Correction to: Postpartum Collapse Subsequent to Catatonia in a Female with COVID-19 Infection: A Rare Entity Visited.

[This corrects the article DOI: 10.1007/s13224-022-01737-5.].

Correction to: Postpartum Collapse Subsequent to Catatonia in a Female with COVID-19 Infection: A Rare Entity Visited.

[This corrects the article DOI: 10.1007/s13224-022-01737-5.].

Analysing the Effect of Incorporating Images While Framing MCQs For Online Clinical Anatomy Assessment Among First Year Medical Students

The disruptions caused by COVID-19 pandemic has significantly affected the assessment component of the undergraduate medical curriculum. The lack of physical ascertainment of the learning outcomes has forced the medical educators across the world to adopt online modes of assessment. Though multiple options like true / false, short answers and viva were available, the most common tool for many was multiple choice questions as they could be arranged according to the cognitive hierarchy of Miller's pyramid. The present study was undertaken to analyze the effect of incorporating images while framing MCQs for online anatomy assessment among first year medical students. The study was planned in a quasi-controlled design where a batch of 150 students were subjected to a set of 40 multiple choice questions (20 text based and 20 image based MCQs). The questions were designed following Ebel and Frisbie guidelines of MCQs and validated by three investigators independently. Three cycles of assessments were conducted, and the scores were analyzed. At the end of 3 cycles of assessment feedback was taken from the students regarding this method of assessment. The performance of students was better in image based MCQs compared to traditional MCQs in all regions. Upon documenting the percipience, students had felt that image based MCQs were interesting, improved their clinical reasoning skills, lateral thinking abilities and quest for learning applied anatomy. Thus, we postulate that image based MCQs could be considered as better assessment tool in the era of online learning. © 2022, IMED Research Publications. All rights reserved.

Postpartum Collapse Subsequent to Catatonia in a Female with COVID-19 Infection: a Rare Entity Visited.

Postpartum collapse is a life-threatening condition caused by obstetrical and non-obstetrical events. In this case report, we discuss a case of postpartum collapse in COVID-19-positive woman who required intensive care and mechanical ventilation for two days. After confusing collision of many provisional diagnoses soldiering for three days, she was ultimately diagnosed with malignant catatonia. Targeted therapy with lorazepam challenge resulted in drastic improvement, and she was discharged with her baby in healthy condition.

Gravité de la COVID-19 chez les receveurs d'une transplantation d'organe plein au Canada, 2020­2021 : étude de cohorte prospective multicentrique.

