Burden of COVID-19 pandemic on tuberculosis hospitalisation patterns at a tertiary care hospital in Rajasthan, India: a retrospective analysis.

OBJECTIVE: This study aimed to investigate the burden of the COVID-19 pandemic on tuberculosis (TB) trends, patient demographics, disease types and hospitalisation duration within the Respiratory Medicine Department over three distinct phases: pre-COVID-19, COVID-19 and post-COVID-19. DESIGN: Retrospective analysis using electronic medical records of patients with TB admitted between June 2018 and June 2023 was done to explore the impact of COVID-19 on patients with TB. The study employed a meticulous segmentation into pre-COVID-19, COVID-19 and post-COVID-19 eras. SETTING: National Institute of Medical Science Hospital in Jaipur, Rajasthan, India. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome includes patients admitted to the Respiratory Medicine Department of the hospital and secondary outcome involves the duration of hospital stay. RESULTS: The study encompassed 1845 subjects across the three eras, revealing a reduction in TB incidence during the post-COVID-19 era compared with the pre-COVID-19 period (p<0.01). Substantial demographic shifts were observed, with 5.2% decline in TB incidence among males in the post-COVID-19 era (n=529) compared with the pre-COVID-19 era (n=606). Despite the decrease, overall TB incidence remained significantly higher in males (n=1460) than females (n=385), with consistently elevated rates in rural (65.8%) as compared with the urban areas (34.2%). Extended hospital stays were noted in the post-COVID-19 era compared with the pre-COVID-19 era (p<0.01). CONCLUSION: The study underscores the influence of the COVID-19 pandemic on the TB landscape and hospitalisation dynamics. Notably, patient burden of TB declined during the COVID-19 era, with a decline in the post-COVID-19 era compared with the pre-COVID-19 era. Prolonged hospitalisation in the post-COVID-19 period indicates the need for adaptive healthcare strategies and the formulation of public health policies in a post-pandemic context. These findings contribute to a comprehensive understanding of the evolving TB scenario, emphasising the necessity for tailored healthcare approaches in the aftermath of a global health crisis.

Prevalence of breast cancer in rural population of Jaipur: a survey-based observational study.

Breast cancer, a global health concern predominantly affecting women, recorded 2.3 million new cases and 685,000 deaths in 2020. Alarmingly, projections suggest that by 2040, there could be over 3 million new cases and 1 million deaths. To assess breast cancer prevalence in 24 rural villages within a 60 km radius of NIMS Hospital, Tala Mod, Jaipur, Rajasthan, North India 303,121. A study involving 2023 participants conducted initial screenings, and positive cases underwent further tests, including ultrasound, mammography, and biopsy. SPSSv28 analysed collected data. Among 2023 subjects, 3 screened positive for breast lumps. Subsequent clinical examination and biopsy identified 1 normal case and 2 with breast cancer, resulting in a prevalence proportion of 0.0009 or 98 per 100,000. This study helps fill gap in breast cancer prevalence data for rural Rajasthan. The results highlight a concerning prevalence of breast cancer in the rural area near NIMS hospital, emphasizing the urgent need for increased awareness, early detection, and better healthcare access. Challenges like limited resources, awareness programs, and delayed diagnosis contribute to this high incidence. To address this, comprehensive approach is necessary, including improved screening programs and healthcare facilities in rural areas. Prioritizing rural healthcare and evidence-based strategies can reduce the burden of breast cancer and improve health outcomes.

The Influence of Obesity on Bone Health in Post-COVID-19 Recovery- Single-Center Experience.

Introduction: The ongoing repercussions of the COVID-19 pandemic include potentially deleterious impacts on bone health. Aim: This research aimed to ascertain the effects of COVID-19 on the bone health of obese and non-obese Indian individuals. Methods: We executed a case-control study enrolling individuals who recovered from COVID-19. Participants were stratified into obese and non-obese groups based on their BMI. Comprehensive assessments encompassed anthropometric evaluations, laboratory tests, and bone mineral density (BMD) measurements using dual-energy X-ray absorptiometry (DEXA). Results: From April to July 2022, we enrolled obese (n = 27, mean BMI = 30.54 ± 4.51 kg/m 2) and non-obese (n = 23, mean BMI = 21.97 ± 2.20 kg/m 2) individuals. The cohort's average age was 36.08 ± 15.81 years, with a male-to-female ratio of 1.6:1. There was a difference in BMD, especially at the total hip, between the two groups. BMD at the spine (L1-L4), the neck of the femur, and ultra-distal radius were consistent across both groups. Weight exhibited a significant positive correlation with BMD at L1-L4 (r = 0.40, p = 0.003) and the left femur total (r = 0.27, p = 0.001). Haemoglobin levels were lower in the obese group compared to their non-obese counterparts (12.3 ± 2.0 vs 13.6 ± 1.9, p = 0.01). Multivariate analysis underscored weight as a crucial predictor for BMD at the spine (L1-L4, p = 0.003) and total hip (p = 0.001). Conclusion: Even with advanced age, obese post-COVID-19 individuals demonstrate a higher bone mineral density (BMD) at the hip than non-obese subjects.

