Pub Date : 2021-05-01DOI: 10.4103/jopcs.jopcs_4_20
Divija Sharma, B. Khandelwal, S. Kar
Background and Objectives: Diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) are common disorders that not only often coexist but also have a bidirectional association where each condition exacerbates the other. The present study was performed to ascertain the occurrence and predictors of risk factors of OSA in patients with type 2DM. Materials and Methods: A cross-sectional hospital-based study recruiting 164 patients for over 2 months was conducted, in which each diabetic patient was assigned to complete a questionnaire on various variables followed by a general physical examination for associated comorbidities diabetic complications (neuropathy, nephropathy, and retinopathy). Their fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were recorded, following which they were administered and assessed using Berlin Questionnaire and Epworth Sleepiness Score for risk category and daytime sleepiness. Patients with already diagnosed OSA including ones receiving treatment for it were excluded from the study. Results: Of the 164 diabetic patients recruited in the study, 64 (39%) were at high risk for OSA in contrast to the 100 (61%) who were at low risk for OSA. Neck circumference, waist circumference, presence of hypertension and more than one comorbidities along with patients who experienced witnessed apnea at least three times a week, excessive daytime sleepiness, and habitual snorers found to be significant risk factors and practices in posing DM patients at a higher risk for OSA. Patients with body mass index ≥25 were more likely to have a high risk of OSA. FBG and HbA1c were not significant risk factors for OSA. Conclusions: OSA has a high prevalence in subjects with T2DM which reinforces the clinicians to remain observant for signs and symptoms of OSA in diabetic patients and monitor their compliance in terms of weight management, diet control, and medication adherence.
{"title":"A cross-sectional study to assess the risk factors for the presence and severity of obstructive sleep apnea among patients with type 2 diabetes mellitus at a tertiary care hospital, Gangtok","authors":"Divija Sharma, B. Khandelwal, S. Kar","doi":"10.4103/jopcs.jopcs_4_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_4_20","url":null,"abstract":"Background and Objectives: Diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) are common disorders that not only often coexist but also have a bidirectional association where each condition exacerbates the other. The present study was performed to ascertain the occurrence and predictors of risk factors of OSA in patients with type 2DM. Materials and Methods: A cross-sectional hospital-based study recruiting 164 patients for over 2 months was conducted, in which each diabetic patient was assigned to complete a questionnaire on various variables followed by a general physical examination for associated comorbidities diabetic complications (neuropathy, nephropathy, and retinopathy). Their fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were recorded, following which they were administered and assessed using Berlin Questionnaire and Epworth Sleepiness Score for risk category and daytime sleepiness. Patients with already diagnosed OSA including ones receiving treatment for it were excluded from the study. Results: Of the 164 diabetic patients recruited in the study, 64 (39%) were at high risk for OSA in contrast to the 100 (61%) who were at low risk for OSA. Neck circumference, waist circumference, presence of hypertension and more than one comorbidities along with patients who experienced witnessed apnea at least three times a week, excessive daytime sleepiness, and habitual snorers found to be significant risk factors and practices in posing DM patients at a higher risk for OSA. Patients with body mass index ≥25 were more likely to have a high risk of OSA. FBG and HbA1c were not significant risk factors for OSA. Conclusions: OSA has a high prevalence in subjects with T2DM which reinforces the clinicians to remain observant for signs and symptoms of OSA in diabetic patients and monitor their compliance in terms of weight management, diet control, and medication adherence.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"241 1","pages":"48 - 54"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77045421","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 : 2021-01-01DOI: 10.4103/jopcs.jopcs_3_20
A. Rathi, Vikas Kumar, J. Majhi, N. Jayaraj, Satyavir Singh
Introduction: When doctors assume the role of a researcher, then they have to play from both ends – many times, the enthusiasm of research might play with morality of a physician. The quality of research in India is not at par with most countries and it has a publication share of only 1.59%. Objectives: The objectives were to find out the research practices of doctors to identify loopholes in research and recommend rectifications. Materials and Methods: It is a cross-sectional study done with the help of an anonymous online pretested questionnaire. The questionnaire was randomly mailed from a mailing list to 500 doctors of different places and specialties and 100 of them filled the form and participated in the study. Results: Out of the 100 participants, 77 (77%) said that they had received some training or have attended some workshop on research methodology. More than one-fourth of the researchers agreed to modifying data to get desired results and 14% agreed to producing false data owing to the pressure by a supervisor. Almost one-third of the researchers agreed to having deliberately ignored bias or errors in their studies. Twenty-three percent revealed that they do not always take informed consent from their study subjects. More than one-third researchers revealed that they do not seek the permission of the institutional ethics committee (IEC) before commencing a study. The proportion of researchers having low, medium, or high good research practices score is 15.4%, 21.8%, and 62.8%, respectively. Conclusion: Majority of researchers indulge in misconduct, knowing, and unknowingly. These issues need to be tackled through capacity building, training of investigators and IEC members, strengthening of IEC functioning, and encouraging greater community participation.
