Compelling Impacts of Natural Polymer-Centered Drug Delivery Systems as Prophylactic and Therapeutic Approaches in Various Pulmonary Disorders/Lung Diseases

Pulmonary disorders are common illness that affects people of all ages world­wide. Common pulmonary disorders include pulmonary hypertension, CF (cystic fibrosis), asthma, chronic obstructive pulmonary disorder, emphysema, chronic bronchitis, lung cancer, and COVID-19. Treatments of these disorders vary but can be broadly categorized into pharmacological (medicinal), non-pharmacological, rehabilitation, and surgical techniques. Often, a combina­tion of these approaches is used, both for symptomatic relief and treatment. Regarding these prophylactic and therapeutic approaches, advances are rapidly being made, and scientists are currently investigating modern and unique theranostic methods. However, there is a lacuna in drug delivery, pharmacokinetic aspects, and drug-induced adverse effects. One particular area for improvement that needs to be immediately addressed is the drug delivery system to significantly improve healthcare associated with pulmonary disorders. Natural polymer-based drug delivery systems are widely adopted for their ease of production, lack of biotoxicity, and strong bioaffinity. Of the natural polymer­based drug delivery systems, chitosan, sodium alginates, albumin, hydroxyapa­tite, and hyaluronic acid are the most common natural polymers. Each of these natural polymers has its preferred use, either due to tissue-specific delivery or medical property packaging. The current scientific article discusses the common pulmonary disorders, their pathophysiology, and the current therapeutic approaches. Additionally, we discuss the major natural polymer drug delivery systems, including their properties and common uses. © The Author (s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

Real-time Fitness Activity Recognition and Correction using Deep Neural Networks

Fitness activities are beneficial to one's health and well-being. During the Covid-19 pandemic, demand for virtual trainers increased. There are current systems that can classify different exercises, and there are other systems that provide feedback on a specific exercise. We propose a system that can simultaneously recognize a pose as well as provide real-time corrective feedback on the performed exercise with the least latency between recognition and correction. In all computer vision techniques implemented so far, occlusion and a lack of labeled data are the most significant problems in correctly detecting and providing helpful feedback. Vector geometry is employed to calculate the angles between key points detected on the body to provide the user with corrective feedback and count the repetitions of each exercise. Three different architectures-GAN, Conv-LSTM, and LSTM-RNN are experimented with, for exercise recognition. A custom dataset of Jumping Jacks, Squats, and Lunges is used to train the models. GAN achieved a 92% testing accuracy but struggled in real-time performance. The LSTM-RNN architecture yielded a 95% testing accuracy and ConvLSTM obtained an accuracy of 97% on real-time sequences. © 2023 IEEE.

Psychological impact of COVID-19 Pandemic on dentists

Background: The Covid-19 pandemic seems to have an incessant out-turn on the people in every field in some or the other way. It has been reported that maximum number of deaths in the countries during this pandemic are caused due to a term called death anxiety or phobia. There are certain parameters such as anxiety, apprehension, depression which if influence a person can alter one's well-being. Objective(s): The steadfast intent of this review article is to narrate the psychological impact of this pandemic on dentists. The eloquence and emergence of this topic will alarm all the medicos and paramedics to have a check on this scenario. Method(s): The article consists of detailed study from several articles from PubMed publications. Articles written only in English language were referred. Various keywords such as "Covid-19 pandemic" or "Psychological Impact" were used. Result(s): The Covid-19 Pandemic has adversely affected all of us physically as well as psychologically. This article signifies the psychological impact of this pandemic on dentists. Conclusion(s): The current studies that are carried out till date show an extensive impact on the psychology of the dental professionals. The following review article elaborates the importance of the same.Copyright © 2023 Patil B et al.

Antiviral Potential of Coconut (Cocos nucifera L.) Oil and COVID-19

Background: COVID-19 caused by the novel SARS Coronavirus-2 (SARS-CoV-2) is causing serious problems in the global public health sphere. In the absence of a powerful antiviral treatment, the exploration of plant-based products with antiviral potential has gained interest. Scope and Approach: This commentary presents the prospects of utilizing coconut oil directly or its derivatives such as monolaurin in treating COVID-19 with a special emphasis on their biochemical characteristics features. The potential pitfalls therein and way forward are also highlighted. Key findings and conclusions: There are enough research-backed evidences to demonstrate the antiviral capabilities of coconut oil and monolaurin. The possibility of developing a medium-chain fatty acidbased nasal spray as a prophylactic or therapeutic is also discussed. Nevertheless, the potential impediments in devising suitable therapeutic models to treat SARS-CoV-2, are presented.Copyright © 2021 Bentham Science Publishers.

