COVID-19 anxiety among undergraduate students of a medical college in Chengalpattu district -- A cross-sectional study

Background: COVID-19 is caused by severe acute respiratory syndromes-CoV-2, a virus that affects the physical as well as mental health of people. Aims and Objectives: Our study was conducted to estimate the COVID-19 anxiety prevalence and its associated sociodemographic factors in a medical college. Materials and Methods: Undergraduate medical students of a medical college in Chengalpattu district were the study participants, with inclusion criteria of students above 18 years of age from 2nd, 3rd, and final year and interns being included for the study. Using simple random sampling, students were selected with a sample size of 197. After obtaining approval from the Institutional Human Ethics Committee and informed consent, data were collected using a structured and pre-tested questionnaire, with anxiety being assessed using coronavirus anxiety scale and data analyzed using SPSS version 21. The statistical tests used were proportions, Chi-square test. P<0.05 was considered to be statistically significant. Results: Among the 197 students, males constituted 82 (41.6%) and females 115 (58.4%), of which 60 (73.1%) of males and 88 (76.5%) of females had COVID-19 anxiety. Overall 75.1% had COVID-19 anxiety. Based on the year of study, 43 (22%) 2nd-year students and 38 (19.3%) 3rd-year students, 29 (14.8%) final-year students, and 38 (19.3%) inters had COVID-19 anxiety. Sociodemographic factors such as the type of family, year of study, and staying with parents had a strong association with COVID-19 anxiety. Conclusion: In our study, 75.1% experience Coronavirus related anxiety, and thus, there is need for focus on the mental well-being of undergraduate students requiring attention as well as support from college administration, family, and society to cope up with the pandemic situation. [ FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences 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 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 . (Copyright applies to all s.)

Comparison of master two-step exercise stress test versus six-min walk test in patients tested positive for SARS-CoV-2.

Background and Aim: There has been a lack of uniformity on how to triage coronavirus disease 2019 (COVID-19) patients visiting the emergency units of hospitals. Triage tools are themselves spreading the pandemic in hospital areas. The present study compared a master two-step (M2ST) exercise stress test versus a 6-min walk test (6MWT) in COVID-19-positive patients visiting the emergency unit of a hospital. Materials and Methods: Thirty-nine patients underwent 6MWT followed by M2ST, while another set of 38 patients underwent M2ST followed by 6MWT in this randomized, crossover, open-label, and noninferiority study. The exercise tests assessed the change from baseline in SpO2, heart rate (HR), respiratory rate, blood pressure, exertion, and dyspnea on the modified-Borg scale. Results: Noninferiority was established for SpO2 (P < 0.05), systolic blood pressure (SBP; P < 0.001), and diastolic blood pressure (DBP; P < 0.05), but not for HR (P = 0.3) and respiratory rate (P = 0.6). The difference between the pretest and posttest (delta change) values for the parameters SpO2, respiratory rate, HR, SBP, and DBP correlated significantly (P < 0.001) with Pearson correlation coefficient (r = 0.764, 0.783, 0.473, 0.838, and 0.783, respectively). The delta change values of modified-Borg scale for dyspnea (P = 0.291) and exertion (P = 0.208) were statistically insignificant between the two exercise tests. However, the correlation between the tests was statistically significant (P < 0.001). Conclusion: M2ST, a timesaving, cost-effective, and easy to perform exercise stress test, has been identified as a reliable alternative for 6MWT.

Interface of G-quadruplex with both stabilizing and destabilizing ligands for targeting various diseases.

Guanine-rich DNA sequences may fold back into non-canonical four-stranded secondary structures termed as G-quadruplexes. The role of G-quadruplexes has already been well established in different diseases like cancer, neurological and viral disorders etc. Also, several small molecules have been reported, which can influence the involvement of G-quadruplexes either through stabilization or destabilization in the cellular environment. Growing statistics have associated G-quadruplex assemblies to a discrete biological process in vivo, including DNA replication, transcription, genomic stability, and epigenetic regulation. DNA G-quadruplex existence in human telomere is well recognized attractive target for anticancer drugs. G-quadruplex-interactive ligands have been known to prevent telomerase access as well as telomere capping. To the best of our understanding, the role of G-quadruplexes in virology, neuropharmacology, cancer progression and its treatment has not been discussed on a single platform till date. This review aims to enhance our knowledge regarding these magical sticky quadruplex structures, which have been quite significantly proved to be the part of many cellular processes along with their established in vivo existence. Understanding regarding stabilizing or destabilizing ligands of these multistranded guanine quadruplex structures might be proved as the facilitator of drug discovery process for many incurable diseases in future.

