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The coronavirus disease-2019 (COVID-19) pandemic has imposed a situation where all healthcare facilities except emergency services remain suspended. These times generated the necessity for the implementation of a healthcare delivery system that can be accessed digitally and, thus, benefit the majority of children as well as healthcare professionals. This review aims to propose a sound model of less technique sensitive, safe and handy strategies for dental traumatic injuries, endodontic and restorative concerns, and orthodontic urgencies until complete clinical help can be sought. Five hundred thirty articles were obtained from the PubMed, Google Scholar, Embase, Lilacs, and Cochrane databases published from 2011 to 2021. Nineteen articles that described teledentistry in the COVID-19 era were included. Teledentistry can serve as a vital patient management strategy that can aid in triaging urgent and elective patient treatment needs, ultimately easing the burden of clinics and at the same time providing a safer means of consultation. Copyright © 2021 Goswami, Nangia, Saxena, Chawla, Mushtaq, Singh and Jain.
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INTRODUCTION: Coronavirus disease 2019 (COVID-19) has affected hospitalization of cardiac patients, both in terms of number of hospitalizations as well as hospital outcomes. In this study, we intended to understand the effects of COVID-19 pandemic on heart failure hospitalizations in the state of California. HYPOTHESIS: We hypothesized that adverse hospital outcomes such as in-hospital mortality, mechanical ventilation, mechanical circulatory support, vasopressor use, and acute respiratory distress syndrome (ARDS) would be higher among heart failure hospitalizations during 2020, compared to 2019. METHOD(S): The current study was a retrospective analysis of data collected and stored in California State Inpatient Database (SID) during March to December of 2019 and 2020. All adult (>=18 years of age) hospitalizations with heart failure were included for the analysis. ICD-10-CM diagnosis and procedure codes were used for identifying hospitalizations and procedures. We used propensity score matching and conditional logistic regressions to find the association between hospitalizations during 2019 versus 2020 with respect to outcome variables. RESULT(S): There were 101,032 (56.0%) heart failure hospitalizations during March to December of 2019, compared to 79,637 (44.0%) during March to December of 2020 (relative decrease, 21.2%). Hospitalizations for COVID-19 increased from 2,252 to 46,217 during the same period (relative increase, 19521.3%). Adverse hospital outcomes such as in-hospital mortality rates (2.9% versus 2.7%, P=0.003), mechanical ventilation (2.9% versus 2.2%, P<0.001), mechanical circulatory support (0.7% versus 0.5%. P<0.001), vasopressor use (1.3% versus 1.0%, P<0.001), and ARDS (0.1% versus 0.06%, P=0.007) were significantly higher in 2020, compared to 2019. Conditional logistic regression analysis showed that the odds of adverse clinical outcomes such as in hospital mortality (OR, 1.09;95% CI, 1.06-1.11), mechanical ventilation (OR, 1.07;95% CI, 1.05-1.09), vasopressor use (OR, 1.07;95% CI, 1.04-1.10), and ARDS (OR, 1.74;95% CI, 1.58-1.91) were significantly higher among heart failure hospitalizations in 2020. However, the odds of mechanical circulatory support did not differ between the two-time frames. CONCLUSION(S): Our study found that patients with heart failure hospitalized during the COVID-19 pandemic had greater in-hospital adverse events such as greater in-hospital mortality, mechanical ventilation use, vasopressor use, and ARDS. These findings warrant that heart failure requires prompt hospitalization and aggressive treatment irrespective of restrictive mandates during COVID-19 pandemic.Copyright © 2022
