ABSTRACT
Introduction: Active cancer increases the odds of death among patients with COVID-19.1 Cancer patients may be at increased risk of complications and mortality from COVID-19 owing to the systemic effects of malignancy, immune suppression after chemotherapy, treatment-related complications and presence of co-morbidities.2 They may develop serious complications necessitating ICU admission. In a meta-analysis, the pooled mortality in cancer patients with COVID-19 admitted to an ICU was 60.2%.3 Our hospital is a tertiary referral cancer centre, and the ICU admitted cancer patients with Covid-19 throughout the pandemic. Objective(s): To determine the 30-day in-hospital mortality of adult cancer patients with Covid-19 admitted to the ICU. We also aimed to determine the factors associated with mortality in cancer patients with Covid-19. Method(s): After approval from the Institutional Ethics Committee, data of all cancer patients (age = 16 years) with Covid-19 admitted to the ICU between March 2020 and March 2021 were retrieved from the hospital records. In case of multiple ICU admissions, data from the first admission was recorded. Data recorded included demographic details, type of cancer (solid, haematological), surgical status, APACHE-II and SOFA scores, C-reactive protein, and interventions in ICU. The primary outcome was 30-day in-hospital mortality. Data were analysed using Man-Whitney test and chi-square test. A multivariable regression analysis was carried out to determine factors associated with mortality. Result(s): Data of 127 cancer patients with Covid-19 was analysed. The median [interquartile range, IQR] age was 55 (43-62) years, and there were 50 females (39.3%). Comorbidities were present in 46 (36%) patients, the commonest being diabetes (29 patients) and hypertension (31 patients). The median [IQR] APACHE-II and SOFA scores were 15[8-20] and 4[2-7], respectively. Overall, 62/127 patients died, and 30-day hospital mortality was 49%. There were 30 patients with haematological malignancy and 97 with solid tumours with 30-day in-hospital mortality rates of 46.7% and 49.5%, respectively;p = 0.84). Amongst patients with solid tumours, there was no difference in mortality in surgical patients compared to non-surgical patients (43.3% vs. 52.2%;p = 0.42). Table 1 summarises the parameters and interventions in survivors and non-survivors. On multivariable analysis, only the change in SOFA score from Day 1 to Day 3 was independently associated with outcome (Odds ratio 1.36 (95% confidence interval 1.01-1.84, p-0.04). Conclusion(s): In patients with cancer and Covid-19 and age =16 years admitted to our ICU, the crude 30-day hospital mortality was 47%. There was no association of mortality with cancer type or surgical status. The only independent predictor of mortality was progression of organ failure. Cancer patients with Covid-19 have a reasonable outcome and should be given a trial of intensive care.
ABSTRACT
Introduction: Several studies have evaluated the occurrence of oral lesions and changes in sensory functions in patients positive for COVID-19. Objective(s): To evaluate the manifestations of COVID-19, emphasizing olfactory and gustatory changes, xerostomia, and oral lesions. Material(s) and Method(s): A cross-sectional and observational study was conducted. Approved by the Institutional Ethics Committee (#46151121.6.0000.5141). All patients were diagnosed by reverse transcription-polymerase chain reaction assay (RT-PCR) and considered to have mild symptoms, according to the latest WHO joint report. The patients were evaluated at a reference Service for COVID-19 in Minas Gerais, Brazil. The oral cavity was evaluated for each patient on the second and seventh days. Result(s): A total of 414 patients older than 18 years were evaluated. One hundred thirty-nine presented at least one of the studied conditions, oral lesions (19.08%) were the most frequently observed, followed by gustatory disorders (18.11%), xerostomia (14.25%), and olfactory dysfunction (14%). Among the oral lesions, there were various anatomical locations and clinical presentations. The occurrence involving lips and tongue represented 49 oral lesions, the most prevalent being, respectively, ulcerations (n=51), candidiasis (n=8), and erythema or red plaques (n=7). Fifty patients died. Conclusion(s): This study represents, to date, the largest case series of oral lesions in Brazilian patients with COVID-19, and oral alterations were observed in an expressive percentage of patients with COVID-19. However, it cannot be concluded that SARS-CoV-2 directly causes them.
