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The following sections are included: • Introduction • Supply Chain Decisions, Actions Taken and The Impact of Covid-19 • Stage 1: Sourcing and Procurement • Stage 2: Production • Stage 3: Distribution and Transportation • Stage 4: Marketing and Sales • Stage 5: Consumers • Conclusion • References. © 2023 by World Scientific Publishing Co. Pte. Ltd.
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The coronavirus disease-2019 (COVID-19) pandemic has imposed a situation where all healthcare facilities except emergency services remain suspended. These times generated the necessity for the implementation of a healthcare delivery system that can be accessed digitally and, thus, benefit the majority of children as well as healthcare professionals. This review aims to propose a sound model of less technique sensitive, safe and handy strategies for dental traumatic injuries, endodontic and restorative concerns, and orthodontic urgencies until complete clinical help can be sought. Five hundred thirty articles were obtained from the PubMed, Google Scholar, Embase, Lilacs, and Cochrane databases published from 2011 to 2021. Nineteen articles that described teledentistry in the COVID-19 era were included. Teledentistry can serve as a vital patient management strategy that can aid in triaging urgent and elective patient treatment needs, ultimately easing the burden of clinics and at the same time providing a safer means of consultation. Copyright © 2021 Goswami, Nangia, Saxena, Chawla, Mushtaq, Singh and Jain.
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Background: COVID-19 is still going on with lots of uncertainties. There is a need for early and effective marker for prognostication of COVID-19 patients. Coagulation dysfunction and increased D-dimer levels are seen in this disease. Thus, present study was aimed to compare D-dimer value in relation to disease severity and disease mortality, and to evaluate prognostic significance of D-dimer. Method(s): All symptomatic SARS-CoV-2 RT-PCR confirmed COVID-19 patients admitted in Hospital from March 31, 2021, to May 31, 2021 were evaluated and clinical, demographical and laboratory findings were collected and analysed. According to disease severity patients were grouped and death events and D-dimer value were assessed. Optimal D-dimer cut off point in all groups were evaluated. Result(s): 388 patients were included in the study out of which 142 (36.5%) died during hospital stay. Mean D-dimer value in mild disease was 1.17+/-0.21, moderate disease was 1.47+/-0.17 and in severe disease was 2.92+/-0.23 FEUmicrog/ml. Mean D-dimer value in non-survivors were significantly (P<0.001) different and higher (59.3%) as compared to survivors. ROC curve analysis showed a prognostic value of D-dimer in mild (AUC=0.755, Z=3.30, P=0.001), moderate (AUC=0.762, Z=4.65, P<0.001) and severe (AUC=0.694, Z=5.08, P<0.001) patients. Optimal cut off of D-dimer between survivor and non survivors was >0.78 in mild cases, >1.05 in moderate patients and >2.11 in severe cases. Conclusion(s): Mean D-dimer value showing increasing trend with increase disease severity and prognostic significance was found highest in moderate patients followed by mild patients and least in severe patients in terms of mortality.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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Researchers are exploring the eutectic mixture because of their obvious great potential in various disciplines. Herein, authors have presented the DFT calculations, molecular docking and QSAR results for designed eutectic mixtures (EMs) using thiourea and resorcinol on taking different equivalent ratio. Authors have used Jakob et al. method to determine the melting temperature of the systems or EMs theoretically. Thermodynamic parameteres such as the free energy, enthalpy, and other energy of the EMs at room temperature are determined through DFT calculations using Gaussian. Authors have also calculated the physiochemical descriptors of various eutectic mixture based on DFT calculations. Further, molecular docking of the designed EMs is carried out to investigate their biological potential for inhibition of the Mpro of SARS-CoV-2. © 2023 Elsevier B.V.
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A computational study to design a 2D-photonic crystal (PC) structure with a fluorescence-based biosensor has been demonstrated for the detection of the severe acute respiratory syndrome corona virus 2 (SARS-COV-2) virus in the lungs. The proposed sensor can detect the different concentrations of the virus without any pretreatment of the sample. The virus detection is performed by measuring the mid-gap wavelength from the dispersion diagram and a redshift in the mid-gap wavelength has been observed as the concentration of virus increases in the lung tissue. The plane wave expansion method is used to determine the dispersion diagram of the proposed PC. The interaction of incident light with the proposed PC-based biosensor has been analyzed to evaluate the shift in the mid-gap wavelength. A maximum sensitivity of about 1459.3 nm/RIU is obtained for r/a = 0.45 with a mid-gap wavelength shift of 145.93 nm at n net = 1.49 concentration of SARS-COV-2. Moreover, a very small detection time has been observed with the proposed device as compared to conventional methods. This study provides a simple process to detect the presence of a virus within a short period and could be helpful in the development of a direct and easy-to-use portable detection kit in the future. © 2023 IOP Publishing Ltd.
