ABSTRACT
Background: Patients with obstructive sleep apnea (OSA), related to their disease consequences and treatment modalities, are physically and mentally vulnerable during the outbreak. Objectives: To investigate the association between pandemic-related changes and positive airway pressure (PAP) adherence and sleep quality in OSA patients. Methods: This was a multi-center cross-sectional study, and the necessary data were collected prospectively. A total of 221 patients were included in the study, who were invited from four different centers from June 1 - December 1, 2020. Pittsburgh Sleep Quality Index (PSQI) was administered to evaluate sleep quality. Information on demographics positive airway pressure (PAP) device use, Coronavirus disease (COVID-19) a questionnaire collected related changes. Patients >18 years with a diagnosis of OSA and prescribed PAP treatment before the pandemic period were included in the study. Lack of cooperation with the questionnaires and incompliant with PAP treatment for longer than one year were the exclusion criteria. Results: Of the 221 participants, 79.2% were men. The mean apnea-hypopnea index was obtained at 40.8+or-24.3. A positive COVID-19 test was reported in nine cases, and three patients had hospitalization. During the pandemic, 102 (46.2%) subjects were retired, 26 (11.8%) lost their jobs, and 34 (15.3%) reported home office work or on-call or on leave. Poor sleep quality was found in 54 (24.4%) individuals. It was also reported that poor sleep quality was more common in those who reported mask use difficulty (38.7% vs. 18.9%;P=0.004) and increased or decreased PAP use (increased, decreased, no change in PAP use: 45.5%, 36.0%, 19.4%, respectively;P=0.01). The good sleep quality group had higher PAP use than the poor sleep quality group (6.2+or-1.5 vs. 5.3+or-2.4 night/week;P=0.002;6.2+or-1.5 vs. 5.5+or-2.2 hour/night;P=0.01). Conclusions: Pandemic period had several negative effects on sleep apnea patients regarding sleep quality and social lives which also influenced PAP adherence in OSA patients. Most patients did not change their regular PAP use attitudes during this period. Similar to the pre-COVID-19 disease period, PAP adherence and compliance positively influenced sleep quality;people who were "good sleepers" were the ones who were the "good PAP device users".
ABSTRACT
Non-invasive ventilation (NIV) might be successful if carefully selected in adult patients with cardiac dysfunction presenting with community-acquired pneumonia. The main objective of this study was to identify the early predictors of NIV failure. Adult patients with left ventricle ejection fraction (LV EF) <50% admitted to the intensive care unit (ICU) with community-acquired pneumonia and acute respiratory failure were enrolled in this multicenter prospective study after obtaining informed consents (study registrationID: ISRCTN14641518). Non-invasive ventilation failure was defined as the requirement of intubation after initiation of NIV. All patients were assessed using the Acute Physiology and Chronic Health Evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores at admission, while their Heart rate Acidosis Consciousness Oxygenation and Respiratory rate (HACOR) and lung ultrasound (LUS) scores in addition to blood lactate were assessed at NIV initiation and 12 and 24 hours later. A total of 177 patients were prospectively enrolled from February 2019 to July 2020. Of them, 53 (29.9%) had failed NIV. The mean age of the study cohort was 64.1+or- 12.6 years, with a male predominance (73.4%) and a mean LV EF of 36.4 +or- 7.8%. Almost 55.9% of the studied patients had diabetes mellitus, 45.8% had chronic systemic hypertension, 73.4% had ischemic heart disease, 20.3% had chronic kidney disease, and 9.6% had liver cirrhosis. No significant differences were observed between the NIV success and NIV failure groups regarding underlying morbidities or inflammatory markers. Patients who failed NIV were significantly older and had higher mean SOFA and APACHE II scores than those with successful NIV. We also found that NIV failure was associated with longer ICU stay (p < 0.001), higher SOFA scores at 48 hours (p < 0.001) and higher mortality (p < 0.001) compared with the NIV success group. In addition, SOFA (Odds Ratio (OR): 4.52, 95% Confidence Interval (CI): 2.59-7.88, p < 0.001), HACOR (OR: 2.01, 95% CI: 0.97-4.18, p = 0.036) and LUS (OR: 1.33, 95% CI: 1.014-1.106, p = 0.027) scores and blood lactate levels (OR: 9.35, 95% CI: 5.32-43.26, p < 0.001) were independent factors for NIV failure. High initial HACOR and SOFA scores, persistent hyperlactatemia and non-decrementing LUS score were associated with early NIV failure in patients with cardiac dysfunction presenting with community-acquired pneumonia, and could be used as clinical and paraclinical variables for early decision making regarding invasive ventilation.