ABSTRACT
This manuscript uses competitive college football as a lens into the complexities of decision-making amid the Covid-19 pandemic. Pulling together what is known about the decision-makers, the decision-making processes, the social and political context, the risks and benefits, and the underlying obligations of institutions to these athletes, we conduct an ethical analysis of the decisions surrounding the 2020 fall football season. Based on this ethical analysis, we provide key recommendations to improve similar decision processes moving forward.
Subject(s)
COVID-19 , Football , Humans , Pandemics , COVID-19/epidemiology , Ethical Analysis , AthletesABSTRACT
Introduction: Hypertension is the most common co-morbidity associated with COVID-19 patients. Many patients take angiotensin-converting enzyme (ACE) inhibitors for the management of hypertension. The study aimed to compare the clinical and hematologic features in hypertensive and non-hypertensive patients suffering from COVID-19. Material(s) and Method(s): This observational study compared clinical and hematologic features in hypertensive and non-hypertensive patients suffering from COVID-19. The study enrolled patients from SMS Medical College, Jaipur (Rajasthan, India) after approval from the institutional Ethics Committee. The comparison of quantitative variables was performed using the Mann-Whitney test, and qualitative attributes were compared using the chi-squared test. The level of confidence is considered at 5%. Result(s): There were no significant differences found in clinical and hematologic features between hypertensives and non-hypertensives suffering from COVID-19. Conclusion(s): The present study concludes that there is no evidence that either use of ACE inhibitors is useful or harmful in patients with hypertension. Therefore, it is endorsed to use these agents in the management of hypertensives in patients suffering from COVID-19, till further evidence is found.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
ABSTRACT
Background: About 90% of the estimated cervical cancer deaths occur in low and middle-income countries. In Brazil, cervical cytology (i.e Pap smear) is a widely used strategy for its early detection. Considering the crucial role of the primary care in women's health in Brazil and the COVID-19 pandemic related health crisis, this cross-sectional study aimed to analyze the repercussions of the COVID-19 pandemic in cervical cancer screening in a teaching Basic Health Unit (BHU) from South of Brazil, in the city of Pelotas. Method(s): This study was approved by the institutional ethics committee (5.706.229). We analyzed records of Pap smears performed between February 2019 to February 2020 and March 2020 to April 2022, referred to as pre-pandemic and pandemic period. The statistical analysis was performed using the Statistical Package for the Social Sciences program. Result(s): The sample mean age was 43.6 years and they were mostly residents of the area covered by the BHU (94.35%). During the pre-pandemic and pandemic period 339 and 653 exams were collected, respectively. A 42% reduction in tests performed in 2020 compared to 2019 was observed as well as an increase of 107% in 2021 compared to 2020. An increase was assessed in the rate of non-residents (of the area of responsibility of the BHU) performing Pap tests in the Unit during the pandemic period (p = 0.001). Most of the results were negative for intraepithelial lesion or malignancy (NILM). A significant difference in abnormal results in the pre-pandemic and pandemic period, respectively, was seen (p = 0.012). [Formula presented] Conclusion(s): The crisis brought on by the COVID-19 pandemic may have exacerbated pre-existing health disparities in cervical cancer already present in Brazil in pre-pandemic periods. Recovery strategies in primary care are needed to prioritize high-risk patients and lessen the burden of cervical cancer in the future. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest.Copyright © 2023 European Society for Medical Oncology
ABSTRACT
COVID-19 is a pandemic responsible for more than 200 million confirmed cases and 4 million deaths worldwide. The virus for COVID-19, Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2), was first identified in Wuhan, China, in December 2019. Virus spreads via droplet transmissions, leading to variable symptoms, ranging from asymptomatic or mild respiratory illness to severe multiorgan failure and death of infected individuals. COVID-19 patients were being treated with glucocorticoids which in tum induce hyperglycemia. Present study was designed to elucidate the incidence and mechanism of new onset diabetes in COVID patient. Study was conducted after approval of Institutional Ethics Committee. Retrospective cohort study with 105 patients attending the OPD of Department of Medicine was conducted, history was taken and biochemical investigations were done. Totall05 cases and 105 controls (age and sex matched) participated in the study. Out of 105 cases, 59 were male and 46 were female, age ranged between 38 to 72 years, on the other hand, outof105 controls, 61 were male and 44 were female, age ranged between 34 to 72 years. Results showed a significant increase in plasma glucose and HbA1C in cases as compared to controls. Fasting plasma glucose values were found elevated (3 8.21%) as compared to controls. However, all the cases have normal plasma glucose values before corona infection. The glycated hemoglobin (HbA1 C) values were also found elevated (1 0.86%) but nonsignificant in cases as compared to controls. The aim of this study was to find out what is currently known about the incidence and mechanisms of relationship between COVID- 19 and diabetes. We thus propose further large group study to understand the mechanism of new onset diabetes in post COVID-19 patients.
