ABSTRACT
Purpose : To determine whether there is an increased risk of herpes zoster ophthalmicus (HZO) following COVID-19 vaccination. Methods : Retrospective observational study utilizing OptumLabs® Data Warehouse, a longitudinal, real-world data asset with de- identified administrative claims and electronic health record data. A cohort study design and a self-controlled design were both utilized to investigate HZO following vaccination, defined by an ICD-10 diagnosis code within 30 days after vaccine administration (or up to the second dose if a second dose was administered), plus a new prescription or dose escalation of antivirals within 5 days of HZO diagnosis. Using a cohort design, COVID-19 vaccinated individuals from 12/11/2020- 6/30/2021 were compared to two influenza-vaccinated cohorts: a pre-pandemic group (1/1/2018-12/13/2019) and an early pandemic group (3/1/2020-11/1/2020). Cox proportional hazard models were used to identify unadjusted and adjusted hazard ratios for HZO. Using a self-controlled design, the incidence rate ratio comparing the risk of HZO in the risk intervals following COVID-19 vaccination to a control interval 60 to 90 days prior to the first dose was estimated using conditional Poisson regression. Results : Among 3,567,715 patients in the COVID-19 vaccinated cohort, there were 60 post-vaccine HZO cases. Patients vaccinated against COVID-19 were not at increased risk of HZO compared to pre-pandemic influenza vaccinated patients (N= 5,101,709;HR= 0.84;95% CI: 0.61-1.16;p= 0.29) and early pandemic influenza vaccinated patients (N= 4,060,412;HR= 0.93;95% CI: 0.64-1.34;p= 0.69) after adjustment for demographics, comorbidities, zoster vaccine, and medication use. Additionally, HZO cases post-COVID-19 vaccination were less likely to be prescribed ophthalmic steroids compared to cases following pre-pandemic and early pandemic influenza vaccination (18.3% vs 29.6% vs 41.4%, respectively). In the self-controlled design, patients were not at increased risk of HZO after COVID-19 vaccination compared to their control interval (IRR= 0.74;95% CI: 0.49-1.12;p= 0.15). Conclusions : There is not an increased risk of HZO following COVID-19 vaccination. These results provide reassurance for the safety of the COVID-19 vaccine from an ophthalmic standpoint.
ABSTRACT
Demand for contract tracing applications is significantly increasing as governments across the globe are relying on these mobile apps to help combat the spread of the COVID-19 virus. However, while this technology has a potential benefit, there is widespread concern that consumers’ fears around privacy and data protection prevent them from downloading such apps. By focusing on this emerging crisis, in this study, we investigate the potential obstacles imposed by privacy concerns (i.e., the perceived risk of accepting the app permission, the perceived risk of providing the information). This study also investigates the popularity of Aarogya Setu, the Indian government’s COVID-19 app. In doing so, we examine privacy concerns through the theoretical lens of the Elaboration Likelihood Model and explore the download intentions of new users. Using the above dimensions of privacy, we then propose a conceptual framework that depicts the influence of privacy concerns over the download intention of new users. Lastly, this paper provides suggestions to allow the Aarogya Setu to improve its perceived reliability among its users and increase downloads. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
COVID-19 (Coronavirus infectious disease 2019) denotes an ever changing and varied disease which has crippled the health care systems throughout the world. There have been studies conducted across the globe to establish the important factors for severity and mortality associated with COVID-19. We tried to study the effect of chronic obstructive pulmonary disease (COPD) on the severity as well as outcome of COVID-19. Material and methods: A total of 180 patients with COVID-19 were enrolled in this study and were then screened for history of COPD. There were 49 patients with history of COPD and 131 patients with no history of COPD. Inflammatory markers and HRCT scores were assessed for all the patients and they were followed up to study the outcome. Result: COPD was significantly associated HRCT Score, inflammatory markers and outcome. The mean HRCT Score for patients with COPD was more in COPD group (15.39 +/- 4.65) when compared with Non-COPD group (9.39 +/- 3.98). Mortality was also significantly higher in patients with COPD (67.3%) when compared to the patients without COPD (3.3%). Conclusion: We conclude that COPD is an important factor which has to be considered while treating the patients of COVID-19 especially in the rural India where lockdown restrictions and lack of knowledge have provided hinderance in achieving optimal follow up as there is increased severity and mortality associated with it.
