A comprehensive review of analyzing the chest X-ray images to detect COVID-19 infections using deep learning techniques.

COVID-19, a highly infectious respiratory disease a used by SARS virus, has killed millions of people across many countries. To enhance quick and accurate diagnosis of COVID-19, chest X-ray (CXR) imaging methods were commonly utilized. Identifying the infection manually by radio imaging, on the other hand, was considered, extremely difficult due to the time commitment and significant risk of human error. Emerging artificial intelligence (AI) techniques promised exploration in the development of precise and as well as automated COVID-19 detection tools. Convolution neural networks (CNN), a well performing deep learning strategy tends to gain substantial favors among AI approaches for COVID-19 classification. The preprints and published studies to diagnose COVID-19 with CXR pictures using CNN and other deep learning methodologies are reviewed and critically assessed in this research. This study focused on the methodology, algorithms, and preprocessing techniques used in various deep learning architectures, as well as datasets and performance studies of several deep learning architectures used in prediction and diagnosis. Our research concludes with a list of future research directions in COVID-19 imaging categorization.

Gender differences in COVID-19 knowledge, risk perception, and public stigma among the general community: Findings from a nationwide cross-sectional study in India.

Introduction: Individual and community characteristics predictive of knowledge, perception, and attitude on COVID-19, specifically on gender, have not been adequately explored. Objective: To examine the gender differences in COVID-19 knowledge, self-risk perception and public stigma among the general community and to understand other socio-demographic factors which were predictive of them. Method: A nationally representative cross-sectional multi-centric survey was conducted among adult individuals(≥18 yrs) from the community member (N = 1978) from six states and one union territory of India between August 2020 to February 2021. The participants were selected using systematic random sampling. The data were collected telephonically using pilot-tested structured questionnaires and were analyzed using STATA. Gender-segregated multivariable analysis was conducted to identify statistically significant predictors (p < 0.05) of COVID-19-related knowledge, risk perception, and public stigma in the community. Results: Study identified significant differences between males and females in their self-risk perception (22.0% & 18.2% respectively) and stigmatizing attitude (55.3% & 47.1% respectively). Highly educated males and females had higher odds of having COVID-19 knowledge (aOR: 16.83: p < 0.05) than illiterates. Highly educated women had higher odds of having self-risk perception (aOR: 2.6; p < 0.05) but lower public stigma [aOR: 0.57; p < 0.05]. Male rural residents had lower odds of having self-risk perception and knowledge [aOR: 0.55; p < 0.05 & aOR: 0.72; p < 0.05] and female rural residents had higher odds of having public stigma [aOR: 1.36; p < 0.05]. Conclusion: Our study findings suggest the importance of considering thegender differentials and their background, education status and residential status in designing effective interventions to improve knowledge and reduce risk perception and stigma in the community about COVID-19.

COVIDPRO-NET: a prognostic tool to detect COVID 19 patients from lung X-ray and CT images using transfer learning and Q-deformed entropy

The humankind had faced several pandemic outbreaks, and coronavirus illness (COVID-19) caused by severe, acute respiratory syndrome coronavirus 2, is designated an emergency by the World Health Organization (WHO). Recognition of COVID-19 is a challenging task. The most commonly used methods are X-ray and CT scans images to inspect COVID-19 patients. It requires specialised medical professionals to report each patient's health manually. It is found that COVID-19 shows considerable similarity to pneumonia lung disease. Thus, knowledge learned from a model to diagnose pneumonia can be translated to identify COVID-19. Transfer learning method offers a drastic performance when compared with results from conventional classification. In this study, Image pre-processing is done to alleviate intensity variations between medical images. These processed images undergo a feature extraction which is accomplished using Q-deformed entropy and deep learning extraction. The feature extraction techniques are employed to remove abnormal markers from images, noise impedance from tissues and lesions. The traits acquired are integrated to differentiate between COVID-19, pneumonia and healthy cases. The primary aim of this model is to produce an image processing tool for medical professionals. The model results to inspect how a healthy or COVID-19 individual outperforms conventional models. The maximum accuracy of the collected data set is 99.68%. [ FROM AUTHOR] Copyright of Journal of Experimental & Theoretical Artificial Intelligence is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Ethical leadership and its influence on employee voice behavior: role of demographic variables

