Health care professional's perceived stress levels and novel brief COPE-4 factor structure-based assessment of coping methods during COVID-19 pandemic in India: A multi-modal cross-sectional study.

Background: SARS-CoV-19 or popularly known as COVID-19 is recognized as a global public health emergency and a pandemic necessitating readiness of the health system and its operational work force to address the unprecedent challenge. Objective: To assess perceived stress and coping methods using novel brief COPE-4 factor structure and narrate thematic testimonials among health care professionals involved in COVID care in India. Settings and Designs: Health care settings and multi-state cross-sectional study. Methods and Material: A cross sectional mixed-methods study, with multi-modal aids was undertaken during April-May, 2020 using a novel brief COPE-4 Factor structure. Oral informed consent was obtained to document narrative testimonials verbatim from interviews among doctors, nurse practitioners. Statistical Analysis Used: The web-survey data from Google forms analyzed using STATA (Ver 12.0) statistical package. The interview content was subjected to manual inductive thematic coding, grouped into piles to identify broad themes as main categories. Results: Among total 218 respondents, 75 (34.4%) were female and 143 (65.6%) male, mean age of 34.71 (SD = 8.9) years. Majority of the respondents were medical post-graduates on duty (38%) followed by nurses (25%) and public health professionals (14%). Slightly higher levels of stress seen among respondents involved in COVID-19 duty, compared to those not involved (p < 0.001) and positive thinking is the major coping method adopted. Conclusions: Appraising the coping mechanisms of health care professionals reveals positive outlook amidst medium levels of perceived stress while providing COVID-19 pandemic related health care services.

Effect of educational intervention on the knowledge of rabies among medical school students of Chennai.

BACKGROUND: Although rabies is highly fatal, with timely and correct postexposure prophylaxis (PEP) of animal bite victims, it could be prevented. Medical school students should be trained about the appropriate rabies management during their formative years so that they put the right practice later on. The study was conducted to assess the knowledge about rabies epidemiology and prophylaxis among medical students and to find the effect of an educational intervention. MATERIALS AND METHODS: This was a quasi-experimental study conducted with 156 third academic year medical school students at a tertiary care teaching hospital. The study participants were given health education intervention. A study tool assessed the knowledge of study participants on domains such as epidemiology of rabies, pre-exposure prophylaxis (PrEP) and PEP, and national program guidelines of rabies prevention. The study tool was administered before and after the intervention. The impact of educational intervention was measured with scores. Wilcoxon signed-rank test was applied to test the difference. RESULTS: The overall total mean pretest total score was 14.9 (±3.7) and posttest score was 22.7 (±3.23) for a maximum score of 29. The mean pretest scores for epidemiology, PrEP and PEP and national program components were 6.09, 7.95, and 0.85 respectively. Likewise, the mean posttest scores were 8.09, 13.26, and 1.35 respectively. There were a statistically significant improvement in the scores after health education intervention. CONCLUSIONS: After educational intervention, there were statistically significant improvement in the scores of all the three domains. PrEP and PEP and national program domain of rabies need to be emphasized during formative years.

Medical research: Perception and barriers to its practice among medical school students of Chennai.

BACKGROUND: Knowledge of medical students about research has been little explored. Although there has been a practice of medical research among undergraduate level, the practice is not universal and there have been potential barriers and difficulties in carrying out the research. The present study was done to find the perception and attitude toward medical research and to assess the practices and potential barriers in carrying out medical research. METHODOLOGY: This cross-sectional study was conducted among 344 medical school students of a medical college in Chennai, Tamil Nadu, in 2018. Systematic random sampling was used. The study tool was self-administered questionnaire including questions on knowledge, barrier, and 5-point Likert scale for assessing attitude. Adequate knowledge (>70% correct answers) and positive attitude (>25 score) were considered. RESULTS: Among the 344 study participants, only 127 (36.9%) of students had adequate knowledge and 68 (19.8%) had positive attitude toward medical research. Regarding practice of research, only 34.3% had conducted a research and only 17.4% had published in journals. Difficulty in choosing topic, difficulty in collecting data, and allocation of time amidst academic activities were considered as a barrier by 41.6%, 40.7%, and 45.9%, respectively. Association of adequate knowledge and practice was statistically significant for age (P = 0.000), gender (P = 0.000), and academic year (P = 0.000). CONCLUSION: Adequate knowledge and positive attitude were lacking in majority of students. Barriers could be addressed by support programs and sensitization toward research.

Comparison of safety and immunogenicity of 2 WHO prequalified rabies vaccines administered by one week, 4 site intra dermal regimen (4-4-4-0-0) in animal bite cases.

The currently advocated rabies post-exposure prophylaxis regimens are of one month duration with reduced patient compliance. WHO recommended research on shortened vaccination regimens which have a practical and economic advantage over the existing regimens. Hence, the present study was undertaken to assess the safety and immunogenicity of 2 WHO prequalified rabies vaccines administered by one week, 4 site intra dermal regimen (4-4-4-0-0) in animal bite cases. This study was a comparative, open label, phase III, randomized clinical trial conducted at Anti rabies clinic, KIMS Hospital, Bangalore, India. The study was registered in Clinical Trials Registry of India (CTRI) bearing the registration number CTRI/2012/12/003230. Ninety subjects with category II/III animal bites/exposures were enrolled. Equine rabies immunoglobulin was administered to all category III exposures. 0.1 mL of either purified chick embryo cell vaccine (Rabipur) or purified verocell rabies vaccine (Verorab) was administered intradermally into 4 sites on days 0, 3 and 7 to all the study subjects. Serum of subjects collected on day 0, 14, 90 and 365 were analyzed for rabies virus neutralizing antibody (RVNA) concentration. The incidence of ADR in Rabipur and Verorab group was 2.96% and 1.14% respectively. In Rabipur group, geometric mean concentration (95% confidence interval) of RVNA was 14.5 (13.50, 15.57), 11.78 (11.27, 12.31) and 5.95 (5.50, 6.44) IU/mL on days 14, 90 and 365 respectively; In Verorab group geometric mean concentration (95% confidence interval) of RVNA was 14.43 (13.41, 15.53), 11.93 (11.47, 12.40) and 5.67 (5.29, 6.08) IU/mL on days 14, 90 and 365 respectively. In conclusion, Rabipur and Verorab were found to be safe, immunogenic and comparable with each other, when administered using one week, 4 site intradermal regimen (4-4-4-0-0) in animal bite cases.