Background: Coronavirus disease-2019 (COVID-19) outbreak has affected more than 100 countries worldwide with more than 100,000 cases, during the first week of March 2020. As there are no approved therapeutics or vaccines for the treatment/prevention of COVID-19 till date, awareness among healthcare workers (HCWs) about the disease, mode of transmission, safety precautions, and early diagnosis plays a great role. Aim and objective: To investigate the knowledge, perception, and practices among HCWs of pediatric surgery toward COVID-19. Materials and methods: A cross-sectional, web-based study was conducted among HCWs posted in the Department of Pediatric Surgery, PGIMER, during the first week of May 2020 who were supposed to be involved in the care of COVID-suspected or positive patients. A 26-item survey instrument was devised and circulated via e-mail. A Chi-square test was applied to know the levels of associations between variables, with p value < 0.05 set to be significant. Results: Of 100 responders, 98 responded to a question regarding common symptoms with fever (98%), dry cough (89.8%), and sore throat (81.6%). While asked about the situations of pediatric surgical relevance like the progression of severity, majority (75.8%) opted for difficulty in breathing, followed by persistent high fever (78.9%). Regarding routine practices, HCWs were aware of procedures such as endotracheal tube suctioning (99%), tracheal sample collection (90.9%), changing of ventilator tubings (78.8%), and chest physiotherapy (60.6%) which are liable for transmission. Vertical transmission through breast milk and immediate postpartum care of babies born to infected mothers were associated with inadequate knowledge. Conclusion: HCWs are high-risk group for COVID 19; only knowledge and training can help to prevent and contain the disease. HCWs involved in pediatric surgical specialty had accepted levels of perception. Regular scheduled educational and training programs are crucial to fight with this disease.

Aim and objective: Coronavirus disease-2019 (COVID-19) has emerged as a serious global health problem in the 21st century. Due to its rapid spread across the nations, the World Health Organization declared it as a Public Health Emergency of International Concern (PHEIC), and efforts are being made worldwide to find a permanent solution. This disease outbreak has also shown certain gender-based impacts and has shown gender differences in vulnerability and mortality toward COVID-19. Materials and methods: A 3-month cross-sectional study aimed to study the gender differentiation among COVID-19-positive patients was conducted in one of the premier tertiary-care multispecialty hospital of North India. The data pertaining to all the screened, tested, and reported positive for COVID-19 patients admitted in the “COVID hospital” of the institute was taken into analysis. Results: A total of 1,566 of suspected patients were screened, and 271 were tested for COVID-19. Of the total of 271 tested, 104 patients were reported as COVID-19 positive; 63 (60.6%) were male and 40 (39%) were female. It was also attributed that male patients were having associated comorbidities, such as diabetes mellitus, hypertension, and smoking. Similarly, of 104 COVID-19–positive patients, death rate was also more towards male patients, 04 (3.84%), than female patients, 03 (2.88%). Conclusion: The study has provided insight into the differences in disease severity in males, and more workup is needed to generalize our findings on gender effects of the COVID-19 outbreak.

Coronavirus disease-2019 (COVID-19) has come up as most difficult problem as of today faced by whole world especially by the medical community. All kinds of measures are being done by various governments and health officials to deal with this present pandemic. Intensivists, physicians, and anesthetists have defined role in primary and ICU care. Although the orthopedic community is not involved in first-line management of COVID-19-infected patients, we have equal responsibility to provide emergency care to all trauma patients and various other orthopedic emergencies. While delivering services, it is essential to restrict the consumption of various resources. It is our collective responsibility to prevent the spread of infection among healthcare workers and patients. Lockdown implemented by various governments has impacted the global economy, which in turn resulted in reduction of purchasing power of patients, so we may have to choose more cost-effective implants and curtail the number of investigations. While performing operations, certain procedures like using diathermy and saw blade generate aerosols. So, it is our responsibility to understand these procedures and to make use of them only when absolutely essential. We may experience second wave of cases later this year. Relaxation of lockdown may not mean relaxation from the virus.

