The effect of coronavirus disease-19 lockdown on the incidence and profile of penetrating ocular injuries

Background: Perforating ocular injuries in particular carry a high risk of visual morbidity in all age groups. Risk factors associated with ocular trauma include gender, age, occupation, and lower socioeconomic status. Eye injuries are causing a major concern to the general ophthalmologists both in the developed and developing countries. Background: The objective of this article is to study the profile of penetrating ocular injuries before and during the period of lockdown. Materials and Methods: A study was done to make a comparative analysis of the penetrating ocular injuries occurring during the period of lockdown of 3 months (April 1, 2020-June 30, 2020) and 3 months (January 1, 2020-March 31, 2020) before lockdown. Results: The study included 33 patients hospitalized before lockdown and 45 hospitalizations during the lockdown in all age groups. Injuries were more common in males. The injuries reported in the age group of 0-15 years before lockdown were 36.36% while during lockdown 60% injuries were observed. Modes of injuries reported before lockdown were indoor injuries (36.36%) and road traffic accidents (36.36%) while during lockdown, the major mode of injuries were indoor injuries (76.6%) whereas the road traffic accidents (10.0%) declined. Conclusion: During the lockdown, indoor injuries were more common in comparison to the outdoor injuries such as road traffic accidents, the latter being more prevalent before lockdown. During lockdown, increase in the indoor leisure activities of children led to a rise in the cases of eye injuries and an increase of almost double the number was observed. In addition to this, immobilization led to a decrease in the injuries due to road traffic accidents. The coronavirus disease-19 lockdown did have an impact on the profile of penetrating ocular injuries.

Effect of educational intervention on knowledge and attitude about the role of vitamins, minerals and nutraceuticals in COVID-19 and other disorders among medical and nursing undergraduates of a tertiary care teaching hospital.

PURPOSE: There must be a perfect balance between Food and Dietary supplements (DS) to ensure optimal well-being. The purpose of this study was to evaluate the impact of a webinar on the change in knowledge and attitude about the role of vitamins, minerals and DS among medical and nursing undergraduates so that they could bring about a positive change in popular practices, as well-informed Health Care Professionals (HCPs). MATERIALS AND METHODS: The study was a cross-sectional analytical study comprising 12 knowledge and 11 attitude questions administered to medical and nursing undergraduates with the help of semi-structured and pre-validated google form both before and after a webinar explaining the role of key nutrients and also the evidence and recommendations surrounding DS. Data were analyzed using STATA.12 to assess the impact of the webinar. RESULTS: There were 415 participants, with 265 medical and 150 nursing students. There was a significant improvement both in the knowledge (4.95 (±1.45), 7.76 (±1.69) and attitude scores (pre-webinar mean score 31.8 (±5.57) post-webinar mean score 27.7 (±4.90))of the participants after the webinar. An overall positive correlation before the webinar changed to a more significant negative correlation, indicating a positive impact of the webinar (0.0054-0.0701). CONCLUSION: The study suggests that continuing education informing various HCPs and undergraduate students about the absolute necessity of a diet rich in nutrients, vitamins, minerals, and probiotics is the need of the hour. Additionally, the efficacy and safety concerns, appropriate indications and dosages of various DS should be adequately stressed so that informed decisions can be made. Such training programs might have a far-reaching impact on the nutrition choices of the population at large.

An empirical analysis of deep ensemble approach on COVID-19 and tuberculosis X-ray images

COVID-19 is a pandemic and a highly contagious disease that can severely damage the respiratory organs. Tuberculosis is also one of the leading respiratory diseases that affect public health. While COVID-19 has pushed the world into chaos and tuberculosis is still a persistent problem in many countries. A chest X-ray can provide plethora of information regarding the type of disease and the extent of damage to the lungs. Since X-rays are widely accessible and can be used in the diagnosis of COVID-19 or tuberculosis, this study aims to leverage those property to classify them in the category of COVID-19 infected lungs, tuberculosis infected lungs or normal lungs. In this paper, an ensemble deep learning model consisting of pre-trained models for feature extraction is used along with machine learning classifiers to classify the X-ray images. Various ensemble models were implemented and highest achieved accuracy among them was observed as 93%.

