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Background: COVID-19 made many changes in life of persons and even after post COVID era these changes are integral to our life. Some of the changes were online classes, work from home, and online gaming. Computer work leads to static position of neck, shoulders, and upper limbs for extended hours. This leads to higher risk of developing visual, musculoskeletal and psychological problems. Aims and Objectives: The present study was carried out to determine prevalence of musculoskeletal health disorders, assess work distribution, and their probable interaction with musculoskeletal health problems in computer users of Ahmedabad city. Material(s) and Method(s): A cross-sectional study was carried out over a period of 1-year time among 800 participants to study the musculoskeletal problems among computer users. Result(s): Out of 800 participants, 76.75% of participants had any computer related musculoskeletal problem. If participants work more than 4 h in a single spell prevalence of musculoskeletal problems was 82.95%. Regular exercise has significant role in preventing computer-related musculoskeletal problems. Conclusion(s): Computer-related musculoskeletal problems have relation with number of hours spent in single spell, total daily working hours, and years of computer-related work.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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Objective: The aim was to describe the impact of the COVID-19 pandemic upon referral patterns and incident diagnosis of inflammatory rheumatic and musculoskeletal diseases (iRMDs). Methods: UK primary care data were used to describe referral patterns for patients with musculoskeletal conditions. Trends in referrals to musculoskeletal services and incident diagnoses of iRMDs (specifically, RA and JIA) were described using Joinpoint Regression and comparisons made between key pandemic time periods. Results: The incidence of RA and JIA reduced by -13.3 and -17.4% per month, respectively, between January 2020 and April 2020, then increased by 1.9 and 3.7% per month, respectively, between April 2020 and October 2021. The incidence of all diagnosed iRMDs was stable until October 2021. Referrals decreased between February 2020 and May 2020 by -16.8% per month from 4.8 to 2.4% in patients presenting with a musculoskeletal condition. After May 2020, referrals increased significantly (16.8% per month) to 4.5% in July 2020. The time from first musculoskeletal consultation to RA diagnosis and from referral to RA diagnosis increased in the early pandemic period [rate ratio (RR) 1.11, 95% CI 1.07, 1.15 and RR 1.23, 95% CI 1.17, 1.30, respectively] and remained consistently higher in the late pandemic period (RR 1.13, 95% CI 1.11, 1.16 and RR 1.27, 95% CI 1.23, 1.32, respectively), compared with the pre-COVID-19 pandemic period. Conclusion: Patients with underlying RA and JIA that developed during the pandemic might be yet to present or might be in the referral and/or diagnostic process. Clinicians should remain alert to this possibility, and commissioners should be aware of these findings, enabling the appropriate planning and commissioning of services.
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Background/Aims In November 2019, there were abundant cases of COVID-19 for which the first case was reported in Wuhan, China. Cytokine storm syndrome is the severe immune reaction that may cause a severe tissue response in COVID-19 patients. Colchicine has an important role in inhibiting activation of NLRP3 inflammasome that predispose to decrease cytokine production. This study aimed to evaluate whether colchicine is effective in treatment of COVID-19 patients or not. Methods A randomized, open labelled, clinical trial of colchicine for the treatment of COVID-19, allocated between 8th May to 18th June 2021. Patients with mild, moderate, or severe COVID-19 infection;confirmed by real time PCR (RT-PCR) and/or lung involvement confirmed by computed tomography scan compatible with COVID- 19. The colchicine tablet dosage was 0.5mg twice daily for 14 days added to the standard treatment versus control group who received standard treatment without colchicine, with the trial registration ID: NCT04867226. The study was conducted in Erbil City, Iraq with the endpoints being clinical, laboratory parameters duration of hospitalization and side effects. Results 80 patients participated in the study. Fewer patients in the colchicine group had musculoskeletal symptoms (17.5%, p: 0.001) in comparison to the patients, who received control treatment. The serum ferritin level in most of patients who treated with colchicine returned to normal in contrast to the control group, whose serum ferritin level was still high (p: 0.041). Similarly, the average of CRP and D-dimer after treatment among the colchicine group participants was significantly lower than the control group, the P-values were 0.011 and 0.043, respectively. The colchicine group patients stayed for a shorter duration at the hospital (18.4 days) compared to the control group (24.24 days). Pvalue was 0.009. In addition to that the response and cure rate were higher in the colchicine group (56%) in the comparison to control group (43.1%) Table 1: Laboratory Parameters with musculoskeletal symptoms and duration of hospitalization of both Treatment Regimens. Conclusion The colchicine drug can be effective in treating patients with COVID-19 infection by improving musculoskeletal symptoms and inhibiting inflammatory biomarkers;it is also effective in reducing duration of hospitalization. (Table Presented).