Reinforced Learning Experience Framework

A reinforced learning experience (Lx) framework (through a) developed, executed, and evaluated against preCOVID19 and COVID19 operational semesters. This framework is designed through the unlearning approach of the inhouse design thinking tool and lateral executive of curricular delivery, assessments, and evaluations. © 2023 American Institute of Physics Inc.. All rights reserved.

Role of herbal medicines in the treatment of infectious diseases.

Herbal medicines have helped to cure illness because the practice has continued for generations. Multiple alkaloids/compounds that occur naturally (as against single extracts) exhibit synergistic actions such as antiviral, antibacterial, anti-protozoal, and antioxidant. The cases related to viral, protozoal, and bacterial infections were selected. Patients with amoebiasis, E-coli, gastrointestinal infection, skin and urinary tract infections were treated using herbal drugs. Diagnoses were confirmed with investigations. Due to their cost effectiveness, these medicines are in great demand for primary health care with cultural acceptability and minimal side effects. The aim of the reported study is to show the actual use of Indian medicinal plants used for the treatment of various types of infectious diseases. Cases varying from COVID 19 to gastrointestinal infection, viral diseases, skin and wound infections are being treated effectively with herbal drugs.

SARS-CoV-2 genome sequencing and promising druggable targets

This chapter introduces the resultant outcomes and predictions of SARS-CoV-2 genome sequencing. It begins with the structural features of the viral genome, which are the results of initial efforts of genome sequencing. It then deals with the revelations about the origin and phylogeny of the virus, highlighting the zoonotic transmission and possible animal reservoirs. In addition, the genomic variations found during genome sequencing have been discussed. For convenience, these have been divided according to the life cycle of the virus that occurs in different stages. Furthermore, the chapter focuses on promising druggable targets that have been discovered so far, due to the efforts of genome sequencing. Several targets have been discussed, with respect to their structure and mechanism of possible inhibition. © 2022 Elsevier Inc. All rights reserved.

Current approach on COVID-19 for Emergency Use Authorization in Europe: Sotrovimab

COVID-19 plays a massive role in the health care sector. A coronavirus is a group of viruses that causes mild, moderate, and severe respiratory infections in humans. In recent times monoclonal antibodies have been used to treat and overcome the infection spread in mild to moderate infections of SARS-COV-2. It is a new neutralizing dual-action monoclonal antibody with an activity that plays a role against severe acute respiratory disorder coronavirus 2, known as SARS-CoV-2. Monoclonal antibodies are engineered molecules in the laboratory which acts as substitute antibody. Monoclonal antibodies can enhance and restore the attack of the immune system on pathogens. It is under development by GlaxoSmithKline, and Vir Biotechnology, Inc. Proteins developed by the laboratory have similar characteristics to natural antibodies produced from the human immune system. This sotrovimab is designed to avoid the entry of pathogens and viral attachment and neutralize the previously infected cells. It has been shown that there is a reduction level in hospitalization or death in age factor between 18-45 with mild-to-moderate COVID-19 by 79% who are at high risk of progressing to serious illness in COMET-ICE (COVID-19 Monoclonal antibody Efficacy Trial - Intent to Care Early) trial. Some of the adverse effects of the sotrovimab were rash and diarrhea (1%). Hypersensitivity reactions, including anaphylaxis, have been reported at at least rate. In this article, we have explained in detail the Sotrovimab overview, history, Clinical data, Special conditions, and Approval data of the European Union.

