Reductions in anxiety, depression and insomnia in health care workers using a non-pharmaceutical intervention.

The COVID-19 pandemic has caused significant medical and psychological challenges worldwide, and not only exceeded the capacity of hospitals and intensive care units but also an individuals' ability to cope with life. Health-care workers have continued to provide care for patients despite exhaustion, fear of transmission to themselves and their family, illness or death of friends and colleagues, and losing many patients. They have also faced additional stress and anxiety due to long shifts combined with unprecedented population restrictions, including personal isolation. In this study, we study the effect of an app-based Yoga of Immortals (YOI) intervention on mental health of healthcare workers. In this study, the health care workers were digitally recruited, and their psychological parameters were measured using validated questionaries. The participants were randomly grouped into control and test groups. The validated psychological measures were the Patient Health Questionnaire-8 (PHQ-8), Insomnia Severity Index (ISI) and generalized anxiety disorder (GAD-7) scales. The digital YOI intervention significantly reduced the anxiety, depression symptoms, and insomnia in healthcare workers of all age groups. In contrast, there was no improvement in the control group. This study details the effectiveness of an app-based YOI intervention in healthcare workers.

Cloud Computing & Pandemic: Open-Source Cloud Platform Reliability for SME System Development

The wave of the Covid-19 pandemic has devastated business development, especially traditional SMEs in Indonesia. As the largest contributor to assets in developing countries, SMEs are forced to digitize every business sector they are engaged in. As a form of business adaptation to the development of the 4.0 industrial revolution which is mostly cloud-based, SMEs need to build a cloud system that can be useful for the future of SME' business development. The need for SMEs in IT infrastructure and databases to move quickly while increasing their competitive advantage is often constrained by high costs and relatively slow returns. The implementation of an open-source cloud computing system is needed to overcome these problems which can provide a good and reliable service information system, as evidenced by stress testing on the Cloud Platform as a Service (PaaS) system using the reliability characteristics of ISO 25010: 2011. In this study, Proxmox was selected as the IT infrastructure and virtualization machine for the SME open-source cloud system to be tested directly. © 2022 American Institute of Physics Inc.. All rights reserved.

Reductions in anxiety, depression and insomnia in health care workers using a non-pharmaceutical intervention

The COVID-19 pandemic has caused significant medical and psychological challenges worldwide, and not only exceeded the capacity of hospitals and intensive care units but also an individuals’ ability to cope with life. Health-care workers have continued to provide care for patients despite exhaustion, fear of transmission to themselves and their family, illness or death of friends and colleagues, and losing many patients. They have also faced additional stress and anxiety due to long shifts combined with unprecedented population restrictions, including personal isolation. In this study, we study the effect of an app-based Yoga of Immortals (YOI) intervention on mental health of healthcare workers. In this study, the health care workers were digitally recruited, and their psychological parameters were measured using validated questionaries. The participants were randomly grouped into control and test groups. The validated psychological measures were the Patient Health Questionnaire-8 (PHQ-8), Insomnia Severity Index (ISI) and generalized anxiety disorder (GAD-7) scales. The digital YOI intervention significantly reduced the anxiety, depression symptoms, and insomnia in healthcare workers of all age groups. In contrast, there was no improvement in the control group. This study details the effectiveness of an app-based YOI intervention in healthcare workers.

Rule Based Medicine Recommendation for Skin Diseases Using Ontology with Semantic Information

Generally, skin diseases are taken seriously only after it gets aggravated. Many patients do not feel comfortable to consult physician for their skin problems and try to cure with home remedies. Identifying good dermatologist is more challenging. Disease gets cured with ease, if treated properly otherwise it becomes complicated. To handle this, knowledge-based decision support system is developed which provide recommendation for treatment. System realizes patient’s symptoms with location, cause and recommends appropriate medicines. Ontology is used to elaborate data concepts and their relationships in skin disease, which permits sharing and reuse of domain knowledge. Semantics described using Web Ontology Language (OWL) with vocabularies, resources, logic’s, and inference rules are queried for relevant information through SPARQL. System proved to render most valuable service to skin patients with ease and accuracy of its recommendation is high. It renders best treatment in COVID situation where people’s movement is restricted to great extent. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Oral Manifestations in Hospitalized COVID Patients

