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Background Acute bacterial pericarditis is rare and can decompensate quickly to cardiac tamponade and cardiac arrest. Targeted antibiotic therapy, pericardiocentesis, and pericardiotomy are the cornerstones of management. Case 51-year-old male presented with 2-weeks of progressive chest pain, cough, and fatigue. A month prior he tested positive for COVID-19. On exam he was tachycardiac, tachypneic, and normotensive. JVD and peripheral edema were present. Labs revealed elevated WBC, BNP, HS-troponin, and ESR/CRP. Blood cultures were positive for methicillin susceptible Staphylococcus aureus (MSSA). Echo showed a large pericardial effusion with a swinging heart. ECG showed diffuse ST elevations and PR depression. He was not clinically in tamponade but shortly after became bradycardic and had a PEA arrest. Emergent bedside pericardiocentesis was performed, and after 9-minutes of ACLS, ROSC was attained. Pericardial fluid grew MSSA. Decision-making Vancomycin and cefepime were started and tapered to cefazolin to cover MSSA bacteremia and pericarditis. Repeat blood cultures were negative. A month after discharge he had no cardiac symptoms and echo showed minimal pericardial fluid. Conclusion In patients with COVID-19 and pericardial effusion, bacterial pericarditis can be secondary to contiguous spread from lung parenchyma or myopericarditis with superimposed infection, or due to primary pericarditis. This is the second reported case of spontaneous purulent pericarditis with MSSA. [Formula presented]Copyright © 2023 American College of Cardiology Foundation
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Entity extraction from the text data in the biomedical domain has an essential role in biomedical research. In natural language processing entity extraction task aims to identify the terms into predefined categories. With the emergence of the covid-19, covid related digital resources increased drastically and the new type of entities is introduced. State-of-the-art named entity extraction models is heavily relying on domain-specific resources which are hard to perform adequately on covid related data. In this paper, we proposed a deep-learning-based architecture for named entity recognition. The experiment was performed on the CORD-NER dataset which was released by the University of Illinois. We compare the performance of different deep learning-based architectures on this data for a named entity recognition task. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Coronavirus disease 2019(COVID-19), the enormously transmissible disease resulting due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the causative agent, instigated a dreadful outcome ensuing worldwide emergency with its rapid spread and greater mortality rate resulting in grievous disruptions. It arose as the greatest substantial world-wide health catastrophe ever since the period of influenza pandemic of 1918, causing more than 3.7 million deaths worldwide. The influence of this pandemic was ascertained in every arena of life on a worldwide level. COVID-19 has devastated many countries, thrashing our health care system besides having a major impact on the academic sector encompassing an enormous number of students, teachers along with staff members. With the implementation of the lock-down the offline classes were substituted for the online mode not only in India but globally. This has chiefly prompted an effect on the mental health of people apart from their physical health. Mental well-being has a vital significance and the spread of pandemic has accelerated a series of mental disorders ranging from anxiety, stress to depressive disorders. This review, based on questionnaires prepared using the perceived stress scale method compiles the response data of how COVID-19 has affected the mental health of students and members of the educational sphere. Not only this but it shows a contrast between the offline and the new tech-friendly online classes. Thus, this survey study reflects on creating a framework for the academic sector to aid in resolving and helping people manifested with mental health issues so as to lead a normal healthy lifestyle. Copyright © 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd.
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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.
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Objective: Given the reductions in in-person visits and the increases in teleneurology visits, we sought to determine whether patients increased their use of virtual complementary and integrative therapies. Background: Patients with neurological disorders may seek treatment options in addition to those recommended by their providers. Prior to the COVID-19 pandemic, about half of patients from populations that sought care in neurology tried complementary and integrative therapies (CITs). Design/Methods: By examining two separate datasets that included cohorts of patients with neurological disorders, we assessed patients' use of virtual (and non-virtual) CITs and determined whether there were clinical characteristics that predicted their use. The two studies that comprised this report included one that examined patient and provider experiences with teleneurology visits, and another that assessed patients with a history of COVID-19 infection who presented for neurologic evaluation. Results: Patients who postponed medical treatment for non-COVID-19-related problems during the pandemic were more likely to seek CITs. Virtual exercise, virtual psychotherapy and relaxation/meditation smartphone applications were the most frequent types of virtual CITs chosen by patients. In both studies, age was a key demographic factor associated with mobile/virtual CIT usage. Conclusions: Data from our investigations demonstrated that, in addition to its other roles in teleneurology, CIT-related technologies may be utilized in the treatment of neurologic conditions.
