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1.
Turk J Anaesthesiol Reanim ; 50(4): 255-260, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-2025088

ABSTRACT

OBJECTIVE: Intubation is a highly aerosol-generating procedure. Recent airway management guidelines advocate the use of appropriate personal protective equipment, videolaryngoscope, and "intubation box" while intubating a suspected or infected coronavirus patient. We undertook a study to compare C-MAC videolaryngoscope with McGrath videolaryngoscope for tracheal intubation using an intubation box by donned anaesthesiologists. METHODS: The patients were randomly allocated to 2 groups by computer-generated random numbers, depending upon the videolaryngoscope used. In group C, C-MAC videolaryngoscope (n=30) was used, whereas McGrath videolaryngoscope was used in group M (n=30). The primary outcome was the total time required for successful intubation. The secondary outcomes included the number of attempts required, Cormack and Lehane grade, the percentage of glottis opening score, the difficulty faced while using the device, and the user's preference. RESULTS: The time to intubation was 57.17 ± 19.98 seconds with C-MAC videolaryngoscope as compared to 57.93 ± 14.92 seconds with McGrath. Both the devices had a good percentage of glottis opening score. Twelve patients in each group were found to have a Cormack and Lehane grade of 1. The time to glottis visualization was more with McGrath than with C-MAC although not significant (23.8 ± 14.03 vs 20.10 ± 10.78 seconds). Both the devices were easy to use. CONCLUSIONS: Both C-MAC and McGrath videolaryngoscopes are equally effective devices for intubation by a donned anaesthesiologist using an intubation box. McGrath with a disposable blade should be preferred for intubation in these conditions.

