Emerging applications of green coconut: A promising lignocellulosic biomass

Waste accumulation is a grave concern and becoming a transboundary challenge for environment. During Covid-19 pandemic, diverse type of waste were collected due to different practices employed in order to fight back the transmission rate of the virus. Covid-19 was proved to be capricious catastrophe of this 20th century and even not completely eradicated from the world. The havoc created by this imperceptible quick witted, pleomorphic deadly virus can't be ignored. Though a number of vaccines have been developed by the scientists but there is a fear of getting this virus again in our life. Medical studies prove that immunity drinks will help to reduce its reoccurrences. Coconut water is widely used among all drinks available globally. Its massive consumption created an incalculable pile of green coconut shells around the different corners of the world. This practice generating enormous problem of space acquisition for the environment. Both the environment and public health will benefit from an evaluation of quantity of coconut waste that is being thrown and its potential to generate value added products. With this context, present article has been planned to study different aspects like, coconut waste generation, its biological properties and environmental hazards associated with its accumulation. Additionally, this review illustrates, green technologies for production of different value added products from coconut waste. © 2023 Wiley Periodicals LLC.

Effectiveness of Probiotics

Background: To evaluate the potential of probiotics in stress management caused by the Covid-19 pandemic. Material(s) and Method(s): PubMed, Elsevier, New England journal of Medicine and Google Scholar were searched for the keywords "Probiotics and stress management during the Covid pandemic" up to 30th April 2022. Result(s): Probiotics have a great potential of managing mild stress. The pandemic has brought about physical as well psychological distress and has had a negative impact on the mental health of individuals. Stress increases the risk of cardiovascular diseases, hypertension and neuropsychiatric disorders. Probiotics can be used to alleviate mental stress. Probiotics maintain ecological balance of gut and provide immunity. They also affect mood and health of host by regulating gut-brain axis of host and may be used as Psychobiotics by altering various neurotransmitters like dopamine, serotonin, adrenocorticotrophic hormone, epinephrine, norepinephrine and GABA. The use of probiotics in mild stress will help reduce the risk of adverse effects and dependence associated with the psychotropic drugs. Conclusion(s): The ongoing studies on probiotics seems to be a good solution towards stress and related problems which is rapidly increasing due to COVID-19 pandemic. Probiotics seem to be beneficial in handling stress as they alter the release of neurotransmitters reducing stress level of an individual and have a positive effect on mood. The current pandemic is likely to continue and there is a need for greater preparedness of stress management, therefore, it is essential to explore the full potential of probiotics application in stress management.Copyright © 2022 Authors.

Vaccination Status and Outcome of Patients at a Dedicated COVID-19 Centre, Delhi, India: A Retrospective Study

Introduction: Coronavirus Disease-2019 (COVID-19) vaccine provides strong protection against transmission, serious illness, hospitalisation, and death. As India carried out robust vaccination drive covering more than two third of its population, the study was aimed to highlight the effects of vaccination status of patient on the outcome of COVID-19 infection. Aim: To describe the relation of vaccination with disease severity and its outcome during the third wave of COVID-19. Materials and Methods: It was a single centre retrospective, cross-sectional study conducted in a dedicated COVID-19 hospital (Guru Tegh Bahadur Hospital) in Delhi, India. A total of 257 patients were admitted between January 10th 2022 to 9th February 2022, and 246 were included in the study. For each individual, demographic, and clinical data was collected. Vaccination data was extracted via the CoWin platform which included vaccine type as well as date of administration. The profile of patients was established based on clinical examination, laboratory data, nursing record and radiological record during the course of hospitalisation. The clinical outcome was described as discharge, length of hospital stays, and in-hospital death in relation to the vaccination status. Statistical Analysis was done using Statistical Package for the Social Sciences (SPSS) v22. Results: Total of 246 patients were divided into three groups -97 were fully vaccinated, 46 were partially vaccinated and 103 were unvaccinated. Both vaccinated and unvaccinated groups had similar percentage of co-morbidities i.e. 61.3% vs 63.5%. Those who were fully vaccinated were more likely to maintain saturation at room air 30.9% vs 26.1% vs 3.9%, had lesser requirements of mechanical ventilation (6.2% vs 15.2% vs 21.4%), shorter duration of hospital stay (4.2 vs 5.3 vs 7.2 days), and lesser mortality (9.3% vs 21.7% vs 33%) as compared to the partially vaccinated and unvaccinated patients respectively. Conclusion: The beneficial effect of the vaccination was observed in severity, mortality, morbidity, and lesser number of hospitalisations. Hence, vaccination coverage was critical in reducing the severity in reducing the and the hospitalisation in third wave of COVID-19.

