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1.
Global Discourse ; 12(3-4):641-658, 2022.
Article in English | Scopus | ID: covidwho-2054221

ABSTRACT

Covid-19 was widely pitched as a potential turning point of history, a rare crisis-as-opportunity by political leaders and policymakers. This claim of being at a revolutionary threshold, an exceptional time in history, and capitalising upon that claim to reshape the political-economic landscape is at the core of the speculative politics of crisis, or what I call crisis futures. COVID-19 was widely pitched as a potential turning point of history, a rare crisis-as-opportunity by political leaders and policymakers. Critical in this future-oriented discourse, I argue, is how time is invoked as a good in short supply, a precious opportunity, albeit one that can only be availed within a restricted period. This temporal limitation is what accrues speculative value to the crisis: the urgency to accelerate the desired change and to suspend any opposition to that change. Grounded in the event of the COVID-19 lockdown in India, the article unpacks multiple scales and speeds – of acceleration and slowdowns – that constitute the edifice of crisis futures. It traces how the pandemic crisis was capitalised on by the state, at once, to consolidate India as a commercial enclosure for global capital, as well as a cultural enclosure for Hindu majoritarianism. It asks what precisely is accelerated and what is put on hold, and which events or goals are turned into exceptions within an exceptional moment, such as a pandemic. Finally, the article looks at the modes of ‘im-mediation’ – mass-mediated communication and the activation of pandemic publics – which underpin the politics of crisis futures. © Author 2022.

2.
Indian Journal of Critical Care Medicine ; 26:S23-S24, 2022.
Article in English | EMBASE | ID: covidwho-2006330

ABSTRACT

Introduction: The severity of COVID-19 is determined by the presence of pneumonia, severe ARDS, cytokine storms, and small vessels thrombosis, all involves underlying inflammation. Vitamin D is a fat-soluble vitamin with immuno-modulating and anti-inflammatory properties. The high prevalence of vitamin D deficiency is usually due to inadequate sunlight exposure, sedentary lifestyle, diet poor in vitamin D, and traditional clothing. Vitamin D deficiency is a modifiable risk factor their identification and management can improve outcomes. Materials and methods: This was a prospective observational single centre study of moderatelysevere COVID-19 patients. All consecutive, moderately-severe COVID-19 patients with ICU stay >48 hours were included. Exclusion criteria: consent refusal, pregnant and lactating mothers, Age <18 years, post-cardiac arrest resuscitated patient before ICU admission, patient on multivitamin or Neutraceuticals supplements, chronic diarrhea, and cancer patients. Based on vitamin D levels on ICU admission, patients were stratified into two groups, i.e., ≤20 ng/mL deficient and >20 ng/mL non-deficient group. After demographic data, we collected data of underlying disease;cause of admission;APACHE II on admission and daily SOFA scoring, various morbidities during ICU stay (mechanical ventilation, inotropes/vasopressor, nosocomial infections, etc.), length of ICU stay, ICU mortality and 30 days mortality. Results and discussion: A total of 88 patients were studied, 73 (82.9%) patients had vitamin D deficiency. Median [IQ range] vitamin D levels of the deficient and non-deficient group were 11 [5-17] and 27 [22-35]. Groups did not differ in demographic or clinical characteristics except for age. The elderly age group had a higher prevalence of deficiency and was statistically significant, mean (±SD) age of the deficient vs non-deficient group was 54.78 (±13.30) vs 46.47 (±5.75), p value 0.02. The overall mortality rate of the cohort was 42.05%. Percentage mortality in the deficient group (46.5%) was lower than the non-deficient group (20%) but failed to show statistical significance p value 0.058. In continuous data, deficient group had a poor association with ICU morbidities vs nondeficient group as mean (±SD) duration of mechanical ventilation 4.59 (±2.78) vs 4.07 (±3.21) p value 0.521, and length of ICU stay 8.04 (±2.82) vs 8.53 (±3.04) p value 0.545. In categorical data, deficient group showed increased ICU morbidities vs non-deficient group but were not statistically significant, inotropes/vasopressor requirement 60.3% vs 53.3% p value 0.619, hospital-acquired infection incidence 45.2% vs 40% p value 0.712 and 30 days mortality 75.6% vs 24.4% p value 0.059. In severity scoring, deficient group had higher severity vs non-deficient group but statistical significance was not demonstrated APACHE II 10.74 (±4.42) vs 8.73 (±3.39) p value 0.101 and mean SOFA score 4.17 (±3.33) vs 2.51 (±2.68) p value 0.074. Mean (±SD) levels of vitamin D in survivor vs non-survivors were 11.54 (±5.76) vs 15.45 (±6.92) p value 0.006 showed a correlation between mortality and low vitamin D deficiency levels. However, vitamin D levels failed as an independent risk factor for mortality in multivariate analysis OR (95% C.I.) 1.198 (0.732-1.672), p value 0.296. Conclusion: In moderately-severe COVID-19, vitamin D deficiency was associated with a greater incidence of mortality and morbidity, although the relationship was not statistically significant. Vitamin D deficiency was not found to be an independent risk factor for mortality.

