Emerging zoonotic diseases and COVID-19 pandemic: global Perspective and Indian Scenario.

The current coronavirus disease 2019 (COVID-19) pandemic is one example of the scores of zoonotic diseases responsible for various outbreaks resulting in the deaths of millions of people for centuries. The COVID-19 pandemic has broken the age-old healthcare infrastructure and led to utter chaos. In the shadow of this pandemic, other zoonotic infections like the nipah virus, monkeypox, and langya virus, to name a few, have been neglected. Hence, outbreaks caused by such zoonotic viruses are rising in their endemic areas, like the Indian subcontinent. The mortality and morbidity due to such zoonoses are greater than usual due to the shortage of healthcare professionals caused by the COVID-19 crisis. Due to the lack of vaccines and therapeutics directed against this viral infection, treatment of patients is limited to supportive management and prevention, making preparedness for these potential zoonotic viral outbreaks essential. This paper highlights some of these zoonotic infections, which perpetuated and wreaked havoc while the world was occupied with containing the COVID-19 pandemic.

Coexistence of proboscis lateralis and multiple craniofacial, neurological, cardiac and spinal deformities: a one-of-a-kind case report.

BACKGROUND: Proboscis lateralis (PL) is an uncommon congenital facial deformity marked by the protrusion of a primitive tubular structure made up of skin and soft tissue that generally emerges from the eye's medial canthus and is associated with some craniofacial deformities. We report the first case of PL with multiple craniofacial, neurological, cardiac, and spinal anomalies. CASE PRESENTATION: A full-term female baby delivered by cesarean section cried immediately at birth. The mother reported having a normal pregnancy but has a history of x-ray during her first trimester. The baby was born with a rare presentation of proboscis lateralis which was accompanied by multiple anomalies, including but not limited to bilateral colpocephaly, corpus callosum agenesis, complex cyanotic congenital heart disease, and hemivertebra of the T10 body. CONCLUSION: PL is an uncommon congenital condition that causes a variety of craniofacial abnormalities. Multiple additional defects affecting various organ systems should also be evaluated in a person diagnosed with PL.

Management of Subacute Thyroiditis - A Systematic Review of Current Treatment Protocols.

Purpose: This systematic review endeavors to find an effective treatment protocol for subacute thyroiditis (SAT) to minimize side effects, recurrence and long-term hypothyroidism. Materials and Methods: We analyzed available original studies on treatment protocols for SAT. A thorough literature search was performed on the following online databases PubMed, Cochrane library nd Google Scholar using appropriate keywords for choosing relevant articles. Two reviewers assessed the methodological quality of selected articles independently using a critical appraisal instrument. The results were analyzed and synthesized qualitatively using the level of evidence method. Results: The literature search retrieved a total of 460 publications after abstract screening; out of which 36 articles met the inclusion criteria. After full text screening, 23 articles were further excluded as they were focusing on aspects of SAT other than management, the remaining 15 articles were investigated for both reliability and validity. Thirteen studies provided low-quality evidence, and two randomized control trials (RCT) provided a high quality of evidence. Steroid therapy was found to be the most effective for moderate to severe SAT and provided relief from acute symptoms but was found to not be a risk factor for recurrence. Low initial doses of steroid (15 mg) were preferred over high initial dosage (30-40 mg). Furthermore, a look into the mode of steroid delivery (RCT) revealed that intrathyroidal steroid therapy can potentially become a safer and faster mode of therapy. The duration of tapering was found to be of significance as a short tapering period was linked with greater recurrence rates. Conclusion: Low initial doses of steroid along with an extended tapering period may help lower recurrence rates; also, intrathyroidal steroid injections are potentially a better alternative to oral prednisone (PSN) with regard to safety and speed of action. However, the evidence is of moderate quality and further investigation is required.

Teleradiology in India during the COVID-19 pandemic: merits, pitfalls and future perspectives.

The field of teleradiology has been of interest for almost 55 years and its potential prospects for healthcare have been constantly assessed and investigated. In view of the global preventive measures, such as social distancing and hand hygiene, the ongoing COVID-19 pandemic has further accentuated the necessity for telemedicine and teleradiology. In a country as densely populated as India wherein radiology services are often fragmented, teleradiology can prove to be a lifesaving technology and aid dampen the repercussions stemming from the highly skewed doctor to patient ratio. Although innovative, the effective adoption of teleradiology faces several obstacles in India, such as inadequate technological infrastructure, a lack of knowledge among most medical practitioners, urban-rural disparities and a lack of financing. Similar challenges continue to also be faced by several other developing countries across the globe. This article therefore aims to elaborate on the most important facets of implementation of teleradiology observed in the Indian context to help provide salient pointers for the readership of relevant jurisdictions who may be embracing comparable teleradiology challenges. Despite the hurdles, the future of teleradiology seems promising. The respective governments, policymakers and all relevant stakeholders must continue to take decisive action to ensure that this potential is fully exploited by allocation of necessary funds, strengthening of information technology and its related fields, involvement of human resources with adequate technical and administrative expertise as well as taking continued action to improve existing telemedicine and teleradiology services.

