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1.
Psychiatr Danub ; 34(1):185-186, 2022.
Article in English | PubMed | ID: covidwho-1801679
2.
Cureus Journal of Medical Science ; 14(3):9, 2022.
Article in English | Web of Science | ID: covidwho-1798745

ABSTRACT

Background: Clinical presentation of coronavirus disease 2019 (COVID-19) varies from an asymptomatic state to severe disease characterized by acute respiratory distress syndrome, respiratory failure, thrombosis, and multi-organ dysfunction syndrome. The neutrophil-to-lymphocyte ratio (NLR) has been reviewed as one of the laboratory factors that have been proposed to predict the severity of disease and mortality in COVID-19 pandemic. Aim and objectives: To evaluate the association between NLR and the disease severity and mortality in COVID-19. Materials and methods: After approval from Institutional Ethics Committee, this prospective cohort study was carried out in a tertiary-care teaching medical institute of Central India. COVID-19 patients of the age group 18 years and above admitted during the study period were included. Cases were categorized into four groups as asymptomatic (Group A), mild (Group B), moderate (Group C), and severe (Group D) based on clinical symptoms, respiratory rate, oxygen saturation, and chest imaging. NLR was calculated by doing a complete blood count at the time of hospitalization by the Mindray BC-6000 auto hematology analyzer. The outcome of the disease was classified as recovery and death during hospitalization. Receiver operating characteristic (ROC) curve analysis was used to assess the ability of NLR at admission to predict severe COVID-19 or mortality. Ordinal regression analysis was used to assess the impact of NLR on disease severity and mortality. Results: Mean NLR was significantly higher in the severe COVID-19 group as compared to the mild/moderate group and in deceased as compared to discharged cases. ROC curve analysis revealed NLR to be an excellent predictor of disease severity as well as a prognostic parameter for risk of death. NLR was found to be a significant independent positive predictor for contracting the severe disease (Odd's ratio 1.396, 95% CI=1.112-1.753, p=0.004) and mortality (Odd's ratio 1.276, 95% CI=1.085-1.499, p=0.003). Conclusion: High NLR was significantly associated with the disease severity and mortality in COVID-19.

3.
Biointerface Research in Applied Chemistry ; 13(1), 2023.
Article in English | Scopus | ID: covidwho-1789946

ABSTRACT

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) caused coronavirus disease 2019 (COVID-19) pandemic has become a global health issue. Recently, the SARS-CoV-2 strain (B.1.617 double mutant variant) has raised alarms in India and other nations. B.1.617 variant was found to contain two key mutations (L452R and E484Q) in the RBD region of the spike protein. In this work, we have focussed on the effect of the double mutations in spike protein on its binding to the host cell receptor protein, angiotensin-converting enzyme 2 (ACE2). From the molecular dynamics simulation, we observed that the L452R and E484Q double mutant (DM) in spike protein utilizes unique strategies to achieve stable binding to ACE2 compared to the spike protein's wild type (WT). Using MM-GBSA/MM-PBSA algorithms, we found that the binding affinity between spike protein-containing DM and ACE2 is high (GBTOT =-47.09 kcal mol-1, PBTOT=-19.93 kcal mol-1) in comparison with spike protein WT and ACE2 (GBTOT =-31.79 kcal mol-1, PBTOT=-6.33 kcal mol-1). Stable binding of spike protein to ACE2 is essential for virus entry. They should understand interactions between them while designing drugs and treatment modalities to target or disrupt this interface. © 2022 by the authors.