PurposeThe purpose of this paper is to examine the nature of relationship between ethical leadership and employee voice behavior. Study of employee voice behavior is important, because leaders in organizations make numerous decisions based on employees' work-related inputs which do influence the decision quality and team performance.Design/methodology/approachSurvey data were collected through structured questionnaire from Indian organizations. Data were analysed through statistical techniques such as confirmatory factor analysis and structural equation modeling.FindingsThe findings showed that ethical leadership did impact the employee voice in a positive and significant but moderate manner. The study also found no significant differences in ethical leadership and voice behavior across demographic variables such as gender, age, educational qualification and job level in the Indian context.Research limitations/implicationsThe study is conducted using single cross-sectional research design, and for better causal inferences of the relationship between various variables, future research studies may be conducted with longitudinal research design, multiple data sources and variety of industries with large sample size.Practical implicationsWith erosion of ethical values and corporate scandals, managers need to develop and display ethical leadership as employees emulate their leaders' ethical behavior because ethical leadership, or its perception, relates positively and significantly to employee voice behavior.Originality/valueThere is less study to understand ethical leadership and its influence on voice behavior in developing countries, especially in India. Ethical leadership behavior encourages employees to voice their work-related constructive opinions and concerns for improved decision-making and reduced unethical practices. Also, there is scarcity of research that explores the impact of demographic variables and this study is an effort to understand this gap.

Quality and selling price dependent sustainable perishable inventory policy: Lessons from Covid-19 pandemic

This paper addresses the impact of the Covid-19 lockdown on the warehousing of perishable items facing demand-side shocks, mainly those with selling price and product quality dependent demand, for example, fresh fruits, meats, vegetables, packed foods, etc. Along with demand-side issues, such an inventory system consumes a significant amount of energy in terms of freshness, increasing carbon tax and dwindling the firm's total profit. We formulate two-warehouse inventory models of perishables items using the first-in-first-out (FIFO) dispatching policy under two different Covid-19 lockdown scenarios. The two-warehouse system primarily consists of an owned warehouse (OW) and a rented warehouse (RW). Two different lockdown scenarios are considered as;(i) the lockdown during the consumption of goods in OW and (ii) the lockdown during the consumption of goods in RW. The demand rate is assumed to decline and surge by a finite volume as lockdown is forced and relaxed. The proposed models help in assessing the impact of lockdown on (i) product quality, (ii) product cost, (iii) inventory level, (iv) freshness keeping efforts, (v) investment in green technologies, and (vi) carbon cap and trade policy. We determine the above six parameters to maximize the firm's total profit. The key findings of this model suggest that yield is primarily affected due to carbon cap and trade policy, lockdown period, item price, backlogging, and variation in the holding costs in OW and RW. These models may assist the small, medium, and large firms involved in perishable or cold supply chains to assess the effect of Covid-19 like disruption and take corrective measures to maximize their profit.

Early Warning Scores at Time of ICU Admission to Predict Mortality in Critically Ill COVID-19 Patients.

