All India Institute Of Medical Sciences Research Articles

An Assessment of the Profile and Predictors of Outcomes in COVID-19 Patients Hospitalized in a Tertiary Care Institute in Central India

BackgroundCoronavirus disease 2019 (COVID-19) is the largest pandemic that has affected people around the globe. Various researches have been conducted worldwide, but there is a scarcity of data from Central India on the relationship between several risk factors for infection and mortality. Our study assessed the predictors and patient profiles of those with COVID-19, which will aid in prioritizing patient treatment and preventive measures.MethodsA retrospective study was done between March and December 2020. The study included 5,552 COVID-19 patients admitted to the All India Institute of Medical Sciences (AIIMS), Raipur. A validated questionnaire form provided by the WHO was used. Data for multiple clinical and nonclinical parameters were collected, and analysis was done using SPSS version 26 (IBM Corp., Armonk, NY, USA) and STATA version 12 (StataCorp LLC, College Station, TX, USA). Mortality and risk assessment of patients was done using multivariate logistic regression.ResultIn our study cohort of 5,552 COVID-19 patients, the median age was found to be 47 years (interquartile range (IQR): 31-60 years; range: 14-100 years), and 3,557 (64%) were male. Predominantly, patients presented with fever (41.30%), cough (40.20%), and dyspnea (29.29%). The major comorbidities were hypertension (29.70%), diabetes (25.40%), and chronic cardiac disease (5.79%). The common complications were liver dysfunction (26.83%), viral pneumonitis (23.66%), acute renal injury (15.25%), and acute respiratory distress syndrome (ARDS) (13.41%). In multivariate analysis, age (more than 40 years) (odds ratio (OR): 2.63; 95% confidence interval (CI): 1.531-4.512; p<0.001), diabetes (OR: 1.61; 95% CI: 1.088-2.399; p=0.017), obesity (OR: 6.88; 95% CI: 2.188-12.153; p=0.004), leukocytosis (OR: 1.74; 95% CI: 1.422-2.422; p<0.001), lymphocytopenia (OR: 2.54, 95% CI: 1.718-3.826; p<0.001), thrombocytopenia (OR: 1.15; 95% CI: 1.777-8.700; p=0.001), and ferritin concentration > 1,000 ng/mL (OR: 4.67; 95% CI: 1.991-10.975; p<0.001) were the independent predictors of mortality among COVID-19 patients.ConclusionThe leading comorbidities in our study were hypertension, followed by diabetes. Patients who were 40 years or older, obese patients, and diabetic patients have a higher mortality risk. The poor prognostic predictors in COVID-19 patients were high ferritin levels (>1,000 ng/mL), leukocytosis, lymphocytopenia, and thrombocytopenia.

Prospective Validation of a Novel Triage System Developed in a Middle Income Country - AIIMS Triage Protocol.

Triage is a crucial process not only to identify sick patients and prioritize prompt management but also to foster efficient resource utilization. In low-and middle-income countries (LMICs) most emergency departments (ED) still have an informal triage process. Although an important element of emergency care, triage research has not been a priority in LMICs, and hence, very few triage systems have been validated. The All India Institute of Medical Sciences (AIIMS) triage protocol or ATP for adult patients was developed by expert consensus at AIIMS using the Delphi method. We attempted a prospective validation of the ATP in terms of mortality and intensive care unit (ICU)/hospital admission at 24 h. Patients presenting to the ED, who were 14 years and above were included in the study. The patients were followed up at 24 h and their outcome documented on a standardized data collection form. Mortality and ICU admission were noted at 24 h. A total of 15,505 patients were recruited. After exclusion, among 13,754 patients, 6303 (45.83%) were triaged red and 7451 (54.17%) were triaged yellow. Mortality at 24 h was 10.31% (650) in red triaged patients and 0.35% (26) in yellow triaged patients. The 24-h mortality of red triaged patients was significantly higher (P <0.001) than that of yellow triaged patients. The presence of one or more ATP "Red" criteria was 96.2% (95% confidence interval [CI]: 94.42%-97.47%) sensitive and 56.8% (95% CI: 55.92%-57.63%) specific in predicting 24-h mortality. The sensitivity and specificity of ATP "Red" criteria for 24-h ICU admission were 98.5% (95% CI: 97.7%-99.1%) and 59.6% (95% CI: 58.8%-60.5%), respectively. When applied to adult nontrauma patients, ATP had a high accuracy in recognizing sick patients presenting to the ED. A time-tested and validated triage system like ATP may be a good starting point for public hospital EDs in LMICs.