4.
Indian Journal of Critical Care Medicine ; 26(3):327-330, 2022.
Article in English | Scopus | ID: covidwho-1742855

ABSTRACT

Introduction: Providing cardiopulmonary resuscitation (CPR) to a coronavirus disease-2019 (COVID-19) patient is challenging for the healthcare providers (HCP). COVID-19 cases have specific CPR requirements, which differ from standard resuscitation efforts. Objective: This paper aims to evaluate whether online learning can be an effective methodology for imparting information on the management of cardiopulmonary arrest in COVID-19 patients due to a novel virus unknown to HCP based on evaluation of knowledge acquisition and satisfaction of the nurses in the new area of medicine and virology. Methodology: In a single-arm, one group before and after design, from a cohort of 160 nurses trained in comprehensive cardiac life support (CCLS) formulated by the Indian Resuscitation Council (IRC), 73 nurses participated in the study. After obtaining informed consent through the email from the nurses, baseline data including demographic profile and knowledge related to CPR in COVID-19 patients were collected. An online intervention spread over 1 week was given using a validated e-learning module. The online intervention was found to be effective (pre-and post-intervention knowledge score 13.65 ± 3.01 vs 19.92 ± 1.94, p = 0.001). The majority of nurses were highly satisfied with the content and the training methodology (37.23 ± 4.70). Conclusion: A well-structured, online study material can be used in imparting knowledge and demonstrating the basic and essential skills to nurses, required for giving CPR to COVID-19 patients. © The Author(s). 2022.

5.
Journal of Association of Physicians of India ; 70(1):38-39, 2022.
Article in English | Scopus | ID: covidwho-1728116

ABSTRACT

During COVID-19 pandemic, one of the most common arrythmia reported with this illness is sinus bradycardia. Treatment for COVID-19 and associated cardiac dysfunction is still evolving. Temporary pacemaker insertion is difficult due to pandemic and risk of spread of infection to the additional staff involved. Orciprenaline stimulates the sino-atrial and atrioventricular nodes and accelerates atrioventricular conduction. Theophylline improves sinus node function in subjects with sinus bradycardia and enhances atrioventricular nodal conduction We report a case series of 10 patients admitted in dedicated COVID-19 ICUs and developed sinus node dysfunction. All of these patients were started on etophylline and theophylline prolonged release tablet (150mg) once a day. On subsequent follow up after 72 hours, all patients reported heart rate well within normal range. COVID-19 virus directly involves the myocardium by entering the cardiac myocytes resulting in inflammation and injury. As the sinus bradycardia due to COVID-19 is usually transient and respond well this drug, short course of this drug could be added to treat this arrythmia in future. © 2022 Journal of Association of Physicians of India. All rights reserved.

6.
MEDLINE;
Preprint in English | MEDLINE | ID: ppcovidwho-326637

ABSTRACT

Severe COVID-19 is characterised by immunopathology and epithelial injury. Proteomic studies have identified circulating proteins that are biomarkers of severe COVID-19, but cannot distinguish correlation from causation. To address this, we performed Mendelian randomisation (MR) to identify proteins that mediate severe COVID-19. Using protein quantitative trait loci (pQTL) data from the SCALLOP consortium, involving meta-analysis of up to 26,494 individuals, and COVID-19 genome-wide association data from the Host Genetics Initiative, we performed MR for 157 COVID-19 severity protein biomarkers. We identified significant MR results for five proteins: FAS, TNFRSF10A, CCL2, EPHB4 and LGALS9. Further evaluation of these candidates using sensitivity analyses and colocalization testing provided strong evidence to implicate the apoptosis-associated cytokine receptor FAS as a causal mediator of severe COVID-19. This effect was specific to severe disease. Using RNA-seq data from 4,778 individuals, we demonstrate that the pQTL at the FAS locus results from genetically influenced alternate splicing causing skipping of exon 6. We show that the risk allele for very severe COVID-19 increases the proportion of transcripts lacking exon 6, and thereby increases soluble FAS. Soluble FAS acts as a decoy receptor for FAS-ligand, inhibiting apoptosis induced through membrane-bound FAS. In summary, we demonstrate a novel genetic mechanism that contributes to risk of severe of COVID-19, highlighting a pathway that may be a promising therapeutic target.

