Serum Interleuk.in-6 as a Potential Indicator of Severity In Covid-19 Patients: A Cohort Study

The outbreak of corona virus disease 2019 (COVID-19) in December 2019, caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). It poses a severe threat to global public health. Interleukin-6 (IL-6) was proposed to be associated with the severity of corona virus disease. The present study aimed to explore the role of IL-6 levels with severity in adult CO VID-19 patients. To correlate the serum level of IL-6 with severity of COVID-19 and monitoring of the disease in adult COVID-19 patients.A retrospective study was carried out after obtaining approval from the relevant Ethics Committee. Patients established with COVID-19 infection as shown by positive real-time quantitative PCR test were included. This study was conducted first time in Hadoti region of Jhalawar, Rajasthan. In this study, we have divide patients into three groups common (N=30), severe (N=30) and critical (N=30).The diagnosis and severity classification was based on Clinical Guidance for management of adult Covid-19 patients (Ministry of Health & Family welfare) and WHO interim guideline. The mean concentration of IL-6 were 1.75 +/-0.5 pg/ml, 9.45+/-0.1.5 pg/ml, and 21.55 +/-2.5 pg/ml for the common, severe, and critical groups respectively (P < 0.001 ). Our result shows that serum IL-6 levels increased as disease progress toward critical condition. Serum IL-6 should be included in diagnostic work-up to stratify disease severity. Therefore, full monitoring the severity of COVID-19 and effective early intervention are the fundamental measures for reducing mortality.

WITHDRAWN: CNN Implementation for Detect Cheating in Online Exams During COVID-19 Pandemic : A CVRU Perspective

This article has been withdrawn: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal).This article has been withdrawn as part of the withdrawal of the Proceedings of the International Conference on Emerging Trends in Materials Science, Technology and Engineering (ICMSTE2K21). Subsequent to acceptance of these Proceedings papers by the responsible Guest Editors, Dr S. Sakthivel, Dr S. Karthikeyan and Dr I. A. Palani, several serious concerns arose regarding the integrity and veracity of the conference organisation and peer-review process. After a thorough investigation, the peer-review process was confirmed to fall beneath the high standards expected by Materials Today: Proceedings.The veracity of the conference also remains subject to serious doubt and therefore the entire Proceedings has been withdrawn in order to correct the scholarly record.

Transition to online higher education during COVID-19 pandemic: turmoil and way forward to developing country of South Asia-Nepal

Purpose: Every day thousands of academic institutes suspend their classes and students are staying in their home maintaining social distancing due to the fear of COVID-19 pandemic and Nepal is no exception. Realizing these facts, this study aims to explore the factors for the effectiveness of online mode of classes to on-class course-based students and analyzes the perception of faculties and students toward online mode during the COVID-19 pandemic. Design/methodology/approach: It is based on exploratory research design, following mixed methods of qualitative and quantitative procedure. To build a rich understanding of the phenomenon, three-stage data collection procedure: preliminary interview, structural survey and validation were used. Findings: This study revealed triplet factors: infrastructure, student and teacher as antecedents of effectiveness of online classes during a pandemic. Technological support, infrastructure availability, faculty and students' perception have a significant relationship for the effectiveness of the online mode of the teaching-learning process. Students faced anxiety during the COVID-19 pandemic, but a higher willingness to learn reduces the level of anxiety. Originality/value: This study significantly contributes to the future management of higher education and digs the future path of online and on-class teaching-learning practices. © 2021, Dhruba Kumar Gautam and Prakash Kumar Gautam.

Modification of Management Strategies During Sars COVID 2 Pandemic Improved the Quality, Criticality, and Outcomes of In-Patients

