A Cross Sectional Survey on Self-Medication Practices during the COVID-19 Pandemic among the General Population in India

Background: Self-medication(SM) trend has been reported to have increased worldwide due to a surge in the internet usage particularly during and after the pandemic. This global trend has posed a great challenge for clinical practice more so as there was a rise in the availability of new and repurposed pharmaceuticals. Objective: 1) To assess the prevalence and pattern of SM during covid-19 pandemic among the general population. 2) To determine demographic variables and adverse events associated with SM. 3) To evaluate the drugs commonly used. Materials and Methods: This pre-validated questionnaire-based cross-sectional survey was conducted between July 2021 to September 2021 on 400 subjects of the general population. The categorical variables were represented using frequencies and percentages. The chi-squares test used to see the statistical significant level and binary logistic regression were performed to determine the probable factors associated with SM practice. Results: The study showed a prevalence of self-medication as 83% during Covid-19. There was also a significant increase in self-medication practice during the COVID-19 pandemic due to anxiousness (68.7%) among respondents. According to our results, 93% of respondents had heard about SM through pharmacist, the media, family, friends. Most commonly used drug was paracetamol primarily used for fever (76.2%).2.7% of respondents reported adverse events. SM practices were more among the females and employed individuals. Conclusion: The study revealed the there was increase in the practice of SM during Covid time which was due to panic and anxiousness driven by wide media coverage on COVID 19, lockdown, restricted availability of medicines. This study has shown that there is a need for continued awareness and education about the risks of Self-medication.

P09.48 Experience and Outcome of COVID-19-Positive Lung Cancer Patients from a Eastern Indian Hospital

Introduction: The COVID-19 pandemic has caused unprecedented crisis in the care of non-Covid patients all across the globe and care for lung cancer patients is no exception. Lung Cancer patients are at increased risks of COVID due to increased mortality from dual aggressive pathology in the lungs. Our aim was to examine the impact of COVID-19 on lung cancer therapy and factors responsible delay in optimal care during the pandemic. Methods: This study included all patients with a diagnosis of lung cancer being treated at our Institute, a tertiary level referral hospital in eastern part of India during on going pandemic. Seven developed COVID-19, confirmed by RT-PCR method (Table 1). Results: The mean age of the patients was 49 years. All the patients had metastatic lung cancer. All males had history of smoking. Hypertension was present in only one patient. Four patients (57%) died from concomitant COVID-19 at our institution.Three patients who recovered from COVID were stable. One of them (positive for ROS1) was switched over to Crizotinib and other patient resumed chemotherapy only after he had recovered from COVID-19. Most of the patients acquired COVID-19 infection during the process of evaluatio/chemotherapy and that further delayed the treatment. [Formula presented] Conclusion: The results were disappointing because more than half of lung cancer patients died due to COVID-19. The disease course of COVID-19 has been more severe in patients with lung cancers with Chemotherapy. There have been delay in resuming treatment among survivors by few weeks. Fear of aggressiveness of disease was the key factor for interruption or delay in chemotherapy. Other variable factors like stage of cancer, palliative intent of chemotherapy, ECOG status were key determinants for interruption of treatment. The decision to temporarily suspend chemotherapy while waiting for recovery from SARS-CoV-2 and then restart, was not easy due to the risk of cancer progression. The findings amplify the importance of optimizing of lung cancer care in the context of the COVID-19 prevalence. The decisions need to be taken on the basis of individual cases rather than rely on a generalized approach. In resource limited country like India diverting the existing resources to an emergency leads to compromise of routine outpatient care, especially patients with chronic illness. We need to be flexible in restarting of services guided by local COVID prevalence, while awaiting a definite management plan for COVID-19. Keywords: lung cancer, India, COVID-19, SARS-CoV-2

