Ayurvedic Herbs and Spices: A Promising Approach for the Treatment of COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus accountable for the coronavirus disease 2019 (COVID-19) that has led to many fatal cases worldwide. It causes a severe acute respiratory syndrome, a hyperinflammatory response, vascular damage, mi-croangiopathy, and widespread thrombosis. Vaccines, interferon therapies, and small-molecule drugs may be among the various alternatives for managing or preventing emerging SARS-CoV-2 infections. New interventions, on the other hand, are likely to take months to years to develop. Furthermore, existing antiviral agents commonly develop viral resistance along with certain side effects. Therefore, effective prevention and treatment medications without side effects against human coronavirus are urgently needed. Indian and Chinese traditional medicine have suggested some natural products for the prevention, treatment, and rehabilitation of the diseases, including COVID-19 and various herbs and mushrooms that have been reported to possess potential antiviral and anti-inflammatory activities. Therefore, in this pandemic, traditional medicines pose a ray of hope for human health. The Ministry of Ayush, India, has also recommended a number of therapies to increase immunity in addition to ayurvedic treatments. Thus, the probability of naturally occurring substances as successful treatments against COVID-19 may seem hopeful due to their diverse biological and therapeutic properties. This review focuses on the latest updates of Ayurvedic herbs and spices as promising approaches for treatment during this devastating pandemic situation.Copyright © 2023 Bentham Science Publishers.

Multidisciplinary Management of COVID-Associated Mucormycosis Syndemic in India.

The study aimed to determine clinical presentation, contributing factors, medical and surgical management, and outcome of patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM). A cross-sectional, single-center study was conducted on patients receiving multidisciplinary treatment for mucormycosis following the second wave of COVID-19 pandemic from April to June 2021 in India. Clinicoepidemiological factors were analyzed, 30-day overall survival and disease-specific survival were determined, and t-test was used to determine the statistical significance. A total of 215 patients were included in the study, the cases were stratified into sino-nasal 95 (44.2%), sino-naso-orbital 32 (14.9%), sino-naso-palatal 55 (25.6%), sino-naso-cerebral 12 (5.6%), sino-naso-orbito-cerebral 16 (7.4%), and sino-naso-orbito-palato-cerebral 5 (2.3%) based on their presentation. A multidisciplinary team treated patients by surgical wound debridement and medical therapy with broad-spectrum antibiotics and amphotericin B. Across all disease stages, cumulative 30-day disease-specific survival is 94% (p < 0.001, intergroup comparison, Breslow (generalized Wilcoxon) CI 95%) and overall 30-day survival is 87.9% (p < 0.001, intergroup comparison, Breslow (generalized Wilcoxon) CI 95%) (censored). Early identification, triaging, and proper multidisciplinary team management with systemic antifungals, surgical debridement, and control of comorbidities lead to desirable outcomes in COVID-associated mucormycosis. The patients with intracranial involvement have a higher chance of mortality compared to the other group. Supplementary Information: The online version contains supplementary material available at 10.1007/s12262-021-03134-0.

Adverse cutaneous reactions post Covid-19 vaccination- Case series from a tertiary care centre in Eastern India

Background Since the advent of the novel coronavirus, vaccines have been the most important tool of combat against the raging pandemic. However, several reports of adverse effects following vaccinations including dermatological reactions have emerged. Methods A descriptive observational study was carried out from June to August 2021 with all patients who presented with a new onset cutaneous reaction within 14 days of vaccination excluding patients with other possible causes of cutaneous reaction, particularly exposure to any drugs. Results A series of 13 cutaneous reactions post vaccination with the two major vaccines available in India, Covishiled and Covaxin have been reported in this series. Most of the reactions were mild and included urticaria, pityriasis rosea, morbilliform rash, whereas some uncommon reactions such as lichen planus and vitiligo were found. Severe reactions were rare, only one case of erythema multiforme major was seen. Conclusion The pathophysiology of post vaccination cutaneous reaction is still elusive and warrants further research. It is important for the dermatologist to be aware of such adverse events in order to address the common misconceptions and apprehension of people regarding vaccination. Copyright © 2023 Pakistan Association of Dermatologists. All rights reserved.

