CLINICAL MEMORY OF COVID-19 PANDEMIC: A COMPARATIVE ANALYSIS OF CLINICAL AND ANGIOGRAPHIC CHARACTERISTICS OF PATIENTS WITH ACUTE CORONARY SYNDROME

Objectives: To describe the clinical characteristics and angiographic features of COVID-19 patients presenting with acute coronary syndrome (ACS) and to compare with non-COVID-19 ACS patients presenting simultaneously. Methodology: In a case control design, data were extracted from a prospectively collected COVID-19 and NCDR registry. All ACS patients who underwent cardiac catheterization from April 2020 to May 2021 were included. All of the patients were taken to the Cath lab for diagnostic coronary angiography and possible percutaneous intervention. Demographic and clinical characteristics, angiographic features, and in-hospital outcomes were compared between ACS patients with and without COVID-19. Results: A total of 4027 COVID-19 negative patients, and 80 COVID-19 positive were included. Total of 83% in COVID-19 and 88% in non-COVID-19 group had ST elevation myocardial infarction. Majority of the COVID-19 positive patients had sub-optimal TIMI flow grade (<III) post procedure and had a high thrombus burden (11.2% vs. 2.9%;p<0.001). Majority of the patients who had COVID-19 and ACS required mechanical circulatory support (48.8% vs. 0.3%;p<0.001). The mortality rates were also higher in COVID-19 positive group (38.8% vs. 1.3%;p<0.001). Among the COVID-19 positive patients 66.3% (53) had high thrombus burden (≥4 grade), intervention was performed in 73.7% (59). Post-intervention myocardial blush grade ≤2 was observed in 57.6% (34), slow flow in 85.3% (29), and phasic flow possibly due to elevated LVEDP in 41.2% (14) patients. Conclusion: COVID-19 patients with ACS had a higher severity of illness at presentation and worse outcomes as compared to simultaneously presenting non-COVID patients. © 2023 The authors.

A Covid-19 Study and Forecasting

Covid-19 has proven to be a particularly challenging epidemic to contain. Covid-19 has been around for more than two years, despite the swift efforts of medical specialists. Our paper helps this cause by presenting ways to forecast the estimated number of cases in a certain state or country on a future date. This will contribute in the preparation and fight against the spread of the virus as people will know which states require lockdown and which do not. The research paper will also provide statistics on the many patterns that have been observed in India as a result of the Covid-19 problem, as well as how it has affected the people. © 2022 IEEE.

Indian Guidelines on Nebulization Therapy.

Inhalational therapy, today, happens to be the mainstay of treatment in obstructive airway diseases (OADs), such as asthma, chronic obstructive pulmonary disease (COPD), and is also in the present, used in a variety of other pulmonary and even non-pulmonary disorders. Hand-held inhalation devices may often be difficult to use, particularly for children, elderly, debilitated or distressed patients. Nebulization therapy emerges as a good option in these cases besides being useful in the home care, emergency room and critical care settings. With so many advancements taking place in nebulizer technology; availability of a plethora of drug formulations for its use, and the widening scope of this therapy; medical practitioners, respiratory therapists, and other health care personnel face the challenge of choosing appropriate inhalation devices and drug formulations, besides their rational application and use in different clinical situations. Adequate maintenance of nebulizer equipment including their disinfection and storage are the other relevant issues requiring guidance. Injudicious and improper use of nebulizers and their poor maintenance can sometimes lead to serious health hazards, nosocomial infections, transmission of infection, and other adverse outcomes. Thus, it is imperative to have a proper national guideline on nebulization practices to bridge the knowledge gaps amongst various health care personnel involved in this practice. It will also serve as an educational and scientific resource for healthcare professionals, as well as promote future research by identifying neglected and ignored areas in this field. Such comprehensive guidelines on this subject have not been available in the country and the only available proper international guidelines were released in 1997 which have not been updated for a noticeably long period of over two decades, though many changes and advancements have taken place in this technology in the recent past. Much of nebulization practices in the present may not be evidence-based and even some of these, the way they are currently used, may be ineffective or even harmful. Recognizing the knowledge deficit and paucity of guidelines on the usage of nebulizers in various settings such as inpatient, out-patient, emergency room, critical care, and domiciliary use in India in a wide variety of indications to standardize nebulization practices and to address many other related issues; National College of Chest Physicians (India), commissioned a National task force consisting of eminent experts in the field of Pulmonary Medicine from different backgrounds and different parts of the country to review the available evidence from the medical literature on the scientific principles and clinical practices of nebulization therapy and to formulate evidence-based guidelines on it. The guideline is based on all possible literature that could be explored with the best available evidence and incorporating expert opinions. To support the guideline with high-quality evidence, a systematic search of the electronic databases was performed to identify the relevant studies, position papers, consensus reports, and recommendations published. Rating of the level of the quality of evidence and the strength of recommendation was done using the GRADE system. Six topics were identified, each given to one group of experts comprising of advisors, chairpersons, convenor and members, and such six groups (A-F) were formed and the consensus recommendations of each group was included as a section in the guidelines (Sections I to VI). The topics included were: A. Introduction, basic principles and technical aspects of nebulization, types of equipment, their choice, use, and maintenance B. Nebulization therapy in obstructive airway diseases C. Nebulization therapy in the intensive care unit D. Use of various drugs (other than bronchodilators and inhaled corticosteroids) by nebulized route and miscellaneous uses of nebulization therapy E. Domiciliary/Home/Maintenance nebulization therapy; public & health care workers education, and F. Nebulization therapy in COVID-19 pandemic and in patients of other contagious viral respiratory infections (included later considering the crisis created due to COVID-19 pandemic). Various issues in different sections have been discussed in the form of questions, followed by point-wise evidence statements based on the existing knowledge, and recommendations have been formulated.

