Journal of Family Medicine and Primary Care

IntroductionThe corona virus disease 2019(COVID-19) is caused by the virus SARS-CoV-2 and is declared as a global pandemic by World Health Organization (WHO). Various hematological parameters alteration has been documented in the Chinese literature in SARS-Cov-2 infection. However, there is a need for research to evaluate the pattern of the hematological parameters of COVID-19 patients in the Indian population. Aims & ObjectivesThe objective of the study is to see the Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), and other hematological parameters alteration of COVID-19 patients along with their clinical course in the Indian scenario. MethodsA single-center prospective study of 32 patients with laboratory-confirmed COVID-19 admitted to Super Speciality Pediatric Hospital & Post Graduate Teaching Institute NOIDA, from March to April, were enrolled for the study. The demographic date, the clinical status of the patients during admission and follow up, baseline, and follow up hematological findings were recorded. Statistical analysis of the data was carried out, and relevant findings were presented. ResultsDemographic characterization shows a mean age of 37.7 years, male (41.9%),female (58.1%)with majority patients are mildly symptomatic to asymptomatic(93%). The CBC values and NLR, PLR at baseline between the male and the female patients, are not showing any statistically significant difference as the 95% C.I. A statistically significant increment in the lab parameters is observed in follow-up visits. ConclusionMajority of the patients are younger and have mild clinical presentation with female predominance. Pediatric cases have mild symptomology. Baseline CBC findings show mild neutrophilia, lymphopenia, eosinopenia and normal to mild thrombocytopenia. An increase in CBC parameters, NLR was noted in follow up cases. Anemia was not noted in baseline CBC and in follow up group. A onetime PLR is not indicative of disease progression.

The death rates of medical situations like bacterial meningitis are always quite high. Cerebrospinal fluid (CSF) culture is the most common and reliable test to confirm the diagnosis of bacterial meningitis. All CSF samples that were received in the microbiology lab between January 2017 and December 2021 were included in the study. The study removed all duplicate samples and samples from patients who had recently started taking antibiotics. During the course of the trial, 2000 CSF samples were received. Just 157 of these samples successfully tested positive for the presence of infections. The results of the current investigation showed that the typical pathogens associated with meningitis were not isolated from CSF samples in our method. In contrast, in our setups, highly resistant microorganisms were isolated from CSF. primarily from patients with ventriculoperitoneal shunts.

IntroductionThe COVID-19 outbreak created a major panic among all the citizens of the country owing to its severity, contagiousness within the community, lack of specific treatment and possibility of re-infection. All these factors along with the uncertain behaviour of the virus lead to state of fear and concern all throught out the nation. The current study represents the mental health survey conducted on the students of South Indiaafter the completion of one month quarantine period of the COVID-19 outbreak. MethodologyThe present study is a cross-sectional, web-based online survey which consists of 21-item DASS questionnaire. Thiswas used to assess the emotional states of depression, anxiety, and stress. Using Google Forms, the questionnaire was randomly distributed among the pharmacy students of selected colleges. Mean with standard deviation was calculated for continuous variables and the number with percentage was calculated for categorical variables. ResultsA total of 500 participants responded to the questionnaire. More than half of the responses were received from females (65%). On assessment it was found that, 26 % of respondents reported severe to extremely severe depressive symptoms; 31.5 % of respondents reported severe to extremely severe anxiety symptoms, and 19 % reported severe to extremely severe stress levels. ConclusionIn India during the outbreak of COVID-19, an alarming number of students were found to have an impact on mental health due to the outbreak and were observed to have higher levels of stress, anxiety, and depression. The study findings shows the need of conducting more such studies and can be used to prepare appropriate psychological interventions to improvemental health among the young public during the pandemic.

