ABSTRACT
Background: Corona virus disease 2019 (COVID-19) was first reported in China and became the global pandemic. This pandemic has proven fatal for the world and lasts drastic effects on the whole world. To combat with this hilarious pandemic, the whole world has adopted the strategy of social distancing and precautionary measures. Aim: To compare trends of social anxiety and avoidance during covid wave 1 and covid wave 2. Methodology: A cross-sectional study was conducted at Central Park Medical College from October 2020 and January 2021. To assess social avoidance and anxiety LIEBOWITZ Social Anxiety and avoidance Scale was employed. Paired sample t test and correlation was used to compare mean differences. A p value less than 0.05 were considered significant. Results: There was a reduction of score of social anxiety from covid wave 1 and wave 2 (26.73±4.65. 17.86±3.81) with p value of .001 and similarly there was a reduction of score of social avoidance (25.31±0.597 v/s 15.±0.3390) as well from wave 1 to wave 2 with p value of .001 Conclusion: There is a continuous decline in social avoidance and social anxiety which can cause an increase in covid 19 infection rate in order to combat that there's need of prompt vaccination along with the precautionary measures to combat covid pandemic.
ABSTRACT
Introduction: Chemo-radiotherapy for lung cancer can be a morbid treatment, often in an older and co-morbid population. Our patients are not routinely seen by a dietitian. Methods: As a pilot project, all patients receiving either sequential or concurrent chemo-radiotherapy for lung cancer between May and November 2020, were identified by the lead lung radiographer and bookings team and referred to a specialist oncology dietitian. These patients were offered up to 3 routine fortnightly assessments on treatment. We recorded their symptoms (based on a standardised tool, PG-SGA) and weight during treatment. Results: 15 patients were referred to the dietitian: 7 male, 8 female. All patients accepted dietetic review. The median age was 64 years old;mean age 63 years old (range 50-79). The mean average number of cycles of chemotherapy was 3.4. Concurrent chemo-radiotherapy was given to 11 patients, with the remaining 4 having sequential treatment. Of all patients, 1 had small cell lung cancer, 1 had a mixed adenocarcinoma and small cell. The remaining 13 were non-small cell lung cancers, and of these 6 were adenocarcinomas and 6 were squamous cell carcinomas and 1 mixed histology. All patients were reviewed at least twice whilst on treatment. The most complete data was for the review in weeks 3/4 of radiotherapy. All 15 patients had scores for this time point. Mean number of symptoms was 5.5 (range 3-9). The commonest symptoms were fatigue (100%), loss of appetite (67%), pain (67%) and dysphagia (60%). For 12 patients receiving 6 weeks of radiotherapy median symptom number increased from 5 in 1st 2 weeks, to 5.5 in weeks 2nd 2 weeks, to 6.5 in final 2 weeks. All patients in this group lost weight. Median weight loss during treatment was 6.6% (range 1.8-15.9%). All patients received food fortification advice throughout their treatment and advice on symptom management. The symptom management advice for 12 of the 15 patients either reinforced advice, or, made adjustments to the timing of medications prescribed by medical or nursing staff. The other 3 patients did not have an existing prescription, and so recommendations were made of medications to manage symptoms, e.g. oxcetacaine, anti-emetics and laxatives. Oral nutritional supplements (ONS) were recommended if patients were not meeting their estimated nutritional requirements from dietary assessment. Seven patients received ONS prescription in addition to the food fortification advice. One patient declined an ONS prescription. Conclusion: 1. Routine dietetic review during radical chemo-radiotherapy is feasible and occurred successfully during the COVID-19 pandemic. It led to some simple, but vital changes in practice such as weekly weighing of patients on treatment 2. Patients undergoing chemo-radiotherapy have a high symptom burden. 3. All patients receiving 6 weeks of radiotherapy lost weight during treatment. 4. We received positive feedback from patients. Keywords: Dietitian, Dietician, radiotherapy