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1.
Research Journal of Pharmacy and Technology ; 15(9):4270-4276, 2022.
Article in English | EMBASE | ID: covidwho-2207038

ABSTRACT

A properly balanced diet can improve the immunity system and also prevent various diseases including COVID-19 which is caused by severe acute respiratory syndrome coronavirus 2 (SARC-Co2). This review mainly describes dietary guidelines or approaches to build up our immunity as well as better health and protect from corona virus. As we all know one line "Health is Wealth". So this wealth can be established or secure by optimal diet. Basic food components that are carbohydrates, protein, fat, vitamin and minerals have various important functions to fight against diseases. Most of the documents encourage to consumption of fruits, green vegetables, proteins, whole grains and fluids. Vitamins such as C, E, D, A most important to boost up our immunity. Vitamin C and E also known as natural antioxidants because they protect our body from infection and vitamin C also helps to absorption of iron. Zinc selenium, amino acid and omega 3 fatty acids are necessary to fight COVID-19. Besides this good hygiene practice, proper physical practice or daily work out and proper amount of water intake can improve good health status and prevent chronic illness. Sleep is necessary to heal and rest our body especially during critical illness. Exercise helps to increase the level of white blood corpacell and antibody which helps to fight against infections. This paper discussed the role of these nutrients and specific functions related to improving COVID patients. These nutrients can protect our health from various infectious diseases as well as can decreases mortality and the morbidity rate of COVID-19 patients by improving immunity levels. Copyright © RJPT All right reserved.

2.
Managerial Finance ; 2022.
Article in English | Web of Science | ID: covidwho-2191585

ABSTRACT

PurposeThe paper intends to comprehend the pattern of usage of FinTech services among bank customers during the COVID-19 pandemic. The paper also examines the factors influencing the adoption of FinTech services by using the constructs from the technology acceptance model (TAM) together with highlighting the issues faced in using FinTech services in Assam.Design/methodology/approachThe research is empirical in nature. Data have been collected from 1,066 prime earners of the households having a bank account.FindingsThere has been an upsurge in the use of FinTech services in the area of study. Apart from government and private service employees, businessmen, self-employed professionals, many daily-wage earners and agriculturists have also experienced an increase in their frequency of usage of FinTech services thereby making technology-based financial services an indispensable tool in enhancing access, improving inclusivity in the times of crisis and aftermath. Government support, trust, perceived usefulness (PU), attitude and social influence have a positive influence on FinTech adoption;however, perceived risks impact respondents' trust towards FinTech services thereby requiring necessary measures to evaluate organizations' preparedness to deal with cyber threats.Originality/valueThe paper provides insight into the factors impacting the adoption of FinTech services to stimulate superior connectivity infrastructure, robust security measures and maintaining financial stability with adequate supervisory and monitoring regulations to enhance trust towards FinTech services during the crisis and aftermath.

3.
Journal of Interdisciplinary Mathematics ; 25(7):1951-1959, 2022.
Article in English | Web of Science | ID: covidwho-2187214

ABSTRACT

The educational sector of Bangladesh is severely affected due to the sudden outbreak of novel Corona virus (COVID-19). Bangladesh which is one of the densely populated countries has a significant improvement in the education sector along with the others in last some decades but this pandemic has played a serious setback to almost all the sectors of this small country. As all the educational institutes of Bangladesh are closed since 17th March 2020 till 30th June 14, 2021 and this may lead to many detrimental effects. To measure these, a survey was conducted and collected data was analyzed by SPSS Statistics v 25.0. This paper highlighted the mental stress, socio-economic crisis of the students that badly affected their education. It is observed in this study that around 80% of the students are going through mental stress particularly for internet facilities and financial crisis in pandemic period.

