Tele-rehabilitation of a middle-aged female with bronchiectasis as post COVID-19 sequelae: a case report

COVID-19 pneumonia causes dilatation of lung parenchyma which leads to destruction of segmental bronchi that can further progress into bronchiectasis. COVID-19 causes many sequels in the respiratory system and frequently presents with dyspnoea, fatigue, loss of strength, reduced functional capacity and sometimes severe multi-organ affection. Physiotherapy interventions through tele-rehabilitation have acquired a fundamental role in the recovery of the functions and quality of life. Pulmonary tele-rehabilitation which is done in this case report study includes patient education, respiratory care, exercise training, ambulatory program with supplementary oxygen, strengthening, endurance training and energy conservation. All these interventions play an important role in patent’s treatment protocol from hospital discharge to resuming work by assisting in weaning of supplementary oxygen, improving functional capacity of lungs and thus facilitating recovery. Rehabilitation of COVID-19 causing bronchiectasis in healthy individual has not been reported in literature yet. So, here we present a case report of tele-rehabilitation of a middle- aged female who developed progressive bronchiectasis as a sequela of COVID-19 pneumonia evident on serial chest CT scans

Obstetric emergencies: preparedness among nurses for safe motherhood

Background: Obstetric emergencies may turn catastrophic in women’s as well as obstetrician’s life. In the event of real emergency, all prior preparations may fall deficient. Every little contribution towards safe confinement brings about large reductions in maternal mortality and morbidity.Methods: Cross-sectional questionnaire based study carried out on nurses involved in perinatal care of parturient conducted at the Dept of Obstetrics & Gynecology of PCMS & RC, Bhopal.Results: Total study participants were 36 (100% response rate). Majority (83%) were aware about the two leading causes of maternal mortality (PE, PPH). Twenty four (67%) knew the warning signs of eclampsia and 61% knew the signs of eclampsia but only 17% were aware of MgSO4 toxicity. Only 56% could correctly prepare the loading dose of MgSO4. All were aware about PPH; however only17% knew methergine as the drug for active management. Grossly wrong attitude noted only in 27% for PPH and 27% for severe PE. Overall preparedness for emergency was satisfactory in LR and PNC.Conclusions: Though the overall awareness for identifying emergencies (PE, PPH) was satisfactory, lacunae in awareness were noted about components of eclampsia, magnesium toxicity and drugs required for initial management of PE and PPH. Preparedness of nurses in labour room and postnatal ward was fairly good. Regular assessment of awareness & preparedness for obstetric emergencies would be desirable to optimize the overall delivery outcomes especially at peripheral rural centres where nurses are primarily involved in the care of labouring women

Implementation challenges of Pradhan Mantri Jan Arogya Yojana: A Cross- Sectional study in Meerut, Uttar Pradesh

Background: Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana has been launched to provide financial protection expenditure to nearly 500 million vulnerable Indians. For expanding the coverage under the scheme, it is necessary to understand the perspective of health care service providers involved in the scheme. Aim & Objective: To find out the bottlenecks in implementation of PMJAY scheme using empanelled hospitals’ perspective Settings and Design: Cross sectional study Methods and Material: 8 Public and 23 Private hospitals were selected through Simple Random Sampling from the list of PMJAY empanelled hospitals. The PMJAY Medical Officer co-ordinators in the empanelled hospitals were interviewed using a predesigned and pretested questionnaire. Statistical analysis used: Data was analysed using descriptive statistics in Epiinfo software. Results: Among the 31 empanelled hospitals studied, 93.5% were satisfied with the process for empanelment under PMJAY. 64.5% hospitals were not satisfied with the Health Benefit Packages. 77.4% hospitals perceived the PMJAY to be poorer as compared to private health insurance with reasons being poor grievance reprisal, poor claim processing and settlement, denial of reimbursement of health packages, poor rates of health packages and little information about the scheme. Conclusions: Various hurdles are being faced in the implementation of the scheme. There definitely remains a huge scope for further improvements so as to enhance the insurance coverage in the country

