To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
Upsurge of chikungunya cases in Uttar Pradesh, IndiaAhmad Ozair
Background & objectives: Chikungunya (CHIK) re-emerged in India in 2006 after a gap of three decades. In Uttar Pradesh (UP), <100 confirmed cases per million were reported during this outbreak. Based on an upsurge of CHIK cases at UP, this retrospective study was conducted to investigate clinical and serological profile of CHIK cases in UP. Methods: A retrospective study was done on all clinically suspected CHIK cases that had been tested by ELISA for anti-CHIK virus IgM antibodies from September 2012 to December 2017. Based on clinical features, a subset of patients had earlier been tested serologically for dengue and Japanese encephalitis (JE). Results: Of the 3240 cases enrolled, 771 (23.8%) were seropositive. Patients had a range of clinical manifestations with seropositivity highest in those exhibiting arthralgia with fever (40%), followed by fever of unknown origin (FUO) (22%), encephalitis (13%) and fever with rash (12%). Cases (total, seropositive) increased over 20-fold in 2016 (1389, 412) and 2017 (1619, 341), compared to 2012-2015. Nearly a third of dengue serology-positive cases and a fifth of JE serology-positive cases were co-positive for CHIKV. Interpretation & conclusions: Archival data from 2006-2011 and data from this study (2012-2017) indicated that UP experienced first CHIK outbreak in the decade in 2016, as part of a large-scale upsurge across northern India. CHIK should be considered as a differential diagnosis in patients presenting with fever of unknown origin or fever with rash or acute encephalitis, in addition to classical arthralgia.
Observational Study on 255 Mechanically Ventilated Covid Patients at the Beginning of the USA Pandemic
This article is a preprint and has not been peer-reviewed.
Twitter: @MattisVollan
A Study On Clinical Profile Of Sepsis Patients In Intensive Care Unit Of A Te...dbpublications
Background : Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection which is one of the most important cause of mortality & morbidity in critically ill patients. In this study clinical profiles of the sepsis patients admitted in ICU in this part of India have been evaluated. Methods & Materials: This prospective hospital based observational study was undertaken in the department of Emergency Medicine ICU of Gauhati Medical College & Hospital, over a period of one year from August 2014 to July 2015 after obtaining institutional ethical committee clearance.
RESULTS: Clinical profiles of 50sepsis patients, with male preponderance (56%) & mortality rate 36% were studied. Mean age was 48.36 years (SD ±17.16). fever & tachycardia were present in all patients. 30 patients (60%) required ventilatory support, 28 patients (56%) required inotropic support, 10 patients (20%) required dialysis. Gram negative bacteria were found to be the predominant pathogens associated with sepsis(73.4%) where most common organism responsible was Klebsiella (36.8%). Conclusion : assessment of clinical signs & initial serological & radiological investigations are of utmost importance to detect more critically ill patients as early as possible to intervene earlier for saving the life of the sepsis patients.
A Possible Role of Rosmarinic Acid against CD2 Associated Protein for the Tre...YogeshIJTSRD
Multiple sclerosis is a chronic inflammatory neurodegenerative disorder which directly affects Central Nervous System CNS . People with MS suffer with an episodic reversible memory loss during the initial stages and later it leads to the neurological deterioration. Number of research and studies has been done on the natural compounds and phytochemical compounds in order to develop the particular drug for the treatment of MS in vivo andin vitro. The present study focuses on the inhibitory effect of Rosmarinic acid against the effect of CD2 Associated protein with the help of Molecular Docking. Molecular Docking basically screens the ligand and the target protein and shows the interaction between them on the basis of the minimum binding affinities and drug likeliness properties. In our research, docking was performed between CD2 Associated protein and selected ligands with the help of docking software. Ligands were selected on the basis of their minimum Binding affinities and finally by their drug likeliness properties. Rosmarinic acid BA 5.6 was the resultant ligand of our recent study. It showed the perfect interaction with CD2 Associated protein. Therefore, we may conclude that Rosmarinic acid may act as a compound which may be used as a drug for the treatment of multiple sclerosis fromfurther in vitro and in vivostudies in future. Jitin Kumar | Tejaswee Anand | Ritika Sharma | Noopur Khare | Abhimanyu Kumar Jha | Yamini Dixit "A Possible Role of Rosmarinic Acid against CD2-Associated Protein for the Treatment of Multiple Sclerosis through in Silico Approach" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd44979.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/44979/a-possible-role-of-rosmarinic-acid-against-cd2associated-protein-for-the-treatment-of-multiple-sclerosis-through-in-silico-approach/jitin-kumar
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 29th publication iosr jdms 3rd name
study of hematological paremeter in sepsis patients and its prognostic implic...RahulGupta1687
The current study was a cross-sectional study with a sample size of 117 patients with sepsis. Various hematological parameters of all the patients were obtained on day of admission (day 1) and seventh day (day 7) using hemogram reports and the difference of their statistical mean and standard deviation was estimated.
