Quality of Life in Mucormycosis Patients Post Discharge: A Pilot Study Using a New MQOL-36 Questionairre.

To evaluate the Quality of Life in Mucormycosis patients in our hospital using a new MQOL36 questionnaire post discharge. 37 cases between Apr 2021 to July 2021 were included in the study with a minimum follow up period of 4 weeks. They were administered Mucormycosis quality-of-life questionnaire (MQOL-36) either in person or via telephonic interview and answers were recorded into digital questionnaire modulated by us using a digital data recording app-KoBoCollect. Their demographic, clinical, imaging, histopathological and treatment data was retrieved and analysed. Most of the patients reported their health to be good with only 1 patient who had extensive cranial involvement reporting as poor and still undergoing repeated surgeries. 46.67% had no nasal complaints, 20% had nasal obstruction, 13.33% had nasal discharge with 2 patients complaining of crusting and 1 of whistling sound at quiet respiration. Most worrying factor was financial condition with 33.33% patients financially distraught and 43.33% being affected but barely managing at present. Only 2 patients reported no economic impact. Mucormycosis in COVID-19 has changed the face of otorhinolaryngology as we know it-while treating the disease is important, treating the post operative aftermath also becomes equally important. The MQOL-36 produces a quality-of-life profile scoring an individual's perception of quality of life in the following domains: Physical, Psychological, Level of Independence, Social Relationships and Environment. Monitoring the quality of life in patients post discharge could help us manage the enormous morbidity associated with the disease.

Demystifying quantum blockchain for healthcare

The healthcare industry and the battle against the COVID‐19 pandemic are two areas where blockchain technology might be useful. In this study, blockchain's significance is examined. Blockchain technology and related procedures will be used in future healthcare systems for collecting sensor data, automated patient monitoring, and safe data storage. Because it can store a large amount of data in a dispersed and secure way and provide access whenever and wherever it is needed, this technology greatly simplifies the process of carrying out activities. The advantages of quantum computing, such as the speed with which patients can be found and monitored, may be fully used with the help of quantum blockchain. Quantum blockchain is an additional resource that may be used to safeguard the veracity, integrity, and availability of stored information. Combining quantum computing with blockchain technology may allow faster and more secure medical information processing. In this research, the authors examine the potential uses of blockchain and quantum technology in the healthcare industry. Quantum technologies, blockchain‐based technologies, and other cutting‐edge ICTs (such as ratification intelligence, machine learning, drones, and so on) were investigated and contrasted in this article. [ FROM AUTHOR] Copyright of Security & Privacy is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID 19 Associated Mucormycosis: Preventable Risk Factors Leading to a Better Prognosis: A Case Series.

India was severely affected by the second wave of coronavirus disease (COVID­19), leading to sudden expansive spread of Mucormycosis, presenting with sinusitis, blackish mucus secretions, discolouration of palate, facial pain, swelling and blurring of vision. Hyperglycemia, hypercoagulable state and elevated levels of serum ferritin were the major contributing factors in progression of the deadly disease. To highlight the correlation between Diabetes Mellitus, hyperferritenimia and elevated levels of D-Dimer with increased rate of incidence and poor prognosis of the disease. This study was undertaken in KLES Dr Prabhakar Kore Hospital & MRC, Belagavi, including 30 patients, between April to July 2021. Serum ferritin, HbA1C and D-Dimer were evaluated for patients on admission, along with the other routine blood investigations. The mean age was 50 years (49.99 ± 1.8), with a male predominance of 83.33% (25 Male patients). 93.33% patients had uncontrolled Diabetes Mellitus with a mean value of 10.12% (± 0.37) indicating Diabetes Mellitus to be the prime risk factor. The raised levels of serum ferritin with a mean of 662.01 ng/ml (± 129.18) and high levels of D-Dimer (Mean- 761.33 ± 151.8 ng/ml) also demonstrated their role as interlinked factors. Mucor epidemic was caused by convergence of interlinked risk factors. Awareness of red flag clinical features, prompt diagnosis, early initiation of treatment with amphotericin-B with aggressive surgical debridement are essential for successful outcome, to avoid high rate of mortality and morbidity rates in the mucormycosis patients.

