A cross-sectional study on satisfaction with teleconsultation in people with diabetes during the COVID-19 pandemic in semi-urban and village parts of Kerala

Background: Since the emergence of the pandemic situation, there has been a gradual paradigm shift in the clinical management of diabetes, wherein, the scheduled clinical visits have been converted into teleconsultations. Patient satisfaction is an important parameter which is not well understood. The aim of the study was to assess patient satisfaction with diabetes management through teleconsultation in these populations.Methods: This cross-sectional study was conducted in the Safe Care clinic in Tirur, Kerala from March 2021 to August 2021. This study included 163 T2D patients who availed of teleconsultation. Patient satisfaction was obtained through an online 12-item questionnaire developed by the authors and administered online via a survey tool.Results: In this study, 60% of the patients were male. The majority of the teleconsults occurred in the 41-60 years age group. Of the 163 responses obtained, 145(88.9%) of patients were satisfied with the explanation provided by their physician about their condition, while 148 (90.7%) were satisfied with the duration of the consultation. Further, 158 (96.9%) would be happy to use teleconsultation again, while 155 (95%) would recommend teleconsultation to their friends and family. Around 150 (92%) feel their confidentiality is maintained similar to in-clinic face-to-face consultation and 98 (60%) opined they would continue to use teleconsultations even after face-to-face interactions resume post-pandemic.Conclusions: The patient satisfaction results of the study indicate that telemedicine is there to stay during and beyond the COVID-19 pandemic for the management of diabetes in the sub-urban and village populations in Kerala

COVID, Obstructive Airway Diseases and Eosinophils: A complex interplay

NON

Pneumothorax or Skin Fold? Mind the Gap

NON

Is Clinical Judgment of Asthma Control Adequate? : A prospective survey in a tertiary hospital pulmonary clinic

Objectives: Asthma control is often difficult to measure. The aim of this study was to compare physicians’ personal clinical assessments of asthma control with the Global Initiative for Asthma (GINA) scoring. Methods: Physicians in the adult pulmonary clinics of a tertiary hospital in Oman first documented their subjective judgment of asthma control on 157 consecutive patients. Immediately after that and in the same proforma, they selected the individual components from the GINA asthma control table as applicable to each patient. Results: The same classification of asthma control was achieved by physicians’ clinical judgment and GINA classification in 106 cases (67.5%). In the other 32.5% (n = 51), the degree of control by clinical judgment was one level higher than the GINA classification. The agreement was higher for the pulmonologists (72%) as compared to non-pulmonologists (47%; P = 0.009). Physicians classified 76 patients (48.4%) as well-controlled by clinical judgment compared to 48 (30.6%) using GINA criteria (P <0.001). Conversely, they classified 34 patients (21.7%) as uncontrolled as compared to 57 (36.3%) by GINA criteria (P <0.001). In the 28 patients who were clinically judged as well-controlled but, by GINA criteria, were only partially controlled, low peak expiratory flow rate (PEFR) (46.7%) and limitation of activity (21.4%) were the most frequent parameters for downgrading the level of control. Conclusion: Using clinical judgment, physicians overestimated the level of asthma control and underestimated the uncontrolled disease. Since management decisions are based on the perceived level of control, this could potentially lead to under-treatment and therefore sub-optimal asthma control

Review on Unconventional Wind Energy

Fossil fuel is the major source of energy and is a fast depleting resource. The phenomenal increase in fossil fuel consumption has adversely affected carbon footprint impacting our environment. With strict environmental regulations in place, the focus towards renewable sources of energy is gaining momentum supported by recent advancement in technologies in wind, hydro and solar. Wind turbines were the first forms of clean energy has seen a major increase in power production. The site restrictions, have limited the wind turbine from being used to its maximum potential. In recent years, the concept of some unconventional methods is being proposed. In this review, the various types of wind turbines are emphasized with their recent advances and depicting the challenges faced in various aspects. The reviews contain details mainly about 4 types of wind turbines i.e. floating offshore wind turbine, airborne wind turbine, highway wind turbine systems and locomotive mounted wind turbine

Persistent Pneumothorax: Alveolar pleural fistula due to a hole in a bulla

non

Assessment of Carbon Storage and Biomass on Minelands Reclaimed to Grassland Environments Using Landsat Spectral Indices

This study investigated carbon (C) storage and biomass in grasslands of West Virginia reclaimed surface minesites. Mine-related disturbance and subsequent reclamation may be an important component of C cycling. Biomass and C storage generally increased for the first five years after reclamation, but then declined, suggesting a nonlinear pattern to vegetation recovery. Three 2007 Landsat 5 Thematic Mapper and Landsat 7 Enhanced Thematic Mapper Plus images were used to assess the potential to predict biomass from raw red and near infrared radiance, the tasseled cap transformation (TC), and four vegetation indices [normalized difference vegetation index, enhanced vegetation index (EVI), triangular vegetation index, and the soil adjusted vegetation index]. TC greenness and EVI were most strongly correlated with biomass and illustrate a modest potential for monitoring vegetation recovery in reclaimed minelands. Additionally, a number of regression models that included age since reclamation and spectral indices were statistically significant suggesting a temporal recovery pattern amongst minesites in this study

Severe Pulmonary Involvement in Leptospirosis : Alternate antibiotics and systemic steroids

Pulmonary complications in leptospirosis, though common, are often unrecognized in a non-endemic area. We report here a patient with leptospirosis and severe pulmonary involvement who was treated with meropenem (1 g every 8 hours), moxifloxacin (400 mg once daily), and high doses of corticosteroids. Systemic steroids were continued for 3 months because of persistent pulmonary lesions