Search

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

Background: "CoviSainik Program" was implemented in collaboration with the Ambuja Cement Foundation and Community Medicine Department in rural districts of eight states of India from May to December 2021 to create a cadre of volunteers. The aim of the present paper is to describe the program and evaluate it so that the findings can be the guiding tool for policymakers to replicate a similar program. Material and Method: A cross-sectional, mixed-method – concurrent study design was adopted to evaluate the program for its short-term outcomes such as gain in the basic knowledge of COVID-19 amongst master trainers and their feedback and program output viz – the proportion of volunteers trained and their profile by census sampling. Motivational factors, experiences of volunteers, and outcomes of COVID-19 work in their villages were explored by purposive with maximum diversity sampling with 62 online in-depth interviews and 8 online focus group discussions (FGDs). Results: There was a statistically significant difference in the pre-test (12.8 ± 5.6) and post-test (25.9 ± 9.3) scores of the Master Training Program evaluation test. Out of 6534 trained volunteers, 5901 worked as volunteers, and amongst those, 47.1%, 35.1%, and 17.8% worked for ≤3 months, 3 to 6 months, and ≥6 months, respectively, in their villages. The major themes generated for motivational factors to join the program were altruism, savior nature, generating awareness, and concern for others. The major outcomes generated by trained volunteers COVID-19 vaccination were in raising awareness on COVID-19 appropriate behavior and early identification of COVID-19 cases in their villages. Conclusion: The "CoviSainik Program" was successful in creating cadres of trained volunteers. [ABSTRACT FROM AUTHOR]

Background: Journal of Oral and Maxillofacial Pathology (JOMFP) is a periodical publication and is one of the most prestigious dental specialty journals in India. Aim: To perform bibliometric analysis and network visualisation of articles published in the JOMFP. Methodology: Scopus online bibliometric search of articles published in JOMFP from 2011 (Issue 2, May–August) to 2022 (Issue 2, April–June) was performed. A total of 1385 articles out of 1453 were included for analysis. VOSviewer software was used for science mapping and network analysis of extracted data from JOMFP. Basic steps of bibliometric analysis including performance analysis, science mapping, and network analysis were performed to draw conclusions and recommendations. Results: The annual frequency of articles was maximum in the year 2019 with 150 articles. The most frequently appearing keywords were "oral squamous cell carcinoma" and "immunohistochemistry". The mean count of the top 10 cited articles and authors was 144.6 and 293.2, respectively. Conclusion: More efforts are warranted not only for increasing the volume of quality papers in JOMFP but also to enhance the collaborations between the various authors and research groups. Large volumes of laboratory and clinical-based research have been published in JOMFP from every part of India; thus, this journal truly represents the global face of Indian oral and maxillofacial pathologists. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

The sudden upsurge in the newly emerging COVID-19 variants acted as a catalyst for India to scale up the viral Genomic surveillance in order to understand the nature and trends of the newer variants of concern and strengthen public health interventions across the country. The Government of India has proposed the Indian SARS-CoV-2 Genomics Consortium to expand the whole-genome sequencing (WGS) of this virus. However, in a vast country like India introduction and implementation of any new strategies amidst the already existing barriers due to COVID-19 will be a herculean task. This paper talks about how the primary care physicians can play a vital role in successful implementation of the above strategy in addition to the surveillance systems in India. [ABSTRACT FROM AUTHOR]

A resilient health system necessitates strong governance, political commitment, effective administrative entities and inter-organisational collaboration. This paper examines India's current health policy landscape and explores the analytical and operational capacities required to establish a robust post-pandemic health system using the policy capacity framework described by Wu et al. (2015). We emphasised the need for a coordinated policy response to strengthen health information systems, health service management, human resource management and healthcare financing. The role that the planned implementation of Indian public health management cadres would play in the coming era, the importance of a comprehensive health information management system and the need for operational coordination between government and non-governmental organisations has also been emphasised. [ABSTRACT FROM AUTHOR]