7.
12th Indian Conference on Computer Vision, Graphics and Image Processing, ICVGIP 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1605834

ABSTRACT

One of the main challenges in controlling the spread of COVID19 pandemic is to diagnose infection early. The most reliable method RT - PCR takes several hours to give results. Although the Anti-Body (Serological) test gives the results in a few hours, it is not accurate, and hence it is not reliable. Moreover, they are invasive. Another issue with these methods is that the number of labs performing these tests are very limited. It will be beneficial if the already existing clinical infrastructure is used for diagnosing COVID19 accurately in real time. Recently chest CT images are used by researchers to diagnose the COVID19 with impressive accuracy. The state of the art method for detecting COVID19 using CT chest images involves Deep Learning. Deep Learning is expected to provide accurate and reliable results only when the model is trained on a large data set. Due to non-availability of a large data set the existing models have been trained on a smaller size data set. Therefore it would be better to design a model to give good accuracy with reliability. To achieve accuracy along with reliability we proposed a COVID19 detection model with the combination of deep learning model and the traditional machine learning model. The novelty of the proposed model is the fusion of image quality and deep learning. The proposed method outperformed the state of the art method in terms of accuracy, recall and F1 score (more than 99 % in almost all the metrics) on a benchmark data set. The efficacy of the selected features and also explainability of the method are demonstrated through various tests. © 2021 ACM.

8.
Internal Medicine Journal ; 51(SUPPL 4):11, 2021.
Article in English | EMBASE | ID: covidwho-1583534

ABSTRACT

Background: Since 2019 the National Allergy Strategy (NAS) 250K youth project has run annual camps to support school-aged teens living with severe allergies. In 2021, the COVID-19 pandemic presented several challenges for conducting camps. To reduce the risk of potential COVID-19 exposure, the NAS conducted a 250K fun day for school-aged teens, supported by local peer mentors, staff and volunteers. This study compares confidence levels for a range of allergy based self-management indicators, between the fun day and camp offerings. Method: The 250K fun day was held in Perth, Western Australia, in February 2021. Perth-based NAS staff and volunteer health professionals attended. School-aged teens and peer mentors from Perth were invited to participate. Several meetings with volunteers and catering staff were held prior. Findings: Fourteen school-aged teens with severe allergies and 1 peer mentor participated in the fun day, and 14 school-aged teens and 8 peer mentors participated in the 2020 camp. Confidence levels were measured using a participant survey. Table 1 provides a comparison of the results of the 2021 fun day and the 2020 camp. Conclusion: The 250K fun day helped connect young people with food allergy. The fun day as a one-day event substantially improved confidence levels in allergy self-management, however, did not increase confidence to the same level as the 2020 camp. Should COVID-19 continue to restrict access to camps, the fun day model represents a good option to engage youth and still provide significant benefit to participants.

9.
Journal of Pharmaceutical Research International ; 33(53B):130-135, 2021.
Article in English | Web of Science | ID: covidwho-1579787

ABSTRACT

Aim of Object: During the COVID-19 pandemic, the entire world is experiencing a mortality situation;most people are battling against the corona virus, but some individuals have already suffered from cardiovascular problems. For improved patient care, adequate information and comprehension of the relationship between cardiovascular disorders and COVID-19 is required. The dominant clinical manifestations of the corona virus infection are on the respiratory system. In this instance, the acute cardiac injury is the most often reported cardiac abnormality, in which the degree of cardiac output is increased, troponin levels rise, and mostly it is found in about 8% to 12% of patients. The involvement of viral cardiomyocytes and systemic inflammation is the most prevalent mechanism for cardiac damage. The corona virus attaches itself and enters through angiotensin converting enzyme-II. Discussion and Conclusion: Recent articles on COVID-19 have revealed nothing regarding these individuals' cardiac vascular manifestations. This is a critical component of all that has a big influence on COVID-19 patients' cardiovascular systems. To fully comprehend the method and effects, more study is required.

