Characterizing the Blood Pressure Response to Physical Counterpressure Manoeuvres Using Surface Electromyography in Adults With Long Covid

Orthostatic intolerance (OI) is common in Long Covid. Physical counterpressure manoeuvres (PCM) may improve OI in other disorders. We characterised the blood pressure-rising effect of PCM using surface electromyography (sEMG) and investigated its association with fatigue in adults with Long Covid. Participants performed an active stand with beat-to-beat hemodynamic monitoring and sEMG of both thighs, including PCM at 3-minutes post-stand. Multivariable linear regression investigated the association between change in systolic blood pressure (SBP) and change in normalised root mean square (RMS) of sEMG amplitude, controlling for confounders including the Chalder Fatigue Scale (CFQ). In 90 participants (mean age 46), mean SBP rise with PCM was 13.7 (SD 9.0) mmHg. In regression, SBP change was significantly, directly associated with change in RMS sEMG ( 0.25 , 95% CI 0.07-0.43, P = 0.007);however, CFQ was not significant. PCM measured by sEMG augmented SBP without the influence of fatigue. Copyright © 2013 IEEE.

Prediction of muscular paralysis disease based on hybrid feature extraction with machine learning technique for COVID-19 and post-COVID-19 patients.

Many Coronavirus disease 2019 (COVID-19) and post-COVID-19 patients experience muscle fatigues. Early detection of muscle fatigue and muscular paralysis helps in the diagnosis, prediction, and prevention of COVID-19 and post-COVID-19 patients. Nowadays, the biomedical and clinical domains widely used the electromyography (EMG) signal due to its ability to differentiate various neuromuscular diseases. In general, nerves or muscles and the spinal cord influence numerous neuromuscular disorders. The clinical examination plays a major role in early finding and diagnosis of these diseases; this research study focused on the prediction of muscular paralysis using EMG signals. Machine learning-based diagnosis of the diseases has been widely used due to its efficiency and the hybrid feature extraction (FE) methods with deep learning classifier are used for the muscular paralysis disease prediction. The discrete wavelet transform (DWT) method is applied to decompose the EMG signal and reduce feature degradation. The proposed hybrid FE method consists of Yule-Walker, Burg's method, Renyi entropy, mean absolute value, min-max voltage FE, and other 17 conventional features for prediction of muscular paralysis disease. The hybrid FE method has the advantage of extract the relevant features from the signals and the Relief-F feature selection (FS) method is applied to select the optimal relevant feature for the deep learning classifier. The University of California, Irvine (UCI), EMG-Lower Limb Dataset is used to determine the performance of the proposed classifier. The evaluation shows that the proposed hybrid FE method achieved 88% of precision, while the existing neural network (NN) achieved 65% of precision and the support vector machine (SVM) achieved 35% of precision on whole EMG signal.

A possible mechanism of erectile dysfunction in coronavirus disease-19: Cavernosal smooth muscle damage: A pilot study.

INTRODUCTION: Studies have reported that coronavirus disease 2019 (COVID-19) may cause erectile dysfunction (ED), however, its role in the pathophysiology of ED has not yet been fully elucidated. We aimed to elucidate COVID-19's effects on cavernosal smooth muscle, which has a pretty important role in erection physiology, by corpus cavernosum electromyography (cc-EMG). MATERIALS AND METHODS: Twenty-nine male patients aged 20-50 years who applied to the urology outpatient clinic due to ED were included in the study. Nine patients that had COVID-19 and were treated as outpatients were classified as group 1, 10 patients who were hospitalized due to COVID-19 were classified as group 2, and 10 patients who did not have COVID-19 were classified as the control group (group 3). Patients underwent diagnostic evaluation including International Index of Erectile Function (IIEF)-5 form, penile color Doppler ultrasonography (CDUS), cc-EMG, and fasting serum levels of reproductive hormones (07-11am). RESULTS: According to penile CDUS and hormonal values results, there was no significant difference between the groups. According to cc-EMG results, amplitudes and relaxation capacities of the cavernosal smooth muscle of patients in group 3 were significantly higher than those in the other groups. CONCLUSIONS: COVID-19 can cause ED not only by psychogenic and hormonal factors but also with cavernosal smooth muscle damage. CLINICAL TRIAL REGISTRATION NUMBER: NCT04980508.

