Biomedical waste management during pandemics

For many years, proper biomedical waste (BMW) management in line with the rules was among the overlooked components of health care. Biomedical waste presents a series of environmental contamination. As a result, it must be treated using extreme caution and disposed of properly. There are a few gaps in the handling of biological generated waste, and the coronavirus epidemic has made it very hard. The virus's quick breakout resulted in a massive increase in the amount of biohazardous matter. The COVID-19 epidemic's devastation has altered global waste generation trends, needing special attention. Sudden variations in trash generation and volume need a dynamic response from authorities. This study highlights the problems that the collection and recycling business faces even after a pandemic, as well as the basic possibility to eliminate current framework faults. The study covers specific situations for handling medical waste, polymeric garbage, and recycling bins, which were all major causes of concerns all through this time period. We also go over successful stakeholder involvement and teamwork.The existence of illness sewage treatment in regular effluent created offers significant dangers and liabilities to hygiene workers. Small metal usage is predicted to recover as a result of rising hygiene concerns, particularly from items used for safety precautions and medication. The research further underlines the significance of creating localized, streamlined supply channels to deal with these kinds of situations in the case of unanticipated devastating catastrophes. Despite presenting unique solutions to existing recycling challenges, the paper also presents numerous crucial recommendations to regulators to enable them to cope with any potential outbreaks in a holistic way. © 2023 Author(s).

Study of body composition analysis in the view of obesity prognosis

Chronic overweight is characterized by significant elevations in abdominal fat as well as changes in the composition of fat free mass, particularly total body fluids and its interstitial compartment. The applied in the real restrictions placed by morbid obesity, as well as changes in body content from those of healthy weight, provide enormous hurdles to fat percentage assessment. This research concentrates on some of the research and practice challenges connected with using popular fat percentage measures, and it finds available evidence on suitable approaches for use in extremely obese people. There is already little scientific literature on which body composition measures may be utilised confidently in very obese people. A typical 3 model that combines readings of body mass by air - assisted plethysmography and total body liquid by bio-electrical impedance could provide metrics of percentage body fat in the extremely obese that are significant compared to a conventional, technically skilled 3 storage area prototype that requires infrastructure including such isotopic ratios mass spectrometry as well as important technological knowledge. This study focuses on a few fundamental issues that investigators and physicians confront when doing anthropometric studies on highly obese individuals. A 3 basic framework that is efficient and simple to implement shows potential for usage in this community. Nonetheless, more study on this and other suitable techniques of fat percentage measurement in a broad sample of extremely overweight adults is required. © 2023 Author(s).

Evaluation of Anxiety of Medical Personnel during the Coronavirus Outbreak in Tasikmalaya, Indonesia

Background: Coronaviruses are a large family of viruses that can cause respiratory infections. A factor that has recently caused a great deal of anxiety is anxiety associated with the coronavirus. The purpose of this study was to evaluate the level of anxiety among medical personnel exposed to the new coronavirus pandemic. Methods: This descriptive, cross-sectional research was conducted on 210 medical personnel working in hospitals and health centers in Tasikmalaya, Indonesia. Medical personnel, who were exposed to or not exposed to this disease, were included in the study through census sampling in 2021. The data collection tools used include a demographic information questionnaire and the Corona disease anxiety scale (CDAS). Data analysis was performed using ANCOVA in Excel software. Results: The mean score of anxiety of the medical personnel during the new coronavirus pandemic in Tasikmalaya was 30.02%. Furthermore, in the medical personnel, the mean score of mental symptoms (47.22%) was higher than physical symptoms (13.15%). The anxiety, and psychological, and physical symptoms scores for women was higher than for men personnel, and there was a significant difference between them (P ˂ 0.05). The demographic variables of gender (P = 0.001), work experience (P = 0.023), and number of family members (P = 0.004) had a statistically significant relationship with anxiety (P < 0.05). Conclusion: According to the results of the study, the level of anxiety among female personnel was higher than male personnel. As a result, holding training classes and stress management courses among all personnel, especially female personnel, should be considered. © 2023, Vesnu Publications. All rights reserved.

