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Introduction: The second wave of SAR Cov-2 Infection brought a new menace that was the escalation in the number of mucormycosis, which is a potentially life-threatening, opportunistic, invasive, fungal infection commonly called the "Black fungus". Objective: To find out the factors responsible for occurrence of mucormycosis and the pattern that have emerged in the Post SARS - CoV-19 infected cases admitted in tertiary care hospital of Central India. Material and methods: This descriptive Cross-sectional study was conducted in Government Netaji Subhash Chandra Bose Medical college and hospital of Central India from May 2021 to June 2021. 96 Confirmed cases of mucormycosis were included in this study. The details about Demographical, Epidemiological, clinical data were retrieved by us through interview with patient or his relative and by going through the case sheets of the cases. Results: The mean age for the mucormycosis was among male is 52.68 ±11.13 years and among female it is 47.47±10.07years. 78% of study subjects were hospitalized for treatment while 22% received treatment at home. 72.40% had steroid intake, Mean duration of steroid therapy was 10.15±5.71 days. Mean duration between steroid therapy and appearance of mucormycosis as 14.21±9.1 while mean duration between Covid infection and mucor mycosis was found to be 19.71±9.84 days. Conclusion: Immunosuppression during Covid -19 treatment had catalyst effect on the development of mucormycosis. Early diagnosis and careful monitoring of immuno-compromised individuals is essential. Steroid and other immune- suppressive drugs should be given cautiously. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has transformed consumer buying behavior across the world. COVID-19 crisis brought a behavioral change in consumers' attitudes toward health, financial and social well-being. The current research work highlights the factors influencing consumer buying behavior during the COVID-19 pandemic considering saving and safety perspectives. Design/methodology/approach: This study attempts to understand the gap in buying behavior with reference to saving and safety. Survey-based study was conducted during the second phase of COVID-19, and the respondents were those who lived in highly affected COVID cities in India. Exploratory factor analysis and multiple regression analysis were carried out for testing the hypotheses. Findings: Seven factors became the prominent factors in consumer buying patterns during the pandemic. Consumers in the times of COVID-19 pandemic spend only on essential items as compared to nice-to-have and non-essential items. Research limitations/implications: Respondents considered in the research were millennials aged 25–40. The current research is limited to specific geographic location. Practical implications: The study assessed how savings and safety influence consumer buying behavior. The 2S framework model for consumer buying behavior during pandemic has been developed. The findings of the study provides a road map to the companies, policy makers, managers and consumers in understanding the consumer buying behavior during pandemic. Originality/value: The current research work observe the changes in the behavioral patterns of consumers in the context of 2S framework, i.e. saving and safety. This study offer novel contribution as there is no available literature that examined the saving and safety aspects together for consumer buying behavior during crisis. [ABSTRACT FROM AUTHOR]

The de-focalisation of reporting and the focalisation of post-truth ideology is antithetical to the tenets of democracy. It reverts to the traditional centralised propagation of one truth, one reality, and one perspective while contracting, negating, or antagonising the possibility of alternative and parallel narratives. The right wing has created a narrative of suspicion, which is based on the conviction that anything deviating from the traditional cultural patterns is a contamination of the ethos of one's own native values, a deviation from the nativity, and hence an influence that needs to be disposed of. The ongoing Covid pandemic has magnified the narrative of post-truth through the use of sensationalism as an effective modus operandi. The blinding of the truth is rampant as news outlets are being guarded by right-wing gatekeepers and sensationalism is used to reflect the surging emotions of a public already gripped by a precarious reality. This paper examines the three primary and seemingly independent threats to democracy during the pandemic in India: de-focalisation of reporting, coerced homogeneity based on religion and language, and sensationalism. It addresses the question of how adversity is turned into a breeding ground for demagoguery. [ABSTRACT FROM AUTHOR]

