Homoeopathy as an Adjuvant to Standard Care in Moderate and Severe Cases of COVID-19: A Single-Blind, Randomized, Placebo-Controlled Study.

OBJECTIVES: This study aimed to evaluate whether individualized homeopathic medicines have a greater adjunctive effect than adjunctive placebos in the treatment of moderate and severe cases of coronavirus disease 2019 (COVID-19). METHODS: The study was a randomized, single-blind, prospective, placebo-controlled clinical trial set in the clinical context of standard care. INTERVENTION: Patients of either sex, admitted in a tertiary care hospital, suffering from moderate or severe COVID-19 and above 18 years of age were included. In total, 150 patients were recruited and then randomly divided into two groups to receive either individualized homeopathic medicines or placebos, in addition to the standard treatment of COVID-19. OUTCOME MEASURES: The primary outcome was time taken to achieve RT-PCR-confirmed virus clearance for COVID-19. Secondary outcomes were changes in the Clinical Ordinal Outcomes Scale (COOS) of the World Health Organization, the patient-reported MYMOP2 scale, and several biochemical parameters. Parametric data were analyzed using unpaired t-test. Non-parametric data were analyzed using the Wilcoxon signed rank test. Categorical data were analyzed using Chi-square test. RESULTS: In total, 72 participants of the add-on homeopathy (AoH) group showed conversion of RT-PCR status to negative, in an average time of 7.53 ± 4.76 days (mean ± SD), as compared with 11.65 ± 9.54 days in the add-on placebo (AoP) group (p = 0.001). The mean COOS score decreased from 4.26 ± 0.44 to 3.64 ± 1.50 and from 4.3 ± 0.46 to 4.07 ± 1.8 in the AoH and AoP groups respectively (p = 0.130). The mortality rate for the AoH group was 9.7% compared with 17.3% in the AoP group. The MYMOP2 scores between the two groups differed significantly (p = 0.001), in favor of AoH. Inter-group differences in the pre- and post- mean values of C-reactive protein, fibrinogen, total leukocyte count, platelet count and alkaline phosphatase were each found to be statistically significant (p <0.05), favoring AoH; six other biochemical parameters showed no statistically significant differences. CONCLUSION: The study suggests homeopathy may be an effective adjunct to standard care for treating moderate and severe COVID-19 patients. More rigorous, including double-blinded, studies should be performed to confirm or refute these initial findings.

Indian medical student perspectives on online mode of education.

Purpose: The coronavirus pandemic has led to drastic changes in the education system globally. The medical education curriculum has also undergone a significant drift from traditional or physical classes to online classes. The study aims to explore the viewpoints of the Indian medical students toward online classes, their ramifications, and suggestions for improvement. Methods: The self-administered online questionnaire using the Google form was developed, validated, and circulated among students of All India Institute of Medical Sciences (AIIMS), New Delhi. The data of the survey were systematically analyzed by descriptive statistics. Results: A total of 223 students filled the Google form. After applying the inclusion and exclusion criteria, 171 students were finalized, and the analysis was done. The data suggested that 49.7% of the participants were facing technical glitches, poor Internet connectivity being the commonest. Eye straining (56.7%) was the major physical health hazard, whereas lack of concentration (53.8%) was the major psychological issue reported by the students. The major advantage of online classes reported was its accessibility (93%) at any time and place, whereas students also reported that the traditional learning method is more interactive and motivating (72.5%). Overall, 72.5% of the students wanted to continue both modes of education after the coronavirus disease (COVID-19) pandemic. Conclusion: As per the analysis of the results, it is concluded that, since both online and offline modes of education have advantages and disadvantages, henceforth, mixed or blended method of learning is the best form of learning medical science.

Environmental Factors Affecting Covid-19 Dynamics: A Study in Bengaluru City of Karnataka State of India.

