CRITICAL SUCCESS FACTORS FOR LARGE HYDROCARBON PROJECTS

According to World Energy Outlook 2020, investment of near about USD 1.2 Trillion is required every year to meet global energy demand for the period of 2020-30. Out of this, substantial portion of investment is expected in the hydrocarbon industry. Like many other industries, hydrocarbon industry is hit hard by Covid-19 pandemic with decrease in demand though recovery in demand picked up gradually from the latter half of year 2021. Timely execution of Large Hydrocarbon (LHC) projects within budgeted estimates is necessary to keep the faith of investors in this sector and to attract further investment. The LHC projects are more complex in nature due to various stakeholders' involvement, which may typically involve process technology licensors, owners, project management consultants, contractors, government agencies etc. The purpose of this study is to find out the Critical Success Factors (CSFs) for LHC projects. The study commenced with comprehensive literature review for identification of reported CSFs for various industries. Thereafter, data collected from expert interviews and questionnaire survey are analyzed to find out CSFs for LHC projects. The study provides a list of CSFs which may be referred as guiding tool by industry practitioners and may help in reducing the schedule and cost overruns. © 2022 ISEC Press.

Management and outcome of infectious spondylodiscitis in patients with and without neurological deficit: A prospective study

Introduction: The term Infectious Spondylodiscitis involves infection of the vertebra and infection of the intervertebral disc, or both. Any delay in its diagnosis or management may cause serious long-term morbidity and mortality. In this study, we report the experiences in our Institution in the management of severe and complicated cases of infectious spondylodiscitis. Material(s) and Method(s): Over the period of 2 years from 2020-2022 (covid-19) 40 patients were operated in our medical college the management was tailored according to the clinical condition based on VAS, ODI, radiological studies and lab results of each case;and patients were then prospectively followed-up for 2 years. Result(s): The goals of treatment for spondylodiscitis is to relieve pain, restore pain free mobilization of the patient and to eliminate infection. Magnetic resonance imaging (MRI) was considered the main choice of investigating tool other assessments were done by ODI, VAS, Neurologic deficits was assessed by Modified McCormick scale, sepsis, an intraspinal empyema, the failure of conservative treatment, and spinal instability are all indications for surgical treatment. Conclusion(s): The quality of life of patients who have been appropriately treated for infectious spondylodiscitis has been found to be highly satisfactory in general. The risk of recurrence increases in the presence of accompanying illnesses such as diabetes mellitus, renal failure, which were managed by immediate debridement and results were good which was assessed according to above mentioned post-op ODI and VAS. Copyright © 2023 Ubiquity Press. All rights reserved.

Functional Outcome in Intradural Extramedullary Tumor Patients after Surgical Tumour Excision: Case Series

Background: About two-thirds of the benign intraspinal neoplasms are intradural extramedullary spinal cord tumours (IESCT). On rare occasions, they exhibit neurological involvement ranging from acute to chronic, necessitating urgent surgical intervention. Method(s): Here, we examined a group of 10 intradural extramedullary tumours treated between 2020 and 2022 by a single orthopaedic surgeon at Rajshree Medical and Research Institute, Bareilly's department of orthopaedics. Patients were followed up forat least two years. Clinical and functional outcome of these patients were evaluated by Karnofsky Performance Score [KPS], and Modified McCormick scale. Result(s): Thoracic spine 07 (70%) and junctional tumours 3 (30%) were the major sites of the majority of IESCT tumour in our study. There were 5 meningiomas, 2 schwannomas, 2 inflammatory, and 1 benign cyst on histo-pathological analysis. Meningiomas were typically found dorsal spine and dorso-lumbar junction, while schwannomas were found in the middle of the dorsal region. Both KPS and the Modified McCormick scale were significantly improved after surgery. Conclusion(s): MRI scan with constrast can easily identify the majority of benign intradural extramedullary tumours. It was observed that earlier diagnosis of neurological involvement were associated with good prognosis. Notably, surgical intervention is followed by positive functional outcomes. Copyright © 2022 Ubiquity Press. All rights reserved.

