Evaluation of cardiac involvement in patients with clinical post-COVID-19 syndrome

Introduction: The underlying pathophysiology of Post-COVID-19 syndrome remains unknown, but increased cardiometabolic demand and state of mitochondrial dysfunction have emerged as candidate mechanisms. Cardiovascular magnetic resonance (CMR) provides insight into pathophysiological mechanisms underlying cardiovascular disease and 31-phosphorus magnetic resonance spectroscopy (31P-MRS) allows noninvasive assessment of the myocardial energetic state. Purpose(s): We sought to assess whether Post-COVID-19 syndrome is associated with abnormalities of myocardial structure, function, perfusion and tissue characteristics or energetic derangement. Method(s): Prospective case-control study. A total of 20 patients with a clinical diagnosis of Post-COVID-19 syndrome (seropositive) and no prior underlying cardiovascular disease (CVD) and ten matching controls underwent 31P-MRS and CMR at 3T at a single time point. (Figure 1) All patients had been symptomatic with acute COVID-19, but none required hospital admission. Result(s): Between the Post-COVID-19 syndrome patients and matched contemporary controls there were no differences in myocardial energetics (phosphocreatine to ATP ratio), in cardiac structure (biventricular volumes, left ventricular mass), function (biventricular ejection fractions, global longitudinal strain), tissue characterization (T1 and extracellular volume [ECV] fraction mapping, late gadolinium enhancement) or perfusion (myocardial rest and stress blood flow, myocardial perfusion reserve). One patient with Post-COVID-19 syndrome showed subepicardial hyperenhancement on the late gadolinium enhancement imaging compatible with prior myocarditis, but no accompanying abnormality in cardiac size, function, perfusion, ECV, T1, T2 mapping or energetics. This patient was excluded from statistical analyses. (Table 1) Conclusion(s): In this study, the overwhelming majority of patients with a clinical Post-COVID-19 syndrome with no prior CVD did not exhibit any abnormalities in myocardial energetics, structure, function, blood flow or tissue characteristics.

A Multifaceted and Multi-Institutional Analysis of the COVID19-Associated Mucormycosis Outbreak in the Delhi Area Indicates the Simultaneous Convergence of Multiple Risk Factors

Background. A major outbreak of COVID19-associated mucormycosis (CAM) in India in spring 2021 aggravated the death toll of COVID19. As the causes of that CAM outbreak remain unclear, we performed a multifaceted study of host, pathogen, environmental, and heath care-related factors in adult CAM patients (pts) in the metropolitan New Delhi area. Methods. We reviewed the records of all pts diagnosed with culture- or biopsyproven CAM at 7 hospitals in the New Delhi area (April 1 - June 30, 2021). We used a multivariate logistic regression model to compare clinical characteristics of either all CAM cases (analysis 1, n = 50) or only pts with CAM after moderate or severe COVID19 (analysis 2, n = 31). As controls for both analyses, we used 69 COVID19-hospitalized contemporary pts. Selected hospital fomites were cultured for Mucorales. Additionally, we compared meteorological data and fungal spore concentrations in outdoor air before the CAM outbreak (January-March 2021) and during the outbreak (April-June 2021). Mucorales isolates from CAM pts were identified by MALDI-TOF-MS and ITS sequencing. A subset of 15 isolates underwent whole genome sequencing (WGS). Results. Risk factors for CAM in both analyses were newly diagnosed diabetes mellitus (odds ratio [OR] 8.26/5.67) and active cancer (OR 5.98/5.68) (Figure 1). Supplemental oxygen for COVID19 was associated with a lower CAM risk in both analyses (OR 0.13/0.17). Another significant CAM risk predictor identified only in analysis 1 was severe COVID19 (WHO score >= 6, OR 4.09), while remdesivir therapy (OR 0.40) and ICU admission for COVID19 were protective (OR 0.41) (Figure 1). No Mucorales were cultured from hospital fomites. The CAM incidence peak coincided with a significant uptick in environmental spore concentrations but was not linked to specific meteorological factors. Rhizopus was the predominant Mucorales genus (64%) identified by MALDI-TOF-MS and ITS sequencing;WGS found no clonal population of isolates but detected 2 cases of the rare pathogen Lichtheimia ornata. Figure 1 Conclusion. An intersection of host, environmental, pathogen and healthcare-related factors might have contributed to the emergence of CAM. Surrogates of access to advanced treatment of COVID19 were associated with lower CAM risk.

