Mask Associated Dry Eye (MADE) in Healthcare Workers: A Cross-sectional Study

Introduction: The Coronavirus disease-19 (COVID-19) pandemic mediated by Severe Acute Respiratory Syndrome-CoV2 (SARS-CoV2), made the use of face masks mandatory to check the spread of the disease. With the increased use of face masks, more people started presenting to the ophthalmologist with symptoms of dry eye. The proposed mechanism of dry eye was attributed to air blowing upwards from behind the mask into the eyes, especially in loose fitting masks. This air leads to rapid evaporation of tears and disturbance of homeostasis of the tear film.Aim: To measure self reported symptoms of dry eye and to establish mask use as a risk factor for the development of Dry Eye Disease (DED) in healthcare workers in a Tertiary Care Hospital.Materials and Methods: This cross-sectional, observational study was conducted at Nilratan Sircar (NRS) Medical College and Hospital for a duration of three months from December 2021 to February 2022. The study was conducted on 146 participants. An online survey was conducted using Google Forms, sent via email to hospital employees working in different departments of the hospital. All healthcare workers employed at NRS Medical College and Hospital who wore a face mask during duty hours and were willing to participate in the study were included. The Ocular Surface Disease Index (OSDI) questionnaire was used and modified by adding "while wearing a facemask" to the end of each question. To establish face mask use as a causative agent for development of DED, a few other questions related to face mask usage were included in the survey. The data was tabulated in Microsoft Excel and analysed with Statistical Package for Social Sciences (SPSS) version 24. Results: The mean age of the study population was 27.4+/-8.28 years. The mean hours of wearing a mask was 6.38+/-3.04 hours. N95 face mask was the most common type of mask used. The study population included 100 doctors, 14 nursing staff, 18 optometrists, eight group D staff (sweepers and ward attendants), and six dieticians. The mean OSDI score was 14.24. Increased usage of face masks, in particular surgical, more hours of reading significantly correlated with higher incidence of DED. Conclusion: This study showed that increased hours of face mask use in particular surgical was associated with development of DED. To encourage more people to wear face masks, all possible problems arising from face mask use should be promptly identified and dealt with.

Cataract Surgery Trends during Lockdown and Unlocking Periods of COVID-19 Pandemic: A Cross-sectional Hospital-based Study

Introduction: Coronavirus Disease-2019 (COVID-19) has affected healthcare access to population around the world. India also had its own set of problems for patients with disruption of healthcare services during the pandemic. This also brought in unique challenges for ophthalmologists who adapted to new challenges to provide quality care to the patients including those reporting for cataract surgery. Aim: To find out cataract surgery trends and demographic variables during lockdown and unlocking periods of COVID-19 pandemic. Materials and Methods: This cross-sectional hospital-based study was conducted at Ophthalmology department of a tertiary care centre in eastern India, from January 2020 to March 2022. Trends of cataract surgery including numbers, demographic factors, visual acuity at presentation, difference during first and second lock and unlock periods etc were compared during various lock and unlock period over more than two years. Results: A total of 3,843 patients were planned for surgery and 3,594 patients underwent cataract surgery. A total of 218 patients reported being positive for COVID-19 preoperatively and voluntarily dropped out from surgery. A total of 24 patients were found to be positive during preoperative Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) workup and were excluded from surgery. Seven patients didn't report for the surgery. A total of 59 patients reported febrile illness during one month postoperative period. There was dip in cataract surgery during lockdown periods (from 178.33 every month in pre COVID-19 period to near zero during first lockdown period) but recovery was much faster during second unlock period compared to first unlock period. Conclusion: The study concludes that there was drastic decrease in number of patients undergoing cataract surgery during COVID-19 pandemic. Predominantly young, male patients who had advanced morphology of cataracts with poor visual acuity accessed healthcare set-up for cataract surgery during initial lock and unlock period. Similar trend was seen during second lock and unlock period with rapid recovery of numbers and demography of cataract surgery patients to pre-COVID-19 levels. [ FROM AUTHOR] Copyright of Journal of Clinical & Diagnostic Research is the property of JCDR Research & Publications Private Limited 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.)

