ABSTRACT
Paediatric patients comprise a small proportion of the SARS-CoV-2 infected population. They usually present with mild symptoms, however a small proportion of them may require intensive care due to shock and multi-organ failure related to Paediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 (PIMS-TS). This review article summarises the oral mucosal lesions in children with COVID-19 and PIMS-TS. The most common sites affected are the tongue and lips. Commonly reported lesions include cheilitis, dry and red lips, and tongue swelling. This article is of importance to all healthcare professionals involved in the multidisciplinary care for this group of patients.Copyright © 2021 The Authors
ABSTRACT
The Internet of Things (IoT) has revolutionized the ways;the physical world is connected to the cloud for real-time data dissemination through embedded sensors and microcontrollers. IoT plays an important role in almost every sphere of the world, may it be physical sensor connection to the cloud, the Structural Health Monitoring Systems (SHMS), Smart Homes, Health care, etc. Healthcare Internet of Things (H-IoT) has taken the healthcare sector to the next level by incorporating remote patient monitoring and diagnosis, Robotic surgeries, patient's vital data monitoring in real time, etc. This paper presents a novel and a simple technique of remotely monitoring patients suffering from highly contagious diseases like the Corona Virus, thereby reducing the direct patient-doctor physical contact and ensuring the social distance. The patients' medical data is acquired and end-to-end encryption is done on the data to ensure no loss of the data between the transmitting end and the receiving end. The designed system is based on the Node_Mcu microcontroller platform. The sensor data is acquired and processed using the Arduino-Integrated Development Environment (IDE) and further predictions regarding the patient's health are performed in the MATLAB 2019a computation software.
ABSTRACT
Purpose : During the COVID-19 pandemic, ophthalmologists were presented with the challenge of providing safe care to patients while limiting the spread of COVID-19. As a result, many institutions implemented universal pre-surgical COVID-19 screening prior to surgery for all patients. The goals of this study are to characterize the rate of COVID-19 positivity during pre-surgical screening at our institution, the surgical outcomes experienced in COVID-19 positive ophthalmic patients, and to report overall cost of universal pre-surgical screening. Methods : This retrospective study included patients ≥ 18 years who underwent ophthalmic surgical procedures at a tertiary institution between May 11, 2020 and December 31, 2020. Patients without a valid pre-surgical COVID-19 test within the three days prior to their scheduled procedure, incomplete or mislabeled visits, and incomplete or missing data in their file were excluded. COVID-19 screening was completed by the Thermo Fisher TaqPath Polymerase Chain Reaction (PCR) kit. Results : Of the 3,585 patients who met inclusion criteria, 2,044 patients (57.02%) were female, and the average age was 68.2 ± 12.8 years (mean ± standard deviation). 13 asymptomatic patients (0.36%) tested positive for COVID-19 via PCR screening. Three patients had known positive COVID-19 infection within the 90 days prior to surgery, thus 10 patients (0.28%) were found to have asymptomatic naïve COVID-19 infection via PCR. Testing was associated with a total charge of $788,700. Five of the 13 COVID-19 positive patients (38.46%) experienced a delay in their surgery. The average surgical delay was 17.23 ± 22.97 days (mean ± standard deviation). Conclusions : Asymptomatic ophthalmic surgical patients experienced a low positivity rate with a limited impact on surgery scheduling at a significant cost. Further studies would be valuable in evaluating a targeted pre-surgical screening population as opposed to universal testing.
ABSTRACT
Objective: Since April 2021, there has been significant increase in number of COVID-19 cases in India. As the caseload increased, so did the complications like pneumomediastinum (PM) and subcutaneous emphysema (SE). Case Presentation: We present clinical course of 4 patients as case series of COVID-19 pneumonia who developed PM and SE during their management. Two cases with the need of non-invasive ventilation (NIV) recovered and two cases that needed invasive mechanical ventilation (IMV) ultimately expired. Conclusion: This case series highlights the importance of positive pressure ventilation via NIV and IMV as a predisposing factor for PM and SE as well as the need of strict vigilance by clinicians managing COVID-19 patients in IMV. © 2022 The Author(s).
