ABSTRACT
Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (> or equel 3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (> or equal 2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients.
Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , SARS-CoV-2 , ChAdOx1 nCoV-19ABSTRACT
Background: Chest X-rays are important for tracking the progression of lung abnormalities, particularly in critically ill COVID-19 patients in the intensive care units (ICU). We aimed to assess correlation of chest X-ray findings with the COVID-19 disease severity and outcome. Methods: This prospective observational study was conducted at B & C Teaching Hospital, Birtamode from 15 March to 15 July 2021. All diagnosed COVID-19 patients admitted in the ICU for respiratory distress with oxygen saturation < 90% and evaluated by portable X-rays were enrolled. The radiographic findings were evaluated for the distribution and patterns of affection, and the total severity score was calculated using RALE scales of 0 - 8 and Brixia scales of 0 - 18. The scores were then compared between the expired and improved patients. Results: The age of patients (mean +or- SD) was 48.2 +or- 13.84 years. During the first four days of hospitalization, there was no significant difference in Brixia score (p = 0.793) or RALE score (p = 0.842) between expired and improved patients. The differences in both (Brixia and RALE) scores grew with each passing day (p < 0.05). The Brixia and RALE severity scores had a strong positive correlation at various stages of disease in both expired and improved patients. (r > 0.75, p < 0.001). Conclusion: In resource limited setting, the severity scores (RALE or Brixia) can be used as a quantitative method of the extent of COVID-19 pneumonia, correlating with an increased risk of ICU admission.
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Background The frequent lockdown in Nepal during COVID-19 pandemic had brought various kinds of complexities such as stress among college students. This situation had created uncertainty of future academic career of undergraduate students in medical colleges. Some previously published literature showed gaming as a coping mechanism against stress. Objective To assess the gaming behavior of Medical college students during lockdown in COVID-19 pandemic. Method A cross-sectional study was conducted during lockdown period of July to August 2020. A total of 412 college students were enrolled. Online Google forms were shared to all the eligible students through email, viber and messenger with the help of class representative. Collected data were analyzed in SPSS version 20.0. Result The prevalence of gaming disorder was 8.5% among 260 internet gaming users. About 69.2% of the participants reported that their gaming behavior had increased due to stress of COVID-19 pandemic. Gender and spending more time online per day showed significant associations with greater scores on the internet gaming disorder. Conclusion During lockdown period of COVID-19 pandemic, the gaming behavior of medical college students has increased. Copyright © 2020, Kathmandu University. All rights reserved.
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Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (>=3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (>=2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients. Copyright © 2022, Kathmandu University. All rights reserved.
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This project was originally envisaged as an 18-month development-oriented project based in Provinces 1 and 2 of the Nepal Terai. It aimed to build solidarity and teamwork around the drive for agri-mechanisation in each of these two provincial governments. Unfortunately, the short time frame paired with intensive efforts to establish new relationships and then the onset of COVID-19 meant that there was limited scope to deeply develop these new relationships and fully build the envisaged roadmap process and plans. Regardless of this, the project has made some essential steps in improving provincial agri-mechanisation planning and implementation, including: (1) substantial capacity developed though placement of engineering experts within the Nepal Agricultural Research Council (NARC), the Ministries of Agriculture, Land Management and Cooperatives (MoLMAC), various cooperatives and agricultural knowledge centres;(2) new and deepened relationships with and between key stakeholders, and particularly between NARC and provincial government, as well as with and between various cooperatives;(3) development of the first quantification of the status of agri-mechanisation on the Nepal Terai - indicating that there is high potential for rapid mechanisation if some key constraints are addressed;(4) publication of the learnings for a review of mechanisation in India and Bangladesh, and what that means for Nepal's agri-mechanisation planning;(5) regional learnings and new collaborations with various stakeholders in Nepal and West Bengal;(6) a national symposium on agri-mechanisation on the Nepal Terai, with a large number of supported individuals attending and learning from the national Agrimechanisation Fair;(7) development of a "roadmap" process that can be used more widely with additional further development;and (8) technical guidance and relationship building to improve the scaling of government supported custom hire centres in Province 1.
