Psychosocial Determinants of Covid Vaccine Hesitancy And Stage of Motivation In Lactating Women

Background: The Government of India recommends pregnant and lactating women to get vaccinated against the Novel Coronavirus Disease 2019 (COVID-19). However, vaccine hesitancy in this population adversely affects the uptake of vaccination. There is an urgent need for assessing extent of vaccine hesitancy in this group and study its determinants, motivation stages and barriers. Objective(s): To determine psychosocial Factors affecting uptake of COVID-19 Vaccination in lactating women and their attitude towards infant vaccination in general and stage of motivation for vaccination. Method(s): A cross-sectional analysis survey was conducted amongst 80 women visiting postnatal OPD or immunization clinic of a tertiary care hospital of Delhi using Oxford COVID-19 vaccine hesitancy scale (OC19-VHS) and participants were classified as hesitant, non-hesitant, and unsure. Result(s): We enrolled 80 postnatal women with mean age of 25.3 ((SD, 9.6) years. The vaccine hesitancy rate was 44% acceptance rate in the participants. Regression analysis showed young age group (20-45 years), low socioeconomic status and no past history of COVID infection were factors independently associated with Vaccine hesitancy. Doubts on vaccine safety and concerns about its impact on lactation were primary barriers affecting vaccine uptake. Amongst participants in vaccine hesitancy group only 40% had got their children completely vaccinated for age. Conclusion(s): Nearly 40% lactating women visiting hospital had vaccine hesitancy and concern for its impact on lactation and vaccine safety were the primary determinants for reduced vaccine uptake in lactating women.

FinTech Lending

In this article, we review the growing literature on financial technology (FinTech) lending - the provision of credit facilitated by technology that improves the customer-lender interaction or used in lenders screening and monitoring of borrowers. FinTech lending has grown rapidly, though in developed economies like the United States it still accounts for only a small share of total credit. An increase in convenience and speed appears to have been more central to FinTech lending's growth than improved screening or monitoring, though there is certainly potential for the latter, as is the case for increased financial inclusion. The COVID-19 pandemic has shown potential vulnerabilities of FinTech lenders, although in certain segments they have displayed rapid growth. © 2022 by Annual Reviews.

Osmotic Demyelinating Syndrome and COVID-19

Introduction: Osmotic demyelination syndrome (ODS) is a dreaded complication of rapid sodium correction in high-risk hyponatremic patients. Predisposing factors include chronic alcoholism, malnourishment, severe hyponatremia. SARS-Cov2 infection may also be a risk factor as it is linked with multiple patterns of brain injury, renal damage and hyponatremia. Case Description: Patient is a 48-year-old female with history of alcohol use disorder who presented with malaise, vomiting, diarrhea for 3 days. On admission, the patient was stuporous and confused. She was clinically hypovolemic. Initial labs demonstrated severe hyponatremia (102 mmol/L), hypokalemia (2.2 mmol/L), HCO3 of 35mmol/L, lactic acid of 4 mmol/L, no EtOH, preserved GFR. SARS-CoV2 PCR was positive. She was not hypoxic, her chest X-ray was clear. The patient was resuscitated with 1L of isotonic saline, potassium correction was attempted. Her bloodwork 4 hours later showed Na of 113 mmol/L and K of 2.4 mmol/L. At this point patient had prominent diuresis, UNa was 13mmol/L, Uosm 175mOsm/kg and U spec gravity 1.006. Immediately DDAVP and D5W were started. She had a poor response to this therapy and her sodium continued raising even at maximal doses. At 24h her sodium was 118 mmol/L and at 48h it was 125mmol/L with stabilization at this level. She had clinical improvement and was more responsive on day 3. On the following days, sodium gradually drifted toward 132 mmol/L. On day 5 she developing worsening mental status. She was found poorly responsive with fixed gaze, aphasia, minimally removing extremities from pain, able to blink when asked. Brain MRI revealed signal abnormalities in the central pons, bilateral thalami, caudate, basal ganglia, subinsular regions consistent with ODS. Intensive treatment was restarted with D5W and DDAVP. Na of 124mmol/L was achieved at 24h. Over the course of the following days, she had partial recovery. She was discharged to rehab, able to smile, move her head and partially move her extremities. Discussion(s): SARS-Cov2 causes hyponatremia through several mechanisms. Poor oral intake, gastrointestinal loses, kidney injury and SIADH have been described. All of them may occur at the same time and cause hypovolemic/euvolemic states with high ADH. Volume replacement rapidly shuts off the ADH drive predisposing patients to get sodium overcorrection.

