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1.
Kathmandu Univ Med J (KUMJ) ; 19(75): 351-355, 2021.
Article in English | MEDLINE | ID: covidwho-2073782

ABSTRACT

Background COVID-19 is an infectious disease caused by a newly discovered coronavirus. The number of cases and dramatic loss of human life worldwide created psychological problems among general public, including health care workers. Objective To determine the burden of anxiety, depression, and functional impairment among health care workers in the early days of lockdown during the first wave of COVID-19 outbreak in Nepal. Method A hospital-based cross-sectional study was carried out among all the employees of Hospital for Children Eye ENT and Rehabilitation Services, Bhaktapur during the COVID-19 pandemic lockdown from April 3, 2020 to May 2, 2020 using an online questionnaire. The tools used were adopted from Nepali version of Hospital Anxiety and Depression scale (HADS) and Nepali version of WHO Disability Assessment Schedule (WHODAS 2.0). Result The mean age (SD) of the participants (n=86) was 32.53 (7.92) years. Male and female participants were equal in number. The point prevalence of anxiety and depression was 25.6% and 14.0%, respectively. Females had a higher prevalence of both anxiety (39.5% vs 11.6%, p < 0.01) and depression (18.6% vs 9.3%, p=0.351). Clinical and nonclinical staff both had a higher prevalence of both anxiety (31.0% and 20.5%, p=0.265) and depression (16.7% and 11.4%, p=0.478). The mean functional impairment score (WHODAS 2.0) among all participants and participants with anxiety and depression was 19.47 (95% CI: 18.13-20.80), 21.27 (95% CI: 18.08-24.46), and 19.92 (95% CI: 15.28- 24.56), respectively. Conclusion Anxiety and depression during the first lockdown due to COVID-19 pandemic were highly prevalent in clinical and non-clinical employees. Besides controlling the outbreak, special consideration should be given to mental health.


Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Child , Communicable Disease Control , Cross-Sectional Studies , Depression/epidemiology , Female , Health Personnel/psychology , Humans , Male , Pandemics , SARS-CoV-2
2.
Chest ; 162(4):A428-A429, 2022.
Article in English | EMBASE | ID: covidwho-2060594

ABSTRACT

SESSION TITLE: Post-COVID-19 Infection Complications SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: Chest CT features in COVID-19 pneumonia include scattered ground-glass infiltrates in milder cases to confluent ground-glass change, dense consolidation, and crazy paving in the critically ill. However, cavitary lesions are uncommon in these patients. We present a case of lung cavity in a patient who had recent COVID-19 pneumonia. CASE PRESENTATION: A 33-year-old male diagnosed with COVID-19 four weeks ago presented with hemoptysis and exertional dyspnea. He had pleuritic chest pain without fever, night sweats, weight loss, skin rashes, hematemesis, or epistaxis. He had COVID-19 in Brazil, where he had received dexamethasone, hydroxychloroquine, ivermectin, colchicine, azithromycin, and rivaroxaban. The last dose of rivaroxaban was three days prior to the presentation. He had no history of travel to caves or exposure to birds or animals. His past medical history included hypertension, diabetes, and bariatric surgery. He had no history of smoking or IV drug use. He had moved from Brazil to the United States six years ago and worked as an interpreter. Physical examination was notable for stable vitals with O2 sat of 99%. Systemic examinations were unremarkable. Blood work including CBC, platelet count, PT/INR was within normal limits. COVID-19 testing (PCR) was negative. A chest CT revealed bilateral scattered ground-glass opacities with central cavitation in the left lower lobe concerning for septic pulmonary emboli. HIV 1/2, ANA, rheumatoid factor, and Quantiferon TB gold were negative. Blood cultures showed no growth. An echocardiogram was negative for any vegetations. Bronchoalveolar lavage from the left lower lobe was negative for AFB and gram staining. Sputum cultures, fungal cultures, and NAAT for Mycobacterium tuberculosis were negative, as was the cytology. He was started on amoxicillin-clavulanic acid during his hospital stay. He did not experience any recurrence of hemoptysis and was discharged home. The subsequent follow-up chest CT scans showed resolving cavitation at one month and a complete resolution of the cavity at 3 months. DISCUSSION: Cavitary lung lesions are usually related to fungal, mycobacterial, autoimmune, parasitic, thrombotic, or neoplastic etiologies. While not often seen in patients with viral pneumonia, lung cavitation can rarely occur in COVID-19. Mycobacterium tuberculosis and Nocardia were suspected given the history of being an immigrant and a recent trip to Brazil. As these tests were negative and the lung cavity resolved over a few months with conservative treatment, the etiology of the cavity was attributed to a late presentation of COVID-19 pneumonia. CONCLUSIONS: COVID-19 has variable complications which are still to be explored. The lung cavity in a COVID patient is an under-recognized entity. This case report highlights the need for further studies to determine the cause of cavitation, which could be related to COVID infection or its treatment. Reference #1: Selvaraj V, Dapaah-Afriyie K Lung cavitation due to COVID-19 pneumonia. BMJ Case Reports CP 2020;13:e237245. Reference #2: Chen Y, Chen W, Zhou J, Sun C, Lei Y. Large pulmonary cavity in COVID-19 cured patient case report. Ann Palliat Med 2021;10(5):5786-5791. doi: 10.21037/apm-20-452 Reference #3: Zoumot, Z., Bonilla, MF., Wahla, A.S. et al. Pulmonary cavitation: an under-recognized late complication of severe COVID-19 lung disease. BMC Pulm Med 21, 24 (2021). https://doi.org/10.1186/s12890-020-01379-1 DISCLOSURES: no disclosure on file for Raul Davaro;No relevant relationships by Susant Gurung No relevant relationships by Bijay Khanal No relevant relationships by Anil Phuyal No relevant relationships by Kamal Pokhrel No relevant relationships by REGINA SHRESTHA No relevant relationships by Mithil Gowda Suresh

