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Background: The ability to publish is a career-critical skill but requires the acquisition of a wide and disparate skill set. The Write a Scientific Paper (WASP) course was created in Malta in 2010, an intensive, three-day event. WASP is an accredited event held in Malta, London, and Bahrain. The COVID pandemic forced WASP to go online. This study compared satisfaction with WASP online as opposed to in-person by analyzing course feedback pre- and post-pandemic. Methods: Google forms are used to collect anonymous feedback on a Likert scale for various aspects of each WASP. The period 2017 to 2022 was used to compare four courses on-site and five courses online. Feedback on: Rate lectures, handouts, WASP overall and how likely are you to recommend WASP was compared. Results: Response rates were >60% and almost all Cronbach's Alpha values were >0.7. High satisfaction scores were achieved in all four questions (>4/5). There were no significant differences except in lectures, which scored well but fared slightly worse overall online. Conclusions: Migrating online does not necessarily lead to change/s in presentation contents but transforms delivery. Our results indicate that WASP is accepted online but the slightly lower lectures score implies that WASP might be better delivered in-person than online. However, students remained happy to recommend WASP and this accords with other studies that overall, student satisfaction with online education is common. It is hoped that as the pandemic recedes, webinars complement and not continue to totally replace traditional in-person meetings. [ABSTRACT FROM AUTHOR]

During the second wave of COVID-19 pandemic, there is a sudden increase in number of cases mucormycosis infection in India. This communication by the Tropical Neurology subsection expert group of the Indian Academy of Neurology (IAN) describes the clinical and diagnostic features, treatment of the disease and gives recommendations about the ways forward. [ABSTRACT FROM AUTHOR]

The entire world seems to have responded to COVID-19 pandemic in a knee-jerk manner with a short mindset without building on the existing strengths of public health infrastructure. National governments cannot be blamed for this as we are dealing with a crisis that comes once in a lifetime. Realising this, the Organized Medicine Academic Guild (OMAG) an association of major health associations in this country has suggested measures for long-term solutions to COVID-19-like pandemics in the form of a policy paper by OMAG. [ABSTRACT FROM AUTHOR]

What started as a cluster of patients with a mysterious respiratory illness in Wuhan, China, in December 2019, was later determined to be coronavirus disease 2019 (COVID-19). The pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel Betacoronavirus, was subsequently isolated as the causative agent. SARS-CoV-2 is transmitted by respiratory droplets and fomites and presents clinically with fever, fatigue, myalgias, conjunctivitis, anosmia, dysgeusia, sore throat, nasal congestion, cough, dyspnea, nausea, vomiting, and/or diarrhea. In most critical cases, symptoms can escalate into acute respiratory distress syndrome accompanied by a runaway inflammatory cytokine response and multiorgan failure. As of this article's publication date, COVID-19 has spread to approximately 200 countries and territories, with over 4.3 million infections and more than 290,000 deaths as it has escalated into a global pandemic. Public health concerns mount as the situation evolves with an increasing number of infection hotspots around the globe. New information about the virus is emerging just as rapidly. This has led to the prompt development of clinical patient risk stratification tools to aid in determining the need for testing, isolation, monitoring, ventilator support, and disposition. COVID-19 spread is rapid, including imported cases in travelers, cases among close contacts of known infected individuals, and community-acquired cases without a readily identifiable source of infection. Critical shortages of personal protective equipment and ventilators are compounding the stress on overburdened healthcare systems. The continued challenges of social distancing, containment, isolation, and surge capacity in already stressed hospitals, clinics, and emergency departments have led to a swell in technologically-assisted care delivery strategies, such as telemedicine and web-based triage. As the race to develop an effective vaccine intensifies, several clinical trials of antivirals and immune modulators are underway, though no reliable COVID-19-specific therapeutics (inclusive of some potentially effective single and multi-drug regimens) have been identified as of yet. With many nations and regions declaring a state of emergency, unprecedented quarantine, social distancing, and border closing efforts are underway. Implementation of social and physical isolation measures has caused sudden and profound economic hardship, with marked decreases in global trade and local small business activity alike, and full ramifications likely yet to be felt. Current state-of-science, mitigation strategies, possible therapies, ethical considerations for healthcare workers and policymakers, as well as lessons learned for this evolving global threat and the eventual return to a "new normal" are discussed in this article. [ABSTRACT FROM AUTHOR]

Background: The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID-19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged =18 during the global COVID-19 pandemic. Methods: This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies. Results: Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants. Conclusions: The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders. [ABSTRACT FROM AUTHOR]

The world is passing through a global pandemic of COVID 19. The number of positive cases has crossed over twenty thousand as of April 2020. Like everyone else, it is indeed a very challenging situation for family physicians and primary care providers as most of the guidelines presently have focused on screening, quarantine, isolation, and hospital-based management. Limited information or clarity is available on running small private clinics during pandemic times. The key concern is professional obligation versus risks of community transmission. Family physicians see routine flu-like illnesses throughout the year with seasonal variation within their practices. This document is intended to develop consensus and standard practices for the family physicians and other primary care providers during the pandemic, ensuring optimal continuity of care. This document was reviewed by the national executive of the Academy of Family Physicians of India and approved for dissemination among members. However, due to the dynamic status of the pandemic, all practitioners are advised to closely follow the instructions, guidelines, and advisories of national, state and local health authorities as well. [ABSTRACT FROM AUTHOR]

Background: This paper reviews some of the literature on the safety and efficacy of different COVID-19 vaccines, the attitudes, and perceptions of people towards the vaccines, and the factor underlying such perceptions and behavior. Methods: Two major databases (PubMed and Epistemonikos) were checked using search expansion mechanisms and several search strings. After the title, abstract, and full-text analysis, 19 studies were selected for review. Results: The seven different vaccines studied all have supporting data on their efficacy in the reduction of COVID-19 cases, prevention of hospitalization after infection, and reduction in the mortality rate of COVID-19 patients. There was high hesitancy about the COVID-19 vaccine and the perceived efficacy and safety of the vaccines are less than recorded in clinical data. Distrust of the vaccines, their manufacturers and different institutions and governments, personal beliefs and feelings, age, gender, education, and socioeconomic status were identified factors affecting behaviors towards the COVID-19 vaccines. Conclusion: Several articles support the efficacy of COVID-19 vaccines, but general awareness and conception about them vary, including hesitancy, distrust, and some acceptance. Many factors affected the perception and attitude of people toward these vaccines. More clinical data on the efficacy and safety of COVID-19 vaccines should be generated to help boost confidence among users. Résumé Contexte: Cet article passe en revue une partie de la littérature sur l'innocuité et l'efficacité de différents vaccins COVID-19, les attitudes et les perceptions des personnes à l'égard des vaccins, ainsi que les facteurs sous-jacents et le facteur sous-jacent à ces perceptions et comportements. Méthode: Deux bases de données majeures (PubMed et Epistemonikos) ont été vérifiées à l'aide de mécanismes d'expansion de la recherche et de plusieurs chaînes de recherche. Après l'analyse du titre, du résumé et du texte intégral, 19 études ont été sélectionnées pour examen. Résultat: Les 7 vaccins différents étudiés ont tous des données à l'appui sur leur efficacité dans la réduction des cas de COVID-19, la prévention des hospitalisations après infection et la réduction du taux de mortalité des patients COVID-19. Il y avait une grande hésitation à propos du vaccin COVID-19 et l'efficacité et l'innocuité perçues des vaccins sont inférieures à celles enregistrées dans les données cliniques. La méfiance à l'égard des vaccins, de leurs fabricants et des différentes institutions et gouvernements, les croyances et sentiments personnels, l'âge, le sexe, l'éducation et le statut socio-économique ont été identifiés comme des facteurs affectant les comportements à l'égard des vaccins COVID-19. Conclusion: Plusieurs articles soutiennent l'efficacité des vaccins COVID-19, mais la sensibilisation et la conception générales à leur sujet varient, y compris l'hésitation, la méfiance et une certaine acceptation. De nombreux facteurs ont affecté la perception et l'attitude des gens envers ces vaccins. Plus de données cliniques sur l'efficacité et l'innocuité des vaccins COVID-19 devraient être générées pour aider à renforcer la confiance des utilisateurs. Mots-clés: Attitude, COVID-19, vaccins COVID-19, efficacité, innocuité [ABSTRACT FROM AUTHOR]

