Week Of March Research Articles

Non-alcoholic fatty liver disease: a Sri Lankan perspective.

Ceylon Medical Journal (CMJ) is a peer-reviewed, open access journal published quarterly by the Sri Lanka Medical Association in the last week of March, June, September and December each year. The mission of the CMJ is to promote the science and art of medicine and betterment of public health. The Journal publishes original papers and commentaries which have relevance to medicine and allied sciences. The CMJ is committed to maintaining and conforming to the editorial and ethical standards recommended by the International Committee of Medical Journal Editors.

Cannula segment pulmonary embolism. A rare complication of a fractured cannula.

Ceylon Medical Journal (CMJ) is a peer-reviewed, open access journal published quarterly by the Sri Lanka Medical Association in the last week of March, June, September and December each year. The mission of the CMJ is to promote the science and art of medicine and betterment of public health. The Journal publishes original papers and commentaries which have relevance to medicine and allied sciences. The CMJ is committed to maintaining and conforming to the editorial and ethical standards recommended by the International Committee of Medical Journal Editors.

Evaluation of Pakistani wheat germplasm for leaf rust resistance at various locations.

341 entries comprising of 250 genotypes/lines and 91 gene differentials were tested for leaf rust (Puccinia triticina Erik) in different ecological zones of Punjab during 2016–17 and 2017–18. Each entry was planted in a single 1 m long row and Morocco was used as a spreader. Data on leaf rust severity was recorded once in 3rd week of March during both study years at all locations by following Modified Cobb Scale while the data was recorded three times on 2nd, 22nd and 29th March during 2018 at Faisalabad location to study rust development pattern. The disease severity ranged from 0-100S during 2016–17 and from 0-80S during 2017–18. The genotype HYT 60–5 and the genes Lr-19, Lr-26 and Lr 27+31 showed no disease symptoms at any location during both the study years. These genes can be used for future breeding material development. Area under disease progressive curve (AUDPC), calculated on the basis of periodical readings from Faisalabad, ranged from 0–550 and the susceptible check Morocco has AUDPC value of 600. 120 entries including HYT 60–5 have disease progression 0, which showed that there may be a major gene based resistance in these entries. Area under disease progressive curve/Day (AUDPC/DAY) was calculated for the rest of 130 genotypes to have an understanding of the disease progression pattern and out of which 43 entries have AUDPC/Day value ranging from 1–2 and 28 entries have AUDPC/Day value ranging from 2–3 which revealed that these entries are very useful for use in breeding for durable rust resistance and can be utilized as a parent in back cross and top cross breeding schemes. Material with AUDPC value less than 10 is the best source of resistance against the leaf rust. Varieties/advanced lines, Ujala-16, V-14154, and V-14124 have shown slow rust development and are very good sources of resistance. Similarly, HYT 60–5 has proven an excellent source of resistance. The advance line V-14154 has been approved as a commercial cultivar by the name “Akbar-19”.

Cross-sectional internet survey exploring women’s knowledge, attitudes and practice regarding urinary tract infection-related symptoms in the Netherlands

ObjectivesUrinary tract infections (UTIs) are the most prevalent cause for women to consult a general practitioner (GP) and are commonly treated with (broad-spectrum) empirical antibiotics, even though 50% of UTIs...

Covid-19 pandemic- A global concern

The world faces a severe and acute public health emergency due to the corona virus pandemic COVID-19. On 31st December 2019, a new coronavirus causing pneumonia emerged in Wuhan, China, which was confirmed by the World Health Organization (WHO)'. After the identification of the first case, till the 1st week of March 2022 448,175,126 confirmed cases and 6,027,357 deaths reported by WHO globally. As the virus is highly contagious and due to its rapidly spreading in nature, on March 11, 2020, WHO declared the disease as a pandemic. In Bangladesh, the first case was confirmed on March 8, 2020. Initially, it was named 2019-nCoV but later officially it was named severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) by the Coronavirus Study Group of the International Committee on Taxonomy of Viruses (ICTV) and the disease caused by this virus was named COVID-19 by the WHO. Complete genome sequencing confirms the virus belongs to the beta coronavirus genus. Delta variant spread in the community having more pathogenic and responsible for a large no of death. Subsequently, new variant B.1.1.529 named as omicron variant came into the community which spread more but was less pathogenic. Although now treatment and vaccine are available, there are many infected patients with no symptoms and slight illness, who spread the virus into the society insidiously. In addition to effective personal protection measures, the vaccination can prevent the disease and limit the spread of infection.
 Update Dent. Coll. j: 2022; 12(1): 1-2

