Internet of Things (IoT) based Health Monitor Device

Health is the centre of human enlightenment. Due to the recent Covid outbreak and several environmental pollutions, checking one's vitals regularly has become a necessity. Ours is an IoT-based device that measures a user's heart rate, blood oxygen level and body temperature. The device is compact and portable, making it easy for users to wear. The readings are measured and shown on an OLED display with the help of sensors. The data is also available on the cloud. A webpage and a mobile application were developed to view the data from the cloud. Individual graphs of the vitals with time are available on the mobile application. This can be used for progress measurement and statistical analyses. Authorized personnel can access the patient's vitals. This creates a scope for Tele-medication in rural and underdeveloped regions. Besides, one can also view his/her vitals for personal health routine. © 2022 IEEE.

Effect of Systemic Illness and Comorbidities in the Prognosis of Severe Acute Respiratory Illness Patients: An Observational Study

Background: Globally critically ill COVID-19 (Coronavirus disease-19) patients have stretched critical care services. This study was undertaken to find factors implicated in mortality amongst COVID positive and negative patients presenting with severe acute respiratory illness (SARI) and factors having the probability of indicating COVID positivity. Methods: The demographic parameters, comorbid illness, clinical parameters and laboratory values of 327 patients were retrospectively analyzed to find the risk factors for mortality in COVID positive and negative patients and factors predicting COVID positivity amongst SARI patients. Results: 58% of SARI patients tested positive by RTPCR. Most common comorbidities were diabetes and hypertension, 35.2% and 33% respectively. Duration of swelling and low haemoglobin were significantly associated with mortality in COVID positive group (p=0.01, 0.005). Acidosis and tachycardia (p=0.003, 0.034) were associated with mortality amongst COVID negative. Creatinine, Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) were higher in non-survivors of both groups (p<0.001). Age, history of contact or from containment zone, cough, pain abdomen and P/F ratio were significant predictors of COVID positivity (1.020(1.006–1.035);3.889(1.316–11.495);2.908(1.182–7.152);2.147(1.149–4.012);0.997(0.994-1.000) respectively) by multivariable regression analysis. Conclusion: A long duration of swelling and low haemoglobin (<12 g%) were responsible for COVID positive mortality while pain abdomen, raised levels of AST, tachycardia and acidosis were associated with mortality in COVID negative. Deranged creatinine, higher SOFA and qSOFA were associated with mortality in both groups. Age, contact history, residence in containment zone, cough, pain abdomen and poor P/F ratio are predictive factors for COVID positivity. © 2023 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.

PSSO: Political Squirrel Search Optimizer-Driven Deep Learning for Severity Level Detection and Classification of Lung Cancer

Lung cancer accounts for about 7.6 million deaths annually worldwide. Early identification of lung cancer is essential for reducing preventable deaths. In this paper, we developed a Political Squirrel Search Optimization (PSSO)-based deep learning scheme for efficacious lung cancer recognition and classification. We used Spine General Adversarial Network (Spine GAN) to segment lung lobe regions where a Deep Neuro Fuzzy Network (DNFN) classifier forecasts cancerous areas. A Deep Residual Network (DRN) is also used to determine the various cancer severity levels. The Political Optimizer (PO) and Squirrel Search Algorithm (SSA) were combined to create the newly announced PSSO method. Experimental outcomes are assessed using the dataset of images from the Lung Image Database Consortium.

An IoT Based Smart Vault Security and Monitoring System with Zero UI

Recent advances have introduced IoT as one of the key technologies globally. As safety remains a critical issue for those who spend much time outside. Automated security systems are very useful where safety is an important issue. With a prospect of a Zero User Interface (UI) model this work represents a novel IoT based smart vault security system. The system is built and designed based on IoT combining with Arduino-Uno and Bluetooth module. This system involves LDR sensor, IR sensor and Sonar sensor for monitoring. The vault provides security on three levels. Password protected entry to connect with the smartphone using Bluetooth module, IR sensor array to use 'secret gesture pattern' to unlock the door, tracking number of transactions from the vault using Sonar sensor and LDR was used as a switch. To avoid the replication of physical unlocking of objects IR sensor array was used to introduce 'secret gesture pattern' unlocking system through touchless interfaces for the avoidance of transmissive diseases like COVID-19. This novel system has substantial possibility as a security vault system for industrial and residential use in a contactless manner. © 2023 IEEE.