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Background: Medicine is one of the few academic disciplines that cannot be taught in the distance education mode. Hands-on practice for clinical skills and competency is critical in medical education. Although this pandemic has offered new learning modes such as teleconsultation, videoconferencing, virtual simulations, and digital podcasts, how much actual knowledge transfer and skill gain will be achieved, is unanswered. Aims and Objectives: The present study has been planned to understand the impact of COVID on medical education and to identify the factors which promoted or hindered learning during COVID-19 pandemic. Material(s) and Method(s): This cross-sectional study was conducted among 261 willing MBBS students from various colleges of Tamil Nadu after obtaining Institutional Ethical committee clearance using a pre-validated structured online questionnaire through Google form link in online social platforms through "Voluntary opt in" method of sampling. Result(s): About 22.6% of the study participants were affected by COVID-19. About 46% of the participants family members suffered from COVID and all of them accepted that it significantly affected their academics. About 71.6% experienced anxiety/depression. About 93.5% were addicted to social media during class hours. About 88.1% welcomed "flipped/blended learning". More than 90.8% reported that they missed skill-based learning/Primary health care training. About 80.8% positively felt that they got more duration for preparing exams. About 89.3% found that practical exams were challenging. Conclusion(s): Not only have we witnessed the importance of having a robust health-care system, but the pandemic has created a critical need to transform various aspects of medical education especially to a model of blended learning of online and offline methods to enable a better academic environment so as to reflect the changing medical landscape.Copyright © 2023 Jeevithan Shanmugam, et al.
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Aims: Medical students belong to frontline health care providers of future. Risk of COVID 19 exposure is more among medical students, and COVID 19 vaccination plays very crucial role for controlling COVID 19 pandemic. Hence, this study was planned with the objective to evaluate attitude of medical students towards COVID 19 pandemic and their vaccination status. Material(s) and Method(s): We conducted an online web-based survey among medical students of Madhya Pradesh, India. Online Google form-based Questionnaire was sent through WhatsApp groups, and responses were collected and analysed. Voluntary consent was obtained through from all the participants. Finding(s): A total of 516 medical students from different medical colleges of Madhya Pradesh voluntary participated in this study. Out of that majority of the participants were in 18-20 years' age groups, unmarried and belonged to rural areas. Most of them were worried about their MBBS studies due to COVID 19 pandemic. 71% of the medical students received two doses of the COVID 19 vaccination till 15the August, 2021. Conclusion(s): Medical students of Madhya Pradesh are worried about their MBBS course completion, examination and education shift towards online due to COVID 19 pandemic. There is a need of psychological counselling and awareness program regarding vaccination among medical students. Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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Viruses are the most abundant biological entities on our planet. On the basis of parameters like capsid structure, morphology, genetic material, etc., they are classified into different families. The Coronaviridae family of viruses includes a diverse group of positive strand RNA viruses and a subset of these viruses infects humans. Though some of these human-infecting coronaviruses cause minor respiratory ailments in healthy adults but three of them are responsible for major pandemics of the 21st century. These pandemics claimed thousands to several hundred thousands of human lives and have plunged the regional economies and even the global economy into an abyss. This work highlights the current research on human coronaviruses involving their diversity, evolution, clinical, and zoonotic attributes. An economic impact analysis of major coronaviruses is also presented to point out how these pathogens have claimed billions of dollars. © 2022 by the Author(s).
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Maxillectomy is the surgical removal or resection of the maxilla or upper jaw bone. Maxillectomy may be total or partial. It is performed during surgical treatment of cancer and infections (bacterial. fungal) of the oral cavity, nasal cavity and maxillary sinuses. Patient affected from post-Covid mucormycosis require local debridement or surgical resection resulting in maxillectomy. After surgery, patient has difficulty in mastication, speech, and swallowing because of communication between oral and nasal cavity. This may also give rise to psychological challenges and social exclusion. The prosthodontic rehabilitation of such patient using obturator provide a separation between oral and nasal cavity and improve the quality of life of the patient. There are various techniques and materials used for fabrication of definitive obturator. This article discusses the prosthodontic rehabilitation after maxillectomy in post-covid mucormycosis patients using obturator by conventional and 3D printed techniques. © 2022 Manu Rathee et al., published by Sciendo.