Purpose: With the advent of the COVID-19 and increased access to Internet technologies, students tend to use e-learning technologies for improved academic results, and since then, improving student engagement in a virtual space became a difficult task for educational institutions globally. The present study aims to examine the effect of key e-learning factors (i.e. perception, hedonic motivation (HM), usefulness, empowerment and attitude) on student engagement among open and distance learners (ODLs) of the central region of India. Design/methodology/approach: Simple random sampling was applied to collect data from ODLs of Chhattisgarh. ODLs who are using e-learning platforms for at least one year were chosen to be the participant in the study. The authors collected 1,137 responses using both online and offline modes of collection. Findings: The test results indicated that usefulness, HM and attitude factors were found to have a significant relationship with student engagement in e-learning, while perception and empowerment variables did not contribute to the engagement of students. Originality/value: The present study is novel in its approach. It clarifies the key factors to student engagement which might increase the students' level of involvement in e-learning technologies, if these factors are addressed tactfully by the educational institutions or concerned administration. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mucormycosis is a rare but serious fungal infection which has dramatically increased in post-COVID patients. There is a paucity of safety data on amphotericin B (amphoB) used for mucormycosis treatment. OBJECTIVES: The objective of this prospective, observational, active safety surveillance study was to evaluate the safety profile of amphoB in a cohort of hospitalized patients who were on the drug for suspected mucormycosis. MATERIALS AND METHODS: All suspected adverse drug reactions (ADRs) in hospitalized mucormycosis patients who had received amphoB were analyzed. The nature, severity, outcome of the ADRs were recorded and analyzed. RESULTS: Of the 77 patients enrolled, 70% had documented history of prior COVID-19 infection. 96% had comorbidities, the most common being diabetes. Majority received conventional amphotericin B deoxycholate formulation. 97% experienced at least one suspected ADR and the median ADR/patient was 3. Out of 214 ADRs, 91 were serious but there were no ADR-related deaths. The most common ADRs were hypokalemia (31.78%), infusion-related reactions (22.43%), and anemia (17.29%). Thirty-three patients had serum potassium <2.5 mEq/L, while 11 had serum magnesium <1.25 mg/dL. Doubling of pretreatment creatinine level was noted in 15 patients. Seventy percent ADRs were of "possible" category as per the World Health Organization Uppsala Monitoring Centre categorization. CONCLUSION: AmphoB deoxycholate use in mucormycosis patients was associated with a high incidence of electrolyte abnormalities and infusion-related reactions. All ADRs subsided with medical management and none were fatal. The safety data generated from this study may be useful in resource-limited settings where the far more expensive liposomal formulation is not being used. [ABSTRACT FROM AUTHOR]

Background: COVID-19 mediated immune dysregulation and cytokine storm can precipitate and aggravate Moyamoya angiopathy (MMA), influencing its disease course. This index study was undertaken to prospectively evaluate the status of neurological symptoms of MMA in relation to COVID-19 affection. Methodology and results: Follow-up MMA patients of institute's Stroke-clinic were telephonically interview from 24th March to 30th September, 2020. The first call familiarized them with COVID-19 symptoms and neurological manifestations of MMA, followed by monthly-calls with predesigned questionnaire. Patients with suggestion of COVID-19 underwent nasopharyngeal-swab-testing for COVID-19 Reverse transcription-polymerase chain reaction (RT-PCR) positive cases were subjected to antibody levels for COVID-19 Enzyme-linked immunoassay (ELISA) 8–12 weeks after recovery. During symptomatic phase till 14 days of asymptomatic, they were contacted daily/alternate day. Any new onset/worsening of neurological symptoms were noted. The baseline clinico-radiological details were obtained from stroke-clinic registery. Subsequently, all data were analyzed and compared using descriptive statistics. Seventy four of 104 MMA patients could be contacted and enrolled. The mean age, time since last follow-up and compliance to previously prescribed medication were 23.5 ± 16.1 years, 9.2 ± 1.7 months and 90.5% (n = 67), respectively. Aggravation/new onset neurological symptom were seen in 64.3% (n = 9) of COVID-19 positive MMA (n = 14), of which 8 were seen among the 11 pediatric COVID-19 positive MMA [(Transient ischemic attacks) TIA-4, TIA with headache-1, seizure-2, stroke causing mortality-1]. Conclusion: COVID-19 infection can potentiate MMA causing significant morbidity and mortality, especially in children. Providing optimal care for severe diseases (such as MMA) in developing countries during pandemic remains a challenge. [ABSTRACT FROM AUTHOR]

