Showing papers in "Journal of family medicine and primary care in 2021"
TL;DR: In this article, an attempt has been made to assess the indirect effect of the Covid-19 Pandemic on maternal and child health services in public health facilities in the wake of which there was an overall decrease of 2.26 % in number of institutional deliveries.
Abstract: Background: In the wake of the Covid-19 Pandemic, parts of the public health system at increased risk of reduced efficiency include healthcare services for women and children. This in turn could reverse all the progress achieved over the years in reducing maternal and child mortality. In this study, an attempt has been made to assess the indirect effect of the pandemic on maternal and child health services in public health facilities. Methods: Data pertaining to maternal and child health services being provided under specific Government programmes, were collected from public health facilities of District Sant Kabir Nagar in Uttar Pradesh, India. Comparative analysis of the data from the pandemic phase with data from the year 2019 was done to determine the impact on services. Results: Reduced coverage across all maternal and child health interventions was observed in the study. There was an overall decrease of 2.26 % in number of institutional deliveries. Antenatal care services were the worst affected with 22.91% decline. Immunization services were also dramatically decreased by more than 20%. Conclusion: The response of the public healthcare delivery system to the Covid-19 Pandemic is negatively affecting both the provision and utilization of maternal and child healthcare services. It is deterrent to the progress achieved in maternal and child health parameters over the years. Better response strategies should be put in place to minimize lag in service deliwvery.
22 citations
TL;DR: A review article as mentioned in this paper highlights major viral pandemics that have occurred in the last two decades, to understand factors contributing to their emergence, transmission and suggest ways to curb future outbreaks.
Abstract: An epidemic that occurs worldwide, involving many countries and affecting a large population is called as a pandemic. The ongoing corona virus disease (COVID-19) pandemic has not only adversely affected the global healthcare infrastructure, but has significantly impacted world economy, socio-political and cultural environment. There are 219 different types of viruses, known at present to be able to infect human beings. This number is just a tip of the iceberg, with the possibility of a substantial pool of undiscovered human viruses and millions of other virus species (which affect plants and non-human animals) that can be potentially infectious to humans as well. Throughout human history there have been numerous pandemics and disease outbreaks that have not only led to huge loss of life, but also hindered economic growth and development. Therefore, in this review article we wanted to highlight major viral pandemics that have occurred in the last two decades, to understand factors contributing to their emergence, transmission and suggest ways to curb future outbreaks.
22 citations
TL;DR: Dental plaque is a complex microbial population of bacterial and salivary polymers present on the tooth surface, and plaque prevention is an efficient way to both treat and avoid periodontal diseases.
Abstract: Dental plaque is a complex microbial population of bacterial and salivary polymers present on the tooth surface. It is understood that human diseases must be avoided and a high social concern for the population as a whole. The argument for the implementation of successful prevention measures is strong for life-threatening diseases or those with serious morbidity. However, regardless of seriousness, the case for avoiding any disease may be based on the belief that it is easier to be healthy than dead or sick. Thus plaque prevention is an efficient way to both treat and avoid periodontal diseases, it is an important component of gingival and periodontal diseases' primary management.
16 citations
TL;DR: In this paper, the prevalence of obesity and overweight among type 2 diabetic patients, and explore the association between Body Mass Index (BMI), social demographics and time since diagnosis was explored.
Abstract: Context Obesity is a significant worldwide public health issue and one of the significant risk factors for type 2 diabetes and cardiovascular diseases. Aims This study aims to determine the prevalence of obesity and overweight among type 2 diabetic patients, and explore the association between Body Mass Index (BMI), social demographics and time since diagnosis. Settings and Design This study followed a cross-sectional study design in Bisha, Saudi Arabia. Methods and Material Participants were identified by convenience sampling from 6 Primary Health Care Centers (PHCC) over a period of two weeks from March 16 to March 28, 2020. Statistical Analysis Used Frequency and percentage were used to report the obesity prevalence. Chi-Square test was used to test the association between social demographics and time since diagnosis with BMI. Results Obesity and overweight prevalence was 85.8% (n = 525), among which 27.9% (n = 171) were overweight, 57.8% were obese (n = 354), and only 13.2% (n = 81) had normal weight. A statistically significant difference between BMI and age was observed (P = 0.01). Differences between BMI and time since obesity diagnosis were statistically significant (P < 0.0001). Differences between BMI and time since type 2 diabetes diagnosis were not found to be statistically significant. Conclusion There is a high prevalence of obesity and overweight among type 2 diabetic patients in Bisha. Differences in BMI were found to be statistically significant according to age, gender, education level and time since obesity diagnosis. Patient education programs and public health awareness about diabetes and obesity are highly recommended.
14 citations
TL;DR: In this paper, the agreement between two widely used causality assessment scales, that is, the WHO-UMC criteria and the Naranjo algorithm, was assessed using the weighted kappa (κ) test.
