Institutional awareness campaign: COVID-19 vaccination drive among nursing students.

Objectives: Possessing accurate knowledge and utilization of reliable information sources may play a vital role in adoption of positive health behaviours, including acceptance of vaccine. The present study was conducted with an objective to assess the awareness and attitude of undergraduate nursing students regarding COVID-19 vaccine. Methods: A cross-sectional survey was conducted in Mid May 2021 using Google Forms through Google platform on-line. A total of 354 nursing students participated in the survey. A validated and pre-tested structured knowledge and Attitude, questionnaire was used to collect data from undergraduate nursing students regarding COVID-19 vaccine. Chi-square test, followed by binary logistic, was applied to determine factors associated with knowledge scores. Results: The mean knowledge score was 11.31 (SD ± 2.31, range: 2-15), with a correct response rate of 75.4%. However, the mean attitude score was 40.56 (SD ± 5.10, range: 28-55) with an unfavourable response towards COVID-19 vaccination (54.8%). The knowledge level was found to be significantly associated with student's professional qualifications and Vaccination status (P < 0.05). In binary logistic regression analyses, the knowledge score found to be significantly associated with participant's professional qualification i.e., B.Sc. (Hons.) Nursing 2 nd Year (AOR: 2.45, CI: 1.43-4.19, P < 0.001) and B.Sc. (Hons.) Nursing 3rd Year (AOR: 2.69, CI: 1.50-4.83, P < 0.001) and students who has received COVID-19 vaccination (AOR:3.08 CI: 1.81-5.25, P < 0.000). Conclusion: The current study findings represent adequate knowledge among undergraduate nursing students which is a very good sign. However, efforts must be taken to develop positive attitude towards COVID-19 Vaccination.

Impact of the COVID-19 pandemic on an online cancer screening training programme for healthcare providers in the public sector in India: learnings from a hub and spoke model perspective.

Introduction: This article elicits our experiences and strategic approaches to ensure the sustainability of the online capacity-building programmes for healthcare providers (HCPs) in comprehensive cancer screening through the 'Hub and Spoke' model during the coronavirus disease (COVID-19) pandemic. Methods: During the first wave of COVID-19, training for three cohorts of medical officers (MO) (Batch-A) was ongoing (May-December 2020). The Indian health system abruptly shifted focus towards containing the COVID-19 spread, leading to new challenges in conducting training courses. A new five-step strategic approach for cohort MO-14 (Batch-B) was adopted to spread awareness about the importance of cancer screening and the roles and responsibilities of HCPs in the implementation and conduct of practical sessions in their states in collaboration with their respective state governments. We also adopted social media - WhatsApp for official communication. Results: Enrolling Batch-B following the new strategic approach reduced refusals by 25% and dropouts by 36% compared to Batch-A. Course compliance and completion was a significant 96% in Batch-B. Conclusion: The COVID-19 pandemic opened a window of opportunity to understand the need for vital changes to improve the quality of our hybrid cancer screening training. Inclusion of the state government in planning and implementing the changes, awareness among HCPs about the importance of training and responsible acceptance of cancer screening, district-wise approach, use of social media in sharing course materials and conducting in-person training in the respective state have demonstrated significant impact on the quality of the training and in scaling-up of cancer screening. Prolonged mentorship, robust Internet connectivity for providers and training on handling gadgets and online video communication would profoundly benefit remote training programmes.A well-devised backup system is essential for training programmes during unforeseen eventualities such as the COVID pandemic.

Financial toxicity and mental well-being of the oral cancer survivors residing in a developing country in the era of COVID 19 pandemic - A cross-sectional study.

