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1.
Annals of Emergency Medicine ; 80(4 Supplement):S173-S174, 2022.
Article in English | EMBASE | ID: covidwho-2176282

ABSTRACT

Study Objectives: Lung point-of-care ultrasound (L-POCUS) is a novel, radiation-free diagnostic tool that could aid in COVID-19 prognosis in non-critically ill patients. Prognostication requires capturing presenting symptoms and outcomes that may change over time. Variations of environment, presenting symptomatology and follow up can introduce uncontrolled heterogeneity impacting outcome. The purpose of our study was to examine demographic, clinical, and 40-day follow up patterns between two national sites enrolling ambulatory COVID patients for the purpose of determining the association between hypoxia at day 40 and initial L-POCUS findings. Method(s): This was a cross sectional study design of patients at two tertiary care institutions in the Northeast (NE) and Midwest (MW) from January 1st, 2021-April 30th, 2022. We included subjects with respiratory complaints who tested positive for COVID-19 and maintained oxygen saturation >=92% for two hours after presentation to the emergency department as part of a larger project focused on describing L-POCUS prognostic characteristics in non-critically ill COVID patients. Initial vital signs and diagnostic data were collected. Blinded L-POCUS operators recorded seven lung windows (two anterior, two lateral and three posterior per lung field). We utilized a rubric that ranged from zero to six with zero being normal lung and six indicating severe lung pathology from COVID to score each image. Pleural findings included indentation, thickening (each one point), or discontinuity (two points). Parenchymal abnormalities included B lines (1-3 B lines =1 point, >3 B lines =2 points, coalescing or "waterfall" B lines=3 points). Subpleural consolidations scored an automatic six points out of a maximum of 42 per lung. Subjects received pulse oximetry use training and were followed by structured chart review or telephone interview 40-days following presentation. Telephone follow up included highest and lowest pulse oximetry at rest and on 60 second ambulatory test and a structured chart review at any health care visit documented evidence of hypoxia. Hypoxia was defined at <=92% 40 days from index visit. We present descriptive data and corresponding parametric or non-parametric statistic. Result(s): We enrolled 154 subjects (MW 122 (80%), NE 32 (21%). The NE population was more likely to be Hispanic (55% vs 18%, p=<.05) while the MW site was more likely to be African American (76% vs 42%, p<.05). There were no sex differences (NE, 63% female, MW 56% female). There were no significant differences between age (NE 40 years (IQR 31-54), MW 42 years (IQR, 30-56), or Body Mass Index (NE 29 (IQR 25-33), MW 29 (IQR, 24-35). CXR was ordered for 128 (83%) subjects and CT for 18 (12%) but there was no difference between sites (NE: CXR 27(93%), CT 5 (17%), MW: CXR 101 (83%), CT 13 (11%)). Median L-POCUS scores were 6 (IQR 5-12) and differed by site (NE 14, (IQR 13-27);MW 2 (IQR 2-10, p<.0001). Forty day telephone follow-up was 40% (59/154) and did not differ by site. We identifed 40 (26%) cases of subsequent hypoxia within 40 days of index visit. Outcome did not differ by site (NE 5/32 (16%): MW35/122 (29%), P=0.18). Conclusion(s): There were no meaningful clinical differences between cohorts at distinct geographical locations although NE subjects score higher on initial L-POCUS. Telephone follow up rates were low at both sites. Prognostication may need to account for L-POCUS scoring variability. No, authors do not have interests to disclose Copyright © 2022

2.
Journal of Nepal Health Research Council ; 20(2):475-481, 2022.
Article in English | MEDLINE | ID: covidwho-2206057

ABSTRACT

BACKGROUND: The second wave of COVID-19 pandemic hit all age groups with different presentations and outcomes. This study aimed to explore the clinical characteristics, investigational findings, hospital outcomes along with a ninety days telephonic follow-up of COVID-19 infection in children.