4.
Immunogenetics: a Molecular and Clinical Overview: Clinical Applications of Immunogenetics, Volume II ; 2:185-218, 2022.
Article in English | Scopus | ID: covidwho-2175658

ABSTRACT

Understanding of the genetic basis underlying inflammatory disorders has progressed in recent years. Contribution of proinflammatory cytokines, human leukocyte antigen (HLA), and non-HLA polymorphisms in the pathogenesis of several autoimmune and immune-mediated inflammatory disorder is critical. HLA plays a central role in disease pathology. Harmful stimuli triggering the signaling mechanisms including nuclear factor-kappa B pathway, Janus kinase-signal transducer and activator of transcription pathway, and mitogen-activated protein kinase pathway results in the release of inflammatory mediators. From acute to chronic inflammation, the etiology of various inflammatory disorders is poorly understood. Inflammatory disorder such as COVID 19 is a devastating havoc to the world. As we reach the end of 2020, >1 million people have succumbed to death worldwide. Disease-manifesting clinical features include mild to severe pneumonia, loss of respiratory function progressing to acute respiratory distress syndrome with occasional multiorgan failure. Cytokine storm, decreased T cell count, and insufficient immune response are conducive issues to COVID 19 pandemic. Varied immune responses to the same antigen across different individuals determine the genetic perspective of disease susceptibility. Through genome-wide association studies, next-generation sequencing and other genetic techniques, several genetic risk loci associated with various inflammatory diseases such as inflammatory bowel disease, psoriasis, sclerosis, and systemic lupus erythematosus (SLE) have been identified. Dysregulated inflammatory pathways, gene mutation, or elevated cytokine level may lead to the disease progression. However, the production of autoantibodies against the nuclear antigens is a hallmark of diseases like SLE and rheumatoid arthritis. Moreover, environmental factors like smoking also increase the risk of inflammatory disorders. Understanding the functional aspects of casual genetic factors underlying the disease pathogenesis greatly facilitates the ability to identify the therapeutic targets relevant to disease. The current chapter deals with the idea of genetic perspective associated with various inflammatory disorders and their potential therapeutic targets along with the factors contributing to disease susceptibility. © 2022 Elsevier Inc. All rights reserved.

5.
Ifac Papersonline ; 55(10):395-399, 2022.
Article in English | Web of Science | ID: covidwho-2131049

ABSTRACT

In this modern era of digitization, the competition is significantly increasing among retailers. One of the major challenges for them is demand prediction or sales forecasting. Especially in this Covid pandemic, retail sales forecasting became very crucial due to the employee shortage, and increasing online demand. In the modern era of digitization, competition is increasing. This research explores the application of an advanced deep learning approach in predicting the market demands in advance of individual products for the future seasons. This application aims to support an American Multinational Retail company in ordering, purchasing, and managing inventory. Accordingly, the company provides a real sales dataset to perform this study. This research proposes two sales forecasting strategies based on LSTM and LGBM models. We first execute data preprocessing techniques using statistical feature engineering on the raw sales data. Thereafter perform the LSTM and LGBM algorithms for training and prediction. LGBM takes past data from lag feature engineering for better forecasting. For that, we found that LGBM performs better than LSTM in forecasting. Copyright (C) 2022 The Authors.

6.
Jundishapur Journal of Microbiology ; 15(1):4960-4965, 2022.
Article in English | CAB Abstracts | ID: covidwho-2125443

ABSTRACT

India is a developing country, where education is given a high importance. However, the importance of updating the methods of educating the upcoming generation is not considered as seriously as it has to be. Covid-19 pandemic brought a sudden change around the globe in every field of service, including education sector. Mode of education has fully transformed into online learning atmosphere. Technology which is always a fascination to its users has taken over traditional method of teaching and learning. This study is done in the state of Kerala, collecting responses from college students of every district. This paper focuses on understanding the impact of disruptive technology in the field of education and to assess the attitude of students towards merging this technology with the traditional classroom learning system.

