Online ISSN: 2515-8260

Keywords : covid-19


Complete blood count alterations of covid-19 patients in a tertiary care hospital in north India

Dr Meenakshi Khajuria, Dr Mohit Thalquotra, Dr Amit Kumar Khajuria, Dr Manpreet Kour

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 4072-4078

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

Effect of COVID-19 Infection On Levels of Beta trace, Haptoglobin And some Biochemical Parameters

Sahar Salah Abdul-Aziz , Omar Thaer Jawad , Wiaam Abid Jwair

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3371-3383

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

Impact of SARS-CoV-2 pandemic on Sleep Quality

Akanksha Togra, Sudhir Pawar, Jaisen Lokhande, Zarrin Ansari, Sanjay Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 848-859

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

Genome Analysis for Sequence Variants in Sars-Cov -2 in Symptomatic Individuals at Tertiary Care Hospital

M. Mary Sumani, Lavanya.D, Padma Priya. N, Queenileena.p, Vijayaswetha.v

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2608-2613

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

Knowledge, Attitude and Practices toward COVID vaccine among medical students in Belagavi- A cross-sectional study

Dr Hemavathe S, Dr Abhinandan Wali, Dr Sriram T R, Dr Aniketh Manoli, Dr Chandra Metgud

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 222-230

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

Prevalence of low back pain and osteoporosis in health care workers after the COVID 19 pandemic

Dr. Amit Kumar Gupta, Dr. Anil Kumar Sharma, Dr. Sahil Bhagat, Dr. Smit Saurabh, Dr. Nikhil Gupta, Dr. Ashwani Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3930-3936

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

The impact of pandemic of COVID-19 on routine immunization: A cross-sectional study in tertiary care centre at Pune

Dr. Vidya Asaram Pawar, Dr. Varsharani V Kendre, Dr. Yallapa U Jadhav, Dr. Muralidhar P Tambe, Dr Ganesh Jagadale, Dr Minal Hatnapure

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 4001-4006

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

Effect of covid-19 infection on levels of Thrombomodulin, Surfactant D proteins and some biochemical parameters

Haitham Akram Sobhi, Aseel Mokdad Hatam Abdulwahed

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3363-3370

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

Maternal and foetal outcomes in pregnant women undergoing lower segment caesarean section during COVID-19 pandemic: a retrospective analysis

Dr Harish Naik S, Dr Mallanna BP, Dr Dhanesh BM, Dr Francis Rufus Joshi, Dr Asha patil,Dr Sangeetha kattimani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 778-784

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

To identify rising level of CRP and D-Dimer as a predictor of increased morbidity and mortality in COVID -19 patient- A retrospective study

Dr. Mayank Varshney, Dr. Y.P. Singh, Dr. Akhil Taneja, Dr. Saurabh Jain, Dr. Gaurav Pratap Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 847-855

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

Lab Parameter among Corona Patients

Dr Vikas Kumar, Dr Bismay Das, Dr Susan M Mendonca, Dr Manoj Sharma, Dr Rajnish Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1075-1083

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

Effect Of COVID-19 Lockdown On The Prevalence Of Computer Vision Syndrome In Medical Students.

Gauri Parvathy; Naga Harrika Korrapati; Pramodhiya Sanduni Perera; Rushali Prasad; Aakansh Maheshwari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1991-2001

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

EVALUATION OF BONE MARROW & PERIPHERAL BLOOD SMEAR FINDINGS IN SARS-COV-2 PATIENTS, CENTRAL INDIA

Dr. Sourabh Singh Dudve, Dr.Neha banseria, Dr. Atul Kumar Pandey, Dr. Pankaj Kumar Jain

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 979-986

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

" A cross-sectional observational Study to assess the severity of coronavirus disease 2019 according to Clinical value of immune inflammatory markers"

Dr. Sarika Rawat Dr. Sunil Bajoliya Dr. Sachin Kumbhare Dr Roshan Mandloi Dr. Ranjeet Badole

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 955-961

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

Does COVID-19 hit hard in Diabetic Patient: A Cross-sectional study at Tertiary Care Hospital

Dr.C.Ranjani, Dr.S.Sukanya, Dr.R.Rajesh Gowtham, Dr.Sopia Abigail, Dr.B.Ananthi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 717-724

