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Aim/Introduction: Tolosa-Hunt Syndrome (THS) is a rare disease with incidence rate of about 1/106 per year worldwide. Etiology include idiopathic granulomatous, nonspecific unilateral inflammation of the superior orbital fissure- cavernous sinus, causing severe headaches, eye pain, and ophthalmoplegia- paresis of the cavernous sinus nerves, sometimes Horner syndrome. THS is a diagnosis of exclusion that requires careful ruling out of alternative diagnoses. Material(s) and Method(s): We report an interesting case of 45 years old lady, who presented with complains of left sided headache, left eye retro-orbital pain with diplopia (double vision), ptosis and gradual difficulty in eye movements since last 2 months. She had history of nasopharyngeal mucosal swab collection for COVID 19 RT-PCR test after which she started complaints of pain along nasopharynx and later along ipsilateral eye orbit. MRI of brain and bilateral orbit suggested mild relative prominence of peri-optic CSF space along left side, without any abnormality along cavernous sinus or rest of the brain parenchyma. FDG PET/CT (PET/ CT) scan was performed to rule out other cause of THS showed impaired tracer uptake along left eye rectus muscles, suggesting paresis of CN III, IV and VI without any abnormal metabolically active lesion in brain parenchyma or rest of the body. Result(s): Based on clinical, radiological and PET/CT findings presumptive diagnosis of resolving left sided THS secondary to trauma induced inflammation was made. The patient shows clinical improvement after treatment with high dose steroid on follow up. Conclusion(s): PET/CT is helpful in detection of inflammatory tissue is a recognized fact. When MRI is unable to shows any tissue abnormality in cavernous sinus or superior orbital fissure;PET CT can play a role in its ability to demonstrate the paresis of cranial nerves supplying ipsilateral eye extrinsic muscles. Thus reaching the diagnosis of post traumatic inflammatory THS by exclusion. This case of THS with unique PET/ CT findings imply the useful indication of PET/CT in detecting and monitoring of treatment response in THS when MRI is inconclusive.
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Introduction: Candida spp.accounts for 70%-80% of invasive bloodstream fungal infections.It is most commonly spread in long-term care facilities, caring for people with severe medical conditions. Patients hospitalized for COVID-19 are at risk for healthcare-associated infections like candidemia. Candida auris is an emerging, multidrug-resistant, healthcare-associated fungal pathogen. Candida auris is currently one of the most common clinical fungal pathogens, causing nosocomial infections. Due to its higher drug-resistance rate, C. auris is more difficult to treat, requires longer hospitalization periods, and results in higher morbidity and mortality than other Candida species. Aim and Objectives: To analyze the risk factors associated with C. auris candidemia in COVID-19 and post-COVID-19 patients at tertiary care center. Material(s) and Method(s): We prospectively analyzed all positive blood samples which were received in the Microbiology department at SGPGI, Lucknow for a period of 1 year (March 2020-March 2021).Blood samples were inoculated and cultured in BACTECBottles (BD) andincubated for 5days at 37degreeC.The bottles whichflagged positive, aGram's stain wasperformed and were sub-cultured on SDA for isolation of yeast colonies. Isolated yeasts were identified by phenotypic method and confirmed by MALDI-T OF MS. Demographics details of the patients were collected and recorded. The significant associated risk factors with C. auris candidemia were analyzed. Result(s): A total of 13 000 blood samples were received during the 1-year study period from different departments of the hospital.1.25% (n = 163) of the blood culture samples were positive for candidemia. Out of 163 Candida culture-positive blood samples, 27.61% (n = 45) were C. auris. A total of 64% (n = 29) C. auris candidemia was seen in non-COVID-19 patients, 31.1% (n = 14) in COVID-19patients, and twopatients had ahistory ofpost-COVID-19 infection.Theassociated risk factors included the use of broad-spectrum antibiotics, intravenous catheterization, underlying respiratory illness, mechanical ventilation, use of steroids, and dialysis. A total of 46.6% (n = 21) mortality was seen with C. auris candidemia. Conclusion(s): Candida auris candidemia continues to be a threat in hospitalized patients. This study shows prevalence of C. auris candidemia in COVID-19 and post-COVID-19 patients with 47% mortality. Candida auris is continuously reported from different departments in our institute, especially from intensive care units with high morbidity and mortality.An alertness, awareness and infection control practices by the healthcare personnel will help in early diagnosis and appropriate antifungal therapy and control the spread of C. auris.
