Journal of Family Medicine and Primary Care

IntroductionThe corona virus disease 2019(COVID-19) is caused by the virus SARS-CoV-2 and is declared as a global pandemic by World Health Organization (WHO). Various hematological parameters alteration has been documented in the Chinese literature in SARS-Cov-2 infection. However, there is a need for research to evaluate the pattern of the hematological parameters of COVID-19 patients in the Indian population. Aims & ObjectivesThe objective of the study is to see the Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), and other hematological parameters alteration of COVID-19 patients along with their clinical course in the Indian scenario. MethodsA single-center prospective study of 32 patients with laboratory-confirmed COVID-19 admitted to Super Speciality Pediatric Hospital & Post Graduate Teaching Institute NOIDA, from March to April, were enrolled for the study. The demographic date, the clinical status of the patients during admission and follow up, baseline, and follow up hematological findings were recorded. Statistical analysis of the data was carried out, and relevant findings were presented. ResultsDemographic characterization shows a mean age of 37.7 years, male (41.9%),female (58.1%)with majority patients are mildly symptomatic to asymptomatic(93%). The CBC values and NLR, PLR at baseline between the male and the female patients, are not showing any statistically significant difference as the 95% C.I. A statistically significant increment in the lab parameters is observed in follow-up visits. ConclusionMajority of the patients are younger and have mild clinical presentation with female predominance. Pediatric cases have mild symptomology. Baseline CBC findings show mild neutrophilia, lymphopenia, eosinopenia and normal to mild thrombocytopenia. An increase in CBC parameters, NLR was noted in follow up cases. Anemia was not noted in baseline CBC and in follow up group. A onetime PLR is not indicative of disease progression.

Depression in post-surgical patients is a common occurrence. It is likely to occur in cardiac surgery like Coronary Artery Bypass Grafting. This condition could significantly prolong recovery time and could result in complications. Therefore, this study aimed to study the prevalence of Post-Operative Depression amongst Coronary Artery Bypass Graft patients. The undertaken research was conducted amongst patients who had undergone CABG at CMH Lahore and Punjab Institute of Cardiology. A survey was conducted on a sample size of 150 patients, out of which 147 gave consent to participation. The sample size was calculated using WHO Formula. The severity of depression was analyzed through questions in the Becks Depression Inventory. Data was analyzed using SPSS software (25.0 version). Out of 147 patients, 110 were males and 37 were females. The results depicted greater depression amongst females than in males both pre-operatively and post-operatively, with a mean score of 1.41 and 1.08 respectively. A significant difference (p<0.01) was obtained between the correlation of Pre-Operative Scores (in percentages and frequency) and Post-Operative Scores (in percentages and frequency). An insignificant difference (p=0.125) was obtained between the correlation between Preoperative Scores and Gender. A greater Mean Score (1.41) was seen in females, indicating more post-operative depression than males (1.05). An insignificant difference (p=0.239) was obtained between the correlation between Preoperative Scores and Gender. A greater Mean Score (1.08) was seen in females, indicating more post-operative depression than males (0.84). The study concluded that the prevalence of postoperative depression among patients was not significant.

Back groundUrinary tract infections are common bacterial infections that affect almost 150 million people internationally each year. A catheter-associated urinary tract infection arises when germs enter the urinary tract via a urinary catheter, leading to infection and have been linked with increased mortality, morbidity, healthcare costs in intensive care units. It is one of the highest prevalent health care-related infections, accounting for nearly 30% of intensive care unit (ICU) reports because of its association to urinary catheterization, but has great preventive potential. MethodInstitutional based cross-sectional study design applied to determine the prevalence and associated factors of Health care-associated urinary tract infections among adult 391 patients admitted to ICU from 2017 to 2019 GC at Addis Ababa Public Governmental Hospital, Addis Ababa, Ethiopia, June-December 2020.Data had manually checked and entered to Epi-data manager version 4.6 and statistical analyses have been performed using SPSS version 23 software program. Strength of association between dependent and independent variables is assessed using crude odds ratio (COR) and adjusted odds ratio (AOR) with confidence Interval (CI) of 95%. Variables that had a value of P < 0.25 on bi-variate analysis were directly forward to be analyzed by multi variable analysis. Goodness of fit test had also computed for logistic regression using Hosmer and Lemeshow test resulted in (sig=0.073), finally having P-values < 0.05 is considered as statistically significant. Resultthe study find that the prevalence of Healthcare Associated Urinary Tract Infection among ICU admitted patients was 91(23.3%) 95%CI ;(19.2-27.4), While length of stay, Having tracheostomy, patients on Mechanical Ventilation and taking Proton pump inhibitor drugs were associated with HAUTI in the study area. ConclusionHealthcare-associated Urinary Tract infection is highly emerging clinical condition among ICU admitted patients in the study areas.

