ABSTRACT
Despite ranking amongst the highest in medical systems in Africa and spending a substantial amount on health sector than other African nations, Algeria suffered a major blow in the first wave of the Covid-19 pandemic. Vaccine hesitancy also affected the country adversely in subsequent waves of the disease. This study estimates the number of Covid-19 cases for Algeria in January 2022 using two numerical methods Multi-step Differential Transform Method (MsDTM) and Repeated MsDTM. Stability analysis of the pandemic for the country has also been discussed in the paper.
ABSTRACT
Intro: Mucormycosis is known to effect patients with immunocompromised status from a variety of causes such as diabetes mellitus, hematologic malignancy, and HIV infection. Most common form of presentation is rhinocerebral infection. However, isolated presentation of renal mucormycosis is rare. With the ongoing COVID-19 pandemic and use of high-dose steroids and antibiotics, there have been increasing reports of bacterial and fungal coinfections in COVID-19 positive patients. We report a rare case of isolated renal mucormycosis, post COVID-19 infection, in a healthy individual presenting as unilateral right non-functioning pyonephrotic kidney. Method(s): A conscious, well oriented, afebrile 37 years old female patient presented with the complaints of right flank pain for one month. Patient was diagnosed as a case of post COVID-19 renal infarct with perinephric collection, right non-functioning pyonephrotic kidney. She had no previous comorbidities. Routine investigations, chest X-ray and CT scan were done. Finding(s): CT scan findings reveal a large right perinephric hyperdense collection inseparable from right kidney involving the internal oblique, psoas and quadratus lumborum muscles. Right simple nephrectomy was done and specimen was sent for histopathology and fungal culture. Histopathology report showed necrotizing granulomatous inflammation with broad, aseptate, irregularly branched fungal hyphae morphologically resembling Mucor species and fungal culture also confirmed Mucor species.Copyright © 2023
ABSTRACT
Introduction and Objective Health care professionals (HPs) have been at the forefront facing the pressures and uncertainties of the COVID-19 pandemic, and thus have a higher psychological vulnerability. The incidence of psychological distress, which can negatively affect an HP's work efficiency and long-term well-being, has not been studied in depth in India.Materials and Methods A multicentric study was conducted using the digital means of communication across Max Healthcare between June and August 2020. HPs in the department of oncology, including doctors, nurses, and other support staff, were invited to voluntarily participate in the self-administered online survey. A total of 87 HPs in oncology (41 doctors, 28 nurses, and 18 in other fronts) were assessed using the 12-item General Health Questionnaire (GHQ-12). Outcome of interest was psychological distress (defined as a GHQ-12 score >15).Results The overall incidence of psychological distress among HPs in oncology during the COVID-19 pandemic was 17.20%. Significantly higher levels of psychological distress were observed among HPs with a history of psychiatric illness ( p = 0.003), and among HPs with a work experience of less than 10 years ( p = 0.017).Conclusion The COVID-19 pandemic had a significant impact on the psychological well-being of HPs in India. This study implicated the recognition of the psychological well-being of HPs in oncology as an unmet need during the COVID-19 pandemic, further recommending efforts toward increasing accessibility of mental health services for them.
