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Background: Early diagnosis of COVID-19 is key to prevent severe cases and poor outcomes in vulnerable populations, including pregnant women and people living with HIV or infected with tuberculosis (TB). The feasibility of integration of SARS-CoV-2 antigen rapid diagnostic testing (Ag-RDT) into maternal neonatal, and child Health (MNCH);HIV;and TB clinics is unknown. Method(s): We analyzed data from a SARS-CoV-2 screen and test program implemented in 50 health facilities (25 in Kenya and 25 in Cameroon), integrating SARS-CoV-2 Ag-RDT in MNCH, HIV, and TB clinics between May and October 2022. Clients aged two and older attending MNCH, HIV, and TB clinics were offered SARS-CoV-2 screening, and those eligible were tested using SARS-CoV-2 Ag-RDT. Routine SARS-CoV-2 program data were captured through dedicated paper forms in Cameroon or an electronic medical record (EMR) interface in Kenya and transferred to a database for analysis. We estimated the proportion of clients screened and tested and the SARS-CoV-2 positivity rates. Result(s): Overall, 527,184 attendee visits were reported in Cameroon (282,404) and Kenya (244,780), with screening for COVID-19 symptoms and exposure performed in 256,033 (48.5%) with substantive variations between countries (62.6% in Cameroon and 32.4% in Kenya). Among the 256,033 screened, 19,058 (7.4%) were eligible for testing (9.0% in Cameroon and 3.9% in Kenya), of whom 12,925 (67.8%) were tested for SARS-CoV-2 with substantial variation in testing rates between countries (61.9% in Cameroon and 97.9% in Kenya) and clinics (59.9% in MNCH, 68.7% in HIV, and 92.8% in TB clinics). A total of 390 (3.0%) positive tests were identified (329 (3.3%) in Cameroon and 61 (2.0%) in Kenya). The estimated case detection rate was 1.26 (95% CI=0.76-1.75) per 1,000 attendee visits in Cameroon and 0.49 (95% CI=0.12-0.86) per 1,000 attendee visits in Kenya. Country integration strategy, facility level, setting, and clinic were independently associated with screening (Table 1) and testing. Conclusion(s): Integration of SARS-CoV-2 Ag-RDT in HIV, TB, and MNCH clinics was feasible in both countries despite challenges with low screening rates in Kenya and low testing rates in Cameroon. Decentralization of SARS-CoV-2 testing at different facility clinics allowed detection of SARS-CoV-2 cases among vulnerable populations. Integration strategies should consider facility settings (rural compared to urban) and additional human resources in high volume facilities to improve screening and testing rates.
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Background: Most programs use a screen and test strategy to identify SARS-CoV-2 infection, but this strategy does not identify individuals with asymptomatic infection. We determined the SARS-CoV-2 case detection rates in a test-all model compared to the standard screen-and-test model in Kenya and Cameroon. Method(s): A cluster-randomized trial was conducted in 20 health facilities between May-October 2022. In each country, 5 facilities were randomized to test all (testing offered regardless of screening outcome) or screen and test (testing offered if screened positive) arms. Additional staff were hired to support implementation of the two models in Kenya (K) and the test all model in Cameroon (C). Clients age>2 years attending HIV, TB and MNCH clinics were tested using SARS-CoV-2 rapid antigen tests. We estimated case detection rates (CDR) with facility level weighted averages and used a weighted t-test with robust standard errors for between arm comparison. Result(s): Overall, 80,828 attendee visits were reported in the test-all arm (63,492 C and 17,336 K) and 71,254 attendee visits were reported in the screenand- test arm (56,589 C and 14,665 K). In the test-all arm, 42,325 (52.4%) were screened for COVID-19 symptoms (46.7% C and 73.2% K) and 21,536 (26.6%) were tested (29.2% C and 17.4% in Kenya) with a positivity rate of 1.4% (2.0% C and 1.1% K). In the screen-and-test arm, 48,314 (67.8%) were screened (72.8% C and 48.6% K), and 3,629 (7.5%) were eligible for testing (8.2% C and 3.7% K) - of those, 2,139 (58.9%) were tested (57.1% C and 82.4% K) with a positivity rate of 4.1% (3.4% C and 10% K). The estimated CDR was 3.59 (95% CI:1.55-5.64) per 1,000 attendee visits in the test-all arm and 1.46 (95% CI:0.60-2.32) per 1,000 attendee visits in the screen-and-test arm. Compared to the screen-and-test arm, the test-all arm had significantly higher COVID-19 CDR in MNCH clinics (3.57 vs.1.29, p=0.034). There were no significant differences in COVID-19 CDR between the two arms in HIV (4.20 vs.1.98, p=0.174) and TB (10.33 vs. 5.03, p=0.283) clinics, though the number of SARS-CoV-2 infections was small. Conclusion(s): The test-all arm identified more SARS-CoV-2 cases than the routine screen-and-test model, despite overall low testing coverage. The test-all model should be considered in future epidemics to improve early detection of SARS-CoV-2 infection among vulnerable populations, but effective implementation requires additional human resources to manage the clinic volumes. COVID-19 Case Detection Rates Per 1,000 Attendees: Comparison of Screen-and- Test and Test-All Arms.
