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Background: Vaccine is an essential tool to limit the health of the COVID-19 pandemic. AstraZeneca vaccine already provided promising effectiveness data. Still, the study must check the correlation between vaccination and antibody titer. Aim: This study aims to evaluate antibody titer after AstraZeneca vaccination based on the age group. Materials and Methods: This study used a prospective cross-sectional method with convenience sampling. Inclusion criteria were all Indonesian citizens above 18 years old who were vaccinated at UTA'45 Jakarta Vaccine Center with no history of COVID-19 before the vaccination and had filled up the informed consent. Results: This study's total sample was 102 females;51.90%, residents of Java Island;91.17% had comorbidities;50,98%, smokers;9,80%, alcohol drinker;9,80%, exercise;80,39%, blood pressure;128/73, SpO2: 97,82. Most participants aged around 30 years had a body mass index of 23.33. Age, comorbidity, smoking, alcohol, and exercise habit significantly correlate with the increase of the participants' antibodies (P < 0.001). The age shows that the younger the participant, the higher the titer antibody 2 will be (P = 0.001, 95% confidence interval [CI],-1.935,-0.694). The exercise shows that the participant with the routine practice will have a higher titer antibody 2 (P = 0.002, 95% CI, 12.016, 51.791). Antibody titer for participants younger than 35 years old increased 5.7 times while for participants between 35 and 45 years old was 3.9 times. Another group (>45-55 years old) has shown an improvement in antibody titer at 1.7 times, but the last group (>55 years old) described an increase in antibody titer at 232.3 times. Conclusions: Age, comorbidity, smoking, alcohol, and exercise contributed to the increase in titer antibody 2 value of the AstraZeneca vaccine participants. Participants in the age group <35 years have an excellent immune system.
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Present study focuses on the attitudes/perceptions regarding negative attitudes, hesitancy (uncertainty, unwillingness) and anxiety towards COVID-19 within the Saudian context. A cross-sectional web-based study uses convenience sampling technique for data collection through self-administrated validated questionnaire translated in Arabic language. Outcomes of the study revealed that more than 3/4th (80%) of respondents expressed intermediate to high levels of negative attitude towards vaccines, in general. The most common reasons for vaccine hesitancy were the concerns about the vaccine's possible side effects, not taking it as a serious infection, and its efficacy in preventing the infection. Regarding anxiety towards coronavirus, it was found to be quite low. Decision tree analysis was used to assess the relationship between hesitancy and demographic characteristics of the respondents. Findings of the study pinpoint specific areas, on which to focus on, for the health care administrators in case of resurgence of the pandemic. The health administrators may incorporate the suggestions of the present study when framing their future policies for enhancing confidence and alleviating fears of the populace at large to receive COVID-19 vaccination.
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Purpose: The present research aims to investigate the impact of "COVID-19 phobia” factors (psychological, social, economic and psychosomatic) on career anxiety and perceived distress. Further, this research assesses whether career anxiety and perceived distress foster or diminish students' employability confidence. Design/methodology/approach: "Partial Least Squares Structural Equation Modeling (PLS-SEM)” has been used to analyze the data. Findings: The results depict that factors (psychological, economic and psychosomatic) are positively and significantly associated with career anxiety and perceived distress. However, social factors indicate an adverse impact on perceived distress. Further, career anxiety and perceived distress positively influence employability confidence, but the associations are not highly impactful. Originality/value: This research elucidates an unexplored phenomenon in the context of a developing country that coronavirus disease 2019 (COVID-19) phobia scale (i.e. psychological, social, economic and psychosomatic) result in career anxiety and distress. Moreover, no studies highlighted the direct impact of career anxiety and perceived distress on employability confidence. © 2023, Emerald Publishing Limited.
