A cross-sectional study on the seroprevalence of the SARS-CoV-2 IgG antibody in patients with cancer from central Kerala

Background: Patients with cancer are vulnerable to coronavirus disease 2019 (COVID-19). Given the rising number of COVID-19 cases and relaxation of stringent COVID-19 protocols, assessment of the level of protective immunity to COVID-19 in patients with cancer has assumed importance. Objective(s): Our primary objective was to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in patients with cancer. Material(s) and Method(s): We conducted a cross-sectional study on 100 patients with solid tumors attending our Oncology Department at the Believers Church Medical College, Kerala, India, between December 2020 and June 2021. Seroprevalence was assessed using the VITROS Anti-SARS-CoV-2 IgG test (Ortho-Clinical Diagnostics, Rochester, NY, USA). Additionally, we assessed the factors associated with seropositivity and collected data regarding the general experience of patients with cancer during the pandemic. Result(s): The median age of the participants was 62 years (IQR, 53-69.8);52 (52%) were males. The seroprevalence of the SARS-CoV-2 IgG antibodies was 11% (95% CI, 4.8-17.1). Age < 50 years was the only factor that was significantly associated with a higher rate of COVID-19 antibodies (77% vs 8.9% in patients >= 50 years;P = 0.007), and sex, smoking, and the use of alcohol did not show any association. The majority (77/100, 77%) of the patients were worried about contracting COVID-19 infection;some even deferred cancer-directed treatment because of the fear of visiting health care settings. Conclusion(s): Low seroprevalence of SARS-CoV-2 IgG antibodies in unvaccinated patients with cancer is a matter of concern as it indicates that many of these patients are still vulnerable to infection. There is an urgent need to continue implementing strict safety measures in oncology centers and to encourage widespread COVID-19 vaccination to prevent the uncontrolled spread of COVID-19 among patients with cancer. (Funded by the institution, Believers Church Medical College, Kerala).Copyright © 2023 Neurology India, Neurological Society of India Published by Wolters Kluwer - Medknow.

A study of morbidity and mortality from COVID-19 in India

The recent Human Coronavirus 2019 (hCoV-19) pandemic has devastated the whole world and impacted all aspects of human life. One of the most comprehensively recorded data for this outbreak is the daily morbidities and mortalities record. The analysis of this dataset would provide insight into the pattern and progression of this disease. The present study focused on the quantitative investigation and descriptive statistical examination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as part of a series of evaluations for this epidemic in the primarily affected geopolitical regions. The year 2021 is worse than 2020 in terms of the recorded daily newly emerging cases and deaths, and there are no signs that there would be an improvement in 2022, as could be estimated from early warning signs, even if there could be an apparent decline in the outbreak waves. India is one of the major countries that have been adversely affected by this global pandemic. The present study addressed this nation as a detailed record of COVID-19 cases and deaths extracted from a chronologically arranged dataset for the newly emerged cases and deaths on a daily basis. Cumulative counts were calculated and logarithmically transformed. Two significant peaks - embracing multiple waves - were observed with tailing for morbidity and mortality, which were highly correlated. There were no signs of a recession in the outbreak census. However, relative calm periods between waves might be detected. There were rising trends in morbidities and mortalities with a clustering tendency upon examination of the run charts. The Morgan-Mercer-Flodin (MMF) model was found to demonstrate the best-fitting non-linear curve for the transformed cumulative database. Derivatization of the model equation demonstrated a factor that could be used in the assessment of the outbreak effect numerically to show influence on the impacted population.

The Kerala model 25 years later. Lessons in Covid times

The Indian state of Kerala, recognized for its model of human development whose achievements are far from the rest of India and the developing world, has been able to successfully deal with Covid despite the adverse conditions that the region faced. The legacy of the Kerala model, especially the availability of a primary care public health system and high educational levels, together with an effective public action where a proactive state and an organized society are fed back, explain the good results in containment of the Covid pandemic, as well as in alleviating its socioeconomic impacts.