P88.03 Asymptomatic COVID-19 in a ROS1 positive Non Small Cell Lung Cancer

Introduction: COVID-19 pandemic has led to reconsider the traditional management approach in lung cancer. Oral tyrosine kinase inhibitors (TKIs) are being preferred in oncogene addicted advanced non-Small Cell Lung Cancer. Methods: A young never-smoker woman presented with left hilar mass with left pleural effusion in February 2020. There was an incidental detection of thrombus in right main and descending pulmonary artery. She was diagnosed to have ROS1 rearranged advanced NSCLC with pulmonary embolism. She was initiated on conventional chemotherapy with carboplatin and pemetrexed along with anticoagulation. After fourth cycle of chemotherapy, although there was clinical improvement attributed to reduction of amount of effusion and disappearance thrombus, RECIST 1.1 criteria suggested the progression of disease in view of appearance of adrenal metastasis. Meanwhile, she had a history of high risk exposure with a patient of COVID- 19 in July 2020. Although she was asymptomatic, RT- PCR for SARS-COV2 came out to be positive. Results: She remained asymptomatic for next 10 days during hospitalization. Then she was started on Crizotinib and was discharged with advice on further follow up. Conclusion: Although patients on cancer chemotherapy are at high risk of severe COVID-19 diseases, asymptomatic cases can happen. The patients preferably should be shifted to or started on oral TKIs as per available expert recommendations. Keywords: ROS1, COVID-19, TKI

Diagnostic algorithm of covid 19 screening and testing - A review

Covid 19 is a fast spreading pandemic which is threatening the world now. It is an invisible enemy against which the whole world is fighting. The virus is a protein enveloped with fat molecules. It has spike proteins on the envelope. These spike proteins are mainly responsible for causing the disease. The virus mostly causes respiratory problems like breathlessness, associated with cold and cough along with intermittent fever. They mainly affect elderly people with low immunity and people with medical conditions like cardiovascular diseases, diabetes, hypertension and other medical conditions. They pose greater risk of infection. It is very important to diagnose and test people to detect the presence of infection. In this way, it can help us to stop the spread of infection and also provide appropriate treatment at the exact time to patients. Covid 19 has created a major impact on laboratories for several months due to the outbreak and the need for testing to detect the presence of the pathogen. There are many techniques to diagnose covid 19 such as the PCR technique which is very specific as they determine target genes. We also have antigen and antibody tests which are useful in diagnosis but they also face disadvantages like time to produce antibodies and antigens from escaping the antibodies. The serological testing is specific as they determine the level of certain enzymes like the liver enzymes gamma glutamyl transferase and other enzymes (Kadiyala and Savitha 2018, Preetha and Others 2016). The basic level of covid diagnosis is the thermal screening test which normally takes place in airports and railway stations. They identify people which is the most important and basic level. Sometimes they may not be reliable which serves as a disadvantage. In the preanalytical stage of diagnosis, proper respiratory tract specimens have to be collected from the right anatomical site of our human body to arrive at a proper diagnosis. Appropriate training is essential for the technicians so that they can produce reliable test results. In the analytic stage, real time reverse transcription-PCR (RT-PCR) assays were considered as the choice of test for diagnosis. In the post analytical stage, testing results should be carefully interpreted using molecular and serological findings.

Awareness of infection control from ncovid-19 a survey among denture wearers

Background: Complete denture is prosthesis to replace the lost tooth structures and restore aesthetics and function. COVID-19 is a spreading pandemic. COVID-19 mostly affects the people in the elderly age group who have less immunity power according to previous research conducted. So it leads to more risk among those people. Aim: This survey is conducted to know the awareness level among older people regarding COVID-19. This tests their knowledge of infection control of COVID-19 and the hygiene measures they follow to disinfect the dentures. Material and Method: Validated questionnaires were prepared and circulated among the patients via social media. Their responses were collected in Google forms. The responses were collected. It depicts if they follow proper oral hygiene like mouthwash usage, hand hygiene while handling dentures. If they had any medical conditions and were aware of how it could affect them in lack of infection control. Result: Nearly half of our population was aware of the infection control methods. But still, some of them have to be made aware of the infection control. © IJCRR.

Pros and cons on the measures taken by the indian government to curb the menace of Covid 19 - a review

Aim: This review gives an overview on the pros and cons of the measures taken by the Indian government and also its impact on the public health and economy. Materials and methods: The review is done by collecting and analyzing the articles from pubmed, google scholar and other government websites and were analysed. Period of the article retrieval ranges from Jan to May 2020 with proper inclusions and exclusions on the articles towards the data. Results: When the articles were analysed pros outweigh the cons of the measures and had severe impact in the control and spread of Covid 19. Social distancing and lock-down measures were such measures taken with significant reduction in the covid 19 transmission. But they also resulted in certain specific adverse effects like disruption in the supply of basic amenities, fall of economy and unemployment. Conclusion: We conclude that the public must strictly abide by the government measures since it has resulted in certain unforeseen events, albeit, advantageous results too. Together with the public support, the menace of covid-19 can be put to an end. © 2020 Ubiquity Press. All rights reserved.