South India Research Articles

Prevalence of Periodontitis among Thermal Power Station Workers in South India

ABSTRACT The occupational stressors has an effect on overall health and dental health. Oral health is a vital aspect of general health. The current study was performed to assess the periodontitis among thermal power station workers in South India. Pilot study was done for 52 mine workers and based on the periodontal disease prevalence among them, the sample size was calculated as 603 subjects. The data collection was done using WHO 1997 proforma. Among the total study population, about 92 (30%) thermal power station 1 workers and 83 (28.1%) thermal power station 2 workers had pocket 4-5 mm, one (0.2%) thermal power station, 2 worker had pocket 6 mm or more thermal power station I workers, and 23 (7.8%) thermal power station 2 workers had 6 – 8 mm attachment loss. Only 1 (0.3%) thermal power station I worker had 9 – 11 mm attachment loss. In the current study, nearly 70% mine workers had calculus, nearly 30% had pocket 4-5 mm, and only 0.2% Mine II workers had pocket measuring 6 mm or more.

Snoezelen therapy for pain, labor outcome and maternal satisfaction among parturient at tertiary hospital, South India

IntroductionLabor is a physiological process that causes severe discomfort, leading to maternal dissatisfaction. Snoezelen therapy, a multisensory complementary therapy, promotes comfort and relaxation by releasing endorphins, thereby improving satisfaction during the labor process. ObjectiveTo assess the effectiveness of Snoezelen therapy on pain perception, labor outcomes, and maternal satisfaction among parturients. MethodsAn experimental pretest-posttest control design was conducted among 74 parturient selected using consecutive sampling techniques in South India. Baseline observations were obtained at the beginning of the active stage, after which the study group parturient were subjected to Snoezelen therapy until reaching 10 cm of cervical dilatation. Hourly assessments of pain, using a numerical pain scale, were performed. Labor outcomes were measured in terms of labor duration and mode of delivery. Maternal satisfaction with the birth experience and satisfaction with Snoezelen therapy components were collected 24 h after delivery. Descriptive and inferential statistics were used for data analysis. ResultsA statistically significant decrease in pain perception (p < 0.001) and an increase in maternal satisfaction (p < 0.001) were noted among parturient who underwent Snoezelen therapy. Parturient expressed high satisfaction with the use of aroma, music, and massage. There was no statistical significance in the duration of delivery and mode of delivery between the study and control groups. ConclusionSnoezelen therapy reduces pain perception and increases maternal satisfaction during the active stage of labor. Thus, Snoezelen therapy can be implemented as part of nursing care during the labor process.

Prevalence of Dental Caries among Thermal Power Station Workers in South India

ABSTRACT Introduction: An increase in the trend of rapid industrialization has resulted in the mushrooming of industries in various sectors throughout the world. This study tries to document caries prevalence among thermal power station workers in South India. Materials and Methods: A pilot study was conducted among 53 thermal power station workers, and based on the same, the sample size was calculated. Results: The caries prevalence was 62.5% in thermal power station I workers and 61.5% in thermal power station II workers. The mean DMFT was 2.96 among thermal power station I workers and 2.87 among thermal power station II workers. Conclusion: The caries prevalence was 79.2% in the 35- to 44-year-old age group, according to the National Oral Health Survey and Fluoride Mapping.

The prevalence of pulmonary and extrapulmonary tuberculosis in forensic autopsies in a teaching hospital in South India

ABSTRACT Introduction: An autopsy is a valuable tool for finding the cause of death, exploring the clinical diagnosis, documenting unexpected findings, and resolving diagnostic questions. However, this may subject the forensic pathologist and other workers to a wide variety of blood-borne and aerosolized pathogens. Tuberculosis (TB) is the most common cause of illness and death, resulting in infection transmission in the autopsy room. Our objective in this study was to estimate the prevalence of pulmonary and extrapulmonary tuberculosis among forensic autopsies in a tertiary care hospital in South India. Material and Methods: We identified positive TB cases from acid-fast bacteria staining and culture (Mycobacterium Growth Indicator Tube and Lowenstein–Jensen medium) out of 380 autopsy cases. Results: The prevalence of tuberculosis was 2.4% (n = 9), among which 2.1% of cases were positive for only pulmonary tuberculosis (n = 8), and 0.3% of cases had both pulmonary and extrapulmonary involvement (n = 1). In the bivariate analysis of TB cases, sex, occupation, family history of TB, habit of smoking, BCG vaccine scar, period of hospital stay, and cause of death were potentially significant. Conclusion: The prevalence of TB in forensic autopsy cases were similar to forensic autopsy-based studies, and it was less as compared to the prevalence of TB in the general population.

