European Journal of Molecular & Clinical Medicine

Interleukin-6 receptor antagonists (IL-6RAs) and steroids are emerging immunomodulatory therapies for severe and critical coronavirus disease (COVID-19). In this preliminary report, we aim to describe the epidemiology, clinical characteristics, and outcomes of adult critically ill COVID-19 patients,
Aim: to evaluate whether the immunomodulation with an IL-6 antagonist is associated with an improved hemostasis in patients with COVID-19 as measured by viscoelastic tests.
Materials and methods: This prospective study was conducted in Kirkuk city – Iraq, from the first of March 2021 until the end of June 2021. The study included 50 patients from both sexes with age above (18-60) years. Clinical and laboratory parameters, such as blood pressure (systolic, diastolic), heart rate, peripheral capillary oxygen saturation (SpO2), respiratory rate, body temperature, disease severity scores, ventilation parameters, blood gas parameters, VHA results will be recorded at set time intervals (see later). All the medication that the patient has taken during the study period will be noted. Blood culture samples will also be taken when indicated to exclude superinfection thus ensuring that these will not influence the results of the study. Blood sample was collected by vein puncture from each subject enrolled in this study .  for determination  of ALT, AST, LDH , S. creatinine, BUN , TSB and  S . Albumin . The primary outcome is the change of the Lab parameters measured   before IL-6 antagonist and  2 weeks after immunomodulation therapy of IL-6 antagonist. As and the effect of it are relatively shortly seen in inflammatory parameters after administration, we decided to use the parameters. In addition, the study will investigate the following secondary outcomes
Results: The study revealed that, the risk of covid-19 infection increased with age as elderly was most affected. The study showed that 36.36%  of covid-19 smoker cases were with  severe infection, 27.27%  were with critical  infection and 18.18% were with moderate infection (P<0.001). The study demonstrated that,   74% (37 0f 50) of covid-19 infected patients improved after two weeks of infection 22% had complication of infection while unfortunately, 4%  (3 of 50) died due to complications of Covid-19 infection.The study showed  that random  blood sugar was relatively high in COVID-19 patients  (213.4±60.14) mg/dL and  then decreased slightly two weeks after treatment (174.9±49.9) mg/dL  compared to the control group  (105.7  ±15.9) (P:0.001), andthe highest rate of D-Dimer testing was recorded in  COVID-19 patients  (760.3±187).  8 ng/ml  and then decreased slightly two weeks after treatment (167.3±657.9 ng/ml compared to the control group  (105.7±15.9). The study also showed that the highest rate of lactate dehydrogenase (LDH) was recorded in COVID-19 patients  (  348.6±65.7) U/L  and then relatively decreased after two weeks of treatment  (315.3±60.4) U/L  compared to the control group (96.7±23.9)  U/L.  The study showed that the  highest levels of ferritin were recorded in COVID-19 patients  (390.4±83.5) ng/ml and then relatively low two weeks after treatment  (319.5±81). 3)ng/ml, compared to the control group (96.7±23.9)ng/ml. The study also revealed that the  highest levels of urea, creatinine and ALT were recorded in patients with  Covid- and then its rate decreased relatively two weeks after receiving treatment, compared  to a group. While  the study revealed that the rate of albumin  was significantly low in COVID-19 patients  and then  increased relatively after two weeks of receiving compared to the control group who were characterized by a normal rate of albumin. TCZ appears to be an effective treatment option in COVID-19 patients with a risk of cytokine storms. And for these critically ill patients with elevated IL-6, the repeated dose of the TCZ is recommended

Medical education involves pre-clinical and clinical teaching to build a strong knowledge foundation and clinical experience for the medical students. COVID-19 pandemic has imposed challenges for medical education facilities, with the need to shift from tradition class room teaching to E-learning modality. This paradigm shift could generate changes in students’ perception of this way of teaching and their perception might be different from the one found in studies previous to the pandemic

It determined the frequency, dimensions, treatment, and results of the COVID-19 pandemic in children who had endocrine problems and diabetes.
Methods: A worldwide network of endocrine societies was sent an internet survey in the form of a cross-sectional questionnaire. The professional and practice characteristics of respondents, the size of their clinics, the nation in which they practiced medicine, and the influence that COVID-19 had on endocrine illnesses were explored.
Results: The study was completed by respondents from 134 pediatric endocrine institutions located in 51 different countries and across all seven continents. The majority of pediatric endocrinology clinics have made adjustments to their standard checkups as well as their educational programming. More than twenty percent of clinics reported experiencing a lack of availability of crucial supplies or drugs. Patients diagnosed with diabetes and COVID-19 needed therapy in an intensive care unit. It has been clearly stated that pediatric patients with endocrine abnormalities have alterations in their biopsychosocial functioning as well as their behaviors.
Conclusions: This extensive worldwide study was carried out during the COVID-19 pandemic, and its findings underscore the fact that diabetes is more difficult to control than any other juvenile endocrine illness, and it also carries a higher risk of morbidity. It is necessary to acknowledge and treat the psychological anguish that has been caused by COVID-19. Every patient ought to have easy access to medical supplies, and it is essential that they maintain frequent interaction with the medical staff who are responsible for their treatment

Acute respiratory distress syndrome (ARDS) and multiorgan dysfunction that results in death are significant in COVID-19 infection, with a greater mortality risk in elderly people with comorbidities. Along with inflammatory markers (like C-reactive protein, Pro-calcitonin, Lactate-dehydrogenase, Ferritin, D-Dimer, Interleukin-6), neutrophil-lymphocyte ratio(NLR), platelet-lymphocyte ratio(PLR), and absolute-lymphocyte count(ALC) are new adjuncts in COVID-19 management.
STUDY DESIGN: Retrospective cross-sectional study at a tertiary care hospital of Indore.
METHOD:
The study included patients in third-wave who tested positive (RT-PCR/RAT) for SARS-CoV2 and hospitalized with routine blood investigations like complete blood count and differential values of serum biochemical tests C-reactive protein, D-dimers, liver-function test, renal-function test and ABG were done at admission.
STATISTICAL ANALYSIS: chi square and fisher’s exact test.
RESULTS:
A value >= 4.94 for NLR and >=263 for PLR was suggestive of severe COVID-19 disease. While absolute-lymphocyte count (<= 1210 lymphocytes/mcl) was suggestive of severe COVID-19 disease along with D-Dimer value of >0.6 ngFEU/l and C-reactive protein of > 16.6 mg/l.
CONCLUSION:
As COVID-19 pneumonia is secondary to inflammation, we showed that a more severe inflammation, as evaluated through inflammatory markers, correlates with more severe disease via different grading scores/systems (ARDS Grading, APACHE-2 Scoring, Covid-19 infection severity and Final outcome). Higher levels in NLR, PLR, CRP and D-Dimer while lower absolute-lymphocytes count should prompt the clinician to proceed aggressively in management of Covid-19 patients.

COVID-19-causing SARS-CoV-2 is global. respiratory distress. COVID-19 exhausts oxygen in the lungs. COVID-19 patients worry about their own and their family's health, being alone, losing their job, feeling helpless, and dying, which causes anxiety, depression, physiological stress, decreased physical performance, and decreased physical activity. Respiratory rehabilitation helps chronic pulmonary disease patients breathe. Rehabilitating COVID-19 patients is rare. Thus, this study compares the male and female effects of physiotherapy management on performance, anxiety, and stress in hospitalized COVID-19 pneumonia patients

Active immunization (vaccination) is the main strategy adopted for the prevention of COVID-19 across the world. Vaccination is known to stimulate the human body to produce protective molecules and prepare for a possible encounter with the actual virus in the future. Antibody formation against the virus is one of the types of response to vaccination. The objective of the study was to analyze the antibody response of ChAdOx1-nCOV (Covishield^TMÒ) vaccine administration among health care workers (HCWs).
Methods: The transfusion medicine department of SNMC, Agra enrolled health care workers who received ChAdOx1-nCOV (Covishield^TM) vaccine and obtained their informed consent. The enrollment for the study was done in January and February2021 (6 months follow-up was done till August 2021). The sampling was done on five points: day 0 (prior to the first dose), day 28 (prior to the second dose), day 56, day 120, and day 180 (from the first dose). Antibody against SARS-CoV-2 spike protein (mainly IgG) quantification was done by Roche (using Elecsys Anti-SARS-CoV-2 S kit) based on Electrochemiluminescence Immunoassay (ECLIA) at the department of microbiology, AMU, UP.
Results: A total of 117 HCWs were enrolled in the study who received the vaccine between 16^thJanuary to 18^thFebruary 2021. 57 health care workers out of 117 (48.8%) had pre-existing antibodies on day 0 (group A) and 60 did not have any pre-existing antibodies (naïve participants, group B). The mean gap between the first and second dose of the vaccine was 29.8 days. The baseline (day 0) antibody levels in group A were 150.8±332.2 U/mL compared to 0.47 ±0.14 U/mL in group B. The antibody response due to vaccination was significantly higher in group A than group B on the 28^thday and 56^thdays sampling. A total of 26 out of 117 enrolled HCWs (22.2%) reported a breakthrough infection of COVID-19 after 56^thdays sampling. The breakthrough infection resulted in a significant rise in the antibody levels compared to participants who were never exposed toSARS-CoV-2 in group B (39 out of 60; naïve participants).
Interpretation and Conclusion: We concluded that the antibody production in response to vaccination, was significantly higher in a group of participants who had previous exposure to the virus before vaccination. Exposure to the virus after a complete schedule of vaccination also induced a significant rise in antibody levels. The antibody response in naïve participants who hadboth doses of the vaccines (never exposed to the virus) had significantly lower levels at 180 days compared to their antibody peak at 56 days

The modern coronavirus infectious disease COVID-19 has been labeled internationally as a pandemic and is considered an emergency to the public health. Many studies were targeting university students as they play a great role after healthcare workers in relaying and spreading the awareness of COVID-19 and its preventive measures among colleagues, families, and friends. Therefore, it is of great importance to increase the knowledge and awareness about COVID-19.
Objectives: In this review article, we compare the most relevant studies that measure health awareness and attitude towards the COVID-19 pandemic.
Method: The articles are obtained from electronic databases such as PubMed, Science Direct and Google Scholar that are published during 2020.
Conclusion: Most studies showed high level of awareness among university students, and social media was found to be their main source of information. Among all the selected research papers, we found that the studies conducted in both the United Arab Emirates and Qassim Universities showed results that may be comparable to our topic

Introduction: COVID- 19 caused by Corovirus, is a global pandemic which our country has witnessed in its most disastrous way. Early diagnosis is always a prerequisite for a country in early detection and decreasing the prevalence in the world. As we have faced  the second disastrous wave in India where mortality rate increased upto 10% of detected cases, it is a strict prerequisite to lean on methods encouraging early diagnosis and prompt treatment. TrueNat, a nucleic acid amplification test, offers a fast, point of care diagnostic method which is a reliable, time bound and affordable.
Aims and Objective: The study warrants a compact, easy to approach, alternative diagnostic tool with possible measures like mobile NAAT labs(MiLaN) in a developing country like India which would help in timely diagnosis with approach to distant places in search of hidden cases with use of minimal resources. this study also aimed at the need for capacity building of technician which would further decrease the chances of technical inaccuracies
Materials and Methods: This is the study of 3310 samples received at a tertiary care centre in North India by a chip-based, real-time quantitative PCR system manufactured by Molbio diagnostics, Goa
Results: Comparative analysis of samples with different age groups were done in High detected, Medium detected, Low detected and Very low detected cases.
Discussion: Prompt timely diagnosis with approach to distant places in search of detection of hidden cases with high sensitivity and specificity warrants a compact, easy to approach, alternative diagnostic tool with possible measures like mobile NAAT labs (MiLaN) and capacity building of skilled technicians leading to decrease in technical inaccuracies.
Conclusion: Due to machine portability and accessible technical skills, True nat machine is highly recommended in settings where facilities for tertiary care laboratories are lagging.

The information about imaging findings of COVID-19 disease on HRCT is evolving every day and is widely distributed across numerous publications Main objectives of our study were to identify important imaging manifestations, atypical manifestations and distribution of the lesions in the patients with COVID-19 to help the fellow radiologists and physicians globally so that it ensures proper clinical management. Our study is a multi-centric retrospective study done on a total of 81 COVID-19 affected symptomatic patients. HRCT was done on all the patients and detailed history of the patient’s symptoms and characteristics are recorded. The most common symptoms observed were fever, cough and dyspnoea. On HRCT the most common finding observed was ground glass opacities, seen in 28 cases which comprise 35% of the study population. Consolidation alone and combined consolidation & ground glass opacities were observed in 12(15%) and 17(21.1%) cases respectively. Among other ancillary findings air-bronchogram, sub-pleural lines and fibrotic opacities were most commonly observed. Most of the cases showed peripheral or sub-pleural involvement and both lower lobes are the most affected regions of the lungs. In our study we found that ground glass opacities are the most common findings in the lungs of COVID-19 patients. The sub-pleural or peripheral lung fields and the lower lobes are the most affected regions of the lungs. Most of the COVID-19 cases show region s of sub-pleural fibrosis as evidenced by presence of sub-pleural lines

Breast cancer is a leading cause of cancer mortality among women second only to lung carcinoma. There has been substantial progress over the years and decline in mortality is due to early diagnosis and intervention. Growing knowledge regarding breast carcinoma biology has had a greater impact on its management. SARS CoV-2 COVID-19 outbreak had a significant effect on the existing health care services. This pandemic posed multiple challenges in care and management of non-COVID diseases including breast cancer management. Methods: The present study is retrospective data analysis of patients suffering from carcinoma breast reporting to the Government Medical College and Hospital, Jammu from March 2020 to August 2022 and type of management offered to them. This was compared with data from January 2018 to December 2019. 372 patients in the age group of 20-80 years of either sex reported in 2020-2022 and 710 patients in the age group of 20-80 years of either sex reported during 2018-2019. Result: During 2020-2022, most of the patients (n= 346) presented with advanced breast cancer and underwent neo-adjuvant therapy. 26 patients underwent modified radical mastectomy followed by adjuvant chemotherapy. 157 patients were lost to follow up. As against the previous years where the number of patients who underwent modified radical mastectomy were n= 67(2018), n= 73(2019) and number of patients who underwent neoadjuvant therapy were n= 253 (2018) and n= 317 (2019). Conclusion: Due to COVID – 19 pandemic, there was drastic decrease in carcinoma breast patients reporting to tertiary health care centre. Whosoever reported were in advanced stage of the disease leading to poor prognosis. Furthermore, large number of patients were lost to follow up. Healthcare policy needs to be redefined for non-COVID surgical diseases management including cancer patients

The COVID-19 pandemic caused relatively high mortality in patients, especially in those with concomitant diseases (i.e., diabetes, hypertension, and chronic obstructive pulmonary disease (COPD)). In most of aforementioned comorbidities, the oxidative stress appears to be an important player in their pathogenesis. The direct cause of death in critically ill patients with COVID-19 is still far from being elucidated. In this regard oxidative stress is one of the topics that need to be investigated. Therefore, the present research study was carried out to explore the relationship between the oxidant/antioxidant system and COVID‐19 exacerbation.
Materials and Methods: A total number of 60 children were involved in this study; they further equally divided into patient and control group. Blood Samples were collected from 30children confirmed diagnosed with COVID-19 infection and 30 healthy children volunteers as the control group. The patient group consisted of 22children with mild disease and 8 children severely ill patients.
Results: COVID-19 patients with mild and severe disease have shown the signs ofanaemia, leucocytosis and thrombocytopenia than control group. Serum levels of total antioxidant capacity (TAC) and nitric oxide (NO) were measured. TAC levels were considerably lower in patients compared with healthy individuals (control group). An increasing trend was found in NO concentration as well as MDA levels in patient group.
Conclusion: These findings suggest that COVID-19 patients may be susceptible to depleted total antioxidant capacity. Moreover, showing such variations in blood samples of infected individuals could be considered as a predictive marker of COVID-19 severity.

Background: Covid-19 infection time and again has been causing major morbidities and mortalities. Increased vulnerability of Covid-19 recovered patients was seen towards mucormycosis infection. Mucormycosisis is an aggressive, angioinvasive fungal disease caued by fungi of order Mucorales. This increase in cases may be attributed to a weakened immune system, pre-existing comorbidities such as diabetes, overzealous use of steroids. We conducted a study on 25 cases admitted in mucor ward in a tertiary care setting to highlight this association and focusing on possible causes so that we can be prepared to handle any such catastrophe in future in a better way.
 Methods and results: We did a retrospective study on 25 cases admitted in a tertiary care center catering to large population of Covid -19 patients with varying severity.Covid-19 associated mucormycosis(CAM) was found to be more common in males(76%).Diabetes mellitus was the most common underlying condition(72%).68% patients had received steroids and antibiotics , 28% patients had history of receiving Oxygen. In CAM predominant presentation was rhino-orbital mucormycosis. Unilateral orbit involvement was seen in (88%) cases.
Conclusion: As severe acute respiratory syndrome coronavirus-2 is highly susceptible to mutations and is causingseries of waves, its association with opportunistic fungal infection is a serious concern. Incidences of mucormycosis were increased in Covid-19 patients due to immune modulation and coexistence of immunosuppressive conditions  such as diabetes. Concurrent glucocorticoid therapy further heightens the risk. Early diagnosis and prompt intervention can help improve outcome.

Introduction: Coronavirus is a family of viruses that can cause illnesses such as the common cold, Severe Acute Respiratory Distress Syndrome & Middle East Respiratory Syndrome. In 2019 new coronavirus was identified, originating in China. The emergence of COVID-19 disease has led to high demand for intensive care services worldwide. Materials And Methods: It is a cross-sectional hospital-based observational study of the clinical profile and outcome of laboratory-confirmed COVID-19 cases admitted in the intensive care unit (ICU) at C.U. Shah Medical College and hospital between October 2020 to March 2021. We have taken a detailed clinical history of patients regarding symptoms of COVID-19 according to the predefined COVID-19 questionaries. Allied history from the patient's relatives was taken regarding contact with COVID-19-positive patients and recent travel history. Emphasis was also made on comorbidities, past medications, and past medical events like ischemic heart disease (IHD), stroke, diabetes mellitus, thyroid disorders, and hypertension. Result: In the present study, the most common symptom of COVID-19 disease is breathlessness, followed by fever and cough. Peak incidence was noted in the older age group. Diabetes and hypertension are associated with a more severe form of COVID-19 disease. Most patients have been admitted due to severe acute hypoxemia and tachypnoea. Most patients required mechanical ventilation, although most died due to severe acute respiratory syndrome.
Conclusion: In a hospital-based cross-sectional study of laboratory-confirmed COVID-19 patients, males and females are at equal risk of COVID-19 infection, and there was no significant difference in severity among them. Hypertension and diabetes, and old age are the most common risk factors for severity and ICU admission in covid-19 patients. Proper strategies regarding covid-19 management and practical training of healthcare personnel with adequate health resources can dramatically reduce mortality in COVID-19 patients.

Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by novel coronavirus SARS-CoV-2 predominately involving the respiratory system. Bronchoalveolar lavage (BAL) is a safe, easily performed, minimally invasive and well tolerated procedure which explores large areas of the alveolar compartment providing cells as well as non-cellular constituents from the lower respiratory tract. It opens a window to the lung.Alterations in BAL fluid cellular and non-cellular components reflect pathological changes in the lung parenchyma. The information obtained from BAL fluid analysis, if considered carefully can have a reliable diagnostic criterion.

Covid 19 has been responsible for one of the deadliest pandemics in human history, resulting in widespread human suffering and loss of life. Minor alterations in the menstrual cycle have caused females to worry about the covid 19 vaccination because they are seen as a threat to the health and fertility that regular menstruation represents. Understanding the correlation between the covid-19 vaccine & changes in menstural cycle is crucial for sustaining community confidence in vaccination programmes.
Aim: To analyse menstrual cycle patterns in reproductive age group women who have received covid 19 vaccination.
Materials & methods: It was an observational cross-sectional study of 382 women wherein before & after getting the immunisation, women were surveyed through web-based questionnaire to assess changes in menstrual cycle parameters such as menstrual cycle length, its duration, flow volume. Menstrual cycle patterns were evaluated before vaccination, between first and second dose, between second and third dose and post booster dose.
Results: Out of 382 women, majority of women were between the age group of 26-35 years.. Seventy-five percent of women got the covishield vaccine, and seventy percent of those were Hindu. Only 16% of women saw transient, minor changes in menstrual cycle characteristics such as flow volume and frequency of cycles.
Conclusion: Immunisation against COVID-19 did not significantly alter the characteristics of the menstrual cycle. Therefore, more research is needed to assuage worries about the impact of covid immunisation on the menstrual phase.

Background: It is a fact that the ongoing worst ever pandemic caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), have affected millions of people with large number of casualties worldwide. There has been now several published studies regarding the clinical, laboratory and radiological findings of COVID 19 infections. The aim of this study was to combine the two common hematological abnormalities viz. lymphopenia and elevated LDH to increase the sensitivity of diagnosis of COVID-19 infection. We compared the LDH-to-lymphocyte ratio in patients with COVID-19 infection admitted in the ICU and general ward to assess its relation with severity of disease. Our study may help in early identification and categorization of COVID-19 patients.
Methodology : A total of 100 adult patients diagnosed by RT-PCR for COVID-19 were recruited for the study. One patient was excluded due to unclear history. We included 49 patients with severe disease from intensive care unit (ICU) and 50 patients from COVID ward with less severe disease. Serum lactate dehydrogenase (LDH) levels and absolute lymphocyte counts (ALC) of these patients were obtained during admission and the ratio of LDH to ALC was calculated for both groups. The collected data was statistically analyzed.
Results : Serum LDH levels were higher in ICU patients group compared to the COVID ward patients. ALC on admission were lower in ICU patients than the ward patients. In both cases the difference was statistically significant with p value of 0.001 in all the cases. A p value of <0.05 was considered as statistically significant. LDH/ALC ratio median of all included patients was 0.390 with interquartile range (IQR) 0.450. In COVID ICU group the median of the LDH/ALC ratio was 0.580 with IQR 0.340 and in COVID ward group median was 0.220 with IQR 0.240. It suggests that the LDH/ALC ratio is significantly higher (p value of 0.001 )  in COVID ICU patients with severe disease in comparison to COVID ward patients having non-severe disease.
Conclusion: LDH/ALC ratio on admission can be used as a sensitive prognostic marker in COVID-19 patients which can help in early identification of COVID patients who have potential risk to develop severe disease.