3.
Hepatology International ; 16:S301-S302, 2022.
Article in English | EMBASE | ID: covidwho-1995892

ABSTRACT

Objectives: The present study focus on the liver-related adverse events (AEs) reported with COVID-19 vaccines in VigiBase, a database maintained by WHO for reporting adverse events. Materials and Methods: The data of liver-related adverse events following COVID-19 vaccination was acquired on a subscription basis from VigiBase. This study included all the suspected liverrelated adverse events reported in VigiBase after administering any of the three COVID-19 vaccines: Moderna, BNT162b2 Pfizer and 1222 AstraZeneca between December 15, 2020, and January 24, 2021. The MedDRA (Medical Dictionary for Regulatory Activities) and WHOART terminology- SOC (System Organ Class) and PT (Preferred Terms) were used for analysis. We extracted three SOCs - hepatobiliary disorders, gastrointestinal disorders and investigations. All the SOC were further cleaned to remove all PTs other than those related to the liver. Disproportionality analysis was reported in the form of IC025, Reporting Odds Ratio and Prevalence Odds Ratio. Results: A total of 103,954 AEs were reported for COVID-19 vaccines from 32,044 individuals, out of which only 51 (0.049%) AE from 32 patients was related to the liver. Most common liver-related AE reported were in the SOC ''investigations''- increase in alanine amino transferase (0.009%) followed by increased aspartate aminotransferase and increased bilirubin (0.006%). Based on the disproportionality analysis (IC025 values) none of them was vaccinerelated AE. Conclusion: COVID-19 vaccines are safe for liver and there was no increase in the events were associated with the use of vaccines. As these were early data of vaccine use, analysis based on recent data need to be done to ascertain it fully.

4.
Hepatology International ; 16:S301, 2022.
Article in English | EMBASE | ID: covidwho-1995875

ABSTRACT

Objectives: Remdesivir was granted emergency approval for use in the management of COVID-19 though some studies exhibit concerns regarding its effectiveness, it is still being used for COVID-19 infection management in many parts of the globe. To date, limited data is available regarding its safety as it's a newer drug. Thus there is a need to observe and record its adverse events to aid future decisions. This study was designed with the aim of analyzing the liver-related adverse drug events (ADEs) reported in VigiBase, the WHO database for adverse event reporting. Materials and Methods: The analysis of all suspected adverse events related to remdesivir reported in the last 5 years to VigiBase®, i.e. from January 1, 2015, to July 19, 2020, was performed. We used SOC (System Organ Class) information and PT (Preferred Terms) for analysis in the present study. We extracted three SOCs - hepatobiliary disorders, gastrointestinal disorders, and investigations. Descriptive statistics were reported in the form of frequency and percentages. Results: The majority of ADEs were reported from males and the majority were serious in nature. A total of 1086 ADEs were reported from the 439 individuals up to July 19, 2020, in the VigiBase®, after exclusion of duplicates1004 ADE were analyzed. out of this 18.12% (182 of 1004), ADE was related to the liver from 142 subjects. The most common ADE were alternations in the liver enzymes with Alanine aminotransferase increased 4.98% (50 of 1004), 3.19% (32 pf 1004) of increase in Aspartate Aminotransferase, and increased in transaminase increased in 2. 39% (24 of 1004). Conclusion: Deterioration of liver functions was observed with the use of remdesivir in a few patients. A thorough review of cases and proportionality analysis should be done to ascertain the causality of these adverse events as COVID-19 infection may itself leads to an increase in liver enzymes.