CONTEXTE: La forme grave de COVID-19 semble affecter de manière disproportionnée les gens immunovulnérables, même si les données canadiennes dans ce contexte sont limitées. Nous avons voulu déterminer quels facteurs sont associés aux paramètres de la forme grave de COVID-19 chez les receveurs de transplantations au Canada. MÉTHODES: Nous avons procédé à une étude de cohorte multicentrique prospective regroupant tous les receveurs d'une transplantation d'organe plein ayant reçu un diagnostic de COVID-19 suivis dans 9 programmes de transplantation au Canada entre mars 2020 et novembre 2021. Les données ont été analysées afin de dégager les facteurs de risque à l'égard du recours à l'oxygénothérapie et autres critères de la gravité de la maladie. Nous avons comparé les paramètres selon le type d'organe transplanté et suivi l'évolution des paramètres au fil du temps. Nous avons procédé à une analyse multivariée pour déterminer quelles variables sont associées au recours à l'oxygénothérapie. RÉSULTATS: En tout, 509 patients ayant reçu une transplantation d'organe plein ont contracté la COVID-19 durant la période de l'étude. Les facteurs de risque associés au recours à l'oxygénothérapie (n = 190) ou non (n = 319) incluaient l'âge (âge médian 62,6 ans, intervalle interquartile [II] 52,5­69,5 ans c. âge médian 55,5 ans, II 47,5­66,5; p < 0,001) et le nombre de comorbidités (nombre médian 3, II 2­3 c. nombre médian 2, II 1­3; p < 0,001), de même que les paramètres concernant l'immunosuppression. Les receveurs d'une transplantation pulmonaire (n = 48) étaient plus susceptibles de souffrir d'une forme grave de la maladie, avec un taux de mortalité élevé (n = 15, 31,3 %) comparativement aux receveurs d'autres organes, y compris le rein (n = 48, 14,8 %), le cœur (n = 1, 4,4 %), le foie (n = 9, 11,4 %) et le rein­pancréas (n = 3, 12,0 %) (p = 0,02). Les facteurs protecteurs contre le recours à l'oxygénothérapie incluaient le fait d'avoir subi une transplantation hépatique et de recevoir de l'azathioprine. Le fait d'avoir reçu 2 doses de vaccin anti-SRAS-CoV-2 n'a pas eu d'influence appréciable sur le recours à l'oxygénothérapie. L'analyse multivariée a montré que l'âge avancé (rapport des cotes [RC] 1,04, intervalle de confiance [IC] de 95 % 1,02­1,07) et le nombre de comorbidités (RC 1,63, IC de 95 % 1,30­2,04), entre autres facteurs, étaient associés au recours à l'oxygénothérapie. La gravité de la maladie n'a pas considérablement diminué au fil du temps. INTERPRÉTATION : Malgré les progrès thérapeutiques et la vaccination des receveurs d'une transplantation d'organe plein, les signes de gravité accrue de la COVID-19, en particulier chez les receveurs d'une transplantation pulmonaire, justifient le maintien des mesures de santé publique pour protéger ces personnes à risque, et l'utilisation hâtive de traitements contre la COVID-19 chez les receveurs d'une transplantation d'organe plein.

Outcomes of COVID-19 in Solid Organ Transplant Recipients in Canada 2020-2021: A Prospective, Multicenter Cohort Study

Purpose: To understand the outcomes and changes in disease severity of COVID-19 in Solid Organ Transplant (SOT) recipients over time in the context of therapeutic advances. Method(s): We performed a multicenter, prospective cohort study of all SOT recipients diagnosed with COVID-19, across 9 transplant programs in Canada, from March 2020-November 2021. Baseline characteristics, demographics, treatment and disease severity outcomes were collected. The primary outcome was need for supplemental oxygen. Factors associated with the primary outcome and changes in outcomes over time were analyzed. Pandemic time periods were divided into four time frames coinciding with 4 waves in North America. Result(s): We enrolled 509 SOT recipients with confirmed COVID-19 during the study period. The risk factors associated with oxygen requirement are outlined in Table 1. Severe disease and mortality were greatest in lung transplant recipients compared to other organ types (15/48 (31.3%) lung deaths vs 63/461(13.7%) nonlung organs, (p=0.001). There was no influence of 2-dose vaccination and 3 patients were infected after 3-dose vaccine. Disease with alpha or delta variant was not associated with increased oxygen requirement. In a subgroup analysis of participants requiring oxygen (n=190), remdesivir was associated with less death (p=0.035). Over the pandemic period (Figure 1), there were no significant changes in the proportion of patients requiring oxygen, ICU admission, ventilatory support or death. (Table Presented) Conclusion(s): COVID-19 is especially severe in lung transplant recipients and immunosuppression plays a significant role. The outcomes associated with COVID-19 in SOT have not appreciably changed over time despite the emergence of novel variants and changes in therapeutic regimens.