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A pandemic like COVID-19 being a highly infectious disease has severely affected mankind and business activities. Seeing the critical situation, the honourable Prime Minister of India has called for a lockdown in the entire country in order to suppress the spread of this pandemic. While there are many debates about the spread of disease and lockdown in the entire country, we wish to mathematically understand the diffusion of this pandemic in the context of four highly infected states of India. Moreover, through this paper, we wish to examine the impact of these lockdown periods in order to understand the spread of COVID-19. Copyright © 2022 Inderscience Enterprises Ltd.
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A pandemic like COVID-19 being a highly infectious disease has severely affected mankind and business activities. Seeing the critical situation, the honourable Prime Minister of India has called for a lockdown in the entire country in order to suppress the spread of this pandemic. While there are many debates about the spread of disease and lockdown in the entire country, we wish to mathematically understand the diffusion of this pandemic in the context of four highly infected states of India. Moreover, through this paper, we wish to examine the impact of these lockdown periods in order to understand the spread of COVID-19.
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The happiness and well-being of students are the prime focus of every educational institution. The pandemic forced us to once again think of a robust structure of curriculum that can stand firm in any such unseen futuristic conditions. An attempt has been made to study the effects of psychological, physical, and social factors contributing to happiness among students along with their comparative study before and during pandemic scenarios. Data was collected from 366 respondents through structured questionnaires both before and during the pandemic using convenience sampling. SPSS was used where paired t-test was conducted to compare the before and during Covid-19 happiness of students. Happiness was found to be reduced during the pandemic. The physical factors impacted happiness the most closely followed by the psychological factors and social factors with no significant effect between before and during pandemic happiness. The research explored the difference between happiness scores and factors contributing to happiness amongst students in pre and during covid scenarios in the Indian context. Results may help educational systems to strategise curricula, maximise students' happiness, and a more robust structure for future education systems. Disciplinary: Psychology, Education & Management. (C) 2022 INT TRANS J ENG MANAG SCI TECH.
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India has recorded 4, 10, 000 active cases at present in India with a death toll of 4, 40, 533 since the outbreak of the pandemic. As per NCRB (2018), Indian prisons have a population of 4, 66, 084 prisoners and it has been confirmed that this contagious disease breeds and spreads in overcrowded space, which is not well-ventilated, and which lacks proper sanitation. In such situation the overcrowded prisons of India are also being vulnerable for both prisoners and prison staff. The problem of overcrowded Indian prison has also been acknowledged by the Apex Court in the case of In Re Inhuman Conditions in 1382 Prison, (2018) when it said that there are several prisons where the overcrowding is well beyond 100% and in some cases, it exceeds 150% and admitted that this violates the human rights of the prisoners. The problem of overcrowding has been taken seriously during the pandemic of COVID-19 and there have been number of recommendations from the Indian Judiciary during last one year to protect the prisoners' health. But the recommendations would be worth nothing unless they are being implemented efficiently. Thus, this paper aims to critically analyse the implementation of the recommendations to protect prisoners' health due to overcrowding in situation like pandemic and their efficacy. The research paper will be based on doctrinal research, as the authors would investigate the issue at hand with the help of both primary and secondary data.