Aim: Evaluation of oral lesions in COVID-hospitalized patients, analyzing the potential etiopathogenetic mechanisms. Materials and methods: We evaluated a total of 58 hospitalized COVID patients in the time span from April 2021 to May 2021. The group analyzed consists of 38 male patients (66%) and 20 female patients (34%), aged between 22 and 92, with a preponderance of 60–80 years. All patients underwent an oral evaluation in order to detect the various oral manifestations;moreover, the onset time of these lesions has been correlated with the time of manifestation of the general symptoms of COVID infection. Results: Xerostomia has been the most frequent oral manifestation detected (30 patients, 51.7% of the sample), followed by ageusia (16 patients, 27.6%), and white tongue (13 patients, 22.4%). Other oral manifestations observed were aphthous lesions, fissured tongue, metallic taste, tingling in the lip and chin, and burning mouth syndrome. Conclusion: Our findings show a significant correlation between the oral manifestations and the burst of viral replication phase in COVID patients. Clinical significance: Awareness of the possible oral manifestations of COVID infection is important to conduct a correct diagnosis in oral pathology. © The Author(s). 2022.

Targeting eosinophils in chronic respiratory diseases using nanotechnology-based drug delivery.

Asthma, COPD, COVID-19, EGPA, Lung cancer, and Pneumonia are major chronic respiratory diseases (or CRDs) affecting millions worldwide and account for substantial morbidity and mortality. These CRDs are irreversible diseases that affect different parts of the respiratory system, imposing a considerable burden on different socio-economic classes. All these CRDs have been linked to increased eosinophils in the lungs. Eosinophils are essential immune mediators that contribute to tissue homeostasis and the pathophysiology of various diseases. Interestingly, elevated eosinophil level is associated with cellular processes that regulate airway hyperresponsiveness, airway remodeling, mucus hypersecretion, and inflammation in the lung. Therefore, eosinophil is considered the therapeutic target in eosinophil-mediated lung diseases. Although, conventional medicines like antibiotics, anti-inflammatory drugs, and bronchodilators are available to prevent CRDs. But the development of resistance to these therapeutic agents after long-term usage remains a challenge. However, progressive development in nanotechnology has unveiled the targeted nanocarrier approach that can significantly improve the pharmacokinetics of a therapeutic drug. The potential of the nanocarrier system can be specifically targeted on eosinophils and their associated components to obtain promising results in the pharmacotherapy of CRDs. This review intends to provide knowledge about eosinophils and their role in CRDs. Moreover, it also discusses nanocarrier drug delivery systems for the targeted treatment of CRDs.

Comparison of Positivity Rates of Rapid Antigen Testing and Real-Time Polymerase Chain Reaction for COVID-19 During the First and Second Waves of the Pandemic in Eastern Uttar Pradesh, India.

Background The advent of the second wave of coronavirus disease 2019 (COVID-19) in India caused a new range of challenges in diagnosing the virus. Various point-of-care tests have been introduced for rapid diagnosis. Although rapid antigen tests are the most commonly used, the false-negative rates are high. Therefore, the purpose of this study was to compare the positivity rate of real-time polymerase chain reaction (RT-PCR) testing in rapid antigen-negative cases of COVID-19 during the first and second waves of the COVID-19 pandemic. Methodology This was an observational study conducted in the Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur. Results In total, 2,168 patients were tested. The percentage positivity rate of the RT-PCR tests among the antigen-negative samples was 4.34% in the first wave of the pandemic whereas it was 8.08% in the second wave. Conclusions The main conclusion of this study was that antigen tests should never be used alone for the diagnosis of COVID-19. Instead, they should be confirmed with a RT-PCR test.

Yoga of Immortals Intervention Reduces Symptoms of Depression, Insomnia and Anxiety.

Background: Depression, anxiety, and disordered sleep are some common symptoms associated with sub-optimal mental health. During the COVID-19 pandemic, mental health issues have grown increasingly more prevalent in the population. Due to social distancing and other limitations during the pandemic, there is a need for home-based, flexible interventions that can improve mental health. The Yoga of Immortals (YOI) mobile application provides a structured intervention that can be used on any mobile device and applied from the user's home. Methods: A total of 1,505 participants were enrolled in the study and used the YOI app for an 8-week period. Participants were asked to fill out three questionnaires: The Patient Health Questionnaire, 8 items (PHQ-8), the Generalized Anxiety Disorder questionnaire (GAD-7) and the Insomnia Severity Index (ISI). These three items were completed by 1,297 participants a total of four times: before starting YOI, two more times during use, and a fourth time after the 8-week usage period. Changes in PHQ8, GAD7 and ISI in participants were compared to a control group, who did not use the YOI app but completed all questionnaires (590 controls finished all questionnaires). Results: Participants reported significant decreases in depression and anxiety-related symptoms. Compared to baseline, PHQ-8 scores decreased 50% on average after the 8-week period. GAD-7 scores also decreased by 40-50% on average, and ISI scores decreased by 50%. These changes were significantly greater (p < 0.05) than that observed in the control group. Participants who reported a previous diagnosis of depression and generalized anxiety reported significantly larger decreases in PHQ-8 and GAD-7 as compared to participants with no prior diagnosis (p < 0.05). Conclusions: Regular use of the YOI intervention over an 8-week period led to significant decreases in symptoms of both depression and anxiety, as well as alleviation of insomnia.