Impact of the COVID-19 Pandemic on Molecular Surveillance in the KOAR Registry

Background: The SARS-CoV2 pandemic increased the complexity of delivering clinical care and laboratory services for immunosuppressed kidney transplant (KTx) recipients. We evaluated how the pandemic impacted adherence with laboratory draws among patients in the Kidney allograft Outcomes AlloSure Registry (KOAR,NCT03326076). Method(s): 1663 KTx recipients undergoing post-transplant surveillance using donorderived cell-free DNA (dd-cfDNA) were enrolled in KOAR between 2017 and 2021. Participating centers were free to individualize their surveillance strategies. We estimated adherence by using the pre-pandemic distribution of surveillance dd-cfDNA draws across participating sites to establish a baseline regimen, and then compared adherence before the pandemic (P1;through 1/2020) with two subsequent periods in 2020: P2 (2/2020 - 6/2020), coinciding with the first wave of infections, and P3(7/2020 - 12/2020), which captures the bulk of the second and third waves in the US. Result(s): The distribution of surveillance dd-cfDNA draws at participating sites before COVID (P1) identified 7 peaks corresponding to draw points at months 1, 2, 3, 4, 6, 9, and 12 [Figure 1a]. Estimated adherence during P1 based on this regimen was 60.5%. Over the subsequent 5 months (P2), reflecting the early months of the pandemic, adherence declined to 50.5% (p < 0.01). After the expanded availability of mobile phlebotomy services in 7/2020 and despite rising SARS-CoV2 case counts and hospitalizations, adherence during P3 improved to 57.6% (p < 0.01 compared to P2, p = 0.1 compared to P1) [Figure 1b]. Conclusion(s): Our findings demonstrate that adherence to laboratory surveillance among transplant recipients enrolled in the KOAR registry declined in theearly period of the SARS-CoV2 pandemic, however, a variety of adaptations in the latter half of 2020, including the widespread availability of remote phlebotomy for these patients, appears to have led to substantial improvements, with adherence approaching pre-pandemic levels. (Figure Presented).

Impact of the Covid-19 Pandemic on Longitudinal Molecular Surveillance in the KOAR Registry

Purpose: The SARS-CoV2 pandemic increased the complexity of delivering routine clinical care and laboratory services for immunosuppressed kidney transplant (KTx) recipients. We evaluated how the pandemic impacted adherence with scheduled laboratory draws among patients enrolled in the Kidney allograft Outcomes AlloSure Registry (KOAR, NCT03326076). Method(s): 1663 kidney transplant (KTx) recipients undergoing post-transplant surveillance using donor-derived cell-free DNA (dd-cfDNA, AlloSure, CareDx Inc.) were enrolled in KOAR between 2017 and 2021. Participating centers were free to individualize their surveillance strategies. We estimated adherence by using the pre-pandemic distribution of surveillance dd-cfDNA draws across participating sites to establish a baseline regimen, and then compared adherence before the pandemic (P1;through 1/2020) with two subsequent periods in 2020: P2 (2/2020 - 6/2020), coinciding with the first wave of infections, and P3 (7/2020 - 12/2020), which captures the bulk of the second and third waves in the US. Result(s): The distribution of surveillance dd-cfDNA draws at participating sites before COVID (P1) identified 7 peaks corresponding to draw points at or around months 1, 2, 3, 4, 6, 9, and 12 [Figure 1a]. Estimated adherence during P1 based on this regimen was 60.5%. Over the subsequent 5 months (P2), reflecting the early months of the pandemic, adherence declined to 50.5% (p < 0.01). After the expanded availability of mobile phlebotomy services in 7/2020 and despite rising SARS-CoV2 case counts and hospitalizations, adherence during P3 improved to 57.6% (p < 0.01 compared to P2, p = 0.1 compared to P1) [Figure 1b]. Conclusion(s): Our findings demonstrate that adherence to laboratory surveillance among transplant recipients enrolled in the KOAR registry declined in the early period of the SARS-CoV2 pandemic, however, a variety of adaptations in the latter half of 2020, including the widespread availability of remote phlebotomy for these patients, appears to have led to substantial improvements, with adherence approaching pre-pandemic levels.

