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The SARS-CoV-2 virus is still mutating since the pandemic and producing Variant of Concern (VOCs). Genome sequencing revealed the recent strain B.1.1.529 (Omicron) in Botswana, South Africa. WHO’s Technical Advisory Group on Virus Evolution (TAG-VE) declared Omicron a VOC on November 26, 2021. [1, 2] As we have learned from the earlier variants that vaccination reduces the disease severity, we are more concerned about the children, as they are not vaccinated. 79,592 children in the U.S. below five years had a first infection, including 7,201 in late December 2021 and early January 2022 when Omicron emerged and was responsible for 90% of cases. A recent report shows that affected children in the Omicron surge had a 29% reduced risk of visiting the emergency, 67% drop in hospital admission, 68% lower risk of needing intensive care, and a 71% less risk for mechanical breathing. Black and Hispanic children are susceptible for both Omicron and Delta below five years age group had higher infection rates. [3] A dramatic increase in infections by the contagious Omicron variant in the community was reported from the middle of November 2021 in South Africa. Tshwane District first observed a sharp rise in paediatric COVID-19-associated hospitalisations. Data from October 31 to December 11, 2021, showed that amongst 6,287 (≤19 years) paediatric COVID-19 cases reported from Tshwane District, 7.2% of them were hospitalized. The number of paediatric patients is raised compared to the earlier three waves of COVID-19. A vast majority of the hospitalization cases (76%) were ≤13 years, where 0-4 years was 62%. Fever (47%), cough (40%), vomiting (24%), difficulty breathing (23%), diarrhoea (20%) and, convulsions (20%) were major symptoms, with a short hospital stay (mean 3.2 days). Only one-fourth received oxygen therapy; four died due to underlying co-morbidities. Interestingly, most of the infected children and their parents were unvaccinated. [4] Now the million-dollar question is how to protect the children from the Omicron variant? 1. Parents should vaccinate themselves along with the child if they’re in eligible age group If children are not eligible for vaccination because of lower age, vaccination of the parents will protect the child. Pfizer-BioNTech is currently experimenting on a new version of the COVID-19 vaccine for the Omicron variant, expected to be ready in March 2022. 2. Wearing masks in public children older than two years should wear masks (KF94, N95, and KN95 masks) in residence around outsiders and public places. Clothed masks with layers may also be helpful. 3. Practice good hand hygiene After visiting public places, the family should practice thorough handwashing with soap and water for at least 20 seconds or sanitizing hands. 4. Social distancing must be maintained strictly if the child is not eligible for vaccination. 5. COVID-19 tests are recommended before family and relatives get together 6. Avoid nonessential travel with the child. [5] The Omicron variant is more contagious, spreading faster, but reduced hospitalization risk than the Delta variant is a relief for the parents. Vaccination to the child is strongly recommended [6] according to the rules and regulations of the Government. Profound research and constant monitoring may further unveil the Omicron variant's long-term impact on children. Regards, Dr. Bedanta Roy, Ph.D. Associate Professor, Department of Physiology, Faculty of Medicine, QIU Editor-in-Chief, Quest International Journal of Medical and Health Sciences Prof. Dato' Dr. Sellaiah S. Pillay, AMP; DPMP MBBS; M.MED RADIOLOGY; FAMM Dean & Consultant Radiologist, Faculty of Medicine, QIU Co-Editor-in-Chief, Quest International Journal of Medical and Health Sciences

Meat is an important protein source for humans obtained from slaughtering a living animal. Rearing an animal requires land, water, and other resources, which is challenging to feed the growing population in the world. Therefore, lab-grown meat is one of the optional replacements for farmed animal meat production. Tissue engineering-based cellular agriculture is adopted for production, where bioreactors are used for the cellular harvest. Ample beneficial aspects bring cultured meat to the frontline in the food industry. Cell-based meats are environment friendly in the context of greenhouse gas production, less prone to contamination of infectious pathogens compared with livestock animals. The nutritional content of cultured meat can be regulated, which made it unique. There are disadvantageous aspects too. Cell-based meat is expected to consume higher energy and produce more carbon dioxide than potent methane, impacting the environment. There are ethical questions and religious issues raised by the communities to use Bovine foetal blood as a cultured ingredient. Effects of growth factors are required to observe the long-term effect on humans. Lab-grown meat may be a game-changer for the growing demand for meat. Still, several challenges such as financial, environmental, cultural, and health-related effects need to be considered before large-scale production

