Effect of Psychosocial Interventions on Cancer's Caregiver Quality of Life: Meta-analysis.

Background: People living with cancer benefit greatly from informal caregivers. No previous meta-analysis was done to check the effect of psychological intervention on cancer caregiver's quality of life. Objectives: The goal of this meta-analysis was to check the effect of psychosocial interventions on Cancer's Caregiver quality of life and check the impact of various psychological intervention programs. Methods: A comprehensive literature search was conducted from January 2006 to April 2021 using PubMed, PubMed Central, Clinical Key, CINAHL Database, EBSCO, Google Scholar and Cochrane database. Results: The effect of psychological intervention programs on caregiver's quality of life was evaluated using a mean difference between experimental and control groups. A random-effects model was used to measure the mean difference (MD) for calculating the cancer caregiver's quality of life. The final report comprised eight trials with a total of 1142 participants. The caregiver intervention programme was found to improve cancer caregivers' quality of life, but not statistically significantly (mean difference=0.10; p<0.00001). Conclusion: According to this meta-analysis, The psychological intervention program positively affected cancer caregiver's quality of life. Further randomised controlled trials are required to prove that psychological interventional programs are successful strategies for improving cancer caregiver's quality of life.

Effectivity of Palliative Care Bundle on Advanced Gallbladder Cancer: A Randomised Controlled Trial.

Objectives: The main aim of this study was to develop, test, and compare palliative care bundles to improve functional recovery, resilience, and quality of life among advanced gallbladder cancer patient with their routine palliative care. Material and Methods: This study was to test a palliative care bundle, a single-center, and two-arm randomised controlled trial done on a total of 116 participants (58 in each arm) from July 2019 to December 2021 at All India Institute of Medical Sciences, Rishikesh. Results: By the end of 4th month, the recruitment rate was 96.7%, retention rate acceptance rate was 95%, and adherence rate was 85%. The palliative care bundle showed that a significant difference in trial outcome index score (P = 0.014*) indicates the effectiveness of the palliative care bundle related to improvement in physical mobility, resilience, and quality of life of patients and reduced caregiver burden. Reported barriers faced by participants were physical exhaustion (65%), psychological factors (25%), social factors (15%) and unfamiliar surroundings (5%). Caregivers reported barriers that their job (40%), physical fatigue related to the care of their patient (40%), their education (10%), and lack of support for their other family members (10%) were some reasons forcing them not to practice palliative care bundle. Conclusion: The palliative care bundle did not interfere with the palliative treatment plan of any patients and significantly improved physical mobility, resilience, quality of life of patients, and reduced caregiver burden. Hence, a palliative care bundle can be considered in the palliative care of advanced cancer patients during their palliative treatment to provide holistic care.

Quality of Life of People with Cancer in the Era of the COVID-19 Pandemic in India: A Systematic Review.

Background: The recent pandemic of COVID-19 caused havoc on the health system globally and raised a lot of questions and issues. Treatment for cancer is an emergency that cannot be taken back, particularly in an era of global pandemics. Cancer treatment mainly includes chemotherapy, surgery, radiotherapy, and palliative care, and because of the pandemic, all of these treatments are affected. The COVID-19 pandemic also had a potential effect on the quality of life and mental health of patients as well as health workers. Objective: This systematic review was intended to discuss the quality of life of people with cancer in the era of the COVID-19 pandemic in India in the light of the best available facts. Methods: An extensive literature search was done on PubMed, Medline, Embase, Clinical Key and Google Scholar databases till 3rd Feb 2021. Out of 1455 research articles, 06 research articles were included in this systematic review. Results: The results showed that cancer treatment delivery was as per standard safety protocol and the best treatment decisions were made by scheduling and setting priority. Till data, no direct research was conducted on the Indian continent to assess the quality of life of cancer patients in the COVID-19 era. The effect on the quality of life of cancer patients is very large and needs to be explored more by further research. Issues to be discussed with health care administrators and policy makers further. The tele-oncology method of cancer care delivery to patients is another rational option which is applicable as well. Conclusion: This systematic review demonstrated up-to-date evidence regarding the quality of life of cancer patients in the COVID-19 era in India. No research has been done to assess the quality of life of cancer patients. Still, the area is unrevealed, but evidence from other global studies indicates an altered quality of life for cancer patients. To maintain quality of life, cancer physicians should make evidence-based decisions and incorporate multidisciplinary management into decision making.

