Pub Date : 2022-03-01DOI: 10.4103/2221-6189.342665
N. Humaney, Shilpa S. Kuthe, S. Akhtar, V. Pande
Objective: To evaluate patient demographic characteristics and risk factors for mortality during the first and the second wave among COVID-19 patients in a tertiary care hospital of India. Methods: Data were taken from the hospital’s electronic system for COVID-19 patients from August 2020 to December 2020, and the second from January 2021 to May 2021. The mortality rate, demographic and clinical characteristics, laboratory profile, and reasons for the death of the two waves were retrieved and compared, and the risk factors of the two waves were determined. Results: In the first wave, 1 177 COVID-19 cases visited the hospital and 96 (8.2%) died. In comparison, the death rate in the second wave was significantly higher (244/2 038, 12.0%) (P<0.001). No significant difference in age [60 (50-69) vs. 60.5 (53-70), P=0.11] or gender (P=0.34) was observed between the two waves. Compared to the first wave. there were significantly more cases with fever, cough, weakness, loss of taste and smell, and sore throat during the second wave (P<0.05), but significantly fewer cases with kidney disease (6.6% vs. 13.5%, P=0.038) and diabetes mellitus (35.7% vs. 50.0%, P=0.015). Besides, during the second wave, more patients had abnormal X-ray findings, higher levels of lymphocytes and serum ferritin (P<0.05). In addition, there were significant differences in the rate of death cases with acidosis, septic shock, acute kidney injury, diabetes mellitus, cardiovascular events, hypothyroidism (P<0.05). Multivariate regression showed that during the first wave, age (OR: 1.10; 95% CI: 1.02-1.21), diabetes mellitus (OR: 3.16; 95% CI: 2.08-3.53), and abnormal X-ray (2.67; 95% CI: 2.32-2.87) were significant independent risk factors of mortality; while in the second wave, age (OR: 1.13; 95% CI: 1.12-1.28), diabetes mellitus (OR: 8.98; 95% CI: 1.79-45.67), abnormal X-ray (OR: 12.83; 95% CI: 2.32-54.76), high D-dimer (OR: 10.89; 95% CI: 1.56-134.53), and high IL-6 (OR: 7.89; 95% CI: 1.18-47.82) were significant independent risk factors of mortality . Conclusion: Overall mortality and incidence of severe diseases are higher in the second wave than the first wave. Demographic characteristics, co-morbidities, and laboratory inflammatory parameters, especially D-dimer and IL-6, are significant risk facors of mortality during the COVID-19 pandemic.
{"title":"Mortality characteristics during the two waves of COVID-19 in India: A retrospective observational study","authors":"N. Humaney, Shilpa S. Kuthe, S. Akhtar, V. Pande","doi":"10.4103/2221-6189.342665","DOIUrl":"https://doi.org/10.4103/2221-6189.342665","url":null,"abstract":"Objective: To evaluate patient demographic characteristics and risk factors for mortality during the first and the second wave among COVID-19 patients in a tertiary care hospital of India. Methods: Data were taken from the hospital’s electronic system for COVID-19 patients from August 2020 to December 2020, and the second from January 2021 to May 2021. The mortality rate, demographic and clinical characteristics, laboratory profile, and reasons for the death of the two waves were retrieved and compared, and the risk factors of the two waves were determined. Results: In the first wave, 1 177 COVID-19 cases visited the hospital and 96 (8.2%) died. In comparison, the death rate in the second wave was significantly higher (244/2 038, 12.0%) (P<0.001). No significant difference in age [60 (50-69) vs. 60.5 (53-70), P=0.11] or gender (P=0.34) was observed between the two waves. Compared to the first wave. there were significantly more cases with fever, cough, weakness, loss of taste and smell, and sore throat during the second wave (P<0.05), but significantly fewer cases with kidney disease (6.6% vs. 13.5%, P=0.038) and diabetes mellitus (35.7% vs. 50.0%, P=0.015). Besides, during the second wave, more patients had abnormal X-ray findings, higher levels of lymphocytes and serum ferritin (P<0.05). In addition, there were significant differences in the rate of death cases with acidosis, septic shock, acute kidney injury, diabetes mellitus, cardiovascular events, hypothyroidism (P<0.05). Multivariate regression showed that during the first wave, age (OR: 1.10; 95% CI: 1.02-1.21), diabetes mellitus (OR: 3.16; 95% CI: 2.08-3.53), and abnormal X-ray (2.67; 95% CI: 2.32-2.87) were significant independent risk factors of mortality; while in the second wave, age (OR: 1.13; 95% CI: 1.12-1.28), diabetes mellitus (OR: 8.98; 95% CI: 1.79-45.67), abnormal X-ray (OR: 12.83; 95% CI: 2.32-54.76), high D-dimer (OR: 10.89; 95% CI: 1.56-134.53), and high IL-6 (OR: 7.89; 95% CI: 1.18-47.82) were significant independent risk factors of mortality . Conclusion: Overall mortality and incidence of severe diseases are higher in the second wave than the first wave. Demographic characteristics, co-morbidities, and laboratory inflammatory parameters, especially D-dimer and IL-6, are significant risk facors of mortality during the COVID-19 pandemic.","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"11 1","pages":"77 - 84"},"PeriodicalIF":0.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45993549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01DOI: 10.4103/2221-6189.342663