Are Low Serum Vitamin D Levels a Risk Factor for Advent of COVID-19 Associated Rhinocerebral Mucormycosis: A Preliminary Case Control Study.

To determine whether low serum vitamin D level is a risk factor for development of Rhinocerebral mucormycosis in COVID-19 afflicted patients. A case control study was conducted in a tertiary care hospital utilizing the archived records of COVID-19 afflicted Rhinocerebral mucormycosis cases and age and gender matched controls. The mean value (± standard deviation) of vitamin D level in patients with Mucormycosis was 19.65 ± 13.07 ng/ml and in control subjects it was 27.88 ± 18.04 ng/ml.There was a significant difference between groups (p = 0.02). Thus, low Vitamin D level may be implicated as a risk factor for the advent of mucormycosis in a COVID-19 afflicted patient and therefore Vitamin D supplements may be provided to such patients to achieve normal serum levels.

Single-center Haemodialysis Experience in India During COVID-19.

Introduction: Since COVID-19 has been announced as a pandemic, outcome of dialysis patients in terms of morbidity and mortality from India is lacking. We studied the clinical, epidemiological features of COVID-19 along with outcome in terms of mortality in our dialysis cohort. Methods: Data of End-Stage Kidney Disease (ESKD) patients who were admitted in COVID-19 designated hospital block as positive and suspected patients from 1st April 2020 to 31st July 2020 was retrieved. Data about epidemiological characteristics, clinical features, mortality outcomes of COVID-19 positive and negative patients were analyzed. Results: A total of 97 ESKD patients were admitted during the study period, of which 44 (45.4%) and 53 (54.6%) patients were found to be COVID-19 positive and negative respectively. The mean age of COVID positive patients was 46 years with 54.5% being female. Only three patients (6.8%) remained asymptomatic throughout the course of illness. Amongst COVID-19 positive, 20 (45.45%) were severely ill while 18 (40.9%) were having mild illnesses. Breathlessness (65.9%) and fever (61.4%) were common symptoms. The death occurred in 17 (38.6%) and 25 (47.1%) COVID-19 positive and negative ESKD patients respectively. 14 (82.3%) patients who expired amongst COVID-19 positive were having severe illness and significantly more were associated with negligible residual renal function. Conclusions: Breathlessness and fever were common symptoms amongst COVID-19 ESKD patients. Very few patients remained asymptomatic in our cohort and significantly more mortality is observed in severely ill patients and those with negligible residual renal function.

Knowledge, attitudes, and beliefs among dental students and faculty members regarding COVID-19 Vaccines in Dental Colleges of Haryana, India - A cross-sectional study.

Aim: To assess knowledge, attitudes, and beliefs among dental students and faculty members regarding COVID-19 vaccines in dental colleges in Haryana, India. Objectives: To assess knowledge level, attitudes, and beliefs differences among BDS, MDS students and faculty members and find association between knowledge and COVID-19 vaccine inoculation among study participants. Materials and Methods: A cross-sectional study was carried out among students and faculty members of dental colleges in Haryana, India. Data collection was done via an online questionnaire based on questions to assess the knowledge, attitude and beliefs regarding COVID-19 vaccines. Results: The present study comprised of 270 study participants, where majority, i.e., 81.5% have reported COVID-19 vaccine inoculation. The mean knowledge score of the participants was reported to be 5.54 ± 2.19. A significant difference was found in the mean knowledge score of faculty members (7.81 ± 1.69), MDS (6.72 ± 1.49), and BDS (4.39 ± 1.68) students. COVID-19 vaccine inoculation was found to be significantly associated with average knowledge score of participants (OR = 6.1, P < 0.01). Conclusion: Dental professionals have an adequate degree of knowledge and attitude level regarding COVID-19 vaccines and are generally optimistic about resolving the pandemic situation with the immunization.

Current insights and molecular docking studies of the drugs under clinical trial as rdrp inhibitors in COVID-19 treatment.

