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Background: The COVID-19 vaccines were developed unprecedentedly and have proven safe and efficacious in reducing transmissibility and severe infection. The impact of mRNA-based COVID-19 vaccines on atrial arrhythmias (AA) incidence is unknown. Objective(s): To analyze the incidence of AA after COVID-19 vaccination in patients with a cardiac implantable electronic device (CIED). Method(s): BIOTRONIK Home Monitoring data and Medicare claims data from CERTITUDE patients implanted with a CIED between 2010-20 were utilized to identify recipients of one or more doses of the COVID-19 vaccine in 2021. Those who had influenza vaccination in 2020 were also identified in the same cohort as a control. From remote monitoring data, the number of atrial high rate events (AHR) and % burden of AA in the three months post-vaccination was compared to the preceding three months using Wilcoxon signed rank test. Kruskal-Wallis test was used for group difference comparisons. New AF diagnosis was determined from ICD-10 diagnosis codes in Medicare claims. Result(s): First and 2nd doses of COVID vaccine (50% Pfizer, 47% Moderna, and 3% J&J) were administered to 7757 and 6579 individuals with a CIED (age 76.2 (+/-9.0) y, 49% males), respectively. In the same cohort, 4723 (61%) individuals received the influenza vaccine. A statistically significant increase in the number of AHR episodes and % burden of AA was noted in the three months post-vaccination compared to the preceding three months after the 1st and 2nd doses of the COVID-19 vaccine (Figure). No such association was noted following influenza vaccination. In subgroup analysis, AHR episodes increased significantly in age groups >70 and men. Post-vaccination increase in AHR episodes was more significant in those without a pre-vaccination history of AHR episodes (mean increase of AHR 6.9+/-88.4, p<0.001) and was non-significant in those with a preceding history of AHR (p=0.8). Among the 764 patients with no AF diagnosis in claims preceding the first COVID-19 vaccine, 87 (11.4%) developed a new AF diagnosis or AHR event in the first three months post-vaccination. Conclusion(s): We report a small but significant increase in the number of CIED-detected atrial arrhythmias following vaccination for COVID-19 but not influenza, specifically in men and age >70 years. Acknowledging the immense public health benefit of COVID-19 vaccines, our results should prompt increased awareness of evaluating for AF in this high-risk group following vaccination. [Formula presented]Copyright © 2023
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Methods: multicentric observational study, included 6000 COVID-19 RT PCR Positive cases with lung involvement on HRCT thorax at entry point & categorised as Radiological presentation phenotypes as severity assessmentmild, moderate, severe as per lung segment involvement (mild<7, moderate 8-15 and severe 16-25), Evolving and Evolved phenotype- with or without GGOs, consolidations, and crazy paving with or without spreading edges, Anatomical phenotype-Unilateral or bilateral as per lung lobe segment or lobe involvement, Clinicalradiological-pathological phenotypes-five types as classical GGOs, consolidations, Bronchopneumonia, Necrotizing pneumonia and cavitating. Response to treatment phenotypes-easy to treat and difficult to treat as per interventions required & response to treatment. Radiological outcome phenotypes as Resolving, Persistent and Progressive as per lung reticular and fibrosing lesions as with or without honeycombing and or tractional bronchiectasis. Statistical analysis by Chi test and students t test and ANOVA. Observations and analysis:In 6000 radiological assessment of covid-19 pneumonia, significant association was documented in Evolving and Evolved pneumonia phenotypes (p<0.000026), Unilateral and Bilateral pneumonia anatomical phenotypes (p<0.00001), Clinical-radiological-pathological phenotypes (p<0.00001), Easy to treat and Difficult to treat pneumonia phenotypes (p<0.00001), Radiological final outcome phenotypes-Persistent, Progressive & Resolving phenotype (p<0.00001) conclusion: Radiological phenotypes will guide in assessing severity, predicting response to therapy and final outcome in covid-19 pneumonia.
