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Showing papers in "Journal of family medicine and primary care in 2022"


Journal ArticleDOI
TL;DR: In this article , the authors examined the status of cancer screening in India from the National Family Health Survey (NFHS)-5 report for the period of 2019-2021 and found that only 1.9% of women participated in cervical, breast, and oral cavity screening.
Abstract: ABSTRACT Background: Cancer is often detected much later to its onset, resulting in poor prognosis. This makes cancer the second most common cause of death globally. Looking for cancers much before any symptoms occur is termed “cancer screening” and is a powerful strategy for prevention, early diagnosis, and better management of several cancers. This paper examines the status of cancer screening in India from the National Family Health Survey (NFHS)-5 report for the period of 2019–2021. Methods: Secondary data on participation in screening for cervical, breast, and oral cancer were extracted from the NFHS-5 report. Participation status for all the above cancer types is represented as percentages and compared across 28 states and eight union territories in India. Results: The percentages of women who have ever undergone cervical, breast, and oral cavity screening were 1.9%, 0.9%, and 0.9%, respectively. About 1.2% of men participated in oral cavity screening. The highest percentage of cervical and breast cancer screening participation was reported in Tamil Nadu (9.8% and 5.6%, respectively), followed by Puducherry (7.4% and 4.2%) and Mizoram (6.9% and 2.7%). Andaman and Nicobar Islands reported the highest oral cancer screening among women (10.1%) while Andhra Pradesh (6.3%) reported the highest participation among men. Conclusion: Cancer screening participation in India is extremely inadequate and calls for the immediate attention of national and state governments. Additional efforts are warranted to improve public awareness of cancer screening, and appropriate measures should be implemented to conduct well-organized screening programs across the country to ensure maximum participation.

30 citations


Journal ArticleDOI
TL;DR: In this article , a five-year bibliometric analysis of the Journal of Family Medicine and Primary Care (J Family Med Prim Care) between 2016 and 2020 was conducted in the Department of Conservative, Endodontics and Aesthetic Dentistry, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand and Rohilkhand Medical College and Hospital, Bareilly, UP.
Abstract: Aim: To conduct a five-year bibliometric analysis of the Journal of Family Medicine and Primary Care (J Family Med Prim Care) between 2016 and 2020. Setting and Design: This retrospective secondary data analysis was conducted in the Department of Conservative, Endodontics and Aesthetic Dentistry, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand and Rohilkhand Medical College and Hospital, Bareilly, UP. Material and Methods: The data of publications including research articles, review and case reports excluding editorials and letters to the editor, commentaries and invited articles published in the J Family Med Prim Care between 2016 and 2020 were downloaded from the journal website and analysed in terms of the bibliometric parameters. Results: The results revealed that the journal gave equal weightage to all types of articles. The total number of articles published between 2016 and 2020 was 2,426 out of which 1,666 articles were published from India and the remaining from other parts of the world. In India, the state of Delhi had the maximum publications while speciality Preventive and Social Medicine (22.42%) and General Medicine (23.12%) had the maximum articles. Moreover, between 2016 and 2020, J Family Med Prim Care had 2,132 citations of published articles and had 65 publications in 2020 about the Corona Virus Disease (COVID-19) pandemic. Conclusion: The issue numbers per year for J Family Med Prim Care has gradually increased over time. The publication is open for all fields of medical, dental sciences and allied sciences.

21 citations


Journal ArticleDOI
TL;DR: The review thoroughly summarises the state-of-the-art information and compares the biochemical properties of these deadly coronaviruses with the clinical characteristics, laboratory features and radiological manifestations of illnesses induced by them, with an emphasis on comparing and contrasting their similarities and differences.
Abstract: In the 21st century, we have seen a total of three outbreaks by members of the coronavirus family. Although the first two outbreaks did not result in a pandemic, the third and the latest outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) culminated in a pandemic. This pandemic has been extremely significant on a social and international level. As these viruses belong to the same family, they are closely related. Despite their numerous similarities, they have slight distinctions that render them distinct from one another. The Severe Acute Respiratory Distress Syndrome and Middle East Respiratory Syndrome (MERS) cases were reported to have a very high case fatality rate of 9.5 and 34.4% respectively. In contrast, the CoVID-19 has a case fatality rate of 2.13%. Also, there are no clear medical countermeasures for these coronaviruses yet. We can cross information gaps, including cultural weapons for fighting and controlling the spread of MERS-CoV and SARS-CoV-2, and plan efficient and comprehensive defensive lines against coronaviruses that might arise or reemerge in the future by gaining a deeper understanding of these coronaviruses and the illnesses caused by them. The review thoroughly summarises the state-of-the-art information and compares the biochemical properties of these deadly coronaviruses with the clinical characteristics, laboratory features and radiological manifestations of illnesses induced by them, with an emphasis on comparing and contrasting their similarities and differences.

19 citations


Journal ArticleDOI
TL;DR: The concept, applications, and advantages of mobile technology for health and the present pandemic have been discussed and the opportunities to improve its applications for unseen future health crises are discussed.
Abstract: Healthcare systems deal with disease prevention, early detection, diagnosis, investigation, and timely, affordable, and safe treatment. For the delivery of services in the health sector, communication is the key to linking the service provider and the patients. Mobile technology in the recent past has rendered various platforms of communications for the healthcare system. Thus, in health, mobile technology has greatly contributed to time management and cost reduction for healthcare at every level including hospital visits to individual appointments with doctors, hence the convenience. With advancements in mobile technologies and the growing number of mobile users, newer opportunities have opened up for the use of mobiles for patient care. Emerging information and communication technologies with the help of the Internet of Things (IoT) have been instrumental in integrating different domains of the health sector with mobile technology. Thus, the technology may have the potential to become powerful medical tools to support the health sector at all levels of care. In this review, the concept, applications, and advantages of mobile technology for health and the present pandemic have been discussed. It also discusses mobile health technology, as a support system for convenient and safer healthcare for public health, and the opportunities to improve its applications for unseen future health crises.