Effect of Girdling on Yield and Quality of Kiwifruit (Actinidia deliciosa Chev.) Raised hrough Different Propagation Methods

The present investigation entitled “Effect of girdling on yield and quality of kiwifruit ( Chev.) raised through different Actinidia deliciosa propagation methods was carried out during 2019-20 at Dr. YS Parmar University of Horticulture and Forestry, Nauni-Solan, Himachal Pradesh. Ten years old vines of uniform size and vigour, planted at 4.0 m × 6.0 m spacing were selected for the study. There were twelve treatment combinations. The experimental plants were raised through three different modes of propagation , , grafting and own viz. in siturooted (cuttings) which were planted in different sections of experimental orchard. Four different girdling levels namely; full (100% girdling), 1/2 (50% girdling), 1/4 (25% girdling) and no girdling were applied to the experimental vines. The grafted kiwifruit vines girdled upto 1/4 (25%) trunk girth by removing 2 mm bark in the last week of March exhibited best performance in terms of improvement in flower and yield parameters name ; number of flowers per shoot, per cent fruit set, number of fruits per shoot, total yield and graded yield.

Ocular events following the surge of cough and cold medications use during the Omicron outbreak in Hong Kong.

To the Editor Coronavirus disease 2019 (COVID-19) situation worsened since the Omicron spread in Hong Kong,1 numerous infected but mildly ill patients accumulated in our community.2,3 We report a surge in acute primary angle closure (APAC) since the local outbreak of Omicron. This letter highlights the potential ocular sequelae of antitussive and nasal decongestants usage and serves to alert practitioners to wear adequate personal protective equipment upon attending APAC cases. In second to third week of March, we encountered consecutive eight eyes (seven patients) of APAC (Table 1) in our hospital, which was more than triple of usual. Five (71.4%) were without past ocular history. The remaining two (28.6%) were known to be primary angle-closure suspect (PACS). All admitted prior cough mixture or cold medications uses for relief of upper respiratory tract symptoms, including promethazine compound linctus, diphenhydramine compound linctus, actified syrup (pseudoephedrine and triprolidine), chlorpheniramine and different over-the-counter anti-histamine and nasal decongestant. Four (57.1%) patients were known cases of COVID-19, when the first week of March was the peak of the Omicron surge. The remaining three (42.9%) were not yet tested upon attendance, yet symptomatic with cough, sputum and runny noses. All were SARS-CoV-2 RNA positive by polymerase chain reaction subsequently. Investigation gonioscopy of the contralateral eye revealed PACS in all cases.

Development and Validation of a Simple Risk Model for Predicting Metabolic Syndrome (MetS) in Midlife: A Cohort Study.

PurposeTo develop and validate a simple risk model for predicting metabolic syndrome in midlife using a prospective cohort data.DesignProspective cohort study.ParticipantsA total of 7626 members of the 1958 British birth cohort (individuals born in the first week of March 1958) participated in the biomedical survey at age 45 and have completed information on metabolic syndrome.MethodsVariables utilised were obtained prospectively at birth, 7, 16, 23 and 45 years. Multivariable logistic regression was used to develop a total of ten (10) MetS risk prediction models taking the life course approach. Measures of discrimination and calibration were used to evaluate the performance of the models. A pragmatic criteria developed was used to select one model with the most potential to be useful. The internal validity (overfitting) of the selected model was assessed using bootstrap technique of Stata.Main Outcome MeasureMetabolic syndrome was defined based on the NCEP-ATP III clinical criteria.ResultsThere is high prevalence of MetS among the cohort members (19.6%), with males having higher risk as compared to females (22.8% vs 16.4%, P < 0.001). Individuals with MetS are more likely to have higher levels of HbA1c and low HDL-cholesterol. Similarly, regarding the individual components of MetS, male cohort members are more likely to have higher levels of glycaemia (HbA1c), BP and serum triglycerides. In contrast, female cohort members have lower levels of HDL-cholesterol and higher levels of waist circumference. Furthermore, a total of ten (10) MetS risk prediction models were developed taking the life course approach. Of these, one model with the most potential to be applied in practical setting was selected. The model has good accuracy (AUROC 0.91 (0.90, 0.92)), is well calibrated (Hosmer-Lemeshow 6.47 (0.595)) and has good internal validity.ConclusionEarly life factors could be included in a risk model to predict MetS in midlife. The developed model has been shown to be accurate and has good internal validity. Therefore, interventions targeting socioeconomic inequality could help in the wider prevention of MetS. However, the validity of the developed model needs to be further established in an external population.