Study background & Objective: After the influenza pandemic (1918), COVID-19 was declared a Vth pandemic by the WHO in 2020. SARS-CoV-2 is an RNA-enveloped single-stranded virus. Based on the structure and life cycle, Protease (3CLpro), rdrp, ACE2, IL-6, and TMPRSS2 are the major targets for drug development against COVID-19. Pre-existing several drugs (FDA-approved) are used to inhibit the above targets in different diseases. In coronavirus treatment, these drugs are also in different clinical trial stages. Remdesivir (rdrp inhibitor) is the only FDA-approved medicine for coronavirus treatment. In the present study, by using the drug repurposing strategy, 70 preexisting clinical or under clinical trial molecules were used in scrutiny for rdrp inhibitor potent molecules in coronavirus treatment being surveyed via docking studies. Molecular simulation studies further confirmed the binding mechanism and stability of the most potent compounds. MATERIAL AND METHODS: Docking studies were performed using the Maestro 12.9 module of Schrodinger software over 70 molecules with rdrp as the target and remdesivir as the standard drug and further confirmed by simulation studies. RESULTS: The docking studies showed that many HIV protease inhibitors demonstrated remarkable binding interactions with the target rdrp. Protease inhibitors such as lopinavir and ritonavir are effective. Along with these, AT-527, ledipasvir, bicalutamide, and cobicistat showed improved docking scores. RMSD and RMSF were further analyzed for potent ledipasvir and ritonavir by simulation studies and were identified as potential candidates for corona disease. CONCLUSION: The drug repurposing approach provides a new avenue in COVID-19 treatment.

Demystifying quantum blockchain for healthcare

The healthcare industry and the battle against the COVID-19 pandemic are two areas where blockchain technology might be useful. In this study, blockchain's significance is examined. Blockchain technology and related procedures will be used in future healthcare systems for collecting sensor data, automated patient monitoring, and safe data storage. Because it can store a large amount of data in a dispersed and secure way and provide access whenever and wherever it is needed, this technology greatly simplifies the process of carrying out activities. The advantages of quantum computing, such as the speed with which patients can be found and monitored, may he fully used with the help of quantum blockchain. Quantum blockchain is an additional resource that may be used to safeguard the veracity, integrity, and availability of stored information. Combining quantum computing with blockchain technology may allow faster and more secure medical information processing. In this research, the authors examine the potential uses of blockchain and quantum technology in the healthcare industry. Quantum technologies, blockchain-based technologies, and other cutting-edge ICTs (such as ratification intelligence, machine learning, drones, and so on) were investigated and contrasted in this article.

COVID 19 Associated Mucormycosis: Preventable Risk Factors Leading to a Better Prognosis: A Case Series

India was severely affected by the second wave of coronavirus disease (COVID‑19), leading to sudden expansive spread of Mucormycosis, presenting with sinusitis, blackish mucus secretions, discolouration of palate, facial pain, swelling and blurring of vision. Hyperglycemia, hypercoagulable state and elevated levels of serum ferritin were the major contributing factors in progression of the deadly disease. To highlight the correlation between Diabetes Mellitus, hyperferritenimia and elevated levels of D-Dimer with increased rate of incidence and poor prognosis of the disease. This study was undertaken in KLES Dr Prabhakar Kore Hospital & MRC, Belagavi, including 30 patients, between April to July 2021. Serum ferritin, HbA1C and D-Dimer were evaluated for patients on admission, along with the other routine blood investigations. The mean age was 50 years (49.99 ± 1.8), with a male predominance of 83.33% (25 Male patients). 93.33% patients had uncontrolled Diabetes Mellitus with a mean value of 10.12% (± 0.37) indicating Diabetes Mellitus to be the prime risk factor. The raised levels of serum ferritin with a mean of 662.01 ng/ml (± 129.18) and high levels of D-Dimer (Mean- 761.33 ± 151.8 ng/ml) also demonstrated their role as interlinked factors. Mucor epidemic was caused by convergence of interlinked risk factors. Awareness of red flag clinical features, prompt diagnosis, early initiation of treatment with amphotericin-B with aggressive surgical debridement are essential for successful outcome, to avoid high rate of mortality and morbidity rates in the mucormycosis patients.

