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Introduction and aim. With the third wave of COVID-19 hitting the country, there is an urgent need to systematically document the clinical-epidemiological and vaccination details of the patients to formulate evidence-based decisions. So, this study was planned to describe the profile of patients attending the flu clinic of a tertiary care hospital in eastern India. Material and methods. This hospital-based cross-sectional study was done for 6 weeks (Jan-Feb 2022) among 623 patients using a pre-tested, structured questionnaire related to COVID-19. An unadjusted odds ratio was calculated and statistical significance was attributed to a p-value <0.05. Results. Out of 623 patients, almost 90% of the patients were vaccinated against COVID-19 with at least one dose of any vaccine. Cough (57.8%) was the most common complaint. Patients aged > 60 years and those having one or more than one comorbidity suffered from moderate-severe COVID-19 infection when compared to their counterparts (p<0.001). Also, 2.1% of fully vaccinated, 3.8% of one dose vaccinated and 10.9% of unvaccinated patients suffered from moderate-severe COVID-19. Conclusion. During the third wave of the COVID-19 pandemic, a smaller number of elderlies compared to the previous two waves were affected indicating age shifting. The severity of COVID-19 was less among vaccinated individuals compared to unvaccinated highlighting the importance of COVID-19 vaccination. © 2022 Universidad Nacional de Colombia, , Department of Linguistics. All rights reserved.
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Introduction: The hematological spectrum of Covid 19 varies from a prothrombotic state to bleeding diathesis. Thrombocytopenia in COVID infection is reported to a poor prognostic marker. As it is multifactorial with variable presentation, critical treatment decisions are challenging and individually tailored. Aims & Objectives: To study COVID 19 induced thrombocytopenia and their response to Intravenous Immunoglobulin. Material(s) and Method(s): Prospective observational study. All covid positive patients presenting with thrombocytopenia (<50,000> The data regarding bleeding symptoms, comorbidities, CBC, peripheral smear, coagulation profile, viral markers, LDH, CRP, S. Ferritin, RFT, LFT, Covid severity, treatment, response and follow up data was obtained from medical records and OPD visit records. Result(s): Total of 19 cases with a mean age of 50.6 years and M:F ratio of 0.9 were studied. Nadir platelet count was below 10,000/ul in 57.9 Conclusion(s): Thrombocytopenia in COVID can occur both in early and late phase. Close monitoring and timely intervention with IVIG in severe thrombocytopenia may be life saving. Severe thrombocytopenia during early active infection confers poor survival.
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Mucormycosis is a rare and devastating disease caused by a ubiquitous fungus that belongs to the class Zygomycetes and order Mucorales.It is an opportunistic fungal infection which is most commonly seen in immunocompromised patients.The pandemic coronavirus disease 2019 (COVID-19) continues to be a significant problem worldwide.SARS-COV-2 is a cytokine storm syndrome that causes severe immunosuppression that might compromise the host response and increase the risk to develop opportunistic infections. There are several cases which have shown occurrence of Mucormycosis in patients who have a history of COVID-19. Therefore this review will highlight about the fungal infection Mucormycosis and its relation with COVID 19 disease.
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Background: Community Medicine specialists play a crucial role in the prevention and control of communicable and non-communicable diseases, monitoring and surveillance, healthcare planning and management and research but the awareness about the speciality even among the medical fraternity is limited. Aim: To determine the perceptions of Medical Professionals from Tertiary care teaching institutes towards the specialty of community medicine and its specialists. Materials and Methods: This was a web based cross-sectional survey conducted in October- November, 2021 among Medical professionals of Tertiary Care Teaching Institutes in the state of Uttar Pradesh, North India using a semi structured, pretested questionnaire circulated as google forms using WhatsApp and personal email ids.
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After the COVID-19 spread in early 2020, China became a "benevolent" donor and accelerated its public diplomacy in South Asia. The Chinese donated medicines, ventilators and provided other forms of assistance. China has also ramped up the supply of vaccines to the South Asian countries. Initially, India also offered all forms of support to its neighbours;however, it was "forced" to pause supply after the country was devastated by the second wave of the pandemic between end of March and July 2021. This paper discusses China's foreign aid policy and diplomacy in South Asia, especially during the COVID-19 health crisis. © 2021 Institute of China and Asia-Pacific Studies - National Sun Yat-sen University. All rights reserved.
