Coronavirus anxiety and cyberchondria among undergraduate medical students during the COVID-19 pandemic in a Tertiary Care Hospital: A cross-sectional study

Background: Despite widespread rise in anxiety due to the COVID-19 pandemic, there is a paucity of studies of coronavirus anxiety and cyberchondria, which is searching for more health-related information, among medical students. Aim: The aim of the study is to assess the prevalence of coronavirus anxiety and cyberchondria in the context of COVID-19 in undergraduate medical students. Materials and Methods: This is a cross-sectional study done between August 24, 2020 and September 5, 2020. A total of 280 students have given consent to participate in the study by filling online self-designed questionnaire, coronavirus anxiety scale, and cyberchondria severity scale-12. Data analysis was done by SPSS version 20 using appropriate statistical tests. Results: Coronavirus-related anxiety was present in 55% of the students. Moderate and severe cyberchondria were seen in 39% and 50% of the students, respectively. Association between coronavirus anxiety and severity of cyberchondria was statistically significant (P < 0.001). Majority of the students spent >2 h in watching or reading COVID-19 related news. Conclusions: As significant number of medical students had anxiety and cyberchondria related to COVID-19, medical colleges have to implement necessary psychological interventions to safeguard the students' mental health. © 2022 by the Author(s).

Efficiency & Patient Satisfaction of Colorectal Telephone Consultation during the Covid-19 Pandemic

Aim: COVID-19 has necessitated a new approach to consult patients due to requirement for social distancing and avoiding unnecessary contact. This study aimed to assess the feasibility and patients' satisfaction of virtual clinic (VC) appointment compared to face-to- face (F2F) appointment. This study aimed to assess the feasibility and patients' satisfaction of virtual clinic (VC) appointment compared to face-to- face (F2F) appointment. Method(s): Patients referred under routine referral to the service between 09/10/2019 and 31/12/2019 and waiting for an appointment for more than one year were screened and allocated to VC or F2F according to set criteria based on symptoms and pathology. Demographic data, symptoms, pathology and waiting time were collected retrospectively. Structured telephone interviews were conducted to evaluate patients' satisfaction. Result(s): 559 patients were referred in the study period. Of this, 33.6% and 49.4% were triaged to attend a VC, or F2F clinic, respectively. Of the VC patients, 53.9% patients were discharged after an initial appointment, whereas 37.3% patients required a follow-up F2F appointment due to persistent symptoms or patient preference. Of the F2F patients, 82.8% were from the initial triage due to requirement for clinical examination or patients' preference. 90.5% of patients who underwent VC reported being either satisfied or very satisfied with their experience, in contrast to 86.0% of patients who underwent a F2F appointment (P < 0.05). Conclusion(s): VC appointments significantly reduced waiting times and only 1/3 of VC patients required a further F2F appointment. Patient were more satisfied with VC than an F2F appointment, and it may be a useful approach for service efficiency, particularly during ongoing COVID pandemic.

Significance of Laboratory Markers in Predicting the Severity of COVID-19 in the Central Reserve Police Force Front-line Workers with a Review of Literature.

COVID-19 disease has variable clinical presentations, ranging from asymptomatic to mild symptoms to severe manifestation with pneumonia, acute respiratory distress syndrome, septic shock, disseminated intravascular coagulation, and/or multiple organ failure. The real-time reverse transcription-polymerase chain reaction is gold standard test for severe acute respiratory syndrome-coronavirus-2 detection. In the present study, we aimed to predict the significance of various hematological and biochemical markers for early identification of complications and assessing the severity of the disease. A total of cases were divided into two study groups, namely, severe and nonsevere based on clinical presentation. Out of 210 cases, 186 (88.5%) cases were nonsevere and 24 (11.5%) cases were severe. Among various hematological and biochemical markers studied, hemoglobin, total leukocyte count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, albumin, lactate dehydrogenase, C-reactive protein, ferritin, D-dimer, and interleukin-6 are found to have P < 0.05 and significantly correlated with the severity of disease.