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Introduction: Myocarditis commonly results from viral infections, which causes inflammation of the heart muscles. This could lead to adverse outcomes such as prolonged hospitalizations, cardiogenic shock, cardiac arrest, and event death. Studies have shown that COVID-19 could lead to myocarditis. However, the differences between COVID-19 myocarditis and non-COVID-19 myocarditis have not been explored. Hypothesis: We hypothesized that adverse hospital outcomes such as in-hospital mortality, cardiogenic shock, cardiac arrest, mechanical ventilation, and acute respiratory distress syndrome would be higher among hospitalizations for COVID-19 myocarditis, compared to non-COVID-19 myocarditis. Method(s): We conducted a retrospective analysis of data collected in California State Inpatient Database (SID) during 2019 and 2020. We included data from all hospitalizations for COVID-19 myocarditis during 2020 and compared with data from all hospitalizations for non-COVID-19 myocarditis during 2019. ICD-10-CM diagnosis codes were used to identify procedures and conditions. Cox proportional and logistic regression analyses were done to compare the outcomes between the two groups. Result(s): A total of 1,165 non-COVID-19 myocarditis and 575 COVID-19 myocarditis hospitalizations were included for the analysis. Nearly 45% of COVID-19 myocarditis hospitalizations were >=65 years, while 52.3% of non-COVID-19 myocarditis hospitalizations were between 18-44 years of age. The rates of in-hospital mortality (4.2% versus 31.5%, P<0.001), cardiac arrest (2.0% versus 8.8%, P<0.001), mechanical ventilation (10.4% versus 41.2%, P<0.001), and acute respiratory distress syndrome (0.3% versus 17.5%, P<0.001) were significantly higher among COVID-19 myocarditis hospitalizations, compared to non-COVID-19 myocarditis hospitalizations. Kaplan Meier survival analysis showed that survival rates among COVID-19 myocarditis hospitalizations were significantly lower than non-COVID-19 myocarditis hospitalizations, compared to non-COVID-19 myocarditis hospitalizations (logrank P<0.001). Cox proportional regression analysis showed that in-hospital mortality (hazard ratio [HR], 2.15;CI: 1.41-3.28) was significantly higher among COVID-19 myocarditis hospitalizations. Logistic regression analysis showed that the odds of cardiac arrest (odds ratio [OR], 3.23;95% CI: 1.75-5.94), mechanical ventilation (OR, 5.65 95% CI: 4.09-7.81), and acute respiratory distress syndrome (OR, 72.56;95% CI: 21.52-244.68) were significantly higher among COVID-19 myocarditis hospitalizations. Conclusion(s): Our study using a large administrative database found that COVID-19 myocarditis compared to non-COVID 19 myocarditis affected older individuals and was associated with greater rates of in-hospital mortality and adverse hospital outcomes. These findings highlight the different nature of COVID related myocarditis compared to other forms of acute myocarditis.Copyright © 2022
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INTRODUCTION: Patients with COVID-19 can develop myocarditis due to respiratory hypoxemia, hyperinflammation, as well as direct injury due to binding of the virus to the angiotensin-converting enzyme 2 receptors in myocyte. In this study we examined the association between myocarditis among COVID-19 hospitalizations and adverse hospital outcomes. HYPOTHESIS: We hypothesized that adverse hospital outcomes such as in-hospital mortality, cardiac arrest, cardiogenic shock, mechanical ventilation, and acute respiratory distress syndrome would be higher among COVID-19 hospitalizations with myocarditis. METHOD(S): The current study was a retrospective analysis of data collected in California State Inpatient Database (SID) during 2020. All hospitalizations for COVID-19 were included for the analysis. ICD-10-CM diagnosis was used to identify COVID-19 (U07.1) and myocarditis hospitalizations and other procedures and conditions. Propensity score match analysis, survival analysis, and conditional logistic regression were done to compare adverse clinical outcomes between COVID-19 patients with and without myocarditis. RESULT(S): A total of 164,368 COVID-19 hospitalizations were included for the analysis. Among them, 575 (0.4%) hospitalizations had myocarditis. Prior to propensity score matching, the rate of in-hospital mortality was significantly higher among COVID-19 hospitalizations with myocarditis (29.8% versus 