Unexposed individuals are fully equipped at the genetic level in terms of peptide coverage and T-cell repertoire against SARS-CoV-2: Analysis in a cohort of healthy donors and alloHSCT recipients

T-cell recognition of antigenic peptides presented by HLA molecules at the cell surface is critical for mounting an efficient adaptive immune response during acute viral infection such as COVID-19 caused by SARS-CoV-2. Recent data suggest that the depth of peptide coverage and the breadth of T cells that are able to respond are both important parameters associated with disease outcome. Strong T-cell responses against SARS-CoV-2 have also been reported in unexposed individuals, pointing to a possible role of heterologous immunity. In this study, we performed immunosequencing of the TCR CDR3beta region in a large cohort of 116 alloHSCT recipients and their corresponding healthy donors collected prior to the emergence of SARS-CoV-2. We used bioinformatics analyses and a large database of about 150,000 SARS-CoV-2 specific T-cell sequences in order to investigate the composition of the TCR repertoire regarding the presence of SARS-CoV-2 specific clonotypes in unexposed subjects among the more than 3.5 million CDR3beta sequences that we retrieved by immunosequencing. We also performed peptide binding predictions based on the reference proteome of the virus and by using the HLA class I high resolution typing data of the 116 patients. We could show that every individual is equipped with a large and diverse repertoire of clonotypes sharing their CDR3beta sequence with a SARS-CoV-2 specific T cell. Furthermore, the composition of the anti-SARSCoV- 2 repertoire was very similar among individuals, in healthy donors but also in the context of immune reconstitution in recipients, despite significant differences previously reported when accounting for the whole repertoire or for CMV-specific clonotypes only. In addition, each individual had the potential to cover a diverse repertoire of SARS-CoV-2 derived peptides (i.e., a few thousands strong and weak binders), but, interestingly, some interindividual differences were observed when only accounting for a strong affinity level of binding.

Machine Learning based COVID-19 Patients Monitoring System using CNN

Ever since an anonymous disease broke out in late 2019, the whole world seems to have own ceased functioning. COVID-19 patients are proliferating at an exponential rate, straining healthcare systems around the world. Traditional techniques of screening every patient with a respiratory disease is unfeasible due to the restricted number of testing kits available. We presented a method for recognizing COVID-19 infected patients utilizing data collected from chest X-ray scans to overcome this challenge. This attempt will benefit both patients and doctors significantly. It becomes even more critical in nations where the number of people affected far outnumbers the number of laboratory kits available to test the disease. When current systems are confused whether to retain the patient on the ward with other patients or isolate them in COVID-19 zones, this could be useful in an inpatient setting. Apart from that, it would aid in the identification of patients with a high risk of COVID-19 and a false negative RT-PCR who would require a repeat. Most of the COVID-19 detection methods use traditional image classification models. This has the issue of low detection accuracy and incorrect COVID-19 detection. This method starts with a chest x-ray enhancement procedure like this: Rotation, translation, random conversion. The survey's accuracy has considerably increased as a result of this. For the COVID-19 infection, our model has 97.5 percent accuracy and 100 percent sensitivity (recall). In addition, we used a visualization technique that distinguishes our model from the others by displaying contaminated areas in X-ray pictures. © 2022 IEEE.

Workers' knowledge, attitude and performance of a waste recycling center in tehran metropolis regarding health aspects during the spread of covid-19

Background and Objective: Today, the issue of health aspects in urban waste management, especially recycling, has received a lot of attention during Covid-19 around the world. Therefore, the purpose of this research is to investigate the knowledge, attitude, and performance of workers of one of the waste recycling centers in Tehran metropolis regarding health aspects during the spread of Covid-19. Materials and Methods: This was a descriptive-analytical cross-sectional study and the study population was all workers working in one of the recycling centers of Tehran Municipality. The data collection tool was a researcher-made questionnaire with validity and reliability in four sections: Demographic, knowledge, attitude, and practice of workers toward Covid-19 and solid waste. Results: Findings of the study showed that the highest number of workers employed were in the age group of 20 to 40 years (60 percent). The level of knowledge was about 80 percent and the lack of awareness was 20 percent. The level of workers' positive attitude, negative attitude, and lack of attitude were 79.71, 14.56, and 5.72 percent, respectively. The level of positive practice among workers was about 67.43 percent and the negative practice was 32.57 percent. Conclusion: The results clarified that in order to succeed in waste management programs in recycling centers, municipal waste managers should pay more attention to educational aspects, especially through the focus on programs and their development and adaptation for different age groups, especially 20 to 40 years. © 2022 Iranian Association of Environmental Health, and Tehran University of Medical Sciences.

