Attitude of the staff nurses toward COVID care and work challenges faced by them.

Background: At the beginning of pandemic, many of the nurses were scared of contracting COVID infection by themselves. The work of nurses during the pandemic was highly appreciated by the society though they worked with severe challenges. Hence, it was utmost necessary to explore the attitude of the nurses toward COVID care and what challenges they faced during caring for the COVID patients. Objectives: The main objectives of the study were to assess the attitude of the nurses toward working in COVID units, to identify the challenges faced by the nurses, and to find out the relationship between the nurses attitude and challenges. Methods: The study was carried out adopting descriptive survey design with 190 conveniently selected staff nurses working in the selected COVID care units of Kolkata and Bankura. Two self-developed rating scales were administered using self-reporting method to measure the attitude and challenges of the nurses. Results: All the staff nurses expressed their favorable (positive) attitude. Maximum (64.21%) of the staff nurses had a high level of challenges. A very weak positive correlation found between attitude of the staff nurses toward COVID care and challenges they faced (ρ = 0.197, P = 0.006). Computation of Chi-square test revealed that neither attitude nor challenges was influenced by any of the personal characteristics of the nurses. Conclusion: In spite of working with a high level of challenges, the majority of the nurses demonstrated favorable attitude toward taking care of COVID patients.

Dual insulin resistance causes: how frequently type 2 diabetes mellitus and COVID-19 infection caused diabetic ketoacidosis? a case report.

Infection with coronavirus disease 2019 (COVID-19) worsens insulin resistance and causes diabetic ketoacidosis (DKA). Patients with COVID-19 infection who develop DKA run the risk of worse outcomes. In both diabetic and nondiabetic patients, the COVID-19 infection may hasten the development of ketoacidosis, which could have negative effects on the fetus. Case presentation: A 61-year-old retired Black African female was taken into the emergency room on 22 April 2022, with significant complaints of frequent midnight urination, shortness of breath, blurry vision, and tingling in her hands and feet. On a chest radiography, bilateral diffuse, patchy airspace opacities that might be due to multifocal pneumonia or viral pneumonia were seen. The severe acute respiratory syndrome infection was confirmed by real-time reverse transcription-PCR testing from nasopharyngeal swabs. She received intravenous fluids and an intravenous insulin infusion and monitored her blood electrolyte levels as part of her treatment. She received subcutaneous enoxaparin 80 mg every 12 h a day for prophylaxis of deep venous thrombosis due to her confirmed COVID-19. Clinical discussion: In a large number of patients, COVID-19 has the ability to trigger DKA, and type 2 diabetes mellitus amplifies the underlying COVID-19 infection. Diabetes mellitus and COVID-19 are noted to have a reciprocal relationship in this regard. Conclusions: By making the body resistant to insulin and raising blood sugar levels, a COVID-19 infection can cause DKA. It is probable that her severe acute respiratory syndrome coronavirus 2 infection has a detrimental effect on the pancreatic beta cells, which are responsible for her body producing insufficient levels of insulin.

Breastfeeding and infection control measures among lactating COVID-positive mothers: a retrospective study

Background: Exclusive breastfeeding along with infection prevention measures is recommended for lactating COVID-positive mothers as benefits outweigh the risk. Aims and Objectives: The present study was undertaken to assess the feeding and infection prevention measures among the COVID-19 infected lactating mothers in Indira Gandhi Medical College and Research Institute, Puducherry to identify areas of concern. Materials and Methods: The cross-sectional and observational study was conducted by telephonic survey after verbal consent on a series of 103 COVID-positive postnatal mothers regarding their feeding practices and infection prevention measures. Descriptive statistics was used. Results: Breastfeeding was given by 72 (69.9%), mixed feeding by 27 mothers (26.2%), and formula feeds by four (3.9%). Overall, exclusive breastfeeding was given by 66 mothers (64.1%). With respect to infection prevention measures, high performance of frequent/always was observed for use of hand hygiene (n=90, 87.3%) and use of mask (n=81, 78.5%). Conclusion: Despite the pandemic situation, the most COVID-positive mothers breastfed their infants with fair compliance to infection prevention measures.

Case report on rare otologic sequelae of coronavirus disease-2019: Labyrinthine ossificans

Among multiple etiologies of hearing loss, viral infections often goes unnoticed due to flu like symptoms.Otologic dysfunctions have been reported with COVID – 19 infection as well. however, this case report is unique in terms of otologic dysfunction following the COVID illness. This case report is indicative of the intracochlear damage following COVID - 19 illness. So far, there is no reported case of LO following COVID -19 in the literature. This article brings out the first reported case of SNHL due to labyrithnine ossificans following covid-19 infection.

Oxygen Cylinder Fire during the COVID-19 Pandemic.

The coronavirus disease-2019 (COVID-19) pandemic has resulted in the massive utilization of oxygen cylinders during the treatment of patients. This rapid turnover has necessitated their frequent replacements. Infection control measures have encouraged the use of alcohol-based sanitizers. Over-enthusiastic or inappropriate use of these solutions may increase the risk of fire. We report an unfortunate incident of accidental fire arising out from the integration of fuel, a source of ignition, and oxygen. We also discuss the proper practices to minimize such mishaps. How to cite this article: Paliwal B, Kothari N, Purohit A. Oxygen Cylinder Fire during the COVID-19 Pandemic. Indian J Crit Care Med 2022;26(8):974-975.

