Background: Pharmacotherapy of Severe Acute Respiratory Corona Virus-2 (SARS-CoV-2), also denoted as COVID-19 is evolving. Many antivirals were found to be ineffective. Antiviral therapy used in 2020 was not originally developed for COVID-19. The effectiveness of favipiravir (an original drug for influenza) in COVID-19 pneumonia is questionable. Methods: A small sample retrospective study was conducted to indicate if favipiravir is effective in COVID-19 clearance. It was conducted in a tertiary-level care hospital in the United Arab Emirates. COVID-19 pneumonia patients were admitted to the hospital from January to December 2020 were studied. SPSS version 26 was used for the data analysis. Results: The average day of COVID-19 clearance for those who received favipiravir alone or favipiravir and hydroxychloroquine together were 12 days. Those who received no antivirals had COVID-19 clearance in an average of 11 days. Independent-Samples Kruskal-Wallis Test shows no statistically significant difference (p-value 0.663) in the length of COVID-19 clearance between these three treatment groups. Conclusion: Favipiravir was not effective in mild COVID-19 pneumonia for achieving COVID-19 clearance. The effectiveness of favipiravir on COVID-19 clearance needs to be studied further.

Interleukin 6 (IL-6) is an interleukin that works as a pro-inflammatory cytokine and as an anti-inflammatory myokine. The production of IL-6 in humans is under genetic control. IL-6 is a pleiotropic cytokine created in response to tissue injury and infections. IL-6 is one of the basic cytokines after stimulated macrophages. Hence, control of systemic IL-6 levels in SARS-CoV-2 infected patients may be a consideration for COVID-19 disease. This review will focus on the role of IL-6 in diagnosis and follow up of infection in addition to being the target for treatment.

Background:Severe acute respiratory syndrome Coronavirus 2 (SARS-COV 2) infection elicits an inflammatory response which is responsible for severe clinical manifestations, disease progression and, poor outcomes.Objectives: This study aims to assess the pattern of elevation of inflammatory markers in COVID-19 and to determine their association with clinical, radiological severity and outcome of COVID 19.Methodology: This is a retrospective single-center cross-sectional study conducted at Chettinad Hospital and Research Institute, a tertiary care Hospital in Tamil Nadu, India, encompassing a cohort of 1220 patients. The source population was all cases of COVID-19 admitted at the hospital with a confirmed diagnosis of COVID-19 using RT PCR. The data was obtained from the patient’s case sheets and laboratory investigations and from the electronic data management system. The patient’s clinical severity on admission, baseline characteristics, co-morbid illnesses, presenting complaints, vitals, and inflammatory markers like D-dimer, C-reactive protein IL-6, Serum ferritin, and Lactate dehydrogenase were collected. The data for radiological severity and outcome were coded and analysed.Results: Diabetes and hypertension were found to be the most common comorbidities in the study population; females more affected than males. Fever and cough are the most common presenting symptoms. The clinical severity of patients was found to have a significant association with radiological severity. D-dimer is having a strong correlation with disease severity and outcome at any point in time. IL-6, CRP, Serum ferritin also showed a strong correlation with outcome in COVID-19.Conclusion:Our study suggests D-dimer at any point of time in a hospitalized COVID-19 patient as a promising marker for the same. IL-6 is the next best inflammatory marker followed by CRP and Serum ferritin. LDH is the least significant one among these.

