Background Primary health centers (PHCs) represent the first tier of the Indian health care system, providing a range of essential outpatient services to people living in the rural, suburban, and hard-to-reach areas. Diversion of health care resources for containing the coronavirus disease (COVID-19) pandemic has significantly undermined the accessibility and availability of essential health services. Under these circumstances, the preparedness of PHCs in providing safe patient-centered care and meeting the current health needs of the population while preventing further transmission of the severe acute respiratory syndrome coronavirus 2 infection is crucial. Objective The aim of this study was to determine the primary health care facility preparedness toward the provision of safe outpatient services during the COVID-19 pandemic in India. Methods We conducted a cross-sectional study among supervisors and managers of primary health care facilities attached to medical colleges and institutions in India. A list of 60 faculties involved in the management and supervision of PHCs affiliated with the community medicine departments of medical colleges and institutes across India was compiled from an accessible private organization member database. We collected the data through a rapid survey from April 24 to 30, 2020, using a Google Forms online digital questionnaire that evaluated preparedness parameters based on self-assessment by the participants. The preparedness domains assessed were infrastructure availability, health worker safety, and patient care. Results A total of 51 faculties responded to the survey. Each medical college and institution had on average a total of 2.94 (SD 1.7) PHCs under its jurisdiction. Infrastructural and infection control deficits at the PHC were reported in terms of limited physical space and queuing capacity, lack of separate entry and exit gates (n=25, 49%), inadequate ventilation (n=29, 57%), and negligible airborne infection control measures (n=38, 75.5%). N95 masks were available at 26 (50.9%) sites. Infection prevention and control measures were also suboptimal with inadequate facilities for handwashing and hand hygiene reported in 23.5% (n=12) and 27.4% (n=14) of sites, respectively. The operation of outpatient services, particularly related to maternal and child health, was significantly disrupted (P<.001) during the COVID-19 pandemic. Conclusions Existing PHC facilities in India providing outpatient services are constrained in their functioning during the COVID-19 pandemic due to weak infrastructure contributing to suboptimal patient safety and infection control measures. Furthermore, there is a need for effective planning, communication, and coordination between the centralized health policy makers and health managers working at primary health care facilities to ensure overall preparedness during public health emergencies.
Background: Infection due to hospital-acquired microbes is an evolving problem worldwide, and horizontal transmission of bacterial organism continues to cause a high nosocomial infection rate in health care settings. Most nosocomial infections are thought to be transmitted by the hands of health care workers.The application of hand hygiene is effective in reducing infection rates. Objectives:To assess the level of knowledge and attitude regarding hand hygiene practices amongst the health care professionals and to identify areas of gaps in their knowledge and attitude. Materials and Methods:A cross-sectional study.
Difficulties of the hearing impaired have increased due to COVID-19, leading to lack of inclusiveness along with the breakdown of their mental, physical, and social health. The study objective was to assess the challenges faced by the deaf and hearing-impaired people during COVID-19 by a literature review. Literature search was done using keywords such as “challenges” OR “barriers” and “COVID-19” OR “Deaf” OR “Hearing Impaired” OR “Communication” on PubMed and Google Scholar from November 2019 to June 2020. The challenges faced were lack of information, face mask making communication difficult, social distancing affecting their physical, mental health, stigma and barriers related to the health-care system. Strategies included use of technology, help from sign language instructors, and preparedness of health-care settings for the hearing disabled. System strengthening, tele-medicine, and policy amendments can be the pillars to build up the support system for the hearing impaired to protect them from COVID-19.
A significant proportion of patients with coronavirus disease 2019 require timely hospitalization to reduce the risk of complications and mortality. We describe the trends of the age and gender stratified outcomes among hospitalized COVID-19 patients with moderate to severe illness at the largest dedicated tertiary care COVID-19 government hospital in New Delhi, India. A retrospective cohort study through secondary data analysis from in-patient hospital data of patients admitted from April 1 to November 15, 2020 was conducted. The data of 10,314 laboratory-confirmed patients with COVID-19 was analyzed, of which 8899 (86.28%) were discharged after recovery, and 1415 (13.72%) died. The mean (SD) age of the hospitalized patients was 46.43 (18.74) years (n = 10,309) including 6031 (58.50%) male and 4278 (41.50%) female patients (n = 10,309). On bivariate analysis, increasing age was associated with significantly higher odds of mortality in both gender (p < .001). The mortality rate in female patients was lower (11.92%) compared with male patients (15.75%) (p = .675). However, elderly women had the highest odds of mortality (p < .001), indicating the possible role of delayed health seeking behavior, secondary to familial, and social neglect. Mortality in the patients with COVID-19 also occurred early after admission suggesting rapid deterioration, delayed reporting by patients, or their late referral from other health facilities.However, the overall statewide recovery rate showed steady improvement since the onset of the pandemic. In contrast, the recovery rate among the moderatesevere cases that were hospitalized at this tertiary care center during the same period reflected a lower nonspecific zigzag pattern indicating limited effectiveness of the COVID-19 treatment regimens.
INTRODUCTIONDiabetes mellitus (DM) has become major public health problem in India. It is a metabolic disorder caused by impaired insulin secretion, peripheral insulin resistance or both. It is characterised by raised blood glucose with diminished uptake and metabolism of cellular glucose as well as altered lipid and protein metabolism.1 Diabetes is not only increasing morbidity and mortality but also decreases the quality of life. Also disease and its complications are causing heavy economic burden for patients suffering from it. 2,3ABSTRACT Background: Diabetes is endemic globally with increasing prevalence in both developing and developed countries. Persistent hyperglycaemia of diabetes is associated with micro as well as macro vascular complications like coronary heart disease, stroke, diabetic renal disease, diabetic retinopathy and neuropathy etc. Dyslipidemia contribute to considerable increased risk of atherosclerosis and consequent mortality in diabetic patients. It often precedes onset of diabetes particularly type 2 DM and may persist inspite of adequate control of blood sugar. The objective of the study was to study prevalence and pattern of dyslipidemia in type 2 diabetes mellitus patients attending Rural Health and Training Centre of medical college in Bhopal, Madhya Pradesh. Methods: This was a cross sectional study carried out among 50 Type 2 diabetic mellitus patients attending OPD of Rural Health Training Centre (RHTC) of medical college in Bhopal Madhya Pradesh. Study population included known as well as newly diagnosed type 2 diabetic patients more than 30 years of age attending OPD at RHTC. Results: According to ATP III guidelines dyslipidemia was observed in 43 (86%) study subjects. Hypercholesterolemia was seen in 18 (36%) study subjects. Increased LDL and triglycerides was observed in 33 (66%) and 32 (64%) study subjects respectively. Lower HDL cholesterol values were observed in 26 (52%) study subjects. Out of 43 study subjects having dyslipidemia, 14 (32.6%) study subjects were having isolated single parameter dyslipidemia, while 10 (23.2%) had combined two parameter dyslipidemia and 19 (44.2%) study subjects showed mixed dyslipidemia. Conclusion: Results suggest high (86%) prevalence of dyslipidemia among type 2 diabetes mellitus study subjects. Most common pattern observed was mixed type dyslipidemia. These lipid abnormalities might be the important in view of development of cardiovascular or cerebrovascular diseases. Hence type 2 diabetic patient should undergo the routine monitoring of blood sugar and lipid profile so that any abnormalities can be identified and preventive measures along with interventions can be initiated at the earliest.
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