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BACKGROUND: Prolonged use of N95 masks by healthcare workers might affect physical health due to mask-related hypoxia in addition to the psychological effects of N95 masks. We tried to explore the association of N95 mask-related hypoxia and headache with stress, quality of sleep, and anxiety in the current study. MATERIALS AND METHODS: The sample (N = 78) consisted of 41 doctors and 37 nurses involved in COVID-19 patient care and using N95 masks with or without PPE for at least 4 hours. Perceived stress scale (PSS), Coronavirus anxiety scale (CAS), and Pittsburgh sleep quality index (PSQI) were administered, and physical parameters like heart rate and oxygen saturation (SpO2) were measured. RESULTS: Around 42% of the study participants experienced headaches after wearing an N95 mask and had a higher increase in heart rate (mean percent:10.5% vs 6.3%) and decline in SpO2 (mean percent: 2.6% vs 1.5%) compared to those who didn't develop a headache after N95 mask use. Independent samples t-test showed a mean difference for PSS and CAS between those who experienced headaches and those who didn't. The mean PSQI scores among the study participants were 8.91 ± 5.78; the score among those participants with and without headache was 10.57 ± 3.11 and 7.68 ± 2.53, respectively. CONCLUSION: Perceived corona anxiety, poor sleep quality, and corona anxiety are associated with N95-related headaches and SpO2 drop among health professionals who wear N95 masks for at least 4 hours.
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COVID-19 , Cefalea de Tipo Tensional , Humanos , Respiradores N95 , Calidad del Sueño , Máscaras/efectos adversos , Cefalea/etiología , Hipoxia/etiología , Atención al Paciente , Personal de Salud , Ansiedad/etiologíaRESUMEN
Introduction India is the second most populated country in the world. The declaration of the COVID-19 pandemic has caused significant morbidity and mortality in pregnant women and newborns. Due to the decreased lung volume and immunocompromised state, pregnant women are more prone to rapid clinical deterioration. Regarding the transmission of COVID-19 infection to newborns, there is no clear-cut evidence regarding the intrauterine or vertical transmission of COVID-19 from the affected pregnant women to their neonates. Aim This study aimed to assess the outcome of neonates born to mothers with COVID-19 in a tertiary care hospital in Puducherry, India. Methods This retrospective case record-based study was conducted among all neonates born to COVID-19-positive mothers at a tertiary care institution in Puducherry from April 2020 to June 2020. All the newborns born to COVID-19-positive mothers during the specified period of time were included in the study. Results A total of 98 COVID-positive mothers were included in the study. Of these, 13.27% showed mild upper respiratory infection, and one had a moderate category. The mean gestational age was 38.4+1.12 weeks. About 53.06% of COVID-19-positive mothers had C-sections, 45.92% had a normal vaginal delivery, and only one had an instrumental vaginal delivery. All the mothers gave birth to singleton neonates; of 98 newborns, 51 were female, and 47 were male with the mean birth weight of 3.1 ± 0.4 kg. Among the 98 neonates, only six developed COVID-19 infection. Among the six, four acquired infections during the first to second week of the postnatal period and two acquired infections during the fourth week. Three neonates born by normal vaginal delivery only had a fever; two neonates manifested fever, cough, and increased respiratory rate; and only one neonate developed hypoxia. Conclusion The study showed that vertical transmission from the mother to the newborn is extremely minimal. In our study, six neonates acquired infection mostly due to the close contact of the newborn with the mother during rooming-in and breastfeeding.
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BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is increasingly recognized in obese and overweight children. NAFLD is the commonest cause of chronic liver disease in these children. We undertook a study to assess the prevalence of NAFLD and to identify the associated anthropometric and metabolic risk factors. METHODS: This cross-sectional study was done with 154 overweight and obese children. The study population was divided into 2 groups based on the presence or absence of NAFLD by screening with ultrasonography and/or alanine transaminase levels. Anthropometric (body mass index [BMI], waist circumference) and biochemical parameters (triglyceride, high density lipoprotein, low density lipoprotein, very low density lipoprotein, total cholesterol, insulin, homeostasis model assessment of insulin resistance [HOMA-IR], alanine transaminase, aspartate transaminase) were compared between these two groups. RESULTS: NAFLD was diagnosed based on abnormal screening in 79 (51.3%) overweight and obese children. No age or gender difference was noted between the 2 groups. There were no significant differences in BMI, systolic blood pressure, diastolic blood pressure, and waist circumference between patients with and without NAFLD. Low-density lipoprotein (LDL) cholesterol levels were found significantly higher in the NAFLD group. There was no significant difference in lipid profile apart from LDL cholesterol, aspartate transaminase, and HOMA-IR between the 2 groups. CONCLUSION: NAFLD is common in overweight and obese southern Indian children. High LDL cholesterol level is a risk factor for NAFLD in these children. Screening of this high-risk group for early diagnosis of NAFLD is essential to prevent and monitor further progression of the disease.
