Endogenous fungal endophthalmitis following COVID-19 infection with microbiological and molecular biological correlation - A report of two cases.

This case report describes three eyes of two patients, who were diagnosed to have endogenous fungal endophthalmitis post coronavirus disease 2019 (COVID-19) infection. Both patients underwent vitrectomy with intravitreal anti-fungal injection. Intra-ocular samples confirmed the fungal etiology by conventional microbiological investigations and polymerase chain reaction in both cases. The patients were treated with multiple intravitreal and oral anti-fungal agents; however, vision could not be salvaged.

Comparative Study of Bun/Albumin Ratio (BAR) with D Dimer/Albumin Ratio (DAR), A Better Prognostic Indicator for Outcomes of Hospitalized COVID-19 Patients

Introduction: On December 31, 2019, China reported cases of pneumonia of unknown etiology in the city of Wuhan, Hubei Province of China. With further investigations, the Chinese health authorities, on 7th January 2020 reported the agent as the novel Coronavirus, 2019-nCOV. Initially, Wuhan and later the entire Hubei province was brought under stringent lockdown. Material(s) and Method(s): This retrospective record analysis study involving laboratory investigations was carried out in a single center in the months of June and July 2022. The ethical clearance for this single-centre study was obtained from the Institutional Ethics Committee (IEC). This study included 112 patients, of ages more than or equal to 18 years, who were confirmed cases of COVID-19 with at least one reverse transcriptase polymerase chain reaction test positive and admitted for inpatient treatment for a minimum of 8 days or longer in the wards or ICU between May 2020 to March 2022. Result(s): A total of 112 patients who had a positive RT PCR test were identified and included in the study after excluding patients who had sought discharge against medical advice, who had been referred to other hospitals and patients with a history of chronic renal failure. The mean age of patients included was 60.25 + 15.66. Among these patients 76 (67.9%) were male and 36 (32.1%) were female. Of the 112 patients, 47 patients (42%) survived of which 21(32.3%) were male, 15(31.9%) were female and 65 patients (58%) did not survive, of which 44(67.7%) were male and 21(32.3%) were female. Conclusion(s): Through this study, we can see that all the parameters considered ie. Serum Albumin, Serum Blood urea nitrogen (BUN), D dimer, BUN/Albumin ratio (BAR) and D dimer/Albumin ratio (DAR) are very solid indicators of predicting the outcome of admitted COVID-19 patients.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Social media communication with intensified pandemic fears: evaluating the relative impact of user- and firm-generated content on brand loyalty

PurposeThe purpose of this study is to analyse user-generated content and firm-generated content on perceived quality and brand trust, and eventually how it impacted brand loyalty with pandemic fear as the moderator.Design/methodology/approachThis study employed an online survey questionnaire method in the Facebook online shopping groups to collect the data. The filter question technique was adopted to verify the respondent's validity. A total of 434 samples was collected using purposive sampling. The data were then analysed using SmartPLS 3.0.FindingsThe analysis showed that firm-generated content appeared to have a stronger positive relationship on perceived quality and brand trust than on user-generated content. Brand trust and perceived quality are found to influence brand loyalty positively. However, pandemic fears only moderate the relationship between firm-generated content and brand trust and perceived quality. This study revealed that the main components in social media communication do not influence perceived quality and brand trust to the same extent.Originality/valueThis study contributes to the knowledge of social media communication during the pandemic period that has not been studied empirically in the Malaysian context. The main components in social media communication were delineated and the impact of pandemic fears on how they would possibly affect the established relationships in the literature were examined. This study enables the researchers and practitioners to take a closer look at how the pandemic crisis could provide a shift on what has been understood so far.

Contribution of infection and vaccination to population-level seroprevalence through two COVID waves in Tamil Nadu, India (preprint)

Four rounds of serological surveys were conducted, spanning two COVID waves (October 2020 and April-May 2021), in Tamil Nadu (population 72 million) state in India. Each round included representative populations in each district of the state, totaling  ≥20,000 persons per round. State-level seroprevalence was 31.5% in round 1 (October-November 2020), after India’s first COVID wave. Seroprevalence fell to 22.9% in 2 (April 2021), consistent with waning of SARS-Cov-2 antibodies from natural infection. Seroprevalence rose to 67.1% by round 3 (June-July 2021), reflecting infections from the Delta-variant induced second COVID wave. Seroprevalence rose to 93.1% by round 4 (December 2021-January 2022), reflecting higher vaccination rates. Antibodies also appear to wane after vaccination. Seroprevalence in urban areas was higher than in rural areas, but the gap shrunk over time (35.7 v. 25.7% in round 1, 89.8% v. 91.4% in round 4) as the epidemic spread even in low-density rural areas. The study documents substantial waning of SARS-CoV-2 antibodies at the population level and demonstrates how to calculate the extent to which infection and vaccination separately contribute to seroprevalence estimates.

