Health Research

During the COVID-19 lockdown, India saw a major restriction in the movement of people. Patients with acute myocardial infarction (MI) required early interventions and follow-up of independent predictors like symptom-to-balloon (STB) time and door-to-balloon (DTB) time. This study aimed to determine changes in STB and DTB time before and after the COVID-19 lockdown and its associated risk factors. A hospital-based cross-sectional study of 105 patients admitted to the cardiac care units (CCU) of two tertiary care centers in a district of Southern India for six months was conducted to compare the changes in STB and DTB time before and after the COVID-19 lockdown (three months before March 2020 and three months after March 2020), and data was collected from medical records. The data collected was then entered into Microsoft Excel (Microsoft Corporation, Washington, USA), numerically coded, and analyzed using SPSS Statistics version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.). The Chi-square and Mann-Whitney U tests assessed the association between the dependent and independent variables. The STB/DTB time (before and after the COVID-19 lockdown) was the dependent variable, while the age, gender, co-morbidities, smoking status, and date of admission of patients (before and after the COVID-19 lockdown) were taken as the independent variables. A p-value of <0.05 was considered statistically significant. The predictor variables were identified using the regression method, where all variables with a significance of <0.2 were taken. The overall mean (±SD) STB time was 408.7 (±307.1) minutes, and the mean (±SD) DTB time was 161.7 (±261.6) minutes. The pre-lockdown mean STB time was 404.6 minutes, and the mean DTB time was 153 minutes, whereas the post-lockdown mean STB and DTB time were higher at 413.3 minutes and 171.6 minutes, respectively. Out of the total 105 patients, 95 (90.5%) had an STB time of ≥120 minutes, and 77 (73.3%) had an ideal DTB time of <90 minutes. There was no statistically significant variation in the STB and DTB time before and after the lockdown. Only the age group >60 years (38 (97.4%)) was found to be statistically significant with an STB time of ≥120 minutes after the lockdown (p-value=0.040), and patients referred from primary and secondary care centers (AOR (95% CI)=4.669 (1.129-19.298)) were found to be an independent factor in reducing DTB time before and after the COVID-19 lockdown. The efficiency of the health system, irrespective of the COVID-19 lockdown, was observed; nevertheless, a delay in the overall recognition of symptoms of MI was perceived. The importance of time factors in identifying the symptoms of non-communicable diseases (NCDs), especially MI and stroke, has to be ascertained among the general population.

To investigate the relationship between erythrocyte membrane polyunsaturated fatty acid (PUFA) and serum prostate- specific antigen (PSA) levels in Jamaican men, as there may be an association between prostate cancer incidence and dietary fatty acids, and prostate cancer incidence in Jamaica is among the highest in the world. Blood from 107 Jamaican men was analysed for 32 individual fatty acids and PSA levels. Special attention was given to correlations between Omega3 and Omega6 PUFAs and PSA. Data were analysed using standard linear regression methods. The mean PSA was 18.6 ng/mL (normal 0-4.0); for age groups of 51-60, 61-70 and 71-80 years the levels were 14, 26 and 23 ng/mL, respectively. Eicosapentaenoic acid (Omega3) levels decreased as PSA exceeded 10 ng/mL (P = 0.02). Arachidonic acid (Omega6) levels decreased as PSA was < 2 ng/mL (P = 0.02). Linoleic acid (Omega6) levels decreased in men with PSA levels of 2-10 ng/mL (P = 0.04). In men with a PSA of > 10 ng/mL there was a positive correlation between the ratio of Omega6 to Omega3 PUFAs and PSA (P = 0.036); there was also a negative correlation between the ratio of Omega3 to Omega6 PUFAs and PSA (P = 0.08). When the ratio of Omega3 PUFAs over the products of Omega6 PUFAs were used, this trend was significant (P= 0.03). Increased levels of Omega6 PUFAs and the ratio of Omega6/Omega3 PUFAs in Jamaican men are associated with an increased mean PSA level and risk of prostate cancer. Additional studies are needed to establish a causal link between dietary fatty acid intake and the development of prostate cancer in Jamaican men.