Coagulopathy: A Vicious Indicator of COVID-19

COVID-19 is routinely associated with coagulopathy and complications associated with thrombosis. However, the difference between the coagulopathy, which is associated with COVID-19 and the coagulopathy, which is due to different causes, is that the "COVID-19 associated coagulopathy" shows raised levels of D-Dimer and that of fibrinogen. However, it shows quite some abnormalities in the levels of prothrombin time and also in the platelet count. "Venous thromboembolism" and arterial thrombosis is frequently seen in COVID-19 associated coagulopathy as opposed to "disseminated intravascular coagulopathy". Patients suffering from COVID-19 have many have multiple factors in common for thromboembolism which is associated with "Adult respiratory distress syndrome" from different etiologies like generalized inflammation and being unambulatory. "Cytokine storm" is the hallmark of COVID-19 associated coagulopathy which is distinguished by high levels of IL-6,1, tumour necrosis factor and other cytokines. The clinical features of COVID-19 associated coagulopathy overlap that of some syndromes like antiphos-pholipid syndrome and thrombotic microangiopathy. Studies have shown that patients diagnosed with disseminated intravascular coagulation have a poor prognosis compared to the one's that don't get diagnosed with DIC. The advancement of the condition from coagulopathy in the vasculature of the lungs to DIC in patients who have tested positive for COVID-19 shows that the patient's dysfunction associated with coagulation has evolved from local to generalized state. Investigating the coagulopathies will help in understanding the mechanism of COVID-19 associated coagulopathy.Copyright © International Journal of Research in Pharmaceutical Sciences.

Characteristics Of Heart Failure Clinical Trials Registered In Clinicaltrials.gov- A Cross Sectional Analysis

Purpose: To perform an analysis of trends and characteristics of heart failure (HF) trials registered in ClinicalTrials.gov (CTG). Design(s): Cross-sectional study Methods: All heart failure clinical trials registered on CTG from September 27, 2007 to March 31, 2022 were identified using Advanced Search feature in ClinicalTrials.gov. Trial characteristics were assessed through relative frequency calculations. Hazard ratio and 95% confidence intervals were determined for characteristics associated with early discontinuation. Result(s): A total of 4272 clinical trials were registered in CTG during this period. There were 68.8% interventional studies and 31.2% were observational studies. Patient registry studies constituted 15.8% of observational studies. Interestingly, registry studies in HF were more frequent compared overall clinical studies (4.8% vs 2.5%). In HF, 32.4% trials were funded by industry, 6.6% trials were by funded the National Institute of Health (NIH) and other U.S Federal agencies (FA) and 61.8% trials by all others which includes individuals, universities, research organizations etc. Observational studies constituted 28% of the industry sponsored trials in HF versus 15% of the total registered clinical trials. Completion rate were 58.9% for NIH and FA funded trials as compared to 50% for industry sponsored and 38.9% for other sponsored. Discontinuation rates were 9.6% for NIH and FA funded trials as compared to 16.8% for industry sponsored. On the other hand unknown status of the trial was higher for other sponsors (19.8%) as compared to NIH and FA (3.2%) and industry sponsors (9.3%). Trend analysis for last 15 years showed an increasing number of clinical trials in HF each year. During the two years of COVID-19 pandemic (April 2020 to March 2022) 15.5% total number of trials registered were in HF even though the number of NIH and FA funded trials decreased by 28.9%. This was much higher than the previous two years (April 2018 to March 2020). Total of 492 trials (11.52%) were withdrawn, suspended or discontinued early. Trials were less likely to be discontinued if funded by sources other than industry and NIH considered together (OR 1.93;X2= 47.50;p<0.01). A detailed analysis of various phases of trials and trends of discontinued trials will also be presented. Conclusion(s): Number of clinical trials in HF are increasing. Registry trials and observational studies are more common in HF. Number of HF trials increased during COVID-19 pandemic. Trials funded by NIH and FA have better completion rate, whereas discontinuation rates were much higher for industry sponsored trials.Copyright © 2022

Engineering of silk fibroin bio-nanocomposites: A glimpse of advanced research on innovative formulations for potential applications