CML-466 Asciminib Provides Durable Molecular Responses in Patients With Chronic Myeloid Leukemia in Chronic Phase (CML-CP) With the T315I Mutation: Updated Efficacy and Safety Data From a Phase I Trial

CONTEXT: In CML-CP, the BCR::ABL1 T315I mutation confers resistance to previously approved ATP-competitive tyrosine kinase inhibitors (TKIs), except ponatinib and olverembatinib. In a previous analysis of the phase I, dose-escalation trial X2101, asciminib-a BCR::ABL1 inhibitor that binds to the ABL myristoyl pocket-demonstrated efficacy and a favorable safety profile in heavily pretreated patients with T315I-mutated CML. We report updated efficacy and safety data in patients with CML-CP with the T315I mutation (data cutoff: January 6, 2021). OBJECTIVE: Provide updated safety and efficacy data for patients with T315I-mutated CML-CP after added exposure. DESIGN: Patients with T315I-mutated CML-CP and treated with >=1 prior TKI were enrolled and received asciminib 200mg twice daily (BID). RESULTS: 48 patients were included;25 patients (52.1%) received >=3 prior TKIs. At data cutoff, treatment was ongoing in 27 patients (56.3%). 45 of 48 patients were evaluable (BCR::ABL1IS >0.1% at baseline) for major molecular response (MMR);3 were excluded for BCR::ABL1 atypical transcripts. Among evaluable patients, 19 (42.2%) achieved MMR by week 24 and 22 (48.9%) by week 96. Evaluable patients included 26 ponatinib-pretreated and 19 ponatinib-naive patients;34.6% and 68.4%, respectively, achieved MMR by week 96. The probability of maintaining MMR for >=96 weeks was 84% (95% CI, 68.1%-100.0%). 23 of 37 patients (62.2%) with BCR::ABL1IS >1% at baseline achieved BCR::ABL1IS <=1% by week 96. The safety/tolerability profile of asciminib remained favorable after =9 months of added exposure (median duration of exposure, 2.08 years;range, 0.04-4.13 years). The most common (>=10%) grade >=3 adverse events (AEs) were lipase increase (18.8%, all asymptomatic elevations) and thrombocytopenia (14.6%). Arterial occlusive events occurred in 4 patients (8.3%);none led to dose adjustment/interruption/discontinuation. AEs leading to discontinuation occurred in 5 patients (10.4%). Only 2 study deaths, both due to COVID-19, occurred in this patient population. CONCLUSIONS: After a median exposure of >2 years, asciminib monotherapy 200mg BID exhibited a sustained, favorable safety profile and clinical efficacy in patients with T315I-mutated CML-CP-a population with high unmet medical need. This updated analysis confirms asciminib as a treatment option for patients with T315I-mutated CML-CP, including those previously treated with ponatinib.

ASCIMINIB PROVIDES DURABLE MOLECULAR RESPONSES IN PATIENTS (PTS) WITH CHRONIC MYELOID LEUKEMIA IN CHRONIC PHASE (CML-CP) WITH THE T315I MUTATION: UPDATED EFFICACY AND SAFETY DATA FROM A PHASE I TRIAL

