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1.
Lung India ; 39(SUPPL 1):S33, 2022.
Article in English | EMBASE | ID: covidwho-1857682

ABSTRACT

Background: Defaults in serious diseases like lung cancer cause significant morbidity and mortality. Thus an effort was made to know the impact of COVID-19 pandemic on the follow up of lung cancer patients. Reasons once identified may help in reducing the default rate in future during similar conditions. Methods: 115 patients of carcinoma lung on chemotherapy were enrolled and followed up till the end of the study during COVID-19 pandemic. Defaults if any was studied and analysed by questionnaire method. Results: Mean age was 54.63 (SD-12.11) majority of the patients were males 91 (79.1%), mainly from rural background (75.7%). The major histological type was adenocarcinoma 65 (56.5%). 70 (60.9%) patients were exsmokers and 45 (39.1%) were non smokers. Mean distance from home to hospital was 156.42 (SD-147.56). All the patients were of advanced cancer;i.e. stage III or IV. 68 (59.13%) patients defaulted during the study period. 77 defaults were documented, 60 patients (88.24%) defaulted once, 7 patients (10.29 %) were defaulted twice and 1 defaulted (1.47 %) thrice. Lock down in 22 (32.35%), poor health in 13 (16.88%) and fear of covid in 12 (15.58%) were the most frequent reasons. No correlation was found between ages, gender, residence, distance from home to hospital, patient education, care taker education, socio economic status, ECOG status, stage of the disease, type of chemotherapy (conventional or oral TKI) with the default rate. Conclusion: Even though the OPD and indoor services never stopped for cancer patients, still major cause of default in were covid related problems, like lock down, fear of covid, transport related problems during COVID-19 pandemic.

2.
Lung India ; 39(SUPPL 1):S138, 2022.
Article in English | EMBASE | ID: covidwho-1857681

ABSTRACT

Background: Post COVID -19 infection has wide range of presentation, cavitation and fungal infections were very common in these patients especially when they are immune compromised. This is a case study of a post covid patient with cavitary consolidation and Rasmussen's aneurysm secondary to invasive aspergillus infection. Case Study: A 62 year old gentleman, hypertensive, diabetic and survivor of severe COVID-19 infection presented with low grade fever, breathlessness and cough with expectoration. The CT scan showed bilateral cavitary consolidation . Sputum examination showed aspergillus growth and MTB negative. Serum galactomannan was positive. While getting treated with antifungal therapy for invasive aspergillus infection, he had one episode of massive haemoptysis. CT angiography showed Rasmussen aneurysm and planned for bronchial artery embolization. But the patient was not willing for any urgent intervention and got discharged on request after stabilisation, warning signs were explained. After 5 days patient had massive haemoptysis followed by circulatory collapse. Patient could not be saved even after resuscitation measures and emergency intubation. Discussion: Rasmussen's aneurysm is a pseudo-aneurysmal dilatation of a branch of pulmonary artery secondary to chronic inflammation in a contiguous cavity. The reported incidence of such pathology is around 5% in cavitary lesions. It may ruptures into the cavity, producing massive haemoptysis. Conclusion: Rasmussen aneurysm itself is a very dangerous entity irrespective of its etiology. Early interventions to prevent the fatal haemoptysis is the management strategy as conservative treatment may not give us enough time to act at the time of emergency.

3.
Lung India ; 39(SUPPL 1):S137, 2022.
Article in English | EMBASE | ID: covidwho-1857381

ABSTRACT

Background: COVID-19 pandemic has affected majorly the lungs besides many other organs. Many of the patients later developed pulmonary-fibrosis. This study was planned to know the determinants resulting in pulmonary-fibrosis in post COVID survivors. Methods: Hospital-based, cross-sectional study done over a period of one year. A pre-designed proforma used to collect necessary information and follow-up HRCT and other investigations were evaluated. Results: Out of 87 patients 41.3% (n=36) developed pulmonary fibrosis among which majority i.e., 66.6% (n=24) were males. Out of 87 patient 49.42% (n=43) belonged to the age group of 51-70 years among which 48.83% (n=21) developed fibrosis. Infection was more common in urban 63.2% (n=55), middle-class family 55.17% (n=48), non-smoker 65.51% (n=57), homemaker and office worker 49.4% (n=43). Out of 87 patients 57.47% (n=50) had different comorbidities out of which 52% (n=26) developed pulmonary fibrosis. The proportion of fibrosis among diabetic patients was 67.7% (n=21, p=0.036). A total of 27 patients were treated in ICU, out of which 66.67% (n=18) developed pulmonary fibrosis. About 57.14% (n=28) of the patient with leucocytosis developed pulmonary fibrosis. Pulmonary fibrosis developed more in which steroid are not used 9/19, 47% (n=9) compared to those where was steroid used 27/68, 39.7% (n=27). Majority of the patient i.e.,>90% fibrotic patient had raised inflammatory marker. Higher CT severity score and consolidation are predictive for post covid fibrosis Conclusion: Post-COVID-19 pulmonary-fibrosis was observed in about half of the survivors. This study emphasized the relation of pulmonary-fibrosis with many factors like age, comorbidities, ICU-admission, steroid usage, inflammatory-markers and secondary-infections.