ABSTRACT
Background: Although research on mathematics learning programs has taken off in recent years, little is known about how different person characteristics are related to practice behaviour with such programs. When implementing a mathematics learning program in the classroom, it might be important to know whether students with specific characteristics need more encouragement to make use of this learning opportunity. Objectives: Using a supply‐use model, we analysed the predictive power of students' cognitive characteristics (prior mathematics knowledge), personality traits (conscientiousness), motivational‐affective characteristics (mathematics self‐concept and mathematics anxiety), and family background characteristics (socioeconomic status and migration background) for practising with an adaptive arithmetic learning program. Methods: We used longitudinal data from 203 fifth graders from seven non‐academic‐track schools in Germany. Practice behaviour, measured by completed tasks in the learning program, was recorded weekly for every student over a period of 22 weeks. Results and Conclusions: The results of our multilevel analyses showed that mathematics anxious students practised less with the program. We did not find any relationship with the other characteristics. Takeaways: Our results suggest that mathematics anxious students need more encouragement when practising with a mathematics learning program;otherwise, they do not get the chance to benefit from the use. Lay Description: What is already known about this topic: The use of mathematics learning programmes in mathematics education has recently intensified.It is important that students practice with such learning programmes regularly over a longer period of time in order for them to achieve learning success.Students differ in their mathematics learning behaviour. What this paper adds: Little is known about how person characteristics are related to practice behaviour with mathematics learning programmes.Students may differ in their use of a mathematics learning programme, which is why cognitive characteristics, personality traits, motivational‐affective characteristics, and family background characteristics may affect students' practice behaviour. Implications for practice: Mathematics anxious students practiced less with a mathematics learning program, and need more encouragement to benefit equally from the implementation in school.Teachers should keep in mind that after the initial enthusiasm, practice with a programme may decrease over time, especially after school holidays.
ABSTRACT
The COVID-19 pandemic has had massive impacts across the globe. Children with developmental delays are an increasingly vulnerable population, highlighting the importance of ensuring they have access to high-quality virtual services during this time. The Early Discovery program currently provides therapeutic interventions for children with mild developmental delays. We sought to compare the outcomes of 2 cohorts within the Early Discovery program using different delivery approaches (n = 238 families): children who received services in person before the pandemic (n = 126) and children who received services via telehealth in the acute phase of the pandemic (n = 112). Both groups of children showed significant improvements in language skills posttreatment, and, with regard to auditory comprehension, both groups showed similar rates of improvement. However, children receiving in-person services before the pandemic showed greater improvements in expressive communication skills than children receiving telehealth services during the pandemic. Results indicate that the Early Discovery program was able to make adjustments during the pandemic that assisted families in maintaining progress in improving their child's language skills.
ABSTRACT
Objective: To look for any relationship between severe/critical coronavirus disease 2019 (COVID-19) illness and post-discharge cardiac function, and also assess any correlation between this and post-COVID symptom burden. Design: Observational cohort study with both retrospective and prospective components. Setting: Intensive Care Unit (ICU) and subsequent outpatient clinic at a tertiary hospital in Western Sydney, New South Wales (NSW), Australia. Patients: All patients admitted to the ICU with COVID-19 infection between 01 July 2021 and 31 December 2021 were included (n=89). Interventions: The cohort was divided into survivors (n=61) and non-survivors (n=28). Those who underwent transthoracic echocardiography (TTE) (survivors, n=22;and non-survivors, n=23). The survivors who had an inpatient TTE were invited back for a repeat TTE and standardised symptom assessment questionnaire (COVID-19 Yorkshire Rehabilitation Scale [C19-YRS]). For all patients, demographic, clinical, biochemical, and pharmacologic data was collected. Measurements and results: Eighty-nine patients were included in the initial dataset, of which 45 had a TTE whilst acutely unwell, and 22/45 survived to hospital discharge. There were no significant differences in the measured TTE parameters between survivors and non-survivors. Of the survivors with a follow-up TTE, the majority of the changes seen in the initial study had resolved. Despite this, there was still an appreciable symptom burden in the domains of fatigue, breathlessness, ability to independently do activities of daily living, and overall reduced perception of health. Conclusions: In a cohort of critically unwell COVID-19 patients, there were no significant echocardiographic differences between survivors and non-survivors. For the survivors, whilst the majority of acute cardiac changes associated with COVID-19 infection resolved over time, however, there remained a significant symptom burden, including breathlessness and fatigability, suggesting a non-cardiac aetiology of these symptoms.