A comparative study of waste management practices in pre-COVID and during-COVID scenarios: an overview of the hotel industry

The COVID-19 pandemic has been challenging for the hotel industry, with rooms being converted into quarantine centres and leading to an increase in waste volume and composition. With frequent lockdowns and stringent guidelines by governments on social distancing, 60% of hotels converted 10% of their rooms into quarantine facilities, which drastically changed the composition of hotel waste (JLL, 2020). This waste may lead to environmental degradation if handled inappropriately. The primary objective of this study is to identify, compare and highlight the challenges faced in waste management practices in two different circumstances, namely pre-COVID and during-COVID, in the hotel industry. Data were collected using a structured questionnaire put to hoteliers in selected hotels in India. A total of 61 responses were recorded out of 100 respondents. Descriptive analysis indicated new practices in hotel housekeeping such as use of single-use PPE kits, arrangement of separate zones for disposing of medical waste and digitalization of services. Another interesting finding of the research is the aggravation of single-use plastic in the form of disposable crockery, cutlery and packaging of PPE kits. Lastly, the study showed an increase in operational costs and highlighted innovative procedures in existing waste management disposal practices and suggested new practices that will be of great significance for dealing with similar episodes in the future.

Vitamin-D deficiency, the hidden pandemic in sunshine sufficient countries, exacerbating hypocalcaemia in a health worker undergoing thyroidectomy - a global perspective and review of literature

Introduction: Vitamin D deficiency (VDD) is common in young adults even in sunlight sufficient countries. It manifests with subtle and trivial symptoms that are often ignored. Nutritional deficiency due to improper dietary habits, poverty, long hours at work and study are factors. The lockdown during COVID has exacerbated the incidence. We had a patient with VDD who became symptomatic after routine thyroidectomy prompting our review into literature on the global health perspective of VDD. Material and method: - A 21-year-old nursing student developed hypocalcaemia within 24 hours after a routine thyroidectomy. VDD was detected and patient improved after supplementation. Literature was reviewed from Pubmed database for the medical aspects of the problem, from Government archives like the Scientific Advisory Committee on Nutrition, ICMR etc for cause and medical archives including those of paediatric and general health for the impact of disease at the state, national and global level. A global health problem list was prepared and data was reviewed. Discussion: Vitamin D is protective against respiratory infections due to viral aetiology including COVID. However, complete lockdown to prevent spread of COVID, online learning, and work from home culture has reduced sunlight exposure and increased incidence of VDD. Post thyroidectomy hypocalcaemia is common in VDD. Conclusion: Since there is a high prevalence of asymptomatic VDD even in sunshine sufficient countries, it is recommended to screen all patients especially young adults for VDD during routine preoperative work up.

The Distribution of Fecal Contamination in an Urbanized Tropical Lake and Incidence of Acute Diarrheal Disease

Aquatic ecosystems of tropical countries are vulnerable to fecal contamination that could cause spikes in the incidences of acute diarrheal disease (ADD) and challenge public health management systems. Vembanad lake, situated along the southwest coast of India, was monitored for one year (2018-2019). Escherichia coli, an indicator of fecal contamination, was prevalent in the lake throughout the year. Multiple antibiotic resistance among more than 50% of the E. coli isolates adds urgency to the need to control this contamination. The high abundance of E. coli and incidence of ADD were recorded during the early phase of the southwest monsoon (June-July), prior to the once-in-a-century floods that affected the region in the later phase (August). The extent of inundation in the low-lying areas peaked in August, but E. coli in the water peaked in July, suggesting that contamination occurred even prior to extreme flooding. During the COVID-19-related lockdown in March-May 2021, fecal contamination in the lake and incidence of ADD reached minimum values. These results indicate the need for improving sewage treatment facilities and city planning in flood-prone areas to avoid the mixing of septic sewage with natural waters during extreme climate events or even during the normal monsoon.