Impact of the heartfulness program on stress and sleep among healthcare professionals: Pre experimental study.

Background: Healthcare professionals (HCPs) worldwide suffer from stress and poor sleep and the COVID-19 pandemic has further raised these issues. This study sought to determine whether HCPs had reduced stress and increased sleep quality while participating in a heartfulness meditation program. Subjects and Methods: For a 2-month (8 weeks) heartfulness meditation program, we included 41 individuals in a prospective one-group pretest post-test intervention design from February 2023 to April 2023. Scores on the Perceived Stress Scale and Pittsburgh Sleep Quality Index were gathered at baseline and 8 weeks. Forty-one (76%) of the 54 participants completed this study for 8 weeks. Results: Results showed a substantial decline in stress (preintervention mean ± standard deviation [SD] = 20.54 ± 4.46; postintervention mean ± SD = 18.42 ± 6.14; t-value = -1.947 [0.05*]) and improvement in sleep quality (preintervention mean ± SD = 6.63 ± 3.82; postintervention mean ± SD = 5.29 ± 2.44) among HCPs after following this 8-week heartfulness meditation program. In the end, a substantial decrease in perceived stress score and an improvement in the sleep quality index was found. Conclusion: Additionally, practicing heartfulness meditation may aid in developing the traits of empathy, acceptance, and inner serenity. We draw the conclusion that more extensive research is required to fully understand the impact of heartfulness meditation practice.

Development and Validation of Palliative Care Bundle for Advanced Gallbladder Cancer "PALLICR".

Kusum K. RohillaBackground The aim of this study was to develop and validate a comprehensive palliative care bundle "PALLICR" for advanced gallbladder cancer (GBC) patients. Materials and Methods The present study was an exploratory study with instrument validation design which was conducted at All India Institute of Medical Sciences, Rishikesh, India. A total of 25 advance cancer patients were selected using the purposive sampling technique. Results The newly developed PALLICR bundle consists of six items under three subfactors, that is, functional recovery, resilience, and quality of life. The final version of bundle with six items of PALLICR bundle was validated and showed a good fit to provide palliative care to advanced GBC patients. Standardized scales, that is, palliative care outcome scale, European Organization for Research and Treatment of Cancer quality-of-life scale for patients and caregiver strain index for caregivers were used for evaluation of PALLICR bundle effectiveness. Conclusion PALLICR bundle is valid and reliable methods to provide palliative care to advanced GBC patients.

Expression of ER, PR, and HER-2 Neu and correlation with tumor markers in gall bladder carcinoma.

Background: Females having a large proportion of gallbladder carcinoma (GBC) and a higher incidence of gallstones pointed toward the role of sex hormones in GBC development. In this study, we evaluated the expression of Estrogen receptor (ER), Progesterone receptor (PR), and Her2/neu and their correlation with tumor markers and clinicopathological parameters in the GBC. Methods: A total of 50 patients of GBC and 42 patients in control group undergoing surgery for other conditions were taken. The patient's biopsy sample's paraffin block was tested for ER, PR, and Her2/neu expression by immunohistochemistry. Results: ER and PR had no significant expression in GBC and control group, but Her2/neu had 16% expression in GBC, significantly associated with the degree of differentiation with 62.5% (n-5) being well-differentiated; 75% of Her2/neu positive were in stages III and IV. Her2/neu did not correlate with tumor markers despite expression. Conclusions: Her2/neu amplification is a small step in validating that option so it could be included in the treatment and prognostication of GBC.

COVID-19 Infodemic: Evaluating Information-Seeking Behaviour Among Healthcare Workers During a Pandemic.