Impact of the Coronavirus Disease 2019 Pandemic on the Patient Profile Evaluated in the Electromyography Laboratory

Objective: The objective of this study was to evaluate how the coronavirus disease 2019 pandemic affected the profile of patients admitted to the electromyography (EMG) laboratory and the types of neurophysiologic evaluations. Method(s): We included patients who were admitted to our EMG laboratory in the first 6 months of the pandemic period (Period 1) and the same 6 months of the previous year (Period 2). In view of changes in health-care strategies, lockdown, and disease awareness during the pandemic, each group was divided into 3-month periods (early and late). Demographic and clinical characteristics and electrophysiologic data were evaluated retrospectively and compared between the groups. Result(s): In Period 1, there were 1872 studies of 1829 patients, and in Period 2, there were 625 studies of 607 patients. Electrodiagnoses for cranial neuropathies were more frequent during the pandemic when compared with before the pandemic (P = 0.018). The subgroup analysis revealed that the ratio of segmental anterior horn involvement decreased in the early pandemic period (P = 0.003), myopathies decreased in the late pandemic period (P = 0.001), and cranial neuropathies increased in the late pandemic period (P = 0.005) compared with the same periods in the previous year. Conclusion(s): During the pandemic, there have been changes in clinical practice approaches in the electrophysiology laboratory. More cranial neuropathies seemed to be diagnosed in the EMG laboratory during the pandemic, including new-onset facial neuropathies, which was the most significant finding of our study.Copyright © 2023 AVES. All rights reserved.

A Case of Ocular Myasthenia Gravis Seen by Rheumatology as Suspected Mononeuritis Multiplex in an Adult Male Shortly after Pfizerbiontech Sars-Cov-2 Vaccination

Background/Aims Myasthenia gravis (MG) is an antibody-mediated autoimmune disease targeting proteins at the postsynaptic membrane of the neuromuscular junction. MG is thought to occur in genetically susceptible individuals following an environmental trigger. SARS-CoV-2 infection has been associated with new-onset autoimmune disease, new-onset MG, and exacerbations of pre-existing MG, with molecular mimicry between SARS-CoV-2 epitopes and autoantigen-induced autoreactivity thought to be part of the underlying mechanism. We report a case of newonset ocular MG following first dose Pfizer-BioNTech BNT162b2 SARS-COV2 vaccination which was referred to rheumatology as suspected mononeuritis multiplex. Methods A 53-year-old man of East Asian ethnicity presented to the emergency department (ED) with sudden onset diplopia and left lateral gaze restriction 7 days after receiving his first dose of the Pfizer-BioNTech BNT162b2 SARS-COV2 vaccination. He had longstanding myopia and dry eyes but no other medical history, no regular medications or significant family history. He was a current smoker, with a 50-pack year history. He did not drink alcohol or use any recreational drugs. He was found to have an isolated left VI cranial nerve (CN) palsy with an otherwise normal ocular and physical examination. Blood tests were unremarkable apart from raised cholesterol, and he was discharged with a suspected self-limiting microvascular CN lesion. Three weeks later he presented to ED with worsening diplopia, increasingly restricted eye movements, headache, nausea, vomiting and blurred vision. Ophthalmology assessment noted new right sided CN III and VI palsy, persistent left CN VI palsy, and vertical diplopia in all fields of gaze. Neurological and physical examination were normal. Bloods including an autoimmune screen were unremarkable. SARS-CoV-2 Spike antibodies were positive consistent with SARS-CoV-2 vaccination but not infection. Intracranial and thoracic imaging were unremarkable. He was referred to and seen by both rheumatology and neurology as a case of suspected mononeuritis multiplex. Results A diagnosis of ocular MG was confirmed with positive serum acetylcholine receptor antibodies, and he was started on prednisolone, and pyridostigmine to good effect. Daily forced vital capacity (FVC) showed no respiratory muscle involvement, and nerve conduction studies and electromyography were normal, excluding secondary generalisation. Conclusion A review of the literature found 14 reported cases of new-onset MG all within 4 weeks following SARS-CoV-2 vaccine. Whilst these cases provide interesting insights into the pathogenesis of autoimmune conditions such as MG, they are not epidemiological studies to inform vaccine safety. Ultimately, current evidence suggests that the risks of SARS-COV-2 infection outweigh the risk of vaccine-related adverse events, therefore we suggest clinicians should be aware of potential new-onset autoimmune conditions, but support the safety of SARSCOV2 vaccination. Further, research into possible immunological mechanisms behind this phenomenon, including identifying potential epitopes inducing molecular mimicry, could help establish the likelihood of a causative link.