14 citations


Journal ArticleDOI
TL;DR: Xerostomia, frequent aphthous ulcers, swallowing difficulty, and burning mouth were the most frequently encountered symptoms in study subjects during the disease and post recovery.
Abstract: Background: Viral diseases continue to emerge as a threat to mankind and are a serious concern to public health. The latest lethal SARS-CoV-2 or COVID-19 is a highly contagious disease, which propagated quickly across the globe. Similar to other influenza-like viral infections, symptoms such as fever, dry cough, myalgia, arthralgia, headache, diarrhea, dyspnea, and fatigue were reported among COVID-19 patients. Evidence suggests that the oral cavity is affected by this virus either directly or indirectly. Aim: The aim of this observational study was to determine the oral manifestations among COVID-19 patients. Materials and Methods: A cross-sectional, questionnaire-based study was carried out among COVID-19 recovered patients. A sample of 100 subjects, diagnosed as mild and moderate cases of COVID-19 disease were selected based on inclusion and exclusion criteria. Results: The study comprised an almost equal number of male (51%) and female (49%) participants and among them, 48% belong to the health professional group. A total of 54% of subjects were aged above 35 years and 46% below 35 years. Oral manifestations among study subjects during and after the disease illness included xerostomia being the commonest symptom (44%), followed by swallowing difficulty (16%), mouth ulcerations (10%), chewing problem (7%), gum bleeding (6%), and burning sensation (4%). Conclusion: Xerostomia, frequent aphthous ulcers, swallowing difficulty, and burning mouth were the most frequently encountered symptoms in study subjects during the disease and post recovery. Early identification of oral symptoms in COVID-19 recovered or suspected cases can help a dentist or a general physician to diagnose high-risk groups, mitigate transmission, and promote overall health.

11 citations


Journal ArticleDOI
TL;DR: A comprehensive review on the additions in the medical infrastructure during the time of oxygen crisis in India along with the introduction of certain novel approaches towards oxygen production and conservation is presented in this article .
Abstract: Oxygen is used extensively in illnesses involving respiratory system. In emergencies such as the one created by the flare of Covid-19, oxygen consumption has increased tremendously. This article aims to improve our understanding about the medical oxygen, its production (air separation unit, pressure swing adsorption, oxygen concentrators), the supply chain, storage methods, and the final delivery system to the patient. This article also provides a comprehensive review on the additions in the medical infrastructure during the time of oxygen crisis in India along with the introduction of certain novel approaches towards oxygen production and conservation. We aim to minimize the panic among our readers by giving them an insight about the course behind the oxygen supply in that oxygen mask.

10 citations


Journal ArticleDOI
TL;DR: EuDKA is commonly seen in middle-aged female, T2DM patients taking SGLT2 inhibitors along with metformin, and the risk of DKA in patients receiving SGLt2 inhibitors increases by 3.7 times than the other medication.
Abstract: Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) rarely cause euglycemic diabetic ketoacidosis (euDKA) in diabetic patients. The aim was to identify demographic, clinical, and predisposing factors for euDKA from published case reports. Methods: A systematic review of published case reports of euDKA in patients receiving SGLT2 inhibitors and meta-analysis of clinical trials to quantify the risk ratio (RR) of DKA in patients receiving SGLT2 inhibitors. PubMed and EMBASE databases were searched for the case reports of and clinical trials from January 2010 to August 2020. Studies published in English language were included and other languages were excluded. Data related to patients' demography, clinical presentation, drug and dose of SGLT2 inhibitors, and concomitant medication were extracted. Incidence of diabetic ketoacidosis (DKA) extracted from clinical trials. Data related to demographic, clinical, and other parameters presented as ratios and proportions and incidence of DKA in RR using Review Manager 5.3. Results: Forty-seven of 160 reports with an aggregate of 77 patients were included in the analysis. The majority of the patients were females (67.53%), with T2DM and with gastrointestinal symptoms (58%). Surgery was the most common precipitating factor (n/N = 15/77). Canagliflozin (n/N = 34/77) was the commonest SGLT2 inhibitor reported along with metformin as the concomitant medication (63.6%). The pooled RR of DKA was 3.70 (95%CI 2.58, 5.29) and I2 = 0%. Conclusion: euDKA is commonly seen in middle-aged female, T2DM patients taking SGLT2 inhibitors along with metformin. The risk of DKA in patients receiving SGLT2 inhibitors increases by 3.7 times than the other medication.

10 citations


Journal ArticleDOI
TL;DR: SARS-CoV-2 seropositivity rate among children was high and comparable to that of the adult population, Hence, it is unlikely that any future third wave by prevailing SARS- CoV- 2 variant would disproportionately infect children 2 years or older.
Abstract: Background: Estimating seroepidemiolgical prevalence of SARS-CoV-2 antibody is an essential public health strategy. There is insufficient evidence of prevalence among those belonging to young age population in India. Objective: To compare the SARS-CoV-2 seropositivity rate between children and adults in selected sites from India. Materials and Methods: This was a multicentric population-based seroepidemiological study conducted in selected urban and rural areas of five sites selected from four states (Delhi, Odisha, Uttar Pradesh, Tripura) of India. Participants aged ≥1 year were included from different clusters of each area. Total serum antibody against SARS-CoV-2 virus was assessed qualitatively by using a standard enzyme-linked immunosorbent assay (ELISA) kit.Results: Data collection period was from 15 March 2021 to 10 June 2021. Total available data was of 4509 participants, of whom 700 were <18 years of age and 3809 were ≥18 years of age. The site-wise number of available data among those aged 2–17 years was 92, 189, 165, 146 and 108 for the sites of Delhi urban, Delhi rural, Bhubaneswar rural, Gorakhpur rural and Agartala rural area, respectively. The seroprevalence was 55.7% in the <18 years age group and 63.5% in the ≥18 years age group. The prevalence among female children was 58% and among male children was 53%. Conclusion: SARS-CoV-2 seropositivity rate among children was high and comparable to that of the adult population. Hence, it is unlikely that any future third wave by prevailing SARS-CoV-2 variant would disproportionately infect children 2 years or older.