{"title":"A cross-sectional study on research practices among doctors in India","authors":"A. Rathi, Vikas Kumar, J. Majhi, N. Jayaraj, Satyavir Singh","doi":"10.4103/jopcs.jopcs_3_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_3_20","url":null,"abstract":"Introduction: When doctors assume the role of a researcher, then they have to play from both ends – many times, the enthusiasm of research might play with morality of a physician. The quality of research in India is not at par with most countries and it has a publication share of only 1.59%. Objectives: The objectives were to find out the research practices of doctors to identify loopholes in research and recommend rectifications. Materials and Methods: It is a cross-sectional study done with the help of an anonymous online pretested questionnaire. The questionnaire was randomly mailed from a mailing list to 500 doctors of different places and specialties and 100 of them filled the form and participated in the study. Results: Out of the 100 participants, 77 (77%) said that they had received some training or have attended some workshop on research methodology. More than one-fourth of the researchers agreed to modifying data to get desired results and 14% agreed to producing false data owing to the pressure by a supervisor. Almost one-third of the researchers agreed to having deliberately ignored bias or errors in their studies. Twenty-three percent revealed that they do not always take informed consent from their study subjects. More than one-third researchers revealed that they do not seek the permission of the institutional ethics committee (IEC) before commencing a study. The proportion of researchers having low, medium, or high good research practices score is 15.4%, 21.8%, and 62.8%, respectively. Conclusion: Majority of researchers indulge in misconduct, knowing, and unknowingly. These issues need to be tackled through capacity building, training of investigators and IEC members, strengthening of IEC functioning, and encouraging greater community participation.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"51 1","pages":"16 - 20"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79918188","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 : 2021-01-01DOI: 10.4103/jopcs.jopcs_11_20
Arvind Sharma, Deepali Soni, P. Dubey, Richa Sharma, Aditi Bharti, T. Singh
Background: In the scenario of the COVID-19 pandemic, it is important to assess the quality of care that is being provided to COVID-19 positive patients as the health-care quality plays a crucial role in winning over any health crisis. Objective: This study aims to assess satisfaction among COVID-19 positive patients in a tertiary care hospital. Methodology: A retrospective cross-sectional study was done on COVID-19 positive patients admitted in a tertiary hospital of central India. Sample size was calculated by using the following formula: n = Z2 pq/d2, which came out to be 113. Simple random sampling was done to select the patients. A quantitative structured interview schedule was used to collect data. Results: Majority of the respondents were satisfied with the available amenities, clinical care, and behavior of health-care providers except services regarding linen, toilet, and doctors' explanation of illness and treatment. Overall impression of the visit was excellent to good according to 84% of the respondents. On inquiring the likelihood of recommending this hospital to others, 91.3% of the respondents gave a positive reply. Conclusion: Improvement is needed in linen and toilet facilities. Patients should be counseled via telephones regarding their illness and treatment if this is not possible face to face as the treating physicians are in personal protective equipment kits and it is quite difficult to interact while wearing these kits. Patient satisfaction surveys should be institutionalized periodically.
