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   Table of Contents - Current issue
September-December 2020
Volume 1 | Issue 1
Page Nos. 1-25

Online since Thursday, December 31, 2020

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Primary care specialties: Call for scholarship development during post-COVID period p. 1
Raman Kumar
Among medical specialties, family medicine, internal medicine, obstetrics & gynecology, pediatrics are traditionally considered primary care disciplines. Within the scope of service provision, a wider integration from the perspective of community needs is needed in the present times. Primary care providers also include nurse practitioners. Several subspecialties, such as preventive cardiology, also intersect the disciplinary boundaries of primary care.
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Factors leading to delayed testing from the time of symptom onset for COVID-19 by health-care personnel: A study from all india institute of medical sciences, New Delhi p. 3
JS Anuvindha, Vishwajeet Singh, Radhika Sarda, Vishal Kumar Vishwakarma, Aishee Pal, Bharathi Arunan, Shivam Goel, Piyush Ranjan, Arvind Kumar, Naveet Wig
Background and Objectives: Early testing and diagnosis of COVID-19 infection can help decrease the spread of the virus. Undoubtedly, health-care workers (HCWs) have been the frontline warriors in the COVID-19 pandemic and are at maximum risk of acquiring the infection. We thereby conducted this study to assess the factors that lead to delayed testing after symptom onset in health-care personnel. Methodology: This single-center, cross-sectional study was conducted at a dedicated COVID-19 Employee Health Services Outpatient Department at a tertiary care center, New Delhi, in July 2020. HCWs who were suspected COVID and presented for testing were included in the study. The duration between symptom onset and date of testing was noted. Delayed testing was defined as testing after 24 h from symptom onset. Results: A total of 653 HCWs were included in the study, and 55.9% were males. Female workers presented after a mean (standard deviation [SD]) of 3.43 days (1.91) from symptom onset as compared to male counterparts 3.16 days (1.84). Frontline HCWs who managed patients directly had delayed testing when compared to others at mean (SD) days of 3.46 (1.96) versus 3.13 (1.79), P = 0.04. Conclusion: In the ongoing COVID-19 pandemic, prevention and mitigation of the disease are still the mainstays of combating the disease, for the given fact that treatment and immunization still remain largely unanswered. All HCWs, irrespective of sex, age, and place of working, should be routinely reiterated, motivated, and reinforced for early testing in case of COVID-19-related symptoms.
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Mental health status among the family members of COVID-19 patients in Jabalpur District Madhya Pradesh: A Cross-sectional study Highly accessed article p. 8
Arvind Sharma, Tej Pratap Singh, Aditi Bharti, Richa Sharma, Deepali Soni, Priyanka 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.
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Landolfi's sign: A riddle for primary care physicians p. 13
Ritwik Ghosh, Swagatam Sengupta, S K 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.
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Autoimmune encephalitis, the great masquerader: A case report and review of successful outcome in a child Highly accessed article p. 15
Fadila , Praveen Kumar
Autoimmune encephalitis (AE) is an important and treatable cause of acute encephalitis. It may mimic other conditions of the central nervous system, including primary psychiatric disorders, particularly early in the disease course. Due to similarities in clinical, imaging, and laboratory findings between autoimmune and infectious encephalitis, as well as limited awareness and availability of specific antibody testing, AE remains an elusive, often underrecognized etiology. If left untreated, it may be fatal or leave significant morbidities, but with prompt recognition and sequential immunotherapy, the prognosis is encouraging despite a stormy disease course. We report a 4-year-old child with abnormal behavior and recurrent seizures who was referred as encephalitis and subsequently diagnosed as AE and managed at our hospital. He recovered well because of early identification and adequate management.
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Insight into the challenges in diagnosis and management of infections in adults with primary immunodeficiency diseases: A study from AIIMS, New Delhi p. 18
Bharath Gangadharaiah, Monalisa Sahu, Arvind Kumar, Piyush Ranjan, Prayas Sethi, Naveet 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.
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COVID-19 central sampling team: An experience from AIIMS, New Delhi p. 24
R Chandra Shekar Reddy, Arvind Kumar, Komal Singh, Naveet Wig
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