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1.
BMC Health Serv Res ; 21(1): 914, 2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34479540

RESUMO

BACKGROUND: In 2018, 875 000 under-five children died in India with children from poor families and rural communities disproportionately affected. Community health centres are positioned to improve access to quality child health services but capacity is often low and the systems for improvements are weak. METHODS: Secondary analysis of child health program data from the Uttar Pradesh Technical Support Unit was used to delineate how program activities were temporally related to public facility readiness to provide child health services including inpatient admissions. Fifteen community health centres were mapped regarding capacity to provide child health services in July 2015. Mapped domains included human resources and training, infrastructure, equipment, drugs/supplies and child health services. Results were disseminated to district health managers. Six months following dissemination, Clinical Support Officers began regular supportive supervision and gaps were discussed monthly with health managers. Senior pediatric residents mentored medical officers over a three-month period. Improvements were assessed using a composite score of facility readiness for child health services in July 2016. Usage of outpatient and inpatient services by under-five children was also assessed. RESULTS: The median essential composition score increased from 0.59 to 0.78 between July 2015 and July 2016 (maximum score of 1) and the median desirable composite increased from 0.44 to 0.58. The components contributing most to the change were equipment, drugs and supplies and service provision. Scores for trained human resources and infrastructure did not change between assessments. The number of facilities providing some admission services for sick children increased from 1 in July 2015 to 9 in October 2016. CONCLUSIONS: Facility readiness for the provision of child health services in Uttar Pradesh was improved with relatively low inputs and targeted assessment. However, these improvements were only translated into admissions for sick children when clinical mentoring was included in the support provided to facilities.


Assuntos
Serviços de Saúde da Criança , População Rural , Criança , Centros Comunitários de Saúde , Pessoal de Saúde , Humanos , Índia
2.
BMC Health Serv Res ; 21(1): 905, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479545

RESUMO

BACKGROUND: In an effort to encourage Family Planning (FP) adoption, since 1952, the Government of India has been implementing various centrally sponsored schemes that offer financial incentives (FIs) to acceptors as well as service providers, for services related to certain FP methods. However, understanding of the role of FIs on uptake of FP services, and the quality of FP services provided, is limited and mixed. METHODS: A qualitative descriptive study was conducted in Chatra and Palamu districts of Jharkhand state. A total of 64 interviews involving multiple stakeholders were conducted. The stakeholders included recent FP acceptors or clients, FP service providers of public health facilities including Accredited Social Healthcare Activists (ASHAs), government health officials managing FP programs at the district and state level, and members of development partners supporting FP programs in Jharkhand. Data analysis included both inductive and deductive strategies. It was done using the software Atlas ti version 8. RESULTS: It has emerged that there is a strong felt need for FP among majority of the clients, and FIs may be a motivator for uptake of FP methods only among those belonging to the lower socio economic strata. For ASHAs, FI is the primary motivator for providing FP related services. There may be a tendency among them and the nurses to promote methods which have more financial incentives linked with them. There are mixed opinions on discontinuing FIs for clients or replacing them with non-financial incentives. Delays in payment of FIs to both clients and the ASHAs is a common issue and adversely effects the program. CONCLUSION: FIs for clients have limited influence on their decision to take up a FP method while different amounts of FIs for ASHAs and nurses, linked with different FP methods, may be influencing their service provision. More research is needed to determine the effect of discontinuing FI for FP services.