Aim and objective: The current study aimed to evaluate the psychological issues, including the prevalence of anxiety and depression among healthcare workers (HCWs) working in a tertiary care center. Materials and methods: This was a cross-sectional online survey in which the survey link was sent to employees of the institute, either through personal messages or using various WhatsApp groups. The survey questionnaire assessed depression, anxiety, and other psychological issues among the HCWs. Results: The study included 88 participants with a mean age of 32.8 (SD: 9.5) years. A majority of participants were male (54.5%) and were married (53.8%). 29.5% had been quarantined or had to stay in self-isolation for doing duties in coronavirus disease-2019 (COVID-19) area. The anxiety disorder and depressive disorder were present in 15.9 and 13.6%, respectively. All the participants with depressive disorders also had an anxiety disorder. About one-fifth to half of the participants reported “mostly or always” experiencing the feelings of loneliness, social disconnectedness, feeling of being used, running away from work, scared of contacting infection, scared of not getting support from the administration, scared of not getting personal protective equipment (PPE), feeling angry because of lack of adequate safety equipment, tense of getting infected with COVID-19, and tense of unknowingly spreading the infection. However, one-fifth to half of the participants reported “mostly or always” experiencing the feelings of being optimistic and feeling proud of self. Conclusion: Every seventh HCWs found to be suffering from diagnosable mental disorders. A significant proportion of HCWs are also experiencing a multitude of negative emotions. These findings suggest that there is a need to develop mental health support for all HCWs, and also there is a need to address the concern of HCWs.

Background: The existing literature on the mental health outcomes of frontline healthcare workers (HCWs) is silent over the psychosocial issues being faced by the housekeeping/hospital attendants (HAs) and sanitary attendants (SAs) who are also actively involved in coronavirus disease-2019 (COVID-19) patient care and in biomedical waste management. This group of HCWs can be considered as the “faceless corona warriors,” and their psychosocial issues needs to be focused upon too. Aim and objective: To evaluate the psychosocial issues and problems related to issues specific to carrying out duties in COVID-19 wards among the HAs and SAs. Materials and methods: An interview-based approach (cross-sectional assessment) conducted by healthcare professionals in the local languages of the HAs and SAs was followed. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess depression and anxiety, respectively. Along with it, a self-designed questionnaire was added to evaluate the different emotional states and problems faced by the HAs and SAs during their COVID-19 duty. Results: A total of 100 participants (62 HAs and 38 SAs) were enrolled for this study. Overall, 11% reported mild anxiety and 21% reported mild depressive symptoms (as per the GAD-7 and PHQ-9 grading) with an overall psychological morbidity of 25%. A significant proportion (one-third to one-fourth) of the participants reported negative emotional experiences, such as that of sadness, scared, anxious, loneliness, socially disconnectedness, being used, and feeling stigmatized for working in COVID areas. Overall, 40% of the participants were ‘very scared’ of infecting their family members and two-fifths (39%) reported that their family members were worried for “most of the time” about them getting ill. Further, about one-fifth (19%) of the participants had difficulty in learning the steps of donning and doffing of personal protective equipments (PPEs), and one-fourth (25%) reported forgetting the steps of donning and doffing process. More than half of the participants reported of work overload and hectic duty shifts, and majority of the participants reported feeling uncomfortable and “dizzy,” having headache, and feeling thirsty during duty hours while on PPEs. Conclusion: Our findings suggest that a substantial proportion of HAs and SAs have mild anxiety, depression, and several significant negative emotional states as well as family-related concerns during COVID-19 duty period and while under quarantine. They also reported significant and genuine problems related to PPEs usage and infection control measures. Timely steps in the form of appropriate mental health support as well as adequate counseling and reassurance during training can prove beneficial in allying the concerns of this group of HCWs engaged on COVID-19 duties. Key learning points: What is already known about this subject: • The existing literature on the mental health outcomes of healthcare workers on COVID-19 duties have mainly focused on the psychological morbidity among the doctors/physicians and nurses. • No data are currently available on the psychosocial issues and problems faced by the housekeeping/hospital attendants (HAs) and sanitary attendants (SAs) who are actively involved in patient welfare and in biomedical waste management of COVID-19 patients. What this study adds: • Our findings highlight the presence of anxiety and depressive symptoms (mild in intensity), and negative emotional states in a significant proportion of HAs and SAs on COVID-19 duties. • We also found significant evidence related to the family concerns and problems being faced by this group of healthcare workers (HCWs) related to infection control measures and personal protective equipment's usage/training. What impact this may have on practice or policy: • Our findings highlight the importance of mental health support, proactive reassurance, and counseling which are essential to allay the concerns and anxiety of this group of HCWs. • The mental health issues of this group of HCWs needs to be addressed as for other front line HCWs (doctors and nurses).

The ongoing lockdown situation due to coronavirus disease-2019 (COVID-19) pandemic is having its influence on the physical and mental health of individuals in varied ways, with a majority of the population struggling with a change in patterns of day-to-day chores, routine, and behavior. This change of pattern is also observed in diet and nutrition of people, particularly children, who are facing this unique challenge. The influence of dietary habits on overall health in general and oral health in particular can never be overemphasized. The changes in dietary patterns among children during these times may, therefore, have an impact on dental caries cases in the near future.

