Effectiveness of the chAdOx1 nCoV-19 vaccine in preventing COVID-19 infection

AIM: The study aimed to assess the effectiveness of the ChAdOx1 nCoV-19 vaccine in preventing laboratory-confirmed COVID-19. METHODS: It was a test-negative, case-control study conducted at Sharda Hospital, Greater Noida, India, between March 2021 and May 2021. An equal number of cases and controls were included in the study after taking proper informed consent. The individuals with positive reverse transcriptase-polymerase chain reaction test reports were taken as cases, whereas those with negative reports were included as controls. Data were analyzed and the groups were compared using multivariable logistic regression to calculate the odds ratio (OR), with adjustment for gender and presence or absence of comorbidities. The effectiveness of vaccine was calculated by the formula (1-adjusted OR) x100%. RESULTS: On analyzing the data from 560 case-control pairs, the vaccine effectiveness was calculated as 57.46% (95% confidence interval [CI]: 53.85-61.02) and 60.09% (95% CI: 56.32-63.77) for single dose and two doses, respectively. The effectiveness of complete and single-dose vaccination against the moderate-to-severe disease was calculated as 63.79% (95% CI: 58.58-68.77) and 56.19% (95% CI: 51.30-61.0), respectively. CONCLUSION: The ChAdOx1 nCoV-19 vaccine was found to be effective against COVID-19, with protection after two doses being a little more than that after a single dose. It also proved effective in protecting against the severe form of the disease.

Attention-Based Deep Learning Approach for Semantic Analysis of Chest X-Ray Images Modality

The world today is suffering from a huge pandemic COVID-19 that has infected 106M people around the globe causing 2.33M deaths, as of February 9, 2021. To control the disease from spreading more and to provide accurate healthcare to existing patients, detection of COVID-19 at an early stage is important. As per the World Health Organization, diagnosing pneumonia is a common way of detecting COVID-19. In many situations, a chest X-ray is used to determine the type of pneumonia. However, writing a report for every chest X-ray becomes a tedious and time-taking task for physicians. We propose a novel method of creating reports from chest X-rays images automatically via a deep learning model using image captioning with an attention mechanism employed through CNN–LSTM architecture. On comparing the model that does not use an attention mechanism with our approach, we found that accuracy was increased from 80% to 87.5%. In conclusion, we found that results generated with attention mechanism are better, and the report thus produced can be utilized by doctors and researchers worldwide to analyze new X-rays in lesser time. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Modern Mortuary Complex Plan in Covid-19 Era

The COVID-19 pandemicis the most burning health emergency worldwide now a days and all health professionals are called to give support in the diagnosis, treatment of patients and management of dead bodies affected by this disease. Different modes of transmission of corona virus is well established, however aerosol generating procedure has significant importance for mortuary during autopsy. The risk of infection can be minimized by using standard universal precautions for autopsy dissection procedure, applying high bio-safety levels, using negative pressure and laminar flow system for ventilation, UV irradiation for sterilization, virtual autopsy etc. The aim can be achieved by constructing the mortuary complex in more planned way like area division, ventilation planning, environmental disinfection, individual protection, autopsy procedure, virtual autopsy, preservation and transportation of dead body and waste disposal management. The present manuscript describes in detail about modern mortuary complex during the pandemic era of covid-19 © 2022, Journal of Indian Academy of Forensic Medicine.All Rights Reserved.

