Handwashing: a household social vaccine against COVID 19 and multiple communicable diseases

Handwashing is the most cost-effective measure for prevention of a wide spectrum of diseases from respiratory, intestinal, soil transmitted helminthiasis, health-care associated illness to infection with pandemic potential like SARS, MERS and COVID 19. Experts view that handwashing can be the greatest investment in the mankind as it reduces under nutrition, morbidity, mortality and paves way for growth, development, educational attainment of people and thereby achieving healthier communities. Though the evidence of handwashing on health is two centuries old but change in human behaviour seems critical in both developing and developed countries. Hand hygiene is rarely practiced during crucial moments and even rarely soap is used. Therefore emphasis should be given towards a societal shift in behaviour change among children, caretakers and people of all age groups. Every school, community and hospital should be provided with Safe water, Sanitation and adequate Hygiene (WASH) services. Hand hygiene to be given top priority in national health plans by which millions of unnecessary deaths and burden on health care system can be avoided. Nevertheless under the looming threat of the current COVID 19 pandemic, where the exact epidemiology is still evolving and a vaccine doesn’t seem feasible as an immediate measure to control the disease, handwashing should be considered as a ‘social vaccine’ for everyone at every household level

Revamped vaccination policy in India, need of the hour

The unprecedented COVID pandemic has caused catastrophic loss all over the world. India has faced a flabbergasting second COVID wave. The current COVID mutant strain is more virulent and has become a variant of concern (VOC) with its high infectivity rate. The current second wave is more detrimental when compared to the first wave, where its transmissibility is high, affecting the younger generation, and even the mortality rate is high. Currently, there is no specific treatment against COVID-19. The health care workers (HCW’s) have been fighting the pandemic tirelessly since the beginning of the pandemic, and many were affected, and severe loss of HCWs occurred. The only ray of hope in fighting against this deadly virus is vaccination. Studies have shown that COVID vaccination is effective in preventing the severity of the disease. Hence vaccination is now is the need of the hour. COVID vaccination has to be taken rampant with vaccinating every citizen of the country in the current crisis. The government of India should make serious efforts that vaccination is available and accessible to everyone. With every citizen being vaccinated, one can flatten the current wave and also can prevent further outbreaks

Portal Vein Aneurysm: Incidental Detection of Uncommon Entity as Cause of Chronic Abdominal Pain

Portal vein aneurysm is an uncommon anomaly. Both congenital and acquired cases are reported. We report a case of idiopathic probably congenital portal vein aneurysm incidentally detected on contrast CT. There was no evidence of any chronic liver disease or portal hypertension in this patient

COVID-19 pandemic: a narrative review on legislative and regulatory framework in India for disaster and epidemic

Public health legislation plays an important role in the containment of any epidemic or pandemic. During a pandemic, it might be necessary to override the existing laws or (individual) human rights for the containment of the pandemic. The objective of the study is to review the legal framework pertaining to COVID-19 pandemic preparedness in India. This study has been done as an unsystematic narrative review where various legislations were assembled from electronic data base, websites from various legislative and Ministries and discussion with experts. Owing to contain the spread of the novel coronavirus Government of India announced nationwide lockdown on 24th March, 2020.  For proper implementation of lockdown measures various legislative laws belonging to different ministries is required. There are two pioneer acts namely The Epidemic disease act of 1897 and The Disaster management act of 2005. Under these two acts the government has laid down various rules and regulations that have to be followed during lockdown. This article describes the need for the law in a crisis like this and various legislations that have been implemented during lockdown

An intervention study to enhance AIDS awareness among underprivileged population in Chandigarh

BACKGROUND: It is estimated that 4 million persons are suffering from HIV infection/AIDS in India. A family health awareness campaign (FHAC) has been implemented under the National AIDS Control Programme (NACP) to scale up HIV/AIDS awareness in vulnerable groups. METHODS: A community based study was conducted in April 2001 to find the impact of FHAC and IEC activities in 12 villages and slums with a population of 1-1.5 lakhs in Chandigarh. Information was collected from 643 persons in the age group of 15-49 years, 323 in the pre-intervention phase and 320 in the post-intervention phase. RESULTS: Awareness about AIDS increased from 58.2% to 70% (p < 0.01). The major sources of information were the mass media and friends. Knowledge regarding the mode of spread also increased after the campaign. Knowledge regarding prevention of AIDS by using condoms increased from 42% to 61.2%; having a single partner, from 59% to 72.3%; using safe blood, from 14.9% to 29%; and sterile needles/syringes, from 18.1% to 33.9%. Over 90% of respondents consider AIDS a dangerous disease. CONCLUSION: Community based intervention such as FHAC and IEC activities were successful in enhancing the awareness among underprivileged groups. Since a large section of the population still remained unaware, regular efforts must be made to achieve universal awareness about AIDS

