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The mean mass concentrations of black carbon (BC), biomass burning (BC)bb, and fossil fuel combustion (BC)ff have been estimated during March-May 2020 (during the COVID-19 outbreak) and March-May 2019 at a semiarid region of Agra over the Indo-Gangetic basin region. The daily mean mass concentration of BC in 2020 and 2019 was 3.9 and 6.9 µg m-3, respectively. The high monthly mean mass concentration of BC was found to be 4.7, 3.4 and 3.3 µg m-3 in Mar-2020, Apr-2020, and May-2020, respectively, whereas in Mar-2019, Apr-2019, and May-2019 was 7.7, 7.5 and 5.4 µg m-3, respectively. The absorption coefficient (babs) and absorption angstrom exponent (AAE) of black carbon were calculated. The highest mean AAE was 1.6 in the year 2020 (Mar-May 2020) indicating the dominance of biomass burning. The mean mass concentration of fossil fuel (BC)ff and biomass burning (BC)bb is 3.4 and 0.51 µg m-3, respectively, in 2020 whereas 6.4 and 0.73 µg m-3, respectively, in 2019. The mean fraction contribution of BC with fossil fuel (BC)ff was 82.1 ± 13.5% and biomass burning (BC)bb was 17.9 ± 4.3% in 2020, while in 2019, fossil fuel (BC)ff was 86.7 ± 13.5% and biomass burning (BC)bb was 13.3 ± 6.7%. The population-weighted mean concentration of BC, fossil fuel (BC)ff, and biomass burning (BC)bb has been calculated. The health risk assessment of BC has been analyzed in the form of attributable relative risk factors and attributed relative risk during the COVID-19 outbreak using AirQ + v.2.0 model. The attributable relative risk factors of BC were 20.6% in 2020 and 29.4% in 2019. The mean attributed relative risk per 10,000,000 populations at 95% confidence interval (CI) due to BC was 184.06 (142.6-225.2) in 2020 and 609.06 (418.3-714.6) in 2019. The low attributed factor and attributed relative risk in 2020 may be attributed to improvements in air quality and a fall in the emission of BC. In 2020, due to the COVID-19 pandemic, the whole country faced the biggest lockdown, ban of the transportation of private vehicles, trains, aircraft, and construction activities, and shut down of the industry leading to a fall in the impact of BC on human health. Overall, this was like a blessing in disguise. This study will help in future planning of mitigation and emission control of air pollutants in large and BC in particular. It only needs a multipronged approach. This study may be like torch bearing to set path for mitigation of impacts of air pollution and improvement of air quality.
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Introduction The second wave of the coronavirus disease 2019 (COVID-19) pandemic in India, which started from April 2021, has been more severe and deadly than the first wave. The aim of this prospective study was to determine the possibility of other respiratory pathogens contributing towards the severity and hospitalization in the current second wave. Materials and methods Nasopharyngeal and oropharyngeal swab samples were collected and processed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR). These samples were further processed for detection of co-infection in SARS CoV-2 patients by BioFire® Filmarray® 2.0 (bioMérieux, USA). Results We screened 77 COVID-19-positive patients admitted to All India Institute of Medical Sciences (AIIMS), Rishikesh and found cases of co-infections in five (6.49 %) patients. Conclusion Our finding suggests that co-infections had no or minimal role in augmenting the second wave of the COVID-19 pandemic in India, and the emergence of new variants may be the probable cause.