OBJECTIVE: To assess ability of National Early Warning Score 2 (NEWS2), systemic inflammatory response syndrome (SIRS), quick Sequential Organ Failure Assessment (qSOFA), and CRB-65 calculated at the time of intensive care unit (ICU) admission for predicting ICU mortality in patients of laboratory confirmed coronavirus disease 2019 (COVID-19) infection. METHODS: This prospective data analysis was based on chart reviews for laboratory confirmed COVID-19 patients admitted to ICUs over a 1-mo period. The NEWS2, CRB-65, qSOFA, and SIRS were calculated from the first recorded vital signs upon admission to ICU and assessed for predicting mortality. RESULTS: Total of 140 patients aged between 18 and 95 y were included in the analysis of whom majority were >60 y (47.8%), with evidence of pre-existing comorbidities (67.1%). The most common symptom at presentation was dyspnea (86.4%). Based upon the receiver operating characteristics area under the curve (AUC), the best discriminatory power to predict ICU mortality was for the CRB-65 (AUC: 0.720 [95% confidence interval [CI]: 0.630-0.811]) followed closely by NEWS2 (AUC: 0.712 [95% CI: 0.622-0.803]). Additionally, a multivariate Cox regression model showed Glasgow Coma Scale score at time of admission (P < 0.001; adjusted hazard ratio = 0.808 [95% CI: 0.715-0.911]) to be the only significant predictor of ICU mortality. CONCLUSIONS: CRB-65 and NEWS2 scores assessed at the time of ICU admission offer only a fair discriminatory value for predicting mortality. Further evaluation after adding laboratory markers such as C-reactive protein and D-dimer may yield a more useful prediction model. Much of the earlier data is from developed countries and uses scoring at time of hospital admission. This study was from a developing country, with the scores assessed at time of ICU admission, rather than the emergency department as with existing data from developed countries, for patients with moderate/severe COVID-19 disease. Because the scores showed some utility for predicting ICU mortality even when measured at time of ICU admission, their use in allocation of limited ICU resources in a developing country merits further research.

Label-Free Saliva Test for Rapid Detection of Coronavirus Using Nanosensor-Enabled SERS.

The recent COVID-19 pandemic has highlighted the inadequacies of existing diagnostic techniques and the need for rapid and accurate diagnostic systems. Although molecular tests such as RT-PCR are the gold standard, they cannot be employed as point-of-care testing systems. Hence, a rapid, noninvasive diagnostic technique such as Surface-enhanced Raman scattering (SERS) is a promising analytical technique for rapid molecular or viral diagnosis. Here, we have designed a SERS- based test to rapidly diagnose SARS-CoV-2 from saliva. Physical methods synthesized the nanostructured sensor. It significantly increased the detection specificity and sensitivity by ~ten copies/mL of viral RNA (~femtomolar concentration of nucleic acids). Our technique combines the multiplexing capability of SERS with the sensitivity of novel nanostructures to detect whole virus particles and infection-associated antibodies. We have demonstrated the feasibility of the test with saliva samples from individuals who tested positive for SARS-CoV-2 with a specificity of 95%. The SERS-based test provides a promising breakthrough in detecting potential mutations that may come up with time while also preparing the world to deal with other pandemics in the future with rapid response and very accurate results.

A critical assessment of SARS-CoV-2 in aqueous environment: Existence, detection, survival, wastewater-based surveillance, inactivation methods, and effective management of COVID-19.

In early January 2020, the causal agent of unspecified pneumonia cases detected in China and elsewhere was identified as a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was the major cause of the COVID-19 outbreak. Later, the World Health Organization (WHO) proclaimed the COVID-19 pandemic a worldwide public health emergency on January 30, 2020. Since then, many studies have been published on this topic. In the present study, bibliometric analysis has been performed to analyze the research hotspots of the coronavirus. Coronavirus transmission, detection methods, potential risks of infection, and effective management practices have been discussed in the present review. Identification and quantification of SARS-CoV-2 viral loads in various water matrices have been reviewed. It was observed that the viral shedding through urine and feces of COVID-19-infected patients might be a primary mode of SARS-CoV-2 transmission in water and wastewater. In this context, the present review highlights wastewater-based epidemiology (WBE)/sewage surveillance, which can be utilized as an effective tool for tracking the transmission of COVID-19. This review also emphasizes the role of different disinfection techniques, such as chlorination, ultraviolet irradiation, and ozonation, for the inactivation of coronavirus. In addition, the application of computational modeling methods has been discussed for the effective management of COVID-19.

Diabetic post-covid mucormycosis: A dermatoglyphic prediction.

