Development of an Open Source, Low-Cost Imaging System for Continuous Lung Monitoring

A lost-cost open-source electrical impedance tomography (EIT) device was equipped with a novel lidar based workflow to extract torso and electrode position which was then used in the EIT image reconstruction. EIT data was gathered from 9 healthy volunteers (5 male, 4 female) whilst undergoing a controlled breathing protocol. Four different reconstruction configurations were undertaken: a subject specific lidar based mesh versus a generic oval mesh, and subject specific lidar based electrode placements versus generic equal spaced electrode placements. Our results showed that torso shape error and electrode position errors can be drastically reduced with the lidar-based method allowing for the future utilization of patient-specific information. Good correlation was observed between volume delta and the EIT difference image. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Mucormycosis an Emerging Fungal Infection Associated with COVID-19- A Case Report

Introduction: Mucormycosis is an exceptional but rising fungal infection correlated with the COVID-19 disease. COVID-19 positive patients exhibiting severe symptoms admitted in the ICU have an increased susceptibility to develop bacterial and fungal infection. We hereby report a case of oral mucormycosis that is seen in a patient in post COVID-19 infection. Case Presentation: A 65-year-old woman presented to our institution, with the chief complaint of ulceration in her right palate region for the past 7 days along with pyrexia and generalised malaise. The patient reported to have recovered from COVID-19 infection recently. She presented with medical history of diabetes and hypertension for past 8 years. Post recovery from COVID-19 infection the patient developed an ulcer in the hard palate. Treatment: Surgery was done under General anesthesia. Maxillectomy was done with aggressive debridement of necrotic tissue. Bilaterally periosteal flap was approximated and suture was placed. Conclusion: The extensive use of steroids and broad-spectrum antibiotics in COVID-19 treatment may raise the risk of fungal infections. Medical practitioners should be aware of the possibility of invasive secondary fungal infections in patients with COVID-19 infection.

Face Mask Detection Using YOLOv3

The COVID-19 is an unprecedented crisis that has resulted in several security issues and large number of casualties. People frequently use masks to protect themselves against the transmission of coronavirus. In view of the fact that specific aspects of the face are obscured, facial identification becomes extremely difficult. During the ongoing coronavirus pandemic, researchers' primary focus has been to come up with suggestions for dealing with the problem through rapid and efficient solutions, as mask detection is required in the current scenario, whether in public or in some institutions such as offices and other workplaces. Only detecting whether a person wears mask or not is not enough. There is another aspect of wearing the mask properly such that it covers all the required portion of the face to ensure there is no exposure to any viruses. To address this, we proposed a reliable technique based on image classification and object localization, which can be accomplished using YOLO v3's object detection in machine learning. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Role of digital twin technology in medical sector-Toward ensuring safe healthcare

In today's scenario, digital technology is gaining prominence in different sectors like business, healthcare, education, security, aerospace, construction, automotive, etc. Digital twin technology is a novel technology. It represents virtually physical objects or process. The basic building block of a digital twin is internet of things (IoT) and the goal of digital twin technology is to create, test, and validate in the virtual environment. In the perspective of the healthcare sector, the digital twin virtually represents physical entity or process. The chapter organization is as follows: introduction to digital twin technology, generic applications of the digital twin, the role of digital twin technology in healthcare, and finally, the conclusion. © 2023 Scrivener Publishing LLC.

Mechanism-based approaches of 1,3,4 thiadiazole scaffolds as potent enzyme inhibitors for cytotoxicity and antiviral activity

Significant progress in understanding cancer pathogenesis, it remains one of the leading causes of death after cardiovascular diseases. Similarly viral infections have emerged from wildlife or re-emerged, generating serious threats to the global health. As a result, there is an urgent need for the development of novel, more effective anticancer and antiviral therapeutics. Scientists, medicinal chemists and researchers are continuously finding novel targets, mechanisms and molecules against theses severe and dangerous infections. Therefore, ongoing extensively study and research emphasizes 1,3,4 thiadiazole pharmacophore have versatile pharmacological actions. Due to mesoionic behaviour of 1,3,4 thiadiazole pharmacophore allows to enter and easily cross biological membrane which allow to interact various biological proteins. In this review study an attempt has been made of various mechanisms involved in cancer and viral prevalence with updated studies done so far. This review study also findings the role of 1,3,4 thiadiazole motif in the management of various cancers and viral infection. This study also highlighting research statics on clinical trials and various patents containing 1,3,4 thiadiazole derivatives. © 2022 The Author(s)