Limited data were available for managing a pregnant woman developing coronavirus disease-2019 (COVID-19) infection as the pandemic gripped the world. Presumptive information for guiding the management of pregnancy and COVID-19-infected women came from various bodies, such as Royal College of Obstetricians and Gynaecologists (RCOG) and American College of Obstetricians and Gynecologists (ACOG), which were updated from time to time as more information was built up, publications came from China, US, and UK as pregnant women with COVID-19 got admitted with infection. Indian Council of Medical Research also prepared guidelines for India based on the publications of international agencies. The obstetrician should have protocols to manage women who are pregnant, individualizing risk stratification of each woman, management of person who is under investigation (PUI) or the suspect for COVID-19, and management protocol for confirmed case of COVID-19 infection, with adequate preparation to face the situation and training of all healthcare workers. It appears that pregnant women are not at increased risk to develop the viral infection and only 5% will have severe pneumonia. If infected most would have mild disease and the pregnancy will not impact the overall outcome of the illness. The incidence of cesarean section is reported higher in women delivered with COVID-19. Vertical transmission to the baby is controversial and women may be advised to breast feed.

Coronavirus disease-2019 (COVID-19) was acknowledged as a pandemic in March 2020. COVID-19 affected substance users by aggravation of stress and reduction of substance availability. This led to the proliferation of gray market, inadvertent consumption of toxic substances, withdrawal-related suicide attempts, and even completed suicide. Among these, a silver lining was an increased treatment-seeking behavior. Tobacco is a highly debated substance in the context of COVID-19, with contradictory and controversial evidence regarding the interrelationship between the two. Nicotine affects the expression of angiotensin-converting enzyme-2 (ACE-2), which acts as a cellular receptor for the entry of SARS-CoV-2. Cholinergic nicotinic stimulation to alveolar macrophages can also reduce cytokine release. This might be helpful during the cytokine storm phase of the illness. So nicotine may be a treatment option for COVID-19. Some counterintuitive data show a reduced prevalence of smoking among COVID-19 patients in comparison to the general population. Smoking and vaping-related lung injuries are proposed to be a contributory factor for increased mortality among adult males. Vaping may further increase vulnerability by acting as a fomite source for infection due to the sharing of the device. Lockdown has increased predilection for tobacco use and also restricted substance availability and treatment access. In this situation, various behavioral managements such as distraction techniques and relaxation exercises might be helpful to handle craving. Telemedicine and app-based interventions might also be helpful in some situations.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease is a primarily respiratory illness transmitted among close contacts mainly via respiratory droplets and direct contact. It uses angiotensin-converting enzyme 2 (ACE2) receptor to enter into the cells of the respiratory epithelium and as ACE2 receptor is also expressed in gastrointestinal (GI) epithelial cells, some patients with coronavirus disease-2019 (COVID-19) have GI symptoms, such as abdominal pain, vomiting, nausea, and diarrhea. Patients with COVID-19 with GI and hepatic manifestations are at risk of severe disease as well as development of acute respiratory distress syndrome. Also, detection of SARS-CoV-2 viral RNA in stool samples of infected patients has raised possibility of GI tract being an additional site of infection as well as viral replication and further studies are needed to study the possibility of feco-oral transmission of COVID-19. This updated review discusses GI and pancreatic manifestations of COVID-19 and its clinical implications.

Coronavirus disease-2019 (COVID-19) pandemic has created many challenges. The suddenness of this mandate and the concomitant spread of the disease have left orthopedic surgeons with notable anxiety and confusion. As the orthopedic practice is now resuming, there is yet no clarity on the guidelines on the personal protective equipment (PPE) that is needed for orthopedic surgeons, and the guidelines coming from multiple sources has been difficult to assimilate. In this article, we seek to provide a summary of available PPE, the latest recommendations for various clinical areas (outpatient, inpatient and operating room), and the procedure for donning and doffing the PPE.

Introduction: We aimed to predict the trend of coronavirus disease-2019 (COVID-19) in India using autoregressive integrated moving average (ARIMA) model. Even though many models are available, ARIMA is found to be the best in COVID-19 situation; because ARIMA uses actual data and predicts accurately for a short period and thus proved as an effective public health tool especially in COVID-19 pandemic. On the contrary, most of the other models uses assumptions instead of actual data; based on agent, host, environmental factors, which is not yet clearly understood in this pandemic and those models will suit for well-understood diseases. Materials and methods: The trend of COVID-19 was predicted using Gretl software and ARIMA model. Information about the COVID-19 was collected on a daily basis during January 1, 2020 to July 4, 2020 and predicted from July 5 to August 30, 2020. Various ARIMA models were assessed and the best one was selected. Then, the model's fitness was evaluated based on the normality of the residuals’ distribution, based on the Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC). We also compared the first 20 days’ data with actual data. Results: The study results indicated that the ARIMA model (1,2,1) in confirmed cases could appropriately predict the cases and death in India and it is predicted that the cases may reach to 2.4 million by September 5, 2020 from the current status of 0.64 million. Conclusion: Autoregressive integrated moving average prediction is a good tool in public health, for the current COVID-19 pandemic.

