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Abstract Background The Coronavirus disease 2019 (COVID-19) pandemic increased the utilisation of healthcare services. Such utilization could lead to higher out-of-pocket expenditure (OOPE) and catastrophic health expenditures (CHE). We estimated OOPE and the proportion of households that experienced CHE by conducting a cross-sectional survey of 1200 randomly selected confirmed COVID-19 cases. Methods A cross-sectional survey was conducted by telephonic interviews of 1200 randomly selected COVID-19 patients who tested positive between 1 March and 31 August 2021. We collected household-level information on demographics, income, expenditure, insurance coverage, direct medical and non-medical costs incurred toward COVID-19 management. We estimated the proportion of CHE with a 95% confidence interval. We examined the association of household characteristics; COVID-19 cases, severity, and hospitalisation status with CHE. A multivariable logistic regression analysis was conducted to ascertain the effects of variables of interest on the likelihood that households face CHE due to COVID-19. Results The mean (95%CI) OOPE per household was INR 122,221 (92,744–1,51,698) [US$1,643 (1,247–2,040)]. Among households, 61.7% faced OOPE, and 25.8% experienced CHE due to COVID-19. The odds of facing CHE were high among the households; with a family member over 65 years [OR = 2.89 (2.03–4.12)], with a comorbid individual [OR = 3.38 (2.41–4.75)], in the lowest income quintile [OR = 1.82 (1.12–2.95)], any member visited private hospital [OR = 11.85 (7.68–18.27)]. The odds of having CHE in a household who have received insurance claims [OR = 5.8 (2.81- 11.97)] were high. Households with one and more than one severe COVID-19 increased the risk of CHE by more than two-times and three-times respectively [AOR = 2.67 (1.27–5.58); AOR = 3.18 (1.49–6.81)]. Conclusion COVID-19 severity increases household OOPE and CHE. Strengthening the public healthcare and health insurance with higher health financing is indispensable for financial risk protection of households with severe COVID-19 from CHE.

Background: COVID-19 resulted in loss of human lives owing to respiratory failure caused by dysregulated immune system. Though many treatments are evaluated, the most appropriate is yet to be established. Objective: To determine the safety and efficacy of Siddha add-on therapy in COVID -19 in terms of accelerated recovery, reduced hospital stay & mortality and follow up assessment of post discharge status until 90 days as compared to the Standard Care management. Methods: In a randomized, controlled, single-center, open-label trial conducted on 200 hospitalized COVID-19 patients, they were allocated equally to be treated with add-on Siddha regimen with Standard care or only Standard care. Standard care was in accordance to the Government norms. Recovery was defined as amelioration of symptoms, viral clearance and attaining SpO2 > 94% in room air indicating the derived score of zero on WHO clinical progression scale. The primary and secondary end points were accelerated recovery (≤ 7 days) and mortality comparison between the groups respectively. Also, disease duration, length of hospital stays and laboratory parameters were assessed for safety and efficacy. Patients were followed through for 90 days after admission. Results: In this study the accelerated recovery was 59.0% and 27.0% in treatment and control groups (ITT analyses) (p < 0.001) respectively and Odds for it were four times higher in the treatment group (OR: 3.9; 95% CI: 1.9, 8.0). The estimated median time for recovery in the treatment group was 7 days (95% CI: 6.0, 8.0; p=0.003) and 10 days (95% CI: 8.7, 11.3) in control. Hazard ratio for death in control was 2.3 times that of treatment group. No adverse reactions or alarming laboratory values were observed in response to intervention. In Severe COVID treatment group (n=80), mortality was 15.0% and 39.5% in control (n=81). The COVID stage progression was 65% less in test group. Mortality during treatment and 90 days follow up in Severe COVID patients were 12 (15%) and 35 (43.2%) in treatment and control groups respectively. Conclusion: The selected Siddha regimen when co-administered with Standard of Care have demonstrated that they can synergistically act to improve oxygenation status of patients, enhance the recovery rate from COVID-19 and reduce the mortality better when compared to administration of only Standard of Care. Clinical Trial Registry of India: CTRI/2020/06/025768 Registered on: 09/06/2020.