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Objective: The purpose of this research was to examine how the Coronavirus epidemic has affected the compassion of dentistry students in Bhubaneswar. Materials and Equipment: In this study, undergraduate dental students in Bhubaneswar served as the research subjects for a cross-sectional analysis. Following informed permission, dental school students from two time periods (one before and one after the occurrence of Coronavirus in India) were given the authorized and pretested Toronto Sympathy Poll (TEQ) (Bhubaneswar). A five-point scale was used to indicate members' levels of comprehension. Using a one-way analysis of variance, we compared students' TEQ scores during their four years of dentistry school (investigation of difference). The results of the meetings were analyzed using Tukey's post hoc test. The Chi-square test was used to analyze data collected before and during the recent Coronavirus epidemic (importance level, p 0.05). Only 270 of the 300 dentistry students enrolled in the focus before Coronavirus reached its conclusion;the remaining 260 enrolled thereafter. Comparing results from the same group before and after exposure to the Coronavirus revealed striking discrepancies in the compassion ratings. More than eighty-five percent of individuals answered the survey. As a result of this study's findings, it is concluded that undergraduate dental students' mean empathy ratings increased after COVID-19, indicating a discernibly greater degree of empathy at that time. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Children with early signs and symptoms of Type 1 Diabetes need to be diagnosed promptly, before they become acutely unwell with diabetic ketoacidosis (DKA). Early diagnosis and optimal management of established DKA is key to reducing morbidity and mortality. To follow the evidence based standards. To assess whether the newly diagnosed type 1 diabetes were in DKA at presentation or not. To assess compliance to guidelines on admission. As per retrospective cohort study, charts of newly diagnosed type 1 diabetes over one year study period reviewed. Proportion of new on- set type 2 diabetes presentating during this COVID-19 pandemic was higher then previously reported. There was an increase in presentation of severe DKA at diagnosis in children and young people under the age of 16 years old.we were not sure what could account for this rise in proportion.Delayed presentation ranging fear from of contracting COVID to an inability to contact or access a medical provider for timely evaluation. Multicultural nature of our study population could also be a factor. More public health awareness and diabetes education should be disseminated to healthcare providers on the timeliness of referrals of children with suspected T1D.
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Background: A 68 year old patient with squamous cell carcinoma (SCC) of lower oesophagus (T3N0M0) presented for Ivor Lewis oesopphagectomy (ILO) following neoadjuvant chemoradiotherapy. Four years previously the patient had undergone total laryngectomy, radical right neck dissection with right pectoralis major flap and bilateral adjuvant radiotherapy for hypopharyngeal SCC (pT3N2bM0). A tracheal stoma was present with speaking valve in-situ. An ILO was planned requiring one lung ventilation (OLV) to facilitate surgical access. In our institution, OLV is routinely achieved via double lumen endotracheal tube (DLT), although endobronchial blocker through single lumen endotracheal tube or laryngeal mask airway and endobronchial intubation with a single lumen tube are potential options. Post laryngectomy the method used for lung isolation is limited and care must be taken not to traumatise the stoma site or surrounding tissue. Additionally, the angulation formed by the trachea and stoma mean a DLT is often not suitable while specific double lumen tracheostomy tubes may have too great a diameter for a small stoma. Surgically, close relations of the tumour to gastro-oesophageal junction, left diaphragmatic crus and descending thoracic aorta made suitability for resection uncertain, despite two negative staging laparoscopies. We describe the anaesthetic and surgical management of this interesting case. Method(s): General anaesthesia was delivered via an intravenous induction and maintenance was with sevoflurane. Airway management included bag mask ventilation with a neonatal facemask followed by placement of an 8mm reinforced endotracheal tube through the tracheal stoma. Prior to right thoracotomy a right sided 9Fr VivaSight endobronchial blocker (Ambu) was placed under direct vision using a single use Ambu aScopeTM 4 Broncho Slim fibreoptic bronchoscope. OLV was successful using this method;SpO2 >=96% (FiO2 0.6) and peak inspiratory pressure 18-20cmH2O-1. Analgesia comprised intrathecal morphine, right erector spinae plane local anaesthetic block and infusion catheter and morphine PCA. Abdominal phase was undertaken laparoscopically. The hiatus was noted to be fibrotic following chemoradiotherapy and a small capsular