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One of the most detrimental and severe presentations of Systemic Lupus Erythematosus (SLE) is Lupus Nephritis (LN), which is a type of glomerulonephritis. Type-IV Lupus Nephritis, or diffuse Lupus Nephritis, is a severe illness characterised by diffuse proliferative lesions. In this setting, the prognosis worsens if cellular crescent is present. It is divided into two types: diffuse segmental and the other being diffuse global. Wire-loop lesions could also be observed. There have been reports of Collapsing Glomerulopathy (CG) in SLE patients with Focal Segmental Glomerulosclerosis (FSGS). The collapsing variety of FSGS (cFSGS) is defined histopathologically by segmental or global glomerular capillary condensation and obliteration, the appearance of hyperplastic and hypertrophic podocytes, and substantial tubulointerstitial damage. Numerous aetiologies have been proposed, including viral infections such as Human Immunodeficiency Virus (HIV), Cytomegalovirus (CMV), Epstein-Barr virus, and Parvovirus B19, as well as medications and acute ischaemia. Patients infected with Coronavirus Disease-2019 (COVID-19) have an increased risk of acute renal injury as there is a systemic inflammatory cascade due to an acute infection, causing impairment of basic cellular activities in podocytes. Hereby, the authors present a case report of a 17-year-old female who experienced cardiac tamponade and seizures due to Posterior Reversible Encephalopathy Syndrome (PRES). Further investigation and kidney biopsy revealed she had lupus nephritis Stage-IV Diffuse Proliferative Glomerulonephritis (DPGN) but with the collapsing variety, which is a rare finding. Additionally, the patient tested positive for COVID-19, which may have contributed to the development of the collapsing type of DPGN. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic caused significant mortality among vulnerable populations in India, including patients with Chronic Kidney Disease (CKD) on maintenance haemodialysis. The vaccination was the mainstay of prevention. CKD Stage 5 patients requiring haemodialysis have high mortality and poor immune response to many infections, including postvaccination Hepatitis B and Influenza. Antibody response to COVID-19 vaccination in these patients was lower compared to the general population. Aim: To estimate Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) IgG antibody level in the blood sample of CKD Stage 5 maintenance haemodialysis patients. Materials and Methods: A prospective observational study was conducted at the Nephrology department of Government Medical College, Ernakulam, Kerala, India for six months. A total of 55 patients of CKD Stage 5 who were on maintenance haemodialysis were included in the study. The control group consisted of 55 matched close relatives of patients. The anti-SARS-CoV-2 antibody levels were measured in both groups. Blood samples for antibody testing were drawn from the cases, along with routine monthly tests done before a dialysis session. The blood samples were collected simultaneously from the controls, sent to the hospital's central laboratory and processed on the same day. Serum was separated after centrifugation and then stored in small 1 mL Eppendorf tubes/vials and refrigerated at 2-8°C. These serum samples were analysed for anti-SARS-CoV-2 IgG antibody levels in both cases and controls within 24 hours, using the Chemiluminescence Immunoassay (CLIA) method on the VITROS ECiQ Immunodiagnostic system. Relevant data were collected in MS Excel and statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software version 27.0. An unpaired t-test was applied for comparison, with a p-value <0.05 considered statistically significant. Results: Males predominated in the test/case group (43, 78.1%), while females were more prevalent in the control group (42, 76.4%). The comparison of antibody levels between cases and controls showed higher levels in the control group, with a p-value of 0.65, indicating a lack of significance (p-value >0.05). Interestingly, participants vaccinated with Covishield had significantly higher antibody levels at 188.95 BAU/mL compared to those vaccinated with Covaxin or other vaccines, with a p-value of 0.04. Conclusion: The antibody response in CKD Stage 5 haemodialysis patients was found to be lower compared to the control group; however, the difference was not significant. In the current study, the antibody response to the Covishield vaccine was high compared to other vaccine. Larger sample size studies should be conducted in future to validate the results of the present study, if similar COVID-19 like situation reoccurs. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus Disease-2019 (COVID-19) affects mental health, causing various psychiatric symptoms, including cognitive impairment, which may persist for a long time. To develop effective strategies for combating this global health burden, it is necessary to ascertain whether COVID-19 itself causes cognitive decline or whether other factors also play any role. Aim: To determine the prevalence of cognitive impairment in long COVID patients who present with post-COVID-19 psychiatric sequelae, and to investigate its association with socio-demographic factors, depression, anxiety, and stress. Materials and Methods: A cross-sectional study was conducted from July 2022 to June 2023 at a ‘Post-COVID Mental Health Clinic’ in a tertiary care medical college in Kolkata, India. A total of 204 subjects were selected through simple random sampling, aged between 18 and 65 years, of both sexes, who had recovered from COVID-19 more than three months but less than six months prior, and who presented with post-COVID-19 psychiatric sequelae, excluding those with a history of psychiatric disease before contracting COVID-19. The dependent variable, cognition, was measured using the Montreal Cognitive Assessment (MoCA) score, while independent variables included socio-demographic factors, depression, anxiety, and stress, measured by the Depression Anxiety Stress Scale -21 (DASS-21) scores. The Chi-square test was used to find the association between cognition and socio-demographic variables and Pearson’s correlation test was applied to measure the association of cognition with depression, anxiety, and stress scores. Results: The prevalence of cognitive impairment was found to be 86.8%. Chi-square tests of association showed no significant association with socio-demographic factors. However, there was a significant correlation between the severity of depression (r-value=-0.337, p-value

Objectives: This study evaluated the endoscopic management and clinical outcomes of patients with colonic diverticular bleeding (CDB) during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A total of 388 hospitalized patients diagnosed with CDB at two hospitals during (April 2020-March 2023) and before (April 2017-March 2020) the pandemic were enrolled in the study. We performed one-to-one propensity score matching (PSM) on the participants. We analyzed endoscopic management and clinical outcomes before and during the pandemic using a total of 264 patients matched in a PSM analysis. Results: A total of 213 (1.3%) and 172 (1.2%) colonoscopies were performed before and during the pandemic, respectively in patients with CDB (P = 0.70). After PSM, the number of early colonoscopies (63.6% vs. 76.5%, P = 0.03) and colonoscopies performed outside regular working hours (23.8% vs. 47.7%, P < 0.01) was significantly lower during the pandemic than before it. A univariate logistic regression analysis revealed that the risks of rebleeding within 30 days (odds ratio [OR]: 0.81, P = 0.42) and composite outcome (OR: 0.90, P = 0.69) were not increased during the pandemic. Conclusions: During the pandemic, the number of early colonoscopies and colonoscopies performed outside regular working hours decreased; however, this decrease did not influence rebleeding and composite outcome in patients with CDB.

Objective: In this retrospective and cross-sectional study, it was aimed to evaluate the efficacy of tocilizumab (TCZ) treatment in critical COVID-19 patients who were hospitalized in the intensive care unit (ICU) and developed cytokine storm. Materials and Methods: The study included 219 critically ill COVID-19 patients followed in the ICU and treated with TCZ. All patients received 2 doses of 400 mg/day TCZ treatment during their stay in the ICU. Clinical conditions, laboratory data, inotrope requirement and chest radiographs before and after TCZ treatment were compared. Mortality rates at the 7th day, 28th day and total mortality rates of the patients were recorded. Results: It was observed that there was a significant decrease in CRP values over time after TCZ treatment. There was a significant increase in leukocyte, lymphocyte, lactate, urea, creatinine, AST, D-dimer, LDH and PCT values. The 7-day mortality of the patients was 21%, the 28-day mortality was 64.8%, and the total mortality rate was 65.3%. Conclusion: It was determined that after TCZ treatment, only CRP levels, which are among the inflammatory parameters, decreased significantly in patients, and the mortality rates were still high with the increase in the values of kidney and liver function tests of the patients.

