The impact of age and gender on mortality from COVID19 at A UK Hospital

Rationale: Age poses greater mortality risk to COVID-19 patients. This may be due to co-morbidities and age-related impairment of immunity. It has been shown that females are more likely to be infected however, severe disease is more often seen in males, which could be explained by greater levels of interferon-gamma promoter activity driven by oestrogen in females in addition to higher levels of IgG antibody providing more protection. We aim to investigate the effects of age and gender on the mortality rate in patients with COVID-19. Method(s): A retrospective study of all in-patients aged >= 18 years with a confirmed diagnosis of COVID-19 during the first and second waves of the pandemic. Admission CXRs were analysed. Statistical analysis was performed using the Chi-Squared Test for independence. Result(s): 1759 COVID-19 patients were included in the study, of which 481 were aged <65 years and 982 were aged > 65 years. The study had 967 males and 792 females. We found a higher mortality rate in those aged > 65 (41%) compared to those aged <65 years (18%) (P<0.001). There were no significant differences in the mortality rates between both genders. However, interestingly males had a greater severity of pneumonitis (22%) on CXRs compared to females (13%) (P=0.01). Conclusion(s): Our study demonstrated a positive correlation between increasing age and mortality with males showing a greater disease severity. This data should be considered when stratifying at risk groups and prioritising them for early intervention.

Comparing the mortality of COPD and non-COPD patients with COVID-19 in a UK hospital

Rationale: Initial reports during the pandemic have shown that COPD patients with COVID-19 have a poorer prognosis due to an increased risk of respiratory failure. It is well known that in COPD, there is an increased expression of angiotensin converting enzyme-2 (ACE2), the receptor which plays a role in SARS-CoV-2 entry into cells. In the absence of infection, ACE2 converts angiotensin-2 (AngII) to angiotensin-1-7- helping regulate inflammation. During COVID-19 infection, ACE2 activity is reduced due to receptor occupancy, resulting in greater levels of AngII- leading to a pro-inflammatory state. We aim to investigate the impact of COPD and COVID-19 on mortality, length of in-patient stay and gender. Method(s): A retrospective study of all in-patients aged >= 18 years with a confirmed diagnosis of COVID-19 during the first wave of the pandemic. Statistical analysis was performed using the Chi-Squared Test for independence. Result(s): 445 COVID-19 patients were included in the study, out of whom 52 (12%) had COPD. Mortality in COPD patients (65%) was found to be significantly higher than non-COPD patients (49%) (P=0.03) There were no significant differences in mortality between COPD and non-COPD patients when grouped for male and female (P=0.68). Furthermore, there were no significant differences in length of in-patient stays of >7 days between COPD and non-COPD patients (P=0.79). Conclusion(s): Our study demonstrated how COPD increases mortality in COVID-19. This data should be considered when highlighting at risk groups- prioritising them for treatment, isolation, and preventative public health measures such as the COVID-19 vaccination programme.

Duodenal Stricture as a Rare, Possible Complication of Eosinophilic Gastrointestinal Disease (Egid)

