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1.
Pediatric Critical Care Medicine Conference: 11th Congress of the World Federation of Pediatric Intensive and Critical Care Societies, WFPICCS ; 23(11 Supplement 1), 2022.
Article in English | EMBASE | ID: covidwho-2190740

ABSTRACT

BACKGROUND AND AIM: The multisystem inflammatory syndrome in children (MIS-C) is a new entity and needs data to study its evolution. To describe the clinicolaboratory profile, intensive care needs, and outcome of MIS-C during the first and second waves. METHOD(S): Retrospective analysis of 122 children with MIS-C admitted to Pediatric emergency and PICU of a tertiary-teaching hospital during first and second wave of Covid-19. RESULT(S): Median (IQR) age was 7 (4-10) years with 67% boys. Common manifestations included fever (99%), abdominal symptoms (81%), rash (66%), conjunctival injection (65%), oral mucosa and respiratory involvement (43% each). Elevated CRP (97%), D-dimer (89%), procalcitonin (80%), IL-6 (78%), ferritin (56%), NT-pro- BNP (84%), and positive SARS-CoV-2 antibody (81%) were common laboratory abnormalities. Cardiovascular manifestations included myocardial dysfunction (55%), shock (48%), and coronary artery changes (10%). The treatment included intensive care support (57%), non-invasive (33%) and invasive (18%) ventilation, vasoactive drugs (47%), IVIG (83%), steroids (85%), and aspirin (87%). Mortality was 5% (n=6). Duration of hospital stay was 5 (3-8) days. During second wave, significantly higher proportion had positive SARS-CoV-2 antibody, contact with COVID-19 case, and oral mucosal changes;lower markers of inflammation (CRP, procalcitonin, ferritin, and IL-6);lower rates of shock, myocardial dysfunction, and coronary artery changes;lesser need of PICU, vasoactive drugs, and IVIG;and shorter hospital stay. CONCLUSION(S): MIS-C is febrile multisystemic disease characterized by hyperinflammation, cardiovascular involvement, relationship to SARS-CoV-2, and good outcome with immunomodulation and intensive care. During the second wave, the severity of illness, degree of inflammation, and intensive care needs was lesser.

2.
Sci Rep ; 13(1):378, 2023.
Article in English | PubMed | ID: covidwho-2186021

ABSTRACT

The efficacy of Hydroxychloroquine (HCQ) as post-exposure prophylaxis (PEP) for the prevention of COVID-19 was contentious. In this randomized control double-blind clinical trial, asymptomatic individuals with direct contact with laboratory-confirmed COVID-19 cases were randomized into PEP/HCQ (N = 574) and control/placebo (N = 594) group. The PEP/HCQ group received tablet HCQ 400 mg q 12 hourly on day one followed by 400 mg once weekly for 3 weeks, and the control/Placebo group received matching Placebo. The incidence of COVID-19 was similar (p = 0.761) in PEP [N = 24 out of 574, (4.2%)] and control [N = 27 out of 594, (4.5%)] groups. Total absolute risk reduction for the incidence of new-onset COVID-19 was -0.3% points with an overall relative risk of 0.91 (95% confidence interval, 0.52 to 1.60) and the number needed to treat (NNT) was 333 to prevent the incident of one case of COVID-19. The study found that, PEP with HCQ was not advantageous for the prevention of COVID-19 in asymptomatic individuals with high risk for SARS-CoV-2 infection. Though HCQ is a safer drug, the practice of irrational and indiscriminate use of HCQ for COVID-19 should be restrained with better pharmacovigilance.

3.
2022 IEEE-EMBS International Conference on Biomedical and Health Informatics, BHI 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2161379

ABSTRACT

Non-invasive monitoring of pulmonary health could revolutionize the care of health conditions ranging from COVID-19 to asthma to heart failure, but current technologies face challenges that limit their feasibility and adoption. Here, we introduce a novel approach to monitor respiration by measuring changes in impedance from the back of the thigh. The integration of electrodes into a toilet seat ensures patient compliance with unobtrusive daily respiration monitoring benefitting from repeatable electrode placement on the skin. In this work, the feasibility of the thigh and the sensitivity of impedance to respiration have been investigated empirically by comparing thorax and thigh-thigh bioimpedance measurements to spirometer measurements, and computationally, using finite element modeling. Empirical results show a measurable peak-peak impedance (0.022 ohm to 0.290 ohm for normal breathing across 8 subjects) with respiration across thigh-thigh and a high correlation (0.85) between lung tidal volume and impedance change due to respiration. Thigh-thigh bioimpedance measurements were found to be able to distinguish between shallow, normal, and deep breathing. Further, day-to-day variability in the relationship between impedance and tidal volume was investigated. The results suggest that the novel approach can be used to detect respiration rate and tidal volume and could provide valuable insight into disease state for conditions ranging from COVID-19 to heart failure. © 2022 IEEE.

