Flood susceptibility assessment of the Agartala Urban Watershed, India, using Machine Learning Algorithm.

Frequent floods are a severe threat to the well-being of people the world over. This is particularly severe in developing countries like India where tropical monsoon climate prevails. Recently, flood hazard susceptibility mapping has become a popular tool to mitigate the effects of this threat. Therefore, the present study utilized four distinctive Machine Learning algorithms i.e., K-Nearest Neighbor, Decision Tree, Naive Bayes, and Random Forest to estimate flood susceptibility zones in the Agartala Urban Watershed of Tripura, India. The latter experiences debilitating floods during the monsoon season. A multicollinearity test was conducted to examine the collinearity of the chosen flood conditioning factors, and it was seen that none of the factors were compromised by multicollinearity. Results showed that around three-fourths of the AUW area was classified as moderate to very high flood-prone zones, while over 20 percent was between low and very low flood-prone zones. The models applied performed well with ROC-AUC scores greater than 70 percent and MAE, MSE, and RMSE scores less than 30 percent. DT and RF algorithms were suggested for places with similar physical characteristics based on their outstanding performance and the training datasets. The study provides valuable insights to policymakers, administrative authorities, and local stakeholders to cope with floods and enhance flood prevention measures as a climate change adaptation strategy in the AUW.

Establishment of Capra hircus somatic cells and induction of pluripotent stem-like cells.

Capra hircus (goat) induced pluripotent stem cells (giPSCs) harbor enormous scientific value and contribute to cellular agriculture, animal cloning, etc. Conventional approaches to giPSC generation suffer from complexity and low preparation efficiency. In the present study, we introduced the episomal vectors carrying the human pluripotent genes in goat somatic cells to generate the giPSC-like colonies. Initially, a simple non-enzymatic method was used to isolate the goat dermal fibroblast cells and, further, a cell line was established. Later, goat fibroblast cells were transfected with commercially available episomal vectors carrying the human pluripotent genes and successfully generated the iPSC-like colonies which exhibited the expression of goat endogenous pluripotent genes and positive staining with alkaline phosphatase. Moreover, giPS-like cells formed embryoid bodies (EBs)-like aggregates and weekly expressed the marker genes of two germ layers. Reprogramming of goat fibroblast using episomal vectors carrying human pluripotent genes could lead to the development of an efficient and time- and cost-effective approach to giPSC generation.

Out-of-pocket expenditures and catastrophic expenditures on inpatient care among households of an urban village in Delhi.

Background: Out-of-pocket expenditure (OOPE) for inpatient care has been known to cause maximum impoverishment. It can have debilitating consequences for urban poor households. It is necessary to study inpatient care costs and the related factors among the households of an urban village to determine their vulnerability to catastrophic expenditure and to protect them from it. Objective: The study aimed to calculate the mean OOPE on inpatient care, and catastrophic health expenditure among households of an urban village in Delhi. Design: This was a cross-sectional study conducted over 18 months among urban village households of Delhi who have been residing for the last 1 year. Methods: A sample size of 188 was calculated based on another study, and households were selected using systematic random sampling. A pre-designed, pre-tested, semi-structured, and interviewer-administered questionnaire in Hindi was used to elicit and record relevant information. Data were recorded and coded, and analysis was done using licensed SPSS v.26 software. Tables were generated for relevant data, and cross-tables were used to assess statistical association with chi-square or Fisher exact tests, as required. A p-value of 0.05 was considered statistically significant. Results: The mean annual OOPE borne by a household on inpatient care was INR 6870.3 (SD ± 30,580.6), where 93.3% of OOPE was incurred while seeking treatment from public facilities. The OOPE on inpatient care had a statistically significant association with households having joint family, members from vulnerable population, and belonging to Delhi. Conclusion: The households of an urban village of Aliganj, Delhi, have high OOPE on inpatient care (60.6%) and catastrophic health expenditure (75.6%).