The microfinance sector has played a vital role in economic development and financial inclusion in India. However, with the COVID-19 pandemic affecting economic activities, microfinance institutions (MFIs) were impacted adversely. The Government of India introduced a moratorium to borrowers for loan repayments. This study examines the impact of the government's initiative of easing borrowers' financial burdens and the number of active COVID-19 cases on the operational efficiency of MFIs in Indian states. Additionally, the analysis explores the macro-economic determinants of MFI performance. The study incorporates the random effects robust regression model. The findings suggest that interest rate and inflation impact every MFI performance criterion while national income only affects the loan penetration efficiency of MFIs. It is also found that the moratorium significantly helped borrowers, whereas, it had adverse effects on the loan penetration by MFIs. Lastly, it is shown that MFIs remained resilient to COVID-19 cases, except in the case of reduced number of borrowers. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has triggered a large number of publications to inform, understand, conduct more research and control the situation. Although the researchers are analyzing the bibliometrics on this condition, no bibliometric studies are available on the publications related to post-covid mucormycosis. This study is aimed at bibliometric assessment of the publications related to post-covid mucormycosis. Methods: In the presented study, authors have performed the bibliometric analysis of the World health organization (WHO) database named ‘Global literature on coronavirus disease.’ WHO is maintaining this database since the pandemic, and it contains thousands of reports. Two simple search terms, ‘Covid’ and ‘mucormycosis’ used to search the entire database in ‘title, abstract, subject’ mode with the search string was tw:(mucormycosis covid). The search was not restricted to any date range. Results: Only 51 reports (40 articles and 01 clinical trials) were obtained with the above search terms. The study found that there is considerable growth in such publication in the last 6 months. Interestingly only three such reports were published in the year 2020. Database wise 38 of these 51 reports were available in Medline. Most of such reports were published by Indian authors. Indian Journal of Ophthalmology emerged as the most productive journal contributing the highest number (10) of these reports. Conclusions: The highly acclaimed publications were the reviews. This study suggests that India is the most productive country for publications related to post-covid mucormycosis. This resembles the fact that the country, faced the excessive emergence of post-covid-19 mucormycosis cases reported the secondhighest number of Covid 19 cases in the substantial worldwide outbreak in the second wave, which is followed by post covid mucormycosis. [ABSTRACT FROM AUTHOR]