breach of the left lobe of liver occurred, controlled with Surgiflo (Ethicon). A right thoracotomy was performed through the 6th intercostal space. Right lung was deflated and surgical access was adequate. OrVil (Covidien - Medtronic) anastomosis was attempted but the anvil was unable to pass through the pharynx, therefore a purse string applicator was applied and OrVil staple used. The left pleura was also breached during dissection. One left and two right chest drains were placed. Result(s): Postoperatively, analgesia was adequate and the patient did not require any cardiovascular or respiratory support. However, on first postoperative day it was noted that the speaking valve was not functioning causing significantly hoarse voice. A valve leak was detected and though hard to know the precise cause, it was assumed that it had become dislodged via either anaesthetic procedures, surgical handling or a combination. Despite some improvement in the symptoms over the first post-operative week, the patient also experienced airway soiling on commencing oral intake and after review by ENT a new valve was successfully sited and all symptoms resolved. Although a minor and easily rectifiable complication, the 'loss of voice' was very distressing for the patient. The patient had an otherwise uneventful postoperative course and was discharged home on day-11. Clinic review at six weeks revealed the patient had made a complete recovery and had resumed all normal activities. Histology showed scattered small foci of moderately differentiated SCC infiltrating the muscularis propria (stage ypT2). Longitudinal margins were clear of both dysplasia and malignancy. There was no evidence of lymphatic, venous or perineural invasion. One of 12 lymph nodes showed metastatic SCC. Adjuvant course of Nivolumab immunotherapy is currently anned. Conclusion(s): We have presented an unusual case of previous laryngectomy plus requirement for OLV for ILO. The use of an endobronchial blocker via a reinforced endotracheal tube has been shown to be a successful airway management strategy. Speaking valve displacement and/or malfunction is a potential complication in such cases and should form part of preoperative counselling. Close liaison between surgical, anaesthetic and ENT teams is essential in the management of complex and unusual cases and, as we have demonstrated, strong teamwork leads to successful outcomes for patients.
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Background: COVID-19 has significantly disrupted cancer care. This has impacted on staging, management and survival of gastric cancer as health services worldwide had to adapt. Responding to the pandemic, the UK government declared a national lockdown on 23 March 2020. Our aim was to determine the impact of COVID-19 and socio-economic deprivation on patients with newly diagnosed gastric cancers. Method(s): This was a retrospective cohort study. Consecutive new patients presenting in NHS Scotland to five regional OG cancer MDTs covering 93.2% of the Scottish population between October 2019 and September 2020 were identified. Gastric cancers were included and electronic health records were reviewed. Patient's residential address was used to calculate Scottish Index of Multiple Deprivation (SIMD). Patients were divided into two groups: Most deprived (SIMD 1-5) and least deprived (SIMD 6-10) and results compared. The study period was divided into pre- and post-lockdown, based on the first UK national lockdown of 23 March 2020. Result(s): 269 patients were diagnosed with gastric cancer;4 (1.5%) were excluded due to unrecognised postcode. 173 (65.3%) were male and the median age was 73 years (range 29-94). 143 (54.0%) were in most deprived and 122 (46.0%) were in least deprived group. Deprivation and lockdown: Age, sex, ECOG performance status and route of referral were not significantly different. No clinically meaningful difference in median time to gastroscopy was observed (16.5 vs 17 days). Stage 4 cancer were more commonly observed in most deprived group (60.8% vs 52.1%). In whole cohort, the palliative care intent was higher post-lockdown (70% vs 83.2%, p=0.033). Palliative intent treatment increased in the most deprived group from 74.3% to 81.2% and in least deprived from 65.2% to 85.7% (p=0.092). The median survival for the whole cohort decreased post-lockdown (9.0 vs 6.9 months, p=0.14), but did not reach statistical significance. The medial survival did not change for the most deprived group (7.6 vs 7.1 months, p=0.840), however it decreased significantly for the least deprived group post-lockdown (11 vs 6.7 months, p=0.014). A test of heterogeneity between lockdown period and SIMD group supported the suggestion that the least deprived cohort did worse post-lockdown (HR 1.72, p=0.055). Conclusion(s): This national study highlights that the least deprived patients had survival advantage pre-lockdown, which has been completely lost post COVID-19 national lockdown. This disproportional impact on the least deprived patients could be because early cancers were not diagnosed in the least deprived population.
