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Background: The objective of the study was to evaluate the effect of Colchicine 0.5 mg and Aspirin 75 mg oral tablets given together on management of moderate COVID-19. Methods: The study was carried out in 122 moderate COVID-19 patients between ages 40-80 years in hospital, instructed to take either 1 tablet of Colchicine 0.5 mg and Aspirin 75 mg each (treatment group), or 1 tablet of Aspirin 75 mg (Control group), twice a day along with standard of care. Result: At the end of treatment, reduction was seen in the treatment group in score of 8-point ordinal scale, troponin, D-Dimer, Hs-CRP from baseline. There was a fall of 51.1% among control arm and 53.4% among treatment arm in 8-point ordinal score. The reduction in mean D-Dimer was 37% in control group and 38.1% in treatment group. The mean reduction in CT severity score in control group was 3.65 and in treatment group was 4.82, and the difference between the two groups was statistically significant (P value = 0.018). Conclusion: It was evident from CT scan scores that the treatment group has shown significant improvement in the reduction of inflammation and other COVID-19 symptoms as compared to the control group. The fall in Ferritin, Hs-CRP and D-Dimer level after treatment were indicative of improvement in internal inflammatory response of body in COVID-19 disease. As increased troponin levels indicate some degree of heart damage, the fall in troponin levels indicated that test treatment improved heart health in COVID-19 patients.
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COVID-19 has expanded overall across the globe after its initial cases were discovered in December 2019 in Wuhan-China. Because the virus has impacted people's health worldwide, its fast identification is essential for preventing disease spread and reducing mortality rates. The reverse transcription polymerase chain reaction (RT-PCR) is the primary leading method for detecting COVID-19 disease; it has high costs and long turnaround times. Hence, quick and easy-to-use innovative diagnostic instruments are required. According to a new study, COVID-19 is linked to discoveries in chest X-ray pictures. The suggested approach includes a stage of pre-processing with lung segmentation, removing the surroundings that do not provide information pertinent to the task and may result in biased results. The InceptionV3 and U-Net deep learning models used in this work process the X-ray photo and classifies them as COVID-19 negative or positive. The CNN model that uses a transfer learning approach was trained. Finally, the findings are analyzed and interpreted through different examples. The obtained COVID-19 detection accuracy is around 99% for the best models.
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The impact of the COVID-19 pandemic on Higher Education has been considerable, none more so for practical/vocational subjects such as Product Design. However, consider being deaf/hard-of-hearing (D/HOH) whilst being forced to study predominantly online, with reduced practical in-person teaching opportunities, being socially distanced, and having to contend with face coverings limiting your ability to hear and lip read. The everyday challenges for D/HOH students in higher education is constantly demanding, but the global pandemic exacerbated this, presenting significant educational challenges. This paper presents a case study focused on the 2020/21 academic year whereby we examine the challenges and successes of supporting a product design student with Auditory Neuropathy Spectrum Disorder (ANSD) and permanent bilateral severe-profound hearing loss. The scope of this paper presents the learner arrangements for their product design education and highlights methods of managing the blended learning/teaching environment in combination with the use of British Sign Language (BSL) interpreters, electronic/handwritten notetakers and accompanying technologies. Numerous challenges were presented ranging from, managing rapidly developing online learning tools, adapting personal protective equipment to facilitate lip reading, managing multiple recording technologies to facilitate captioning/transcription, amongst others. The perspectives of the learner are presented, with reflections on how different session types, timetabling, delivery methods, etc., affected their day-to-day learning. Recommendations are made for improved collaboration with student support staff (i.e., BSL interpreters and electronic/handwritten note takers) and the need to implement digital technologies to facilitate the optimal blended learning and socially distanced teaching environment. © Proceedings of the 24th International Conference on Engineering and Product Design Education: Disrupt, Innovate, Regenerate and Transform, E and PDE 2022. All rights reserved.
