Association between Usage of Prophylactic AYUSH Medicines and Disease Severity in COVID-19 Patients: A Retrospective Cohort Study.

BACKGROUND: Prior vaccination is often studied for its impact on individuals' post-infection prognosis. Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) medicines, advised by the Government of India as prophylaxis during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, were consumed by the masses in 2020. A study was therefore undertaken to observe any association between the prior usage of AYUSH prophylactic medicines and post-infection severity as reported by recovered COVID-19 individuals. METHODS: This was a retrospective, multi-centre, cohort study conducted in 21 cities of India from 5th August to 30th November 2020. Data from recovered COVID-19 patients, of either sex or any age, captured information about AYUSH prophylactic medicines intake prior to infection, disease severity, symptomatology, duration of complaints, etc. The study participants were grouped into AYUSH intake and non-intake. Primary composite outcome was the disease clinical course. Secondary clinical outcomes were the rate of and time to clinical recovery. RESULTS: Data of 5,023 persons were analysed. Ayurveda or homeopathic prophylactic medicines were consumed by more than half of the study participants: that is, 56.85% (n = 1,556) and 56.81% (n = 1,555) respectively. The overall adjusted protective effect (PE) of AYUSH prophylactic intake against moderate/severe forms of COVID-19 disease was 56.7% (95% confidence interval [CI], 48.7 to 63.50; p < 0.001). Adjusted PE for homeopathy and Siddha was 52.9% (95% CI, 42.30 to 61.50; p < 0.001) and 59.8% (95% CI, 37.80 to 74.10; p < 0.001), respectively. A statistically significant association was found between AYUSH prophylactic medicine intake and clinical recovery more frequently by the 3rd day of illness (χ2 = 9.01; p = 0.002). Time to resolution of symptoms in the AYUSH intake group was on average 0.3 days earlier than in the non-intake group (p = 0.002). CONCLUSION: AYUSH prophylactics were associated with statistically significant levels of protection against COVID-19 disease severity. Amongst these, previous intake of homeopathy or Siddha medicines was associated with some protection against moderate/severe illness and with a somewhat quicker clinical recovery. Prospective studies with experimental research design are needed to validate the findings of this study. STUDY REGISTRATION: Clinical Trials Registry-India (CTRI/2020/08/027000).

Efficacy of Arsenicum album 30C in the Prevention of COVID-19 in Individuals Residing in Containment Areas: A Prospective, Multicenter, Cluster-Randomized, Parallel-Arm, Community-Based, Open-Label Study.