5.
2nd FICR International Conference on Rising Threats in Expert Applications and Solutions, FICR-TEAS 2022 ; 434:229-235, 2022.
Article in English | Scopus | ID: covidwho-1971600

ABSTRACT

Online study is not a new technology it was used since 2013 but become popular during the Corona virus. This research articles contain the study of the comparison between study through virtual platform and study by physical medium. Our study involves how the both traditions are different from each other. In this review paper we will also discuss the different online tools and methods used by the particular organisation for taking online classes. The advantage and disadvantage of online education and how it has changed the perspective of learning are also discussed. We will also discuss the importance of campus learning for improving the social skills and technical skills. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

6.
2020 National Conference on Advances in Applied Sciences and Mathematics, NCASM 2020 ; 2357, 2022.
Article in English | Scopus | ID: covidwho-1873613

ABSTRACT

Coronavirus Disease-2019 (COVID-19) pandemic discovered in 2019 was caused through Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). It is spreading rapidly as a communicable disease which has been declared as a pandemic by WHO. This virus was firstly reported in people of China who were associated with the Huanan seafood wholesale market of Wuhan. COVID-19 pandemic has challenged the lives of millions of people in India butdiabetic patients are at high risk of hospitalization and mortality during the COVID-19 pandemic. So, they need to deal effectively with the difficulty of its treatment as diabetes acts as a risk factor for the severity of this disease. This paper presents a statistical analysis of the information given by 125 diabetic patients in India. The effect of this information was determined through analysis of variance (ANOVA) using SPSS. Further, a bibliometric analysis of 51 Indian publications indexed in Scopus related to diabetic patients having COVID-19 was also conducted. The aim of this paper is to briefly study the effect of coronavirus on diabetic people as well as to study the recent research trends of present researches togive a better knowledge of COVID-19 in diabetic patients. © 2022 Author(s).

7.
Blood ; 138:4179, 2021.
Article in English | EMBASE | ID: covidwho-1736301

ABSTRACT

Introduction In sickle cell disease (SCD), the polymerization of deoxygenated HbS fundamentally alters the structure of the erythrocyte, producing the sickle cell that is characteristic of the disease. Clinical manifestations often perceived in patients suffering from SCD include vaso-occlusion, anemia, and hemolysis. Due to these sequelae, patients frequent the emergency room (ER), urgent care clinic, and hospital. Voxelotor, an oral medication approved by the Food and Drug Administration (FDA) in 2019 for the treatment of SCD, directly targets the pathophysiology of SCD by inhibiting deoxygenated HbS polymerization. Results of the Phase III HOPE trial indicate that the drug can increase hemoglobin levels and reduce markers of hemolysis as well as the incidence of worsening anemia in patients with SCD (Vichinsky et al. N Engl J Med 2019). The COVID-19 pandemic has posed several challenges for patients with SCD in 2020. Amid the pandemic, patients continued to seek out acute medical care, including care in the ER, urgent care clinics, and hospital. The aim of this study was to determine whether utilization of acute medical care differed for patients who received voxelotor before and after therapy in 2020. We also evaluated the utilization of healthcare through telemedicine platforms to facilitate access to novel therapies such as voxelotor for patients with SCD. Methods 13 patients (≥18 years of age as of January 1, 2020) with SCD who had begun treatment with voxelotor between January 1, 2020 and December 31, 2020 were included in the initial analysis. Six patients were excluded from final analysis: three discontinued treatment due to side effects, one was noncompliant with treatment, and two were lost to follow-up. Acute care utilization, measured by the number of times each patient visited the ER, urgent care clinic, and hospital was compared for each patient in the period six months prior to their first dose of voxelotor and in the period six months after their last dose of the drug in 2020 using paired t-tests and Wilcoxon matched-pairs signed rank tests. Demographic information and the type of visit at which patients agreed to proceed with voxeletor was recorded for each patient. Simple linear regressions and multiple regressions controlled for covariates, defined as sex, BMI, age, type of insurance coverage, and duration of treatment. Results All seven (100%) patients discussed voxelotor treatment with their provider during a telehealth video visit. In the period before initiating treatment, patients frequented the ER an average of 2.71 (SD=6.75) times. In the six months after their last dose, patients visited the ER less than they had in the period prior to treatment, on average 0.57 (SD=0.79) times. This difference did not achieve statistical significance (p>0.9999). The mean number of visits to the urgent care clinic in the six months before treatment was 2.71 (SD=6.75) compared to 2 (SD=4) in the period after patients' last dose in 2020. This finding was not statistically significant (p>0.9999). Hospitalizations, on average, decreased significantly from 5.14 (SD=2.34) in the six months before starting treatment to 1.57 (SD=0.98) after ending therapy for 2020 (p=0.0015). Covariates did not have an effect on the differences in acute care utilization before treatment and after last treatment in 2020. Conclusions The findings of this study imply that treatment with voxelotor was associated with a decrease in the frequency of hospitalizations for the seven patients analyzed. This finding can potentially be attributed to the efficacy of voxelotor in improving anemia and reducing complications associated with SCD. While the difference between ER visits and urgent care visits before treatment and after the last dose in 2020 did not achieve statistical significance, likely due to small sample size, the data does suggest a reduction in both outcomes. In addition, the observation that all visits in which patient and provider discussed and initiated treatment were virtual support the use of telemedicine technology o improve access to multidisciplinary care and novel therapies for SCD patients. The impact of voxelotor treatment will continue to be assessed in SCD patients at our institution, and more data from clinical encounters will lead to a greater understanding of the efficacy of voxelotor. [Formula presented] Disclosures: Jain: GBT: Speakers Bureau;Novartis: Speakers Bureau;Sanofi: Other: advisory board;Argenx: Other: advisory board;DOVA: Other: advisory board.