Hamissou Roufai, J. Yang, Guang-fu Song, Fu-yi Yang
Objective: To investigate the effect of cold weather on carotid artery stenosis and occlusion. Methods: We conducted a retrospective observational study, in which 145 patients with carotid artery stenosis and occlusion were enrolled [115 men and 30 women; the mean age was 61.08 years (95% CI 59.27-62.88)]. Patients were divided into the low-temperature group (n=98) (≤12 °C) and the non-low temperature group (n=47) (>12 °C). Clinical characteristics, blood pressure, National Institutes of Health Stroke Scale (NIHSS), blood fat, and blood viscositys were compared between the two groups. Correlation between NIHSS and mean daily temperature was analyzed. Results: There was no significant difference in the systolic and diastolic blood pressure between the two groups (P>0.05). The NIHSS score was slightly higher in the non-low temperature group compared to that of the low-temperature group (U=2 984, P<0.01). Glycemia, cholesterol level, prothrombin time, fibrinogen, and International Normalized Ratio did not show any significant difference (P>0.05). Correlation analysis showed a very low positive and statistically significant correlation between ambient temperature and NIHSS score (r=0.18, P=0.029). Conclusion: Cold weather does not impact blood pressure, blood cholesterol, and coagulation factors of patients with carotid artery stenosis and occlusion. The neurological deficit is more severe in the non-low ambient temperature group. A potential relationship exists between ambient temperature and the level of neurological impairment.
{"title":"Effect of cold weather on carotid artery stenosis and occlusion: A retrospective observational study","authors":"Hamissou Roufai, J. Yang, Guang-fu Song, Fu-yi Yang","doi":"10.4103/2221-6189.342663","DOIUrl":"https://doi.org/10.4103/2221-6189.342663","url":null,"abstract":"Objective: To investigate the effect of cold weather on carotid artery stenosis and occlusion. Methods: We conducted a retrospective observational study, in which 145 patients with carotid artery stenosis and occlusion were enrolled [115 men and 30 women; the mean age was 61.08 years (95% CI 59.27-62.88)]. Patients were divided into the low-temperature group (n=98) (≤12 °C) and the non-low temperature group (n=47) (>12 °C). Clinical characteristics, blood pressure, National Institutes of Health Stroke Scale (NIHSS), blood fat, and blood viscositys were compared between the two groups. Correlation between NIHSS and mean daily temperature was analyzed. Results: There was no significant difference in the systolic and diastolic blood pressure between the two groups (P>0.05). The NIHSS score was slightly higher in the non-low temperature group compared to that of the low-temperature group (U=2 984, P<0.01). Glycemia, cholesterol level, prothrombin time, fibrinogen, and International Normalized Ratio did not show any significant difference (P>0.05). Correlation analysis showed a very low positive and statistically significant correlation between ambient temperature and NIHSS score (r=0.18, P=0.029). Conclusion: Cold weather does not impact blood pressure, blood cholesterol, and coagulation factors of patients with carotid artery stenosis and occlusion. The neurological deficit is more severe in the non-low ambient temperature group. A potential relationship exists between ambient temperature and the level of neurological impairment.","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"11 1","pages":"65 - 70"},"PeriodicalIF":0.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48379723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01DOI: 10.4103/2221-6189.342660
Gautam Jesrani, Samiksha Gupta, S. Gaba, Monica Gupta
Cardiovascular manifestations and electrocardiographic abnormalities have been reported among some prevalent infections in tropical regions, which lead to a great amount of morbidity and mortality. The major infectious diseases include chikungunya, dengue fever, H1N1 influenza, and coronavirus disease-19 (COVID- 19) in the viral category, leptospirosis, salmonellosis, scrub typhus and tuberculosis in the bacterial category, and malaria in the protozoan parasite category. All these infirmities constitute a foremost infection burden worldwide and have been linked to the various cardiac rhythm aberrancies. So we aimed to identify and compile different studies on these infections and associated acute electrocardiographic (ECG) changes. The search was made in online international libraries like PubMed, Google Scholar, and EMBASE, and 38 most relevant articles, including original research, systematic reviews, and unique case reports were selected. All of them were evaluated thoroughly and information regarding ECG was collected. Myocarditis is the predominant underlying pathology for rhythm disturbance and can be affected either due to the direct pathogenic effect or the abnormal immune system activation. ECG variabilities in some infections like chikungunya, scrub typhus, and leptospirosis are associated with longer hospital stay and poor outcome. Tropical infective diseases are associated with prominent acute cardiac rhythm abnormalities due to myocarditis, which can be identified preliminarily by ECG changes.
