Clinical Profile of Congenital Factor XIII Deficiency in Children.

OBJECTIVES: Congenital Factor 13 Deficiency (FXIIID) is a rare bleeding disorder (RBD) of autosomal recessive inheritance, with an incidence of 1 in 3-5 million. The clinical symptomatology, diagnosis, and management of FXIIID are described. METHODS: A retrospective chart review of children with FXIIID was performed from January 2000 through October 2021 at a tertiary care center in Southern India. The diagnosis was performed by the Urea clot solubility test (UCST) and Factor XIII antigen assay. RESULTS: Twenty children (representing 16 families) were included. Male: Female ratio was 1.5:1. The median age of symptom onset was 6 mo, and the median age of diagnosis was 1 y, demonstrating a delay in diagnosis. Consanguinity was present in 15 (75%) with 4 children having affected siblings. Clinical symptomatology ranged from mucosal bleeds to intracranial bleeds and hemarthrosis, with many children having a history of prolonged umbilical bleeding in their neonatal period. Fourteen children were on cryoprecipitate prophylaxis. Four children had breakthrough bleeds due to irregular prophylaxis, including one intracranial bleed due to a delay in cryoprecipitate prophylaxis during the covid pandemic. CONCLUSIONS: Congenital FXIIID presents with a wide range of bleeding manifestations. The high prevalence of consanguinity in Southern India can be a cause of FXIIID's high prevalence in this region. There is a propensity for intracranial bleeding with a significant number having this at first presentation. Regular prophylaxis is required and feasible to prevent potentially fatal bleeds.

Statistical Model for COVID-19 in Different Waves of South Indian States.

Background: COVID-19 has resurfaced in India, where it is rapidly spreading and wreaking havoc in rural areas. An effort has been undertaken to assess the levels and patterns of COVID-19 active cases in the southern states of India. To trace and reason out anomalous trends in the COVID-19 curve so that particular actions such as lockdown, de-lockdown, and healthcare improvisation can be implemented at the appropriate time. Methods: The data has retrieved from the government websites through a platform called Kaggle. The entire duration of COVID - 19 were classified into three compartments: Phase one, Resting phase, and Phase two. The Case Fatality Rate in south Indian states was analysed corresponding to the phases, and a compartmental model for COVID-19 dynamics in the region was proposed. Results: The quadratic regression model was fitted and found to be the best model for the phases except for the resting phase. Phase one was comparatively less fitted when compared to phase two. In most of the south Indian states, the active cases in phase one were almost more than four times that of phase two. The average CFR value in phase one was lower than the subsequent phase in all of the southern Indian states. In phase one, Telangana, Karnataka, and Tamil Nadu had the highest CFR (4.77,4.22, and 3.71, respectively), whereas Lakshadweep and Kerala had the lowest CFR (0.27 and 0.71, respectively). In the resting phase, the CFR stabilized in all states and reached a value between 0.2 to 2. The trend was similar in phase two also, CFR of Lakshadweep, Kerala, Telangana, and Andhra Pradesh (0.143, 0.416,0.553, 0.803) were very low, while the CFR of Andaman and Nicobar Islands, Karnataka, and Tamil Nadu (1.237, 1.306, 1.490) were very high. Conclusion: The first and second phases of the COVID-19 virus in south Indian states had different characteristics. A District-level working group with the autonomy to respond to rapidly changing local situations must be empowered to tackle the next phase. The upcoming phases could be more peaked in less time and could be a hectic situation for the health care system.

The Impact of Social Media Use on Young Adults' Quality of Life during the COVID-19 Pandemic in South India

During the COVID-19 pandemic, the use of social media increased. Social media was shown to have both positive and negative effects on users. Social media use can negatively affect mental health and it can also lead to addiction. On the other hand, using social networks has helped people stay connected with friends and family during the COVID-19 pandemic. To analyze the impact of social media use among young adults during the COVID-19 pandemic, an online survey was conducted with 231 university students in South India. It was explored which type of social media use, such as using social media to connect with family and friends, as compared to other uses, was associated with an increased quality of life (QoL). However, there was a positive association between QoL and using social media to obtain information and for news. The intensity of use was not associated with the level of QoL. © 2022 IEEE.

Bengali Migrant Workers in South India: A Mixed-Method Inquiry into Their Earnings, Livings and Struggle During Covid Pandemic.

