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COVID-19-associated rhino-orbital cerebral mucormycosis (ROCM) has a rapidly evolving course with high morbidity and mortality. We describe imaging features of COVID-19-associated ROCM based on noncontrast computed tomography (NCCT). This retrospective single-center observational study included 50 patients with COVID-19 from January 1, 2021 to June 30, 2021 who subsequently developed ROCM confirmed by fungal culture studies. All patients underwent NCCT of the paranasal sinuses as the diagnostic workup. The involvement of the nasal cavity, paranasal sinuses, orbits, and intracranial cavity was identified and graded. The ethmoid sinuses were most commonly involved [right (n = 46 of 50) > left (n = 45 of 50)], followed by the maxillary, sphenoid, and frontal sinuses. Thinning and erosions of the hard palate were noted in 18% of patients (n = 9), whereas 34% (n = 17) showed dehiscence of the lamina papyracea. Retromaxillary fat stranding was noted in 68% of patients (n = 34). Severe ethmoid sinusitis was associated significantly with ipsilateral pterygopalatine fossa involvement. The extraocular muscles were involved in 64% of patients (n = 32), with 84% (n = 42) showing orbital fat stranding. Proptosis of the affected eye was seen in 66% of patients, optic nerve involvement in 52%, and irregularity of globe contour in 12% (n = 6). The cavernous sinuses were affected in 10% of patients (n = 5), with three of them having temporal infarcts. COVID-19-associated ROCM is an acute, invasive fungal disease characterized by multisinus involvement, often with orbital and intracranial extension. Bilateral involvement with rapid progression should alert one to underlying COVID-19 disease.

The magnitude and duration of immune response to COVID-19 vaccination in older adults are known to be adversely affected due to immunosenescence and inflammaging. The threat of emerging variants warrants studies on immune response in older adults to primary vaccination and booster doses so as to understand the effectiveness of vaccines in countering the threat of emerging variants. Non-human primates (NHPs) are ideal translational models, as the immunological responses in NHPs are similar to those in humans, so it enables us to understand host immune responses to the vaccine. We initially studied humoral immune responses in aged rhesus macaques employing a three-dose regimen of BBV152, an inactivated SARS-CoV-2 vaccine. Initially, the study investigated whether the third dose enhances the neutralizing antibody (Nab) titer against the homologous virus strain (B.1) and variants of concern (Beta and Delta variants) in aged rhesus macaques immunized with BBV152, adjuvanted with Algel/Algel-IMDG (imidazoquinoline). Later, we also attempted to understand cellular immunity in terms of lymphoproliferation against γ-inactivated SARS-CoV-2 B.1 and delta in naïve and vaccinated rhesus macaques after a year of the third dose. Following the three-dose regimen with 6 µg of BBV152 with Algel-IMDG, animals had increased Nab responses across all SARS-CoV-2 variants studied, which suggested the importance of booster dose for the enhanced immune response against SARS-CoV-2-circulating variants. The study also revealed the pronounced cellular immunity against B.1 and delta variants of SARS-CoV-2 in the aged rhesus macaques even after a year of vaccination., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Patil, Shete, Yadav, Sapkal, Deshpande, Kaushal, Mohandas, Fulari, Jain, Kumar and Abraham.)

Objective: To determine the clinical manifestations, risk factors, treatment modalities and maternal outcomes in pregnant women with lab-confirmed COVID-19 and compare it with COVID-19 negative pregnant women in same age group., Design: Multicentric case-control study., Data Sources: Ambispective primary data collection through paper-based forms from 20 tertiary care centres across India between April and November 2020., Study Population: All pregnant women reporting to the centres with a lab-confirmed COVID-19 positive result matched with controls., Data Quality: Dedicated research officers extracted hospital records, using modified WHO Case Record Forms (CRF) and verified for completeness and accuracy., Statistical Analysis: Data converted to excel files and statistical analyses done using STATA 16 (StataCorp, TX, USA). Odds ratios (ORs) with 95% confidence intervals (CI) estimated using unconditional logistic regression., Results: A total of 76,264 women delivered across 20 centres during the study period. Data of 3723 COVID positive pregnant women and 3744 age-matched controls was analyzed. Of the positive cases 56·9% were asymptomatic. Antenatal complications like preeclampsia and abruptio placentae were seen more among the cases. Induction and caesarean delivery rates were also higher among Covid positive women. Pre-existing maternal co-morbidities increased need for supportive care. There were 34 maternal deaths out of the 3723(0.9%) positive mothers, while covid negative deaths reported from all the centres were 449 of 72,541 (0·6%)., Conclusion: Covid-19 infection predisposed to adverse maternal outcomes in a large cohort of Covid positive pregnant women as compared to the negative controls., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Kumar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