Awareness about basic life support among undergraduate medical students before and after clinical exposure in a tertiary care hospital attached to a medical school in South India

Background: Knowledge of basic life support (BLS) is one of the life-saving measures that every medical undergraduate student must possess. Aims and Objectives: This study focused on knowing the level of knowledge in fresh medical undergraduate entrants (knowledge A [KA]) and 3rdyear students with clinical exposure but no BLS training (knowledge B [KB]). We also assessed the knowledge in 1st-year students (retention A [RA]) soon after foundation course and compared it with retained knowledge after 6 months (retention B [RB]). Materials and Methods: This non-randomized multigroup cross-sectional study was done on medical undergraduate students in a tertiary care hospital attached to a medical school in South India. A validated questionnaire with 25 questions assessing knowledge of BLS was formulated and administered to 508 medical students. Results: After analyzing data in SPSS V24, the mean scores in KA and KB were 11.03±4.33 and 13.95±5.43, respectively, with a P&lt;0.001 which was significant. Although both the scores were &gt;50%, clinical exposure had some effect on mean scores in medical undergraduates. Mean scores in RA and RB were 23.16±5.09 and 16.17±6.97, respectively, with P&lt;0.001 which was significant, implying less retention of knowledge in RB 6 months after BLS training. Conclusion: A foundation course introduced into the medical curriculum is essential and refresher courses should be conducted frequently to retain the knowledge of BLS as daily academic commitments can prevent retention of BLS knowledge.

IJCM_155A: Socio-demographic profile of patients with Dermatophytoses in tertiary care hospitals in Coastal South India

Background: Dermatophytoses or Dermatophytic infections are diseases characterized by the infection of keratinized tissues. This study was done to study the epidemiological profile and factors associated with Dermatophytosis and the awareness towards the same among patients with such infections. Methodology: This cross-sectional study was carried out in the tertiary hospitals affiliated with Kasturba Medical College, Mangalore. A semi-structured questionnaire was used for the collection of data, which was entered and analysed using SPSS version 25. The results were expressed as proportions. To compare the groups, the Chi-square test was used and p&lt;0.05 was considered statistically significant. Results: Out of the total 118 patients who were included in the study, 57% (n=67) were males. The mean age of the participants was 33.93 years (S.D-12.76). According to our study, among the 118 participants studied, 31% (n=37) of the infected cases belonged to the low-income group (Upper lower), and 63% (n=74) of infected cases belonged to the middle-income group. The study population attributed the occurrence of dermatophytosis to poor skin hygiene (24.5%) followed by occupational exposure (20.1%). A higher proportion, 73% of the patients have increased exposure to water, soil/organic matter, or both. Overall, 90.6% (n=107) were unaware of the complications of the disease and 83.9% (n=99) patients didn’t know of the safety practices followed to prevent it. Conclusion: The occurrence of dermatophytosis is the highest among middle and lower socioeconomic strata people. Poor hygiene, contact with patients and reduced immunity are important risk factors for the disease.

IJCM_110A: How informed are our patients about generic medicines? – A study from coastal South India

Background: Medicines form a major part of out-of-pocket expenditure (OOPE) for patients. The government has introduced schemes to distribute generic medicines at low cost to reduce the financial burden on patients. This study was undertaken to assess the community’s perception of the same. The study aimed to assess the awareness and perception of generic medicines among people visiting tertiary care hospitals in Mangalore. Methodology: This study was a hospital-based cross-sectional study, conducted in two hospitals, one private hospital, and another a government tertiary healthcare centre. A semi-structured questionnaire including socio- demographic variables and questions to assess the knowledge, attitude, and perception about generic medicines and programs about the same was given to the participants. The information obtained was analyzed using SPSS version 17.0 for descriptive statistics. Results: The study included 300 participants. Around 50% of the study participants were aware of the program, of which 59.3% were from a private health setup. The main source of information was found to be friends and family (21.3%). More than half of the people who were aware of the program had never visited a generic medicine store (56%). Conclusion: Knowledge regarding generic medicines was found to be minimal among the participants, especially from the people visiting the public health setup. Hence there is less than optimum utilization of these schemes.