7.
27th IEEE Symposium on Computers and Communications, ISCC 2022 ; 2022-June, 2022.
Article in English | Scopus | ID: covidwho-2120546

ABSTRACT

Detection of COVID-19 has been a global challenge due to the lack of proper resources across all regions. Recently, research has been conducted for non-invasive testing of COVID-19 using an individual's cough audio as input to deep learning models. However, these methods do not pay sufficient attention to resource and infrastructure constraints for real-life practical deployment and the lack of focus on maintaining user data privacy makes these solutions unsuitable for large-scale use. We propose a resource-efficient CoviFL framework using an AIoMT approach for remote COVID-19 detection while maintaining user data privacy. Federated learning has been used to decentralize the CoviFL CNN model training and test the COVID-19 status of users with an accuracy of 93.01 % on portable AIoMT edge devices. Experiments on real-world datasets suggest that the proposed CoviFL solution is promising for large-scale deployment even in resource and infrastructure-constrained environments making it suitable for remote COVID-19 detection. © 2022 IEEE.

8.
National Journal of Physiology, Pharmacy and Pharmacology ; 12(11):1958-1963, 2022.
Article in English | EMBASE | ID: covidwho-2110645

ABSTRACT

Background: Adolescence is the intermediary linking phase from childhood to adulthood. Physical, sexual, psychological and social developmental changes during this period. Adolescence is a period of increased awareness of bodily cues and self-reflection, including evaluation of one's own body and appearance. Body misconception and body dissatisfaction, two very important potential causative factors of bad nutritional status of adolescents, have not been adequately investigated in rural India. Aims and Objectives: The present study on adolescents was conducted to assess the lifestyle factors and degree of dissatisfaction and misconception of their body. Material(s) and Method(s): An observational, descriptive, and community-based cross-sectional study was conducted by interviewing adolescents residing in the field practice area of the Department of Community Medicine, Medical College, Kolkata, during the months of March-April, 2022. The data were analyzed with the Statistical Package for the Social Sciences. Result(s): A total of 239 respondents were interviewed (74.1% male and 25.9% female). About 47.3% were early adolescents, 46.4% were middle adolescents, and rest 6.3% were late adolescents. About 56.5% was indulged in some kind of exercise. According to the total adolescent body image satisfaction scale score, 66.5% seemed to be satisfied with their body image. Body image dissatisfaction was associated with participants' age, gender, socio-economic status, and type of family. Conclusion(s): It is evident from the study that girl children, adolescents of the lower socio-economic status group, and middle, and late adolescents are more prone to be dissatisfied with their body image. Hence, they need to be given extra focus for restoration of their mental health. Copyright © 2022 Sudipta Das, et al.

9.
Journal of Clinical Oncology ; 40(16):E18699-E18699, 2022.
Article in English | Web of Science | ID: covidwho-2092516
10.
Decision Analytics Journal ; 2022.
Article in English | PubMed Central | ID: covidwho-2076041

ABSTRACT

The coronavirus pandemic was a global health crisis taking away millions of lives worldwide. People diseased by the virus, differ in the extent of severity of the infection. While it turns out to be fatal for some, for several others the extent of severity is as ordinary as common cold. These people are reported to have recovered from the disease without hospitalization and consuming some relevant medicine and home remedies. But people who have comorbidity like geriatric, high blood pressure, heart and lung problems, diabetes, cancer etc. are at high risk of developing serious illness from the infection. This study is an application of the Cox proportional hazard model with an aim to identify the risk factors that affect the recovery time of the COVID-19 patients. The model is an advanced regression technique that can be utilized to evaluate simultaneously the effect of several factors on the possibility of instantaneous failure in patients. The paper also uses the Mental-Heinzen test (Log-Rank test) to compare if the probability of survival of different treatment procedures or different groups of patients differ significantly. The information is collected from 129 respondents of Assam, India. The study identifies that the significant risk factors that prolong the recovery time from COVID-19 are pre-disease, location, and food habits.

