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Introduction: The early approaches to prevent the spread of COVID-19 included lockdown and social distancing measures, leading to university closures. These measures forced unparalleled changes to the delivery of healthcare education. Concerns included the preparedness of faculty and students to e-learning as well as the routine availability and funding of equipment and internet bundles. This needed addressing with fully trained healthcare professionals required given rising inappropriate use of antibiotics in India, growing prevalence of non-communicable diseases as well as an increasing number of patients with joint comorbidities. Consequently, there is a need to ascertain the current impact of the pandemic on healthcare student education across India. Materials and Methods: This was a pilot study among 10 purposely selected healthcare educators in both private and public universities. The questionnaire built on published studies. Results: Identified challenges included a lack of familiarity with online education, no bedside teaching, lack of equipment and affordability of internet bundles, poor internet connectivity and postponed examinations. Ways forward included training faculty on e-learning, providing students with loans and other financial support to purchase equipment and internet bundles, establishing COVID-19 prevention protocols and protective equipment, recording lectures and tutorials to make up for lost time and simulated methods to teach clinical aspects. Conclusion: Despite challenges, there was a rapid move to online learning among surveyed universities. Alongside this, courses to address lack of familiarity with e-learning approaches with hybrid teaching approaches here to stay. The next step will be to undertake a wider study and to use the combined findings to provide future guidance.
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There has been a fundamental shift in the way firms in every industry manage, examine, and utilize their data. Health care is one of the most promising industries in which the use of big data may make a positive impact. Healthcare technology is being improved at a fast rate as an outcome of growing information and innovative innovation. In healthcare, there are different articles of big data. Digital medical data, biometric data, medical image processing, biosensor data, physician data, patient information, and administrative data are examples of these types. Many combined technologies are being deployed to modify healthcare systems in the COVID-19 pandemic. The security of medical data is required for the management of an integrated healthcare solution. In this paper, we found that many researchers face significant hurdles in encrypting sensitive patient information to prevent misuse or leakage. Our aim is to provide a focus on security issues in healthcare system and try to give a solution. © 2021 IEEE.
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This study has collected information of 145 countries to predict the effect of cases per million (CPM), tests per million (TPM), and proportion of people aged 65 and above (PAO) on the number of deaths per million DPM at the country and continent level. In addition, it evaluates the economic cost of tests, deaths, COVID-19 cases in terms of reduction in GDP growth rate across the countries. This paper uses a different econometrics model, including analysis of variance (ANOVA), regression, and multinomial regression model. The robust regression model with M and MM-estimation was also used due to leverage and residuals in country wise GDP database. A significant difference was found in deaths per million (DPM), TPM, number of COVID-19 cases (CPM), and percentage of people aged 65 and above (PAO) across continents. The DPM is negatively associated with TPM, and it was relatively more effective in reducing DPM in Africa (0.32%) as compared to Asia (0.25%) and Europe (0.28). The results show that a 1% increase in the elderly population causes a 0.62% increase in DPM in Africa, while it caused a 2.31% increase in Europe. The study will be helpful in ascertaining the impact of these indicators in this pandemic and help in policy formation and decision-making strategies to fight the COVID19 pandemic.
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Introduction: COVID 19 often presents with flu-like symptoms. Elderly patients with systemic comorbidities are more likely to have severe COVID 19 infections and deaths. Severe neurological complications are frequently reported in severely and critically ill patients. In COVID-19, both central and peripheral nervous systems can be affected. The study aims to overview the spectrum, characteristics, and outcomes of neurologic manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: A total of 1000 confirmed CoVID-19 patients were enrolled for the study. Demographic features and initial clinical manifestations were noted, and patients were followed during the hospital stay to develop any new neurological signs and symptoms. For analytical purposes, neurological presentations were grouped into the central nervous system, peripheral nervous system, and musculoskeletal system manifestations. Appropriate laboratory testing was employed as required on a case-to-case basis. Results: The mean age was 44.6 +/- 14.3 years. 625 (62.5%) patients were male, while 375 (37.5%) were female. The neurological illness was a primary manifestation in 119 (11.9%) cases. These included encephalopathy (n=78), ischemic stroke (n=28), Guillain- Barre syndrome, (n=3), facial nerve palsy (n=4), and encephalitis (n=6). The most common neurological symptoms were headache 313 (31.3%) and hyposmia 52 (5.2%), followed by encephalopathy 78 (7.8%). More serious complications like seizures 18 (1.8%) and stroke 28 (2.8%) were also seen. Conclusion: CoVID-19 can present with a neurological illness, and we should remain vigilant to the possibility of neurological presentation of COVID-19 that can be thrombo-embolic, inflammatory, or immune-mediated.
