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1.
Critical Care (London, England) ; 27(1):3, 2023.
Article in English | MEDLINE | ID: covidwho-2196401

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a frequent and severe complication of both COVID-19-related acute respiratory distress syndrome (ARDS) and non-COVID-19-related ARDS. The COVID-19 Critical Care Consortium (CCCC) has generated a global data set on the demographics, management and outcomes of critically ill COVID-19 patients. The LUNG-SAFE study was an international prospective cohort study of patients with severe respiratory failure, including ARDS, which pre-dated the pandemic.

2.
Indian Journal of Medical Microbiology ; 41:19-24, 2023.
Article in English | EMBASE | ID: covidwho-2179612

ABSTRACT

Purpose: Antimicrobial resistance [AMR] has emerged as a global and national priority and establishing an effective surveillance system for antimicrobial resistance is an essential prerequisite for generating evidence for informed policymaking at both national and state levels. Method(s): Twenty-four laboratories were enrolled after assessment in the WHO-IAMM Network for Surveillance of Antimicrobial Resistance in Delhi [WINSAR-D]. The NARS- NET standard operating procedures were adopted along with its priority pathogen lists and antibiotic panels. The members were trained to use WHONET software and monthly data files were collected, collated, and analyzed. Result(s): Multiple logistic issues such as procurement, erratic supply of consumables, non-availability of standard guidelines, lack of automated systems, high workload and low manpower were reported by the majority of member laboratories. Microbiological challenges such as differentiation between colonization and pathogen in absence of patient details, lack of confirmation of resistance, identification of isolates and lack of dedicated computer and genuine windows software for data were common to most laboratories. The total number of isolates of priority pathogens in 2020 was 31,463. Of these, 50.1% isolates were from urine 20.6% were from blood and 28.3% were from pus aspirate and other sterile body fluids. High levels of resistance were observed for all antibiotics. Conclusion(s): There are many challenges in generating quality AMR data in lower-middle-income countries. There is a need for resource allocation and capacity building at all levels to ensure the collection of quality assured data. Copyright © 2022 Indian Association of Medical Microbiologists

4.
Medical Journal of Dr. D.Y. Patil Vidyapeeth ; 15(4):487-493, 2022.
Article in English | Scopus | ID: covidwho-1954410

ABSTRACT

Coronavirus disease-2019 (COVID-19) was announced as a global pandemic by the World Health Organization on March 11, 2020 due to its rapid spread and multinational involvement. Operating room preparedness in these times should encompass increased vigilance, protective measures, and alternative procedures in an effort to mitigate the spread from a proven or suspected case. Specifically, by reducing aerosol-generating procedures as in general anesthesia, anesthesiologists can decrease exposure to patient's respiratory secretions and transmission of virus to the health-care professional and other patients. The Interoperability Standards Advisory in its advisory has also recommended regional anesthesia over general anesthesia as one of the steps that can reduce aerosol spread. Further, to restrict airway manipulation, peripheral nerve blocks (PNB) should be considered whenever possible in suspected or confirmed cases of COVID-19 undergoing surgery. PNB has the advantage of maintenance of respiratory functions, prevention of aerosolization, and so preventing viral transmission. This article explores the practical information and suggested measures for conducting PNB in COVID-19 patients with suggestions toward resource planning, clinical environment modification, equipment preparation, supply of drugs, choosing of correct personal protective equipment, safe PNB procedures, anesthesia monitoring, and postanesthetic care. By addressing these issues, infection control during anesthesia can be achieved and which is essential in the present era with emerging infection and novel pathogens such as coronavirus 2 causing the severe acute respiratory syndrome. Thus, framing a structured protocol for PNB among these patients is essential for the best perioperative outcome. © 2022 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow

5.
Natural Products Journal ; 12(6):2-11, 2022.
Article in English | EMBASE | ID: covidwho-1938560

ABSTRACT

Since the initial outbreak in December 2019, the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to more than 3 million deaths worldwide. There is an urgent need for developing a potential therapy against SARS-CoV-2. Exploring the potentials of phytochemicals towards inhibition of SARS-CoV-2 proteins remains of significant scientific interest. The therapeutic values of phytochemicals in the treatment of diseases, such as viral infections, are known for a long time. In this review, we present a brief overview of the past experimental and computational efforts on evaluating phytochemicals against SARS coronaviruses, an earlier coronavirus strain. We discuss natural metabolites of different structural and chemical scaf-folds, including polyphenols, flavonoids, and phytosterols, which can be promising compounds for screening against the currently evolving SARS-CoV-2 virus.