Abstract: Background The Pharmacovigilance Program of India recommends the use of the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) scale, while many clinicians prefer the Naranjo algorithm for its simplicity. In the present study, we assessed agreement between the two widely used causality assessment scales, that is, the WHO-UMC criteria and the Naranjo algorithm. Materials and Methods In this study, 842 individual case safety reports were randomly selected from 1000 spontaneously reported forms submitted to the ADR Monitoring Center at a tertiary healthcare Institute in Central India between 2016 and 2018. Two well-trained independent groups performed the causality assessment. One group performed a causality assessment of the 842 ADRs using the WHO-UMC criteria and the other group performed the same using the Naranjo algorithm. The agreement between two ADR causality scales was assessed using the weighted kappa (κ) test. Results Cohen's kappa coefficient (κ) statistical test was applied between the two scales (WHO-UMC scale and Naranjo algorithm) to find out the agreement between these two scales. "No" agreement was found between the two scales {Kappa statistic with 95% confidence interval = 0.048 (P < 0.001)}. Conclusion There was no agreement found between the WHO-UMC criteria and the Naranjo algorithm in our study.
13 citations
TL;DR: In this article, a community-based online cross-sectional study involving adult general population was conducted, where the authors found that the practice of both yoga and meditation is associated with higher level of mental wellbeing during the COVID-19 pandemic.
Abstract: Background: COVID-19 pandemic has resulted in increased mental health issues. Yoga and meditation can help in alleviating mental stress and improving psychological wellbeing. Methods: It was a community-based online cross-sectional study involving adult general population. Data collection was done by using a Google form link that was circulated via online platforms. The data were analyzed using Microsoft Excel and SPSS version 22. Qualitative data were expressed in proportions or percentages and quantitative data were expressed in mean and standard deviation. Chi-square test was used to check the association of various factors and mental wellbeing. Results: A total of 649 (58.4%) subjects had normal mental wellbeing score, whereas 279 (25.1%) were found to be at risk of developing psychological distress and 184 (16.5%) were at risk of depression. A significantly larger proportion of subjects with normal mental wellbeing was found with the practice of both yoga and meditation (66.2%), followed by practice of only meditation (62.1%), only yoga (59.9%), and none of them (50.6%). A similar association of yoga and meditation practices was found with the change in eating, sleeping patterns, and family relations. The frequency of practice was positively associated with a higher level of mental wellbeing in the case of both yoga as well as meditation, with daily practice having the highest wellbeing scores. Conclusion: The practice of yoga and meditation, preferably both of them, is associated with higher level of mental wellbeing during the COVID-19 pandemic.
13 citations
TL;DR: Gua sha is a traditional healing technique that aims to create petechiae on the skin for a believed therapeutic benefit as mentioned in this paper. But, the mechanisms underlying Gua sha have not been empirically established.
Abstract: Gua sha is a traditional healing technique that aims to create petechiae on the skin for a believed therapeutic benefit. Natural healings are mostly based on repeated observations and anecdotal information. Hypothetical model for healing does not always fit the modern understanding. Yet, the mechanisms underlying Gua Sha have not been empirically established. Contemporary scientific research can now explain some events of traditional therapies that were once a mystery. It is assumed that Gua Sha therapy can serve as a mechanical signal to enhance the immune surveillance function of the skin during the natural resolving of the petechiae, through which scraping may result in therapeutic benefits. The current review, without judging the past hypothetical model, attempts to interpret the experience of the ancient healings in terms of contemporary views and concepts.
12 citations
TL;DR: A significant change in the lifestyle and dietary patterns of people brought about because of the COVID-19 lockdown most highly seen as a major increase in screen usage and a decrease in junk food consumption are suggested.
Abstract: Aims, Settings, and Design: The COVID-19 pandemic has forced upon sudden lifestyle changes because of nationwide lockdowns mandating isolation at home, affecting daily habits and lifestyle changes. The present study was conducted with an aim to assess these changes brought about because of COVID-19 lockdown restrictions. Methods: The web-survey aimed to understand the immediate impact of the COVID-19 lockdown on people by using a structured questionnaire collecting demographic, lifestyle, and dietary information. The survey was disseminated online among the literate, urban, adult population with internet access. Results: Of the 1,200 people who received the survey, a total of 1,008 respondents participated in the study, aged between 18 and 81 years (Median- 24). An increase in daily screen time has been observed in 56.7% of the population. A decrease in work-related stress was observed in 43% of the population, sleep pattern improved in 36.7% people, and 27.1% of the inactive population showed increased physical activity. A significant decrease in the proportion of people consuming junk food (73.8%), alcohol (27.6%), and smoking (8.1%) was observed. Conclusions: The present web-based survey study suggests a significant change in the lifestyle and dietary patterns of people brought about because of the COVID-19 lockdown most highly seen as a major increase in screen usage and a decrease in junk food consumption.
12 citations
TL;DR: In this article, a cross-sectional study was conducted among the residents of Delhi, India from July to October 2020 to assess the present state of knowledge people have about the probable vaccine for COVID-19, to know the preferences of respondents about this vaccine and to learn the expectations and apprehensions of people about features of this prospective COVID19 vaccine residing in the capital city of India.