Upsurge of chikungunya cases in Uttar Pradesh, IndiaAhmad Ozair
Background & objectives: Chikungunya (CHIK) re-emerged in India in 2006 after a gap of three decades. In Uttar Pradesh (UP), <100 confirmed cases per million were reported during this outbreak. Based on an upsurge of CHIK cases at UP, this retrospective study was conducted to investigate clinical and serological profile of CHIK cases in UP. Methods: A retrospective study was done on all clinically suspected CHIK cases that had been tested by ELISA for anti-CHIK virus IgM antibodies from September 2012 to December 2017. Based on clinical features, a subset of patients had earlier been tested serologically for dengue and Japanese encephalitis (JE). Results: Of the 3240 cases enrolled, 771 (23.8%) were seropositive. Patients had a range of clinical manifestations with seropositivity highest in those exhibiting arthralgia with fever (40%), followed by fever of unknown origin (FUO) (22%), encephalitis (13%) and fever with rash (12%). Cases (total, seropositive) increased over 20-fold in 2016 (1389, 412) and 2017 (1619, 341), compared to 2012-2015. Nearly a third of dengue serology-positive cases and a fifth of JE serology-positive cases were co-positive for CHIKV. Interpretation & conclusions: Archival data from 2006-2011 and data from this study (2012-2017) indicated that UP experienced first CHIK outbreak in the decade in 2016, as part of a large-scale upsurge across northern India. CHIK should be considered as a differential diagnosis in patients presenting with fever of unknown origin or fever with rash or acute encephalitis, in addition to classical arthralgia.
Observational Study on 255 Mechanically Ventilated Covid Patients at the Beginning of the USA Pandemic
This article is a preprint and has not been peer-reviewed.
Twitter: @MattisVollan
A Study On Clinical Profile Of Sepsis Patients In Intensive Care Unit Of A Te...dbpublications
Background : Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection which is one of the most important cause of mortality & morbidity in critically ill patients. In this study clinical profiles of the sepsis patients admitted in ICU in this part of India have been evaluated. Methods & Materials: This prospective hospital based observational study was undertaken in the department of Emergency Medicine ICU of Gauhati Medical College & Hospital, over a period of one year from August 2014 to July 2015 after obtaining institutional ethical committee clearance.
RESULTS: Clinical profiles of 50sepsis patients, with male preponderance (56%) & mortality rate 36% were studied. Mean age was 48.36 years (SD ±17.16). fever & tachycardia were present in all patients. 30 patients (60%) required ventilatory support, 28 patients (56%) required inotropic support, 10 patients (20%) required dialysis. Gram negative bacteria were found to be the predominant pathogens associated with sepsis(73.4%) where most common organism responsible was Klebsiella (36.8%). Conclusion : assessment of clinical signs & initial serological & radiological investigations are of utmost importance to detect more critically ill patients as early as possible to intervene earlier for saving the life of the sepsis patients.
