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Objective: To compare the role of intra-ovarian Platelet-Rich Plasma (PRP) versus marrow derived Stem-Cells (SC) instillation for improvement in ovarian-reserve (AFC,AMH, FSH). Design: A prospective comparative study. Method: 72 infertile females (20-39 years) with poor ovarian reserve (AMH <1.2 ng/ml;AFC < 5) (POSEIDON criterion) were enrolled for study between January 2020 -December 2021. The two comparative groups underwent either intra-ovarian PRP instillation (n = 42) or autologous SC transplantation (n = 30). After the two groups were matched (PRP vs. SC) for baseline characteristics (Age, AMH, AFC, FSH, Estradiol), 30 subjects in each group were compared for change in serum FSH/AMH/Estradiol levels and AFC at 1st month and 3rd month post intervention from the baseline. This was also compared between the two groups using Student t-test. The cost and procedural pain measured using Visual analog scale (VAS) were also compared. Results: After matching for baseline characteristics, significant ∼ 1.8/2 and ∼1.5/1.6fold increase in AFC at 1st/3rd month post intervention (p < 0.001) was observed after PRP instillation and SC transplantation respectively. However, PRP group fared better than SC group at 3rd month post intervention (7.07 vs. 5.60, p = 0.02), while no significant difference existed amongst the two at 1st month of follow up. Levels of Serum FSH, AMH and Estradiol (p > 0.05) did not differ significantly from the baseline at 1st and 3rd month post intervention in both the groups. Similarly, there was no significant difference between the two groups in serum FSH level (7.98 IU/ml vs. 9.62 IU/ml, p = 0.062;8.26 IU/ml vs. 9.50 IU/ml, p = 0.15), AMH level (1.62 ng/ml vs. 1.02 ng/ ml, p = 0.27;1.35 ng/ml vs. 0.95 ng/ml, p = 0.24), Estradiol level (49.12 pg/ml vs. 56.48 pg/ml p = 0.443;54.7 pg/ml vs. 61.12 pg/ml, p = 0.44) at 1st and 3rd month post intervention respectively. PRP is comparatively more cost effective and is associated with lesser pain (32.5 mm vs. 28.13 mm, p = 0.02) then SC group thus showing better compliance and acceptability. Conclusion: Both PRP and SC therapies improves the ovarian reserve markers however, response to PRP is superior to SC. Also, further to note that PRP is minimally invasive and has better compliance and acceptability. The main limitation of this study is small sample size and due to Covid pandemic inability to perform the IVF cycles to show improvement in clinical pregnancies and live births. Therefore, a large randomized trial is required to validate these results.
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Indoor tanning using ultraviolet (UV) radiation increases skin cancer risk. However, there is little objective information on when or where indoor tanning is used. We aimed to evaluate tanning salon geography and patterns of use using objective data rather than self-report. We used data from SafeGraph, a company that combines smartphone location data and proprietary geographic data. Our dataset included aggregate, anonymous data from January 1, 2018-December 31, 2020. We developed and validated an algorithm (positive predictive value 92.6%) to identify businesses offering UV indoor tanning. We evaluated tanning salon locations, number of tanning salons per state population, and foot traffic patterns by visits per month, per day of the week, and per hour of the day. Our algorithm identified 7412 businesses as tanning salons. Of those, 2795 (37.7%) had foot traffic data available. The highest concentrations of tanning salons were in Midwestern states. We found peaks in the spring (April) of 2018 and 2019, a slightly later peak (June) in 2020, and a short-term decrease in tanning salon visits during the early phases of the COVID-19 pandemic (March-May 2020). Visits were most frequent during weekdays (Monday-Friday). Peak times of day were 12pm-3pm. Our study has limitations: it includes only a small portion of the US population (approximately 10% of mobile devices) and we could not account for indoor tanning outside of tanning salons. Indoor tanning is a known carcinogen, but the majority of information on use is based on cross-sectional surveys. Our study represents new information for public health strategies to decrease exposure to this carcinogen.