BackgroundNovel Coronavirus infection disease 2019 (NCOVID-19), caused by the corona virus, was first spotted in Wuhan, city of China, December 2019. The NCOVID-19 virus is spread among individuals through close communication in the form of droplets, not via airborne. Those individuals are at risk of infection who are in close contact with a NCOVID-19 patient or who take care of NCOVID-19 patients. Infection prevention and control measures are critical to prevent the possible spread of any infection in healthcare facilities. Therefore, healthcare workers should be aware of basic knowledge and all procedures concerning prevention and protection from NCOVID-19. ObjectiveThe objective of this study was to evaluate the awareness level of healthcare workers toward NCOVID-2019 in Pakistan. Material and MethodsA questionnaire was generated according to WHO information that was circulated among the healthcare workers of different hospitals and medical institutes of Pakistan. Calculated sample size was 650. ConclusionHealthcare workers have insufficient knowledge of preventive measures and infection control. The authorities must take initiatives on urgent basis to increase the awareness among the healthcare workers and general public also so that the drastic circumstances can be avoided in the developing country like Pakistan.

BackgroundDrug therapy problems (DTPs) defined as medication-related events compromising optimal health outcomes, present particular challenges for patients with cardiovascular disease (CVD) due to complex regimens for multiple comorbidities, often resulting in adverse clinical consequences. This hospital-based cross-sectional study assessed the prevalence and determinants of DTPs among adult ambulatory CVD patients at Wolaita Sodo University Comprehensive Specialized Hospital from May to July 2022. MethodsWe conducted an institution-based cross-sectional study of ambulatory cardiovascular disease (CVD) patients receiving chronic care at Wolaita Sodo University Comprehensive Specialized Hospital. Data were collected through structured patient interviews and comprehensive medical record reviews. Drug therapy problems (DTPs) were systematically identified and classified using Cipolles validated methodology, adapted for the local patient population. We employed binary logistic regression to assess individual associations between predictor variables and DTPs, followed by multiple logistic regression to control for potential confounders. Statistical significance was determined at p[≤]0.05, with 95% confidence intervals used to estimate precision of effect measures. ResultAmong 195 ambulatory CVD patients, hypertension (59.5%, n=116) and heart failure (47.2%, n=92) were the most prevalent conditions. The study identified drug therapy problems (DTPs) in 69.7% of patients (n=136), totalling 168 DTPs (mean 1.3 SD 0.461 per affected patient). Unmet therapeutic needs (41.0%) and medication non-adherence (24.4%) emerged as the most common DTP categories. ASCVD risk assessment classified 40% of evaluated patients as high-risk (10-year risk [≥]20%). Significant predictors of DTPs included polypharmacy (AOR=3.48, 95%CI:1.47-8.24) and age (25-64 years: AOR=16.38), while comorbidities (AOR=0.15) and prior hospitalization (AOR=0.31) demonstrated protective effects. Conclusion and recommendationThis study identifies unmet therapeutic needs and medication non-adherence as the predominant drug therapy problems among ambulatory CVD patients at Wolaita Sodo University Comprehensive Specialized Hospital, calling for systematic medication reviews, pharmacist-led interventions for high-risk groups, and enhanced adherence support programs to optimize treatment outcomes.