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Background: The role of BCG and MMR/Measles vaccination in reducing the burden of COVID-19 has been based on ecological data mostly. We planned this explorative pilot case-control study to under-stand the role of vaccination with Bacillus Calmette–Guerin (BCG) and measles administered as part of MMR vaccine on COVID 19. Methodology: A case-control study was conducted in AIIMS Patna during December 2020 and January 2021. A total of 100 COVID-19 patients confirmed by RT-PCR test were taken as cases, and for each case, age and gender-matched SARS-COV-2 negative individual was taken as control. A study tool containing a pre-tested semi-structured questionnaire was used. Results: The unadjusted odds of COVID-19 were found to be significantly higher among BCG vaccinated [1.88(1.03-4.4)] and MMR vaccinated individuals [5.06(2.34-10.90]. BCG vaccine was not found to have an independent effect on COVID-19 after adjusting for tobacco use, MMR vaccination status, unprotected contact with SARS-COV-2 positive patients, and co-morbidities. But Measles vaccine was found to inde-pendently increase the risk of COVID-19 [AOR: 4.505(1.8-11.3)]. Conclusion: BCG vaccination status was not found to be an independent predictor of COVID-19. Further studies with large sample size and better study design (cohort, randomized trials) need to be conducted. © 2022, MedSci Publications. All rights reserved.
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The study attempts to understand students' apprehensions, satisfaction, and experience concerning online hospitality and tourism education (HTE) during the COVID-19 pandemic. Focused group discussions were conducted to gather student experiences implementing ICT in hospitality and tourism education. The group discussions were recorded, transcribed, and analyzed in search of themes to identify and validate the constructs to develop the questionnaire for the study. The questionnaire was then presented before the subject experts to cross-check the validity of constructs. Importance-Performance Analysis (IPA) was used to determine students' satisfaction by comparing students' perceptions to students' expectations. The study's findings show the importance of practical classes and labs and on-site instructor comments on students' overall satisfaction. Online teaching can complement traditional classroom teaching but cannot fully replace lab sessions with instructor feedback. Transitioning to an online platform requires effective tools and curriculum modifications to fill the gap in industry expectations regarding student employability. Online teaching has immense capability, but it cannot be generalized and requires subject-specific attention and feedback. Online education needs to keep evolving alongside contemporary classroom teaching to meet student expectations. Future research would concentrate on communication, interpersonal, and technology skills and their effect on the study's results.
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COVID-19 pandemic has taught the world researchers the urgent need for new sources and novel pharmaceuticals not only for existing diseases but also for both seasonal epidemics and future pandemics. Pharmaceutical drug discoveries for the past fifty years depended deeply on the procedure of empirical transmission of a huge number of pure bioactive compounds to provide new leads. The screening of extracts or isolating compounds is a common way to discover novel biologically active molecules. Most of the valuable Blue-Green algal metabolites are concentrated in their biomass. For existence in nature, Blue-Green algae (BGA) secrete and contain various organic substances like proteins, fatty acids, vitamins, pigments, primary and secondary metabolites, and these compounds are explored for potential biological activities such as antibacterial, antifungal, antiviral (including the anti-SARS-CoV-2 virus that causes COVID-19), anticancer, antioxidant, antidiabetic, protease inhibitory activity, anti-inflammatory activity, etc. Due to their diverse application, pharmaceutical companies have shown commercial interest in the Blue-green algal group for the discovery and development of novel molecules to combat deadly diseases for the benefit of society and mankind. The current review paper highlights and discusses the diverse pharmaceutical potential of laboratory-grown cultures of BGA along with comprehensive and current knowledge on bioactive compounds discovered by researchers globally. © 2021, Editorial board of Journal of Experimental Biology and Agricultural Sciences. All rights reserved.