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Background/Aims Rheumatic and musculoskeletal diseases (RMDs) are some of the most common indications for prescribed opioids. It is unclear how opioid prescribing has changed in the UK for RMDs, especially during the COVID-19 pandemic with limited healthcare access and cancelled elective-surgical interventions, which could impact prescribing in either direction. We aimed to investigate trends in opioid prescribing in RMDs and assess the impact of the pandemic in the UK. Methods Adult patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (AxSpA), systemic lupus erythematosus (SLE), osteoarthritis (OA) and fibromyalgia with opioid prescriptions between 01/Jan/2006-31/Aug/2021 without prior cancer in the UK Clinical Practice Research Datalink (CPRD) were included. We calculated ageand gender-standardised yearly rates of people with opioid prescriptions between 2006-2021, and identified change points in trends by checking whether the rate of change of standardised rates crossed zero. For people with opioid prescriptions, monthly measures of mean morphine milligram equivalents (MME)/day were calculated between 2006-2021. To assess the impact of the pandemic, we fitted regression models to the monthly number of people with opioid prescriptions between Jan/2015-Aug/2021. The time coefficient reflects the trend pre-pandemic and the interaction term coefficient represents the change in the trend during the pandemic. Results We included 1,313,519 patients: 36,932 with RA, 12,649 with PsA, 6,811 with AxSpA, 6,423 with SLE, 1,255,999 with OA, and 66,944 with fibromyalgia. People with opioid prescriptions increased from 2006 to 2018 for OA, to 2019 for RA, AxSpA and SLE, to 2020 for PsA, and to 2021 for fibromyalgia, and all plateaued/decreased afterwards. OA patients on opioids increased from 466.8/10,000 persons in 2006 to a peak of 703.0 in 2018, followed by a decline to 575.3 in 2021. From 2006 to 2021, there was a 4.5-fold increase in fibromyalgia opioid users (17.7 vs.78.5/10,000 persons). In this period, MME/day increased for all RMDs, with the highest for fibromyalgia (>=35). During COVID-19 lockdowns, RA, PsA and fibromyalgia showed significant changes in the trend of people with opioid prescriptions. With a decreasing trend for RA (-0.001,95%CI=-0.002,-0.001) and a decreasing-to-flat curve for PsA (0.0010,95%CI=0.0006,0.0015) prepandemic until Feb/2020, the trends changed by -0.005 (95%CI=-0.008,-0.002) for RA and -0.003 (95%CI=-0.006,-0.0003) for PsA, leading to steeper decreasing trends during the pandemic (Mar/2020-Aug/2021). Fibromyalgia, conversely, had an increasing trend (0.009,95%CI=0.008,0.009) pre-pandemic, and this trend started decreasing by -0.009 (95%CI=-0.011,-0.006) during the pandemic. Conclusion The plateauing/decreasing trend of people with opioid prescriptions in RMDs after 2018 may reflect the efforts to tackle the rising opioid prescribing in UK primary care. Of all RMDs, fibromyalgia patients had the highest MME/day throughout the study period. COVID-19 lockdowns contribute to fewer people on opioids for most RMDs, reassuring there was no sudden increase in opioid prescribing during the pandemic.