6.
International Journal of Engineering Trends and Technology ; 70(5):185-193, 2022.
Article in English | Scopus | ID: covidwho-1879671

ABSTRACT

The Internet has become an essential part of life, especially after the COVID-19 pandemic. The increasing use of technology brings new challenges. Cyber security has emerged as a major threat during the pandemic. Distributed Denial of Service Attack (DDoS) attacks have become more refined than other cyber-attacks during the pandemic. The most important question comes into mind: What is the source of the DDoS attack? The answer is botnet which provides the platform for the attacker. A botnet has targeted the escalation of vulnerable systems. Therefore, real-life and accurate botnet detection and prevention techniques must be effectively designed. Due to this organized dataset, IoCs are required for a most dangerous botnet to prevent networks at an early stage. Various malware datasets have been published for the research work, but most are outdated. The author has proposed a new dataset of windows based botnets using different analysis techniques. This work provides the geolocation of the live malicious connection made by emotet. They have also presented the mechanism which calculates the IP reputation and detects botnet based on IoCs using snort Intrusion Detection. © 2022 Seventh Sense Research Group®

7.
Journal of Investigative Medicine ; 70(2):698, 2022.
Article in English | EMBASE | ID: covidwho-1700388

ABSTRACT

Purpose of Study Initially detected in Wuhan, China, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which is responsible for coronavirus disease 2019 (COVID-19) rapidly became a global pandemic. Immunocompromised patients, including kidney transplant recipients, are at increased risk of morbidity and mortality but granular data from transplant centers such as ours serving a majority- minority and rural population are still scant. We aim to describe the impact of COVID-19 in our unique cohort of transplant patients. Methods Used During the pandemic, all transplant patients followed up at our center with reported COVID-19 were included in a registry. A case series of 136 patients drawn from this registry were included in this preliminary analysis spanning the period of March 2020 to March 2021. Statistical analysis was performed with R. Summary of Results The characteristics of our patients were: 54% male, 53% Black, 40% White, Median age 53 years, Median BMI 31, 47% were diabetic, 96% had hypertension, 16% had coronary artery disease. Median time after transplantation was 6.2 years (range 4 days to 37 years), 61% had thymoglobulin induction and almost uniformly were on tacrolimus, mycophenolate and prednisone. Baseline median creatinine 1.3 mg/dl and urine protein to creatinine ratio 0.18 g/g. The most commonly reported symptoms were fever (51%) dyspnea (48%), fatigue (46%) and myalgia (31%). 49% were hospitalized of whom half required ICU care. 82% of ICU patients were on ventilator support. 45% of patients had AKI, 7% required dialysis. 35% of patients required oxygen. There were 6 graft losses (4%) and 26 deaths (19%). Immunosuppression was reduced in most patients with antimetabolite reduction in 54%, and calcineurin inhibitor reduction in 44%. Treatments included dexamethasone (31%), and remdesivir (21%, convalescent plasma (6%), and monoclonal antibodies (4%). Creatinine and proteinuria post-COVID remained stable (1.4 mg/dl and 0.17 g/g respectively). 118 patients were followed up in clinic post-COVID and of these 15% reported continued severe COVID symptoms. On univariate analysis, age, race, gender, ABO blood type, diabetes status, cardiovascular disease, induction, time from transplant, baseline creatinine, proteinuria, baseline immunosuppression regimen, ACEi or ARB use, and reported symptoms (except for dyspnea) were not associated with risk of death. On multivariate analysis, ICU admission and need for dialysis were strongly predictive of death. Conclusions Despite serving a large rural population with a high burden of comorbidities, patient outcomes following COVID infection from our study are similar to other singlecenter and multi-center reports. As expected, the mortality rate in our cohort is much higher than the general population with high rates of hospitalization and need for ICU care. Aside from a significant minority, most patients recovered well and had stable renal allograft function. Our study is limited by its retrospective nature and risk of reporting bias.