Effectiveness of Probiotics

Background: To evaluate the potential of probiotics in stress management caused by the Covid-19 pandemic. Material(s) and Method(s): PubMed, Elsevier, New England journal of Medicine and Google Scholar were searched for the keywords "Probiotics and stress management during the Covid pandemic" up to 30th April 2022. Result(s): Probiotics have a great potential of managing mild stress. The pandemic has brought about physical as well psychological distress and has had a negative impact on the mental health of individuals. Stress increases the risk of cardiovascular diseases, hypertension and neuropsychiatric disorders. Probiotics can be used to alleviate mental stress. Probiotics maintain ecological balance of gut and provide immunity. They also affect mood and health of host by regulating gut-brain axis of host and may be used as Psychobiotics by altering various neurotransmitters like dopamine, serotonin, adrenocorticotrophic hormone, epinephrine, norepinephrine and GABA. The use of probiotics in mild stress will help reduce the risk of adverse effects and dependence associated with the psychotropic drugs. Conclusion(s): The ongoing studies on probiotics seems to be a good solution towards stress and related problems which is rapidly increasing due to COVID-19 pandemic. Probiotics seem to be beneficial in handling stress as they alter the release of neurotransmitters reducing stress level of an individual and have a positive effect on mood. The current pandemic is likely to continue and there is a need for greater preparedness of stress management, therefore, it is essential to explore the full potential of probiotics application in stress management. Copyright © 2022 Authors.

Telehealth maintains access to early phase clinical trials during the Covid-19 pandemic

Aims: The COVID-19 pandemic substantially disrupted healthcare globally. Quarantine, travel restrictions, health worker furloughs and institutional mandates to limit non-essential clinical activity significantly impacted upon trials recruitment abroad. The purpose of this review was to compare the demographics and enrolment for patients referred to The Kinghorn Cancer Centre (TKCC) Phase 1 Unit between January 2020 and March 2022, with historical data from the same institution from the twelve months prior to determine the impact of COVID-19 on Phase 1 activity. Method(s): A single institutional retrospective study was performed utilising a purpose-built Phase 1 database. Data extracted from electronic medical records and trials electronic data capture software included patient demographics, date and method of first review, consent date, screen-failure rate, date to enrolment, duration on trial and outcome post-trial. Analyses were performed in SPSS V26.0. Result(s): Four hundred and thirty-four patients were referred/seen in the Phase 1 unit between January 2020 and March 2022 (16/month), of which 341 (79%) were consented/screened onto a Phase 1 trial and 157 (46%) proceeded to treatment. The proportion initial consultations using telehealth increased from 11.3% to 45.3% pre-post pandemic (P < 0.0001). However, the proportion of interstate referrals or regional/remote referrals did not change likely to widespread increase in telehealth utilisation. Pandemic-induced lockdowns decreased absolute numbers of Phase 1 referrals in the short term, however did not influence enrolment or screen failure rates. Further mitigation strategies successfully employed at our Phase 1 unit included treatment-athome, teleconsenting, Phase 1 coordinators/investigators working in split teams, and remote monitoring. Conclusion(s): The COVID-19 pandemic did not impact upon the demographics of Phase 1 referrals to a major metropolitan hospital, however absolute numbers of referrals were influenced by lockdowns/ outbreaks. Telehealth was successful at maintaining access to trials for patients in need and should be continued to allow equity of access to Phase 1 trials.