ABSTRACT
Background: The whole planet is facing one of the scariest pandemic situations in this era. On 11th February, 2020 the World Health Organization announced the name of an unknown disease as COVID-19, which is caused by the ssRNA virus SARS-CoV-2 (formally recognized as a sister of SARS-CoV and MERS-CoV). The epicenter of this disease is Wuhan, Hubei Province, China. COVID-19 can affect all age groups, but particularly affects immune compromised and aged persons with co-morbid conditions. It is highly contagious disease that involves mild to severe respiratory symptoms along with breathing difficulties. Objectives: As SARS-CoV-2 is a new strain of β-coronavirus that spreads from animals to humans via an unknown intermediate host, no vaccines have been developed yet and only supportive treatment is given to the infected patients. The review paper highlights the pharmacological therapy as a supportive treatment given to the COVID-19 patients and nonpharmacological therapeutic approaches for the prevention. Methods: Methods: Authors were surveyed and reviewed numerous articles, magazines, news papers, conference proceedings from different search engines and made the review successful. Results: Some drugs of different categories are approved and prescribed to the patients and some others are still under investigation and have gone through clinical trials. Conclusion: As no specific treatment or drugs for this disease have been developed till the date;therefore, social distancing, home quarantine, and proper healthy lifestyle management are the best current short-term options to avoid further spread of this pervasive virus.
ABSTRACT
The Quality 4.0 concept is derived from the industrial fourth revolution, i.e., Industry 4.0. Quality 4.0 is the future of quality, where new digital and disruptive technologies are used to maintain quality in organizations. It is also suitable for traditional Chinese medicine (TCM) to maintain quality. This quality revolution aims to improve industrial and service sectors’ quality by incorporating emerging technologies to connect physical systems with the natural world. The proposed digital philosophy can update and enhance the entire TCM treatment methodology to become more effective and attractive in the current competitive structure of the pharmaceutical and clinical industries. Thus, in healthcare, this revolution empowers quality treatment during the COVID-19 pandemic. There is a major requirement in healthcare to maintain the quality of medical tools, equipment, and treatment processes during a pandemic. Digital technologies can widely be used to provide innovative products and services with excellent quality for TCM. In this paper, we discuss the significant role of Quality 4.0 and how it can be used to maintain healthcare quality and fulfill challenges during the pandemic. Additionally, we discuss 10 significant applications of Quality 4.0 in healthcare during the COVID-19 pandemic. These technologies will provide unique benefits to maintain the quality of TCM throughout the treatment process. With Quality 4.0, quality can be maintained using innovative and advanced digital technologies. © 2021 Digital Chinese Medicine
ABSTRACT
Industry 4.0 is being implemented with the help of advanced technologies. Big data, Artificial Intelligence (AI), Robotics, Internet of Things (IoT), Cloud computing, and 3D printing are the major technologies used to adopt Industry 4.0 successfully. Here, the study's need is to discuss the major potential of big data for Industry 4.0. These technologies' primary purpose is to collect the right data to solve the relevant issue during manufacturing and other required services. This technology plays a significant role in creating advancements in this fourth industrial revolution. Conclusively, big data applications are useful for in-process management and productivity improvement in the automation sector. Complex systems of drivers and intelligent sensors can be easily optimized based on information collected using this technology. Big data is the key to gain a competitive leap by reconnoitring the fundamental issues like deviations during the process, quality discriminations, and energy efficiency squander in a manufacturing process. The study discusses the significant applications of big data in Industry 4.0. For a proper surveillance system, industries need to have an immensely technical or personalized way, making big data a valuable source for predicting analysis and operation management based on market insight statistics or information. In upcoming days, big data will provide further advancement in Industry 4.0 and is supposed to play an efficient role in its successful adoption.
ABSTRACT
Libraries are considered the heart of academic and research institutions. Without a library, academics will have no progress. Though the digital library is a frequent buzzword for libraries and information centres in the present era, traditional services, especially in public and academic libraries, still exist. But due to the COVID-19 pandemic, all types of libraries have been equally affected. The paper discusses the impact of the COIVID-19 pandemic on the continuity of library services and access in the Indian academic and research libraries. It describes how the libraries safeguard the resources and staff and examine the difficulties and challenges faced by the libraries during the COVID-19 outbreak. It details the adoption of services for the benefit of the communities that support the educational mission. The study is carried out by administering an online questionnaire to about 58 libraries and analyzed. In conclusion, the paper proposes firm ideas and recommendations to deal with the pandemic situation like COVID-19 and continue the library support to users. © 2021. All Rights Reserved.