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

A STUDY ON CORRELATION BETWEEN MORTALITY AND CO-MORBIDITIES IN PATIENTS WITH COVID 19 INFECTION

Dr. Chirayu Vijaykumar Vaidya, Dinker NGoswami, Sashikumar Mundra, Parth Rameshbhai Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 928-939

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

CHANGE IN EDUCATION METHOD IN COVID-19 PERIOD: EFFECT ON PATTERN OF MYOPIA IN PEDIATRIC AGE GROUP

Dr. Shailly Raj, Dr. Naveen Kumar, Dr. Granth Kumar, Dr. Vimal Nag, Dr. Rashmi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1921-1927

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

CLINICAL STUDY OF COVID ASSOCIATED RHINO-ORBITAL MUCOR MYCOSIS IN STATE COVID HOSPITAL

T. Divya, N. Lakshmi, G. Sirisha, C. Triveni

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2067-2072

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

TO EVALUATE LOCKDOWN EFFECTS ON PEDIATRICS ORTHOPEDIC TRAUMA EPIDEMIOLOGY BEFORE, DURING AND AFTER COVID-19 PANDEMIC IN A TERTIARY HOSPITAL- AN OBSERVATIONAL STUDY

Kuldip Singh Sandhu, Dharminder Singh, Akashdeep Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3249-3256

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

Sensitivity and specificity of RT PCR and HRCT Thorax for Confirmed Diagnosis ofCOVID-19

Siddharth Singh,Santosh Kumar Nayan,Sumeet Kumar,Abhay Kumar, Sweta Muni,Deepak Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1437-1444

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

POST COVID MUCORMYCOSIS: AN OVERVIEW OF AETIOLOGICAL FACTORS

Beladakere Channaiah Vijayalakshmi, Anand Shalini, Thuraganur KapaniGowda Shashikala, Honnavara Govindaiah Manjunath, Govinda Rao Dinesh, Nagaraj Kokila, Anand Poornima

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1815-1822

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

To assess the severity of COVID-19 in relation toclinical value of immune inflammatory markers: An observational study

Dr. Preety Motiyani, Dr. RS Meena, Dr. Dileep Dandotiya, Dr. Mamta Meena, Dr. Jitendra Rai

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 657-662

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

A study on clinical presentation of rhino orbital cerebral mucormycosis associated with COVID-19 infection

Dr. Bomma Vijay Kumar, Dr Naresh Mogilicharla, Dr. Potlacheruvu Nagaraju, Dr. Moota Madhuri, Dr. A Shobhan Babu

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1988-1997

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.

Clinicopathological profile of thrombocytopenia in a tertiary care center in Himachal Pradesh

Monica Puri, Neelam Gupta, Naveen Kakkar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 364-372

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.

A study on correlation between mortality and co-morbidities in patients with covid 19 infection

Dr. Chirayu Vijaykumar Vaidya, Dinker N Goswami, Sashikumar Mundra, Parth Rameshbhai Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11894-11903

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

SEVERITY OF DEPRESSION, ANXIETY AND STRESS AMONG RECOVERED PATIENTS OF COVID-19: AN CROSS-SECTIONAL OBSERVATION STUDY VIA TELEPHONIC CONVERSATION.

Dr.Tarun Pal, Dr.Chitrakshee Singh, Dr.Gyanendra Kumar .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5306-5310

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.

Covid 19 and dermatological manifestations

Dr. Veerbhan Singh, Dr. Savita Arya, Dr. Anupama Shrivastva, Dr. Archana Paliwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 285-290

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.

Correlation of morphological abnormality in Peripheral blood smears with disease severity and mortality in Covid 19

Dipti Sidam, Abhilasha Yadav, Mukta Pujani, Sujata Raychaudhuri, Lokesh Parashar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2873-2887

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.

To determine the relationship between biochemical indicators and the severity of COVID-19

Dr Saleha Shaheen

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5861-5865

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.

To evaluate the Prevalence of anxiety and depression during COVID- 19 pandemic

A SATYA SAI VENKATA LAKSHMI

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1896-1906

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).

Study of biochemical and other parameters in patients treated with remdesivir vs. without the remdesivir in mildmoderate covid 19 patients

Dr. Bheemesh Vangalapati, Dr. Sudarshan Reddy, Dr. Venkappa S Mantur, Dr. Avula Naveen, Dr. Arun Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 818-821

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.