Indian medical student perspectives on online mode of education.

The coronavirus pandemic has led to drastic changes in the education system globally. The medical education curriculum has also undergone a significant drift from traditional or physical classes to online classes. The study aims to explore the viewpoints of the Indian medical students toward online classes, their ramifications, and suggestions for improvement. The self-administered online questionnaire using the Google form was developed, validated, and circulated among students of All India Institute of Medical Sciences (AIIMS), New Delhi. The data of the survey were systematically analyzed by descriptive statistics. A total of 223 students filled the Google form. After applying the inclusion and exclusion criteria, 171 students were finalized, and the analysis was done. The data suggested that 49.7% of the participants were facing technical glitches, poor Internet connectivity being the commonest. Eye straining (56.7%) was the major physical health hazard, whereas lack of concentration (53.8%) was the major psychological issue reported by the students. The major advantage of online classes reported was its accessibility (93%) at any time and place, whereas students also reported that the traditional learning method is more interactive and motivating (72.5%). Overall, 72.5% of the students wanted to continue both modes of education after the coronavirus disease (COVID-19) pandemic. As per the analysis of the results, it is concluded that, since both online and offline modes of education have advantages and disadvantages, henceforth, mixed or blended method of learning is the best form of learning medical science.

Post-graduate training in Laboratory Medicine: Potential to fill a crucial gap in Indian healthcare system

Quality Laboratory services with a widespread reach is the core of a healthcare system of the country. Diagnostic services at all levels requires technical expertise of different laboratory specialists. However the presence of all specialist together in one setup is always not possible due to limited number of trained manpower. Even today, diagnostic laboratory services remain unsupervised. To void this gap, All India Institute of Medical Sciences (AIIMS) New Delhi, in 1988, opened up the patient-centric department of Laboratory Medicine with a centralised specimen collection centre and a core laboratory performing the majority of the routine laboratory investigations, offering a one-window solution to both patients and clinicians. In 1997, a three-year postgraduate Masters degree (MD) in Laboratory Medicine was started. This medical specialty encompasses the art of test selection, test operation, and test interpretation to manage patients. It aligns with the recent technological advancement of automation and advanced instrumentation that are breaking boundaries of the traditional medical laboratories of pathology, biochemistry, and microbiology. This postgraduate model ensures that the laboratory services are accessible, affordable, and available to both patients and clinicians without compromising quality care. Laboratory Medicine is emerging as an answer to one of the several inadequacies and pitfalls of the Indian health system.

AIRWAY INFLAMMATION IS ASSOCIATED WITH PULMONARY FUNCTION IN OBESE ASTHMATIC INDIAN CHILDREN

Objective: Obesity and asthma are related conditions, however, the underlying mechanism between the two is not understood. This study aims to determine the correlations between fractional exhaled nitric oxide (FeNO) and spirometry parameters in obese asthmatic children. Design and method: In this study, 47 overweight/ obese asthmatic children (physician-diagnosed children with partly/ uncontrolled asthma as per Global Initiative forAsthma guidelines) were recruited from Pediatrics Chest Clinic, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India. The measured height and weight were used to calculate BMI. BMI derived was categorized by using Z score tables of WHO-BMI for age standards for boys and girls between 5 and 19 years. Children were assessed using measurement of FeNO(NIOX1; Aerocrine, Solna, Sweden), and spirometry parameters were assessed using Superspiro MK2 Micro Medical Ltd, UK. Correlation between FeNO levels and spirometry parameters were investigated using Spearman’s correlation coefficients. Results: The mean ± SDage was 11.3 ± 2.5 years (males, n = 37), BMI = 24.91 ± 7.05 Kg/m2 and median (interquartile range) FeNO levels were 22.0 (17.0, 65.0) ppb. The mean ± SD predicted forced expiratory flow (FEF25–75) predicted was 83.5 ± 16.3%. The mean age of onset of asthma was 6.3 years. Twenty-four children had partly controlled asthma and 23 children had uncontrolled asthma. FeNO was significantly and inversely correlated with predicted FEF25-75 (r = -0.378, p &lt; 0.001). Conclusions: FeNO an easily measurable indicator of airway inflammation in combination with lung function may prove a useful tool in the asthma assessment and management in obese Indian asthmatic children.