4.
Managing Complexity and COVID-19: Life, Liberty, or the Pursuit of Happiness ; : 130-144, 2022.
Article in English | Scopus | ID: covidwho-1975137
5.
5th International Conference on Smart Computing and Informatics, SCI 2021 ; 283:449-455, 2022.
Article in English | Scopus | ID: covidwho-1899061

ABSTRACT

COVID-19 has significantly increased interest in remote working. The phenomenon of this increase was examined in this paper by examining tweets on Twitter by analysis the sentiments of people working remotely. Data were collected by downloading tweets by using keywords “#remoteworking.” The study also explored magazines like HR people matters, HBR, and articles from reputed journals, and by visiting regularly NASSCOM Web site and newspapers. Compiled data are then refined through data mining techniques, and then, sentiment analyses have been deployed. Sentiment index was found greater than one which reflected that people are very happy with having remote working. It was also found that the issue of remote work increased nearly 15 times in a year, reaching an epidemic peak in March 2020. The study has shown that in the post-COVID period it will stay permanently. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

6.
Pacific Business Review International ; 14(6):88-93, 2021.
Article in English | Web of Science | ID: covidwho-1790361

ABSTRACT

From ancient times, India has been touted as a global study venue that offers high-quality education at a low cost. However, this trend has declined over the years. Thus, the study aims to discuss the present Indian Higher Education environment in light of the covid-19 pandemic. Attempt to explore if there are any opportunities for Indian higher education to expand worldwide and capitalize from contemporary technological advancements. According to the research findings, international academic institutions must be encouraged to operate in India. Likewise, Indian academic institutions should also partner with industries to encourage technology transfer both at the national and international levels. Therefore, a regulatory mechanism should be put into effect to facilitate such entrance and assist India in reclaiming its status as a Viswa Guru.

7.
Journal of Clinical and Diagnostic Research ; 16(1):VC05-VC09, 2022.
Article in English | EMBASE | ID: covidwho-1677775

ABSTRACT

Introduction: Coronavirus disease 2019 (COVID-19) pandemic has adversely affected people's physical and mental health necessitating a comprehensive public and mental health strategy focusing on venerable populations including Health Care Professionals (HCPs). Anxiety is a common mental health problem and untreated anxiety may cause immediate and long-term adverse health effects. Currently the data on the psychological impact of COVID-19 among specialities of HCPs is sparse. Aim: To study the prevalence of anxiety and its severity among different specialties of HCPs during COVID-19 pandemic. Materials and Methods: This cross-sectional survey was conducted among HCPs from 1st October, 2020 to 20th February, 2021 at Kishori Ram Hospital and Diabetes Care Centre, Bathinda, Punjab, India, during COVID-19 pandemic in India using E-copies and hard copies of anonymously complete voluntary survey proforma. The proforma included socio-demography variables and a validated pretested structured Generalized Anxiety Disorder Scale (GAD-7) questionnaire distributed physically and by social media platforms to Indian doctors and medical students of >18 years of age from all over India. From all responses received, 2246 were found to be valid responses from HCPs comprising of 1624 from medical specialities, 225 surgical specialities, 101 emergency/critical care specialities and 296 from students/dental speciality. No HCPs other than doctors with valid MBBS/BDS degrees or MBBS/BDS students were included. Valid responses were analysed according to the speciality in relation to prevalence of anxiety, its severity, age and gender. Mann-Whitney Test was used to compare GAD-7 score among different specialty group. Results: About 972 (43.3%) were in 20 to 40 years age group including 655 (67.4%) medical, 42 (4.3%) surgical, 37 (3.8%) emergency/critical care and 238 (24.5%) from students/dental speciality. Male HCP were 1513 and female HCP were 733. Prevalence of anxiety was 79.3% among all HCPs. According to gender groups prevalence of anxiety was 78.1% in males and 81.6% in females. According to age groups the prevalence of anxiety was 81.3% in 20-40 years age group, 81.6% in 41-60 years and 61.5% in >60 years age group. Among specialities prevalence of anxiety was 78% in medical speciality group, 86.7% in surgical speciality group, 92.1% in emergency/critical care group and 76.4% in students/dental speciality group. Results showed maximum mean score in emergency/critical care speciality group and minimum mean score in medical speciality group. Conclusion: High prevalence of anxiety and its severity among HCPs across specialities highlights the adverse mental health impact of the COVID-19 pandemic underscoring the need for appropriate mental health support with multidisciplinary comprehensive mental health care measures.