The Unaccounted Morbidity of Covid 19 Pandemic: A Tertiary Level Center's Assessment of Impact of Pandemic on Urolithiasis Patients

Introduction &Objective: Severe acute respiratory syndrome coronavirus 2 causes coronavirus disease 2019 (COVID-19). Since March 2020, this pandemic has caused unprecedented human suffering. With limiting medical services available and prolonged neglect, patients with urolithiasis have seen significant increase in morbidity during this pandemic. Method(s): The study was conducted at a tertiary level apex medical centre of north India from November 2020 to July 2021. Patients who were diagnosed with urolithiasis before March 2020 but could not receive timely management due to pandemic situations were enrolled for study. Result(s): The study included 91 patients(53-male, 38-female) with mean age of 40.3 +/- 13.2 (18-65) years. Among these 83 patients had urolithiasis whereas 8 patients had encrusted DJS. Sixty four (70.3%) patients had primary stones whereas 21 (23.1%) had recurrent stones. Proposed management at initial assessment of these patients pre-pandemic was Medical (5), ESWL (38), URSL (17), RIRS (5), DJR (8) and PCNL (18). The mean (range) stone size (n = 83) pre pandemic was 13.8 +/- 8.43 (5-55) mm and at the time of final management due to pandemic delay was 19.1 +/- 10.1 (6-60) mm. This translates into a mean increase of stone size of 5.3 +/- 5.7 (0-35) mm. Mean (range) delay in management of these patients was found to be 11.2 +/- 5.8 (9-15) months. Thirty-two patients required change in management due to delay as a result of Covid pandemic. Despite restrictions during the pandemic, a total of 19 patients had to visit emergency department out of which 7 patients required percutaneous nephrostomy (PCN) placement. Among seven patients undergoing PCN placement, 3 had accidental slippage of PCN which required additional emergency department visit for PCN re-placement. Two patients who were planned for URSL at initial presentation with stone sizes of 8mm and 7mm in the lower ureter passed their stone spontaneously with self-continued medical expulsive therapy During the pandemic imposed restrictions, 8 patients presented with encrusted stents and underwent URSL in 5, CLT in 2 and URSL,CLT with PCNL in 1 patient for stent removal. Conclusion(s): Effect of Covid 19 pandemic on urolithiasis has been immense. Urolithiasis patients need to be carefully evaluated and in presence of complications or loss of renal function early intervention should be offered. Role of non ot procedures like ESWL, DJ stenting, PCN insertion have to be given importance beyond traditional practices. Surgical interventions providing maximal clearance in least attempts should be chosen over miniaturization.

REGRESSIVE BONE MINERAL DENSITY TRENDS SEEN with DELAY in FOLLOW UP of DENOSUMAB TREATMENT DUE to the PANDEMIC INDUCED LOCKDOWN-A SINGLE CENTRE INDIAN EXPERIENCE

