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Background: Current research comparing CPR-associated injuries between those receiving LUCAS device and manual CPR has primarily focused on patients who suffered out-of-hospital cardiac arrest. During the SARS-CoV-2 pandemic, more hospitals leveraged mechanical CPR devices to provide distant yet high quality chest compressions for in-hospital cardiac arrest (IHCA) patients. We sought to investigate autopsy thoracic injury patterns in in-hospital non-traumatic cardiac arrests, comparing traditional manual compressions with the mechanical LUCAS device compressions. Design: Autopsies were screened for a history of in-hospital cardiopulmonary resuscitation in the absence of prior traumatic injuries at a single, large quaternary care center from 1/1/2018 to 06/30/2021. 20 received LUCAS compressions and 40 received manual compressions. Student's T-Tests were used to compare means for continuous variables, while chi-squared and Fischer's exact tests were used for categorical variables. An alpha of 0.05 was chosen as the threshold for statistical significance. Results: A statistically significant decrease in the rate of sternal fractures and rate of multiple sternal fractures during mechanical CPR was found. A statistically significant increase in other soft tissue injuries, such as pleural wall or lung injuries was seen in mechanical CPR cases, while an increased rate of bilateral rib fractures was noted in manual compression cases. Conversely, no difference in the number or laterality of rib fractures were noted. There was no significant difference in age, biological sex, or rate of scoliosis or kyphosis between cohorts. Results are listed in table 1. (Table Presented) Little research has looked at the injury patterns of mechanical CPR in the IHCA patient population. These results point to a potential difference in thoracic injury patterns from manual compressions when compared to LUCAS device compressions. The statistically significant decrease in sternal fractures with mechanical compressions is noteworthy. Conversely, the increase in other soft tissue injury demands further examination. The decrease in bilateral rib fractures with LUCAS use suggests that placement of the device may play a role in the epidemiology of rib injuries, but not in the number of ribs injured. Further research should examine rib injuries in more detail, and quantify additional comorbidities in both survivors and non-survivors of cardiac arrest.
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Background: During the COVID pandemic period, our home-restricted life led to many undesirable physical, physiological, and mental alterations. Yoga a traditional system of medicines by virtue of its holistic approach toward health and disease and also due to reasonable cost, the technique has an edge in dealing with health problems and with primary prevention of disease. Aim: The current study has been designed to assess the effect of short-term (for 3 months for 5 days in a week or 40 days) yoga practice on lipid profile, and blood glucose level, C-reactive protein (CRP), and other physical and physiological parameters among healthy controls. Materials and Methods: Students went for yoga practice for 3 months (90 days) for 5 days in a week under the supervision of trained yoga instructor. Yoga activity was conducted via Google Meet app through broadband connectivity. The procedure began with Surya Namaskar (Sun Saluation) with a session of 12 asanas (fixed postures) for 20 min, followed by 15 min Pranayam (breathing exercise including anulome-vilome, surya bandana, sheetali, and bhramari). The session ended with 10 min meditation. Yoga program was started on September 27, 2020, and ended on December 27, 2020, after the completion of 3 months. Biochemical investigation (lipid profile, fasting blood glucose, CRP) and physiological parameters (blood pressure [BP], pulse), and other anthropometric parameters including weight, height body mass index reports were collected before September 27 and after December 27 in 5 days after the completion of 3 months tenure. Results: Results of the study clearly indicate fasting sugar, systolic BP, and low-density lipoprotein were significantly decreased (with value <0.02, 0.007, and 0.001, respectively) in the postyoga phase as compared to preyoga baseline investigation. Conclusion: The The present study substantiates some good results of the yoga training. Although all the tested parameters could not show desired changes and they were statistically insignificant. © 2022 Journal of Datta Meghe Institute of Medical Sciences University ;Published by Wolters Kluwer - Medknow.
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This chapter looks at the effect of the Covid-19 pandemic on internal migrants in India. According to the 2011 Census, there are over 450 million internal migrants, of which a massive 54 million are inter-state migrants. A large number of these migrants consist of labourers who comprise a huge percentage of the informal sector workforce, both in the rural and urban areas of India, and are vital to the country’s economy. These workers are also some of the most vulnerable, with inadequacies in terms of working conditions and coverage of social safety nets, and are also largely absent from India’s policy discourses. This chapter highlights the size and extent of internal migration as well as its distribution across different states in India. It shows how the current crisis and lockdowns have affected their lives and livelihoods. It particularly looks at the responses of central and various state governments – at destinations and origins – to ensure migrants’ wellbeing. It also analyses the socioeconomic impact of the migrant exodus from major destinations and looks at solutions to enable and ensure that migration patterns in the future are sustainable, and more importantly, ensure migrants’ rights and dignity. © 2022, The Author(s).
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A series of experiments was undertaken on an intercity train carriage aimed at providing a “proof of concept” for three methods in improving our understanding of airflow behaviour and the accompanied dispersion of exhaled droplets. The methods used included the following: measuring CO2 concentrations as a proxy for exhaled breath, measuring the concentrations of different size fractions of aerosol particles released from a nebuliser, and visualising the flow patterns at cross-sections of the carriage by using a fog machine and lasers. Each experiment succeeded in providing practical insights into the risk of airborne transmission. For example, it was shown that the carriage is not well mixed over its length, however, it is likely to be well mixed along its height and width. A discussion of the suitability of the fresh air supply rates on UK train carriages is also provided, drawing on the CO2 concentrations measured during these experiments. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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This book reconceptualizes migration studies in India and brings back the idea of citizenship to the center of the contested relationship between the state and internal migrants in the country. It interrogates the multiple vulnerabilities of disenfranchised internal migrants as evidenced in the mass exodus of migrants during the COVID-19 crisis. Challenging dominant economic and demographic theories of mobility and relying on a wide range of innovative heterodox methodologies, this volume points to the possibility of reimagining migrants as 'citizens'. The volume discusses various facets of internal migration such as the roles of gender, ethnicity, caste, electoral participation of the internal migrants, livelihood diversification, struggle for settlement, and politics of displacement, and highlights the case of temporary, seasonal, and circulatory migrants as the most exploited and invisible group among migrants. Presenting secondary and recent field data from across regions, including from the northeast, the book explores the processes under which people migrate and suggests ways for ameliorating the conditions of migrants through sustained civic and political action. This book will be essential for scholars and researchers of migration studies, politics, governance, development studies, public policy, sociology, and gender studies as well as policymakers, government bodies, civil society, and interested general readers. © 2022 selection and editorial matter, Ashwani Kumar and R. B. Bhagat;individual chapters, the contributors.