Spinal Versus General Anesthesia for Spine Surgery During the COVID-19 Pandemic: A Case Series

Background: Hospitals are one of the primary resources for disease transmission, so many guidelines were published, and neuro-surgeons were advised to postpone elective spine surgeries during the COVID-19 pandemic. Objective(s): To avoid pulmonary complications and reduce the risk of spreading the virus and contracting the disease during the COVID-19 era, we operated a group of our patients under spinal anesthesia rather than general anesthesia. Method(s): We retrospectively analyzed all patients who underwent discectomy surgery for lumbar spinal disc herniation under SA between September 2020 and 2021. Result(s): Sixty-four patients diagnosed with lumbar disc herniation underwent lumbar discectomy with SA. All patients except three were male. The mean age was 44.52 +/- 7.95 years (28 to 64 years). The mean procedure time for SA was 10 minutes. The duration of the surgery was 40 to 90 minutes per each level of disc herniation. The mean blood loss was 350 cc (200 to 600 cc). The most common involved level was L4/L5 intervertebral disc (n = 40 patients;63.5%). The mean recovery time was 20 minutes. Only three patients requested more analgesics for relief of their pain postoperatively. All patients with discectomy were discharged a day after surgery, and in the case of fusion, two days after surgery. All the patients were followed up for six months, showing no recurrence symptoms, good pain relief, satisfaction with the surgery, and no bad memory of the surgery. Conclusion(s): Spinal anesthesia is a good alternative or even the main anesthesia route for patients with lumbar disc herniation. More studies are needed to elucidate the best candidate for SA in patients with lumbar pathology.Copyright © 2023, Author(s).

Miller-Fisher syndrome following by Sputnik V vaccine: Case report.

Miller-Fisher syndrome (MFS), defined as a rare variant of Guillain-Barre syndrome (GBS), is characterized by the classic triad of ataxia, areflexia, and ophthalmoplegia. It is a demyelinating polyneuropathy resulting from a deregulated autoimmune response secondary to infection by viruses and bacteria. SMF and GBS have been described during the COVID-19 pandemic. There are some reports in the literature of GBS after vaccination for COVID-19. In contrast, reports of post-vaccination FMS for SARS-CoV-2 are scarce in the literature. A 75-year-old patient is presented who consults for asthenia, adynamia, and difficulty swallowing that progresses to respiratory distress. She refers to the application of the Sputnik V vaccine as an important antecedent. During the hospital stay, the diagnosis was made by electromyography and nerve conduction study of GBS variant SMF. The objective is to expose a post-vaccination SMF to SARS-CoV-2 with the biological Sputnik V and highlight the importance of this background for surveillance in clinical practice and future research.Copyright © 2022 Asociacion Colombiana de Infectologia. All rights reserved.