8.
American Journal of Respiratory and Critical Care Medicine ; 203(9):1, 2021.
Article in English | Web of Science | ID: covidwho-1407304
9.
Medical Science ; 25(114):1878-1881, 2021.
Article in English | Web of Science | ID: covidwho-1372330

ABSTRACT

The coronavirus disease resulted by infection with severe acute respiratory syndrome-Coronavirus 2 (SARS-CoV-2) was initiated in China in during the end of 2019 and spread exponentially as a global health Pandemic. The current pandemic (COVID-19) caused by SARS-CoV-2 novel coronavirus lead to high mortality and morbidity in terminally ill patients. We present a link between maternal severe acute respiratory syndrome-Coronavirus 2 (SARS-CoV-2) infections in the peripartum period and rapid maternal deterioration with coagulopathy. Also, we wish to draw attention towards the overlap which is significant between the clinical findings of COVID19 and HELLP Syndrome along with importance of persistence of inflammation over 3 months after COVID19 known as "Long COVID".

10.
Current Nutrition & Food Science ; 17(7):699-707, 2021.
Article in English | Web of Science | ID: covidwho-1370972

ABSTRACT

Background: Insects have formed a part of the human diet since pre-historic times. Entomophagy has garnered recent attention due to its increased role in food security as nutrient-rich alternatives of conventional livestock. Methods: We have made an effort in this paper to study the edible insect composition of Manas National Park, a UNESCO Natural World Heritage Site and Biosphere Reserve, located in the In do-Burma biodiversity hotspot of Southern Asia. Edible insect variety was determined through a field reconnaissance while the nutrient composition (macronutrient and micronutrient) of each edible insect species was computed through biochemical analyses with a view to explore the possibility of promoting them as food/feed or as a base for nutritive products. We conducted nutrient profiling using the Nutrient Value Score (NVS) model and UK Ofcom nutrient profiling (NP) model. Results: Hymenoptera and Orthoptera were found to be the dominant orders with 4 species each, followed by Hemiptera with 3 species, Lepidoptera with 2 species, Mantodea, Blattodea and Coleoptera with 1 species each. The nutrient analysis shows that insects have a rich nutrient composition that is comparable with typical livestock. Conclusion: As realised during COVID-19, insects may prove to be an alternative, sustainable, and cheaper sources of nutrients necessary for ensuring global food security.

11.
Medical Science ; 25(113):1517-1521, 2021.
Article in English | Web of Science | ID: covidwho-1335696

ABSTRACT

Features of unilateral cranial nerve 7th lower motor neuron palsy and same sided 6th nerve involvement without hemiplegia or hemiparesis is a rare clinical entity in itself, which is referred to as Facial Colliculus Syndrome. This presentation was noticed in a patient of Covid 19 positive status and mucormycosis not on prolonged steroid treatment. This is a case report of an 80-year old female patient who was admitted to the medical ward of our hospital with presenting complaints of breathlessness and fever of 5 days duration. Later during course of the disease on followup in hospital she developed left sided 6th and 7th cranial nerve involvement. This case report highlights the case of an elderly female patient presenting with cranial nerve involvement with mucormycosis with covid 19 superinfection on follow-up after home quarantine.