2.
Kotanidis, Christos P.; Xie, Cheng, Alexander, Donna, Rodrigues, Jonathan C. L.; Burnham, Katie, Mentzer, Alexander, O’Connor, Daniel, Knight, Julian, Siddique, Muhammad, Lockstone, Helen, Thomas, Sheena, Kotronias, Rafail, Oikonomou, Evangelos K.; Badi, Ileana, Lyasheva, Maria, Shirodaria, Cheerag, Lumley, Sheila F.; Constantinides, Bede, Sanderson, Nicholas, Rodger, Gillian, Chau, Kevin K.; Lodge, Archie, Tsakok, Maria, Gleeson, Fergus, Adlam, David, Rao, Praveen, Indrajeet, Das, Deshpande, Aparna, Bajaj, Amrita, Hudson, Benjamin J.; Srivastava, Vivek, Farid, Shakil, Krasopoulos, George, Sayeed, Rana, Ho, Ling-Pei, Neubauer, Stefan, Newby, David E.; Channon, Keith M.; Deanfield, John, Antoniades, Charalambos, Ahern, David J.; Ai, Zhichao, Ainsworth, Mark, Allan, Chris, Allcock, Alice, Angus, Brian, Ansari, M. Azim, Arancibia-Cárcamo, Carolina, Aschenbrenner, Dominik, Attar, Moustafa, Baillie, J. Kenneth, Barnes, Eleanor, Bashford-Rogers, Rachael, Bashyal, Archana, Beer, Sally, Berridge, Georgina, Beveridge, Amy, Bibi, Sagida, Bicanic, Tihana, Blackwell, Luke, Bowness, Paul, Brent, Andrew, Brown, Andrew, Broxholme, John, Buck, David, Burnham, Katie, Byrne, Helen, Camara, Susana, Ferreira, Ivan Candido, Charles, Philip, Chen, Wentao, Chen, Yi-Ling, Chong, Amanda, Clutterbuck, Elizabeth, Coles, Mark, Conlon, Christopher, Cornall, Richard, Cribbs, Adam, Curion, Fabiola, Davenport, Emma, Davidson, Neil, Davis, Simon, Dendrou, Calliope, Dequaire, Julie, Dib, Lea, Docker, James, Dold, Christina, Dong, Tao, Downes, Damien, Drakesmith, Hal, Dunachie, Susanna, Duncan, David, Eijsbouts, Chris, Esnouf, Robert, Espinosa, Alexis, Etherington, Rachel, Fairfax, Benjamin, Fairhead, Rory, Fang, Hai, Fassih, Shayan, Felle, Sally, Fernandez Mendoza, Maria, Ferreira, Ricardo, Fischer, Roman, Foord, Thomas, Forrow, Aden, Frater, John, Fries, Anastasia, Gallardo Sanchez, Veronica, Garner, Lucy, Geeves, Clementine, Georgiou, Dominique, Godfrey, Leila, Golubchik, Tanya, Gomez Vazquez, Maria, Green, Angie, Harper, Hong, Harrington, Heather, Heilig, Raphael, Hester, Svenja, Hill, Jennifer, Hinds, Charles, Hird, Clare, Ho, Ling-Pei, Hoekzema, Renee, Hollis, Benjamin, Hughes, Jim, Hutton, Paula, Jackson-Wood, Matthew, Jainarayanan, Ashwin, James-Bott, Anna, Jansen, Kathrin, Jeffery, Katie, Jones, Elizabeth, Jostins, Luke, Kerr, Georgina, Kim, David, Klenerman, Paul, Knight, Julian, Kumar, Vinod, Kumar Sharma, Piyush, Kurupati, Prathiba, Kwok, Andrew, Lee, Angela, Linder, Aline, Lockett, Teresa, Lonie, Lorne, Lopopolo, Maria, Lukoseviciute, Martyna, Luo, Jian, Marinou, Spyridoula, Marsden, Brian, Martinez, Jose, Matthews, Philippa, Mazurczyk, Michalina, McGowan, Simon, McKechnie, Stuart, Mead, Adam, Mentzer, Alexander, Mi, Yuxin, Monaco, Claudia, Montadon, Ruddy, Napolitani, Giorgio, Nassiri, Isar, Novak, Alex, O'Brien, Darragh, O'Connor, Daniel, O'Donnell, Denise, Ogg, Graham, Overend, Lauren, Park, Inhye, Pavord, Ian, Peng, Yanchun, Penkava, Frank, Pereira Pinho, Mariana, Perez, Elena, Pollard, Andrew, Powrie, Fiona, Psaila, Bethan, Quan, T. Phuong, Repapi, Emmanouela, Revale, Santiago, Silva-Reyes, Laura, Richard, Jean-Baptiste, Rich-Griffin, Charlotte, Ritter, Thomas, Rollier, Christine, Rowland, Matthew, Ruehle, Fabian, Salio, Mariolina, Sansom, Stephen Nicholas, Sanches Peres, Raphael, Santos Delgado, Alberto, Sauka-Spengler, Tatjana, Schwessinger, Ron, Scozzafava, Giuseppe, Screaton, Gavin, Seigal, Anna, Semple, Malcolm, Sergeant, Martin, Simoglou Karali, Christina, Sims, David, Skelly, Donal, Slawinski, Hubert, Sobrinodiaz, Alberto, Sousos, Nikolaos, Stafford, Lizzie, Stockdale, Lisa, Strickland, Marie, Sumray, Otto, Sun, Bo, Taylor, Chelsea, Taylor, Stephen, Taylor, Adan, Thongjuea, Supat, Thraves, Hannah, Todd, John, Tomic, Adriana, Tong, Orion, Trebes, Amy, Trzupek, Dominik, Tucci, Felicia Anna, Turtle, Lance, Udalova, Irina, Uhlig, Holm, van Grinsven, Erinke, Vendrell, Iolanda, Verheul, Marije, Voda, Alexandru, Wang, Guanlin, Wang, Lihui, Wang, Dapeng, Watkinson, Peter, Watson, Robert, Weinberger, Michael, Whalley, Justin, Witty, Lorna, Wray, Katherine, Xue, Luzheng, Yuen Yeung, Hing, Yin, Zixi, Young, Rebecca, Youngs, Jonathan, Zhang, Ping, Zurke, Yasemin-Xiomara, Banning, Adrian, Antonopoulos, Alexios, Bajaj, Amrita, Kelion, Andrew, Deshpande, Aparna, Kardos, Attila, Hudson, Benjamin, Koo, Bon-Kwon, Shirodaria, Cheerag, Xie, Cheng, Kotanidis, Christos, Mahon, Ciara, Berry, Colin, Adlam, David, Newby, David, Connolly, Derek, Scaletta, Diane, Alexander, Donna, Nicol, Ed, McAlindon, Elisa, Oikonomou, Evangelos, Pugliese, Francesca, Pontone, Gianluca, Benedetti, Giulia, He, Guo-Wei, West, Henry, Kondo, Hidekazu, Benedek, Imre, Das, Intrajeet, Deanfield, John, Graby, John, Greenwood, John, Rodrigues, Jonathan, Ge, Junbo, Channon, Keith, Fabritz, Larissa, Fan, Li-Juan, Kingham, Lucy, Guglielmo, Marco, Lyasheva, Maria, Schmitt, Matthias, Beer, Meinrad, Anderson, Michelle, Desai, Milind, Marwan, Mohamed, Takahashi, Naohiko, Mehta, Nehal, Dai, Neng, Screaton, Nicholas, Sabharwal, Nikant, Maurovich-Horvat, Pál, Rao, Praveen, Kotronias, Rafail, Kharbanda, Rajesh, Preston, Rebecca, Wood, Richard, Blankstein, Ron, Rajani, Ronak, Mirsadraee, Saeed, Munir, Shahzad, Thomas, Sheena, Neubauer, Stefan, Klömpken, Steffen, Petersen, Steffen, Achenbach, Stephan, Anthony, Susan, Mak, Sze, Mittal, Tarun, Benedek, Theodora, Sharma, Vinoda, Lin, Wen-Hua.
The Lancet Digital Health ; 2022.
Article in English | ScienceDirect | ID: covidwho-2004681