BackgroundPatients experiences with health care professionals are a central component of quality of care, complementing more technical aspects of care such as the appropriate use of medications and procedures. AimsThis study sought to assess patients quality of care and level of satisfaction in healthcare facilities in Cross River State, Nigeria. MethodsThe study adopted a descriptive cross sectional survey employing quantitative data collection method that utilized a semi-structured questionnaire to collect data from patients. A multi-stage sampling procedure was used where 405 respondents were selected through simple random sampling. A 27 items semi-structured questionnaire was used to elicit data from respondents. Data collected were analyzed and presented using descriptive statistics. ResultsOn a multi response options, the study showed that more than half 294(72.8%) respondents were satisfied with the services provided by healthcare professionals on their current admission; more than half of the respondents 235(58.2%) were satisfied with previous care received; about half 197(48.8%) of the respondents complained about long waiting time to be seen on admission; more than half 209(51.7%) of the respondents strongly disagreed that the hospital/ward environment into which they were admitted was clean and conducive, with a significant proportion 335(82.9%) who were unable to get all the prescribed drugs from the facility, while just 69(17.2%) of those not satisfied could recall some instances/aspects of healthcare they were not satisfied with where 49(12.2%) recalled poor attitude of healthcare professionals. ConclusionsTimely care and better communication between patient and healthcare providers were recommended among others. What is already known on this topicO_LIThere is a recorded level of patients dissatisfaction with healthcare in the study setting. C_LI What this study addsO_LIPoor attitude of healthcare workers has been associated with patients dissatisfaction with healthcare. C_LIO_LIPoor attitude of healthcare workers has been associated with poor work environment which by extension affect the mental health of healthcare staff. C_LI How this study might affect research, practice or policyO_LIThis study outlines the implication of poor work environment on mental health of workers as by extension affects patients quality of care and as such calls better healthcare management by trained experts. C_LI

BackgroundCoronavirus disease 2019 (COVID-19) has emerged as a pandemic, and the infection due to SARSCoV-2 has now spread to more than 200 countries3. Surveillance systems form the foundation stone of active case finding, testing and contact tracing, which are the key components of the public health response to this novel, emerging infectious disease4. There is uncertainty about the true proportion of patients who remain asymptomatic or pre-symptomatic at a given time. As per the WHO-China Joint Monitoring Mission Report, and an analysis of 21 published reports, anywhere between 5 and 80 per cent of SARS-CoV-2-infected patients have been noted to be asymptomatic5, 6 Whereas in India 4197563 cases are positive, in which in West Bengal total 180788 cases(4.04% of Cases of India) positive of COVID 19. In Paschim Medinipur (West Medinipur) district contributing total 5489 cases (3.03% cases of West Bengal)9,10,11. In this scenario, we want to know the status of IgG seroprevalence of SARS-CoV-2 among asymptomatic general population, so that we can determine the extent of infection of SARS-CoV-2 in general population. ObjectivesPrimary Objective:- To estimate the seroprevalence for SARS-CoV-2 infection in the general asymptomatic population at Paschim Medinipur District. Secondary Objectives-To estimate age and sex specific seroprevalence. To determine the socio demographic risk factors for SARS-CoV-2 infection; To determine the other risk factors like comorbidities, vaccination status, travel history, contact history etc.; To determine the durability of Immunity (IgG) conferred by natural infection of SARS-CoV-2 in individuals previously RTPCR positive. MethodologyIt was a cross sectional 30 cluster study among the population of Paschim Medinipur district of West Bengal conducted in last week of July and 1st week of August 2020 among 458 asymptomatic general population and 30 RTPCR positive cases in 30 villages or wards of municipalities. 30 clusters were chosen from list of COVID 19 affected villages/wards of municipality as per PPS (Probability Proportional to Size) method. ResultsOf the 458 asymptomatic general population,19 asymptomatic people found to be seropositive IgG for SARS-CoV-2 with Mean or average total seropositivity rate of 4.15%. 19 Out of 30 (63.33%) RTPCR positive patients found Seronegative. Median of Days between RTPCR test and sero negativity found was 60 with minimum 28 days to maximum 101 days and Range of 73 days and a standard deviation of 19.46. Among risk factors, the risk of having IgG is more in persons having Travel history with odds ratio of 2.99-95%CI (1.17-7.65) with p-value-0.02. Hydroxychloroquine prophylaxis with Odds ratio of 8.49-95% CI(1.59-45.19) with p value - 0.003. Occupation as migrant labour with Odds ratio of 5.08-95% CI(1.96-13.18) with p value of 0.001. H/O Chicken pox with Odds ratio of 2.15-95% CI(0.59-7.79) with p value of 0.017. Influenza vaccinated with Odds ratio of 8.07 with 95% CI (0.8-81.48) with a p value of 0.036. ConclusionOf the 458 asymptomatic general population,19 asymptomatic people found to be seropositive IgG for SARS-CoV-2 with Mean or average total seropositivity rate of 4.15%. 19 Out of 30 (63.33%) RTPCR positive patients found Seronegative. Median of Days between RTPCR test and sero negativity found was 60 with minimum 28 days to maximum 101 days and Range of 73 days and a standard deviation of 19.46. Those having Travel History and having occupation as Migrant Labourer - have significantly higher probability of getting infected with SARS-CoV-2. No role has been found of Hydroxychloroquine Medicines as Chemoprophylactic. No durable immunity conferred by natural infection with SARS-CoV-2 -mean time to become seronegative after positive RTPCR test 60 days. So there is a chance of reinfection after average 2 months.