Impact of Nonpharmacological Public Health Interventions on Epidemiological Parameters of COVID-19 Pandemic in India.

Background Public health interventions are epidemiologically sound and cost-effective methods to control disease burden. Non-pharmacological public health interventions are the only mode to control diseases in the absence of medication. Objective To find the impact of public health interventions on the epidemiological indicators of disease progression. Methods This is a secondary data analysis done on COVID-19 data. The median doubling time and R0 were calculated for a rolling period of seven days. Interventions were scored from zero to three with an increasing level of stringency. Multivariate linear regression was performed to find the role of individual interventions on R0 and the median doubling time. Results The highest intervention score was reported in the lockdown phase, which gradually decreased to the lowest level of 22. The R0 values settled to a level of 1.25, and the median doubling time increased to 20 days at the end of the study. Public awareness and public health laws were found to be related to both R0 and the median doubling time in the pre-lockdown phase only. Conclusion The implementation of interventions at the ground level is one of the key factors in the success of public health interventions. Post implementation, poor effectiveness of many interventions is evident from the study. Further, studies related to the sequence of interventions are required to further analyze the poor effect of the interventions.

Feasibility and safety of remdesivir in SARS-CoV2 infected renal transplant recipients: A retrospective cohort from a developing nation.

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection has drastically impacted the transplant communities. Remdesivir (RDV) has shown some promising results in coronavirus disease (COVID-19) albeit with low certainty. Data in kidney transplant recipients (KTR) are still lacking. METHODS: This was a retrospective cohort of 57 moderate to severe COVID-19 positive KTR in a single center who received RDV as a part of COVID-19 management. No dose adjustments were done. The outcomes were measured as acute kidney injury (AKI) recovery; liver function tests abnormalities; other side effects; graft loss and death. RESULTS: The median (inter-quartile range) age of presentation was 44 (31-51) years. The duration from onset of symptoms to RDV initiation was 6 (5-7) days. Thirty-two (56%) cases received RDV on the day of admission. Forty-six (81%) cases were on oxygen support upon initiation of RDV. Thirty-eight (66.6%) cases had acute kidney injury on admission. The median baseline, admission, and 28-day follow-up serum creatinine of the cohort were 1.59 (1.1-2.1), 2.13 (1.3-3.1), and 1.58 (1.05-2.1) mg/dl, respectively. A total of 8(14%) cases died in the study with 1 (1.7%) graft loss. All those cases that died were on oxygen therapy at the time of initiation of RDV. No liver function derangements or any other major adverse events with the drug were reported. CONCLUSION: RDV therapy is safe and clinically feasible in renal transplant recipients as seen in our cohort. Larger clinical registries and randomized clinical trials should be conducted to further explore the efficacy in transplant recipients.

Analyzing social distancing policy effectiveness using Computational Fluid Dynamics inside a bus to prevent COVID-19 airborne transmission

Coronavirus disease (COVID-19) is a kind of disease that transmits from one body to another through air by the moist particles caused during sneezing and coughing. As a result, to reduce the virus spreading accordingly, 1.83 m of social distancing has been advised to be followed among the humans. Also, it is not well studied that whether the ambient wind and relative humidity (RH) will cause COVID-19 laden cough droplets to transport farther in the air, and make the current social distancing practice ineffective. In this study, computational fluid dynamics simulations are carried out to analyze the transient transport, condensation/evaporation, and deposition of COVID laden droplets emitted by coughs, with the different environmental conditions, cough velocities and Relative Humidity using the developed bus model of size 12 m x 3.5 m x 3.2 m. Different conditions of sneezing and coughing from the human’s i.e., the laminar and the turbulent flows of the laden droplets in the air inside the bus were also examined. The distance between the two virtual humans is set as 6 m for a 12 m bus length in order to track the distance covered by cough particles. The facial covering effect on reducing the airborne transmission of the cough droplets has also been evaluated. It is found that due to the ambient air and humidity, the generation of secondary laden droplets occur which travels far and accumulates on the ground or any other third human being around and causes a strong potential risk to their health. The secondary droplets are transforming into large droplets due to high humidity and the hygroscopic effect is evaluated. The 6 feet social distancing is found to be ineffective for halting the spread of viruses among human beings because the micro-laden droplets caused during the sneezing and coughing are influenced by the convection effects and transport from one body to another within 5 s. It is thus recommended to wear masks for both infected and healthy humans to reduce the airborne cough droplets.