Background: In pts with CML, the BCR::ABL1 T315I mutation is associated with poor clinical outcomes and confers resistance to previously approved ATP-competitive tyrosine kinase inhibitors (TKIs). Until recently, ponatinib (PON) was the only TKI available for these pts, but its use may be limited by associated cardiovascular events. In the primary analysis of the phase I trial X2101, asciminib-the 1st BCR::ABL1 inhibitor to Specifically Target the ABL Myristoyl Pocket (STAMP)-demonstrated efficacy and a favorable safety profile in heavily pretreated pts with CML with T315I. These results supported the FDA approval of asciminib as a new treatment option for pts with CML-CP with T315I (NCCN 2021). We report updated efficacy and safety data in these pts (data cutoff: January 6, 2021). Aims: Provide updated safety and efficacy data for pts with CML-CP with T315I treated with asciminib monotherapy 200 mg twice daily (BID) after added exposure. Methods: Pts with CML-CP with T315I were enrolled if treated with ≥1 prior TKI and no other effective therapy was available, provided informed consent, and received asciminib 200 mg BID. Results: 48 pts with T315I were included;2 (4.2%) pts had additional BCR::ABL1 mutations at baseline. Eight (16.7%), 15 (31.3%) and 25 (52.1%) pts received 1,2, and ≥3 prior TKIs, respectively. At data cutoff, treatment was ongoing in more than half (27 [56.3%]) of pts;the predominant reason for treatment discontinuation was physician's decision (11 [22.9%]), mainly due to lack of efficacy. Of the 48 pts, 45 were evaluable (BCR::ABL1IS >0.1% at baseline) for major molecular response (MMR);3 were excluded for BCR::ABL1 atypical transcripts. Among evaluable pts, 19 (42.2%) achieved MMR by wk 24 and 22 (48.9%) by wk 96;19 were still in MMR at the cutoff date. Evaluable pts included 26 PON-pretreated and 19 PONnaive pts;34.6% and 68.4%, respectively, achieved MMR by the cutoff date (Table). The probability of pts maintaining MMR for ≥96 wks was 84% (95% CI, 68.1-100.0). Thirteen (28.9%) and 11 (24.4%) pts achieved MR4 and MR4.5, respectively. Twenty (54.1%) and 23 (62.2%) of 37 pts with BCR::ABL1IS >1% at baseline achieved BCR::ABL1IS ≤1% by wk 48 and 96, respectively. The median duration of exposure was 2.08 (range, 0.04-4.13) yrs with more than half (27 [56.3%]) of pts receiving treatment for ≥96 wks;the median daily dose intensity was 398.3 (range, 179-400) mg/day. The safety/tolerability profile of asciminib remained favorable after ≈9 months of added follow-up (Table). The most common (≥5%) grade ≥3 adverse events (AEs) were lipase increase (18.8%, all asymptomatic elevations), thrombocytopenia (14.6%), and vomiting, ALT increase, abdominal pain, hypertension, anemia, neutropenia, and neutrophil count decrease (6.3% each). Arterial occlusive events occurred in 4 (8.3%) pts;none led to dose adjustment/interruption/discontinuation. AEs leading to discontinuation were reported in 2 new pts since the previous data cutoff;both pts discontinued and died due to COVID-19. These were the only study deaths reported in this pt population. Image: Summary/Conclusion: Asciminib monotherapy 200 mg BID exhibited a sustained, favorable safety profile after added exposure with no new safety signals in pts with CML-CP with T315I-a population with high unmet medical need. The clinical efficacy of asciminib is demonstrated by the high proportion of pts achieving durable MMR and BCR::ABL1IS ≤ 1%. The updated analysis confirms asciminib as a treatment option for pts with CML-CP with T315I, including those for whom treatment with PON has failed.

A Comprehensive Review on In Silico-predicted Potential Phytochemicals against SARS-CoV-2: Food for Thought for Researchers

The novel coronavirus disease (COVID-19) emerged in December 2019. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is still existent all over the world. Researchers worldwide are continuously conducting in silico studies or virtual screening on various phytochemicals and reporting potential candidates that can be developed against COVID-19 after in vitro and in vivo validation. Antiviral effects of several phytochemicals have been demonstrated against different kinds of coronavirus, including SARS-CoV. Using drug repurposing techniques, a number of phytochemicals have shown substantial antiviral efficacy against COVID 19. This article reviews the efficacy of lead phytochemicals in computational studies on different important targets of SARS-CoV-2 like main protease, ACE-2, papain-like protease, spike protein, nsp-1, nsp-15, RdRp, MTase, helicase, cathepsin, TMPRSS-2. This review discusses potential application of these phytochemicals, which can guide medicinal chemists to choose phytochemicals to proceed with further in vitro and in vivo testing for SARS-CoV-2, which may eventually lead to an effective therapeutic agent and thus can be used to control the current ongoing pandemic. © 2022 Bentham Science Publishers.

Menstrual Cycle Changes after COVID-19 Infection: Does Coronavirus-induced Stress Lead to Hormonal Change?

