ABSTRACT
Coronavirus has a great impact in some other ways of everybody's life. It greatly affected the education sector in India. All of the sudden changes from traditional teaching–learning to online teaching–learning become difficult to manage students as well as faculties. This research focuses on examining students’ learning habits during a pandemic when all school colleges closed because of the spread of COVID-19. A data was collected to examine Indian (Maharashtra) student’s learning time spent throughout epidemic, academic, were inactive due to the novel coronavirus—SARS-CoV-2 (COVID-19). In response to understanding the potential effects of the coronavirus epidemic, the questionnaires were spread over Facebook, WhatsApps a network of educational group from September 30 to October 20, 2020. This research focuses on the impact of different factors on students learning during COVID-19. To represent correlations between independent and dependent variables, heat maps are used. It helps to analyze the impact in terms of their values that exist between variables. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
Introduction Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2) is a novel coronavirus of zoonotic origin that emergedin China at the end of 2019. The outbreak of COVID-19 was challenging to the health care professional across the globe. COVID-19presents with a wide spectrum of clinical scenarios ranging fromasymptomatic to ARDS with sepsis and multi-organ failure. Patientswith various hematological malignancies are immunosuppressed andvulnerable to many infections including COVID-19.Aims &Objectives: The objective of the study was to look at theprevalence of COVID-19 infection in patients with hematologic disorders who are admitted in a large tertiary care hospital and the aimwas to describe the characteristics and outcome of Covid-19 infection.Materials &Methods: A retrospective descriptive study was conducted at the Department of Hematology of CMC, Vellore. Alladmitted patients under Hematology department from 1st March,2021 to 30th August, 2021 were included in the study and clinicaldata was extracted from the electronic medical records.The diagnosis of the COVID-19 infection was confirmed with Polymerase Chain reaction-based test and those cases with positive testresults received ward-based care or ICU care as per their healthcondition.Result: A total of 866 patients were admitted under Department ofHematology during the above-mentioned period. Among thesepatients, there were a total of 117 (13.5%) patients who had COVID-19. The median age was 42 years (Range: 2-70). There were 69(59%) males. Fifty patients (42%) had mild and 46 (39%) had severemanifestation of the disease while the rest had moderate disease. Atotal of 90 (77%) patients received ward based care and the rest 27(33%) required ICU care. Ninety-nine (84%) patients with COVID-19were being treated for hematologic malignancy. The overall mortalitywas 32 (27%) which was accounted by 31 (96.8%) among those withhematologic malignancy and 1(3.2%) in benign disorders. NHL(n = 29, 25%) and ALL (n = 27, 23%) were the major disordersrepresented in those with malignancy.Conclusions: COVID-19 infection constituted a significant proportion of inpatient admissions in patients with hematological disordersduring the six-month period when the pandemic was at its high. Themortality rate was higher in patients with hematological malignancy.
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Introduction: Relapsed refractory Hodgkin lymphoma (R/R HL) isa challenging disease to treat. Check-point inhibitors have come tothe forefront of therapy in many tumours, including R/R HL, witha recent shift from intensive salvage regimens to an immunotherapybased approach.Phase I/II studies have established the safety of these novel agents,however the optimal efficacy dose has not been established. Recentlya few case reports and case series have reported efficacy of a lowdose of nivolumab in refractory HL.Aims &Objectives: To assess the efficacy and immune-relatedadverse event profile (iRAE) profile of nivolumab in a fixed dose of40 mg in patients with primary progressive (PP) and R/R classicalHL.Materials &Methods: Single center retrospective analysis ofpatients with PP or R/R HL treated with low dose nivolumab at ourcentre. 4 doses of nivolumab 40 mg were administered at 2 weeklyintervals. The response to therapy was assessed after 4 doses ofnivolumab by PET/CT scan (reported as per the Deauville criteria).Result: 11 patients with HL were treated with low dose nivolumab,the median age of patients was 30.5 years (Range 14-61 years), outof which 8 patients were male. 3 had R/R disease, 6 patients had PPdisease, and 2 had relapsed after ASCT (indication for transplant-PPdisease). Patients received a median of 2 salvage regimens prior totherapy with nivolumab (Range 1-3)0.2 patients did not complete theplanned 4 doses-1 died due to covid-19 pneumonia, 1 had diseaseprogression after 2 doses. In × patients who completed 4 doses ofnivolumab, 5 had a Deauville score of 1-3 (including one patient withpost-autologous relapse), 2 had a Deauville score of 'X', and 2 hadscore of 5 and/or clinical evidence of disease.5 patients underwentASCT in complete remission and 2 patients are currently planned forautologous (n = 1) and allogeneic stem cell transplant (n = 1). 4patients did not undergo ASCT-suboptimal response/disease progression (n = 3) and inter-current infection resulting in death(n = 1).Commonly described iRAEs were not seen, however onepatient developed a skin rash and transient elevation of liver enzymes.Conclusions: Low dose nivolumab in setting of PP and R/R HL is acost-effective alternative to standard dosing, with equivalent efficacyin this small case series. Larger prospective studies are warranted tovalidate these findings.