8.
Blood ; 138:4178, 2021.
Article in English | EMBASE | ID: covidwho-1736300

ABSTRACT

Background Sickle cell disease (SCD) is a hemoglobinopathy which manifests clinically as hemolytic anemia and recurrent episodes of pain caused by vaso-occlusion, among other symptoms. Vaso-occlusive crises (VOCs) account for an overwhelming majority of visits to the emergency room (ER) and hospitalizations for patients with SCD (Shah et al. PLoS One 2019). Upregulation of P-selectin, a cellular adhesion protein expressed on activated platelets and endothelial cells, contributes to the pathophysiology of VOCs. Crizanlizumab is a monoclonal antibody administered intravenously that inhibits the interaction of P-selectin with its ligand;it was approved by the Food and Drug Administration (FDA) as a treatment for SCD patients in 2019. In the Phase II SUSTAIN trial, crizanlizumab therapy resulted in a significantly lower rate of sickle cell-related pain crises than placebo (Ataga et al. N Engl J Med 2017). Due to their high-risk status for COVID-19, the pandemic has posed significant challenges for SCD patients to readily access healthcare, including novel therapies such as crizanlizumab. This study aimed to investigate the utility of telemedicine in facilitating access to crizanlizumab as well as compare acute medical care utilization for patients on crizanlizumab six months before initiating therapy and up to six months after their final dose in 2020. Methods All patients (≥18 years of age as of January 1, 2020) with SCD who received crizanlizumab between January 1, 2020 and December 31, 2020 at Rush University Medical Center (RUMC) were included in the final analysis. Demographic features as well as the type of visit when the patient and healthcare provider discussed crizanlizumab treatment was documented. Paired t-tests and Wilcoxon matched-pairs signed rank tests were utilized to compare acute medical care utilization - defined by the number of ER visits, urgent care visits, and hospitalizations - six months prior to initiating therapy and six months after completing the specified therapy regimen for 2020. Simple linear regression models and multiple regression models were conducted to control for sex, BMI, age, insurance, duration of treatment, and type of visit. Results A total of ten patients were included in the final analysis. Five (50%) patients first agreed to proceed with crizanlizumab therapy during a telehealth video visit with their provider, one (10%) made the decision during a telehealth phone visit, and the other four (40%) did so during a traditional office visit. 9 (90%) patients were still on crizanlizumab after June 1, 2020, the date that RUMC urgent care started seeing patients with SCD. The mean number of visits to the ER in the period before initiating therapy was 2.8 (SD=4.26) compared to 2.5 (SD=2.76) after last dose in 2020, however this finding did not achieve statistical significance (p>0.9999). Visits to the urgent care clinic, on average, increased significantly from 1.7 (SD=2.87) in the six months before initiating therapy to 8.2 (SD=11.02) in the six months after ending therapy for 2020 (p=0.0234). The mean number of hospitalizations in the period before initiating therapy was 6.6 (SD=5.19) compared to 4.6 (SD=3.44) in the period after last dose in 2020, however this was also not statistically significant (p=0.2309). None of the covariates had a significant effect on differences in acute care utilization in the period before and after therapy in 2020. Conclusion This study suggests that administration of crizanlizumab therapy did reduce hospitalization and ED visits, but the results could not achieve statistical significance due to our small sample size and short study duration. The number of urgent care visits for these patients, however, did differ significantly from the period before initiating therapy to the six months after the last dose in 2020. This finding can be attributed to the fact that due to the COVID-19 pandemic, urgent care services were made increasingly available to SCD patients beginning on June 1, 2020 to avoid admissions to the ER and hospital. Additionally, our study suggests that during the COVID-19 pandemic, telemedicine played an important role in providing health services to patients with SCD, and it could continue to improve care accessibility for SCD patients after the pandemic. Continued collection and analysis of real-world data is needed to further understand the effect of crizanlizumab therapy on utilization of acute medical care. [Formula presented] Disclosures: Jain: DOVA: Other: advisory board;Sanofi: Other: advisory board;Argenx: Other: advisory board;Novartis: Speakers Bureau;GBT: Speakers Bureau.