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Background: COVID-19 has significantly disrupted cancer care. This may have impacted on staging, management and survival as health services worldwide had to adapt. Responding to the pandemic, the UK government declared a national lockdown on 23rd March 2020. This national study investigated the effect of the national response on oesophago-gastric (OG) cancers in Scotland, including time from referral to gastroscopy, staging at presentation, multidisciplinary team (MDT) treatment outcomes and overall survival. Method(s): This was a retrospective cohort study. Consecutive new patients presenting in NHS Scotland to five regional OG cancer MDTs covering 93.2% of the Scottish population between October 2019 and September 2020 were identified. Electronic health records were reviewed. The study period was divided into pre- and post-lockdown, based on the first UK national lockdown. Result(s): 931 patients with biopsy-proven OG cancer were identified;499 (53.6%) pre- and 432 (46.4%) post-lockdown. Median age was 71 years (range 25-95) and 66% were male. There were 252 (27.1%) gastric and 679 (72.9%) oesophageal cancers. No clinically meaningful difference in median time to gastroscopy was observed post-lockdown (19 days vs 15 days, P<0.001), however, patients were more likely to present as an emergency (11.1% vs 8.2%, p=0.014). Post-lockdown, patients tended to poorer ECOG PS (p=0.09), were more symptomatic (p=0.007), and presented with higher stage disease (stage 4;57.6% vs 49.3%). There was a significant shift to palliative intent treatment post-lockdown (76.2% vs 64.7%, p<0.001). Median overall survival post-lockdown was 7.6 months vs 10.1 months pre-lockdown (HR 1.24;95% CI 1.06-1.43, p=0.005). Conclusion(s): This national study highlights the impact of COVID-19 on OG cancer diagnosis and outcome in Scotland. Patients presented at a later stage and a shift towards palliative intent treatment was observed, with subsequent negative impact on overall survival. The reason for the observed stage migration of OG cancers is likely multifactorial, occurring prior to the diagnostic pathway and not simply due to a delay in performing gastroscopy.
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Background: COVID-19 has significantly disrupted cancer care. This has impacted on staging, management and survival of oesophageal cancer as health services worldwide had to adapt. Responding to the pandemic, the UK government declared a national lockdown on 23rd March 2020. Our aim was to determine the impact of COVID-19 and socio-economic deprivation on patients with oesophageal cancers. Method(s): Thiswas a retrospective cohort study.Consecutivenewpatients presenting in NHS Scotland to five regional OG cancer MDTs covering 93.2% of the Scottish population between October 2019 and September 2020 were identified. Electronic health records were reviewed. Patient's residential address was used to calculate Scottish Index of Multiple Deprivation (SIMD). Patients were divided into two groups: Most deprived (SIMD 1-5) and least deprived (SIMD 6-10) and results compared. The study period was divided into pre- and post-lockdown, based on the first UK national lockdown on 23rd March 2020. Result(s): 728 patients with were identified, 5 were excluded due to unrecognised postcode. 365 (50.5%) were in the more deprived and 358 (49.5%) were in least deprived group. 488 (67.0%) were male and the median age was 71 years (range 25-95). Deprivation and lockdown: Age, sex, WHO performance status and route of referral was not significantly different. No clinically meaningful difference in median time to gastroscopy was observed. Palliative intent treatment increased in the most deprived from 67.0% to 71.4% and in least deprived from 54.0% to 74.0% (p=0.002). The overall survival for the whole cohort decreased post-lockdown (11.3 vs 7.8 months, p=0.001). Pre-lockdown the median survival for most deprived group was 8.9 vs 15 months for the least deprived group (p=0.001). Post-lockdown the median survival was similar irrespective of socioeconomic status (7.8 vs 6.9 months, p=0.99). The medial survival did not changed post-lockdown for the most deprived group (8.9 vs 7.8 months, p=0.480). However, the median survival for the least deprived group significantly decreased post lockdown (15 vs 6.9 months, p<0.001). A test of heterogeneity between lockdown period and SIMD group supported the suggestion that least deprived group did worse post-lockdown (HR 1.45, p=0.035). Conclusion(s): This national study highlights that the least deprived patients had survival advantage pre-lockdown, which has been completely lost due to the lockdown. This disproportionate impact on the least deprived patients could be because early cancers were not diagnosed in the least deprived population.