ABSTRACT
Background: There are various studies on coronavirus disease-2019 (COVID-19) from globally which are mainly focused on respiratory and other medical manifestations of the disease. There are few studies on ocular manifestations in COVID-19 and post-COVID-19 patients. Objective(s): We aim to investigate the ocular manifestations of hospitalized post-COVID-19 patients at a tertiary care institute in the North Eastern part of India. Material(s) and Method(s): This cross-sectional study was conducted among hospitalized post-COVID-19 patients 18 years and above during July 1, 2021-December 31, 2021. A universal sampling method was employed. A structured pro forma was used for data collection along with detailed ocular examination. Descriptive statistics were generated from collected data. Approval of the study was obtained from the institutional ethics committee. Result(s): A total of 105 patients were included in the study with ages ranging from 18 to 85 years and males constituting 63.8%. Around two-thirds of the patients (70, 66.7%) had not received any vaccination. Chest X-ray showed bilateral moderate consolidation in 59 (56.2%) patients. Twelve (11.4%) patients developed ocular signs and symptoms. Dry eye, redness of the eye, dimness of vision, itching, blurring of vision, and discharge from the eyes are some of the symptoms encountered. Two patients developed subconjunctival hemorrhage, one patient had a retinal hemorrhage and exposure keratopathy was detected in one patient. Conclusion(s): In this study, 11.4% of hospitalized post-COVID-19 patients have ocular manifestations. Post-COVID-19 syndrome could affect the eyes thus necessitating meticulous follow-up of patients who recovered from COVID-19.Copyright © 2023 Journal of Medical Society Published by Wolters Kluwer-Medknow.
ABSTRACT
Introduction: There is sparse literature on child and adolescent consultation liaison psychiatry during the COVID pandemic in India. Aims and objectives: To study the patterns of Child and Adolescent Consultation Liaison Psychiatry Services at a Covid-19 Designated Tertiary Medical College and Hospital Material(s) and Method(s): This was a retrospective chart-based study. Institutional Ethics Committee clearance was obtained. It was conducted from April 2020-21. The inclusion criteria comprised records of children and adolescents who were referred for consultation liaison services while they were admitted in COVID-19 designated tertiary hospital. Incomplete records were excluded. Data was tabulated and analysed with descriptive analysis. Result(s): We found 50 referrals out of which 42 records were complete and 8 incomplete were excluded. There were 47.62% boys and 52.38% girls with the mean age (10.8 years) All the 42 patients had been tested for COVID-19 at the time of intake admission as per hospital protocol. We found that 11.9% were confirmed cases of COVID-19 disease and 88.1% had tested negative for COVID-19 disease .The referrals were received mostly from Paediatric Intensive Care Unit (57.14%) followed by Paediatric ward (26.19%) and Special Paediatrics COVID High Dependency Unit (16.67%). The most common psychiatric disorder in COVID negative patients was adjustment disorder with deliberate self-harm (35.14%) and in COVID positive patients was delirium (60%) .The most commonly used medication were Escitalopram, Risperidone and Clonazepam. Conclusion(s): We conclude that psychiatric disorders were prevalent in child and adolescent patients admitted during COVID 19 pandemic and had a distinct profile.