COVID19-Far from Over: Call for Urgent Novel and Advanced Measures

The COVID19 pandemic that started in late 2019 has already killed millions people, it is yet far from over and the road to the COVID-free world is much tougher than we all imagined;however, it ends at a vaccine functional against all coronaviruses. In this article, we try to present the aetiology behind evolution of superior pathogenicity of SARS-CoV-2 and point out fundamen-tal and highly hazardous loopholes in the current vaccination regimens and propose new vaccination strategies. We also suggest societal and personal level management that are necessary to en-sure prevention and better recovery outcomes until the arrival of the vaccine. In turn, we apprise the physician for long-term and stringent management of certain chronic diseases, avoiding pre-scribing certain drugs and suggesting physical exercises and diets that are fortified with specific mi-cronutrients.Copyright © 2022 Bentham Science Publishers.

Developing an IoT based Mass Crowd Management System Reviewing Existing Methodologies

This work revolves around proper handling and monitoring of crowds at big events like concerts and public gatherings. To ensure appropriate management of the crowd at these events, a system is proposed and designed. The system consists of a series of modules namely a RFID based identification system for entry of only registered audience and a blood oxygen level and heart rate measurement unit which utilizes MAX30100 sensor to further check the health conditions. Along with these, an ultrasonic technology-based proximity monitoring unit (HC-SR04 module) is used to ensure the fulfilment of social distancing norms. This multi-module crowd management and monitoring system is tested in real-Time and the results are verified based on physical response as well as with the help of serial monitor values. The modules for this system are initially constructed on Fritzing, then implemented in real-life. The ThingSpeak platform and Arduino IDE are used to store the data and program the micro-controllers (Arduino and NodeMCU) respectively. © 2022 IEEE.

Effect of patient portals on perception of care quality, general health, and mental health: An exploratory analysis

This study analyzes the relationship between patients' understanding of online medical records and their perception of care quality. It also explores the mediating role of patients' general health perception and mental health and the moderating role of age in this relationship. The study develops and tests an exploratory conceptual model by analyzing the 2020 US-based Health Information National Trends Survey (HINTS) collected during the COVID-19 pandemic. We checked the survey for multicollinearity and common method bias and adjusted for family-wise error. Using models 6 and 59 of the Hayes PROCESS macros, the study articulates a sequential mediation and a parallel moderated mediation model to capture the intended relationships. Patients' understanding of online medical records had a significant positive association with the perception of care quality (Direct: s=0.17;Indirect: s=0.12). Additionally, the study captured the significant effect of age and perception of general health (self-health) on the perception of care quality. We also reported significant associations between mental health and general health perception (s=0.26). These findings suggest that the patient portals' contents should be designed in a way to be easily understood by patients from various backgrounds to improve the overall care experience.Copyright © 2022 The Author(s)

Co-infections due to Aspergillus and Mucorales: Case series from a superspecialty medical center in India