Incorporation of mechanisms for providing green environment post COVID-19

It has been observed that the damage to the environment caused has grown multi-fold in recent years especially with the exponential rise in population. The sad part of it lies with the fact that no part of earth be it the mountains or oceans or plains have been spared. In order to predict the global climate change, a number of models have been developed over the years. All reliable models clearly indicate the overall deterioration in the quality of air levels. The geographical distribution of precipitation changes at different places leading to changes in water availability. Living a healthy life in a clean environment has soon become a distant dream for the common man. To add to the same, the arrival of Corona virus in the year 2019 has put human life in the doldrums as its contagious and fast spreading nature has put day to day life on hold besides causing deaths and forcing people to throng to hospitals at a rapid rate not witnessed during the recent past. On the other hand, the outbreak of the COVID-19 Pandemic had a positive impact on the environment as most of the highly polluted cities witnessed a clear blue sky. Air Quality Index (AQI) and Particulate Matter (PM2.5) levels in all the major cities improved during the lockdown period. However, with life slowly limping back to normal, there is a dire need to ensure that humans do not go back to their old ways of polluting the environment. The way of work needs to change in each and every type of industry. This paper focuses on mechanisms for providing a green enterprise transformation for some of the commonly functioning industries post COVID-19 times. The research study focused on a specific country in Asian continent, and it can be extended to other countries/continents. © Copyright by Wydawnictwo Uniwersytetu Warminsko-Mazurskiego w Olsztynie.

SARS-COV-2 INFECTION AND VACCINATION PATTERNS DETERMINE LONG-TERM ANTIBODY RESPONSES IN NURSING HOME RESIDENTS: DATA FROM NH-COVAIR

Background: Older Nursing Home Residents (NHRs) are at greatest risk of morbidity and mortality from SARS-CoV-2, particularly in the context of both waning vaccine efficacy and the emergence of Variants-of-Concern (VOCs). However, the determinants of long-term vaccine-induced protective antibody responses are yet to be determined in this group. Methods: NH-COVAIR recruited older NHRs for comprehensive clinical and frailty (NH-FRAIL) assessment. Blood samples were obtained pre-vaccination, at 6-weeks and 6-months following primary vaccination and 6-months following booster vaccination. Antibody titres were measured using both an electrochemiluminescence assay and a custom bead-based array (Luminex™) to measure antibody titre and avidity for Wuhan strain/major VOC antigens. Stepwise adjusted linear regression (log-transformed) assessed longitudinal determinants of vaccine-induced antibody responses. Results: Of 86 participants (81.1 ± 10.8 years;65% female), just under half (45.4%) had evidence of previous SARS-CoV-2 infection. All NHRs mounted a significant antibody-response to vaccination at 5 weeks followed by a significant decrease in antibody titre by 6 months. Previous SARS-CoV-2 infection was the strongest predictor of antibody waning at all timepoints (β: 3.59;2.89, 4.28;P < 0.001 for 6-months). Independent of infection history, both age (β: –0.05;–0.08, –0.02;p<0.001) and frailty (β: –0.22;–0.33, –0.11;p<0.001) were associated with faster antibody waning at 6-months. Cross-reactivity and avidity were significantly lower for Beta (B.1.351) and Gamma (P.1) VOC strains (all p<0.001). Additionally, there was faster antibody waning and significantly reduced antibody avidity to Beta and Gamma VOCs in SARS-CoV-2 naïve NHRs. Conclusion: Older NHRs are capable of mounting protective antibody responses to SARS-CoV-2 vaccination. Responses were more durable, with a greater cross-reactivity to and avidity for VOCs in those with previous SARS-CoV-2 infection. Increasing age and greater frailty in NHRs was associated with faster antibody waning. Our findings support ongoing serological surveillance and use of additional vaccine doses in older NHRs, particularly in those without previous SARS-CoV-2 exposure.

Reporting a Case Series of CMV Reactivation in COVID Patients

The current pandemic caused by SARS-CoV-2 virus infection has provoked an unprecedented health care burden worldwide with an abrupt demand for critical care provision and consequent strain on the intensive care unit (ICU). A history of cytomegalovirus (CMV) infection is very common among adults, the majority of which evolve with a period of latency characterized by a persistent control of viral replication [2]. Reactivation usually implies some type of weakened immunity which can be attributed to various etiologies [3]. Nevertheless, infection of immunocompetent patients in the ICU is well acknowledged, with the highest reactivation rates in septic patients. Furthermore, CMV reactivation is associated with higher ICU length of stay, longer need for invasive mechanical ventilation (IMV), increased risk of infections, and mortality. We report a case series of eight patients admitted to the ICU due to SARS-CoV-2 pneumonia who presented concomitant CMV infection/reactivation during hospital stay.