AIMS AND OBJECTIVESTo study the distribution and frequencies of ABO and Rhesus (Rh) blood groups among confirmed cases of Covid-19 infection. We also studied the relation between ABO blood group system and lymphopenia and studied the gender association in COVID-19 patients. METHODESA hospital based retrospective study was conducted at Government Medical College Suryapet from 01 Aug 2020 to 30 Sep 2020. A total of 200 Covid cases were included in the study who came to the hospital with the complaints of Fever, Sore throat, Body Pains, Cough, Breathlessness, Diarrhoea etc. Patients confirmed Covid infection was tested for blood grouping and RH typing by using forward blood grouping with the help of commercially available standard monoclonal antisera. CBP was processed in sysmax 5 part Haematology analyser. Blood group frequency was tested also assed the gender association, Covid patients presents with lymphopenia the relation between the ABO blood group and lymphocyte count was determined. RESULTSMales were more compared to the females .Middle aged group male patients were more commonly involved. Most predominant blood group was group B 79(39.5%), group O 78(39%),group A 37(18.5%), group AB 6(3%),most of them were 190 (95%)Rh positive, only 10 Rh negative (5%).To assess the Lymphopenia in our study we divided the absolute lymphocyte count into 5 groups. Group 1 cases are more 58 (29%), Group 2 91(45.5%), Group 3 30 (15%), Group 4 16(8%), Group 5 5(2.5%). CONCLUSIONMale patients with blood group B were more compared to other blood groups however more number of studies are necessary to confirm these findings in a larger sample and among individuals of different ethnicities.

The purpose of this study was to identify and analyze the personal, social and psychological impact of COVID -19 on the mental health of students of age group 16 to 25. A response from N= 351 students (from the most affected state in India), provided a comparative analysis based on the gender, and background via t-test with significance factor of p[≤]0.5, to understand the pattern in issues related to mental health during the pandemic. The results show that female students are more concerned about health, and future, and are more prone to psychological issues like feelings of uncertainty, helplessness and outbursts than male students. Urban students population is more mentally affected than their rural counterparts, however time spent on the internet is almost the same despite the difference in infrastructure and resources. Also, there is an increase in need for solitude, being withdrawn and self-harm in male students require attention. A shift in perception from seeing family as a source of support to that of a restriction is indicated, although the benefits of a collectivistic society are undisputed. The results indicate that there is overall increased awareness about mental health among the student population and with programs/strategies focusing on background and gender, a significant improvement is attainable. Impact StatementThis study performs an analysis of the students response to questions based on social and self-perception as a result of COVID-19. It also discusses the nature of adaptive strategies espoused by them and their effectiveness in dealing with the pandemic, isolation, and the new normal. FundingNot applicable Conflicts of interest/Competing interestsThere was no conflict of interest