{"title":"Electrocardiographic abnormalities in prevalent infections in tropical regions: A scoping review","authors":"Gautam Jesrani, Samiksha Gupta, S. Gaba, Monica Gupta","doi":"10.4103/2221-6189.342660","DOIUrl":"https://doi.org/10.4103/2221-6189.342660","url":null,"abstract":"Cardiovascular manifestations and electrocardiographic abnormalities have been reported among some prevalent infections in tropical regions, which lead to a great amount of morbidity and mortality. The major infectious diseases include chikungunya, dengue fever, H1N1 influenza, and coronavirus disease-19 (COVID- 19) in the viral category, leptospirosis, salmonellosis, scrub typhus and tuberculosis in the bacterial category, and malaria in the protozoan parasite category. All these infirmities constitute a foremost infection burden worldwide and have been linked to the various cardiac rhythm aberrancies. So we aimed to identify and compile different studies on these infections and associated acute electrocardiographic (ECG) changes. The search was made in online international libraries like PubMed, Google Scholar, and EMBASE, and 38 most relevant articles, including original research, systematic reviews, and unique case reports were selected. All of them were evaluated thoroughly and information regarding ECG was collected. Myocarditis is the predominant underlying pathology for rhythm disturbance and can be affected either due to the direct pathogenic effect or the abnormal immune system activation. ECG variabilities in some infections like chikungunya, scrub typhus, and leptospirosis are associated with longer hospital stay and poor outcome. Tropical infective diseases are associated with prominent acute cardiac rhythm abnormalities due to myocarditis, which can be identified preliminarily by ECG changes.","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"11 1","pages":"45 - 51"},"PeriodicalIF":0.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45040535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01DOI: 10.4103/2221-6189.342662
Manpreet Singh, A. Tiwari, Priya Taank, Shalendra Singh, Amrinder Kaur, M. Sood, Rahul Yadav
Objective: To compare the safety and efficacy of dexmedetomidine and dexamethasone for the prevention of postoperative nausea and vomiting (PONV) in patients scheduled for laparoscopic surgery. Methods: A total of 86 female patients were prospectively administered dexmedetomidine 1 μg/kg i.v. (the group A, n=43), and dexamethasone 8 mg i.v. (the group B, n=43). The two groups were compared in treatment response, hemodynamic changes, and Numerical Analog Scale (NAS). Besides, the relation of PONV with patient baseline characteristics in the perioperative period was determined as well. Results: Patients in group A had lower PONV scores (t=3.1, P<0.002), less needs for rescue anti-emetics (χ2=0.47, P<0.001), and decreased intraoperative heart rate (t=9.72, P<0.001) and mean arterial pressure (t=7.58, P<0.001) compared to that of group B. Group A reported lower NAS than group B (t=2.66, P<0.001). In addition, we found no relationship between PONV score and rescue anti-emetic requirement, age, or body mass index (P=0.96, P=0.60, P=0.28, respectively). Conclusion: Dexmedetomidine could be used as an effective antiemetic in laparoscopic surgeries, with better efficacy than dexamethasone. Dexmedetomidine not only can reduce PONV but also is effective in postoperative analgesia.