ABSTRACT
Main effect models contend that perceived social support benefits mental health in the presence and the absence of stressful events, whereas stress-buffering models contend that perceived social support benefits mental health especially when individuals are facing stressful events. We tested these models of how perceived social support impacts mental health during the COVID-19 pandemic and evaluated whether characteristics of everyday social interactions statistically mediated this association – namely, (a) received support, the visible and deliberate assistance provided by others, and (b) pleasantness, the extent to which an interaction is positive, flows easily, and leads individuals to feel understood and validated. 591 United States adults completed a 3-week ecological momentary assessment protocol sampling characteristics of their everyday social interactions that was used to evaluate between-person average values and within-person daily fluctuations in everyday social interaction characteristics. Global measures of perceived social support and pandemic-related stressors were assessed at baseline. Psychiatric symptoms of depression and anxiety were assessed at baseline, at the end of each day of ecological momentary assessment, and at 3-week follow-up. Consistent with a main effect model, higher baseline perceived social support predicted decreases in psychiatric symptoms at 3-week follow-up (β = −.09, p =.001). Contrary to a stress-buffering model, we did not find an interaction of pandemic-stressors × perceived social support. The main effect of perceived social support on mental health was mediated by the pleasantness of everyday social interactions, but not by received support in everyday social interactions. We found evidence for both main effects and stress-buffering effects of within-person fluctuations in interaction pleasantness on daily changes in mental health. Results suggest the importance of everyday social interaction characteristics, especially their pleasantness, in linking perceived social support and mental health.
ABSTRACT
Objective: In this study, the effect of having had coronavirus disease-2019 (COVID-19) disease on anti-vaccination was investigated. Material and Methods: The study was conducted between February 2022-August 2022 in the COVID chest diseases clinic in our hospital. The cases who were COVID-19 vaccine hesitancy and not vaccinated against COVID-19 hospitalized in our clinic were included in the study. The level of anti-vaccination of the cases was measured with the Vaccine Hesitancy Scale (VHS). In addition, demographic informations such as age, gender, educational status, marital status, number of people living in the household, average monthly income, smoking history, and additional chronic diseases were recorded. Routine radiological and laboratory examinations, follow-up times in the clinic, and treatment results were recorded for cases like all patients hospitalized in our COVID chest diseases clinic. Results: 46 cases were included in the study. The mean age of the cases was 54.63+or-14.81 years, 24 (52.1%) were female. VHS was applied to all cases at the time of hospitalization. Since 6 cases were referred to the intensive care unit due to respiratory failure, the second VHS could not be applied to these cases, and these 6 cases were excluded from the study. A 2nd VHS was performed in the remaining 40 patients just before discharge. Each question score, A-B-C section score and total scale score were compared for the pre-COVID-19 and post-COVID-19 cases. While the VHS total score before COVID-19 infection was 36.48+or-7.36, the post-COVID-19 total score was found to be 25.65+or-9.10, a statistically significant decrease was observed (p < 0.001). It was observed that the mean scores of A-B-C decreased statistically in all sections (p < 0.001). Conclusion: As a result of our study, we found that the degree of anti-vaccine resistance decreased after the patients who were against the COVID-19 vaccine had the disease. As a result of our study, we found that the degree of COVID-19 vaccine hesitancy of patients decreased after they had the disease. We believe that conducting similar studies and sharing their results through mass media, can change the perspective of vaccine hesitancy individuals in society on this situation, especially during pandemic periods.