Multifactorial Benefits of Radial Access in Endovascular Interventions to Treat Peripheral Arterial Disease-Critical Limb Threatening Ischemia

Background A paradigm shift appears to be occurring with overwhelming evidence of trans-radial access (TRA) being a safe and feasible approach for peripheral interventions compared to trans-femoral access (TFA). Our study explores the additional, multifactorial benefits of TRA regarding perioperative times, radiation, contrast administration, and cost-savings for patients and hospitals during Covid era. Methods A retrospective review of all peripheral interventions were performed over two years to outline the advantages and limitations of TRA compared to TFA approach. Patient demographics, procedural time, contrast usage, and radiation dose were recorded and analyzed. Hospital discharges and bed utilization were also studied. Results Total of 170 procedures performed via radial access were evaluated and compared to a control population of n=20 femoral access procedures. Procedural success rate for all interventions was 100% with 10% of cases presenting with acute limb ischemia and 90% presenting with chronic limb ischemia. A two-fold decrease in procedural time for TRA was evident in our analysis compared to the procedures conducted via TFA (81 +/- 43 mins vs. 164 +/- 36 mins, respectively). Furthermore, contrast usage and radiation absorption in TRA procedures decreased dramatically, adding to the potential cost-saving and safety measures for the patient and hospital system. Conclusion While current TRA limitations include operator experience, length of devices, and sheath sizes, the overall benefits of TRA over traditional TFA management cannot be ignored. TRA approach is undoubtedly a safe, feasible, efficient, and cost-saving route for peripheral interventions. It is here to stay as the present and future of diagnosing and treating peripheral arterial disease.Copyright © 2023 American College of Cardiology Foundation

Use of Blockchain Technology to Protect Privacy in Electronic Health Records- A Review

Patients' medical files are electronically preserved and accessible through a network such as Electronic Health Records (EHRs). Numerous opportunities exist for EHRs to enhance patient care, clinical practice performance indicators, and potential future clinical research contributions. The techniques used to preserve EHRs have proved incredibly unsafe in the contemporary era of smart homes and urban areas. Data can be easily accessed by hackers and unauthorized third parties. Furthermore, the data is not accessible to patients or healthcare practitioners. These plans cannot balance the accessibility and security of the data. But with blockchain, these issues can be resolved. Any application created utilizing blockchain technology is secure and inaccessible to unauthorized parties thanks to the three critical characteristics of the technology: Security, Decentralization, and Transparency. In a blockchain network, it is nearly difficult to manipulate data. This research work utilizes blockchain technology to deploy EHRs and improve their security and privacy. With its decentralized structure and cryptographic techniques, blockchain technology will maintain control over who gets access to information. Furthermore, it will maintain a balance between accessing data and privacy. The advanced aspects of the EHR system are handled by this research using smart contracts. The comprehensive healthcare management solution across a network can incorporate several sectors, such as billing and transportation. A website program can be combined with it to increase interactivity. By adding pharmacists to the system as a participant, EHRs can help them track medical sales. © 2023 IEEE.

Real-Time Tracking of Health Parameters Using IOT and Data Logger: Application to COVID-19

There is an alarming upward trend in COVID-19 cases, and the existing healthcare system is unable to cater the day-to-day requirements from testing followed by appropriate patient care. The use of monitoring devices has found the importance of detecting the presence of the virus early. In order to expand the exciting monitoring system, every technocrat needed to come forward and donate his money to this. Authors as a responsible persons deemed it proper to work on the development design of multipurpose all in one reliable device to help the front like warriors in identifying persons with COVID-19 symptoms like temperature, heartbeat, humidity and positioning real time. After putting in an extra effort, author has succeeded in translating my idea into action. A device that is so well-designed and will increase the medical brotherhood effort to continue monitoring patient health parameters using a variety of sensors connected to the Arduino board. The generated data is then transmitted via Wi-Fi module to IOT platform, i.e., ThingSpeak and which can be monitored on devices like desktop, laptop or smartphone. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Performance of micro and small foodpreneurs in Manipur during COVID-19 pandemic

