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Purpose of Study: The COVID-19 pandemic has presented considerable challenges in the care of patients with chronic diseases, including osteoporosis. In this study, we determined whether initiation of pharmacologic treatment was delayed for patients who were newly diagnosed with osteoporosis during the pandemic. Methods Used: Patients >= 50 years who were newly diagnosed with osteoporosis using dual-energy x-ray absorptiometry (DXA) screening at a single academic institution were included. Patients with osteoporosis diagnosed between March 1, 2018 to January 31, 2020 (pre-pandemic cohort) were compared to patients diagnosed between March 1, 2020 to January 31, 2022 (pandemic cohort). Basic demographics including age, gender, race, and ethnicity were evaluated. Primary outcomes included the proportion of patients who were initiated on pharmacologic therapy at 3-months and 6-months of diagnosis, as well as the mean time from osteoporosis diagnosis to initiation of pharmacologic treatment. Ordering providers (primary care vs specialty care providers) and types of pharmacologic agents were also compared. Summary of Results: In total, 1,189 were newly diagnosed with osteoporosis on DXA during the study period, with 576 patients in the pre-pandemic cohort and 613 in the pandemic cohort. There was no significant difference between cohorts with regard to age (69.3 vs 68.8 years, p=0.33), gender (87.0 vs 86.1% female, p=0.67), or ethnicity (88.2 vs 86.0% Non-Hispanic, p=0.25). However, there was a higher proportion of Whites in the pre-pandemic cohort (74.1 vs 68.4%, p=.028). Overall, only 40.5% of patients (n=481) newly diagnosed with osteoporosis were started on pharmacologic therapy within 6 months of diagnosis. Proportions of patients treated at 3-months (31.8 vs 35.4%, p=0.19) and at 6-months (37.8 vs 42.9, p=0.08) were comparable between cohorts (47.2 vs 50.2% p=0.30). Mean time from osteoporosis diagnosis to initiation of pharmacologic treatment was similar (46 vs 45 days, p=0.72). Ordering providers did not differ between cohorts (65.1 vs 57.4% primary care providers, p=0.08). Bisphosphonates were the most often prescribed in pre-pandemic (90%) and pandemic cohorts (82.1%). Conclusion(s): This is the first study to compare the impact of the COVID-19 pandemic on the pharmacologic treatment of patients who were newly diagnosed with osteoporosis. In our retrospective comparative study, we found only 40.5% of patients with newly diagnosed osteoporosis were treated pharmacologically within 6 months of diagnosis, and the COVID-19 pandemic did not significantly affect treatment rates. Bisphosphonates were the most often prescribed medication group. Further studies are needed to better understand patient-, provider-, and system-specific factors contributing to the low treatment rates of patients newly diagnosed with osteoporosis.
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Purpose of Study: Several survey studies have expressed concerns regarding a general decline in osteoporosis screening as a result of the COVID-19 pandemic. We compared our institution's experience on osteoporosis screening using dual-energy x-ray absorptiometry (DXA) before and during the COVID-19 pandemic. Methods Used: Patients >=50 years who received DXA screening at our academic institution were included. Patients with DXA completed between March 1, 2018 to January 31, 2020 (pre-pandemic cohort) were compared to patients with DXA completed between March 1, 2020 to January 31, 2022 (pandemic cohort). Basic demographics including age, gender, race, and ethnicity were evaluated. DXA utilization was calculated as the number of DXA studies completed monthly. The ordering providers (primary care vs specialty care providers) and mean time from initial order to DXA completion were compared between cohorts. Chi square tests were performed for categorical data, while independent t-tests were performed for continuous data, with significance set at 0.05. Summary of Results: In total, 10,680 DXA studies were completed at our institution over the study period. From March 1, 2018 to January 31, 2020, 5,375 DXA studies were completed (pre-pandemic cohort). From March 1, 2020 to January 31, 2022, 5,305 DXA studies were completed (pandemic cohort). Mean monthly DXA utilization did not differ between cohorts (233.7+/-28.5 vs 230.7+/-59.9 studies, p=0.83). There were also no statistically significant differences when comparing total DXA procedures per quarter per year between cohorts. Patients were older in the pandemic cohort at the time of DXA completion (69.3+/-8.2 vs 68.6+/-8.3 years, p<0.001). The distributions for gender (89.6% vs 89.2% female, p=0.5), ethnicity (90.3% vs 89.3% Non-Hispanic, p=0.09), and race (74.4% vs 73.3% White, p=0.21) did not differ between cohorts. The mean time from initial order to DXA completion was shorter for the pre-pandemic cohort (79.1+/-104.4 vs 88.8+/-107.6 days, p<0.001). The ordering providers (67.2% vs 62.7% primary care providers, p<0.001) also differed. Conclusion(s): This is the first study to quantitatively compare the rates of osteoporosis screening before and during the COVID-19 pandemic. In our retrospective study, we found that DXA utilization to screen for osteoporosis was not affected by the COVID-19 pandemic. However, DXA completion was more delayed, and the ordering providers were more likely to be non-primary care providers.