3.
Journal of Public Health Research ; 10(2_SUPPL), 2021.
Article in English | Web of Science | ID: covidwho-2003385

ABSTRACT

Background: COVID-19 pandemic has caused an extraordinary situation, especially for the healthcare workers (HCWs), leading to increased psychological stress. The aim of the study was to estimate the prevalence of different grades of anxiety and depression across different centers in the Philippines and identify demographic factors associated with them. Design and Method: A cross-sectional, web-based, multi-center study was conducted among HCWs of Philippines from April 20- May 20, 2020. The study instruments used were the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Risk perception scores were analyzed using Mann-Whitney and Kruskal-Wallis test. Logistic regression was done to identify factors significantly associated with symptoms of anxiety and depression determined. Results: A total of 516 HCWs were included in the study. Most of them have anxiety symptoms (70.74%), but only half of them have symptoms of depression (50.97%). In addition, gender, age, marital status, living status, occupation, work premises, and availability of mental health services were significantly associated with the participants' anxiety symptoms. In contrast, gender, marital status, occupation, and work premises were significantly associated with depression symptoms. Conclusion: This study reiterates the fact and demonstrates that COVID-19 has disrupted the mental well-being of HCWs in the Philippines. Majority of HCW was psychologically affected by COVID-19. Therefore, there is a dire need to address mental illness amongst HCWs and frame guidelines based on proven algorithms to overcome these mental illnesses.

4.
Journal of the Nepal Medical Association ; 60(251):621-624, 2022.
Article in English | EMBASE | ID: covidwho-1939704

ABSTRACT

Introduction: The disastrous effect of COVID-19 pandemic on the mental health of vulnerable populations like pregnant women should not be neglected. The objective of the study was to find out the prevalence of anxiety among pregnant women attending the obstetrics unit of a tertiary care centre during the COVID-19 pandemic. Methods: A descriptive cross-sectional study was conducted from 16 May 2020 to 30 July 2020 among pregnant women attending obstetrics unit of a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee (Reference number: 365/076/077-IRC). Convenience sampling method was used. Pregnancy-related anxiety questionnaires were used and semi-structured questionnaires were used for sociodemographic data. Point estimate and 95% Confidence Interval were calculated. Results: Out of 115 pregnant women, anxiety was found in 21 (18.26%) (11.20-25.32, 95% Confidence Interval). Conclusions: Anxiety among the pregnant women reported in this study was found to be lower than similar studies conducted in similar settings.