Assessment of knowledge, attitude and practice towards covid-19 vaccine among healthcare workers in a tertiary care center

Background: In the current scenario of vaccine scepticism amidst India’s massive vaccination drive, assessment of knowledge and attitude of healthcare workers towards the vaccine and their appropriate training is vital to build trust in the vaccine and increase acceptance. Objectives: To study and assess Knowledge, Attitude and Practice towards Covid-19 Vaccine among healthcare workers in a tertiary care center. Materials & Methodology: The study was Pre & Post Questionnaire Survey. After informed consent, the responders were provided an online questionnaire for the collection of information on knowledge, attitude and practices about COVID-19 vaccines. Responses were collected both before and after the sensitisation programme. Results: The study included 366 participants with mean age of 23.25 years (SD=9.08). Our study found that there was significant change in the knowledge, attitude and willingness of the HCWs after the sensitising program. After the sensitisation, 83.7% were ready to accept that the vaccine is a good idea (compared to 65.6%). 83.7% were ready to accept that the vaccine is a good idea (compared to 65.6% pre-sensitisation). Concerns about the side effects reduced among HCWs from 53.3% to 48.3%. Willingness to take the vaccine increased from 37.7% to 69.78% after the sensitisation Also more healthcare workers were willing to recommend the vaccine to others (70.6% compared to 40.2%). Conclusion: We found that the sensitizing program showed significant change in the knowledge, attitude, and willingness among the HCWs. This provides further opportunities for development of similar educational and awareness programmes for HCWs and for the general population.

Severity of COVID-19 among solid organ transplant recipients in Canada, 2020-2021: a prospective, multicentre cohort study.

BACKGROUND: Severe COVID-19 appears to disproportionately affect people who are immunocompromised, although Canadian data in this context are limited. We sought to determine factors associated with severe COVID-19 outcomes among recipients of organ transplants across Canada. METHODS: We performed a multicentre, prospective cohort study of all recipients of solid organ transplants from 9 transplant programs in Canada who received a diagnosis of COVID-19 from March 2020 to November 2021. Data were analyzed to determine risk factors for oxygen requirement and other metrics of disease severity. We compared outcomes by organ transplant type and examined changes in outcomes over time. We performed a multivariable analysis to determine variables associated with need for supplemental oxygen. RESULTS: A total of 509 patients with solid organ transplants had confirmed COVID-19 during the study period. Risk factors associated with needing (n = 190), compared with not needing (n = 319), supplemental oxygen included age (median 62.6 yr, interquartile range [IQR] 52.5-69.5 yr v. median 55.5 yr, IQR 47.5-66.5; p < 0.001) and number of comorbidities (median 3, IQR 2-3 v. median 2, IQR 1-3; p < 0.001), as well as parameters associated with immunosuppression. Recipients of lung transplants (n = 48) were more likely to have severe disease with a high mortality rate (n = 15, 31.3%) compared with recipients of other organ transplants, including kidney (n = 48, 14.8%), heart (n = 1, 4.4%), liver (n = 9, 11.4%) and kidney-pancreas (n = 3, 12.0%) transplants (p = 0.02). Protective factors against needing supplemental oxygen included having had a liver transplant and receiving azathioprine. Having had 2 doses of SARS-CoV-2 vaccine did not have an appreciable influence on oxygen requirement. Multivariable analysis showed that older age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02-1.07) and number of comorbidities (OR 1.63, 95% CI 1.30-2.04), among other factors, were associated with the need for supplemental oxygen. Over time, disease severity did not decline significantly. INTERPRETATION: Despite therapeutic advances and vaccination of recipients of solid organ transplants, evidence of increased severity of COVID-19, in particular among those with lung transplants, supports ongoing public health measures to protect these at-risk people, and early use of COVID-19 therapies for recipients of solid organ transplants.