Aim: To identify the characteristic pattern/parameter among diabetic post-covid mucormycosis patients which may further help in identifying such susceptible patients in a much earlier course of the disease. Materials and Methods: The study was done with 30 diabetic patients (21 males and 9 females) admitted in RIMS Ranchi during the second wave of Covid-19 for post-covid complications. Palm and fingerprint pattern was taken by ink and pad method to measure the qualitative and quantitative parameters. Result: Diabetic post-covid mucormycosis patients were found to have predominantly whorl pattern in males, loop in females, and C-line pattern absent in 36.6%. Proximal axial triradii with ulnar deviation was 76.6%. All the ridge counts (except ab ridge count of right hand) when compared with hypothesized value were found to be significant with P value (<0.005). None of the three angles measured were found to be significant. Conclusion: All the ridge counts (except ab ridge count of right hand) were found to be a reliable parameter for the diagnosis of diabetic post-covid mucormycosis. ATD angle known to be the most reliable parameter for diagnosis of diabetes mellitus in dermatoglyphics is found to be nonreliable with respect to diabetes post-covid mucormycosis.

Omicron variant of SARS-CoV-2: a review of existing literature.

On November 24th, 2021 a case of a new viral variant of SARS-CoV-2 was reported by South Africa and Botswana to WHO, which later was designated as the variant of concern on 26th November 2021. It has around 60 mutations (50 non synonymous, 8 synonymous, and 2 non coding) as compared to the original parent strain of Wuhan. Different hypotheses have been put forward as an explanation for the origin like reverse zoonosis i.e. animal to human transmission, origin from an immune compromised patient or use of highly mutagenic drug like molnupiravir as treatment. A huge spike in cases around the globe is suggestive of a high rate of infectivity and transmissivity as compared to the previous known variants. With whatever cases have been documented so far, it is said that omicron causes mostly mild clinical illnesses and there is a less chance of hospitalization according to the clinicians. Among the reported cases, there were already vaccinated patients also. So there is a possibility that omicron might be able to evade the vaccine induced immunity due to a huge number of mutations (especially in the spike protein sequences). Until new vaccines specific to the pathogen are being developed, the coverage of the currently acceptable vaccines should be increased so that none is deprived of the mandatory doses and a third booster dose might help to reduce the chances of serious complications of this new strain beforehand. So an equal focus on the host and environment is required along with the pathogen.

COVID-19: a viewpoint from hepatic perspective.

Coronaviruses as such are known since last century. The name is derived from their shape which has crown (corona) like radiating spikes. The recent one however is a different one from the Coronavirus involved in SARS (2002-2004) and MERS (2012) in being highly infectious. Initially COVID 19 had a high case fatality rate which has now decreased to a significant extent. Many cases of COVID 19 are asymptomatic with a significant number of positive cases developing a triad of fever, breathlessness and GI symptoms. Recent travel increases the probability of infection. The pathogenesis involves ACE 2 receptors. So, it has been found that there are more cases and mortality among hypertensive individuals. Even higher among the people who use ACE inhibitor in comparison to those who use other anti-hypertensive drugs. Treatment is usually symptomatic. Antiviral drugs and vaccines against COVID-19 are being used. Deranged liver enzymes are common in COVID-19, however, serious liver injury is not much documented. Liver injury is either due to disease itself or due to antiviral drugs. Extra care like strict social distancing, avoiding unnecessary contact is needed for those with autoimmune hepatitis, liver cancer and those who are in immunosuppression because of a scheduled or already liver transplant. Further research is definitely needed in this field. The upcoming researches should also focus on liver injuries associated with disease course and derangements arising as side effects of treatment of COVID-19.

Retention of Knowledge and Efficacy of a Hands-on Training Session in Oxygen Therapy for COVID-19 among Healthcare Workers.