Development and Validation of Total Pain Scale for Evaluation of Total Pain in Cancer Patients.

Objectives: Cancer pain has all the components of total pain such as physical, social, psychological, and spiritual. These components contribute to the overall pain experience in cancer patients. Many instruments have been developed till date to assess the effect of pain in cancer patients but none of the instruments include all components of total pain. In this article, we describe the development and validation of the total pain scale (TPS) for the evaluation of total pain in cancer patients with pain. This study aimed to develop and validate a questionnaire for the evaluation of total pain in cancer patients with pain. Material and Methods: This study included a review of existing pain questionnaires for cancer pain for item pool generation. Items were generated in the Hindi language by six stakeholders to create 23 items to develop TPS. TPS was applied to 300 Hindi-speaking cancer patients. Bivariate correlation was used to reduce the number of items as well as construction of the domain followed by factor analysis to finalise TPS. Confirmatory factor analysis (CFA) was performed for testing the validity and reliability of TPS. Results: TPS is an 18-item scale composed of four domains (physical, social, spiritual and psychological domain). The internal consistency of TPS and its subscales was found to be very good (a = 0.84-0.88). CFA and structural equation modeling Goodness of fit has confirmed that model 4 is the best fit as it yielded a lesser root-mean-squared error of approximation value of 0.062 and a greater comparative fit index, Tucker-Lewis index value of 0.944. The convergent and divergent validity of TPS and its domain was good. Conclusion: This study reports TPS to be a brief (18-item), valid, and reliable questionnaire in the Hindi language for assessment of all components of total pain in cancer patients with pain.

Satisfaction among patients seeking services at an urban health training center during the COVID-19 pandemic in South Delhi, India.

Background: The COVID-19 pandemic has posed challenges to the provision of routine health services. As we continue providing non-COVID services, it is essential that the community perceives them to be satisfactory and safe to ensure optimum uptake. The objective of the study was to determine the satisfaction and perceived safety among patients availing services at an urban health training center (UHTC) during the COVID-19 pandemic in South Delhi. Methods: UHTC, Aliganj caters to a population of over 6000, in an urbanized village of South Delhi. A pre-designed, semi-structured questionnaire incorporating the North Indian OPD Satisfaction Scale along with questions on sociodemographic details and perception of safety was used. Systematic random sampling was used to select the patients from the study population which included those above 18 years attending UHTC from November-December 2020. Exit interviews were done by a trained independent interviewer to reduce bias. Data were analyzed in SPSS using Chi-square and Fisher's Exact tests. Results: Out of 218 patients, 161 (73.7%) were satisfied, 174 (79.8%) felt safe to visit UHTC during the pandemic and 143 (65.6%) felt both satisfied and safe. Patients were dissatisfied with screening for COVID-19 (29.5%), amenities (47.1%), cleanliness (51.8%), and waiting and registration (62.9%). Conclusion: The majority of patients were satisfied and found the UHTC services safe. A large proportion of patients found location, doctor-patient interaction, and COVID-appropriate behavior at the center to be satisfactory, but there was scope to improve waiting and registration, cleanliness, and effectiveness of screening for COVID.

Recent trends and advances in type 1 diabetes therapeutics: A comprehensive review.

Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by the destruction of pancreatic ß-cells, leading to insulin deficiency. Insulin replacement therapy is the current standard of care for T1D, but it has significant limitations. However, stem cell-based replacement therapy has the potential to restore ß-cell function and achieve glycaemic control eradicating the necessity for drugs or injecting insulin externally. While significant progress has been made in preclinical studies, the clinical translation of stem cell therapy for T1D is still in its early stages. In continuation, further research is essentially required to determine the safety and efficacy of stem cell therapies and to develop strategies to prevent immune rejection of stem cell-derived ß-cells. The current review highlights the current state of cellular therapies for T1D including, different types of stem cell therapies, gene therapy, immunotherapy, artificial pancreas, and cell encapsulation being investigated, and their potential for clinical translation.