A Possible Role of Rosmarinic Acid against CD2 Associated Protein for the Tre...YogeshIJTSRD
Multiple sclerosis is a chronic inflammatory neurodegenerative disorder which directly affects Central Nervous System CNS . People with MS suffer with an episodic reversible memory loss during the initial stages and later it leads to the neurological deterioration. Number of research and studies has been done on the natural compounds and phytochemical compounds in order to develop the particular drug for the treatment of MS in vivo andin vitro. The present study focuses on the inhibitory effect of Rosmarinic acid against the effect of CD2 Associated protein with the help of Molecular Docking. Molecular Docking basically screens the ligand and the target protein and shows the interaction between them on the basis of the minimum binding affinities and drug likeliness properties. In our research, docking was performed between CD2 Associated protein and selected ligands with the help of docking software. Ligands were selected on the basis of their minimum Binding affinities and finally by their drug likeliness properties. Rosmarinic acid BA 5.6 was the resultant ligand of our recent study. It showed the perfect interaction with CD2 Associated protein. Therefore, we may conclude that Rosmarinic acid may act as a compound which may be used as a drug for the treatment of multiple sclerosis fromfurther in vitro and in vivostudies in future. Jitin Kumar | Tejaswee Anand | Ritika Sharma | Noopur Khare | Abhimanyu Kumar Jha | Yamini Dixit "A Possible Role of Rosmarinic Acid against CD2-Associated Protein for the Treatment of Multiple Sclerosis through in Silico Approach" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd44979.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/44979/a-possible-role-of-rosmarinic-acid-against-cd2associated-protein-for-the-treatment-of-multiple-sclerosis-through-in-silico-approach/jitin-kumar
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 29th publication iosr jdms 3rd name
study of hematological paremeter in sepsis patients and its prognostic implic...RahulGupta1687
The current study was a cross-sectional study with a sample size of 117 patients with sepsis. Various hematological parameters of all the patients were obtained on day of admission (day 1) and seventh day (day 7) using hemogram reports and the difference of their statistical mean and standard deviation was estimated.
Clinical characteristics of children with COVID-19 pneumoniaAI Publications
For this purpose, 75 children under the age of 18 were included in the study. The test for SARS-CoV-2 virus RNA was positive in the pathological material from the nasopharynx in all examined patients. The control group consisted of 15 healthy children. The patients included in the study were divided into 2 groups according to severity of disease: 49 (65.3%) patients with moderate COVID-19 were included in group I, 26 (34.7%) patients with severe COVID-19 - in group 2. Examination methods included anamnestic, clinical, instrumental and laboratory studies. The most common symptoms among children examined were fever (66 (88.0%)) and cough (74 (98.7%)). Rarely, muscle pains, loss of sense of smell and taste, headaches have been observed in older children. Intergroup comparison revealed higher levels of ferritin, D-dimer and fibrinogen in group II compared with group I. According to the results obtained, the course of the disease in children, in contrast to adults, is more favorable.
Clinical spectrum of COVID- 9 and risk factors associated with severity in Sp...Javier González de Dios
Solo de la suma de un gran número de pacientes recogidos en un estudio multicéntrico como EPICO-AEP es posible disponer de un tamaño muestral que nos devuelve resultados válidos desde el punto de vista de la investigación y relevantes en relación a su importancia clínica.
Y en este estudio sobre los factores de riesgo de gravedad de la COVID-19 en la edad pediátrica cabe concluir: Hospitalised children with COVID-19 usually present as one of fve major clinical phenotypes of decreasing severity. Risk factors for PICU include MIS-C, elevation of infammation biomarkers, asthma, moderate or severe live disease and cardiac disease.
What is Known:
• All studies suggest that children are less susceptible to serious SARS-CoV-2 infection when compared to adults. Most studies describe symptoms at presentation. However, it remains unclear how these symptoms group together into clinically identifable syndromes and the severity
associated with them.
What is New:
• We have gathered the primary diagnoses into fve major syndromes of decreasing severity: MIS-C, bronchopulmonary syndrome, gastrointestinal syndrome, fever without a source and mild syndrome. Classifcation of the children in one of the syndromes is unique and helps to
assess the risk of critical illness and to defne the spectrum of the disease instead of just describing symptoms and signs.