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Background: When the world is running away from everyone with possible COVID disease, healthcare staff wade their way towards such patients. Clad in a protective wear they follow all rules hoping not to carry the germs home. Despite taking all precautions during his shift, if a worker fails to doff the protective equipment properly, he carries significant risks of carrying the germs on his person. This study assesses this risk of self-contamination due to improper doffing of PPEs. Methods: An analytical study involving 154 healthcare staff was conducted. Colourless lotion which glows with a greenish fluorescent hue under uv light was applied on the PPEs to simulate germ contamination. Objectives were to note what percentage of workers have contamination on their person after improper doffing. Which portions of the health care worker gets maximally contaminated after doffing, and to assess infestation of which portion of the PPE causes maximum contamination. Results: 27.92% of healthcare workers were carrying germs on them simply because of improper doffing. Almost 15% of these workers had more than one area of contamination. Commonest areas on the body for carrying these germs were the arms (33%), clothing on the abdomen (24%), areas in the lower limb (23%). Germ infestation on the upper parts of a PPE is 2.39 times more likely to cause contamination after doffing, compared to lower suit area infestation. Conclusion: Improper doffing carries a significant risk of contaminating oneself. Risk of carrying germs home is more when the germs are nested in the upper portions of the suit. Proper and regular training regarding doffing, presence of a doffing mate and post doffing showers could reduce this risk.
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Background: The COVID-19 pandemic has created worldwide emergency with morbidities, mortality and panic. The BCG vaccine, usually given to prevent childhood tuberculosis, surfaced as an option as suggested by some ecological observations. However, some others studies could not establish and explain the protective effects of BCG vaccination against COVID-19 pandemic. India is one country with high BCG vaccination coverage and is among the countries with lowest COVID-19 case fatality rate. Aims and Objectives: We examine the relationship between the BCG coverage and COVID-19 burden in various states/UTs of India. Materials and methods: The information on BCG coverage and morbidity and mortality of COVID-19 was obtained from NFHS and www.covid19India.org respectively. Results: The analysis suggested very weak positive relationship of BCG coverage with cases and deaths due to COVID-19. Moderate positive relationship was observed between BCG coverage and COVID-19 case fatality rate even after adjusting for health system performance. Conclusion: The conclusion of the study is against the role of BCG vaccination in containing the COVID-19 pandemic. The positive correlation which is not significant may be spurious and affected by many confounding factors like co-morbid conditions, testing strategies, population level immunity for other viral infections etc. Hence, the states and UTs should not be complacent by the hypothesized role of BCG vaccine in COVID-19 control. Rather, they should continue with the principles of social distancing, contact tracing, treating and surveillance of COVID-19. © 2021, Indian Association of Preventive and Social Medicine. All rights reserved.
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This paper proposes a system to model the spread of COVID-19. This system will work in post lockdown conditions, when the only mode of travel, is by road. It defines impact measures, that state the severity of potential disease spread, in a specific area. These impact measures are calculated based on existing hotspots, and are clustered into regions of varying danger-levels, using a graph clustering algorithm. Using this method, it can be predicted where more lenient measures may be taken, and which areas are less prone to the virus spread. There exist other methodologies to model the spread of viruses, but most overlook the spatial nature of viruses. The proposed system focuses on this limitation. Specifically, it focuses on preventing the virus spread, from a geographical point of view. Since the virus spread depends entirely on contact, regions near existing hotspots may potentially become new hotspots. The entire country is first visualized as a weighted graph of regions, at an appropriate administrative level, such as districts. The weights of the nodes are the number of active cases, and the weights of the edges are the geographical distances between those nodes. This graph is connected based on a distance threshold. The impact measure tells the impact of a region, on nearby regions, and the danger value tells the transmission possibility, between separate regions. Using this data, potential hotspots are easily identified. This data will help administrative bodies, to make more fine-tuned lockdown restrictions, based on the impact measures. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Background: A significant proportion of the individuals having the illness of moderate to severe nature due to COVID-19 infection require immediate critical care. High incidence of mortality among elderly population or those with comorbid conditions were reported. Objectives: The study was carried out with objectives to assess the epidemiological and clinical factors associated with mortality among the COVID-19 cases admitted and treated in AIIMS, Patna. Methods: This was a hospital -based cross-sectional analytical study of epidemiological and clinical features of COVID-19-positive patients admitted and treated during the outbreak from March 20, to August 31, 2020. Results: The median age of COVID-19 cases was 51.5 years (IQR : 37-62 years) which was significantly higher (p-value = 0.001) as compared to females. Male-female ratio of cases was 2.88:1. Out of 1696 cases, the case fatality rate was 309 (18.22%). The mean age of cases who died due to COVID-19 was significantly higher (pvalue=0.001) as compared to those who survived. The odds of mortality was significantly higher in males as compared to females (Adjusted OR = 1.534, 95% CI = 1.10 - 2.13, p=0.011). The odds of mortality showed a significant increasing trend with increasing age (Mantel-Hanszel p-value for trend = 0.015). The covariates like gender, age groups 45-59, 60-74 and 75>=, breathlessness and CKD were found to be significantly associated with mortality after controlling for the confounders. Conclusions: Factors like gender, higher age, lower oxygen saturation causing breathlessness and chronic kidney diseases could be attributed to high risk of mortality in COVID-19 patients.