{"title":"Satisfaction among COVID-19 positive patients: A study in a tertiary care hospital in central India","authors":"Arvind Sharma, Deepali Soni, P. Dubey, Richa Sharma, Aditi Bharti, T. Singh","doi":"10.4103/jopcs.jopcs_11_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_11_20","url":null,"abstract":"Background: In the scenario of the COVID-19 pandemic, it is important to assess the quality of care that is being provided to COVID-19 positive patients as the health-care quality plays a crucial role in winning over any health crisis. Objective: This study aims to assess satisfaction among COVID-19 positive patients in a tertiary care hospital. Methodology: A retrospective cross-sectional study was done on COVID-19 positive patients admitted in a tertiary hospital of central India. Sample size was calculated by using the following formula: n = Z2 pq/d2, which came out to be 113. Simple random sampling was done to select the patients. A quantitative structured interview schedule was used to collect data. Results: Majority of the respondents were satisfied with the available amenities, clinical care, and behavior of health-care providers except services regarding linen, toilet, and doctors' explanation of illness and treatment. Overall impression of the visit was excellent to good according to 84% of the respondents. On inquiring the likelihood of recommending this hospital to others, 91.3% of the respondents gave a positive reply. Conclusion: Improvement is needed in linen and toilet facilities. Patients should be counseled via telephones regarding their illness and treatment if this is not possible face to face as the treating physicians are in personal protective equipment kits and it is quite difficult to interact while wearing these kits. Patient satisfaction surveys should be institutionalized periodically.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"28 1","pages":"10 - 15"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78640162","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 : 2021-01-01DOI: 10.4103/jopcs.jopcs_1_20
Sudip Bhattacharya, S. Saleem, R. Juyal, R. Kaur, Amarjeet Singh
“Texting neck” or “iNeck pain” syndrome is emerging as a public health threat globally because of our adjustment to a NEW NORMAL existence (work-from-home culture) because of the COVID-19 pandemic. This term coined by Dr. Dean L. Fishman, “text neck,” refers to overuse syndrome or a repetitive stress injury, in which we have our head hung forward and down looking at our cellular electronic device for prolonged durations. In our normal anatomical position, neck muscle groups are designed to endure the load of our head, which is about 10–12 pounds and when we bend our head ahead for an inch, we double the weight on these neck muscle groups. The signs and symptoms vary from continual nagging ache to muscle fatigue and limited variety of neck movements. For handling “Texting neck” or “iNeck ache” syndrome, nonpharmacological and pharmacological treatment alternatives are available. The burden of neck pain is already high in countries such as Norway, Finland, and Denmark. It is emerging as a public health problem in other countries also, thanks to work-from-home culture in the COVID-19 era. Few studies have revealed that the awareness for texting neck is poor among poor countries, and increasing population awareness about the risk factors and preventive measures for neck pain is the only way to tackle this emerging threat.
“短信脖”或“颈部疼痛”综合征正在成为全球公共卫生威胁，因为我们正在适应新常态(在家工作文化)。迪安·l·菲什曼(Dean L. Fishman)博士创造的“短信脖”一词，指的是过度使用综合症或重复性应激性损伤，这种情况下，我们的头一直向前或向下垂着，长时间盯着手机。在我们正常的解剖位置，颈部肌肉群被设计来承受我们头部的负荷，大约是10-12磅，当我们向前弯曲一英寸时，颈部肌肉群的重量就会增加一倍。体征和症状各不相同，从持续的唠叨疼痛到肌肉疲劳和颈部活动有限。对于“短信脖”或“颈痛”综合症，有非药物和药物治疗方案可供选择。在挪威、芬兰和丹麦等国家，颈部疼痛的负担已经很高了。在其他国家，由于新冠肺炎时代的在家工作文化，这也成为了一个公共卫生问题。很少有研究表明，贫穷国家对短信脖的认识很差，提高人们对风险因素和预防颈部疼痛措施的认识是解决这一新兴威胁的唯一途径。
{"title":"“Texting neck” or “iNeck pain” syndrome – An emerging public health threat: In the era of NEW NORMAL","authors":"Sudip Bhattacharya, S. Saleem, R. Juyal, R. Kaur, Amarjeet Singh","doi":"10.4103/jopcs.jopcs_1_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_1_20","url":null,"abstract":"“Texting neck” or “iNeck pain” syndrome is emerging as a public health threat globally because of our adjustment to a NEW NORMAL existence (work-from-home culture) because of the COVID-19 pandemic. This term coined by Dr. Dean L. Fishman, “text neck,” refers to overuse syndrome or a repetitive stress injury, in which we have our head hung forward and down looking at our cellular electronic device for prolonged durations. In our normal anatomical position, neck muscle groups are designed to endure the load of our head, which is about 10–12 pounds and when we bend our head ahead for an inch, we double the weight on these neck muscle groups. The signs and symptoms vary from continual nagging ache to muscle fatigue and limited variety of neck movements. For handling “Texting neck” or “iNeck ache” syndrome, nonpharmacological and pharmacological treatment alternatives are available. The burden of neck pain is already high in countries such as Norway, Finland, and Denmark. It is emerging as a public health problem in other countries also, thanks to work-from-home culture in the COVID-19 era. Few studies have revealed that the awareness for texting neck is poor among poor countries, and increasing population awareness about the risk factors and preventive measures for neck pain is the only way to tackle this emerging threat.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"41 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74589876","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 : 2021-01-01DOI: 10.4103/jopcs.jopcs_1_21
