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Purpose: Housing policies in India (last modified in 2017) define "affordable housing" on three main parameters – income of the target group, dwelling unit size and house price to income ratio. The Covid-19 pandemic has questioned the robustness of the defining parameters of affordable housing. This paper aims to study the impact of Covid-19 pandemic on housing affordability and adequacy for the urban poor and highlights how one pandemic has directly challenged the practicality of the affordable housing criteria in urban India. Design/methodology/approach: The study is based on a pilot test conducted through interviews with the consumer group. Furthermore, the affordable housing policies of urban India were studied in conjunction with the pandemic guidelines laid down by the World Health Organization. The consumer responses were analyzed in relation to the policies and guidelines to arrive at the inferences. The secondary case examples of the Dharavi slums in Mumbai and the Savda Ghevra slum resettlement colony in Delhi, along with the findings of the primary survey in the economically weaker section category, are used to formulate the conclusions. Findings: The pilot test conducted for the target consumer group clearly indicates that (i) the pandemic has severely affected the housing purchase capacity of the target consumer, thereby questioning the "affordability" of housing; (ii) proposed housing solutions are inadequate to enable livability, thereby questioning the "adequacy" of housing; and (iii) proposed housing solutions are inept to accommodate pandemic protocols. The Covid-19 pandemic and the conditions it imposed on the built environment clearly highlight the inadequacy of affordable housing parameters being followed in urban India. Research limitations/implications: Further research may be conducted on global best practices in housing, which may advise the housing policies in India. Practical implications: The study suggests key areas that need intervention and modification to make the housing policies more robust and effective. Social implications: The study explores the social sustainability aspects of housing, which are often considered secondary in policies. Originality/value: Because housing has a direct bearing on the physical, social and mental well-being of society, it is imperative to find housing solutions that are safe and resilient for a sustainable future. This paper is an original attempt by the author to question and highlight how the current affordable housing solutions adopted in urban India will continue to fail under any external adverse conditions unless modifications are considered in the existing housing parameters. [ABSTRACT FROM AUTHOR]

Introduction: Triage is a dynamic and complex decision-making process to determine fair access to medical care in mass casualty situations. Triage takes place through healthcare settings including Intensive Care Units (ICUs). Triage governing principles have been subject to ethical debates for a long time specifically with the recent global pandemic of COVID-19. This study aims to revisit the ethical principles guiding patient prioritisation during recent COVID-19 disaster triage in the Indian subcontinent and attempts to look for principles with consideration of social justice. Methods: Key electronic databases such as WHO, EMBASE, and DOAJ were used to access published literature relating to ICU triage in the Indian subcontinent. Literature on and from 2015–2022 were included in this study. The SPICE framework was used to identify the literature. The Inclusion criteria were as follows: Literature with ethical connotations focusing on India and neighbouring countries, and in an ICU setting during pandemics. The Exclusion criteria were as follows: Literature focusing on other countries, without ethical foundations, hospital admissions, and non-COVID-19 ICU admissions. The PRISMA standard was applied to screen the appropriate literature. The BOOLEAN operator "OR" was used to enhance the literature search. Finally, six papers were found suitable for this study and thus were included in the literature review. Additionally, for the second time, the frequency of certain ethical phrases was reassessed in the plans and guidelines to check the changed awareness of ethical pandemic planning, if any. A thematic analysis was applied to analyse the data and generate findings and new knowledge. Results: The findings highlight gaps in knowledge around ICU triaging in the region which indicates the scope of better ethical pandemic preparation at the regional level. The findings show that there is a debate between researchers on prioritisation from available resources and ethical perspectives and principles associated with fair access to healthcare even during pandemic times. The literature also highlights enhancing the regional capacity and building equitable approaches to reduce existing health inequities and the need of the social justice framework for ICU triaging during a pandemic. Conclusions: ICU triaging in five South Asian neighbour nations was studied for the presence of a guided ethical framework. Additionally, for the second time, certain ethical phrases were reassessed in the plans and guidelines; however, usage of those terms was found to be significantly low. The discussion shows that the plans and guidelines have the scope to improve ethical ICU triaging in these countries and in the specific region. After analysing different ethical guidelines, this study emphasises that there is a need for a just and fair framework, specifically a social justice framework in ICU triage in the subcontinent to address the underlying health inequities. [ABSTRACT FROM AUTHOR]

Covid-induced lockdowns have increased the importance of technology in education. Though access to technology as well as availability of the internet remain a major concern for a lot of children in the global south, children with intellectual disabilities are disadvantaged even more as most of the e-content is developed keeping in mind the average learner. Unstructured interviews were conducted with children with intellectual disabilities studying in government schools in Haryana as well as their teachers and parents. Thematic analysis of the interviews was conducted to understand the use-patterns of mobile phones by children with intellectual disabilities. Findings suggest that these children are learning to use mobile phones on their own or with some support and are able to navigate the complexities of these smartphones quite well. They use these devices mostly for their entertainment. This paper then reflects on the need and strategies to develop these technologies in ways that they can be used as effective tools for teaching children with intellectual disabilities, especially in the inclusive education system in developing countries. The paper reflects on the need to develop technology and tools using flexible and exploratory designs to enhance the learning processes for children with intellectual disabilities from the lower income strata. This study highlights the importance of being able to use mobile phones by children with intellectual disabilities belonging to low income families. Following this, the article argues for designing of mobile phones suitable for use by children with intellectual disabilities using playfulness and explorations, and Building e-content keeping the elements of playfulness and exploration which can enhance the learnings of this group of students which is often ignored. [ABSTRACT FROM AUTHOR]

According to the Center for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program, the cervical cancer screening rate dropped by 84% soon after the declaration of the COVID-19 pandemic. The challenges facing cervical cancer screening were largely attributed to the required in-person nature of the screening process and the measures implemented to control the spread of the virus. While the impact of the COVID-19 pandemic on cancer screening is well-documented in high-income countries, less is known about the low- and middle-income countries that bear 90% of the global burden of cervical cancer deaths. In this paper, we aim to offer a comprehensive view of the impact of COVID-19 on cervical cancer screening in LMICs. Using our study, "Prevention of Cervical Cancer in India through Self-Sampling" (PCCIS), as a case example, we present the challenges COVID-19 has exerted on patients, healthcare practitioners, and health systems, as well as potential opportunities to mitigate these challenges. [ABSTRACT FROM AUTHOR]

Background: The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis. Methods: This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies. Results: In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article. Conclusion: Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat. Registration: Open Science Framework (DOI: 10.17605/OSF.IO/74GHM). [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to indicate the current situation of the COVID-19 outbreak in India, the world's second-most populous country. India reported its first COVID-19 case in the southern province of Kerala in late January 2020. Since then, the outbreak has spread to other provinces and union territories, with the highest number of cases reported in Maharashtra province as of 24 May 2020. Design/methodology/approach: This paper presents the age- and gender-wise analysis of COVID-19 patients in Maharashtra province and the whole nation. Findings: It shows that 75% of them belong to the age group of 21–60 years and the age above 50 years has a very high fatality rate of 14.52% in Maharashtra. This analysis also shows that 76% of COVID-19 cases are in males in the nation. The data indicates that in the nation, 75.3% of the deaths are in the age group over 60 years and 86% of cases of death had diabetes-related comorbidity, hypertension, chronic kidney problems and heart problems. In India, the case-fatality rate, which estimates the proportion of deaths among identified confirmed cases, is 2.93% as of 24 May, which is significantly less than that many countries. Originality/value: To the best of the author's knowledge, this is the first attempt to indicate the current situation of the COVID-19 outbreak in India based on age and gender. [ABSTRACT FROM AUTHOR]