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Objective: To analyze the characteristics of commercially available sleep-exclusive apps using the Mobile Health Index and Navigation (MIND) apps database published by the Division of Digital Psychiatry at BIDMC for app review. Background: Over 70 million Americans endure a chronic sleep disorder during their lifetime. Due to the COVID-19 pandemic, mobile app benefits have been postulated as a means of expanding patient access to scientifically-based interventions in aiding their sleep disorders. With the increasing adoption of mobile health apps, it is critical that information regarding these mobile apps are sufficiently analyzed. Design/Methods: Using pre-specified criteria, we identified 106 sleep related mobile apps in the iOS and Google Playstores, and rated them using a 105 question review that is part of the MIND database. Questions focused on: Accessibility, Privacy & Security, Clinical Foundation, Engagement Style, and Interoperability. The features of the 106 apps were compared to a control group of non-sleep apps to evaluate the features and limitations sleep apps bear relative to the remainder of the marketplace. Results: The most common features of sleep apps were mindfulness (68.9%), deep breathing (54.7%), and psychoeducation (30.2%). Regarding functionality, 39.6% of apps have accessibility features and 49.1% can be used offline. However, sleep apps lack sleep trackers (22.6%), exportability features (21.7%), and opportunities to collaborate with one's provider (7.6%). Only 10.4% of sleep apps have an efficacy study. Conclusions: Sleep apps in the marketplace are primarily used to help the user fall and stay asleep. In its current state, sleep apps can assist only the user as a self-help tool. The lack of sleep tracking, support, exportability, the inability to collaborate with one's provider and efficacy studies limit the potential of implementing sleep apps for clinical use.
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Objective: We aimed to assess the characteristics of the pain application (app) marketplace and determine improvements to mobile health (m Health) that could assist patients with pain disorders in obtaining more accessible care. Background: During the COVID-19 pandemic, complementary and integrative therapies delivered via mHealth technologies have become more popular due to their accessibility. As more users are downloading apps to address health concerns, it is important to analyze the ever growing marketplace's features and limitations. Design/Methods: After searching the iOS and Google Play Stores for commercially available pain apps that met pre-specified search criteria, trained app raters entered 47 apps into the Mobile-Health Index and Navigation Database (MIND) published by the Division of Digital Psychiatry at BIDMC. Through a 105-question objective rating framework, each app was evaluated for its accessibility, privacy, cost, functionalities, features, and clinical foundations. The data was compared with a control group of non-pain apps-matched for platform and cost -to examine the traits of pain apps in contrast with the rest of the marketplace. Results: The top features were 44.7% (21/47) offered symptom tracking, 34.0% (16/47) offered medication tracking, and 42.6% (20/47) offered physical health exercises. Just 2.13% (1/47) of apps offered HIPAA privacy protections or had a crisis management feature. Additionally, only 10.64% (5/47) of pain apps were supported by efficacy studies. Conclusions: Commercially available pain apps are typically used to record pain episodes or document medications. However, the lack of privacy, crisis management, and efficacy studies may be preventing their clinical implementation.