3.
BMC Health Services Research ; 23(1):41, 2023.
Article in English | MEDLINE | ID: covidwho-2196265

ABSTRACT

BACKGROUND: While emerging studies suggest that the COVID-19 pandemic caused disruptions in routine healthcare utilization, the full impact of the pandemic on healthcare utilization among diverse group of patients with type 2 diabetes is unclear. The purpose of this study is to examine trends in healthcare utilization, including in-person and telehealth visits, among U.S. veterans with type 2 diabetes before, during and after the onset of the COVID-19 pandemic, by demographics, pre-pandemic glycemic control, and geographic region.

4.
Crit Rev Biotechnol ; : 1-18, 2023.
Article in English | PubMed | ID: covidwho-2186995

ABSTRACT

Phloroglucinol and derived compounds comprise a huge class of secondary metabolites widely distributed in plants and brown algae. A vast array of biological activities, including antioxidant, anti-inflammatory, antimicrobial, and anticancer has been associated to this class of compounds. In this review, the available data on the antiviral and antibacterial capacity of phloroglucinols have been analyzed. Some of these compounds and derivatives show important antimicrobial properties in vitro. Phloroglucinols have been shown to be effective against viruses, such as human immunodeficiency virus (HIV), herpes or enterovirus, and preliminary data through docking analysis suggest that they can be effective against SARS-CoV-19. Also, some phloroglucinols derivatives have shown antibacterial effects against diverse bacteria strains, including Bacillus subtilis and Staphylococcus aureus, and (semi)synthetic development of novel compounds have led to phloroglucinols with a significantly increased biological activity. However, therapeutic use of these compounds is hindered by the absence of in vivo studies and scarcity of information on their mechanisms of action, and hence further research efforts are required. On the basis of this consideration, our work aims to gather data regarding the efficacy of natural-occurring and synthetic phloroglucinol derivatives as antiviral and antibacterial agents against human pathogens, which have been published during the last three decades. The recollection of results reported in this review represents a valuable source of updated information that will potentially help researchers in the development of novel antimicrobial agents.

5.
Radiat Phys Chem Oxf Engl 1993 ; 2023.
Article in English | PubMed Central | ID: covidwho-2182606

ABSTRACT

Hydroxychloroquine (HCQ) is a potential drug molecule for treating malaria. Recently it has also been tried as adjustment in Covid 19 therapy. Interaction of HCQ with free radicals is very important, which controls its stability in the environment where free radicals are generated unintentionally. In this report, we present detailed investigation on the reactions of hydrated electrons (eaq−) and hydroxyl radical (•OH) with HCQ in aqueous solution through electron pulse radiolysis technique and computational studies. The degradation of HCQ was found to be faster in the case of reaction with •OH radicals. However, the degradation could be substantially slowed down in the presence of antioxidants like ascorbic acid and gallic acid. This revealed that the stability of HCQ could be enhanced in an oxidative environment in the presence of these two compounds, which are easily available through food supplements. Various global and local reactivity parameters are also determined to understand the reactivity trend using Hard-Soft Acid-Base (HSAB) principle in the realm of the DFT methods. Computational studies were performed to elucidate the site-specific reactivity trend towards the electrophilic and nucleophilic attack by calculating the condensed Fukui index for various species of HCQ.

6.
Kathmandu Univ Med J (KUMJ) ; 19(75): 351-355, 2021.
Article in English | MEDLINE | ID: covidwho-2073782

ABSTRACT

Background COVID-19 is an infectious disease caused by a newly discovered coronavirus. The number of cases and dramatic loss of human life worldwide created psychological problems among general public, including health care workers. Objective To determine the burden of anxiety, depression, and functional impairment among health care workers in the early days of lockdown during the first wave of COVID-19 outbreak in Nepal. Method A hospital-based cross-sectional study was carried out among all the employees of Hospital for Children Eye ENT and Rehabilitation Services, Bhaktapur during the COVID-19 pandemic lockdown from April 3, 2020 to May 2, 2020 using an online questionnaire. The tools used were adopted from Nepali version of Hospital Anxiety and Depression scale (HADS) and Nepali version of WHO Disability Assessment Schedule (WHODAS 2.0). Result The mean age (SD) of the participants (n=86) was 32.53 (7.92) years. Male and female participants were equal in number. The point prevalence of anxiety and depression was 25.6% and 14.0%, respectively. Females had a higher prevalence of both anxiety (39.5% vs 11.6%, p < 0.01) and depression (18.6% vs 9.3%, p=0.351). Clinical and nonclinical staff both had a higher prevalence of both anxiety (31.0% and 20.5%, p=0.265) and depression (16.7% and 11.4%, p=0.478). The mean functional impairment score (WHODAS 2.0) among all participants and participants with anxiety and depression was 19.47 (95% CI: 18.13-20.80), 21.27 (95% CI: 18.08-24.46), and 19.92 (95% CI: 15.28- 24.56), respectively. Conclusion Anxiety and depression during the first lockdown due to COVID-19 pandemic were highly prevalent in clinical and non-clinical employees. Besides controlling the outbreak, special consideration should be given to mental health.


Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Child , Communicable Disease Control , Cross-Sectional Studies , Depression/epidemiology , Female , Health Personnel/psychology , Humans , Male , Pandemics , SARS-CoV-2
7.
Sci Total Environ ; : 159351, 2022.
Article in English | ScienceDirect | ID: covidwho-2069672

ABSTRACT

Z-drugs, benzodiazepines and ketamine are classes of psychotropic drugs prescribed for treating anxiety, sleep disorders and depression with known side effects including an elevated risk of addiction and substance misuse. Both groups of these drugs have a strong potential for misuse, which has escalated over the years and was hypothesized here to have been exacerbated during the COVID-19 pandemic. Wastewater-based epidemiology (WBE) constitutes a fast, easy, and relatively inexpensive approach to epidemiological surveys for understanding the incidence and frequency of uses of these drugs. In this study, we analyzed wastewater (n=376) from 50 cities across the United States and Mexico from July to October 2020 to estimate drug use rates during a pandemic event. Both time and flow proportional composite and grab samples of untreated municipal wastewater were analyzed using solid-phase extraction followed by liquid chromatography-tandem mass spectrometry to determine loadings of alprazolam, clonazepam, diazepam, ketamine, lorazepam, nordiazepam, temazepam, zolpidem, and zaleplon in raw wastewater. Simultaneously, prescription data of the aforementioned drugs were extracted from the Medicaid database from 2019 to 2021. Results showed high detection frequencies of ketamine (90%), lorazepam (87%), clonazepam (76%) and temazepam (73%) across both Mexico and United States and comparatively lower detection frequencies for zaleplon (22%), zolpidem (9%), nordiazepam (<1%), diazepam (<1%), and alprazolam (<1%) during the pandemic. Average mass consumption rates, estimated using WBE and reported in units of mg/day/1000 persons, ranged between 62 (temazepam) and 1100 (clonazepam) in the United States. Results obtained from the Medicaid database also showed a significant change (p<0.05) in the prescription volume between the first quarter of 2019 (before the pandemic) and the first quarter of 2021 (pandemic event) for alprazolam, clonazepam and lorazepam. Study results include the first detections of zaleplon and zolpidem in wastewater from North America.

8.
9.
Sci Total Environ ; : 159166, 2022.
Article in English | PubMed | ID: covidwho-2049913

ABSTRACT

Monkeypox disease (MPXD), a viral disease caused by monkeypox virus (MPXV), is an emerging zoonotic disease endemic in some countries of Central and Western Africa but seldom reported outside the affected region. Since May 2022, MPXD has been reported at least in 74 countries globally, prompting the World Health Organization to declare the MPXD outbreak a Public Health Emergency of International Concern. As of July 24, 2022;92 % (68/74) of the countries with reported MPXD cases had no historical MPXD case reports. From the One Health perspective, the spread of MPXV in the environment poses a risk not only to humans but also to small mammals and may, ultimately, spread to potent novel host populations. Wastewater-based surveillance (WBS) has been extensively utilized for monitoring communicable diseases, particularly during the ongoing coronavirus disease, the COVID-19 pandemic. It helped to monitor infectious disease caseloads as well as specific viral variants circulating in communities. The detection of MPXV DNA in lesion materials (e.g. skin, vesicle fluid, crusts), skin rashes, and various body fluids, including respiratory and nasal secretions, saliva, urine, feces, and semen of infected individuals, supports the possibility of using WBS as an early proxy for the detection of MPXV infections. WBS of MPXV DNA can be used to monitor MPXV activity/trends in sewerage network areas even before detecting laboratory-confirmed clinical cases within a community. However, several factors affect the detection of MPXV in wastewater including, but not limited to, routes and duration time of virus shedding by infected individuals, infection rates in the relevant affected population, environmental persistence, the processes and analytical sensitivity of the used methods. Further research is needed to identify the key factors that impact the detection of MPXV biomarkers in wastewater and improve the utility of WBS of MPXV as an early warning and monitoring tool for safeguarding human health. In this review, we shortly summarize aspects of the MPXV outbreak relevant to wastewater monitoring and discuss the challenges associated with WBS.