COVID-19 has affected more or less every nation across the world and affected the economy very badly. Infection of this virus in human took the life of millions. We have already faced the first and the second waves of COVID-19 and recently, the nations or humanity is afraid of new strain, that is, OMICRON. Considered to highly infectious than the previous strains. Therefore, the researchers are working to find a promising molecule with no or permissible toxicity. In the present work, authors have chosen 10 molecules including the molecules used in curing the infection from nCoV. All the molecules were docked against Mpro of nCoV using iGemdock, a reliable computational tool. Based on the binding energy obtained, it can be seen that only latermovir; remdesivir; zanamivir showed better binding affinity than the gamma oryzanol, the molecule of interest in this work. These three molecules are already in use to cure the patients siffering from the infection of nCoV. But, we need a cost effective and easily available molecule to fight against this viral infection. The binding energy obtained for the formation of complex of gamma oryzanol with Mpro of nCoV through molecular docking is -118.787 kcal/mol. It forms conventional hydrogen bonds with the CYS145 (2.51 Å), LEU141 (3.01 Å) and SER144 (3.09 Å); forms C-H bonds with PHE140 (3.37 Å) and HIS163 (2.91 Å), forms alkyl interactions with ALA191 (3.59 and 4.74 Å), CYS145 (4.90 Å). One interesting information is obtained that the value of log Kp of gamma oryzanol is least means more permeable to skin in comparison of other molecules used in the work. Gamma oryzanol in known for to its biological potency like it can modulate the oxidative stress as well as inflammation. DFT calculations of gamma oryzanol (GO) was made at different temperature and no change in the delocalization of electron density as well no change in free energy is observed. Molecular dynamics (MD) simulations of gamma oryzanol with the Mpro of nCoV at different temperatures was performed. The formation of the complex between GO and Mpro of CoV at 290 K, 300 K, 310 K and 320 K for 100 ns was investigated. It has been observed that the effective binding is observed at 290 K, therefore, it can be said that the inhibition of the Mpro of nCoV with GO is maximum at 290 K.Communicated by Ramaswamy H. Sarma.

Due to the coronavirus disease (COVID-19) pandemic and its associated response, TB deaths increased for the first time in a decade. In any potentially fatal illness, an assessment of severity is essential. This is not systematically done for adults with TB, mostly due to a lack of policy and/or limited availability of diagnostic and clinical capacity. We developed a screening tool using simple and easily measurable indicators that can be used by paramedical TB program staff to quickly identify people with severe illness. During October-November 2020 in Karnataka, India, the paramedical program staff from 16 districts screened people with TB (aged ≥15 years) notified by public facilities for "high risk of severe illness," which was defined as the presence of any of the following indicators: (1) body mass index (BMI) ≤14.0 kg/m 2 ; (2) BMI ≤16.0 kg/m 2 with bilateral leg swelling; (3) respiratory rate >24/minute; (4) oxygen saturation <94%; (5) inability to stand without support. In this cohort study, we determined the incidence of program-recorded early deaths (within 2 months) and its association with high risk of severe illness. Of 3,010 people with TB, 1,529 (50.8%) were screened at diagnosis/notification, of whom 537 (35.1%) had a high risk of severe illness. There were 195 (6.5%, 95% CI=5.7, 7.4) early deaths: 59 (30.2%) within a week and 100 (51.3%) within 2 weeks of treatment initiation. The incidence of early deaths was significantly higher among those with high risk of severe illness (8.9%) at diagnosis compared to those without (3.8%) [adjusted relative risk: 2.36 (95% confidence interval=1.57, 3.55)]. To conclude, early deaths were especially high during the first 2 weeks and strongly associated with a high risk of severe illness at diagnosis/notification. Screening for severe illness should be explored as a potential strategy to end TB deaths., (© Shewade et al.)

Infection Prevention and Control (IPC) measures are critical to the reduction in healthcare-associated infections, especially during pandemics, such as that of COVID-19. We conducted a hospital-based cross-sectional study in August 2021 at Connaught Hospital, Princess Christian Maternity Hospital and Ola During Children's Hospital located in Freetown, Sierra Leone. We used the World Health Organization's Infection Prevention and Control Assessment Framework Tool to assess the level of IPC compliance at these healthcare facilities. The overall IPC compliance score at Connaught Hospital was 323.5 of 800 points, 313.5 of 800 at Ola During Children's Hospital, 281 of 800 at Princess Christian Maternity Hospital, implying a 'Basic' IPC compliance grade. These facilities had an IPC program, IPC committees and dedicated IPC focal persons. However, there were several challenges, including access to safe and clean water and insufficient quantities of face masks, examination gloves and aprons. Furthermore, there was no dedicated budget or no healthcare-associated infection (HAI) surveillance, and monitoring/audit of IPC practices were weak. These findings are of concern during the COVID-19 era, and there is an urgent need for both financial and technical support to address the gaps and challenges identified.

Inappropriate use of antibiotics during the COVID-19 pandemic has the potential to increase the burden of antimicrobial resistance. In this study, we report on the prevalence of antibiotic use and its associated factors among suspected and confirmed COVID-19 patients admitted to 35 health facilities in Sierra Leone from March 2020-March 2021. This was a cross-sectional study using routinely collected patient data. Of 700 confirmed COVID-19 patients, 47% received antibiotics. The majority (73%) of the antibiotics belonged to the 'WATCH' group of antibiotics, which are highly toxic and prone to resistance. The most frequently prescribed antibiotics were azithromycin, ceftriaxone, amoxicillin, metronidazole, and amoxicillin-clavulanic acid. Antibiotic use was significantly higher in patients aged 25-34 years than in those with severe disease. Of 755 suspected COVID-19 patients, 61% received antibiotics, of which the majority (58%) belonged to the 'WATCH' category. The most frequently prescribed antibiotics were ceftriaxone, metronidazole, azithromycin, ciprofloxacin, and amoxycillin. The prevalence of antibiotic use among suspected and confirmed COVID-19 patients admitted to healthcare facilities in Sierra Leone was high and not in line with national and WHO case management guidelines. Training of health care providers, strengthening of antimicrobial stewardship programs, and microbiological laboratory capacity are urgently needed.