Early Monitoring of Social Distancing using Open cv and Deep Learning

Social distancing is one of the community mitigation measures that may be recommended during influenza epidemics. Social distancing can reduce virus transmission by boosting physical distance or reducing frequency of congregation in socially close community settings, similar as academies or workplaces. This is a common practice which has been carried out over generations to minimize the spread of virus by limiting its reproduction rate among communities. In the battle against COVID-19, social distancing has proved to be a highly successful strategy for slowing disease transmission. People are being advised to minimize their contacts with one another in order to reduce the risk of the virus spreading through physical touch. The social distancing detection system will monitor whether people are maintaining a safe distance from each other in public places and workplaces or not to ensure social distancing protocol. We can see a clear overview of how we can detect social distancing in public places using Python, Computer Vision, YoLov3, and Deep Learning in this proposed framework.

Study on patients arrival at hospital using queuing model with self-similar characteristics

Patient lines are frequent in medical care, and one indicator of access to healthcare is waiting time. We explain queuing theory - an empirical method that provides service providers with a lot of experience in the design and management of existing services. This paper focuses on the pattern of arrival and the facilities available in the hospital in Vijayanagara District. The most important purpose of this research was to provide policymakers with knowledge to contribute to the well-being of the population by reducing waiting time for service, in this study, the waiting time of patients in the ambient department was first analyzed with the M / M/1 queuing method. The entire world is spreading of coronavirus-COVID-19 has increased exponentially across the globe, and still, no vaccine is available for the treatment of patients. The crowd has grown tremendously in the hospitals where the facilities are minimal. The queue theory is applied for the Single-server system and its self-similarity existence in a queue used to identify the queue time, waiting time, and Hurst parameter by different patient arrivals methods Health care center in our local area located in Hospet, Vijayanagara district, Karnataka. © 2022 Author(s).

Anxiety and Coping Strategies Among Medical Students During COVID-19 Pandemic: A Cross-sectional Study

Introduction: COVID-19 pandemic has impacted the mental health of medical students due to multiple factors like the fear of getting infected, the stress of maintaining the preventive measures, the demands of the online classes, and the uncertainty of the future. Aim: To assess the anxiety levels of the medical students and strategies, they used to cope up with the anxiety during the pandemic. Materials and Methods: A cross-sectional study was carried out among all the first and final year MBBS students of a Women's Medical College and Teaching Hospital in Hyderabad, Telangana, India. The questionnaire contained a total of 25 questions- three questions to collect the demographic data, a 7-item Generalised Anxiety Disorder Scale (GAD), and 15 questions assessing their coping strategies;was distributed to all the study participants as a Google form. Data from completed questionnaires were entered into an excel sheet and analysed using Jamovi software version 1.6.23.0. Results: A total of 164 students completed the questionnaire-59.1% first year MBBS students and 40.8% final year MBBS students. Mean age of the participants was 19.4 years among the first year MBBS students, and 21.7 years among the final year MBBS students. Majority of the participants had mild anxiety (43.2%). There was no statistically significant difference in the anxiety levels of the first year MBBS and final year MBBS students. The most commonly used coping strategy factor was putting trust in the god (59.7% of first year MBBS, and 62.6% of final year MBBS) while the least commonly used coping strategy was substance abuse-use of alcohol or drugs to feel better (0 among first year MBBS and 2.9% among the final year MBBS). There was statistically significant association between one of the coping strategy and anxiety-I can adjust to the situation and deal with the changes and anxiety levels (p=0.010). Conclusion: COVID-19 pandemic has impacted the mental health of medical students by causing anxiety. There is a need to mitigate these negative effects by introducing supportive programs in the form of educational programs, yoga and meditation to relieve anxiety and maintain mental health of medical students.