4.
Lung India ; 39(SUPPL 1):S8-S9, 2022.
Article in English | EMBASE | ID: covidwho-1857236

ABSTRACT

Background: Amidst fight against COVID-19 pandemic, efforts to mitigate other communicable disease threatening public health including TB has taken a back step. Limited evidence exists about the change in prevalence of Pediatric Dr. TB post 2020. Objective: The study aimed to find out the change in prevalence of Pediatric DR TB pre and post 2020. Methods: Descriptive retrospective and prospective study. Pediatric Dr. TB was defined on the basis of Gene X pert/ line probe assay and/ or drug susceptibility testing (DST). Results: Prevalence of Pediatric Dr. TB in year 2018, 2019, 2020 and 2021 (January-September) were 17.4%, 15.1%, 18.4% and 16.6% respectively in the age group of 1-18 years. Majority (93.9%, 90.5%, 89.5%, 96.8%) had pulmonary TB. Cumulative prevalence of Pediatric Dr. TB for the 24 months of year 2018 & 2019 was 16.3% while it was 17.6% for the 21 months of year 2020 & 2021 (January-September). It reveals an increase of 4.1%. On extrapolating the prevalence rate of Dr. TB for the 9 months of year 2021, prevalence rate of Dr. TB by the end of year 2021 is expected to be 22.1%. Among Dr. TB, prevalence (%) of XDR TB;MDR TB;monoresistant TB for year 2018, 2019, 2020 & 2021 was (10.9,88.0,1.1), (5.1,92.8,2.1), (3.4,94.9,1.7) and (7.4,91.6,1.0) respectively. Conclusion: With this report of increase in prevalence of Pediatric Dr. TB, it has become the need of the hour to start focusing on TB vigorously and to take uncompromising relentless measures to achieve the country's vision to eliminate TB by 2025.

5.
Lung India ; 39(SUPPL 1):S137-S138, 2022.
Article in English | EMBASE | ID: covidwho-1857128

ABSTRACT

Background: We estimated levels of oxidative stress biomarkers (Lipid peroxidation (LPO) via Malondialdehyde MDA concentration , Superoxide dismutase (SOD), Glutathione Reductase (GR) and Total antioxidant activity (TAA) in patients who were symptomatic beyond 4 weeks of COVID infection. Methods: It's a single centre, hospital based case control study in which levels of oxidative stress biomarkers in 40 Long COVID patients and 40 healthy controls were compared and analysed with their clinico-radiological profile. Results: 1. Lipid peroxidation (MDA) was significantly higher (1155.9 ± 204.82nmole/ml) in Long COVID patients as compared to control (715.5 ± 85.51nmole/ml) (p value 0.0405) 2. SOD in Long COVID patients was lower (18.05 ± 2.83 unit/mg) as compared to control (27.36 ± 2.18 unit/ mg) (p value 0.0096) 3. GR was reduced in Long COVID patients (10.2 ± 1.26 unit/min/mg of protein) as compared to control (15.7 ± 1.42 unit/min/mg of protein) (p value 0.0356) 4. TAA was also moderated in Long COVID patients (94.61 ± 16.40mM) as compared to control (241.64 ± 12.95mM) , (p value 0.0486) 5. LPO was directly and remaining markers were inversely proportional to the Severity of COVID and Xray Severity score 6. The patients with added comorbidities showed even higher oxidative stress than those with no comorbidities (p value 0.05) 7. Lipid peroxidation was significantly high in patients who developed neurological sequelae after COVID infection (p value 0.0083). Conclusion: A subset of patients develop a sequelae to COVID infection and in those patients oxidative stress plays a major role.