IoT based Wearable Health Monitoring System for COVID-19 Patients

Whenever the patient is admitted to a hospital, the doctors and nurses have to keep a regular check on each of them and also maintain a record of all the vital health parameters of patient. In a situation of pandemic like the one due to COVID-19 a huge number of patients are admitted at once which becomes very difficult for hospital staff to monitor each of them continuously. So, the model proposed here is a IoT based wearable system which is an assistive device for patient monitoring which will help the doctors, nurses and patient's relatives to keep a track of some vital health parameters like heartbeat, temperature and blood oxygen levels. All of these sensor data will be stored into the cloud platform "Thingspeak"and also to the mobile app "Blynk". And this system is made automatic so it will keep on monitoring and storing the sensor data at regular intervals which can be accessed from anywhere via the internet and even the alert system will notify about the emergency. Another part of the model which is separate from the wearable system is to monitor and store volume of drip or IV fluids is given to the patient. © 2022 Copyright for this paper by its authors.

Efficient Municipal Solid Waste Management: A Case Study of Dehradun City

Sanitization having a Lion Share of Attention on a Global dais in all the three-time zone Pre-COVID, COVOID, and Post-COVID is a matter of concern, especially for countries, which in the pre-era were striving hard to achieve it. Indian Government knitting the Spheris of Central and State Government has in the recent past shown bend towards the burning issue of Municipal Solid Waste Management. The Government had launched the schemes Swatch Bharat Mission, and it has been successful but is still on the backstage of its optimal potential as the basic motor of planning, i.e., “Master Plan” is missing in tier II and III cities when it comes to execution of such schemes. An attempt has been made in this paper to prepare a comprehensive plan for Dehradun city of Uttarakhand named “Solid waste Management Master Plan for Dehradun City 2041”. The following study will provide a complete spectrum approach towards the management of each component of Municipal Solid Waste Management of the city, including Waste Generation, Collection, Transportation, Treatment, and Disposal. Also, a service Level Benchmarking of both the Existing and Proposed System has been done to quantify the Output of the proposals and recommendations in the Existing System. Software such as GIS, GPS, and Remote Sensing is used in the study and has given an extra edge of Real-time and locational management for the Waste Management system of Dehradun until 2041. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Preparation of Coronavirus Nosodes Sourced from a Clinical Sample of SARS-Cov-2 Positive Patient, Inactivated Strain, and Spike Glycoprotein

Introduction Nosodes, the homeopathic preparations sourced from biological materials including clinical samples, cultures of organisms, and diseased tissues have been in use against the sourcespecific infections as well as other diseases. The nosodes have demonstrated some efficacy in managing epidemics, such as influenza, dengue, and leptospirosis. This article presents the need and process of development of nosodes from the SARS-CoV-2 to explore its prophylactic and therapeutic potentials against certain related viral diseases. Materials and methods A clinical sample of SARSCov-2 positive patient, based on the cycle threshold (CT) value of the qRT-PCR, heat-inactivated SARS-CoV-2, and spike glycoprotein all were processed for making nosodes as per the method described in Homoeopathy Pharmacopoeia of India. Molecular tests, such as qRT- PCR and sterility tests were performed to establish the live organisms, RNA material, and the absence of contamination. Results Three variants of Coronavirus Nosode were developed using a clinical sample, heat-inactivated SARS-CoV-2, and spike glycoprotein. In potencies 3c and above, no detectable SARS-CoV-2 RNA material was found by PCR. The analytical results for nosodes were reported as compliant for sterility testing as per the IP. Conclusion Three variants of Coronavirus nosodes were prepared which need to be evaluated further through pre-clinical and clinical studies. © International Journal of High Dilution Research. Not for commercial purposes.