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The harsh and saddening reality of gender equality cripples the ideology behind human rights. The "modern" world, although moving ahead, is still far behind in providing equal standards to men and women, favouring the former. The paper explains the various types of gender inequalities in detail, broadly classifying them as: academics, economics, social and pandemic. The academic gender inequality highlights the alarming differences in literacy rate of males and females from the year 1901 to 2011 and its impact on the lives of women. Further, it is seen that dropout rates are higher in the case of females as compared to males. Thus, females are often underrepresented in science, technology, engineering and mathematics (STEM) fields. The paper also looks into the contribution of female authors vs. male authors in research areas. The category of the economics of gender inequality discusses the economic factors affecting equality. Inequality at the workforce, its causes and its impacts on the financial independence of women are discussed in the paper, highlighting the effect of women empowerment on GDP. The social factors of gender equality discuss the physical and mental health of women and the violence faced by them in the patriarchal society. In the situation of a pandemic, a rise in gender inequality is seen. The paper discusses the reasons behind this using three scenarios: Ebola virus pandemic of 2014-2016, Zika virus pandemic and the current coronavirus pandemic. Several measures that have been opted to reduce the gender gap are also discussed in the paper.
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The working environment has evolved after the COVID-19 pandemic from office work to working from home because of changing industry needs with the pandemic effect. Globally, organizations continue to identify the right way to balance employee satisfaction by giving them the hybrid working option, but it lacks standardization. In this research paper, the author discusses the emerging need for the Chief Remote Officer in post-pandemic working conditions. The study also reflects the use of Artificial Intelligence and how it can support human resources in the remote setup. The pandemic virus of 2020 has evolved with several variants, and the continued uncontrollable global situation has arisen. In such unpredictable conditions, the need to bring work sustainability shall be the focus among the organizations for remote working conditions. This study discusses the literature and analyzes the industry's Chief Remote Officer role requirement in detail as people continue to work in the presence of the COVID-19 pandemic. The author elaborates on the Chief Remote Officer and discusses the roles, responsibilities, Knowledge skills, and purpose behind this role. This research paper offers a broader aspect along with Artificial Intelligence usage. Since it is a early stage, the proposed approach would require to be tested by the organizations during the pandemic. © 2023 IEEE.
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Industry 4.0 influences automation, better logistics warehouse, smart manufacturing for larger productions, and supply chain management. Gamification is no longer a new topic where its framework and methodology got used for user engagement and motivation towards attitude change from repetitive activities. This paper aims to study Gamification's implementation to improve Industry 4.0 as more intelligent supply chain management needs emerge from its different departments as the current system lacks integration. Also, the supply chain industry has several monotonous tasks, and keeping employee motivated is the challenge. Industries are lagging in utilizing the gamification benefits to set up game-based engagement. In the continuously evolving market and competition, relevance is the key, which the study proposes with Gamification. With the emerging technology needs and urges of adaptability, that may lead to progressive growth and value to compete in the unceasing demands in the market. The author analyzes the annex of Gamification in supply chain management among the different aspects of Industry 4.0 to affect employee motivation in tedious work. Motivation drives human action, and different Gamification approach in literature has demonstrated the power to change the individual attitude. And the study analyzes the Gamification framework with Industry 4.0 technologies to support supply chain management to bring modernization. The research approach of this study is to understand the existing literature and analyze the detailed area under Gamification and Supply Chain Management. © 2022 IEEE.