Mucormycosis, earlier known as zygomycosis, is a rare fatal fungal infection with a high mortality rate (46–96%). A group of ubiquitous environmental moulds called mucormycetes is the causative organism, which is commonly present in the soil and decomposing organic substances. [1] Mucormycosis mainly affects the uncontrolled diabetic persons or cancer patients undergoing immunosuppressive chemotherapy and those treated with corticosteroids. In the affected individuals, spores germinate into hyphae, spreading at the tissue level, which includes blood vessels causing hemorrhagic infarction. Mucormycosis is commonly known as “black fungus” because of the dark colour of the affected necrotic tissue in the victim. This is an opportunistic fungal infection which rapidly spreads to the sinus, eyes, lungs, brain, nerves and other body tissues including the skin. Late diagnosis, delay in medical and surgical intervention causes a high fatality. [2] Common signs and symptoms are sinus pain, ocular pain, headache, toothache, one-sided nasal congestion and swelling or numbness. Loss of eyelid, blindness and blurred vision has also been reported. [3] Clinical syndromes associated with mucormycosis Rhino-orbito-cerebral and pulmonary mucormycosis are the commonly found clinical syndromes. The rhino-orbito-cerebral forms start from the sinuses spreading in the associated tissues, resulting in facial deformity, cranial nerve palsies, loss of sight, and invade the central nervous system. Early detection is vital to save the life. Unfortunately, for the patients admitted at an advanced stage, choices are limited and often involves removal of one or both eyes to curb the fungal spread. Mucormycosis surge in COVID-19 pandemic Reports on mucormycosis has shown a rapidly increasing trend. A systematic review on mucormycosis in COVID-19 patients based on the collected data until May 13, 2021, revealed that out of 101 cases, a vast majority was reported from India (82 cases) compared to the rest of the world (19 cases) with a mortality rate of 30.7%. In both the active and recovered groups of SARS-CoV-2 infection, males (78.9%) were the predominant victims. In 88.9% of cases, the nose and sinuses were affected, followed by rhino-orbital tissues. 80% of these COVID-19 infected patients were diabetics, and 76.3% were treated with corticosteroids. Irrational use of antibiotics and the presence of mucor spores in the hospital environment were also blamed for the disease. [4] On May 23, BBC reported a surge in the number of rhino-orbito-cerebral mucormycosis cases; 9000 patients alone were infected in India. [5] The surge of cases of this rare disease during the COVID-19 pandemic was well connected and thrown a massive challenge to the healthcare system. [6] A few days later, Aljazeera reported, as of June 8, 2021, India recorded 28,252 mucormycosis cases from 28 states, where 86.0% had a history of COVID-19 infection and 62.3% suffered from diabetes. [7] This spike in the numbers of mucormycosis cases during the second wave of the pandemic in India is frightening and serves as a warning bell for the rest of the world. An estimated 65 million Indian adults suffer from diabetes, [8] a comorbid condition for the black fungus disease. The hot and humid climate in India is a growth-promoting factor for the Mucorales species. The countries with similar climates, higher diabetics burden and bleeding with COVID-19 waves possess a significant risk for this opportunistic fungal infection. Contamination from humidifiers during prolonged ventilation also poses an additional risk factor for the hospitalized inpatients. [9] Relation of SARS-CoV-2 infections and Mucormycosis Dexamethasone at a dosage of 6 mg OD for up to 10 days has been recommended for hospitalised COVID-19 patients with oxygen support or mechanical ventilation. [10] However, glucocorticoids do not play any significant role in patients who do not require supplementary oxygen. Unfortunately, glucocorticoids were misused in India, sometimes in higher doses and durations, to treat mild COVID-19 symptoms and administered to the patients who didn’t require oxygen support. This indiscriminate pharmacologic measure was the final nail in the coffin inviting mucormycosis by immunosuppression and increased blood glucose level for prediabetes and diabetes. Biochemical evidence showed a majority of COVID-19–associated mucormycosis patients had elevated blood glucose levels. [4] The other possible factors were organ transplantation and poor hospital hygiene. [11] In India, during the second wave of COVID-19, oxygen shortage was reported, and extensive antibiotic usage was observed to treat mild and moderate cases despite knowing the ineffectiveness of such measures. Lack of oxygen causes hypoxia intensifying tissue damage, and antibiotics may suppress normal bacterial flora promoting fungal growth in the sinuses. Antibiotic misuse was also observed in the first wave of COVID-19 with an excess of 216 million doses. [12] Available treatment option Immediate surgical debridement and administration of antifungal drugs save the life of the affected patients. Amphotericin B, as a lipid formulation, is a treatment option. [13] The Indian Health Ministry recently issued evidence-based guidelines for the management of mucormycosis. [14] Measures required to control mucormycosis Rational use of steroids and antibiotics to manage the COVID-19 patients Limiting over-the-counter use of the drugs Adequate supplies of Amphotericin B in the hospitals [As an increase in demand for amphotericin B in India caused an acute shortage] Promoting affordable treatment options can save lives. Increase in the testing facilities for black fungus, as early diagnosis is essential to stop the spread of the infection. Close monitoring and control of blood glucose for the Covid infected diabetic patients. Recovered diabetic COVID-19 patients are needed to be communicated and assessed for the Mucormycosis infection. Avoiding environments where exposure to Mucorales may happen. National campaigns for the awareness of health care providers and common people. Finally, controlling the COVID-19 pandemic by movement control order or lockdown measures, vaccination drives, social distancing, and sanitisation will automatically bring down the rate of black fungus infection. Strengthening the healthcare system’s infrastructure cannot be the sole solution to stop the mucormycosis infection; vital cooperation is needed from the public. It is a tough challenge to combat opportunistic fungal infection for the low and middle-income countries, but taking proper measures like controlling blood glucose, early diagnosis, and rational use of steroids and antibiotics may rein this disease outbreak. Regards, Dr. Bedanta Roy, Ph.D. Senior Lecturer, Department of Physiology, Faculty of Medicine, QIU Editor-in-Chief, Quest International Journal of Medical and Health Sciences Prof. Dr. Sumitabha Ghosh, Ph.D. Professor and HOD, Department of Physiology, Faculty of Medicine, QIU Editorial Board Member, Quest International Journal of Medical and Health Sciences 18.7.2021