Background: COVID-19 has been one of the worst pandemics that hit the humans. Mucormycosis in people with COVID-19 have been increasingly reported world-wide, in particular from India. Rhino-Orbito-Cerebral Mucormycosis is the most common form of it. Intracranial involvement of mucormycosis increased the fatality rate to as high as 90%.
 Aim and Objectives: To assess the clinical manifestations of the patients with post COVID-19 mucormycosis and to study steroids and oxygen usage in such patients.
Materials and Method: This retrospective cross-sectional study was carried out in the Department of Ear, Nose and Throat, Grant medical college and Sir JJ Group of Hospitals, Mumbai, from Oct 2020 to September 2022.

To assess the hardships faced by dentists during covid pandemic.
Introduction: COVID-19 was declared a pandemic by the World Health Organisation (WHO). The primary clinical appearances are respiratory in nature. Dental practitioners are among the most elevated hazard categories for transmission of covid since numerous dental methods have the potential to transmit the disease.
Materials and Methods:
A cross sectional survey via an online questionnaire of 11 close ended questions was done. It was circulated via Google forms. The questionnaire contains questions on demographic details also. Data was collected and tabulated in excel sheet and statistical analysis was done using SPSS version 23. A total of 133 dentists responded to the study.
Results:
Most of the dentists reported that they were worried about operational and financial challenges to run their practice during Covid-19 pandemic.  53.4% of the dentists were male while 46.6% of the participants were female. Most of the dentists agreed that they are at higher risk of contracting covid-19 than other medical professionals. Most of the dentists agreed that they may be the major cause of transmitting the infection to their patients.

Background: COVID-19 pandemic hit the world in 2019 and its successive waves have created high alerts periodically across many nations including India. At the time of successive waves of the COVID-19 pandemic, one of the key concerns among developing nations was to manage the patient burden in hospitals with limited available infrastructure.
Objective: In the present study we have analysed the role of common laboratory markers as a predictor of hospital stay in COVID-19-positive patients so that hospital resources can be managed efficiently.
Methods: We studied the data of 200 COVID-19-positive patients for TLC, LDH, D-dimer, and serum ferritin and analysed their correlation with hospital stay
Results: TLC and LDH exhibit a positive correlation with hospital stay whereas D-dimer and serum ferritin showed a negative correlation with hospital stay among COVID-19 patients. Patients with a negative CRP showed a longer duration of hospital stay with a median stay of 9 days.
Conclusion: Being a developing nation, healthcare centres in India have limited resources. In such a scenario, common laboratory markers can prove to be a promising tool in managing hospital resources by estimating the hospital stay of patients.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), which causes coronavirus disease 2019 (COVID‑19), has swiftly grown into a pandemic. Despite extensive research, the function of numerous haematological and biochemical markers in prognosis remains unknown. There have been scientific papers in the Indian setting that describe demographics, clinical characteristics, hospital course, morbidity, and death in COVID-19 patients, however the numbers are limited. The current study provided us with a better understanding of the disease development and progression in COVID-19 patients, as well as the factors that determine disease severity.
Methods: This study was carried out at a COVID-19 tertiary care facility at Dr. D. Y Patil Medical College, Hospital and Research Centre, Pune. The demographic and clinical information, laboratory parameters of admitted COVID‑19 patients were collected were subsequently analysed.
Results: The mean (SD) age of COVID 19 patients was 48.21(16.37) years. The total number of COVID-19 patients with mild disease was 273 (45.27%), moderate disease was 177 (29.35%), and severe disease was 153 (25.37%). The Serum urea, serum AST, Serum total bilirubin, Serum Conjugated Bilirubin, Serum Unconjugated bilirubin , serum  LDH, Serum CRP and Serum Ferritin were differ significantly between mild, moderate, and severely ill  COVID-19 cases.
Conclusion: In conclusion the study revealed the role of numerous biochemical indicators in the severity of COVID-19, as well as the order of effectiveness among the markers. Our findings suggested that LDH and CRP levels were a promising biomarker for predicting COVID-19 severity.

The goal of the paper is to assess early economics impact of Covid-19 on the aviation industry as it is one of the hardest hit industries. Covid-19 has an unprecedented impact on the international passenger seat capacity and gross passenger operating revenues of airlines. In the first part, we look at the impact of the pandemic on the economy as a whole and subsequently look at the economic cost of airlines. Two main elements are driving this negative trend – travel restrictions and overall economic development. We are currently experiencing the tightest international travel restrictions in the modern era of flight transportation with the economies worldwide experiencing a greater decline in GDP than during the last 3 recessions. In the second part, we look at two out of many possible path scenarios which are likely to drive the trend: V-shaped path and U-shaped path. All pandemic outbreaks before followed V-shaped scenario but Covid-19 has paralyzed the society for longer with stricter governmental measures and so U-shaped scenario has to be taken into account as the most likely outcome for the aviation industry during this pandemic.

Background – There has been a significant impact of COVID-19 on the global economy and public health. Various countries have made unmatched efforts and awareness to ensure containment of this deadly virus. In order to make it possible, several routine activities have been affected which changed behavioural patterns of the common public. A lot of countries have imposed lockdown, social distancing, use of masks and sanitizers, frequent hand washing, vaccination, and other preventive measures. Elderly citizens have been the most vulnerable group which has been affected by the pandemic.
 
Objective – Considering the above arguments, this study is aimed to study the impact of COVID-19 pandemic on elderly people in India, especially their daily life, physical and mental health, social life, and preventive measures taken by them.
 
Methodology – An empirical survey was conducted as part of descriptive research. A self-structured questionnaire was sent through Google Form to collect survey data online. Total 126 responses were collected to analyse the impact of COVID-19 on elderly. All the survey participants are elderly to meet the inclusion criteria. SPSS version 22 was used to analyse the survey data.
 
Result – The finding of the study suggests that there was a significant impact of COVID-19 on daily life and overall health of elderly in India (p<0.05). However, the best part is that all of the survey respondents have followed all security measures suggested by the government, such as double dose of vaccination, social distancing, masks and sanitizers, and avoiding social gatherings.

The aim of the present study was to investigate the level of satisfaction among indoor COVID positive patients at a private tertiary care specialty hospital and to determine the underlying causes of dissatisfaction.
Methods: The present study was done on patients of COVID-19 hospital part of CIMS hospital which is a tertiary care private hospital in Ahmedabad Gujarat. Hospital has treated more than 7000 patients so far for COVID-19. In this study, the number of patients studied from COVID-19 area in Hospital was 2408 out of which 10 were excluded due to incomplete data.
Results: 95.29% of the patients appear to agree that Reception service is good. While another 4.59% appear to agree that Reception service is very good. 31.90% of the patients appear to agree that Consultant service is good. While another 67.93% appear to agree that Consultant service is very good. 32.53% of the patients appear to agree that Medical service is good. While another 67.31% appear to agree that Medical service is very good. 31.19% of the patients appear to agree that Nursing service is good. While another 67.97%appear to agree that Nursing service is very good.
Conclusion: On the basis of patient feedback and observations, it can be concluded that maximum patients are satisfied with the services provided in the hospital especially Nurses, consultants and Front office. Only some patients were dissatisfied with supportive services like food services, Diagnostic services, Billing Services and discharge services. Therefore, by improving these services overall patient satisfaction can be improved.

Background: At the onset of Covid-19 pandemic, it was an unknown entity in terms of risk status of the pregnant women for fetomaternal outcome. Both fetus and pregnant women were considered as groups under special concern due to their unique physiological characteristics.
Method: A retrospective study was conducted in department of Obstetrics & Gynaecology along with Paediatrics department in Maharishi Markandeshwar Medical College and Hospital, Solan on pregnant females admitted to the Covid-19 Ward/ ICU over a period from August 2020 till 31st March 2022. Participants were included into 3 waves of pandemic based upon time of presentation and these 3 groups were further studied for the various fetomaternal parameters such as maternal age, symptom status, need for respiratory support, maternal mortality, abortions, still births, gestational age and weight of newborn and other morbidity and mortality in newborns.
Results: A total of 171 pregnant were included in the study, of whom 47, 64 and 60 were seen in 1^st, 2^nd and 3^rd waves respectively. Majority of subjects were asymptomatic in 1^st, 2^nd & 3^rd wave, (p=0.30). Age wise distribution of the patients showed majority subjects in the age group of 20-30 years (p= 0.94). LSCS rates in 3 waves were not different significantly (p = 0.67). Maternal mortality rates and need for respiratory support were in similar proportions in all 3 waves (p=0.71) and (p=0.73) respectively. No significant difference was seen in maternal morbidity and neonatal outcome.
Conclusion: The study showed nosignificant difference between the waves of Covid-19 pandemic in terms of fetomaternal outcome except no maternal mortality in 3^rd wave.

  Data Science is one of the dominating fields in the today’s world. It plays its role in all the fields such as Agriculture, Healthcare, Education, Banking, and Entertainment. Data becomes the fuel of the Industry in 21^st Century. This data is growing exponentially as the new data is getting generated from various sources such as YouTube, Face book, Mobile devices and Twitter in each and every millisecond of time. This data needs to be handled effectively which could not be done by the traditional data handling techniques/methods/tools. This invites many researchers to apply various data handling techniques using data science. E-healthcare system is considered as a digital healthcare system to perform disease prediction and analysis. Data Science techniques are predominantly adapted in E-healthcare system for the prediction of plenty of diseases such as various cancer prediction, heart diseases, autoimmune diseases, allergy and respiratory system diseases and so on. In addition to these disease prediction techniques, COVID’19 pandemic situation has made the researchers to make use of data science methods in E-healthcare systems. Hence, certain methods such as disease prevention and predictive medicine is useful in COVID-19 pandemic after performing pre-processing which involves huge volume of structured, unstructured and semi-structured data. Also, visual exploratory analysis technique using data science helps even the rural people to get the insight of understanding the COVID with respect to various symptoms, no. of COVID cases in each day, recovery rate & death rate and all the other details. This chapter discusses the impact of COVID-19 and its analysis using data science in E-healthcare system. Framework used for analysing the COVID-19 dataset using Software Engineering in connection with data science technique is also discussed. It provides a clear understanding of performing the disease prediction in a step-by-step manner. Results are shown using visual exploratory techniques.

The percentage of healthcare personnel suffering from anxiety and insomnia increased during the Covid -19 pandemic. The objective of the study is to assess insomnia and anxiety among healthcare personnel involved in the management of the Covid-19 pandemic in Delhi.
Materials and Methods: A cross-sectional study was carried out among healthcare personnel. Residents. 5 tertiary care hospitals were selected purposively in Delhi. 91 respondents were selected for the study. A questionnaire through google forms was distributed and some of the questions required hybrid mode so the interview was conducted in hybrid mode in person or telephonically.
Results: The study revealed an 88% prevalence of definite cases of anxiety and 44.6% of some insomnia. The chi-square test reported a linear-by-linear association of 0.002 between Anxiety, Insomnia, fear of infecting the family members, and feeling of agitation while wearing the PPE kits. The study found that healthcare personnel having direct contact through the treatment of the infected patients experienced an increase in their anxiety scores, compared to HCPs having no direct contact with infected patients.
Conclusion: The results of this survey indicate that mental health symptoms like anxiety and insomnia have increased during the COVID-19 outbreak among healthcare professionals. The study also identified the associated risk factors and causes of mental health problems. Therefore, governments should proactively help in implementing mental health intervention policies in the country for the health professionals at risk, particularly those working in the COVID-ward.

Introduction:KabasuraKudineerChooranam is a formulation that is used traditionally by Siddha practitioners for treating common respiratory ailments like flu. The usage of KabasuraKudineerChooranam is increased during Covid -19.Aim: To understand the attitudes and self-use of kabasurakudineer among health care professionals in ChennaiMaterials and Methods:The descriptive online cross-sectional survey using snowball sampling was carried out among health care professionals in Chennai. A pretested and well-structured questionnaire consisting of closed-ended questions was employed to assess perception and usage of KabasuraKudineer.The estimated sample size is 456.The differences in the attitude, belief and usage of KabasuraKudineer among health care professionals was compared using the Chi-square test. Spearman correlation was used to correlate between medical, dental and nursing professions. Results:Only 28 health care professionals have heard of kabasurakudineer before covid 19 and it was positively correlated between all the three groups.Most of them does not like the taste of KabasuraKudineer and only few had prescribed kabasurakudineer to their patients. Conclusion:There is a better view of Kabasurakudineer among the medical professionals which might be because of that they are routinely taking care of COVID-infected patients followed by the nursing professionals and dental profession.

This study aims to evaluate the efficiency of the Indian state’s health care systems in increasing the recovery rate of the Corona virus by using data envelopment analysis.
Methodology: The Data envelopment analysis (Output Oriented CRS Model) has been applied to evaluate the efficiency scores of Indian states concerning the recovery rate of people affected by COVID -19. The tobit regression model is used to find the efficiency drivers. The required corona data has been collected during the period of time Feb 2019 - May 2020 from the government official websites like Worldometer, MoHFW, Corona Tracker etc,.
Findings: The efficient states were found along with the factor that increases the state’s efficiency in increasing the recovery rate. The study reveals that out of 36 State/UT, only 5 State/UT were efficient in increasing the recovery rate. In addition the study found that there is an input slack in the number of hospitals for inefficient states/UTs.

Aim: Our study aims at analysing the undergraduate students’ perspective of online ophthalmology classes during the Covid 19 pandemic.
Settings and Design: The study is a descriptive cross-sectional observational analysis conducted in the month of June 2021 at Medical College, Karnataka, India. 
Materials and Methods: An online self-completion questionnaire containing 13 questions was sent through Google forms. 346 medical students of third and final year, who have completed or undergoing online ophthalmology classes were included in the study. Most of the questions were semi open question. Link to the questionnaire was sent through the WhatsApp group and was available to them for a period of two weeks.
Results: The online survey questionnaire was responded by 237 students.166 students (70%) did not have any online learning experience before the pandemic. Majority of the students preferred problem-based learning 92 (27.62%) over other methods. Benefit of reading the study material at own pace was perceived as the prime advantage of online classes.  Poor internet connectivity was opted as the major hurdle (170-35%) of the online classes. Multiple choice questions were the most preferred method of online assessment (150 -41.32%). 105 students (44.3%) felt that the ophthalmological clinical skills were learnt better by attending clinical postings. Majority of the students (166-70%) favoured classroom teaching over online classes for fruitful learning.
Conclusion: The COVID-19 pandemic has introduced newer teaching methods in ophthalmology.  Most students, even in the era of the internet showed a preference to classroom teaching and clinical postings for a better learning experience.

The infection of the covid-19 fears the world population. As prevention strategies have not been developed, existing clinical approaches are only applicable to treat covid-19-positive individuals. Identifying the severity of the patient's illness is crucial for reducing the covid-19-related mortality rate. It is the pathology reports that are used as the foundation for determining the severity of the disease by the clinical specialists. However, a clinician's skill in making a diagnosis has a significant impact on how correct that diagnosis turns out to be. This manuscript described a supervised learning technique for performing computer-assisted covid-19 mortality scope using the pathology reports of the target patient. The experimental examination of the value of the suggested approach for anticipating mortality scope with few false alarms.

Context/Background: COVID-19 is an emerging and rapidly evolving situation. Though several vaccines have been developed and brought into general use, vaccine hesitancy still exists among the public. Assessing the awareness toward COVID vaccine among medical students is important since their perception and practice will have a significant impact on their family members, friends and relatives.
Aims/Objectives: This study aimed to assess the knowledge, attitude and practices toward COVID vaccine among medical students.
Methodology: A cross-sectional study was carried out among the undergraduate medical students of a medical college in Belagavi between May - June 2021. A total of 802 students participated in the study. A framed questionnaire assessing their knowledge, attitude and practice toward COVID vaccine was distributed to each participant.
Results: Most of the study participants were female (51%), and most of them were in the first year of their course at the time of the study (23.6%). Majority of them received COVID-19 related information from healthcare workers (72.7%). 92.8% and 92.6% of the participants responded that the vaccines control COVID-19 and it was by developing antibodies, respectively. 70.5% said that the vaccines should not be given to immunocompromised individuals. 82.2% of the participants have taken 2 doses of COVID-19 vaccination. Almost all participants (98.8%) felt that even after vaccination other measures like social distancing, wearing mask and avoiding social gathering are to be followed.
Conclusions: The findings in the present study show good knowledge, positive attitude and practice towards COVID-19. It is necessary to keep on with further education and training strategies to get a better understanding and positive attitude toward the pandemic for all medical students.

With the rise of covid-19 world saw what was unprecedented, and just when we thought we got things under control second wave of covid-19 virus hit us. No one was left unaffected, either directly or indirectly covid caused disruptions in everyone’s lives and thus left with psychological problems in unforeseen majority. Aim of this study was to measure the psychological impact it had on health care workers and general public. Results showed significant differences between the socio demographic profiles of the two groups. Significant difference was found in scores of stress, anxiety, insomnia and depression. This study highlights the need for specialist guided assistance and action towards betterment of mental health of health care workers as well as general public in post covid era.

Purpose: Diagnosis of acute undifferentiated febrile illness (AUFI) has been a challenge and burden in clinical practice in the tropics. COVID-19 cases that present with fever alone may be difficult to distinguish from other AUFIs in the tropics. Malaria, Scrub Typhus and Dengue fever are among the most common endemic diseases in the tropics. With the availability of rapid sero-diagnostic tests for these infections, it has been observed that patient’s samples frequently show seropositivity for two or more infections posing challenges in clinical diagnosis and treatment. This study was performed to determine the false-positive serological test (seropositivity) in COVID-19 patients for Scrub typhus, Dengue and Malaria.
Materials and Methods: The present study was a type of observational prospective study conducted from April 2020 to November 2020. A total of 574 febrile patients which were positive in Real time PCR for Covid-19, were included in the study.
Results: Dengue IgM antibody positive for 124, Scrub typhus IgM antibody positive in 107 and no positive in malarial test, were found.
Conclusion: Our experience suggests that false-positive in the serological test should be interpreted with caution and requires surveillance. There should be a continuous follow-up of these patients during COVID-19 pandemic and the importance of recognising false positive serological results in patients with COVID-19, especially in the resource-constrained tropical settings.

Background: Due to COVID-19 pandemic there was implementation of preventive measures like lockdown, mobility restriction and fear had an impact on routine immunization of children. There are significantly increases the susceptibility window for vaccine preventable diseases due to delayed vaccination in under five children. The objective of study is to know the trend of routine immunization of previous five year and to assess the impact of COVID-19 pandemic on routine immunization of children of age group up to 7 years at tertiary care hospital at Pune.
Methods: A hospital-based cross-sectional study was conducted in a tertiary care hospital of Pune city from the month of January 2017 to December 2021. All the data of immunization from age group 0 to 7 years present at tertiary care center Pune, was compared and analysed. Data is expressed as numbers and percentages and means. Chi-square test was used to compare observed results with expected results.
Results: In year 2020, there was a declining trend of all vaccines among children compared to previous 3 years.  In year 2019, 2020, 2021, number of children vaccinated are 6547, 4052, and 5062 respectively. Out of this 1078(16%), 1089(26.9%), 1165(23%) children had delayed vaccination in year 2019, 2020, 2021 respectively. There was highly significant increase in delayed vaccination of children in COVID-19 period.
Conclusion: The routine immunization of children was decreased and delayed due to COVID-19 pandemic. This is an alarming finding to prevent reappearance of new epidemics of vaccine preventable diseases.Actions should be taken to avoid delayed routine immunization in future.

Background: Telogen effluvium (TE) after COVID-19 infection or vaccination is a common sequelae in dermatology clinics.
Objective: to study the prevalence of telogen effluvium in COVID-19 patients and its association with COVID vaccine.
Methods: Cross-sectional study via online questionnaire in Saudi Arabia and other Arabic countries.
Results: Prevalence of hair loss among COVID-19 patients is ~85% with 45.9%  meeting the criteria of TE. Majority of those with high fever associated with COVID-19 developed TE (87.5%). 100% of hospitalized patients exhibited TE with 58% having diffuse hair loss for less than 6 months (acute TE) and 32% for more than 6 months (chronic TE). 63.2% of our participants had hair loss after COVID vaccination regardless of vaccine type with the majority experiencing it after the first dose (55.8%).
Limitations: The majority of the participants were female. Other factors associated with hair loss were taken into consideration.
Conclusions: COVID-19 infection and its vaccines carry a high risk for development of telogen effluvium.

Aim: Purpose of the present research was to assess the co-relation between covid-19 and periodontal disease.
Methodology: A case-control study was conducted amongst 150 participants. Patients who had positive real time reverse transcription polymerase chain reaction results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were included in the case group (n = 79), and patients with negative results were included in the control group (n = 71). The periodontal examination involved recording the plaque scores, calculus scores, tooth mobility, gingival bleeding, probing depth, recession, and clinical attachment level (CAL).
Results: Logistic regression analysis showed significant associations of mean plaque scores ≥ 1 (odds ratio (OR), 7.01; 95% confidence interval (CI), 1.83 to 26.94), gingivitis (OR, 17.65; 95% CI, 5.95 to 52.37), mean CAL ≥ 2 mm (OR, 8.46; 95% CI, 3.47 to 20.63), and severe periodontitis (OR, 11.75; 95% CI, 3.89 to 35.49) with COVID-19; these findings were more prevalent in the case group.
Conclusion: Based on the above mentioned observations, it can be concluded that there is an association between periodontitis severity and COVID-19. Gingival bleeding and dental plaque accumulation are also more frequent among COVID-19 patients. Hence, it is essential to maintain periodontal health and good oral hygiene as an important measure for COVID-19 prevention and management.

