Interactive Governmental Communication Promoting Participatory Citizen Engagement in Health Crisis Events - Evidence from India

During crises events, governments attempt to diminish the situational uncertainty and distrust among citizens and control their emotional response. Drawing on the merits of interactive communication in the crisis times and potential of social media platforms, we empirically investigated how Government of India (GoI) used Twitter to enable participatory citizen engagement during the nationwide lockdown (March 24 - May 31, 2020) to deal with COVID-19. In this study we used social media analytics to examine, how interactive governmental communication relates to some theoretically relevant factors such as participatory citizens' engagement, media richness, situational uncertainty, level of distrust and citizens' emotions fostered by pandemic crisis. The analysis based on data extracted from official Twitter handles of GoI for the lockdown period showed that the participatory citizen engagement in interactive governmental communication effectively promotes citizens' positive emotions and reduces levels of situational uncertainty and distrust. But media richness should not be overemphasized, as it may attract undesirable outcomes.

COVID-19 pandemic from an ophthalmology point of view.

Coronavirus disease 2019 (COVID-19) is caused by a highly contagious RNA virus termed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Ophthalmologists are at high-risk due to their proximity and short working distance at the time of slit-lamp examination. Eye care professionals can be caught unaware because conjunctivitis may be one of the first signs of COVID-19 at presentation, even precluding the emergence of additional symptoms such as dry cough and anosmia. Breath and eye shields as well as N95 masks, should be worn while examining patients with fever, breathlessness, or any history of international travel or travel from any hotspot besides maintaining hand hygiene. All elective surgeries need to be deferred. Adults or children with sudden-onset painful or painless visual loss, or sudden-onset squint, or sudden-onset floaters or severe lid oedema need a referral for urgent care. Patients should be told to discontinue contact lens wear if they have any symptoms of COVID-19. Cornea retrieval should be avoided in confirmed cases and suspects, and long-term preservation medium for storage of corneas should be encouraged. Retinal screening is unnecessary for coronavirus patients taking chloroquine or hydroxychloroquine as the probability of toxic damage to the retina is less due to short-duration of drug therapy. Tele-ophthalmology and artificial intelligence should be preferred for increasing doctor-patient interaction.

Perception of college-going girls towards corneal donation in North India: A latent class analysis study.

Purpose: To assess the perception of college-going girls toward corneal donation in Northern India. Methods: An online survey with a pre-structured, pre-validated questionnaire was conducted on 1721 college-going girls in Northern India. The knowledge and attitude scores were regressed, and latent class analysis was carried out. Results: The average of scores for all participants was computed individually for the knowledge questions and the attitude questions, and based on this score, total participants were divided into two groups: Better corneal donation behaviors (BCDB) and poor corneal donation behaviors. The binomial logistic regression model of knowledge domain for predicting BCDB, age of the participant, their awareness about corneal donation, and willingness to discuss eye donation among family members were found significant. Similarly, for the attitude domain, awareness about corneal donation, knowledge about hours within which ideal eye donation needs to be undertaken, and knowledge about eye donation during coronavirus disease 2019 (COVID-19) pandemic were found to be significant. Latent class analysis identified one subset of participants having poorer knowledge and attitude scores and that they were more from a rural background, were having more than first order as birth order, were belonging to SC/ST classes, had illiterate or secondary education of father and mother, and were living in rented houses. Conclusion: The findings of the study significantly contribute to devising a mechanism to improve knowledge and influencing the attitude about eye donation among the youth, especially young women, who can act as counselors and motivators for the masses as well as their own families, in the generations to come.

Users’ response toward online doctor consultation platforms: SOR approach

Purpose>This study aims to investigate the external and internal stimuli, which affect the organismic experiences of the users and thereby influence their response in terms of behavioral intention toward the use of online doctor consultation platforms.Design/methodology/approach>The study operationalized the stimulus–organism–response framework for the research model and surveyed 357 users in India who had experienced online doctor consultation platforms. The analysis has been done using the structural equation modeling approach.Findings>The authors’ main results indicate the following key points. One, perceived usefulness, social influence, health anxiety, offline consultation habit and perceived technology usage risk are significant predictors of perceived value. In contrast, perceived ubiquity is identified to be an insignificant predictor of perceived value. Second, social influence and perceived technology usage risk have significant influence on trust. However, perceived usefulness is not a significant predictor of trust.Research limitations/implications>This study contributes to the theory by integrating technology-oriented factors with behavioral attributes for determining the behavioral intention of users toward the online doctor consultation platforms.Practical implications>The managerial contributions of this study involve highlighting those technology-oriented and behavioral elements, which can be targeted to attract more users toward these platforms.Originality/value>This is an original study that has looked beyond the role of technology-oriented factors in influencing the perceived value and trust elements while investigating the behavioral intention among the users toward the online doctor consultation platforms.