Introduction: Physical activity (PA) is an indifferent part of physical, mental and social wellness. Emotional intelligence (EA) is closely associated with appraising, perceiving, expressing, and understanding emotions, emotional knowledge that promotes emotional and intellectual growth. This study aimed to determine the relationship between PA and EI among undergraduate students. Methods: A cross-sectional study was conducted among 149 students using the Global Physical Activity Questionnaire (GPAQ) for PA levels, Trait Meta-Mood Scale (TMMS-30) for EI measurement and a sociodemographic questionnaire for the potential moderating influence of gender, linked to the relationships between EI and PA. Results: Participants showed an average EI of 101.97 ± 13.26. Mood repair was significantly associated with PA with a spearman’s rho of 0.172 (Weak positive association), and overall EI is also significantly associated with PA (Weak positive association). Women scored significantly higher in the attention to feelings (ATF) component of EI as compared to men. Conclusion: Students who performed PA had higher levels of overall EI as well as mood repair. The relationship found is relatively small, and PA’s predictive power regarding mood repair (MR) and overall EI were feeble. Men performed higher PA levels whereas women more frequently performed PA although at lower levels compared to men. &nbsp

Introduction: Numerous stressors influence medical students’ health and quality of life (QoL) in their clinical years. QoL can be assessed through the WHOQOL-BREF (World Health Organization Quality of Life Instrument). There have been relatively fewer studies done in Malaysia, so authors undertook the research to find out the QoL of the clinical year medical students in Perak. Methods: WHOQOL-BREF and a sociodemographic questionnaire were provided to the clinical phase MBBS students of Quest International University (QIU), and Royal College of Medicine Perak (RCMP). The analysis was performed using IBM SPSS version 22.0. Results: Quality of life significantly affected in year 5 students. High parental expectation affected the quality of life significantly (p Conclusion: We conclude that year 5 was a period of major impairment to the quality of life of medical students. Medical schools need to develop strategies to counsel the students to improve the psychological wellbeing and quality of life.