Impact of COVID-19 Lockdown on Ambient Air Quality in the Southwest Coastal Urban Regions of India

The rapid growth of urban areas and population as well as associated development over recent decades have been a major factor controlling ambient air quality of the urban environment in Kerala (India). Being located at the southwestern fringe of the Indian peninsula, Kerala is one of the regions that has been significantly influenced by the activities in the Indian Ocean. The present study focuses on the effect of the COVID-19 lockdown (in 2021) on ambient air quality in the selected coastal metropolitan areas of Kerala. Although previous research studies reported improvement in ambient air quality in Kerala during the lockdown period, this study demonstrates the potential of onshore transport of air pollutants in controlling the air quality of coastal urban regions during the lockdown period. Data from the ambient air quality monitoring stations of the Kerala State Pollution Control Board in the urban areas of Thiruvananthapuram (TM), Kollam (KL), Kozhikode (KZ), and Kannur (KN) are used for the analysis. Temporal variation in the concentration of air pollutants during the pre-lockdown (PRLD), lockdown (LD), and post-lockdown (PTLD) periods (i.e., 1 March to 31 July) of 2021 is examined to assess the effect of lockdown measures on the National Air Quality Index (AQI). Results indicate a significant decline in the levels of air pollutants and subsequent improvement in air quality in the coastal urban areas. All the effect of lockdown measures has been evident in the AQI, an increase in the concentration of different pollutants including CO, SO2, and NH3 during the LD period suggests contributions from multiple sources including onshore transport due to marine traffic and transboundary transport. © 2023, The Author(s) under exclusive licence to Institute of Earth Environment, Chinese Academy Sciences.

The Kerala, India Experience of Facing the COVID-19 Pandemic

Kerala, a southwestern state of India, reported the first COVID-19 case in India. Its alert health department went into a detailed preparation to face the pandemic and its related effects. Kerala soon earned international attention for its handling of the COVID-19 emergency. Some of the factors that are outstanding about Kerala, apart from its achievements in education and healthcare, are decentralized governance, active public involvement, and a high level of women's participation. This chapter explores Kerala's COVID-19 crisis management during the first phase of the pandemic. It explains how the welfare system of Kerala, which is the outcome of the years of accountable governance, has worked to provide a protective safety net to the people of Kerala. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

The long-term effects of Kerala Diabetes Prevention Program on diabetes incidence and cardiometabolic risk: a study protocol.

INTRODUCTION: India currently has more than 74.2 million people with Type 2 Diabetes Mellitus (T2DM). This is predicted to increase to 124.9 million by 2045. In combination with controlling blood glucose levels among those with T2DM, preventing the onset of diabetes among those at high risk of developing it is essential. Although many diabetes prevention interventions have been implemented in resource-limited settings in recent years, there is limited evidence about their long-term effectiveness, cost-effectiveness, and sustainability. Moreover, evidence on the impact of a diabetes prevention program on cardiovascular risk over time is limited. OBJECTIVES: The overall aim of this study is to evaluate the long-term cardiometabolic effects of the Kerala Diabetes Prevention Program (K-DPP). Specific aims are 1) to measure the long-term effectiveness of K-DPP on diabetes incidence and cardiometabolic risk after nine years from participant recruitment; 2) to assess retinal microvasculature, microalbuminuria, and ECG abnormalities and their association with cardiometabolic risk factors over nine years of the intervention; 3) to evaluate the long-term cost-effectiveness and return on investment of the K-DPP; and 4) to assess the sustainability of community engagement, peer-support, and other related community activities after nine years. METHODS: The nine-year follow-up study aims to reach all 1007 study participants (500 intervention and 507 control) from 60 randomized polling areas recruited to the original trial. Data are being collected in two phases. In phase 1 (Survey), we are admintsering a structured questionnaire, undertake physical measurements, and collect blood and urine samples for biochemical analysis. In phase II, we are inviting participants to undergo retinal imaging, body composition measurements, and ECG. All data collection is being conducted by trained Nurses. The primary outcome is the incidence of T2DM. Secondary outcomes include behavioral, psychosocial, clinical, biochemical, and retinal vasculature measures. Data analysis strategies include a comparison of outcome indicators with baseline, and follow-up measurements conducted at 12 and 24 months. Analysis of the long-term cost-effectiveness of the intervention is planned. DISCUSSION: Findings from this follow-up study will contribute to improved policy and practice regarding the long-term effects of lifestyle interventions for diabetes prevention in India and other resource-limited settings. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Registry-(updated from the original trial)ACTRN12611000262909; India: CTRI/2021/10/037191.