Introduction: Rural doctors typically work in low resource settings and with limited professional support. They are sometimes pushed to the limits of their usual scope of practice to provide the medical care needed by their community. In a previous phenomenological study, we described the concept of clinical courage as underpinning rural doctors' work in this context. In this paper, we draw on rural doctors' experiences during the unfolding COVID pandemic to re examine our understanding of the attributes of clinical courage. Methods: Semi structured interviews were conducted with rural doctors from 11 countries who had experience preparing for or managing patients with COVID 19. Interviews were transcribed verbatim and coded using NVivo. A deductive thematic analysis was undertaken to identify common ideas and responses related to the features of clinical courage. Results: Thirteen interviews from rural doctors during the unfolding COVID 19 pandemic affirmed and enriched our understanding of the attributes of clinical courage, particularly the leadership role rural doctors can have within their communities. Conclusion: This study extended our understanding that rural doctors' experience of clinical courage is consistent amongst participants in many parts of the world, including developing countries. [ABSTRACT FROM AUTHOR]

Public health programmes are interlinked and intertwined with communication, advocacy and social mobilisation for their success. The unprecedented situation created by COVID-19 brought a medical emergency all over the world, the like of which was probably not seen after the Spanish Flu outbreak, a century ago. First there seemed no solution in sight when tens of thousands of people lost their lives to the coronavirus in various countries, but when the vaccine arrived, there were, in general, doubts about its efficacy and safety. Indian scenario was not any different. When the government launched the vaccine in a campaign mode in January 2021, it was also battling with misperceptions and vaccine hesitancy. Prime Minister Narendra Modi took it upon himself to address the issue through his various addresses to the nation and his signature programme Mann ki Baat (MKB) on the radio. This review paper examines the empirical research on MKB coverage of the COVID-19 pandemic, the media multiplier impact of the MKB, people's voices through their engagement with various social media platforms, and what is the impact on vaccine uptake. [ABSTRACT FROM AUTHOR]

Since the pandemic of the coronavirus disease 2019 (COVID-19) infection, many people have been affected in different ways. The majority of infected people experience mild to moderate symptoms and recover without the need for hospitalization. However, in some affected people, it may lead to catastrophic disease. The severity of COVID-19 infection is widely influenced by co-morbidities, immune system functions, and extra-pulmonary organ injuries. Since the emergence of COVID-19, multi-organ involvement has been documented. In order to implement preventative and protective measures, full attention to potential organ injuries is required. Most existing articles and review papers are focused on a specific organ system, and their numbers are growing. In this review paper, attempts were made to collect review papers and articles published on seven organ system involvements in COVID-19 infection published till 15 July and highlight conclusions and managements of all affected organs. We tried to add to the medical knowledge on COVID-19, pointing out its multi-organ system impact. Finally, we tried to facilitate access to organized information and optimum conclusion by representing review tables for each organ system. Besides, this review article can clarify and magnify the empty research space easily for future investigations. [ABSTRACT FROM AUTHOR]

Background: This paper reviews some of the literature on the safety and efficacy of different COVID-19 vaccines, the attitudes, and perceptions of people towards the vaccines, and the factor underlying such perceptions and behavior. Methods: Two major databases (PubMed and Epistemonikos) were checked using search expansion mechanisms and several search strings. After the title, abstract, and full-text analysis, 19 studies were selected for review. Results: The seven different vaccines studied all have supporting data on their efficacy in the reduction of COVID-19 cases, prevention of hospitalization after infection, and reduction in the mortality rate of COVID-19 patients. There was high hesitancy about the COVID-19 vaccine and the perceived efficacy and safety of the vaccines are less than recorded in clinical data. Distrust of the vaccines, their manufacturers and different institutions and governments, personal beliefs and feelings, age, gender, education, and socioeconomic status were identified factors affecting behaviors towards the COVID-19 vaccines. Conclusion: Several articles support the efficacy of COVID-19 vaccines, but general awareness and conception about them vary, including hesitancy, distrust, and some acceptance. Many factors affected the perception and attitude of people toward these vaccines. More clinical data on the efficacy and safety of COVID-19 vaccines should be generated to help boost confidence among users. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is a global public health problem that is crucially important to be diagnosed in the early stages. This study aimed to investigate the use of artificial intelligence (AI) to process X-ray-oriented images to diagnose COVID-19 disease. Methods: A systematic search was conducted in Medline (through PubMed), Scopus, ISI Web of Science, Cochrane Library, and IEEE Xplore Digital Library to identify relevant studies published until 21 September 2020. Results: We identified 208 papers after duplicate removal and filtered them into 60 citations based on inclusion and exclusion criteria. Direct results sufficiently indicated a noticeable increase in the number of published papers in July-2020. The most widely used datasets were, respectively, GitHub repository, hospital-oriented datasets, and Kaggle repository. The Keras library, Tensorflow, and Python had been also widely employed in articles. X-ray images were applied more in the selected articles. The most considerable value of accuracy, sensitivity, specificity, and Area under the ROC Curve was reported for ResNet18 in reviewed techniques; all the mentioned indicators for this mentioned network were equal to one (100%). Conclusion: This review revealed that the application of AI can accelerate the process of diagnosing COVID-19, and these methods are effective for the identification of COVID-19 cases exploiting Chest X-ray images. [ABSTRACT FROM AUTHOR]

