Comparative Analysis Of Psychological Well-Being, Mood Disorders And Burnout Among People Working From Home Versus Office Going Bank Employees During The Covid-19 Pandemic

BACKGROUND: As a result of rising Covid cases in India, Nationwide Lockdown was implemented from March 22, 2020, followed by a second wave leading to phase 2 of lockdown. Prolonged Work from home and its impact on mental health needs to be evaluated on urgent basis. METHODOLOGY: The study was cross sectional in nature and the participants taking part in this survey were selected randomly (snowball sampling) through phone, email or in person. A questionnaire was sent to them in a google form document and entries received. The survey questionnaire included Beck's depression scale, Burnout index, and WHO well being scale. The survey was done during the timeline of second wave of Covid 19 in India (1 April 2021-31 August 2021). Comparision between two groups done by Chi square test. RESULT(S): The study revealed that 53% of work from home employees suffered from moderate depression as compared to the second group which had more number of people (39%) suffering from mild depression and less than 1% suffering from moderate depression. 66% of the work from home employees had average and above-average levels of burnout, in comparison, 47% of the regular office goers had average and above-average levels of burnout. As per WHO Well being scale, Regular office goers had mean value of 18.16 indicating greater well being as compared to Work from home employees that had 12.90 as the mean value. CONCLUSION(S): It is intriguing that apart from the benefits from working from home, it has negative repercussions on the mental health of the employees. Copyright © 2022, Anka Publishers. All rights reserved.

Corona Chronicles: A Cross-sectional Survey of Practices, Challenges, and Dermatological Impact of the COVID-19 Pandemic

OBJECTIVE: Mask usage and hand hygiene are the pillars of defense against the novel pathogen causing COVID-19. This study was conducted to compare these practices among healthcare workers (HCWs) and nonhealthcare workers (nonHCWs) and to examine the outlook toward the healthcare sector among the two. METHODS: A cross-sectional online survey (via Google forms) using snowball sampling was conducted. Appropriate ethical clearance was taken from the Institutional Ethical Committee (IEC). HCWs and nonHCWs 18 years of age or older with basic literacy in English and with internet access were included. RESULTS: There were 404 total respondents (M:F ratio: 0.87:1;mean age: 30.16±9.63 years). Among the respondents, 63.3 percent were HCWs while 35.6 percent were nonHCWs. Persons performing hand hygiene more than10 times/ day were found to be almost three times more likely to develop skin dryness (odds ratio [OR]: 2.95, 95% confidence interval [CI]: 1.372, 6.362). Female participants were found to be 2.5 times more likely to develop dryness (odds ratio: 2.594, 95% CI: 1.590, 4.234). Use of gloves was found to be a protective factor against development of dryness (odds ratio: 0.485,95% CI: 0.287, 0.818). A statistically significant correlation was found between mask acne and female respondents (p-value=0.000), HCWs (p-value=0.000), and use of N95 mask in combination with surgical mask (p-value=0.04). LIMITATIONS: Being an online survey, responses could not be captured from people with limited internet access and of lower socioeconomic strata. CONCLUSION: There is a considerable burden of preventive measures on HCWs and nonHCWs alike. Significant dermatological implications are seen with frequent hand hygiene and mask usage.

Test, Track, and Treat Ameliorative Strategy to Contain Severe Acute Respiratory Syndrome Coronavirus 2: An Indian Perspective

Ever since in January 2020, the WHO declared an international public health emergency, emerged as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease-19) pandemic which has devastated human race with its human-to-human transmission, mutation, and mortality with complex pathogenicity mechanism. Earlier theories postulated it to have emerged from "Wet Market," Huanan Seafood Wholesale Market in Wuhan city of Hubei Province in China. Based on initial speculations, this pandemic was suggested to be of enzootic origin, considerably bats and pangolins as connecting link between human-animal transmissions, which were later refuted. Time bound and effective Test, Track, and Treat policy initiatives taken by Indian Government proved to be a benchmark in controlling the pandemic, up to certain extent. Molecular diagnostics have witnessed a scaled up trend in terms of reverse transcription polymerase chain reaction and Rapid Antigen Tests to detect the contagion in oro-pharyngeal and naso-pharyngeal swabs. It is imperative that frequent mutations in SARS-CoV-2 lead to development of new serotypes making screening for novel therapeutics or repurposing of drugs cumbersome. With an effort to consummate existing clinico-pharamaceutical gaps to curb SARS-CoV-2, ardent remains the fact that plants have been considered as medicinal power houses. Green therapeutics are formulation of active phyto components when administered, enhance the bio-availability through different drug delivery systems. Exploration of medicinal plants for their bio-active ingredients to develop immune-boosters as an antiviral prophylactic tool against SARS-CoV-2 remains a preferred choice among health-care practitioners, pharmacologists, and life sciences fraternity at large. In addition, indigenous vaccines have been granted approval for Emergency Use Authorization which would help lower the rates of transmission and mortality by significant numbers in times to come.