12.
Medical Science ; 25(112):1402-1406, 2021.
Article in English | Web of Science | ID: covidwho-1292514

ABSTRACT

Since 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV2) has led to major impact on both the physical as well as mental health. Although the health care facilities aim to provide treatment for the respiratory, cardiovascular as well as neurological manifestations, its huge impact on the mental wellness of patients is somewhat neglected. Perinatal depression is a commonly encountered psychological disorder. Various factors can aggravate or trigger post-partum depression. COVID-19 is one of such triggers. There is microglial cell activation leading to neuroinflammation along with Hypothalmo-pituitary Axis Dysfunction in COVID-19 leading to neuropsychiatric manifestations. Also similarity in genes for Angiotensin Convertase Enzyme 2 and Dopa Decarboxylase leads to reduction in Dopamine and Serotonin in COVID-19 patients leading to Depression. While complications like HELLP Syndrome and Intra Uterine Death remain well reported in association with COVID-19, Post-Partum Depression remains an underreported post COVID sequalae. Thus, we report a case series of COVID-19 positive pregnant patients who suffered from postpartum depression later as a Post COVID sequalae and were successfully treated with antidepressants and cognitive behavioral therapy preventing any complications.

13.
Medical Science ; 25(112):1417-1421, 2021.
Article in English | Web of Science | ID: covidwho-1292471

ABSTRACT

Since the December of 2019 there has been an increase in reporting of cerebrovascular events in patients infected with COVID-19. Though it is a common complication which is encountered mostly in the old age it is rare to witness the same in young patient in the absence of prior risk factors. We report a rare case of a young patient with COVID-19 postivie status who presented with a hyper acute infarct in left caudate nucleus, Lenti from nucleus, internal capsule, insular cortex, temporal lobe, parieto-occipital region, focal areas in frontal region and was immediately posted for thrombectomy. The patient improved drastically post procedure. Therefore we highlight the importance of contemplating the differential of stroke induced by COVID-19 even in young patients who present with symptoms consistent with a stroke in the ongoing pandemic.

14.
Medical Science ; 25(112):1413-1416, 2021.
Article in English | Web of Science | ID: covidwho-1292441

ABSTRACT

Ever since its emergence Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV 2) has caused an enormous amount of morbidity and mortality. Pregnancy being a high risk state is also being affected by this lethal pandemic causing an increased risk of rising maternal mortality. The treatment strategies for managing COVID-19 in pregnant female remains limited with no definite treatment available. With the growing evidence of Lymphocytopenia in COVID-19 there has been a emergence of immunoglobulin (IVIg) as a relatively safe treatment option in immunodeficient states such as pregnancy. Though research remains limited in the aspect of immunoglobulin therapy in pregnancy a risk versus benefit ratio might allow use of immunoglobulin therapy. We present a case of COVID-19 associated cytokine storm with lymphocytopenia in a Pregnant female which was successfully treated with immunoglobulin therapy.

15.
Economic and Political Weekly ; 56(24):28-38, 2021.
Article in English | Scopus | ID: covidwho-1281161

ABSTRACT

Micro, small, and medium enterprises contribute a third of India's gross domestic product and provide employment to over 110 million workers. Using a mixed methods design to ascertain the level of sectoral distress at the peak of the nationwide lockdown in May 2020, we found production falling from an average of 75% of capacity to just 13%. On an average, fi rms retained only 44% of their workforce, and 69% of fi rms reported inability to survive longer than three months. Distress measures were more severe for smaller fi rms by employment size. © 2021 Economic and Political Weekly. All rights reserved.