Students' perceptions on the effect of COVID 19 on agricultural higher education in India

The study analysed the temporal changes in the perceptions of students of agricultural higher education due to disruption of the COVID 19 pandemic and recommends strategies to deal with it. An online survey was conducted involving students of agricultural higher education at two intervals to capture their perceptions on the academic, physical, and psychological disruptions due to the COVID 19 pandemic. Among these three aspects, changes in behavioural aspects are significant over time, which is reflected in terms of viz., attitude, frustration, anxiety, depression, uncertainty, desire for cocooning and boredom. Students showed a positive response towards continuing educational activities through online and e-learning modes. Adapting to new normal necessitated extensive use of digital technologies in education that challenged the face to face instructions, approaches to learning and assessment. Counselling and mentoring of students are found mandatory in pandemics. The development of a sustainable digital ecosystem of learning with equal weightage on students' physical and psychological well-being is needed. New approaches of learning are to evolve due to the COVID19 pandemic.

Tomato Flu/Fever-An analysis of the Hand Foot and Mouth Disease outbreak reported in India

The term "Tomato Flu” or "Tomato Fever” is the colloquial term in India used to describe multiple diseases that present with a fever and rash, with characteristic red, "tomato” shaped blister that appears on different parts of the body, which begin small and increase in size as disease progresses. Some controversy exists on this ‘new viral "flu” that emerged in May 2022 over a period of 2 weeks in areas in the south of India. Currently, local healthcare workers have been encouraged to address the disease as a variant of Hand Foot and Mouth Disease to avoid unnecessary panic on the emergence of a "new outbreak”. With the circulation of other viruses, inadequate testing and poor-quality surveillance in a low resource setting, where healthcare systems are already burdened with ongoing monkeypox outbreak and COVID-19 pandemic, the use of colloquial terms may cause unnecessary panic in the current hypervigilant climate. Confirmation from Government is required to confirm whether this outbreak is due to a mixed infection or a variant of the highly infectious Hand Foot and Mouth Disease virus. © 2022, The authors.

COVID-19 pandemic and resilience in the agricultural sector: a local strategy may solve the global challenges

Agriculture remains a major engine of growth among the majority of developing and underdeveloped countries throughout the globe. But the sudden outbreak of COVID-19 has severely affected all sectors of agribusiness industries. In many parts of the world agriculture production became almost half due to the impact of this pandemic. But in two Himalayan regions of India, Darjeeling and Sikkim, mixed effects were observed during the pandemic period. Although a large number of marginal farmers were severely affected during the lockdown and even in the unlock phases, while a significant number of farmers also gained nominal to a large amount of profit;chiefly because of reliability on complete organic farming including producing organic manure and bio-pesticides by the farmers themselves, lack of competition with imported agricultural commodities into the local market due to the inter-state travel ban, marketization of the agricultural products to the consumers through Farmers Producers Organizations (FPOs), NGOs and Sikkim State Co-operative Supply and Marketing Federation ltd. (SIMFED) and above all creation of the Farmers' Helpline at district levels by the local government bodies to solve the problems of the farmers even in the remotest regions.