ABSTRACT
Introduction: The clinical outcomes of COVID-19 infection in children with cancer have been variable worldwide. Therefore, we aimed to collect data from all regions in India through a national collaborative study and identify factors that cause mortality directly related to COVID-19 infection. Method(s): Data was collected prospectively on children across India on cancer therapy and diagnosed with COVID-19 infections from 47 centers from April 2020 to October 2021. Information was recorded on the demographics, the number of children that required intervention, and the outcome of the infection. In addition, we analyzed the impact of the delta variant in 2021. Result(s): A total of 659 children were studied, of whom 64% were male and 36% were female. The data from the eastern region was sparse, and this was a collection bias. COVID-19 infection was predominantly seen in children less than five years. The delta variant had a higher impact in the southern region, and this was statistically significant. Of the 659 children, 30 children died (4.5%), however only 7 of the deaths were directly attributed to COVID-19 infection (1%). Conclusion(s): The study reports the largest nationally representative cohort of children with cancer and COVID-19 to date in India. We identified demographic and clinical factors associated with increased all-cause mortality in patients with cancer. Complete characterization of the cohort has provided further insights into the effects of COVID-19 on cancer outcomes. The low mortality allows us to recommend that specific cancer treatments be continued without delays in therapy.Copyright © 2022
ABSTRACT
Neurological complications of COVID-19 contribute significantly to mortality in the intensive care unit (ICU). Preventive therapy, though discussed in literature, is limited for COVID-19 neurological manifestations and treatment algorithms continue to rely on evidence from previous pandemics. Thus, in this chapter we evaluate current in vitro, in vitro, histopathological studies to ascertain the most likely mechanisms of SARS-CoV-2 central nervous system entry. From this understanding, we determine probable mechanisms for neurological compilations observed in COVID-19 as relevant to the clinician. SARS-CoV-2 infection of nasal epithelium and the respiratory tract may allow for a systemic inflammatory response that results in neuroinflammation. While most neurological complications are inflammatory in etiology, rarely, SARS-CoV-2 may enter into the central nervous system and mediate neuronal damage. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
ABSTRACT
In this paper, we have discussed the impact of Coronavirus variants in a phase of 2021-22 along with a previous phase of 2020-21 in Italy. We analyse and compare the Covid-19 scenario in Italy for the period from October 04, 2020 to January 16, 2021 with a period from October 04, 2021 to January 16, 2022. For this study, we have used repeated multi-step differential transform method (RMsDTM). Also, we have predicted the number of active cases for 10 days following the period of study.
ABSTRACT
Background: Bone allografts have been an integral part of orthopedic procedures such as revision hip surgery or reconstruction of large bone defects. Femoral heads and necks were harvested from living donors undergoing total hip arthroplasty (THA). They were stored fresh frozen or processed into bone chips by the Innsbruck Bone Bank. The challenge was to meet the demand for bone grafts through in-house manufacturing even during Covid-19 pandemic restrictions. Method(s): Key data from the bone bank's registry and the hospital administration between January 2019 and March 2022 were analysed with regard to collection of fresh frozen allogenic femoral heads /necks and the manufacture of bone chips and their discard. Donor suitability and release criteria were assessed in accordance with EU and national legislation. Result(s): In 1,249 primary THA surgeries 640 femoral heads and necks were harvested. In the mean 51.4% of these yielded the bulk material for bone chips manufacture. Due to Covid-19 pandemic restrictions the number of grafts retrieved was lowest in Q1 2020 and Q4 2021. The proportion of unreleased transplants remained fairly consistent at 14%, but the reasons for discard varied: technical issues were eliminated, but the increase for discard to >30% due to reasons in donor history required the revision of the questionnaire and the collaboration with the team responsible for listing diagnoses in the medical records. By 2020, the bone chip discard rate had increased to 8%. Hence modification of cleaning and gowning brought it back down to 2% . Conclusion(s): Providing high quality bone allografts is a complex task. In this context, it is important to regularly evaluate the registry data and to modify the process accordingly, thus ensuring adequate supply of allografts even in times of significant restrictions.
ABSTRACT
The demand for personal hygiene products has increased during COVID-19 pandemic outbreaks. It has resulted in the increasing production of hygiene products. During the coronavirus epidemic, globalised and uncertain demand for personal hygiene products creates complicated situations for the manufacturing firms. This article explores the fuzzy model of economic production for hygiene products with uncertainty in demand and production. Due to the rising demand for hygiene products, the demand rate has been set as a linear time function, while the production rate has been taken directly proportional to the rate of demand. Therefore, due to ambiguity or vagueness in demand, this proposed model has considered the triangular fuzzy number with an upper and lower split. The weighted sum method has turned the multi-objective problem into a single objective. The optimisation technique was used to minimise the producer's overall cost under the condition mentioned earlier, and the model is validated numerically. © 2022 Inderscience Enterprises Ltd.