Transverse myelitis as neurologic sequelae in a COVID-19 recovered patient

Background: Months after the initial report of an unknown cause of pneumonia outbreak in Wuhan, China, the SARS-COV-2 continues its rampant spread globally. This novel corona virus has been known to cause severe respiratory illness. It is important to be wary of the complications that would soon present at the Out-patient centers after being cured from the infection. Case: This is a case of a 59-year-old, female who came in at the Out-Patient Clinic with progressive bilateral pins and needles sensation of the feet after recovering from COVID-19 infection followed by a sensory level on T7-T10. Case Report: Here we present a case of transverse myelitis as a complication of COVID-19 infection, the first to have occurred after recovery from the virus. With the success of treatments and recoveries, possible post infectious sequelae could be the next wave that could come into the present picture of the pandemic. Conclusion(s): Post infectious transverse myelitis after recovering from COVID-19 is a possibility and that documentation of such cases and other complications must be reported.Copyright © 2022

A Bilateral Diaphragmatic Paralysis Post-COVID-19 Infection: A Case Report and a Review of the Literature.

The diaphragm is the essential respiratory muscle, and damage can significantly impede a human's capacity for blood oxygenation. During inspiration, the diaphragm domes permit the pleural cavity to expand. Whenever this process is disrupted, it results in decreased thoracic expansion and, as a result, hypoventilation. The phrenic nerve innervates the diaphragmatic muscle via the cervical nerve roots C3, C4, and C5. Diaphragmatic paralysis is a multifactorial consequence caused by trauma, neurogenic diseases, infections, inflammatory responses, and chest operative surgery, with the last being the most prevalent causative factor. Here, we are describing the case of a 52-year-old male patient who has had ongoing dyspnea for months after contracting COVID-19 in December 2021, despite the remission of his previous COVID-19 pneumonia in 2020. An X-ray of the chest revealed no diaphragm elevation, whereas electromyography verified diaphragm impairment. On the conservative treatment plan, he reported persistent dyspnea following a period of pulmonary rehabilitation. To a lesser extent, it is advised to wait at least one year to see if there is any reinnervation, which could benefit his lung capacity. COVID-19 has been linked to many systematic diseases. As a result, COVID-19 will not be restricted to its inflammatory effect on the lungs. In other words, it is a multi-organ systematic syndrome. One of these effects is diaphragm paralysis, which should be considered a post-COVID-19 disease. However, there is a need for more literature to support physicians as guidelines for neurological conditions related to COVID-19 infection.

Impaired Neuromuscular Efficiency and Symptom-Limited Aerobic Exercise Capacity 4 Weeks After Recovery From COVID-19 Appear to Be Associated With Disease Severity at Onset.

OBJECTIVE: The objectives of this study were to evaluate neuromuscular recruitment and efficiency in participants who recovered from COVID-19 and assess the association between neuromuscular efficiency and symptom-limited aerobic exercise capacity. METHODS: Participants who recovered from mild (n = 31) and severe (n = 17) COVID-19 were evaluated and compared with a reference group (n = 15). Participants underwent symptom-limited ergometer exercise testing with simultaneous electromyography evaluation after a 4-week recovery period. Activation of muscle fiber types IIa and IIb and neuromuscular efficiency (watts/percentage of root-mean-square obtained at the maximum effort) were determined from electromyography of the right vastus lateralis. RESULTS: Participants who had recovered from severe COVID-19 had lower power output and higher neuromuscular activity than the reference group and those who had recovered from mild COVID-19. Type IIa and IIb fibers were activated at a lower power output in participants who had recovered from severe COVID-19 than in the reference group and those who had recovered from mild COVID-19, with large effect sizes (0.40 for type IIa and 0.48 for type IIb). Neuromuscular efficiency was lower in participants who had recovered from severe COVID-19 than in the reference group and those who had recovered from mild COVID-19, with a large effect size (0.45). Neuromuscular efficiency showed a correlation with symptom-limited aerobic exercise capacity (r = 0.83). No differences were observed between participants who had recovered from mild COVID-19 and the reference group for any variables. CONCLUSION: This physiological observational study supports the notion that more severe COVID-19 symptoms at disease onset appear to correspondingly impair neuromuscular efficiency in survivors over a short time frame of 4 weeks after recovery, potentially contributing to reduced cardiorespiratory capacity. Further studies are needed to replicate and extend these findings with respect to their clinical implications for assessment/evaluation and interventions. IMPACT: After 4 weeks of recovery, neuromuscular impairment is particularly evident in severe cases; this problem may contribute to reduced cardiopulmonary exercise capacity.