Ventilator-associated Pneumonia in COVID-19 Patients

Aim and background: Coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a high incidence of patients with the severe acute respiratory syndrome (SARS). Many of these patients require admission to an intensive care unit (ICU) for invasive ventilation and are at very high risk of developing ventilator-associated pneumonia (VAP).1-3 Objectives: To study the incidence and mortality of VAP of ventilated COVID-19 patients. Materials and methods: We retrospectively collected data on all patients hospitalized for COVID-19 during the first phase of the epidemic in a 9 bed ICU who were on invasive mechanical ventilation for >48 h. We studied the characteristics of VAP in these patients. VAP was diagnosed based on official recommendations. Results: Data of 55 patients was analyzed. Of these 23 (41.8%) had VAP. Patients with VAP required a greater number of ventilatory days (13.6 ± 6.2 vs 6 ± 4) and underwent more tracheostomies [9 (39.13%) vs 1 (3.13%)]. Length of ICU and hospital stay were significantly prolonged in COVID-19 VAP group 17.9 ± 11 vs 9.18 ± 6.11 days (p = 0.0002) and 18.3 ± 11 vs 9.9 ± 6.4 days (p = 0.0004), respectively. Also, organ involvement was significantly higher in the VAP group. Patients in both group had similar mortality, VAP - 15 (65.2%) vs non VAP - 18 (56.25%). Conclusion: COVID-19 is associated with an increased risk of VAP, which is not fully explained by the prolonged duration of ventilation. Complications like organ involvement and prolonged ventilatory days are common in COVID-19 VAP patients and need to focus on general supportive treatment and organspecific treatment.

Tension Pneumomediastinum in COVID-19 ARDS Patient Managed with Percutaneous Ultrasound-guided Catheter Insertion: A Case Report

Introduction: Tension pneumomediastinum is a condition in which there is a trapping of air in the mediastinum with a resultant increase in the pressure causing compression of the great vessels which leads to decreased venous return and cardiovascular collapse. It is a rare and severe form of pulmonary barotrauma in ICU ventilated patients which can lead to refractory hypotension and death if not addressed at the right time. Case description: A 42-year-old man with no known comorbidities referred to our centre in view of severe COVID ARDS with refractory hypoxemia. Endotracheally intubated and put on ventilatory support. Developed shock not responding to fluid resuscitation and was started on IV vasopressor infusion. CT chest revealed tension pneumomediastinum. The patient continued to worsen clinically with hypotension and hypoxia despite low PEEP and high FiO2 ventilation. So bedside USG-guided pigtail catheter was inserted into the anterior mediastinum using a modified Seldinger technique following which there was a rapid clinical improvement. Conclusion: Tension pneumomediastinum is a rare and life-threatening cause of refractory hypotension and hypoxia in mechanically ventilated ARDS patients and bedside ultrasound-guided intervention is a feasible and quick therapeutic option. Highlights: A review of the literature showed very few case reports of tension pneumomediastinum in mechanical ventilated ARDS patients. Because ultrasound of the chest gives air artefacts and poor visualization in patients with pneumomediastinum and subcutaneous emphysema, CT-guided drainage catheters insertion is the standard of care. But in a very sick ICU patient, bedside ultrasound-guided catheter insertion could be a safe and immediate measure to save a patient's life. To our knowledge, this is the first case report of an adult ARDS patient with tension pneumomediastinum managed with bedside ultrasound-guided catheter insertion.

Review and practical recommendations for peripheral nerve block during Coronavirus Disease-2019 pandemic

Coronavirus disease-2019 (COVID-19) was announced as a global pandemic by the World Health Organization on March 11, 2020 due to its rapid spread and multinational involvement. Operating room preparedness in these times should encompass increased vigilance, protective measures, and alternative procedures in an effort to mitigate the spread from a proven or suspected case. Specifically, by reducing aerosol-generating procedures as in general anesthesia, anesthesiologists can decrease exposure to patient's respiratory secretions and transmission of virus to the health-care professional and other patients. The Interoperability Standards Advisory in its advisory has also recommended regional anesthesia over general anesthesia as one of the steps that can reduce aerosol spread. Further, to restrict airway manipulation, peripheral nerve blocks (PNB) should be considered whenever possible in suspected or confirmed cases of COVID-19 undergoing surgery. PNB has the advantage of maintenance of respiratory functions, prevention of aerosolization, and so preventing viral transmission. This article explores the practical information and suggested measures for conducting PNB in COVID-19 patients with suggestions toward resource planning, clinical environment modification, equipment preparation, supply of drugs, choosing of correct personal protective equipment, safe PNB procedures, anesthesia monitoring, and postanesthetic care. By addressing these issues, infection control during anesthesia can be achieved and which is essential in the present era with emerging infection and novel pathogens such as coronavirus 2 causing the severe acute respiratory syndrome. Thus, framing a structured protocol for PNB among these patients is essential for the best perioperative outcome. © 2022 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow

The placental pathology in Coronavirus disease 2019 infected mothers and its impact on pregnancy outcome.