BackgroundMental health has always been under the shadow of everyones belief about their health. Concerns about mental health have already risen in the whole world. The COVID-19 pandemic has caused havoc worldwide, notably in the educational system. It has been difficult to quantify the influence of COVID-19 on the mental health of medical students in Bangladesh. AimsThis study was conducted to assess medical students mental health status in Dhaka during COVID-19 pandemic. MethodsThis study was undertaken at Dhaka Medical College, Dhaka, Bangladesh and 359 medical students were the primary respondents for this study. ResultsDepression, anxiety and stress were found in around half of the study participants. Overall, three-fourth of the medical students had poor mental health status. The research study showed that depression, anxiety and stress were dependent on various socio-demographic and behavioral characteristics of medical students. ConclusionPoor mental health is still highly prevalent in the medical students. Different factors like age, gender, academic year, and physical exercise behavior have affected medical students mental health. This calls for attention towards the needs of the more vulnerable demographics and creating a welcoming environment for medical students.

The current study focuses on psychological stress level among doctors, estimated by calculating anxiety score. For the assessment of anxiety levels, the GAD-7 scale was used. Chi-Square test and Odd ratios were calculated among the exposed and not exposed groups involved in the management of COVID-19 patients. Results revealed increased anxiety levels in the exposed group. Besides, the availability of personal protective equipments and stress from the family to quit the job were the substantial contributing factors that increased anxiety. Based on the results, it is proposed that the concern administrative authorities should consider these findings to facilitate medical healthcare professionals.

IntroductionThe COVID-19 has emerged as a global concern for public health due to large scale outbreak. The number of confirmed cases has also been increased in India in past few weeks. The predictions for the COVID-19 can provide insights into the epidemiology of the disease, which helps policymakers to check health system capacities. MethodsWe obtained data on daily confirmed, recovered and deaths cases for a period of 21 days and have implemented the exponential growth model to predict the future cases for all the three components. The mathematical model was used to calculate the average reproduction number and herd immunity. We estimated the number of active cases till 30th of April. We have also tried to analyze the public health capacity to combat COVID-19 in India. ResultsIf the exponential growth in number of cases continue then the total number of active cases will be 2,49,635 until the end of April. The reproduction number for COVID-19 in India was found to be 2.56 and herd immunity as 61%. The cumulative cases predicted by the mathematical model was 1,20,203. DiscussionThis prediction provides an alarming situation for India in terms of public health preparedness. The number of tests is needed to increase to detect all the cases of COVID-19 in India. Though some serious preventive measures have been implemented, but India should be ready to face any sudden community outbreak.

ObjectivesThe COVID-19 pandemic has resulted in interruptions in training for surgical residents in particular. This has been compounded by burnout and mental health concerns among surgical trainees across the world. We aim to determine the impact of the COVID-19 pandemic on psychological outcomes of surgical trainees in a tertiary-care hospital in Pakistan. SettingA cross-sectional, online survey-based study was conducted at a private tertiary care hospital of Karachi, Pakistan. ParticipantsAll the surgery trainees including; residents, fellows and instructors acquiring training at a private tertiary care hospital of Karachi, Pakistan were included in the study. Outcome measuresThe participants were assessed for their perceptions, and concerns regarding the COVID-19 pandemic, impact on their quality of life and generalized anxiety disorder (GAD). ResultsA majority (85%) of surgical trainees were concerned regarding contracting COVID-19 infections. Residents were more concerned with fellow residents developing burnout and anxiety as compared to their own psychological concerns. A strong, significant positive correlation (r=0.66, p <0.001) was noted between negative impact on QoL scores and developing GAD in surgical residents. On multivariable analysis, significant associations with GAD remained for family system, and negative impact of COVID-19 on QoL. The increased working hours for junior trainees showed more likelihood of developing GAD as compared to senior trainees. ConclusionOur investigation on QoL and psychological outcomes of surgical residents showed significant rates of burnout and GAD, which were attributed to concerns with the COVID-19 pandemic. We showed the impact this had on surgical trainees perception regarding their training and concerns with infecting others. This calls for structural interventions to address mental health concerns and provide psychological and educational support to surgical residents. Strengths and Limitations of the studyO_LIValidated measures were used for evaluating the outcomes C_LIO_LIThe study results can be generalized to all the surgery resident trainees working at private tertiary care hospitals. C_LIO_LIThe response rate of trainees was 50%, the authors attempted to mitigate this through regular follow-up emails and reminders for responses. C_LI