An Insight to Heat Shock Protein 90: A Remedy for Multiple Problems.

Heat shock protein 90 (Hsp90) is a chaperone protein that prevents many other proteins from aggregating by folding them in a certain way. Hsp90 consists of three structural domains: N-terminal, middle and C-terminal domains. Hsp90 has many activities in numerous proteins and signaling pathways like chimeric fusion proteins, steroid hormone receptors, tumor suppressor genes, and cell cycle regulatory proteins. The role of Hsp90 is not only in cancer but also in other diseases like COVID-19, leishmaniasis, diabetes, flavi virus, systemic sclerosis, grass carp reovirus, psoriasis, malaria, cardiac fibrosis, and alcohol-related liver diseases. This review is a compilation of the pharmacological profile of Hsp90 inhibitors, problems associated with them, and suggested remedies for the same.

Disease Characteristics, Care-Seeking Behavior, and Outcomes Associated With the Use of AYUSH-64 in COVID-19 Patients in Home Isolation in India: A Community-Based Cross-Sectional Analysis

Background During the second wave of the COVID-19 pandemic in India, the Ministry of Ayush conducted a community study to provide therapeutic care to patients with asymptomatic, mild, and moderate COVID-19 in home isolation based on the empirical evidence generated on the efficacy of AYUSH-64 in COVID-19. Objective To document disease characteristics, care-seeking behavior, and outcomes in patients with asymptomatic, mild, or moderate COVID-19 in home isolation who used AYUSH-64 for COVID-19. Methods Cross-sectional analysis of the data generated through a community study conducted in India from 08 May to 31 August 2021 was performed to study the disease characteristics, care-seeking behavior during home isolation, clinical outcomes, adverse events, and the association between various risk factors and clinical recovery during the study period. The data were collected through semi-structured questionnaires, available in electronic data collection format at the baseline, 7, 14, and 21 days. A logistic regression was performed to explore the relationship between relevant variables and clinical recovery. Results Data from 64,642 participants were analyzed for baseline assessment, and final analysis was done for 49,770 participants. The mean age of the enrolled participants was 38.8 ± 11.7 years, and 8.4% had co-morbidities. AYUSH-64 was utilized as an add-on to the standard care by 58.3% of participants. Comparable clinical outcomes were observed in participants utilizing AYUSH-64 either as a standalone or as an add-on to standard care, in terms of clinical recovery, disease progression, the requirement for oxygen supplementation, hospitalization, ICU admission, and need for ventilator support. Younger age, having no co-morbidities or substance abuse, and having been vaccinated were associated with early clinical recovery than those who were older and not vaccinated. Conclusions The study findings suggest that AYUSH-64 use, either standalone or as an adjunct to standard care, in asymptomatic, mild, or moderate COVID-19 is associated with good clinical outcomes. Ayush services and interventions can be effectively integrated into the mainstream public health architecture to serve public health goals.

Double zero tillage and foliar phosphorus fertilization coupled with microbial inoculants enhance maize productivity and quality in a maize-wheat rotation.

