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Introduction: The associations between ABO system of blood and COVID-19 infection in various studies provide reason to think true associations may be in reality between blood type and incidence of COVID-19 and death due to COVID-19. Objectives: To estimate frequency of COVID-19 illness in different ABO blood systems and also to find linkage between the ABO system of blood and degree of COVID-19 illness. Methods: A prospective cohort study was conducted on all COVID-19 patients (Patients were grouped A positive and A negative blood groups into 1st group and other blood types such as B, AB, and O, irrespective of their Rh status, into 2nd group) admitted at Tertiary Care Hospital of Ahmedabad City, Gujarat, India during the four months of study duration. Results: COVID-19 infection was found in 380 (63.3%) male. Mean age was 56.46 ±15.35 years in which 26.8% patients were in age group of 60 to 70 years. Among total 600 patients, 35% of patients were having B positive type of blood followed by O positive type of blood (25%). There were 25% of patients having overall co-morbidity like diabetes. And 8% of B positive patient having co-morbidity and amongst the, 1.2% patients were admitted to Intensive Care Unit. Case fatality rate was 7.5%. Among B positive blood group patients, 37.8% deaths occurred. Conclusion: Patients having blood group O may have lower chances of ICU admission as compared to other blood groups. © 2022 IJPH.
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Background : Data pertaining to preventable causes of maternal mortality are valuable in each set up to design interventional steps for the significant reduction of the maternal mortality ratio. Objectives : (1) To study the trend on Maternal Mortality Rate (MMR);(2) To find out the factors for the Maternal Mortality. Material and Methods : A retrospective cross-sectional study of maternal death was conducted in the Obstetrics Department of Tertiary Care Hospital of Ahmedabad city. The data of total 9 years from 1st April 2013 to 31st January 2021 were taken in the study. Epidemiological factors and causes affecting maternal mortality were assessed through pretested questionnaire that includes parity, duration between admission and mortality etc. Results: Maternal Mortality Rate (MMR) was 180.2 per 1 lac live births during the study period. Young mothersaged 20 to 30 years (78.5%), and rural residence (76.6%), multiparous mothers (66.7%)were at risk for Maternal Mortality. Obstetric haemorrhage (25.8%) was the most common cause whereas COVID-19 pandemic later on were indirect causes contributing to Maternal Mortality. Conclusion: Great Care should be taken for high-risk pregnancy like young age, multiparous women and also of postpartum women. Postpartum haemorrhage was the commonest direct cause of Maternal Mortality. Strengthening of existing obstetric care facilities, facility for easy transport, appropriate referral linkages are keys to reduce Maternal Mortality to further extent.
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Introduction: Patient satisfaction in health care describes the degree to which patients' needs 'meet their expectations and provide an acceptable standard of care'. Therefore, their opinion should be incorporated to understand factors affecting patients' satisfaction with the health-care setting. The recent COVID-19 pandemic has posed a significant challenge for the field of dentistry owing to its working characteristics. It is difficult for dentists to provide optimum satisfaction to patients receiving dental care with such changes proposed. A study aiming to evaluate the patient's satisfaction receiving treatment in the Department of Dentistry during the pandemic was planned. Materials and Methods: A cross-sectional observational study from September to November 2020 was conducted. A self-administered printed questionnaire drafted in English/Gujarati was provided to 225 patients on completion of their dental treatment. Thirteen close-ended questions were included in determining the patient's satisfaction. Descriptive statistical analysis was used to describe the parameters of the questionnaire. The Chi-square test was used to find a significant association between parameters, and P < 0.05 was considered statistically significant. Results: About 74.3% of the participants were satisfied with dentist-patient communication. Positive response (80%) by patients where they were able to get an appointment as per their suitability and were informed in advance by the department if there were any changes. One hundred and sixty-eight (84%) patients responded that the waiting area was hygienic. One hundred and thirty-seven (68.5%) patients assured that their arrival was intimated to the respective dentist by supporting staff and that they were taken into an operatory for treatment within 10 min of arrival. Participants said that they were informed about the delay from their allotted appointment schedule with reasons;hence, better compliance (79%) was obtained from them. Conclusions: This cross-sectional study indicated that with proper communication, a positive response by participants over satisfaction was obtained even due to changing treatment patterns due to pandemic.