Unmasking N95 for COVID-19 health-care workers in India.

A general term N95 Mask has been widely used by all including the health care personnel. It has been use incorrectly by all and it should be replaced with the term filtering facepiece respirator. There are two types of respirators being used in the world. One is the industrial type whereas the other one is the medical surgical one. The medical surgical masks are an intermediate product between the industrial and the triple layer medical mask. Many other equivalent products like KN95 masks are also available in the market. There is an urgent need of certification because this is the only way quality face masks can be provided to the public in these difficult times of COVID-19. This is essential because of the entry of many counterfeit and uncertified respirators have entered the market.

Molecular Binding Mechanism and Pharmacology Comparative Analysis of Noscapine for Repurposing against SARS-CoV-2 Protease.

Originating in the city of Wuhan in China in December 2019, COVID-19 has emerged now as a global health emergency with a high number of deaths worldwide. COVID-19 is caused by a novel coronavirus, referred to as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulting in pandemic conditions around the globe. We are in the battleground to fight against the virus by rapidly developing therapeutic strategies in tackling SARS-CoV-2 and saving human lives from COVID-19. Scientists are evaluating several known drugs either for the pathogen or the host; however, many of them are reported to be associated with side effects. In the present study, we report the molecular binding mechanisms of the natural alkaloid, noscapine, for repurposing against the main protease of SARS-CoV-2, a key enzyme involved in its reproduction. We performed the molecular dynamics (MD) simulation in an explicit solvent to investigate the molecular mechanisms of noscapine for stable binding and conformational changes to the main protease (Mpro) of SARS-CoV-2. The drug repurposing study revealed the high potential of noscapine and proximal binding to the Mpro enzyme in a comparative binding pattern analyzed with chloroquine, ribavirin, and favipiravir. Noscapine binds closely to binding pocket-3 of the Mpro enzyme and depicted stable binding with RMSD 0.1-1.9 Å and RMSF profile peak conformational fluctuations at 202-306 residues, and a Rg score ranging from 21.9 to 22.4 Å. The MM/PB (GB) SA calculation landscape revealed the most significant contribution in terms of binding energy with ΔPB -19.08 and ΔGB -27.17 kcal/mol. The electrostatic energy distribution in MM energy was obtained to be -71.16 kcal/mol and depicted high free energy decomposition (electrostatic energy) at 155-306 residues (binding pocket-3) of Mpro by a MM force field. Moreover, the dynamical residue cross-correlation map also stated that the high pairwise correlation occurred at binding residues 200-306 of the Mpro enzyme (binding pocket-3) with noscapine. Principal component analysis depicted the enhanced movement of protein atoms with a high number of static hydrogen bonds. The obtained binding results of noscapine were also well correlated with the pharmacokinetic parameters of antiviral drugs.

COVID-19 - In Silico Structure Prediction and Molecular Docking Studies with Doxycycline and Quinine

Coronavirus disease (covid-19) is a pandemic of international concern. It creates serious health risk all around the globe and it has no effective treatment. Doxycycline and Quinine are the drugs used as ligands in the study as these drugs has proved in vitro antiviral activity against dengue virus and herpes simplex virus. These compounds were targeted against non structural protein (nsp 12) which plays a vital role in replication and transcription of Corona viral genome. The protein 6 NUR that showed maximal identity of target protein nsp 12 was retrieved using BLASTp. Further the protein was modelled and the compounds were docked using AUTODOCK software and to study the structure activity relationship of ligand with target protein and biochemical information of ligand receptor interaction was done. Both the compounds, Doxycycline and Quinine were well engaged into the active site of target protein nsp 12 with strong hydrogen bond interaction and non polar interaction with active site of the protein. The Docking score of Doxycycline is found to be - 7.34 kcal/mol while that of Quinine being -6.14 Kcal/mol. This indicates the potential of these drugs as a lead against the nsp target protein of Corona virus which need further analysis and Optimisation studies.