OBJECTIVE: During the early part of the COVID-19 pandemic, non-pharmacologic interventions were the strategies for the prevention of severe acute respiratory syndrome coronavirus 2. The Ministry of Ayush, Govt. of India, had advised Arsenicum album 30C as a prophylactic to prevent COVID-19. This study was undertaken to evaluate the protective efficacy and safety of the Arsenicum album 30C. METHODS: We conducted a prospective, multicenter, cluster-randomized, parallel-arm, community-based, open-label study involving apparently healthy individuals residing in containment areas of 7 cities in India. Clusters are defined as the population residing in the containment areas, who are under restriction for movement. Forty-two clusters were randomly assigned at 2:1 to the Arsenicum album 30C group (30 clusters) or to the control group (12 clusters, which received no specific therapy). The medicine was given twice daily for 7 days. The primary outcome was the incidence of COVID-19, as per the case definition notified by the National Centre for Disease Control, Government of India, during 3-week follow-up period. RESULTS: The analysis included 32,186 individuals residing in 42 clusters (containment areas). A total of 22,693 individuals from 30 clusters received Arsenicum album 30C, and 9,493 individuals from 12 clusters were observed in the control group. The overall protective effect of the Arsenicum album 30C was 80.22% (95% confidence interval [CI], 71.16-86.44; 40 cases per 22,693 [6.04 per 10,000 person-weeks] in the Arsenicum album 30C group vs. 84 cases per 9,493 [29.78 per 10,000 person-weeks] in the control group). The protective effect of the Arsenicum album 30C against laboratory-confirmed COVID-19 was 68.22% (95% [CI], 49.64-80; 32 cases per 22,693 [4.83 per 10,000 person-weeks] in the Arsenicum album 30C group vs. 42 cases per 9,493 [14.93 per 10,000 person-weeks] in the control group). Adverse effects observed in both groups were mild and resolved without medication and sequelae. CONCLUSION: Homeopathic medicine Arsenicum album 30C was associated with a decrease in the incidence and provided some protection against COVID-19 as compared to nontreatment. Further randomized, double-blind, placebo-controlled trials may be conducted to validate the results of this study.In der Anfangszeit der COVID-19-Pandemie setzte man auf nicht-medikamentöse Massnahmen zur Prävention von Infektionen mit SARS-CoV-2 (Schweres-Akutes-Respiratorisches-Syndrom-Coronavirus 2). Das Ayush-Ministerium der indischen Regierung empfahl Arsenicum album 30C als Prophylaxe zur COVID-19-Prävention. Das Ziel dieser Studie war die Beurteilung der Schutzwirkung und Sicherheit von Arsenicum album 30C.An unserer prospektiven, multizentrischen, Cluster-randomisierten, unverblindeten Parallelgruppen-Bevölkerungs-Studie nahmen gesund erscheinende Bewohner von Sperrzonen in sieben indischen Städten teil. Die Cluster waren definiert als die Bewohnerpopulation je einer Sperrzone, für welche Mobilitätsbeschränkungen galten. 42 Cluster wurden per Randomisierung im Verhältnis 2:1 dem Arsenicum-album-30C-Arm (30 Cluster) oder dem Kontrollarm (12 Cluster, die keine spezifische Behandlung erhielten) zugeteilt. Das Medikament wurde sieben Tage lang zweimal täglich angewendet. Die primäre Zielgröße war die COVID-19-Inzidenz laut der vom National Centre for Disease Control der indischen Regierung bekannt gegebenen Falldefinition in einem Nachbeobachtungszeitraum von drei Wochen.Die Analyse umfasste 32.186 Personen in 42 Clustern (Sperrzonen). Insgesamt 22.693 Personen in 30 Clustern erhielten Arsenicum album 30C, und 9.493 Personen in 12 Clustern wurden als Kontrollarm beobachtet. Die Ergebnisse für Alter, Geschlecht und Komorbidität waren im Behandlungs- und Kontrollarm vergleichbar. Die Gesamt-Schutzwirkung von Arsenicum album 30C betrug 80,22 % (95-%-Konfidenzintervall [KI]: 71,16­86,44; 40 Fälle unter 22.693 [6,04 pro 10.000 Personen-Wochen] im Arsenicum-album-30C-Arm vs. 84 Fälle unter 9.493 [29,78 pro 10.000 Personen-Wochen] im Kontrollarm). Die Schutzwirkung von Arsenicum album 30C gegen laboranalytisch bestätigte COVID-19-Erkrankung betrug 68,22 % (95-%-KI: 49,64­80; 32 Fälle unter 22.693 [4,83 pro 10.000 Personen-Wochen] im Arsenicum-album-30C-Arm vs. 42 Fälle unter 9.493 [14,93 pro 10.000 Personen-Wochen] im Kontrollarm). Die beobachteten unerwünschten Wirkungen waren in beiden Gruppen von geringer Schwere und klangen ohne Medikation folgenlos ab.Das Homöopathikum Arsenicum album 30C war im Vergleich zur Nichtbehandlung mit einer Verringerung der Inzidenz assoziiert und bot gewissen Schutz vor COVID-19. Weitere randomisierte, doppelblinde, placebokontrollierte Studien könnten durchgeführt werden, um die Ergebnisse dieser Studie zu validieren.

Polarizable Frozen Density Embedding with External Orthogonalization.

We report a polarizable subsystem density functional theory to describe electronic properties of molecules embedded on a metal cluster. Interaction between the molecule and metal cluster is described using frozen density embedding (FDE). Substituting the nonadditive kinetic potential (NAKP) by approximate functionals is circumvented by enforcing external orthogonality (EO) through a projection operator. The computationally expensive freeze/thaw (FT) cycles are bypassed by including a polarization term in the embedding operator. Furthermore, the combination of polarization and EO permits supermolecular basis set calculations, which was not possible for strongly interacting systems with existing kinetic energy functionals. To test the method, we described the ground state density of pyridine, water, and benzene on a silver cluster. Performing FT on top of EO results in exact density embedding for this category of systems and is thus used for benchmarking the method. We find that the density is reproduced to within 0.15e, and the dipole and quadrupole moments are within 18% of the reference points for subsystem separations ranging from bonding to noninteracting distances. Additionally, our formalism allows the flexibility of incorporating different density functionals to the molecular and the metallic subsystems reducing the overall computational cost.