Erratum: [Corrigendum] Differential regulation of mitochondrial complex I and oxidative stress based on metastatic potential of colorectal cancer cells.

[This corrects the article DOI: 10.3892/ol.2020.12176.].

Non-Invasive Objective Markers to Measure Pain: A Direction to Develop a Pain Device - A Narrative Review.

Objective: To review the literature regarding non-invasive objective measurements of pain. Measuring pain is of uttermost importance, but it can be an inconvenient task, especially in terms of the interpretation of patient's information. Reiterating, there is no "standard" that provides the physician with a method to objectively quantify this problem of patient's pain. For assessing the pain, physician relies solely on unidimensional assessment tools or questionnaire-based pain assessment. Although pain is a subjective experience of the patient, but there is a need to measure pain sometimes in the individuals who cannot communicate their quality and severity of pain. Material and Methods: The articles from PubMed and Google Scholar without any year and age limit were searched in the current narrative review. A total of 16 markers were searched and their relation to pain was studied. Results: Studies have shown that these markers change in relation to pain and it can be considered a valuable tool for pain measurement but there are multiple factors like psychological and emotional factors which affect these markers. Conclusion: There is lack of evidence to show which marker can be used for measuring pain accurately. This narrative review is an attempt to look into the various pain-related markers that can be used and it calls for further studies including clinical trials with different diseases and taking into accounts different factors affecting pain to give an accurate measurement of pain.

Intussusception among Children Admitted in a Department of Pediatric Surgery of a Tertiary Care Centre: A Descriptive Cross-Sectional Study.

Introduction: Intussusception is the second most common cause of acute abdominal pain in infants and preschool children. The aetiology for intussusception is idiopathic at this age. Hydrostatic reduction and exploratory laparotomy with proceed are the options for the management of intussusception. The aim of this study was to find out the prevalence of intussusception among patients admitted to the Department of Pediatric Surgery of a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among admitted patients in the Department of Pediatric Surgery of a tertiary care centre after ethical approval from the Ethical Committee (Reference number: A37-77/78). Data were collected from 1 January 2018 to 31 December 2020 from admitted children aged 6 months to 5 years of age. Data collection was done from the hospital record section using the convenience sampling method. Point estimate and 95% Confidence Interval were calculated. Results: Among 1785 admitted patients, 267 (14.96%) (13.31-16.61, 95% Confidence Interval) were found to have intussusception. Among them, the hydrostatic reduction was successful in 246 (92.13%). Meanwhile, 21 (7.86%) of cases underwent laparotomy. The peak age of patients was seen in 148 (55.43%) in the age group of 1-3 years. Conclusions: Intussusception is one of the common surgical emergencies in children. Hydrostatic reduction of intussusception is a simple and effective method for the treatment of intussusception in children. Keywords: intussusception; laparotomy; paediatrics; prevalence; ultrasound.

Omphalocele, Exstrophy of Cloaca, Imperforate Anus, and Spinal Defects Complex: A Case Report.

 Omphalocele, exstrophy of cloaca, imperforate anus, and spinal defects complex is a rare malformation complex that includes omphalocele, cloacal exstrophy, imperforate anus and spinal defects with the incidence of 1 in 200,000 to 400,000 pregnancies and is even rarer in twin gestation. The etiology of this complex is still unclear. Most cases are sporadic. Prenatal screening must be done for diagnosis and appropriate multidisciplinary management of cases. In severe cases, termination of pregnancy is considered. We present a 4-day first twin child with underdeveloped ambiguous genitalia delivered via emergency lower section cesarean section at 32+3 weeks of gestation with giant liver containing omphalocele, cloacal exstrophy, imperforate anus and meningocele with severe pulmonary artery hypertension and non-visualization of right kidney and ureter, absence of uterus, fallopian tubes and right ovary. Separation and repair of the cecum and bladder were done. The ladd procedure was performed. Ileostomy was created and single-stage repair of the abdominal wall was done. Keywords: anorectal malformations; bladder exstrophy; case reports; neural tube defects; umbilicus.