Introduction With the surge in coronavirus disease 2019 (COVID-19) cases across nations worldwide, World Health Organization (WHO) declared it a pandemic on March 11, 2020. Besides various policy guidelines and directions issued from time to time to combat the menace, there was the dissemination of a lot of misinformation and disinformation through social media or otherwise. This led to emotional, psychological, and mental agonies in the general population as well as Healthcare Workers (HCWs). Methods A cross-sectional quantitative study using purposive sampling techniques was done to assess the health-seeking behavior during the pandemic among HCWs of a tertiary care hospital in North India, designated as a dedicated COVID-19 hospital by the Ministry of Health and Family Welfare, India. A semi-structured questionnaire validated by experts with a reliability value (r=0.92) was taken. To maintain minimal contact and to follow COVID-19 Appropriate Behavior (CAB), a web-based link was used to obtain the data. Privacy of the participants and confidentiality of data obtained was maintained. Results Out of the total 250 participants enrolled in the study, the response rate was 81% (203). For 123 (60%) respondents, social media was one of the sources of access to information during the pandemic. The most common social media app(s) accessed were WhatsApp 82 (40%), Facebook, and Instagram 67 (33%). Social media had both positive as well as negative impacts on the mindset of respondents as 147 (72%) agreed that social media networks helped to further improve their understanding, whereas 178 (88%) stated that it aroused fear and panic among them. Conclusion During epidemics, timely, accurate, and authentic information is vital in shaping public opinion; on the contrary, an infodemic can pose a serious threat and panic in society by disseminating false and wrong information as was seen in the COVID-19 pandemic.

Let's talk about mucormycosis emergency with COVID-19: Invest in future.

Despite recent breakthroughs in the detection and treatment during the COVID-19 pandemic, mucormycosis is a serious infection with a high death rate. It is a filamentous fungal infection from the zygomycetes class of order mucorales. It is a fatal fungal infection with a 50% or higher overall fatality rate. Mucormycosis is a fungal infection caused by mucor, which is a mold that can be found in soil, rotting fruits, and vegetables. It can primarily affect the brain, lungs, and sinuses. It is very much fatal in patients with diabetes or who are highly immunocompromised such as patients with cancer. In addition to more than 50% mortality rate, surgical intervention may require necrotic tissue removal, which leads to severely disfiguring surgery.

Nurses in NICUs' views on nosocomial infection prevention.

BACKGROUND: Basic infection control measures are required in India's health-care setting in Neonatal Intensive Care Units (NICUs) to lower the prevalence of hospital-associated infections. The aim of the present study was to assess practices followed by nurses of NICUs for nosocomial infection prevention. MATERIALS AND METHODS: From January to February 2020, a descriptive cross-sectional study was conducted. Participants in the study were chosen by total enumeration sampling technique, i.e., 60 nurses were included in this study who working in tertiary care institutions, India. The study respondents' knowledge and practice for nosocomial infection control strategies were assessed by using a 30-item and 27-item questionnaires, respectively. SPSS (version 23.0) was used to analyze the data collected. RESULTS: Results showed that all nurses (100%) were females, belongs to the age group of 26-35 years (82%), hold professional qualifications (34%) in GNM as well as post basic BSc nursing, married (72%), had 1-5 years of professional experience (66%), and working in the NICUs for 1-3 years (74%). Most of nurses (55%) had never attended any session on nosocomial infection prevention. Nurses of NICUs (70%) had just a moderate degree of understanding on nosocomial infection prevention. Nurses' practice showed good practise (60%) for nosocomial infection prevention in NICUs. CONCLUSIONS: The necessity to adopt health-care policy about nosocomial infections and execution of regular training program to upgrade and refresh nurses' knowledge and practices regarding for nosocomial infection control measures is indicated to fill gap among knowledge and practices concerning nosocomial infection control and prevention.

Telemedicine as an unexpected catalyst during and beyond the COVID-19 Pandemic.