11.
Journal of Clinical and Diagnostic Research ; 16(9):DC24-DC27, 2022.
Article in English | EMBASE | ID: covidwho-2067201

ABSTRACT

Introduction: Hybrid Problem-Based Learning (h-PBL) is a type of teaching-learning technique that incorporates both in-person learning and virtual learning via hybrid classroom tools. It reportedly increases student engagement, positively impact their learning process and improve communication skills. During Coronavirus Disease 2019 (COVID-19) times, its applicability was further enhanced as it allowed the flexibility of teaching as well as learning from home to both teachers and students. Aim: To assess the perception and experience of 2nd phase MBBS students after undergoing training by the h-PBL method. Materials and Methods: A cross-sectional study was conducted on 2nd phase MBBS students in the Department of Microbiology at College of Medicine and Sagore Dutta Hospital, Kolkata from 15th March to 14th April 2022. A total of 111 students of 2nd phase MBBS of the college gave an informed consent to be part of the study. All inductees underwent a structured training by h-PBL technique following which their perception and experience about the exercise was sought via questionnaire. Data were presented in frequency and percentage. Association between mean scores of male and female participants was calculated by Chi-square test. Results: Out of the 111 participants, 58 (52.2%) were male and 53 (47.8%) were female with mean age of 19.5±0.5 years (range 18-22 years). The h-PBL technique was perceived to be motivating for self-directed learning by 97 (85.6%) of the respondents. A total of 107 (96.4%) students agreed that h-PBL is more effective than traditional teaching for acquiring both theoretical and practical knowledge, learning and understanding topics correctly and also identifying and rectifying their deficiencies in knowledge and skills. More than 90% participants (102 of 111) felt that h-PBL has more potential than traditional teaching to establish fruitful student-teacher interaction and provide better feedback opportunities. Overall student satisfaction in our study showed 96.4% agreement (107 of 111). Conclusion: The students considered h-PBL model to be better than traditional teaching to help them acquire theoretical knowledge and practical skills. They also felt that it improved their communication skills, teamwork ethics and motivated them to undertake self-directed learning.

12.
Journal of Tourism ; 23(1):1-10, 2022.
Article in English | CAB Abstracts | ID: covidwho-2033872

ABSTRACT

The scope for wellness promotion and related tourism has increased manifold amidst this global crisis exhibited through COVID 19 pandemic that results in formation and popularity of medical hotels, patient hotels and such other new types through partnerships and alliances in many cities in Asia. Severely affected hospitality industry and their professionals are in search for new avenues and scopes now. This present study is an understanding of perceptions and attitudes of hospitality professionals in two diverse sectors with relatively new expertise and skills. This study includes the finding of determinants from the perspective of hospitality professionals by employing an ordered probit model and expressing its implications for future industry and academia.

13.
Medical Journal of Dr. D.Y. Patil Vidyapeeth ; 15(7):S8-S13, 2022.
Article in English | Scopus | ID: covidwho-2024839

ABSTRACT

Background: Health-care workers at all levels are putting their best efforts to contain the COVID-19 pandemic. In resource-poor country like India, the community health workers are given primary responsibility for prevention and control measures at the village level. Learning from their experiences and addressing constraints will ensure improved service delivery in the face of further waves of pandemic. Aim: The aim of the study is to explore the field level experiences of Accredited Social Health Activists (ASHAs), working in Bhatar block of Purba Bardhaman district, West Bengal, while delivering COVID-19 response services and to elicit the nature of constraints faced by them. Materials and Methods: This was a qualitative study with phenomenological approach conducted among ASHA workers from December 2020 to January 2021. Convenient sampling was done to select 8 participants for data collection by focused group discussion (FGD) using FGD guide. A total of four FGDs with 32 participants were conducted. Data were analyzed using thematic framework approach to identify codes and themes. Results: The experiences are presented under five broad themes and in subthemes. ASHAs were engaged in extensive work amidst various challenges, though they received ample support and cooperation from society and general administration. ASHAs faced issues with inadequate supply of protective equipment and were in need for refresher trainings. Events of social stigma and ostracizations had also surfaced. Limited financial incentives, increased susceptibility to COVID-19, and detachment from family were the main source of stress among ASHAs. Conclusion: The issues identified in this study can be addressed to further utilize ASHAs in delivering services in pandemic context. © Medical Journal of Dr. D.Y. Patil Vidyapeeth 2022.