ABSTRACT
Introduction and Aim: The COVID-19 pandemic has caused a huge economic burden and impacted physical and mental health of the people. The young medical graduates are facing a lot of disappointments with regard to career, higher studies, personal life etc. The current research aims to assess the various stressors and their coping strategies among the young medical graduates during the COVID-19 pandemic. Material(s) and Method(s): The cross-sectional study was conducted in the Department of General Medicine at a tertiary care teaching hospital in South India. Undergraduate medical students of 228 in number of both genders who completed their residency training just before and during the COVID-19 pandemic were enrolled in the study. The data was collected through a preformed questionnaire. Ethics clearance was obtained from the Institutional Ethics Committee. Informed consent was obtained. Statistical analysis was done by SPSS software version 18.0. P value < 0.05 was considered statically significant. Result(s): The mean scores obtained in PSS-10 were found to be higher among males than females. Around 79.4% showed moderate stress while 20.6% showed high stress (P=0.001). Males showed more stress compared to females in general as well as academic stressors. Male doctors and female doctors had differing stress coping skills. Conclusion(s): The study highlighted the vulnerable state of mind of the young medical doctors. The best way to overcome stress is by providing adequate resources, training to cope stress and ambient conditions for study and work, social support and relaxation techniques at both individual and organisational levels to help them to achieve a reasonable work-family interface.Copyright © 2023, Indian Association of Biomedical Scientists. All rights reserved.
ABSTRACT
Introduction: Early reports from China estimated that overall cardiac arrhythmia prevalence in patients hospitalized for COVID-19 was 17%. A higher arrhythmia incidence (44%) was observed in patients admitted to intensive care unit. The industrial workforce was affected by COVID-19 to a great extent. A noteworthy proportion also suffered from cardiac abnormalities. Objective(s): To determine the incidence of arrhythmia in patients with COVID-19 among the industrial workforce using remote patient monitoring technology. Material(s) and Method(s): This was a retrospective, observational, descriptive study of the industrial workforce from Telangana State, India. Approval of the institutional ethics committee was obtained. The need for informed consent was waived off. Patients who tested positive for COVID-19 by RTPCR and aged above 18 years were eligible. The five-day recording of lead-2 ECG on Vigo Monitoring Solution (Connect Care India Pvt. Ltd) was collected and analysed. Brady-arrhythmia during day time, second degree AV block Type-2 (Mobitz II) during the day time, complete heart block, wide QRST, non-sustained ventricular tachycardia and sinus pause were considered "clinically significant". The other sub-types were defined as "clinically non-significant". The ECGs with regular sinus rhythm were interpreted as "normal". The prevalence of clinically significant, clinically non-significant and normal heart rhythm are described here. Result(s): Out of 240 COVID-19 patients who were on-board for remote monitoring, 216 (148 male and 68 female, mean age 51+/-15 years) met the eligibility criteria and only their ECG were analysed. Among them, 18 were known diabetics, 40 were hypertensive and 31 had both comorbidities. 112 were asymptomatic and 104 were symptomatic. The burden of arrhythmia was found clinically significant in 12 (5.6%) patients, clinically non-significant in 87 (40.4%) and normal among 117 (54%) out of 216 patients. Conclusion and Recommendation: The remote patient monitoring may be utilized as a tool for early screening of significant arrhythmia which are to be addressed immediately for better clinical outcome. These devices on being integrated into COVID-19 management strategies may contribute to patient satisfaction, emergency alerts, timely management, reducing mortality rate and enhancing the safety of healthcare providers.
ABSTRACT
INTRODUCTION. COVID 19 outbreak of the disease has put a lot of psychological pressure on Hospital staff who are in a direct contact with the patients. According to World Health Organization, among physical and mental illnesses, depression is one of the most common mental disorder in the world. Nursing out of all the other occupations ranked 27th amongst those prone for mental illness. During COVID-19 pandemic, the heavier workload and life-threatening condition of nurses aggravated the psychological pressure and were more at risk for after contacting with COVID-19 patients. Methodology: This cross-sectional study was conducted at tertiary care centre using convenience sampling after approval by Institutional ethics Committee. Tools used were ICD 10 for diagnosis, Patient Health Questionnaire (PHQ-9). Socio demographic factors and clinical variables were compiled using semi structured proforma. Result(s): Out of 150 nurses working in tertiary care hospital,74.7% (109)were females and 25.3%(38) were males of which 83% (125)were married and 14.7%(22) were single. 40.7% were diagnosed with minimal depression, 45.3% had mild depression,10.7% had moderate depression with 2% had moderately severe, 1.3% with severe depression. Conclusion(s): During the pandemic, nurses have worked under intense pressure, which has negatively affected their resilience and caused higher levels of depression. Awareness of health administration about the level of stress, anxiety, and depression and can help to provide psychological support programs for improving the mental health of nurses during the COVID-19 pandemic.
