Background: Corona virus disease (COVID-19) was declared a pandemic by the World Health Organization in March 2020. This has affected service delivery among all medical disciplines in India including neurorehabilitation services.Aims and Objectives: The aims and objectives of the study were to assess the effect of COVID-19 pandemic on neurorehabilitation services across India.Methodology: A prospective nationwide survey study was undertaken by the Indian Federation of Neurorehabilitation during the pandemic. A questionnaire was prepared using Google forms software consisting of four sections: demography, neurorehabilitation practice before COVID-19 pandemic, neurorehabilitation practice during COVID-19 pandemic, and continuing medical education during COVID-19 pandemic.Results: Responses (872) were received from neurorehabilitation professionals across the country out of which 2.2% professionals did not give consent for participating in the survey. Participants (36.6%) were practicing traditional or independent referral basis rehabilitation, while 63.4% participants were practicing multidisciplinary rehabilitation. On an average, respective units were conducting 500–750 therapy sessions per month. Majority of the rehabilitation units in India lacked a physiatrist, rehabilitation nurse, music therapist, cognitive therapist, and urologist. Approximately 80% of the rehabilitation units have the basic rehabilitation modalities and advance technology was present in only 20% of the rehabilitation units. During COVID-19 pandemic, 19.5% centers were providing elective services, 50.3% emergency services, 15.6% new outpatient services, and 22.7% were providing follow-up outpatient services. Centers (51.5%) were providing telerehabilitation services for neurological conditions during the times of COVID-19 pandemic. Professionals (61.1%) providing telerehabilitation were working from home. Among the patients who needed neurorehabilitation, 28% were doing their exercises independently, 31% were supervised by caregivers, 17% were supervised by therapists, and 24% were not receiving any therapy. Participants (95.5%) wanted to receive more training in the field of neurorehabilitation. The participants utilized webinars (71%), online courses (22%), case discussion forums (19%), panel discussions (13%), and literature search (8%) during COVID-19 pandemic to continue education.Conclusion: The study reflects the situation of neurorehabilitation service delivery in India during the pandemic as the respondents were from all parts of the country and included most components of the neurorehabilitation team. Neurorehabilitation services were severely affected across India during the COVID-19 pandemic. Tele-neurorehabilitation has emerged as a new service delivery model during the pandemic. Online means of education has emerged as the primary source of continuing medical education during the pandemic.
Background – Social distancing leads to decrease in the spread of the novel virus but at the same time it shows to have a negative effect on the quality of life of the general population. Methodology - A cross-sectional survey study was conducted using an electronic version of WHOQOL-BREF scale. The demographic data was collected along with the 26 questions of the scale. We distributed this survey to the general population through electronic and social media. Results – We received 861 responses. Excluding the incomplete responses, we analyzed 832 responses. They had a mean age of 48.33yrs, majority being graduates (56.4%), majority of the subjects were males (59.25%), and there was no significant age difference between both the genders. The overall quality of life was perceived to be 3.48 and the satisfaction for health was 3.77. Most affected domains were the physical and psychological domains. Lowest quality of life responses were noted for questions pertaining to financial, transportation and sleep related. Conclusion- The quality of life in lock downs due to corona virus is affected due to social distancing. Law makers need to take care to avoid increasing this negative impact while enforcing lock downs.
Background: Immunisations is one of commonest cause of iatrogenic pain among healthy infants though several authorities have recommended that no aspiration is required before injecting into the anterolateral thigh, it is still a commonly followed procedure. Method: 202 healthy infants of either sex of age group 6 weeks to 6 months receiving routine intramuscular pentavalent vaccine were selected randomly by computer generated numbers and divided into two groups "standard" group and "pragmatic" group with 101 infants in each group. Two methods of vaccination conventional and pragmatic are used. In both cases pre vaccination and post vaccination pain was accessed by using FLACC scale and modified behavioural pain scale as well as cry time was noted. Results: The pre vaccination mean FLACC score in standard group is 2.07 (±1.17) while that in pragmatic group is 1.79 (±1.28). Post vaccination mean FLACC score in standard group is 8.5 (±0.82) while that in pragmatic group is 7.79 (±1.25). The pre vaccination mean MBPS in both standard & pragmatic group is 2.16 (±1.07). The post vaccination mean MBPS in standard group is 8.13 while that in pragmatic group is 8.16. Conclusions: Our study revealed that there was significant difference in perception of pain among the two groups. The Pragmatic group being a better technique for vaccination.
The COVID19 pandemic in India is causing significant morbidity and disruptions of healthcare delivery. The rapidly escalating contagion is straining our public health system, which is already under pressure due to a shortage of infrastructure and inadequate workforce. Neuro rehabilitation services that are still in its infancy in our country have been significantly interrupted in the last six months. An expert group from Indian Federation of Neurorehabilitation (IFNR) have formulated the guidelines and consensus recommendations for Neurologists, Physiatrists, and Therapists managing neurological disabilities during COVID 19. The aim of this consensus paper is to sensitize the clinicians and therapists about maintaining the continuum of care and rehabilitation needs of Covid patients as well as non Covid patients with neurological disorders during the ongoing COVID 19 pandemic
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