Impact of COVID-19 pandemic on health service utilisation and household economy of pregnant and postpartum women: a cross-sectional study from rural Sri Lanka.

OBJECTIVES: This study aims to describe how household economies and health service utilisation of pregnant and postpartum women were affected during the pandemic. DESIGN: A cross-sectional study. SETTING: This study was conducted in the Anuradhapura district, Sri Lanka. PARTICIPANTS: The study participants were 1460 pregnant and postpartum women recruited for the Rajarata Pregnancy Cohort during the initial stage of the COVID-19 pandemic. PRIMARY AND SECONDARY OUTCOME MEASURES: Household economic (income, poverty, nutritional and health expenditures) and health service utilisation details during the COVID-19 pandemic were gathered through telephone interviews. Sociodemographic and economic data were obtained from the cohort baseline and analysed with descriptive and non-parametric analysis. RESULTS: Out of the 1460 women in the sample, 55.3% (n=807) were pregnant and 44.7% (n=653) were postpartum women. Of the total sample, 1172 (80.3%) women participated in the economic component. The monthly household income (median (IQR)=212.39 (159.29-265.49)) reduced (median (IQR)=159.29 (106.20-212.39)) in 50.5% (n=592) families during the pandemic (Z=-8.555, p<0.001). Only 10.3% (n=61) of affected families had received financial assistance from the government, which was only 46.4% of the affected income. The nutritional expenditure of pregnant women was reduced (Z=-2.023, p=0.043) by 6.7%. During the pandemic, 103 (8.8%) families with pregnant or postpartum women were pushed into poverty, and families who were pushed into poverty did not receive any financial assistance. The majority of women (n=1096, 83.3%) were satisfied with the free public health services provided by the public health midwife during the pandemic. CONCLUSION: During the early stages of the pandemic, healthcare utilisation of pregnant women was minimally affected. Even before the country's current economic crisis, the household economies of pregnant women in rural Sri Lanka were severely affected, pushing families into poverty due to the pandemic. The impact of COVID-19 and the aftermath on pregnant women will have many consequences if the policies and strategies are not revised to address this issue.

Adaptive 3D and VFX Films Virtual Learning Environments

In this study, the analysis of the topic 'Adaptive 3D and VFX Films Virtual Learning' has been provided. As virtual learning and 3D technologies use are increasing, the interest in their learning in academic discussion is increasing daily. However, there are various drawbacks to the use of3D for learning environments. To solve this drawback, the use of adaptive learning environments is increasing more, such as an environment that can dynamically adapt to the learner and the activities that can be performed by that specific learner. As the new ways of learning have been increasing over the past years (in the times of the COVID-19 Pandemic) through the use of computers in the educational sector. The learning environment has been widely adopted by the educational sectors in the case of obtaining promising outcomes. In recent years, these environments have evolved into more advanced environments with the implication of3D technology. With the help of 3D, these adaptive environments are helping learners according to their preferences. © 2022 IEEE.

Clinical Characteristics and Outcomes of Laboratory-Confirmed SARS-CoV-2 Cases Infected With Omicron Subvariants and the XBB Recombinant Variant.