OBJECTIVES: The primary outcome measures evaluated the financial toxicity and mental well-being of the oral cancer survivors. METHODS: A cross-sectional study of oral cancer survivors who were disease-free for more than 6 months after treatment and visited the hospital for a routine follow-up is included in the study. Mental well-being and financial toxicity were evaluated using the Depression, Anxiety, and Stress Scale - 21 (DASS 21) and Comprehensive Score for financial Toxicity (COST- Functional Assessment of Chronic Illness Therapy) questionnaires. A literature review was done to compare the results with financial toxicity and mental health in cancer patients from the pre-pandemic era. RESULTS: A total of 79 oral cancer survivors were included in the study, predominantly males (M: F = 10:1). The age ranged from 26 to 75 years (The median age is 49). The full-time employment dropped from 83.5% in the pre-treatment period to 21.5% post-treatment. Depression was observed in 58.2% and anxiety in 72.2%. Unemployed survivors were observed to have more depression (OR = 1.3, 95% confidence interval (CI) = 0.3-5.4, p = 0.6), anxiety (OR = 3.5, 95% CI = 0.3-21.2, p = 0.1) and stress (OR = 1.6, 95% CI = 0.3-6.6, p = 0.5) than rest of the cohort. On univariate analysis, unemployed survivors (M = 11.8 ± 3.8, p = 0.01) had significantly poorer financial toxicity scores. Survivors with depression (M = 16.4 ± 7.1, p = 0.06) and stress (M = 14.4 ± 6.8, p = 0.002) had poor financial toxicity scores. On multifactorial analysis of variance, current employment (p = 0.04) and treatment modality (p = 0.05) were significant factors impacting the financial toxicity. CONCLUSION: There is a trend towards increased incidence of depression, anxiety, and stress among oral cancer survivors compared to the literature from the pre-COVID era. There is significant financial toxicity among either unemployed or part-time workers. This calls for urgent public/government intervention to prevent the long-term impact of financial toxicity on survival and quality of life.

The epidemiology and dynamics of COVID-19 disease transmission among healthcare workers of a tertiary healthcare setting in India.

Context: The novel coronavirus disease 2019 (COVID-19) that has emerged as a pandemic now has put health care workers (HCWs) at great risk as they are the warriors in frontlines screening and treating the infected patients. When a COVID-19-positive HCW is identified, its contacts need to be traced to check the spread of the infection among patients and other HCWs. Aims: This study was aimed to study epidemiology and risk factors associated with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection among HCWs and to quantify the risk of infection among HCWs in a tertiary level health care setting. Settings and Design: This cross-sectional study enrolled all the HCWs who were exposed to a patient with COVID-19 in a tertiary level health care center, Rishikesh, Uttarakhand from 1st May to 30th July, 2020. Methods and Material: All the exposed HCWs were followed up for 14 days after the last exposure to a patient with confirmed COVID-19 infection. Epidemiological data were obtained using structured interviews. Statistical Analysis Used: The data were analyzed using SPSS 23.0. Frequencies and proportions were calculated for descriptive variables, and risk ratios were calculated for risk factors affecting the transmission of disease. Results: We observed that 1,141 HCWs of the tertiary level health care hospital were exposed to COVID-19 patients during the study period. A total of 22 HCWs were tested COVID-19 positive among these exposed HCWs. Univariate analysis revealed a high risk of exposure to be significantly associated with a higher secondary attack rate of SARS CoV-2. Conclusions: The study demonstrates the risk of COVID-19 transmission through asymptomatic carriers. Therefore, periodic testing of all health care workers is necessary to ensure early mitigation of the shortage of health care providers.

COVID-19 Infection after vaccination among Healthcare Workers at a Tertiary Level Health Care Center in Northern India: A Cross-Sectional Study.