Study of health seeking behaviour in parents of children in a population-based childhood visual impairment study in North India - "CHVI 2".

Background: The background of this study is to determine the awareness about health seeking behaviour (HSB) in parents of visually impaired children in a population-based study. Methods: The study was conducted in population <16 years in urban area of North India. A total of 20,955 (97.3%) children underwent visual acuity examination. Of these, 789 children were referred to the centrally based clinic with unaided visual acuity <6/12 in any eye for undergoing detailed ophthalmic examination. Results: Along with ocular examination, the parents of these 789 referred children, were interviewed for the questions related to HSB, the most common ocular symptom known to them was redness of eyes followed by watering and diminution of vision, 249 (34.6%) denied for any ocular problem in their children previously, amongst the remaining 469 parents/care takers with any ocular problem, a total of 367 (51.1%) referred children wore glasses and the proportion of parents wearing glasses was similar amongst these children (11.7% fathers and 11% mothers). Amongst the 118 respondents of visually impaired children (presenting visual acuity less than 6/18 in better eye with available correction), 56 (47.5%) denied for any ocular problem in their children previously, of the remaining 62 (52.5%), parents, 58 (93.5%) had consulted various healthcare agencies, 45.8% of the respondents reported not said that their children wore glasses prescribed to them. Only 24 (20.3%) respondents were aware that Vitamin A is good for eye health. Discussion: Diminution of vision, watering and redness of eyes were the most common ocular symptoms known to parents of referred children. HSB can be further improved via primary healthcare physicians by primary healthcare creating awareness about importance of wearing glasses and healthy diet in parents of visually impaired children.

Mechanistic aspects of reversible methylation modifications of arginine and lysine of nuclear histones and their roles in human colon cancer.

Developmental proceedings and maintenance of cellular homeostasis are regulated by the precise orchestration of a series of epigenetic events that eventually control gene expression. DNA methylation and post-translational modifications (PTMs) of histones are well-characterized epigenetic events responsible for fine-tuning gene expression. PTMs of histones bear molecular logic of gene expression at chromosomal territory and have become a fascinating field of epigenetics. Nowadays, reversible methylation on histone arginine and lysine is gaining increasing attention as a significant PTM related to reorganizing local nucleosomal structure, chromatin dynamics, and transcriptional regulation. It is now well-accepted and reported that histone marks play crucial roles in colon cancer initiation and progression by encouraging abnormal epigenomic reprogramming. It is becoming increasingly clear that multiple PTM marks at the N-terminal tails of the core histones cross-talk with one another to intricately regulate DNA-templated biological processes such as replication, transcription, recombination, and damage repair in several malignancies, including colon cancer. These functional cross-talks provide an additional layer of message, which spatiotemporally fine-tunes the overall gene expression regulation. Nowadays, it is evident that several PTMs instigate colon cancer development. How colon cancer-specific PTM patterns or codes are generated and how they affect downstream molecular events are uncovered to some extent. Future studies would address more about epigenetic communication, and the relationship between histone modification marks to define cellular functions in depth. This chapter will comprehensively highlight the importance of histone arginine and lysine-based methylation modifications and their functional cross-talk with other histone marks from the perspective of colon cancer development.

Epigenetic regulation of pluripotency inducer genes NANOG and SOX2 in human prostate cancer.