SARS-CoV-2 infection, pulse oximetry, and interpretive caveats.

Hypoxaemia in COVID-19 does not necessarily imply COVID pneumonia or post-COVID lung fibrosis, and the caveats of finger pulse oximetry should be remembered. Drug-induced methaemoglobinemia should be considered in individuals with unexplained cyanosis, refractory hypoxaemia, or the presence of a saturation gap. Here, we share our recent encounter of 'spurious hypoxia' in a patient with COVID-19 and methaemoglobinemia.

Clinical Profile and Outcomes of Diabetic Ketoacidosis during the COVID-19 Pandemic in North India.

Although recent data have shown a declining trend in mortality in diabetic ketoacidosis (DKA), the outcomes are likely to be different during the coronavirus (COVID-19) pandemic. We conducted a prospective cohort study to evaluate the spectrum and outcomes of adult DKA during the pandemic and document differences in DKA patients with or without COVID-19. A total of 169 patients (mean age 44 years) were admitted at the Emergency Department of PGIMER, Chandigarh (India), from January 2020 to June 2021. The precipitating factors were noncompliance with antidiabetic therapy (77.5%), infections (62.7%), and noninfectious conditions (21.3%). Thirty-nine (23.1%) patients had COVID-19, including 31 with severe infection. DKA severity and resolution, ventilator requirement, hospital stay, and mortality were similar in the patients with or without COVID-19. In-hospital mortality was 39.6% (n = 67). The independent mortality predictors were ventilator requirement (p-0.000), an infection trigger (p-0.049), and hyperosmolarity (p-0.048). DKA mortality is increased significantly during the pandemic.

Startups, Barriers and its Opportunities in India

Uttam Kheti Madhyam Baan, Nikhad Chakri Bheekh Saman That is, best farming (agriculture work) was the best work in our society, Madhyam Baan (trade) - Business had been called medium level work. Chakri means job had been said to be a bad job, our elders had considered it like a dogs tail. But today all this has changed and has become a completely reverse definition. Today we give priority to all jobs;the job is purchasing our skills and providing food for us two times in a day. Today our mindset has changed so much that we are afraid of taking any risk in life and this fear keeps us from working new Innovations/Startups. We need startups to improve the country's economic system;we can improve the economic economy of the country only through startups. The jobber can only improve himself and his family's living standard, but a businessman can improve the family economy as well as the country economy also. 35 years ago, China gave priority to startups and today Chinese products available over the world which strengthens China's economy. In today's conditions, India will have to do less import and in India it will have to prepare raw materials and finished goods itself. For this it is necessary to create new startups in India and the government should help grow the startups.

Is there an association between zinc and COVID-19-associated mucormycosis? Results of an experimental and clinical study.

BACKGROUND: The enormous increase in COVID-19-associated mucormycosis (CAM) in India lacks an explanation. Zinc supplementation during COVID-19 management is speculated as a contributor to mucormycosis. We conducted an experimental and clinical study to explore the association of zinc and mucormycosis. METHODS: We inoculated pure isolates of Rhizopus arrhizus obtained from subjects with CAM on dichloran rose Bengal chloramphenicol (DRBC) agar enriched with (three different concentrations) and without zinc. At 24 h, we counted the viable colonies and measured the dry weight of colonies at 24, 48 and 72 h. We also compared the clinical features and serum zinc levels in 29 CAM cases and 28 COVID-19 subjects without mucormycosis (controls). RESULTS: We tested eight isolates of R arrhizus and noted a visible increase in growth in zinc-enriched media. A viable count percentage showed a significantly increased growth in four of the eight isolates in zinc-augmented DRBC agar. A time- and concentration-dependent increase in the mean fungal biomass with zinc was observed in all three isolates tested. We enrolled 29 cases of CAM and 28 controls. The mean serum zinc concentration was below the reference range in all the subjects and was not significantly different between the cases and controls. CONCLUSIONS: Half of the R arrhizus isolates grew better with zinc enrichment in vitro. However, our study does not conclusively support the hypothesis that zinc supplementation contributed to the pathogenesis of mucormycosis. More data, both in vitro and in vivo, may resolve the role of zinc in the pathogenesis of CAM.

Severe Acute Respiratory Infection Surveillance during the Initial Phase of the COVID-19 Outbreak in North India: A Comparison of COVID-19 to Other SARI Causes.

