ABSTRACT
Background: There has been a tremendous increase in number of cases of rhino-orbitocerebral involvement with mucor in the COVID era, as reported from India. It is well established that management of ROCM involves early clinical and radiological diagnosis, reversal of underlying risk factors, prompt antifungal therapy and surgical debridement when indicated. Materials &Methods: Multiplanar MR imaging and CT scan were performed for brain, orbit and paranasal sinuses. All the cases were assessed for involvement of the paranasal sinuses, nasal cavities, orbits and brain. Results: 25 cases with ROCM were identified over 8 months. The mean age of the cases was 56.1 years. 18 of the 25 cases had a positive RT-PCR test result at the time of diagnosis with ROCM. 20 cases had poorly controlled diabetes mellitus, 2 had a hematological malignancy, 2 had chronic kidney disease and 1 had ischemic heart disease. There was involvement of the paranasal sinuses, nasal cavities, orbits and brain inclusing necrosis in most of the cases. The number of cases identified during the interval is much higher than the numbers presenting in the prior 2 years during equivalent intervals than those reported in the literature in different settings in the pre-pandemic era. Conclusions: Rhino-orbito mucormycosis can have aggressive necrosis of the involved paranasal sinuses and orbits with or without cerebral extension. Hence, the correct diagnosis is imperative as prompt antifungal drugs and surgical debridement can significantly reduce mortality and morbidity.
ABSTRACT
Introduction: The emergence of newer mutated variants of COVID-19 virus has posed a significant challenge. The present study is aimed at investigating the clinical characteristics of COVID-19 and the parameters that may serve as predictors of severity and mortality related to COVID-19 in an Indian setting. Method(s): The observation study was carried-out by using the data of COVID-19 patients admitted between July 2020 to June 2021 at JLN Medical College, Ajmer, Rajasthan, India. The demographic and clinical data of clinically significant parameters were collected. The statistical difference between recovery and death and between patients who required long-term oxygen and those who did not was evaluated for various demographic and clinical variables. Chi-square and Fisher exact test were performed for categorical variables and t-test for continuous variables. Regression analyses were also carried-out for different variables with respect to survival and death, and for oxygen dependency. Result(s): Variables namely age, duration of hospital stay, overweight, breathlessness, O2 mask therapy, BiPAP support, and ventilator usage were found to be significantly different between recovered and expired subjects (P 0.00). The study has noted hypertension (25.06%) and diabetes (23.73%) as the common comorbidities noted in COVID patients, followed by coronary artery disease (2.98%) and asthma. The study has validated the role of oxygen saturation and requirement of oxygen in predicting mortality among COVID-19 patients. The study identified age as a significant predictor of mortality, obesity as a risk factor in COVID-19 patients, gender as a factor influencing the requirement of oxygen, and fever as an independent factor related to oxygen therapy. Bilevel positive airway pressure was given to majority of expired patients (83%) compared to 10% in recovered patients. Conclusion(s): Variables namely age, BMI, duration of hospital stay, breathlessness, O2 mask therapy, BiPAP support, and ventilator usage could be predictive in COVID-19 severity and mortality. The variables to be considered for predicting oxygen dependency are age, urban/rural, gender, duration of hospital stay, weight, height, BMI, fever, cough, breathlessness, diabetes, hypertension, and CAD. Copyright © 2022, Indian Academy of Clinical Medicine. All rights reserved.
ABSTRACT
Objective: Mental health problems among children and adolescents are increasingly observed during the outbreak of COVID-19, leading to significant healthcare concerns. Survey studies provide unique opportunities for research during this pandemic, while there are no existing systematic reviews in this setting. The objective was to summarize existing survey studies addressing the effects of the current COVID-19 pandemic on the mental health of children and adolescents. Methods: For this systematic review, we performed an electronic search in multiple databases from December 2019 to December 2020. The quality appraisal of the included studies was performed with the Critical Appraisal Skills Programme Qualitative Checklist. Because of the high methodological heterogeneity between studies, a narrative synthesis of the qualitative data was used. Results: In total, 35 survey studies with 65,508 participants, ranging from 4 to 19 years of age, are included in this review. Anxiety (28%), depression (23%), loneliness (5%), stress (5%), fear (5%), tension (3%), anger (3%), fatigue (3%), confusion (3%), and worry (3%) were the most common mental health issues reported. Children and adolescents with psychiatric and/or developmental disorders, such as severe obesity, chronic lung disease, attention deficit hyperactivity disorder, cystic fibrosis, and obsessive-compulsive disorders, were especially vulnerable to the mental health effects of the COVID-19 pandemic. Age, gender, psychological quality, and negative coping strategies were identified as risk factors for the development of mental health problems. Social and family support, along with a positive coping style, was associated with better outcomes. Conclusion: The impact of the COVID-19 pandemic on mental health of children and adolescents is multifaceted and substantial. Survey studies regarding child and adolescent mental health amid COVID-19 indicated that anxiety, depression, loneliness, stress, and tension are the most observed symptoms. Positive coping strategies with family and social support may be important to achieving better outcomes. Due to limited available evidence, more well-designed studies in this area are urgently needed.
ABSTRACT
Covid-19 and its terrible effect has shaken the globe at its core. Therefore, majority of the governments across the globe have shut down the all educational institutions for an unanticipated period to control the spread of COVID-19 pandemic. As a result, to this, the pandemic has triggered the experts to have a relook at the traditional method of education and learning. Therefore, integration of online education is likely to take place in conventional education system. India, to an extent, has been able to include modern information communication technology (ICT) into the education sector. Therefore, the elements affecting learners' Usage Intention towards e-learning becomes vital to be studied. This study empirically examines the impact of factors affecting e-learning on undergraduate students' Usage Intention on digital platform, using Technology Acceptance Model (TAM). The data was collected of 300 undergraduate and post graduate students at private universities in Rajasthan state. which was further analysed using Structured Equation Modelling (SEM). The findings of the study reveal that Subjective Norms (SN), Experience (EXP), Computer Anxiety (CA), and Enjoyment (ENJ) have positive significant effect on students' e-learning ease of use. Further, Enjoyment and Computer Anxiety showed a positive significant influence on users' perceived usefulness. Additionally, a positive significant association was found between Perceived Ease of Use (PEOU) and Perceived Usefulness (PU) and both had a strong and positive influence on students' e learning Usage Intention (UI). The outcomes of the study play a significant role in policy decision making for designing a new e-learning environment in university education systems © 2020 IEEE.