Impact of the COVID-19 Pandemic on the Mortality Rate and Clinical Outcome of Patients Admitted to Pauls Stradiņš Clinical University Hospital with Spontaneous Intracerebral Haemorrhage

Spontaneous intracerebral haemorrhage (SICH) remains the most devastating type of stroke with the highest morbidity and mortality. Since the start of the COVID-19 pandemic, serious modifications have been made in health care systems, affecting patients with all kinds of disease, including SICH. This study compared mortality rates, and clinical and functional outcomes of patients diagnosed with SICH in the pre-COVID-19 and COVID-19 time periods. Retrospective analysis was performed using patient data from Pauls Stradiņš Clinical University Hospital from 2018 to 2021, dividing it into two subgroups based on the beginning of the COVID-19 pandemic. In this study, 329 patients in total were analysed. No statistically significant differences were found in mortality rate (p = 0.389) and neurological status at hospital admission (p = 0.309) between the time periods prior to COVID-19 and during the COVID-19 period. A statistically significant difference was found in the clinical status of patients (p = 0.016) measured using the Glasgow Coma Scale, indicating a worse level of consciousness of patients diagnosed with SICH at the time of admission to the hospital in the COVID-19 period. No statistically significant differences were found in the clinical outcome (p = 0.204) and functional outcome (p = 0.556) of the patients at discharge from the hospital. In the COVID-19 period, admission of patients with SICH fell by 25%. For patients with SICH, the COVID-19 pandemic was associated with a reduced admission rate and a worse level of consciousness at the time of admission, calling for further research to identify what caused it and how to avoid delayed medical help in the case of the development of acute neurological symptoms during the COVID-19 outbreak. © 2023 Inese Blimhena-Pastare et al., published by Sciendo.

Differentially Expressed Inflammatory Cell Death-Related Genes and the Serum Levels of IL-6 are Determinants for Severity of Coronaviruses Diseases-2019 (COVID-19).

Background: Inflammatory cell death, PANoptosis, has been suggested to orchestrate the lymphocyte decrement among coronavirus disease-2019 (COVID-19) patients. The main aim of this study was to examine the differences in the expression of key genes related to inflammatory cell death and their correlation with lymphopenia in the mild and severe types of COVID-19 patients. Materials and Methods: Eighty-eight patients (36 to 60 years old) with mild (n = 44) and severe (n = 44) types of COVID-19 were enrolled. The expression of key genes related to apoptosis (FAS-associated death domain protein, FADD), pyroptosis (ASC (apoptosis-associated speck-like protein containing caspase activation and recruitment domains (CARD)), the adapter protein ASC binds directly to caspase-1 and is critical for caspase-1 activation in response to a broad range of stimuli), and necroptosis (mixed lineage kinase domain-like, MLKL) genes were examined by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) assay, and compared between the groups. The serum levels of interleukin (IL)-6 were measured by enzyme-linked immunosorbent assay (ELISA) assay. Results: A major increase in the expression of FADD, ASC, and MLKL-related genes in the severe type of patients was compared to the mild type of patients. The serum levels of IL-6 similarly indicated a significant increase in the severe type of the patients. A significant negative correlation was detected between the three genes' expression and the levels of IL-6 with the lymphocyte counts in both types of COVID-19 patients. Conclusion: Overall, the main regulated cell-death pathways are likely to be involved in lymphopenia in COVID-19 patients, and the expression levels of these genes could potentially predict the patients' outcome.

Mental health of health care workers during the hour of crisis - A study from tertiary care hospital in North India.

Background and Aims: This cross-sectional study aimed to analyze the psychosocial, behavioral, and sleep impact of coronavirus disease-19 (COVID-19) pandemic on healthcare workers (HCWs) at a tertiary-care hospital in Northern India. Materials and Methods: An online questionnaire including three psychological scales - peritraumatic distress inventory (PDI), insomnia Severity Index (ISI), and Depression anxiety stress scale was circulated among the HCWs at a tertiary-care hospital in Northern India. Results: Three hundred and ninety-six HCWs (Mean age standard deviation: 34.8 [8.1%] years; 181 females) responded. Place of posting was active COVID area (27.2%), reserve active COVID team (23.2%), trained reserve pool (29.5%), and non-COVID areas (19.9%). More than half of all the respondents (51%) had abnormal PDI score (>14) with a propensity to develop posttraumatic stress disorder. Furthermore, there was a significantly higher prevalence of abnormal PDI scores in those involved in active COVID care units (74%) versus non-COVID care unit (24%, P = 0.001). More than 60% of all the respondents had abnormal ISI score suggesting significant insomnia. Stress was seen in 71% of all the respondents while 82% were anxious and 77% participants had depressive symptoms. Hence, the psychological morbidity among the HCWs was high. Conclusion: Our study found a much higher prevalence of peritraumatic distress, insomnia, anxiety, stress, and depression among the HCWs, more so in those working in COVID areas. Factors indigenous to Indian population in terms of psychological health must be studied and addressed to reduce this psychological morbidity since the battle with COVID is long.

