Plastic Waste-Derived Carbon Dots: Insights of Recycling Valuable Materials Towards Environmental Sustainability.

Carbon dots (CDs) or carbon quantum dots (CQDs) have emerged as rising stars in the carbon family due to their diverse applications in various fields. CDs are spherical particles with a well-distributed size of less than 10 nm. Functional CDs are promising nanomaterials with low toxicity, low cost, and enormous applications in the field of bioimaging, optoelectronics, photocatalysis, and sensing. Plastic is non-biodegradable and hazardous to the environment, however extremely durable and used in abundance. During the COVID-19 pandemic, the use of plastic waste, particularly masks, goggles, face shields, and shoe cover, has increased tremendously. It needs to be recycled in a productive way as plastic wastes take hundreds or thousands of years to degrade naturally. The conversion of plastic waste into magnificent CDs has been reported as one of the key alternatives for environmental sustainability and socio-economic benefits. In this review, synthetic routes for the conversion of plastic wastes into CDs utilizing hydrothermal, solvothermal, pyrolysis, flash joule heating, and characterization of these CDs using different techniques, such as Fourier-transform infrared spectroscopy, Raman spectroscopy, X-ray diffraction, and transmission electron microscope, have been discussed. Furthermore, potential applications of these plastic-derived CDs in sensing, catalysis, agronomics, and LED lights are summarized herein.

Phytomedicines explored under in vitro and in silico studies against coronavirus: An opportunity to develop traditional medicines.

The widespread COVID-19 pandemic, caused by novel coronavirus SARS-CoV-2, has emanated as one of the most life-threatening transmissible diseases. Currently, the repurposed drugs such as remdesivir, azithromycine, chloroquine, and hydroxychloroquine are being employed in the management of COVID-19 but their adverse effects are a matter of concern. In this regard, alternative treatment options i.e., traditional medicine, medicinal plants, and their phytochemicals, which exhibit significant therapeutic efficacy and show a low toxicity profile, are being explored. The current review aims at unraveling the promising medicinal plants, phytochemicals, and traditional medicines against SARS-CoV-2 to discover phytomedicines for the management of COVID-19 on the basis of their potent antiviral activities against coronaviruses, as demonstrated in various biochemical and computational chemical biology studies. The review consists of integrative and updated information on the potential traditional medicines against COVID-19 and will facilitate researchers to develop traditional medicines for the management of COVID-19.

Effect of SARS-CoV-2 on glycemic control in post-COVID-19 diabetic patients.

Aim: To study the clinicodemographic profile, outcomes, and post-COVID change in glycemic control among treated COVID-19-infected patients with poorly controlled or well-controlled diabetes mellitus (DM). Methods: Adult COVID-19-infected patients who tested positive with rapid antigen test or RT-PCR admitted were included in this prospective observational study. Patients were divided into well-controlled and poorly controlled diabetes group based on HbA1c values at admission. Telephonic follow-up and HbA1c estimation was done after three months. Clinical and laboratory investigations performed were compared between both groups. Hazard ratios (HRs) for mortality risk in both well-controlled and poorly controlled COVID-19 patients with DM was done by Cox proportional hazard models. Results: Out of 260 patients, 140 (53.84%) and 120 (46.15%) were poorly and well-controlled diabetics respectively. One hundred sixty-three patients (62.69%) were male, and the mean age was 52.67 ± 15.69 years. Severity, duration of hospital stay, steroid duration, insulin requirement and mean HbA1C, both at admission and after three months, were significantly higher in poorly controlled group than the well-controlled group (P < 0.005). With increase in age, the HR for all-cause mortality increased by 1.15 times (95% CI, 1.05-1.25; P = 0.0025) in well-controlled than poorly controlled group, whereas with increase in FBS at admission, the HR for all-cause mortality increased by 1.03 times in poorly controlled than well-controlled group (95% CI, 1.01-1.06; P = 0.0044). Conclusion: Our results show that well-controlled blood glucose levels or improved glycemic control are associated with a better outcome in patients with COVID-19 and pre-existing type 2 diabetes mellitus.