The coronavirus disease 2019 (COVID-19) pandemic has led to considerable stress and anxiety, adversely affecting the quality of the sleep. A study was conducted to evaluate if the COVID-19 pandemic had any effects(s) on the sleeping pattern and on overall sleep quality. Study was conducted as a cross sectional, questionnaire-based survey in Indian population on an online platform utilising Pittsburgh Sleep Quality Index (PSQI) to assess pattern and quality of sleep before and during the pandemic. The survey questionnaire was conducted during pandemic; hence the data collected for “before pandemic” duration was retrospective. A total of 1615 participants’ responses were received of which there were 756 female and 859 male participants. The mean PSQI score (global) before the pandemic was 4.68 ± 2.98 while that during the pandemic is 6.02 ± 3.62 indicating a significant change in the sleep quality. The proportion of poor sleepers also increased dramatically from 26.1% pre-covid to 49.3% during covid. Both sleep deprivation and poor-quality of sleep are well-known to produce significant mood disturbances and to lower the immunity. Thus, it can be extrapolated that those individuals who developed significant sleep disturbances during COVID-19 are likely to be at a greater risk for negative health consequences even if they did not develop active COVID-19 infection. As sleep is vital for both mental and physical health of the human body, adequate measures should be taken at an individual level as well as at the community level to maintain quality of the sleep during pandemic or other disasters like war that trigger considerable stress

Background: Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic taking more than 1.7 million lives. Many developed countries had started their vaccination drive, India is not far behind but still not much is known about the willingness to get vaccinated in India.¹ Due to the COVID-19 pandemic, the world faced a novel infectious disease, for which there currently is no treatment or herd immunity². The pandemic poses a serious threat to our health and well-being (WHO, 2020) and researchers are racing to develop and test vaccines against COVID-19 (Callaway, 2020).³
Aim: To determine Perception of covid 19 vaccination in rural population of Maharashtra: after one year of vaccine introduction.
Objectives: 1.To study Perception of covid 19 vaccination in rural population of Maharashtra after one year of vaccine introduction. 2. To study the socio-demographic profile with comorbid status of study participants.
Material and Methods: A cross-sectional study carried out among 189 peoples coming to vaccination center as per inclusion & exclusion criteria in SRTRGMC, Ambajogai city (Maharashtra) from May 2022 to June 2022.
Results and Conclusion: Out of total 189 study participants majority of the participants in the study were from age group 30-50 years i.e. 89 (47.5%) and least were >50 years of age group i.e.36 (19.05%), Male and female participants were 96 (50.80%) and 93 (49.20%) respectively, 146 (77.25%) were Married, 174 (92.07%) were Hindu by religion, 115 (60.86%) were from Nuclear family, and 80 (42.32 %) were belonging to Class III Socio-economic status, Least i.e. 4.24% participants were having comorbidity. Over all perception of the participants in this study towards covid 19 vaccines was positive with sound knowledge regarding the covid 19 vaccines.

The study aimed to Effect of COVID-19 infection on levels Haptoglobin and Beta trace protein and some of Biochemical parameters COVID-19. The study groups included 30 patient men infected with COVID-19, 30 men who recovered and 30 healthy men as a control group. Protein and biochemical assays include: Beta trace protein , Haptoglobin , LDH, AST , Na, Albumin , ferritin , Albumin / creatinine ratio (ACR)  .The results showed a significant increase at (P ≥ 0.05)  in levels of Beta trace Protein, haptoglobin, LDH, AST, and Na in infected patients compared to control and recovery groups, while infected men group showed a significant decrease in albumin and ferritin levels at (P≤ 0.05)  compared to control and recovery groups, while recovery group showed a significant increase in levels of albumin/creatinine ratio compared to control and patient groups. While there was a substantial drop in the levels of haptoglobin, beta-trace protein, and LDH in the recovery group compared to the healthy group, the levels of AST and albumin did not differ significantly between the control and recovery groups.

Recent years have seen a rise in the significance of sentiment analysis as a direct result of the explosion in the amount of material available online. The practice of analyzing textual data created on social media sites such as Facebook and Twitter using a natural language processing approachis called sentiment analysis. Since the beginning of the COVID-19 pandemic, several postings, including videos and text messages, have been uploaded on the social media platform in order to provide real-time updates on the progression of the pandemic across the world's nations. 

Background: Corona virus disease is an ongoing pandemic. COVID-19 had put cumbersome mental and physical pressure on the healthcare staff which may lead to burnout in them. Also there is paucity of Indian literature regarding prevalence of burnout in rural health care staff.
Objectives: To study the prevalence of burnout and its association with the determinants among the healthcare workers in rural population of a Ajmer district, Rajasthan.
Methodology: A Cross Sectional Questionnaire based study was conducted from January 2021 to June 2021 on 173 healthcare staff of rural population in a Ajmer district, Rajasthan after ethical clearance. Copenhagen Burnout Inventory was used to assess the burnout among Health Care Workers and a semi structured Performa was used to evaluate the demographic and clinical determinants of burnout. Prevalence of burnout was determined and the association of determinants with burnout was assessed.
Results: The prevalence of personal burnout, work related burnout and pandemic related burnout in health care workers was 42.5%, 33.75% and 49.37%. Pandemic related burnout was significantly greater than personal burnout and work related burnout in health care workers. Doctors, redeployed healthcare staff and staff having covid positive case in family have significantly greater burnout. Supportive work environment and adequate protective measures at workplace significantly reduces the burnout among health care staff.
Conclusion: Almost half of the rural health care workers are burnout. Protective authoritative and individual measures are needed to prevent burnout in HCWs.

The review expected to decide the degrees of Thrombomodulin, Surfactant proteins D and various biochemical factors in men with Coronavirus Study bunches included 30 men with Coronavirus, 30 men who recuperated from Coronavirus, and 30 solid men as a benchmark group. Protein and organic chemistry measures include: Thrombomodulin, Surfactant proteins D, Glucose, Phosphorous, the outcomes were a critical (P ≥0.05) decline in the degrees of Thrombomodulin, Surfactant proteins D in Coronavirus patients contrasted with the benchmark group, while in the recuperating bunch, Thrombomodulin was low. Contrasted with the benchmark group, the Surfactant proteins D were higher in those recuperating from Coronavirus, while the degree of glucose and phosphorus was high in the gathering with Coronavirus, while the phosphorus was essentially lower at (P≥ 0.05) in the gathering of recuperated men contrasted with the benchmark group, While the Glucose was high in recuperating from Coronavirus.

Aim: Prevalence of low back pain and osteoporosis in health care workers after the COVID 19 pandemic.
Material and methods: The present prospective study was conducted among 300 apparently healthy adults who are working as a health care individual in the institute. A questionnaire addressing known risk factors for osteoporosis was made. The severity of the LBP was graded using a visual analogue scale for pain (VAS). The VAS is a reliable scale used to register the intensity of chronic pain where 0 signifies no pain and 10 signifies the worst pain imaginable. Those who had chronic LBP were also questioned on whether the onset of LBP preceded the Covid-19 pandemic, and whether the severity of the LBP had increased during the pandemic.
Results: Light, moderate, sedentary and vigorous physical activity was revealed in 50.1%, 33.6%, 11.1% and 5.2% of the subjects respectively. >1 hour sun exposure in a day was reported among 15.4% of the subjects.In this study, low back was found among 42.7% of the subjects. Mean BMD level was -0.49±2.40. Mean BMD level was lower in subjects having back pain, sedentary/vigorous physical activity and no sun exposure as compared to counterparts.
Conclusion: The confinement decreed due to the COVID-19 pandemic led to a significant increase in LBPintensity among health care workers

Background: COVID-19 is an acute viral illness caused by severe acute respiratory syndrome corona virus 2(SARS-CoV-2). Since the onset of the SARS-CoV-2 pandemic, multiple new variants of concern have emerged which are associated with enhanced transmissibility and increased virulence? It also highlights the role of the clinical interprofessional teams, public health agencies, and community participation in improving patientcare. An analysis of genomic sequencing variants of SARS-CoV-2 in symptomatic patients during 2nd and 3rd wave of pandemic by next-generation sequencing (NGS).
Material and Methods: A total of 200 symptomatic patients, throat/nasopharyngeal swab were collected for real-time reverse transcription-polymerase chain reactions (RT-PCR) at tertiary care hospital, Ongole. The specimens were transported under cold chain according to guidelines to Centre for Cellular & Molecular biology (CCMB), Hyderabad, for genome sequence analysis by next generation sequencing (NGS). Study period – 2ndwave i.e., MARCH 2021 –NOVEMBER 2021 & 3rdwave i.e., DECEMBER 2021 –MARCH 2022 according to WHO.
Results: Out of 200 samples analysed, 132 samples of 2nd wave & 68 samples in 3rd wave. Out of 132 samples, 57 Delta (B.1.617.2), 75 Delta sub-lineages. Out of 68 samples 41 Omicron (B.1.1.529), 11 Omicron lineages (BA.1), 16 Omicron (BA.2).
Conclusion: During the 2ndwave the symptomatic patients were detected with more delta and delta sub lineages showing high mortality rate. During 3rdwave omicron and omicron sub lineages were detected more than delta showing very high transmissibility and less mortality. Continuous monitoring and analysis of the sequence variants to understand the genetic heterogenicity.

In confirmed positive patients, the purpose of this study is to assess the relationship between Coronavirus Disease 19 (COVID-19) and the primary complete blood count (CBC) parameters. In a retrospective cross-sectional study, 192 files of patients with a confirmed diagnosis of COVID-19 who were being treated at Govt medical College &Hospital Rajouri in India were randomly chosen as a study group for haematological parameters, and an additional 192 files of patients without a confirmed diagnosis of COVID-19 whose medical histories did not include any conditions that might have an impact on their haematological profile were chosen as a control group. The control group's gender, age, and nationality were matched to those of the study group. In contrast to COVID-19 negative patients, anaemia and thrombocytopenia weresignificantly more common in COVID-19 positive patients.However, the prevalence of leukopenia did not differ statistically between the two groups, but the positive individuals were 3.4 times more likely to be anaemic and around 5.3 times more likely to be thrombocytopenic. The median values for mean cell volume (MCV), total white blood cell (WBC) count, lymphocyte count, and basophil count between the two groups, however, did not indicate any statistically significant differences. Further research is advised to corroborate these findings because severe positive individuals may have highly developed anaemia and thrombocytopenia.

Since the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) as a pandemic, it has become a major challenging public health problem worldwide. This pandemic has affected all aspects of Population life in almost all nations and among all socioeconomic groups. Population of all types are facing an unprecedented crisis with the rapid spread of COVID-19 and severity of the disease in many infected individuals.  As such many healthcare systems have been overwhelmed and HCWs presented with work load . There is a potential shortage of physical resources, such as ventilators and intensive care unit beds, needed to care for surges of critically ill patients, however, additional medical supplies and beds will be of limited help unless there is an adequate medical workforce, as the Middle East respiratory syndrome coronavirus (MERS-CoV) continues to occur in small outbreaks in Saudi Arabia. Aim of the study: To assessment the Knowledge, Attitude and Practice toward COVID-19 among the Population attending primary healthcare centers in Makkah Al-Mukarramah Saudi Arabia 2022

Pattern and Group behavior of COVID-19 patient’s data is very much important aspect of data analysis for medical stakeholders to frame decision strategies and to design routine set-ups. PCA is old mathematical machine learning grouping analysis technique but popular in recently for data analysis in grouping insights, so the researcher has implemented principal component analysis to study dominance in data with varied component grouping with proportional variation and also used graphical visualizations. The strength of PCA implementation is to maintain real valued data with dimension reduction but without loss of key information. The experiment result of COVID-19 data is showing component 1 contributing to highly positive testResult that is having High impact on patients. PCA shows relative dimensions analysis. PCA dimensions plotted shows independence in dimension with 90⁰ angle dimensions in data spread. The results identified for COVID-19 data glimpse with dominant component formation.

Background and Aims: Coronavirus disease 2019 (COVID-19) adds more challenges to the perioperative management of pregnant women. The aim of this study is to examine severity of COVID-19 disease and maternal and foetal outcome among COVID-19 positive pregnant women undergoing caesarean section. Methods: This retrospective observational study was conducted at a tertiary teaching hospital in Karnataka between 1stApril to 31st July 2021, during which 100 COVID-19 positive pregnant women with ASA physical class II, III and IV who have undergone lower segment emergency caesarean section were selected on the basis of simple random sampling method. Results: A total of 100 women who had undergone caesarean section under spinal anaesthesia with positive SARS-CoV-2 PCR tests were assessed. Mean age was 24.45± 4.3 years, eight women were having severe covid-19 infection and overall mortality rate was 5% (5/100) in women and 1 woman had HELPP syndrome and one met with PPH (post-partum haemorrhage). Seven (7%) COVID-19 pregnant women required intensive care in the perioperative period. Eight neonates required NICU admission and had APGAR score less than 7. Fifty-five (55%) women were asymptomatic. While the rate of pneumonia in symptomatic women was 3.6% (8/45), the pneumonia incidence among all SARS-CoV-2 PCR (+) pregnant women was 8% (8/100). Conclusion: In our study, 61% of patients had pulmonary involvement and the mortality rate was 8% among mothers and 1% in neonates.

Title-" A cross-sectional observational  Study to assess the severity of coronavirus disease 2019 according to Clinical value of immune  inflammatory markers"
Background: In Wuhan, China, since December 2019, a new strain of pneumonia has appeared and spread quickly over the world. The World Health Organization determined that a separate strain of coronavirus, designated COVID-19, caused this pneumonia (WHO). This unique coronavirus was identified as acute respiratory syndrome coronavirus 2 based on phylogeny, taxonomy, and accepted practise (SARS-COV2).
Objective: a cross-sectional observational study to show the co-relation between inflammatory markers and the severity of disease
Materials and Methods: a total of 250 patients were selected who are microbiologically covid positive and ready to give consent were included in the study. There basic test will be done.
Result- There is preponderance of male gender among the patients 147 were male 103 were female. The mean age of participant is 43 ±2.825 (±6.57%)65 patient were immediately required the either oxygen or mechanical ventilation,among all this 26 patient were died. Among this entire 65 patient, 21 patients have raise CRP level,14 have raised IL -6 Level among them all 26 were have raised D-Dimer .
Conclusion- Our study showed that high level of D-Dimer, IL-6 and CRP was independent risk factors for assessing the severity of COVID-19. IL-6 played a determiningrole in the severity of SARS-COV2 and had a potential value for monitoring the process of severe cases.

Introduction: The COVID-19 pandemic has been raging across the globe since early January 2020. Various geographical regions have been passing multiple swells of upsurge of cases which aren't matched temporally as well as in severity. The diapason of the complaint ranges from asymptomatic to severe life-hanging complaint. Advanced age and the presence of comorbidities similar as cardiovascular complaint, diabetes mellitus, hypertension, chronic lung complaint, chronic kidney complaint, cancer, and obesity are among the major threat factors for severe disease.
Aims and objectives: Significance of lab parameter among Corona Patients. Materials and methods: The covid- 19 opinion was verified by reverse transcription- polymerase chain reaction (RT- PCR) assay of nasopharyngeal swab sample. Hematology blood samples were used to analyze by flow cytometry. Biochemical samples were used to analyze by completely auto analyzer diagnostic outfit. Serology tests were carried out the styles based on indirect ELISA technique, immune plates are coated with a admixture of purified viral antigen and probe using the patient serum.
Results: It is found that there is statistically significant (p-value<0.05) mean difference within the lab parameters (IL-6, LDH and Ferritin) in Covid patients using the Post Hoc Analysis. It is also found that there statistically significant (p-value<0.05) mean difference between RBC, Hb level, Hematocrit, MCV, MCH, MCHC, Platelet, RDW, PCT and NL ratio while Age, WBC, MPV, M(Monocyte), E(Eosinophil), B(Basophil), D-dimer and PDW were found to be statistically insignificant (p-value>0.05) with respect to gender.
Discussion: CBC, D- dimer, IL-6, LDH and Ferritin were analysed and found associated with adverse outcomes. There is significant association of age, gender, comorbidity.
Conclusion: High NLR at admission associated with a higher mortality. Laboratory features (e.g., IL-6, LDH, Ferritin D-dimer etc.) were associated with poor outcomes

Background: To assess the pattern of covid-19 manifestations in group of patients visiting tertiary care hospital.

Aim and objectives: The present study assessed the correlation between rising levels of CRP and D-dimer with morbidity and mortality in adult Covid -19 patients.
Materials and method: This retrospective observational study was conducted at Max Super speciality Hospital I.P. Extension, Delhi a tertiary care centre in North India. CRP and D-Dimer values were collected at the time of admission and within 15 days after admission. The statistical analysis was done by independent t-test.
Results: The study population consisted of 194 (64.7%) males and 106 (35.3%) females. The mean age of the study population was 56.78±15.42 (28-94) years. The mean age of the non-survivors (58.83±15.64 years) was significantly more than survivors (54.43±14.85 years). The mean CRP and D-DIMER at the time of admission and within 15 days after admission was significantly more among non-survivors compared to survivors.
Conclusion: A high CRP and elevated D-Dimer levels among COVID-19 patients predict higher odds of mortality; however, large scale and longer-term studies are needed to validate our findings. The predictive model based upon CRP and D-DIMER levels can help the clinicians to improve individual treatment, make timely clinical decisions, and make optimal use of limited clinical resources.

This study was done to assess the morphological changes in peripheral blood smears during COVID-19 infection .We aimed to examine the characteristics of the cells detected in the peripheral blood smear and bone marrow at the time of diagnosis in COVID-19 patients. Clinical features, laboratory data, peripheral blood smear of 35patients diagnosed with COVID-19 by PCR was evaluated at diagnosis. Peripheral smear samples of the patients were compared with the age and sex-matched 35 healthy controls. The relationship between the laboratory values of all patients and the duration of hospitalization was analyzed. Peripheral smear shows neutrophilic leucocytosis, lymphopenia and thrombocytopenia while Bone marrows were normocellular to hypercellular, most showing maturing trilineage hematopoiesis with myeloid left shift. In 09 out of 35 evaluable bone marrows, hemophagocytic histiocytes were identified.

Background and Objective
Coronaviruses are a family of viruses that can cause respiratory illness in humans. They are called “corona” because of crown-like spikes on the surface of the virus. Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and the common cold are examples of coronaviruses that cause illness in humans.
The primary mode of transmission of SARS-CoV-2 is via exposure to respiratory droplets carrying the infectious virus from close contact or droplet transmission from pre-symptomatic, asymptomatic, or symptomatic individuals harbouring the virus
This study is conducted to analyse the extent of association between COVID-19 & Diabetes Mellitus and its correlation with the inflammatory markers as it is still unclear if diabetes interferes in the prognosis of COVID-19
Material & Methods
A Cross-sectional study was conducted over a period of 6 months from April 2021–September 2021.Among 149 RT-PCR positive COVID-19 patients the random blood sugar levels, CT chest severity score & C-Reactive Protein was compared among the diabetic & non-diabetic population in ACS Medical college & hospital Chennai.
Results
The study shows that out of 149 COVID-19 positive patients, 88 (59.1%) were diabetic & 61 (40.9%) were non-diabetic. Patients with diabetes had significantly higher CT chest severity score and elevated C-reactive protein than non-diabetic patients.
Conclusion
The interaction between covid-19 & diabetes could be bi-directional, with SARS-CoV-2 potentially worsening pre-existing diabetes.

Context: Computer Vision Syndrome (CVS) refers to ocular symptoms which occur as a result of prolonged use of digital devices.
Aims: The main objective was to understand the effects of continuous online classes due to the COVID-19 pandemic on the ocular health of medical students.
Materials and Methods: This quantitative study used data from a survey questionnaire administered to 200 medical students at Tbilisi State Medical University in Georgia. The questions mainly comprised symptoms related to CVS and digital device use patterns. As a part of the research, 200 students between the ages of 18 and 26 were surveyed.
Results: After the pandemic, 33.8% of students recorded a 3 to 5-hour increase in their screen time while 29.4% reported an increase by 1 to 2 hours. Eye strain and dry eyes as a result of the pandemic saw a significant increase in affected individuals from 69 to 84 and 47 to 60 respectively. Among other non-visual ailments, there was an increase in symptoms like headaches (from 90 to 100 students), backaches (from 50 to 78), and neck pains (from 37 to 75 students).
Conclusion: It was concluded that the prevalence of symptoms related to Computer Vision Syndrome in medical students had seen a rise resulting from the online classes due to the pandemic. Awareness of CVS and the prevention of symptoms is necessary, especially among students.

Background: Mucormycosis is one such infection which has shown a sudden rise during the second wave in India. (Our present study has been designed to all the confirmed cases of rhino orbital mucormycosis. In our study we have included all the rhinorbital mucormycosis cases that have been confirmed by microscopy and or radiological evidence.Mucormycosis (also called zygomycosis) is a serious fungal infection caused by agroup of molds called mucoromycetes.
Materials and Methods: All   the patients that have directly attended the ophthalmology OPD. Chief  complaint with duration (Look for redness , watering, discharge & pain in the eye, diplopia, eyelid/ periocular swelling) facial swelling, eyelid/perioculay facial discoloration, Worsening headache, sudden drooping of eyelid (or) restricted eye movements, sudden loss of vision, facial parasthesia / anaesthesia, nasal discharge (blakish/ bloody/foul smell nasal stuffiness, dental pain.
Results: Out of all 60 cases, 79 there were 47 males and 13 females.  In this study 48.33% cases belongs to age group of 50-60 years followed by    36.66% belongs to age group of 60-70 years. Among the 60 patients who presented to hospital within 1 week of onset of symptoms likee pain redness watering et 35 of them got good vision, whereas among the 15 members who presented beyond 2 weeks after the onset of their symptoms only 7 got good vision while 2 of them got poor vision below 6/60 indicating the importance of early diagnosis.  65% cases affected at right eye and 63.33% cases showing symotoms like Redness, treatment under goes with    total Restriction   42 members and Painful oculr movement   in 43.33% cases.
Conclusion: The second wave of COVID-19 in India has led to more deaths than the first. In just a few weeks, the B.1.617.2 (Delta) variant became the dominant strain across India. It has since spread to about 40 nations, which include United Kingdom, Fiji and Singapore.18 the first case of Covid-19-related Mucormycosis has now been found in Chile. It is important to recognise at an early stage this infection, so as to potentially reduce soft and hard tissue necrosis and severe complications and alert colleagues of this mutilating and life threatening infection.