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Corona Virus Disease 2019 (COVID-19) has emerged as a supreme challenge for the whole world as well as India. As of now approximately 6.5 million people died in the world. However, the major setback to the world was in 2021 as a result of the second and third waves of COVID-19, which were caused by a different variation of COVID-19 than the first variant. The governments and health sectors were not aware of the subsequent possible waves due to the lack of data analysis competency and improper forecasting models. Hence finding an inflection point of this epidemic curve for COVID-19 infection and death is very imperative to understand different waves and variants instigating these waves. Similarly predicting the epidemic curve for the future is vital to make the government and the systems aware of the impending situation and make them prepare accordingly. Hence this work attempts to demonstrate conditions for finding inflection points and intervals which helps in finding the number of waves and the variants of COVID-19. Simultaneously the forecasting of the number of infections in forthcoming wave is also done using the auto-regressive integrated moving average model to identify the number of waves in India. The prediction of the two months data was compared with actual data for proper analysis. © 2022 IEEE.
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INTRODUCTION: Histoplasmosis results from spore inhalation of Histoplasma capsulatum, an endemic fungus in the soil of the Ohio and Mississippi River Valleys of the United States. While the majority of infections with H. capsulatum are asymptomatic and self-limited, immunosuppressed patients may develop severe, disseminated disease. Few reports have described disseminated histoplasmosis following SARS-CoV-2 (COVID-19) infection such as described in this case. DESCRIPTION: A 69-year-old female was evaluated for shortness of breath. Her medical history was significant for rheumatoid arthritis on methotrexate and recent COVID-19 infection treated with dexamethasone. Initial CT-angiography of the chest showed patchy bilateral ground glass opacities. She had leukopenia with white blood cell count of 1.3 K/uL and elevated procalcitonin of 5.88 ng/mL. Broad spectrum empiric antibiotics were initiated. On day 6, the patient decompensated and required ICU transfer. Urine histoplasma antigen, M and H precipitin bands, and serum galactomannan antigen returned positive. Amphotericin B was initiated. The patient underwent bronchoscopy with bronchoalveolar lavage showing atypical reactive macrophages with rare intracellular organisms suspicious for fungi. Repeat CT of the chest, abdomen, and pelvis showed extensive bilateral ground glass opacities, bilateral pulmonary calcifications consistent with granulomas, and calcifications in the spleen and liver. On hospital day 10, the patient required intubation due to hypoxemic respiratory failure. Despite appropriate antifungal therapy, she had worsening encephalopathy, leukocytosis, erythema nodosum, and renal failure. She passed away on day 19. DISCUSSION: This case highlights the development of disseminated histoplasmosis in an immunocompromised adult following COVID-19 infection. It was not until treatment with high dose glucocorticoids that the patient developed disseminated disease and declined. It is important to be aware of the impact that the COVID-19 pandemic has on the emergence of infectious disease and the role its treatment plays in immune suppression. Disseminated histoplasmosis is a consideration for immunocompromised patients in high risk, H. capsulatum endemic areas who are being treated for COVID-19 with high doses of steroids for prolonged periods.
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The coronavirus 2 (SARS-CoV-2) epidemics and accompanying illness (COVID-19) have reached global proportions, putting additional strain on healthcare systems to contain and manage COVID-19. To curb the spread of virus, improvements in diagnosis is needed along with mass screening of a large proportion of population. Search for viral RNA in upper and lower respiratory airways using RT-PCR methods are on-going which will be used to make a molecular diagnosis of SARS-CoV-2 infection and illness. Serological testing for viral antibodies could aid healthcare personnel in supporting COVID-19 diagnosis and follow-up, as well as population screening. First step is to collect the specimen as early as patient come. Site of collection of swabs should be anatomically appropriate for accurate result of test. Main diagnostic test is molecular test that is RTPCR in initial stage whereas supportive test is serological test. CoV-2 is made up of single-strand ribonucleic acid (ssRNA) along with a positive sense strand which is enveloped. Patients with comorbid diseases such as diabetes, cancer, hypertension, malnutrition, old age, children, and pregnancy have severe infection and a high mortality rate. Most appropriate and frequently used test for diagnosing COVID-19 is RTPCR. It makes use of TaqMan fluorogenic probe-based chemistry and Taq DNA polymerase's 5'-nuclease activity. Early discovery, diagnosis, isolation, and treatment are the most efficient methods for prevention and control of COVID-19. Both clinical and preclinical knowledge is important for fighting COVID-19 like pathology, microbiology and other detection techniques required for molecular diagnosis and improving ability of early diagnosis.