Background: Pieces of clinical evidence suggest that coronavirus disease-2019 (COVID-19) viral infection results in hormonal imbalance leading to changes in menstrual cycles of women. This study has been conducted with the aim to determine the effect of COVID-19 infection and its vaccine on menstrual cycle patterns. Materials and methods: This was a cross-sectional study to observe any changes in menstrual cycle after COVID-19 infection or after its vaccination. A Web Link collector generated the survey‘s universal resource locator (URL) and was sent via social media messages to females in the general population as well as healthcare workers. Results: Menstrual cycles remained unaltered in 154/228 (67.5%) of women post-COVID-19 infection irrespective of its severity. Out of 228, one-third of women, i.e., 74/228 (33%), reported changes in their menstrual patterns, with respect to either cycle length, duration of flow, number of pads used, pain during menses, or premenstrual symptoms (PMSs). Menstrual blood loss was decreased by 14% (32/228) and 18%;42 women complained of increased flow during menses. Twenty percent of women who had severe infections had menorrhagia. Out of the 590 women who completed the questionnaire, 436 (73.8%) were vaccinated against COVID-19 and 154 (26%) were unvaccinated. After vaccination, 290/436 around one-third of women (66.5%) had normal menstrual cycle, 21 women (4.8%) had decreased menstrual blood flow, and 18 women (4.1%) reported increased menstrual flow. Conclusion: COVID-19 infection affected the menstrual cycle of only one-third of women and this effect was temporary. This effect might be due to stress and anxiety affecting the hypothalamic-pituitary axis (HPA). More studies are needed to support this effect.

ADHERENCE TO BIRTH DOSE OF HEPATITIS B VACCINATION IN THE HOUSTON METROPOLITAN AREA

Introduction: Perinatal infection with Hepatitis B virus (HBV) becomes chronic in 90% of cases with subsequent risk of developing serious liver disease. To prevent this, American Academy of Pediatrics has set recommendations for 3 groups of newborns weighing $ 2,000 grams: (1) maternal Hepatitis B surface antigen (HbSAg) negative: administration of HBV vaccine by 24 hours of life (HoL);(2) maternal HbSAg unknown: administration of HBV vaccine by 12 HoL (and HBV immune globulin by hospital discharge if status remains unknown);and (3) maternal HbSAg positive: administration of HBV vaccine and immune by 12 HoL. These timings maximize effectiveness of the HBV vaccine in preventing vertical transmission. Given poor compliance with current HBV vaccination demonstrated by the National Immunization Survey, this study aims to better understand factors associated with vaccine implementation at a large women's and children's center during the SARS-CoV-2 pandemic. Methods: This study was a retrospective chart review of newborns born from January 2019-September 2021 at Texas Children's Hospital in Houston, Texas (n=17,294). All newborns$2,000 grams were included and stratified by maternal HbSAg result (negative, unknown, or positive by 12 HoL) (see Figure). Univariate analysis was used to identify factors associated with timely receipt of the HBV vaccine and/or HBV immune globulin. Results: In the group with negative maternal HbsAg (n=17,185), 70.3% (n=12,077) received the HBV vaccine by 24 HoL. Those not receiving the vaccine prior to discharge (6.9%, n= 1,180) were more likely to be Caucasian, have commercial insurance, and not receive vitamin K or erythromycin. In the group with unknown maternal HbSAg (n=74), 17.6% (n=13) received the HBV vaccine by 12 HoL while 75.7% (n=56) received it between 12 HoL and discharge. In the group with positive maternal HbSAg (n=35), 91.4% (n=31) received the HBV vaccine and immune globulin by 12 HoL. Overall deviation from vaccination guidelines was highest in newborns admitted to intensive care units, and similar vaccination rates occurred in the period before and during the SARS-CoV-2 pandemic. Conclusions: Newborn HBV vaccination practices are not meeting American Academy of Pediatrics recommendations, which suggests a need to reevaluate current hospital protocol. Given that newborns with maternal HBV positive or unknown status are at highest risk of vertical transmission, initial interventions to improve timely vaccination should target these groups first, especially in intensive care settings. While 30% of newborns born to HbSAg negative mothers were not vaccinated by the recommended 24 HoL, only 7% had not received HBV vaccination prior to discharge. Dialog to increase HBV vaccine acceptance with individual families will likely be required to improve these rates. (Figure Presented)

