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The unprecedented surge of Disease occurred in 2019, December named under covid-19, also known as corona-virus, was responsible for outbreaks happening in 2019-2020. It was first diagnosed in Wuhan, Hubei Province in the country China. Coronavirus is phenotypically and genotypically diverse in its behavior. Further, confirmed worldwide cases on April 6, 2020, consisting of 12,11,214 cases reported to the World Health Organization (WHO). The reverse-Transcript-Ase polymer-Ase chain reaction (RT-PCR) is the common solution utilized in the recognition of coronavirus, which has been found to be time-consuming and troublesome. On February 14, 2020, the laboratory-confirmed cases were 49,053 and deaths including 1,381 were documented. As of August 12, 2020, the virus has afflicted the lives of 20,674,903 people. It shows that deadly diseases are surging, plunging, and scattering illiberally in the current world. In accordance with the World Health Organization (WHO), over and above, 30 peculiar diseases like SARS coronavirus (SARS-COV), MERS coronavirus (MERS-COV), and H1N1 influenza, etc., have been diagnosed in previous twenty years to affect the health fitness situation of billions of people. The prime objective of this article is to make a review paper with artificial intelligence as a primary objective. It takes all the research to draw the comparative analyses of the distinct characteristics of data, mainly x-ray images of the chest, providing technologies and approaches to detect and prognosis coronavirus with learning algorithms. With the aim of finding the best-suited model, we compared the research on the basis of essential factors such as size of the batch , rate of learning, summed epochs till which it runs, and nature of optimizer. © 2022 IEEE.
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Introduction: Studies have linked lower vitamin D levels with cardiovascular disease (CVD) and mortality in general population and chronic kidney disease (CKD). The preliminary evidence of vitamin D supplementation is encouraging but there is a huge void with respect to good quality long term data supporting the use of this promising intervention for translation into better outcomes for CVD in CKD. This study is exploring the effect of cholecalciferol supplementation on cardiovascular disease, markers of inflammation and bone metabolism in CKD. We present the baseline characteristics of feasibility phase of the trial. Methods: The study is a multicentric, prospective, randomized, placebo controlled, double blind trial in two parallel groups and feasibility phase is being done at Postgraduate Institute of Medical Education and Research, Chandigarh, India. The trial is registered at Clinical Trials Registry of India (CTRI/2019/05/019211). After a run-in period of 2 weeks, the enrolled subjects are randomized in 1:1 to receive either 60,000 IU/2 weeks of cholecalciferol or matching placebo. The subjects will be then followed up every three month till 3 years. The primary outcome of the study is a composite of major adverse cardiac events (MACE). Secondary outcome measures include all-cause mortality, need of RRT, change in hsCRP, IL-6, iPTH, FGF-23, bone specific alkaline phosphatase, and CTX-1. Results: A total of 720 subjects have been screened till date. Out of 119 enrolled, 86 subjects have been randomized over 24 months period. 76% subjects have completed annual follow up at 12 months, 66% subjects - 15thmonths follow up, 40%- 18 months follow up, 26% subjects - 21 months follow up, 6% subjects – 24 months follow up. Baseline characteristics and serum biomarkers levels has been analysed in 80 subjects. Mean age of the subjects were 51.3 ± 12.2 years and 58.8 % were males. Serum haemoglobin levels were 11.6 ±1.7 g/dl. Mean eGFR was 26.3 (17.4, 35.1) ml/min/1.73m2. Outcome events were;MACE: 1 (due to CVD), death other than due to MACE: 1 (due to COVID 19), subjects with composite of all-cause death and non-fatal MACE: 2, subject with need of RRT:1 and subjects with composite of 50% decline in GFR or need of RRT: 3. 2 serious adverse events unrelated to study drug were reported during the course of study. Table: Baseline levels of various serum biomarkers [Formula presented] Conclusions: Despite COVID 19 related restrictions being in place for most of the last 18 months, the study has been able to screen and enrol participants. The follow ups have been ensured either through physical or remote (mobile/telephonic) means. Once in the multi-centric phase, the study will be able to test a relatively inexpensive intervention in the form of vitamin D supplementation for CVD in CKD. No conflict of interest
