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Background: Coronavirus disease 2019 (COVID-19) and associated outcomes manifest differently depending on patientsâ™ background and pre-existing conditions. It remains unclear how African Americans with and without cancer have been affected. Aim: To determine epidemiological, clinical comorbidities, and laboratory test results to identify markers associated with mortality in COVID-19 cancer patients. Methods: We reviewed all Covid-19 hospitalized patients records from Dec. 2019 to Oct. 2021 at Howard University Hospital. Patients having a history of, or active cancer status were reviewed. All the clinical, treatment, lab values, and pathological data were extracted. Statical analysis of the Covid-19 cancer patients and comparison with non-cancer Covid-19 patients was performed using univariate and multivariate analyses. Results: Out of 512 COVID-19 infected patients, a total of 49 patients were identified with different types of cancer, with both active and previous history. Females consisted of 26 cancer patients (53%). African American race was predominant in both cases and controls, 83.6% and 66.7% respectively. Cancer patients were older than non-cancer patients (Mean Age-70.6 vs. 56.3 years) and had an increased length of hospital stay (Mean 13.9 vs 9.4 days). Among cancer patients, breast cancer was more prevalent in females and prostate cancer in males, (54% and 52% respectively). Comparison of patients with active vs. previous cancer showed no significant difference in the clinical outcome, death vs. discharge (P=0.34). A higher reduction in albumin level in cancer cases, from the time of admission to day five, was significantly associated with death during the same hospital stay compared to those discharged (n=24, 48.9%, p<0.001). In controls, Lymphopenia (n=436, 94.1%, p=0.05), AST (n=59, 12%, p=0.008) and Albumin (n=40, 10.7%, p=0.02) have shown an association with increased mortality. Conclusion: Albumin level has shown to have an inverse relationship with clinical outcomes among all COVID infected African American patients. Reduction in Albumin level during the hospital stay, particularly in COVID-19 cancer patients should be considered as a predictor of mortality. No significant difference was noticed in the clinical outcome in patients with previous versus active cancer. Further research with a large cohort size is needed to verify and identify other predictors of outcome in Covid-19 cancer patients and develop appropriate treatment modalities.
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Introduction: Controversies remain regarding the safety of tocilizumab in the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this study, we seek to describe the infectious complications after tocilizumab in COVID patients and determine the related risk factors. Methods: A single-center retrospective observational study was conducted among adult patients with SARS-CoV-2 infection admitted between 06/01/2020 and 12/31/2021 who received tocilizumab at our institution. Baseline demographics and laboratory values are obtained through reviewing electronic medical records. Risk factors of infectious complications after tocilizumab are identified through regression analysis. Statistics are performed using SPSS. P-value <0.05 is considered statistically significant. Results: Out of the 52 patients identified, infectious complications after tocilizumab were documented in 30 patients (57.7%). The most common infections include pneumonia, urinary tract infections, and bacteremia of unknown sources. Overall mortality was 42.3%. Through multivariate regression analysis, age more than 65, hyperglycemia on admission, and tocilizumab administration more than 2 days after hospital admission are independent risk factors associated with developing infections. Conclusions: In real-world experience, infectious complications are not uncommon in COVID patients who receive tocilizumab. Early use of tocilizumab may be of benefit. More rigorous patient selection and monitoring should be explored in future studies.
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Background: In patients with comorbid illnesses, COVID 19 disease is a severe acute respiratory syndrome that is linked to a variety of opportunistic bacterial and fungal infections. Finding the cause of fungal infections among post-covid patients in tertiary care hospitals is the aim of the study. Objective(s): To study the etiology of post-covid fungal infections among various age groups Methods: Out of 578 samples (pus/tissue/biopsy) collected from patients attending Koti ENT hospital with complaints of pain in eye, cheek swelling, headache. All samples were subjected to direct KOH mount and inoculated on SDA, incubated for 1 week at 25degreeC. Result(s): Out of 578 samples 214 are KOH positive and 291 are culture positive with fungi isolated - Mucor species, Aspergillus species and Candida species. Conclusion(s): As post covid fungal infections are rapidly progressive and devascularised disease, timely diagnosis helps in effective management and treatment of patients. Copyright © 2023, Institute of Medico-legal Publication. All rights reserved.
