Comparison of Obstetric Outcomes in First and Second COVID-19 Waves: Analysis from a COVID-19-dedicated Tertiary Care Hospital

Introduction: The physiological changes in the respiratory and cardiovascular systems in the immunosuppressed state of pregnancy may exacerbate clinical features and deteriorate outcomes due to COVID-19 infection. We aimed to compare the maternal and neonatal adverse effects in the first and second COVID-19 waves. Methodology: This study was a prospective cohort study conducted in a tertiary care COVID-19-dedicated hospital. In total, 104 (group A) and 96 (group B) COVID-19-positive pregnant women admitted during the first and second waves, respectively, were included in the study. Data on baseline variables, associated comorbidities, clinical presentations, management strategies, and neonatal and maternal outcomes were collected and compared using parametric and nonparametric tests and analyzed. Result(s): Around 2.08% in group A and 6.72% in group B of COVID-19-infected pregnant women, respectively, had moderate-to-severe disease and required intensive care unit stay. Almost 1.04% in group A and 3.84% in group B had maternal mortality, 13.4% and 19.8% babies of groups A and B required admission in neonatal intensive care units, and 8.6% and 7.3% of newborns in groups A and B had COVID-19-positive reports by reverse transcriptase polymerase chain reaction (RT-PCR) at birth, respectively. Of them, 2.1% newborns in group B had RT-PCR positive on day 7 of life and beyond, whereas none had positive RT-PCR reports on 7 days and beyond in group A. Conclusion(s): Dreadful maternal outcomes like requirement of ICU and mechanical ventilator and persistence of neonatal infections were higher during the second wave.Copyright © The Author(s). 2023.

A retrospective review to assess the clinical outcome of rhino-orbito-cerebral mucormycosis patients with COVID-19 infection and its association with glycaemic control

Introduction: The coronavirus disease 2019 (COVID-19) pandemic in India, having caused 29 500 000 confirmed cases and 374 000 deaths as of June 14, 2021, continues to have devastating consequences, including a large epidemic of COVID-19-associated mucormycosis (COVID-Mucor), manifesting as rhino-orbito-cerebral mucormycosis (ROCM), which has worsened the morbidity among vulnerable populations (JHU, 2021) 1. Reports have shown a much larger surge in the incidence of COVID-Mucor during the second wave in 2021 than during the first wave (Patel et al., 2021, Moorthy et al., 2021) 2, 3. This rapid rise in COVID-Mucor is probably caused by several factors. For patients with diabetes mellitus, lockdowns, travel restrictions, and restricted access to medical care have worsened glycaemic control, the central risk factor for ROCM in India (Chakrabarti et al., 2006) 4. Addressing these could reduce morbidity and mortality among vulnerable populations. Material(s) and Method(s): A Retrospective chart review was conducted in Department of General medicine Dr S N Medical College Jodhpur among population included all rhinoorbito-cerebral mucormycosis patients with Covid-19 infection who were admitted in Mucormycosis ward, Dr S N Medical College Jodhpur from Oct. 2020 to Sept 2021. Bed head tickets of all these patients were reviewed. The final outcome was noted from the bed head ticket, the outcome was correlated with random blood sugar and HbA1c level at admission. Conclusion(s): Mucormycosis is angioinvasive fungal disease with significant morbidity and mortality. The disease has risen dramatically due to interplay of COVID 19 pandemic, uncontrolled diabetes and inappropriate corticosteroid use leading to pathogenic invasion and adverse outcomes. The treatment involves early detection, surgical debridement and antifungal drugs for better survival. Our study revealed an evident role of hyperglycemia as major risk factor for mucormycosis infection. Those patients who had HbA1c> 10 could not survive inspite of best treatment and those patients who survived their hospital stay was directly proportional to their HbA1c level. All those patients who had cerebral involvement could not be saved. Hence, we suggest that closely tracking the levels of blood sugar in COVID-19 patients is a valuable tool to stratify the risk that a patient will have mucormycosis. Copyright © 2022 Ubiquity Press. All rights reserved.

Preparing for Transplant - Screening and Prophylaxis of Donor and Recipients before Solid Organ Transplantation: Expert Group Opinion from South Asia

Infections are major cause of morbidity and mortality after transplantation. Although many infections are common worldwide, there are differences in various geographic locations. South Asia and India, in particular, has a very active transplant program for kidney and liver transplantation, however, there are no guidelines as how to screen and provide prophylaxis to solid organ transplant (SOT) recipients and donors for both specific infections prevalent in this region along with usual infections. Keeping this in mind, a working group was created comprising transplant physicians, surgeons, and infectious disease specialists from South Asia as well as experts from other countries. This working group developed guidelines based on published evidence, unpublished data from large centers in this region, along with expert opinion. This section of the guidelines deals with pretransplant screening of donors and recipients, which should be useful in dealing with transplants performed in this region for patients belonging to these countries, for those coming for transplantation from other countries, and for programs outside of South Asia who are screening donors and recipients from this region or who have spent significant time in this region. Copyright © 2022 Indian Journal of Transplantation Published by Wolters Kluwer - Medknow.

COVID-19 as an Opportunity to Engage with Urban Malnutrition Challenge: Preliminary Insights from India

As the world is urbanising fast, a growing body of literature highlights malnutrition as an imminent urban challenge, further compounded by the outbreak of COVID-19. The nutrition policy discourse, however, is yet to accommodate this shift. In fact, it continues to exhibit a rural bias. This itself has partly been reinforced by the absence of authoritative evidence on urban malnutrition. Based on preliminary analysis of Indian data, this paper examines whether there is urbanisation of child malnutrition. The paper finds that urban India is witnessing a decline in nutrition advantage. While for less urbanised states, urban child stunting is relatively higher, in more urbanised states, urban child wasting is a challenge. Given that wasting is an indicator of acute malnutrition, it is partly attributable to lack of adequate food. Though it might be early to connect this to a looming hunger crisis, growing child wasting questions the claims of food security in urban India. Seeing this further in context of implications of COVID-19 provides a potential basis for broadening of the nutrition policy agenda. © 2022 Economic and Political Weekly. All rights reserved.