Spatial propagation of different drought types and their concurrent societal risks: A complex networks-based analysis

This study proposes a novel complex networks-based framework to examine the spatial propagation of one type of drought to another (concurrent droughts) in a region and the associated risks. The methodology involves two major steps: (1) Analysis of drought connection patterns using spatial networks of different drought types in a region, using event synchronization and network measures; and (2) Building concurrent drought risk networks to identify smaller-scale (district-level) homogeneous drought risk communities. Meteorological, agricultural, and hydrological droughts as well as hot events are considered for developing the methodology. The proposed method is implemented to study droughts in Peninsular India, a water-stressed region that often witnesses intra- and inter-basin conflicts during drought periods. The results indicate that drought sources of all types and severity are located primarily on the high-altitude divides of river basins. This finding has great significance, since any drought occurring at a source could hint at a forthcoming event in the connected locations. Analysis of the distances of drought connections reveals that meteorological droughts are more localized when compared to the other drought types and that the distances increase with severity levels for all drought types. Furthermore, based on the construction of a correlation-based concurrent drought risk network (using a copula-based multivariate drought index), seven distinct communities of districts are demarcated. The network thus formed is found to inherently capture the topographical and rainfall pattern along with the socio-economic aspects existing in the area. Therefore, the communities detected could facilitate devising appropriate drought mitigation strategies.

Statistical Analysis and Water quality Modeling towards Holistic Health Assessment of Himalayan and Peninsular rivers of India

Water occurs naturally in a variety of forms. Liquid water is present in rivers, lakes, the ground, the sea, and precipitation. The primary objective of water quality monitoring is to ascertain whether the water quality being observed is appropriate for its designated purposes. An investigation was undertaken to assess the concentration levels of various water quality parameters, including total hardness, electric conductivity, temperature, Ca, Cl, K, Mg, Na, SO4, and HCO3. The research assessed the physicochemical parameters of ten (10) rivers, including the following: Brahmaputra (Arunachal Pradesh); Barak (Assam); Godavari (Maharastra); Brahmani (Odisha); Sabarmati (Gujarat); Tapi (Gujarat); Mahi (Gujarat); and Ganga (Uttar Pradesh). Water samples were obtained from the aforementioned rivers spanning the years 2013 to 2020. Descriptive Analysis, one-way ANOVA, Covariance, and Correlation were utilized to examine the impact of the rate of change on the interrelationships among the parameters. At the current level, the Narmada River cannot meet the daily demands that arise during and after the monsoon. The primary sources of pollution were inputs from households, businesses, and agriculture. The Gang River portions have been poisoned by sewerages, untreated industrial discharges, and chemical surges from agricultural fields. The basin is still being impacted by a number of anthropogenic pressures associated with an expanding human population, such as changes in land use, elevated water pollution, increased water demand, river channelization, and the Brahmanputra River's regulating flow. Anthropogenic heavy metals Cu, Cd, Cr, Pb, and Ni have not been shown to exhibit seasonal changes; however, geogenic heavy metals Mn, Fe, Mg, and Ca have been recorded to undergo seasonal oscillations in the Barak River and Still. The alkaline impacts of the Godavari water sample on the river are shown by the physical-chemical analysis of the samples. The amount of dissolved oxygen has decreased at various sites when pollutants are added to the water. A rise in BOD and turbidity levels is a result of the introduction of contaminants at different sites. The tests of TDS and F-coli showed an increase in value because of the sewage and burial procedures. Reduced flows below the dam and sudden increases resulted in a significant loss of organisms due to water discharge for hydropower generation. The Krishna River lost several of its characteristic characteristics as a result of dams being built both upstream and downstream. The Brahmani River's summertime dissolved oxygen (DO) levels are found to vary from 6.16 to 7.81 mg/L. The Brahman River's water quality index varied from 36.7 to 44.1, which is considered excellent water quality. Huge public awareness, strong implementing environmental policy decisions are some of the potential solutions to increase the health conditions of the Himalayan and Peninsular rivers of India. India's Himalayan and Peninsular rivers' health is measured via water quality modeling. This study evaluates river health using physiochemical and biological parameters. This study examines Himalayan and Peninsular India's water resource management, environmental preservation, and public health.

