Measuring the impact of a single dose of ChAdOx1 nCoV-19 (recombinant) coronavirus vaccine on hospital stay, ICU requirement, and mortality outcome in a tertiary care centre.

OBJECTIVE: To comparatively evaluate ICU requirement, length of stay, and mortality between single-dose vaccinated and non-vaccinated hospitalized COVID-19 patients. DESIGN: A retrospective observational study was carried out in a tertiary care hospital in western Indian, from April 1 to June 30, 2021. RESULTS: Of the 569 patients who fulfilled the eligibility criteria and were enrolled in the study, 137 (24.08%) patients had received a single dose of ChAdOx1 nCoV-19 vaccine, while 432 (75.92%) patients had not received any form of vaccination. The overall length of stay in hospital was similar for both groups; however, a significant difference was seen in length of stay in the ward and in the ICU. Vaccinated patients were admitted to the ward for 6.21 ± 3.204 days, while non-vaccinated patients were admitted for 5.56 ± 4.55 days (p < 0.001). The mean length of ICU stay for the 21 vaccinated patients requiring intensive care was 4.47 ± 2.3 days, while that for the 145 non-vaccinated patients was 6.29 ± 2.19 days (p < 0.001). Mortality was observed in four patients in the vaccinated group and in 95 patients in the non-vaccinated group. CONCLUSION: A single dose of ChAdOx1 nCoV-19 vaccine was associated with a significantly lower severity of SARS-CoV-2 infection compared with no vaccination.

Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine.

Objective We aimed to evaluate and compare the effectiveness of physical and yoga therapies as an adjuvant therapy along with standard pharmacologic treatment in patients with migraine. Materials and Methods A total of 61 consenting patients diagnosed to have migraine were randomized into three groups to receive either standard treatment alone, physical therapy along with standard treatment, or yoga therapy along with standard treatment. The respective adjuvant intervention was taught to the respective group of patients and they were advised to perform it daily for 3 months with weekly telephonic reminders and review of their activity logs. Outcome measures assessed were headache frequency, Short-Form McGill Pain Questionnaire (SF-MPQ), and Headache Impact Test-6 (HIT-6) at recruitment and once every month for 3 months. Statistical Analysis Statistical analysis of the study was done by using Stata 14.1 software. All the descriptive statistics, paired t -test was used to compare the difference between pre and postintervention values of headache frequency, SF-MPQ, and HIT-6 score within all the three groups. Analysis of variance test and post hoc test were used to compare the differences between all groups for outcome measures ( p < 0.05). Results Headache frequency and the visual analog scale before intervention compared during each month intervals for 3 months in all the three groups were significantly decreased in all the three groups ( p < 0.005). Yoga or physical therapy as an adjuvant to standard treatment leads to a higher reduction in headache frequency and severity. Sensory and affective pain ratings of SF-MPQ and HIT-6 also showed a significant improvement at 1 to 3 months of treatment compared with baseline in all the three groups. Conclusion Either physical or yoga therapy as an adjuvant to standard pharmacologic treatment may further improve the quality of life and reduce headache frequency in patients with migraine.

Awareness and practice of aerobic exercise and yoga among hypertensive patients in Anand city.

BACKGROUND: Aerobic exercise is helpful in reducing elevated blood pressure (BP). It was also found that yoga is useful in reducing raised BP. Thus, they both can be used in prevention and treatment of hypertension. Hence, the study aimed to observe both awareness and practice of aerobic exercise and yoga among hypertensive patients in Anand city. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted. A questionnaire was prepared containing 24 questions about awareness and practice of aerobic exercise and yoga among hypertensive patients. The questions were explained to all the patients, and 200 patients were recruited from Anand city through convenience sampling. RESULTS: Two-hundred patients were included in this study, of which 100% were aware of hypertension. 67.68% were aware of the role of aerobic exercise in hypertension, of which 58.29% practiced them. The awareness of the role of yoga in hypertension was noted in 33.67% of patients, of which only 13.07% practiced pranayama and 9.50% practiced asanas. CONCLUSION: There was a complete awareness of hypertension among hypertensive patients. A large number of patients were aware of the role of aerobic exercise in hypertension, but only few of the patients practiced them. However, there was less awareness of the role of yoga in hypertension and even lesser number practiced them.

Work-related musculoskeletal disorder among surgeons in Gujarat.