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Introduction: In an effort to alleviate the outbreak of COVID-19, many countries have imposed drastic Lockdown, movement control or shelter in place orders on their residents. Aim(s): The attitudes and factors of people hold towards visiting health care services play an integral role in determining a society's readiness to accept behavioral change measures from health authorities. Material(s) and Method(s): A cross-sectional online survey of 220 Indian residents was conducted between 3rd April 2020 and 15th may 2020.1 Result: Findings showed that 79.09% is not visited to health facilities for COVID-19 and 20.91% sought medical help. Out of that majority 39.39% want to visit government hospital, 34.85% are visited private hospital, 15.15% are community health center, 6.06% are primary health center, and 3.03% are in rural Hospital and 1.52% private clinic. Contributing factor distribution shows that 98.18% are aware about COVID-19 disease condition majority 22.71% from Health Professionals. 74.09%, person acknowledges availability of health facility and 80% persons acknowledge advice and guidance from Government, friends, relatives made them to seek medical help for COVID-19. Hindrance factors shows 66.82% peoples hesitate to contact health facility for COVID-19 among them 41.26% due to Fear of isolation or quarantine and other factors like How to tell, Whom to tell, Fear of relationships with family and neighbors and. 49.55% people not visiting health care facilities due to fear of covid-19 positive diagnosis. 46.39% peoples are having fear of Quarantine foe so many days so not approaching to health care facilities. Conclusion(s): There are some other factors not to seek medical help are Responsibility of family, Fear of isolation by society, Somebody may discuss about them & Others health issues will open, Fear of breaking of relationship, Social stigma, Specialty doctors are available only in big cities, Lack of society support.Copyright © 2020 Ubiquity Press. All rights reserved.
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Infections hold a major place in the global disease burden. About thousands of different microbial species invade human body thereby leading to complications in the physiology of a particular system or the body as a whole. While the world has tried to combat the microbial infections through various natural and synthetic chemical constituents and certain additional medical aids, we still lack effective treatment against all kinds of microorganisms especially, the evolving new microbial species. Currently, as the world is suffering from a major pandemic spread of infection caused by severe acute respiratory syndrome coronavirus 2, scientists all over the world are trying to produce an effective prophylaxis as well as treatment to fight the viral attack. Amongst different trials going on, this review focuses on the effectiveness of plasma therapy, its mechanism and its applications in various infections so far and it's possible role to treat coronavirus disease 2019.
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Background: Different arrhythmias have been reported in patients with COVID-19 due to the complication of the disease, and medications used in the management of COVID-19. Remdesivir was approved by FDA for the management of COVID-19 patients in October 2020. There are several case reports suggesting remdesivir causing bradyarrhythmia in COVID-19 patients. Objective: To increase the knowledge and awareness among healthcare professions (HCPs) about the risk of arrhythmias associated with the use of remdesivir. Methods: We used the FDA Adverse Events Reporting System (FAERS) database to find bradyarrhythmia as a reported adverse event (AE) due to remdesivir until October,2021. Total 6,504 events were reported, out of which 5,996 (92.2%) were reported by HCPs. These AEs were included and further analyzed. Results: Out of 5,996 AEs reported with remdesivir, total 537 (9.0%) events were bradyarrhythmia. There were 74 (1.27%) events reported for atrial fibrillation, and 24 (0.04%) for ventricular tachycardia attributed to the use of remdesivir. Reported events of bradyarrhythmia were further divided and analyzed into men vs women, and different age groups of years 18-64, 65-85, >85. Total events of bradyarrhythmia among men (238, 6.5%) vs women (141, 6.4%) were not significantly different. Among all the age groups, more events were reported in younger women in the age group of 18-64 (12.3%) vs 65-85 (7.9%) vs >85 (6.9%). Conclusion: Multiple studies have shown COVID-19 associated tachyarrhythmias, likely secondary to the myocardial damage due to hypoxia. Few studies have also suggested bradyarrhythmias in these patients. Our analysis of the FAERS database also showed many reported AEs of bradyarrhythmia attributed to the use of remdesivir. Postulated mechanisms include;medication side effects, damage to the SA node as a complication of the COVID-19 disease process, and electrolyte imbalance due to the renal failure. Close surveillance of these patients with early diagnosis can lead to prompt discontinuation of the medication, which can further decrease the mortality related to bradyarrhythmias. Further studies are required to identify the at-risk population and to better understand the risk of bradyarrhythmia associated with remdesivir.