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Introduction: Short term studies have shown that vitamin D supplementation may favorably influence vascular function, inflammation and bone metabolism in CKD. There are no long-term studies that have looked at hard clinical end points in this regard. This study will explore the effect of cholecalciferol supplementation on cardiovascular disease, markers of inflammation and bone metabolism in CKD. We present the design and results of initial pilot phase of the proposed clinical trial. Methods: The study is a multicenter, prospective, randomized, placebo-controlled, double blind trial in two parallel groups. After a run-in-phase of 2 weeks, the enrolled patients are randomized in 1:1 ratio to receive cholecalciferol or matching placebo. Cholecalciferol is given at the dosage of 60,000 IU/2 weeks. The patients will be followed up at 3, 6, 9, 12, 24 and 36 months after enrolment. All clinical events and hospitalizations during the course of the study will be recorded. Primary outcome is a composite of Major Adverse Cardiovascular Events (MACE) that includes new onset heart failure, coronary heart disease, peripheral vascular disease, cerebrovascular accident, any coronary or peripheral arterial revascularization procedure and death due to cardiovascular disease. Secondary outcomes include all-cause mortality, need for renal replacement therapy, change in hsCRP and IL-6, change in iPTH, FGF-23, bone specific alkaline phosphatase and CTX-1. The feasibility phase is currently being run at PGIMER, Chandigarh, India. Serum levels of 25(OH)D, calcium, and iPTH will be checked at every scheduled follow up visit. The concurrent clinical care will continue as per prevailing standards of care. We plan to enroll 1244 patients (622 in each group) across 11 centers. The trial is registered at Clinical Trials Registry of India (CTRI/2019/05/019211). Results: Till date, 340 patients have been screened for enrolment. 61 have been successfully randomized;their baseline samples have been collected and stored, and drugs have been dispensed to them. Till now, 30 patients have completed their 3 months follow up with 6 subjects having completed 6 months follow up as well. Figure 1 depicts the conduct of study so far. Table 1 shows the baseline characteristics of the study population. Though delayed due to ongoing COVID 19, the study has fulfilled the pre-specified feasibility criteria of recruitment of >50% eligible subjects (achieved 94.9%), recruitment rate of ≥7 subjects per month (achieved 8.7 subjects per month) and ≤25% overall subject withdrawal rate (subject withdrawal rate 10.63%). [Formula presented] [Formula presented] Conclusions: The study has achieved pre specified feasibility criteria. In the multi-centric phase, the study will set the stage for testing a relatively inexpensive intervention in the form of vitamin D supplementation for CVD in CKD. Conflict of Interest: The study is funded by Department of Biotechnology, Government of India under a grant to Dr Vivek Kumar (sanction order No BT/PR29764/PFN/20/1417/2018).
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INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has affected the care of patients with noncommunicable diseases, including those suffering from kidney-related ailments. Many parts of the world, including India, adopted lockdown to curb community transmission of disease. The lockdown affected transportation, access to health care facilities, and availability of medicines and consumables as well as outpatient and inpatient services. We aimed to analyze the effect of lockdown imposed due to the COVID-19 pandemic on the care of patients with kidney diseases in India. METHODS: We surveyed 19 major hospitals (8 in the public and 11 in the private sector) to determine the effect of lockdown on the care of patients with kidney disease, including those on dialysis after the first 3 weeks of lockdown. RESULTS: The total number of dialysis patients in these centers came down from 2517 to 2404. Approximately 710 (28.2%) patients missed 1 or more dialysis sessions, 69 (2.74%) required emergency dialysis sessions, 104 (4.13%) stopped reporting for dialysis, and 9 (0.36%) were confirmed to have died. Outpatient attendance in the surveyed hospital came down by 92.3%, and inpatient service reduced by 61%. Tele-consultation was started but was accessed by only a small number of patients. CONCLUSION: Lack of preparedness before lockdown resulted in an interruption in health care services and posed an immediate adverse effect on the outcome of dialysis patients and patients with kidney disease in India. The long-term impact on the health of patients with less severe forms of kidney disease remains unknown.