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Background: At seasonal tourist destinations like Shimla, rooms may remain vacant and unoccupied during lean periods. To add on, pandemic has already shut many small lodging facilities. Background: The aim of this study is to improve our understanding of how homestay activities can contribute to revitalize sustainable tourism trends in Shimla, the study assumes particular importance in a period of economic crisis characterized by post COVID trauma. Methodology: A survey was conducted in Shimla after first wave of corona virus from September 20 to December 20 as soon as the travel restrictions were uplifted. The travel and accommodation preferences of tourists were observed and found to be shifting towards less frequently visited places avoiding mass tourism. To highlight the role of homestays in reviving these tourism trends, three objectives were identified. Two separate questionnaires were developed to get the quantitative and qualitative data for this research. The data was tabulated and evaluated using SPSS tool. Results: The findings presented the analysed profile of the potential homestay operators as well as visitors seeking homestay tourism. It also reports the motivations, expectation and experience of the tourists regarding various aspects of homestay. Conclusion: Homestays can act as potential vital tool in reviving tourism.
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Background: The World Health Organization (WHO) designated SARS-CoV-2 infection as coronavirus disease 2019 (Covid-19).Due to the government implication of Covid-19 specific guideline of using mask, there could be a significant decrease in the allergic rhinitis. Objective(s): Present study aims to analyze the changes in the trends of nasal allergies from hilly regions of Himachal Pradesh following Covid-19 pandemic. Method(s): The prospective data obtained from January 2022 to November 2022 was compared from the retrospective data available between January 2019 to November 2019. Prospectively, a total of 596 patients were included in the study. All these patients underwent Skin prick tests for common allergens. All these patients also underwent testing for total IgE levels in biochemistry lab of the hospital by chemiluminescence method.The results were compared with retrospective dataof 728 age sex match patients. Result(s): A significant difference in the allergen sensitivity was observed. The number of patients who were sensitized during Covid was comparatively less than those during Pre covid period.Dust mite, Cockroach, Peanut and Wheat revealed a non-significant odds ratio indicating that they were not true predictors for sensitization and non-sensitization. Whereas Grass pollen, Mould mix and Pine mix revealed a significant odds ratio. Usage of mask found to have an impact on improvement in symptoms. Majority of the patients who did not use mask had no improvement in symptoms. Majority of the patients had high IgE levels in pre covid period whereas it was normal for majority of them during covid. Conclusion(s): In our study, allergic rhinitis incidence decreased throughout the pandemic period. After pandemic, there was a noticeably decreased level of sensitivity to grass pollen, mould, and pine mix. Use of face masks lead to significant decrease in symptoms of allergic rhinitis.Copyright © 2022, Anka Publishers. All rights reserved.
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The unexpected nature of COVID-19 tested the institutional strength and resilience of state agencies across the world. Preliminary evidence is presented on how reduced mobility due to COVID-19 affected the functioning of the Forest Department in the northern Indian state of Himachal Pradesh and triggered changes in forest use by local communities as perceived by forest officials. Our evidence shows mixed outcomes in terms of the effectiveness of the forest bureaucrats in handling the COVID-19 pandemic as assessed through their own perceptions and other forestry records. The positive and negative elements relating to the bureaucratic forest administration during the COVID-19 lockdown are presented, and some possible reasons behind these varying patterns across the state of Himachal Pradesh are suggested. Lessons drawn from the COVID-19 crisis that can help guide forest bureaucracies to deal effectively with unpredictable events in the future are presented. © 2023 Commonwealth Forestry Association. All rights reserved.
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Background: Coronavirus disease 2019 (COVID-19) has rapidly become a worldwide concern ever since first being reported from Wuhan, China in December 2019. With no known cure, there is widespread fear-provoking interest in studying the factors contributing to mortality. Aim and Objectives: The current study was undertaken with a view to try to understand the cause of morbidity and mortality. Materials and Methods: A retrospective study done in our Institution on COVID-19 patients admitted over a course of 3 months after approval from Institutional Ethics Committee. Results: We had 17 deaths over the period under consideration whereas 73 patients improved (mortality = 19%, n = 90). Most of the patients were in the 41-80 years age group (>70%). No gender preponderance was found with mortality in each being around 20%. A clear correlation between co-morbidities and mortality was found with no person without any comorbidity succumbing to the disease. Respiratory and Heart conditions were found to contribute most to mortality with patients presenting with shortness of breath being most at risk. Similarly, a Neutrophil: Lymphocyte ratio greater than 12 was found to significantly increase the mortality. Conclusion: Patients with comorbidities need to be monitored closely with treatment being directed at improving the respiratory outcome.
