ABSTRACT
Diabetic nephropathy (DN) is the most consequential and longstanding microvascular complication of type 1 diabetes mellitus (T1DM) and the most common cause for renal replacement therapy throughout the world. The most important risk factor for DN includes poor glycemic control. We present a rare case where biopsy-proven grade 3 DN had a concurrent presentation at the time of diagnosis of T1DM in a 12-year-old female child. This earlier than expected DN noted in this patient raises the question regarding the need for earlier surveillance for DN in children.
ABSTRACT
Background Since the outbreak, healthcare systems across the globe are overcrowded with coronavirus disease (COVID-19) patients. To sustain the response towards the pandemic, many hospitals have adapted to virtual healthcare and telemedicine. Google™ has become the most widely used search engine over the years. Google Trends™ can be used to depict the public interest over a certain topic. The output of the Google Trends™ is displayed as relative search volume (RSV) which is the proportionate search volume regarding a specific topic comparative to the total search volume in a specific time and region. The primary aim of this study was to evaluate the relationship between the daily reported number of new COVID-19 cases and deaths and the corresponding changes in Google Trends™ RSV of telehealth over six months. Methods A retrospective study was conducted from January 21, 2020 to July 21, 2020. About 17 countries that reported the total number of cases greater than 200,000 in the situation report of July 21, 2020 were selected to be a part of this study. The daily reported new cases and deaths globally and of the selected countries were extracted from the World Health Organization (WHO) situation reports. The combination of keywords used for obtaining the RSV data through Google Trends™ was "telehealth", "telemedicine", "mHealth", and "eHealth". These words were used with the "+" feature of Google Trends™ with "1/21/2020 to 7/21/2020" as time range, "all categories" for the category, and "web search" for the type of search. The worldwide RSV as well as the RSVs of the selected countries were obtained from the Google Trends™ website. Spearman's correlation coefficient (ρ) was used to determine the strength of the relationship between new cases or deaths and RSVs related to telehealth. Results A positive fair correlation was established between the global interest in telehealth and the new cases (ρ=0.307, p-value<0.001) and deaths (ρ=0.469, p-value<0.001) reported worldwide. The United States of America (USA), India, and Bangladesh were found to have a positive fair correlation between the public interest regarding telehealth and the emerging new COVID-19 cases and deaths. The United Kingdom (UK) and Italy demonstrated a positive poor correlation between the rising new cases or deaths and RSV. Similar statistics were noted for the daily new cases of Chile. For Turkey, a positive fair correlation between new deaths and RSV while a positive poor correlation between new cases and RSV was observed. No significant correlation was observed for the rest of the selected countries. Conclusion This study highlights the steadily rising public interest in telehealth during the COVID-19 pandemic. Telemedicine can provide the necessary remote consultation and healthcare for patients in the current situation. However, previous studies have shown that the majority of the countries are inadequately equipped for the digitization of the healthcare system. Therefore, it has become necessary to incorporate telemedicine into the healthcare system to combat any possible pandemic in the future.
ABSTRACT
Background Cervical carcinoma is a widespread disease of the female genital tract, for which human papillomavirus (HPV) is an utmost risk factor. Of the total global burden, the majority is endured by the developing nations of the world, mainly due to inadequate knowledge regarding the disease and ineffective measures taken for its prevention, early detection, and screening. Hence, our study aimed to determine the level of knowledge, general attitudes and perception, and prevention practices related to HPV-based cervical cancer and its socioeconomic correlates among women in Karachi, Pakistan. Methods A cross-sectional, questionnaire-based study was conducted by approaching 450 females in the out-patient department (OPD) of a tertiary care hospital in Karachi, Pakistan from June 2019 to November 2019. The modified Kuppuswamy socioeconomic scale 2018 was deployed to assess the socioeconomic status of participants, while the knowledge score of the participants was determined based on the original Bloom's cut off point. The analysis was conducted using Statistical Package for Social Sciences (SPSS) version 24.0 (IBM Corp., Armonk, NY). Descriptive statistics were used to present the knowledge, attitude, and practice level of respondents. The respondents' knowledge, attitude, and practice scores were compared across socioeconomic and demographic variables using the chi-square test. Results Of the 388 females interviewed, 199 (51.3%) were aware of the term cervical cancer, and 68 (34.2%) knew about Pap smear as a screening test; only 80 (40.2%) women were familiar with HPV vaccination as prophylaxis against cervical cancer. The practice of screening and prevention was found to be remarkably low (2.1% and 1.8% respectively). Socioeconomic status and education level had a significant association with knowledge of cervical cancer. Although around 64% of participants had poor knowledge, 308 (79.4%) demonstrated a favorable attitude as they were willing to know more about screening and preventive practices regarding cervical carcinoma. Conclusion The majority of the participants had insufficient overall knowledge about cervical cancer, HPV, Pap smear test, and HPV vaccination, highlighting the need for mass education through health professionals and media. In addition, the government authorities should provide screening services and vaccination against HPV free of cost to promote early detection of lesions and prophylaxis against this deadly disease.
ABSTRACT
Background: The Coronavirus disease (COVID-19) has created chaos across the globe. Health care workers having close contact with infected individuals play a decisive role in infection control. This study assessed the level of knowledge, attitude, practice (KAP) and perceived stress among health care workers of Karachi, Pakistan. Methods: A cross sectional study was performed between March 11, 2020 and March 25, 2020 among health care workers of Karachi, Pakistan. Data were collected through an online, self-administered questionnaire. The level of KAP was categorized using modified Bloom's cut off point. Chi-square test, independent sample t test, and one-way ANOVA were used to analyze the data with Statistical Package for Social Sciences (SPSS) version 24.0. Results: A total of 304 health care workers responded to the survey. The most popular source of information was found to be TV/radio/newspaper. Although 54.3%, 75%, and 58.9% respondents had good knowledge, good attitude, and good practice, respectively, more than 40% of respondents did not use gloves during patient interaction. Most of participants rated their level of knowledge as moderate and were inclined towards the need for more training. Around 80% of participants had either moderate stress or severe perceived stress. Conclusion: Our study revealed a relatively good level of KAP among respondents, but there is a need for further training programs. This study yielded high stress levels among respondents, with personal and family safety being the main concerns. The government should, therefore, take proper measures to alleviate the stress levels to provide a strong frontline force.