Silk Fibroin is widely used as a green biomaterial in various fields of research like textiles, biomedical engineering biotechnology, electronics, photonics and energy research. This is because SF can be reconstituted in numerous forms by physical and chemical processes in numbers of studies have attempted to incorporate addition to its unique functional aspects that can be incorporated into SF while maintaining its beneficial natural characters. This new area of biotechnology with bio-nanocomposites is the result of breakthroughs in nanoscience and nanotechnology. SF bio-nanocomposites and their innovative applications for the use of these SF bio-nanocomposites materials have been developed in recent years and these are documented in previous chapters of this book. In this chapter, we report on the advanced research of the engineering of silk fibroin bio-nanocomposites suitable for emerging technologies. Though the formulation of silk fibroin is a natural process, carried out with silkworms, it can be modified with the mulberry leaves which are the silkworm feed. Further, silk fibroin can be changed by doping rare earth elements or by incorporating their nanoparticles at different stages of its formulations. Thus, the properties of silk fibroin are engineered suitably to meet the requirements of various devices with different methods reported recently in the literature. Lastly, the hypothetical applications of silk fibroin in protecting healthcare buildings (hospitals) from pathogenic infections specifically with photocatalytic disinfection of pathogens have been reported in this chapter. This innovative emerging potential application of silk fibroin seems to be an attractive solution to control the spread of communicable diseases like COVID-19. The chapter ends with a report on a recent method based on microwave applications in which formulation of time SF bio-nanocomposites. This modification is reduced synthesis time from 52 hours to 4 hours. This alteration is predicted as a significant step towards commercialization of formulation of SF bio-nanocomposites technologies newly developed in recent years. © 2023 Nova Science Publishers, Inc.

Silk Fibroin/PVA/ZnO nanocomposites wound dressings

Impaired wound recovery can fail to local hypoxia or tissue necrosis and ultimately result in abnormality or even death. Several factors can influence the wound healing environment, including bacterial or fungal infections, different disease states, desiccation, edema, and even systemic viral infections such as COVID-19. Silk fibroin, the fibrous structural-protein component in silk, has emerged as a promising treatment for these impaired processes by promoting functional tissue regeneration. Silk fibroin's dynamic properties allow for customizable nanoarchitectures, which can be tailored for effectively treating various wound healing impairments. Wound dressing materials designed from biocompatible and biodegradable polymersare widely used in wound healing. The present investigation deals withthe preparation of a unique blend of Silk Fibroin (SF)-Polyvinyl Alcohol (PVA) and ZnO nanoparticles (NPs) composite film (SF-PVAZnO NPs). The comparison of blend of SF- PVA and SF-PVA-ZnO Ps composite films were studied. The physical-chemicalcharacterizations of synthesized ZnO NPs and prepared composite films (SF-PVA and SF-PVA-ZnO) were studied. The field emission scanning electron microscopy confirmed the ZnO NPs embedded into SF-PVA composite film. The SF-PVA-ZnO NPs composite film showed enhanced mechanical property due to ZnO NPs. Antibacterial activity of the prepared composite filmsreveals that embedded ZnO NPs shows excellent antibacterial activity against wound infection-causing microorganisms. SF-PVA-ZnO composite film showed enhanced swelling behavior and faster blood clotting ability compared to control SF-PVA composite film. In-vitro cytocompatibility study exhibits the nontoxic nature of the synthesized SF-PVA-ZnO composite film. These studies confirm the designed composite film holds a huge potential to be used in dressing material for infected wound. © 2023 Nova Science Publishers, Inc.

Impact of SARS-CoV-2 pandemic on Sleep Quality

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.

Teaching vaccine development in schools: Learnings from a survey and curriculum design for a course

Although vaccines are being developed and administered to people for more than a century, the understanding of the steps involved in vaccine development is a relatively new subject to the general public. During the current pandemic, there has been an explosion of non-validated news about COVID-19 and vaccines. To enhance the understanding of this critical societal science, there is an urgent need to teach these topics in the early education systems. Defining the essential subjects and courses for high school and developing syllabi for undergraduate courses in immunology and vaccinology can be difficult, as students choose diverse career options after their studies. To define these curricula, understanding the current level of awareness regarding vaccinology and immunology among students becomes essential. Thus, we have undertaken an exploratory survey of 650 high school and undergraduate college students in India on their awareness of the processes of vaccine development. Our results confirmed our hypothesis that there is a very limited understanding of this topic among school-going students. In this article, we propose an outline for a course for teaching in high schools. We recommend that this course should be interdisciplinary and a mix and match of majors and minors. It should train students with soft skills and prepare them for their careers in biomedical research. Copyright © 2023 Ghosh, Lalsare, Chirmule, Khare, Kalakuntla, Zarkar, Pawar and Sheth.

