Diabetes and tuberculosis syndemic in India: A narrative review of facts, gaps in care and challenges.

Both diabetes mellitus (DM) and tuberculosis (TB) are prevalent all across in India. TB-DM comorbidity has emerged as a syndemic and needs more attention in India considering gaps in screening, clinical care, and research. This paper is intended to review published literature on TB and DM in India to understand the burden of the dual epidemic and its trajectory and to obtain perspectives on the gaps, constraints, and challenges in care and treatment of this dual epidemic. A literature search was carried out on PubMed, Scopus, and Google Scholar, using the key words 'Tuberculosis' OR 'TB' AND 'Diabetes' OR 'Diabetes Mellitus' AND 'India', focusing on the research published between the year 2000 to 2022. The prevalence of DM is high in patients with TB. Quantitative data on the epidemiological situation of TB/DM in India such as incidence, prevalence, mortality, and management are lacking. During the last 2 years convergence of TB-DM syndemic with the COVID-19 pandemic has increased cases with uncontrolled DM but also made coordinated control of TB-DM operationally difficult and of low effectiveness. Research regarding TB-DM comorbidity is required in the context of epidemiology and management. Detection and bidirectional screening are aggressively warranted. Management of DM in those with TB-DM comorbidity needs more efforts, including training and supervision of frontline workers.

Bibliometric analysis of the top 50 most cited publications of the Journal of Clinical Orthopaedics and Trauma.

BACKGROUND: The Journal of Clinical Orthopaedics and Trauma (JCOT) is one of the top three orthopaedic journals from India. We set out to analyse the top 50 cited articles from JCOT since indexing in PubMed and Scopus. METHODS: We looked into the bibliometrics of the top 50 cited articles and compared citations from PubMed and Scopus, and depicted outputs from VOS viewer analysis on co-authorship and keywords. RESULTS: Total citations for top-cited articles were 1076 in numbers, with a maximum of 103.2016 and 2018 were the most productive years. The major contribution was from India with 74%, followed by the USA. New Delhi published maximally at 72%. Clinical topics and narrative reviews were the most common types of studies. Trauma and Adult reconstruction was the most common sub-specialities, and Level 4 was the most frequent level of study. The basic science and COVID-19 related articles received the maximum citations. The authors from Indraprastha Apollo Hospitals published the maximum number of top-50 cited articles in the JCOT. CONCLUSIONS: There is a steady increase in the number of publications in the JCOT, with an increasing number of citation counts. Both the Indian and foreign authors have been publishing in this journal at a comparative rate. Although the citation counts in Scopus are more than those in PubMed for given articles, more than 80% of articles are listed in both databases as top 50 cited articles. The majority of top-cited articles belonged to trauma and adult reconstruction, level III studies, and narrative reviews.

Significant Role of Modern Technologies for COVID-19 Pandemic

Modern technologies are now available to provide appropriate information and improved services in healthcare delivery. During the COVID-19 pandemic, these technologies have played a vital role in providing advanced and digital solutions. The main objective of this paper is to explore various modern technologies. This study further describes the significant applications of these technologies for the COVID-19 pandemic. In this paper, we have identified research papers on modern technologies applications for COVID-19 from the databases of Scopus, Google Scholar, Science direct, and Research Gate. In this paper, we have provided the significant challenges faced during the ongoing COVID-19 pandemic and the role of various modern technologies that can be used to take the challenges of the COVID-19 pandemic. The substantial benefits and limitations of these technologies are briefly discussed. Finally, the paper would provide essential details of these technologies and their significant role during the COVID-19 pandemic. These technological innovations are increasing rapidly to save human beings’ lives by providing innovative solutions that can convert doctors’ and researchers’ ideas into reality. Various software and digital applications are now available to manage these technologies to provide better healthcare services digitally.

Impact of COVID-19 on the practice of orthopaedics and trauma-an epidemiological study of the full pandemic year of a tertiary care centre of New Delhi.

PURPOSE: In an observational study, we studied the impact of COVID-19 pandemic on our clinical practice of trauma and orthopaedics, in tertiary care hospital of New Delhi. METHODS: We collated the hospital data for 2019 and 2020 and analyzed and compared it extensively. We looked for the effects of the COVID-19 pandemic on several important clinical practice parameters like outpatient attendance, inpatients admissions, and surgery. The correlation of the number of surgeries done during the pandemic time was done with the number of positive cases in Delhi, monthwise. A trend of recovery was also observed. RESULTS: During the pandemic period, the attendance of outpatients fell by 71.93%, admissions by 59.35%, and surgery by 55.78%. Adult trauma surgery was the least affected (42.21%), followed by arthroscopic surgery (49.81%). Fragility hip fractures requiring bipolar hip arthroplasty were reduced by 34.15%. The maximum adverse impact of the pandemic was seen on arthroplasty surgery (hip > knee), followed by on the paediatric orthopaedic cases, and spinal surgery. We notice a "lazy V-shaped" recovery after the lockdown period. CONCLUSION: COVID-19 pandemic has had a severe impact on all aspects of orthopaedics and trauma's clinical practice in our setup. These adverse effects were maximally seen during the lockdown period, with a reduction of 90.77% in the outpatients, 84.63% in the admissions, and 86.67% in the surgery.