ABSTRACT
Introduction: Although AVFs are preferred vascular access for hemodialysis, tunneled cuffed catheters(TCC) are increasingly being used as dialysis access in certain clinical situations such as in AVF failure or lack of suitable vessels for AVF creation or bridge to living donor transplant. Aim and objective of this study was to study the characteristics of the population having benefited from tunneled cuffed catheters, to identify the different indications as well as the complications secondary to tunneled cuffed catheters in hemodialysis patients and to determine the catheter and patient survival rate and the factors associated with complications and survival. Method(s): This was an retrospective Observational study done after institutional ethics committee approval. All data was captured using standard proforma. The data was tabulated using MS excel and all results projected in form of bar graphs, pie charts, histograms or tables. Kaplan- meier analysis was used for survival. All patients included in the study consented for the procedure as well as collection of data. 527 TCC placement were done in 498 patients by nephrologists without fluoroscopy in a percutaneous fashion between jan 2021 to march 2022. Minimum follow up was 12 months. 37 patients lost to follow up. Result(s): 316 (68.5%) were males and mean age was 48.3+/-12.6 years. Staggered tip MAHURKAR MaxidTM Covidien, was used in every patient. Most common native kidney disease was cresentic GN 176(38.1%). Most common Site of TCC was right internal jugular 88.9%(441/496), followed by left internal jugular 10.48%(52/496), femoral TCC done in 0.6%. Mean blood flow achieved was 311+/- 32ml/min. Most common indication of TCC placement was starting of HD after 1/2 temporary access- 162(32.66%), followed by awaiting Maturation of autogenous AVF 66 (13.3%) and awaiting living-related transplantation 54(10.88%). Total catheter related infective episodes (CRBSI) were 229 (1.07 episodes/1000catheter days),Exit site infection was in 57 cases (0.26 /1000 catheter days), Tunnel infection was in 51(0.19/1000 catheter days), Infective endocarditis was seen in 3 cases. Catheter loss due to CRBSI was 23 (12.16%). Most common organism was Enterococci (29.7%), followed by s.aureus (24.32%). Most common immediate complication was tunnel bleeding (5.9% ), followed by improper tip position 4.68%. Late complications due to TCC thrombosis/ fibrin sheath was 74(15.07%). Recanalisation with urokinase was successful in 36.84%. Central venous stenosis was in 26 cases. successful recanalisation after central venoplasty was 16/19 (84.21%). Mean catheter survival was 201.9 +/- 114.9 days (3day to 12 months). Catheter survival at the end of 3 months was 75.76%, at 6 months 63.4%, at 12months 32.17%. Patient survival at 6 months was 86.7%, at 12 months- 77.5%. Most common cause of death was unrelated to TCC - cardiovascular cause (77.6%). Direct TCC related death was in 5 cases. Most common cause of catheter drop out was patient death (33.03%), followed by maturation of AVF (22.82%), catheter thrombosis/fibrin sheath (22.2%). [Formula presented] Conclusion(s): Though AVF is the best access, for late unplanned HD initiation in many CKD patients, TCC insertion becomes next best option. In access crisis patients, TCC may remain one feasible option for bridge to available live donor transplant. With strict asepsis protocol and technical aptitude TCC placement is safe with few side effects. No conflict of interestCopyright © 2023
ABSTRACT
Background: The novel corona virus disease 2019 (COVID-19) presented as an emergent threat to global health. It was necessary to identify level of public awareness on disease prevention to mitigate the pandemic. Until then, no vaccine or effective drug were available for the control, prevention, and treatment of COVID-19. Preventive measures were the only way out. Objective(s): a) To study knowledge of people regarding COVID-19. b) To study attitude of people towards lockdown. c) To assess practices of people in taking preventive measures for COVID-19. Method(s): A cross sectional study was carried out among general population. Sample size was calculated using the formula 4pq/l2 where, p= proportion of people having knowledge regarding COVID-19 THAT IS 50%. Minimum calculated sample size was 205. Data was collected using pre- tested, structured questionnaire through online portal. Study was approved by Institutional Ethics committee. Result(s): The present study included a total of 249 subjects in which subjects' age varies from 18-65+ years. Maximum number of subjects held a graduate degree 214 (86%). More than 80% study subjects were aware about contagious nature of COVID-19, practice of social distancing, usage of sanitizer and vaccination. 66.7% subjects were using N95 marks and more than 60% were vaccinated. 69% opined that strict lockdown should be enforced. Conclusion(s): Present study had some shortfall in knowledge among subjects regarding some aspects of COVID-19. Therefore, there was an obligation for awareness that can be directed via health education and training programs. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