Pulse of Gujarat during Lockdown

Background: Coronavirus pandemic has dealt a severe blow to India’s poor and socioeconomically disadvantaged group. Among a nationwide lockdown to contain the spread of the infection. This study assessed the availability of food and access to healthcare among the vulnerable population of Gujarat– pregnant women and severe acute malnourished children. Specifically, we assessed events of starvation or skipped meal, availability of healthcare services, and self-reported psychological distress during the lock down. Materials and Methods: A cross-sectional study across 252 talukas and 33 districts of Gujarat was undertaken using a structured questionnaire. A telephonic survey was carried out and positive responses were received from 161 households (HHs) with severe acute malnourished children, 328 pregnant women with severe maternal anemia, and 402 lactating women. Results: We found 79.7% of surveyed HHs received ration where major reliance was on public distribution system (51.7%). Less than half of the beneficiaries (48.6%) received take-home ration under the ICDS program. Despite efforts of the State as well as voluntary agencies, 7.3% of HHs experienced episode of hunger, mostly from Devbhumi Dwarka, and Navsari district. A third of the respondents showed signs of psychological distress associated with lockdown. Conclusion: Food insecurity may lead to malnutrition impairing the immunity of the individuals to cope with the disease. Thus, given the uncertainty around the emergency situation, preparedness measures should not only focus on the availability of healthcare commodities but also to ensure the availability of other essentials, especially to the socioeconomic disadvantaged group. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Head to Toe Imaging of Complications and Sequelae of COVID- 19 and COVID-19 Vaccination

Background. COVID 19 is associated with a hypercoagulable state with cytokine storm syndrome and thrombocytopenia leading to complications across various systems. COVID-19 infection, its treatment, resultant immunosuppression, and pre-existing comorbidities have made patients vulnerable to secondary infections Methods. We systematically reviewed COVID-19 cases between Jan to May 2021 for pulmonary and extrapulmonary complications. Patients with recent COVID-19 vaccination and neurological symptoms were also included. Results. Neurological complications: Neurological complications include ischemic and haemorrhagic strokes. Other complications are encephalopathy, encephalitis, Guillain-Barré syndrome, acute hemorrhagic necrotizing encephalopathy. Demyelination and radiculopathies are seen as post vaccination complications. Mucormycosis: Unprecedented high rate of invasive fungal sinusitis in association with COVID -19 is reported from the Indian subcontinent. This has a propensity for intra orbital and intracranial extension. COVID -19 associated coagulopathy: COVID -19 is a pro-inflammatory hypercoagulable state. Pulmonary thromboembolism, deep venous thrombosis and catheter related thrombosis are well documented. Cardiac complications: Cardiac manifestations include Myocardial Injury with non-obstructed coronary arteries (MINOCA), myocarditis, myocardial ischemia, cardiomyopathy. Pulmonary complications and sequelae of COVID -19: Progression of lung injury to ARDS during the initial phase and fibrosis of parenchyma in the recovery phase. Spontaneous pneumomediastinum, pneumatoceles and pneumothorax and secondary infections are identified in our study. COVID- 19 associated gastrointestinal complications: Patients evaluated for renal colic, pancreatitis, cholecystitis showed, ground glass opacities or subpleural bands in typical Covid-19 distribution. COVID-19 may lead of acute kidney and bowel injury due to arterial thrombosis. COVID - 19 associated myonecrosis: Ischemia of the small caliber vessels may result in myonecrosis. Conclusion. Awareness of these unusual manifestations will facilitate an early diagnosis, improve management and help reduce morbidity and mortality.

Unfolding trends of COVID-19 transmission in India: critical review of available Mathematical models. (Special Issue: The epidemiologist and the pandemic.)

Background: There is a surge in epidemiological modeling research due to sudden onset of COVID-19 pandemic across the globe. In the absence of any pharmaceutical interventions to control the epidemic, nonpharmaceutical interventions like containment, mitigation and suppression are tried and tested partners in epidemiological theories. But policy and planning needs estimates of disease burden in various scenarios in absence of real data and epidemiological models helps to fill this gap. Aims and Objectives: To review the models of COVID-19 prediction in Indian scenario, critically evaluate the range, concepts, strength and limitations of these prediction models and its potential policy implications.

Free-Roam Virtual Reality: A New Avenue for Gaming

Recent coronavirus pandemic has restricted people’s movement. This has resulted in people spending more time indoors, and quite often, in pursuits like streaming and/or gaming. Traditional gaming often requires the users to sit for hours in front of a screen. This makes the practice unhealthy, and at the same time, makes it relatively less social. Free-roam gaming is a new form of gaming that utilizes virtual reality (VR) techniques to create an environment in which the user feels present. In free-roam gaming, a camera captures users’ movements and converts into gaming actions in the game. Generally such free-roam games are conducted in large spaces to allow for free movement, and thus, allow a group of users to play the same simultaneously. This chapter explores the free-roam VR games via a case study of Zero Latency and the potential of such VR games in dealing with the isolation caused by the coronavirus pandemic. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Low vitamin D levels and prognosis in a COVID-19 pediatric population: a systematic review.

We aim to study the relationship between vitamin D level, risk and severity of Coronavirus disease of 2019 (COVID-19) infection in pediatric population through systematic review. We searched PubMed, CINAHL, EMBASE, Cochrane Library and Google Scholar from December 2019 to June 2021 for retrieving articles studying association between vitamin D deficiencies with COVID-19. Qualitative details were synthesized in evidence table and quantitative data was used for deriving pooled estimate through meta-analysis. After initial search of 2261 articles, eight eligible studies (two reviews) were included in the systematic review. Meta-analysis of the quantitative data (six studies) showed pooled prevalence of vitamin D deficiency as 45.91% (95% CI: 25.148-67.450). In infected pediatric patients, low levels of vitamin D increased the risk of severe disease (odds ratio-5.5; 95% CI: 1.560-19.515; P = 0.008). It was also found that children and adolescents having vitamin D deficiency had greater risk of COVID infection as compared to patients with normal vitamin D levels. Improvement in disease severity with vitamin D supplementation was also noted. The systematic review showed that almost half of the pediatric COVID patients suffer from vitamin D deficiency. It is also clear that the low level of vitamin D is associated with greater risk of infection and poorer outcome in pediatrics.

Epidemiological, clinical and biomarker profile of pediatric patients infected with COVID-19.

BACKGROUND: Given the limited and diverse nature of published literature related to COVID-19 in pediatrics, it is imperative to provide evidence-based summary of disease characteristics for guiding policy decisions. We aim to provide comprehensive overview of epidemiological, clinical and biomarker profile of COVID-19 infection in pediatric population. METHODS: For this umbrella review, published systematic reviews from PubMed and pre-print databases were screened. Literature search was conducted from December 2019 to April 2021. Details of clinical, radiological and laboratory features were collected from each review. Qualitative observations were synthesized and pooled prevalence of mortality and asymptomatic cases were assessed using meta-analysis. RESULTS: Evidence synthesis of 38 systematic reviews included total 1145 studies and 334 398 children and adolescents. Review revealed that COVID-19 is relatively milder with better prognosis in pediatrics. However, patients with comorbidity are at higher risk. Meta-analysis of reviews showed that 21.17% (95% CI: 17.818-24.729) of the patients were asymptomatic and mortality rate was 0.12% (95% CI: 0.0356-0.246). Though there was no publication bias, significant heterogeneity was observed. Fever (48-64%) and cough (35-55.9%) were common symptoms, affecting almost every alternate patient. Ground-glass opacities (prevalence range: 27.4-61.5%) was most frequent radiographic observation. Rise in C-reactive protein, lactate dehydrogenase and D-dimer ranged from 14% to 54%, 12.2-50% and 0.3-67%, respectively. Some of the included reviews (44.7%-AMSTAR; 13.2%-GRADE) were of lower quality. CONCLUSION: Current umbrella review provides most updated information regarding characteristics of COVID-19 infection in pediatrics and can be used to guide policy decision regarding vaccination prioritization, early screening and identification of at-risk population.

Procurement 4.0 to the rescue: catalysing its adoption by modelling the challenges

Purpose: The pandemic crisis has resulted in global chaos that had caused massive disruption to the supply chain. The pharmaceutical industry, in particular, has been working tirelessly to ensure that they can cater to the people who need them. With restrictions being imposed to prevent the spread of the COVID-19 virus, the movement of raw materials required has been affected, thus creating the need for the procurement function to be innovative. This study proposes the application of Industry 4.0 concepts into the procurement activities of an organization to make it more resilient and efficient. Design/methodology/approach: To study the intensity of the challenges, Total Interpretive Structural Modelling is used alongside the “Matrice des Impacts Croises Multiplication Appliquee a un Classement” (MICMAC) technique. Findings: Resilience can be achieved through the collaboration between the organization and its network of suppliers. This is however easier said than done. High and unclear investments have been identified as the challenge that is taking a toll on all technological investments in the pandemic era. The study also shows that organizational inertia which is present in established and structured firms are a deterrent as well. Originality/value: This study is based on the application of procurement 4.0 to ensure that pharmaceutical supply chains stay least affected since they are essentials. This study using a multi-criteria decision-making approach to prioritize the challenges. This will help practitioners make decisions faster. © 2021, Emerald Publishing Limited.

