ABSTRACT
There is a demand for more comprehensive studies related to diabetes management in Indian settings covering; incidence, multimorbidity and complications in diabetes patients, clinical progression, medication, and treatment-seeking patterns. CHIPS study aims to bridge this research gap through a systematic analysis of the medical records maintained under an employees contributory health services scheme (CHSS). The CHSS based in an urban metropolitan area has 89,204 beneficiaries. The hospital information management system (HIMS) has records of lab reports, clinical summaries, prescriptions, and drugs and other medical consumables, supplied for every interaction with CHSS. Firstly, a cohort of 835 patients newly diagnosed as diabetic in the year 2011-2012 was identified from the HIMS. Their 10-year (2011-2021) medical history after getting diagnosed as a diabetic patient was elicited from the HIMS in a retrospective manner. For comparison needs another cohort of 1670 age-sex matched non-diabetic beneficiaries was created and similar 10-year medical history was created. A total of 144,511 lab records and 247,473 drug records from the HIMS for the period 2010-2012 were scrutinized to identify newly diabetic patients and their non-diabetic counterparts. The reconstructed 10-year medical history of these two groups will be used to investigate the burden of diabetes in the community, transitions from a non-diabetic and pre-diabetic to a diabetic, excess morbidity in diabetic patients, seasonal variation in glycaemic levels, association between glycaemic control and frequency of health care utilization, and COVID-19-induced temporal changes in glycaemic control.
Subject(s)
Cross Infection , Diabetes Mellitus , COVID-19ABSTRACT
BackgroundThe COVID-19 pandemic and subsequent lockdowns adversely affected global health care services to varying extent. Emergency Services were affected along-with elective surgeries, to accommodate the added burden of COVID19 affected patients. We aimed to reflect, quantify and analyse the trends of essential surgeries and bellwether procedures during the waxing and waning of the pandemic, across various hospitals in India.MethodologyA research consortium led by WHO Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in Low-and Middle-Income countries, India, conducted this study with 5 centres. All surgeries performed during the months of April 2020 (wave 1), November 2020 (recovery 1) and April 2021 (wave 2) were compared with those performed in April 2019 (pre-pandemic period). ResultsThe total number of surgeries reduced by 77% during wave 1, which improved to 52% reduction in recovery 1, as compared to pre-pandemic period. However, surgeries reduced again during wave 2 to 68%, but reduction was less as compared to wave 1. Emergency and essential surgeries were affected along-with the elective ones, but to a lesser extent.ConclusionOur study quantified the effects of the pandemic on surgical-care delivery across a timeline and documented reduction in overall surgical volumes during the peaks of the pandemic (wave 1 and 2) with minimal improvement as the surge of COVID19 cases declined (recovery 1). The second wave showed improved surgical volumes as compared to the first one which may be attributable to improved preparedness. Caesarean sections were affected the least.
Subject(s)
COVID-19ABSTRACT
Background: The ongoing COVID-19 pandemic and subsequent lockdown have adversely affected global health care services to varying extent. Emergency Services were also affected along with elective surgeries, which were deferred to accommodate the added burden of COVID 19 affected patients, on the healthcare systems. We aimed to assess the change in delivery of essential and emergency surgeries due to the pandemic. Methodology: A research consortium led by WHO Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in Low- and Middle-Income countries (LMIC), India, conducted this retrospective cross-sectional study with 12 recruited centers. All surgeries performed during the months of April 2020 were compared with those performed in April 2019. These surgeries were stratified into emergency and elective, and further categorized based on NHS surgery prioritization documents. Results: A total of 4396 surgeries were performed at these centers in April 2019 and 1216 surgeries were performed in same month during 2020, yielding a fall of 72.3% (1216 /4396).We found a 54% reduction in emergency surgeries and a 91% reduction in the elective surgeries. Number of cesarean sections reduced by 29.7% and fracture surgeries declined by 85.3% Laparotomies and surgeries for local soft tissue infections with necrotic tissue reduced by 71.7% and 69.5% respectively. Conclusion: Our study quantifies the effects of COVID 19 pandemic on surgical care delivery in India and documents that the overall surgical volume reduced by three fourths in the pandemic period. Emergency surgeries reduced to half when compared with pre-pandemic period. Cesarean section surgeries were affected the least by pandemic, whereas the fracture surgeries and laparotomies were affected the most.
Subject(s)
COVID-19 , Fractures, Bone , NecrosisABSTRACT
Background The ongoing COVID-19 pandemic and subsequent lockdown have adversely affected global health care services to varying extent. Emergency Services were also affected along with elective surgeries, which were deferred to accommodate the added burden of COVID 19 affected patients, on the healthcare systems. We aimed to assess the change in delivery of essential and emergency surgeries due to the pandemic.Methodology A research consortium led by WHO Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in Low- and Middle-Income countries (LMIC), India, conducted this retrospective cross-sectional study with 12 recruited centers. All surgeries performed during the months of April 2020 were compared with those performed in April 2019. These surgeries were stratified into emergency and elective, and further categorized based on NHS surgery prioritization documents. Results A total of 4396 surgeries were performed at these centers in April 2019 and 1216 surgeries were performed in same month during 2020, yielding a fall of 72.3% (1216 /4396).We found a 54% reduction in emergency surgeries and a 91% reduction in the elective surgeries. Number of cesarean sections reduced by 29.7% and fracture surgeries declined by 85.3% Laparotomies and surgeries for local soft tissue infections with necrotic tissue reduced by 71.7% and 69.5% respectively.Conclusion Our study quantifies the effects of COVID 19 pandemic on surgical care delivery in India and documents that the overall surgical volume reduced by three fourths in the pandemic period. Emergency surgeries reduced to half when compared with pre-pandemic period. Cesarean section surgeries were affected the least by pandemic, whereas the fracture surgeries and laparotomies were affected the most.
Subject(s)
COVID-19 , Fractures, Bone , NecrosisABSTRACT
Purpose: The notorious COVID 19 pandemic has caused rapid and drastic changes in cancer care all over the world in 2020. This online survey aims to assess the extent to which the pandemic has affected cancer care in gynecological oncology amongst members of Association of Gynecological Oncologists of India (AGOI), a registered professional society, founded in 1991. Methods: We developed and administered a cross-sectional, flash survey to members of The Association of Gynecological Oncologists of India (AGOI) in the first week of April 2020. Data were analyzed using Microsoft Office Excel 2016. Results were expressed as percentages of total responses excluding blank or unattended response. Overall theme-specific responses were expressed as a spectrum of finding and related inferences were drawn.Results: Among approached practitioners, 90 responded to the survey, more than 80 % were practicing consultants and more than 50 % from academic institutions. Results of the survey showed that the ongoing pandemic had severely affected gynecological oncology practice and care amongst all responders. There were modifications in diagnostic pathways, interventions and follow ups across all organ sites. There was near unanimous opinion on use of general safety measures to combat the virus and to use complete PPEs in high risk situation. There was mixed responses to alternative educational activities especially using electronic technology and distant learning methods. There was an optimism among responders with regards to the current situation normalizing in 3 to 6 months. Conclusion: This study documents the pandemic affected scenario of gynecological cancer care and perceptions of Gynecological Oncologists in India. Significant effect on all aspects of cancer care were observed. Technological learning methods both for patient care and educational activities were being adopted by many responders. Keywords: COVID-19, pandemic, gynecological oncology care, survey, AGOI