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Butyrylcholinesterase (BChE), a hepatic enzyme produced by the liver is affected by and influences a variety of inflammatory, infectious and metabolic dysfunction processes. Considering that COVID-19 is a multisystem disorder related to conditions influenced by BChE, the potential interrelation of the two is reviewed. BChE is altered in a variety of infectious diseases, and serves as a prognostic marker in both infections and in non-infectious diseases. Closely related to acetylcholinesterase (AChE), BChE plays a role in modulating inflammation via the cholinergic system. It forms part of the signaling pathway linking the immune system, nervous system and the endocrine system. COVID-19 progresses to a stage of unregulated inflammation in a subset of subjects. Cholinergic dysfunction could be potentially responsible for a march to cytokine storm. BChE could influence the course of COVID-19 by acting through the brain-immune-endocrine axis via cholinergic transmission, as well as affecting factors predicting adverse outcomes of COVID-19 (obesity, insulin resistance, coronary artery disease, type 2 diabetes mellitus). Interestingly, variant forms of the enzyme with impaired hydrolytic activity are reported in endogamous ethnic populations. It would be instructive to study the effect of COVID-19 in these natural human knock-out equivalents. Biomed Rev 2021;32: 37-46.
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India is one of the countries with the highest number of young students enrolling for higher studies. Education plays a vital role in the life of students about career advancement. In the COVID pandemic situation, many youngsters feel restless and dissatisfied due to syllabus incompletion. So many academies are offering online courses but because of improper facilities or sources and financial constraints. We aim at introducing Artificial Intelligence (AI)-powered E-learning methods to students who can dynamically interact with the faculty and peers and clarify their queries while studying. In addition, we aim at personalizing education which helps in assessing students' skills/talents and evaluating their performance. EDUBOT is a student friendly AI-powered chatbot and the Learning Management System (LMS) that provides students with the resources they need on any topic the need and solves their problems. The features provided by this product are dynamic front-end, Interactive Query Search, Personalized Student centric Assessment and Super User. © 2022 IEEE.
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Background and Aims: Over 404 million people worldwide have been infected with coronavirus disease-2019 (COVID-19), 145 million in the United States (77 million) and Europe (151 million) alone (as of February 10, 2022). This paper aims to analyze data from studies reporting gastrointestinal bleeding (GIB) and/or endoscopic findings in COVID-19 patients in Western countries. Methods: We conducted a systematic review of articles on confirmed COVID-19 cases with GIB in Western countries published in PubMed and Google Scholar databases from June 20, 2020, to July 10, 2021. Results: A total of 12 studies reporting GIB and/or endoscopic findings in 808 COVID-19 patients in Western countries were collected and analyzed. Outcomes and comorbidities were compared with 18,179 non-GIB COVID-19 patients from Italy and the United States. As per our study findings, the overall incidence of GIB in COVID-19 patients was found to be 0.06%. When compared to the non-GIB cohort, the death rate was significantly high in COVID-19 patients with GIB (16.4% vs 25.4%, P < .001, respectively). Endoscopic treatment was rarely necessary, and blood transfusion was the most common GIB treatment. The most common presentation in GIB patients is melena (n = 117, 47.5%). Peptic, esophageal, and rectal ulcers were the most common endoscopic findings in upper (48.4%) and lower (36.4%) endoscopies. The GIB cohort had worse outcomes and higher incidence of hypertension (61.1%), liver disease (11.2%), and cancer (13.6%) than the non-GIB cohort. Death was strongly associated with hypertension (P < .001, r = 0.814), hematochezia (P < .001, r = 0.646), and esophagogastroduodenoscopy (P < .001, r = 0.591) in COVID-19 patients with GIB. Conclusions: Overall, the incidence of GIB in COVID-19 patients is similar to that estimated in the overall population, with melena being the most common presentation. The common endoscopic findings in GIB COVID-19 patients were ulcers, esophagitis, gastritis, and colitis. Patients with GIB were more prone to death than non-GIB COVID-19 patients.