As the number of COVID-19 cases is rapidly increasing internationally, management, recommendations and guidelines of COVID-19 are rapidly evolving and changing. Formulating local clinical management policies among institutions adopting these recommendations is vital to staff as well as the patients' safety. Also, training multidisciplinary teams on these policies is an important, yet challenging, part of the process. The purpose of this paper is to present the process that has been followed to formulate COVID-19-specific response anesthesiology and operating room (OR) policies at King Abdulaziz University Hospital, by applying David A. Kolb's experiential learning theory during simulation-based training. This project had a total of six simulation-based sessions (four simulation scenarios and two clinical drills) designed to test the efficacy and efficiency of the then current practice in the hospital, facing the COVID-19 pandemic. Qualitative data analysis was completed using qualitative thematic data analysis. To apply experiential Kolb's theory, session's checklist (two raters per session), outcomes, and participants' feedback to develop and improve clinical management pathway in the department were used. The 12 reports and participants' feedback highlighted three main areas for improvement. These are Personal Protective Equipment implementation, team dynamics, and airway management. This process then guided in creating a new understanding of the multidisciplinary clinical management pathway, in addition to enhancing viability of the current practice and clinical management guidelines and protocols, which were already established and adapted at the hospital before the COVID-19 pandemic crisis. The alignment with Kolb's experiential theory helped formulate anesthesiology and OR effective clinical management pathway has been demonstrated. Applying experiential learning theory by a clinical institute using interprofessional, multidisciplinary simulations and clinical drills can guide the process of formulating clinical management pathways during pandemic outbreaks. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic restricted movement, closed businesses, and economic activities which disproportionately affected people globally. This pandemic has resurfaced the existing cracks in the societal set-up and has pushed the vulnerable and marginalized communities like migrant workers, people with disabilities, geriatric population, and commercial sex workers (CSWs) to an edge for their existence. Materials and Methods: Due to the paucity of peer-reviewed research publications on CSWs, formative research was conducted to identify the determinants and attributes of the challenges faced by CSWs during COVID-19 situation in India. Media scanning approach was used to collate literature from newspaper and magazine reporting, and peer-reviewed articles were referred from research-based search engines. Results: In total, 31 articles were included for content analysis and four domains of issues i.e., economic, social, psychological and health related challenged faced by them were identified which are supported with the verbatims of the community members as reported in the data sources considered for this study. It was identified that the CSWs adopted several protective measures and coping strategies to deal with the pandemic situation. Conclusion: This research highlighted that there is a need for further exploration of issues among CSWs by conducting studies among the communities. Furthermore, this paper provides a scope for future implementation research by identifying the key priorities and determinants of the challenges among the personal livelihood of CSWs in the country. [ABSTRACT FROM AUTHOR]

Background: The second wave of COVID-19 was disastrous and claimed many lives in India and abroad. The most challenging task was to provide the required treatment as per the patient's condition, within a limited span of time. The lack of prognostic predictors at the time of admission led to failure in prioritizing the patient's need for intensive care. Aim: This study was conducted to find out the clinical and laboratory parameters at the time of admission to ICU as predictors of outcomes in COVID-19 patients, which can help in judicious utilization of the available resources for better patient care. Subjects and Methods: Study comprises of 161 ICU admitted patients. Study of clinical traits, comorbidities, test results, and demographic variables were carried out among survivors and non-survivor. Result: Maximum death were patients of age group 21–30 years and male gender. Mortality in hypertensives, diabetics, and patients with sepsis were found to be statistically significant. Patients who developed ARDS and pneumonia or needed ventilation died invariably. High levels of laboratory parameters like IL-6, LDH, PT, INR, aPTT, ferritin, WBC count, and D-dimer were significantly associated with poor outcomes and at a particular cutoff had optimum sensitivity and specificity to predict mortality in ICU admitted COVID-19 patients. At the same time, low lymphocyte count and PaO2/FiO2 ratio was significantly associated with bad prognosis (P < 0.05). Conclusion: This paper will help in prioritizing patients in ICU who need special attention especially at the time of meager supply of resources. [ABSTRACT FROM AUTHOR]

Background: Repeated contact with patients with COVID-19 and working in quarantine conditions has made health workers vulnerable to psychological distress during the COVID-19 pandemic. The goal of the present systematic review and meta-analysis was to examine the prevalence of the various psychological distresses among health workers during the COVID-19 pandemic. Methods: PubMed, Scopus, Web of Science, EMBASE, and Cochrane databases were searched for access to papers examining psychological distress among healthcare workers during the COVID-19 pandemic. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Heterogeneity among the studies was examined using the Cochran's Q test; because heterogeneity was significant, the random effects model was used to examine the prevalence of psychological distress. Results: Overall, 12 studies with a total sample size of 5265 were eligible and included in the analysis. Prevalence rates of depression, anxiety, and PTSD were 20% (95% CI: 14-27), 23% (95% CI: 18-27), and 8% (95% CI: 6-9), respectively. The highest prevalence rates of depression and anxiety were related to the SDS and the GAD-7, respectively, and the lowest prevalence rates of the two aforementioned variables were related to the DASS-21. Conclusions: The high prevalence of psychological distress among healthcare workers during the COVID-19 epidemic can have negative effects on their health and the quality of services provided. Therefore, training coping strategies for psychological distress in this pandemic seems necessary. [ABSTRACT FROM AUTHOR]

Floods are the most common natural disasters in the world. Currently Pakistan is in an acute emergency situation due to the recent flood that occurred as a result of the monsoon rains in July–August 2022. Unfortunately, the country was already under an economic crisis and was just recovering from the COVID pandemic when this devastating calamity struck. Almost one-third of the country's land was affected, with millions of houses damaged and property lost. As the victims are displaced and local health units are flooded, their medical needs are being met through medical flood relief camps arranged by public and private sector welfare organizations. Due to a lack of disaster preparedness and policies, most of the healthcare workers are untrained to manage medical flood relief camps and are hence learning from experience rather than following any standardized policy guidelines. We did not find any guidelines for organization and management of a flood relief camp in previous literature. As natural disasters continue to cause mass destruction every few years, there is a need to devise policies and procedures for disaster preparedness and hazard reduction. This paper is thus an effort to provide the best possible delivery of acute health services in a developing country during and after a flood in the transit phase, while the government and other non-governmental organizations (NGOs) help communities rebuild their health system. [ABSTRACT FROM AUTHOR]

The world is gradually getting out of the grip of COVID-19 pandemic, although there are still high number of cases in some countries. Most of the initial attempts to predict and project the course of pandemic were hypothetical or based on historical data, as no current and specific data were available in the early days of pandemic. Most governments followed the policy of "flattening the curve" in order to avoid overwhelming their health systems. Most of the world also followed the policy of forced lockdowns to stop the spread of the virus. However, these policies produced did not produce consistent results across the globe. To investigate the impact of various policy measures on the reported outcomes, this research analyzed the actual COVID-19 data up till May 29, 2021, and the associated outcomes. Using global COVID-19 death rate as a base, the death rates of various countries were analyzed to gauge the efficacy of lockdown measures through probabilistic estimates and relative lack of uncertainty. Brier score was calculated to find the accuracy of probabilistic estimates. The data show high divergence in infection, death, and growth rates of the virus in different countries. The research also includes comparing the effects of virus in year 2020 and 2021, and the effect of vaccination. It can be seen that the collective world response was not commensurate with the actual risks involved. The paper concludes by emphasizing the need for specific evidence-based governance and disaster response management to face similar challenges in the future. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) infection in India demonstrated three peaks in India, with differences in presentation and outcome in all the three waves. The aim of the paper was to assess differences in the epidemiological, clinical features and outcomes of patients with COVID-19 presenting at a tertiary care hospital in the three waves at Jaipur, India. Methods: This was a retrospective study conducted at a tertiary care hospital at Jaipur, India. Demographic, clinical features and outcomes were compared of confirmed COVID-19 cases admitted during the first wave (16-7-2020 to 31-1-2021), second wave (16-3-2021 to 6-5-2021) and third wave (1-1-22 to 20-2-22) of the outbreak. Results: There were 1006 cases, 639 cases and 125 cases admitted during the three waves, respectively. The cases presenting in the second wave were significantly younger, with significantly higher prevalence of symptoms such as fever, cough, sore throat, nausea, vomiting, headache, muscle ache, loss of appetite and fatigue (P < 0.05). A significantly higher proportion of patients received Remdesivir in the second wave (P < 0.001). However, in the second wave, the use of low molecular weight heparin, plasma therapy, non-invasive and invasive ventilator were higher (P < 0.001). Co-morbid conditions were significantly higher in the admitted patients during the third wave (P < 0.05). Radiological scores were similar in second and third wave, significantly higher than the first wave. Lymphopenia and rise of inflammatory markers including C-reactive protein and interleukin-6 were more evident in the second wave (P < 0.001). The mean mortality, hospital stay and air-leak complications were also significantly higher in the second wave (P < 0.001). Conclusions: The second wave was more vicious in terms of symptoms, inflammatory markers, radiology, complications, requirement of ventilation and mortality. Mutation in the virus, lack of immunity and vaccination at the time point of second wave could have been the possible causes. The ferocity of the second wave has important implications for the government to formulate task forces for effective management of such pandemics. [ABSTRACT FROM AUTHOR]