ABSTRACT
Purpose : Telehealth has a variety of proposed uses in ophthalmology and has become a valuable asset to health care in the COVID-19 pandemic. This retrospective, observational study characterizes the use of virtual visits and compares the outcomes of these visits to in-person visits during the pandemic period at a large academic institution. Methods : 2,943 virtual and 56,174 in-person visits occurring at Cole Eye Institute, Cleveland Clinic, were identified. A random sample of 3,000 in-person visits was selected for comparison. Canceled, incomplete and duplicated visits, as well as visits for patients aged less than 18 years old were excluded. Pearson's chi-square test of independence and test of proportions were used to assess relationships between categorical variables. Results : 2,266 virtual visits and 2,590 in-person visits were included. The visits distribution across ophthalmology specialties is summarized in table 1. 72.3% of the virtual visits resulted in a planned follow-up compared to 70.3% following an in-person visit (p=0.121). 15.9% of virtual patients were discharged compared to 10.8% of in-person patients (p<0.001). 5.6% of virtual patients were referred to a primary care doctor or different ophthalmology subspecialty compared to 6.9% in-person patients (p=0.081). 6.0% of the patients had an outpatient surgery scheduled after a virtual visit compared to 4.8% inperson patients (p=0.08). 0.2% of the virtual patients had a clinic procedure scheduled compared to 7.2% in-person patients (p<0.001). Loss to follow-up occurred due to cancelations (4.6% and 3.5% in the virtual and in-person visits, respectively, p=0.11), no shows (2.8% and 2.1%, p=0.2) and no schedule (10.4% and 2.3%, p<0.001). 84.6% of the completed follow-up visits after virtual visits were in-person and 15.4% were virtual, in comparison to 97.4% and 2.6% after an in-person encounter (p<0.001). Conclusions : The similar number of follow-up, referral and outpatient surgery outcomes across virtual and in-person visits suggests that teleophthalmology is a viable alternative for patient care. Virtual follow-ups occurred more often after a virtual visit. Discharges and unscheduled follow-up visits were also more prevalent in the virtual setting, implying a higher risk of care discontinuation in this group. Further research into the applications of telehealth for ophthalmology may be beneficial.
ABSTRACT
Purpose : To implement and assess the impact of an electronic clinical decision support tool (DST) on prescriber adherence to 2016 Academy of Ophthalmology (AAO) recommendations for a hydroxychloroquine maximum daily dose of 5 mg/kg actual body weight. Methods : A DST was developed to trigger a pop-up alert within the electronic medical record when a prescriber orders hydroxychloroquine exceeding 5 mg/kg actual body weight or >400mg daily. The prescriber may choose to amend the prescription or override the alert. The tool was implemented on April 21, 2020. A chart review was performed of all hydroxychloroquine prescriptions in the 6-month post-intervention period (May - November 2020). Inclusion criteria were patient age ≥18 years;availability of dose and frequency;availability of actual body weight;and outpatient prescription status. Only the most recent prescription was used in cases of an individual patient having multiple prescriptions. Prevalence of excess hydroxychloroquine dosing (>5mg/kg/day) and mean daily dose in the post-intervention period was compared to previously collected, preintervention data from 2018 (under review for publication), using the chi-squared test and 2-sample t-test, respectively. The odds ratios of excessive dosing was assessed using multivariable logistic regression that included sex, race, weight, and prescriber specialty. Results : There were 7915 patients with active hydroxychloroquine prescription, of which 7415 (94%) met inclusion criteria. There prevalence of excessive dosing decreased from 27.4% pre-DST to 21.1% post-DST (P<0.001). Mean daily dose decreased from 342±94 mg (4.3±1.4 mg/kg/day) pre-DST to 324±93mg (4.1±1.3mg/kg/day) post-DST (P<0.001). Only 0.2% prescriptions exceeded mean 400mg daily, and 0.1% prescriptions were indicated for COVID-19. In multivariable analysis, a rheumatologist prescriber (in comparison to all other specialties, OR 0.66 [99% CI 0.54-0.80]) and greater weight (OR 0.94 [99% CI 0.93- 0.95], equivalent to -0.062 log odds per 1 kg increase in weight) were associated with reduced odds of excessive dosing. Conclusions : Implementation of a DST significantly improved prescriber adherence with 2016 AAO ophthalmic safety recommendations for hydroxychloroquine dosing. As daily dosage is a strong predictor of retinopathy risk, an electronic DST demonstrates potential to reduce ophthalmic morbidity associated with chronic hydroxychloroquine use.