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Background/Aims The COVID-19 pandemic abruptly changed healthcare delivery. This study describes the impact the pandemic had on time to referral and diagnosis of inflammatory arthropathies (IA), including rheumatoid arthritis (RA) and juvenile inflammatory arthritis (JIA), in patients presenting in primary care with musculoskeletal problems. Methods Data from the Clinical Practice Research Datalink (CPRD) Aurum were analysed from 01/04/17 to 01/10/2021 to describe episodes of care for patients with musculoskeletal conditions for pre-COVID-19 (01/04/ 2017-31/03/2020), peri-COVID-19 (01/04/2020-31/07/2021), and post- COVID-19 lockdown (01/08/2020-31/10/2021) periods. Prevalent and incident musculoskeletal consultations were determined. Referrals were matched to these consultations. Trends in referrals to musculoskeletal services and further incident diagnoses of IA were described using Joinpoint Regression and comparisons made between timeperiods. Negative binomial regression was used to compare incident rates between time-periods of: RA/JIA/IA diagnosis and referral from first musculoskeletal consultation;and RA/JIA/IA diagnosis from first referral. The number of consultations between first musculoskeletal consultation and referral/diagnosis were described. Results were adjusted for age and sex and further stratified by geographical region and deprivation. Results The incidence rate of RA and JIA reduced by average -13.32% (from 31.98 per 1,000,000 to 17.15 per 1,000,000) and -17.43% (from 1.77 per 1,000,000 to 0.97 per 1,000,000) per month respectively between January 2020 and April 2020, then increased by 1.9% (from 17.15 per 1,000,000 to 25.22 per 1,000,000) and 3.7% (from 0.97 per 1,000,000 to 1.28 per 1,000,000) per month respectively between April 2020 and October 2021. Referral incidence decreased between February 2020 and May 2020 by -16.8% per month in patients presenting with a musculoskeletal condition. After May 2020, referrals increased significantly (16.8% per month) July 2020. Time from first musculoskeletal consultation to RA diagnosis, and referral to RA diagnosis increased in the peri-COVID-19 period (IRR 1.11, 95%CI 1.07-1.15;IRR 1.23, 95%CI 1.17-1.30) and remained consistent in the post- COVID-19 (IRR 1.13, 95%CI 1.11-1.16;IRR 1.27, 95%CI 1.23-1.32) periods respectively, compared to the pre-COVID-19 period. Similarly, number of consultations between first musculoskeletal consultation and referral/RA diagnosis reduced significantly in the peri-COVID-19 (IRR 0.92, 95%CI 0.88-0.96) and post-COVID-19 (IRR 0.92, 95%CI 0.90-0.95) periods. No change was observed between first musculoskeletal consultation and first referral. Similar results were observed for IA but not for JIA. Conclusion Patients with RA/JIA onset during the pandemic may be yet to present or are currently transitioning through referral and diagnosis. Primary care clinicians should remain alert to possible IA diagnosis and consider fast-track referral pathways where indicated. Patients developing incident episodes of IA may display a prodrome of other musculoskeletal symptoms and conditions, which alone may not warrant referral but in combination require further investigation. Commissioners should be alert to these findings to allow for the appropriate planning and commissioning of services.
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Background/Aims In the recent past, there has been growing research interest in COVID- 19 vaccines and their impact on the disease dynamics of rheumatic and musculoskeletal diseases (RMDs). The intersection of COVID-19 and autoimmunity has led to the theoretical possibility of flare-ups of autoimmune diseases with COVID vaccines. This study was conducted to evaluate the occurrence and the nature of flare-ups following the COVID vaccination on patients with RMDs. Methods This cross-sectional analytical study was conducted at Ragama Rheumatology and Rehabilitation Hospital, Sri Lanka involving 248 clinic patients using a structured questionnaire. Results The mean age of the study population was 52.69 and 75.4% were females. 12 patients (4.7%) reported flare symptoms following 1st dose of vaccination. Of them, 67% were females and 41.7% were within the 40-45 years age group. 75% of patients have experienced the onset of the flare symptoms following 1 week of the vaccination and 41.7% of symptoms have lasted more than 8 weeks. 66.7% who had this flare have received Sinopharm, while 25% received Covishield. In this flare 58.3% got polyarthritis,16.7% monoarthritis, 8.3% oligoarthritis and 16.7% generalized rash. By contrast, 42 (16.9%) patients who received the 2nd dose of the vaccine had flare symptoms. 90.5% of this population were females and 38.1% were within the 50-59 years age group. 42% got flare following 1st week of the vaccination and 57% of symptoms have lasted more than 8 weeks. 5 patients who had flare symptoms following the first dose reported having flare after the 2nd dose too. None of the flare symptoms following 1st or 2nd dose of the vaccinations needed hospitalization. Interestingly gender (p=0.012), use of methotrexate (p=0.043), and the presence of flare to the first dose (p=0.02) were found to be significantly correlated with the occurrence of flare symptoms following 2nd dose of vaccination. Conclusion This study reveals a considerable incidence of non-severe RMD flareups following COVID vaccination, mainly with the 2nd dose. Further studying on the effects of repeated and periodic COVID vaccination among patients with RMDs is timely to reassure and to improve vaccine acceptance in this group of patients.