Background and Objective: Coronavirus is spreading across the globe since December 2019. As India's first case was reported on January 30, 2020, the spread of this virus is experiencing by our population. As a result, there are extensive emotional distress and anxiety among populations due to this pandemic. Screening mental health is important for psychological well-being of any individual during this pandemic. The objective of this study was to validate the Coronavirus Anxiety Scale (CAS) in an Indian population. Materials and Methods: The research proposal was laid out before an ethical clearance committee, which approved the conduct of the research and consequent publication of the paper. Data were collected from 246 respondents through online. CAS, developed by Lee (2020), was adopted for the study. Informed consent was given by all the respondents, and their participation was voluntary. AMOS and SPSS were used to calculate confirmatory factor analysis and other statistical analyses. Bartlett's test of sphericity and Kaiser-Meyer-Olkin (KMO) test, and Cronbach's alpha, were also calculated. Convergent validity was calculated through average variance extracted (AVE) and composite reliability (CR) in Microsoft Excel. Results, and Conclusions: Bartlett's test of sphericity was highly significant measuring Chi-square = 494.004, df = 10, and P < 0.001. The KMO was acceptable at 0.805. Fit indices (P < 0.001, Chi-square/df = 3.24, goodness of fit index = 0.976, Tucker-Lewis index = 0.954, and comparative fit index = 0.977) are statistically significant. Cronbach's alpha coefficient (0.822), AVE (0.526), and CR (0.745) were adequate. The overall findings of the analyses demonstrate that the CAS is a reliable and valid scale that evaluates the severity levels of dysfunctional anxiety linked to COVID-19 in an Indian sample. CAS is applicable to measure the level of dysfunctional coronavirus anxiety in the Indian population. [ABSTRACT FROM AUTHOR]

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

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

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

Governments across the globe have responded to the COVID-19 pandemic by imposing restrictions of various magnitudes on citizen activities. The Indian government imposed one of the strictest lockdown among all nations. The lockdown initially meant for 3 weeks has been extended thrice for a total duration of about 10 weeks. During this period, there has been closure of nonessential services. While the government did take certain proactive steps, however much remains to be desired at the ground level. This unprecedented move and other precautionary steps to control the pandemic unearthed numerous psychosocial consequences; however, for this particular paper, we will focus on social challenges such as migration, poverty and hunger, social disconnection, homelessness, and increased screen time arising as a result of government-based measures. Government policies for health-care workers have been only partially successful as there had been numerous incidents of struggles expressed from different corners of the country. Further stigma related to pandemic has had a serious impact on control measures. It remains unclear whether the social changes occurring to combat the crisis are transient or will create a totally transformed society. The true extent of the devastation due to the pandemic will only be clear in the near future. [ABSTRACT FROM AUTHOR]

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

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

The coronavirus disease (COVID-19) disease has shaken the health-care system globally. It has become a global public health emergency for which scientists and physicians are trying to find an answer. This pandemic at present has no answer, as conventional medicine is trying to put their best foot forward by using hydrochloroquinone. Clinical trials are underway to find the efficacy of hydrochloroquinone or to develop any other possible immunization in COVID-19, which leaves us in an uncertain situation. Treating the existing condition remains a challenge in one side whilst containing the spread of this disease remains another challenge. Though nations across the globe have declared lock-downs to prevent community transmission, this is insufficient, looking at the magnitude of the disease. Host friendly interventions from traditional medicine focused on improving immunity and offering mental strength to cope with this pandemic are the need of the hour. Yoga and Naturopathy, a holistic system of medicine under the ministry of AYUSH operates by adapting the principle of salutogenesis can be easily integrated into the existing standard of care in prevention and management. This paper discusses about the possibility and necessity of integrating yoga and naturopathy interventions like fasting, diet therapy, hydrotherapy, sunbath, and yoga therapy based on its evidence in the management of COVID-19. [ABSTRACT FROM AUTHOR]

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

The COVID-19 pandemic has brought with it the huge burden of mortality and morbidity across the world and the added effects of the mandatory lockdown measures to try and control the spread. A number of aspects of healthcare including eye donation and eye collection require adequate safety precautions in place to keep both the involved healthcare workers and patients safe. This paper highlights the consensus-based guidelines by an expert panel on how to restart eye banking and eye collection services and carry out emergency corneal surgeries during this COVID-19 time. These guidelines will be applicable to all eye banks across the country and should help ophthalmologists and eye banking staff to restart eye banking while safeguarding themselves and their patients. [ABSTRACT FROM AUTHOR]

Novel Coronavirus (COVID 19) has usurped human peace and mobility. Since December 2019, the virus has claimed the lives of 87,816 people across the globe as of April 9, 2020 with India reporting a high case fatality of 3.4%. Among the vulnerable population, elderly people, and patients with comorbidities such as diabetes, chronic life-threatening illnesses, such as COPD and advanced malignancies are susceptible to COVID-19 infection and may have poor clinical outcomes. Considering the imbalance in demand and supply of healthcare resources, initiating palliative care will be essential to alleviate the suffering of such patients. The current paper deliberates on the following aspects of palliative care delivery in the community; the need for palliative care in a pandemic crisis, the role of telemedicine in palliative care delivery in the community, the vital role of a family physician in providing primary palliative care in the community and a "wholistic" community palliative care package to serve the needy in the community. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has forced substantial changes in the practice of psychiatry, including that of electroconvulsive therapy (ECT). There is higher risk of transmission of the SARS-CoV-2 virus during ECT unless due care is taken. However, in many cases, ECT cannot be avoided. In this paper, we discuss various measures that may be adapted to reduce the risk of transmission of the virus during ECT. We also suggest certain modifications to the practice of ECT in order to achieve a balance between risks and benefits of the procedure during the pandemic. [ABSTRACT FROM AUTHOR]