ABSTRACT
Purpose : The current standard of care following retina surgery, particularly pars plana vitrectomy (PPV), is an in-person evaluation conducted on postoperative day 1 (POD1). Given the inherent difficulty of patients with visual disability attending POD1 visits and the safety concerns raised during the COVID-19 pandemic, a critical examination of this standard of care is needed. This study is a meta-analysis that aims to evaluate the necessity of the POD1 review following PPV. Methods : The analysis included available literature documenting medical and surgical interventions performed on POD1 review following PPV. 2262 patients across 14 eligible studies were included in the analysis. A meta-analysis of proportions was conducted using a binomial-normal model to analyze datasets consisting of all interventions, medical interventions, and surgical interventions. The primary outcome measured was the proportion of patients requiring an intervention on POD1. Heterogeneity and publication bias analyses were performed. Statistical analyses were performed using R (version 3.5.1). Results : Of the 80 references identified as being of potential relevance, 14 studies met all eligibility criteria. POD1 reviews of 2262 patients were analyzed to yield an intervention rate estimate of 4.7% [95% CI 3.0-13.9]. The proportion of patients requiring medical interventions (4.1% [95% CI 1.4-11.6]) was significantly greater than that of surgical interventions (0.7% [95% CI 0.3-1.3]). Elevated intraocular pressure was the most frequent POD1 complication, accounting for 77.0% and 40.0% of medical and surgical interventions respectively. The heterogeneity analysis revealed significant inter-study variation, with I values of 97.93%, 97.80%, and 20.99% for the all intervention, medical intervention and surgical intervention datasets respectively. Attempts to integrate the different indications for surgery into this analysis were unsuccessful due to variability in reporting of indications and interventions. Conclusions : Given the wide confidence interval of the estimated intervention rate, variability in postoperative practices, and range of interventions performed, the POD1 review cannot be discarded. Future analyses could identify clinical characteristics associated with patients at a higher risk of requiring POD1 intervention.
ABSTRACT
Coronaviruses are single-stranded positive-sense RNA viruses possessing unique replication machinery, which consists of non-structural proteins (nsp1–16), structural proteins (S, E, M, N), and several accessory proteins. The non-structural proteins carry out activities critical for viral functions, and the structural proteins play a significant role in viral assembly and structure. The zoonotic nature of coronaviruses is responsible for the past epidemics and the current pandemic. The current global pandemic of COVID-19 caused by SARS-CoV-2 has caused infections worldwide and now crossed over a million fatalities. The high transmission rate of the virus has caused new cases emerging every day. While vaccines remain an ideal solution, it is also important to identify alternative potential small molecules and other inhibitors against molecular targets of SARS-CoV-2. The present chapter describes the current scenario of the world facing the COVID-19 pandemic and details the molecular machinery of the causative agent, i.e., SARS-CoV-2. It discusses the role of drug repurposing against SARS-CoV-2 and explains its methodology. It aims to provide an overview toward coronaviruses and the role and method of drug repurposing against crucial viral targets (here, 3CLpro as a case study) to create a report of current computational drug discovery approaches coherently.
ABSTRACT
The current COVID-19 pandemic caused by SARS-CoV-2 has now seen an unprecedented global trend of viral transmission leading to over a million fatalities worldwide. SARS-CoV-2 is a betacoronavirus which possesses a single-stranded positive-sense RNA genome that encodes various structural, non-structural, and accessory proteins. Due to the zoonotic nature of SARS-CoV-2 and current transmission trend, scientists must identify effective therapeutics against the virus. Ligand-based drug designing is a computational approach based on the principle that similar compounds exhibit similar activities;hence, it is employed to identify, screen, or design drug-like molecules based on the existing drug molecules. The present chapter provides an overview of SARS-CoV-2, COVID-19, viral drug targets and dives deeply into the computational approach of ligand-based drug designing (LBDD). The chapter aims to provide a detailed methodology of LBDD and the current research endeavors that have utilized the technique to identify, screen, or design potential drug molecules against SARS-CoV-2.
ABSTRACT
COVID-19 is a new disease that presents mainly with respiratory symptoms. However, it can present with a multitude of signs and symptoms that affect various body systems and several oral manifestations have also been reported. We carried out a systematic review to explore the types of oral mucosal lesions that have been reported in the COVID-19-related literature up to 25 March 2021. A structured electronic database search using Medline, Embase, and CINAHL, as well as a grey literature search using Google Scholar, revealed a total of 322 studies. After the removal of duplicates and completion of the primary and secondary filtering processes, 12 studies were included for final appraisal. In patients with COVID-19 infection, we identified several different types of oral mucosal lesions at various locations within the oral cavity. Most of the studies appraised had a high risk of bias according to the Joanna Briggs Institute checklist. The current published literature does not allow differentiation as to whether the oral lesions were caused by the viral infection itself, or were related to oral manifestations secondary to existing comorbidities or the treatment instigated to combat the disease. It is important for healthcare professionals to be aware of the possible link between COVID-19 and oral mucosal lesions, and we hereby discuss our findings.