Sudip Bhattacharya, S. Saleem, Amarjeet Singh
{"title":"COVID-19 vaccine: A battle with the uncertainties and infodemics","authors":"Sudip Bhattacharya, S. Saleem, Amarjeet Singh","doi":"10.4103/jopcs.jopcs_1_21","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_1_21","url":null,"abstract":"","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"24 1","pages":"21 - 23"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72549870","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 : 2021-01-01DOI: 10.4103/jopcs.jopcs_2_20
Sheikh Saleem, S. Khan, I. Haq, M. Qurieshi
Objectives of the Study: The objectives of the present study which was conducted in four districts of Kashmir valley (Anantnag, Baramulla, Budgam, and Srinagar) were to (1) estimate the “total goitre rate” (TGR) among schoolchildren in the age group of 6–12 years, (2) estimate the proportion of households with adequately iodized salt, and (3) to assess the dietary iodine intake by measuring urinary iodine levels. Study Design: Prospective, cross-sectional study. Methodology: The present study was conducted in the four districts of Kashmir Valley, namely Anantnag, Baramulla, Budgam, and Srinagar in March 2017. This was a school-based study among children in the age group of 6–12 years. For each district, 30 schools were randomly selected using Probability Proportionate to Size sampling. A total of 90 students (45 boys and 45 girls) were randomly selected from each school. Selected children were examined by trained doctors for the presence of goitre. Every 5th child in the school was selected for the collection of the salt sample from the child's house. Every 10th child in the school was selected for the collection of the urine sample for iodine estimation. Results: A total of 10,800 children in the age group of 6–12 years were examined in the four districts. The overall TGR for the four districts combined was 14.8%. The TGR was the highest in district Budgam (16.4%) and lowest in district Anantnag (13.8%). Across all districts, ≤1% of the examined children had a goitre of Grade II. In districts Baramulla, Budgam, and Srinagar, an increasing trend in TGR was observed with age. The median urinary iodine ranged from a minimum of 46.14 μg/L in district Baramulla to a maximum of 56.06 μg/L in district Anantnag. Conclusion: The TGR was high in all the four districts, way beyond the 10% iodine deficiency disorder control goal that was to be achieved by the year 2012. Moreover, the population level median urinary iodine was less than the recommended ≥100 μg/L in all the four districts. Except for district Anantnag, all three districts had median urinary iodine levels of <50 μg/L indicating moderate iodine deficiency.
{"title":"A cross-sectional survey of iodine deficiency disorders among school children (aged: 6–12 years) in Kashmir valley, Northern India","authors":"Sheikh Saleem, S. Khan, I. Haq, M. Qurieshi","doi":"10.4103/jopcs.jopcs_2_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_2_20","url":null,"abstract":"Objectives of the Study: The objectives of the present study which was conducted in four districts of Kashmir valley (Anantnag, Baramulla, Budgam, and Srinagar) were to (1) estimate the “total goitre rate” (TGR) among schoolchildren in the age group of 6–12 years, (2) estimate the proportion of households with adequately iodized salt, and (3) to assess the dietary iodine intake by measuring urinary iodine levels. Study Design: Prospective, cross-sectional study. Methodology: The present study was conducted in the four districts of Kashmir Valley, namely Anantnag, Baramulla, Budgam, and Srinagar in March 2017. This was a school-based study among children in the age group of 6–12 years. For each district, 30 schools were randomly selected using Probability Proportionate to Size sampling. A total of 90 students (45 boys and 45 girls) were randomly selected from each school. Selected children were examined by trained doctors for the presence of goitre. Every 5th child in the school was selected for the collection of the salt sample from the child's house. Every 10th child in the school was selected for the collection of the urine sample for iodine estimation. Results: A total of 10,800 children in the age group of 6–12 years were examined in the four districts. The overall TGR for the four districts combined was 14.8%. The TGR was the highest in district Budgam (16.4%) and lowest in district Anantnag (13.8%). Across all districts, ≤1% of the examined children had a goitre of Grade II. In districts Baramulla, Budgam, and Srinagar, an increasing trend in TGR was observed with age. The median urinary iodine ranged from a minimum of 46.14 μg/L in district Baramulla to a maximum of 56.06 μg/L in district Anantnag. Conclusion: The TGR was high in all the four districts, way beyond the 10% iodine deficiency disorder control goal that was to be achieved by the year 2012. Moreover, the population level median urinary iodine was less than the recommended ≥100 μg/L in all the four districts. Except for district Anantnag, all three districts had median urinary iodine levels of <50 μg/L indicating moderate iodine deficiency.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"17 1","pages":"4 - 9"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83912676","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 : 2020-09-01DOI: 10.4103/jopcs.jopcs_10_20
