Statistical estimation of noise induced hearing loss among the drivers in one of the most polluted cities of India.

In the present study, an attempt has been made to assess the impact of vehicular noise upon the 3-wheeler tempo drivers and to know whether there is any relationship between hearing loss and cumulative noise exposure. For this purpose, 3-wheeler tempo drivers (Exposed group) and non-commercial light motor vehicle car drivers (Unexposed group) were chosen as study subjects. Three traffic routes were selected to assess the noise level during waiting and running time in the exposed and unexposed groups. Among all three routes, the highest mean noise level (Leq) was observed on the Chowk to Dubagga route for waiting and en-route noise measurement. It was measured as 84.13 dB(A) and 86.36 dB(A) for waiting and en-route periods of 7.68 ± 3.46 and 31.05 ± 6.6 min, respectively. Cumulative noise exposure was found to be significantly different (p < 0.001) in all age groups of exposed and unexposed drivers. Audiometric tests have been performed over both exposed and unexposed groups. The regression analysis has been done keeping hearing loss among tempo drivers as the dependent variable and age (years) and Energy (Pa2 Hrs) as the independent variable using three different criteria of hearing loss definitions, i.e., World Health Organization, National Institute for Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration criteria. Among these three criteria, the NIOSH criterion of hearing loss best explained the independent variables. It could explain the total variation in dependent variable by independent variable quite well, i.e., 68.1%. The finding showed a linear relationship between cumulative noise exposures (Pa2 Hrs) and the exposed group's hearing loss (dB), i.e., hearing loss increases with increasing noise dose. Based on the findings, two model equations were developed to identify the safe and unsafe noise levels with exposure time.

Are the labour rooms of primary healthcare facilities capable of providing basic delivery and newborn services? A cross-sectional study.

OBJECTIVES: The study aimed to assess the functionality of labour rooms by evaluating the labour room infrastructure with reference to the standard guidelines, the status of the availability of human resources, the availability of essential equipment and consumables in the labour room and by documenting the knowledge of the healthcare provider in terms of labour room practices. The study also explored the facility parameters associated with its delivery load taking the facility as a unit of analysis. DESIGN: A cross-sectional analytical study. SETTING: India has realised the importance of improving the quality of care in public health facilities, and steps are being taken to make healthcare more responsive to women's needs. With an increase in the proportion of institutional deliveries in India, the outcome of the delivery process can be improved by optimising the health facility components. PARTICIPANTS: The study was conducted in 52 health facilities and healthcare providers involved in the delivery process in the selected facilities. RESULTS: The infrastructure of the facilities was found to be the best for medical college followed by district hospitals, Community Health Centres (CHCs), Primary Health Centres (PHCs) and subcentres. Similar findings were observed in terms of the availability of equipment and consumables. Lack of healthcare providers was observed as only 20% of the posts for health personnel were fulfilled in CHCs followed by PHCs, subcentres and district hospitals where 43, 50 and 79% of the available vacancies were fulfilled. The level of knowledge of healthcare providers in terms of partograph, active management of the third stage of labour and post-partum haemorrhage ranged as per their designation. The specialists were the most knowledgeable while the Auxiliary Nurse Midwife (AMNs) were the least. All the components of structural capacity, i.e. infrastructure (r 2 = 0.377, P value < 0.001), equipment and consumable (r 2 = 0.606, P value < 0.001) and knowledge of healthcare providers (r 2 = 0.456, P value < 0.001) along with the overall facility score were positively correlated with the average delivery load of the health facility. The results from multivariate linear regression depict significant relation between the delivery load and availability of equipment and consumables (t = 4.015, P < 0.01) and with the knowledge of healthcare providers (t = 2.129, P = 0.039). CONCLUSIONS: The higher facilities were better equipped to provide delivery and newborn care. A higher delivery load was found at high-level facilities which can be attributed to better infrastructure, adequate supply of equipment and consumables and availability of trained human resources.

Systemic review of CNS involvement and its manifestations in SARS-CoV2 positive patients.

Coronavirus is known to cause various systemic infections both in human and animal which are mostly mild in nature. However, recent years have seen major pandemics caused by coronavirus which are very invasive and virulent in nature. The recent SARS-CoV2 is a new addition to this list of coronavirus pandemics. So the present study was done to systematically review the CNS involvement and its manifestations in SARS-CoV2 positive patients. Systemic review of article published between 1st Dec 2019 to 31st July 2020 searched through web-based database of MEDLINE (Pubmed) and Google scholar using following keywords "COVID -19" OR "CORONAVIRUS" OR "SARS-CoV2" AND "NEUROLOGICAL" OR "CNS" OR "BRAIN". Using the steps of systemic review eight article were selected for qualitative analysis. Majority of these article were reporting neurological symptoms among patients admitted in different wards along with others general symptoms. None of the study was specifically devoted to study the neurological manifestations and complications in SARS-CoV2 positive patients. The present study concludes that there is a scarcity of good quality research which attempts to establish the role of SARS-CoV2 infection in CNS and its manifestations. However, there are evidences that CNS involvement is present in majority of the patients. Proper documentation of theses involvement and indentification of these into mild, moderate and severe infection will help in early identification and treatment of these patients.

Neurological Involvement in COVID-19 Patients: A Narrative Review.

Background Coronavirus disease 2019 (COVID-19) is a viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) belonging to the coronavirus family. The primary target of SARS-CoV-2 is peripheral mucosal cells of respiratory tract. Recent days have seen few cases where virus has affected extrapulmonary organ such as nervous system. Materials and Methods The present study was a narrative review done using techniques of systemic review, that is, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases such as PubMed (Medline) and Google Scholar were searched systematically for published article from December 1, 2019 to June 5, 2020. A total of 189 articles were initially selected by the authors. A final list of 17 articles was prepared and following information were extracted from selected studies: study design, main result, and limitations of the study. Results Majority of these article were descriptive studies describing spectrum of signs and symptoms among admitted patients. In majority of these studies, patients have developed symptoms suggestive of neurological involvement. Most common central nervous system symptoms reported were headache, followed by dizziness and confusion. Similarly, the most common peripheral nervous system involvement was loss of taste and smell. Conclusion The present study concludes that there are enough evidences to prove that SARS-CoV-2 infection affects both central and peripheral nervous system. Various mechanisms are proposed to explain the pathophysiology of neurological manifestations in COVID-19-positive patients that needs to be established and verified.