Objectives To examine a cohort of children and adolescents quarantined during Coronavirus disease 2019 outbreak in India and to describe their understanding of, compliance with and the psychological impact of quarantine experience. Methods One hundred twenty one children and adolescents along with their parents were interviewed regarding their compliance and psychological distress during the quarantine period. A comparable data was also obtained from 131 children and adolescents who were not quarantined. Results Most of the children and adolescents were non-compliant as compliance with all requirements was low (7.43%), though compliance with community protective measures (17.35%) was better than compliance with household protective measures (10.71%). Quarantined children and adolescents experienced greater psychological distress than non-quarantined children and adolescents (p ˂0.001). Worry (68.59%), helplessness (66.11%) and fear (61.98%) were the most common feelings experienced under quarantine. Conclusions The low compliance with quarantine requirements as seen in this study raises a serious concern about the effectiveness of quarantine as a preventive measure of disease transmission. Compliance and mental health problems can be improved by providing adequate financial support and enhanced knowledge about pandemic planning.

Highlights Anakinra averted need for mechanical ventilation in patients with severe COVID-19 pneumonia. Anakinra accelerated weaning off oxygen therapy and hastened transition to room air. Patients treated with anakinra had significant reduction in biomarkers of inflammation. Study results did not demonstrate significant difference in in-hospital mortality. We provided further evidence for the utility of anakinra in severe COVID-19 pneumonia.

No abstract

An activity-directed fractionation and purification process was used to identify the antioxidant components of Cedrus deodara. Dried heartwood powder of C. deodara was first defatted with petroleum ether and then extracted with chloroform. The chloroform extract showed strong antioxidant activity on 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical. This fraction was then subjected to separation and purification using silica gel column chromatography. Three compounds with potent antioxidant activity were isolated in significant yields and identified by spectroscopic methods ((1)H NMR, (13)C NMR, IR, and MS). They were identified as (-)-matairesinol, (-)-nortrachelogenin, and a dibenzylbutyrolactollignan (4,4',9-trihydroxy-3,3'-dimethoxy-9,9'-epoxylignan). This is the first report of the occurrence of these compounds in C. deodara.

BackgroundMobile application based delivery of psycho-social interventions may help reduce the treatment gap for severe mental illnesses (SMIs) and decrease the burden on caregivers. Apps developed in high income settings show effectiveness, but they suffer from lack of applicability in low resource scenarios due to the difference in technology penetration, affordability, and acceptance.ObjectiveThis study aimed to understand health technology usage, perceived needs, and acceptability of app based interventions in patients with SMIs to improve illness management and reduce caregiver burden.MethodsThe study was conducted in inpatient and outpatient settings of a tertiary care center in North India. A cross-sectional survey assessed smartphone and health app usage. Further, three focus group discussions evaluated the needs and apprehensions in using apps in management of SMIs.ResultsA total of 176 participants including 88 patients and 88 caregivers completed the survey. Smartphone ownership was similar to the national average (30%) in both caregivers (38.6%) and in patients (31.8%). Although subjects regularly used a third party app, health app usage was very low. Cost, unfamiliarity, and language were significant barriers to adoption. The focus group discussions provided insight into the various apprehensions of caregivers in using and in allowing patients to use smartphones and such apps. Caregivers wanted mobile apps for accessing information regarding services and resources available for people with SMI, and they felt such apps can be helpful if they could automate some of their routine caregiving activities. However, the significant difficulty was perceived in regards to the cost of the device, language of the medium, and unfamiliarity in using technology. Apprehensions that SMI patients might misuse technology, or damage the device were also prevalent.ConclusionsThe study systematically looks into the scope, design considerations and limitations of implementing a mobile technology based intervention for low resource settings. With only one-third of the patients and caregivers having access to smartphones and internet, parallel outreach strategies like IVRS should be actively considered while designing interventions. The difficulty of understanding and searching in a non-native language needs to be addressed. Hand holding of caregivers and frequent encouragement from treating doctors might significantly help in technology adoption and in surmounting the apprehensions related to using technology. To make the solution acceptable and useful to the already over-burdened caregivers, developers need to work closely with patients’ family members and follow a ground-up collaborative approach to app development. The scope of delivering mental health services through technology is immense in resource constrained settings like India, provided we, researchers, appreciate and accept the fact that in the varied landscape of a divergent economic, educational, and cultural milieu, a single solution will never suffice for all...