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Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disease which presents infections as one of the most frequent complications, including more severe outcomes of Coronavirus disease 2019 (COVID-19). Immunization of these patients has been strongly recommended, however, data on safety are still scarce. In this study we evaluate the safety after vaccination against SARS-CoV2 in patients with SLE. Method(s): Safety and Efficacy on COVID-19 Vaccine in Rheumatic Disease - the 'SAFER' study, is a longitudinal Brazilian multicenter phase IV study. In this study patients with SLE (according to the 2019 ACR/EULAR criteria), older than 18 years who received vaccination against SARS-CoV-2 CoronaVac (Inactivated SARS-CoV-2 Vaccine), ChadOx-1 (AstraZeneca) and BNT162b2 (Pfizer-BioNTech) were included. The evaluation of adverse events (AEs) was done by telephone contact, symptom diaries and a face-to-face visit on the 28th day after each dose. Patients were followed up also by disease activity, assessed using SLEDAI-2 K score. Result(s): A total of 367 individuals with SLE were included, 207 received CoronaVac, 128 received ChadOx-1 and 32 received BNT162b2. Ninety percent of the subjects were female with a mean age of 37 years. About 50% (182) of patients were using oral glucocorticoids and azathioprine was the most frequent immunosuppressive therapy. Regarding disease activity parameters, 38%(140) of patients had zero SLEDAI-2Kat baseline and 41%(147) had zero SLEDAI-2 K 28 days after the 2nd dose. After the first and second dose the most frequent AEs were pain at injection site (58%/44%), headache (48%/33%) and pruritus (42%/37%). Comparing the three vaccines, after the first dose, local symptoms, myalgia, and fever were less frequent in patients who received CoronaVac (p alpha 0.001) as well as headache, tiredness (p = 0.001) and arthralgia (p = 0.003). After the second dose, only local symptoms such as pain at the application site and thickening of the skin around the application site were less frequent in the CoronaVac group (p alpha 0.05). Headache, tiredness, musculoskeletal symptoms and fever were more common in patients receiving AstraZeneca. No serious adverse events were reported regardless of the vaccination schedule used. Conclusion(s): This study suggests that vaccines against SARS-COV-2 are safe in SLE patients. Neither severe AEs were reported nor worsening of disease activity were reported. Comparing the different vaccines, CoronaVac had fewer adverse events.
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Introduction/Aim: Medium and long-term impacts of COVID-19 pneumonitis are being increasingly recognised. Our study aimed to evaluate outcomes of hospitalised COVID-19 patients with moderate-to-severe respiratory compromise. Method(s): Patients admitted to a tertiary centre with COVID-19 pneumonitis (March 2020-October 2022) were followed in the Post-COVID Respiratory Clinic at 6-24 weeks. Baseline demographics, admission details, pulmonary function tests (PFTs), and clinic data were collected. Univariable and multivariable logistic regression were performed to investigate for predictors of persisting respiratory symptoms (dyspnoea, cough, chest pain) and functional limitation (self-reported). Result(s): 125 patients (64.8%male, 63.2+/-16.7years, 42.5% former/current smokers, BMI 31.0+/-8.0kg/m2, 49.6% fully vaccinated) with median follow-up time of 85 [interquartile range (IQR) 64-131] days were included. Pre-existing conditions included lung disease (29.6%), immunocompromise (15.2%), diabetes (24.8%) and hypertension (43.6%). 35.2% required ICU care (14.4% mechanical ventilated, 4% ECMO), 44.8% received high flow nasal prong oxygen and/or continuous positive airway pressure (CPAP). At initial clinic follow up, 65.4% had persisting X-ray changes. Mean predicted FEV1, FVC, DLCO were 86.8+/-20.7%, 85.3+/-20.3%, 82.2+/-19.8% respectively. Symptoms included dyspnoea (63.2%), fatigue (24.2%), cognitive dysfunction (12.9%) and musculoskeletal complaints (10.5%). Univariate predictors of continued respiratory and/or functional disability included age [odds ratio (OR) 1.03, 95%confidence interval (CI) 1.01-1.06, p = 0.01), prior lung disease (OR2.98, 95%CI 1.05-8.48, p = 0.04), hypertension OR2.61, 95%CI 1.09-6.22, p = 0.03) and length of hospital stay (LOHS) (OR1.03, 95%CI 1.00-1.07, p = 0.04). On multivariable analysis, only LOHS was independently predictive of continued respiratory and functional limitations (OR1.03, 95%CI 1.00-1.07, p = 0.02). Conclusion(s): Patients recovering from COVID-19 pneumonitis have a large burden of disability at follow-up. Older age, hypertension, lung disease and LOHS are risk factors for delayed recovery.