ABSTRACT
Extreme situations such as the COVID-19 pandemic transparently show all the shortcomings of the Serbian system that should, in theory, provide support and protection to citizens in such circumstances. A particularly demanding task was to determine and measure the well-being of individuals during the pandemic, especially those from marginalized groups whose needs are not the priority to the system even under regular circumstances, those on the bottom of the social hierarchy who cannot influence the policies that shape their daily lives, or the decisions of authorities that further reproduce social inequalities. The paper examines institutional ethics of care during the pandemic in Serbia through the analysis of the adequacy of lockdown measures and their effects on the girls and women trafficking survivors. Analysis of the data collected in semi-structured interviews with girls and women showed that three central elements of the institutional (ethics of) care: the purpose of care, recognition of power relations, and the need for pluralistic tailoring of care to meet individuals' needs, were not fulfilled during the pandemic and that the logic of institutional care has had a politicizing character in Serbia. © 2022, University of Belgrade - Institute for Philosophy and Social Theory. All rights reserved.
ABSTRACT
Aims: The Coronavirus Disease 2019 (COVID-19), that results of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, manifests with dysfunction of hemostasis and thrombosis. This study aims to evaluate laboratory parameters of hemostasis in hospitalized individuals with suspected COVID-19. Method(s): Individuals aged 18 years or older with suspected COVID-19 admitted to two hospitals were invited to participate in this study. The study inclusion period was from April 2020 to March 2021. The study was approved by the institutional ethics committees. The diagnosis of COVID-19 was confirmed by positive SARS-CoV-2 real-time reverse-transcription polymerase chain reaction. Antithrombin, factor V, factor VII, factor XI, factor XII, factor XIII and prothrombin assays were performed using the Multiplex immunoassay technique (ThermoFisher Scientific, Vienna, Austria). Propensity score matching for sex and age were estimated by a logistic regression model for COVID-19 and non-COVID-19 individuals in the R software. The proportions found in each group were compared by Fisher's exact test, when the variable was categorical, and by the Mann-Whitney test, when it was continuous. Linear regression was performed adjusting the levels of clotting factors and antithrombin for the severity score (Sequential Organ Failure Assessment - SOFA). Correlation between SOFA, clotting factors and antithrombin in individuals with COVID-19 were performed by using the Spearman test. Only very strong correlations (>=0.9) were considered;p-value<0.05 was considered statistically significant. Result(s): A total of 151 individuals were included in the study, of whom 138 (91.4%) with the diagnosis of COVID-19 and 13 (8.6%) non-COVID-19. After 2:1 matching, 26 individuals with COVID-19 and 13 non-COVID-19 participated in the study. In the univariate analysis, the group of COVID-19 had higher levels of antithrombin, factor V, factor VII, factor XI and prothrombin compared to the non-COVID-19 group. However, after adjusting for SOFA, only the levels of factor XI and prothrombin remained different between the groups (higher in the COVID-19) (p=0.04 and p=0.04, respectively). We found no association between factor XI and prothrombin with mortality. However, we found a very strong correlation between coagulation factors V and VII (r=0.923, p<0.0001). Discussion(s): Our results show that plasma levels of antithrombin, factor V, factor VII, factor XI and prothrombin were higher in the COVID-19 when compared with non-COVID-19 group of critically-ill patients, but the difference was lost after adjusting the analysis for SOFA. Only the levels of factor XI and prothrombin remained significant in the COVID-19 group after adjustment. This finding suggests that the severity of the disease rather than viral etiology was the main determinant of the difference in the plasma levels of these proteins. We also showed a strong correlation between factor V and VII in our study. Indeed, factor VII is the major trigger of coagulation in vivo. Therefore, it is possible that factor V and VII could act together to boost coagulation and promote thrombus formation in patients with COVID-19. Conclusion(s): Our study suggests that increased levels of procoagulant factors in hospitalized critically-ill individuals with suspected COVID-19 are rather related to disease severity than to its cause. Copyright © 2022
ABSTRACT