To critically assess the performance of micro and small foodpreneurs during COVID-19 pandemic in Manipur state of India, an online survey was conducted during the year 2020. The survey data was subjected to non-parametric statistical analysis using PROC NPAR1WAY and Dwass, Steel, Critchlow-Ffigner multiple comparison analysis. The findings suggested that during COVID-19 pandemic, the micro and small foodpreneurs faced multifaceted challenges with respect to the number of employees, working hours, supply of raw material, selling mode, production, sale, turnover and the extent of loss, etc. The performance of different categories of foodpreneurs was compared based on the change in various performance indicators between pre-pandemic and pandemic period. The study also highlights the major problems faced by the foodpreneurs and remedial measures. This is the first report on the impact of COVID-19 pandemic on foodpreneurs from North East India.

Myeloid-derived suppressor cells as a potential biomarker and therapeutic target in rhino-orbital mucormycosis patients

Background: Mucormycosis is a deadly fungal infection that emerges in patients affected with COVID-19. All fungal illnesses are caused by dysregulated adaptive immunity, but Myeloid-derived suppressor cells (MDSC) have added a new di-mension to the chronic inflammatory response. Objective(s): We attempted to enumerate the MDSC immune response in rhino-orbital mucormycosis patients before and after treatment and compared the data with healthy control. Method(s): A total of 3 ml of blood samples were taken in an EDTA vial from 20 patients with mucormycosis and 20 age-matched healthy control. A second blood sample was collected to examine the immune system post three months of treatment. Mycological identification was performed on nasal crust retrieved aftersurgery using KOH/culture.The expression of the MDSC marker was analyzed by immunostaining with the antibodies against CD14, HLA-DR, CD11b, CD33, CD66 (Biolegend). Flu-orescence profiles were recorded by Flow Cytometer (BD FACSAria TM III) and analyzed by Flow Jo s oftware (BD Biosciences). The percentage of positive cells is used to express the results.The GraphPad Prism (version 8, GraphPad s oftware, LaJolla, CA, USA) was used to analyze the data. All of the results were considered significant when P <.05. Result(s): All of the patients tested positive for Rhizopus arrhizus, which was confirmed by the culture. The percentages of Monocytic-MDSC (mMDSC: CD14 + HLA-DR-/low) cells were significantly high in patients compared to healthy control. In post-3-month treatment, the percentages of mMDSC were found significantly low and comparable with healthy control. Granulocytic MDSC (gMDSC: HLA-DR-/low CD33 + CD11b + CD66 +) cell population was higher in patients compared with healthy control and patients with post-3-month treatment. Conclusion(s): MDSC regulates T cells and other immune cells with a different mode of action. The findings in this study imminently indicatethe mechanism of immunedysregulation involvingMDSCpathways inmucormycosis andprovide evidence that restoration of immune balance causes reduction of MDSCcells may be considered a therapeutic option for long-term benefit.

A Bibliometric Analysis of Literature on Covid-19 and Mental Health

Purpose: The present study analyzed the existing literature related to COVID 19 and Mental Health by using the technique of bibliometric analysis which may serve as guide-map for future researchers and policy makers. Method: Bibliometric analysis is conducted in the present study by using various techniques like citation analysis, co-citation analysis, co-occurrence of keywords, thematic mapping by using visualization of similarities (VOS) viewer open-source software and R-based bibliometrix. Results: The study highlighted the most significant journals, authors, co-cited authors, institutions, keywords co-occurrence, and most cited articles in the area of COVID-19 and Mental Health on the basis of bibliometric analysis of 149 studies taken from the database of Scopus for the past three years (2020– first quarter of 2022). Also, authors identified few relevant themes such as Economic Effects of COVID-19, COVID-19 and its Impact on Healthcare workers, COVID-19 and its Impact on Patients and General Population as important emerging key areas for further research. Conclusion: We have highlighted significant citations, co-citations and keywords co-occurrence to summarize the literature. The present bibliometric study convincingly confirms the effect of COVID 19 pandemic on mental health and provides enough evidence to advocate formulation of strategies to tackle mental health issues. © 2022, MedSci Publications. All rights reserved.