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The World Wide Web has become one of the most important resources for the large part of the population in searching healthcare information. The available COVID-19 information on Websites should be reliable and accurate in order to spread awareness. This has become all the more important in times like COVID-19, pandemic situation when it is necessary to create awareness about the disease to large population in a country like India and also provide updated information and status of the situation. However, readability poses barrier for many people. In this paper, readability of online information related to the novel coronavirus disease (COVID-19) is evaluated using online readability tool. It was found that the readability of content addressing COVID-19 is satisfactory. But the absence of multilanguage option in majority of Websites under study forms another barrier in information dissemination. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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The microblogging social networking service Twitter has been abuzz around the globe in the last decade. A number of allegations as well as exculpation of different types are being held against it. The list of pros and cons of social networks is huge. India on one hand had an abundance of internet access in last half of the decade. The growth of social media and its influence on people have affected the society in both good as well as in bad way. The following research was done in the month of September and October. The research was carried out on 13 lakh tweets approximately, collected over the course of a month from September to October providing insights about the different attributes of general tweets available on Twitter API for analysis. Insights include the hashtags, account mentions, sentiment, polarity, subject, and object of a tweet. The topics like Rhea Chakraborty and Sushant Singh Rajput, PM Narendra Modi's Birthday, IPL 2020 overshadowed the topics like COVID-19 and women's security. © 2021, IGI Global.
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CONTEXT: Lymphopenia has been frequently documented and linked to coronavirus disease 2019 (COVID-19) in a severe acute respiratory syndrome (SARS)-coronavirus 2 (CoV-2) attack. A decrease in the T-lymphocyte count has shown promise as a clinical indicator and predictor of COVID-19 severity. OBJECTIVE: The review intended to examine the relationship of COVID-19 infections in individuals to lost expression of CD28 on naive CD4+/CD8+-mediated, vaccine-specific, neutralizing antibody responses. DESIGN: The research team performed a narrative review by searching eight databases: Medline, Elsevier, Cochrane, PubMed, Google Scholar, Mendeley, and Springer Nature. The search used the following key terms: SARS CoV-2, clinical aspects and pathology of SARS CoV-2, involvement of viral spike (S) protein in SARS CoV-2, immunological changes in COVID-19 infection, basic overview of CD28 immuno-molecule ligand, reduction of vaccine therapeutic efficacy in COVID-19 infection, and immunomodulatory response of lost CD28 ligand. SETTING: This study was done in a Maharishi Arvind College of Pharmacy, Jaipur, India. RESULTS: In COVID-19 patients, particularly those with severe disease, had increased levels of IL-2 or IL-2R. Given IL-2's supportive role in the expansion and differentiation of T cells, the authors exhibiting that lymphopenia, particularly in severe COVID-19, could be attributed to nonfunctional and dysfunctional differentiation of CD4+ and CD8+ T cells as a result of low CD28 immuno-molecule expression on naive T cells. CONCLUSIONS: The literature review found that independent, early immunological prognostic markers for a poor prognosis, in addition to higher levels of IL-6, include a substantial proportion of large inflammatory monocytes and a small proportion of chronic CD28+ CD4+T cells. The current findings suggest that a combination of COVID-19 vaccination with SARS CoV-2-reactive naive T cells with the CD28 immune-molecule may be a viable method for establishing T-cell-based, adaptive cellular immunotherapy against COVID-19 infection. Further research is needed, especially larger studies to confirm the current findings, to improve early clinical treatment.
