81st Annual Academic Sessions of the Galle Medical Association, Galle, Sri Lanka, 13-14 October 2022

This journal issue includes s of papers presented at the conference. Topics discussed are: sleeping characteristics among primary school children in Gampaha District, Sri Lanka;cosmetic effects of post thyroidectomy scar and evaluation of patient satisfaction;post-vaccination symptoms of COVID-19 vaccines among adults in Galle;multiple chest trauma in a victim of road traffic collision;anatomical variations of renal vein in a group of Sri Lankan cadavers;hospital acquired infections among patients in Intensive Care Units in Teaching Hospital, Karapitiya;serum Vitamin D level among 1 to 5-year-old children in Galle Municipality and Bope Poddala MOH area.

Demographic and clinical profile of patients with COVID-19 infection during first and second wave in a tertiary care hospital of South Assam

BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was first detected in Wuhan, China in 2019 and since then has engulfed the entire globe at an unprecedented pace. The virus has infected all age groups, both males and females with or without symptoms and with significant variations. In this study, we wanted to analyse the data related to demographic features of COVID-19-infected patients mainly focusing on their age, gender and symptoms. METHODS: This was a hospital-based retrospective study that included all laboratory-confirmed COVID-19 cases which were declared SARS-COV-2 real-time RT-PCR positive by VRDL, SMCH, Silchar from March 2020 to August 2021. Data related to the demographic characteristics of patients with COVID-19 infection was retrieved from the ICMR-COVID-19 portal of the laboratory and analysed. RESULTS: The study included 8065 laboratory-confirmed COVID-19 cases which involved 5605 cases during the first wave and 2460 cases during the second wave of COVID-19, diagnosed from different districts of South Assam. The majority of infected patients were of the younger age group of 20-30 years. The mean age of the patients was almost similar in both waves i.e. 35.9 and 38.4 years. Of the total enrolled patients, 91.7% were reported asymptomatic while 8.3% were symptomatic with fever and cough being the commonest ones. CONCLUSIONS: The COVID-19 pandemic is a huge burden on healthcare facilities. The majority of the infected patients presenting to our hospital were young and asymptomatic, thus posing risk to the community. Hence, it is crucial to practice proper hygiene, wearing of masks and complete the vaccination schedule to achieve better vigilance to combat the COVID-19 pandemic more efficiently and effectively.

Vaccine prevention of COVID-19 in the system of anti-epidemic and preventive measures. literature review

Relevance: Despite the undoubted successes achieved in the fight against infectious diseases, the importance of pathogens in human pathology not only does not decrease, but also shows a tendency to increase. Thousands of people die from complications every year. This is due to the fact that viruses, primarily influenza viruses and coronaviruses, have the ability to change their structure and the mutated virus is able to infect a person again. So, a person who has had the flu has a good immune barrier, but nevertheless a new modified virus is able to easily penetrate it, since the body has not yet developed immunity against this type of virus. To date, the most effective measure of protection against viral infections is vaccination. Aim: Analysis of literature data on the role of vaccination in the system of anti-epidemic and preventive measures in the fight against viral infections, including COVID-19. Search strategy: Scientific publications were searched in the following databases: PubMed, Medline, e-Library, using the Google Scholar scientific search engine. The search depth is 3 years. Criteria for inclusion: publications in Russian and English by thematic requests: vaccination, COVID-19, pandemic;publications included in the PubMed, Medline, e-Library databases;publications for the last 3 years. Criteria for excluding: articles with paid access;s. A total of 168 sources were found. 62 articles passed the selection algorithm, accepted for analysis. Results: Analysis of the literature data has shown that today vaccination is an effective and beneficial measure against various infections worldwide. Vaccines save millions of lives every year. The development of safe and effective vaccines against COVID-19 is a huge step forward towards ending the pandemic and returning to a normal lifestyle. Conclusions: Based on the literature review, it became known that with the help of vaccines, humanity managed to get rid of a number of dangerous infections, and today, in the confrontation with the coronavirus pandemic, great hope is placed on them. A lot of research teams in different countries have joined in the search for a reliable vaccine.