Background: Dealing with the COVID-19 pandemic has been one of the most important objectives of many countries.Intently observing the growth dynamics of the cases is one way to accomplish the solution for the pandemic., Introduction: Infectious diseases are caused by a micro-organism/virus from another person or an animal. It causes difficulty at both the individual and collective levels. The ongoing episode of COVID-19 ailment, brought about by the new coronavirus first detected in Wuhan, China, and its quick spread far and wide revived the consideration of the world towards the impact of such plagues on an individual's everyday existence. We suggested that a basic structure be developed to work with the progressive examination of the development rate (cases/day) and development speed (cases/day2) of COVID-19 cases., Methods: We attempt to exploit the effectiveness of advanced deep learning algorithms to predict the growth of infectious diseases based on time series data and classification based on symptoms text data and X-ray image data. The goal is to identify the nature of the phenomenon represented by the sequence of observations and forecasting., Results: We concluded that our good habits and healthy lifestyle prevent the risk of COVID-19. We observed that by simply using masks in our daily lives, we could flatten the curve of increasing cases.Limiting human mobility resulted in a significant decrease in the development speed within a few days, a deceleration within two weeks, and a close to fixed development within six weeks., Conclusion: These outcomes authenticate that mass social isolation is a profoundly viable measure against the spread of SARS-CoV-2, as recently recommended. Aside from the research of country- by-country predominance, the proposed structure is useful for city, state, district, and discretionary region information, serving as a resource for screening COVID-19 cases in the area., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

In 2019, global diabetes prevalence was 463 million. Diabetes increases the risk of TB and adverse treatment outcomes including death and relapse. Diabetes also increases the risk of severe disease, multi-organ failure, coagulopathy and death in COVID-19. TB and COVID-19 share many features, suggesting opportunities to integrate prevention, diagnosis and care. Three areas for further work are highlighted: better infection control in diabetes clinics, easier and quicker diagnosis using similar technology platforms and optimal blood glucose control. The funding and resources for COVID-19 should be harnessed to improve TB and diabetes care and achieve their respective sustainable development goal targets., (© The Author(s) 2021. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Connecticut was impacted severely and early on by the COVID-19 pandemic due to the state's proximity to New York City. Hartford Healthcare (HHC), one of the largest healthcare systems in New England, became integral in the state's response with a robust emergency management system already in place. In this manuscript, we review HHC's prepandemic emergency operations as well as the response of the system-wide Office of Emergency Management to the initial news of the virus and throughout the evolving pandemic. Additionally, we discuss the unique acquisition of vital critical care resources and personal protective equipment, as well as the hospital personnel distribution in response to the shifting demands of the virus. The public testing and vaccination efforts, with early consideration for at risk populations, are described as well as ethical considerations of scarce resources. To date, the vaccination effort resulted in over 70 percent of the adult population being vaccinated and with 10 percent of the population having been infected, herd immunity is eminent. Finally, the preparation for reestablishing elective procedures while experiencing a second wave of the pandemic is discussed. These descriptions may be useful for other healthcare systems in both preparation and response for future catastrophic emergencies of all types.

Background: Activins are members of the transforming growth factor-β superfamily implicated in the pathogenesis of several immunoinflammatory disorders. Based on our previous studies demonstrating that overexpression of activin-A in murine lung causes pathology sharing key features of coronavirus disease 2019 (COVID-19), we hypothesized that activins and their natural inhibitor follistatin might be particularly relevant to COVID-19 pathophysiology., Methods: Activin-A, activin-B, and follistatin were retrospectively analyzed in 574 serum samples from 263 COVID-19 patients hospitalized in 3 independent centers, and compared with demographic, clinical, and laboratory parameters. Optimal scaling with ridge regression was used to screen variables and establish a prediction model., Result: The activin/follistatin axis was significantly deregulated during the course of COVID-19, correlated with severity and independently associated with mortality. FACT-CLINYCoD, a scoring system incorporating follistatin, activin-A, activin-B, C-reactive protein, lactate dehydrogenase, intensive care unit admission, neutrophil/lymphocyte ratio, age, comorbidities, and D-dimers, efficiently predicted fatal outcome (area under the curve [AUC], 0.951; 95% confidence interval, .919-.983; P <10-6). Two validation cohorts indicated similar AUC values., Conclusions: This study demonstrates a link between activin/follistatin axis and COVID-19 mortality and introduces FACT-CLINYCoD, a novel pathophysiology-based tool that allows dynamic prediction of disease outcome, supporting clinical decision making., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Introduction: Living-donor liver transplantation (LDLT) has been mostly suspended and deceased-donor living transplantation activity has been considerably reduced because of coronavirus disease 2019 (COVID-19). We modified our protocols and procedures in line with COVID-19 guidelines. Since the restructuring, we have performed 20 LDLTs. Our study reports the outcomes of these cases and demonstrates the feasibility of LDLT during this pandemic., Materials and Methods: The changes were influenced by experiences and communications from across the globe. A month-long self-imposed moratorium was spent in restructuring the program and implementing new protocols. Twenty LDLTs were performed between April 18 and September 15 using the new protocols. Our experience includes 2 simultaneous liver-kidney transplants, 1 ABO-incompatible LDLT, and 1 pediatric case (age 11 months)., Results: Nineteen patients recovered and 1 patient died. We maintained our postoperative immunosuppression protocol without many changes. Major complications were observed in 30% of recipients but none of the donors. One recipient was infected with COVID-19 during the postoperative period. A donor-recipient couple contracted COVID-19 after discharge from the hospital. All patients recovered from COVID-19 and liver enzymes were unaffected., Conclusion: This study represents a microcosm of experience in LDLT during the COVID-19 era. Outcomes of LDLT are not affected by COVID-19 per se, provided that we make necessary changes., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Despite considerable progress over the years, tuberculosis (TB) still remains the top cause of death among the infectious diseases and has devastating socio-economic consequences for people in low- and middle-income countries. To add to this, the emergence of the COVID-19 pandemic has worsened delivery of TB care across the globe. As a global community, we have committed to end the TB epidemic by 2030. The World Health Organization has framed a strategy to achieve this goal which consists of three pillars namely i) integrated patient-centred care and prevention, ii) bold policies and systems and iii) intensified research and innovation. An analysis of the performance of national tuberculosis programmes (NTPs) across the globe against the ten priority indicators recommended for monitoring the end TB strategy show that there are huge gaps at every step in the cascade of care of TB patients. In our view, these gaps reflect suboptimal implementation of existing strategies known to be efficacious and operational research (OR) is one of the best available tools to plug the gaps. In this paper, we define what operational research is and how it differs from other kinds of research. We also share our views and experiences about how operational research can be used by NTPs to identify implementation gaps and their reasons, and develop and test possible solutions - which are then integrated to make changes to policy and practice and eventually improve programme outcomes. OR can be defined as research into interventions, strategies and tools which produces practical useable knowledge that can be used to enhance the quality, coverage, effectiveness and efficiency of disease control programmes, health services or health systems in which the research is conducted. The key steps in integrating operational research in the NTPs include: i) securing political commitment reflected by inclusion of OR in the national strategic plans of NTPs and earmarked funding, ii) having a critical mass of dedicated and trained human resources in OR within the NTP, iii) setting research priorities and steering the direction of research in the country, iv) using output-oriented models of capacity building such as the Structured Operational Research Training Initiative (SORT IT) model and building communities of practice, v) harnessing existing capacity in the country by forging partnerships with academia, vi) NTP-led nationwide, multicentre OR studies, vii) providing access to anonymized patient and programme surveillance data, vii) creating a forum for evidence dissemination and fostering policy change and ix) monitoring and accountability. In conclusion, ending the TB epidemic will not be possible without new tools (diagnostics, drugs, vaccines) and a multi-sectoral response involving stakeholders beyond the health ministry, including private providers, patients and communities. However, timely conduct of operational research to fine-tune programme implementation and ensuring proper deployment of new tools will be equally crucial to maximize the effectiveness and efficiency of interventions and ultimately contribute towards ending TB., Competing Interests: Conflicts of interest All authors have none to declare., (Copyright © 2020 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

