Impact of Ayush Alternative Medicine Interventions in the COVID-19 Pandemic

The five Indian systems of alternative and complementary medicine (Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy) are frequently used to treat "COVID-19" throughout the country (referred to simply as "AYUSH"). At the outset of the pandemic, "The Ministry of AYUSH" (the governing authority of the Indian system of medicine) issued recommendations for the use of particular herbs and acts to improve immunity, based on the advice of an advisory council of "AYUSH" doctors and scant evidence. Some of these suggestions involved using traditional herbs and practices, which have been used for centuries and are effective in treating a wide range of conditions, including fever, sore throat, and breathing difficulties, as well as acting as a non-specific leniency enhancer thanks to their anti-viral, anti-bacterial, and anti-microbial properties. A number of the formulations recommended here-including AYUSH 64, Chyawanprash, Guduchi Ghanavati, Arsenic Album, Kabasur Kudineer, and Nilavembu Kudineer-have been the subject of scientific research into their putative prophylactic or therapeutic benefits.

Shaping OTT Movie Consumption through Immersive Cinema: A Qualitative Investigation of Consumer Perspectives

Due to the COVID-19 pandemic, the entertainment sector saw a worldwide disruption with restrictions on outdoor activities. Consequently, consumers turned towards video and music streaming services for their entertainment consumption. Several film studios have taken the digital release route on over-the-top (OTT) sites to avoid revenue losses and indefinite delays. However, these non-theatrical OTT film releases need to experiment with different strategies to bring the experiences to par with theatrical ones. This exploratory study aims to provide insights on whether Immersive Cinema can be used to imitate the physical world through digital simulation on OTT platforms to gain credibility in a competitive entertainment market. We conducted semi-structured, qualitative interviews with 21 consumers and Focus Group Discussions with 14 MBA students to understand perspectives about Immersive Cinema consumption on OTT platforms and its potential when compared to traditional theatrical releases. Using the findings of this study, OTT platforms can curate their new films as a direct alternative to theatrical releases. © 2022 MDI.

Teleconsultation: An importatnt tool leading to a paradigm shift in the management of maintenance phase chemotherapy of acute lymphoblastic leukemia

Background: The COVID-19 pandemic severely impacted patients with acute lymphoblastic leukemia(ALL) in maintenance phase of chemotherapy. Teleconsultation was introduced to ensure continuity of care for these patients during the lock-down phase of the pandemic and was continued well after its end. Hence, we decided to analyze the impact of teleconsultation in a cohort of ALL patients. Method(s): Our study was a single-centre retrospective analysis of patients with ALL on maintenance chemotherapy. Thirty-five patients records were analyzed, comparison was made between absolute neutrophil counts (ANC) and frequency of consultations before and after the start of teleconsultation, which included 2-weekly phone calls, necessitating visit only once in 3 months as opposed to a monthly visit as required before. Hemograms were done twice a month and sent on WhatsApp. Consultations were done via phone calls and prescriptions sent via WhatsApp. Result(s): The median [IQR] age of our cohort was 7.5 [4.2;9.3] years and age at diagnosis was 5.4 [2.3;7.5] years;23/35 (66%) were male and 30/35 (88%) were phenotypically B-ALL;rest T-ALL/Lymphoma. All patients received chemotherapy as per the ICiCLE (Indian Collaborative Childhood Leukaemia group) protocol. A total of 437 teleconsultations were done (73/month). Before teleconsultation, the mean (SD) ANC was 2272 (644)//microL, and after teleconsultation it was 1754 (461)/microL (p value=0.0001). Teleconsultation improved target ANC (<2000/microL) attainment in our cohort of patients (31% vs 80%, p value=0.0002). Prior to teleconsultation, majority (27/35, 77%) visited the hospital once a month which reduced to once in 3 months, after teleconsultation. Conclusion(s): Teleconsultation is time saving, economical and reduces the gap in schooling in a child with ALL. It also helps optimize compliance during this maintenance phase of chemotherapy, a key in management of leukemia patients, contributing to the continuum of care and improvement in overall survival of these patients. Copyright © 2022

Opportunities to prevent and manage undernutrition to amplify efforts to end TB.