6.
Lung India ; 39(SUPPL 1):S139, 2022.
Article in English | EMBASE | ID: covidwho-1856957

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in Wuhan and has quickly spread worldwide. The mortality rate in critically ill patients with COVID-19 is high. This study analyzed clinical comorbidities in different groups to early identify harsh or critical patients. Objective: To identify different clinical symptoms and comorbidities in CIVID 19 patients. Methods: In this single-center, cross-sectional study, 142 COVID-19 patients were enrolled. Clinical characteristics and comorbidities were assessed. Results: Of the 142 patients, 92(64.8%) were male, with a mean age of (56.00±14.81)years. The patients were elderly above 60(n = 62,43.7%) and adults (n = 80). Of these, 92 (64.7%) had comorbidities. Patients with severe COVID pneumonia 102(71.8%)were admitted to the intensive care unit (ICU), and 12(8.5%) patients have died. On admission, the main clinical manifestations were Fever (90.1%), dyspnea (83.8%), cough (78.2%), Anosmia (19%),alteration of taste (13.4%), haemoptysis (10.6%),headache (5.6%) and conjunctivitis (3.5%). Common comorbidities were diabetes mellitus(42.3%),hypertension (27.5%),Obesity (10.6%),heart failure (6.3%),COPD (3.5%),Asthma (2.5%),coronary artery disease (2.1%), ILD (2.1%),Post tubercular (1.4%),and CKD,CLD less than one perent.19% patients had history of contact COVID 19 cases. Smoking was present in 8.5% of cases. One comorbidity has been seen in 46, two in 28, and more than two in 5 patients. Patients were divided into four groups: no comorbidities, one comorbidity, two comorbidities, and more than two comorbidities. ANOVA test was used and showed that the value of serum creatinine (p=.017), serum bilirubin (p=.006), and serum SGOT (P=.009) were significantly associated. Conclusion: Severe COVID 19 disease had the worst outcome. In addition, serum creatinine and serum bilirubin values differed significantly in different comorbidities groups.

7.
Journal of Positive School Psychology ; 6(1):53-61, 2022.
Article in English | Scopus | ID: covidwho-1738108

ABSTRACT

Purpose –Sudden occurrence of uncertainty because of COVID-19 pandemic altered the teaching and learning practices and leads to changes in entrepreneurial intentions among students that are going be become future entrepreneurs. Thus, rational behind present paper is to investigate student’s intentions about Entrepreneurship behavior in case of Bule Hora University, Ethiopia students with mediating role of COVID-19 panic. Design/ approach/methodology – Primary data about student entrepreneurs’ learning experiences during the COVID-19 was through survey questionnaire from 350 respondents. Confirmatory factor analysis was employed to check uni-dimensionality, validity of construct and model reliability. SEM with help of STATA-14 software employed to measure the mediating role of covid-19 panic on comprehensive university student’s entrepreneurial behavioral intentions. Findings – Outcomes of the study show that covid-19 panic has the mediating and indirect effect on comprehensive university student’s entrepreneurial behavior intentions. Practical implications – Study results have indications for educational policymakers and practitioners to adjust the distorted entrepreneurship learning environment which is based on face to face practical incubation based learning, during the COVID-19 panic. Originality/value –The research add value in literature on education by unique contribution by investigate the COVID-19 panic affect on incident of learning in comprehensive university students of Ethiopia. The findings of present research will help in expanding the policy maker’s insights about nurturing of entrepreneurship spirit among students to cope with the poverty and unemployment situation during post COVID-19 period. © 2021 Academia Peruana de la Lengua.

8.
European Respiratory Journal ; 58:2, 2021.
Article in English | Web of Science | ID: covidwho-1700224
9.
Journal of Clinical and Diagnostic Research ; 15(11):OI1-OI3, 2021.
Article in English | Web of Science | ID: covidwho-1538818

ABSTRACT

Coronavirus Disease 2019 (COVID-19) is a respiratory and systemic illness that may progress to severe Acute Respiratory Distress Syndrome (ARDS). There is a pressing need to identify clinical predictors of severe COVID-19 which can help in risk stratification and prognostication. The COVID-19 pandemic tends to have more severe clinical presentation in older age group and in chronic diseases;Chronic Obstructive Pulmonary Disease (COPD) is one of them. COPD is the common cause of high mortality and morbidity worldwide. It is obvious to fear for patients with underlying COPD. Acute episode of exacerbation and COVID-19 pneumonia are the two pivotal differential diagnoses in contemporary era, in patients of COPD presenting with worsening dyspnoea. Mortality rate have been higher among COPD group of patients with the development of hypoxemia. Literature shows that pre-existing COPD worsens the risk of COVID-19 progression and leads to poorer prognosis. Even after recovery from the acute event, proper adherence to maintenance therapy for COPD (inhalational agents) continues to be of paramount importance and remains the standard of care. Because COPD remains a subset that is highly vulnerable for adverse outcomes with COVID-19 infection, preventive therapy should be directed towards-attenuation of contact with droplets, proper hand hygiene and maintenance of adequate nutritional status. The aim of this brief review is to know the burden and impact of COPD on COVID-19 pandemic and challenges in diagnosis and management of COPD patients.

