Face Mask and Body Temperature Scanning System for Covid-19

Coronavirus illness 2019 has had a major impact on the entire world over the past two to three years. One important approach for people's protection is to wear masks in public. Furthermore, putting on a mask properly Many public service providers demand that users only utilise the service while properly wearing masks. Only a small number of studies have examined face mask identification using image analysis, nevertheless. We suggest Face Mask, a highly accurate and practical face mask detector, in this study. The suggested Face Mask is a one-stage detector that combines a novel context attention module for detecting face masks with a feature pyramid network to fuse high-level semantic information with various feature maps. We also provide a brand-new cross-class object removal method to reject and predictions with a high intersection of union and low confidence. Additionally, we investigate the viability of integrating Face Mask with a portable or embedded neural network called MobileNet. By utilising1)Contactless temperature sensing,2)we create a fack mask detection alarm system to boost COVID-19 indoor safety.Infrared sensor and contactless temperature sensing subsystems rely on Arduino Uno, while computer vision algorithms are used for mask identification. © 2023 IEEE.

Study of Clinical Spectrum of Severe COVID-19 Infection in Elderly Patients and its Outcome-A Major Mumbai Tertiary Care Hospital Observations

Background: At 140 million, India has the second largest population of old people in the world, as per the 2011 census.1 The covid 19 pandemic has wreaked havoc in millions of lives. Elderly are especially vulnerable to COVID-19 and experience high morbidity and mortality as a result of immunosenescence. Age is independently linked with mortality, but age alone does not adequately capture the robustness of older adults who are a heterogeneous group. The current research was done in a tertiary healthcare hospital in Maharashtra to understand the clinical profile and factors that affected the outcome of elderly during the second wave of the COVID pandemic. Method: This was a single centre retrospective observational study done in a tertiary hospital which was admitting both covid and non-covid patients during the time of this study. All elderly patients admitted with COVID 19 disease in Covid ward and covid ICU (Intensive care unit) were included in the study. Their Demographic details, duration of illness, vital parameters, oxygen saturation, partial pressure of arterial oxygen compared to fraction of inspired oxygen (PaO2-FiO2 ratio) were recorded and also relevant investigations such as complete blood count, kidney function tests, liver function tests, arterial blood gases, chest X-rayand ECG (Electrocardiogram),CT scan of the brain, CSF(cerebrospinal fluid) studies and other tests where relevant were recorded. Inflammatory markers such as C-Reactive Protein (CRP), Ferritin, D-Dimer and Chest CT scan were noted. Clinical profiles and outcomes were noted till discharge or death. Results: Among 231 patients that were included in this study, 81(35%) were female and 150 (65%) were male. Ninety-two patients died (39.8%) while 139 patients (60.2%) survived in our study. Majority of our patients (211;91.3%) presented in category E(pneumonia with respiratory failure) or category F(pneumonia with respiratory failure and multiorgan dysfunction syndrome). Factors which had a major impact on mortality were- a low PaO2-FiO2 ratio on admission, high C-Reactive Protein (CRP) levels, high d-dimer levels, a finding of bilateral ground glass opacities on x-ray, and need for invasive ventilation on admission. Conclusions: Elderly remain vulnerable to severe consequences of COVID-19 infection owing to the increasing comorbidities and immunosenescence in them. Prolonged oxygen therapy and intensive respiratory rehabilitation are the mainstays of effective management. Given the constant threat of mutating virus, masking, maintaining hand sanitization, vaccination and also caring for our elders while still maintaining social distance are our best bet against a fatal third wave. © 2022 Journal of Association of Physicians of India. All rights reserved.

COVID-19 associated stroke — A single centre experience

Background and Purpose: Various neurological complications have been reported in association with COVID-19. We report our experience of COVID-19 with stroke at a single center over a period of eight months spanning 1 March to 31 October 2020. Methods: We recruited all patients admitted to Internal Medicine with an acute stroke, who also tested positive for COVID-19 on RTPCR. We included all stroke cases in our analysis for prediction of in-hospital mortality, and separately analyzed arterial infarcts for vascular territory of ischemic strokes. Results: There were 62 stroke cases among 3923 COVID-19 admissions (incidence 1.6%). Data was available for 58 patients {mean age 52.6 years;age range 17–91;F/M=20/38;24% (14/58) aged ≤40;51% (30/58) hypertensive;36% (21/58) diabetic;41% (24/58) with O2 saturation <95% at admission;32/58 (55.17 %) in-hospital mortality}. Among 58 strokes, there were 44 arterial infarcts, seven bleeds, three arterial infarcts with associated cerebral venous sinus thrombosis, two combined infarct and bleed, and two of indeterminate type. Among the total 49 infarcts, Carotid territory was the commonest affected (36/49;73.5%), followed by vertebrobasilar (7/49;14.3%) and both (6/49;12.2%). Concordant arterial block was seen in 61% (19 of 31 infarcts with angiography done). ‘Early stroke’ (within 48 hours of respiratory symptoms) was seen in 82.7% (48/58) patients. Patients with poor saturation at admission were older (58 vs 49 years) and had more comorbidities and higher mortality (79% vs 38%). Mortality was similar in young strokes and older patients, although the latter required more intense respiratory support. Logistic regression analysis showed that low Glasgow coma score (GCS) and requirement for increasing intensity of respiratory support predicted in-hospital mortality. Conclusions: We had a 1.6% incidence of COVID-19 related stroke of which the majority were carotid territory infarcts. In-hospital mortality was 55.17%, predicted by low GCS at admission. © 2021 Journal of Association of Physicians of India. All rights reserved.