COVID-19 pandemic has been an ultimate test of resource management for any governance, especially in the healthcare system. Bangladesh, being a developing country and with very limited resources, is fighting the COVID-19 pandemic. The frontline workers, especially the physicians and nurses are going through immense physical and psychological stress during the pandemic. Social unawareness, the absence of strict preventive policies, increasing workload, and the lack of resource management are making the frontline healthcare workers extremely vulnerable to COVID-19. In this paper, we present the outcome of our study on peritraumatic distress of COVID-19 among physicians in Bangladesh. Based on the user study, we have identified a number of key factors behind the peritraumatic distress and psychological stress caused by COVID-19. Our study shows, more than 78% respondents are suffering from peritraumatic psychological distress. We also recommended some very important and yet easy to implement policies to reduce the peritraumatic stress of the physicians of Bangladesh. These policy recommendations were a result of the survey analysis and the suggestions from the COVID-19 designated physicians.

BackgroundSpirituality has been strongly associated with good blood pressure control as it forms a strong coping mechanism in hypertensive patients. PurposeThis hospital-based cross-sectional study was done to determine the relationship between spirituality and blood pressure control among adult hypertensive patients in rural Southwestern Nigeria with a view to achieving good blood pressure control. MethodThe selection was done by systematic random sampling technique. Socio-demographic and clinical information were obtained through semi-structured interviewer-administered questionnaires. The level of spirituality was assessed using the Spiritual Perspective Scale. Data were analysed using the Statistical Package for Social Sciences version 20.0. Statistical significance was set at p [&le;] 0.05. ResultsThe mean age of the respondents was 61.1{+/-}11.1 years. More than half (52.6%) had high level of spirituality and more than two-thirds (67.1%) of respondents had controlled blood pressure. Respondents with high level of spirituality were 4.76 times more likely to have a good blood pressure control {p<0.001, 95%CI (1.05-14.99)}than those with low level of spirituality. ConclusionProper understanding and effective utilization of this relationship will assist health professionals and researchers in the appropriate integration of this concept into patients holistic care with the aim of achieving better blood pressure control among hypertensive patients.

The coronavirus (COVID-19) is spreading rapidly across the country but Indias testing regime is far from the global standards. It is important to identify the states where testing needs expansion and the magnitudes of active COVID cases are higher focusing on current health infrastructure to meet the pandemic. The data on COVID-19 was extracted from the Application Programming Interface. Test positive rate, test per confirmed case, recovery rate, case fatality rate, and percent distribution of active cases were computed. Availability of hospitals, hospital beds, intensive care unit and ventilators per lakh population was also computed by public and private sector. The result revealed that, Maharashtra constitutes more than one-third positive cases in the country. More than a quarter of the active cases in India belonged to the Mumbai district of Maharashtra, followed by the Chennai district (9.4%) and Ahmedabad district (9.1%). Further, about 40 percent of the active cases in India belonged to the 11 districts of Maharashtra. The increased test positive rate in Maharashtra and Gujarat to almost double in last one month is a concern. In order to bring the states and the country in right track, the test positive rate need to be brought down to below 2 percent. The procurement of higher number of high throughput machine, the Cobas 6800 testing machine, is need of the hour. Only few states have adequate health infrastructure. The priority should be the laid on expansion of more laboratories and hospitals, storage of PPE kit, testing kit, and indigenously developed vaccines. HighlightsO_LIMaharashtra is having the highest number of positive cases followed by Gujarat and Tamil Nadu. Maharashtra constitutes more than one-third positive cases in the country, but the test per confirmed cases (8) is much lower than the other states. C_LIO_LIMore than a quarter of the active cases in India belonged to the Mumbai district (26.1%) of Maharashtra, followed by the Chennai district (9.4%) and Ahmedabad district (9.1%). Further, about 40 percent of the active cases in India belonged to the 11 districts of Maharashtra. C_LIO_LIThe test positive rate is higher in Maharashtra, Gujarat and Delhi is a concern. C_LIO_LIThe recovery rate in India increased substantially by 26.5 percent point from 11.9 percent on April 14 to 38.4 percent on May 17, 2020. C_LIO_LIThe case fatality rate of Covid-19 in India declined by 0.2 percent from 3.4 percent on April 14 to 3.2 percent on May 17 in India. C_LIO_LIThe number of Dedicated Covid Hospitals is not sufficient in India. C_LIO_LIThe available ventilators in the country will deficit in near future to cater to a growing number of active Covid-19 patients and the burden of other communicable and non-communicable diseases. C_LIO_LIIndia has only 569 testing laboratories (396 govt. and 173 private) against its 1.35 billion population. The procurement of higher number of high throughput machine, the Cobas 6800 testing machine, is need of the hour. C_LI