Parsonage-Turner Syndrome Following Covishield (AstraZeneca ChAdOx1 nCoV-19) Vaccination: A Case Report.

Parsonage-Turner Syndrome (PTS) is a rare neurological disorder involving brachial plexus and periscapular muscles following viral infection, surgery, and vaccination. We hereby describe the first case of PTS from India following Covishield (AstraZeneca ChAdOx1 nCoV-19) COVID-19 vaccination. A 21-year-old healthy male presented to us with complaints of pain and weakness in the right shoulder five weeks after Covishield vaccination on the contralateral deltoid. There was no history of injury or constitutional symptoms. On examination, hyperalgesia over the area innervated by the axillary nerve and wasting of the deltoid, supra, and infraspinatus muscles were noted. An MRI scan of the shoulder, cervical spine, and brachial plexus neurogram were normal. Decreased motor amplitude in right axillary and musculocutaneous nerve was recorded in the nerve conduction study (NCS). High titers of SARS-COV-2 IgG neutralizing antibodies were noted after a single dose of vaccination and SARS CoV-2 IgM antibodies were negative. Having been diagnosed with post-vaccination PTS, the right shoulder was splinted and an intravenous injection of 1g methylprednisolone was administered for three days followed by oral steroids for three weeks. NCS and electromyography at 10 weeks showed insignificant differences between the two sides suggesting early neurological recovery. Currently, the patient is being followed up regularly for complete neurological recovery. PTS is a known side effect of vaccination. We report the index case of PTS following the administration of Covishield vaccination from India to aid in early diagnosis and management, further evaluation, and public health safety.

Parsonage-Turner Syndrome Following Covishield (AstraZeneca ChAdOx1 nCoV-19) Vaccination: A Case Report

Parsonage-Turner Syndrome (PTS) is a rare neurological disorder involving brachial plexus and periscapular muscles following viral infection, surgery, and vaccination. We hereby describe the first case of PTS from India following Covishield (AstraZeneca ChAdOx1 nCoV-19) COVID-19 vaccination. A 21-year-old healthy male presented to us with complaints of pain and weakness in the right shoulder five weeks after Covishield vaccination on the contralateral deltoid. There was no history of injury or constitutional symptoms. On examination, hyperalgesia over the area innervated by the axillary nerve and wasting of the deltoid, supra, and infraspinatus muscles were noted. An MRI scan of the shoulder, cervical spine, and brachial plexus neurogram were normal. Decreased motor amplitude in right axillary and musculocutaneous nerve was recorded in the nerve conduction study (NCS). High titers of SARS-COV-2 IgG neutralizing antibodies were noted after a single dose of vaccination and SARS CoV-2 IgM antibodies were negative. Having been diagnosed with post-vaccination PTS, the right shoulder was splinted and an intravenous injection of 1g methylprednisolone was administered for three days followed by oral steroids for three weeks. NCS and electromyography at 10 weeks showed insignificant differences between the two sides suggesting early neurological recovery. Currently, the patient is being followed up regularly for complete neurological recovery. PTS is a known side effect of vaccination. We report the index case of PTS following the administration of Covishield vaccination from India to aid in early diagnosis and management, further evaluation, and public health safety.

Improving performance of classifiers for diagnosis of critical diseases to prevent COVID risk.

The risk of developing COVID-19 and its variants may be higher in those with pre-existing health conditions such as thyroid disease, Hepatitis C Virus (HCV), breast tissue disease, chronic dermatitis, and other severe infections. Early and precise identification of these disorders is critical. A huge number of patients in nations like India require early and rapid testing as a preventative measure. The problem of imbalance arises from the skewed nature of data in which the instances from majority class are classified correct, while the minority class is unfortunately misclassified by many classifiers. When it comes to human life, this kind of misclassification is unacceptable. To solve the misclassification issue and improve accuracy in such datasets, we applied a variety of data balancing techniques to several machine learning algorithms. The outcomes are encouraging, with a considerable increase in accuracy. As an outcome of these proper diagnoses, we can make plans and take the required actions to stop patients from acquiring serious health issues or viral infections.