Emergence of Landauer transport from quantum dynamics: A model Hamiltonian approach.

The Landauer expression for computing current-voltage characteristics in nanoscale devices is efficient but not suited to transient phenomena and a time-dependent current because it is applicable only when the charge carriers transition into a steady flux after an external perturbation. In this article, we construct a very general expression for time-dependent current in an electrode-molecule-electrode arrangement. Utilizing a model Hamiltonian (consisting of the subsystem energy levels and their electronic coupling terms), we propagate the Schrödinger wave function equation to numerically compute the time-dependent population in the individual subsystems. The current in each electrode (defined in terms of the rate of change of the corresponding population) has two components, one due to the charges originating from the same electrode and the other due to the charges initially residing at the other electrode. We derive an analytical expression for the first component and illustrate that it agrees reasonably with its numerical counterpart at early times. Exploiting the unitary evolution of a wavefunction, we construct a more general Landauer style formula and illustrate the emergence of Landauer transport from our simulations without the assumption of time-independent charge flow. Our generalized Landauer formula is valid at all times for models beyond the wide-band limit, non-uniform electrode density of states and for time and energy-dependent electronic coupling between the subsystems. Subsequently, we investigate the ingredients in our model that regulate the onset time scale of this steady state. We compare the performance of our general current expression with the Landauer current for time-dependent electronic coupling. Finally, we comment on the applicability of the Landauer formula to compute hot-electron current arising upon plasmon decoherence.

Current-Driven Hydrogen Desorption from Graphene: Experiment and Theory.

Electron-stimulated desorption of hydrogen from the graphene/SiC(0001) surface at room temperature was investigated with ultrahigh vacuum scanning tunneling microscopy and ab initio calculations in order to elucidate the desorption mechanisms and pathways. Two different desorption processes were observed. In the high electron energy regime (4-8 eV), the desorption yield is independent of both voltage and current, which is attributed to the direct electronic excitation of the C-H bond. In the low electron energy regime (2-4 eV), however, the desorption yield exhibits a threshold dependence on voltage, which is explained by the vibrational excitation of the C-H bond via transient ionization induced by inelastic tunneling electrons. The observed current independence of the desorption yield suggests that the vibrational excitation is a single-electron process. We also observed that the curvature of graphene dramatically affects hydrogen desorption. Desorption from concave regions was measured to be much more probable than desorption from convex regions in the low electron energy regime (∼2 eV), as would be expected from the identified desorption mechanism.

Plasmon-Mediated Electron Transport in Tip-Enhanced Raman Spectroscopic Junctions.

We combine experiment, theory, and first-principles-based calculations to study the light-induced plasmon-mediated electron transport characteristics of a molecular-scale junction. The experimental data show a nonlinear increase in electronic current perturbation when the focus of a chopped laser beam moves laterally toward the tip-sample junction. To understand this behavior and generalize it, we apply a combined theory of the electronic nonequilibrium formed upon decoherence of an optically triggered plasmon and first-principles transport calculations. Our model illustrates that the current via an adsorbed molecular monolayer increases nonlinearly as more energy is pumped into the junction due to the increasing availability of virtual molecular orbital channels for transport with higher injection energies. Our results thus illustrate light-triggered, plasmon-enhanced tunneling current in the presence of a molecular linker.

Spectrum of hemoglobin variants in the population of northern region of west bengal: an ethnogenetic proposition.