Background: Denosumab (Dmab), a fully human monoclonal antibody that inhibits receptor activator of nuclear factor kappa-β ligand (RANKL), which selectively inhibits osteoclastogenesis can be used for a long period unlike the relatively short period with Teriparatide.1-2 However the effects of Dmab can quickly regress if the treatment is delayed.3 Objectives: The pandemic led to multiple prolonged lockdowns since March 2020 to Jan 2022 in India. This resulted in follow up Dmab treatment delays. The retrospective study was aimed to look for the effect of the delays. Methods: The bone mineral density (BMD) trends from the central dual-energy X-ray absorptiometry (DXA) at our centre were studied. The trends of patients under Dmab for one year and delay in follow up for 10-12 months for the forth dose were evaluated. 21 postmenopausal women who had been under treatment with Dmab 60 mg subcutaneous injection at 6 monthly interval for one year followed up with such delays. 6 were excluded because of history of sars-cov-2 infection and glucocorticoid use. In the study group of 15 (n=15), the mean BMD at L2, L3 & L4 (sp BMD) and Right and Left Hip (hip BMD) were studied from before treatment (a BMD), 6 months after 1st and at the time of 2nd injection (b BMD), 6 months of the 2nd and at the time of 3 rd injection of Dmab (c BMD), and that due to delay in follow up of 10-12 months (d BMD). The mean percentage trend change between a-b, b-c, and c-d BMDs was evaluated. The least signifcant change (LSC) 4 from a single centre DXA was used to validate the fndings. Results: The mean percentage change after the treatment for the 1st 6 months of Dmab (a-b BMD) was 4.08% and 3.60% and the second injection resulted in a further change (b-c BMD) of 5.98% and 4.52% in the sp BMD & hip BMD respectively. The delay in follow up of 10-12 months resulted in a change (c-d BMD) of-7.81% in the sp BMD and-2.96% in the hip BMD. The LSC from a single centre DXA is 2.6% and 3.6% for sp BMD and hip BMD respectively. A p>0.05 was considered statistically signifcant. Table 1 shows the BMD changes. Conclusion: These fndings suggest that regressive trend in BMD are seen when the treatment with Dmab is delayed even as early as 10 to 12 months. It was seen much faster in the spine compared to the hip. It is therefore advised that short term treatment with Dmab without follow up could lead to loss of all gains and may also worsen the osteoporosis.

IMPACT OF SERUM IGG LEVELS AGAINST SARS-COV-2 ON CLINICAL OUTCOMES FOR HOSPITALIZED COVID PATIENTS

BACKGROUND: The SAR-CoV-2 pandemic continues to negatively impact the healthcare system globally with over 800,000 deaths in the United States and millions more worldwide. The cases are rising despite availability of vaccines. For most immunocompetent patients these vaccines will generate a humoral response and also a memory T-cell response. Few if any studies have reported data that measure anti-spike IgG titers and also correlate those titers with clinical outcomes in the instance of breakthrough infection. METHODS: We conducted a pilot prospective observational clinical study enrolling 30 immunocompetent patients who were admitted with a positive SARS-CoV-2 PCR. Leftover blood from admission was used to obtain antispike and anti-nucleocapsid antibody levels. Baseline characteristics were collected and patients were divided into two categories based on anti-spike antibody level and vaccination status. Clinical outcomes including mortality, major adverse cardiac events (MACE), overall length of stay (LOS), ICU LOS, maximum oxygen support needs, and mechanical ventilation needs were analyzed on day 28 in both categories. RESULTS: On analyzing the patients enrolled, the median age was 59 years, 56.67% were female and 73.3% were Caucasian. 6 patients (20%) were asymptomatic, and 63.3% patients had hypertension. Among all patients, the median duration of symptoms was 7 days, and the median LOS was 7 days as well.Anti-spike antibody was detected in 22 patients (73.33%), and the median value was 956. Anti-nucleocapsid antibody was positive only in 9 patients (30%). Three patients (10%) were admitted to ICU, and all 3 were mechanically ventilated. Four patients (13.33%) had a MACE event in those 28 days, and 5 patients (16.67%) died. Comparing vaccinated vs unvaccinated: 3/5 deceased patients were unvaccinated, and 2/3 mechanically ventilated were unvaccinated as well but these were not statistically significant. 0.6% patients were asymptomatic in unvaccinated group versus 33% in the vaccinated group. Among the 7 patients with high oxygen needs (fio2 100%), 5 had undetectable anti-spike antibodies, and one had low value (89.6). 2 out of 3 mechanically ventilated and 3 out of 5 deceased patients had undetectable anti-spike antibodies. CONCLUSIONS: Our pilot study did not show significance in outcomes between vaccinated and unvaccinated patients, but this relation has been verified in multiple larger studies. We also noted patients with undetectable/ low anti- spike antibody levels had increased fio2 needs, ICU admission, and mortality.However, it was not feasible to compare both these findings between groups due to less number of patients. This demands a larger study to better describe these relations.