Background SARS-CoV-2 has evolved to produce new variants causing successive waves of infection. Currently, six variants are being monitored by the World Health Organization that are replacing BA.5. These include BF.7 (BA.5 + R346T in spike), BQ.1 (and BQ.1.1, with BA.5 + R346T, K444T, N460K mutations in spike), BA.2.75 (including BA.2.75.2 and CH.1.1), and XBB (including XBB.1.5). BQ.1 and XBB variants are more immune evasive and have spread quickly throughout the world. Concerning the potential severity of infections caused by these variants, the present study describes the clinical characteristics and outcomes of these major variants in Maharashtra. Methodology A total of 1,141 reverse transcriptase-polymerase chain reaction (RT-PCR)-positive SARS-CoV-2 samples, with a cycle threshold (Ct) value of less than 25, were processed for SARS-CoV-2 whole genome sequencing between July 10, 2022, and January 12, 2023. All corresponding demographic and clinical data were recorded and analyzed using Microsoft® Excel and Epi Info™. Results Out of the 1,141 samples sequenced, BA.2.75* (63.78%) was the predominant Omicron variant, followed by the XBB* (18.88%), BA.2.38* (4.94%), BA.5* (4.06%), BA.2.10* (3.51%), and BQ.1* (1.65%). A total of 540 cases were contacted telephonically, of whom 494 (91.48%) were symptomatic with mild symptoms. Fever (77.73%) was the most common symptom, followed by cold (47.98%), cough (42.31%), and myalgia and fatigue (18.83%). Of the 540 cases, 414 (76.67%) cases recovered at home, and 126 (23.33%) were institutionally quarantined/hospitalized. Among the home-isolated and hospitalized cases, 416 (99.76%) and 108 (87.80%), respectively, recovered with symptomatic treatment, while one (0.24%) and 15 (12.20%), respectively, succumbed to the disease. Out of the 540 cases, 491 (90.93%) were vaccinated with at least one dose of the COVID-19 vaccine, 41 (7.59%) were unvaccinated, and for eight (1.48%) cases, vaccination data was not available. Conclusions The current study indicates that the XBB* variant is causing mild disease in India. However, as XBB* possesses both immune-escape and infectivity-enhancing mutations, it has the potential to spread to other parts of the world rapidly. Further, anti-SARS-CoV-2 vaccination improves survival rates in COVID-19.

Chasing SARS-CoV-2 XBB.1.16 Recombinant Lineage in India and the Clinical Profile of XBB.1.16 cases in Maharashtra, India (preprint)

ABSTRACT Background: SARS-CoV-2 has evolved rapidly, resulting in emergence of lineages with competitive advantage over one another. Co-infections with different SARS-CoV-2 lineages can give rise to recombinant lineages. To date, XBB lineage is the most widespread recombinant lineage worldwide, with the recently named XBB.1.16 lineage causing a surge in the number of COVID-19 cases in India. Methodology: The present study involved retrieval of SARS-CoV-2 genome sequences from India (between 1st December 2022 and 8th April 2023) through GISAID; sequences were curated, followed by lineage and phylogenetic analysis. Demographic and clinical data from Maharashtra, India were collected telephonically, recorded in Microsoft (R) Excel, and analysed using IBM (R) SPSS statistics, version 29.0.0.0 (241). Results: A total of 2,944 sequences were downloaded from the GISAID database, of which 2,856 were included in the study following data curation. The sequences from India were dominated by the XBB.1.16* lineage (36.17%) followed by XBB.2.3* (12.11%) and XBB.1.5* (10.36%). Of the 2,856 cases, 693 were from Maharashtra; 386 of these were included in the clinical study. The clinical features of COVID-19 cases with XBB.1.16* infection (XBB.1.16* cases, 276 in number) showed that 92% of those had a symptomatic disease, with fever (67%), cough (42%), rhinorrhoea (33.7%), body ache (14.5%) and fatigue (14.1%) being the most common symptoms. Presence of comorbidity was found in 17.7% of the XBB.1.16* cases. Among the XBB.1.16* cases, 91.7% were vaccinated with at least one dose of vaccine against COVID-19. While 74.3% of XBB.1.16* cases were home-isolated; 25.7% needed hospitalization/institutional quarantine, of these, 33.8% needed oxygen therapy. Out of 276 XBB.1.16* cases, seven (2.5%) cases succumbed to the disease. Majority of XBB.1.16* cases who died belonged to an elderly age group (60 years and above), had underlying comorbid condition/s, and needed supplemental oxygen therapy. The clinical features of COVID-19 cases infected with other co-circulating Omicron variants were similar to XBB.1.16* cases. Conclusion: The study reveals that XBB.1.16* lineage has become the most predominant SARS-CoV-2 lineage in India. The study also shows that the clinical features and outcome of XBB.1.16* cases were similar to those of other co-circulating Omicron lineage infected cases in Maharashtra, India. Keywords: XBB.1.16, XBB.1.16.1, XBB.1.16*, XBB, Omicron variant, COVID-19, SARS-CoV-2, Clinical features