The horrifying and fast spreading COVID-19 pandemic has shocked India and in fact the entire world to its core. Indian Government has taken all the possible preventive steps to contain the wider spread of this highly contagious disease but the second wave in the month of April, 2021 has turned this strong country in a helpless position. In this paper, the effect of environmental factors like temperature and air quality index on the new confirmed cases along with recovered cases has been seen in Bengaluru Urban district of Karnataka State of India. Regression analysis has been carried out with the help of SPSS software. The outcomes from the paper will definitely give some valuable insights for the researchers around the world in their future combat measures.

Environmental Factors Affecting Covid-19 Dynamics: A Study in Bengaluru City of Karnataka State of India

The horrifying and fast spreading COVID-19 pandemic has shocked India and in fact the entire world to its core. Indian Government has taken all the possible preventive steps to contain the wider spread of this highly contagious disease but the second wave in the month of April, 2021 has turned this strong country in a helpless position. In this paper, the effect of environmental factors like temperature and air quality index on the new confirmed cases along with recovered cases has been seen in Bengaluru Urban district of Karnataka State of India. Regression analysis has been carried out with the help of SPSS software. The outcomes from the paper will definitely give some valuable insights for the researchers around the world in their future combat measures.

Perfusion Lung Scans During the Pandemic: COVID-19 Experience in a Large Trauma Hospital

PURPOSE To evaluate the results of perfusion only lung scans and the frequency of necessary addition of the ventilation part of the scans to diagnose acute pulmonary embolism (PE) during Corona Virus Disease of 2019 (COVID 19) pandemic. MATERIAL AND METHODS We retrospectively reviewed perfusion lung scans’ results between April to December, 2020. The images were interpreted by two experienced nuclear medicine physicians as daily routine studies. Ventilation images were performed only if deemed necessary for accurate diagnosis of acute PE. RESULTS A total of 128 lung perfusion scans in 127 patients were included. The scans were interpreted with certainty using the modified PIOPID criteria in 122 patients (95.3%). The results included low probability for acute PE in 110 patients (85.9%), normal in 6 patients (4.7%) and high probability of acute PE in 6 patients (4.7%). Ventilation imaging were performed in 4 patients with high probability, after negative testing for COVID19. The other 2 high probability results were confirmed clinically and with radiologic imaging. Only 6 scans (4.7%) were interpreted as intermediate perfusion scans, two of which due to inability to differentiate old from new perfusion defects in patients with chronic thromboembolic disease. Thus, the true indeterminate results due to the lack of ventilation scan were encountered in only 4 intermediate probability lung scans (3.1%). Thus, the total number of requested ventilation scans was 8 scans (6.2%) when considering both the high and intermediate probability interpretations. Six scans were performed (2 in the intermediate and 4 in the high probability scans). The two ventilation scans performed in the intermediate probability changed the diagnosis to low probability and the four performed in the high probability confirmed the initial interpretation of high probability scans by perfusion only. CONCLUSION The ventilation part of lung scans is required only in a small number of patients for certain interpretation of the result. Perfusion lung scans are sufficient for evaluation of acute PE with certainty in most patients.

Harvest for Health, a Randomized Controlled Trial Testing a Home-Based, Vegetable Gardening Intervention Among Older Cancer Survivors Across Alabama: An Analysis of Accrual and Modifications Made in Intervention Delivery and Assessment During COVID-19.