The second wave of the pandemic exposed many hospitals to their unpreparedness to handle sudden surge patients due to lack of infrastructure to handle the relentless inflow of pts whilst also running short of beds, o2, ventilators, trained HCW's, PPE, medications, and other essentials. The aim of the study was to use judiciously the available resources, fine-tune the patient care, reduce the workload and burden of HCW s, optimize pts care, and improve the outcomes. This observation was done at a tertiary care hospital. The following fine-tuning was done: 1. Oxygen: Robust O2 systems that would support the pandemic, would take time to put in place, so conducting training programmers in a short period for HCW regarding optimal usage and avoid misusing or wastage of O2 was done in a relatively short time. We selected an HCW as O2 provider, the only job to check o2 delivery and SPO2 around the clock. 2. Foleys Catheters and Diapers: Patients on high O2 requirements when mobilized, O2 delivery to patients were discontinued along with disruption of prone positions and derecruitment of lungs and had severe hypoxia. So we started catheterizing the pts on high O2 need. 3. Family Visit: Family visits made pts comfortable, more compliant to the care. And it also reduced the significant burden of HCW's who had to otherwise communicate multiple times with their relatives via audio or video phone calls. This also brought transparency of the care. 4. Simple Protocols: We simplified the charts with only two sheets, one for the doctor one for the staff. These simple changes made work easy and more efficient and also help in collecting data. 5. DRUG Boy: Drugs indenting and on-time delivery were challenging. We selected a person only for drug delivery and later with drugs becoming precious and anticipating problems, drug boy used to deliver medications to the patient in presence of family. 6. Continuous Monitoring by a Leader: COVID is a dynamic process and requires continuous monitoring, timely interventions. Leaders have to take complete charge continuously from admission to discharge. Fragmented care by multiple people worsens the situations. 7. DVT Stockings: COVID is a prothrombotic state for the prevention of clots all moderate to severe pts were applied DVT stockings, along with chemoprophylaxis which prevented DVT significantly. 8. Anxiolytics, Restricted Mobilization, and Spirometry: Mild anxiolytics reduced the stress, work of breathing, and good compliance to the NIV. Strict restriction in mobilizing and adequate spirometry was supervised in moderate to severe COVID patients in the early stages to help in early recovery from COVID-19. 9. Prone Position in COVID: In moderate and severe ARDS in patients on O2 with face mask, O2 by BIPAP support and in invasively ventilated patients were subjected to prone positioning for 16-18 hours/day, which helped in improving lung recruitment oxygenation of patients and better outcomes while reducing the oxygen requirements. Conclusion: COVID pandemic is very challenging. Conservative management and fine-tuning of the resources available will have multiple benefits and also improve outcomes. With these innovations, quality will improved was costeffective and easily replicable in any hospital.

Efficacy and Doses of Ulinastatin in Treatment of COVID-19: A Single Centre Study

Aim and objective: Ulinastatin is a glycoprotein extracted from fresh human urine. It inhibits the activity of various proteolytic enzymes. Patient with severe COVID-19 exhibit elevated serum levels of proinflammatory cytokines IL-6, tumour necrosis factor, IL-I beta, characterised as cytokine storm, which is believed to progress, leading to deterioration and death. Ulinastatin dampens inflammatory response. However, data on efficacy and the doses are limited. We evaluated the efficacy and doses of ulinastatin in the hospital all-cause mortality in patients with moderate to severe COVID-19. Materials and methods: This retrospective study was conducted between April 1 and June 30, 2021, at tertiary care centre. COVID-19 was confirmed with RT PCR by nasopharyngeal swab. Patients with moderate to severe COVID-19 (moderate SPO2<94%, severe SPO2<90%) on room air were included. This is the first study comparing the doses of ulinastatin in COVID-19. Results: In total 145 patients, 75 patients with moderate to severe COVID-19 were treated with ulinastatin + other standard treatment. 70 patients were treated only with standard treatment regime. Allcourse mortality was significantly lower in patients treated with ulinastatin (15.3% vs 20.5%). In a total of 75 patients treated with ulinastatin, 40 patients were given 200,000 units BD and 35 patients were given 200,000 units QID. There was not much difference in the all-cause mortality (15% vs 13%) between the two doses. No adverse effects were noted. Conclusion: Our observational data showed a beneficial effect in moderate-severe COVID-19 patients and there was not much difference in beneficial effects with regular doses 200,000 q12th hourly as compared to higher doses of 200,000 q 6th hourly. This is the first observational study comparing the doses and having highest number of patients treated with ulinastatin.