Maize is an important industrial crop where yield and quality enhancement both assume greater importance. Clean production technologies like conservation agriculture and integrated nutrient management hold the key to enhance productivity and quality besides improving soil health and environment. Hence, maize productivity and quality were assessed under a maize-wheat cropping system (MWCS) using four crop-establishment and tillage management practices [FBCT-FBCT (Flat bed-conventional tillage both in maize and wheat); RBCT-RBZT (Raised bed-CT in maize and raised bed-zero tillage in wheat); FBZT-FBZT (FBZT both in maize and wheat); PRBZT-PRBZT (Permanent raised bed-ZT both in maize and wheat], and five P-fertilization practices [P100 (100% soil applied-P); P50 + 2FSP (50% soil applied-P + 2 foliar-sprays of P through 2% DAP both in maize and wheat); P50 + PSB + AM-fungi; P50 + PSB + AMF + 2FSP; and P0 (100% NK with no-P)] in split-plot design replicated-thrice. Double zero-tilled PRBZT-PRBZT system significantly enhanced the maize grain, starch, protein and oil yield by 13.1-19% over conventional FBCT-FBCT. P50 + PSB + AMF + 2FSP, integrating soil applied-P, microbial-inoculants and foliar-P, had significantly higher grain, starch, protein and oil yield by 12.5-17.2% over P100 besides saving 34.7% fertilizer-P both in maize and on cropping-system basis. P50 + PSB + AMF + 2FSP again had significantly higher starch, lysine and tryptophan content by 4.6-10.4% over P100 due to sustained and synchronized P-bioavailability. Higher amylose content (24.1%) was observed in grains under P50 + PSB + AMF + 2FSP, a beneficial trait due to its lower glycemic-index highly required for diabetic patients, where current COVID-19 pandemic further necessitated the use of such dietary ingredients. Double zero-tilled PRBZT-PRBZT reported greater MUFA (oleic acid, 37.1%), MUFA: PUFA ratio and P/S index with 6.9% higher P/S index in corn-oil (an oil quality parameter highly required for heart-health) over RBCT-RBCT. MUFA, MUFA: PUFA ratio and P/S index were also higher under P50 + PSB + AMF + 2FSP; avowing the obvious role of foliar-P and microbial-inoculants in influencing maize fatty acid composition. Overall, double zero-tilled PRBZT-PRBZT with crop residue retention at 6 t/ha per year along with P50 + PSB + AMF + 2FSP while saving 34.7% fertilizer-P in MWCS, may prove beneficial in enhancing maize productivity and quality so as to reinforce the food and nutritional security besides boosting food, corn-oil and starch industry in south-Asia and collateral arid agro-ecologies across the globe.

Continuing arteriovenous fistula creation by nephrologist and its outcome during COVID pandemic—Analysis of 376 cases

Abstract There has been a significant reduction of elective surgeries including creation of arteriovenous fistulas (AVF) during the ongoing pandemic by the surgeons. Here, we report the retrospective observational data of AVF creation by nephrologists in a single center, during a period of 8?months. A total of 376 fistulae were created in 310 patients. Patients were followed up at 2, 6, and 12?weeks. Twenty-eight patients required fistula creation twice, 16 patients thrice, and two patients underwent fistula creation four times. Of the total, 259 (68.8%) fistulae were radio-cephalic while 99 (26.3%) and 18 (4.79%) were brachio-cephalic and brachio-basilic, respectively. A total of 207 (67%) patients were already on hemodialysis whereas 103 (33%) were planned for elective initiation after fistula maturation. Of the 211 (69%) patients who completed 3?months of follow-up, 31 (15%) expired and 7 (3.3%) were lost to follow-up. Primary failure was observed in 70 (33.2%) fistulae. Fifteen (7.1%) patients were noted to be COVID positive during the follow-up. A total of 279 (90%) patients were alive at last follow-up. Amongst 20 dialysis staffs with 10 nephrologists, only two have developed COVID. Both were having mild illness and recovered completely. This study demonstrates that AVF creation can be performed safely with careful screening and by using adequate personal protective equipment.

An Emotion Care Model using Multimodal Textual Analysis on COVID-19.

At the dawn of the year 2020, the world was hit by a significant pandemic COVID-19, that traumatized the entire planet. The infectious spread grew in leaps and bounds and forced the policymakers and governments to move towards lockdown. The lockdown further compelled people to stay under house arrest, which further resulted in an outbreak of emotions on social media platforms. Perceiving people's emotional state during these times becomes critically and strategically important for the government and the policymakers. In this regard, a novel emotion care scheme has been proposed in this paper to analyze multimodal textual data contained in real-time tweets related to COVID-19. Moreover, this paper studies 8-scale emotions (Anger, Anticipation, Disgust, Fear, Joy, Sadness, Surprise, and Trust) over multiple categories such as nature, lockdown, health, education, market, and politics. This is the first of its kind linguistic analysis on multiple modes pertaining to the pandemic to the best of our understanding. Taking India as a case study, we inferred from this textual analysis that 'joy' has been lesser towards everything (~9-15%) but nature (~17%) due to the apparent fact of lessened pollution. The education system entailed more trust (~29%) due to teachers' fraternity's consistent efforts. The health sector witnessed sadness (~16%) and fear (~18%) as the dominant emotions among the masses as human lives were at stake. Additionally, the state-wise and emotion-wise depiction is also provided. An interactive internet application has also been developed for the same.