Assuntos
Serviços de Planejamento Familiar , Motivação , Atenção à Saúde , Governo , Humanos , Índia , Pesquisa Qualitativa
3.
East Mediterr Health J ; 27(8): 745-754, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34486710

RESUMO

Background: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread to most countries around the world. Disproportionate spread of COVID-19 among the Indian community in Kuwait prompted heightened surveillance in this community. Aims: To study the epidemiological characteristics of COVID-19 patients and their contacts among the Indian community in Kuwait. Methods: Data collection was done as a part of contact tracing efforts undertaken by the Kuwaiti Ministry of Health. Results: We analysed contact-tracing data for the initial 1348 laboratory-confirmed Indian patients and 6357 contacts (5681 close and 676 casual). The mean (standard deviation) age of the patients was 39.43 (10.5) years and 76.5% of the cases were asymptomatic or had only mild symptoms. Asymptomatic patients were significantly older [40.05 (10.42) years] than patients with severe symptoms [37.54 (10.54) years] (P = 0.024). About 70% of the patients were living in shared accommodation. Most of the close contacts were living in the same household, as compared with casual contacts, who were primarily workplace contacts (P < 0.001). Among the different occupations, healthcare workers had the highest proportion of cases (18.4%). Among the 216 pairs of cases with a clear relationship between the index and secondary cases, the mean serial interval was estimated to be 3.89 (3.69) days, with a median of 3 and interquartile range of 1-5 days. Conclusion: An early increase in the number of COVID-19 cases among the Indian community could be primarily attributed to crowded living conditions and the high proportion of healthcare workers in this community.


Assuntos
COVID-19 , Adulto , COVID-19/etnologia , Busca de Comunicante , Humanos , Índia/etnologia , Kuweit/epidemiologia , Pessoa de Meia-Idade , Pandemias
4.
Environ Monit Assess ; 193(10): 639, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34505936

RESUMO

Lower Shiwalik foothill ranges (Kandi regions) are dominated by different land use systems, varying in fertility status due to soil erosion owing to undulating topographical features. For assessment of soil nutrient status of study area, the soil sampling was conducted to investigate the variation in micronutrient status and physicochemical characteristics of soil. Long-range basis soil sampling was carried out in 11 blocks falling in the entire Shiwalik ranges of lower Himalaya under different land use systems (LUSs), viz., agriculture (AG), horticulture (HR), agri-horticulture (AH), grassland (GL), and agroforestry (AF) systems. A total of 440 soil samples were collected from two depths (0-15, 15-30 cm) for analysis. The results had reported that the soils were slightly acidic to slightly alkaline (6.61 to 8.10) in the whole range. Soil organic carbon (SOC) was found to be varying from very low to very high (2.43 to 10.43 g kg-1). DTPA-extractable Fe and Mn were found to be in dominant concentrations in the soils whereas, the deficiency of Zn was found under all existing land uses. Interestingly, Fe (r = 0.62*), Cu (r = 0.44), and Mn (r = 0.35) micronutrients were positively correlated with clay content whereas Zn (r = - 0.02) was negatively correlated. Soil quality based on principal component analysis (SQI-PCA) reported clay, SOC, and Zn are major dominating parameters to be considered of soil in Shiwalik ranges.


Assuntos
Carbono , Solo , Agricultura , Carbono/análise , Monitoramento Ambiental , Índia , Micronutrientes
5.
Neurol India ; 69(4): 792-796, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34507391

RESUMO

Background: Clinicians in neurological practice, particularly surgeons, encounter more deaths than most other specialists. Objective: This communication reviews the literature on "good death" and extrapolates the observations and inferences to neurological practice. Changes in approaches to "good death" in the COVID-19 era (coronavirus disease 2019) are also discussed. Materials and Methods: The author, over a 40-year period, has come across 2,500 deaths in a government, trust, and corporate hospital in Chennai, India. Retrospectively, the author questions if, in spite of his conservatism and obsession with quality of life, he should have taken proactive measures to also ensure a good quality of death. Results and Conclusion: In the background of the lessons learned in a metro, across various socioeconomic groups and with varied access to technology, the author concludes that ensuring "good death" should also fall within the domain of neurologic practice.