The bidirectional relationship between TB and nutrition is well recognized - primary undernutrition is a risk factor for developing TB disease, while TB results in wasting. Although nutrition support is acknowledged as an important intervention in TB programmes, it is seldom afforded commensurate priority for action. TB incidence and deaths worldwide are falling too slowly to meet WHO End TB Strategy milestones, and the number of undernourished people is increasing, likely to be further exacerbated by the ongoing COVID-19 pandemic. Undernutrition needs to be more urgently and intensively addressed. This is especially true for the WHO South-East Asia Region, where the high rates of undernutrition are a key driver of the TB epidemic. The evidence base has been sufficiently robust for clear and workable programmatic guidance to be formulated on assessment, counselling and interventions for TB patients. Many high-burden countries have developed policies addressing TB and nutrition. Gaps in research to date have frustrated the development of more refined programmatic approaches related to addressing TB and malnutrition. Future research can be shaped to inform targeted, actionable policies and programmes delivering dual benefits in terms of undernutrition and TB. There are clear opportunities for policy-makers to amplify efforts to end TB by addressing undernutrition.

Urgent need to address the slow scale-up of TB preventive treatment in the WHO South-East Asia Region.

In September 2018, all countries made a commitment at the first ever United Nations High-Level Meeting (UNHLM) on TB, to provide TB preventive treatment (TPT) to at least 30 million people at high-risk of TB disease between 2018 and 2022. In the WHO South-East Asia Region (SEA Region), which accounts for 44% of the global TB burden, only 1.2 million high-risk individuals (household contacts and people living with HIV) were provided TPT (11% of the 10.8 million regional UNHLM TPT target) in 2018 and 2019. By 2020, almost all 11 countries of the SEA Region had revised their policies on TPT target groups and criteria to assess TPT eligibility, and had adopted at least one shorter TPT regimen recommended in the latest WHO TPT guidelines. The major challenges for TPT scale-up in the SEA Region are resource shortages, knowledge and service delivery/uptake gaps among providers and service recipients, and the lack of adequate quantities of rifapentine for use in shorter TPT regimens. There are several regional opportunities to address these gaps and countries of the SEA Region must make use of these opportunities to scale up TPT services rapidly to reduce the TB burden in the SEA Region.

The impact of oral health status on covid-19 severity, recovery period and c-reactive protein values

Background: The mouth cavity can serve as source for respiratory viruses, putting patients at risk of superinfection. Poor oral hygiene has been linked to hyper-inflammation in several studies. COVID-19 severity has also been connected to increased inflammatory responses. As a result, we hypothesised in this study that greater COVID-19 severity could be connected to poor dental health. This was accomplished by evaluating dental health, COVID-19 symptom severity, C-reactive protein (CRP) levels, and recovery time. Methods and Materials: After meeting the study's exclusion criteria, 419 patients with confirmed positive polymerase chain reaction (PCR) tests were enrolled in the study. The questionnaire was divided into two components, the first of which assessed oral health and the second of which assessed COVID-19 severity. An oral health score was used to assess the impact of dental health on COVID-19 severity. As a secondary outcome, the impact of dental health on CRP and recovery time was assessed. The questionnaire was used to obtain data on CRP levels and COVID-19 PCR testing, which were then verified by consulting medical records. Results: There was a significant inverse connection between oral health and COVID-19 severity (p0.001, r = -0.512). Furthermore, there was a strong inverse association between oral health and recovery period and CRP values (p 0.001, -0.449 and p 0.001, -0.190, respectively), indicating that poor dental health was linked to higher CRP levels and a longer recovery period. Conclusion: Our findings suggest that oral health may have a role in the severity of COVID-19. The study design, however, limits the correlation. To explore this relationship, a larger study endeavour is required.