ABSTRACT
Derangements in coagulation profile due to on-going anticoagulant medication can complicate the most primitive physiology in a woman, ovulation. Unmonitored anticoagulant therapy can lead to an array of complications, one of which is intraperitoneal haemorrhage secondary to numerous medical and surgical conditions. The resultant haemoperitoneum can cause sudden hypovolemic shock, especially in a patient with compromised cardiovascular status. This report narrates the case of a 30 years old nulliparous female patient on anticoagulant therapy, operated for multiple cardiac defects and developed massive haemoperitoneum as a consequence of ovulation. The patient presented in shock to the Emergency Department with unstable haemodynamic status. A multi-disciplinary approach to the case converged on ruptured functional ovarian cyst as a working diagnosis. Conservative management of haemoperitoneum was decided upon, whereby correcting shock and providing pro-coagulant therapy along with blood products was the main line of management. All efforts failed soon after when the cyst wall ruptured catastrophically, leading to collapse of the general condition of the patient. Surgical approach was undertaken and a ruptured ovarian cyst wall was identified to be the cause. The cyst wall was subsequently repaired electrosurgically and the patient recovered well with an uneventful postoperative period. However, the characteristic feature of this case is the lack of follow-up due to lockdown restrictions of this continuum, the Coronavirus Disease-2019 (COVID-19) pandemic. The management of such cases must be carefully titrated, keeping in mind the risks and benefits of both pro-coagulant and anti-coagulant therapy wherein one can jeopardise the effects of the other.
ABSTRACT
Incidence of Dengue has been on the up rise ever since the second wave of the pandemic of COVID19 has ended introducing an old enemy on the frontline to the health care professionals.A 28 year old Gravida 2 Parity 0 Living 0 Abortion 1 with twin pregnancy presented with fever along with chills and retro orbital pain along with body ache since two days in the emergency department with the gestational age of 36 weeks.She tested positive for Dengue NS1 antigen.Patient was having thrombocytopenia and was managed with intravenous fluids,platelet and blood transfusion and was taken for caesarian section and she delivered twins with normal birth weight.During the post operative period the patient went into dengue shock syndrome and which was managed with fluids and inotropic support and patient ultimately recovered and was discharged on day seventeen of admission .This case report emphasises on the importance of prompt detection and management of dengue in a case of high risk pregnancy such as twin pregnancy.After extensive review of literature we found that this is the first case report to report the association of twin pregnancy with dengue shock syndrome making it an important topic of discussion.
ABSTRACT
Since 2019, The Coronavirus Disease (COVID19) has emerged as a global health concern. Various kinds of disorders like the vascular involvement along with neurological complications continue to be reported worldwide. In this case report we describe the case of a 28 year old Female who was antenatal (6.5 months) presented with Genereliazed Tonic Clonic Convulsions of duration more than 30 minutes which upon investigations turned out to be a case of subdural bleed and upon Nasopharyngeal swab testing revealed to be COVID19 positive case. Though the patient underwent urgent craniotomy and evacuation of hematoma was done, the patient ultimately succumbed leading to maternal mortality. Thus, this case report is an attempt to draw attention towards the maternal mortality caused due to COVID19 which we tend to overlook.