BACKGROUND: Accelerated functional decline is a concern among older cancer survivors that threatens independence and quality of life. Pilot studies suggest that vegetable gardening interventions ameliorate functional decline through improved diet and physical activity. OBJECTIVE: The aim of this article was to describe the rationale, recruitment challenges, and enrollment for the Harvest for Health randomized controlled trial (RCT), which will test the impact of a home-based, vegetable gardening intervention on vegetable and fruit consumption, physical activity, and physical functioning among older cancer survivors. Modifications made to the intervention and assessments to assure safety and continuity of the RCT throughout the COVID-19 pandemic also are reported. DESIGN: Harvest for Health is a 2-year, 2-arm, single-blinded, wait-list controlled RCT with cross-over. PARTICIPANTS/SETTING: Medicare-eligible survivors of cancers with ≥60% 5-year survival were recruited across Alabama from October 1, 2016 to February 8, 2021. INTERVENTION: Participants were randomly assigned to a wait-list control or a 1-year home-based gardening intervention and individually mentored by extension-certified master gardeners to cultivate spring, summer, and fall vegetable gardens. MAIN OUTCOME MEASURES: Although the RCT's primary end point was a composite measure of vegetable and fruit consumption, physical activity, and physical functioning, this article focuses on recruitment and modifications made to the intervention and assessments during COVID-19. STATISTICAL ANALYSES PERFORMED: χ2 and t tests (α < .05) were used to compare enrolled vs unenrolled populations. RESULTS: Older cancer survivors (n = 9,708) were contacted via mail and telephone; 1,460 indicated interest (15% response rate), 473 were screened eligible and consented, and 381 completed baseline assessments and were randomized. Enrollees did not differ from nonrespondents/refusals by race and ethnicity, or rural-urban status, but comprised significantly higher numbers of comparatively younger survivors, those who were female, and survivors of breast cancer (P < .001). Although COVID-19 delayed trial completion, protocol modifications overcame this barrier and study completion is anticipated by June 2022. CONCLUSIONS: This RCT will provide evidence on the effects of a mentored vegetable gardening program among older cancer survivors. If efficacious, Harvest for Health represents a novel, multifaceted approach to improve lifestyle behaviors and health outcomes among cancer survivors-one with capacity for sustainability and widespread dissemination.

Towards Reviewing an Immediate Impact of COVID-19 on the Integrative World Economy: An Evolving Perspective

The coronavirus (CoV) belongs to Severe Acute Respiratory Syndrome (SARS) species that lead to infection, causing illness, starting from common cold to some serious sickness. Finally, on 11 March 2020, the WHO Director-General Dr. Tedros Adhanom Ghebreyesus announced the outbreak as a pandemic. As the fear and ambiguity rose among companies and firms, the profit rate seemed to be lower due to the Covid-19 global impact, say nearly US$6 trillion in wealth from 24th to 28 February 2020 of the stock market has been wiped out. There was a great decrease in value over the S&P index, which abolished over $5 trillion in the same week. However, the largest ten companies of S&P faced a loss of $1.4 trillion. The investors make an analytical prediction that firms' profits may drop in response to the impact of coronavirus. Our prime focus is on the importance of digital business practices and how different sectors have been affected in terms of economic loss during this pandemic outbreak in this paper.

Major Stressors and Coping Strategies of Internal Migrant Workers During the COVID-19 Pandemic: A Qualitative Exploration.

COVID-19 forced lockdown in India, leading to the loss of job, crisis of food, and other financial catastrophes that led to the exodus migration of internal migrant workers, operating in the private sector, back to their homes. Unavailability of transport facilities led to an inflicted need to walk back to homes barefooted without lack of any other crucial resources on the way. The woeful state of internal migrant workers walking back, with all their stuff on their back, holding their children, was trending on social media worldwide. Their problem continued even after reaching home, including misbehavior of villagers, indifferent mannerism of family members toward them, inability to fulfill family responsibility, and financial crisis, which led to stress, fear, and trauma for these internal migrant workers. The present paper aimed to assess the idiosyncratic stressors of internal migrant workers throughout the pandemic era and their responses toward those problems, which helped them cope with it. In-depth semistructured telephonic interviews were conducted with 25 internal migrant workers who were working in different cities in India before lockdown. The analyses revealed that multiple stressors include financial crisis, unavailability of food, inability to continue education, inability to pay house rent, lack of support from neighbors and family, and other psychological stressors that affected them. However, they also tried multiple strategies to deal with the problems, including a cognitive appraisal of the problem and making oneself psychologically competent to deal with the situation. Social support of family and friends played a vital role in enhancing hardiness and increasing the level of happiness at scarce times. At the same time, some of them could not deal with stressors and opted for psychiatric help to manage the physical symptoms of stress.