ABSTRACT
Covid-19 is a highly infectious disease caused by novel Corona virus SARS-CoV-2, affecting the whole world. In this paper, we introduce and apply two iterative methods, RMsDTM and R2KM, to obtain approximate values of Covid-19 cases in Morocco. We also compare the approximations of both methods and see that the solution of RMsDTM is more accurate. © 2022, Erdal Karapinar. All rights reserved.
ABSTRACT
Background: Hemorrhage, coagulopathy and thrombosis (HECTOR) are reported complications of coronavirus disease 2019 (COVID-19) however, more information is needed on the prevalence of these complications and their associated outcomes in intensive care unit (ICU) settings. Aim(s): To determine the prevalence and outcomes of HECTOR complications in ICU patients with COVID-19. Method(s): Observational cohort study spanning 229 ICUs across 32 countries. Patients >=16 years admitted for severe COVID-19 from 1st January 2020, through 31st December 2021 were included. Patient characteristics and clinical data were collected. Survival analysis estimated the instantaneous impact of HECTOR complications on ICU-mortality and discharge. Result(s): HECTOR complications occurred in 1,735 (14%) of 11,972 study-eligible patients. Acute thrombosis occurred in 1,249 (10%) patients, including 712 (57%) with pulmonary embolism, 413 (33%) with myocardial infarction, 93 (7.4%) with deep vein thrombosis, and 49 (3.9%) with ischemic stroke. Hemorrhagic complications were reported in 582 (4.9%) patients, including 276 (48%) with gastrointestinal hemorrhage, 83 (14%) with hemorrhagic stroke, and 77 (13%) with pulmonary hemorrhage. Disseminated intravascular coagulation occurred in 11 (0.09%) patients. Univariate analysis identified diabetes, hypertension, cardiac and kidney disease and ECMO as statistically-significant risk factors for HECTOR complications. Patients with versus without HECTOR complications suffered higher ICU-mortality at 28 days (25%vs.13%, p < 0.001), 90 days (32%vs.15%, p < 0.0001) and overall (44%vs.36%, p < 0.001). Among ICU survivors, the ICU stay was longer (median days 19vs.12, p < 0.001). ICU mortality was similar between patients with and without HECTOR complications (HR = 1.01, 95%CI 0.92-1.12, p = 0.783) where an increased hazard of ICU mortality with hemorrhage (HR = 1.26, 1.09-1.45, p = 0.002) was balanced by a reduced hazard of thrombosis (HR = 0.88, 0.79-0.99, p = 0.03). Kaplan-Meier curves are presented in the Figure. Conclusion(s): HECTOR events are frequent complications of severe COVID-19 in ICU patients. Hemorrhagic, but not thrombotic complications are associated with increased ICU-mortality.
ABSTRACT
The main purpose of the present research paper was to identify the Human Resource Management practices affecting the job satisfaction of employees. The target respondents were the employees working in Indian IT organizations located in North India. To study the hypotheses, data was gathered from 395 teleworkers and Smart PLS 2.0 was employed for analyzing the data. The results revealed that there was a significant relationship between performance appraisal and job satisfaction, employment security and job satisfaction, training and development and job satisfaction, compensation and rewards and job satisfaction. The employees have not given due weightage to the recruitment and selection practices as the contributor in affecting their job satisfaction level. As the COVID pandemic has affected the economies globally, the findings of the present study would be essential for the organizations to maintain the satisfaction of their employees during such crises.
ABSTRACT
Lethal midline granuloma is a rare aggressive, mutilating disorder of the upper airways. It is most likely secondary to natural killer/T-cell lymphoma and is difficult to diagnose owing to the varied and nonspecific symptoms. It is usually prevalent in the fourth decade of life and carries a poor prognosis. Our patient was a 19-year-old male with disease duration of 3 months, was diagnosed with lethal midline granuloma based on clinical examination, histopathology, and immunohistochemistry. The patient responded well to the first cycle of chemotherapy.
