patient. A special topic of understanding would be the COVID-19-associated cardiovascular complications which have been recently discovered and studied as a result of the pandemic.

The Global Impact of COVID-19 on Mental Health of General Population: A Narrative Review.

Mental wellness is a crucial component of happiness. A person is happy with better relationships, financial stability, good mental health, and longevity. Disinformation, stigma, ongoing isolation, and disruption of daily activities are all quite prevalent. Any of these elements may impact one's mental health. The Ministry of Health and Family Welfare has taken several steps to address COVID's mental health concerns. In addition to frontline healthcare personnel, who engage in dealing with COVID-19, the general population's mental health was also at stake due to the unprecedented and catastrophic emergency of COVID. Various keywords, including MeSH terms, were used in PubMed and Google Scholar searches. This paper was based on previously available data and article searches on how COVID-19 affected the mental health of the general population and the elements that may influence it. Quarantine and self-isolation have been found to have affected people's daily livelihoods and behaviors, leading to increased feelings of loneliness, anxiety, dejection, insomnia, risky alcohol and drug use, self-harm, and suicidal thoughts. Many of the victims of COVID-19 who were critical survivors exhibited lasting psychological harm a year after being discharged, including high anxiety levels, melancholy, and post-traumatic stress disorder. Healthcare employees too experienced significant psychological consequences due to factors such as an excessive workload or the number of hours worked, inadequate personal safety equipment, overly enthusiastic media coverage, and a sense of being under-supported. As a result of this major disaster, mental health concerns have surfaced, perhaps leading to long-term health problems, loneliness, and guilt. To reduce this deportment, global health solutions should be used, particularly while executing the isolation/quarantine and dealing with the people with fear and vulnerability. The mental health of the general population should be at the forefront of any worldwide response.

Comparison of Public Health Investments of Various Countries Amid a Need for Greater Transparency: A Narrative Review

A robust health system demands investments in public health and healthcare as they aid in closing the health protection gap. They are primarily responsible for longer life expectancies, disease prevention, and protection. Loopholes in the public health system were formed due to a lack of transparency and have only worsened throughout COVID-19. Spending more on public health is associated with fewer deaths, fewer food-borne illnesses, better sanitation, food safety, clean air and water, increased immunizations to stave against infectious diseases, and a decline in low birth weight. A comprehensive literature and data search was conducted using web-based search engines like PubMed, National Center for Biotechnology Information (NCBI), Google Scholar, Science Direct, and the New England Journal of Medicine. The review study standpoints healthcare spending, out-of-pocket expenditures, and other monetary use in various low-to-high-income countries, and the results are graphically represented. Countries with a strong public health system provide all the necessary aid to protect their citizens. They have cost-effective, readily available resources with fewer out-of-pocket expenditures (OOPs), government schemes, and health insurance to help their people. During our research, it was found how little the Indian government spends on healthcare as a percentage of gross domestic product (GDP) as compared to 'thought-to-be' poor countries like Bhutan.

Behind the Frontline: A Review on the Impact of COVID-19 Pandemic on Healthcare Workers.

The recent COVID-19 pandemic has been havoc that spread like wildfire, snatching the lives of many, attacking the mental health of many more, and leaving a major chunk with the constant fear of contracting this illness. It need not be mentioned that the aftermath of this pandemic was much more on frontline workers as compared to the general population. It has now become evident that the COVID-19 pandemic has influenced medical services and assets. This unpredictable mass health crisis had a significant impact on healthcare facilities, clinical transportation, patients with healthcare workers (HCWs), and their families. This difficult situation reinforces the requirement to step forward and take the necessary steps to shield frontline workers from deeds of violence and assaults. In this context, the present article reviews the impact the COVID warriors had on their physical, social, and especially psychological health. It revealed that the COVID-19 outbreak imparted a lesson greater than ever, that shielding the health and lives of HCWs is crucial to enable a better worldwide outcome. Be it doctors or nurses or paramedical staff, no one is exempt from the horrendous effect this crisis created on the mental as well as the physical and social well-being. Frontline HCWs demonstrated more degradation of these dimensions of their health and wellbeing as compared to non-frontline healthcare staff. Constant exposure to various infectious agents over the years, along with strenuous duties in the healthcare setup, led to neglected health. Being in direct contact with several COVID patients for longer durations imposed a greater risk on frontline workers. Not many studies have been done on this aspect, as health care workers are altruistically involved in saving lives rather than focusing on their own health. Efforts should be made to have a closer look at the aftermath of this havoc on HCWs and go into the depth of depredation in order to better manage any forthcoming healthcare crisis without hampering the well-being of HCWs.

Challenges and Barriers for Accessing Online Education Amongst School Children in an Urban Slum Area of Pune, India.

Background COVID-19 has restricted the education of students on a global scale. With the nationwide stay-at-home directives, schools, colleges and universities have been shut down. Online education is a measure for continuing the learning of the students in times of pandemic. However, the school-going children of urban slum areas face challenges in attending online classes. Through this study, we have tried to highlight the problems and challenges faced by the students and their parents from an urban slum area of Mangalwarpeth, Pune for attending online education in times of COVID. The urban slum area mainly consists of people from low socioeconomic backgrounds lacking the necessary resources and supportive environment for an online mode of education. We have observed and recorded the response of the participants in the context of online education in times of COVID and challenges faced by the lower socio-economic strata due to reasons like non-availability of resources, poor internet connectivity, poor understanding, and distractions while classes leading to low attendance. Methods A cross-sectional qualitative study was conducted in an urban slum area of Mangalwarpeth, Pune. Data was collected over four months after receiving consent from the parents of the children from the metropolitan slum area of Mangalwarpeth. A structured questionnaire was used. Data was coded on an excel sheet and was transferred to SPSS software version 21 (IBM Corp., Armonk, NY) and was represented in frequency and percentage. Result After the data collection and analysis, we found that (according to the modified Kuppuswamy scale for socioeconomic status) around 53% of the study population were from the lower middle class followed by the upper lower class (27.16%), upper middle class (9.87%), lower class (8.64%) and upper class (1.23%). Sixteen percent of participants do not have smartphones available, and 95.5% do not have a laptop required for online classes. A total of 19.5% of the students do not have access to internet services. Eighty-four percent of parents agreed on increased expenses of the internet. Conclusion Students from urban slum areas belong to lower socioeconomic classes and face problems while attending online classes like the nonavailability of resources and lack of a supportive environment. There are increased expenses of the internet as a result of the online mode of education, with increased distractions from the surroundings, concentration problems, and less understanding of the subjects. The students cannot interact with their teachers and friends and as a result, their social interaction is reduced. A supportive environment and proper resources are essential for the learning of students to continue education in times of emergencies like pandemics.