Tab Application Banner
  • Users Online: 221
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
   Table of Contents - Current issue
Coverpage
December 2022
Volume 17 | Issue 7 (Supplement)
Page Nos. 363-434

Online since Saturday, December 24, 2022

Accessed 21,047 times.

PDF access policy
Journal allows immediate open access to content in HTML + PDF
View as eBookView issue as eBook
Access StatisticsIssue statistics
RSS FeedRSS
Hide all abstracts  Show selected abstracts  Export selected to  Add to my list
FROM THE EDITORS DESK  

Digital health in rheumatology p. 363
Chris Wincup, Sakir Ahmed
DOI:10.4103/injr.injr_196_22  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
EDITORIALS Top

Patient-centred outcomes for monitoring disease remotely in idiopathic inflammatory myopathies p. 364
Arpit Mago, R Naveen, Johannes Knitza, Samuel Katsuyuki Shinjo, Latika Gupta, Rohit Aggarwal
DOI:10.4103/injr.injr_171_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Digital technologies in rheumatology: new tools, new skills, and new care p. 369
Natasha Ung, Rebecca Grainger
DOI:10.4103/injr.injr_150_22  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
REVIEW ARTICLES Top

Abbreviated health-care services for older persons during the COVID-19 pandemic – A wake-up call for a longer-term plan p. 372
Shaileja Yadav, Ashish Goel
DOI:10.4103/injr.injr_341_20  
The last 1 year has underscored the need of a robust global public health system like never before. Both the infection itself, and the measures taken to contain it, have forced us to adopt new ways of life. Measures taken by the Indian government ranged from initial advisories on social distancing and hand hygiene to a full-fledged nationwide lockdown. The lockdown disrupted all the routine health-care activities – right from the suspension of curative outpatient department (OPD) services to preventive immunization and antenatal care services; the entire system has been affected. The problem has been especially complex for older patients due to the fact that they are at a higher risk for infection by the virtue of their age and likely to have a more severe disease due to the presence of multiple comorbidities, including but not limited to the other pandemic of diabetes that we have been witnessing over the past few decades. Resuming a health-care service for older people requiring inperson visits for OPD consultation may not be a good enough option for them. Thus, we have two major issues with geriatric population – access and utilization of health-care services. While telemedicine has been widely employed to solve the problem of access; does it really solve the issue of utilization of health-care services by a scared geriatric patient who needs a caregiver, too? In this article, we explore the impact and some of these changes, telemedicine, and other potential solutions, focusing on the health care needs of older persons and the future discourse.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Digital health and rheumatology: The Indian context p. 377
Suchitra Kataria, Vinod Ravindran
DOI:10.4103/injr.injr_127_21  
India as a country of contrast and diversity has witnessed digital evolution in different waves and stages. The technology is already an integral part of lives of millions in India; however, its application in the health management remains limited unlike developed economies. COVID-19 pandemic has plunged the country into universal, regional, or local lockdowns repeatedly since the last year. An unexpected and unforeseen impact of this has been the usage of technology for doctor–patient interactions through telemedicine. Hitherto limited to certain pockets, virtual interactions with doctors, ordering laboratory investigations through an application or procuring medicines through internet, are now part of mainstream patient behavior. This is a crucial change in the mindset but requires a lot more to be done at various levels to tap its full potential with rheumatologists being at the forefront and leading the change in their specialty. The pool of rheumatologists is very small and mostly concentrated in few urban areas, leading to diagnostic delay, suboptimal treatment, and poor outcomes. Technology could, therefore, become a catalyst for change and harbinger for greater clinician access. There are plenty of discussions about the impact and potential of deep learning, artificial intelligence, remote monitoring with wearables, etc., but plenty of them may not be relevant to Indian patients in the current scenario. Hence, the context, relevance, and applicability are the key for rheumatologists when making a judgment.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Review: Remote disease monitoring in rheumatoid arthritis p. 384
Amy MacBrayne, William Marsh, Frances Humby
DOI:10.4103/injr.injr_142_21  
Rheumatoid arthritis (RA), the archetypal inflammatory arthritis, remains a complex and challenging disease to manage in spite of the abundance of new therapies in the last 20 years. The unpredictable relapsing/remitting nature of RA is at odds with the current prevailing system of scheduled follow-ups, leaving patients with RA to manage pain, flares, and medications between appointments, which may be of little value if occurring during a period of disease control. The rapid progress in the field of mobile health (mHealth) in the last 10 years has led to a proliferation of smartphone applications (apps) targeted at people with RA. Harnessing the power of smartphones to deliver remote monitoring for patients with RA has gone from an exciting possibility to an urgent necessity due to the COVID-19 pandemic. Apps developed solely by commercial providers have been found to be of limited utility in disease monitoring. However, multiple global institutions have developed mHealth technology to support remote monitoring of RA patients, utilizing asynchronous technology for patients to submit indicators of their disease activity, ranging from validated electronic patient-reported outcome measures, to innovative monitoring utilizing smartphone biosensors. This review discusses the current published evidence for mobile applications designed to facilitate remote monitoring of RA, the common barriers faced in implementing mhealth monitoring and strategies to overcome these, and potential areas for future research.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Telerheumatology during the COVID-19 pandemic: Impact on clinical practice, education, and research p. 394
Su Ann Yeoh, Anastasia-Vasiliki Madenidou
DOI:10.4103/injr.injr_229_21  
Telerheumatology, the use of telemedicine in the provision of rheumatology care, has been on the periphery of rheumatology practice for several years. However, the need for remote rheumatology service has emerged during the COVID-19 pandemic in order to help prevent the spread of the virus. EULAR and ACR published guidelines to address the rheumatological clinical needs safely. Synchronous and asynchronous telemedicine, including remote patient-monitoring systems, were used. The majority of telerheumatology studies focus on rheumatoid arthritis, which is reflective of the caseload in the rheumatology clinic. Connective tissue diseases are likely to pose more challenges for telemedicine use, given its multi-organ involvement and heterogeneity. The benefits of telemedicine include patient safety, minimizing travel time and time off work, and the evidence of patient satisfaction has supported this. On the other hand, the lack of clinical examination and privacy is a concern which patients might have about receiving telerheumatology care. Physicians are more comfortable providing telemedicine consultations for already-established patients, especially those with stable disease, and less with new patients. Rheumatology training has been disrupted, and rheumatology trainees were required to rapidly adapt their practices to telemedicine as outpatient clinics transitioned to virtual clinics. Tele-education and virtual rheumatology conferences have enabled education to be delivered in a more inclusive way. In conclusion, it is likely that hybrid models will be adopted for patient care after the pandemic. However, it is imperative that the patient is at the center of future telerheumatology service design.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Smart health-care systems for rheumatology p. 402
Suneeta Mohanty, Prasant Kumar Pattnaik
DOI:10.4103/injr.injr_238_21  
Smart health care comprises e-health, m-health, electronic resource management, smart and intelligent home services, and medical devices. Wireless sensors, radio-frequency identification technology, Internet of things, and machine learning (ML) algorithms are the underlying technology to implement smart health care. Sensor plays a vital role in smart health care for the collection of real-time data. Sensors such as accelerometers, wearable sensors, and thermal infrared camera sensors are extensively used to assemble data for patients with arthritis. ML algorithms are used to observe ailments and classify patients with respect to various diseases. This article presents a basic introduction to these concepts, existing smart health-care applications for rheumatology along with the pros and cons of smart health-care system. This article will help the researchers working in the field of medicine to understand the underlying technology of smart health-care systems.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