The cells of multicellular organisms are genetically homogeneous but heterogenous in structure and function by virtue of differential gene expression. During embryonic development, differential gene expression by modification of chromatin (DNA and histone complex) regulates the developmental proceedings before and after the germ layers are formed. Post-replicative DNA modification, where the fifth carbon atom of the cytosine gets methylated (hereafter, DNA methylation), does not incorporate mutations within the DNA. In the past few years, a boom has been observed in the field of research related to various epigenetic regulation models, which includes DNA methylation, post-translational modification of histone tails, control of chromatin structure by non-coding RNAs, and remodeling of nucleosome. Epigenetic effects like DNA methylation or histone modification play a cardinal role in development but also be able to arise stochastically, as observed during aging, in tumor development and cancer progression. Over the past few decades, researchers allured toward the involvement of pluripotency inducer genes in cancer progression and apparent for prostate cancer (PCa); also, PCa is the most diagnosed tumor worldwide and comes to the second position in causing mortality in men. The anomalous articulation of pluripotency-inducing transcription factor; SRY-related HMG box-containing transcription factor-2 (SOX2), Octamer-binding transcription factor 4 (OCT4) or POU domain, class 5, transcription factor 1 (POU5F1), and NANOG have been reported in different cancers which includes breast cancer, tongue cancer, and lung cancer, etc. Although there is a variety in gene expression signatures demonstrated by cancer cells, the epigenetic mode of regulation at the pluripotency-associated genes in PCa has been recently explored. This chapter focuses on the epigenetic control of NANOG and SOX2 genes in human PCa and the precise role thereof executed by the two transcription factors.

Novel Biotherapeutics Targeting Biomolecular and Cellular Approaches in Diabetic Wound Healing.

Wound healing responses play a major role in chronic inflammation, which affects millions of people around the world. One of the daunting tasks of creating a wound-healing drug is finding equilibrium in the inflammatory cascade. In this study, the molecular and cellular mechanisms to regulate wound healing are explained, and recent research is addressed that demonstrates the molecular and cellular events during diabetic wound healing. Moreover, a range of factors or agents that facilitate wound healing have also been investigated as possible targets for successful treatment. It also summarises the various advances in research findings that have revealed promising molecular targets in the fields of therapy and diagnosis of cellular physiology and pathology of wound healing, such as neuropeptides, substance P, T cell immune response cDNA 7, miRNA, and treprostinil growth factors such as fibroblast growth factor, including thymosin beta 4, and immunomodulators as major therapeutic targets.

Growth of water hyacinth biomass and its impact on the floristic composition of aquatic plants in a wetland ecosystem of the Brahmaputra floodplain of Assam, India.

Inland water plants, particularly those that thrive in shallow environments, are vital to the health of aquatic ecosystems. Water hyacinth is a typical example of inland species, an invasive aquatic plant that can drastically alter the natural plant community's floral diversity. The present study aims to assess the impact of water hyacinth biomass on the floristic characteristics of aquatic plants in the Merbil wetland of the Brahmaputra floodplain, NE, India. Using a systematic sampling technique, data were collected from the field at regular intervals for one year (2021) to estimate monthly water hyacinth biomass. The total estimate of the wetland's biomass was made using the Kriging interpolation technique. The Shannon-Wiener diversity index (H'), Simpson's diversity index (D), dominance and evenness or equitability index (E), density, and frequency were used to estimate the floristic characteristics of aquatic plants in the wetland. The result shows that the highest biomass was recorded in September (408.1 tons/ha), while the lowest was recorded in March (38 tons/ha). The floristic composition of aquatic plants was significantly influenced by water hyacinth biomass. A total of forty-one plant species from 23 different families were found in this tiny freshwater marsh during the floristic survey. Out of the total, 25 species were emergent, 11 were floating leaves, and the remaining five were free-floating habitats. Eichhornia crassipes was the wetland's most dominant plant. A negative correlation was observed between water hyacinth biomass and the Shannon (H) index, Simpson diversity index, and evenness. We observed that water hyacinths had changed the plant community structure of freshwater habitats in the study area. Water hyacinth's rapid expansion blocked out sunlight, reducing the ecosystem's productivity and ultimately leading to species loss. The study will help devise plans for the sustainable management of natural resources and provide helpful guidance for maintaining the short- to the medium-term ecological balance in similar wetlands.

Effect of UV Stress on the Structure and Function of Pro-apoptotic Bid and Anti-apoptotic Bcl-xl proteins.

