IOT Based Temperature and Oxygen Pulse Scan Entry System

In this project the system has been designed in the manner to detect the body temperature and oxygen saturation level (SpO2) of the person. To detect the body temperature and oxygen pulses we are using the respective sensors. The sensors we are using in this project is MLX90614 ESF thermometer and MAX30100 is integrated with the pulse oximeter. Here we have used the two Node MCU (ESP 32) for the different sensors, one Node MCU is connected to the temperature sensor and another Node MCU is connected to the pulse oximeter. The components we are using in this project is Eco friendly. The software we are using in this project is ARDUINO UNO R3 IDE (Integrated development board) and To show the results we are making use of Blynk app. The maximum errors we get in this project is about 2%. When it comes to health monitoring, it has shown the good results. This is the best way to minimize the spread of the COVID-19. It is a low cost and high functionality which makes it use in the different places like Hospitals, Malls, Sports etc. © 2022 IEEE.

Nasal Drug Delivery In Ayurveda: A Narrative Review

Ayurveda is the ancient medical system in India that uses nasal therapy. During COVID -19 pandemic, the ministry of AYUSH provided guidelines to boost immunity. The Nasya (nasal delivery) was one of the recommendations by the AYUSH ministry to boost immunity. Nasya has been still in practice for various ailments like chronic rhinitis, headache, cervical spondylosis, Dyspnea, etc., but the knowledge about how Nasya works is still unclear. This review article discusses the practice and current advances in nasal delivery in modern science. It also discusses the possible mechanism of how Nasya can act and boost immunity and what research can be done in the form of clinical and experimental studies to increase the knowledge and understanding of Nasya. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Bilateral persistent placoid maculopathy following COVID-19 Vaccines: real or co-incidence?

Purpose : COVID-19 vaccination has been accompanied by reports of inflammatory events. We aim to report the first case of bilateral persistent placoid maculopathy (PPM) following COVID-19 vaccination. Methods : Case report Results : A 58-year-old man presented with bilateral sudden painless decrease in vision approximately two weeks after the second dose of AstraZenaca® COVID-19 vaccine. Visual acuity (VA) at presentation was 1.00 LogMAR in the right eye (RE) and hand movement in the left eye (LE). He had no known medical or ophthalmic history, up until after his first AstraZenaca® COVID-19 vaccine dose, he was diagnosed with palmoplantar pustular psoriasis and was started on 60mg of oral Prednisolone. Fundus examination revealed bilateral well-delineated whitish plaque-like macular lesions involving the fovea, sparing the peripapillary region in the RE (Figure 1a & e). Multimodal imaging including fluorescein angiography, indocyanine-green angiography, fundus autofluorescence and optical coherence tomography were consistent with PPM (Figure 1 & 2). Infective and auto-immune screen were all negative apart from a positive MPO-ANCA, prompting a rheumatology review which subsequently excluded any systemic vasculitis. Patient was monitored closely and his VA improved and stabilised with tapering regime of oral Prednisolone. To prevent relapse of PPM, patient was commenced on Mycophenolate Mofetil as a long-term steroid sparing immunosuppression. Conclusions : Our case demonstrated a likely inflammatory or autoimmune response affecting choriocapillaris driven by the COVID-19 vaccine and there may be a correlation between the two. The patient in our case portrayed features classical of PPM, which is a selective autoimmune vasculitis causing microinfarcts on choriocapillaris, resulting in focal choroidal hypoperfusion after the COVID-19 vaccine. (Figure Presented).

Phase 1 clinical trial for intravenous administration of mesenchymal stem cells derived from umbilical cord and placenta in patients with moderate COVID-19 virus pneumonia: results of stage 1 of the study