COVID-19 vaccine hesitancy: A telephonic survey in patients with systemic lupus erythematosusxs p. 406
Reuben Praharsh Kumar, Sandra Manuel, D Elizabeth, Vineeta Shobha
DOI:10.4103/injr.injr_22_22  
Background: Vaccine against COVID-19 is an effective preventive measure; however, systemic lupus erythematosus (SLE) patients were excluded from the vaccine trials, which leads to questions regarding vaccine safety and efficacy, giving rise to vaccine hesitancy. We aim to study the prevalence of vaccine hesitancy among SLE patients and study the factors affecting it. Methods: The study is a cross-sectional telephone-based survey done on SLE patients. The questionnaire included a series of 15 questions pertaining to their baseline characteristics, COVID-19 infection and vaccination details, and their perceptions regarding the COVID-19 vaccine. Nonvaccinated individuals were defined as “willing” and “hesitant” based on their intent to get vaccinated. Results: Among 418 (93% women) participants, about 8% had contracted COVID-19 infection in the past. Nearly half had been vaccinated against COVID-19, and 83% had experienced one or more side effects which were largely mild. Out of the 215 nonvaccinated participants, 84% were “willing” and 16% were “hesitant.” Among the reasons for hesitancy, hasty vaccine production, fear of SLE flares, general vaccine refusal and limited transport facilities were significant. On the whole, 65.1% had a positive attitude toward the vaccine. Conclusion: Despite a low-hesitancy rate, the number of SLE patients with a negative attitude toward the COVID-19 vaccine is reasonably high, with more than half of the patients yet to be vaccinated. This highlights that the mistrust and negative perceptions of the vaccine still persists. The role of health-care providers in vaccine acceptance in SLE patients is crucial.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
TOPICAL REVIEW Top