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Objective: Adverse drug reactions increase morbidity and mortality, prolong hospital stay and increase healthcare costs. The primary objective of this study was to determine the prevalence of emergency department visits for adverse drug reactions and to describe their characteristics. The secondary objective was to determine the predictor variables of hospitalization for adverse drug reactions associated with emergency department visits. Method(s): Observational and retrospective study of adverse drug reactions registered in an emergency department, carried out from November 15th to December 15th, 2021. The demographic and clinical characteristics of the patients, the drugs involved and the adverse drug reactions were described. Logistic regression was performed to identify factors related to hospitalization for adverse drug reactions. Result(s): 10,799 patients visited the emergency department and 216 (2%) patients with adverse drug reactions were included. The mean age was 70 +/- 17.5 (18-98) years and 47.7% of the patients were male. A total of 54.6% of patients required hospitalization and 1.6% died from adverse drug reactions. The total number of drugs involved was 315 with 149 different drugs. The pharmacological group corresponding to the nervous system constituted the most representative group (n = 81). High-risk medications, such as antithrombotic agents (n = 53), were the subgroup of medications that caused the most emergency department visits and hospitalization. Acenocumarol (n = 20) was the main drug involved. Gastrointestinal (n = 62) disorders were the most common. Diarrhea (n = 16) was the most frequent adverse drug reaction, while gastrointestinal bleeding (n = 13) caused the highest number of hospitalizations. Charlson comorbidity index behaved as an independent risk factor for hospitalization (aOR 3.24, 95% CI: 1.47-7.13, p = 0.003, in Charlson comorbidity index 4-6;and aOR 20.07, 95% CI: 6.87-58.64, p = 0.000, in Charlson comorbidity index >= 10). Conclusion(s): The prevalence of emergency department visits for adverse drug reactions continues to be a non-negligible health problem. High-risk drugs such as antithrombotic agents were the main therapeutic subgroup involved. Charlson comorbidity index was an independent factor in hospitalization, while gastrointestinal bleeding was the adverse drug reaction with the highest number of hospital admissions.Copyright © 2022 Sociedad Espanola de Farmacia Hospitalaria (S.E.F.H)
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Currently, the relevance of the issues of diagnosis and treatment of invasive fungal diseases has increased significantly due to the pandemic of a new coronavirus infection COVID-19 and the massive use of corticosteroids for the treatment. The key success factors in the outcome of invasive fungal diseases are early diagnosis and treatment, including the applying of an adequate systemic antifungal therapy and surgical treatment. Extensive areas of mycotic lesions of the facial bones and paranasal sinuses are life-threatening conditions due to anatomical proximity to brain structures and a high risk of dissemination of I invasive fungal diseases with a fatal outcome. The objective of this work was to study the risk factors, possible pathogenesis, diagnosis and treatment strategy of invasive fungal diseases of the orofacial region in convalescents of COVID-19. We present case-series data on six patients in the clinics of maxillofacial surgery and otorhinolaryngology of the Pavlov First Saint Petersburg State Medical University over the period of 2021-2022. Predisposing factors, clinical and radiological symptoms, features of diagnosis, therapy and surgical strategy were analyzed. The presented observations confirm the relevance and danger of complications after a COVID-19 in the form of the development of invasive fungal diseases with damage to the maxillofacial region caused by mucormycetes and Aspergillus spp., as well as importance of early diagnosis and treatment.Copyright © 2021, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. All rights reserved.
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Funding: None. Synopsis: Because of COVID-19, re-imbursement restrictions for medical services have been relaxed, both to continue provision of healthcare services and afford physicians a stream of revenue. While telemedicine may have relevance in medical and psychiatric practices, its benefits appear less tangible for vascular surgical patients. Those patients, most of whom have multiple co-morbidities, have a high acuity of illness and assessment absent physical examination has the potential for providing a lower standard of care. Many articles laud telemedicine without determining if telemedicine is non-inferior to customary hand-on care. To determine if telemedicine is equivalent, a retrospective review was performed to ascertain if telemedicine provides equivalent care Methods: A retrospective, single observer, the charts of 100 consecutive patients were reviewed to determine if their condition could have been adequately treated via telemedicine. Data were collected from patient records and each chart was reviewed to determine if physical patient contact was essential to the assessment and treatment strategy. Result(s): Of the 100 patient encounters, 78 patients were determined to require an in-depth interview and physical examination. 40 were new patients and 60 were established patients, seen either for post-surgical follow-up or manifestation of a new problem. There were 55 males and 45 females. Average age was 56.2 years with 59 patients older than 65. Diagnoses and clinical severity were recorded and the determination was made if a face-to-face encounter could have been conducted via telemedicine. Those conditions requiring direct contact included chronic kidney disease, differentiation between vascular and neurogenic symptoms, aneurysm, carotid stenosis, wound complications, and musculoskeletal disorders. (TABLE 1) Conditions that could have been safely managed with telemedicine included venous insufficiency, carotid ultrasound results, lymphedema, and pre-operative patients. Of the 100 patients, only 7 seven patients were candidates for telemedicine. (TABLE 2) Not included in this study were 57 additional patients who underwent ultrasounds/non-invasive studies and whose results were transmitted to the patients by a mid-level. Conclusion(s): A small minority of vascular patients are adequately treated via telemedicine. While Medicare payments for the telephone evaluation and management visits are equivalent to established office/outpatient visits, care must be taken to assure that equivalency exists between telemedicine and face-to-face encounters. Controlled outcome studies with larger populations should be performed to determine if telemedicine and in-person visits provide equal patient benefit. [Formula presented] [Formula presented] Institution: Memorial Healthcare System, Davie, FLCopyright © 2022