The devastating impact of COVID-19 on businesses has led to the redefinition of workforce resilience. This study hence explores workforce resilience factors that will be important in the post-COVID-19 era. It investigates whether these factors perform differently in the manufacturing vs. the service sector and in small and medium enterprises (SMEs) vs. large firms. Sixty-five firms were studied in Malaysia and analyzed through Rasch modelling. The results indicate that three workforce resilience factors (positive thinking, sense of responsibility, and emotional control) are difficult to overcome in the manufacturing sector. Regarding the SMEs and large firm contexts, six workforce resilience factors (positive thinking, differentiation, degree of involvement, sense of responsibility, cognitive processes, and innovation) are complicated for SMEs. In comparison, two workforce resilience factors (work–life balance and decision-making) are difficult for large firms. Capitalizing on these findings, managers in various organizations (manufacturing vs. service and SMEs vs. large firms) can adopt different strategies to leverage workforce resilience post-COVID. Moreover, government agencies can use these findings for policy-making when leading post-COVID-19 projects and initiatives. [ABSTRACT FROM AUTHOR]

To cure SARS-CoV-2 infection, the repurposing of conventional antiviral drugs is currently advocated by researchers, though their action is not very effective. The present study, based on in silico methods, was intended to increase the therapeutic potential of conventional drugs: hydroxychloroquine (HCQ), favipiravir (FAV), and remdesivir (REM) by using curcuminoids like curcumin (CUR), bisdemethoxycurcumin (BDMC), and demethoxycurcumin (DMC) as adjunct drugs against SARS-CoV-2 receptor proteins, namely main protease (Mpro) and the S1 receptor-binding domain (RBD). The curcuminoids exhibited similar pharmacokinetic properties to the conventional drugs. The webserver (ANCHOR) predicted greater protein stability for both receptors with a disordered score (<0.5). The molecular docking study showed that the binding energy was highest (−27.47 kcal/mol) for BDMC toward Mpro receptors, while the binding energy of CUR (−20.47 kcal/mol) and DMC (−20.58 kcal/mol) was lower than that of HCQ (−24.58 kcal/mol), FAV (−22.87 kcal/mol), and REM (−23.48 kcal/mol). In the case of S1-RBD, CUR had the highest binding energy (−38.84 kcal/mol) and the lowest was in FAV (−23.77 kcal/mol), whereas HCQ (−35.87 kcal/mol) and REM (−38.44 kcal/mol) had greater binding energy than BDMC (−28.07 kcal/mol) and DMC (−30.29 kcal/mol). Hence, this study envisages that these curcuminoids could be employed in combination therapy with conventional drugs to disrupt the stability of SARS-CoV-2 receptor proteins. [ABSTRACT FROM AUTHOR]

For the last three years, the world has faced the unexpected spread of the pandemic of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The high mortality rate and ever-changing shape of the virus are the challenging factors in the effective management of SARS-CoV-2. However, in last three years, research communities have made significant progress in developing vaccines and controlling the spread of the pandemic to a certain extent. These vaccines contain the attenuated pathogens, which after application did not kill the virus but protected the human by enhancing the immune system response during pandemic exposure. However, the negative side effects and the high cost of the synthetic vaccines are always of concern for researchers, consumers, and the government. Therefore, as an alternative to synthetic drugs, natural medicines or natural plant products have piqued researchers' interest. Algae are considered as a treasure house of bioactive compounds such as carotenoids, vitamins, polysaccharides, proteins, etc. These bioactive compounds have been well documented for the treatments of various human ailments such as cancer and cardiovascular diseases. Furthermore, sulfated polysaccharides such as alginate and carrageenan have been reported as having antiviral and immunomodulating properties. Therefore, this review addresses algal polysaccharides, especially alginate and carrageenan, and their application in the treatment of COVID-19. In addition, in silico approaches are discussed for the inhibition of the S1-RBD (receptor-binding domain) of SARS-CoV-2, which attaches to the host receptor ACE2 (angiotensin-converting enzyme 2), and the interaction with the network of relative proteins is also explored, which will help in drug discovery and drug design. [ABSTRACT FROM AUTHOR]