Objectives: The objective of this research was to investigate the correlation between the SYNTAX score II (SS-II), a measure of the occurrence of coronary artery disease and mortality over a 4-year period, and factors that increase the susceptibility of individuals to atherosclerosis in coronavirus disease-2019 (COVID-19) patients diagnosed with non-ST-elevation myocardial infarction (NSTEMI). Materials and Methods: We retrospectively examined 200 NSTEMI patients with COVID-19 who applied to Adıyaman Training and Research Hospital between 01.07.2021 and 01.11.2021. We recorded demographic data (age, gender), comorbid diseases, laboratory parameters (hemogram, biochemistry, serological test results), thorax computed tomography findings (COVID-19-compatible or not), angiography results, intervention needs, and mortality status. COVID-19 was confirmed by positive reverse transcription polymerase chain reaction. All patients had SS values and SS-II values calculated. Based on a median SS II value of 28.5, the patients were classified into the low and high SS-II groups. Results: The high-SS-II group exhibited elevated total cholesterol, low-density lipoprotein, carotid intima-media thickness (CIMT), and left ventricular ejection fraction values (p

The objective of this study was to describe the prevalence, characteristics, and risk factors of coronavirus disease-2019 (COVID-19) infection among health care workers (HCWs) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. A prospective cross-sectional study of HCWs confirmed to have COVID-19 infection from March 1, 2020 to December 31, 2022. A total of 746 HCWs were diagnosed with COVID-19. Patients' age ranged from 22 to 60 years with a mean ± standard deviation of 37.4 ± 8.7 years. The infection was community-acquired in 584 (78.3%) HCWs. The vast majority (82.6%) of the infected HCWs had no comorbidities. Nurses (400/746 or 53.6%) represented the largest professional group, followed by physicians (128/746 or 17.2%), administrative staff (125/746 or 16.8%), respiratory therapists (54/746 or 7.2%), and physiotherapists (39/746 or 5.2%). Symptoms included fever (64.1%), cough (55.6%), sore throat (44.6%), headache (22.9%), runny nose (19.6%), shortness of breath (19.0%), fatigue (12.7%), body aches (11.4%), diarrhea (10.9%), vomiting (4.4%), and abdominal pain (2.8%). Most (647 or 86.7%) patients were managed as outpatients. Four (0.5%) HCWs died. HCWs face a dual risk of SARS-CoV-2 infection, both from community exposure and within the hospital setting. Comprehensive infection control strategies are needed to protect HCWs both inside and outside the hospital environment. • 78.3% of COVID-19 infections among healthcare workers (HCWs) were community-acquired. • The vast majority (82.6%) of the infected HCWs had no comorbidities. • Nurses (53.6%) represented the largest professional group, followed by physicians (17.2%). • Most (86.7%) patients were managed as outpatients and 4 (0.5%) patients died. • HCWs face a dual risk of infection, both from community and hospital exposures. [ABSTRACT FROM AUTHOR]

Background: It was initially believed that Coronavirus disease-2019 (COVID-19) increased the risk of complications as well as mortality in obstetric patients. This study was done to analyze any difference in-patient admissions, indications and outcomes in the obstetric ICU before and during the COVID-19 pandemic. Materials and methods: A retrospective study of obstetric cases admitted to the intensive care unit over a period of 6 years was done. The 6-year period was divided into 2 groups, pre-COVID-19 era (1st March 2017-1st March 2020) and the COVID-19 pandemic (2nd March 2020-2nd March 2023). The causes of admission, clinical characteristics, interventions required and outcomes of these patients were compared to see if there was any difference between the two periods and whether COVID-19 out obstetric patients at any additional risk as compared to patients admitted during the pre-COVID-19 period. Results: It was found that there was no significant difference in the number of admissions, associated problems, interventions required and outcomes of patients between the two groups. The data seemed to suggest that the number of abortions have increased post COVID-19, but further studies would be required for that. Conclusion: Obstetric patients did not seem to be at an increased risk for ICU admission due to SARS-CoV-2. Furthermore, no additional increase in morbidity or mortality was observed in those patients in comparison to those admitted before the pandemic. [ABSTRACT FROM AUTHOR]

Background: Community‐acquired pneumonia (CAP) leads to considerable morbidity and mortality globally. However, data on CAP burden in Australia, especially during the coronavirus disease 2019 (COVID‐19) pandemic, are limited. Aims: We characterised and assessed clinical outcomes of non‐COVID‐19 CAP hospitalisations over a 6‐year period at two major hospitals in South Australia. Methods: All non‐COVID‐19 CAP hospitalisations were identified using the International Statistical Classification of Diseases and Related Health Problems, Tenth revision, Australian modification (ICD‐10‐AM) codes, between 1 January 2018 and 31 December 2023, at two tertiary hospitals in Adelaide. Clinical outcomes included in‐hospital and 30‐day mortality, length of stay (LOS) in, intensive care unit (ICU) admission and 30‐day readmissions. Multilevel regression models were utilised to identify predictors of clinical outcomes. Results: Over the 6‐year period, there were 7853 non‐COVID‐19 CAP hospitalisations, with a temporal increase from 100 per 100 000 population in 2018 to 208 per 100 000 population in 2023 (P < 0.001). The mean (SD) age was 75.1 (17.6) years, and 54.6% were males. The mean age declined over time (P < 0.05), while other characteristics remained stable. Streptococcus pneumoniae was the most commonly identified bacterium (21.8% of cases). In‐hospital mortality occurred in 7.8% of patients, with 30‐day mortality and readmission rates of 14.3% and 16.9% respectively. LOS declined significantly during the pandemic years; however, mortality remained stable over time. Frailty status, malnutrition and number of comorbidities significantly predicted 30‐day mortality and LOS, in addition to pneumonia severity and ICU admission. Conclusions: There has been an increasing trend of hospitalisations for non‐COVID‐19 CAP during the COVID‐19 pandemic, with a concomitant trend towards shorter LOS and no significant shift in other clinical outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus Disease-2019 (COVID-19) affects mental health, causing various psychiatric symptoms, including cognitive impairment, which may persist for a long time. To develop effective strategies for combating this global health burden, it is necessary to ascertain whether COVID-19 itself causes cognitive decline or whether other factors also play any role. Aim: To determine the prevalence of cognitive impairment in long COVID patients who present with post-COVID-19 psychiatric sequelae, and to investigate its association with socio-demographic factors, depression, anxiety, and stress. Materials and Methods: A cross-sectional study was conducted from July 2022 to June 2023 at a 'Post-COVID Mental Health Clinic' in a tertiary care medical college in Kolkata, India. A total of 204 subjects were selected through simple random sampling, aged between 18 and 65 years, of both sexes, who had recovered from COVID-19 more than three months but less than six months prior, and who presented with post-COVID-19 psychiatric sequelae, excluding those with a history of psychiatric disease before contracting COVID-19. The dependent variable, cognition, was measured using the Montreal Cognitive Assessment (MoCA) score, while independent variables included socio-demographic factors, depression, anxiety, and stress, measured by the Depression Anxiety Stress Scale-21 (DASS-21) scores. The Chisquare test was used to find the association between cognition and socio-demographic variables and Pearson's correlation test was applied to measure the association of cognition with depression, anxiety, and stress scores. Results: The prevalence of cognitive impairment was found to be 86.8%. Chi-square tests of association showed no significant association with socio-demographic factors. However, there was a significant correlation between the severity of depression (r-value=-0.337, p-value<0.001), anxiety (r-value=-0.275, p-value<0.001), and stress (r-value=-0.277, p-value<0.001) with cognitive impairment. When controlling for anxiety and stress, only depression showed a significant correlation (r-value=-0.221, p-value=0.002). Simple linear regression indicated that the severity of depression significantly predicted the severity of cognitive impairment {R2 =0.114, F(1, 202)=25.88, p-value<0.001}. Conclusion: Cognitive impairment was found to be unrelated to socio-demographic factors, post-COVID-19 anxiety, or stress, except for post-COVID-19 depression, which was identified as a significant predictor of cognitive dysfunction in some patients. This suggests that COVID-19 infection itself may be the most important factor contributing to post-COVID-19 cognitive impairment in patients with post-COVID-19 psychiatric sequelae. [ABSTRACT FROM AUTHOR]

Objective: In this retrospective and cross-sectional study, it was aimed to evaluate the efficacy of tocilizumab (TCZ) treatment in critical COVID-19 patients who were hospitalized in the intensive care unit (ICU) and developed cytokine storm. Materials and Methods: The study included 219 critically ill COVID-19 patients followed in the ICU and treated with TCZ. All patients received 2 doses of 400 mg/day TCZ treatment during their stay in the ICU. Clinical conditions, laboratory data, inotrope requirement and chest radiographs before and after TCZ treatment were compared. Mortality rates at the 7th day, 28th day and total mortality rates of the patients were recorded. Results: It was observed that there was a significant decrease in CRP values over time after TCZ treatment. There was a significant increase in leukocyte, lymphocyte, lactate, urea, creatinine, AST, D-dimer, LDH and PCT values. The 7-day mortality of the patients was 21%, the 28-day mortality was 64.8%, and the total mortality rate was 65.3%. Conclusion: It was determined that after TCZ treatment, only CRP levels, which are among the inflammatory parameters, decreased significantly in patients, and the mortality rates were still high with the increase in the values of kidney and liver function tests of the patients. [ABSTRACT FROM AUTHOR]