10.
Nepalese Journal of Ophthalmology ; 13(2):39-50, 2021.
Article in English | Web of Science | ID: covidwho-1542293

ABSTRACT

Introduction: Eye examination and different procedures performed in close contact with eye and face, put medical and non medical staff of an eye hospital at higher risk for COVID-19. This causes increased psychological burden. The objective of this study was to find out depression, anxiety, stress and insomnia among Mechi Eye Hospital staff. Materials and methods: A web based cross-sectional study among Mechi Eye Hospital staff was done from 1st to 20th July 2020. Insomnia Severity Scale and DASS-21 were used. Results: Out of 220, 190 (86.6%) participated, 63.2% were female and 61.05% were medical staff with an overall mean age of 31.1 +/- 8.4 years. Overall prevalence of anxiety, depression, insomnia and stress were 20.5%, 18.9%, 16.3% and 12.6% respectively and those were common in female with 63.9% (p value <0.02), 64.1% (p value 0.5), 58.4% (p value 0.2) and 100% (p value <0.01) respectively. Depression, anxiety and insomnia were common in the age group 30-39 years (50%, p value< 0.02), 20-29 years (56.4%, p value 0.1) and 20-29 years (70.9%, p value 0.8) respectively. Stress was common in 20-29 years and 30-39 years, 45.8% each (p value <0.03). Depression (75%, p value 0.2), anxiety (71.7%, p value 0.9) and stress (70.8%, p value 1.0) were common in medical staff. Insomnia was present in medical staff only (p value<0.01). Conclusion: Mechi Eye Hospital staff had greater prevalence of psychological reaction than the national baseline during the pandemic which was more common in female, younger age and medical staff.

11.
Use of AI, Robotics, and Modern Tools to Fight Covid-19 ; : 1-15, 2021.
Article in English | Scopus | ID: covidwho-1525129

ABSTRACT

In the realm of infectious diseases, a pandemic is the worst-case scenario. When an epidemic is spread beyond a country's borders, then it is officially called pandemic. Humankind has always seen communicable diseases, but shift to aggregarion life made epidemic and later pandemic more possible. Malaria, tuberculosis, leprosy, influenzae [1, 2], and smallpox were some of them. The more civilized humans became, the more likely the pandemics became - like the first cholera pandemic in 1817 originated in Russia. In recent history, the world's one of the deadliest pandemics in 1918 was Spanish flu which struck 50 million deaths in Europe, USA, and parts of Asia. In 1981 AIDS, and then the world witnessed SARS- CoV-1 in 2003 in China, a form of coronavirus, a name which helps us recognize this new one of the most contagious pandemics the world has ever witnessed, called SARS-CoV-2 or popularly called COVID-19 or, as some say, Wuhan virus. SARS-CoV-2 was reported by China in late December 2019 with pneumonia-like symptoms of unknown origin. Without a vaccine available, it spread beyond borders, to more than 163 countries. COVID-19 has revealed vulnerabilities in the global communities' response to outbreaks of viruses, which has damaged the world's economy to the worst recession since the Great Depression. Shift of power and bringing the world to a standstill is something which none has ever imagined. Deaths, broken families, helplessness, fear and anxiety, uncertainty, and many more emotions were heaped on mankind. Economies suffered but the planet breathed, humans stopped but wildlife played. Life under COVID-19 brought blue skies and clean air, and many suffered but then many held them. Humans sought to learn and strive, sufferings created fighters, roadblocks paved new paths, and this horrendous experience changed the outlook and paved the perspective for a new world after COVID-19. © 2021 River Publishers. All rights reserved.

12.
Movement Disorders ; 36:S134-S134, 2021.
Article in English | Web of Science | ID: covidwho-1436669
13.
Indian Journal of Medical Specialities ; 12(3):155-160, 2021.
Article in English | Web of Science | ID: covidwho-1350357

ABSTRACT

Objectives: In the wake of COVID-19 pandemic, strict lockdown measures posed many challenges in managing chronic diseases such as hypertension and diabetes. The impact of lockdown on physical and biochemical parameters along with contributing factors was assessed. Design: Cross-sectional analytical study. Materials and Methods: One hundred and fifty consecutive patients with chronic illnesses attending medicine outpatient department during unlock down phase I were enrolled. A 5 point Likert scale was used to determine the effect on diet, exercise, pain, physical and psychological symptoms, and a personal interview to assess the contributing factors. Clinical examination and laboratory investigations were done to compare between pre and post lockdown status and appropriate statistical tests were used. Results: The mean age of the patients was 48.53 +/- 6.4 years with a female preponderance. Mean duration of illness was 8.93 +/- 2.4 years and majority had hypertension (21%), diabetes (19%) or both (12%), hypothyroidism (18%), and gastroesophageal reflux disease (8%). While physical symptoms and pain did not show a significant change, 41.3% had worsening of psychological symptoms, 53.3% diet, and 70.6% exercise noncompliance. Weight, blood pressure, lipids, serum thyroid-stimulating hormone showed little change. Glycemic control was deranged in 72.5% with HbA1c increasing from 6.47 +/- 1.9 to 8.1 +/- 2.4 (P = 0.007). Contributing factors, 52.3% reported lack of exercise, 40% financial problems, 36% transport difficulties, and 30% unavailability of medicines. Conclusion: Lockdown negatively affected the management of chronic diseases with significant worsening of psychological symptoms, diet, and exercise adherence. Glycemic control worsened in diabetics. Lack of transport and unavailability of medicines were the significant contributing factors.

