RESUMO
Background: With the emergence of new mutated variants of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), we have witnessed three waves of coronavirus disease (COVID) with varying severity, complication, and outcome in Punjab. The physiological changes of pregnancy make mother more vulnerable for severe infection. Current study is aimed at comparison of maternal and neonatal outcomes of COVID-positive pregnant women in second and third waves. Materials and Methods: This was a retrospective observational single-center study conducted at a dedicated COVID hospital in Punjab, India. Records of all COVID-positive pregnant women admitted from January to June 2021 and from January to February 2022 were reviewed. The demographic details, severity of symptoms, maternal and fetal complications, outcomes, and mortality were noted. Results: There were 220 COVID-positive pregnant patients in the second wave and 65 in third wave. The majority of patients belonged to the age group of 20-34 years (57.73% in the second wave and 70.77% in the third wave). Maternal deaths and severity of disease increased with increasing age of the mother, that is, 6.7% in <35 years and 13.95% in >35 years age group (RR = 2.058, P value = 0.1248). Also, the maternal deaths increased with increasing parity (RR = 2.00, P value = 0.2380). The majority of the study subjects were in the third trimester, with 77.73% in the second wave and 90.77% in the third wave. The majority of the patients in both the waves were asymptomatic or had mild symptoms. In the COVID second wave, 10.91% pregnant patients had moderate COVID symptoms and 8.18% had severe COVID symptoms, whereas none presented with moderate or severe symptoms in the third wave. Eighteen maternal deaths (8.18%) were seen during the COVID second wave, whereas no maternal death occurred in the third COVID wave. 100% of these deaths were because of COVID. Need of oxygen supplementation and intensive care unit admission had statistically significant association with maternal mortality. Conclusion: In the third COVID wave, the morbidity and mortality were significantly reduced. This could be a result of wide-spread vaccination, new strain of COVID, or both. In spite of this, the pregnancy complications such as pre-term birth, IUGR, and IUD were significant. Hence, pregnancies complicated by COVID should be considered as a high risk and closely monitored.
RESUMO
Background: Hidradenitis Suppurativa (HS) is a chronic, relapsing, inflammatory skin condition which is physically, psychologically and socially disabling and often affects a patient's quality of life (QOL). There are numerous QOL tools used in dermatology. However, assessment of QOL in patients with HS is difficult due to the inability of generic QOL tools to specifically capture QOL in patients with HS. Numerous HS-specific QOL tools have been developed in recent years. It is important to identify evidence on full psychometric evaluation of these tools. Objectives: There has been a gradual increase in the use of generic and disease-specific QOL tools in the last few decades. The aim of this scoping review (SR) is to evaluate the most widely used generic QOL tools and HS-specific QOL tools to identify the psychometric evaluation of such tools. Methods: Design: An SR guided by Joanna Briggs Institute manual and Arskey O'Malley framework guidelines. Data extraction included the studies available on full psychometric evaluation of the most widely used dermatology generic QOL tools in HS and HS-specific QOL tools. Results: Ten papers were included in the review, eight papers demonstrated HS-specific QOL assessment tools. The psychometric properties of these tools were underpinned by reliability, validity and sensitivity measurement. Six disease-specific tools were identified in this SR. However, they all lack full psychometric evaluation. Conclusion: This review indicates that an extensive research in the field of QOL tools for HS is much needed. It is crucial to develop user-friendly and validate disease-specific tools to measure the real impact of disease on patients QOL. QOL instruments can evaluate the impact on life of an HS patient, thus helping improve intervention and management of disease. There is a necessity for more research into existing HS-specific QOL tools and they should be widely tested and fully validated.