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In India, 2.93 crore people had been succumbed to COVID-19 on 5 June 2020.1 Containing a series of unparalleled catastrophic event that required hedging on innovation and technologies developed by industry and academia. The purpose of the paper is to identify technologies developed at academia related to COVID-19 pandemic. The exploration by employing PATENTSCOPE COVID-19 functionality, 85 institutions were found to accumulate 1427 out of more than 6000 patents over 20 years COVID-19 technologies under 10 classifications entertained by the World Intellectual Property Organization. Finally, the reflection of COVID-19 in response to selected Indian higher educational institutions is inconclusive. The results imply policy makers to encourage the indigenous innovations in all the functionalities in combating the pandemic. © 2021, National Institute of Science Communication and Information Resources. All rights reserved.
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Background:COVID-19 caused by SARS CoV 2 has emerged into a global pandemic. Paediatric COVID-19 infection is rela- tively mild when compared to adults, and children are reported to have a better prognosis. Mortality in children appears rare. Many infected children are often asymptomatic and remain undiagnosed without population screening. Due to these reasons children can be potential source of infection and may lead to higher transmission. Therefore knowledge on prevalence of asymptomatic and symptomatic cases among children is essential for effective control of COVID Methods:Nasopharyngeal Samples received at VRDL which were collected from children from 1st June to 30th Novem- ber of 2020 were subjected to RT-PCR for detection of SARS CoV-2 RNA and the Positive cases were correlated with the clinical information submitted along with the samples Results:Among the samples of children received and analysed at VRDL in three months, 343 tested positive for COVID - 19, of which 129 (37.60%) cases were symptomatic and 214(62.3%) were asymptomatic. Among the symptomatic cases, 25(19.3%) cases were diagnosed with SARI. Fever was the most common non respiratory symptom seen. The results of the remaining three months will be produced at the time of the presentation Conclusions:Knowing the prevalence of asymptomatic and symptomatic cases of COVID-19 among children helps in making strategies for effective control of COVID-19
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Background:The new pandemic caused by COVID-19 (SARS CoV-2) originated at Wuhan, China became the public health crisis throughout the globe. Susceptibility to this airborne infection is low in children when compared to adults due to nonspecific protection resulting from recent infection by other respiratory viruses, which children experiences more frequently than adults. Age is the most important factor in diminishing one’s chance to survive COVID -19 especially after 60 years of age as comorbidities also play a role. Methods:Reverse transcriptase Polymerase Chain Reaction testing (RT-PCR) was done on nasopharyngeal swab speci- mens from persons with respiratory illness attending at SRRIT & CD Hyderabad during 6 months period from May 2020 to October 2020. Results:A total of 4617 samples were tested by RT-PCR of which 1722(37%) shows positive results for COVID-19. 1056 (61.3%) were males and 666 (38.7%) were females. Highest positive rate was noted in month of June 528(11.4%) fol- lowed by July, August, September & October which are 8.6%, 6.8%. 5.3%, 3.2% respectively. Male preponderance was seen in 31-45 years of age group while it is 16-30 years in females. Conclusions:The clinical features and prognosis of the disease vary among patients of different ages and a thorough assessment of age may help clinicians to establish risk stratification for all COVID-19 patients
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Background:An outbreak of unusual viral pneumonia in Wuhan China, identified as novel Corona virus as evolved into global health crisis and it has been declared as pandemic by WHO on 11th March 2020.Indian government took strin- gent measures to control the outbreak by implementing lockdown on 22nd March and improvising the diagnostic and isolation facility. Reverse transcriptase polymerase chain reaction (RT- PCR) testing for presence of infection occupies a critical role in diagnosis, managing the patient and also in implementing the preventive control measures both at indi- vidual level and at a community and global level. Methods:Nasopharyngeal/Oropharyngeal swab samples from symptomatic patients and the contacts of positive pa- tients were tested by RT-PCR from March to November 2020. Individual sample details including age,gender,address,co morbidities, symptomatic/ asymptomatic, history of contact,history of travel,were registered in standard sample refer- ral form (SRF) prescribed by ICMR. Results of RT-PCR test and the above data were analysed with reference to the phas- es of lockdown and its role in the control of virus transmission. 5 phases of lockdown were described, phase 1: 24th March to 5th April, phase 2: 6th April to 30th April. Phase 3: 1st May to 15th June, phase 4: 16th June to 15th July, phase 5: 16th July to 15th August. Results:A total of 30351 samples were tested using RT-PCR and 8604 (28.3%) were positive. Among the positives 61.3% were male and 38.7% were female. Positivity during phase 1 was 4.4%, in phase 2 was 6.7%, in phase 3 was 22.6%, in phase 4 was 12.8% and in phase 5 was 41%. After phase 5 positivity was 33.4%. Conclusions: Results of the present study has shown that lockdown and intervention undertaken in a timely manner helped in curbing the spread of the virus thus controlling the morbidity and mortality. Importance of interventions such as use of mask, hand hygiene and social distancing is reinforced for the containment of the disease.