10 citations


Journal ArticleDOI
TL;DR: This review identifies the impacts of the pandemic on biomedical waste management and systematized efforts from all stakeholders, at all levels, not only refines epidemic preparation but also helps to attain a sustainable development of health for a healthier future.
Abstract: The whole world was shaken with the pandemic of Coronavirus Disease (COVID-19) in end of the year 2019. Due to its novel origin, it was required to follow all precautions possible. Dealing with the massive amount of infectious healthcare waste became an enormous challenge. This review identifies the impacts of the pandemic on biomedical waste management. This systematic review was made by using keywords “biomedical waste” and “COVID 19” in open access databases like PubMed, Science Direct, Scopus, Google Scholers etc. 2124 articles downloaded and 765 found duplicate and 634 not related to the topic. after scrutiny with inclusion criteria 102 articles were considered to analyze the practices related to biomedical waste management during pandemic using PRISMA guideline.. The COVID-19 waste segregation, collection, storage, transportation, and disposal are a big challenge with all stakeholders. In order to control the virus spread, strict monitoring of the complete waste management cycle is required. Adoption of appropriate guidelines is paramount to worker safety and containment of infection. Sustainable recycling methods are needed to deal with the ever-increasing plastic waste resulting from mandatory personal protective equipment (PPE) usage. The situation also demands a rethinking of the healthcare system. Overall, there was an increase in BMW generation, and municipal waste had increased globally. Pandemic preparedness requires a global public health strategy and long-term investments. This will be vital for making a robust community capable enough to fight against any public health pressures in the future, as well as the pandemic tremors. Systematized efforts from all stakeholders, at all levels, not only refines epidemic preparation but also helps to attain a sustainable development of health for a healthier future.

9 citations


Journal ArticleDOI
TL;DR: Though COVID-19 and leptospirosis are two different diseases, both of them show a similar life-saving response to steroids, the common factor in the pathogenesis being cytokine storm.
Abstract: Background: COVID-19 is an emerging infectious disease with a global outreach. Leptospirosis is a zoonotic disease mainly confined to tropical areas. In both cases, most of those affected are asymptomatic or have only mild respiratory disease. Those who turn critical develop acute respiratory distress syndrome (ARDS) and/or multiple-organ failure occurs rapidly, with high fatality. Methodology: This is a retrospective observational study from 2020 involving COVID-19 and leptospirosis patients. The data were collected using a semi-structured proforma, and analysis was performed using Easy R (EZR) software. Results: There were five patients with COVIDC-19 and four patients with leptospirosis; with pulmonary involvement. All the patients were males. There was no significant difference in age, the onset of pulmonary involvement, time of initiation of steroids, duration of steroids, and outcome between the two groups. However, in the case of COVID-19, it took a longer period for clearing of infiltrates. Conclusion: Though COVID-19 and leptospirosis are two different diseases, both of them show a similar life-saving response to steroids, the common factor in the pathogenesis being cytokine storm. Primary care physicians in tropical areas of the world should be aware of the similarities between these two diseases, especially the initial clinical presentation, the pathogenesis, and the response to steroids.

8 citations


Journal ArticleDOI
TL;DR: Most of the participants have the willingness to be vaccinated, and the majority of students who agreed to take the vaccine were in the medical field, and that is mostly due to their high knowledge exposure, indicating the importance of raising the awareness of the non-medical students.
Abstract: Background: COVID-19 was declared a public health emergency of global concern by the World Health Organization (WHO) on January 30, 2020. Vaccination is one of the most effective methods for halting the pandemic and preventing complications. Vaccine hesitancy is a possible threat to global public health. Understanding the key determinants that influence the community's preferences and demands for a future vaccine may aid in the development of strategies to improve the global vaccination program. The aim of this study was to assess the beliefs, barriers, and acceptance of COVID-19 vaccination among Taif University students in Saudi Arabia. Materials and Method: This was a descriptive cross-sectional study, based study in Taif University, Saudi Arabia. Data was collected using a designed self-administered questionnaire that was shared as a link through social media. 332 students were considered eligible to participate voluntarily. Data were analyzed using the (SPSS) program version 25. Results: Out of 332 participants, 278 (83.7%) were accepting to take the covid vaccine, while 54 (16.3%) refused. Believes in vaccine safety and effectiveness and trust in the ability of the vaccine to prevent the complication, were all associated with high acceptance rate. Fear about side effects is considered a major factor for vaccination refusal. Conclusion: Most of the participants have the willingness to be vaccinated. The majority of students who agreed to take the vaccine were in the medical field, and that is mostly due to their high knowledge exposure. This indicates the importance of raising the awareness of the non-medical students.