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Background: Good quality of operation notes are essential for good post-operative care, patient safety and medico-legal issues. RCSEng have guidelines on items that should be included in all operation notes. RCSEng Guidelines state: Ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. We re-audited the quality of operation notes in general surgery. Method(s): We re-audited and compared the results with the first cycle. Four months (1st August to 30th November 2021) period of consecutive operation notes were reviewed. Operation notes for endoscopy were excluded. Operations notes were analysed for documentation of the items as per RCSEng guidelines. There were less operations post COVID-19, hence longer study period. After first cycle, departmental presentation given for education and posters displayed in theatres as reminder. Initial plan for 2nd cycle in 2020 but it was not possible due to COVID-19. Problems/complications, extra procedures and prosthesis used were not included. Additional criteria reviewed was: Type of anaesthetic, patient position, indication for procedure and ASA grade. Result(s): A total of 239 operation notes were identified. 169 emergency and 70 elective cases. 193 were handwritten and 46 were typed.The results were compared to the first cycle: Conclusion(s): Higher proportion was ofemergency procedures during the 2nd cycle. Also, higher proportion of handwritten notes during 2nd cycle. There was improvement in documenting elective/emergency, time, type of anaesthesia, indication, position, operative findings/diagnosis, details of tissue removed/added/altered, blood loss, antibiotics, DVT prophylaxis. However, there was poorer documentation of date, name of assistant, incision, closure, signature remains. Ongoing education of the surgeons is vital to improve the quality of the operation notes. We suggest addition of further headings on the current op-note as aid-memoire and introduction of digital operation notes.
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Purpose: The COVID-19 pandemic has led to a widespread backlog of patients undergoing repair of abdominal aortic aneurysm (AAA) treatment. Prior to the pandemic the UK NICE guidelines have recommended open surgery as the preferred surgical intervention, compared to Endovascular aortic aneurysm repair (EVAR). Therefore this study assess whether EVAR has an increase role in AAA repair compared to pre-pandemic. Material(s) and Method(s): 565 patients were analysed who underwent elective AAA repair at our tertiary vascular centre from April 2012 to May 2018. Patients were risk scored using an EVAR risk score model as well as analysed for mortality and length of hospital stay. Result(s): Comparing both groups collectively OR had significantly better survival compared to EVAR (P=0.012). The low risk group had significantly higher survival with OR repair (P=0.001).In the medium risk group there was insignificant difference between EVAR and OR (P=0.713). In the high risk group, there was significantly better survival with EVAR (P=0.036). The EVAR group had significantly lower hospital stays post-operatively with a mean of 3.87 days compared to 12.21 days (P<0.0001). Conclusion(s): The results have identified a significant proportion of patients which fit the EVAR 1.5 patient - those who have good outcomes with EVAR but are unfit for OR. With the pandemic leading to longer waiting times for surgery, inevitably there will be more ruptures which are more costly and carry a higher mortality. Therefore, the inclusion of EVAR in elective AAA repair may result in a more financially sustainable outcome.
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Objective: To summarize pharmacy students' previous experience and current confidence with online learning and explore the association of prior experience with online learning and resilient coping with perceived stress at the beginning of the COVID-19 pandemic. Method(s): Students completed an online cross-sectional survey during April-June, 2020. Measures included Likert items for experience and current comfort levels with online learning;the Brief Resilient Coping Scale (BRCS);and the Perceived Stress Scale-10 Item Version (PSS-10). We summarized experience and comfort with online learning;reported scores and internal consistency for the BRCS and PSS-10;and estimated a regression model of perceived stress as a function of prior experience with online education, gender, and resilient coping. Result(s): Of 113 respondents (response rate 41%, 78% female, mean age 22.3 years) >50% had only occasional prior experience with online learning, coursework, and examinations, but 63% expressed confidence with online learning. Mean PSS-10 and BRCS scores were 23.8 and 13.3 respectively, and both scales demonstrated good internal consistency (a > .80). BRCS score was the single predictor of PSS-10 score (r2 = 0.18, p < 0.001). Gender was not a significant predictor of perceived stress (p = 0.11). A simultaneous regression model explained a moderate amount of variation in perceived stress (adjusted R2 = 0.19). Conclusion(s): Most students had limited previous online learning, coursework, and examination experience. Responses indicated moderate levels of stress and coping skills after introducing online teaching. Lower resiliency scores, but not lack of virtual learning experience, predicted higher perceived stress. Results underscore the importance of efforts to enhance coping and resilience of students.