Objectives: To present details of a case series of fungal co-infection (aspergillosis and mucormycosis) including clinical course, laboratory diagnosis, treatment, and outcome. Method(s): Clinical histories of 7 cases of fungal co-infection (3 pulmonary, 4 rhino-orbito-cerebral or sino-nasal) were collected by chart review, and reports of samples sent to the mycology laboratory for direct microscopy and fungal culture were retrieved from laboratory records.Presence of septate and aseptate hyphae in direct microscopy of clinical samples and/or growth of Aspergillus spp and Mucorales in culture was considered as evidence of probable co-infection with mucormycosis and aspergillosis (as per EORTC guidelines). Result(s): Mechanical ventilation, cavitary lung disease, and renal failure with metabolic acidosis were unique risk factors observed for pulmonary co-infection, while use of systemic corticosteroids for treatment of SARS-CoV-2 infection was common in rhino-orbito-cerebral (ROC) or sino-nasal (SN) co-infection. Diabetes mellitus was a common risk factor for both groups of cases. Fever, cough, chest pain, and shortness of breath were the most common features in pulmonary fungal co-infection cases, while headache, facial swelling and pain, nasal stuffiness, decreased vision, and altered sensorium were the most common features in ROC/SN co-infection. Consolidation or collapse, bronciectasis, cavitatory changes in and nodules were the most frequent radiological features in pulmonary fungal co-infection cases, while mucosal thickening in multiple paranasal sinuses, and involvement of orbit and cavernous sinuses were the most frequent features in ROC or SN co-infection. Presence of aseptate and septate hyphae in direct microscopy was seen in tissue samples from all ROC/SN cases, which enabled early intervention. However direct microscopy was not indicative of co-infection in any of sputum samples from pul-monary cases, and diagnosis was only established by culture, leading to delayed initiation of treatment or no treatment. Lipo-somal amphotericin B (lAMB) ranging from 50-200 mg/day was used for treatment of fungal co-infection, with posaconazole 600-800 mg/day as step-down therapy or if lAMB was not tolerated. Out ofthree pulmonary fungalco-infection cases, onlyone received appropriateantifungal treatment butexpired nonethe-less. Out of the two untreated patients, one expired, and one was discharged against medical advice without resolution of symptoms. Surgical intervention was not done for any patient. In comparison, 3 out of 4 cases of ROC/SN co-infection were appropriately managed with immediate surgical debridement and survived. The remaining patient received appropriate anti-fungals but refused surgical intervention and expired. Conclusion(s): Fungal co-infection with aspergillosis and mucormycosis is a serious condition requiring early intervention. This is facilitated by high sensitivity of direct microscopy in tissue samples used for diagnosis in ROC/SN co-infection, but hindered by low sensitivity of direct microscopy in sputum/BAL samples used for diagnosis in pulmonary cases rather than lung biopsy. Robust clinical advisory services, early diagnosis, and combined surgical and pharmacological approaches are crucial to a favorable outcome.

Low Serum Albumin at Admission Is Associated with Mortality among Inpatients with Cirrhosis: A Multi-National Experience

Background: MELD and Child-Pugh scores have traditionally been used as prognostic indicators in patients with cirrhosis. Albumin infusions in outpatients have been associated with improved outcomes, but not in transplant waitlisted patients or inpatients. This aim of this study was to assess whether low serum albumin (sAlb) on admission alone is a poor prognostic indicator among cirrhotic inpatients from a new multi-national cohort. Method(s): The CLEARED study is a global study that enrolled consecutive non-electively admitted inpatients without organ transplant or COVID-19 from 6 continents. Admission demographics, medical history, laboratory data, inpatient course, death/hospice transfer and mortality at 30 days post-discharge were recorded. Patients were divided into 3 groups: sAlb <28gm/L(A), sAlb >=28 but <35gm/L (B), and sAlb>=35gm/L (C) were compared. Multi-variable logistic regression was performed using inpatient mortality and overall 30-day mortality as outcomes. Result(s): 2429 patients were enrolled from 21 countries worldwide. The distribution was A:49%, B:39%, C:12%. Gp A patients were significantly younger (54yrs vs. 57yrs vs 58yrs p<0.0001) but with similar gender distribution, and higher MELD-Na score of 25 vs. 20 vs. 17 (p<0.0001). Gp A patients were more likely to have alcohol as etiology of cirrhosis (49% vs. 45% vs 38%, p=0.004), and were more likely to have either infection (27% vs. 18% vs. 13%, p<0.0001), HE (39% vs. 33% vs. 23%, p=0.005) or fluid related issues as a reason for admission (p<0.0001). More patients in Gp A received albumin infusion during their hospital stay (120gm vs. 100gm vs. 100gm p=0.0004), mostly for the indications of AKI (47% vs. 49% vs. 47%, p=0.79) and performance of large volume paracentesis (44% vs. 42% vs. 41%, p=0.80), followed by bacterial peritonitis indication (22% vs. 17% vs. 11%, p=0.01). Group A patients had longer hospital stays (9 days vs. 8 days vs. 7 days (p<0.001), but similar ICU transfer (23% vs. 22% vs. 20%, p=0.55). group A patients were more likely to die while inpatients (19% vs. 11% vs. 5%, p<0.0001), or by 30 days post-discharge (29% vs. 20% vs. 9%, p<0.0001). Table shows the admission variables associated with a poor outcome. Conclusion(s): Hypoalbuminemia is extremely common among admitted cirrhotic patients, with sAlb of <28gm/L occurring in almost half. Together with MELD-Na score and infection at admission, a low sAlb is associated with a poor outcome in these patients. Future studies will need to validate these findings and to assess whether albumin infusions will improve the outcome of these patients. (Figure Presented).