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Introduction While the COVID-19 pandemic may still be ongoing, we have simultaneously entered into the post-acute phase of COVID-19, which comes with its own challenges. This case series reports 11 patients of COVID-19 treated with corticosteroids who subsequently developed osteonecrosis of the femoral head (ONFH). Methods All consecutive patients diagnosed on MRI with ONFH from August 2020 to May 2021 and were retrospectively COVID-19 positive were included. The treatment administered for COVID-19 was retrieved and evaluated. The patients were managed for femoral head necrosis, and results were reported. Results Overall, 11 patients developed ONFH in a total of 16 hips. The severity of femoral head necrosis depended on the dose of corticosteroid administered during COVID-19. A high dose for a longer duration resulted in a higher ONFH stage (FICAT & Arlet ). Hips in the lower grade were treated conservatively, and in the higher grade were treated surgically. The follow-up scores of patients demonstrated steady improvement. Conclusions High suspicion of femoral head necrosis has to be considered in patients treated with corticosteroids for COVID-19 as it can aid in early detection and early intervention to preserve the native femoral head © Kandari A.K.s, Bhamare D.S., Salunkhe R., Sukrethan S.V., Shevate I., Deshmukh A., Pisal T., Kulkarni K., Janapamala K., 2022
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Introduction: Among jurisdictions of the United States, Puerto Rico (PR) has the highest incidence of cervical cancer, and cervical cancer screening (CCS) is below 80%. Public health emergencies have an impact on people's access to health care services. We examined the impact of the public policy implemented by the government of Puerto Rico during the first 5 months of the COVID-19 pandemic in the utilization of CCS for participants of the Government's Public Health Plan. Methodology: This was a retrospective cohort study. A total of 40 government executive orders (issued between March 15 to July 31, 2020) were analyzed according to the level of restrictions they imposed on the population. Three periods with the greatest restrictions were identified: two of them in the government's initial response phase (March 15-30th & March 31st -April 12th ) and one in the re-opening phase (July 17-July 31st ). We examined the utilization of all modalities of CCS (pap test only and pap + HPV contesting). Rate ratios (RRs) were estimated to compare to CCS rates during periods of 2020 and compared to 2018-2019. Results: In comparison to 2019, CCS decreased during the most restricted period (March 31st-April 12th) of the response phase (RR= 0.19, 95% CI=0.15-0.24 for women 21-29 years;RR= 0.04 95% CI= 0.03-0.05 for women 30-65 years). During the re-opening phase, screening services started to rebound. However, an increase in COVID-19 cases led to another restriction (July 17-July31st), which led to a second phase of decrease in utilization of CCS (RR=0.17 95% CI=0.13-0.21 for women 21-29 years (RR= 0.09, 95% CI=0.08-0.10 for women 30-65 years). Conclusion: Our results evidence how the public policy implemented as a result of the COVID-19 pandemic in Puerto Rico had a direct impact on the utilization of CCS services in this Hispanic population. Future studies should examine screening patterns and social barriers of service utilization after July 2020 in Puerto Rico.
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In this paper we present our preliminary results from the first trial conducted with "WallBo"a robotic buddy to improve handwashing for children in schools. The one-week trial was carried out in a Scottish school with 16 pupils, aged 6-7 in an ecologically valid setting. The 1:1 interaction with WallBo resulted in 86.25% handwashing compliance, a 33.25% improvement from the baseline handwashing technique pre-WallBo training, and an overall, ≈ 35% improvement on knowledge about hand hygiene. We also report some insights about perceptions about WallBo in this paper. © 2021 Owner/Author.