Post-COVID-19 cardio-pulmonary manifestations after 1-year of SARS-CoV-2 infection among Indian population: A single centre, case-control study (OneCoV2 study).

BACKGROUND: The evolving challenge of persistent symptoms post-Coronavirus disease-2019 (COVID-19), particularly debilitating cardio-pulmonary manifestations, necessitates further exploration. Our study aimed to assess the cardio-pulmonary complications in patients a year after hospital discharge from severe COVID-19, contrasting these with findings from a non-COVID group. METHODS: The OneCoV2 study, a prospective, case-control study, was conducted at a tertiary care teaching hospital in northern India. We enrolled 43 subjects, with a mean age of 25.57 ± 7.94 years (COVID group) and 27.30 ± 8.17 years (non-COVID group). Comprehensive tests included pulmonary function tests, cardiac function tests, 6-min walk tests, and laboratory investigations. RESULTS: Significant differences were found in the pulmonary function [forced vital capacity (FVC) (p = 0.037), forced expiratory flow (FEF) 25-75 % (p = 0.013)], and cardiac function [left ventricular ejection fraction (LVEF) (p = 0.032), heart rate (HR) (p = 0.047)], along with the six-minute walk test results between the two groups. In the COVID group, Pearson's correlation showed a negative correlation between FVC and C-reactive protein (CRP) [r = -0.488, p = 0.007] and a positive correlation between the six-minute walk test [r = 0.431, p = 0.003] and HR [r = 0.503, p = 0.013]. CONCLUSIONS: Our data suggest that pulmonary abnormalities are prevalent in COVID patients even after 1-year of hospital discharge. Cardiac biomarkers also show an inclination towards the COVID group. While we found significant correlations involving some parameters like FVC, CRP, HR, and results from the six-minute walk test, we did not find any significant correlations with the other tested parameters in our study.

Exploring the risk of glycemic variability in non-diabetic depressive individuals: a cross-sectional GlyDep pilot study.

Background: Data on the correlation between glycemic variability and depression in nondiabetic patients remain limited. Considering the link between increased glycemic variability and cardiovascular risks, this relationship could be significant in depressed patients. Methods: In this single-center pilot study, we utilized Flash Glucose Monitoring (Abbott Libre Pro) to study glycemic variability. The CES-D (Center for Epidemiological Studies- Depression) scale was employed to measure depression levels. Based on CES-D scores, patients were classified into two groups: those with scores ≥ 33 and those with scores < 33. We analyzed various glycemic variability indices, including HBGI, CONGA, ADDR, MAGE, MAG, LI, and J-Index, employing the EasyGV version 9.0 software. SPSS (version 28) facilitated the data analysis. Results: We screened patients with depression visiting the department of psychiatry, FGM was inserted in eligible patients of both the groups which yielded a data of 196 patient-days (98 patient-days for CES-D ≥ 33 and 98 patient-days for CES-D < 33). The glycemic variability indices CONGA (mg/dl), (76.48 ± 11.9 vs. 65.08 ± 7.12) (p = 0.048), MAGE (mg/dl) (262.50 ± 25.65 vs. 227.54 ± 17.72) (p = 0.012), MODD (mg/dl) (18.59 ± 2.77 vs. 13.14 ± 2.39) (p = 0.002), MAG(mg/dl) (92.07 ± 6.24vs. 63.86 ± 9.38) (p = <0.001) were found to be significantly higher in the CES-D ≥ 33 group. Conclusion: Patients with more severe depressive symptoms, as suggested by CES-D ≥ 33, had higher glycemic variability.

Frailty Predicting Health-Related Quality of Life Trajectories in Individuals with Sarcopenia in Liver Cirrhosis: Finding from BCAAS Study.

The association between frailty and health-related quality of life (HRQoL) among Asian patients with liver cirrhosis and sarcopenia remains largely unexplored. To address this knowledge gap, we conducted a cross-sectional study involving individuals aged 32 to 69 years, all diagnosed with liver cirrhosis. The chronic liver disease questionnaire (CLDQ) was used to assess HR-QoL, the CLDQ score was used as an outcome to measure the factors related to HR-QoL, and the liver frailty index (LFI) was used to assess the frailty status. The association between the frailty status and the CLDQ summary scales was investigated using the correlation coefficient and multiple regression analyses. A total of 138 patients in the frail (n = 62) and non-frail (n = 76) groups with (alcohol: 97; viral: 24; autoimmune: 17; and cryptogenic: 12) were included in the study. Age, CTP score, and model for end-stage liver disease (MELD) sodium were significantly higher in the frail group. In the CLDQ domains, there was a significant difference between the frail and non-frail groups (p value = 0.001). In health-related quality-of-life summary measures, there was a strong negative correlation between frailty and the scores for activities, emotional function, and fatigue (p value = 0.001). When comparing frail to non-frail patients, these characteristics demonstrated significantly increased odds as indicated by their adjusted odds ratios: OR 3.339 (p value = 0.013), OR 3.998 (p value = 0.006), and OR 4.626 (p value = 0.002), respectively.