A new strain of coronavirus was reported to WHO by the United Kingdom authorities on 14 December 2020 [WHO], which raises burning questions worldwide regarding the nature of the new strain, contagiousness, and effectiveness of the currently available vaccine. [1] Coronavirus is an RNA virus that evolves and changes due to mutation in different geographic regions worldwide. In 2020 we observed multiple variants of COVID-19, which initially evolved in Wuhan, China. The strain that created a global fear after the outbreak in Wuhan was first detected in South-eastern England in September 2020. By December, it had contributed more than half of the newly infected cases globally. This variant strain was then seen in Denmark, the United Kingdom of Great Britain and Northern Ireland, and South Africa. About 23 genetic changes were reported in this new strain. A strong connection between a surge in new cases and the appearance of this specific strain unambiguously draws our attention towards the high contagiousness of this variant. [2] How this new virus strain differs? This variant is referred to as SARS-CoV-2 VOC 202012/01 (Variant of Concern, the year 2020, month 12, variant 01) contains 23 nucleotide substitutions, is not phylogenetically related to the SARS-CoV-2 virus circulating in the UK. So, the origin is still unclear. As of 26 December 2020, it replaced other viral lineages in the UK, including London. [1] As of 30 December, VOC-202012/01 variant has spread to over 31 other countries. [3] South Africa named this variant 501Y.V2, because of an N501Y mutation. Spike proteins of the COVID-19 virus, which helps in the human cells' attachment, are mutated and stickier in this variant; but more research must be established. The new strain is also associated with a higher viral load, making it more contagious, but the preliminary analyses indicate that there is no sign of change in the virulence or the severity of the disease. [2] The mutation increases the chances of survival of a virus rather than becoming virulent because if a virus becomes deadly, there is a lesser chance to reproduce. Regarding the susceptibility of this viral strain to the children is also yet to be established. Do we need to take more precautionary measures compared to earlier? We do not need to overreact as the current strain is not biologically different and we need to practice the same prevention strategy as avoiding gatherings, social distancing, adequate ventilation indoors, sanitizing hands, and using masks when going outside. Whether the vaccine will work as effectively on the other variants? According to WHO, as one of the mutations (N501Y) – are present in SARS-CoV-2 VOC 202012/01 and 501Y.V2 variants – is in the receptor-binding domain, so the neutralization activity of the sera obtained from recovered and vaccinated patients against these new strains are currently under investigation. To date, there is no evidence that immune responses driven by available vaccines fail to work against this new variant. [3] Mutations will continue to take place as coronavirus spreads through the population. The genomic data of the SARS-CoV-2 VOC 202012/01 and 501Y.V2 variants are shared and uploaded to the Global Initiative on Sharing Avian Influenza Data (GISAID), which is paving the way to understand more about nature and future directions for the SARS-CoV-2 pandemic. Regards, Prof. Dato' Dr.Sellaiah S. Pillay, AMP; DPMP MBBS; M.MED RADIOLOGY; FAMM Dean & Consultant Radiologist, Faculty of Medicine, QIU Co-Editor-in-Chief, Quest International Journal of Medical and Health Sciences Dr. Bedanta Roy, Ph.D. Senior Lecturer, Department of Physiology, Faculty of Medicine, QIU Editor-in-Chief, Quest International Journal of Medical and Health Sciences 31.12.2020

Haze is a phenomenon of the lower atmosphere where dust, smoke and other dry particulate matter (PM) decreases visibility. Particles with different bioaerosol and chemical compositions form haze. Gases, volatile organic compounds, metals, acids, sulphates are key constituents for the formation of haze. The seasonal haze that afflicts large parts of Southeast Asia is mainly observed during the dry periods. The transboundary smoke haze has drawn international attention as it has become a major concern due to its deadly impact on human health and economy. According to the Global Burden of Disease Study 2015, approximately 4.2 million deaths were associated with fine particle air pollution (PM2.5) and 59% of those are from South Asia. Physiological complications of haze include dry mouth, eye and nose discomfort, headache, shortness of breath, cough, sore throat, rhinitis, sudden worsening of chronic obstructive airway disease (COPD) symptoms, acute childhood asthma, decreased pulmonary function among children and skin irritation. Haze has a major impact on the economy due to the increasing number of hospitalizations, loss of biodiversity and disruption of transportation which has caused a marked decline in the number of tourists. Farmers should also be encouraged to practice sustainable agriculture methods other than the slash and burn method.

No abstract available

Stress is evident amongst all organisms as a part of their life. It triggers various neurohormonal changes to restore homeostasis. Physiological responses and psychological changes occur during stress. The hypothalamic pituitary adrenal (HPA) axis and sympathetic nervous system (SNS) play a major role in response to stress. SNS acts via norepinephrine through subcortical activation of the locus coeruleus. Reactive oxygen species (ROS) are the derivatives of oxygen, which produce free radicals. The cell membrane contains a high level of unsaturated fatty acids that is damaged by ROS oxidation. Protein damages occur directly or indirectly by ROS by fragmentation, peroxidation, structural changes, proteolysis and formation of cross-linkages. ROS can damage DNA bases and deoxyribose sugars; cause purine losses, DNA strand breaks, DNA-protein cross-linkages and harm to the DNA repair mechanism. Higher levels of ROS lead to disease states. Understanding the mechanisms and significance of ROS involving pathways may help to reveal therapeutic strategies for diseases. &nbsp