Telemedicine that also known as the practice of medicine at a distance whereby information technology is used to ensure the delivery of medical care services. Telemedicine is not a new concept in the world and India.Indian Space Research Organization (ISRO) started telemedicine in India during year 2001 as a pilot project and in year 2005 Ministry of Health and family welfare started full time program of telemedicine by connecting all major health institutions. Telemedicine is connecting people across border and culture. The need-based changes are coming in telemedicine sectors such as smart apps, involvement of private sector players and high intensity internet connections reaching to rural areas and difficult demographic locations. During Covid-19 pandemic telemedicine benefited people by supplying health information and consultation without breaching them without breeching physical contact restrictions. The ease of access to telemedicine applications, its low cost, and the lack of infrastructure requirements propelled to become the top choice in these dayswhere physical distancingconsidered the aforementioned, thus we can conclude that telemedicine is promising tool.

COVID-somnia: Sleep disturbance among Indian nurses during COVID-19 pandemic.

Background: Sleep is vital for every aspect of human life. Inadequate sleep has a massive negative impact on health and work. There is very limited information about the impact of COVID-19 on the sleep disturbance of health-care workers. In our current study, we aim to find answers to certain questions about the impact of the COVID-19 pandemic on sleep patterns on nurses working in COVID care area. Methods: A cross-sectional study was conducted on 305 health-care workers who were purposively enrolled for this study. The study was conducted at the Postgraduate Institute of Medical Education and Research, Chandigarh, India, from April to June 2021. An e-survey method was used to collect data. A questionnaire including sociodemographic characteristics, queries about sleep disturbances, and the patient health questionnaire-9 scale to assess anxiety among participants are among the research tools. Results: Mean age of health-care workers was 26.3 years (SD = 6.3). Most of them were women (81%) with a bachelor's degree in nursing (62%), nursing interns (46%), and married (71%). The majority of nurses (85%) were not infected with COVID and were given suitable personal protective equipment (46%) in the hospital. The majority of participants (45%) got 6-8 h of sleep per night did not receive any sleep therapy (90%). The most of participants (42%) reported that they did not enjoy performing activities and were under moderate stress (15.4). Conclusion: Health-care workers are struggling to cope with the COVID-19 pandemic with limited and almost hackneyed resources. Healthy sleep is everyone's right. The current situation of the pandemic has a great impact on the psychological health of frontline health-care workers by affecting their professional performance.

Clinical profile of COVID-19 patients and their length of stay: Tertiary care hospital experience.

Background: SARSCoV-2, a coronavirus that causes COVID-19, is spreading rapidly. By the middle of August-2021, it has affected over 3 million confirmed cases in India. The main aim of this study was to examine the clinical profile of COVID-19 patients and their length of stay during treatment in a hospital. Materials and Methods: It was a hospital-based retrospective study conducted by using a total enumeration technique in July-August 2021 at Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER) in India. The present study was conducted on 72 COVID-19 patients who took treatment in 4C and 5C wards. Structured questionnaires were used to collect data, which included bio-demographic factors and questions about their treatment and length of stay. Results: The majority of the 72 COVID-19 positive patients were men (62%), belonged to the age group of 41-60 years (35%), had SpO2 levels ranging from 91%-95% (45%), and received room air O2 therapy (63%) during their treatment in the hospital. Female patients had a longer length of stay (7.33 days), patients under the age of 20 years had the longest hospital stay (11.5 days), patients with SpO2 less than 70% had the longest hospital stay (8 days), and patients who received oxygen using a non-rebreathing mask had the longest hospital stay (11 days). Conclusion: To avoid panic situations, regular admission and discharge of patients was essential due to the considerable increase in cases during the second wave. Patient length of stay was reduced as a consequence of collaboration and cooperation among all physicians, residents, staff nurses, and paramedics, with the goal of discharging the patient after a room air trial and follow up if needed.

Practices followed by type-II diabetes mellitus patients for prevention of foot ulcers.