Results of the PCM-204 phase 2b trial of partial-gland ablation for men with intermediate-risk prostate cancer with padeliporfin (WST11 or TOOKAD) vascular-targeted photodynamic therapy

INTRODUCTION AND OBJECTIVE: Padeliporfin (WST11) vascular-targeted photodynamic therapy (VTP) has shown significant clinical benefit as a localized partial gland ablation (PGA) therapy when compared to active surveillance for low-risk prostate cancer, by curbing progression and the need for radical treatment, leading to its regulatory approval in Europe. This Phase 2b trial prospectively investigated WST11-VTP for intermediate-risk cancers. METHODS: 50 men with unilateral Grade Group 2 (GG2) cancers (Gleason 3+4) evaluated with MRI and ultrasound-guided (TRUS) biopsy were treated with up to 2 sessions of unilateral PGA using padeliporfin VTP. Eligibility criteria included <cT2b, PSA <10, and fusion biopsy for PIRADS 3+ lesions on pretreatment MRI. Contralateral very lowerisk disease was observed. MRI and systematic, 14-core TRUS biopsy (+/- fusion) were performed 3 and 12 months after treatment, evaluating for Gleason Grade 4 or 5 (≥GG2) cancer as the primary endpoint. Additional data included adverse events and patient-reported quality of life. The study was powered using β=0.2 to reject the null hypothesis (r≥70%), using a one-sided exact binomial test with 5% alpha risk. To be valid, 44 evaluable patients were required by the 12-month primary endpoint. Treatment safety and patient-reported quality of life for sexual and urinary function were assessed with validated questionnaires (IIEF-15 and IPSS, respectively). RESULTS: 46 men were evaluable for the 12-month primary endpoint. Before 12 months, 1 man proceeded to prostatectomy (treatment failure), 2 men refused 12-month biopsy, and 1 man died of COVID-19. 12/49 (24%) underwent per-protocol second hemiablation treatment for GG2 tumor at 3 months: 9 for residual cancer and 4 with newly identified contralateral GG2 tumors (1 bilateral). 45 of the 46 evaluable men underwent 12-month biopsy: 38 (83%) had no Gleason grade 4 or 5 cancer, including 11/12 (92%) patients receiving 2 treatments. By 3 months, median decline in IIEF-5 score from baseline was -1.0 (IQR -7,0). Median improvement in IPSS score was -1.0 (IQR -1,5), with pad-free continence observed in 100% of patients. Median change in IIEF score by 12-months was -1.0 (IQR -5,0). Grade 3 treatment-related adverse events occurred in 6 (12%) patients;all procedure-related prostate/pelvic pain resolved by 3 weeks. CONCLUSIONS: These positive trial results show that WST11- VTP is effective for PGA of intermediate-risk prostate cancer with minimal toxicity including impact on urinary and sexual function, consistent with the Phase 3 trial results in low-risk disease. Based on these data this therapy bears consideration for approval as a conservative therapeutic option for selected cases of intermediate risk disease.