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Purpose The occurrence of COVID-19 has impacted the wide-reaching dimensions of manufacturing, materials, procurement, management, etc., and has loaded disruptions in the wide range of supply chain (SC) activities. The impact of COVID-19 has twisted supplier performance and influenced stakeholders' thinking towards selecting supplier sources and making strategic sourcing decision for convinced arrangement of construction management (CM) resources. Nowadays, suppliers are intently evaluated by stakeholders in post-COVID-19 phase to induce agile availability of CM resources. Accordingly, this paper aims to demonstrate competent CM dimensions under post COVID-19 scenario for ease managing construction projects by the stakeholders. Design/methodology/approach The authors have implicated Grey Sets Theory along with decision-making trial and evaluation laboratory (DEMATEL) technique for understanding significant outcomes. Varieties of diverse decision aspects responsible for strategically influencing supplier sourcing decision is projected under post COVID-19 scenario for handling construction projects by the stakeholders. Findings This study investigated sustainable construction management dimensions (SCMD) at the stage of resource deliveries and client aspirations under post COVID-19 situation. The study demonstrated "Lead time" as the most crucial, "Product Range" as the second and "Customers dealings and relationship" as the third crucial aspect considering by the stakeholders for selecting supplier sources based on the attainment of performance score of 0.1338, 0.1273 and 0.1268, respectively. It is found that high lead time stimulates the stakeholders to divert their orders to other competent supplier sources holding a low degree of lead time as compared. Research limitations/implications The present study rollovers its existence by serving critical thinking, conceptual modelling, criteria identification and evaluation under CM domain for drafting effectual strategies by the suppliers. The study investigated the impact of COVID-19 on stakeholders' decision-making and enlisted SCMD that strategically stimulated them in choosing supplier sourcing decision. Originality/value The present study realizes the insights of stakeholders in the post COVID-19 scenario related to the supplier sources based on performance score. The study quantified sustainable supplier attribute for construction work and practices. The study analysed the expectations of the stakeholders purchasing different varieties of construction materials from supplier sources for civil works in the post COVID-19 scenario.
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Background: Breast services are heavily dependent on radiology support for diagnostic tests. Breast ultrasound is the preferred imaging tool in the under 40s. The covid pandemic has resulted in a huge increase in waiting times for breast patients throughout the country. Additionally, there is a shortage of radiologists to support screening and breast services. Surgeons who are experienced in breast ultrasound are able to reduce the workload of radiologists and reduce waiting times. We present our results of one stop under 40s clinic by breast surgeons who do ultrasound and the impact it has had on waiting times within our unit. Method: Retrospective study of patients seen as part of the weekend waiting list initiative during May-July 2021. Clinics were built every weekend (Sat and Sun) in the absence of radiology support. Results: 899 patients of all ages were waiting to be seen in one stop clinics. A total of 11 under 40s one stop clinics were coordinated during this period when there was no radiology support. 197 patients were seen in these clinics by two surgeons proficient in performing ultrasound thereby reducing the waiting list by 22%. There are 8 consultant surgeons within our unit. Conclusion: The above study highlights the immense usefulness of ultrasound as a clinical adjunct to breast surgeons. Given the pressures that continue to occur in the light of the pandemic, it is imperative that our present generation of breast surgical trainees learn to perform ultrasound.
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Aim: Ultrasound is increasingly being used by non-radiologists in clinical practice. Currently wire-guided localisation (WGL) of impalpable breast tumours requires the expertise of radiologists but can be uncomfortable and demands significant radiology resource. Furthermore, for logistical reasons at our institution during the COVID pandemic, wires were inserted the day before surgery, resulting in disruption to patients. At our institution, two of eight breast surgeons use ultrasound intraoperatively for localisation of breast lesions, thus obviating the need for a radiologist to localise the lesion for the surgeon. We hypothesise that ultrasoundlocalisation by surgeons is an effective way to improve patient experience. Method: We undertook a retrospective review of all patients undergoing wire-guided localisation of impalpable breast tumours between 01/ 05/20-01/08/20. We retrospectively collected the following data: modality of image-guided insertion (ultrasound versus x-ray), operating surgeon and size of tumour. Results: 48 tumours were excised using WGL. 45 of these relied on ultrasound guidance for insertion. The median lesion size was 17mm, with 30 (62.5%) of lumps being 310mm in size. Conclusions: Most impalpable lumps were visualised using ultrasound. The majority of these lumps were >10mm. Surgeons trained in ultrasound did not need localisation by radiologists. If breast surgeons were unanimously trained to use ultrasound for intra-operative localisation, a significant proportion of wires could be avoided, saving cost, radiology time, patient time and improving the patient experience. We argue that ultrasound should be a core part of breast trainees' curriculum.