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Introduction & Objectives: Day-case Transurethral Resection of Bladder Tumour (TURBT) is currently only performed in 18% cases across the United Kingdom. Concerns exist regarding the quality of TURBT, early recurrence rate and the high-risk patient cohort that makes this approach less popular in some centers. The Primary Outcome was to determine 30-day readmission rate and 30-day morbidity using the Clavien-Dindo classification. The Secondary Outcomes were to determine patient cohort selection, quality of TURBT and early recurrence rate and to report patient feedback following day-case TURBT. Materials & Methods: A retrospective audit of day-case TURBTs in a District General Hospital (DGH) over 3 years pre-COVID19 (January 2017 - March 2020) was performed. We only included patients who underwent a TURBT and excluded any cystoscopy, biopsy or fulguration. A day-case TURBT pathway is in place, for postoperative recovery, instillation of intravesical chemotherapy postoperatively if required and re-admission for trial without catheter when indicated in the hospital. Case notes were reviewed manually. Feedback was obtained from patients who had new tumour TURBT in the last year using hospital patient feedback forms. Results: We included 77 patients who underwent TURBT in the day-case theatre, of these 5 patients required in-patient stay after the surgery. Of the remaining 72 discharged on the same day, 8 were re-admitted (11%) for Clavien-Dindo I complications. The mean age of the patients was 71 years (34-94 years);77% (59/77) were male;reported ASA scores were 3/77 ASA 1 (4%), 43/77 ASA 2 (56%), 28/77 ASA 3 (36%);30% (23/77) patients were on anticoagulants or antiplatelets;the average tumour size was 2cm (1mm – 5cm), 69% (53/77) were papillary in nature and 36/77 were newly diagnosed tumours (47%) and the remainder were recurrences or re-resections. Of the new tumours, 32/36 (89%) received mitomycin C as indicated. On final histology, muscle was present in specimen in 50/77 (65%). The readmission/failed discharge group had a higher rate of older patients, with higher ASA scores and longer operative times, however resection quality and tumour characteristics were not different from the day-case TURBTs. The recurrence rate at first check cystoscopy for the newly diagnosed tumours was 3% (1/36) while 1 patient had residual disease in a bladder diverticulum. All patients reported an overall positive experience. Conclusions: In the first of its kind audit patients reported outcomes after day-case TURBT, though readmission rate was relatively higher than previous reports in the literature, the overall patient experience was favorable and the outcomes of TURBT quality and early recurrence were satisfactory. The data obtained can provide guidance to employ better patient selection to reduce readmission rates. Hence, day-case TURBT can be a feasible option in appropriately selected patients, with a suitable pathway in place.
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Introduction: During the initial peak of the COVID-19 pandemic, many centers globally reported a significant decrease in volumes of emergencies including acute stroke (AS) and acute myocardial infarction (AMI). While the reason for this remains unknown, pandemic-driven anxiety among patients may have resulted in unwarranted refusals to transport when deemed necessary by EMS (Emergency Medical Services) providers. We sought to study the impact of COVID-19 pandemic on the patterns of Emergency Medical transport (EMTr) and patient refusals to transport when serious medical conditions were suspected by EMS personnel. Methods: In this retrospective, observational study of Grady Health System's EMS, we compared the rates of EMTr and refusals for adult patients with suspected diagnoses of AS, AMI, and other medical conditions in the first year of the pandemic (Y1, Mar 2020-Feb 2021) with the corresponding period in the year prior (Y0). We also compared the temporal trends for these variables across the different pandemic waves (1st , Mar-May 2020;2nd , Jun-Aug 2020;3rd, Sep 2020-Feb 2021) with the corresponding periods in the year before. Results: Grady EMS responded to 207,888 calls in Y1 compared to 201,968 in Y0. The overall rate of refusals for all diagnoses was 15.5% in Y1 vs 14.1% in Y0, that for AS was 2.25% in Y1 vs 1.77% in Y0 and 7.5% in Y1 vs 5.67% in Y0 for AMI (Figure). Conclusion: There were more refusals in the first two waves of the pandemic. While refusals were higher for AS and AMI, this was not statistically significant. Our study provides valuable insight into the behavioral patterns of patients seeking emergency care during the pandemic and emphasizes a need for public education and more research. (Figure Presented).