ABSTRACT
We present a case of term pregnancy which presented with chief complaint of Breathlessness, chest pain as well as a one day history of vomiting. She tested positive for COVID19 through reverse transcriptase polymerase chain reaction of nasopharyngeal swab and the symptoms were attributed to Pneumonia caused due to COVID19.However,the arterial blood gas showed metabolic acidosis with high anion gap. This was a non lactate acidosis with no hypoxemia. Most reasonably the state of pregnancy with increased energy demands along with increased metabolic maternal demand due to infection coupled with maternal starvation had resulted in this Ketoacidosis. In view of non progression of labor caesarian section was carried out and a healthy neonate was delivered. There was an initial improvement in maternal ketoacidosis post partum however optimal management of COVID19 pneumonia required oxygen support and use of corticosteroids. Thus we highlight how an unusual metabolic demands of pregnancy might mimic COVID19.
ABSTRACT
Purpose: Medical education systems were heavily impacted by the public health measures implemented due to COVID-19. This literature review serves to summarize and discuss the strengths and limitations of novel medical education interventions or proposed suggestions during the COVID-19 pandemic in order to assist medical institutions with the evaluation of various interventions prior to their implementation. Method: The research team conducted a scoping review following the Arksey and O'Malley framework. MEDLINE and EMBASE were searched for publications from January 1st, 2019 to August 10th, 2020 that proposed novel medical education interventions or suggestions during the COVID-19 pandemic. The search included MeSH searches, titles, abstracts, and keywords of studies. Our inclusion criteria was comprised of articles that used qualitative designs;included medical students as the primary study cohort;involved suggestions for new medical education strategies to accommodate for the COVID-19 changes;involved studies that assessed the challenges and strengths of new COVID-19 medical school interventions;were primary studies, reviews, published letters to an editor, or opinion pieces. Results: The final number of articles included in this review was 54. Each article had one or more interventions proposed. 10 articles reported integrating medical students in the workforce. 7 articles discussed efforts to manage medical students' stress. 5 articles described changes to the residency program application process. 10 articles discussed changes to examinations. 12 articles discussed changes to clinical rotations and electives. 11 articles discussed implementing online clinical experience. 36 articles implemented or suggested online learning strategies. Conclusions: The literature review suggests that quantitative studies to assess the efficacy of each intervention is still required given the differences in suggestions offered by different institutions across the world.
ABSTRACT
The outbreak of novel coronavirus disease was first reported in China in December 2019, and WHO declared the coronavirus pandemic on 11 March 2020. Since then, all the continents have observed a fast-growing upward trend in number of confirmed cases. During the epidemics, Sexual and reproductive health (SRH) and rights became a monumentous public health issue. The novel coronavirus (SARS-CoV-2) is new to humans and there is only some experimental data available to describe the sexual and reproductive health (SRH) effects of COVID-19 disease, including clinical appearance and consequences of COVID-19 infection during birth, or for people with STI (sexually transmitted infections) or HIV-related immunosuppression. We should not neglect the bearings at the level of the health system and delays or interludes in the routine availability of SRH facilities outside the therapeutic reach of SRH, such as pre-and postnatal tests, safe abortion, contraception, HIV/AIDS, and sexually transmitted infections. In addition, other factors warrant con-sideration, such as the possible rise in gender-based violence and domes-tic abuse and the consequences of COVID-19-related stigma and prejudice and their effect on SRH customers and health care providers. Therefore, the research community has an immediate requirement for the creation of all-inclusive clinical, epidemiological, and psycho-social behavioral ties between COVID-19 and SRH and the effects of rights. A comprehensive systematic literature search of the databases of PubMed, Web of Science, Embase, Medline, Cochrane and MedRxiv, was carried out.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is a novel type of highly contiguous pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Pregnant ladies are vulnerable to the virus infection due to alteration in anatomic and immune system. The chance of infection would apparently rise due to antenatal visits but inadequate medical care facilities during pregnancy can be harmful for both maternal and perinatal outcome. The Government of India has divided the districts of various states into Red, Orange and Green zones. Most of the hospitals from Red and Orange zones have made it mandatory COVID-19 testing for all antenatal patients near term making it easier to isolate and manage patients accordingly. The green zone hospital presently not doing COVID testing for all peripartum patients. Thus, proper maternal health care management at tertiary level is required with minimum exposure and risk in suspected cases especially in green zone hos-pitals. Here, we present our experience as a team at our Obstetrics and Gynae-cology department of pregnant women with upper respiratory tract infec-tion/suspected case of COVID-19 infection during hospitalization in our rural setup and further we will discuss patient triage based on risk level, antenatal care planning and handling emergencies during COVID-19 lockdown. © International Journal of Research in Pharmaceutical Sciences.