14.0%, P<0.001). Even after propensity score matching, the rate of in-hospital mortality was significantly higher among the myocarditis group (30.0% versus 17.5%, P<0.001). Supporting this finding, survival analysis with log-rank test also showed that 30-day survival rates were significantly lower among those with myocarditis (39.5% versus 46.3%, P<0.001). Conditional logistic regression analysis showed that the odds of cardiac arrest (OR,1.90;95% CI, 1.16-3.14), cardiogenic shock (OR,4.13;95% CI, 2.14-7.99), mechanical ventilation (OR,3.30 (2.47-4.41), and acute respiratory distress syndrome (OR, 2.49;95% CI, 1.70-3.66) were significantly higher among those with myocarditis. CONCLUSION(S): Our study using a large administrative database found that myocarditis was associated with greater rates of in-hospital mortality and adverse hospital outcomes among COVID-19 patients. Early suspicion is important for prompt diagnosis and timely management.Copyright © 2022
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Background It is a well-established fact that cardiovascular disease (CVD) adversely affects COVID-19 outcomes. However, the extend of the burden posed by CVD on hospitalized COVID-19 patients in the United States is unknown. In this study, using a national database, we estimated the effects CVD on COVID-19 hospitalizations in the United States. Methods This study is a retrospective analysis of National Inpatient Sample data, collected during 2020. Patients >=18 years of age, admitted with primary diagnosis of COVID-19 were included in the analysis. CVD was defined as presence of coronary artery disease, myocardial infarction, heart failure, sudden cardiac arrest, conduction disorders, cardiac dysrhythmias, cardiomyopathy, pulmonary heart disease, venous thromboembolic disorders, pericardial diseases, heart valve disorders, or peripheral arterial disease. The primary outcomes of the study were in-hospital mortality rate, prolonged hospital length of stay, mechanical ventilation, and disposition other than home. Multivariable logistic regression analysis was done to examine the association between presence of CVD and primary outcomes. Results During 2020 there were 1,050,040 COVID-19 hospitalizations in the United Sates. Of these 454650 (43.3%) had CVD. COVID-19 patients with CAD were older, males, and had higher comorbidity burden. The odds of in-hospital mortality (OR, 3.40;95% CI: 3.26-3.55), prolonged hospital length (OR, 1.71;95% CI: 1.67-1.76) and mechanical ventilation use (OR, 3.40;95% CI: 3.26-3.55), and disposition other than home (OR, 2.11;95% CI: 2.06-2.16) were significantly higher for COVID-19 hospitalizations with CAD. Mean hospitalization costs were also significantly higher among COVID-19 patients with CAD ($24,023 versus $15,320, P<0.001). The total cost of all COVID-19 hospitalizations during 2020 was $19.9 billion - $10.9 billion for those with CAD and $9.0 billion for those without CVD. Conclusion Cardiovascular disease was present in a substantial proportion of COVID-19 patients hospitalized in the United States and contributed to considerable adverse hospital outcomes and significantly higher hospitalization cost.Copyright © 2023 American College of Cardiology Foundation
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Copper and Gold today are some of the key metals in the metals and mining space especially due to the external events happening such as Covid-19 pandemic and Russia-Ukraine war. Also, the rupee-dollar exchange rate is highly volatile currently. The study's goal is to determine how copper and crude oil's shock volatility and price volatility affect the exchange rates between the rupee and the dollar. The study tries to find the correlation and mutual association between the metals (copper prices and gold prices) and foreign exchange rate. In order to establish such a relationship, bi-variate GARCH models (VEC GARCH and BEKK GARCH) are applied to sample data of the copper price, gold price, and foreign exchange rate (rupee-dollar) taken from the period 2005 to 2020 to determine a mutual correlation and volatility spillover effect in the metals and forex markets. © 2022 IEEE.
