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Meghnaa Hebbar College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Halimah Khalil College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Nawal Zia College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Jameela Sheikh College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom

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Eka Melson University of Leicester, Leicester, United Kingdom

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Meri Davitadze Clinic NeoLab, Tbilisi, Georgia

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Helena Gleeson Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom

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Tejal Lathia Apollo Hospitals, Mumbai, India

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Chitra Selvan Department of Endocrinology, M S Ramaiah Medical College, Bengaluru, India

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Punith Kempegowda Clinic NeoLab, Tbilisi, Georgia
Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom

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PCOS SEva Working Group
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PCOS SEva Working Group

With increasing evidence of emotional well-being disorders associated with polycystic ovary syndrome (PCOS), effective screening processes are of utmost importance. We studied the impact of using questionnaires to screen for emotional and psychosexual well-being across different models of care for PCOS. We analysed the data from the surveys to assess the difference in the prevalence of emotional and psychosexual ill-being across ethnicity and region. In this prospective cohort study, we invited all women attending consultations for PCOS in Birmingham, UK, and Bengaluru and Navi Mumbai, India. Those who consented to participate in the study were invited to complete a pre-clinic survey about socio-demographic data, Hospital Anxiety and Depression Scale (HADS), Body Image Concern Inventory (BICI), Beliefs about Obese Person scale (BAOP), and Female Sexual Function Index score (FSFI) and a post-clinic survey on clinic experience, lifestyle advice, and specialist referral. A total of 115 women were included in this study. The rate of questionnaire completion was 98.3% (113/115), 97.4% (112/115), 93.04% (107/115), and 84.3% (97/115) for HADS, BICI, BAOP, and FSFI, respectively. In the post-clinic survey, 28.8% reported they were screened for anxiety, 27.1% for depression, and 45.8% for body image concerns. The prevalence of anxiety, depression, and body dysmorphic disorder through pre-clinic survey was 56.5% (50.0% UK vs 59.5% India, P = 0.483), 16.5% (13.9% UK vs 17.7% India, P = 0.529), and 29.6% (36.1% UK vs 26.6% India, P = 0.208), respectively. Surveys with validated questionnaires can improve screening for emotional and psychosexual well-being associated with PCOS which may be missed by ad hoc screening during consultations.

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Shams Ali Baig S Ali Baig, University of Birmingham College of Medical and Dental Sciences, Birmingham, B15 2TT, United Kingdom of Great Britain and Northern Ireland

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Kashish Malhotra K Malhotra, Department of Surgery, Rama Medical College Hospital and Research Centre Hapur, Hapur, India

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Josh Banerjee J Banerjee, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland

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Mukunth Kowsik M Kowsik, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland

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Khushi Kumar K Kumar, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland

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Fazna Rahman F Rahman, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland

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Syeda Sabbah Batul S Batul, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland

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Mohammed Faraaz Saiyed M Saiyed, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland

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Vardhan Venkatesh V Venkatesh, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland

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Pranav Vishwanath Iyer P Vishwanath Iyer, University of Birmingham College of Medical and Dental Sciences, Birmingham, B296DR, United Kingdom of Great Britain and Northern Ireland

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Punith Kempegowda P Kempegowda, University of Birmingham, Birmingham, B15 2TT, United Kingdom of Great Britain and Northern Ireland

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YouTube® is one of the leading platforms for health information. However, the lack of regulation of content and quality raises concerns about accuracy and reliability. CoMICs (Concise Medical Information Cines) are evidenced-based short videos created by medical students and junior doctors and reviewed by experts to ensure clinical accuracy. We performed a systematic review to understand the impact of videos on knowledge and awareness about diabetes and PCOS. We then evaluated the quality of YouTube® videos about diabetes and PCOS using various validated quality assessment tools and compared these with CoMICs videos on the same topics. Quality assessment tools like DISCERN, JAMA benchmark criteria, and Global Quality Score (GQS) were employed. Some of the authors of this study also co-authored the creation of some of the CoMICs evaluated. Our study revealed that while videos effectively improve understanding of diabetes and PCOS, there are notable differences in quality and reliability of the videos on YouTube®. For diabetes, CoMICs videos had higher DISCERN scores (CoMICs vs YouTube®: 2.4 vs 1.6), superior reliability (p<0.01) and treatment quality (p<0.01), and met JAMA criteria for authorship (100% vs. 30.6%) and currency (100% vs. 53.1%). For PCOS, CoMICs had higher DISCERN scores (2.9 vs. 1.9), reliability (p<0.01), and treatment quality (p<0.01); and met JAMA criteria for authorship (100% vs. 34.0%) and currency (100% vs. 54.0%); and had higher GQS scores (4.0 vs 3.0). In conclusion, CoMICs outperformed other similar sources on YouTube® in providing reliable evidence-based medical information which may be used for patient education.

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Punith Kempegowda Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Eka Melson Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Agnes Johnson College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Lucy Wallett College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Lucretia Thomas College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Dengyi Zhou College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Catherine Holmes University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Agata Juszczak University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Mohammed Ali Karamat University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Sandip Ghosh University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Wasim Hanif University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Parth Narendran University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK

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Srikanth Bellary University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
School of Life and Health Sciences, Aston University, Birmingham, UK

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Objective

COVID-19 in people with diabetes is associated with a disproportionately worse prognosis. DKA is an acute complication of diabetes with a mortality rate of approximately 0.67%. Little is known about the natural history of DKA in the presence of COVID-19. This study aimed to explore the effects of COVID-19 on presentation, clinical course and outcome in patients presenting with DKA.

Design

Retrospective cohort study.

Methods

All patients treated for DKA between 1 March 2020 and 30 May 2020 were included. Patients were categorised as COVID-positive or COVID-negative based on the swab test. A pre-COVID group was established using data from 01 March 2019 to 30 May 2019 as external control. Data regarding demographics, diabetes type, pH, bicarbonate, lactate, glucose, DKA duration, complications and outcome were collected.

Results

A total of 88 DKA episodes were included in this study. There was no significant difference in the severity or duration of DKA between the three groups. COVID-positive T1DM were more hyperglycaemic on admission compared to COVID-negative and pre-COVID patients. There was an over representation of T2DM in COVID-positive patients with DKA than in pre-COVID or COVID-negative groups.

Conclusion

COVID-19 appears to influence the natural history of DKA differently in T1DM and T2DM. Patients with T1DM and COVID-19 presented with more hyperglycaemia (60 mmol/L (35.9–60.0) vs 31.4 mmol/L (28.0–39.1) vs 24 mmol/L (20.2–33.75), respectively). Patients with T2DM were unusually presenting in DKA when infected with COVID-19 with greater ICU need and higher mortality rates. A collaborative, multi-centre study is needed to provide more definitive results.

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