Protocol for process evaluation of SMART Mental Health cluster randomised control trial: an intervention for management of common mental disorders in India

IntroductionIn India about 95% of individuals who need treatment for common mental disorders like depression, stress and anxiety and substance use are unable to access care. Stigma associated with help...

Methanol Poisoning: An Autopsy-Based Study at the Tertiary Care Center of Uttarakhand, India.

Aims and objectiveThis study describes postmortem and histopathological findings to understand the internal progression of methanol poisoning. The study also aims to examine clinical, biochemical, and histological changes seen with methanol poisoning.Materials and methodsThe study describes the methanol poisoning tragedy that occurred in February 2019 in the Haridwar district of Uttarakhand. Ninety-one patients were admitted to the hospital, four were brought dead, four died within a few hours of admission (designated as early deaths), and four died between 10 and 45 days of hospitalization (designated as late deaths). A medicolegal autopsy was performed on all 12 deaths. Gross external and internal findings were noted, and routine viscera and blood were preserved and sent to Uttarakhand's Forensic Science Laboratory (FSL) to estimate methyl alcohol. A section of the optic nerve was taken from the optic chiasma for histopathological examination. Data were collected retrospectively from records. All data were tabulated and analyzed using Microsoft Excel version 2019. The study was approved by the Institutional Ethics Committee of All India Institute of Medical Sciences (AIIMS), Rishikesh (249201), Uttarakhand, India.ResultsMethanol poisoning is a health-associated disaster in many regions of India. Autopsy, including histopathological examination, could elicit the adverse effects of methanol on different organs. Their mean age was 37.7 years (range 21-70), and 67% (n = 8) of all victims were in the age range of 30-50 years. The average methyl alcohol level reported among hospital deaths and brought dead was 116.08 mg/dl and 224.6 mg/dl, respectively. A blurred vision had been their most common complaint, identified in 75% (n = 6), followed by vomiting and abdominal pain, while 50% (n = 4) had features of respiratory insufficiency. Mean pH and bicarbonate levels among hospital deaths were 6.61 mmol/l and 6.18 mmol/l, respectively. An autopsy revealed signs of hypoxia in all cases. Internal organs were congested. Severe metabolic acidosis leading to the respiratory failure was the cause of death in early deaths. Cerebral and pulmonary edema consequent upon septicemic shock was the cause of late deaths. A case with the most extended survival duration showed cerebral edema with intracerebral hemorrhage. Cirrhotic liver, along with features of renal failure, was an additional internal finding in late deaths. Optic nerve histopathology showed no demyelination or axonal necrosis; however, mild edematous changes were evident.ConclusionsMethanol poisoning is one of the manmade disasters in the developing world. There are various adverse effects of different organs and organ systems inside the body. Timely intervention and diagnosis can save several lives. The organ-directed meticulous autopsy can help autopsy surgeons in establishing the diagnosis and thus help the judiciary in delivering justice to the sufferers.

Effectiveness of nurse-led educational intervention package on back pain and activity of daily living in primigravidae women with back pain

Background: The primigravida women often have more complaints of back pain during pregnancy. Pregnant women reported that back pain might affect the activities of daily routine e.g. walking, climbing stairs, sitting, and women may expect help from family members.Methods: A quasi-experimental study was directed on primigravidae women visiting antenatal outpatient department (OPD) of All India Institute of Medical Sciences (AIIMS) Jodhpur. An absolute of 60 primigravidae women (30 in each experimental and control group) were incorporated through the non-probability consecutive sampling method.Results: The pre-test score uncovered that the majority of the women (70%) in the experimental group and (60%) in the control group revealed moderate pain. The post-test score uncovered that (56.6%) in the experimental group detailed mild pain and 53.3% of women in the control group reported severe pain. When compared with the pre-test, the pain score of members in the experimental group was diminished and in the control group, the pain score was increased in post-test (p≤0.000). No critical contrast was found in the activity of daily living in the experimental and control group. For analysis, paired and unpaired t-test, x2, and Fisher exact tests were used.Conclusions: The majority of primigravidae women had back pain during pregnancy and participants recognized prolong sitting as the most well-known aggravating factor. It was discovered that there was a significant distinction in pain scores between pre-test and post-test in the experimental and control group.

