Introduction: Cardiovascular diseases are the leading causes of death in developed countries, and its incidence is on the rise in developing countries. Electrocardiogram (ECG), 2 Dimensional Echocardiography (2D-Echo) and myocardial injury biomarkers help in the diagnosis, prognostification of Myocardial Infarction (MI). Aim: To correlate the findings of ECG, 2D-Echo and Troponin I levels in locating the site and extent of MI. Materials and Methods: This observational study was conducted in the cardiology Intensive Care Unit (ICU)/ward, PES Hospital, Kuppam, Andhra Pradesh, India, from January 2019 to June 2020. A total of 95 patients of acute MI were studied at baseline, and repeat 12 lead ECG, 2D-Echo and serum troponin I levels were recorded. Ejection Fraction (EF) was estimated from the QRS score by means of a formula, and Echocardiographic correlation was obtained on the same day with ECG-QRS scoring by direct estimation of EF in ‘Q’ wave infarction. High sensitivity cardiac Troponin – I was measured at the time of hospitalisation and repeated at six hours if required, and its levels were correlated to the extent of MI i.e., Left Ventricular Ejection Fraction (LVEF). The categorical data were analysed using Chi-square test and p<0.05 was considered as statistically significant. Regression analysis was done for associated factors. Results: There was better correlation between EF calculated from ECG-QRS scoring system and 2D-Echo (r value-0.78, p-value <0.001). There was poor correlation between serum Troponin I levels at admission, and extent of MI i.e., LVEF as estimated by ECG and 2D-Echo (r=-237.13, p=0.334 and r=-120.78, p=0.585). There was a significant correlation between serum Troponin I levels at 72 hours of chest pain or peak values and extent of MI i.e., LVEF as estimated by ECG and 2D-Echo (r=-1446.14, p<0.001 and r=-1354.42, p<0.001). Conclusion: The location of MI, seen on ECG, correlated broadly with those seen on 2D-Echo. 2D-Echo was able to elaborate regional wall motion abnormalities in detail when compared to the ECG. LVEF can be calculated from ECG at bedside in Q wave infarction, which correlated fairly with 2D-Echo findings.
Background: Worldwide health-care personnel are dealing with coronavirus disease 2019 (COVID-19) at various levels. From fears of protecting themselves and their family while treating COVID patients to succumbing to COVID infection themselves, they are at the receiving end of divergent ramifications of COVID infection. One such aspect that is less known is the long-haul manifestations of COVID infection in health-care workers (HCWs). Aims: The aim of this study was to assess the persisting symptoms in HCWs who had recovered from COVID-19 and to investigate the associated factors contributing to the persistent symptoms. Settings and Design: It was a longitudinal, follow-up study of HCWs who had recovered from acute COVID infection but have lingering symptoms workers in a medical college hospital. Materials and Methods: HCWs were evaluated using standardized questionnaires that included sociodemographic, clinical variables, and persistence of post-COVID symptoms. Health-Related Quality of Life Scale was used to evaluate the quality of life. After detailed clinical evaluation, appropriate and relevant investigations were done where necessary. The data were statistically analyzed using Microsoft Excel Sheet and Stata 14.1 version. Results: The most common manifestations were fatigue, generalized weakness, fever, shortness of breath, chest pain, and palpitations. In the majority, health-related quality of life was affected. Respiratory and cardiovascular systems were most affected, followed by the central nervous system. Conclusion: Patients with COVID 19 infection develop diverse set of symptoms that evolve over time, with infected HCWs being no exception. Recognizing these persisting and ongoing symptoms is the first step taken toward addressing and alleviating them. This highlights that care of COVID patients does not conclude at hospital discharge. Long-term follow-up of these cases is essential in identifying and managing the sequelae of COVID infection. With the growing population recovering from COVID infection, it is imperative to focus on the prolonged effects of COVID infection.
Background: A Medicine and Bachelor of Surgery (MBBS) graduate will gain the required skills and competencies under supervision during the internship training. Many factors influence the competency levels. Coronavirus disease-19 (COVID-19) pandemic could be one of those factors. Objectives: The objectives were to assess the competency levels among medical interns, postinternship, during the COVID pandemic and also to assess the association between the competency levels with their final year results. Subjects and Methods: A cross-sectional study was conducted among 113 interns using a self-assessment questionnaire. Self-perception about the competencies was graded into three categories as low, moderate, and high. The Chi-square test was used for analysing statistical association between self-perception and MBBS final year part II results. Results: The level of self-perception about the competencies among the interns was found to be high in-analysis, display and interpretation of information; hypothesis formulation and decision-making (45.1%) and interpersonal communication, management, organizing health care system and professionalism (42.5%), whereas it was low for obtaining information from the patients and their families (29.2%) and procedural skills (18.6%). About 75.2% and 76.1% of the interns had low self-perception for endo-tracheal intubation and lumbar puncture, respectively. High level of self-perception was noted for urethral catheterization (84.2%) and intramuscular drug administration (76.1%). It was found that none of the competencies were statistically associated with the grade based on marks obtained in final year part II. Conclusion: COVID pandemic has affected the interns training to a significant extent. There was no statistically significant association between final year grades and the competencies.
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