Effect on Ambient Air Quality in Nagpur due to lockdown to contain the spread of COVID-19 pandemic in the year 2020: a case study

The present paper deals with the studies on the change in concentration of three standard pollutants namely, respiratory suspended particulate matter (RSPM or PM10), Sulphur dioxide (SO2) and Nitrogen dioxide (NO2) because of lockdown in India to prevent the spread of COVID-19 pandemic in 2020. The monthly average concentrations of the above pollutants observed at four monitoring stations in and around Nagpur city during January to December 2020 were analyzed and compared. Due to COVID-19 pandemic, there was a complete lockdown from 25th March to 31st May 2020 and phased reopening of areas outside containment zones from June 1st onwards. It is found that the average concentration of all the three pollutants at all four stations was reduced by about 50 % to 75 % due to lockdown. During lockdown, the minimum concentration of PM10, SO2 and NO2 amongst all stations were found to be 40, 5 and 11 µg/m3, respectively, whereas the maximum concentrations were found to be 159, 20, and 50 µg/m3, respectively. The concentrations during lockdown were below the standards prescribed by CPCB, which were found to increase due to reopening. The Air quality index (AQI) at all four stations during lockdown was less than 50 (i.e. SATISFACTORY), whereas it increased above 100 (i.e. MODERATE) after reopening. As a result, the annual average concentration of pollutants was reduced in 2020 compared to previous years.

COVID-19–induced anxiety and protective behaviour among nursing students: A survey from western India

Introduction: The COVID-19 Pandemic has caused anxiety and stress among people. Nursing students, being an important link in the delivery of health care services, are always exposed to stressful situations which in turn put a great toll on their mental health. Moreover, the perceived risk of pandemics motivates people to embrace different protective measures so as to reduce any potential threats of an emerging health concern. Objective: The aim of this study was to assess the COVID-induced anxiety and protective behaviors among nursing students. Methods: Nursing students studying at 02 nursing institutes of Jodhpur, Rajasthan, India were enrolled for the study. The data were collected using COVID-induced anxiety scale and protective behaviors towards COVID-19 Scale. These scales were converted to online google forms, and the link was circulated among 370 nursing students through emails and WhatsApp. A total of 229 students submitted their responses within stipulated time and were included in the final data analysis. Results: The response rate of the survey was 62%. Evidently, nursing students had a moderate level of anxiety (mean score 31.28 ± 5.29) due to the COVID-19 outbreak. Overall protective behavior mean score was 56.63 ± 6.4 which reflects that students were following higher quality of protective behaviors. There is a negative linear correlation between anxiety score and protective behavior score. Conclusion: The nursing students exhibited a moderate level of anxiety, and routing protective behaviors were frequently performed by these students. There is a timely need to plan and implement interventions for nursing students so as to make them self-capable to resolve psychosocial issues, especially during disease outbreaks.

Gesture Interfaced Restaurant Billing System using IOT

Restaurants have always been experimental to give a better customer service which is evident from the evolution of a handwritten food ordering system to the utilization of robots in delivering food at a restaurant table. The year is 2020 and the human race is fighting against COVID-19, a global pandemic. In this project we are addressing a safe hygienic billing system along with a great customer experience, for a contact less process or service in a crowded restaurant. The device is an affordable commodity that can be utilized to reduce manpower and increase productivity by reducing the delay in between food ordering and delivery in a restaurant. Considering the fact that every restaurant customer would be expecting a safe hygienic service, this device stands essential. We were not able to put it on service owing to the hardware integration limitation during this lockdown phase in our country and considers that as a limiting factor to the success of this project. © 2021 IEEE.

