Viral Infections and the Kidney

Viral infections are associated with a number of renal diseases in children resulting in significant morbidity and mortality worldwide. The role of viral infections in the pathogenesis of kidney disease has been largely based on clinical and histologic kidney findings in temporal association with a systemic viral infection and the demonstration of kidney cells infected with viral particles. Viral infections associated with productive viral replication in the kidney of immunocompromised hosts are of particular concern for children. Here, we will discuss the epidemiology, pathogenesis, outcomes, and treatment of the most relevant kidney diseases associated with viral infections in children, excluding those occurring in kidney transplant recipients, which are discussed elsewhere in this textbook (see chap. 84, Renal transplantation: infectious complications). Well-defined associations between a viral infection and kidney disease have been made for the hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV-1), hantaviruses, and the new coronavirus SARS-CoV-2. In children with immunodeficiency states, herpes viruses, polyomavirus, and adenovirus have been recognized to induce kidney diseases. The roles of other viruses in the pathogenesis of kidney diseases are not clearly defined and remain speculative. With increasing application of molecular techniques, the understanding of the role of viruses in the pathogenesis of kidney diseases is expected to increase. In addition, more specific antiviral treatments and vaccines are currently under development and are expected to improve the outcome of viral-mediated kidney diseases in children. © Springer Nature Switzerland AG 2009, 2016, 2022.

Miscellaneous causes of abdominal pain

FAPDs (Functional Abdominal Pain Disorders) are the most common cause of chronic abdominal pain but are largely diagnoses of exclusion. More specific, but much less common, causes of acute and chronic abdominal pain include COVID-19 (PIMS-TS), Helicobacter pylori infection, Yersinia spp. Infection and Familial Mediterranean Fever. © Springer Nature Switzerland AG 2022. All rights reserved.

A Static Machine Learning Based Evaluation Method for Usability and Security Analysis in E-Commerce website

Measurement of e-commerce usability based on static quantities variable is state-of-the-art because of the adoption of sequential tracing of the next phase in the categorical data. An offline static model is trained. A static model is trained offline. In other words, we train the model once and then use it for a set period of time. The global COVID-19 outbreak has completely disrupted society and drastically altered daily life. The concept refers to an electronic commerce network that appears with thorough, understandable conviction, demand, and rapid confirmation as a replacement for the economic market’s "brick-and-mortar" model, which replaces how we do everything, including business strategy, and provides a better understanding with the interpretation of e-commerce features. This study was supervised to analyses usability assessments using statistical methods, as well as security assessments using online e-commerce security scanner tools, in order to investigate e-business standards that take into account the caliber of e-services in e-commerce websites across Asian nations. The method was developed to optimize complex systems based on multiple criteria. The initial (supplied) weights are used to determine the compromise ranking list and compromise solution. This paper examines the usability of e-commerce in rural areas using a new data set from the Jharkhand region. On the e-commerce websites of Jharkhand, India, usability is commonly considered in conjunction with learnability, memorability, effectiveness, engagement, efficiency, and completeness. Using a user-oriented questionnaire testing method, this survey attempts to close the gaps mentioned above. Then, across each column, divide each value by the column-wise sum that is created using their corresponding value, whichever produces a new matrix B. Finally, determine the row-wise sum of matrix B that represents the (3 X 1) matrix. Using model trees and bagging, this study addresses classification-related issues. This regression technique is useful for problems involving classification. The model is trained using secondary data from the MBTI 16 personality factors affecting personality category. Author

Semi-virtual patch testing: a review of the clinical impact, practicalities, patient experience and environmental impact in a tertiary dermatology centre