Orbital magnetic resonance imaging profile and clinicoradiological correlation in COVID-19-associated rhino-orbital-cerebral mucormycosis: A single-center study of 270 patients from North India.

PURPOSE: To study the clinical profile and magnetic resonance imaging (MRI) features in patients of COVID-19-associated rhino-orbital-cerebral mucormycosis (CA-ROCM) with orbital involvement and perform a clinicoradiological correlation. METHODS: A cross-sectional study was performed at a tertiary care center in north India from May 2021 to June 2021. Consecutive patients with clinical, nasal endoscopic, and/or microbiological evidence of CA-ROCM underwent MRI of paranasal sinuses, orbit, and brain as per the study protocol. Orbital MRI findings were studied in detail and were correlated with clinical signs. RESULTS: Two hundred and seventy patients were studied. The mean age was 48.4 (± 16.82) years. A male predilection was noted (male:female = 1.77). Orbital involvement was seen in 146 (54%) patients on clinical evaluation and in 184 (68%) patients on MRI. Unilateral orbital involvement was more common (134; 92%). The most common presenting symptom was periorbital and/or facial pain (141; 52.2%) and the most common clinical sign was periorbital edema (116; 43%). The most common MRI finding was suggestive of orbital cellulitis (160; 59%). Orbital compartment syndrome was found in 17 (6.3%) patients. The inter-rater agreement between clinical and radiological assessments to detect the involvement of infraorbital nerve and frontal nerve was found to be 85.56%, (κ 0.621) and 93.70% (κ 0.776), respectively. The diagnostic accuracy, sensitivity, and specificity of MRI to detect medial orbital wall defect were found to be 87.9%, 65%, and 97%, respectively. CONCLUSION: Orbital imaging features of a cohort of ROCM patients have been presented with clinicoradiological correlation.

Association of screen time, quality of sleep and dry eye in college-going women of Northern India.

PURPOSE: To evaluate the association of daily screen time and quality of sleep with the prevalence of dry eye among college-going women. METHODS: This study was a cross-sectional, comparative questionnaire-based study of 547 college-going women in northern India. A 10-item Mini Sleep Questionnaire was used to check the quality of sleep, and the Standard Patient Evaluation of Eye Dryness (SPEED) scale was used to examine the prevalence of dry eye among college-going women. RESULTS: Multinomial logistic regression showed a significant association between dry eye with daily screen time spent (P < 0.05) and the quality of sleep (P < 0.05) among college-going girls. Using Latent Class Analysis, two latent classes were selected based on the Bayesian Information Criteria. It was found that the majority population falls in class two and was having Severe Sleep-Wake difficulty. It was seen that the participants in class two belonged to the age bracket of 18-21 years, were from stream Humanities, education of father and mother equal to graduation, father working only, belonging to the nuclear family, having one sibling, hailing from the urban locality, spending more than 6 h daily on-screen, a majority of them using mobile phones, not using eye lubricants, and reported an increase in screen time during COVID-19. CONCLUSION: Dry eye and sleep quality are essential global health issues, and coupled with increased screen time, may pose a challenge in the present era. Preventive strategies need to be incorporated in school and college curriculums to promote physical, social, and psychological well-being and quality of life.

Impact of COVID-19 pandemic on cataract surgical volume: A North Indian experience.

PURPOSE: To analyze the impact of the pandemic on trends in cataract surgical volume in 2020 in a high-volume tertiary care academic center in North India. METHODS: The monthly cataract surgical volume for a large, high-volume, tertiary care academic center in North India was obtained from January 2018 through December 2020. Based on historical trends, we used time-series forecasting, probability sensitivity analysis, and linear regression models to estimate what the expected monthly cataract volume should have been from March 2020 onward. RESULTS: In 2020, we expected to perform 7500 cases (assuming historical trends) but performed only 2500 cases (33% of the expected volume). The remaining 5000 cases (67% cases) constituted the "fixed" backlog. Assuming the ramp-up in cataract surgical volume starts in January 2021, results of the Monte Carlo simulation revealed that for our system, it would take on average 5 months (May 2021) under the optimistic scenario and 10 months (October 2021) under the ambivalent scenario to reach pre-pandemic expected surgical volume. There would be a collective backlog of 5500 cases under the optimistic scenario (8.8 months' worth of cases) and a collective backlog of 6900 cases under the ambivalent scenario (11 months' worth of cases). CONCLUSION: An intuitive approach and out-of-the-box solutions are required by the government and private institutes' collaborative efforts to help mitigate the disruptions caused by the pandemic and lessen the backlog without causing provider burnout.

Reworking protocols of ophthalmic resident surgical training in the COVID-19 era - Experiences of a tertiary care institute in northern India.