Introduction: We conducted basic hands-on training in oxygen therapy and ventilatory management of coronavirus disease-2019 (COVID-19) patients to health care workers (HCWs) at our tertiary care hospital. We designed this study aiming to find out the impact of hands-on training in oxygen therapy for COVID-19 patients on the knowledge and degree of retention of this gained knowledge 6 weeks after the training session among HCWs. Materials and methods: The study was conducted after obtaining approval from the Institutional Ethics Committee. A structured questionnaire consisting of 15 multiple-choice questions was given to the individual HCW. This was followed by a structured 1-hour training session on "Oxygen therapy in COVID-19", following which the same questionnaire was given to the HCWs with the questions in a different order. After 6 weeks, the same questionnaire with questions in a different format was sent to the participants as a Google form. Results: A total of 256 responses were obtained for the pre-training test and post-training test. The median [IQR] pre-training test scores and post-training test scores were 8 [7-10] and 12 [10-13], respectively. The median retention score was 11 [9-12]. The retention scores were significantly higher than the pre-test scores. Conclusion: About 89% of the HCWs had a significant gain of knowledge. About 76% of the HCWs were able to retain knowledge, which also means the training program was successful. A definitive improvement in baseline knowledge was observed after 6 weeks of training. We propose conducting reinforcement training after 6 weeks of primary training to further augment retention. How to cite this article: Singh A, Salhotra R, Bajaj M, Saxena AK, Sharma SK, Singh D, et al. Retention of Knowledge and Efficacy of a Hands-on Training Session in Oxygen Therapy for COVID-19 among Healthcare Workers. Indian J Crit Care Med 2023;27(2):127-131.

Knowledge, practices and compliance related to COVID-19 among Nepalese population in Province 2, Nepal.

Aim: The study aimed to access the knowledge, practice, and compliance related to COVID-19 among people residing in Province 2, Nepal. Materials and methods: A descriptive cross-sectional study was conducted from October 2020 to March 2021. A total of 457 participants of eight districts of Province 2 were enrolled after obtaining consent. Data were collected by face-to-face interviews with participants. A total of 31 validated pre-structured questionnaires were asked to participants in which 11 questions were for knowledge, 12 questions were for practices, and 8 questions were for compliance related to COVID-19. For tool validation, pre-testing was done in 10.0% of individuals of the targeted study population of Mahottari district. Results: Out of 457 participants, 353(77.2%) were male. The majority of the participants were unmarried (68.3%), had only school-level education (26.5%), Hindu by religion (89.7%), farmers (23.0%), and businessmen (23.0%). More than 75.0% of individuals had knowledge about the causative agent of COVID-19 symptoms and the purpose of isolation. About 53.8% of participants had good knowledge of social distancing, 31.1% had knowledge of masks, and 39.3% knew about sanitizer. Moreover, 94.3% of the respondents had good knowledge of hand-washing practice with soap-water and use of sanitizer, 89.1% had good knowledge of wearing masks and 82.9% followed social distancing. Compliance with standard procedures of sneezing was recorded in 43.1%, washing hands with soap water/sanitizer was 82.3%, and disposal of masks was 53.6%. A significant association was observed between gender with knowledge and compliance (p < 0.05). District-wise association with knowledge, practice and compliance was found to be significant (p < 0.05). Conclusion: The findings suggest that participants have a good level of knowledge; however, the practice and compliances are considerably low related to COVID-19.

Challenges in Accessing and Delivering Maternal and Child Health Services during the COVID-19 Pandemic: A Cross-Sectional Rapid Survey from Six States of India.

BACKGROUND/OBJECTIVES: Globally, the COVID-19 pandemic and its prevention and control policies have impacted maternal and child health (MCH) services. This study documents the challenges faced by patients in accessing MCH services, and the experiences of health care providers in delivering those services during the COVID-19 outbreak, explicitly focusing on the lockdown period in India. METHODS: A cross-sectional study (rapid survey) was conducted in 18 districts from 6 states of India during March to June, 2020. The sample size included 540 MCH patients, 18 gynaecologists, 18 paediatricians, 18 district immunisation officers and 108 frontline health workers. Bivariate analysis and multivariable analysis were used to assess the association between sociodemographic characteristics, and challenges faced by the patients. RESULTS: More than one-third of patients (n = 212; 39%) reported that accessing MCH services was a challenge during the lockdown period, with major challenges being transportation-related difficulties (n = 99; 46%) unavailability of hospital-based services (n = 54; 23%) and interrupted outreach health services (n = 39; 18.4%). The supply-side challenges mainly included lack of infrastructural preparedness for outbreak situations, and a shortage of human resources. CONCLUSIONS/RECOMMENDATIONS: A holistic approach is required that focuses on both preparedness and response to the outbreak, as well reassignment and reinforcement of health care professionals to continue catering to and maintaining essential MCH services during the pandemic.