Right atrial thrombus in a case of immunocompromised state with COVID-19

Introduction: COVID-19 is a worldwide pandemic. Pieces of evidence are suggesting a strong association between COVID-19 and prothrombotic states. We are reporting a case of critical COVID- 19 complicated by a right atrial thrombus. We describe a patient with COVID-19 pneumonia and a clinical hyperinflammatory state. She developed hypoxia and required O2 support. Echocardiography suggestive of right atrial thrombus. She was managed with oxygen therapy and thrombolysis. Case presentation: A 55-year-old woman came with chief complaints of fever, dyspnea, bilateral pedal edema, and oliguria for 4 days. she was in a known c/o immunocompromised state for 2 years on tenofovir, lamivudine, and efavirenz regimen. She was diagnosed with COVID-19 based on RT-PCR testing which detected SARS-CoV-2. There is no history of i.v. drug abuse. General examination: Febrile+, pulse = 100/ minute, blood pressure-130/90 mm Hg, bilateral pedal edema+, no pallor/icterus/cyanosis/clubbing/lymphadenopathy, jugular venous pressure - raised, tachypneic + SpO2 78% on room air. Systemic Examination: Respiratory system - bilateral basal crepts. Cardiovascular System - holosystolic murmur of tricuspid regurgitation+. Nervous system-normal. Per abdomen-soft, nontender. Investigations: HB-13 g% WBC-3,900, platelets 187,000. BUN/creatinine-22/1.3. SGOT/SGPT-149/89. HIV1-Reactive. CD4-259. HbsAg and HCV-Non-reactive.ESR-33. C-reactive protein-9. D-dimer-2,054.63 ng/mL [normal-500 (cut-off)]. ECG s/o P-Pulmonale. Chest X-ray (CXR)-s/o cardiomegaly and bilateral peripheral pulmonary infiltrates. SARS-CoV-2 RT-PCR-positive 2D ECHO-right ventricle volume overload pattern, dilated right atrium and right ventricle, mild mitral regurgitation, severe tricuspid regurgitation, mild pulmonary regurgitation, mild pulmonary arterial hypertension, aortic valve pressure gradient (AVPG)-7, pulmonary arterial pressure gradient (PASP)-31. Bilateral lower limb Doppler-s/o mild atherosclerotic changes along with bilateral lower limb arterial system biphasic waveform in bilateral anterior tibial artery (ATA), posterior tibial artery (PTA), and dorsalis pedis artery (DPA). CT pulmonary angiography-Moderate cardiomegaly with dilated right atrial, right ventricle, and prominent pulmonary arteries, mild pericardial effusion s/o pulmonary hypertension. Few non-enhancing filling defects in right atrium just distal to opening of superior vena cava anteriorly and along the anterior wall of right Atrium with largest measuring 1.3 × 1 cm distal to opening of superior vena cava s/o thrombosis. Early opacification of inferior vena cava and hepatic veins on arterial phase s/o tricuspid regurgitation. Course in the ward: Patient was tachypneic on admission with SpO2 of 78% on room air, she was treated with oxygen, antibiotics, inj. Lasix, and inj. heparin. The patient had a long stay of 1 month in the ward, initially, the oxygen requirement was quite high about 15 L/minute by a non-rebreather mask. Oxygen tapered off gradually and shifted to O2 by nasal prongs thereafter weaned off from O2, urine output improved and the patient discharged on oral anticoagulation therapy after patient being asymptomatic and negative COVID swab. Materials and methods: COVID-19 cases in tertiary care center. Results: The hypercoagulation state in critically ill COVID-2019 pneumopnia patients should be monitored closely, and anticoagulation therapy should be considered in treatment early in the course of disease Early investigations and treatment with anticoagulants remains the cornerstone of treatment of COVID 19 to avoid further complications. Discussions: Severe COVID-19 infection is associated with hypercoagulable states. It is associated with a high risk for arterial as well as venous thrombosis and pulmonary thromboembolism. Prophylactic anticoagulants are recommended in all patients with severe COVID-19 infection. Full therapeutic dose of anticoagulants is required in patients with proven venous thromboembolism. The dysfunction of endothelial cells induced by infection and hypoxia found in severe C VID-19 can stimulate thrombosis not only by increasing blood viscosity but also through a hypoxia-inducible transcription factor-dependent signaling pathway. A case series of COVID-19 patients with clinically significant coagulopathy, antiphospholipid antibodies, and multiple infarcts in the brain, both digital and pulmonary, has been described. However, these antibodies can also arise transiently in patients with critical illness and various infections. The presence of these antibodies may in rare cases lead to thrombotic events that are difficult to differentiate from other causes of multifocal thrombosis in critically ill patients, such as DIC, heparin-induced thrombocytopenia, and thrombotic microangiopathy. All reported patients had severe hypoxemia and markedly elevated D-dimer levels. Our patient has developed a right atrial thrombus and was having elevated D-dimer level. She was treated with anticoagulation therapy. The international society of thrombosis and hemostasis recommends that all the hospitalized COVID-19 patients should receive a prophylactic dose of LMWH unless they have contraindications (active bleeding and low platelet count). There is a rare occurrence of COVID-19 pneumonia complicated by right atrial thrombus. Conclusion: The hypercoagulation state in critically ill COVID-19 pneumonia patients should be monitored closely, and anticoagulation therapy should be considered in treatment early in the course of the disease. Early investigations and treatment with anticoagulants remain the cornerstone of treatment of COVID-19 to avoid further complications. We are reporting this case for its rare occurrence.