Mycological profile of acute invasive fungal rhinosinusitis during COVID-19 pandemic at a tertiary care hospital

Introduction: During the coronavirus disease-19 (COVID-19) pandemic, a surge in acute invasive fungal rhinosinusitis (AIFRS) cases with high mortality was reported in India. Objective: The objective was to study the spectrum of fungus associated with AIFRS during the pandemic of COVID-19. Materials and Methods: A total of 51 patients who were clinically diagnosed as cases of acute invasive rhinosinusitis in the department of ear, nose and throat (ENT) were included in the study. The clinical data along with demographic details were noted, and fungal identification was done using a conventional method. Results: Out of 51 patients, 66.6% were males and 33.4% females. Predominantly affected age group was 41-50 years. Out of 51 patients, 92.15% (47/51) had suffered from COVID-19 and 7.8% (4/51) did not have COVID-19 infection previously. Thirty-seven patients out of 51 (72.54%) were diabetics. Out of 51 samples collected from patients, 94.11% (48/51) were fungal culture-positive and only 5.8% (3/51) were culture-negative. A total of 52 fungi were isolated from the 48 culture-positive samples. Mucormycetes were predominantly isolated from the samples followed by Aspergillus species and Candida species. Among mucormycetes, Rhizopus species was the predominantly isolated. Conclusion: Patients with COVID-19, especially those at high risk, need to undergo an ENT examination once they recover because an early identification of AIFRS and a strong clinical suspicion of the disease are crucial for a successful course of treatment and to improve patient prognosis. © 2022 Medical Journal of Babylon ;Published by Wolters Kluwer - Medknow.

Clinical profile and outcome of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 infection: a single-center observational study from South India

Background: Multisystem inflammatory syndrome in children (MIS-C) is a post-infectious sequelae of acute COVID-19 infection affecting children. This study was done over a period of 12 months from December 2020 to November 2021 to describe the clinical presentation, laboratory abnormalities, and outcome of children with MIS-C. Method(s): Seventy-eight children below 12 years of age who satisfied the WHO diagnostic criteria for MIS-C were included in the study. Clinical parameters were recorded at admission. Relevant laboratory investigations, radiological studies, and outcome were documented. Result(s): The most commonly affected age group was 6-12 years with a female predominance. COVID RTPCR was negative in all patients. Most cases presented 2-6 weeks after the onset of acute COVID-19 infection. Lethargy, poor feeding, vomiting, abdominal pain, loose stools, cough, and cold are common symptoms of MIS-C syndrome in children and the common signs were rash, conjunctival congestion, hypotension, tachycardia, tachypnea, and hypoxemia. Gastrointestinal system was the commonly affected followed by the hepatic, renal, and cardiovascular systems. Coronary artery abnormalities were seen in 20% of cases. IVIg was the mainstay of therapy used in 95% of patients. Mortality was 1.3%. Cases responded well to IVIg and steroids. Conclusion(s): Overall, the short-term outcome was favorable with low mortality in our study cohort. One-fifth of children had coronary artery abnormalities during acute phase underscoring the need for long-term follow-up. Copyright © 2022, The Author(s).

Objective-structured clinical examination in cardiovascular system for the assessment of internal medicine postgraduates amidst the Covid-19 pandemic.