This study has tried to compare the earning and non-earning aspects of migrant workers from West Bengal engaged in different types of work in Karnataka and Kerala based on survey of 111 Bengali-speaking migrant workers and a number of in-depth interviews and FGDs. The study has found that most of the migrant workers landed in south India only after working in Kolkata, northern or western Indian cities. Lack of regular employment opportunities and low-wage rate in rural as well as urban West Bengal are the dominant reasons for their migration. Hostile social environment and increasing earning uncertainties in northern and western Indian cities along with higher-wage rate in south India are reasons for the migrant workers shifting to south India. On an average, they earn Rs. 1.7 lakhs annually and are able to send almost two-thirds of their earnings as remittances. Except the rag pickers in Bengaluru, all other migrant workers live without their families at destination locations. The living conditions of the migrant workers, especially the rag pickers, are poor. Continuous inflow of migrant workers from eastern and north-eastern India is now a challenge for the incumbent Bengali migrant workers in south India; however, majority of them are not willing to return to West Bengal in future. The pandemic and successive rounds of lockdown in destination and home states have unsettled their lives. Not only their income has fallen, getting job and movement across different destination locations has become uncertain too. They have now hardly any resource to cope up with this continuing uncertainty.

Serosurvey for Nipah virus in bat population of southern part of India.

Nipah virus (NiV) is one of the priority pathogens with pandemic potential. Though the spread is far slower than SARS-CoV-2, case fatality is the biggest concern. Fruit bats belonging to genus Pteropus are identified to be the main reservoir of the virus causing sporadic cases and outbreaks in Malaysia, Bangladesh and India. The sudden emergence of Nipah in Kerala, India during 2018-2019 has been astonishing with respect to its introduction in the unaffected areas. With this, active Nipah virus surveillance was conducted among bat populations in Southern part of India viz., Karnataka, Kerala, Tamil Nadu, Telangana, Puducherry and Odisha during January-November 2019. Throat swabs/rectal swabs (n = 573) collected from Pteropus medius and Rousettus leschenaultii bat species and sera of Pteropus medius bats (n = 255) were screened to detect the presence of Nipah viral RNA and anti-Nipah IgG antibodies respectively. Of 255 P. medius bats sera samples, 51 bats (20%) captured from Karnataka, Kerala, Tamil Nadu and Puducherry demonstrated presence of anti-Nipah IgG antibodies. However, the presence of virus couldn't be detected in any of the bat specimens. The recent emergence of Nipah virus in Kerala in September 2021 warrants further surveillance of Nipah virus among bat populations from the affected and remaining states of India.

An Analysis of the Psychological Implications of COVID-19 Pandemic on Undergraduate Students and Efforts on Mitigation

The whole world is combating the COVID-19 pandemic, which has affected mankind in enormous ways. To limit its pervasive expansion, many measures were taken up by the Indian government, as a result of which colleges were closed, and education was imparted through the online mode. The pandemic has induced psychological strain in the minds of students. The present study analyses the psychological impact of the COVID-19 pandemic on engineering undergraduates in south India, who are in the age group of 19 to 22. A survey from 365 students was analyzed during the second wave of COVID-19. Data revealed that although there is an overall increased awareness about the outbreak, there is a considerable inclination towards depression, anxiety, and stress in students. Amongst the participants, 116 (31.78%) screened positive for depression, 79 (21.64%) for anxiety, and 53 (14.52%) for stress. Besides, 46 (12.60%) participants had comorbid conditions, with moderate, severe, or extremely severe levels of stress, anxiety, and depression. The Center of Excellence in AI&ML at the study center implemented a multilingual chatbot to provide mental health support during the pandemic and deployed the bot in Facebook and Web modes. © 2022, Springer Nature Switzerland AG.

A descriptive cross-sectional study on COVID-19 knowledge, attitude, and practices of South Indian population.