Prevalence of Rota Virus Detection by Reverse TranscriptasePolymerase Chain R...IOSRJPBS
The present study was conducted for the period from 1/6/2016 to 20/1/2017 in Baquba city. The study aimed to detection of rotavirus in stool specimens of children fewer than five age and also explore the effects of certain demographic factors on the detection rates by revers transcriptase- polymerase chain reaction. The study included 49 patients with acute diarrhea, 32 were male and 17 were female. The age range was two months to 5 years. Demographic information on the patients regarding age, sex, residence, type of feeding and source of drinking water were collected from their parents. Stool specimens were collected from each patients and. Detection of rotavirus in stool specimens was done by conventional reverse transcriptase polymerase chain reaction (RT-PCR). The results of present study showed that the overall infection rate by rotavirus among patients with acute diarrhea by RT-PCR tests was 93.88%. The highest infection rate was recorded among those >10-≤15 months of age. None of the results showed significantly difference between female and male, PCR (88% vs 96.87%). Likewise, there was insignificantly difference between urban and rural residence, PCR (95.65% vs 92.30%). The results revealed insignificantly higher infection rate among patients (those below 2 years) feed mixing (91.66%) and bottled (100%) compared to that breast feeding (77.77%) by RT-PCR. The rotavirus infection rate was insignificantly higher among patients consuming municipal water for drinking (97.22%) compared to those consuming bottled water (84.61%) by the RT-PCR. The study concluded that rotavirus was detected in high rates among children less than 5 years old with acute diarrhea in Baquba city, particularly those less than 2 year old.
Remdesivir in the Management of COVID-19: Evidence Based Approachfarah al souheil
the presentation starts with a quick overview of COVID-19 followed by Remdesivir focused clinical trials assessment and evaluation for the treatment of Corona virus
CONFERENCE PROCEEDINGS
11th International Conference on Biotechnology, Bio Informatics, Bio Medical Sciences and Stem Cell Applications (B3SC), 21-22 Sept, 2016,
Imperial College London, South Kensington Campus | London SW7 2AZd
Similar to Predictors and Outcomes of Pediatric COVID 19 Cases in Recent Scenario: Systematic Review & Meta Analysis. (20)
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapa...DrHeena tiwari
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapadu Village of Guntur District, Andhra Pradesh, India: An Original Research
An Evaluation of Short Term Success and Survival Rate of Implants Placed in F...DrHeena tiwari
An Evaluation of Short Term Success and Survival Rate of Implants Placed in Fresh Extraction Socket Post Prosthetic Rehabilitation- A Prospective Study
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Predictors and Outcomes of Pediatric COVID 19 Cases in Recent Scenario: Systematic Review & Meta Analysis.
1. Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 4876 - 4882
Received 25 April 2021; Accepted 08 May 2021.
4876
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Predictors and Outcomes of Pediatric COVID 19 Cases in Recent Scenario:
Systematic Review & Meta Analysis
Dr. Amruta.C. Naik1
, Dr. SanjuSundeepBhargeva2
,Dr. M. BagavathyPerumal3
, Dr.
Sathyanarayanan R4
, Dr. Aravinth R5
, Dr. Puneeta Vohra6
, Dr. Heena Tiwari7
1
MDS, Consultant Pediatric and preventive dentist, Pune, Maharashtra, India.
dramrutanaik@ymail.com
2
MDS, Public Health Dentistry, Senior Resident, Government Dental College, Hyderabad,
Telangana. sanjubhargava10@gmail.com
3
MD (Paed). Associate Professor, Department of Pediatrics, KKGMCH, Kanyakumari.
kalabags79@gmail.com
4
Professor and HOD, Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of
Dental Science, Pondicherry. camvannamathy@gmail.com
5
Post Graduate Resident, Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute
Of Dental Science, Pondicherry. aravinthram1@gmail.com
6
Professor ,Dept Of Oral Medicine And Radiology, Faculty Of Dental Sciences , SGT
University, Gurgaon, Haryana, India.mithi7k@gmail.com
7
BDS, PGDHHM, MPH Student, ParulUniveristy, Limda, Waghodia, Vadodara, Gujrat,
India.drheenatiwari@gmail.com
Corresponding Author:
Dr. Amruta.C. Naik, MDS, Consultant Pediatric and preventive dentist, Pune, Maharashtra,
India. dramrutanaik@ymail.com
ABSTRACT:
Background – Studies summarizing the clinical findings of COVID 19 in children are lacking.