A Proposed Sentiment Analysis Deep Learning Algorithm for Analyzing COVID-19 Tweets.

With the rise in cases of COVID-19, a bizarre situation of pressure was mounted on each country to make arrangements to control the population and utilize the available resources appropriately. The swiftly rising of positive cases globally created panic, anxiety and depression among people. The effect of this deadly disease was found to be directly proportional to the physical and mental health of the population. As of 28 October 2020, more than 40 million people are tested positive and more than 1 million deaths have been recorded. The most dominant tool that disturbed human life during this time is social media. The tweets regarding COVID-19, whether it was a number of positive cases or deaths, induced a wave of fear and anxiety among people living in different parts of the world. Nobody can deny the truth that social media is everywhere and everybody is connected with it directly or indirectly. This offers an opportunity for researchers and data scientists to access the data for academic and research use. The social media data contains many data that relate to real-life events like COVID-19. In this paper, an analysis of Twitter data has been done through the R programming language. We have collected the Twitter data based on hashtag keywords, including COVID-19, coronavirus, deaths, new case, recovered. In this study, we have designed an algorithm called Hybrid Heterogeneous Support Vector Machine (H-SVM) and performed the sentiment classification and classified them positive, negative and neutral sentiment scores. We have also compared the performance of the proposed algorithm on certain parameters like precision, recall, F1 score and accuracy with Recurrent Neural Network (RNN) and Support Vector Machine (SVM).

Perceived stress, emotion regulation and quality of life during the Covid-19 outbreak: A multi-cultural online survey.

The present COVID-19 epidemic is a threat to physical health and brings a drain to Quality of life and mental health in the general population. However, changes in Quality of life and mental health status due to pandemic-related is less known. This study was implemented to investigate and predict changes in the Quality of life and psychological changes in people worldwide due to the pandemic. 3002 individuals participated in an online survey. The result showed that Quality of life is significantly decreased over time, meanwhile perceived stress level is raised significantly, and an increased level of difficulty in emotion regulation has happened. Almost everyone faced with increased perceived stress and current quarantine experience were significant predictors of perceived stress escalation. Younger people and individuals who had a worsening quality of life response tended to show more stress and emotion regulation problems. Furthermore, prediction models show that by extending the time of quarantine, Quality of life will worsen, and therefore the rate of perceived stress will be higher, and the problem with emotion regulation will arise more. As the whole world faces the pandemic, this research provides several implications for public mental health intervention.

L'épidémie actuelle de COVID-19 est une menace pour la santé physique et pèse sur la qualité de vie et la santé mentale de la population générale. Cependant, les changements dans la qualité de vie et l'état de santé mentale dus à la pandémie sont moins connus. Cette étude a été mise en œuvre pour étudier et prédire les changements dans la qualité de vie et les changements psychologiques chez les personnes dans le monde en raison de la pandémie. Trois mille et deux personnes ont participé à une enquête en ligne. Le résultat a montré que la qualité de vie diminue considérablement au fil du temps, que le niveau de stress perçu augmente de manière significative et que la régulation des émotions est plus difficile. Presque tous les sujets confrontés à une augmentation du stress et à une quarantaine étaient des prédicteurs significatifs de l'escalade du stress perçu. Les jeunes et les individus dont la qualité de vie se détériorait avaient tendance à présenter davantage de problèmes de stress et de régulation des émotions. De plus, les modèles de prédiction montrent qu'en prolongeant la durée de la quarantaine, la qualité de vie se détériore, le taux de stress perçu est plus élevé, et le problème de la régulation des émotions se pose davantage. Alors que le monde entier fait face à la pandémie, cette recherche fournit plusieurs pistes pour l'intervention publique en santé mentale.

Physical Fitness and Exercise During the COVID-19 Pandemic: A Qualitative Enquiry.