ABSTRACT
Background: In patients with COVID-19 and respiratory failure, class 3 obesity (body mass index > 40 kg/m2) has been associated with worse survival. Obese patients on mechanical ventilation with progressively more severe acute respiratory syndrome (ARDS) may be offered venovenous (VV) extracorporeal membrane oxygenation (ECMO) therapy. The impact of morbid obesity on the outcome of COVID-19 patients supported with VV ECMO has been underexplored. Methods: This is a multicenter, retrospective observational cohort analysis of critically ill adults with COVID-19 ARDS requiring advanced mechanical ventilation with or without VV ECMO. Data was collected from 236 international institutions forming the COVID-19 Critical Care Consortium international registry. Patients were admitted between January 2020 to December 2021. Included patients were stratified by ECMO status and a BMI threshold at 40 kg/m2. Median values with interquartile range (IQR) were used to summarize continuous variables and multi-state analysis was used to explore the effect of Class 3 obesity on the study endpoints of patient survival to discharge or death. Results: Complete data was available on 8851 of 9059 patients on mechanical ventilation, of which 767 patients required VV ECMO. For the entire study group, older age and male gender were associated with an increased risk of death. The demographics and comorbidities of the higher BMI (H >40 kg/m2) and lower BMI (L ≤40 kg/m2) cohorts were similar with the exception of age and weight. Patients with a higher BMI were younger. The median age of the H, non-ECMO cohort was 56 years (46-64), and the H, ECMO cohort was 41 years (35-51) versus the L, non-ECMO cohort of 64 years(55-71), and the L, ECMO cohort of 53years (45-60). Patients requiring VV ECMO had higher SOFA scores, experienced longer ICU and hospital lengths of stay, and a longer duration of total mechanical ventilation. Table The median time to intubation was longer in the mechanical ventilation only group (2 versus 0 days). Predictors for requiring ECMO included younger age, higher BMI and male gender. Risk factors for death included advancing age (every 10 years), male gender and increasing BMI (every 5kg/m2). The association between BMI and a higher rate of death was reduced in the mechanical ventilation only group (HR 0.92, 95% confidence interval 0.85 to 0.99). Conclusion: In patients with severe ARDS due to COVID-19 requiring mechanical ventilation, the likelihood of progressing to VV ECMO therapy or experiencing death is impacted by age, gender and higher BMI. The cohort of COVID-19 patients that ultimately required ECMO appear to be sicker at time hospital admission owing to the shorter time until mechanical ventilation. It appears the association between increasing BMI and death differs among the ECMO and mechanical ventilation alone cohorts. We would advocate for a prospective study to determine the benefit of VVECMO for the obese patient requiring VV-ECMO for COVID-19 ARDS. (Figure Presented).
ABSTRACT
Objective: The objective of the study was to find out the sociodemographic profile and psychological impact of COVID-19 pandemic in the key caregivers of COVID-19 patients. Methods: The psychological impact of COVID-19 pandemic was measured using DASS-21 scale in a sample of 100 caregivers of corona-positive patients admitted in Guru Nanak Dev Hospital under Govt. Medical College. Results: In our study, majority of the family caregivers of corona-positive patients in the hospital setting were male (76%), belonged to 21–40 years age group (58%), wedded (64%), Sikh by religion (69%), employed (58%), and from rural region (56%). Caregivers showed extremely severe depression (30.58±6.521), extremely severe anxiety (29.34±7.130), and severe stress (29.14±5694). Participants with increasing age showed higher levels depression, anxiety, and stress scores but significant association was seen only with mean anxiety scores with increasing age (p<0.05). A significant association was seen between mean scores of stress and education status (p<0.05). A significant association was also seen between mean scores of anxiety and stress scores and nuptial status (p<0.05). No significant associations were seen between gender of caregivers, employment status, religion, family type, and mean depression, anxiety, and stress scores (p>0.05). Conclusion: The impact of COVID-19 pandemic on mental health of family caregivers of COVID-19 cases is significant.