Factors Influencing COVID-19 Prevention Behavior: A Community-based Cross-sectional Study

BACKGROUND: The coronavirus disease-19 (COVID-19) pandemic in Indonesia forced the local community to live in a New Normal era with several rules and health protocols that control the community's behavior on COVID-19 prevention and control. This policy enabled several districts in Indonesia to reopen their travel and tourism sectors including Banyuwangi. Although the Banyuwangi Government already taking action in the implementation of the New Normal in the travel and tourism sectors, the COVID-19 trend in Banyuwangi was significantly increased. This suggest that the violation to health protocols and new normal policy could exist in Banyuwangi. AIM: This study aimed to identify the predisposition, enabling, and reinforcing factors in the COVID-19 prevention and control behavior and analyze factors that associated with the COVID-19 prevention and control behavior in Banyuwangi district local community. MATERIALS AND METHODS: A cross-sectional study design was conducted. The data were obtained through online survey that was disseminated to Banyuwangi district local community. A descriptive, linear regression, and logistic regression analysis was applied. RESULT(S): The knowledge and attitude on COVID-19 preventive behavior of the 352 respondents in this study were poor and adequate, respectively. The predisposition factors associated with the COVID-19 prevention and control behavior in this study were sex (p = 0.005), level of education (p = 0.028), knowledge (p = 0.015), and attitude (p <= 0.01). The reinforcing factor associated with the behavior was support from family (p <= 0.01), key opinion leader (p = 0.02), and health worker (p = 0.05). Health facility and infrastructure were also found to be associated with the behavior (p <= 0.01). CONCLUSION(S): Several approaches and commitments from the policymakers to strengthen those factors are required to improve the behavior on COVID-19 prevention and control.Copyright © 2023 Ernawaty Ernawaty, Nabilla Belqys Dherindri.

Efficacy of low dose whole-lung irradiation for the treatment of moderate to severe COVID-19 pneumonia: Meta-analysis. TT -.

Objective To systematically evaluate the efficacy of low dose whole-lung irradiation in COVID-19 pneumonia based on the present evidence. Methods All literature related to the application of low dose whole-lung irradiation in COVID-19 pneumonia were retrieved from Pubmed, Embase, the Cochrane Library, Web of Science, Google scholar, Scoupus, CNKI, Wanfang database, VIP database until May 2022. Two researchers independently screened the literature. For the literature that met the inclusion criteria, both data extraction and literature quality evaluation were blinded. Revman 5.3 software was used for statistical analysis. Results A total of 5 controlled clinical trials involving 194 patients met the inclusion criteria. No statistically significant differences were detected in the low dose whole-lung irradiation group compared with the best supportive care group for clinical recovery rates, intubation rates, radiographic improvement rates and 28 d-overall survival. Conclusions In patients of COVID-19 pneumonia, low dose whole-lung irradiation conferred no significant benefit to clinical outcomes. Currently, the routine use of low dose whole-lung irradiation for the treatment of moderate to severe COVID-19 pneumonia is not recommended.Copyright © Chinese Medical Journals Publishing House Co.Ltd. All Rights Reserved.

Cutaneous Manifestation in COVID-19: A Lesson Over 2 Years Into the Pandemic.

Cutaneous manifestations related to Coronavirus Disease-19 (COVID-19) have been reported over 2 years since the pandemic began. This research aimed to review articles published in English that describe cutaneous manifestations related to COVID-19/SARS-CoV-2. A data search for case reports, original studies, and review articles from the onset of the current COVID-19 pandemic to December 31, 2022, was performed using PUBMED, Cochrane Library, ResearchGate, and Google search engines. Keywords were "coronavirus", "novel coronavirus 2019", "COVID-19", "SARS-CoV-2", and "2019-nCoV" in combination with "cutaneous", "skin" and "dermatology" The extracted data included authors, region, sex, age, number of participants with skin signs, cutaneous signs, its location, symptoms, extracutaneous/associated symptoms, suspected or confirmed status for COVID-19, timeline, and healing duration. Six authors independently reviewed the abstracts and full-texts to identify publications providing these details concerning cutaneous manifestations related to COVID-19. A total of 139 publications with full text (122 case reports, 10 case series, and 7 review articles) that reported cutaneous manifestations were identified, and reviewed from 5 continents. The most common cutaneous manifestations of COVID-19 were maculopapular, followed by chilblain-like lesion, urticarial, livedoid/necrotic, vesicular, and other/non-descript rashes/skin lesions. After 2 years into the COVID-19 pandemic, we can conclude that there is no pathognomonic cutaneous manifestation of COVID-19, since it can be also found in other viral infections.

