THE SYMPTOMS AND CO-MORBIDITIES OF COVID-19 PATIENTS AT HOME ISOLATION IN INDIA

Indian Government has issued the guidelines on home isolation for very mild/pre-symptomatic COVID-19 cases based on a proposal of the Directorate of Public Health and Preventive Medicine. This has originated when COVID-19 designated hospitals started to shift asymptomatic and stable patients to quarantine facilities to reserve beds for those in need of treatment. To determine the prevalence of symptoms and co-morbidities of COVID-19 positive patients at home isolation OPD. This cross-sectional study was conducted at a designated COVID-19 tertiary care hospital in Pune, India, which had included all COVID-19 positive patients enrolled for the home isolation care from the 15th July to 15th August 2020. There were total 639 adults out of which 362 were males and 277 females. The most common presenting symptom present in 49.4% cases was fever. Hypertension was the most prevalent comorbidity noticed in 10% of patients followed by Diabetes in 6.7%. The maximum time lag of positive COVID-19 test to registration for home isolation OPD of 8 days was observed in only 1 patient. The significant association was seen between symptom of fever with the adults (males) and in the age group of 31-50 years(p<0.05). Home isolation could be considered a classic model for COVID19 patients in resource constrained situation. Home isolation can substantially reduce health care expenses for the asymptomatic and mild symptomatic COVID-19 multitude

Care seeking behaviour and various delays in tuberculosis patients registered under RNTCP in Pune city

Introduction:&nbsp;Case finding in tuberculosis is known to be influenced by factors such as patient motivation, care seeking, the degree of diagnostic suspicion by health care provider which could result in a delayed diagnosis. Objective:&nbsp;To determine care seeking behaviour and delay in diagnosis and treatment of new sputum positive tuberculosis patients registered under RNTCP. Material and Methods: Descriptive cross sectional study. 283 new sputum positive tuberculosis patients (?15 years of age) registered during a period of six months at two randomly selected tuberculosis unit of Pune city. Questionnaire by WHO was modified and used. Interviews were conducted in DOT centres. Statistical analysis: Frequency, mean and standard deviation, chi square test. Results:&nbsp;Mean age of patients was 35 (±15) years18% of patients were unemployed and 77% resided in urban slums. The commonest co morbidity in 7.4% and 3.5 % patients was HIV/ AIDS followed by diabetics respectively. Majority of the patients, for the first and second time visited a general practitioner. Median patient, health care system and total delay were 18, 22 and 47 days with mean of 24±21, 32±30 and 56±33 days respectively. Health care system delay was less (p&lt;0.05) in patients who first visited the public health care facility than patients who first visited a private health care provider. Conclusions:&nbsp;General practitioners are preferred first choice of health care provider for tuberculosis patients. Mean health care system delay is more than patient delay

Tuberculosis awareness program and associated changes in knowledge levels of school students

Background: This study aimed to assess the effectiveness of tuberculosis awareness program amongst school students. Methods: This school-based interventional study was done on 135 secondary school students. They were randomly selected in field practice area of Urban Health Training Center (UHTC) of a private medical college in Pune city. Health awareness session on tuberculosis was conducted by using various visual and audiovisual aids by the medical college undergraduate students. A pre-test and post-proforma was filled before and after the session. Paired t-test was used to assess the effectiveness of awareness program. Results : There was a highly significant (P = 0) increase in the knowledge of school students after the tuberculosis awareness program by medical undergraduate students. The mean pre-test scores were 6.31 (52.58%), and the mean post-test scores were 10.20 (85%). This activity also helped medical undergraduate students to acquire skills related to communication, working in a team, preparation and presentation of various visual aids for health awareness program; they also gained knowledge of research methodology. Conclusions: Health education program by medical students helped significantly to improve the knowledge of school students regarding tuberculosis. Thus, medical college students can be involved to some extent for conducting health-related behavioral change communication (BCC) activities in schools during their Community Medicine morning posting. Collaboration of private medical colleges, schools, and district tuberculosis units (DTUs) can be ideally achieved under public private partnership (PPP) for health awareness programs

ASSESSMENT OF INSOMNIA AND PSYCHO-SOCIAL HEALTH STATUS OF INDIAN CITIZENS DURING COVID-19 PANDEMIC LOCKDOWN PERIOD

The Pandemic lockdown period in India had created changes in various health aspects of the general population. One of the common anticipated responses is Insomnia. A National level online survey using a non-probability snowball sampling technique was conducted and 1007 responses were received from people within the range of 18 to 70 years. This cross-sectional study attempted to assess the Psycho-social health status of the general population of India during the Pandemic Lockdown period and provides an overview of evidence regarding relevant information like availability status of essential requirements, distress levels when facing the shortage of those preventive medications that were being taken by participants, degree of worry on appearance of minor symptoms, changes in perception towards people belonging to other countries It also reports the fraction of participants who faced ostracism due to being infected or having minor symptoms or due to profession. Insomnia prevalence during the period was assessed by using ISI scores of participants. The questionnaire also included open-ended questions to record the Major challenges faced by people during lockdown( like Psychological, Behavioural, Physical, Social and Economic), their perception about safety measures that can protect them, and aspects of the current Pandemic management system that they believe must be improved

Evaluation of the Quality and Scientific Accuracy of YouTube Videos as a Source of Patient Education Information on Skin Self-examination