So, we aimed to provide a comprehensive meta-analysis and systematic review of previously
published papers related to clinical features and lab findings of COVID -19 in pediatric
population.
Methods – a systematic search and meta-analysis of scientific literatures was conducted by using
PubMed, Embase, Scopus, Medline, google Scholar databases. Studies were reviewed for
methodological quality, and random-effects model was used to conduct the primary meta-
analysis. I2
value and Egger’s test was used to estimate heterogeneity and publication bias
respectively.
Results – we reviewed 10 eligible studies that included 1215 pediatric population with PCR
tested COVID -19 positive. The most frequent symptoms were fever, cough, vomiting, diarrhea,
sore throat, and dyspnea. Regarding the combined results of the meta-analysis, fever (60%),
cough (78%), dyspnea (74%) and pharyngalgia (59%) were the most widely reported symptom.
Besides, positive RT-PCR test results, elevated inflammatory markers including Procal (92 %),
D- Dimer (82%) and CRP (73 % ) were the most common laboratory findings.
Conclusion - COVID-19 is prevalent across all pediatric age-groups and presents with varying
degree of symptomology. However, children have a milder course of the disease with extremely
favorable prognosis.Future longitudinal studies are needed to confirm our findings and better
2. Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 4876 - 4882
Received 25 April 2021; Accepted 08 May 2021.
4877
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understand which patients are at increased risk for developing severe inflammation and multi
organ failure.
Key words: Pediatric, COVID 19, Outcomes, Predictors.
INTRODUCTION
In December 2019, a sudden outbreak of pneumonia cases of unknown origin emerged from
Wuhan, China. . Till 3 Jan. 2020 a total of 44 pneumonia cases were detected. On 7 Jan2020,
Chinese research authorities were announced that they were isolated new virus from sea food
market in Wuhan city; Named as 2019-nCoV. Though the SARS-CoV-2 originated from bats,
the intermediary animal through which it crossed over to humans is uncertain.1
Coronaviruses are
enveloped positive sense RNA viruses ranging from 60 nm to 140 nm in diameter with spike like
projections on its surface giving it a crown like appearance under the electron microscope; hence
the name coronavirus.2
Differential diagnosis is important in current scenario as it includes all
types of respiratory viral infections [influenza, parainfluenza, respiratory syncytial virus (RSV),
adenovirus, human metapneumovirus, non COVID-19 coronavirus], atypical organisms
(mycoplasma, chlamydia) and bacterial infections. It is not possible to differentiate COVID-19
from these infections clinically or through routine lab tests. Specific diagnosis is by specific
molecular tests on respiratory samples (throat swab/ nasopharyngeal swab/ sputum/ endotracheal
aspirates and bronchoalveolar lavage).
MATERIAL AND METHODS:
PRISMA FLOW CHART
Search strategy and selection criteria
Our systemic review and meta analysis adhere to the guidelines established by preferred
reporting items (ie PRISMA).3
This comprehensive search from 2019 to 2020 was conducted in
the following databases – PubMed, Embase, Scopus, Medline, googlescholar using various
combinations of keywords – novel coronavirus, COVID – 19, 2019-Ncov, SARS-COV-2,
3. Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 4876 - 4882
Received 25 April 2021; Accepted 08 May 2021.
4878
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Wuhan coronavirus, Wuhan Pneumonia and pediatric or neonate or new born or infant or
children or adolescence. Title and abstract screening was conducted by two investigators and
results were also reviewed by two authors (conventional double screening). Full texts of selected
studies were reviewed and 10 publications were selected for meta analysis. Excluded articles
included those that did not contain relevant and adequate data concerning clinical features, lab
findings; exclusively neonatal or specific age group studies; comorbidities and non English
publications.