Family physician virtual care during COVID-19 in London-Middlesex, Ontario, Canada: a mixed methods exploration.

Context: On March 14, 2020, the Ontario, Canada health insurance plan approved COVID-19 physician virtual billing codes; family physicians (FPs) rapidly adopted a new model of care. Virtual care may remain post-pandemic; however, its future should be informed by evidence that considers access and continuity. Objective: 1) to determine FP virtual visit volumes and patient characteristics and 2) to explore FPs' perspectives on virtual visit adoption and implementation. Study Design: Mixed methods: Secondary analysis of health administrative (HA) data and semi-structured qualitative interviews with FPs. Setting or Dataset: London and Middlesex County, Ontario, Canada. HA data through ICES, Ontario entity holding data. Population studied: FPs and their patients. Outcome Measures: Volumes of FP in-person and virtual visits during early pandemic; characteristics of patients receiving care; FPs' perspectives on adopting and delivering virtual care. Results: Overall visit volume dropped by 36% during first wave, recovered to pre-pandemic levels by October 2020. Sharp in-person visit drop of 73% and virtual visit uptake from 0.08% of total visits to 57% within two weeks of March 2020. FPs described this initial drop in volume as patients not seeking care and practices lacking PPE. The move to virtual care was largely to telephone visits. Patient characteristics compared to pre-pandemic, the proportion seeking care were older (46 vs 50 years), more vulnerable (38% vs 41%), and more multimorbidity (33% vs 41%). This was consistent with FP reports that healthier patients stayed away, routine care deferred, sicker patients needed to be seen. FPs believed most vulnerable patients had access to care but cautioned highly vulnerable such as those homeless did not have cell phone access or a safe place to receive calls. Rural FPs reported access issues because of lack of high-speed internet. FPs attributed success of virtual care to the continuity in relationships they had with patients that were established in person pre-pandemic. Conclusions: FPs moved rapidly to virtual care. FP offices remained open despite PPE concerns but overall volumes dropped initially. Vulnerable and sicker patients received care but FPs expressed concern for highly vulnerable and rural residents. FPs believed they could offer patient-centred care over the phone but indicated the importance of maintaining in-person care to build relationships.

Estimates of the Nutritional Impact of Non-Participation in the National School Lunch Program during COVID-19 School Closures.

The COVID-19 pandemic resulted in widespread school closures, reducing access to school meals for millions of students previously participating in the US Department of Agriculture (USDA) National School Lunch Program (NSLP). School-prepared meals are, on average, more nutritious than home-prepared meals. In the absence of recent data measuring changes in children’s diets during the pandemic, this article aims to provide conservative, back-of-the-envelope estimates of the nutritional impacts of the pandemic for school-aged children in the United States. We used administrative data from the USDA on the number of NSLP lunches served in 2019 and 2020 and nationally representative data from the USDA School Nutrition and Meal Cost Study on the quality of school-prepared and home-prepared lunches. We estimate changes in lunchtime calories and nutrients consumed by NSLP participants from March to November 2020, compared to the same months in 2019. We estimate that an NSLP participant receiving no school meals would increase their caloric consumption by 640 calories per week and reduce their consumption of nutrients such as calcium and vitamin D. Because 27 to 78 million fewer lunches were served per week in March–November 2020 compared to the previous year, nationally, students may have consumed 3 to 10 billion additional calories per week. As students return to school, it is vital to increase school meal participation and update nutrition policies to address potentially widening nutrition disparities.

