Journal of Ideas in Health
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A cross-sectional study of socio-demographic and clinical profile of HIV patients at ART plus centre, Sawai Man Singh Hospital, Jaipur, India
Get PDFBackground: This study aimed to understand the regional variation in the socio-demographic and clinical profile of human immunodeficiency virus (HIV) infected patients at antiretroviral therapy plus centre of Sawai Man Singh (SMS) hospital, Jaipur, India.
Methods: A descriptive cross-sectional study was conducted on HIV patients from January to December 2019. The HIV-positive patients of all age groups and all categories were included in the study. The socio-economic status was assessed by BG Prasad classification-based consumer price index. However, the clinical staging was done according to the World Health Organization (WHO) classification of HIV/AIDS. Data were expressed as mean ± standard deviation.
Results: Among 525 HIV patients 59.16% were males, 40.26% females and 0.57% intersex. About half (51.0%) in the reproductive age group with mean age 36 ±13 years. The commonest mode of HIV transmission was heterosexual (89.77%). Maximum belonged to social class I (57.84%) and class II (26.05 %) of BG Prasad\u27s socioeconomic status. Each of the non-agricultural laborers and semi-skilled workers constitutes 18.0%, and the housewives were 23.6%. At the time of presentation, baseline CD4+Tcell count was <350 /mm3 in 55.0% of HIV patients. Pulmonary tuberculosis and skin involvement were the most predominant secondary opportunistic infections accounting for 24.8% and 7.8%, respectively. More than half (52.09%) of patients were in WHO clinical stage I of HIV disease.
Conclusion: Socio-demographic and clinical profile of study participants reflect an impact of early case detection and timely institution of highly active antiretroviral therapy
Multiple irregularities and thrombus in a patient with COVID-19 presenting with ST-segment elevation myocardial infarction: a case report
Get PDFBackground: Multiple thrombi are likely to develop in Coronavirus Disease 2019 (COVID-19) patients. Hence, achieving successful outcomes following catheterization becomes quite challenging in such patients.
Case presentation: We report a challenging case of a 36-year-old female with ST-Segment Elevation Myocardial Infarction (STEMI). Coronary angiography revealed multiple irregularities in the coronary tree as well as thrombi. Although computed tomography imaging of the thorax was normal, reverse transcription-polymerase chain reaction (RT-PCR) confirmed the diagnosis of COVID-19. The outcome was good TIMI flow after a successful Primary Angioplasty in Acute Myocardial Infarction (PAMI), and the patient was isolated and then switched to oral anticoagulants (clopidogrel) for dual antiplatelet therapy (DAPT) therapy.
Conclusion: This case emphasizes the management of a COVID-19 patient for PAMI
Evaluation of health system in Iraq from people\u27s point of view: a comparative study of two different eras
Get PDFBackground: Since the 2003 United States–British coalition military invasion, Iraq has been in a state of continuous deterioration at all levels, including the health sector. This study aimed to elicit the viewpoints of the Iraqi people on the current health system, focusing on many provided health services and assessing whether the public prefers the current health system or that was provided before the invasion.
Methods: A cross-sectional survey designed to explore the Iraqi people’s opinions on their health system. A self-administered questionnaire using a multi-stage sampling technique was distributed in five geographical regions in Iraq to collect the data from the head of household between 1st October and 31st of December 2019. Multiple logistic regressions were recruited to determine the significant contributing variables in this study.
Results: A total of 365 heads of households (response rate: 86.1%) with the mean age of 48.36 + 11.92 years (ranged 35-78) included in the study. Most of the respondents (61.4%) complained of healthcare inaccessibility, 59.7% believed that health resources were not available, 53.7% claimed a deterioration in the quality of care, and 62.2% believed that the political / media position did not contribute to positive changes during the past two decades. Indeed, most respondents (66.0%) believe that the current healthcare system is worse than before. In the multivariate analysis, there was a statistically significant relationship between the characteristics and opinions of the respondents. Old age group (p = 0.003), men (p = < 0.001), married (p = 0.001), low educated (p = < 0.001), rural resident (p = < 0.001), unemployed (p = 0.003), monthly income of less than USD 400 (p = < 0.001), consider themselves to be unhealthy (p = 0.001), and those who think that people are unhappy now than two decades ago (p = 0.012) have a more negative opinion of the health system.