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Copper and Gold today are some of the key metals in the metals and mining space especially due to the external events happening such as Covid-19 pandemic and Russia-Ukraine war. Also, the rupee-dollar exchange rate is highly volatile currently. The study's goal is to determine how copper and crude oil's shock volatility and price volatility affect the exchange rates between the rupee and the dollar. The study tries to find the correlation and mutual association between the metals (copper prices and gold prices) and foreign exchange rate. In order to establish such a relationship, bi-variate GARCH models (VEC GARCH and BEKK GARCH) are applied to sample data of the copper price, gold price, and foreign exchange rate (rupee-dollar) taken from the period 2005 to 2020 to determine a mutual correlation and volatility spillover effect in the metals and forex markets. © 2022 IEEE.
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Background: The COVID-19 pandemic has led to dramatic loss of human life worldwide and presents an unprecedented challenge to public health, food systems, and the world of work. The availability of a safe and effective vaccine for COVID-19 is well recognized as an additional tool to contribute to the control of the pandemic. Although vaccines proved efficacious in preventing infection, yet some cases of post-vaccination breakthrough infections (BTIs) have been reported, raising concerns about the efficacy and safety of COVID vaccines. Aim and Objectives: This study was aimed to investigate the occurrence of BTIs among the vaccinated healthcare workers (HCWs), to analyze the severity of their disease and to know the trends in drug therapy. Material(s) and Method(s): This was a retrospective cross-sectional study. Data were obtained by a predesigned questionnaire and was distributed through Google platform. Details of time, severity of BTIs and the trends in drug therapy among the vaccinated healthcare workers (HCWs) was evaluated and statistically analyzed. Result(s): A total of 616 HCWs participated in the study, out of which 553 were vaccinated and 63 of them were unvaccinated. About 15%, that is, 85/553 of the vaccinated HCWs developed BTI. Case rate was lesser (12.9%) in fully vaccinated HCWs as compared to partially vaccinated HCWs (19.5%). Most BTI cases (94%) suffered mild to moderate severity of symptoms and were managed in home isolation with medicines (mainly paracetamol, azithromycin, and doxycycline). Only five out of 85 BTI cases developed severe disease and needed hospitalization. Conclusion(s): BTIs after COVID-19 vaccination are uncommon and typically present with mild symptoms. Thus, vaccination along with hand sanitization, wearing of masks, and maintaining social distancing has provided hope in combating the pandemic. Copyright © 2022 Anju Saxena, et al.
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Introduction: Current estimates show that, globally, there are 531 million cases and 6.3 million deaths due to COVID-19. Studies have shown that COVID-19 could lead to deep vein thrombosis (DVT) resulting in increased morbidity and mortality. In this study we sought to estimate the prevalence of DVT among COVID-19 hospitalizations as well as its effects on hospital outcomes using a large administrative database. Hypothesis: The adverse in-hospital outcomes of COVID-19 will be significantly higher among DVT hospitalizations. Method(s): We conducted a retrospective analysis of the 2020 California State Inpatient Database. All hospitalizations with age 18 and above and primary diagnosis of COVID-19 were included for the study. They were classified into those with and without DVT. The main outcomes of the study were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission. Length of stay >=75th percentile was grouped as prolonged length of stay. Multivariate logistic regressions with covariate adjustments were conducted to compare COVID-19 related outcomes between those with and without DVT. Result(s): We included a total of 94,114 primary COVID-19 hospitalizations for the analysis. Among them 1575 (1.7%) had DVT. The prevalence of mortality (27.5% versus 11.1%, P<0.001), prolonged length of stay (62.2% versus 27.8%, P<0.001), vasopressor use (7.9% versus 2.1%, P<0.001), mechanical ventilation (36.2% versus 9.7%, P<0.001), and ICU admission (35.7% versus 9.3%, P<0.001) were significantly higher among those with DVT. After adjusting for covariates, regression analysis showed that those with DVT had significantly greater odds for mortality (aOR, 2.34, 95% CI: 2.07-2.65), prolonged length of stay (aOR, 3.51, 95% CI: 3.16-3.91), vasopressor use (aOR, 4.23, 95% CI: 3.78-4.74), mechanical ventilation (aOR, 2.90, 95% CI: 2.38-3.53), and ICU admission (aOR, 4.32, 95% CI: 3.85-4.84). Conclusion(s): In our cohort, only few COVID-19 hospitalizations had a diagnosis of DVT. However, among those with DVT, the risk for adverse outcomes were significantly higher. Since DVT among COVID-19 is uncommon but associated with adverse hospital outcomes, healthcare providers should promptly monitor for DVT and manage it.