BACKGROUND AND AIMS: COVID19 vaccines are now accessible to all Indian citizens. Infection with COVID19, on the other hand, continues to spread continuously. Our study aimed to determine the number of persons who had COVID-19 infections despite receiving the recommended number of doses of the COVID 19 vaccination at AIIMS Rishikesh, a tertiary care facility in Uttarakhand, India. METHODS: We analysed meticulously preserved data regarding COVID-19 vaccination, COVID-19 infection, Clinical symptoms, and RT-PCR testing among all HCWs in our healthcare institution during period from 16 January 2021 to 30th June 2021.. RESULTS: During this period, 5273 (90.3%) HCWs received two doses of COVID-19 vaccine, while 566 (9.7%) received only one dose. 628 HCWs (10.8%) were BBV152 recipients and 5211(89.2%) AZD1222 (ChAdOx1-S) recipients. 423 HCWs (7.2%,confidence interval of 95% - 13.8, 22.0) reported COVID-19 infections.274(5.19% of total vaccinated HCWs ) breakthrough infections and 149 non-breakthrough COVID-19 infections reported in HCWs who had previously received a single dose of the COVID-19 vaccination. . CONCLUSION: Viral infections sepecially breakthrough infections following adequate vaccination are a cause for concern, but there is a lack of data on these infections in the actual world. Therefore, the primary focus of research should be on the emergence of illness in India following the completion of a full vaccine course.

Health budget in light of pandemic: Health reforms from mirage to reality.

The outbreak of coronavirus disease (COVID-19) has triggered changes and reforms in the health sector in India. As the pandemic points to a gap in the industry, it has led to the creation of new opportunities to solve problems. To help the country repair the damage caused by the virus pandemic, the Government of India announced that in the health budget 2021, promotion of health and well-being will be one of the six pillars. Investment in health infrastructure in the 2021 budget has increased significantly to welcome the much-needed increase in budget allocations of Rs. 2.3 lakh crore. Three areas will also be strengthened, including preventive health care and therapeutic health care. Special emphasis is placed on prevention, treatment, and health care. To promote primary health care, the country will establish 17,000 rural and 11,000 urban health care centers. Provision of affordable quality medical insurance will be provided by the government. The integrated and collaborative model of the public and private sectors in the provision of health services has led to a rapid expansion of work. This is an attempt to demonstrate the planned reforms in the health budget, especially during the COVID-19 pandemic. The budget of 2022-23 is about to be announced soon. It is to be seen how the financial allocation for the health sector impacts the health of the Indian people.

Is it time to consider shreds of epidemiological and environmental evidence associated with high transmission of COVID-19?

Novel coronavirus named COVID-19 that emerged in late December from Wuhan affected almost the entire globe. Recent studies provided new insight into the high transmission of the disease. This review explores the current evidence of epidemiological and environmental factors associated with high transmission of COVID-19. Even transmission and symptoms found among cats, dogs, ferrets, and tiger suggested low species barrier of the virus. The airborne transmission was found even up to 4 m, and fecal transmission with virus particles and RNA in sewage and wastewater suggests rethinking containment strategies. However, temperature, humidity, and pollution were also associated with transmission and mortality trends of COVID-19. To better mitigate and contain the current pandemic, it is a need of hours to consider the recent shreds of evidence to prevent further spread and require detailed investigations of these evidences by extensive epidemiological and meteorological studies.

Hacking Covid-19 with Technology.

The development, implementation and advancement of technology solutions aimed at combating the COVID-19 outbreak are rapidly taking shape in India. Governments, Venture Capitalists, Academic Institutions, Incubators, Start-ups, and businesses large and small are all doing their part to deploy new innovative solutions as quickly as possible. Various databases were searched to look for different advancements in technology during the current coronavirus pandemic. It is seen that on one end nonpharmacological measure (social distancing, self-isolation, clean hands, and face masks) are time-tested and low-tech ways to help mitigate the viral spread. On the other end, Science and technology sector constituting of data science, machine learning, rapid diagnostic tests, mobile-first telehealth and computational simulation systems for drug development, artificial intelligence, virtual collaboration, and data tracking are complex ways of using the technology that have strengthened our pandemic response.

Awareness and readiness of health care workers in implementing Pradhan Mantri Jan Arogya Yojana in a tertiary care hospital at Rishikesh.

