Life after COVID-19: Future directions?

The humans’ vulnerability and fragility have been demonstrated during pandemics, and as a community, will need proper preparation. The coronavirus outbreak was first reported at the end of 2019 and declared a pandemic by the World Health Organization. Around the world, the response to the virus outbreak has been different. The detection, traceability, and the response for different countries have been delayed, causing the overwhelming of the health systems. However, some other nations exercised various strategies to contain the infection’s dissemination and recorded a low number of cases. The different measures taken, including contact tracing, lockdown, case detection, social distancing, and quarantine strategies, helped control the disease’s spreading. Only time will tell how well the world faced the outbreak. We also suggest the future directions that the global community should take to manage and mitigate the emergency. © 2022 Elsevier Inc. All rights reserved.

Profile of severe covid-19 ARDS patients in ICU

Background: COVID-19, an infectious disease caused by SARS-CoV-2 virus has reported to be a global pandemic. About 5% of the total develop severe ARDS. Aim: To study the clinical profile, comorbidities and outcome including mortality rate in severe Covid- 19 ARDS patients. Methodology: 40 cases of severe COVID 19 infection (P/F ratio<300) admitted in tertiary care ICU treated with standard covid protocol were included in the study. Their demography, severity of hypoxia, mode of ventilation and outcome analysed. Results: Out of the 40 patients admitted, 29 (72%) were discharged with 11 patients (38%) requiring home oxygen therapy. The most common comorbidities were diabetes mellitus (30%) and hypertension (22.5%). Mean hospital stay was 17 days, and 35 patients (87.5%) required ventilation of which 80% on NIV and 20% on Mechanical ventilation. The mortality rate was 27.5%. The P/F ratio and CRP values was statistically significant with mortality rate (p-value<0.05). Three patients (7.5%) on positive pressure ventilation developed pneumothorax. One patient (2.5%) developed pulmonary thromboembolism.14 patients (35%) were in MODS out of which 8 patients died. Conclusion: Mortality rate was less in patients with a high P/F ratio and low CRP levels at the time of admission. Severe COVID 19 patients admitted in the ICU had developed additional complications requiring interventions. Patients in MODS had high mortality rate. Most common comorbidity associated was diabetes mellitus.

Outcome of COVID-19 and tuberculosis coinfection

Background: Covid 19 and Tuberculosis are the infectious diseases primarily affecting the lung. Both of them present with cough, fever and difficulty in breathing but Tuberculosis has a longer incubation period and onset of disease is slower. The patients of Tuberculosis are more likely to have comorbidities (malnutrition, diabetes mellitus, Human Immunodeficiency Virus) that increases their vulnerability to covid-19. Aim: To study the clinical profile, course, management and outcome in patient presented with covid-19 and tuberculosis in covid pandemic in Mumbai. Methods: We studied the 323-patient admitted in covid Intensive Care Unit and ward who were proven covid 19 positives by Reverse Transcriptase Polymerase Chain Reaction, Cartridge Based Nucleic Acid Amplification Test or rapid antigen test. All patients were given standard medical care, ventilatory support if required as per covid19 protocol. The chest x-ray, blood investigation and sputum investigation were studied till the time of discharge or death. Results: Out of 323 patients studied 14 had Tuberculosis. Out of those 14 patients 10 patient had pulmonary tuberculosis, 3 had Tuberculous pleural effusion and one had abdominal tuberculosis. All of them had pneumonia on chest x-ray which can be attributed to covid-19 or Tuberculosis. Conclusion: In our study all 14 patients were survived and discharged. As there is high burden of tuberculosis the covid-19 only helped in exposing the tip of the iceberg of the grave problem of undiagnosed tuberculosis in community. It seems that there is just coincidental occurrence of tuberculosis and covid19 coinfection than a causal association.