Yoga tourism is an emerging market in India, with a great economic potential to boost revenue in the wellness travel and hospitality industries. Millions of tourists from foreign countries visit India each year to explore the history, philosophy, practice, and experiences of Yoga as the art originated there. However, little is known in the scientific literature on the Yoga-linked tourism and hospitality subject. Besides, how the enduring COVID-19 pandemic impacts the emerging Yoga tourism and hospitality sector in India is not fully understood. This article highlights the less-known aspects of India's Yoga tourism and hospitality and how the continuing COVID-19 pandemic impacts the business. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has become a global pandemic, prompting lockdowns in practically every country. To prevent the spread of the disease, India has enforced a rigorous nationwide lockdown that commenced in March 2020. The lockdown imposed amid the pandemic ensured that most commercial activities and vehicle transportation ceased, resulting in a significant reduction in air pollution levels. Material and Methods: The value of air pollutants PM10, PM2.5, NO2, and SO2 from January to May 2020 was obtained from the Indian Central Pollution Control Board. Before lockdown and during lockdown, relative fluctuations in ambient concentrations of four air contaminants were investigated. The Box-Jenkins approach was used to estimate future air pollution data points using time series data analysis. Results: The PM10 level reduced by 61%, 30%, 68%, 37%, and 43% in the selected cities, respectively. Comparison of other pollutant concentrations before and after the lockdown also found a reduction in ambient pollutant concentrations, resulting in improved air quality. Inference of predicted model values to observed values revealed a significant increase in the concentrations of all pollutants. The percentage increases in AQImean from predicted to observed values were 206% in Ghaziabad, 148% in Delhi, 59% in Hyderabad, and 160% in Cochin. Conclusion: The strict lockdown has resulted in a significant drop in air pollutant levels. Upgrading present technologies could help keep pollution to a minimum of 37% under control. The findings would prompt the government to consider how to strictly reduce vehicle and industrial pollution to improve air quality and maintain improved public health. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) affects not only individual’s physical health but also their well-being and makes them vulnerable in different ways. Post-COVID-19 depression is dependent on the dynamic interaction between social, medical, economic, geographical, and political factors determining the availability, vulnerability, and distribution of pandemic outbreaks that create fear apprehension and instability among the population. Aim: To evaluate the level of depression (pre and post) and the management of depression among patients from Western Uttar Pradesh of Northern India after the pandemic of COVID-19. Materials and Methods: It was a longitudinal study involving a total of 156 patients with depression. Through chit randomization methods, patients are allocated into two groups, that is, experimental (n=92) and control (n=64). Both groups received appropriate pharmacotherapy. The experimental group in addition also underwent eight therapeutic sessions of cognitive behavior therapy (CBT) (relaxation breathing exercise, activity scheduling, and cognitive restructuring). The period of study was from July 2021 to January 2022. Depression was assessed by applying the Beck Depression Inventory (BDI-II) pre- and post-intervention. Results: According to BDI II, 59.78% of patients report severe levels, 25% of patients report moderate levels, and 15.21% report mild levels of depression. Patients who received medications plus CBT showed significantly better improvement than the patients who received only medications. Conclusion: Patients with post-COVID-19 depression showed better improvement with medications plus CBT than medications alone. The finding of this study underline the importance of CBT in the treatment of depression. [ABSTRACT FROM AUTHOR]

Background: The Indian government launched national teleconsultation services (eSanjeevani OPD) to provide safe doctor-to-patient consultations. This study aimed to determine the awareness and willingness to seek services from eSanjeevani OPDs. Material and Methods: This is a cross-sectional descriptive study conducted in Nandigudi village, Karnataka. The total sample size was 273, and participants were recruited using a systematic sampling technique. Results: The prevalence of awareness about teleconsultations was 2.2% (n = 6, 95% CI: 0.8–4.7%). None of the participants utilized eSanjeevani services in the last year. Approximately 56.0% (n = 153, 95% CI: 49.9–62.0%) were willing to use eSanjeevani OPD. "Not being familiar" (n = 99, 82.5%) with eSanjeevani OPD was the major reason for unwillingness to use teleconsultation, and 73.8% (n = 113) preferred video calls as the mode of communication. Conclusion: The majority of the participants were not aware of and were unwilling to use eSanjeevani OPD. Therefore, healthcare professionals should focus more on creating awareness of teleconsultations. [ABSTRACT FROM AUTHOR]