FinTech Lending

In this article, we review the growing literature on financial technology (FinTech) lending-the provision of credit facilitated by technology that improves the customer-lender interaction or used in lenders' screening and monitoring of borrowers. FinTech lending has grown rapidly, though in developed economies like the United States it still accounts for only a small share of total credit. An increase in convenience and speed appears to have been more central to FinTech lending's growth than improved screening or monitoring, though there is certainly potential for the latter, as is the case for increased financial inclusion. The COVID-19 pandemic has shown potential vulnerabilities of FinTech lenders, although in certain segments they have displayed rapid growth.

COVID-19 Pandemic Effect on Psychological Status and Perception towards the Medical Profession among Haryana’s First Year MBBS Students: A Cross-sectional Study

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has emerged as a major health crisis throughout the world. In order to control the spread of disease in India, the Central Government imposed a nationwide lockdown. The ongoing spread of the pandemic, strict lockdown measures and delay in the opening of educational institutions in the country are expected to affect the mental health of medical college students too. In order to help and guide the students, we should first be aware of the magnitude of the problem faced by medical students due to the pandemic. For this purpose, this study was conducted online. Aim: To assess the effect of the pandemic on the psychological status of the students and their perception towards medical profession. Materials and Methods: A cross-sectional study was conducted by the Department of Biochemistry of Kalpana Chawla Government Medical College, Haryana, India from 22nd May 2020 to 5th June 2020, among 538 first year Bachelor of Medicine, Bachelor of Surgery (MBBS) students from several Government and Government aided medical schools in the state of Haryana after obtaining ethical clearance. The detailed questionnaire, a study consisting of sections on the current status in relation to the COVID-19 pandemic, perception towards medical profession and psychological status. It was posted online on social media platforms and the responses were collected within 15 days of posting. The psychological status was assessed based on a 21 item Depression, Anxiety, and Stress Scale (DASS-21). Statistical analysis was done by Chi-square test, using Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: Out of 538 student’s responses, it shows that 19.1% (n=103) of students experienced moderate stress, probably because of the COVID-19 outbreak and the effect it had on the social and academic aspects of their lives. About 11.5% (n=62) of students had a moderate level of anxiety, and 16.9% (n=91) had experienced moderate depression during the ongoing pandemic. Conclusion: The study demonstrates various factors, like interruptions in regular studies, social distancing, fear of infection, fear of losing a loved one, and worry about the completion of the syllabus and examinations, all cause stress and anxiety in students.

Clinicopathological profile of thrombocytopenia in a tertiary care center in Himachal Pradesh

Introduction: Thrombocytopenia is a common condition seen in clinical practice. A wide range of etiologies and variation in clinical presentation often pose a challenge in its diagnosis. Early recognition of thrombocytopenia and its causes can avoid critical bleeding. Aim: This study aimed to assess etiology and clinicopathological profile of thrombocytopenia in a tertiary care center. Materials and methods: Of all patients whose blood samples were received for complete blood count analysis, 500 patients with thrombocytopenia were included. Blood samples were run in Sysmex XP-100 and PCi 20 fully automated, three-part differential hematology analyzers. Leishman-stained peripheral blood smears were also studied. Results: Mild thrombocytopenia (platelet count 60,000-1,50,000/μl) was seen in majority (84.8%) of the patients followed by moderate thrombocytopenia (platelet count 20,000-60,000/μl) in 10.8% and severe thrombocytopenia (platelet count <20,000/μl) in 4.4% of the patients The most common cause of thrombocytopenia was found to be infections (50% patients) followed by chronic liver disease (14.8% patients), macrothrombocytopenia (10.6% patients), hematological disorders (8.6% patients), gestational thrombocytopenia (7.8% patients), drug intake (4.4% patients) and chronic kidney disease (1.8% patients). Among infections, acute febrile illness (nonspecific) was the most (23.2%) common cause followed by COVID 19 infection (19.4%) and bacterial sepsis (5.4% patients). Four distinct patterns of platelet histogram in patients with thrombocytopenia were seen. Conclusion: Similar to most previous studies, infections were the most common cause of thrombocytopenia in the present study. The present study also highlights two novel entities- suspected asymptomatic macrothrombocytopenia and Covid-19 infection.

Disaster Management Using Recent Technologies During COVID-19

As we came across in earlier chapters, during the time of worldwide lockdown, various sectors like industry, healthcare, and agriculture are facing a lot of difficulty in meeting the basic needs of the people due to issues identified in supply chain management. Apart from addressing the discussed problems, governments have various other issues to address, such as enforcing the proper lockdown among the people;providing the citizens with basic necessities like food, groceries, and vegetables, from the retailers;enforcing and monitoring law and order during the lockdown period pertaining to areas like transportation, markets, shops, public gatherings, and medical facilities;and identification and treatment of people suffering from coronavirus attack. Apart from these general issues, there were some other challenges faced that attracted attention such as blocking of false messages generated, related to COVID-19, etc. The chapter aims at addressing these issues using various technologies like drones for monitoring activity, AI technology for planning and prediction in order to curtail the growth rate of coronavirus infections using algorithms, etc. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.