Psychological Impacts of COVID-19 in Dental Patients are Moderated and Mediated by Hospital-Infection-Control-Policy and Satisfaction-with-Life: A Prospective Observational Dental-COVID Study.

Introduction: COVID-19 pandemic has imposed nation-wide lock-downs which severely impacted day-to-day lifestyle and caused anxiety, stress and fear among patients taking medical care including dental treatments. These psychological behaviors have also been observed during the strategic relaxation of social restrictions (Unlock). However, potential effect of these psychological behavior in endodontic cases have not been probed. Here, it is of great interest to explore the magnitude and buffering effect of two important psychological resources: satisfaction-with-life, and confidence in hospital-infection-control-policy in relation with COVID-19 risk perception on psychological impact due to fear for COVID-19. Methods: Patients visiting Dental Clinic & Research Center for endodontic procedures were randomly asked to fill survey questionnaire, and were later enrolled as per the study criteria. The study carried out in two phases: from 15 Sept 2020 to 15 Dec 2020 (restrained confinement; Unlock 1.0); and from 16 Dec 2020 to 12 Feb 2021 (mild confinement; Unlock 2.0) with total sample size of 136. We used data collection tools such as fear-of-COVID-19 scale (FCV-19), perceived-stress-scale (PSS), modified-dental-anxiety-scale (MDAS), satisfaction-with-life scale (SWLS), COVID-19 risk perception, and confidence in hospital-infection-control-policy for COVID-19. Results: A double moderation and dual moderated mediation structured model were used to establish the correlation of various parameters using SPSS (version 25.0) software suite. Confidence in hospital-infection-control-policy and SWLS were negatively correlated with FCV-19, MDAS, and PSS. Risk perception of COVID-19 was found to positively associated with FCV-19, MDAS, and PSS. Discussion: Patient's confidence in hospital-infection-control-policy for COVID-19 and SWLS acted as independent moderator for FCV-19 and mental distress. FCV-19 and risk perception were found to be lower during mild confinement (Unlock 2.0), and were also the positive predictors of PSS; and negative predictors of SWLS. The higher SWLS correlated very well with lower COVID-19 risk perception, concerning PSS and MDAS.

Impact of Branched Chain Amino Acid on Muscle Mass, Muscle Strength, Physical Performance, Combined Survival, and Maintenance of Liver Function Changes in Laboratory and Prognostic Markers on Sarcopenic Patients With Liver Cirrhosis (BCAAS Study): A Randomized Clinical Trial.

Background: This study aimed to investigate the long-term effects of branched-chain amino acids (BCAAs) supplementations on the parameters associated with improved prognosis in sarcopenic patients with liver cirrhosis (LC) and evaluate its impact on cirrhotic-related events. Methods: A 24-week, single-center, randomized, open-label, controlled, two cohort parallel-group intervention study was carried out by comparing the efficacy of BCAAs against lactoalbumin (L-ALB) on 106 sarcopenic patients with LC. The BCAA (intervention) group was treated with 7.2 g BCAA per dose, whereas the L-ALB group was treated with 6.3 g of L-ALB. The primary outcome was to assess the effect of BCAA on the parameters of sarcopenia, such as muscle mass, muscle strength, and physical performance. The secondary outcomes were to study the combined survival and maintenance of liver function changes in laboratory and prognostic markers over the duration of 6 months. Results: The treatment with BCAA leads to the significant improvement in sarcopenic parameters, such as muscle strength, muscle function, and muscle mass. The total cirrhotic-related complications and cumulative event-free survival occurred fewer in the BCAA group than in the L-ALB group. In addition, prognostic markers improved significantly in the study. Conclusion: The current study demonstrated that long-term BCAAs supplementation improved sarcopenia and prognostic markers in patients with advanced LC.

Influence of Patient-Reported Treatment Satisfaction on Psychological Health and Quality of Life Among Patients Receiving Divya-Swasari-Coronil-Kit Against COVID-19: Findings from a Cross-Sectional "SATISFACTION COVID" Survey.