Over the counter drugs and self-medication: A worldwide paranoia and a troublesome situation in India during the COVID-19 pandemic.

Self-medication is the use of drugs to treat self-diagnosed ailments without the use of a formal prescription. Self-medication is defined by the World Health Organization as the use of medications to address self-diagnosed diseases or symptoms. Over-the-counter (OTC) pharmaceuticals are medications that can be sold without a prescription directly to the client in accordance with the laws of each nation. During the COVID-19 pandemic, an increasing tendency in the use of OTC and self-medication was seen, with the situation in India particularly deteriorating due to lax regulatory restrictions. This has resulted in a slew of problems, ranging from a lack of drugs to severe responses due to overdosage and drug-drug combinations. There is an urgent need for more tangible regulatory control over self-medication and OTC medications to safeguard the uninformed populace from harm.

HIV epidemic amidst COVID-19 pandemic in India: a conundrum for the country's healthcare system.

India has the third-largest burden of human immunodeficiency virus (HIV) infection in the world. The coronavirus disease 2019 (COVID-19) pandemic has only exposed the cracks in the Indian healthcare infrastructure concerning HIV. The prevalence of HIV in India is more among the destitute or sections of society shrouded by years of social stigma such as prostitutes, truck drivers, transsexuals and intravenous drug users. National AIDS Control Organisation and The Joint United Nations Programme on HIV/AIDS (UNAIDS) organisation have many several efforts over the years to set up counselling and testing centres all over the country and spread awareness about HIV among the masses. COVID-19 pandemic has reversed years of progress made by the same. HIV patients are biologically more susceptible to COVID-19, and the lockdown has led to the loss of jobs, economic crises, shortage of drugs and necessities such as food and housing among this vulnerable population, which can result in lowered CD4-T cell counts in the coming months and make way for dangerous opportunistic infection outbreaks in this population increasing the overall HIV burden of India. This article explores how COVID-19 has impacted India's already existing HIV epidemic and tries to put forth recommendations based on the evidence found to be better prepared in treating the HIV-positive population in India in the face of another catastrophe like the COVID-19.

Medical Student's Perspective Regarding Undergraduate Surgical Education with Special Reference to Pandemic.

The COVID-19 pandemic has disrupted teaching in medical schools across the world. Online learning has become the core method of teaching during this pandemic. The aim of this study was to investigate the impact of this mode of education among medical students in India. A survey was conducted by distributing online questionnaires to medical students across India. Data gathered from the survey was analyzed using SPSS® version 16. The overall response rate of survey was 58.4%. Practical training was most severely affected by online classes (93.32%) as compared to theory classes (60.93%). A total of 71.98% students agreed that canceling of physical medical conferences adversely affected the building up of their resumes while only 28.79% agreed that virtual conferences and meetings enhanced their learning. A total of 56.81% agreed that online exams adversely affected their performance. A total of 46.79% feels that online classes using simulated patients and simulation technology is not useful but 41.90% think that simulated teaching should be a part of the medical curriculum. A majority of the students (87.66%) had technical issues with online classes and 89.72% complained of poor concentration during online teaching due to distractions. A total of ~75% felt that the pandemic has adversely affected the availability of research opportunities and development of skills, ethics, communication, and behavior. Online education has adversely affected all aspects of learning, performance in exams, research, and the overall future plans of students. Moving forward from this pandemic, in order to maximize the benefits of both face-to-face and online teaching, we suggest medical schools resort to a hybrid pattern.

Tuberculosis amidst COVID-19 pandemic in India: unspoken challenges and the way forward.

India is home to the most significant number of tuberculosis (TB) cases around the globe. The COVID-19 crisis has deeply perturbed most of the essential TB services in India. Regulating TB is difficult in a densely populated country like India due to latent TB infection in millions of Indians, which can reactivate at any point in the future. Due to the ongoing pandemic, healthcare workers have been diverted to activities implemented for effective COVID-19 management, leaving a meager workforce to help deal with TB management. Integrating TB and COVID-19 to augment India's health outreach is the need of the hour to diminish the effect of the COVID-19 crisis on TB. Increasing overall testing capacity, active screening, implementation of strategies for easy identification of TB hotspots, and ensuring uninterrupted drug supply for treatment through heedful planning of local and regional distribution and transportation will especially help cater to the vulnerable population who are at a high risk of suffering from adverse outcomes of TB. Lessons learnt in the battle against COVID-19 can most definitely help in providing insights to fulfill the goal of eliminating TB from India.