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Introduction: Research on Coronavirus Disease-2019 (COVID-19) seroprevalence in children and adolescent population across the globe is quite limited. In India, there is a dearth of data on COVID-19 seropositivity, especially in unvaccinated paediatric population, particularly in the Himalayan region. Aim: To estimate the seroprevalence of COVID-19 in children presenting in a tertiary care health institution. Materials and Methods: A hospital-based cross-sectional serosurvey was conducted on 500 children, from October 2021 to March 2022 in paediatric age group, attending Indira Gandhi Medical College Shimla, Himachal Pradesh, India, for various health related concerns such as fever, cough, loose stools, vomiting and fast breathing using convenience sampling. Socio-demographic profile was recorded and blood sample was drawn for COVID-19 antibody titre estimation. Chi-squared and Fisher's-exact tests for proportions was used for testing statistical significance. Results: A total of 500 children, age ranged from 12 hours to 17 years 7 months were enrolled with maximum children belonging to 01-05 years age group and there was slight male preponderance. Seropositivity in males (27.3%) was significantly higher than females (8.3%). Highest (42.3%) seropositivity was seen in age group of 06 months to 01 year. About 10.8% of cases were positive for Immunoglobulin (Ig) G antibody, 4.4% were positive for IgM antibody, while about 6.6% cases were positive for both antibodies. Conclusion: The seroprevalence status of children and adolescents is quite low in this region, revealing the high susceptibility of children to SARS-CoV-2 in the study region. It further emphasises benefits of serological testing in children for SARS-CoV-2 as well as the need of safe and effective vaccination for the unimmunised, unprotected and vulnerable paediatric age group.
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Introduction: The entire world has been affected by Coronavirus disease 2019 (COVID-19) and experts all over the world are working hard to combat this global pandemic. There is a panic among people with resultant psychosocial consequences. Aim: To evaluate the fear factor of COVID-19 using Fear of COVID-19 Scale (FCV-19S) among two groups of patients, one with dermatological diseases managed with immunomodulators and second with dermatological diseases not requiring immunosuppression and also to counsel both the groups regarding the course of their disease and tailoring their visits to the hospital accordingly. Materials and Methods: This cross-sectional study was conducted from 16th January 2021 to 30th April 2021 in the Outpatient Department (OPD) of Dermatology of a tertiary care centre, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. Consecutive 52 patients meeting the inclusion criteria, with dermatological diseases requiring long-term immunosuppressive therapy and 49 patients with dermatological diseases or cosmetic concerns not requiring immunosuppressive treatment were enrolled for the study. The obtained data was analysed using Epi Info software version 7.2.4.0. results: A total number of 101 patients were enrolled in the study with a male to female ratio of 1.7:1. Mean age of patients was 41 years (range 18-71 years). Among them, 52 (51.49%) had chronic diseases with relapsing and remitting course requiring immunomodulator drugs and 49 (48.51%) had either cosmetic concerns or diseases not requiring immunomodulation. Seventeen (16.83%) of the total patients had other co-morbidites like diabetes mellitus, hypertension, chronic kidney disease or cardiac diseases. Out of all the study participants, 3 (2.9%) had severe fear, 16 (15.8%) had moderate fear, 36 (35.6%) had mild fear and 46 (45.5%) had no fear of COVID-19. conclusion: During this pandemic time, patients need to be counselled regarding the course and management of their diseases and stress factor should also be addressed.
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Background: To date, the 2019 novel coronavirus pneumonia (COVID-19) is the greatest public medical issue in the world. World Health Organization (WHO) declared this outbreak a “public health emergency of international concern” on January 31, 2020. Therefore, it bodes well to look for a potential biomarker that could quickly and effectively distinguish serious cases early. Of the total confirmed Covid-19 patients, the severe cases often suffer from underlying diseases such as cardiovascular disease and diabetes that can accelerate the movement of 2019 novel coronavirus (SARS-CoV-2) infection. Moreover, acute respiratory distress syndrome could lead to death in some severe Covid-19 patients, and various disorders often accompany this. Biochemical findings showed representative features of acute respiratory distress syndrome and association of multiple organs. Aim: To estimate routine biochemical parameters of patients admitted to the Covid-19 ward. Method: Clinical samples from cases of Covid-19 admitted to Adesh Medical College and Hospital, Mohri, Shahbad (M), Haryana, India, during 1st, 2nd, and 3rd waves were collected and analyzed. Result: In this study, we investigated routine biochemical investigations (RBS, LFT, RFT & Serum Electrolyte) of Covid-19 patients and calculated De Ritis ratio. It was found that biochemical parameters and De Ritis ratio were worse affected than the first and second waves. Conclusion: De Ritis ratio may be a good marker for liver abnormalities and prognosis and a hospital stay of the Covid-19 patients.