BackgroundTransplacental congenital malaria is a vertical transplacental transmission of malaria parasites from the mother to the baby in utero or perinatally during labor. Cord blood that conveyed oxygen and nutrients from mother to fetus and return with carbon dioxide and other waste materials can transmit malaria pathogen. This study is aim to establish early diagnosis of transplacental congenital malaria using cord blood biochemical and haematological indices. Cord blood from 164 babies delivered at three hospitals in Kogi State between January and December, 2020 were microscopically investigated for malaria parasite. Biochemical and Haematological analyses were done using SYSMEX XP-300, Roche 9180 and VIS Spectrophotometer model 721. The data obtained were expressed as mean {+/-}standard deviation using SPSS 23. The indicator level of statistical significance was set at p<0.05. The results showed significant (p<0.05) decreased in values of WBC, platelet, sodium, potassium, urea, creatinine, RBC, PCV, haemoglobin and MCHC in malaria infected cord blood in comparison to malaria negative control group. Significant (P<0.05) increased activities of liver enzymes (AST, ALT, ALP), total protein, bicarbonate and chloride in malaria infected cord blood when compared with malaria negative group. However, no statistically significant difference in lymphocyte, MCV, MCH, neutrophil and mixed of both malaria infected and malaria negative cord blood. This study suggests that cord blood biochemical and haematological indices can be used to diagnose and manage transplacental congenital malaria in fetus and neonates.

AIMS AND OBJECTIVESTo study the distribution and frequencies of ABO and Rhesus (Rh) blood groups among confirmed cases of Covid-19 infection. We also studied the relation between ABO blood group system and lymphopenia and studied the gender association in COVID-19 patients. METHODESA hospital based retrospective study was conducted at Government Medical College Suryapet from 01 Aug 2020 to 30 Sep 2020. A total of 200 Covid cases were included in the study who came to the hospital with the complaints of Fever, Sore throat, Body Pains, Cough, Breathlessness, Diarrhoea etc. Patients confirmed Covid infection was tested for blood grouping and RH typing by using forward blood grouping with the help of commercially available standard monoclonal antisera. CBP was processed in sysmax 5 part Haematology analyser. Blood group frequency was tested also assed the gender association, Covid patients presents with lymphopenia the relation between the ABO blood group and lymphocyte count was determined. RESULTSMales were more compared to the females .Middle aged group male patients were more commonly involved. Most predominant blood group was group B 79(39.5%), group O 78(39%),group A 37(18.5%), group AB 6(3%),most of them were 190 (95%)Rh positive, only 10 Rh negative (5%).To assess the Lymphopenia in our study we divided the absolute lymphocyte count into 5 groups. Group 1 cases are more 58 (29%), Group 2 91(45.5%), Group 3 30 (15%), Group 4 16(8%), Group 5 5(2.5%). CONCLUSIONMale patients with blood group B were more compared to other blood groups however more number of studies are necessary to confirm these findings in a larger sample and among individuals of different ethnicities.

ObjectivesThis study aimed to analyse the epidemiological and clinical characteristics of critical COVID-19 cases and investigate risk factors including comorbidities and age in relation with the clinical aftermath of COVID-19 in critical cases in Bangladesh. MethodsIn this retrospective study, epidemiological and clinical characteristics, complications, laboratory results, and clinical management of the patients were studied from data obtained from 168 individuals diagnosed with an advanced prognosis of COVID-19 admitted in two hospitals in Bangladesh. ResultsIndividuals in the study sample contracted COVID-19 through community transmission. 56.5% (n = 95) cases died in intensive care units (ICU) during the study period. The median age was 56 years and 79.2% (n=134) were male. Typical clinical manifestation included Acute respiratory distress syndrome (ARDS) related complications (79.2%), fever (54.2%) and cough (25.6%) while diabetes mellitus (52.4%), hypertension (41.1%) and heart diseases (16.7%) were the conventional comorbidities. Clinical outcomes were detrimental due to comorbidities rather than age and comorbid individuals over 50 were at more risk. In the sample, oxygen saturation was low (< 95% SpO2) in 135 patients (80.4%) and 158 (93.4%) patients received supplemental oxygen. Identical biochemical parameters were found in both deceased and surviving cases. Administration of antiviral drug Remdesivir and the glucocorticoid, Dexamethasone increased the proportion of surviving patients slightly. ConclusionsSusceptibility to developing critical illness due to COVID-19 was found more in comorbid males. These atypical patients require more clinical attention from the prospect of controlling mortality rate in Bangladesh.

