European Journal of Molecular & Clinical Medicine

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 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.

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: 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: 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.
 

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.

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: 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

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.

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.

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: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.

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: 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: 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.

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.

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 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.

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).

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.

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.

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.

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.

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

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.

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
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 08, Issue 04, 2021
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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.

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.

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.

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

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
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 08, Issue 04, 2021
1836
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.

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.

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%).

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 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

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.

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

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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

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.

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

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.

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.

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 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.

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.

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.

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.

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 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: 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.

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.

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.

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.

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.

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.

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.

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.