Journal ArticleDOI
TL;DR: SARS-CoV-2 RNA clearance time is likely to be longer in non-severe COVID-19 patients, representing an additional risk for the virus dissemination among the community and calling for higher caution among the population.
Abstract: Objectives: To estimate SARS-CoV-2 RNA clearance time among non-severe COVID-19 patients and explore factors associated with delayed negative conversion. Methods: A retrospective cohort study was conducted at the COVID-19 unit of a tertiary care center in the Western region of Saudi Arabia. Reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed COVID-19 patients diagnosed between April 1 and June 30, 2020, were considered. The primary outcome was the time (days) from disease onset to first negative RT-PCR, which was analyzed using Kaplan–Meier and Cox regression survival methods. Demographic data, clinical history, baseline clinical, radiological and laboratory findings and management, and outcome data were collected and analyzed as factors associated with the viral RNA clearance time. Results: One hundred and forty-four patients were included. The mean (standard deviation [SD]) age was 36.93 (14.41) years, 50.7% were females, and 45.1% were healthcare workers. COVID19 was asymptomatic, mild and moderate in 11.1%, 71.5% and 17.4% of the participants, respectively. Fever (59.4%) and cough (58.0%) were the dominant onset symptoms. The mean viral RNA clearance time was 22.9 days (SD = 8.6; 95% confidence interval [CI] = 21.5–24.3 days). Extended clearance time was associated with older age (mean = 24.0 vs. 22.0 days; log-rank = 0.037), married status (23.2 vs. 22.6 days; log-rank = 0.021), working in health sector (24.2 vs. 21.8 days; log-rank = 0.006), and having a chronic disease (24.8 vs. 21.9 days; log-rank = 0.028), compared to their counterparts, respectively. In the adjusted model, the job sector was the only factor that was independently associated with clearance time. Non-healthcare sector showed hazard ratio 1.8 (95% CI = 1.3–2.7; log-rank = 0.002) with reference to healthcare sector. Conclusion: SARS-CoV-2 RNA clearance time is likely to be longer in non-severe COVID-19 patients, representing an additional risk for the virus dissemination among the community and calling for higher caution among the population.

Journal ArticleDOI
TL;DR: In this paper , a 50-year-old female presented with lightheadedness, palpitation, and neck pain for 3 years, and a multicomponent treatment approach was adopted including the use of thermal ultrasound therapy, cervical and thoracic spinal manipulation, and intermittent motorized cervicothoracic traction.
Abstract: Postural orthostatic tachycardia syndrome (POTS) is a form of dysautonomia that's characterised by an abnormal heart rate response to a positional change. A 50-year-old female presented with lightheadedness, palpitation, and neck pain for 3 years. Lightheadedness and palpitation occurred when shifting from a prolonged seated or lying position. Standing radiographs showed spinal misalignment with cervical kyphosis and thoracic scoliosis. Continuous static stress on these minor variants could aggravate biomechanical and autonomic disorder like POTS. After ruling out cardiovascular, neurological, or vestibular pathophysiology, a multicomponent treatment approach was adopted including the use of thermal ultrasound therapy, cervical and thoracic spinal manipulation, and intermittent motorized cervicothoracic traction to manage her neck pain complaints. Following 3 months of regular treatment, the patient reported a full resolution of neck pain, dizziness, and POTS. At 12-month follow-up, all radiographic metrics showed improvement, including improvement of cervical alignment and thoracic curvature. POTS is a prevalent, under-diagnosed dysautonomia. This study might arouse the alertness of clinicians that symptoms related to POTS may be erroneously attributed to other neuro-cardiovascular disorders.

Journal ArticleDOI
TL;DR: This study was unable to detect a significant increase in sales of antimicrobials, which is encouraging, but there was an increase in the demand for COVID-19 medications without prescription.
Abstract: Background: COVID-19 pandemic led to increased self-medication of antimicrobials, vitamins, and immune boosters among the common people and consuming without prescription can lead to adverse consequences including antimicrobial resistance. Methods: A cross-sectional study was conducted on community pharmacies in Jodhpur, India. They were inquired regarding the prescription and increased sales (<25%, 25—50%, 50--75%, or 75--100%) of various medicines (Hydroxychloroquine, Azithromycin, Ivermectin, and Vitamin C) during the COVID-19 pandemic. Logistic regression analysis was conducted to assess the relationship between requests for certain COVID-19 medications and an increase in their sale. Results: A total of 204 pharmacies took part, and 88.23% reported patients to approach them without prescriptions. Most of the pharmacies revealed that <25% of patients came without prescription. The majority came for azithromycin (68%) and vitamin C (92%). Increased sales of the four targeted medications were seen by 85.92% of pharmacies compared to last year. A majority (51.5%) reported <25% increased sales of azithromycin, but no change in the sale of hydroxychloroquine and ivermectin. However, 39.6% reported >75% increase in vitamin C sales. Conclusion: There was an increase in the demand for COVID-19 medications without prescription. This study was unable to detect a significant increase in sales of antimicrobials, which is encouraging.

Journal ArticleDOI
TL;DR: A review of publications from PubMed analysing the biochemical, immune-inflammatory, nucleic acid, and cellular biomarkers that predict infection, disease progression in COVID-19 with emphasis on organ-specific damage found promising association in the early diagnosis, prediction of prognosis and severity disease.
Abstract: The reasons for high morbidity and mortality with Corona virus disease (COVID-19) disease remain unanswered with extremes of manifestation and uncertainty of modes of transmission for which biomarkers are urgently needed for early prediction of severity and prompt treatment. We have reviewed publications from PubMed (years 2019–2021) analysing the biochemical, immune-inflammatory, nucleic acid, and cellular biomarkers that predict infection, disease progression in COVID-19 with emphasis on organ-specific damage. Our analysis of 65 biomarkers assessing the impact of SCoV-2 infection on five organs (lung, liver, cardiac, kidney, and neural) reported that increased levels of CRP, TNF-α, ferritin, IL-6, D-dimer, Procalcitonin, Fibrinogen to Albumin Ratio (FAR), and decrease platelet count (PC), lymphocyte count, leukocyte count, and CD4+/CD8+ ratio shows promising association in the early diagnosis, prediction of prognosis and severity disease and also correlates with cytokine storm a cardinal feature of COVID-19 progression. In the above scenario, this review has put forth the most promising biomarkers for COVID diagnosis and prognosis based on the reported literature. In recent year's chemically synthesized antibody-like biomolecules, aptamers were also used in the diagnosis of COVID-19 which could be preferably used for diagnosis over antibodies. Biomarkers including increase in free DNA and Fibrinogen-to-Albumin Ratio, CRP, PCT, and Ferritin along with a consequential decrease of CD3+ T, CD4+ T, CD8+ T, NK cells with corresponding increase in CD4+/CD8+ ratio following SARS CoV-2 infection has been consistently correlated with disease severity. Despite the two waves of COVID-19 pandemic, currently there is no standard clinical practice guideline for evaluating the severity of the devastating pandemic of COVID-19, hence these biomarkers will have immense relevance for the third and subsequent wave of COVID-19 and related pandemic.