ABSTRACT
The outbreak of the novel coronavirus in China in December 2019 and its sub-sequent dissemination to nearly all nations in the world has raised immense concern for human health, especially maternal and child health. Experts across the globe are probing into etiopathogenesis of the virus and developing vaccines and medications to contain the spread and treat the diseased. Numerous research projects have been undertaken to understand the full spectrum of the disease including transmission dynamics and clinical pre-sentation and to evaluate the risk and predictability of vertical transmission. However, there is no reliable evidence that suggests vertical transmission of COVID-19 and this article reviews the existing literature and management protocols regarding the same. With the immunocompromised state of pregnancy and various physiological adaptations associated with it, maternal and foetal safety and management has become a major concern for institutions across the globe, especially in developing countries. The literature reviewed in this narrative article is obtained from articles from various databases such as PubMed, Scopus, Web of Science and various national and international Obstetric and Gynaecological associations using MeSH-compliant keywords including COVID-19, SARS-COV-2, 2019-nCoV upto April 2020. © 2020, J. K. Welfare and Pharmascope Foundation. All rights reserved.
ABSTRACT
Corona virus disease which originated from Wuhan in China has engulfed the whole globe. COVID-19 is leading the list of diseases people are extremely concerned about, followed by cancer and HIV/AIDS, according to the study by market research and analysis company Velocity MR. This disease has brought around many changes in the lives of people. The medical officials and scientists are working all day long to find a cure for this disease or to create a vaccine. But the question that rises is will there ever be a cure?. Will the world be normal again? For how long will this disease cause a havoc in the life of the people? And many such questions which still remain unanswered. But in this article we have discussed about how will the world change after COVID-19 pandemic.
ABSTRACT
Inadequate supply of filtering facepiece respirators (FFRs) for healthcare workers during a pandemic such as the novel coronavirus outbreak (SARS-CoV-2) is a serious public health issue. The aim of this study was to synthesize existing data on the effectiveness of ultraviolet germicidal irradiation (UVGI) for N95 FFR decontamination. A systematic review (PROSPERO CRD42020176156) was conducted on UVGI in N95 FFRs using Embase, Medline, Global Health, Google Scholar, WHO feed, and MedRxiv. Two reviewers independently determined eligibility and extracted predefined variables. Original research reporting on function, decontamination, or mask fit following UVGI were included. Thirteen studies were identified, comprising 54 UVGI intervention arms and 58 N95 models. FFRs consistently maintained certification standards following UVGI. Aerosol penetration averaged 1.19% (0.70-2.48%) and 1.14% (0.57-2.63%) for control and UVGI arms, respectively. Airflow resistance for the control arms averaged 9.79 mm H2O (7.97-11.70 mm H2O) vs 9.85 mm H2O (8.33-11.44 mm H2O) for UVGI arms. UVGI protocols employing a cumulative dose >20,000 J/m2 resulted in a 2-log reduction in viral load. A >3-log reduction was observed in seven UVGI arms using >40,000 J/m2. Impact of UVGI on fit was evaluated in two studies (16,200; 32,400 J/m2) and no evidence of compromise was found. Our findings suggest that further work in this area (or translation to a clinical setting) should use a cumulative UV-C dose of 40,000 J/m2 or greater, and confirm appropriate mask fit following decontamination.