INTRODUCTION: This study aims at observing placental pathologies in COVID-19 infected women, and analyzing its impact on pregnancy outcome. METHOD: This is a descriptive-analytical study done at a tertiary centre of Northern India. All COVID-19 positive pregnant women with gestational age ≥20 weeks, with placental histopathological reporting, were included in this study. A total of 173 COVID-19 pregnant women were included in the study. RESULTS: Placental abnormalities were noticed in 49·16% of total 179 placentae examined. Maternal vascular malperfusion (27·93%) was the most observed placental pathology followed by villous fibrin deposits (22·90%), fetal vasculopathy (16·75%), and acute inflammation (6·70%). Stillbirths were 22 and NICU admissions were seen in 50 neonates. Abnormal placental abnormalities led to higher stillbirths (p value 0·011) and lower Apgar scores at 1 and 5 min (p-value 0·028; p-value 0·002, respectively). Intervillous fibrin deposits had higher risk associated with lower Apgar score at 1 and 5 min [RR 2·05 (95% CI 1·21-3·48, p-value 0·010) and RR 5·52 (95% CI 2·58-11·81, p-value <0·001), respectively]. RP clot/hemorrhage was also associated with lower Apgar score at 1 and 5 min [RR 2·61 (95% CI 1·52-4·49, p-value 0·002) and RR 3.54 (95% CI 1·66-7·55, p-value 0·001), respectively]. DISCUSSION: Placental abnormalities in COVID-19 infection were associated with significant higher incidence of unexplained stillbirths, and lower Apgar scores. Although, this is the largest descriptive-analytical study done so far, comparative studies are required to draw a clear conclusion regarding the impact of COVID-19 infection on human placenta and its effect on pregnancy outcomes.

In silico evaluation of the compounds of the ayurvedic drug, AYUSH-64, for the action against the SARS-CoV-2 main protease.

BACKGROUND: Outbreak of Corona Virus Disease in late 2019 (COVID-19) has become a pandemic global Public health emergency. Since there is no approved anti-viral drug or vaccine declared for the disease and investigating existing drugs against the COVID-19. OBJECTIVE: AYUSH-64 is an Ayurvedic formulation, developed and patented by Central Council of Research in Ayurvedic Sciences, India, has been in clinical use as anti-malarial, anti-inflammatory, anti-pyretic drug for few decades. Thus, the present study was undertaken to evaluate AYUSH-64 compounds available in this drug against Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2) Main Protease (Mpro; PDB ID: 6LU7) via in silico techniques. MATERIALS AND METHODS: Different molecular docking software's of Discovery studio and Auto Dock Vina were used for drugs from selected AYUSH-64 compounds against SARS-CoV-2. We also conducted 100 ns period of molecular dynamics simulations with Desmond and further MM/GBSA for the best complex of AYUSH-64 with Mpro of SARS-CoV-2. RESULTS: Among 36 compounds of four ingredients of AYUSH-64 screened, 35 observed to exhibits good binding energies than the published positive co-crystal compound of N3 pepetide. The best affinity and interactions of Akuammicine N-Oxide (from Alstonia scholaris) towards the Mpro with binding energy (AutoDock Vina) of -8.4 kcal/mol and Discovery studio of Libdock score of 147.92 kcal/mol. Further, molecular dynamics simulations with MM-GBSA were also performed for Mpro- Akuammicine N-Oxide docked complex to identify the stability, specific interaction between the enzyme and the ligand. Akuammicine N-Oxide is strongly formed h-bonds with crucial Mpro residues, Cys145, and His164. CONCLUSION: The results provide lead that, the presence of Mpro- Akuammicine N-Oxide with highest Mpro binding energy along with other 34 chemical compounds having similar activity as part of AYUSH-64 make it a suitable candidate for repurposing to management of COVID-19 by further validating through experimental, clinical studies.