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BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has affected over 61 million U.S. citizens, and up to 30-80% of COVID-19 survivors may go on to develop post-acute sequelae of SARS-CoV-2 (PASC). These sequelae can be debilitating and often impair quality of life and daily function. Although it has been suggested that severity of acute COVID-19 infection is directly related to PASC development, this association remains unclear. METHODS: This prospective cohort study was conducted through consecutive recruitment of confirmed and probable COVID-19 patients with persistent symptoms lasting ≥3 weeks from disease onset or positive SARS-CoV-2 test from academic PASC clinics at Emory University and Grady Memorial Hospital in Atlanta, GA during January-December 2021. Sociodemographic, comorbidity, and acute COVID-19 data were collected. Severe acute COVID- 19 was defined as requiring hospitalization, and critical acute COVID-19 required intensive care. New or worsening symptoms persisting ≥3 weeks from COVID-19 onset were collected using a standardized review of systems, and confirmed by clinician interview. Differences in PASC symptom type were assessed by calculating risk ratios (RR) and 95% confidence intervals (CI) using the Taylor series, and difference in PASC duration was assessed using student's t-test. Two-tailed p-values ≤0.05 were considered significant. RESULTS: Of 269 enrollees, median age was 52 years (range 18-93) and there were more women (74%) than men (26%). There were 152 (57%) African American, 76 (28%) White, and 21 (8%) Hispanic. Among PASC patients, the most common symptoms were dyspnea (68%), fatigue (63%), brain fog (48%), dizziness (27%), chest pain (25%), cough (23%) and headache (23%) with a median PASC duration of 132 days (range 21-523). Acute COVID-19 severity was asymptomatic in one participant, mild in 149 (55%), severe in 95 (35%), and critical in 23 (9%). Asymptomatic- mild acute COVID-19 patients had more persistent dyspnea (RR: 1.33, 95%, CI: 1.09- 1.61), fatigue (RR: 1.53, 95%CI: 1.22-1.91), brain fog (RR: 2.00, 95%CI: 1.44-2.67), dizziness (RR: 2.03, 95%CI: 1.27-3.25), and headache (RR: 2.07, 95%CI: 1.22-3.48) compared with severe-critical acute disease, who had a non-significant trend towards more cough and chest pain. Asymptomatic-mild participants were further from incident infection (153 days) compared to severe-critical participants (110 days) (p=0.04). CONCLUSIONS: Contrary to previous observations, COVID-19 survivors who experienced asymptomatic-mild infections may develop higher rates of prevalent PASC symptoms compared to those with severe- critical antecedent infections. These findings are not attributable to PASC duration, as longer PASC duration has been previously associated with fewer symptoms. To ensure early identification and linkage to specialized care, clinicians should be aware of PASC in patients with antecedent asymptomatic-mild acute COVID-19 infections.
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Voting is the backbone of democracy and the fundamental right of every citizen. BlockChain based Election is like a boon for every nation through which the election can be conducted digitally, Unlike those old (paper based) and traditional (EVM) voting systems it makes the whole process of election safe, smooth and easy. In this era of Covid-19 this Block chain enabled election is the need of the hour, People can cast votes from their own space just with the help of a mobile phone or a computer, Security would get enhanced and threats like EVM hacking, Chaos at election booth would reduce drastically just by the implementation of this advanced voting system. Personal ID's and unique keys would be provided to each and every eligible voter which can't be tampered at any cost. It has two modules to make the entire project look consolidated and unified. First module is the Election Commission who could be liable for undertaking it, appending concerned everyone competing for the voting attached under blockchain. User end will be the resident's component where every eligible voter can choose a leader according to their separate Constituent sitting and the votes would get registered on the blockchain to make it tamper protected. © 2022 IEEE.