Introduction: In December 2019, a cluster of atypical cases of pneumonia was reported in Wuhan, China, which was later designated as Coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO) on Feb 11, 2020. We all are facing a global pandemic, and it is very important to be clear that there is no correct roadmap to navigate this difficult situation. It is imperative to state that this global pandemic impacted the spine care services of our institute. In the present study, we have assessed the spine surgeries performed by orthopedic surgeons in terms of volume and etiologies during the COVID-19 pandemic and compared the data with a pre-COVID period. Materials and Methods: We retrospectively collected data from all patients who underwent spinal surgeries at our institute under the department of orthopedics from August 20, 2019 to August 20, 2020 (a total of 12 months duration). The data was then divided into two groups--pre-COVID period (August 20, 2019-February 19, 2020-6 months) and during the COVID pandemic (February 20, 2020-August 20, 2021-6 months). Results: A total of 140 patients underwent surgery at our institute from August 20, 2019 to August 20, 2020. Of these, 91 patients underwent surgery during the pre-COVID period, and 49 patients underwent surgery during the COVID pandemic. In this devastating phase of the pandemic, our department's total number of surgeries significantly declined to 46.15%. The routine surgeries performed during the pandemic phase show a steep fall from 59.34% in the pre-COVID period to 10.20%. Conclusion: This paper is meant to focus attention on the exorbitant reduction in the operative workflow of the spine patients during the COVID-19 pandemic at a tertiary healthcare institute. It is the need of the hour that orthopedic surgeons maintain equilibrium while providing the best possible treatment to their patients and limiting the spread of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has proven to be the worst pandemic in the history of mankind. While the pandemic still continues to perplex scientists globally, attempts are being made to quantify the mortality caused by the pandemic. Official COVID-19 figures in India grossly understate the true scale of the pandemic in the country. Fatality rates help us understand the severity of a disease, identify at risk populations, and evaluate quality of healthcare. Official COVID-19 mortality figures in India grossly understate the true scale of the pandemic in the country. A COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g., trauma) and excess mortality is defined as the difference in the total number of deaths in a crisis compared to those expected under normal conditions. Materials and Methods: We did a systematic review of multiple papers on PubMed, Medline, Embase, MedRxiV pre print on excess mortality. Differentiation between model based estimated excess mortality and data based excess mortality was studied. Results: All the studies showed that the excess mortality was to the tune of almost three times the official figures. The model based excess mortality assumptions showed higher deaths as compared to the data based one. However, there were a lot of discrepancies in the data provided by various states along with variations observed between the two waves as well. Health survey data suggested higher mortality rate as compared to data compiled from the civil registration system. Additionally, in the second wave, a small but a significant number of deaths occurred due to non availability of oxygen and beds in the hospitals. Conclusions: Official COVID-19 deaths have entirely failed to capture the scale of pandemic excess mortality in India. If most excess deaths were, indeed, from COVID-19 then under ascertainment of COVID-19 deaths has been high, with around 8-10 excess deaths for every recorded COVID-19 death. [ABSTRACT FROM AUTHOR]

Background: With a new mutation, coronavirus has now become an important pandemic that gripped the entire world. Coronavirus infection often begins in the nasopharynx and destroys the olfactory epithelium. Despite many studies, little progress has been made in the treatment of coronavirus. This study aimed to further investigate the pathogenicity of coronavirus to reduce its infection by examining the virus function in the body and its stages of infection. Material and Methods: With the aim of investigating the coronavirus and its effect on the human respiratory system from 1992 to 2020, this study examined the coronavirus and its different aspects and tried to answer whether there is an association between pneumonia and immune cells. This study was conducted in April 2020 and to obtain the related papers on the characteristics of the virus, Nature, ISC Pubmed, Medline WHO, NCBI, and PsycINFO databases were used. Out of 284 papers, 53 were used in this study. Result: Studies have shown that avoiding infected areas and strengthening the immune system inhibit the virus to bind the mucosal layers. Given the important role of acquired immunity and lymphocytes against coronavirus, it is necessary to pay attention to boost the immune system in adults and the elderly. Antioxidants help reduce the oxidative stress and inflammation in the immune system thus help it regenerate better. The results showed that children are susceptible to the virus though have lower mortality and clinical manifestations than adults. Conclusion: The vaccine should receive further attention and in the long run, antiviral drugs and broad-spectrum vaccines are produced for infectious diseases. [ABSTRACT FROM AUTHOR]

Rapidly growing rate of infection among health workers during the current COVID-19 pandemic, is posing a serious challenge to global health systems. Lately, India is also witnessing an intensifying COVID-19 disease burden and its impact on health workers. This paper aims to discuss the challenges to health worker protection in India and the possible ways forward. Given the inadequate and unequally distributed healthcare workforce, it is highly essential for the country to strategize prompt measures for ensuring occupational health and safety of its health workers. Information for this paper were gathered by searching PubMed and Google Scholar databases using "COVID-19", "Infection Control", "Health worker", "India" as search keywords in different combinations. In addition, websites of Government of India, relevant UN agencies and leading news agencies were also searched manually for related reports and publications. India must take timely measures in rapid manufacturing and procurement of essential personal protective equipment (PPE) to ensure adequate stockpiling to meet the rising demands. Comprehensive and repeated training with sharply focussed content including usage of PPE kits as well as active surveillance of adherence to recommended protocol are critical in protecting health workers especially the primary care physicians and frontline health staff from the deadly COVID-19 infection. The provision of psychological and financial support for health workers and their families is absolutely critical in building trust and dedicated work efforts by the health workforce for a continuous fight against the deadly disease. [ABSTRACT FROM AUTHOR]

According to the World Health Organization, over 41 million cases of COVID-19 and 1 million deaths have been reported globally. More than 7 million cases of coronavirus have been reported in India alone. The growing number of cases of coronavirus worldwide poses numerous challenges to the country's current healthcare delivery system, especially in developing nations such as India. In such a situation, the task of maintaining continuity in the provision of comprehensive primary healthcare services in the community becomes a big challenge. This article discusses how family physicians can help to augment the healthcare system at the time of pandemic by providing easily accessible, holistic healthcare and by use of telemedicine. It also talks about the need to mainstream family medicine into the undergraduate and postgraduate medical curriculum and establish a robust network of family physicians trained in outbreak response and disease preparedness. For this study we looked for all papers with the terms 'Family physician', 'COVID-19', 'pandemic', and 'Primary health care'. Databases searched include PubMed, Google Scholar and DOAJ, using key words – family physician, family medicine, primary healthcare, COVID-19, and pandemic in different combinations. [ABSTRACT FROM AUTHOR]

