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Introduction: Information on the cardiac manifestations of coronavirus disease 2019 (COVID-19) is scarce. In this study we assessed the echocardiogram of consecutive patients with COVID-19 infection to assess the frequency of cardiac abnormalities. Materials and Methods: This retrospective descriptive study examined the echocardiographic study of 43 patients with severe and critical COVID-19 infection admitted at the ICU of Chitwan Medical College from May 16, 2021 to June 05, 2021. The study focused on left ventricle (LV) and right ventricle (RV) function. The results were then compared between severe and critical infections to examine if any differences exist between them. Results: The mean age of the study population was 54 years and predominately males. One-third were classified as critical COVID-19 while the remaining were severe COVID-19. Majority(83.7%) had a normal echocardiogram. Among the patients with abnormal reports, the distribution of echocardiographic pattern were biventricular dilation with biventricular dysfunction in two patients (4.6%), LV dialtion with LV dysfunction in two patients (4.6%) and isolated LV dysfunction (diastolic and systolic) in three patients (6.9%). None of the echocardiographic parameters were significantly different between the severe and the critical infection. Conclusion: COVID-19 in primarily a respiratory disease and the cardiac complications is largely attributed to the critical nature of the illness than the specific infection. Considering the risk of infection spread, routine echocardiography for all patients with COVID-19 infection is not advisable.
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Increased urbanization and on-demand mobility have resulted in the boon of many ride-sharing companies. Besides providing faster, economical, and comfortable rides, these rideshares are also environment-friendly as they save a lot of energy. This research work presents a model which would be beneficial for the passengers riding these carpools as it would not only help to curb the spread of infection in current pandemic but also detect whether the driver is drowsy or not to prevent possible road accidents. The proposed web application includes three detections based on novel deep learning algorithms implementing face recognition, facemask, and drowsiness detection of the driver with an alert mechanism to send immediate email alerts to the company and driver. The novelty of the proposed application is that the current and live status of the driver is continuously recorded using latest technologies like convolutional neural networks (CNNs), histogram of oriented gradients (HOG), support vector machine (SVM) classifier, and computer vision. In addition to this, a real-time vehicle tracking device is also implemented using Node MCU, Global Positioning System (GPS) module, and Blynk app to keep the company updated about the real-time location of the rideshare. The name of the recognized driver is displayed as output. Face mask and drowsiness detection is done with an accuracy of 99%, and the real-time location of the cab is indicated in Google Maps on the Blynk app. The proposed web application would be very beneficial for ride-sharing companies in the current COVID situation. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Developing countries like Nepal face challenges in accessing health services due to sparse distribution in communities, difficult geographic terrain, limited transportation, poverty, and lack of health human expertise in rural areas. The COVID-19 pandemic added woes to the wound. To address this gap, the Hospital for Children, Eye, ENT, and Rehabilitation Services adopted an innovative approach to remote rural patient care using telehealth and artificial intelligence in close coordination with IT professionals and healthcare professionals. We developed a deep learning-based disease prediction model that incorporates telemedicine with AI for screening and diagnosing Eye and ENT diseases using nonspecialist health workers. Deep learning-based disease prediction models in Diabetic Retinopathy (DR) and Glaucoma added quality specialized services to telehealth. This paper presents the adoption of digital innovations and the incorporation of telehealth to tackle various diseases. To predict DR, 61,458 colorful retinal photographs from fundus photography and 1500 for Glaucoma were used. To reduce the biases, EyePACS data sets were also incorporated. Inception V3 transfer learning model was used for DR and employed DenseNet architecture for Glaucoma. An accuracy of more than 90 %in both models was achieved. Accurate specialized diagnosis, better medical care, patient monitoring, limited specialized hospital visits, and easier with shorter wait times are now possible. In the future, this successful model can be replicated nationally and in other developing countries. © 2022 IEEE.