INTRODUCTION: World Health Organization proposes severe acute respiratory infection (SARI) case definition for coronavirus disease 2019 (COVID-19) surveillance; however, early differentiation between SARI etiologies remains challenging. We aimed to investigate the spectrum and outcome of SARI and compare COVID-19 to non-COVID-19 causes. PATIENTS AND METHODS: A prospective cohort study was conducted between March 15, 2020, to August 15, 2020, at an adult medical emergency in North India. SARI was diagnosed using a "modified" case definition-febrile respiratory symptoms or radiographic evidence of pneumonia or acute respiratory distress syndrome of ≤14 days duration, along with a need for hospitalization and in the absence of an alternative etiology that fully explains the illness. COVID-19 was diagnosed with reverse transcription-polymerase chain reaction testing. RESULTS: In total, 95/212 (44.8%) cases had COVID-19. Community-acquired pneumonia (n = 57), exacerbation of chronic lung disease (n = 11), heart failure (n = 11), tropical febrile illnesses (n = 10), and influenza A (n = 5) were common non-COVID-19 causes. No between-group differences were apparent in age ≥60 years, comorbidities, oxygenation, leukocytosis, lymphopenia, acute physiology and chronic health evaluation (APACHE)-II score, CURB-65 score, and ventilator requirement at 24-hour. Bilateral lung distribution and middle-lower zones involvement in radiography predicted COVID-19. The median hospital stay was longer with COVID-19 (12 versus 5 days, p = 0.000); however, mortality was similar (31.6% versus 28.2%, p = 0.593). Independent mortality predictors were higher mean APACHE II in COVID-19 and early ventilator requirement in non-COVID-19 cases. CONCLUSIONS: COVID-19 has similar severity and mortality as non-COVID-19 SARI but requires an extended hospital stay. Including radiography in the SARI definition might improve COVID-19 surveillance. HOW TO CITE THIS ARTICLE: Pannu AK, Kumar M, Singh P, Shaji A, Ghosh A, Behera A, et al. Severe Acute Respiratory Infection Surveillance during the Initial Phase of the COVID-19 Outbreak in North India: A Comparison of COVID-19 to Other SARI Causes. Indian J Crit Care Med 2021;25(7):761-767.

COVID-19 and police personnel: An exploratory community based study from South India.

INTRODUCTION: COVID-19 has ensured that countries enforced complete lock down to prevent the spread of infection. Despite millions of people working from home during this pandemic situation, police personnel 'the front line workers' who deal with the general population to ensure their safety and wellbeing are at risk of stress and other mental health problems in addition to the risk of infection itself. AIM: The aim of this study is to explore the perception of police personnel towards the disease, factors influencing stress and coping abilities of them amid COVID-19. METHODS: A cross-sectional qualitative study was conducted using in-depth interviews among randomly selected police personnel working in COVID-19 situation across the district of Karaikal, Puducherry. RESULTS: Of the 32 police personnel, majority were of age group 36-45 (43.75%), followed by 25-35 (37.5%). More than half of them were married (78.12%). Around 62.5% had been in the present occupation for more than 5 years. The in depth interviews were group under 5 themes namely perception, practice they follow amid COVID-19, stress they go through, challenges faced, coping strategies used by them. CONCLUSION: It is the need of the hour to care for the well-being of frontline workers, especially police personals.

Telepsychiatry Netiquette: Connect, Communicate and Consult.

Globally, telepsychiatry has been around since the 1950s. It is in the COVID era that it has gained the relevance and much-needed momentum amongst mental health care professionals. Given the restrictions imposed by the global lockdown owing to the fear of contracting the virus, the ease of access and safety offered by telepsychiatry makes it both appealing and "the new normal." Despite some hesitation from mental health professionals, there is adequate research to support the role of telehealth services in the management of various mental health disorders. As with any formal system, the practice of telepsychiatry is regulated by professional guidelines to show the way forward to both health provider and seeker. The manuscript examines the ways telepsychiatry is redefining our virtual conduct. It emphasizes the evolving "netiquette" needed to navigate online consultations. It also elucidates the challenges faced by health professionals, and possible ways of maneuvering and circumventing the same. Telepsychiatry, a dynamic process which is interactive and personalized, adds a third dimension to the practice of modern medicine. It is here to stay. So, it is not a question of "if" instead "how soon" we can adapt to and get conversant with this revolutionary mode of connection, communication, and consultation, which will make all the difference.