Journal ArticleDOI
TL;DR: Prevalence of hypertension in the rural population of the Varanasi district in India was high and most of the observed predictors were modifiable.
Abstract: Background: Raised blood pressure (BP) is the leading global risk factor for cardiovascular diseases and a major cause of premature death. Worldwide, one in four men and one in five women are hypertensive. For effective preventive strategy, understanding of predictors of hypertension is necessary. Objective: To assess prevalence and predictors of hypertension in the rural adult Indian population. Material and Methods: This cross-sectional study was carried out on 425 rural subjects (25–64 years) of the Varanasi district in India selected through multistage sampling. Blood pressure of each subject was measured using a standard technique. Sociodemographic data and predictors of hypertension were assessed by interviewing subjects with help of a predesigned and pretested proforma. Results: Prevalence of hypertension was 31.5% (95% CI: 27.1–35.9). There existed a significant (P < 0.05) association of BP with age, educational status, occupation, socioeconomic class, tobacco consumption, waist circumference, waist-hip ratio, and nutritional status. No significant association was found with gender, religion, caste, marital status, type and size of family, family without NCDs, awareness of screening camps for NCDs and national program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke, and alcohol consumption. Significant association of education, nutritional, and occupational status obtained in univariate analysis got eliminated in the logistic model. Risk of hypertension was higher in the 45–64 years age group (AOR: 3.06; 95% CI: 1.75–5.35) and in socioeconomic class IV and V (AOR: 2.24; 95% CI: 1.17–4.31). Conclusion: Prevalence of hypertension in the rural population was high and most of the observed predictors were modifiable.

Journal ArticleDOI
TL;DR: Internet addiction is significantly associated with psychopathology among the respondents and there is an urgent need to develop effective strategies for the prevention of internet addiction by promoting awareness among the students.
Abstract: Background: With ever-increasing digitization, the internet has intertwined into the daily lives of users to a large extent. It holds tremendous educational benefits to college students; however, its excessive usage can lead to addiction and even psychological morbidities. Objectives: To determine the prevalence of internet addiction and its association with various factors including depression, anxiety, and stress. Materials and Methods: A cross-sectional study was conducted among undergraduate students of two professional colleges, i.e., medical and engineering colleges in the Jammu region. A pre-tested, semi-structured questionnaire was used to elicit the information regarding socio-demographic and personal details of students. Young's internet addiction scale was used to assess internet addiction, whereas the DASS 42 scale was used to measure depression, anxiety, and stress. Data thus collected were analyzed using the PSPP software. Results: A total of 480 students constituted the study population. The prevalence of internet addiction was found to be 78.7%, with a significantly higher prevalence seen among the male students in comparison to females (P < 0.005). A significantly positive correlation of internet addiction was found with depression, anxiety, and stress. Conclusions: Internet addiction is significantly associated with psychopathology among the respondents. In this context, there is an urgent need to develop effective strategies for the prevention of internet addiction by promoting awareness among the students.

Journal ArticleDOI
TL;DR: The most vulnerable group in the study was of young males in age group of 21-30 years and less educated, who had lost their jobs due to COVID-19 pandemic lockdown, and it was found that scoring systems PSS and GCS were good assessment tools for degree of severity of poisoning at an early stage.
Abstract: Objective: To assess the pattern, prevalence and outcome of poisoning cases reporting to hospital in North India during COVID-19 pandemic. Material and Methods: An observational, prospective study was conducted for 100 patients reporting to medical emergency with history of poisoning intake from April 2020 to January 2021. Age range was 14-85 years. Obtained data were analysed using descriptive statistics and results were expressed as percentage and mean. Results: Out of 100 patients (77M, 33F), mean age of 32.6 years, most cases belong to age group of 20-30 years and 50% were matriculates and majority of the patients belonged to Punjab and Himachal Pradesh. The most common poisoning agents consumed were corrosives (34%) followed by Aluminium Phosphide (24%). Respiratory distress (53%), loss of consciousness (43%), acute kidney injury (36%) were the common clinical presentations. PSS (Poisoning Severity Score) was moderate in 52% of patients, severe in 14%, fatal in 16% and minor PSS in 18% of patients. 16 patients with fatal PSS and 16 patients with moderate to severe PSS got expired. High mortality of 33% was seen in our study. Conclusions: The most vulnerable group in our study was of young males in age group of 21-30 years and less educated, who had lost their jobs due to COVID-19 pandemic lockdown. Corrosives were the most commonly consumed poison during lockdown. Our study found that scoring systems PSS and GCS were good assessment tools for degree of severity of poisoning at an early stage.

