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  Citation statistics : Table of Contents
   2021| April-June  | Volume 6 | Issue 2  
    Online since July 6, 2021

 
 
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ORIGINAL ARTICLES
Association between climatic and nonclimatic parameters and transmission of SARS-CoV-2 infection in Nepal
Sarmila Tandukar, Dinesh Bhandari, Rajani Ghaju Shrestha, Samendra P Sherchan, Anil Aryal
April-June 2021, 6(2):38-44
DOI:10.4103/ed.ed_2_21  
Background: Preliminary evidence suggests that environmental factors may modify the transmission of SARS-CoV-2 infection. Although the role of non-pharmaceutical interventions (NPIs) on the reduction of SARS-CoV-2 transmission rate is well explored, the role of local climate across different geographical transects on the onset and transmission of SARS-CoV-two remains unclear. Aims and Objectives: In this study, we explored the potential association among climatic factors, non-climatic factors and COVID-19 burden, via Pearson correlation analysis. We also investigated the association between COVID-19 cases and cumulative effect of NPIs or behavioral changes during lockdown as non-climatic factors in our analysis. Setting and Design: The research was carried out in the COVID-19 impacted districts across Nepal. Material and Methods: The meteorological/climatic factors consisting of temperature and rainfall as predictor variables and total laboratory confirmed COVID-19 cases reported between January and May 2020 were considered in the study. Statistical Analysis Used: The statistical tests were carried out using R programming language. Results: Of the total 375 confirmed positive cases until May 19, 2020, clusters of the cases were diagnosed from the Terai region, which was associated with comparatively higher temperature and open border to India. Upon time series and spatial analysis, the number of positive cases increased after the end of April, possibly due to expansion of diagnostic tests throughout the country. We found a positive correlation betweenCOVID-19, and temperature indices (mean and minimum) (P < 0.05). Conclusions: In the absence of an effective vaccine, these findings can inform infection control division of Nepal on the implementation of effective NPIs based on the observed variability in meteorological factors, especially in prevention of possible second wave of infection during winter.
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Spiritual wellbeing and depression for pregnant mothers in Covid-19 crisis
Hadi Alimoradi, Mahsa Nazari, Reza Jafari Nodoushan, Alireza Ajdani
April-June 2021, 6(2):45-51
DOI:10.4103/ed.ed_28_20  
Background: Women with high-risk pregnancies experience changes in their personal, family, and social lives that can affect their quality of life and depression. Pregnancy, along with other predisposing factors, can cause or exacerbate depression. Eventually, 15% of depressed people commit suicide. The purpose of this research was to see how COVID-19 affected the condition of pregnancy (high risk or normal), as well as well-being and depressive symptoms in pregnant women. Methods: This is an analytical case–control analysis that included 500 pregnant women (250 in the case group and 250 in the control group) who were pregnant during the COVID-19 timeframe for health care during pregnancy. The samples were chosen at random and then grouped into two categories based on the definitions of high-risk pregnancy and normal pregnancy: normal pregnancy (control group) and high-risk pregnancy (case group). A three-part questionnaire with demographic features, the Paloutzian and Ellison Religious Well-Being Questionnaire, and the Depression, Anxiety, and Stress Scale-42 Depression Inventory were used to gather data. Results: According to the findings of this report, the mean score of religious well-being of pregnant mothers with high-risk pregnancies was lower than that of pregnant women with average pregnancies, as were the mean scores of depression. The distinction between a normal pregnancy and a high-risk pregnancy is important. Furthermore, the Pearson correlation coefficient test revealed a strong association between psychological well-being and depression in all types of mothers with high-risk and average pregnancies (r = −0.7) (P = 0.001). Conclusion: Pregnant women with high-risk pregnancies have less psychological well-being than pregnant women with regular pregnancies. Furthermore, these mothers have a greater risk of depression than pregnant women with normal pregnancies.
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Direct, non-Vitamin K antagonist oral anticoagulants compared with warfarin for stroke with atrial fibrillation and cerebral small vessel disease
Lipeng Cai, Honglian Duan, Sara Saymuah, Ruiqiang Xin, Xiaokun Geng, Yuchuan Ding
April-June 2021, 6(2):52-57
DOI:10.4103/ed.ed_9_21  
Background: Cerebral small vessel disease (CSVD) is not only associated with an increased risk of intracranial hemorrhage (ICH) in patients on oral anticoagulation, but also associated with an increased risk of ischemic stroke. Limited data support the benefits of direct, non-Vitamin K antagonist oral anticoagulants (direct oral anticoagulants [DOACs]) in acute ischemic stroke (AIS) or transient ischemic attack (TIA) patients with nonvalvular atrial fibrillation (AF) and CSVD. We aimed to evaluate the effectiveness and safety of DOACs in AIS or TIA with AF and CSVD. Patients and Methods: We conducted a retrospective study with consecutive patients who experienced AIS or TIA with AF and CSVD from January 1, 2017 to December 31, 2019 in the Stroke Center at Beijing Luhe Hospital, Capital Medical University. Patients are followed for 12 months by outpatient visits or telephone interviews. The safety endpoint of this study was symptomatic ICH (sICH), while the efficacy endpoint was recurrent ischemic events (AIS or TIA). Patients in the DOACs group were compared with patients in the warfarin group using Chi-square tests or the continuity correction Chi-square tests. The safety and efficacy endpoint was progression-free survival assessed by the log-rank test. Results: A total of 542 patients were finally included in this study (353 in the DOACs group and 189 in the warfarin group). There were no significant differences in vascular risk factors, NIH Stroke Scale score at baseline, and CHA2DS2-VASc score between the two groups. There were no significant differences in recurrent events between the two groups (P = 0.68). Patients in the DOACs group showed lower risks of sICH (P = 0.03) and a shorter hospital stay (P = 0.03) compared to patients in the warfarin group followed over 12 months. Conclusion: DOACs were associated with lower risks of sICH and similar risks of the recurrent ischemic event as compared to the warfarin group with AF and CSVD. Patients in the DOACs group had shorter hospital stay when compared to patients in the warfarin group. DOACs may be a better option than warfarin for AIS or TIA patients with AF and CSVD for secondary prevention.