BACKGROUND: Right to health is one among the important components of basic human rights. The Government of India had announced "Ayushman Bharat for a new India-2022", during 2018-19 parliament budget sessions with two components namely, Health and wellness centers for strengthening primary care and national health protection scheme now known as "Pradhan Mantri Jan Arogya Yojana (PMJAY)" for enabling access to secondary and tertiary healthcare services. Current study was conducted to assess awareness and readiness of the health care workers in implementation of Pradhan Mantri Jan Arogya Yojana. MATERIALS AND METHODS: A hospital based cross sectional study was conducted with estimated sample size calculated of 236, with treating consultants and residents as study participants. Participants filled a self-administered pretested semi-structured questionnaire to assess the level of awareness and readiness in implementing PMJAY. Data was entered and analyzed using EPI Info 7 software. RESULTS: Total number of participants were 181. Mean awareness score was 4.5±1.96 and mean readiness score was 16±5. Mean awareness and readiness score among medical and surgical branches was not statistically significant. There was significantly high awareness score among faculty as compared to senior residents. Relationship between awareness and readiness was found to be correlated with Pearson's correlation of 0.206 and was statistically significant. Linear regression model demonstrated an increase of 0.531 units in readiness for every unit increase in awareness score. CONCLUSION: Mean awareness score of doctors was just around half of maximum possible score. Awareness is more among faculty members than residents. With increase in awareness there is an increase in readiness among the study population. There is a need to organize workshops on PMJAY for stakeholders.

Challenges with the proposed approach in enhancing the accessibility of antimalarial activities during COVID 19 pandemic.

COVID 19 has hardly left any part of the world untouched. Two hundred thirteen countries have been affected by this disease, with 17,208,324 cases and 670,626 deaths as of July 30, 2020. If we look at the death toll caused by Malaria, this year, it is closely nearing COVID 19 deaths, 5, 68,700 deaths. Malaria mostly occurs in poor, tropical, and subtropical regions across the globe. In 2018, Malaria was most rampant in Africa, followed by Southeast Asian Regions (SEAR). SEAR is at the greatest risk of both COVID 19 and malaria. Strategies for essential commodities and antimalarial activities are affected by COVID 19 when the rainy season registers the maximum malaria load. We searched the literature to explore the evidence regarding efficacious antimalarial activities and the gap created by the COVID 19 pandemic, responsible barriers, and challenges, with the possible approaches towards accomplishing a target for malaria control.

Primary to tertiary COVID-19 transmission in a hospital - A cluster outbreak analysis.

The recent pandemic of SARS COV-2, a novel coronavirus requires research into understanding of its transmission dynamics and clinical presentations to help in understanding the spread of the disease, how to prevent it not only locally but also for national policy formulations. In this study, we described the transmission dynamics and clinical presentations of a cluster outbreak of SARS COV-2 in a tertiary level hospital. We also calculated the secondary attack rate for the primary, secondary, and tertiary transmissions. We conclude that symptomatic COVID-19 are primary and secondary contacts rather than tertiary contacts, hence, former to be quarantined. However, tertiary transmission is causing more COVID-19 compared to other transmissions in a hospital outbreak without further transmissibility. And overall secondary attack rate is very low in a hospital outbreak.