5.
Minerva Psychiatry ; 63(2):111-120, 2022.
Article in English | Web of Science | ID: covidwho-1918287

ABSTRACT

BACKGROUND: COVID-19 pandemic has affected the healthcare workers (HCWs) worldwide. We plan to assess the psychological impact of this pandemic in different groups of HCWs including female community health volunteers (FCHVs) at various types of health facilities in Nepal, factors associated with it and the degree of satisfaction with the ongoing mental health support system. METHODS: A cross-sectional web-based survey with an option of telephone interview was conducted from June 20 to July 7, 2020. The questionnaire included socio-demographic characteristics, work related characteristics, substance use history, and degree of satisfaction with family, society and institutional support. Depression, anxiety, and stress scales (DASS-21) and the impact of events scale-revised (IES-R) tool were used to access the level of psychological impact. Linear regression was used to analyze factors associated with psychological outcome. RESULTS: Out of 608 respondents, the overall prevalence of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) was 20.89%. 24.18%, 13.82%, and 15.46% respectively. Nurses had higher depression, anxiety, stress, and PTSD scores while FCHVs had high depression and PTSD compared to doctors. For various types of health facilities, HCWs working in provincial-level hospitals had high-stress level. Similarly, "have to go into quarantine" and increased level of substance abuse were directly associated with poor psychological impact. Finally, 62% of HCWs did not have any institutional mental health support system. Among those who had institutional mental health support, 39.4% were not satisfied. CONCLUSIONS: We found mild to extremely severe level of depression, anxiety, stress, and PTSD among HCWs in Nepal. Urgent plans are required to mitigate the mental health risk caused by this current pandemic.

6.
Topics in Antiviral Medicine ; 30(1 SUPPL):329-330, 2022.
Article in English | EMBASE | ID: covidwho-1879986

ABSTRACT

Background: The prevalence of vaccinated, previously infected, and individuals at risk of SARS-CoV-2 infection is important for epidemiologic studies and public health interventions. Asymptomatic infections and reluctance to disclose vaccination status hinder accurate assessments of the current state of the epidemic. Since COVID-19 vaccines generate immune responses to spike (S1), but not nucleocapsid (N), it is possible to differentiate between vaccinated, infected, and unexposed individuals by comparing antibody reactivity to each antigen. The MSD V-Plex SARS-CoV-2 IgG assay can potentially differentiate each state in one test by simultaneously evaluating IgG reactivity to the S1, receptor binding domain (RBD), and N proteins. Methods: The MSD assay was validated with three sample sets: known vaccination with no previous infection (n=158);known infected and not vaccinated (n=157);and samples collected prior to the COVID-19 pandemic in 2016 (n=144). Of the previously infected individuals, 15 (9.6%) were hospitalized;sample collection occurred a median of 48 days after a PCR-positive result. Using an algorithm, samples with positive results on both S1 and RBD but negative on N were classified as vaccinated. Samples with a positive result on all three proteins were considered to be infected with the possibility of subsequent vaccination. Any other result was classified as unexposed. Sensitivity and specificity for each state were calculated. Results: Reactivity to each antigen is shown in the figure. 100% (95% confidence interval [CI] 97.7-100), 92% (95% CI 86.3-95.5), and 0.7% (95% CI 0.02-3.8) of vaccinated, infected, and unexposed samples were positive for S1. 100% (95% CI 97.7-100.0%), 91% (95% CI 85.5-95.0%), and 0.7% (95% CI 0.02-3.8%) of vaccinated, infected and unexposed samples were positive for RBD. 0% (95% CI 0-2.3), 86% (95% CI 79.6-91.0), and 2.1% (95% CI 0.4-6.0) of vaccinated, infected and unexposed samples were positive for N. Algorithm sensitivity and specificity for classification of vaccinated samples were 100% (95% CI 97.7-100) and 96.7 (95% CI 94-98.4). For the classification of samples from previously infected individuals, sensitivity and specificity were 83.4% (95% CI 76.7-88.9) and 100% (95% CI 98.8-100). Conclusion: This study establishes the sensitivity and specificity for a high-throughput assay ideal for SARS-CoV-2 seroprevalence studies. Future research should focus on applying this assay in health care settings to guide practice and policy to mitigate the pandemic.