Objective: Mesenchymal stem cells can serve as a therapeutic option for COVID-19. Their immunomodula-tory and anti-inflammatory properties can regulate the exaggerated inflammatory response and promote recovery of lung damage. Method: Phase-1, single-centre open-label, prospective clinical trial was conducted to evaluate the safety and efficacy of intravenous administration of mesenchymal stem cells derived from umbilical cord and placenta in moderate COVID-19. The study was done in 2 stages with total 20 patients. Herein, the results of stage 1 including first 10 patients receiving 100 million cells on day 1 and 4 with a follow up of 6 months have been discussed. Results: No adverse events were recorded immediately after the administration of MSCs or on follow up. There was no deterioration observed in clinical, laboratory and radiological parameters. All symptoms of the study group resolved within 10 days. Levels of inflammatory biomarkers such as NLR, CRP, IL6, ferritin and D-dimer improved in all patients after intervention along with improved oxygenation demonstrated by improvement in the SpO2/FiO2 ratio and PaO2/FiO2 ratio. None of the patients progressed to severe stage. 9 out of 10 patients were discharged within 9 days of their admission. Improvements were noted in chest x-ray and chest CT scan scores at day 7 in most patients. No post-covid fibrosis was observed on chest CT 28 days after intervention and Chest X ray after 6 months of the intervention. Conclusion: Administration of 100 million mesenchymal stem cells in combina-tion with standard treatment was found to be safe and resulted in prevention of the cytokine storm, halting of the disease progression and acceleration of recovery in moderate COVID-19. This clinical trial has been registered with the Clinical Trial Registry-India (CTRI) as CTRI/2020/08/027043. http://www.ctri.nic.in/Clinicaltrials/pmaindet2. php?trialid=43175.

Automatic COVID-19 Detection from Chest X-Rays using Deep Learning Techniques

COVID-19 emerged in November 2019 in the Wuhan city of China. Since then, it has expanded exponentially and reached every corner of the world. To date, it has infected more than three hundred eighty-five million people and caused more than five million seven hundred deaths. Traditional COVID-19 diagnostic tests lack sensitivity and result in false-negative reports several times. Using X-Rays and CT scans to detect covid-19 can aid the diagnosis process when powered by deep learning techniques. Using deep learning will provide accurate results in a fast and automatic manner. The proposed research work has performed a total of twenty-eight experiments. This research work has experimented with seven different Deep Learning models including, DenseNet201, MobileNetV2, DenseNet121, VGG16, VGG19, InceptionV3, and ResNet50. The performance of each model is tested based on the distinct image enhancement techniques. The four different experiments include raw data, data preprocessed with gamma correction for two different gamma values (0.7 and 1.2), and Contrast Limited Adaptive Histogram Equalization (CLAHE). Gamma Correction with gamma value 1.2 performed the best. Lastly, this research work has created an ensemble of three best-performing algorithms including, DenseNet201, MobileNetV2, DenseNet121, and achieved an accuracy, precision, recall, f1 score, and AUC of 98.34%, 98.61%, 98.78%, 98.2%, and 99.8%, respectively. © 2022 IEEE.

AN IN VITRO ANTIBACTERIAL STUDY OF NIMBADI ARKA: A NON-ALCOHOL BASED HERBAL HAND SANITIZER

Hand hygiene is crucial as it gets contaminated easily from direct contact with airborne microorganism droplets and droplet nuclei from coughs and sneezes. In situations like a pandemic outbreak of COVID-19, it is imperative to interrupt the transmission chain of the pathogens by the practice of proper hand sanitization. It can be achieved with contact isolation and strict infection control tools like maintaining good hand hygiene in the house, in hospital settings, and in public. The success of hand sanitization solely depends on practical hand disinfecting agents formulated in various types and forms, such as antimicrobial soaps and water-based or alcohol-based hand sanitiser, with the latter being widely used in hospital settings and by common people. Most effective hand sanitiser products are alcohol-based formulations containing 62%–95% of alcohol as they can denature the proteins of microbes and the ability to inactivate pathogens. Considering the need, we prepared five herbal hand sanitizers in Arka form using drugs of krimighna gana dravyas that have an antimicrobial property and are volatile. Among all the five preparations, it was noticed from the statistical analysis, that there was a significant reduction in the bacterial count in the ‘immediate application’ of Batch I (Tulsi Arka), and Batch II (Tulsi, Nimba Arka) showed a significant decrease in the bacterial count in ‘after 30 minutes of application’. However, Batch III (Tulsi, Nimba, Haridra arka) gave an intermediate result in ‘immediate application’ and ‘after 30 minutes of application’. None of the preparations showed any sort of irritation, dryness or discomfort to the subjects even after 30 minutes while conducting the study.