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Background Nearly after 6 months of the spread of Corona Virus Disease 19, along with the world Nepal is still trying to control the spread and prevent general population from acquiring it. With limited resources in manpower, technology and evidence it has been a difficult battle. But with time and more understanding of the virus new technology to detect the virus are coming up. It is a major breakthrough in the diagnostic field as this helps us in not only detecting the virus but also helps us to mobilize our human resources. This comes in a time where the cases are increasing at an alarming rate. Although numbers of Polymerase Chain Reaction testing have increased but due to the time consuming and the cost wise, we need a faster and equally reliable alternative. Antigen test approved by different countries can be used for point of care, screening and surveillance depending upon the requirements after calculating its sensitivity, specificity and accuracy. Objective To find out sensitivity and specificity of the Antigen test kit for COVID-19. Method Antigen tests were compared with Reverse Transcription Polymerase Chain Reaction as a reference standard in calculated sample size of 113 subjects in a high risk population. Both Reverse Transcription Polymerase Chain Reaction and antigen test were performed in a same subject with in maximum of 2 days' interval. Convenience sampling technique was used to select the subjects. Ethical approval was taken from Nepal Health Research Council before data collection. Study was done from August to September 2020 from Quarantine center of Province 3. Result There were total of 113 test carried out, among those 47 were positive and 66 were negative in Reverse Transcription Polymerase Chain Reaction. After preparing two by two table, Sensitivity and specificity of the tested was calculated which came out to be 85% and 100% respectively, with accuracy of 93.80%. Conclusion Even though the sensitivity and specificity came to be higher, this test should be interpreted cautiously depending upon the prevalence of Corona Virus Disease 19 in that particular community and the clinical and epidemiological context of the person who has been tested. When in doubt by clinical correlation should be confirmed with Reverse Transcription Polymerase Chain Reaction. Copyright © 2020, Kathmandu University. All rights reserved.
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Aims: Paediatric inflammatory multisystem syndrome-temporally associated with SARS-CoV-2 (PIMS-TS) is a novel hyperinflammatory condition that most commonly presents with an acute abdomen. Here we present a case of PIMS-TS mimicking appendicitis and a review of The literature with a proposed protocol for managing abdominal pain in patients with recent SARS-CoV-2 infection. Result(s): An 8-year old girl presented with suspected appendicitis. She underwent a day case open appendicectomy with normal appendix confirmed on histology. Unfortunately, she re-presented The following day with persistently high fever and was investigated for post-appendicectomy complication. She was started on intravenous antibiotics. MRI of abdomen and pelvis showed no collection but evidence of lymphadenopathy. on post-operative day four she was transferred to The tertiary centre PICU for specialist management of suspected severe PIMS-TS. Common abdominal radiological findings in PIMS-TS include ascites, bowel wall thickening and mesenteric inflammation. In addition, CRp and ferritin have been found to be significantly higher in PIMS-TS. White cells may be raised with neutrophilia and lymphopaenia. In addition, highly deranged inflammatory markers in The context of a normal abdominal imaging are more consistent with PIMS-TS than appendicitis. We propose anyone with these findings is considered as having PIMS-TS and requires urgent imaging including combined senior surgical and paediatrician review. Conclusion(s): PIMS-TS may present mimicking acute appendicitis and given The severe cardiac compromise that can develop in patients with PIMS-TS is it important to avoid unnecessary General anaesthetic and abdominal Surgery where possible. Our proposed protocol could help reduce unnecessary abdominal Surgery in these patients.