Shorter Course of Remdesivir in Moderate COVID-19 is as Efficacious as Compared to Standard Regime: Observational Study

Aims and objectives: Remdesivir is an RNA polymerase inhibitor with potent antiviral activity in vitro. It is the current recommended antiviral treatment in moderate to severe COVID-19. However, data on shorter durations of treatment and the adverse effects are limited. Studies have not shown a significant difference between a 5-day course and 10-day course of the remdesivir in severe COVID- 19. We evaluated the efficacy of the shorter durations of 3 days vs 5 days on time to recovery and adverse reactions in a patient with moderate COVID-19. Materials and methods: This retrospective study was conducted between April 15 and March 30, 2021, at a tertiary care centre. Patients with moderate COVID-19 (SPO2- 90-94%) were included. Results: In total 56 patients were included and began treatment. The median duration of the treatment was 3 days for 30 patients and 5 days for 26 patients. The time recovery in 3-day course and 5-day course was 8 days and 9 days. After adjustment for baseline clinical status, patients treated for 3 days and 5 days were similar. The most common adverse event nausea and altered liver enzymes were less in 3 days course (6% vs 8%). Conclusion: In patients with moderate COVID-19, our study did not show a significant difference between 3-day course and 5-day course of remdesivir and adverse effects were less in 3 days course.

CNN Implementation for Detect Cheating in Online Exams During COVID-19 Pandemic: A CVRU Perspective

Here, the use of CNN-based technologies is provided with a new method for the detection of fraud during e-exams. This technology will assist providers in identifying any unknown situation during online tests, which are recommended by the majority of governments worldwide owing to the Covid-19 pandemic. Most colleges and students worldwide are severely impacted by their academic programmers, and the universities' role of testing using conventional approaches is a challenge. Thus, the students undergo several of their classes from various kinds of online third-party apps. The universities cannot, however, rely on these service providers for a long time to perform online examinations. Therefore, this work provides a full set-up of computing applications for students who can use them on their own laptops/personal computers with strict university guidance. © 2021

Implementation of Encryption Technique for analysis of Image Transmission during COVID-19 Pandemic

The necessity of rapid and appropriate diagnosis is emphasized by the COVID 19 as a serious danger to world health. The interchange of patient data across health centers addresses the growth of the number of patients and minimizes needless trials. The sharing of medical information helps patient care to accelerate;thus the sharing of health data is a need nowadays. Due to the sharing of information online among healthcare professionals, safety remains a key concern. In a diagnostic method during the COVID-19 pandemic, computer tomography (CT) and X-ray photos play an essential role in the transmission of information to organizations. Steganography techniques of encryption and imaging can be used in order to secure transmission of COVID-19 pictures. This work proposes a novel encryption for COVID-19 diagnostic using the image steganography (EIS-SDT) paradigm for safe data transfer. For the breakdown of images, a discrete multiple-level transformer for EIS-SDT employs the technique for optimizing the pixel selection for MANTA RY Foraging. For secrete image encryption, the EIS-SDT approach employs a dual logistic chaotic map. Additional security for the steganography process is ensured by the implementation of the DLCM-based encryption mechanism. The EIS-SDT model is efficiently performed by thorough simulation results analysis, and the results are analyzed using many assessment parameters. The analysis showed that the EIS-SDT model exceeds existing technology considerably. © 2021 IEEE.

Enhancement of Manpower for Management of COVID-19 Crisis in India

The Coronavirus Disease 2019 (COVID-19) pandemic overwhelmed not just the resources in terms of infrastructure but also manpower. With many healthcare workers turning COVID-19 positive themselves, and the healthcare system being overburdened, we were short-staffed in most health institutions across India. In anticipation of a similar crisis, at our tertiary care centre, we came up with certain measures to enhance the manpower should the need arise for not just hospitals, but also the society at large.

Modeling and Predictions of COVID-19 Spread in India

COVID-19 pandemic is a worldwide task because of its excessive unfold and alarming mortality rate. The capability to forecast this scenario might permit the authorities to modify their plan and guidelines accordingly. Researchers worldwide are using different outbreak prediction models for COVID-19 to make informed decisions and implement applicable control measures. However, we should not use epidemiological models in India as they do not provide desired predictions as a vast country with a different socio-economic status and dynamically varying cases of infection in different locations. Thus, because of high variability and lack of evidence, epidemiological models have shown low reliability. This paper provides a comparative study of the time series, deep learning, and mathematical models to forecast the COVID-19 outbreak as an alternative to epidemiological models. It also includes a modified version of Levitt metrics in order to predict the peak. This research experiments with various methods having different structures and parameters to model the outbreak, based on the findings presented here and the complex virtue of the COVID-19 pandemic across India. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.