Exploring the nature of Double Transitional Phases in Emerging Adults during COVID-19 Pandemic

Achieving Environmental Harmony: An Analysis Based on the Narratives From Mahabharata

The amplified development in science and technology has made the lifestyle of human beings fast-paced but much easier at the same time when compared to the previous eras. It is also notable that man has turned the impossible into possible with such advanced technology in various fields such as medicine, education, commerce, and so on. Human beings find it hard to communicate with their family members, friends, and peers because of their hurried mechanical life. Under such circumstances, it is obvious that man does not find time to harmonize with nature. The ancient Hindu writings portray nature as God and emphasize the fact that the worship of nature by humans and treating other living beings with respect maintained the ecological balance. Climate change and the proliferation of numerous pathogens are currently the greatest worries. Such threat-posing viruses not only place human lives in peril but also upset the ecosystem's balance. This paper analyses the select text Mahabharata whi ch is both an ancient literary text and a religious book to highlight the fact that the current ecological imbalance is the result of human indifference to nature. The study throws light on the narratives found in the select text to argue the same and puts forth the measures to attain environmental harmony. © 2023 ACADEMY PUBLICATION.

Innovative Changes to Study Abroad: Virtual Intercultural Learning during the Pandemic

Intercultural competence (ICC) is increasingly important for healthcare professionals, and study abroad (SA) programs have been one mechanism to increase students' ICC. With SA programs being cancelled due to the pandemic, and qualitative literature supporting virtual intercultural learning (ICL), the purpose of this paper is to describe a novel approach towards "study abroad" without traveling abroad and evaluate participant gains in ICC with a virtual international ICL experience embedded into a graduate level pediatric audiology course. Nine U.S students and ten students at a partner institution in India were enrolled in the course. Comparison of pre- and post-IDI® scores showed a significant increase in ICC in both groups of participants. The increase in the group mean score for the U.S. students was substantially higher than the group mean score increases in SA students from the same institution. Qualitative reflections support the quantitative data. Overall, results indicate that embedding virtual international ICL activities in a course can be an effective mechanism to enhance ICC, both for U.S. students without traveling abroad, and for the overseas partner students, indicating that the program was mutually beneficial.

Self-reported perspectives, Lived experiences and Assessment of COVID-19 survivors in India from media and social media during Nationwide lockdown: A Preliminary study.

Background: Coronavirus disease 2019 (COVID-19) pandemic poses a tremendous threat as a rapidly spreading disease, and has significant consequences on the global public health in particular to the psychological aspect of the survivors. The lived experiences require urgent documentation to tailor-make psychiatric assessments and long-term follow-ups. Aim: To explore adolescents' self-reported perspectives and lived experiences during their COVID-19 illness which was voluntarily shared through media and social media platforms during the nationwide lockdown in India. Methods: Being a preliminary study, the sample size was calculated as 20 based on similar studies in the literature. Voluntarily shared data of COVID-19 survivors were extracted from media and social media. Based on the data, an assessment sheet was prepared, pre-tested and shared with three observers via convenient sampling. Results: Male predominance was noted. The mean age was found to be 39.5 years. English was the most commonly uploaded language to communicate suffering. Instagram and YouTube were the most prevalent social media sites for self-reported experiences. The most prevalent physical symptom was fever and cough. Stress, anxiety and stigmatization were more commonly reported. Statistical significance was obtained between fear and end of life, depression and suicide, pain and isolation and worried with insomnia. Conclusion: COVID-19 not only affects physical health but also takes a toll on the mental health of the patients. There is a high prevalence rate of psychological distress among COVID-19 survivors, and we recommend a formal psychiatric assessment and long-term follow-up to understand the unique challenges faced by the COVID-19 survivors, with effective communication and empathy towards them.

