Notes

Bifunctional crosslinking ligands for transthyretin.
Procalcitonin, a biomarker to adjudge the duration of antibiotic therapy in patients with sepsis.

A prospective, randomized, controlled, interventional, single-center study was conducted in a mixed adult intensive care unit (ICU). In a nonblinded study, 90 adult patients admitted to the ICU with sepsis and septic shock were randomized into group P (group procalcitonin) and group C (group control). The duration of antibiotic therapy was decided based on serum procalcitonin levels for patients in group P versus standard treatment protocols in group C. A procalcitonin value of <0.01 ng/mL or a subsequent decline of >80% from the baseline was cutoff and chosen to stop the antibiotic therapy. The primary aim was to compare the duration of antibiotic therapy (in days) in the two groups. The secondary objective was to compare and assess the length of ICU stay, reinfection, secondary infection rate, readmission rate, and mortality among the groups.

The mean duration of antibiotic therapy was significantly Patients with Sepsis and Septic Shock in Intensive Care Units A Prospective Study. Indian J Crit Care Med 2021;25(5)507-511.
Coronavirus disease-2019 (COVID-19) in the last few months has disrupted the healthcare system globally. The objective of this study is to assess the impact of the COVID-19 pandemic on the psychological and emotional well-being of healthcare workers (HCWs).

We conducted an online, cross-sectional, multinational survey, assessing the anxiety (using Generalized Anxiety Disorder [GAD-2] and GAD-7), depression (using Center for Epidemiologic Studies Depression), and insomnia (using Insomnia Severity Index), among HCWs across India, the Middle East, and North America. We used univariate and bivariate logistic regression to identify risk factors for psychological distress.

The prevalence of clinically significant anxiety, depression, and insomnia were 41.4, 48.0, and 31.3%, respectively. On bivariate logistic regression, lack of social or emotional support to HCWs was independently associated with anxiety [odds ratio (OR), 3.81 (2.84-3.90)], depression [OR, 6.29 (4.50-8.79)], and insomnia [OR, 3.79 (2.81-5.110)]. Female gender and self-COVID-19 were independent risk factors for anxiety [OR, 3.71 (1.53-9.03) and 1.71 (1.23-2.38)] and depression [OR, 1.72 (1.27-2.31) and 1.62 (1.14-2.30)], respectively. Frontliners were independently associated with insomnia [OR, 1.68 (1.23-2.29)].

COVID-19 pandemic has a high prevalence of anxiety, depression, and insomnia among HCWs. Female gender, frontliners, self-COVID-19, and absence of social or emotional support are the independent risk factors for psychological distress.

Jagiasi BG, Chanchalani G, Nasa P, Tekwani S. Impact of COVID-19 Pandemic on the Emotional Well-being of Healthcare Workers A Multinational Cross-sectional Survey. Indian J Crit Care Med 2021;25(5)499-506.
Jagiasi BG, Chanchalani G, Nasa P, Tekwani S. Impact of COVID-19 Pandemic on the Emotional Well-being of Healthcare Workers A Multinational Cross-sectional Survey. Indian J Crit Care Med 2021;25(5)499-506.
Severe acute respiratory distress syndrome associated with coronavirus disease-2019 (COVID-19) (CARDS) pneumonitis presents a clinical challenge as regards to the timing of intubation and ambiguity of outcome. There is a lack of clear consensus on when to switch patients from trials of noninvasive therapies to invasive mechanical ventilation. We investigated the effect of the timing of intubation from the time of admission on the clinical outcome of CARDS.

The aim and objective was to analyze the effect of timing of intubation early (within 48 hours of admission to critical care unit) versus delayed (after 48 hours of admission to critical care unit) on mortality in severe CARDS patients.

A retrospective observational study performed in a 28-bedded COVID-19 intensive care unit of a tertiary care hospital in Pune, India. All patients admitted between April 1, 2020, and October 15, 2020, with confirmed COVID-19 (RT-PCR positive) requiring mechanical ventilation were included in the study.

The primary ou.02).

Current study concludes that early intubation is associated with improved survival rates in severe CARDS patients.

Zirpe KG, Tiwari AM, Gurav SK, Deshmukh AM, Suryawanshi PB, Wankhede PP,
Timing of Invasive Mechanical Ventilation and Mortality among Patients with Severe COVID-19-associated Acute Respiratory Distress Syndrome. Indian J Crit Care Med 2021;25(5)493-498.
Zirpe KG, Tiwari AM, Gurav SK, Deshmukh AM, Suryawanshi PB, Wankhede PP, et al. Timing of Invasive Mechanical Ventilation and Mortality among Patients with Severe COVID-19-associated Acute Respiratory Distress Syndrome. Indian J Crit Care Med 2021;25(5)493-498.How to cite this article Rao SM. National Registries The Need of the Hour. Indian J Crit Care Med 2021;25(5)491-492.How to cite this article Daptardar AA. Quest of Knowledge and Perceived Barriers toward Early Mobilization of Critically Ill Patients in Intensive Care Unit A Continuing Journey! Indian J Crit Care Med 2021;25(5)489-490.How to cite this article Kumar V. There is No Substitute for Human Intelligence. Indian J Crit Care Med 2021;25(5)486-488.How to cite this article Todi SK. Procalcitonin "To Follow or Not to Follow" That's the Question. Indian J Crit Care Med 2021;25(5)484-485.How to cite this article Ramakrishnan N. Chronic Critical Illness Are We Just Adding Years to Life? Indian J Crit Care Med 2020;25(5)482-483.
Coronavirus disease-2019 (COVID-19) in the last few months has disrupted the healthcare system globally. The objective of this study is to assess the impact of the COVID-19 pandemic on the psychological and emotional well-being of healthcare workers (HCWs).

