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Background: Post-Covid retropharyngeal mucormycosis is a rare presentation, and no case has been reported in literature until date. Case presentation: A-32-year-old female post Covid presented to our OPD with history of dysphagia and with a history of steroid intake. Radiology confirmed it as retropharyngeal abscess. Endoscopic-guided aspiration was done. HPE (histopathological examination) revealed classic broad aseptate hyphae of mucormycosis. Patient was managed conservatively with broad-spectrum antifungal. Conclusion(s): Retropharyngeal mucormycosis is a rare entity in Covid era. Rapid diagnosis and management are needed to save life of an individual, or results could be fatal.Copyright © 2022, The Author(s).
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The year 2020 was an unprecedented time for all, combating COVID, following precautionary measures and finding a cure for the virus was of utmost importance. As the COVID-19 is here to stay, it is imperative to detect it as early as possible. Our web application (COVID RayScan) is a prediction-based Machine Learning application which can be used by technicians, doctors at hospitals to understand a X-ray or CT-Scan and hence quickly detect if a patient suffers from Covid or not. According to NCBI, it takes 17.4 minutes for a doctor to treat every patient and that metric has increased exponentially with increase in COVID. COVID RayScan with the help of Deep Learning CNN Networks like ResNet50,VGG16,Inception and Xception helps a technician to run the X-Ray/CT-Scan image through our web application to get the desired result which in turn saves the doctor's as well as patients time and make the process much more efficient. © 2022 IEEE.
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SARS-CoV-2 encodes a nucleocapsid protein that binds to the single-stranded RNA genome present inside the viral particles. It is one of the predominant proteins expressed during infection and tends to be highly immunogenic in infected individuals. Consequently, it has been recognized as an important diagnostic marker for the development of antigen or antibody detection-based diagnostic platforms for COVID-19. In this work, we have described cloning, autoinduction-based expression, and purification of full-length SARS-CoV-2 nucleocapsid protein using Escherichia coli as the heterologous host. We have characterized the purified protein using commercial rapid antigen test kits and indirect ELISA to demonstrate its suitability as bait for diagnostic assays. The purified recombinant protein reported in this study can be useful for numerous applications including the development of monoclonal or polyclonal antibodies, studying protein structure and function, and mapping B-and T-cell epitopes for designing suitable vaccines and therapeutics. © 2023 Verma and Abhishek.
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In this paper, we have proposed an SEIHRV mathematical model of the pandemic COVID-19 using a system of ordinary differential equations. The mathematical modelling is a vital tool to make the use of imposing a strategy in order to fight against this pandemic. We are obtained a boundedness of the system and steady state of the solutions. The basic reproduction number is computed and used as a threshold to negotiate the asymptotic behavior of the mathematical model. Our analytical and numerical results show a close faith of the basic reproduction number on epidemic parameters. Also, our model delineates the various transmission route in the infection dynamics and an exertion the foreword of the environmental reservoir in the devolution and the dispersion of this disease © 2023 L&H Scientific Publishing, LLC. All rights reserved
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Building a local supply chain requires separating the regions and creating alliances with local partners and customers, resulting in a new business model. In local supply chains, the factory procures material, parts, and preassembled elements from local suppliers and sells the final products to local customers. Three-dimensional printing (3DP) has the potential to enable a more local, globally connected, and efficient supply chain through reduced inventory and transportation costs transforming the make-to-stock to the make-on-demand production cycle. In this study, we use an integrated Interpretive Structural Model and Decision-making Trial and Evaluation Laboratory technique to explore and assess the challenges faced by the 3DP companies to become enabling partners in the localized supply chains. The scope of the study, which was limited to 3DP of medical parts and components, identified that regulatory compliance, stringent quality standards, and lack of design expertise are significant barriers to developing localized three-dimensional printing ecosystems. Furthermore, the study identified immediate support from the local government, the high collaboration between the stakeholders, and the need for change in business approach as the key drivers for developing 3DP-enabled localized supply chain ecosystems. IEEE
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Objectives: Postpartum depression (PPD) has been described as "the thief that steals motherhood" by depriving women of the anticipated joy of a new infant. Through this study, we intend to see the incidence, treatment rates (TR), relative-treatment rate (TRR), absolute treatment rate (ATR), and number needed to treat (NNT) pre- and post-COVID-19 on treatment of women with PPD. Method(s): This retrospective cohort study included newly diagnosed patients with PPD in 2019 (1st Jan - 31st Dec [pre-pandemic]) and 2020 (1st Jan - 31st Dec [pandemic]) using ICD-10-CM codes from Optum's de-identified Clinformatics Data Mart. Only the patients having continuous eligibility between 12 months before (baseline period) to 12-months post (follow-up period) the first diagnosis of PPD (index date) were included in study. During the follow-up period, patients were then checked for pharmacological treatment received (SSRI, SNRI's and other anti-depressants) using NDC codes. To measure effects, percentages of patients getting treatment, TRR (TR in pandemic/TR in pre-pandemic), ATR (TR in pre-pandemic - TR in a pandemic), and NNT (1/ATR) were calculated before and during COVID. The significance of categorical variables was examined using the Chi-square test. Result(s): We observed 39% increase in incidence of PPD patients during pandemic (n=16,095) vs pre-pandemic (n=11,565). Only 51% TR (risk ratio) was observed during pandemic vs 60% TR (risk ratio) in pre-pandemic with any SSRI, SNRI, and anti-depressants (p<.01). Compared to patients receiving treatment during pandemic vs pre-pandemic: TRR was found to be 85% (relative risk) and ATR was 9% (absolute risk reduction). The NNT comparing pre- and during pandemic was 11. Conclusion(s): The results of the study demonstrated that treatment of women with PPD was impacted during pandemic vs pre-pandemic (9% women did not receive treatment during pandemic). Alternative methods or non-pharmacological treatments may be required to further alleviate non-treated patients and improve their condition. Copyright © 2022