7.
International Journal of Interactive Mobile Technologies ; 16(7):22-37, 2022.
Article in English | Scopus | ID: covidwho-1847445

ABSTRACT

The Covid-19 outbreak has affected several aspects of field-based learning. The best way to ensure the survival and safety of everyone involved in field-based learning is to adapt and integrate technology. In response to this problem, numerous innovations in learning technology that lead to the virtualization of the learning environment have begun to emerge. However, the various application products developed have fallen short of the expectations of students. As a result, in order to design the optimal virtual application for use in fieldbased learning, a needs analysis must be done. This study offers an understanding of student needs for virtual field-based learning applications. An online survey of 140 active university students was carried out to do so. The results showed that students require applications with sophisticated features that resemble the real world for the implementation of online field-based learning. They expect the incorporation of online meeting features, 360 Virtual Reality Panorama, access to learning videos, augmented reality, learning materials, chatbox, and multimedia into the software that will be developed. © 2022. All Rights Reserved.

8.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-334553

ABSTRACT

Convalescent plasma is currently one of the leading treatments for COVID-19, but there is a paucity of data identifying therapeutic efficacy. A comprehensive analysis of the antibody responses in potential plasma donors and an understanding of the clinical and demographic factors that drive variant antibody responses is needed. Among 126 potential convalescent plasma donors, the humoral immune response was evaluated by a SARS-CoV-2 virus neutralization assay using Vero-E6-TMPRSS2 cells, commercial IgG and IgA ELISA to Spike (S) protein S1 domain (Euroimmun), IgA, IgG and IgM indirect ELISAs to the full-length S or S-receptor binding domain (S-RBD), and an IgG avidity assay. Multiple linear regression and predictive models were utilized to assess the correlations between antibody responses with demographic and clinical characteristics. IgG titers were greater than either IgM or IgA for S1, full length S, and S-RBD in the overall population. Of the 126 plasma samples, 101 (80%) had detectable neutralizing titers. Using neutralization titer as the reference, the sensitivity of the IgG ELISAs ranged between 95-98%, but specificity was only 20-32%. Male sex, older age, and hospitalization with COVID-19 were all consistently associated with increased antibody responses across the serological assays. Neutralizing antibody titers were reduced over time in contrast to overall antibody responses. There was substantial heterogeneity in the antibody response among potential convalescent plasma donors, but sex, age and hospitalization emerged as factors that can be used to identify individuals with a high likelihood of having strong antiviral antibody levels.

9.
Kathmandu University Medical Journal ; 19(3):351-355, 2021.
Article in English | GIM | ID: covidwho-1743586

ABSTRACT

Background: COVID-19 is an infectious disease caused by a newly discovered coronavirus. The number of cases and dramatic loss of human life worldwide created psychological problems among general public, including health care workers.

10.
International Journal of Infectious Diseases ; 116:S38-S38, 2022.
Article in English | PMC | ID: covidwho-1720010
11.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-329167

ABSTRACT

Background: Emergency Departments (EDs) can serve as surveillance sites for infectious diseases. Our purpose was to determine the burden of SARS-CoV-2 infection and prevalence of vaccination against COVID-19 among patients attending an urban ED in Baltimore City. Methods: Using 1914 samples of known exposure status, we developed an algorithm to differentiate previously infected, vaccinated, and unexposed individuals using a combination of antibody assays. We applied this testing algorithm to 4360 samples ED patients obtained in the springs of 2020 and 2021. Using multinomial logistic regression, we determined factors associated with infection and vaccination. Results: For the algorithm, sensitivity and specificity for identifying vaccinated individuals was 100% and 99%, respectively, and 84% and 100% for naturally infected individuals. Among the ED subjects, seroprevalence to SARS-CoV-2 increased from 2% to 24% between April 2020 and March 2021. Vaccination prevalence rose to 11% by mid-March 2021. Marked differences in burden of disease and vaccination coverage were seen by sex, race, and ethnicity. Hispanic patients, though 7% of the study population, had the highest relative burden of disease (17% of total infections) but similar vaccination rates. Women and White individuals were more likely to be vaccinated than men or Black individuals (adjusted odds ratios [aOR] 1.35 [95% CI: 1.02, 1.80] and aOR 2.26 [95% CI: 1.67, 3.07], respectively). Conclusions: Individuals previously infected with SARS-CoV-2 can be differentiated from vaccinated individuals using a serologic testing algorithm. SARS-CoV-2 exposure and vaccination uptake frequencies reflect gender, race and ethnic health disparities in this urban context. Summary: Using an antibody testing algorithm, we distinguished between immune responses from SARS-CoV-2-infected and vaccinated individuals. When applied to blood samples from an emergency department in Baltimore, disparities in disease burden and vaccine uptake by sex, race, and ethnicity were identified.