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The EULAR COVID-19 registry, launched in March 2020, is an observational registry that captures physician-entered data on both adult and paediatric patients with a pre-existing rheumatic and musculoskeletal disease (RMD) and SARSCoV-2 infection. Data are entered voluntarily directly into the European data entry portal. In addition, as some countries were already collecting COVID-19 data, either within existing registries or in new COVID-19 registries (France, Germany, Greece, Italy, Portugal, Sweden and Switzerland), they were invited to share their data with the EULAR COVID-19 registry. EULAR data are then merged with data from the Global Rheumatology Alliance (GRA) for analysis. The aim of the EULAR-GRA COVID-19 registry is to collect, analyze, generate and disseminate information about COVID-19 and rheumatology to patients, physicians and other relevant groups to improve the care of patients with rheumatic disease. Later during the pandemic, patients with immune-mediated inflammatory diseases (including inflammatory RMDs) were excluded from SARS-CoV-2 vaccine clinical development programmes;therefore, questions regarding the safety, effectiveness and potential measures that may increase the safety and effectiveness of vaccination against SARS-CoV-2 were unanswered. Lack of data led to some contradictory advice from rheumatology organisations and healthcare professionals regarding some of these vaccination aspects. In order to contribute to more informed decisions by patients and healthcare professionals and more robust and homogeneous evidence-based recommendations from relevant organisations, EULAR decided to create a second registry to collect data and learn about vaccination outcomes in people with RMDs. At the 4th Global Conference on Myositis (GCOM), myositis-specific data from these two registries will be presented.
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Introduction: The COVID-19 pandemic highlighted the importance of the use of personal protective equipment (PPE) such as a face shield, face mask, and protective eyewear by Health Care Workers (HCWs). Research has documented that usage of PPEs could lead to musculoskeletal disorder (MSDs), headache, impingement of neck etc. Objective(s): To identify the perceptions of face-shield use and its relation to MSDs among Health Practitioners (HPs). Material(s) and Method(s): An online cross-sectional survey was conducted among 145 Health Practitioners (HPs) in Chennai during April and September 2021 to identify their perceptions about wearing a face shield and MSDs using a validated self-administered questionnaire. We analysed the data using Pearson's chi-squared test on SPSS. Result(s): Among 145 HPs, 52.4% reported to have experienced MSDs. 44.7% of the HPs reported MSDs due to continuous wearing of the face shield. This was found to have a significant association. It was found that 95% of the HPs reported discomfort and poor visual clarity. The MSD risk was 3.4 times higher among those HPs using PPEs (95% CI: 1.03-11.28;p=0.035). 72% of them perceived that movement restriction due to PPE had caused MSD. Those who perceived thus, were 2.5 times more likely to experience MSD (95%CI: 1.27-5.07;P=0.007). Although, the duration of PPE use was not associated with MSD, 9% of the HPs who work for more than 6 hrs reported higher MSD. A significant association was found between having previous history of work-related MSDs and prevalence of MSDs among the HPs (OR: 9.5;95% CI: 2.71-33.53;p=0.000). Conclusion(s): Majority of the participants perceived discomfort, lack of visual clarity, movement restriction as factors that were found to be significantly associated with MSD among HPs. Recommendation: Hence adaptation and proactive intervention are required to safeguard HPs against the detrimental effects of face shields.
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Introduction: Symptoms after covid are common. The clinical manifestation of long-covid was't described completely for the long term period. Aim(s): The aim was to describe veariety of patient's symptoms at least 4months after infection. Method(s): a)prepare questionnaire items;b)selection of relevant items;c)formal adjustment;d)pilot verification on 50pts;e)modification of the structure of questions;f)performing an exploratory factor analysis. Result(s): We enrolled 703consecutive pts(352 males;53+/-15yrs;BMI 29+/-5;222+/-112days from diagnosis)from Mar21 to Jan22. Two-fifths(272pts;39%)of them were initialy hospitalized due to covid. Eight clusters of long-covid symptoms/manifestations(s/m)were identified: respiratory+fatigue cluster;musculo-skeletal c.;skin c.;psychical c.;recurrent infections c.;smell+taste c.;trombotic c;nefrological c.Elderly pts were more affected by musculoskeletal s/m;less frequently experienced psychical s/m;recurrent infection s/m;small+taste s/m.Obese pts reported more frequently respiratory+fatigue s/m;musculo-skeletal s/m;thrombotic s/m;nephrological s/m. Educational level was not associated with the dominance of any s/m cluster. The Delta variant predisposed to the dominance of respiratory+fatigue s/m;musculo-skeletal s/m. Previously hospitalized suffered more frequently from musculo-skeletal s/m;trombotic s/m;less frequently from smell+taste s/m. Conclusion(s): Manifestation of long-covid symptoms is heterogeneous condition for many months after the initial diagnosis.