A Multi-Criteria Decision Approach using Divergence Measures for Selection of the Best COVID-19 Vaccine

COVID-19 is a worldwide health threat that has resulted in a significant number of deaths and complicated healthcare management issues. To prevent the COVID-19 pandemic, there is a need to choose a safe and most effective vaccine. Several Multi-criteria Decision-Making (MADM) techniques and approaches have been selected to choose the optimal probable options. The purpose of this article is to deliver divergence measures for fuzzy sets. To validate these measures, some of the properties were also proved. The Multi-criteria Decision-Making method is employed to rank and hence select the best vaccine out of available alternatives. The proposed research allows the ranking of different vaccines based on specified criteria in a fuzzy environment to aid in the selection process. The results suggest that the proposed model provides a realistic way to select the best vaccine from the vaccines available. A case study on the selection of the best COVID-19 vaccine and its experimental results using fuzzy sets are discussed. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

A Case Series of Mucocutaneous Mucormycosis and its Risk Factors among SARS-CoV-2 Patients.

Mucormycosis is a rare, aggressive angioinvasive deep fungal infection caused by mucorales. The epidemiology of mucormycosis has changed in recent times with the increase in incidence, identification of new causative agents, and predisposing factors. The clinical spectrum of mucormycosis includes rhinocerebral, sinopulmonary, cutaneous, and disseminated forms. Cutaneous mucormycosis is an emerging infectious disease especially in post COVID-19 era. Cutaneous mucormycosis can be of two varieties: primary cutaneous and secondary cutaneous. Primary cutaneous mucormycosis is caused by direct inoculation of spores at the site of local trauma resulting in necrotic ulcers, especially, in immunosuppressed patient. Secondary cutaneous mucormycosis results from either dissemination or local invasion to the skin from a rhinocerebral form. The existing data on mucocutaneous mucormycosis is sparse especially in India. Herein, we present a case series describing the demographic factors, predisposing factors, clinical presentation, management of unique cases of mucocutaneous mucormycosis and its association with COVID-19 infection.

An observational multi-centric COVID-19 sequelae study among health care workers.

Background: India has seen more than 43 million confirmed cases of COVID-19 as of April 2022, with a recovery rate of 98.8%, resulting in a large section of the population including the healthcare workers (HCWs), susceptible to develop post COVID sequelae. This study was carried out to assess the nature and prevalence of medical sequelae following COVID-19 infection, and risk factors, if any. Methods: This was an observational, multicenter cross-sectional study conducted at eight tertiary care centers. The consenting participants were HCWs between 12 and 52 weeks post discharge after COVID-19 infection. Data on demographics, medical history, clinical features of COVID-19 and various symptoms of COVID sequelae was collected through specific questionnaire. Finding: Mean age of the 679 eligible participants was 31.49 ± 9.54 years. The overall prevalence of COVID sequelae was 30.34%, with fatigue (11.5%) being the most common followed by insomnia (8.5%), difficulty in breathing during activity (6%) and pain in joints (5%). The odds of having any sequelae were significantly higher among participants who had moderate to severe COVID-19 (OR 6.51; 95% CI 3.46-12.23) and lower among males (OR 0.55; 95% CI 0.39-0.76). Besides these, other predictors for having sequelae were age (≥45 years), presence of any comorbidity (especially hypertension and asthma), category of HCW (non-doctors vs doctors) and hospitalisation due to COVID-19. Interpretation: Approximately one-third of the participants experienced COVID sequelae. Severity of COVID illness, female gender, advanced age, co-morbidity were significant risk factors for COVID sequelae. Funding: This work is a part of Indian Council for Medical Research (ICMR)- Rational Use of Medicines network. No additional financial support was received from ICMR to carry out the work, for study materials, medical writing, and APC.

The best COVID-19 vaccine: understanding the conundrum behind comparing vaccines

Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2) infection has created global devastation in the past three years. The Corona Virus Disease-19 (COVID-19) vaccine is the only available resource to fight SARSCoV- 2 infection and its associated complications. As world is trying to recover with the help of vaccines, the change in vaccine development strategy and allowing the usage of vaccines at an emergency level with small size clinical data has created a storm of confusion among many individuals concerning efficiency and efficacy of the vaccine. Though multiple pieces of literature are available regarding the different types and strategies of vaccine development, no paper gives an idea about which vaccine should be used in this emergency. More than 90 vaccine candidates are in the race showing 70-95% efficiency at clinical trials, and still, people are afraid to take vaccines due to lack of awareness. This review compares the available vaccines and evaluates their efficiency based on the available clinical trial results to answer the most frequently asked question of which vaccine is best to be taken at this time?