Are we adequately prepared to handle the anticipated 3rd peak of COVID-19: A KAP survey among HCWs

Experts in the field are predicting a third COVID-19 peak very soon in coming times, it is important to assess recent knowledge, attitude in view of prolonged exhaustion and adherence to preventive practices of HCWs. This cross-sectional study involved 168 HCWs (42 doctors, 42 nurses, 42 paramedical staff and 42 ANMs). Data was collected through online survey tool Google forms in July and August 2021. First section included sociodemographic information and infection with SARS-CoV-2, section 2 assessed recent knowledge, section 3 practices of COVID-19 appropriate behavior and section 4 assessed attitude of HCWs. Shapiro Wilk test was used to determine normality of distribution of variables. Kruskal-Wallis and Mann-Whitney U tests were used to determine the association between two variables. Pairwise comparison was done following a significant Kruskal-Wallis test using Bonferroni's correction. 42.9% of the HCWs and family members of 44.6% HCWs were infected with SARS-CoV-2. 54.1% of infected HCWs were infected during the March-May 2021 peak. 85.1% HCWs had taken COVID-19 vaccine. Mean knowledge, attitude, practice scores were 7.88 +/- 3.03(maximum score: 12), 20.35 +/- 3.2 (maximum score: 25), 69.89 +/- 9.39 (maximum score: 85) respectively. Only 48.8% HCWs had good knowledge about more recent COVID-19 information. A significant association was observed between profession and knowledge scores (p<0.001). Over 85% HCWs had good scores for attitude towards COVID-19 and 88.7% HCWs scored good in COVID-19 appropriate behavior practices. Our HCWs need to be better equipped with the more recently available knowledge about COVID-19 to improve our preparedness for the next anticipated peak.

Responding to pandemic challenges: leadership lessons from multinational enterprises (MNEs) in India

Purpose The business sector plays a major role in achieving comprehensive economic development goals in emerging economies. Consequently, the effects of business responses to the COVID-19 pandemic are receiving increasing research attention from an organizational management development perspective. This article aims to examine the role of leadership in charting the course in an extraordinary crisis context. Design/methodology/approach Using institutional leadership theory, leadership contingency theory and dynamic leadership capability theory, the authors present a research framework that defines macrochallenges and organizational level responses and outcomes. The article adopts a case study approach, which includes the identification of four target companies and conducting in-depth interviews with senior management professionals within those companies at different time periods. Findings Based on the interviews, the steps that Indian companies adopted to respond to the COVID-19 challenge are identified. Expanding the insight from the case study, the findings suggest that although feeling overwhelmed at first, organizational leaders combine prudent (i.e. timely and speedy actions for survival first) and bold (i.e. future envisioning for expansion and growth) actions enabling these firms to weather two waves of the COVID-19 pandemic in India. Originality/value These multiple case studies are unique in exploring MNEs from different industries. This study also highlights the dynamic relationships between leadership practices, risk management strategies and performance outcomes based on a sound theoretical model and rigorous study methods.

White Swan - The pandemic crisis, lockdown and unlock effect on the Indian stock market

The COVID-19 pandemic crisis, the White Swan event, has pushed the world markets to crash to levels that have not been witnessed since the 2008 Global Financial Crisis. Therefore, this study investigates the impact of the first wave of pandemic COVID-19, nationwide lockdown and unlock on the Indian stock market. The findings reveal that the lockdown has a significant positive impact on the volatility of BSE returns. Secondly, this study investigates the relationship between daily confirmed cases of COVID-19 and the closing price of BSE Sensex using Johansen's cointegration test. The results of cointegration test indicate that there is a long run relationship between daily confirmed cases and closing price of Sensex. Therefore, the findings of this research are beneficial to investors of all categories and portfolio managers. Copyright © 2022 Inderscience Enterprises Ltd.