Assuntos
COVID-19 , Qualidade de Vida , Humanos , Índia , Masculino , Estudos Retrospectivos , SARS-CoV-2
6.
BMC Res Notes ; 14(1): 355, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507611

RESUMO

OBJECTIVES: Induction of labour (IOL), or starting labour artificially, can be a lifesaving intervention for pregnant women and their babies, and rates are rising significantly globally. As rates increase, it becomes increasingly important to fully evaluate all available data, especially that from low income settings where the potential benefits and harms are greater. The goal of this paper is to describe the datasets collected as part of the Induction with Foley OR Misoprostol (INFORM) Study, a randomised trial comparing two of the recommended methods of cervical ripening for labour induction, oral misoprostol and Foley catheter, in women being induced for hypertension in pregnancy, at two sites in India during 2013-15. DATA DESCRIPTION: This dataset includes comprehensive data on 602 women who underwent IOL for hypertensive disorders in pregnancy. Women were randomly assigned to cervical ripening with oral misoprostol or a transcervical Foley catheter in two government hospitals in India. The main dataset has 367 variables including monitoring during the induction of labour, medications administered, timing and mode of delivery, measures of neonatal morbidity and mortality, maternal mortality and morbidity, maternal satisfaction and health economic data. The dataset is anonymised and available on ReShare.


Assuntos
Hipertensão , Misoprostol , Ocitócicos , Cateteres , Maturidade Cervical , Feminino , Humanos , Índia , Recém-Nascido , Trabalho de Parto Induzido , Gravidez
7.
BMC Health Serv Res ; 21(Suppl 1): 196, 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34511088

RESUMO

BACKGROUND: Achievement of successful health outcomes depends on evidence-based programming and implementation of effective health interventions. Routine Health Management Information System is one of the most valuable data sets to support evidence-based programming, however, evidence on systemic use of routine monitoring data for problem-solving and improving health outcomes remain negligible. We attempt to understand the effects of systematic evidence-based review mechanism on improving health outcomes in Uttar Pradesh, India. METHODS: Data comes from decision-tracking system and routine health management information system for period Nov-2017 to Mar-2019 covering 6963 health facilities across 25 high-priority districts of the state. Decision-tracking data captured pattern of decisions taken, actions planned and completed, while the latter one provided information on service coverage outcomes over time. Three service coverage indicators, namely, pregnant women receiving 4 or more times ANC and haemoglobin testing during pregnancy, delivered at the health facility, and receive post-partum care within 48 h of delivery were used as outcomes. Univariate and bivariate analyses were conducted. RESULTS: Total 412 decisions were taken during the study reference period and a majority were related to ante-natal care services (31%) followed by delivery (16%) and post-natal services (16%). About 21% decisions-taken were focused on improving data quality. By 1 year, 67% of actions planned based on these decisions were completed, 26% were in progress, and the remaining 7% were not completed. We found that, over a year, districts witnessing > 20 percentage-point increase in outcomes were also the districts with significantly higher action completion rates (> 80%) compared to the districts with < 10 percentage-point increase in outcomes having completion of action plans around 50-70%. CONCLUSIONS: Findings revealed a significantly higher improvement in coverage outcomes among the districts which used routine health management data to conduct monthly review meetings and had high actions completion rates. A data-based review-mechanisms could specifically identify programmatic gaps in service delivery leading to strategic decision making by district authorities to bridge the programmatic gaps. Going forward, establishing systematic evidence-based review platforms can be an important strategy to improve health outcomes and promote the use of routine health monitoring system data in any setting.


Assuntos
Sistemas de Informação Administrativa , Serviços de Saúde Materna , Feminino , Programas Governamentais , Humanos , Índia , Assistência Médica , Gravidez
8.
Biomed Res Int ; 2021: 6658070, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34485525