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Introduction: Incidence of AKI reported varies from 0.5% to 37%.These incidence cannot be extrapolated in our patients as the severity of COVID-19 infection, the ethnicity of the patients l, the clinical profile and the healthcare delivery system is different.The aim of this study was to explore whether urinary cell cycle arrest markers and other renal biomarkers have a role in predicting AKI in critically ill patients with COVID-19 and acute respiratory disease Methods: This prospective, longitudinal cohort study included critically ill COVID-19 patients without AKI at study entry. Patients aged more than 18 years with moderate or severe respiratory disease as defined by Berlin criteria were subsequently recruited from November 2020 to May 2021. Urine samples were collected on admission to critical care areas for determination of KIM1, NGAL, IL-18,IGF-BP-7, TIMP -2 at the time point of study inclusion, 12h, 24h, 48h, after inclusion. The demographic information, comorbidities, clinical, and laboratory data were recorded. The study outcomes were the development of AKI and mortality during hospitalization. Result(s): [Formula presented] ROC analysis was done to determine the diagnostic performance of the various urinary biomarkers;AUC was 0.655 for normalised IL-18, 0.685 for normalised NGAL, 0.658 for normalised TIM-1, and so on Conclusion(s): AKI was common in critically ill COVID-19 patients. Raised values of urinary biomarkers with clinical information, are useful for the identification of AKI in critically ill COVID-19 patients. No conflict of interestCopyright © 2023
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Introduction: The association of hematological abnormalities in severe COVID-19 pneumonia is multifactorial. The hemostatic abnormalities in COVID-19 are related with disease progression, severity and mortality. In this study, we aim to investigate the association of routine hematological parameters along with newer CBC parameters in COVID-19 disease Methods: Retrospective study of 164 RT PCR confirmed COVID-19 patients between May' 20 to Dec'20 D-dimer was estimated by immunometric assay with a reference range of 0-0.35ug/L (Instrument -Nephle plus one) and CBC was run on Sysmex 2000 XN. The patients were divided into mild/moderate, severe and the nonsurvivor outcome groups according to the MoHFW India guidelines.Data are expressed as the mean +/- sd for continuous variable and frequency percentage for categorical variable. Comparisons of three groups were performed using Kruskall Wallis test for continuous variables and Chi square test, Fisher's exact test as appropriate for categorical variables. Result(s): RESULTS Of the 164 admitted cases with an age range of 28-90 years, the majority were males(n-117-71.3%) The Receiver operating characteristic curve analysis showed that Neutrophil lymphocyte ratio at discharge had the highest area under curve (0.713) followed by lymphocyte percentage at discharge (0.712).In advanced CBC parameters lymphocyte Y and lymphocyte Z at discharge had the highest area under the curve (Table Presented) Conclusion(s): As the Pandemic draws to an end and Covid 19 becomes an endemic disease ,the routine and advanced CBC parameters can be used -As a Biomarker for severity of disease at admission -For serial monitoring and prognosis of the patients.
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Introduction: COVID-19 is a global pandemic disease first identified in Wuhan, China in late 2019. As of March 2022, over 450 million cases and 6 million deaths have been reported across the world, with the confirmed numbers probably being a fraction of the real numbers. Red Cell Distribution width (RDW) is a measure of anisocytosis, that is, variation in the circulating red blood cell volume. It is a nonspecific marker of acute illness. Increased RDW is suggestive of dysfunctional erythropoiesis and/or shortened RBC lifespan. Hence, it is a good predictor of clinical outcome in many disorders. Aims & Objectives: AIMS: To prove association of RDW with COVID-19 infection requiring ICU stay in a tertiary care hospital. OBJECTIVE(S): Primary Objective: To assess the predictive value of RDW on admission with requirement of ICU as a marker of severity in COVID-19 patients. Secondary Objectives: To compare RDW to other markers commonly used in COVID-19 infection, such as D-Dimer and CRP. Material(s) and Method(s): Patients over 18 years of age getting admitted at COVID ward or ICU at P.D. Hinduja Hospital, Mumbai were included in the study. RDW, CRP and D-dimer values of Ward group and ICU group patients were noted and compared. Result(s): 234 patients were screened and 190 patients were included in the final study. RDW was found to have significant association with ICU requirement (p = 0.0066). Further, an RDW value of 13 or more is found to be 85% sensitive for predicting ICU requirement. RDW of 16 or more is found to be 80% specific for predicting requirement of ICU stay. Regarding secondary objectives, RDW was found to have significant correlation with D-Dimer (p = 0.0005) but not with CRP (p = 0.12). Conclusion(s): RDW can be a potentially useful marker for risk stratification in COVID-19. A value of RDW more than 16 is associated with a significant risk of ICU requirement in COVID-19 disease. Further studies may be indicated to find a statistically significant correlation between RDW values and mortality in COVID- 19.