SEVERE CORONARY ARTERY SPASM WITH CARDIAC ARREST IN A PATIENT WITH COVID-19

TOPIC: Cardiovascular Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: SARS-CoV-2 has been associated with cardiac complications, especially in patients with pre-existing cardiovascular disease. We present a case of a patient without any history of coronary artery disease (CAD), who contracted COVID-19 and developed severe coronary artery spasms resulting in cardiac arrest. CASE PRESENTATION: A 55-year-old man with past medical history of tobacco use of 30 years was admitted with severe COVID-19 pneumonitis with acute hypercapnic and hypoxemic respiratory failure, requiring invasive mechanical ventilation. On hospital day 9, he had intermittent episodes of polymorphic ventricular tachycardia. An EKG showed acute ST elevations in leads II, III, aVF and V1-V3 with troponin T rise to 0.83 ng/mL. He developed cardiac arrest due to polymorphic ventricular tachycardia. Successful resuscitation was achieved after 5 minutes including defibrillation and 2 cycles of CPR. An emergent left heart catheterization revealed insignificant CAD, normal left ventricular systolic function and no wall motion abnormalities with a presumptive diagnosis of coronary artery spasm (CAS) as the most likely cause for his cardiac arrest. He was started on a nitroglycerin patch, and his vasopressor support was switched from norepinephrine to epinephrine. The previously observed EKG changes resolved within five hours and troponin levels started to decline. A head CT showed diffuse cerebral edema with early uncal herniation and following goals of care discussion, the patient was transitioned to comfort with terminal extubation. DISCUSSION: Rarely does CAS result in polymorphic ventricular tachycardia with cardiac arrest, in patients without CAD. Initial reports showed that patients with COVID-19 and ST segment elevations are found to have myocardial injury with non-obstructive coronary arteries (MINOCA), however there are no reports of COVID-19 patients with CAS resulting in cardiac arrest. The pathophysiology of CAS is not completely understood however, the current literature has described multiple mechanisms including endothelial dysfunction, systemic inflammation, oxidative stress and smooth muscle hyperreactivity, amongst others. CONCLUSIONS: More studies are required to elucidate the mechanism of myocardial injury associated with COVID-19 infection in order to risk stratify those patients at increased risk of CAS and arrthymias and possibly tailor their management;including choice of vasopressor support and use of nitrates to lower the risk of life-threatening complications. REFERENCE #1: Bangalore S, Sharma A, Slotwiner A, et al. ST-Segment Elevation in Patients with Covid-19 — A Case Series. N Engl J Med. 2020;382(25):2478-2480. doi:10.1056/NEJMc2009020 REFERENCE #2: Matta A, Bouisset F, Lhermusier T, et al. Coronary Artery Spasm: New Insights. J Intervent Cardiol. 2020;2020:1-10. doi:10.1155/2020/5894586 REFERENCE #3: Rivero F, Antuña P, Cuesta J, Alfonso F. Severe coronary spasm in a COVID -19 patient. Catheter Cardiovasc Interv. Published online August 2020:ccd.29056. doi:10.1002/ccd.29056 DISCLOSURES: No relevant relationships by Andres Cordova Sanchez, source=Web Response No relevant relationships by Markus Gutsche, source=Web Response No relevant relationships by Matthew Kovach, source=Web Response No relevant relationships by Jasmine Sandhu, source=Web Response

Phase 2b trial results of padeliporfin (WST11 or Tookad) vascular-targeted photodynamic therapy for partial gland ablation in men with intermediate-risk prostate cancer

Background: Padeliporfin (WST11) vasculartargeted photodynamic therapy (VTP) has shown significant clinical benefit as a localized partial gland ablation (PGA) therapy when compared to active surveillance for low-risk prostate cancer, by curbing progression and the need for radical treatment, leading to its regulatory approval in Europe. This phase 2b trial prospectively investigated WST11-VTP for intermediate-risk cancers. Methods: Men with unilateral Grade Group 2 (GG2) cancers (Gleason 3+4), evaluated with MRI and ultrasound-guided (TRUS) biopsy, underwent up to two WST11-VTP PGA sessions. Eligibility criteria included <cT2b, PSA < 10, and fusion biopsy for PIRADS 3+ lesions on pretreatment MRI. Contralateral very low-risk disease was observed. The primary endpoint was prevalence of any Gleason Grade 4 or 5 (≥GG2) cancer, determined by MRI and systematic, 14-core TRUS biopsy of the entire gland (+/- fusion) at 3 and 12 months after treatment. Treatment safety and patient-reported quality of life for sexual and urinary function were assessed with validated questionnaires (IIEF-15 and IPSS, respectively). The study was powered using β = 0.2 to reject the null hypothesis (r≤70%), using a one-sided exact binomial test with 5% alpha risk. To be valid, 44 evaluable patients were required for the 12-month primary endpoint assessment. Results: Of the 50 men treated, 46 were evaluable for the 12-month primary endpoint. Before 12 months, 1 man proceeded to prostatectomy (treatment failure), 2 men refused 12-month biopsy, and 1 man died of COVID-19. At 3 months, 12/49 (24%) men underwent per protocol second WST11-VTP PGA session for GG2 tumor: 9 for residual cancer and 4 for newly identified contralateral GG2 tumors (1 bilateral). The 12-month biopsy was performed in 45 men;38 (83%) had no Gleason grade 4 or 5 cancer, including 11/12 (92%) patients who underwent 2 PGA sessions. By 3 months, median decline in erectile function score (IIEF-5) from baseline was -1.0 (IQR -7,0). Median improvement in urinary function score (IPSS) was -1.0 (IQR -1,5), with pad-free continence observed in all patients. Median change in IIEF score by 12-months was -1.0 (IQR -5,0). Grade 3 treatment-related adverse events occurred in 6 (12%) patients. All procedurerelated prostate/pelvic pain resolved by 3 weeks. Conclusions: The positive results from this trial show that WST11-VTP is effective for PGA of intermediate-risk prostate cancer, with minimal toxicity or impact on urinary and sexual function, consistent with the phase 3 trial results in low-risk disease. Based on these data, this therapy bears consideration for approval as a conservative therapeutic option for selected cases of intermediate-risk disease.

