Introduction Access to health care and care delivery during the COVID-19 pandemic may be challenging for cancer patients. Several guidelines have been developed, which recommend treatment adjustments depending on the site of cancer, grade, and stage. However, few studies in India and across the globe have looked into the real challenges faced by cancer patients and assessed the effectiveness of the adopted interventions. This study was undertaken with the objective to study the challenges faced by cancer patients in India during the COVID-19 pandemic. Materials and Methods This was a cross-sectional study undertaken between May 1, 2020 and May 15, 2020. A link to a prestructured questionnaire was sent through email to 100 randomly selected cancer patients in different stages of treatment and follow-up. Data were decoded and entered in Microsoft Excel 2010 and analyzed using descriptive statistics. Results Slot availability for teleconsultation, network issues, deferral of radiotherapy dates and long waiting hours beyond appointment time, transportation problems from residence to hospital, restriction of visitors/attendants, deferral of surgery, deferral of tumor boards, delay and deferral of advice of the nutritionist, problems faced in extension of visa, unavailability of peer group support services and psychological counseling sessions, difficulty in maintaining precautionary measures, availability of chemotherapy medications and availability of chemotherapy slots in day care were cited as problems faced by cancer patients. Majority (91.7%) of the study respondents mentioned an increase in their anxiety levels. Conclusion As highlighted in the study, cancer patients faced challenges in cancer care delivery during the COVID-19 pandemic. This study suggests the need for larger studies on cancer patient care during a pandemic.
Pericardial cysts are very rare disorder with an incidence of about 1 in 1, 00,000. Pericardial cyst and diverticulum share similar developmental origin and may appear as an incidental finding in chest x ray in an asymptomatic patient. CT scan is considered as best modality for diagnosis and delineation of surrounding anatomy. Cardiac MRI is another excellent tool in diagnosis and evaluation of compressive effect and diffusion weighted cardiac MRI are very helpful for cases with diagnostic confusion. Echocardiography is best modality for follow up and image guided aspiration of the cyst. Conservative management with regular follow up may be considered if the cyst is small, patient is asymptomatic and probability of subsequent complication is low. Surgical resection should be considered in symptomatic patients, large cysts and with high probability of complications. Percutaneous aspiration and ethanol sclerosis is another attractive option.
Introduction: Hospital-acquired infection (HAI) rates were reported to have declined in healthcare settings during the Covid-19 pandemic. Needless to mention that HAI is of paramount interest and relevance to a primary care physician who need to care from womb to tomb inside pandemic. Objectives: This study was conducted to find the impact of Covid-19 pandemic on the four parameters of HAIs, namely, catheter-associated urinary tract infections (CAUTI), central-line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP) and surgical site infections (SSIs) with hand hygiene compliance rates among healthcare workers. Materials and Methods: This retrospective data mining was undertaken in a 700 bed multispecialty teaching hospital in the Eastern India which was a Government of Bihar approved speciality Covid Care Hospital. Data from the monthly routine infection control monitoring and surveillance activities was collated from January 2019 to December 2020. Control charts with upper and lower control limit set at mean ± 1 SD were used to monitor monthly trends of HAIs. Results: The CAUTI rates reduced by 28.01%; the CLABSI rates declined by 37.61%, the SSI rates reduced by 62.39%, while the highest VAP rates were reported in November 2019 (1.9 per 1000 ventilator days). The hand hygiene compliance rates from January 2019 to December 2020 among different healthcare staffs showed a sharply rising trend. Conclusion: Covid-19 pandemic highlighted paramount importance regarding compliance to hand hygiene and implementation of standard infection control practices as recommended by World Health Organisation and Centres for Diseases Control and Prevention (CDC), which can drastically reduce range of HAIs.
Introduction: The choice of muscle relaxant for endotracheal intubation may be straightforward in selective cases, but in most patients, who are otherwise uncomplicated, poses a dilemma among anesthesiologists and intensivists. The authors examined the most commonly used muscle relaxants (Vecuronium, atracurium and rocuronium) in equipotent doses and compared the most vital parameters, i.e., rapidity of development of clinically acceptable intubating condition and quality of laryngoscopic view. Method: 150 adult patients of 18 to 50 y of age were recruited randomly into 3 equal groups having 50 patients (n=50) in each and equipotent dose of vecuronium, atracurium and rocuronium was administered. Endotracheal intubations were attempted every 30 seconds till excellent or good intubating conditions were achieved upto a maximum of 240 s. The available data were analyzed statistically. Results: The three study groups were comparable in terms of the demographic characteristics. The quality of intubating condition was rated significantly better with Rocuronium than with Vecuronium and Atracurium. Time required to achieve successful intubation was also significantly less with rocuronium than with Vecuronium (107.48 ± 1.98*6.583 s vs. 165.46 ± 1.98*6.790 s) and Atracurium (107.48 ± 1.98*6.583 s vs. 195.43 ± 1.98*6.583 s). Excellent laryngoscopic condition was found in more patients with rocuronium at 60 and 90 s and number of successful intubation was also higher. Conclusion: Therefore, the study confirms that rocuronium produces clinically acceptable intubating condition earlier than the other two drugs and the quality of intubating condition is better in terms of laryngoscopic view.
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