COVID-19 induced renal injury differs from that in other viral-infections

Background: Kidney injuries caused by several viral diseases have been reported worldwide among all age groups, races, and genders. Of particular importance is coronavirus disease 2019 (COVID-19), and its prevalence in communities infecting all patient populations with symptoms ranging from asymptomatic to severe, including complications and mortality. Methods: Data were acquired from PubMed, Scopus, Google Scholar, Centers for Disease Prevention and Control (CDC), and Lexi-Comp using the following search terms: “COVID-19 and renal pathology,” “COVID-19 induced kidney disease,” “Viral infection induced kidney disease,” and “Viral infection induced renal damage.” Titles and s were manually analyzed as per the exclusion and inclusion criteria of relevant articles;relevance of articles included studies on the pathology of a specific viral infection and the impact of the virus on the adult renal system. Results: The mechanisms for renal disease due to COVID-19 include direct renal tubular injury, cytokine storm, inflammation, thrombosis vs. acute tubular necrosis, thrombotic events, and direct renal injury. Although some mechanisms behind renal dysfunction among the studied viral infections are similar, the prevalence rates of kidney injury or damage differ. This might be described by recommended prophylactic and therapeutic approaches that can alter the viral infection characteristics and possibly the impact a particular organ system. Conclusion: The patient population at risk was old in age and had a high body mass index. The mechanisms associated with renal dysfunction are similar, including direct renal injury through angiotensin converting enzyme 2 (ACE2) entry, inflammation, and thrombosis. The renal pathology of coronaviruses that differs from that of other prevalent viral infections is the activation of cytokine storm, which causes elevations of a greater number and different kinds of cytokines than other viral infections. Copyright © 2022 Shandong University, published by Wolters Kluwer, Inc.

Evaluation of orofacial symptoms and oral health-related quality of life among COVID-19 patients attending a tertiary hospital in Thiruvananthapuram: A cross-sectional study

Background: Researchers have been perplexed by the diverse clinical symptoms of COVID-19 spikes, and its oral symptoms are not frequently documented. Objectives: To estimate the prevalence of orofacial symptoms associated with confirmed COVID-19 cases and to assess the oral health-related quality of life among these patients. Methods: After audio consent, a pre-tested structured questionnaire was used to gather data from COVID-19-confirmed patients, and cases from a tertiary dental care facility in Thiruvananthapuram were also included. Results: Out of 200 participants, 86 (43%) were females, and 114 (57%) were males. The mean age was 40 years, ranging from 10 to 75 years. It was found that loss of taste (111, 56%), dry mouth (54, 27%), oral ulceration (18, 9%), white discoloration (12, 6%), burning sensation (9, 4.5%), red discoloration (7, 3.5%), tooth mobility (4, 2%), osteomyelitis (3, 2%), mucormycosis (4, 2%) and gingival bleeding (1, 0.5%) were the orofacial symptoms present in the participants. Conclusion: The prevalence of orofacial symptoms was 68% in COVID-19 patients, with loss of taste, dry mouth, and oral ulcerations as predominant symptoms. The mean oral health impact profile (OHIP) value of the COVID patients who showed oral manifestations was 17.44, whereas for those who did not show oral manifestations, it was only 7.46. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

A review of the role of graphene-based nanomaterials in tackling challenges posed by the COVID-19 pandemic

In 2020, the World Health Organization (WHO) declared a pandemic due to the emergence of the coronavirus disease (COVID-19) which was resulted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Significant efforts have been devoted by many countries to develop more advanced medicines and vaccines. However, along with these developments, it is also extremely essential to design effective systems by incorporating smart materials to battle the COVID-19. Therefore, several approaches have been implemented to combat against COVID-19. Recently, due to its superior physicochemical properties along with other fascinating properties, graphene-based materials have been explored for the current COVID-19 and future pandemics. Therefore, in this review article, we discuss the recent progress and the most promising strategies related to graphene and related materials and its applications for detection, decontamination, diagnosis, and protection against COVID-19. In addition, the key challenges and future directives are discussed in detail for fundamental design and development of technologies based on graphene and its related materials and lastly, our personal opinions on the appropriate approaches to improve these technologies respectively.