BROADENING THE APPROACH TO PERSISTENT WRIST PAIN

CASE: The patient is a 47-year-old woman with a history of hyperlipidemia, asthma, and psoriatic arthritis (on adalimumab) who presented to clinic with 4 weeks of "sawing" left dorsoradial wrist pain, associated with tingling in the fingers and significant finger, hand and wrist weakness. Exam was notable for full strength and range of motion bilaterally. Tinel's and Phalen's sign were positive for mild tingling radiating to left hand fingers and wrist, and Finkelstein test was positive with significant pain on pinch grasp. An ultrasound was sent to evaluate for de Quervain's tenosynovitis;radiographic imaging was deferred by the patient. Ultrasound did not show evidence of de Quervain's tenosynovitis or radial nerve injury. There was significant delay between the initial visit and imaging, and ultimately the patient was referred to an Orthopedic Hand specialist. Magnetic resonance imaging (MRI) of the wrist was ordered, which showed abnormal signal throughout the lunate sparing the radial aspect, consistent with early osteonecrosis. Follow up radiographs demonstrated lunate sclerosis consistent with osteonecrosis. The patient was diagnosed with Kienbock's disease. IMPACT/DISCUSSION: Unilateral wrist pain in the primary care setting has a wide differential including mechanical causes (e.g. De Quervain's tenosynovitis, fracture, joint instability, neoplasm, or avascular necrosis of the scaphoid (Kienböck's disease) or lunate (Preisers' disease)), neurologic causes (e.g. nerve injury or compression) or systemic causes. While detailed history/exam can help narrow down the diagnosis, radiographs are often necessary to make a definitive diagnosis. Computed tomography (CT) is used to evaluate osseous lesions, whereas MRI is used to evaluate soft tissues of the wrist, and ultrasound can show tendonitis, arthritis, or nerve entrapment. Early referral to a hand surgeon is indicated when pain persists despite splinting for bony fractures, recurrent lesions, or avascular necrosis of the scaphoid or lunate. This case underscored Kienbock disease which is a rare but urgent etiology of wrist pain due to lunate osteonecrosis and can require immediate casting or surgical decompression. A key aspect to the case was the 1 month delay from first visit to initial ultrasound, 1 month delay to specialist evaluation and 1 month delay until final diagnostic MRI, primarily due to the impact of the COVID epidemic on the health care system. As the epidemic ebbs and flows with new variants, we can expect further delays in care, making the initial clinical evaluation even more critical to reduce unneeded imaging. CONCLUSION: -When evaluating wrist pain, if exam and first line images are inconclusive and pain persists, it is key to expedite workup with advanced imaging (MRI or CT) and refer to a specialist. In the primary care setting, it is critical to set realistic expectations with our patients regarding timeline of imaging and workup to maintain the therapeutic alliance and continue to build trust.