9.
Journal of Content, Community and Communication ; 14(8):176-187, 2021.
Article in English | Scopus | ID: covidwho-1675615

ABSTRACT

This article attempts to analyze the strategy adopted by the government of India to combat the COVID 19 pandemic, motivating people to take vaccine and addressing the issue of vaccine hesitancy. The study is based on the close review of various digital media platforms utilized by the government of India majorly the website and Facebook page of the ministry of Health and Family Welfare and awareness videos on YouTube. The results include a list of crucial gaps that have not been paid attention to or were ignored during information-based content development and dissemination via the official digital platforms. Also, a major gap was recorded in the set of information available in English, Hindi, and Vernacular languages. Vaccine hesitancy was one of the major issues during the pandemic. The study suggests that the issue of vaccine hesitancy was also under-addressed. © 2021. All Rights Reserved.

10.
International Journal of Special Education ; 37(2):69-75, 2022.
Article in English | Scopus | ID: covidwho-1661191

ABSTRACT

Digital mode of education in the post-humanist society holds huge prospects but at the same timeit poses myriad challenges.The Covid-crisis has initiated fundamental transformation in the pedagogy of Sciences and Social Sciences. These changes have become essential and inevitable in the post-pandemic era also. It is widely accepted that the future will befor the blended mode of education. The major challenges forthe developing world would be to gear up their academic institutions and train the educators to use as well as devise their teaching programme using innovative software. © 2022, International Journal of Special Education. All rights reserved.

11.
Indian Journal of Hematology and Blood Transfusion ; 37(SUPPL 1):S125, 2021.
Article in English | EMBASE | ID: covidwho-1635355

ABSTRACT

Introduction: Peripheral blood changes in Coronavirus disease 19(COVID-19) are diverse and have been reported in literature in theform of brief communications and case series with relatively smallersample size and with a handful of studies showing associationbetween peripheral blood smear (PBS) and clinical severity of thedisease.Aims &Objectives: To highlight the numerical and morphologicalchanges in COVID-19 patients and to compare the same in IntensiveCare Unit (ICU) and non-ICU settings as well as between COVID-19survivors and deceased patients.Materials &Methods: This cross-sectional study included 80COVID-19 positive (41 ICU and 39 non-ICU) patients and 32COVID-19 negative ICU patients, done in Department of Pathology,ABVIMS &Dr RML Hospital, New Delhi from December 2020 toFebruary 2021. Complete blood counts (CBC) and PBS findings werestudied and scored by two pathologists blindfoldedly.Result: Among CBC parameters, absolute lymphocyte count (ALC)and absolute eosinophil count (AEC) were significantly lower inCOVID-19 positive cases as compared to COVID-19 negative group(p = 0.001 &p = 0.001). On PBS, COVID-19 positive group showedsignificant left myeloid shift (p = 0.021), Dohle bodies (p = 0.025)with significant prominence of acquired pseudo pelger-huet anomaly,ring shaped neutrophils, monolobulate neutrophils and plasmacytoidlymphocytes as compared to control group (p = 0.000, p = 0.009,p = 0.046 &p = 0.011 resp). The overall mean White blood cell(WBC) counts were higher in COVID-19 positive ICU patients ascompared to non-ICU COVID positive patients with significant shiftto left (p = 0.017). Ring shaped neutrophils, monocyte vacuolationand large granular lymphocyte (LGL) were significantly higher inCOVID-19 positive ICU patients as compared to non-ICU patients(p = 0.007, p = 0.008 &p = 0.004 resp). Deceased group (14/39 ICUCOVID positive cases) showed significantly high WBC count(p = 0.018) with marked neutrophilia (p = 0.024) and toxic granulation (p = 0.01) and prominence of monocyte vacuolization, ringshaped neutrophils, large granular lymphocytes and reactive lymphocytes as compared to survivor.Conclusions: Morphological parameters like myeloid left shift, ringshaped neutrophils, monocyte vacuolation, LGLs and reactive lymphocytes emerged as highly sensitive markers of COVID-19 diseaseseverity. Therefore, serial CBC with comprehensive PBS analysisshould be done in every newly diagnosed hospitalized COVID-19patients to potentially predicts the course of disease and its clinicaloutcome.