ABSTRACT
Background: Adequate glycemic control improves the prognosis of patients hospitalized for pneumonia associated with severe COVID-19. Objective: To evaluate the impact of hyperglycemia (HG) on the prognosis of patients hospitalized for severe pneumonia associated with COVID-19 in unvaccinated patients. Material and methods: Prospective cohort study. We included patients hospitalized from August 2020 to February 2021, with severe COVID-19 pneumonia, not vaccinated against SARS-CoV-2. Data was collected from admission to discharge. We used descriptive and analytical statistics according to the data distribution. ROC curves were used to determine the cut-off points with the highest predictive performance for HG and mortality, with the IBM SPSS program, version 25. Results: We included 103 patients, 32% women, 68% men, age 57 +/- 13 years;58% were admitted with HG (191, IQR 152-300 mg/dL) and 42% with normoglycemia (NG < 126 mg/dL). Mortality was higher in HG at admission 34 (56.7%) than in NG 13 (30.2%) (p = 0.008). HG was associated with diabetes mellitus 2 and neutrophilia (p < 0.05). The risk of death increases 1.558 times (95% CI 1.118-2.172) if HG is at admission and 1.43 times (95% CI 1.14-1.79) during hospitalization. Maintaining NG throughout the hospitalization contributed independently to survival (RR = 0.083 [95% CI 0.012-0.571], p = 0.011). Conclusion: HG significantly impacts prognosis by increasing mortality more than 50% during hospitalization for COVID-19. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
Background: Coronavirus disease 2019, first reported in December 2019 mainly presented with the symptoms of Cough, Fever, Shortness of breath, Myalgia, Weakness and anosmia. C-reactive Protein (CRP) is an acute-phase reactant protein which is synthesized by the liver in response to raised levels of interleukin-6 (IL-6) which is a biomarker of inflammation. Methods: This was a prospective observational study, done on 110 COVID-19 patients after applying inclusion and exclusion criteria. Detailed history, vaccination status, presence of comorbidities and thorough clinical examination was performed. Serum CRP levels was assessed and Computed Tomographic scan (CT scan) of Thorax was done. CORADS scoring and CT severity grading as per CT scan was done. All the above parameters were recorded in the preformed proforma and data was entered in excel spreadsheet and was analysed using SPSS v26 software. Results: Majority were males (56.3%) and majority were from 61-80 years of age. Majority (57.3%) patients were non-smokers. Hypertension was the most common associated comorbidity (86.4%) (r=0.743, p=0.000). There is a strong positive correlation between CRP levels and CTSS in COVID 19 patients and a strong negative correlation between the CRP levels and outcome of COVID-19 patients (r=-0.449, p=0.000). Conclusion: Elevated serum CRP value is associated with disease progression and poorer outcome.
ABSTRACT
Background: Coronavirus is a highly infectious novel virus we are in urge to know more about their clinical characteristics and laboratory findings for the characterization and selection of treatment protocol. Methods: Prospective, single centre study. Two months data was collected, clinical characteristics data from patient case sheet and the laboratoryvalues from the Hospital Information System (HIS) for the month of July and August 2020. Results: Of 462 patients, 55 (11.9%) are falls under asymptomatic category, 194 (42%) are in mild category, 167 (36.1%) are in moderate category and 46 (10%) in severe category. Fever 230 (49.8%) and cough 211 (45.7%) was most common clinical symptom with p value < 0.01. Non-severe vs severe, 340 (73.6%) and 201 (43.5%) showed decreased in eosinophil count and absolute eosinophil count, 125 (27.1%) and 80 (17.3%) patient showed decrease in lymphocyte count and absolute lymphocyte count, 200 (43.3%) showed increase in neutrophil count with a significance of p value >0.05.186 (40.3%) patients had one or more co-morbidities. Laboratory findings between Asymptomatic VS symptomatic, showed significance changes in neutrophil, lymphocyte, Aspartate aminotransferase, Alkaline phosphatase, globulin values (p value <0.05). Conclusion: Clinical severity categorization at the time of admission was very helpful for the treating doctors in proper understanding of disease progression and appropriate treatment of the patient. Presence of co-morbidity, abnormal laboratory values, old age group patients, higher Computed Tomography score, higher mortality rate are seen more in patients who were in clinical severity grade severe category than in non-severe category patients.