Coronavirus: a threat to global public health

Previously considered of meagre significance to the human race, coronaviruses have effectively evolved to jump the species barrier and cause widespread contagion in mankind. The SARS pandemic, the MERS situation in the middle - east and the ongoing COVID 201 9 epidemic are all attributed to this evolving virus. COVID 2019 is the seventh coronavirus isolated successfully and the third beta-coronavirus that causes a fatal illness in humans;the other two beta-coronaviruses being severe acute respiratory syndrome (SARS) CoV and middle east respiratory syndrome (MERS) CoV. Having a natural reservoir in bats these viruses infect humans through an intermediate host and then rapidly adapt and mutate for human to human transmissions. Four other known alpha coronaviruses cause only common cold in humans. Although mortality rate of COVID 2019 epidemic is lower at 2.5% than the previous two CoV outbreaks, that is, 9.6% in SARS and 34.4% in MERS, but rapid transmissibility points towards a sustained epidemic of epic proportions. In the absence of any specific treatment protocols and experimental vaccines still under research, management largely depends upon symptomatic therapy, strict infection control and quarantine measures. Restriction of human interactions with known animal sources of the virus as a measure of prevention is essentially required. Owing to huge genetic diversity and frequent genomic recombination, novel coronaviruses might emerge periodically, warranting the need for extensive research and development of effective treatments and vaccines.

HEMATOBIOCEMICAL AND HISTOPATHOLOGICAL STUDIES ON THE EFFECTS OF RAJ NIRWAN BATI (A NOVEL ALLOVEDIC DRUG) IN WISTAR RATS

Objective: To see the effects of Raj Nirwan Bati (RNB) on the hematobiochemical parameters, coagulation tests, and histopathological changes in the lungs, liver, kidneys and spleen and also to evaluate the immunomodulatory activity of RNBin Wistar rats. Methods: A total of 24 adult albino Wistar rats (of bodyweight 200-250 g) of either sex were divided into 3 groups. In the normal control group (n=8), no drug was administered and in the rest of the groups (A and B), RNB@ 26 mg/kg body weight./day and 260 mg/kg body weight/day respectively were administered orally for a period of 14 d. The blood samples were collected from the jugular vein at zero d (before drug administration) and after the 14th d of drug administration in both groups (A and B). The organ samples (lungs, liver, kidneys, and spleen) were collected after euthanizing the rats using Ketamine anesthesia overdose intraperitoneally (IP) after the 14th d of drug administration. White Blood Cells (WBC), Red Blood Cells (RBC), Hemoglobin (Hb), Hematocrit (HCT), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin(MCH), Mean Corpuscular Hemoglobin Concentration(MCHC), number of platelets, Differential Leucocyte Count(DLC) i.e. the percentage of neutrophils, lymphocytes, eosinophils, monocytes and basophils, neutrophil adhesion percentage, Prothrombin test (PT), Activated Partial Thromboplastin Time (APTT), fibrinogen, D-dimer, Lactate Dehydrogenase (LDH), urea, creatinine, Aspartate Amino Transferase (AST), Alanine amino Transferase (ALT), Alkaline Phosphatase (ALP), C-Reactive Protein (CRP) were evaluated and histological examination of organs were done. Results: After statistical analysis, it was found that the decrease in TLC, RBC, Hb, HCT, and LDH in Wistar rats after RNB intervention in Group A as compared to that of before RNB intervention, was found to be statistically significant (P=0.001, P=0.002, P=0.001, P=0.039, and P=0.008). On the other hand, an increase was observed in MCV, Urea, Creatinine and ALT values in the Wistar rats after RNB intervention in Group ‘A’ as compared to that of before RNB intervention and this increase in values was statistically significant (P=0.007, P=0.001, P<0.001 and P=0.038). After RNB intervention in Group B, the increase in MCH, fibrinogen concentration, and monocytes percentage, was found to be statistically significant (P=0.004, P=0.033, and P=0.001) as well as the decrease in PT and APTT was statistically significant (P=0.007and P=0.002). After comparing the Mean Hematobiochemical and coagulation test parameters in the rats of Group A and Group B, after RNB intervention, it was observed that the concentration of Urea, Creatinine, APTT, and D-dimer were less in Group B as compared to that of Group A and this difference was statistically significant(P<0.001, P<0.001, P<0.001 and P=0.022). Histologically the findings in the lungs of group B were more distortion of lung architecture, most of the alveoli become collapse and make emphysematous changes, more diffuse inflammatory infiltrate within interalveolar septa and around bronchioles as compared to Group A. In the liver of group B rats, the histological findings were mild to moderate distortion of lobular architecture, healthy hepatocytes with more activation of kupffer cells as well as larger and more aggregates of inflammatory cells as compared to group A. Histological findings of kidneys in group A and group B rats were similar to that of control group rats. Conclusion: The results suggest that the RNB is having an immunomodulatory effect. It might be helpful in the restoration of coagulation factors and can help treat the COVID patients. No harmful effects on the lungs, liver, kidney, and spleen were seen. These findings may act as baseline data for planning further clinical trials in human study subjects to evaluate the effects on various comorbidities.