12.
Gastroenterology ; 160(6):S-846-S-847, 2021.
Article in English | EMBASE | ID: covidwho-1596925

ABSTRACT

Background The Coronavirus 2019 (COVID-19) pandemic has posed significant challenges in the management of liver disease. Missed or delayed diagnosis of hepatocellular carcinoma (HCC) is anticipated due to discontinuity in standard surveillance protocols during the pandemic, though no large studies have documented the same. We attempted to study the baseline characteristics and outcomes in patients hospitalized with alcohol related hepatitis (AH), before and after the COVID-19 outbreak, and analyze the impact of COVID-19 on outcomes including diagnosis of HCC and inpatient mortality. Methods A federated cloud-based network (TriNetX) data from fifty health care organizations across the globe was analyzed retrospectively. Patients admitted with AH between January 2019 and December 2020 were studied. They were categorized into two groups including post-COVID outbreak (group 1, January 1st, 2020 to December 1st, 2020) and pre-COVID outbreak (group 2, January 1st, 2019 to December 1st, 2019). Patient characteristics and outcomes related to hospitalization were compared between these groups. Results Of 23,201 patients studied, 4,383 patients were included in group 1, and 18,818 in group 2. The two groups had comparable demographic features and occurrence of other comorbid diseases (table 1), none of them had a COVID-19 diagnosis. After propensity matched analysis, we found that group 1 (post-COVID group) had a tendency to have higher total bilirubin levels (p=0.05) during hospitalization. Similarly, the post-COVID group had a higher proportion of patients with underlying cirrhosis (p=0.02). Patients had a similar course during hospitalization among most of the variables compared among the two groups except the occurrence of hepato-renal syndrome (higher in the post-COVID group, p<0.001). Among the outcome variables studied, post-COVID group had an increased occurrence of HCC (Odds Ratio [OR]=1.19, CI=1.08-1.32, p<0.001), however occurrence of ascites (OR= 0.72, CI=0.45-1.17, p=0.18), hepatic encephalopathy (OR=0.74, CI=0.49-1.11, p=0.15), need for steroid use (OR=1.13, CI=0.91-1.41, p=0.24) and inpatient death (OR=0.93, CI= 0.72-1.20, p=0.59) were comparable among both groups. Conclusion Patients hospitalized with AH after the COVID-19 outbreak appear to have a higher occurrence of HCC and hepato-renal syndrome, though the occurrence of ascites, hepatic encephalopathy, need for steroid therapy and overall mortality did not change. This may indicate decreased outpatient diagnosis of HCC, likely from delay or discontinuity in standard HCC surveillance as a result of the COVID-19 outbreak. (Table presented.)

13.
Iranian Journal of Microbiology ; 13(6):748-756, 2021.
Article in English | Web of Science | ID: covidwho-1576635

ABSTRACT

Background and Objectives: The entire globe is undergoing an unprecedented challenge of COVID-19. Considering the need of rapid and accurate diagnostic tests for SARS-CoV-2, this study was planned to evaluate the cost effective extraction free RT-PCR technique in comparison to the standard VTM based RT-qPCR method. Materials and Methods: Paired swabs from nasopharynx and oropharynx were collected for SARS-CoV-2 testing, from 211 adult patients (>= 18 years) in VTM and plain sterile tubes (dry swabs). These samples were processed and RT-qPCR was carried out as per standard protocols. Results: 54.5% of the patients were females and 45.5% were males with sex ratio 1:1.19 (M: F). 38.86% were symptomatic, of which fever (86.59%), cough (79.23%) and breathlessness (46.34%) were the most common symptoms. The positivity by VTM based method and index method was 31.27% and 13.27% respectively. Of the 27 inconclusive results from index method, 37.04% were positive, 48.15% were negative by VTM based method. However, in 40 inconclusive results by VTM based method, 90% were negative and rest remained inconclusive by index method. The sensitivity and specificity of the index method were 39.39% and 85.71% respectively. The overall agreement between VTM based method and index method was 49.59% with estimated Kappa value of 0.19. Conclusion: VTM based method showed higher sensitivity compared to the index method. The higher positivity by VTM based method, suggests that VTM based method could plausibly be a better detection method of SARS-CoV-2. Still, the index method might add value in a resource limited setups for detection of SARS-CoV-2.