Background: Corona pandemic and its resultant lockdown have caused a devastated effect of life of human beings. We conducted this study during Covid-19 period to analyze the effects of lockdown on pediatric trauma variations in injury pattern and its severity among children in a tertiary hospital.
Materials and Methods: Patients of less than 16 year presented to orthopedic trauma were defined in this study. The study has been divided into three time periods. Patients presented from March 2019 to July 2019 (base line period), March 2020 to July 2020 (Lockdown period) and March 2021 to July 2021 (post lockdown period) were identified and compared in this retrospective cross sectional study. The children included in this study were either requiring manipulation under anesthesia or surgical intervention in operation theatre. We conducted unadjusted bivariate analyses of injury patterns during these periods. Segmented linear regression models were used to evaluate the rates of injuries before, during and after pandemic period. The one way analysis of variance (ANOVA) was used to evaluate the differences in means of three independent groups.
Results: A total of 231 numbers of children with orthopedic trauma were presented to our tertiary hospital.  Out of these, 111 were admitted during pre-pandemic period and 45 in the pandemic period with 75 children during post pandemic period. During lockdown period, mean age of children with significant orthopedic trauma has decreased to 7.5 years in comparison to base line which was about 8.5 years and post lockdown period 9.25 years. Boys outnumbered the girls during this study. The outdoor injury has drastically decreased from 65.75% in base line to 35.65% in lockdown period, but this pattern has increased to 85.25% in post lockdown period.
Conclusion: Our study has shown that during lock down in Covid pandemic, there was a decrease of 59.46% cases of pediatric trauma patients in which surgical intervention or manipulation in operation theatre was required. These changes in epidemiology may be due to modified approach followed by surgeon while following strict Covid guidelines. Our study has also mentioned increase in domestic injuries requiring surgical intervention which may be due to lock down implications by national protocols. We recommend to create a safe environment for children during indoor and outdoor activities and creating awareness among parents to safe guard their siblings. All above these measures may reduce the burden on health care facilities.

Introduction: Myopia is a major health issue in our society. There is a large number of proportion remain undiagnosed. High myopia can be associated with multiple consequences as myopic retinopathy, myopic macular degeneration, retinal detachment and amblyopia. The aim of our study to focus on magnitude of childhood myopia, increase awareness for myopia in our society so that we can reduce vision threatening sequelae in children.
Methods: Study was conducted in ophthalmology department and ENT department government medical college Saharanpur, medicine department Uttar Pradesh medical sciences, Saifai and pediatric department GTB medical college New Delhi. Children between 7 to 16 years with ametropia included in the study to find out magnitude of myopia among them.
Result: A total of 1460 children between the age of 7-16 years with complains of eyeache, headache, heaviness of head diminution of vision, and with other asthenopic symptoms included in the study. Among these 320 children were myopic. It shows high magnitude of myopia in children. Out of these myopic children mild grade myopic children were in high proportion (35.9%).
Conclusion: The study showed the pattern of myopia in children in Indian population. Screening in schools and early diagnosis of refractive error affect the learning and performances of children. In our study we showed the pattern of severity of myopia in children. Study also showed the effect of digital screen time of children with myopia.

Background: Since December 2019, an novel type of pneumonia emergedin
Wuhan,China,and rapidly transmitted to wholeglobe. This pneumonia was verified to
be caused by a different strain coronavirus and named as coronavirus disease
2019(COVID-19) bythe World Health Organization (WHO). Based on
phylogeny,taxonomy and established practice, this novel coronavirus was designated
as severe acute respiratory syndrome coronavirus2 (SARS-COV2).
Objectives: To show the co-relation between inflammatory markers and the severity of
COVID-19 disease

Introduction:TheCOVID-19pandemichasrepeatedlyhittheplanetwithawaveofinfection.Clinicians are attempting to defend public health care ethics. Asymptomatic COVID-19 casesgounrecorded,andthemajorityofthemisolatethemselves.Significantradiologicalabnormalities have been discovered in RT-PCR positive asymptomatic COVID-19 cases,accordingto studies.
Objective:Thegoalofthiscross-sectionalstudyistoevaluateasymptomaticRT-PCR-positivepatients'chest CT findingsin oneof India's COVID-designatedinstitutions in a tertiary care centre in Bihar.
Methods: In three months, we did HRCT chest of diverse (200 patient case study) proved andprobableinstances of COVID-19 infection. All patients are underwent HRCT chest by multislice (128 slice) Toshiba CT scan (Aquilion) or 16 slice Toshiba CT scan. The following CT parameters were used: collimation 5mm; slice thickness, 0.5- 2.5 mm; reconstruction interval, 2.5 mm; table speed 13.5 mm per rotation; 150 -250 mA effective current; tube potential 120kVp; and matrix size, 512 x 512. the patient was examined in supine position with both arms extended above the head. All CT chest were taken in caudocranial direction, covering entire chest from diaphragmatic dome up to lung apex, without intravenous contrast administration. The image finally send to PACS for reporting.
Results: Positive HRCT chest results were detected in 196 of 200 scanned individuals withclinical complaints and suspicion, indicating clinical-radiological association and an accuracyof 98 percent. Based on positive RT-PCR data, the sensitivity of chest CT in suggestingCOVID-19was98.6%(146/148patients).90percent(18/20)ofpatientswithnegativeRTPCRresultsandsignificantclinicalsuspicionhadpositivechestCTfindings.
Conclusion:InlaboratorynegativeRT-PCRcaseswithstrongclinicalsuspicionofCOVID-19infection,HRCTchestisparticularly sensitive and accurate in detecting up lung parenchymal abnormalities, as well asin all symptomatic patients whose RT-PCR was not done. In patients with a strong clinicalsuspicion,HRCTcanbeexceedinglysensitive,cost-effective,andtime-effective.HRCT outperformsRT-PCRintermsofprovidingimmediateresults,measuringdiseaseseverity,andprognosisprediction.
InallpatientswithclinicalsymptomsandsuspicionofCOVIDinfection,regardlessoflaboratoryRT-PCRstatus,werecommendHRCTchestforidentificationofearlyparenchymalabnormalities and determining diseaseseverity.

Background and objectives:  During the second wave of corona virus pandemic, we saw an increase in the case reports of rhino-orbital mucormycosis in patients with coronavirus disease (COVID -19) or in patients who had recovered from COVID -19 infection. We evaluated the patient characteristics and predisposing factors in these patients having mucormycosis.
Materials and method: This retrospective observational study included 84 patients with mucormycosis diagnosed during their course of COVID-19 illness between May 2021 to July 2021.Data regarding demography, underlying medical condition, extent of involvement of mucormycosis, COVID-19 status and treatment taken during COVID-19 illness were collected.
Results: Eighty-four patients presented with mucormycosis out of which 59 patients were males and 25 females. Majority were in the age group of 40-60 years (71.4%). Rhino-orbital was the most common form of mucormycosis. Intracranial spread was noted in 16 patients. Hyperglycemia at presentation (either pre-existing or new onset diabetes mellitus) was the single most important risk factor observed in majority of these cases (80 patients / 95.23%) followed by history of Corticosteroid use in 68 patients (80.95%) and oxygen administration during their course of treatment for COVID-19 illness in 64 patients. (76.19%)
Conclusion:The association between coronavirus and mucormycosis must be given serious consideration. Uncontrolled diabetes and over-zealous use of corticosteroids are the two most important factors aggravating the illness. All efforts must be made to maintain optimal glucose levels in COVID-19 patients and use corticosteroids judiciously.

Background: Coronavirus disease 2019 (COVID-19) is a new respiratory infection caused by a coronavirus known as SARS coronavirus 2. (SARS- CoV-2). The virus is a member of the coronavirus family, which are zoonotic pathogens that cause and transmit infections between humans and various animals. The World Health Organization (WHO) has designated coronavirus disease 2019 (COVID-19) a pandemic, with 20% of infected individuals requiring hospitalisation and 6% requiring critical care and invasive ventilatory support. Co-morbidities are thought to be a greater risk for reducing the survival probability of SARS-CoV-2 patients. Different types of pre- existing diseases have been identified as co-morbidities in SARS-CoV-2 infection, which increases susceptibility and poses risks of more severe outcomes and deaths in COVID-19 patients.Thisstudy is to identify different co-morbidities of the patients who died due to COVID-19 admitted in GMERS medical college and general hospital in city Gandhinagar in Gujarat state.
Methods:This is a retrospective study of patients admitted to covid hospital, GMERS medical college and hospital, Gandhinagar who had been reported positive either with RT-PCR Test or rapid antigen test and died in hospital during the period of April 2020 to April 2021.
Results: In present study, majority (62.9%) of the study participants were in the age group of 51 to 70 years. The mean age of the study participants was61.91 years.58.4% of the COVID-19 patients were males while 41.6% were females. 93.2% of the COVID-19 patients were having any comorbidity while among 6.8% of the patients were without any comorbidities withhypertension was most common(57.5%) followed by diabetes(53.4%). 44.8% of the study patientswere having only single comorbidity while 55.2% were having more than or equals to two comorbidities. The mean interval between hospital admission and death of the patients was 4.5 days.
Conclusion: It has been concluded that old age, male gender has more severe outcome in case of COVID-19. Hypertension and diabetes mellitus were also reported among more than 50% of the patients who died from COVID-19.

Background: Lockdown is an emergency situation which has confined people to their homes, states and country. Individuals felt insecure and worried about their financial matters and their mental health was affected at some point of time during the corona virus pandemic lockdown.
Aim: The study aimed to assess the effect of lockdown on mental health between the general population and covid-19 frontline health care workers.
Material and Methods: The survey was conducted from July to October 2020 using DSM -5 Self-Rated level 1 cross-cutting symptom measure -Adult scale, circulated through social media platform (Google forms). In this study, 180 participants were enrolled. Hindi version of the measure was used to assess the psychological impact on the participants and a score of 0 was considered as NO and was taken as a Negative response and scores 1 to 4, were considered as YES and were taken as a positive responses.
Result: A total of 180 responses were obtained during the survey, amongst them 36.67% were male and 63.33%were female. Frontline healthcare workers were 51.67% and among the Non-health care workers, unemployed were 10%, Student were 17.78%, and the remaining working were 56.67%. As per DSM 5 Crosscutting symptoms scores, the most common reported psychological symptoms were Anxiety  81.11%, Depression  52.78%, Sleep problems  29.44%, and Substance use 25%,. The comparison between both the groups was not statistically significant (p>0.001). However, non-healthcare workers experienced more psychological symptoms.
conclusion: The covid-19 lockdown was associated with poor mental health across individuals .the lockdown was observed  to be a stressful situation that could have precipitated psychological symptoms like anxiety, stress, depression, and sleep disturbance in the individuals.
 

Background:To evaluate the association of the demographic, clinical sign and symptoms
and laboratory biomarkers in predicting the mortality in COVID-19 infected patients.
Materials and Methods: This was a single centre retrospective observational study
carried out in atertiary care centre of a tribal region of central India, which was a
referral centre for COVID-19.Parameters taken into account were physiological
parameters,symptoms at admission,radiographic findings and laboratory findings.
Results: Out of 103 deaths included in this study 76 were male and 37 females (2:1).
Mean age of the deceased were 54.90 years (18-90 years). The most common symptom
on admission was breathlessness in 92 patients (89.32%). Abdominal symptoms like
diarrhoea and vomiting were associated in 7.7 % of the deceased patients only.Most of
the patients who died were older patients having age 60 years and above (65.04 %).
Most of the patients who died had Spo2 less than 90 % on admission (85.43
%).Lymphopenia (92.23 %) was the most commonly observed finding on blood
investigations done in deceased patients followed by increased CRP level (78.64 %).
Comorbidities were present in 77 patients out of 103 patients (74.75%) included in this
study. Diabetes and hypertension were being the most common comorbidities associated
in these patients.Death was not commonly observed in patients with COVID 19
associated with respiratory diseases.
Conclusion: Identified prognostic factors can help clinicians and policy makers in
tailoring management strategies for patients with COVID-19 infectious disease while
researchers can utilize our findings to develop multivariable prognostic models that
could eventually facilitate decision-making and improve patient important outcomes.

Background: The COVID-19 pandemic has led to an unprecedented surge in hospitalised patients with viral pneumonia. Chest X-Ray (CXR) is one of the important, non-invasive methods and used as a preliminary investigation to detect different pulmonary abnormalities. Present study was aimed to study X-ray findings of COVID 19 from Assam medical college and hospital, Dibrugarh. Assam.
Material and Methods: Present study was single-center, prospective, observational study, conducted in patients 18-65 years age, who were confirmed cases of COVID 19 by RT PCR or RAT testing.
Results: In present study, 220 patients satisfying study criteria were evaluated. Chest X ray abnormalities were noted in 48.18% cases initially, while in 2.73% cases, initial normal CXRs later became abnormal. 5.91% CXRs had unilateral abnormalities while 42.27% CXRs had bilateral abnormalities. Symmetrical abnormal findings was noted in 21.82% as compared to asymmetrical abnormal findings in 20.45% cases. CXRs lesion distribution was peripheral location (35.91%), central location (5.91%) & combined peripheral and central location (6.36%). Localization of abnormalities in CXRs was in Lower, Middle & upper zone in 32.73%, 10.45% & 5% respectively. Common specific radiographic abnormalities were Ground glass opacities (GGOs) (42.73%), Consolidation (23.64%), Nodularity (0.91%), Reticular opacity (5.91%) & Pleural effusion (9.55%), Severity score in present study was mild, moderate & severe in 33.18%, 11.82% & 3.18% cases respectively.
Conclusion: Chest X-ray is a valuable tool in better management of patients during the COVID-19 pandemic. Despite its lower sensitivity compared with CT scans, its inherent advantages such as reasonable cost, broad range of use, and rapid speed make it indispensable.

Introduction: Possibility of breakthrough infection to Covid-19 variants which may cross vaccine induced immunityas immunity acquired from natural COVID-19 infection or vaccines is not absolute and reinfections postnatural COVID-19 infections, as well as vaccine breakthrough infections, are not uncommon. Furthermore, lack of data is available on breakthrough infection as well as reinfection in India especially in Bihar. Thus, the present study is undertaken to find out magnitude of breakthrough infection and re-infection of COVID 19 and to find out factors associated with breakthrough infection and re-infection.
Materials and Method: The present telephone based cross sectional study was carried over a period of 3 months among400 subjects of age group ≥18yrs vaccinated with both doses of COVID Vaccine. A predesigned; semi-structured, pre-tested questionnaire was designed for elucidating the information about demographic details, vaccination, infection and serology. Data analysis was carried out using SPSS version 16. Chi square test was used to analyze association. P value of <0.05 considered significant.
Results: Regarding patients who suffered from Covid breakthrough infection after vaccination were 40 patients and patients who suffered from reinfection, total was 8 patients, among them 1 positive patient was out of 137 who were in age group of 18-25 years, 4 out of 59were in 26-44 years, 0 out of 17 were in 45-59 years and 3 out of 187were ≥60 years age group. P-value was significant with p=0.037 (as p>0.05). Regarding vaccine intake, among 400 subjects, 134 subjects were suffering were vaccinated with Covaxin, out of which 17 acquired covid breakthrough infection; those who were given Covishield, out of 242, 22 acquired covid breakthrough infection and among 24 subjects who were not knowing about type of vaccination given 1 acquired covid breakthrough infection. P-value was not significant among all those parameters.
Conclusion: The study identifies the possibility of breakthrough infections among vaccinated peoples and ensures the impact of vaccination in limiting disease severity. However, prior vaccination provided substantial protection against symptomatic re-infection and severe disease. The findings suggest that COVID-19 preventive measures should be continued even among vaccinated individuals. Breakthrough infection in India after complete dose of vaccination should be major area of research.

Aim: To evaluate the cardiovascular changes associated with covid-19
Methods: One hundred consecutive patients diagnosed with COVID-19 infection
underwent complete echocardiographic evaluation within 24 hours of admission and were
compared with reference values. Echocardiographic studies included left ventricular (LV)
systolic and diastolic function and valve hemodynamics and right ventricular (RV)
assessment, as well as lung ultrasound. A second examination was performed in case of
clinical deterioration.
Results: Clinical data were collected in 120 consecutive patients hospitalized with
COVID-19 infection. A total of 20 patients were excluded because they did not undergo
echocardiographic assessment. The reasons for not performing the echocardiogram were as
follows: hospital discharge within 24 hours of admission (8 patients), patient refusal (2
patient), and death shortly after hospitalisation (8 patients, all >80 years of age and with a
“do not resuscitate” status).
Conclusions: patients presenting with clinical deterioration at follow-up, acute RV
dysfunction, with or without deep vein thrombosis, is more common, but acute LV systolic
dysfunction was noted in ≈20%.

Background: The mortality rate covid-19 is still not understood completely but was reported around five percent worldwide. This study puts in an effort to find one such difference if any between the survivors when compared to the non-survivors. This study makes an effort to find the acute inflammatory proteins in the survivors in comparison with the non-survivors.
Aims and Objectives: To study the acute inflammatory proteins levels and their significance in Covid-19.
Materials and Methods: This is a retrospective study done in the Department of Medicine, Dr. Chandramma Dayanand Sagar Institute of Medical Education and Research, Bangalore.
Results: There is a significant difference in the levels of acute inflammatory protein levels in survivors when compared to that of non-survivors.
Conclusion: This study successfully portrays the importance of acute inflammatory protein levels in understanding the progression of the disease.

Background: Coronavirus disease 2019 (COVID-19) is a new respiratory infection caused by a coronavirus known as SARS coronavirus 2. (SARS- CoV-2). The virus is a member of the coronavirus family, which are zoonotic pathogens that cause and transmit infections between humans and various animals. The World Health Organization (WHO) has designated coronavirus disease 2019 (COVID-19) a pandemic, with 20% of infected individuals requiring hospitalisation and 6% requiring critical care and invasive ventilatory support. Co-morbidities are thought to be a greater risk for reducing the survival probability of SARS-CoV-2 patients. Different types of pre- existing diseases have been identified as co-morbidities in SARS-CoV-2 infection, which increases susceptibility and poses risks of more severe outcomes and deaths in COVID-19 patients. This study is to identify different co-morbidities of the patients who died due to COVID-19 admitted in GMERS medical college and general hospital in city Gandhinagar in Gujarat state.

Introduction: The pandemic disease COVID-19 has varied presentations clinically and even
radiologically. Early diagnosis and treatment help in containment of the disease. Therefore, assessing
the radiological patterns in order to contribute to the diagnosis COVID-19 is the aim of this study.
Materials and method: A cross-sectional descriptive study from January 2021 to June 2021 was
carried out on 165 patients suspected of COVID-19 with delayed RT-PCR report or in cases with initial
RT-PCR negative, but having high clinical of suspicion of COVID-19. HRCT pattern in such cases
were documented and correlated with the repeat RTPCR and other laboratory parameters such as
Interleukin IL-6, serum ferritin, C-reactive protein, Lactate Dehydrogenase.
Results: Most common HRCT pattern was bilateral multifocal peripheral ground glass opacities
predominantly involving posterior segments. Other common patterns were crazy paving and
consolidation.
Conclusion: Specific patterns on the HRCT can be used in diagnosis of COVID-19 when there is high
clinical likelihood, however the study should be used judiciously only when indicated.

Background: There are various studies that suggest that short term and early prone positioning can increase PaO2/FiO2 in moderate to severe acute respiratory distress syndrome (ARDS). The aim of our study was to observe the effect of prone position on oxygenation status in spontaneously breathing non intubated covid19 patients on either non rebreathing mask (NRBM) or on noninvasive ventilation (NIV).
Aims: To observe the effect of prone position along with oxygen therapy (NIV or NRBM) on oxygenation in spontaneously breathing none intubated covid19 patient.
Material and Methods: This prospective observational study was performed in a covid19 intensive care unit (ICU) at tertiary care hospital for the period of two months. Non-intubated confirmed RTPCR (Reverse transcription polymerase chain reaction) positive covid19 patients were included and observed who were placed in prone position with NIV BIPAP (Bi level positive airway pressure) or with NRBM by ICU consultant. Primary outcome was oxygenation status from Pao2/fio2 ratio from arterial blood gas analysis. Secondary outcome was hemodynamic parameter and any adverse effect occurred during prone positioning. Collected data were analyzed using SPSS software and P value of Pao2/Fio2 ratio of before and after prone position, less than 0.05 considered significant.
Results: We observed among our study participants significant improvement of PaO2/FiO2 ratio in both group of patients.
Conclusions: Early use of prone position improved oxygenation in majority of our patients in short periods of time in both NIV and NRBM group of patients.

Background and aims: During the second wave of coronavirus disease 2019 [covid-19] in India, there is a rapid surge of opportunistic fungal infections among covid-19 patients. Rhino-Orbito-Cerebral mucormycosis is the most common disease among these patients apart from pulmonary aspergillosis. The study aims to determine the clinical presentation, signs, and symptoms in patients with rhino-orbito-cerebral mucormycosis associated with coronavirus disease in the present scenario.
Methods: It is a retrospective observational study. The Clinical history of 100 patients from medical records with Rhino-Orbito-Cerebral mucormycosis associated with covid-19 during the months of May and June 2021 is collected and analyzed.
Results: In our study on 100 patients with mucormycosis infection 95 patients were diagnosed with covid-19 infection and 82 patients were diabetic. Among the diabetic group, 53 were chronic diabetic and 29 were detected denovo. The disease is seen most prominently in the people of the age group between 30-60yrs. Males are more affected. The urban population represented 67 percent. The chief complaints of the patients with mucormycosis related covid-19 are pain (88%), swelling/edema (79%), visual disturbance (51%), numbness over the face (47%), nasal discharge (45%). Clinical findings of the disease are, ptosis (52%), blurring/absent vision (51%), proptosis (41%), ophthalmoplegia (33%), discoloration over the face (26%) and necrosis of the soft tissues (8%).The percentage of people presented with mucormycosis between diagnosis of covid-19 infection and onset of symptoms of mucormycosis is observed to be 72% within two weeks and 89% within three weeks. Regarding the covid-19 symptoms, mild symptoms were seen in 59.9%, moderate symptoms in 29.4% and severe symptoms in 10.5% of patients. 76 patients were on corticosteroid therapy and 35 patients were oxygen-dependent.