8.
Alternative Therapies in Health and Medicine ; 27:18-23, 2021.
Article in English | Web of Science | ID: covidwho-1576552

ABSTRACT

Context . Inflammation is a significant factor driving the rise of multiple cases of viral pneumonia, including COVID-19 infection. Peripheral white blood cells (WBCs), the neutrophil (NEU)-to-lymphocyte (LYM) ratio (NLR), the platelet-to-lymphocyte (PLR) ratio, and hemoglobin (Hb) are markers of systematic inflammatory reaction and often predict disease severity. Objective . The current study intended to examine the prognostic importance of hemoglobin (Hb), total leukocyte count (TLC), absolute neutrophile count (ANC), absolute lymphocyte count (ALC), NLR, d-NLR [derived NLR = ANC/(WBC-ANC)], absolute platelet count (APC), and PLR, based on complete blood counts (CBCs) for COVID-19 patients. Design . The research team designed a retrospective that was conducted between March 27 and June 5, 2020, after the first COVID-19 case was reported in Ajmer, Rajasthan, India on March 27. Setting . The study took place at Jawaharlal Nehru ( JLN) Medical College in Ajmer, Rajasthan, India. Participants . The study included 364 participants who were all COVID-positive patients who came to the hospital during the study's period, including patients from various age groups and of both genders. Outcome Measures . Using the results of the CBC, the research team measured: (1) Hb in g/dl, (2) ANC, (3) ALC, and (4) APC. The neutrophil-lymphocyte ratio (NLR) and the platelet- lymphocyte ratio (PLR) were calculated from measurements of the levels of the circulating biomarkers, as cells x 10(3)/mu l. Result . For participants who were severely symptomatic, the mean age was 57.86 +/- 8.92. Males were more likely to experience severe symptoms. Participants' Hb values were significantly different between groups, and TLC, ANC, NLR, d-NLR, and PLR were highest in the severely symptomatic group and lowest in the asymptomatic group. NLR was positively associated with a risk of COVID-19 pneumonia, while Hb was negatively associated with development of pneumonia. Conclusions . Disease severity and age are independent predictors of poor outcomes. The NLR should be used as a routine blood test that can help in the diagnosis of disease severity in COVID-19. NLR is very simple tool that can be used as a fast and low-cost test that is easily available, even in small centers where the facilities for other tests, such as tests of LDH, CRP, and IL-6, and high resolution CT scans aren't available. Thus, NLR can be used as single independent predictor of COVID-19 disease severity.

10.
Qualitative Research in Financial Markets ; 2021.
Article in English | Scopus | ID: covidwho-1294898

ABSTRACT

Purpose: This study aims to explore the impact of the containment measures during COVID-19 on individuals’ finances, financial resilience during such distress and identifying the most financially vulnerable among them. Tracing such impact during the pandemic has been challenging due to a lack of representative data. This paper addresses this gap in the present study. Design/methodology/approach: A survey has been conducted using a structured questionnaire containing various items that portray the impact on income, spending, saving, investment, borrowing, insurance and retirement. The sample consists of 699 respondents and purposive and snowball sampling has been used for data collection. The results are presented and analyzed using infographics and frequency distributions. This study conducts an analysis of variance and Chi-square tests for significance. Findings: This paper finds a fall in income and limited ability to cope with the current economic conditions. The survey highlights inadequate savings and insurance, weak retirement planning, outstanding loans and under-diversified investments inhibiting financial resilience even among the higher-income group. Particularly, lower-income strata, women and not much educated are most financially vulnerable. Further, no substantial financial benefits have been received from the government and people rely on their usual income sources. Originality/value: To the best of the authors’ knowledge, this is the first study that measures the pandemic’s impact on personal finances, especially in connection with a developing economy like India. Policy interventions are critical to the millions for whom financial literacy is required now more than ever. © 2021, Emerald Publishing Limited.

11.
Journal of Neuroanaesthesiology and Critical Care ; 7(3):160-162, 2020.
Article in English | EMBASE | ID: covidwho-1260976
12.
Journal of Neuroanaesthesiology and Critical Care ; 7(3):128-139, 2020.
Article in English | EMBASE | ID: covidwho-1260970