The fatal fetal sting of Dengue: experience from a tropical country

Objectives: Dengue is a vector borne infectious disease, endemic in the tropical regions, that may be associated with significant maternal and fetal morbidity and mortality. However, literature is sparse on the rate and factors associated with stillbirths in women suffering from dengue. In this study, we aimed to explore the frequency of stillbirths in dengue infection in pregnancy during the COVID pandemic. We also studied the effect of severity of the disease on fetal morbidity and mortality. Design: Retrospective review of registers and case records Method: We reviewed the data of pregnant women admitted for dengue in the Obstetrics & Gynecology department in a tertiary care hospital of Northern India between September and December, 2021. Data collected included the age, parity, gestation at admission, severity of the maternal disease, other comorbities, maternal outcome, obstetrical outcome during the dengue disease and fetal outcome. Results: Twenty three pregnant women were admitted to the department between September and December 2021. The average age of the women was 26+/-5 years. Half of these women were primigravidas (12 out of 25). Most women were in the third trimester, while one woman each presented in second trimester and the postpartum period. Eleven mothers presented with severe dengue, 11 had dengue with warning signs and only one woman had dengue without warning signs. There were 7 maternal deaths. Three mothers died undelivered. There were 10 stillbirths of 20 deliveries and 22 babies. Majority of the woman delivered preterm. There were 2 twin deliveries. Of the babies who delivered at term, most were liveborn(6 of 7). The stillbirth rate was higher in the severe dengue group, dengue with warning signs and dengue without warning signs were 60%, 36% and nil respectively. Conclusions: The stillbirth rate is high in women with dengue in pregnancy, especially in the third trimester. The chances of stillbirth escalate with the severity of dengue. Maternal mortality is high in women admitted with dengue in pregnancy. Public health strategies to prevent dengue should be strengthened to avoid high stillbirth rates and maternal mortality. The data is limited by the retrospective design and skewed as women with only severe form of dengue would have been admitted.

Impact of COVID-19 on Physical Activity, Diet, and Stroke Awareness in Homeless Individuals of Chicago

Objective: This research aims to characterize stroke awareness in homeless individuals of Chicago while providing guidance on stroke recognition and response. Additionally, we aim to assess the effects that the COVID-19 pandemic and social isolation have on stroke risk factors. Background: Strokes occur every 40 seconds in the United States and are one of the leading causes of preventable death and debilitation for both men and women. Higher stroke mortality rates occur in neighborhoods with larger proportions of Black residents and lower median incomes. Some physicians are concerned that risk factors for stroke such as physical inactivity and poor diet have worsened in the setting of the COVID-19 pandemic and have led to an even higher risk stratification in these populations. Design/Methods: A 53-item stroke survey along with health and wellness questionnaires were administered to 40 residents at A Safe Haven, a social enterprise serving the homeless. Participants were recruited at random from a booth on-site. Results: The majority of participants were Black (n=36/40) with most being between the ages 30-44. Participants identified as male (n=18) or female (n=22). Those surveyed endorsed decreased physical activity levels (m=2.2/5) and increased screen time (m=4.0/5) since the beginning of the pandemic. Subjectively worse dietary changes were reported in 78% of participants since the pandemic began. Stroke symptom and risk factor awareness was poor in 29%, fair in 40%, and good in 31% of participants. Among those surveyed, 45% agreed they would not be able to recognize a stroke and 55% agreed they would not know what to do if they witnessed a stroke. Conclusions: These data suggest that poor stroke awareness, decreased physical activity levels, and worsening dietary habits have become more prevalent among homeless populations in Chicago during the ongoing pandemic. Our goals of promoting healthy lifestyles and raising stroke awareness are particularly important during this time.