Ultraviolet C (UV-C) radiation induces apoptosis in mammalian cells via the mitochondrion-mediated pathway. The Bcl-2 family of proteins are the regulators of the mitochondrial pathway of apoptosis and appears responsive to UV-C radiation. It is unknown how the structure and, effectively, the function of these proteins are directly impacted by UV-C exposure. Here, we present the effect of UV-C irradiation on the structure and function of pro-apoptotic Bid-FL and anti-apoptotic Bcl-xlΔC proteins. Using a variety of biophysical tools, we show that, following UV-C irradiation, the structures of Bcl-xlΔC and Bid-FL are irreversibly altered. Bcl-xLΔC is found to be more sensitive to UV stress than Bid-FL Interestingly, UV-C exposure shows dramatic chemical shift perturbations in consequence of dramatic structural perturbations (α-helix to ß-sheet) in the BH3- binding region, a crucial segment of Bcl-xlΔC. Furter it has been shown that UV-exposed Bcl-xlΔC has reduced efficacy of its interactions with pro-apoptotic tBid.

Recent advances in bioengineered scaffold for in vitro meat production.

In vitro meat production via stem cell technology and tissue engineering provides hypothetically elevated resource efficiency which involves the differentiation of muscle cells from pluripotent stem cells. By applying the tissue engineering technique, muscle cells are cultivated and grown onto a scaffold, resulting in the development of muscle tissue. The studies related to in vitro meat production are advancing with a seamless pace, and scientists are trying to develop various approaches to mimic the natural meat. The formulation and fabrication of biodegradable and cost-effective edible scaffold is the key to the successful development of downstream culture and meat production. Non-mammalian biopolymers such as gelatin and alginate or plant-derived proteins namely soy protein and decellularized leaves have been suggested as potential scaffold materials for in vitro meat production. Thus, this article is aimed to furnish recent updates on bioengineered scaffolds, covering their formulation, fabrication, features, and the mode of utilization.

Geospatial modeling to assess the past and future land use-land cover changes in the Brahmaputra Valley, NE India, for sustainable land resource management.

Satellite remote sensing and geographic information system (GIS) have revolutionalized the mapping, quantifying, and assessing the land surface processes, particularly analyzing the past and future land use-land cover (LULC) change patterns. Worldwide river basins have observed enormous changes in the land system dynamics as a result of anthropogenic factors such as population, urbanization, development, and agriculture. As is the scenario of various other river basins, the Brahmaputra basin, which falls in China, Bhutan, India, and Bangladesh, is also witnessing the same environmental issues. The present study has been conducted on the Brahmaputra Valley in Assam, India (a sub-basin of the larger Brahmaputra basin) and assessed its LULC changes using a maximum likelihood classification algorithm. The study also simulated the changing LULC pattern for the years 2030, 2040, and 2050 using the GIS-based cellular automata Markov model (CA-Markov) to understand the implications of the ongoing trends in the LULC change for future land system dynamics. The current rate of change of the LULC in the region was assessed using the 48 years of earth observation satellite data from 1973 to 2021. It was observed that from 1973 to 2021, the area under vegetation cover and water body decreased by 19.48 and 47.13%, respectively. In contrast, cultivated land, barren land, and built-up area increased by 7.60, 20.28, and 384.99%, respectively. It was found that the area covered by vegetation and water body has largely been transitioned to cultivated land and built-up classes. The research predicted that, by the end of 2050, the area covered by vegetation, cultivated land, and water would remain at 39.75, 32.31, and 4.91%, respectively, while the area covered by built-up areas will increase by up to 18.09%. Using the kappa index (ki) as an accuracy indicator of the simulated future LULCs, the predicted LULC of 2021 was validated against the observed LULC of 2021, and the very high ki observed validated the generated simulation LULC products. The research concludes that significant LULC changes are taking place in the study area with a decrease in vegetation cover and water body and an increase of area under built-up. Such trends will continue in the future and shall have disastrous environmental consequences unless necessary land resource management strategies are not implemented. The main factors responsible for the changing dynamics of LULC in the study area are urbanization, population growth, climate change, river bank erosion and sedimentation, and intensive agriculture. This study is aimed at providing the policy and decision-makers of the region with the necessary what-if scenarios for better decision-making. It shall also be useful in other countries of the Brahmaputra basin for transboundary integrated river basin management of the whole region.