IntroductionThe COVID-19 outbreak created a major panic among all the citizens of the country owing to its severity, contagiousness within the community, lack of specific treatment and possibility of re-infection. All these factors along with the uncertain behaviour of the virus lead to state of fear and concern all throught out the nation. The current study represents the mental health survey conducted on the students of South Indiaafter the completion of one month quarantine period of the COVID-19 outbreak. MethodologyThe present study is a cross-sectional, web-based online survey which consists of 21-item DASS questionnaire. Thiswas used to assess the emotional states of depression, anxiety, and stress. Using Google Forms, the questionnaire was randomly distributed among the pharmacy students of selected colleges. Mean with standard deviation was calculated for continuous variables and the number with percentage was calculated for categorical variables. ResultsA total of 500 participants responded to the questionnaire. More than half of the responses were received from females (65%). On assessment it was found that, 26 % of respondents reported severe to extremely severe depressive symptoms; 31.5 % of respondents reported severe to extremely severe anxiety symptoms, and 19 % reported severe to extremely severe stress levels. ConclusionIn India during the outbreak of COVID-19, an alarming number of students were found to have an impact on mental health due to the outbreak and were observed to have higher levels of stress, anxiety, and depression. The study findings shows the need of conducting more such studies and can be used to prepare appropriate psychological interventions to improvemental health among the young public during the pandemic.

BackgroundDepressive disorders, with a prevalence of 15 - 21%, are among the most common disorders in children and adolescents, and increases the risk of suicide, the second leading cause of death in children aged 10 to 19. AimTo determine the prevalence and correlates of depressive disorders among senior students attending secondary schools in Abeokuta. MethodThe study was conducted in five schools randomly selected from a representative sample and was carried out in 2 phases. In the first phase, students were selected via systematic random sampling and given consent forms and GHQ-12 to administer to the parents. In the second phase, students who returned a signed informed consent form and filled out GHQ-12 were interviewed using MINI-KID, Rosenbergs Self-Esteem Scale, Family-APGAR, and sociodemographic questionnaire. Multivariate regression analyses were conducted with p-value <0.05 as level of significance. ResultsThe mean age was 15.3 years (SD=1.27); 48.8% were male. The twelve-month prevalence of major depression was 11.3% and dysthymia was 1.4%. In the final regression analysis, female gender [OR=4.3, p=0.046], the experience of bullying [OR=7.96, p=0.004], difficulty getting along with friends, [OR=7.5, p=0.004], history of sexual abuse [OR=8.1, p=0.01], and perceived family dysfunction [OR=4.9, p=0,023] were found to be independent predictors of depressive disorders ConclusionDepressive syndromes are a significant health burden in adolescents. Being female, being bullied, having a history of sexual abuse, and family dysfunctionality are risk factors associated with depression among these population.

BackgroundThe study aimed to analyze the demographic, comorbidities, biomarkers, pharmacotherapy, and ICU-stay with the mortality outcome of COVID-19 patients admitted in the intensive care unit of a tertiary care hospital in a low-middle income country, Bangladesh. MethodsThe retrospective cohort study was done in Holy Family Red Crescent Medical College Hospital from May to September 2020. All 112 patients who were admitted to ICU as COVID-19 cases (confirmed by RT-PCR of the nasopharyngeal swab) were included in the study. Demographic data, laboratory reports of predictive biomarkers, treatment schedule, and duration of ICU-stay of 99 patients were available and obtained from hospital records (non-electronic) and treatment sheets, and compared between the survived and deceased patients. ResultsOut of 99 patients admitted in ICU with COVID-19, 72 were male and 27 were female. The mean age was 61.08 years. Most of the ICU patients were in the 60 - 69 years of age group and the highest mortality rates (35.89%) were observed in this age range. Diabetes mellitus and hypertension were the predominant comorbidities in the deceased group of patients. A significant difference was observed in neutrophil count, creatinine and, NLR, d-NLR levels that raised in deceased patients. There was no significant difference as a survival outcome of antiviral drugs remdesivir or favipiravir, while the use of cephalosporin was found much higher in the survived group than the deceased group (46.66% vs 20.51%) in ICU. ConclusionsSusceptibility to developing critical illness due to COVID-19 was found more in comorbid males aged more than 60 years. There were wide variations of the biomarkers in critical COVID-19 patients in a different population, which put the healthcare workers into far more challenge to minimize the mortality in ICU in Bangladesh and around the globe during the peak of the pandemic.