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

Background: Association between the ABO blood group and patient outcomes in COVID-19 patients is still unexplored. A known association may help to understand possible risks in advance to the management of such COVID-19 patients. The present study was designed to test such association if there is any, between the ABO blood group and the severity of COVID-19 patients. Methods: The present hospital-based observational study was conducted at a COVID-19 dedicated tertiary care hospital in North India over a period of six months during the first wave of the pandemic in the country. Five hundred consecutive patients, who tested positive for COVID-19 using RT-PCR on oropharyngeal/nasopharyngeal swabs, admitted to the hospital were included in the study. ABO and Rhesus (Rh) blood grouping was done on leftover hematology blood samples using gel column agglutination technology. Required clinical details of patients including age, gender, clinical symptoms, comorbidities, outcomes, etc., were obtained from the patient’s case sheets. Results: The most common blood group was ‘B’ (42.8%) followed by ‘O’ (23.4%), and ‘A’ (22.4%) while the least common was ‘AB’ (11.4%). Rh positive was seen in 96.2% while 3.8% were negative. Baseline characteristics were comparable including length of hospital stay, duration of symptoms, and associated comorbid illnesses. The need for intensive care unit (ICU) admissions (P = 0.05) and intubations (P = 0.20) was similar across all four blood groups. Differences in the severity of COVID-19 disease and mortalities among the groups were non-significant. Conclusion: There was no observed association found between the ABO blood group and COVID-19 infection requiring hospitalization, ICU admission, intubation, and outcomes. However, there was a higher proportion of breathlessness and the presence of at least one comorbidity in blood group O as compared to others. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 pandemic caused a huge impact on the healthcare system worldwide. With a spectrum of outcome ranging from mild symptoms to mortality, the experiences of patients admitted in isolation wards have not been documented. Objective: To explore the experience of COVID-19 patients during hospitalization during the early phase of pandemic. Materials and Methods: A qualitative study using in-depth interviews was conducted among 30 COVID positive patients admitted in COVID wards of a private medical college in Coimbatore, South India between May and June 2020. Qualitative data analysis was done using the seven steps of Colaizzi's descriptive phenomenological method. Results: The experiences of COVID-19 patients during their hospitalization were categorized into three themes. Firstly, their initial reaction to being diagnosed positive for COVID-19. Secondly, experience during hospitalization with regards to their mental health, treatment providers, caregivers (family and relatives) and other COVID patients admitted in the same ward. Lastly, perceived change in their quality of life after discharge. Conclusion: The study highlights that the psychological experiences of COVID-19 patients admitted to the hospital were heterogeneous. Therefore, primary care physicians should provide individualized psychological interventions based on the needs. Since many expressed fear on diagnosis and stigma of the disease, hence policy makers and health care providers should plan intervention for control and treatment without causing stigma to patients and their families. [ABSTRACT FROM AUTHOR]

Introduction: Multimorbidity is the coexistence of two or more chronic medical conditions in a person. The study aims to investigate the immediate cause of death and risk factors of mortality including multimorbidity among patients hospitalized with SARS CoV2 infection in Kasaragod district in Kerala, India. Methods: A record-based case-control study was done using the hospital records and follow-up surveillance system of SARS-COV 2 patients admitted in the Kasaragod district. SARS-COV 2 patients who had expired during the study period from June to December 2020 and reported as COVID-19 deaths (N = 226) were the cases, and an equal number of hospital controls were the study participants. Results: The mean (SD) age of the cases and controls were found to be 64.6 (14.2) years and 61.5 (13.4) years, respectively. Covid pneumonia alone was reported as the cause of death in more than half (52%) of the study participants. This was followed by cardiovascular events (8.5%) and acute kidney injury (6.5%). Among individual comorbidities among people who expired, diabetes mellitus (53%) was the most common, followed by hypertension (46%) and cardiovascular diseases (23%). More than 50% were found to have multimorbidity. Logistic regression showed chronic kidney disease (CKD) (Adjusted odds ratio (AOR) = 2.18 (1.24-3.83)) and malignancy (AOR = 3.05 (1.27-7.32)) to be significantly associated with mortality as individual determinants. Hypertension--diabetes mellitus [AOR = 1.68 (1.02-2.76), P = 0.043] and hypertension--CKD [AOR = 3.49 (1.01-12.01), P = 0.48] dyads were multimorbidities significantly associated with mortality. Conclusion: Combinations of hypertension with diabetes mellitus and CKD were found to be significant determinants for mortality in hospitalized COVID-19 patients. Uniformity in death certification is required to understand the causes and contributors to death in COVID-19. [ABSTRACT FROM AUTHOR]