Study of COVID-19 Pandemic in Representative Dialysis Population Across Mumbai, India: An Observational Multicentric Analysis.

COVID-19 has emerged as a pandemic of significance with potential to cause significant morbidity and mortality worldwide. Elderly with or without following comorbidities i.e Diabetes, hypertension, cardiac disease, chronic respiratory illnesses, chronic liver disease, CKD, malignancy and immunocompromised hosts are at increased risk of developing complicated course. Hemodialysis population hence are at increased risk for contracting the infection due to patient characteristics, environmental characteristics and procedural lapses. The current study was aimed at describing prevalence and characteristics of COVID19 in hemodialysis population across different HD centers across Mumbai. We found a prevalence rate of COVID19 in 6.4%, with 9 patients (12%) died during the study period. A fair proportion of Non covid HD patients (1.5%) also died due to lack of access to dialysis. At baseline, mean age of presentation was 54.5 years. On routine test 80% were asymptomatic at presentation. Patients with COPD, requiring ICU care and those on ventilation faired poorly. Contrary to assumption patients with underlying cardiovascular disease didn't show poor outcome. Total of 4.1% health care workers turned positive during the study period with mean age of 31 years and median of 28years. Out of them 5 (45.4%) were symptomatic. All recovered from the illness without any sequelae. Seventy two percent of healthcare workers were on Hydroxy-chloroquine chemoprophylaxis didn't reach statistical significance in preventing the infection. In our study elderly age with comorbidities had poor prognosis. We proposed extra healthcare measures to be taken in the dialysis unit presuming all as COVID suspect in the resource limited settings.

Effectiveness of Three-Dimensional Myofascial Release on Lumbar Lordosis in Individuals with Asymptomatic Hyperlordosis: A Placebo Randomized Controlled Trial.

Background: Lumbar hyperlordosis is the most prevalent musculoskeletal postural deformity. Maintenance of normal limits of lumbar lordosis is necessary for obtaining an ideal posture. Literature suggests that poor posture results in fascial restriction in which the fascia reorganizes in response to tension. Gross myofascial release (MFR) combined with posterior pelvic tilting exercises proved to be beneficial in improving the lumbar range of motion. Three-dimensional (3D) MFR is a novel approach toward reducing fascial restrictions. However, the literature determining the effects of 3D MFR is still emerging. Aim: To determine the effect of 3D MFR on a lumbar lordosis angle and lumbar range of motion, in individuals with asymptomatic hyperlordosis. Method: Participants (n = 30) with hyperlordosis were randomly assigned to either the experimental group receiving 3D MFR (n = 15) or the control group (n = 15) that received sham 3D MFR for six sessions (3 alternate days for 2 weeks). The outcomes were assessed at day 1 and day 6. Lumbar range of motion was assessed using modified-modified Schober's test and the lumbar lordosis angle was measured using x-ray and flexicurve. Results: There was significant decrease (p = 0.0001) in the lumbar lordosis angle, increase in the lumbar flexion (p = 0.0001), and decrease in the extension (p = 0.0011) range of motion in the experimental group when compared to the control group. Conclusion: Lumbar lordosis decreased and the lumbar range of motion increased in the experimental group only with 3D MFR and not with sham 3D MFR. Hence, 3D MFR is an effective method in the correction of lumbar hyperlordosis and improving the lumbar range.Clinical Trial Registry of India (CTRI) trial number CTRI/2023/03/050340.