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Artificial intelligence (AI) has a great impact on our daily living and makes our lives more efficient and productive. Especially during the coronavirus disease (COVID-19) pandemic, AI has played a key role in response to the global health crisis. There has been a boom in AI innovation and its use since the pandemic. However, despite its widespread adoption and great potential, most people have little knowledge of AI concepts and realization of its potential. The objective of this white paper is to communicate the importance of AI and its benefits to society. The report covers AI applications in six different topics from medicine (AI deployment in clinical settings, imaging and diagnostics, and acceleration of drug discovery) to more social aspects (support older adults in long-term care homes, and AI in supporting small and medium enterprises. The report ends with nine steps to consider for moving forward with AI implementation during and post pandemic period. These include legal and ethical data collection and storage, greater data access, multidisciplinary collaboration, and policy reform.
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Aim and background: Efficacy of therapeutic vitamin D3 supplementation for ICU outcomes in severe COVID-19 is sparingly studied. Objective: Effect of single high-dose vitamin D3 supplementation on sequential organ failure assessment (SOFA) score in patients with moderate to severe COVID-19 disease. Materials and methods: A single centre, randomized, doubleblind, placebo-controlled study was carried out among 90 patients with moderate to severe COVID-19 ARDS defined by PaO2/FiO2 <200. Participants received 0.6 million IU vitamin D3 (oral nanoformulation) (intervention) or placebo (equal volume, oral). SOFA score on day-3, -7, -10, and -14 was measured. The primary outcome was a change in day-7 SOFA score from admission. Pre-specified secondary outcomes were day 10 and day-14 SOFA score, change in PaO2/FiO2 ratio, in-hospital all-cause mortality, and inflammatory cytokine levels. Results: A total of 358 patients were screened and 90 patients (45 in each group) were included. 25(OH)D3 levels were 12.0 (10.0-16.0) and 12.7 (12-18) ng/mL (p = 0.059) at study entry;60 (54.40 to 65.59) ng/mL and 3.8 [1.05 to 6.55] at day-3 in the intervention and placebo group, respectively. The SOFA score on day-7 was better in the treatment group [intergroup difference was -2 (95% CI, -3.99 to -0.01, p = 0.009) with effect-size of r = 0.35 (95% CI, 0.09-0.55). The all-cause mortality with intervention was 24.4% compared to 44.4% (p = 0.046) in the control group. A significant improvement in the day-7 PaO2/FiO2 ratio [200.50 (101.01-291.30) and 110.70 (66.20-166.50), p = 0.003;intergroup difference -98.6 (40.70 to 156.49)], a decrease in CRP [-48.63 (-80.78 to -16.48) and 5.4 (-17.62 to 28.42), p = 0.042)], ferritin [-412.3 (-736.29 to -88.31) and 41.5 (-293.68 to 376.68), p = 0.018] was observed in the intervention and placebo groups, respectively. Conclusion: Single high-dose oral cholecalciferol supplementation to increase vitamin D3 >50 ng/mL improves the SOFA score and reduces in-hospital mortality in vitamin-D deficient patients with severe COVID-19.
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Aim and objective: Non-invasive fluid management in COVID shock patient in ICU. Materials and methods: Our hospital use sterling stroke volume-guided fluid management for COVID shock patients. In the University of Kansas health system evaluated 200 cases for stroke volume (sv) guided fluid resuscitation this study showed ICU length of stay reduced by 2.89 days, risk of mechanical ventilation reduced by 51%, initiation of acute dialysis therapy reduced by 13.2%, this system saves an estimated $14498 per treated patient this system use Bioreactance technology to measure sv in shock patient in two sensor place above the heart and two below the heart and continue measurement of sv done in 48 seconds. Validation studies over 500 patient published clinical studies result are same all major technologies (Swan Ganz, pulse contour, Doppler, fick) and over 100 peer-reviewed publications are there. This technique is 100% non-invasive accurate flexible-this sterling system use PLR or bolus test for sv management we are using in emergency for our Rapid Response Team in MICU OT for perioperative fluid management and all surgical ICU. Results: 1 ICU length of stay reduced by 2.89 days 2 risk of mechanical ventilation reduced by 51% 3 initiations of acute dialysis therapy reduced by 13.5% 4 save an estimated $14498 per treated patient. Conclusion: Sterling monitoring platforms use unique, patented Bioreactance technology to take measures continuously and precisely, and they require only four easy to place sensor pads. The sensors can be- anywhere on the chest two above the heart and two below the heart to create a box around the heart we advise sterling stroke volume guided fluid management in emergency medical ICU surgical ICU and perioperative and RRT for accurate fast and 100% non-invasive technique for COVID patient.