Prognostic Factors Associated with Mortality in Covid 19 Disease: A Retrospective Single Centre Institutional Study

Atul Kumar, Devendra Nargawe, Sanjay Kumar Dubey, Shivani Sinha, Neelam R. Charles

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4721-4728

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.

Study of X-Ray findings of COVID 19 from Assam medical college and hospital, Dibrugarh, Assam

Dr. Parama Nanda Taye, Dr. Siddhartha Sarma Biswas, Dr. Mary Hazarika Bhuyan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2155-2161

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.

Adverse events following COVID vaccination among undergraduate students in a medical college, South India: A cross sectional study

Dr. Nandini RC, Dr. Tejashwini K, Dr. Shanthi M, Dr. Dilip Kumar, Nishitha Gowda

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1786-1802

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. 

Outcome of Bevacizumab Use in Moderate to Severe COVID-19 Induced ARDS Patient: A Prospective Study from North India

Sahil Popli, Deepak Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10058-10064

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.

A CROSS SECTIONAL STUDY TO FIND THE MAGNITUDE AND FACTORS ASSOCIATED WITH BREAK THROUGH INFECTION AND RE-INFECTION OF COVID- 19 IN ADULT POPULATION BEING VACCINATED AT A MEDICAL COLLEGE OF PATNA, BIHAR

Md. Zamshaid Ansari, Dr. Vikash Chandra, Dr. Sanjay Kumar, Dr. Tulika Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11447-11455

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

To evaluate the cardiovascular changes associated with covid-19

Dr.Jainam Shah

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1879-1895

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%.

Evaluation of severity of Covid-19 inpatient by Computed tomography in tertiary centre of Bihar

Deepak kumar, Ashutosh Jha, Umakant Prasad, Sanjay Kumar Suman, Rashmi Rani Bharti, Amit Kumar, Dinesh, .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 111-117

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.

A study of acute inflammatory proteins and its relevance in Covid-19

Dr. Reddy Spoorthi Channa, Dr. Aparna, Dr. Reddy Channa

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1471-1474

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.

To ascertain the effect of digital eye strain on ocular healthamong school children during COVID Pandemic: A cross sectional stu

Dr Aditya Kashyap, Dr Minakshi Sumbria, Dr Smriti Sharma, Dr Rashmi Kashyap

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1425-1429

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

Indices and Parameters in the Diagnosis and The Management of COVID-19: A Comprehensive Review

Sangeeta Kapoor, Jyoti Trivedi, Fozia Jamal, Anil Kumar, Sushil Yadav, Himani Muniyal, Mukesh Pal Singh, Anjali Verma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2360-2374

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.

Spectrum of Chest HRCT findings in covid-19 pneumonia

Dr. Ashok Kumar Kattimani, Dr. Shivaraj G Biradar, Dr. Neeraja Akki

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 251-257

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.

A comparative study to find out/ assess the impact of lockdown on the mental health of the general population and covid-19 frontline health care workers

Nandkishor Tak, Aditya Soni, Abhilasha Suwalka, Rujul Modi, Manju bhasker .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3019-3029

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.
 

A cross-sectional study to analysis of depression level among frontline health care worker, working at tertiary care canter during COVID-19 at central India

Chouhan Vijay, Churihar Ritesh, Shukla Aanand, Baghel Anil Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 475-479

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.

Prone positioning in the management of spontaneously breathing non intubated covid-19 patients on oxygen therapy: A prospective observational study

Patel Shweta A, Chaudhari Tejalben A

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1458-1464

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.

Fetomaternal outcome of pregnancy with COVID-19

Dr. ChhaviBhomia,Dr. Neelima Shah, Dr. Prashant Shah, Dr. Vasudha Sawant

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 695-700

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.

A Systematic Review of Omicron Outbreak in Indonesia: A Case Record and Howthe Country is Weathering the New Variant of COVID-19

Abdul Kadir, Stevan Deby Anbiya Muhammad Sunarno .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 364-373

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

Depression, Anxiety and Stress in healthcare workers (HCWs) during COVID-19 pandemic- an observational study from central India

Mansi Anand, Kavya Rawat, Srikanth Reddy, Hiral Kotadia

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1715-1721

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

Study of Secondary Infections in Hospitalized Covid-19 Patients and its Outcome

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1557-1565

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.

THE COVID-19 EFFECTS ON DENTISTRY

Dr Pallavi Priya,Dr. Deepika Khurana,Dr. Gauri bhatia

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 676-685

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.