INTRODUCTION: The correlation among treatment satisfaction with demographic characteristics, health symptoms or psychological health, and quality of life with the prophylactic regime against COVID-19 is rather unexplored. This real-world exploratory study was conducted to determine patient-perspectives regarding their treatment satisfaction receiving Divya-Swasari-Coronil-Kit with correlative impacts on psychological health (PH) and Quality of life (QoL) based on four hypotheses each relating to PH, QoL, Demographic characteristics, and Treatment satisfaction. METHODS: This cross-sectional, web-based survey collected data on demographic characteristics and psychological health with DASS-21; QoL with 5-level 5-dimension EuroQol instrument; and treatment satisfaction using Treatment Satisfaction Questionnaire for Medication (TSQM) V9. Pearson correlation coefficient analysis was used to examine the relation between TSQM and PH and the demographic variables. Factor analysis was used for multi-collinearity tests, and multiple linear regression analysis was used to explore demographic variables and TSQM. RESULTS: Out of 421 initial screenings, 367 patient-participants were included in the analysis. The mean age of included participants was 33.61 ± 9.47 years. Marital status and socio-economic class positively correlated with TSQM. Physical symptoms in patients are positively correlated with depression, anxiety, and stress; and in contrast, negatively with QoL. Global satisfaction with Divya-Swasari-Coronil-Kit medication negatively correlated with depression, anxiety, stress, effectiveness, convenience; whereas global satisfaction correlated positively with QoL. CONCLUSION: Present study (SATISFACTION COVID) indicates that treatment satisfaction due to avaliablity and treatment of Divya-Swasari-Coronil-Kit has constructive and beneficial implications on psychological health, Quality of life and demographic factors. In addition, web-based patient-reported perspectives may well be a feasible way to provide better insights into treatment satisfaction, in relation to psychological health and Quality of life.

Mental Health outcome and Professional quality of Life among Healthcare Worker during COVID-19 pandemic: A (FRONTLINE-COVID) survey.

BACKGROUND: - Health care workers are under a substantial level of psychological impact due to the risk of exposure, workload and moral dilemmas as the nation is on upsurge of COVID-19 cases. Since there are limited research available on this issue from India, we have decided to conduct an online survey to evaluate mental health outcome and professional quality of life among healthcare worker during COVID-19 pandemic. METHODS: - From 25th May to 10th June 2020, a web-based (FRONT-LINE COVID) survey was conducted. Impact of event revised (IES-R), Connor-Davidson Resilience scale (CD-RISC) and Professional Quality of life (ProQOL) and Feeling related questions were administered among Healthcare workers from different departments of hospital. RESULTS: - Among the respondents,218 (52.1%) belongs from the low-risk unit and 200 (47.9%) from the 'high-risk unit' including a higher proportion of nurses 191 (45.7%), female 282(67.5%), aged 31-40 years (48.3%), and married 220 (52.6%). Overall female nurses (P=>0.001), doctors (P=0.02) those were working in an emergency unit (P= <0.001) were at greater risk of psychological distress. Middle-aged (31- 40 years) had a higher level of resilience (p=0.02) contrast to this; working in COVID-19 unit was associated with a lower scale of resilience (p=0.009). Resilience and QoL were an important predictor for psychological distress. CONCLUSION: - Results implicate interventions for stress management and social support among medical staff working in the pandemic.

Les travailleurs de la santé subissent un impact psychologique important en raison du risque d'exposition, de la charge de travail et des dilemmes moraux alors que le pays est face à la recrudescence des cas de COVID-19. Puisqu'il y a peu de recherches disponibles sur cette question en Inde, nous avons décidé de mener une enquête en ligne pour évaluer les résultats en matière de santé mentale et la qualité de vie professionnelle des travailleurs de la santé pendant la pandémie de COVID-19. Du 25 mai au 10 juin 2020, une enquête en ligne (FRONT-LINE COVID) a été menée. L'impact de l'événement révisé (IES-R), l'échelle de résilience Connor-Davidson (CD-RISC) et les questions relatives à la qualité de vie professionnelle (ProQOL) et au ressenti ont été administrées aux travailleurs de la santé de différents départements de l'hôpital. Parmi les répondants, 218 (52,1 %) appartiennent à l'unité à faible risque et 200 (47,9 %) à l'unité à haut risque dont une proportion plus élevée d'infirmières : 191 (45,7 %), de femmes : 282 (67,5 %), l'âge : 31-40 ans (48,3 %) et mariés 220 (52,6 %). Dans l'ensemble, les infirmières (P => 0,001), et les médecins (P = 0,02) qui travaillaient dans une unité d'urgence (P = <0,001) étaient plus à risque de détresse psychologique. Les personnes d'âge moyen (31 à 40 ans) avaient un niveau de résilience plus élevé (p = 0,02); travailler dans l'unité COVID-19 était associé à une échelle de résilience plus faible (p = 0,009). La résilience et la qualité de vie étaient un prédicteur important de la détresse psychologique. Les résultats impliquent des interventions de gestion du stress et de soutien social parmi le personnel médical qui lutte contre la pandémie.