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Objective: To qualitatively analyze experiences and reflections of COVID-19 patients about their journey through illness and reflections about anguish and suffering. Materials and methods: Setting: The study was carried out at Shree Krishna Hospital, Karamsad - a government-designated COVID tertiary care center in central Gujarat during the second wave of COVID. Study design: A investigator-designed interview guide was prepared to capture experiences and reflections of patients suffering from/ those recently recovered from COVID-19 to capture responses to illness and experiences through the journey of illness. In-depth qualitative interviews were conducted and audio recorded. Participants' selection: Eight patients who were of mild illness and 8 patients who were of moderate or severe illness (total 16), who fulfilled inclusion and exclusion criteria were selected by random, convenient sampling method. They were interviewed after their recovery from acute illness. The interview was recorded. Data analysis: To organize data, we used thematic analysis, coupled with a validated conceptual model of clinician-surrogate communication. Qualitative analysis of the audio recordings was carried out as per standard protocols. The steps of Collaizi's phenomenological data analysis were followed. Results: 1. Unprecedented illness, unplanned and abrupt hospitalization and inability to have access to the comforting presence of family members were identified as the most significant experiences reported by all patients. It was observed in patients of all severity and in both genders and at all ages. Patients also reported that their family members too were missing them during the illness like no other. 2. In the resulting situation, they looked for the needed emotional support from the treating physicians and healthcare team. 3. A number of themes emerged from the interviews. Inferring from a validated conceptual model, we finalized 2 domains for our coding: inner strength and relationship building. 4. In the domain of inner strength, we coded To have the support of next of kin, The wish to go on living, seen by a doctor, and health care professionals' positivity for him/her. 5. In relationship building, we coded emotional support, trust, and consensus as the key elements. Patients reported that they wanted timely, accurate information about their condition and an interaction with a healthcare professional and their keen too. 6. The presence of family members was reported by all patients as the most crucial factor which could make them strong from within and facilitate overcoming the crisis of his/her own as well as enhance the comfort of their family. Conclusion: 1. Factors contributing to phenomenal suffering that COVID had produced are: (i) unprecedented illness, unplanned and abrupt hospitalization, (ii) inaccessibility of comforting presence of family members. 2. Correspondingly, factors potentially capable of reducing the anguish and suffering were: (i) one's inner strength supplanted by communication with family,(ii) one's wish to go on living, (iii) to be seen and comforted by a doctor on time, and (iv) healthcare professionals' positivity for him/her.
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The world has been paralysed by corona virus variants for the past 2 years which has affected all the realms of activities of society. Its effect on the medical field was two-fold – on one side there was stress to handle the large inflow of highly contagious cases, while on the other, healthcare priorities got skewed towards COVID-19 care. Within a short timeframe after the first report of coronavirus-2 (SARS-CoV-2) in China in December 2019 (ref. 1), it has spread as an epidemic and progressed to a pandemic, percolating through the boundaries of countries. There was patient overflow in medical-care facilities across the world due to the escalation of symptomatic patients at each surge of new variants of the coronavirus. The highly contagious nature of the virus has put additional pressure of handling the situation with proper level of infection-control measures. Strategies of dealing with the pandemic have been implemented aggressively in all countries. The most notable change was a shift from patient-centred to public-centred healthcare. It was inevitable, but had put limits to specialty care, especially the elective services2. © 2022, Current Science. All Rights Reserved.
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Introduction: Coronavirus disease (COVID-19) is a declared public health emergency of international concern. Occupational Safety and Health Administration (OSHA) classified health-care professionals and exposure risk to coronavirus (COVID-19), identifying dental professionals in the very high-risk group due to the specificity of dental procedures and instrumentations used. Guidelines from relevant authorities suggested providing only emergency and urgent dental treatment during the pandemic which has led majority of dental practice to stop, thus instilling anxiety in the dental professionals. A study to assess the attitude, practice and experience of dental professionals from Gujarat state during the COVID-19 pandemic was planned. Materials and Methods: An online questionnaire consisting of 32 questions using Google Form was distributed to 315 dental professionals. Data obtained were analysed using the Statistical Package for the Social Sciences 22.0. Descriptive statistical analysis was used to describe variables. Chi-square test was used to find a significant association between parameters, and P < 0.05 was considered statistically significant. Results: Overall, 194 dental professionals (104 general dentists and 90 specialists) filled the questionnaire. Nearly half of the participants (49.5%) said that personal protective equipment (PPE) is uncomfortable while performing dental procedures. The majority of them (86.6%) insisted on increasing the cost of dental treatments. Regarding new practices adapted during the pandemic, 53 dental professionals (27.3%) did not find teledentistry effective in resolving the patient's problem. Only 75 dental professionals (38.7%) followed all the screening criteria for patients. Fifty-nine participants (30.4%) got the COVID-19 test for patients requiring the aerosol-generating procedure. While 125 participants (64.4%) performed aerosol-generating procedures either in urgent/emergency cases or elective cases, only 115 (59.3%) used full PPE with an appropriate mask. One hundred and thirty-seven (70.6%) of them reported a decrease in income during the pandemic, while 74 (38.1%) suffered from anxiety and depression. Conclusion: Dental health-care providers are at the highest risk of contracting COVID-19. Thus, they should execute proposed precautionary measures more diligently. Regular training and screening of dental professionals should be undertaken by state regulatory bodies. Adapting and adhering to change in work protocols by dental professionals will ensure not only their safety but also their patients. The emergence of COVID-19 has been great learning for the field of dentistry, and the dental practice is going to change for the better.