ABSTRACT
Introduction: According to scientific studies, a high incidence of thrombotic events is known in hospitalized patients with COVID-19. Less than 50% of pulmonary embolisms (PE) are associated with signs of deep vein thrombosis (DVT) of the lower extremities. Background: To identify significant risk factors for thrombosis thrombosis (DVT) in intensive care patients with COVID-19. Materials and methods: We conducted a prospective cross-sectional study that included 465 adult patients with laboratory-confirmed COVID-19 admitted to the intensive care unit. All patients underwent computer tomography of the chest organs, ultrasound angioscanning of lower extremities, body mass index was calculated, the presence of comorbotity diseases and indicators of volumetric blood saturation were considered. The level of D-dimer in blood plasma, coagulation parameters (fibrinogen, factor VIII) were taken from laboratory parameters in calculations. For subgroups with 5 or fewer people, the chi-square test and Fisher's exact test were used. For quantitative variables, analysis of variance (ANOVA) and the Pearson and Spearman correlation coefficient were used. For multiple variables, ordered logistic regression models were built, with likelihood ratio tests performed to compare the models. Results: A total of 465 patients were included in the study. Comorbidities were present in 435 of 465 patients (93.55%) had at least one comorbidity. The most common was arterial hypertension - 370 (79.57%), followed by chronic heart failure - 196 (42.15%), obesity - 161 (34.62%), diabetes mellitus - 144 (30.97%), chronic renal failure (CRF) -58 (12.47%) and oncological diseases -25 (5.38%). The average body mass index was 29.7 kg/m2. In patients with DVT and venostasis, the body mass index (BMI) was more than 30 kg/m2 than without DVT (32.57+or-10.92 kg/m2, and 30.24+or-6.85 kg/m2, versus 29.22+or-6.46 kg/m2, respectively). Ultrasound angioscanning (USAS) confirmed deep vein thrombosis in 60 patients (13.8%) and was associated with older age (71.12+or-13.98 versus 67.20+or-11.16, p < 0.006), venous stasis was detected in 56 patients (12%) no DVT was detected in the rest of the studied patients. In the majority of cases, DVT was detected in the tibial segment -26 (43.33%), in 18 (30%) patients it was diagnosed in the popliteal veins and in 14 (23.33%) cases in the femoral segment. Diabetes mellitus (p=0.041), obesity (p=0.01) and CRF (p=0.028) were also significant risk factors for DVT. Conclusions: Significant risk factors for deep vein thrombosis in intensive care patients with COVID-19 are high levels of D-dimer (>=2.33 g/ml) and comorbidities such as obesity, chronic kidney failure, and diabetes mellitus.
ABSTRACT
Background: Countries around the world are now racing to vaccinate people against SARS-CoV-2, the virus that causes COVID-19. The Government of India also rolled out its vaccination drive from 16th January '2021. Aims: To estimate the antibody response of the COVID-19 vaccine in the form of SARS-COV-2 IgG antibodies in vaccinated healthcare workers.Methods: Prospective follow-up was study conducted on healthcare workers (HCWs) of a Medical college in Dehradun, Uttarakhand. Healthcare workers who have been vaccinated for COVID-19 were tested for SARS-CoV-2-IgG antibodies at regular intervals i.e at 4 weeks after the 1st dose and then again at 4 weeks after the 2nd dose. The third sample was taken 6 months after the 2nd dose. Results: A total of 302 HCWs were enrolled in the study who gave their samples for IgG antibody estimation after the Covishield vaccine. After 4 weeks of completion of both doses, 96% HCWs formed SARS-COV-2 IgG antibodies, whereas 4% didn't. Then after 6 months of follow-up, 14% HCWs have become negative for antibodies and better immunity is seen in people who also got infected with COVID-19 during this time.Conclusion: This study concludes that the immunity gained after vaccination is waning off in around 6 months and there is a need for a booster dose, especially for people at high risk. The infection control practices still play a crucial role in the prevention of this deadly disease.
