The low-and-middle-income country (LMIC) context is volatile, uncertain and resource-constrained. India, an LMIC, has put up a complex response to the COVID-19 pandemic. Using an analytic approach, we have described India’s response to combat the pandemic during the initial months (from 17 January to 20 April 2020). India issued travel advisories and implemented graded international border controls between January and March 2020. By early March, cases started to surge. States scaled up movement restrictions. On 25 March, India went into a nationwide lockdown to ramp up preparedness. The lockdown uncovered contextual vulnerabilities and stimulated countermeasures. India leveraged existing legal frameworks, institutional mechanisms and administrative provisions to respond to the pandemic. Nevertheless, the cross-sectoral impact of the initial combat was intense and is potentially long-lasting. The country could have further benefited from evidence-based policy and planning attuned to local needs and vulnerabilities. Experience from India offers insights to nations, especially LMICs, on the need to have contextualised pandemic response plans.
Background: Once a device for telecommunication, now a powerful device bringing the whole world in one's palm, smartphones are increasingly becoming a common commodity among the medical students. Smartphones foster social interaction and facilitate multitasking and learning, but they also have some adverse effects. Young people, especially students, who are always inquisitive towards new technology, are likely to be affected by both these positive and negative impacts. Objective: To assess smartphone use and its association with the quality of life (QOL) of medical students. Materials and Method: A cross-sectional study was conducted among the undergraduate medical students of Government Medical College (GMC), Haldwani. All the students enrolled in MBBS course in GMC, Haldwani, who gave consent for participation and were present on the day of questionnaire administration, were included in the study. Smartphone addiction scale (SAS-SV), and WHO-BREF questionnaires for QOL were used for assessing smartphone use, and QOL of the medical students, respectively. Results: A total of 395 medical students were included in the study; out of them, 42% considered themselves addicted to the smartphone. According to SAS-SV, smartphone addiction was found among 43.8% medical students. It was seen that the junior-most and senior-most batches were significantly less addicted to the smartphone (p-value < 0.001). Male students were more addicted (OR = 1.45, CI = 0.962–2.174) to the smartphone as compared to females. The QOL of the students was significantly affected by smartphone use in all domains assessed (p-value ranging from < 0.001 to 0.002). Conclusions: Smartphone addiction is high among medical students and it has a significant negative impact on their QOL.
Background: Protective role of estrogen in COVID-19 was speculated once the epidemiological studies reported increased susceptibility of estrogen-deficient population – males and postmenopausal females to severe disease category and involvement of angiotensin-converting enzyme 2 receptors and renin–angiotensin– aldosterone system in pathophysiology. Materials & Methods: An open-label randomized controlled trial was planned to assess the efficacy of short-course oral estradiol in preventing the clinical progression to severe disease and reduce case-fatality rate and the hospital stay duration in estrogen-deficient postmenopausal women. The intervention group (n = 40) received 2 mg per day of estradiol valerate per orally for 7 days along with the standard care, while the control group (n = 40) received only the standard care. Results: A significant difference was observed in the rate of reverse transcriptase–polymerase chain reaction negativization in the intervention versus control group at day 5 and day 7 of admission (42.5% vs. 15%, P = 0.007; 72.5% versus 50%, P = −0.026). No significant difference was noted in the duration of hospitalization (P = 0.213). A significant decrease was noted in the mean values of inflammatory biomarkers – D-dimer, lactate dehydrogenase, and C-reactive protein on day 5 in the intervention group. Interleukin-6 also showed a declining trend on day 5 in the intervention group, while a rising trend was noted in the control arm. Only one case (2.5%) in the intervention group while seven in the control group (17.5%) progressed to the moderate category; however, the difference was not statistically significant (P = 0.057). Conclusion Oral estradiol in postmenopausal females can be a novel and efficient option for managing nonsevere COVID-19 infection.
Rapid collection of data is of utmost importance in monitoring and evaluation of activities of public health importance. Among others techniques, 30 by 7 cluster sampling and Lot quality assurance sampling(LQAS) methods have been described in literature for this purpose. However, LQAS is often sparingly used in most settings, undermining its importance as a effective epidemiological tool in public health practice. To some extent LQAS is inadequately understood and even less emphasized method, especially in the postgraduate teaching and training. In this paper we aim to explain the use, method and application of LQAS in public health settings as well as discuss common pitfalls to avoid while planning and drawing inferences based on data collected through LQAS.
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