Prevalence of COVID Associated Mucormycosis with Antifungal Susceptibility Profiles of Isolates in a Tertiary Care Hospital

Mucormycosis is an angioinvasive opportunistic fungal infection, but these have become emerging pathogens, especially in conditions with underlying predisposing risk factors in a favourable setting. With the exponential rise in COVID-19 cases, there was an increase in the number of mucormycosis cases among them. The global prevalence rate of mucormycosis in COVID-19 globally varies from 0.005 to 1.7 per million population and in India, it is approximately 0.14 cases/1000. The objective of this study is to detect the prevalence of mucormycosis with the antifungal susceptibility pattern among COVID-19 patients admitted in our hospital. A total of 347 COVID-19 and post-COVID-19 patients with symptoms suggestive of mucormycosis were included in this study. Nasal scrapings, debrided necrotic tissue, unhealthy tissue bits and biopsy tissues taken through FESS were processed for mycological examination under sterile conditions. Among the total 347 samples processed, 87(25%) were positive for fungal culture. Among the culture positves 7.8% (25) belong to mucorales. Among the total 87 fungal isolates, the majority of organism isolated was Aspergillus sp(68%), followed by Rhizopus sp (18%). Rhizopus/Aspergillus sp (5%), Mucor species (5%), Rhizomucor sp (2%), Mucor/Aspergillus sp(1%), Curvularia sp (1%) were the other fungi isolated. All the strains of Mucorales were sensitive to Posaconazole and one strain showed resistance to amphotericin B with MIC 8 microg/ml by microbroth dilution method based on CLSI M27 guidelines for Amphotericin B, and Posaconazole.Copyright © The Author(s) 2023.

Design of IoT Based Indoor Air Purifier

An IoT-based system for monitoring the quality of the air within a building, which includes a "Smart-Air"air quality sensor on a web server. IoT and cloud storage are used to evaluate the quality of the air at any time and from any place. Smart-Air is a product of the Internet of Things (IoT), a device that uses LTE to broadcast real-time data on air quality to a web server. Today, air pollution is a leading cause of preventable mortality and disease across the world. Pollution has become a major concern all around the globe. The discharge of chemicals or unfriendly compounds has a devastating impact on human, animal, and plant life. This is referred to as pollution. Many studies have been conducted on different air purification techniques because of this. Air purifiers that utilize HEPA filters, activated carbon, and UV light are discussed in this paper. The water and chemicals that an air purifier sprays into the air will spread out contaminants. © 2022 IEEE.

Ultrasonic Sensor Based Physical Distance and Temperature Tracking System

Now a days maintaining the social distance has become mandatory to decrease the spread of corona. So a novel way of finding pairs automatically of people in a crowded environment that does not participate in the block of public space, that is, about 6 feet of space among them. This Will-making method does not think about crowded traffic or pedestrian directions. Here a moving robot with sensory inputs, a camera to perform non-collision navigation Jump and measure the distance among the adjacent people found in the camera view field. Moreover, this equips the robot with a hot camera that transmits hot wireless images to safety / health workers who watches when someone shows a higher temperature than required. In these situations, the robot integrated with static cameras to improve social distance maintenance Remote Culprits detected, precisely following pedestrians etc. Social segregation measures are important to reduce the spread of Covid. In order to break the chain of transmission, public distribution is strictly followed as usual. This paper centralizes a useful thing to monitor the populated such as ATMs, supermarkets and hospitals for any violations of social segregation. By using the system, I have proposed will be possible to monitor queue world who maintain social isolation in a protected area and to alert individuals in the event. © 2022 IEEE.