The spreading of covid-19 in India and its impact: A mathematical analysis

The rapid spreading of the coronavirus in India and its behaviour for the near future has been studied and analysed as accurately as possible using the SEIR model as a fundamental tool. The official covid-19 data of infected and death cases in India upto 10th October, 2020 have been considered as raw data. The value of various parameters of the model is optimised by feeding the raw data in the simulation model. The various parameters are defined as infection rate, basic reproduction number, death rate, recovery time, exposure time, and other parameters to optimise the best fit model. The total population of India is considered 1.36 billion people. The simulation results that the number of recovered people will be 2.8 × 108 and number of deaths will be 4.2 × 106 after 800 days for the total population of India. In an ideal scenario, at the end of the pandemic total death count is expected to be of the order of 106 which is a big challenge.

Effect of covid-19 on hematological services

Aims & Objectives: To study the effect of COVID 19 on different hematological services. Patients/Materials & Methods: This observational study included 18 patients evaluated from June 2020 till September 2020 belonging to various age groups with a WHO defined hematological disease with laboratory-confirmed and symptomatic COVID-19. The primary outcome was mortality and evaluation of COVID-19 severity in different hematological diseases assessed on day 14 and 28. Patient characteristics, type of disease, symptomatology, HRCT findings and baseline qCRP levels were recorded and the need for oxygenation or in vasiveventilation with administration of various drugs and convalescent plasma and its consecutive effect in delay or nonadministration of chemotherapyevaluated. Results: A total of 140 hematology patients were admitted of which 18 patients (12.85%) were COVID-19 positive. 10 cases (55.55%) were of B cell Acutelymphoblasticleukemia (B-ALL), 3(16.66%) of acutemyeloidleukemia (AML) and 1 (5.55%) each of acute promyelocytic leukemia (APL), T cell acute lymphoblastic leukemia (TALL), T-Lymphoblastic lymphoma (T-LBL), Hodgkins lymphomaandaplasticanaemia. Majority of patients had mild COVID-19 infection (72.22%, n = 13), 4 cases (22.22%) were severely affected and 1 moderately affected. There was delay in administration in chemotherapy in 14 cases(77.77%), while 3 patients continued to receive chemotherapy during the viralillness. Survival at day 14 and 28 in B-ALL was 100%, survival in AML on day 14 and day 28 was 66.6%, survivalin T-ALL on day 14 was 100% and 0% on day 28, survivalin APL and T-LBL on day 14 was0%, survivalin Hodgkinslymphomaandaplasticanemia on day 14 and day 28 was 100%. Discussion & Conclusion: The results indicate that 12.85% cases were COVID-19 positive. 72.22% had mild COVID-19 infection and 22.22% had severe COVID-19 infection. The most common affected was B-ALL (55.55%). In 77.77% cases there was delay in administration of chemotherapy.

A reconstructive model for identifying the global spread in a pandemic

With existing tracing mechanisms, we can quickly identify potentially infected people with a virus by choosing everyone who has come in contact with an infected person. In the presence of abundant resources, that is the most sure-fire way to contain the viral spread. In the case of a new virus, the methods for testing and resources may not be readily available in ample quantity. We propose a method to determine the highly susceptible persons such that under limited testing capacity, we can identify the spread of the virus in a community. We determine highly suspected persons (represented as nodes in a graph) by choosing paths between the infected nodes in an underlying contact graph (acquired from location data). We vary parameters such as the infection multiplier, false positive ratio, and false negative ratio. We show the relationship between the parameters with the test positivity ratio (the number of infected nodes to the number of suspected nodes). We observe that our algorithm is robust enough to handle different infection multipliers and false results while producing suspected nodes. We show that the suspected nodes identified by the algorithm result in a high test positivity ratio compared to the real world. Based on the availability of the test kits, we can run our algorithm several times to get more suspected nodes. We also show that our algorithm takes a finite number of iterations to determine all the suspected nodes. © Springer Nature Switzerland AG 2021.