OVERVIEWThe ongoing Pandemic because of the Coronavirus disease 2019 (COVID-19) has caused all the educational institutes including colleges to be closed for a very long time. As a result the students are compelled to remain in their homes for this time. Prolonged stay at home along with excess use of social media and other modes to "kill" the time are quite famous to cause certain health issues in a person, specially the teenagers and adolescents. Mental wellbegin, being a dimension of health as per WHO should not be ignored at all specially in these situations. METHOD OF STUDYAn Online Questionnaire is prepared based of the ZUNG Self Rating Anxiety and Self Rating Depression Scale (Pre-validated Scales). The Form is circulated digitally among the people and then we have collected the data in excel. Based on the result we have prepared our statistical chart. RESULTQuite a significant number of candidates were suffering due to the pandemic situation. 17.091% were suffering from mild to moderate anxiety, 1.785% had marked to severe anxiety levels(Constituting approximately 18.9% of the total). On the other hand, 8.673% of the students had mild depression, while 1 candidate (0.255%) had moderate depression and 1 (0.255%) had severe depression, (Constituting approximately 9.20% of the total). We found that candidates in the age group of 23-24 years had the maximum prevalence of depression, it was followed by candidates with age between 21-22 years. We found that the candidates with age between 23 to 24 years were having highest prevalence of significant anxiety levels which is closely followed by candidates having age which lies between 22 years to 23 years.

India started its vaccination program at the beginning of 2021, the main beneficiaries being health workers and frontline workers including police, paramilitary forces, sanitation workers, and disaster management volunteers in the first phase. By the time, the second wave of Covid-19 impacted India, approximately 14 million healthcare and frontline workers, including dentists had been vaccinated. AimTo study the effectiveness of vaccination on a subset of high-risk healthcare workers i.e. dentists in preventing Covid-19 during the second wave of the pandemic. Study designA questionnaire based pan-India online survey was carried out to record the Covid-related experiences of dentists prior to and after vaccination. ResultThe sample size for this survey was 4493 respondents from across India. During the second wave, 9.18% (n=364) respondents became positive in spite of the vaccine, while 14.69%(n=78) became positive in the unvaccinated group. A chi-square test of independence was performed to examine the relation between vaccination and the Covid positivity rate in all age groups. The relation between these variables was highly significant, [X2 (1, N = 4493) = 15.9809, p=.000064]. ConclusionOur pan-India online survey inferred that vaccination has a definitive role to play in reducing the positivity rate amongst dentists during the second wave of the pandemic across all age groups.