EXTENDED PARALLEL PROCESS MODEL IN COVID-19 RISK PERCEPTION AND RISK ASSESSMENT AMONG GENERAL POPULATION

Dr.Vijeth SB, Dr. TejasviHT, Dr. Kotresh M, Dr. Bhoovanachandaran M

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1597-1607

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.

Awareness of the Impact of COVID-19 virus on the depression on Population at Saudi Arabia at Makkah in Saudi Arabia 2021

Moaaz Mohammed Fadelelahy, Basem Saad Alghamdi, Molham Emam Badry

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 3210-3226

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

ASSESSMENT OF THE AUDIOVESTIBULAR SYMPTOMS IN THE SUBJECTS WITH COVID-19: A CLINICAL STUDY

Dr Rajveer Basu, Dr Preeti Lahari, Kiran Lahari, Dr Jugvendra Lahari

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1948-1954

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.

A Comparative study of the clinical characteristics of the first and second waves of COVID-19 in a tertiary care centre of North India

Dr Vijay Kumar , Dr Divendu Bhushan , Dr Sushmita Supriya , Dr Pallavi Lohani Dr Avinash Aravind Ganapule , Dr. Anjani Kumar , Dr. (Prof.) Sanjay Pandey .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2082-2094

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

Assessment of the stress, anxiety, and depression in students during COVID-19 pandemic

Dr Rajveer Basu, Dr Preeti Lahari, Kiran Lahari, Dr Jugvendra Lahari .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1835-1841

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

Assessment of the willingness to Vaccinate Against COVID-19 Among Adult Saudi Population in Makkah AL-Mokarramah, 2021

Turki Mohammed Abdulqader Maghrabi1; Rani Omar A Alnabati1; Sondos abdelmalik aboukhashaba; Abeer ali alharbi; Khalid Mohammed A Alobaid; Hani Ahmed H Alharbi; Yahya Helal H Almalki; Ahmed Saeed Ahmed Almalk; Ali Marzook Albajali; ,Abdullah Faisal Ahmed Alhazmi; Ayman Mohammed H Aljabri; Balqassm Ahmaed Almalki; Yousef Ahmed Ali AlghamdI

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 3399-3415

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

ANALYSING THE DYNAMICS OF THE INDIAN PHARMACEUTICAL INDUSTRY IN LIGHT OF THE COVID-19 PANDEMIC

Anandini Badhwar; Mugdha Bhate; Yashika Chawla; Dhairya Dhand

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1086-1100

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.

Incidence, Presentation and Management of Acute Appendicitis During COVID Lockdown: An Experience from Rural Tertiary Care Hospital

Dr. Hakeem Vaqar, Dr.Shakeeb Nabi , Dr. SajidBazaz

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2373-2379

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

Predictive study of the end of the Covid-19 pandemic in Morocco by regression, and ARIMA modeling (p, d, q)

Majdouline Larif; Adnane Aouidate; Mohammed Bouachrine; Tahar Lakhlifi; Abdelmajid Soulaymani

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2009-2018

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.

CLINICAL AND EPIDEMIOLOGICAL PROFILE OF COVID-19 PATIENTS ADMITTED AT A TERTIARY CARE CENTRE OF NORTH INDIA

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4748-4759

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.

Tracheostomy on a COVID-19 Patient:Case report and Review of Literature

Nekwu E. Okolugbo; Ufuoma M. Efole; Onome O. Ogueh; Anastacia O. Ojimba; Ejiro A. Benjamin

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2864-2872

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

Maternal and perinatal outcomes of pandemic Covid-19 in pregnancy in Basrah

Maysoon Sharief, C.A.B.O.G.; Gufran Jaafar, C.A.B.O.G.,; Alla Hussan, M. B. Ch. B., D.O.G

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 517-529

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%).

A Study on the Problems of Online Teaching- Learning Classroom During Covid-19

Pranjal Das

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1919-1929

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.

CINNAMON: A CLINICAL APPROACH AS MULTIFARIOUS NATURAL REMEDY WITH ABSOLUTE IMMUNITY

Shefali Arora; Mahak Gusain; Ravi Gunupuru; Rohit Kaushik; Pushpendu Sinha; Deepak Kumar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2331-2345

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

FORMATION OF HERD IMMUNITY TO SARS-CoV-2 IN THE REGIONS OF UZBEKISTAN

Rakhimov R.A.; Ibadullaeva N.S.; Khikmatullaeva A.S.; Abdukadirova M.A.; Sadirova Sh. S.; Lokteva L.M.; Rakhimov R.R.; Bayjanov A.K.; Samatova I.R.