ABSTRACT
Background: In this coronavirus disease-2019 (COVID-19) pandemic, safe and effective preventative vaccines are essential to contain the pandemic, which has had severe medical, economic, and societal consequences, despite some people still becoming infected after receiving immunisation. Methods: A total of 200 patients were examined and split into two groups: (1) 100 consecutive COVID-19-positive cases who had been vaccinated and (2) 100 consecutive COVID-19-positive patients with no vaccination. At the time of the scan, the patient's vaccination status was noted. Results: The computed tomography severity score (CTSS) of unvaccinated individuals was found to be considerably greater than that of partly or fully vaccinated patients (median 13 vs. 7, P < 0.001). Completely vaccinated individuals had a considerably lower median CTSS than partly vaccinated patients (6 vs. 9, P < 0.001). Conclusions: Individuals should be thoroughly vaccinated to avoid major lung disease. As a result, stronger dedication and motivating efforts should be made worldwide to improve the COVID-19 vaccination program.
ABSTRACT
The primary purpose of the present research paper was to investigate the influence of flexible work arrangements on personal and family well-being and performance of employees. The study also examined the moderating role of managerial support on the relationship between flexible work arrangements and well-being & performance. The target respondents were the teleworkers employed with Indian IT organizations located in North India. Data were gathered from 412 teleworkers to study the hypotheses, and Smart PLS 2.0 was employed to analyze the data. The results revealed a significant relationship between flexible work arrangements, personal and family well-being, and employee performance. The study further confirmed the significant and moderating effect of managerial support on the relationship between flexible work arrangements and performance. During the work-from-home policies at the workplace, the employees perceived that receiving support from the managers helped them perform well. As the COVID-19 pandemic has affected the economies globally, the present study’s findings would be essential for the managers to support their employees during such crises. © 2022, Associated Management Consultants Pvt. Ltd.. All rights reserved.
ABSTRACT
Introduction: Corticosteroids have shown controversial results in severe infections. Limited data is available to prove the efficacy of this drug against Coronavirus Disease 2019 (COVID19) infection. Such studies have highlighted that steroids such as dexamethasone can be effective against the patients who are exhibiting severe symptoms of COVID-19. Aim: To determine the effectiveness of dexamethasone as adjunct drug in treatment of in critical COVID-19 patients. Materials and Methods: This observational single cohort study was conducted on all COVID-19 positive patients admitted to the tertiary care hospital, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India during August 2020 to October 2020. Critically ill patients suffering from COVID-19 receiving 6 mg dexamethasone along with standard treatment protocol as prescribed by the Indian Council of Medical Research (ICMR) were included in this study. Serum interleukin-6, D-dimer, ferritin, levels along with CT values from RT-PCR of nasopharyngeal and oropharyngeal swab were recorded on the day of admission and after 7 days of dexamethasone therapy along with standard treatment protocol of ICMR. The data was analysed using descriptive statistics and paired-t test. Results: There were 22 males and 28 females enrolled in the study with mean age of males as 55 years and mean age of females as 56 years. The mean weight of males was 68.4 kg, while the mean weight of females was 59.8 kg. Statistically significant decrease in serum levels of interleukin-6, D-dimer, and ferritin after 7 days of dexamethasone treatment along with standard treatment protocol of ICMR was observed. The results were found to be significantly different with p-values=0.001, 0.003 and 0.002, respectively. Conclusion: Dexamethasone, as an adjunct drug, is an important corticosteroid that is efficient in countering the inflammatory response generated in COVID-19 patients along with standard treatment protocol of ICMR. It reduces the inflammatory markers in patients suffering from COVID-19.