Over the years, healthcare system in India has been largely centralized, expensive and impersonal. In a country where expenditure on healthcare is low, most healthcare expenditure is out‑of‑pocket and where most of the population continue to live in rural areas or in urban fringes, such a care is inaccessible, unresponsive and unaffordable. COVID pandemic exposed these realities further. Based on experiences of directly managing health services during COVID‑19 pandemic in different settings and across different levels, authors of this paper argue for a decentralized, distributed and responsive health systems for India, that is likely to be more effective and sustainable in normal times, and in times of crisis. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the trend of COVID-19-related publications in the Indian Journal of Ophthalmology (IJO) and assess the specialty wise correlation, distribution, and citation trend during the COVID-19 pandemic.Methods: A retrospective analysis of all COVID-19-related articles was performed from April 2020 to May 2021. The bibliographic records were obtained from the website of IJO, Editor IJO email, and PubMed. The data was then exported as XML into Microsoft access for scientometric analysis. The articles were segregated as Original, Review, Case Report/Series, Letter to the Editor/Commentary, Guest Editorial, PointCounterpoint, Consensus Criteria, Ophthalmic Images, Photo Essay, Surgical Techniques, and All India Ophthalmic Society Meeting Papers. The data was comprehensively analyzed for specialty-wise correlations, distribution, citation trend, and reasons for the same.Results: A total of 231 COVID-19-related articles were published during the study period. The maximum articles were [82 (35.49%)] letters to the editor, followed by [51 (22.08%)] original articles, [30 (12.99%)] commentaries, and [20 (8.66%)] editorials. The least were perspectives, consensus, images, and photo assay with [1 (0.43%)] each. The maximum publications were in July [44 (19.05%)] and least in April [1 (0.43%)]. Considering specialty, the maximum articles were related to general ophthalmology [124 (53.68%)] and least were in refractive surgery and community ophthalmology with [1 (0.43%)] each. The maximum citations were for original articles [352 (34.65%)], which was 2.3 times higher than review articles and letters to editor [150 (14.76%)]. General ophthalmology had 740 (72.83%) citations, which were nearly five times that of cornea [140 (13.78%)].Conclusion: The IJO showed a trough and crest pattern of COVID-19 publications month wise. Letter to editor and general ophthalmology COVID-19 articles had maximum publications with maximum citations for general ophthalmology owing to practice patterns and COVID-19 challenges. [ABSTRACT FROM AUTHOR]

Despite the evolving science on Covid-19 pointing to the contrary, the concept of Herd immunity continues to influence decision making in this pandemic. This paper attempts to evolve an understanding of the concept of herd immunity and its relevance in context of pandemics in general and Covid-19 in particular. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has challenged and overwhelmed most healthcare institutions and healthcare workers, across the world. Despite being unprepared for this pandemic, frontline workers have worked relentlessly to provide the much-needed care to these patients. Doctors from different branches of medicine, including dermatologists, came forward and played a substantial role in mitigating the impact of this pandemic on the general population. Sadly, in the process, these healthcare workers faced many personal, social, psychological, economic, and health-related issues. The psychological burden and health-related issues received due attention in the main-stream news as well as scientific research papers. With most frontline workers isolated from their families, social media became the new platform to reduce the sense of isolation and share their anxiety, insomnia, and fatigue. This article is aimed at highlighting various challenges faced by healthcare workers during the ongoing COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of the study was to assess the perceived utility and the impact of web-based teaching programs being conducted following the COVID-19 pandemic. METHODS: An online survey was sent to trainee ophthalmologists across India through various social media platforms. The responses were tabulated and analyzed. RESULTS: A total of 768 valid responses were recorded. Majority of respondents (52.2%) felt that the ideal duration for webinars was 1 hour or less. Factors that helped trainees in choosing a webinar were the topic (95.1%), the timing (53.6%), and the speaker list (42.4%). Residents indicated a preference for webinars to attend aimed at postgraduate residency training, more specifically clinical problem-solving. Further questions were answered using a 1-10 Likert scale (1: least useful and 10: extremely useful). The median score when asked for overall usefulness of the webinars in general was 8 (interquartile range/IQR: 2). The median response when asked about utility of webinars in enhancing theoretical knowledge was 8 (IQR: 2) and the median for utility of webinar-based teaching programs in enhancing practical knowledge/surgical learning was also 8 (IQR: 2). The median score when asked about the utility of the webinar programs in acquiring skills for writing research papers/thesis was 7 (IQR: 3). Connectivity issues, audio/voice issues, and the long duration of webinars were some of the problems faced while attending webinars. CONCLUSIONS: Ophthalmology trainees in India found online teaching programs and webinars to be useful in enhancing their theoretical knowledge and practical skills/surgical learning. Administrators and educational institutes should tailor online teaching programs as per the needs and preferences of the residents. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the trend of COVID-19-related and non-COVID-19-related articles published in the Indian Journal of Ophthalmology (IJO) during the COVID-19 pandemic.Methods: A retrospective analysis of all COVID-19 and non-COVID-19-related articles published in all the issues of IJO from January 2020 to March 2021 was performed. The data were obtained from the official website of IJO, Editor IJO monthly email, and PubMed. The monthly data were analyzed and a comparative analysis was done. The articles were segregated as Original, Review, Case Report/Series, Letter to the Editor/Commentary, Guest Editorial, Research methodology, Point-Counterpoint, Consensus Criteria, Ophthalmic Images, Photo Essay, Surgical Techniques, and AIOS Meeting Papers.Results: Out of 1343 articles published in IJO during the pandemic, 182 (13.55%) were COVID-19-related and 1161 (86.45%) were non-COVID-19-related articles. Among COVID-19 articles (182), majority were letter to the editors 66 (36.26%), followed by original articles 39 (21.42%), commentaries 24 (13.18%), editorials 18 (9.89%), and preferred practices 13 (7.14%). The least were case reports five (2.74%), current ophthalmology and innovation three (1.64%) each, and one (0.54%) each of consensus criteria, images, and photo assays. In the non-COVID-19-related articles (1161), maximum were original articles 276 (23.77%), followed by case reports 179 (15.41%), photo assays 157 (13.52%), and commentaries 141 (12.14%). The least were three (0.25%) consensus criteria and two (0.17%) each of current ophthalmology and innovations. The lockdown issue with 223 articles, postlockdown phase 1 had 267, postlockdown phase 2 had 321, and postlockdown phase 3 with 316 (1127 articles) articles in IJO showed a rising trend in a number of published articles compared with the prelockdown issues (216 articles).Conclusion: The quality and quantity of articles published in IJO increased and improved significantly. The results were seen with progressive improvement in citations and impact factors of the journal. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic situation has forced a shift in medical education from physical classroom to virtual online teaching. However, students and teachers perceive this differently. It is important to study these perceptions to improve the teaching–learning process, and thus to validate the role of online learning in the country. Objective: To document the process of a pilot for a questionnaire-based study regarding perception of undergraduate medical students towards on-going online classes. Methods: Medical Education Department of a teaching hospital developed a new questionnaire with the primary objective of studying the satisfaction and usefulness of the online classes (e-Learning). Content validity was done. For the pilot work, 10% of the total student strength was targeted. Random purposive sampling from each phase of the undergraduate course was done to choose the participants. The questionnaire was administered via Google Classroom. It was an external, undeclared type of pilot. All the responses were documented and analysed for both changes in the questions as well as for statistical sample size derivation for the main study. Results: Responses from 30 students were analysed for the pilot study. Based on the proportion of the level of satisfaction (23.3%) and usefulness (23.3%) of the on-going online classes observed, and with 20% relative precision and 95% confidence, the minimum sample size for the main study was calculated. The responses revealed the need for minor changes in the questionnaire tool for overall feasibility and achievement of the objectives of the main study. Conclusions: A pilot study is a necessary component for a research project, especially when it involves the use of a new tool. This paper shows the relevance of the same. The authors intend to convey the importance of documenting the processes of conduct of a pilot study, the issues involved therein, and the steps taken to resolve the same. [ABSTRACT FROM AUTHOR]