Background: Kabasura Kudineer (KSK) is a Siddha polyherbal decoction recommended by the Ministry of AYUSH and the Tamil Nadu government to prevent and manage COVID-19 in India. Objective(s): We aimed to determine the outcome of integrated therapy for COVID-19 using KSK in virologic clearance and length of hospital stay. Materials and methods: It was a single-centre, retrospective cohort study. We included the COVID-19 patients admitted to SRM Medical College Hospital and Research Centre, Chennai, during May–June 2020. KSK was administered along with the standard of care for all the patients. We collected data pertaining to demographic, clinical, and laboratory parameters and presented as frequencies and proportions. Results: We collected 204 COVID-19 positive patients’ data. The mean (SD) age was 39.5 (13.4) years with a range of 13–79. Majority of the patients were male (n = 157; 77%), 28% (n = 58) had any co-morbidities, and 61% (n = 131) had mild symptoms. Fever (n = 57; 27.9%) and cough (n = 53; 25.9%) were the commonly reported symptoms. Paracetamol (n = 135; 66.7%) and Zincovit (n = 197, 96.6%) were the commonly administered medicines along with KSK. About 74% of asymptomatic (n = 54) and 65% of mild symptomatic (n = 85) patients turned negative for COVID-19 in RT-PCR within 4–7 days. There was a significant difference in the blood parameters (p < 0.05) after the integrated treatment. Conclusion: The use of KSK with standard care of treatment in COVID-19 treatment had notable results in the duration taken for virologic clearance, thereby reducing the length of hospital stay and improvement in laboratory parameters.

The silver-cheeked toad fish, Lagocephalus scleratus, was recorded for the first time on 25 September 2014. Two specimens of this fish species were collected from the by-catch landed by a commercial deep-sea trawler at Kasimedu Fishing Harbour, Chennai coast, Southeast India. The morphometric and meristic characters of the recorded specimens are described and discussed. The specimen was compared with earlier reports.

Background & objectives: In view of anecdotal reports of sudden unexplained deaths in India's apparently healthy young adults, linking to coronavirus disease 2019 (COVID-19) infection or vaccination, we determined the factors associated with such deaths in individuals aged 18-45 years through a multicentric matched case–control study. Methods: This study was conducted through participation of 47 tertiary care hospitals across India. Cases were apparently healthy individuals aged 18-45 years without any known co-morbidity, who suddenly (<24 h of hospitalization or seen apparently healthy 24 h before death) died of unexplained causes during 1st October 2021-31st March 2023. Four controls were included per case matched for age, gender and neighborhood. We interviewed/perused records to collect data on COVID-19 vaccination/infection and post-COVID-19 conditions, family history of sudden death, smoking, recreational drug use, alcohol frequency and binge drinking and vigorous-intensity physical activity two days before death/interviews. We developed regression models considering COVID-19 vaccination ≤42 days before outcome, any vaccine received anytime and vaccine doses to compute an adjusted matched odds ratio (aOR) with 95 per cent confidence interval (CI). Results: Seven hundred twenty nine cases and 2916 controls were included in the analysis. Receipt of at least one dose of COVID-19 vaccine lowered the odds [aOR (95% CI)] for unexplained sudden death [0.58 (0.37, 0.92)], whereas past COVID-19 hospitalization [3.8 (1.36, 10.61)], family history of sudden death [2.53 (1.52, 4.21)], binge drinking 48 h before death/interview [5.29 (2.57, 10.89)], use of recreational drug/substance [2.92 (1.1, 7.71)] and performing vigorous-intensity physical activity 48 h before death/interview [3.7 (1.36, 10.05)] were positively associated. Two doses lowered the odds of unexplained sudden death [0.51 (0.28, 0.91)], whereas single dose did not. Interpretation & conclusions: COVID-19 vaccination did not increase the risk of unexplained sudden death among young adults in India. Past COVID-19 hospitalization, family history of sudden death and certain lifestyle behaviors increased the likelihood of unexplained sudden death. [ABSTRACT FROM AUTHOR]

Introduction: The Siddha system of medicine (SSM) is one of the Indian Systems of Medicine (ISM). In recent times, it has received adequate support from the Indian Ministry of Ayush. Like many such indigenous systems of medicine globally, the SSM is based on its own theoretical principles, philosophy, and methods of practice. Nevertheless, SSM conducts and needs basic and applied research using scientific methods. Such research is evidenced by research publications. In the absence of a review, we did a bibliometric analysis of research publications from SSM for the period of 1972-2019., Materials and Methods: We used the term "Siddha" to retrieve the data from the PubMed database. We retrieved data from the National AYUSH research portal and homepages of institutions mandated to do research in SSM. We abstracted bibliometric information and used Epi info (Version 7.2) for analysis. We described the trends and key characteristics., Results: Of a total of 2009 retrieved articles, we included 1457 (73%) for analysis. Between 1972 and 2001, the median number of publications per year was three (range: 0-13). Beyond 2012, the publications increased exponentially with an annual growth of 23%. The maximum number of publications ( n = 224) was in 2019. Among 43 countries that produced the papers, India topped it (88%). Of 1457, 1.7% ( n = 25) of publications from Siddha institutions were indexed in PubMed., Conclusion: A bibliometric review of research output from SSM suggests that the publications have increased in the last two decades. The review recommends improving research output from SSM in terms of quantity and quality., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)