14.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009611

ABSTRACT

Background: Cancer patients infected with COVID-19 are very vulnerable to increased complications and mortality while actively being treated with chemotherapy or immune checkpoint inhibitors (ICIs). The full impact of COVID-19 infections on this subset of patients has not been fully defined. Our goal was to track clinical outcomes in patients with an underlying malignancy and COVID-19 infection who received chemotherapy or ICIs. Methods: We performed a retrospective chart review of 121 patients (age > 18 years) at the University of Alabama-Birmingham from January 2020 till November 2021 with an advanced solid malignancy that were treated with chemotherapy or ICIs within 12 months of their COVID-19 diagnosis. The aim of this study was to track clinical outcomes including: hospitalization rates, ICU admissions, treatments, and deaths of any cause. Results: A total of 121 patients were examined in this study and 61 received immunotherapy treatment within 12 months. The median age at diagnosis for the ICI group was 62.3 years and 54% were male while for the patients that receive chemotherapy the median age at diagnosis was 65.1 years and 53% were male (Table1). The 3 most common cancers represented in the ICI cohort were lung (30%, NSCLC), liver (13%, HCC) and renal (11%, RCC). While in the chemotherapy group, the 3 most cancers were NSCLC (40%), HCC (12%,), and head & neck (10%, H&N). 25% of patients on ICIs died while only 13% of patients died post chemotherapy. Of the ICI patients that died, 33% were admitted to the intensive care unit (ICU) and 53% received oxygen, steroids and antiviral therapy. For the chemotherapy patients that died, 25% were admitted to the ICU and 50% received oxygen, steroids and antiviral therapy. Patients with lower ECOG (0.98) had lower mortality compared to patients with worse functional status (0.98 vs 1.52;t = 3.20;p < 0.01). Factors associated with increased admission were higher ECOG (1.07 vs 1.67;f = 3.05;p = 0.05), higher AST (21.2 vs 40.9, f = 10.2;p < 0.001), lower absolute lymphocyte count (1122.8 vs 408.9, f = 5.99;p < 0.01) and higher oxygen needs (0.02 vs 1.11, f = 29.5;p < 0.001). Conclusions: ICI mortality was higher compared to patients receiving chemotherapy, especially for those with reduced functional status. Factors for hospitalization included: higher ECOG, higher AST, lower lymphocyte count and increased oxygen needs. However, further investigation still needs to be undertaken to understand if the PD-1-PD-L1 pathway with the subsequent inflammatory cascade post COVID-19 can impact overall survival.

15.
Female Pelvic Medicine and Reconstructive Surgery ; 28(6):S3-S4, 2022.
Article in English | EMBASE | ID: covidwho-2008699

ABSTRACT

Introduction: Telehealth has emerged as an increasingly useful tool to provide care amidst the COVID-19 pandemic. The acceptability and safety of telehealth has been previously reported in Urogynecology for preoperative counseling and postoperative care but not for new patient evaluation. Objective: To determine if new patient telehealth encounters are non-inferior to inperson office encounters for women presenting to a Urogynecology clinic using a patient satisfaction questionnaire. Secondary objectives were to assess number of follow up visits, phone calls, and travel distance and time. Methods: This was a randomized controlled trial of women presenting to a Urogynecology clinic for a new patient visit. Participants were randomized after appointment scheduling to either telehealth or in-person visits. Telehealth visits were scheduled for 15 minutes and conducted over a video platform by the attending physician. Pelvic exams were not performed over telehealth and patients were counseled and scheduled for follow-up including procedures and treatments. In-person visits included trainees and a pelvic exam. Patients completed the validated Patient Satisfaction Questionnaire-18 (PSQ-18) after their visit. The primary outcome was composite patient satisfaction on the PSQ-18 questionnaire. Demographics and health care utilization data were ed from chart review. Using a non-inferiority margin of 5 points on the PSQ-18 composite score, 25 patients per arm were required with a power of 80% and an alpha of 0.05. Results: From March to September 2021, 133 women were screened for eligibility, 71 were randomized, and 58 were included in the final analysis (30 in telehealth group and 28 in in-person group). Demographic characteristics were similar between groups. Patients overall had a high education level, with 60% having a college degree or higher. Patient satisfaction, as measured on the PSQ-18 questionnaire (maximum score 90), was high for both groups but higher for in-person visits vs telehealth visits (75.68 ± 8.55 vs 66.60 ± 11.80, P = 0.001, difference -9.08, 90% confidence interval -4.57 to -13.6) and our results were inconclusive with respect to determining non-inferiority. Patients ≥60 years reported higher rates of satisfaction overall compared to those younger than 60 years (P = 0.009). Women in the in-person group were more likely to perceive that they had enough time with the provider (P = 0.003) and their visit was timely and efficient (P = 0.016) despite having less attending physician face time. Women in the telehealth group expressed uncertainty regarding the format and the perceived benefits of telehealth. There were no differences in the number of follow up visits (P = 0.81), patient-initiated (P = 0.52) or staff-initiated phone calls (P = 0.07), distance from home to office (P = 0.87), or travel time from home to office (P = 0.94) between groups. There were no differences in treatments (surgical vs non-surgical) chosen based on PSQ-18 scores. Conclusions: Women seen by urogynecologic providers either in person or via telehealth demonstrated high satisfaction with their first visit. Although the results are inconclusive with respect to non-inferiority, telehealth is safe and does not impact conversion to surgical or procedural treatments. As telehealth use continues to demonstrate safety, efficacy, and tolerability by patients, we must educate providers and patients on the utility of this platform.