COVID-19: Correlation between HRCT findings and clinical prognosis and analysis of parenchymal pattern evolution.

Objectives: Severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2) is a single-stranded positive ribonucleic acid virus of the coronaviridae family. The disease caused by this virus has been named by the World Health Organization coronavirus disease 19 (COVID-19), whose main manifestation is interstitial pneumonia. Aim of this study is to describe the radiological features of SARS-CoV-2 infection in its original form, to correlate the high-resolution computed tomography (HRCT) patterns with clinical findings, prognosis and mortality, and to establish the need for treatment and admission to the intensive care unit. Material and Methods: From March 2020 to May 2020, 193 patients (72 F and 121 M) who were swab positive for SARS-CoV-2 were retrospectively selected for our study. These patients underwent HRCT in the clinical suspicion of SARS-CoV-2 interstitial pneumonia. Results: Our results confirm the role of radiology and, in particular, of chest HRCT as a technique with high sensitivity in the recognition of the most peculiar features of COVID-19 pneumonia, in the evaluation of severity of the disease, in the correct interpretation of temporal changes of the radiological picture during the follow-up until the resolution, and in obtaining prognostic information, also to direct the treatment. Conclusion: Chest computed tomography cannot be considered as a substitute for real-time - polymerase chain reaction in the diagnosis of COVID-19, but rather supplementary to it in the diagnostic process as it can detect parenchymal changes at an early stage and even before the positive swab, at least for patients who have been symptomatic for more than 3 days.

COVID-19-associated mucormycosis in India: Why such an outbreak?

An unprecedented mucormycosis outbreak occurred in India during the second COVID-19 wave in spring 2021. COVID-19-associated mucormycosis (CAM) was observed, mainly rhino-orbito-cerebral mucormycosis (ROCM), in patients with poorly controlled diabetes and treated with inappropriate doses of glucocorticoids. The aim of this mini-review was to compare the characteristics of the CAM epidemic in India with (i) mucormycosis cases before the COVID-19 pandemic and (ii) CAM in the rest of the world (particularly in France) in order to identify the reasons for this outbreak. In India, the major mucormycosis epidemiologic change during the COVID-19 pandemic was an increase in the percentage of patients treated with corticosteroids who developed CAM. Compared with the rest of the world, India reported a higher mucormycosis incidence even before the COVID-19 pandemic. Moreover, in India, patients with CAM were more likely to have diabetes mellitus and ROCM; conversely, mortality rates were lower. The reasons for such a localized epidemic in India have remained unclear, but some hypotheses can be put forward, particularly the combination of high prevalence of uncontrolled diabetes mellitus and frequent indiscriminate corticosteroid utilization in a country that already had a high mucormycosis burden before the COVID-19 pandemic.

Efficacy and safety of human umbilical cord-derived mesenchymal stem cells for COVID-19 pneumonia: a meta-analysis of randomized controlled trials.

BACKGROUND: Elevated levels of inflammatory factors are associated with poor prognosis in coronavirus disease-19 (COVID-19). However, mesenchymal stem cells (MSCs) have immunomodulatory functions. Accordingly, this meta-analysis aimed to determine the efficacy and safety of MSC-based therapy in patients with COVID-19 pneumonia. METHODS: Online global databases were used to find relevant studies. Two independent researchers then selected and evaluated the studies for suitability while the Cochrane risk of bias tool determined the quality of all articles and Cochran's Q test and I2 index assessed the degree of heterogeneity in the principal studies. Statistical analysis was performed using Review Manager software, and the effect of each study on the overall estimate was evaluated by sensitivity analysis. RESULTS: Seven studies were included in the meta-analysis, and all MSCs used in the trials were acquired from the umbilical cord. The results of these studies (n = 328) indicated that patients with COVID-19 pneumonia who received MSCs had a 0.58 risk of death compared with controls (95% CI = 0.38, 0.87; P = 0.53; I2 = 0%). In terms of inflammatory biomarkers, MSCs reduced the levels of C-reactive protein (n = 88; MD = - 32.49; 95% CI = - 48.43, - 16.56; P = 0.46; I2 = 0%) and interferon-gamma (n = 44; SMD = - 1.23; 95% CI = - 1.89, - 0.57; P = 0.37; I2 = 0%) in severe COVID-19 patients but had no significant effect on interleukin-6 (n = 185; MD = - 0.75; 95% CI = - 7.76, 6.27; P = 0.57; I2 = 0%). A summary of the data revealed no significant differences in adverse events (n = 287) or serious adverse events (n = 229) between the MSC and control groups. CONCLUSIONS: Infusion of umbilical cord-derived MSCs is an effective strategy for treating patients with COVID-19 pneumonia, with no noticeable adverse effects.