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Effect of parity on the serum calcium in the pregnancy: A retrospective study
Nan-Nan Wu, Bin Cao, Jia-Nan Lang, Dong Zhao
April-June 2021, 6(2):58-63
DOI:10.4103/ed.ed_6_21  
Background: Maternal hypocalcaemia has adverse outcomes on pregnant women and offspring development. The objective of this study is to test whether parity number is associated with maternal calcium level. Materials and Methods: According to parity numbers, the pregnant women were divided into never parturition group (NPG) and previous parturition group (PPG). Association between parity number and serum calcium was tested in multivariate linear regression models controlling for age, body mass index (BMI), Vitamin D, and Homeostasis model assessment for insulin resistance (HOMA-IR). The subjects were also subgrouped by recruitment in four seasons and their development of gestational hypertension (GH) and diabetes. Results: Mean serum calcium was lower in the PPG than that in the NPG (2.15 vs. 2.20 mmol/L, P < 0.001). After adjusted for albumin, adjusted serum calcium was still lower in PPG than that in NPG (2.20 vs. 2.23 mmol/L, P < 0.001). Interestingly, adjusted serum calcium level is consistently lower in the PPG in both the diabetic and hypertension subgroups compared to NPG (2.20 vs. 2.23 mmol/L, P < 0.001). In different seasons, the serum calcium level and adjusted serum calcium level in the PPG were significantly lower than the NPG (P < 0.001). Importantly, adjusted calcium correlated negatively with the parity number (r = −0.044, P < 0.001), when adjusting for age, BMI, Vitamin D, and HOMA-IR. In addition, there was a significant increase in the PPG compared to the NPG including age (29.61 vs. 33.39 years old), BMI (22.80 vs. 23.55), triglyceride (2.27 vs. 2.43 mmol/L), and fasting basal blood glucose (4.73 vs. 4.81 mmol/L), and a significant decrease regarding the albumin (38.72 vs. 37.65 g/L) and Vitamin D (20.98 vs. 18.62 ng/ml). There was no difference in the onset of GH and gestational diabetes mellitus (GDM) between the two groups. Conclusion: Parity negatively correlated with the serum calcium level. The small but significant difference in the calcium levels indicated that parity may play an intricate role in calcium homeostasis. Timely monitoring of maternal calcium could be clinically beneficial to the multiparous women.
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REVIEW ARTICLE
Principles and practices of biosafety: Expanding and extending to food safety and food supply chain
Murli Manju, Amrita Ghosh, Ranabir Pal, Gabriel Alexander Quiñones-Ossa, Rajashekar Mohan, Amit Agrawal
April-June 2021, 6(2):31-37
DOI:10.4103/ed.ed_34_20  
The perception of biosafety on food and supply chains moves around the philosophical axis of “coping and living with occupational health hazards” to upheld the sustainable development of occupational safety. COVID-19 pandemic opened the “Pandora's box” of prevailing lackadaisical attitude on the basic public health aspects principles that should apply to food safety and food supply chain. We must revamp the collaboration of food production and public health-care delivery system to save the community by containing the spread of highly infectious agent from known and unknown natural and artificial reservoirs. Equity of distribution of quality and quantity of the food and nutrition has to be ensured for the majority of the global population at this crossroads of socio-economic crisis which has pauperized en masse as the negative fallout of pandemic. Food safety should be an urgent agenda for comprehensive internalization and be supplemented with the mitigation plan to minimize psychosomatic stresses and revitalize emotional and psychosocial health by targeted interventions. There is dire need of translational research and holistic streamlining of biosafety program in the phase of the rising trend of the cases and sequels epidemiologic pandemic curve on ground. Needless to mention that apart from SARS-COV2, the holistic concept of the implementation of the biosafety programs can interrupt the transmission of innumerable infectious agents from the plant and animal resources. Biosafety models were reviewed for high laboratory standards in the real time “new normal” situation of containment and risk assessment in this unprecedented pandemic of new millennium.
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