Six months follow-up study on health care workers on persistence of antibodies to SARS-CoV-2 after covishield vaccination

BACKGROUND: Efficacy of COVID vaccines has been evaluated in various studies. The interim analysis from four randomized controlled trials in UK, Brazil, and south Africa regarding efficacy of two doses of the vaccine was found to be 70.4% (95.8% CI 54.8-80.6). There is a limited data on follow-up Ab titer post vaccination. Hence, the current study is first of its kind with the objective to determine vaccine long term efficacy and its determinants. METHODS: Health Care Workers (HCW) from Apollo Multispeciality Hospitals, Kolkata who underwent Covishield vaccination from January 2021 to April 2021 were included in the study. Serological testing was done prior to first and second dose of vaccinations, and additionally around six months post second dose. RESULTS: Between January 2021 to April 2021, 2032 HCW, with predominant age of less than 30 years (44.83%) and male gender (61.96%) undergoing Covishield vaccination were enrolled. Antibodies were detected in 953 (46.9%) individuals prior to first dose, 1449 out of 1495 (96.9%) remained positive prior to second dose and 465 out of 504 (92.3%) HCW after 6 months and remaining 39 (7.7%) either had lost or never had antibodies in their blood. The mean +or- SD value of first, second and third antibodies were 2.35 +or- 3.10, 10.46 +or- 4.84 and 8.75 +or- 4.88 respectively. CONCLUSIONS: This study provides long observation period, covering the complete progress of the pandemic which provides a "real-life" picture of the antibody level dynamics over time, and after vaccination.

Non-invasive ventilation an alternative to invasive ventilation in COVID-19 patients

Objectives: To study the role of non-invasive ventilation (NIV) in the treatment of COVID-19 patients with mild to moderate acute respiratory distress syndrome (ARDS).

Reasons for hesitancy to take COVID-19 vaccinea survey amongst healthcare workers

Background: Concern about vaccine hesitancy is growing worldwide. Vaccine hesitancy can have effects for both the individual and the community, especially in the context of severe acute respiratory syndrome coronavirus 2 disease (COVID-19) pandemic. Methods: A 16-item questionnaire was administered to 385 healthcare workers to find out the reasons for COVID-19 vaccine hesitancy. Results: Their mean age was 36.6 +or- 9.6 years. 'Fear of getting side effects' (61.8%) was the most common reason for vaccine hesitancy, followed by reasons such as 'to wait and observe for some more time' (60.3%), 'doubts on safety and efficacy of vaccine' (49.4%), 'The intensity of COVID-19 has come down' (36.6%), 'self-perception of having good immunity' (33.8%), 'need to apply for leave' (30.3%) and 'Fear of death' (29.0%). 'To wait and observe for some more time' was the major reason for hesitancy amongst men. Security guards were more hesitant to take the vaccine, because of side effects, whereas doctors and sanitary workers wanted to wait and observe for some more time. Conclusions: Factors identified in the present study need to be addressed for overcoming vaccine hesitancy.

The vaccination process against COVID-19 - present and future

In some people, SARS-CoV-2 infections cause mild symptoms, but in others they are severe, even fatal. The best way to control the pandemic and fight this "invisible enemy" is to vaccinate and create virus-specific immunity. The purpose of this article is to examine the level of vaccination and attitudes to conduct it in order to prevent infection, severe course and/or obtaining a digital certificate. Materials and methods: An anonymous and voluntary online survey was conducted in the period 21 October - 3 November 2021 among 106 respondents. Documentary, statistical method and method of graphic analysis of the obtained results were also used. Results and conclusions: The study confirms the negative trends observed in the vaccination process. Approximately 25% of the respondents have completed a vaccination course against COVID-19, and 34% have positive attitudes towards the vaccination process. Two thirds of the participants in the study have a negative attitude towards vaccination, with approximately half of them categorically stating that they would not be vaccinated under any circumstances.