COVID-19 has emerged as global pandemic with largest damage to the public health, economy and human psyche.The genome sequence data obtained during the ongoing pandemic are valuable to understand the virus evolutionary patterns and spread across the globe. Increased availability of genome information of circulating SARS-CoV-2 strains in India will enable the scientific community to understand the emergence of new variants and their impact on human health. The first case of COVID-19 was detected in Chambal region of Madhya Pradesh state in mid of March 2020 followed by multiple introduction events and expansion of cases within next three months. More than 5000 COVID-19 suspected samples referred to Defence Research and Development Establishment, Gwalior, Madhya Pradesh were analyzed during the nation -wide lockdown and unlock period. A total of 136 cases were found positive over a span of three months that included virus introduction to the region and its further spread. Whole genome sequences employing Oxford nanopore technology were generated for 26 SARS-CoV-2 circulating in 10 different districts in Madhya Pradesh state of India. This period witnessed index cases with multiple travel histories responsible for introduction of COVID-19 followed by remarkable expansion of virus. The genome wide substitutions including in important viral proteins were identified. The detailed phylogenetic analysis revealed the circulating SARS-CoV-2 clustered in multiple clades including A2a, A4 and B. The cluster-wise segregation was observed, suggesting multiple introduction links and subsequent evolution of virus in the region. This is the first comprehensive whole genome sequence analysis from central India, which revealed the emergence and evolution of SARS-CoV-2 during thenation-wide lockdown and unlock. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 infections and deaths have largely been uneven within and between countries. With 17% of the world's population, India has so far had 13% of global COVID-19 infections and 8.5% of deaths. Maharashtra accounting for 9% of India's population, is the worst affected state, with 19% of infections and 33% of total deaths in the country until 23rd December 2020. Though a number of studies have examined the vulnerability to and spread of COVID-19 and its effect on mortality, no attempt has been made to understand its impact on mortality in the states of India.Method: Using data from multiple sources and under the assumption that COVID-19 deaths are additional deaths in the population, this paper examined the impact of the disease on premature mortality, loss of life expectancy, years of potential life lost (YPLL), and disability-adjusted life years (DALY) in Maharashtra. Descriptive statistics, a set of abridged life tables, YPLL, and DALY were used in the analysis. Estimates of mortality indices were compared pre- and during COVID-19.Result: COVID-19 attributable deaths account for 5.3% of total deaths in the state and have reduced the life expectancy at birth by 0.8 years, from 73.2 years in the pre-COVID-19 period to 72.4 years by the end of 2020. If COVID-19 attributable deaths increase to 10% of total deaths, life expectancy at birth will likely reduce by 1.4 years. The probability of death in 20-64 years of age (the prime working-age group) has increased from 0.15 to 0.16 due to COVID-19. There has been 1.06 million additional loss of years (YPLL) in the state, and DALY due to COVID-19 has been estimated to be 6 per thousand.Conclusion: COVID-19 has increased premature mortality, YPLL, and DALY and has reduced life expectancy at every age in Maharashtra. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 pandemic has been a curse for cancer patients. The lack of understanding and unawareness in handling cancer patients during this pandemic has worsened their conditions. To analyze the real-world scenario, we studied 13 patients who were given immunotherapy during this COVID pandemic era and tried to analyze their outcome or any serious adverse effect that they suffered. This was a pilot study which would pave the way for further bigger studies in future. The aim of the study was to collect the details of patient receiving immunotherapy during COVID-19 pandemic. The data collected included the diagnosis, certain investigations, and the effects of the immunotherapy drugs and its side effects. Results: During this COVID pandemic period starting from March 20 to June 20, we have been regularly giving immunotherapy drugs such as nivolumab, pembrolizumab, and atezolizumab to our patients. We had given six patients nivolumab, six patients pembrolizumab, and one patient atezolizumab. Of the 13 patients who continued to receive immunotherapy in COVID pandemic era, 4 patients were receiving immunotherapy for lung cancer, 3 for head-and-neck malignancy, 2 for relapse lymphoma, and 1 each for hepatocellular carcinoma, renal cell cancer, malignant melanoma, and soft-tissue cancer. One of the patients receiving atezolizumab had actually progressed after receiving pembrolizumab. There was no Grade 3 or 4 toxicity to these drugs and most of our patients continued to be in stable disease/partial remission. One patient had died just after receiving one cycle of nivolumab. Conclusion: COVID-19 infection has posed an unforeseen predicament both for the patients and the treating oncologist. In absence of any previous data, it is very difficult to manage cancer patients where the treatment itself is thought to harm the patients. This is a humble effort to bring to the notice of the world that immunotherapy can be continued during COVID pandemic, provided we take all due precautions. [ABSTRACT FROM AUTHOR]

The current global pandemic caused by COVID-19 has brought about an immense effect on the mental health of the general public. Considering the escalation in number of cases, mankind is facing a myriad of psychological problems, ranging from those related to taking precautions and maintaining safety to the ones caused by separation and bereavement. The current study aims to explore whether there is a significant difference between individuals with excellent, good, fair and vague knowledge of COVID-19 with respect to depression, anxiety, stress, level of mindfulness, specific cognitive emotion regulation strategies and psychological flexibility; to find out whether there is any significant relationship among these variables; and to determine whether knowledge of COVID-19, level of mindfulness, specific cognitive emotion regulation strategies and psychological flexibility are significant predictors of depression, anxiety and stress in the sample of the current study. The sample consisted of 402 individuals selected from the community following the research criteria. Data was collected using digital consent form, information schedule and questionnaires, from 3rd May to 13th May, 2020. The questionnaires consisted of a semi-structured interview schedule to assess knowledge of COVID-19, Depression, Anxiety and Stress Scale – 21, Five Facet Mindfulness Questionnaire-Short Form, Cognitive Emotion Regulation Questionnaire-Short version and Acceptance and Action Questionnaire-II. The data was statistically analyzed using analysis of variance test, correlational analysis and linear regression. The findings show that significant differences were present among individuals having varying degrees of knowledge of COVID-19 with respect to anxiety, level of mindfulness and psychological flexibility. Significant relationships were found to be present among the variables of the present study, having differing trends brought forward by the COVID-19 crisis. Certain socio-demographic characteristics and study variables were found to significantly predict the existing levels of depression, anxiety and stress in the current sample. The study suggests the necessity to formulate and implement appropriate mindfulness-based therapeutic interventions to address the mental health concerns arising as a result of the pandemic. [ABSTRACT FROM AUTHOR]