Virtual consulting for remote physiotherapy advice in chronic rheumatic diseases during the COVID-19 pandemic Highly accessed article p. 414
Ilke Coskun Benlidayi
DOI:10.4103/injr.injr_292_20  
The coronavirus disease-19 pandemic has caused a considerable deterioration in medical practices. This resulted in a rapid shift to telemedicine/telehealth as an alternative to conventional interventions and in-person visits. Telerheumatology practices have been increasing worldwide. Virtual consulting for remote physiotherapy advice in rheumatic diseases is also essential. The present topical review aimed to provide an insight to telehealth for musculoskeletal physiotherapy among patients with rheumatic diseases. Patient assessment, goal setting, teleeducation, and providing individual-based, goal-directed exercises are components of telerehabilitation. Telephone/video calls can be used to further progress the exercise program and to evaluate patient adherence. Future studies on the role of virtual consulting for physiotherapy advice in rheumatic diseases would be of value.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
BRIEF REPORT Top

Virtual consulting in the times of COVID-19 p. 418
Latika Gupta, Supriya Sharma, Rajat Kharbanda, Shelley Aggarwal, Durga Prasanna Misra, Vikas Agarwal
DOI:10.4103/injr.injr_320_20  
Background: Confinement and economic uncertainty, along with disease-specific issues such as pain and suffering may uniquely impact rheumatology patients, putting non-COVID morbidity at par with COVID-related losses. Methods: We conducted a review of records to explore the clinical profile and interventions in rheumatology patients at a tertiary care center in Northern India to identify the potential problems and propose direction for the future. Results: In our experience spanning 5 weeks, among 508 rheumatology patients who sought teleconsultations, rheumatoid arthritis was the most common diagnosis (35.2'), and 43' were asked to continue the same treatment over tele consults, whereas investigations were awaited for another 16'. Nearly one-third (29.9') required an intervention, though this largely consisted of dose titrations (104 of 152, 68.4'). Certain diseases such as myositis were under-represented among consults (1.2') but over-represented (33.3') among admissions. Among the 54 patients who were asked to rate their teleconsultation experience, the voice and consultation quality were rated and average of 9.9 each, and 88.9' (48/54) said they would prefer teleconsultations until the pandemic is over. Conclusion: A sizeable proportion of rheumatology patients can be managed with teleconsultations, with some requiring greater assistance, calling for a triage protocol for the times ahead. With propositions for a deliberate transition into the realm of virtual consulting, chronic caregivers can hope to reach an optimal balance between e-consults and in-person visits.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Virtual consultation in lupus during the COVID-19 pandemic – patients' perspective p. 422
Keerthi Talari
DOI:10.4103/injr.injr_118_21  
Background: Virtual consultations have become the norm during the COVID-19 pandemic with disruption of regular outpatient services due to fear of infection and travel restrictions. Methodology: A telephonic survey was conducted among 54 patients with systemic lupus erythematosus (SLE) who sought virtual consultations to understand patients' perspective about these consultations. Results: 42/54 (77.78%) patients had inactive disease. Most patients (42/48 [87.5%]) did not visit the hospital for fear of COVID, whereas 58% of them also had travel restrictions. About one-fourth of individuals felt that consultation from home was comfortable (12/48 [25%]), cost-saving (14/48 [29.16%]) and they preferred virtual over physical consultation (14/48 [29.16%]). The satisfaction levels of patients during the process of booking appointment, the consultation process, and postconsultation queries also seem adequate. Conclusion: Virtual consultations in SLE are a feasible and conceivable option, especially for those with inactive disease on stable treatment.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
PERSPECTIVE Top

Future of digital health and precision medicine in rheumatology practice in India p. 426
Joydeep Samanta, Debashish Mishra
DOI:10.4103/injr.injr_146_22  
With the digitalization of the services across various sectors in an Indian setting, health care is also influenced by the same. It was evidenced during the COVID-19 pandemic that Indian patients were orienting themselves toward more teleconsultations and digital and smartphone-based health care. This not only saves time and money but also reduces the chances of hospital-acquired cross infections. This is more important for patients with rheumatic diseases who try to avoid frequent hospital visits despite the need for regular health-care consultations due to the aforementioned reasons. Apart from the telemedicine and smartphone apps, health care is expanding to robotics and artificial intelligence-based machine learning. Healthcare digitalization will lead to the expansion of precision based medicine. When more robust genomics, proteomics, metabolomics, and transcriptomics data become available for Indian patients with rheumatic diseases, management then would be more personalized than blanket therapy. However, such futuristic advancements face challenges of their own which are neither time nor knowledge bound. We are currently just at the tip of this massive iceberg. We describe various aspects of the future of digital health and precision medicine in rheumatology in an Indian setting.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
LETTERS TO EDITOR Top

Telecommunication in the COVID-19 era: As an assessment tool for patients with dermatomyositis p. 431
Prakash Gupta, Latika Gupta
DOI:10.4103/injr.injr_286_20  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Digital health practices in rheumatology p. 433
Ilke Coskun Benlidayi
DOI:10.4103/injr.injr_148_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta