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Background Anxiety and stress in COVID-19 lead to continual pro-inflammatory cytokine activity resulting in excessive inflammation. Levels of different bio indices of COVID-19 may predict clinical outcomes and the severity of COVID-19 disease and may correlate with anxiety and stress levels. Objectives To measure the level of anxiety in COVID-19 patients using the coronavirus anxiety scale (CAS) as an assessment of psychological stress. To measure the levels of blood biomarkers and biochemical and hematological markers of inflammation in COVID-19. To record and measure the indices of short-term HRV in COVID-19 patients to assess their physiological and psychological stress levels. To determine the relationship between anxiety scores, levels of laboratory indices (blood biomarkers), and HRV parameters across mild, moderate and severe cases of COVID-19. Material and method A total of 300 COVID-19 patients aged between 18 and 55 years were included. A questionnaire-based CAS was used to assess anxiety levels. Short-term HRV was recorded to measure stress. Blood biomarkers: Biochemical and hemato-cytological markers of inflammation were measured. Statistical analyses were performed using the SPSS software version 20.0. Results Anxiety and stress increased with the severity of COVID-19. A positive correlation was detected between anxiety and serum ferritin, IL-6, MCV, and MCH levels, and a negative correlation between the corona anxiety score and RBC count. The increase in the severity of COVID-19 showed elevated levels of WBC count, neutrophil%, platelet count, neutrophil/lymphocyte ratio, serum ferritin, D-dimer, C-reactive protein, procalcitonin, interleukin-6, and lactate dehydrogenase, and decreased lymphocyte and monocyte percentages. The increase in the severity of COVID-19 decreased lymphocyte, monocyte, and eosinophil counts. Conclusion The Corona Anxiety Scale and heart rate variability can be used as complementary tools to index COVID-19-related anxiety and stress. An association exists between immune dysregulation and heart rate variability, which can be used to predict the inflammatory response and prognosis of COVID-19.
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Background It is well known that some viral infections may affect male fertility. Coronavirus disease (COVID-19) can lead to multiorgan damage through the angiotensin-converting enzyme-2 receptor, abundant in testicular tissue. However, little information is available regarding the shedding of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in semen and its impact on spermatogenesis and fertility potential. We planned to investigate the presence of SARS-CoV-2 in the semen of COVID-19 males and to study the effect of COVID-19 on semen quality and sperm DNA fragmentation index. Material and method Thirty COVID-19 male patients aged 19-45 registered to AIIMS Patna hospital participated in the survey between October 2020 and April 2021. We conducted a real-time reverse transcriptase test on all the semen samples. Detailed semen analysis, including the sperm DNA Fragmentation Index, was done at first sampling that is during COVID-19. After 74 days of the first sampling, we obtained the second sampling and repeated all the above tests. Results All semen samples collected in the first and second sampling tested with real-time reverse transcription-polymerase chain reaction (RT-PCR) were negative for SARS-CoV-2. In the first sampling, semen volume, vitality, total motility, sperm concentration, total sperm count, % normal morphology, % cytoplasmic droplet, and fructose were significantly lower. In contrast, semen agglutination, % head defect, DNA Fragmentation Index, liquefaction time, semen viscosity, and leukocytes were increased. These findings were reversed at the second sampling but not to the optimum level. All these findings were statistically significant (p < 0.05 for all). Thus, COVID-19 negatively affects semen parameters, including sperm DNA fragmentation index. Conclusion Although we could not find SARS-CoV-2 in the semen, the semen quality remained poor until the second sampling. Assisted reproductive technology (ART) clinics and sperm banking facilities should consider assessing the semen of COVID-19 males and exclude men with a positive history of SARS-CoV-2 until their semen quality returns to normal.
