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Objectives: Possessing accurate knowledge and utilization of reliable information sources may play a vital role in adoption of positive health behaviours, including acceptance of vaccine. The present study was conducted with an objective to assess the awareness and attitude of undergraduate nursing students regarding COVID-19 vaccine. Methods: A cross-sectional survey was conducted in Mid May 2021 using Google Forms through Google platform on-line. A total of 354 nursing students participated in the survey. A validated and pre-tested structured knowledge and Attitude, questionnaire was used to collect data from undergraduate nursing students regarding COVID-19 vaccine. Chi-square test, followed by binary logistic, was applied to determine factors associated with knowledge scores. Results: The mean knowledge score was 11.31 (SD ± 2.31, range: 2-15), with a correct response rate of 75.4%. However, the mean attitude score was 40.56 (SD ± 5.10, range: 28-55) with an unfavourable response towards COVID-19 vaccination (54.8%). The knowledge level was found to be significantly associated with student's professional qualifications and Vaccination status (P < 0.05). In binary logistic regression analyses, the knowledge score found to be significantly associated with participant's professional qualification i.e., B.Sc. (Hons.) Nursing 2 nd Year (AOR: 2.45, CI: 1.43-4.19, P < 0.001) and B.Sc. (Hons.) Nursing 3rd Year (AOR: 2.69, CI: 1.50-4.83, P < 0.001) and students who has received COVID-19 vaccination (AOR:3.08 CI: 1.81-5.25, P < 0.000). Conclusion: The current study findings represent adequate knowledge among undergraduate nursing students which is a very good sign. However, efforts must be taken to develop positive attitude towards COVID-19 Vaccination.
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INTRODUCTION: Studies have shown that elderly have been disproportionately impacted by COVID pandemic. They have more comorbidities, lower pulmonary reserve, greater risk of complications, more significant resource utilization, and bias towards receiving lower-quality treatment. OBJECTIVES: This research aims to determine the characteristics of those who died inhospital due to COVID illness, and to compare these factors between elderly and young adults. METHODS: We conducted a large retrospective study at a government run center in Rishikesh, India, from 1st May 2020 till 31st May 2021, and divided study population into adults (aged 18 to 60 years) and elderly (aged 60 years). We evaluated and compared our data for presenting symptoms, vitals, risk factors, comorbidities, length of stay, level of care required, and inhospital complications. Long-term mortality was determined using telephonic follow-up six months after discharge. RESULTS: Analysis showed that elderly had 2.51 more odds of dying inhospital compared to younger adults with COVID. Presenting symptoms were different for elderly COVID patients. The utilization of ventilatory support was higher for elderly patients. Inhospital complications revealed similar profile of complications, however, kidney injury was much higher in elderly who died, while younger adults had more Acute Respiratory Distress. Regression analysis showed that model containing cough and low oxygen saturation on admission, hypertension, Hospital Acquired Pneumonia, Acute Respiratory Distress Syndrome, and shock, predicted inhospital mortality. CONCLUSION: Our Study determined characteristics of inhospital and long-term mortality in elderly COVID patients and compared them from adults, to help better triaging and policy making in future.
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COVID-19 , Aged , Humans , COVID-19/therapy , SARS-CoV-2 , Retrospective Studies , Hospitalization , Comorbidity , Hospital MortalityABSTRACT
Introduction Frailty is a multidimensional complex state that leads to increased chances of hospitalization and death in patients, especially in the elderly. Our study aimed to determine the factors associated with the development of frailty and their predictors in the elderly population. Methods The study was conducted in the Outpatient Department (OPD) of General Medicine at a tertiary care hospital in Rishikesh town of Dehradun district, Uttarakhand, India. It was a cross-sectional study design, conducted from January 2019 to July 2020. Data regarding sociodemographic factors, medical conditions, and laboratory investigations were collected on a predesigned performa. Patients diagnosed with COVID-19 were excluded from the study. It being a hospital-based study, participants with one frailty criteria were considered as non-frail and those with two or more than two as frail. Results We enrolled 149 patients in our study, based on the inclusion and exclusion criteria. The mean age of the patients was 67.50+/-6.74 years. A total of 87 (58.38%) participants had a frailty score > 2. Region of residence, body mass index (BMI), albumin, transferrin saturation, ferritin, vitamin D3, sodium, calcium, creatinine, urea, hemoglobin, glycosylated hemoglobin (HbA1c), number of prescribed drugs, substance dependence, power grip strength (PGS), slow walking time (SWT), low physical activity (LPA), self-reported exhaustion (SRE), unintentional weight loss (UWL), and erythrocyte sedimentation rate (ESR) were independent significant predictors of frailty. Conclusion Various modifiable factors were found to be predictors of frailty in adults. Timely identification and necessary interventions of these risk factors can provide valuable information for future prevention of the progression of frailty in the elderly.