COVID-19 which emerged in Wuhan, China has rapidly spread all over the globe and the World Health Organisation has declared it a pandemic. COVID-19 disease severity shows variation depending on demographic characteristics like age, history of chronic illnesses such as cardio-vascular/renal/respiratory disease; pregnancy; immune-suppression; angiotensin converting enzyme inhibitor medication use; NSAID use etc but the pattern of disease spread is uniform – human to human through contact, droplets and fomites. Up to 3.5% of health care workers treating COVID-19 contact an infection themselves with 14.8% of these infections severe and 0.3% fatal. The situation has spread panic even among health care professionals and the cry for safe patient care practices are resonated world-wide. Surgeons, anesthesiologists and intensivists who very frequently perform endotracheal intubation, tracheostomy, non-invasive ventilation and manual ventilation before intubation are at a higher odds ratio of 6.6, 4.2, 3.1 and 2.8 respectively of contacting an infection themselves. Elective surgery is almost always deferred in fever/infection scenarios. A surgeon and an anesthesiologist can anytime encounter a situation where in a COVID-19 patient requires an emergency surgery. COVID-19 cases requiring surgery predispose anesthesiologists and surgeons to cross-infection threats. This paper discusses, the COVID-19 precautionary outlines which has to be followed in the operating room; personal protective strategies available at present; methods to raise psychological preparedness of medical professionals during a pandemic; conduct of anesthesia in COVID-19 cases/suspect cases; methods of decontamination after conducting a surgery for COVID-19 case in the operating room; and post-exposure prophylaxis for medical professionals. [ABSTRACT FROM AUTHOR]

Introduction: Countries globally are evaluating the concept of herd immunity and its critical role in the control of pandemic. The current paper attempts to conduct a critical interpretative synthesis (CIS) on the role of herd immunity in current COVID‑19 pandemic. Methods: CIS is tool for developing theoretical framework using interpretation drawn from relevant empirical and non‑empirical sources. This review is done by formulating review question for literature search. Purposive sampling of literature was done followed by reciprocal translational analysis of extracted data. Results: Herd immunity is indirect protection from a contagious infectious disease when a population is immune either through vaccination or natural immunity developed through previous infection. The reproduction number for COVID‑19 in India was found to be 2.56 and herd immunity threshold as 61%. Discussion: Exposing 71% young population in India to the SARS‑CoV‑2 infection can achieve herd immunity but with high morbidity as well as mortality. Vaccine are under process. Feco‑oral transmission and reinfection of COVID 19 are major factors to develop or break the circle of herd immunity in community. “Immunity passport” can give false sense of security. Surveillance and seroprevalence studies assess immunity status, gradual exposure of infection to younger population and collaborative partnerships on organizations are few strategies to acquire herd immunity. Conclusion: Herd immunity is a measure for prevention and control of COVID‑19 pandemic against the backdrop of mortality and morbidity. Vaccine can be boon but if herd immunity is to be acquired by natural infection then preparedness is necessary. [ABSTRACT FROM AUTHOR]

The COVID19 pandemic in India is causing significant morbidity and disruptions of healthcare delivery. The rapidly escalating contagion is straining our public health system, which is already under pressure due to a shortage of infrastructure and inadequate workforce. Neuro rehabilitation services that are still in its infancy in our country have been significantly interrupted in the last six months. An expert group from Indian Federation of Neurorehabilitation (IFNR) have formulated the guidelines and consensus recommendations for Neurologists, Physiatrists, and Therapists managing neurological disabilities during COVID 19. The aim of this consensus paper is to sensitize the clinicians and therapists about maintaining the continuum of care and rehabilitation needs of Covid patients as well as non Covid patients with neurological disorders during the ongoing COVID 19 pandemic [ABSTRACT FROM AUTHOR]

Coronavirus outbreak in Wuhan, China, turned into a pandemic in record time. Communication of disease presentation and mechanism of spread remain keys to getting ahead of the virus and limiting its spread beyond the capacity of management. Owing to huge academic focus and pandemic concern around the globe, this bibliometric analysis investigated research productivity related to coronavirus disease (COVID-19) pandemic using the Web of Science database. The relevant data were harvested, and search query was further refined by publication years (2020 OR 2019) and document types (article, book chapter, and proceedings paper). Finally, 6694 records were imported and downloaded in Plaintext and BibTeX formats on August 1, 2020. The data analysis was performed using MS Excel, VOS viewer, and Biblioshiny software. Of the 6694 publications that appeared in that period, the USA and Chinese research institutions topped the numbers. At the same time, the Journal of Medical Virology and CUREUS (Cureus Journal of Medical Science), remained favorite journals for publications. The pattern of multi-author publications has outstripped that of single-authors. Apart from COVID-19 and the novel coronavirus, the important keywords mentioned included pandemic, pneumonia, epidemiology, public health, outbreak, epidemic, China, infection, and treatment. The analysis shows a strong local research response from China, with large teams reporting on the disease outbreak. Subsequent studies will document a global response as the virus spreads worldwide. The initial research related to the current coronavirus outbreak was reported from within China. The data and patterns were supposed to alter as the virus spread globally. [ABSTRACT FROM AUTHOR]

Background and Objectives: Coronavirus disease-19 (COVID-19) pandemic has affected people all over the world and poses challenges to health-care services. Lockdown was first response strategy implemented by governments including India to prevent spread of coronavirus 2. The lockdown and anxiety among public had severely affected transfusion services. This paper analyses the impact of COVID-19 pandemic and lockdown on blood transfusion services. Methods: A retrospective analysis of the transfusion services for 5 months was carried out. The data regarding blood collections, blood donation camps, blood issued, and therapeutic plasma exchange (TPE) performed were collected and analyzed during 3 phases of the study period, i.e., phase 1 (pre-lockdown, 84 days), phase 2 (complete lockdown, 40 days), and phase 3 (partial lockdown, 28 days), and compared. Results: A significant drop (P = 0.010) was observed in blood donation from phase 1 to phase 2 but slight nonsignificant improvement was found from phase 2 to phase 3. The issue of blood was significantly reduced from phase 1 to phase 2 (P < 0.0001) and improved from phase 2 to phase 3 (P < 0.0049). There was a significant reduction (P < 0.00001 and 0.002) in patients referred for TPE during two phases of LD. Conclusion: There is significant decrease in blood supply and utilization due to pandemic and lockdown. An emergency blood management plan is required which can include donor education focusing to alleviate donor hesitation, relaxation to donor selection criteria, blood drive planning with inventory management and ensuring staff and product safety. [ABSTRACT FROM AUTHOR]