Predicting Timelines in Healthcare Infrastructure Projects: Learnings From an Apex Tertiary Care Teaching Hospital in North India.

AimHealthcare infrastructure projects are a requirement for the progress of the country. The aim of this study was to identify major completed healthcare infrastructure projects in a tertiary teaching hospital in Northern India and to find out the various factors that influenced the success or failures and the cost and time overrun during the project implementation.Materials and methodsPeriodical review meetings were conducted, right from the planning to the execution and commissioning of these projects. All these had been documented as minutes of the meetings, and the records of the same had been maintained. The study comprised of studying all these documents in detail and finding an answer to the research questions.ResultsFour major completed projects of a tertiary medical institute of India, All India Institute of Medical Sciences (AIIMS), New Delhi, India, were studied. These were the new Outpatient Department (OPD) Block, Burns and Plastic Surgery Block (BPS), Maternal and Child Health Block (MCH), and National Cancer Institute (NCI). Our study revealed that there was no dearth of funds, and hence, there was no cost overrun in any of the projects. Whenever the funds had to be reworked, the funds that were asked for were released. However, there was a considerable time overrun in all the projects ranging from about one to four years. The various reasons that could be attributed to this are the delay in obtaining statutory clearances, political interference, communication hurdles, improper planning, introducing a project officer late into the project, safety concerns, and the COVID-19 pandemic.ConclusionsThis study focuses mainly on the very important hurdles that were faced during the implementation of the projects and tries to suggest an average time frame for various activities for project implementation in a healthcare project in the Indian scenario. This can be taken as blueprints while planning newer healthcare projects of this magnitude.

Prospective validation of AIIMS index as a predictor of steroid failure in patients with acute severe ulcerative colitis.

Optimal outcomes in acute severe ulcerative colitis (ASUC) are related to time-bound management based upon early prediction of response to intravenous (IV) steroids. In an earlier study, we described the All India Institute of Medical Sciences (AIIMS) index (baseline Ulcerative Colitis Endoscopic Index of Severity [UCEIS] ≥ 7 and day 3 fecal calprotectin [FCP] > 1000μg/g) for predicting failure of IV steroids. The current study is designed to validate this index in a prospective cohort. IV steroid-naïve patients with ASUC, satisfying Truelove and Witts' criteria, hospitalized from August 2018 to July 2019 were included. Patients' assessment included baseline sigmoidoscopy, day 1 and 3 FCP, hemogram, biochemistry and day 3 C-reactive protein. All patients received IV steroids, and the primary outcome was steroid failure, defined as the need for colectomy or rescue therapy with cyclosporine (CYC)/infliximab (IFX) during admission. Of the 47 patients, eight were excluded (four received steroids outside, two were directly taken for surgery/infliximab therapy, one had toxic megacolon, and one had infectious colitis), and 39 patients were included (mean age: 36.1 ± 12.6years, male: 31%). Fifteen patients (38%) failed IV steroid and required rescue therapy (IFX: 9, CYC: 2, Colectomy: 3, IFX followed by colectomy: 1). On univariate analysis, UCEIS ≥ 7 at baseline (p = 0.006), day 1 FCP (p = 0.03), day 3 FCP > 1000μg/g (p = 0.001), Oxford criteria (p = 0.04) and AIIMS index (p < 0.001) were significantly different between steroid responders and steroid failures. On multivariate analysis, day 3 FCP > 1000μg/g (odds ratio (odds ratio (OR)= 6.4;(95% CI =2.2-196.1) and baseline UCEIS ≥ 7 (OR) = 10.1;(95% CI = 2.1-80.2) were independent predictors. The AIIMS index predicted steroid failure with a better specificity (100% vs. 83%, p = 0.04) and positive predictive value (100% vs. 64%, p = 0.03) than Oxford criteria. AIIMS index has been validated in 39 prospective ASUC patients as an effective early predictor of steroid failure (sensitivity = 53%, specificity = 100%).