Importance of Antiviral and Antibacterial Face Mask Used in Pandemics: An Overview

Community-wide mask wearing may contribute to the control of COVID-19 by reducing the amount of emission of infected saliva and respiratory droplets from individuals with subclinical or mild COVID-19. In this work, a brief review is presented on face masks and related things. First, the size of microorganisms in relation to PM2.5 and PM10 is given for an approximate estimate of the sizes of objects that needs to be filtered. In continuation, the principles of filtration of objects by the network of fibers (woven, non-woven, knitted, etc.) are given. Common fibers used for making face mask is presented along with various fabric structure and their manufacturing. Additionally, advancements like the treatment of fibers in terms of coated fabrics, nano-particle finishes, and green synthesized nano-particle coatings have been explained in view of their anti-bacterial and anti-viral properties. The classification of the face masks based on their fabric make-up has been given which has been extended to classification based on the barrier properties and various efficiencies of the face masks. The characterization of face masks like particle filtration efficiency, bacterial filtration efficiency, breathing resistance, flash resistance, and flame resistance are also included.

Effect of covid 19 situation on stress level of Undergraduate Students: a study from Karad

Stress is a component of students' lives, and it can impair their ability to manage the academic rigours of college life. Their regular labour presents numerous obstacles, resulting in tension. Several studies indicate that there is an immediate need to analyse the influence of the present pandemic scenario on the mental health and well-being of students, which justifies conducting such research in multiple Indian states, including Maharashtra. Purpose of the study: The purpose of the study was to determine the prevalence of depression among patients with chronic renal disease and the relationship between depression prevalence and chosen sociodemographic characteristics. 300 nursing students were enrolled in the current study. It was a descriptive cross-sectional study design. In this investigation, a convenient sampling strategy was adopted. The research was conducted at the Karad Krishna Institute of Nursing Sciences. Utilizing the perceived stress scale, the depression was evaluated. Using descriptive and inferential statistics, the acquired data were evaluated and analysed.56.66% of the students in the present study had moderate stress, 26.33 % had high stress, and only 17% of the participants had a low stress level. The data indicate that nursing students had a moderate amount of stress due to the covid scenario. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

A study to determine knowledge of COVID 19 among rural area families

The SARS-CoV-2 virus is the infectious agent that causes the corona virus illness (COVID-19). This virus can cause mild to moderate respiratory sickness in infected individuals, but they can recover without the need for special medical care. Little was known about the level of COVID-19 knowledge among inhabitants in such a dire scenario. The purpose of the study was to ascertain the general population's degree of knowledge and attitude toward COVID-19 in Karad Taluka. METHOD(S): For this study, 300 residents of Kale Village who are part of the community were enrolled. The design of the study was cross-sectional. For this investigation, a practical sampling strategy was employed. Participants' knowledge and attitude were evaluated using a structured knowledge questionnaire. In the two months from December 2021 to January 2022, data collecting was finished. RESULT(S): The majority of participants, 180 (60%) had average knowledge of Covid 19, 100 (33.33%) had bad knowledge, and only 20 (6.66%) of the individuals had strong understanding of Covid 19. People have a favourable view toward covid 19. CONCLUSION(S): The data show that people have a positive attitude and have an average level of knowledge of COVID 19. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Impact of SARS-CoV-2 pandemic on Sleep Quality

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. Copyright © 2022 Ubiquity Press. All rights reserved.