Performance Evaluation of Indian states healthcare systems in the management of COVID -19 recovery rate using DEA

Purpose: This study aims to evaluate the efficiency of the Indian state's health care systems in increasing the recovery rate of the Corona virus by using data envelopment analysis. Methodology: The Data envelopment analysis (Output Oriented CRS Model) has been applied to evaluate the efficiency scores of Indian states concerning the recovery rate of people affected by COVID -19. The tobit regression model is used to find the efficiency drivers. The required corona data has been collected during the period of time Feb 2019 - May 2020 from the government official websites like Worldometer, MoHFW, Corona Tracker etc,. Finding(s): The efficient states were found along with the factor that increases the state's efficiency in increasing the recovery rate. The study reveals that out of 36 State/UT, only 5 State/UT were efficient in increasing the recovery rate. In addition the study found that there is an input slack in the number of hospitals for inefficient states/UTs. Copyright © 2022 Authors. All rights reserved.

Mepolizumab as a Potential Protective Factor of COVID-19 Mortality: A Case Report of Chronic Bronchitis and Asthma in an Elderly Patient.

BACKGROUND Patients with multiple comorbidities who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have a higher risk of mortality. However, treatment with mepolizumab may be a key factor in counteracting the risk of these comorbidities. We present a patient who had an uneventful recovery from coronavirus disease 2019 (COVID-19), despite having 5 independent risk factors for severe disease and increased mortality. CASE REPORT A 75-year-old man with a long-standing history of asthma, chronic bronchitis, coronary artery disease, and hypertension presented to the Emergency Department in November 2020 with a 4-day history of fever, chills, shortness of breath, cough, and fatigue. Six months prior to this presentation, the patient was hospitalized for severe chronic bronchitis and acute exacerbation of asthma. His medications included mepolizumab, aclidinium, ramipril, diltiazem, aspirin, albuterol sulfate, and micronized budesonide/micronized formoterol fumarate dihydrate. Physical examination was unremarkable, except for cardiopulmonary distress. Laboratory tests showed leucocytosis. His chest X-ray revealed infiltrates and interstitial edema in the lower lung fields. A PCR test for SARS-CoV-2 was positive. COVID-19 pneumonia was diagnosed, and the patient was admitted to the hospital, where he was treated with acetaminophen, amoxicillin, dexamethasone, and supplemental oxygen. The patient remained stable and was discharged from the hospital the following day. He was free of all symptoms after 21 days. CONCLUSIONS This case of a 75-year-old man who presented with mild COVID-19 supports the findings from other reports of improvement in clinical outcomes for some patients with asthma who received treatment with mepolizumab.

Endometriosis and COVID-19: A Systematic Review and Meta-Analysis.

Endometriosis is defined as ectopic endometrial tissues dispersed outside the endometrium. This can cause disruption in hormonal and immunological processes, which may increase susceptibility to SARS-CoV-2 infection. Worsening of endometriosis symptoms may occur as a result of this infection. The aim of our review was to estimate the pooled prevalence of SARS-CoV-2 infection and the health impacts of the COVID-19 pandemic in endometriosis patients. We conducted a systematic review and meta-analysis. MEDLINE, Science Direct, Scopus, and Google Scholar databases were searched, using the keywords: (endometriosis) AND (COVID-19 OR SARS-CoV-2). Forest plots and pooled estimates were created using the Open Meta Analyst software. After screening 474 articles, 19 studies met the eligibility criteria for the systematic review, and 15 studies were included in the meta-analyses. A total of 17,799 patients were analyzed. The pooled prevalence of SARS-CoV-2 infection in endometriosis patients was 7.5%. Pooled estimates for the health impacts were 47.2% for decreased access to medical care, 49.3% increase in dysmenorrhea, 75% increase in anxiety, 59.4% increase in depression, and 68.9% increase in fatigue. Endometriosis patients were undeniably impacted by the COVID-19 pandemic, which caused the worsening of symptoms such as dysmenorrhea, pelvic pain, anxiety, depression, and fatigue.