16.
Indian Journal of Critical Care Medicine ; 26:S116, 2022.
Article in English | EMBASE | ID: covidwho-2006404

ABSTRACT

Background: Hospitalised COVID-19 patients are known to exhibit varying degrees of immune dysfunction, few modifiable risk factors have been identified to improve this state of which one is the immune modulator effects of vitamin D. Vitamin D is being prescribed as a treatment of COVID-19 in a few guidelines as there is generalised assumption that vitamin D enhances immunity during this illness. So this is an attempt to find out whether a deficiency of vitamin D is associated with the severity of COVID-19. Aim: To study the relationship of serum 25 hydroxy vitamin D [25(OH)D] deficiency with disease severity in hospitalised COVID-19 patients. Materials and methods: The present case-control study compared serum 25(OH)D levels among Mild to moderate and severe COVID- 19 patients. Around 39 diagnosed and Hospitalised Severe COVID- 19 disease are compared with 39 Hospitalised Mild and Moderate COVID-19 disease in Care Hospital, Bhubaneswar, Odisha, India between April 1, 2021, ad August 31, 2021. Patients were divided into 2 groups. The Group 1-Mild to Moderate infection with CT Severity index < 10/25 and Group 2-Severe Infection with HRCT Chest of CTSI >10/25. As per hospital policy, severe infection patients were kept in Critical Care Area and Mild infection patients were kept in Ward/Cabin areas. Any patients becoming sick and being transferred to critical areas are shifted from Group 1 to Group 2 after HRCT chest. Vitamin D levels (25 D Cholecalciferol) are done on the day of admission by chemiluminescence immunoassay test after taking due consent from the patients/attenders. The level of cut-off used in our study is 20 ng/mL. The association was analysed using regression analysis and other statistical methods. Results: The status of 25(OH)D deficiency (present/absent with cut-off being 20 ng/mL) showed no significant difference among cases and control at p < 0.05. Chi-square statistics with Yates correction is 1.8909. The p value is 0.169099. So there were no significant differences in vitamin D3 levels between Mild to moderate and Severe COVID- 19 patients. Conclusion: 25(OH)D levels appear to have no strong association with disease severity amongst hospitalised COVID-19 patients. Hence, its prescription for COVID-19 treatment as well as prevention needs to be reconsidered.