CONTEXT: The birth of transfusion-dependent states of hemoglobinopathies including thalassemias is preventable by population screening and genetic counseling. Magnitude is not addressed in the Northern Region of West Bengal where many ethnic variants inhabit. AIMS AND OBJECTIVES: The aim of the following study is to find out the burden of different entities of hemoglobinopathies, their correlation with ethnicity and the "at risk" groups. SUBJECTS AND METHODS: A descriptive study was conducted from the Hematology Unit of North Bengal Medical College over 1 year on the subjects underwent screening for hemoglobinopathies for detection of abnormal hemoglobin (Hb) variants by "cation-exchange high-performance liquid chromatography" principle along with other relevant tests. STATISTICAL ANALYSIS: Data was analyzed by frequency distribution and Chi-square test assuming P value as 95% of the level of significance using the SPSS version 16 (SPSS Inc., Chicago, Illinois, U.S.A). RESULT: Abnormal Hb variant was 47.5% among 1872. Hb E trait (34.4%) was most common followed by Hb E disease (25.3%) and others. Hb E disorders (92.7%) were observed mostly among Rajbangsi population while E-ß-thalassemias (40%) in the Muslims and a heterogeneous pattern noted among tribal and mongoloid. CONCLUSION: Hb E hemoglobinopathies was high among Rajbangsi and Muslims with identification of some other hemoglobinopathies involving tribal and mongoloid.

Iron and Folic Acid Consumption by the Ante-natal Mothers in a Rural Area of India in 2010.

BACKGROUND: The average rural Indian women enter her reproductive life, particularly in pregnancy, suffer from nutritional anemia due to iron deficiency. National program of India had implemented a strategy for supplementation of iron folic acid by means of iron folic acid (IFA) tablets at least 3 months during antenatal period. The study had been conducted to assess the proportion of pregnant mothers consumes the IFA tablets and the factors determine compliance. METHODS: A cross-sectional, community-based study was conducted in rural area of India on 50 antenatal mothers by multistage sampling technique. The data were analyzed by using SPSS 16 (Statistical Package for the Social Sciences, ver. 16), Chicago, considering the level of significance at 95%. RESULTS: The IFA tablet was adequately consumed by 62% mother among the study population. The consumption is more among the mother who were explained properly than those who were not explained by the health worker (χ(2)= 4.529, P < 0.05). CONCLUSIONS: The compliance of iron folic acid tablets was still far behind to reach the National Goal though the service component are quite strong by the front line workers and health providers. An effort should be given at the level of front line health workers by training and re-training them to improve the compliance of IFA consumption.

Efficacy of intra-umbilical oxytocin in the management of retained placenta: a randomized controlled trial.

AIM: Retained placenta is an important cause of maternal mortality. The present study was aimed to determine the efficacy of umbilical injection of oxytocin as a treatment modality in this condition. MATERIAL AND METHODS: This was a single-center randomized controlled trial incorporating 58 women with retained placenta of more than 30 min, equally distributed into two study arms of intra-umbilical injection of oxytocin (50 IU oxytocin diluted with normal saline [NS] to a total volume 30 mL) and intra-umbilical injection of NS (30 mL). Primary outcome was expulsion of the placenta within 30 min following intervention. All the data were analyzed on an intention-to-treat basis. RESULTS: The success rate in the intra-umbilical oxytocin group was 51.72% compared to 20.69% in the control arm. This difference in the primary outcome was statistically significant with a P-value<0.05 (P=0.014) favoring intra-umbilical oxytocin infusion with an efficacy rate of 1.5 and a number-needed-to-treat of 3. The peripartum bleeding complications were more in the NS group with a statistically higher (P<0.001) requirement of extra oxytocin to control post-partum bleeding. There were no differences between the two groups in respect to other secondary outcomes, such as post-partum fever, antibiotic requirement and hospital stay. CONCLUSION: Umbilical vein injection of 50IU oxytocin in 30mL of NS delivered effectively via the umbilical cord with milking in cases of retained placenta seems a simple and promising technique to reduce the incidence of a potentially morbid procedure and other complications.

On the suppression and significance of ghost transmission in electron transport modeling of single molecule junctions.

The difficulty in achieving experimental control over a metal-molecule-metal junction formation hinders the understanding of the relationship between the contact geometry and electron transmittance. Computational studies on the other hand have the potential to resolve structural effects on the transport in molecular junctions. In a recent computational effort substantial transport was indicated even in the case where all the junction atoms were removed, while their corresponding atomic basis functions were included in the basis set (i.e., ghost atoms). In this report we explain the origin of the artifact termed as "ghost transmission." We provide a systematic analysis of the factors that enhance or suppress the artifact. We find that symmetric electronic densities at the two metal-molecule interfaces can lead to an amplification of the artificial transmission. In addition, interaction between an unpaired electron of the left electrode with one in the right electrode results with a substantial increase in "ghost transmission." Finally we find that a self-consistent single particle Green's function formalism that solves the junction electronic structure self-consistently with respect to the electrodes self-energies, reduces the artifact substantially.