Cutaneous Malignancies: A Prospective Study of Demographic Patterns, Risk Factors, and Clinical Spectrum at a Tertiary Care Center in South India

Background and Objectives: The incidence of skin cancer is increasing worldwide and is causing a massive burden to the health-care system. It arises as a result of interplay between various predisposing factors. We intend to study the various clinical presentations of cutaneous malignancies and the demographic pattern and risk factors associated with them. Methodology: The study was done over a period of 7 years, 181 patients were diagnosed with cutaneous malignancy in the department of dermatology of our tertiary care hospital. A diagnosis was done based on history, clinical and histopathological examination. Results: Of 181 patients, majority of the patients belonged to 7th decade (n = 56, 31%) with the mean age being 55 years. The study group had 105 males (58%) and 76 (42%) females. The most common site was the head-and-neck region (n = 105, 58%). The most important associated condition/predisposing factor was ultraviolet (UV) radiation exposure (n = 79, 44%). Keratinocytic tumors formed the largest group (n = 131, 72%) in which basal cell carcinoma (BCC) was the most common (n = 75, 41%). Surgical excision was the main modality of treatment and was done in 111 (61%) patients. Conclusion: BCC was the most common skin cancer with head-and-neck region being the most common location in our study. Important risk factors were increasing age, male sex, and prolonged exposure to UV radiation. Early diagnosis helps in planning effective management strategies.

Profiling of swallowing function in head and neck cancer patients prior to radiation therapy-Findings from a tertiary hospital in South India

PurposeHead and neck cancer (HNC) patients often face difficulties with swallowing, which can be due to the cancer itself or the treatment modalities like radiation therapy. The presentation of HNC can vary between developing and developed countries due to socioeconomic factors. The current study aimed to profile the swallowing function of HNC patients before starting radiation therapy in a tertiary hospital in India. MethodThis cross-sectional observational study examined patients with HNC who were scheduled for radiation therapy. The Functional Oral Intake Scale (FOIS) and Karnofsky Performance Status Scale were used to assess the patients’ swallowing status and functional abilities, respectively. The study also evaluated the relationship between swallowing function and clinical-demographic factors. ResultsOur assessment of 162 HNC patients found that the cancer site significantly affects swallowing. Although 92% of patients had an oral diet, 64% made dietary modifications. Patients with non-oral intake had either oral or pharyngeal cancer, and over 80% of oral cancer patients and 60% of those with pharyngeal cancer had already made changes to their diet. Patients with laryngeal cancer had a better oral intake, with 58% reporting no swallowing issues. ConclusionPatients with HNC scheduled for radiation therapy may experience varying degrees of swallowing difficulty. Early intervention and teaching of safe swallowing strategies are crucial to prepare for the potential worsening of swallowing difficulties resulting from the treatment. Advanced tumor stages and oral/pharyngeal cancers increase the risk of significant swallowing issues.

Evaluation of the Metered Dose Inhaler Technique: Initial Assessment and Post-counseling Improvements Among the Indian Population.

Objective The objective of this study was to evaluate errors in the use of metered-dose inhalers (MDIs) among patients diagnosed with asthma or chronic obstructive pulmonary disease (COPD). Additionally, we aimed to assess improvements following corrective interventions. Settings and design This cross-sectional study was done by simple random sampling. Methods and materials This study was done at a tertiary care center in South India in an outpatient department and ward for tuberculosis and chest disease to find out the right way to use an MDI and investigate the reasons why people with asthma and COPD don't use it correctly. There were a total of 12 steps. The patient was given an empty canister to try the inhalation technique and was scored one pointfor every correct step and zero for every incorrect step, for a total of 12 steps.Following the demonstration, an educator used a variety of tools, including verbal communication, pictorial demonstrations,and practical demonstrations, to correct the mistakes. After education was provided, post-interventional data was collected. Results During pre-intervention of the 12 steps out of the 183 participants, step one had 183 correct participants (100%), step two had 104 correct participants (56.83%), step three had 129 correct participants (70.49%), step four had 71 correct participants (38.79%), step five had 167 correct participants (91.25%), step six had 123 correct participants (67.21%), step seven had 132 correct participants (72.13%), step eight had 81 correct participants (43.71%), step nine had 123 correct participants (67.21%), step 10 had 108 correct participants (59.01%), step 11 had 128 correct participants (69.94%), and step 12 had 175 correct participants (95.62%). During the post-intervention of the 12 steps, out of the 183 participants, step one remained at 183 correct participants (100%), step two increased to 149 correct participants (81.42%), step three to step seven increased to 183 correct participants (100%), step eight increased to 142 correct participants (77.59%), step nineincreased to 174 correct participants (95.08%), step 10 increased to 177 correct participants (96.72%), step 11 increased to 143 correct participants (78.14%) and step 12 increased to 177 correct participants (96.72%). Conclusion This study highlights the prevalent errors in the use of metered-dose inhalers (MDIs) among patients diagnosed with asthma or chronic obstructive pulmonary disease (COPD). The results demonstrate significant improvements in the MDI technique. Following educational interventions such as verbal communication, pictorial demonstrations,and practical exercises, patients were able to correct their inhaler technique effectively and emphasized the importance of patient education and counseling to ensure the maintenance of correct usage over time.