A qualitative analysis of perspectives of district level frontline managers in Karnataka during first wave of COVID 19

With the emergence of pandemic, health sector has been facing innumerable challenges right from prevention to management of COVID-19. This study attempts to understand these factors from a local perspective that will help in better planning and management of situation for the future. Karnataka was one of the 8 states selected as part of a multisectoral qualitative study. Perspectives of frontline managers regarding the management of COVID 19 pandemic situation were taken by in depth interviews. Deductive thematic analysis from the audio recordings and transcripts showed public apprehensions, gaps in decentralized approach and specific guidelines, monitoring difficulties and workforce related issues as factors of concern. © 2022, Indian Association of Preventive and Social Medicine. All rights reserved.

An Observational Study on the Effects of Improvised Cpap (Icpap) in Cardiovascular Diseases with Acute Respiratory Failure

Objectives: This study describes three surges of COVID-19 hypoxemic respiratory failure and our experience with using iCPAP in patients with cardiovascular diseases at a tertiary cardiac care centre. Methodology: This observational study was conducted from March 23rd 2020 to May 31st 2021, analysis of data from the PRICE Network Registry. Data was collected for all adult patients with cardiovascular diseases admitted with acute hypoxemic respiratory failure and a confirmed Results: Among 362 patients with 'severe' or 'critical' COVID-19 were hospitalized;163 (45%) in the 1st surge, 92 (25.4%) in the 2nd and 107 (29.6 %) in the 3rd surge. All-cause mortality was 118 (32.6%). iCPAP was used in 39% (141) patients, 19% (69) patients required oxygen only, 25.4% (92) were on BiPAP support and 16.6% (60) were intubated. 'iCPAP failure' occurred in 48/141 (34%) patients. iCPAP failure occurred in patients with higher APACHE II scores (16.3 +/- 5.7 v/s 21.3 +/- 6, p <= 0.001), lower ROX index on admission (5.0 +/- 2.2 vs. 10.4 +/- 5.4, p <= 0.001), lesser degree of improvement in ROX index at 48 hours (Day 3 ROX 18.7 +/- 8.9 vs. 9.9 +/- 6.3, p <= 0.001). Mortality rate on iCPAP was 44 (31.2%). Conclusion: COVID-19 outcomes in a resource-limited setting in patients having cardiovascular diseases, appear comparable to global reports. A modification of standard CPAP (iCPAP) appeared to be safe and effective. This modification of standard CPAP (iCPAP) identifies an option for resource-limited or resource-exhausted critical care units.

Double chelation of Iron through dimer formation of favipiravir: Density functional theory analysis

This work was performed to examine an idea about full chelation of Iron (Fe) by well-known favipiravir (Fav) as a possible mechanism of action for medication of COVID-19 patients. To this aim, formations of Fe- mediated dimers of Fav were investigated by performing density functional theory (DFT) computations of electronic and structural features for singular and dimer models. The results indicated that the models of dimers were suitable for formation, in which two cis (D1) and trans (D2) models were obtained regarding the configurations of two Fav counterparts towards each other. Energy results indicated that formation of D1 was slightly more favorable than formation of D2. Molecular orbital features affirmed hypothesized interacting sites of Fav for Fe-mediated dimers formations, in which atomic charges and other molecular orbital related representations affirmed such achievements. Moreover, detection of such dimer formation was also possible by monitoring variations of molecular orbitals features. As a consequence, formations of Fe-mediated dimers of Fav could be achievable for possible removal of excess of Fe as a proposed mechanism of action for Fav in medication of COVID-19 patients.