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Introduction: According to recent global estimates there are nearly 530 million cases and 6.3 million deaths due to novel coronavirus disease 2019 (COVID-19) pandemic. Studies have shown that COVID-19 disproportionately affects males than females. In this study we looked at differences in in-hospital outcomes of COVID-19 based on sex using a larger administrative database. Hypothesis: The adverse in-hospital outcomes of COVID-19 will be significantly higher among males. Method(s): This was a retrospective analysis of the California State Inpatient Database 2020. All COVID-19 hospitalizations with age 18 years and above were included for the analysis. These hospitalizations were classified into males and females. The main outcomes of the study were inhospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission. Any length of stay >=75th percentile value for the entire cohort was considered as prolonged length of stay. Logistic regression analyses after adjusting for covariates were used to compare COVID-19 related outcomes between males and females. Result(s): A total of 95,180 primary COVID-19 hospitalizations were included for the analysis. Of these 52465 (55.1%) were males and 42715 (44.9%) were females. Among these hospitalizations, mortality (12.4% versus 10.1%, P<0.001), prolonged length of stay (30.6% versus 25.8%, P<0.001), vasopressor use (2.6% versus 1.6%, P<0.001), mechanical ventilation (11.8% versus 8.0%, P<0.001), and ICU admission (11.4% versus 7.8%, P<0.001) were significantly higher among males. Logistics regression analysis showed that males had significantly greater odds for mortality (aOR, 1.38, 95% CI: 1.32-1.44), prolonged length of stay (aOR, 1.35, 95% CI: 1.31-1.39), vasopressor use (aOR, 1.59, 95% CI: 1.51-1.66), mechanical ventilation (aOR, 1.62, 95% CI: 1.47- 1.78), and ICU admission (aOR, 1.58, 95% CI: 1.51-1.66). Conclusion(s): Adverse outcomes such as mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission were independently associated with male sex. These findings could be due differences to both biological and social factors between the sexes. Future studies should explore these factors to efficiently control COVID-19.
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INTRODUCTION: SARS-CoV-2 (COVID-19) has continued to be a public health emergency, affecting almost 450 million people worldwide, with a disproportionate significant disease burden in the elderly community. Our objective is to provide population specific prognostic markers upon description of demographic factors, clinical characteristics, diagnostic variables, treatment characteristics and outcome variables in critically ill geriatric patients with acute hypoxic respiratory failure due to COVID-19 infection. METHOD(S): This is a retrospective chart review of 165 patients admitted to a single institution's medical and cardiovascular intensive care unit between the dates of March 01, 2020 and December 31, 2020. Inclusion criteria was patients age greater than or equal to 65 years, documented positive COVID-19 polymerase chain reaction test result and a diagnosis of acute hypoxic respiratory failure. Our primary end point evaluated the rate of mortality in relation to multiple variables during intensive care unit admission. RESULT(S): Of 165 patients, 45 patients were excluded. Of the remaining 120 patients, 41 were females and 79 were males. Four independent risk factors are significantly associated with higher odds of mortality for the concerned population: presence of solid tumor (AOR: 0.002, 95% CI: < 0.001, 0.31), maximum value of PaCO2 (AOR: 1.094, 95% CI: 1.029, 1.163), Charlson comorbidity index (AOR: 2.962, 95% CI: 1.59, 5.52), and use of diuretics (AOR: 0.015, 95% CI: < 0.001, 0.49). CONCLUSION(S): It was to our surprise that the mortality rate among those intubated was not statistically significant. However, it has been shown in prior research, which is in alignment with our results, that mechanical ventilation does not necessarily result in increased mortality. Certain factors were found to be poor prognostic markers during intensive care unit admission, which may predict a higher rate of mortality in those patient populations.