Abstract: Background: Understanding the perception and concerns of people about COVID-19 vaccine in developing and populous country like India will help in understanding demand for the vaccine and further tailoring out public health information and education activities. The study was carried out to assess the present state of knowledge people have about the probable vaccine for COVID-19, to know the preferences of respondents about this vaccine and to learn the expectations and apprehensions of people about features of this prospective COVID-19 vaccine residing in the capital city of India. Methods: This cross-sectional study was conducted amongst the residents of Delhi, India from July to October 2020. Both offline and online interview method was used to collect date from 513 participants representing various occupational strata. Data were collected on sociodemographic variable, vaccine acceptance and concerns regarding COVID-19 vaccine. Results: Among the study population, 79.5% said they will take the vaccine while 8.8% said they were not going to take the vaccine and remaining 11.7% had not yet decided about it. More than 50% were willing to pay for the vaccine and 72% felt vaccine should first be given to health workers and high-risk group. Conclusion: The following study has helped to understand the percentage of people who are hesitant to take the vaccine and also the concerns regarding the vaccine. Also since half of the population is willing to pay for the vaccine, a strategic approach considering the various economical classes of people could be applied in a developing country like India.
11 citations
TL;DR: Nurses are providing their services beyond boundaries so that the authors can overcome with hard time of COVID-19 pandemic, although less but still nurses are suffering from anxiety and depression which need to be addressed to protect and enhance their mental well-being.
Abstract: Background: During this pandemic everyone is facing the wrath of this novel coronavirus but nurses who are meticulously working in closed contact with diseased are at more risk for developing anxiety, depression and compromised quality of life. This study was conducted with an intent to identify anxiety, depression and quality of life and its predictors among nurses who are actively involved in caring of COVID-19 patients. Methods: A cross-sectional online survey was carried out among nurses who were actively involved in COVID-19 duties at government tertiary health care institutes of India and data was collection through convenience sampling. Standardized tools (HADS, WHOQOL-BREF) were preferred for the assessment of participants' anxiety, depression and quality of life. Multivariate regression analysis was used to identify predictors for anxiety and depression. Results: Of 354 nurses, 12.1% were suffering from anxiety while 14.7% had depression. Mean score for physical, psychological, social and environmental domains were 14.75 ± 1.86, 14.92 ± 2.46, 15.21 ± 3.01, and 14.48 ± 2.38 respectively. Nurses' education was a significant predictor for anxiety (odds ratio [OR] = -0.262, 95% CI: -0.510- -0.014, and P value = 0.038). Similarly for depression, designation of nurses acts as a contributing factor (odds ratio [OR] = 0.287, 95% CI: 0.016- 0.557, and P value = 0.038). Conclusion: Nurses are providing their services beyond boundaries so that we can overcome with hard time of COVID-19 pandemic. Although less but still nurses are suffering from anxiety and depression which need to be addressed to protect and enhance their mental well-being.
11 citations
TL;DR: The most common lung problem faced by a post-COVID patient is lung fibrosis and no definitive therapy for managing this pulmonary fibrosis exists as of date, even though various options are being explored as discussed by the authors.
Abstract: The most common lung problem faced by a post-COVID patient is lung fibrosis. Clinical recovery is generally complete in mild-to-moderately severe COVID-19 cases but a small proportion of patients with severe disease may go on to develop lung fibrosis. Patient groups at the highest risk to develop lung fibrosis are the elderly, especially those requiring ICU stay and mechanical ventilation. No definitive therapy for managing this pulmonary fibrosis exists as of date, even though various options are being explored. This case series highlights three cases of post-COVID lung fibrosis and reviews the existing literature.
TL;DR: Estimating the coverage, utilization, and impact of Ayushman Bharat scheme in the rural field practice area of Saveetha Medical College and Hospital, Chennai concluded that creating awareness, appropriate governance, and working toward quality assurance, prompt referral pathways in both public and private healthcare providers can make AyUSHman Bharats scheme effective.
Abstract: Introduction: Ayushman Bharat scheme, otherwise called as Pradhan Mantri Jan Arogya Yojana (PMJAY), is a National Health Protection Scheme introduced on 23 September 2018 by the government of India to aid the economically disadvantaged families. Aim: The study was initiated to estimate the coverage, utilization, and impact of Ayushman Bharat scheme in the rural field practice area of Saveetha Medical College and Hospital, Chennai. Settings and Design: This is the cross-sectional study conducted in the rural field practice area of Saveetha Medical College and Hospital, Chennai. Methods and Material: This cross-sectional study done among 300 households in Mappedu region of Thiruvallur district, Tamil Nadu. Simple random sampling was done to choose the study participants to reach the sample size of 300. Data was collected using semi-structured questionnaire. After the entry of data, the descriptive statistics was presented in frequency tables and graph. Result: The study found that out of 300 households only about 42.33% of the households were covered under Ayushman Bharat scheme. Among the households covered under Ayushman Bharat scheme, 47.24% households have availed Ayushman Bharat scheme in the past 1 year and only 10% of those availed the scheme has spent additional amount for health care. Around 39.88% of the households not having Ayushman Bharat scheme has faced financial burden because of health care expenditure. Conclusion: Creating awareness, appropriate governance, and working toward quality assurance, prompt referral pathways in both public and private healthcare providers can make Ayushman Bharat scheme effective.