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Background: Tertiary hospital care may vary from isolation bed ward care to high dependency units (HDUs) with oxygen support to intensive care unit (ICU) where patients may be intubated for mechanical ventilation The major risk factors for severe disease are age more than 60 years and underlying diseases like diabetes, hypertension. COVID-19 patients present at varying levels of severity. Understanding how long patients hospitalized with COVID-19 remain in hospital is critical for planning. Objectives: 1. To determine risk factors associated with disease severity 2. To determine risk factors associated with length of hospital stay in COVID-19 patients 3. To study the disease outcome Material & Methods: This was retrospective record-based study of inpatients with COVID-19 at Tertiary Care Hospital of Ahmedabad City. All patients admitted at tertiary care hospital diagnosed with COVID-19 between April 2020 to June, 2020, were included in present study. Inclusion criteria were all COVID-19 patients admitted at tertiary care hospital during the duration of April 2020 to June 2020. Results: A total of 916 COVID-19 patients were included in the study. Out of 916 total admitted patients 526 (57.4%) were male. 174 (19%) patients having one or more comorbidities like diabetes, hypertension, tuberculosis, heart diseases etc. Total 769 discharged (83.9%), 115 deaths (12.6%) and 32 transferred to other COVID-19 hospital (3.5%) out of total 916 patients admitted during study period. Conclusion: Severity of disease and deaths were associated with age and comorbidities. COVID-19 patients with comorbidities have more deteriorating outcomes compared with patients without. © 2021, Indian Association of Preventive and Social Medicine. All rights reserved.
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Introduction: Occupational Safety and Health Administration (OSHA) classified health care professionals and exposure risk to Coronavirus, identifying Dental Professionals in very high risk group due to specificity of dental procedures and instrumentations used. As per guidelines from relevant bodies to provide only emergency and urgent dental treatment has led majority of dental practice to stop, instilling apprehension in profession and fear in public. Aim: To narrate the experience from Department of Dentistry, on how to safely and effectively practice dentistry that would provide guidance to practicing dental professionals without major environment alteration and capital items requirement. Materials and Methods: This was an observational study from Department of Dentistry from May to August 2020, attached to a rural tertiary care medical teaching institute, following customised protocol after reviewing available guidelines in relation to Coronavirus Disease-2019 (COVID-19) and dentistry. Data collection was done from Institutional Electronic Medical Record System for patients receiving dental treatment during the study period. It used descriptive narrative analysis to provide chronology of experiences for practicing dentistry as per various unlock phases declared by Government of India. Results: The Department of Dentistry was able to manage four Non-Aerosol Generating Procedures (Non-AGP), three Aerosol Generating Procedures (AGP) and eighteen Outdoor Patient Department (OPD) consultations on an average for a working day, from May to August 2020. During the tenure while providing dental care, none of the member of dental team was detected COVID positive. The result was achieved by simple alteration done by patient, man-power, practice and environment management. Conclusion: A simple alteration in practice and practice area ensuring safety of all members of dental team was made by department. It included the effective use of Personal Protective Equipment (PPE) during all dental procedures including oral examination. Special emphasis on history of patients, facility and environment management along with regular training for hand hygiene, donning-doffing, aerosol appointment and practice was given. An attempt to provide prophylactic and elective dental need of patients were done and department was successfully able to treat seven patients per day on an average during May to August, 2020.
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Introduction: The world has been facing a pandemic of COVID-19, and while dealing with this pandemic is not easy for anyone, it is especially hard on health care workers (HCWs) as they are the front-line warriors. Aim of the study: To assess the psychological disturbances that the COVID-19 pandemic has inflicted on healthcare workers in India and to assess the correlation between different parameters including socio-demographic variables, job-related variables, personal history and psychological disturbances such as perceived stress, depression and anxiety. Material and methods: Health care workers from a few tertiary care institutes (government as well as private sectors, which are caring for patients with COVID-19) in a western state of India were invited to participate with a self-administered online questionnaire. That questionnaire consisted of self-report scales including Fear of COVID-19 Scale, the Depression, Anxiety and Stress Scale 21 items (DASS 21), and the Perceived Stress Scale with socio-demographic, job-related and personal details. Results: Out of 302 subjects, on the Perceived Stress Scale, 101 (33.44%) reported low, 185 (61.26%) moderate and 16 (5.30%) high levels of stress. On DASS 21, depression was reported by 56 (18.54%) subjects, 60 (19.87%) subjects were found to have anxiety and 50 (16.56%) subjects reported to have stress. Perceived stress score on Perceived Stress Scale (PSS) was significantly correlated with the depression, anxiety and stress score on DASS 21. A few risk factors such as female gender, single marital status, past history of psychiatric illness, working as interns and residents doctors with lesser experience and high risk duty areas such as COVID-19 duties in a particular situation were significantly associated with psychological disturbances such as stress, depression and anxiety. Conclusions: We observed significant psychological impacts of the COVID-19 pandemic on HCWs as well as a few risk factors related to it. Supporting the mental health of HCWs is a critical part of the public health response to maintain an adequate workforce and to maximize the ability of HCWs to face this pandemic. © 2020 Termedia Publishing House Ltd.. All rights reserved.