Background The Covid-19 pandemic has posed a challenge to organizing a safe clinical assessment for postgraduate degree candidates completing the residency programmes in various specialties. Although minimizing the risk of Covid-19 transmission is a priority, fulfilling the objectives of the assessment is equally important. Methods We conducted this study in the Department of Internal Medicine at our institute. Instead of physically examining patients, case scenarios that included history, clinical and investigational data of the cardiovascular system (CVS) were presented to the candidates. Performance was scored by both the conventional and the CVS objective-structured clinical examination (CVS-OSCE) method and compared. Results Clinical assessment examination of 27 candidates for the degree of Doctor of Medicine showed that the median cumulative score gained in narrating and analysing various differential diagnoses was lower compared to the mean cumulative score gained in arriving at a single correct diagnosis (50% [interquartile range-IQR 39%-64%] v. 79% [IQR 64%-100%], p<0.01). Most of the candidates agreed that case scenarios were good alternatives to the conventional physical examination amidst the pandemic. Conclusion CVS-OSCE-based assessment using structured case scenarios is a feasible and effective alternative for clinical skill assessment in high-stake examinations.

SARS-CoV-2 virus: mechanism of pathogenesis, replication and significant impact on children, cancerous, diabetic patients and pregnant women - a review

'Corona', this alarming word comes from the 'Latin' word 'Crown' that protects the virus. On Dec, 19, firstly, this virus was isolated from three patients having pneumonia connected to a cluster of acute illnesses. WHO declared it a 'pandemic' in Jan, 20 but later in Feb, WHO's general director Tedros Adhanom Ghebreyesus named the virus nCOVID-19. It was first identified in Wuhan, China, as a respiratory illness causing novel diseases (SARS and MERS). CDC informed corona primarily causes mild to moderate upper RTI and, in a few cases, lower RTI (pneumonia, bronchitis). Transmission occurs through direct contact or air droplets of sneezing, coughing, etc. The origin is not clear, but recent studies reported that ACE 2, a membrane exopeptidase receptor, was used to enter the human cell. The primary symptoms are fever above 104 degrees F, shortness of breath, pneumonia, throat soreness, diarrhea, etc. Available approved therapeutics include hydroxychloroquine. This current review updates about the viral transmission and main effect of this virus on children, pregnant women, diabetic, and cancer patients.

Multivariate Covid-19 Forecasting with Vaccinations as a factor: the case of India and USA

Accurate forecasting of Covid-19 case load is essential to ensure healthcare system preparedness in all countries due to highly infectious strains like Omicron. Although many countries have started vaccination drives, forecasting of case numbers predominantly hasn't accounted for vaccinations. This paper investigates whether multivariate models that include vaccinations as a factor such as VAR, VARIMA and Multivariate LSTM, perform better than their univariate counterparts AR, ARIMA and Univariate LSTM, at forecasting daily case numbers. Both long-term and short-term forecast accuracies of the models have been compared using the RMSE, MAE and MAPE metrics. This study is conducted in the context of cases and vaccinations in India and USA up to January 2022 to find out the relative effect of the rate of vaccination on case load and contrast the situations in the two countries. © 2022 IEEE.

Real time social distance detection using Deep Learning

In the Covid-19 pandemic, if residents do not take action to prevent the virus from spreading, the process of softening the curve of the coronavirus will be complicated in the face of the worldwide Covid-19 scenario. Without vaccination, the only method to combat the disease is social isolation. The proposed system employs the You Only Look Once, Version 3 (YOLOv3) object detection model to identify persons in the background and bind boxes around them, and assign IDs for in-depth tracking of recognized people. This study focuses on public space surveillance and determining whether or not people maintain social distance as per Covid-19 guidelines. YOLOv3 is an efficient tracking method that produces positive results with a moderate mean Average Precision(MAP) and Frame Per Second (FPS) score for monitoring community deviations in real-Time. In this study, YOLOv3 is used for object capture, and the OpenCV library is used for image processing. Proposed work is helpful in areas where big crowds are expected, such as retail malls, movie theatres, railway stations, airports, and public places. © 2022 IEEE.

