A case report on anesthetic challenges in the post-Covid complication of active mucormycosis: Patient preparedness for family physicians.

Mucormycosis is a well-known yet complicated illness that seems benign but behaves malignantly. This article discusses the anesthesia challenges in providing care for a 49-year-old male who presented with post-Covid pneumonia and uncontrolled diabetes along with active mucormycosis and scheduled for functional endoscope sinus surgery (FESS) and debridement of necrotic tissue. We want to illustrate the importance of anticipated difficult airway, while highlighting the toxicity of intravenous amphotericin-B and its combination against anesthesia drugs.

Foot-and-mouth disease status in India during the second decade of the twenty-first century (2011-2020).

Foot-and-mouth disease (FMD) is a major disease of livestock in India and causes huge economic losses. The formal FMD control program started in 2003-04 in selected districts and was gradually expanded. The present study provides a descriptive review of the FMD outbreaks, prevalent serotypes, and genetic and antigenic features of the FMD virus (FMDV) that circulated in the country between 2011 and 2020. FMD outbreaks were regularly reported in cloven-hoofed domestic livestock and wildlife, with three serotypes including O, A, and Asia1. During the study period, a total of 2226 FMD outbreaks were documented and serotypes confirmed. FMDV serotype O dominated the outbreak scenario, accounting for about 92% of all outbreaks, followed by Asia1 (5% of all outbreaks) and A (3% of all outbreaks). Two major epidemics of FMD on an unprecedented scale during the years 2013 and 2018 by serotype O were recorded. The spatial distribution of FMD was characterized by a larger number of outbreaks in the southern region of the country. In an annual-scale analysis, 2020 was the year with the lowest outbreaks, and 2013 was the year with the highest. The month-scale analysis showed that outbreaks were reported throughout the year, with the highest numbers between October and March. The emergence of three major lineages (O/ME-SA/Ind2001d, O/ME-SA/Ind2001e, and O/ME-SA/Ind2018) of serotype O was observed during the period. In the cases of serotype A and Asia1, the appearance of at least one novel lineage/genetic group, including A/G-18/non-deletion/2019 and Asia1/Group-IX, was documented. While serotype A showed the advent of antigenic variants, serotypes O and Asia1 did not show any antigenic diversity. It was noticed during the course of an outbreak that animal movement contributes significantly to disease transmission. Except for 2018, when numerous FMD outbreaks were recorded, the number of annual outbreaks reported after 2016 has been lower than in the first half of the decade, probably due to mass vaccination and COVID-19 pandemic-linked movement restrictions. Even during outbreaks, disease symptoms in ruminant populations, including cattle, were found to be less severe. Regular six-monthly immunization certainly has a positive impact on the reduction of disease burden and should be followed without fail and delay, along with intensive disease surveillance.

Foot-and-mouth disease status in India during the second decade of the twenty-first century (2011–2020)

Foot-and-mouth disease (FMD) is a major disease of livestock in India and causes huge economic losses. The formal FMD control program started in 2003–04 in selected districts and was gradually expanded. The present study provides a descriptive review of the FMD outbreaks, prevalent serotypes, and genetic and antigenic features of the FMD virus (FMDV) that circulated in the country between 2011 and 2020. FMD outbreaks were regularly reported in cloven-hoofed domestic livestock and wildlife, with three serotypes including O, A, and Asia1. During the study period, a total of 2226 FMD outbreaks were documented and serotypes confirmed. FMDV serotype O dominated the outbreak scenario, accounting for about 92% of all outbreaks, followed by Asia1 (5% of all outbreaks) and A (3% of all outbreaks). Two major epidemics of FMD on an unprecedented scale during the years 2013 and 2018 by serotype O were recorded. The spatial distribution of FMD was characterized by a larger number of outbreaks in the southern region of the country. In an annual-scale analysis, 2020 was the year with the lowest outbreaks, and 2013 was the year with the highest. The month-scale analysis showed that outbreaks were reported throughout the year, with the highest numbers between October and March. The emergence of three major lineages (O/ME-SA/Ind2001d, O/ME-SA/Ind2001e, and O/ME-SA/Ind2018) of serotype O was observed during the period. In the cases of serotype A and Asia1, the appearance of at least one novel lineage/genetic group, including A/G-18/non-deletion/2019 and Asia1/Group-IX, was documented. While serotype A showed the advent of antigenic variants, serotypes O and Asia1 did not show any antigenic diversity. It was noticed during the course of an outbreak that animal movement contributes significantly to disease transmission. Except for 2018, when numerous FMD outbreaks were recorded, the number of annual outbreaks reported after 2016 has been lower than in the first half of the decade, probably due to mass vaccination and COVID-19 pandemic-linked movement restrictions. Even during outbreaks, disease symptoms in ruminant populations, including cattle, were found to be less severe. Regular six-monthly immunization certainly has a positive impact on the reduction of disease burden and should be followed without fail and delay, along with intensive disease surveillance.