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Introduction: Medical education has been adversely affected during COVID-19 pandemic. Imparting medical education through e-platforms exclusively was a novel experience both for students and teachers. Even though online classes have been ongoing since almost a year and half, not much data on perception and experience about e-learning among medical students is available from India. Aim: To evaluate perceptions, experiences and challenges faced by medical students regarding e-learning during lockdown period owing to COVID-19 along with their future preferences. Materials and Methods: The present study was a questionnaire based cross-sectional survey regarding use of e-learning during COVID-19 pandemic among 340 MBBS (Bachelor of Medicine and Bachelor of Surgery) and Bachelor of Science Nursing (BSc-NUR) students. It was conducted in the Department of Pulmonary Medicine at Shri Lal Bahadur Shastri Medical College and Hospital Mandi, Himachal Pradesh, India from May-July 2021. Students perceptions’ of e-learning were assessed using the validated Technology Acceptance Model (TAM) model and responses were measured on 5-point Likert scale. Quantitative data was expressed by mean and standard deviation and significant level of differences between means were tested by Student’s t-test (unpaired). Proportions were compared by Chi-square test or Fisher’s-exact test. Results: Out of 400 students, 340 responded of which 225 were females. Of the total 340 students, 97.9% (n=333) respondents, had an idea of e-learning and more than half (n=188;55.3%) had used any type of e-learning platform prior to onset of COVID-19. More number of MBBS students had used e-learning than BSc-NUR students (55% v/s 41%;p=0.033). Cell phone was the most common device (n=324;95.3%) used. The quick sharing of material (n=258;76%) and flexibility (n=233;68.5%) were top rated benefits of e-learning. The key disadvantages were suboptimal practical training (n=222;65.3%) and lack of face-to-face interactions (n=146;43%). Majority of students voted for traditional learning (n=156;45.9%) closely followed by blended learning (n=140;41.2%). Conclusion: The students had an overall positive attitude towards e-learning and wanted to continue e-learning alongside traditional teaching i.e., blended learning. Exploration of merits and barriers to e-learning during pandemic can act as a guide to implement blended learning in medical curriculum for enhanced teaching/learning experience.
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Introduction: Thrombocytopenia is a common condition seen in clinical practice. A wide range of etiologies and variation in clinical presentation often pose a challenge in its diagnosis. Early recognition of thrombocytopenia and its causes can avoid critical bleeding. Aim: This study aimed to assess etiology and clinicopathological profile of thrombocytopenia in a tertiary care center. Materials and methods: Of all patients whose blood samples were received for complete blood count analysis, 500 patients with thrombocytopenia were included. Blood samples were run in Sysmex XP-100 and PCi 20 fully automated, three-part differential hematology analyzers. Leishman-stained peripheral blood smears were also studied. Results: Mild thrombocytopenia (platelet count 60,000-1,50,000/μl) was seen in majority (84.8%) of the patients followed by moderate thrombocytopenia (platelet count 20,000-60,000/μl) in 10.8% and severe thrombocytopenia (platelet count <20,000/μl) in 4.4% of the patients The most common cause of thrombocytopenia was found to be infections (50% patients) followed by chronic liver disease (14.8% patients), macrothrombocytopenia (10.6% patients), hematological disorders (8.6% patients), gestational thrombocytopenia (7.8% patients), drug intake (4.4% patients) and chronic kidney disease (1.8% patients). Among infections, acute febrile illness (nonspecific) was the most (23.2%) common cause followed by COVID 19 infection (19.4%) and bacterial sepsis (5.4% patients). Four distinct patterns of platelet histogram in patients with thrombocytopenia were seen. Conclusion: Similar to most previous studies, infections were the most common cause of thrombocytopenia in the present study. The present study also highlights two novel entities- suspected asymptomatic macrothrombocytopenia and Covid-19 infection.
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Aim: To determine the demographic profile of pregnant females with COVID-19 infection. The outcome and prognosis in pregnant women with COVID-19 infection was also evaluated. Method and material:The study included 38 pregnant women with COVID-19 infection and hospital admission for at least 24 hours. Cause of admission was classified as obstetric and COVID-19-related. All the patients were COVID positive and were referred from other centres/ hospital to this facility andwas admitted to this hospital for delivery. Primary outcomes included maternal admission to intensive care unit (ICU), COVID-19 pneumonia, maternal mortality. The information on socio-demographic factors, pre-gestational chronic diseases (including cardiac, renal, endocrine, psychiatric, hematologic and autoimmune disease, cancer and HIV)and mode of delivery was collected. Results:The mean age of the patients was 28.8±6.2 years. The mode of delivery for 60.5%patients(23) was normal vaginal delivery and lower segmentcaesarean section in 39.5%(15) patients.94.7%(36) patients were asymptomatic in the present study. Maximum patients in the present studywere hospitalized for 3-5 days. Conclusion: COVID-19 infection was associated with higher rates of caesarean section in pregnant women. However, COVID-19 cannot be considered as an indication for caesareansectiondelivery. Patients with increased age have more days of hospitalization than younger patient.