Prekallikrein deficiency: Challenges in laboratory testing

International Journal of Laboratory HematologyEarly View REPLY Prekallikrein deficiency: Challenges in laboratory testing Reema Abraham, Reema Abraham Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorGanesh Kumar Viswanathan, Corresponding Author Ganesh Kumar Viswanathan ganesh@aiims.edu orcid.org/0000-0003-4793-6829 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India Correspondence Ganesh Kumar Viswanathan, Department of Hematology, All India Institute of Medical Sciences (AIIMS), #206, New Private Ward, New Delhi 110029, India. Email: ganesh@aiims.eduSearch for more papers by this authorJasmita Dass, Jasmita Dass orcid.org/0000-0001-8282-7842 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorRishi Dhawan, Rishi Dhawan Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorMukul Aggarwal, Mukul Aggarwal Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorPradeep Kumar, Pradeep Kumar Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorTulika Seth, Tulika Seth orcid.org/0000-0001-9760-7957 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorManoranjan Mahapatra, Manoranjan Mahapatra Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this author Reema Abraham, Reema Abraham Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorGanesh Kumar Viswanathan, Corresponding Author Ganesh Kumar Viswanathan ganesh@aiims.edu orcid.org/0000-0003-4793-6829 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India Correspondence Ganesh Kumar Viswanathan, Department of Hematology, All India Institute of Medical Sciences (AIIMS), #206, New Private Ward, New Delhi 110029, India. Email: ganesh@aiims.eduSearch for more papers by this authorJasmita Dass, Jasmita Dass orcid.org/0000-0001-8282-7842 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorRishi Dhawan, Rishi Dhawan Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorMukul Aggarwal, Mukul Aggarwal Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorPradeep Kumar, Pradeep Kumar Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorTulika Seth, Tulika Seth orcid.org/0000-0001-9760-7957 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorManoranjan Mahapatra, Manoranjan Mahapatra Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this author First published: 04 April 2022 https://doi.org/10.1111/ijlh.13843Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Audit of In-Hospital Mortality from a Medical Oncology and Hemato-Oncology Center with the Emphasis on Best Supportive Care.

Deepak SundriyalBackground and Objectives The newly established medical oncology and hemato-oncology center at the All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India, provided us an opportunity to audit in-hospital mortalities with a vision that the audit will serve as a standard for ceaseless improvement. Aim of the study was to initiate a vigorous process for the evaluation of all-cause mortality in patients suffering from cancer. Methods An audit of all in-hospital deaths that occurred during the year 2019 was performed, and comprehensive scrutiny of various parameters (demographic, clinico-pathological, therapeutic, causes of death) was done. Reviews from two independent observers sharpened the infallibility of the audit. The lacunae in the existing practices and the scope for further improvement were noted. Results Forty-five in-hospital deaths were registered during the study period (January-December 2019). The majority of the deaths occurred in patients with advanced stage of malignancy ([ n = 31] 68.8%). Most common causes of death were progressive disease, neutropenic, and non-neutropenic sepsis. Chemotherapeutic agents, growth factors, blood components, and antibiotics were found to be used judiciously as per institutional policy. The reviewers emphasized on the use of comorbidity indexes in the treatment planning and avoiding intensive care unit referrals for patients receiving best supportive care (BSC). Emphasis was put on providing only BSC to the patients with a very limited life expectancy. Emphasis was also laid down on record of out of the hospital deaths. Interpretation and Conclusion The audit disclosed areas of care which require further improvement. The mortality audit exercise should become a regular part of evaluation and training for the ongoing and future quality commitment. This should impact the clinical decision making in an oncology center providing quality care to the terminally ill patients.