Objective: YouTube is currently being used for obtaining healthcare-related information. The objective of the study was to evaluate the quality and scientific accuracy of YouTube videos as a source of patient education information about skin self-examination. Methods: A YouTube search was conducted using keywords: skin self-examination and skin self-exam. First 100 videos of each search term (total 200) were included. Videos with irrelevant content, non-English videos, and videos with no audio or visuals were excluded from the study. Selected videos were divided into two groups based on the source of the video: healthcare group and non-healthcare group. A 5- point Global Quality Score (GQS) was used to evaluate quality and a 9- point content score was used to assess the scientific accuracy of the videos. Total views and number of days since upload were noted. Results: Of the 200 videos, 22 videos were selected for the study. The mean GQS and content score of all videos assessed were four and 8.09 respectively. Of these, 19 videos were uploaded by healthcare group. The mean GQS and content score of these videos were 4.11 and 8.11, respectively. Three videos were uploaded by non-healthcare group. The mean GQS and content score of these videos were 3.33 and 8 respectively. There was no statistical significant difference (P &lt; 0.05) for all the measured variables among videos based on source. Conclusion: There is potential to increase public awareness about skin self-examination by utilizing YouTube. Considering there is a lot of low-credibility information, people need to be guided to reliable videos

Knowledge and practices related to reproductive health amongst adolescent girls

Objective: To assess knowledge and practices related to menstruation and reproductive health amongst college going adolescent girls. Materials and Methods: Cross-sectional study done on 323 adolescent girls admitted in the year 2012 to professional colleges belonging to the health sciences faculty of a private university in Pune, India, using self-administered proforma. Results: Mean age of onset of menarche was 13.35 years. Many girls (86.65%) had knowledge of menstruation prior to menarche. For 68% of girls, mother was a source of menstrual information. Half of the girls reported some form of restriction in activities during menstruation due to religious reasons. 11% girls suffered from some form of reproductive tract infections (RTIs). Practices related to menstruation revealed that cloth piece is used for menstrual protection by 3% of girls. Soaked sanitary pads were disposed sanitarily by 96% of girls. Adolescent of medical faculty had significantly more knowledge than nursing faculty adolescents regarding emergency contraceptives (P < 0.05). Only four girls reported a history of sexual contact, of these, three were aware of emergency contraceptives, while one used them to prevent pregnancy. Conclusions: Adolescent girls received knowledge of menstruation prior to menarche from their mothers. Restriction in activity during menstruation due to religious reasons is practiced by many girls. Sanitary pad was used by almost all girls, and all disposed the same in a sanitary manner. More than half of the girls were aware about emergency contraceptives. Prevalence of RTI was found to be low and very few girls reported history of sexual exposure

Determinants and perception of postpartum intrauterine contraceptive device services in Maharashtra, India

Undesired and unintended pregnancies increase unwanted births or induced abortions, consequently increasing maternal morbidity and mortality. Postpartum insertion of the Intra Uterine Contraceptive Device (PPIUCD) is an effective method for population control. The authors conducted the study to assess the determinants of PPIUCD services by identifying beneficiaries and healthcare workers' perceptions. We conducted this study in Maharashtra State, India having five geographical divisions and 36 districts. The authors visited 10 Primary Health Centers and three Community Health Centers from five districts, randomly selecting one from each division. We interviewed 45 women who had undergone insertion one day to one year prior and 17 health care workers. About one-third of women received counseling during pregnancy. The medical officers obtained the consents mostly during delivery. They inserted about 85% of devices within one hour of delivery. About 38% of women had at least one complication. Lower abdominal pain (22.22%), irregular bleeding (20.00%), the expulsion of CuT (13.33%), pain during periods (13.33%) were common. The removal rate was 6.67%. The complication rates observed in the present study are comparable to the hospital studies. Thus, the study reassures that the services in small institutions are very safe, and governments can fearlessly implement the program.Keywords: ComplicationsCounselingExpulsionHealth center Quality Removal

Reported incidence and risk factors of childhood pneumonia in India: a community-based cross-sectional study

Abstract Background Pneumonia is responsible for high morbidity and mortality amongst children under five year of age. India accounts for one-third of the total WHO South East Asia burden of under-five mortality. There is a paucity of epidemiological studies indicating the true burden of pneumonia. Identification of the risk factors associated with pneumonia will help to effectively plan and implement the preventive measures for its reduction. Methods It was a descriptive cross-sectional study conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. All mothers of under-five children in the selected clusters were included. A validated pretested interview schedule was filled by trained field supervisors through the house to house visits.WHO definition was used to define and classify clinical pneumonia. Height and weight of children were taken as per standard guidelines. Quality checks for data collection were done by the site investigators and critical and noncritical fields in the questionnaire were monitored during data entry. For continuous variables mean and SD were calculated. Chi-square test was applied to determine the association between the variables. Level of significance was considered at 0.05. Results There were 3671 under five-year children, 2929 mothers in 10,929 households.Unclean fuel usage was found in 15.1% of households. Mean birth weight was 2.6 kg (SD;0.61). Exclusive breastfeeding till 6 months of age was practiced by 46% of mothers. Reported incidence of ARI was 0.49 per child per month and the reported incidence of pneumonia was 0.075 per child per year. It was not associated with any of the housing environment factors (p > 0.05) but was found to be associated with partial immunization (p < 0.05). Poor practices related to child feeding, hand hygiene and poor knowledge related to signs and symptoms of pneumonia amongst mother were found. Conclusions Very low incidence of pneumonia was observed in Pune and Sangli districts of Maharashtra. Partial immunization emerged as a most important risk factor. Reasons for low incidence and lack of association of pneumonia with known risk factors may be a better literacy rate among mothers and better immunization coverage. Trial registration Registration number of the trial- CTRI/2017/12/010881; date of registration-14/12/2017