Rejuvenating multiple true-false: proposing fairer scoring methods

INTRODUCTION

The COVID-19 pandemic has reached a phase where many have been infected at least once. Healthcare workers were not spared from being infected. This study aimed to determine the period prevalence of COVID-19 among the paediatric healthcare workers in Negeri Sembilan as the country transitioned into an endemic phase of the pandemic. Additionally, we investigate potential sociodemographic and occupational characteristics associated with SARS-CoV-2 infection among healthcare workers.

MATERIALS AND METHODS

A cross-sectional study was conducted among the healthcare workers in the paediatric department at three public specialist hospitals in Negeri Sembilan between 15 and 21 April 2022. Data were collected through a self-administered questionnaire.

RESULTS

Out of the 504 eligible healthcare workers, 493 participated in this study (response rate 97.8%). The overall prevalence of COVID-19 (11 March 2020-15 April 2022) among healthcare workers was 50.9%. The majority (80.1%) were infected during the Omicron wave two months before the survey. Household contacts accounted for 35.9% of infection sources. The proportion of non-doctors in the COVID-19-infected group was significantly higher compared to the non-infected group (74.1% vs 64.0%, p=0.016). The COVID-19-infected group had a higher proportion of schoolgoing children (44.6% vs 30.6%, p=0.001) and children who attended pre-school/sent to the babysitter (49.0% vs 24.4%, p<0.001). There were no significant differences between infection rates among the healthcare workers working in the tertiary hospital and the district hospitals. There were also no significant differences in the proportion of COVID-19- infected doctors and nurses when analysed by seniority.

CONCLUSION

Our study provided an estimate on the prevalence of COVID-19 among paediatric healthcare workers in Negeri Sembilan and the factors associated with infection, which captures the extent and magnitude of this pandemic on the state's paediatric department. Most infections resulted from household contact, with a higher proportion of infected healthcare workers having young children.

Making physical examination in medicine user-friendly

Physical examination (PE) techniques used in medical schools appear redundant in several aspects: unnecessarily regimental, lacking in efficiency, and lengthy. Many techniques are sustained solely because of the age-old tradition. This commentary suggests a simplification of PE techniques to make them acceptable to all the stakeholders, such as patients, medical students, and medical teachers. This is especially relevant in this era when imaging is widely used for diagnosis, and the confidence and reliance on PE are declining. Opinions of 10 senior consultants active in medical practice, teaching, and assessment were sought to know their concurrence with the authors' views. Seven of them provided their opinions, which showed considerable agreement with the authors' views regarding PE. All the items presented in this paper are mostly supported by the opinions of the senior consultants, textbooks, and literature. We consider sharing this work with the fraternity worthwhile.

Making collapsing pulse user-friendly

Collapsing pulse is generally elicited by elevating the patient's arm. However, the pulse becoming stronger on arm elevation is a physiological phenomenon, which is bound to create confusion, if routine lifting of the arm in search of collapsing pulse is practiced. The name 'collapsing pulse' represents only the second component of this sign. It masks the more important first component - the slapping, bounding upstroke, characterised by its other name 'water-hammer pulse'. It is possible to elicit this sign by appreciating the slapping character on routine pulse examination. The insistence on arm lifting in medical school teaching is better avoided.