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Introduction:COVID-19 usually manifests clinically as pneumonia with predominant imaging findings of an atypical or organizing pneumonia. The standard technique for confirming COVID-19 is molecular testing by RT-PCR however chest imaging by CT scan can show signs of pneumonia in patients with negative RT-PCR and results can be achieved significantly faster, thus offering a potential role in supporting rapid decision making. CT scan has been shown to have more sensitivity than RT-PCR and Chest X-ray. CT Severity scoring also helps in better assessment of severity of disease. Aim:To estimate typical and atypical chest CT findings in COVID-19 RTPCR positive patients for better assessment of the role of chest CT in COVID-19 management. Materials andMethods:100 patients with confirmed COVID-19 were included in study. Findings like ground glass haze (GGO), reticulations, crazy paving appearance, consolidation, subpleural curvilinear line, bronchiectasis, subpleural transparent line, vascular enlargement, mediastinal lymphadenopathy, nodules, pleural effusion, Inverted halo sign, Halo sign and pericardial effusion were documented in them and analysis was done. Results:The typical Chest CT features present in our COVID-19 cases were GGO in 93 patients (93%), reticulations in 71 patients (71%), crazy paving appearance in 59 patients (59%), consolidation in 47 patients (47%), subpleural curvilinear line in 39 patients (39%), bronchiectasis in 37 patients (37%) and subpleural transparent line in 30 patients (30%). Most cases had bilateral (98%), peripheral (57%) and patchy involvement (86%) by GGO and lower lobe predominance (55%) by consolidation. Conclusion:GGO, reticulations, crazy paving and consolidation involving bilateral lung, in a peripheral and patchy distribution with lower lobe predilection are the typical findings on chest CT in COVID-19. Chest CT scan may act as a quick diagnostic tool with high sensitivity taking into consideration that almost all COVID-19 patients demonstrate typical features.
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With the changing time, the innovative technologies and communication systems have given a new vision to the education sector. The growing number of young people has brought attention to the higher education system to build a new form of learning. The new perspectives towards education systems have brought a blend of virtual as well as traditional modes of learning, known as "blended learning." The purpose of this chapter is to understand the impact of COVID-19 on teaching learning practices of higher education institutes (HEI) and to understand the influence of a blended learning approach on attitude and behavioral aspects of the learners and teaching professionals. © 2021 by IGI Global. All rights reserved.
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Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has imposed an unprecedented burden on our healthcare system. Serological testing for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) antibodies serves as an useful marker for determining an infection by the virus in the recent past and the immune response. The immune response, including the humoral response to the infection is one of them and the knowledge in this area is still evolving. Virus specific antibodies are expected to help in eliminating the virus and to provide protective immunity against reinfection. Aim: To serially monitor the total antibody response to SARSCoV-2 in order to gain better insight into the duration of antibody persistence. Materials and Methods: This prospective observational study was conducted in 66 Healthcare Workers (HCW) with a history of Reverse Transcription- Polymerase Chain Reaction (RT-PCR) proven COVID-19 infection. The study was conducted between May 2020 to April 2021 at the Suburban diagnostics Central Processing Laboratory, Mumbai, Maharashtra, India. Serum samples were serially examined for the presence of total antibodies against the Nucleocapsid (N) protein of SARS-CoV-2 upto 180 days postinfection. A further follow-up examination was done at 360 days. A qualitative Electrochemiluminescence Immunoassay (ECLIA) assay was used for assessment of the antibody response. The chi-square or Fisher-exact test was used to compare categorical variables and the Mann-Whitney U test, Kruskal Wallis test and student t-test were used to compare continuous variables across groups. For assessing relationship between variables, the Pearson test or linear regression were used as appropriate. Results: Out of 66 healthcare workers, 32 were male (48.5%) and 34 were females (51.5%) with the median age of 29.5 years. Out of 66 cases, 62 (94%) cases developed antibodies against SARS-CoV-2 at different time intervals, 48 cases during the 14-30 day interval, 10 cases during the 31-60 day interval, three cases during the 61-90 day interval and one case during the 90-120 days interval. Thirty one out of 35 (88%) cases that could be followed-up at 360 days showed persistence of antibodies. No patient reported symptoms which would warrant a repeat RT-PCR test. Conclusion: This study showed that the antibody response to SARS-CoV-2 virus was sustained for 12 months postinfection in most cases. The absence of fresh infection in these cases during the study period suggests that the antibodies might protect against reinfection with the virus. So, it may be safe to defer vaccination in postinfection cases by 6-9 months thereby saving precious resources.