Introduction: COVID-19 vaccine have been indicated to successfully decrease the hazard for symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection furthermore associated hospitalisations. Objective: To study the immune response among different types of SARS-CoV-2 vaccines. Methods: This study includes 100 vaccinated individuals (43 Sinopharm, 30 AstraZeneca and 27 Pfizer) with one or two doses from different health centres in Baghdad. During the period from April 2021 to the end of May 2021, SARS-CoV-2 IgG and SARS-CoV-2 IgM levels were detected using AFIAS-6 device depending on FIA (Fluorescence Immunoassay) technique. Results: 93% of the cases were positive for IgG levels, and negative in 7% cases. Coronavirus IgM concentrations for all individuals were negative. The highest IgG mean level was seen in vaccinated persons with Pfizer than AstraZeneca (34.41, 26.29 respectively) and the lowest mean value was detected in Sinopharm (23.76). There was a significant elevation in IgG levels in the previously infected group in comparison with non-infected individuals. IgG levels decrease in antibody responses to SARS-CoV-2 in older individuals compared to younger participants. Also, results reported that SARS-CoV-2 IgG levels increased in males who were vaccinated with Pfizer and AstraZeneca more than females, while there is a significant decrease in IgG levels in vaccinated males with Sinopharm as compared to females. Conclusion: Different vaccines against SARS-CoV-2 produce different levels of IgG.

Background: COVID-19 pandemic has created thelargest disruption in education systems in history. Numerous medical institutions have shifted to online teaching with the hope to reduce viral transmission.Objectives:To compare the effectiveness of online teaching and traditional teaching in the domains of collaborative learning, critical thinking skills and social interaction and to describe the advantages and difficulties faced in online learning by MBBS students.Materials and Methods: Anonline-based cross-sectional study was conducted fromMay 2021 to August 2021 in a private medical college in Salem district of Tamil Nadu, India. Among the 600 MBBS students attending online classes from the first year to final year MBBS, 574 students consented tothe study through mail and were studied using a semi-structured questionnaire prepared in Google form and sent through mail. Descriptive analysis was done and the association between the categorical variables were tested using chi-square test.Results: Traditional way of teaching was perceived to improve the critical thinking skills (p <0.0006), social interaction skills (p<0.044) and collaborative learning (p <0.01) more than online teaching. Advantages of online teaching identified were comfortable learning environment (38%) easier for slow learners (19%), learning at their own pace (18%) etc. Difficulties faced in online teaching were technical difficulties (62%), lack of self-motivation (61%), time management (56%) etc. Conclusion: Challenges faced by the students need to be identified earlier and Governments/educational institutions can focus more on removing the barriers to connectivity.

Background: COVID-19 is a disasterous pandemic that the world has ever faced. It is affecting the global health system irrespective of race, ethnicity, environment, and economic status. This study is conducted with the aim of assessing the progression of the COVID-19 pandemic in India. Methods: This article uses the functional concurrent regression analysis approach to describe the pattern of daily reported confirmed cases of COVID-19 in India. The approach provides an excellent fit to the daily reported confirmed cases of the disease. The data used in this study have been taken from covid19india.org. Results: Estimated value of the parameter kbof the model is highly volatile. During the first phase of the pandemic which last up to 31st March 2020, value was very high. During 31st March to 19th July 2020 except for a few exceptions. Its value again increased rapidly from 17th February 2021 to 16th April 2021 and started decreasing after mid-March, 2021 and continued decreasing till present. Conclusion: The data-driven approach used in this study is purely empirical and does not make any assumption about the progression of the pandemic or about the data. The article suggests that based on the parameter of the model, an early warning system may be developed and institutionalised to undertake the necessary measures to control the spread of the disease, thereby controlling the pandemic.

Introduction: In the fight against COVID-19, doctors, nurses, administrative staff, police personnel and other supporting staff have been in the frontline providing emergency services. While performing their duties, they are at risk of getting infections and transmitting them to their near and dear ones. This can lead to increased psychological stress levels among them. This study was conducted to assess the level of stress among health care workers and police personnel during the COVID-19 pandemic period in Delhi. Methodology: This is a cross-sectional study among the COVID-19 warriors working in designated COVID-19 hospitals using Google forms. The relationship between various social, demographic, and administrative factors and the level of stress experienced by the study subjects was assessed using Perceptive Stress Scale (PSS-10). Results: The results describe heightened severity of perception of stress among the study cohort. We found at least 10 risk factors that showed statistically significant association with increased TPSS in the studied cohort group. Conclusion: There is an urgent need for screening, proper diagnosis, and management of psychiatric issues among FLCWs, and for expanding mental health services for reducing stress among the target population.