Prevalence of dry eye diseases in hospital-based population in West Bengal, Eastern India.

To determine the prevalence of dry eye diseases in general clinical ophthalmic practice in a hospital-based population in West Bengal, Eastern India, a cross-sectional study was undertaken among 3023 subjects with the age of > or = 30 years, attending general ophthalmic clinic in a tertiary eye hospital. Demographics, detailed history and 6-items McMonnies' dry eye questionnaire were asked. Tear film break-up time (TBUT), Schirmer-I test, Rose Bengal (RB) staining, slit lamp examination and Meibomian gland dysfunction (MGD) were studied. Dry eye diseases were significantly higher in women than in men ie, 51.9% versus 48.1% (p < 0.01). Symptom-based dry eye (one or more symptoms present often or most of the time) was diagnosed in 1234 subjects (40.8%). With symptoms and at least one sign [TBUT < 10 seconds, RB staining (van Bjisterveld score: 4 or more) and Schirmer-I test = 5 mm in 5 minutes], the prevalence of dry eye was 786 (26%). Different grades of MeibOmian gland dysfunction (MGD) were detected in 957 cases (31.7%). Primary Sjogren syndrome was found in 21.5%; and 10.9% patients of dry eye had some form of systemic collagen vascular disorders. Using computers was not a risk factor in this geographical area. No significant correlation was seen between significant symptoms and positive signs in the study population. The prevalence of dry eye disease is high in West Bengal, Eastern India in hospital-based population. The risk is higher with age, female gender, systemic collagen diseases and with oral antidepressant/anxiolytic medication. Meibomian gland dysfunction is found to be common among dry eye subjects.

Evaluation of the prevention of parent to child transmission program in a rural tertiary care hospital of west bengal, India.

BACKGROUND: In India, 67,500 infants acquire HIV infection yearly due to mother to child transmission. OBJECTIVE: The objective was to assess the operational aspect of the Prevention of Parent to Child Transmission (PPTCT) program in a tertiary care hospital and explore its bottleneck. MATERIALS AND METHODS: A 5-year (2004-2008) prospective evaluation study was conducted among the pregnant women attending Obstetrics Department of a rural tertiary care hospital, since the year of implementation. Indicators were used according to UNAIDS/WHO guideline. RESULTS: Out of 40,140 registered pregnant women, 23,812 were counseled of which 19,794 were agreed to undergo HIV testing and 111 were found HIV positive with a prevalence of 0.56%. Overall HIV counseling and testing rates were 59.32% and 83.13%, respectively. The nevirapine (NVP) dispensing rate of the mother and newborn were 29.72% and 85.4%, respectively. At 18 months of age, 85% babies were found HIV negative in the mother baby pair who received NVP with absolutely formula feeding but it was 42.8% without such intervention. CONCLUSION: Majority of the pregnant women who came to the labor room directly were deprived of the program (PPTCT) coverage. Although the HIV testing rate reached the WHO target which was excellent, but the NVP dispensing rate lagged far behind.

Prevalence of ischemic heart disease among urban population of siliguri, west bengal.

OBJECTIVES: To determine the prevalence of ischemic heart disease and the associated risk factors among the urban population of Siliguri. MATERIALS AND METHODS: A cross-sectional survey of a random sample of the population aged >/=40 years old in the Municipal Corporation area of Siliguri. Study variables were age, sex, occupation, addiction, food habit, physical activity, body mass index, blood pressure, and electrocardiogram change. RESULTS: Out of 250 individuals who took part in this study, 29 (11.6%) had ischemic heart disease (IHD) and 118 (47.2%) had hypertension. Males had a higher (13.5%) prevalence of IHD than females (9.4%). About 5% of the patients had asymptomatic IHD. IHD among the study population is significantly associated with hypertension and smoking.