Abstract The coronavirus disease-2019 (COVID-19) pandemic has impaired the quality of life (QoL) for many due to its extensive impacts. However, few studies have addressed the specific impact of COVID-19 on the mental health of adolescents, particularly post-traumatic stress disorder (PTSD). This study considered the impact of COVID-19-related PTSD on the QoL of adolescents in China, the mediating effects of insomnia, and the moderating effects of resilience. Participants included 50,666 adolescents aged 12–18 years selected using a comprehensive sampling method. We performed data collection from January 8th to January 18th, 2023, using the Children’s Revised Impact of Event Scale, Pittsburgh Sleep Quality Index, Ten-item Connor-Davidson Resilience Scale, and Screening for and Promotion of Health-related QoL in Children and Adolescents Questionnaire for data collection. Male adolescents exhibited significantly lower levels of PTSD and insomnia compared to females and scored significantly higher in psychological resilience and overall QoL. Insomnia played a mediating role between PTSD and QoL. Psychological resilience moderated the impact of COVID-19-related stress on adolescents’ QoL through its influence on insomnia. PTSD resulting from the COVID-19 pandemic affects the QoL of adolescents through the presence of insomnia. Psychological resilience plays a moderating role in this process. Cultivating psychological resilience in adolescents can effectively enhance their ability to cope with the impacts of sudden public events.

Introduction: Measles, a highly transmissible disease marked by fever and a maculopapular rash, posed a substantial threat to life in the 1960s. Nevertheless, the advent of the measles vaccine had a profound impact, significantly diminishing its toll on mortality. Similarly, through effective influenza surveillance and early epidemic warning systems, public health officials can timely identify influenza trends and provide crucial scientific support for prevention and control measures. This proactive approach holds great public health significance. Aim: To analyse the long-term trend of measles cases in Rajasthan, India, and the impact of Coronavirus Disease-2019 (COVID-19) on it, with future predictions using Auto-Regressive Integrated Moving Average (ARIMA) modelling. Materials and Methods: The present study was a retrospective, descriptive observational study in which monthly diagnosed measles cases were collected from the Measles Rubella Laboratory, Department of Microbiology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India, for the period of April 2010 to April 2023. An ARIMA model was developed using data from 2010 to 2020 to predict the monthly number of measles cases in 2021. The predicted values were then compared to the actual cases in 2021 to assess the model’s accuracy. Results: Out of the total positive cases, males were slightly more prone to acquire infection than females (1734 males, 54%; 1477 females, 46%). The monthly index for new measles cases ranged from 0.11 to 2.6. It reached its lowest point in July (0.106) and August (0.25) and peaked in March (2.594) and April (1.84). The overall trend was fluctuating; however, the incidence of measles cases clearly increased after the year 2021. The difference between observed cases and predicted cases for the period of April 2020 to December 2021 was not statistically significant (t-value=0.261 and p-value=0.797). Conclusion: The fluctuating trend of measles was observed during the last decade; however, the observed cases of measles showed an upward trajectory during and after the COVID-19 outbreak. This study also highlighted the monthly index of the measles cases, which peaked in March to April and was lowest in July to August.

Introduction: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in China, the epidemic has rapidly spread all over the world in just a few months. Different steroids have been proven effective in treating COVID-19 pneumonia. However, comparative efficacy data between different steroids have been evaluated in a few studies from various parts of the world. To date, no study with a large number of patients has been conducted in the eastern part of India. Aim: To compare the efficacy of dexamethasone and methylprednisolone in terms of outcomes and disease progression in COVID-19 pneumonia patients. Materials and Methods: This retrospective cohort study included 377 patients with moderate and severe COVID-19 pneumonia admitted to Medical College and Hospital from May 2020 to December 2020, Kolkata, West Bengal, India. Patient records were divided into two groups based on the type of steroids administered (dexamethasone and methylprednisolone). Clinical, laboratory, treatment, and outcome data were tabulated for analysis. Demographic patterns in the two groups were compared, and efficacy was analysed in terms of hospital course (hospital stay length, type of respiratory support received) and final outcome (cured or death) in both groups. The data collected were analysed using Statistical Package for Social Sciences (SPSS) software version 29.0. Qualitative variables were expressed as counts and percentages, while quantitative variables were presented as mean±Standard Deviation (SD). Results: There were no significant differences between the two treatment groups based on demographic features (age, sex), co-morbidities (diabetes, hypertension, etc.), disease severity (hypoxia, hypotension) on admission day, and smoking status. The study showed that methylprednisolone significantly reduced the requirement for high-flow oxygen (p-value=0.002), Non Invasive Ventilation (NIV) (p-value=0.001), and invasive ventilation (p-value=0.001) compared to dexamethasone. However, there was no significant difference (p-value=0.800) in the duration of hospital stay between the methylprednisolone and dexamethasone treatment groups. Kaplan-Meier survival analysis also showed a significant survival benefit among patients who received methylprednisolone compared to dexamethasone (log-rank p-value=0.039). Conclusion: The present study concludes that in COVID-19 pneumonia, the administration of methylprednisolone leads to a significant reduction in mortality and the need for high-flow oxygen, NIV, and invasive ventilation compared to dexamethasone.

Introduction: Coronavirus disease 2019 (COVID-19), a unique viral infection causing multiorgan failure, can lead to diverse dermatological manifestations, unlike other viral exanthems. There is a scarcity of Indian literature describing these manifestations. Aims and Objectives: To study the dermatological manifestations due to COVID-19 infection. Materials and Methods: It was a retrospective analysis (6 month) of patients with dermatological manifestations related to COVID-19 infection. Medical records were evaluated with respect to demography, detailed clinical presentations, real-time reverse transcription–polymerase chain reaction/rapid antigen test positivity, and related investigations. Statistical Analysis: It was done using proportion, mean, and percentages. Results: A total of 76 cases were recruited. Out of the 76 COVID-19-related cases, there were 67 diagnosed and 9 suspected cases (later came positive). The overall female predominance (n = 69) was observed. The most common age affected was 31-40 years. The most common presentation during prodromal, acute, and postacute phases was urticaria. Other manifestations were chilblain-like, varicella-like, pityriasis rosea-like, erythema multiforme-like, petechial rash, multisystemic inflammatory syndrome in children and confirmed cases of mucormycosis seen with cutaneous manifestation. Conclusion: Our study highlights the need for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in patients presenting with rash in otherwise asymptomatic individuals having contact with confirmed case and when associated with systemic symptoms. Dermatological manifestations may play an important role in identifying cases early and serve as an important proxy in managing further spread of this disease in the midst of the global pandemic. Urticaria with fever has diagnostic significance since this combination can be a symptom of an otherwise not confirmed SARS-CoV-2 infection.

Recent research has highlighted the link between childhood obesity, dental caries, and malocclusion, and how the Coronavirus Disease - 2019 (COVID-19) pandemic and social media have worsened these health issues. Increased screentime and decreased physical activity during the pandemic have significantly contributed to these conditions among children. Studies emphasise the need to address common risk factors such as unhealthy diets, limited healthcare access, and poor public health policies to reduce their negative effects. This review explores the complex relationship between childhood obesity, dental caries, and malocclusion, with a focus on their global importance. It examines the connections and shared risk factors between these conditions, particularly in the context of the pandemic and the growing influence of social media on children. The goal is to provide insights for developing effective interventions and management strategies to improve children's health worldwide. The present review stresses the urgent need for comprehensive strategies that target both individual and collective risk factors, while also considering broader socio-economic and digital influences on children's health behaviours. Promoting healthy lifestyles, access to nutritious foods, physical activity, and better dental care can help to alleviate these conditions. Understanding the interplay between these health issues and the digital environment is crucial to creating effective and adaptable public health interventions.

