Background We retrospectively data-mined the case records of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients hospitalized to a tertiary care centre to derive mortality predictors and formulate a risk score, for prioritizing admission. Methods and findings Data on clinical manifestations, comorbidities, vital signs, and basic lab investigations collected as part of routine medical management at admission to a COVID-19 tertiary care centre in Chengalpattu, South India between May and November 2020 were retrospectively analysed to ascertain predictors of mortality in the univariate analysis using their relative difference in distribution among ‘survivors’ and ‘non-survivors’. The regression coefficients of those factors remaining significant in the multivariable logistic regression were utilised for risk score formulation and validated in 1000 bootstrap datasets. Among 746 COVID-19 patients hospitalised [487 “survivors” and 259 “non-survivors” (deaths)], there was a slight male predilection [62.5%, (466/746)], with a higher mortality rate observed among 40–70 years age group [59.1%, (441/746)] and highest among diabetic patients with elevated urea levels [65.4% (68/104)]. The adjusted odds ratios of factors [OR (95% CI)] significant in the multivariable logistic regression were SaO2<95%; 2.96 (1.71–5.18), Urea ≥50 mg/dl: 4.51 (2.59–7.97), Neutrophil-lymphocytic ratio (NLR) >3; 3.01 (1.61–5.83), Age ≥50 years;2.52 (1.45–4.43), Pulse Rate ≥100/min: 2.02 (1.19–3.47) and coexisting Diabetes Mellitus; 1.73 (1.02–2.95) with hypertension and gender not retaining their significance. The individual risk scores for SaO2<95–11, Urea ≥50 mg/dl-15, NLR >3–11, Age ≥50 years-9, Pulse Rate ≥100/min-7 and coexisting diabetes mellitus-6, acronymed collectively as ‘OUR-ARDs score’ showed that the sum of scores ≥ 25 predicted mortality with a sensitivity-90%, specificity-64% and AUC of 0.85. Conclusions The ‘OUR ARDs’ risk score, derived from easily assessable factors predicting mortality, offered a tangible solution for prioritizing admission to COVID-19 tertiary care centre, that enhanced patient care but without unduly straining the health system.
Background: Maternal mental health is a public health concern especially during COVID pandemic. Essential regular Maternity services are affected due to lockdown and fear of its spread. COVID 19 had its psychological impact among general public and also among perinatal mothers. Psychological problems impact perinatal mothers, and are associated with increased risk to mother and the child. Objectives: To study the prevalence of depression, anxiety and stress among perinatal mothers delivering at a tertiary hospital. To compare these levels between COVID positive and negative mothers Methodology: A case control study among 150 COVID positive and 150 COVID negative antenatal and postnatal mothers in a tertiary hospital. Interview schedule including DASS-21 was administered to assess the levels of depression, anxiety and stress among them. Grades of depression, anxiety and stress were correlated with each other and compared with age and pregnancy status of mothers both among cases and controls. Results: Proportion of some grade of depression 96 (64.0%) among COVID cases was lesser 107(71.3%) than that of controls. Anxiety prevalence was slightly higher among cases 81(54.0%) than compared to controls 78 (52.0%). Prevalence of stress among cases 29(19.3%) and controls 28 (18.7) were similar. Mean depression scores among cases were 10.05±5.10 was significantly lesser that of controls which is 11.44±4.92.There was no association between psychological problems with age and pregnancy status both in cases and controls. There was a significant positive correlation between the scores of depression, anxiety and stress both among cases and controls. Conclusions: COVID pandemic has a significant psychological impact on all pregnant mothers irrespective of their COVID status. This emphasises the need for prompt and early assessment and management of maternal mental health among all pregnant mothers during COVID pandemic.
Tuberculosis (TB) is an infectious disease caused by the bacillus Mycobacterium tuberculosis (Mtb). The present work reports the design and synthesis of a hybrid of the precursors of rifampicin and clofazimine, which led to the discovery of a novel Rifaphenazine (RPZ) molecule with potent anti-TB activity. In addition, the efficacy of RPZ was evaluated in-vitro using the reference strain Mtb H37Rv. Herein, 2,3 diamino phenazine, a precursor of an anti-TB drug clofazimine, was tethered to the rifampicin core. This 2,3 diamino phenazine did not have an inherent anti-TB activity even at a concentration of up to 2 µg/mL, while rifampicin did not exhibit any activity against Mtb at a concentration of 0.1 µg/mL. However, the synthesized novel Rifaphenzine (RPZ) inhibited 78% of the Mtb colonies at a drug concentration of 0.1 µg/mL, while 93% of the bacterial colonies were killed at 0.5 µg/mL of the drug. Furthermore, the Minimum Inhibitory Concentration (MIC) value for RPZ was 1 µg/mL. Time-kill studies revealed that all bacterial colonies were killed within a period of 24 h. The synthesized novel molecule was characterized using high-resolution mass spectroscopy and NMR spectroscopy. Cytotoxicity studies (IC50) were performed on human monocytic cell line THP-1, and the determined IC50 value was 96 µg/mL, which is non-cytotoxic.
The current study assessed the effect of an intervention on problematic internet use (PIU), biopsychosocial functioning, and academic performance in 100 adolescents with PIU in grades 9 and 11 in Ernakulam District, Kerala, India. Students from four comparable schools were randomly assigned to experimental and wait-list control groups after being screened for PIU. The experimental group participated in a 10-week intervention and parents of these adolescents were provided with two sessions. The wait-list control group received the intervention after the posttest. A PIU questionnaire, sociodemographic data, internet usage pattern, a biopsychosocial functioning tool, and academic performance were used to assess participants at baseline and immediately after and 3 months postintervention. Findings revealed significant differences in PIU; physical, psychological, and social functioning; and academic performance immediately and 3 months postintervention ( p < 0.05). Thus, the intervention was effective in reducing PIU among adolescents and improved their physical, psychological, and social functioning and academic performance. [ Journal of Psychosocial Nursing and Mental Health Services, 58 (7), 16–26.]
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