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The aim of this study is to examine the results of physiotherapy in a patient with critical illness polyneuropathy (CIP) due to coronavirus disease 2019 (CO-VID-19). The 48-year-old male patient with CIP due to COVID-19 was enrolled in a physiotherapy program for 3 months with 5 sessions/week. Pain intensity, motor skills, daily living activities, fatigue level, cognitive status, and decubitus ulcer were evaluated with a visual analogue scale, the Medical Research Coun-cil-Sum Score, the Functional Independence Scale, the Fatigue Severity Scale, the Standardized Mini-Mental Test, and pressure wound staging, respectively. Positive improvements were achieved in functional level, fatigue, pain, and pressure sores with the physiotherapy program for this patient with CIP due to COVID-19. This report provides an idea about the effects of physiotherapy programs for COVID-19-related CIP to academics and clinicians working in this field.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Background: Health sectors can be listed under the high-risk work areas. As we all know, in this COVID 19 pandemic, doctors, nurses, health workers are the front line warriors. If we consider only the nursing personnel here, their tasks alone are prone to occupational hazards. Musculoskeletal disorders (MSDs) are most common among the self-reported occupational diseases. In previous studies, a significantly large number of participants reported musculoskeletal symptoms faced at least once. Insufficiency of ergonomic expertise is one of the most important recognizable risk factors as well as the shortage of staff in hospitals. MSDs are caused due to stressful physical work, static work postures, frequent bending, and twisting, lifting, pushing, and pulling of heavy objects, vibrations, localized mechanical pressure, etc. Various studies have shown that the daily chores of nursing personnel put them at high risk of MSDs. Methods : The study areas were different hospitals and nursing homes in West Bengal. Only the female, registered nurses working in different wards are chosen for this study. The study's inclusion criteria were only the female, registered nurses and the absence of any chronic disease in them. The exclusion criteria were the nursing students, nurses having histories of recent or previous major accidents/injuries or chronic diseases. The study population was interviewed on a one-to-one basis by means of a questionnaire based on Modified Nordic Musculoskeletal Questionnaire. Result(s): Among the total study population, 67.5% of subjects reported low back pain (LBP). 22.5% reported upper back, knee, and ankle discomfort. 27.5%, 15%, and 12.5% reported neck, shoulder, and wrist/hand discomfort, respectively. Conclusion(s): The results of this study have revealed that MSDs are a common phenomenon among nursing personnel. LBP is the most familiar among them, 67.5% of subjects have reported the presence of discomfort. Not only LBP, subjects reported neck, shoulder, knee, and upper back discomfort along with ankle and wrist symptoms. In this COVID-19 scenario, their jobs have become more strenuous than usual. It is found that tasks requiring continuous long hours to perform are causing symptoms to appear. Shift rotations, splitting of shifts, using more ergonomically designed tools, knowledge of ergonomic skills are required in this situation to avoid the aggravation of symptoms.