Objectives: In coronavirus disease-2019 (COVID-19), autonomic dysfunction may ensue. The heart rate recovery index (HRRI) measures autonomic function and predicts cardiovascular disease (CVD). The research assessed HRRI in patients with COVID-19. Materials and Methods: The research group included 160 verified COVID-19 cases, and the control group had 160 healthy participants without a history of immunization. All patients underwent treadmill stress electrocardiogram according to the Bruce protocol. After the stress test, HRRIs were taken at 1, 2, 3, and 5 min. HRRI is computed by subtracting the subject’s maximum exercise heart rate (HR) at the end of the exercise from HR after 1, 2, 3, and 5 min of recovery. Results: Both groups had equal exercise duration, metabolic equivalents, maximum (max.) HR, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at baseline, max. SBP and DBP, and changes in SBP and DBP (p>0.05). HRRIs were greater in COVID-19 patients than in controls at 1, 2, 3, and 5 min (p

The coronavirus disease-2019 (COVID-19) pandemic has impaired the quality of life (QoL) for many due to its extensive impacts. However, few studies have addressed the specific impact of COVID-19 on the mental health of adolescents, particularly post-traumatic stress disorder (PTSD). This study considered the impact of COVID-19-related PTSD on the QoL of adolescents in China, the mediating effects of insomnia, and the moderating effects of resilience. Participants included 50,666 adolescents aged 12–18 years selected using a comprehensive sampling method. We performed data collection from January 8th to January 18th, 2023, using the Children's Revised Impact of Event Scale, Pittsburgh Sleep Quality Index, Ten-item Connor-Davidson Resilience Scale, and Screening for and Promotion of Health-related QoL in Children and Adolescents Questionnaire for data collection. Male adolescents exhibited significantly lower levels of PTSD and insomnia compared to females and scored significantly higher in psychological resilience and overall QoL. Insomnia played a mediating role between PTSD and QoL. Psychological resilience moderated the impact of COVID-19-related stress on adolescents' QoL through its influence on insomnia. PTSD resulting from the COVID-19 pandemic affects the QoL of adolescents through the presence of insomnia. Psychological resilience plays a moderating role in this process. Cultivating psychological resilience in adolescents can effectively enhance their ability to cope with the impacts of sudden public events. [ABSTRACT FROM AUTHOR]

Purpose: Examine the alterations in antipsychotic concentrations following coronavirus disease-2019 (COVID-19) infection among hospitalized patients with mental disorders and conduct an analysis of the factors influencing these changes. Methods: Data were collected from inpatients at Beijing Huilongguan Hospital between December 12, 2022, and January 11, 2023, pre- and post-COVID-19. Based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, 329 inpatients with mental disorders were included (3 with incomplete data excluded). Primary outcomes assessed changes in antipsychotic concentrations pre- and post-COVID-19, while secondary outcomes examined factors linked to concentration increases and antipsychotic dose adjustments. Results: Clozapine (P < 0.001), aripiprazole (P < 0.001), quetiapine (P = 0.005), olanzapine (P < 0.001), risperidone (P < 0.001), and paliperidone (P < 0.001) concentrations increased post-COVID-19 in patients with mental disorders. Notably, clozapine concentration surpassing pre-infection levels was highest. Clozapine users were more likely to adjust their dose (50.4%) compared to olanzapine (17.5%) and other antipsychotics. Moreover, traditional Chinese patent medicines and antibiotics during COVID-19 infection were associated with antipsychotic reduction or withdrawal (OR = 2.06, P = 0.0247; OR = 7.53, P = 0.0024, respectively). Conclusion: Antipsychotic concentrations in hospitalized patients with mental disorders increased after COVID-19 infection, that may be related not only to COVID-19, but also to the use of Chinese patent medicines during infection. The pre-infection concentration and types of antipsychotics, patient's gender, and combination of traditional Chinese medicine or antibiotics, were factors found to correlate with increased drug concentrations and necessitate dose adjustments. [ABSTRACT FROM AUTHOR]

Introduction: The severe acute respiratory syndrome coronavirus 2 that is the cause of the coronavirus disease-2019 (COVID-19) pandemic is linked to a variety of opportunistic bacterial and fungal coinfections. Orofacial mycoses, fungal infections affecting the oral and facial regions, have recently gained attention as potential complications in individuals with COVID-19. Materials and Methods: This study aims to contribute to the understanding of orofacial mucormycosis in the context of COVID-19, particularly focusing on the prevalence among patients in a tertiary care center in Northern India. This study comprised respiratory materials from 255 COVID-19 patients treated at Max Hospital, Saket. The laboratory received specimens for microbiological pneumonia workup culture and molecular detection. Results: The most prevalent site for mucormycosis was the rhino-orbital region, accounting for a majority of cases at 58.2%. Following the rhino-orbital region, the involvement extended to the rhino-orbital-cerebral region in a notable proportion of cases. Pulmonary sites were identified as a significant location for mucormycosis, though less frequent compared to the rhino-orbital region. Mucormycosis diagnoses were predominantly made using direct microscopy, with 82.6% (196/255) of patients undergoing this diagnostic method. Conclusion: Our study in Northern India revealed a high prevalence of orofacial mucormycosis in middle-aged diabetic males, often with a history of COVID-19 hospitalization and steroid use. Rhizopus spp. were the most common Mucorales identified, with treatment challenges due to antifungal resistance. Molecular tests, such as matrix-assisted laser desorption ionization–time of flight, are valuable for species identification, emphasizing the need for heightened awareness during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Having a weakened immune system can make patients easily get nosocomial infection (NI) with multi-drug resistant (MDR) bacteria and put them in a dangerous situation. It causes long hospital stays, disability, economic burden, and even death. The present study aimed to determine the prevalence of NI in patients suffering from COVID-19. Methods: In this retrospective study, the information on 250 patients suffering from COVID-19 in the intensive care unit (ICU) (2020 to 2021) was considered. For statistical analysis, analysis of variance (ANOVA), paired samples t-test, and chi-square using SPSS-23 software were used (p<0.05). Results: Two hundred and fifty hospitalized (107 females and 143 males, mean ± standard deviation (SD) of age; 56.50 ± 17.20) patients were considered. The most (97.60%) medicine prescribed was remdesivir. Candida spp. (two females), Escherichia coli (two females), Acinetobacter spp. (one female), Citrobacter spp. (one female), Pseudomonas spp. (one male), Sphingomonas spp. (one male), Stenotrophomonas spp. (one male) and Enterobacter spp. (one male) were isolated from the patient's specimens. Four of seven bacterial isolates were positive for MDR. NI was diagnosed in six patients. There was no significant relationship between the age with the isolated microbes (P=0.154) and MDR (P=0.987) and also between gender with common microbes (P=0.576) and MDR (P=0.143). Conclusion: The coexistence of bacteria and NI was observed in patients. Remdesivir was prescribed for most patients. Most bacteria were resistant to antibiotics, especially, β-lactams. [ABSTRACT FROM AUTHOR]

Introduction: Measles, a highly transmissible disease marked by fever and a maculopapular rash, posed a substantial threat to life in the 1960s. Nevertheless, the advent of the measles vaccine had a profound impact, significantly diminishing its toll on mortality. Similarly, through effective influenza surveillance and early epidemic warning systems, public health officials can timely identify influenza trends and provide crucial scientific support for prevention and control measures. This proactive approach holds great public health significance. Aim: To analyse the long-term trend of measles cases in Rajasthan, India, and the impact of Coronavirus Disease-2019 (COVID-19) on it, with future predictions using Auto-Regressive Integrated Moving Average (ARIMA) modelling. Materials and Methods: The present study was a retrospective, descriptive observational study in which monthly diagnosed measles cases were collected from the Measles Rubella Laboratory, Department of Microbiology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India, for the period of April 2010 to April 2023. An ARIMA model was developed using data from 2010 to 2020 to predict the monthly number of measles cases in 2021. The predicted values were then compared to the actual cases in 2021 to assess the model’s accuracy. Results: Out of the total positive cases, males were slightly more prone to acquire infection than females (1734 males, 54%; 1477 females, 46%). The monthly index for new measles cases ranged from 0.11 to 2.6. It reached its lowest point in July (0.106) and August (0.25) and peaked in March (2.594) and April (1.84). The overall trend was fluctuating; however, the incidence of measles cases clearly increased after the year 2021. The difference between observed cases and predicted cases for the period of April 2020 to December 2021 was not statistically significant (t-value=0.261 and p-value=0.797). Conclusion: The fluctuating trend of measles was observed during the last decade; however, the observed cases of measles showed an upward trajectory during and after the COVID-19 outbreak. This study also highlighted the monthly index of the measles cases, which peaked in March to April and was lowest in July to August. [ABSTRACT FROM AUTHOR]