The COVID-19 pandemic has influenced the way patch testing is carried out at our tertiary centre. From July 2020 we introduced 'semi-virtual patch testing', where suitable patients remove patches at home on day 2 (D2) and take photos, which were reviewed during the D4 face-to-face appointment. Our aim was to assess the continued efficacy and practicality of this service, as well as the photo quality, patient satisfaction and environmental impact of the changes. Data were collected from patients attending patch testing at the Bristol Royal Infirmary from August to December 2021. Patients/carers were asked at their D4 clinic appointment to complete a pre-prepared questionnaire, with their consent, regarding their patch test experience. A clinician (consultant or clinical fellow) concurrently filled out a questionnaire on image quality. These data were collated with data obtained via telephone questionnaires (July-November 2020). Data were available for 181 patients (age range 0-89 years, 74.8% female and 25.2% male). Ninety-seven per cent (n = 135/139) were happy to have patch testing during the pandemic. Ninety-three per cent (n = 130/140) removed their patches at home on D2. Only 3.9% (n = 5/129) would have preferred to attend hospital. Information was provided by multiple sources: verbally by a nurse (95.2%), a doctor (60.7%), a written information sheet (88.1%) and a video (29.8%). Almost all patients (n = 127/ 136) felt confident/fairly confident removing the patches at home, and 85.0% (n = 108/127) reported it saved > 1 h. Seventy-four per cent (n = 95/129) would have had to take time off work/caring commitments to attend. Almost all patients (n = 131/135) reported that their overall experience was good or very good. Seventy per cent (n = 59/84) of patients travelled independently to their appointment, and 79.8% (n = 67/84) came by car/taxi. The mean mileage (one way) to attend the appointment was 13.3 (range 0.2-46.5;n = 98). Ninety-seven percent (n = 89/92) used a smartphone device for D2 photos. The overall presentation of the D2 reading was clear in 91.2% (n = 83/91), adequate in 6.6% (n = 6/91) and inadequate in 2.2% (n = 2/91). Image focus and colour exposure was good/adequate in 97.8% (n = 90/92) and 97.2% (n = 70/72), respectively. Virtual reading negatively affected the final interpretation of the patch test in 2.2% (n = 2/89) of patients and 9.4% (n = 16/170) would have had additional tests added on D2 if they had attended, the results of which were followed-up virtually. Our review of semi-virtual patch testing in our centre demonstrates this method as being an excellent option for most patients, with very limited adverse clinical impact. There were high levels of patient satisfaction, a reduced need for time away from work/home and a reduction in travel required. The vast majority of patients can competently remove their patch tests and produce high-quality images with good focus and colour exposure, mostly using smartphone technology.

Burger King India IPO: Investment Dilemma

Burger King India (BKI), a master franchisee of the leading global quick service restaurant (QSR) chain Burger King US, filed its red herring prospectus (RHP) on 5 November 2019, with the Securities Exchange Board of India (SEBI) expressing its interest in going public. BKI was a major franchise of a multinational QSR, and its going public in India showed the confidence that large global QSRs had in the Indian markets. Despite the volatility caused by the global COVID-19 pandemic, BKI launched its IPO on 2 December 2020. The case study captures the complexity and challenges faced by the growing Indian QSR market and its diverse players and provides information for industry analysis. The case also provides strategic and financial information along with initial public offer (IPO) information to assess BKI's performance and debate whether the price set is appropriate given that BKI was a loss-making firm and the uncertainty surrounding the pandemic continued. © 2023 Lahore University of Management Sciences.

Face Mask Waste Generation and Its Management During Covid-19

The pandemic during COVID-19 has had a negative influence on the world's fabric, including health systems, travel, living and working habits, and economies in numerous countries throughout the world. Furthermore, it has had a significant negative impact on continuing global attempts to curb excessive usage of plastic materials. The extensive usage by healthcare professionals and the overall community, of masks, sanitizers, and synthetic-based personal protective equipment (PPE) kits, has resulted in massive amounts of plastic trash, with no effective measures or policies in place to reduce its severity. Wearing a face mask as a way of protection against COVID-19 has become commonplace. However, because present mask disposal techniques (i.e., burning and reclamation) produce dangerous chemicals, huge production of contaminated face masks causes environmental difficulties. Furthermore, disposable masks are prepared of a variety of materials that are either non-recyclable or difficult to recycle. Therefore, as a result, it is critical to comprehend the scope of the problem and, equally essential, to devise a viable solution to contribute to the creation of a sustainable civic society. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Is the pandemic masking waste management?–A review on fallout of the COVID-19 viral contagion

The global outbreak of SARS-CoV-2 has spurred a reassessment of Municipal Solid Waste management strategies and approaches. A significant need for sanitation and hygiene was accentuated for disease prevention and control with the onset of the pandemic. With an alteration of the status quo in waste management system, an unprecedented amount of face masks, protective equipment, and other biological wastes was generated in the form of Municipal Solid Waste. This upsurge of potentially infected wastes originated a risk of transmission amongst frontline workers. Furthermore, the potential contamination of Municipal Solid Waste was rendered as a legitimate threat due to improper collection practices, disposal and handling of solid waste. Several novel waste disposal techniques and waste management policies were also introduced during this period. However, the sanitation-policy making-occupational safety nexus remains inadequately explored under the prevalent COVID-19 scenario. Through the prism of shifting waste composition, this review offers a global assessment of existing solid waste management systems during the COVID-19 pandemic. The physiological and psychological hazards faced by the frontline workers were explored and instances of best-case and worst-case policies on solid waste handling were recorded. Modern methods of waste disposal and latest trends of policymaking were evaluated. A model study of unsupervised learning via Partition Around Medoids cluster analysis was undertaken to reveal underlying patterns of waste management policies. Although, the clusters were formed devoid of any socio-economic parameters, this study strives to indicate proof of concept and can serve as a precursor to advanced clustering studies. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Cardiovascular involvement in patients with COVID-19 pneumonia: Observation from a tertiary care infectious disease Hospital