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Aim and objective: Monoclonal antibody for emergency COVID exposure treatment. Materials and methods: For the treatmentof mild to moderate COVID-19 in adults and peadiatric patient (12 years of age and older weighing at least 40 kg) with laboratoryconfirmed -SARS-COVID-infection and who are at high risk of severe COVID-10 and does not require oxygen. Dose casirivimab and imdevimab is approved at a combined dose of 1200 mg (600 mg of each drug) administered by intravenous infusion or subcutaneous route. US-FDA EUA Approval. DGCI (CDSCO) Restricted use in an Emergency situation. We have used it in a high-risk case. 1. Age >60 years. 2. Obesity. 3. Cardiovascular disease, including hypertension. 4. Chronic lung disease, including asthma. 5. Type 1 and type 2 diabetes mellitus. 6. Chronic kidney disease, including those on dialysis. 7. Chronic liver disease. 8. Immunosuppressed. Results: Evidence Summary. Interpretation: 70% relative risk reduction in COVID-19 - related hospitalizations or all-cause death in participants who received CAS 600 mg plus IMD 600 mg compared to those who received placebo. 71% relative risk reduction in COVID- 19 related hospitalization and all-cause death in participants who received CAS 1200 mg plus IMD 1200 mg compared to those who received placebo. Administration intravenous infusion with 0.2 micron filter 50 ns 180 mL/hour in 20 minutes 600 mg casirivimab and 600 mg imdevimab as a single infusion. Conclusion: 1. India is currently seeing the COVID-19 third wave majority of patients develop mild to moderate disease. 2. Casirivimab and imdevimab are recombinant human IgGI monoclonal antibodies that bind to spike protein of COVID-19 and reduce viral replication. Cocktail is effective against variants and reduced the viral escape. The cocktail will aid in reducing the risk of hospitalization and death in patients with mild to moderate COVID-19 disease who are at risk of progration to severe disease.
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Technology surrounds Human society, and through which trillion tons of Data are readily available in different forms. Gamification is becoming a part of the human lifestyle through entertainment, fun, or learning and growing immensely in various industries such as e-commerce marketing. Data has become available to a large extent but extracting valuable information is still a question in different sectors. Moreover, to handle big data, several organizations are making investments and trying to hire talent from around the globe. This paper discusses the industry case studies that reflect the importance of gamified event Datathon to solve such problems. During COVID-19, where Data plays a key factor, valuable case studies are discussed and analyzed in this paper. Gamification offers users different pleasures through achievement and competition, and Datathon is prominent in problem-solving for emerging data but lacks the gap in studies. This research paper highlights the various aspects of the true gamification benefit implemented across industries through Datathon to solve significant problems. The author shares detailed insights by discussing the case studies considering different regions and sectors and analyzing during the COVID-19 pandemic. © 2022 IEEE.