Development, implementation, and uptake of a novel Canadian Resident Matching Service (CaRMS) residency recruitment committee strategy in the era of COVID-19.

INTRODUCTION: Given restrictions on electives outside of medical students' home institutions during the COVID-19 pandemic, the objective of this study was to create a novel recruitment strategy for the University of Ottawa's (uOttawa) urology residency program. METHODS: A steering committee was formed and created a three-part recruitment strategy that included a new uOttawa urology website, a residency program social media campaign (Twitter and Instagram), and a virtual open house (VOH). Descriptive data from the website and Instagram and Twitter accounts were collected. Attendees of the VOH completed a mixed-methods survey, which collected quantitative and qualitive responses assessing aspects of the VOH and virtual resource use. RESULTS: From August 1 to December 31, 2020, the uOttawa urology website had 1707 visits. The Twitter account had a total of 29 000 views with 1000-5000 views per tweet. Thirty-one candidates attended the VOH. Survey responders reported that the most frequently used resources to gain knowledge of the program were the website (81%) and Twitter account (71%). The most helpful and informative resources were the uOttawa urology website, the VOH, and direct conversations with residents arranged through the website. Despite not having completed an elective, 26 students (84%) felt they had an understanding of what it might feel like to train in the program. Suggestions by students for future initiatives included one-on-one virtual meetings, another VOH, and more information on selection processes. CONCLUSIONS: A multifaceted, virtual recruitment strategy can be implemented to improve candidate understanding and engagement with residency programs while visiting elective opportunities remain limited.

A Comparative Study of Absolute Lymphocyte Count (Alc), Neutrophil Lymphocyte Ratio (Nlr) and Red Cell Distribution Width (Rdw) among Covid 19 Death and Survival Group.

At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, a city in the Hubei Province of China. It rapidly spread throughout the world. Identifying patients at highest risk for severe disease is important to facilitate early, aggressive intervention and to mitigate the crises occurring throughout the world. Biomarkers were needed for patient stratification into those likely to develop severe disease and with high risk of mortality. Present study aims to find out those indicators. MATERIAL: Total patients admitted over a period of 1 year from 1st April 2020 to 31th March 2021 in Dedicated COVID Hospital of RNT Medical College and MB hospital Udaipur was 4304 out of which 620 died and 3498 got discharged, 186 couldn't be followed up as they took leave against medical advise. From death group (620 patients) and Survival group (3498 patients), 400 patients were selected randomly from each group and were analysed and comparison was made between both the groups including parameters like ALC(Absolute lymphocyte count), NLR(Neutrophil Lymphocyte)ratio and RDW(Red cell distribution width). OBSERVATION: Median age in death and survival group was 62.03 and 47.18 respectively. Mean Absolute lymphocyte count was 0.88 and 0.93 in death and survival group respectively. Mean Neutrophil -Lymphocyte ratio in death and survival group was 8.37 and 4.34 respectively. Mean RDW- CV was 1.86 and 1.67 in death and survival group respectively. CONCLUSION: From the present study we conclude that Decreased ALC and Elevated NLR are a reliable indicator of death as an outcome in COVID 19 disease whereas RDW was high in COVID19 patients but had no significant relationship with outcome of the disease.

Smart Sanitizer Disperser with Level Monitoring

A smart sanitizer is an automatic sanitizer dispensing machine with no physical contact. It is an alcohol-based hand sanitizer which can be used in schools, hospitals, work places, offices and much more. In this alcohol is basically a solvent and not only a solvent it is also a very good disinfectant which is very much required in this current pandemic, as alcohol is volatile so it will vaporise instantly after application to hands. It is also proven and well known that above 70% of alcohol can kill Coronavirus in hands. In this we are using IR sensor to sense the hand placed near the bottle, esp32 as microcontroller which sense the distance and the result is the pump running to pump out the hand sanitizer. Ultrasonic sensor for the sensing the level of percentage that present in the bottle, the esp32 will sense the distance and the result is to send the alert when the percent of sanitizer in the bottle is less than the threshold, esp32 has the inbuilt network connectivity like WIFI module or Bluetooth module which is used to transfer the data from the esp32 to cloud. The data from the esp32 is analysed and the required alert are given