Ensembling of Efficient Deep Convolutional Networks and Machine Learning Algorithms for Resource Effective Detection of Tuberculosis using Thoracic (Chest) Radiography (June 2022)

Tuberculosis (TB) is a communicable pulmonary disorder and countries with low and middle-income share a higher TB burden as compared to others. The year 2020-2021 universally saw a brutal pandemic in the form of COVID-19, that crushed various lives, health infrastructures, programs, and economies worldwide at an unprecedented speed. The gravity of this estimation gets intensified in systems with limited technological advancements. To assist in the identification of tuberculosis, we propose the ensembling of efficient deep convolutional networks and machine learning algorithms that do not entail heavy computational resources. In this paper, the three of the most efficient deep convolutional networks and machine learning algorithms are employed for resource-effective (low computational and basic Imaging requirements) detection of Tuberculosis. The pivotal features extracted from the deep networks are ensembled and subsequently, the machine learning algorithms are used to identify the images based on the extracted features. The said model underwent k-fold cross-validation and achieved an accuracy of 87.90% and 99.10% with an AUC of 0.94 and 1 respectively in identifying TB infected images from Normal and COVID infected images. Also, the model’s error rate, F-score, and youden’s index values of 0.0093, 0.9901, and 0.9812 for TB versus COVID identification along with the model’s accuracy claim that its use can be beneficial in identifying TB infections amid this COVID-19 pandemic, predominantly in countries with limited resources. Author

Association between ABO blood group and COVID-19 infection: an updated systematic review and meta-analysis.

The relationship between ABO blood group and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 - coronavirus disease 19 [COVID-19]) infection has been investigated, and several studies have reported discordant findings. This systematic review and meta-analysis study were conducted to investigate the relationship between ABO blood group and COVID-19 infection. The international databases Institute for Scientific Information (ISI)/Web of Science, PubMed, and Scopus were systematically searched from 1 January 2020 through 14 June 2021. Twenty-seven studies met the inclusion criteria for meta-analysis including 23,285 COVID-19 case subjects and 590,593 control subjects. The odds of having each blood group among COVID-19 patients compared with control subjects were calculated. The random effects model was used to obtain the overall pooled odds ratio (OR). Publication bias and subgroup and sensitivity analyses were performed to explore the source of heterogeneity. According to the random effects model, the results indicated that the pooled estimates of OR (95% confidence interval) for blood groups A, O, B, and AB were 1.26 (1.13-1.40), 0.77 (0.71-0.82), 1.05 (0.99-1.12), and 1.11 (0.99-1.25), respectively. Therefore, individuals infected with COVID-19 have higher odds of having blood group A and lower odds of having blood group O. In conclusion, this study indicated that individuals with blood group A are more susceptible to COVID-19 infection, whereas those with blood group O are less susceptible to COVID-19 infection. However, further studies are warranted to support these findings.

Evaluation of mobile phone-based tele-monitoring of cystic fibrosis patients during the COVID-19 pandemic: A 3-year experience in Iran

Background: Telemedicine has been used for cystic fibrosis (CF) in a wide range of signs and symptoms even before the COVID 19 pandemic, however, little is known about the health consequences and use of specific health care for cystic CF. This study aimed to evaluate the evolution of clinical trends and data related to mobile based monitoring activities in CF patients at home for 3 years. Methods: This is a semi experimental single group study. Forty five CF patients under 7 years' old who were referred to the Masih Daneshvari Hospital between 2018 and 2021 were selected. A mobile phone_based customized Short Message Service (SMS) application used to monitor patients. Remotely monitored variables included the amount and color of sputum, cough, wheezing, and shortness of breath at rest. SPSS using Chi square and Friedman tests. Results: The condition of patients based on the number and type of cough increased sputum, decreased appetite, fatty stool, fever and dyspnea, headache, noninvasive ventilation, and drug comfortably remained almost unchanged in the study of the 1st, 2nd, and 3rd years, and the studied parameters did not show a significant difference (P > 0.05). Of course, the number of outpatient visits decreased significantly (P value: 0.02). The respiratory rate and arterial oxygen saturation variables were almost the same in three consecutive annual measurements (P values: 0.544 and 0.639, respectively). Conclusion: Telemedicine is a method that is useful in the follow up of chronic diseases such as CF and improves the quality of life and reduces the deterioration of lung function;therefore, there is less need for invasive treatments in the long run, and a fundamental change in referral motivation brings to the hospital. © 2022 Biomedical and Biotechnology Research Journal. All rights reserved.