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Background: Adult recipients of hematopoietic cell transplantation (HCT) are at a very high risk of adverse outcomes after COVID-19 (Sharma A, Bhatt NS, et al. Clinical characteristics and outcomes of COVID-19 in haematopoietic stem-cell transplantation recipients: an observational cohort study. The Lancet Haematology. 2021 Mar 1;8(3): e185-93). While children are known to have better outcomes after COVID-19 compared to adults in general, data on risk factors and outcomes of COVID-19 among pediatric recipients of HCT are lacking. Methods: Using the data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) between March 2020 and May 2021, we describe characteristics, severity, treatment approaches, and outcomes of pediatric HCT recipients who were ≤21 years of age at COVID-19 diagnosis. All diagnoses, donor choice/graft sources, and conditioning regimens were included. Patient, disease, and HCT-related factors were described as frequency for categorical variables and median, range, and interquartile range (IQR) for continuous variables. The probability of overall survival after COVID-19 was calculated using the Kaplan Meier estimator. Additionally, an analysis was performed in the subset of allogeneic HCT COVID-19 cases from the United States (US) to identify risk factors for developing COVID-19. COVID-19 cases were compared with a cohort of all pediatric allogeneic HCT recipients without COVID-19 matched by the transplant center. Impact of hematopoietic cell transplant comorbidity index (HCT-CI), HCT indication, donor type, conditioning intensity, graft vs. host disease (GVHD) prophylaxis, and occurrence of acute and chronic GVHD on development of COVID-19 was examined using Cox proportional hazards model. Hazard ratio (HR) and 95% confidence intervals (CI) were provided. Cumulative incidence of COVID-19 among the US centers reporting at least 1 COVID-19 infection was also calculated, using death from any cause as a competing risk. P value <0.05 was considered statistically significant for the analyses. Results: A total of 167 pediatric HCT recipients (allogeneic, allo: 135 and autologous, auto: 32) met study inclusion criteria. Median age at COVID-19 diagnosis for allo and auto HCT recipients were 15 years (range <1-21y) and 7 years (range 1-21y), respectively. Median time from HCT to COVID-19 diagnosis was 15 months (IQR 7-45) for allo recipients and 16 months (IQR 6-59) for auto HCT recipients. Forty-two percent (42%) of the patients had at least one comorbidity prior to HCT. Thirteen percent (13%) were receiving immunosuppression within six months prior to COVID-19 diagnosis. COVID-19 disease severity was mild in 87% of patients, while 4% of patients had severe disease requiring mechanical ventilation or supplemental oxygen. Only 36 HCT recipients (22%) received any COVID-19 directed therapy. Median follow-up from COVID-19 diagnosis was 53 days (range 1-270) and 37 days (range 1-179) for allo and auto HCT recipients, respectively. The overall probability of survival at 45 days was 95% (95% CI 90-99%) and 90% (95% CI 74-99%) for allo and auto HCT recipients, respectively (Figure 1). Forty-five (45) day survival was lower among recipients transplanted at the transplant centers outside the US [non-US recipients 85% (95% CI 71-95%) versus US recipients 98% (95% CI 93-99%)]. No deaths occurred in patients who had received a transplant between 2000-2013. The primary cause of death was COVID-19 in 54% of patients and primary disease in 38% of patients. In the subset analysis restricted to pediatric allogeneic HCT recipients transplanted at the US centers (n=34), the cumulative incidence of COVID-19 infection was noted to be 1.9% (95% CI 1.2-2.9%) at 6 months post-HCT and increased to 4.7% (95% CI 3.4-6.3%) by 1-year post-HCT. Cox regression analysis showed that compared to HCT-CI score of 0, patients with HCT-CI score of 1-2 were more likely to develop COVID-19 (HR 1.95;95% CI 1.03-3.69, p=0.042). Underlying diagnosis, donor type, treatment exposures, or GVHD did not predict COVID- 9 incidence. Conclusions: This is the largest series to date summarizing the cumulative incidence, risk factors, and outcomes of pediatric HCT recipients with COVID-19. Patients with pre-HCT comorbidities were more likely to develop COVID-19. However, the overall disease severity and mortality after COVID-19 were low in this patient cohort. [Formula presented] Disclosures: Bhatt: Rite Aid Corporation: Divested equity in a private or publicly-traded company in the past 24 months;Pfizer Inc.: Divested equity in a private or publicly-traded company in the past 24 months;Moderna, Inc.: Divested equity in a private or publicly-traded company in the past 24 months;Johnson & Johnson: Divested equity in a private or publicly-traded company in the past 24 months. Sharma: Medexus Inc: Consultancy;Spotlight Therapeutics: Consultancy;Vindico Medical Education: Honoraria;CRISPR Therapeutics: Other, Research Funding;Novartis: Other: Salary support paid to institution;Vertex Pharmaceuticals/CRISPR Therapeutics: Other: Salary support paid to institution. Riches: ATARA Biotherapeutics: Other: Payment;Jazz Pharmaceuticals: Other: Payment;BioIntelect: Membership on an entity's Board of Directors or advisory committees. Dandoy: Omeros: Other: Consulted and received Honorarium.