Introduction: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in China, the epidemic has rapidly spread all over the world in just a few months. Different steroids have been proven effective in treating COVID-19 pneumonia. However, comparative efficacy data between different steroids have been evaluated in a few studies from various parts of the world. To date, no study with a large number of patients has been conducted in the eastern part of India. Aim: To compare the efficacy of dexamethasone and methylprednisolone in terms of outcomes and disease progression in COVID-19 pneumonia patients. Materials and Methods: This retrospective cohort study included 377 patients with moderate and severe COVID-19 pneumonia admitted to Medical College and Hospital from May 2020 to December 2020, Kolkata, West Bengal, India. Patient records were divided into two groups based on the type of steroids administered (dexamethasone and methylprednisolone). Clinical, laboratory, treatment, and outcome data were tabulated for analysis. Demographic patterns in the two groups were compared, and efficacy was analysed in terms of hospital course (hospital stay length, type of respiratory support received) and final outcome (cured or death) in both groups. The data collected were analysed using Statistical Package for Social Sciences (SPSS) software version 29.0. Qualitative variables were expressed as counts and percentages, while quantitative variables were presented as mean±Standard Deviation (SD). Results: There were no significant differences between the two treatment groups based on demographic features (age, sex), co-morbidities (diabetes, hypertension, etc.), disease severity (hypoxia, hypotension) on admission day, and smoking status. The study showed that methylprednisolone significantly reduced the requirement for high-flow oxygen (p-value=0.002), Non Invasive Ventilation (NIV) (p-value=0.001), and invasive ventilation (p-value=0.001) compared to dexamethasone. However, there was no significant difference (p-value=0.800) in the duration of hospital stay between the methylprednisolone and dexamethasone treatment groups. Kaplan-Meier survival analysis also showed a significant survival benefit among patients who received methylprednisolone compared to dexamethasone (log-rank p-value=0.039). Conclusion: The present study concludes that in COVID-19 pneumonia, the administration of methylprednisolone leads to a significant reduction in mortality and the need for high-flow oxygen, NIV, and invasive ventilation compared to dexamethasone. [ABSTRACT FROM AUTHOR]

Objectives The objective of this research was to investigate the correlation between the SYNTAX score II (SS-II), a measure of the occurrence of coronary artery disease and mortality over a 4-year period, and factors that increase the susceptibility of individuals to atherosclerosis in coronavirus disease-2019 (COVID-19) patients diagnosed with non-ST-elevation myocardial infarction (NSTEMI). Materials and Methods We retrospectively examined 200 NSTEMI patients with COVID-19 who applied to Adıyaman Training and Research Hospital between 01.07.2021 and 01.11.2021. We recorded demographic data (age, gender), comorbid diseases, laboratory parameters (hemogram, biochemistry, serological test results), thorax computed tomography findings (COVID-19-compatible or not), angiography results, intervention needs, and mortality status. COVID-19 was confirmed by positive reverse transcription polymerase chain reaction. All patients had SS values and SS-II values calculated. Based on a median SS II value of 28.5, the patients were classified into the low and high SS-II groups. Results The high-SS-II group exhibited elevated total cholesterol, low-density lipoprotein, carotid intima-media thickness (CIMT), and left ventricular ejection fraction values (p<0.001). Logistic regression analysis revealed that CIMT (odds ratio: 3.124, 95% confidence interval: 1.744-5.628; p<0.001) was an independent predictor of SS-II. Conclusion In patients with NSTEMI and COVID-19, CIMT and SS-II might increase the risk of atherosclerosis. The combination of NSTEMI and COVID-19 increases mortality. Keywords:Coronavirus disease-2019, non-ST elevation myocardial infarction, SYNTAX score II: [ABSTRACT FROM AUTHOR]

Recent research has highlighted the link between childhood obesity, dental caries, and malocclusion, and how the Coronavirus Disease - 2019 (COVID-19) pandemic and social media have worsened these health issues. Increased screentime and decreased physical activity during the pandemic have significantly contributed to these conditions among children. Studies emphasise the need to address common risk factors such as unhealthy diets, limited healthcare access, and poor public health policies to reduce their negative effects. This review explores the complex relationship between childhood obesity, dental caries, and malocclusion, with a focus on their global importance. It examines the connections and shared risk factors between these conditions, particularly in the context of the pandemic and the growing influence of social media on children. The goal is to provide insights for developing effective interventions and management strategies to improve children's health worldwide. The present review stresses the urgent need for comprehensive strategies that target both individual and collective risk factors, while also considering broader socioeconomic and digital influences on children's health behaviours. Promoting healthy lifestyles, access to nutritious foods, physical activity, and better dental care can help to alleviate these conditions. Understanding the interplay between these health issues and the digital environment is crucial to creating effective and adaptable public health interventions. [ABSTRACT FROM AUTHOR]

Introduction: In the relentless global battle against the Coronavirus Disease-2019 (COVID-19) pandemic, accurate prediction of disease severity remains a critical challenge, with profound implications for patient outcomes and healthcare resource allocation. As the virus continues to evolve and pose new threats, the need for reliable prognostic indicators becomes increasingly urgent. Effective identification of patients at high-risk of developing severe illness not only facilitates timely intervention and personalised treatment strategies but also optimises healthcare resource utilisation. In this context, the exploration of novel biomarkers and predictive models holds immense promise for enhancing ones understanding of disease progression and improving clinical decision-making. Aim: To study the association between haematological parameters, including Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), and Platelet-to-Lymphocyte Ratio (PLR), with Computed Tomography Scan Severity Score (CTSS) in COVID-19 patients. Materials and Methods: A prospective cohort study was conducted from March 2021 to July 2022 at Government General Hospital (GGH) Nizamabad, Telangana, India. The study encompassed all three COVID-19 waves, included a sample size of 159 Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) positive patients, excluding pregnant women and children under 10 years. Upon admission, CTSS and ratios of NLR, LMR, and PLR were recorded in an MS Excel sheet before any medical intervention and then analysed using Statistical Package for Social Sciences (SPSS) software 22.0. Results: The study comprised 159 patients with a mean age of 50.86±13.89 years (ranging from 16 to 85), predominantly male 90 (56.61%). The highest infection rate 85 (53.45%) was in the 41-60 years age group. The NLR was significantly elevated from a mean value of 4.58 to 11.24 (r value=0.78, p-value=

Background: Having a weakened immune system can make patients easily get nosocomial infection (NI) with multi-drug resistant (MDR) bacteria and put them in a dangerous situation. It causes long hospital stays, disability, economic burden, and even death. The present study aimed to determine the prevalence of NI in patients suffering from COVID-19. Methods: In this retrospective study, the information on 250 patients suffering from COVID-19 in the intensive care unit (ICU) (2020 to 2021) was considered. For statistical analysis, analysis of variance (ANOVA), paired samples t-test, and chi-square using SPSS-23 software were used (p

Introduction: Survivors of severe Coronavirus Disease-2019 (COVID-19) pneumonia may experience Exercise-Induced Desaturation (EID), which can remain undiagnosed at discharge, as most exhibit normal resting Arterial Blood Gases (ABGs). This undiagnosed condition may lead to unexpected hospital readmissions, causing additional burden to the health system. However, the prevalence of EID among this population, especially in developing countries, is not well documented. Aim: To estimate the prevalence of EID among survivors of severe COVID-19 pneumonia and to explore the predictive role of Lung Ultrasound Scan (LUS) in detecting EID. Materials and Methods: This hospital-based, observational, cross-sectional study was conducted at the Institute of Chest Diseases in Kozhikode, Kerala, India from October 2021 to September 2022. It involved 153 COVID-19 patients aged 18 years and above who had recovered from severe pneumonia, were otherwise fit for hospital discharge, and had normal resting ABGs. The study examined the prevalence of EID using the 6-Minute Walk Test (6MWT). Additionally, it investigated the predictive ability of a LUS for EID. A LUS was performed on all patients and scoring was conducted according to the established protocol. Results: The mean age of the study subjects was 53.50±14.13 years, with 119 (77.8%) being male. During the 6MWT, 96 patients (62.7%) showed significant desaturation. A total of 83 (95.4%) subjects in the desaturated group required Non-Invasive Ventilation (NIV) compared to 4 (4.6%) in the non-desaturated group (p

The coronavirus disease-2019 (COVID-19) has been declared a global pandemic by the World Health Organization due to its spread to more than 90% of nations of the world with significant consequences on their health, social structure, and economy. The causative agent, severe acute respiratory syndrome coronavirus 2, is a highly contagious virus of the coronaviridae family that is known to survive on many surfaces for days at various temperatures. It is acid stable at a high titer (1.2 × 103 PFU) for up to an hour and inactivated when exposed to temperatures 33°C and above for up to 30 min. Chemical agents such as ethanol, diethyl ether, chlorine, per-acetic acid, and chloroform likewise inactivate it as well as exposure to ultraviolet (UV) rays at 254 nm. Emerging evidence indicate that while modes of transmission of the disease are the same across the globe, incidence rates, clinical manifestation, severity, and outcome of COVID-19 in tropical Africa differ from other continent. Patients in Africa have presented with less severe symptoms, higher rates of recovery, and lower case-fatality rates. There are suggestions that higher environmental temperature and humidity in African countries, immune status, dietary pattern, and sociocultural practices of the people may have contributed to this. This review of literature sought to investigate the probable influence of these factors on the impact of COVID-19 in Africa with recommendations to mitigate its spread and impact on morbidity and mortality.