Impact of the COVID-19 Pandemic on Bedside Medical Education: A Mixed-Methods Study

Background. The COVID-19 pandemic obligated academic medical programs to substantially alter the traditional Internal Medicine (IM) rounding model to decrease risk of inpatient nosocomial viral transmission. Our study aimed to describe how IM rounding practices changed during the COVID-19 pandemic and to understand the impacts of these changes on medical education. Methods. We conducted a two-phase, mixed-methods study of inpatient IM rounding team practices at a large academic hospital in Houston, TX. In the first phase (January-February 2021), we organized and audio-recorded 4 virtual (Zoom) focus groups. Each included 5-6 rounding team members, divided by: attendings;senior residents;interns;and medical and physician assistant students. In the second phase (March-May 2021), we performed 6 direct observations of IM teams during rounds. Two observers systematically recorded variables such as time spent on non-bedside versus bedside rounds, number of each team member type entering patient rooms for bedside teaching, and types of personal protective equipment (PPE) worn. Results. Topics discussed during focus groups included comparisons of rounding team size, rounding duration, physical distancing and PPE use, bedside education, communication methods, and patient safety before and after March 2020. Perceptions of changes in each topic were generally consistent across groups (Table 1). Direct observation data showed that team rounding styles remained diverse in the proportion of rounding time spent in an office versus on the wards, and in the number and types of team members entering patient rooms. IM team members uniformly wore respiratory PPE when entering all patient rooms;use of eye protection varied. Teams spent more total time discussing patients with or suspected to have COVID-19 compared to patients without COVID-19 (median 24 min versus 13 min, p< 0.0001). Conclusion. Our results suggest that the COVID-19 pandemic adversely impacted bedside medical education, even into Spring of 2021. Conclusions from this study can be used to 1) address educational gaps related to COVID-19 pandemic-associated rounding changes and 2) create innovative methods of providing high-quality clinical education that will be minimally impacted by future respiratory virus pandemics.

Medical Student Engagement with the COVID-19 Pandemic Is Increased Through Participation in a Preclinical Elective

Background. The medical field's response to the Coronavirus Disease 2019 (COVID-19) pandemic required a multifaceted approach. Medical students were often excluded from the initial phases of pandemic response, resulting in feelings of disengagement. This study aimed to determine if offering educational experiences on current events related to the COVID-19 pandemic could increase medical students' understanding of, and engagement with, the pandemic. Methods. In Fall 2020, an elective course reviewing several aspects of the COVID-19 response was implemented. Preclinical medical students attended a discussion-based seminar series given by expert faculty on a variety of topics including pathophysiology, vaccine development, telemedicine, and others. Upon course completion, students were asked to complete a survey quantifying their understanding of the overall COVID-19 response, understanding of various individual facets of the response, and feelings of personal engagement on a Likert scale from 1-5, with 5 representing the most understanding or engagement. The differences in pre-course and post-course mean scores were compared using a Wilcoxon matched-pairs signed rank test for each question. Results. A total of 65 students completed the course;35 (54%) students filled out the final course survey. Results showed significant improvement in students' perceived holistic understanding of the pandemic response (2.67 pre-course vs. 4.36 post-course;p < 0.001), and their feelings of personal engagement (3.06 pre-course vs. 4.33 postcourse;p < 0.001). Students also reported significantly increased feelings of understanding for each individual facet of the pandemic response reviewed during the course (8 questions total, all p-values < 0.001). Conclusion. Preclinical medical student participation in a course reviewing COVID-19 pandemic response significantly increased feelings of engagement with and understanding of the medical field's response to the pandemic. Students showed improved understanding of each aspect of the pandemic response that was covered in the elective. Therefore, it appears that seminar- and discussion-based electives can be a useful tool for fostering preclinical student engagement in current events in medicine.