NEEDLE IN A HAYSTACK: OPPORTUNISTIC SCREENING OF LUNG NODULES AMIDST COVID-19 USING DEEP LEARNING

SESSION TITLE: Lung Cancer Assessment and Risk Calculations SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Detection of pulmonary nodules is central to early diagnosis of lung cancer. Many types of observer error have been reported in literature. During the pandemic the radiology departments were stretched, and it is possible that the radiologists were primarily looking to either confirm or rule out COVID and missed nodules due to satisfaction of search and fatigue. This study was undertaken to estimate the magnitude of such errors. METHOD: 1312 consecutive chest CT scans interpreted in two specialist radiology units during the months of May-Jun 2021 (peak of India's 2nd covid wave) were used in this study. All scans were processed by qCT-Lung, a deep learning algorithm capable of flagging nodules. The radiology reports of the cases flagged by qCT were searched for findings suggestive of lung cancer. Cases for which nodules or mass were not mentioned in the report were re-read by an independent radiologist with qCT's assistance. The radiologist was aware of the context and was asked to mark flagged lesions as Yes/no for nodules. They also rated the nodule for malignancy potential in a positive directed five-point Likert scale if the flag was correct and gave an alternative finding if incorrect. RESULTS: 381 (29.0%) scans were flagged for nodules by qCT. 52 of these were also reported in radiology reports. Of the 329 scans re-read by radiologist, 65 (19.8 %) scans were reported as having nodules. These 65 scans had a total of 134 nodules. The median size (longest diameter) of these nodules was 14 mm (range: 7 - 33) and most (95) were solid nodules. The most common reason (94.5%) of false flag by qCT was ground-glass opacity with consolidation. 53 of 65 of the correctly identified scans were given malignancy rating of 1 or 2 (non-malignant or probably non-malignant). 10 were given a rating of 3 (could be malignant or non-malignant) and 2 were rated as probably malignant. Two cases of lung cancers were flagged by both qCT and reports. CONCLUSIONS: Nodules were not reported in 65 scans. All of them can't be considered as missed by radiologists. From the ratings provided by the radiologist doing re-reads - it is possible that previous radiologists could have not reported the nodule due to perceived malignancy risk. 12 scans had ratings that would have warranted follow-up action. False flags were mainly due to ground glass with consolidation. The occurrence of ground glass opacities in COVID could in part explain the high number of false flags in this study. CLINICAL IMPLICATIONS: All scans had nodules with size > 6 mm and 26 had multiple nodules making the patients eligible for follow-up as per Fleischner guideline. Radiologist report only clinically significant findings focussing mostly on indication(s) of the scan. Taking a conservative approach and reporting all nodules irrespective of perceived risk will help clinicians plan follow-up. Algorithms like qCT-Lung can help readers in identifying all nodules. DISCLOSURES: Employee relationship with Qure.ai Please note: 15/12/2020 Added 04/04/2022 by Vikash Challa, value=Salary Removed 04/04/2022 by Vikash Challa Employee relationship with Qure.ai Please note: Current employee Added 04/04/2022 by Vikash Challa, value=Salary Owner/Founder relationship with bodyScans Please note: Current co-founder Added 04/05/2022 by Era Dwivedi, value=Salary Employee relationship with Aarthi Scans and Labs Please note: Current Employee Added 04/04/2022 by Arunkumar Govindarajan, value=Salary Owner/Founder relationship with bodyScans Please note: Current Director Added 04/05/2022 by Arpit Kothari, value=Salary Employee relationship with Qure.ai Please note: Current employee Added 04/04/2022 by Souvik Mandal, value=Salary Employee relationship with Qure.ai Please note: Current employee Added 04/04/2022 by Ankit Modi, value=Salary Self relationship with Qure.ai Please note: Current employee Added 04/04/2022 by SAI NAREN V S, value=Salary Employee elationship with Qure AI Please note: Current Employee Added 04/04/2022 by Vanapalli Prakash, value=Salary Employee relationship with Qure.ai Please note: Current employee Added 04/07/2022 by Preetham Putha, value=Salary Employee relationship with Qure.ai Please note: 4 years Added 04/04/2022 by Bhargava Reddy, value=Salary Employee relationship with Qure.ai Please note: Current Employee Added 03/27/2022 by Saigopal Sathyamurthy, value=Salary Owner/Founder relationship with Qure.ai Please note: Current co-founder Added 04/04/2022 by Prashant Warier, value=Salary

Retinal venous occlusion in a child following Corbevax COVID-19 vaccination.