Data extraction and quality assessment
Following the full text screening for eligibility all relevant data was collected included author,
the type of article (e.g. case series), publication year, country of origin, number of pediatric
patients, clinical symptoms (e.g. cough, fever ), lab findings (e.g. D-dimer).
RESULTS:
Data analysis
Primary outcomes of study were – clinical symptoms, lab markers. I2
index was used to assess
heterogeneity with values 25%, 50% and 75% representing low, moderate, high heterogenecity.4
If analysis included more than three studies, egger precision weighted linear regression was used
to test potential publication bias, with p-value <0.05 considered significant for publication bias.
If publication bias was present, the trim and fill method was performed to evaluate the
effect(data not shown). Meta-analysis was performed using metapackages in R (version 3.6.0).
Meta analysis
Meta-analysis was conducted on 9 clinical symptoms and 9 laboratory markers. Overall, 67 %
of the patient population were with headache (67 % ), fever (60 % ), and cough (78%), being the
most common symptoms. The remaining clinical symptoms had an overall estimated prevalence
of <20 %. Among commonly reported laboratory findings, elevated inflammatory markers
including Procal (92 %), D- Dimer (82%) and CRP (73 % ) were the most common. Decreased
lymphocytes (50 % ) and leukocytes (71%) were also more common than elevated counts of
these immunological markers.
Table 1: Characteristics of the included studies on COVID – 19/20
Study Location N Age Gender (male)
Dong, Y. et al 12
China 728 10 (4-15) 418
Bai K. et al 20
China 25 11 (6.3 – 14.5) 14
Qiu , H. et al 13
China 36 8.3 ± 3.5 23
Song, W. et al 21
China 16 8 (11.5 – 14) 10
Shekerdemian, L.S.
22
Canada 48 13 (4.2 – 16.6) 25
Feng et al 23
China 15 4 – 14 5
Tagarro et al 24
Spain 41 <18 18
Rahimzadeh et al 25
Iran 9 2 – 10 6
Bialek et al 26
United
States
291 <18 165
Hu et al 27
China 6 <15 3
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Table 2: Summary of the study characteristics and results of meta-analysis of clinical and
laboratory findings in pediatric COVID-19 patients. Abbreviations: GI: Gastrointestinal;
LDH: Lactate Dehydrogenase; AST: Aspartate transaminase; ALT: Alanine transaminase;
ESR: Erythrocyte Sedimentation Rate; CRP: C reactive protein; Procal:Procalcitonin.
Clinical and lab
variables
Number of
studies
Total patients I2
(%) Egger’s test
P - value
Fever 9 388 60 % 0.670
Cough 7 357 78 % 0.353
Dyspnea 7 215 74 % 0.006
Sore throat 6 50 59 % 0.005
Rhinorrhea 9 38 52 % 0.600
Congestion 4 17 75 % 0.125
Headache 5 95 67 % 0.960
Fatigue 6 53 59 % 0.373
GI symptoms 8 21 70 % 0.660
Leukocytosis 5 49 62 % 0.034
Leukopenia 3 30 71 % 0.396
Lymphopenia 4 21 50 % 0.020
Procal 3 60 92 % 0.030
D – Dimer 4 20 82 % 0.045
CRP 5 100 73 % 0.002
LDH 3 45 68 % 0.091
ESR 3 89 76 % 0.784
AST/ALT 4 65 0 % 0.065
DISCUSSION
In the last 6 months, worldwide cases of SARS-COV2 infection & our knowledge of the disease
and its epidemiologic and new clinical characteristics continue to evolve. It was first reported in
Wuhan city in China in December 2019. Rapidly emerging the new mutants of this novel virus is
threat and identification of clinical features and lab findings is essential to guide good clinical
care, predict severity and to determine prognosis. COVID-19 is present across all age ranges.