Journal ArticleDOI
TL;DR: In this article , the adjusted prevalence ratio for having UHT among reported tobacco users and non-users was estimated for men aged 15-54 years in the Indian National Family Health Survey (NFHS) of 1.04 million men.
Abstract: Background: Tobacco use is a modifiable risk factor for developing cardiovascular diseases, of which hypertension is a major killer. Uncontrolled hypertension (UHT) is a major public health concern that exerts a financial and service burden on the health system. Aim: The current analysis aimed to determine the association between tobacco use and UHT among Indian males. Material and Methods: Data from the 4th National Family Health Survey (NFHS) of 1,04,120 men aged 15–54 years were used. We estimated the adjusted prevalence ratio for having UHT among reported tobacco users and non-users. Results: The prevalence of UHT was the lowest (41.02%) among those who did not consume tobacco in any form. Among tobacco users, those smoking tobacco had the highest prevalence (53.53%) of UHT followed by those using both smoked and smokeless forms of tobacco (43.84%) and those using only smokeless forms of tobacco (42.26%). Factors significantly associated with UHT were alcohol consumption (aPR: 1.30; 95% CI: 1.19–1.43), belonging to the richer wealth quintile (richest quintile- aPR: 1.27; 95% CI: 1.05–1.38), being overweight (aPR: 3.14, 95% CI: 2.35–4.21), and being obese (aPR: 2.89, 95% CI: 2.12–.94). Higher educational status was significantly protective against UHT (aPR: 0.75; 95% CI: 0.63–0.88). Conclusions: Tobacco use is significantly associated with hypertension in Indian men. Addressing tobacco control and prevention of UHT remain the cornerstones for achieving the SDG target 3.4 by 2030, which aims to reduce premature mortality from NCDs by a third by 2030 relative to 2015 levels.

Journal ArticleDOI
TL;DR: It is proposed that the use of steroids, monoclonal antibodies, and prolonged hospitalization in the treatment of CO VID-19 has substantially decreased the immunity in COVID-19-affected patients and maybe the reason for the emergence of fungal infections.
Abstract: Mucormycosis, a rare fungal disease has emerged as a new epidemic in India, during the CoronaVirus Disease 2019 (COVID-19) pandemic. Mucormycosis is caused by the mucormycetes group of molds. Immunocompromised states such as diabetes, chronic steroid use, and patients receiving immunosuppressant drugs are the risk factors for mucormycosis. The second wave of the COVID-19 pandemic has also invited the notorious mucormycosis in the current scenario. India has announced mucormycosis as a notifiable disease in May 2021, as the number of COVID-19-associated mucormycosis cases has increased swiftly. There are different opinions and evidence for the emergence of mucormycosis or the so-called 'black fungus'. It is proposed that the use of steroids, monoclonal antibodies, and prolonged hospitalization in the treatment of COVID-19 has substantially decreased the immunity in COVID-19-affected patients and maybe the reason for the emergence of fungal infections. The other hypothesis is that improper disinfection procedures such as using non-sterile water for humidification of oxygen can be the reason. Or, the COVID-19 infection itself produces an immunocompromised and diabetic-like state is again a question. This review mainly focuses on the discussion and identification of the most common risk factor for mucormycosis, investigations, and management of mucormycosis.

Journal ArticleDOI
TL;DR: In this article , the effect of increased screen time on ocular health during the coronavirus disease (COVID-19) crisis was assessed, and the most common symptoms associated with digital eye strain were eyestrain 52.8% and headache 31.3%.
Abstract: Purpose: The objective of the study was to assess the effect of increased screen time on ocular health during the coronavirus disease (COVID-19) crisis. Materials and Method: An online pretested, self-reported questionnaire with relevant details was generated through Google form and sent to participants. Chi-square or Fisher’s exact test was used to investigate the associations between the qualitative variables. The associated risk factors of number and frequency of ocular health problems were analysed by univariate and multivariate logistic regression. Result: A total of 435 responses were considered where 48.5% (N = 211) were female participants and 51.5% (N = 224) were male. Average age of the participants was 35 years. 89% of the participants reported an increase in the screen time during the during the lockdown period. Younger age group reported to have greater screen time than the older participants (p = 0.001) and hence experienced more symptoms of digital eye strain (DES) (p = 0.003). The most common symptoms associated with digital eye strain in our study were eyestrain 52.8% (N = 230) and headache 31.3% (N = 136). In total, 81.37% (354/435) of participants had experienced at least one symptom related to digital screen usage. Conclusion: DES is non-vision-threatening but discomfort caused due to it can have implications on overall physical, mental, and social well-being. The study highlights the increase in digital screen time during the pandemic and the resultant eye strain. There is need of spreading awareness regarding the adverse effects of digital device use and the preventive measures to safeguard our ocular health.

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TL;DR: A 61-year-old female who presented with neck pain and cervical radiculopathy attributed to an anterior cervical discectomy and spinal fusion performed for degenerative disc disease 30 years earlier is described.
Abstract: Adjacent segment pathology (ASP) refers to degenerative changes at segments immediately contiguous to previous spinal fusion. Its pathophysiology is hypothesized as being possibly due to altered biomechanical stresses on adjacent levels following spinal fusion or due to patient propensity to develop progressive degenerative change. This case report describes a 61-year-old female who presented with neck pain and cervical radiculopathy attributed to an anterior cervical discectomy and spinal fusion performed for degenerative disc disease 30 years earlier. ASP was seen on magnetic resonance imaging (MRI) and radiograph. Treatment consisted of cervical manipulation, soft-tissue mobilization, flexion-distraction decompression, and therapeutic ultrasound to release restriction and restore muscle strength. Following 34 sessions of chiropractic intervention, her symptoms were resolved. Patients with ASP will have ongoing shared care between general practitioners and secondary or tertiary care pain units. This report aims to build a shared understanding from the wider vision of ASP and help primary practitioners to manage ASP effectively.