PURPOSE: Coronavirus Disease 2019 (COVID-19) pandemic has negatively impacted medical professionals in all fields of medicine and surgery in their academic, clinical and surgical training. The impact of surgical training has been described as 'severe' by most ophthalmology residents worldwide due to their duties in COVID-19 wards, disruption of outpatient and camp services. METHODS: Ophthalmic surgery demands utmost accuracy and meticulousness. Fine motor proficiencies, stereoscopic skills and hand-eye coordination required can only be achieved by practice. So, a multileveled structured wet-lab teaching schedule was prepared for the residents and implemented to bridge this gap between theory and practice at our tertiary care institute. A semester-wise training schedule was made with the proper distribution of wet-lab and simulator training. Surgeries like phacoemulsification, scleral buckling, pars plana lensectomy and vitrectomy, trabeculectomy and intravitreal injections were practised by the residents on the goat eyes. Simulator training was provided for phacoemulsification and vitrectomy to increase the hand-eye coordination of the residents. RESULTS: Residents noticed improvement in their surgical skills and ambidexterity post wet-lab and simulator training . It also increased their confidence and provided essential surgical skills required to be used in the operation theater later. CONCLUSION: It is imperative that wet-lab training be included in the residency training programme in this COVID-19 era.

Pediatric cataract surgery practices in the COVID-19 era: Perspectives of a tertiary care institute in Northern India.

PURPOSE: To discuss the impact of COVID-19 pandemic on the pediatric cataract surgery services in a tertiary care institute in India, as well as the protocol followed for these surgeries. METHODS: COVID-19 has hampered outpatient and elective services and surgeries throughout the world. During the national lockdown imposed in March in India, outpatient services were suspended in our institute, leading to a tremendous backlog of pediatric patients with cataract. Since the delay in surgery in pediatric cataract can cause amblyopia, our institute had resumed pediatric cataract surgeries in June 2020 at the time of Unlock-1 in the country. RESULTS: We have discussed the percentage of reduction in pediatric cataract surgeries in 2020 during the Unlock 1, 2, 3, and 4, as compared to the number of surgeries done by the pediatric ophthalmology unit in the same months last year. We had introduced triage and telemedicine in our department. We have discussed the preoperative, intraoperative, and postoperative protocol followed in our institute for children with pediatric cataract, and also the measures which can be taken for the safety of patients and staff. CONCLUSION: It is essential to ensure COVID-19 protocol, i.e., wearing a mask, social distancing, and frequent hand hygiene, among the patients and health care personnel. Redesigning pediatric cataract surgery practices is essential to ensure the safety of the health care workers and the patients.

System for administering and monitoring hydroxychloroquine prophylaxis for COVID-19 in accordance with a national advisory: preliminary experience of a tertiary care institute in India.

BACKGROUND: Hydroxychloroquine (HCQ) was one of the earliest drugs to be recommended for tackling the COVID-19 threat leading to its widespread usage. We provide preliminary findings of the system, established in a tertiary care academic center for the administration of HCQ prophylaxis to healthcare workers (HCW) based on Indian Council of Medical Research (ICMR) advisory. METHODS: A dedicated clinical pharmacology and internal medicine team screened for contraindications, administered informed consent, maintained compliance and monitored for adverse events. RESULTS: Among the 194 HCWs screened for ruling out contraindications for prophylaxis, 9 were excluded and 185 were initiated on HCQ. A total of 55 adverse events were seen in 38 (20.5%) HCWs out of which 70.9%, 29.1% were mild and moderate & none were severe. Before the completion of therapy, a total of 23 participants discontinued. Change in QTc interval on day 2 was 5 (IQR: -3.75, 11) ms and the end of week 1 was 15 ms (IQR: 2, 18). Out of the 5 HCW who turned positive for COVID-19, 2 were on HCQ. CONCLUSION: HCQ prophylaxis was found to be safe and well tolerated in HCW when administered after appropriate screening and with monitoring for adverse events.

COVID-19 pandemic lockdown: An emotional health perspective of Indians on Twitter.

BACKGROUND: Novel corona virus (2019-nCoV) has spread in the world since its first human infection in December 2019. India has also witnessed a rising number of infections since March 2020. The Indian government imposed lockdowns in the nation to control the movement of its citizens thereby confining the spread of the virus. Tweeters resorted to usage of social media platform to express their mind. AIM: Through this article, an attempt has been made to understand the mind-set of Indian people using Python and R statistical software, during the recent lockdown 2.0 (15 April 2020 to 3 May 2020) and lockdown 3.0 (4 May 2020 to 17 May 2020) through their tweets on the social media platform Twitter. Also, opinion on e-commerce during this pandemic has been analysed. METHOD: Analysis has been performed using Python and R statistical software. Also, recent articles related to COVID-19 have been considered and reviewed. RESULT: Although the country had a positive approach in lockdown 2.0 with only few instances of sadness, disgust and others, the majority of the people had a negative approach in lockdown 3.0. CONCLUSION: This analysis can help the health specialists to understand people's mind-set, the authorities to take further corresponding measures in washing out the virus and the e-commerce stakeholders to adapt to the changing attitudes by adjusting demand and supply plans accordingly.