Myths and misbelieves regarding COVID vaccines in India

Background: - COVID-19 is the most important public health problem of recent time. Many people require hospitalization after infection. COVID vaccination is the most effective way to prevent the disease. Due to extensive negative publicity through social media channels/platforms,significant number of individuals are not coming forward for vaccination. Therefore, study is needed to evaluate adverse effects associated with different vaccines available in India. Objectives: - To assess the adverse effects associated with COVID-19 vaccination and compare the side effect of two most commonly used COVID vaccines in India. Methods:- In the current report, a cross sectional study was conducted among beneficiaries of COVID-19 vaccines at the vaccination center of the LLRM Medical college, India. After institutional ethical clearance and informed consent, patients were asked about the symptoms they experienced after vaccination. A very simple random sampling approach was used to select beneficiaries. Information was collected on predesigned Google form and total 391 patients submitted the responses. Results:- Out of total respondents 77 % individuals reported one or more symptoms. Fever was reported to be most common problem (59.3%) followed by body ache (57.5%). Out of total beneficiaries, 68.3% experienced mild symptoms while 23% remain asymptomatic. Only few subjects reported moderate adverse effects (8.7%).  None of the respondent reported severe and serious adverse effect. Conclusions:- Vaccine associated adverse effects were found less than 3 days and of mild variety in most of the beneficiaries. There was no difference in adverse effect profile of two commonly used vaccines in India. People must come forward for vaccination in mass without fearing of adverse effects of vaccines

Inverse Relation of 25-OH Vitamin D Level with Severity of Diabetic Retinopathy and HbA1c in Type 2 Diabetes Patients: Supplementation May Halt Severity

Purpose: Vitamin D has been proposed to have a role in ocular health as its anti-angiogenic and anti-inflammatory property. Our aim was to analyze the relationship of 25-OH Vitamin D level with severity of diabetic retinopathy (DR) and HbA1c in Type 2 diabetes patients. Methods: In the present observational study we enrolled 140 cases of Type 2 Diabetic patients (98 with DR and 42 without DR). Complete ophthalmological evaluation was done. 25-OH Vitamin D levels were compared with severity of DR and HbA1c level. Serum concentration of 25 hydroxyvitamin D was measured by radioimmunoassay method. Vitamin D deficiency was considered when 25 hydroxyvitamin D level less than 20ng/ml. Results: There was no significant difference in age, sex, Calcium, PTH and phosphate levels between groups. Sixty nine out of 98 with retinopathy while 15 out of 42 without retinopathy were having 25 hydroxyvitamin D level less than 20 ng/ml. DR patients have higher proportion of subjects with vitamin D deficiency as compared to without DR (p=0.045). We also found significant inverse correlation of serum 25-OH Vitamin D with severity of DR on ANOVA and HbA1c levels(p <0.001) on Pearson’s correlation. Conclusion: 25-OHvitamin D deficiency is associated with DR and increased HbA1c levels. Vitamin D supplementation with good blood sugar control may decrease the severity of DR in Type 2 diabetes. All patients with type 2 diabetes mellitus, besides undergoing fundoscopic examination, must be assessed for their vitamin D statu

Effect of sleep on blood pressure among adults of urban slums: A Cross sectional study

Introduction: Hypertension, the “Silent, Invisible killer” - is a modern day’s universal epidemic. The adult populations in slum area are more vulnerable for hypertension as they are so busy in the fulfilment of even day to day basic needs and care, family commitments and economic stress. Aim and objectives: To estimate the prevalence of hypertension among the adults (25-44 years) and to study the effect of sleep on blood pressure levels. Methodology: The present cross-sectional study was carried among adults aged between 25 to 44 years residing in the slums of Meerut District. 30 Cluster Sampling technique was used. The slum was selected as a cluster unit. During the visit by house-to-house survey, members of the family were listed and eligible person were interviewed and examined. Data collected on a structured and pretested questionnaire. Results: Prevalence of hypertension among those who had sleep duration of >8 hours per day was 44.8% followed by 20.1% and 17.5% among those who had 7-8 hours and less than 7 hours of sleep time respectively. It was found that 24.2% monophasic sleep pattern follower were hypertensives while the prevalence was 19.4% in biphasic pattern. Conclusion: Majority (55.4%) had a sleep duration between 7-8 hours, followed by 33.9% and 10.7% with <7 hours and >8 hours of sleep time respectively. Majority (61.3%) of the study population were having monophasic sleep pattern, while 36.3% were biphasic and 2.4% were multiphasic