SARS-CoV-2 and Glutamine: SARS-CoV-2 Triggered Pathogenesis via Metabolic Reprograming of Glutamine in Host Cells.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, as coronavirus disease 2019 (COVID-19) pandemic, has killed more than a million people worldwide, and researchers are constantly working to develop therapeutics in the treatment and prevention of this new viral infection. To infect and induced pathogenesis as observed in other viral infections, we postulated that SARS-CoV-2 may also require an escalation in the anabolic metabolism, such as glucose and glutamine, to support its energy and biosynthetic requirements during the infection cycle. Recently, the requirement of altered glucose metabolism in SARS-CoV-2 pathogenesis was demonstrated, but the role of dysregulated glutamine metabolism is not yet mentioned for its infection. In this perspective, we have attempted to provide a summary of possible biochemical events on putative metabolic reprograming of glutamine in host cells upon SARS-CoV-2 infection by comparison to other viral infections/cancer metabolism and available clinical data or research on SARS-CoV-2 pathogenesis. This systematic hypothesis concluded the vital role of glutaminase-1 (GLS1), phosphoserine aminotransferase (PSAT1), hypoxia-inducible factor-1 alpha (HIF-1α), mammalian target of rapamycin complex 1 (mTORC1), glutamine-fructose amidotransferase 1/2 (GFAT1/2), and transcription factor Myc as key cellular factors to mediate and promote the glutamine metabolic reprogramming in SARS-CoV-2 infected cells. In absence of concrete data available for SARS-CoV-2 induced metabolic reprogramming of glutamine, this study efforts to connect the gaps with available clinical shreds of evidence in SARS-CoV-2 infection with altered glutamine metabolism and hopefully could be beneficial in the designing of strategic methods for therapeutic development with elucidation using in vitro or in vivo approaches.

Non-COVID area of a tertiary care hospital: A major source of nosocomial COVID-19 transmission.

COVID-19 pandemic has spread to all corners of the world where infection control measures are being implemented. There is now a resurgence of the disease in health care facilities with documented in-hospital transmission and cases becoming positive in areas designated to cater for COVID-19 negative patients. We encountered such an event at our institution where fourteen patients (including health care workers) in the non-COVID zone were found to be COVID-19 positive. This highlights the loopholes in the system and the need for better and systematic infection control measures in hospitals that deal with infectious diseases with high infectivity. Findings also suggests the failure of government's criteria for suspected COVID-19 cases, and therefore needs a rethinking.

Discordance of COVID-19 guidelines for patients with cancer: A systematic review.

This review was aimed to systematically evaluate the available literature on the impact of COVID-19 on cancer care and to critically analyze the diagnostic and therapeutic strategies suggested by various healthcare providers, societies, and institutions. Majority guidelines for various types of cancers favored a delay in treatment or a nonsurgical approach wherever feasible. These guidelines are based on a low level of evidence and have significant discordance for the role and timing of surgery, especially in early tumors.

The impact of COVID-19 related lockdown on ophthalmology training programs in India - Outcomes of a survey.

Purpose: In 2020, in response to the emergence and global spread of the disease COVID-19, caused by a new variant of coronavirus 2019-nCoV, the government of India ordered a nationwide lockdown for 21 days, which was then extended to a total of over 50 days. The aim of this study is to assess the effect of the lockdown on ophthalmic training programs across India. Methods: An online survey was sent across to trainee ophthalmologists across India through various social media platforms. Results: In all, 716 trainees responded; the average age was 29.1 years. Results showed that majority of the respondents were enrolled in residency programs (95.6%; 685/716) and the others were in fellowship programs. About 24.6% (176/716) of the trainees had been deployed on 'COVID-19 screening' duties. Nearly 80.7% (578/716) of the trainees felt that the COVID-19 lockdown had negatively impacted their surgical training. Furthermore, 54.8% (392/716) of the trainees perceived an increase in stress levels during the COVID-19 lockdown and 77.4% (554/716) reported that their family members had expressed an increased concern for their safety and wellbeing since the lockdown began. In all, 75.7% (542/716) of the respondents felt that online classes and webinars were useful during the lockdown period. Conclusion: Our survey showed that majority ophthalmology trainees across the country felt that the COVID-19 lockdown adversely affected their learning, especially surgical training. While most found online classes and webinars useful, the trainees' perceived stress levels were higher than normal during the lockdown. Training hospitals should take cognizance of this and reassure trainees; formulate guidelines to augment training to compensate for the lost time as well as mitigate the stress levels upon resumption of regular hospital services and training. Going ahead, permanent changes such as virtual classrooms and simulation-based training should be considered.