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TL;DR: It is concluded that there is significant increase in vitamin D levels as well as Z-score, bone mass density (BMD) and bone Mass Content (BMC) after 6 months of GFD.
Abstract: Objective: Celiac disease (CD) is a multifactorial immune-mediated enteropathy caused by a response to ingested gluten. The current available treatment for CD is lifelong gluten-free diet (GFD). This study was done to see the effect of GFD on Vitamin D levels and bone mass density in celiac patients. Methods: A prospective interventional study on newly diagnosed celiac patients was conducted in the Pediatrics department of a tertiary care teaching institute in 2 stages viz. on presentation and after 6 months of GFD. Anthropometric measurements, biochemical investigations, Vitamin D levels, and DEXA scan was done at recruitment and after 6 months of GFD and was analyzed. Results: In newly diagnosed 60 pediatric celiac patients, positive effect of GFD on anthropometry, hemoglobin, Vitamin D levels, DEXA scan parameters was observed. Significant difference was found in Vitamin D levels which increased from baseline 14.85 ± 5.39 to 18.22 ± 5.67 ng/ml after 6 months of GFD (P < 0.05). Significant difference was found in BMD (mean Z-score) which increased from -0.941 ± 0.738 to -0.640 ± 0.60 after 6 months of GFD (P < 0.001). Conclusion: Our study concluded that there is significant increase in vitamin D levels as well as Z-score, bone mass density (BMD) and bone Mass Content (BMC) after 6 months of GFD.

Journal ArticleDOI
TL;DR: An immunosuppressive environment created due to the COVID-19, diabetes mellitus, and extensive use of corticosteroid provide a suitable background for the increased incidence of mucormycosis.
Abstract: Background: A significant surge of cases of mucormycosis is seen in individuals with COVID-19 with presence of diabetes mellitus (DM) and usage of corticosteroids. We aim to conduct a systematic analysis of the cases involving presence of mucormycosis and to find out its association with COVID-19, diabetes mellitus, and corticosteroids. Method: >The electronic records of PubMed, Google Scholar, and Science Direct were searched for the case reports and case series that reported mucormycosis in association of COVID-19. The particulars of each case report and case series were retrieved, stored and analyzed. Results: In this study, 476 cases of mucormycosis were reported. In 346 cases of mucormycosis, the patients were found to be COVID-19 positive. The incidence of diabetes Mellitus (DM) was 67.01%. Corticosteroid was administered in 57.77% of the cases. Mortality was reported in 36.34% of the cases. Conclusion: An immunosuppressive environment created due to the COVID-19, diabetes mellitus, and extensive use of corticosteroid provide a suitable background for the increased incidence of mucormycosis. The COVID task force should adopt an aggressive multidisciplinary approach to optimize the use of corticosteroids and maintain glucose in the optimal range.

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TL;DR: In this article , the authors present three patients with small fiber neuropathy (SFN) after the second dose of messenger ribonucleic acid-based SARS-CoV-2 vaccines.
Abstract: Generally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations are not free of side effects. A rarely reported adverse reaction to SARS-CoV-2 vaccinations is small fiber neuropathy (SFN). Here, we present three patients with SFN after the second dose of messenger ribonucleic acid-based SARS-CoV-2 vaccines. Data for this study were collected via the self-made platform “Pubbly” for reporting side effects of SARS-CoV-2 vaccinations. Three patients with post-SARS-CoV-2 vaccination SFN were identified: a 40 yo Caucasian female (patient 1), a 52 yo Caucasian female (patient 2), and a 32 yo Caucasian female (patient 3). Patient 1 complained about fatigue, dizziness, flushing, palpitations, diarrhea, muscle weakness, and gait disturbance 10 days after the second Pfizer jab. Patient 2 reported dizziness, balance problems, brain fog, palpitations, dysphagia, and sleep problems. Patient 3 complained about profound fatigue, brain fog, vertigo, pre-syncopal sensations, hair loss, chest pain, dyspnea, palpitations, paresthesias, irregular menstrual cycles, muscle weakness, and hives 1 day after the second Moderna dose. All three patients underwent skin biopsy upon which SFN was diagnosed. Patient 1 profited from immunoglobulins, but patient 2 did not require any treatment. Symptoms in patient 3 resolved upon symptomatic treatment. Despite treatment, patient 1 did not completely recover. SFN can be a rare side effect of SARS-CoV-2 vaccinations. Post-SARS-CoV-2 vaccination SFN can be mild or severe and may or may not require treatment. Post-SARS-CoV-2 vaccination SFN is most likely immune-mediated as it responds to intravenous immunoglobulins.

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TL;DR: A patient with autoimmune polyglandular syndrome type 2 who presented with adrenal crisis, precipitated by COVID-19 is reported, highlighting the importance of stress dosing in preventing adrenalrisis in patients with adrenAL insufficiency (AI).
Abstract: COVID-19 (corona virus disease 2019), caused by the severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), has spread throughout the globe and affected millions of people worldwide. Here, we report a patient with autoimmune polyglandular syndrome type 2 who presented with adrenal crisis, precipitated by COVID-19. We intend to highlight the importance of stress dosing in preventing adrenal crisis in patients with adrenal insufficiency (AI). A uniform structured education programme is needed to improve knowledge and practices in patients with AI in our country.