12.
MEDLINE;
Preprint in English | MEDLINE | ID: ppcovidwho-328519

ABSTRACT

The COVID-19 outbreak in China was devastating, and spread throughout the country before being contained. Stringent physical distancing recommendations and shelter-in-place were first introduced in the hardest-hit provinces, and by March, these recommendations were uniform throughout the country. In the presence of an evolving and deadly pandemic, we sought to investigate the impact of this pandemic on individual well-being and prevention practices among Chinese urban residents. From March 2-11, 2020, 4,607 individuals were recruited from 11 provinces with varying numbers of COVID-19 casers using the social networking app WeChat to complete a brief, anonymous, online survey. The analytical sample was restricted to 2,551 urban residents. Standardized scales measured generalized anxiety disorder (GAD), the primary outcome. Multiple logistic regression was conducted to identify correlates of GAD alongside assessment of community practices in response to the COVID-19 pandemic. We found that during the COVID-19 pandemic, recommended public health practices significantly (p <0.001) increased, including wearing facial mask, practicing physical distancing, handwashing, decreased public spitting, and going outside in urban communities. Overall, 40.3% of participants met screening criteria for GAD and 49.3%, 62.6%, and 55.4% reported that their work, social life, and family life were interrupted by anxious feelings, respectively. Independent correlates of having anxiety symptoms included being a healthcare provider (aOR=1.58, p <0.01), living in regions with a higher density of COVID-19 cases (aOR=2.13, p <0.01), having completed college (aOR=1.38, p =0.03), meeting screening criteria for depression (aOR=6.03, p <0.01) and poorer perceived health status (aOR=1.54, p <0.01). COVID-19 had a profound impact on the health of urban dwellers throughout China. Not only did they markedly increase their self- and community-protective behaviors, but they also experienced high levels of anxiety associated with a heightened vulnerability like depression, having poor perceived health, and the potential of increased exposure to COVID-19 such as living closer to the epicenter of the pandemic.

13.
MEDLINE;
Preprint in English | MEDLINE | ID: ppcovidwho-326589

ABSTRACT

Accurate serological assays to detect antibodies to SARS-CoV-2 are needed to characterize the epidemiology of SARS-CoV-2 infection and identify potential candidates for COVID-19 convalescent plasma (CCP) donation. This study compared the performance of commercial enzyme immunoassays (EIAs) to detect IgG or total antibodies to SARS-CoV-2 and neutralizing antibodies (nAb). The diagnostic accuracy of five commercially available EIAs (Abbott, Euroimmun, EDI, ImmunoDiagnostics, and Roche) to detect IgG or total antibodies to SARS-CoV-2 was evaluated from cross-sectional samples of potential CCP donors that had prior molecular confirmation of SARS-CoV-2 infection for sensitivity (n=214) and pre-pandemic emergency department patients for specificity (n=1,102). Of the 214 potential CCP donors, all were sampled >14 days since symptom onset and only a minority had been hospitalized due to COVID-19 (n=16 [7.5%]);140 potential CCP donors were tested by all five EIAs and a microneutralization assay. When performed according to the manufacturers' protocol to detect IgG or total antibodies to SARS-CoV-2, the sensitivity of each EIA ranged from 76.4% to 93.9%, and the specificity of each EIA ranged from 87.0% to 99.6%. Using a nAb titer cutoff of >=160 as the reference positive test (n=140 CCP donors), the empirical area under receiver operating curve of each EIA ranged from 0.66 (Roche) to 0.90 (Euroimmun). Commercial EIAs with high diagnostic accuracy to detect SARS-CoV-2 antibodies did not necessarily have high diagnostic accuracy to detect high nAbs. Some but not all commercial EIAs may be useful in the identification of individuals with high nAbs in convalescent individuals.