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The SARS-CoV-2 (COVID-19) epidemic has a huge impact on the health and daily life of people. More than 200 countries are impacted due to this pandemic. To light the COVID-19 virus we need a powerful monitoring system to identify the patients and isolate them. The current detection tests are either done by measuring the body temperature or spotting the genetic material of the SARS-CoV-2. These techniques are time-consuming and have a poor detection rate. Radiological images like chest X-rays are also highlighted and help in the diagnosis of COVID-19 patients. Initial studies suggest that COVID-19 patients have abnormalities in their chest X-rays and can be used in the diagnosis of COVID-19. Based on this literature research, various solutions have been proposed utilizing chest X-rays to detect the SARS-CoV-2. Most of these solutions use non-public datasets and complicated structures with fewer accurate results. In our study, we propose a self-learning, interpretable model for real-time detection of COVID-19. This model utilizes a Differential evolution algorithm for feature selection and Support Vector Machine (SVM) as a classifier. The aim is to obtain higher accuracy in detecting COVID-19 infected patients using X-ray images. We have also used the LIME explanation algorithm to explain the predictability of our model and this makes our design very robust and sustainable. This fully transparent, Interpretable, and explainable model can be used in hospitals where there is a huge demand for rapid tests and radiologists are busy. © 2021 IEEE.
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A sizeable reduction in demand of milk and milk products (MMP) due to COVID-19 lockdown has adversely impacted the milk producers and processors. The consequent decrease in prices of MMP has been instrumental in the losses of their stakeholders. The preliminary estimates of economic losses to the milk producers stand at 112.3 crores per day which are highly concentrated in nine states out of which two states, namely, Uttar Pradesh and Rajasthan alone are accounting for more than one fourth of these losses. The improvement in the welfare of consumers on account of decline in prices is not sufficient enough to compensate the producers, leaving 66.7 crores per day of economic losses uncovered. This dark shadow of lockdown is expected to last long with reduction in milk production and the profitability of dairy industry subject to the mitigation strategies adopted afterwards. It is suggested that procurement of milk by public and private dairy plants should be increased and the same should be utilized to produce dairy products having comparatively longer shelf life like butter, ghee, skim milk powder (SMP), etc. The additional workforce which returned to rural areas may prove to be a boon for the agriculture and dairy sector, provided they are trained in the respective field and channelized in the right direction by equipping them with productive assets like dairy animals, besides developing essential livestock supporting services, viz., veterinary and artificial insemination (AI) centres, milk marketing network and milk processing facilities.
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ICOVID-19 has involved serious occupational health risk to the health care professionals who are frequently exposed to infected individuals. Knowledge and attitude among health care professionals can prevent the spread of COVID-19. The present study was aimed to identify the current status of knowledge and attitude regarding COVID-19 among healthcare professionals in a tertiary care hospital. A questionnaire-based cross-sectional study was conducted among medical staff (doctors, nurses and lab technicians) in a tertiary care hospital to assess the knowledge and attitude toward COVID-19 among healthcare workers. The questionnaire comprised of three sections (demographic, knowledge and attitude) for data collections. Non parametric tests and Pearson correlation was used to analyze data using R (The comprehensive R archive network) version 3.6.2. Of the 117 respondents, 46.15% were doctors, 25.64% nurses and 28.20% technical staff. On data analysis, 94% were in good knowledge category, 6% had poor knowledge and 100% had positive attitude. In the knowledge section, median value for doctors was higher than nurses and technical staff (P = 0.02). Doctors showed higher median values for attitude than nurses and technical staffs (P = 0.02). A weak positive correlation, r(115)=.20, p=.0299 was evidenced between knowledge and attitude for COVID-19. Present study shows that the health care workers of a tertiary care institute had good knowledge and positive attitude towards COVID-19, though in some areas the knowledge and attitude was observed low. The study also observes that there is need for continuous teaching and training programs.