Association of vitamin D with the severity of disease and mortality in COVID-19: Prospective study in central India.

Background: Many factors have been proposed to be associated with the severity of disease and mortality in COVID-19. Vitamin D had recently been reviewed as one of these factors. Aim and Objectives: To evaluate the association between Vitamin D and the disease severity and mortality in COVID-19. Materials and Methods: After approval from Institutional Ethics Committee, this prospective cohort study was carried out in selected tertiary care teaching medical institutes of Central India. Participants were COVID-19 patients of the age group of 18 years and above admitted during the study period. They were categorized into four groups as asymptomatic (Group A), mild (Group B), moderate (Group C), and severe (Group D) based on clinical symptoms, respiratory rate, oxygen saturation, and chest imaging. Serum level of Vitamin 25(OH) D was measured using chemiluminescent immunoassay. The outcome of the disease was classified as recovery and death during hospitalization. The association of sociodemographic and medical characteristics with treatment outcome was studied using an appropriate statistical test. A full logistic regression model was built for the assessment of the relationship between treatment outcomes with Vitamin D level. Further, one receiver operating characteristic curve was developed to examine the prognostic significance of Vitamin D levels in COVID-19 patients. Results: Out of 748 enrolled patients, 44 (5.88%), had severe disease (Group D). A total of 721 cases (96.39%) recovered and were discharged, whereas 27 (3.61%) died during hospitalization. Mean Vitamin D level was found to be significantly different in discharged patients compared to those who were deceased. Increasing age-adjusted odds ratio (AOR) (95% confidence interval [CI]=1.07 [1.02-1.12]), known hypertension AOR (95%CI) = 3.38 (1.13-10.08), and diabetes mellitus AOR (95%CI) =28.5 (6.04-134.13) were found to be significant predictors of death among COVID-19 patients. Increasing Vitamin D level was found to be protective against COVID-19-related death (AOR (95% CI = 0.87 [0.80-0.94]). Conclusion: Vitamin D was significantly associated with the disease severity and mortality in COVID-19.

Résumé Contexte: Il a été proposé que de nombreux facteurs soient associés à la gravité de la maladie et de la mortalité dans le Covid - 19. La vitamine D avait récemment été examinée comme l'un de ces facteurs. Objectif et objectifs: évaluer l'association entre la vitamine D et la gravité de la maladie et la mortalité dans le Covid-19. Matériel et méthodes: Après l'approbation du comité d'éthique institutionnel, cette étude de cohorte prospective a été réalisée dans des instituts médicaux d'enseignement des soins tertiaires de l'Inde centrale. Les participants étaient des patients Covid-19 du groupe d'âge de 18 ans et plus admis au cours de la période d'étude. Ils ont été classés en quatre groupes comme asymptomatiques (groupe A), légers (groupe B), modérés (groupe C) et sévères (groupe D) sur la base des symptômes cliniques, de la fréquence respiratoire, de la saturation en oxygène et de l'imagerie thoracique. Niveau sérique de la vitamine 25 (OH) DWAS mesuré en utilisant l'immunodosage chimioluminescent. L'issue de la maladie a été classée comme récupération et décès pendant l'hospitalisation. L'association des caractéristiques sociodémographiques et médicales avec les résultats du traitement a été étudiée à l'aide d'un test statistique approprié. Un modèle de régression logistique complet a été construit pour l'évaluation de la relation entre les résultats du traitement au niveau de la vitamine D. De plus, une courbe caractéristique de fonctionnement du récepteur a été développée pour examiner la signification pronostique des niveaux de vitamine D chez les patients COVID-19. Résultats: Sur 748 patients inscrits, 44 (5,88%), avaient une maladie grave (groupe D). Un total de 721 cas (96,39%) ont récupéré et ont été libérés, tandis que 27 (3,61%) sont décédés pendant l'hospitalisation. Le niveau moyen de la vitamine D s'est révélé significativement différent chez les patients libérés par rapport à ceux qui ont été décédés. Augmentation du rapport de cotes ajusté à l'âge (AOR) (intervalle de confiance à 95% [IC] = 1,07 [1,02­1,12]), hypertension connue AOR (IC à 95%) = 3,38 (1,13­10,08) et diabète mellite aor (IC 95% ) = 28,5 (6,04­134.13) se sont révélés être des prédicteurs significatifs de la mort chez les patients COVID-19. L'augmentation du niveau de vitamine D s'est avérée protectrice contre la mort liée au Covid - 19 (AOR (IC à 95% = 0,87 [0,80­0,94]). Conclusion: La vitamine D était significativement associée à la gravité de la maladie et à la mortalité dans le Covid - 19. Mots clés: Covid - 19, tempête de cytokines, mortalité, gravité, vitamine D.