Black Fungus an Add on Epidemic to Cosvid-19 Pandemic

COVID-19 patients have lower immunosuppressive CD4+ T and CD8+ T cells and henceforth patients in intensive care units (ICU) need mechanical ventilation, henceforward they stay in hospitals. These patients have been exposed to advances in fungal co-infections. COVID-19 patients progress towards mucormycosis a black fungal infection that is deadly leading to loss of sight and hearing and eventually death. This article discusses the clinical manifestations, risk factors and emphases on virulence traits and management of black fungus.

Comparative analysis of the diagnostic performance of five commercial COVID-19 qRT PCR kits used in India.

To meet the unprecedented requirement of diagnostic testing for SARS-CoV-2, a large number of diagnostic kits were authorized by concerned authorities for diagnostic use within a short period of time during the initial phases of the ongoing pandemic. We undertook this study to evaluate the inter-test agreement and other key operational features of 5 such commercial kits that have been extensively used in India for routine diagnostic testing for COVID-19. The five commercial kits were evaluated, using a panel of positive and negative respiratory samples, considering the kit provided by National Institute of Virology, Indian Council of Medical Research (2019-nCoV Kit) as the reference. The positive panel comprised of individuals who fulfilled the 3 criteria of being clinically symptomatic, having history of contact with diagnosed cases and testing positive in the reference kit. The negative panel included both healthy and disease controls, the latter being drawn from individuals diagnosed with other respiratory viral infections. The same protocol of sample collection, same RNA extraction kit and same RT-PCR instrument were used for all the kits. Clinical samples were collected from a panel of 92 cases and 60 control patients, who fulfilled our inclusion criteria. The control group included equal number of healthy individuals and patients infected with other respiratory viruses (n = 30, in each group). We observed varying sensitivity and specificity among the evaluated kits, with LabGun COVID-19 RT-PCR kit showing the highest sensitivity and specificity (94% and 100% respectively), followed by TaqPath COVID-19 Combo and Allplex 2019-nCoV assays. The extent of inter-test agreement was not associated with viral loads of the samples. Poor correlation was observed between Ct values of the same genes amplified using different kits. Our findings reveal the presence of wide heterogeneity and sub-optimal inter-test agreement in the diagnostic performance of the evaluated kits and hint at the need of adopting stringent standards for fulfilling the quality assurance requirements of the COVID-19 diagnostic process.

Attitude, practices and experience of dental professionals during COVID-19 pandemic: A cross-sectional survey from Gujarat, India

Introduction: Coronavirus disease (COVID-19) is a declared public health emergency of international concern. Occupational Safety and Health Administration (OSHA) classified health-care professionals and exposure risk to coronavirus (COVID-19), identifying dental professionals in the very high-risk group due to the specificity of dental procedures and instrumentations used. Guidelines from relevant authorities suggested providing only emergency and urgent dental treatment during the pandemic which has led majority of dental practice to stop, thus instilling anxiety in the dental professionals. A study to assess the attitude, practice and experience of dental professionals from Gujarat state during the COVID-19 pandemic was planned. Materials and Methods: An online questionnaire consisting of 32 questions using Google Form was distributed to 315 dental professionals. Data obtained were analysed using the Statistical Package for the Social Sciences 22.0. Descriptive statistical analysis was used to describe variables. Chi-square test was used to find a significant association between parameters, and P < 0.05 was considered statistically significant. Results: Overall, 194 dental professionals (104 general dentists and 90 specialists) filled the questionnaire. Nearly half of the participants (49.5%) said that personal protective equipment (PPE) is uncomfortable while performing dental procedures. The majority of them (86.6%) insisted on increasing the cost of dental treatments. Regarding new practices adapted during the pandemic, 53 dental professionals (27.3%) did not find teledentistry effective in resolving the patient's problem. Only 75 dental professionals (38.7%) followed all the screening criteria for patients. Fifty-nine participants (30.4%) got the COVID-19 test for patients requiring the aerosol-generating procedure. While 125 participants (64.4%) performed aerosol-generating procedures either in urgent/emergency cases or elective cases, only 115 (59.3%) used full PPE with an appropriate mask. One hundred and thirty-seven (70.6%) of them reported a decrease in income during the pandemic, while 74 (38.1%) suffered from anxiety and depression. Conclusion: Dental health-care providers are at the highest risk of contracting COVID-19. Thus, they should execute proposed precautionary measures more diligently. Regular training and screening of dental professionals should be undertaken by state regulatory bodies. Adapting and adhering to change in work protocols by dental professionals will ensure not only their safety but also their patients. The emergence of COVID-19 has been great learning for the field of dentistry, and the dental practice is going to change for the better.