This paper develops a scale that measures the perceived service quality of hospitals during a pandemic. To develop the scale, data from 206 respondents from India, was subjected to exploratory and confirmatory factor analysis. The newly developed scale was named PAND-SERVQUAL, which includes factors namely, assistance, facility & layout, trust, empathy, promptness, and knowledge. The resulting scale is likely to be useful for researchers exploring service quality research and health care quality as well. Findings will facilitate understanding patient's expectations regarding the service quality of hospitals during a pandemic. Supplemental data for this article is available online at https://doi.org/10.1080/00185868.2021.1939827. [ABSTRACT FROM AUTHOR]

In this paper, we study the incidence of COVID-19 and the associated fatality with altitude using high frequency, district level data from India. To understand the implications of the nationwide lockdown after the outbreak, we use data for about four months- two from the lockdown period starting from March 25 till May 31, 2020 and about two months after unlocking was initiated (June 1-July 26, 2020). The multivariate regression result indicates slower growth in average rate of infection during the lockdown period in hilly regions, the gains of which attenuated after the unlocking was initiated. Despite these early gains, the rate of fatalities is significantly higher during the lockdown period in comparison to the plains. The findings remain robust to multiple alternative specifications and methods including one that accounts for confounding possibilities via unobservable and provides consistent estimates of bias adjusted treatment effects. The evidence supports the need for provisioning of public health services and infrastructure upgradation, especially maintenance of adequate stock of life support devices, in high altitude regions. It also underscores the necessity for strengthening and revising the existing Hill Areas Development Programme and integrating important aspects of public health as part of this policy. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 pandemic negatively influenced the entire life globally including various aspects of patients' care. Its effect on medical research production is not known. The aim of this study is to assess the impact of COVID-19 pandemic on medical research reporting trend. Methods: Advanced search on PubMed was performed over 2011- August, 2021. Monthly comparison was done for the years 2019, 2020, and 2021. Kruskal Wallis test was used to compare continuous distributions. Results: The total publication count showed constant increment over the study period. Faster rise was noticed on 2020 (15.7%). A steady growth in publications over the years and through the pandemic was also seen in seven studied countries with variable, both in total and also after exclusion of COVID-19 related papers. Italy and India have the highest proportions of COVID-19 related publications in comparison to the total papers in 2020, but USA has the highest quantity. Statistically significant differences exist between the first eight months of the last three years with and without counting COVID-19 related publications (p-values=0.0003907 and 0.001084, respectively). Conclusion: Our results reflect that investigators world-wide succeeded to reconfigure their work style and utilize the spared time induced by the lockdown to enrich the medical research platform. [ABSTRACT FROM AUTHOR]

Background: COVID-19 infection requires an easily accessible yet precise variable for diagnosis and prognosis. This study aims to describe the predictive value of the Neutrophil-to-Lymphocyte Ratio (NL Ratio) for COVID-19 diagnosis and deteriorating clinical course, which has not been extensively demonstrated. Objective: To determine the correlation of the NL ratio and CT severity score(CTSS) with the lung injury severity in adult patients having COVID-19 infection. Materials and Methods: A retrospective study at a COVID centre included 123 hospitalized patients those who are COVID-19 positive by RT-PCR or Rapid Antigen Test. The study lasted six months (July 2020 - November 2020). In addition, the patient's demographics, chest CT findings, CRP, lymphocyte and neutrophil counts were documented. Results: The differences in NL Ratio were significant across the all grades of CT severity score groups, as well as within each group (p<0.001). There was an excellent correlation between the NL Ratio and the CTSS (r = 0.863, p<0.001). According to a ROC curve analysis, NL Ratio had diagnostic and prognostic relevance in COVID-19 subjects with negative or positive CT results. The AUC (area under curve) was 0.858 (95% CI: 0.728-0.903, p<0.001), the sensitivity was 69.9%, the specificity was 93.1%, and the optimum NL Ratio cut-off value was 3.734. Conclusion: NL ratio is a low-cost prognostic tool and a convenient, on-site alternative to a chest CT scan for determining the degree of lung injury in COVID-19 subjects, particularly in developing countries. [ABSTRACT FROM AUTHOR]

Numerous studies have captured the experiences of teachers teaching online, but the current 'emergency' to teach online is unprecedented and has been challenging. Grounded in the theory of cognitive dissonance, this paper attempts to recapitulate the experiences of university teachers and analyses whether they have developed the consonant cognitions to teach online during the pandemic period or would they prefer switching back to 'normal' teaching as soon as the circumstances permit. Technology-enabled teaching has been found to be complex as it mandates teaching in a computerised setting and lacks an element of social interaction, which is at the heart of face-to-face teaching. Using Structural Equation Modelling, this study presents the determining factors that motivate teachers to embrace technology-driven teaching more convincingly. The study finds that in the absence of adequate training imparted to the teachers for developing technological and pedagogical knowledge (TPK), high psychological capital and facilitating conditions are the two most important factors ensuring teaching proficiency, creating positive online experiences and a continued intention to teach online. [ABSTRACT FROM AUTHOR]

The Coronavirus disease 2019 (COVID-19) pandemic has necessitated medical centers across the world to deliver healthcare through telemedicine. We discuss the adoption, delivery of telemedicine services at a tertiary care center and patient satisfaction involving 456 patients in south India. Most respondents had sought telemedicine care at the department of Medicine (16.23%). The maximum satisfaction was reported by patients in OBG (100%). The responses were generally positive across all the age groups. The paper offers insights on best practices adopted at the center, lessons learnt, and provides recommendations for health care systems offering telemedicine during COVID-19 times. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID-19) pandemic is a worldwide public health crisis. During huge surge in COVID-19 cases, most of the patient arrived at Rajiv Gandhi Government General Hospital, Chennai were severe due to late presentation and also available evidence demonstrating that the delay in treatment is directly associated with increased mortality or poor patient outcome. As an innovative concept of Zero Delay COVID-19 Ward were set up to provide the required critical care for all severe COVID-19 cases. The experience of setting up of such Zero Delay COVID-19 Ward and profile of admitted COVID-19 patients were described in this paper. Methods: A total of 4515 laboratory-confirmed COVID-19 patients admitted at Zero Delay COVID-19 Ward was analyzed retrospectively from 7th July to 31st December 2020. Results: At the time of admission the frequency of dyspnea were 85.6% among them 99.1% recovered from dyspnea after the oxygen therapy and other management at Zero Delay COVID-19 Ward. Of the 4515 COVID-19 individuals, about 1829 (40.5%) had comorbidity, 227 (5%) had died. Multivariable logistic regression analysis, COVID-19 death was more likely to be associated with comorbidity (OR: 18.687; 95% CI: 11.229-31.1) than other variables. Conclusions: Comorbidity is an independent high risk factor for mortality of COVID-19 patients. From our observation, it is strongly recommended that effective zero delay covid-19 ward model will help for the prevention of mortality in current/expected waves of COVID-19. [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]

India is more challenged than developed nations in reducing the Covid-19 cases and lowering death rates due to the huge population and unprepared health care system. As intention to vaccinate is contextual and its availability does not translate into their de facto adoption., this paper examines the factors that determine intention to vaccinate against COVID-19 in India. A research model was tested using 222 responses was tested using structural equation modeling. Findings suggested that credibility and awareness positively impacted whereas vaccine hesitancy and perceived risk negatively influenced intention to vaccinate. The fear of side effects did not impact the intention to vaccinate. [ABSTRACT FROM AUTHOR]

