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Current Bioactive Compounds ; 19(5):17-25, 2023.
Article in English | EMBASE | ID: covidwho-2267434


Hesperidin has gained major interest recently due to the outbreak of COVID-19. The traction has led to more research being conducted on the compound hesperidin. Recent studies have shown its anti-inflammatory and anti-viral attributes, which have beneficial effects on severe acute respiratory syndrome (SARS-CoV-2). Hesperidin has also shown unique effects on the protein of SARS-CoV-2, which lead to a good preventative measure for SARS-CoV-2. Hesperidin also causes a suppression of appetite, which helps to combat obesity through the release of cholecystokinin. Furthermore, hesperidin has shown cardioprotective properties, which cause an increase in plasma high-density lipoprotein levels and a decrease in plasma low-density lipoprotein levels. Hesperidin is also used in combination with the Japanese herb Rikkunshito, which has shown potential in a discovery of a new drug for gastrointestinal motility as hesperidin can depolarize pacemaker potential in interstitial cells of Cajal (ICC). The chemo-preventive effects of hesperidin are caused by its antioxidant effect, which may prevent tissue necrosis due to oxidative stress. The photo-protective effect of hesperidin can reduce the damage to the skin caused by UV rays. Hesperidin also possesses wound-healing properties.Copyright © 2023 Bentham Science Publishers.

Indian journal of palliative care ; 28(1):115-119, 2022.
Article in English | EuropePMC | ID: covidwho-1877378


The unexpected lockdown announced by the Government of India in March 2020 in response to the pandemic left the coastal community in Kerala deprived of not only essential amenities but also healthcare. Some poverty-ridden, over-crowded coastal regions had been declared as critical containment zones with severe restriction of movement, adding to their vulnerability. People with serious health-related suffering (SHS) in this community required urgent relief. A group of educated youth in the community joined hands with a non-governmental organisation specialised in palliative care (PC) services and strived to find the best possible solutions to address the healthcare needs in their community. This paper reports the collaborative activities done during the pandemic in the coastal region and compares the activities with steps proposed by the WHO to develop community-based PC (CBPC). By engaging, empowering, educating, and coordinating a volunteer network and providing the required medical and nursing support, the programme was able to provide needed services to improve the quality of life of 209 patients and their families who would have been left with next-to-no healthcare during the pandemic. We conclude that even in the context of much poverty, delivery of CBPC with the engagement of compassionate people in the community can successfully reduce SHS.

Journal of Clinical and Diagnostic Research ; 16(SUPPL 2):49, 2022.
Article in English | EMBASE | ID: covidwho-1798717


Introduction: Assessments during COVID-19 pandemic in many institutes were done using Multiple choice questions (MCQs). While most of the faculty were trained for traditional type of framing questions for essay and short answers, setting up MCQs were new to many. Aim: 1. To validate 'MCQ based online assessment' using 'item quality indicators'. 2. To correlate difficulty level of MCQs perceived by question setter and calculated difficulty index. Material and method: It was a retrospective cross-sectional study conducted among 51 second year undergraduates at JIPMER Karaikal. A total of 80 MCQs conducted online via 'Google forms' from mid-semester pathology test were analysed. Item analysis of the MCQs were done by calculating 'difficulty index, discrimination index and distractor effectiveness'. Each item was analysed for item writing flaws. Results: Of 80 MCQs, majority (61, 76.25%) were 'easy' based on 'difficulty index' while 50% had 'poor' discrimination index. Most of the MCQs (51) had two or three non-functional discriminators. Five of the items were invalid with negative discrimination index. Of 11 'image based questions six were easy. All case based questions had acceptable difficulty level. 25 of the items perceived as difficult by question setters were found to be easy on calculating difficulty index. Conclusion: MCQs with 'poor' discrimination index and 'easy' difficulty index could be accounted to very predictable or irrelevant options. This highlights the significance of framing 'functional discriminators' while setting up MCQs. Creating flaw free, item analysed MCQs help in building question banks which can further be used for formative and summative assessments.