Change in Knowledge, Awareness, and Perception of Dentists Regarding COVID-19 in Belagavi City, Karnataka: A Questionnaire Study

Aim: The study aims to assess the change in knowledge, awareness, and perception about COVID-19 among the dentists in Belagavi city, Karnataka. Materials and methods: A cross-sectional study was conducted among 212 dentists in Belagavi city, Karnataka. A self-designed questionnaire consisting of eight close-ended and five open-ended questions was used for the data collection in two phases, once in June 2020 and once in December 2020. All the data relating to demographic details followed by knowledge, awareness, and perception of dentists regarding COVID-19 were recorded. Descriptive statistics, Chi-square test, and McNemar test were used. Results: A total of 212 dentists participated in both phases of the study in June 2020 and December 2020. Most of them (39.6%) belonged to the age-group of 35–45 years, and 41.5% had more than 5 years of working experience in a private clinic. In phase 1 of the assessment of June 2020, almost 86.3% of the dentists agreed that dentists should use personal protective equipment kits for treatment, but only 35.8% knew what was included. There was a change in the knowledge, awareness, and perception in the second phase in December 2020 which was statistically significant. Conclusion: The knowledge, awareness, and perception of the dentists regarding COVID-19 in Belagavi city in December 2020 have increased when compared to June 2020. The ready availability of information and easy acquirement of knowledge, leading to better adaptability were the major reasons behind it. Clinical significance: The knowledge, awareness, and perception type of assessment regarding COVID-19 among the dentists in Belagavi city is important to analyze and evaluate their readiness to restart dental practices and how prepared they are in doing so. © The Author(s). 2022.

Association of knowledge, perception, and fear regarding COVID-19 with the socioeconomic status of patients attending a dental hospital in Belagavi district: A cross-sectional study

Background: The COVID-19 pandemic has resulted in a significant loss of human life over the world and poses an unparalleled public health threat. As a result, it is critical to comprehend the patients' perspectives and knowledge on the subject. Aim: The aim of the study is to assess the knowledge, fear, and perception regarding COVID-19 among patients attending a dental hospital in Belagavi, India, and to compare it with their socioeconomic status using Kuppuswamy scale 2019. Materials and Methods: A cross-sectional questionnaire study was conducted among patients attending the dental hospital during the complete lockdown. A total of 170 respondents were included in the study. A self-designed, validated questionnaire with 14 closed-ended questions was prepared, among which 11 questions were knowledge based, two were on perception, and one on fear. Data were entered into Microsoft Excel and analyzed using the SPSS version 25. P & LE;0.05 was considered statistically significant. Results: A total of 170 participants were included in the study. The age ranged between 26 and 80 years. Majority of the population (95%) knew the symptoms of COVID-19 and the measures to be taken to prevent it. An association was found between participants' educational status and their knowledge regarding signs and symptoms of novel coronavirus (P = 0.005). Most of the study participants were not aware of the distance to be kept during social distancing (45.8%). Lockdown caused financial burden to more than 70% of the study participants. Conclusion: Nonliterate youth and adults were most likely to be the hardest hit by educational, social, and economic impacts of COVID-19.

Assessment of Knowledge Regarding Infection Control Protocols among Dental Health Professionals during COVID-19 Pandemic: An Observational Cross-sectional Study

Introduction: It is necessary to prioritize occupational welfare, safety of dental students and health professionals to reduce coronavirus transmission, to offer the best benefit for patients. Aim: To assess knowledge regarding standard operating procedures to be adhered in clinical setting during pandemic amongst undergraduate, postgraduate dental students and dental interns of dental colleges in northwest region, Karnataka. Materials and Methods: This observational cross-sectional study was undertaken in dental colleges in northwest region, Karnataka from January 2021 to February 2021. Sample size was estimated to be 360 based on a pilot study. Participants were selected by the simple random sampling technique and were interviewed using a questionnaire comprising of 20 close-ended questions. The questionnaire was evaluated for reliability with Cronbach's α value of 0.82, face validity 0.85%, and content validity ratio 0.76. The collected data was entered in MS Excel and analysed using Statistical Package of the Social Science (IBM-SPSS) statistics-version 21 using descriptive analysis, Chi-square analysis, spearman's correlation coefficient test, and regression. Results: The mean age of the participants was 24.6±1.35 years with marked gender distribution of 261 (72.5%) females and 99 (27.5%) males. Overall knowledge score for the standard operating procedure to be adhered during the pandemic was found to be 10.92±1.96 (undergraduates), 12.68±1.80 (postgraduates) and 11.55±1.82 (interns). More than half of the respondents 57.78% displayed a moderate level of knowledge. Spearman's correlation coefficient test revealed a high statistically significant difference between awareness about Coronavirus disease 2019 (COVID-19) among participants and recommended masks during the procedure. Conclusion: Postgraduate students had higher knowledge regarding standard operating procedures to be adhered in dental clinics compared to undergraduate students and interns. It's necessary that dental students are aware of latest infection control guidelines and implement them into their practices right from beginning.