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BACKGROUND: Corticosteroids have become the mainstay treatment in severe COVID-19. However, its role is mild disease is controversial due to lack of robust scientific evidence. This systematic review and meta-analysis were conducted to assess effect of steroids in mild COVID-19 patients. METHODS: PubMed, EMBASE, Web of Science and medRxiv were searched from 31 December 2019 to 14 May 2021 for studies that reported effectiveness of steroids in non-oxygen requiring COVID-19 patients in terms of progressing to severe disease, mortality, duration of fever, duration of viral clearance and length of hospital stay (LOHS). Studies on inhalational steroids, case reports and reviews were excluded. Risk of bias (ROB) was assessed by the Cochrane's ROB tool and ROBANS tool. Quantitative data synthesis was done using the generic inverse variance method. RESULTS: A total of 6411 studies were identified, 2990 articles were screened after exclusion. Seven studies which fit the criteria (involving 2214 non-oxygen requiring COVID-19 patients) were included and analysed. Overall odds of progression to severe disease among the non-oxygen requiring COVID-19 patients receiving steroids was 5.97 [95% confidence interval (CI): 1.27-27.99, I2 = 0%] and odds of death (OR: 1.35, 95% CI: 1.01-1.79; I2 = 0%) as compared to the patients not receiving steroids. Mean duration of fever (7.4 days), duration to viral clearance (18.9 days) and LOHS (20.8 days) were significantly higher in the steroid arm, as compared to that in no-steroid arm (6.7, 16.5 and 15.2 days, respectively). CONCLUSION: Steroids in non-oxygen requiring COVID-19 patients can be more detrimental than beneficial. PROTOCOL REGISTRATION: The study was prospectively registered in PROSPERO (CRD 42021254951).
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COVID-19 , Adrenal Cortex Hormones/therapeutic use , Humans , Length of Stay , SARS-CoV-2 , SteroidsABSTRACT
BACKGROUND: Mucormycosis (MM) is a deadly opportunistic fungal infection and a large surge in COVID-19-associated mucormycosis (CAM) is occurring in India. AIM: Our aim was to delineate the clinico-epidemiological profile and identify risk factors of CAM patients presenting to the Emergency Department (ED). DESIGN: This was a retrospective, single-centre, observational study. METHODS: We included patients who presented with clinical features or diagnosed MM and who were previously treated for COVID-19 in last 3 months of presentation (recent COVID-19) or currently being treated for COVID-19 (active COVID-19). Information regarding clinical features of CAM, possible risk factors, examination findings, diagnostic workup including imaging and treatment details were collected. RESULTS: Seventy CAM patients (median age: 44.5 years, 60% males) with active (75.7%) or recent COVID-19 (24.3%) who presented to the ED in between 6 May 2021 and 1 June 2021, were included. A median duration of 20 days (interquartile range: 13.5-25) was present between the onset of COVID-19 symptoms and the onset of CAM symptoms. Ninety-three percent patients had at least one risk factor. Most common risk factors were diabetes mellitus (70%) and steroid use for COVID-19 disease (70%). After clinical, microbiological and radiological workup, final diagnosis of rhino-orbital CAM was made in most patients (68.6%). Systemic antifungals were started in the ED and urgent surgical debridement was planned. CONCLUSION: COVID-19 infection along with its medical management have increased patient susceptibility to MM.