MIS-CM imicking Acute Appendicitis

Introduction: Abdominal pain is one of the most common complaints seen in the pediatric acute care setting. SARS-CoV-2 disease in children includes a hyperinflammatory syndrome called Multisystem Inflammatory Syndrome in Children (MIS-C). Gastrointestinal symptoms are most common in pediatric acute SARS-CoV-2 infection as well as in MIS-C. Case Description: A 13- year-old female presented with diffuse lower abdominal pain for 3-days. Pain was 10/10 in intensity, worsened with movement, and had associated constipation, anorexia, nausea, and vomiting. Exam showed an ill-appearing female with labile vitals and generalized lower abdominal tenderness with good bowel sounds. Ultrasound suggested features of acute appendicitis but a follow-up CT did not visualize the appendix. She was admitted to the inpatient unit after routine screening revealed positive SARS-CoV-2 antibody but negative PCR. She received IV fluid bolus, narcotic analgesics, and ampicillin-sulbactam preoperatively. Within hours, she spiked high-grade fevers (101.4F), sustained hypotension, and tachycardia with concern for sepsis secondary to a possible ruptured appendix. She underwent emergency diagnostic laparoscopy which revealed bile-tinged fluid in the lower quadrant, a mildly inflamed appendicular tip without perforation, and thickened mesenteric nodes within the inflamed distal ileum. Intra-operatively, she had persistent hypotension requiring fluid boluses and vasopressors. Her admission labs revealed elevated inflammatory markers, deranged coagulation profile, and elevated cardiac enzymes. Her differential diagnosis was then revised to include MIS-C and severe sepsis. Antibiotic coverage was broadened to Vancomycin and Meropenem. An Echocardiogram showed mitral regurgitation with moderately to severely decreased right and left ventricular systolic dysfunction with an ejection fraction of 32.8% The patient was then transferred to the pediatric cardiac critical unit where she received treatment with IVIG, steroids, and anticoagulants. Her clinical status and lab studies improved with EF > 50%. She was discharged from the intensive care unit after 7 days and has had an uneventful follow-up. Discussion: Differential diagnosis for acute lower abdominal pain in an adolescent female is broad. Similar cases with predominant GI symptoms and later generalized multisystem involvement have been reported, however, most were managed conservatively. Two reports have been published on MIS-C presenting as acute appendicitis, but neither had significant cardiac involvement. Our patient's presentation can easily be confused with an acute surgical abdomen but the pathology report confirmed a congested appendix without any fecoliths supporting either inflammation or vasculitis as the cause for her presentation, which is in concordance with the hyperinflammatory state that has previously been described in patients presenting with a history of past SARS-CoV- 2 infections. Conclusion: MIS-C can mimic serious pediatric illnesses including sepsis, acute abdomen, and Kawasaki disease. Clinicians should have a low threshold for suspecting MIS-C, as prompt treatment can be lifesaving. Universal screening for COVID-19 infection with PCR and antibody tests can expedite the diagnostic evaluation of severely ill children. Showing reactive wall thickening of the cecum and small bowel loops (red arrow) and enlarged mesenteric lymph nodes (yellow arrow). The appendix could not be visualized here.

Enhanced IoT- Assisted Wearable Data Analytics for Patient Monitoring and Healthcare Systems

Recent technological advancements have opened the path for smart gadgets, including wearable devices. Wearable sensors can predict human body motions and track a variety of medical symptoms associated with chronic diseases. The proposed study utilizes IoT sensors to monitor human bodily states, with the obtained data being saved in a cloud context. The data saved in the cloud environment is analyzed further using data analysis algorithms to enable clinicians' efficient monitoring and prompt response. Moreover, data fluctuation may assist physicians in notifying them of emergencies, preserving a precious human life. The proposal might be implemented efficiently in emergency medical settings when patients need continual monitoring and the greatest attention from medical professionals. The suggested idea might be used to deploy several life-threatening conditions such as spinal muscular atrophy, hypertrophic cardiomyopathy, and Covid patient monitoring. © 2022 IEEE.

A State of the Art Review on Air Quality at Visakhapatnam During Lockdown

Post reporting of deadly virus infecting mankind in city of Wuhan (China) major changes in socio-economic conditions have been encountered. Being reported on 31st December 2019, later named Covid-19 disease has been declared global pandemic on March 11th, 2020 by WHO. Assuming 40-60% people of entire world might get affected due to this virus, lockdown was imposed as an immediate action. This was to curtail transmission of virus through physical contact. This lockdown has shown significant impact on air pollution on a global scale which needs to be analysed for further requirements. It is a known fact that air pollution impacts human respiratory system. Hence analysis of particulate matter and air pollutants post-lockdown and pre-lockdown during Covid pandemic may yield significant results. Even though treatment and prevention of Covid-19 is a big challenge right now, role of nanotechnology should not be ignored. Since nanotechnology is a multidisciplinary and focused field, it is capable of pivoting solutions for problems posed due to this virus and could relieve the excess strained hospitals. Since Covid-19 work on a nanoscale idea of using nanotechnology may offer significant results in the biomedical field that include both diagnostic and therapeutic approaches. In this context an attempt was made to review some of the published results related to the nature of virus and role of nano and microparticles on Covid-19 as well as to analyse particulate matter and air pollutants for a coastal, urban, industrial station in Visakhapatnam India. © 2022 - Kalpana Corporation.