Robotics Applications in COVID-19: A Review

The COVID-19 outbreak has resulted in the manufacturing and service sectors being badly hit globally. Since there are no vaccines or any proven medical treatment available, there is an urgent need to take necessary steps to prevent the spread of this virus. As the virus spreads with human-to-human interaction, lockdown has been declared in many countries, and the public is advised to observe social distancing strictly. Robots can undertake human-like activities and can be gainfully programmed to replace some of the human interactions. Through this paper, we identify and propose the introduction of robots to take up this challenge in the fight against the COVID-19 pandemic. We did a comprehensive review of the literature to identify robots’ possible applications in the management of epidemics and pandemics of this nature. We have reviewed the available literature through the search engines of PubMed, SCOPUS, Google Scholar, and Research Gate. A comprehensive review of the literature identified different types of robots being used in the medical field. We could find several vital applications of robots in the management of the COVID-19 pandemic. No doubt technology comes with a cost. In this paper, we identified how different types of robots are used gainfully to deliver medicine, food, and other essential items to COVID-19 patients who are under quarantine. Therefore, there is extensive scope for customising robots to undertake hazardous and repetitive jobs with precision and reliability.

Impact of the coronavirus pandemic on the supply chain in healthcare

As the coronavirus pandemic spreads worldwide, the effect on global healthcare systems has been profound. One of the key challenges in managing this public health crisis has been the production and distribution of medical devices, surgical supplies and pharmaceuticals to those on the clinical frontline. This article assesses the impact of the coronavirus outbreak on the supply chain in healthcare and evolving solutions.

Impact of COVID-19 on post-graduate orthopaedic training in Delhi-NCR.

PURPOSE OF THE STUDY: The Coronavirus disease 2019 (COVID-19) pandemic has had profound effects on healthcare system including medical training and education in India. The study was aimed to evaluate the impact of COVID-19 on post-graduate teaching and learning amongst candidates pursuing higher qualification in orthopaedics, in the Delhi-National Capital Region in India. DESIGN: An online cross-sectional survey of 29 questions was circulated amongst post-graduate students pursuing higher orthopaedics degree to evaluate (i) Impact on PG teaching (ii) Impact on surgical training (iii) Impact on Dissertation (iv) Future implications on PG training programme (v) Mental wellbeing. RESULTS: 138 (77.5) PG trainees contributed in the survey, and 65.1% of them stated that no clinical classes are being held presently. The majority (94%) confirmed that COVID-19 has affected their surgical and clinical training. A large number (71.6%) had problems in completing their dissertations and 96% had concerns about mental health. CONCLUSION: COVID-19 pandemic has severely disrupted the education and training of the Orthopaedic PG students, in Delhi-NCR region and perhaps elsewhere similarly too. The Government and Teaching organisations should take serious consideration of the plights of PGs and devise satisfactory mechanisms to overcome their problems and provide reasonable solutions also.

Differential mortality in COVID-19 patients from India and western countries.

BACKGROUND AND AIMS: COVID-19 disease has been associated with disproportionate mortality amongst world population. We try to elucidate various reasons for lower mortality rate in the Indian subcontinent due to COVID-19 pandemic. METHOD: We carried out a comprehensive review of the literature using suitable keywords such as 'COVID-19', 'Pandemics', 'disease outbreaks' and 'India' on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the month of May 2020 during the current COVID-19 pandemic and assessed mortality data. RESULTS: The mortality observed in Indian and south Asian subcontinent is lower than in the west. Multifactorial reasons indicated for this differential mortality due to COVID-19 have been described in the current literature. CONCLUSIONS: The effects of COVID-19 on the health of racial and ethnic minority groups are still emerging with disproportionate burden of illness and death amongst some black and ethnic minority groups. Overall the current COVID-19 related mortality appears to be lower in the health and resource challenged populous Indian subcontinent. Further scientific studies would be helpful to understand this disparity in mortality due to COVID-19 in the world population.

Optimal utilization of MSK imaging during COVID-19 pandemic.

The COVID-19 pandemic has caused multi-dimensional global crisis in the recent times. There is an increasing necessity of understanding and developing a strategy for optimal utilization of healthcare resources in this time of crisis. Radiology department remains the backbone for diagnosis and for appropriate management of orthopaedic ailments. Amidst COVID-19 pandemic, there is a need to change in imaging algorithm, for various clinical conditions taking care of the exposure risk to patients and healthcare workers and to handle the volume of diagnostic and intervention work. Radiology preparedness is to set the workflow protocols and policies applicable to radiology investigations for different clinical conditions, which will help to attain these objectives. Radiologists are in best position to decide the most appropriate imaging investigation and protocol making it vital to have a frequent Orthopaedic surgeon-Radiologist interaction, which is one of the most important steps in patient management pathway.