In today's business, environment natural and manmade disasters like recent event (Covid 19) have increased the attention of practitioners and researchers to Supply chain vulnerability. Purpose of this paper is to investigate and prioritize the factors that are responsible for supply chain vulnerability. Extant literature review and interviews with the experts helped to extract 26 supply chain vulnerability factors. Further, the relative criticality of vulnerability factors is assessed by analytical hierarchy process (AHP). Critical part supplier; location of supplier; long supply chain lead times; Fixing process owners and mis-aligned incentives in supply chain are identified as the most critical factors among twenty-six vulnerability factors. Research concludes that not only long and complex supply chain but supply chain practices adopted by firms also increase supply chain vulnerability. Relative assessment of vulnerability factors enables professionals to take appropriate mitigation strategies to make the supply chains more robust. This research adds in building a model for vulnerability factors that are internal to supply chain & controllable. [ABSTRACT FROM AUTHOR]

In rapidly changing business conditions, it has become extremely important to ensure the sustainability of supply chains and further improve the resiliency to those events, such as COVID-19, that can cause unexpected disruptions in the value supply chain. Although globalized supply chains have already been criticized for lack of control over sustainability and resilience of supply chain operations, these issues have become more prevalent in the uncertain environment driven by COVID-19. The use of emerging technologies such as blockchain, Industry 4.0 analytics model and artificial intelligence driven methods are aimed at increasing the sustainability and resilience of supply chains, especially in an uncertain environment. In this context, this research aims to identify the problematic areas encountered in building a resilient and sustainable supply chain in the pre-COVID-19 era and during COVID-19, and to offer solutions to those problematic areas tackled by an appropriate emerging technology. This research has been contextualized in the automotive industry; this industry has a complex supply chain structure and is one of the sectors most affected by COVID-19. Based on the findings, the most important problematic areas encountered in SSCM pre-COVID-19 are determined as supply chain traceability, demand planning and production management as well as purchasing process planning based on cause and effect groups. The most important issues to be addressed during COVID-19 are top management support, purchasing process planning and supply chain traceability, respectively. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) declared in May 2021 that SARS-CoV-2 is transmitted not only by close contact with infectious respiratory fluids from infected people or contaminated materials but also indirectly through air. Airborne transmission has serious implications for the control measures we can deploy, given the emergence of more transmissible variants. This emphasizes the need to deploy a mechanism to reduce the viral load in the air, especially in closed and crowded places such as hospitals, public transport buses, etc. In this study, we explored ultraviolet C (UVC) radiation for its ability to inactivate the SARS-CoV-2 particles present in aerosols and designed an air disinfection system to eliminate infectious viruses. We studied the virus inactivation kinetics to identify the UVC dosage required to achieve maximum virus inactivation. Based on the experimental data, UVC-based devices were designed for the sanitization of air through HVAC systems in closed spaces. Further, a risk assessment model to estimate the risk reduction was applied which showed that the use of UVC radiation could result in the reduction of the risk of infection in occupied spaces by up to 90%. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare workers (HCWs) are at higher risk of getting infected with COVID-19 infection due to their close proximity to COVID-19-positive patients. We studied the risk stratification and positivity rate in HCWs at risk of getting COVID-19 infection as well as the possible factors responsible for their being at risk of COVID-19 infection during the study period. Material and Methods: This prospective study was conducted after approval by the institutional ethics committee. The data regarding demographic variables, risk stratification, COVID-19 (reverse-transcription polymerase chain reaction) report, and possible sources of exposure for HCWs were recorded in a proforma by personal/telephonic interviews as well as from hospital records from March 2020 to June 2021. The data generated were entered into Microsoft Excel® software and analyzed using percentages, proportions, and Chi-square tests for qualitative variables. Results: COVID-19 infection's positivity rate was 19.5% among high-risk and 0.6% among low-risk HCW contacts. HCWs working in non-COVID-19 areas (67.9%) were more at risk than those working in COVID-19 areas (32.1%). In contrast, the COVID-19 positivity rate was significantly higher among high-risk contact HCWs from COVID-19 areas (34.2%) than in non-COVID-19 areas (12.6%). The maximum COVID-19 positivity rate was seen in high-risk contacts with body fluid exposure (21%), performing aerosol-generating procedures (20%), and close exposure in operation theaters (18%). Conclusions: Risk stratification is an important tool to contain infection among HCWs who had unprotected close contact with a COVID-19-positive case. With appropriate contact tracing, we were able to avoid over- and under-quarantine, save many man-hours as well as contain the spread of infection. HCWs should not only wear appropriate personal protective equipment (PPE) during work hours but should also practice mask-wearing and social distancing while they are in the community. [ABSTRACT FROM AUTHOR]