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This study was done to assess the morphological changes in peripheral blood smears during COVID-19 infection .We aimed to examine the characteristics of the cells detected in the peripheral blood smear and bone marrow at the time of diagnosis in COVID-19 patients. Clinical features, laboratory data, peripheral blood smear of 35patients diagnosed with COVID-19 by PCR was evaluated at diagnosis. Peripheral smear samples of the patients were compared with the age and sex-matched 35 healthy controls. The relationship between the laboratory values of all patients and the duration of hospitalization was analyzed. Peripheral smear shows neutrophilic leucocytosis, lymphopenia and thrombocytopenia while Bone marrows were normocellular to hypercellular, most showing maturing trilineage hematopoiesis with myeloid left shift. In 09 out of 35 evaluable bone marrows, hemophagocytic histiocytes were identified.
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The outbreak of Covid-19 (COV-19) has become one of the global severe public health issues. It is an ongoing global pandemic that has spread rapidly. It not only affected human beings but also paralyzed most industries. It is very critical to diagnose COV-19 & Pneumonia (PNA) because both are having the same sign & symptoms that correlate to the most extent. The (RT-PCR) Reverse Transcription- Polymerise Chain Reaction widely used official screening method for detection of COV-19, while radio-logical imaging CT Scan (Computed Tomography) of human chests is used for detection of PNA as well as for COV-19 diagnosis also. The method for detecting COV-19 & PNA using CXR (Chest X-ray) & CT scans is too time consuming for an expert while the result accuracy is less. In this proposed project the work is based on the transfer learning model utilizing the Deep learning module for COV-19 & PNA solicitation from radiological images of the patient suffering from PNA & COV-19 which plays critical role in early detection & classification of COV-19 & PNA. In the present work multi-model deep learning modules are used for the image detection are as follows: DenseNet 121, MobileNet, Inception V3, ResNet 50, & VGG 16. In this study, the data set contains X-Ray & CT-Scan Images which had been collected from CORD-19 & PNA Data sets. To evaluate the effect of dataset size based on the performance of multi-modal deep learning modules, to train the proposed module of deep learning using both the original & augmented dataset, the result were quite promising for DenseNet-121 for CT Scan with 97% accuracy while VGG 16 for CXR images with 99% accuracy. © 2022 IEEE.
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The present study aims to assess the life expectancy at birth (LEB) of the fifteen major states in India and verify for the regional disparity in LEB over the study period. An analysis of secondary data on LEB is performed. The coefficient of variation (CV) of LEB across states is estimated to examine sigma-convergence and absolute convergence is assessed by means of ordinary least square (OLS) technique. Gini Coefficient is also used to measure the change in regional inequality in LEB over the time period. A technique of estimating divergence reduction is employed to assess the accomplishment of states on the LEB indicator. The sigma and absolute convergence estimation reveals that India is experiencing continuous gains in life expectancy and regional divide in LEB has reduced over the years. But a regional gap still remains. A variation in life expectancy is mostly caused by differences in the social determinants of health viz. potable water, medical care, sanitation, hygiene. The states which are aiming at improving LEB should focus on non-clinical measures as well to enhance the life span of individuals and also to reduce the burden on health infrastructure. The health policy design and implementation should also be designed in creating health rather than purely focused on curing illness. A pandemic like the coronavirus disease (COVID -19) has urged a new way of looking at health;beyond pharmaceutical measures. Social, meditative and technology based intervention can help in improving the life expectancy and other health indicators.
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We train a deep learning algorithm to flag potential covid-19 infected in chest x-rays. The deep learning algorithm used is a Convolutional Neural Network that is 121 layers deep. Due to the lack of a large open-source of covid-19 infected x-ray images, we combine data from five different sources. Combined, the dataset has 17,194 images that are used for training procedure. The model classifies a given chest X-ray image as either a "Normal", "Covid-19", or a 'Pneumonia"infection. The trained model has a 0.93 F1 Score and 93.496% accuracy. © 2022 IEEE.