INTRODUCTION: Work-related musculoskeletal symptoms are a major health issue in many occupations all over the world. Past researches on hospital workers have mainly been focused on nurses, and not many studies have examined musculoskeletal symptoms among doctors in various specialties. The work of surgeons can involve high levels of mental concentration and very precise movements that can be categorized as mild-to-moderate physical demands. OBJECTIVE: To identify the prevalence of musculoskeletal problems and their related physical and psychosocial factors of surgeons who are involved in such work. METHODOLOGY: Forty-three surgeons were enrolled in this study. To evaluate the musculoskeletal disorders, the participants were assessed through Standardized Nordic Questionnaire, Quick Exposure Check for the work pattern, and Work style Short Form for screening purpose. RESULTS: Out of 43 participants, 30 were male and 13 were female. Their mean age was 42.07 ± 12.35 years, and the mean working years ± standard deviation of the group was 15.14 years ± 9.017. On an average, they worked a total of about 8.58 h ± 1.96 per day. The prevalence of work-related musculoskeletal symptoms was found in 36 participants (83.70%), while only seven surgeons (16.30%) were symptom free. CONCLUSION: The present study indicates a high prevalence of musculoskeletal symptoms in surgeons. The results also indicated that surgeons had a high sense of commitment and self-imposed pressure.

The effect of positional changes on oxygenation in patients with head injury in the intensive care unit.

BACKGROUND: Following head injury, cardiopulmonary functions are impaired and this disturbs the oxygenation transport pathway. Expanding cardiopulmonary physical therapy to encompass the oxygen transport system as a whole has implication for treatment as well as assessment and treatment outcome. Therefore, the aim of the study is to assess the oxygenation level in head injury patients with relation to body positioning in the intensive care unit (ICU). METHODOLOGY: Thirty consecutive patients with head injury with hemodynamically stable were included from the surgical ICU, ages ranging from 15 to 50 years. Noninvasive vital parameters (oxygen saturation [SpO2], pulse rate [PR], respiratory rate [RR], and blood pressure [BP]) were observed and recorded in different body positions at regular intervals of 5 min for 15 min in each position. RESULTS: There was increment in SpO2 value in all positions from 0 min to end of 15 min in supine (98.63 ± 0.36-98.73 ± 0.30), right-side lying (98.77 ± 0.30-98.93 ± 0.20), left-side lying (98.73 ± 0.29-99.03 ± 0.24), and recline sitting (30°-70°) (99.03 ± 0.24-99.50 ± 0.22). However, there was statistically significant increment in recline sitting (30°-70°) compared to other positions (P = 0.036) while other parameters (PR, RR, and BP) were getting stabilized at lower values at end of 15 min in every positions tested. CONCLUSION: We conclude that upright position bring about significant increase in arterial SpO2 compared to any other positions. Other vital parameters were seen to stabilize at lower values at the end of 15 min in every position tested.

To identify morbidity and mortality predictors in acute organophosphate poisoning.

BACKGROUND: Organophosphorus poisoning remains an important cause of morbidity and mortality, but no definite parameters have been identified as predictors of outcome. Prediction of morbidity at presentation might help in decision making in places of limited resources like rural settings in developing countries. MATERIALS AND METHODS: A total of 76 cases were included in this retrospective cohort study. Logged relative risk of requirement of mechanical ventilation and hospital stay >7 days was measured in patients with serum acetylcholinesterase (s. acetylcholinesterase) <1000 versus >1000, presenting in <2 h versus ≥ 2 h after exposure, with Glasgow Coma Scale (GCS) ≤12 versus >12 and in patients with SpO2 <85% versus ≥85% at room air at presentation. RESULTS: S. acetylcholinesterase <1000, time elapsed after ingestion to presentation ≥ 2 h and SpO2 (at room air) at presentation <85% were found to have positive association with requirement of ventilation. GCS ≤ 12 had a significant association with both requirement of ventilation and hospital stay >7 days. CONCLUSION: S. acetylcholinesterase, SpO2 at room air, GCS, and duration of exposure at presentation can be used to identify the requirement of special care in acute organophosphorus poisoning. This can aid in decision making regarding admission to intensive care unit and referral in the places with limited resources.

Rare case of dystrophia myotonica with mega cisterna magna.

Myotonic dystrophy is also known as dystrophia myotonica (DM). The condition is composed of at least two clinical disorders with overlapping phenotypes and distinct molecular genetic defects: myotonic dystrophy type 1, the classic disease originally described by Steinert, and myotonic dystrophy type 2, also called proximal myotonic myopathy (PROMM). Mega cisterna magna is thought to be an anatomic variant with no clinical significance. We report a rare case of type 1 dystrophia myotonica in combination with mega cisterna magna.