Introduction: Thrombocytopenia is a common condition seen in clinical practice. A wide range of
etiologies and variation in clinical presentation often pose a challenge in its diagnosis. Early recognition
of thrombocytopenia and its causes can avoid critical bleeding.
Aim: This study aimed to assess etiology and clinicopathological profile of thrombocytopenia in a
tertiary care center.
Materials and methods: Of all patients whose blood samples were received for complete blood count
analysis, 500 patients with thrombocytopenia were included. Blood samples were run in Sysmex XP-100
and PCi 20 fully automated, three-part differential hematology analyzers. Leishman-stained peripheral
blood smears were also studied.
Results: Mild thrombocytopenia (platelet count 60,000-1,50,000/μl) was seen in majority (84.8%) of the
patients followed by moderate thrombocytopenia (platelet count 20,000-60,000/μl) in 10.8% and severe
thrombocytopenia (platelet count <20,000/μl) in 4.4% of the patients The most common cause of
thrombocytopenia was found to be infections (50% patients) followed by chronic liver disease (14.8%
patients), macrothrombocytopenia (10.6% patients), hematological disorders (8.6% patients), gestational
thrombocytopenia (7.8% patients), drug intake (4.4% patients) and chronic kidney disease (1.8%
patients). Among infections, acute febrile illness (nonspecific) was the most (23.2%) common cause
followed by COVID 19 infection (19.4%) and bacterial sepsis (5.4% patients). Four distinct patterns of
platelet histogram in patients with thrombocytopenia were seen.
Conclusion: Similar to most previous studies, infections were the most common cause of
thrombocytopenia in the present study. The present study also highlights two novel entities- suspected
asymptomatic macrothrombocytopenia and Covid-19 infection.

Aim: To determine the relationship between biochemical indicators and the severity of COVID-19.
Methods: Blood samples were obtained by competent doctors and nurses in accordance with ICMR
guidelines. The samples were then forwarded to the central biochemistry laboratory for additional
analysis. The Access-2 completely automated chemical analyzer was used to test ferritin, quantitative
CRP, and IL-6, while the AU 480 analyzer was used to assess LDH.
Results: We included 200 confirmed covid-19 patients in our trial. All of the patients were above the
age of 18. The prevalence of HTN, diabetes, CKD, COPD, and Cardiac Disease in the study patients
was 40%, 32%, and 15%, respectively. 20 and 30 percent, respectively. In the current research, the
mean values of IL-6, ferritin, CRP, and LDH were shown to be higher in covid patients, with the rise
being greater in patients on intubation. The mean and standard deviation of biochemical parameters in
non-ICU, ICU, and intubation patients.
Conclusion: Serum CRP, LDH, IL-6, and ferritin levels that are increased may be employed as
laboratory indicators for a bad prognosis in COVID-19.

As a major virus outbreak in the 21st century, the Coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented hazards to mental health globally. While psychological support is being provided to patients and healthcare workers, the general public's mental health requires significant attention as well. This systematic review aims to synthesize extant literature that reports on the effects of COVID-19 on psychological outcomes of the general population and its associated risk factors. A systematic search was conducted on PubMed, Embase, Medline, Web of Science, and Scopus from inception  following the PRISMA guidelines. Relatively high rates of symptoms of anxiety , depression , post-traumatic stress disorder , psychological distress , and stress  are reported in the general population during the COVID-19 pandemic . Risk factors associated with distress measures include female gender, younger age group , presence of chronic/psychiatric illnesses, unemployment, student status, and frequent exposure to social media/news concerning COVID-19.The COVID-19 pandemic is associated with highly significant levels of psychological distress that, in many cases, would meet the threshold for clinical relevance. Mitigating the hazardous effects of COVID-19 on mental health is an international public health priority.

Background and Aim: Since the onset of the 2019-nCoV disease (COVID-19), many skin
manifestations have been reported in COVID-19 patients. This study aims to analysis of various skin
manifestations among patients with COVID-19.
Methods: An observational study was conducted in department of dermatology, Bharatpur Medical
College & Hospital, Bharatpur.
Results: Among Covid positive patients 47% had maculopapular eruptions, 19%, 19% each had
urticarial and pseudo chilblains, 9% had pedicular eruptions and only 6% had necrotic lesions and they
present within 1-4 week. There is a significant association between gender and skin lesions, co morbidity
and skin lesions.
Conclusion: Infection with 2019-nCoV may lead to skin manifestations with various clinical symptoms.
These clinical features combined with clinical symptoms of COVID-19 may aid in the timely diagnosis
of patients with COVID-19.

Introduction: COVID 19 pandemic, caused by SARS –CoV-2 virus causes flu like mild
symptoms to severe acute respiratory syndrome. Pathogenesis is Immune system
deregulationand is haracterized by the presence of lymphopenia in the peripheral blood smears.
The clinical laboratory plays an important role in the diagnosis, treatment and prognosis of
coronavirus patients.

Background: The ACTT-1 trial showed that the median time to recovery was 10 days in the
remdesivir group compared to 15 days in the placebo group. However, remdesivir failed to
provide a survival benefit. This study puts in an effort to find the difference in biochemical
and other parameters in patients treated with remdesivir vs. without the remdesivir in mildmoderate
covid 19 patients.
Aims and Objectives: To study the biochemical and other parameters in patients treated with
remdesivir vs. without the remdesivir in mild-moderate covid 19 patients.
Materials and Methods: This study was done in the Department of Pharmacology,
Kanachur Institute of Medical Sciences, Mangalore. This study was done from May 2020 to
June 2021. The study was done in 30 patients who were treated with remdesivir and thirty
without.
Results: There is significant difference between the remdesivir used group when compared to
the unused group.
Conclusion: It may be useful in mild to moderate cases.

Background: COVID Vaccination has given a ray of hope in fighting against coronavirus disease 2019 (COVID-19).Since the experiences are relatively new to all, it is important to monitor safety of vaccines in a real-world setting. With this background, this study was conducted.
Objective: To assess the pattern of AEFI among undergraduate students.
Methods: This cross-sectional study was conducted in a Hospital setting with 200 vaccinated medical students being enrolled in the study and Data were analysed using SPSS version 20.00.
Results: Total of 200 medical students, 142(71%) and 74(37%) of study subjects had one or more AEFI following COVID-19 vaccination following 1st and 2nd dose respectively. All the AEFI’s (100%) were only minor reactions.
Conclusion: The study reflected that COVID-19 vaccination caused only mild and non-serious AEFI in most of the vaccine recipients. Hence the vaccine given can be considered safe. 

Background:Atypical pneumonia is caused by the SARS CoV-2 virus in persons who
have it. Inflammation is induced by the virus, which aids viral reproduction,
dissemination, tissue injury, and hypoxia. Bevacizumab is a prominent anti-VEGF
monoclonal antibody that has been approved by the USFDA for colorectal carcinoma,
non-small cell lung carcinoma, renal carcinoma, recurrent glioblastoma, cervical
carcinoma, and ovarian carcinoma. We conducted this study to look into the clinical
benefits of bevacizumab in combination with standard care for patients with moderate
to severe COVID-19 disease.
Materials and Methods: The present prospective study was conducted among patients
with moderate to severe COVID-19 pneumonia, admitted at CMC
MULTISPECIALITY HOSPITAL Hospital during SEP 2020 to june 2021. After taking
informed consent from relatives a pretested proforma was used to record the
demographic data, presenting symptoms, the changes of status of oxygen-support as
well as the symptom. Each eligible patient received two doses (400 mg) of bevacizumab
and arterial blood gas analysis, chest computed tomography (CT) scanning, chest Xray,
and laboratory tests were performed at baseline, Day 1 and Day 7 after start of
bevacizumab. To compare differences between different time points after intervention
and baseline point, a paired t-test or Wilcoxon matched-pairs signed-rank test was used
for quantitative data.
Results: In present study, the mean age of patients was 50.2±14.1 years. Majority of
enrolled patients were males (80.0%). The fever (85.0%) followed by cough (76.7%) and
dyspnoea (70.0%) were the common symptoms among enrolled patients. The mean
temperature of the enrolled patients was 99.3±1.4 F. CT chest showed that left lung
lesion ratio was 19.7±15.4% at baseline and it showed improvement and reduced to
12.1±4.3% and similar significant improvement was observed for right lung lesion ratio
(baseline: 35.2±14.9% vs Day 7: 17.2±13.9%). The discharge rate in our study was
65.0%. Due deteriorating of condition or addition of new complications, 18.3% of
patients were referred to higher centres for further management. The death rate was
16.7% in our study.
Conclusion: To reduce mortality in the global COVID-19 pandemic, the necessity for
efficient treatment with few complications should be prioritised. These 60 patients also
demonstrate bevacizumab's high efficacy in SARS CoV-2 patients.

Introduction- COVID -19 now become pandemic disease andChest computed tomography (CT) has very important role in diagnosis and characterizing the Covid patient severity by CT severity score.
Objectives:  The main purpose of this study was to evaluate the performance of MDCT in identifying & categorising the severity of COVID-19 inpatients.
Methods: This is retrospective cohort study and is performed on about 512 hospitalized COVID-19 patients in IGIMS from 15 April to July 2021. The CT severity score was assessed by two independent radiologists by involvement of percentage of area of each lobe of both lung parenchyma on HRCT lung. All admitted RT-PCR positive patient whose HRCT chest done in IGIMS were included in this study and OPD RT-PCR positive patient (COVID positive) & RT-PCR positive (COVID positive) patient with previous history of chronic lung disease, Tuberculosis, Lung mass, bronchiectasis etc were excluded in this study.
Results- In our study, Male (72.5%) are more affected in comparison to female (27.5%) and most of the patient are above the forth decade (69.5 %). Most patients are presented with severe CT severity score, i.e. > 15 CT severity score (about 41 percent) and about 20 percent & 22 percent present with mild & moderate CT severity score. Males are present with more CT severity than female.
Conclusion- Our studies show that older age group male patient (> 40 year) more affected in second peak of covid-19 and patient with chest involvement presented with severe CT severity score, so more mortality was noted , however this study is retrospective, needs prospective study for better correlation.

Background: The present study was conducted to assessthe effect of digital eye strain due to
online mode of teaching in school children during COVID Pandemic.
Materials & methods:A cross sectional study was conducted among school children during
the period 2020-2022to assessthe refractive errors during COVID Pandemic. A total of 4393
(1442,1532, 1419) schoolchildren were enrolled and examined for refractive errors during the
year 2020,2021,2022 respectively.Prevalence of various refractive errors was assessed based
on refractive error study in children (RESC) survey group.
Results:There were 2324(52.9%) male and 2069(47.0%) female students. Ocular
examination depicted enhancement of refractive errors in all the age groups. However among
the children in the age group of 9 to 12 years, refractive errors were detected among
612/1507(43.1%) children.
Conclusion: There has been an increase in use of digital devices after the initiation of the
COVID-19 lockdown, and has resulted in deterioration of ocular health of school going
children

Aim: To evaluate the Prevalence of anxiety and depression during COVID-19 pandemic.
Methods: This study was conducted during the Coronavirus outbreak. Following
development by the research team, the online survey was tested during these study periods.
100 participants were included in this study.
Results: 40% of participants reported feeling tight or wounded up from time to time
(sometimes), whereas 23% reported feeling this way all of the time. Many (35%) were
worried as if something terrible was going to happen, but 'not too severely,' while 33 percent
felt frightened 'a bit' as if something terrible was about to happen, but it did not bother them.
Many people (38 percent) had anxious thoughts from time to time, while others (24 percent)
had them all the time. Only 41% said they sat at ease and felt calm "generally," while others
said they didn't sit at ease and felt relaxed "very frequently" (33 percent ). More than half of
the students (55%) reported not being afraid or having a 'butterfly' feeling in their stomach,
whereas many others (24%) had that scared emotion 'sometimes.' Only 15% of the
participants reported being restless and on the move. In terms of experiencing a sudden sense
of panic attacks, just a small percentage (9%) reported having had this 'often' or 'very
frequently' (20 percent ). When asked if they still enjoyed the things they used to appreciate,
just 36% said they didn't enjoy them as much anymore. Only half of the students (50%) said
they could laugh and see the funny side of things "as much as they always could." A fresh
look at the participants' emotions indicated that just 47 percent of them felt joyful'sometimes,'
while others felt cheery 'not often/not at all' (24 percent , 14 percent respectively).

Coronavirus outbreak has challenged the medical, public health infrastructure and economic status of nearly all countries across the World. The main issue of concern with SARS-CoV-2 has been the high infectivity rate and the high mortality rate especially, observed during the wave 2 of COVID-19. The symptoms associated with SARS-CoV-2 are often misleading with influenza and another respiratory tract seasonal viral infection as, majority of the patients report common constitutional symptoms. Hence, correct diagnosis for COVID-19 may play a key role in early detection, management and curtailment in the transmission rate.Therefore, apart from limiting this outbreak, efforts need to be made to plan comprehensive and stringent measures to develop diagnostic tools to prevent future outbreaks of this zoonotic disease. The present manuscript provides a detailed description of various indices and parameters which are currently being used for easier, rapid, accurate diagnosis, medical managementand prognosis assessment of COVID-19 patients in various stages of the disease.

Background: At the end of 2019 a new viral disease namely covid-19 has occurred which was highly
contagious within a few months it spreads to more than 100 countries. A poor understanding of new
infections and lack of knowledge leads to compromised patient health benefits as well as psychological
stress to front-line health workers. This study aimed to assess the knowledge and level of perception of
health care workers about covid-19.
Methods: A cross-sectional web-based survey was carried out among front-line health care workers who
work at tertiary health care centers the survey instrument constituted a semi-structured pre-tested
questionnaire. The 29-item questionnaire was divided into two sections. Statistical tool chi-square test
used to investigate the stress, anxiety, and depression with significance set to p<.05.
Results: Out of 100 participants 30 front-line health care workers have minimal depression, 25 mild
depression, 14 moderate depression, 13 moderately severe depression, maximum participants belong to
age group 26-35 (P-value .001). The participant with a child is a total of 67 out of 100 participants who
show a variety of depression, Maximum number of participants is 21 having mild depression P (value is
.010). There total of 57 participants who confident caring covid-19 patient, maximum of 22 participants
who have mild depression (P-value is .000).
Conclusion: As the entire world faced the covid-19 thread and continued to emerge, most frontline health
care workers have a varying degree of depression but according to PHQ-9 no one has severe depression.
Definitive or effective treatment of covid-19 including prevention of this by vaccination is mandatory.
Education intervention, personal protection equipment and appropriate knowledge are urgently needed
to reach frontline health care work beyond the international border and future studies are warranted.

Background: In this study, it was aimed to describe rates, etiological agents of the secondary infections and its effect on clinical outcomes among hospitalized patients with COVID-19.
Materials and Methods: A prospective comparative analysis of the characteristics of patients with and without secondary infection was carried out among 75 hospitalized adult patients with a confirmed diagnosis of COVID- 19 via RT-PCR.

Objective: To study the Feto maternal outcome of Covid-19 in Pregnancy.
Methodology: This is a retrospective study done on 53 pregnant patients who tested positive
for SARS-CoV-2 and were delivered in D. Y. Patil Hospital, Kolhapur from April 2020 to
July 2020. Maternal and fetal characteristics and the outcome of Covid-19 infection in
pregnancy was studied.
Results: Among the 53 patients, 49 patients (92%) were asymptomatic. Remaining presented
with fever, sore throat, cough. 69% were primigravida and 30% were multigravida. 66%
underwent LSCS while 28% were delivered normally. In majority, LSCS was done for
oligohydramnios and fetal distress. All the patients were discharged after negative swab
report and no maternal death was reported. About 32% of neonates required NICU admission
for hyperbilirubinemia, pneumonia and sepsis. There was no neonatal death and none of the
neonates turned out to be positive for covid-19.
Conclusion: The severity of SARS-CoV-2 was seen to be mild to moderate in pregnant
women. Majority of the women infected with coronavirus disease were asymptomatic. The
risk of vertical transmission to the neonate was also found to be low. Oligohydramnios and
fetal distress were commonly seen in the patients, pointing towards the lack of antenatal
follow up visits due to restricted mobility in the covid era.

The rapid spread of the COVID-19virus and related pneumonia has posed a major challenge for
healthcare systems worldwide. The infection was discovered in the city of Wuhan, Central of
China and swept across the world.Theincubation period of the viruscan range from 1–14 days,
and the virus spread can happen in the absence of clinical symptoms as well.The most frequently
reported symptoms are fever, cough, dyspnea, and myalgia or fatigue. Modes for transmission of
virus include direct transmission through coughing,sneezing, and inhalation of droplets and
contact transmission through contact with nasal, oral, and ocular mucosa. Droplet and aerosol
transmission of the virus are the most common causes of COVID-19 infection in dental clinics
and hospitals.COVID-19 virus has lately been detected in saliva of infected patients, thus posing
an alert to health professionals to be customarily vigilant in protecting against the infectious
disease spread. Because of the presence of virus in saliva, it may be helpful as a non-invasive
tool in the rapid detection of the virus.During this pandemic dissemination of COVID-19, dental
treatment must be confined to the procedures that cannot be deferred. All the precautions must be
taken in terms of triaging, personal protective equipment, hand hygiene, pre-procedural
mouthrinse, use of rubber dam, disinfection of the surfaces. Dental professionals are at the
highest risk of COVID-19 infection; hence, dental practicehas to be reorganized in order to
ensure higher safety standards for both dentists and patients.

Background: Since March-April 2020, India and its overburdened health care services have faced a new challenge of COVID-19 pandemic. HCWs, along with stress of rigorous duties and long work hours have faced additional stress like fear of infection, transmission, alienation and rejection.Burden not only undermines the quality of life of HCWs but also impacts the quality of health services provided by them, increase practice errors, leading to worse outcomes and additional costs. As our hospital was one of the busiest tertiary care centers of central India with maximum patient load, during this pandemic, we initiated this study to assess how mental health of the HCWs is being affected.To measure the level of Depression, Anxiety & Stress in Health care workers (Resident doctors & Consultants) working in a tertiary care centre in central India. To compare the depression, anxiety & stress scores between various factors related to the work profile.
Material and Methods: It was a Cross sectional study carried out in a tertiary care center in central India. 145 HCWs (resident doctors and consultants) working in COVID wards and ICUs were included in the study. After taking an informed consent, socio-demographic details were obtained and DASS-21 (Depression, anxiety and stress scale) was applied.
Results: 78 (53.7%) of HCWs were males and 67 (46.2%) were females. Majority 97 (66.8%) were from medicine allied branches and 48 (33.1%) from surgery allied branches. Majority [110 (7.6%)] were 1^st and 2^nd year residents. 72 (49.6%) had more than 4 months of duty. 84 (57.9%) had 1-60 hours of ICU duty. The prevalence rates of depression, anxiety and stress were 62%, 66%, and 56% respectively.  Out of these extremely severe grades of depressive, anxiety and stress symptoms were seen in 30%, 18% and 10% respectively. Significantly higher scores were observed in residents of surgery allied branches (54 +/- 32.5), HCWs who had no previous experience (52.18 +/- 31.8), 1^st (56.6+/-34.6) and 2^nd (43.2+/-27.6) year residents, total duration of duty upto 2 months (59.12+/-36.4) and ICU duty of 100 hours (62.1+/- 33.2). However the scores decreased in HCWs who had duties of more than 2 months and ICU duty of more than 100 hours.
Conclusion: More than half of HCWs had depression, anxiety & stress. Significantly higher scores were seen in junior residents, more number of ICU work hours and total duration of duties, and the HCWs with no prior experience. Reducing the duty hours, adequate training in intensive care settings and sensitization about various methods to regulate emotions might help to reduce the stress in HCWs in such difficult times.

Most countries have been struggling in facing the coronavirus. In Indonesia, various proposals and regulations have been introduced as a strategy in handling and preventing the spread of COVID-19, such as the instruction to use masks and for social distancing, travel limitations, area-based restrictions, and vaccination. Unfortunately, COVID-19 has continuedto be an issue since a new variant of concern, known as Omicron (B.1.1.529), was identified. Literature review was conducted in this study, featuring254 cases of Omicron in Indonesia by January 4, 2022. Indonesian government has developed at least fivecriteria to prevent the spreading of the COVID-19 virus,in particular the Omicron variant. Testing rate in Indonesia still below Malaysia, while tracing and treatment control conducted by the Indonesian government is quite similar, and massive in comparison to Malaysia and Singapore, with the PeduliLindungi mobile application launched in 2021. Conducting health promotion has become a necessity, with an understanding of the health belief model, engaging the religious leaders, and providing psychological support for mental health issues.
Keywords: Omicron, COVID-19, Outbreak, Indonesia, Case Record

Background: shifting of the school classes to online format owing to social distancing
norms led to amplification of academic stress, independent learning pressure, dropouts,
everyday life abandonment, less study chance made researchers focus on assessing the
impact of coronavirus on the mental condition of the students. This requires prompt
intervention as stress can further increase in subjects adopting conventional coping
strategies and in subjects with pre-existing stressors.
Aim: The present study was conducted to assess stress, anxiety, and depression in subjects
at a defined geographical area to assess psychological needs in subjects dealing with
causal factors and the pandemic.
Methods: In 156 subjects, DASS 21 scale was used having 21 questionnaires that were
answered by the subjects themselves and were concerned about stress, anxiety, and
depression. The responses were recorded on a scale of 0 to 4 where 0 meant little time/none
and 3 meant most of the time. The responses were recorded based on symptoms severity in
the last week before answering the questionnaire. The interpretation of the DASS 21 scale
was divided into categories of normal, mild, moderate, severe, or very severe. The collected
data were subjected to statistical evaluation.
Results: For gender, only anxiety was statistically significant (p=0.01) which was higher in
females with the value of 1.72±0.993 compared to males with the value of 1.47±0.881. For
the age anxiety levels were significantly higher in subjects of age ≤ 20 years with 1.76±1.01
compared to ≥ 21 years with the value of 1.52±0.883 (p=0.02). For familial history also
significantly correlated to anxiety with p=0.004, whereas for depression and stress the pvalues
were 0.758 and 0.238 respectively and were non-significant. For family history, it
was significantly related to anxiety with a p-value of 0.12, whereas, it was non-significantly
related to depression and stress with respective p-values of 0.753 and 0.297. The
socioeconomic status was also significantly associated with anxiety with the low
socioeconomic group having a strong association having a p-value of 0.25.
Conclusion: The present study concludes that the depression, anxiety, and stress in
students during COVID-19 was seen ranging from mild to severe levels, whereas, majority
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of the students showed normal levels of DASS. Also, positive family history of COVID-19
and family income was associated with increased depression, anxiety, and stress in the
students.

assess perceived risk by EPPM(Extended Parallel Processing Model) and the risk of COVID-19 infectionamong general population.
Methods: Cross sectional study was conducted among 185 general population ofChitradurga district. Questionnaire had three parts, 1. Socio-demographic data along with habits and co-morbidities. 2. Risk perception questions (29) with efficacy, defensive response and perceived threats. 3. A predesigned semi-structured questionnaire (24 questions) regarding their attitudes and practices towards COVID 19. Based on which their risk was assessed depending on score.. Chi-square, ANOVA, t-test and binary logistic regression was applied to find significant association.
Results: Among 185 study participants, majority were elders (>60 years) 25.5%, 100 (54.05%) were males, 108 (58.37%) belonged to nuclear family. Perceived risk scores were almost same in all the categories. A total of 106 (57.3%) participants were engaging in danger control processes and 79(42.7%) in fear control processes. Among population, 32.08%, and 44.30% people were in high and medium risk of infection respectively. Everybody is in risk. 85.27% frequently washed hands with soap or sanitizer, 76.8% used mask regularly when they go out, 74.26% do not wash their dress once they come from outside, 70.37% do not wash their shoes, 54.64% use mass transport. Among socio-demographic variables education, type of family and travel history were significantly associated with risk of infection.
Conclusion: Perceived risk was equal in almost all classes. The attitude and practice towards COVID 19 during pandemic was not so impressive.