Background: Knowledge about malaria associated with pregnancy (MAP) is scarce in Latin America and Colombia. Methodology: This paper presents an overview of studies captained in Pubmed, Lilacs, GoogleScholar and thesis repositories from six Colombian universities and bibliographic references of manuscripts. Results: The following topics have been described: study sites, infectious agents, genetic variation of Plasmodium in MAP, vector resistance to insecticides, incubation period, natural susceptibility and resistance to infection, immunity in MAP, frequency, coexistence of gestational (GM) and placental (PM) malaria, associated factors, efficacy of antimalarial treatment, material living conditions in MAP. The MAP has a high prevalence, with a high frequency of submicroscopic infections. There are cases of MAP due to P. falciparum, P. vivax, or both. Monotherapy with chloroquine or amodiaquine for MAP for P. vivax has efficacy greater than 95% and artemether-lumefantrine or artesunate-mefloquine 100% for P. falciparum. There are high rates of anemia in pregnancies (30-70%). In “The Region,” there is no problem of resistance of vectors to insecticides. MAP occurs in poor territories, with interaction of food insecurity, chronic malnutrition, dissatisfaction of basic needs, intestinal parasites, violence and abuse of human rights. Conclusions: MAP study is just beginning in Colombia; there are no programmes that effectively operate to detect and solve this problem; Government agencies, international health organizations, and private companies should finance the multidisciplinary and comprehensive research (natural and social) of the MAP, in order to know its main characteristics throughout the country and use that knowledge as a basis to seek solutions.

Introduction: Gastric cancer (GC) is the second and fourth most prevalent cancer in men and women, respectively, and is one of the leading causes of cancer death worldwide. Many studies have shown that heavy metal exposure and trace element levels in the body are the most critical etiologies for cancer development. As a result, the goal of our research was to assess the imbalances in the serum concentrations of selected elements (Cu, Co, Se, Ni, Cd, and Pb) in post-operative GC patients against healthy participants/ controls. Methods: The metal levels were determined using a nitric acid/perchloric acid-based wet digestion technique and flame atomic absorption spectrometry, Serum levels of CEA were measured using a two-site immunoenzymometric assay, which is performed entirely in the AIA-PACK SLa test cups. Results: Pb, Cd, and Ni concentrations were found to be significantly higher in the blood of GC patients than in the blood of controls, but Cu and Co levels were significantly lower in the blood of GC patients than in the blood of controls. In the blood of post-operative GC patients, correlation analysis revealed a positive association between CEA-Cd, CEA-Pb, and CEA-Ni, while the correlation was negative for CEA-Cu. These findings were statistically significant (p < 0.05). Conclusion: According to our findings, low Co and Se levels, as well as high Pb and Cd levels, may have a role in the development of stomach cancer.

Background: Malaria is one of the major public health problems in India and climate change is expected to aggravate the situation by opening new windows for transmission, particularlyin the Himalayan region. It is, therefore, essential to identify knowledge gapsand adaptive capacity of communities to the adverse impacts of climate change, to develop adaptation plan and improve resilience. Methods: The adaptive capacity to potential risks of malaria due to climate change was assessed in the states of Himachal Pradesh and Uttarakhand, based on the knowledge, attitude, health seeking behaviour, practices and socio-economic status of the communities. The preparedness of health facilities was also assessed in the respective healthcare facilities in view of the threat of climate change. Results: Though communities had basic knowledge about malaria, lack of specific knowledge about breeding sources of mosquitoes, use of traditional protective measures (41%) from mosquito bites, delayed health seeking behaviour by 40% households (2-4 days after illness) were found unsatisfactory.The assessment of health system revealed inadequacies in capacity for beds at CHCs (in 60%), lack of training of staff and logistics in preparedness for the threat of malaria. Conclusion: The general knowledge of communities regarding malaria was satisfactory, but several misconceptions which may affect the vulnerability to future risk of malaria were found. The adaptive capacity was found slightly above average (57.04) owing to the overall good socio-economic status. However, lack of proper health care infrastructure may impact the overall adaptive capacity of the communities to malaria.