ABSTRACT
Introduction: COVID-19 has emerged as a major health care problem during 2020. The risk of infection and transmission led to imposition of a severe lockdown by the government. The diversion of health care machinery towards the control of transmission, treatment of the infected individuals led to a compromise in delivery of care towards non-COVID ailments. This is truer in rural and unapproachable areas where the health facilities were already in jeopardy. Study Design: A prospective observational study was conducted from May 2020 to November 2020 at PGIMER satellite center, Sangrur. Methods: Standard operating procedures (SOP) were instituted for physical consultation during the COVID-19 pandemic at PGIMER satellite center, Sangrur, a branch of PGIMER, Chandigarh. These were approved by the committee constituted for this purpose. The effectiveness of these SOPs was reported as percentage of healthcare workers who contracted infection for non-COVID OPD. Results: A total of 9963 patients attended the Out Patient Department (OPD). Male to female ratio of the patients was 1.2:1. Maximum (6141) consultations were sought for general physician followed by ophthalmologist (1464). Majority of the consultation were for benign non-communicable disorders. Seventy patients who visited the OPD were referred for COVID-19 testing as they had symptoms of infection. A total of 5 (3.8%) incidents of COVID-19 infection were reported among the healthcare workers at the center. Conclusions: The SOPs proved effective in the delivery of physical care with low occupational hazard to the healthcare workers (HCW).
ABSTRACT
Objective: Rheumatoid arthritis (RA) is the most common inflammatory joint disease. Many studies have shown that erosions and synovitis can be picked up at an early stage on ultrasonography (US) when X-rays appear normal. Ultrasonography exams in inflammatory arthritis helps in determining objective evidence of inflammatory arthritis- synovitis, erosions, effusions and also help in monitoring therapy in established RA patients. Materials and methods: Ninety patients aged over 18 years, who were diagnosed with RA (according to 2010 ACR criteria) of less than two years duration, were included in the study prospectively. Baseline data, disease activity score of 28 joints (DAS 28 score), complete clinical evaluation and laboratory investigations were registered. Conventional radiographs of both hands were taken in posteroanterior views. A power Doppler US was performed on all metacarpophalangeal (MCP) joints and proximal interphalangeal (PIP) joints of both hands. Results: Out of the 90 patients, 84 had positive findings on US and only 13 subjects had positive radiographic findings. The second MCP was the most common joint involved on US. The mean cumulative flow signal (CFS) score was 4.15±5.12. The relation between CFS and DAS 28 scores was highly significant, with p value <0.01. Conclusion: Ultrasonography can detect changes in joints at an earlier stage than radiographs. Both grey scale and power Doppler US have a role in detecting synovitis and erosions.
ABSTRACT
BACKGROUND: Pediatric nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, hypertension, metabolic syndrome, cardiovascular problems, and increased risk of chronic liver disease and Type II diabetes mellitus. The aim of the study was to assess the metabolic profiles and associated risk factors of NAFLD in obese children. MATERIALS AND METHODS: Children with a body mass index (BMI) of >27 kg/m2 an adult equivalent cutoff (Indian Academy of Paediatrics, 2015 guidelines) aged 5-18 years presenting to the pediatric outpatient unit of PGIMER Satellite Centre, Sangrur, India, were retrospectively recruited over a 1-year period. Anthropometry, lipid profile, thyroid levels, liver function test, fasting blood sugar, and blood pressure were measured. Ultrasonography was used to diagnose NAFLD. Logistic regression was used to assess the risk factors. RESULTS: A total of 100 children participated in the study. The mean age was 10.6 ± 2.6 years and the mean BMI-Z score was 2.6 ± 0.5. The prevalence of NAFLD was 62%. Alanine transaminase (ALT) was significantly elevated in all the children with NAFLD. Lipid levels and BMI Z-score were similar in both groups. Unadjusted odds ratio shows statistically significant association of ALT (2.058 [1.11-1.01]) and waist circumference (1.089 [1.19-0.99]) with NAFLD. With adjusted odds ratio only, ALT (1.12 [1.24-1.01]) was found to be significantly associated with NAFLD. CONCLUSION: There is quite a high prevalence of nonalcoholic fatty liver in obese Indian children. All children with raised liver enzymes should undergo sonography to rule out NAFLD.
