Journal of Applied Sciences and Clinical Practice

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Awake repositioning has been recommended in various national and international guidelines for the management of COVID-19 as patients with moderate-to-severe acute respiratory distress syndrome appear to have responded well to treatment in the position changes. It involves moving patients' positions in such a way that led to improve the respiratory status. Awake repositioning among COVID patients improves ventilation, reduces hypoxemia, and improves secretion clearance. Nurses must be aware of the correct technique of awake repositioning and must educate the community at large on how to perform the awake positioning using mass media or telenursing services. The current review highlights the significance of awake repositioning in patients with COVID-19 along with nursing considerations.

Background: Herpes simplex virus (HSV) infection of the brain is treated with antiviral drugs such as acyclovir. A summary of randomized control trials (RCTs) of antiviral drugs against HSV encephalitis has not been put forward yet. We aimed to determine the effect of antiviral agents in treating HSV encephalitis on mortality and neurological sequelae at approximately 2 years. The secondary objective was to assess the adverse effect of antiviral agents on the patients. Materials and Methods: RCTs were identified by searching PUBMED, European Medicines Agency ( EMA ), USFDA, US Clinical trials, Elsevier database, and Cochrane website and the reference lists of published trials. Randomized controlled trials of antiviral therapy in biologically proven HSV infection were included in the study. Results: A total of 5 studies met the criteria. The first study was published in 1980 and the latest was in 2015. All the studies used acyclovir/valacyclovir or vidarabine. Three studies compared acyclovir and vidarabine, one study was placebo-controlled vidarabine trial and another one was a placebo-controlled trial of long-term valacyclovir therapy. Acyclovir improved mortality and lowered the incidence of neurological sequelae. There was no significant reduction in the risk of mortality with vidarabine therapy. Conclusion: Trial evidence suggests that acyclovir decreases mortality and morbidity in acute HSV encephalitis.

COVID-19 disease is known to cause pulmonary and extrapulmonary complications including effects on cardiovascular, gastrointestinal, renal, and neurovascular system. Ischemic stroke seems to be one of the most serious neurologic complications in patients with COVID-19 infection. In this case report, we have documented, 70-year-old male presented with acute respiratory syndrome with hypoxemia and neurological involvement as right hemiparesis with altered level of consciousness, COVID-19 real-time polymerase chain reaction positive, with abnormal laboratory parameters such as ferritin, lactate dehydrogenase, and D-dimer. Further investigations such as echocardiography documented cardiomyopathy and left heart dysfunction, high-resolution computed tomography thorax documented COVID pneumonia, and magnetic resonance imaging brain documented left frontoparietal and parieto-occipital lobe infarct. We have observed excellent clinical and radiological response to anticoagulation, antiplatelets, and steroids with other supportive care in critical care unit.

Introduction: Chronic kidney disease is an enormous public health issue, the tide of which continues to inexorably rise. In the 2015 Global Burden of Disease Study, kidney disease was the 12^th most common cause of death, accounting for 1.1 million deaths worldwide. The aim of the study was to assess the effectiveness of self-instruction module on knowledge and attitude regarding postdialysis home care among caregivers of hemodialysis patients. Methodology: A preexperimental one-group pretest–posttest design was selected for the study which was conducted from June 1 to June 31, 2019. A total of sixty caregivers of hemodialysis patients attending at Max Hospital, Dehradun, Uttarakhand, were selected through purposive nonprobability sampling technique. The data were collected through a self-structured questionnaire and attitude scale toward postdialysis home care. Results: The results showed that pretest mean score was 18.58 ± 2.99 while, after administering the self-instruction module, posttest mean score was 27.66 ± 2.69. In addition, the intervention was significantly effective to enhance the knowledge (P = 0.00001) and attitude (P = 0.00001) of caregivers regarding postdialysis home care. Conclusion: The study concluded that self-instruction module was effective in increasing the knowledge and positive attitude regarding postdialysis home care. Therefore, it is recommended that such a type of teaching program should be conducted from time to time for improving knowledge, attitude, and practices of caregivers of dialysis patients.

Online since 18^th September 2020