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 574-581

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.

FORMATION OF HERD IMMUNITY TO SARS-CoV-2 IN THE REGIONS OF UZBEKISTAN.

Rakhimov R.A.; Ibadullaeva N.S.; Khikmatullaeva A.S.; Abdukadirova M.A.; Sadirova Sh.S., Lokteva L.M.; Rakhimov R.R.; Bayjanov A.K.; Samatova I.R.

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1247-1252

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.

FORMATION OF HERD IMMUNITY TO SARS-CoV-2 IN THE REGIONS OF UZBEKISTAN..

Rakhimov R.A.; Ibadullaeva N.S.; Khikmatullaeva A.S.; Abdukadirova M.A.; Sadirova Sh.S.; Lokteva L.M.; Rakhimov R.R.; Bayjanov A.K.; Samatova I.R.

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1529-1534

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 – Impact on Banking and Insurance Sector

Aditya More

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2355-2362

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.

Disinfectants and Sprayers for Prevention of COVID-19 Pandemic in India

Kishore Chandra Swain; Abhinab Mishra; Rutuparna Biswal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 899-912

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.

IMPACT OF IMPROPER BIOMEDICAL WASTE DISPOSAL ON HUMAN HEALTH AND ENVIRONMENT DURING COVID- 19 PANDEMIC

Dr. Biswapriya Jena, Dr. (Ms) Sanghamitra Patnaik, Dr. Nabnita Patnaik

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4137-4143

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

ANALYSIS OF VULNERABILITY AND SPATIO-TEMPORAL DISTRIBUTION TOWARD THE SEVERITY LEVEL OF COVID-19 IN BENGKULU, INDONESIA

Dessy Triana; Riry Ambarsarie; Utari Hartati Suryani; Nikki Aldi Massardi; Mardhatillah Sariyanti; Enny Nugraheni; Debbie Rizqoh

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 657-663

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.

Covid-19: A Pedodontist Perspective

Dr. Shimoli Shah; Dr. Deep Devendrabhai Patel; Dr. Susheel Kumar; Dr. Rucha Thakkar; Dr. Himani Janakbhai Patel; Dr. Musaib Syed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2873-2880

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

The Impact of COVID-19 in the Procedure of Religious-Worship and Social Life, In Islamic View

Muhammad Fuad Zain; Hasanudin .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 272-278

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.

Prevalence of Fatigue in Patients Post Covid-19

Shendy W; Madonna Maher Ezzat; Doaa Abdallah ELaidy, MD; Abdelaziz Abdelaziz Elsherif

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1330-1340

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.

Anxiety and aggressiveness in Peruvian postgraduate students in COVID-19 context

Nancy Isabel Herrera Paico; Sanchez Diaz Sebastian; Juan Méndez Vergaray; Edith Gissela Rivera Arellano; Enaidy Reynosa Navarro

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 713-726

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.

CYTOKINE STORM GOES HAND IN HAND WITH PROLONGED FEVER IN SARS COVID-19 DISEASE: A STUDY OF 1324 PATIENT’S DATABASE OF PAST 1 YEAR. CYTOKINE STORM GOES HAND IN HAND WITH PROLONGED FEVER IN SARS COVID-19 DISEASE

Dr.Vijay P. Bakhtar. Dr. Neha Bakhtar (Pandey)

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4690-4698

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.

Financial performance analysis of banking sector in India

Dr. Divyang Joshi, Mr. Samir Thakkar, Ravina Machhi, Devyesh Chauhan

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3129-3136

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.

COVID-19: Fear and anxiety among healthcare students in Saudi Arabia: A cross-sectional study

Sameer Shaikh; Syed Fareed Mohsin; Muhammad Atif Saleem Agwan; Saqib Ali; Ziyad Ahmad Alsuwaydani; Saleh Ahmad AlSuwaydani

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1638-1647

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.

Redesigning Dentistry To A New Reality In The Era Of COVID-19- A Review Article

Aayushi Aggarwal; Vinisha Pandey; Neha Awasthi; Subhra Dey

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 28-44

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.