{"title":"Comparative study on effects of dexmedetomidine and dexamethasone on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic surgery","authors":"Manpreet Singh, A. Tiwari, Priya Taank, Shalendra Singh, Amrinder Kaur, M. Sood, Rahul Yadav","doi":"10.4103/2221-6189.342662","DOIUrl":"https://doi.org/10.4103/2221-6189.342662","url":null,"abstract":"Objective: To compare the safety and efficacy of dexmedetomidine and dexamethasone for the prevention of postoperative nausea and vomiting (PONV) in patients scheduled for laparoscopic surgery. Methods: A total of 86 female patients were prospectively administered dexmedetomidine 1 μg/kg i.v. (the group A, n=43), and dexamethasone 8 mg i.v. (the group B, n=43). The two groups were compared in treatment response, hemodynamic changes, and Numerical Analog Scale (NAS). Besides, the relation of PONV with patient baseline characteristics in the perioperative period was determined as well. Results: Patients in group A had lower PONV scores (t=3.1, P<0.002), less needs for rescue anti-emetics (χ2=0.47, P<0.001), and decreased intraoperative heart rate (t=9.72, P<0.001) and mean arterial pressure (t=7.58, P<0.001) compared to that of group B. Group A reported lower NAS than group B (t=2.66, P<0.001). In addition, we found no relationship between PONV score and rescue anti-emetic requirement, age, or body mass index (P=0.96, P=0.60, P=0.28, respectively). Conclusion: Dexmedetomidine could be used as an effective antiemetic in laparoscopic surgeries, with better efficacy than dexamethasone. Dexmedetomidine not only can reduce PONV but also is effective in postoperative analgesia.","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"11 1","pages":"59 - 64"},"PeriodicalIF":0.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49609213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/2221-6189.347783
R. Hota, Shalendra Singh, Rakesh Sharma, P. Khandare
{"title":"A rare fatal case of rabies coexisting with COVID-19","authors":"R. Hota, Shalendra Singh, Rakesh Sharma, P. Khandare","doi":"10.4103/2221-6189.347783","DOIUrl":"https://doi.org/10.4103/2221-6189.347783","url":null,"abstract":"","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70255289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/2221-6189.336579
L. Safaeian, B. Zolfaghari, Zahra Haghighatian, M. Etebari, Tahereh Nasirimoghadam
Objective: To assess the potential toxicity of hydroalcoholic extract of Allium affine (A. affine) aerial parts after acute and sub-acute administration in female and male Wistar rats. Methods: For acute toxicity assay, animals orally received the limit test dose of 2 000 mg/kg of A. affine extract and were observed for 2 weeks. For sub-acute toxicity study, rats were orally treated with 125, 250, and 500 mg/kg/day of the extract over 28 days, and hematological, biochemical, and histological evaluations were then conducted. Results: All rats were alive with normal body weight gain over 14 days, with LD50>2 000 mg/kg. No abnormality in body weight changes but significant increases in the relative weight of spleen and lung were detected after administration of the highest dose of extract for 28 days in sub-acute assay. Hematological analysis showed prominent elevations in total white blood cells in male rats and neutrophils count in female rats after exposure to 500 mg/kg of A. affine extract. In biochemical evaluations, significant increases in serum creatinine level (female rats, 250 and 500 mg/kg) and in aspartate aminotransferase (male and female rate, 500 mg/kg) and alanine aminotransferase (male, 250 and 500 mg/kg and female, 500 mg/kg) activities, however, notable decreases in serum blood glucose (male rats, 125 and 500 mg/kg), triglycerides (male rats, 500 mg/kg and female rates, 250 mg/kg), and low-density lipoprotein cholesterol levels (male, 250 mg/kg) were found. Histological examinations presented slight portal inflammation in liver tissue, moderate pneumocyte hyperplasia, congestion and peri-bronchial inflammation in lung tissue, and mild histiocytosis and lymphoid follicular activation in spleen tissue after exposure to 500 mg/kg of A. affine extract in male and female animals. Conclusions: The present investigation reveals the safety of A. affine extract at doses of lower than 250 mg/kg in rats and monitoring of lung, spleen, and liver functions is suggested during excessive and prolonged uses.