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Background: COVID-19 caused by a novel coronavirus (SARS- COV-2) has emerged as a global pandemic. There is a con- tinuous debate whether to consider allergic respiratory disorders as protective factor or as a risk factor for COVID -19. At the same time severity of COVID 19 is found to be more if patient’s level of disease control is poor according to some studies. Hence there is a need to find the prevalence of allergic respiratory diseases among COVID 19 positive cases. HCW are taken as the study population as they have equal COVID exposer risk and also good level of disease control. AIM: To find the prevalence of allergic respiratory diseases among COVID positive HCW. Methods: Nasopharyngeal samples of HCW collected from May 15 to November 15 2020 were subjected to RT PCR for detection of SARS COV -2 RNA and the positive cases were noted for history of allergic respiratory disorders like chronic rhinosinusitis, asthma from the clinical information provided while sample collection. Results: Out of total 912 Health Care Workers tested for COVID 19 in first 5 months by RT PCR 121 were COVID positive, among them 24(19.8%) have known history of allergic respiratory diseases of which 4(3.3%) were known for Chronic Rhinosinusitis, 15(12.3%) were asthmatic, 5(4.13%) have both CRS and asthma, further results will be provided at the time of presentation. Conclusions:Prevalence of allergic respiratory diseases helps in finding out if it’s a risk factor or not and also if any pro- tective role against COVID 19 to help in further studies
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Background:Healthcare workers are at a high risk of contracting SARS CoV 2 infection due to their close contact with COVID19 confirmed and suspected cases. Preventing infection amongst healthcare workers is crucial, not only for main- taining a healthy and functional workforce during the pandemic, but also to reduce secondary transmission to collegues and other patients. Prevalence of IgG antibodies against the infection provides essential information regarding unde- tected infection and transmission. The present study is being conducted to estimate the seroprevalence of SARS CoV 2 antibodies among healthcare workers working in COVID19 isolation wards. Methods:90 healthcare workers working in covid isolation wards were recruited into the study. A questionnaire was administered for risk assessment and history of previous RT-PCR confirmed COVID-19 infection,if any. Serum sample collected from the participants were tested for anti SARS CoV 2 IgG antibodies by Indirect ELISA (Covid Kawach IgG Mi- crolisa by J Mitra). Results:Out of 48 samples processed so far, 16(33.3%) samples were positive for SARS CoV 2 IgG antibody.of the 16 pos- itive samples, 14 samples were negative by RT-PCR previously. The remaining results will be produced at the time of the presentation. Conclusions:Presence of anti SARS CoV 2 IgG antibodies among healthcare workers at high risk, who tested negative by RT-PCR previously can indicate a previou asymptomatic infection, which calls for further evaluation
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Background:COVID-19 is an infectious disease caused by a novel coronavirus (SARS-CoV-2). Serologic assays for SARS- CoV-2, play an important role in understanding the immune status of post covid health care workers who are at highest risk of infection. In this infection, IgM and IgG antibodies can arise nearly simultaneously in serum within 2 to 3 weeks after illness onset. Around day 14 after symptom onset, IgG will rise above detection levels and will generally continue to rise for 28 - 35 days after symptom onset, peaking around or after clinical recovery. IgG typically has a long half-life and will remain above detectable thresholds for months after the resolution of infection. Most widely used treatment strategies include steroids, antivirals and antibiotics. Aim of the study is to assess the effect of treatment strategies on IgG antibodies against SARS-CoV-2 among covid infected Health care workers Methods:All the post covid HCWs (60-75 days after detection) were categorized into 4 groups on the basis of treatment strategies. 1st group (30) – combination of antiviral and steroid therapy, 2nd group (30) – only steroids, 3rd group (15) – only antivirals, 4th group (15)– only antibiotics (asymptomatic). All the groups were treated with multivitamins and VitC along with above mentioned therapy. Qualitative IgG ELISA using Merilisa kits was adopted to assess the prevalence of IgG antibodies against SARS-CoV-2 to know the pattern of IgG antibody titres. Results:90 samples were collected for this study, which were subjected to qualitative ELISA. Out of these highest IgG titres were found in patients only on antibiotics followed by only on antivirals, followed by steroid and antiviral combi- nation and least was found in patients only on steroids. Conclusions:This study showed that administration of steroids results in early weaning of antibodies. Re -infection could be more in these cases
