ABSTRACT
Introduction: Rapid cost effective, Point-of-Care (PoC) Truenat assay for the diagnosis of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) have been developed to shorten the Turn Around Time (TAT) of reporting with a wireless data transfer system. Aim: To explore the SARS-CoV-2 positivity using closed system Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Materials and Methods: An observational cross-sectional study was carried out in Molecular Laboratory of, Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India, using Truenat RT-PCR (Molbio diagnostics) and data was entered from May 2020 to April 2021. Manufacturer's literature was followed while performing the test. Screening of sample was done with Envelope (E) gene test and confirmed with RNA-dependent RNA polymerase gene (RdRP) gene test. Statistical analysis was done using Microsoft Excel sheet by calculating the percentage, proportions. Results: A total of 1,528 individuals were tested for SARS-Cov-2 and 73 tests were reported positive. The positivity rate by age was highest among 21-30 years. The positivity rate was higher among males than females. Among 1,105 asymptomatic individual, 27 (2.4%) were positive and among 423 symptomatic, 46 (10.9%) were positive. Conclusion: Using Truenat, positivity rate among symptomatic Coronavirus Disease 2019 (COVID-19) suspected persons was about four times more than positivity rate among exposed contact persons who are asymptomatic.
ABSTRACT
Globally white oils demand is expected to grow at a compound annual growth rate of 3.1%, to reach almost 2 million ton by 2025, mainly due to the global economy recovering from COVID-19 impact. The COVID-19 pandemic had an adverse effect on global white oils demand, causing an estimated 5% drop in 2020. White oils are produced in two quality grades, pharmaceutical and industrial grade. Pharmaceutical grade is the most refined white oil while industrial grade white oils are mainly used in non-food contact industrial applications, including textiles and plastics. In Europe and North America, pharmaceutical white oil dominates the market, with more than three-fourths of market share. Li-ion battery separators is expected to be the fastest-growing white oils application from 2020-2025, driven by the increased interest in electric vehicles. For base oils, demand for Group II and III base oils for manufacturing white oils is expected to grow faster than demand for Group I and naphthenic base oils.
ABSTRACT
Background: A modified paediatric facemask has been shown to provide nasal CPAP ventilation/ oxygenation in obese OSA patients during sedation or general anaesthesia induction.1-2 A combined nasal mask-face tent provided continuous oxygenation and reduced aerosol/droplet spread in a COVID-19 positive patient (Fig.1).3 It avoided severe desaturation and reduced aerosol/droplet spread during difficult intubation/extubation in a morbidly obese patient.4 We used it in an obese OSA patient recovered from severe COVID-19 pneumonia undergoing peroral endoscopic myotomy (POEM). Case Report: A 60-year-old obese male with OSA, atrial-fibrillation, cardiomyopathy, severe COPD on home O2, previous severe COVID-19 pneumonia s/p convalescent plasma therapy, and achalasia presented for POEM. An infant facemask was secured over his nose and his mouth was covered with a clear plastic sheet (face-tent) to reduce aerosol/droplet spread. Following pre-oxygenation with 4LO2/min, RSI with cricoid pressure was induced with etomidate/propofol/succinylcholine. Video-laryngoscopy-assisted intubation was performed under the face-tent while the nasal mask delivered apnoeic oxygenation (Fig. 1). SpO2 was maintained at 100% throughout. He developed tension pneumoperitoneum with insufflated CO2 which was reduced with 14G angiocatheter x3. Upon awakening, he was agitated and required additional propofol/ fentanyl/ dexmedetomidine and three providers to restrain him in order to provide nasal oxygenation and suction oral secretions for >20 mins (Fig.2). Discussion: This simple nasal mask-face tent provided continuous oxygenation during RSI and intubation in an obese OSA patient with previous severe COVID-19 pneumonia undergoing POEM. It maintained spontaneous CPAP nasal ventilation and oxygenation post-extubation. Combining with oral suctioning, it reduced aerosol/droplet spread. Amid the COVID-19 pandemic, it may optimize patient safety and provide additional provider protection. (Figure Presented).
ABSTRACT
Background: A paediatric facemask was used to maintain spontaneous nasal ventilation/oxygenatoion in deeply sedated obese OSA patients.1-2 Amid COVID-19 pandemic, a combined nasal mask-face tent provided pre/apneic nasal oxygenation and reduced aerosol/droplet spread during RSI, intubation and extubation in a COVID-19 positive patient.3 It avoided severe desaturation and reduced aerosol/ droplet spread during difficult intubation/extubation in a morbidly obese patient.4 We used it in an obese OSA patient during EPS/VT ablation. Case Report: A 79-year-old COVID-negative male, BMI 30.7 kg/m2, with HTN, OSA, CAD, s/p PCIx3 stents, dilated cardiomyopathy, AICD/pacemaker, presented for EPS/VT ablation under sedation. A toddler facemask was secured over his large nose with elastic head-straps and connected to the anaesthesia circuit/machine delivering 6-8 cm H2O CPAP with 4L/min O2. His mouth was covered with a clear plastic sheet (face-tent) (Fig.1). Moderate sedation was achieved with midazolam and remifentanil infusion. SpO2 improved from 93% to 100%. During ablation, GA was requested due to his breathing interfering with ablation. He was induced and intubated with propofol/etomidate/rocuronium. Video-laryngoscopy-assisted intubation was performed under the face-tent while the nasal mask delivering pressure-control ventilation/oxygenation (Fig.2). His SpO2 was maintained at 100% throughout. He was extubated smoothly with nasal mask-face tent to maintain spontaneous ventilation/ oxygenation and minimize aerosol/droplet spread (Fig.1). Discussion: This simple nasal mask-face tent maintained continuous CPAP ventilation in an obese OSA patient during EPS. It provided pressure-control ventilation/oxygenation during GA induction and intubation. It also reduced aerosol/droplet spread during the procedure. Amid COVID-19 pandemic, it should be used as a universal precaution to provide additional provider protection. (Figure Presented).