{"title":"Acute and sub-acute toxicities of hydroalcoholic extract of Allium affine aerial parts in rats","authors":"L. Safaeian, B. Zolfaghari, Zahra Haghighatian, M. Etebari, Tahereh Nasirimoghadam","doi":"10.4103/2221-6189.336579","DOIUrl":"https://doi.org/10.4103/2221-6189.336579","url":null,"abstract":"Objective: To assess the potential toxicity of hydroalcoholic extract of Allium affine (A. affine) aerial parts after acute and sub-acute administration in female and male Wistar rats. Methods: For acute toxicity assay, animals orally received the limit test dose of 2 000 mg/kg of A. affine extract and were observed for 2 weeks. For sub-acute toxicity study, rats were orally treated with 125, 250, and 500 mg/kg/day of the extract over 28 days, and hematological, biochemical, and histological evaluations were then conducted. Results: All rats were alive with normal body weight gain over 14 days, with LD50>2 000 mg/kg. No abnormality in body weight changes but significant increases in the relative weight of spleen and lung were detected after administration of the highest dose of extract for 28 days in sub-acute assay. Hematological analysis showed prominent elevations in total white blood cells in male rats and neutrophils count in female rats after exposure to 500 mg/kg of A. affine extract. In biochemical evaluations, significant increases in serum creatinine level (female rats, 250 and 500 mg/kg) and in aspartate aminotransferase (male and female rate, 500 mg/kg) and alanine aminotransferase (male, 250 and 500 mg/kg and female, 500 mg/kg) activities, however, notable decreases in serum blood glucose (male rats, 125 and 500 mg/kg), triglycerides (male rats, 500 mg/kg and female rates, 250 mg/kg), and low-density lipoprotein cholesterol levels (male, 250 mg/kg) were found. Histological examinations presented slight portal inflammation in liver tissue, moderate pneumocyte hyperplasia, congestion and peri-bronchial inflammation in lung tissue, and mild histiocytosis and lymphoid follicular activation in spleen tissue after exposure to 500 mg/kg of A. affine extract in male and female animals. Conclusions: The present investigation reveals the safety of A. affine extract at doses of lower than 250 mg/kg in rats and monitoring of lung, spleen, and liver functions is suggested during excessive and prolonged uses.","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"11 1","pages":"32 - 41"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43555891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/2221-6189.347780
N. Pursnani, P. Agrawal, A. Gautam, Anjana Pandey, Harendra Kumar
Rationale: COVID-19 usually presents with flu-like symptoms and signs, but some rare presentations like leukemoid symptoms cannot be ignored. Patient's concerns: A 37-year-old female presented to the outpatient department with flu-like symptoms. Diagnosis: The RT-PCR test for SARS-CoV-2 infection was positive, while complete blood cell and peripheral blood smear showed leukemoid reaction. Intervention: Paracetamol and fexofenadine for flu-like symptoms and leukemoid presentation. Outcomes: On the 10th day, the patient was asymptomatic and RT-PCR was negative. So the patient was discharged and leukemoid presentation subsided after clearance of viral disease. Lessons: COVID-19 has a myriad of presentations, and unusual symptoms/signs especially in this pandemic could be induced by COVID-19 infection.
{"title":"Leukemoid reaction in a patient with COVID-19 infection: A case report","authors":"N. Pursnani, P. Agrawal, A. Gautam, Anjana Pandey, Harendra Kumar","doi":"10.4103/2221-6189.347780","DOIUrl":"https://doi.org/10.4103/2221-6189.347780","url":null,"abstract":"Rationale: COVID-19 usually presents with flu-like symptoms and signs, but some rare presentations like leukemoid symptoms cannot be ignored. Patient's concerns: A 37-year-old female presented to the outpatient department with flu-like symptoms. Diagnosis: The RT-PCR test for SARS-CoV-2 infection was positive, while complete blood cell and peripheral blood smear showed leukemoid reaction. Intervention: Paracetamol and fexofenadine for flu-like symptoms and leukemoid presentation. Outcomes: On the 10th day, the patient was asymptomatic and RT-PCR was negative. So the patient was discharged and leukemoid presentation subsided after clearance of viral disease. Lessons: COVID-19 has a myriad of presentations, and unusual symptoms/signs especially in this pandemic could be induced by COVID-19 infection.","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70254346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/2221-6189.336576
Akbar Sheikhrabori, H. Peyrovi, H. Khankeh, P. Kolivand
Objective: To identify the influential factors of healthcare staff resilience in disasters. Methods: In this qualitative study, the influential factors of healthcare staff resilience in disasters were investigated through interviewing 20 experts. The interviews were conducted face-to-face, and MAXQDA software version 10 was used to organize the data and thematic analysis. Results: The participants included 5 medical emergency technicians, 5 physicians, 2 Red Crescent technicians, and 8 nurses. The main influential factors of healthcare providers’ resilience were limited relief infrastructure, supportive empowerment, organizational capitals, and contradictory consequences. Other important factors were resource limitation, confusion and uncertainty, empowerment training, comprehensive support, human and value capital, social capital, physical capital, suffering, disability, calm, and excellence. Conclusion: Improving healthcare providers’ resilience can be achieved by reducing uncertainty, providing the physical, economic, and human resources, strengthening motivation and comprehensive supports. It is suggested that disaster managers consider all identified dimensions to improve the resilience of healthcare providers to serve better in disasters. Moreover, researchers should study each dimension to provide profound knowledge regarding resilience in disasters.