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The detection of the virus is a basic concern for the doctors and the virology for over a decades due to the dynamic behavior and mutations of the virus makes it difficult to detect the virus and study its behaviors. Latest computational techniques enables scientists to crate models that are proficient of learning patterns from the data as well as used to make predictions for unseen data.. As machine learning techniques predicts the corona viruses by allowing for their differing genetic purposeful characteristics, we propose machine learning supported coronavirus prediction method Novel-COV-2 Predictor wherever RNA sequences of SARSCoV-1, MERS, and SARS-CoV-2 are used to instruct a classifier so that it can expect any indefinite sequence of these viruses. The RNA sequence is given in the form of the large text files. Consequently, it becomes a text classification complexity. We convert these data in the text files into numerical data using the count vectorization and utilize machine learning to create a model to know the patterns. In this regard, we have considered Support Vector Machine (SVM) algorithm to evaluate and so that SARSCoV-2 can be predicted as untimely as potential to save human life. © 2021 IEEE.
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PURPOSE OF REVIEW: Continuous glucose monitoring (CGM) systems are Food and Drug Administration approved devices for the ambulatory setting; however, they remain investigational systems for inpatient use. This review summarizes the most recent and relevant literature on the use of continuous glucose monitoring in the hospital setting. RECENT FINDINGS: CGM provides real-time glucose data that enable healthcare professionals to make proactive and timelier clinical decisions with regards to diabetes management. CGM devices appear to be safe and accurate systems for glucose monitoring in the hospital setting. Real-time CGM systems and glucose telemetry can decrease hypoglycemia and reduce hyperglycemia in hospitalized patients with diabetes. Remote glucose monitoring decreases the need of frequent Point-of-care checks and personal protective equipment use while also mitigating staff exposure risk which is timely in the advent of the COVID-19 pandemic. Although most nursing staff have limited exposure and training on CGM technology, early studies show that CGM use in the hospital is well received by nurses. SUMMARY: Given the evidence in the current literature regarding CGM use in the hospital, CGM devices may be incorporated in the inpatient setting.
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COVID-19 , Diabetes Mellitus, Type 1 , Blood Glucose , Blood Glucose Self-Monitoring , Hospitals , Humans , Pandemics , SARS-CoV-2ABSTRACT
Although the Covid-19 pandemic, has affected all aspects of human life, including education worldwide, technology has provided an opportunity for teachers to replace their classroom-based education and face-to-face learning with digital modes of online teaching and learning. With the paradigm shift in education, the present study adopted a descriptive research design that involved the analysis of quantitative data, investigated the preparedness, attitudes, beliefs and difficulties of 452 English language teachers from India and Afghanistan towards various ways of using technology for language teaching. A questionnaire with 23 items on Likert scale and open-ended questions was shared online with the teacher respondents to collect data. The findings revealed that lack of technological tools, low parental support for active participation of students, time taken to adopt technical tools to virtual mode of teaching and sudden paradigm shift without systematic training, little time space to adapt to the paradigm shift, planning, and executing classes were among the challenges that teachers faced while using technology in their classes during the Covid-19 pandemic. The study suggested some pedagogical implications and information for further studies.