14.
PUBMED; 2021.
Preprint in English | PUBMED | ID: ppcovidwho-293003

ABSTRACT

Serologic, point-of-care tests to detect antibodies against SARS-CoV-2 are an important tool in the COVID-19 pandemic. The majority of current point-of-care antibody tests developed for SARS-CoV-2 rely on lateral flow assays, but these do not offer quantitative information. To address this, we developed a new method of COVID-19 antibody testing employing hemagglutination tested on a dry card, similar to that which is already available for rapid typing of ABO blood groups. A fusion protein linking red blood cells (RBCs) to the receptor-binding domain (RBD) of SARS-CoV-2 spike protein was placed on the card. 200 COVID-19 patient and 200 control plasma samples were reconstituted with O-negative RBCs to form whole blood and added to the dried protein, followed by a stirring step and a tilting step, 3-minute incubation, and a second tilting step. The sensitivity for the hemagglutination test, Euroimmun IgG ELISA test and RBD-based CoronaChek lateral flow assay was 87.0%, 86.5%, and 84.5%, respectively, using samples obtained from recovered COVID-19 individuals. Testing pre-pandemic samples, the hemagglutination test had a specificity of 95.5%, compared to 97.3% and 98.9% for the ELISA and CoronaChek, respectively. A distribution of agglutination strengths was observed in COVID-19 convalescent plasma samples, with the highest agglutination score (4) exhibiting significantly higher neutralizing antibody titers than weak positives (2) (p<0.0001). Strong agglutinations were observed within 1 minute of testing, and this shorter assay time also increased specificity to 98.5%. In conclusion, we developed a novel rapid, point-of-care RBC agglutination test for the detection of SARS-CoV-2 antibodies that can yield semi-quantitative information on neutralizing antibody titer in patients. The five-minute test may find use in determination of serostatus prior to vaccination, post-vaccination surveillance and travel screening.

15.
Kathmandu Univ Med J (KUMJ) ; 19(74):137-142, 2021.
Article in English | PubMed | ID: covidwho-1529534

ABSTRACT

Background The spread of SARS-CoV-2 has become a global public health crisis. Nepal is facing the second wave of COVID-19 pandemic but, there is still a limited data on the genomic sequence of SARS-CoV-2 variants circulating in Nepal. Objective The objective of this study is to sequence the whole genome of SARS-CoV-2 in Nepal to detect possible mutation profiles and phylogenetic lineages of circulating SARSCoV-2 variants. Method In this study, swab samples tested positive for SARS-CoV-2 were investigated. After RNA extraction, the investigation was performed through real-time PCR followed by whole genome sequencing. The consensus genome sequences were, then, analyzed with appropriate bioinformatics tools. Result Sequence analysis of two SARS-CoV-2 genomes from patient without travel history (Patient A1 and A2) were found to be of lineage B.1.1. Similarly, among other four samples from subjects returning from the United Kingdom, genomes of two samples were of lineage B.1.36, and the other two were of lineage B.1.1.7 (Alpha Variant). The mutations in the consensus genomes contained the defining mutations of the respective lineages of SARS-CoV-2. Conclusion We confirmed two genomic sequences of variant of concern VOC-202012/01 in Nepal. Our study provides the concise genomic evidence for spread of different lineages of SARS-CoV-2 - B.1.1, B.1.36 and B.1.1.7 of SARS-CoV-2 in Nepal.

16.
Journal of BP Koirala Institute of Health Sciences ; 4(1):48-55, 2021.
Article in English | CAB Abstracts | ID: covidwho-1496938

ABSTRACT

Health is a fundamental right for which concerned sides should bear the responsibility at the individual, societal, state, and international level. Not only curative but preventive, promotive, and rehabilitative services should also be availed in accessible, affordable, and acceptable form. The quest for health becomes more intense during adverse periods like a pandemic. The whole world has witnessed the COVID-19 pandemic, the unprecedented pandemic of this century. This quest is more dismal in developing nations like Nepal when even resource- rich countries are laid down by it. The quest of health demands, hence more during this pandemic, for the bearing of the responsibility by all. Here, we have made an attempt to draw together the general and some specific responsibilities of various direct stakeholders in this pandemic with multifaceted mayhem. We have incorporated here, the responsibilities of the public, COVID and non-COVID patients, media personnel, health science students, professionals, institutions, state, and media to ensure or safeguard the health of self and others in this pandemic.