EGID is a recently described condition with an unknown etiology and pathogenesis. There are three case reports of duodenal stricture associated with EGID: one in an adult requiring pancreaticoduodenectomy due to the suspicion of malignancy and 2 cases in a child and a young adult, who responded to oral steroids. We report the case of a 10-year-old who presented to A&E with a 9-month history of epigastric abdominal pain and 1 episode of haematemesis, on a background of asthma. He was treated for Helicobacter pylori, based on a positive stool antigen. Abdominal pain and vomiting persisted, therefore an oesophago-gastro-duodenoscopy (OGD) was performed. This identified widespread white plaques throughout the oesophagus, erythema and nodularity of the gastric antrum and white nodules in the first part of the duodenum. Histology revealed changes of EGID and eosinophilic oesophagitis (EOE) and patient was commenced on Montelukast, oral viscous Budesonide (OVB), Cetirizine and continued proton pump inhibitor (PPI). After the allergy workup identified house dust mites, cat sensitisation and fish allergy, a 6-food elimination diet was initiated. During the next 2 years, symptoms subsided, and endoscopy changes improved, with only mild signs of active EOE while on OVB, PPI and diary/egg/fish free diet. However, the patient relapsed due to poor compliance to treatment. He became more unwell during the Covid pandemic with recurrent vomiting and static weight. A trial of dupilumab was considered, however his reassessment OGD had to be delayed due to restricted access to theatre. He was treated empirically with a reducing course of oral prednisolone, with temporary response. The endoscopic assessment performed subsequently showed erythema, erosions and white plaques in the distal oesophagus and gastric antrum with narrowing between the first and the second part of the duodenum (D2), that could not be entered. Histology identified mild upper oesophagitis (4 eosinophils (eos)/HPF), active middle and lower oesophagitis (20 eos/HPF and 12 eos/HPF, respectively), chronic gastritis (80 eos/HPF) and nonspecific reactive changes of the proximal duodenum. A barium meal confirmed a duodenal stricture. At this stage, we recommended a sloppy diet and a second weaning course of oral prednisolone, along with Montelukast. He was subsequently commenced on azathioprine for maintenance of remission. A repeat barium study and small bowel MRI performed post course of steroids and on azathioprine revealed stable appearances of the proximal duodenal stricture, excluding the presence of further strictures. While the patient has responded to the course of oral steroids and azathioprine, a repeat upper GI endoscopy is currently planned to dilate the duodenal stricture. The challenges posed by this case were the rarity of the condition, limited treatment options and access to endoscopy during the Covid pandemic and the fact that unlike previous case reports a sustained remission could not be obtained on steroids, and a maintenance immunosuppressive medication was required. We can conclude that this subgroup of patients should be monitored closely for signs of bowel obstruction and will require more intense treatment, including immunomodulators, endoscopic dilatation and or surgery.

Sustainability of migratory pastoralism through value addition during Covid-19 pandemic in Kachchh district

This study was conducted among the Maldhari community to understand the sustainability of migratory pastoralism during Covid-19. Bhuj and Lakpat Talukas of Kachchh district, Gujarat were selected to study the effect of profile variables on the annual income and net income of the families. The study revealed that family size and taluka were the significant factors influencing total income whereas taluka was the only significant factor influencing net income. Due to reduced sale of milk resulting from Covid-19, most of the milk was converted into khoa and the income generated from its sale was the major source of income for the migratory families. Cow dung fetched a minimal price which served as major source of their livelihood with no input cost. The value addition with better marketing facilities can significantly enhance the income of the pastoralists in the Kachchh district. Copyright © 2022 Indian Council of Agricultural Research. All rights reserved.

Risk and risk management: a historical review and research agenda

This paper aims to compile and improve the current understanding of risk, risk management, risk lexicon, and enterprise risk management (ERM) and summarise theoretical and empirical research regarding the relationship between risk management and firm value by summarising over a hundred publications from the domain of risk understanding, typology of risk, the evolution of risk management and firm performance, and enterprise risk management. This literature review suggests that better risk management should lead to better risk-taking and not just risk reduction and finds strong theoretical and empirical evidence that risk management leads to improved firm valuations and performance while reducing cash flow uncertainty and return volatility. The literature review validates the positive relationship between risk management and firm value. Firms with sound risk management practices experience higher valuations and lower costs of financial distress. Evidence suggests that ERM has significant potential for wealth creation and cost mitigation. Copyright © 2022 Inderscience Enterprises Ltd.

Analyzing the State of Mind of Self-quarantined People during COVID-19 Pandemic Lockdown Period: A Multiple Correspondence Analysis Approach

COVID-19 (Corona) virus has spread across the world threatening lives of millions of people. In India first COVID-19 case was detected on 30th January 2020 in Kerala. To minimize the spread of Corona Virus, countries all over the world implemented complete lockdown. Due to complete lockdown even people who are not exposed to corona virus, have to self-quarantine to keep themselves safe from getting infected by the disease. People (especially Indians) have never experienced such complete lockdown and quarantining situations before. Thus, this creates a space for curiosity that how people are going to react to this situation. The present study aims to analyse how self-quarantined people during COVID-19 lockdown period are reacting to quarantining, what measures they are taking to deal with this situation, and what are their sentiments towards quarantining. The study also aims to measure their Happiness and to identify the factors that are statistically significant to Happiness. For this study, the data is collected through a survey method. Multiple correspondence analysis are performed to analyse the survey data. The happiness score is evaluated by using the GNH (Gross National Happiness) methodology. Proportional Odd Logistics Regression is used to identify factors that are statistically significant in predicting happiness. The study suggests that family factor is related to the happiness of the self-quarantined people during such lockdown situations. © 2022,International Journal of Advanced Computer Science and Applications. All Rights Reserved.