BACKGROUND: Type-II diabetes mellitus is a serious lifestyle-related health problem globally and its prevalence is rapidly increasing day by day. The main purpose of this study was to assess practices followed by Type-II diabetes mellitus patients regarding the prevention of foot ulcers. METHOD: This study was a cross-sectional study using a case series type of research design. Purposively, a total of 100 type-II diabetes mellitus patients were registered with AIIMS Rishikesh for their treatment. Data collection tools were a semi-structured questionnaire that included 20 items. By conducting an interview schedule, data was collected from each participant. RESULTS: Majority of participants belong to age group of 51-60 years and were males. Practice score showed majority of Type-II DM patients were following moderate-level practices, followed by only few (15%) were following good practice for preventing foot ulcers. CONCLUSION: Health care professionals must empathize on educating type-II diabetes patients regarding preventive measures for foot ulcers. Educate patients regarding the importance of self-foot care practice and promoting them for proper follow-up as well to decrease incidence of diabetic foot ulcers.

Effect of yoga on pulse rate and blood pressure among women.

OBJECTIVES: Change in the past few decades in human life style, nowadays international health organizations, i.e., World Health Organization are also focusing on prevention along with treatment aspect of chronic illness. Researches focus that women of age group 30-45 years are at increased risk for hypertension and heart disease due to increased weight. Yoga is an effective method to control our physiological variables like blood pressure (BP), pulse, etc. The main aim of this study was to identify the effects of yoga on physiological variables. METHODS: The study was an experimental study with two group, pretest and posttest control group, design, which was conducted on 40 female participants. Pranayama and meditation for a period of 6 weeks was done by these women. RESULTS: Yoga therapy significantly reduced the BP (0.000*) and pulse rate (0.000*) of women, which was also statistically proved. CONCLUSIONS: Yoga therapy can be an effective method to control BP and pulse rate of patients with chronic diseases.

Prevalence and contributing factors for adolescent obesity in present era: Cross-sectional Study.

BACKGROUND: Adolescent obesity is a very common issue in our culture. Recent studies have shown that this is a form of global burden that may predispose factors in advanced life for many other diseases. Adolescents are a positive force for a country, responsible for their future prosperity and also for their nations. OBJECTIVES: The main objective of the study was to identify the prevalence of obesity among adolescents and its diverse contributing factors. METHODS: The analysis was a cross-sectional sample method and was carried out using a sampling methodology which was not possible. Through using standardized questionnaires and using validated and calibrated heighometers and weighting devices, data was obtained from 385 participants. Body mass index (BMI) scale of the World Health Organization (WHO) has been used to create a category for obesity. BMI values greater than + 1 SD fall in the range of overweight, and levels of obese greater than + 2 SD. RESULTS: It was found that 6.8% of adolescents were obese and that about 17.1% were overweight. Remaining 53.8% percent had normal category of BMI and 22.3 percent were category of underweight. A significant association of gender, socioeconomic status, dietary habits, chocolate eating habits, mode of transportation to school, sports participants, physical activity, and screen time. Adolescents who were athletic enthusiasts and those who did physical activity had a good BMI. The teens who watched more than 2 h of screen time were more obese, and these were only a few reasons that were responsible for teenage obesity. CONCLUSION: Health care practitioners and policy makers need to be aware of the prevalence and contributing factor to teenage obesity. Adolescents will embrace practices such as healthy eating habits, avoiding smoking and physical inactivity. This obesity may increase their risk of developing chronic illnesses in adulthood and later life stage.

Strategy to prevent infection from Covid-19 among security officers of tertiary care centre: A preexperimental study.