10.
129th ASEE Annual Conference and Exposition: Excellence Through Diversity, ASEE 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2046243

ABSTRACT

With the structural shift in education due to the pandemic, worldwide educators adapted by a variety of methods, including a change to the course delivery method. Many universities closed and/or moved to wholly online delivery. With the online video formats, either synchronous or asynchronous, faculty were able to create a library of videos which could be later used as a tool. This new collection of videos could be used for asynchronous delivery or online courses, or as supplemental instructional videos. A survey was conducted to determine student perceptions of supplemental instructional videos. Supplemental instructional videos were available pre-pandemic by individual instructors and publishers. Instructors may have offered videos through a Learning Management System (LMS) or a streaming platform. These types of videos vary from general topic overviews to course specific content. Certain types of courses and content have long been identified as appropriate for online delivery, like software-based courses. However, instructors have been slow to adopt online delivery for hands-on laboratory exercises or architectural studios. Because of this post-pandemic paradigm shift, there is an opportunity to identify the associated shift in student perceptions. A survey instrument was developed to assess student perceptions about supplemental instructional videos. All of the students surveyed are enrolled in courses which provide supplemental instructional videos through their LMS. The survey was not limited to perceptions about current courses. Students across engineering, engineering technology, and architecture disciplines were asked about their perceptions of supplemental instructional videos made available through LMS. The LMS collects analytical data about usage, and depending on the LMS, precisely how much and which portions of a video were viewed by students. The survey included demographic questions in addition to questions about experience with online learning and supplemental instructional videos. Students surveyed included all levels of undergraduate students and graduate students from two universities in different states. Students are generally split in their preference for online or face-to-face delivery methods. About two-thirds of the respondents had been exposed to supplemental instructional videos. Similar to completely online courses, respondents identified reasons that supplemental instructional videos were a good resource, which included the lack of time constraints and the ability to watch and re-watch the videos. © American Society for Engineering Education, 2022.

11.
129th ASEE Annual Conference and Exposition: Excellence Through Diversity, ASEE 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2045957

ABSTRACT

The majority of the academic institutions across the globe transitioned education delivery to alternate methods, irrespective of specializations, in response to the pandemic. However, very little is explored regarding how architecture educators perceive the Online Learning Environment (OLE) transition impacts based on gender differences. The need for such a study emerges as the literature indicates that women are more impacted than males during natural disasters, which might include a pandemic. The unit of analysis for the study was architecture educators in India. India was purposely selected as it is one of the top three countries globally from the perspective of enrolled university students. The study explored the impacts of the OLE transition among architecture educators as per gender in India. An online survey method was used to allow adequate data collection during a pandemic. The developed online instrument was hosted on Qualtrics. The developed online instrument was pilot tested by education experts in India. The instrument was emailed to the deans of more than 450 architecture colleges in India for dissemination among the educators affiliated with the institutions. In addition, the research team used interpersonal channels such as Whatsapp for instrument distribution. Two follow-up emails were sent to increase the response rate. The survey instrument was disseminated in March and April 2021, one year after the pandemic had impacted globally, also the timeframe when the pandemic started to severely impact India. The study used 165 complete responses from architecture educators. Approximately 59% of the respondents identified themselves as females. Further, most of the respondents had a Master's degree as a terminal degree. The study identified perception differences of COVID-19 impact on architecture educators. The study found that female educators had less experience with OLE and were less aware of the resources available at the University and institute levels before the impact of COVID-19. At the same time, a higher number of male educators indicated a negative productivity impact than their female counterparts. Finally, agreement among genders could be observed in the areas of administration monitoring online teaching, factors impacting the productivity of the architecture educators, and concerns about working from home. © American Society for Engineering Education, 2022.