Aims & Objectives : To compare the clinical characteristics/profiles of the patients in first and second waves of COVID-19 in India and correlate these characteristics with risk of in-hospital mortality.
Design: Observational analytical study with longitudinal follow-up. The clinico-epidemiological and laboratory profile of patients admitted in the second wave of COVID-19 will be noted at the time of admission, and they will be followed-up during their stay in the hospital to record their outcome status. Medical records will be used to record the data of COVID-19 patients admitted in the first wave.
Setting: A tertiary care centre in Bihar, India
Participants: All patients who are COVID-19 positive based on positive RT-PCR test of oropharyngeal or nasopharyngeal swab and admitted to AIIMS, Patna during the study period.
Outcome measures: The difference in clinic-epidemiological profile of patients admitted in AIIMS Patna during the first and second wave of COVID-19 and thus we attempted to discover the effects of multiple factors such as vaccination and mutant viruses on the profile of the 2nd wave. We could also correlate the outcome status of the patient with their clinic-epidemiological profile.
Results: Females were relatively more commonly affected in the second wave. Contact history was significantly higher in the second wave. Comorbidities and clinical features were mostly similar although generalized weakness and fatigue was more common in the second wave. ARDS and septic shock were less frequent in the second wave although overall mortality was slightly higher. Azithromycin, HCQ use was discontinued whereas pulse methylprednisolone started to be used frequently. Remdesevir and tocilizumab use was
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rationalized. HFNC and NIV were better utilized in the second wave. Mucormycosis outbreak complicated the second wave. Out of 42 individuals who were partly immunized (fourteen days after 1st dose to symptom onset), 28 patients survived.

The COVID-19 pandemic is a global crisis that caused economic disruptions. India faced challenges like limited resources and increasing demand for essentials, including medicines and supplies. To analyze this, time-series data was extracted to study the impact of the pandemic on India’s major retail pharmaceutical companies. Net sales and total revenue significantly increased post-pandemic and were especially noticeable in the third quarter of 2020. This resulted from a spike in covid cases and price hikes on major drugs needed to treat the disease. While e-commerce has thrived in other areas, rising demand and growth opportunities are leading it to make its way to retail pharmacies. Restriction of movement led to increased users of e-pharmacy. A survey using an electronic questionnaire was conducted on 190 participants across tier 1, 2, and 3 cities to understand consumer behaviour towards e pharmacy. Common age groups were tech-savvy youth aged between 15 and 30 years. 55% of respondents were e-pharmacy users before lockdown restrictions. Other data points including feasibility and delivery time were positive in tier 1 and 2 cities as opposed to tier 3 cities which can be attributed to logistics challenges. 78.3% of the study participants are likely to recommend and use the service post the pandemic. The pandemic has had a small impact on E-Pharmacy, but a shift at its core has begun, which has a promising future as observed through primary research.

Background: Hearing difficulties in COVID may range from mild to severe and vary based on COVID-19 severity. They range from the self-manageable at home to the ones needing hospitalization. They include dizziness, vertigo, tinnitus, and/or hearing loss.
Aims: To assess the long-term impact of COVID-19 on the existence of audiovestibular disorders in subjects hospitalized previously for COVID-19.
Materials and Methods: 30 test and 30 control subjects hospitalized in the institution after COVID-19 were assessed for audiovestibular screening Tonal Audiometry was then done to measure bone and air conduction thresholds. Gain threshold was assessed for vestibular loss set at a value less than 0, 6 at 60ms, and vHIT was performed.  The collected data were subjected to statistical evaluation and the results were formulated.
Results:Dizziness was seen in 10% (n=3) subjects, tinnitus in 3.33% (n=1) subject, spinning vertigo in 3.33% (n=1) subject, Dynamic disequilibrium/ imbalance in 3.33% (n=1) subject, static disequilibrium/ imbalance in 6.66% (n=2) subjects, and hearing loss in 10% (n=3) subjects. PTA values were statistically non-significant at all frequencies except at 0.25, 0.5, 2, and 4 kHz with respective p-values of 0.003, 0.083, 0.04, and 0.03. In gain values only vHIT significant gain was seen in right anterior canal with values of 0.798±0.257 in cases and 0.949±0.121 in controls and the p-value of 0.004
Conclusion:Within its limitations, the present study concludes that audiovestibular symptoms and components are involved in subjects with COVID-19. No definitive conclusion can be drawn on auditory involvement in subjects with a history of COVID-19 with the previous hospitalization.

      The COVID-19 pandemic in KSA resulted in a nationwide quarantine on March 27th, 2020. This study represents the assessment of rates of depression in the general population of KSA during the pandemic. The COVID-19 pandemic has created an unprecedented global crisis, necessitating drastic changes to living conditions, social life, personal freedom and economic activity.  study has yet examined the presence of depression symptoms in the KSA population under similar conditions. Patients at risk of severe SARS-CoV-2 acute respiratory syndrome are characterised by the high prevalence of pre-existing diseases (high blood pressure and cardiovascular disease, diabetes, chronic respiratory disease, or cancer), most of them typically present in severely depression patients. Indeed, the biological role of adipose tissue in sustaining SARS-CoV-2 infection is not completely elucidated. Aim of the study: To assessment the awareness of the Impact of COVID-19 virus on the depression on Population at Saudi Arabia at Makkah in Saudi Arabia 2021 Method : Across-sectional study among Population residents in primary health care center in Makkah Al-Mukarramah was conducted using an online questionnaire designed during April 2021. The questionnaire collected socio-demographic characteristics, depression Symptoms in participants before and during the COVID-19 Pandemic (via the PHQ-9 patient depression questionnaire) our total participants were (200). Results: most of the participants (41.0%) were in the age group more than 60 years  follow by the (37.0%)were in the age 30-40 years, the majority of them were female (27.0%) while male(28.0%), regarding  the marital status most of participants married were(44.0%), regarding level of education the majority of participant are Primary/ Intermediate were(35.0%), regarding Chronic Medical conditions the majority of participant are Diabetes were(42.0%) while High blood pressure were(33.0%) , regarding  the Working/studying from home most of participants answer No were(74.0%)while answer Yes were(15.33%).Conclusion: The research's showed increase in the prevalence of mental health problems and depression in the early stages of the pandemic, and these problems were predicted by several specific COVID related variables. Further similar surveys, particularly of those with children at home, are required as the pandemic progresses. In addition Anxiety and depression levels amongst Population at Saudi Arabia in healthcare were found to be high when assessed during the COVID-19 pandemic

Background: Vaccination against COVID-19 is the key to controlling the pandemic. Vaccines are a critical new tool in the battle against COVID-19 and it is hugely encouraging to see so many vaccines proving successful and going into development, vaccines save millions of lives each year. Vaccine hesitancy is a potential threat to global public health. Since there is a vaccine against the COVID-19 pandemic, much less is known about its acceptance in the community. It is important to understand the correlates of COVID-19 vaccine hesitancy in the Saudi public and the reasons why individuals intend to refuse a COVID-19 vaccine. The COVID-19 vaccine is an effective measure to manage the pandemic as it prevents severe illness and death. Developing immunity through vaccination means there is a reduced risk of developing the illness and its consequences. This immunity helps you fight the virus if exposed.

Background: Acute appendicitis (AA) is the most common surgical disease with a lifetime risk
of 7–8%.Traditionally, appendectomy has been the treatment of choice for acute appendicitis.
Mortality rate after appendectomy is very low and may range from 0.07 to 0.7% rising to 0.5 to
2.4% in patients without and with perforation. Over 250,000 appendectomies are performed each
year in the USA alone.It was observed during the outbreaks of influenza and Middle East
Respiratory Syndrome (MERS) in 2012 , that referrals for non-respiratory causes decreased
significantly as the epidemics progressed. An outbreak of respiratory disease should not by itself
affect the incidence and presentation of acute appendicitis. Nevertheless, we have noticed in our
institution that as the COVID-19 pandemic spread in our community there was a significant
decrease in the number of cases of acute appendicitis presenting to the ED of our institution and
an increase in the number of admitted patients of AA requiring surgery.
Objectives: To compare the incidence and presentation of aute appendicitis before and during
the COVID-19 lockdown period.Also, to compare thepercentage of patients requiring operative
management, intraoperative findings and postoperative complications before and during the
COVID-19 pandemic for cases of acute appendicitis.
Methodology:This prospective observational cohort study was undertaken at Government
Medical College Baramulla which is a 300 bedded teaching hospital catering as a referral
institute for a catchment population of roughly 1.2 million. All consecutive patients of clinically
or radiologically diagnosed AA admitted between 25th March and 25th July were included in
this study (corresponding to complete lockdown in our country). This was designated as group
A. Data was also collected from hospital records of all acute appendicitis patients admitted in the
corresponding months of 2019 i.e from 25th March 2019 to 25th July 2019 and analysed for
comparison and designated as group B

Coronavirus disease of 2019 (COVID-19) is a newly discovered respiratory syndrome which has adversely affected millions of people around the world. The study aims to estimate the psychological impacts of COVID-19 in the form of fear and anxiety among the healthcare students of the Central Region of Saudi Arabia. A cross-sectional study was conducted amongst health care students in Saudi Arabia. A non-probability convenience samplingapproach was adopted to collect data by mean of an online questionnaire on social media. The sample size was determined by using Epi info software; the minimum sample required for this study was 567. Likert scale with five points was used to measure healthcare students' fear and anxiety level. Data were analysed using SPSS version 23. The descriptive data were expressed as frequencies and percentages. Spearman correlation was used to determine the strength of the relationship between variables. Amongst 571 health care students, 359 were males, and 212 were females. Data revealed that 84 (15%) of students had a severe level of anxiety, 438 (77%) had a moderate level of anxiety and 49 (9%) of the students had mild level of anxiety. Correlation coefficient was found insignificant between gender, academic year and institute (=0.066, p=0.116), (=0.018, p=0.661) and (=0.034, p=0.423) respectively. The COVID-19 pandemic has a negative impact on higher education because of the long-lasting pandemic situation. Our study's results illustrate the critical need to implement approaches and prevention measures to address healthcare students' mental health.

The COVID-19 outbreak has affected human existence in many ways, with
uncertainty faced globally. The dental practice and orthodontic care during the pandemic
and future practice will require precautionary and selective case evaluation based on the
practitioner’s judgment to reduce cross-contamination and prevent new outbreaks. This
article aims to provide a comprehensive guideline for managing the pediatric dental
patients at a clinical setup, using the currently available guidelines.

The pandemic caused by Covid-19 has had a huge effect in various parts of the world. The
global situation of COVID-19 as of January 20th, 2021 were 99.864.391 cases with a death rate of 2.2%
with 183 countries infected by local transmission. The COVID-19 situation in Indonesia as of January
27th, 2021 were 1.024.298 cases with a death rate of 2.8%, occurred within 182 regions by local
transmission. Bengkulu Province is one of the areas experiencing local transmission of Covid-19 since
March 31st, 2020 and this condition continues to develop. This study aimed to determine the regional
vulnerability and temporal distribution of Covid-19 in Bengkulu. There were 956 confirmed cases of
Covid-19 within the period of July-October 2020. The overlay results between clustering analysis and
population density were gathered by using the Kernel Density Estimation method and ArcGIS software
version 10.3. The area that has a high risk of contracting the Covid-19 disease is Bengkulu City. The
use of technology-based information systems is indispensable in the digital era, including spatiotemporal
analysis, disease and health mapping, geographic dimensions which can be the basis for
decision making in an area.

The COVID-19 pandemic is reported to have reduced air pollution and environmental-related noise and improved biodiversity and tourist sites, however, the impact of stay-at-home and preventive measures on waste management is alarming. The present review article highlighted the impact of improper biomedical waste disposal on human health and environment during COVID- 19 pandemic

Background: pandemic Covid-19 isn't a simple health-care problem that will go away and never come back. One of the most common symptoms of Post-acute covid-19 is fatigue. Purpose of the study: To determine the prevalence of fatigue in adult people post mild and moderate covid-19 cases and the relation between fatigue post covid-19 and several factors. Material and methods: Eighty-one post covid-19 patients from both genders were recruited from registry records of preventive medicine and surveillance of Ministry of Health and Population in the city of El Minya / Egypt. The study was conducted from 15st September 2020 till 15st December 2020. Demographic data were collected (age, sex, BMI), smoking status, Data about status of covid-19 if they hospitalized or not hospitalized and received treatment. Fatigue post covid-19 was evaluated by using Modified Fatigue Impact Scale (MFIS) and Shortness of breath (dyspnea) by Numerical rating scale of dyspnea. Results: fatigue in adult patients post mild and moderate covid-19 cases after three to five months from their recovery was prevalent 64.2% using the MFIS. There was no significant association between fatigue and age, sex, BMI, smoking, hospitalization and received treatment. The association between NRS and MFIS was moderately positive and significant. (r = 0.39, p = 0.0001). Conclusion: fatigue was prevalent among adult patients post covid-19 with 64.2% using the MFIS. Continuous monitoring and timely intervention prevent long-term symptoms from being chronic.

A novel coronavirus (nCoV), originating from Wuhan, China had begun as an epidemic in
December 2019, declared as a pandemic in March and reiterated the call for countries to
go for lock down mode and other strict measures. With the onset of winter, the threat of 2nd
wave of infection is looming large over the Northern Hemisphere of the World. Virus is
mainly transmitted through droplets and then by touching contaminated surfaces and
mucous membranes with the hands. Though the virus survives on environmental surfaces
for varied period of time; it gets easily inactivated by biological or chemical disinfectants.
Alcohol based disinfectants viz. hand disinfectants, sprayers, mist blowers, cannon, and
butterfly sprinklers etc. act as vital component in controlling the pandemic disease.
Various biological and physical measures, such as self-disinfectant surfaces, UV-C
sterilization, cold plasma technique etc. will assist in disinfecting the surfaces and
materials. With unlocking underway, fast disinfection of the office space, meeting room,
marketing spaces and even the areas in contaminant zones need quick disinfection through
various sprayers, blowers and drones. This review emphasizes on the ongoing efforts to
prevent the transmission of COVID-19 and can guide the public health responses,
particularly in India.

In this era of science and technology human beings made a tremendous progress
which we have never think of in the earlier days. Now we can interact with anyone without
much facing difficulty by thinking about our distances. But in 2020 we human beings came
into contact with a corona virus which creates sufferings in our life. It made a huge impact in
all areas of human life and education sector is one of such area. Due to covid-19 outbreak we
shifted our teaching-learning process from offline mode of teaching-learning to online mode
of teaching-learning. In this shift we have came across with different problems which we face
in the online teaching-learning classroom. So in this paper the researcher discussed in a detail
manner about an empirical study which was conducted to study the problems which are faced
in the online teaching- learning classroom.

6 months after the start of the COVID-19 epidemic in Uzbekistan, a comparative analysis of the reported incidence of COVID-19 and the level of herd immunity to SARS-CoV- 2 was carried out. The registration of patients with COVID-19 in the country was carried out on the basis of the positive results of the examination for the presence of SARS-CoV-2 RNA, using the PCR method. To study herd immunity, the WanTai SARS-CoV-2 Ab Rapid test (China) was used to detect total antibodies (IgM and IgG) in blood. In the period from August 27, 2020 to September 11, 2020, in all 14 administrative-territorial regions of Uzbekistan, blood samples of 86879 people who sought medical help at an outpatient clinic at their place of residence were tested for the presence of total antibodies to SARS-CoV-2. According to official figures, 0.14% of the population were infected with COVID-19. The proportion of the population with the presence of specific protective antibodies to the SARS-CoV-2 virus was 23.1%. This proves that the actual incidence of COVID-19, on the national average, was at least 165 times higher than officially reported. An uneven territorial distribution of the level of herd immunity was revealed. All regions were conditionally divided into 3 zones: 1) regions with a high level of herd immunity ˃ 20% (8 regions), 2) regions with an average level of herd immunity ˂ 20% and ˃ 10% (3 regions), 3) regions with a low the level of herd immunity ˂ 10% (3 regions). The degree of population affected in different regions of the county did not depend on the population density in the region, its age and gender composition. It was shown that the factors that influenced the intensity of the epidemic process and the formation of the level of herd immunity were the degree of external and internal migration.

To evaluate the maternal, fetal and neonatal complications in pregnant women with Covid-19 infection. Setting and design: A prospective descriptive study was carried out in Basrah Teaching Hospital, Iraq during the period 15/3/2020 till 1/11/2020. There were 135 infected pregnant women with Covid-19. The maternal information's were obtained included Age, parity, residence, travel history, gestational age at time of diagnosis. The pregnancy measures of interest were evaluated according to the severity of the disease, medical disease, history of antepartum hemorrhage, mode of delivery, type of delivery, post-natal complication and admission to
intensive care unit and maternal death. The neonatal outcomes of interest were fetal weight, neonatal Apgar
score, admission to neonatal intensive care unit and neonatal death. Results: The mild type of the disease was common (41.48%) in comparison to severe conditions (17.77%).

Plants are the oxygen support for our planet and all living things. They can be considered as “mothers of medicine”. As mothers take care of a child, Plants do the same for all human beings and animals. Medicinal plants have therapeutic properties that produce a beneficial pharmacological effect on the animal and human body. In recent years plants are surveyed as new drugs and gain attention to the discovery of new bioactive compounds. Hippocrates quoted “Let thy food be thy medicine, and thy medicine shall be thy food”. The flavor, aroma, taste, and nutritional properties make the Cinnamon offers a wide range of health benefits. The present study explores the connection between the Cinnamon plant and medicine, our food, modern science

6 months after the start of the COVID-19 epidemic in Uzbekistan, a comparative analysis of the reported incidence of COVID-19 and the level of herd immunity to SARS-CoV-2 was carried out. The registration of patients with
COVID-19 in the country was carried out on the basis of the positive results of the examination for the presence of SARS-CoV-2 RNA, using the PCR method. To study herd immunity, the WanTai SARS-CoV-2 Ab Rapid test (China) was used to detect total antibodies (IgM and IgG) in blood. In the period from August 27, 2020 to September 11,   020, in all 14 administrative-territorial regions of Uzbekistan, blood samples of 86879 people who sought medical help at an outpatient clinic at their place of residence were tested for the presence of total antibodies to SARS-CoV-2. According to official figures, 0.14% of the population were infected with COVID-19. The proportion of the population with the presence of specific protective antibodies to the SARS-CoV-2 virus was 23.1%. This proves that the actual incidence of COVID-19, on the national average, was at least 165 times higher than officially reported. An uneven territorial distribution of the level of herd immunity was revealed. All regions were conditionally divided into 3 zones: 1) regions with a high level of herd immunity ˃ 20% (8 regions), 2) regions with an average level of herd immunity ˂ 20% and ˃ 10% (3 regions), 3) regions with a low the level of herd immunity ˂ 10% (3 regions). The degree of population affected in different regions of the county did not depend on the population density in the region, its age and gender composition. It was shown that the factors that influenced the intensity of the epidemic process and the formation of the level of herd immunity were the degree of external and internal migration.

Objective and methods: The objective of our study is to provide forecasts on the key data of the
epidemiological situation in Morocco in order to predict the number of beds in hospitals.The data sources
used in this study are official and they were daily collected updated with information from the Moroccan
Ministry of Health at 6:00 p.m. before the month of Ramadan and 4:00 p.m. for this month.
The autoregressive integrated moving average ARIMA was applied to real-time for the two month
Predictions on the Moroccan population. ARIMA models were able to estimate the number of positive cases
confirmed based on two criteria. The first criterion is to determine the reliability of the statistics and the
second one is to measure the accuracy of forecasting ability of the model equation. The sparse model with
the lowest order of the (AR) or (MA) and (RMSE) values of the forecasts for each dataset was considered the
best.
Result and Conclusion: The ARIMA (1,0,0), ARIMA (9,0,0) and ARIMA (10,0,1) models were deemed to be
the best suited to provide the best possible model to predict the number of positive cases for two months of
prediction of the coronavirus disease 2019 (Covid-19).
However, the ARIMA model (10,0,1) predicts the best model with an expected end of home confinement at
the end of June 2020 with an epidemiological peak of 5000 accumulated cases caused by the coronavirus
disease 2019 (Covid-19) on 13/05/2029.The models were able to predict the number of confirmed cases of the
coronavirus disease 2019 (Covid-19) within a range of two months in Morocco. Thus, it can be a useful tool
for health officials to improve management of the fight against the pandemic and to warn in advance of the
spread of the pandemic.

The objective of this work was to determine the level of anxiety and aggressiveness in
graduate students from a private university in Lima; likewise, establish the level of
association between the variables under study in the COVID-19 context.
Methodology: quantitative approach, non-experimental descriptive cross-sectional
design; population made up of 378 graduate students from the César Vallejo
University (San Juan de Lurigancho, Lima-Peru Campus). Non-probabilistic sample
of 203 doctoral students from the mentioned university. The instrument used to
measure state anxiety and trait anxiety was the STAI “State-trait Anxiety inventory”
and the Buss and Perry aggressiveness questionnaire (AQ). Results: 84.7% of the
participants presented a high level of state anxiety, while 44.3% presented a trait
anxiety above the average; on the other hand, 60.6% showed a low level of
aggressiveness. The Chi-squared test showed a significant association between the
variable state anxiety and aggressiveness at a confidence level of p = 0.008 ˂ 0.05;
Likewise, the association between trait anxiety and aggressiveness showed a
confidence level of p = 0.009 ˂ 0.05. Conclusions: As a consequence of the
confinement caused by COVID-19, the levels of state anxiety and trait anxiety
increased, which is probably associated with the increase in aggressiveness in its
different variants.