Title-Perspective of methemoglobin, hemoglobin, lactate dehydrogenase and C reactive protein levels in covid-19 patients with diabetes mellitus

Objectives: Dynamics of COVID-19 disease are changing with the emergence of the new variant of the COVID virus. Still, the severity of this disease is associated with comorbid conditions like diabetes mellitus (DM), hypertension, etc. and several biomarkers are studied. The objectives of the study were to estimate methemoglobin (Met-Hb), hemoglobin(Hb), lactate dehydrogenase (LDH) and C reactive protein(CRP) levels in COVID-19 patients with DM and without DM and then to compare between two groups. Materials and methods: This observational study was conducted in 40 COVID-19 patients with DM and 40 COVID-19 patients without DM from June 2021 to October 2021 in the biochemistry department of a tertiary care hospital. For all patients, estimation of Met-Hb, Hb, LDH and CRP levels were estimated on the 2nd-3rd day of hospital admission. Results: Met-Hb, LDH and CRP levels were significantly high and Hb levels were significantly low in elderly COVID-19 patients with DM than in those without DM (P<0.05). There was a significant positive correlation between Met-Hb with LDH and Met-Hb with CRP in both groups and a significant negative correlation was found between Met-Hb with Hb in the diabetic group. Conclusion: In elderly patients, diabetes is one of the important and independent risk factors for the severity of COVID-19 disease. Derangement of Met-Hb along with LDH and CRP shows the need for routine monitoring of Met-Hb. This may open new options in the treatment of COVID-19 disease with DM and improve outcomes in the future.

Early versus Late Awake Prone positioning in COVID-19 Patients

Background: Awake prone positioning (APP) under CARP protocol is widely used in the management of patients with coronavirus disease (COVID-19) in recent years. The primary objective of this study was to compare the outcome. Aim: Compare the outcome of COVID-19 patients who received early versus late awake prone position in terms of oxygenation, patient comfort, increased nonventilatory days, and final outcome. Settings and design: Single centre, retrospective and observational study. Materials and methods: Analysis of data collected for a randomized controlled trial in adult patients with acute hypoxemic respiratory failure secondary to COVID-19, who received awake prone positioning under CAPR protocol for minimal one hour were included. Early prone positioning was defined as APP initiated within 24 h of high-flow nasal cannula (HFNC) start. 50 patients were included in the study. Primary outcomes were patient comfort, hospital stay, complications during ICU stay, 28-day mortality, and intubation rate. Statistical analysis: Data analysis was done using SPSS software. P value < 0.05 was considered statistically significant. Results: We included 50 patients between the ages of 18 and 60 years. The early APP group had lower mortality compared to the late APP group but no difference was found in intubation rate. Advanced age, intubation, longer time to initiate APP were associated with increased mortality. Conclusion: Early initiation (< 24 h of HFNC use) of APP in acute hypoxemic respiratory failure secondary to COVID-19 improves 28-day survival.

Development of a clinical score for the use of nebulizers in primary care through consensus by an expert working group

Background: The use of nebulizers is an important and useful method for delivering drugs to the lungs in patients with various airway and lung parenchymal disorders. Use of nebulization had markedly increased during the COVID-19 pandemic. This had raised concerns about the potential spread of infection to others in the surroundings exposed to the virus dissemination through aerosolized particles. We considered it necessary to ensure appropriate use of nebulizers by primary care physicians and therefore developed a simple nebulization score to decide when to use nebulizers. Methods: An expert working group (EWG) of pulmonologists was formed who using a semi-Delphi method developed a list of variables and a cut-off score. The EWG started with 55 variables developed through an exhaustive review of literature. These were further reduced to smaller number that had the maximum score as well as concordance with the EWG. The scores ranged from 1-10 (completely disagree to completely agree) and only those above 7.5 were selected. Results: A total of 8 variables with the highest scores were selected [Table 1] which had a total maximum score of 40. A score of <15 was suggested to indicate not-to use and >20 to suggest a definite-use of nebulizer. A score between 15-20 was suggested to use as per physician judgement. A separate table of 12 conditions was made where use of nebulizers was mandatory. Conclusion: This first of its kind nebulizer score should be used by primary care physicians to decide which patients should be put on nebulization treatment.