R. Reddy, Arvind Kumar, Komal Singh, N. Wig
{"title":"COVID-19 central sampling team: An experience from AIIMS, New Delhi","authors":"R. Reddy, Arvind Kumar, Komal Singh, N. Wig","doi":"10.4103/jopcs.jopcs_10_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_10_20","url":null,"abstract":"","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"8 1","pages":"24 - 25"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78987677","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 : 2020-09-01Epub Date: 2020-12-31DOI: 10.4103/jopcs.jopcs_14_20
Ritwik Ghosh, Swagatam Sengupta, Sk Minhajuddin Siraj, Julián Benito-León
Landolfi's sign, alternating systolic constriction and diastolic dilatation of pupils, is a clinical hallmark of aortic regurgitation. It is thought to stem from exacerbation of physiological circulatory hippus in the vessels of iris due to a wide pulse pressure in a backdrop of severe aortic valvular incompetence. Degenerative and rheumatic heart diseases are exquisitely common in rural India and often these patients turn up late with complications to the primary care physicians. Herein, the authors report a 34-year-old pregnant female who presented with acute heart failure, and on examination, Landolfi's sign was found. It was immediately followed by Doppler echocardiography to stamp it as a case of severe aortic regurgitation. The patient was stabilized with anti-failure medications and feto-maternal health was closely monitored. The authors want to conclude claiming that bedside clinical training in cardiology will forever remain important, more so, while dealing patients at non-sophisticated primary health-care facilities. Besides, they also argue that basic tool supports like an echocardiography should be made available at those centers.
{"title":"Landolfi's Sign: A Riddle for Primary Care Physicians.","authors":"Ritwik Ghosh, Swagatam Sengupta, Sk Minhajuddin Siraj, Julián Benito-León","doi":"10.4103/jopcs.jopcs_14_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_14_20","url":null,"abstract":"<p><p>Landolfi's sign, alternating systolic constriction and diastolic dilatation of pupils, is a clinical hallmark of aortic regurgitation. It is thought to stem from exacerbation of physiological circulatory hippus in the vessels of iris due to a wide pulse pressure in a backdrop of severe aortic valvular incompetence. Degenerative and rheumatic heart diseases are exquisitely common in rural India and often these patients turn up late with complications to the primary care physicians. Herein, the authors report a 34-year-old pregnant female who presented with acute heart failure, and on examination, Landolfi's sign was found. It was immediately followed by Doppler echocardiography to stamp it as a case of severe aortic regurgitation. The patient was stabilized with anti-failure medications and feto-maternal health was closely monitored. The authors want to conclude claiming that bedside clinical training in cardiology will forever remain important, more so, while dealing patients at non-sophisticated primary health-care facilities. Besides, they also argue that basic tool supports like an echocardiography should be made available at those centers.</p>","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"1 1","pages":"13-14"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40529379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.4103/jopcs.jopcs_13_20
Bharath Gangadharaiah, M. Sahu, Arvind Kumar, P. Ranjan, P. Sethi, N. Wig
Primary immunodeficiency diseases (PIDDs) comprise a group of genetic disorders which are characterized by abnormalities involving one or more components of the immune system. Most of them are diagnosed in children and adolescents. Advancement in medical management has resulted in most of these patients living till adulthood. Moreover, few PIDD patients are diagnosed for the first time in their adulthood. In most of the developing countries, where the prevalence of infectious disease is quite high, diagnosis of patients presenting in adulthood with PIDDs poses a major challenge. The diagnosis may be delayed or even missed altogether when they present late in adulthood. Hence, having in-depth knowledge regarding common PIDDs seen in this age group, the natural course of these diseases and the wide range of clinical spectrum with which these patients can present is quite imperative for a physician dealing with such patients. This case series provides the details of three such PIDD patients presenting in the late adolescence and adult age group, along with a comprehensive review on the common and uncommon infections occurring among PIDD patients in this age group.