ABSTRACT
Background:COVID-19 is a respiratory disease caused by novel coronavirus SARS CoV -2 and has been declared as pan- demic by WHO. The timely detection of cases and their contacts is crucial to help curtail the pandemic. Introduction of antigen based RDT has been able to bridge the time gap of detection and tracing as these tests are timely and easy to perform. However the real world performance of these assays is uncertain and the sensitivity of the test is claimed to be between 50% to 87%. This study was conducted to evaluate the currently used antigen -based RDT for the detection of SARS CoV-2 virus in respiratory specimens. Methods:This prospective study included patients who were seeking healthcare in Ophthalmology department for eye ailments and were subjected to SARS CoV-2 antigen based RDT. Regardless of results of RDT, nasopharyngeal swabs were collected from these patients and were tested for SARS CoV-2 RNA by real-time RT PCR using commercial assay (SD Biosensor). The evaluation of antigen-based RDT for the detection of SARS CoV-2 virus was performed with real time RT-PCR as gold standard. Results:A total of 564 patients were tested by both antigen based RDT and real time RT -PCR. The antigen based RDT exhibited analytical sensitivity and specificity of 37.5% and 99.79% respectively. Positive predictive value and negative predictive value of RDT were 96.4% and 91.6% respectively. Negative correlation was found between antigens based RDT’s positivity and Ct values of E and RdRp genes. Conclusions:Overall poor sensitivity of RDT does not allow adopting it as point of care test in screening for COVID -19 and it only serves as an additional test to RT-PCR because of potential false negative results.
ABSTRACT
In the pandemic of Coronavirus disease 2019 (Covid-19), lung diseases are the leading cause of death worldwide. Among these diseases, pneumonia is the largest infectious disease caused by bacteria, viruses (including coronavirus) that collapses alveoli present in the lungs. Most effective and economic modality for diagnosing it is Chest X-Ray (CXR) imaging. In this paper we have proposed a scratch Convolutional Neural Network (CNN) 13 layers model for detecting pneumonia from CXR images. We have evaluated proposed CNN-13 model on pneumonia and normal CXR image dataset which is freely available on website of Kaggle. After simulation, the proposed CNN-13 model attained results with training and testing accuracy of 98.51% and 96.7% respectively. Metrics log loss and Area Under the Curve (AUC) scored 0.0371 and 0.9984 on training set and 0.1285 and 0.9819 on testing set respectively. © 2021 IEEE.
ABSTRACT
Background: The virus responsible for COVID-19 enters human cells by binding angiotensinconverting enzyme 2. The influence of renin-angiotensin-aldosterone system (RAAS) inhibitors, including angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs), remains uncertain. Aim: To examine the role of ACEi / ARB exposure on outcomes in COVID-19 patients with preexisting hypertension (HTN) admitted to intensive care units (ICU). Methods: The COVID-19 Critical Care Consortium is a prospective, observational cohort study of patients requiring ICU admission for active COVID-19 spanning 354 participating sites in 54 countries. Patients >18 years old with pre-existing HTN requiring antihypertensive therapy were analysed. Length of stay and in-hospital mortality to 90 days post ICU admission were analysed as time-to-eventoutcomes by multistate survival analysis, and the influence of ACEi / ARB use on the hazards of death and discharge by multi-state Cox proportional hazard modelling and sensitivity analysis. Results: From December 1, 2019 through December 30, 2020, 663 eligible patients were registered. Of these, 480 patients had received ACEi and / or ARB therapy (median age 65 years, 67% male) in the 2 weeks before ICU admission, while 183 had not (66 years, 61% male). Average lengths of ICU and general ward stays were longer in the ACEi / ARB than non-ACEi / ARB group (20.8 days and 6.5 days vs. 15.5 and 6.0 days, respectively). ACEi / ARB use was associated with a decreased hazard of death (HR, 0.69, 95% CI, 0.54 -0.88) that persisted after adjusting for propensity scores (0.67, 0.53 -0.86). Cumulative probabilities (unadjusted for baseline characteristics) for death and discharge post ICU admission are depicted in the figure for ACEi/ARB (red) and non-ACEi / ARB (blue) patients. Conclusions: In 663 critically ill COVID-19 patients with pre-existing HTN, RAAS inhibition pre-ICU admission was linked to reduced in-hospital mortality.