Perspectives of Teachers about Online Classes and Their Psychosocial Well-Being During School Reopening Phase: A Cross-sectional Study from North India

Background: During COVID-19 pandemic, education of children was continued in online mode for an extended period of time. Research from India in the beginning of pandemic indicated that teachers faced numerous challenges while adapting to this new mode of teaching. However, no prior study from India evaluated perspective of teachers regarding online classes and their psychosocial well-being during school reopening phase, which started in Feb 2022. During this period both online and offline classes were being conducted and thus presented the opportunity for better comparison of effects of both systems. Schools still revert to online mode of teaching periodically, but it remains to be seen if it benefits the teachers and students. Methods: It was a cross-sectional online survey-based study. Self-designed questionnaires assessing perspectives of teachers regarding online classes and psychosocial impact were administered. Depression, Anxiety, and Stress Scale-21 was used to measure psychological distress. Results: N = 708 school teachers participated in this survey. A total of 96% of them preferred offline mode of teaching. Several disadvantages of online classes were listed such as connectivity issues, poor interaction with students, poor concentration, and knowledge transfer. Due to online classes, most of them reported increase in working hours, and decrease in leisure time and quality of life. The teachers who conducted online classes (either alone or combined with offline classes), who were employed in private schools and those with lesser family income, had significantly higher psychological distress. Conclusion: According to school teachers, online classes carried many disadvantages. Online classes also decreased the psychosocial well-being of teachers.

Are Mobile Cardiac Outpatient Monitors Reliable to Monitor Qtc in Comparison to 12 Lead ECG

Introduction: Use of mobile cardiac outpatient monitor (MCOT) increased during the COVID-19 pandemic as a substitute for telemetry and monitoring of arrythmias during loading of antiarrhythmic drugs (AAD). However, data comparing difference of QTc interval between a MCOT, and 12 lead ECG is scare. Hypothesis: To assess the accuracy of mobile cardiac outpatient monitor in comparison to 12 lead ECG for QTc monitoring Methods: We prospectively evaluated 24 patients at our institution who received IV sotalol as single day loading dose for initiation of oral sotalol therapy for atrial fibrillation/atrial flutter (AF/AFL). All patients were discharged 6 hours after the IV loading dose with a MCOT for 3 days. All patients had a 12 lead ECG within 12-18 hours of the baseline line MCOT transmission. Variation in heart rate and QTc was assessed. Result(s): A total of 24 patients were included in the study. The mean age was 65+7.3 years, 80% of patients were men. The mean difference between the QTc interval measured on 12 lead ECG and MCOT was 5.1+ 6 milliseconds [450+33 (EKG) - 445+39 (MCOT)], p=0.92. The mean heart rate difference between the two modalities was also not significant, p=0.726 [ 70.4+19 (EKG) -72+ 11.8 (MCOT), DELTAHR=1.6+7.2 beats per minute]. Conclusion(s): MCOT can be considered as a reliable alternate to 12 lead ECG for monitoring of QTc in patients receiving AAD.

AN EXPLORATORY STUDY EVALUATING EXPERIENCED STIGMA AMONG DOCTORS IN A DEDICATED COVID-19 HOSPITAL OF NORTH INDIA

Objective: Doctors may experience stigma and discrimination from community, friends and even family due to their association with COVID-19 patients. The present study was planned to assess actual stigma experienced by doctors because of working in COVID-19 wards. Methods: A cross-sectional study was conducted in the Department of Psychiatry of a dedicated COVID-19 Hospital of North India. A Google Survey Form which measured Experienced Stigma was circulated through WhatsApp groups in October-November 2020 among all the doctors working in COVID-19 ward. Data collected was analyzed statistically. Results: Around 250 doctors participated in the study and 70% of them experienced stigma in one or more ways. Approximately, 60% doctors had stopped socializing because of people’s reactions, they felt that people were afraid of them and that people avoided touching them because they were treating patients with COVID-19. 110 (44%) respondents were denied social exchanges/friendships, 88 (35.2%) felt neglected by family or friends, and 71 (28.4%) lost friendships because they worked with patients with COVID-19. Stigma was experienced significantly higher in younger age (p=0.012*), resident doctors (p=0.001**) and those with longer working hours (p=0.01*). Conclusion: Doctors experience stigma from friends, family and general public due to their contact with COVID-19 patients. Experienced stigma is higher in young age and resident doctors.

Bortezomib-Pomalidomide-Dexamethasone (VPD) As Novel Induction Therapy in Newly-Diagnosed Multiple Myeloma: Early Safety Data from an Ongoing Single Arm Phase-II Investigator-Initiated Clinical Trial (PRIME Study)