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Background: Abuja, Nigeria's annual World Cancer Day Walk (WCDW) is a tool for promoting public awareness of cancer risk factors, preventative lifestyle strategies, and the importance of early screening as critical elements of prevention and control. The day includes physical activities (walk, race, ride, skate, cycle, marathon), as well as health education and free breast cancer, cervical, and prostate screenings. The effectiveness of the event to attract the most vulnerable Nigerian populations has not been studied. Aim: To determine the social-demographic characteristics of participants and evaluate the impact of outreach campaigns. Methods: Approximately 2,000 Nigerians attended Abuja WCDW on February 1, 2020. A similar number attended Abuja WCDW on February 5, 2022. Trained research assistants recruited participants to complete a one-sheet questionnaire that assessed basic demographic, social, and lifestyle information. Participants were given informed consent. In 2020, 237 (11%) participants, aged 18-68 years voluntarily completed survey (ClinicalTrials #NCT04248881). In 2022, 111 (6%), aged 17-74 years voluntarily completed survey (ClinicalTrials #NCT05239325). Note: In 2021, Abuja WCDW was canceled due to COVID. Results: In 2020, the mean age for participants was 28;SD 7.71. Sixty-eight percent were women. Eighty-seven percent had at least an undergraduate education. Of the 237 participants, 65% reported that they attended to obtain free cancer screening. More than 50% reported they had no health insurance. Of those insured, more had National Health Insurance Scheme (NHIS) than private insurance. The average body mass index (BMI) was between 24-28;BMI was highest among the mid-20 age group. Lifestyle data revealed more men than women were concerned with their health;those with health worries were more likely to have had cancer screening at the event. The 2022 WCDW data were being analyzed at the time of submission;findings will be presented at the meeting. Analysis: Data from 2020 revealed participants are predominately associated with a lower risk of developing cancer. They have higher levels of knowledge about cancer and lifestyle/health-related behaviors beneficial for early detection and prevention. WCDW is a great avenue for cancer awareness/lifestyle prevention interventions yet there is an urgent need to evaluate efficacy of current outreach to target underserved members of Nigerian population: those with lower levels of education, unemployed, lower income, and without insurance. Conclusions: Attendees in 2020 are younger people of higher socioeconomic status with lifestyle practices that could reduce cancer risk. If our 2022 data are similar, we must elaborate better strategies to reach populations at greater risk and encourage them to attend future events to have more impactful lifestyle/prevention outcomes.
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To study tolerability and outcome of oral favipiravir treatment among COVID-19 patients in Nepal. In this multi-centered randomized, open-labelled phase III clinical trial, we enrolled 18-80 years old, RT-PCR confirmed patients with mild to moderate COVID-19 infection from 9 participating hospitals of Nepal, within 6 days of onset of symptoms. The investigational product (Favipiravir) was compared against placebo in patients with mild infection and against Remdesivir in moderate infection. Patients who met the eligibility criteria were randomly enrolled in the study after taking informed consent. This is a preliminary report of the data analysis. At the time of this preliminary data analysis, 90 cases were enrolled in the study including 70 mild and 20 moderate cases (see table). Among the participants with mild COVID19 infection, clinical improvement was noted in 30 (78.9%) and 27 (84.4%) patients who received Favipiravir and placebo, respectively (p=0.78). While among the participants with moderate infection, 9 (81%) and 8 (88.9%) patients who received Favipiravir and Remdesivir, respectively, had clinical improvement (p=1). Patients tolerated Favipiravir well with only 3 (6.12 %) patients showing adverse events, which were mainly elevated liver function test & uric acid level, both considered minor. None of the patients receiving placebo or remdesivir reported any adverse events. The investigational product has been tolerated well by this group of patients with only mild and reversible side effects in 6.12 % cases. The outcomes between the study groups were comparable. [ FROM AUTHOR] Copyright of International Journal of Infectious Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Purpose: Knowledge management (KM) is widely adopted by organisations to improve their performance and make informed decisions. Prior research has confirmed that Information Systems (IS) play a critical role in effective KM. The purpose of this study is to examine the existing literature on the role of cloud-based KM systems (C-KMS) in small- and medium-sized enterprise (SMEs) by understanding its impact on the five KM processes: knowledge acquisition, creation, storage, sharing and usage. Design/methodology/approach: This study conducted a systematic literature review by examining 133 journal articles and 24 conference papers from 2010 to 2021 on the role of cloud computing in KM for SMEs. Findings: This study revealed that there are numerous empirical analyses on KM processes and tools in SMEs;however, only few studies demonstrate how the whole gamut of KM processes can adopt cloud computing in SMEs. Therefore, SMEs are ineffective at KM with limited IS intervention. This paper offers a proposition on how C-KMS can impact all five KM process, thereby increasing its effectiveness of KM in SMEs. This study analysed the benefits of C-KMS that brings to SMEs in terms of availability, scalability, reliability, security and cost. Research limitations/implications: This systematic review is restricted to certain databases (ScienceDirect, Sage journals, Scopus and Emerald Insight) and specific IS conference proceedings to source articles. The selection of search criteria and time frame is based on this study’s assessment and choice. This study adds value to our understanding of the role of KM in SMEs, and it reinforces the role of cloud computing in effectively managing knowledge in SMEs. The proposal of C-KMS for the enhancement of KM has significant implications for SMEs to effectively use knowledge for their survival and superior performance. Practical implications: This study suggests three practical implications. First, adopting and using C-KMS provide a strong foundation to manage knowledge for SMEs in a cost-effective way. Second, C-KMS improves the effectiveness of KM by increasing availability of knowledge artifacts, which in turn aids SMEs’ growth. Third, C-KMS is useful to codify SME’s knowledge, and accordingly supports employees to acquire and use knowledge based on their requirements. Social implications: This study discussed C-KMS with contemporary social issues, such as the COVID-19 pandemic challenges for SMEs and demonstrated how C-KMS can support SMEs to handle such crises by managing knowledge effectively. Originality/value: This research highlights the importance of the implementation of a C-KMS for the enhancement of KM in SMEs. The review provides empirical evidence on the challenges faced by SMEs regarding KM, as they often only have enough resources to focus on a single KM process, predominantly knowledge sharing. Consequently, a holistic approach to KM cannot be realised by SMEs. In this context, the findings of this study offer theoretical and practical insights into the role of cloud computing by addressing the challenges of KM in SMEs. © 2020, Emerald Publishing Limited.