Electricity Demand and CO Emissions during the COVID-19 Pandemic: The Case of India

The present study examines the impact of electricity demand on CO emissions in the Indian economy using daily real-time data during the Covid-19 period. The subject was hardly addressed explicitly and quantitatively in environmental studies. Our study applied recently developed non-linear (asymmetric) autoregressive distributed lag (ARDL) and the Quantile ARDL techniques for analysis. The empirical findings confirm the existence of an asymmetric long-run relationship between electricity demand and CO emissions during the Covid-19 pandemic. Furthermore, the results reveal that the decrease (increase) in electric demand leads to a reduction (increase) in CO emissions in the long run. Besides, the results show that the increase in electricity demand generates more CO emissions in the short run. Our study will be helpful for policy-makers and regulators associated with energy and climate change amid the ongoing pandemic crisis and provide directions to the expected waves of pandemic scenarios. © 2022, Econjournals. All rights reserved.

THE RELATIONS BETWEEN NEUTROPHIL-LYMPHOCYTIC RATIO AND DIFFERENT COMORBIDITIES IN CORONAVIRUS-INFECTED PATIENTS

Objective: The study's aim was to determine the neutrophil-to-lymphocyte ratio (NLR) is most helpful predictor factor for COVID-19-related serious illness. Methods: A total of 51 patients with COVID-19 infection with laboratory-confirmed reports were enrolled in this study: Age, neutrophil-to-lymphocyte (LYMLYM) ratio (NLR), an examination, and comparison. Data analysis, compilation, and report writing were completed based on the acquired data. Using SPSS.ver-23, standard statistical procedures were used to analyze the mean and standard deviation, as well as the Pearson correlation. If p<0.05, it is deemed significant. Results: The mean hemoglobin level was 12.44±3.55%, the mean platelet count was 1.95±0.65 cumm, the mean white blood cell count was 17400 ±6455.22 cumm, and the mean NLR was 5.72±1.24. When we looked at people who had hypertension, diabetes mellitus, and high cholesterol, we found that the NLR value was significantly higher in people with these diseases (p=0.05). Conclusion: We found that NLR is an excellent way to predict COVID-19-infected patients who are likely to get a lot of other illnesses and have a lot of problems early on.

COVID-19 Detection System using Chest X-rays or CT Scans

Covid-19 is a compelling infection occur due to freshly discovered virus in Covid family in December 2019. It is an irresistible sickness that fundamentally influences lungs territory of human body and have comparable side effects as an ordinary flue has which makes it difficult to perceive. It has a quick spread across the globe, which has conveyed dangerous difficulties since the time it began. As nations hope to extend testing, such test arrangements should not exclusively be technically sound, yet ought to likewise be achievable and helpful for the user. [2] Recently, X rays and CT scans have indicated remarkable highlights that delineate the seriousness of Covid in lungs. Since radiographs, for example, Xrays and CT scans are practical and generally accessible at general wellbeing offices, emergency clinic trauma centers and even at rustic facilities, they could be utilized for quick recognition of conceivable COVID-19-prompted lung contaminations. Advanced AI in sending a profound learning based clinical field is staying amazing to deal with a gigantic information with precise and quick outcomes in clinical image to analyze sicknesses all the more precisely and efficiently with additional help in the distant regions. In this paper, we are using deep learning to analyze Covid-19 by CT-scans x-ray pictures. [7],[8] The chest x-beam is performed to check the spread of contamination. It separates features from pictures and it is expected that there is no clamor in picture and every pixel contributes in feature building of a picture. This strategy gives favored results over various methodologies. © 2021 IEEE.

Mask Detection using Computer Vision

Covid-19, a pandemic caused by a noble coronavirus, has afflicted the world for the past two years Every aspect of development has been impacted by Covid-19 There were several problems with the healthcare system In the meanwhile, numerous methods have been made to lessen the spirit of this condition, one of which is the use of a mask on the face In this research, we offer a strategy for reducing covid-19 development by identifying persons who are not using masks or are not wearing them appropriately Closed-circuit television (CCTV) cameras are used in smart cities and public places When a person without a mask is identified, the city network informs the authorities The deep learning design is based on a data set that compares photos of individuals wearing and without wearing masks from a variety of sources For prior test information, the prepared design aided 97. 3 percent of existence on dysentery individuals with and without a facial mask It is anticipated that our research would prove to be a beneficial tool in protecting our people from diseases like these © 2021 IEEE.