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Background/Case Studies: TACO is a leading cause of reported fatalities, presenting as respiratory distress with cardiogenic pulmonary edema. The objective was to assess TACO occurrence and potential risk factors among the U.S. population ages 65 and older transfused in the inpatient setting before and during COVID-19 pandemic. Study Design/Methods: This is a hypothesis-generating study utilizing large Medicare databases for January 1, 2011-December 31, 2021. Transfusions were identified by recorded procedure and revenue center codes, and TACO by diagnosis codes. We evaluated unadjusted TACO rates (per 100,000 inpatient transfusion stays): overall, 2 years pre- and during pandemic, by immunocompromised (IC) and COVID-19 status, calendar year, demographics, blood components and number of units. We also assessed inpatient mortality, Charlson Comorbidity Index (CCI) score, ICU/CCU admission, and length of stay (LOS). Fisher's exact tests were performed to compare rates, and Cochran-Armitage tests to ascertain trends by year, age, and units. Results/Findings: Of 13,352,710 inpatient transfusion stays, 12,483 had a TACO diagnosis, an overall rate of 93.5 per 100,000 stays, with 2-year pre- and pandemic rates of 122.7 and 117.4. The annual TACO rates ranged from 61.9 in 2011 to 122.3 in 2021 (p < 0.001). Rates by units increased from 47.2 for 1 unit to 200.8 for >9 units (p < 0.001). Rates by blood components were for convalescent plasma only: 26.5;platelets only: 52.3;plasma only: 64.5;RBCs only: 97.9;RBCs and plasma: 203.0;RBCs and platelets: 237.8;and RBCs, plasma, and platelets: 223.1. Rates by age group ranged from 69.8 for 65-69 to 118.2 for 85+ (p < 0.001). Rates among females and males were 102.2 and 82.8 (p < 0.001);whites and nonwhites: 98.0 and 71.7 (p < 0.001). For IC vs. non-IC, rates were 138.9 vs. 81.7 [rate ratio 1.7 (95% CI 1.6-1.8)]. During pandemic, TACO rates were 39.3 for transfusion stays with vs. 127.8 without COVID-19 (p < 0.001). TACO cases with vs. without COVID-19 were ages 85+ (18.1% vs. 25.0%), females (50.0% vs. 58.4%);had CCI>=3 (50.0% vs. 66.2%), ICU/CCU admission (69.4% vs. 59.3%), mechanical ventilation (40.3% vs. 11.1%), LOS>=11 - days (51.4% vs. 28.1%), and inpatient mortality (45.8% vs. 8.5%). Conclusion(s): Our 11-year population-based study shows significantly increasing TACO trends over time, with greater number of units and advancing age. The study identified similar TACO risk during and pre-pandemic. By components, the highest TACO risk was for RBCs, either alone or in combination, while one of the lowest risks was for convalescent plasma only. Findings show higher rates for IC vs. non-IC, females vs. males, and whites vs. non-whites. For stays with COVID-19, TACO rates were substantially lower, but with marked case severity, which requires further investigation.
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Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic situation propelled the regular student mentorship program onto a virtual mode. Various surveys and studies have uncovered the ramifications on mental health and academic upheaval caused by the changing academic regulations and protocols. Aim(s): To evaluate the perception of mentors and mentees regarding the utility of virtual mentorship and to deduce barriers in continuing virtual mode mentorship program for 1st-year medical students. Material(s) and Method(s): The present observational study was conducted at Sri Siddhartha Institute of Medical Sciences and Research Centre, from April-June 2020. A feedback form was administered to all participants after two months of the online mentorship program, via a semistructured questionnaire. The questionnaire had four open and eight close-ended responses for mentees. The contents were related to the frequency of meetings, mode of communication, perceived barriers, and futility of course, along with one open and five close-ended responses for mentors on barriers to effective conduct and perceived level of the mentoring relationship forged with students. A total of 12 mentors and 125 students responded. Result(s): It was observed that 96% of mentees felt that the program helped to fight alienation and stay connected, 89.6% felt inspired to study and 83% felt oriented to the online teaching programs. Both 91.7% of mentors and 82.4% of mentees asked for better applications, connectivity, and network support. In fact, the major barrier to effective communication was quoted as being poor network connectivity and applications support (47%). A comparable trend was noted among both mentees and mentors with respect to the program being rated good and above (91.7% mentors and 85.6% mentees). Hence, in the observational study, via thematic analysis and content analysis of qualitative data, two points were observed-1. The virtual mentorship program helped mentees to get emotionally and academically connected, cleared their doubts, and helped to reduce stress. 2. Poor technical and connectivity support were deduced as major barriers to the successful conduct of virtual mentorship. Conclusion(s): A well-structured virtual mentorship program guides the mentors to effectively chaperone mentees through a stressful uninterrupted academic course period, enhance academic performances and help alleviate the feeling of alienation. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.