Indian J Palliat Care ; 26(Suppl 1): S8-S16, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1792231


BACKGROUND: Palliative care has an important role to play in the global coronavirus disease 2019 (COVID-19) pandemic. It is integrated and is a key component in the governmental and community structures and services in Kerala, in India. Palliative care in the state has grown to be a viable model recognized in global palliative care and public health scene. The community network of palliative care, especially the volunteers linking with clinical teams, is a strong force for advocacy, relief support including provision of emergency medications, and clinical care. OBJECTIVE: To develop a palliative care resource tool kit for holistic care of patients affected with COVID-19 and to support the health-care workers looking after them to enable palliative care integration with COVID-I9 management. METHODS: The Kerala State government included senior palliative care advisors in the COVID-19 task force and 22 palliative care professionals formed a virtual task force named Palli COVID Kerala as an immediate response to develop recommendations. Results: Developed a palliative care in COVID-19 resource toolkit which includes an e-book with palliative care recommendations, online training opportunities, short webinars and voice over power point presentations. CONCLUSION: Integrated Palliative care should be an essential part of any response to a humanitarian crisis. The e resource tool kit can be adapted for use in other low- and middle-income countries.

Journal of General Internal Medicine ; 36(SUPPL 1):S388-S388, 2021.
Article in English | Web of Science | ID: covidwho-1348933
J Pain Symptom Manage ; 63(2): e224-e236, 2022 02.
Article in English | MEDLINE | ID: covidwho-1330996


CONTEXT: Palliative care access is fundamental to the highest attainable standard of health and a core component of universal health coverage. Forging universal palliative care access is insurmountable without strategically optimizing the nursing workforce and integrating palliative nursing into health systems at all levels. The COVID-19 pandemic has underscored both the critical need for accessible palliative care to alleviate serious health-related suffering and the key role of nurses to achieve this goal. OBJECTIVES: 1) Summarize palliative nursing contributions to the expansion of palliative care access; 2) identify emerging nursing roles in alignment with global palliative care recommendations and policy agendas; 3) promote nursing leadership development to enhance universal access to palliative care services. METHODS: Empirical and policy literature review; best practice models; recommendations to optimize the palliative nursing workforce. RESULTS: Nurses working across settings provide a considerable untapped resource that can be leveraged to advance palliative care access and palliative care program development. Best practice models demonstrate promising approaches and outcomes related to education and training, policy and advocacy, and academic-practice partnerships. CONCLUSION: An estimated 28 million nurses account for 59% of the international healthcare workforce and deliver up to 90% of primary health services. It has been well-documented that nurses are often the first or only healthcare provider available in many parts of the world. Strategic investments in international and interdisciplinary collaboration, as well as policy changes and the safe expansion of high-quality nursing care, can optimize the efforts of the global nursing workforce to mitigate serious health-related suffering.

COVID-19 , Hospice and Palliative Care Nursing , Humans , Palliative Care , Pandemics , SARS-CoV-2 , Workforce
Indian J Med Ethics ; V(3): 189-191, 2020.
Article in English | MEDLINE | ID: covidwho-1034313


COVID-19 is an amplifier of serious physical suffering and emotional trauma, which together could be all-consuming. It is important for health systems to go beyond methods of prevention and treatment, and focus on the palliation of suffering, and to systematically integrate palliative care into Covid-19 management.

Further, in cases where the triage process indicates poor chances of survival, it is particularly important to respect autonomy by honest and sensitive disclosure of prognosis, and to jointly arrive at goals of care. Hooking every dying person to a ventilator would violate the ethical principles of beneficence and non-maleficence. It is also important to ensure at least electronic communication between the patient and family members.

Keywords: Covid-19, palliative care, end of life care, isolation, quarantine, intensive care, ethics of intubation, consent


Beneficence , COVID-19/therapy , Critical Care/ethics , Moral Obligations , Palliative Care/ethics , Stress, Psychological , Terminal Care/ethics , COVID-19/psychology , Clinical Protocols , Communication , Critical Care/psychology , Family , Fear , Humans , India , Intubation, Intratracheal , Medical Futility , Pain Management , Personal Autonomy , Prognosis , SARS-CoV-2 , Social Isolation