The uncertainty in all spheres of higher education due to the COVID-19 pandemic has had an unprecedented impact on teaching–learning and assessments in medical colleges across the globe. The conventional ways of assessment are now neither possible nor practical for certifying medical graduates. This has necessitated thoughtful considerations in making adjustments to the assessment system, with most institutions transitioning to online assessments that so far have remained underutilized. Programmatic assessment encourages the deliberate and longitudinal use of diverse assessment methods to maximize learning and assessment and at present can be utilized optimally as it ensures the collection of multiple low-stake assessment data which can be aggregated for high-stake pass/fail decisions by making use of every opportunity for formative feedback to improve performance. Though efforts have been made to introduce programmatic assessment in the competency-based undergraduate curriculum, transitioning to online assessment can be a potential opportunity if the basic tenets of programmatic assessment, choice of online assessment tools, strategies, good practices of online assessments and challenges are understood and explored explicitly for designing and implementing online assessments. This paper explores the possibility of introducing online assessment with face-to-face assessment and structuring a blended programmatic assessment in competency-based medical education. [ABSTRACT FROM AUTHOR]

Data from published epidemiological and virology studies around the world provide evidence that coronavirus disease 2019 (COVID-19) has a lower incidence rate in children compared with adults. COVID-19 infection typical presentations include respiratory symptoms, such as cough, respiratory distress and hypoxia, fever, and dyspnea, which are considered the main symptoms of this novel disease in adults, but atypical presentations, especially in children, could be a diagnostic challenge. We report a child whose initial presentation was gastrointestinal, and in whom COVID-19 infection was confirmed, concluding that cases of mesenteric adenitis may be confusing and may mask this virus infections, and they should therefore be investigated in this respect. Earlier studies reported 15–16% of COVID-19-infected patients presented with gastrointestinal symptoms such asloss of appetite, nausea, vomiting,abdominal pain, diarrhea, and variable liver injury. Gastrointestinal symptoms may be associated with respiratory symptoms or without it. There are very few studies on COVID-19 infection in children, and there are uncertainties in the published papers. Thisarticle isabout a 5-year-old COVID-19-infected girl who presented with acute abdomen owing to mesenteric adenitis. [ABSTRACT FROM AUTHOR]

Coronavirus (cov) disease 2019 pandemic caused by severe acute respiratory syndrome cov 2 has imposed significant demands on healthcare systems across the world. These demands were more significant on obstetrics and gynecology (obgyn) patients, who required services that had to continue despite the closure of other services. This paper describes the change management of an obgyn department at a tertiary health-care center. That experience resulted in a complete management shift in the institution and the formation of an infectious disease epidemic plan for respiratory infections. Description of the change management performed, difficulties encountered, and achievements obtained can assist other departments change management when they face similar situations. [ABSTRACT FROM AUTHOR]

The first Mohalla or Community clinic was set up in July 2015 in Delhi, India. Four hundred and eighty such clinics were set up in Delhi, since then. This review was conducted to synthesize evidence on access, utilization, functioning, and performance of Mohalla clinics. A desk review of secondary data from published research papers and reports was conducted initially from February–May 2020 and updated in August 2020. Eleven studies were included in the final analysis. Studies have documented that more than half to two-third of beneficiaries at these clinics were women, elderly, poor, and with school education up to primary level. One-third to two-third of all beneficiaries had come to the government primary care facility for the first time. A majority who attended clinics lived within 10 min of walking distances. There was high rate of satisfaction (around 90%) with overall services, doctor–patient interaction time and the people were willing to return for future health needs. Most beneficiaries received consultations, medicines, and diagnostics at no cost. A few challenges such as dispensing of medicines for shorter duration, lack of awareness about the exact location of the clinics, and services available among target beneficiaries, and the incomplete records maintenance and reporting system at facilities were identified. Mohalla Clinics of Delhi ensured continuity of primary care and laboratory services during COVID-19 pandemic in 2020. In summary, Mohalla Clinics have made primary care accessible and affordable to under-served population (thus, addressed inequities) and brought attention of policy makers on strengthening and investing on health services. The external evaluations and assessments on the performance of these clinics, with robust methodology are needed. The services through these clinics should be expanded to deliver comprehensive package of primary healthcare with inclusion of preventive, promotive, community outreach, and other public health services. [ABSTRACT FROM AUTHOR]

The outbreak Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a highly contagious and lethal beta coronavirus SARS-CoV-2, which has spread fast to encroach the entire globe and hence declare pandemic. Pregnancy alters body physiology and immune systems, can have worse effects of some respiratory infections and due to limited research and published data we still are in dilemma of appropriate management guidelines This article covers the updated guidelines for infection prevention and control (IPC), screening, sampling, antenatal visit schedules, risk scoring, triaging, supportive care, delivery, postpartum care and care of the newborn. This article aims to provide up-to-date information as per recent guidelines of various association which would serve as guidance in managing pregnant women and newborn with suspected or confirmed COVID-19. All the published papers till date, NCPRE, WHO Interim guidelines, RCOG, FOGS GCPRI, Medical Council of India, ICMR, MOFHW, CDC, ACOG guidelines are referred to compile this article to reach to a conclusion of evidence based management of pregnant ladies during COVID-19 pandemic. This article covers the not only infection prevention and control (IPC) guidelines, but also screening and sampling guidelines, antenatal visit schedules, risk scoring, triaging but also in-patient supportive care, delivery, postpartum care and care of the newborn. Data are very limited and hence very difficult to accurately define clinical management strategies and needs to be constantly updated. [ABSTRACT FROM AUTHOR]

COVID-19 is a pandemic throughout the world, leading to the hunger of knowledge as well as evidences regarding the corona virus which causes this disease. Interleukins are the chemokines which belong to the family of cytokines which are chemotactic in nature and cause the recruitment of cells of inflammation. In the recent COVID 19 pandemic the adverse outcomes in children, though reported less, has been related to the establishment of a cytokine storm, the components of which are common with the cytokine expression profile of Dental caries and early childhood caries in children. IL-6 levels are raised in the serum of the patients infected with COVID-19. Dental caries in children has been attributed to having its pathophysiology related in a cytokine response. Salivary IL-6 levels have been found to be elevated in children with multiple carious lesions. Hypotheses The present letter aims to propose that the multiple carious lesions can be a biomarker for the patients affected with COVID 19 due to raised IL-6 levels. Evaluation of hypotheses: The authors screened the data on COVID 19 and its association with dental caries in children. This paper is an hypotheses to highlight the importance of raised levels of IL-6 as a biomarker in the saliva of children with carious lesions and those affected with COVID-19. This communication proposes the connection between COVID-19 and dental caries through their cytokine connection to form a translational basis for recommending maintenance of oral hygiene in the COVID era. Thus every dentist must suspect every patient affected with multiple carious lesions to be a carrier of COVID-19. [ABSTRACT FROM AUTHOR]

In a brief span of time, coronavirus has become a major cause of concern worldwide ever since the first case was reported in Wuhan, China in December 2019. The pace at which the virus is being transmitted across the globe and the sudden increase in numbers of cases is much faster than severe acute respiratory syndrome and Middle East respiratory syndrome. With the rising number of cases, coronavirus disease 2019 (COVID-19) not only has an adverse effect on health, it has a deep seated impact on the economic and social front. Hence, the development of an effective vaccination strategy seems to be the only light at the end of the tunnel. The ongoing pandemic mandates the speedy evaluation of multiple approaches in order to elicit protective immunity and to curtail unwanted immune-potentiation which plays an important role in the pathogenesis of this virus. Being developed by more than 90 institutions in the world, a vaccine which is both effective and safe becomes all the more essential in the current time. Various types of vaccine strategies are being tested under different phases of clinical trials. The present paper hopes to provide an overview of the current work going on in this direction, with an aim to further fuel effects for an early and effective COVID-19 vaccine platform. [ABSTRACT FROM AUTHOR]

