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Cureus ; 15(2): e35349, 2023 Feb.
Article in English | MEDLINE | ID: covidwho-2282375


AIM: The present study addressed overcoming the lacunae in the literature of psychiatric manifestations associated with rhino-orbital mucormycosis. The current study aimed to assess the symptoms of depression, anxiety, stress, coping measures, suicidal intent, and visual disability in patients of rhino-orbital mucormycosis (ROM) during the epidemic of the disease at the nodal tertiary care center in North India. METHODS: Fifty-four inpatients of laboratory-proven rhino-orbital mucor-mycosis (ROM) were included for an observational, cross-sectional study at nodal, designated COVID-19, and mucormycosis treating tertiary care hospital. Patients with Hindi Mini-Mental State Examination score <24, prior psychiatric illness, and severely ill requiring ventilator support were excluded. The psychological variables were assessed using Depression, Anxiety, and Stress Scale 21 (DASS 21), Beck's Suicide intent Scale, Coping Scale Questionnaire, and Visual disability scale (IND-VFQ33). Their socioeconomic status was assessed using the Modified Kuppuswamy Scale. RESULTS: Ninety percent of patients with ROM had diabetes mellitus. The majority (44%) of patients belonged to lower socioeconomic strata. Higher frequencies of severe depression (28%), extremely severe anxiety (26%), and mild stress (17%) were noted in the study participants. On the Tukey test, depression score was higher in patients of ROM compared to COVID (with ROM) (p-value= 0.016). On Tukey analysis, anxiety score was significantly higher in ROM patients compared to COVID (with ROM) patients (p-value = 0.018). Coping scores were significantly higher in COVID (with ROM) patients compared to ROM patients (p value = 0.035). Mild to moderate visual disability was noted in the study participants.  Conclusion: The current study reflects the association of higher depression and anxiety scores in cases with ROM that indicated higher mental health needs. Early assessment, early detection, and early intervention for psychological help, along with the multidisciplinary team, helped to improve the overall psychological outcome of the affected patients.

Ann Clin Microbiol Antimicrob ; 22(1): 1, 2023 Jan 03.
Article in English | MEDLINE | ID: covidwho-2196305


BACKGROUND: Carbapenem resistance is endemic in the Indian sub-continent. In this study, carbapenem resistance rates and the prevalence of different carbapenemases were determined in Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa during two periods; Pre-COVID (August to October 2019) and COVID (January to February 2021) in a north-Indian tertiary care hospital. METHODS: Details of patient demographics and clinical condition was collated from the Hospital Information System and detection of carbapenemases NDM, OXA-48, VIM, IMP and KPC was done by Polymerase chain reaction (PCR) in 152 and 138 non-consecutive carbapenem resistant isolates during the two study periods respectively. Conjugation assay and sequencing of NDM and OXA-48 gene was done on a few selected isolates. RESULTS: As compared to Pre-COVID period, co-morbidities and the mortality rates were higher in patients harbouring carbapenem resistant organisms during the COVID period. The overall carbapenem resistance rate for all the four organisms increased from 23 to 41% between the two periods of study; with Pseudomonas aeruginosa and Klebsiella pneumoniae showing significant increase (p < 0.05). OXA-48, NDM and co-expression of NDM and OXA-48 were the most common genotypes detected. NDM-5 and OXA-232 were most common variants of NDM and OXA-48 family respectively during both the study periods. CONCLUSION: Higher rate of carbapenem resistance in COVID times could be attributed to increase in number of patients with co-morbidities. However, genetic elements of carbapenem resistance largely remained the same in the two time periods.

Anti-Bacterial Agents , COVID-19 , Humans , Anti-Bacterial Agents/pharmacology , Tertiary Care Centers , COVID-19/epidemiology , Bacterial Proteins/genetics , Carbapenems/pharmacology , beta-Lactamases/genetics , Escherichia coli/genetics , Klebsiella pneumoniae/genetics
Indian J Tuberc ; 69(2): 157-160, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1253038


The whole world is wrestling against SARS-CoV-2 infection (COVID-19). COVID-19-TB co-infection is also reported but there are limited number of studies which analyze the impact of COVID-19 pandemic in TB diagnosis and management. In this retrospective study, we observed that the TB diagnosis was reduced in pandemic time. Before COVID-19 pandemic (March-December 2019), there were 644 TB tests out of which 127 were TB positive. In ongoing COVID-19 pandemic (January-October 2020), 484 TB tests were performed and 146 patients were TB positive. Male accounted for 64%/57% of TB cases in 2019/2020 whereas female patients were 35%/42% in 2019/2020. Increase in female TB positive cases was a noticeable feature. The newly diagnosed with TB cases in 2019/2020 were 112/130 respectively. Though, we have seen only 7 COVID-TB co-infection cases, we could not establish the causal relationship in COVID-TB co-infection. The increase in the number of TB positive cases during COVID-19 pandemic clearly showed how adversely COVID-19 has affected TB diagnosis and management. Anticipating the increase in TB cases in future, we emphasize the need to ensure continuous TB testing and treatment despite the pandemic burden. Further study on the COVID-TB co-infection in high TB-burden countries like India, is required to enable analyses of interactions, risk factors in COVID-19-TB co-infection.

COVID-19 , HIV Infections , COVID-19/epidemiology , Female , HIV Infections/epidemiology , Hospitals , Humans , India/epidemiology , Male , Pandemics , Retrospective Studies , SARS-CoV-2