17.
Indian Journal of Critical Care Medicine ; 26:S51-S52, 2022.
Article in English | EMBASE | ID: covidwho-2006347

ABSTRACT

Introduction: Macroglossia is defined as an enlargement of the tongue in the resting position, protruding beyond the teeth. Many cases have been reported secondary to patient positioning while under anesthesia, post oro-pharyngeal packing, trauma or surgery, and allergic or non-allergic angioedema. However, acute macroglossia in the ICU is a rare situation. In COVID-19 related severe ARDS, endotracheal intubation and prolonged proning is an important part of management of hypoxemic respiratory failure Prone positioning also has the potential to independently cause macroglossia. Awareness of this complication of proning could help mitigate morbidity in patients. Case report: A 53-year-old diabetic, hypertensive overweight female with OSA presented with progressive shortness of breath and productive cough. She was mechanically ventilated in ICU in view of respiratory distress secondary to COVID-19 pneumonia. Intubation was minimally traumatic with minimal oral bleeding settling over few minutes. Though managed with medications as per COVID-19 management protocol, she progressed to severe ARDS hence proned on hospital day 1 for 16 hours - PaO2/FiO2 ratio improved. She was not proned further. Acute macroglossia (3 inches outside the oral cavity) with lower facial edema was noted 4 days post proning. Saline moistened gauze was loosely wrapped around the tongue every hour. Circumferential ecchymosis was noticed around her neck on the 6th day. On day 8, macroglossia did not show signs of resolution. Hence, the tongue was pushed in manually every 2 hourly and the position was maintained manually for 10 minutes. The swelling decreased gradually with the tongue staying in a retracted position on treatment day 2. On day 3, there was a complete resolution of the swelling. However, she had persistent swallowing difficulty causing difficulty in weaning from tracheostomy. MRI of neck and chest showed large pre-vertebral collection from the upper border of C2 inferiorly across the thoracic inlet to the posterior mediastinum with thin linear extension up to the lower border of T4. Mass effect with airway compression, displacement, and compression of esophagus and neck vessels was seen. Trans-oral exploration revealed mucosal rent and bulge in the posterior pharyngeal wall. The hematoma was evacuated by ENT specialists. She was discharged on tracheostomy and feeding tube. Tracheostomy decannulation was done after 1 month. Discussion: In our practice of proning patients with ARDS for >10 years, this is the first case of macroglossia as a complication of proning that we encountered. Other factors that could have contributed to this patient are obesity and mildly traumatic intubation. Development of macroglossia 4 days after proning and resolution over a short period of time is rare and suggests lymphatic and vascular compression as the cause. Later development of ecchymosis and dysphagia may be due to the posterior pharyngeal injury. Conclusion: Proning, especially in obese patients, can be a challenge. Positioning of the face and avoidance of injury to any of the structures is vital to the care of the proned patient. Medical staff involved in patient care should be aware and vigilant to pick up this condition early to avoid further injury.