Clinical Characteristics and Outcomes of Laboratory-Confirmed SARS-CoV-2 Cases Infected with Omicron subvariants and XBB recombinant variant (preprint)

Background: The SARS-CoV-2 has evolved to produce new variants causing successive waves of infection. Currently, six variants are being monitored by the World Health Organization that are replacing BA.5. These include BQ.1*, BA.5 with one or several of five mutations (R346X, K444X, V445X, N450D, N460X), BA.2.75*, XBB*, BA.4.6*, and BA.2.30.2*. BQ.1 and XBB variants are more immune evasive and have spread quickly throughout the world. With the concern of the potential severity of infections caused by these variants, the present study describes the clinical characteristics and outcomes of these major variants in Maharashtra. Material and Methods: A total of 1039 Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) positive SARS-CoV-2 samples, with a cycle threshold value (Ct) less than 25, were processed for SARS-CoV-2 whole genome sequencing between 10th July 2022 and 10th December 2022. All corresponding demographic and clinical data were recorded and analyzed using MicrosoftTM ExcelTM and Epi InfoTM. Results: Out of 1039 samples sequenced, 829 (79.79%) were assigned Pango lineages, of which BA.2.75 (67.31%) was the predominant Omicron variant, followed by the XBB* (17.13%), BA.2.38* (5.43%), BA.2.10* (3.62%) and BA.5* (3.50%). A total of 494 cases were contacted telephonically, of which 455 (92.11%) were symptomatic with mild symptoms. Fever (78.46%) was the most common symptom, followed by rhinorrhoea (46.37%), cough (42.20%), myalgia (19.56%) and fatigue (18.24%). Of the 494 cases, 379 (76.72%) cases recovered at home, and 115 (23.28%) were institutionally quarantined/ hospitalized. Among the home-isolated and hospitalized cases, 378 (99.74%) and 101 (87.83%) recovered with symptomatic treatment, whereas 01 (0.26%) and 14 (12.17%) succumbed to the disease, respectively. Of the 494 cases, 449 (90.89%) were vaccinated with at least one dose of the COVID-19 vaccine, 40 (8.10%) were unvaccinated, and for 05 (1.01%) cases, vaccine data was not available. Conclusion: The current study indicates that the XBB* variant is causing mild disease in India. However, as XBB* possess both immune-escape and infectivity-enhancing mutations, it has the potential to spread to other parts of the world rapidly.

An Early and Preliminary Assessment of the Clinical Severity of the Emerging SARS-CoV-2 Omicron Variants in Maharashtra, India.

BACKGROUND: The SARS-CoV-2 Omicron variants BA.2.74, BA.2.75, and BA.2.76 have appeared recently in India and have already spread to over 40 countries. They have acquired additional mutations in their spike protein compared to BA.2, branching away on the SARS-CoV-2 phylogenetic tree. These added mutations have raised concerns about the impact on viral pathogenicity, transmissibility, and immune evasion properties of the new variants. MATERIAL AND METHODS: A total of 990 Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) positive SARS-CoV-2 samples, with a cycle threshold value (Ct) less than 25, were processed for SARS-CoV-2 whole genome sequencing between June 3, 2022 to August 7, 2022. All corresponding demographic and clinical data were recorded and analyzed using Microsoft® Excel. RESULTS: Out of 990 samples sequenced, BA.2.75 (23.03%) was the predominant Omicron sublineage, followed by BA.2.38 (21.01%), BA.5 (9.70%), BA.2 (9.09%), BA.2.74 (8.89%) and BA.2.76 (5.56%). A total of 228 cases of BA.2.74, BA.2.75, and BA.2.76 were contacted by telephone, of which 215 (94.30%) were symptomatic with mild symptoms, and 13 (5.70%) had no symptoms. Fever (82.02%) was the most common symptom, followed by cough (49.12%), cold (35.97%), fatigue (27.19%), headache (21.05%), and myalgia (20.61%). Of the 228 cases, 195 (85.53%) cases recovered at home, and 33 (14.47%) required institutional quarantine. Recovery with conservative treatment was observed in 92.98% of cases, while 4.83% required additional oxygen therapy. Only three (1.32%) cases had poor outcomes resulting in death, and the remaining 225 (98.68%) survived. Among the 228 cases, 219 (96.05%) cases were vaccinated with the COVID-19 vaccine; of these, 72.60% had received both doses, 26.03% had also received the precautionary booster dose, while 1.37% were incompletely vaccinated with a single dose of vaccine. CONCLUSION: The current study indicates that the three BA.2 sublineages are causing mild disease in India. However, BA.2.75 has key mutations that are notable for accelerated growth and transmission and require close and effective monitoring.