RESUMO

In light of the devastation caused by COVID-19, the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and vaccine research and development (R&D) have been occupying a prominent position in the field of global health diplomacy (GHD). Most countries, international organizations, and charitable organizations have been engaged in the R&D of COVID-19 vaccines to ensure timely affordability and accessibility to all countries. Concomitantly, the World Trade Organization (WTO) provides some provisions and enforcements regarding copyrights, patents, trademarks, geographical indications, and industrial designs. Given these safeguards, it is considered that intellectual property rights (IPRs) have become major barriers to the affordability and accessibility of vaccines/medicines/technology, particularly to the developing/least developed countries. Realizing the gravity of the pandemic impact, as well as its huge population and size, India has elevated this issue in its global health diplomacy by submitting a joint proposal with South Africa to the World Trade Organization (WTO) for a temporary waiver of IPRs to ensure timely affordability and accessibility of COVID-19 medical products to all countries. However, the issue of the temporary waive off had become a geopolitical issue. Countries that used to claim per se as strong advocates of human rights, egalitarianism, and healthy democracy have opposed this proposal. In this contrasting milieu, this paper is aimed at examining how the TRIPS has become a barrier for developing countries' development and distribution of vaccines/technology; secondly, how India strategizes its role in the WTO in pursuant of its global health diplomacy? We conclude that the IPRs regime should not become a barrier to the accessibility/affordability of essential drugs and vaccines. To ensure access, India needs to get more engaged in GHD with all the involved global stakeholders to get strong support for their joint proposal. The developed countries that rejected/resisted the proposal can rethink their full support.


Assuntos
Vacinas contra COVID-19/imunologia , COVID-19/imunologia , Diplomacia/métodos , Indústria Farmacêutica/métodos , Saúde Global , Acesso aos Serviços de Saúde , Direitos Humanos/métodos , Humanos , Índia , Saúde Pública/métodos , SARS-CoV-2/imunologia
9.
Sci Total Environ ; 792: 148367, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34465041

RESUMO

Following the proven concept, capabilities, and limitations of detecting the RNA of Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) in wastewater, it is pertinent to understand the utility of wastewater surveillance data on various scale. In the present work, we put forward the first wastewater surveillance-based city zonation for effective COVID-19 pandemic preparedness. A three-month data of Surveillance of Wastewater for Early Epidemic Prediction (SWEEP) was generated for the world heritage city of Ahmedabad, Gujarat, India. In this expedition, 116 wastewater samples were analyzed to detect SARS-CoV-2 RNA, from September 3rd to November 26th, 2020. A total of 111 samples were detected with at least two out of three SARS-CoV-2 genes (N, ORF 1ab, and S). Monthly variation depicted a significant decline in all three gene copies in October compared to September 2020, followed by a sharp increment in November 2020. Correspondingly, the descending order of average effective gene concentration was: November (~10,729 copies/L) > September (~3047 copies/L) > October (~454 copies/L). Monthly variation of SARS-CoV-2 RNA in the wastewater samples may be ascribed to a decline of 20.48% in the total number of active cases in October 2020 and a rise of 1.82% in November 2020. Also, the monthly recovered new cases were found to be 16.61, 20.03, and 15.58% in September, October, and November 2020, respectively. The percentage change in the gene concentration was observed in the lead of 1-2 weeks with respect to the percentage change in the provisional figures of confirmed cases. SWEEP data-based city zonation was matched with the heat map of the overall COVID-19 infected population in Ahmedabad city, and month-wise effective gene concentration variations are shown on the map. The results expound on the potential of WBE surveillance of COVID-19 as a city zonation tool that can be meaningfully interpreted, predicted, and propagated for community preparedness through advanced identification of COVID-19 hotspots within a given city.


Assuntos
COVID-19 , Humanos , Índia/epidemiologia , Pandemias , RNA Viral , SARS-CoV-2 , Águas Residuárias
10.
J Assoc Physicians India ; 69(4): 11-12, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34470187