A Study Of Covid-19 Spread And Death Contributing Factors In America Using Multi- Layer Perception (MLP) And Radial Basis Function (RBF)

Shafaf IBRAHIM; Saadi Ahmad KAMARUDDIN; Nur Nabilah ABU MANGSHOR; Ahmad Firdaus AHMAD FADZIL

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 144-158

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.

Neurological disorders in patients underwent COVID-19

Nargiza Nasriddinovna Ergasheva; Dilbar Nabievna Khidoyatova; Yakutkxon Nabievna Madjidova; Yuldasheva Manzura Muchammad Tofik kizi; Zulfiya Amalgeldievna Xodjaeva

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 256-262

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

VITAMIN C IN TERMS OF COVID-19, CURRENT TRENDS

IlxamdjanKarimdjanov Asamovich,Nozima Sаdiqova Baxadirovna, BotirTadjiev Mirkhashimovich,NurlanDinmukhammadiev Aktamovich, BobirMirkhashimovBotirovich,YaxyayevaKomola Zokirovna,AnvarTursunbayev Karimberdiyevich,FatimaXoltayeva Fayziyevna

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 1341-1351

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.

Health Care in Prisons and Detention Homes During COVID-19 Pandemic in India

M.Z.M. Nomani; Zafar Hussain

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 1488-1492

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.

AWARENESS OF DIAGNOSTIC TESTS FOR COVID AMONG DENTAL STUDENTS

Reshmi B; Dhanraj Ganapathy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 521-530

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.

PRACTICE OF PERSONAL PROTECTIVE EQUIPMENT DURING DENTAL TREATMENT

Reshmi B; Dhanraj Ganapathy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 570-578

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.

Implementation of Deep Learning for Automatic Classification of Covid-19 X-Ray Images

Muhammad Shofi Fuad; Choirul Anam; Kusworo Adi; Muhammad Ardhi Khalif; Geoff Dougherty

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1650-1662

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.

Liriodenine: The Prospect For Covid-19

Ade Zuhrotun

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1381-1399

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

CORRELATION BETWEEN TEMPERATURE AND INCREASE IN COVID-19 CASES IN TELANGANA STATE

D.Lakshmi Padmaja; Medisetty Sujith; Sai Sruthi Bejagam; Manish Reddy Morapally

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2047-2052

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

Oral Health Condition and Dental Care in Children with Congenital Heart Disease during the COVID-19 Pandemic: A Systematic Review

Harun Achmad; Sasmita M. Arief

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1233-1247

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.

POTENTIAL INVESTMENT OPPORTUNITIES IN GCC HEALTHCARE DURING COVID PANDEMIC: A RESEARCH & REVIEW

Dr. Vinod Kumar Patchigalla; Dr Vikram V Khare; Dr. Heena Tiwari; Dr. Rahul VC Tiwari; Dr. Amit Dalmia; Dr. Prashik Parvekar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 7150-7160

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

Survival analysis to assess the length of stay of novel coronavirus (COVID-19) patients under Integrated Medicine - Zinc, Vitamin C & Kabasura Kudineer (ZVcKK)

D. Jamuna; P. Sathiyarajeswaran; M. S. Shree Devi; K. Kanakavalli; N. P. Vinod; A. Nirmala; T. Ravikumar; P. Pathiban; K. Babu; C. Dhanam

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1375-1387

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.

Real-Time Measurement Of Psychological Impact Due To E- Learning; Among The Undergraduate Dental Students During Covid-19

H.M. Owais Nasim; Azeem Ul Yaqin Syed; Laraib Qamar; Saba Saleem; Zainab Javaid; Ayesha Khalid; Muhammad Sohail Zafar; Nausheen Aga

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 7875-7884

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.

Coronavirus (COVID-19): preventive measures and potential interventions

Marwan M Merkhan; Ghayth M Abdulrazzaq; Hiyam A Al-Taii

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1388-1399

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 ROLE OF SPIRITUAL AND PSYCHOLOGICAL WELL-BEING IN PANDEMIC SITUATION, AN INDIAN PERSPECTIVE

Sree Jyothsna Beesetti; Nagendra Kumar Turaga; Girish Salaka; Mohana Turaga

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 2341-2349

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.

Challenges of COVID-19 Vaccine Delivery Management in India

Dr Sandeep Bhardwaj

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2509-2515

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

The Impact of LSSR Policy on the Anxiety Level of Undergraduate Students during COVID-19

Xindy Imey Pratiwi; Jayanti Dian Eka Sari; Bela Yuli Selfia; Ianatul Ulya Dewi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2178-2186

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.