ABSTRACT
As the COVID-19 pandemic threatens to overwhelm healthcare systems across the world, there is a need for reducing the burden on medical staff via automated systems for patient screening. Given the limited availability of testing kits with long turn-around test times and the exponentially increasing number of COVID-19 positive cases, X-rays offer an additional cheap and fast modality for screening COVID-19 positive patients, especially for patients exhibiting respiratory symptoms. In this paper, we propose a solution based on a combination of deep learning and radiomic features for assisting radiologists during the diagnosis of COVID-19. The proposed system of CovidDiagnosis takes a chest X-ray image and passes it through a pipeline comprising of a model for lung isolation, followed by classification of the lung regions into four disease classes, namely Healthy, Pneumonia, Tuberculosis and COVID-19. To assist our classification framework, we employ embeddings of disease symptoms produced by the CheXNet network by creating an ensemble. The proposed approach gives remarkable classification results on publicly available datasets of chest X-rays. Additionally, the system produces visualization maps which highlight the symptoms responsible for producing the classification decisions. This provides trustworthy and interpretable decisions to radiologists for the clinical deployment of CovidDiagnosis. Further, we calibrate our network using temperature scaling to give confidence scores which are representative of true correctness likelihood. © 2020, Springer Nature Switzerland AG.
ABSTRACT
Background: Patients with cardiovascular disease (CVD) are at an increased risk of developing severe disease and mortality associated with coronavirus disease 2019 (COVID-19). Statins form the cornerstone of therapy for primary and secondary prevention of CVD. Objective: This review aims at exploring the possible advantages and the risks associated with the use of statins in patients with COVID-19. Methods: We searched the PubMed and Google Scholar databases until June 5, 2020, and reviewed the available literature on this topic. Results: Statins have been shown to improve outcomes in acute respiratory distress syndrome, which is one of the major causes of death in COVID-19. Statins exert many pleiotropic effects (anti-inflammatory, immunomodulatory effect, nitric oxide release, and effects on coagulation cascade), which would theoretically appear beneficial in COVID-19. Statins also increase angiotensin-converting enzyme 2 levels in animal models and can potentially reduce lung injury related to viral infections. Besides, the cardioprotective effects of statins can be beneficial in cardiovascular complications (e.g., acute myocardial infarction) of COVID-19. Nonetheless, there are concerns regarding the adverse effects associated with the use of statins in the setting of COVID-19, which can be simply avoided by dose modification and clinical monitoring. Conclusions: Statins appear to be beneficial in COVID-19 and may improve the outcome, but future-focused studies are needed before recommending their de novo use in COVID-19.
ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is rapidly spreading in India and across the world. Healthcare workers (HCWs) are at increased risk of contracting COVID-19 due to direct or indirect exposure to COVID-19 patients, and require special attention. Limited information is available about its effect in HCWs. Secondary transmission from HCWs is a possibility among patients, family members, and the community. Therefore, it is important to investigate the infection risk of HCWs and the clinical characteristics of affected cases and possible source of infection with exposure details. The aim of this study is to analyze the medical records of HCWs with COVID-19 retrospectively and carry out the analysis of the data of HCWs with COVID-19 at TNMC and BYL Nair Charitable Hospital (NH, COVID-19 Hospital) in Mumbai. Interim analysis was carried out for the data collected from 6th April to 20th August 2020. Total 3711 HCWs (frontline, 74.32%, non-frontline, 25.68%) are working at NH Mumbai. We observed 11% prevalence of SARS-CoV-2 infection among HCWs, 4% co-infection and 1% mortality. Majority (85%) of the HCWs with COVID-19 were symptomatic and 15% were asymptomatic. Comorbidities were reported in 19% of HCWs with COVID-19. Hypertension and Diabetes Mellitus were the most common co-morbidities reported. More than 4% percent of HCWs with COVID-19 were also positive for plasmodium vivax Malaria. The results of the study will be useful for determining the impact of COVID-19 and adverse outcomes in HCWs, identifying probable mode of acquiring SARS-CoV-2 infection in HCWs. This is required for planning the strategies to handle the epidemic of COVID-19 among HCWs in Mumbai region, and at Maharashtra state level.