Behavioral Response of Some Migratory birds and Gangetic Dolphins to COVID-19 Induced Lockdown: A Case Study in the Vikramshila Gangetic Dolphin Sanctuary (VGDS), Bhagalpur, Bihar, India

Vikramshila Gangetic Dolphin Sanctuary (VGDS), Bhagalpur, Bihar is the only protected area in India for the endangered Gangetic Dolphins ( Platanista gangetica gangetica ). Besides, this sanctuary has been an important roosting, nesting and foraging ground for a large number of resident and migratory birds for the last many years. Birds are the Bio-indicators and play a major role to maintain the ecological balance being an important member of the different food chains. The imposition of complete lockdown in the country and abroad in 2020 and 2021 due to COVID-19 like pandemic severely affected the life of a human as well animals both. Many alterations were seen in the environmental parameters such as in the quality of air, water and land due to complete lockdown resulting in unusual and uncommon bevaviors in birds and other wildlife. The present investigation was carried out to study the behavioral responses of some migratory birds and Gangetic Dolphins to CoVID -19 induced lockdown in the Vikramshila Gangetic Dolphin Sanctuary (VGDS), Bhagalpur, Bihar. Many migratory birds were recorded just after lockdown even in the month of last week of May ( normal departure time is last week of March to the first week of April ) in 2020 and 2021. These birds were showing their prolonged stay in the sanctuary area in comparison to previous years. Detectability of Gangetic Dolphins was also observed significantly higher in comparison to other days. Gharials were sighted in both the years in 2020 and 2021 after a decade or more. All these uncommon behavioral changes as recorded in some migratory birds, Gangetic Dolphins and other aquatic fauna during and just after lockdown may be due to sudden and unexpected changes in the weather and climate or due to less human interferences and complete ban on fishing activity due to complete lockdown in the country and abroad. This study will be useful and informative for the birders, wild lifers and academicians too and may be a part of further research in the future.

Sustained Reductions in Online Search Interest for Communicable Eye and Other Conditions During the COVID-19 Pandemic: Infodemiology Study.

BackgroundIn a prior study at the start of the pandemic, we reported reduced numbers of Google searches for the term “conjunctivitis” in the United States in March and April 2020 compared with prior years. As one explanation, we conjectured that reduced information-seeking may have resulted from social distancing reducing contagious conjunctivitis cases. Here, after 1 year of continued implementation of social distancing, we asked if there have been persistent reductions in searches for “conjunctivitis,” and similarly for other communicable disease terms, compared to control terms.ObjectiveThe aim of this study was to determine if reduction in searches in the United States for terms related to conjunctivitis and other common communicable diseases occurred in the spring-winter season of the COVID-19 pandemic, and to compare this outcome to searches for terms representing noncommunicable conditions, COVID-19, and to seasonality.MethodsWeekly relative search frequency volume data from Google Trends for 68 search terms in English for the United States were obtained for the weeks of March 2011 through February 2021. Terms were classified a priori as 16 terms related to COVID-19, 29 terms representing communicable conditions, and 23 terms representing control noncommunicable conditions. To reduce bias, all analyses were performed while masked to term names, classifications, and locations. To test for the significance of changes during the pandemic, we detrended and compared postpandemic values to those expected based on prepandemic trends, per season, computing one- and two-sided P values. We then compared these P values between term groups using Wilcoxon rank-sum and Fisher exact tests to assess if non-COVID-19 terms representing communicable diseases were more likely to show significant reductions in searches in 2020-2021 than terms not representing such diseases. We also assessed any relationship between a term’s seasonality and a reduced search trend for the term in 2020-2021 seasons. P values were subjected to false discovery rate correction prior to reporting. Data were then unmasked.ResultsTerms representing conjunctivitis and other communicable conditions showed a sustained reduced search trend in the first 4 seasons of the 2020-2021 COVID-19 pandemic compared to prior years. In comparison, the search for noncommunicable condition terms was significantly less reduced (Wilcoxon and Fisher exact tests, P<.001; summer, autumn, winter). A significant correlation was also found between reduced search for a term in 2020-2021 and seasonality of that term (Theil-Sen, P<.001; summer, autumn, winter). Searches for COVID-19–related conditions were significantly elevated compared to those in prior years, and searches for influenza-related terms were significantly lower than those for prior years in winter 2020-2021 (P<.001).ConclusionsWe demonstrate the low-cost and unbiased use of online search data to study how a wide range of conditions may be affected by large-scale interventions or events such as social distancing during the COVID-19 pandemic. Our findings support emerging clinical evidence implicating social distancing and the COVID-19 pandemic in the reduction of communicable disease and on ocular conditions.