Blockchain Technology: A Boon at the Pandemic Times – A Solution for Global Economy Upliftment with AI and IoT

Blockchain technology is a potential sector at the foreground, though it is currently in its embryonic form, but will retain itself as an emerging technology at an early stage. Besides blockchain being a trusted, decentralized database, it has its success in many applications across various fields like education, medicine, insurance, finance, energy, environment, supply chain management, and various other associated operations. The work provides a systematic survey of blockchain, how it works, and its characteristics, applications, and challenges. The aim is to investigate how blockchain technology, besides artificial intelligence and the Internet of Things, would be an effective factor to fight the current pandemic scenario. To the end, a brief survey is carried out on how blockchain technology would be fruitful in uplifting the global economy post-COVID, with a summary of the blockchain toolkit by the World Economic Forum. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Case study on nCOV-19 pandemic effect on indian economy and geographic impact

COVID-19 is a disease caused by severe acute respiratory syndrome corona Virus-2 (SARS-COV-2), which emerged in Wuhan city, Hubei province of China, and has now spread its roots over 220 countries and territories around the world. A few vaccines developed for this contagious disease till date have shown promising results. As a consequence of the COVID-19 pandemic, there is a tremendous impact on the economy, mortality rate, and environment of the affected countries, including India. The present study carried out shows that the lockdown had a negative impact on the Indian economy and human life. Surprisingly, the Air Quality Index (AQI) has significantly improved in most Indian cities and around the world due to a decline in pollution levels due to the closure of all industrial and construction activities, reduced vehicular traffic, etc. Also, levels of critical parameters like pH, dissolved Oxygen) and biological Oxygen Demand) have shown improvement in water quality of major Indian rivers. In this paper, an attempt is made to address the impact of lockdown and human life index with current data and presented in graphical form. © 2021 Ecological Society of India. All rights reserved.

In silico docking analysis revealed the potential of phytochemicals present in Phyllanthus amarus and Andrographis paniculata, used in Ayurveda medicine in inhibiting SARS-CoV-2.

The Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in outbreak of global pandemic, fatal pneumonia in human referred as Coronavirus Disease-2019 (Covid-19). Ayurveda, the age old practice of treating human ailments in India, can be considered against SARS-CoV-2. Attempt was made to provide preliminary evidences for interaction of 35 phytochemicals from two plants (Phyllanthus amarus and Andrographis paniculata used in Ayurveda) with SARS-CoV-2 proteins (open & closed state S protein, 3CLpro, PLpro and RdRp) through in silico docking analysis. The nucleotide analogue remdesivir, being used in treatment of SARS-CoV-2, was used as a positive control. The results revealed that 18 phytochemicals from P. amarus and 14 phytochemicals from A. paniculata shown binding energy affinity/dock score < - 6.0 kcal/mol, which is considered as minimum threshold for any compound to be used for drug development. Phytochemicals used for docking studies in the current study from P. amarus and A. paniculata showed binding affinity up to - 9.10 kcal/mol and - 10.60 kcal/mol, respectively. There was no significant difference in the binding affinities of these compounds with closed and open state S protein. Further, flavonoids (astragalin, kaempferol, quercetin, quercetin-3-O-glucoside and quercetin) and tannins (corilagin, furosin and geraniin) present in P. amarus have shown more binding affinity (up to - 10.60 kcal/mol) than remdesivir (up to - 9.50 kcal/mol). The pharmacokinetic predictions suggest that compounds from the two plants species studied in the current study are found to be non-carcinogenic, water soluble and biologically safe. The phytochemicals present in the extracts of P. amarus and A. paniculata might have synergistic effect with action on multiple target sites of SARS-CoV-2. The information generated here might serve as preliminary evidence for anti SARS-CoV-2 activity of phytochemicals present from P. amarus and A. paniculata and the potential of Ayurveda medicine in combating the virus. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13205-020-02578-7.