Global Epidemiology of Mucormycosis associated with post Covid-19 complication

COVID-19, which is caused by the SARS-CoV-2 virus, first appeared in Wuhan, China in the year 2019. It has been linked to a variety of fungal and bacterial illnesses that are opportunistic. There have been several reports of fungal infections following COVID-19. Recently, several cases of mucormycosis have been reported worldwide, particularly in India. Mucormycosis (zygomycosis) is a fungal infection caused by members of the Mucorales and Zygiomycotic species with inhalation of fungal spores as the mechanism of infection. Poorly controlled debilitating diseases (such as diabetes), immunosuppression and trauma are all risk factors. The rise in cases of mucormycosis is a result of corticosteroid application in patients having COVID-19 complications. In diabetes mellitus, the rhinocerebral form of mucormycosis is most commonly seen whereas pulmonary mucormycosis has been seen in patients having hematological malignancy or undergoing blood/organ transplantation. However, in this mini-review, we are emphasizing the role of mucormycosis during COVID-19 infection, encompassing the types of mucormycosis, their diagnosis and treatment.

Automated Gate Control System using Face Mask Detection

This research paper gives a brief idea of controlling entrance gates of different areas like metro stations, railway stations, airports, corporate offices, restaurants, hotels and home with the face mask detection technology. In this, the camera will capture the real time video of a person using Artificial Intelligence[15],whosoever is entering the gate, processes the video and detects if the concerned person is wearing the mask properly or not. If the person is wearing a mask then the gate will open, if not then the gate will remain closed until the mask has been worn properly. The main motivation for this project comes from the current situation in the world where Covid-19 is spreading at a pace which is being difficult to control. This upcoming technology prototype can fuel in new ideas into different projects which are already ongoing to battle the pandemic. Also, the scope of this technology is not just limited to the face mask detection and has a wider and a more complex use-case in the real world. © 2022 IEEE.

Potential applicability of Schiff bases and their metal complexes during COVID-19 pandemic - a review

The rapid growth and revolution in the area of emerging therapeutics has been able to save the life of millions of patients globally. Besides these developments, the microbes are consistently struggling for their own survival and hence becoming quite more sturdy and incurable to existing drugs. Covid-19 virus and Black Fungus are recent examples of failure of medical preparations and strength of these viruses beyond the imagination of medical practitioners. Henceforth the study has made an extensive survey of exiting literature on heterocyclic schiff bases and their transition metal complexes to look for their potential applicability as antimicrobial agents. The inherent physiognomies of the essential properties of these transition metal complexes including thermodynamic, kinetic and chelating are comparatively modifiable as per requirements. The study has found that the biological applications of these transition metal complexes are well suited to be used as antibacterial and antifungal agents.

Current advances in solar-blind photodetection technology: using Ga2O3 and AlGaN

The rapid spread of the novel coronavirus disease (COVID-19) and emergence of different variants worldwide have caused a pandemic. With the sudden outbreak of this virus, ultraviolet-C (UV-C) sterilizing devices are significantly employed to destroy around 99% of these viruses. However, continuous exposure to UV-C may harm the environment and humans, leading to an increased risk of skin cancer, DNA damage, cataracts and many more severe health complications, which may result in another pandemic situation. Thus, it is highly necessary to monitor the intensity of UV-C exposure and limit the radiation in the environment. It is advisable to employ a highly sensitive solar-blind (SB) UV photodetector (PD) together with UV-C radiation devices. Among the various ultra-wide bandgap semiconductors, AlGaN and Ga2O3 have emerged as the most suitable materials for application in solar-blind photodetection devices due to their high radiation hardness and high chemical and thermal stability. In lieu of exploring efficient SB UV detection systems, herein, we present a comprehensive review of the latest progress in solar-blind UV PDs based on the device architecture and the accompanying physical mechanisms. Further, the technical issues related to material synthesis and device fabrication, which limit the large-scale implementation of these detectors, are also addressed. Finally, a perspective for the future integration of these semiconducting materials with emerging two-dimensional materials towards highly sensitive SB detection devices is given.