14.
Indian Journal of Critical Care Medicine ; 25(SUPPL 1):S26, 2021.
Article in English | EMBASE | ID: covidwho-1200243

ABSTRACT

Introduction: Pneumonia with severe respiratory failure represents the principal cause of death in COVID-19, where hyper-inflammation plays an important role in lung damage. An effective treatment aiming at reducing the inflammation without preventing virus clearance is thus urgently needed. Tocilizumab, an anti-IL-6 receptor monoclonal antibody, has been proposed for the treatment of patients with COVID-19. Early use of tocilizumab prevents sudden deterioration of patient but after 15 days cavitary lesions are found in HRCT chest which is manageable. Objectives: To discuss the use of early tocilizumab in severe COVID pneumonia patients. Materials and methods: A 46-year-old Indian man presented in casualty with the complaint of shortness of breath, cough fever since 5 days admitted in COVID ward after COVID-19 RT-PCR tested positive HRCT chest shows 90% lung involvement. The initial patient was vitally stable with SpO2 98 with 15 L oxygen support NRBM, respiratory rate was 18/minute. ABG shows mild hypoxia. On day 2, the patient started deteriorating, not maintaining saturation on NRNM support taking on NIV support. Worsening of blood marker started. We plan for use of early tocilizumab 400 mg. The next day tocilizumab was given. The patient intubated and took on AC/VC support. After 5 days, the patient successfully extubated. On the seventh day, the patient extubate Results: Use of early tocilizumab prevents sudden deterioration of patient with 90% lung involvement but after 20 days cavitary lesions found which is manageable. Discussions: The patient came with severe pneumonia due to COVID. Tocilizumab was given on the third day of admission. The blood marker shows regular improvement. The patient intubated then extubated. Cavitary lesion developed. Oxygen requirement slowly decreases. Bronchoscopy shows normal findings. BAL shows tubercular etiology. ATT started. After 30 days, the patient successfully discharge. Conclusion: Tocilizumab can be beneficial to the suddenly deteriorating patients due to hyperimmune reaction if the timing of administration is right.

15.
Indian Journal of Critical Care Medicine ; 25(SUPPL 1):S6, 2021.
Article in English | EMBASE | ID: covidwho-1200228

ABSTRACT

Introduction: An inflammatory response to SARS-CoV-2 infection, due to cytokine release syndrome, has been implicated in the pathology of acute respiratory distress syndrome in patients with COVID-19. Baricitinib is a reversible JAK-inhibitor that interrupts the multiple inflammatory cytokines in COVID-19 immunopathology. Objectives: Our aim to study the overall outcome of baricitinib on critical patients with COVID-19. Materials and methods: A cross-sectional study of 10 cases, infected with COVID-19 severe pneumonia and were critically ill. The patient's average ICU stay, CBC, changes in HRCT scans, clinical improvement, cytokine storm markers before and after baricitinib doses were taken into account. Due consent was taken from all patients. Results: Seventy percent of patients showed a reduction in CRP values. In 70% of patients, D-dimer values either decreased or were kept within normal limits. 90% of patients were shifted from NIV support to NRBM within 7 days of baricitinib. 50% of patients showed a rising trend in platelet counts. 70% patients were shifted to ward from ICU 30% patients were discharged within 7 days of Baricitinib. Discussions: Baricitinib is the Janus kinase (JAK) inhibitor, which may prevent cytokine storm in patients with SARS-CoV-2 pneumonia. Conclusion: In our study, baricitinib has shown promising results. It is incumbent on researchers to develop and validate reliable tools to monitor the overall outcome of patients with baricitinib in COVID-19.