Telemedicine practice guidelines in India: Global implications in the wake of the COVID‐19 pandemic

Telemedicine is the delivery of healthcare services from a distance, by use of information and communication technology. There have been no statutory regulations or official guidelines in India specific for telemedicine practice and allied matters so far. For the first time, the government of India released telemedicine practice guidelines for Registered Medical Practitioners on March 25, 2020, amid the COVID‐19 outbreak. This review would initiate the discussion on the features of the guidelines, their limitations, and their significance in times of the COVID‐19 pandemic. The guidelines are with a restricted scope for providing medical consultation to patients, excluding other aspects of telemedicine such as research and evaluation and the continuing education of healthcare workers. The guidelines have elaborated on the eligibility for practicing Telemedicine in India, the modes and types of teleconsultations, delved into the doctor‐patient relationship, consent, and management protocols, and touched upon the data security and privacy aspects of Teleconsultation. After releasing the guidelines, the telescreening of the public for COVID‐19 symptoms is being advocated by the government of India. COVID‐19 National Teleconsultation Centre (CoNTeC) has been initiated, which connects the doctors across India to All India Institute of Medical Sciences (AIIMS) in real‐time for accessing expert guidance on the treatment of the COVID‐19 patients.

Nutritional overview of non-critical COVID-19 patients during quarantine in a premier hospital of India

Corona virus disease (COVID-19) is a recent global disease. During hospital quarantine of non-critical COVID-19 patients, specific attention is given on their general management and little is known regarding the nutritional approach. The present study was therefore conducted to assess their dietary predilections during hospital quarantine.A prospective observational study was conducted in non-critical COVID -19 patients admitted in isolation wards of All India Institute of Medical Sciences (AIIMS), New Delhi from 1 November 2020 to mid of January 2021. A dietician administered a pre validated questionnaire telephonically to obtain data regarding demographic, anthropometric and dietary characteristics. The results were expressed as mean, standard deviation and median. Chi square tests were used to compare category variables. Statistical analysis was performed using SPSS 9 version 20.0.SPSS, Inc., Chicago IL). 132 patients volunteered to enrol in the study. The mean age of patients was 34.6 +13.5years. Portion size of foods served and number of food groups in breakfast, lunch and dinner as per standard diet scale for balanced hospital diet, did not differentiate by BMI categories (Pearson’s x&amp;#62;0.05). The mean body mass Index (BMI) was 23.75+4.15. Being overweight and obese correlated with taste issues (Pearson’s x&amp;#60; 0.05). Additional centre of attention on fruits, vegetables, fluids and proteins Owing to the recent growing COVID-19 situation, the findings of the present study may be utilized in developing the most favourable nutritional strategies within the inpatient hospital menu for providing enhanced nutritional care.

Prediction of Preeclampsia Using First-Trimester Uterine Artery Doppler and Pregnancy-Associated Plasma Protein-A (PAPP-A): A Prospective Study in Chhattisgarh, India

IntroductionPreeclampsia is a major contributor of maternal and perinatal morbidity and mortality. Uterine artery waveform and biomarkers like pregnancy-associated plasma protein-A (PAPP-A) may reflect the pathophysiology of preeclampsia. Thus, we aim to find out whether abnormal uterine artery pulsatility index (PI) and low serum PAPP-A in the first trimester can predict preeclampsia.MethodologyAntenatal women at 11-13+6 weeks of gestation visiting All India Institute Of Medical Science (AIIMS) in Raipur were enrolled after informed consent. Uterine artery Doppler was done with the early anomaly scan at 11-13+6 weeks. Serum levels of PAPP-A were analyzed. The women were followed up at intervals up to delivery. Incidence of preeclampsia and gestational hypertension was noted.ResultsThe incidence of preeclampsia was 12.7%, and that of gestational hypertension was 4.9%. The mean uterine artery PI among those who developed hypertension in pregnancy was 2.007, which was significantly higher than the unaffected group (p=0.01). The first-trimester uterine artery PI as a screening tool showed a sensitivity of 68%, specificity of 52.99%, and detection rate (DR) of 55.63%.The mean PAPP-A MoM of the affected group was 0.67 which was significantly higher than the unaffected group (p<0.001). The first trimester PAPP-A as a screening tool showed a sensitivity of 28%, specificity of 90.6%, and DR of 79.58%.ConclusionBoth the tests were concluded to be good predictors of hypertension in pregnancy. Identification of high-risk factors, screening, and surveillance are of utmost importance in order to predict preeclampsia and initiation of preventive therapy.