A Survey to Assess the Impact of COVID-19 Pandemic on Lifestyle in an Adult Age Group

Context • A healthy lifestyle has been the need of the hour during the COVID 19 pandemic. Analyzing the current lifestyle patterns of many individuals can be the basis for finding solutions toward building a healthy future for India. Objectives • The study intended to evaluate the current lifestyles of adults in an urban setting in the midst of a pandemic and to examine the diseases that people could face with respect to their current lifestyles. Design • The research team performed a cross-sectional study. Setting • The survey was conducted in an urban setting in the Pimpri Chinchwad area of Pune, India. Participants • Participants were 500 men and women between the ages of 18 and 25. Outcome Measures • The research team created a survey with 13 multiple-choice questions. Results • The pandemic has taken a toll on people’s mental and physical health. Social distancing and staying indoors for long periods are factors that have affected people’s mental health. Conclusions • Efforts need to be made by individuals to focus not only on their physical health but also on their mental health. (Altern Ther Health Med. [E-pub ahead of print.]). © 2022, InnoVision Communications. All rights reserved.

Review of jatwadi dhoom agad as a proposed fumigation product for mosquito repellent and antimicrobial action

Ayurveda has given much importance to prevent the diseases by stating var-ious measures. Medicated smoke fumigation (Dhoopana) is one of such measures described for disinfection as well as protection from poisonous animals and insects. Herbal, herbo-mineral and animal origin formulations containing volatile oil and having antimicrobial property are used for medicated smoke fumigation. Fumigation with such drugs is safe, natural and cost effective technique. Mosquito borne diseases are major human health problem in all tropical and subtropical countries by affecting millions of people each year. Commercial repellents like Allethrin, DEET have been reported many harmful effects for humans. There is a need for further standardised studies in order to develop new products that offer high repellency as well as good consumer safety. A review is planned to investigate ingredients of Jatwadi Dhoom Agad through analyzing published experimental research work. Out of eight ingredients of Jatwadi Dhoom Agad, two showed mosquito repellent effect and three have mosquito larvicidal effect. This paper is foot step in the efforts to estab-lish probable mode of action of Jatwadi Dhoom Agad as insect repellent. The effect of smoke of these drugs may be repellent for mosquitoes. All drugs have shown antimicrobial activity in vitro. This product has potential to be used as fumigation product in current COVID 19 pandemic.

COVID 19: recent updates on SARS-CoV-2 and preventing its community transmission in India by 21 days lockdown. (Special Issue: Coronaviruses and COVID-19- Past, Present, and Future.)

The current pandemic of COVID-19 has caused havoc all over world since its emergence and rapid spread. Within three months the virus SARS-CoV-2 which was isolated from pneumonia cases in Wuhan City, Hubei Province, China in late December 2019, has affected almost all countries. India reported its first case of COVID-19 from state of Kerala on January 30, 2020, a student returned from city of Wuhan. Till date in India the disease had affected 12759 patients with 420 deaths. With every passing day the mysterious virus is been uncovered with its unique characteristics enabling the researcher to unfold the various methods including hand washing and social distancing to curtail the pandemic. Measures like 21 days lockdown to certain extent are effective but considering asymptomatic spreaders, extended measured lockdowns will be useful in the long term war against COVID-19. Till the vaccine and therapeutic solutions are derived, answer to pandemic and SARS-CoV-2 lies in lockdown, social distancing, contact tracing and containment.

Assessment of the possible causes of diabetes mellitus developed in patients post covid-19 treatment in a tertiary care hospital

Objective: Novel COVID-19 virus is extensively being studied for its long-term effects. A predominant trend of development of Diabetes Mellitus (DM) in Covid-19 patients is being observed, and hence further relation is explored in this study. Methods: This is an observational inductive retrospective study conducted for four months in a tertiary care hospital. The study included subjects who recovered from COVID-19 and were treated post-COVID-19 in the hospital. The subjects who had stable glucose counts were excluded. The data obtained from the medical record department encompassed demographic details and clinical data of the patient. The data were tabulated, and observations were reported using descriptive analysis. Results: Among 5632 admitted patients for COVID-19, 694 came for follow-up. 105 patients were re-admitted, but 11 had newly developed DM, and 14 observed uncontrolled DM managed by medical attention. The reported incidence rate in Newly-Diagnosed DM was 0.195%, and the person above 41 y was at greater risk. Similarly, the incidence rate in Uncontrolled-DM was 13.33%, and persons above 47 y were at greater risk. It was found that both these categories of patients had comorbidities, and the development of this was seen between the 25th-40th day. In both cases, males were more prone than females. Conclusion: The study reports a bi-directional relationship between Covid-19 and DM. The use of steroids may have stepped-up this relationship. Cautious use of steroids, changes in the hospital formulary, and further quantitative clinical investigations are primary recommendations that may prevent such episodes.