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COVID-19 is having a major effect not only on healthcare delivery systems but also on the science and research sector. The pandemic of COVID-19 immediately closed universities as well as colleges all over the world, amid government orders to adopt social distance, which could help to flatten the transmission curve and decrease the total mortality from the pandemic. Fundamental scientific studies have been especially difficult hit as a result of statewide lockdown restrictions, whilst clinical researchers have encountered similar difficulties as a result of the cessation of medical care and a sudden return to full-time clinical tasks. The number of publications on COVID-19 has rapidly and dramatically increased. This emphasizes the importance of collaborating with other medical research facilities in addition to intra-institute cooperation and collaboration. One method to modify the picture of clinical research is to incorporate additional innovation into the study's design.
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The proliferation of covid-19 has caused extensive damage worldwide and brought global movement into a state of complete stagnation. By the year 2019, another type of infection came into the world knowledge that followed its origins in the bats of Wuhan, China. Coronavirus was declared a global epidemic by the World Health Organization and thinks that the Earth is fighting the inevitable danger posed by humans. As we may be aware that this infection is a new phenomenon, so no vaccines or drugs are available for treatment and the medication currently being used gives our body time to build up its defenses against COVID-19. Immune system is a combination of different organs and cells where each person performs their function in a consistent manner to protect the host from any non-particulate matter for example infections, microbes, growths, parasites, etc. Our body needs a large variety of micro (such as sugar, protein,fats) add to the synthesis of different types of safe cells. In this article, I have tried to explain the role of the immune system in the fight against covid-19 virus and how exercise and proper diet can help build strong immune systems.
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Introduction: Day-case Transurethral Resection of Bladder Tumour (TURBT) is currently only performed in 18% cases across the United Kingdom. Aim: To determine 30-day readmission rate and morbidity after day-case TURBT in a district general hospital (DGH) and to report patient demographics, quality of TURBT and early recurrence rate as well as patient feedback after day-case TURBT. Patients and Methods: A retrospective audit of day-case TURBTs over a three-year pre-COVID19 (2017-20) was performed. We only included patients who underwent a TURBT and excluded any cystoscopy and biopsy or fulguration. A day-case TURBT pathway is in place in this centre. Feedback was obtained using hospital patient feedback forms. Results: We included 77 patients who underwent TURBT in the day-case theatre, of these 5 patients required in-patient stay after the surgery. Of the remaining 72 discharged on the same day, 8 were re-admitted (11%) for Clavien-Dindo I complications (Table1). The readmission/failed discharge group had a higher rate of older patients, with higher ASA scores and longer operative times, however resection quality and tumour characteristics were not different from the day-case TURBTs. All patients reported an overall positive experience (good or very good) (Table 2). Conclusion: In the first of its kind audit reporting patient feedback after day-case TURBT, the data obtained can provide us and other centres adopting day-case TURBTs guidance to employ better patient selection to reduce readmission rates. Hence, day-case TURBT can be a feasible option in appropriately selected patients, with a suitable pathway in place.