Since the COVID-19 pandemic, the world began a frantic search for possible prophylactic 11 options. We conducted a study to assess the role of hydroxychloroquine for COVID-19 12 prophylaxis in health-care workers. The study was a prospective cohort with four arms (high, 13 medium, low dose, and control) of HCQ prophylaxis. Participants were grouped as per their 14 opting for any one arm on a voluntary basis as per institute policy. The outcomes studied 15 were COVID-19 positivity by RT-PCR and its severity assessed by WHO COVID-19 16 severity scale. Total 486 participants were enrolled, of which 29 (6%) opted for low dose, 2 17 (<1%) medium dose, and none for high dose HCQ while 455 (93.6%) were in the control 18 arm. Of the 164 participants who underwent RT-PCR, 96 (58.2%) tested positive. Out of 19 these 96 positive cases, 79 [82.3%]) were ambulatory and were managed conservatively at 20 home. Only 17.7% participants, all from the control group, required hospitalization with the 21 mild-moderate disease. None of the participants had severe disease, COVID-related 22 complications, ICU stay, or death. The difference in the outcome was statistically 23 insignificant (p value >0.05). This single-centre study demonstrated that HCQ prophylaxis in 24 healthcare workers does not cause a significant reduction in COVID-19 as well as mitigating 25 its severity in those infected. At present, most of the trials have not shown any benefit. 26 Though COVID-19 vaccines have reduced the need for prophylaxis, the search for a safe and 27 reasonable chemoprophylaxis should continue until a large population of individuals gets 28 vaccinated, especially in underdeveloped countries. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease-2019 (COVID-19) pandemic has been a cause of significant mental health disturbances in medical health personnel. However, 18 months into the pandemic, healthcare workers (HCWs) have become accustomed to the heightened stress and anxiety that comes with caring for COVID patients. Through this study, we aim to measure depression, anxiety, stress, and insomnia in doctors with the help of validated scales. Materials and methods: This was a cross-sectional study with an online survey design conducted among doctors from major hospitals in New Delhi. The questionnaire included participant demographics, including designation, specialty, marital status, and living arrangements. This was followed by questions from the validated depression, anxiety, stress scale (DASS-21), and insomnia severity index (ISI). Depression, anxiety, stress, and insomnia scores were calculated for each participant, and the data were analyzed statistically. Results: The mean scores of the whole study population showed no depression, moderate anxiety, mild stress, and subthreshold insomnia. Female doctors exhibited more psychological issues (mild depression and stress, moderate anxiety, but only subthreshold insomnia) as compared to males (mild anxiety, but no depression, stress, and insomnia). Junior doctors also had higher depression, anxiety, and stress scores than senior doctors. Similarly, single doctors, those living alone, and those not having kids had higher DASS and insomnia scores. Discussion: HCWs have been under tremendous mental stress during this pandemic which is influenced by multiple factors. Female sex, junior doctors, working on the frontline, not being in a relationship, and living alone may be some of the factors recognized in our study and corroborated by many authors, which may increase the chances of depression, anxiety, and stress in them. HCWs need regular counseling, time off for rejuvenation, and social support to overcome this hurdle. [ABSTRACT FROM AUTHOR]

Chronic pain is the leading cause of morbidity in the world and is strongly associated with physical and psychological disabilities. In this pandemic, most of the pain care centers are forced to shut their doors leaving patients in dismay and adding to their misery. A systematic review was performed following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. All research articles from March 2020 to September 15, 2020, available on PubMed, Google scholar, and EmBase were included in this study. The keywords used for data search were "chronic pain," "coronavirus," "pain management," "COVID-19," "drugs usage in covid-19," "recommendation," and "guidelines". This review summarizes findings from the current literature available worldwide from different databases regarding guidelines to practice during chronic pain in coronavirus disease (COVID) crisis. This article acts as a specimen on how to handle future pandemics. We concluded that chronic pain management is a fundamental right and telemedicine is the silver lining that can be used for primary, follow-up consultation and to address mental health issues in chronic pain patients. Outpatient department visits should be scheduled using "forward triage." Pain Interventions should be carried out if urgent or semi-urgent with necessary precautions. Reopening of elective procedures with COVID testing can be planned, considering pain interventions to be usually percutaneous, of short duration, and involving office procedures with minimal aerosol generation. Drugs contributing to immune suppression, for example, strong opioids and steroids, should be avoided. Regenerative therapy can be used instead during pain interventions. Physicians are expected to follow the recommended government guidelines before prescribing any drugs. [ABSTRACT FROM AUTHOR]

Introduction  The coronavirus disease 2019 (COVID-19) pandemic has affected the healthcare system. The residents who are at the frontline of this pandemic have suffered the most. The extent of the training loss due to the COVID-19 pandemic on gastroenterology (GE) training is not studied in India. Methods  We designed a 36-question based google survey and distributed it to the GE residents all across India, via email. All the responses collected were analyzed using appropriate statistical methods. Results  A total of 140 responses were received. No significant decrease in teaching sessions/ classes was reported. Most of the residents (83.5%) reported inability to complete the target thesis enrolment. The number of patients seen by the residents in outpatient department, patients managed in wards and endoscopic procedures done by residents have decreased significantly (p -valve <0.001 for all). An overwhelming 89.9% (n  = 125) of the GE residents were posted for COVID-19 duties. Almost half (50.4%) of them were COVID-19 positive. Conclusion  The COVID-19 pandemic has affected the training of GE residents in India immensely and an extension period of 3 months may be offered to them. [ABSTRACT FROM AUTHOR]