16.
National Journal of Physiology, Pharmacy and Pharmacology ; 11(1):28-33, 2021.
Article in English | EMBASE | ID: covidwho-1076817

ABSTRACT

Background: Online virtual lectures have the advantages of mass communication from any location and can be recorded and repeated as long as computers and internet access are available. The medical students here had never been offered online virtual lectures until now. Taking the advantages of online virtual teaching and the need of the hour, the present study was conducted with the following aims and objectives. Aims and Objectives: To study, evaluate and compare the effectiveness and satisfaction of students in two modalities of teaching-learning (T-L) technique – (1) face to face classroom lectures versus (2) virtual online lectures. Material and Methods: The present observational study was conducted in 93 undergraduate medical students of the second year. A series of 10 face to face classroom lectures and then a series of 10 virtual online lectures were conducted on different topics of forensic medicine and toxicology at a frequency of 1 lecture/week. A well-designed and-structured questionnaire was forwarded to the students through “Google form.” The students could fill in the form and submit only if willing. The statistical analysis of the descriptive variables was expressed as mean ± SD and percentage separately. The comparison of the variables for both modalities of T-L technique was done by unpaired-t test. Results: The attendance of the students was highly significantly increased in online virtual lectures as compared to face to face classroom lectures. The impact of online virtual lectures on knowledge, the connectivity with the teacher, attentiveness, and satisfaction grades as experienced by students and rated on a 5 point Likert scale was statistically significantly low as compared to face to face classroom lectures. The online virtual lectures were experienced as significantly more monotonous as compared to face to face classroom lectures. Conclusion: After so many years of pedagogical nature of medical education, the students will require time to adapt to the self-directed learning protocol. It is the role of the educator to keep the students motivated and use multimedia and social media to make the online virtual lectures more interesting, informative, interactive, and hence more effective.

17.
Journal of Mathematical and Computational Science ; 11(1):563-576, 2021.
Article in English | Scopus | ID: covidwho-1050824

ABSTRACT

In this paper, we prefer to implement a retrial queueing contraption with a finite number of homogeneous sources for covid-19 patients, orbital requests for the care, and unstable orbit, driven by the wish for overall output models suitable for modelling and study of covid-19 patients. Day by day pandemic situation in India is more critical, patients are facing the unavailable of treatment resources so they are automatically switched into the orbit mode. Data is taken from the ICMR website, Dated: Sep 21, 2020. It is believed that all random patients who are concerned with seeking care are impartial and exponentially distributed. Regular-state analysis of the underlying continuous-time Markov process is performed victimization Time NET package constant state performance measurements are computed by providing a generalized pandemic random Petri net model. The implementation of an unstable orbit and its use in a pandemic situation is the main novelty. Numerical derivation to explain the death/ recovery time effect. © 2021 the author(s). This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

18.
Proc. Int. Conf. Electron., Commun. Aerosp. Technol., ICECA ; : 1582-1587, 2020.
Article in English | Scopus | ID: covidwho-1050282

ABSTRACT

COVID19 is a respiratory disease and World health organization [WHO] has classified this disease as pandemic because of its high mortality rates among people with poor medical history conditions. It is important to identify such individuals, who are not safe and to avoid severe complications if get exposed to COVID19. There is no system, which can alert the person based on his health condition. Proposing a machine learning approach would help to achieve safety, personification and mitigate the effects of COVID19 disease. In presence of scarcity of information about COVID19 for the purposes of model building is a key challenge. Proposed research used natural language embedded media data information maintained in hospitals about respiratory diseases and used this information to identify the individuals who can be not safe if exposed to COVID19 patients. The proposed approach will provide an intuitive way to understand the risk of being getting affected based on the immunization of respiratory system of an individual. The risk factor will provide a basis for personification and to take safety measures in this long lasting pandemic situation. © 2020 IEEE.

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