Outcomes of SARS-CoV-2 Infection in Unvaccinated Compared With Vaccinated Solid Organ Transplant Recipients: A Propensity Matched Cohort Study.

BACKGROUND: Solid organ transplant (SOT) recipients are at high risk for complications from coronavirus disease 2019 (COVID-19). Vaccination may mitigate this risk; however, immunogenicity appears to be significantly impaired, with reports of increased risk of breakthrough infection. It is unknown if vaccine breakthrough infections are milder or as severe as infections in unvaccinated patients. METHODS: We performed a multicenter matched cohort study between March 2020 and September 2021 to assess influence of COVID-19 vaccination on outcomes of COVID-19 infection. Treatment characteristics and disease severity outcomes were compared on the basis of vaccine status; breakthrough infections versus unvaccinated infections. Variable ratio propensity score matching based on age, sex, transplant type, and number of comorbidities, was used to develop the analytic cohort. Logistic regression was used to assess the influence of vaccination status on the selected outcomes. RESULTS: From a cohort of 511 SOT patients with COVID-19, we matched 77 partially or fully vaccinated patients with 220 unvaccinated patients. Treatment characteristics including use of dexamethasone, remdesivir, and antibiotics did not differ. Vaccinated participants were more likely to receive tocilizumab, 15 of 77 (19.5%) versus 5 of 220 (2.3%), P < 0.001. Disease severity outcomes including oxygen requirement, mechanical ventilation, and mortality were similar among medically attended vaccine breakthroughs compared with unvaccinated patients. CONCLUSIONS: SOT recipients who develop medically attended COVID-19 following 1- or 2-dose vaccination seem to have similar disease severity to unvaccinated patients who develop infection. This is consistent with the requirement that SOT recipients need 3 or more vaccine doses and emphasizes the importance of alternate strategies for this population.

An Integrated Approach- Demographic, Clinical, Laboratory and Radiological Features in Predicting Mortality of COVID-19 Patients in Critical Care Medicine

Introduction: Now the situation is rapidly evolving with new variants of SARS-Cov-2, and the scientific community is still learning to identify patients with higher risks for effective triaging and better resource allocation as there is no effective specific therapeutics for COVID-19 patients. This was the main motivating factor behind this study. Aim: 1) Analyse the demographic, laboratory, clinical and radiological features in COVID-19 patients admitted in critical care medicine and to study their association with survivors and non-survivor. 2) To propose a model to predict mortality rate in critically ill COVID-19 patients. Materials and Methods: This study was conducted on RT-PCR confirmed COVID-19 patients admitted in Critical Care Medicine Department at Yenepoya Medical College, Mangalore during May and June 2021. The data collected (age, gender, RR, PR, BP, SpO2, DM, HTN, WBC, Hb, Platelet, CRP, LDH, D-dimer, Creatinine, Urea, CT Score, lung involvement pattern and distribution) was retrospectively evaluated and compared between survivors and non-survivors Result: Among the 91 enrolled patents, 65(71.42%) survived and 26 succumbed to death. In the non-survivors mean age was 61.42±13.24, male 18(69.23%). Backward stepwise logistic regression is used to identify the significant predictors of mortality. These parameters were significant in Backward logistic regression model: RR (p:0.008, OR1.164), spO2(p:0.05, OR:0.928), WBC (p:0.001, OR:1.170), D-dimer (p: 0.005, OR:0.999), Urea (p:0.001, OR:0.916) and CT (p:0.000, OR:1.259). The sensitivity of the model is 80.00%% (95% confidence interval is [59.30% 93.17%]), specificity is 92.68%. (95% CI is [80.08% 98.46%]). The overall accuracy is 87.88%. (95% CI is [77.51% 94.62%]). The positive predictive value is 86.96%. (95% CI is [68.79% 95.28%]). The negative predictive value is 88.37%. (95% CI is [77.55% 94.36%]) Conclusion: Involving clinical, laboratory and radiological features has shown to be a good approach in mortality prediction of critically ill COVID-19 patients.

