Electrocardiographic findings in COVID-19 patients

Background: Severe acute respiratory syndrome coronavirus 2 (SARS CoV2) has caused the global pandemic, COVID-19. Though predominantly a respiratory illness, cardiac manifestations of COVID-19 significantly contribute to mortality. We wanted to determine whether admission electrocardiographic (ECG) characteristics provide prognostic information in COVID-19.Methods: We performed a retrospective, cross-sectional observational study in a designated District COVID hospital. COVID-19 patient’s medical records were converted into an electronic database which included demographic data, clinical characteristics and electrocardiogram recorded at/near the time of admission. Primary outcome assessed was the occurrence of severe COVID-19.Results: Of 180 patients, the majority were males (67.8%) and aged 31-50 years (38.9%). The predominant comorbidity among patients who were discharged (non-severe COVID-19 disease) and those who got referred (severe COVID-19 disease) was hypertension (56.5% vs 43.3%), followed by diabetes mellitus (37.7% vs 36.7%). Fatigue (41.9%) and cough (18.5%) were the most frequent symptoms among non-severe cases. Of 32.8% of the patients with abnormal ECG, abnormal axis (25.5%), poor R wave progression (23.5%), T inversion (15.3%), left ventricular hypertrophy (12.2%) followed by ST segment depression (8.3%) were the frequent findings. Logistic regression analysis revealed that elderly patients (>60 years) (β=2.276, OR=9.737, p=0.002), Heart rate (β=0.191, OR=1.211, p=0.045) and ST segment depression (β=9.986, OR=21725.39, p=0.022) showed statistically significant positive association with Severe COVID-19.Conclusions: ST segment abnormalities on admission ECG are markers of cardiac injury and may assist in prognostication of COVID-19. Early identification of these findings might play a crucial role in identifying patients likely to progress to severe COVID-19

Practices and perceptions of online teaching among faculty of medical colleges

Background: COVID-19 pandemic has enormously impacted the medical education system owing to a nationwide lockdown. The faculty of medical colleges had to face an abrupt switch from traditional classroom teaching to online teaching methods, which proved challenging. We aimed to evaluate the practices and perceptions of online teaching among faculty of medical colleges. Methods: An online survey tool consisting of socio-demographic variables, teaching experience details, online teaching practices, perceived self-efficacy and training and support received was used. Results: Only 89 of 108 faculty members participated were eligible for the survey. Majority (69.7%) belonged to the age 25-40 years, were Assistant Professors (44.9%) and from Private medical colleges (79.8%) and used Zoom application (71.6%) as their teaching tool. About 16.9% had previous experience of online teaching. Among the teaching practices, content related practices were frequently utilised by the faculty followed by effective communication practices. The overall responses for perceived self- efficacy were above neutral. The faculty received highest and least training/support in content specific knowledge and online classroom management respectively. Linear regression analysis revealed statistically significant positive association of perceived professional and technological self-efficacy with effective communication [(β=0.238, p=0.05), (β=0.510, p<0.001)] and content related practices [(β=0.309, p=0.007), (β=0.477, p<0.001)]. Conclusions: Addressing faculty concerns and appropriate training in the use of digital platforms can help improve online teaching practices thus facilitating effective e-learning. Post-pandemic, a blended classroom and online teaching curriculum would probably provide a better learning environment

Clinical profile of patients with hypertensive emergencies in a tertiary care hospital

Background: Hypertensive emergency is defined by systolic blood pressure (SBP) ≥180 mmHg and/or diastolic blood pressure (DBP) ≥120 mmHg with acute target organ damage. Hypertensive emergencies can be life threatening and fatal unless timely treated. In the present study we aim to study the clinical profile and outcome of patients admitted with hypertensive emergency in the medical intensive care unit in our hospital. Methods: A cross-sectional observational study of all cases with hypertensive emergency admitted in Medical Intensive care unit (ICU) in Government General Hospital, Srikakulam during the study period was conducted. The clinical profile and outcome of the patients were assessed. Results: Out of the fifty patients in the present study, about 36 (72%) were males and 14 were females (28%) and about one third of the patients (36%) belonged to the age group of 60-69 years. Diabetes mellitus (30%) and dyslipidemia (40%) were the commonly encountered comorbidities in the study population. Most frequent presenting symptoms were neurological deficits (50%) followed by dyspnoea (32%) and chest pain (24%). Intracerebral haemorrhage was the commonest target organ damage found in 30% of the patients. Patients presenting with hypertensive emergencies with neurological target organ damage had statistically significant increased chance of mortality (p=0.007). Conclusions: As hypertension emergencies are consequence of uncontrolled hypertension, it is important to educate and bring awareness among public regarding the screening, early detection, and adherence to prescribed medication for hypertension to avoid adverse clinical outcomes