Conclusion: Most Iraqis surveyed expressed disappointment from the health system after the 2003 United States–British Coalition military invasion. The current health system is faltering at all levels and does not meet the citizens\u27 basic needs. Health Transformation Program (HTP) has become inevitable to develop an accessible, affordable, high-quality, efficient, and effective health system
Prioritization of resource allocation amid the COVID-19 outbreak response in Nigeria
Get PDFThe COVID-19 pandemic has revealed the massive shortcomings of health systems globally, particularly in Nigeria with weak healthcare infrastructure, high population, and chronic high morbidity and mortality from the double burden of infectious and non-infectious causes. Many routine and elective services were suspended or withdrawn, and existing delivery approaches adapted to the evolving COVID-19 pandemic across all the states in Nigeria. Preventive programs such as screening were completely suspended. The vaccination schedules were missed for many children due to the closure of the immunization clinics. Many Nigerian children being liable to infections, alongside a reduction in the possibility of child survival. Funds to manage the COVID-19 pandemic were donated from internal organizations and corporate agencies. However, the modalities involved in the disbursement of these funds were not publicly revealed by the Nigerian government. Therefore, we recommend optimal allocation of inadequate health resources in ways that maximize health care delivery benefits to the greatest number of people, give priority to the worst off, ensure equality and promote continued care provision for non-COVID-19 conditions, including pregnancy and chronic conditions. To ensure the improved trust of Nigerians and donor agencies and organizations, accountability on all funds should be ensured by the Nigerian government. For this cause, such funds should be committed into the hands of trustworthy and expert finance managers and infectious disease experts
The perception of biopsychosocial impacts of COVID-19 during lockdown restrictions over time in the UK – a mixed methods study
Get PDFBackground: The COVID-19 pandemic has profoundly impacted the health of individuals physically, mentally, and socially. This study aims to gain a deeper understanding of this impact across the pandemic from a biopsychosocial stance.
Methods: A survey created by the research team was employed between November 2020 and February 2021 across social media, relevant organizations, and networks. The survey incorporated 5-time points across the different stages of the pandemic, covering biological, psychological, and social. There were 5 items for each survey (Very Positive affect to Very Negative affect), and analysis was undertaken using SPSS version 16. Descriptive statistics and non-parametric Friedman and Wilcoxon Tests, as well as correlations between the three domains, were implemented.
Results: This study included 164 participants (77.0% female and 35.0% male) across 24 out of 38 counties in the UK. The impact of COVID-19 on biological domain was significant across the five data points χ2(4) = 63.99, p < 0.001, psychological χ2(4) = 118.939, p <0.001 and socially χ2(4) = 186.43, p <0.001. Between the 5 data points, 4 out of 5 had a negative impact, however between the first stage of lockdown and the easing of restrictions, findings for biological (Z=-2.35, p <0.05), psychological (Z=-6.61, p < 0.001), and socially (Z = -8.61, p <0.001) were positive. Negative correlations between the three domains across the pandemic are apparent, but in later stages, the biological domain had a positive correlation r = 0.52, p < 0.001.
Conclusion: The data shows a negative impact from the self-reported perception of wellbeing from a biopsychosocial stance over time, as well as perceiving the three domains to interact negatively. To address these biopsychosocial issues, the research implies a place-based integrated recovery effort is needed, addressing biological, psychological, and social issues simultaneously. Further research should investigate biopsychosocial health among a more generalizable population
Underreporting of treatment outcomes in hospitalized COVID-19 infected diabetes patients: a systematic review, meta-analysis, and meta-regression
Get PDFBackground: Prolonged inpatient care requirements and time constraints of research and researchers lead to the non-reporting of the treatment outcome of certain COVID-19 infected diabetes patients in published manuscripts. This study aims to quantify its global burden.
Methods: A search for citations addressing the above outcome ensued chiefly in the PubMed, Embase, and Scopus databases, irrespective of the publication date and geographical region. Recruited studies were critically appraised with the National Heart, Lung, and Blood Institute\u27s tool. Using the random-effects meta-analysis with an exact binomial method and Freeman-Tukey double arcsine transformation, the overall and subgroup-wise weighted pooled prevalence of the missing treatment outcome data was determined. The heterogeneity and publication bias assessment utilized I2 and Chi2 statistics, and funnel plot, and Egger\u27s test, respectively.
Results: Ten publications (primarily case series; 70.0%) included in this review sourced data from 6687 COVID-19 infected inpatient diabetes patients from Asia, Australia, Europe, and North America. The global pooled prevalence of missing treatment outcome data among these patients was 33.0% (95% CI: 15.0-53.0%; I2: 99.53%; P of Chi2: <0.001). It was highest in Europe (63%; 95% CI: 61.0-66.0%). Publication bias assessment was not suggestive of any small study effect.
Conclusion: A considerable proportion of crucial prognosis information of hospitalized COVID-19 patients with diabetes goes underreported. It increases the risk of biasing the contemporary COVID-19-diabetes literature. The reporting of these data in the post-publication era or postponing the primary publication until the availability of all patients\u27 treatment outcome data, when feasible, is recommended to address this enigma
Covid-19 in Iraq: an estimated cost to treat patients at a private clinic
Get PDFThe impact of the COVID-19 pandemic extended to health, social and economic aspects of human life. The international failure to combat this crisis has left many countries suffering under the influence of successive waves of the pandemic. In this report, we present a private medical clinic\u27s experience dealing with the COVID-19 epidemic in Iraq. The adopted protocol to treat COVID-19 patients has briefly been discussed with an estimated cost of treatment in the private sector. We found that most COVID-19 patients recovered from the disease, except for cases that were associated with co-morbidities. The cost of treatment in the private sector is expensive, and most infected people could not afford it without public sector support
Assumption of heparin-induced thrombocytopenia in mucopolysaccharidoses
Get PDFBackground: Mucopolysaccharidoses (MPSs) are a group of lysosomal storage diseases, resulted from glycosaminoglycans’ breakdown failure (GAGs). The study aims to determine the presence of thrombocytopenia, its prevalence, clinical implication, and correlation with the types of MPSs and with the types of glycosaminoglycans storage.