A case of Blaschkoid pityriasis rosea following COVID-19 vaccination: A rare exceptional occurrence

The launch of COVID-19 vaccines in India has raised the expectations of the dreadful COVID-19 pandemic ending in the future. Various mild and benign cutaneous manifestations of the different forms of the COVID-19 vaccine have been documented. Herein, we are reporting a unique case of Blaschkoid pityriasis rosea (PR) developing after COVID-19 vaccination. A forty-two-year-old female presented with PR along a linear arbitrary zone on the back at the level of L1-L2 extending to involve the abdomen and an oblique zone on the thigh. She was vaccinated with the first dose of the COVISHIELD ChAdOx1/nCoV-19 (recombinant) coronavirus vaccine six days before the onset of the lesions. There are only several case reports of typical pityriasis rosea occurring after COVID-19 vaccination. Our unique case depicts the occurrence of atypical PR after COVID-19 vaccination. [ FROM AUTHOR] Copyright of Our Dermatology Online / Nasza Dermatologia Online is the property of Our Dermatology Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Convalescent plasma - An insight into a novel treatment of covid-19 ICU patients.

INTRODUCTION: Various therapies have been tried for Covid disease including the use of antivirals, steroids, monoclonal antibodies and convalescent plasma. METHOD: The study was conducted on convalescent plasma transfused ICU patients. Part A of the study involves clinical outcomes based on gender, age, comorbidities, blood group,and the average length of stay. Part B investigates clinical outcomes in patients transfused with convalescent plasma before and after the November 2021 guidelines. Part C of the study includes patients in cytokine storm and the efficacy of tocilizumab in these patients. RESULT: Out of the 326 ICU patients transfused with convalescent plasma the overall mortality was 152 (53.3 %). On comparing blood groups and clinical outcomes, a clinically significant result was found. A clinically significant association was also seen on comparing the clinical outcome of 18-50 years and 61-70 years age group and in female gender patients. The average number of ICU days had a positive impact on the overall patient survival. Out of the patients in 'cytokine storm' (n = 109), on day 20, the survival percentage in the non-Tocilizumab group showed a downward trend throughout. However, in the Tocilizumab group, the survival percentage remained stable throughout till around day 50. CONCLUSION: Amongst the convalescent plasma transfused ICU patients, females, having blood group B, and an average length of stay of fewer than 20 days had a better chance of survival. The patients given tocilizumab and convalescent plasma had a better chance of survival compared to tocilizumab alone.

Role of power distance phenomena in blended learning in higher education post-Covid-19

COVID has posed several challenges for higher education. There is a rise in blended teaching and learning models that can improve the quality of education, observed Raman. Classroom interaction vital in quality of education is affected by power distance between the teacher and students, states Kasuya. Much research has been done on blended learning but hardly any on the role of power distance in blended learning in higher education, specifically post COVID. Keeping in mind the growing significance of blended learning shortly, it becomes strategically important to understand the role of power distance in blended learning in higher education post-COVID-19. This research paper tries to address the research gap. The study is exploratory, exploring the role of power distancing in blended learning formats during post-COVID-19. The findings indicate that there is a relationship between power distance and the autonomy of an individual. The higher the power distance between a teacher and a student from the teacher's perspective, it becomes teacher-centred learning. So blended learning with the best of low power distances in terms of the media and delivery mechanism of offline and online ensures the mitigation of power between the teacher and the taught. The research will help the universities create a perfect blended learning format that enhances the quality of higher education. Due to the paucity of time and resources and a ban on respondent interaction due to pandemics, this research is based on secondary data analysis.

Comparative study of coping, anxiety, and resilience in doctors caring and not-caring for COVID 19 patients

BACKGROUND: Doctors are more vulnerable to the negative effects of the COVID 19 pandemic than the general population due to direct contact with patients causing an increase in levels of anxiety and compromising resilience by isolation and risk to family members. This study aims to explore the anxiety, resilience, and coping among health care professionals. AIM: To compare the coping strategies, anxiety, and resilience in doctors caring and not caring for COVID 19 patients. METHODS: A cross-sectional study was carried out in a tertiary care center from September 2020 to September 2021. A written informed consent was obtained for participation in the study from all doctors recruited for the study after explaining the purpose and design of the study. By purposive sampling a total of 100 doctors were recruited in the study after fulfilling the inclusion and exclusion criteria. RESULTS: The mean Coronavirus Anxiety Scale (CAS), Brief COPE, Connor – Davidson Resilience Scale scores in doctors treating COVID 19 patients was significantly more than the respective scores for doctors not treating COVID 19. CONCLUSION: The doctors treating COVID 19 patients had more anxiety as compared to doctors not treating COVID 19 patients, whereas doctors not treating COVID 19 patients had better coping and resilience as compared to doctors treating COVID19 patients.