Assessment of post-COVID syndrome manifestations among COVID-19 patients in Ernakulam district

The study was conducted between 2021 and 2022 among the post-COVID patients in Ernakulam district of Kerala by assessing Dietary Diversity Score (DDS), comorbidities, symptoms during COVID and post-COVID, fatigue, stress, and insomnia. The research was a six-month community-based prospective cohort study comprising 250 patients. Out of the 250 patients, 41.6% were male and 58.4% were female. On studying the age-wise distribution of patients, the majority (38%) belonged to the 18-29-year age group. Among the patients, 26% had a high Dietary Diversity Score. The most common comorbidities observed were hypertension (24%), followed by obesity (20.8%), diabetes mellitus (19.2%), and cardiovascular disease (16.8%), respectively. During the period of infection, the most common symptom among patients was tiredness (89.2%), followed by fever (83.2%), headache (78.8%), dry cough (67.6%), and loss of taste or smell (56.4%). Breathlessness (30%), chest pain (26%), and diarrhea (9.2%) were the other significant symptoms. The most prevalent post-COVID symptoms in various systems among patients were loss of appetite (89%), weakness (62.4%), sore throat (51.6%), dry cough (40.4%), joint pain (26.8%), and pain/burning in the chest (14.8%). During COVID, 42.4% of the patients were severely fatigued, 61.2% of the patients had a moderate level of perceived stress, and 44.4% of the patients had subthreshold insomnia. During post-COVID, 80.4% were severely fatigued;moderate stresswas found in 40%, of the subjects;and 22.8% of the study subjects had subthreshold insomnia. The Pearson's coefficient of correlation, 'r', between stress and insomnia among study subjects was 0.37. The obtained t-value for stress (7.14 > 2.58), fatigue (8.31 > 2.58), and insomnia (10.97 > 2.58) were significant. Post-COVID is associated with comorbidities and disease severity. The prevalence of new-onset fatigue, perceived stress, and insomnia was significant among COVID-19 survivors.

Observational study on prevalence of adverse effects of COVID vaccination among general population in South India

Introduction: COVID-19 is a viral disease due to the Severe Acute Respiratory Syndrome Coronavirus 2. The patients show flu-like symptoms with a dry cough, sore throat, high fever, and breathing problems. This was conducted to assess the adverse effects after taking Covid 19 vaccines in general population of Kerala state. Methodology: About 353 participants were enrolled in the study according to inclusion and exclusion criteria for a period of November 2021 to April 2022. Data collection was done with structured questionnaire in google form. The data were analysed and reported using tables, pie diagram, bar diagrams and different charts forms. Results: Majority of patients enrolled in the study were vaccinated with 2 dosed of Covid vaccines. From 351 participants vaccinated with Covid 19 vaccine 249 experienced an AEFI. The most reported AEFI was fever, body pain and injection site reactions. From the results it was found that females had experienced more AEFI than males. Most of the participants from our study were vaccinated with Covishield and all participants taken Sputnik vaccine had experienced some adverse effects. Conclusion: The present study reveal that majority of people vaccinated by Covid 19 vaccines had experienced any kind of AEFIs. Majority of patients enrolled in the study were vaccinated with 2 dosed of Covid vaccines. The most reported AEFI was fever, body pain and injection site reactions. From the results it was found that females had experienced more AEFI than males.

Construction of scale to measure impact of COVID-19 pandemic on farm operations of tapioca growers in Kerala & Andhra Pradesh

The impact of COVID-19 and resultant lockdown were quite harsh on agriculture sector of India. Tapioca and plantain farmers suffered the most in Kerala and Andhra Pradesh during COVID-19 pandemic. In this context the present study was conducted to develop a scale to measure impact of COVID-19 pandemic on pre farmgate-post farmgate operations of tapioca growers in Kerala and Andhra Pradesh. Four dimensions were identified based on literature review & expert opinion for easy classification and measuring the impact of COVID-19 pandemic. A total 200 statements under four dimensions of impact of COVID-19 pandemic was collected, out of these 80 consistent statements were selected through relevancy test. Out of 80 statements, these 43 statements were retained on the final scale through t-test item analysis. Reliability and validity of the scale indicates its consistency and precision of the results. This scale was found to be reliable and valid.