BackgroundCoronavirus disease 2019 (Covid-19) occurs after exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For persons who are at high risk of exposure, the standard of care is personal protection from getting infected. Whether Ayurvedic rasayana drug like Chyawanprash can prevent symptomatic infection in frontline health care workers is unknown. ObjectiveTo evaluate the effect of the combination of Chyawanprash and Standard Preventive Regimen compared to the use of Standard Preventive Regimen alone on the proportion of RT-PCR confirmed COVID-19 infections among frontline healthcare workers (HCWs). MethodsAn open-label randomized controlled trial was conducted in the HCWs between 25 to 60 years age currently working in an environment with chance of direct exposure to COVID-19 cases. The interventions to be compared in this trial were Standard Preventive Regimen as per institutional guidelines and based on their roles (Group I) and Ayurvedic Intervention viz., Chyawanprash 12 g twice for 30 days from day of randomization plus Standard Preventive Regimen (Group II). The incidence of RT PCR confirmed COVID-19 cases in both groups, was the primary outcome measure. Evaluation of the safety of the study drug (by any statistically significant change in various biochemical and hematological parameters and occurrence of any adverse drug reactions); incidence of any other infective diseases (bacterial /viral/ fungal / etc.) like upper respiratory tract illness during the study period and any change in the immunoglobulins like IgG, IgM and IgE and inflammatory markers like TNF alpha, IL-6 and IL-10 were the secondary outcome measures. ResultsOut of 193 participants who completed the study, no participant in both groups was COVID-19 positive at the end of one month. In post intervention follow-up, 4 subjects in Group I and 2 subjects in Group II were COVID-19 positive. No adverse drug reaction or any serious adverse event was reported during the study. No clinically significant change in the safety parameters was observed before and after the study. Statistically significant rise in Serum IgG level was seen in Group II but other inflammatory and immune markers did not show statistically significant difference. ConclusionChyawanprash was well tolerated by all the participants in the intervention group but to prove its adaptogenic effect and efficacy as an add-on to the standard care in preventing the occurrence of COVID-19, clinical trial for longer duration with larger sample size is needed. Trial registrationClinical Trials Registry of India vide CTRI/2020/05/025275 dated 20/05/2020 Date of IEC approval19.5.2020

Due to the significant number and its effects on quality of life, depression is becoming a major concern worldwide. Though its prevalence among junior healthcare professionals is also increasing day by day, still very few data are available regarding this. So, weve conducted a study to find out the prevalence and associated factors of depression among this vulnerable population. A total of 218 participants were enrolled from two public teaching tertiary-level hospitals in Dhaka, Bangladesh from October 2018 to April 2019. Data were collected by using a self-administered questionnaire including the WHO-5 well-being index. Prevalence of major depression was found at 17.9% and poor-emotional well-being was 25.2%. Factors associated independently with major depression were those thinking to be a doctor as the wrong decision (aRRR: 6.85, 95% CI: 1.40-33.45, p=0.017) and taking sedative or anxiolytic drugs (aRRR: 4.54, 95% CI: 1.50-13.73, p=0.007). On the other hand, doing physical exercise (aRRR: 0.32, 95% CI: 0.12-0.89, p=0.028) and being satisfied in their current job position (aRRR: 0.07, 95% CI: 0.02-0.29, p<0.001) had significantly less chance of being suffering of major depression. Suicidal and self-hurting ideation was also found among 23.4% of participants. If these modifiable factors can be addressed properly and by taking necessary steps against these simply identifiable factors, unwanted incidences can be prevented especially in low- and middle-income countries. What is already known on this topicDepression is common among healthcare professionals but is still neglected especially in low- and middle-income countries. What this study addsThinking of being a doctor as the wrong decision, taking sleeping pills, not doing physical exercise, and being not satisfied in their current job position are associated with depression among junior healthcare professionals. Suicidal and self-hurting ideation were also found high among the participants. How this study might affect research, practice or policyEarly identification of major depression by simple factors may help to initiate prompt strategies that will reduce the burden of depression among junior healthcare professionals and may improve the healthcare services of low- and middle-income countries.