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COVID-19 , Mucormycosis , Adult , Emergency Service, Hospital , Female , Humans , Male , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Retrospective Studies , SARS-CoV-2ABSTRACT
In this paper, an IoT-based system has been developed, which can quickly monitor the health of an employee while tagging their RFID cards, and depending on the health status collected by corresponding sensors, it authorizes the entry by opening solenoid door lock. The system is also connected to the remote server, so as to transfer health status of each person to a PHP server running remotely in the office premises. The unique data of RFID is transferred corresponding to each RFID tag and is saved in the remote server running PHP server with mySQL database. If any employee is found unhealthy as per the sensor data, the door will not open for its corresponding RFID tag, and the employee will not be allowed by the system for entering the office premises for at least two days. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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In the present era of coronavirus disease 2019 (COVID-19) pandemic, lack of an established and effective targeted therapy sans a vaccine is proving to be a major hurdle in containing the contagion. Hydroxychloroquine (HCQ), a widely used antimalarial and anti-inflammatory drug, has been proposed for coronavirus infection management by various drug regulatory authorities for emergency use including Indian Council of Medical Research. However, clinical safety concerns primarily regarding cardiovascular issues have been raised against HCQ usage, especially in relatively higher dosage in conjunction with azithromycin (AZM) coprescription. HCQ and to some extent, AZM have proven to be effective against COVID-19. Barring a small at-risk population for cardiovascular adverse effects, their clinical use in the treatment and prevention of COVID-19 was deemed to be beneficial and even recommended by various national and international representative societies including the World Health Organization, especially in high-risk individuals such as health-care workers and exposed contacts of coronavirus positive patients under due medical supervision. Multiple studies evaluating the anticoronaviral efficacy for prevention as well as for treatment prospect were conducted, but none could convincingly demonstrate a beneficial effect of HCQ with or without AZM on alleviating symptoms, shortening hospitalization, improving survival, or preventing disease transmission.
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Introduction: Steam inhalations are often used for the treatment of the viral infections of the respiratory tract such as common cold or croup. Objective: This study was aimed to evaluate the effect of the steam inhalation on COVID-19 infection. Methods: This is a prospective and descriptive study. The participants of this study were COVID-19 positive health care professionals and divided into two groups such as Group-A and Group-B. Group-A included 52 asymptomatic COVID-19 patients whereas Group-B included 44 symptomatic COVID-19 patients. The steam with a temperature of 42 0C to 45 0C was inhaled by all of Group-A and Group-B patients. Results: There were 52 asymptomatic COVID-19 patients in Group-A where 34 male and 18 female patients with a male to female ratio was 1.8:1. Out of the 44 symptomatic COVID-19 patients, 28 male and 16 female with male to female ratio was 1.75:1 The age ranges of the participant patients were 22 years to 68 years with a mean age of 38±16 years. All the mild and moderate symptomatic patients except one became symptom-free by one week use of steam inhalation. Conclusions: The symptoms of the COVID-19 patients were drastically reduced after use of the steam inhalation. The favourable effect of the steam inhalation for reducing the symptoms of the COVID-19 infections is to decrease the severity and duration of this infection and it also justifies its therapeutic application and acts as a ray of hope in this dreaded pandemic. © @IJCRR.
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Wuhan Municipal Health Commission, China, gave an account of a few cases of pneumonia which were later established as cases of the Novel Coronavirus Disease by the end of December 2019. By 4th of January, WHO reported these cases on social media and by the beginning of March WHO had declared it as a pandemic which was preceded and followed by lockdowns in various countries and had led to a scenario of fear and panic amidst the minds of all. The coronavirus disease 2019 (COVID-19) pandemic has challenged the society in many aspects, one of them being the psychosocial aspect. The stress due to the pandemic could produce worry and fear about health for oneself, family members and friends. Even changes in sleeping or eating patterns, the worsening of chronic health problems,unavailability of alcohol, tobacco or other drugs in the market due to shutting down of manufacturing units and problems in concentration are among the possible etiologies of a precipitating panic disorder. Containment measures such as lockdown and isolationcan also precipitate psychiatric illnesses and morbidities such aspanic disorder, depression, anxiety and suicidal tendencies.COVID-19 may cause or exacerbate even the existing psychiatric illnesses or existing panic disorder in individuals which could lead to physiological symptoms like palpitations, sweating, shortness of breath and a decreased sense of wellbeing. It gives a feeling of impending doom or danger and is followed by intense fear which can all take place when one is facing such a pandemic. Conclusion: The COVID-19 pandemic has not only had physical but even mental and psychosocial impacts. New mental health challenges may arise owing to this pandemic. © 2020, Institute of Medico-Legal Publications. All rights reserved.