Purpose: The new coronavirus is a highly infectious disease with mutating variants leading to pervasive risk around geographies and public health system. The economy has been suffering due to the strategic lockdown adopted by the local administrative bodies, and in most of the countries, it is further leading to a major wave of unemployment with millions of job and business losses affecting the hotels, travel and tourism industry widely. To attain a sustainable business in the post-pandemic situations, the industry now must think of information system approaches to convince tourists to feel safe with the most hygienic hospitality and services to be offered in any property. The key aspect of the study is to provide the impact of new-age AI-driven technology solutions that will dominate the future direction of the modernized hospitality industry promising robust health-safety measures in a hotel, and further help create sustainable business and leisure travel facilities to cope with post-epidemic scenarios. Design/methodology/approach: The study emphasizes to provide a robust technology-oriented framework based on a mixed research method that would help hotels to adopt and implement new-age AI-driven solution within the hotel premise to serve customers with at most hygiene, contactless service and thereafter, aiming for faster recovery of businesses and regaining customer trust to fuel booking intent in the post-epidemic scenario. Findings: The paper provides a technology-focused solution that would impact hotel industries' post-pandemic scenario. The study contributes to helping boost the tourism industry using information management solutions such as biosensors, robotic room services and contactless hosting. The findings show the adoption of robots/RPA solutions and Biosensors by the industry will be a disruptive paradigm shift. Originality/value: The study expands the scope of research in information technology and management with a focus on the hospitality industry while contributing to new factors impacting customer buying behavior in the industry. [ABSTRACT FROM AUTHOR]

Hormones like testosterone and progesterone in the humans play significant role in the regulation of various biological processes like the body growth, reproduction, and others. In last two decades, researchers are using ionic liquids (ILs) extensively in different areas of sciences, and they are a novel class of compounds as well as their polarity can be tuned. ILs are multidisciplinary in nature and can be used in chemistry, materials science, chemical engineering, and environmental science. Further, ILs are being explored to increase the solubility of drugs or biological potential molecules. Testosterone and progesterone are found to be not very polar in nature; therefore, the authors attempt to increase the solubility of testosterone and progesterone via interaction with ILs. It was studied with density functional theory calculations using Gaussian, and an increase in the value of dipole moment is observed for the complex of testosterone/progesterone with the ILs in comparison of individual one. The optimization energy and other thermodynamic energies of the ILs (IL1‐IL3), testosterone (T), testosterone‐IL (T‐IL1 to T‐IL3), progesterone (P), and progesterone‐ILs (P‐IL1 to P‐IL3) are found to be negative. Further, the change in free energy for the formation of complexes at room temperature is calculated. Further, the authors have investigated the synergistic effect of testosterone and progesterone against the main protease of new coronavirus using molecular docking. It is observed that the testosterone‐IL1 {IL1‐3‐(2‐hydroxyethyl)‐1‐methyl‐1H‐imidazol‐3‐ium 2,4,6‐trinitrophenolate} is found to be prominent against the main protease of SARS‐CoV‐2. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the impact of lockdown on sexual functioning in India. In addition, impact of lockdown on relationship with the partner and mental health was evaluated. Materials and Methods: An online survey was conducted using changes in sexual functioning questionnaire, Patient Health Questionnaire-4, and a self-designed questionnaire. Results: The mean age of the participants was 41.5 (standard deviation: 11.2; range: 22--77; median: 39.5) years, with the majority being males 385 (85.6%). The participants reported that lockdown led to reduction in the frequency of sexual intercourse and also touching the partner (fondling, caressing, touching, or kissing) when not indulging in sexual intercourse. Majority of the participants reported improvement in the overall relationship, communication with the partner, and interpersonal conflicts. About two-fifths of the participants reported engaging in sexual intercourse more than twice a week or more. About one-fifth screened positive for psychiatric morbidity, with 14.2% screened positive for anxiety, 14.8% screened positive for depression and 8.7% screened positive for both. In both genders, presence of depression and anxiety were associated with lower sexual functioning in all the domains. Conclusion: Lockdown led to a reduction in the frequency of sexual intercourse, and reduction in the frequency of intimacy in the form of fondling, caressing, touching, or kissing partner when not doing sexual intercourse. However, lockdown led to the improvement in overall relationship and communication with the partners and a reduction in interpersonal conflicts. [ABSTRACT FROM AUTHOR]

Identification of neurological manifestations associated with SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) in patients with no or mild pulmonary infection proves to be a challenge. The incidence of neurological associations of COVID-19 may be small as compared with respiratory disease; however, in the present scenario with an increasing number of cases each day, the overall incidence of patients with neurological manifestations and their health-related socioeconomic impact might be large. Hence it is important to report such cases so that healthcare providers and concerned authorities are aware of and may prepare for the growing burden. The literature on primary neurological manifestations of COVID-19 is limited, and hence our case series is relevant in the current scenario. The most commonly reported neurological complications are cerebrovascular accidents, encephalopathy, encephalitis, meningitis, and Guillain-Barré syndrome (GBS). We present a series of seven cases with various neurological presentations and possible complications from this novel virus infection. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) are at increased risk of exposure to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Personal protective equipment (PPE) is mandated for HCWs. However, the physiological effects on the HCWs while working in the protective gear remains unexplored. This study aimed to assess the physiological effects of the prolonged use of PPE on HCWs. Materials and methods: Seventy-five HCWs, aged 18-50 years were enrolled in this prospective, observational, cohort study. The physiological variables [heart rate, oxygen saturation, and perfusion index (PI)] were recorded at the start of duty, 4 hours after wearing N95 filtering facepiece respirator (FFR), pre-donning, and post-doffing. The rating of perceived exertion (RPE) score and modified Borg scale for dyspnea was evaluated. The physiological variables were represented as the mean ± standard deviation. Wilcoxon signed-rank test was used to show any difference in RPE and modified Borg scale for dyspnea. A p value of <0.05 was considered significant. Results: There is a statistically significant difference in the physiological parameters post-doffing compared with baseline: Heart rate (p < 0.001); oxygen saturation (p < 0.001); PI (p < 0.001). RPE score showed increased discomfort with continuous use of N95 FFR. However, exertion increased only marginally. The major adverse effects noted with PPE use were fogging, headache, tiredness, difficulty in breathing, and mask soakage, with a resultant mean duration of donning to be 3.1 hours. Conclusion: The use of PPE can result in considerable changes in the physiological variables of healthy HCWs. The side effects may lead to excessive exhaustion and increased tiredness after prolonged shifts in the intensive care unit (ICU) while wearing PPE. [ABSTRACT FROM AUTHOR]