Predictors of acute myocardial infarct size in STEMI patients receiving thrombolytic therapy: A delayed contrast enhanced cardiac MRI study

AbstractIntroductionDelayed contrast enhanced Cardiac MRI has been accepted as a standard tool worldwide for determination of infarcted myocardium and viability. Infarct size as determined by cardiac MRI has important therapeutic and prognostic information.MethodsTwenty six STEMI patients who had received thrombolytic therapy were subjected to cardiac MRI assessment at 5–7 day of admission. Base line variables of the study population were compared with the acute infarct size as determined by the Cardiac MRI.ResultsThe mean acute infarct size in our study population was 27.2 ± 17.4% of LV. We found through univariate analysis that final infarct size was dependent on time to thrombolysis (p = 0.04), Status of Thrombolysis (p = 0.01), smoking status (p = 0.02), location of infarct (p < 0.00001), presence of microvascular obstruction (p = 0.01) and viability status (p = 0.0004). Thus, larger acute infarct size was seen in delayed time to thrombolysis, failed status of thrombolysis, smokers, anterior location of the infarct, presence of microvascular obstruction and non viable myocardial status.ConclusionInfarct size as determined by Cardiac MRI has been shown to carry important therapeutic and prognostic information. We have tried to evaluate predictors of acute infarct on cardiac MRI in STEMI patients during their initial hospital stay. Knowing the predictors of acute infarct size can help in early intervention and provide prognostic information for future cardiac events

Epidemic of undernutrition during COVID-19 pandemic

Undernutrition continues to be a major public health challenge for ages. Under-five age children are still at risk of undernutrition even though there exist many policies and programs at various levels. The lower–middle-income countries (LMIC) struggle hard to combat the undernutrition epidemic. The unprecedented advent of the COVID-19 pandemic has worsened the existing undernutrition scenario. This article reviews the burden and impact of the COVID-19 on undernutrition among children. Necessary measures have to be taken to mitigate the crisis and thereby reduce the risks due to morbidity and mortality related to undernutrition. A manual search of relevant data has been taken from the website of the World Health Organization (WHO), UNICEF, Ministry Health and Family Welfare (MOHFW), government of India. (GOI). A search of relevant publications was done through electronic databases such as PUBMED

Beta-Blocker Use and 30-Day All-Cause Readmission in Medicare Beneficiaries With Systolic Heart Failure

BACKGROUND: Beta-blockers improve outcomes in patients with systolic heart failure. However, it is unknown whether their initial negative inotropic effect may increase 30-day all-cause readmission, a target outcome for Medicare cost reduction and financial penalty for hospitals under the Affordable Care Act. METHODS: Of the 3067 Medicare beneficiaries discharged alive from 106 Alabama hospitals (1998-2001) with a primary discharge diagnosis of heart failure and ejection fraction RESULTS: Beta-blocker use was not associated with 30-day all-cause readmission (hazard ratio [HR] 0.87; 95% confidence interval [CI], 0.64-1.18) or heart failure readmission (HR 0.95; 95% CI, 0.57-1.58), but was significantly associated with lower 30-day all-cause mortality (HR 0.29; 95% CI, 0.12-0.73). During 4-year postdischarge, those in the beta-blocker group had lower mortality (HR 0.81; 95% CI, 0.67-0.98) and combined outcome of all-cause mortality or all-cause readmission (HR 0.87; 95% CI, 0.74-0.97), but not with all-cause readmission (HR 0.89; 95% CI, 0.76-1.04). CONCLUSIONS: Among hospitalized older patients with systolic heart failure, discharge prescription of beta-blockers was associated with lower 30-day all-cause mortality and 4-year combined death or readmission outcomes without higher 30-day readmission