ABSTRACT

Summary Background Direct evaluation of vascular inflammation in patients with COVID-19 would facilitate more efficient trials of new treatments and identify patients at risk of long-term complications who might respond to treatment. We aimed to develop a novel artificial intelligence (AI)-assisted image analysis platform that quantifies cytokine-driven vascular inflammation from routine CT angiograms, and sought to validate its prognostic value in COVID-19. Methods For this prospective outcomes validation study, we developed a radiotranscriptomic platform that uses RNA sequencing data from human internal mammary artery biopsies to develop novel radiomic signatures of vascular inflammation from CT angiography images. We then used this platform to train a radiotranscriptomic signature (C19-RS), derived from the perivascular space around the aorta and the internal mammary artery, to best describe cytokine-driven vascular inflammation. The prognostic value of C19-RS was validated externally in 435 patients (331 from study arm 3 and 104 from study arm 4) admitted to hospital with or without COVID-19, undergoing clinically indicated pulmonary CT angiography, in three UK National Health Service (NHS) trusts (Oxford, Leicester, and Bath). We evaluated the diagnostic and prognostic value of C19-RS for death in hospital due to COVID-19, did sensitivity analyses based on dexamethasone treatment, and investigated the correlation of C19-RS with systemic transcriptomic changes. Findings Patients with COVID-19 had higher C19-RS than those without (adjusted odds ratio [OR] 2·97 [95% CI 1·43–6·27], p=0·0038), and those infected with the B.1.1.7 (alpha) SARS-CoV-2 variant had higher C19-RS values than those infected with the wild-type SARS-CoV-2 variant (adjusted OR 1·89 [95% CI 1·17–3·20] per SD, p=0·012). C19-RS had prognostic value for in-hospital mortality in COVID-19 in two testing cohorts (high [≥6·99] vs low [<6·99] C19-RS;hazard ratio [HR] 3·31 [95% CI 1·49–7·33], p=0·0033;and 2·58 [1·10–6·05], p=0·028), adjusted for clinical factors, biochemical biomarkers of inflammation and myocardial injury, and technical parameters. The adjusted HR for in-hospital mortality was 8·24 (95% CI 2·16–31·36, p=0·0019) in patients who received no dexamethasone treatment, but 2·27 (0·69–7·55, p=0·18) in those who received dexamethasone after the scan, suggesting that vascular inflammation might have been a therapeutic target of dexamethasone in COVID-19. Finally, C19-RS was strongly associated (r=0·61, p=0·00031) with a whole blood transcriptional module representing dysregulation of coagulation and platelet aggregation pathways. Interpretation Radiotranscriptomic analysis of CT angiography scans introduces a potentially powerful new platform for the development of non-invasive imaging biomarkers. Application of this platform in routine CT pulmonary angiography scans done in patients with COVID-19 produced the radiotranscriptomic signature C19-RS, a marker of cytokine-driven inflammation driving systemic activation of coagulation and responsible for adverse clinical outcomes, which predicts in-hospital mortality and might allow targeted therapy. Funding Engineering and Physical Sciences Research Council, British Heart Foundation, Oxford BHF Centre of Research Excellence, Innovate UK, NIHR Oxford Biomedical Research Centre, Wellcome Trust, Onassis Foundation.