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Introduction: We have witnessed an unprecedented panic among the public on the non-availability of hospital beds during the first wave of the COVID pandemic. The geriatric population was the major sufferers, as resources were diverted to the younger or working generation. As emergency providers, we faced the challenge of using a screening tool to suspect the severity of disease progression for triaging patients to the correct level of the COVID facility. Objectives: Risk Stratify Geriatric Population with Suspected COVID-19 Infection based on VACO INDEX. Materials and methods: Two hundred and two consecutive patients above the age of 65 years were subjected to the calculation of the score using simple parameters like age, sex, history of DM, chronic pulmonary disease, renal disease, peripheral vascular disease, CHF, dementia, cancer, stroke, liver disease, MI, peptic ulcer disease, AIDS, and rheumatological disorder. The results of our study in detail will be discussed at the conference. Results: We utilized the VACO index to calculate a score and keep the patients well informed. The information helped us to ration beds to them in critical care areas, especially during the times while rationing was limited. Discussions: A 10% decrease in organ function is known to occur every decade after the age of 65. This means that it is unphysiological to apply the same parameters of qCSI across the whole population. We recommend the VACO index, which uses demographic and preexisting condition data and does not require immediate laboratory investigations. Conclusion: We recommend the VACO index, which uses demographic and preexisting condition data and does not require immediate laboratory investigations. With constrained resources, a score to identify 30-day mortality with COVID infection at the time of the first contact with a patient helped us immensely to risk stratify our patients.
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Background: There are sufficient evidences on the association of epidemiological and clinical features of the patients with COVID-19 but still there are paucity of evidences on socio-economic aspects of this disease. An ecological study has been carried out with aim to assess the associations of the Human Development Index (HDI) and its components of each states and Union territories in India with incidence and mortality from COVID-19. Methods: Information on confirmed cases and deaths have been extracted from the data on the website of Covid India Organization and the data on HDI and its components have been extracted from various national and international agencies. Regression analysis was performed which showed a direct significant association (p-values<0.05) of incidence and mortality rates with HDI and its components at the national level. Concentration index was estimated to measure socio-economic inequality in COVID-19 incidence and mortality rates with 95% confidence interval (CI), which were 0.41 (0.27-0.54) and 0.42 (0.26-0.58) for incidence and mortality rates of COVID-19 respectively. Results: The high incidence and mortality rates of COVID-19 in states and union territories of India with high HDI and its components warrant priority for interventions by the national health policy-makers. Cases detection and screening facilities need to be scaled up in states and UTs with low incidence and mortality rates to minimize the under-reporting of the cases.
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The outbreak of coronavirus disease was first noticed in the Wuhan city in Hubei province of Central China. This disease has now spread to all over world including USA, Italy, France, UK and India. Due to its global effect, World health organization has declared this as pandemic. Till date there is no reliable cure and vaccination for this Virus. This disease has made a large scale damage to both life and property all over the world. To check the community transmission many countries in the world including India have opted for the completed lockdown of all activities for a month or half. This sudden lockdown have forced to shutdown all activities of manufacturing, processing, transporation, trade and commerce. This loackdown have left many vulnerable grops stranded without food and shelther and livelihood. This study has tried to review the preparedness and mitigation effort of Government of India towards COVID-19 and analysed the impact of lockdown on the economy of India. This study is entirely based on the secondary sources of data which is further processed and represented using MS-office, and ArcGIS. After the review and analysis it has been found that the GoI has swiftly acted towards continment and checking of COVID-19. Also, it has been analysed that this lockdown will bring the GDP to as low as 2.5% and there will be a collective loss of more that 43 lakhs crores. Moreover, this disease has left many vulnerable groups straded in their places without food and livelihood. Finally this study has suggested to provide best possible protective gear and equipments to medical workers who are sacrificing their lives for betterment of humankind. © 2020 by Advance Scientific Research. This is an open-access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)