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Gross Domestic Product is the aggregate value of all final services and products generated by the country during the measurement period, including private inventories, paid-in capital expenditures, government purchases, personal consumption, and the balance of international commerce. During the Pandemic period of the last two years, the COVID-19 outbreak has caused chaos in the worldwide economy. Sickness outbreaks, supply-chain disruptions, and, more recently, inflation have made policymaking exceedingly difficult. This research aims to forecast GDP (Gross Domestic Product) per capita for the coming years while also examining historical and present trends in India. This study's objective is to forecast India's future GDP per capita over ten years, from 2021 to 2030, using ARIMA. According to a study, India's GDP per capita has been growing during the last 10 years, and this movement is likely to last over the following ten years. © 2022 IEEE.
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Learning outcomes: After working through the case and assignment questions, students will be able to understand the following aspects:▪ how good strategic planning can convert a crisis into an opportunity;▪ importance of service excellence and customer satisfaction through customer delight and customer feedback;and▪ utilisation of resources and excellent time management strategies. Case overview/synopsis: This case discusses how vital teamwork and motivated leadership can convert a crisis such as Covid-19 into an opportunity. This case study talks about Uttar Pradesh Metro Rail Corporation (UPMRC), a metro rail corporation working to develop metro trains in the Indian state of Uttar Pradesh. The case discusses how challenging it was for the metro rail corporation to transform its processes in a short period and deal with the crisis on major fronts such as facilities maintenance, human resource management, ensuring safety and security of its staff and riders, motivation of staff, service quality and maintaining all operational aspects. The case discusses how UPMRC is a leader on all fronts and has excelled in its operational work. It talks about what challenges the lockdown and unlocking phase posed in front of the leadership and how teamwork, dedication to exemplary service quality and customer satisfaction gave the team the strength to make changes that improved their processes and helped them overcome the crisis.The case starts with a discussion of metro rail inception and incorporation of UPMRC and then how this newly formed metro has to face the challenges of pre-lockdown period where the team worked very hard for sanitisation and safety. The lockdown created a completely different set of challenges related to the facilities and the entire metro train systems, which was a difficult situation to deal because of restrictions and other challenges. However, the team dealt with situations with strength and strategic planning, leading to better managed processes and staff. The unlocking phase also gave many challenges that the team handled with a lot of care and efficiency. Complexity academic level: This case is suitable for post-graduate-level courses on services marketing, service operations management, general management, crisis management and strategic management. Participants can use the case to develop an understanding of strategic planning and management.This case can also be used in the executive education program for managers to encourage them to think through challenges faced by metro rail corporations. Supplementary materials: Teaching notes are available for educators only. Subject Code: CSS 10: Public Sector Management. © 2022, Emerald Publishing Limited.
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Internet trend is growing day by day and the education system is going to be online sooner or later. In developing countries, like India, technological changes are rapidly taking place irrespective of age and gender. We have witnessed COVID 19, which brought technological adaptations in the education system. There was a clear shift of teaching-learning process from traditional to online. Technology is spreading out in 360 degree angle without which one cannot survive even. When it comes to the higher secondary education, how internet and other technologies can be utilized in an effective way? It is often observed adolescents are getting emotional when they watch online brutal advertisements. It is very difficult to balance their emotions once they are trolled or embarrassed in social networking sites. Such adolescents often isolate themselves from online or stop using social networking cites for some time. If we see the availability of internet, there are huge demographic differences. The students who have availability of internet are likely to access and visit online frequently compare to others. Thisstudy will help teachers to identify students with internet addiction and their emotional stability in class. The present study has gone in this direction in order to explore the relationship between availability of internet usage and emotional maturity in the students of higher secondary. A survey was conducted on 200 participants randomly and correlation was established. The findings were interesting and results were discussed.