Introduction: Acute respiratory failure is the most common clinical feature in patients with severe Coronavirus Disease -2019 (COVID-19) who are admitted to an Intensive Care Unit (ICU) and may require invasive mechanical ventilation, which is generally linked with a high fatality rate. Patients with established co-morbidities, such as diabetes, invariably fall into the category of patients with severe disease presentation and rapid disease progression. Aim: To study the clinical outcomes of COVID-19 diabetic patients after sequential oxygen therapy using a reservoir bag mask, High Frequency Nasal Oxygen (HFNO), and Non-invasive Ventilation (NIV). Materials and Methods: In this retrospective cohort study, adhering to the STROBE statement criteria, the authors included 150 patients suffering from COVID-19 acute respiratory failure, who were known diabetics, divided into three groups based on admission oxygen saturation and Respiratory Rate (RR) for Non-Rebreather Bag-Mask (NRBM) therapy, HFNO, and NIV. For two weeks, all patients were monitored, and measures such as Saturation of peripheral Oxygen (SpO2), Respiratory Rate (RR) escalation of oxygen requirement, glycaemic management, compliance and problems with continued oxygen therapy, the need for invasive mechanical ventilation, and mortality were recorded. The recorded parameters among the three groups were compared using Analysis of Variance (ANOVA) test. Results: Among the demographic parameters recorded, the authors noted that individuals older than 50-55 years of either sex were admitted for HFNO (56.02±11.71 years) and NIV (54.28±14.67 years) therapy, whereas no such preponderance was noted among the two genders. Significant results were noted in all three groups in terms of the escalation of oxygen fraction (FiO2) requirements on the 10th day of observation (NRBM 12.63±2.48%, HFNO 37.74±13.56%, NIV 82.44±11.11%). The need for tracheal intubation was higher in patients in the NIV group (10) compared to the HFNO (9) and NRBM (1) groups. Patients whose blood sugar levels remained uncontrolled throughout the course of observation in the study were disparagingly seen to have been a part of the HFNO and NIV groups, and hence the subsequent mortality. Conclusion: There was a steady escalation of mean oxygen requirements in all three groups of oxygen therapy over the course of two weeks, coinciding with the ensuing ‘cytokine storm’ associated with Severe Acute Respiratory Syndrome- Coronavirus- 2 (SARS-CoV-2) infection. This trend of escalation of oxygen requirement also in turn coincided with the raised glycaemic charting trends of the patients over the same course of two weeks, delineating those individuals with diabetes mellitus, in view of their compromised immunity and innate pro -inflammatory state, are more prone to develop severe form of the disease with more serious complications, which may even lead to mortality. With regards to the compliance, NRBM & HFNO provided best results in comparison to NIV. The rates of complications were also noted to be higher with the use of NIV in this instance.

Aims:This study aimed to evaluate the mental health of mothers of children with attention deficit hyperactivity disorder (ADHD) after distance learning measures during the Coronavirus disease-2019 (COVID-19) pandemic, considering factors that may influence their well-being.Methods:In a cross-sectional design, the levels of burnout, depression, anxiety, stress, coping strategies, social support, and perceived changes in mental health among the mothers were assessed using the Maslach Burnout Inventory (MBI), Depression Anxiety Stress Scale-21 (DASS-21), Brief Coping Orientation to Problems Experienced Inventory, Multidimensional Scale of Perceived Social Support Scale, and Global Rating of Change (GRC) scale. Furthermore, the mothers completed the Atilla Turgay Scale (T-DSM-IV-S) to evaluate their perceptions of their children’s ADHD and behavioral problems.Results:Of the 72 mothers (mean age: 42.46±6.73 years, mean children age: 11.39±3.12 years), 50%, 44.4%, and 43.1% had depression symptoms, anxiety, and stress, respectively. According to the GRC, most mothers (67%) reported deterioration in mental well-being compared with the pre-pandemic period. The strongest correlations were between the subscales of T-DSM-IV-S and the total MBI score (r=0.51, p

Objective: The aim of this study was to investigate the association between coronavirus disease-2019 (COVID-19) vaccination and stent thrombosis in patients with coronary stents. Material and Methods: This was a retrospective study conducted between January 2021 and December 2022. The study included patients with existing coronary stents who underwent coronary angiography for suspicion of stent thrombosis. A broad range of clinical data, including COVID-19 related data (disease history, number and brand of COVID-19 vaccinations), laboratory findings, follow-up time, and mortality data were obtained retrospectively. The endpoints of the study were coronary stent thrombosis and all-cause mortality. Results: A total of 969 patients were included in the study. Stent thrombosis was present in 538 patients (55.52%), who were significantly younger and had a higher proportion of males compared to those without stent thrombosis. Multivariable logistic regression revealed active smoking, hypertension, diabetes mellitus, and coronary artery bypass graft+stent history as being independently associated with higher risk for stent thrombosis. Whereas, anticoagulant use and receiving 4 or more vaccine doses were independently associated with lower likelihood of stent thrombosis. Diabetes mellitus, previous cerebrovascular disease, high urea, and stent thrombosis were independently associated with mortality; whereas hyperlipidemia and receiving the BioNTech vaccine were independently associated with lower risk for mortality. Conclusion: Receiving multiple COVID-19 vaccine doses (regardless of type) may reduce the likelihood of stent thrombosis, possibly by protecting against COVID-19. However, more research is needed to understand the potential pathophysiological links between COVID-19 vaccination and coronary stent thrombosis. [ABSTRACT FROM AUTHOR]

Aim: Coronavirus disease 2019 emerged in December 2019 and spread worldwide. This study aimed to clarify the impact of the coronavirus disease 2019 pandemic on the diagnosis and treatment of hepatocellular carcinoma (HCC) in Japan. Methods: First, we collected the monthly numbers of HCC‐related general medical practices from January 2019 to December 2021 at liver disease‐specific medical institutions in Japan. Next, we collected individual clinical information from patients with newly diagnosed HCC during this period. Results: There was a decrease in the number of HCC‐related medical practices, including referrals, enhanced abdominal ultrasonography and radiofrequency ablation, in Japan's first state of emergency (SOE; April–May 2020) compared with 2019. Fewer patients were diagnosed with new HCC during the first SOE than before or after it. There was no difference in tumor diameter, number of tumors or Barcelona Clinic Liver Cancer stage between patients diagnosed before the first SOE and those diagnosed during or after the first SOE. The median waiting times for treatment of patients diagnosed during and after the first SOE were 31 and 37 days, which were significantly shorter and not longer than that of patients diagnosed before the first SOE (36 days), respectively. Conclusion: The number of HCC‐related general medical practices decreased during the first SOE. However, the coronavirus disease 2019 pandemic did not lead to HCC progression by diagnostic delays or cause HCC treatment delays in Japan. [ABSTRACT FROM AUTHOR]

Introduction: In the relentless global battle against the Coronavirus Disease-2019 (COVID-19) pandemic, accurate prediction of disease severity remains a critical challenge, with profound implications for patient outcomes and healthcare resource allocation. As the virus continues to evolve and pose new threats, the need for reliable prognostic indicators becomes increasingly urgent. Effective identification of patients at highrisk of developing severe illness not only facilitates timely intervention and personalised treatment strategies but also optimises healthcare resource utilisation. In this context, the exploration of novel biomarkers and predictive models holds immense promise for enhancing ones understanding of disease progression and improving clinical decision-making. Aim: To study the association between haematological parameters, including Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), and Platelet-to-Lymphocyte Ratio (PLR), with Computed Tomography Scan Severity Score (CTSS) in COVID-19 patients. Materials and Methods: A prospective cohort study was conducted from March 2021 to July 2022 at Government General Hospital (GGH) Nizamabad, Telangana, India. The study encompassed all three COVID-19 waves, included a sample size of 159 Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) positive patients, excluding pregnant women and children under 10 years. Upon admission, CTSS and ratios of NLR, LMR, and PLR were recorded in an MS Excel sheet before any medical intervention and then analysed using Statistical Package for Social Sciences (SPSS) software 22.0. Results: The study comprised 159 patients with a mean age of 50.86±13.89 years (ranging from 16 to 85), predominantly male 90 (56.61%). The highest infection rate 85 (53.45%) was in the 41-60 years age group. The NLR was significantly elevated from a mean value of 4.58 to 11.24 (r value=0.78, p-value=<0.001), and LMR notably reduced from 8.27 to 3.80 (r value=0.67, p-value=0.003) in correlation with the severity as indicated by CTSS. Although PLR values were higher in severe cases, increasing from 173.07 in mild cases to 272.29 in severe cases, there was no significant correlation with CTSS (r-value=-0.78, p-value=0.177). Conclusion: CTSS emerges as a valuable radiological biomarker for predicting COVID-19 severity. However, due to its cost and limited availability in grassroots-level hospitals, there is a need for alternative severity prediction models. Present study proposes a predictive model using NLR and LMR biomarkers as alternatives to CTSS for assessing COVID-19 severity. [ABSTRACT FROM AUTHOR]