ABSTRACT

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) has rapidly spread across the world including India. Management of patients complicated with neurological illness requiring neurocritical care is challenging during this time. Patients with neurological disease may develop COVID-19 infection or there could be independent neurological manifestations of COVID-19. Critically ill neurological patients are more vulnerable to contracting SARS-CoV-2 infection. Also, neurological patients with comorbidities and multisystem involvement are at increased risk of adverse outcomes. Though SARS-CoV-2 predominantly affects the pulmonary system, it can complicate the assessment and management of neurological patients. With increasing COVID-19 numbers, the hospitalizations of both non-COVID and COVID-19 neurological patients will bring significant strain on the hospital and neurocritical care facilities. Streamlining work pattern, understanding the pathophysiology of COVID-19 and its impact on neurological function, establishing general and specific neurocritical care management strategies, ensuring protection and well-being of health care providers, and implementing effective infection control policies are key elements of efficient neurocritical care management during this pandemic. This joint position statement and advisory on the practice of neurocritical care during the COVID-19 pandemic by the Neurocritical Care Society of India and the Indian Society of Neuroanaesthesiology and Critical Care has been developed to guide clinicians providing care to the critically ill neurological patients in the neurocritical care unit during the current pandemic. As the situation from this novel disease is rapidly evolving, readers must constantly update themselves with newly emerging evidence to provide the best possible care to the critically ill neurological patients.

13.
Information Discovery and Delivery ; ahead-of-print(ahead-of-print):9, 2021.
Article in English | Web of Science | ID: covidwho-1225642

ABSTRACT

Purpose Universities across the USA are facing challenging decision-making problems amid the COVID-19 pandemic. The purpose of this study is to facilitate universities in planning disease mitigation interventions as they respond to the pandemic. Design/methodology/approach An agent-based model is developed to mimic the virus transmission dynamics on campus. Scenario-based experiments are conducted to evaluate the effectiveness of various interventions including course modality shift (from face-to-face to online), social distancing, mask use and vaccination. A case study is performed for a typical US university. Findings With 10%, 30%, 50%, 70% and 90% course modality shift, the number of total cases can be reduced to 3.9%, 20.9%, 35.6%, 60.9% and 96.8%, respectively, comparing against the baseline scenario (no interventions). More than 99.9% of the total infections can be prevented when combined social distancing and mask use are implemented even without course modality shift. If vaccination is implemented without other interventions, the reductions are 57.1%, 90.6% and 99.6% with 80%, 85% and 90% vaccine efficacies, respectively. In contrast, more than 99% reductions are found with all three vaccine efficacies if mask use is combined. Practical implications This study provides useful implications for supporting universities in mitigating transmissions on campus and planning operations for the upcoming semesters. Originality/value An agent-based model is developed to investigate COVID-19 transmissions on campus and evaluate the effectiveness of various mitigation interventions.

14.
J Dent Res ; 100(2): 187-193, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-901606

ABSTRACT

Understanding the pathophysiology of the coronavirus disease 2019 (COVID-19) infection remains a significant challenge of our times. The gingival crevicular fluid being representative of systemic status and having a proven track record of detecting viruses and biomarkers forms a logical basis for evaluating the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The study aimed to assess gingival crevicular fluid (GCF) for evidence of SARS-CoV-2 in 33 patients who were deemed to be COVID-19 positive upon nasopharyngeal sampling. An attempt was also made to comparatively evaluate it with saliva in terms of its sensitivity, as a diagnostic fluid for SARS-CoV-2. GCF and saliva samples were collected from 33 COVID-19-confirmed patients. Total RNA was extracted using NucliSENS easyMAG (bioMérieux) and eluted in the elution buffer. Envelope gene (E gene) of SARS-CoV-2 and human RNase P gene as internal control were detected in GCF samples by using the TRUPCR SARS-CoV-2 RT qPCR kit V-2.0 (I) in an Applied Biosystems 7500 real-time machine. A significant majority of both asymptomatic and mildly symptomatic patients exhibited the presence of the novel coronavirus in their GCF samples. Considering the presence of SARS-CoV-2 RNA in the nasopharyngeal swab sampling as gold standard, the sensitivity of GCF and saliva, respectively, was 63.64% (confidence interval [CI], 45.1% to 79.60%) and 64.52% (CI, 45.37% to 80.77%). GCF was found to be comparable to saliva in terms of its sensitivity to detect SARS-CoV-2. Saliva samples tested positive in 3 of the 12 patients whose GCF tested negative, and likewise GCF tested positive for 2 of the 11 patients whose saliva tested negative on real-time reverse transcription polymerase chain reaction. The results establish GCF as a possible mode of transmission of SARS-CoV-2, which is the first such report in the literature, and also provide the first quantifiable evidence pointing toward a link between the COVID-19 infection and oral health.


Subject(s)
COVID-19/diagnosis , Gingival Crevicular Fluid/virology , SARS-CoV-2/isolation & purification , Adult , Aged , Female , Humans , Male , Middle Aged , Saliva/virology , Young Adult
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