COVID-19 virus has resulted in the lockdown of schools, offices, factories, temples, railway stations, and even the airspace. It is estimated that due to the lockdown, the Indian economy may face prolonged adverse impact. The paper is an attempt to ascertain the impact of lockdown on the Indian economy and explore future perspective. The study has addressed important issues like consumption expenditure, demand & supply, unemployment rate, purchasing power, financial market, etc. Under the given circumstances, the lockdown will cost India around USD 120 bn. The manufacturing and service sector has come to an abrupt stop and interrupted domestic supply chains. If this crisis continuous it will indirectly affect all economic sectors. The study has given suggestions as a learning curve which can be used by different stakeholder to improve the economic situation of the country and minimize negative effect of lockdown.

Objective: Diabetes is a known risk factor for mortality in Coronavirus disease 2019 (COVID-19) patients. Our objective was to identify prevalence of hyperglycemia in COVID-19 patients with and without diabetes and quantify its association with COVID-19 disease course. Research Design and Methods: In this observational cohort study, all consecutive COVID-19 patients admitted to John H Stroger Jr. Hospital, Chicago, IL from March 15, 2020 to May 15, 2020 were included. The primary outcome was hospital mortality and the main predictor was hyperglycemia (any blood glucose ≥7.78 mmol/L during hospitalization). Results: Of 403 COVID-19 patients studied, 228 (57%) developed hyperglycemia. Of these, 83 (21%) had hyperglycemia without diabetes. A total of 51 (12.7%) patients died. Compared to the reference group no-diabetes/no-hyperglycemia patients the no-diabetes/hyperglycemia patients showed higher mortality (1.8% versus 20.5%, adjusted odds ratio 21.94 (95% confidence interval 4.04-119.0), p < 0.001); improved prediction of death (p=0.0162) and faster progression to death (p=0.0051). Hyperglycemia within the first 24 and 48 hours was also significantly associated with mortality (odds ratio 2.15 and 3.31, respectively). Further, compared to the same reference group, no-diabetes/hyperglycemia patients had higher risk of ICU admission (p<0.001), mechanical ventilation (p<0.001) and acute respiratory distress syndrome (p<0.001) and a longer hospital stay in survivors (p<0.001). Conclusions: Hyperglycemia in the absence of diabetes was common (21% of hospitalized COVID-19 patients) and was associated with an increased risk of and faster progression to death. Development of hyperglycemia in COVID-19 patients who do not have diabetes is an early indicator of poor prognosis.

We prospectively examined the efficacy of systemic antibiotics and antibiotic catheter locks for the treatment of tunneled hemodialysis catheter related blood stream infections (CRBSI). Patients with clinical signs of tunnel or metastatic infection were excluded. All patients with suspected CRBSI were treated empirically with systemic antibiotics at the onset of symptoms before final culture and susceptibility results were available. Once the organism was identified, antibiotics treatment was tailored and antibiotic catheter locks were instilled after each dialysis treatment. Clearance of infection was documented by negative surveillance cultures after completion of antibiotic course. Out of 46 episodes of CRBSI; 16 were due to gram positive organisms, 22 were due to gram negative organisms, and 8 were polymicrobial (≥2 organisms) infections. 19 cases required removal of dialysis catheter. Antibiotic lock protocol was successful for eradicating infection in 27 of 46 episodes (59%). The likelihood of a clinical cure was identical in both gram-positive and gram-negative infections (63% and 62% respectively). Antibiotic lock protocol remains an option in the treatment of clinically stable patients with CRBSI; however, success rate of this protocol in eradicating the infection is modest.

Background There is a lack of data that systematically address toxicity with docetaxel, cisplatin, and 5-uorouracil (TPF) regimen in routine care. Objective To detect, pro le, and quantify the toxicity in Indian patients with head and neck cancers who received neoadjuvant TPF chemotherapy in a routine clinical practice (non-trial setting). Methods 58 patients with locally advanced head and neck cancer who received TPF chemotherapy were selected for this analysis. They received 2 cycles of TPF chemotherapy every 21 days. The patients were monitored for the occurrence of adverse drug reactions in accordance with Common Terminology Criteria for Adverse Events (version 4.03) during the hospitalization (median length of stay in cycle 1, 10 days), daily (at least until day 8 after chemotherapy initiation), then at days 15 and 20. Descriptive statistics was done and factors predicting for toxicity were identi ed using logistic regression analysis. Results The cumulative rate of grade ≥3 anemia, neutropenia, and thrombocytopenia were 12.1%, 56.9%, and 5.2%, respectively. The cumulative incidence of febrile neutropenia was 20.7% (12 of 58 patients). The cumulative incidences of mucositis and diarrhea were 67.2% and 74.1%, respectively. There was no mortality associated with induction chemotherapy, and all of the patients completed the planned 2 cycles of TPF. None of the tested factors predicted for any of the adverse events considered in the study. Limitations Small, single-center study Conclusion The incidence of TPF-related toxicity in Indian patients in routine practice is high, and the toxicities differ substantially from the toxicities seen in trial settings.