A Wake-up Call: Covid-19 and Its Impact on Reforming Biosciences Education Towards Resiliency and Sustainability

COVID-19's global pandemic has had a significant impact on bioscience education, which has switched to online learning. Every entity within the higher education ecosystem, whether technical, pedagogical, or social, has faced a number of challenges as a result of this. Regardless, biosciences education stakeholders have been fast to implement innovative strategies to maintain high standards and quality of biosciences online teaching and learning. This paper focuses on the biosciences education transition toward developing resiliency, as well as the technology resources and approaches that have been deployed in the current context to change biosciences education to be robust in the face of the COVID-19 upheaval. Finally, significant insights into 'resilience sustainability' approaches that may be employed in relation to the digitisation of biosciences education in a concerted effort to promote resiliency, adaptability and sustainability in biosciences education are presented. © 2022 UPM Press. All rights reserved.

Deployment of Cellular Application Using Flutter for Covid-19 Visualization

Coronavirus disease 2019 (COVID-19) is caused by a new virus called SARS-CoV-2. Its impact on public health creates adverse effects. Because it is a brand-new virus, scientists are getting to know more every day. Although the majority who've COVID-19 have slight symptoms, COVID- 19 can also cause intense infection or even demise. a few corporations, together with older adults and those who've certain underlying scientific conditions, are at accelerated risk of extreme contamination So monitoring and Visualization of COVID-19 cases and simply representing the information for a higher understanding of the COVID-19 instances around the world helps humans recognize the present-day state of affairs and to try this a cellular application is a fine way. In this paper, We summarize and illustrate with examples the way to amass and Visualize the statistics of the COVID-19 cases in a cellular application using Flutter. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Blepharoconjunctivitis and Otolaryngological Disease Trends in the Context of Mask Wearing during the COVID-19 Pandemic.

(1) Purpose: In 2020, wearing of face masks was mandated in the United States in an effort to lessen transmission of the novel 2019 coronavirus disease (COVID-19) pandemic; however, long-term mask wearing may present with unintended side-effects in both ophthalmic and otolaryngologic clinical practice. This study aims to examine if mask wearing increased the incidence of primarily chalazion, blepharoconjunctivitis, and rhinitis occurrence during the mask-mandated COVID-19 pandemic period. (2) Methods: Medical records from tertiary academic center clinics were analyzed for incidence of ophthalmic and otolaryngologic diagnoses of interest (blepharoconjunctivitis- and rhinitis-related disorders). Data were collected from a pre-pandemic (March 2019-February 2020) and a mid-pandemic window (March 2020-February 2021) during which widespread mask mandates were implemented in Texas. Comparison was performed using a t-test analysis between incidence of chosen diagnoses during the described time periods. (3) Results: Incidence of ophthalmic disorders (primarily blepharoconjunctivitis and chalazion) in the pre-pandemic versus mid-pandemic windows did show a significant difference (p-value of 0.048). Similarly, comparison of otolaryngologic diagnoses (primarily rhinitis and related conditions) between the two time periods showed a significant difference (p-value of 0.044) as well. (4) Conclusion: Incidence of the chosen ophthalmic and otolaryngologic disorders did increase during periods of mask mandates. While these findings are preliminary, further studies are warranted to understand other factors that may have played a role in eye and nose pathology.