Meropenem Induced Severe Thrombocytopenia in an Adult Patient: A Case Report

Drug induced immune thrombocytopenia is a serious life-threatening clinical condition, the diagnosis of which is often very difficult, and mainly performed on clinical criteria and rarely on confirmatory laboratory tests. A 52-year-old male, post Covid-19 patient, admitted to the hospital for the management of severe vomiting and abdominal pain, developed sepsis, and started with meropenem as an empirical anti-microbial agent. After two days of therapy, the patient presented with severe oral gingival bleeding, thrombocytopenic purpura, and severe thrombocytopenia, which was also accompanied by lymphopenia in the patient. The clinical significance of this case encouraged us to report this rare complication of meropenem. The health-care professionals and caretakers should be aware of this adverse drug reaction so that it can be promptly diagnosed and managed.

Supporting efforts to address malnutrition in the context of the COVID-19 pandemic in India: An emergency need

India has been on a steady march to address malnutrition in the last decade. The nutrition community has worked on building consensus on key actions, implementation platforms were put in place and financing for nutrition slowly increased. Under the strong leadership of the Prime Minister, a revolutionary program to address malnutrition was launched in 2018. As actions under the mission accelerated, the COVID-19 pandemic arrived in early 2020. Affecting health systems, food systems, nutrition programs, social safety nets, and the economy, the pandemic has the potential to exacerbate the challenge of malnutrition in multiple ways. India can mitigate some of the possible ways in which COVID-19 will affect malnutrition but will require strong leadership and continued commitment, adaptation of the national nutrition mission, strengthening of the social safety net and innovative evidence-based data to take informed decisions, implement them and ensure feedback to take necessary corrective action. In this article, we outline some challenges and key areas for action. We conclude that India's nutrition journey is too important to be derailed by a crisis like COVID-19. This is a clarion call for the nutrition community in India to rally strongly to support continued attention to malnutrition in all its forms, to generate relevant evidence, and to support and engage all of society to urgently and adequately address malnutrition in the context of the COVID-19 pandemic. We have come too far to turn back now. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.

Knowledge, attitude, and practices among police force toward covid-19 pandemic during Lockdown in Pune, India - An Online cross-sectional survey

Background: COVID-19 has affected millions of people and more than thirty thousand deaths. Social distancing and lockdown are important measures for prevention. Police personnel are losing their lives due to COVID-19 while doing their duty in this lockdown time. Aim: The study aims to assess knowledge, attitude, and practices (KAP) of police force toward COVID-19. To assess correlation of knowledge with their practices and attitude. Materials and Methods: A cross-sectional, self-administered, anonymous survey questionnaire was administered to 8706 police personnel and data collected over a time period from April 11 to 16, 2020. We used t-test and multivariable binary logistic regression analysis to identify the association between KAP and demographic variables. Results: In all 8706 police personnel participated in the study. The median age of participants was 35 years (interquartile range: 19-59), 6787 (77.9%) were male, 6675 (76.6%) were of constable grade. Seven thousand three hundred thirty-two (83.7%) of participants recorded accurate (high) knowledge, and 6790 (78%) reported following preventive practices. Female participants were more likely to follow preventive measures despite low knowledge as compared to their male counterparts (P < 0.0001). Female gender, age more than 35 years, and lower rank were associated with low knowledge and fear of contracting the disease. Multivariable binary logistic regression analysis showed that low knowledge is significantly associated with fear of getting disease odds ratio 1.29;95% confidence interval (1.15-1.46). Conclusion: In a cohort of police personnel, overall knowledge about COVID-19 is high. Female participants are found to be practicing appropriate preventive measures and they have faced stigmatizing behavior from society. The study provides important information on the need for developing health awareness programs to improve COVID-19 KAP. © 2021 Medical Journal of Dr. D.Y. Patil Vidyapeeth.