Intravenous ozonized saline therapy as prophylaxis for healthcare workers (HCWs) in a dedicated COVID-19 hospital in India - A retrospective study.

OBJECTIVE: In the current pandemic, Health Care Workers (HCWs) are at a high risk of developing COVID-19. Preventive methods like the use of personal protective equipment, isolation, social distancing, and chemoprophylaxis show limited benefit. Despite standard prophylaxis, many of the HCWs develop COVID-19. Medical ozone therapy has immunomodulatory, antioxidant and antiviral effect, and, therefore, it can be explored as prophylaxis for COVID-19. PATIENTS AND METHODS: We conducted a retrospective controlled cohort study. IV ozonized saline was administered once a day for a total of 4 days in one month in addition to standard prophylaxis for COVID-19 to HCWs in a dedicated COVID hospital. Fresh ozonized saline was prepared for every administration and was given over 1 hour. RESULTS: There were 235 HCWs, 64 received the ozone prophylaxis and 171 did not. The incidence of COVID-19 was significantly (p=0.04) lesser in HCWs that received ozone prophylaxis (4.6%) as compared to those who did not (14.03%). The benefit was seen irrespective of the risk of exposure. In the red zone, 8.69% of the HCWs who received ozone prophylaxis tested positive as opposed to 15.3% of those who did not. In the orange zone, 4.34% of the HCWs who received ozone prophylaxis tested positive, remarkably lesser than those who did not (20%). In the green zone, none of the HCWs who received ozone prophylaxis tested positive; however, 3.4% of the HCWs who did not receive ozone prophylaxis tested positive. No major adverse events were noted. CONCLUSIONS: IV ozonized saline can be used in addition to the standard prophylactic regimen for the prevention of COVID-19 in HCWs. Prospective larger studies are required to establish the potency of IV ozonized saline as prophylaxis.

Role of medical institution amidst the crisis: Sustaining the academic milieu and contributing to components of COVID-19 pandemic response

In early March 2020, the whole world was startled due to the COVID-19 pandemic. Amidst the crisis, a private medical college relentlessly worked toward sustaining the academic momentum and contributing to the mitigation of COVID-19. The areas of involvement were as broad as it had its roots. Educating the larger public through schools, colleges, and primary health-care centers was initiated. The hospital was operationally segregated into COVID and non-COVID zones. The screening centers and isolation wards were made operational. The health-care personnel were trained and motivated. The outreach and public health activities were in tandem with district health priorities, namely mass screening, health system strengthening at district COVID hospital, answering public queries, panel discussions, webinars, and TV shows. Apart from these activities, teaching and learning went on, as usual, using online platforms. Research, innovations, and publications were accomplished without interruption.

Impact of COVID-19 pandemic on the dimensions of health and well-being: Time to widen our gaze

Novel coronavirus disease termed as nCOVID-19 by the World Health Organization has posed serious threat to the health and well-being of humankind. The pandemic has caused unprecedented disruption of life and impacted almost all the sections of the society. Health-related emergencies and urgencies due to COVID-19 have drawn major attention of all the stakeholders involved in ensuring the well-being of the society. On the other hand, the pandemic has impacted the mental, emotional, social, educational, nutritional, and vocational dimensions of health. Nationwide lockdown, a measure taken toward achieving social distancing, thereby flattening the curve has resulted in a rise of mental health issues, emotional disturbances, migrant exodus, poverty, deficient food supply, hunger, academic stagnation, learning crisis, unemployment, and job insecurities among people. All these problems have the potential to impact the health and well-being of the society in the long run and hamper the attainment of sustainable development goals.