Objective: Rhino-orbito-cerebral mucormycosis is a rapidly progressive disease with high mortality rates of about 60 per cent. The increasing incidence of rhino-orbito-cerebral mucormycosis in coronavirus disease 2019 patients in India and worldwide has become a matter of concern owing to the case fatality rate. This study explored the use of low dose aspirin in decreasing the mortality rate of coronavirus disease 2019 associated mucormycosis. Method: This was a retrospective observational study. Patients suffering from post-coronavirus disease 2019 mucormycosis were included in the study. Each patient was treated with surgical debridement and systemic amphotericin B. Low dose aspirin was added, and mortality rates were compared with the patients who did not receive aspirin. Results: The demographic data and rhino-orbito-cerebral mucormycosis staging between the two groups were not significantly different. There was a statistically significant difference in mortality outcomes between the two groups (p = 0.029) and a 1.77 times higher risk of dying for patients not receiving aspirin. Kaplan–Meier survival indicated that patients receiving aspirin had better survival rates (p = 0.04). Conclusion: Low dose aspirin improves survival rates in coronavirus disease 2019 associated mucormycosis. [ABSTRACT FROM AUTHOR]

Background: COVID‐19 has been linked to over 40 million infections and 1.1 million deaths in 210 countries as of October 19, 2020. This highly contagious communicable disease has put not only infected individuals but other patients and frontline workers like nurses at risk in hospitals, especially in Intensive Care units (ICUs). There is a need for minimizing patient contact, improving hand hygiene practices, and optimizing healthcare provider time, especially nurses. Globally it is estimated that nearly a million health care providers have been infected with COVID‐19 as of the end of October 2020. Methods: This retrospective service evaluation documents the experience of health care providers in a COVID‐19 ICU in India that was used to implement new protocols for secretion management and oral hygiene. Patient chart information and staff feedback were utilized. Intervention: This pilot study captures the practical benefits of using VAPCare, an automated, closed‐loop system for oral secretion removal. Results: Six patients were included in this small‐scale study; three patients following the current standard of care for suctioning and oral hygiene and three receiving the new VAPCare and Lumen device protocol. With the new device protocol, the number of infected secretion interactions by a nurse was 50% lower, and nursing time spent on oral hygiene and secretion management 70% less than seen with the current standard of care. The number of disposable gloves used with VAPCare and Lumen was reduced by over 50%. All 10 nurses and six doctors gave positive feedback on device usage. The department recommended updating protocols to prioritize the use of the new secretion management system for patients with COVID19 and other highly contagious conditions. Conclusion: The findings are an early indication that using VAPCare for patients could help protect infected patients, other ICU patients, and health care workers. [ABSTRACT FROM AUTHOR]

Purpose: Covid-19-associated Rhino-orbital-cerebral Mucormycosis (ROCM) has reached epidemic proportion during India's second wave of Covid-19 pandemic, with several risk factors being implicated in its pathogenesis. The present study aimed to document cases of rhino-orbital Mucormycosis and to evaluate risk factors including comorbidities, clinical characteristics, diagnosis, management and outcome at Tertiary care centre during Covid-19 (2021) pandemic. Methods: It is retrospective study, carried out at tertiary care centre from April 2021 to September 2021. 42 patients of biopsy proven Mucormycosis were included in the study. These patients' records were reviewed from hospital data. All patients were subjected to complete ophthalmological, ENT examination and imaging studies. Orbital staging was done. Each case was treated by multidisciplinary approach with Functional Endoscopic Sinus Surgery (FESS) and intravenous amphotericin B(AMB). Retrobulbar liposomal amphotericin-B and Exenteration was done whenever indicated. A minimum 60 day follow up period was attributed from the day of discharge to all study patients. Statistical analysis was done using Chi square test. A P value ≤0.05 was taken as signi􀃶cant. Results: Total 42 patients of ROCM were documented. Most of the cases showed onset of symptoms of ROCM between day 20 and day 30 from the diagnosis of Covid-19. The mean age was 50.48 years with a male preponderance (82.9%). A total of 95.1% of patients had diabetes (30) and Covid-19 positivity (40). Concurrent steroid use was seen in 83.3% where 73.1% of patients had received oxygen support during Covid-19 infection. The most common ophthalmologic presentation was orbital/facial oedema (33) and pain, diminution of vision (24) and ophthalmoplegia (26). Direct nasal endoscopy and biopsy was done to establish diagnosis. The most common imaging 􀃶ndings were orbital cellulitis (30), extra ocular muscle involvement (26) and pansinusitis (33). Orbit was involved in 58.5% of patients, with stage ranging from 2a-4d. All patients were treated with FESS and intravenous AMB. Retrobulbar AMB was given in 11 patients. Exenteration was done in (n = 4) 10.5% of cases. 41 patients recovered and mortality was seen in 1 patient. Conclusion: Corticosteroids and DM are the most important predisposing factors in the development of Covid-19-associated ROCM. Covid-19 patients must be followed up beyond recovery. Awareness regarding red 􀃸ag symptoms and high index of clinical suspicion in Covid-19 recovered patients with prompt diagnosis and early initiation of treatment are essential for successful outcome with less mortality. [ABSTRACT FROM AUTHOR]

Background: COVID-19 was declared a pandemic by the World Health Organization (WHO) on 11th March 2020. The SARS-CoV-2 virus has mutated over time, which has resulted in genetic variation among population of circulating viral strains over the course of the COVID-19 pandemic. Preventive measures like vaccination, social distancing, using of face mask and hand hygiene practices played a vital role in mitigating the spread of this pandemic. But were these measures effective enough to curtail this pandemic. Purpose: To assess the presenting features of COVID 19 in the third wave and to assess the effectiveness of preventive measures against COVID 19 during the third wave. Methods: This is a hospital based prospective study where participants were regularly followed up till 14 days, conducted in rural part of North of India. Results: A total of 239 participants were included in this study. The study found that 95% of these participants received first dose of COVID vaccine as compared to 49.8% who received second dose. Some of the participants (39.7%) were not obeying the norms of social distancing. 52.1% of the subjects were using masks, which has been proven to be one of the effective measures for prevention of transmission of COVID 19. 71.1% were practicing hand hygiene measures. Conclusion: Vaccination and using face mask were significantly associated with mitigating the spread of COVID-19 among rural population who visited the health care facility. [ABSTRACT FROM AUTHOR]

Aim: The aim was to examine the outcomes of pregnant women admitted to intensive care unit with coronavirus disease-2019 (COVID-19) infection during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in India. The primary outcome of the study was maternal mortality at day 30. The secondary outcomes were the intensive care unit (ICU) and hospital length of stay, fetal mortality and preterm delivery. Materials and methods: This was a retrospective multicentric cohort study. Ethical clearance was obtained. All pregnant women of the 15--45- year age admitted to ICUs with SARS-CoV-2 infection during 1st March 2020 to 31st October, 2021 were included. Results: Data were collected from nine centers and for 211 obstetric patients admitted to the ICU with a confirmed diagnosis of COVID-19. They were divided in to two groups as per their SpO2 (saturation of peripheral oxygen) level at admission on room air, that is, normal SpO2 group (SpO2 > 90%) and low SpO2 group (SpO2 < 90%). The mean age was (30.06 ± 4.25) years and the gestational age was 36 ± 8 weeks. The maternal mortality rate was10.53%. The rate of fetal death and preterm delivery was 7.17 and 28.22%, respectively. The average ICU and hospital length of stay (LOS) were 6.35 ± 8.56 and 6.78 ± 6.04 days, respectively. The maternal mortality (6.21 vs 43.48%, p < 0.001), preterm delivery (26.55 vs 52.17%, p = 0.011) and fetal death (5.08 vs 26.09%, p = 0.003) were significantly higher in the low SpO2 group. Conclusion: The overall maternal mortality among critically ill pregnant women affected with COVID-19 infection was 10.53%. The rate of preterm birth and fetal death were 28.22 and 7.17%, respectively. These adverse maternal and fetal outcomes were significantly higher in those admitted with low SpO2 (<90%) at admission compared with those with normal SpO2. [ABSTRACT FROM AUTHOR]