First reported case of parvovirus triggering painful widespread livedoid vasculopathy: another virus causing hypercoagulability?

Livedoid vasculopathy (LV) is a noninflammatory thrombotic disease caused by occlusion of dermal small vessels associated with systemic autoimmune disorders and coagulopathies. However, LV is often reported as being 'idiopathic', despite extensive investigation. We report a case of severe LV in an otherwise healthy 27-year-old woman, associated with parvovirus infection. The patient presented with a short history of a livedoid rash initially covering her torso, which spread to acral sites. Burning pains in the lower limb caused reduced mobility;systemically, she remained well and stable throughout. Examination revealed generalized acral skin pallor, livedoid patches of violet erythema and purpura with deep serpiginous ulcerations over extensor aspects of upper and lower limbs with a more broken/racemosa nonulcerated livedoid appearance on the trunk. On admission a transaminitisareas continued to ulcerate. Codeine was present with a creatine kinase of 1569 U L.1, but other blood test results were unremarkable including erythrocyte sedimentation rate, complement, cryoglobulins, antinuclear antibodies, antineutrophil cytoplasmic antibodies, extractable nuclear antigen, rheumatoid factor, myositis screen, antiphospholipid screen and thrombophilia screen. Parvovirus IgG and IgM were both positive and tested for, as the patient's young daughter had recently been diagnosed with 'slapped cheek disease'. Magnetic resonance imaging of the thighs showed a diffuse mild myositis;electromyography, nerve-conduction studies, barium swallow and computed tomography of the chest, abdomen and pelvis were all normal. An incisional skin biopsy was performed, which revealed a blood vessel with organizing (Solimani F, Mansour Y, Didona D et al. Development of severe pemphigus vulgaris following SARS-CoV-2 vaccination with BNT162b2. J Eur Acad Dermatol Venereol 2021;35: e649- 51) have been reported. The main proposed mechanisms for AstraZeneca vaccine-induced pemphigus could be a hyperimmune reaction in genetically predisposed individuals, with eventual formation of anti-desmoglein antibodies. An alternative hypothesis is that vaccine components could act as foreign antigens resulting in a cross-reaction with pemphigus antigens. The close association of COVID-19 vaccination with the acute onset of pemphigus in our patient, as well as exacerbations after subsequent vaccine administration, is more than coincidental. Considering the recent pandemic with COVID-19 and the widespread administration of the COVID-19 vaccine, continued observation and documentation of true adverse events is essential.

Physiotherapy results of a patient with critical illness polyneuropathy due to COVID-19: A case report

The aim of this study is to examine the results of physiotherapy in a patient with critical illness polyneuropathy (CIP) due to coronavirus disease 2019 (CO-VID-19). The 48-year-old male patient with CIP due to COVID-19 was enrolled in a physiotherapy program for 3 months with 5 sessions/week. Pain intensity, motor skills, daily living activities, fatigue level, cognitive status, and decubitus ulcer were evaluated with a visual analogue scale, the Medical Research Coun-cil-Sum Score, the Functional Independence Scale, the Fatigue Severity Scale, the Standardized Mini-Mental Test, and pressure wound staging, respectively. Positive improvements were achieved in functional level, fatigue, pain, and pressure sores with the physiotherapy program for this patient with CIP due to COVID-19. This report provides an idea about the effects of physiotherapy programs for COVID-19-related CIP to academics and clinicians working in this field.Copyright © 2022, Derman Medical Publishing. All rights reserved.