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Introduction: The COVID-19 pandemic has wreaked havoc on the presentation, care and outcomes of patients with acute cerebrovascular and cardiovascular conditions. We sought to measure the national impact of COVID-19 on the care for acute ischemic stroke (AIS) and acute myocardial infarction (AMI). Methods: In this retrospective, observational study, we used the Premier Healthcare Database to evaluate the changes in the volume of care and hospital outcomes for AIS and AMI in relation to the pandemic. The pandemic months were defined from March 1, 2020- April 30, 2020 and compared to the same period in the year prior. Outcome measures were volumes of hospitalization and reperfusion treatment for AIS and AMI (including intravenous thrombolysis [IVT] and/or mechanical thrombectomy [MT] for AIS and percutaneous coronary interventions [PCI] for AMI) as well as inhospital mortality, hospital length of stay (LOS) and hospitalization costs were compared across a 2- month period at the height of the pandemic versus the corresponding period in the prior year. Results: There were 95,453 AIS patients across 145 hospitals and 19,744 AMI patients across 126 hospitals. There was a significant nation-wide decline in the absolute number of hospitalizations for AIS (-38.94%;95%CI,-34.75% to -40.71%) and AMI (-38.90%;95%CI,-37.03% to -40.81%) as well as IVT (-30.32%;95%CI,-27.02% to -33.83%), MT (-23.54%;95%CI,-19.84% to -27.70%), and PCI (-35.05%;95%CI,-33.04% to -37.12%) during the first two months of the pandemic. This occurred across low-, mid-, and high-volume centers and in all geographic regions. Higher in-hospital mortality was observed in AIS patients (5.7% vs.4.2%, p=0.0037;OR 1.41,95%CI 1.1-1.8) but not AMI patients. A shift towards an increase in the proportion of admitted AIS and AMI patients receiving reperfusion therapies suggests a greater clinical severity among patients that were hospitalized for these conditions during the pandemic. A shorter length of stay (AIS: -17%, AMI: -20%), and decreased hospitalization costs (AIS: -12%, AMI: -19%) were observed. Conclusions: Our findings shed light on the combined health outcomes and economic impact the COVID-19 pandemic has had on acute stroke and cardiac emergency care.
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Background: Intraluminal carotid thrombi (ILT) are uncommon and present in only 0.4 to 1.5 % of patients with stroke. The endothelial inflammation and hypercoagulable state associated with COVID-19 (caused by SARS-CoV-2) poses a risk of arterial and venous thromboembolism. Herein, we present a series of stroke patients with ILT in the setting of a recent SARS-CoV-2 infection. Methods and Results: From July 9 , 2020 to August 17 , 2020, four patients were identified with acute ischemic stroke with varying thrombus burden but similar morphological patterns of ILT. All patients had evidence of recent SARS-CoV-2 infection as confirmed by PCR (n=3) or IgG antibody (n=1) in addition to clinical and radiological manifestations consistent with COVID-19. General characteristics and imaging of the patients are shown in table 1. Mean age was 55.3 ±7.7 years. Most patients (3) had at least two vascular risk factors and none had a central embolic source other than ILT. D-Dimer was profoundly elevated in 3 patients. ILT involved the cervical (3) and intracranial (1) internal carotid artery. COVID-19 symptoms ranged from mild transient respiratory symptoms to severe pneumonia requiring critical care support. None of the patients received acute reperfusion therapy either due to presentation beyond the therapeutic window or due to the absence of large vessel occlusion and/or unfavorable imaging profile. Conclusion: In this small case series of relatively young patients with acute ischemic stroke we found an association between COVID-19 infection and ILT. This suggests a distinctive pathophysiological pattern of stroke in COVID-19 patients. Further studies are necessary to elucidate the underlying pathophysiology and target specific treatment modalities. (Figure Presented).
