IntroductionThere are limited data on the impact of COVID‐19‐associated disruptions and novel HIV service delivery strategies among key populations (KPs) in low‐ and middle‐income countries. In March 2020, in response to COVID‐19, the Government of India revised HIV service delivery policies to include community antiretroviral therapy (ART) distribution and multi‐month dispensing (MMD) of ART for all people living with HIV (PLHIV).MethodsTo assess the acceptability of these adaptations and impact of the pandemic among KPs, we conducted focus groups in November–December 2020 with purposively sampled men who have sex with men (MSM), female sex workers (FSWs) and transgender women (TGW) in Telangana and Maharashtra. Seven discussions were conducted. Topics included HIV service access, risk behaviours, economic security and feedback to ensure service continuity. Inductive coding identified themes across topics.ResultsForty‐four individuals aged 20–49 years participated in discussions (13 MSM; 16 FSW; and 15 TGW). Twenty‐four participants self‐identified as living with HIV. People not living with HIV reported challenges in accessing HIV antibody testing at hospitals due to travel restrictions and fear of contracting COVID‐19. Participants accessed HIV antibody testing using transportation arranged by community‐based organizations after lockdowns eased. PLHIV reported uninterrupted ART refills and generally consistent adherence; however, there were experiences of delayed CD4 and HIV RNA testing. Participants shared appreciation for MMD as it saved time, money, and reduced exposure to COVID‐19. Participants expressed gratitude for home deliveries which enabled ART access, yet shared concerns about home‐based services causing confidentiality breaches with family/neighbours. Participants voiced preferences for community‐based service provision due to proximity, convenient hours, and welcoming environments compared to public hospitals. Other requests included support for income, employment, nutrient‐rich food and more accessible mental health, HIV, and other health services.ConclusionsCOVID‐19 restrictions had a greater impact on access to HIV antibody, CD4, and RNA testing services compared to ART access. High acceptance of MMD and community‐based services support the continued role of differentiated service delivery models to improve KP access to HIV antibody, CD4, RNA testing services, convenient ART retrieval, and integrated services beyond HIV, which may be critical for survival and wellbeing.
Background and Objectives: Circle of Willis plays a vital role in collateral circulation and redistribution of blood to all areas of the brain. Variation in circle of Willis is known to cause grave disorders like cerebrovascular disorders, subarachnoid haemorrhage, cerebral aneurysm and schizophrenia. The objectives of the present study are to study the formation and branching pattern of circle of Willis and also to study the distribution of variations. MATERIALS & Methods: The study was conducted on 50 adult brain specimens. Each brain was removed in one piece by dissection and the circle of Willis was observed for its formation, pattern and variations. Results: Among the 50 specimens studied, 28 cases (56%) had a normal pattern of circle of Willis and variations were observed in the remaining 22 cases (44%). More number of variations was observed on the right side than on the left side. The most common variation observed was hypoplastic posterior communicating artery (7 cases, 31.8%). Posterior communicating artery was found to be the most variable vessel while middle cerebral artery was the least variable vessel. Interpretation and Conclusion: The results with respect to the circle of Willis and all its component arteries were consistent with the results in the available literature. The only exception was the increased incidence of absence of both the anterior and posterior communicating arteries. This finding is of clinical significance to neurologists and neurosurgeons in this geographical location of north Karnataka. A higher incidence of variations in the communicating arteries is likely to manifest as a higher incidence in disorders like migraine, schizophrenia and cerebrovascular disorders due to compromised collateral circulation and poor redistribution of blood.
BACKGROUND: COVID-19 lockdown has mandated the medical colleges to start academics using electronic mode. Synchronous e-learning was started by our institute to replicate traditional classes in line with the routine academic schedule. the objective of this study attempted to assess the e-learning readiness of the students of our institute. MATERIALS AND METHODS: A cross-sectional descriptive study was planned using the model proposed by Oketch et al . with local modifications. The questionnaire was designed in Google Forms and mailed to respond using Likert scale. The nonparametric data collected from the total 84 respondents were analyzed for validity and reliability of the questionnaire, mean values to know the readiness (mean = 3.4), and one-step multiple regression to know the predictors. RESULTS: The mean eLR (e-learning readiness) as evaluated from attitudinal readiness (Mean AR = 3.6), culture readiness (Mean CR = 2.3), material and technological readiness (Mean MTR = 3.7), and mental health readiness (Mean MHR = 2.4) is 3.03 (60.6% with n = 84). Multiple regression analysis revealed that all the variables except MHR can significantly predict e-learning readiness linearly ( P < 0.05). CONCLUSION: The institute is ready for e-learning in terms of AR and MTR (mean values >3.4). CR and MHR still need a lot of improvisation to make it acceptable for e-learning. The model could explain 54.9% readiness level with CR as the most important predictor. More than 73% ( n = 84) of the respondents have acknowledged the present form of online classes to be the best available option in COVID-19 lockdown and most of them are adapted to e-classes in the institute.
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