Web based library Services in AIIMS Library in India: an overview

We are living in the virtual environment and the emerging growth and developments of internet has modified our society in every aspect. Libraries are more responsive in making users net-savvy. Not only have internet and technological developments affected the formats and sources of information, but also how and where libraries provide their services to the user. The World Wide Web (WWW) and Internet's emergence as a new medium for information storage and transmission have created an unrivalled medium for delivering information with higher speed and efficiency. All India Institute of Medical Sciences (AIIMS) are autonomous, government-funded, public medical institutions established for the advancement of medical education in India. The paper examines what web-based services, why they are important, and why they are so popular among users , as well as their benefits and drawbacks in AIIMS library, and on the basis of their website details, the evaluation of four AIIMS libraries is also emphasized.

Covid-19 and Psychology: A Scientometric Assessment of India’s Publications during 2020-21

International Journal of Medicine and Public Health,2022,12,1,1-7.DOI:10.5530/ijmedph.2022.1.1Published:January 2022Type:Review ArticleCovid-19 and Psychology: A Scientometric Assessment of India’s Publications during 2020-21Sandeep Grover, BM Gupta, Madhu Bansal, and K.K. Mueen Ahmed Sandeep Grover1,*, BM Gupta2, Madhu Bansal3, K.K. Mueen Ahmed4 1Post Graduate Institute of Medical Education and Research, Chandigarh, INDIA. 2Formerly with CSIR-NISTADS, New Delhi 110012, INDIA. 3Panjab University, Department of Mathematics, Chandigarh, INDIA. 4Phcog.Net #17, Cox Town, Bengaluru, Karnataka, INDIA. Abstract:Objectives: The present study examines the publication output of authors from India on the topic of “Covid-19 and Psychology” using bibliometric methods. Methods: The publications as listed in Scopus database were identified by using “Covid-19” and its synonyms keywords in “Keyword” and “Title” tags. The results obtained were further restricted to subject “Psychology” under subject tag and country to India. Results: 372 publications emerged in the last 2 years on the topic of “Covid-19 and Psychology”, accounting to 4.63% share of global output. About 9.95% and 25.81% share of Indian publications received external funding support and involved international collaboration, respectively. The author’s from 277 organizations and 416 authors participated unevenly in the research in this area. The highest number of publications emerged from National Institute of Mental Health and Allied Sciences (NIMHANS), Bangaluru, followed by Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, All India Institute of Medical Sciences (AIIMS), New Delhi and All India Institute of Medical Sciences (AIIMS), Bhubaneswar. Authors from Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry had highest impact in terms of citations per paper and relative citation index, followed by authors from King George’s Medical University (KGMU), Lucknow, and Manipal Academy of Higher Education (MAHE), Manipal. The journals that published the highest number of publications were Asian Journal of Psychiatry (158 papers), Indian Journal of Psychological Medicine (44 papers), and Frontier in Psychology (18 papers). The most commonly investigated topics in terms of frequency of appearances of keywords were mental health (93), followed by anxiety (80), mental disease (68), depression (64), mental stress (34), and social isolation. Conclusion: Over the last 2 years a large number of publications have emerged in the area of COVID-19 and psychology from India. Keywords: Covid-19, Psychology, India, Bibliometrics, Scientometrics. Keywords:Bibliometrics, COVID-19, India, Psychology, Scientometrics.View:PDF (579.03 KB)

Unwelcomed and devalued: Preachers of exclusion plagiarize from documents of inclusion.

The All India Institute of Medical Sciences (AIIMS), New Delhi published guidelines, titled "Report of the Expert Group for framing Guidelines for admission of candidates with benchmark disabilities in postgraduate courses at AIIMS, New Delhi", for doctors with disabilities seeking postgraduate admissions to the Institutions of National Importance. The expert group, which lacked representation of people with disabilities, in general, and doctors with disabilities, in particular, puts immense effort into justifying why trainees with disabilities must not join AIIMS, at times in bold and/or capital letters, and at other places, in an outright ableist language. In addition, there is blatant plagiarism from well-known advisories and guidelines which are known for promoting the inclusion of trainees with disabilities. Attitudinal barriers and biases remained incorrigible as sections of these documents were selectively abridged to justify prevailing exclusion practises. We link the connection of these members to the controversial National Medical Council guidelines for undergraduate admission of persons with specified disabilities, which were successfully challenged in courts, as well as to the identification of posts for employment at AIIMS. We justify disability accommodations by citing inclusive court interventions from India to emphasise that the notion of inclusive equality includes the provision for reasonable accommodations. It is high time that the motto "Nothing about us, without us" becomes a locus classicus for immediate change of these discriminatory guidelines, as well as the prescribing powers of such experts.