{"title":"Influential factors of healthcare provider resilience in disasters: A thematic analysis","authors":"Akbar Sheikhrabori, H. Peyrovi, H. Khankeh, P. Kolivand","doi":"10.4103/2221-6189.336576","DOIUrl":"https://doi.org/10.4103/2221-6189.336576","url":null,"abstract":"Objective: To identify the influential factors of healthcare staff resilience in disasters. Methods: In this qualitative study, the influential factors of healthcare staff resilience in disasters were investigated through interviewing 20 experts. The interviews were conducted face-to-face, and MAXQDA software version 10 was used to organize the data and thematic analysis. Results: The participants included 5 medical emergency technicians, 5 physicians, 2 Red Crescent technicians, and 8 nurses. The main influential factors of healthcare providers’ resilience were limited relief infrastructure, supportive empowerment, organizational capitals, and contradictory consequences. Other important factors were resource limitation, confusion and uncertainty, empowerment training, comprehensive support, human and value capital, social capital, physical capital, suffering, disability, calm, and excellence. Conclusion: Improving healthcare providers’ resilience can be achieved by reducing uncertainty, providing the physical, economic, and human resources, strengthening motivation and comprehensive supports. It is suggested that disaster managers consider all identified dimensions to improve the resilience of healthcare providers to serve better in disasters. Moreover, researchers should study each dimension to provide profound knowledge regarding resilience in disasters.","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"11 1","pages":"12 - 17"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45014273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/2221-6189.336578
Rajinder P. Sharma, I. Chowdhary, Ankita Sharma
Objectives: To determine the occurrence of arrhythmia and its associated risk factors in the first week after acute myocardial infarction (MI). Methods: A total of 100 patients with acute MI were recruited, who were followed up for one week to determine the occurrence of arrhythmia and its association with electrolyte disturbances, left ventricular ejection fraction (LVEF), and demographic factors. Univariate and multivariate logistic regression was used to identify significant risk factors of arrhythmia. Results: Among 100 cases, arrhythmia was seen in 27 patients. Sinus tachycardia was the commonest, followed by ventricular premature beats and sinus bradycardia. Ejection fraction, serum calcium and magnesium were significantly different between non-arrhythmia and arrhythmia patients (P<0.05). Multivariate logistic regression analysis showed that ejection fraction was an independent significant risk factor of arrhythmia. Patients with ejection fraction >40% had a significantly lower risk of arrhythmia with an adjusted odds ratio of 0.22 (95% CI: 0.08 to 0.64). Conclusions: Arrhythmia is common in the first week after myocardial infarction. The type of arrhythmia and the type of block may depend on the heart muscles involved during myocardial infarction. Ejection fraction is a risk factor that may affect the occurrence of arrhythmia.