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This paper attempts to develop a model to predict Novel Coronavirus affected cases in India. The virus is officially named as SARS-CoV-2 and was declared as a pandemic by WHO on 11th March 2020. This pandemic erupted in the Wuhan city of the People's Republic of China in December 2019. By now the whole world is in the grip of this virus. The first case of the COVID-19 in India was reported on 30th January 2020 in the state of Kerala. In India, the Ministry of Health and Family Welfare (MOHFW) keeps the track of COVID-19 cases daily. As of 14th June 2020, the total number of confirmed, recovered, and death cases in India are 332424, 169798 and 9520 respectively. The corresponding world statistics are 7900924, 3769712 and 433065 respectively. The disease is infectious and contagious and is affecting the health of people at large. The government and administration are trying hard to control the disease, and trying to find an effective treatment. This research aims to forecast the number of confirmed cases, recoveries and deaths of India and its six hotspot states (Maharashtra, Delhi, Tamil Nadu, Madhya Pradesh, Rajasthan, and Gujarat). To check the accuracy of the model, the first round of forecast is done from 15/4/2020 to 25/04/2020 based on the data available from 30th January 2020 to 14th April 2020. The second round of forecast is done from 16/05/2020 to 30/06/2020 based on the actual data from 30/01/2020 to 15/05/2020. Auto-Regressive Integrated Moving Average (ARIMA) model has been used to forecast the trend of COVID-19 cases in R programming.
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Rasayana is one of the unique branches of Ayurveda & it is suggested to increase ojas. Modern scientific observation’s on Rasayana shows that reju-venating drugs can protect the body against detrimental effects of the atmo-sphere in which we survive, by augmenting the individual’s capability to fight against disease-carrying organism through stimulating the immune system. The Rasayana therapy improves the merits of rasa, build up to it with nutri-ents so one can attain prolonged existence, memories, intellect, freedom from diseases, quality in lustre, complexion and voice, optimal improvement of physique and all sense organs. Rasayana is very useful to increase the immunity of the person to keep him away from disease. Rasayana herbs have antiox-idant properties which prevent the damage caused by free radicals. According to Ayurveda, Rasayana brings about proper nourishment, growth &enhanced function of all sevens dhatus (tissues). Rejuvenation therapy affects body &mind at the same time it checks the effect of early ageing on both, and enhance the body’s resistance to disease. Considering the grave situation of COVID-19 where effective medicine is yet to be invented, one should develop a healthy immune system for survival. Rasayana drugs provide nutritional sup-plementation along with enhancing immunity to fight against viral infections such as COVID-19.
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In the Pandemic of COVID-19, the Whole world is severely affected in many areas, including the health sector. Ayurveda being a holistic science also explains similar condition thousand years back with their aetiology, sign and symptoms and effective management. Such communicable diseases are described under headings such as Janapadodhwansa, Aupasargicvyadhi etc. with their effective management such as Rejuvenation (Rasayana) therapy, Panchakarma procedures, following codes of right conducts (SadvritaaPalan, AacharRasayana). Till date, there is no established protocol for the management of COVID-19 like disorders, the only option left with us is a preventive aspect, and that is the first aim of Ayurveda. To make body and mind healthy and capable of fighting against any disease, is possible by following principles of Ayurveda. AacharaRasayana is advised for the same purpose, which is a code of conduct aimed in providing excellent mental, physical, social and spiritual health without having any medicine. Due to the change in lifestyle and not following the codes of conduct, we are becoming more prone to various diseases. Therefore, it must be implemented in the community to obtain the full span of life without disease. This article explains the Ayurvedic view ofAacharRasayana as a Preventive aspect in COVID-19 like diseases.