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Several COVID-19 vaccines have been developed and approved for use around the world from December 2020, to combat the pandemic caused by the novel SARS-CoV-2 virus. Several ophthalmic manifestations of the COVID-19 vaccines have been reported by ophthalmologists. This review was undertaken to recognize, encourage active reporting and determine the pathogenesis and time of appearance for better awareness and understanding of the ophthalmic manifestations of COVID-19 vaccines. A literature search was performed for publications on the ophthalmic manifestations of COVID-19 vaccines between January 1, 2021 and November 7, 2021. 23 case reports, 17 letters to editors, 3 ophthalmic images, 4 brief communications, 4 retrospective cohort studies and 2 case control studies were included. Posterior segment, including the uvea, choroid and retinal vasculature, was most commonly affected and the reported clinical features developed at a median of four days from the time of vaccination. The possible mechanisms include molecular mimicry of the vaccine components with host ocular tissues, antigen-specific cell and antibody-mediated hypersensitivity reactions to viral antigens and adjuvants present in the vaccines. The causal relationship of the ocular signs and symptoms and COVID-19 vaccines has not been established and requires long-term and large multicentre data. Most of the reported manifestations are mild, transient and adequately treated when diagnosed and managed early. The benefits of COVID-19 vaccination outweighs the reported rare adverse events and should not be a deterrent to vaccination. © 2022 by the Author(s).
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Introduction: While managing COVID-19 patients, the healthcare professionals are at higher risk for contracting the infection and also could be a potential source of transmitting the disease in the community unknowingly. Therefore awareness [knowledge, attitude, and practice (KAP)] among healthcare professionals becomes of utmost importance. Methods: We conducted this observational cross sectional study to evaluate the knowledge, attitude and perceived practices toward COVID-19 among HCWs using a self-administered questionnaire at tertiary level healthcare facility in western Rajasthan. The questionnaire was shared with all the healthcare professionals of the pre identified tertiary care facilities through electronic mail (e-mail) and the responses received were recorded and analyzed. Results: A total of 59 responses were recorded. Out of the total participants, 61% were aware of national COVID-19 helpline numbers, 54.2% answered correctly about Hydroxychloroquine prophylaxis, 13.6% answered appropriately on COVID-19 testing. Almost 96.6% acknowledged to wear a medical mask however only 55.9% participants answered correctly regarding using a face mask. 52.5% responded that ash collection as a ritual may be allowed after funeral (cremation) of the body of a COVID-19 patient. More than 90% of participants acknowledged to clean their hands > 6-10 times in a day. 72.9% of participants admitted to open the MoHFW website to keep themselves updated on COVID-19 in India and 66.1% have 'Aarogya Setu' application in their mobile phone. However only 23.7% have ever used central helpline number or email-ID to get information on COVID-19. Conlcusion: We concluded that healthcare professionals were aware of the management strategies and treatment protocol however there is significant differences in the KAP of HCW sub groups. It also becomes important to study the KAP in various other populations (general populations, close contacts of COVID-19 etc.) for planning effective intervention strategies for them.
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Computed Tomography has played a vital role in Coronavirus Disease 2019 (COVID-19) infection, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) over the last two years. The typical features of COVID-19 on High Resolution Computed Tomography (HRCT) of chest including ground glass opacities and consolidation with a peripheral and lower lobar predilection have been very well documented in literature worldwide. However, thin-walled lucencies in the lung parenchyma called cysts is not very well documented. Authors thus present a case series comprising six SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction (RT-PCR) positive patients admitted to the hospital during the period 1stApril 2021 to 31stMay 2021 with lung cysts on HRCT. It was a retrospective study wherein details of the patients were drawn from the case record sheets and the clinical parameters along with HRCT chest findings were analysed, and correlations were drawn to study the cause, timing and significance of these cysts. In this study, the cysts were found to be thin-walled, varying in size from 5-20 mm in diameter and subpleural in distribution with no obvious lobar predilection.The immediately surrounding lung parenchyma showed features of maximal involvement by the atypical pneumonitis. All six cases had moderate to severe lung involvement entailing oxygen therapy. The high flow oxygen therapy and its duration along with degree of lung involvement, are important determinants of cystic degeneration. In the present case series, cystic changes were observed somewhere between day 15 to day 40 of the disease and thus a part of postacute fibrosis in COVID-19 infection.