3.
PLoS One ; 17(2): e0263607, 2022.
Article in English | MEDLINE | ID: covidwho-1968851

ABSTRACT

BACKGROUND: A reduction in overall acute coronary syndrome (ACS) cases, increases in the severity of ACS presentation, and increased rates of out-of-hospital cardiac arrest (OHCA) have been reported from multiple countries during the COVID-19 pandemic. The attributed factors include COVID-19 infection, fear of COVID-19 and resultant avoidance of health care facilities, and restrictions on mobility. Pakistan, a country with a high burden of cardiovascular disease (CVD) and challenges related to health care access, will be expected to demonstrate these same findings. Therefore, we compared ACS hospitalization, ACS severity, and patients who have already died (dead on arrival, or DOA) due to presumed OHCA at a tertiary cardiac hospital during pre-pandemic and intra-pandemic periods in Pakistan. METHODS: Standardized data elements were extracted from the charts of patients with ACS, and telephonic verbal autopsies (VA) using a validated tool were conducted for patients who were arrived DOA. As a comparison, cases during the same months prior to the COVID-19 were analyzed for respective waves. Events were counted, and proportions and frequencies are reported for each time period. RESULTS: A total of 4,480 ACS cases were reviewed; 1,216 cases during March-July 2019, 804 cases in the same months of 2020 (33.8% decrease); 1,304 cases in August 2019-January 2020 and 1,157 in the corresponding months of 2020 and 2021 (11.2% decrease). There was no observed change in the baseline characteristics of patients with ACS or their symptom-to-door time, and in-hospital mortality was unchanged across all time periods. There were 218 DOA cases in pre-pandemic months and 360 cases during the pandemic. The pre-pandemic rate of DOA was 12/1000 emergency patients (95% CI 10-13) compared to 22/1000 (95% CI 22-27) during the pandemic (30/1000in the 1st wave and 17/1000 during 2nd wave). On VA, CVD was found to be the major cause of death during both time periods. CONCLUSION: At a cardiac hospital in Pakistan, the COVID-19 pandemic was associated with a reduction in ACS hospitalization and an increased DOA rate.


Subject(s)
Acute Coronary Syndrome/epidemiology , COVID-19/epidemiology , Death , Hospitalization , Hospitals, Urban , Out-of-Hospital Cardiac Arrest/epidemiology , Pandemics , SARS-CoV-2 , Tertiary Care Centers , Aged , COVID-19/virology , Female , Hospital Mortality , Humans , Incidence , Male , Middle Aged , Pakistan/epidemiology
4.
Vaccines ; 10(8):1200, 2022.
Article in English | MDPI | ID: covidwho-1969525

ABSTRACT

The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has severely impacted human health and the health management system globally. The ongoing pandemic has required the development of more effective diagnostic strategies for restricting deadly disease. For appropriate disease management, accurate and rapid screening and isolation of the affected population is an efficient means of containment and the decimation of the disease. Therefore, considerable efforts are being directed toward the development of rapid and robust diagnostic techniques for respiratory infections, including SARS-CoV-2. In this article, we have summarized the origin, transmission, and various diagnostic techniques utilized for the detection of the SARS-CoV-2 virus. These higher-end techniques can also detect the virus copy number in asymptomatic samples. Furthermore, emerging rapid, cost-effective, and point-of-care diagnostic devices capable of large-scale population screening for COVID-19 are discussed. Finally, some breakthrough developments based on spectroscopic diagnosis that could revolutionize the field of rapid diagnosis are discussed.

5.
Sci Rep ; 12(1): 13146, 2022 Jul 30.
Article in English | MEDLINE | ID: covidwho-1967629

ABSTRACT

The main protease (Mpro) of SARS-CoV-2 has been recognized as an attractive drug target because of its central role in viral replication. Our previous preliminary molecular docking studies showed that theaflavin 3-gallate (a natural bioactive molecule derived from theaflavin and found in high abundance in black tea) exhibited better docking scores than repurposed drugs (Atazanavir, Darunavir, Lopinavir). In this study, conventional and steered MD-simulations analyses revealed stronger interactions of theaflavin 3-gallate with the active site residues of Mpro than theaflavin and a standard molecule GC373 (a known inhibitor of Mpro and novel broad-spectrum anti-viral agent). Theaflavin 3-gallate inhibited Mpro protein of SARS-CoV-2 with an IC50 value of 18.48 ± 1.29 µM. Treatment of SARS-CoV-2 (Indian/a3i clade/2020 isolate) with 200 µM of theaflavin 3-gallate in vitro using Vero cells and quantifying viral transcripts demonstrated reduction of viral count by 75% (viral particles reduced from Log106.7 to Log106.1). Overall, our findings suggest that theaflavin 3-gallate effectively targets the Mpro thus limiting the replication of the SARS-CoV-2 virus in vitro.