Investigation on the risk factores for mortality of patients with COVID-19 and prioritization these factores using neural network in some southern cities of Iran

Background & Aims: Epidemics of human viruses began during the period of Neolithic around 12,000 years ago. Humans developed more densely population which allowed viruses to spread rapidly among communities. Also, plant and livestock viruses increased along with human viruses (2). At the January 2020, the coronavirus disease (COVID-19 7th human coronavirus) was discovered in Wuhan, Hubei province of China. COVID-19 virus caused six million deads in the world to date and cussed infection of more than seven million of cases in Iran (1). This infectious disease caused by the SARS-CoV-2 virus. This virus was contagious and fast-spread. Despite the aquarantine politics, SARS-CoV-2 virus caused many permanent economic and health damages in most countries. Coronaviruses are positive-sense, single- stranded enveloped RNA viruses with helical capsids that infect a wide range of hosts including humans, bats, other mammals, and birds (2). Coronaviruses are belonging to Nidovirales order, Coronaviridae family, Coronovirinae subfamily and four genera of alpha, beta, delta, and gamma. Alpha and beta coronaviruses are known as human infection agents. SARS-COV-2 virus abilities are including: high mortality number, short period of incubation, widespread transmission protocols, asymptomatic infection and affecting on most vital organs (heart, brain, lungs and ...) which have attracted the health system attention and caused neglect to the other chronic and non-communicable diseases (4). Therefore, the disease incidence, prevalence and prioritization around the world may change in the future. From the beginning of COVID-19 pandemic, some symptoms and risk-factors have been introduced to the world as the increase elements of morbidity and mortality. Studies have shown that having any kind of underlying diseases and risk factors will be effective in the COVID-19 disease severity and mortality (6). Some of these important risk factors are including of chronic kidney disease, hypertension, age, gender, obesity, obstructive pulmonary diseases, diabetes, lung diseases, cardiovascular diseases, cancer, and liver disease. Also, each risk factors have different impact in different geographic areas (7). Some factors, such as different viral load kinetics in each individual person, epidemiological history, therapeutic or pharmacological effects and immune response have some major impacts on the laboratory diagnostic results. Due to the successive mutations of the SARS-CoV-2 virus and the high incidence disease, it seems that the vaccination alone cannot prevent the COVID-19 (9). On the other hand, the World Health Organization has warned about the vaccination as the only pandemic control protocol. Therefore, the prevalence of morbidity and mortality have become the public health concerns in the world since the beginning of the COVID-19 epidemic and the vaccination. Recognizing of the risk-factors and symptoms on COVID-19 in different geographic areas can be a helpful source to prevent the mortality. Understanding risk factors can help the world to control of the coronaviruses pandemic period and similar situations in the future. Therefore, the aim of this study was to determine the risk-factors of mortality of COVID-19 patients in three cities of Khuzestan province, Iran. Methods: This research was an analytical cross-sectional study. Some details of 27963 COVID-19 patients such as clinical symptoms, individual characteristics and underlying diseases were gathered from hospitals in Abadan, Shadegan and Khorramshahr cities in Khuzestan province, Iran, from 20 February 2020 to November 2020. All the under-study population was previously investigated in terms of COVID-19 infection by the medical examinations and laboratory methods. This under-study population was categorized into three different groups such as hospitalized, outpatients and dead patients. Hospitalized patients have admitted in general or ICU (Intensive Care Unit) sector. Obtained database of COVID-19 patients was analyzed by IBM SPSS version 22.0 under regression, logistic model (u

[Guiding opinion for infection protection in Ear & Nose & Throat Department during the outbreak of coronavirus disease].

It has been more than 2 months since the outbreak of coronavirus disease（COVID-19）. The Chinese Ear & Nose & Throat Department（ENT） health care workers are brave in defending against the disease. The COVID-19 patients without predominant symptoms may consult ENT doctors, even though the ENT department isn't thought first front of the battle. The ENT health care workers have high risks of exposing to the SARS-CoV-2 virus. This article gives some recommendations of infection prevention and control to ENT health care workers of the outpatient and inpatient department.