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Background: During COVID-19 pandemic, the pattern of hospital admissions for acute ST-elevation myocardial infarction (STEMI) has been changing, and increased mortality and morbidity is being noted in these patients. Patient may present with acute myocardial infarction, myocarditis simulating a presentation like STEMI, coronary spasm, myocardial injury not fulfilling the criteria of type 1 & type 2 acute MI and cardiomyopathy. In this study we have tried to determine some important differences among the patients presented with STEMI during The COVID-19 pandemic versus non-COVID-19 era. Method(s): This prospective observational study was carried out in National Heart Foundation Hospital & Research Institute from 8thMarch,2019 to 7th March, 2021. Total 2531 patients were included. The study populations were divided into two groups. Group I: Acute STEMI patients presenting during pre COVID period (n=1385). Group II: Acute STEMI patients presenting during COVID period (n=1146). COVID period was calculated from 8th march, 2020 onward as first case of COVID -19 was detected on that day in Bangladesh. All patients presented with Acute STEMI was included in the study however NSTEMI-ACS, Unstable angina were excluded from the study. Result(s): Male was predominant in both groups. Regarding risk factors Hypertension, Obesity and family H/O of CAD was statistically significant (p<0.05). Acute STEMI patients presented lately during COVID-19 period probably due to lock down& lack of transport facility. Regarding coronary artery disease severity, vessel score was more during COVID period. SV-CAD were more during pre COVID period while DV-CAD & TV-CAD were more during COVID period. Gensini score was also calculated among the study populations, it was 57.21+/-28.42 and 63.16+/- 40.43respectively in group I and group I, which was statistically significant. Regarding treatment options of the patients, primary PCI was less during COVID period, however medical management, elective PCI and Thrombolysis were more during COVID era. Regarding in hospital outcome, acute LVF, cardiogenic shock were more during COVID period which were also statistically significant. [Formula presented] [Formula presented] Conclusion(s): During COVID -19, STEMI patients presented lately in comparison to pre COVID period. Coronary artery Disease were more severe during COVID period as evaluated by Vessel Score & Gensini Score. During COVID -19 period majority of patients got medical management& routine PCI were done more in comparison to primary PCI. In Hospital outcome of STEMI was worse during COVID-19 period in terms of acute LVF & cardiogenic shock. [Formula presented] [Formula presented] [Formula presented]Copyright © 2023
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Critically endangered Aquilaria malaccensis Lam. is known for highly expensive agarwood with unique aroma. Agarwood has been used as a phytomedicine in chronic degenerative neurological disorders, paralysis, rheumatism, asthma, and others. Its production is dependent naturally or artificially on interaction of endophytic fungi, and by nailing, drilling, and microbial inoculation respectively. The majorly produced biomarkers of terpenes, fatty acids, alkanes, chromones, and flavonoids exhibited several biological activities in congruence to their ethnomedicinal claims. During the pandemic, several in-silico, studies showed the potential of a few sesquiterpene hydrocarbons against covid-19. The review aimed to deliver a comprehensive outline of the immunomodulatory potential of agarwood oil with allied traditional medicinal use, biomarkers, pharmacological evaluation, toxicity, and mechanistic action. The review eventually showed the agarwood oil, extracts, and major biomarkers viz., aromadendrene II, valencene, phytol, octacosane, caryophyllene oxide, b-caryophyllene, hinesol, agarospirol, with immunomodulatory, anti-inflammatory, and allied neural, antidiabetic, antimicrobial activity, toxicity, along with molecular target binding potential against 3CLpro, RDRP, Mpro, PLpro, Spike protein S1 of SARS-CoV2 through in-vitro, in-vivo, in silico studies and limited human clinical trials. The expression of HMGR, ASS, ADXPS, ADXPR, FPS, and WRKY genes of sesquiterpenoid biosynthetic pathways were upregulated for signature aroma and immunomodulatory markers viz., d-guaiene, dodecane, tetracosane, agarospirol, farnesol, and geranylgeraniol acetate as a defensive response. The review would ignite future research on potential immunomodulatory markers viz., caryophyllene oxide, octacosane, heneicosane, agarospirol, n-hexadecanoic acid, a-eudesmol, a-santalol and inoculum guided invitro agarwood production restoring the prized aroma, therapeutic efficacy, and wild population. (c) 2022 SAAB. Published by Elsevier B.V. All rights reserved.