6 months after the start of the COVID-19 epidemic in Uzbekistan, a comparative analysis of the reported incidence of COVID-19 and the level of herd immunity to SARS-CoV-2 was carried out. The registration of patients with COVID-19 in the country was carried out on the basis of the positive results of the examination for the presence of SARS-CoV-2 RNA, using the PCR method. To study herd immunity, the WanTai SARS-CoV-2 Ab Rapid test (China) was used to detect total antibodies (IgM and IgG) in blood. In the period from August 27, 2020 to September 11, 2020, in all 14 administrative-territorial regions of Uzbekistan, blood samples of 86879 people who sought medical help at an outpatient clinic at their place of residence were tested for the presence of total antibodies to SARS-CoV-2. According to official figures, 0.14% of the population were infected with COVID-19. The proportion of the population with the presence of specific protective antibodies to the SARS-CoV-2 virus was 23.1%. This proves that the actual incidence of COVID-19, on the national average, was at least 165 times higher than officially reported. An uneven territorial distribution of the level of herd immunity was revealed. All regions were conditionally divided into 3 zones: 1) regions with a high level of herd immunity ˃ 20% (8 regions), 2) regions with an average level of herd immunity ˂ 20% and ˃ 10% (3 regions), 3) regions with a low the level of herd immunity ˂ 10% (3 regions). The degree of population affected in different regions of the county did not depend on the population density in the region, its age and gender composition. It was shown that the factors that influenced the intensity of the epidemic process and the formation of the level of herd immunity were the degree of external and internal migration.

COVID-19 affects various industries and economies across the world. India is one amongst the countries severely affected and in 3rd place globally. BSFI sector, which is one in every of the cores for the Indian economy, also affected poorly thanks to COVID-19. during this paper, we discuss various factors like lockdown approach, moratorium, different impacts in banking, financial services and insurance sector. Further, we've given some recommendations to mitigate things so the financial services can continue with the less negative impact which can help for better services to the customer and minimal revenue loss to the financial organisation.

This article discusses the effects of a coronavirus pandemic in social life. Coronavirus is a global problem that has yet to be resolved until now, it has changed behavior in life, especially in the procedure of religious-worship and social life. The author find that the differences in understanding and attitude related to COVID-19 was caused by knowledge and mental readiness. So the case of COVID-19 corpse will not occur if they have understood and readiness even though it is clear that the coronavirus has changed the way of worship and social life.

A new respiratory illness the severe acute respiratory virus (Sars Cov2), was identified at the beginning of the new decade 2020.
Severe cases present with respiratory distress and tracheostomy has been considered to play a role in their management.
We present a report of a Tracheostomy performed on a Covid-19 patient and also a review of the relevant literature.
A 62 year old man, was brought in on a transport ventilator with a endotracheal tube insitu. From a private clinic after testing positive for COVID-19.
While on admission he desaturated further and subsequently had a tracheostomy done with marked improvement of the oxygen saturation immediate post operative period.
However on the day following the tracheostomy, he desaturated suddenly, resuscitation was commenced immediately but proved abortive, Patient was later certified dead.
Despite the unfavourable outcome, we believe the decision to perform the tracheostomy offered the patient a chance at survival

Background & objectives: The COVID-19 pandemic emerged as a major public health emergency affecting the healthcare services all over the world. It is essential to analyse the epidemiologicalandclinicalcharacteristicsofpatientswithCOVID19indifferentpartsofourcountry.Thisstudyhighlights clinical experience in managing patients with COVID-19 at a tertiary care centre in northernIndia.
Methods:Clinicalcharacteristicsandoutcomesofconsecutiveadultpatientsadmittedtoatertiarycare hospitalatAll India Institute of medical Sciences, Patna, Bihar,India,from August12020 toJanuary 31,2021werestudied.ThediagnosisofSARS-CoV-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) on throat and/or nasopharyngeal swabs. All patients were managed according to the institute’s consensus protocol and in accordance with Indian Council of Medical Researchguidelines.
Results: During the study period, 283 patients with SARS-CoV-2 infection were admitted. The history of contact with COVID-19-affected individuals was available in only29 patients. The median age of the patients was 53.85 years (15-95 years), and there were 217 (76.67 %) males. Of the total enrolled patients, only 19 patients (7%)were asymptomatic and rest 264 patients (93%) were symptomatic.Thecommonpresentingcomplaintswerefever in 231 patients(81 %),cough in 217 patients(76 %) and shortness of breath in 204 patients (72%). Out of 283 patients enrolled for the study, 113 patients (39%) had Hypertension as an accompanying comorbid illness, 122 (43%) had Diabetes mellitus, CKD and Hypothyroidism each in 8% of patients, CAD & COPD in 7% and 6% patients respectively
Agemorethan60yearsandpresenceofdiabetesandhypertensionweresignificantlyassociatedwith severeCOVID-19disease.Mortalityof 65 patients ( 23%) wasobserved.
Interpretation&conclusions:MajorityofthepatientswithCOVID-19infectionpresentingtoourhospital were elderly and symptomatic. Fever was noted only in three-fourth of the patients and respiratory symptoms in more than half of the enrolled patients. Patients with comorbidities were more vulnerable to complications. Certain Inflammatory markers like serum CRP, Ferritin, LDH, & D-Dimer have define prognostic value. Triaged classificationofpatientsandprotocol-basedtreatmentresultedingoodoutcomesandlowcasefatality.

Cytokine storm syndrome is a cascade of intensified immune responses disposing the immune system to exhaustion, which might eventually result in organ failure and fatal respiratory distress. Infection with severe acute respiratory syndrome-coronavirus-2 results in uncontrolled production of cytokines and eventually the development of cytokine storm syndrome. Clinical intervention in patients with SARS has demonstrated upregulation of cytokine production in patients with prolonged fever. Such an association between fever and cytokine storm is studied in the present research which is a hospital-based case-control study of COVID-19 patients. To the best of our knowledge, the present study is the first study of Indian population, which highlights the link between prolonged fevers, Lymphocyte count and cytokine profile in patients with the COVID-19 disease.
Methods- We conducted a hospital-based case–control study of patients admitted for COVID-19 with prolonged fever and short duration of fever with a positive SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR).All the patients underwent investigationswhich includes HRCT chest, Complete Blood Count (CBC), Renal and liver panel, C- Reactive Protein (CRP), Lactate dehydrogenase (LDH), Interleukin-6 (IL-6) and Ferritin, as a part of their COVID-19 protocol clinical laboratory findings at regular intervals till discharge.
Conclusions-The study reported that prolonged fever i.e. fever > 7 days from beginning of illness was associated with increased risk of cytokine storm from COVID-19 than patients with short duration of fever.There was also a marked reduction in Lymphocyte count with increased levels of inflammatory markers and fever, which is again considered an indicator of poor prognosis.
The study concludes that prolonged fever should be considered as one of the earliest markers for predisposing the patient to the cytokine storm. These early signs if diagnosed correctly right at the inception of complications the further progression of cytokine storm could be avoided.
Which can minimize the mortality and foster the chances of the patient’s recovery from this deadly disease.

The banking industry is important to a country's economic growth. With a large network of
branches and a diverse range of financial services, India's banking system is large. The
aim of this research is to study the financial results of India's two largest private and two
public banks. The financial performance of banks was analyzed using net profit, assets,
liabilities, income, expense, margin ratio, and return on equity ratio. After evaluating
financial data from 2015 to 2019, the study concluded that the private banks performed
better than public banks. The results of this study will benefit bank, shareholders and
customers, as well as bank management.

The paper deals with the legal framework for the health care in prisons and detention homes during COVID-19 pandemic in India. The World Health Organization has issued Guidance on COVID-19 for Prisons and Detention, 2020 for the health care system to deal with challenges of contagion in the arena of criminal justice system. The National Crime Record Bureau and the Prison Statistics India, 2020 revealed overcrowding and occupancy in jails as formidable threat of infection and transmission. Though the health and human rights envisages highest attainable standard of health among prisoners and detainees, ripple effect on community infection through detainees in detention homes and jails cannot be ruled out. The global outbreak of the COVID-19 has cascading effect on the health of inmates and convicts living in enclosed environments during the pandemic.

Until December 13, 2020, the total Covid-19 cases worldwide is 70,476,836 cases and counted 1,599,922 deaths globally since the start of the pandemic. The best medicine for Covid-19 has not been found yet, so this review intended to reveal potency of Liriodenine to overcome and help care for those affected. Liriodenine (C17H9NO3) along with Quinine and its derivate Chloroquine and hydroxychloroquine are include in the compound of nitrogen-containing group or alkaloid. The main mechanism of its activity of Liriodenine is DNA Topoisomerase I and II inhibitors that have cytotoxic effect on several human cell lines such as A549, NCI-H226, SPC-A-1, NPC-TW01, ECV2 and 7111, KB, HEp‑ 2, and against gram (+) and (-) bacteria. Review results showed that Topoisomerase Inhibitor posses dual activity that works on both DNA and RNA, so does Liriodenine predict may affect to RNA virus include SARS-CoV-2 strain or 2019-nCoV. The potency of Liriodenine as new agents for Covid-19 diseases is supported by its other activity antifungal, antiplasmodial (such as Plasmodium falciparum), antidiabetic, antioxidant, and anti-inflammatory (Immunomodulatory) activity. Plants-containing Liriodenine in the world is abundant, not limited to Annonaceae, Magnoliaceae, Lauraceae, Menispermaceae, and Rutaceae. So Liriodenine prospective for developing as herbal therapy or single
compound for Covid-19 diseases

Introduction: COVID-19 is the current global coronavirus pandemic caused by the SARS-CoV-2 coronavirus. The first reports of the disease outbreaks appeared in China on December 31, 2019 and the first clinical manifestations occurred earlier on December 8, 2019. On January 30, 2020, the World Health Organization declared the outbreak as a public health emergency of international concern. On March 11 it was declared a pandemic. Common symptoms include fever, cough, fatigue, shortness of breath, and anosmia (loss of smell).Complications can cause acute respiratory distress syndrome (ARDS) and pneumonia. The incubation period is usually around five days, but can range from two to fourteen days.
Aim of the research isto study of clinical and diagnostic criteria for neurological disorders and changes of laboratory parameters in patients with COVID-19.
Material and methods: We examined 31 patients who had undergone COVID-19 and were hospitalized at the private clinic "Neuromed-Service" named after academician N.M. Madjidov. There were 19 males and 14 females. The age of the patients varied from 18 to 75 years (the mean age made up 41 years).
Results: Patients with inflammatory diseases of the peripheral nervous system (neuropathy, facial nerve, trigeminal neuralgia), considering an increase of C-reactive protein were performed anti-inflammatory therapy with NSAIDs and steroids (Dexamethasone intramuscularly). In patients with convulsive syndrome EEG was monitored using the "Neuron - range 2" (Russia). Diffusechangesinthebioelectricalactivityofthecerebralcortexwererevealedinthestudiedpatients.Epiactivityinthefronto-parietalregionofthebrain (against the background of taking anticonvulsants)was also recorded. The dose of anticonvulsants was increased for these patients and decongestants were prescribed. An increase in fibrinogen was also noted in the blood of these patients. Conclusion: Thereby, in patients after suffering COVID-19, the blood tests showed an increase of fibrinogen by more than 2 times and an increase of C-reactive protein. All this testifies the fact that in these patients after treatment, at the alleged improvement of their condition, the blood continued the process of thrombosis strengthening and inflammation persisted in tissues and organs. In patients who prematurely stopped taking antiplatelet agents and anti-inflammatory drugs after illness, neurological and other complications were developed

The main aim of this paper is to know whether the temperature have any impact on the increase of corona virus. Covid-19, this name has brought a drastic change in our day-to-day life. People of Telangana have lived through 10 months of the Covid-19 pandemic and there might be more to come. Till date 2.8lakh official cases of covid-19 have been registered in Telangana and there may be many more which have gone unnoticed. In our busy life, we are neglecting our health and no one is maintaining a proper hygiene. And we have been more addicted to junk foods rather than nutrition, because of this reason covid-19 became a threat to our life. So proper precautions and awareness must be spread among people to avoid spread of virus. Fever, cough, breathing problems etc are the
symptoms of this covid-19. If we neglect these symptoms it leads to a severe problem like pneumonia, kidney failure and eventually leads to death of that person. At this moment we don’t have any vaccine to cure this disease, the only prevention or avoiding corona is to boost our immune system. To overcome this pandemic situation, firstly we need to know the important factors that increases in covid-19 cases. In this paper, machine learning techniques are used to identify how temperature varies with the increase of covid-19. Which means we find how the effect of temperature depends on the number of covid-19 cases in Telangana

Background:Reading radiographic images for Covid-19 identification by an expert radiologist requires significant time, therefore the development of an automated analysis system to assisting and saving time in diagnosing Covid-19 is important.
Objective: The purpose of this study is to implement the GoogleNet architecture with various epochs in hope achieving higher level of accuracy in Covid-19 detection.
Methods: We retrospectively used 813 images, i.e. 409 images indicating Covid-19 and 404 normal images. The deep TL model with GoogleNet architecture was implemented.The training was carried out several times to get the best acquisition value with a learning rate of 0.0001 for all levels. The network training was carried out with different epochs, i.e. 12, 18, and 24 epochs, and each epoch with 65 iterations.
Results: It was found that accuracy was determined by changes in the number of epochs. The classification accuracy was 96.9% in epoch 12, 98.2% in epoch 18, and 99.4% in epoch 24.
Conclusion: An increase in the number epochs increases the accuracy in the detection of Covid-19. In this study, the accuracy of the method reached 99.4%. These results are promising for the automation of Covid-19 detection from radiographic images.

COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19 the particular transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency has spread rapidly all over the world. Human-to-human transmission seems to occur mainly through close contact with symptomatic people affected by COVID-19, and the main way of contagion is only through the inhalation of respiratory droplets, for example when patients talk, sneeze or cough.The dental practitioners are particularly exposed to a high risk of SARS-CoV-2 infection because they cannot always respect the interpersonal distance of more than a meter and are exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The questionnaire was shared among students pursuing dentistry which contained a set of 10 questions . The questions were about duration , practice on PPE and how aware and protected the students are during treating the patients.88% of them agreed that the gloves they wear protect them from viral pathogens and 5% did not agree and 7% of them were not sure about it .90% of them were trained on personal protective equipment whereas 10% of them were not trained before.This study observed good awareness regarding the practice of using protective equipment during dental treatment among the respondents.

The role of vitamin C in the prevention and treatment of pneumonia andsepsis has been investigated for past decades. This reviewaimsto translatethese findings into patients with severe coronavirus disease (COVID-19). It has indicatedthat patients with pneumonia and sepsis have low vitamin C status and elevated oxidative stress.Additional oral or intravenous (IV) vitamin C administered patients with pneumonia can mitigate the severity and course ofthe disease. Severely ill patients with sepsis need for intravenous administration of amounts counted in grams ofthe vitamin to achieve adequate plasma levels, an intervention that some studies suggest reduces mortality.The vitamin has physiological functions like pleiotropic, many of which are closely connected to COVID-19.These are its antioxidant, antiinflammatory, antithrombotic and immunomodulatory functions.Previous observational studies found out low vitamin C status in critically ill patients with COVID-19.A number of randomized controlled trials (RCTs) conductedworldwideevaluate intravenous vitamin C as monotherapy in patients with COVID-19. Optimization of the intervention protocolsin future trials, e.g., earlier and continuously administration, is justified to potentially improve itsefficacy. In order to the excellent safety profile, low cost, and potential for rapid enlargement of production,administration of vitamin C to patients, especially with hypovitaminosis C and severe respiratory infections,e.g., COVID-19, appears warranted. In addition, there are few new ways of concurrent using vitamin C and other manipulations or medications.

The epidemic of coronavirus disease 2019 (COVID-19) led to unprecedented outbreak in Wuhan, China; has become a major public health challenge for not only China but also countries around the world. The severe global quarantine efforts and social distancing were taken worldwide in response to this global outbreak. This has challenged the health professions and systems evoking heightened reactions around the globe as response to Covid-19. While most heavily impacted, the role of the dental professionals in preventing the transmission and responding to its long-term impacts on dentistry is crucially important. This review article, while outlining the essential knowledge about COVID-19 and nosocomial infection in dental settings, provides recommended strategies for dental practitioners to redesign dentistry to a new reality in a way to combat dental crisis to bridge the gaps in dental settings to overcome this emergency.

Congenital heart disease (CHD) is one of the most common congenital defects, present at birth, it can affect the walls, valves or the great vessels of the heart. CHD considered to be among the most common malformations in newborn infants with an incidence of 8 out of 1000 live births worldwide. Children with congenital disease certainly need special health care. Healthy teeth and gums are important for everyone, especially for children with heart conditions. Providing children with dental care during the COVID-19 pandemic, and in particular during the increased social restrictions, can be a challenging task. The purpose of writing this systematic review is to examine about oral health condition and dental care in children with congenital heart disease during the COVID-19 pandemic. Data source of Pubmed, published from 2011-2021. After eliminating duplicated articles, the titles and abstracts of each article were analyzed across 119 articles resulting in 86 articles being excluded. The full-text articles in the remaining 33 articles were re-analyzed and excluded 23 articles and produced 10 articles which were then entered into the analysis. Based on this systematic review shows that children with congenital heart disease (CHD) have poor oral health. Education and disease awareness about and prevention of dental illnesses have to be guided and steered by the parents. The role of dentists and pediatricians is very important in this case. Providing children with dental care during the COVID-19 pandemic, and in particular during the increased social restrictions, can be a challenging task.

In recent years, Artificial Neural Networks (ANN) was widely implemented for
developing predictive and estimation models to estimate the needed parameters. As the
Coronavirus disease 2019 (COVID-19) case numbers are rising internationally as
uncontrolled outbreaks, it is important to better understand what factors promote the super
spreading events. In this paper, the use of Multi-Layer Perceptron (MLP) and Radial Basis
Function (RBF) of ANN for COVID-19 spread and death contributing factors in America
was described. A comparison was made by using a dataset of COVID-19 cases and deaths
reported from 49 states in America during April 2020. Seven covariates used in the network
which are High Temperature, Low Temperature, Average Temperature, Population,
Percentage of Cases over Population, Percentage of Death over Population, and Total
Cases. However, the performance of MLP and RBF networks may be evaluated relatively
similar. It was found that both MLP and RBF proved that the Population, Percentage of
cases over population, and Total cases are the most contributing factors towards COVID-19
spread and death in America particularly.

Coronavirus disease caused by SARS-COV2, a potentially fatal disease has become a global public health concern. As the understanding of this novel disease is evolving, dental students and professionals should have an in-depth knowledge and understanding and should be updated with the practices that have to be adapted to identify a possible COVID-19 infection .Not only knowledge but also an update on diagnostics, treatment ,variant ,side effects will be required to survive the infection on the upper hand .Knowledge of diagnostic tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still evolving, and a clear understanding of the nature of the tests and interpretation of their findings is important.The aim of the study was to assess the awareness of diagnostic tests for COVID-19 among dental students.This questionnaire containing 10 questions regarding awareness about the diagnostic test were given to 100 students including interns , final year students ,and third year students through google forms and responses were collected and results were tabulated using SPSS software.In this survey 79.8% were females and 20.2% were males. 16.2% were third years, 12.2% were final years , 34.3 % were interns and 37.4% were post graduates. 66.6% of the students know PCR is used for diagnosing and detecting viruses responsible for COVID 19 and 33.4% don't know that PCR is a key test for diagnosing COVID and detecting viruses.7-11 The study concluded the respondents had moderate awareness about the diagnostic tests for COVID-19.

Background: In this time of COVID-19 crisis, need of hour to appropriately perform dental
procedures to reduce the spread of this deadly disease, it is importance to assess the knowledge
and attitude of pediatric dentists regarding spread and control of infection before and after
COVID-19 crisis.
Methods and Materials: Questionnaire-based survey composed of 6 questions that assess the
knowledge of pediatric dentists regarding COVID-19 infection and 10 questions each designed
to gather information about their clinical practice before and after COVID-19 crisis which
shows attitude of pediatric dentists. Online survey link was circulated through social media
and an e-mail to pediatric dentists from different locations in India and the responses were
collected. 346 pediatric dentists willingly responded in the study.

COVID19 pandemic out of all odds has created an opportunity to offer treatment in an integrative manner. This study measures the Length of stay (LS) of patients in an integrative way as done earlier in China and Vietnam. Length of stay,
Clinical presentations, and Comorbidities were analyzed among COVID19 patients in ESI Hospital, Coimbatore, Tamil Nadu, India.
Method: Retrospective cross-sectional data on 251 Positive COVID19 patients of both sexes irrespective of age admitted from 27 March 2020 and 26 April 2020 cases were included in the study. The final discharge date is taken as 5th May 2020. Kaplan Meier survival analysis was adopted.
Results: Male, female ratio were 141(56.2%): 83(33.1%), 12 (4.8%) Male Child and 15 (6.0%) were Female child. 5.2% of the patients were in the age group greater than 60, 75.3% were in the age group 20-60, and the remaining 19.5% were 0-20 age group. 84.9% of patients were Asymptomatic, while fever and cough were the main symptoms recorded in the remaining cases. CT scan was done for 7 patients. No mortality and no serious adverse events were reported. Comorbidity is 15% and does not influence hospital length of stay. The overall median length of stay is 12 days for those who were under ZVcKK (Median ST CI- 11.59-12.41).
Conclusion: This study recorded a median of 12 days in the Length of stay and 13.5 days in the Length of stay average. Comparing earlier studies, patients taking ZVcKK have savings of 7 days. i.e., the relief speed is higher while using ZVcKK.