Aim and objective: To review the status of various approaches for prophylaxis of coronavirus disease-2019 (COVID-19). Background: The extensive spread of the novel COVID-19 has seen tremendous success over the span of few months. In comparison, our progress in developing an adequate treatment or preventive modality has been sluggish, at most. Results: Many observational studies and clinical trials are published evaluating chloroquine and hydroxychloroquine as prophylactic measures for COVID-19. Some question its safety, some refute its use while some uphold its beneficial effect. Although some scientific bodies advocated its routine use in some population without adequate evidence, current consensus proposes its prophylactic use in the context of clinical research only. Apart from chemotherapeutic drugs, several vaccines are under various phases of clinical development. Innovative vaccine development faces many hurdles as do the new drugs—from the inception of concept and establishing manufacturing process to time-consuming preclinical and clinical development, regulatory processes, large scale production, and then marketing. There is a lot of hopes and expectations from AstraZeneca's candidate vaccine, ChAdOx1-S, and Serum Institute of India's recombinant bacille Calmette–Guerin that are currently in phase III clinical trial. In order to expedite vaccine development, controlled human infection models are also being explored. Some research bodies also suggest using complementary and alternative medicine to supplement the existing and novel prophylactic therapies in preventing the infection. Conclusion and clinical significance: The increase in literature on the management of COVID-19 reflects the demand to address the current pandemic. At the same time, it becomes critical that research community works toward providing best evidence for guiding the clinicians’ practice and that clinicians and regulators emphasize on appraising the existing evidence before prescribing and making policies, respectively.

Infectious diseases are one of the major global health concerns affecting innumerable individuals worldwide. Lately, in December 2019, a novel coronavirus, now coronavirus disease-2019 (COVID-19) has emerged in Wuhan, China and spread its wing over the whole globe. The fact, that there is no vaccine and medicine available to treat and prevent the COVID-19 infection, has forced everyone to avoid physical contacts followed by an advice to stay safe at home. As a part of its health promotion activity, Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh had started a new drive “From handshake to hands-free greetings”, christened as “SALAAM–NAMASTE” Campaign from February 5, 2019, long time before the onset of novel COVID-19 pandemic. The aim of this awareness initiative was to promote hands-free way of greetings to reduce the transmission of pathogens and infections from one another. This practice has been recommended by many specialists worldwide calling it a “modern-day” health hazard as handshaking is responsible for transmission of around 90% of bacteria.

Good hand hygiene practices include cleaning of hands either by handwash or by hand rub. In healthcare settings, it is not easy to wash hands with soap after seeing each patient and is time-consuming as doctors are already working overtime. Hence, in hospital settings, it is also recommended to use alcohol-based hand sanitizers that can rapidly kill microorganisms, which spread various contagious diseases. Amidst the coronavirus disease-2019 (COVID-19) outbreak, the demand for essential commodities such as hand sanitizer, masks, etc., increased and hampered the hospital supplies. To address the shortage and limited supply of hand sanitizers to the various medical and paramedical departments of a tertiary hospital, the Department of Community Medicine and School of Public Health in coordination with the Pharmacology and Medical Microbiology Department prepared hands sanitizers following the World Health Organization (WHO) guidelines. The paper discusses the procedure that was followed for the preparation of hand sanitizer to meet the institutional demand and motivate others in similar settings to address the issue of restricted supply during the COVID-19 pandemic.

The increased risk faced by otorhinolaryngologists during coronavirus disease-2019 (COVID-19) is due to high concentration of viral particles in the upper aerodigestive tract. There have been multiple recommendations and reviews for COVID-19 pandemic among the otolaryngologists for different regions of the world, but it is more of lessons learnt than definitive evidence due to lack of any study on the healthcare worker. Therefore, we must learn from each other's prospective so as to change lessons into practice and time testing of all these might bring out the most applicable standard of care. This study focuses on the changes in the operation theater (OT), outpatient department (OPD), emergency, and other routine services in the Otorhinolaryngology department of PGIMER which caters to a majority of North Indian population.