Maternal and foetal outcomes in pregnant women undergoing lower segment caesarean section during COVID-19 pandemic: a retrospective analysis

Background and Aims: Coronavirus disease 2019 (COVID-19) adds more challenges to the perioperative management of pregnant women. The aim of this study is to examine severity of COVID-19 disease and maternal and foetal outcome among COVID-19 positive pregnant women undergoing caesarean section. Methods: This retrospective observational study was conducted at a tertiary teaching hospital in Karnataka between 1stApril to 31st July 2021, during which 100 COVID-19 positive pregnant women with ASA physical class II, III and IV who have undergone lower segment emergency caesarean section were selected on the basis of simple random sampling method. Results: A total of 100 women who had undergone caesarean section under spinal anaesthesia with positive SARS-CoV-2 PCR tests were assessed. Mean age was 24.45± 4.3 years, eight women were having severe covid-19 infection and overall mortality rate was 5% (5/100) in women and 1 woman had HELPP syndrome and one met with PPH (post-partum haemorrhage). Seven (7%) COVID-19 pregnant women required intensive care in the perioperative period. Eight neonates required NICU admission and had APGAR score less than 7. Fifty-five (55%) women were asymptomatic. While the rate of pneumonia in symptomatic women was 3.6% (8/45), the pneumonia incidence among all SARS-CoV-2 PCR (+) pregnant women was 8% (8/100). Conclusion: In our study, 61% of patients had pulmonary involvement and the mortality rate was 8% among mothers and 1% in neonates.

Covid-19 Impact on Cyber Crimes in India: A Systematic Study

In this digital era of online processing, most information is accessible electronically and is prone to cyber threats. There is a vast range of cyber threats whose behavior is hard to understand in the early phases. These attacks may have some motivation behind them that have significant societal impacts in the form of economic damage, psychological disturbance, a threat to national security, and so on. With the worldwide spread of COVID-19, India experienced an astonishing 86% rise in cybercrimes. Nowadays, cybercrime has become an attractive strategy for hackers to create chaos and disruption. This paper is based on the quantitative analysis of cybercrime in India and its impacts on society, with preventive measures to handle them. In our study, we found that digital related offenses and online frauds are drastically increasing in India during COVID-19 pandemic. As a result, awareness campaigns and security solutions are needed to prevent or mitigate them. © 2022 IEEE.

Healthcare Chatbot System: A Survey

A chatbot is a software that produces a computer model of conversation through auditory or textual method between the user and the computer. Such bots use AI and NLP to understand user's questions and automate responses to them, simulating human conversation. In this modern technology almost, every person utilize smartphones in their day to day lives. Simply because, it has made life of a person simple by the touch of the screen, from extracting information from the internet, to provide personal assistance to entertainment everything happens just by the click of a button. Today Chatbots are used in various domains like education, customer service, medical, website help etc for seeking information, FAQ answering and guidance. Due to the advancements in AI and techniques used in data mining, healthcare chatbots are often used for medical screening. The aim of this paper is to do detailed study of various research papers related to chatbots and analyze the different tools, algorithms, software and platforms that are utilized. © 2022 IEEE.

Clinical profile and outcomes of COVID 19 patients having acute kidney injury: an experience from a tertiary care centre Eastern India

Introduction: SARS COVID 19 is the third corona virus affecting all over the world in last 20 years following SARS COV and MERS COV. Multiple complications and death usually occurs in 6.4 % cases. In the beginning reports, incidence of AKI was negligible. Various data shows AKI occurs is >20% hospitalized patients and >50% of ICU patients. Methods: The study was a cross sectional study, carried out in the department of nephrology, of IMS and SUM Hospital, Bhubaneswar for a period of 1.2 years (April 2020-June 2021). The patients data was obtained from the hospital information system (HIS). It included the individuals of at least 18 years old, with a laboratory confirmed SARS-COV2 infection, and were hospitalised for the same. It excluded the known ESKD prior to admission and patients who were hospitalised for less than 48 hours. Results: It was observed that most patients were in their 6th decade, 40 % were Female. Patients with AKI, have low Hb%,high TLC count, low platelet count, high potassium level and low albumin, bicarbonate level,lymphocyte count, and higher creatinine values. Out of 3993 patients, 46% 1 developed AKI. In ICU 76% developed AKI. Peak Serum Creatinine was 2.2(IQR 1.5-3.6) in non dialysis patients and 8.2 in dialysis requiring patients (IQR 6.1-11). Conclusion: It is not uncommon to come across AKI patients in patients suffering from COVID-19 also associated with high death rate. Meticulous clinical observation and instillation of therapy helps to render better patient care.