10.
Journal of the American Society of Nephrology ; 32:100, 2021.
Article in English | EMBASE | ID: covidwho-1489752

ABSTRACT

Background: The development of efficacious vaccines against COVID-19 is an overarching achievement of modern medicine. This efficacy, however, may not be achieved in patients on immunosuppression. We looked to ascertain humoral response and tolerability of these vaccines in patients with ANCA associated vasculitis(AAV) treated with B-cell depleting agents Methods: AAV patients who completed 2 doses of BNT162b2 or mRNA-1273 or a dose of JNJ-78436735, subsequently screened for spike protein antibody against SARSCoV-2 were included in the study. Clinical details, demographics and immunosuppression regimes were ascertained, with primary outcome being humoral response to SARSCoV-2.Statistics included Fischer's exact test and Wilcoxon rank sum test. Results: Forty-eight patients with a mean age of 67y(35% female) completed vaccine series with BNT161b2(n=19), mRNA-1273(n=25) and JNJ-78436735(n=4). Vaccine associated side effects occurred in 27% of patients after 1st dose, with 39% after the 2nd dose. Spike protein antibody was tested at a median of 31 days after vaccination-30(61%) patients had demonstrable antibody. All patients (n=44) other than 4 post-transplant patients, were treated with Rituximab-only 17/44(39%) developed an antibody response. In the setting of rituximab treatment, absence of seroconversion post vaccination was associated with vaccine type, duration elapsed since last rituximab dose (figure 1), low IgM level and absence of B-cell reconstitution (all stastically significant). Two patients without serologic response had severe COVID-19 infection Conclusions: This data demonstrates that majority of patients treated with rituximab lack demonstrable serologic response, with risk of severe COVID-19 infections despite vaccination. Confirmation of B-cell reconstitution before vaccination may have a bearing on serological conversion. It is imperative that authorities consider these factors while designing vaccination schedules and provide recommendations for booster doses in this vulnerable population.

11.
Journal of the Indian Medical Association ; 119(4):79-82, 2021.
Article in English | EMBASE | ID: covidwho-1357881
12.
Journal of the Indian Medical Association ; 119(6):87-90, 2021.
Article in English | EMBASE | ID: covidwho-1357839

ABSTRACT

Healthy life and longevity is the ultimate desire of one and all. There is a difference between disease free life and healthy life. Both of these elements are essential for healthy living. This is high time when about 10 lakhs Doctors of Allopathy (Modern Medicine) and similar Doctors of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) should join hands together to fight against Corona Pandemic and other dreaded diseases like Diabetes, Hypertension, Heart Disease, Liver Disease, Cancer, TB etc. There is no competition or contradiction between Allopathy (Modern Medicine), Ayurveda or other pathies. All are for the good and wellbeing of mankind. There is no justification for cross allegations among them. So-called Propagates of Ayurveda recently criticized and blamed Allopathy (Modern Medicine) for their vested interest. It is against the medical ethics, Indian values and traditions. Such forces which want to create rift between the Allopathy (Modern Medicine) and Ayurveda are against the Society and Humanity. Such people are also weakening the spirit and vision of Prime Minister’s Healthy India while all systems of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) are meant primarily for prevention and promotion of health and care of chronic life style related disease, Allopathy (Modern Medicine) is more useful for emergencies, trauma, infections and Intensive care services during the covid pandemic. The services rendered by all pathies were marvelous and fruitful for the management of COVID-19 in India. [J Indian Med Assoc 2021;119(6): 87-90].