Impact of COVID 19 pandemic on blood pressure of healthcare professionals during lockdown-an Indian study

Objective: Covid-19 pandemic has challenged the healthcare system globally. Hypertension is one of the risk factors associated with increased mortality and morbidity with Covid-19 infection. Few studies have looked into the impact of the Covid-19 pandemic on the mental health of healthcare professionals (HCPs). However not much is known about its impact on physical health and blood pressure of HCPs.Objective is to to Study the distribution of blood pressure and impact of Covid 19 on blood pressure of HCPs. Design and method: Prospective cross-sectional survey Methods: The study was conducted among Indian HCPs. A self administered survey asked about the socio demographic data, known risk factors, past history of hypertension, working conditions in lockdown (work from home or working at a healthcare establishment with potential to exposure to Covid-19), work hours and blood pressure measurement for three consecutive days during lockdown. Results: Six Hundred and eighty seven HCPs (52.8% doctors, 25.1% nurses & paramedics, 22.1 allied HCPs), 63.78% males and 36.22% females, mean age 34.8% (SD=11.5 years) participated in the study. 14.4% (98) had known hypertension while 28.8% (198) were found to be hypertensive for the first time (50% Doctors, 26.26% Nurses/Paramedics and 23.74% Allied Healthcare Professionals). 79.3% (n=198) of these had normal blood pressure when checked in the past 12 months. 76.26% (n=198) of these were directly at risk of exposure to Covid-19. The pandemic has seriously impacted the mental and psychological health of HCPs. Our study highlights that Covid 19 pandemic significantly impacts the blood pressure of HCPs with an alarming rise in risk for their health. Conclusions: Health care professionals developed hypertension in significantly higher numbers during COVID-19 pandemic. While working on the frontline with COVID-19, they are already on higher risk of getting infection. COVID-19 has been found to have serious complications with hypertension. Apart from this hypertension itself is known to lead adverse cardiovascular outcomes. Unfortunately, the majority of them are not aware of their elevated blood pressure. HCPs should remain more careful for their own blood pressure while working in pressure of COVID 19.

Calm my headspace: Motivations and barriers for adoption and usage of meditation apps during times of crisis

Meditation applications for smartphones have been steadily growing in popularity. During the current Coronavirus pandemic, usership of various meditation apps has grown to reach record levels. This study explores the motivations for and barriers to adoption and usage of meditation apps during times of crisis. The study is based on qualitative, semi-structured interviews conducted with seventeen participants. The interviews were audio recorded, transcribed verbatim, and coded using the NVivo software. Inductive thematic analysis identifies five themes: job-related factors, changing lifestyles, psychological conditions and worries, perceived outcomes, and price. All themes except for pricing were found to be motivators for use, while price was deemed a barrier to use. The themes align with the constructs from the Technology Acceptance Model (TAM), the Unified Theory of Acceptance and Use of Technology (UTAUT), and the Diffusion of Innovation (DOI) Theory, providing some useful guidance to meditation app providers. © 2020 International Consortium for Electronic Business. All rights reserved.

Secondary attack rate of COVID-19 in household contacts: a systematic review.

Coronavirus disease 2019 (COVID-19) is a novel virus with continuously evolving transmission trends. Contact tracing and quarantining of positive cases are chief strategies of disease control that has been accepted globally, though scientific knowledge regarding household transmission of the COVID-19 through contact of positive case is sparse. Current systematic review was planned to assess global statistics and characteristics of household secondary attack rate (SAR) of COVID-19. Eligible articles were retrieved through search of-MEDLINE, SCOPUS and EMBASE for the period December 2019 to 15 June 2020. Search terms were developed to identify articles reporting household SARs in various countries. After initial screening of 326 articles, 13 eligible studies were included in the final evidence synthesis. We found that SAR varies widely across countries with lowest reported rate as 4.6% and highest as 49.56%. The rates were unaffected by confounders such as population of the country, lockdown status and geographic location. Review suggested greater vulnerability of spouse and elderly population for secondary transmission than other household members. It was also observed that quarantining and isolation are most effective strategies for prevention of the secondary transmission of the disease. Symptomatic status of the index case emerged to be a critical factor, with very low transmission probability during asymptomatic phase. Present review findings recommend that adequate measures should be provided to protect the vulnerable population as only case tracing and quarantining might be insufficient. It should be combined with advisory for limiting household contacts and active surveillance for symptom onset.