Introduction: Pomalidomide is a third-generation immunomodulatory drug approved for relapsed and/or refractory Multiple Myeloma (RRMM). In the phase 3 OPTIMISMM trial, pomalidomide, bortezomib, and dexamethasone demonstrated superior efficacy in patients with RRMM. PRIME study (CTRI/2019/10/021618) is testing this combination in Newly Diagnosed Multiple Myeloma (NDMM) Aim: To determine safety of Pomalidomide in combination with Bortezomib and dexamethasone (VPD) in NDMM Study design: A prospective, single arm, phase II study from a tertiary center. Both transplant eligible and ineligible patients with NDMM aged between 18-70 years are being recruited in the study. Patients with Plasma cell leukemia, POEMS and amyloidosis were excluded. The regimen consists of weekly Bortezomib 1.3mg/sq.m (subcutaneous), Tab. Pomalidomide 2-4mg once daily for 21days, and Tab Dexamethasone 20mg twice weekly, with the cycle repeating every 28 days, 9-12 cycles. Here we report the adverse events (AE) by NCI CTCAE v5.0, upon recruiting 26 patients, as predetermined in the study. Results: Of the proposed 45-50 patients, 26 patients were enrolled in the study between April 2020 to May 2021 and 23 (88.4%) have completed 4 cycles of VPD. The median age is 55years (18-70), and gender ratio 1:1. At disease presentation, bone lesions were the commonest (96.2%, n=25), IMWG high risk cytogenetics were seen in 42.4% (n=11), RISS-2 in 69.3% (n=18), IgG kappa paraproteinemia in 54% (n=14) patients and ECOG performance score 2-3 in 57.6%(n=15). Ten (38.5%) patients have completed 9 cycles, and 3 underwent auto-transplant (between Cycle 4 & 6). Protocol adherence was 96.1% (25/26 patients). Table-1 shows drug-induced toxicity, hematological toxicities were the commonest. Two patients withdrew consent in view of bortezomib-induced peripheral neuropathy. Serious adverse events (SAE) were reported in 9 (34.6%) patients and were considered unrelated to the regimen by the safety committee (PSVT=1, Bony pain=2, dyspnea=1, pneumonia=1, constipation=1, diarrhea=1, hypotension=1) and one death due to SARS-CoV2 pneumonia. Treatment delays of 2 weeks in 4 patients (SARS-CoV2 = 3, Syncope = 1) After 4 cycles (n=23), 6 (26%) patients were in stringent Complete Response (sCR), 17(74%) in Very Good partial response (VGPR) and 13 (56.5%) are Measurable Residual Disease (MRD) negative. Of 10 patients who completed cycle 9, 9 were MRD negative and 1 showed disease progression. Conclusion: Safety data from the PRIME study demonstrates that VPD regimen has a favorable tolerance profile in patients with NDMM. Early efficacy signals are encouraging, and recruitment continues. [Formula presented] Disclosures: Radhakrishnan: Dr Reddy's Laboratories: Honoraria, Membership on an entity's Board of Directors or advisory committees;Emcure Pharmaceuticals: Research Funding;Intas Pharmaceuticals: Research Funding;Janssen India: Honoraria;NATCO Pharmaceuticals: Research Funding;Novartis India: Membership on an entity's Board of Directors or advisory committees;Roche India: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding;AstraZeneca India: Honoraria, Speakers Bureau;Bristol-Myers-Squibb India: Membership on an entity's Board of Directors or advisory committees, Research Funding;Cipla Pharmaceuticals India: Research Funding;Aurigene: Speakers Bureau. Garg: Dr Reddys Laboratories: Honoraria, Speakers Bureau. Nair: Dr Reddy's Laboratories: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Intas pharmaceuticals: Honoraria, Speakers Bureau;Mylan pharmaceuticals: Honoraria;Novartis India: Honoraria;Fresenius Kabi India: Honoraria;Cipla Pharmaceuticals: Honoraria, Speakers Bureau;Janssen India: Honoraria, Speakers Bureau. Chandy: Janssen: Honoraria;Pfizer: Honoraria;Intas Pharmaceuticals: Research Funding.

Perceived stress among doctors working in a dedicated COVID-19 hospital in North India

Objectives: The present study was aimed to assess the level of perceived stress among doctors working in COVID-19 ward in a tertiary care medical college and hospital of North India and to find the association of stress with time spent in ward, age, and designation of the doctors. Material and Methods: It was a cross-sectional, Google-based survey conducted in October and November 2020. The form was circulated and recorded the sociodemographic data, time spent in the COVID-19 ward, etc. The perceived stress scale (PSS) was used to assess the level of stress. Appropriate statistical analysis was used and all ethical considerations were followed.

Spatial and temporal variations of air pollution over 41 cities of India during the COVID-19 lockdown period.

In this study, we characterize the impacts of COVID-19 on air pollution using NO2 and Aerosol Optical Depth (AOD) from TROPOMI and MODIS satellite datasets for 41 cities in India. Specifically, our results suggested a 13% NO2 reduction during the lockdown (March 25-May 3rd, 2020) compared to the pre-lockdown (January 1st-March 24th, 2020) period. Also, a 19% reduction in NO2 was observed during the 2020-lockdown as compared to the same period during 2019. The top cities where NO2 reduction occurred were New Delhi (61.74%), Delhi (60.37%), Bangalore (48.25%), Ahmedabad (46.20%), Nagpur (46.13%), Gandhinagar (45.64) and Mumbai (43.08%) with less reduction in coastal cities. The temporal analysis revealed a progressive decrease in NO2 for all seven cities during the 2020 lockdown period. Results also suggested spatial differences, i.e., as the distance from the city center increased, the NO2 levels decreased exponentially. In contrast, to the decreased NO2 observed for most of the cities, we observed an increase in NO2 for cities in Northeast India during the 2020 lockdown period and attribute it to vegetation fires. The NO2 temporal patterns matched the AOD signal; however, the correlations were poor. Overall, our results highlight COVID-19 impacts on NO2, and the results can inform pollution mitigation efforts across different cities of India.