TL;DR: In this paper, the authors evaluated the impact of online medical education using videoconferencing platforms on the education environment, satisfaction, and perception of the medical undergraduate students to online teaching.
Abstract: Introduction: The impact of online medical education using videoconferencing platforms on the education environment during the present COVID-19 pandemic is not known. The objectives were to evaluate the impact of online teaching using videoconferencing platforms on the education environment, satisfaction, and perception of the medical undergraduate students to online teaching. Methods: This prospective observational survey undertaken at a medical college included voluntarily participating medical undergraduate students from first (2nd semester), second (4th semester), and third year MBBS (6th and 8th semesters). The education environment was evaluated using the validated Dundee Ready Education Environment Measure (DREEM). The perception of the students was evaluated using questionnaire with five point Likert scale response. Results: The response rate in our survey was 77.5% (465 out of 600 students). The mean DREEM score of medical undergraduate students was 132.3 ± 19.8. Domains of DREEM evaluated were students' perception of learning (30.1 ± 6.3), students' perception of teachers (29.7 ± 4.6), students' academic self-perception (21.3 ± 4.9), students' perception of atmosphere (32.5 ± 6.2), and students' social self-perception (18.7 ± 3.5). Two hundred and fifty five students (54.8%) were extremely satisfied and quite satisfied with the online teaching–learning modalities. Two hundred and fifty eight students (55.5%) rated online learning methods to be very useful and quite useful during the lockdown period. Conclusion: The educational environment at our medical college was positive and students had a positive perception and attitude toward the role of the videoconferencing platforms for learning (telemedicine) during the COVID-19 pandemic lockdown.
TL;DR: Immune and inflammatory markers are significantly altered and related to severity of manifestation in COVID-19 infection and there was a significant rise in total leukocyte count, C-reactive protein, ferritin and IL-6, IL-10, procalcitonin in severe cases but absolute lymphocyte count registered a fall in severe Cases in comparison to non-severe group.
Abstract: Deregulated immune response and raised inflammation are the cardinal laboratory features in COVID-19 infection reflecting severity of condition. Detection of the markers will help in early diagnosis with timely therapeutic implementation and effective outcome. Observational studies have suggested alteration in these parameters with severity of the condition. This systematic review and meta-analysis was conducted to assess the relevance of the fact. Observational studies from databases were scrutinised and 3669 articles were identified. Further screening, based on the inclusion criteria a total of 19 articles with 3115 participants, were reviewed for meta-analysis using random effects model. Any data in median and interquartile range were converted to mean ± SD. There was a significant rise in total leukocyte count, C-reactive protein, ferritin, IL-6, IL-10, procalcitonin in severe cases but absolute lymphocyte count, CD4+ and CD8+ registered a fall in severe cases in comparison to non-severe group. Immune and inflammatory markers are significantly altered and related to severity of manifestation in COVID-19 infection.
TL;DR: In this paper, a cross-sectional, observational, and questionnaire-based study, performed over B.Sc. nursing students of University College of Nursing, WBUHS, found that smartphone addiction and late-night usage affects sleep quality.
Abstract: Background: Smartphones are now an important gadget for us, but the many are getting addicted to it. Researchers showed that smartphone addiction and late-night usage affects sleep quality. Indian nurses are already facing a heavy burden of depression and present position of nurses is quite insecure. Very few studies were performed over nursing students and that leads to the selection of this topic for my research. Methodology: It was a cross-sectional, observational, and questionnaire-based study, performed over B.Sc. Nursing students of University College of Nursing, WBUHS. The questionnaire has three parts. The first part was for sociodemographic variables, the second part measures the addictive phenomena associated with smartphone overuse using a Smartphone Addiction Scale (SAS), the last part was intended to measure the sleep quality by using Pittsburgh Sleep Quality Index (PSQI). Collected data was compiled and analyzed with the help of MS-Excel from Microsoft Office Package-2016. Results: Out of 91 students, 46 students were found to be not addicted, while 45 were addicted to smartphone, as measured by SAS. On PSQI, 17.58% students were found to be good sleepers, while 82.42% came out to be poor sleepers. Significant association was found between age and smartphone addiction (p=0.000031) and between daily calls and sleep quality (p=0.025333). Conclusion: It can be finally concluded that increase in smartphone usage is now a serious matter of concern and lower age groups are more susceptible towards it. Broad-spectrum studies involving multiple institutions is needed to reveal the bigger picture
TL;DR: In this article, a cross-sectional study was conducted using an electronic questionnaire that was distributed randomly through phones and social media to reach the local residents in Saudi Arabia to assess the prevalence of renal stones.