18.
Indian Journal of Critical Care Medicine ; 26:S25, 2022.
Article in English | EMBASE | ID: covidwho-2006331

ABSTRACT

Aim and background: SARS-CoV-2 pandemic questioned many basic concepts in medicine. COVID-19 affects many organ systems despite the lung being the primary affected organ. ARDS management is challenging and a new complication during the management adds to the burden. Macklin described a pathophysiological process by which air escaped through the ruptured alveolar basement membrane causing pneumomediastinum. The occurrence of air leak syndromes (ALS) in COVID-19 made us investigate the disease and its association with the complication. Objective: To observe the clinicopathological profile of patients who developed air leak syndrome during the second wave of the pandemic. Materials and methods: A retrospective analysis was conducted on SARSCoV- 2 patients admitted to ICU due to ARDS. The study included patients admitted from March to June 2021 with rTPCR positive test for SARS-CoV-2 illness and diagnosed to have ARDS as defined by the Berlin criteria. We analyzed 195 cases admitted in the ICU who met the above criteria and received protocolised care as per national and institutional guidelines. Cases who received ventilatory support either as HFNO (high flow nasal oxygenation), NIV (noninvasive ventilation), or invasive mechanical ventilation as per ARDS NET protocol and developed ALS were included. Demographic and clinical profiles of patients and laboratory parameters like acute phase reactants, haemogram, and serum creatinine were analysed. Results: 5.6% of patients were diagnosed to have air leak syndrome, which includes subcutaneous emphysema, pneumomediastinum, pneumopericardium, and pneumothorax. 81% of the cases were men. The average age was 44.8 years. 90% of the patients had no pre-existing lung pathology or respiratory comorbidity. 81.8% did not have a documented history of smoking. 63.33% of patients had other preexisting co-morbidities. 27.2% of patients had more than one comorbidity with diabetes mellitus being the most common. The average time to develop air leak syndrome was 6 days. 81% of the patients received mechanical ventilation, 2 patients were only on HFNO. 90% of the patients were prone in view of severe ARDS. From air leak syndromes mentioned above, 72.2% developed pneumothorax, 63.3% of the patients developed subcutaneous emphysema, 54.5% of the patients developed pneumomediastinum, and 9% developed pneumopericardium. 1 patient (9%) developed the complete spectrum of ALS. 63% of the patients developed 2 or more entities of the air leak, i.e., subcutaneous emphysema, pneumomediastinum, pneumopericardium, and pneumothorax. Acute phase reactants were elevated in all patients who developed ALS. There was neutrophil predominance in the haemogram. Only one patient developed AKI. Another compelling finding was the development of secondary infection, the majority was respiratory tract infections (81%) followed by urinary tract infections. Candiduria was observed in 36.6% of patients. The average duration of stay was 21.6 days. The mortality rate was 63%. 4 patients were discharged who had an average time to resolution of 8 days. Conclusion: COVID-19 is majorly a self-limiting disease. Secondary bacterial infection and poor oxygenation was major finding in our study. Development of ALS in a previously normal lung with no preexisting lung pathology points towards the need to conclude ALS and viral pneumonias.

19.
International Conference on Data Science, Computation, and Security, IDSCS 2022 ; 462:469-480, 2022.
Article in English | Scopus | ID: covidwho-1971619

ABSTRACT

The COVID-19 pandemic has struck every sector around the world, including the education sector. The pandemic has forced educational institutions around the world to close, putting academic calendars in jeopardy. To keep academic activities going, most educational institutes have switched to online learning platforms. However, the lack of e-learning readiness and the current crisis has taken a toll on students’ mental health significantly. In this study, we hope to understand better students’ impressions of online education and the impact of prolonged screen time on students’ mental health. From the responses of 438 students, our study aims to identify the causes of stress in students due to the online mode of education. From eye stress to limited social interaction, all factors leading to poor mental health are considered. Suggestions for addressing the challenges of online education and approaches to create a more successful online learning environment are also provided. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

20.
Biointerface Research in Applied Chemistry ; 13(3), 2023.
Article in English | Scopus | ID: covidwho-1965106

ABSTRACT

Recently, small compounds from Indian spices (Carnosol, Arjunglucoside-I, and Rosmanol) have been identified as SARS-CoV-2 main protease (Mpro) inhibitors. The structural dynamics and characteristic features of binding of these small molecules to the SARS-CoV-2 Mpro are not well understood. Here, we have constructed the potential of mean force (PMF) for dissociating Mpro-small molecule inhibitor complexes from the umbrella sampling simulations using the weighted histogram analysis method. Mpro-small molecule inhibitor complexes exhibited relatively higher dissociation energy values than the alpha-ketoamide-Mpro complex (positive control) from the PMF calculations. We found that binding affinity between protein and ligand is higher in Mpro-Arjunglucoside-I complex [∆Gbind =-19.74 kcal mol-1 from MM-GBSA and ∆Gbind =-9.13 kcal mol-1 from MM-PBSA] than in other three SARS-CoV-2 small molecule complexes. The MM-GBSA/MM-PBSA calculations revealed that the small molecule inhibitors studied in this work have substantially higher binding affinity for Mpro. We found the residues present in SARS-CoV-2 Mpro's binding pocket contributed the most binding free energy to SARS-CoV-2 Mpro-small molecule interactions. Our findings emphasize the structural and binding features of the identified small molecule inhibitors with SARS-CoV-2 Mpro, which could be relevant in developing therapeutic candidates to combat SARS-CoV-2. © 2022 by the authors.

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