An Early and Preliminary Assessment of the Clinical Severity of the Emerging SARS-CoV-2 Omicron Variants in Maharashtra, India (preprint)

BackgroundThe SARS-CoV-2 Omicron variants BA.2.74, BA.2.75 and BA.2.76 have appeared recently in India and have already spread to over 40 countries. They have acquired additional mutations in their spike protein compared to BA.2, branching away on the SARS-CoV-2 phylogenetic tree. These added mutations, over and above those of the parental BA.2 variant, have raised concerns about the impact on viral pathogenicity, transmissibility, and immune evasion properties of the new variants. Material and MethodsA total of 990 RT-PCR positive SARS-CoV-2 samples, with a cycle threshold value (Ct) less than 25, were processed for SARS-CoV-2 whole genome sequencing between 3rd June 2022 to 7th August 2022. All corresponding demographic and clinical data were recorded and analyzed using Microsoft(R) Excel. ResultsOut of 990 samples sequenced, BA.2.75 (23.03%) was the predominant Omicron sublineage, followed by BA.2.38 (21.01%), BA.5 (9.70%), BA.2 (9.09%), BA.2.74 (8.89%) and BA.2.76 (5.56%). A total of 228 cases of BA.2.74, BA.2.75 and BA.2.76 were contacted by telephone, of which 215 (94.30%) were symptomatic with mild symptoms, and 13 (5.70%) had no symptoms. Fever (82.02%) was the most common symptom, followed by cough (49.12%), cold (35.97%), fatigue (27.19%), headache (21.05%) and myalgia (20.61%). Of the 228 cases, 195 (85.53%) cases recovered at home, and 33 (14.47%) required institutional quarantine. Recovery with conservative treatment was observed in 92.98% of cases, while 4.83% required additional oxygen therapy. Only 03 (1.32%) cases had poor outcomes resulting in death, and the remaining 225 (98.68%) had a good outcome. Among the 228 cases, 219 (96.05%) cases were vaccinated with COVID-19 vaccine; of these 72.60% had received both doses, 26.03% had also received the precautionary booster dose, while 1.37% were incompletely vaccinated with a single dose of vaccine. ConclusionThe current study indicates that the three BA.2 sublineages are causing mild disease in India. However, BA.2.75 has key mutations that are notable for accelerated growth and transmission and require close and effective monitoring.

Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Tests Performed by a Large National Laboratory-United States, 2019 to 2020.

BACKGROUND: During the COVID-19 pandemic, disruptions were anticipated in the US health care system for routine preventive and other nonemergency care, including sexually transmitted infection care. METHODS: Using a large national laboratory data set, we assessed the impact of the COVID-19 pandemic on the weekly numbers and percent positivity of chlamydia and gonorrhea tests ordered from the 5th week of 2019 to the 52nd week of 2020 in the United States. We compared weekly 2020 values for test volume, percent positive, and number of positives with the same week in 2019. We also examined the potential impact of stay-at-home orders for the month of April 2020. RESULTS: Immediately after the declaration of a national emergency for COVID-19 (week 11, 2020), the weekly number of gonorrhea and chlamydia tests steeply decreased. Tests then rebounded toward the 2019 pre-COVID-19 level beginning the 15th week of 2020. The weekly percent positive of chlamydia and gonorrhea remained consistently higher in 2020. In April 2020, the overall number of chlamydia tests was reduced by 53.0% (54.1% in states with stay-at-home orders vs. 45.5% in states without stay-at-home orders), whereas the percent positive of chlamydia and gonorrhea tests increased by 23.5% and 79.1%, respectively. CONCLUSIONS: To limit the impact of the pandemic on control of chlamydia and gonorrhea, public health officials and health care providers can assess measures put in place during the pandemic and develop new interventions to enable care for sexually transmitted infections to be delivered under pandemic and other emergency conditions. The assessment like this study is continuously needed.