Abstract: Background: Urolithiasis is the most common urological problem worldwide. It is a recurrent multifactorial problem that is caused by the interaction of several environmental and genetic factors. This study aimed to assess the prevalence of renal stones among local residents in Saudi Arabia in order to renew the statistics of renal stones occurrence in the current Saudi population. Methods: A cross-sectional study was conducted using an electronic questionnairethat was distributed randomly through phones and social media to reach the local residents in Saudi Arabia. We then reviewed the published papers in Saudi journals for patients with renal stones. Results: From a total of 580 responders to the electronic questionnaire, the prevalence of renal stones was 9.1% (n = 64). The median age at diagnosis was 29 years and the mean age at diagnosis was 36.91 years (SD = 18.66, Range of 20–99). Two peaks of age were observed, the first peak was at the (21–25) age group representing 34.4% of the kidney stones patients. The second peak was older than 47 years. The majority of those diagnosed with kidney stones had normal BMI (n = 29, 45.3%), and the family history of kidney stones among first degree relatives was found in 35.9% of the cases (n = 23). Conclusion: Kidney stones is a common health problem with the local incidence being underreported. In our sample, the prevalence was 9.1%. We also observed a relatively high percentage of positive family history among renal stone patients (34.9%) that could be attributed to the high rates of consanguinity. We encourage more local epidemiological studies to describe the patterns and the contributing factors of the development of kidney stones.
TL;DR: In this article, a single centre, prospective observational study conducted in a tertiary care centre in north India was conducted to find the predictors of mortality and the need for mechanical ventilation in COVID-19 patients.
Abstract: Background and Objectives: As the number of COVID-19 cases keeps on rising, a better awareness of the nature and severity of the disease will aid in clinical decision-making and management. Hence, this study was conducted to find the predictors of mortality and the need for mechanical ventilation in COVID-19 patients. Methods: This was a single centre, prospective observational study conducted in a tertiary care centre in north India. We included patients with influenza like illness who tested positive for COVID-19. Information regarding patient demography, symptoms, and vital signs on presentation, laboratory values, chest imaging findings, and disease severity was collected by the emergency physician. QSOFA score and National early warning score (NEWS) score were calculated using initial vital signs. Each patient was followed up till discharge or death. Results: We included 116 COVID-19 patients with 33 patients having mild, 46 patients with severe and 37 patients with critical disease. The median age of our patients was 47 years (39–59) with 63% males. About 58% of patients had at least one comorbidity and shortness of breath was the most common presenting feature. The patients with severe and critical disease had a significantly higher respiratory rate and heart rate as compared to mild disease (p
TL;DR: In this paper, the authors evaluated the CFR and RR of COVID-19 across majorly affected States in India and found that the CFR of a disease varies greatly in different regions of the same country and is influenced by numerous factors such as health control policies, medical standards, and detection efficiency and protocols apart from number of screening tests done.
Abstract: Background and aim: CFR and RR are important indicator of disease pandemic. As of now no data is available about cross-states analysis of these. We aimed to evaluate CFR and RR of COVID-19 across majorly affected States in India. Method: We observed and compared data of confirmed COVID-19 cases, number of deaths, number of recovered/discharged cases and calculated CFR and RR across majorly affected States/UT in India from official database of Government of India, State Government official bulletin, accurate database worldometer. Results: The data showed that Gujarat, Madhya Pradesh, West Bengal reported highest CFR on 8th April, 22nd April, 6th May, 1st June 2020 (95% CI 4.91 – 6.99). Kerala showed encouraging recovery rates 24.32%, 70.31%, 93.24%, 45.81% on 8th and 22nd April, 6th May and 1st June 2020 respectively. India had an average estimated weekly Recovery rate of newly discharged/recovered cases was 32.68% from 19th March to 1st June 2020. (95% CI 20- 45.4%). (The Recovery rate across India was 80.83% as on 22nd September 2020.). Conclusion: The CFR of a disease varies greatly in different regions of the same Country and is influenced by numerous factors such as health control policies, medical standards, and detection efficiency and protocols apart from number of screening tests done. This comparison discusses need of evaluating policies with optimal reporting of medical history of affected persons when comparing COVID-19 case and fatality rates in different regions of the Country.
TL;DR: A critical interpretative synthesis (CIS) on the role of herd immunity in current COVID-19 pandemic against the backdrop of mortality and morbidity is conducted.