CirrhoCare®-a pilot study of digital home management of advanced cirrhosis to determine feasibility and utility to diagnose new decompensation events

Background and AimsPatients discharged from hospital following acute decompensation are at high risk of new complications and need close follow-up, limited currently by the growing burden of cirrhosis and impact of COVID-19. Specialist liver care in the community is an unmet need, to reduce hospital exposure and manage new decompensation events.MethodsWe included 20 patients with cirrhosis and recent acute decompensation. Commercially available devices and a smartphone (+SIM card) were given to all patients for daily recording of ECG, blood pressure, weight, and% body-water (bioimpedance), Stroop test (hepatic encephalopathy (HE) assessment), and self-reported well-being and food/fluid/alcohol intake. Data was Blue-toothed via a secure server to the CirrhoCare®-App, which had 2-way patient-physician communication. Hepatologists evaluated daily data and facilitated interventions as required. A matched control cohort (n=20) with advanced cirrhosis was observed in parallel.ResultsPatient demographics: Mean age 59±10 years, 14 male, main etiology alcohol (75%);75% Child-Pugh class B. Fifteen patients (75%) showed good compliance, (≥4 readings/week), 2 had moderate compliance (2–4/week), and 3 had poor compliance (<2/week). In a usability questionnaire scored 1–10, the median score was ≥9 for any given question.Mean follow-up was 10.1±2.4 weeks. Amongst CirrhoCare® managed patients, 1 died and 1 received a liver transplant. Eight readmissions occurred in 5 different patients: 3 due to HE, 1 to acute-kidney injury (AKI), 1 to both AKI and HE, and 3 in the same patient to rectal bleeding. The median readmission lasted 5 (IQR 3.5–11) days, and none was >14 days. Except for the acute bleeds, we identified early signs of decompensation in all cases, e.g. failed Stroop test, hypotension or reduction/gain in body fluid (weight), and facilitated 2 short hospitalizations of the 8 total readmissions.Based on early signs of decompensation, we contacted patients on 16 other occasions, guiding intervention and likely preventing further readmissions as confirmed by an independent physician panel. Two controls died during follow-up, and there were 13 readmissions in 8 patients, lasting median 7 (IQR 3–15) days with four admissions >14 days. They had 6 unplanned paracenteses compared to 1 in CirrhoCare®-managed patients.ConclusionsCirrhoCare®’s novel, multimodal, home-monitoring in patients with advanced cirrhosis is feasible with excellent patient engagement, and prompts early diagnosis of decompensating events and their intervention;and hospital admissions are fewer and shorter in duration than in controls. We propose the application of CirrhoCare® for assisted, specialist, community management of advanced cirrhosis.

Emergence and expansion of highly infectious spike protein D614G mutant SARS-CoV-2 in central India.

COVID-19 has emerged as global pandemic with largest damage to the public health, economy and human psyche.The genome sequence data obtained during the ongoing pandemic are valuable to understand the virus evolutionary patterns and spread across the globe. Increased availability of genome information of circulating SARS-CoV-2 strains in India will enable the scientific community to understand the emergence of new variants and their impact on human health. The first case of COVID-19 was detected in Chambal region of Madhya Pradesh state in mid of March 2020 followed by multiple introduction events and expansion of cases within next three months. More than 5000 COVID-19 suspected samples referred to Defence Research and Development Establishment, Gwalior, Madhya Pradesh were analyzed during the nation -wide lockdown and unlock period. A total of 136 cases were found positive over a span of three months that included virus introduction to the region and its further spread. Whole genome sequences employing Oxford nanopore technology were generated for 26 SARS-CoV-2 circulating in 10 different districts in Madhya Pradesh state of India. This period witnessed index cases with multiple travel histories responsible for introduction of COVID-19 followed by remarkable expansion of virus. The genome wide substitutions including in important viral proteins were identified. The detailed phylogenetic analysis revealed the circulating SARS-CoV-2 clustered in multiple clades including A2a, A4 and B. The cluster-wise segregation was observed, suggesting multiple introduction links and subsequent evolution of virus in the region. This is the first comprehensive whole genome sequence analysis from central India, which revealed the emergence and evolution of SARS-CoV-2 during thenation-wide lockdown and unlock.