INTRODUCTION: A week after, on March 7, COVID-19 cases topped 100,000. The WHO proclaimed COVID-19 a pandemic a few days later, on March 11. COVID-19 developed fast from a potentially fatal infection limited to Beijing to either a worldwide health crisis practically overnight. In India, the Covid-19 vaccination drive started on January 16, and during the first phase, frontline and healthcare workers were vaccinated against the disease. While the logistics of such a programme have been a challenge in a country as large as India, currently over 100 million people have already been given the shot. OBJECTIVES OF THE STUDY: To assess the knowledge regarding COVID vaccine among adults& to find out the association between knowledge and selected demographic variables. MATERIAL AND METHODS: A non-experimental Descriptive design carried out among 100 adult. Non-probability purposive sampling technique was used and was statically analyzed after collecting the data through structured questionnaire was prepared for data collection. Ethical clearance was taken from the Institutional ethics committee. Data analysis was done using descriptive statistics RESULT: The present study result showed that Knowledge regarding Covid Vaccine among the Adults. Majority 40% were of ordinary knowledge, 35% were of good knowledge, and just 25% were of low knowledge. CONCLUSION(S): The present the study's goal is to determine how well people know about the COVID vaccination the adults from selected rural areas of Pune District. Copyright © 2022 Ubiquity Press. All rights reserved.
ABSTRACT
Online education became a norm during the recent COVID-19 pandemic and medical education institutes in India accepted the new normal. It was timely to assess the perceptions and experiences of medical students to find out its relevance and application, if required, in future. Method(s): Following permission from the Institutional Ethics Committee, a cross-sectional observational questionnaire-based study was conducted among undergraduate medical students in the fifth semester using a Google form. A validated questionnaire consisting of 21 items was circulated. The data were analyzed using descriptive statistics. Result(s): A total of 150 students out of 180 (83.3%), who were approached participated in the study. About 46% of the students were of the opinion that online teaching-learning was not as effective as classroom teaching and 25% gave a neutral response. Only half the number of students (50.7%) felt attentive throughout the class and 40.7% attended solely for the purpose of attendance. Around 70% felt that their doubts were clarified while using this method of teaching, but 54% of them felt the amount of interaction was inadequate. Nearly 18% of students found it impossible to prepare for their examinations after learning through online classes. All the students (98.7 %) responded that they lost out on ward postings and clinical training. Although 79.3% of students agreed that online education was a useful option during the pandemic, only 46% of them felt that hybrid mode can be adopted in the post-pandemic era. Conclusion(s): As per medical students' perspectives noted in this study, online medical teaching should not completely replace traditional modes of teaching. Copyright © 2022, Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.
ABSTRACT
Introduction and Aim: A sudden shift of medical education from physical class teaching to online teaching during the COVID-19 pandemic created concern in both the students and teachers. The aim of the study is to evaluate the perception of medical students towards online learning during COVID-19 pandemic lockdown. Material(s) and Method(s): This observational study included all the MBBS students of our institution. The study was conducted after obtaining ethical clearance from the Institutional Ethics Committee. A validated questionnaire was used to collect the information. The data was analysed using the statistical software SPSS-28. Demographic variables were expressed in terms of frequencies and percentages. Data was analysed using Chi square test and Mann Whitney U test. P-value of less than 0.05 was considered statistically significant. Result(s): Five hundred sixty-five students of both genders out of total 600 (94%) participated. 54.3% experienced online classes for the first time and 48.1% studied online for 3-6 hrs. They liked recorded MP4 videos of their own teachers. Majority felt that online classes should be more interactive. They did not want the online classes to continue after the pandemic and opined that online classes cannot replace classroom teaching. Majority agreed that online learning saved time of travel, saves cost, was flexible but practical knowledge and interaction with teachers and patients was lacking. They experienced additional stress and their examination results are affected. Conclusion(s): Online learning is a less effective mode for learning practical skills and may be used as a supplementary mode to teach a few elective topics. Copyright © 2022, Indian Association of Biomedical Scientists. All rights reserved.