Abstract: Introduction: Countries globally are evaluating the concept of herd immunity and its critical role in the control of pandemic. The current paper attempts to conduct a critical interpretative synthesis (CIS) on the role of herd immunity in current COVID-19 pandemic. Methods: CIS is tool for developing theoretical framework using interpretation drawn from relevant empirical and non-empirical sources. This review is done by formulating review question for literature search. Purposive sampling of literature was done followed by reciprocal translational analysis of extracted data. Results: Herd immunity is indirect protection from a contagious infectious disease when a population is immune either through vaccination or natural immunity developed through previous infection. The reproduction number for COVID-19 in India was found to be 2.56 and herd immunity threshold as 61%. Discussion: Exposing 71% young population in India to the SARS-CoV-2 infection can achieve herd immunity but with high morbidity as well as mortality. Vaccine are under process. Feco-oral transmission and reinfection of COVID 19 are major factors to develop or break the circle of herd immunity in community. “Immunity passport” can give false sense of security. Surveillance and seroprevalence studies assess immunity status, gradual exposure of infection to younger population and collaborative partnerships on organizations are few strategies to acquire herd immunity. Conclusion: Herd immunity is a measure for prevention and control of COVID-19 pandemic against the backdrop of mortality and morbidity. Vaccine can be boon but if herd immunity is to be acquired by natural infection then preparedness is necessary.
TL;DR: In this article, an electronic survey was distributed randomly through social media platforms among the general population in Saudi Arabia, between the period from July to December 2017, irrespective of their sociodemographic factors, aiming to determine the prevalence of CVS and to verify the most common associated risk factors.
Abstract: Introduction: In the recent era of technological evolution, electronic devices have become an essential part of our lives, not merely in professional work settings, but also in daily leisure activities. Although these devices have simplified our lives, they are associated with a wide variety of health complaints. Thus, the so-called computer vision syndrome (CVS) has become a growing public health problem and has gained significant attention as it plays an important role in the quality of life of each individual, which in turn has put an increased burden on the health care system. Eye symptoms are among the most reported, yet extraocular symptoms were frequently described as adding an extra load. Method: An electronic survey was distributed randomly through social media platforms among the general population in Saudi Arabia, between the period from July to December 2017, irrespective of their sociodemographic factors, aiming to determine the prevalence of CVS and to verify the most common associated risk factors. Results: In total, 690 participants were involved in our study, with a mean age of 33.8 years. Of these, 77.6% suffer from CVS, with eye-burning being the most common ocular symptoms (71%), as well as itching (67.5%), blurred vision (65%), tearing (62.3%), and other eye symptoms being reported. Neck/shoulder pain was found to be the most prevalent extra ocular symptom (85.2%); also back pain and headache are frequently expressed (78% and 70% respectively). A significant positive correlation was observed between CVS symptoms and time spent using the devices (P-value: 0.002). Conclusion: As technology advances, electronic devices have become a common tool that is used for different purposes on daily basis. We found in our study that the so-called computer vision syndrome is a growing public health problem. Thus, community education about the impact of such a lifestyle for proper handling of electronic devices must be addressed to avoid such health complaints.
TL;DR: Younger patients and the group with a higher level of education were found to be more aware of DR, and most of them had knowledge about the relationship between retinopathy and DM.
Abstract: Introduction: Diabetic retinopathy (DR) is a well-known complication of diabetes mellitus (DM) and a major cause of vision loss. Increased awareness of DR is crucial for the prevention and early diagnosis of the disease and preservation of vision. The objective of this study is to assess the level of DR awareness in the Qassim region among type 2 diabetic patients. Materials and Methods: A cross-sectional study was conducted among patients who visited diabetic clinics between January and March 2019 in the Qassim region, Saudi Arabia. This study used structured questionnaires to assess awareness and knowledge of DR. The patients were considered to have a good level of DR awareness if they answered more than 60% of the questions correctly. Results: A total of 307 patients with type 2 DM, 201 males (65.5%) and 106 females (34.5%), participated in the current study. The results revealed that 63.5% of the participating patients involved in this study had good knowledge about DR; 86% of the patients had knowledge about the correlation between retinopathy and DM, and 89.9% believed that DR can be prevented by good control of diabetes. Conclusion: The study showed that about two-thirds of the participants were aware of DR, and most of them had knowledge about the relationship between retinopathy and DM. Younger patients and the group with a higher level of education were found to be more aware of DR. Awareness of DR should be correlated with behavioral practices to improve a patient's compliance in attending annual eye examinations.
TL;DR: Adherence to preoperative risk stratification and a standard anti-emetic prophylactic protocol can significantly reduce the prevalence of postoperative nausea and vomiting.
Abstract: Context: Postoperative nausea (PON) and postoperative vomiting (POV) are the most undesirable morbidity after anaesthesia. There is paucity of data on PONV from the Indian subcontinent. Aims: We aim to study the prevalence of PON and POV, associated risk factors and the effect of following standardized risk stratification and prophylaxis protocols in the day care patient population. Settings and Design: This was a prospective cohort study at a tertiary care teaching institute. Methods and Material: Data from 500 patients undergoing day care surgery over a period of 12 months were analysed. We used the Apfel scoring system for evaluation of risk of post-operative nausea and vomiting (PONV) for each participant. A standard PONV prophylaxis protocol was used intra-operatively. Statistical analysis used: Data analysis was done using the Mann-Whitney U test, the Chi-square and Fisher's exact test. Results: The period prevalence of post-operative nausea (PON) and post-operative vomiting (POV) was 2.04% and 2.45%, respectively, in this study. The prevalence of PONV in each risk category was lower than that predicted by the Apfel score due to utilization of a standard anti-emetic prophylactic protocol. We found younger age, previous history of nausea, previous history of vomiting, urological surgeries and alcohol consumption as significant risk factors for postoperative nausea. Longer duration of surgery, previous history of nausea, alcohol consumption and higher BMI were the significant risk factors for postoperative vomiting. Conclusions: Adherence to preoperative risk stratification and a standard anti-emetic prophylactic protocol can significantly reduce the prevalence of postoperative nausea and vomiting.