It Takes Two to Make a Thing Go Wrong

Seventy-three-year-old diabetic male was a high-risk transfer from Alaska for respiratory decompensation in the setting of progressive bulbar and proximal weakness. He was diagnosed with COVID-19 two months prior and viral mononucleosis 1 month prior to presentation. While the patient had a fall 3 months prior to presentation, and decreased mobility at home, there was abrupt onset of progressive upper/lower extremity weakness, dysphagia, and difficulties managing secretions 2 weeks prior to presentation. Initial exam was notable for MRC 3-4/5 proximal upper/lower extremity weakness, areflexia, and negative inspiratory force of 224 to 230 cm H20. A subtle periorbital heliotrope rash was documented. Lumbar puncture demonstrated albumino-cytologic dissociation (protein 142 mg/dL, 6 WBCs) and CK remained elevated (1930 U/L) despite intravenous hydration. Outside electrodiagnostic testing demonstrated a sensorimotor axonal neuropathy with questionable myopathic features on needle electromyography. Given concern for an inflammatory neuropathy and concomitant inflammatory myopathy, intravenous immunoglobulin 2G/kg and IV methylprednisolone 1G/day over 5 days was started. He was transferred for further diagnostic workup and supportive care 6 days after presentation and required intubation within 24 hours of admission. Exam showed progressive proximal and distal weakness of the extremities and general areflexia/hyporeflexia. Repeat electromyography confirmed a severe sensorimotor axonal polyneuropathy without acquired demyelinating features and normal repetitive nerve stimulation. While the patient could no longer activate muscles voluntarily, proximal muscles had increased spontaneous activity with predominant myotonia. Neuroaxis imaging was notable only for enhancement of the lumbar nerve roots. Combined vastus lateralis muscle biopsy and serologic testing confirmed a second pathologic process contributing to the patient's weakness. This case highlights the cooccurrence of 2 distinct neuropathological entities, with potential relation to a prior viral infection, and the importance of ancillary testing to guide treatment for acute causes of neuromuscular respiratory failure.

Guillain-Barre syndrome associated with SARS-CoV-2 infection: A case series from 4 Colombian cities during the pandemic

SARS-CoV-2 infection has been associated with multiple neurological manifestations. One such manifestation, which has been described since the early stages of the COVID-19 pandemic and is relevant for current neurological practice, is Guillain-Barre syndrome (GBS). The literature describes neurotoxic mechanisms of the virus itself and the possible pathways by which it may affect the peripheral nerves in experimental studies;however, we still lack information on the mechanisms causing the immune response that gives rise to GBS in the context of SARS-CoV-2 infection. Colombia is one of the Latin American countries worst affected by the pandemic, with the third-highest number of cases in the region;thus, it is essential to recognise GBS, as this potential postinfectious complication may severely compromise the patient's functional status in the absence of timely diagnosis and treatment. We present a series of 12 cases of GBS associated with SARS-CoV-2 infection from hospitals in 4 different Colombian cities and describe the clinical presentation, laboratory and electrophysiological study findings, and treatment.Copyright © 2022 Sociedad Espanola de Neurologia

AZD1222 (ChAdOx1 nCoV-19) Vaccine: Hurdles and Visions

ChAdOx1 nCoV-19 (AZD1222) is a replication-deficient chimpanzee adenovirus vectored vaccine developed by Oxford and AstraZeneca for a disease we all know as Coronavirus, or COVID-19. Ongoing clinical studies reveal that the ChAdOx1 nCoV-19 vaccine has a tolerable safety profile and is effective against symptomatic COVID-19. This vaccine may prove crucial in boosting herd immunity, averting life threatening illness, and relieving the current pandemic. In this mini review, we performed a thorough literature search through PubMed and Google Scholar and reported various case reports associated with complications of the adenovirus-vectored COVID-19 vaccine. Various adverse effects of the ChAdOx1 nCoV-19 vaccine were reported around the globe, which were often serious but rare and developed into life-threatening pathologies such as GBS, thrombocytopenia, demyelinating neuropathies, progressive dementia, cerebral infarction, IgA vasculitis, hemophagocytic lymphohistiocytosis, herpes zoster, cutaneous reactions, and vein thrombosis. These worldwide reported complications, which are usually rare and severe, will aid clinicians in understanding and managing unforeseen situations. There is a need for more research to find out more about these complications and their etiopathogenesis. However, the benefits of these vaccinations for stopping the spread of the outbreak and lowering the fatality rate outweigh the potential risk of the uncommon complications.Copyright © The Author(s) 2023.

