• Published on: Jul 14, 2021
  • 1 minute read
  • By: Raj Dwivedi

Telemedicine, COVID-19 And Liver Diseases

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  • For liver diseases, there have been successful experiences with the use of different modalities of telemedicine [i.e. asynchronous telemedicine (analysis of patient's data by a single physician or multidisciplinary team), synchronous real-time patient management and tele-education]
  • Our Telemedicine program showed successful results as the sustained virologic responses achieved by those patients treated in primary care settings under the expert guidance.
  • Currently, this type of care is considered a vital tool for the goal of global elimination of HCV infection.In addition to HCV management, telemedicine offers opportunities for a better management of patients with chronic liver diseases by increasing their access to tertiary care, thus improving efficiency of healthcare delivery at reasonable cost .
  •  We forsee expansion of telemedicine into other areas of hepatology is desirable and hold potential for improving management of pre- and post-liver transplant patients, patients with hepatocellular carcinoma (HCC) and patients with both compensated and decompensated cirrhosis.
  • It is important to note that in liver transplant setting existing data suggest that use of telemedicine may expedite evaluation and listing of patients referred to liver transplant centers and could improve outcomes (hospital readmissions, and quality of life) after liver transplantation.
  • In the case of HCC, telemedicine aslo offers the possibility of multidisciplinary evaluation in virtual tumor boards leading to tailored and more effective treatments . Finally, in cirrhosis, telemedicine may enhance self-care and facilitate HCC surveillance eventually preventing readmissions in recently hospitalized patients.
  • With the onset of COVID-19 pandemic everyone has forced the implementation of telemedicine actions for many liver patients.
  • Major international societies have released recommendations encouraging the use of remote care to manage patients with all liver diseases, particularly liver transplant patients.
  • However, the crisis will seriously impact cirrhosis care with social distancing and isolation causing major delays in elective procedures and routine care with potential overwhelm of medical centers managing postponed and potentially decompensated patients in the upcoming months.
  • Developing robust telemedicine programs and revamping remote care initiatives in hepatology will be critical during COVID times. The next challenge will be how to integrate telemedicine into routine clinical care beyond the COVID-19 pandemic.
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Monkeypox

Monkeypox Virus Symptoms: Early Signs, Disease Progression, and When to Seek Care

Monkeypox, now commonly referred to as mpox, is a viral infection that has gained global attention due to outbreaks beyond traditionally affected regions. Understanding monkeypox virus symptoms is essential for early detection, timely isolation and prevention of further spread.

According to the World Health Organization and Indian public health authorities, awareness of symptom patterns plays a critical role in controlling outbreaks and protecting vulnerable populations.

What Is the Monkeypox Virus?

Monkeypox is caused by the monkeypox virus, a member of the Orthopoxvirus family, which also includes smallpox. While generally less severe than smallpox, monkeypox can still cause significant illness and discomfort.

The virus spreads primarily through close physical contact.

 

Incubation Period of Monkeypox

After exposure, symptoms typically appear within:

  • 5 to 21 days

  • most commonly 6 to 13 days

Individuals may feel well during this period but can become infectious once symptoms begin.

 

Early Monkeypox Virus Symptoms

Fever

Fever is usually the first symptom and may be:

  • sudden in onset

  • moderate to high grade

  • accompanied by chills

Fever signals the start of systemic infection.

 

Headache and Body Aches

Patients often experience:

  • severe headache

  • muscle aches

  • back pain

These symptoms resemble many viral illnesses.

 

Fatigue and Weakness

Marked tiredness and low energy levels are common and may limit daily activities.

 

Swollen Lymph Nodes

Swollen lymph nodes are a distinguishing feature of monkeypox.

Common sites include:

  • neck

  • armpits

  • groin

This helps differentiate monkeypox from chickenpox or smallpox.

Development of Monkeypox Rash

The skin rash usually appears:

  • 1 to 3 days after fever onset

It may begin on the face or genital area and spread to other parts of the body.

 

Stages of Monkeypox Rash

The rash progresses through well-defined stages:

Macules

Flat red spots on the skin.

Papules

Raised, firm bumps.

Vesicles

Fluid-filled blisters.

Pustules

Pus-filled lesions that are painful.

Scabs

Lesions crust over and eventually fall off.

Complete healing occurs once scabs detach.

 

Distribution of Rash

Rash commonly affects:

  • face

  • hands and feet

  • mouth

  • genital and anal areas

The number of lesions can vary widely.

 

Pain and Discomfort

Rash lesions may be:

  • painful

  • itchy during healing

Pain severity differs between individuals.

 

Other Possible Symptoms

Additional symptoms may include:

  • sore throat

  • cough

  • nasal congestion

These reflect upper respiratory involvement.

 

Duration of Illness

Monkeypox symptoms typically last:

  • 2 to 4 weeks

Recovery occurs gradually as lesions heal.

 

Who Is at Higher Risk of Severe Illness?

Higher risk groups include:

  • children

  • pregnant women

  • individuals with weakened immunity

  • people with chronic illness

Early care is crucial in these groups.

 

Complications of Monkeypox

Though uncommon, complications may include:

  • secondary bacterial skin infections

  • dehydration

  • pneumonia

  • eye involvement

Prompt medical guidance reduces risk.

 

How Monkeypox Is Transmitted

Transmission occurs through:

  • direct skin-to-skin contact

  • contact with lesions or bodily fluids

  • respiratory droplets during close contact

  • contaminated clothing or bedding

Understanding transmission helps prevent spread.

 

When to Seek Medical Care

Seek medical evaluation if:

  • fever is followed by rash

  • lymph nodes become swollen

  • rash appears in genital or facial areas

Early diagnosis supports isolation and care.

 

Diagnosis and Testing

Diagnosis may involve:

  • clinical examination

  • laboratory testing of lesion samples

Public health authorities guide testing protocols.

 

Prevention and Control Measures

Preventive steps include:

  • avoiding close contact with infected individuals

  • maintaining good hand hygiene

  • isolating during illness

  • following public health guidance

Vaccination may be recommended for high-risk groups.

 

Role of Public Awareness

Awareness of symptoms:

  • enables early detection

  • reduces stigma

  • supports timely care

WHO emphasises community education in outbreak control.

 

Conclusion

Monkeypox virus symptoms typically begin with fever, body aches and swollen lymph nodes, followed by a characteristic rash that progresses through defined stages. While most cases are self-limiting, early recognition, medical evaluation and isolation are essential to prevent complications and reduce transmission. Staying informed and acting promptly protects both individual and public health.

 

References

  • World Health Organization (WHO) – Mpox (Monkeypox) Clinical and Public Health Guidance

  • Indian Council of Medical Research (ICMR) – Emerging Viral Infections Reports

  • National Centre for Disease Control (NCDC), India – Monkeypox Advisories

  • Lancet – Clinical Features and Outcomes of Mpox

  • NITI Aayog – Public Health Preparedness and Infectious Disease Control

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