Subject(s)
COVID-19 , Oral Ulcer , Health Personnel , Humans , SARS-CoV-2ABSTRACT
The low-pressure system developed in the Bay of Bengal and the Andaman Sea during March-October, often forms tropical cyclones, depending upon the intensity widespread destruction occurs in the areas where landfall takes place along the Indian coastal region. On 20 May, 2020, tropical cyclone Amphan hit the Indian coast at Bakkhali, West Bengal, in the afternoon (1330 IST). On 19 May, 2020, the intensity strengthened into a super cyclonic storm, with a strong wind speed up to 220 km/h. This cyclone affected a large population of India and Bangladesh. More than twenty-two thousand houses were damaged and millions of people were shifted to a safe place and due to the spread of COVID-19, the rescue missions were quite challenging. The cyclone affected most of the eastern states of India, heavy rainfall occurred causing floods along the track of cyclones. Using multi-satellite, ground and Argo floats data, we have analyzed meteorological and atmospheric parameters during May 2020. Our detailed analysis shows pronounced changes in atmospheric (CO mole fraction, total ozone column) and ocean parameters (chlorophyll concentration, dissolved oxygen, salinity, sea surface and sub-surface temperature) before and after the cyclone. Changes in ocean parameters such as caused by the cyclone Amphan along its track and the atmospheric and meteorological parameters change as the cyclone moves over the land.
ABSTRACT
Ninety-six million hectares of degraded land, unprecedented loss of biodiversity, and extreme climatic events are the key ecological challenges for India. Offering livelihood opportunities to millions of workers who migrated to their villages and recovery from economic crisis due to covid-19 pandemic have emerged as the biggest socio-economic challenges for the country. A framework of different policies and strategies are in place to overcome these ecological and socio-economic challenges. But they are loosely interconnected with independent aims and involvement of different governments' institutions and departments. This article, therefore, here briefs challenges and shows how aiming at ecosystem restoration and biodiversity conservation through these policies can provide a cost-effective, efficient, and sustainable way for India to overcome its ecological and socio-economic challenges. © 2021 Society for Ecological Restoration
ABSTRACT
We previously published a study on the provision of emergency maxillofacial services during the first UK COVID-19 pandemic national lockdown. We repeated the study during the second lockdown and now present our findings that highlight the main differences and learning issues as the services have evolved.
Subject(s)
COVID-19 , Pandemics , Communicable Disease Control , Humans , SARS-CoV-2 , United KingdomABSTRACT
The COVID-19 started from Wuhan city in China, slowly spread across the globe after December 2019. Due to movement of people from one city to other cities, one country to other countries, infection spreads and COVID-19 became a pandemic. Efforts were made at local, regional and national levels to lockdown the movement of people and to keep infected one in quarantine or isolation to stop the spread of COVID-19. The traffic, market and small industries were closed, as a result pronounced decline in the concentrations of particulate matters (PM) were observed. Normally these sources contribute to the high concentrations of particulate matters (PM<sub>2.5</sub>) which represents air quality of a location. In this short communication, we present analysis of PM<sub>2.5</sub> of major cities (New York, Los Angeles, Zaragoza, Rome, Dubai, Delhi, Mumbai, Beijing and Shanghai) around the world suffered severely with the COVID-19. Our analysis shows decline in PM<sub>2.5</sub> concentration due to lockdown, mainly due to less movement of people to keep "social distancing" to control the spread of CORONA-19. The low concentrations of PM<sub>2.5</sub> reflect the efforts made in the cities to curb the spread of infection, that improve air quality.
ABSTRACT
The global pandemic of Coronavirus disease (COVID-19) represents one of the greatest challenges to healthcare systems, and has forced medical specialties to rapidly adapt their approaches to patient care. Oral and Maxillofacial Surgery is considered particularly at risk of disease transmission due to aerosol generation during surgical interventions, patient proximity and operating environment. On day 2 (26th March, 2020) of when severe restrictions in population movement were instigated in the United Kingdom, we began a study to prospectively monitor the presentation and management of maxillofacial emergencies at five hospital trusts. Data was collected onto an online live database fed through a smartphone application. Of the total 529 patients over six weeks, 395 attended for face-to-face consultations and 134 patients received remote consultations via telephone or video link. There were 255 trauma related cases, 221 infection and 48 cases of postoperative complications. Most trauma cases were minor soft tissue injury related to slip, trip or fall at home. There were 44 cases of facial fractures with a tendency for conservative treatment. 19 cases were related to domestic violence or self-harm. Of the 216 dental related emergencies, 68% could have been managed in the primary care setting. A quarter of all emergency patients were satisfactorily managed by remote consultations. There was a significant change in the provision of emergency maxillofacial service during the pandemic lockdown. We discuss the study findings as well as the potential implications in relation to planning for possible further COVID- 19 spikes and future pandemics.