RESUMO

OBJECTIVE: Guidelines recommend prescription of statins in all high-risk patients with hypertension irrespective of their cholesterol levels. We performed a prescription audit in India to determine the application of recommendations. METHODS: A registry-based audit of patients with primary diagnosis of hypertension (n=3073) was performed. Details of co-morbidities and medications were obtained. Patients with known vascular disease were excluded. Patients were classified into subgroups based on risk factors and type of therapy. A multivariate model of risk was developed using clinical data and patients were classified into low, moderate and high risk. Statin prescriptions were divided into low, medium and high intensity based on US guidelines. Descriptive statistics are reported. RESULTS: Mean age of patients was 59±13 years, 47 % were women and 26 % were less than 50 years age. Diabetes was noted in 31.1 %, current smoking in 1.3 %, obesity in 14.7 % and hypothyroidism in 7.9 %. Statins were prescribed in 41.2 % (95% CI 39.4-42.9%), more in men compared to women (47.7% vs 33.7%, p<0.001). Most of the patients received moderate intensity statins (83.9%). In age-groups >40, 40-59, 60-79 and 80+ years, statins were prescribed in 18.7%, 36.5%, 49.5% and 49.4% respectively (ptrend <0.001). Statins were prescribed in 52.0% diabetics, 60.9% obese, 52.5% smokers and 34.8% hypothyroid. In the multivariate model statins use in low, medium and high risk patients was 28.4%, 46.6% and 55.1% respectively (ptrend <0.001). CONCLUSION: In an Indian secondary care practice only half of patients with moderate to high risk uncomplicated hypertension receive statins.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases , Hipertensão , Adulto , Idoso , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prescrições , Fatores de Risco
11.
J Assoc Physicians India ; 69(4): 11-12, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34470189

RESUMO

BACKGROUND: Hyperuricemia is found to be associated with the development and progression of gout, chronic kidney disease, cardiovascular diseases and several others. However, consistent recommendation in the management of hyperuricemia among physicians in India is absent. This study was done to assess the knowledge, attitude, practice (KAP) and barriers in the management of hyperuricemia among physicians in India. METHODS: A cross-sectional study using a telephonically-administered questionnaire was distributed to 350 physicians treating hyperuricemia patients with co-morbidities like hypertension, diabetes mellitus, metabolic syndrome etc. The questionnaire included 25 questions on qualitative and quantitative aspects. Descriptive statistics were used for demographic characteristics. Inferential statistics (binary logistic regression) was used to identify the relationship between knowledge scores across different physician factors. RESULTS: A total of 350 responses were obtained with a response rate of 100%. Majority of the physicians (90%) were male and 10% were female with median age of 45.5 ± 12.2 years. Mean scores for knowledge and attitude were 7.4 ± 2.35 and 12.1 ± 1.6, respectively. 66.1% (230) of physicians had adequate knowledge score, while the remaining 33.9% (118) had inadequate score. Irrespective of comorbidity status, no change in the attitude of physicians towards management of hyperuricemia was found. CONCLUSION: This study demonstrated that the majority of physicians demonstrated adequate level of knowledge, positive/favourable attitude and reported optimal treatment practices for the management of hyperuricemia while exhibiting a few perceived barriers. Nevertheless, facilitating widespread physician awareness about the benefits of optimal management of hyperuricemia is warranted.


Assuntos
Hiperuricemia , Médicos , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hiperuricemia/epidemiologia , Hiperuricemia/terapia , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
12.
J Assoc Physicians India ; 69(4): 11-12, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34470190