Sentiment and Emotion Analysis for Effective Human-Machine Interaction During Covid-19 Pandemic

With the onset of Covid-19, interactions between humans and machines have increased at a rapid rate. Helping the machine identify the emotion and sentiment of the user plays a key role in making these interactions feel more natural. To do so, existing models for Speech Emotion Recognition (SER) and Sentiment Analysis (SA) focus on the detection of either only emotion or sentiment on acted databases. Unlike these existing works, this work presents a simple model with a comparatively small speech feature vector, to detect both emotion and sentiment from the spontaneous database, Multimodal Emotion Lines Dataset (MELD). This contains voice samples similar to those in a real-time environment. Speech features such as Mel Frequency Cepstral Coefficients (MFCC), Entropy, Teager Energy Operator have been extracted from the voice samples and are classified using Logit Boost, Logistic and Multiclass classifier. The performance of the model is improved by using feature selection techniques such as Backward elimination and Gaussian distribution coefficients. The proposed model is simple, and the results are comparable to existing work on the MELD database. © 2021 IEEE

Smart Nursing Robot for COVID-19 Patients

Corona Virus Disease is a novel syndrome virus and it causes severe respiration problems for human beings. It spreads the virus close contact persons from the affected ones. This is the main reason behind the pandemic of this virus. It is toughest to handle the patients for the doctors. Affected patients need adequate drugs swallowing and untimed care. Because of the consequences, it spreads over the person from the affected peoples. So to overcome the problems, this proposed device act as a robot instead of nurses. This proposed nursing robot designed well as which keep monitor the patient and consumption of medicine with depends on the time. It programmed fine potential into delivering of medicine, food and clothes. It plays a vital role in a measure the amount of drugs to give for the patient. It more helps to the frontline practitioners and protect themselves from the minute corona virus. Due do the pandemic conditions immensely affect the world economic throughputs. This proposed nursing robot will more help to reduce the social transmission. It also reduces the number of severe cases as well as severity localization of diseases. © 2021 IEEE.

Olive Oil Consumption can Prevent Non-communicable Diseases and COVID-19: A Review.

The Mediterranean diet is appraised as the premier dietary regimen, and its espousal is correlated with the prevention of degenerative diseases and extended longevity. The consumption of olive oil stands out as the most peculiar feature of the Mediterranean diet. Olive oil rich in various bioactive compounds like oleanolic acid, oleuropein, oleocanthal, and hydroxytyrosol is known for its antiinflammatory as well as cardioprotective property. Recently in silico studies have indicated that phytochemicals present in olive oil are a potential candidate to act against SARS-CoV-2. Although there are many extensive studies on olive oil and its phytochemical composition, however, some lacunas persist in understanding how the phytochemical composition of olive oil is dependent on upstream processing. The signaling pathways regulated by olive oil in the restriction of various diseases are also not clear. For answering these queries, a detailed search of research and review articles published between 1990 to 2019 were reviewed. Olive oil consumption was found to be advantageous for various chronic non-communicable diseases. Olive oil's constituents are having potent anti-inflammatory activities and thus restrict the progression of various inflammation-linked diseases ranging from arthritis to cancer. But it is also notable that the amount and nature of the phytochemical composition of household olive oil are regulated by its upstream processing, and the physicochemical properties of this oil can give a hint regarding the manufacturing method as well as its therapeutic effect. Moreover, daily uptake of olive oil should be monitored as excessive intake can cause body weight gain and a change in the basal metabolic index. So, it can be concluded that the olive oil consumption is beneficial for human health, and particularly for the prevention of cardiovascular diseases, breast cancer, and inflammation. The simple way of processing olive oil is to maintain the polyphenol constituents, whichprovide the protection against noncommunicable diseases and SARS-CoV-2.