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Case Report A 29-year-old male with a past medical history significant for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection presented with epigastric pain, vomiting, fever, and inability to tolerate oral intake for 1 day. The patient was diagnosed with COVID-19 six weeks prior to presentation and four weeks later was diagnosed with idiopathic acute pancreatitis. He reported initial resolution of pain, however symptoms recurred for one day prior to this admission. The patient denied a history of alcohol use disorder. He is a lifetime nonsmoker. He does not take any medications. Vital signs were stable and he was afebrile. Labs on presentation were remarkable for elevated lipase of 1,527 and leukocytosis (23,000). The patient was still positive for COVID-19. However, he maintained oxygen saturation >95% on room air with no apparent distress. On physical examination, he had severe tenderness to palpation at the epigastrium and left upper and lower quadrants. Abdominal ultrasound had no evidence of gallstones. Triglyceride levels were within normal limits. CT abdomen showed necrotizing pancreatitis. MRCP showed evidence of acute pancreatitis with peripancreatic acute necrotic collection in the pancreatic head measuring up to 8.8 cm. Intrinsic T1 signal within the peripancreatic collection compatible with hemorrhagic pancreatitis. There was about 30% pancreatic parenchymal necrosis in the pancreatic head. A nonocclusive thrombus involving the main portal vein was also seen. Autoimmune workup was negative. In the setting of hemorrhagic pancreatitis, treatment with anticoagulation was deferred. The patient was treated with supportive measures, including intravenous fluids and adequate pain control with eventual advancement of his diet. He was started on empiric antibiotics and discharged for outpatient follow-up. SARS-CoV2 is known to cause many extrapulmonary effects, including transaminitis, myocarditis and pericarditis. There have been rare cases of SARS-CoV2-induced acute pancreatitis reported in the literature. The exact mechanism behind pancreatic injury in the setting of SARS-CoV2 infection remains unclear, but it is hypothesized that it may occur secondary to the presence of SARS-CoV2 receptors on the pancreas. The main receptor used by SARS-CoV2 is angiotensin- converting enzyme 2, which is also expressed in the GI tract. The most common causes of acute pancreatitis, including alcohol abuse, gallstones, medications and autoimmune causes were ruled out in our patient. In a patient with no particular risk factors, it is likely that SARS-CoV2 precipitated his first episode of acute pancreatitis. Moreover, it is well known that acute pancreatitis can commonly lead to necrotizing pancreatitis as the initial injury and inflammation from the first attack can cause the pancreatic tissue to necrotize and later become infected. This case highlights that SARS-CoV2 can be a possible etiology of acute pancreatitis and its local complications.
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Background: The increased global obesity rate presents a major public health issue for people of every age group belonging to all regions. Obesity increases health risks, such as cardio-vascular disease, cancer, diabetes, osteoarthritis, and chronic kidney diseases. At present, we have all faced the impact of the damage caused by COVID-19. All past researches and traditional weight machines were found to be either plate-loaded or weight-stack-loaded. The plate-loaded machine requires the location of various load plates and manual adjustment of the load. Machines based on such techniques always have chances for user injury. Objective: The objective of developing a new innovative gym machine provides a load lifting apparatus which does not require weight stacks or weight plates for the user to exercise and is adapted to adjust user of various height and weight, requiring lower maintenance cost, providing user safety, and easy handling nature;this machine offers a cost-effective alternative for the existing devices. Methods: The present paper provides an innovation approach in developing multi exercise self-weight gym machine. The machine includes a unique design with new features for holding the handle during load lifting exercise, an input shaft having one or more first pulleys coupled to the handle for rotating the input shaft. An intermediate shaft having the first set of gears is configured for selective engagement with the input shaft. The output shaft includes a second set of gears which are configured for selective engagement with the intermediate shaft, and one or more second pulleys coupled for lifting one or more loads. A weight-based exercise machine that depends on user weight will add to its independence for adding or withdrawing weights, which makes the designed machine more cost-effective. The addition of parallelogram linkages in its design bene-fitted in providing a non-swing motion. The concept of maintaining proper resistance has also been an important factor during the design of the machine. Patents: The paper presents the idea of designing multi self-weight exercise machine as an innovation, involving a gear change mechanism for the users, having different weights and height. Results: The results concerning the gear ratio for the first and second lever are computed for the respective machine. Effective gear ratio and standardized load values calculation have been obtained for the user having less or more than 78 KG weight. Conclusion: The designed machine has been proved to be efficient by involving innovative ideas and design consisting of engagement configuration of the input shaft and intermediate shaft that further provide different gear ratio between the input, output & intermediate shaft. The concept of movable chairs along with the change of weight through gear mechanism and the use of this machine in different exercises have proved it to be effective and beneficial for users and the manufacturer due to its easy handling nature. © 2021 Bentham Science Publishers.