Background: Covid 19 pneumonia presents with various cardiovascular manifestations. The proposed mechanisms of cardiovascular involvement in COVID-19 are direct invasion of myocardial cell by the virus, hyper- inflammatory state secondary to cytokine storm, increased angiotensin II, low ACE2 levels, antiphospholipid antibodies and increased platelet reactivity which contribute significantly to thrombus formation in systemic and pulmonary vasculature. Objectives: To find out various cardiovascular manifestation of patients admitted with covid 19 pneumonia. Methodology: A retrospective observational study had been conducted in a tertiary care infectious disease hospital from July 2020 to December 2020 that included a total of 108 patients. Results: Most common risk factor were combination of hypertension and diabetes(40.7%) followed by hypertension alone (28.7%)and diabetes in 18.5% patients. Most common presentation was asymptomatic myocarditis found in 37 patients followed by sinus tachycardia in 34, sinus bradycardia in 18, Orthostatic hypotensionin in 16, Atrial fibrillation in 14, cerebrovascular accident in 9, Acute limb ischemia in 7, and acute coronary syndrome in 4 patients. Asymptomatic diastolic dysfunction (Grade 2 or more) found in 17 patients without any overt features of heart failure (all have raised NTproBNP and HSTrop I along with clinical features). A positive correlation was found between D- dimer level and severity of pneumonia by CT severity score. Conclusion: A high index of suspicion and necessary investigation may be needed for early detection of myocarditis and to prevent any complication particularly fatal arrhythmia and sudden cardiac death. © 2022 Heart India ;Published by Wolters Kluwer - Medknow.

Polymer-Thread-Based Fully Textile Capacitive Sensor Embroidered on a Protective Face Mask for Humidity Detection

The COVID-19 pandemic has created a situation where wearing personal protective masks is a must for every human being and introduced them as a part of everyday life. This work demonstrates a new functionality embedded in single-use face masks through an embroidered humidity sensor. The design of the face mask humidity sensor is comprised of interdigitated electrodes made of polyamide-based conductive threads and common polyester threads which act as a dielectric sensing layer embroidered between them. Therefore, the embroidered sensor acts as a capacitor, the performance of which was studied in increasing humidity conditions in the frequency range from 1 Hz to 100 kHz. The moisture adsorbed by sensitive hygroscopic polyester threads altered their dielectric and permittivity properties which were detected by the change in capacitance values of the face mask sensors at different relative humidity (RH) levels. The calculated limit of detection (LOD) values for the two proposed sensors at different frequencies (1, 10, and 100 kHz) were found in the range from 11.46% RH-27.41% RH and 29.79% RH-38.65% RH. The tested sensors showed good repeatability and stability under different humidity conditions over a period of 80 min. By employing direct embroidery of silver-coated polyamide conductive threads and moisture-sensitive polyester threads onto the face mask, the present work exploits the application of polymer-based textile materials in developing novel stretchable sensing devices toward e-textile applications.

Expectations, Views, And Awareness Of Covid-19 Vaccination Among Indian Dental Clinics: A Survey Study

Background: Various vaccines have been developed, licensed, and administered against COVID-19 infection to combat the disease globally including in India. The behavior, expectations, views, and awareness of dental clinics in India for COVID-19 vaccination are not well understood. Aim(s): The present survey study aimed to assess the expectations, views, and awareness in Indian dental clinics concerning the COVID-19 vaccination. Method(s): The present survey study included 900 subjects seeking dental care treatment in Indian dental clinics. The questionnaire used in the present survey study comprising of four parts. The participants filled out the survey after giving informed consent. The 4 parts of the survey were demographics, knowledge, attitude, and perception. The data gathered was assessed statistically. Result(s): Mean awareness and attitude scores were significantly more in subjects with higher education, socioeconomic status, subjects residing in the urban areas, and who received all the vaccines previously. The attitude scores were also higher in subjects female subjects compared to male subjects. It was reported by 21.44% (n=83), 18.60% (n=72), 1.55% (n=6), and 58.39% (n=226) females reported that uninfected, infected, recovered, and everyone should be vaccinated. In males, these responses were reported by 26.70% (n=137), 24.17% (n=124), 1.55%(n=8), and 47.56% (n=244) males respectively. Conclusion(s): It can be concluded from the results of the present study that subjects visiting Indian dental clinics lack awareness concerning the COVID-19 vaccine. However, these subjects have more optimism in their attitude toward the vaccine. Before vaccination, immediate promotion programs must be implemented to raise awareness. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Family’s sufferings from asymptomatic COVID: Clinicians’ perspective