BackgroundHeart failure is a complex clinical syndrome resulting from structural and functional impairment of ventricular filling or ejection of blood. Cor pulmonale is one type of this clinical syndrome. There are only a few published studies on cor pulmonale from Ethiopia. The objective of this study was to determine the prevalence among patients with heart failure and the clinical and laboratory profiles of patients with cor pulmonale who had follow up at one of the tertiary hospitals in Ethiopia MethodsA hospital-based cross-sectional study was conducted at Felege Hiwot Referral Hospital from December 2018 to April 2019. A single population proportion formula was used to determine the number of heart failure patients that had to be included in the study to determine the prevalence of cor pulmonale. The medical records of cor pulmonale patients among the sample heart failure patients were then retrieved and data was extracted using a structured checklist. Data was entered into, cleaned, and analyzed using IBM.SPSS version 23.0. Descriptive statistics were used to report the findings. ResultsEight percent (35) of patients with heart failure had cor pulmonale. Fifty-four point three percent (19) of the patients with cor pulmonale were males and 45.7 %(16) were females. The median age of patients with cor pulmonale was 55 years. The commonest clinical features were cough and dyspnea (91.4 % and 97.1 % respectively). All patients had right ventricular dilation on echocardiography. Pulmonary Complications post-treatment for tuberculosis were the leading causes followed by interstitial lung disease. There was no identified respiratory disease in 40% of patients with cor pulmonale ConclusionCor pulmonale accounted for less than 10 % of heart failure cases. Complications post-pulmonary tuberculosis were found to be the leading respiratory conditions underlying the cor pulmonale. Programs on prevention, early detection, and treatment of pulmonary tuberculosis must be strengthened.

BackgroundAdolescence constitutes a risk factor for mental health problems, and this may be further complicated by pregnancy. The rate of adolescent pregnancy is still extremely high in the sub-Saharan Africa including Nigeria. Pregnancy and mental health problems during adolescence constitute double vulnerability for negative outcomes for the adolescents and their offspring. MethodologyThe study was cross-sectional in design and it compared prevalence of depression and associated factors among pregnant and non-pregnant adolescents. It was conducted in Osogbo metropolis, Osun State, Southwest, Nigeria. The study population comprised pregnant adolescents (aged 15-19 years) attending antenatal care (ANC) in selected formal and informal health facilities. Non-pregnant adolescents who were equally attending services at the facilities were recruited as the control group. Information was obtained from the adolescents with the use of a structured questionnaire and data was analysed with IBM-SPSS version 21 software. ResultsThree hundred and thirty-four respondents (167 per group) were involved in the study; the pregnant adolescents had a mean age ({+/-}SD) of 17.92 ({+/-}1.13) years while the non-pregnant adolescents had a mean age of 17.70 ({+/-}1.23) years. The prevalence of depression among the pregnant adolescents was 8.4% while that of the non-pregnant adolescents was 3.0%. The result showed a statistically significant association between pregnancy status and depression among the adolescents (p= 0.033). Living arrangement was the only socio-demographic variable that had significant relationship with depression among the pregnant adolescents while living arrangement and employment status had significant relationships with depression among the non-pregnant adolescents. History of mental illness, childhood sexual abuse and anxiety symptoms showed significant relationship with depression among pregnant adolescents, however, only anxiety symptoms showed significant relationship with depression among non-pregnant adolescents. ConclusionThe study concluded that the prevalence of depression is significantly higher among pregnant adolescents with similarities and differences in the factors associated with depression in the two groups.