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Introduction: COVID-19 or 2019-nCoV, the novel Coronavirus looms over the planet Earth as an imminent threat to mankind. According to expert’s opinion complete lockdown as the only measure to stop the exponential infectivity rates of the virus. Even though some relaxation is offered in the beginning of June month, school & colleges are continuing online sessions for current academic year. Online studies have been started for students & their academic loss is controlled to some extent. Students were forbidden to continue with prolonged home stay. This prolonged home stay may lead towards sedentary lifestyle & thus may affect one’s physical activity. The aim of this study is to investigate impact of five months of lockdown due to Covid19 on physical activity & psychological wellbeing of healthcare students in Nagpur city, Maharashtra. Methodology: a cross sectional observational study is carried out in healthcare students of Nagpur city, Maharashtra. A self-structured questionnaire was prepared & converted into google form. A google form was shared with participants via WhatsApp group. Responses were collected over a period of one week. Result: Participants were between age group of 18-23 years of age group with female participants were 91% & male participants were 9%. Study results showed that students spent almost 2-4 hours (44.1%) & 4-6 hours (44.1%) for online learning. 17,4% students didn’t involve themselves in any physical activity. 35.9% participants experienced pain in low back region followed by neck region (28.7%). 94.1% participants were worried for ongoing things & their purpose in life. Conclusion: This change in lifestyle during lockdown leads to decreased physical activity & students were more vulnerable for pain in different areas of body. This lockdown also affected their self-perceived psychological wellbeing. Helpful strategies to deal with increased stress & reduced physical activities for healthcare students can be implemented for students which will be useful in case repeated lockdown. © 2021, Universitatea de Vest Vasile Goldis din Arad. All rights reserved.
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INTRODUCTION: The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) or novel corona virus disease (COVID-19) pandemic is sweeping the globe. Latest information on the outbreak of the corona virus epidemic in 2019, which was caused by the extreme acute respiratory syndrome corona virus 2 strains, has begun to shed light on the disease's effects on the liver. However, no studies have systematically to date, there have been no impaired liver tests in COVID-19 patients. In patients with irregular liver test results, we looked at the clinical features of COVID-19. The goal of this research was to explain the clinical outcomes of COVID-19 in patients with irregular liver tests and CLD. AIM:We performed an observational study to see how irregular liver tests and patients' clinical outcomes were influenced by chronic liver disease admitted to SMHRC Nagpur. MATERIAL AND METHODS: The research included 200 people aged 25 to 65 years old who had been diagnosed with corona positive and were admitted to Shalinitai Meghe Hospital in Nagpur. They were split up into different parties. One group had chronic liver disease, and the other did not, but both groups had patients that were corona positive. We included patients who had liver defects as a result of corona viruses in this study. During the research phase, we gathered information from this patient. As a research group and a control group, we test SGOT, SGPT, ALP, Protein, Total bilirubin, and GGT levels. RESULTS: The findings show that corona positive patients with liver disease had elevated liver function tests, such as increased levels of SGOT, SGPT, Total billirubin, Alkaline phosphates, and GGT, when compared to those who did not have any liver abnormalities but were corona positive. A history of irregular liver tests and liver damage was related to the development of serious pneumonia. The detrimental impacts on liver injury were linked to some drugs taken during hospitalization, implying that these patients should be monitored and evaluated on a regular basis. CONCLUSION: Patients who had irregular liver tests were more likely to develop serious disease. The negative effects on liver damage were mostly due to some drugs taken during hospitalization, which should be closely monitored and evaluated. © 2021, Annals of R.S.C.B. All rights reserved.
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Following the outbreak of the novel SARS-CoV-2 (COVID-19), the World Health Organization made a number of recommendations regarding the utilisation of healthcare services. In general, there has been a reduction in elective healthcare services including outpatient clinics, diagnostic services and elective surgery. Inevitably these reductions for all but the most urgent clinical work will have a detrimental impact on patients, and alternative ways of working including the use of telemedicine may help to mitigate this. Similarly, electronic solutions may enable clinicians to maintain inter and intra-professional working in both clinical and academic settings. Implementation of electronic solutions to minimise direct patient contact will be new to many clinicians, and the sheer number of software solutions available and varying functionality may be overwhelming to anyone unfamiliar with â virtual communication'. In this article, we will aim to summarise the variety of electronic communication platforms and tools available for clinicians and patients, detailing their utility, pros and cons, and some 'tips and tricks' from our experience through our work as an international research collaborative. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.