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BACKGROUND: Telemedicine service was historically started for ambulatory and hospice care patients. Since 2020, we have been in the midst of the COVID-19 pandemic. The availability of healthcare facilities became limited due to repeated locked down during the COVID-19 pandemic. Thus, telemedicine service has gained tremendous popularity among healthcare services. Telemedicine service was started at All India Institute of Medical Sciences (AIIMS), Deoghar, as a COVID Helpline facility to provide guidance and care to the home isolated COVID-19 patients during the second wave of COVID-19. But we observed that more than 40% of calls were due to non-COVID-19-related problems, but we managed the non-COVID-19-related calls by discussing with a specialist in conference calls or WhatsApp consultation. Therefore, we planned to compare individual satisfaction with telemedicine services in patients with COVID-19 and non-COVID-19-related problems. METHODS AND MATERIALS: This study was a cross-sectional retrospective analysis of the register of telemedicine maintained in AIIMS, Deoghar, callers were grouped into two- COVID-19 and non-COVID-19-related problems. We obtained feedback from the patients and recorded it in a google form, collected data were analyzed in both groups. Telephonic consent was taken for participating in the study. The sample size was calculated to be 252, the COVID-19 group: 126, and the non-COVID-19 group: 126, and simple random sampling was used to choose the participants from the 730 total callers of the first month of telemedicine service. Their response was graded on 4 points Likert scale (1=Poor, 2=fair, 3=Good, 4=Excellent) and outcomes were analyzed by IBM SPSS (version 20.0) software. A p-value of <0.05 was considered statistically significant. OBJECTIVE: The primary objective is to estimate the level of satisfaction in both groups and compare their level of satisfaction. The secondary objective is to determine the department-specific telemedicine services requirement for people in need. RESULTS: Out of a total of 252 patients, most (54%) callers were 18-45 years old, and 44% were above 45 years old. 64% of patients were male. 90% of callers were from urban or semi-urban districts. 90% of callers had a 10th-grade or more education. 89% of patients were willing to use telemedicine services in the future. An Independent sample t-test was used to compare the means of both the groups showed a significant difference (p < 0.05) in the level of satisfaction in the COVID-19 group to the non-COVID-19 group. It showed that satisfaction in the COVID-19 group was higher than the group with non-COVID-19-related problems. CONCLUSION: COVID-19 has changed the whole spectrum of healthcare needs of the community. Our study findings showed that there is a need for separate department-wise telemedicine services to provide satisfactory service for attending to problems related to that department. For example, problems with diabetes should be attended to by an endocrinologist or an internal medicine specialist. This study finding helped us to change the policy and start department-wise telemedicine service.
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Hypercoagulability and the need for prioritizing coagulation markers for prognostic abilities have been highlighted in COVID-19. We aimed to quantify the associations of D-dimer with disease progression in patients with COVID-19. This systematic review and meta-analysis was registered with PROSPERO, CRD42020186661.We included 113 studies in our systematic review, of which 100 records (n = 38,310) with D-dimer data) were considered for meta-analysis. Across 68 unadjusted (n = 26,960) and 39 adjusted studies (n = 15,653) reporting initial D-dimer, a significant association was found in patients with higher D-dimer for the risk of overall disease progression (unadjusted odds ratio (uOR) 3.15; adjusted odds ratio (aOR) 1.64). The time-to-event outcomes were pooled across 19 unadjusted (n = 9743) and 21 adjusted studies (n = 13,287); a strong association was found in patients with higher D-dimers for the risk of overall disease progression (unadjusted hazard ratio (uHR) 1.41; adjusted hazard ratio (aHR) 1.10). The prognostic use of higher D-dimer was found to be promising for predicting overall disease progression (studies 68, area under curve 0.75) in COVID-19. Our study showed that higher D-dimer levels provide prognostic information useful for clinicians to early assess COVID-19 patients at risk for disease progression and mortality outcomes. This study, recommends rapid assessment of D-dimer for predicting adverse outcomes in COVID-19.