Operation of a triage committee for advanced life support during the COVID-19 pandemic

BackgroundDuring the first weeks of March 2020 in Spain, the cases of severe respiratory failure progressively increased, generating an imbalance between the clinical needs for advanced life support (ALS) measures and the effective availability of ALS resources. To address this problem, the creation of triage committees (TC) was proposed, whose main function is to select the best candidates to receive ALS. The main objective of our study is to describe the clinical characteristics of the patients evaluated by the TC of the Alcorcón Foundation University Hospital (AFUH) during the first wave of SARS CoV-2. Other objectives are to determine if there are differences between the patients considered candidates / not candidates for ALS and to analyze the functioning of the TC.MethodsRetrospective observational study of all patients assessed by the AFUH TC.ResultsThere were 19 meetings, in which 181 patients were evaluated, 65.4% male and with a mean age of 70.1 years. 31% had some degree of functional dependence, the Barthel median was 100 and Charlson 4. 58.5% were not considered a candidate for ALS at that time. The patients considered candidates to receive ALS were younger (72 vs 66; p < 0.001), had less comorbidity (Charlson 4 vs 3; p < 0.001) and had a better previous functional situation. A median of 5 physicians participated in each meeting and, after being assessed by the TC, 13.6% received ALS: 29.3% of those considered candidates for ALS and 2% of the non-candidates.ConclusionsThe patients evaluated by the TC had a mean age of 70 years, high comorbidity and almost a third had some degree of functional dependence. More than half were not considered candidates for ALS at that time, these patients being older, with more comorbidity and a worse previous functional situation. TC decisions, based on objective clinical criteria, were almost always respected. Public institutions must get involved in triage procedures, which should and in our opinion must include the creation of TC in health centers. The implementation of Anticipated Decision programs (ADP) would help enable patients affected by triage decisions to participate in them.

Performance of Selected COVID-19 Centers in the Primary Health Care System during COVID-19 Pandemics in Iran

Background. In order to address the community’s health needs during the COVID-19 crisis in 2020, several comprehensive urban health centers affiliated with the primary healthcare system were designated as COVID-19 centers. Considering the importance of evaluating the performance of the mentioned centers and ensuring the continuity of the services provided in accordance with the rules and instructions, the performance evaluation of the mentioned units was conducted from July 2020 to March 2021 in three levels: self-evaluation (first-level evaluation), university evaluation (second-level evaluation) and the evaluation of the experts of the Ministry of Health and Medical Education (third-level evaluation). Methods. This cross-sectional descriptive-analytical study was conducted in all selected COVID-19 centers, including 978 in 63 universities / medical schools across the country in 2020. The sample was selected by census sampling method and included a total of 978 centers. In this study, 28 main criteria in the fields of education and information, safety of staff and clients by observing social distance, use of personal protective equipment, supplying manpower and equipment, disinfection, and work processes, and 91 sub-criteria were determined by using Delphi Technique. Results. With the criteria and sub-criteria defined in the areas of "community education and information", staff training, observance of social distance, facilities, waste management, manpower supply, supply of medical equipment and work processes, it was identified that in the self-evaluation (first level evaluation), the criterion with the lowest score was "staff training". The lowest score in the evaluation of the level of universities / medical schools (second level evaluation) was related to the observance of social distance in the centers and the highest score in both evaluation levels was related to the criterion of "providing the necessary education to patients regarding prevention and control of COVID-19". Conclusion. The establishment and setting up of selected COVID-19 centers has been one of the effective measures in controlling and managing the COVID-19 epidemic, which was created as a result of changing the structure of the primary healthcare system. The continuity of service quality of selected centers requires continuous monitoring and evaluation of their performance.