Can Non-Humanoid Social Robots Reduce Workload of Special Educators : An Online and In-Premises Field Study

Although Socially Assistive Robotics have been used in Autism Spectrum Disorder (ASD) interventions, such studies often exclude Special Educators (SEs) and often use expensive humanoid robots. In this paper, we investigate whether non-humanoid toy robots can act as teaching aids in ASD Education, in particular, can they reduce the workload of SEs. We target two most common yet divergent problems from Individualized Education Plans (IEPs) of ASD children - communication and gross motor skills. We present results from three studies a) toy robot Cozmo assists SEs in verbal lessons in school premises, b) mini drone Tello helps SEs in exercise lessons in school premises, and c) Cozmo, SEs, and ASD children connect remotely, as mandated due to the Covid-19 pandemic, for verbal lessons. All three studies showed improvement in learning outcomes and reduction in prompts from the SEs, denoting reduced workload. The effect of a robot's virtual presence in online ASD interventions has not been studied before. However, our results show that children spent more time on lessons in online intervention with Cozmo, suggesting that using robots should also be considered when designing online interventions. Furthermore, the roles of Cozmo were analyzed, and we found children showed increased spontaneous interaction when Cozmo acts as a Co-Instructor. Thus, preliminary results indicate toy robots, as opposed to expensive humanoids, may have significant potential in aiding SEs in Autism education.

Demographic analysis and clinical outcomes of COVID-19 and myocardial infarction from a tertiary care centre in south India

Back ground-COVID-19 is reported in India from March 2020. It is known to cause myocarditis , arrythmias and heart failure. COVID-19 infection has been proposed to be associated with myocardial infarction. PURPOSE -We intent to study outcomes of acute coronary syndrome associated with COVID-19 patients . METHODS-This is a single center case-control study done in an University hospital in south India , from May 2020 to October 2020 . Data of patients who came with acute coronary syndrome (ACS) with COVID- 19 were collected retrospectively from the hospital database. The clinical outcomes of the these patients were compared with the patients who were admitted in the hospital for ACS without COVID -19 in the same period. RESULITS-508 patients were admitted between May 2020 to October 2020 with ACS and out of which 58 patients were positive for COVID-19 and 450 patients were COVID-19 negative. In COVID positive group, most of the patients were above 50 years with 17 % of them being female sex. 60 % were having diabetes and 44.8 % had hypertension . 55% of them had STEMI with the rest being NSTEACS . 43.1 % patients were thrombolysed . 25% patients underwent revascularization either with PCI / CABG . 10.3% died in the COVID-19 positive group , at the same time there were only 2.2 % deaths in the control group . Most the patients were asymptomatic COVID-19 at presentation . Among the symptomatic COVID-19 patients the onset of myocardial infarction after COVID-19 ranged from 9-90 days . CONCLUSION-Acute coronary syndrome in COVID-19 patients can present as late as 3 months after index infection, and these patients had higher mortality compared with those who did not have COVID -19.

Influence of COVID-19 on Microplastics Pollution in Coastal Water and Sediment of Chennai, India

Event of microplastics (plastic garbage < 5 mm) along the coast is a developing concern around the world, because of the expanded contribution of disposed of squanders from different sources. Around 400 million tons of plastic are produced per year worldwide, out of which only 18% is recycled that has led to its poor disposal practices. The significance of my work is to analyze mainly the positive impacts due to lockdown during COVID-19. The discharged plastics remain in the environment for several 100 years either in their original or fragmented form. The fragmentation of particles is caused by several factors like wind currents, wave currents, abrasions, exposure to sunlight, etc. The study of the distribution of microplastics in time and space, as well as their distribution on parameters, such as polymer type, size, shape, in different coastal environmental all over the world, is the need of the hour. This study describes a framework to assess the presence and distribution of microplastics in marine water and sediments of Adyar and Cooum Estuary along the Chennai coast. Ten sampling sites from each estuary were selected from which surface water and sediments were collected. The samples were carried over to the laboratory for analyzing the presence of microplastic content, and also basic seawater quality parameters were analyzed in the Environmental Engineering Department laboratory. The study investigated the presence and distribution of microplastics before and during COVID-19. The presence and distribution study of microplastics in coastal waters and sediments were carried out by means of FTIR and XRD spectroscopy methods. From this analysis, microplastics occur in both estuaries and there is a significant reduction in Microplastic content in both estuaries because of continuous lockdown due to COVID-19. From FTIR analysis, it was found that the concentration of Polyethylene(PE) and Polypropylene (PP) was higher than the other types of polymer in both the locations and both the times (August 2019 and 2020). And from XRD analysis, black residues were found on most of the microplastics surfaces. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

A Novel Deep Learning-Based Black Fungus Disease Identification Using Modified Hybrid Learning Methodology.

