Assessment of Physical Disability After Three Months in Patients Recovered From COVID-19: A Cross-Sectional Study.

PURPOSE: This study was done to assess the extent of disability in coronavirus disease 2019 (COVID-19) survivors using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). MATERIAL AND METHODS: This was a cross-sectional study with convenient sampling. Institutional ethical clearance was taken. Informed consent was taken from all patients. Disability assessment was done using WHODAS 2.0. All patients were initial reverse transcriptase-polymerase chain reaction (RT-PCR) positive for COVID-19. Patients with neuromuscular deficits or who were taking medication for psychiatric illness before getting infected with COVID-19 were excluded from the study. RESULTS: Fatigue followed by dyspnea was the most common reported symptom after three months of COVID-19 infection. COVID-19 survivors with fatigue or dyspnea had a more significant disability as compared to other patients. Females had a more significant disability when compared to males. We did not find any significant disability in COVID-19 survivors after three months of disease based on body mass index, hospitalization, diabetes, and oxygen requirements. CONCLUSION: COVID-19 survivors suffered from significant disability after three months of disease especially females and survivors with fatigue or dyspnea. Recognizing post-COVID-19 sequelae and the availability of rehabilitation services will be critical in preventing another public health crisis after acute COVID-19 infection.

Comparing Effectiveness of Combination of Collagen Peptide Type-1, Low Molecular Weight Chondroitin Sulphate, Sodium Hyaluronate, and Vitamin-C Versus Oral Diclofenac Sodium in Achilles Tendinopathy: A Prospective Randomized Control Trial.

Background Achilles tendinopathy, a common cause of heel pain, is primarily considered mechanical in origin, but its pathogenesis and treatment lack consensus. Molecules such as collagen peptide type-1, low molecular weight chondroitin sulphate, sodium hyaluronate and vitamin C have been shown to act as building blocks of tendon structure, and oral supplementation of these have promising results in Achilles tendinopathy. Methods This study was a prospective randomized control trial to compare the effectiveness of oral diclofenac sodium versus a nutraceutical combination of collagen peptide type-1, chondroitin sulphate, sodium hyaluronate, and vitamin C in the treatment of Achilles tendinopathy on pain and ultrasonographic structures. A total of 40 patients satisfying inclusion and exclusion criteria were randomly allocated into two groups and were given the nutraceutical combination in group A and diclofenac sodium in group B. The patient evaluation was done at baseline, six-week, and 12-week intervals in terms of VAS (Visual Analogue Scale) and tendo-Achilles thickness by ultrasound. Results Both nutraceutical combination and diclofenac reduced pain in persons with Achilles tendinopathy. The nutraceutical combination had a statistically significant better outcome in reducing pain at the end of 12 weeks. On ultrasound, both the interventions reduced Achilles tendon anteroposterior and mediolateral thickness by the end of 12 weeks. Although there was no absolute significant intergroup difference, the percentage change was more in the nutraceutical group in the case of anteroposterior thickness. Conclusion Combining collagen peptide type-1, low molecular weight chondroitin sulphate, sodium hyaluronate, and vitamin C is more effective than oral diclofenac in controlling pain in Achilles tendinopathy.

Reaction order and neural network approaches for the simulation of COVID-19 spreading kinetic in India.

COVID-19 has created a pandemic situation in the whole world. Controlling of COVID-19 spreading rate in the social environment is a challenge for all individuals. In the present study, simulation of the lockdown effect on the COVID-19 spreading rate in India and mapping of its recovery percentage (until May 2020) were investigated. Investigation of the lockdown impact dependent on first order reaction kinetics demonstrated higher effect of lockdown 1 on controlling the COVID-19 spreading rate when contrasted with lockdown 2 and 3. Although decreasing trend was followed for the reaction rate constant of different lockdown stages, the distinction between the lockdown 2 and 3 was minimal. Mathematical and feed forward neural network (FFNN) approaches were applied for the simulation of COVID-19 spreading rate. In case of mathematical approach, exponential model indicated adequate performance for the prediction of the spreading rate behavior. For the FFNN based modeling, 1-5-1 was selected as the best architecture so as to predict adequate spreading rate for all the cases. The architecture also showed effective performance in order to forecast number of cases for next 14 days. The recovery percentage was modeled as a function of number of days with the assistance of polynomial fitting. Therefore, the investigation recommends proper social distancing and efficient management of corona virus in order to achieve higher decreasing trend of reaction rate constant and required recovery percentage for the stabilization of India.

Tubercular Thyroiditis as a Part of Disseminated Tuberculosis in a Young Male: A Rare Clinical Presentation.

Thyroid tuberculosis is uncommon even in countries like India where prevalence of tuberculosis is high. Bactericidal actions of colloid, excess iodine stores and high vascularity of the gland have been implicated for the very rare occurrence of thyroid tuberculosis. We present a case of a 16-year-old male with thyroid involvement as a part of disseminated tuberculosis. The clinical presentation of thyroid tuberculosis is varied and may be missed if not kept in the differential diagnosis of goitre. This case also highlights the role of fine needle aspiration cytology in management of goitre. It is an important diagnostic test as it avoids unnecessary surgical intervention.