TL;DR: In this paper, a cross-sectional study was conducted to determine the prevalence and dependency with tobacco use among tribal gypsies in Thoothukudi district in Tamil Nadu, India.
Abstract: Introduction: The Narikuravars or “gypsy” are a semi vagrant groups distributed across borders, but primarily live in Tamil Nadu, India. They are notorious to face discrimination that interprets into low education level, low socio-economic status and lack of pertinent access to health care. The focus of the present study is to determine the prevalence and dependency with tobacco use among tribal gypsies in Thoothukudi district. Materials and Methods: The study design of the present study was a cross sectional which was done in Thoothukudi district in the month of December, 2019. Oral health status of the study population was analysed by WHO assessment form (adults), 2013. Tobacco dependence was analysed by Fagerstrom Nicotine dependency scale. The inclusion criteria were to include every gypsy person who is a citizen of Thoothukudi district and of all ages. The study included all the narikuravars (164) whose origin is Thoothukudi district. SPSS version 20.0 was used for statistical analysis. Descriptive statistics and Chi square tests were done to establish the distribution and association of the variables, respectively. Results: The total study participants of this cross-sectional study were 164, among them 128 were adults and 36 were children. Results revealed that among the adult population 64.55% were using tobacco, among them 29.1% were using smoking tobacco, 63.4% were using smokeless tobacco and 7.5% were using both. Medium nicotine dependency was more prevalent in both smoking and smokeless tobacco users (82.75% and 53.57%). The association between prevalence of tobacco use and gingival bleeding was statistically significant. Gingival bleeding was present in 88.9% of tobacco users and 11% of non-users (p value- 0.01). Significant association was found between gender and tobacco usage (p value- 0.042), dental erosion and tobacco usage (p value- 0.007). There exists significant association established between gender and nicotine dependency. (p value - 0.000). Conclusion: More than 60% of the adult study participants were using some form of tobacco. Medium tobacco dependency was prevalent among tobacco users. The tribal people have no access to all the services as their counterparts and it's our duty to educate them and create an insight about the ill effects of tobacco usage.
TL;DR: In this paper, a study was conducted to find the impact of Covid-19 pandemic on the four parameters of hospital-acquired infection (HAI) namely, catheter-associated urinary tract infections (CAUTI), central-line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP), and surgical site infections (SSI) with hand hygiene compliance rates among healthcare workers.
Abstract: Introduction: Hospital-acquired infection (HAI) rates were reported to have declined in healthcare settings during the Covid-19 pandemic. Needless to mention that HAI is of paramount interest and relevance to a primary care physician who need to care from womb to tomb inside pandemic. Objectives: This study was conducted to find the impact of Covid-19 pandemic on the four parameters of HAIs, namely, catheter-associated urinary tract infections (CAUTI), central-line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP) and surgical site infections (SSIs) with hand hygiene compliance rates among healthcare workers. Materials and Methods: This retrospective data mining was undertaken in a 700 bed multispecialty teaching hospital in the Eastern India which was a Government of Bihar approved speciality Covid Care Hospital. Data from the monthly routine infection control monitoring and surveillance activities was collated from January 2019 to December 2020. Control charts with upper and lower control limit set at mean ± 1 SD were used to monitor monthly trends of HAIs. Results: The CAUTI rates reduced by 28.01%; the CLABSI rates declined by 37.61%, the SSI rates reduced by 62.39%, while the highest VAP rates were reported in November 2019 (1.9 per 1000 ventilator days). The hand hygiene compliance rates from January 2019 to December 2020 among different healthcare staffs showed a sharply rising trend. Conclusion: Covid-19 pandemic highlighted paramount importance regarding compliance to hand hygiene and implementation of standard infection control practices as recommended by World Health Organisation and Centres for Diseases Control and Prevention (CDC), which can drastically reduce range of HAIs.
TL;DR: A unique case of Wernicke's encephalopathy induced by hyperemesis gravidarum that presented in mid-trimester of pregnancy in a rather extremely unusual way with focal seizures and secondary generalization but fortunately ended up with a good feto-maternal outcome as mentioned in this paper.