CO- morbidities in first and second wave of COVID-19 and their outcomes

Background: SARS-CoV-2 virus is the cause of the most recent pandemic that has affected the world since December 2019. Objective: To study the outcome of Covid patients along with the associated co-morbidities during the First and Second Covid wave in a Respiratory Covid ward (including ICU) at a tertiary care centre. Methods: We studied 214 Covid patients in the First Covid wave and 97 patients in the Second Covid wave. Patients mainly had complaints of dyspnea, fever, cough, generalized weakness as the main symptoms. All patients with and without co-morbidities with Covid-19 were given standard treatment as per protocol. Outcome (Discharge/ Death) of all the patients were studied in both the Covid waves. Results: Out of the 214 patients in the First Covid wave, 30.8% (66) patients died. Of these, 60% (40) had comorbidities. The major co-morbidities in dead patients were diabetes (33.33%) followed by hypertension (24.2%). In patients with underlying respiratory diseases, COPD (12.1%) was followed by Post Tuberculosis OAD (3%) and Tuberculosis (3%). As compared with the First Covid wave, the Second wave had a mortality of 48.5% (47). The major co-morbidities in dead patients were hypertension (38.3%) followed by diabetes (25.5%). In patients with underlying respiratory diseases, COPD (4.3%) was the most common cause of death. Conclusion: In both the Covid waves, diabetes, hypertension and COPD (underlying respiratory disease) were the leading co-morbidities associated with death.

Spontaneous Pneumothorax in Patients of COVID 19 Pneumonia

COVID 19 pandemic has put a massive strain on healthcare all over the world. Every day new data is getting released and various complications are being reported in patients of COVID 19 Pneumonia. One such complication is pneumothorax and pneumomediastinum. Both these conditions can lead to an increase in mortality and morbidity in patients with COVID 19 pneumonia. We studied 476 patients of COVID 19 pneumonia at our hospital, out of which 18 (3.78%) had developed pneumothorax and/or pneumomediastinum. While most of these patients were on some form of positive pressure ventilation (invasive/non-invasive), some of them had a HRCT Chest suggestive of either air trapping and/or cyst formation. Three patients had developed bilateral pneumothorax while on non-invasive ventilator. Nine of the 18 patients expired and nine were discharged. Through this article, we would like to emphasize that an acute deterioration in hypoxemia in a COVID-19 patient could indicate a pneumothorax. Pneumothorax as well as pulmonary thromboembolism are reported complications in COVID-19 and clinician vigilance is required during assessment of patients, as both share the common symptom of breathlessness and therefore can mimic each other. © 2022 Journal of Association of Physicians of India. All rights reserved.

Redefining the importance of polylactide-co-glycolide acid (PLGA) in drug delivery.

The limitations of non-biodegradable polymers have paved the way for biodegradable polymers in the pharmaceutical and biomedical sciences over the years. Poly (lactic-co-glycolic acid) (PLGA), also known as "Smart polymer", is one of the most successfully developed biodegradable polymers due to its favorable properties, such as biodegradability, biocompatibility, controllable drug release profile, and ability to alter surface with targeting agents for diagnosis and treatment. The release behavior of drugs from PLGA delivery devices is influenced by the physicochemical properties of PLGA. In this review, the current state of the art of PLGA, its synthesis, physicochemical properties, and degradation are discussed to enunciate the boundaries of future research in terms of its applicability with the optimized design in today's modern age. The fundamental objective of this review is to highlight the significance of PLGA as a polymer in the field of cancer, cardiovascular diseases, neurological disorders, dentistry, orthopedics, vaccine therapy, theranostics and lastly emerging epidemic diseases like COVID-19. Furthermore, the coverage of recent PLGA-based drug delivery systems including nanosystems, microsystems, scaffolds, hydrogels, etc. has been summarized. Overall, this review aims to disseminate the PLGA-driven revolution of the drug delivery arena in the pharmaceutical and biomedical industry and bridge the lacunae between material research, preclinical experimentation, and clinical reality.

Deep Learning Based Face Mask Detection and Crowd Counting

Without any uncertainty, the COVID-19 pandemic has set the world to a stop. The infection is spreading rapidly and could be a peril to the human race. Seeing the prerequisite of the hour, one needs to continuously make certain safeguards of that one being wearing a mask in any way at all times. To make a secure environment that leads to open safety, we propose a proficient learning and computer vision based approach concentrated on the real-time robotized observation of individuals to find unmasked faces in open areas. Subsequently, the recommended solution favors the society by sparing time and helps in bringing down the spread of coronavirus. It can be implemented successfully when lockdown is lifted completely bringing about people in open get-togethers, shopping centers, etc.. Automated inspection will reduce manpower to oversee the public and can also be used in any place.