The Relationship Between Vitamin D Levels and Severity in Illness in COVID-19 Patients: A Cross-Sectional Study.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic hit the world badly with high mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increased the COVID-19 burden among developed and developing countries due to the unavailability of proven treatment options. Vitamin D has many important anti-inflammatory, immunomodulator, and anti-viral functions. The present study was conducted to evaluate the relationship between Vitamin D in COVID-19. METHODS: A cross-sectional study was conducted at a tertiary care hospital in Patna, India. All the patients were enrolled during the period of 3.5 months. A chemiluminescence-based immunoassay analyzer was used to quantify Vitamin D among COVID-19 patients. The study compared Vitamin D deficiency and insufficiency among different groups, i.e., age, sex, BMI, comorbidity, etc. Diabetes and hypertension were evaluated as risk factors for mortality. RESULTS: A total of 225 patients were investigated. Of these, 13.6% had Vitamin D deficiency and 38.9% had insufficiency. Vitamin D level was statistically significant among different age groups, sex, and smokers. Patients aged >60 years were 23 times more likely to have a severe illness (adjusted OR (aOR) 23.53, 95%CI 4.67-118.61), whereas those aged 40 to 60 years were 11 times more likely to have a severe illness (aOR 10.86, 95%CI 2.39-49.31). Patients with many comorbidities, on the other hand, had a tenfold greater chance of severe COVID-19 (aOR 9.94, 95%CI 2.47-39.88). A deficiency of vitamin D increased the chance of a serious illness by nearly five times (aOR 4.72, 95%CI 1.31-17.03). CONCLUSION: Vitamin D level was associated with severity of illness; it can be used to estimate the prognosis of COIVD-19 patients and aid in the modification of treatment protocols.

Successful application of wastewater-based epidemiology in prediction and monitoring of the second wave of COVID-19 with fragmented sewerage systems-a case study of Jaipur (India).

The present study tracked the city-wide dynamics of severe acute respiratory syndrome-corona virus 2 ribonucleic acids (SARS-CoV-2 RNA) in the wastewater from nine different wastewater treatment plants (WWTPs) in Jaipur during the second wave of COVID-19 out-break in India. A total of 164 samples were collected weekly between February 19th and June 8th, 2021. SARS-CoV-2 was detected in 47.2% (52/110) influent samples and 37% (20/54) effluent samples. The increasing percentage of positive influent samples correlated with the city's increasing active clinical cases during the second wave of COVID-19 in Jaipur. Furthermore, wastewater-based epidemiology (WBE) evidence clearly showed early detection of about 20 days (9/9 samples reported positive on April 20th, 2021) before the maximum cases and maximum deaths reported in the city on May 8th, 2021. The present study further observed the presence of SARS-CoV-2 RNA in treated effluents at the time window of maximum active cases in the city even after tertiary disinfection treatments of ultraviolet (UV) and chlorine (Cl2) disinfection. The average genome concentration in the effluents and removal efficacy of six commonly used treatments, activated sludge process + chlorine disinfection (ASP + Cl2), moving bed biofilm reactor (MBBR) with ultraviolet radiations disinfection (MBBR + UV), MBBR + chlorine (Cl2), sequencing batch reactor (SBR), and SBR + Cl2, were compared with removal efficacy of SBR + Cl2 (81.2%) > MBBR + UV (68.8%) > SBR (57.1%) > ASP (50%) > MBBR + Cl2 (36.4%). The study observed the trends and prevalence of four genes (E, RdRp, N, and ORF1ab gene) based on two different kits and found that prevalence of N > ORF1ab > RdRp > E gene suggested that the effective genome concentration should be calculated based on the presence/absence of multiple genes. Hence, it is imperative to say that using a combination of different detection genes (E, N, RdRp, & ORF1ab genes) increases the sensitivity in WBE.