Background: Anxiety during the COVID-19 pandemic has been a significant concern for people of all age groups, including geriatric individuals. The elderly population has faced unique challenges during this time, which can contribute to increased anxiety levels. The uncertainty and fear surrounding the pandemic can lead to increased anxiety and stress, which can negatively impact sleep quality and duration. Purpose: The aim of this study is to find out the effect of vagal nerve stimulation on anxiety and sleep disturbances among geriatric population. Methodology: Using the Purposive Sampling method, a total of 20 individuals were chosen based on the inclusion and exclusion criteria. The participants were divided into two groups using the closed envelope method, and they took part in therapy sessions lasting 30 minutes, three times per week for a period of four weeks. The control group received Jacobson's progressive relaxation technique, whereas the experimental group received non-invasive Transcutaneous auricular vagal nerve stimulation. Result: With a p value of 0.001, transcutaneous auricular vagal nerve activation significantly improved sleep quality and reduced anxiety after 4 weeks. Conclusion: Study showed that transcutaneous vagal nerve stimulation was effective in reducing Anxiety and improving sleep quality in geriatric population. [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: 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]

Background: The coronavirus disease 2019 pandemic has resulted in various changes in knowledge, attitude and practice among doctors. A survey was conducted of otolaryngologists in India regarding these aspects in relation to the coronavirus disease 2019 pandemic. Method: Otolaryngologists from West Bengal (India) were invited to participate in an online self-administered survey. Data were collected and analysed using appropriate methods. Results: Responses from 133 participants, grouped into 4 groups by their career stage, were collected and analysed. Of the participants, 36.8 per cent were directly involved in treating a known or suspected coronavirus disease 2019 patient, although 66.2 per cent considered the personal protective equipment inadequate. Ninety-four per cent indicated that their willingness to perform procedures depended on personal protective equipment availability. Of the respondents, 83.5 per cent revealed additional mental stress due to the pandemic. Of the participants, 41.4 per cent took hydroxychloroquine as coronavirus disease 2019 prophylaxis. Conclusion: This study provides an insight into which issues may need attention, to help ENT surgeons tackle the coronavirus disease 2019 pandemic more effectively based on analysis of responses in the survey. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to comprehend the traumatic experiences of intensive care unit (ICU) patients during the COVID-19 pandemic and the impact of the same post-discharge. It assesses the role of nature and open green spaces on the mental health and well-being of critically ill patients. Design/methodology/approach: Using interpretative phenomenological analysis, this study highlights the major factors contributing to adverse mental health and well-being. The subjects were interviewed using semi-structured personal interview techniques. Thematic content analysis was adapted to derive the major themes apparent in the succinctly rich information gathered from the participants. Findings: The findings cast light on the significant role of nature and open green spaces in psychotherapeutic healing post-discharge of intensive care survivors. Originality/value: The study is novel and adds to the existing literature in an advanced manner. To the best of the author's knowledge, no other study was witnessed, especially in the Indian context, confirming the relationship between humans and nature with ICU patients as a subset. [ABSTRACT FROM AUTHOR]

Background A wide variety of computed tomography (CT) findings in COVID-19 have been reported in different studies, and the CT findings differ according to the stage of the disease and disease severity and associated co-morbidities. The study aimed to determine the role of HRCT chest in the evaluation of COVID 19 patients. Methods This is a retrospective study done at K.J. SOMAIYA MEDICAL COLLEGE & HOSPITAL SION, MUMBAI. The Present Study was on 160 hospitalized patients who underwent HRCT CHEST with symptoms of COVID 19. Results Most of the patients in the fifth and sixth decade of age group with a mean age of 58.36±15.36 years. There was a male preponderance (68.13% male and 31.88% female). Out of 160 patients, 145 patients (90.6%) were symptomatic, while 15 patients (9.4%) were asymptomatic. 53.8% of patients had some or the other underlying comorbid disease in the sample population. HRCT chest of the study population showed the variety of opacity characteristics. Out of 160 patients, 61 (38.13) patients had pure Ground glass opacities (GGO) while another 82 (51.25) patients had both mixed GGO. In early phase of the CT scan, 66.67% patients had GGO while in the intermediate phase high percentage of (56.1%) of the patients had mixed GGO & consolidation. The lobe involvement was measured using the Ct severity scoring system. In this study majority (59.38%) of the patients had a CT severity score between 1-7 indicating mild disease, 35.63% patients had CT score 8-15 indicating moderate disease while only 5.00% had CT severity score 16-20 indicating severe disease. Conclusion: HRCT chest in COVID-19 patients had significant diagnostic and prognostic importance as positive CT findings more prominent in symptomatic patients and comorbid patients. CT imaging was found to be useful in predicting a patient's clinical recovery or disease progression. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the present study was to investigate relationship between locus of control and psychological distress among working women during the COVID-19 pandemic. Method: A mixed method study was conducted among 81 working women in Bangalore identified through convenient and purposive sampling. In Phase 1, Levenson's Locus of control Scale and Kessler Psychological Distress Scale were administered to measure the locus of control orientation and the level of psychological distress. In Phase 2, interviews were conducted based on open ended questions developed by the researchers to understand the perception of the impact of the COVID-19 pandemic on personal and professional life. Results: Pearson's product moment correlation was used for Phase 1 and thematic and content analysis for Phase 2. The findings from Phase 1 revealed a moderate negative correlation between internal locus of control and psychological distress, and a weak negative correlation between external locus of control and psychological distress. The thematic analysis showed the variations in the perceptions of the impact of the COVID-19 on the personal and professional lives and the adaptable nature of women. Conclusion: The present study helps to understand whether a relationship exists between locus of control orientation and psychological distress during the time of COVID-19 and reflects on the how the COVID-19 has affected the personal and professional lives of working women. [ABSTRACT FROM AUTHOR]

Background: The rolling out of the COVID -19 vaccination programme was accompanied by several doubts including the safety and occurrence of adverse effects after the vaccination. Methodology: A cross sectional study was conducted amongst the health care professionals working in the state of Himachal Pradesh to assess the frequency and types of side effects associated with the administration of Covid-19 vaccines using a semi structured questionnaire floated through a Google form. Result: Of the 187 responses received, after the 1st dose, 37.5% participants reported malaise, 31% myalgia, 36.4% low-grade fever, while 18.5% high-grade fever. Mild reactions at the injection site were reported by 37.5%, headache was reported by 3%, low back ache, drowsiness, giddiness and diarrhea were reported by about 3%. No reactions were reported by 18.5% of the participants. After the second dose, 51.8% did not report any adverse event, 17.1% reported malaise,15.2% reported low grade fever, 3% reported high grade fever, 20.1% reported mild reactions at the site of injection while 4.2% reported drowsiness, breathlessness on exertion, nausea, low back ache and diarrhea. Conclusion: The frequency of adverse events with COVID -19 vaccines is not higher than those observed with other commonly used vaccines. [ABSTRACT FROM AUTHOR]

Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown's impact on COVID-19 cases and associated healthcare costs. Methods: Using daily case data for 84 days (9 March–31 May 2020), we modeled the epidemic's trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R0), daily reproduction number (Re), and case doubling time. Based on pre-restriction and Phase 1 R0, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis. Results: The estimated median R0 during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, −15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, –204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83). Conclusion: Maharashtra's early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India. [ABSTRACT FROM AUTHOR]