Subject(s)
COVID-19 , SARS-CoV-2 , Animals , Antiviral Agents/chemistry , Antiviral Agents/pharmacology , Biflavonoids , COVID-19/drug therapy , Catechin , Chlorocebus aethiops , Coronavirus 3C Proteases , Molecular Docking Simulation , Molecular Dynamics Simulation , Peptide Hydrolases , Protease Inhibitors/chemistry , Protease Inhibitors/pharmacology , Vero Cells
6.
Comput Electr Eng ; 102: 108236, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1966456

ABSTRACT

The risk of developing COVID-19 and its variants may be higher in those with pre-existing health conditions such as thyroid disease, Hepatitis C Virus (HCV), breast tissue disease, chronic dermatitis, and other severe infections. Early and precise identification of these disorders is critical. A huge number of patients in nations like India require early and rapid testing as a preventative measure. The problem of imbalance arises from the skewed nature of data in which the instances from majority class are classified correct, while the minority class is unfortunately misclassified by many classifiers. When it comes to human life, this kind of misclassification is unacceptable. To solve the misclassification issue and improve accuracy in such datasets, we applied a variety of data balancing techniques to several machine learning algorithms. The outcomes are encouraging, with a considerable increase in accuracy. As an outcome of these proper diagnoses, we can make plans and take the required actions to stop patients from acquiring serious health issues or viral infections.

7.
Comput Intell Neurosci ; 2022: 9107430, 2022.
Article in English | MEDLINE | ID: covidwho-1916485

ABSTRACT

Novel coronavirus 2019 has created a pandemic and was first reported in December 2019. It has had very adverse consequences on people's daily life, healthcare, and the world's economy as well. According to the World Health Organization's most recent statistics, COVID-19 has become a worldwide pandemic, and the number of infected persons and fatalities growing at an alarming rate. It is highly required to have an effective system to early detect the COVID-19 patients to curb the further spreading of the virus from the affected person. Therefore, to early identify positive cases in patients and to support radiologists in the automatic diagnosis of COVID-19 from X-ray images, a novel method PCA-IELM is proposed based on principal component analysis (PCA) and incremental extreme learning machine. The suggested method's key addition is that it considers the benefits of PCA and the incremental extreme learning machine. Further, our strategy PCA-IELM reduces the input dimension by extracting the most important information from an image. Consequently, the technique can effectively increase the COVID-19 patient prediction performance. In addition to these, PCA-IELM has a faster training speed than a multi-layer neural network. The proposed approach was tested on a COVID-19 patient's chest X-ray image dataset. The experimental results indicate that the proposed approach PCA-IELM outperforms PCA-SVM and PCA-ELM in terms of accuracy (98.11%), precision (96.11%), recall (97.50%), F1-score (98.50%), etc., and training speed.


Subject(s)
COVID-19 , Deep Learning , COVID-19/diagnostic imaging , Humans , Pandemics , SARS-CoV-2 , X-Rays
8.
Sci Total Environ ; 845: 157221, 2022 Jul 06.
Article in English | MEDLINE | ID: covidwho-1914990

ABSTRACT

Among the various emerging contaminants, pharmaceuticals (PhACs) seem to have adverse effects on the quality of water. Even the smallest concentration of PhACs in ground water and drinking water is harmful to humans and aquatic species. Among all the deaths reported due to COVID-19, the mortality rate was higher for those patients who consumed antibiotics. Consequently, PhAC in water is a serious concern and their removal needs immediate attention. This study has focused on the PhACs' degradation by collaborating photocatalysis with membrane filtration. TiO2-based photocatalytic membrane is an innovative strategy which demonstrates mineralization of PhACs as a safer option. To highlight the same, an emphasis on the preparation and reinforcing properties of TiO2-based nanomembranes has been elaborated in this review. Further, mineralization of antibiotics or cytostatic compounds and their degradation mechanisms is also highlighted using TiO2 assisted membrane photocatalysis. Experimental reactor configurations have been discussed for commercial implementation of photoreactors for PhAC degradation anchored photocatalytic nanomembranes. Challenges and future perspectives are emphasized in order to design a nanomembrane based prototype in future for wastewater management.

10.
Indian J Palliat Care ; 26(Suppl 1): S45-S47, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1792228

ABSTRACT

BACKGROUND: The ongoing coronavirus disease 2019 (COVID-19) pandemic has affected all the aspects of life of mankind, posing unique challenges for health-care services. In order to contain the spread of the virus, a countrywide mass lockdown has been imposed in India. Although the lockdown has modified the epidemic trajectory, it has affected the lives of many non-COVID patients. Patients in need of care could not approach hospitals. METHODS: This retrospective observational study was conducted in the Department of Onco-Anaesthesia and Palliative Medicine at a tertiary care center in India. The yearly data of patient flow for the year 2019 was compared with that during the lockdown. RESULTS: The single-day average of out-patients, in-patients, and other department consultation requests requiring palliative care decreased drastically during the lockdown in comparison to the previous year. The single-day average of teleconsultations increased more than double during the lockdown. CONCLUSION: Although lockdown decreases the spread of the epidemic, it increases the suffering of other patients who require medical care. Various steps have to be adopted in the regular working pattern of hospitals to cater to the needs of the patients requiring care, without increasing the risk of contracting COVID-19.