Time series analysis of COVID-19 cases

Purpose: This study analyses the prevalent coronavirus disease (COVID-19) epidemic using machine learning algorithms. The data set used is an API data provided by the John Hopkins University resource centre and used the Web crawler to gather all the data features such as confirmed, recovered and death cases. Because of the unavailability of any COVID-19 drug at the moment, the unvarnished truth is that this outbreak is not expected to end in the near future, so the number of cases of this study would be very date specific. The analysis demonstrated in this paper focuses on the monthly analysis of confirmed, recovered and death cases, which assists to identify the trend and seasonality in the data. The purpose of this study is to explore the essential concepts of time series algorithms and use those concepts to perform time series analysis on the infected cases worldwide and forecast the spread of the virus in the next two weeks and thus aid in health-care services. Lower obtained mean absolute percentage error results of the forecasting time interval validate the model’s credibility. Design/methodology/approach: In this study, the time series analysis of this outbreak forecast was done using the auto-regressive integrated moving average (ARIMA) model and also seasonal auto-regressive integrated moving averages with exogenous regressor (SARIMAX) and optimized to achieve better results. Findings: The inferences of time series forecasting models ARIMA and SARIMAX were efficient to produce exact approximate results. The forecasting results indicate that an increasing trend is observed and there is a high rise in COVID-19 cases in many regions and countries that might face one of its worst days unless and until measures are taken to curb the spread of this disease quickly. The pattern of the rise of the spread of the virus in such countries is exactly mimicking some of the countries of early COVID-19 adoption such as Italy and the USA. Further, the obtained numbers of the models are date specific so the most recent execution of the model would return more recent results. The future scope of the study involves analysis with other models such as long short-term memory and then comparison with time series models. Originality/value: A time series is a time-stamped data set in which each data point corresponds to a set of observations made at a particular time instance. This work is novel and addresses the COVID-19 with the help of time series analysis. The inferences of time series forecasting models ARIMA and SARIMAX were efficient to produce exact approximate results. © 2020, Emerald Publishing Limited.

Severe acute respiratory syndrome coronavirus 2 may be an underappreciated pathogen of the central nervous system.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a highly contagious respiratory disease referred to as COVID-19. However, emerging evidence indicates that a small but growing number of COVID-19 patients also manifest neurological symptoms, suggesting that SARS-CoV-2 may infect the nervous system under some circumstances. SARS-CoV-2 primarily enters the body through the epithelial lining of the respiratory and gastrointestinal tracts, but under certain conditions this pleiotropic virus may also infect peripheral nerves and gain entry into the central nervous system (CNS). The brain is shielded by various anatomical and physiological barriers, most notably the blood-brain barrier (BBB) which functions to prevent harmful substances, including pathogens and pro-inflammatory mediators, from entering the brain. The BBB is composed of highly specialized endothelial cells, pericytes, mast cells and astrocytes that form the neurovascular unit, which regulates BBB permeability and maintains the integrity of the CNS. In this review, potential routes of viral entry and the possible mechanisms utilized by SARS-CoV-2 to penetrate the CNS, either by disrupting the BBB or infecting the peripheral nerves and using the neuronal network to initiate neuroinflammation, are briefly discussed. Furthermore, the long-term effects of SARS-CoV-2 infection on the brain and in the progression of neurodegenerative diseases known to be associated with other human coronaviruses are considered. Although the mechanisms of SARS-CoV-2 entry into the CNS and neurovirulence are currently unknown, the potential pathways described here might pave the way for future research in this area and enable the development of better therapeutic strategies.