ABSTRACT
Background: The impact of COVID-19 pandemic has been highly heterogeneous across the globe and different regions within the country. The differences in the outcome of these patients is related to their demographic profile, genetics, socio-economic conditions, and government health policies. Prior to the COVID-19 pandemic, the Healthcare Access and Quality (HAQ) Index for hematological malignancies (HAQ index <30) in a low-middle socio-demographic index(SDI) country like India was less than the mean HAQ index for all other diseases (HAQ index 41) with a significant regional disparity.(1)Several national and international registries from high socio-demographic Index (SDI) countries have reported worse short-term outcomes of coronavirus disease (COVID-19) in patients with hematologic as compared to other solid cancers. The outcomes of COVID-19 in patients with hematologic malignancies from a low-middle SDI country are yet unknown. The COVID-19 Hematologic Cancer registry of India reports these outcomes from India. Methods: Ten tertiary referral hospitals across India reported the demographic, clinical, laboratory, treatment, and outcomes of COVID-19 infection in patients with hematological malignancies. The registry was retrospective from March 21, 2020, and prospective from November 1, 2020, till March 20, 2021. Risk factors associated with severity and mortality were evaluated using the penalised logistic regression and Cox proportional hazards model. Findings: Data from 565 patients was included in this study. Among these, 429 (76%) patients were hospitalized, 186 (33%) patients had moderate/severe COVID-19.There were 116 (20.5%) non-survivors at a mean follow up of 147 (95% CI : 142-153) days. Age >60 years (HR 2·55, 1·23 - 5·27), diagnosis of acute myeloid leukemia (HR 2·85, 1·58 - 5·13), interruption or alteration of anticancer therapy (HR 2·78, 1·65 - 4·68), and post hematopoietic cell transplant status (HR 3·68, 1·82 - 7·45) predicted mortality. In contrast, increasing age [20-40 years (OR 2·54, 1·32 - 4·90), 41-60 years (OR 3·51, 1·84 - 6·71), >60 years (OR 6·04, 3·01 - 12·10), comorbidities such as diabetes mellitus (OR 1·89, 1·18 - 3·04), hypertension (OR 1·94, 1·17 - 3·19), diagnosis of AML (OR 3·70, 2·06 - 6·67), indolent non-hodgkin lymphoma (OR 3·20, 1·68 - 6·09), multiple myeloma (OR 2·88, 1·64 - 5·05), malignancy not being in remission (OR 1·71, 1·12 - 2·60)were significantly associated with severe COVID-19 on univariate analysis. Of these, only increasing age [20-40 years (OR 2·60 (1·31 - 5·15), 40-60 years (OR 3·44, 1.60 - 7·41), more than 60 years (OR 5·70, 2·43 - 13·35)], AML (OR 2·73, 1·45 - 5·12), and malignancy not being in remission (OR 1·85, 1·18 - 2·89) were significantly associated with severe COVID-19 on multivariable analysis Conclusion: The overall mortality from COVID-19 infection of the entire cohort was 20.5%;the mortality was 46.2% in patients who had moderate to severe disease COVID-19 illness. Similar to previous studies, age, diagnosis of acute myeloid leukemia and a post stem cell transplant status was associated with mortality. In addition, interruption or de-escalation of anticancer therapy during Covid-19 infection was identified as an important factor associated with higher mortality on follow up in the current study. References 1. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. Lancet (London, England)2018;391(10136): 2236-71.Lee AJX, Purshouse K. COVID-19 and cancer registries: learning from the first peak of the SARS-CoV-2 pandemic. Br J Cancer 2021;124(11): 1777-84. [Formula presented] Disclosures: No relevant conflicts of interest to declare.
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6-6-2020 was a landmark date for the ophthalmology community, not only because of the normal visual acuity connotation of 6/6 and 20/20, but because it genuinely reflects every ophthalmologist's dream to bring back perfect vision for every patient. The Covid-19 pandemic had forced ophthalmologists to "refuse to operate" albeit for a short period. This narrative describes how, during a telemedicine call, a surgeon experienced the distress of refusing to operate on a mature cataract. It reveals the trauma caused by the disordered goals of eye care during the pandemic, when elective procedures were abandoned and only emergency services were provided.