Role of social media tools in online teaching: perception of physiotherapy students and knowledge translation

Background During the COVID-19 lockdown period many education institutions have shifted their focus from the traditional face-to-face education to online instruction mainly through various social media (SM) tools. However, it is not known if these results can be generalized across locations where infrastructure facilities are unevenly distributed. Further, no previous work has explored the role played by SM tools in knowledge translation. The objectives of this work are 1. To evaluate the students perceptions on the accessibility and acceptability of SM tools via an anonymous online survey and 2. Assess the efficacy of SM tools as an educational medium in imparting knowledge change. An online survey using an anonymous web-based questionnaire was conducted to assess the student’s accessibility and acceptability of SM tools as a direct information sharing pathway between the faculty and students. A randomized comparative design was utilized to evaluate knowledge change via an online examination administered 10 min before and after an online class delivered via 2 different SM platforms (Google meet, YouTube) and e-mail. Results Data were obtained from 627 participants through a survey. Though 71.1% of the respondents believed online classes have helped them in their study, only 21.4% and 22.6% of the participants strongly agreed that social networking platforms are helpful for teaching and will be used for teaching/learning in the future respectively. The ANOVA responses to evaluate knowledge transfer from 224 participants who were randomized to receive course content through Google meet, YouTube, and e-mail showed no significant differences in outcomes before and after the delivery of contents. Conclusion Our findings suggest that multiple external and internal factors need to be addressed before substituting classroom teaching with online teaching, especially during emergencies.

Effect on Mental Health among Undergraduate College Students of India during the COVID-19 Pandemic: A Cross-Sectional Multicentric Study.

BACKGROUND: College students show higher prevalence of mental health issues as compared to the general population. Unfortunately, this year, students all over the world have to face, added pressure due to COVID-19. This study aimed to estimate the effect of COVID-19 pandemic and lockdown on the mental health of Medical and Engineering Students. SUBJECTS AND METHODS: The study was carried out at different medical and engineering colleges in Bihar, Delhi and Maharashtra, and Tamil Nadu. 699 responses were collected and analyzed during the study period. Data was collected by email/ online platform through Google form via non- probability Sampling Technique. Mental health status was determined by using Corona virus anxiety screening (CAS), GHQ (General Health Questionnaire)-12, GAD (General Anxiety Disorder)-7 scale and PHQ (Patient Health Questionnaire)-9 scales.369 (53%) MBBS and 330 (47%) Engineering students participated in the study. RESULTS: Maximum participants in both groups did not have anxiety related to COVID-19 (MBBS (96.8%) and Engineering (95.2%). About two-third participants secured above cut off score i.e., MBBS (62.3%) and Engineering (64.8%) in GHQ-12. Approximately comparable proportion in both groups were found to have severe anxiety and depression (16% vs 20%), when applied GAD-7 and PHQ-9. Uncertainty in the timing of the exams/ Academic delay was found to be the most worrying factor (MBBS, 41.19% vs Engineering 31.82%). CONCLUSIONS: About two-thirds of medical and engineering students psychologically equally affected by current pandemic in our study. A student wellness clinic is the need of hour in current scenario, which is supported by mental health experts (Psychiatrists, Clinical Psychologists) and residents on rotation basiswhere all psychological problem including Stress, Anxiety, Interpersonal crisis, Relationship issues and Personality problems of the students are dealt effectively in institute campus near to student residential area.

Moderate to Severe Thrombocytopenia in Four Pregnant Women With Asymptomatic COVID-19 Infection.

Coronavirus disease 2019 (COVID-19) pandemic is one of the biggest healthcare crises faced globally. Since its emergence, uncertainty about its progress and treatment options has challenged clinicians around the world. Pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection pose a higher challenge due to the concerns of an already altered immune system during pregnancy and the disease's effect on the fetus. Thrombocytopenia is associated frequently with moderate to severe coronavirus disease and is also an established marker of worsening of the disease. However, it is infrequently seen in mild or asymptomatic cases. Neuraxial anesthesia is the preferred choice of anesthesia in COVID-19 positive patients but thrombocytopenia in a parturient with coronavirus disease can cause a dilemma for the obstetric anesthesiologist. Here we describe the management of four pregnant women with asymptomatic COVID-19 disease who had moderate to severe thrombocytopenia. These cases highlight the importance of careful monitoring of the platelet count of pregnant women with COVID-19 infection even if asymptomatic.

Regenerated silica-based RNA purification columns to address the short supply of RNA purification kits for COVID-19 diagnosis.

BACKGROUND: RT-qPCR technique is the current world-wide method used for the early detection of SARS-CoV2 RNA in the suspected clinical samples. Viral RNA extraction is the key pre-analytical step for SARS-CoV2 detection which often achieved using commercial RNA-extraction kits. However, due to the COVID-19 pandemic, bulk production and the supply chains for the commercial RNA-extraction kit have been seriously compromised. The shortage of commercial RNA-extraction kit is even more acute in developing country. Furthermore, use of one-off design RNA-columns can generate plastic wastes that have an environmental pollution effect. METHODS AND RESULTS: To address these issues, in this study, we used warm alkaline solution containing Triton X-100 for the complete removal of the residual SARS-CoV2 RNA from the used RNA-binding silica column. Columns regenerated using the alkaline solution have the viral RNA purification capability that is comparable to the fresh silica columns. We also demonstrated that RNA-binding silica columns can be regenerated and reused for a minimum of five-times. CONCLUSIONS: Therefore, the use of the RNA-column regeneration method may benefits several SARS-CoV2 diagnostic laboratories throughout the world by cutting down the requirement of commercial RNA-purification column.