Immunomodulator Therapy in Severe COVID-19 Pneumonia with Respiratory Failure During the Second Wave of the Pandemic: A Retrospective Analysis

Aim and background: Severe COVID-19 pneumonia can be lifethreatening with a high mortality, largely due to an uncontrolled systemic hyperinflammatory response, generally referred to as cytokine storm. Tempering the immune response with immunomodulators has been considered as a potential therapeutic option. Except for a few, data on the effectiveness of different immunomodulating drugs are scarce and are limited to a few case reports and retrospective observational-cohort studies. Additionally, in the pandemic due to shortages, various immunomodulators were used with limited data on their effectiveness. This study looks at various immunomodulators used in the 2nd wave of COVID-19, and their impact on outcomes. Materials and methods: Retrospective analysis of 124 patients with severe COVID-19 disease who were treated with immunomodulators. The study population included patients above 18 years of age with confirmed COVID-19 admitted to ICU with severe pneumonia. All patients received standard of care treatment at the time of hospital admission according to the hospital protocols and updated data on treatment of COVID-19. Patients were considered eligible for immunomodulatory treatment if they showed rapidly worsening hypoxia and elevated inflammatory markers, as per standard recommendations. Immunomodulators were administered depending on the availability of specific agents at time of treatment. The immunomodulators used were tocilizumab, itolizumab, bevacizumab, pulse dose steroid with methylprednisolone and baricitinib. Results: 124 patients were treated with immunomodulators, 45 (36.3%) of them survived, and 79 (63.7%) passed away. Mean age in survivors was 48.2, and in non-survivors was 54.8, which was statistically significant. Diabetes and hypertension were the most common comorbidities observed. 97/124 patients (78.2%) received immunomodulator therapy within 48 hours of ICU admission, out of which 41 (42.2%) recovered and 56 (57.7%) passed away. 21/124 (21.8%) patients received immunomodulators after 48 hours of admission, and had a high mortality with only 3 (14.2%) recovering and 18 (85.7%) dead. There was a significant reduction in CRP levels post immunomodulator therapy among survivors compared to nonsurvivors. The mean invasive ventilator days were 4.27 and there was a significant difference among survivors and non-survivors. Among survivors (45) in our study, we found that immunomodulator therapy was seen to avoid mechanical ventilation in severe COVID patients (33) who received immunomodulator therapy early within 48 hours of ICU admission as seen by the improvement on a 7-point ordinal scale. The mean ventilator days for patients who received immunomodulator therapy after intubation were also reduced. Most common adverse events were found with itolizumab administration. Secondary infections were more in non-survivors and secondary bacterial pneumonia was the commonest. Conclusion: Our descriptive study showed that the early administration(<48 hours) of various immunomodulators reduced the need for ventilation and the number of ventilator days, compared to administration after 48 hours. There was an increased incidence of secondary bacterial infections among the non-survivors.

One Disease But Different Outcomes: A Comparative Study of Characteristics and Outcomes of COVID-19 ICU Patients in the 2 Waves

Introduction: The 1st wave of COVID-19 spread rapidly affecting most countries globally in a short duration. Many countries suffered the 2nd wave of COVID-19 infection, months after the 1st wave, largely driven by viral mutants with high transmissibility and reduced susceptibility to neutralising antibodies (1-3). Despite COVID-19 being the common etiology, the two waves have significant differences impacting both current understanding and future planning of the impact of COVID-19. This study from a tertiary ICU is a comparative analysis focusing on the cardinal differences in COVID-19 ICU patients between the two waves, with respect to baseline demographics, clinical features, disease severity, and outcomes. Materials and methods: Retrospective data was collected from the medical records of all patients with COVID-19 disease admitted to the intensive care unit (ICU) in the 1st and 2nd wave of the pandemic. COVID-19 disease was confirmed by means of a positive RT-PCR or a rapid antigen test (RAT) on a nasopharyngeal swab or respiratory sample. Baseline demographic and clinical data, disease severity, and outcomes were analysed. Results: 419 patients (74.9% males) were admitted to the ICU between July and December 2020 and 206 (65% males) patients between April and June 2021. The mean age of patients admitted in the 1st wave was 59.84 ± 13.7 (mean ± SD) years and the 2nd wave was 55.31 ± 14.9 years (p = 0.038). The duration from symptom onset to admission (Median, IQR) was 5 days (3, 7) for the 1st wave and 5 days (3, 8) for the 2nd wave. 74.5% (312/419) of the patients in the 1st wave and 64.5% (129/206) in the 2nd wave had one or more comorbidities (p = 0.05). The median CRP values were 83.0 mg% (IQR 31.45, 159.7) for the 1st wave and 93.0 mg% (IQR 48.0, 141.0) for the 2nd wave, respectively, statistically not significant. 31.8% (131/412) of the ICU patients in the 1st wave and 52.3% (103/196) in the 2nd wave required mechanical ventilator support (p < 0.05). The overall ICU mortality was 32.1% (134/418) for the 1st and 52.5% (104/198) for the 2nd wave (p value?). Conclusion: There is a significant difference between the 2 waves in age, comorbidities, and mortality, likely related to viral mutants, vaccination policies, and social mobility dynamics.