{"title":"Insight into the challenges in diagnosis and management of infections in adults with primary immunodeficiency diseases: A study from AIIMS, New Delhi","authors":"Bharath Gangadharaiah, M. Sahu, Arvind Kumar, P. Ranjan, P. Sethi, N. Wig","doi":"10.4103/jopcs.jopcs_13_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_13_20","url":null,"abstract":"Primary immunodeficiency diseases (PIDDs) comprise a group of genetic disorders which are characterized by abnormalities involving one or more components of the immune system. Most of them are diagnosed in children and adolescents. Advancement in medical management has resulted in most of these patients living till adulthood. Moreover, few PIDD patients are diagnosed for the first time in their adulthood. In most of the developing countries, where the prevalence of infectious disease is quite high, diagnosis of patients presenting in adulthood with PIDDs poses a major challenge. The diagnosis may be delayed or even missed altogether when they present late in adulthood. Hence, having in-depth knowledge regarding common PIDDs seen in this age group, the natural course of these diseases and the wide range of clinical spectrum with which these patients can present is quite imperative for a physician dealing with such patients. This case series provides the details of three such PIDD patients presenting in the late adolescence and adult age group, along with a comprehensive review on the common and uncommon infections occurring among PIDD patients in this age group.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"47 1","pages":"18 - 23"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79773766","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 : 2020-09-01DOI: 10.4103/jopcs.jopcs_7_20
Arvind Sharma, T. Singh, Aditi Bharti, Richa Sharma, Deepali Soni, P. Dubey
Objective: The objective of the study was to assess mental health status among the family members of the COVID-19 patients and the severity of depression in the Jabalpur district, Madhya Pradesh. Setting and Design: A cross-sectional study was conducted among family members of COVID-19 patients admitted at a tertiary care center. Methodology: Out of 160 respondents, 130 have participated, and the remaining 30 were dropouts. Participants included one member from each family of confirmed COVID-19 cases admitted at a tertiary care hospital, preferably their spouse or first-degree members living in the same house, aged 18 years and above. The Patient Health Questionnaire-9 was used to determine depression and was completed through a telephonic platform survey. Statistical Analysis Used: SPSS 20.0 statistical software was used to analyze the data. Significance was determined at P < 0.05 and 95% confidence interval. Results: The majority of respondents, 61.5%, screened positive for depression. Among them, 46 were mildly depressed (35.4%), 28 were moderately depressed (21.5%), 4 were moderately severe depressed (3.1%), and two were severely depressed (1.5%). Females had approximately 4 times higher risk for depressive symptoms (P = 0.001). Conclusion: There is a need to emphasize the mental health of this vulnerable population. Our findings are also crucial in enabling the government to allocate health resources and offer appropriate treatment for family members who suffer mental health problems during the COVID-19 pandemic or any other infectious disease outbreak in the future.
{"title":"Mental health status among the family members of COVID-19 patients in Jabalpur District Madhya Pradesh: A Cross-sectional study","authors":"Arvind Sharma, T. Singh, Aditi Bharti, Richa Sharma, Deepali Soni, P. Dubey","doi":"10.4103/jopcs.jopcs_7_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_7_20","url":null,"abstract":"Objective: The objective of the study was to assess mental health status among the family members of the COVID-19 patients and the severity of depression in the Jabalpur district, Madhya Pradesh. Setting and Design: A cross-sectional study was conducted among family members of COVID-19 patients admitted at a tertiary care center. Methodology: Out of 160 respondents, 130 have participated, and the remaining 30 were dropouts. Participants included one member from each family of confirmed COVID-19 cases admitted at a tertiary care hospital, preferably their spouse or first-degree members living in the same house, aged 18 years and above. The Patient Health Questionnaire-9 was used to determine depression and was completed through a telephonic platform survey. Statistical Analysis Used: SPSS 20.0 statistical software was used to analyze the data. Significance was determined at P < 0.05 and 95% confidence interval. Results: The majority of respondents, 61.5%, screened positive for depression. Among them, 46 were mildly depressed (35.4%), 28 were moderately depressed (21.5%), 4 were moderately severe depressed (3.1%), and two were severely depressed (1.5%). Females had approximately 4 times higher risk for depressive symptoms (P = 0.001). Conclusion: There is a need to emphasize the mental health of this vulnerable population. Our findings are also crucial in enabling the government to allocate health resources and offer appropriate treatment for family members who suffer mental health problems during the COVID-19 pandemic or any other infectious disease outbreak in the future.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"13 1","pages":"8 - 12"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81537511","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}
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