A spatiotemporal analysis of NO concentrations during the Italian 2020 COVID-19 lockdown.

When a new environmental policy or a specific intervention is taken in order to improve air quality, it is paramount to assess and quantify—in space and time—the effectiveness of the adopted strategy. The lockdown measures taken worldwide in 2020 to reduce the spread of the SARS‐CoV‐2 virus can be envisioned as a policy intervention with an indirect effect on air quality. In this paper we propose a statistical spatiotemporal model as a tool for intervention analysis, able to take into account the effect of weather and other confounding factor, as well as the spatial and temporal correlation existing in the data. In particular, we focus here on the 2019/2020 relative change in nitrogen dioxide (NO2) concentrations in the north of Italy, for the period of March and April during which the lockdown measure was in force. We found that during March and April 2020 most of the studied area is characterized by negative relative changes (median values around −25%), with the exception of the first week of March and the fourth week of April (median values around 5%). As these changes cannot be attributed to a weather effect, it is likely that they are a byproduct of the lockdown measures. There are two aspects of our research that are equally interesting. First, we provide a unique statistical perspective for calculating the relative change in the NO2 by jointly modeling pollutant concentrations time series. Second, as an output we provide a collection of weekly continuous maps, describing the spatial pattern of the NO2 2019/2020 relative changes.

On the Origin and Propagation of the COVID-19 Outbreak in the Italian Province of Trento, a Tourist Region of Northern Italy.

Background: Trentino is an Italian province with a tourism-based economy, bordering the regions of Lombardy and Veneto, where the two earliest and largest outbreaks of COVID-19 occurred in Italy. The earliest cases in Trentino were reported in the first week of March 2020, with most of the cases occurring in the winter sport areas in the Dolomites mountain range. The number of reported cases decreased over the summer months and was followed by a second wave in the autumn and winter of 2020. Methods: we performed high-coverage Oxford Nanopore sequencing of 253 positive SARS-CoV-2 swabs collected in Trentino between March and December 2020. Results: in this work, we analyzed genome sequences to trace the routes through which the virus entered the area, and assessed whether the autumnal resurgence could be attributed to lineages persisting undetected during summer, or as a consequence of new introductions. Conclusions: Comparing the draft genomes analyzed with a large selection of European sequences retrieved from GISAID we found that multiple introductions of the virus occurred at the early stage of the epidemics; the two epidemic waves were unrelated; the second wave was due to reintroductions of the virus in summer when traveling restrictions were uplifted.

Interest in Home Birth During the COVID-19 Pandemic: Analysis of Google Trends Data.

IntroductionNearly all (94%‐99%) pregnant persons in developed countries search for pregnancy‐related information online. The advent of the novel coronavirus disease 2019 (COVID‐19) and the associated restrictions in hospital policies may have pushed pregnant persons in the United States to consider giving birth at home to achieve their desired birth experience.MethodsGoogle Trends is an open, rich source of real‐time, anonymized, relative data on disease patterns and population behavior that provides data in the form of search volume index (SVI): the search volume for a queried term relative to overall search volume for a given time frame and geographic location. The SVI is normalized to a scale of 0 to 100. After the World Health Organization declared COVID‐19 a pandemic on March 11, 2020, Google Trends was queried on February 21, 2021, for the search term home birth with location set to the United States and the time frame March 11, 2019 to February 21, 2021.ResultsThe median SVI for home birth during nominally pre‐COVID‐19 baseline (weeks of March 17, 2019 to March 8, 2020) was relatively constant at 43 (range, 25‐56) and increased sharply to 77 during the week of March 15, to 86 during the week of March 22, and peaked at 100 during the week of March 29, 2020. The SVI declined substantially in the following weeks but remained significantly elevated compared with baseline levels. During the approximate 2‐year period of query, the states with the highest SVI values (≥80) were Arkansas, Washington, Montana, and Georgia.DiscussionInterest in home birth spiked in the United States immediately after COVID‐19 was declared a pandemic and remained significantly elevated thereafter. These results have implications for caregivers and health systems to ensure safe pregnancies and childbirths through the resolution of the ongoing pandemic.