Currently, countries across the world are suffering from a prominent viral infection called COVID-19. Most countries are still facing several issues due to this disease, which has resulted in several fatalities. The first COVID-19 wave caused devastation across the world owing to its virulence and led to a massive loss in human lives, impacting the country's economy drastically. A dangerous disease called mucormycosis was discovered worldwide during the second COVID-19 wave, in 2021, which lasted from April to July. The mucormycosis disease is commonly known as "black fungus," which belongs to the fungus family Mucorales. It is usually a rare disease, but the level of destruction caused by the disease is vast and unpredictable. This disease mainly targets people already suffering from other diseases and consuming heavy medication to counter the disease they are suffering from. This is because of the reduction in antibodies in the affected people. Therefore, the patient's body does not have the ability to act against fungus-oriented infections. This black fungus is more commonly identified in patients with coronavirus disease in certain country. The condition frequently manifests on skin, but it can also harm organs such as eyes and brain. This study intends to design a modified neural network logic for an artificial intelligence (AI) strategy with learning principles, called a hybrid learning-based neural network classifier (HLNNC). The proposed method is based on well-known techniques such as convolutional neural network (CNN) and support vector machine (SVM). This article discusses a dataset containing several eye photographs of patients with and without black fungus infection. These images were collected from the real-time records of people afflicted with COVID followed by the black fungus. This proposed HLNNC scheme identifies the black fungus disease based on the following image processing procedures: image acquisition, preprocessing, feature extraction, and classification; these procedures were performed considering the dataset training and testing principles with proper performance analysis. The results of the procedure are provided in a graphical format with the precise specification, and the efficacy of the proposed method is established.

PILLBOT: Non-Contact Medicine Dispensing System for Patients in Quarantine

The COVID-19 pandemic has brought about a great risk faced by health workers when attending to those infected. We can reduce the risk of infection and minimize direct contact with these patients. For this, we need to develop a smart substitute that can carry out some of the necessary tasks. Advances in IoT have led to different applications. This paper presents PILLBOT, which is a prototype that moves using voice control mechanisms. It has two main contents: Pill dispenser and Syrup dispenser. Pill dispenser is designed for patients who forget to take their medication in time and the Syrup dispenser is designed for patients who are prescribed cough syrups. The prototype can be controlled by the health worker via Google assistant with Adafruit.io cloud service and remote-control app. Once it reaches the patient, he/she can place the medicine container on a sensor-based platform that triggers the dispenser circuit, therefore, procuring the medicine. PILLBOT represents an ideal substitute for a service robot that can be remotely controlled. © 2021 IEEE.

Teprotumumab use in a real-world setting: Expanded access program findings

Purpose : Teprotumumab was recently approved in January of 2020 to treat thyroid eye disease (TED). The purpose of this study was to evaluate the safety profile and Graves' ophthalmopathy quality of life questionnaire (GO-QOL) for a group of patients in which compassionate use of teprotumumab was deemed appropriate, prior to U.S. Food and Drug Administration (FDA) approval. Methods : Adults with active, moderate-to-severe TED were scheduled to receive 8 infusions (10 mg/kg first infusion, 20 mg/kg thereafter) of teprotumumab over 21 weeks. Adverse events (AEs), lab assessments, vitals and GO-QOL (max QOL=100) were assessed. Results : 22 patients (52.4±16.2 years, 64% female, 91% non-smokers, 7.2±3.0 months TED duration) from 8 sites were treated. 19/22 (86%) received 8 infusions (3 discontinued treatment due to COVID-19, personal choice, and hyperglycemia). Baseline Total GO-QOL was 47.8±21.4 (appearance [AP]: 42.9±26.7, visual function [VF]: 52.9±24.6). At Week 21, Total GO-QOL improved from baseline by 24.9±21.0 points (AP improved by 23.8±26.2, VF improved by 25.7±25.8), all large changes. All patients reported an AE. One patient suffered from appendicitis, which was deemed unrelated. Other AEs (>2 patients) included muscle spasms (n=11), fatigue (n=10), hypoacusis (n=5), headache (n=5), nausea (n=5), extremity pain (n=4), alopecia (n=4), hypertension (n=4), dry skin (n=3), diarrhea (n=3), tinnitus (n=3), myalgia (n=3), increased lacrimation (n=3), and hypogeusia (n=3). No new safety concerns were identified. Conclusions : Teprotumumab resulted in large QOL improvements as demonstrated previously in controlled clinical trials. Safety findings were consistent with the previously established teprotumumab profile.