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Objective: To assess the perceived stress levels amongst faculty and students of medicine, dentistry and allied health sciences during COVID-19 pandemic. Material and Method: This multi-institutional descriptive study was conducted from April to June 2020. All the students and faculty from three institutes namely University College of Medicine, University College of Dentistry and the Institute of Allied Health Sciences were invited to participate. Data was collected using a pre-validated Perceived Stress Scale (PSS-10). descriptive and inferential statistics were calculated using SPSS v.21. Results: 1199 responses were obtained. Students from the University College of Medicine reported higher scores on the Perceived Stress Scale (23.02+11.85) than those from the University College of Dentistry (21.87+10.86) and the Institute of Allied Health Sciences (21.95+11.32). The students and the faculty experienced stress ‘sometimes to fairly often’ during this pandemic. Females experienced more stress than males and there was no significant difference among students and faculty of various age groups. Conclusion: During the COVID-19 pandemic, the students and the faculty from medicine, dentistry and allied health sciences institutes were moderately stressed. The medical students were more affected than the allied health and dental students. A higher stress level was reported among dental faculty as compared to the other two institutes. Institutions should hence promote resilience and mental well-being and provide for more flexible work schedules.
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COVID-19 infodemic has been spreading faster than the pandemic itself. The misinformation riding upon the infodemic wave poses a major threat to people's health and governance systems. Managing this infodemic not only requires mitigating misinformation but also an early understanding of underlying psychological patterns. In this study, we present a novel epidemic response management strategy. We analyze the psychometric impact and coupling of COVID-19 infodemic with official COVID-19 bulletins at the national and state level in India. We looked at them from the psycholinguistic lens of emotions and quantified the extent and coupling between them. We modified Empath, a deep skipgram-based lexicon builder, for effective capture of health-related emotions. Using this, we analyzed the lead-lag relationships between the time-evolution of these emotions in social media and official bulletins using Granger's causality. It showed that state bulletins led the social media for some emotions such as Medical Emergency. In contrast, social media led the government bulletins for some topics such as hygiene, government, fun, and leisure. Further insights potentially relevant for policymakers and communicators engaged in mitigating misinformation are also discussed. We also introduce CoronaIndiaDataset, the first social-media-based Indian COVID-19 dataset at the national and state levels with over 5.6 million national and 2.6 million state-level tweets for the first wave of COVID-19 in India and 1.2 million national tweets for the second wave of COVID-19 in India.</p>
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Objective: The importance of nursing care is unquestionable;therefore, it is important to explore the impact of Coronavirus disease pandemic on nurses and the associated challenges. Methods: A descriptive survey of frontline nurses was carried out from April to June 2020. Participants included nurses from different specialties in public and private hospitals of Pakistan. Sample size was not predetermined. Data were simultaneously collected and analyzed until saturation was achieved. Qualitative data were thematically analyzed and refined through memo writing and team discussions. Results: Nurses (n=210) working at different stages in their careers from both public and private hospitals of Pakistan responded. The nurses felt anxious, distressed and depressed. They faced exceptional workload in resource constraint health facilities. Most of the nurses experienced an improved self-esteem and self-image in the society, while others were discouraged. Some family, academia, clinical services and public related challenges were also identified. Conclusion: For frontline nurses, the COVID-19 crisis is overwhelming. They are providing patient care at a huge personal cost, while watching their own getting infected and die. They are distressed, depressed and overworked. We need to recognize the role of nurses at the forefront and give them their long-awaited social capital as healthcare professionals in their own right. Future studies should explore the lived experiences and coping methods of nurses.
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Objectives: To analyze the current rate of COVID-19 testing in select countries and what India can learn Methods: Number of tests per million people and case doubling time was collected through tracking websites and analyzed for 1 Feb – 6 Apr 2020 for 11 countries. Results: South Korea, with a very high testing rate, reported 380 cases per million for as early as Feb 22, a rate matched by the UK two weeks later. Germany also steeply increased its testing rate starting Mar 10. The total number of samples tested in Germany was 918,460, as of Mar 29 and the case doubling time was 9 days. S. Korea had tested 443, 273 (1% of the total population) cases as of Apr 3 and the case doubling time was 33 days. In contrast, test numbers in India were negligible, and doubling time was 4 days1,2. Importantly, testing capacity globally is currently limited. S. Korea, at number three after US and China in terms of testing kit production, can only support a capacity of 1,35,000 tests per day at present3. Additionally, ICMR guidelines such as “Laboratory test should only be offered when prescribed by a qualified physician” and 48 hours of turnaround time for test results further delay case identification and isolation4. Conclusions: If India was to mirror the testing rate of S. Korea, ∼15 million individuals may have to be tested within coming few weeks to be able to bend the curve of the COVID-19 cases. A balance of both the strategies – exponentially increasing testing and social distancing will be crucial. Sources: 1. https://ourworldindata.org/coronavirus” l "testing-for-covid-19, accessed on Apr 6, 2020 2. Statista,, accessed on Apr 6, 2020 3. News: 4. MoHFW website,, accessed on Ap 7, 2020