BackgroundMortality and morbidity are highest in severe and critically ill patients with COVID -19 pneumonia. We used interleukin-6 (IL-6) receptor inhibitor, tocilizumab in the above patients who failed to show any clinical improvement after initial treatment with steroids. MethodsThis is a retrospective observational study conducted at a tertiary care hospital in India. Severe and critical COVID-19 patients, who got admitted to intensive care unit and subsequently received tocilizumab were included. Patients who worsened clinically or had no change in oxygen requirement even after 24hrs of receiving intravenous methylprednisolone at a dose of 1-2mg/kg/day received a maximum total dose of 800mg of intravenous tocilizumab. The day 28 all-cause mortality and progression to mechanical ventilation were the primary outcome measures. Clinical improvement and oxygen requirements after tocilizumab administration along with trends in inflammatory markers and secondary infections rates were also noted. ResultsA total of 51 patients who did not show clinical improvement even after 24 hours of intravenous steroids had received tocilizumab. In these patients, there was a significant decrease in oxygen requirement and clinical progression by day 7 of tocilizumab administration. Baseline median values of CRP (114.2 mg/L), IL-6 (69.8 pg/ml) and neutrophil-lymphocyte ratio (12.4) in these patients were elevated. Out of these, only CRP showed a significant decrease after the drug administration. 13 (26.5%) of the 49 patients on non-invasive oxygen support progressed to mechanical ventilation and the day 28 all-cause mortality was 10/51(19.6%). 10(19.6%) of the 51 patients had life threatening infections. ConclusionEarly and timely administration of tocilizumab is a viable option in selected severe and critical COVID-19 patients who do not respond to initial steroids. When given along with steroids, a high suspicion of secondary infections should be kept.

BackgroundThe emergence of Coronavirus disease 2019 (COVID-19) an infectious disease caused by the newly discovered severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has caused a lot of harm to humanity. Healthcare workers who are the leading the charge in the fight against the virus can experience mental health challenges with anxiety being an important illness. Anxiety can become morbid quickly and ultimately affect function, hence the need to study its prevalence among HCWs, since they are a high-risk population. Studies across various regions worldwide reported elevated levels of anxiety amongst HCWs during the SARS, Ebola, and H1N1 pandemics. Nevertheless, Generalized Anxiety Disorder (GAD), an easily measured and ubiquitous member of the family of anxiety disorders has hardly been researched. However, new studies in Togo, China, India and Mexico have reported elevated levels of GAD in HCWs during the COVID-19 pandemic. Given the complexities surrounding mental health care in Ghana, and Africa as a whole it would be expedient to uncover the prevalence of GAD among HCWs during the pandemic. Hence, a study at Family Health Hospital will provide information about the prevalence of COVID-19 related GAD among Health care workers representative of Ghana. AimThe aim of this study was to establish the prevalence of COVID-19 related GAD amongst healthcare workers, in a tertiary hospital in Accra. MethodsA descriptive cross-sectional study design using a self-administered questionnaire was employed. Nine-two (92) HCWs in the study area were sampled. A consecutive sampling technique was used to select the respondents for the study. The study was analyzed using SPSS version 25. The results were presented in summary tables and analyzed using frequencies and percentages. Chi square test performed on categorical data to test association between selected variables and their outcome with COVID-19 related GAD. ResultsThe GAD level among nurses was 55.4%, and for doctors it was 30.4%. The GAD level among medical laboratory technicians and pharmacists were 7.6% and 6.5% respectively. Furthermore, being age 50-69 years was a significant risk factor for developing GAD during the COVID-19 pandemic in Ghana. Female HCWs were more likely to experience GAD. However, only 13.1% of the HCWs were considered to have Corona phobia. Perception of workplace as being high risk was positively correlated with mild to moderate forms of anxiety. However, perception of organizational support as being guaranteed in case one succumbed to the virus and confidence in PPE availability was not reported to be strong protective factors against GAD among HCWs. ConclusionCOVID-19 related GAD is a challenge amongst HCWs especially nurses in FHH. The management of the FHH should set up certain services such as psychological help lines, peer support programs as well as run a sensitization campaign to cater for the wellbeing of doctors as well as encourage mental health seeking behavior.