This write-up is a brief reflection of a rural doctor couple, Dr. Himmatrao Saluba Bawaskar (HSB) and Dr. Pramodini Himmatrao Bawaskar (PHB), working in the remote area of Maharashtra state of India during COVID-19 pandemic. During the pandemic, rural doctors are routinely exposed to symptomatic COVID-positive cases in the outpatient as well as indoor setting. The authors, both husband and wife, were in compulsory quarantine for twice at home and experienced social stigmas attached to a positive case. Here is a report the details of COVID-19 pattern and its management learned from the published scientific papers on COVID-19, and severe acute respiratory syndrome due to SARS-CoV-2 from December 2019 and their own experience in rural setting and the current literature shared in the form of personal narration. Apart from the personal experience of patients experience regarding quarantine period, COVID-19 is discussed in detail for the benefit of rural practitioners. [ABSTRACT FROM AUTHOR]

Introduction: As COVID-19 develops around the world, numerous publications have described the psychiatric consequences of this pandemic. Although clinicians and healthcare systems are mainly focused on managing critically ill patients in an attempt to limit the number of casualties, psychiatric disease burden is increasing significantly. In this scenario, increased domestic violence and substance abuse have been recently reported. Objective: The objective of this study is to perform a systematic review of the literature regarding the consequences of severe acute respiratory syndrome-CoV-2 infection in terms of domestic violence and substance abuse, and compare incidences found. Materials and Methods: We conducted a literature search using the preferred reporting items for systematic reviews and meta-analyses guidelines. The keywords included "domestic violence," "substance abuse" AND "COVID-19," including multiple variants from December 2019 through June 2020. An extensive bibliographic search was carried out in different medical databases: Pubmed, EMBASE, LILACS, medRxiv, and bioRxiv. Titles and abstracts were reviewed according to the eligibility criteria. The risk of bias in the retrieved articles was assessed by the Joanna Briggs Institute's critical assessment instrument. Results: A total of 1505 papers were initially retrieved after consulting the selected databases. After browsing through titles and abstracts, 94 articles were initially included considering the predefined eligibility criteria. After a more detailed analysis, only six scientific articles remained in our selection. Of these, three were evaluating domestic violence against children, while the other three were about substance abuse. Conclusion: There is not enough evidence to support the concept that COVID-19 has led to an increase in the rates of domestic violence and substance abuse. The initial decrease in violence reports might not translate into a real reduction in incidence but in accessibility. Apparently, there has been a slight increase in alcohol and tobacco abuse, especially by regular users, which also requires confirmatory studies. The inconsistency between expert opinon articles and the actual published data could be a result of the limited time since the beginnging of the crisis, the fact that psychitaric patients have been chronically exposed to stressful situatons, and a possible stimulated increase in demand for psychatric consultations. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic was confirmed to have spread to Slovakia on 6th March 2020. To date of paper submission, it has very favorable course. However, since the beginning healthcare workers have been working under increasing pressure, anxiety and fear. Aim: Authors evaluated the psychosocial impact of COVID-l9 pandemic on mental health experts and their clinical practice in Slovakia. Materials and Methods: A total of 157 mental health experts (79% women) submitted their responses via online questionnaire. Results: The most frequent occupation categories were 38.2% outpatient psychiatrists, 26.1% inpatient psychiatrists and 20.4% psychologists. The mental health experts felt maximum of stress during the peak of Slovak COVID-19 crisis, which was identified as the situation just after the declaring the state of emergency by Slovak government. The main sources of stress were statistical data, prognoses and other public presented information. Mental health experts felt mainly personal stress, then general and working stress. They identified also pathological effect of COVID-19 pandemic on the mental status of their patients, especially with anxiety and affective disorders and advantages of use of telemedicine. Conclusion: Psychosocial support in Slovakia was newly organized in COVID-19 pandemic for medical professionals, patients and other inhabitants under high stress within a very short time. This unexpected situation has revealed to Slovakia the need for reform of the mental healthcare system. [ABSTRACT FROM AUTHOR]

Telemedicine and related e-health facilities facilitate care from a distance through electronic information systems. COVID-19 pandemic is establishing telemedicine in the health care delivery system of countries. Telehealth is contributing significantly in health care delivery during the COVID-19 crisis. For mild-to-moderate symptoms of COVID-19 or any illness, telehealth services might represent a better, efficient way to receive initial care and perform triaging. Telemedicine also has a significant role in screening for COVID-19 symptoms and delivering routine needs and follow-up care. The large-scale adoption of telemedicine in public health care delivery is still not visible in low- and middle-income countries like India. Adoption by patients and healthcare professionals is limited and their concerns need to be addressed to ensure its utilization in future of the care continuum. In the current paper, we aim to review recent measures of Telemedicine adopted during the course of pandemic and its impact on public health in lower-middle income countries like India. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) infection is thought to increase thrombotic events by activating coagulation system and making endothelial damage. The frequency of severe acute respiratory syndrome coronavirus 2 pneumonia and pulmonary embolism has drawn attention. There are recommendations for prophylactic low-molecular-weight heparin (LMWH) for COVID-19 at hospitalized patients. However, there is no consensus regarding the duration and doses of LMWH given with COVID-19 treatment. We presented three cases of pulmonary embolism at different times of COVID-19 infection who were diagnosed with pulmonary embolism under anticoagulant treatment. Subsegmental thrombus was detected in computed thoracic pulmonary angiography in all cases and treated with LMWH in the hospital, two cases were discharged with warfarin and one case with LMWH. Care should be taken in dyspnea that develops in the of COVID-19 infection, especially in terms of subsegmental pulmonary embolism. This paper shows that COVID-19 is an important risk factor for venous thromboembolism and the duration and dose of anticoagulant treatment should be re-evaluated. [ABSTRACT FROM AUTHOR]

Cataract is the second leading cause of preventable blindness on the globe. Several programs across the country have been running efficiently to increase the cataract surgical rates and decrease blindness due to cataract. The current COVID-19 pandemic has led to a complete halt of these programs and thus accumulating all the elective cataract procedures. At present with the better understanding of the safety precautions among the health care workers and general population the Government of India (GoI) has given clearance for functioning of eye care facilities. In order to facilitate smooth functioning of every clinic, in this paper, we prepared preferred practice pattern based on consensus discussions between leading ophthalmologists in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics. The guidelines include triage, use of personal protective equipment, precautions to be taken in the OPD and operating room as well for elective cataract screening and surgery. These guidelines have been prepared based on current situation but are expected to evolve over a period of time based on the ongoing pandemic and guidelines from GoI. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has threatened the humanity at a global level to a large extent by the burden of the disease with significant mortality and to a certain extent as a byproduct of the necessary efforts to contain the same. There is a significant impact on the health care system, as we not only have to contain pandemic, but continue to treat our non-COVID-19 patients in a safe and responsible manner. Ophthalmology practice in general and glaucoma in particular needs certain modifications and additional precautions while examining as well as managing these patients keeping their and our safety in mind. As the lockdown relaxations are in vogue we need to learn how to deal with our regular patients as well in addition to emergency care. This paper presents the consensus-based guidelines by an expert panel on how to restart glaucoma practice during this COVID-19 time. These guidelines will be applicable across the country and should help ophthalmologists and glaucoma specialist to restart their practices while safeguarding the patients and their own selves from getting infected. [ABSTRACT FROM AUTHOR]