ABSTRACT
Objective: To determine the frequency of contraceptive usage, the social barriers affecting their use, and the frequency of unplanned pregnancies during the COVID-19 pandemic Methodology: This is a prospective cross-sectional study carried out at the Department of Obstetrics and Gynaecology, Fazaia Ruth Pfau Medical College & PAF Hospitals from July 2020 to September 2020. All women of reproductive age attending the outpatient department were consecutively included. A pre-structured questionnaire was used for the purpose of collection of data. We obtained information regarding the use of contraception before and during the COVID-19 pandemic and the contraception methods used by these women. Furthermore, reasons for discontinuing contraception amongst those women who were using it earlier. The occurrence of pregnancy during pandemic was also noted. Results: Of the 350 women, 306 (87.4%) women practiced contraception before and 288 (82.3%) practiced it during the lockdown. Of 306 women practicing contraception before the lockdown, 265 (86.6%) continued practicing during the lockdown as well. Condom 145 (50.3%) and withdrawal method 116 (40.3%) were the most used methods amongst the 288 women practicing contraception during the lockdown. The noticeable increase in the number of those using withdrawal method was due to the lack of consultation following the fear of getting COVID (17 women, 41.5%) and no access to the clinic (14 women, 34.1%). These were the most common reasons for not using contraception, amongst the 41 women practicing contraception before the pandemic. Pregnancies were reported by 93 (26.6%) women out of whom 75 (80.6%) reported these to have been unplanned. Conclusion: The COVID pandemic has largely affected the utilization of contraceptives among women who were already practicing different contraceptive methods. Moreover, unplanned pregnancies are increasingly reported by women.
ABSTRACT
Researchers have found that women who deliver babies in the midst of a pandemic are more likely to have mental health consequences, including postpartum depression, and their infants are likely to suffer as well, if the stressors are not mitigated. The cohort study of 318 mothers in the United States, Australia, and the United Kingdom found that COVID‐related stress was significantly associated with poor postpartum mental health and increased negative affectivity among infants.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) is a rapidly spreading global emergency, causing significant damage to the global economy and health care. Knowledge and awareness are crucial elements in stimulating self-imposed preventive measures. Objectives: We evaluated the knowledge and awareness about COVID-19 and the practice of hygiene measures to prevent the spread of coronavirus disease. Methods: A prospective observational study was conducted in Karachi, Pakistan, between March 01 and March 25, 2020, using a non-probability consecutive sampling technique. All individuals aged 18 years or above were included in the study. The individuals who had no formal education were excluded from the study. A self-reported questionnaire assessing knowledge, awareness, and practices was distributed among the participants. Results: The mean age +or- SD of the study population was 29.11 +or- 7.8 years. In our study, 424 (98.6%) participants knew that a virus causes COVID-19, and most were knowledgeable about the disease's transmission mode. Higher education status and the medical profession were associated with the better practice of preventive measures. Conclusions: We recommend that knowledge about COVID-19 and preventive measures be spread across the country via electronic media.
ABSTRACT
Objective: This study was conducted to evaluate the impact of the COVID-19 pandemic on the use of Cancer Early Diagnosis, Screening, and Education Centers (KETEM) services. Materials and Methods: In this study, which was conducted as a descriptive retrospective cohort type, a total of 52.955 patient application records made to KETEM between January 1st and December 31st, 2017-2020 and January 1st-1 October 2021 were examined. The data obtained within the scope of the study were expressed as frequency and percentage. Results: In the study, it was determined that the numbers decreased as compared to previous three years (2017, 2018 and 2019) 70.4%, 59.1%, 68.8% for mammography screenings, 75.8%, 68.8%, 65.8% for HPV-Pap smear scans and 46.1%, 81.9%, and 72.2% for colorectal scans, respectively. Conclusion: It was detected that mammography, HPV-Pap, smear, and colorectal screenings offered within the scope of KETEM services decreased significantly in 2020 and 2021 which includes the pandemic process, compared to the previous years. It is estimated that cancers that cannot be detected in the early period due to the decrease in the number of applications will cause a significant increase in