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Aim: There is no study that have assessed face-to-face using the multidimensional pain scale in COVID-19 patients with musculoskeletal pain. This study aimed to reveal the pain region, character and severity in COVID-19 patients with musculoskeletal pain. Material(s) and Method(s): This cross-sectional study was carried out in 214 patients who had a positive result of the polymerase chain reaction test within the last five days and at least one musculoskeletal pain symptom, such as fatigue, myalgia, and arthralgia/polyarthralgia. The cases were divided into groups as clinically severe and non-severe. Evaluations were made on the first day of admission. Myalgia symptoms were classified as diffuse and local. The McGill Pain Questionnaire was used for pain regions and caharacters while the Visual Analog Scale (VAS) was for pain intensity. Result(s): The frequency of involvement was myalgia (96.3%), fatigue (77.6%) and polyarthralgia (62.6%), respectively. The diffuse myalgia was (53.3%) in all patients. The mean myalgia VAS score in the non-severe group was 5.88+/-1.83 and 6.25+/-1.24 in the severe group (p=0.192). The most common pain areas were the back, feet, and knees respectively, and throbbing (40.7%), aching (30.8%), and pricking (26.1%) were the most common characteristics. The suffocating character of the pain was significantly higher in the severe group (p<0.05). Discussion(s): Defining disease-specific pain regions, character and severity in COVID-19 patients with musculoskeletal pain is important in managing possible chronic pain.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Background: COVID-19 is essentially an illness brought about by corona virus. COVID-19 is transmitted primarily by close contact between infected individuals. COVID-19 has been related to myalgia and general weakness in one-quarter to one-portion of suggestive patients. Aim(s): To recognize the number of Covid-19 recovered patients who at present complain of musculoskeletal impairments. Method(s): This was an observational study in which 181 covid-19 recovered patients were surveyed. Data was collected from different hospitals of Pakistan, throughself-made questionnaire and analyzed by SPSS version 21. Result(s): After the collection of data, gender differences exist in musculoskeletal disorders after comparison of both genders with age group 20 to 50 years with 48% are males 58% are females and pie chart shows prevalence of musculoskeletal disorders among covid-19 recovered patients. According to the findings, around 35% of 181 healed patients (with pain in their body parts) have seen a doctor in the last 6 months, while 65% have not visited a hospital to consult a doctor for MSK disease Practical Implication: Musculoskeletal impairments are leading cause of pain and disability that canlead to deformity if remain untreated or left without prior notice. As Covid-19 infection rate is getting higher day by day and till date vaccinationis not available to everyone here. We must ensure that anyone getting infected by the novel Corona can have least negative effects even after patients get cured. Conclusion(s): Gender differences exist in musculoskeletal problems. We have to compare it with Covid. Here we may say that it may be due to more stress among females, there are more chances of MSK issue among females as compared to males.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
ABSTRACT
Psoriasis is a chronic inflammatory skin condition characterized by scaly erythematous patches or plaques affecting the extensor surfaces that are prominent but spreading to all areas of the body, including the flexor surfaces. Psoriasis occurs when the body's immune system attacks the skin;the interleukin (IL)-12 and IL-17/23 axes play a major role in its pathogenesis. Biologic therapies targeting IL-17 or IL-23 have emerged as an important treatment option for psoriasis and have led to substantial improvements in patients' quality of life. This systematic review aimed to evaluate the comparative efficacy and safety of secukinumab, ustekinumab and guselkumab for the treatment of moderate to severe plaque psoriasis. Based on the final analysis, there were 10 articles, namely 5 RCTs and 5 observational. We found that patients who were given secukinumab showed a rapid response, whereas guselkumab was superior in terms of long-term response (approximately 1 year) and complete remission compared to other biologics. Among all the biologics assessed, ustekinumab showed relatively low efficacy.
ABSTRACT
Background: COVID-19 has severely influenced all aspects of life since its emergence and one of the strategies to end this pandemic rest on the vaccination to achieve herd immunity. While vaccinations are usually a safe and effective tool, the abbreviated development process of the available COVID -19 vaccines has increased uncertainties about the safety among the general population especially among patients with immune-mediated diseases (IMD) such as RMD. Method(s): This was a cross sectional study looking at the incidence of adverse events within a month following COVID-19 vaccination among the RMD patients attended rheumatology clinic at the Hospital Tuanku Ja'afar Seremban (HTJS) from 1 May 2021 to 31 September 2021. Result(s): 549 patients were recruited with mean age of 51.5 years. Majority (n = 417, 76%) were females. 414 (75.4%) received Pfizer/ BioNTech, 127 (23.1%) received Sinovac, 7 (1.3%) received Oxford/ AstraZeneca and 1 (0.2%) received Moderna. 35 (6.3%) patients had COVID-19 infection with half of them contracted the infection after at last 1 dose of vaccine. The underlying RMD included RA (n = 217, 39.5%), SLE (n = 122, 22.2%), gout (n = 65, 11.8%), osteoarthritis (n = 41, 7.5%) and psoriatic arthritis (n = 30, 5.5%). 288 (52.4%) patients did not report any side effects following the vaccination. Pain at the site of the injection (n = 169, 30.8%) was the most common side effects, followed by muscle pain (n = 91, 16.4%), fever (n = 90, 16.4%), joint pain (n = 55, 10%) and tiredness (n = 43, 7.7%). 30 (5.4%) cases of RMD flares were reported following the vaccination. 25 were arthritis flare, 3 were SLE flare (2 renal and 1 mucocutaneous involvement) and 2 were psoriasis flare. There were no serious adverse events that required hospitalization. Conclusion(s): This study supports the overall safety of COVID-19 vaccines in patients with RMD. This information can help to overcome vaccine hesitancy among this population.