IJCM_29A: Expenditure incurred by cancer patients covered under National Health Protection Scheme attending a tertiary care hospital in Mangalore

Background: Over the past decades, cancer has become the second leading cause of death and morbidities around the world, accounting for nearly 1 in 6 of the total global deaths. The cost of treatment depends on the type of cancer, the duration of treatment, the type of hospital, and whether they are covered under any health insurance. Objectives: 1. Cost of cancer treatment, before and after registration under VAS, among cancer patients attending an empanelled tertiary care hospital in South India 2. Pattern of OOPE incurred by households of cancer patients. 3. Proportion of expenditure spent on cancer treatment in comparison to the annual family income. Methodology: A hospital-based cross-sectional study was conducted in tertiary care centre among cancer patients covered under VAS, from April to May 2018. Patients who were not covered under the schemes were excluded from the study. Results: Out of the 150 cancer patients actively receiving cancer treatment, a majority, i.e., 65% of them were females. More than half of them (66%) were in the age group of 20-60 years. Only 9% of patients had additional health insurance to aid their expenditures while the rest were dependent only on VAS. The median (IQR) monthly income of the patient and family members was 153(83;293) USD. The overall median (IQR) cost was 525(230;980) in our patients. Costs before initiation of treatment under VAS constituted almost 90% of direct medical OOPE spent by the patient and his family. The overall mean OOPE in this study was 856 USD. 70% of the patients incurred a monthly cost of ≥40% of their monthly family income and 41% of the patient’s OOPE was more than 100% of their monthly family income. Conclusion: A monthly cost-to-income ratio of 240% is seen in 70% of the patients, Loans were taken and donations received to combat the expenditures. Hence VAS should reimburse the medical cost before enrolment under VAS. VAS can step up and protect its objectives by reimbursing the diagnostic costs and any long-term non-medical costs associated with the illness, as this would help reduce the OOPE by 1/3 making a huge difference to their financial status.

Book Review: Violence of Democracy: Interparty Conflict in South India

Book Review: Violence of Democracy: Interparty Conflict in South India

Study of maternal near miss cases at a tertiary centre in South India

Study of maternal near miss cases at a tertiary centre in South India

Optimizing antimicrobial drug utilization through antimicrobial stewardship programme in a tertiary care referral hospital in south India

Optimizing antimicrobial drug utilization through antimicrobial stewardship programme in a tertiary care referral hospital in south India

Analyzing Tumor Budding Scores in Invasive Breast Carcinoma: A Tertiary Care Center Study in South India

ABSTRACT Introduction and Aim: Tumor budding is a distinctive phenomenon which involves the presence of small clusters or individual cancer cells at the invasive front of tumors. Tumor budding has garnered attention due to its potential implications for prognosis, treatment strategies, and our understanding of cancer progression. Our aim is to study the distribution of tumor buds and its scoring in patients with infiltrating breast carcinoma and to associate with other histopathological parameters like the size of the tumor, its grade, lymphovascular invasion, and lymph node metastasis. Materials and Methods: This was a study analyzing the data of 70 resected specimens of primary breast carcinomas and providing a descriptive overview. Tumor budding was recognized, counted, and graded in hematoxylin and eosin slides. The cases were classified as low (0–4), intermediate (5–9), and high (≥10 buds) based on the count of tumor buds. Tumor budding has significant correlation with tumor grade and tumor size. Results: Of the 70 cases, 60 cases (85.71%) were diagnosed as invasive ductal carcinoma NOS. The majority [38 (54.28%)] of the cases showed an intermediate tumor budding score of 5–9/10 HPF. Conclusion: Evaluation of tumor budding allows pathologists and oncologists to gather valuable information about the tumor’s biological aggressiveness and potential for metastasis. It also helps in better risk stratification of patients, enabling a more personalized and tailored approach to treatment planning. In conclusion, assessing tumor budding in breast carcinoma holds significant clinical importance in the management and prognosis of this disease.