11.
Indian J Palliat Care ; 26(Suppl 1): S21-S26, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1792222

ABSTRACT

CONTEXT: The coronavirus pandemic has put an unprecedented burden on the health-care workers who are the cornerstone of the work system, preparing to mitigate its effects. Due to the lack of protective equipments, guidelines for managing patients, or proper training and education regarding the same, health care professionals (HCPs) working in non-COVID areas may face even greater problems than those working in COVID areas of a hospital. Our aim was to find out the concerns of HCPs working in non-COVID areas. SUBJECTS AND METHODS: After obtaining institutional ethics approval, a descriptive cross-sectional study was planned. An online Google-based questionnaire was rolled out to all doctors through various social media platforms who were dealing with COVID-negative patients. RESULTS: We received a total of 110 responses. 84.5% of participants were concerned about the risk of infection to self and family, 67.3% were concerned by the disruption of their daily activities. 56.4% of HCPs were disturbed by the lack of any concrete protocol for patient management. Less staff availability, delay in discharging duties toward their patients, and increased workload were other concerns. More than half of the doctors received N-95 masks whenever required and were trained in donning and doffing of Personal protective equipment. Sixty-eight percemt of our respondents labeled their current quality of life as stressful. CONCLUSION: It is the need of the hour to develop a comprehensive strategy focussing on the above challenges that HCPs working in non-COVID areas are facing. This will go a long way in not only providing holistic care to the patients but also in controlling this pandemic.

12.
Indian J Palliat Care ; 26(Suppl 1): S31-S35, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1792221

ABSTRACT

BACKGROUND AND AIMS: With the COVID-19 pandemic, lockdown, and fear from contagion, the advantages of telemedicine are clearly outweighing the setbacks by minimizing the need for individuals to visit health-care facilities. Our study aims to assess how palliative medicine physicians could follow up on cancer patients and barriers they faced, discuss their results, and evaluate their treatment response with the help of telemedicine. MATERIALS AND METHODS: We conducted a prospective analysis of the smartphone-based telemedicine service at our palliative care (PC) unit from March 25, 2020, to May 13, 2020. We recorded the patient's reason for call, main barriers to a hospital visit, and the assistance given to them by the physician on call. Each caller was asked to measure his/her satisfaction with the service on a 4-point scale. RESULTS: Out of 314 patients, 143 (45.54%) belonged to Delhi and 171 (54.46%) belonged to other states. 157 patients sought help for symptom management; 86 patients needed to restock their opioid medications. Seventy-one patients required information regarding their oncological treatments requiring consultation from other departments. Titration of oral opioids and medication prescription (n = 129), contact details of other PC units at their native state for opioid procurement (n = 55), and attachment to our community-based PC service (n = 22) were main modes of management. Fifty-six patients were very satisfied and 152 patients were satisfied with the service. CONCLUSION: Telemedicine is the future of health-care delivery systems. In PC, we deal with immunocompromised debilitated cancer patients and telemedicine is immensely helpful for us to provide holistic integrated care to these patients who are unable to visit hospitals regularly.

13.
Indian J Palliat Care ; 26(Suppl 1): S70-S75, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1792215

ABSTRACT

INTRODUCTION: During the current COVID-19 crisis, striking a balance between adequate pain relief in advanced malignancy patients and avoiding hospitals due to fear of contracting the infection has been the biggest challenge for patients as well as palliative care physicians. This study explored the trends in opioid dispensing for cancer pain before and during the lockdown. METHODS: The trends were calculated based on an analysis of quantity of all opioids dispensed. March 24, 2020, was considered as a cutoff for analyzing before and during lockdown period dispensing trends. No information regarding individual patients was retrieved in the current study. RESULTS: There was a decrease in total morphine, tramadol, and fentanyl patch dispensing parallel to decrease in total number of patients visiting the outpatient department. However, there was a statistically significant increase in per capita opioid dispensing during the lockdown period. There was also an increase in the proportion of cancer pain patients that were dispensed morphine during the lockdown. CONCLUSION: Despite the lockdown, the palliative care team at Institute Rotary Cancer Hospital has continued to provide adequate pain relief to patients that could manage to reach the center. Policy-makers need to be cognizant of the pain relief needs of cancer patients in times when accessing hospitals is becoming increasingly difficult. Cancer-related pain and mortality could well be the next pandemic once the current COVID-19 begins to reduce.