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The fatal outbreak of COVID-19 has placed its fear around the globe since it was first reported in Wuhan, China, in November 2019. COVID-19 has placed all countries and governments across the world in an unstable position. Most countries underwent partial or full lock down due to the dearth of resources to fight the COVID-19 outbreak, primarily due to the challenges of overloaded healthcare systems. The tally of confirmed COVID-19 cases via laboratory continues to increase around the globe, with reportedly 60.5 million confirmed cases as of November 2020. Evidently, innovation has an imperative function to empower the omnipresent health technologies in order to counter the impacts of COVID-19 in a post-pandemic period. More specifically, the Fifth Generation (5G) cellular network and 5G-empowered e-health and Artificial Intelligence (AI) based arrangements are of on the spotlight. This research explores the use of AI and 5G technologies to help alleviate the effects of COVID-19 spread. The novel approach is based on the premises that the COVID-19 vaccine may take years to rollout effectively, whereas the AI and 5G technologies offer effective solutions to reduce the Covid-19 spread within weeks. Currently, the approaches such as contact tracing and virus testing are not secure and reliable;and the cost of testing is high for end users. The proposed solution offers a self-diagnostic mechanism without any security risk of the users’ data with very low cost using cloud-based data analytics using mobile handsets. © 2021, Springer Nature Switzerland AG.
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The world is going through a global crisis due to the contemporary COVID 19 pandemic situations. In these taxing times, students have been severely affected. So our government has not compromised their future and has decided to conduct all competitive examinations. Thus, it becomes crucial for the students to register for the exams. However, the traditional exam hall authentication system does not assure that the students would not be exposed to the infection. So it is important to come up with a solution for this scenario. This paper presents a model in which the student's registration and authentication happen using the fingerprint sensor and Atmega328 microcontroller in addition to recording the student's body temperature by the LM35 temperature sensor. The data is transferred to a cloud server where it can be monitored and analyzed. The cloud server shall store the time of recording and the temperature of the student. If the temperature is higher than standard body temperature, an email alert is sent to the concerned authorities. The authorities can consequently take appropriate action and this would help in curbing the spread of the virus among the students present in the exam hall. © 2020 IEEE.
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Forestry education has always had to adapt to global changes and accommodate students and society’s needs. To address the issues of the day, forestry education has cultivated human capacity to understand the complexity of ever-changing environments, master resource management technologies, and engage in global issues. Educational technology and online learning are important in providing flexible, accessible, and effective forest education at the rate and scale needed within the forestry sector. The transition during the COVID-19 pandemic further illustrates the role of online learning in worldwide education. In this context, this paper shares a case study from the Sustainable Forest Management Online Program led by the Faculty of Forestry, University of British Columbia (UBC) and Partner Universities. This study shows that appropriately integrating educational technologies into an internationally developed and recognized high-quality curriculum is an effective way to create accessible and affordable forestry education in meeting the demand of evolving societal and environmental conditions. © 2020, North American Business Press. All rights reserved.