14.
Critical Care ; 25(1):2, 2021.
Article in English | Web of Science | ID: covidwho-1576486
15.
Journal of Pediatric Gastroenterology and Nutrition ; 73(1 SUPPL 1):S273-S274, 2021.
Article in English | EMBASE | ID: covidwho-1529340

ABSTRACT

Background: The global COVID-19 pandemic forced the abrupt transition of in-person clinic visits to a virtual care platform in the Home Parenteral Nutrition (HPN) Program. Remote patient monitoring technology (TytocareTM) allows for accurate and validated vital sign and nutritional assessment by the caregiver which is shared asynchronously or in real-time with medical providers. This novel FDA-approved device provides high quality data, facilitates precise clinical diagnosis and requires caregiver training and participation. Without remote patient monitoring, accurate nutritional assessments during virtual visits are challenging. The implementation process of this novel device after a 6-month pilot period was investigated. Methods: Tytocare™ (TytoHome™kits, weight scales, pulse oximeters and blood pressure machines) devices (Figure 1) were provided through a Federal Communication Commission grant funding the employment of telemedicine services during the COVID-19 pandemic. 139 devices were deployed to all patients in the HPN program through mail or clinic visit/hospital distribution. 21 Tytocare™devices were returned or not accounted for due caregivers not yet reporting to have received the device (n=10), caregiver opt-out (n=4), discharge from the HPN program (n=3), repatriation (n=2), prolonged inpatient admission (n=1) and death (n=1). From November 2020 through May 2021, 97 unique Tytocare™visits were completed. Patients/caregivers were trained on how to use the TytoCare™app with their device. Patients either saw a provider online in a real-time virtual visit or submitted a TytoCare™exam asynchronously in preparation of their scheduled virtual clinic visit. Assessments included weight, pulse oximetry, heart rate, respiratory rate, blood pressure and temperature. Precise photographs of key components of the examination of a patient with intestinal failure on HPN were sent, including central venous catheter (CVC) dressings, CVC insertion sites, skin rashes and enteral tube sites. A 10-question patient experience survey was emailed to the 118 caregivers with active devices after 6 months of device deployment. Results: 85% (n=118) of patients in our HPN program reported use of the Tytocare™device during or prior to telehealth visits. Patient age ranged from 5 months to 34 years old. Of the nine responses received, results were overall favorable. The average was 7.22 for patient satisfaction (ten-level Likert scale;1 = extremely unsatisfied, 10 = extremely satisfied). 0 disagreed with the statement regarding the Tytocare™device being helpful for patient care management (five-level Likert scale;1 = strongly agree, 5 = strongly disagree) and the average for recommending the device to others was 7.56 (ten-level Likert scale;1 = extremely unlikely, 10 = extremely likely). Conclusion: With the assistance of the Innovation and Digital Health Accelerator team, the HPN program successfully and promptly implemented a remote patient monitoring program to complement our telehealth platform. The ability to utilize Tytocare™during the global COVID-19 pandemic was well-received by caregivers of patients requiring home parenteral nutrition. Of the survey responders, caregiver satisfaction and experience were favorable. However, the data presented may not be a true representation of overall impressions given the limited response rate. Future studies will investigate the feasibility, accuracy and impact of remote patient monitoring in complex pediatric populations and will focus on improving patient experience survey response rates.

16.
Hepatology ; 74(SUPPL 1):382A, 2021.
Article in English | EMBASE | ID: covidwho-1508764

ABSTRACT

Background: The suitability of teleconsultation is crucial for the effective delivery of health care services. Therefore, we evaluated the factors determining the suitability of teleconsultations for hepato-biliary diseases during the COVID-19 pandemic. Methods: In a prospective study conducted between March 2020 and January 2021, we asked the hepatologists delivering the tele-consultations in a tertiarycare center to fill a pre-validated questionnaire to assess the suitability of the given consult in real-time. The patient's sociodemographic and clinical details were noted. Patients were interviewed telephonically seven days after the consultation, and the level of understanding and hospitalization rate was assessed. A consult was deemed suitable when the physician reported its suitability in the absence of hospitalization. Factors determining the suitability of tele-consultations were evaluated on univariable analysis and machine learning models such as decision tree and extreme gradient boosting (XGB). Results: Of 1419 registrations, 1118 (87.2%) patients with male-gender (71%), age of 46 years (IQR: 18-68), and a rural background (72.7%) were analyzed. On univariable analysis, patients with skilled occupation, higher education, paying status, hepatitis B, C, and non-alcoholic fatty liver disease (NAFLD) were likely to be suitable (p<0.05). Patients with cirrhosis (compensated or decompensated), acute-on-chronic liver failure (ACLF), and biliary obstruction were likely unsuitable (p<0.05). A decision tree was developed from the significant variables on univariable analysis and important variables derived from the XGB-model. Patients with compensated cirrhosis who were educated or involved in a skilled occupation with an age of <55 years had a probability of 78% towards suitability. Hepatocellular carcinoma, decompensated cirrhosis, and ACLF patients were unsuitable with a probability of 60-95%. In non-cirrhotic liver diseases, hepatitis B, C, NAFLD were suitable with the probability of 89.7%. Extrahepatic biliary obstruction and previous failure of teleconsultation were unsuitable with a probability of 70%. Other tropical illnesses, extrahepatic portal venous obstruction, noncirrhotic portal fibrosis, dyspepsia, dysphagia not requiring any intervention were suitable with a probability of 88%. Conclusion: A simple decision tree can reliably guide physicians for conducting tele-consults for hepatobiliary diseases during the COVID-19 pandemic and beyond.