Tailoring of neurosurgical practice during COVID-19 in a developing country: Insights gained and a way forward.

Background: The coronavirus disease-19 pandemic has aggravated the already neglected neurosurgical specialty in developing countries with a mounting shortage of specialists, long queues of operative patients, and a lack of adequate critical care units. Methods: We have reviewed the innovative strategies adopted for maintaining an optimal surgical practice while ensuring team safety at the Aga Khan University Hospital, Karachi Pakistan. Results: There is already a scarcity of resources in developing countries. The international guidelines had to be tailored to the context of the developing world. A multimodal strategy that focused on infection control, continuum of care, and the well-being of staff was adopted at Aga Khan University. Patients were screened and seen either in person or through telemedicine, depending on the severity of the disease. All educational activities for residents were shifted online, and this helped in preventing overcrowding. Conclusion: Optimal surgical practice while ensuring team safety can be achieved through a multimodal strategy focusing on infection control, continuum of care, and the well-being of staff.

Potential Mechanism of Colchicine against COVID-19 and Non-Small Cell Lung Cancer based on Network Pharmacology and Bioinformatics Analysis

Colchicine is an alkaloid with antitumor effect isolated from Colchicum autumnale plants, it has been reported in multiple studies as a potential treatment for coronavirus disease-19 and this study applied network pharmacology and bioinformatics analysis to explore the potential mechanism of colchicine against non-small cell lung cancer and coronavirus disease-19. The R software was used to determine the differentially expressed genes of non-small cell lung cancer/coronavirus disease-19, and carry out prognostic analysis and clinical analysis of the differentially expressed genes, the targets of colchicine were obtained from various databases, the protein-protein interaction network of intersection targets of colchicine and non-small cell lung cancer/coronavirus disease-19 was constructed, enrichment analysis of gene ontology and kyoto encyclopedia of genes and genomes pathways was performed by Metascape database and the molecular docking and molecular dynamics simulation were completed. We obtained a total of 716 differentially expressed genes and identified 13 potential prognostic genes associated with the clinical characterization of non-small cell lung cancer/coronavirus disease-19 patients. C-C motif chemokine ligand 2, toll like receptor 4, intercellular adhesion molecule 1, peroxisome proliferator activated receptor gamma, interleukin 17A, interferon gamma, angiotensin I converting enzyme, fos proto-oncogene, nuclear factor kappa B inhibitor alpha, TIMP metallopeptidase inhibitor 1 and secreted phosphoprotein 1 were core targets. The intersection targets of colchicine and non-small cell lung cancer/coronavirus disease-19 were mainly enriched in biological processes such as inflammatory response, response to cytokine and response to lipopolysaccharide, as well as signal pathways such as interleukin 17 signaling pathway, hypoxia inducible factor 1 signaling pathway and nucleotide binding oligomerization domain-like receptor signaling pathway. The results of molecular docking showed that the colchicine is better combined with the core targets. Analysis of molecular dynamics simulation showed that the protein and ligand form a stabilizing effect. Based on bioinformatics analysis and network pharmacology, we obtained biomarkers that may be used for the prognosis of non-small cell lung cancer/coronavirus disease-19 patients and revealed that colchicine may play a potential role in the treatment of non-small cell lung cancer/coronavirus disease-19 by regulating multiple targets and multiple signaling pathways and participating in multiple biological processes.

Early Treatment with Monoclonal Antibodies or Convalescent Plasma Reduces Mortality in Non-Vaccinated COVID-19 High-Risk Patients.