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Purpose: This paper aims to study the perception of school students towards online classes via virtual meeting applications and to unravel the teachers' preparedness and students' preparedness for running synchronous online classes and its impact on student's engagement and their satisfaction during the period of lockdown due to COVID-19. Design/methodology/approach: On the basis of focused group discussions with teachers and students of top 10 private CBSE affiliated schools (National capital Region, Delhi, India), survey instrument was constructed. Further, 489 valid responses were finally analysed through partial least square (PLS) method and structural model was tested. Findings: All the six independent variables such as teachers' structured approach, teachers' technical readiness, teachers' self-efficacy, students' technical readiness, students' autonomy and students' self-efficacy influenced students' engagement and satisfaction towards synchronous online classes significantly. The result of the structural model also reveals that students' engagement is a significant predictor of students' satisfaction. Research limitations/implications: The paper outlines the scope for future research in ascertaining more critical success factors other than satisfaction and engagement. Scope of this research suggests inclusion of not only schools but framework is also important for college and university level educational bodies. Data collection was confined to students only whereas viewpoint of teachers and parents may also be included. Originality/value: This study devised a collaborative form of learning where both the parties learnt while making continuous interactions and also co-created value in terms of new skills. Provision of autonomy given to students can't be overlooked as an important indicator for his/her preparedness. As a result, students feel motivated to get engaged in the whole process which makes them satisfied and will be able to identify the learning outcomes equal to or greater than in physical classroom settings. © 2021, Emerald Publishing Limited.
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Background: Covid-19 disease is caused by novel coronavirus known as SARS CoV 2. Coronaviruses are known to cause disease in humans which can be a common cold or a serious pneumonia. SARS Cov 2 is a new variant of coronavirus which was never reported in humans before detection of cluster of cases of pneumonia in Wuhan on 31st December, 2019.Objective: The study was conducted with the objective to find out clinico-epidemiological profiles of early Covid-19 patients in state of Haryana, India and to find out knowledge about covid appropriate behaviors among covid 19 patients. Methods: All the covid-19 cases in the five districts of Haryana were enumerated from March 2020 to May 2020. These Covid-19 cases were contacted telephonically and those who gave their consent to participate in the study were asked to fill interview schedule. Observations: There were 356 covid cases reported in five districts attached to PGIMS, Rohtak. Out of total,254 subjects participated in the study, there were 60.6 % males and 39.4% females who participated in the study. Blood groups of all the participants were also enquired and it was observed that B +ve was most common (19.7%) blood group followed by A+ve (16.5%) and O +ve (15.7%). Conclusion: It can be concluded by the study that majority of the subjects were males, overweight and blood group A & B were the most common blood groups. It was observed that 75.2 % participants were aware about the use of mask, social distancing, hand hygiene and cough etiquettes.
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Context . Some research has indicated that SARS-CoV-2 has had effects on the various functions of the renal system. Acute kidney injury (AKI) is a dangerous and broadly spread pathological illness. Objective . In this review, we emphasize that AKI can be a severe complication of COVID-19 and highlight the importance of assessing, defining, and reporting the course of AKI. Design . The research team performed a literature review, searching relevant literature databases. We searched four databases, PubMed, EMBASE, Web of Science and CNKI (Chinese Database), to identify studies reporting COVID-19. Articles published on or before May 10, 2020 were eligible for inclusion. We used the following search terms: "Coronavirus" or "2019-nCoV" or "COVID-19" or "AKI" or "renal failure" or "nephrology". Setting . This study was take place at Jouf University, Sakaka, Al-Jouf, Saudi Arabia. Results . The review showed that AKI patients, who were susceptible to a cytokine storm, showed clinical deterioration. This result allowed the current research team to develop a hypothesis of a set of adverse events in COVID-19 that proposes the modification of inflammatory pathways by stimulation of nAChRa7. The stimulation could occur by way of IL-6 / JAK2 / STAT3 / SOCS3 and NF-kappa B (p65)/IL-18, which work together to induce AKI and increase overall renal-related diagnostic markers, such as plasma creatinine and tubular cell damage. In addition, the functioning of the cholinergic anti-inflammatory pathway may be determined by nicotine. Pharmacological nicotine products are widely available, and their role in COVID-19-mediated AKI can be further evaluated. Conclusions . The research team concluded that the dysregulation of the cholinergic anti-inflammatory system could explain most of the clinical features of severe COVID-19.