17.
Drugs Today (Barc) ; 57(10): 631-637, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1496316

ABSTRACT

At the 57th Global Annual Meeting of the Drug Information Association (DIA), attendees met virtually for the second time to support the theme of 'Collaboration without Boundaries.' Sessions included presenters and speakers from regulatory agencies, patient advocacy and academia, with patients at the forefront of discussions. This report covers a number of presentations and panel discussions from the 4-day meeting that primarily focused on the COVID-19 global pandemic.


Subject(s)
COVID-19 , Pharmaceutical Preparations , Humans , SARS-CoV-2
18.
International Journal of Customer Relationship Marketing and Management ; 13(1), 2022.
Article in English | Scopus | ID: covidwho-1481072

ABSTRACT

This study investigates the mediated moderating relationship of self-concept clarity, materialism, and social consumption motivation in the context of COVID-19 pandemic based on the terror management theory. The findings suggest that Malaysian consumers have high self-concept clarity about their materialistic orientation. This materialistic orientation may be of hedonistic-utilitarian nature that is internally directed for self-satisfaction and not exclusively directed externally in material consumption to portray an image to others. Furthermore, this study posits that cultural factors like collectivism and uncertainty avoidance delimits the applicability of terror management theory in Malaysia, suggesting that the development of the theory draw heavily from Western ideology of individualism not directly relevant in the Asian context. Finally, this study offers an understanding of the self-concept clarity from the Asian context, addressing the appeal by Dunlop to investigate the construct of self-concept clarity particularly in non-Western context. Copyright © 2022, IGI Global.

19.
Expert Systems ; : 19, 2021.
Article in English | Web of Science | ID: covidwho-1467545

ABSTRACT

The latest epidemic of COVID-19 has significantly impacted both human capital and the global economy, contributing to pandemics and severe global crises. Research into the creation and propagation of the disease is desperately needed. The Internet of Things, cloud computing, and artificial intelligence offer modern technology for real-time processing for multiple applications such as healthcare applications, transport, traffic control, and so on blockchain is an evolving technology that will dramatically boost transaction protection in finance, supply chain, and other transaction networks. A stable and latency-sensitive Quality of Service framework for COVID-19 is the need of an hour. The purpose of this paper is to combine Fog computing and Artificial Intelligence with smart health to establish a reliable platform for early-stage detection of COVID-19 infection. A new ensemble-based classifier is proposed to detect COVID-19 patients. This research offers a blockchain platform to analyse how the unrelated cases of the COVID-19 virus can be tracked and identified using peer-to-peer, time stamping, and the shared storage advantages of blockchain. In addition to growing patient loyalty, this would effectively enhance the consistency, flexibility, productivity, performance, and effectiveness of healthcare services. The idea of blockchain is used to establish security for the whole framework. Different implementations measure the efficiency of the suggested system. The performance of the proposed framework is evaluated in terms of delay, network usages, RAM usages, and energy consumption. On the other hand, the classifier is evaluated in terms of classifier accuracy, recall, precision, kappa static, and root mean square error. The result shows the performance of the proposed framework and classifier is always better than the traditional frameworks and classifiers.

20.
Journal of Applied Pharmaceutical Science ; 11(8):1-9, 2021.
Article in English | CAB Abstracts | ID: covidwho-1456485

ABSTRACT

The emergency approval of a few COVID-19 vaccines provided a ray of hope to fight the deadly pandemic. However, their approval was solely based on limited data from the clinical trials in a short period, thereby imposing a demand for post-marketing surveillance studies to monitor beneficial and adverse events (AEs). This study focuses on observing the serious adverse events (SAEs) data reported in the World Health Organization database. The data from VigiBaseR was analyzed. The duplicates in the data were removed and analyzed based on age, gender, and SAEs at the system organ classification level and the individual preferred term level. A total of 103,954 AEs were reported. The majority of them were seen as females (80%), from Europe (83%), and were between 18 and 64 years (80.74%) of age. The most-reported AEs were of the nervous system (19.1%), musculoskeletal (11.2%), and elderly (>65 years) people. The reported SAEs from the COVID-19 vaccines were in line with the data published in the clinical trial reports. These SAEs to vaccines will need causality analysis and review of individual reports.

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