Impact of covid-19 on quality of life in COVID recovered patients: A cross-sectional survey

COVID-19 pandemic has affected India to a great extent. Till date total of 3.30 crore peoples has been cured and discharged and 44.6 lakh are died due to covid -19 in India. COVID-19 has a long-term systemic effect on lungs, liver, spleen, anxiety and depression and persistence of inflammatory response even after getting cured or COVID negative. Which may affect quality of life. So, there is a need to evaluate quality of life in post COVID patients.A cross-sectional study was conducted on the 100 COVID-19 recovered Participants. Participants were selected on the basis of inclusion and exclusion criterion. Basic assessment of symptom history, medical history and hospitalisation was done by investigator. A quality of life was evaluated using short form-36 questionnaire (SF-36). Statistical analysis was done using Microsoft excel-2019.A total of 100 participants 61% were male and 39% were female participants. We found that general health component was greatly affected with 68.50%. Following general health emotional well-being (69.68%), social functioning (68.14), pain (64.38%), limitation due to emotional problems (64.19%), energy/fatigue (63.3%), limitation due to physical health (59.61) and physical functioning (48.27%) were affected.We found that there was mild – moderate affection in quality of life in covid recovered subjects. There was more affection in quality of life in participants with other comorbidities. We also found that there were persistence of breathlessness and fatigue after recovery.

Post-COVID-19 Condition and Health Status

Background: Observational studies of the long-term effects of COVID-19 infection generally focus on individual symptoms rather than health status. Objective: Longitudinal assessment of general health status following COVID-19 infection. Design: Observational study, with data collected from two telephone surveys at 32 ± 10 and 89 ± 25 days after discharge from the hospital or emergency department (ED) for a COVID-19 infection. Medicaid or no insurance was our marker of low socioeconomic status (SES). Acute disease severity was determined by summing 10 severity markers (yes-no) from the health encounter. Baseline comorbidity was a modified Charlson Index. Participants: 40 patients. Mean age was 54 ± 15 years, 50% were female, and 40% had low socioeconomic status. Main Measures: (1) the 20-item Medical Outcomes Study Short-Form General Health Survey (SF-20); (2) Dyspnea (modified Medical Research Council); (3) Psychological symptoms (Patient Health Questionnaire for Anxiety and Depression); (4) Cognitive function (Cognitive Change Questionnaire); (5) Fatigue (Short Fatigue Questionnaire); (6) A 10-item review of systems (ROS) questionnaire. Key Results: Percentages with abnormal symptoms at the first and second surveys were (respectively): Dyspnea (40, 33), Fatigue (53, 50), Anxiety (33, 18), Depression (20, 10), PHQ-4 Composite (25, 13), and Cognitive (18, 10). Mean scores on the SF-20 subscales, Physical Functioning, Role Functioning, Social Functioning, Health Perception, Mental Health, and Pain were numerically lower than means from a published study of elderly outpatients. With the exception of Pain, all SF-20 subscale scores improved significantly by the second survey. In multivariable analyses, dyspnea was predictive of impairment in all SF-20 subscales at the second survey. Conclusions: COVID-19 infection causes persistent abnormality across multiple patient-reported outcome areas, including health status. The persistence of impairment in each health status component is influenced by baseline dyspnea.

Determinants of Health Service Utilization Among Adults at High Risk of Developing Type 2 Diabetes in Kerala, India

The purpose of this study was to examine the determinants of health service utilization in a population at high risk of developing type 2 diabetes mellitus in India. Using Andersen’s behavioral model of healthcare utilization, multivariate logistic regression analysis was performed on baseline data of the Kerala Diabetes Prevention Program. We examined the association between predisposing, enabling, and need factors with outpatient health service use in the past four weeks and inpatient health service use in the past 12 months. More than a quarter (27.9%) and 12.9% of 1007 participants used outpatient services and inpatient services, respectively. Men were less likely to use outpatient services (odds ratio [OR] = 0.56; 95% confidence interval [CI] [0.39, 0.82]). Outpatient service utilization was positively associated with low social support (OR = 1.69; 95% CI [1.09, 2.62]), low general health status (OR = 5.71; 95% CI [2.42, 13.47]), and time off from work due to illness (OR = 8.01; 95% CI [5.32, 12.07]). Higher educational status (OR = 0.63; 95% CI [0.41, 0.95]), low general health status (OR = 3.59; 95% CI [1.54, 8.34]), and time off from work due to illness (OR = 1.21; 95% CI [0.76,1.93]) were associated with increased utilization of inpatient services. Although gender, educational status, and social support had important roles, health service utilization in this study population was largely dependent on general health status and presence of illness.