Decompressive hemicraniectomy for acute ischemic stroke associated with coronavirus disease 2019 infection: Case report and systematic review.

BACKGROUND: Decompressive hemicraniectomy (DH) has been performed for some cases of acute ischemic stroke in patients with coronavirus disease 2019 (COVID-19) infection, but there is little information about the clinical course and outcomes of these patients. CASE DESCRIPTION: We report a case of a 36-year-old woman with COVID-19 infection who developed stroke like symptoms while under home quarantine. Cranial CT scan showed an acute left internal carotid artery (ICA) infarct. She subsequently underwent an emergent left DH. Despite timely surgical intervention, she succumbed to chronic respiratory failure. A systematic review of SCOPUS and PubMed databases for case reports and case series of patients with COVID-19 infection who similarly underwent a DH for an acute ischemic infarct was performed. There were eight other reported cases in the literature. The patients' age ranged from 33 to 70 years (mean 48), with a female predilection (2:1). Respiratory preceded neurologic symptoms in 83% of cases. The ICA was the one most commonly involved in the stroke, and the mean NIHSS score was 20. DH was performed at a mean of 1.8 days post-ictus. Only four out of the nine patients were reported alive at the time of writing. The most common cause of death was respiratory failure (60%). CONCLUSION: Clinicians have to be cognizant of the neurovascular complications that may occur during the course of a patient with COVID-19. DH for acute ischemic stroke associated with the said infection was reported in nine patients, but the outcomes were generally poor despite early surgical intervention.

A Complicated Case of COVID-19 and Hyperglycemic Hyperosmolar Syndrome in an Adolescent Male.

Emerging data demonstrate that comorbid conditions and older age are contributing factors to COVID-19 severity in children. Studies involving youth with COVID-19 and diabetes are lacking. We report the case of a critically ill adolescent male with obesity, type 2 diabetes, and COVID-19 who presented with hyperglycemic hyperosmolar syndrome (HHS). This case highlights a challenge for clinicians in distinguishing severe complications of COVID-19 from those seen in HHS. Youth with obesity and type 2 diabetes may represent a high-risk group for severe COVID-19 disease, an entity that to date has been well-recognized in adults but remains rare in children and adolescents.

COVID-19 Infection Risk and Depressive Symptoms Among Young Adults During Quarantine: The Moderating Role of Grit and Social Support.

Prior research has demonstrated that the adverse consequences of the coronavirus disease 2019 (COVID-19) pandemic may go beyond its economic hardships and physical health concerns, having a significant influence on psychological distress for individuals under quarantine. Nevertheless, relatively little attention has been paid to exploring the risk and protective factors in the link between COVID-19 infection risk and psychological distress among young adults. Following a socioecological framework, the current study examines the moderating role of grit (perseverance and consistency) and social support in the association between COVID-19 infection risk and depressive symptoms. A sample of 1,251 young adults under home quarantine (62.6% female; M age = 20.92 years, SD = 1.47; age ranged from 18 to 25 years) was involved in this study, and they were asked to complete a set of self-reported questionnaires online. Results of a linear regression analysis exhibited that COVID-19 infection risk was positively associated with depressive symptoms in young adults in quarantine. Moreover, moderation analyses showed that this association was moderated by perseverance and social support. To be specific, for those reporting higher levels of social support, this linkage was not significantly positive; in contrast, for those reporting lower levels of social support, perseverance was a significant protective factor for depressive symptoms when young adults were exposed to a high infection risk of COVID-19. The current study suggests that greater social support is essential to helping young adults deal with possible negative emotions in the context of the COVID-19 pandemic. Moreover, university-based counseling services should pay specific attention to those young adults with relatively insufficient social support resources and low levels of perseverance.

Timing of Intubation and In-Hospital Mortality in Patients With Coronavirus Disease 2019.

OBJECTIVES: To examine whether increasing time between admission and intubation was associated with mortality in patients with coronavirus disease 2019 who underwent mechanical ventilation. DESIGN: Retrospective cohort study of patients with severe acute respiratory syndrome coronavirus 2 infection who were admitted between January 30, 2020, and April 30, 2020, and underwent intubation and mechanical ventilation prior to May 1, 2020. Patients were followed up through August 15, 2020. SETTING: Five hospitals within the Mount Sinai Health System in New York City, NY. PATIENTS: Adult patients with severe acute respiratory syndrome coronavirus 2 infection who underwent intubation and mechanical ventilation. INTERVENTIONS: Tracheal intubation and mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: The primary outcome was in-hospital mortality. A hospital-stratified time-varying Cox model was used to evaluate the effect of time from admission to intubation on in-hospital death. A total of 755 adult patients out of 5,843 admitted with confirmed severe acute respiratory syndrome coronavirus 2 infection underwent tracheal intubation and mechanical ventilation during the study period. The median age of patients was 65 years (interquartile range, 56-72 yr) and 64% were male. As of the time of follow-up, 121 patients (16%) who were intubated and mechanically ventilated had been discharged home, 512 (68%) had died, 113 (15%) had been discharged to a skilled nursing facility, and 9 (1%) remained in the hospital. The median time from admission to intubation was 2.3 days (interquartile range, 0.6-6.3 d). Each additional day between hospital admission and intubation was significantly associated with higher in-hospital death (adjusted hazard ratio, 1.03; 95% CI, 1.01-1.05). CONCLUSIONS: Among patients with coronavirus disease 2019 who were intubated and mechanically ventilated, intubation earlier in the course of hospital admission may be associated with improved survival.