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Objectives: This study aimed to explore the impact of COVID-19 on patients with PTSD and the burden of resource utilization in the pre- and during the COVID-19 pandemic. Method(s): This retrospective observational study included patients diagnosed with PTSD between 1st January 2018 to 31st December 2020 using ICD-10-CM codes from Optum's de-identified Clinformatics Data Mart database. In the study duration, distinct patients were identified and further classified by age, gender, and location of service. To determine the influence in pre- and during COVID-19 for each of the stratification variables, a year-wise comparison was done. Chi-square was performed as test of significance for categorical variables. Result(s): Overall we observed the number of PTSD patients increased by 7% (n=206,741) during the pandemic (1st January 2020 - 31st December 2020) vs pre-pandemic (1st January 2019 - 31st December 2019). A significant increase was seen across all age groups (p<.05). In the case of teenagers, PTSD was found to have increased by 22% whereas in adults and the elderly an 8% and 3% increase was seen respectively. When broken down by gender, a significant increase was observed. Females (+9% [n=143,032]) were seen to have been affected more compared to males (+4% [n=63,625]) during the pandemic vs pre-pandemic. In healthcare resources utilization overall, there was an observed 24% increase. For both inpatients and office, PTSD decreased significantly (-3% and -4% respectively) (p<.05);while ER visits, increased only by 1% (p<.05). A significant increase in outpatient and telehealth services was observed (122% and 454% respectively) (p<.05). Conclusion(s): An increased exacerbation in PTSD was observed during the pandemic with respect to burden across various stratification and resource utilization;especially in outpatient and telehealth services. Better treatment, psychotherapy and alternative care programs may be required to curb this impact and decrease the overall burden across various care setting. Copyright © 2022
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Objectives: This study aimed to explore the impact of COVID-19 on patients with SSA and the burden of resource utilization in the pre- and during the COVID-19 pandemic. Method(s): This retrospective observational study included patients diagnosed with SSA between 1st January 2019 to 31st December 2020 using ICD-10-CM codes from Optum's de-identified Clinformatics Data Mart. In the study duration, distinct patients were identified and further classified by age, gender, and location of service. To determine the influence in pre- and during COVID-19 for each of the stratification variables, a year-wise comparison was done. Chi-square test was performed to check the significance of categorical variables. Result(s): Overall we observed the number of SSA patients increased by 2% (n=266,329) during the pandemic (1st January 2020 - 31st December 2020). A significant increase was seen across all age groups (p<.01). In the case of teenagers, SSA was found to have increased by 80% whereas in adults and elderly an 15% and 8% increase was seen respectively during pandemic (p<.01). When stratified by gender, a significant increase was observed only in females (+9% [n=174,647]) where in males (-3% [n=91,573]) decrease was observed during pandemic. In healthcare resources utilization overall, there was an observed 12% increase during pandemic. For inpatients, office, and outpatient, SSA decreased significantly (-4%, -8%, and -1% respectively) during pandemic (p<.01). A significant increase in outpatient and telehealth services was observed (34% and 1,299% respectively) (p<.01). Conclusion(s): An increased exacerbation in SSA was observed during the pandemic with telehealth and outpatient services being impacted the highest. This may be attributed to facing near-death scenarios, and the loss of loved ones amongst other factors. With the increase in cases, health care resource utilization across various settings is pressed. Better treatment and programs may be required to curb this impact and decrease the overall burden. Copyright © 2022
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Objectives: This study examines use of telemedicine services and health outcomes in patients with hypertension (HTN) in pre- and post-COVID 19 periods in the US. Method(s): A retrospective analysis, using Optum de-identified Electronic Health Record dataset, was done among hypertensive patients on Medicare plans in three different time periods: 1st Jan 2018 - 30th June 2018, 1st Jan - 30th June 2019, and 1st Jan - 30th June 2020 (first two time periods are pre-COVID 19 and the last one is post-COVID 19). The date of first EHR with mention of HTN diagnosis was considered index date. Study participants were categorized into those who used only telemedicine services (Telemedicine group);only other places of service like outpatient, inpatient, or office (Other POS group);and those who used both telemedicine and other places of service (Both POS groups). Patients were followed for 6-months post-index to determine use of anti-HTN medications, resource utilization, and healthcare outcomes. Result(s): Fewer than 100 patients in each study period belonged to Telemedicine group. Majority (55%) patients in 2018 (pre-COVID 19) belonged to Other POS group, but in 2020 (post-COVID 19) majority (61%) patients belonged to Both POS group. About 70% patients in each of three groups were prescribed anti-HTN drugs and adherence was >90%. About ~60% patients in Telemedicine group had 2-6 healthcare encounters while ~80% in Other POS group and ~95% in Both POS groups had >6 healthcare encounters during follow-up period. Significantly more patients in Both POS groups received anti-HTN nutritional counseling as compared to other two groups. Also, blood pressure was controlled in significantly higher percentage of patients in Both POS groups as compared to other two groups. Conclusion(s): Patients who use telemedicine and other places of service are more likely to receive anti-HTN nutritional counseling and have better blood pressure control. Copyright © 2022
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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.
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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.