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Background: The COVID-19 pandemic and its recurrent waves of infection have propelled the transformation of many outpatient clinics into RC/VCs on an international scale. The Oncology Service at NMUH, based in the UK's NHS, conducted a survey in June 2021 to explore patient experiences of these RCs and aimed to implement changes to refine the service. Methods: Patients were recruited from breast, gastrointestinal and lung oncology clinics between April and June 2021 for the first 'plando-study-act' (PDSA) cycle and in November 2021 for the second PDSA cycle, to participate in an anonymous telephone survey by an independent researcher, 48-72 hours following their consultations. Three broad areas of satisfaction including practical aspects of communication, patient autonomy and control during the consultation, and patients' emotional experiences were evaluated, yielding both quantitative and qualitative accounts to be compared as a measure of success. Following the first cycle, a new cover letter was devised to be sent alongside the outpatient appointment letter entitled 'How to get the most out of your remote consultation'. The second PDSA cycle was then undertaken to assess the success of the intervention. Results: A total of 51 patients were recruited in the initial survey and 15 patients in the second. Quantitative analysis demonstrated comparable levels of satisfaction in both cohorts across all domains. 46/51 (90%) of patients felt their remote oncology consultations were overall 'Excellent', 'Very Good' or 'Good' in the first group compared with 13/15 (86%) in the second group. 86% of patients 'Strongly agreed' that all their questions and concerns had been addressed compared with 58% of patients prior to our intervention. Qualitative data, in the form of patient quotes, highlighted the success of the intervention, addressing patient concerns that were previously raised, namely communication challenges, not having relatives present, the lack of patient preparation ahead of the consultations, managing expectations relating the timing of the appointment and the lack of key points of contact post-consult. Positive aspects of RC/VCs included feeling safer, more flexibility, reduced need for travel and waiting in hospital. Furthermore, we introduced the option to choose between a conference call, video call or face-to-face consult instead of a phone call to personalize experience and maximize patient choice. Conclusions: This study was practice changing. Our data demonstrates that the introduction of the accompanying cover letter successfully enhanced patient experiences and satisfaction with their RCs. Overall, selective RCs should be considered as standard practice in the future. This will enable reduced cancer waiting times, unnecessary exposure of vulnerable patients and improved patient experience by minimizing hospital visits.
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Purpose: The COVID-19 pandemic brought rapid changes to NHS services and practices, including recommendations for shielding and conversion to RCs. This project was set up to explore the patient experience of RCs at NMUH, yielding both quantitative and qualitative accounts, to identify possible areas for improvement. Methods: Participants were recruited from breast, gastrointestinal and lung oncology clinics between April and June 2021. Suitable patients took part in an anonymous telephone survey conducted by an independent researcher, 48–72 h following their consultations. Three broad areas including practical aspects of communication, patient autonomy and control during the consultation and patients’ emotional experiences were evaluated. Results: 51 participants were recruited into the study (63% women, varied ethnic backgrounds, age range 41–88 years). 98% of participants reported no concerns about privacy or confidentiality, with 42–58% strongly agreeing with statements regarding autonomy. Overall, 90% (n = 46) reported RCs as being good, very good or excellent. Good aspects included: feeling safer, reduced travel, flexibility and reduced waiting in hospital. The main concerns were: communication challenges, inability to follow-up if they forgot something, not having family members or carers present, less personal consultations and not being examined. Timing of the appointment was a key point of dissatisfaction. Qualitative data including patient quotes provided real insight into the patient experience. Lack of key worker support was identified as a major cause of concern for patients. Conclusion: This study was practice changing. A new ‘Cover Letter’ entitled ‘How to get the most out of your remote consultation’ was created and sent with outpatient appointment letters. This project also identified an urgent need for recruitment. Overall, selective RCs should be considered as standard practice in the future, which will enable reduced cancer waiting times, unnecessary exposure of vulnerable patients and improved patient experience by minimising hospital visits.
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The importance of Micro, Small, and Medium Enterprises (MSMEs) in economic development and their access to finance post-COVID-19 has been highlighted in this study. The availability of finance is a critical factor for MSMEs to flourish, and they are mostly severely affected by the economic recession. The purpose of this study was to ascertain how the firm-specific factors such as Location, Industry, Size, Age, Ownership, Collaterals, and Business information affect their access to finance in India. This study used a survey to collect primary data from 200 MSMEs in India. Descriptive and logistic regression analysis was used to analyze the data. Results show that firms with collateral, larger and older firms, and private limited firms are less likely to face problems in raising finance, while service firms are more likely to face problems in raising finance. The results from this study will add to the understanding of the financing problems faced by MSMEs in India. The study recommends that firm attributes are important for accessing finance and help policymakers and researchers develop new strategies and policies to support the financing of MSMEs in India. © 2022 Uddin et al.