Background
Acral vascular syndrome clinically presents as digital ischemia with Raynaud’s phenomenon and erythromelalgia but can be rarely seen in the malignant condition. Patients may present pain, ...permanent digital blanching or cyanosis, and desquamation or ulceration of the fingers. Acral vascular syndrome is rarely associated with lymphoid neoplasm and is associated with smoking, autoimmune connective tissue diseases, and vasculitis. Here, we describe a 79-year-old female who was diagnosed with vitiligo and peripheral T cell lymphoma Lennert type stage 4 with anemia of chronic disease with digital acral vascular syndrome.
Case presentation
A 79-year-old female with vitiligo presented with gangrene of the distal extremities associated with pain and intermittent fever for 2 months. On evaluation, she was found to have anemia of chronic disease and generalized lymphadenopathy and diagnosed as peripheral T cell lymphoma Lennert type with bone marrow involvement and digital acral vascular syndrome.
Conclusion
Acral vascular syndrome can be a presentation of lymphoma; if intervened earlier, the patient can be saved from the amputation of fingers or affected limb. Though it is a rare presentation of lymphoma, it should be considered if there is a rapid progression of gangrene. Early initiation of chemotherapy may result in the reduction of further progression of digital gangrene and thus prevents functional dependence on caregivers. In our patient, gangrene of other fingers was prevented even though it is an aggressive variant of T cell lymphoma.
The world is worsely hit by the COVID-19 pandemic resulting in increased morbidity and mortality. Increased mortality has been observed in older adults with multiple comorbidities. Six-minute walk ...distance (6MWD) at admission can help us to guide the requirement of oxygen during hospital stay that can be used to determine which patient can be managed at home.
This study was a prospective observational study conducted on COVID-19 patients admitted at AIIMS, New Delhi, from October to December 2020. Patients aged more than 60 years were included in the study and underwent 6-min walk tests. Polypharmacy and multimorbidity were also assessed along with dyspnea which was measured on BORG scale.
< 0.05 was considered statistically significant. Statistical software STATA (version 14.2) was used for all the analyses.
The mean age of the study population was 68.76 (7.4). Oxygen saturation prior to the 6-MWT was normal and has significantly higher than the post test (
≤ 0.001). 6MWD was significantly correlated with pre values of oxygen saturation. 6MWD was observed more in patients who did not require oxygen during hospital stay. Self-reported dyspnea, pulse rate, oxygen saturation, and systolic blood pressure were significantly associated with the patients who had an oxygen requirement during the hospital stay.
Self-reported dyspnea after 6MWT was found to be associated with oxygen requirement during hospital stay. Patients who have covered more distance in 6-min walk test have less oxygen requirement during hospital stay hence can be managed at home. This will reduce the health-care burden and will help to tackle the outburst during the ongoing pandemic.
BACKGROUNDCOVID-19 may seem to have an impact on middle-aged and elderly people. However, not much is known about the lived experiences of middle-aged and elderly people during this pandemic. The ...study aims to explore psychosocial and behavioral impact of COVID-19 on the lives of these individuals. MATERIALS AND METHODSThree focus group discussions and seven in-depth interviews were conducted. A format to guide discussions and interviews was made to bring uniformity across groups and participants. Participants were recruited through purposive and snowball sampling techniques. Discussions were recorded and transcribed verbatim. Thematic analysis method was used to extract key conceptual themes. RESULTSThere were 12 male and 10 female participants included, with a mean age of 62.2 years. Five subcategories identified were: Fear and anxiety, household confinement, lifestyle modification, preventive practices, and coping strategies. These sub-categories formed three major categories-psychological, social, and behavioral which ultimately led to the emergence of the main theme that is, COVID-19 effects on the life of middle-aged and older individuals. CONCLUSIONMiddle-aged and elderly people are affected in many ways due to COVID-19. Addressing the psycho-social and behavioral problems can help in the better adjustment to tide over the pandemic.
The impact of measures taken to contain COVID-19 on lifestyle-related behaviour is undefined in Indian population. The current study was undertaken to assess the impact of COVID-19 on ...lifestyle-related behaviours: eating, physical activity and sleep behaviour.
The study is a cross-sectional web-based survey. A validated questionnaire to assess the changes in lifestyle-related behaviour was administered on adults across India using a Google online survey platform.
A total of 995 responses (58.5% male, mean age 33.3 years) were collected. An improvement in healthy meal consumption pattern and a restriction of unhealthy food items was observed, especially in the younger population (age <30 years). A reduction in physical activity coupled with an increase in daily screen time was found especially among men and in upper-socio-economic strata. Quarantine induced stress and anxiety showed an increase by a unit in nearly one-fourth of the participants.
COVID-19 marginally improved the eating behaviour, yet one-third of participants gained weight as physical activity declined significantly coupled with an increase in screen and sitting time. Mental health was also adversely affected. A detailed understanding of these factors can help to develop interventions to mitigate the negative lifestyle behaviours that have manifested during COVID-19.
•COVID-19 has affected every aspect of the lifestyle of citizens.•Slight improvement was seen in eating behavior, majorly by reduction in intake of high fat, sugar, salt and sugar foods.•A significant decline was seen in overall physical activity coupled with increase in sitting and screen time.•One third of the sample gained weight during COVID-19.
Workplace violence (WPV) against health-care professionals has been a concern worldwide as it strains the relationship between the patient and healthcare professionals. Implementing mitigation ...interventions to help the healthcare professionals to prevent and manage these violent episodes might make the workplaces more secure.
This study aimed to synthesize the recent evidence on intervention strategies for workplace violence.