{"title":"Arrhythmia and its risk factors post myocardial infarction: A prospective study","authors":"Rajinder P. Sharma, I. Chowdhary, Ankita Sharma","doi":"10.4103/2221-6189.336578","DOIUrl":"https://doi.org/10.4103/2221-6189.336578","url":null,"abstract":"Objectives: To determine the occurrence of arrhythmia and its associated risk factors in the first week after acute myocardial infarction (MI). Methods: A total of 100 patients with acute MI were recruited, who were followed up for one week to determine the occurrence of arrhythmia and its association with electrolyte disturbances, left ventricular ejection fraction (LVEF), and demographic factors. Univariate and multivariate logistic regression was used to identify significant risk factors of arrhythmia. Results: Among 100 cases, arrhythmia was seen in 27 patients. Sinus tachycardia was the commonest, followed by ventricular premature beats and sinus bradycardia. Ejection fraction, serum calcium and magnesium were significantly different between non-arrhythmia and arrhythmia patients (P<0.05). Multivariate logistic regression analysis showed that ejection fraction was an independent significant risk factor of arrhythmia. Patients with ejection fraction >40% had a significantly lower risk of arrhythmia with an adjusted odds ratio of 0.22 (95% CI: 0.08 to 0.64). Conclusions: Arrhythmia is common in the first week after myocardial infarction. The type of arrhythmia and the type of block may depend on the heart muscles involved during myocardial infarction. Ejection fraction is a risk factor that may affect the occurrence of arrhythmia.","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"11 1","pages":"26 - 31"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44975407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/2221-6189.336575
Xinghui Wu, J. Yao, Jin Qian, Qifeng Huang, Tang Deng, Shuangqing Xu, Hangfei Wang, Qi Li, Jiabin Peng, Yang Yi, Nan Li, Yue Huang, Xiaoran Liu
Objective: To systematically evaluate the incidence of adverse reactions to coronavirus disease 2019 (COVID-19) vaccination. Methods: We systematically searched PubMed, Embase, The Cochrane Library, Web of Science, CNKI, WanFang Data, and VIP Database from the inception of each database to August 31, 2021. Randomized controlled clinical trials (RCTs) on the safety of different types of COVID-19 vaccines were retrieved and analyzed. A random or fixed-effects model was used with an odds ratio as the effect size. The quality of each reference was evaluated. The incidence of the adverse reactions of the placebo group and the vaccination group was compared. Heterogeneity and publication bias were taken care of by meta-regression and sub-group analyses. Results: A total of 13 articles were included, with 81 287 subjects. Compared with the placebo group, the vaccination group showed a higher combined risk ratio (RR) of total adverse reactions (RR=1.67, 95% CI: 1.46-1.91, P<0.01), local adverse reactions (RR=2.86, 95% CI: 2.11-3.87, P<0.01), systemic adverse reactions (RR=1.25, 95% CI: 0.92-1.72, P=0.16), pain (RR=2.55, 95% CI: 1.75-3.70, P<0.01), swelling (RR=4.16, 95% CI: 1.71-10.17, P=0.002, fever (RR=2.34, 95% CI: 1.84-2.97, P<0.01), fatigue (RR=1.36, 95% CI: 1.32-1.41, P<0.01) and headache (RR=1.22, 95% CI: 1.18-1.26, P<0.01). The subgroup analysis showed the incidence of adverse reactions of the vaccination group after injection of the three COVID-19 vaccines (inactivated viral vaccines, mRNA vaccines and adenovirus vector vaccines) was higher than that of the placebo group, and the difference between the placebo group and the vaccination group in the mRNA vaccine subgroup and the adenovirus vector vaccine subgroup was statistically significant (P<0.01). The incidence of adverse reactions after injection of COVID-19 vaccine in subgroups of different ages was significantly higher than that in the placebo group (P<0.01). Conclusions: COVID-19 vaccines have a good safety, among which adenovirus vector vaccine has the highest incidence of adverse reactions. Both adolescents and adults vaccinated with novel coronavirus vaccine have a certain proportion of adverse reactions, but the symptoms are mild and can be relieved by themselves. Our meta-analysis can help boost global awareness of vaccine safety, promote mass vaccination, help build regional and global immune barriers and effectively curb the recurrency of COVID-19.