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Background: Covid-19 like other viruses, can change the immunohematological profile of the infected patients and timely identification of these changes can help in the management of these patients. There are various reports which have shown decline in haemoglobin in covid patients due to autoimmune red cell hemolysis. One recent study has shown that patients admitted in ICU have higher chances of DAT positivity as compared to non-covid patients. Aims: • To assess the Immunohematological profile of COVID-19 positive patients. • To find any correlation between the immunohematological profile and clinical spectrum of COVID-19 disease. Methods: It was a prospective observational study. Blood grouping, Direct antiglobulin test (DAT) and antibody screening (ABS) were performed on RT-PCR confirmed COVID-19 positive and COVID-19 negative patients admitted in Intensive care units and General wards of our institute. The immunohematological findings were also correlated with the patient clinical laboratory profiles. Results: A total of 205 patients were recruited. Out of which 102 were RT-PCR Covid-19 positive and 103 were negative. There was difference in blood group distribution with significantly less O group individuals in RT-PCR negative group. The overall DAT positivity was seen in 24.4% of the total 203 patients enrolled in the study. The DAT positivity was significantly higher (p value 0.01) in COVID-19 positive patients (32%) than COVID-19 negative patients (16.7%). However, there was no significant difference in the percentage of DAT positivity among patients admitted in ICU or general ward patients. Among COVID-19 positive patients, the mean haemoglobin was statistically significantly (p value 0.02) lower in DAT positive (Mean Hb: 8.5gm/dl) as compared to DAT negative patients (Mean Hb 9.6gm/dl). Also, DAT positive patients among COVID-19 positive patients were found to have significantly higher C-Reactive protein levels (p value: 0.05). There was no significant difference in other biochemical parameters between COVID-19 positive and COVID-19 negative individuals. DAT positivity was not associated with any drug intake or co-morbid state. Summary/Conclusions: Like other bacterial and viral infections, COVID-19 is also associated with DAT positivity indicating some autoimmune phenomenon due to exposure of the crypt antigens. The specificity of antibodies involved in DAT are mainly IgG and hence it may present as autoimmune hemolytic anaemia. And its association with increased inflammatory makers can help us in decision making by blood transfusion services and better management of COVID-19 patients requiring blood transfusion. .
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The Metaverse is a podium of user mesmerizing interactions in the virtual world with the support of the Internet, software, and hardware required to create the exceptional immersive user experience. Gamification is becoming part of our life, and with the growing technology and digitalization, it has become a prevalent part of different user activities. The increasing reputation of Metaverse is opening the more user immersive online interaction in the virtual internet world where users can meet, participate, and collaborate for a specific purpose such as social interaction. The author discusses the gamified relevant details frequently used in Metaverse since there is currently a lack of study on Gamification in Metaverse surroundings. The approach taken in this paper is understanding the concepts, followed by essential components and future contributions from the Metaverse. This paper concludes the associated future challenges which may get aroused with Metaverse for the current and future generations. © 2022 IEEE.
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Introduction: The cause of respiratory distress by the novel corona virus is an acute hyper inflammatory “cytokine storm”. Besides glucocorticoids, tocilizumab, a recombinant monoclonal antibody, directed against the IL-6 receptor, has been used as a treatment modality with variable results [1]. Factors affecting poor response to tocilizumab remain unrecognized. We report a model to predict worse outcomes among patients with severe COVID-19 pneumonia treated with tocilizumab. Methods: In this retrospective study, patients with severe COVID 19 pneumonia admitted to the intensive care unit of our hospital who received Inj. tocilizumab besides the standard treatment between July 2020 to July 2021, were included. Electronic records of such patients were accessed and demographic, biochemical and outcome measures were recorded. Patients were divided into survivor cohort and mortality cohort. To predict mortality as an outcome, a multivariate logistic regression model was constructed. Results: Total of 101 patients were included, 71 in survival cohort and 30 in mortality cohort. Lactate dehydrogenase (LDH), neutrophil to lymphocyte ratio (NL ratio), creatine kinase myocardial band (CKMB) and partial pressure of oxygen to fraction of inspired oxygen ratio (PFR) on day of drug administration differed significantly among the two cohorts after correction for multiple comparison. However, on multivariable logistic regression analysis, a model incorporating LDH, NL ratio, pro-brain natriuretic peptide levels (ProBNP) and PFR best predicted mortality (Fig. 1). A nomogram was also created to estimate probability of mortality using the model parameters. Conclusions: LDH, ProBNP, NL ratio and PFR at Tocilizumab administration are independently associated with mortality. A model incorporating the combination of these parameters at admission can predict mortality among patients with severe COVID-19 pneumonia with good accuracy. (Figure Presented).