Four electronic databases (PubMed, Wiley, Cochrane and Google Scholar) were searched for peer-reviewed intervention studies published in the last 11 years to mitigate workplace violence. A qualitative synthesis of the findings from included studies was done.
A total of 17 studies were identified based on prevention and management of workplace violence. The interventions were mainly educational in nature based on a workshop format. These interventions were found to be effective in improving the perceived ability to deal with situations that lead to violence.
Strategies to mitigate violent episodes could be helpful to health-care professionals and administrators in their attempts to make safer workplaces in the health-care settings.
Health care workers (HCWs) are at increased risk of getting infected with Coronavirus disease 2019 (COVID-19) and suboptimal preventive practices have been identified as an important risk factor in ...this regard. This study was done to evaluate the preventive practices being followed by health care workers and identify reasons for suboptimal compliance.
A cross-sectional survey was done in HCWs belonging to various occupational roles and socio-cultural backgrounds across India through online platforms and telephonic interviews from July 30, 2020 to August 30, 2020. A scientifically designed and pre-validated questionnaire with good validity (CVR = 0.87, S-CVI/Av = 0.978) and internal consistency (Cronbach’s alpha coefficient = 0.85) was used.
The responses of 956 participants were analysed. Various suboptimal practices like touching outer surface of masks, lack of social distancing in cafeteria and duty rooms, inability to wash hands for adequate duration and properly follow steps of hand hygiene, inability to don and doff PPE properly, carrying PPE to duty rooms before completely doffing, use of personal mobile phones during duty and improper sleep were identified. Lack of knowledge, long duty hours, shortage of PPE, high patient workload, and casual attitude regarding own safety were identified as important barriers. Resident doctors and paramedical staff in the age group 18–30 years reported lower adherence.
Suboptimal compliance in preventive practices like handling PPE, distancing in cafeteria/duty rooms and hand hygiene is not uncommon in HCWs. Certain barriers are identified which should be addressed to ensure adequate safety of HCWs against COVID-19.
•COVID-19 has affected millions of health care workers worldwide.•Suboptimal adherence to hand hygiene, social distancing, PPE use, etc reported.•Barriers include ignorance, long duty hours, shortage of PPE and high workload.•Regular training, reinforcement and robust surveillance is recommended.
Study was aimed to assess magnitude of mental health problems among geriatric population during COVID19 pandemic.
Study was a cross-sectional observational study, total of 106 participants (Age ≥60 ...years) of either gender included in study. Mental health variables depressive and anxiety were assessed using GDS and HAM-A.
On GDS, 20(18.87%) patients had depressive symptoms and on HAM-A, 24(22.6%) patients were having anxiety symptoms.
Study highlight that Geriatric population have significant mental health issues during COVID19 pandemic, it should not be overlooked. It’s necessary to provide elderly psychological intervention measures to improve their wellbeing.
•Coronavirus disease 2019 (COVID19) pandemic had significantly affected the mental health of geriatric population.•Among elderly 18.87% were having depressive symptoms and 22.6% were having anxiety symptoms.•Mental health problems among elderly during and after COVID19 pandemic is an important aspect it should not be overlooked.•There is a need to address the mental health issues of elderly by timely providing intervention measures.
Elderly people account for more than 9% of the global population, and more than 6% of the Indian population. Covid-19 has badly affected the older population, identification of risk factors for ...severe disease and early intervention results in reduced mortality. Older adults may have a varied spectrum of presentation which ranges from mild to severe disease. Milder diseases are more in older adults without prior comorbidities whereas severity increases with increase in number of illness. Till date there is no definitive treatment and vaccines are also at different stages of trial only preventive methods and early detection of cases are important tools for fighting this pandemic. Dedicated centre's for elder care as well as trained geriatricians are very few in India. Prevention should be the most important strategy for older adults. Follow social distancing and maintain a distance of 1 meter from others even if you are healthy. Wash hands repeatedly with soap and water or use hand sanitizer and generous use of masks. Older adults should be encouraged to take their regular medication and the baseline disease should be under controlled. Frequent teleconsultation from the primary physician should be done repeatedly to identify the symptoms and also control of baseline disease. Considering Covid-19 increased mortality and severity in the older population we are providing practical suggestions for family physicians while managing elderly Covid patients.
COVID-19 is expected to have a significant impact on the socio-behavioural aspect of citizens’ lives, although the effects are expected to manifest differently in different population groups. The ...current study was conducted to assess the socio-behavioural impact of COVID-19 among the general population across India between the first and the second wave of pandemic.
A web-based cross-sectional study was conducted from 15th March −25th March 2021 using a pre-validated validated questionnaire upon the general population using e-survey, telephonic and face-to-face interview. The participants were recruited from the different regions of India by the purposive and snowball sampling technique following the principle of maximum diversity. Appropriate statistical tests were applied to study the association between the various sociodemographic variables and different behaviours.
A total of 1079 responses were analysed for the study. Almost half of the participants feared contracting the COVID-19 infection. Overall, female participants, elderly people (more than 60 years of age) and urban dwellers reported a greater fear in the survey. More than half of the participants (53.39%) reported significant difficulties due to home confinement. People have become more inclined to adopt healthy lifestyles. There are mixed responses in the area of following preventive practices.
People have a significant amount of fear and anxiety related to the pandemic, leading to several social and behavioural changes that might have a considerable impact on their everyday lives.
•Population under survey has a significant amount (48.28%) of fear and anxiety related to the pandemic.•Most individuals (68%) have adopted a healthy lifestyle during and after the first wave of pandemic.•The first wave of the pandemic has also led to certain positive social and behavioural changes among the individuals.
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