Utility of serum Galactomannan in diagnosing COVID-19 patients with suspected IPA: an observational study in resource limited settings.

OBJECTIVE: To study the utility of Galactomannan (GM) antigen as a screening marker for diagnosing invasive pulmonary aspergillosis (IPA) in coronavirus disease 2019 (COVID-19) patients. PATIENTS AND METHODS: The serum samples from patients with severe COVID-19 diseases admitted to the Critical Care Unit were collected on the 5th day of admission for GM screening. The samples were analysed by enzyme linked immune sorbent assay (ELISA) and GM index of more than 1 was considered as positive. All GM positive patients were serially followed until discharge or death. RESULTS: The GM was raised in serum of 12 out of 38 patients, indicating an incidence of possible COVID-19 associated IPA (CAPA) in 31.57% of patients. The median age of these CAPA patients was 56.5 years, males were significantly more affected than females. The inflammatory marker serum ferritin was raised in all 12 patients (median value of 713.74 ng/ml), while IL-6 was raised in 9 patients (median value of 54.13 ng/ml). None of these patients received antifungals. Their median length of hospital stay was 20 days (IQR: 12, 34 days). All these patients succumbed to the illness. CONCLUSIONS: The serum GM appears to be sensitive diagnostic tool to identify early IPA in COVID-19 patients and pre-emptive antifungal therapy could play a role in salvaging these patients.

Sustainable investment and the COVID-19 effect – Volatility analysis of ESG index

COVID-19 has created a crisis situation where market volatility has increased. Due to this pandemic, investors have begun to put an emphasis on a company’s long-term viability when it comes to investment decisions. Sustainable investment can be achieved through social objectives, i.e., by making an investment that takes environmental, social and governance (ESG) funds. Therefore, this research paper intends to investigate the effect of the COVID-19 pandemic on the Bombay Stock Exchange (BSE) ESG index volatility by using the EGARCH(1, 1, 1) model. The results of summary statistics depict that the average daily return and volatility of most of the currencies have increased during the COVID-19 crisis period. However, the EGARCH(1, 1, 1) model results demonstrate that there is no effect of pandemic on return and volatility of S&P ESG 100 index. Copyright © 2021 Inderscience Enterprises Ltd.

Paradigm shift in antimicrobial resistance pattern of bacterial isolates during the COVID-19 pandemic

Antimicrobial resistance (AMR) is an emerging public health problem in modern times and the current COVID-19 pandemic has further exaggerated this problem. Due to bacterial co-infection in COVID-19 cases, an irrational consumption of antibiotics has occurred during the pandemic. This study aimed to observe the COVID-19 patients hospitalized from 1 March 2019 to 31 December 2020 and to evaluate the AMR pattern of bacterial agents isolated. This was a single-center study comprising 494 bacterial isolates (blood and urine) that were obtained from patients with SARS-CoV-2 admitted to the ICU and investigated in the Department of Microbiology of a tertiary care hospital in Delhi, India. Out of the total bacterial isolates, 55.46% were gram negative and 44.53% were gram positive pathogens. Of the blood samples processed, the most common isolates were CoNS (Coagulase Negative Staphylococcus) and Staphylococcus aureus. Amongst the urinary isolates, most common pathogens were Escherichia coli and Staphylococcus aureus. A total of 60% MRSA was observed in urine and blood isolates. Up to 40% increase in AMR was observed amongst these isolates obtained during COVID-19 period compared to pre-COVID-19 times. The overuse of antibiotics gave abundant opportunity for the bacterial pathogens to gradually develop mechanisms and to acquire resistance. Since the dynamics of SARS-COV-2 are unpredictable, a compromise on hospital antibiotic policy may ultimately escalate the burden of drug resistant pathogens in hospitals. A shortage of trained staff during COVID-19 pandemic renders it impossible to maintain these records in places where the entire hospital staff is struggling to save lives. This study highlights the extensive rise in the use of antibiotics for respiratory illness due to COVID-19 compared to antibiotic use prior to COVID-19 in ICUs. The regular prescription audit followed by a constant surveillance of hospital infection control practices by the dedicated teams and training of clinicians can improve the quality of medications in the long run and help to fight the menace of AMR.