BackgroundEarly neonatal mortality occurs when a newborn dies within the first seven days of life. Despite interventions, newborn mortality in Ethiopia has grown over time (33 death per 1000 live births). Determinants varies on level of neonatal mortality. The studys goal was to determine magnitude of early newborn death, as well as its causes and drivers, in Newborn Intensive Care Unit of Referral hospital in Ethiopias Somali region. MethodsHealth facility based retrospective study review was conducted between May 2019 to May 2021 in Shiek Hassan Yabare Referral Hospital of Jigjiga University of Ethiopia. All neonates between 0 to 7 days admitted at NICU and get registered using the new NICU registration book from May 2019 to May 2021 with complete data were included. Kobo toolkit was used for data collection and analyzed in SPSS 20. Logistic regression model was used to estimate determinants. ResultThe magnitude of early neonatal mortality rate (defined as death between 0-7 days) of Ethiopias Somali region is estimated to be 130 per 1000 live births--That is say 130 newborn couldnt celebrate their seventh day in every 1000 live births. Hypothermia, prematurity, maternal death at birth and shorter length of stay in NICU were increasing the chance of neonatal mortality at early stage while neonatal resuscitation had shown protective effect against neonatal mortality. Similarly birth asphyxia, preterm, sepsis, and congenital abnormalities were major causes of admission and death in the NICU. ConclusionThe magnitude of early neonatal mortality is considerable and causes are preventable. Enhancing quality of care including infection prevention and hypothermia through mentorship and encouraging the Kangaroo Mother Care practice is necessary at childbirth and NICU of the Hospital.

The respiratory system is a complex interconnected functionality which consists of a series of branching tubules and the lungs containing many alveoli. The alveoli are highly vascularized to provide a large surface area for gaseous exchange. The investigation was conducted in the Fauji Foundation Hospitals Department of Microbiology from November 2019 to June 2022.. The various bacterial strains that were recovered from a total of 802 mechanically intubated individuals make up the data presented in this study. Acinetobacter spp 270 (34%), Pseudomons spp 165(21%), and Klebsiella spp 95 (12%) were the most frequently isolated bacteria. Main Gram-positive organisms isolated included Methicillin-Resistant Staphylococcus aureus 66 (8%), Enterococcus 48 (6%). MRSA was 100% sensitive to Vancomycin, but only 97% sensitive to the Linezolid. The Acinetobacter spp found in the tracheal tubes was reported to be 77% sensitive to Polymyxin B.

ObjectivesTo study the Echocardiographic manifestations of covid 19 illness among patients admitted in our facility, Correlate MAPSE, TAPSE, PASP, CRP levels and CTSI among covid 19 patients with their 28 day outcome as survivors and non survivors and to look for evidence of residual RV dysfunction and Pulmonary hypertension using TTE after 1 year of follow-up. Study designProspective observational study at various medical wards and ICUs in SMS medical college and associated hospitals. Methods258 patients with a Covid-19 RT-PCR positive report from a throat or a nasal swab within 72 hours of admission were included in the study. Each patient underwent a complete clinical assessment and routine blood investigations including CRP levels were done. A complete transthoracic echocardiogram was done within 48 hours of admission. Patients also underwent a HRCT chest and CTSI scores were estimated. All patients were followed for a period of 28 days. The MAPSE, TAPSE, PASP, CTSI and CRP levels were then correlated with the outcome of the patient. The survivors again underwent a TTE at 1 year after their recovery from covid-19 illness to look for residual RV dysfunction by TAPSE and the development of pulmonary hypertension as measured by PASP using Bernoullis equation. ResultsAmongst patient of covid 19 illness the MAPSE, TAPSE, PASP, CTSI and CRP levels all correlated well with outcome of patients. While most covid-19 survivors recovered from their illness yet some patients showed evidence of persistent RV dysfunction and pulmonary hypertension even after 1 year of follow up.

IntroductionSchizophrenia is a severe mental disorder. There is ample evidence to suggest that there are various multi-systemic co-morbidities in the patients with schizophrenia. However, data for dermatological comorbidities in these patients is scarce. This is relevant because of the common embryological basis of the central nervous system and skin, and also the disabling nature of schizophrenia itself. ObjectiveTo analyze the profile and distribution of cutaneous conditions in patients with schizophrenia. MethodsConsecutive adult patients with schizophrenia attending the follow-up service of the outpatient clinic of the department of psychiatry of a tertiary hospital in North India were evaluated for the presence of a skin disorder by a dermatologist. ResultsDermatological findings were seen in 71 patients (69.60%), 39 patients (38.23%) had multiple skin conditions. As a group, infections were the most prevalent diagnosis seen in 18 patients (17.64%) and fungal infections were commonly observed (n=14, 13.72%). Other common dermatoses were nevi, age related cutaneous changes, dyschromias and drug-induced acne. Among medical disorders, blood pressure was found to be elevated in 28 patients (27.45%) while sixty-four patients (69.74%) were either overweight or obese. ConclusionA high prevalence of dermatological diseases is seen in patients with schizophrenia. Both caregivers and psychiatrists managing these patients should familiarize themselves with these conditions and dermatology consultation should be sought for the prompt diagnosis and management.