Management of critically ill elderly COVID-19 patient with severe comorbidities in the intensive care unit: Missed palliative care!

The severe acute respiratory syndrome coronavirus 2 disease (COVID-19) pandemic is not just about medical management in intensive care units (ICUs). The old population and those with severe comorbidities and chronic illnesses are more prone to die due to COVID-19 infection and integrating palliative care support in ICUs is the need of the hour. However, during this pandemic, there is a clear lack of palliative care in ICUs due to several barriers which we will discuss in this particular case. © 2021 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow

Deciphering the Indian Slip on the Global Hunger Index 2021

The Indian slip on the Global Hunger Index 2021 is being attributed by the government to the alleged methodological discrepancies involved in constructing the GHI. This article, to begin with, counters the government's argument defending India's position on the GHI. It further fi nds that India likely has been undergoing a decline in food security since the mid-2000s itself. The trend is corroborated from the 2019-20 data available for selected states. Though COVID-19 has compounded the food insecurity challenges, India's position on the GHI cannot be attributed to the pandemic alone. Rather, it refl ects a trend that India has been experiencing for sometime now. © 2022 Economic and Political Weekly. All rights reserved.

Assessing Supply Chain Resilience During the Pandemic Using Network Analysis

Disruptions induced by the COVID-19 pandemic have wreaked havoc in supply chain networks. To gain an understanding of the dynamics that had been at play, we construct a real supply chain network (scale-free) based on a seed firm (Apple), its customers, and its first- and second-tier suppliers, yielding a network of a total of 883 firms. We then use visualization to derive insight into various network characteristics and develop an agent-based model to capture the disruption of the network over a period of 400 days from the onset of the pandemic. The disruptions experienced by firms depend on the stringency of measures taken to curb the pandemic in their respective countries and the severity of disruptions experienced by suppliers in a specific region. We specifically find that spatial complexity, degree centrality, betweenness centrality, and closeness centrality have changed significantly throughout our observation period. We thus subsequently theorize on the influence of some of these characteristics on supply chain resilience (SCRes), and through our empirical tests, we find that, at the network level, Average degree and spatial complexity significantly influence SCRes. At the firm-level, we find that powerful firms within the network influence SCRes based on their betweenness centrality and closeness Centrality. Implications for managerial practice and academic research are discussed. IEEE

Modelling resilient fashion retail supply chain strategies to mitigate the COVID-19 impact

Purpose: This paper aims to develop supply chain strategies for the fashion retail supply chain (FRSC), likely to be disrupted by the current pandemic (COVID-19) under physical and online retail stores. The resilient retail supply chain design is proposed under budget allocation and merchandise capacity constraints. Design/methodology/approach: This paper utilises the theory of constraint (ToC) and goal programming (GP) to address the COVID-19 impact on FRSC. The budgetary and capacity constraints are formulated with a constraint optimisation model and tested with six different priorities to deal with the physical and online stores. Next, all priorities are developed under different FRSC business scenarios. The ToC-GP-based optimisation model is validated with one of the Indian fashion retail supply chains. Findings: The proposed optimisation model presents the optimal retailing strategies for selling fashion goods over physical and online platforms. The multiple scenarios are presented for developing trade-offs among different strategies to maximise the retailer's merchandise performance. This paper also highlighted the strategic movement from high merchandise density stores to low merchandise density stores. This implies a reduction of sales targets and aspiration levels of both online and physical fashion stores. Research limitations/implications: The proposed model is validated with one of the fashion retailers in India. Other nations or multiple fashion retailers might be considered for more generalisation of findings in the future. Practical implications: This research helps fashion retail supply chain managers deal with consumer demand uncertainty over physical and online stores in pandemic times. Limitation: Other nations or multiple fashion retailers might be considered for more generalisation of findings in the future. Originality/value: This is the first study that considered the impact of COVID-19 on the retail fashion supply chain. The effect of physical and online platforms is mainly discussed from consumer marketing perspectives, but an inventory and resilience perspective is missing in earlier studies. The role of merchandise planning is highlighted in this study. © 2021, Emerald Publishing Limited.

Clinical profile of COVID-19 patients: A review of diagnostic aids and clinical profile of COVID-19

The SARS-CoV-2 is a novel coronavirus which originated in the province Wuhan, China, in December 2019. It is the causative agent of COVID-19, an infection mainly presenting as mild upper respiratory tract infection, with patients presenting with fever, cough, breathlessness and fatigue. The virus predominantly spreads by a person to person contact, which is why it has spread very rapidly in a short span of time, so much so, that multiple countries are affected at present. The number of casualties is ever increasing. Even though our understanding of the novel coronavirus is improving, many countries, including India, are facing a situation which is not getting better with respect to controlling the pandemic. The number of new cases and deaths are ever increasing. There is a general state of panic among all the sections of the society and almost all are affected. With the number of tests being carried out every day, also increasing, a general idea about the signs and symptoms of the disease as well as the diagnostic criterion aids will further help us control the pandemic. This narrative review focuses on the clinical symptoms, diagnostic aids, risk factors, common clinical symptoms, laboratory findings and complications of COVID-19 and also on post COVID 19 Complications.