Changes in the health status and functional outcomes in acute traumatic hand injury patients, during physical therapy treatment

Introduction: Traumatic hand injury causes chronic disability. A large number of studies have reported impairments in clinical parameters, but few studies have described their disability experience. Aims To examine the functional disability and quality of life in traumatic hand injured patients receiving physical therapy. Settings and Design: The physiotherapy department in a multi-specialty public sector hospital. Convenient sampling method was used. Materials and Methods: The 36-item short-form health survey-MOS (SF-36, v2) and disabilities of arm, shoulder and hand (DASH) questionnaire were obtained and subjects were given physiotherapy, accordingly to their condition. Questionnaires were re-administered every month till discharge. Statistical Analysis Used: A One-way ANOVA test. Results: At end of 6 months, among eight subscales of SF-36, there is improvement in mean scores of physical functioning (39.1%). The bodily pain, general health, vitality, social function, and mental health had more than 100% improvement. DASH showed regression in disability (50.8%). Conclusions: Measuring quality of life (QOL) can provide detailed assessment of physical disability and treatment effects as well as the global impact of those effects on the person′s daily life. Hence, the use of self-report questionnaires such as DASH and SF-36, combined with physical performance score, helps to achieve more comprehensive evaluation of outcome

Obstetric emergencies: preparedness among nurses for safe motherhood

Background: Obstetric emergencies may turn catastrophic in women’s as well as obstetrician’s life. In the event of real emergency, all prior preparations may fall deficient. Every little contribution towards safe confinement brings about large reductions in maternal mortality and morbidity.Methods: Cross-sectional questionnaire based study carried out on nurses involved in perinatal care of parturient conducted at the Dept of Obstetrics & Gynecology of PCMS & RC, Bhopal.Results: Total study participants were 36 (100% response rate). Majority (83%) were aware about the two leading causes of maternal mortality (PE, PPH). Twenty four (67%) knew the warning signs of eclampsia and 61% knew the signs of eclampsia but only 17% were aware of MgSO4 toxicity. Only 56% could correctly prepare the loading dose of MgSO4. All were aware about PPH; however only17% knew methergine as the drug for active management. Grossly wrong attitude noted only in 27% for PPH and 27% for severe PE. Overall preparedness for emergency was satisfactory in LR and PNC.Conclusions: Though the overall awareness for identifying emergencies (PE, PPH) was satisfactory, lacunae in awareness were noted about components of eclampsia, magnesium toxicity and drugs required for initial management of PE and PPH. Preparedness of nurses in labour room and postnatal ward was fairly good. Regular assessment of awareness & preparedness for obstetric emergencies would be desirable to optimize the overall delivery outcomes especially at peripheral rural centres where nurses are primarily involved in the care of labouring women

Spy Bot

In various situations, there are times when a person is unable to physically check or provide assistance, leaving a specific action undone. However, with the use of robots, such issues can be resolved, and lives can be saved. To address this need, we have proposed the development of a surveillance robot that can stream real-time videos, transfer audio, and navigate around obstacles. Our aim is to design a system that allows us to wirelessly send commands to the robot, which it will follow accordingly.This proposed system consists of three main parts: the transmitter, receiver, and live streaming section. In the transmitter section, individuals can provide commands to the robot through various means such as gesture or motion tracking. In the receiver section, signals are received and decoded before being sent to the controller, which then directs the robot. Finally, the system is designed to allow for live video streaming to the person monitoring the robot. To achieve this, a common network, such as Wi-Fi, a laptop, and Arduino Uno, will be utilized to enable the surveillance feature for the user. With the implementation of this proposed system, individuals will have access to a reliable and efficient way of remotely checking and assisting in situations where physical presence is not possible. This will provide an effective solution to various problems and, most importantly, save lives