13.
Indian Journal of Community Health ; 32(4):681-687, 2020.
Article in English | Scopus | ID: covidwho-1134766

ABSTRACT

Background: There is an urgent need for developing potential drug targets to protect the health care professionals (HCPs) who are at high risk of infection from coronavirus disease-2019 (COVID-19) as they are directly and/ indirectly involved in treatment facility. We aimed to assess knowledge, attitude, and practices towards hydroxychloroquine (HCQ) pre-exposure prophylaxis (PEP) among HCPs directly and/ indirectly involved in COVID-19 treatment. Materials and Methods: This cross-sectional study was multi-centric, and data was collected from HCPs (only doctors and nurses) involved directly or indirectly with COVID-19 patient treatment. The study questionnaire consisted of socio-demographic profile;assessment of HCQ knowledge, attitude, practices, and related adverse drug reactions (ADRs). Results: Of the recruited 374 HCPs, 302 fulfilled the study criteria. Mean age of participants was 33.30 {±standard deviation 7.65}. 64.2% of the participants were male. 16.9% of the individuals (n=51) had co-morbidities. All the HCPs had basic knowledge of COVID-19 and 87.42% were aware of the role of HCQ as PEP. Further, 269 participants (89.07%) were aware that HCQ can cause ADRs. 56.6% participants agreed that HCQ had a protective role against COVID-19 and 54.3 % participants considered that PEP with HCQ had ‘more benefit’ than risk. 52.32% (n=158) HCPs had used HCQ as PEP and 52.53 % (n=83) of these participants had completed the recommended drug course. Twenty participants (12.67%) had experienced ADR, and 12 had reported it to ADR monitoring centre. Conclusion: Our data shows that HCPs are aware of COVID-19 and HCQ prophylaxis. Approximately 57% of the participants agreed that HCQ has a protective role against COVID-19 and 50% of the participants had taken HCQ prophylaxis. Only 12.67% of the participants reported an ADR and in none of them, it was serious enough to discontinue the drug. © 2020, Indian Association of Preventive and Social Medicine. All rights reserved.

14.
Journal of the Indian Medical Association ; 118(9):70-76, 2020.
Article in English | EMBASE | ID: covidwho-875422

ABSTRACT

The COVID-19 pandemic continues to have a serious impact on the lives of millions of people worldwide. Empirical therapy is being used to reduce morbidity and mortality of COVID-19 patients. Favipiravir, which is an oral broad-spectrum anti-viral agent with proven efficacy against various RNA viruses, acceptable tolerability profile and favorable benefit-risk ratio in short term use, has got an emergency use authorization in many countries including India for the treatment of mild to moderate cases of COVID-19. It has demonstrated promising results in terms of rapid viral clearance, quick symptom control, and pulmonary radiographic improvement. Due to reasons such as lockdown, isolation, diagnostic delays, fear of quarantine or getting tested, cost, etc., the golden time period (first 24-48 hrs) is lost in COVID-19 patients which is crucial for initiating antiviral therapy. Therefore, the panel members of ‘Academy of Advanced Medical Education’ propose that favipiravir can be recommended in confirmed, early probable and possible cases of mild and moderate severity as an empirical therapy during current pandemic. It is important to counsel the patients and explain to them about the limited clinical evidences with favipiravir, therefore, a signed consent form from patient must be kept before initiating treatment. Well-designed double-blind controlled trials are urgently required to understand this further.

15.
Journal of the Indian Medical Association ; 118(9):64-69, 2020.
Article in English | EMBASE | ID: covidwho-875324

ABSTRACT

Novel Corona Virus causes COVID 19 (Corona Virus Disease of 2019) infection. In December 2019, SARS(Severe Acute Respiratory Syndrome)-CoV-2, was first recognized in Wuhan, China. Genetic sequencing of the virus suggests that SARS-CoV-2 is a beta –coronavirus;which is intimately linked to the SARS virus. Mostly patient develop mild or uncomplicated illness, but 14% often them leads to severe disease which needs hospitalization and oxygen therapy and among them 5% need intensive care.[1]. Health Care employees are at the frontline of this pandemic taking care of infected patients and thereby are at a greater risk of acquiring infection. Health workers impart a crucial job not only in the management of the sick, but also ensures adequacy of infection control and its prevention of infection. Systematic literature are scarce but available sources reflect an infection rate of 1% among health care workers (HCW’s) with female preponderance. HCW’s of all ages got infected but those with age greater than 55 years had high mortality after being infected. Case fatality rate among HCW’s varied across the globe with 0.9% in China to almost 6.1% in India. Ignorance about the epidemiology and transmission of the disease, lack of protective gears due to epidemic unpreparedness were main attributable factors for infection in HCW’s. This pandemic has shown great impact on mental health as well as on social wellbeing of health care workers. A proportion of the workforce are faced with depression(22.8%),insomnia(34.3%) and anxiety disorders(23.2%) leading to untoward consequences in few cases. Understanding COVID–19 infection and its impact on health workers is crucial not only for characterizing the transmission pattern of the virus but also as a means of prevention of the infection amongst the providers of health care who have a key role in saving the world from this pandemic.

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