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People must incorporate a “work from home” strategy because of the COVID-19 outbreak. In today's pandemic situation, due to working from home, employees are working for long hours, and spending long hours is a pretty challenging task. Nowadays, irrespective of age concerns, sciatica, Kyphosis, and lordosis are becoming a significant problem even for youngsters. The longest nerve in our body is sciatica, which causes severe pain due to stress applied while sitting in the wrong posture. It gets compressed with our lower back discs, which may lead to severe radiating pain from our lower back disc to the entire right leg, and a person can't even perform his daily activities comfortably. To prevent these problems, sitting posture while working should be maintained correctly. This work mainly focuses on preventing employers, and students from sciatica, Kyphosis, and Lordosis health issues. We used all kinds of sitting postures that interact while working with a laptop, classified which posture was good, and predicted which stance led to health issues. We used Convolutional Neural Network and K-Nearest Neighbor machine learning algorithms to predict the correct sitting postures. In KNN, we followed two techniques to improve the performance: using Edge detection. The other method we used was detecting facial landmark detection and plotting their respective rotational angles. So by using this technique, we improved the accuracy and precision rate compared to the classical Edge detection. We also trained the model with CNN, which gives good results. We performed a comparative analysis to pick the best model to integrate with OpenCV to make it real-time. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Introduction & Objectives: The purpose of prioritisation is to minimise harm while safeguarding access to health care in times of reduced clinical resources. The EAU Guideline Office Rapid Reaction Group (GORRG) issued priority recommendations for use during the COVID-19 pandemic. We evaluated if the clinical prioritisation for suspected renal cell carcinoma (RCC) planned for surgery matched final pathological risk. Materials & Methods: From 23 March 2020 at the beginning of the first lock-down in the UK, patients with suspected RCC were prioritised according to GORRG recommendations until 10 October 2020. To increase statistical power, GORRG prioritisation was also retrospectively assigned to pre-lockdown RCC surgical cases, dating back to April 5 2019. Patient and tumour characteristics were assessed, as was priority group according to GORRG, TNM, and postoperative risk according to 2003 Leibovich scores. We assessed concordance between pre-operative GORGG prioritisation group and post-operative risk, and if stratification could be further improved by subgrouping of size. Results: 351 patients with suspected RCC were prioritised and underwent surgery, of which 16 were benign and 335 were RCC after specimen analysis. The intermediate priority group did not match the pathological risk group in 47.7%, with 25.7% and 16.4% of the group being pathological low and high risk, respectively. The low GORRG priority group harboured 14.9% intermediate and 1.06% high risk RCC, and the high GORRG priority group 27.9% intermediate and no low risk RCC respectively. Within the GORRG intermediate group, 34.2% of cT1b tumours were low risk, and 32.3% of cT2a tumours high risk. Analysing at 1 cm increments, 45.1% of 4-5cm tumours were low risk. The area under the receiver operating characteristics curve for priority groups in predicting matched postoperative risk group was 0.60 (95% CI 0.55-0.65). The sankey diagram shows patients categorised according to EAU GORGG guidelines (left) and pathological risk (right).(Figure Presented)Conclusions: The recommended prioritisation system can be error prone and should be prudently applied based on the centre’s needs. Particularly amongst the intermediate group, centres with clinical capacity should not defer intervention of cT2a tumours for longer than absolutely necessary and in severely limited resources may consider intermediate priority tumours <5cm as low priority.
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BACKGROUND AND PURPOSE: Occurrence of stroke has been reported among patients with COVID-19. The present study compares clinical features and outcomes of stroke patients with and without COVID-19. METHODS: The COVID-19 Stroke Study Group (CSSG) is a multicentric study in 18 sites across India to observe and compare the clinical characteristics of patients with stroke admitted during the current pandemic period and a similar epoch in 2019. The present study reports patients of stroke with and without COVID-19 (CoVS and non-CoVS, respectively) seen between February 2020 and July 2020. Demographic, clinical, treatment, and outcome details of patients were collected. RESULTS: The mean age and gender were comparable between the two groups. CoVS patients had higher stroke severity and extent of cerebral involvement on imaging. In-hospital complications and death were higher among CoVS patients (53.06% vs. 17.51%; P < 0.001) and (42.31% vs. 7.6%; P < 0.001), respectively. At 3 months, higher mortality was observed among CoVS patients (67.65% vs. 13.43%; P < 0.001) and good outcome (modified Rankin score [mRS]: 0-2) was seen more often in non-CoVS patients (68.86% vs. 33.33%; P < 0.001). The presence of COVID-19 and baseline stroke severity were independent predictors of mortality. CONCLUSIONS: CoVS is associated with higher severity, poor outcome, and increased mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and baseline stroke severity are independent predictors of mortality.