Symposium

Patients with first episode psychoses (FEP) have better chances of recovery if detected early and treated rigorously. The implementation of early treatment for first episode and untreated psychosis is key to reducing the burden of disability due to psychotic disorders. However, the complexity of the Indian healthcare system and differences in cultural context means that simple ‘transplantation’ of western interventions is virtually impossible. Early intervention services focus specifically on reducing the duration of untreated psychosis (DUP), enhancing therapeutic engagement, and improving clinical and social outcomes by providing care in community-based, low-stigma settings. UK and Canada have led the development of early interventions in psychosis nationally and internationally.Combining the expertise from the UK, Canada and India, the Warwick-India-Canada (WIC) Project aimed to improve the health, wellbeing, and functioning, and reduce the burden for those with psychotic disorders in India. The focus was tailoring evidence-informed interventions to the Indian socio-cultural context to 1) transform the outcomes of psychotic disorders; 2) provide high quality research evidence for clinicians and policy makers; and 3) build research capacity, including new methodologies such as economic evaluation and implementation science. As part of the WIC project, two clinical sites – All India Institute of Medical Sciences (AIIMS), New Delhi and Schizophrenia Research Foundation (SCARF), Chennai used common assessment and outcome measures and standard management protocol for patients with FEP. The study found substantial improvement on various outcome measures including functioning and family burden. The results offer scope of further application of the management protocol on a larger scale in low- and middle-income countries.In this symposium, the presenters will discuss the background of the study, protocols of assessment and interventions, compare findings at two centres and implications of the findings.Background of the WIC study: Swaran Preet Singh, university of Warwick, UK Study Protocol for First Episode Psychosis: R Thara, SCARF India, Chennai Comparison of two centres: Mamta Sood, AIIMS, New DelhiComorbidity and Physical Activity Intervention: R Padmavati, SCARF India, ChennaiImplications of the study: Rakesh K Chadda, AIIMS, New Delhi

Symposium

Patients with first episode psychoses (FEP) have better chances of recovery compared to schizophrenia. Early stages of psychoses are critical in predicting its course and intervention early in the course of illness is important. Outcome of FEP can be improved by intervening early in the course of the illness. The implementation of early treatment for first episode and untreated psychosis is key to reducing the burden of disability due to psychotic disorders. However, the complexity of the Indian healthcare system and differences in cultural context means that simple ‘transplantation’ of western interventions is virtually impossible. Early intervention services focus specifically on reducing the duration of untreated psychosis (DUP), enhancing therapeutic engagement, and improving clinical and social outcomes by providing care in community-based, low-stigma settings. UK and Canada have led the development of early interventions in psychosis nationally and internationally. Combining the expertise from the UK, Canada and India, the Warwick-India-Canada (WIC) Project aimed to improve the health, wellbeing and functioning, and reduce the burden for those with psychotic disorders in India. The focus was tailoring evidence-informed interventions to the Indian socio-cultural context to: 1) transform the outcomes of psychotic disorders; 2) provide high quality research evidence for clinicians and policy makers; and 3) build research capacity, including new methodologies such as economic evaluation and implementation science. As part of the WIC project, two clinical sites – All India Institute of Medical Sciences (AIIMS), New Delhi and Schizophrenia Research Foundation (SCARF), Chennai used common assessment and outcome measures and standard management protocol for patients with FEP. By using validated and reliable assessment and outcomes measures, we planned cross-country and cross- setting comparisons and provide information to develop culturally appropriate, accessible, and acceptable interventions, which can be robustly tested for clinical and economic effectiveness, to improve psychosis outcomes in India and other LMIC. In this symposium, we share assessment and management protocol used for the FEP, their results and implications in two centres in IndiaBackground of the WIC study: SPSStudy Protocol for First Episode Psychosis: RTComparison of two centers: MS Implications of the study: RKC