Medical certification of cause of death during COVID-19 pandemic - a challenging scenario.

Death certificate data is used to monitor local, regional and national mortality trend and is helpful in improving public health as well as public safety. Accurate and reliable information about the cause of death in a population is useful for understanding disease burden estimation and trends in the health of populations; moreover, the information provided by such data is vital in terms of public health planning as well. With the continuous upsurge in mortality due to coronavirus disease 19 (COVID-19), mortality analysis could be valuable in addressing the current pandemic and implementing the epidemic control strategies effectively and efficiently. Given that COVID-19 death certification substantially affects the local and national responses towards disease prevention and transmission, the importance of the accuracy and quality of information in these certificates cannot be understated. Hence, accurate death certification related to COVID-19 is vital to understand the extent and progression of the current pandemic.

Digital device-based active learning approach using virtual community classroom during the COVID-19 pandemic

Abstract In India, traditional learning approaches in universities follow passive learning and instruction-based studies. The demand for evidence-based instructional and interactive active learning processes increases with the advancement in technology. To improve the quality of teaching and student performance, Laureate International University network has taken a unique initiative by applying an iterative and evidence-based active learning process in small groups at the University of Petroleum and Energy Studies, Dehradun for the Postgraduate Certificate in Academic Practice program. In this study, active learning processes with digital devices (mobile devices) and digital technologies (modeling tools, simulation, and online resources), having virtual small-to-medium strength classrooms are integrated into various scenarios with different levels of education. This has been found to be useful in improving student performance during the COVID-19 pandemic. The proposed process applies both traditional and active learning processes with the provision to use mobile devices for digital content. This process also involves teachers attending a Bootcamp, over a 2-month period, consisting of four modules in which they learn about and use digital content that will then be applied in their courses. Results show that the active learning process is of great benefit to students over traditional learning, and it provides a 30% improvement in student's grades. Further, it is observed that long-term learning average marks increase by 66.9% in two engineering subjects. The simulation-based experimentations are conducted to engage students and faculty members in active learning and simulation learning processes. It shows that the proposed approach (active learning) improves students' learning abilities as compared to the traditional approach.

A drone-based networked system and methods for combating coronavirus disease (COVID-19) pandemic.

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. It is similar to influenza viruses and raises concerns through alarming levels of spread and severity resulting in an ongoing pandemic worldwide. Within eight months (by August 2020), it infected 24.0 million persons worldwide and over 824 thousand have died. Drones or Unmanned Aerial Vehicles (UAVs) are very helpful in handling the COVID-19 pandemic. This work investigates the drone-based systems, COVID-19 pandemic situations, and proposes an architecture for handling pandemic situations in different scenarios using real-time and simulation-based scenarios. The proposed architecture uses wearable sensors to record the observations in Body Area Networks (BANs) in a push-pull data fetching mechanism. The proposed architecture is found to be useful in remote and highly congested pandemic areas where either the wireless or Internet connectivity is a major issue or chances of COVID-19 spreading are high. It collects and stores the substantial amount of data in a stipulated period and helps to take appropriate action as and when required. In real-time drone-based healthcare system implementation for COVID-19 operations, it is observed that a large area can be covered for sanitization, thermal image collection, and patient identification within a short period (2 KMs within 10 min approx.) through aerial route. In the simulation, the same statistics are observed with an addition of collision-resistant strategies working successfully for indoor and outdoor healthcare operations. Further, open challenges are identified and promising research directions are highlighted.