From Propped up to Prone: A Paradigm Shift in the Management of Severe COVID Pneumonia!

Coronavirus disease (COVID) pneumonia in the recent times has shown us the importance of prone positioning during the management of moderate to severe hypoxia. In fact, we have rediscovered the benefits of this positional maneuver in coping with the oxygen crisis during the second wave of this dreaded pandemic. While we (the clinicians) derive benefits of this postural therapy for treating our patients, it is imperative for us to know the underlying mechanisms behind improvement in oxygenation in mild to moderate cases of COVID pneumonia. In this brief communication, we try to decipher the miracles of this great life-saver.

Ready Made Garment (RMG) Factories During the Pandemic: Mapping the Effects in Bangladesh

Since the start of Covid-19 Pandemic in Bangladesh, policies were steered and stimulus packages were provided by the Government for the Ready Made Garments (RMG) industry which contributes heavily on the country’s economy through exports and employment generation of millions of workers but was struggling due to pandemic triggered supply chain disruption and order cancellation from global buyers. It can be a crucial exploration to know how RMG factories fought back after reopening from one month closure during the initial stage of the Covid-19 Pandemic in Bangladesh in 2020. This analysis is a contribution to such exploration by making a comparison based on the data of export oriented RMG factories in Bangladesh from two rapid surveys conducted in two phases in 2020 for understanding the effects of the pandemic on the Bangladesh RMG sector. While factories covered by the rapid surveys were sampled from the database of the ‘Mapped in Bangladesh’ project, the comparison of this analysis addressed several important factors including operational status, capacity utilization and workers employed during Pandemic. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

A Study on Effect of COVID-19 and AI tools to Detect Coronavirus from Chest Medical Images

In December 2019, an outbreak of a series of severe respiratory illness was found in Wuhan, Hubei Province, China. It was due to a novel coronavirus, now identified as SARS-CoV-2. The virus is human-to-human transmissible and that is why it has created a pandemic. Due to the continuous increasing death toll, several governments have been compelled to execute complete lockdown throughout the countries and followed by a social separation. The lack of tailored treatment remains an issue. Usually, patients above the age of 65 are more vulnerable to serious illnesses, according to epidemiological studies, whereas children have lesser symptoms. Depending on the present scenario of coronavirus disease, World Health Organization (WHO) advised to implement precautionary measures to defend self and other population. It has been also instructed to take legal action if some careless personnel do not abide with the guidelines of WHO and respective government of his country. A covid detection mechanism from X-ray images is presented in this paper, where a deep convolutional neural network has been utilized to determine whether a person is a covid patient or not. The proposed model accomplishes more than 96% accuracy, which proofs the goodness of the proposed work. © 2021 IEEE.

Customized Human Mask-Face Recognition using Computer Vision

looking at the present problem of coronavirus disease, it has been advised by World Health Organization to take preventive measures to safeguard ourselves. One of the main preventive measures taken by the government and WHO is to wear a face mask while traveling outside along with social distancing. On the other hand, identifying a person with a facemask is also challenging. To overcome such situations there has been an urgent requirement for the technology to step forward. The proposed work has been implemented to overcome the situation and able to recognize a person behind the mask as well. In this work, haar cascade is used for locating the coordinates of pixels of face mouth and ing the pixels of face mouth from an image. The process of identifying starts by taking an input of the image from the default camera in the RGB format and is converted to a greyscale for fast processing of the image. The proposed work with still images and also with live video streaming with an accuracy of 90%. © 2021 IEEE.