A 13-year-old boy developed painless diminution of vision in left eye 15 days after taking first dose of coronavirus disease 2019 (COVID-19) vaccine (Corbevax). Fundus and fluorescein angiography revealed central retinal vein occlusion in the left eye. Blood investigations were noncontributory. He was administered three doses of pulse corticosteroids followed by a tapering dose of oral corticosteroids. Retinal vascular occlusion can occur following COVID-19 vaccination in children, and early and aggressive systemic anti-inflammatory therapy can be helpful.

HALT - Targeted Therapy with or without Dose-Intensified Radiotherapy in Oligo-Progressive Disease in Oncogene Addicted Lung Tumours

Introduction: Following initial response to TKI, advanced NSCLC patients with actionable mutations ultimately develop treatment resistance. In a proportion of patients (15-40%), initial, limited progression (≤5 lesions) is observed, termed oligoprogressive disease (OPD). SBRT offers hypofractionated, targeted radiotherapy treatment hypothesised to prolong clinical benefit from TKI prior to widespread disease development. With limited evidence to date, and poor clinical/biological selection criteria, the potential benefit offered by SBRT to ablate OPD sites prior to change in systemic therapy is an important question to address. Methods: HALT is a randomised, multi-centre, phase II/III international trial with seamless transition to phase III incorporated. Eligible patients (stage IV NSCLC, actionable mutation, TKI response prior to OPD) are randomised 2:1 to SBRT/continued TKI or continued TKI alone. Eligibility is confirmed by a virtual MDT (vMDT) comprising trial clinicians and radiologists (confirmation of OPD, SBRT suitability). Follow-up assessments are aligned with routine care at 3-monthly intervals until change in systemic therapy is clinically indicated, with imaging and toxicity assessment at each visit. Results: Recruitment commenced November 2017 with 25 centres (17 UK;8 non-UK) open to date. Following the COVID-19 pandemic, recruitment is recovering with 129 registered and 74 randomised patients. Over the last 4 years, little evidence has emerged to confirm any potential benefit of SBRT in this patient group and the impact on patient toxicity remains unknown. Therefore, with persisting questions around clinical equipoise, HALT remains highly relevant. With an 18-month extension and a recent amendment to the HALT inclusion criteria (≤5 OPD lesions, ≤7cm and OPD assessments by PET-avidity), the target of 110 randomised patients remains achievable. Conclusions: As the first randomised trial assessing SBRT benefit in this mutation-positive NSCLC patient population, HALT will provide valuable treatment efficacy and safety information, informing subsequent trial design and contribute to the development of international guidelines for the identification and clinical management of oligoprogression in mutation positive lung cancer. Keywords: Stereotactic body radiotherapy, NSCLC, Phase II

A Framework for Masked-Image Recognition System in COVID-19 Era

Face Recognition techniques have been widely developed and used for many years. Several approaches and models are adopted and successfully used to perform face recognition in airports, supermarkets, banks, etc. However, with the emergence of the COVID-19 pandemic, the whole world came across the requirement to use face masks. The mask’s partial covering of the face makes some well-known face recognition algorithms perform poorly or even fail. This paper has developed a real-time framework to detect, recognize, and identify people to authenticate them before accessing an app, device, or location. The newly created framework offers a unique set of capabilities, including the ability for users to select from various authentication methods based on their preferences or circumstances. The application’s face recognition section uses cutting-edge AI and computer vision algorithms to offer the user accurate face detection and recognition, even when the face is partially hidden behind a mask. © 2022, Springer Nature Switzerland AG.

171 HALT: targeted therapy with or without dose-intensified radiotherapy in oligo-progressive disease in oncogene addicted lung tumours