14.
J Alzheimers Dis ; 87(1): 305-315, 2022.
Article in English | MEDLINE | ID: covidwho-1793085

ABSTRACT

Wang et al. analyze Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment accuracy as screening tests for detecting dementia associated with Alzheimer's disease (AD). Such tests are at the center of controversy regarding recognition and treatment of AD. The continued widespread use of tools such as MMSE (1975) underscores the failure of advancing cognitive screening and assessment, which has hampered the development and evaluation of AD treatments. It is time to employ readily available, efficient computerized measures for population/mass screening, clinical assessment of dementia progression, and accurate determination of approaches for prevention and treatment of AD and related conditions.


Subject(s)
Alzheimer Disease , Cognitive Dysfunction , Alzheimer Disease/psychology , Cognition , Cognitive Dysfunction/psychology , Humans , Mass Screening , Mental Status and Dementia Tests , Neuropsychological Tests
15.
Clinical Epidemiology and Global Health ; : 101044, 2022.
Article in English | ScienceDirect | ID: covidwho-1783224

ABSTRACT

Introduction Newer coexisting conditions should be identified in order to modify newer risk factors. Aim was to identify patients with non-classical or less common coexisting conditions in patients infected of COVID 19. Method Single centred study from June 2020 to May 2021 at a tertiary centre in North India. A preformed questionnaire was used to record clinical and laboratory parameters and to identify cases which are in addition to CDC list and Indian data. Results 0.67% (46) cases out of 6832 patients were identified to have non-classical coexisting illness. It was divided into 2 groups-infections A (60.1%) and non-infections B (39.9%). Group A included-tuberculosis- pulmonary (14.3%) & extra pulmonary (32.9%), bacterial (25.0%) viral infections [dengue, hepatitis B & C] (14.3%), HIV disease (10.7%) and malaria (3.6%). Group B included- organ transplant (27.8%), autoimmune [myasthenia gravis, polymyositis, psoriasis] (22.6%), haematologic [Haemophilia, ITP, Aplastic anaemia, APML, CML] (27.8%), uncommon malignancies [disseminated sacral chordoma and GTN] (11.1%) and snakebite (11.1%). Serum Procalcitonin was not helpful for diagnosis of bacterial infection in COVID-19 disease. Group A had significantly longer duration of illness, hepatitis and elevated CRP. The mortality in group A & B were 32.1% and 43.8% respectively. Death in non-severe COVID cases was in tetanus and snakebite. 30.7% death among tuberculosis patients. More than 70% of deaths were attributable to COVID 19 in both the groups. Conclusion In Indian settings, comorbidities like tuberculosis and bacterial infections can precipitate severe COVID 19 unlike other parts of the world where tuberculosis is relatively uncommon.

16.
Journal of the Indian Chemical Society ; : 100433, 2022.
Article in English | ScienceDirect | ID: covidwho-1747791

ABSTRACT

In the present work, we have designed acyclovir (A), ganciclovir (G) and derivative of hydroxymethyl derivative of ganciclovir (CH2OH of G, that is D) and investigated its potential against the Mpro of nCoV. Density functional theory (DFT) calculations of A, G and D were performed using Gaussian 16 on applying B3LYP under default condition to investigate the delocalization of electron density in their optimized geometry. Free energy of A, G and D were calculated in Hartree per particle. It can be seen that D has the least free energy. Further, the molecular docking of the A, G and D against the Mpro of nCoV was performed using iGemdock and the binding energy for A, G and D were calculated in kcal/mol. It can be seen the D showed effective binding, that is maximum inhibition. For a better understanding of the inhibition of the Mpro of nCoV by A, G and D, temperature dependent molecular dynamics simulations were performed. Various trajectories like RMSD, RMSF, Rg and hydrogen bond were extracted and analyzed. The results of molecular docking corroborate the MD simulations and D could be a promising candidate against Mpro of nCoV.

17.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-330102

ABSTRACT

Main protease (M pro ) of SARS-CoV-2 is crucial for its replication/infection and has been recognized as an attractive drug target. In this study, we identified theaflavin 3-gallate as an inhibitor of M pro protein of SARS-CoV-2 with IC 50 value of 18.48 ± 1.29 µM. Compared to theaflavin, theaflavin 3-gallate exhibited superior antiviral activity and at a concentration of 200 µM reduced the viral count by 75% (viral particles reduced from 10 6.7 to 10 6.1 ). Time-dependent analyses of conventional and steered MD-simulations revealed stronger interactions of theaflavin 3-gallate with the active site residues of M pro than the standard molecule GC373 and theaflavin. Taken together, our findings suggest that theaflavin 3-gallate can be developed into a potential lead molecule against SARS-CoV-2.