The COVID-19 pandemic has brought this fast-moving world to a standstill. The impact of this pandemic is massive, and the only strategy to curb the rapid spread of the disease is to follow social distancing. The imposed lockdown, resulting in the closure of business activities, public places, fitness and activity centers, and overall social life, has hampered many aspects of the lives of people including routine fitness activities of fitness freaks, which has resulted in various psychological issues and serious fitness and health concerns. In the present paper, the authors aimed at understanding the unique experiences of fitness freaks during the period of lockdown due to COVID-19. The paper also intended to explore the ways in which alternate exercises and fitness activities at home helped them deal with psychological issues and physical health consequences. Semi-structured telephone interviews were conducted with 22 adults who were regularly working out in the gym before the COVID-19 pandemic but stayed at home during the nationwide lockdown. The analysis revealed that during the initial phase of lockdown, the participants had a negative situational perception and a lack of motivation for fitness exercise. They also showed psychological health concerns and overdependence on social media in spending their free time. However, there was a gradual increase in positive self-perception and motivation to overcome their dependence on gym and fitness equipment and to continue fitness exercises at home. Participants also tended to play music as a tool while working out. The regular fitness workout at home during the lockdown greatly helped them to overcome psychological issues and fitness concerns.

Maintaining Blood Glucose Levels in Range (70-150 mg/dL) is Difficult in COVID-19 Compared to Non-COVID-19 ICU Patients-A Retrospective Analysis.

Beta cell dysfunction is suggested in patients with COVID-19 infections. Poor glycemic control in ICU is associated with poor patient outcomes. This is a single center, retrospective analysis of 562 patients in an intensive care unit from 1 March to 30 April 2020. We review the time in range (70-150 mg/dL) spent by critically ill COVID-19 patients and non-COVID-19 patients, along with the daily insulin use. Ninety-three in the COVID-19 cohort and 469 in the non-COVID-19 cohort were compared for percentage of blood glucose TIR (70-150 mg/dL) and average daily insulin use. The COVID-19 cohort spent significantly less TIR (70-150 mg/dL) compared to the non-COVID-19 cohort (44.4% vs. 68.5%). Daily average insulin use in the COVID-19 cohort was higher (8.37 units versus 6.17 units). ICU COVID-19 patients spent less time in range (70-150 mg/dL) and required higher daily insulin dose. A higher requirement for ventilator and days on ventilator was associated with a lower TIR. Mortality was lower for COVID-19 patients who achieved a higher TIR.

Cutaneous Manifestations of COVID-19: A Systematic Review.

Objective: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently a pandemic. Although pulmonary health has been the primary focus of studies during the early days of COVID-19, development of a comprehensive understanding of this emergent disease requires knowledge of all possible disease manifestations in affected patients. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant review focuses on cutaneous manifestations reported in COVID-19 patients. Approach: Literature review was conducted using the PubMed database to examine various cutaneous manifestations related to the SARS-CoV-2 infection. Published articles (n = 56) related to search criteria from the onset of the COVID-19 pandemic to June 30, 2020, were included. The primary literature articles included in this study were mainly from France, Spain, Italy, and the United Kingdom. Results: Unique to many other symptoms of COVID-19, its cutaneous manifestations have been found in people of all age groups, including children. The cutaneous manifestations of COVID-19 are varied and include maculopapular, chilblain-like, urticarial, vesicular, livedoid, and petechial lesions. In addition, rashes are common in multisystem inflammatory syndrome in children, a new and serious health condition that shares symptoms with Kawasaki disease and is likely related to COVID-19. In addition, personal protective equipment-related skin wounds are of serious concern since broken cutaneous barriers can create an opening for potential COVID-19 infections. Innovation and Conclusion: As this virus continues to spread silently, mainly through asymptomatic carriers, an accurate and rapid identification of these cutaneous manifestations may be vital to early diagnosis and lead to possible better prognosis in COVID-19 patients. This systematic review and photo atlas provide a detailed analysis of the skin pathologies related to COVID-19. Study of these cutaneous manifestations and their pathogenesis, as well their significance in human health will help define COVID-19 in its entirety, which is a prerequisite to its effective management.