Dry eye disease during COVID-19: Need for investment into research to develop solutions?

Purpose: To review the Clinical Trial Registry of India (CTRI) for clinical trials registered for the interventions for the treatment of dry eye disease. Methods: CTRI was manually searched by using the different key words related to the dry eye. Trials registered after 2009 were included in the analysis. All the parameters like type of interventions, phase of trial, sample size etc of the each trial were extracted in the predesigned proforma. Descriptive statistics was reported in the form of frequency and percentages. Results: Total 35 trials were registered since 2010. Majority were phase 4 trials (Post Marketing Surveillance). More than half of the registered trials were related to the ayurvedic products. Most frequent allopathic intervention was lubricant and most frequently used comparator was Carboxy Methyl Cellulose. Range of sample size in different trials was 30-300. Conclusion: A good number of trials related to the ayurvedic drugs are registered for dry eye. There is a need for similar research efforts for allopathic interventions. © 2021, Institute of Medico-Legal Publications. All rights reserved.

Vitamin D supplementation, COVID-19 and disease severity: a meta-analysis.

OBJECTIVE: Current meta-analysis aims to understand the effect of oral supplementation of vitamin D on intensive care unit (ICU) requirement and mortality in hospitalized COVID-19 patients. METHODS: Databases PubMed, preprint servers, and google scholar were searched from December 2019 to December 2020. Authors searched for the articles assessing role of vitamin D supplementation on COVID-19. Cochrane RevMan tool was used for quantitative assessment of the data, where heterogeneity was assessed using I2 and Q statistics and data was expressed using odds ratio with 95% confidence interval. RESULTS: Final meta-analysis involved pooled data of 532 hospitalized patients (189 on vitamin D supplementation and 343 on usual care/placebo) of COVID-19 from three studies (Two randomized controlled trials, one retrospective case-control study). Statistically (p<0.0001) lower ICU requirement was observed in patients with vitamin D supplementation as compared to patients without supplementations (odds ratio: 0.36; 95% CI: 0.210-0.626). However, it suffered from significant heterogeneity, which reduced after sensitivity analysis. In case of mortality, vitamin D supplements has comparable findings with placebo treatment/usual care (odds ratio: 0.93; 95% CI: 0.413-2.113; p=0.87). The studies did not show any publication bias and had fair quality score. Subgroup analysis could not be performed due to limited number of studies and hence dose and duration dependent effect of vitamin D could not be evaluated. CONCLUSIONS: Although the current meta-analysis findings indicate potential role of vitamin D in improving COVID-19 severity in hospitalized patients, more robust data from randomized controlled trials are needed to substantiate its effects on mortality.

Unfolding trends of covid-19 transmission in india: Critical review of available mathematical models

Background: There is a surge in epidemiological modeling research due to sudden onset of COVID-19 pandemic across the globe. In the absence of any pharmaceutical interventions to control the epidemic, nonpharmaceutical interventions like containment, mitigation and suppression are tried and tested partners in epidemiological theories. But policy and planning needs estimates of disease burden in various scenarios in absence of real data and epidemiological models helps to fill this gap. Aims and Objectives: To review the models of COVID-19 prediction in Indian scenario, critically evaluate the range, concepts, strength and limitations of these prediction models and its potential policy implications. Results: Though we conducted data search for last three months, it was found that the predictive models reporting from Indian context have started publishing very recently. Majority of the Indian models predicted COVID-19 spread, projected best-, worst case scenario and forecasted effect of various preventive measurements such as lockdown and social distancing. Though the models provided some of the critical information regarding spread of the disease and fatality rate associated with COVID-19, it should be used with caution due to severe data gaps, distinct socio-demographic profiling of the population and diverse statistics of co-morbid condition. Conclusion: Although the models were designed to predict COVID spread, and claimed to be accurate, significant data gaps and need for adjust confounding variables such as effect of lockdown, risk factors and adherence to social distancing should be considered before generalizing the findings. Results of epidemiological models should be considered as guiding beacon instead of final destination. © 2020, Indian Association of Preventive and Social Medicine. All rights reserved.