Background: Following initial response to TKI, advanced NSCLC patients with actionable mutations ultimately develop treatment resistance. In a proportion of patients (15-40%), initial, limited progression (<3 lesions) is observed, termed oligoprogressive disease (OPD). SBRT offers hypofractionated, targeted radiotherapy treatment hypothesised to prolong clinical benefit from TKI prior to widespread disease development. The potential benefit offered by SBRT to ablate OPD sites prior to change in systemic therapy is an important question to address, particularly during the current pandemic, where reducing clinic visits is particularly advantageous. Method: HALT is a randomised, multi-centre, phase II/III international trial with seamless transition to phase III incorporated. Eligible patients (stage IV NSCLC, actionable mutation, TKI response prior to OPD) are randomised 2:1 to SBRT/continued TKI or continued TKI alone. Eligibility is confirmed by a virtual MDT comprising trial clinicians and radiologists (OPD, SBRT suitability). Follow-up assessments aligned with routine care at 3-monthly intervals until change in systemic therapy is clinically indicated, imaging and toxicity assessment at each visit. Current status: Recruitment commenced November 2017;27 centres (16 UK;11 non-UK) open to date (09/03/2021), 94 patients registered and 50 randomised. Because of the COVID-19 pandemic, recruitment was temporarily paused on 20/03/2020 and restarted in accordance with national guidelines on 16/06/2020. Of 94 patients registered, vMDT review performed for 74 patients (18 screen fails prior to vMDT);50 randomised, 22 confirmed ineligible via vMDT (inc. >3 lesions, lesion >5cm, intracranial disease identified). Conclusion: The vMDT remains an important, novel aspect of the trial, ensuring robust patient selection ahead of randomisation. As the first randomised trial assessing SBRT benefit in this patient population, HALT will provide valuable treatment efficacy and safety information, informing subsequent trial design and contribute to the development of international guidelines for the identification and clinical management of oligoprogression in mutation positive lung cancer. Disclosure: No significant relationships.

Seroprevalence in Tamil Nadu through India's two COVID waves: Evidence on antibody decline following infection and vaccination (preprint)

Three rounds of population-representative serological studies through India's two COVID waves (round 1, 19 October-30 November 2020; round 2, 7-30 April 2021; and round 3, 28 June-7 July, 2021) were conducted at the district-level in Tamil Nadu state (population 72 million). State-level seroprevalence in rounds 1, 2 and 3 were 31.5%, 22.9%, and 67.1%. Estimated seroprevalence implies that at least 22.6 and 48.1 million persons were infected by the 30 November 2020 and 7 July 2021. There was substantial variation across districts in the state in each round. Seroprevalence ranged from 11.1 to 49.8% (round 1), 7.9 to 50.3% (round 2), and 37.8 to 84% (round 3). Seroprevalence in urban areas was higher than in rural areas (35.7 v. 25.7% in round 1, 74.8% v. 64.1% in round 3). Females had similar seroprevalence to males (30.8 v. 30.2% in round 1, 67.5 v. 65.5% in round 3). While working age populations (age 40-49: 31.6%) had significantly higher seroprevalence than the youth (age 18-29: 30.4%) or elderly (age 70+: 26.5%) in round 1, only the gap between working age (age 40-49: 66.7%) and elderly (age 70+: 59.6%) remained significant in round 3. Seroprevalence was greater among those who were vaccinated for COVID (25.7% v. 20.9% in round 2, 80.0% v. 62.3% in round 3). While the decline in seroprevalence from rounds 1 to 2 suggests antibody decline after natural infection, we do not find a significant decline in antibodies among those receiving at least 1 dose of COVID vaccine between rounds 2 and 3.

Social Distance Shopping Using Embedded Based Auto Cart and Android App

Recently shopping has become a day to day activity and people are visiting the supermarket for purchasing products for their daily needs. Whenever a person is buying products they need to search for the product in such a big store and collect all the required products and need to wait in queue for billing and payment. Since it is time consuming they will be annoyed. Our main aim in developing this product is to reduce the time consumption in searching products and waiting in queue while billing and payment thereby reducing the issues of social distancing which is the need for the hour. In this product RFID card reader is used in each product to identify it and a special RFID tag for payment and also for recharge, using EEPROM to store balance value and android app to search and locate products in store and also a payment option in application. © 2021 IEEE.

Fintechs and payments for international education

This paper examines the landscape of global student mobility, giving special attention to the emergence of FinTechs in the international education payment space. Banks, which have at best been participants in the market for cross-border remittance of person-to-person and person-to-business/university payments, are now seeing new innovative FinTechs solving customer pain points, making transactions more efficient and simple.This paper maps the huge market demand for speed, safety and security in education-related payment instruments. With COVID-19 creating a new normal, the paper also describes how various FinTechs have launched creative solutions to solve payment issues for students and reconciliation-related challenges for universities and other beneficiaries by setting up smart digital interfaces.The issues faced by students and parents at a larger level are very similar to the frictions and challenges seen with peer-to-peer payments. © Henry Stewart Publications, 1750-1806.