BackgroundMental health has always been under the shadow of everyones belief about their health. Concerns about mental health have already risen in the whole world. The COVID-19 pandemic has caused havoc worldwide, notably in the educational system. It has been difficult to quantify the influence of COVID-19 on the mental health of medical students in Bangladesh. AimsThis study was conducted to assess medical students mental health status in Dhaka during COVID-19 pandemic. MethodsThis study was undertaken at Dhaka Medical College, Dhaka, Bangladesh and 359 medical students were the primary respondents for this study. ResultsDepression, anxiety and stress were found in around half of the study participants. Overall, three-fourth of the medical students had poor mental health status. The research study showed that depression, anxiety and stress were dependent on various socio-demographic and behavioral characteristics of medical students. ConclusionPoor mental health is still highly prevalent in the medical students. Different factors like age, gender, academic year, and physical exercise behavior have affected medical students mental health. This calls for attention towards the needs of the more vulnerable demographics and creating a welcoming environment for medical students.

BackgroundSomatic Symptom Disorder with predominant pain (SSD-P) is a common disorder with unsatisfactory treatment options. Transcranial Direct Current Stimulation (tDCS) is useful in chronic pain conditions. ObjectiveTo assess the effect of two within session repeated High Definition tDCS (HD-tDCS) over left motor cortex on pain and other associated variables in SSD-P. MethodsInstitute Ethics Committee approval was sought and the study was registered in the Clinical Trials Registry of India. Single-blind, sham controlled, cross-over study design was employed. Thirty right handed patients with DSM-5 diagnosis of SSD-P, aged 18-60 years, receiving stable treatment were enrolled by consecutive sampling. After simple randomization, two short interval repeated sessions (2mA, 20 minutes each) of either active or sham HD-tDCS was administered followed by a wash out period of seven days and cross over. Assessments were done at baseline, week one and two. Analysis was done using SPSS 21. ResultsParticipants were comparable on all baseline parameters. ANCOVA showed no orderxgroup interaction. On RM-ANOVA all participants irrespective of entering active or sham arm showed statistically significant difference (Cohens d >0.8) in pain and associated parameters like depression, anxiety, pain related interference, burden and disability at week two (p< 0.01). But at week one, this was observed only in active arm. Transient mild local side effects like burning, pain and itching were noted, with no cognitive side effects. ConclusionThis was the first study of HD-tDCS on SSD-P. Single session repeated protocol can be effective in pain reduction with sustained effects up to one week.

IntroductionIntegration of related health services, such as screening of depression in HIV care is crucial for improving the quality of care and enhancing the use of scarce resources in developing countries. However, commonly these interrelated health services are commonly provided separately and there are many missed opportunities. Little is known about the client-related non-implementation issues. This study aims at examining the acceptability of anxiety and depression screening among women living with HIV. Material and methodsThis was a facility based cross-sectional study which included women living with HIV attending two hospitals in Jijiga town, Ethiopia. The study participants were identified using systematic random sampling method. An exit interview was conducted with the use of a pretested questionnaire. The gathered data was analysed using SPSS version 23 and multivariate logistic regression model was used to determine factors associated with the factors associated with the acceptance of anxiety and depression screening. ResultsA total of 409 women participated in this study. Though, only 115 (28.1%) were aware about the existence of anxiety and depression screening, 357 (87.3%) accepted to receive the screening for anxiety and depression. Requisite of partner approval was the most common reason for not accepting the screening of anxiety and depression 21 (40.4%). When used multivariate logistic regression model; holding college level education, divorced and were living without partner, being self employed by occupation, aware of the existing screening service, source of information from health care providers and history of previous screening were significantly associated with acceptance of depression screening. ConclusionThis research has shown that women participant living with HIV were willing to undergo the screening for depression, hence future interventions should focus on the integration of mental health screening in HIV clinical setup.