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Introduction: The practice of infant and young child feeding (IYCF) is critical for a child's growth and development throughout the first two years of life. Poor feeding habits in early childhood contribute to malnutrition and child mortality in India. Aim and Objective: To assess the IYCF practices in children under the age of 2 years. Material and Methods: In rural Uttarakhand, India, a cross-sectional study was undertaken from March 2021 to May 2021. A probability proportional to size (PPS) method was used to select 400 children under the age of 2 years. The World Health Organization IYCF questionnaire, was used to collect house to house data. An appropriate statistical test was used for analysing the data. Results: According to the findings, 47.5 percent of babies under the age of six months were nursed within the first hour of delivery. About 73.9 percent of babies were exclusively breastfed. Approximately 22 percent infants were given pre-lacteal feeds and 20 percent were bottle fed. In addition to breast milk, half of babies aged 6 to 8 months had solid, semi-solid, or soft meals, however minimum acceptable diet was provided to only 33.5 percent children. Odds of male child who were bottle fed in the age group of 6-23 months were 2.02 times higher to that of female child. Also the odds of male child in the age group of 6-8 months to be introduced with solids, semi-solid, or soft food were 4.91 times higher to that of female child. Similarly, odds of male child received minimum dietary diversity (2.35), minimum meal frequency (1.82), and minimum acceptable diet (2.35) in the age group of 6-23 months were found to be higher to that of female child in the similar age group. Total of six mothers reported coronavirus disease (COVID) positive status and only two of them breastfed their babies using COVID appropriate behavior. Conclusion: Exclusive breastfeeding (EBF) has been practiced in more than two-thirds of children, but early breastfeeding is practised in less than half of children. Only one third children of more than six months of age are getting minimum acceptable diet.
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OBJECTIVES: India introduced BBV152/Covaxin and AZD1222/Covishield vaccines in January 2021. We estimated the effectiveness of these vaccines against severe COVID-19 among individuals aged ≥45 years. METHODS: We did a multi-centric, hospital-based, case-control study between May and July 2021. Cases were severe COVID-19 patients, and controls were COVID-19 negative individuals from 11 hospitals. Vaccine effectiveness (VE) was estimated for complete (2 doses ≥ 14 days) and partial (1 dose ≥ 21 days) vaccination; interval between two vaccine doses and vaccination against the Delta variant. We used the random effects logistic regression model to calculate the adjusted odds ratios (aOR) with a 95% confidence interval (CI) after adjusting for relevant known confounders. RESULTS: We enrolled 1143 cases and 2541 control patients. The VE of complete vaccination was 85% (95% CI: 79-89%) with AZD1222/Covishield and 71% (95% CI: 57-81%) with BBV152/Covaxin. The VE was highest for 6-8 weeks between two doses of AZD1222/Covishield (94%, 95% CI: 86-97%) and BBV152/Covaxin (93%, 95% CI: 34-99%). The VE estimates were similar against the Delta strain and sub-lineages. CONCLUSION: BBV152/Covaxin and AZD1222/Covishield were effective against severe COVID-19 among the Indian population during the period of dominance of the highly transmissible Delta variant in the second wave of the pandemic. An escalation of two-dose coverage with COVID-19 vaccines is critical to reduce severe COVID-19 and further mitigate the pandemic in the country.
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COVID-19 , Influenza Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Case-Control Studies , ChAdOx1 nCoV-19 , Hospitals , Humans , SARS-CoV-2ABSTRACT
BACKGROUND: Even with the wide base of knowledge that has been accumulated regarding coronavirus disease 2019 (COVID-19), only limited studies have tried to establish differences in outcomes of elderly patients hospitalized with COVID-19. We, thus, conducted a retrospective study on a large cohort of hospitalized patients with COVID-19 to improve the understanding of such differences and add to the evidence available regarding this age group. Methods: This is a single-centre retrospective study conducted at a tertiary level hospital in the state of Uttarakhand in North India to determine clinical characteristics and outcomes in elderly patients (≥ 60 years) hospitalized with COVID-19 between May 1, 2020, and May 31, 2021. Our study included a retrospective follow-up at six months to also determine rehospitalizations and post-discharge mortality. RESULTS: There was a statistically significant difference (p<0.05) in in-hospital mortality, various in-hospital complications, duration of stay, number of rehospitalizations at six months, and post-discharge mortality up to six months in the elderly age group hospitalized with COVID-19. CONCLUSIONS: This retrospective study demonstrates that the clinical characteristics and outcomes in hospitalized elderly with COVID-19 differ significantly from the younger adult population and demonstrates a need for greater hospital resource utilization in this age group. These results will help policymakers be better prepared for future pandemics.
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Background COVID-19 pandemic has challenged all current management tools used for patient care. This study aims to determine strength, weakness, opportunities and threats (SWOT) to virtual OPD and consultants' perceptions of teleconsultation virtual OPD during the COVID-19 pandemic, adapting to newer technologies for successfully handling this situation. Material and methods A facility-based cross-sectional study was conducted at the Virtual OPD of All India Institute of Medical Sciences Rishikesh among patients availing Telemedicine consultation during the COVID-19 pandemic. All patients availing services from April 2020 to October 2020 were included in this study. Method for SWOT analysis: A checklist was prepared, and investigators assessed SWOT. An external evaluator was invited to evaluate the SWOT analysis conducted by the investigators. For numeric variables, the mean ± SD was used, and for categorical variables, percentages and proportions were used. Results Around 22% of the patients who approached virtual OPDs were ≥ 60 years of age. More than half (55.3%) of the patients or their attendants who consulted Telemedicine OPD were from Uttarakhand, followed by Uttar Pradesh (42.6%). The proportions of male patients were 54.4%. Around 17.6% of teleconsultations were performed for radiotherapy. General medicine and cardiology consultations were (15.2%) and (12.8%), respectively. Conclusion Telemedicine can be effective if certain requirements had been provided. Maintaining privacy of the patient's data was a challenge.