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Introduction: COVID 19 caused by the virus SARS-CoV-2 wasdeclared as a global pandemic by World Health Organization.Alterations in various hematological parameters have been recentlydocumented in the world literature in SARS-Cov-2 infection.As noeffective treatment is known, prediction of disease severity is veryimportant in order to estimate a patients outcome.Aims &Objectives: There is paucity of hematological data in thesepatients. Hence this study is an attempt to evaluate the pattern of thehematological parameters in COVID-19 patients in the Indian population. We present an observational retrospective analysis of D-dimer,neutrophil-lymphocyte ratio and newer CBC parameters in 102Covid-19 patients in a tertiary care hospital and its correlation withdisease severity.Materials &Methods: Records of 102 patients who presented to thehospital between May 2020 to December 2020 with a confirmeddiagnosis of COVID-19 were retrospectively analysed. COVID-19positivity was confirmed based on RT-PCR in all patients. CBC wasrun on the Sysmex XN 2000 and d-dimer was estimated byimmunometric assay with a reference range of 0-0.35 mg/L (Instrument-Nephle plus one).The patients were divided into mild/moderate, severe and the nonsurvivor outcome groups according to the MoHFW, India guidelines.Comparisons of the four groups were performed using Kruskall Qallistest for continuous variables and Chi square test, Fisher's exact test asappropriate for categorical variables.Result: 102 patients were studied retrospectively from May 2020 toDecember 2020.The patients age ranged from 28 to 88 years of which26 female and 75 males. Neutrophil/lymphocyte ratio was found to bestatistically significant at admission and outcome in the severe (median-16.62) and non-survivor group (median-16.52) and correlatedwith the high D-dimer values. The D-dimer values of the 4 groups onadmission and outcome was compared and was significantly higher inpatients belonging to the severe (median-2.81) as compared to themild/moderate (median-0.92) group of patients (P value <0.00001).Conclusions: Hematological parameters appear to be good predictorof severity of the Covid 19 infection and can be used in addition to theclinical findings for monitoring of these patients in our Indianpopulation.
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Purpose : Inherited Retinal Diseases (IRDs) are a group of rare genetic disorders that require a detailed approach and workflow for diagnosis. To facilitate optimal patient care while minimizing the hazard of direct person-to-person exposure during the COVID-19 pandemic, we developed a telehealth management protocol, or telegenetics, for complete or hybrid virtual visits. Methods : Our telegenetics protocol comprised of three key components: (1) Digitization of diagnostic imaging and electrophysiological testing for review by physicians remotely;(2) Telemedicine video visits performed using MyHealth, a Health Insurance Portability and Accountability Act (HIPAA) compliant platform. (3) Complete shift to remote genetic testing using IRB-approved e-consents (electronic consent forms) and remote genetic testing saliva kits. Results : Telegenetic care was provided for 113 patients, including 3 international patients (age range: 5-99 years). During the first eight months of this program, 25 return and 28 new patient evaluations were completed virtually. Sixty patients were seen in a hybrid manner (45 new and 15 return), where an in-person clinic visit was performed followed by remote consenting, and saliva collection, genetic testing, and genetic counseling. A spectrum of retinal dystrophies were diagnosed and pathogenic mutations were detected in several genes, including genes approved or under-investigation for gene therapy like RPE65, CHM, and RPGR. Four patients with cystoid macular edema were successfully treated with topical dorzolamide, and 26 were referred for low-vision rehabilitation Conclusions : Telegenetic services have proved to be a useful tool during the COVID pandemic. They provide a safer alternative by limiting the exposure of patients and staff to the virus while maintaining the same high quality of care that was provided to patients before the pandemic. With the added efficiency and convenience of virtual patient care, we expect that telegenetics will continue and expand into other medical genetic conditions long after the pandemic.