Understanding the Factors Associated with the Temporal Variability in Crash Severity before, during, and after the COVID-19 Shelter-in-Place Order

The COVID-19 travel restriction orders have significantly reduced travel and generally lowered the risk of road traffic collisions, but many accounts suggest an increase in risky driving behaviors and consequent fatal crashes during the shelter-in-place period. Risky driving behaviors including failure to wear a seatbelt, speeding, and drunk driving were observed to be the leading contributing factors of the fatalities. Whereas the fatal crashes that characterized the shelter-in-place period has become a topical issue, the high number of crashes that occurred as a result of the panic shopping and increased travel activities in the weeks before the shelter-in-place order have not received much attention. In this study, we investigated the differences and similarities in the effects of the factors that were associated with crash injury severity before, during, and after the shelter-in-place order. The study used crash data from the state of Alabama for the 2020 calendar year. Preliminary data analysis revealed interesting variations in crash trends across the three periods. It was found that the highest weekly crash frequency occurred in the immediate week before the shelter-in-place order, and a higher proportion of crashes that occurred between 6 p.m. and 6 a.m. and those that occurred in residential areas happened during the shelter-in-place period while shopping area crashes, manufacturing/industrial area crashes, rear-end collisions, and crashes involving female drivers occurred mostly before the shelter-in-place period. Three injury severity models were developed using random parameters logit with heterogeneity in means and variances approach. The results showed that major injury crashes occurred mainly in rural areas and occurred due to speeding, fatigue driving, and failure to use a seatbelt. The effects of these factors on crash outcome did not vary across the year, indicating that the shelter-in-place order did not impact the driving behaviors of the driver population that got into major injury crashes. The results further revealed that the effects of some crash factors, such as road type and manner of collision, varied across the periods. The findings of the study provide a deeper, data-driven understanding of how driving behaviors and associated crash outcomes may be affected by extreme events such as the COVID-19 shelter-in-place.

Rare case of cystic schwannoma presenting as right upper lobe lung cyst

Background: Schwannomaare benign tumors arising from Schwann cells of nerve root sheaths. Schwannomasare mostly solid / heterogeneous solid tumours, rarely cystic. Presentation of cystic schwannomainthorax is extremely rare. Case Study: A 62-year-old female came to our hospital withthe complaint of right sided chest pain for 2 months, which is dull, non-radiating. She had history of fever 4 months back, diagnosed to have covid and took treatment at home. Chest x-ray showed a homogenous opacity in the right upper lobe extending up to 1stintercostal space. Ct reported well-defined thick-walled cyst, hypodensewith central low attenuation, forming acute angles with lung parenchyma in apical segments of right upper lobe towards mediastinum. Mild perilesional atelectasis is seen.On contrast, cyst is non enhancing. Patient is evaluated for the possibilities of Foregut duplication cyst, Hydatidcyst, Neoplasm. Endoscopic ultrasonography revealed a 5cms×5cms cyst, which is not communicating, infiltrating to esophagus. Patient was referred to ctvswhere excision of cyst is done by right thoracotomy .A 6cms×6cms×2cms unilocularcyst with wall thickness ranging from 0.1- 0.4cms. Its outer surface is congested, inner surface showed dark-brown hemorrhagic contents. Histopathological examination revealed cystic schwannoma. Discussion: Schwannomasare mostly benign in nature .Treatment includes excision of Bronchogenic cyst, Brachial cyst, neurogenic tumours, apical lung tumour, hydatid cyst, foregut duplication cyst are to be considered as differential diagnosis. It is important to consider cystic schwannomasin the differential diagnosis of thoracic cystsince the best surgical outcome is strongly related to earlier diagnosis and total resection of the lesion.