Abstract: Wernicke's encephalopathy (WE) is an acute neurological condition characterized by the triad of ophthalmoparesis with nystagmus, ataxia, and global confusion. WE is a life-threatening illness caused by thiamine deficiency, primarily affecting the peripheral and central nervous systems. Thiamine deficiency is predominantly associated with chronic alcoholism, but various other causes have also been reported, including severe malnutrition, prolonged parenteral nutrition, malignancies, immunodeficiency syndromes, liver disease, hyperthyroidism and severe anorexia nervosa, and hyperemesis gravidarum. We, hereby, report a unique case of WE induced by hyperemesis gravidarum that presented in mid-trimester of pregnancy in a rather extremely unusual way with focal seizures and secondary generalization but fortunately ended up with a good feto-maternal outcome.
TL;DR: In this paper, a case with hiccups as an unusual symptom was presented, which brought to light new atypical symptom of COVID-19 are being presented every other day, which shows how the importance being aware of the same.
Abstract: Coronavirus disease (COVID-19) is the newly discovered infectious disease, affecting millions worldwide. Majority of the patients present with mild respiratory syndrome. Some neurological symptoms are reported like anosmia & dysgeusia. We are presenting a case with hiccups as an unusual symptom. An elderly male patient presented to Bapuji teaching hospital attached to JJM medical college, Davangere on 24th July 2020 with intractable hiccups in the last 5 days. There were no other symptoms. Patient's saturation was initially 98% at room air which then dropped to 90%. Based on clinical knowhow, SARS-Cov-2 RNA qualitative RT-PCR test was sent, and the results came positive. Patient improved symptomatically in 2 days and was kept in ward for observation for a total of 7 days. This extremely rare case report brings to light new atypical symptom of COVID-19 are being presented every other day, which shows how the importance being aware of the same.
TL;DR: In this article, the authors highlighted the significance of digitalization in every sphere of life, focusing on virtual care at a large scale, health care delivery becomes possible and convenient even for remote places.
Abstract: The whole world is in the grip of the coronavirus disease (COVID-19) outbreak. This pandemic brought visible changes in the life of humans around the globe. Likewise, the medical health sector is forced to use digital technology to continue to provide medical health services by preventing themselves. COVID-19 pandemic highlighted the significance of digitalization in every sphere of life. By focusing on virtual care at a large scale, health care delivery becomes possible and convenient even for remote places. The use of artificial intelligence concepts in this pandemic, like robots replaced human movements and function automatically to guide the patients in the reception area and found helpful to prevent and manage the crowd in a few countries. Similarly, the use of e-earning platform has emerged as a digital solution to impart medical education to medical students in this corona outbreak.
TL;DR: In this article, the authors assess knowledge, attitude and practice of health care professionals working in Abha primary health care (PHC) centers regarding standard precautions of infection control, and find that only 55.7% attended training programs on infection control and 72.6% viewed a memo about coronavirus.
Abstract: Aim of study: To assess knowledge, attitude and practice of health care professionals working in Abha primary health care (PHC) centers regarding standard precautions of infection control. Subjects and Methods: This cross sectional study included 212 health care professionals in Abha PHC centers. An electronic questionnaire was constructed by the researchers and was used for data collection. It consisted of five parts, i.e., socio-demographic characteristics, knowledge questions about infection control and standard precautions, statements about attitude of participants, practice of health care providers regarding infection control and perceived obstacles against adequate application of standard precautions. Results: Most participants were physicians with Bachelor degree (68.9%, and 45.3%, respectively), while 51.9% had an experience less than five years in PHC. About two thirds of PHC centers (60.8%) had a special and separate room for medical waste. Only 55.7% attended training programs on infection control and 72.6% viewed a memo about coronavirus. About one third of participants (31.6%) had poor knowledge about infection control, 88.2% had positive attitude toward infection control policy and procedures, while 49.5% had poor practice level. There were no significant differences in participants' knowledge or attitude according to their socio-demographic characteristics, while their practices were significantly better among those who got a training program about infection control and those who had an experience
TL;DR: In this paper, a systematic review of COVID 19 in children has been conducted and the outcome included varied aspects of cutaneous and COVID19 infection, including Erythematous maculopapular lesion, varicella like exanthem, and Kawasaki disease like presentations.
Abstract: Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically. Hence, this review gives the clinicians a future direction to be vigilant for skin presentations during pandemics. The Pubmed database used for literature search with keywords COVID 19, children, and skin in different combinations. Articles published in English with cases of age one month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID 19 infection. The authors did not register review protocol. Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion was the most common finding in 138 children. The researcher reported Erythema multiforme, varicella like exanthem, and Kawasaki disease like presentations in the rest of the cases. The duration of the skin lesion was 1 2 weeks in 43%. Skin biopsy done in 18 patients revealed superficial and deep perivascular and peri eccrine lymphocytic infiltrate and lymphocytic vasculitis. RT PCR was positive13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were negative, except positive mycoplasma pneumonia in 2 of 20 cases tested. Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction, drug reaction, or viral infection. The usual cephalo caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study. The absence of any confirmed etiology for such cutaneous manifestations, the possibility of COVID 19, should be explored and thoroughly evaluated and isolated during such a pandemic.