Pneumomediastinum and subcutaneous emphysema as complication in COVID-19 patient with high CT severity score: Two case reports.

Coronavirus disease 2019 (COVID-19) is caused due to infection by severe acute respiratory syndrome virus coronavirus 2 (SARS-CoV-2). It is highly infective virus resulting in recent on-going pandemic and causing multisystem involvement predominantly affecting respiratory system. The most common presenting symptoms are fever, dry cough and breathlessness. The role of Computerized tomography (CT) is crucial especially in those patient having negative (rRT-PCR) but with high clinical suspicion, for prognosis and follow up. CT imaging findings mainly consists of multiple patchy bilateral ground-glass opacity (GGO) with or without consolidation and interlobular septal thickening with a peripheral or posterior distribution, mainly involving the lower lobes, depending upon the stage of disease. We present two case report of high CT severity score COVID-19 infection on non-invasive ventilation (NIV) having rare complication of pneumomediastinum and subcutaneous emphysema apart from typical COVID pattern lung findings during their course of admission in the hospital.

Personal protective equipment guidance during a global pandemic: A statistical analysis of National perceived confidence, knowledge and educational deficits amongst UK-based doctors.

INTRODUCTION: On the 11th of March 2020, the World Health Organisation (WHO) declared a global pandemic following the upsurge of the novel coronavirus disease 2019 (COVID-19). Unprecedented global demand for personal protective equipment (PPE) resulted in restricted availability, as well as evolving guidance on use, the latter of which was complicated by conflicting guidance provided by numerous healthcare bodies. AIM: To assess perceived confidence and knowledge of PPE guidance as published by Public Health England (PHE) amongst doctors of varying specialties and grades. METHOD: A nationwide 11-point survey comprising of multiple-choice questions (MCQs) and a 5-point Likert scale assessing perceived confidence was disseminated to UK-based doctors using multiple platforms. Statistical analysis using one-way analysis of variance (ANOVA), Tukey's honest significant difference (Tukey HSD) and Pearson's chi-squared test was undertaken to assess for statistical significance. RESULTS: Data collated from 697 respondents revealed that average perceived confidence was low across all specialties and grades. Notably, 59% (n = 411) felt they had received insufficient education regarding up-to-date guidance, with 81% (n = 565) advocating further training. Anaesthetics and ophthalmology were highest and lowest scoring specialties in knowledge-based MCQs, achieving scores of 59% and 31%, respectively. Statistical analysis revealed significant differences between specialty, but not grade. CONCLUSION: Ensuring uniformity in published guidance, coupled with education may aid knowledge and subsequent confidence regarding the appropriate use of PPE. The absence of a unified consensus and sustained training not only poses significant ramifications for patient and healthcare professional (HCP) safety, but also risks further depletion of already sparse resources. Because of the novelty of COVID-19, appropriate PPE is continually evolving leaving an absence in formal training and education. This paper reveals insight into confidence and knowledge of PPE amongst doctors of various specialities/grades during a global pandemic, highlighting key deficits in education and training.

Migrant Workers and COVID-19: Listening to the Unheard Voices of Invisible India

The internal migrant workers in India, despite being highly vulnerable in terms of physical and mental health, have remained the backbone of the Indian economy. However, the recent lockdown situation created by pandemic has put them in a more precarious condition. On one hand, they have lost their jobs and earnings, while on the other, they did not have enough resources to survive at the place of migration. As a result, the nation witnessed mass exodus, where men, women, children were seen returning to their native places on foot. This article, through a critical review of interdisciplinary and ethnographic research, focuses on the status of migrant workers in India amidst lockdown and strategies that may help to mitigate the situation. This article also explores the future course of action that can improve migrant workers? condition.