16.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277706

ABSTRACT

Introduction: Anticoagulation in COVID-19 induced hypercoagulable state remains to be balanced with bleeding complications. Spontaneous muscle hematomas (SMH) often occur in the rectus sheath or gluteal muscles. Risk factors include trauma, increased abdominal pressure, anticoagulation, and hypertension. We describe two cases of non-iatrogenic SMH in therapeutically anticoagulated COVID-19 patients. Case Report: 1. 64 year old Caucasian male with ARDS due to COVID-19 was treated with mechanical ventilation, proning, methylprednisolone, tocilizumab (TOZ), and azithromycin/hydroxychloroquine. Right popliteal-posterior tibial vein DVT led to full anticoagulation (FA) with enoxaparin. Later the hemoglobin dropped (12.2 to 6.1 g/dl). Imaging showed SMH in the left posterolateral chest wall and gluteus minimus requiring blood transfusions and cessation of FA. D-dimer was 1.2 μ g/ml. A week later, imaging showed increased hematoma size in the left chest wall and right gluteal area. After hemoglobin stabilized, he was started on DVT prophylaxis. He required tracheostomy/PEG tube and placement in a long term acute care (LTAC) facility where he had decannulation and PEG tube removal. Patient recovered fully and is home with normal function. 2. 27 year old Caucasian female with sepsis due to COVID-19 was treated with mechanical ventilation, dexamethasone, TOZ, convalescent plasma, colchicine, and remdesivir. D-dimer was 1.6 μ g/ml and FA was started with enoxaparin. After intubation, hemoglobin dropped (11-6.9 g/dl). Imaging showed SMH in left biceps and pectoralis. Decreased radial pulse and increased capillary refill time with enlarging forearm hematoma prompted arterial US and CT angiogram. No flow was seen in the distal left upper extremity. Fasciotomy of the left forearm and carpal tunnel was performed with adequate perfusion of radial and ulnar arteries. Debridement was required for the non-viable flexor carpi radialis, flexor digitorum superficialis and flexor digitorum profundus. Patient was extubated and did well thereafter. Discussion: Thrombosis contributes much to the morbidity and mortality in COVID-19 patients. In a recent Veterans Health Administration study, deep vein thrombosis, pulmonary embolism, and cerebral ischemia/infarction comprised 9.3% of these patients. Despite the study's limitations, HESACOVID has shown that therapeutic enoxaparin is associated with fewer days on the ventilator and large reductions in D-dimer levels. Monitoring for SMH should be routinely performed on these patients. Research on optimal anticoagulation is necessary to assess the risk/benefit in this population. The bleeding risks are however less likely to cause mortality or disability as compared to the coagulation problems.

17.
Medical Science ; 25(112):1281-1285, 2021.
Article in English | Web of Science | ID: covidwho-1265279

ABSTRACT

COVID-19 has increased incidence of thrombotic incidents due to its pro thrombotic state. Ever since the initiation of this pandemic in 2020, there has been an increased mortality due to complications arising due to COVID-19 infection. One of the leading causes of mortality in COVID-19 patients besides the respiratory distress has been myocardial infarction. In the discussion of Acute Myocardial Infarction, posterior wall myocardial infarction has always been difficult to diagnose. It is a challenging to diagnose as well as manage Posterior Wall myocardial infarction which is often missed on routine electrocardiogram in the emergency department. We report a case of a young female aged 32 year old who presented with COVID-19 induced Posterior Wall myocardial infarction. Though the cases of myocardial infarction in people with prior comorbidities and in older age group are common this a rare case report show casing a young female who developed myocardial infarction which later turned out to be posterior wall myocardial infarction induced by COVID-19.

18.
Medical Science ; 25(111):1183-1187, 2021.
Article in English | Web of Science | ID: covidwho-1250768

ABSTRACT

Singultus are involuntary manoeuvre that involve the reflex arc of swallowing and can be further divided into acute singultus (<48 hours) or persistent singultus (>48hours). We present a case series of three patients of different age groups who presented with the chief complaint of persistent hiccup not responding to treatment. Other than Hiccup which was episodic physical examination of the patient were unremarkable. However, Reverese Transcriptase Polymerase Chain Reaction for COVID-19 was Positive and High-Resolution CT Scan of the Chest was able to demonstrate Ground Glass Opacities scattered throughout the lung. The patients did not respond to primary treatment for hiccups and were treated with antiviral and other supportive measures. All the three patients recovered and were later discharged in stable condition. Thus, this case series showcases the importance of keeping COVID-19 as an important differential diagnosis of persistent hiccup to be prompt in reaching the diagnosis in this atypical presentation but to also be vigilant of unexpected exposure for the physician himself.

19.
Economic and Political Weekly ; 55:24, 2020.
Article in English | GIM | ID: covidwho-826836

ABSTRACT

Novel disease outbreaks have a history of ravaging the regional economies. The world economy has taken a massive hit due to COVID-19 and is expected to go into a recession by the next quarter. As such, it has become highly imperative to invest in total epidemic preparedness involving health and non-health interventions, research and development as well as capacity building at all levels.

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