Mucormycosis: A triple burden in patients with diabetes during COVID-19 Pandemic.

With the upsurge in the cases of COVID-19 around the world, plenty of potential COVID-19 complications are becoming more prevalent, including a higher risk of secondary bacterial and fungal infections. Mucormycosis is one such condition which has high prevalence among individuals with diabetes who were infected with COVID-19.The usage of steroids in the treatment further inflates the risk of infection and exacerbation of disease in pre-existent mucormycosis patients. Generally, Corticosteroid-induced diabetes can arise on long-term steroid medication, increasing the likelihood of mucormycosis. In patients with COVID-19, the indications and dose of corticosteroids should be properly regulated, and persons with diabetes who take insulin or oral anti-diabetic medicines should be cautious. To avoid poor outcomes, strategies to improve glycemic management should be emphasized. This narrative review elucidates different disciplines on rampant use of steroids, iron and zinc supplements as well as the methods utilized as primary or adjunctive treatment of this fatal condition. This article may help to pave the way for robust research that needs to be done to tackle the deadly triple burden of the disease.

Development & validation of scales to assess stigma related to COVID-19 in India.

Background & objectives: COVID-19 pandemic has triggered social stigma towards individuals affected and their families. This study describes the process undertaken for the development and validation of scales to assess stigmatizing attitudes and experiences among COVID-19 and non-COVID-19 participants from the community. Methods: COVID-19 Stigma Scale and Community COVID-19 Stigma Scale constituting 13 and six items, respectively, were developed based on review of literature and news reports, expert committee evaluation and participants' interviews through telephone for a multicentric study in India. For content validity, 61 (30 COVID-19-recovered and 31 non-COVID-19 participants from the community) were recruited. Test-retest reliability of the scales was assessed among 99 participants (41 COVID-19 recovered and 58 non-COVID-19). Participants were administered the scale at two-time points after a gap of 7-12 days. Cronbach's alpha, overall percentage agreement and kappa statistics were used to assess internal consistency and test-retest reliability. Results: Items in the scales were relevant and comprehensible. Both the scales had Cronbach's α above 0.6 indicating moderate-to-good internal consistency. Test-retest reliability assessed using kappa statistics indicated that for the COVID-19 Stigma Scale, seven items had a moderate agreement (0.4-0.6). For the Community COVID-19 Stigma Scale, four items had a moderate agreement. Interpretation & conclusions: Validity and reliability of the two stigma scales indicated that the scales were comprehensible and had moderate internal consistency. These scales could be used to assess COVID-19 stigma and help in the development of appropriate stigma reduction interventions for COVID-19 infected, and mitigation of stigmatizing attitudes in the community.

Coronavirus disease-19 triggered systemic lupus erythematous: A novel entity.

Coronavirus disease 19 (COVID-19) has been associated with varied immunological diseases due to dysregulated immune responses. We hereby report a rare case of COVID-19 triggered Systemic lupus erythematous arising in a young healthy male, necessitating the use of immunomodulatory drugs for the remission of the disease process.