Effects of Tele-Counseling on Reducing Anxiety Levels of COVID-19 Patients in Isolation Wards: An Observational Study.

Background: COVID-19 causes psychological distress and anxiety due to fear of infection and the possibility of worsening symptoms leading to mortality. Public health measures like contact tracing and lockdowns further increase the panic among infected patients and the public. We intended to assess the effect of telecounseling in reducing anxiety in patients admitted to isolation wards. Methods: In this multi-center observational study, we administered a Generalized Anxiety Disorder-7 (GAD-7) scale before and after telecounseling. The study group consisted of participants who gave consent for telecounseling, and those who did not give consent constituted the control group. The telecounseling was based on the Psychological First Aid model, due to its simplicity. Results: There was a statistically significant decrease in anxiety after telecounseling in the study group (P value ≤ 0.001, effect size = 0.484). There was a statistically significant decrease in anxiety in the study group compared to the control group (P value ≤ 0.001). Conclusion: Telecounseling contributed to the reduction in anxiety in COVID-19 patients in isolation wards. Several other factors like severity of the infection, comorbid medical illness, pre-existing mental health issues, individual's level of coping with stress, and duration and place of admission may have affected the anxiety levels in the patients.

Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India.

BACKGROUND: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. METHODS: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. RESULTS: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. CONCLUSIONS: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.

Challenges Faced by an Otolaryngology Resident During Covid-19 Pandemic: An Indian Perspective.

SARS-CoV-2 virus causing COVID-19 disease has brought tremendous strain on health care sectors around the world. Being a respiratory disease, COVID-19 has tremendous implications on the otolaryngology residency. Otolaryngology residents are dealing with great apprehension of getting infected while working with both COVID-19 and non-COVID patients. Further, drastic change in the routine has affected their residency training. Outpatient and Inpatient care, elective and emergency surgeries which are a crucial part of the residency training have taken a back seat. India being a densely populated country is still in the midst of the pandemic with cases increasing exponentially each day. This article enumerates the challenges faced by an otolaryngology resident during COVID-19 pandemic in a tertiary care hospital in India.