We conducted an online, cross-sectional, multinational survey, assessing anxiety [using Generalized Anxiety Disorder (GAD) Scale GAD-2 and GAD-7], depression (using Center for Epidemiologic Studies Depression Scale), and insomnia (using Insomnia Severity Index Scale), among HCWs across India, the Middle East, and North America. We used univariate and bivariate logistic regression to identify risk factors for psychological distress.

The prevalence of clinically significant anxiety, depression, and insomnia was 41.4%, 48.0%, and 31.3%, respectively. On bivariate logistic regression, lack of social or emotional support to HCWs was independently associated with anxiety [odds ratio (OR), 3.81 (2.84-3.90)], depression [OR, 6.29 (4.50-8.79)], and insomnia [OR, 3.79 (2.81-5.110]. Female gender and self-COVID-19 were independent risk factors for anxiety [OR, 3.71 (1.53-9.03) and 1.71 (1.23-2.38)] and depression [OR, 1.72 (1.27-2.31) and 1.62 (1.14-2.30)], respectively. Frontliners were independently associated with insomnia [OR, 1.68 (1.23-2.29)].

COVID-19 pandemic has a high prevalence of anxiety, depression, and insomnia among HCWs. Female gender, frontliners, self-COVID-19, and absence of social or emotional support are the independent risk factors for psychological distress.

Bhattacharya PK, Prakash J. Impact of COVID-19 on Psychological and Emotional Well-being of Healthcare Workers. Indian J Crit Care Med 2021;25(5)479-481.
Bhattacharya PK, Prakash J. Impact of COVID-19 on Psychological and Emotional Well-being of Healthcare Workers. Indian J Crit Care Med 2021;25(5)479-481.How to cite this article Ray B, Sahu AK. Timing of Endotracheal Intubation and Mortality among Patients with Severe COVID-19. Indian J Crit Care Med 2021;25(5)477-478.Undergraduate surgical education is failing to prepare medical students to care for patients with surgical conditions, and has been significantly compromised by the COVID-19 pandemic. We performed a literature review and undertook semi-structured reflections on the current state of undergraduate surgical education across five countries Egypt, Morocco, Somaliland, Kenya, and the UK. The main barriers to surgical education at medical school identified were (1) the lack of standardised surgical curricula with mandatory learning objectives and (2) the inadequacy of human resources for surgical education. COVID-19 has exacerbated these challenges by depleting the pool of surgical educators and reducing access to learning opportunities in clinical environments. To address the global need for a larger surgical workforce, specific attention must be paid to improving undergraduate surgical education. Solutions proposed include the development of a standard surgical curriculum with learning outcomes appropriate for local needs, the incentivisation of surgical educators, the incorporation of targeted online and simulation teaching, and the use of technology.Thrombo-embolic episodes and invasive mucormycosis (IM) have shown a sudden surge after the second wave of novel coronavirus infection in India. Acute mesenteric ischemia secondary to coronavirus-19 is rare and that too due to invasive mesenteric mucormycosis has not yet been reported in Indian literature. We present a case of post-COVID diabetic woman who was on steroids and had mesenteric thrombosis with IM. The disease is associated with high mortality. ARN509 Treatment of choice is wide surgical resection and iv liposomal amphotericin B. Since the pre-operative as well as intra-operative diagnosis is difficult, high index of suspicion for IM is necessary in post-COVID-19 patients presenting with mesenteric ischemia or bowel perforation.Online teaching platforms have become a core appealing option for education and information delivery in current pandemic of Coronavirus disease 2019 (COVID-19) among medical professionals. This editorial aims to understand perspective of usability and practicality of audio and video conferencing platforms in the current situation. Review of various available online platforms was done, namely Zoom, Google Meet, Google Classroom, Microsoft Teams, Cisco Webex, Go ToMeet, and Say Namaste highlighting and comparing their essential features, their benefits, the system and operating system in which they are supported, user interface, number of individuals who can participate, price packages, security, customer support, and limitations. Based on this, educational implications are discussed and are a guide to choose a suitable platform as well as suggestion for future research.Leishmania tarentolae has been used to produce recombinant intracellular and secreted proteins for their easy handling and posttranslational modifications. Filamentous acid phosphatase is a multimeric protein complex composed of many subunits assembled in a linear highly glycosylated filament, which is secreted in vast amounts into the culture supernatant via the flagellar pocket of Leishmania mexicana promastigotes. This suggested that the protein could be used as a carrier for the Surface Antigen1 protein of a Toxoplasma gondii (SAG1) for easy purification to generate a protein with multiple SAG1 subunits suitable for immunisation. SAG1 has an immunodominant structure that is involved in binding to host cells. Previous studies used this surface protein for vaccination for its immunological importance for triggering a type 1 immune response in the host. This study aims to determine the production of recombinant filamentous protein carried subunits of the surface protein of Toxoplasma gondii for vaccination purposes.
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