cancer mortality in the following years. Accordingly, it is recommended that the society, especially the individuals in the risk group, not delay their applications to cancer screening services, to take the necessary pandemic measures to inform them about making their applications without delay, and to improve their awareness about this issue. Amaç: Bu çalışma COVID-19 pandemisinin Kanser Erken Teşhis, Tarama ve Eğitim Merkezleri (KETEM) hizmetlerinin kullanımı üzerindeki etkisini değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Retrospektif kohort tipinde betimleyici olarak yürütülen bu araştırmada, 2017-2020 yıllarında 1 Ocak-31 Aralık tarihleri ile 1 Ocak-1 Ekim 2021 tarihleri arasında bir ilin Kanser Erken Teşhis, Tarama ve Eğitim Merkezleri'ne yapılan toplam 52.955 hasta başvuru kaydı incelenmiştir. Çalışma kapsamında elde edilen veriler frekans ve yüzde ile ifade edilmiştir. Bulgular: Çalışmada 2020 yılındaki mamografi tarama sayısının önceki üç yıla kıyasla (2017, 2018, 2019) sırasıyla %70.4, %59.1, %68.8 oranında;HPV-Pap smear tarama sayısının %75.8, %68.8, %65.8 oranında;kolorektal tarama sayısının ise sırasıyla %46.1, %81.9 ve %72.2 oranında düştüğü saptanmıştır. Sonuç: Bu araştırmada KETEM hizmetleri kapsamında sunulan mamografi, HPV-Pap smear ve kolorektal taramalarının pandemi sürecini kapsayan 2020 ve 2021 yıllarında önceki yıllara nazaran önemli düzeylerde azaldığı belirlenmiştir. Başvuru sayısındaki azalmaya bağlı olarak erken dönemde tespit edilemeyen kanserlerin ilerleyen yıllarda kanser mortalitesinde önemli bir artışa neden olacağı ön görülmektedir. Bu doğrultuda özellikle risk grubunda yer alan bireyler başta olmak üzere toplumun kanser tarama hizmetlerine başvurularını ertelememeleri, gerekli pandemi tedbirlerini alarak vakit kaybetmeden başvurularını gerçekleştirmeleri konusunda bilgilendirilmesi ve bu duruma yönelik farkındalıklarının geliştirilmesi önerilmektedir.
ABSTRACT
Background: In Mexico, diabetes mellitus (DM) and diseases cardiovascular, register an upward trend. Objective: To estimate the number of complications due to cardiovascular events (CVD) and complications derived from DM (CDM) accumulated in beneficiaries of the Mexican Institute of Social Security (IMSS) from 2019 to 2028, as well as the expense for medical and economic benefits in a scenario baseline and one of change in metabolic profile due to lack of medical follow-up during the COVID-19 pandemic. Material and methods: The number of CVD and CDM was estimated from 2019, with a 10-year risk projection using the ESC CVD Risk Calculator and United Kingdom Prospective Diabetes Study, considering risk factors registered in the institutional databases. Results: From 2019 to 2028, cumulative CVD cases were estimated at 2 million and those of CDM in 960 thousand, with an impact on medical spending of 439,523 million pesos and on the economic benefits of 174,085 millions. When considering the COVID-19 pandemic, CVD events and CDM increased by 589 thousand, with an increase in spending of 93,787 million pesos for medical care and 41,159 million for economic benefits. Conclusions: Without a comprehensive intervention in the management of CVD and CDM, the cost by both diseases will continue to increase, with financial pressures getting older. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
Background: India is one of the most severely affected countries due to the COVID-19 pandemic. A higher risk of severe illness and complications from COVID-19 had been observed in pregnant women as compared to nonpregnant women. The government of India on July 2, 2021, provided approval for the vaccination of pregnant women against COVID-19. A little data regarding the safety or harm during pregnancy of vaccination were available that time. Lack of safety data, fear, mistrust, underestimation of efficacy of vaccine, and chaos due to pandemic makes indecisive surrounding for pregnant women and this causes hesitancy with decision making about the COVID-19 vaccination. Aims and Objectives: This study aims to analyze the willingness and hesitancy of pregnant women to get vaccinated against COVID-19. Materials and Methods: This prospective study was conducted in a tertiary care institute in Northern India. Five hundred antenatal women who were eligible for COVID-19 vaccination were included in this study. Informed consent has been taken and data were analyzed after filling face to face questionnaire regarding vaccine acceptance or hesitancy. Results: The present study revealed low acceptance of COVID-19 vaccination in pregnancy. Prime reasons for the same are no allowance by the family and the possibility of vaccine harming the baby. Conclusion: Specific efforts should be directed toward high-risk populations including pregnant women and those who are planning for pregnancy. This will promote vaccination rates by increasing people's trust in immunization and the health-care system.