Clinical Trial Evaluating Quality of Life in Patients with Intra-Oral Halitosis

Halitosis is considered to be extremely unattractive in the context of social interactions. The main research objective of this study was to evaluate whether intra-oral halitosis may impact patients’ quality of life (QOL). One hundred generally healthy adult participants complaining about oral malodor and diagnosed with intra-oral halitosis were enrolled in this study. For halitosis diagnosis, a gas chromatography (GC) analysis by the Oral Chroma portable device was used. QOL assessment was based on the Short Form 36-item Health Survey (SF-36). The respondents had the highest scores in the physical functioning (PF), activity limitations caused by emotional problems (RE) and activity limitations caused by physical problems (RP) domains, and the weakest in the general health perception (GH), vitality (VT) and emotional wellbeing (MH) ones. The total volatile sulfur compounds (VSCs) level was negatively correlated with SF-36 domains. The SF-36 domains’ scores decreased the higher the level of VSC was. The respondents assessed their QOL to be at its best in physical functioning and activity limitations caused by emotional and physical problems and the worst in general health perception, vitality and emotional wellbeing. The strongest correlation between halitosis and decreased QOL was found in the social functioning (SF), vitality, emotional wellbeing and general health perception domains.

Repairing boundaries along pathways to tuberculosis case detection: a qualitative synthesis of intervention designs

Background Tuberculosis case-finding interventions often involve several activities to enhance patient pathways, and it is unclear which activity defines the type of case-finding intervention. When conducting studies to identify the most effective case-finding intervention it is important to have a clear understanding of these interventions for meaningful comparisons. This review aimed to construct a systems-based logic model of all pathways to tuberculosis case detection through a synthesis of intervention designs. Methods We identified an existing systematic review on the effectiveness of interventions to increase tuberculosis case detection and updated the search from December 2016 to October 2020. We included randomized controlled trials, as these designs encourage detailed description of interventions. Taking each study in turn, intervention descriptions were read in detail. The texts were analysed qualitatively by constantly comparing emerging codes to construct patient journeys, visualized as logical chains. Actions taken as part of interventions were positioned along patient journeys to theorize the sequence of outcomes. Patient journeys formed the basis of the model, which was refined through discussion. Results Based on intervention descriptions from 17 randomized controlled trials, our model distinguishes two care-seeking pathways and four screening pathways. An open invitation to people with tuberculosis symptoms creates care-seeking pathways. On care-seeking pathways, systematic screening can be conducted at general health services, but not at specific TB care services. People invited to tuberculosis services regardless of symptoms follow tuberculosis screening pathways and may be identified with presumptive tuberculosis even if they do not seek care for tuberculosis symptoms. Tuberculosis screening pathways include screening offered to all people accessing care at general health services, screening at a mobile clinic or health facility with open invitation to a whole population or tuberculosis contacts, screening personally offered to a whole population or tuberculosis contacts at home, work or school, and screening offered to people receiving care for human immunodeficiency virus or other clinical risk-group care. Conclusion This systems-based logic model of tuberculosis case-finding pathways may support standardized terminology, consistency, transparency and improved communication among researchers, policy-makers, health workers and community members when implementing and evaluating interventions to improve tuberculosis case detection.

Effect of Dietary Marula Nut Meal on Liver Lipid Content and Surrogate Markers of Liver and Kidney Function of Broiler and Layer Japanese Quail

Marula nut meal (MNM) can substitute soyabean meal (SBM) as a dietary protein source in Japanese quail diets without compromising growth performance and egg production. However, MNM has a high residual oil content which may impact metabolic health. The effects of MNM on hepatic lipid content and general, liver and kidney health have not been determined in both broilers and layers. Accordingly, two studies were run. In the broiler study two hundred 9-days old Japanese quail were randomly allocated to five diets wherein MNM replaced SBM on a crude protein (CP) basis at 0%, 25%, 50%, 75% and 100%, respectively, in both grower and finisher diets. In the layer study, sixty 5-weeks old Japanese maiden hens, individually housed, were randomly allocated to five-layer diets where MNM replaced SBM on a graded CP basis as for the broilers and fed for 8 weeks. At study termination the birds were slaughtered, blood collected and plasma harvested. Livers were excised, weighed and liver lipid content determined. Plasma surrogate markers of general health, liver and kidney function were determined. Dietary MNM had no effect (P > 0.05) on liver lipid content as well plasma surrogate markers of general health, liver and kidney function of the broiler quail. Dietary MNM at 75% of SBM CP significantly increased plasma phosphorus concentration of quail hens compared to that of counterparts fed control. Dietary MNM can be used in broiler and layer Japanese quail diets without risking development of fatty livers and compromising liver and kidney function.