Methods: A retrospective cross-sectional study of complete blood count data was conducted among 108 children with a confirmed diagnosis of MPS in the National Medical Research Center for Children\u27s Health, Moscow, Russian Federation. STATISTICA 10 (Stat Soft, Inc. 1984-2011) was used for statistical analysis. A p-value of ≤0.05 was considered significant.
Results: The median age of children was 65 [IQR: 41; 102] months, range: 3 – 102 months. The male to female ratio was 3:1. The prevalence of fluctuating or persistent thrombocytopenia in all children with MPS was 19.0%. Thrombocytopenia occurred in patients with MPS I (14.0%), II (19.0%), and III (31.0%). Neither of the patients with MPS IV nor VI demonstrated low platelet count. There was a non-significant predominance (P=0.068) of thrombocytopenia frequency in patients with heparan sulfate storage (22.0%) compared with patients without heparan sulfate burden (0%).
Conclusion: Routine checkups of patients with MPSs must include complete blood count with platelet measurement. Cases of thrombocytopenia that requiring treatment, immunomodulatory/ immunosuppressive therapy should be considered. Further research is needed to look for the laboratory confirmation of autoimmune variants of HIT in patients with MPS I, II, III
Prevalence and correlates of geriatric depression in a rural community in Kerala, India
Get PDFBackground: Elderly constitutes a vulnerable group for depression, as they are especially prone to suffer adverse consequences of a depressive episode and have greater rates of completed suicides. This study aims to estimate the prevalence and determinants of geriatric depression.
Methods: A cross-sectional study was done among 250 elderlies from 1st January 2019 to 1st January 2020 in the different rural blocks of Ernakulam district, India. The multistage sampling technique and the Geriatric Depression Scale (GDS-30) were used to collect the data. A score of 0 9 is considered "normal", 10 19 is labeled as "mildly depressed", and 20 30 as "severely depressed". Statistical analysis was performed using the IBM SPSS software. The Chi-square test /Fisher\u27s exact test was used to study the association between the socio-demographic and behavioral variables with depression.
Results: The mean age was 69.33 ± 7.41years and male: female ratio was 0.55: 1.The overall prevalence of depression was 52.4%. Advanced age over 70years [OR=2.04;95% CI, 1.227 – 3.394; P=0.006], female gender[OR=2.844;95% CI,1.663-4.865; P =<0.001], lack of gainful employment [OR=3.504; 95% CI, 1.833–6.699; P =<0.001], physical dependence [OR=0.365;95% CI,0.162–0.821; P =0.012], financial dependence [OR=0.388; 95% CI, 0.219–0.687; P =<0.001], presence of medical co morbidities [OR=0.428; 95% CI, 0.212–0.866; P =0.016],poor lifestyle including the lack of regular exercise [OR =2.020; 95% CI,1.174–3.473; P =0.010], addiction to alcohol [OR=4.932;95%CI,1.600-15.208; P =0.004] and addiction to tobacco smoking [OR=2.905;95%CI,1.273-6.628; P =0.009] and poor family support [OR= 5.180;95% CI,716–15.636; P = 0.002] were found to be significantly associated with depression.
Conclusion: The prevalence of depression among the elderlies was high, and hence early diagnosis and prompt treatment are essential to reduce its burden in the community
IVF laboratory management in COVID-19 pandemic
Get PDFBackground: Since the first report of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), widely known as COVID-19, in late December 2019, it has spread worldwide. The eventual return of new normal has started to happen in most countries where the COVID-19 curve has flattened, and Assisted reproduction technology (ART) services are eventually resuming. Well-organized ART (embryology/andrology) laboratories safeguard the wellbeing of all staff, patients, and their gametes/embryos.
Main body: A well-organized pandemic management plan must be implemented in anticipation of possible subsequent COVID-19 waves. Apart from local and national guidelines, some mandatory changes need to be taken into considerations that will allow us to overcome the fear of this deadly pandemic, work smoothly and stop any possible transmission without comprising the quality control for successful treatment. These mandatory changes include conserving different supplies, reducing manpower needs, and various protective measures for non-clinical and clinical staff, patients, and gametes/embryos.
Conclusion: The current pandemic of COVID-19 suggests a well-organized action-oriented emergency plan to assure the wellbeing of all stakeholders