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Background Since the first report of COVID-19 in December 2019, there have been significant concerns regarding the effects of the disease on pregnant and recently pregnant women. Quantifying prevalence, and identifying risk factors for severe COVID-19 in this population is key to planning and providing effective clinical maternal care. Objectives To identify rates of COVID-19 amongst pregnant and recently pregnant women and to identify maternal risk factors for severe COVID-19 and worsening clinical outcomes. Design To address the objectives using the developing evidence base we are using a 'Living systematic review' study design. Methods A systematic search of various databases and sources was conducted, including: Medline, Embase, Cochrane database, WHO COVID-19 database, CNKI, Wanfang databases, preprint servers, social media, reference lists of guidelines and included studies until the 6th of October 2020. Quality assessment of prevalence studies was done using the risk of bias tool by Hoy et al. and comparative cohorts using the Newcastle Ottawa Scale. Data extraction was completed with a pre-piloted form by two independent reviewers. The analysis is undertaken monthly and findings are regularly updated. Results are disseminated through our website: https://www.birmingham.ac.uk/research/who-collabora ting-centre/pregcov/index.aspx. The living systematic review process and collated database has given rise to distinct review questions, and the authors of this focused on prevalence and maternal risk factors. Random effects meta-analysis was used to determine prevalence of COVID-19 and the maternal risk factors associated with severe COVID-19. Results 192 studies were included. Overall, 10% (95% confidence interval 7% to 12%;73 studies, 67 271 women) of pregnant and recently pregnant women attending or admitted to hospital for any reason were diagnosed as having suspected or confirmed COVID-19. Increased maternal age (1.82, 1.27 to 2.63;I2 = 30.1%;7 studies;3561 women), high body mass index (2.37, 1.83 to 3.07;I2 = 0%;6 studies;3380 women), pre-existing maternal comorbidity (1.81, 1.49 to 2.20;I2 = 0%;3 studies;2634 women), chronic hypertension (2.0, 1.14 to 3.48;I2 = 0%;2 studies;858 women), pre-existing diabetes (2.12, 1.62 to 2.78;I2 = 0%;3 studies;3333 women), and pre-eclampsia (4.21, 1.26 to 14.0;I2 = 0%;4 studies;274 women) were associated with severe COVID-19 in pregnancy. Conclusions 1 in 10 pregnant or recently pregnant women attending or admitted to hospital are estimated to have COVID-19. Pre-existing co-morbidities, chronic hypertension, pre-eclampsia, pre-existing diabetes, high maternal age, and high BMI are risk factors for severe COVID-19.
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The pandemic of COVID 19 caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an extraordinary challenge to health care system across the globe. COVID 19 is highly contagious disease with an incubation period of 2 to 14 days and causes respiratory infection including fever, cough, sore throat, malaise, breathlessness among others. The clinical features vary from mild in most people to acute respiratory distress syndrome (ARDS) and multi organ dysfunction. Most people are asymptomatic and person with co-morbidities and low immunity are more vulnerable. Treatment is essentially supportive with no proven effective therapeutic agent and worldwide there is quest to develop vaccine against virus. With no concrete evidence based therapeutic options for prevention and treatment of patients, one strategy is to boost the immunity of individual. The ancient classical textbooks of Ayurveda, Charaksamhita and Susrutasamhita refers to epidemics, delineate its pathogenesis and measures required for its management. The traditional medicines such as in Ayurveda can help patients to fight against virus by modulating the immunity of a person. This review highlights important clinical features of COVID-19, treatment strategies and options, and role of ayurveda in its management.