Based on current evidence, there does not appear to be any age restriction for COVID-19
susceptibility.5
However, substantial evidence has established that compared to adults, children
only account for a small number of COVID-19 case.6
In our meta-analysis of COVID-19
prevalence across various pediatric age groups the distribution of cases varied but was highly
frequent (21–25 %) in the 8 - 15 year-old age range . Similar observations were made by
G¨otzinger et al. in a large European study.7
Similarly, in regard to common clinical indicators,
fever, cough, and headache accounted for the most dominant symptoms while sore throat,
rhinorrhea, and GI symptoms were rare. The primary mechanism of SARS-CoV2 pathogenesis is
thought to involve its interaction with human ACE-2 receptors leading to T-cell activation and
subsequent inflammatory response. In the early stage, viral copy numbers can be high in the
lower respiratory tract. Inflammatory signaling molecules are released by infected cells and
alveolar macrophages in addition to recruited T lymphocytes, monocytes, and neutrophils. In the
late stage, pulmonary edema can fill the alveolar spaces with hyaline membrane formation,
compatible with early-phase acute respiratory distress syndrome. This pro-inflammatory state
with further vascular and multi-organ injury likely contributes to the variety of laboratory
5. Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 4876 - 4882
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abnormalities commonly seen in infected patients. Previous studies including infections caused
by other novel coronaviruses have reported typically normal or reduced immunological markers
with normal to elevated LDH and D-dimer levels. Our findings were consistent with higher
prevalence of leukopenia and lymphopenia as well as elevated levels of D-dimer and LDH.
However, the most common laboratory markers seen in our study were elevated Procalcitonin
and CRP consistent with a highly inflammatory state.8,9
These clinical markers alone however
are non-specific, thus limiting their clinical utility in absence of a strong clinical correlation to
the patient’s history and physical symptoms. Overall, these clinical symptoms and laboratory
markers are highly non-specific and provide little evidence of COVID-19 infection when
assessed individually. Clinicians should not diagnose or rule out COVID-19 infection solely
based on any one of these findings, but synthesize information based on prevalence of common
features as evidenced in ours and other studies. Although SARS-CoV2 infection was first
identified in China, the United States has now amassed the highest number of confirmed cases.10
Calculations made on June 4th, 2020 from the COVID-19 Dashboard by the Center for Systems
Science and Engineering at Johns Hopkins University indicate that China has 45 % of total
confirmed COVID-19 cases compared to the United States. 11
As expected, the most common
vector for childhood infection is close contact to an affected family member or residing in an
area with a high population of cases. Our findings align with the results of an April 2020 report
by Dong et al, in which there was a clear trend that the disease spread rapidly from a Chinese
province to surrounding provinces and cities in children on December to February.12
.
Furthermore, Qiu and colleague studied 36 pediatric COVID-19 positive patients in which ten
patients (28%) were symptomatic latent cases identified secondary to an adult family member
who was infected, symptomatic, or traveled to an endemic area.13
This lends concern that
children, who may be asymptomatic, may play a role in community transmission of the virus.
Little is known about the perinatal aspects of COVID-19, and there have been several reported
cases of neonatal infection, suggesting a possible perinatal or vertical transmission during
pregnancy.14
However, in a report by Chen et al., all nine neonates born to COVID-19 positive
mothers tested negative for the virus after cesarean delivery.15
In another study by Zhang et al.,
10 neonates from COVID-19 positive mother all tested negative for the infection.16
Moreover,
this is further supported by analysis of breast milk and placental pathologic specimens from
COVID-19 positive mothers, which have returned negative for the virus. Lastly, vertical
transmission was not observed with either SARS-CoV-1 or in MERS-CoV17
therefore, it is
unlikely that maternal vertical transmission during third trimester occurs, or is likely very rare.
However, from the limited data published, we cannot determine the consequences of SARS-
CoV-2 infection in early pregnancy and if it can be transmitted to fetus and hinder organ
development, malformations, growth abnormalities, or even lead to premature labor or
spontaneous abortions. 18,19
AKNOWLEDGEMENT:
We thank Dr. HemanadhKolli, BDS, MPH, Northern Illinois University, DeKalb, Illinois, USA
for final editing and reviewing the manuscript.
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