Vulnerable patients such as immunosuppressed or elderly patients are at high risk for a severe course of COVID-19 upon SARS-CoV-2 infection. Immunotherapy with SARS-CoV-2 specific monoclonal antibodies (mAb) or convalescent plasma represents a considerable treatment option to protect these patients from a severe or lethal course of infection. However, monoclonal antibodies are not always available or less effective against emerging SARS-CoV-2 variants. Convalescent plasma is more commonly available and may represent a good treatment alternative in low-income countries. We retrospectively evaluated outcomes in individuals treated with mAbs or convalescent plasma and compared the 30-day overall survival with a patient cohort that received supportive care due to a lack of SARS-CoV-2 specific therapies between March 2020 and April 2021. Our data demonstrate that mAb treatment is highly effective in preventing severe courses of SARS-CoV-2 infection. All patients treated with mAb survived. Treatment with convalescent plasma improved overall survival to 82% compared with 61% in patients without SARS-CoV-2 targeted therapy. Our data indicate that early convalescent plasma treatment may be an option to improve the overall survival of high-risk COVID-19 patients. This is especially true when other antiviral drugs are not available or their efficacy is significantly reduced, which may be the case with emerging SARS-CoV-2 variants.

Effectiveness of coronavirus disease-19 vaccination on disease transmission, hospitalization, and clinical outcomes in adults in North India

Introduction: Covaxin and Covishield vaccines have been rapidly rolled out in India to curb the Coronavirus disease-19 (COVID-19) pandemic. The present study tested the effectiveness of COVID-19 vaccination in adults in North India. Effectiveness was tested by considering disease transmission and post-COVID outcomes in infected individuals. Materials and Methods: This study was conducted in the Department of Physiology at MGM College, Jaipur (Rajasthan, India), after approval from the Ethics Committee. Vaccinated and nonvaccinated groups were compared for disease transmission, hospitalization, and clinical outcomes. Researchers collected data using questionnaires circulated through Google forms. The association between attributes was tested using the Chi-squared test. The significance level was considered at 5%. Results: Vaccination significantly reduced disease transmission of COVID-19 (χ 2 = 4.51;P = 0.034). However, no significant differences were seen in the Reverse transcription polymerase chain reaction positivity, chest computed tomography findings, and hospitalization. Similarly, COVID-related symptoms and their severity did not differ significantly between the two groups. The proportion of vaccinated individuals increases with age (χ 2 = 41.68;P < 0.001). Youths and older adults were vaccinated once and twice, respectively (χ 2 = 41.77;P < 0.001). The severity of adverse effects postimmunization (AEFI) was similar in all age groups (χ 2 = 13.22;P < 0.21). Males and females were equally vaccinated (χ 2 = 1.13;P < 0.288). However, males took two doses compared to females (χ 2 = 6,57;P < 0.01). Adverse effects postimmunization were more severe in females than males (χ 2 = 13.10;P < 0.001). Researchers found no association between the number of vaccine doses and the severity of AEFIs (χ 2 = 16.42;P = 0.06). Conclusion: The present study concludes the beneficial effect of vaccination in reducing disease transmission. However, vaccination showed no effectiveness in mitigating other COVID-related outcomes. The following core competencies are addressed in this article: Medical knowledge, systems-based practice, practice-based learning, and improvement. © 2023 International Journal of Academic Medicine ;Published by Wolters Kluwer - Medknow.

Knowledge and perception regarding oral manifestations of COVID-19 among the undergraduate and postgraduate students of Vishnu Dental College—a questionnaire based study

Background: The coronavirus disease-19 (COVID-19) and its consequences demonstrate that it is a substantial global health threat with symptoms ranging from mild flu to severe pneumonia. The objective of this study was to assess Indian dental school undergraduate and postgraduate students' knowledge and perception of the oral symptoms present in COVID-19 patients. Methods: Dental students were compared for knowledge and perceptions regarding oral manifestations of COVID-19 according to their academic, gender and age. The questionnaire was broken into three parts and comprised 12 questions about oral manifestations in COVID-19 patients' knowledge and perception. Each participant received a WhatsApp message with a shareable Google Drive link. After gathering data, the Pearson Chi-Square test was used to do statistical analysis. Results: This questionnaire survey was completed by 380 dental students. Significant differences were obtained except for one question about knowledge and perception related questions addressing oral manifestations in COVID-19 patients. Only the knowledge-related questions about oral manifestations in COVID-19 patients showed significant differences when compared to perception related questions when compared to gender-related replies. Conclusions: This study demonstrated that dental students have knowledge of identifying the oral manifestations in COVID-19 infected people, and emphasized the importance of every dental student in identifying oral manifestations and relating these manifestations to the severity of COVID-19 infection in order to preserve patients' oral and overall health. © Frontiers of Oral and Maxillofacial Medicine.