ABSTRACT
Lateral flow assays (LFA’s) are a common diagnostic test form, particularly in low-to-middle income countries (LMIC’s). Visual interpretation of LFA’s can be subjective and inconsistent, especially with faint positive results, and commercial readers are expensive and challenging to implement in LMIC’s. We report a phone-agnostic Android app to acquire images and interpret results of a variety of LFA’s with no additional hardware. Starting from the open-source “rdt-scan” codebase, we integrated new features and revamped the peak detection method. This included improved perspective corrections, phone level check to eliminate shadows, high resolution still-image capture besides existing video frame capture, and new peak detection method. This peak detection incorporated smoothing and baseline removal from the one-dimensional profiles of a given color channel’s intensity averaged across the read window’s width, with location and relative size constraints to correctly report locations and peak heights of control and test lines. The app was tested in a real-world setting in conjunction with an open-access LFA for SARS-CoV-2 antigen developed by GH Labs. The app acquired 155 images of LFA cassettes, and results were compared against both visual interpretation by trained clinical staff and PCR results from the same patients. With an appropriate setting for test line intensity threshold, the app matched visual read for all cases but one missed visual positive. From ROC analyses against PCR, the app outperformed visual read by 1-3% across sensitivity, specificity, and AUC. The app thus demonstrated promise for accurate, consistent interpretation of LFA’s while generating digital records that could also be useful for health surveillance. © 2022 SPIE
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Purpose: In recent times, due to rapid urbanization and the expansion of the E-commerce industry, drone delivery has become a point of interest for many researchers and industry practitioners. Several factors are directly or indirectly responsible for adopting drone delivery, such as customer expectations, delivery urgency and flexibility to name a few. As the traditional mode of delivery has some potential drawbacks to deliver medical supplies in both rural and urban settings, unmanned aerial vehicles can be considered as an alternative to overcome the difficulties. For this reason, drones are incorporated in the healthcare supply chain to transport lifesaving essential medicine or blood within a very short time. However, since there are numerous types of drones with varying characteristics such as flight distance, payload-carrying capacity, battery power, etc., selecting an optimal drone for a particular scenario becomes a major challenge for the decision-makers. To fill this void, a decision support model has been developed to select an optimal drone for two specific scenarios related to medical supplies delivery. Design/methodology/approach: The authors proposed a methodology that incorporates graph theory and matrix approach (GTMA) to select an optimal drone for two specific scenarios related to medical supplies delivery at (1) urban areas and (2) rural/remote areas based on a set of criteria and sub-criteria critical for successful drone implementation. Findings: The findings of this study indicate that drones equipped with payload handling capacity and package handling flexibility get more preference in urban region scenarios. In contrast, drones with longer flight distances are prioritized most often for disaster case scenarios where the road communication system is either destroyed or inaccessible. Research limitations/implications: The methodology formulated in this paper has implications in both academic and industrial settings. This study addresses critical gaps in the existing literature by formulating a mathematical model to find the most suitable drone for a specific scenario based on its criteria and sub-criteria rather than considering a fleet of drones is always at one's disposal. Practical implications: This research will serve as a guideline for the practitioners to select the optimal drone in different scenarios related to medical supplies delivery. Social implications: The proposed methodology incorporates GTMA to assist decision-makers in order to appropriately choose a particular drone based on its characteristics crucial for that scenario. Originality/value: This research will serve as a guideline for the practitioners to select the optimal drone in different scenarios related to medical supplies delivery. © 2022, Emerald Publishing Limited.