Application of Geometric Poisson Distribution for COVID-19 in Selected States of India

In December 2019, a novel coronavirus was found in a seafood wholesale market in Wuhan, China. On January 30, 2020 the first case of COVID-19 pandemic in India was reported. The spread escalated in the month of March and April in India. This paper deals with traditional infectious disease prediction models predicting the bed occupancy rate for few states in India. The correlation for recovered and deceased with confirmed cases were found and a relation is obtained by using linear and quadratic regression equation. Based on the results obtained probabilistic model is predicted for number of bed occupancy for a specific time period. The three distributions that are used with the probabilistic models are Poisson distribution, weighted Poisson distribution and Geometric Poisson distribution. The data has been taken from website for the month of March and April and were tested for fitting of proposed distributions using goodness of fit. Graph of deceased, recovered, and confirmed COVID cases for a particular time period is shown. The study is considered to be preliminary as there is only comparison of the distributions based on bed occupancy and the probability of occurrence. But this method can be extended for more months and for various distributions for better future predictions. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Osteogenesis imperfecta and physical therapy: A review of recent trends during the COVID-19 pandemic

Osteogenesis Imperfecta (OI) is a genetic disease affecting the bones. The main feature of the disease is bone fragility and low bone density. Between 6 and 7 in 100,000 people are affected by the disease. The clinical features are painful bones, bowlegs, short stature, enlarged head, bone fractures, hearing loss, and scoliosis. It is classified into four types: I to IV. Subgroups have been identified, whereby types V, VI, and VII are not associated with collagen muta-tion. Many patients experience deformities resulting in reduced mobility and difficulty to carry out daily activities. COVID-19 is defined as ”a mild to severe respiratory illness that is caused by a coronavirus, is transmitted chiefly by contact with infectious material (such as respiratory droplets) or with objects or surfaces contaminated by the causative virus, and is characterized espe-cially by fever, cough and shortness of breath and may progress to pneumonia and respiratory failure”. During the lock down, OI patients suffer from reduced physical activity. Home exercise programmes/physical therapy and the num-ber of clinical visits is also reduced. Rehabilitation sessions should include strengthening, developmental exercises, positioning, standing, and walking, whole-body vibration exercises, and aerobic exercise. Continuous physiotherapy is recognized as one of the essential conservative treatment options. A search was carried out of databases, including CINHAL, Embase, Cochrane, Pubmed, and Google Scholar. This was used to answer the following research questions: What is OI? How is it being treated? How did rehabilitation change during the COVID-19 pandemic? This is the first extensive review of research on the topic.

Impact analysis of temperature data on the increase in the count of infected cases of COVID 19

There was an outbreak of pneumonia in the month of December 2019 in Wuhan, China that spread with a rapid rate throughout the country and shook the world by spreading across the globe causing many deaths due. This disease is confirmed by means of molecular method as a novel coronavirus and was named as 2019 novel coronavirus (2019-nCoV) in its initial stage;however, on February 11, 2020, World Health Organization (WHO) renamed this disease COVID-19, which means corona virus disease. COVID-19 has impacted nearly the entire world, affecting more than 100 countries including India. The Coronavirus Study Group consisting of the International Committee on Taxonomy of Viruses renamed this virus, which was provisionally named 2019-nCoV, as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This nomenclature is based on taxonomy, phylogeny, and established practice. As on March 2020, WHO has confirmed 692,575 number of cases of COVID-19 with 33,099 deaths, which are distributed across the globe: Western Pacific region with 103,775 confirmed cases with 3,649 deaths;European region with 392,757 number of confirmed cases with 23,962 deaths;South East Asia region with 4,084 confirmed cases with 158 deaths;Eastern Mediterranean region with 46,392 confirmed cases with 2,813 number of deaths;America region with 142,081 confirmed cases with 2,457 deaths;African region with 3,486 confirmed cases with 60 deaths. This paper focuses on these areas and regions and tries to find establish the relationship between numbers of deaths and number of cases with respect to the temperature. This paper takes the study of specific areas around the world and also the case study of India to study the effect of temperature on the rise of and death due to COVID-19 virus. © 2020 IGI Global. All rights reserved.