Strategies to meet blood demand for transfusions during the COVID-19 pandemic: lessons learnt from a large central hospital in Malawi

Background: The coronavirus disease-19 (COVID-19) pandemic affected blood banks globally. We sought to examine how COVID-19 affected blood supply and transfusion in our institution. Method(s): The study was conducted at the Queen Elizabeth Central Hospital (QECH) and the Malawi Blood Transfusion Service (MBTS) in Malawi. Data from April to November 2020, collected during the pandemic, were compared with data from the same time period in 2019 pre-COVID-19. Additionally, in-depth interviews with key personnel were conducted at both institutions. Statistical analysis was performed using Stata 15 and qualitative data were analyzed using Nvivo software. Result(s): There was a significant reduction in blood supplied to the QECH from 7,303 [2019] to 6,028 units [2020] (P<0.04). The highest reduction in blood supply was to the Adult Emergency & Trauma department (29%) while the lowest was in Obstetrics & Gynecology, and Pediatric departments (17% reduction each). This is despite that the transfusion services continued to conduct blood drives during the pandemic, and the hospital laboratory prioritized blood issuing for emergency indications. Conclusion(s): Blood supply has significantly reduced during COVID-19 pandemic in our centers. Developing plans for overcoming similar shortages in future pandemics is critical.Copyright © Annals of Blood. All rights reserved.

Efficacy of low dose whole-lung irradiation for the treatment of moderate to severe COVID-19 pneumonia: Meta-analysis.

Objective To systematically evaluate the efficacy of low dose whole-lung irradiation in COVID-19 pneumonia based on the present evidence. Methods All literature related to the application of low dose whole-lung irradiation in COVID-19 pneumonia were retrieved from Pubmed, Embase, the Cochrane Library, Web of Science, Google scholar, Scoupus, CNKI, Wanfang database, VIP database until May 2022. Two researchers independently screened the literature. For the literature that met the inclusion criteria, both data extraction and literature quality evaluation were blinded. Revman 5.3 software was used for statistical analysis. Results A total of 5 controlled clinical trials involving 194 patients met the inclusion criteria. No statistically significant differences were detected in the low dose whole-lung irradiation group compared with the best supportive care group for clinical recovery rates, intubation rates, radiographic improvement rates and 28 d-overall survival. Conclusions In patients of COVID-19 pneumonia, low dose whole-lung irradiation conferred no significant benefit to clinical outcomes. Currently, the routine use of low dose whole-lung irradiation for the treatment of moderate to severe COVID-19 pneumonia is not recommended.Copyright © Chinese Medical Journals Publishing House Co.Ltd. All Rights Reserved.

Impact of COVID-19 Pandemic on Cardiovascular Testing in Asia: The IAEA INCAPS-COVID Study.

Background: The coronavirus disease-2019 (COVID-19) pandemic significantly affected management of cardiovascular disease around the world. The effect of the pandemic on volume of cardiovascular diagnostic procedures is not known. Objectives: This study sought to evaluate the effects of the early phase of the COVID-19 pandemic on cardiovascular diagnostic procedures and safety practices in Asia. Methods: The International Atomic Energy Agency conducted a worldwide survey to assess changes in cardiovascular procedure volume and safety practices caused by COVID-19. Testing volumes were reported for March 2020 and April 2020 and were compared to those from March 2019. Data from 180 centers across 33 Asian countries were grouped into 4 subregions for comparison. Results: Procedure volumes decreased by 47% from March 2019 to March 2020, showing recovery from March 2020 to April 2020 in Eastern Asia, particularly in China. The majority of centers cancelled outpatient activities and increased time per study. Practice changes included implementing physical distancing and restricting visitors. Although COVID testing was not commonly performed, it was conducted in one-third of facilities in Eastern Asia. The most severe reductions in procedure volumes were observed in lower-income countries, where volumes decreased 81% from March 2019 to April 2020. Conclusions: The COVID-19 pandemic in Asia caused significant reductions in cardiovascular diagnostic procedures, particularly in low-income countries. Further studies on effects of COVID-19 on cardiovascular outcomes and changes in care delivery are warranted.