Subject(s)
COVID-19/diagnosis , COVID-19/immunology , Fibrin Fibrinogen Degradation Products/chemistry , Adult , Aged , Area Under Curve , Biomarkers/blood , COVID-19/epidemiology , Disease Progression , Female , Humans , Male , Middle Aged , Odds Ratio , Prognosis , Proportional Hazards Models , Respiration, Artificial , Risk , SARS-CoV-2 , Severity of Illness Index , Thrombophilia/bloodABSTRACT
The objective of this study was to compare Reverse Hybridisation Assay with conventional sequencing for determination of Hepatitis C Virus Genotype and Subtypes. Anti-HCV antibody was determined followed by HCV RNA extraction which was used for (1) viral load determination (2) qualitative real-time PCR RHA for genotyping and (3) conventional sequencing. Compared to conventional sequencing, accuracy of RHA results was 96.55% for determination of genotype (κ = 0.93) and 89.66% for subtype (κ = 0.85). Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of the qualitative PCR were 82.29%, 100%, 44.44% and 100% respectively with an accuracy of 86.84%. RHA is a less time consuming and cheaper method for determination of HCV genotype and subtype yet results must be interpreted with caution and quality control monitoring should be strictly followed to ensure validity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13337-021-00729-9.
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PURPOSE: To assess and compare the diagnostic accuracy of the GenBody COVID-19 Antigen kit (GenBody Inc., Cheonan, South Korea) available in the market with the gold standard reverse transcription-polymerase chain reaction (RT-PCR) assay to detect severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). METHODS: Nasopharyngeal and oropharyngeal swabs were collected from suspected coronavirus disease 2019 (COVID-19) patients and tested by RT-PCR and GenBody Rapid antigen kit. Performance characteristic of the antigen kit was calculated. RESULTS: We tested nasopharyngeal swabs and oropharyngeal swabs (n=240). Amongst the 102 positive RT-PCR samples, the rapid antigen test detected 36 as positive, showing an overall sensitivity of 35.3%. All the samples detected positive with the antigen rapid test were also detected positive by RT-PCR. CONCLUSION: The performance of the rapid antigen kit was good with respect to high viral load samples, whereas those with lower levels were missed. Unfortunately, the overall low sensitivity of the antigen kit does not allow using it alone as the frontline testing kit for COVID-19 diagnosis.
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Purpose Amidst the current COVID-19 pandemic, traditional teaching methodology took a back foot. However, an urgent need for training health care worker (HCW) on preventive measures for COVID-19 infection was the need of the hour. Keeping in mind the precautionary measures required to combat COVID-19 infection, the only promising option for training was by adopting an online learning method. This study was undertaken to determine the effectiveness of video-based training using online platforms for infection prevention and control (IPC) training during the COVID-19 pandemic. Methods A quasi-experimental study, with only one experimental group comprising of HCWs, was undertaken to assess the effect of intervention which included video-assisted teaching-learning regarding IPC measures with a special focus on COVID-19 at a tertiary care Institute in North India. Online sessions were conducted on Do's and Don'ts, Hand Hygiene, donning and doffing of personal protective equipment (PPE), cleaning and disinfection, and bio-medical waste (BMW) management with the help of pre-recorded videos which was pre-validated. The session was followed by online interaction with participants by a single resource person. Pre-test and post-test were conducted through google forms before commencement and at the end of the online session respectively. The data were analyzed in terms of descriptive frequencies and percentages of different domains to describe the pre- and post-test knowledge. Results A total of 576 participants were included in the study. There was a statistically significant gain in scores of all questions related to cleaning and disinfection; and BMW. No significant change was observed in knowledge regarding the sequence of doffing (p-value: 0.94). The result of pairwise comparisons pre-test and post-test scores showed that intervention through video-assisted teaching-learning resulted in improvement of knowledge which was found to be statistically significant (p-value < 0.001). Conclusion Video-assisted teaching-learning through virtual platforms effectively trained health personnel on infection prevention and control practices during the COVID-19 pandemic. Video-assisted training can successfully be handled by a single resource person to impart the knowledge and skill to the trainee. Virtual teaching and learning is a feasible and efficient method to deliver training to HCWs on infection control practices and this methodology may be adopted in the future for several other training in manpower crunch situations, similar restrictive circumstances as posed by the COVID-19 pandemic.