Psychosocial impact of COVID-19 Quarantine in South India: A online cross-sectional survey

Narrain shree S; Jagannathan K; Vinod N P

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1530-1545

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.

E-Learning In Undergraduates: New Insights In Medical Education

Haritha G; Benjamin M Sagayaraj; Nidhi Sharma

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1708-1718

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

Role of mouthwash in prevention of Covid-19: A review

Dr. Swaroop S; Dr. Shwetha N; Dr. Cilpa Varghese; Dr. Pratik Surana; Dr. Ruchi Gopal; Dr. Sajin Sam

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 8118-8122

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.

Phbs Implementation And Personal Factors Of Medical Students During The Covid-19 Pandemic Period

Agustina Arundina Triharja Tejoyuwono; Rangga Putra Nugraha; Faisal Kholid Fahdi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1499-1510

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.

Assessment of knowledge and attitude among pediatric dentists regarding spread and control of infection before and after COVID-19 crisis.

Dr. Rajesh Ijalkar; Dr. Ritesh Kalaskar; Dr. Shruti Balasubramanian; Dr. Ashita Kalaskar; Dr. Priyanka Bhaje; Dr. Priyanka Sharma

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 8368-8378

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.

Validity And Reliability Test For Research Instruments Regarding Health Professional Student Satisfaction Towards Online Learning During The Covid-19 Pandemic

Kulsum Kulsum; Taufik Suryadi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2802-2817

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.

Automatic Classification of the Severity of COVID-19 Patients Based on CT Scans and X-rays Using Deep Learning

Sara Bhatti; Dr. Asif Aziz; Dr. Naila Nadeem; Irfan Usmani; Prof. Dr. Muhammad Aamir; Dr. Irum Khan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1436-1455

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.

Convalescent Plasma Therapy Against Covid-19: A Comprehensive Review

Dr Suchitra Shenoy M, MD; Dr Pooja Rao, MD; Dr Deepa Adiga S A; Dr Nikhil Victor Dsouza, MD; Dr Basavaprabhu Achappa MD

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 3374-3384

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.

Qurban Innovation Due to The Covid-19: Experiences from Indonesia

Abdul Syatar; Arif Rahman; M. Ilham; Chaerul Mundzir; Muhammad Arif; Hasanuddin Hasim; Muhammad Majdy Amiruddin

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1600-1614

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.

Would Startup-India Assist The Economy In 'Starting Up' After The Covid-19 Pandemic?

Harikumar Pallathadka

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 4372-4349

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.

Use Of Chloroquine And Hydroxychloroquine In COVID-19 Patients- A Dilemma

Archana Bhatia; Sandeep K Bains; Ruchika Gupta; Tajinder Bansal; Kuldeep S Sandhu; Jaideepa .

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 6558-6565

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.

Child Neglect And Its Repercussions In Covid Era

Nagalakshmi Chowdhary; B Suba Ranjana; Subhathira Rajasekaran; V Rajashekar Reddy; Nisha Gupta; A Thirumagal Anuraaga

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 4805-4813

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.

A Survey Of Undergraduate Students On Online Learning During Covid-19 Pandemic In The Indian State Of Manipur

Harikumar Pallathadka

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 5914-5927

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.

Awareness And Practice Of Infection Control Protocol Amidst Covid-19 Pandemic In Private Dental Clinics In North India: An Original Research

Dr. Yash Pal Singh; Dr. Brajesh Gupta; Dr. Heena Tiwari; Dr. Akshay M. Dhewale; Dr. Monika Saini; Dr. Shraddha Joshi; Dr. Rahul VC Tiwari

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 6521-6526

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.

Epidemiological study of COVID-19 pneumonia in pregnant woman and their neonates; report of thirteen confirmed COVID-19 pregnant women

Alireza Kamali; Behnam Mahmodiyeh; Amir Almasi-Hashiani; Morteza Mousavi Hasanzadeh; Maryam Shokrpour

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4455-4461

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.

Relation of COVID-19 infection to outcomes of pregnancy during the pandemic in Kirkuk city

Ebaa Ghassan Akram; Safaa Ibrahim Mohammed; Jaklen Zaea Khoshaba

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4314-4318

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.