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Purpose: The purpose of this study is to highlight the changes incorporated in the Human Resource Management and Compensation strategies owing to the COVID-19 pandemic across the IT and ITeS firms operating in India. Design/Methodology/Approach: This study intends to conduct exploratory research through secondary data and thereby purposive sampling of HR professionals to gather data through primary sources and secondary sources to try to understand the changes that their firms have incorporated. The study was carried out basis the four most widely used strategies across all industries i.e., Layoffs, Salary Cuts, Hiring Freezes, and Pay Hikes. Findings: We see that diverse strategies were incorporated by the firms in their efforts to combat the economic repercussions caused by the pandemic, keeping in mind the financial strength of the company, employee morale, future business outlook, and employer branding. Practical implications: The results of this study help us understand the current industry practices, significant trends, and also help us benchmark these practices against standard industry practices. Originality/value: The study specifically highlights the changes incorporated in the IT & ITeS sectors and creates a distinction between the incorporation of these practices based on the firm size, classified on the parameters of the employee count, and the number of businesses they operate in.
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Aims & Objectives: The beginning of 2020 shook the world with the onset of a pandemic caused by SARS-coronavirus disease 2019 (COVID-19). As the disease outcome data from various parts of the world unfolded, disturbances in the pathways of coagulation emerged as a major cause of morbidity and mortality and reports of utility of d-dimer as a prognostic marker emerged. We present an observational retrospective analysis of value of d-dimer in 496 Covid-19 patients in a tertiary care hospital and its correlation with disease severity. Patients/Materials & Methods: Records of 496 patients who presented to the hospital between May 2020 to September 2020 with a confirmed diagnosis of COVID-19 were retrospectively analysed. COVID-19 positivity was confirmed based on RT-PCR in all patients and d-dimer was estimated by immunometric assay with a reference range of 0-0.35 mg/L (Instrument -Nephle plus one). The patients were divided into mild/moderate, severe and the non-survivor outcome groups according to the MoHFW, India guidelines. The Kruskal-Wallis one-way ANOVA was used to evaluate the statistical significance of the D-dimer values at admission and outcome in the various groups. ROC curves were derived to estimate cut off value of d-dimer to differentiate between outcome groups. Results: 496 patients were studied retrospectively from May 2020 to September 2020.The patients age ranged from 19 to 91 years of which 157 female and 340 males. The D-dimer values of the 3 groups on admission and outcome was compared and was significantly higher in patients belonging to the severe(2.64 + 3.39) as compared to the mild/moderate (1.05 + 1.68) group of patients (p value<0.00001).The p value for the D-dimer levels at admission and outcome for the non-survivor group were significant by the Wilcoxon signed rank test. ROC curves showed a high accuracy of the D-dimer to discriminate between the survivor and the non-survivor group at outcome (cut off>2.16 D-DU mg/l, Se = 82.05, Sp = 80.42, AUC = 0.88). The ROC curve with a cut off of> 1.31(Se = 58,Sp = 81,AUC = 0.72) at discharge between the mild/moderate and severe group was obtained. Discussion & Conclusion: Elevated D-dimer appears to be good predictor of severity of the Covid 19 infection and in addition can be used for monitoring of these patients.
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The sudden spread of COVID-19 across the globe during 2020 severely impacted efficient use of inputs for production in all the sectors in most of the developing countries including India. This paper tries to evaluate technical efficiency of paddy producers by applying the model of stochastic frontier analysis (SFA) under time invariant fixed effect application. To measure the level of technical inefficiency of farmers with family and hired labour with the help of primary data collected from 200 farmers in a field survey in the state of Haryana. Maximum likelihood estimator (MLE) was deployed to estimate the model of production under the assumption of Cobb-Douglas model of production function with stochastic frontier analysis for the variables affecting the technical efficiency. Results show that the important variables that impact the technical efficiency are the cost of labour, seed, fertilizers, machine labour and irrigation charges. Average technical efficiency of the surveyed paddy farmers that used both family and hired labour are 0.73 (73 per cent) and 0.69 (69 per cent) during COVID-19 and before Covid-19 respectively. Farmers have enhanced their level of technical efficiency during COVID-19 by optimally utilizing family labour. This shows that the small agricultural land holders can reduce the level of input requirement by 41 percent for giving the same level of output if their cultivation practices are technically more efficient. © 2020 DAV College. All rights reserved.