目的：系统评价2019冠状病毒病（新冠肺炎）疫苗接种不良反应发生率。方法：系统检索PubMed、Embase、The Cochrane Library、Web of Science、CNKI、万方数据和VIP数据库，从每个数据库成立到2021年8月31日。检索并分析了不同类型新冠肺炎疫苗安全性的随机对照临床试验（RCT）。使用随机或固定效应模型，优势比作为效应大小。评估每个参考文献的质量。比较安慰剂组和疫苗接种组的不良反应发生率。通过元回归和亚组分析来处理异质性和发表偏倚。结果：共收录13篇文章，受试者81287人。与安慰剂组相比，疫苗接种组在总不良反应（RR=1.67，95%CI:1.46-1.91，P<0.01）、局部不良反应（RR=2.86，95%CI:2.11-3.87，P<0.01），全身不良反应（RR=1.25，95%CI:0.92-1.72，P=0.16），疼痛（RR=2.55，95%CI:1.75-3.70，P<0.01），肿胀（RR=4.16，95%CI:1.71-10.17，P=0.002），发烧（RR=2.34，95%CI:1.84-2.97，P<0.01），亚组分析显示，接种组注射三种新冠肺炎疫苗（灭活病毒疫苗、mRNA疫苗和腺病毒载体疫苗）后不良反应发生率均高于安慰剂组，mRNA疫苗亚组和腺病毒载体疫苗亚组与安慰剂组比较差异有统计学意义（P<0.01），不同年龄亚组注射新冠肺炎疫苗后不良反应发生率显著高于安慰剂组（P<0.01）安全性，其中腺病毒载体疫苗不良反应发生率最高。接种新型冠状病毒疫苗的青少年和成年人都有一定比例的不良反应，但症状轻微，可自行缓解。我们的荟萃分析可以帮助提高全球对疫苗安全性的认识，促进大规模疫苗接种，帮助建立区域和全球免疫屏障，并有效遏制新冠肺炎的复发。
{"title":"Incidence of adverse reactions to COVID-19 vaccination: A meta-analysis of randomized controlled trials","authors":"Xinghui Wu, J. Yao, Jin Qian, Qifeng Huang, Tang Deng, Shuangqing Xu, Hangfei Wang, Qi Li, Jiabin Peng, Yang Yi, Nan Li, Yue Huang, Xiaoran Liu","doi":"10.4103/2221-6189.336575","DOIUrl":"https://doi.org/10.4103/2221-6189.336575","url":null,"abstract":"Objective: To systematically evaluate the incidence of adverse reactions to coronavirus disease 2019 (COVID-19) vaccination. Methods: We systematically searched PubMed, Embase, The Cochrane Library, Web of Science, CNKI, WanFang Data, and VIP Database from the inception of each database to August 31, 2021. Randomized controlled clinical trials (RCTs) on the safety of different types of COVID-19 vaccines were retrieved and analyzed. A random or fixed-effects model was used with an odds ratio as the effect size. The quality of each reference was evaluated. The incidence of the adverse reactions of the placebo group and the vaccination group was compared. Heterogeneity and publication bias were taken care of by meta-regression and sub-group analyses. Results: A total of 13 articles were included, with 81 287 subjects. Compared with the placebo group, the vaccination group showed a higher combined risk ratio (RR) of total adverse reactions (RR=1.67, 95% CI: 1.46-1.91, P<0.01), local adverse reactions (RR=2.86, 95% CI: 2.11-3.87, P<0.01), systemic adverse reactions (RR=1.25, 95% CI: 0.92-1.72, P=0.16), pain (RR=2.55, 95% CI: 1.75-3.70, P<0.01), swelling (RR=4.16, 95% CI: 1.71-10.17, P=0.002, fever (RR=2.34, 95% CI: 1.84-2.97, P<0.01), fatigue (RR=1.36, 95% CI: 1.32-1.41, P<0.01) and headache (RR=1.22, 95% CI: 1.18-1.26, P<0.01). The subgroup analysis showed the incidence of adverse reactions of the vaccination group after injection of the three COVID-19 vaccines (inactivated viral vaccines, mRNA vaccines and adenovirus vector vaccines) was higher than that of the placebo group, and the difference between the placebo group and the vaccination group in the mRNA vaccine subgroup and the adenovirus vector vaccine subgroup was statistically significant (P<0.01). The incidence of adverse reactions after injection of COVID-19 vaccine in subgroups of different ages was significantly higher than that in the placebo group (P<0.01). Conclusions: COVID-19 vaccines have a good safety, among which adenovirus vector vaccine has the highest incidence of adverse reactions. Both adolescents and adults vaccinated with novel coronavirus vaccine have a certain proportion of adverse reactions, but the symptoms are mild and can be relieved by themselves. Our meta-analysis can help boost global awareness of vaccine safety, promote mass vaccination, help build regional and global immune barriers and effectively curb the recurrency of COVID-19.","PeriodicalId":45984,"journal":{"name":"Journal of Acute Disease","volume":"11 1","pages":"1 - 11"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43123490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：