Study on Postcovid pulmonary complications in patients attending tertiary care centre

Background: SARS-COV-2 has caused morbidity and mortality at an unprecedented scale globally. During recovery, several patients are found to have functional impairment and radiological abnormalities. Case Study: An observational study done on 54 post-covid patients attending our center during July to November. A detailed history, radiology and clinical data during acute and post-covid visit were analyzed. Aims: To document various post-covid complications, assessing risk factors for complications Discussion: Mean age group of presentation 49.2years, mean time of follow-up presentation is 66.4 days. Incidence is higher in males (64.8%) than females (35%),83.3% are having one or more existing comorbidities during acute covid mainly diabetes 61%, hypertension 38%, Both in 25%, copdin 7.4%, tuberculosis in 3.7%, HIV in 1.85 %. About 79.6% had more than 3 weeks of hospital stay,46.2% are on NIV support during acute covid. Majority of post-covid patients came with dyspnea -75.9%, cough -74%, fatigue -31.4%, productive cough -14%, fever -9%, chest pain -7%. Resting hypoxia is seen in 29.6% of patients. Of post-covid patients,88% presented with pulmonary fibrosis,12.9% with pnemothorax,12.9%with lung cavity,3.6%with necrotizing pneumonia and 1.8%with lung abscess. Both pneumothorax and fibrosis are seen in 9.25%, both cavity and fibrosis in 5.5%. post-covid pulmonary cavities (7) were due to tuberculosis, klebsiella, pseudomonas, E. coli, fungal itology.Comparativelyradiological improvement is seen in 86% of the patients Conclusion: Diabetes,nonvaccinating, severe covid at admission, mechanical ventilation, older age contributes to severe post-covid complications.Regularfollow up,rehabilitation therapy, screening for tuberculosis is to be considered.

Outcome of COVID19 pneumonia in diabetes mellitus patients

Background: Diabetes mellitus significantly increases the severity, risk of hospitalization and mortality in covid19 pneumonia. Methods: A retrospective study was conducted in 248 patients tested positive for covid19 by RTPCR admitted into a tertiary care centre between april 2021 and june 2021 to know the severity assessed by the oxygen requirement and outcome assessed by duration of hospitalization and death rates of covid19 pneumonia in patients with diabetes mellitus. Results: Out of 248 patients, 152 (61.2%) were nondiabetic, 96(38.7%) were diabetic, of which 74 (77%) being previously diagnosed, 22 (22.9%) diagnosed as de novo . Out of 96 diabetics, 24 (25%) were vaccinated with two doses, 20(20.8%) with first dose and 52(54.1%) not vaccinated. Among 96 diabetics, 36 (37.5%) required oxygen, 22 (22.9%) required HFNC support, 19 (19.7%) required NIV support. Among 96 diabetics, 62 (64.5%) were discharged of which 26 (41.9%) required oxygen and death occurred in 34 (35.4%). Out of 34 deaths, 26(76.4%) were not vaccinated and 8 (23.5%) were vaccinated. Conclusion: There is increased severity, mortality and length of hospital stay in patients of covid19 pneumonia with diabetes mellitus. However in vaccinated, risk of mortality is significantly low compared to non-vaccinated patients.

Case series of pneumothorax in patients with COVID 19 pneumonia

Background: Pneumothorax has been noted to be a complication of covid19 pneumonia caused by SARSCOV2 requiring hospitalization and increasing mortality. Case Study: A series of 10 cases of spontaneous pneumothorax in patients with covid19 pneumonia either RTPCR positive or radiological positive admitted into a tertiary care centre from April 2021 to September 2021. Discussion: Of 10 cases of pneumothorax, 8 were confirmed covid19 positive by RTPCR and 2 were radiologically diagnosed based on CT imaging. None of them had previous lung disease, 2 were smokers and 1 had prolonged biomass fuel exposure. 3 of them were kept on NIV support and others required oxygen with facemask. All patients had moderate to severe disease with bilateral GGOs. All of them had acute onset of chest pain, drop in saturation and increased respiratory rate. All the patients were managed with ICD insertion and oxygen supplementation. Out 10 patients, 5 patients had favorable outcome and discharged and death occurred in 5 patients. Conclusion: Acute deterioration in a patient with covid19 pneumonia indicate a pneumothorax which may occur even in the absence of pre-existing lung disease and mechanical ventilation. Early diagnosis and management of this complication is necessary to prevent the risk of mortality.