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Corona viruses are a group of RNA viruses that cause infection in humans and animals. In human Corona viruses cause respiratory tract infections ranging from mild to critical illness. Corona virus disease 2019 (COVID-19) is caused by strain of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The disease was first identified in Wuhan city, of China, in December 2019 and since spread all around the world. In Bangladesh first case has been declared by Institute of Epidemiology, Disease Control and Research (IEDCR) in 8th March, 2020 and first death on 18th march in an ICU and by 13th December total 489,178 cases and 7,020 deaths occurred in this country. The main objective of this study was to determine the Demographic and Clinical Profile of COVID-19 ICU patients in Bangladesh. This retrospective descriptive study on clinical profile along with short term treatment outcomes of COVID-19 patients conducted from COVID-19 dedicated Intensive care unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh during July 2020 to November 2020. Total 300 ICU patients was included in this study. The age range of the patients was from 15 to 91 years. The highest percentage of patients about 49.00%, which was 147 patients were belonged to 61-75 years age group. The patients mean age was 62.80 years. Regarding gender distribution, among those 300 patients;77.00% which is 231 were male and only 23.00% which is 69 were female. Patients admitted with symptoms like, respiratory distress/shortness of breath (100.00%), persistent worsening cough (60.00%), fatigue (55.00%) and fever (40.00%). Patients were also present with sore throat (35.00%), rhinorrhea (30.00%), altered mental status (20.00%), diarrhoea (10.00%) and chest pain (5.00%). Regarding co-morbidities, around half of the patients were suffering from Diabetes (60.22%) and Hypertension (53.44%). Significant amount of patients were also suffering from chronic obstructive pulmonary disease (27.00%) and bronchial asthma (16.78%). Ischemic heart disease was (10.33%), chronic kidney disease (10.89%), hypothyroidism (9.78%) and multiple co-morbidities (15.12%) at the time of admission. Mortality rate in this case were 71.00% and most of the death cases were in between 61 to 75 years of age group (40.00%). After improvement 27.00% patients were transferred to cabin for further management. We could discharge to home directly only 2.00% of patients.
ABSTRACT
Since the first recorded case of SARS-CoV-2 in Bangladesh on 8th March 2020, COVID-19 has spread widely through different regions of the country, resulting in a necessity to re-evaluate the delivery of cardiovascular services, particularly procedures pertaining to interventional cardiology in resource-limited settings. Given its robust capacity for human-to-human transmission and potential of being a nosocomial source of infection, the disease has specific implications on healthcare systems and health care professionals faced with performing essential cardiac procedures in patients with a suspected or confirmed diagnosis of COVID-19. The limited resources in terms of cardiac catheterization laboratories that can be designated to treat only COVID positive patients are further compounded by the additional challenges of unavailability of widespread rapid testing on-site at tertiary cardiac hospitals in Bangladesh. This document prepared for our nation by the Bangladesh Society of Cardiovascular Interventions (BSCI) is intended to serve as a clinical practice guideline for cardiovascular health care professionals, with a focus on modifying standard practice of care during the COVID-19 pandemic, in order to ensure continuation of adequate and timely treatment of cardiovascular emergencies avoiding hospital-based transmission of SARS-COV-2 among healthcare professionals and the patients. This is an evolving document based on currently available global data and is tailored to healthcare systems in Bangladesh with particular focus on, but not limited to, invasive cardiology facilities (cardiac catheterization, electrophysiology & pacing labs). This guideline is limited to the provision of cardiovascular care, and it is expected that specific targeted pharmaco-therapeutics against SARS-CoV-2 be prescribed as stipulated by the National Guidelines on Clinical Management of Corona virus Disease 2019 (COVID-19) published by the Director General of Health Services, Ministry of Health and Family Welfare of Bangladesh.