Survey on Attitude Towards COVID-19 Vaccines and Analysis of Reasons for Vaccine Hesitancy Among Public in Tamil Nadu During The Second Wave Of COVID-19 Pandemic

Vaccines are effective measures to curtail spread of infection in the community, as they break the chain of transmission and help to develop herd immunity, thereby reducing disease induced morbidity and mortality. This holds good for COVID-19 vaccines which are developed rapidly during this pandemic. No much information are available regarding the causes for why people are hesitant to take COVID-19 vaccine in Tamil Nadu even after suffering the ill effects of COVID-19 infection in its second wave. This study is taken up to investigate the attitude of people of Tamil Nadu towards COVID-19 vaccine and to analyse the reasons for vaccine hesitancy and demographic factors influencing vaccine hesitancy among the survey population. An online, cross sectional self-administered questionnaire was instrumentalized to survey adult participants from Tamil Nadu on the acceptability and attitude towards COVID-19 vaccines and to analyse the factors contributing to vaccine hesitancy. Logistic regression analysis was used to find the predictors of COVID-19 among the study population. A total of 2615 completed responses were taken up for survey. The public acceptance rate of COVID-19 was very high (86.3%) in Tamil Nadu. Regarding the attitude, majority of the participants (more than 80%) believed that vaccines are safe and accept that that Indian made vaccines are safe and also believed that government would provide vaccines for all at free of cost. But 51.2% participants expressed their fear of side effects which would prevent them from taking vaccines. Most trusted information regarding COVID-19 vaccines were through governmental agencies (50.8%) and through social media (42%-44%). vaccine hesitancy was noted in 36.9% of the participants. The reasons for vaccine hesitancy were multifactorial. Fear of vaccine related adverse effects (31.4%), non-availability of vaccines (20%), knowledge of multiple vaccine availability leading to confusion regarding safety and efficacy(16.9%) false belief that increasing incidence of corona infection after COVID-19 vaccination (10.8%), fear of associated medical illness (12.8%), influence of family and peer group with negative message(14%) and the belief that living in rural area would not be infected by corona virus and lack of awareness (7.15%,10.52% respectively) all contributed to vaccine hesitancy. In our study, the factors influencing vaccine hesitancy were noted in younger age, rural location, unemployment, non-graduates, unmarried and among smokers and alcoholics with statistically si gnificant values. Systematic interventions are required by public health authorities to reduce the level of vaccine hesitancy and improve their vaccine acceptance especially among the rural population. Instead of online survey, one to one, in person survey would bring real attitude of people 60% of who live in rural India. © 2021, SILAE (Italo-Latin American Society of Ethnomedicine). All rights reserved.

Kabasura Kudineer (KSK), a poly-herbal Siddha medicine, reduced SARS-CoV-2 viral load in asymptomatic COVID-19 individuals as compared to vitamin C and zinc supplementation: findings from a prospective, exploratory, open-labeled, comparative, randomized controlled trial, Tamil Nadu, India.

INTRODUCTION: Despite several ongoing efforts in biomedicine and traditional medicine, there are no drugs or vaccines for coronavirus disease 2019 (COVID-19) as of May 2020; Kabasura Kudineer (KSK), a polyherbal formulation from India's Siddha system of medicine, has been traditionally used for clinical presentations similar to that of COVID-19. We explored the efficacy of KSK in reducing viral load and preventing the disease progression in asymptomatic, COVID-19 cases. METHODS: A prospective, single-center, open-labeled, randomized, controlled trial was conducted in a COVID Care Centre in Chennai, India. We recruited reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 of 18 to 55 years of age, without clinical symptoms and co-morbidities. They were randomized (1:1 ratio) to KSK (60 mL twice daily for 7 days) or standard of care (7 days supplementation of vitamin C 60,000 IU morning daily and zinc 100 mg evening daily) groups. The primary outcomes were reduction in the SARS-CoV-2 load [as measured by cyclic threshold (CT) value of RT-PCR], prevention of progression of asymptomatic to symptomatic state, and changes in the immunity markers including interleukins (IL-6, IL-10, IL-2), interferon gamma (IFNγ), and tumor necrosis factor (TNF α). Siddha clinical assessment and the occurrence of adverse effects were documented as secondary outcomes. Paired t-test was used in statistical analysis. RESULTS: Viral load in terms of the CT value (RdRp: 95% CI = 1.89 to 5.74) declined significantly on the seventh day in the KSK group and that of the control group, more pronounced in the study group. None progressed to the symptomatic state. There was no significant difference in the biochemical parameters. We did not observe any changes in the Siddha-based clinical examination and adverse events in both groups. CONCLUSION: KSK significantly reduced SARS-CoV-2 viral load among asymptomatic COVID-19 cases and did not record any adverse effect, indicating the use of KSK in the strategy against COVID-19. Larger, multi-centric trials can strengthen the current findings. TRIAL REGISTRATION: Clinical Trial Registry of India CTRI2020/05/025215 . Registered on 16 May 2020.