LUNGCOV: A DIAGNOSTIC FRAMEWORK USING MACHINE LEARNING AND IMAGING MODALITY

The COVID-19 is throwing the entire globe into a terrible predicament, bringing living things to a terrifying standstill all across the planet and taking millions of human lives. As we have seen, there is a breakdown in the healthcare sector during pandemics since we are unable to meet all the required demands. This circumstance mandates the automation of the procedure for diagnosing COVID-19 with imaging techniques. Modality of imaging Chest X-rays/CT scans is less expensive and speedier tests that may aid in the timely identification of COVID-19 patients suffering. With AI's rapid growth in popularity in the healthcare industry, it can assist in boosting productivity and efficiency. As a result, AI-based image processing and diagnosis procedures are pursued. The proposed LungCov methodology helps in understanding the diagnostic technique for COVID-19 from an input image to an artificial intelligence-based processed image. AI provides the optimized image which can be further used to classify the image as a COVID-19 positive patient or a healthy one. One technology that might aid in this endeavor is machine learning. The main objective is to improve the healthcare system's care and service to society. © 2022, International Organization on 'Technical and Physical Problems of Engineering'. All rights reserved.

Hematological profile of COVID-19 patients in Ramanagar district, Karnataka-A cross sectional study

Introduction and Aim: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which rapidly evolved into a pandemic infecting humans all over the world. Whether hematologic and immunologic responses play a crucial role in progression of COVID-19 is still not clear. Increasing scientific evidence has shown that abnormalities in routine hematological tests, have the potential to diagnose SARS-CoV-2 infection in an economical way. Major laboratory changes indicating systemic inflammation and multi-organ impairment including hematopoietic system leading to lymphocytopenia, neutrophilia, eosinopenia, mild thrombocytopenia and ratios derived from these hematological parameters indicated severe disease and/or fatal outcomes. The aim was to study the hematological profile of Covid-19 patients admitted at a tertiary care hospital at Ramanagar district. Materials and Methods: This retrospective study included 260 confirmed cases of Covid-19 diagnosed at a tertiary health care centre. Demographic, clinical, laboratory, treatment, and outcome data were extracted from the institutional electronic medical records after obtaining permission from the concerned authorities. From CBC test results obtained neutrophil lymphocyte ratio was derived. Results: The present study revealed that majority of Covid positive patients presented with lymphopenia. While a significant association was observed between N/L ratio and disease severity, no significant association was seen between platelet count and severity of the disease. Conclusion: Since the results of the present study features lymphopenia among large proportion of patients and elevated N/L ratio among critically ill patients these markers could be utilized as useful prognostic indicators during the initial assessment of disease severity and thus appropriate management can be planned for such patients before the condition of the patient deteriorates.

Leukemoid reaction in a patient with COVID-19 infection: A case report

Rationale: COVID-19 usually presents with flu-like symptoms and signs, but some rare presentations like leukemoid symptoms cannot be ignored. Patient's concerns: A 37-year-old female presented to the outpatient department with flu-like symptoms. Diagnosis: The RT-PCR test for SARS-CoV-2 infection was positive, while complete blood cell and peripheral blood smear showed leukemoid reaction. Intervention: Paracetamol and fexofenadine for flu-like symptoms and leukemoid presentation. Outcomes: On the 10th day, the patient was asymptomatic and RT-PCR was negative. So the patient was discharged and leukemoid presentation subsided after clearance of viral disease. Lessons: COVID-19 has a myriad of presentations, and unusual symptoms/signs especially in this pandemic could be induced by COVID-19 infection.