Impact of COVID-19 on Admissions and Outcomes for Children With Complex Chronic Conditions.

Although pediatric health care use declined during the coronavirus disease 2019 (COVID-19) pandemic, the impact on children with complex chronic conditions (CCCs) has not been well reported. To describe the impact of the pandemic on inpatient use and outcomes for children with CCCs. This multicenter cross-sectional study used data from the Pediatric Health Information System. We examined trends in admissions between January 2020 through March 2021, comparing them to the same timeframe in the previous 3 years (pre-COVID-19). We used generalized linear mixed models to examine the association of the COVID-19 period and outcomes for children with CCCs presenting between March 16, 2020 to March 15, 2021 (COVID-19 period) to the same timeframe in the previous 3 years (pre-COVID-19). Children with CCCs experienced a 19.5% overall decline in admissions during the COVID-19 pandemic. Declines began in the second week of March of 2020, reaching a nadir in early April 2020. Changes in admissions varied over time and by admission indication. Children with CCCs hospitalized for pneumonia and bronchiolitis experienced overall declines in admissions of 49.7% to 57.7%, whereas children with CCCs hospitalized for diabetes experienced overall increases in admissions of 21.2%. Total and index length of stay, costs, and ICU use, although statistically higher during the COVID-19 period, were similar overall to the pre-COVID-19 period. Total admissions for children with CCCs declined nearly 20% during the pandemic. Among prevalent conditions, the greatest declines were observed for children with CCCs hospitalized with respiratory illnesses. Despite declines in admissions, overall hospital-level outcomes remained similar.

Public Search Interests Related to COVID-19: Insights from Google Search Trends in Bangladesh

PurposePublic response monitoring is critical to reducing COVID-19 infections and developing effective public health strategies. This study explored Google search trends to understand public responses to COVID-19 concerns in Bangladesh.Methods & MaterialsWe used country-level Google search trends data to examine the association between Google search terms related to COVID-19 deaths, face masks, and COVID-19 vaccines and the actual and one-week lagged actual COVID-19 death counts from February 2, 2020, to December 19, 2020, in Bangladesh.ResultsSearch terms related to COVID-19 deaths, face masks, and COVID-19 vaccines increased and peaked during March and April, but then began declining gradually after June 2020. The mean relative search volume for face masks (35 points) was higher than for death information (8 points) and vaccines (16 points) throughout the study period, and searching for masks peaked (100 points) during the third week of March. Search interests for death information and face masks were negatively correlated with the actual and one-week lagged actual COVID-19 death counts.ConclusionIn response to declining trends in COVID-19-related google search terms, policymakers should strengthen ongoing risk communication and preventive information dissemination programs to control and prevent COVID-19 cases and deaths.

Efficacy of Neem Based Formulations Against Wheat Aphids Under Semi-Arid Irrigated Conditions in South-West Punjab

Neem formulations viz. aqueous extract of neem and NSKE along with standard check thiamethoxam were evaluated for their efficacy against wheat aphids Rhopalosiphum padi (L.) and Rhopalosiphum maidis (Fitch). It was observed that aphids’ incidence on shoots started in the first week of January with a peak (40.90 aphids/ shoot) during third week of March. Thiamethoxam 25 WG @ 50 g/ ha was found significantly superior giving 93.53% reduction after 7 DAS (days of spray). Different formulations of neem also yielded comparable results in controlling wheat aphids. Aqueous extract of neem @ 5 l/ ha resulted maximum (74.21%) reduction followed by NSKE @ 10% (69.04%) after 7 DAS. Occurrence of coccinellids was more in treatments with neem formulations than in thiamethoxam. The treatments resulted in 2.48- 9.25% increase in yield and it can be concluded that aqueous extract of neem and NSKE can be recommended over the most commonly used thiamethoxam for controlling wheat aphids.