17.
Sleep ; 44(SUPPL 2):A267, 2021.
Article in English | EMBASE | ID: covidwho-1402644

ABSTRACT

Introduction: Obstructive sleep apnea (OSA) is the second most common sleep disorder among Veterans and carries risk of serious health complications when untreated. The gold standard for OSA treatment is Positive Airway Pressure (PAP). However, adherence to PAP therapy is chronically low. Interventions to enhance adherence include education, practical support, and psychotherapy. Cognitive behavioral therapy and motivational interviewing have been shown to improve CPAP usage by approximately 1 hour per night. Telemedicine-delivered CPAP education and telemonitoring-with-feedback has demonstrated improved adherence in patients with OSA. Our study evaluated the effectiveness of a telemedicine group psychotherapy intervention for Veterans diagnosed with OSA and found to be nonadherent to CPAP therapy. The intervention is delivered in four weekly 60-minute sessions. Methods: We identified a cohort of 29 patients who participated in the intervention via telemedicine from April 2020 - September 2020 (Telemedicine Psychotherapy cohort). The cohort was compared to a historical control of 35 patients who participated in the in-person group psychotherapy from April 2019 - September 2019 (In-Person Psychotherapy cohort). Through retrospective chart review, we analyzed baseline and post-intervention data from both cohorts. Demographics collected included age, sex, BMI, ethnicity, zip code, as well as medical and mental health comorbidities. Data collected from the medical record included: OSA severity, pre- and post-psychotherapy 90-day average nightly CPAP usage (in minutes), number of psychotherapy classes attended (out of 4) and number of sleep clinic visits at 90-days post-psychotherapy. We used descriptive statistics to provide summary data of this sample and t-test to evaluate Veteran's average CPAP usage per night and number of sleep clinic visits at 90-days post-psychotherapy between cohorts. Results: Compared to a cohort of in-person group psychotherapy to improve CPAP adherence, a telemedicine-based cohort demonstrated improvement in 90-day average nightly CPAP usage by an average of 76 minutes per night. (p=0.08) Additionally, patient engagement with the sleep clinic at 90 days following completion of telemedicine psychotherapy was significantly higher compared to in-person psychotherapy (p<0.001). Conclusion: In a haphazardly-collected convenient sample of veterans during the COVID-19 pandemic, telemedicine psychotherapy led to improved CPAP usage. Veterans who underwent telemedicine intervention also significantly increased engagement with the sleep clinic.

18.
Annals of Behavioral Medicine ; 55:S388-S388, 2021.
Article in English | Web of Science | ID: covidwho-1250754
19.
Annals of Behavioral Medicine ; 55:S388-S388, 2021.
Article in English | Web of Science | ID: covidwho-1250489
20.
Kathmandu University Medical Journal ; 18(4):72-75, 2020.
Article in English | GIM | ID: covidwho-1196248

ABSTRACT

Background: The global health community has emphasized the importance of reporting epidemiological data by age and sex groups in the COVID-19 pandemic. However, age and sex disaggregated data of COVID-19 cases and deaths are rarely reported. Such data are very crucial for public to make truly informed choices about their own diseases risk and also for governments for public policy response. Objective To assess age and gender difference among COVID-19 cases and deaths in Nepal. Method This is a retrospective study which uses public data on COVID-19 cases and deaths released by Ministry of Health and Population, Government of Nepal from January to November, 2020. The data analysis was carried out using SPPS software version 26. Result Nepal reported 233,452 confirmed cases and 1,566 deaths of COVID-19 from 23 January 2020 to 30 November 2020. We found statistically significant differences on COVID-19 cases by age and gender in Nepal with higher number of cases among males of economically active age groups (20-60 years). Similarly, we found significant difference in COVID-19 mortality with more death occurred among male group compared to female group and with highest number of deaths among the people of above 60 years. Furthermore, we found differences in cases and deaths among provinces. Conclusion The age and gender differences in COVID cases and deaths in Nepal indicates needs of considering age and sex groups seriously while planning for testing, case management and vaccination against COVID-19 infections in Nepal.

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