RESUMO

AIMS: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by impaired gut-brain interaction. Considering the paucity of evidence in the Indian setting, the current study was conducted to determine the sociodemographics, clinical profiles, management practices, and patients' perception among newly diagnosed patients with IBS. METHODS: This was a cross-sectional, single-visit, observational, non-interventional, epidemiological study conducted across 12 centres. The primary objective was evaluation of sociodemographic and clinical profiles. The key secondary objective was assessment of gastrointestinal symptom severity including evaluation of anxiety and depression using the hospital anxiety and depression scale (HADS) scores. Knowledge, attitude, and practices (KAP) were evaluated as an exploratory objective. RESULTS: Out of 300 enrolled patients, 120 (40%) were aged 31-45 years (mean age: 38.55±12.45 years), and 204 were men (68%). Overall, 40% of patients belonged to the upper-middle-class, with a Kuppuswamy score of 16-25. Most patients (91%) did not work in night shifts. Only 13% of patients performed more than recommended physical activity. Stress and food were the leading triggers for IBS (29%). Abdominal pain and diarrhoea as cardinal symptoms were reported by 43.3% and 33.0% patients, respectively. Borderline abnormal anxiety and depression were reported by 21.3% and 26.7% of patients, respectively. KAP assessment revealed that 56.0% of patients had poor knowledge, 26.3% had moderate knowledge, and 17.7% had good knowledge about IBS; nevertheless, 43% of patients maintained high levels of precaution towards managing symptoms. CONCLUSION: Given the limited knowledge about IBS in India among newly diagnosed patients, strategies to enhance awareness about the condition are warranted.


Assuntos
Síndrome do Intestino Irritável , Adulto , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Humanos , Índia/epidemiologia , Síndrome do Intestino Irritável/epidemiologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários
13.
J Hazard Mater ; 416: 125909, 2021 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-34492843

RESUMO

Twenty-two water samples from the Thirumanimuthar River course in southern India were collected before COVID-19 lockdown and during COVID-19 lockdown periods and were analyzed for microbiological parameters (fecal coliform bacteria, total coliform bacteria, Escherichia coli, and fecal streptococci) and heavy metals (Fe, Mn, Zn, Cu, Cd, Ni, Pb and Cr). The lockdown has decreased microbial populations and heavy metals. Fe, Cu, Cd, Ni, Pb and Cr exceeded the drinking water limits, respectively, in 77%, 45%, 27%, 18%, 9% and 91% of the pre-lockdown samples. During the lockdown period, Fe, Cu and Cd concentrations in 23% and Cr in 50% of the samples exceeded the limits. Heavy Metal Pollution Index (PI) expressed that 27%, 64% and 9% of the pre-lockdown samples represented 'low', 'medium' and 'high' pollution categories, respectively, but 68% and 32% of the lockdown period samples represented 'low' and 'medium' categories, respectively. The Metal Index (MI) exposed that all samples of pre-lockdown were under the seriously affected category, whereas 54% and 46% of lockdown samples were under strongly and seriously affected categories, respectively. Health risk evaluation predicted that 95%, 91% and 86% of pre-lockdown samples and 45%, 36% and 33% of lockdown period samples were at risk among children, teenagers and adults, respectively. As there is no integrated study on river water quality of COVID-19 lockdown this work is uniquely carried out by combining heavy metal pollution, microbial contamination and human health risk evaluation.


Assuntos
COVID-19 , Metais Pesados , Poluentes Químicos da Água , Adolescente , Adulto , Criança , China , Controle de Doenças Transmissíveis , Monitoramento Ambiental , Sedimentos Geológicos , Humanos , Índia , Metais Pesados/análise , Metais Pesados/toxicidade , Pandemias , Medição de Risco , Rios , SARS-CoV-2 , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade
18.
Indian Pediatr ; 58(8): 793-794, 2021 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-34465665
19.
J Assoc Physicians India ; 69(6): 11-12, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34472779