Working scenario of doctors during early days of coronavirus disease 2019 in india: Lessons for future

Background: During the present pandemic of coronavirus disease 2019 (COVID-19), in spite of providing selfless continuous hours of duties and staying distant from family members and loved ones, contrary, there have been incidences across the nation where health professionals have been assaulted. Apart from that, there have been news that acute shortage of protective gears for doctors and health professionals is putting them at greater risk of COVID-19 exposure. Aims and Objectives: The present study was designed to analyze the working scenario of Indian doctors during the early phase of present emergency situation of pandemic COVID-19 and to make recommendations to stakeholders for future. Materials and Methods: A web-based questionnaire, peer tested by faculty of KGMU, along with informed consent form incorporated into Google Forms was posted on a WhatsApp group which included 400 Indian medical practitioners, selected randomly. Results: The majority of responses (65%) were obtained from physicians in the age group of 20–40 years. About 66% of doctors had stopped running outpatient departments. Whereas 41% did not receive any training for the management of COVID-19, 61% felt that their training was insufficient. About 46% were not trained in protective equipment and infection control for COVID-19. More than 55% of doctors admitted that neither there was any health insurance plan nor any security against the incidences of doctors getting assaulted by patients of COVID-19 and their attendants provided by their institute or state government. Only 21% of doctors reported personal protective equipment in adequate number for all the health care workers at their workplace and triage teams availability by only 51% of doctors. About 50% of doctors were not dealing with patients at all and 30% those attending the patients were undergoing mental distress. About 77% complained that there were no emergency plans for their family and 84% had the grudge that there were no incentives for dealing with patients during the present times of COVID-19 pandemic by their institute. Conclusions: The present study reveals that our preparedness to tackle it in the initial phase was not up to the mark.

Questionnaire based study to explore the barriers of willingness and ability to work among indian doctors during initial phase of COVID-19 pandemic

Introduction: Numerous doctors have been infected while treating the patients of Coronavirus Disease (COVID-2019). Expecting doctors to treat without any regard to their safety is an extreme and unrealistic approach. Apart from professional obligations, doctors have personal obligations to their families too. Aim: To understand the barriers of willingness and ability to serve during pandemics for Indian doctors. Materials and Methods: In this cross-sectional study, Peer-tested web-based questionnaire, along with informed consent form incorporated into Google form, was posted on a WhatsApp group. Study was conducted from April 2020 to June 2020. The group included 400 Indian medical practitioners, selected randomly. It comprised of total 49 questions, including open and close ended type, in English language. Out of these, 14 questions were pertaining to the present study. The exploratory data analysis was used to analyse and interpret the data. Results: Responses were submitted by 256 doctors (64% response rate) out of which 121 were from males, 134 from females and 1 person preferred not to disclose the gender. Majority (64.8%) of the responses were obtained from doctors in age group of 20-40 years and 49% of the total responses were from faculty in government medical college. It was revealed that 9% doctors were willing to quit medical profession and 23%doctors preferred not to serve patients during pandemic of contagious disease. As many as 58.6% expressed that incidences of doctors facing public harassments abuse and social discrimination dissuaded them from serving COVID-19 patients. A 59.4% and 58.2% of doctors had responsibility of child-care and elderly-care respectively which was acting barrier to ability to serve during the pandemic. As many as 49.2% brought it to light that the infrastructure at their workplace was not up to the mark to deal with COVID-19 patients. Conclusion: This study has brought into light that fear of contracting the disease due to lack of Personal protective equipment (PPE), risking one’s family for getting infected, responsibility of child-care and elderly-care along with social ostracism as untouchables are the major deterrents for willingness to work. Distance from workplace, one’s illness and lack of proper infrastructure at workplace are barriers to ability to work during COVID-19 for Indian doctors.