ABSTRACT
Introduction: Coronavirus Disease-2019 (COVID-19) had devastating effects on the healthcare and economic sector worldwide. India stands second in the list of most number of COVID-19 cases. Most of the deaths due to COVID-19 were seen in patients with associated co-morbidities like hypertension, diabetes, chronic kidney disease and obesity. This study would like to examine specific co-morbidities in relation to the COVID-19 disease progression and outcomes. Aim(s): To compare the clinicoradiological profile and outcome of COVID-19 in patients with and without co-morbidities (diabetes and hypertension). Material(s) and Method(s): The present observational, cross-sectional study was conducted at Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh between June 2020 to September 2020, after obtaining Institutional Ethics Committee (IEC) approval. A total of 148 patients with COVID-19 were included in the study. The COVID-19 patients admitted in the hospital were divided into four groups as those having only diabetes, only hypertension, both diabetes and hypertension, and those without any co-morbidities. Those with any other co-morbidity were excluded from the study. The general clinical characteristics, laboratory parameters, disease severity, morbidity and mortality were compared among various groups and the data was analysed. Categorical data were analysed using the Chi-square test. Result(s): A total of 148 patients with COVID-19 were included in the study, of which 26 patients were diabetic, 36 were hypertensive, 24 were both hypertensive and diabetic and 62 patients didn't had any significant co-morbidity. Severe COVID-19 disease was most commonly observed in those with diabetes (n=14) (53.8%). The highest proportion of patients requiring oxygen (84.6%) and Non Invasive Ventilator (NIV) support (46.1%) was also seen among diabetics. The presence of diabetes, severe disease and leukocytosis at presentation increased the risk of mortality. The association of hypertension with COVID-19 does not seem to affect the in-hospital mortality. Conclusion(s): COVID-19 in diabetics is associated with both increased risk of severe disease and increased odds of death. In diabetics, those with uncontrolled diabetes were more prone to severe disease and death than those with good glycaemic control. Hypertension, on the other hand, showed no association. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.
ABSTRACT
Objective: Pharmacovigilance Program of India is a robust program extending from government hospitals to non-government hospital for implementation of policy of safe and rational use of drugs and early signal generation for adverse effects of drugs. Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University is part of this program since 2004. Retrospective analysis of adverse drug reaction (ADR) reported to the adverse drug monitoring center at tertiary Care Hospital. Methods: The study site was Sir Sundar Lal Hospital, Institute of Medical Sciences Banaras Hindu University, Varanasi. The study was performed after the approval of the Institutional Ethics Committee, letter number: Dean/2020/EC/2153. It was a retrospective observational study. Data collected through VigiFlow software in standard IPC Pharmacovigilance Program of India prescribed suspected ADR form, from March 2020 to June 2021 were analyzed. Causality assessment was done using a World Health Organization Uppsala Monitoring Center scale. Results: In the present study, the percentage of male patients affected is 58% and 42% female patient got suffered from adverse drug effects. About 64% of adverse effect are in possible category followed by probable, that is, 36%. The majority of adverse effects are due to antimicrobials, that is, Cephalosporins and Antitubercular group of drugs. About 20.1% adverse events show gastrointestinal symptoms. In the present study, we also observed that 5.17% adverse effects are due to hydroxychloroquine account for gastritis, headache, lethargy, and vomiting which were prescribed as prophylactic drug for COVID-19. Conclusion: Medicine information OPD in every medical college is the need of the hour to increase awareness regarding adverse events. It is important to spread importance of reporting adverse events by spontaneous reporting under Pharmacovigilance Program of India to detect rare and unusual side effects.