RESUMO

BACKGROUND AND OBJECTIVES: The frequency of outbreaks, pandemics is increasing across the globe which can be probably due to increased medical tourism, expansion of international exchange, travel and global warming. COVID-19 outbreak spread across the world within a few months of initiation from Wuhan City of China and affected all the countries across the globe except Antarctica. From the psychopathological view, this current COVID -19 is a stressor, trauma or stigma for health care workers as well as general population. Mental health and psychosocial consequences of COVID 19 has a serious impact on various categories of people : a) those directly involved with viral overload b) health care workers c) general population who are following social media d) quarantined individuals and their family members. The aim of our study was to determine the unforeseen psychosocial impact of COVID 19 pandemic on mental status of health care workers and general population. MATERIAL AND METHODS: A cross sectional online survey using an anonymous questionnaire using snowball sampling strategy was done. The study included 480 respondents, out of which 197 were health care workers and 283 were general population. The participation was totally voluntary. Data collection took place over fifteen days .We included additional questions which were related to COVID-19 outbreak. The structured questionnaire used, consisted of questions that covered several areas. Anxiety level was assessed based on Hamilton Anxiety Rating scale ranging from 0-4 , consisted of 14 items. RESULTS AND CONCLUSION: According to Hamilton anxiety rating scale it was seen that out of 197 health care workers, 27% had mild anxiety (<17), 18.7% had mild to moderate (18-24), 17.7% had moderate to severe (25-30), and 35.5% had very severe(>31). Out of 283 respondents representing general population, 26.14% had mild anxiety (<17), 17.31% had mild to moderate (18-24), 19.08% had moderate to severe (25-30), 37.45% had very severe(>31). The two groups were analyzed statistically, Z test applied between the two groups and it was found that the difference between the mean was found to be statistically significant with p value < 0.0001. The confidence interval was kept at 95%. Concerns about one's own health and that of their beloved ones (particularly elderly or suffering from any physical illness), as well as uncertainty about the future, can generate or exacerbate fear, depression, and anxiety.


Assuntos
COVID-19 , Pandemias , Idoso , Ansiedade , Estudos Transversais , Depressão , Pessoal de Saúde , Humanos , Índia/epidemiologia , SARS-CoV-2 , Inquéritos e Questionários
20.
J Assoc Physicians India ; 69(6): 11-12, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34472787

RESUMO

BACKGROUND: The present study intended to estimate the comorbidities and risk factors among patients with hypertension in India. Further, the current practice of hypertension management was evaluated and the choice of therapy was assessed based on hypertension grade, risk factors, and comorbidities. METHODS: Electronic medical record data (June 2017-June 2019) of Indian adult hypertensive patients (≥140/90 mmHg) who had two blood pressure (BP) readings were retrospectively analyzed. Demographic characteristics, BP readings, comorbidities, medications and co-medications, and laboratory data were collected at baseline. Grids based on hypertension grade (I, II, and III), demographic factors, risk factors, and comorbidities were created and prescribed antihypertensive drugs (AHDs) in each grid were evaluated. RESULTS: Among 100,075 patients, the proportion of patients in 18-40 year, 40-65 year, and >65 year age groups were 11.4%, 65.1%, and 23.4%, respectively. Proportion of men and women was similar (52.0% vs 47.9%). Proportion of patients with BMI <25 Kg/m2 was 8.1%, 25-29.9 Kg/m2 was 11.9%, and >30 Kg/m2 was 8.8%. Mean BP of patients with hypertension was: grade I (145.05/90.73 mmHg), grade II (160.07/95.64 mmHg), and grade III (180.82/102.76 mmHg). Mean low density lipoprotein (113.26 mg/dL), serum creatinine (2.28 mg/dL), mean HbA1c (8.7%) levels were highest among patients with grade III hypertension. Commonly observed comorbidities were type 2 diabetes mellitus (T2DM: 51.5%), dyslipidemia (36.4%), and chronic kidney disease (CKD: 4.4%). Top concomitant medications included anti-diabetic therapies (34.6%), drugs for dyslipidemia (30.0%), and anti-platelet therapies (6.9%). CONCLUSION: Most prescribed AHD monotherapies were angiotensin receptor II blockers (ARBs) and calcium channel blockers (CCBs) and most prescribed combination therapies were ARBs + diuretics and ARBs + CCBs. Telmisartan and amlodipine+telmisartan for patients with comorbid T2DM or dyslipidemia and metoprolol for those with coronary artery disease were the commonly prescribed AHDs.


Assuntos
Diabetes Mellitus Tipo 2 , Hipertensão , Antagonistas de Receptores de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Índia/epidemiologia , Masculino , Morbidade , Estudos Retrospectivos , Fatores de Risco
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