Capillary leak syndrome due to Russell's viper envenomation-A doomy presage for treating clinician.

Russell's viper envenomation is a major challenge to physicians providing intensive care due to diverse presentations and dismal outcomes. The venom can cause idiopathic systemic capillary leak syndrome manifesting with bilateral parotid swelling, hemoconcentration, and refractory shock. Physicians' awareness about this presentation is lacking. Delayed recognition of this syndrome leads to fatalities despite providing the best possible care. We hereby report a fatal case of Daboia russelii bite presenting as capillary leak syndrome. The aim is to create awareness among tropical physicians who are primary caregivers to these victims.

Risk Assessment of COVID-19 Infection among the Elderly Population.

Introduction:Elderly patients are susceptible to COVID-19 infection. They usually present with atypical symptoms and multiple organ dysfunction. The poor outcome in elderly patients is due to multiple comorbidities, declining functional status, and frailty. This study aimed to assess the risk profile of COVID-19 infection in the elderly population. Materials and methods:Patients aged 60 years and above with COVID-19 positive by RT-PCR were included in the study. Patients' demographic data, co-morbidities and severity of illness, complete hemogram, blood sugar, renal, liver function test, lactate dehydrogenase, interleukin-6, ferritin, D-dimer were noted. Patients' outcome in terms of survival was observed. Results:The total count, neutrophil lymphocyte ratio, ESR, urea, creatinine, interleukin 6, D-dimer, and blood sugar value were significantly associated with non-survival even after adjustment for age and gender. Complications such as acute kidney injury (AKI), renal failure, acute respiratory distress syndrome, multiorgan dysfunction syndrome (MODS), and World Health Organization (WHO) severity were also associated with non-survival before and after adjustment for age and gender. On Cox regression survival analysis, . three co-morbidities had hazard ratio (HR) of 54.36 [95% CI 3.66 to 807.01], WHO severity had HR of 31.09 [95% CI 1.31 to 738.22], MODS had HR of 16.97 [95% CI 2.86 to 100.39], creatinine had HR of 8.44 [95% CI 1.99 to 35.77], AKI had HR of 6.71 [95% CI 1.11 to 40.56]. Conclusion:In elderly patients with COVID-19 infection, the presence of at least three co-morbidities, severity of infection by WHO criteria and presence of complications such as MODS, elevated creatinine and AKI were predictors of the survival rate and mortality.

Corrigendum: Knowledge, Attitude, and Practices Associated With COVID-19 Among Healthcare Workers in Hospitals: A Cross-Sectional Study in India.

[This corrects the article DOI: 10.3389/fpubh.2021.787845.].

Knowledge, Attitude, and Practices Associated With COVID-19 Among Healthcare Workers in Hospitals: A Cross-Sectional Study in India.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused phenomenal loss of lives and overburdened the health system in India. Low morale, fatigue, and inadequate knowledge among the healthcare workers (HCWs) are the perceived threats to pandemic control. We aimed to assess the COVID-19 related level of knowledge, attitude, and practices (KAP) among our HCWs. A cross-sectional, electronically distributed, questionnaire-based study was conducted which identified the demographics of HCWs and the current KAP related to coronavirus disease 2019 (COVID-19). The descriptive statistics were used to present the demographics of the participants and chi-square test was used to assess the differences in KAP among the participants. Of 1,429 total participants, 71.9% belonged to age group 21-40 years. Only 40.2% received any infection control training and 62.7% relied upon single source of information update. However, 82.9% of the participants had adequate knowledge. Being married, urban dwelling, and higher qualification were associated with knowledge adequacy (p < 0.001). Interestingly, the senior HCWs (age 41-50 years) were least likely to have adequate knowledge (74.1%). About 84% had positive attitude toward COVID-19, but 83.8% of the participants feared providing care to the patients with COVID-19. However, 93% of HCWs practiced safety precautions correctly most of the times and training had no influence on practice. In conclusion, more than 80% of HCWs in the study had adequate knowledge, positive attitude, and practiced safely most of the time. However, the pitfalls, such as poor training, knowledge uncertainties, and fear of disease acquisition among the HCWs need to be addressed.

Early diagnosis of post-varicella necrotising fasciitis: A medical and surgical emergency.

Necrotising fasciitis (NF) is an extremely rare complication of a rather common paediatric viral exanthem varicella. Delayed diagnosis and treatment can lead to significant morbidity and mortality. Laboratory risk indicator of NF score aids in early clinical diagnosis in suspected cases of post-varicella NF thus enabling timely intervention. Surgery delayed for more than 24 hours, is an independent risk factor for death. Surgical debridement with good antibiotic coverage is the definitive treatment for NF.