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Background Telehealth has become an important part of medical care during the COVID- 19 pandemic. Previous studies have demonstrated patient preference for telehealth care due to convenience and time and cost savings related to travel. The increased ease of access for patients with telehealth may improve the attendance rate. Improving clinic attendance could increase clinic efficiency, decrease cost, and possibly improve patient outcomes. We intended to assess if telehealth in gastroenterology (GI) clinic improves the attendance rate. Methods We performed a retrospective observational cross-sectional study using data from the electronic health record (EHR) of patients scheduled for an appointment at the adult gastroenterology/ hepatology clinic from February 1st to May 1st, 2020. Continuous variables were compared using the independent t-test and categorical variables were compared using the chi-square test or Fisher's exact test, where applicable. Multivariate logistic regression analysis was performed for the missed appointment using the variable visit type as the predictor of interest and patient demographics, and appointment-related factors as covariates. Results Of 2,258 patients scheduled for appointment, 210 (9.3%) missed their appointment. Before COVID-19 pandemic response (before March 13, 2020), all 1,133 appointments were inperson visits. During the COVID-19 era (after March 13, 2020), 806 (71.6%) appointments were televisits, conducted via telephone. In the pre-COVID era, the non-attendance rate was 7.7%;this increased to 10.9% during the COVID era (P=0.008). There was no significant difference in the non-attendance rate between televisits and in-person visits (10.7% and 8.5%;P=0.09). In the multivariate analysis, there was no significant association between visit type and attendance (adjusted odds ratio [AOR] 1.11 [0.73-1.69]). There was no significant difference in attendance before and after March 13, 2020 (AOR 1.50 [0.99-2.27]). Conlcusion The use of telehealth increased significantly during the COVID era. Televisit was not associated with an improved attendance rate in GI clinic. Further studies are needed to investigate the impact of telehealth in clinical practice. (Table Presented) (Table Presented)
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In the situation of an epidemic outbreak, a contact tracing tool is preferred to alert the infection status of daily encountered people. Since we are in the era that smartphone is carried everywhere and embedded with Bluetooth technology, a Bluetooth-based mobile app is proposed in this paper for advanced contact tracing. The proposed app can not only trace the infectious people contacted with the user but also label the danger level by scanning the proximity and lingering time for each case. It is simple yet efficient to apply as it does not employ any new Bluetooth protocol but only requires basic inputs that are acquirable from any smartphone with Bluetooth 2.0 and above. This application is built using service-oriented architecture which helps mobile devices to communicate with a data collection server as well as each other. The collected data will be shown in a web application and used to further study the propagation characteristics of new infectious viruses. It also comprises a daily survey that users answer, and which will be used by health officials for early prognosis. The app is currently tested campus-wide and showed salient features in terms of scalability, mobility, and sensing inaccuracy-proof, which has the potential to be applied in larger populations with more complicated scenarios. © 2021 IEEE.
ABSTRACT
Introduction: Telehealth has become an important part of medical care during the COVID-19 pandemic. Previous studies have demonstrated patient preference for telehealth care due to convenience and time and cost savings related to travel. The increased ease of access for patients with telehealth may improve the attendance rate. Improving clinic attendance could increase clinic efficiency, decrease cost, and possibly improve patient outcomes. We intended to assess if telehealth in gastroenterology (GI) clinic improves the attendance rate. Methods: We performed a retrospective observational cross-sectional study using data from the electronic health record (EHR) of patients scheduled for an appointment at the adult gastroenterology/hepatology clinic from February 1st to May 1st, 2020. Continuous variables were compared using the independent t-test and categorical variables were compared using the chi-square test or Fisher's exact test, where applicable. Multivariate logistic regression analysis was performed for the missed appointment using the variable visit type as the predictor of interest and patient demographics, and appointment-related factors as covariates. Results: Of 2,258 patients scheduled for appointment, 210 (9.3%) missed their appointment. Before COVID-19 pandemic response (before March 13, 2020), all 1,133 appointments were in-person visits. During the COVID-19 era (after March 13, 2020), 806 (71.6%) appointments were televisits, conducted via telephone. In the pre-COVID era, the non-attendance rate was 7.7%;this increased to 10.9% during the COVID era (P=0.008). There was no significant difference in the non-attendance rate between televisits and in-person visits (10.7% and 8.5%;P=0.09). In the multivariate analysis, there was no significant association between visit type and attendance (adjusted odds ratio [AOR] 1.11 [0.73-1.69]). There was no significant difference in attendance before and after March 13, 2020 (AOR 1.50 [0.99-2.27]). Conclusion: The use of telehealth increased significantly during the COVID era. Televisit was not associated with an improved attendance rate in GI clinic. Further studies are needed to investigate the implications of telehealth in clinical practice..
ABSTRACT
Background The frequent lockdown in Nepal during COVID-19 pandemic had brought various kinds of complexities such as stress among college students. This situation had created uncertainty of future academic career of undergraduate students in medical colleges. Some previously published literature showed gaming as a coping mechanism against stress. Objective To assess the gaming behavior of Medical college students during lockdown in COVID-19 pandemic. Method A cross-sectional study was conducted during lockdown period of July to August 2020. A total of 412 college students were enrolled. Online Google forms were shared to all the eligible students through email, viber and messenger with the help of class representative. Collected data were analyzed in SPSS version 20.0. Result The prevalence of gaming disorder was 8.5% among 260 internet gaming users. About 69.2% of the participants reported that their gaming behavior had increased due to stress of COVID-19 pandemic. Gender and spending more time online per day showed significant associations with greater scores on the internet gaming disorder. Conclusion During lockdown period of COVID-19 pandemic, the gaming behavior of medical college students has increased.