Can digital G2P transfers drive financial inclusion and digital payments? Evidence from India

Does channeling government-to-person (G2P) payments through bank accounts encourage financial inclusion and use? This paper explores the factors that have driven the adoption of digital payments in India by beneficiaries of PMGKY, the large-scale COVID-19 relief program launched in May 2020. India's 2013 move to pay social benefits through direct transfers into bank accounts significantly increased account ownership, but uptake of digital payments has been slower, although it has accelerated more recently through smartphone-based apps. Recipient survey data shows that personal and household attributes influence the likelihood of adopting digital payments. Smartphone ownership and digital literacy improve the odds while being a woman reduces them. The strength of the local digital payments ecosystem also exerts significant influence on household adoption;favorable personal and ecosystem factors are needed for widespread use. The historical progression shows that G2P transfers create an entry point but that widespread access to low-cost mobile telecommunications, interoperability, and the entry of new players offering convenient payments interfaces have been vital to the growth of digital payments.

Analysing the residents' food (eating out) behaviour in the pre & post COVID-19 period: a study of Dharamshala region, India

The first epidemic of the modern world that has changed the course of the current civilization & turned out to be a pandemic (i.e. COVID-19) has tremendously affected several industries including that of tourism & hospitality. Due to the multilevel impact, the whole world struggled to overcome this situation but with almost two years of its co-existence, people have now managed to change their style of living & social habits including that of the food habits. One of such food habits i.e. 'Eating out/ Dining out' was bound to change in the post-pandemic period due to the health advisories & closure of several hotels, restaurants and food outlets. The present research tries to find out the changes in the Eating out behaviour of the residents of Dharamshala (H.P.) in the pre & post-pandemic period. Further, it tries to identify the factors which affect the eating out behaviour of the residents & measure their importance in different periods (pre &post pandemic). The data were collected from 286 residents of Dharamshala region, through a structured questionnaire & analysed through reliability checks (Cronbach's Alpha-a), KMO & Bartlett's test, factor analysis, paired sample t-test and analysis of frequency & mean values. The results showed a significant decrease in the frequency of visits, purchasing/ordering, percentage of outside meals consumed, average spending etc, whereas the level of priority given by the residents to hygiene, food safety, quality, service & distribution etc has increased in the post-pandemic period. Hence various strategies were suggested for the restaurants/local eateries like, (1) Use of technology (automatic doors, sensor & timer enabled soap & sanitiser dispenser, online payments), (2) cost reduction tactics (controlling of food wastage, reduction in menu items), (3) training of employees (sanitisation rules, HACCP rules) etc which were if adopted will certainly help them revive from the crisis slowly & steadily over the period.

Household solid waste management - perception and practices during COVID-19 andemic outbreak in Ernakulam

The onset of the COVID-19 pandemic triggered panic buying of food, face masks, gloves, cleaning products and hand sanitizers. Change in food practices, dynamics of plastic and biomedical waste generation during the pandemic has, however, stirred the woes of household solid waste management. The virus loaded waste from indiscriminately discarded face masks, gloves and other biomedical waste with the regular waste stream could cause serious health risks. The present study was undertaken to find out the situation of waste management systems during pandemic outbreak by the households. An online survey was conducted via Google form using well-structured questionnaire. The study covered a sample size of 100 homemakers using simple random sampling technique. Only 45% of households agree with the satisfaction in current waste management system. A majority of 59% of the respondents are burning the household medical waste, 70% of respondents saw the need to avoid mixing of household waste with the PPE products, 64% of respondents are not educated by local authorities on proper waste disposal, and 81% of respondents think there is no sufficient waste management information to the public. Of respondents 54% received awareness regarding the disposal of household medical waste during COVID19 outbreak via social media. Household solid waste management training is important to improve the hygiene and sanitation practices of community people. The current study showed that participants who received training on household solid waste management were significantly correlated with good hygiene practices.