Introduction: Years after SARS coronavirus disease 2019 (COVID-19) recovery, residual pulmonary abnormalities may still exist. This brings on the question of whether or not COVID-19 could have comparable late consequences. Structural changes in the lungs after recovery can be better visualized using computed tomography (CT) thorax. Computed Tomography Lung Parenchymal changes during hospitalization by COVID-19 and after 4 months of follow-up to correlate with the volumetric high-resolution computed tomography thorax indices, Pulmonary function tests (PFTs) indices, SpO2, and 6 min Walking Test (6MWT). Materials and Methods: This is a Hospital based cross-sectional study, with a follow-up among 100 Patients from 2020 to 2022. Each patient's different CT parameters and HRCT volumetric indices Normal Lung (NL), Normal Lung Percentage (NL%), Whole Lung (WL) were correlated with the PFT indices (Forced expiratory volume in 1s [FEV1], forced vital capacity [FVC], FEV1/FVC), Oxygen Saturation (SpO2) and 6-Minute Walking Test (6MWT). Results: The mean NL (L) and NL% during COVID were significantly lower than the mean values 4 months post-COVID. Architectural distortion, bronchiolar dilatation, interstitial thickening, and parenchymal bands were reduced considerably after 4 months post-COVID, compared to during COVID. PFTs results, such as PFT indices, were not significantly different after 4 months post-COVID, compared to during COVID. SpO2 (%) and 6 MWT (m) were significantly increased. During COVID and post-COVID, the values of NL (L) and NL (%) had a significant positive correlation with PFT indices, SpO2, and 6MWT (m). Conclusion: Hence, the different CT indices (NL and NL%) can be used as a surrogate for functional recovery of COVID patients since it correlates with the PFT indices (FEV1 and FEV1/FVC), SpO2, and 6MWT post-COVID. [ABSTRACT FROM AUTHOR]

Background & objective: Cytokine storms play a significant role in conditions leading to multi-organ failure in patients with severe corona virus disease-2019 (COVID-19). The eradication of pro-inflammatory cytokines through hemoperfusion has been suggested to be a possible strategy to improve outcomes in these patients. We evaluated the impact of adjunctive HA330 hemoperfusion on outcomes in severe COVID-19 patients. Methodology: A single-center retrospective cohort study was conducted from December 2021 to December 2022. We included severe COVID-19 patients with elevated pro-inflammatory markers, who received three consecutive sessions of HA330 hemoperfusion in addition to the standard treatment protocol. Clinical data, including demographic information, baseline characteristics, and treatment outcomes, were analyzed. Results: We evaluated 24 severe COVID-19 patients. We observed a significant reduction in levels of CRP (P < 0.001) and IL-6 (P = 0.042), as well as a significant increase in arterial partial pressure of oxygen (P = 0.041). Importantly, no patient experienced cytotoxicity after the HA330 hemoperfusion sessions, confirming the biocompatibility of the treatment. Conclusion: Three consecutive sessions of HA330 hemoperfusion, used as an adjunctive therapy to standard care in severe COVID-19 patients, effectively reduced pro-inflammatory cytokine levels and improved oxygenation. However, large multicenter trials are required to validate these clinical outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Survivors of severe Coronavirus Disease-2019 (COVID-19) pneumonia may experience Exercise-Induced Desaturation (EID), which can remain undiagnosed at discharge, as most exhibit normal resting Arterial Blood Gases (ABGs). This undiagnosed condition may lead to unexpected hospital readmissions, causing additional burden to the health system. However, the prevalence of EID among this population, especially in developing countries, is not well documented. Aim: To estimate the prevalence of EID among survivors of severe COVID-19 pneumonia and to explore the predictive role of Lung Ultrasound Scan (LUS) in detecting EID. Materials and Methods: This hospital-based, observational, cross-sectional study was conducted at the Institute of Chest Diseases in Kozhikode, Kerala, India from October 2021 to September 2022. It involved 153 COVID-19 patients aged 18 years and above who had recovered from severe pneumonia, were otherwise fit for hospital discharge, and had normal resting ABGs. The study examined the prevalence of EID using the 6-Minute Walk Test (6MWT). Additionally, it investigated the predictive ability of a LUS for EID. A LUS was performed on all patients and scoring was conducted according to the established protocol. Results: The mean age of the study subjects was 53.50±14.13 years, with 119 (77.8%) being male. During the 6MWT, 96 patients (62.7%) showed significant desaturation. A total of 83 (95.4%) subjects in the desaturated group required Non-Invasive Ventilation (NIV) compared to 4 (4.6%) in the non-desaturated group (p<0.001). All 24 (100%) subjects in the desaturated group required Invasive Mechanical Ventilation (IMV), while none in the non-desaturated group did. The mean Length Of Stay (LOS) in the hospital was 35.50±13.35 days for the desaturated group, compared to 23.32±16.25 days for the non-desaturated group (p<0.001). The LUS score was significantly higher in the desaturated group (16.61±5.92) than in the non-desaturated group (5.54±4.62). The Receiver Operating Characteristic (ROC) curve for the LUS score indicated a cut-off value of 8.5 for identifying significant EID. Conclusion: Survivors of COVID-19 who recovered from Acute Respiratory Failure (ARF) and have normal resting ABGs may still have significant EID. A protocol-based LUS score can potentially identify individuals at risk for EID. [ABSTRACT FROM AUTHOR]

Objectives: In coronavirus disease-2019 (COVID-19), autonomic dysfunction may ensue. The heart rate recovery index (HRRI) measures autonomic function and predicts cardiovascular disease (CVD). The research assessed HRRI in patients with COVID-19. Materials and Methods: The research group included 160 verified COVID-19 cases, and the control group had 160 healthy participants without a history of immunization. All patients underwent treadmill stress electrocardiogram according to the Bruce protocol. After the stress test, HRRIs were taken at 1, 2, 3, and 5 min. HRRI is computed by subtracting the subject’s maximum exercise heart rate (HR) at the end of the exercise from HR after 1, 2, 3, and 5 min of recovery. Results: Both groups had equal exercise duration, metabolic equivalents, maximum (max.) HR, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at baseline, max. SBP and DBP, and changes in SBP and DBP (p>0.05). HRRIs were greater in COVID-19 patients than in controls at 1, 2, 3, and 5 min (p<0.001). Conclusion: COVID-19 impacts HRRI. COVID-19 may affect neural-cardiovascular systems. [ABSTRACT FROM AUTHOR]

The word library comes from the Latin word liber which translates to “book.” This study has taken library synonymous with books-textbooks, journals, reference books—all conventional methods of gaining knowledge. There has been a rapid decline in the use of traditional methods, including bedside teaching, owing to the new, digital sources of learningwhich has been precipitated by the deadly pandemic of coronavirus disease-2019 (COVID-19) among various other reasons. This research is focused on drawing conclusions regarding learning from actual, physical books, traditional classroom teaching, and the newonset era of digital learning. Digital learning has grown tremendously through the unfortunate COVID-19. [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]

Aims: This study aimed to evaluate the mental health of mothers of children with attention deficit hyperactivity disorder (ADHD) after distance learning measures during the Coronavirus disease-2019 (COVID-19) pandemic, considering factors that may influence their well-being. Methods: In a cross-sectional design, the levels of burnout, depression, anxiety, stress, coping strategies, social support, and perceived changes in mental health among the mothers were assessed using the Maslach Burnout Inventory (MBI), Depression Anxiety Stress Scale-21 (DASS-21), Brief Coping Orientation to Problems Experienced Inventory, Multidimensional Scale of Perceived Social Support Scale, and Global Rating of Change (GRC) scale. Furthermore, the mothers completed the Atilla Turgay Scale (T-DSM-IV-S) to evaluate their perceptions of their children's ADHD and behavioral problems. Results: Of the 72 mothers (mean age: 42.46±6.73 years, mean children age: 11.39±3.12 years), 50%, 44.4%, and 43.1% had depression symptoms, anxiety, and stress, respectively. According to the GRC, most mothers (67%) reported deterioration in mental well-being compared with the pre-pandemic period. The strongest correlations were between the subscales of T-DSM-IV-S and the total MBI score (r=0.51, p<0.001), DASS-21 score (r=0.35, p=0.003), and GRC score (r=-0.40, p=0.004), particularly with the inattention subscale. Child's attention deficit score, maternal education level, maladaptive coping level, and frequency of outdoor activities were identified as predictors of GRC. Conclusions: This study showed that the distance learning during the COVID-19 pandemic was associated with deteriorated mental health among mothers of children with ADHD. The mother's maladaptive coping strategies, frequency of outdoor activities, education level, and attention deficit level were identified as independent predictors of deteriorated mental health in mothers. [ABSTRACT FROM AUTHOR]