IJCM_420A: Chronic morbidity and disability and its effect on quality of life among the institutionalized elderly in Mangalore, South India: A cross-sectional study

Background: Senior citizens, or individuals over 60 years, constitute 8.6% of India’s population. As a result of shifting family dynamics brought about by growing urbanization and globalization, these elderly populations are flocking to elder care centers. The objectives of this research are to ascertain the elderly’s self-reported chronic morbidities, disabilities, and the relationship between these factors with their quality of life (QOL). Methodologys: This cross-sectional study was conducted among 110 residents of old age homes in Mangalore block of Dakshina Kannada district. The data was collected using a semi-structured questionnaire consist of, Indian Disability Evaluation and assessment Scale and the World Health Organization Quality of life Brief Version (WHOQOL BREF) questionnaire and the data obtained was analyzed using SPSS version 24. Odd’s ratio was calculated, independent T test was used to compare the means across the groups and a ‘p’ value &lt; 0.05 was considered as statistically significant. Results: In the current study 65.5% participants were female (N=72) and most of the study participants reported hypertension and musculoskeletal pain (41.8% &amp; 36.7% respectively) as the major ailment they are seeking health care, followed by diabetes mellitus (20.0%), angina (12.3%), asthma (10.9%), COPD (6.4%) and heart attack (4.5%). There was a statistically significant association between age, male gender, and level of disability with quality of life. Age of the participant was found to be directly proportional to quality of life in 2 domains – psychological and social relationships. Male gender was found to be significantly associated with social relationships domain of quality of life. Conclusion: It was shown that there was no clinically significant correlation between chronic morbidities and any dimension of quality of life, suggesting that the frequency and quality of health examinations delivered in the care homes were sufficient, which must carry on in the subsequent years.

Appropriate use of cefoperazone-sulbactam in clinical practice : the need of the hour: an observational drug use evaluation study from tertiary care hospital in South India

Appropriate use of cefoperazone-sulbactam in clinical practice : the need of the hour: an observational drug use evaluation study from tertiary care hospital in South India

Prevalence and determinants of post-COVID-19 syndrome among patients 6 months post-discharge from a teaching hospital in South India

ABSTRACT Background: The coronavirus disease 2019 (COVID-19) infection has affected millions of people worldwide in the last 4 years. Among those infected, the long-term COVID-19 syndrome, in which symptoms of COVID-19 persist for a variable period, is posing new challenges to the health system, but few studies are available in India that examine the post-COVID-19 syndrome, that is, 6 months and beyond COVID-19 infection. This study aimed to find the prevalence and determinants of post-COVID-19 syndrome among patients 6 months and beyond their infection. Methodology: This cross-sectional study was conducted among 300 patients who were admitted and discharged from Government Medical College, Thrissur, at least 6 months before with a diagnosis of COVID-19 infection. The data collection was performed using a semi-structured interview schedule through a telephonic interview. The analysis was performed using the Statistical Package for the Social Sciences (SPSS) software. Results: 21% of the patients studied had at least one persistent symptom at the end of 6 months, and 4.1% had more than one symptom. Among the symptoms persisting most commonly were fatigue (11%) and dyspnea (7.7%). Other than persisting symptoms, 21% of patients developed exertional dyspnea and 19% developed sleep disturbances during the 6 months after discharge. The factors that were associated with persistent symptoms in univariate analysis were increasing age, presence of chronic obstructive pulmonary disease (COPD), presence of chronic kidney disease (CKD), and admission to the intensive care unit (ICU). Conclusion: The study concludes that one-fifth of the patients still suffer from post-COVID-19 syndrome even 6 months after the COVID-19 infection. Our health systems should be prepared for the long-term management of COVID-19-infected people and prepare policies for the same.