This article aims to elaborate the innovations on the Qurban procession during the Covid-19 pandemic by following health protocols. The approach employed is normative-empirical by looking at the texts of revelation, the views of scholars, fatwa products, government policies and relevant journals, online news and the realities that occur in society. The result of the study found that the innovation of of Qurban procession consists of 3 parts. First, the payment system is done by collaborating with online payment services. Second, the process of slaughtering specificied to certain locations that meet health protocols. third, distribution of qurban products is in collaboration with online transportation providers. These innovations are a response to the Government's policy through the relevant ministries to issue a circular to continue to carry out the slaughter of sacrificial animals in a safe location and able to break the chain of the spread of Covid-19. MUI and Muhammadiyah also issued fatwa products in which there was no significant difference. Government policies and existing fatwa products continue to comply with one of the religious teachings every year by implementing the slaughter of sacrificial animals with strict provisions in accordance with health protocols.

This paper brings into light the trending topic of the Indian Startup Ecosystem and the
Government's initiative for the same, 'StartUp-India.' It begins by introducing Startup as a
business concept and how it has benefited the national economy. It discusses issues that
new and existing startups face, ranging from capital acquisition to marketing strategies. It
further discusses how the Indian Economic Environment is a suitable place to run a
startup and the opportunities it presents. The present paper critically analyses the 'StartUp
- India' scheme and how it has helped develop home-grown startups by providing legal and
financial resources and the required expertise. It also examines the economic impact of the
COVID-19 pandemic and how startups can help revive the economy once things return to
normal, as well as suggesting specific sectors for investors and venture capitalists to target.

Aims & objectives: Covid-19 pandemic lead to the close of many real university campuses and initiation of online classes in MBBS curricula. The primary objective of the study is to analyze the conceptual flow and efficacy of online lectures in clinical disciplines and also to assess the medical undergraduate student satisfaction after 6 months of Online Clinical Phase III e-Campus. The secondary objective is to detect the student perspective and difficulties faced by final year medical students while attending online teaching in MBBS.Materials and methodsPhase III MBBS Students underwent Online Curricular activities like PPT lectures, QUIZ, buzz sessions, Case Based Discussions and Short Answer type assignments, on line Video presentation for Six months from April 2020-September 2020. Post test and Feedback was collected after six months as Google forms.
Results:Students felt that there was a longer screen time and there was an inability to focus due to the eyestrain. There were concerns in times of poor Internet accessibility too.
Conclusion:In Medical schools Online –learning is the necessity of the hour during this COVID pandemic especially with teaching hospitals having a high load of COVID -19 cases. Although it is user easy and freely accessible, E–learning cannot completely be used in lieu of in-campus learning. There are numerous effects on student life like eyestrain, easy tiredness due to more screen time and inability to concentrate

Introduction: Corona virus disease 2019 (COVID-19), was recognized and has caused serious illness and numerous deaths. The ultimate scope and effect of this outbreak are unclear at present as the situation is rapidly evolving. The disease causes respiratory illness (like the flu) with main clinical symptoms such as a dry cough, fever, and in more severe cases, difficulty in breathing.
Objective:  To assess knowledge, attitude, and practice of medical students towards corona virus disease 2019 (COVID-19).
Materials and Methods: An online cross-sectional survey was conducted among undergraduate medical students in India from September 2020 to February 2021. Participants were recruited using a snowball sampling technique and all data were collected via an online self-reported questionnaire using Google Forms (http://forms.google.com/) as the data collection period coincided with implementation of the COVID-19 lockdown policy in India. Socio-demographics characteristics, social interaction history, information-seeking behavior, as well as knowledge, attitude, and practice toward COVID-19 were collected through a self-reported questionnaire. A p-value of <0.04 indicated statistical significance.
Results: A total of 2000 eligible participants completed the survey, 71.5% of whom were female, and their mean age was 19.4 years old (SD = 2.1). Almost all had sufficient knowledge (87.1%) and good preventive practice (93.6%) towards COVID-19; however, there was also a rather low level of positive attitude recorded, at 65.7%. The multivariable logistic regression analysis showed that the female participants, and the receiving of information from the official websites, reported a significantly higher level of good practice. Besides, students who had a high level of sufficient knowledge and positive attitude towards COVID-19 were more likely to have good preventive practices (All p<0.001).
Conclusion: Many undergraduate medical students in India had positive attitude and practice against COVID-19, yet only a few had adequate knowledge. This warrants further interventions to keep them updated with COVID-19 evidence to maximize their potentials in raising public awareness on COVID-19.

In the conditions of the COVID-19 pandemic, the strategies carried out to break the chain of transmission, one of which is by limiting social activities. A physical distancing policy has also been created which causes the face-to-face teaching and learning process to be transformed into an online learning system. Research is needed on the factors that can affect the satisfaction of health professional students related to online learning which requires valid instruments to answer research problems. The aim of study is determining the content validity of the questionnaire as a research instrument on the factors that influence health professional student satisfaction with online learning during the COVID-19 pandemic. The content validity of the instrument was carried out on 52 statement items by 7 experts. The validated instrument is an online questionnaire which refers to and adopts and modifies the questionnaire used by Pei-Chen Sun. The results of the validation of the 52 statement items obtained S-CVI/Ave by 7 experts of 0,953, S-CVI/Ave based on I-CVI of 0,945, S-CVI/UA of 0,731. Initial CVI of 0.890, but 4 items were eliminated, there were 48 statement items used as a research instrument with a final CVI of 0.935. The reliability test results obtained a Cronbach’s alpha coefficient value is 0.912. Calculating CVR, CVI and Cronbach’s alpha coefficient ensures that the questionnaire used as a research instrument is valid and reliable to assess the factors that influence health professional student satisfaction with online learning during the COVID-19 pandemic.

A new, universally attractive and applicable paradigm that welcomes and encourages people to take responsibility for themselves and explore their true selves in search of health, especially in sickness and adversity is spirituality and psychological beliefs. In COVID-19 pandemic situation, how people react and will be in a healthy condition is a crucial aspect in India and even in other countries. To investigate the solution, we had aimed to study the impact of two factors like spiritual well-being and psychological well-being on attack of COVID-19 in India. To study the same a sample of 650 respondents were taken through online survey where 285 questionnaires were only selected for further analysis. A well-designed questionnaire was prepared by testing validating through experts for collecting the responses. Factor analysis and multiple regression tools were used to analyse the data for achieving objective of study. The results notified that spiritual well-being and psychological well-being were having less impact on attack of COVID-19 in people, but the relation exhibits significant. Which implies even there is less impact they are having some relation in prevention of attack of COVID-19. The paper continued with the future research of the study.

Novel viral eruption originating in Wuhan city (Hubei, China) has spread internationally reaching all continents in an unexpectedly very short time, posing a great burden on global transportation, health, and economy. This mini-review article aimed at focusing on the available preventive measures and therapeutic interventions taking into account that there is a limited scientific resource of information and lack of specific established vaccination yet We searched Iraq Virtual Science Library (IVSL), PubMed, Cochrane Library MEDLINE, EMBASE, and the Chinese Biomedical Database (CBM), for the 3 target words ‘COVID-19, coronavirus, 2019-CoV’ and we included only articles in English in the study. The outcome of this study is important nationally and globally providing information about general measures and possible interventions relevant to public and health professionals. This review concludes that the nutritional status of the patient together with proper diagnosis should be the priority of the management plan provided that the loci is within the outbreak area and available flu vaccines should be used by unaffected health-care providers and children.

Coronavirus Disease (Covid-19) is an infectious disease caused by the new corona virus and causes most sufferers to experience respiratory disease. The current situation of Covid-19 until December 15, 2020 is known to be 623,309 people in Indonesia who have been confirmed as infected Covid-19. As a result of the continuous increase in the number of confirmed Covid-19 cases, the government implemented a LSSR policy to prevent the spread of Covid-19. However, this policy is felt to have a negative impact on the education sector, especially for undergraduate students. This research was an observational analytic study using a cross-sectional method located in cities and districts in East Java Province and was conducted from August to November 2020. The population in this study were all final semester students domiciled in East Java in 2020 with the number a sample of 385 people. This study was conducted to determine the effect of LSSR policy on the level of anxiety of final semester students in East Java. This study found that there was a significant influence between the implementation of the LSSR policy and the level of student anxiety in the final semester in East Java that was positive. This means that if there is an increase in the effect of the implementation of the LSSR policy on respondents, the level of anxiety will also increase.

The corona virus disease 2019 (COVID-19) caused by severe acute respiratory
syndrome corona virus 2 (SARSCoV-2), first detected in Wuhan, Hubei province of China,
has emerged rapidly as a health crisis that has challenged health systems and health
professionals all over the world. Transmission occurs primarily through droplet spread or
contact routes. Due to these characteristics dental staff and dental practitioners are
considered to be at the highest risk of acquiring SARS-CoV-2 infection because of their
prolonged face to face exposure to patients and exposure to respiratory secretions and
aerosols produced during procedures like ultrasonic scaling and cavity/access preparation
using a high-speed air rotor with water jet cooling systems. Antiseptic mouthwashes have
been widely used as a standard measure before routine dental treatment, especially
preoperatively. They have an essential role in reducing the number of microorganisms in
the oral cavity. Hence, present review of literature provides details on role of mouthwash in
prevention of Covid-19 transmission.

Background:
COVID-19 has been recognized as a pandemic by the World Health Organization. originated from China and has rapidly crossed borders, infecting people throughout the whole world. The present study sought to determine knowledge, attitude and behavior (KAB) of South Indian population toward COVID-19 Quarantine.
Methods: An online cross sectional, semi-structured questionnaire was undertaken through google forms among South Indian population (SIPs). SIPs aged 18 years and above constituted the study population. Data was analyzed using SPSS Software
Results: Totally 280 responses were received. The responders had a moderate level of knowledge about the COVID-19 infection and adequate knowledge about its preventive aspects. The attitude towards COVID-19 showed peoples' willingness to follow government guidelines on quarantine and social distancing. 32% of Participants have felt stressed during quarantine and 32.4% of participant had sleep disturbance. Alarmingly 32% are not anxious and feel free to roam around in public places without protective measures like mask and gloves. In this study, panic about acquiring COVID-19 infection during purchase and travel were reported in 29.5% and 11% participants respectively. The perceived Physical healthcare need was seen in more than 69% of participants.
Conclusions: COVID-19 Quarantine knowledge is gained mainly through media channels, Newspaper, which have strengths and weaknesses. Although the government has taken major steps to educate the public and limit the spread of the disease, there is a need to intensify the alertness of people during this COVID-19 Quarantine.

The COVID-19 pandemic has brought an additional set of challenges to theeconomiesoftheGulf Cooperation Council (GCC). Theregionhasbeen struggling to attract more and better FDI, constrained by investment climateweaknesses and regional geopolitical tensions. While the projected short-termdeclinesareexpectedtohittheGCC economieshard,thecrisiscouldalso bring new opportunities to benefit from global trends, such as reshoringand restructuring of global and regional value chains. The extent to whichthisispossiblewilldependonsustainingexistingreformsunderway,enactingtargetednew strategiesandmeasuresforthepost-COVID- 19context,andreinforcingregionalcooperation.ThisbriefprovidesanoverviewoftheimpactoftheC
OVID-19crisisoninvestmentintheregionandhighlights GCC government policy responses to catalyze investment andfoster an inclusive post-crisis recovery

The recommendation to prevent the coronavirus disease in Indonesia is to implement a clean and healthy lifestyle (PHBS). The good implementation of PHBS during the pandemic period is also the responsibility of medical students as part of the community and prospective health workers in the future. The purpose of this study is to describe the behavior in implementing PHBS and the conditions of student personal factors during the COVID-19 pandemic. This descriptive research was conducted by distributing online questionnaires in July 2020, involving 361 students from six study programs at the Faculty of Medicine Tanjungpura University. The good behavior of implementing PHBS has been carried out by medical students, such as washing their hands in 6 steps, under running water, using soap, providing hand sanitizers, not shaking hands, maintaining distance and carrying out coughing / sneezing etiquette properly. Social media, audio-visual media, and journals are sources of information used by students to obtain information about COVID-19. The impact of the pandemic on the health conditions of families and themselves, education and the family economy is a worrying factor for medical students. Medical education institutions need to provide support for the implementation of PHBS and prevent physical and mental health problems of medical students.

Objectives: To assess the psychological factors in undergraduate dental students towards elearning
in clinical skills education compared to traditional teaching methods and their
relationship with performance during the COVID-19 pandemic.
Methods: In this study, survey conducted among 494undergraduate dental students of all four
sessions from different dental universities within the Pakistan. Total 494 undergraduate
dental students responded to a 28-question online survey to identify e- learning is more
convenient and practical than traditional learning and to measure it 5- point Likert Scale used.
To measure level of psychological impact, Hamilton Anxiety Scale used due to e-learning
among undergraduate dental students.
Results: The majority of undergraduate dental student’s responded e-learning is not
convenient and practical than traditional learning system. The majority of undergraduate
dental students reported very severe level of psychological impact due to e-learning and closing
of institutions during COVID-19 pandemic. Results are statistically significant and analyzed
on IBM SPSS version 23. There are 82% students responded having problem with e-learning
system and among them 58 % have very severe anxiety and 24% have severe anxiety. So the
results shows increased percentage of anxiety due e-learning.

Corona Virus or SARS-CoV-2 or Covid-19 virus has disrupted the world like nothing else humanity has seen. It has brought about an unprecedented health crises that we only heard about in books. Every country was found wanting in preparation to fight the attack. With no treatment in sight, the only solution scientists started working on was to make a vaccine to prevent infection. Vaccine development history shows at best 10 years in the making. In a rare worldwide cooperation of best minds of the world, this feat was achieved in 10 months. Humanity will never forget the year 2020 which brought a crises and the human spirit to find solution to it.
The main objective of this study is to look at the scenario post vaccine discovery and approval. The disease being so contagious, has to be curbed by vaccinating the entire population. This is not an easy task as it involves mind boggling efforts on part of government authorities who are directly concerned with public health. For a vast and highly populated country, it is even more complicated. The study examines the major challenges in vaccinating the billion plus Indian population. Availability of skilled manpower, a weak healthcare infrastructure, delivery logistics, cost of the vaccine, and spread of misinformation are some of the most important challenges that have emerged out of this study.

The pandemic COVID-19, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to create havoc all over the world having caused more than 40 million cases and more than 11,32.528 deaths worldwide as of October 21, 2020. The treatment of COVID-19 is proving to be a challenge to the medical fraternity worldwide with no specific drug therapy or vaccine available in sight. The use of Convalescent plasma (CP) therapy, a form of passive immunization, in the treatment of COVID-19 has been gaining ground all over the world including India as convalescent plasma therapy has been used previously in virus infections like MERS-CoV, SARS-CoV, H1N1 and other viral infection with some success, when the situation was similar as in any infectious outbreak situations. This review looks at CP therapy as a possible treatment option for COVID-19 in terms of: type of antibodies in the convalescent plasma, mechanism of action, possible adverse effects, current approval status and its limitations in the management of COVID-19.

The 2019 novel coronavirus (COVID-19), which originated from China, has been declared a pandemic by the World Health Organization (WHO) as it has surpassed over eighty three million cases worldwide, with nearly two million deaths. The unexpected exponential increase in positive cases and the limited number of ventilators, personal safety equipment and COVID-19 test kits, especially in Low to Middle Income Countries (LMIC), had put undue pressure on medical staff, first responders as well as the overall health care systems. The Real-Time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) test is the decisive test for the diagnosis of COVID-19, but a significant percentage of positive tests return a false negative result. For patients in LMICs, the availability and affordability of routine Computerized Tomography (CT) scanning and chest X-rays is better compared to an RT-PCR test, especially in rural areas. Chest X-rays and CT scans can aid in the prognosis and management of COVID-19 positive patients, but are not recommended for diagnostic purposes. Using Deep Convolutional Neural Networks (CNN), three network based pre-trained models (AlexNet, GoogleNet and Resnet50) were used for the automatic classification of positive COVID-19 chest X-Rays and CT scans based on their severity into three classes- normal, mild/moderate, severe. This classification can aid health care workers in performing expeditious analysis of large numbers of thoracic CT scans and chest X-rays of COVID-19 positive patients, and aid in their prognosis and management. The images were obtained from public repositories, and were verified and classified by trained and highly experienced radiologist from Agha Khan University Hospital prior to simulations. The images were augmented and trained, and ResNet50 was concluded to achieve the highest accuracy. This research can be used for other lung infections, and can aid the authorities in the preparations of future pandemics.

The terror of COVID-19 is present universally. The number of cases is on rise. There is always debate about use of chloroquine and hydroxychloroquine as a prophylaxis. Healthcare workers being the front line soldiers need additional protection as compared to general population. This review article highlighted the mechanism of action of both drugs and their role in COVID- 19 patients.

This research looks into how undergraduate students used social media and video apps for online learning during the Covid-19 lockdown. In Manipur, online learning or teaching online is a relatively new phenomenon. Theoretical concepts of Communities of Inquiry (COI), such as teaching, cognitive, and social presences, were applied to online learning during the pandemic. Survey questionnaires, focus interviews, and various research methodologies were used to assess online learning and its impact. A total of 188 undergraduate students were administered the Google forms, and 10 undergraduate students provided focus interviews. Using SPSS, cross-tabulation and Chi-Square tests were done to look for significance. Students' attitudes toward critical thinking and provoking debates were found to be significant findings, indicating that there is a teaching presence. Students were encouraged to think critically and ask questions. Students trust teachers as knowledge givers, as evidenced by their 82 percent approval that the lecturer possesses the knowledge. For sharing class notes, lecturers used WhatsApp, and for conducting formal classes, they used the Zoom app. Even though one-third of the students had poor Internet access, they could still communicate with their professors, though this is a flaw that needs to be addressed appropriately. The lecturers were forced to learn a new paradigm to deal with a changing context, and as a result, they became capable of completing the task at hand.

Aim: The purpose of our research was to assess the knowledge and awareness regarding infection control practice against coronavirus infection in various dental clinics in North India.
Methodology: A descriptive survey was conducted amongst 200 dentists. A questionnaire consisting of 11 questions was distributed, based upon knowledge of COVID-19, transmission as well as prevention strategies that can be implemented in dental clinics for stopping the chain of outbreak of this pandemic. The data was analysed with the help of descriptive statistics.
Results: 71% of study participants felt the need for using N-95 masks routinely during patient treatment. An astounding number of participants (92%), believed that there have been significant changes in infection control after COVID-19 pandemic. 65% of participants believed that HVE suction devices as well as HEPA filters need to be used to control aerosol spread so as to prevent COVID-19 infection.
Conclusion: Dentists in North India showed satisfactory knowledge and positive attitude towards COVID-19. Improving dentists’ level of knowledge could be achieved through increasing their accessibility to materials provided by dental health care authorities, which specifies the best and safest approaches for dealing with patients during and after the outbreak.

Neglect is one of the most common forms of child abuse, yet is different from other forms of abuse as it refers to omission or negligence in meeting the basic needs of the child. “Neglect of Neglect” is a universal problem that needs one step more attention than the ever soaring physical and sexual abuse. The wellbeing and security of children makes a fundamental part in developing a prosperous nation. Healthcare professionals and teachers play a key role in identifying the child abuse and neglect, and thereby provide an immediate and a long term support to the children. A search was done from pubmed and google scholar with key terms “child” “child neglect” “Covid” “child rights”. The purpose of the present article is to provide an overview of the child neglect from a medical to socio-legal perspective in India and its negligence amidst the Covid pandemic and to ensure a prompt comprehensive multidisciplinary approach to protect the neglected child.

Based on what is known at this time, pregnant women are at an increased risk for severe illness from COVID-19 compared to non-pregnant women. Additionally, pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes, such as preterm birth. The study was conducted in the city of Kirkuk city during the period between February 1, 2020, and September 1, 2020, at Gynecology and children hospital. Through the study, 100 pregnant women were received, complaining of Covid-19 infections, which were diagnosed in Kirkuk, and now Real Time PCR was confirmed through nasopharyngeal swabs that were taken from the Hospital. The study also included measuring the level of blood pressure, sugar and IL-6 in those women during the fifth to eight week, where we were infected, and then in the 12th week of pregnancy took place, where communication was made, and a level was measured, and as a result, these women who completed the period with a pre-term labor, miscarriage before the 24th week of pregnancy or those completed the period with successful pregnancyThe study showed that were asymptomatic, 45% of cases of COVID-19 patients were with mild infection and 10% were with severe infection (P<0.001) In this study, 10 % of COVID-19 pregnant women suffer from hypertension, 13% were with Diabetes, 35% with UTI while 70% were suffered from fever. When reaching 24th week of pregnancy, and as shown in Table 3. The study showed that 40% COVID-19 pregnant women experienced completed the period with a preterm labor, 10% was with miscarriage before the 24th week of pregnancy, while 50% of them completed the period continued the pregnancy. In this study, 82.5 % of COVID-19 pregnant women with preterm labor were suffered previously from fever comparing with 55% of COVID-19 pregnant women without preterm labor.The study showed that the highest mean of serum IL-6 was found in women infected with COVID-19 comparing with healthy control (12.8±3.6 v.s. 29.3±3.1 ng/ml) (P: <0.001). Conclusions:The study showed a significant relation of COVID-19 infection with pregnant women who pre-term labor especially who have high body temperature.

Background: In new pandemic, the probable effects of COVID-19 pneumonia on pregnant woman and their infant is one of new critical challenge for health care. Here we presented clinical symptoms, laboratory findings and outcome of COVID-19 pneumonia in pregnant woman. Methods: In a case series study, from 15 Feb to 15 June 2020, all women with RT-PCR COVID-19 who referred to two hospitals (Taleghani and Qods Hospital) affiliated to Arak University of Medical Sciences were selected. The epidemiological and demographic variables, laboratory test and outcomes obtained from patient’s medical records. Results: In this case series, we presented thirteen confirmed COVID-19 pregnant women. Their mean age was 34.6 (S.D.: 5.9) years and the mean gestational age was 32.4 (S.D.: 7.3) weeks. Most of patient didn’t show any maternal complication and intrauterine vertical transmission. The large number of pregnant women had normal HRCT and also in terms of laboratory most of the patients had normal laboratory tests. Amniotic fluids, cord blood, the throat swab of neonate in our pregnant woman with delivery were tested for COVID-19 and all of them were negative. Conclusion: The COVID-19 mothers and their infant didn’t have higher risk for morbidity and mortality and this virus didn’t associate with intrauterine vertical transmission.