Feasibility of using a General Health Promotion Approach to Helping Smokers with Non- Communicable Diseases Quit Smoking: A Randomized Controlled Trial

This randomized controlled trial aimed to evaluate the efficacy and ascertain the feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking. A total of 60 participants who had medical follow-up in a special out-patient clinic were randomized into two groups, 30 in the intervention group received brief motivational interviewing to assist them with their chosen behavioral changes, and 30 in the control group received only a smoking cessation booklet. The primary outcome, by intention-to-treat, was biochemically validated abstinence at 12 months. The intervention group had a higher biochemically validated abstinence rate than the control group at 12 months (16.7% vs 6.7% P=.23) although the difference was not statistically significant (Adjusted OR 2.4, 95% CI 0.43–13.75; P=.32). In addition, the intervention group had a significantly higher self-reported reduction of at least 50% in daily cigarette consumption than the control group at 6 months (Adjusted OR 7.2, 95% CI 1.22–42.44; P=.03).This study demonstrated the potential efficacy and feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking.

Enhancing Meaning in Life and Psychological Well-Being Among a European Cohort of Young Adults via a Gratitude Intervention

Background: Strengthening the sense of meaning in life and psychological well-being brings benefits for mental health. The group particularly vulnerable to mental problems are young adults, therefore the aim of our research was to explore how a gratitude intervention will affect the sense of meaning in life, psychological well-being, general health and perceived stress among them. The research also took into account the issue of expressing gratitude.Method: The study involved 80 young adults (58 women and 22 men) who were randomly assigned to the experimental group that filled out the specially prepared diaries for a week (participants were asked to list three things for which they feel grateful, to whom they are grateful and if and how they expressed their gratitude) or the control group. Participants completed the Meaning in Life Questionnaire (MLQ), the General Health Questionnaire – 28 (GHQ-28), the Perceived Stress Scale (PSS), and the Ryff Scales of Psychological Well-Being (PWBS) twice (before and after intervention).Results: In the experimental group significant increases were observed in three areas of psychological well-being: environmental mastery, relationships with others and purpose in life. The significant decrease was also noted in anxiety/insomnia and depression symptoms as well as in perceived stress. There were no differences in the level of meaning in life. There was a positive relationship between expressing gratitude and meaning in life and psychological well-being.Conclusion: Proposed gratitude intervention has the potential to enhance psychological well-being among young adults, however, it may not be effective in enhancing meaning in life.

The impact of socioeconomic status, general health and oral health on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health among Polish older adults

Background The study aims to evaluate the impact of socioeconomic status, general health and oral health parameters on Health-Related Quality of Life (HRQoL), Oral Health-Related Quality of Life (OHRQoL) and mental health in elderly urban residents of South-Western Poland. Methods The 500 residents of Wroclaw, aged 65 and older provided demographic and personal information as well as their medical history. A patient's oral condition were determined based on the clinical oral examination.Quality of Life was assessed using Euro-Quality of Life (EQ-5D), Oral Health Impact Profile-14 (OHIP-14) and Patient Health Questionnaire (PHQ-9).The association between exposure (socioeconomic status, general health and oral health) and outcome (HRQoL, OHRQoL and mental health variables) were analyzed with the use of four models: P – Poisson model, NB-Negative Binomial model, ZIP – Zero Inflated Poisson model, ZINB – Zero Inflated Negative Binomial model. Results The best model turned out to be the ZINB model, in which a negative binomial distribution in the count equation is assumed. In this model, only 13 independent variables had a significant effect on HRQoL, OHRQoL, and mental health. HRQoL assessed with the EQ-5D is significantly influenced by: living conditions 0.133 (95% CI: 0.001, 0.267, p = 0.049), income -0.348 (95%CI: -0.466, -0.230, p < 0.001), diabetes mellitus 0.437 (95%CI: 0.250, 0.624, p < 0.001), myocardial infarction 0.454 (95% CI: 0.151, 0.757, p = 0.003), stroke 0.543 (95%CI: 0.094, 0.992, p = 0.018) and renal disease 0.466 (95% CI: 0.206, 0.726, p < 0.001). Factors negatively affecting OHRQOL are: the need for oral treatment 0.278 (95%CI: 0.104, 0.452, p = 0.002), the number of missing teeth 0.053 (95%CI: 0.039, 0.067, p < 0.001) and gender 0.271 (95%CI: 0.015, 0.527, p = 0.038) and age -0.025 (95%CI: -0.042, -0.008, p = 0.003). An important factor influencing the level of depression assessed by the PHQ-9 questionnaire may be the material condition -0.225 (95%CI: -0.349, -0.101, p < 0.001). It should be emphasized that living with other people may be a factor that significantly increases the probability of avoiding the occurrence of depression symptoms. Conclusion The study concerning elderly residents of the macroregion in Poland found the impact of socioeconomic, general health and oral health parameters on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health. Research on the quality of life of the elderly at the local level allowed to assess the factors linked to quality of life of older adults.