Introduction The period of coronavirus disease 19 (COVID-19) is a significant period from various aspects such as world health and socioeconomic considerations. The majority of the hospitals involved in dental education had previously limited their clinical practices to dental emergencies, but now are geared up for nonemergent conditions. As teaching modalities shifted to online platforms, students have reported to be anxious with regard to accomplishment of required clinical skills, patient care, and forthcoming graduation. Fresh graduates have reported a delay in the drive, which they would have been able to achieve in the initial stages of their profession. Objectives To assess the attitude of the dental undergraduate students and interns toward dentistry post-COVID-19. Results The majority (80.2%) were prepared for the challenges lying ahead before beginning to work on patients. Also, 16% were willing to treat patients, 28% did not want to treat patients, while 44% were willing to handle emergency cases. Next, 67.8% were scared of infecting themselves while administering dental treatment and 78.9% were concerned that there could be more such pandemics. In total, 21.6% of the respondents who wished that they chose an alternate profession whereas 70.5% of participants felt that the scope of dentistry has not diminished. Also, 90.7% were interested to pursue postgraduation, and 86.3% felt that this was a passing phase and things would be normalized soon. Conclusion With second and third waves being rampant, novel coronavirus has become a public health crisis. Because dental services cannot be stopped for a long time, it is essential for dental students to be well trained to limit the spread of the disease. Owing to the present scenario, appropriate donning and doffing of PPE (personal protective equipment) is a pivotal step in direct patient care, and simulation-based training may help ensure that these skills are acquired by them. [ABSTRACT FROM AUTHOR]

Background: The causal impact of income shocks on mental well-being in developing countries is an under-researched area. The COVID-19 pandemic, along with the economic recession caused by the lockdowns to reduce transmission, provides a natural experimental setting to examine the causal impact of a decline in monthly per capita expenditure (MPCE) on mental health of the general population in India during the pandemic. Aim: To evaluate the impact of income shocks on mental health of adults in metro cities during the COVID-19 pandemic. Materials and Methods: The data were collected using the abridged version of the Depression Anxiety Stress Schedule administered through a telephonic survey on adult residents of six metropolitan cities in September-August 2020 and July-August 2021. Results: In the present study, 994 adults participated from six metropolitan cities. Average treatment effects were estimated using Propensity Score Matching. The mean normalized scores are significantly higher for respondents whose MPCE had fallen (treated) vis-à-vis respondents whose MPCE had remained same or increased (control): anxiety (0.21 for treated vs -0.19 for control), stress (0.16 vs -0.14), and depression (0.04 vs -0.19). Propensity score matching reveals that the normalized scores for anxiety, stress, and depression were 33 (95% confidence intervals, CI: 20.0-46.7), 25 (95% CI: 12.9-36.9), and 36 (95% CI: 18.6-53.1) higher among the treated group vis-a-vis control group. The ATET was 34 (95% CI: 18.9-48.9), 26 (95% CI: 10.1-42.9), and 32 (955 CI: 12.3-50.7) for these three outcomes, respectively. The post-estimation tests indicated that the results are valid. Conclusions: The study advocates that policies to ensure income security should be made an integral part of the response packages to tackle pandemics like COVID-19. [ABSTRACT FROM AUTHOR]

Background: Tobacco use is one of the major preventable causes of death and disability worldwide. Tobacco use is detrimental at any time. However, it is proving to be more dangerous during the COVID-19 pandemic. Tobacco use may increase the risk of being infected, increases the chances of complications, and also increases the probability of its spread. We assessed the awareness about this association and the impact of the lockdown on tobacco use among current tobacco users of Government Medical College, Gujarat. Aims and Objectives: Our aims and objective of the study is to assess the awareness about the association and the impact of the lockdown on tobacco use among current tobacco users (employees) of Government Medical College, Gujarat. Methodology: A study was conducted among 173 tobacco users (Class 3 & Class 4) of Government Medical College, Gujarat using simple random sampling technique. They were under active follow-up in their course of the 10-month counselling program from January 2020 to November 2020. The data was collected using pretested close ended questionnaire. The analysis was done using the SPSS statistical package Ethical approval was taken from the Institute Ethical Committee. Written informed consents were taken from all the respondents. Appropriate statistical test was used. Result: Two-thirds (68%) of tobacco users were unaware of the association between tobacco and COVID-19. Out of the 173 current tobacco users, 49 tobacco users quit tobacco during the lockdown period; out of which 51% quit because of the unavailability and increased prices of tobacco products and rest because of lockdown and their concern over COVID-19. The extent of Conclusion: awareness about the association of tobacco and COVID-19 influenced the tobacco users to stop tobacco use. Awareness activities about the harmful effects of tobacco during the pandemic have to be prioritized and further strengthened. [ABSTRACT FROM AUTHOR]

Based on in‐depth interviews with 24 middle‐class Indian child participants, this is the first exploratory qualitative study, in India, to demonstrate the ways in which children as reflexive social actors re‐negotiated everyday schedules, drew on classed resources at their disposal and made sense of the impact of the pandemic on their educational pathways and future aspirations. These narratives offer a unique lens on the politics of middle‐classness and its constitutive relation to constructions of normative childhoods in contemporary India. Study findings contribute to the sociology of Indian childhood and more generally help enrich our understanding of southern childhoods and the reproduction of inequalities in contemporary India. [ABSTRACT FROM AUTHOR]

Objectives: COVID-19 incidence became a pandemic immediately after its origin and spread. Apart from death because of coronavirus infection, the pandemic brought unbearable psychological pressure to all. We assessed the psychological pressure on college and university students in India through cluster sampling. Methods: The students responded (n = 209) to an online questionnaire following the Generalized Anxiety Disorder Scale (GAD-7) and Hamilton Anxiety Rating Scale (HAM-A) with some other basic information. Results: According to GAD-7 scoring, we found the respondent students had severe anxiety (1.44%), moderately severe anxiety (14.35%), moderate anxiety (36.36%) and mild anxiety (47.85%). Following HAM-A scoring, anxiety level among the students could be scaled as severe (0.96%), high (4.31%), moderate (13.40%) and mild anxiety (34.93%) level. Age of the students was a confounding factor (p = 0.049, HAM-A) of experiencing anxiety, students <20 years of age were more anxious. We found female students to be more anxious than the males following the HAM-A scoring tool. Academic delays (R2 = 0.996, p = 0.036) and impact on daily life (R2 = 0.996, p = 0.117) were positively associated with anxiety symptoms, while social support was marginally correlated (R2 = 0.726, p = 0.069) with the anxiety level. Conclusions: As the study found almost all the students are experiencing anxiety because of the current pandemic situation, continuous observation of psychological health for all is recommended as well as establishing psychological intervention during the preparedness phase. [ABSTRACT FROM AUTHOR]

Introduction: Policy decisions on containment of commercial activity to control the spread of COVID-19 SARS may influence urban air quality. Methodology: A methodological approach has been proposed to explore the relationship that exists between the policy decisions on six criteria pollutants (PM10, PM2.5, SO2, Ozone, NO2, and CO). This study also explores the knowledge/association that exists between the climatic variables, criteria pollutants, inhalation exposure dose levels and its vulnerable population age group and gender. The methodology explores a mixed urban cluster, Coimbatore, Tamilnadu, INDIA. Results: From the results, PM10, PM2.5, SO2 and CO has reduced to about 31%, 42%, 26% and 29% during phase-I, whereas NO2 (66%) and Ozone (14%) has increased. It is inferred that the reduced criteria pollutant load (during the phase I, II, and III) gets dispersed taking the advantage of geographical location. Conclusion: It is also observed that gender has an influence on the inhalation dose due to variability in inflow rate. [ABSTRACT FROM AUTHOR]