Impact of the COVID–19, lockdown and unlock on the Indian stock market and its international linkage with the Chinese stock market

This study investigates the impact of pandemic COVID–19, nationwide lockdown and unlock on the Indian stock market. Firstly, we analyse the impact of lockdown and unlock episodes on the volatility of the Indian stock market returns by employing the EGARCH model. The findings reveal that lockdown has a significant positive impact on the volatility of BSE returns. Secondly, this study investigates the interlinkage between Indian and Chinese markets using cointegration and causality technique in the pre and during COVID periods. Cointegration test indicates that there is no long run relationship between India and China in both the sub–periods. However, the causality results reveal unidirectional causality between India and China in the pre COVID–19 period. Therefore, the findings of this research are beneficial to investors of all categories and portfolio managers. Copyright © 2021 Inderscience Enterprises Ltd.

Changing agricultural labour market and its effects on farm economy in India

The paper presents long-run changes in agricultural labour market and its effects on farm economy. Further, the effect of COVID-19 led disequilibrium in labour market on cost of cultivation of paddy and wheat has been quantified. The evidence from both census and NSSO surveys point out rising employment diversification towards non-farm sectors. Census estimates of agricultural labour are higher than NSSO estimates which is partly explained by adoption of different 'minor' time criteria by these sources to identify marginal/subsidiary labour. Census based evidences suggest distress-led transition of cultivators to agricultural labours, whereas NSSO surveys based evidences refute such trends and point out towards development-led employment diversification wherein both cultivators and agricultural labours move towards more productive non-farm sectors. The recent NSSO survey (2017-18) reveals deceleration in withdrawal of cultivators and acceleration in withdrawal of agricultural labours. Successive cost of cultivation surveys also report a consistent decline in labour use in crop cultivation and therefore externally validate the trends from NSSO surveys. However, despite reduction in labour use, labour cost has increased. Due to inelastic demand for labour, increase in wages could not bring proportionate decrease in labour use and resulted in increase in labour cost in crop cultivation. Short-term disequilibrium in labour supply caused due to COVID-19 led lockdown increased cost A1+FL by 1.1 per cent in wheat and 4.6 per cent in paddy. However, farmers in Bihar did not witness any benefit on account of increased labour supply due to large scale reverse migration.

Assessment of psychosocial health during COVID-19 Pandemic among Indian adults

Background: Lockdown due to COVID-19 pandemic has an effect on all the dimensions of health. Previous epidemics and pandemics had made a catastrophic impact on mental wellbeing of general public. Methods: A cross sectional online study was carried out in the month of May. Data collection was done using Google form which contained semi-structured questionnaire. Results: Total 450 individuals participated in the study. About one-fourth of the participants felt depressed (28.9%) listening to the constant news updates about corona virus. Almost half of participants (50.7%) had altered eating habits. Nearly one-third of the participants had difficulty (35.1%) in falling asleep. Conclusion: This study reports that there is a negative impact on psychosocial health of general public who were confined to their homes due to COVID-19 pandemic in the country.