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Objective: To study the clinical course of cases with COVID-19 associated possible encephalitis. Background: There is sparse evidence to directly support definite encephalitis from COVID-19, whereas cases with possible encephalitis are uncommon. Design/Methods: A systematic review was done using Pubmed and Embase database from Jan 2020 to Sept 2020 using the search terms "COVID-19", " SARS-CoV-2", "encephalitis", modified as per requirements for the search tool of each database. Results: Total cases found were 14 with mean age 47.3±17 (male 64.3%). 10 cases (71.4%) had initial respiratory symptoms and 6 cases (42.8%) had fever. Common neurological manifestations included altered sensorium (92.8%), headache (42.8%), new onset seizure (35.7%), and dizziness (14.2%). Other features were behavioral issues, mutism, left sided paresis and paresthesia, ataxia, diplopia, bilateral facial weakness, hyposmia and ageusia. Six cases reported meningeal signs among which 71.4% had features of meningism. Out of twelve cases who had CSF analysis, four (33.3%) had normal findings, while the others had elevated CSF opening pressure and/or lymphocytic pleocytosis with elevated protein. Three cases had elevated CSF interleukin levels. SARS-CoV-2 was detected in the CSF of two cases. Eleven cases had MRI Brain imaging among which five cases were reported to have normal findings (45.5%), three cases had temporal lobe T2 hyperintensity (27.3%), one case had necrotizing hemorrhagic encephalitis, and one case had rhombencephalitis. Most of the patients were managed with empirical antibiotics, acyclovir, hydroxychloroquine, steroids, and anti-epileptics. Majority of the patients had complete and early recoveries with median time to recovery of 11 days (IQR 3- 12.5). One case died with refractory seizure. Conclusions: Altered sensorium was the commonest neurological manifestation noted with COVID-19 related possible encephalitis while new onset seizure was seen in >1/3 cases. Majority of cases managed with empiric antivirals, steroids and antiepileptics had early and complete neurological recovery.
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INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a multisystem disease. It can affect the central and peripheral nervous systems. Neurological manifestations at the time of disease presentation may have severe outcomes of COVID-19. The objective of our study is to evaluate the outcomes of hospitalized COVID-19 patients admitted in the intensive care unit who presented with neurological symptoms. METHODS: This is a multi-center, retrospective, and observational study of hospitalized COVID-19 patients in the city of Louisville, Kentucky, and southern Indiana region from March 10, 2020 to June 20, 2020. Patients were included in this analysis if they were: tested positive for COVID-19 by reverse transcriptase-polymerase chain reaction and admitted to the intensive care unit (ICU) in one of the nine hospitals in Louisville, Kentucky. Patients were considered to have a neurological symptom if one of the following clinical features was present during admission: 1) headache 2) dizziness 3) confusion 4) anosmia 5) ageusia and 6) altered mental status. Baseline characteristics and outcomes were compared using t-tests of means for continuous data, and t-test of proportions for categorical data. P-values < 0.05 was considered statistically significant. RESULTS: Out of 700 hospitalized COVID-19 patients in the study, 231 were admitted to ICU. Among 231 ICU patients, 92 (39.82%) patients had neurological symptoms at the presentation. Among the patients admitted to ICU, those who presented with neurological symptoms have higher mortality than those who had no neurological symptoms at presentation (50% vs 30%, p=0.003). In addition, ICU patients who presented with neurological symptoms had a higher rate of cardiac arrest (16% vs 2%, p<0.001) and cerebrovascular accident (7% vs 1%, p=0.034) during hospitalization in comparison to ICU patient without neurological symptoms at presentation. CONCLUSIONS: Our study demonstrated that among the patients admitted in ICU, patients who presented with neurological symptoms have higher mortality than those without neurological symptoms. In addition, ICU patients have a higher rate of cardiac arrest and cerebrovascular accidents if they presented with neurological symptoms.
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The worldwide spread of COVID-19 first reported from Wuhan in China is attributed to migration and mobility of people. In this article, we present how our understanding of migration and livelihood could be helpful in designing a mitigating strategy of economic and social impact of COVID-19 in India. We conclude that there are many challenges migrants face during the spread of COVID-19 resulting from nationwide lockdown. Many internal migrants faced problems such as lack of food, basic amenities, lack of health care, economic stress, lack of transportation facilities to return to their native places and lack of psychological support. On the other hand, COVID-19 has also brought into sharp focus the emigrants from India and the major migration corridors India shares with the world as well. There is a huge uncertainty about how long this crisis will last. This article further provides some immediate measures and long term strategies to be adopted by the government such as improving public distribution system, strengthening public health system, integration of migrants with development, decentralisation as a strategy to provide health services, and providing support to return migrants to reintegrate them, and also strengthen the database on migration and migrant households. © 2020 MIGRATION LETTERS Transnational Press London