Introduction: Acute respiratory failure is the most common clinical feature in patients with severe Coronavirus Disease -2019 (COVID-19) who are admitted to an Intensive Care Unit (ICU) and may require invasive mechanical ventilation, which is generally linked with a high fatality rate. Patients with established co-morbidities, such as diabetes, invariably fall into the category of patients with severe disease presentation and rapid disease progression. Aim: To study the clinical outcomes of COVID-19 diabetic patients after sequential oxygen therapy using a reservoir bag mask, High Frequency Nasal Oxygen (HFNO), and Non-invasive Ventilation (NIV). Materials and Methods: In this retrospective cohort study, adhering to the STROBE statement criteria, the authors included 150 patients suffering from COVID-19 acute respiratory failure, who were known diabetics, divided into three groups based on admission oxygen saturation and Respiratory Rate (RR) for Non-Rebreather Bag-Mask (NRBM) therapy, HFNO, and NIV. For two weeks, all patients were monitored, and measures such as Saturation of peripheral Oxygen (SpO2), Respiratory Rate (RR) escalation of oxygen requirement, glycaemic management, compliance and problems with continued oxygen therapy, the need for invasive mechanical ventilation, and mortality were recorded. The recorded parameters among the three groups were compared using Analysis of Variance (ANOVA) test. Results: Among the demographic parameters recorded, the authors noted that individuals older than 50-55 years of either sex were admitted for HFNO (56.02±11.71 years) and NIV (54.28±14.67 years) therapy, whereas no such preponderance was noted among the two genders. Significant results were noted in all three groups in terms of the escalation of oxygen fraction (FiO2) requirements on the 10th day of observation (NRBM 12.63±2.48%, HFNO 37.74±13.56%, NIV 82.44±11.11%). The need for tracheal intubation was higher in patients in the NIV group (10) compared to the HFNO (9) and NRBM (1) groups. Patients whose blood sugar levels remained uncontrolled throughout the course of observation in the study were disparagingly seen to have been a part of the HFNO and NIV groups, and hence the subsequent mortality. Conclusion: There was a steady escalation of mean oxygen requirements in all three groups of oxygen therapy over the course of two weeks, coinciding with the ensuing 'cytokine storm' associated with Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection. This trend of escalation of oxygen requirement also in turn coincided with the raised glycaemic charting trends of the patients over the same course of two weeks, delineating those individuals with diabetes mellitus, in view of their compromised immunity and innate pro -inflammatory state, are more prone to develop severe form of the disease with more serious complications, which may even lead to mortality. With regards to the compliance, NRBM & HFNO provided best results in comparison to NIV. The rates of complications were also noted to be higher with the use of NIV in this instance. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has had a significant psychological impact on people's lives, including healthcare providers. This impact has manifested in the form of anxiety and fear. Since COVID-19 is a respiratory disease spread through the mouth and nose, dental practitioners have experienced anxiety due to their close proximity to the oro-nasal tissues. Aim: To assess the mental health condition, specifically fear and anxiety, of a group of dental students in Saudi Arabia during the COVID-19 pandemic and to explore students' perceptions about dentistry as a career choice following the pandemic. Materials and Methods: A cross-sectional questionnaire-based study was conducted, which included demographic data, the Coronavirus Anxiety Scale (CAS), the Fear of COVID-19 Scale (FCV-19S), as well as a few questions to assess why students chose dentistry as a career and their perceptions about dentistry as a career following the pandemic. A digital link to the questionnaires was distributed through social media outlets such as Twitter, WhatsApp, etc., with the aim of reaching dental students across all dental schools in Saudi Arabia. Dental students and those undergoing internships from both public and private Dental Colleges across Saudi Arabia were approached. The study included a total of 633 students from 21 dental schools across Saudi Arabia. Data were analysed using the Statistical Package for Social Sciences, including Analysis of Variance(ANOVA), independent t-tests, and Chi-square tests. Results: Fear and anxiety levels were found to be the highest among interns and fourth-year dental students, respectively. A total of 346 (54.66%) of the respondents reported that they chose dentistry as a career due to personal desire. Approximately, 239 (37.8%) of the respondents reported being either 'Not Sure' or would not choose dentistry as a career if they had the choice, considering the uncertainty created by the COVID-19 pandemic. Conclusion: Fear and anxiety were reported to be higher among dental students exposed to clinical practice. The majority of dental students reported that they would still choose dentistry as a career option despite the uncertainty caused by the COVID-19 pandemic.

Introduction: The Coronavirus Disease-2019 pandemic is considered the most catastrophic disease of the last decades, with evolving knowledge and improved management over time. Pregnant women are known to be particularly vulnerable, and COVID-19 has been shown to damage the endothelium due to its proinflammatory nature. Aim: To determine the occurrence of oligohydramnios in pregnant women who tested positive for COVID-19. Materials and Methods: A retrospective observational study was conducted at the Department of Obstetrics and Gynaecology, Koru Health Groups, Ankara, Çankaya, Turkey from January 2023 to June 2023. The study included a total of 459 women who were followed during pregnancy and delivered in the same hospital between April 2020 and October 2022. The patients were divided into two groups: COVID-19 positive group (n=101) and negative group (n=358). Various parameters such as age, parity, gestational week at birth, Body Mass Index (BMI), 1st and 5th-minute Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores, weight of the newborn, Amniotic Fluid Index (AFI), and the risk of developing oligohydramnios were assessed between the positive and negative groups. Parametric variables were analysed using independent t-tests and non parametric ones using Mann-Whitney U tests. Chi-square test was used to compare categorical variables. A p-value of

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic, which began in Wuhan, China, in December 2019, has quickly spread worldwide, causing numerous challenges for people, such as lockdowns, isolation, and subsequent mental stress. Developing mental resilience is crucial for handling stress effectively. Understanding the impact of the COVID-19 pandemic on stress and the resilience of the Indian population enables insight and facilitates thoughtful reformation in aiding the community. Aim: To assess the stress and resilience among the general population during the COVID-19 pandemic and to find the association between demographic variables and stress and resilience. Additionally, the study aimed to evaluate the correlation between stress and resilience among these subjects. Materials and Methods: A cross-sectional study was conducted Department of Psychiatry, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India, from February 2021 to April 2021. A total of 740 willing respondents affected by the COVID-19 pandemic participated in the study. A snowball sampling method was used in which participants were approached via a Google form circulated through their known contacts. The study encompassed those who had experienced either direct or indirect effects of the COVID-19 pandemic. The user-friendly Google form collected essential demographic information such as gender, marital status, and employment type. The stress and resilience levels were measured using the Perceived Stress Scale (PSS) and Resilience Scale. The statistical analysis of sample characteristics with frequency distributions and categorical variables was done with the application of Chi-square tests. Correlation analysis was done using the Spearman's test. A p-value of

Introduction: Coronavirus Disease-2019 (COVID-19) impacts multiple organs like the kidneys, heart, and liver, but primarily affects the respiratory system, leading to symptoms such as cough with sputum production, fever, and in severe cases, respiratory failure. Research on Severe Acute Respiratory Syndrome (SARS)-Coronavirus-2 (CoV-2) has revealed impairments in lung function during the early recovery phase following COVID-19 infection. The aim is to understand the virus’s impact and identify any obstructive, restrictive, or mixed pulmonary alterations in medical professionals six weeks after recovery. Aim: To assess Pulmonary Function Tests (PFTs) six weeks after COVID-19 recovery in health science students at a medical college in North Karnataka. Materials and Methods: A descriptive cross-sectional study was conducted in the Department of Physiology at Jawaharlal Nehru Medical College in North Karnataka, India, from January 2021 to December 2021. A total of 155 COVID-19-recovered health science students were included, and their anthropometry, physiological parameters, and pulmonary parameters were recorded. The “Spirometer Helios 401” was used to estimate an individual’s PFT. Data were analysed using independent sample t-tests, with a p-value