Hepatic steatosis is associated with elevated alanine aminotransferase (ALT) but not elevated bilirubin or hepatic decompensation in patients with novel coronavirus disease 2019 (COVID-19)

Background: Novel coronavirus disease 2019 (COVID-19) is a global pandemic with significant morbidity and mortality. Possible association between non-alcoholic fatty liver disease (NAFLD) and worse COVID-19 disease progression has been suggested but not well described in the United States We investigated whether COVID-19 was associated with elevations in liver enzymes or hepatic decompensation in patients with underlying hepatic steatosis Methods: We retrospectively reviewed the charts of consecutive adults treated at the University of Michigan for COVID-19 between March 1 and April 30, 2020. Hepatic steatosis was defined based on imaging >30 days prior to COVID-19 diagnosis. Outcomes were: (1) peak ALT or bilirubin following COVID-19 diagnosis, (2) ALT >2 or 5 times upper limit of normal (ULN), defined as the higher of baseline ALT or 19 U/L in women and 30 U/L in men, and (3) jaundice defined as bilirubin >2 or 4 mg/dl We conducted regressions with the above outcomes as dependent variables and hepatic steatosis as the primary predictor These regression models were logistic for outcomes of abnormal ALT or bilirubin and linear for maximal ALT or bilirubin Results: Evidence of steatosis on prior imaging was found in 80/159 (50 3%) patients Overall, 89% of patients were hospitalized, 51% were admitted to intensive care unit, and 16% died Chronic liver disease other than NAFLD was found in 14% of patients, 5% had cirrhosis, and 2 7% had prior liver decompensation with ascites, variceal bleeding, or hepatic encephalopathy Patients with steatosis were younger, more often African-American with higher body mass index than those without steatosis Baseline ALT and total bilirubin were higher in the steatosis group Hepatic steatosis was associated with higher incidence of ALT >2x ULN (OR 2.93 [1.23-6.97]) or >5x ULN (OR 6.21 [1.45-26.62]), and with peak ALT (beta 39 7 [7 85-71 49]) Hepatic steatosis was not associated with increased bilirubin Rates of liver decompensation were very low: 1 3% and 2 5%, respectively, with no difference based on NAFLD status (p > 0.4 for both) (Table 1) Conclusion: Analysis from our cohort showed that NALFD is associated with acute hepatocellular injury in patients with COVID-19 Strengths of this study include granularity of data available for review Weaknesses include the observational and single-center nature of the study Larger scale multi-center studies are needed to corroborate these findings.(Table Presented).

Hepatic steatosis is associated with increased disease severity in patients with novel coronavirus disease 2019 (covid-19)

Background: Novel coronavirus disease 2019 (COVID-19) is a global pandemic with significant morbidity and mortality. Possible association between hepatic steatosis (HS) and worse COVID-19 disease progression has been suggested but not well described in the United States We investigated whether patients with HS experienced worse disease outcomes from COVID-19 infection than those without Methods: We retrospectively reviewed a cohort of 342 consecutive adult patients treated at the University of Michigan for COVID-19 between March 1 and April 30, 2020. HS was defined as either prior imaging evidence of steatosis or hepatic steatosis index >36 for Asians or >39 for non-Asians. The primary outcome was disease severity based on admission to intensive care unit (ICU), intubation, death, or the World Health Organization (WHO) ordinal scale We used multivariable logistic regression to assess the predictors of ICU admission, intubation rate, or death and multivariable linear regression for disease severity on WHO ordinal scale HS was the primary predictor Results: A total of 342 patients were analyzed Median age was 63 years;53 5% of patients were male and 44 4% Black, 52 6% required ICU admission, 34 2% required intubation, and 16% died A 178 patients (52%) had HS, who were younger (58 5 vs 66 5 years;p < 0 001), had higher body mass index (34 7 vs 26 6;p < 0 001), and had higher prevalence of diabetes (48 3% vs 37 8%;p = 0 06) than those without HS HS was independently associated with increased odds of requiring admission to the ICU (odds ratio [OR] 1 75 [1 09-2 81], p = 0 02) and intubation (OR 2 58 [1 56-4 28], p < 0 001), as well as higher WHO ordinal scale (beta 0 51 [0 11-0 92], p = 0.013). There was no significant association between HS and death (OR 0 83 [0 42-1 67], p = 0 61) (Table 1) Conclusion: Analysis from our cohort showed that HS is associated with worse disease outcomes, evidenced by increased odds of ICU admission, intubation rate, and WHO ordinal scale in patients with COVID-19(Table Presented).