ABSTRACT
Introduction: Covid-19 is a new respiratory disease that is the cause of an acute infection characterized by a progressive epidemiological picture. On the other hand, it will depend on the stage of the disease in which the patient is and the presence of physiological sequelae or acquired comorbidities, being these factors responsible for altering the quality of life and its relationship in the health field, affecting not only the physiological level but also other alterations such as the physical and mental state and the subjective impression of the state of the disease in the patient. Objective: To determine the quality of life of post Covid-19 patients. Materials and methods: A descriptive, cross-sectional study was carried out with a sample of 24 patients who signed the informed consent prior to the application of the evaluation. A section with sociodemographic variables was included and the Saint George questionnaire was applied for quality of life. Finally, the data analysis was compiled in Excel and SPSS software. Results: It was found that 83.3% of the post-covid-19 patients had a "good" quality of life health;the most impaired dimension was "Impact," with a mean of 24.3 ± 9.90, standing out from the other categories. Similarly, it was shown that 21% of the population was diagnosed with diseases after acquiring the virus, but they fall within a range of "good" quality of life without limitations in the dimensions of the questionnaire. Conclusion: Quality of life can become an important factor in the study of health. However, the percentage of the study population does not fall within a poor quality of life. However, it is essential to mention the correlation between Covid-19 and the sociodemographic variables associated with a negative effect on the quality of life according to the Saint George questionnaire evaluation and the degree of the disease in the patient. Introducción: El covid-19 es una nueva enfermedad respiratoria que es causante de una infección aguda caracterizada por un cuadro epidemiológico progresivo. Por otra parte, dependerá del estadio de la enfermedad en la que se encuentra el paciente y la presencia de secuelas fisiológicas o comorbilidades adquiridas, siendo estos factores los responsables de alterar la calidad de vida y su relación en el ámbito salud afectando no solo a nivel fisiológico si no que esta estará ligada a otras alteraciones como el estado físico, mental y la impresión subjetiva del estado de la enfermedad en el paciente. Objetivo: Determinar la calidad de vida de los pacientes post Covid-19. Materiales y métodos: Se realizó un estudio descriptivo, transversal, con una muestra de 24 pacientes los cuales firmaron el consentimiento informado previo a la aplicación de la evaluación. En ella se adjuntó una sección con variables sociodemográficos y para la calidad de vida se aplicó el cuestionario Saint George. Al finalizar, el análisis de datos se recopilo en la base de datos de Excel y software SPSS. Resultados Se encontró que los pacientes post covid-19 presenta una calidad de vida en relación a la salud "buena" en un-83,3%, la dimensión más perjudicada fue el "Impacto" con una media de 24,3 ± 9,90 sobresaliendo de las otras categorías. De igual forma, se demostró que dentro de la población el 21% se diagnostico con enfermedades posterior de haber adquirido el virus, pero se adentran dentro de un rango de "buena" calidad de vida sin limitaciones en las dimensiones del cuestionario. Conclusión: La calidad de vida puede llegar a ser un factor importante de estudio en la salud, sin embargo, el porcentaje de la población de estudio no se enmarca dentro de una calidad de vida mala. Sin embargo, es imprescindible mencionar la correlación del Covid-19 y las variables sociodemográficas asociadas a un efecto negativo en la calidad vida según la evaluación del cuestionario Saint George y el grado de la enfermedad en el paciente.
ABSTRACT
To clarify associations between changes in going out after lifting a stay-at-home order and decrease in higher-level functional capacities among older adults with impairments. This study was conducted using questionnaires completed by people registered in two day-service facilities and a nursing station. A baseline survey was conducted during Japan's declaration of emergency for the coronavirus disease 2019, and follow-up surveys were conducted in 4, 8, and 12 months after the declaration was lifted. We performed binary logistic regression analyses to clarify the above associations There were significant associations between Δ sum of purposes of going out and the decrease in higher-level functional capacities in 4 months (OR 0.57) and in 8 months (OR 0.47). Increasing the sum of purposes of going out after lifting a stay-at-home order was associated with lower odds for a decrease in higher-level functional capacities in 4 and 8 months.