Anticipating dire consequences, in 2020 the world braced itself for the unparalleled pandemic by resorting to unprecedented measures including stringent lockdowns, unforeseen social isolations, spotlight focus, resource diversions besides reorganized healthcare systems to name the quintessential few. Such unifocal convergence enhanced the vulnerabilities of patients dependent on non-COVID healthcare assistance. For a nation with a meagre allocation of 0.7 hospital beds per 1000 people and a lopsided doctor-population ratio of 1:1800, COVID-centric measures created unintended complications. Ironically, many succumbed in myriad ways, not due to the pandemic but due to the attributes of the survival measures. While such consequences cannot be reversed, we need to be able to draw learnings from all such experiences. Particularly, as healthcare advances into the 21st century and we evolve towards an individualized care model, the contrasting “blanket treatment approach,” while an understandable contingency measure for pandemic emergencies, warrants serious attention. With this narrative, we would like to highlight the anguish and frustration faced by the parents and the doctors as multifarious elements complexly entangled to delay a crucial surgery in a two-year-old child with prolonged RT-PCR positivity. Knowing that mankind is likely to face such pandemics again, future responses require us to visualize the whole picture from a zoomed-out perspective to be able to roll out a synchronized holistic strategy. One needs to introspect on the mutilations incurred, to help redesign our disaster management responses, in order to address “all cause” damage and not just the pandemic ones. © The Author(s), 2022.

Elective versus Emergency management of gallstone disease at a tertiary referral centre amidst the COVID-19 pandemic-should the protocol be altered?

Background: Gallstones are a common pathology affecting approximately 15% of The population in UK, 20% of which are symptomatic. It is suggested symptomatic patients undergo cholecystectomies. Guidelines recommend this is performed within one week of initial Emergency presentation or 52 weeks for elective case. Surgical capacity to manage Emergency cholecystectomies was limited due to The COVID pandemic. We assessed wait time discrepancy between elective and Emergency cholecystectomies. Method(s): A retrospective review of all patients undergoing cholecystectomies between January and November 2021 in a major tertiary referral centre in London was undertaken. Initial pathology at The time of presentation, elective vs Emergency presentation, pre-surgical Biliary complications along and wait times were reviewed. Result(s): 219 (74 elective, 145 emergency) patients underwent surgery, mean age 48 years (23% Male and 77% Female). Average wait times for elective cholecystectomies were 69.7 days (min 0, max 246) in Comparison to 68.9 days (min 1, max 253) for Emergency surgery. 22 (15%) of The patients of initial Emergency presentation re-attended hospital and 6 (4%) had adverse events such as gallbladder perforation or pancreatitis due to delayed treatment. Comparatively, 9 (12%) elective patients attended A&E due to pain, with no adverse outcomes. Conclusion(s): Overall wait time of Emergency vs elective cholecystectomies were similar. This review indicates Emergency cases require prioritisation over elective cholecystectomies due to The higher number of re-attendance and adverse events. Emergency cases need to be prioritised to meet guidelines, which could also reduce complication rates whilst awaiting Surgery and lead to fewer adverse outcomes.

Difficulties in managing acute gallstone disease at a Tertiary Referral Centre admist COVID-19

Background: Acute Biliary disease, a surgical emergency, is predominantly treated conservatively initially. Specialist units aim to follow guidelines set by The Royal College of Surgeons and NICE to provide a cholecystectomy within a set time. Clinical practice at St Thomas' Hospital was reviewed along with The difficulties during The COVID-19 pandemic. Aim(s): Reassess practice at a specialist unit failing to meet guidelines during The start of COVID-19. Prospective data collection, on patients booked for a laparoscopic cholecystectomy (LC) after Emergency attendances. Method(s): Initial retrospective data analysis, reviewing pre-COVID (PC19) practice (03/19-02/20), initial COVID-19 (IC19) management (03/20-12/20). Prospective data (01/21-11/21) after implementing changes (AC19). Identifying demographics, pathology, length of stay during acute admission, average wait for Surgery and readmission rate prior to surgery. Patients receiving Surgery within 6 weeks, which has been set by our Trust as an acceptable standard. Result(s): Patients with acute presentation (acute cholecystitis, gallstone pancreatitis, cholangitis) 162 (PC19), 80 (IC19), 145 (AC19). Gender Ratio M:F 1:2 for all groups. Average wait to Surgery 93 (PC19), 44 (IC19), 69 (AC19) days. Patients receiving Surgery within 6 weeks 24.7% (PC19), 32.5% (IC19), 51.7% (AC19). Patients who were still awaiting Surgery at The end of each time frame 49% (PC19), 51% (IC19), 48% (AC19). Mean length of surgical stay 1.75 (AC19) days. Conclusion(s): Further changes are required, as guidelines are still not being met, with average wait times significantly above The recommended wait to undergo laparoscopic cholecystectomy.