12.
Journal of the Nepal Medical Association ; 60(251):596-599, 2022.
Article in English | EMBASE | ID: covidwho-1939708

ABSTRACT

Introduction: Patients with COVID-19 are characterised by abnormal levels of inflammatory biomarkers. Elevated D-dimer in COVID-19 patients is associated with increased mortality. This study aimed to find out the prevalence of raised D-dimer among COVID-19 patients in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted in COVID-19 unit of a tertiary care centre from 23 January 2021 to 19 June 2021. The ethical approval was taken from the Institutional Review Committee (Reference number: 077/078/159). D-dimer values and demographic data of the hospital-admitted COVID-19 patients were recorded. Convenience sampling technique was used. Point estimate and 95% Confidence Interval were calculated. Results: Out of 180 patients with COVID-19 admitted in the hospital, the D-dimer levels were raised in 85 (47.22%) (39.93-54.51, 95% Confidence Interval) patients. Conclusions: The prevalence of raised D-dimer among admitted COVID-19 patients was found to be lower when compared to other studies conducted in similar settings.

13.
Journal of the Nepal Medical Association ; 60(251):664-666, 2022.
Article in English | EMBASE | ID: covidwho-1939707

ABSTRACT

In the midst of the COVID-19 pandemic, volunteering enabled us to support people facing difficulties in locating healthcare facilities. Working as a medical support volunteer allowed us to interact closely with patients. We assisted them by providing information on the availability of hospital beds, intensive care unit beds, ventilators and oxygen cylinders. We had numerous beautiful as well as dreadful experiences and learned valuable lessons during the process. We experienced a wide range of emotions, from the joy of informing about the availability of a vacant bed to the guilt and dilemma of having to prioritise in such a crisis. We learnt about how an empathetic approach and active listening helps to connect people.

14.
4th RSRI Conference on Recent trends in Science and Engineering, RSRI CRSE 2021 ; 2393, 2022.
Article in English | Scopus | ID: covidwho-1890381

ABSTRACT

Technology has revolutionized our world and everyday life over the years. In all these revolutions, technology our lives easier faster, better fun made. To withdraw or transfer money to someone you no longer have to enter the bank. Many banks have already made online transactions possible, everywhere. With your cell phone and banking application, you can manage all your bills online. Moreover, it is clear that COVID-19 million workers have been forced to stay home for the past eight months. There is a need to quickly transform digital technology into a 2020 vision. This adaptation came into effect almost immediately with the lockout, especially for India digital payments. The Government of been actively promoting online payments since 2016, starting with monetization. 'Digital India' was the driving force behind many digital and Indian economic decisions. There are different methods of digital payments in India, bank cards, Unstructured Support (AEPS) Data (USSD), Aadhaar Enabled Payment System, Integrated Payment (UPI), Bank Prepaid Cards etc. Therefore, overall Govt-19 has provided incentives for digital payment in India. © 2022 Author(s).

15.
Lung India ; 39(SUPPL 1):S134, 2022.
Article in English | EMBASE | ID: covidwho-1856882

ABSTRACT

Background: Neutralizing antibodies cocktail (Casirivimab and Imdevimab) has received conditional recommendation by FDA and WHO for mild to moderate COVID infection in specific high-risk groups. Persons with underlying chronic illnesses are at high risk of developing severe disease. The effectiveness of various repurposed drugs approved for the management is variable. Antibodies cocktail has shown promising results in preventing progression to severe disease. But the data about its use and safety from India is scarce. Herein, we present a retrospective analysis of 10 patients who were administered with the antibodies cocktail between Aug 2021 and Oct 2021. Methodology: We conducted an observational retrospective analysis of clinico-radiological, inflammatory parameters, progression of the disease, and outcome amongst ten mild and moderate COVID 19 patients treated with antibodies cocktail. Results: Ten patients were administered the antibodies cocktail (casirivimab 600 mg and Imdevimab 600 mg). The median age was 63.5 years, and four patients were partially vaccinated, and the rest were unvaccinated. Diabetes and hypertension were the commonest comorbidities;hematological and solid organ malignancies were other comorbidities. The median CRP level on admission was 91.5 mg/dL. Other inflammatory markers like neutrophil: lymphocytes ratio, ferritin, and LDH were higher than normal limits. None of our patients required supplemental oxygen or progressed to severe ARDS nor has any adverse reactions. All patients were discharged in a stable condition within six days of the therapy. Four patients had radiological opacities consistent with COVID 19 pneumonia and had shown regression after the therapy. The observation indicates that this therapy may also be effective in the early pulmonary phase of the disease. Conclusions: The neutralizing antibodies cocktail has shown encouraging results in our analysis in preventing progression to severe disease and is not associated with severe adverse reaction.