Across India, there have been multiple studies conducted to address the issues of the mental health of healthcare workers during the COVID-19 pandemic. The present study estimated the pooled prevalence of psychological morbidity among healthcare workers during the early phase of the COVID 19 pandemic in India. We searched the following electronic bibliographic databases: PubMed, ScienceDirect, Wiley online library, and Google scholar for studies conducted from the onset of the COVID 19 pandemic until 25 September 2021. The methodological quality of each study was scored and outcome measures with uniform cut off scores as per various screening measurements were evaluated. According to the current meta analysis, the pooled estimates of depression, anxiety, stress, and insomnia among Indian healthcare workers during the COVID 19 pandemic are 20.1% (95% CI: 15.6 to 24.6%; n = 21 studies), 25.0% (95% CI: 18.4 to 31.6%; n = 20 studies), 36% (95% CI: 23.7 to 48.2%; n = 22 studies) and 18.9% (95% CI: 9.9 to 28.0%; n = 6 studies) respectively. In subgroup analyses, low quality studies based on the JBI checklist (Score < 3/9) and studies using DASS 21 showed a higher pooled prevalence of depression and anxiety. About 20–36% of the healthcare workers in India reported having depression, anxiety, and stress during the early phase of the COVID 19 pandemic. The present study provides a comprehensive review of the overall burden of mental health problems among healthcare workers during the COVID 19 pandemic in India necessitating appropriate intervention strategies to protect these frontline groups before the memory of the pandemic crisis starts to fade. [ABSTRACT FROM AUTHOR]

Self-realization or the path which involves the elaborate process of knowing oneself leads people to a meaningful and fulfilling life. The present study aims to examine how the COVID-19-led lockdown proved to be an opportunity for emerging adults to reflect on and eventually discover their true selves. This study particularly explores the factors that facilitated the self-realization process during the lockdown. An online survey was conducted on 1280 Indian university students. The age of participants ranged between 18 and 29 years. An eight-item scale was developed to measure self-realization during the lockdown, which was thereafter administered along with other study variables. The results showed that factors including family bonding, social comparison, self-image, and a positive orientation toward life help young adults in the process of self-realization. Furthermore, the participants who employed adaptive ways to cope with the COVID-19 stress reported higher levels of self-realization. The present study showed that the interaction of young adults with their significant others, solving their daily problems, and having a positive outlook toward themselves and the future, helped them during the COVID-19 imposed lockdown and led them on the path of self-realization. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease-2019 (COVID-19) infection can result in pulmonary complications ranging from mild illness to severe life-threatening disease. There are limited studies correlating the association between the clinical course of COVID-19 and histopathological findings. This study aimed to examine the postmortem histopathological changes in lung tissue of COVID-19-positive patients and to correlate those changes with disease severity. Materials and methods: This prospective observational study was conducted in adult COVID-19-positive patients. Postmortem core needle biopsy (CNB) of the lung was done using ultrasonography guidance within 1 hour of death. Histopathological analyses were performed by two expert pulmonary pathologists. The demographic and clinical data of the patients were recorded to correlate them with histopathological findings. Results: In total, 48 patients were assessed for inclusion, and 21 patient relatives consented for the study. The median duration of illness was 21 (range 9--38) days, the predominant histopathological finding was diffuse alveolar damage (DAD) in most patients (19/21), followed by pneumonia (13/21). Exudative, intermediate, and advanced DAD patterns were seen in 9.5%, 52.4%, and 28.6% of cases, respectively. Advanced DAD was associated with a longer duration of disease. The pneumonia findings were associated with positive respiratory and blood cultures. The microvascular thrombus was seen only in one patient. Conclusion: The predominant pathological findings in our patients were DAD and pneumonia. The DAD type correlated with the duration of illness, and we attributed pneumonia findings to secondary infection. The incidence of microvascular thrombi was low, and it might reflect the effect of treatment with anticoagulation. [ABSTRACT FROM AUTHOR]

Background and Aim: Pandemic and consequent lockdowns are likely to affect the drug market by the sudden disruption of the supply chain. We explored the change in the availability, access, purity, and pricing during lockdown from respondents seeking treatment for drugs, alcohol, and tobacco dependence. Materials and Methods: A cross-sectional survey was conducted among 404 respondents from seven treatment centers across India. A structured questionnaire assessed the change in availability, access, quality, and price of substances used during the first phase (March 24–April 14) and the second phase (April 15–May 3) of lockdown. Results: A majority of the respondents in treatment used tobacco (63%) and alcohol (52%). Relatively few respondents used opioids (45%) or cannabis (5%). Heroin (44%) was the most common opioid the respondents were treated for. Seventy-five percent, 65%, and 60% of respondents treated for alcohol, tobacco, and opioid problems, respectively, reported a reduction in the availability and access during the first phase of the lockdown. In the second phase, respondents with alcohol and tobacco dependence reported greater availability than those with opioid and cannabis dependence. The reported price of all substances increased more than 50% during the first phase of lockdown and remained higher throughout the second phase. Deterioration in purity was reported by more than half of the people who used opioid. Conclusion: Lockdown could have affected both licit and illicit drug markets, albeit to a varying degree. The observed changes seemed short-lasting, as suggested by the recovering trends during the second phase of lockdown. [ABSTRACT FROM AUTHOR]

Context: The Coronavirus Disease 2019 (COVID-19) pandemic that began in 2019 has affected more than 232 million people around the world with over 4.7 million deaths as on September 30, 2021. Amidst the crisis, there has been increased generation of biomedical-waste (BMW). In April 2021, a 62% rise was observed compared to 123 metric tonnes of waste generated in February 2021. The hospital waste mismanagement has diverse ramifications as it affects the patients, healthcare workers (HCWs), public, environment, and economy. Proper BMW management aims to reduce generation, ensures efficient collection, handling and safe disposal so that it controls infection and improves safety. Aims: The present study was conducted to assess the knowledge among medical professionals regarding BMW segregation, transport, and treatment. Settings, Design, Methods, and Materials: A google formed based survey was done to assess the knowledge regarding management of COVID-19 BMWamong HCWs (MBBS students, residents, and consultants) associated with tertiary care hospitals of North India. Results: The knowledge score was: for segregation - 27.4%, 59.6%, and 49.8%; transport from site of generation to site of disposal - 63.6%, 89.1%, and 95.2%; disposal - 29%, 71.9%, and 68.2%; overall score - 41.4%, 67.9%, and 61.3% among the students, residents, and consultants respectively. We found that participants with greater years of experience (residents and consultants) had better knowledge as compared to that of the students (P =0.032). Conclusion: We found a mean score of 56.9% which is more than that of few low- and middle-income countries but less than that of European countries. The chances of infection directly correlate with lower knowledge score. Appropriate evidence-based, judicious use of PPE as per the settings and guidelines should be followed. Training aspects, periodic evaluation, and assessment should be strengthened, both for practising medical professionals and for students, to ensure a safe and sustainable healthcare system. [ABSTRACT FROM AUTHOR]

This article aims to identify the factors prevalent among health science librarians toward vaccine hesitancy. With the development of COVID-19 vaccines in 2021, numerous efforts are being taken to vaccinate people to control the spread of coronavirus. Recent research has shown a high level of vaccine hesitancy among various groups in various fields but no study has been conducted to explore the factors responsible for vaccine hesitancy among library professionals. A cross-sectional online survey of Indian health science librarians was conducted. Data was collected through an online questionnaire designed on Google Forms and analyzed using MS-Excel. Descriptive statistics were used in the study. The majority of respondents (77%) showed a high level of vaccine hesitancy due to issues of safety, negative information, and confusion over vaccines. Measures to increase vaccination uptake and authentic sources with respect to COVID-19 vaccines have been discussed. [ABSTRACT FROM AUTHOR]