With an increasing number of COVID-19 cases and a lack of definitive treatment, there is an increasing burden on already stressed health care sector in India.The patients that require medical and surgical intervention need to be triaged and provided with adequate treatment. India has a major chunk of head and neck malignancy in the world attributable to tobacco use. These patients when diagnosed early have a fair survival rate. Health personals bear the responsibility to provide early and adequate treatment to these patients and at the same time, need to follow all measures to contain the spread of the virus. The present review highlights the various issues and newer guidelines in the management of head and neck malignancy patients during the COVID pandemic. The current review aims to present a comprehensive outlook of the updated evidence base available from PUBMED and other search engines. In India, treatment of head and neck malignancy patients are severely affected at this time of COVID-19, due to the long waiting period, delayed diagnosis, limited dedicated centres for head and neck cancer.The pandemic had diverted resources and manpower leading to potentially poor outcome of the head and neck malignancy patients. Triage policy, safety precautions for health care staff is the need of the hour and should be imbibed in regular practice. [ABSTRACT FROM AUTHOR]

Background: In a historic move to ensure comprehensive abortion care, India amended the 1971 Medical Termination of Pregnancy (MTP) Act in 2021, creating an unprecedented opportunity for accelerating safe, respectful, and rights‐based abortion services. The Federation of Obstetric and Gynecological Societies of India (FOGSI), together with World Health Organization (WHO) India and the Ministry of Health and Family Welfare, set up a flagship initiative "Respectful Abortion Care" (RAC) to provide training to obstetricians and gynecologists on the new Act, and also address their values and biases. Methods: Virtual training sessions were organized during the COVID‐19 pandemic to disseminate the amendments made under the MTP Act and address provider values and biases. The primary focus was on private providers as they account for more than half of all abortion services in India (52.9%). The RAC modules were systematically designed and delivered by 690 Master Trainers, trained by FOGSI and WHO. Results: A total of 9051 FOGSI members (22%, with 50% from private clinics) completed the RAC trainings. Pretests and post‐tests were conducted for impact assessment. Significant improvement was seen on knowledge of criteria for termination of pregnancy for significant birth defects (52%–83%). The post‐training survey showed a high level of commitment to promote RAC: >95% were strongly motivated to perform or assist in abortion; 89% reported that the WHO value clarification exercises were helpful in facilitating open discussions on sensitive topics in a comfortable manner; 96% expressed a strong commitment to addressing the issue of respect and confidentiality in abortion care. Conclusion: RAC was a unique initiative around the MTP Act amendment 2021 in India, which demonstrated that collaboration and leadership by professional associations can help motivate providers and lead to improved knowledge and commitment from public and private sector providers. Synopsis: Large‐scale virtual training led to improved knowledge on the new Medical Termination of Pregnancy Act (amendment) 2021, while addressing providers' values and bias to provide respectful abortion care. [ABSTRACT FROM AUTHOR]

When on March 24, 2020 the Government of India ordered a complete lockdown of the country as a response to the COVID-19 pandemic, it had serious unwanted implications for farmers and the supply chains for agricultural produce. This was magnified by the fact that, as typically in developing countries, India's economy is strongly based on farming, industrialization of its agricultural systems being only modest. This paper reports on the various consequences of the COVID-19 lockdown for farming systems in India, including the economy, taking into account the associated emergency responses of state and national governments. Combining quantitative and qualitative sources of information with a focus on the Indian state of Uttar Pradesh, including expert elicitation and a survey of farmers, the paper identifies and analyzes the different factors that contributed to the severe disruption of farming systems and the agricultural sector as a whole following the lockdown. Among other issues, our study finds that the lack of migrant labor in some regions and a surplus of workers in others greatly affected the April harvest, leading to a decline in agricultural wages in some communities and an increase in others, as well as to critical losses of produce. Moreover, the partial closure of rural markets and procurement options, combined with the insufficient supply of products, led to shortages of food supplies and dramatically increased prices, which particularly affected urban dwellers and the poor. We argue that the lessons learned from the COVID-19 crisis could fuel the development of new sustainable agro-policies and decision-making in response not only to future pandemics but also to the sustainable development of agricultural systems in India and in developing countries in general. • The lockdown in response to COVID-19 has seriously disrupted Indian farms. • Farms have been less profitable amid rising food prices, putting pressure on food security. • A lack of migrant labor has led to a loss of produce and affected the spring harvest. • Experience and relief packages may help to develop Indian agriculture sustainably. [ABSTRACT FROM AUTHOR]