Laryngeal sensory neuropathy caused by COVID-19: findings using laryngeal electromyography.

PURPOSE: Laryngeal sensory neuropathy (LSN) is caused by a disorder of the superior laryngeal nerve or the recurrent laryngeal nerve. A diagnosis of LSN should include laryngeal electromyography (LEMG) and laryngovideostroboscopy (LVS). The aim of this study was to characterize the physical and subjective symptoms of neuropathy in patients diagnosed with LSN following COVID-19. MATERIAL AND METHODS: Since the beginning of the COVID-19 pandemic, 6 patients who had recovered from the disease presented to us with LSN symptoms. All patients underwent laryngological and phoniatric examination, objective and subjective voice assessment, and LEMG. RESULTS: The most common LSN symptom reported by patients was periodic hoarseness of varying severity. Other common symptoms were the sensation of a foreign body in the throat and voice fatigue. Endoscopy often showed functional abnormalities. The LSN patients could be characterized by LEMG recordings, and all showed abnormal activity of the cricothyroid (CT) muscle. The degree of EMG changes in the CT correlated moderately with the severity of dysphonia. CONCLUSIONS: Sensory neuropathy of the larynx may be a long-lasting complication of SARS-COV-2 infection. The severity of EMG neuropathic changes in the CT muscle broadly corresponds to the severity of dysphonia.

Internet of Medical Things - The Future of Healthcare

Background: The Internet of Medical Things (IoMT) is now being connected to medical equipment to make patients more comfortable, offer better and more affordable health care options, and make it easier for people to get good care in the comfort of their own homes. Objective(s): The primary purpose of this study is to highlight the architecture and use of IoMT (Internet of Medical Things) technology in the healthcare system. Method(s): Several sources were used to acquire the material, including review articles published in various journals that had keywords such as, Internet of Medical Things, Wireless Fidelity, Remote Healthcare Monitoring (RHM), Point-of-care testing (POCT), and Sensors. Result(s): IoMT has succeeded in lowering both the cost of digital healthcare systems and the amount of energy they use. Sensors are used to measure a wide range of things, from physiological to emotional responses. They can be used to predict illness before it happens. Conclusion(s): The term "Internet of Medical Things" refers to the broad adoption of healthcare solutions that may be provided in the home. Making such systems intelligent and efficient for timely prediction of important illnesses has the potential to save millions of lives while decreasing the burden on conventional healthcare institutions, such as hospitals. patients and physicians may now access real-time data due to advancements in IoM. Copyright © 2022 Wal et al.

Stretchable, self‐healable, and breathable biomimetic iontronics with superior humidity‐sensing performance for wireless respiration monitoring

Stretchable, self‐healing, and breathable skin‐biomimetic‐sensing iontronics play an important role in human physiological signal monitoring and human–computer interaction. However, previous studies have focused on the mimicking of skin tactile sensing (pressure, strain, and temperature), and the development of more functionalities is necessary. To this end, a superior humidity‐sensitive ionic skin is developed based on a self‐healing, stretchable, breathable, and biocompatible polyvinyl alcohol–cellulose nanofibers organohydrogel film, showing a pronounced thickness‐dependent humidity‐sensing performance. The as‐prepared 62.47‐μm‐thick organohydrogel film exhibits a high response (25,000%) to 98% RH, excellent repeatability, and long‐term stability (120 days). Moreover, this ionic skin has excellent resistance to large mechanical deformation and damage, and the worn‐out material can still retain its humidity‐sensing capabilities after self‐repair. Humidity‐sensing mechanism studies show that the induced response is mainly related to the increase of proton mobility and interfacial charge transport efficiency after water adsorption. The superior humidity responsiveness is attributed to the reduced thickness and the increased specific surface area of the organohydrogel film, allowing real‐time recording of physiological signals. Notably, by combining with a self‐designed printed circuit board, a continuous and wireless respiration monitoring system is developed, presenting its great potential in wearable and biomedical electronics.