The efficacy of Siddha Medicine, Kabasura Kudineer (KSK) compared to Vitamin C & Zinc (CZ) supplementation in the management of asymptomatic COVID-19 cases: A structured summary of a study protocol for a randomised controlled trial.

OBJECTIVES: The primary objectives of this study are to determine efficacy of Siddha medicine, Kabasura kudineer in reduction of SARS-CoV-2 viral load and reducing the onset of symptoms in asymptomatic COVID-19 when compared to Vitamin C and Zinc (CZ) supplementation. In addition, the trial will examine the changes in the immunological markers of the Siddha medicine against control. The secondary objectives of the trial are to evaluate the safety of the Siddha medicine and to document clinical profile of asymptomatic COVID-19 as per principles of Siddha system of Medicine. TRIAL DESIGN: A single centre, open-label, parallel group (1:1 allocation ratio), exploratory randomized controlled trial. PARTICIPANTS: Cases admitted at non-hospital settings designated as COVID Care Centre and managed by the State Government Stanley Medical College, Chennai, Tamil Nadu, India will be recruited. Eligible participants will be those tested positive for COVID-19 by Reverse Transcriptase Polymerase Chain reaction (RT-PCR) aged 18 to 55 years without any symptoms and co-morbidities like diabetes mellitus, hypertension and bronchial asthma. Those pregnant or lactating, with severe respiratory disease, already participating in COVID trials and with severe illness like malignancy will be excluded. INTERVENTION AND COMPARATOR: Adopting traditional methods, decoction of Kabasura kudineer will be prepared by boiling 5g of KSK powder in 240 ml water and reduced to one-fourth (60ml) and filtered. The KSK group will receive a dose of 60ml decoction, orally in the morning and evening after food for 14 days. The control group will receive Vitamin C (60000 IU) and Zinc tablets (100mg) orally in the morning and evening respectively for 14 days. MAIN OUTCOMES: The primary outcomes are the reduction in the SARS-CoV-2 load [as measured by cyclic threshold (CT) value of RT-PCR] from the baseline to that of seventh day of the treatment, prevention of progression of asymptomatic to symptomatic state (clinical symptoms like fever, cough and breathlessness) and changes in the immunity markers [Interleukins (IL) 6, IL10, IL2, Interferon gamma (IFNγ) and Tumor Necrosis Factor (TNF) alpha]. Clinical assessment of COVID-19 as per standard Siddha system of medicine principles and the occurrence of adverse effects will be documented as secondary outcomes. RANDOMISATION: The assignment to the study or control group will be allocated in equal numbers through randomization using random number generation in Microsoft Excel by a statistician who is not involved in the trial. The allocation scheme will be made by an independent statistician using a sealed envelope. The participants will be allocated immediately after the eligibility assessment and informed consent procedures. BLINDING (MASKING): This study is unblinded. The investigators will be blinded to data analysis, which will be carried out by a statistician who is not involved in the trial. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): Sample size could not be calculated, as there is no prior trial on KSK. This trial will be a pilot trial. Hence, we intend to recruit 60 participants in total using a 1:1 allocation ratio, with 30 participants randomised into each arm. TRIAL STATUS: Protocol version 2.0 dated 16th May 2020. Recruitment is completed. The trial started recruitment on the 25th May 2020. We anticipate study including data analysis will finish on November 2020. We also stated that protocol was submitted before the end of data collection TRIAL REGISTRATION: The study protocol was registered with clinical trial registry of India (CTRI) with CTRI/2020/05/025215 on 16 May 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).