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INTRODUCTION: Covid-19 has exposed the necessitate for the rapid acceptance of increasingly pioneering digital health technologies, especially remote health monitoring. The digital revolution in Healthcare is dynamic ease of use of inexpensive concern solutions, enhancing patient care, reducing complications, improving effectiveness, and authorizing healthcare decision-makers with intelligence insight at the point of care. OBJECTIVES: The primary objective of this work is to depict the need to recognize wearable sensors as a prerequisite for supporting paradigms in monitoring patients in real-time and enabling access information from the cloud. METHODS: Internet of Things (IoT) is the association of substantial objects where information and communication tools connect various embedded devices to the internet for gathering and switching over data. The combinations of embedded devices with cloud servers recommend extensive pertinence of IoT to several areas of human life. This paper has proposed a method through cloud-based IoT healthcare sensors to formulate patient monitoring remotely. In combination with the implementation of various inbuilt capabilities, internet-enabled heterogeneous wearable sensors can be used for the collection of biomedical data to transmit patient data directly to cloud severe systems to monitor health remotely. RESULTS: Smart healthcare monitoring includes channels of communication, embedded internal and external sensors, IoT server, and cloud storage. The health parameters activities are done at various levels of refining named application layer, management layer, network layer and layer of device. Different data sensors have been collected by wireless media from nodes. It is saved as an unstructured dataset in the cloud. For security with username and password, a patient database is created. Authorized individuals have access to the cloud in order to monitor cloud sensor data in data log, analogue log, digital input and digital output. CONCLUSION: Patient physical parameters like heart beat respiration,high temperature and stress are calculated via sensors and can be progressed by WIFI unit in the cloud. From this healthcare practitioner will analyze medical to have effective medication. For face-to-face consultation between doctors and patients, the video feature can be added in the future work. © 2021 G.Jaya Lakshmi et al.,.
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OBJECTIVE: Advances in continuous glucose monitoring (CGM) have transformed ambulatory diabetes management. Until recently, inpatient use of CGM has remained investigational, with limited data on its accuracy in the hospital setting. RESEARCH DESIGN AND METHODS: To analyze the accuracy of Dexcom G6, we compared retrospective matched-pair CGM and capillary point-of-care (POC) glucose data from three inpatient CGM studies (two interventional and one observational) in general medicine and surgery patients with diabetes treated with insulin. Analysis of accuracy metrics included mean absolute relative difference (MARD), median absolute relative difference (ARD), and proportion of CGM values within 15, 20, and 30% or 15, 20, and 30 mg/dL of POC reference values for blood glucose >100 mg/dL or ≤100 mg/dL, respectively (% 15/15, % 20/20, % 30/30). Clinical reliability was assessed with Clarke error grid (CEG) analyses. RESULTS: A total of 218 patients were included (96% with type 2 diabetes) with a mean age of 60.6 ± 12 years. The overall MARD (n = 4,067 matched glucose pairs) was 12.8%, and median ARD was 10.1% (interquartile range 4.6, 17.6]. The proportions of readings meeting % 15/15, % 20/20, and % 30/30 criteria were 68.7, 81.7, and 93.8%, respectively. CEG analysis showed 98.7% of all values in zones A and B. MARD and median ARD were higher in the case of hypoglycemia (<70 mg/dL) and severe anemia (hemoglobin <7 g/dL). CONCLUSIONS: Our results indicate that CGM technology is a reliable tool for hospital use and may help improve glucose monitoring in non-critically ill hospitalized patients with diabetes.