17.
Frontiers in Sustainable Food Systems ; 6, 2022.
Article in English | Scopus | ID: covidwho-1841324

ABSTRACT

Globally, billions of people and their livelihood are threatened by the onset of COVID-19. In Nepal, resource-poor people who lost their job were the hardest hit among millions of impacted populations. Further, the associated effects of pandemics are food supply chain interruption and people's inferior physical and mental wellbeing. The COVID-19 pandemic and associated impacts have questioned Nepal's ability to achieve the 17 United Nations sustainable development goals (SDGs) in the post-pandemic era. Yet no scientific studies available to see COVID-19 and SDGs relationships in Nepal, government reports, and macroeconomic updates indicated that COVID-19 is likely to deter significantly in achieving SDGs targets. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to quantify the impacts of the COVID-19 pandemic in Nepal's macro-economy from March 2020 to December 2021. Our study indicated that the COVID-19 exerted inevitable challenges in achieving SDGs targets in terms of food security and household poverty. Therefore, this paper recommended creating more employment opportunities in the domestic economy and establishing a resilient food system. Copyright © 2022 Joshi, Poudel, Kafle, Bhattarai, Prasai and Adhikari.

18.
Kathmandu University Medical Journal ; 19(3):351-355, 2021.
Article in English | GIM | ID: covidwho-1743586

ABSTRACT

Background: COVID-19 is an infectious disease caused by a newly discovered coronavirus. The number of cases and dramatic loss of human life worldwide created psychological problems among general public, including health care workers.

19.
2021 IEEE International Conference on Image Processing, ICIP 2021 ; 2021-September:195-199, 2021.
Article in English | Scopus | ID: covidwho-1735798

ABSTRACT

The rapid and seemingly endless expansion of COVID-19 can be traced back to the inefficiency and shortage of testing kits that offer accurate results in a timely manner. An emerging popular technique, which adopts improvements made in mobile ultrasound technology, allows for healthcare professionals to conduct rapid screenings on a large scale. We present an image-based solution that aims at automating the testing process which allows for rapid mass testing to be conducted with or without a trained medical professional that can be applied to rural environment and third world countries. Our contributions towards rapid large-scale testing includes a novel deep learning architecture capable of analyzing ultrasound data that can run in real time and significantly improve the current state-of-the-art detection accuracies using image based COVID-19 detection. © 2021 IEEE.

20.
2021 IEEE Biomedical Circuits and Systems Conference, BioCAS 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1705105

ABSTRACT

This paper presents a novel ultrasound imaging point-of-care (PoC) COVID-19 diagnostic system. The adaptive visual diagnostics utilize few-shot learning (FSL) to generate encoded disease state models that are stored and classified using a dictionary of knowns. The novel vocabulary based feature processing of the pipeline adapts the knowledge of a pretrained deep neural network to compress the ultrasound images into discrimative descriptions. The computational efficiency of the FSL approach enables high diagnostic deep learning performance in PoC settings, where training data is limited and the annotation process is not strictly controlled. The algorithm performance is evaluated on the open source COVID-19 POCUS Dataset to validate the system's ability to distinguish COVID-19, pneumonia, and healthy disease states. The results of the empirical analyses demonstrate the appropriate efficiency and accuracy for scalable PoC use. The code for this work will be made publicly available on GitHub upon acceptance. © 2021 IEEE.

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