Crowd Prediction at Various Public Places for Covid-19 Spread Prevention Employing Linear Regression

Input from a simple sensor-based people counters module is taken as training data for a Linear Regression and a K-Means model for predicting crowds at various public places. The influencing factor can be either time or distance and the outcome factor be crowd strength at a place. By training a Linear Regression and a K-Means algorithm, an efficient predictive model for crowd prediction can be created.

A systemic review of neurological manifestations of COVID-19 infection

Objective: The purpose of the study is to systematically review literature on the neurological manifestations of COVID-19. Our review aims to inform the physicians treating COVID-19 of the neurological manifestations experienced within these patients. Background: While COVID-19 typically presents as a respiratory disease, the neurological manifestations are not uncommon. Neurological reports of COVID-19 patients described headache, dizziness, hypogeusia, hyposmia, acute cerebrovascular disease, myopathy, neuromuscular disorders, encephalitis, ataxia, delirium, and others. There are also reports of Guillaine Barrè syndrome associated with COVID-19. More data is needed to establish the incidence, outcomes and causal mechanisms between COVID-19 and its neurological sequel. Risk factors that may predispose a person with COVID-19 to neurological manifestations also need to be identified. Design/Methods: A PubMed and Scopus search has been conducted identify published papers for systematic review. Case reports, case series, editorials, reviews, case-control and cohort studies were evaluated, and relevant information was ed. Results: We identified 27 article meeting our criteria in the final analysis which included experimental studies, case reports, series of cases, cohort studies, and systematic reviews. Common reported symptoms included hyposmia, headaches, weakness, altered consciousness. Encephalitis, demyelination, neuropathy, and stroke have been associated with COVID-19. The most frequently reported neurological complication was acute ischemic cerebrovascular accident, followed by Guillain-Barré syndrome, with least common being meningitis and/or encephalitis. Presence of preexisting neurological disorders was associated with increased risk of developing neurological signs and/or syndromes with COVID-19. Conclusions: Considering the possibility of neurological involvement in patients with SARSCoV-2 infection can result in earlier diagnosis and treatment. Neurologic manifestations in COVID-19 should alert physicians and medical practitioners to rule in high-risk patients. Using a global network with standardized protocols and common data elements is critical to facilitate further studies to understand COVID-19 neurological manifestations.

Microbial contamination in the coastal waters of the southeast coast of India: A comparison of pre and post COVID-19 lockdown scenario

Anthropogenic activities on the land side cause microbial pollution in coastal waters. The primary culprits in changing coastal water quality are industrial effluents, urban discharges, and agricultural runoff. The current study provides a comparative overview of microbial abundance during the pre (July 2019) and post-lockdown (July 2020) periods. Microbial densities were significantly higher during July 2019. Total heterotrophic bacteria (THB) and E. coli (ECLO) like organisms were about 53 % higher during pre-lockdown, while Fecal coliform (FC) counts were approximately seven× higher than post-lockdown. FC levels surpassed the standard safe limits (100 FC/100 ml) prescribed by Central Pollution Control Board (CPCB) at many locations. Physiochemical variables are significantly high during pre-lockdown. Total suspended matter levels were higher by 40.1 %, Total nitrogen (69.2 %), Total phosphorus (7×), Biological oxygen demand (45.6 %), and pCO2 (20.4%). Although nutrients are not limiting (high TN & TP), the phytoplankton biomass (Chl-a) was relatively low in pre-lockdown due to higher TSM restricting light penetration and affecting photosynthetic activities. Significant reductions in microbial contamination during July 2020 corroborated lesser anthropogenic activities associated with the lockdown, demonstrating the positive impact of lockdown on the coastal water quality. © 2022 IEEE.

