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Background: The objective of this study was to know if there is an association between the Online class work hours and the musculoskeletal health among physiotherapy students. This study helped us to find out the correlation between these two and shows us the pain prevalence of different region. Objective: Association between hours of online work and musculoskeletal problems among the physiotherapy college students in Delhi. Methodology: The data was collected by convenient sampling, around 220 subjects were approached, out of which 157 responded and 155 subjects fulfilled inclusion criteria. The aim of the study was explained via email. The subjects were provided with a consent form and questionnaire. The data collected was arranged into 3 groups, students who study online for 0-3 hours, the students who study online for 4-7 hours, the students who study for more than 7 hours. To evaluate overall muscular health, MSK-HQ scale was used, to record the painful areas Nordic Musculoskeletal Health Questionnaire was administered and to record the intensity of pain Numeric Pain Rating Scale was used .The correlation of these questionnaires with number of working hours was checked Result: Neck was found to be the most pain prevalent area Negative correlation was found between MSKHQ and working hours. Conclusion: This study indicates that with the increasing number of working hours the MSKHQ score decreases and neck pain is most prevalent among the responders. Key words: Upper Crossed syndrome, Muscular Imbalance, LBP, online classes, musculoskeletal pain. more...

Background Although improvement in the access to clotting factor concentrates and provision of comprehensive care has dramatically improved the quality of life of patients with severe hemophilia, inhibitor-positive patients still develop significant morbidity in terms of joint involvement, progression to disability and life threatening bleeds due to poor access to bypassing agents and immune tolerance induction. Objective To analyze the response of patients with severe hemophilia A and high-titer inhibitors started on Emicizumab prophylaxis. Methods Patients with inhibitor-positive severe Hemophilia A were followed up for bleed frequency, joint involvement and health-related quality-of-life assessment (HR-QOL) using PedHAL questionnaire. The data from 1 year prior to start of Emicizumab or from diagnosis of inhibitor status (if shorter period) was compared to that 4 weeks after start of the drug. Emicizumab was administered as per standard guidelines. Results 4 patients were initiated on Emicizumab prophylaxis and followed for a median period of 34 weeks (19–57 weeks). The average bleed frequency reduced from 2 to 3.5 per month to 0 after initiation of prophylaxis. No significant adverse events were reported. Improvement in raw and normalized data for all 7 domains of PedHAL which measures activities of daily living was observed. Functional improvement was noted as early as 4 weeks into treatment. Conclusion Emicizumab is a promising agent for prophylaxis of patients with severe hemophilia A and high titre inhibitors. more...

The concerns for treating non-COVID patients such as pediatric cancer have been worrying since the onset of the COVID pandemic. Different countries have developed policies as per the situation of the COVID-19 infection and the logistic support available. Even in the same country, often different strategies have to be developed to ensure patients do not stop treatment for want of facilities. In this qualitative paper, we describe the difficulties faced since the onset of COVID-19 pandemic and how solutions emerged during the course of time. We conclude that the usual hand-holding needed for families with childhood cancer need to be augmented during these tough times to ensure no child is denied treatment for cancer. more...

Introduction The global pandemic caused by SARS−COV-2 infection has raised several unique concerns in the bleeding disorders community. Although the risk of COVID-19 infection is not increased in patients with inherited bleeding disorders, the indirect effects of this infection are many. Methods A cross sectional survey was conducted among patients registered to our centre with inherited bleeding disorders. A web-based based questionnaire was developed and shared with patients and families. Results 120 patients/ families answered the questionnaire completely. During the period of lockdown, many had bleeds that were left untreated due to either difficulty in travel or unavailability of treatment. The time to treatment ranged from 8 h to 15 days in those who had a bleed. 36 % faced financial difficulties and 40 % families reported losing their job or source of income during this period. Discussion Few solutions that emerged while treating patients during this period and recommendations are discussed. Even though haemophilia has been included under the essential health services and states mandated to continue treatment for these patients despite the global crisis, patients still face challenges in terms of transport and finance. more...

The natural history of COVID-19 infection in children is still evolving as the pandemic unfolds. Few cases of severe and often fatal COVID-19 have been reported although the infection is mild in the large majority. Children with cancers are recognised as a high risk group for all infections. Since there aren’t any definite treatment guidelines established in children with severe COVID, treatment is guided by adult recommendations which too are often not evidence based. We report the case of a 4-year-old girl with severe COVID-19 associated pneumonia who presented to us as febrile neutropenia. The use of convalescent plasma along with steroids and IVIG showed dramatic results in this child and she recovered without the need for any specific treatment. This is highlighted as one of the earliest cases that is reporting the use of convalescent plasma in a child; the first ever in a child with underlying malignancy. more...