18.
Environ Monit Assess ; 194(4): 274, 2022 Mar 14.
Article in English | MEDLINE | ID: covidwho-1739369

ABSTRACT

Most of the published articles which document changes in atmospheric compositions during the various lockdown and unlock phases of COVID-19 pandemic have made a direct comparison to a reference point (which may be 1 year apart) for attribution of the COVID-mediated lockdown impact on atmospheric composition. In the present study, we offer a better attribution of the lockdown impacts by also considering the effect of meteorology and seasonality. We decrease the temporal distance between the impacted and reference points by considering the difference of adjacent periods first and then comparing the impacted point to the mean of several reference points in the previous years. Additionally, we conduct a multi-station analysis to get a holistic effect of the different climatic and emission regimes. In several places in eastern and coastal India, the seasonally induced changes already pointed to a decrease in PM concentrations based on the previous year data; hence, the actual decrease due to lockdown would be much less than that observed just on the basis of difference of concentrations between subsequent periods. In contrast, northern Indian stations would normally show an increase in PM concentration at the time of the year when lockdown was effected; hence, actual lockdown-induced change would be in surplus of the observed change. The impact of wind-borne transport of pollutants to the study sites dominates over the dilution effects. Box model simulations point to a VOC-sensitive composition.


Subject(s)
Air Pollutants , COVID-19 , Air Pollutants/analysis , COVID-19/epidemiology , Communicable Disease Control , Environmental Monitoring , Humans , Meteorology , Pandemics
19.
Geoscience Frontiers ; : 101373, 2022.
Article in English | ScienceDirect | ID: covidwho-1709655

ABSTRACT

The novel coronavirus, SARS-CoV-2, which has caused millions of death globally is recognized to be unstable and recalcitrant in the environment, especially in the way it has been evolving to form new and highly transmissible variants. Of particular concerns are human-environment interactions and the handling and reusing the environmental materials, such as effluents, sludge, or biosolids laden with the SARS-CoV-2 without adequate treatments, thereby suggesting potential transmission and health risks. This study assesses the prevalence of SARS-CoV-2 RNA in effluents, sludge, and biosolids. Further, we evaluate the environmental, ecological, and health risks of reusing these environmental materials by wastewater/sludge workers and farmers. A systematic review of literature from the Scopus database resulted in a total of 21 articles (11 for effluents, 8 for sludge, and 2 for biosolids) that met the criteria for meta-analysis, which are then subdivided into 30 meta-analyzed studies. The prevalence of SAR-CoV-2 RNA in effluent and sludge based on random-effect models are 27.51 and 1012.25, respectively, with a 95% CI between 6.14 and 48.89 for the effluent, and 104.78 and 1019.71 for the sludge. However, the prevalence of SARS-CoV-2 RNA in the biosolids based on the fixed-effect model is 30.59, with a 95% CI between 10.10 and 51.08. The prevalence of SARS-CoV-2 RNA in environmental materials indicates the inefficiency in some of the treatment systems currently deployed to inactivate and remove the novel virus, which could be a potential health risk concern to vulnerable wastewater workers in particular, and the environmental and ecological issues for the population at large. This timely review portends the associated risks in handling and reusing environmental materials without proper and adequate treatments.

20.
Intervirology ; 2022 Feb 22.
Article in English | MEDLINE | ID: covidwho-1704643

ABSTRACT

INTRODUCTION: The ongoing spread of pandemic coronavirus disease (COVID-19) caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) is of growing concern. Rapid diagnosis and management of SARS-CoV-2 is crucial for controlling the outbreak in the community. Here we report the development of a first rapid-colorimetric assay capable of detecting SARS-CoV-2 in the human nasopharyngeal RNA sample in less than 30 minutes. METHOD: We utilized a nanomaterial-based optical sensing platform to detect RNA-dependent RNA polymerase (RdRp) gene of SARS-CoV-2, where the formation of oligo probe-target hybrid led to salt-induced aggregation and change in gold-colloid color from pink to blue visibility range. Accordingly, we found a change in colloid color from pink to blue in assay containing nasopharyngeal RNA sample from the subject with clinically diagnosed COVID-19. The colloid retained pink color when the test includes samples from COVID-19 negative subjects or human papillomavirus (HPV) infected women. RESULTS: The results were validated using nasopharangeal RNA samples from positive COVID-19 subjects (n=136). Using RT-PCR as gold standard, the assay was found to have 85.29% sensitivity and 94.12% specificity. The optimized method has detection limit as little as 0.5 ng of SARS-CoV-2 RNA. DISCUSSION/CONCLUSION: We found that the developed assay rapidly detects SARS-CoV-2 RNA in clinical samples in a cost-effective manner and would be useful in pandemic management by facilitating mass screening.

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