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Resistencia a la Insulina , Enfermedad del Hígado Graso no Alcohólico , Obesidad Infantil , Alanina Transaminasa , Aspartato Aminotransferasas , Índice de Masa Corporal , Niño , LDL-Colesterol , Estudios Transversales , Humanos , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Obesidad Infantil/epidemiología , PrevalenciaRESUMEN
OBJECTIVE: To assess the progression of thyrotropinemia to overt hypothyroidism in overweight and obese children. METHOD: 150 overweight and obese children aged 5-15 years were enrolled. Free T4 and thyroid stimulating hormone (TSH) were done at enrollment and for those with TSH >5 mIU/L, TSH levels were repeated after 1 year. RESULTS: The mean (SD) body mass index (BMI) and TSH were 23.8 (3.19) kg/m2 and 2.70 (2.44) mIU/L, respectively. 17 children had thyrotropinemia (TSH between 10-15mIU/L); 10 (84.6%) of these children attained normal TSH levels at one year follow-up, and none progressed to overt hypothyroidism (TSH >15 mlU/L). CONCLUSION: Levels of 5-15 mIU/L are common in asymptomatic overweight and obese children. Majority of these children revert back to normal TSH levels on follow-up.
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Hipotiroidismo , Obesidad Infantil , Niño , Humanos , Hipotiroidismo/epidemiología , India/epidemiología , Sobrepeso/epidemiología , Obesidad Infantil/epidemiología , Tirotropina , TiroxinaRESUMEN
This cross-sectional study was done to find the agreement between non-contact infrared thermometry and mercury-in-glass thermometer. Two hundred and fifty febrile infants were recruited over a period of two months and axillary temperature was measured by both techniques. The mean (SD) temperature recordings of infrared and mercury thermometer were 37.6 (0.91)°C and 37.6 (2.49)°C, respectively; mean difference - 0.016 (96% CI - 0.32, 0.29). There was moderate agreement between both methods (kappa=0.602). Non-contact infrared thermometry can be used with good accuracy in febrile infants for temperature measurements.
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Recto , Termómetros , Axila , Temperatura Corporal , Estudios Transversales , Fiebre/diagnóstico , Humanos , Lactante , TermografíaRESUMEN
BACKGROUND: Median survival in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) is 2-6 months; conventionally liver transplantation is contraindicated. METHODS: We studied outcomes following living donor liver transplantation (LDLT) post-PVTT downstaging (DS) with stereotactic body radiotherapy (SBRT), and tumor ablation (with transarterial chemo- or radio-embolization). RESULTS: Of 2348 consecutive LDLTs, 451 were for HCC, including 25 with PVTT (mainly Vp1-3) after successful DS and 20 with Vp1/2 PVTT without previous treatment. DS was attempted in 43, was successful in 27 (63%), and 25 underwent LDLT. Median alpha fetoprotein (AFP) at diagnosis and pre-LDLT were 78.1 ng/mL (3-58 200) and 55 ng/mL (2-7320), respectively. Mean DS to LDLT time was 10.2 weeks (5-16). Excluding 2 postoperative deaths, 1- and 5-year overall survival (OS) and recurrence-free survival (RFS) were 82%, 57%, and 77%, 51%, respectively, comparable to survival in 382 HCC patients without PVTT undergoing upfront LDLT (5-y OS 65%, P = 0.06; RFS 66%, P = 0.33, respectively). There was a trend toward better OS in DS+LDLT versus non-DS LDLT group (5-y OS/RFS-48%/40%). OS was significantly better than in HCC-PVTT patients receiving no intervention or palliative Sorafenib alone (1-y OS of 0%) or Sorafenib with TARE/SBRT (2-y OS of 17%) at our center during the study period. Initial AFP <400 ng/mL and AFP fall (initial minus pre-LDLT) >2000 ng/mL predicted better RFS; Grade III/IV predicted worse OS in DS patients. CONCLUSIONS: HCC patients with PVTT can achieve acceptable survival with LDLT after successful DS. Low initial AFP level, a significant drop in AFP with DS and low tumor grade, favorably influence survival in these patients.
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Carcinoma Hepatocelular/terapia , Quimioembolización Terapéutica , Neoplasias Hepáticas/terapia , Trasplante de Hígado , Células Neoplásicas Circulantes/patología , Vena Porta/patología , Radiocirugia , Trombosis de la Vena/terapia , Adulto , Anciano , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/patología , Quimioembolización Terapéutica/efectos adversos , Quimioembolización Terapéutica/mortalidad , Bases de Datos Factuales , Femenino , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/patología , Trasplante de Hígado/efectos adversos , Trasplante de Hígado/mortalidad , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Vena Porta/diagnóstico por imagen , Radiocirugia/efectos adversos , Radiocirugia/mortalidad , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/mortalidad , Trombosis de la Vena/patología , alfa-Fetoproteínas/metabolismoAsunto(s)
Hipotiroidismo/epidemiología , Hipotiroidismo/etiología , Obesidad/complicaciones , Adolescente , Índice de Masa Corporal , Niño , Estudios Transversales , Humanos , Hipotiroidismo/sangre , Incidencia , India/epidemiología , Obesidad/sangre , Obesidad/epidemiología , Obesidad Infantil , Estudios Prospectivos , Tirotropina/sangre , Tirotropina/metabolismoRESUMEN
Although cerebral abscesses caused by animal bites have been reported, they are extremely rare in infants and have not been described following monkey bite. A 55-day-old male infant presented with a multi-loculated Streptococcus oralis cerebral abscess following a monkey bite on the scalp. There was a clinical response to antibiotic therapy and repeated surgical aspiration followed by a ventriculoperitoneal shunt. This is the first report of a patient with a brain abscess following a monkey bite.