BACKGROUND: The extensive spread of Covid-19 pandemic globally became the main cause of concern for everyone, including security officers working in a health care setting. OBJECTIVE: To assess the effectiveness of instructional module for Covid-19 prevention among hospital security officers. METHODS AND MATERIALS: A preexperimental study was conducted at a tertiary care hospital from North India. A total of 344 security officers were selected by the convenient sampling technique. A self-structured knowledge and practice questionnaires and instructional module were developed based on the guidelines released by World Health Organization, Centre for Disease Control and Prevention and Ministry of Health and Family Welfare. Knowledge and practice were pretested, followed by the implementation of a video cum discussion instructional module for Covid-19 prevention. A posttest of knowledge and practice assessment was done after 7 days by using the same questionnaire. Descriptive and inferential statistics were used to compute and analyse the data. RESULTS: The mean age of participants was 29.5 ± 2.25; mos participants (75%) were male security officers. Knowledge and practice scores improved after the implementation of instructional module as mean scores of pretest to mean posttest scores had shown a significant difference (P = 0.00). In practice, instructional module was significantly effective, except for touching hair again and again, as it could be a source of covid-19 infection. CONCLUSION: This study finding highlights the significance of training security officers about the prevention of Covid-19.

Rapid Workforce Development to Combat the COVID-19 Pandemic: Experience From a Tertiary Health Care Centre in North India.

Introduction During a large-scale disease outbreak, one needs to respond to the situation quickly towards capacity building, by identifying areas that require training and planning a workable strategy and implementing it. There are limited studies focused on fast-track workforce creation under challenging circumstances that demand mandatory social distancing and discouragement of gatherings. This study was conducted to analyze the planning process and implementation of fast-track training during the Coronavirus disease (COVID-19) pandemic, and evaluate its effectiveness in building a rapid, skilled, and massive workforce. Methods A cross-sectional study was conducted to evaluate rapid preparedness training delivered from March to June 2020, based on documents and data regarding the process, planning, and implementation for large-scale capacity building. Pre-test and post-test scores were compared to assess the effectiveness of training. The number of personnel trained was evaluated to determine the efficiency of the training program. Data on COVID-19 among health care workers (HCWs) were analyzed. Results The Advanced Center of Continuous Professional Development acted as the central facility, quickly responding to the situation. A total of 327 training sessions were conducted, including 76 online sessions with 153 instructors. The capacity-building of 2,706 individuals (913 clinicians and 1,793 nurses, paramedics, and non-medical staff) was achieved through multiple parallel sessions on general precautionary measures and specialized skills within four months. The rate of hospital staff infected with COVID-19 was found to be 0.01% over five months. Conclusions A fast-track, efficient, large-scale workforce can be created through a central facility even under challenging circumstances which restrict gatherings and require physical distancing. A training action plan for disease outbreaks would be a useful resource to tackle such medical emergencies affecting substantial populations in future.

Undiagnosed elevated blood pressure and its life style related risk factors among adults: Cross sectional survey.

BACKGROUND: Globally, high blood pressure (BP) is a main health problem among adult population. High BP is considered as a major risk factor which may lead to many cardiovascular diseases. Globally, it is also the leading cause of death. According to the American Heart Association, a BP of 120/80 mm of Hg is a normal range but when the systolic blood pressure ≥130 and diastolic blood pressure ≥80, it is always labeled as hypertension. OBJECTIVES: In the present study, the researchers wanted to identify the prevalence of undiagnosed elevated blood pressure in the adult population of Uttarakhand, India and also try to explore its lifestyle-related risk factors. METHODS: This study was an exploratory survey with a cross-sectional design. Data were collected from 440 participants by using the cluster sampling technique. RESULTS: The male:female ratio among participants was 1:4 and most of the participants were aged 25-30 years. The study found that the prevalence of high blood pressure was 26%, in which marginal elevated BP prevalence was 16%, hypertension stage I was 7%, and hypertension Stage II was 3% which is significantly higher in number at a young age. Lifestyle-related risk factors showed a significant association of hypertensive status with gender, consumption of balanced diet, and personal habits. This increases the chances of elevated blood pressure in young adults. CONCLUSION: All health professionals must be sensitized for elevated blood pressure problems among the young adult populations. Elevated blood pressure should be considered as a warning alarm at an early age when prescribing any medication and during any invasive procedure. Awareness should be created among public regarding elevated blood pressure issues at a younger age and motivate people to adopt a healthy and stress-free lifestyle.