COVID-19 infodemic: Unveiling the root causes through public perspectives

INTRODUCTION: The novel coronavirus pandemic raises great concern due to its spread and collateral effects on the society. Nearly 30,000 cases are reported from India by the beginning of May 2020. The current pandemic is associated with a sudden surge of false information termed as infodemic. This study attempts to understand the root causes of COVID-19 infodemic. METHODS: This cross-sectional online study was conducted from April 20, 2020, to April 30, 2020, to collect information on the possible causes of COVID-19 infodemic. A fishbone diagram was developed from the data through iterative process to illustrate the root causes of the infodemic. RESULTS: The total of 179 people responded to the online survey. Among them, 99 were health-care professionals and 75 were representatives of the general public. The mean age of the respondents was 28.93 +/- 9.99 years. The root causes for the COVID-19 infodemic were classified into five domains, namely, social media-associated causes, behavioral aspects, the novelty of the virus and related challenges, causes due to lacunae in policies and health systems, and difficulties in the verification of information. CONCLUSION: A comprehensive action plan has to be developed to contain the infodemic through adequate education of all stakeholders, warnings and legal actions, improvements in policy and health systems. The authorities should brainstorm to design activities that contain the spread of false information through social media at the origin itself.

Continuing Cancer Treatment in a "COVID HOTSPOT" in India: Are We Overestimating the Risks?

Context: We describe the treatment of cancer patients carried out in a Government of India-designated, dedicated coronavirus disease (COVID) hospital (DCH) in a COVID hotspot in India. Aims: The aim was to study the change and delay in the management of cancer patients during the pandemic and its complications. Settings and Design: This was an observational cohort study conducted at a tertiary care center, which was also a DCH. Subjects and Methods: Cancer patients receiving cancer surgery, chemotherapy, and radiotherapy in our DCH, during the lockdown, were studied. Results: A total of 864 patients received treatment for cancer in our hospital during the period of March 20, 2020 - May 31, 2020. There were no COVID-related complications. The treatment of 109/864 patients (12.61%) was delayed due to the pandemic and lockdown situation and the treatment plan was changed for 84/864 (9.72%) patients. There were 21 deaths in these 864 patients (2.43%), but only two deaths were COVID related. Symptomatic patients were tested for COVID, and 3/864 patients (0.34%) were detected to be COVID positive. Conclusions: We successfully delivered cancer treatment to patients in our DCH. The percentage of adverse effects, symptomatic COVID infection, and related mortality has been very low in our study. Cancer care can be continued with due diligence even during this pandemic.

DNet: An efficient privacy-preserving distributed learning framework for healthcare systems

Medical data held in silos by institutions, makes it challenging to predict new trends and gain insights, as, sharing individual data leaks user privacy and is restricted by law. Meanwhile, the Federated Learning framework [11] would solve this problem by facilitating on-device training while preserving privacy. However, the presence of a central server has its inherent problems, including a single point of failure and trust. Moreover, data may be prone to inference attacks. This paper presents a Distributed Net algorithm called DNet to address these issues posing its own set of challenges in terms of high communication latency, performance, and efficiency. Four different networks have been discussed and compared for computation, latency, and precision. Empirical analysis has been performed over Chest X-ray Images and COVID-19 dataset. The theoretical analysis proves our claim that the algorithm has a lower communication latency and provides an upper bound. © Springer Nature Switzerland AG 2021.

Covid-19-infodemic overtaking pandemic? Time to disseminate facts over fear

Coronavirus (COVID-19) is a humanitarian emergency. World Health Organization (WHO) and National Governments are making their best efforts to prevent the spread of disease. But a global epidemic of misinformation which is rapidly spreading through social media platforms and other outlets is posing serious problem to the public health interventions. This rapid spread of all sorts of information pertaining to the epidemic which makes its solution difficult is termed as infodemic. Infodemic creates fear, confusion and stigmatization among people and makes them more vulnerable to practice the measures which are not evidence based and scientifically sound. Hence there is an urgent need to identify the source of misinformation and prevent them from further spreading. WHO and the government of India have taken several steps in controlling this problem but there is a need for active involvement of social media companies, professional bodies, health care providers and general public in identification of misinformation and combating its spread. © 2020, Indian Association of Preventive and Social Medicine. All rights reserved.