Telecounseling and Guided Relaxation for Addressing Patient, Student, and Health-Care Worker Distress: An Experience & nbsp;

Introduction: In the face of the coronavirus disease 2019 (COVID-19) pandemic, the leadership of the institute felt a need for mental health interventions among patients admitted in COVID-19 isolation, university students, and health-care workers engaged in COVID-19 care. This article aims to share our experience in providing these services. Methodology: COVID-19 inpatients were telephonically counseled. Counseling protocol was based on national guidelines. Students of the university were assessed for emotional problems using a symptom checklist and Kessler 10-item Distress Scale. Subsequently, the faculty assigned as mentors were trained in providing telephonic psychological first aid (PFA) to the students. Psychosocial help was offered to health-care workers through daily guided relaxation sessions. Results: Forty-two of 69 COVID-19 inpatients were telephonically contacted. New-onset mental health problems were found in 40%. Half of the COVID-19 confirmed patients and half of the females had a higher prevalence of mental health problems. On the symptom checklist, 330 students were responded. Worry about the future, contagion, and boredom were reported by the majority of students. On the Kessler 10-item Distress Scale, 272 students were responded. Thirty-seven percent had likely mental disorders (22 males and 79 females). Twenty-two students contacted psychiatrists through mentors and were provided teleconsultation. Eighty health-care workers attended guided relaxation sessions. Twenty-nine responded on the feedback form. Most respondents felt guided relaxation was useful in reducing stress, with strongly agree (n = 12) and agree (n = 14) responses. Conclusions: Emotional problems were significantly prevalent among students and COVID-19 patients. Training faculty in PFA can help address students in distress. Guided relaxation may help frontline workers manage stress.& nbsp;

Twitter based sentimental analysis of Covid-19 observations.

The emergence of social media has provided people with the opportunity to express their feelings and thoughts about everything and everything in their lives. There is a massive amount of textual stuff available, and approaches are required to make meaningful use of the information provided by isolating and evaluating the different types of text. Sentimental Analysis is a method of obtaining a human being's point of view through mining his or her emotions. The entire world is sharing their thoughts on social media on the Corona Pandemic that is now underway. This research presents an analysis of attitudes in order to determine whether or not people are optimistic in the face of a difficult circumstance. The technique of polarity is employed by the paper in order to determine if an opinion is positive, negative, or nonpartisan [1]. In order to determine the polarity, the following three major keywords are used: "COVID", "Corona virus," and "COVID-19."

Knowledge and attitude of dental professionals toward COVID-19 in Riyadh, Saudi Arabia: a cross-sectional survey

Background Coronavirus disease-2019 (COVID-19) is a life-threatening global pandemic. The dental profession is considered a high-risk group in the transmission of the responsible virus. Objective To assess the knowledge and attitude among dental professionals in response to the COVID-19 pandemic. Methods We conducted a cross-sectional study of dental graduates, interns, postgraduates, and dental faculty from May to July 2020. A standardized questionnaire was developed to assess knowledge and attitude of 650 participants. The questionnaire comprised 14 questions to assess general knowledge about COVID-19, 11 questions regarding knowledge about prevention of COVID-19 in dental practice, and 10 questions regarding the attitude toward preventing COVID-19. Results Among the study population, only 376 (57.8%) knew the causative virus for COVID-19. Only 425 (65.3%) knew about rinsing the mouth with an antimicrobial solution or 1% hydrogen peroxide before the dental procedure. Regarding the hand hygiene guidelines, 357 (54.9%) had knowledge of the Centers for Disease Control and Prevention (CDC) and 377 (58.0%) about World Health Organization (WHO) guidelines. At the time of our survey, 72% of the participants showed sufficient knowledge, while 28% had low or insufficient knowledge about COVID-19. Conclusion While there was a lack of knowledge among dental professionals in Riyadh, Saudi Arabia about COVID-19, there was an excellent positive attitude toward preventing disease. Greater awareness is needed to control the spread of this disease.

Impact of empirical antibiotic use in patients with COVID-19 on morbidity and mortality during the first and second UK SARS-CoV-2 waves

S53 Figure 1Rates of mortality against cumulative number of antibiotics received per patient during inpatient spell.[Figure omitted. See PDF]ConclusionIn both COVID-19 waves, antibiotic administration correlated to increased inpatient morbidity and mortality. Given a near-linear relationship of mortality and cumulative antibiotic numbers, antimicrobial stewardship is essential, and tapering an appropriate therapy for likely responsible pathogens will yield lower mortality compared to overlapping coverage and inappropriate escalation. We strongly discourage the use of empirical antibiotics without supporting biochemical evidence of bacterial co-infection for possible future COVID-19 waves.ReferenceRussell C, et al. Lancet Microbe. 2021 Jun 2. https://doi.org/10.1016/S2666-5247(21)00090-2