BACKGROUND: The 2019-novel coronavirus (2019-nCoV) started as an epidemic later transformed into a pandemic causing a threat to public health globally. Any community to fight the COVID-19 pandemic requires adequate knowledge, attitude of the people, and practice of the government-imposed laws and regulations. Based on these factors, we framed the objectives to find the sociodemographic profile of the study group and to assess their knowledge, attitude, and practice (KAP) toward COVID-19. These results will help the health planners and administrators in each state to find out the gap in health education efforts. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on South Indian population to know KAP toward COVID-19. A convenient sampling technique was used to collect the data using Google forms, and analysis was done using the SPSS software version 21. The questionnaire includes sociodemographic information, KAP questions toward COVID-19, and perception toward national and community responses. RESULTS: A total of 1644 were participated; the average knowledge score was 17.5 (+1.9). Most of them (92.9%) respondent's perceived that early detection will have a better outcome from COVID-19, whereas the knowledge compared with practice, there is a significant difference Pearson correlation (0.404) P is < 0.001. CONCLUSIONS: Although a high level of knowledge on COVID-19 in the public gradually decreasing the practice of preventive measures, the government should continue the consistent efforts to change the behavioral communication and motivate the public social responsibility to adhere to the health protocols, masking, hand hygiene, social distancing, and vaccination to prevent expected COVID-19 subsequent episodes.

Clinical review of COVID-19 patients presenting to a quaternary care private hospital in South India: A retrospective study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has been declared a global public-health crisis due to its impact on health, economy, and mental well-being. Here, we evaluated the clinical and epidemiological parameters associated with COVID-19 in South India. METHODS: A retrospective, quaternary care hospital-based study that included COVID-19 positive patients admitted to MIOT International Hospital, Chennai between 8 April-7 August 2020. Cases were identified by reverse transcriptase-polymerase chain reaction. Epidemiological, demographic, clinical, and radiological findings were recorded and analyzed. The primary endpoint was stable discharge from hospital/patient recovery or death. Associations between risk factors and comorbidities were analyzed using Chi-Square/Fisher's exact test. RESULTS: Of the 5264 cases reviewed, 3345 cases were included. The mean (standard deviation, SD) age of the patients was 47.58 (16.69) years with a median and range hospital stay of 5 (2-41) days. 69.20% of patients were male. The most frequent comorbidities were diabetes (37.10%) and hypertension (29.10%). Contact history was available for 58% of patients. The most common symptoms were cough (36.60%), fever (28.30%), and myalgia (15.40%). Abnormal chest radiography was reported in 16.9% of patients. Phase of admission, age ≥50 years, hypertension, diabetes, coronary artery disease, chronic kidney disease was significantly associated with mortality (p < 0.05). There were 142 (4.2%) deaths in this study. CONCLUSION: In this single centre hospital-based study, late presentation and more severe form of COVID pneumonia lead to higher mortality although it had lower mortality rate for COVID-19 in comparison. Late phase of the pandemic showed better outcomes vs. the early group.

COVID-19 lockdown impacts on heavy metals and microbes in shallow groundwater and expected health risks in an industrial city of South India.

In this investigation, the positive impact of COVID-19 lockdown on heavy metals concentration and biological parameters in the shallow groundwater samples of Coimbatore city of South India was ascertained. The groundwater samples (n=15) were obtained from shallow open wells during before lockdown (24-25 February 2020) and after lockdown (2-3 June 2020) periods. These samples were analysed for heavy metals (Fe, Mn, Ni, Cr and Pb) and biological parameters (E. coli, Fecal coliforms, Fecal streptococci and Total coliforms). Fe concentration was within the permissible limit but, the concentrations of Mn, Ni, Cr and Pb were above the allowable limits for drinking uses as per the WHO. However, after lockdown the number of samples crossing the cutoff limit had considerably decreased (Mn: from 2 to 0 mg/L; Ni: from 13 to 10 mg/L; Cr: 7 to 5 mg/L and Pb: from 13 to 8 mg/L). The heavy metal pollution index (HPI) revealed that 176.75 km2 (67.4%) and 85.35 km2 (32.6%) areas fell under unsuitable and very poor categories, respectively, during the pre-lockdown period, whereas 138.23 km2 (52.6%), 118.98 km2 (45.3%) and 4.89 km2 (2.1%) areas fell under very poor, poor and good categories, respectively, during the post-lockdown period. Similarly, Total coliform, Fecal coliform and E. coli had decreased distinctly due to the pandemic lockdown. Therefore, the shutdown of small and large-scale industries during the lockdown period had improved the groundwater quality. The health risk assessment showed that 93%, 87% and 80% of pre-lockdown samples, and 87%, 80% and 73% of post-lockdown samples possessed non-carcinogenic risks (HI > 1) for children, female and male categories, respectively.

Effects of COVID-19 pandemic lockdown on microbial and metals contaminations in a part of Thirumanimuthar River, South India: A comparative health hazard perspective.