The pandemic of coronavirus disease-2019 (COVID-19) has taken the world unaware. Spread of the novel coronavirus, severe acute respiratory syndrome–coronavirus-2 (SARS–CoV-2), has reached a pandemic status. Elderly and people with comorbidities (obesity, type 2 diabetes) are hit the hardest with this respiratory disease. Optimum nutritional status is one of the important forms of defense against the process of existence of new viral pathogens. Nutritional malnutrition (imbalanced intake of macronutrients as well as micronutrients) is rampant, both in developing and the developed world; therefore, it is important to check the nutritional status of the patients for studying the cause of the viral disease. Overall immunity is suppressed in case of micronutrient deficiency since it affects cell-mediated and adaptive immune response leading to irregulating of immune response. Nutrition knowledge and research has widened the horizons of prevention and cure of dreaded virus threats, such as COVID-19. It identifies further progress in basic and clinical research for incorporating the type of foods which can make our immune system strong enough to resist the infections. Enhancement of public health is of utmost concern and this has to be from natural things rather than artificially incorporated.

Introduction: Despite global strategies for containment adopted so far, the incidence of coronavirus disease-2019 (COVID-19) continues to rise across the globe transcending borders and cultures. The objective of this paper is to evaluate the impact of short-term Web-based COVID-19 certificate program on knowledge of global public health professionals in managing the corona pandemic in their respective countries. Materials and methods: A series of three webinars were conducted by the Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, between April and May 2020. The program was supported by the Ministry of External Affairs, Government of India, through the Indian Technical and Economic Cooperation Scheme. The program focused on imparting basic knowledge about COVID-19 pandemic and its management to mid- and senior-level healthcare professionals, including program managers, academicians, researchers, and policymakers. The topics covered included 28 lectures under eight modules demonstrating good practices of India ranging from hospital management to field-based surveillance and administrative aspects. Results: A total of 131 participants from 17 countries of 5 continents (Asia, Africa, North America, South America, Oceania) attended the program. Majority of participants were clinicians (n = 55, 42%) followed by other healthcare staff, viz., lab technicians, pharmacists, information technology managers (n = 42, 32.1%), academicians (n = 19, 1.5%), and public health professionals (n = 15, 11.5%). There was a significant increase in participant's knowledge score (p < 0.0001) after the all three programs. Majority (93.1%) of participants felt the program was excellent or very good, especially on relevancy of the program (74.4%) and its application in the workplace (74.4%). Conclusion: The program has not only successfully shown its effectiveness in increasing the knowledge and skills of global participants in managing corona pandemic but also helped in enhancing image of country by showcasing best practices of India to global participants.

The current coronavirus disease-2019 (COVID-19) pandemic is an enormous and unique challenge to the mankind. Its unprecedented global health impact has exposed the vulnerability of existing healthcare systems and infrastructure of all the countries, rich or poor. Devastating effects of COVID-19 have challenged all aspects of patient care, be it emergency or elective. One of the worst affected population is those with underlying cardiovascular disease. In addition to effects on healthcare workers, it has serious consequences for the education and training of fellows. With currently worsening COVID-19 crisis in the country, one wonders the extent of its impact on various aspects of human health and the healthcare systems.

Introduction: Lockdown and quarantine strategies due to coronavirus disease-2019 (COVID-19) scare have made routine health facility inaccessible to patients across the country. To combat this issue, teleconsultation was identified as an interim solution where patients could avail the benefit of routine health check-up. Materials and methods: We at AIIMS, Mangalagiri, started two electronic consultation (e-consultation) designs to tide over the crisis of lockdown and reach out to our patients. These were call-based (group I) and app-based (group II). The patient response to these two modalities was compared over a period of 6 weeks. Results: Total registration of 1836 patients was received (1598 in group I and 238 in group II). There was a statistically significant difference between the two groups in response to ease of the registration process and consultation. Interpretation and conclusion: In our experience, e-consultation through call-based registration fared better than app-based registration. The user-friendly nature of call-based registration design has made it a popular approach among our patients. We strongly recommend the use of e-consultation services by the patients in the current scenario of COVID-19 scare, thus helping the nation fight the dreadful infection by preventing its spread.

Reality check The data presentation is an art based on science. In general, raw data are difficult to understand and present. Therefore, information from data is appropriately summarized and presented in texts and tables. The tables emphasize individual and precise values. Further, these are important and integral components of scientific research. A young trainee has been asked to prepare dummy tables by the mentor. The trainee has a general idea about the tables, but did not hear about the dummy tables. Therefore, the trainee wants to know the answers to a few questions before proceeding ahead with the assigned task. • What are the components of the table? • What are the characteristics of a good table? • What are dummy tables? • What are the advantages of dummy tables?