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TL;DR: Oral dexamethasone can be considered a reliable and better option as compared with prednisolone due to its faster action and minimal side effects.
Abstract: Background: Acute exacerbation of asthma is a common condition leading to emergency visits. Prednisolone is a commonly prescribed drug in the standard management of acute exacerbation of asthma along with other drugs. This study was planned to see the efficacy of oral dexamethasone when compared with oral prednisolone in the management of acute exacerbation of asthma. Methods: A single-center pilot study in the form of randomized control trial was done by recruiting children aged 2–14 years diagnosed with acute asthma exacerbation with mild to moderate severity. A total of 88 patients received oral dexamethasone (0.3 mg/kg) in two doses 24 h apart, which was compared with 87 patients who received oral prednisolone (1 mg/kg) in two divided doses 12 h apart for 5 days. The patients were assessed at the time of admission (zero hour), at 4th hour, and on the 5th day by various parameters such as respiratory rate, use of accessory muscles, Pediatric Respiratory Assessment Measure (PRAM) score, peak expiratory flow rate (PEFR), 6-h admission stay, and rate of hospital admission. Results: Baseline demographic profile, clinical characteristics, comorbidities, indoor pollution, and use of Metered Dose Inhaler (MDI) among the two study groups were comparable. Six-hour emergency stay and rate of admission were significantly lower in the dexamethasone group (P < 0.05). Improvement in PRAM score, PEFR, use of accessory muscles, and respiratory rate was also better in dexamethasone group at the 4th hour and 5th day (P < 0.05). In addition, oral dexamethasone was shown to have less incidence of vomiting/gastritis than prednisolone (P < 0.05). Conclusion: Oral dexamethasone can be considered a reliable and better option as compared with prednisolone due to its faster action and minimal side effects.

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TL;DR: This letter aims to highlight the importance of addressing the potential effects of misinformation creating fear and anxiety and thus affecting the universal vaccination programs.
Abstract: The development of vaccinations against infectious diseases has been one of the most outstanding public health achievements in the twentieth century. The vaccines over the years have saved millions of lives and billions of dollars annually[1] and in the current coronavirus pandemic scenario, vaccines to prevent COVID‐19 disease are perhaps the best hope to end this pandemic. Research studies have estimated that to achieve herd immunity, the COVID‐19 vaccine will need to be accepted by at least 55% of the population, with estimates reaching as high as 85% depending on country and infection rate.[2] As of February 2021, many candidate vaccines have been shown to be safe and effective, around 175.3 million vaccine doses have been administered from 7 different vaccines [3 platforms].[3] World Health Organization issued an Emergency Use Listing (EULs) for various vaccines from the last few months and monitors the progress of such candidate vaccines. Although vaccines reduce morbidity and mortality,[4] many people prefer not get vaccinated for various reasons. Recent research findings suggest that a substantial proportion of European adults are hesitant about, or resistant to, a vaccine for COVID‐19.[5] The vaccine hesitancy is not a new phenomenon and was witnessed in previous outbreaks of infectious diseases like measles‐mumps‐rubella vaccines. The hesitancy and refusal are creating a new challenge for the public health and infection control measures. The problem of hesitancy may affect the COVID‐19 vaccination programs due to beliefs, fears, or concerns such as minor side effects as anticipated by people. This letter aims to highlight the importance of addressing the potential effects of misinformation creating fear and anxiety and thus affecting the universal vaccination programs.

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TL;DR: The young old population in India seems vulnerable to frailty, and health programs aimed at prevention, early detection and treatment of morbidities and frailty will improve their health.
Abstract: Background: There are nearly 10.4 crores elderly in India, with 65% of them living in rural areas. Accessibility to healthcare is limited in rural areas. Primary care physicians deal with a fairly large number of patients from the geriatric age group. With the steady increase in the proportion of elderly, there is a corresponding increase in the prevalence of frailty. Frailty among the elderly leads to increased dependency, adverse health outcomes and mortality. Early identification and targeted interventions by primary care physicians could prevent these adverse outcomes and even reverse its occurrence. Knowledge about environmental and lifestyle influences on frailty would further assist primary care physicians to prevent and manage it optimally. Methods: We interviewed 502 participants (>60 years of age) from four taluks of rural Bengaluru. Participants with frailty scores of 3 and above were considered frail, scores of 1-2 were considered prefrail. Association of frailty with lifestyle and environmental factors were tested using the Chi-square test. A value of P < 0.05 was considered significant. Results: Prevalence of frailty was 24.70% and prefrailty was 62.75%. Elders in age group 60 to 74 years, those living alone or with others (other than the spouse), illiterate, working elders, elderly with less than two diagnosed comorbidities, elderly with low social score and low physical activity were associated with frailty. Conclusion: The young old population seems vulnerable to frailty. Health programs aimed at prevention, early detection and treatment of morbidities and frailty will improve their health.

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TL;DR: Serum ferritin was found to be a potent marker for clinical outcome in intensive care unit patients in terms of death versus treated and it can be used as a marker for Clinical Outcome thereby making it an often neglected biomarker for predicting prognosis in COVID-19.
Abstract: Background: The COVID-19 disease caused by the SARS-CoV-2 virus, has toppled the world since first case noted in 2019, and the cases have been increasing there after. This grave effect is caused by the cytokine storm induced inflammation produced by the noxious virus. As it is an inflammatory state, various acute phase reactants are expected to raise; thus serum ferritin is contemplated to increase. Here we aim to anchor serum ferritin as a way marker for diagnosis and management of COVID-19 patients and study its role as a prognostic marker. Another aspect is the association of COVID-19 with the N: L ratio; observation has stated that higher N: L ratio results in more severe outcome. The study aimed to establish a correlation of COVID-19 severity with serum ferritin in the form of HRCT Score, N: L Ratio and Clinical Outcome in the patients admitted in Intensive Care Unit. Result: Out of 200 patients who were admitted in the intensive care unit with COVID-19, the association of serum ferritin with N: L Ratio and HRCT Score was significant, and the association of serum ferritin with clinical outcome in terms of discharged and expired was found to be statistically significant. Conclusion: Serum ferritin was found to be a potent marker for clinical outcome in intensive care unit patients in terms of death versus treated. HRCT Score and N:L ratio were found to be correlated with serum ferritin. Therefore, we conclude that serum ferritin may determine the severity of COVID-19 infection and it can be used as a marker for Clinical Outcome thereby making it an often neglected biomarker for predicting prognosis in COVID-19 with most of the physicians focusing mostly on interleukin 6, C Reactive protein and d dimer as a marker of severe COVID infection.