In spite of high density of population, higher in poverty, lower levels of per capita public health infrastructure in our country interestingly recovery rate of COVID-19 is good. COVID-19 is a novel respiratory disease. Studies suggest that lack of proper knowledge regarding COVID-19, severe morbidity and high mortality also high in our country. During any kind of disaster or pandemic vulnerable groups or populations like mental and neorudevelopmetal disorder like child with autism spectrum disorder known to be overly effected in negative way. According to epidemiological research report during the last decade there is dramatically increase in the rate of autism with prevalence of 5 to 10 cases of classic autism per 10,000 . Knowledge regarding COVID-19 among mothers child with autism was negatively correlated with the demographical value and social functional support reported by the mothers child with autism. This study sought to assess the knowledge toward COVID-19 among mother with autism seeking care for their child with autism in the District Disability Rehabilitation Centre, Tripura. This descriptive study hypothesized there are adequate knowledge about COVID-19 as because awareness was done by mass media from government and nongovernment side in a very intensive way. We conduct an investigation how mother child with autism with their specific demographical properties shows their knowledge about COVID-19 awareness and strategy they applied to prevent and recover from COVID-19.Our sample was selected randomly. Our study shows that knowledge and strategy of mother regarding COVID-19 significantly associated with their education, mother with special training, source of income, background of family support. The awareness level high among mothers about COVID-19 in percent was high 6.7 levels. Proportion of High Strategic capacity with COVID- 19 as high percentage18.7. This descriptive study is according result is significant with selected demographical variables of mothers child with autism. Method: A descriptive study was conducted in District Disability Rehabilitation Centre, Tripura. A simple random sampling technique was conducted with structured questionnaire in this centre. A total 50 mothers with child autism were randomly sampled. Descriptive analysis was used to assess the knowledge between the mothers with autism with demographic variables. Data was analyzed depending priorities on source of hearing and visualizing awareness, awareness regarding source of infection, sign and symptoms of infection, strategies adopted to withstand challenges from COVID-19,vulnerable group's members, Proportion of high strategies capacity with COVID-19. Result: The awareness level high among mothers about COVID-19 in percent was 6.7 levels. Because our Government did mass awareness on Covid-19 as well as District Disability Centre also. Distribution source of hearing about COVID-19 knowledge among mothers according to study mostly from newspaper is 37%. Awareness among mothers about sources of infection high in percentage via handshaking is 70.3, Cough Droplets and Public Gathering are same as 49.3.Symptom awareness of fever, cough, breathlessness are equal as in percentage 70.Strategies adopted to withstand challenges from COVID-19 in percentages in hand washing and using sanitizer 70.9. The demographical independent variables are the age, religion, education, family income, residential area, with chronic stress child with autism. Mothers child with autism without family support and with no formal education negatively associated with Covid-19 strategic capacity in percentage. According to our study mothers have adequate knowledge regarding COVID-19 is resulted Proportion of high Strategic capacity with COVID-19 in percentage is 18.7 Conclusion: Although majority of mothers have adequate knowledge about COVID-19 and engaged in good practice of COVID-19, awareness level have to increase in all mothers with different demographical variables .As a study result mothers are aware about COVID-19 in percent 33.3 in low lavel,60 percent are in medium level. From result there is some decrease in awareness depending on demographical value as education, family income, special training, background of family support and types of family negatively impact-the adequate knowledge among mothers. From we come in conclusion that mothers have adequate knowledge about COVID-19 with path of strategic capacity. [ABSTRACT FROM AUTHOR]

Context: Adult population visiting COVID vaccination center is a potential teachable moment for screening and preventive advice on non-communicable diseases. Objectives: The objective of this study was to assess the proportion of vaccinees volunteering for screening and to know the proportion of newly detected hypertensives and diabetics among the screened vaccinees at COVID-19 vaccination center. Setting and Design: This descriptive, cross-sectional, operational research study was carried out at the COVID vaccination center at a medical college in central Gujarat from July to September 2021. Methods: After receiving the vaccine, the vaccinee was offered screening through a community-based assessment checklist for risk factors of non-communicable diseases, blood pressure, and blood sugar measurement. Those volunteering for this screening received a slip mentioning their risk score, blood pressure and blood sugar reading, and relevant health information and disease prevention advice. The study variables were acceptability (proportion of vaccinees volunteering for screening) and yield (newly detected hypertensives and diabetics among those screened). Results: Among vaccinees, 27.7% volunteered for risk scoring and blood pressure measurement, whereas 8.3% volunteered for blood sugar measurement. Around 15.5% of vaccinees had high-risk scores as per the community-based assessment checklist. The yield of freshly detected high blood pressure and high blood sugar was 19.3% and 10.5%, respectively. The yield was similar even among vaccinees under 30 years of age. Conclusions: Vaccinees demonstrated interest in undergoing screening for non-communicable diseases. Yield indicates that such screening is worth the effort. [ABSTRACT FROM AUTHOR]

Domestic violence is one of the most pernicious gendered ailments of human society. Researchers have confirmed the inevitable consequences of domestic violence (physical, sexual, and emotional) in increased vulnerability to psychopathologies in addition to physical morbidity. Domestic violence cases are vast in India, and the numbers are further aggravated at an alarming rate during the COVID‐19 pandemic. The present study aimed at exploring the cases of domestic violence among Indian women during the COVID‐19 pandemic. Newspapers reporting the incidents of domestic violence during the last 5 years were analysed to explore the issues related to the surge in domestic violence incidents during the COVID‐19 lockdown period. A major increase in domestic violence cases was observed during the COVID‐19 period as compared to the previous years. Also, the cases were higher during the initial phases of the pandemic but gradually decreased as time progressed.The impact of the COVID‐19 pandemic on women was unprecedented and worse than before. Home containment as a measure to protect the health and well‐being of the general public has resulted in increased sufferings for women in terms of both sufferings from diseases and increased domestic violence. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is still the most common infectious disease globally, affecting 1.5 million people per year.1 Prior to COVID-19 outbreak, India was struggling with a rampant attack of Tuberculosis. With the surge of COVID-19, implementation of all national health programs including NTEP was disrupted. Prioritization of services, availability of drugs, the challenges to reaching all types of communities and the role of stigmatization, and the possibility of increased disease transmission were few problems in the implementation of DOTS during the lockdown. Aim: To assess effect of pandemic on DOTS treatment during COVID-19 lockdown. A cross-sectional study was Methods: conducted among 254 tuberculosis patients who were under DOTS during Covid-19 lockdown in Belagavi district. Participants who were on DOTS during 2019 to 2021 period. Of 254 Result: participants, only 5 (2.0%) were supervised while taking drugs, 67(26.4%) of subject's empty blister packs were taken back by health personnel and 106(41.7%) participants were regularly followed up for treatment by health department. The variables like gender, literacy status, socioeconomic status, and occupation were all significantly associated with hampered access to DOTS during the lockdown period at p<0.05. This study concluded Conclusion: that the participants had hampered accessibilities to DOTS during lockdown [ABSTRACT FROM AUTHOR]