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Background: Nearly after 6 months of the spread of Corona Virus Disease 19, along with the world Nepal is still trying to control the spread and prevent general population from acquiring it. With limited resources in manpower, technology and evidence it has been a difficult battle. But with time and more understanding of the virus new technology to detect the virus are coming up. It is a major breakthrough in the diagnostic field as this helps us in not only detecting the virus but also helps us to mobilize our human resources. This comes in a time where the cases are increasing at an alarming rate. Although numbers of Polymerase Chain Reaction testing have increased but due to the time consuming and the cost wise, we need a faster and equally reliable alternative. Antigen test approved by different countries can be used for point of care, screening and surveillance depending upon the requirements after calculating its sensitivity, specificity and accuracy.
ABSTRACT
The first case of coronavirus disease 2019 was reported on December 31, 2019 in Wuhan, China where the average case fatality rate was 6.1 +/- 2.9%. There are 453 deaths as of September 24, 2020 in Nepal. We report the first death of a 29-years-old postpartum woman due to COVID-19 in Nepal who was referred from a rural health center to Dhulikhel Hospital. On arrival, she was taken to the acute respiratory zone of the emergency department to provide immediate lifesaving procedures. Despite the repeated resuscitative measures, return of spontaneous circulation could not be achieved. The real time polymerase chain reaction test was positive. Our case report highlights the importance of early clinical suspicion, importance of "safety first" in healthcare settings, and the chain of management in such patients. We consider the fact that a postpartum woman registered as the first case of COVID-19 related death in Nepal to be an area of further study.
ABSTRACT
Background Nearly after 6 months of the spread of Corona Virus Disease 19, along with the world Nepal is still trying to control the spread and prevent general population from acquiring it. With limited resources in manpower, technology and evidence it has been a difficult battle. But with time and more understanding of the virus new technology to detect the virus are coming up. It is a major breakthrough in the diagnostic field as this helps us in not only detecting the virus but also helps us to mobilize our human resources. This comes in a time where the cases are increasing at an alarming rate. Although numbers of Polymerase Chain Reaction testing have increased but due to the time consuming and the cost wise, we need a faster and equally reliable alternative. Antigen test approved by different countries can be used for point of care, screening and surveillance depending upon the requirements after calculating its sensitivity, specificity and accuracy. Objective To find out sensitivity and specificity of the Antigen test kit for COVID-19. Method Antigen tests were compared with Reverse Transcription Polymerase Chain Reaction as a reference standard in calculated sample size of 113 subjects in a high risk population. Both Reverse Transcription Polymerase Chain Reaction and antigen test were performed in a same subject with in maximum of 2 days’ interval. Convenience sampling technique was used to select the subjects. Ethical approval was taken from Nepal Health Research Council before data collection. Study was done from August to September 2020 from Quarantine center of Province 3. Result There were total of 113 test carried out, among those 47 were positive and 66 were negative in Reverse Transcription Polymerase Chain Reaction. After preparing two by two table, Sensitivity and specificity of the tested was calculated which came out to be 85% and 100% respectively, with accuracy of 93.80%. Conclusion Even though the sensitivity and specificity came to be higher, this test should be interpreted cautiously depending upon the prevalence of Corona Virus Disease 19 in that particular community and the clinical and epidemiological context of the person who has been tested. When in doubt by clinical correlation should be confirmed with Reverse Transcription Polymerase Chain Reaction.
ABSTRACT
The first case of coronavirus disease 2019 was reported on December 31, 2019 in Wuhan, China where the average case fatality rate was 6.1 ± 2.9%. There are 453 deaths as of September 24, 2020 in Nepal. We report the first death of a 29-years-old postpartum woman due to COVID-19 in Nepal who was referred from a rural health center to Dhulikhel Hospital. On arrival, she was taken to the acute respiratory zone of the emergency department to provide immediate lifesaving procedures. Despite the repeated resuscitative measures, return of spontaneous circulation could not be achieved. The real time polymerase chain reaction test was positive. Our case report highlights the importance of early clinical suspicion, importance of “safety first” in healthcare settings, and the chain of management in such patients. We consider the fact that a postpartum woman registered as the first case of COVID-19 related death in Nepal to be an area of further study. © 2020, Kathmandu University. All rights reserved.