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Cardiogenic shock is a rapidly progressive condition associated with high mortality, often necessitating the use of mechanical circulatory support. Single ventricle physiology with Fontan presents many unique anatomical and hemodynamic challenges, and there is limited published experience with left ventricular assist devices (LVAD) in this population. A 30 year old female with pulmonary atresia with intact ventricular septum and lateral tunneled Fontan presented with chest pressure followed by sustained ventricular tachycardia (VT). Her echo demonstrated severely reduced left ventricular (LV) function with ejection fraction of 15-20%. Endomyocardial biopsy showed lymphocytic myocarditis, and she was treated with pulse steroids and IVIG. Given worsening shock and multiorgan failure with rapid vasopressor escalation, she was placed on femoral VA ECMO with Impella CP for venting. She eventually had LV apical cannulation and aortic graft via an upper hemisternotomy and left thoracotomy as a left ventricular assist device (KVAD). Her course was notable for persistent VT, shock liver, and renal failure requiring dialysis. After 3 weeks of mechanical support, she demonstrated recovery in end organ function and normalization of mental status, allowing for extubation and physical therapy. Given her high BMI and inability to list for a heart transplant, she underwent successful implant of a Heartmate 3 LVAD (via the original left thoracotomy using the previously placed aortic graft). Despite repeatedly negative surveillance and preoperative COVID19 tests following her initial recovery, postoperatively she developed de novo COVID19 infection complicated by respiratory failure, vasodilatory shock, renal failure, complement deposition, inflammatory storm, and concern for Fontan thrombosis. Despite aggressive treatment, she passed away from her COVID19 complications. We present a case of fulminant cardiogenic shock due to lymphocytic myocarditis in a patient with Fontan physiology that was bridged with VA ECMO and KVAD and eventually received a Heartmate 3. Unfortunately, she passed away from de novo COVID19 infection. This case highlights several unique aspects such as the management of profound cardiogenic shock in complex congenital heart disease and the use of mechanical support in single ventricle Fontan physiology. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. 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 abstract 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 abstract. (Copyright applies to all Abstracts.)
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Background: In the current SARS-CoV-2 outbreak, drug repositioning emerges as a promising approach to develop efficient therapeutics in comparison to de novo drug development. The present investigation screened 130 US FDA-approved drugs including hypertension, cardiovascular diseases, respiratory tract infections (RTI), antibiotics and antiviral drugs for their inhibitory potential against SARS-CoV-2. Materials & methods: The molecular drug targets against SARS-CoV-2 proteins were determined by the iGEMDOCK computational docking tool. The protein homology models were generated through SWISS Model workspace. The pharmacokinetics of all the ligands was determined by ADMET analysis. Results: The study identified 15 potent drugs exhibiting significant inhibitory potential against SARS-CoV-2. Conclusion: Our investigation has identified possible repurposed drug candidates to improve the current modus operandi of the treatment given to COVID-19 patients.
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Background: Different infectious disease outbreaks such as bubonic plague, Asiatic flu, cholera, Middle East respiratory syndrome, and Ebola have been associated with polarization, racism, blame, and resultant psychological distress. Health-care providers involved in managing the COVID-19 crisis face challenges such as stigma and discrimination. Aim: The current study is aimed to explore stigma and discrimination related to COVID-19 among healthcare workers. Methods: A cross-sectional study was carried out during April and May 2020. Doctors working at health-care facility were approached and requested to fill semi-structured pro forma containing the following parts: (1) Demographic details of participants, (2) Brief Illness Perception Questionnaire 5 (BIPQ-5), (3) Physical Distance and Discrimination Questionnaire, (4) Avoidance Questionnaire, (5) feeling thermometer toward a person having COVID, HIV, TB, Swine flu. Statistical Analysis: Data entry and analysis was performed using Microsoft excel and SPSS 26 version software. Independent t-test was used to compare the mean and standard deviation of the BIPQ score, physical distance, and discrimination questionnaire score with various demographic variables and avoidance questionnaire. Results: A total of 323 doctors participated in the study. Out of which 51.39% reports that it is necessary to avoid persons and 30.60% have a problem if a person eats in mess/canteen when working in COVID-19 care. Participants living with family members have statistically significant (P < 0.001) a higher score on the BIPQ, and Physical Distancing and Discrimination Questionnaire. A significant positive correlation (r = 0.162, P = 0.004) of brief illness of perception with physical distancing and discrimination score. Conclusion: The study found a high threat perception of COVID-19 as well as stigma and discrimination within health-care staff. The stigma and discrimination for COVID-19 are more than other illnesses such as swine flu, tuberculosis, and HIV. This can result in the work compliance and management strategies of health-care workers. © 2020 Archives of Mental Health ;Published by Wolters Kluwer - Medknow
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It has been widely reported that as a consequence of nation-wide lockdown in India to control COVID-19 pandemic, the air pollution levels have significantly reduced. The near-complete shutdown of economic activities and stay-at-home instructions have tremendously helped in reducing emissions. This paper has attempted to look into the pattern of change in Air Quality Index in five megacities (Delhi, Bengaluru, Chennai, Mumbai and Kolkata) of India from pre-lockdown period to first week of lockdown and fifth week of lockdown. The paper has also discussed changes in air quality parameters at different monitoring stations in Bengaluru during the same period. A discussion on air quality, grounded on contemporary studies conducted to evaluate impact of lockdown on ambient air in different cities, has provided an overview of the changes in air quality. The results provide an understanding that the overall air quality has been improved in all the studied cities;but further comprehensive assessment, considering the factors controlling the present air quality, is suggested to identify pathways for emission reduction to maintain the air quality in business as usual situation in future. © JHE 2020.