Homeopathy as an Adjuvant to Standard Care in Moderate and Severe Cases of COVID-19: A Single-Blind, Randomized, Placebo-Controlled Study.

OBJECTIVES: This study aimed to evaluate whether individualized homeopathic medicines have a greater adjunctive effect than adjunctive placebos in the treatment of moderate and severe cases of coronavirus disease 2019 (COVID-19). METHODS: The study was a randomized, single-blind, prospective, placebo-controlled clinical trial set in the clinical context of standard care. INTERVENTION: Patients of either sex, admitted in a tertiary care hospital, suffering from moderate or severe COVID-19 and above 18 years of age were included. In total, 150 patients were recruited and then randomly divided into two groups to receive either individualized homeopathic medicines or placebos, in addition to the standard treatment of COVID-19. OUTCOME MEASURES: The primary outcome was time taken to achieve RT-PCR-confirmed virus clearance for COVID-19. Secondary outcomes were changes in the Clinical Ordinal Outcomes Scale (COOS) of the World Health Organization, the patient-reported MYMOP2 scale, and several biochemical parameters. Parametric data were analyzed using unpaired t-test. Non-parametric data were analyzed using the Wilcoxon signed rank test. Categorical data were analyzed using Chi-square test. RESULTS: In total, 72 participants of the add-on homeopathy (AoH) group showed conversion of RT-PCR status to negative, in an average time of 7.53 ± 4.76 days (mean ± SD), as compared with 11.65 ± 9.54 days in the add-on placebo (AoP) group (p = 0.001). The mean COOS score decreased from 4.26 ± 0.44 to 3.64 ± 1.50 and from 4.3 ± 0.46 to 4.07 ± 1.8 in the AoH and AoP groups respectively (p = 0.130). The mortality rate for the AoH group was 9.7% compared with 17.3% in the AoP group. The MYMOP2 scores between the two groups differed significantly (p = 0.001), in favor of AoH. Inter-group differences in the pre- and post- mean values of C-reactive protein, fibrinogen, total leukocyte count, platelet count and alkaline phosphatase were each found to be statistically significant (p <0.05), favoring AoH; six other biochemical parameters showed no statistically significant differences. CONCLUSION: The study suggests homeopathy may be an effective adjunct to standard care for treating moderate and severe COVID-19 patients. More rigorous, including double-blinded, studies should be performed to confirm or refute these initial findings.

Nihilism, Neurocognition, and the Novel Coronavirus: A Case of Acute Onset Cotard's Syndrome.

INTRODUCTION: The novel coronavirus (COVID-19) is a respiratory illness that may cause neuropsychiatric sequelae, including persistent psychotic symptoms. CASE PRESENTATION: A 70-year-old White man with no prior psychiatric history presented with altered mental status, Cotard's syndrome, and rigid delusions of poverty and homelessness 6 weeks after recovering from a mild case of COVID-19. After extensive medical workup revealed no organic etiology, he was treated for psychotic symptoms with an atypical antipsychotic, an antidepressant, and electroconvulsive therapy, with improvement over time. DISCUSSION: While COVID-19 is primarily a respiratory disease, some individuals may develop new-onset psychiatric or neuropsychiatric symptoms without prior psychiatric history. CONCLUSIONS: To our knowledge, this is the only published case of post-COVID-19 psychotic symptoms treated with electroconvulsive therapy. As the pandemic continues, the total impact of COVID-19 on psychotic symptoms remains to be seen.