Twenty-two water samples from the Thirumanimuthar River course in southern India were collected before COVID-19 lockdown and during COVID-19 lockdown periods and were analyzed for microbiological parameters (fecal coliform bacteria, total coliform bacteria, Escherichia coli, and fecal streptococci) and heavy metals (Fe, Mn, Zn, Cu, Cd, Ni, Pb and Cr). The lockdown has decreased microbial populations and heavy metals. Fe, Cu, Cd, Ni, Pb and Cr exceeded the drinking water limits, respectively, in 77%, 45%, 27%, 18%, 9% and 91% of the pre-lockdown samples. During the lockdown period, Fe, Cu and Cd concentrations in 23% and Cr in 50% of the samples exceeded the limits. Heavy Metal Pollution Index (PI) expressed that 27%, 64% and 9% of the pre-lockdown samples represented 'low', 'medium' and 'high' pollution categories, respectively, but 68% and 32% of the lockdown period samples represented 'low' and 'medium' categories, respectively. The Metal Index (MI) exposed that all samples of pre-lockdown were under the seriously affected category, whereas 54% and 46% of lockdown samples were under strongly and seriously affected categories, respectively. Health risk evaluation predicted that 95%, 91% and 86% of pre-lockdown samples and 45%, 36% and 33% of lockdown period samples were at risk among children, teenagers and adults, respectively. As there is no integrated study on river water quality of COVID-19 lockdown this work is uniquely carried out by combining heavy metal pollution, microbial contamination and human health risk evaluation.

Impact of teleophthalmology during COVID-19 lockdown in a tertiary care center in South India.

PURPOSE: The aim of this study was to describe the experience of teleconsultations addressed at our hospital in India during the ongoing coronavirus (COVID-19) lockdown. METHODS: This cross-sectional hospital-based study included 977 teleconsultations presenting between April 1st and May 31, 2020. A two-level protocol was implemented to triage the calls. RESULTS: Overall, 977 teleconsultation were addressed. Of the 621 teleconsultation addressed the most common queries were related to redness/pain/ watering/blurred vision/itching/irritation (52.49%), followed by queries related to medications (28.01%), appointments (18.84%) & 0.64% cited an emergency need to visit the hospital due to sudden loss of vision. The majority of the queries were directed to the department of cornea (58.93%) followed by retina (16.26%), cataract (13.04%), glaucoma (10.14%) & pediatric ophthalmology (1.61%). The most common advice given to the patient was related to medications (47.66%) followed by appointment-related queries (31.72%) & fixing of surgical appointment (20.61%). Among the 356 preterm babies that were screened, 57 (16.01%) were diagnosed with retinopathy of prematurity (ROP). Of them 3 required laser and 3 were given injection. CONCLUSION: Teleconsultation is here to stay beyond the pandemic. WhatsApp was the preferred modality of communication for us. Teleophthalmology has given us insights to use this evolving technology to reach out to the population at large to provide eye care services. We believe that this mode of teleophthalmology has helped us in providing feasible eye care to the patients.

Nexus between population density and novel coronavirus (COVID-19) pandemic in the south Indian states: A geo-statistical approach.

The unprecedented growth of the novel coronavirus (SARS-CoV-2) as a severe acute respiratory syndrome escalated to the coronavirus disease 2019 (COVID-19) pandemic. It has created an unanticipated global public health crisis that is spreading rapidly in India as well, posing a serious threat to 1350 million persons. Among the factors, population density is foremost in posing a challenge in controlling the COVID-19 contagion. In such extraordinary times, evidence-based knowledge is the prime requisite for pacifying the effect. In this piece, we have studied the district wise transmissions of the novel coronavirus in five south Indian states until 20th July 2020 and its relationship with their respective population density. The five states are purposefully selected for their records in better healthcare infrastructure vis-à-vis other states in India. The study uses Pearson's correlation coefficient to account for the direct impact of population density on COVID-19 transmission rate. Response surface methodology approach is used to validate the correlation between density and transmission rate and spatiotemporal dynamics is highlighted using Thiessen polygon method. The analysis has found that COVID-19 transmission in four states (Kerala, Tamil Nadu, Karnataka and Telangana) strongly hinges upon the spatial distribution of population density. In addition, the results indicate that the long-term impacts of the COVID-19 crisis are likely to differ with demographic density. In conclusion, those at the helm of affairs must take cognizance of the vulnerability clusters together across districts.