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Aim: This research sought to raise information among the general population in Odisha, India regarding COVID-19. Materials and methods: In March-April 2020, the cross-section study of 440 participants from diverse locations and backgrounds in Odisha included socio-demographic processes including protective steps against COVID-19 information results, which included strong and accurate queries. Results: Most respondents received excellent COVID-19 knowledge and intelligence. Much of the respondents (46,10%) were 18-30 years old including 36,80% graduated from postgraduated, 30,20% did graduate, 23,06% passed 12th, so 5,09% participated 10th. Near to 98.40% of COVID-19 and 73.30% of COVID-19 have recorded a pandemic. The sources of a corona virus throughout China was identified as an infectious illness by 93.60% to 90.70%. Around 65.90 percent recorded an incubation time of 14 days with respect to signs and indications. Participant records of serious conditions such as sickle coughing (84.30%), fever (85.20%), nasal congestion (64.5%) and headaches (59.80%). About 90.70% stated that this can spreads via outlets and 78.40% stated that it can transmit via exposure to infected items. 88% stated they regularly wash their hands, while 85% has said social distinction is the main determinant of security. 79.80% reported staying home & calling helpline, while you notice COVID-19 signs. Conclusions: Healthcare and also the Govt. of India and also the Govt. of Odisha are making huge efforts to address COVID-19 and also to aware the community and to raising understanding regarding COVID-19.
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Background: Currently COVID-19 infection is a global challenge to the medical community. Acute respiratory distress syndrome (ARDS) and respiratory failure require mechanical ventilation. Tracheostomy is needed for prolonged ventilation as COVID-19 infections often escalates, so staying of the patient can be extended in ICU with ventilator. Objective: To evaluate the details of tracheostomy including patients profile, surgical steps, complications and precautions by health care workers at the intensive care unit (ICU) of the specially assigned hospital for COVID-19 patients. Materials and Methods: This is a retrospective study in which 22 COVID-19 patients underwent bedside surgical tracheostomy at the ICU. Clinical patient's profiles such as age, sex, co-morbidities, complication of the tracheostomy, ventilator withdrawal after tracheostomy and nosocomial infections of the health care workers related to tracheostomy were analyzed. Result: Out of the 22 patients with COVID-19 infections those underwent tracheostomy, 16(72.72(%) were male and 6 (27.27%) were female with age ranged from 42 years to 75 years and a mean age of 64 years. The median duration from the day of the orotracheal intubation to the day of tracheostomy was 13 days. Conclusion: Surgical tracheostomy on COVID-19 patients is a high risk aerosol generating procedure for health care workers. It should be performed with close association with otolaryngologists, anesthesiologists and intensive care physicians along with adequate personal protective equipment (PPE) for smooth management of the general anesthesia and airway.
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An unprecedented worldwide spread of the SARS-CoV-2 has imposed severe challenges on healthcare facilities and medical infrastructure. The global research community faces urgent calls for the development of rapid diagnostic tools, effective treatment protocols, and most importantly, vaccines against the pathogen. Pooling together expertise across broad domains to innovate effective solutions is the need of the hour. With these requirements in mind, in this review, we provide detailed critical accounts on the leading efforts at developing diagnostics tools, therapeutic agents, and vaccine candidates. Importantly, we furnish the reader with a multidisciplinary perspective on how conventional methods like serology and RT-PCR, as well as cutting-edge technologies like CRISPR/Cas and artificial intelligence/machine learning, are being employed to inform and guide such investigations. We expect this narrative to serve a broad audience of both active and aspiring researchers in the field of biomedical sciences and engineering and help inspire radical new approaches towards effective detection, treatment, and prevention of this global pandemic. © 2020, Indian Academy of Sciences.