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INTRODUCTION: May-Thurner Syndrome (MTS) is the extrinsic compression of the left common iliac vein by the right common iliac artery against the lumbar vertebrae. While most MTS patients are asymptomatic, some develop deep vein thrombosis (DVT) from venous flow obstruction. Incidence and prevalence are unknown but estimated to occur in 2-5% of patients with lower extremity venous disease. Symptomatic MTS commonly presents in patients 20-40 years-old and rarely occurs in geriatric patients. CASE: An 82-year-old female with past medical history of hypertension, former smoker (quit 50 years prior) presented with acute left lower extremity (LLE) swelling and pain. No prior history of thrombosis, recent travel or surgery, hormone use, trauma or malignancy. Patient lived alone and was functionally independent. Upon admission, patient was afebrile and in no respiratory distress. COVID-19 testing negative. Physical exam notable for unilateral LLE 2+ pitting edema with erythema and mild tenderness. LLE ultrasound revealed extensive femoropopliteal, peroneal and posterior tibial DVT extending into the external iliac vein. CT chest, abdomen and pelvis with contrast showed compression of the proximal left common iliac vein by the right common iliac artery. Initially treated with heparin drip. Later underwent left iliofemoral pharmacomechanical thrombectomy with placement of bare metal stents resulting in successful restoration of blood flow. Patient was discharged on dual antiplatelet therapy and enoxaparin with plan to transition to rivaroxaban. DISCUSSION: Symptomatic MTS commonly presents in women and risk factors include hypercoagulable states, scoliosis, dehydration, cancer and radiation exposure. MTS can be treated with catheter-directed thrombolysis, venoplasty and/or stent placement. Post-thrombotic syndrome develops in 60% of iliofemoral DVTs within the first 5 years. While the decision to pursue thrombolysis and stenting is straight-forward in the typical MTS patient, this was not as obvious in our patient due to her geriatric age and uncertainty of benefit. Given her independence and few comorbidities, intervention was elected. Our case demonstrates that symptomatic MTS can present for the first time in a geriatric patient and that careful consideration is warranted in developing a treatment plan.
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INTRODUCTION: Multiple studies have attempted to characterize the signs and symptoms of infection with SARS-CoV-2 (COVID-19). While fever and respiratory symptoms remain the most common manifestations, gastrointestinal issues including abdominal pain, nausea, vomiting, and diarrhea have been increasingly reported. The etiology of diarrhea in SARS-CoV-2 has not been fully elucidated, but it may be multifactorial. This is a rare case of a COVID-infected patient with diarrhea and multiple gastrointestinal organisms. CASE DESCRIPTION/METHODS: A 59 year old male nursing home resident presented to the hospital with dyspnea, cough, fever, nausea and diarrhea. On arrival, he was febrile (T 38.1 C), mildly tachycardic with an oxygen saturation of 96% breathing room air. His abdomen was soft with diffuse, mild tenderness. Labs showed a normal white blood cell count, but lymphopenia. His chemistry panel and liver enzymes were normal. D-dimer was elevated . 2. He was SARS-CoV-2 positive. Supportive care and therapeutic anticoagulation was initiated. The next day, the patient continued to have frequent diarrhea with streaking of bright red blood. Stool PCR testing revealed Campylobacter and enteropathogenic E.coli. He was started on azithromycin, his anticoagulation was held, and his hematochezia and diarrhea slowly improved. DISCUSSION: The regular use of antibiotics in acute diarrheal illness is generally not recommended unless the risk of complications from diarrheal illness outweigh the risks associated with antibiotic use. Additionally, in diarrhea associated with Shiga-toxin producing E. Coli strains, antibiotic use is associated with higher rates of hemolytic uremic syndrome. In this patient, it was determined that his symptoms were severe enough to warrant antibiotics. Azithromycin was chosen due to its activity against Campylobacter and the potential benefit in COVID-19 infection due to inherent antiinflammatory properties. Intestinal inflammation and diarrhea in SARS-CoV-2 has been hypothesized to result from viral damage to ACE-2 receptors. However, the severity of diarrhea in this patient with potentially infectious enteric bacteria prompted antibiotic administration. The presence of multiple gastrointestinal organisms has rarely been reported in COVID patients. It is difficult to determine which enteric organisms are pathogenic and which may be colonizers. Clinicians must carefully evaluate the potential risks and benefits of initiating antimicrobials for diarrhea in patients with SARS-CoV-2.