The outbreak of the new coronavirus in Wuhan, Chinese Hubei City (COV-2) was also known as COVID-19 and has spread to more than 213 countries, zones or territories worldwide, and is an emergency of international public health with no antiviral drugs or vaccines; and, also, the presencouragement of the disease has become a global public health emergency. This novel coronavirus is now the seventh member of the coronaviridae family, known for infecting humans and showing evidence of causing gastric symptoms, and has the potential to be transmitted through the fecal-oral route according to a new report published online by physicians at Shanghai Jiao Tong University (Gastroenterology. 2020 March 3. doi: 10.1053/j.gastro. 2020.02.054). Here we identify the efforts to compile and disseminate the COVID-19 epidemiological information on Its potential G.I. Demonstration of news media and social networks, and few newspapers recently published. Physicians should know, how GI manifestation discussed in different publications to suspect CORONA virus infection in that patients who does not have any upper and lower respiratory tract symptom and intervein to discuss the disease severity and duration. It will increase the threshold of suspicion of physician toward Covid-19 disease. [ABSTRACT FROM AUTHOR]

Two hundred of 450 patients, who were on venturi mask and non-rebreathing mask, were shifted from MGPS supply to oxygen concentrators and portable oxygen cylinders. Introduction The coronavirus disease-2019 (COVID-19) first outbreak in India in September 2020 led to hospitals augmenting ventilator numbers and oxygen outlet enabled beds.[[1]] Simultaneous assessment of required increase in the supply of medical oxygen, emergency oxygen manifold, augmenting the storage capacity of liquid medical oxygen (LMO), and capacity of medical gas pipeline system (MGPS) was required.[[2]] The present case scenario highlights the insufficiency of hospital MGPS, consequent to augmentation of ventilator and oxygen outlet enabled beds in hospital. [Extracted from the article]

In December 2019, a severe disease with an unknown aetiology has appeared in a Wuhan City, Hubei province, China. Immediately, it was identified as novel Coronavirus Disease (COVID-19) that has spread globally and also called Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and was characterised in China. As we know the presence of viruses with new genetic diversity in nature, it is unclear from where this virus has evolved and transmitted to humans at the first place. As the outbreak of COVID-19 progresses, epidemiological data is essential to guide situational awareness, and intervention strategies and also immune response in COVID-19. That's why treatments dealing with the immune-pathology of SARS-CoV-2 infection is a major issue for focus now-a-days, while a rapid and well-coordinated immune response represent the first line of defence against the viral infection. Presently, limited data and information is available on the host innate and adaptive immune status of SARS-CoV-2 infected patients. Here, authors described that how the immune system plays the first line of defence against viral infection, and attempt to compile, accumulate and disseminate the immune response information on COVID-19 from the World Health Organisation (WHO), MEDLINE, Embase, Cochrane Library, Centers for Disease Control and Prevention COVID- 19 Research Database and trials registries for the recognition in progress and finished studies, cohort, and from Randomised Controlled Trials (RCTs). [ABSTRACT FROM AUTHOR]

The ongoing COVID-19 pandemic has forced every radiology set-up to evolve and formulate guidelines for day-to-day functioning. The sub-speciality of neuroradiology, both diagnostic and neuro-intervention, forms a very important part of any radiology or 'neuro-care' set-up. The present document is a consensus statement of the Indian Society of Neuroradiology, prepared after reviewing the available data and working experience. It scientifically tries to answer many questions faced by neuroradiologists everyday in practice. It encompasses simple things such as which patients need to be imaged, what precautions are essential, the work-flows, cleaning of radiology equipment, how to carry out neuro-interventions in COVID-suspect patients, and what procedures/tests to avoid, or their alternatives, to minimise the spread of COVID infection both to the patients and health care personnel. As radiology set-ups can be large, every sub-speciality may have certain precautions which will not be covered in general guidelines, and this document tries to answer those for neuroradiologists. Carefully evolved Standards of Operating Procedure (SOPs) and guidelines are the need of the hour to guide in providing uninterrupted and adequate services to the needy without compromising the safety of the specialised work force and facilities involved. [ABSTRACT FROM AUTHOR]

In the middle of COVID-19 crisis in India and the psychological impact on millions of peoples, is it time to reconsider psychiatry training for Indian medical graduate under the new competency-based curriculum? India has one of the highest numbers of medical colleges in the world and also has over a million doctors, including MBBS graduates working at the primary health-care centers who are important pillars for health-care delivery. In a major drawback that also plagued the earlier curriculum, the new competency-based curriculum has not incorporated a single mandatory skill in psychiatry which a medical trainee has to demonstrate to become doctor. Mental health and the COVID-19 pandemic are interlinked in a complex manner. Hence, millions are likely to have mental health consequences. With no skill required in psychiatry as a must for a medical trainee to become an MBBS doctor, the mental health services during or aftermath of a disaster are severely compromised and need urgent reconsideration under the new curriculum. [ABSTRACT FROM AUTHOR]