Background. India is currently experiencing a shortage of medical personnel to provide COVID-19 relief services among the population. The government came up with a proposal of involving final-year medical students to solve this problem. However, before initiating any such measures, the perspectives of medical students towards this initiative need to be assessed. Objectives. To assess the perception of medical students regarding their self-preparedness and willingness to volunteer in COVID-19 relief activities. Material and methods. This was a cross-sectional study conducted among medical undergraduate students in their third and fourth year at two private medical colleges. Data was collected using a semi-structured Google Form. The perceptions of the participants were assessed using a five-point Likert scale. Results. The mean age of the 204 participants was 21.6 ± 1.1 years. Only 37 (18.1%) participants had good perception regarding their self-preparedness. As many as 116 (56.9%) participants strongly agreed/agreed, while 39 (19.1%) strongly disagreed/disagreed about their willingness to volunteer in COVID-19 relief activities. The most common reason for agreement among the participants was to make up for the current shortage of healthcare professionals, while for disagreement, it was the feeling of not being fully qualified. Third year students reported better self-preparedness (p = 0.0371). Good perception regarding self-preparedness was associated with strong agreement or agreement about a willingness to involve themselves in COVID-19 relief activities (p = 0.0123). Conclusions. Although more than half of the participants were willing to volunteer, only one-fifth of the participants had good perception regarding their self-preparedness to offer relief services. Thus there is a need for training before involving final-year medical students in COVID-19 relief activities. [ABSTRACT FROM AUTHOR]

Effective response to the COVID-19 pandemic is dependent on individual understanding of the disease and compliance to prevention measures. Early media depiction of health information about COVID-19 may influence public perceptions and behaviour. Media should ensure coverage is relevant, timely and actionable to encourage individuals to respond appropriately. India has been particularly affected by a large COVID-19 caseload. We analysed online reporting in India to assess how well the media represented health information about COVID-19 as per the World Health Organization's Strategic Risk Communications guidelines. This included media coverage of symptoms, transmission and prevention. We found that limited articles (18.8%) provided actionable suggestions to readers, including urging people to stay at home and social distance. Most articles were relevant as per WHO COVID-19 updates, accurately covering symptoms, risk factors for severe symptoms, transmission and prevention. However, 40% of media coverage of treatments options provided misleading information, such as suggesting plasma therapy or chloroquine, were effective. In addition, only 1.9% of articles included discussion of equity issues, where many prevention activities such as distancing are less applicable in lower-income households. Sixty-seven per cent of articles quoting sources of information quoted credible sources such as public health agencies and researchers. Media coverage also did not appear to reflect WHO updates in a timely manner, with most of the coverage preceding these updates. The findings show that Indian media should focus on actionable and relevant reporting that provides guidance for individual response. Media should also endeavour to report on evidence-based prevention and treatment options to avert the spread of misinformation. [ABSTRACT FROM AUTHOR]

Background: Religious and spiritual coping strategies is one of the possible tools that can be used to deal with stress and the negative consequences of life problems and illnesses. The study aims to assess religious coping in the time of the COVID-19 pandemic. Methodology: It was an online survey. The sample was collected using a snowball sampling technique as the data were collected through Google forms. The survey started on 22 April 2020 and was closed on 28 May 2020. The participants were from two countries, India and Nigeria. The inclusion criteria were age between 18 and 60 years, having completed at least 10 years of formal education, and have internet access. For data collection, Semi-structured proforma (demographic and personal characteristics) and Brief RCOPE was used to see the extent to which individuals engage in positive and negative forms of religious coping. Results: A total of 647 individuals (360 from Nigeria and 287 from India) participated in the survey. A total of 188 (65.5%) participants in India reported no change in their religious activities since they heard about COVID-19, while, 160 (44.4%) in Nigeria reported a decrease in religious activities. Positive religious coping in the Nigerian population was significantly higher than the Indian population. Similarly, negative religious coping was significantly higher (for most of the items in the brief RCOPE) in the Indian population than the Nigerian population. Conclusion: Significant percentages of people after the COVID-19 pandemic took religious coping steps to overcome their problems. During this pandemic, positive religious coping among the Indian and Nigerian communities is more prevalent than negative religious coping. There is a substantial cross-national difference between Indians and Nigerians in the religious coping modes. [ABSTRACT FROM AUTHOR]

COVID-19 has created shortages of personal protective equipment. In resource-constrained situations, limited cycles of disinfection and extended use of gloves is recommended by the U.S. Centers for Disease Control and Prevention to conserve supplies. However, these guidelines are based on limited evidence. In this study, serial cycles of hand hygiene were performed on gloved hands using an ethanol-based hand rub (six and 10 cycles), 0.1% sodium hypochlorite (bleach) solution (10 cycles), or soap and water (10 cycles) on latex and nitrile medical exam gloves from the United States and India. A modified water-leak test evaluated glove integrity after repeated applications of these disinfecting agents. When aggregated, dilute bleach demonstrated the lowest difference between treatment and control arms: −2.5 percentage points (95% CI: −5.3 to 0.3) for nitrile, 0.6 percentage points (95% CI: −2.6 to 3.8) for non-powdered latex. For U.S.-purchased gloves tested with six and 10 applications of ethanol-based hand rub, the mean difference in failure risk between treatment and control gloves was within the prespecified non-inferiority margin of five percentage points or less, though some findings were inconclusive since outside the margin. The aggregated difference in failure risk between treatment and control was 3.5 percentage points (0.6 to 6.4) for soap and water, and 2.3 percentage points (−0.5 to 5.0) and 5.0 percentage points (1.8 to 8.2) for 10 and 6 applications of ethanol-based hand rub, respectively. Most leaks occurred in the interdigital webs (35%) and on the fingers (34%). This indicates that some combinations of glove types and disinfection methods may allow for extended use. Ten applications of dilute bleach solution had the least impact on glove integrity. However, the majority of glove and exposure combinations were inconclusive. Additional testing of specific glove and disinfectant combinations may inform future strategies to guide extended use during glove shortages. Additional considerations, not evaluated here, include duration of use, disinfectant chemical permeation, and the effects of hand temperature, movement, and manipulation of instruments on glove integrity. [ABSTRACT FROM AUTHOR]

• The likelihood of spousal violence is higher among families who belonged to the poorest living standard. • The prevalence of IPV is higher among those women whose husbands are currently unemployed due to the COVID-19 lockdown. • The women whose husbands have a loan were at more risk for experiencing IPV. • Partner's daily liquor consumption nature is also associated with IPV. Worldwide the incidents of intimate partner violence (IPV) have increased due to lockdowns related to the COVID-19 pandemic. This paper aims to identify the association between IPV and different socio-economic factors of women & their most recent partner during the COVID-19 pandemic in returnee migrant worker families in Balurghat Block (area 363.9 sq. km), Dakshin Dinajpur district, West Bengal, India. A total of 159 ever-married women were included in this present study, whose husbands were engaged as workers elsewhere at least two years before the lockdown. The result of the multinomial logistic regression model revealed that, after controlling for other variables, the women who had the poorest wealth background were 37% more likely (RRR: 1.37; 95% CI [1.18, 1.47]) to experience IPV almost every day in a week than those who had a middle wealth background. Conversely, the women who had the poorest wealth background were 37% (95% CI [0.57, 0.82]) less likely to experience IPV for three to four days in a week. Furthermore, the women whose partners were currently unemployed were 21% more likely (RRR: 1.21; 95% CI [1.16, 1.36]) to experience IPV almost every day in a week than those whose husbands were currently employed. The women whose husband's had a loan were 26% more likely (RRR: 1.26; 95% CI [1.25, 1.33]) to experience IPV for three to four days in a week than those whose husbands did not have any loans. The likelihood to experience IPV almost every day in a week is higher among those women whose husbands attain weekly (31%) loan instalment pattern and consume alcohol daily (31%). Interventions are needed at the grassroots level and some economic planning is required at an urgent basis. [ABSTRACT FROM AUTHOR]