Continuous Remote Monitoring in Moderate and Severe COVID-19 Patients

Background COVID-19 steadily built up the pressure on healthcare systems worldwide, creating the need for novel methods to alleviate the burden. Continuous remote monitoring of vital parameters reduces morbidity and mortality in hospitals by providing real-time disease data that can be analyzed through web portals. It enables healthcare workers to identify which patients require prompt administration of healthcare. Patients remain under the purview of their doctors and can be notified early if there are any deteriorations in the parameters being monitored. Aims To evaluate the use of remote monitoring in moderate and severe COVID-19 patients and to correlate the Dozee Early Warning Score (DEWS) with severity and outcome in moderate and severe COVID-19 patients. Materials and methods We conducted a prospective study on adult (>18 years old) moderate and severe COVID-19 patients during the second wave of COVID-19. The vitals of the subjects were continuously monitored using Dozee, a contactless remote patient monitoring system enabled with DEWS that reflects the overall patient condition based on respiratory rate (RR), heart rate (HR), and oxygen saturation (SpO2). We assessed the correlation of DEWS with patients' clinical outcomes: deteriorated or recovered. Results Thirty-nine COVID-19 patients were recruited for the study, of whom 29 were discharged after recovery and 10 deteriorated and died. Respiratory rate trend, respiratory rate DEWS, SpO2 DEWS, and total DEWS showed a significant reduction in recovered patients, while the same parameters showed a significant increase followed by consistently high scores in patients who deteriorated and died due to the disease. Total DEWS was proportional to the risk of mortality in a patient. Conclusion We concluded that continuous vitals monitoring and the resulting DEWS in moderate and severe COVID-19 patients were indicators of their improvement or deterioration. DEWS uses continuous remote monitoring of routinely collected vitals (HR, RR, and SpO2) to serve as a predictor of patient outcome.

Inhibition of SARS-CoV2 viral infection with natural antiviral plants constituents: An in-silico approach

Background and Objective

In 2019, a novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) was declared pandemic. Advancement in computational technology has provided rapid and cost-effective techniques to test the efficacy of newer therapeutic agents. This study evaluated some of the potent phytochemicals obtained from AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homeopathy)-listed medicinal plants against SARS-CoV-2 proteins using computational techniques.

Materials and methods

The potential SARS-CoV-2 protein targets were utilized to study the ligand-protein binding characteristics. The bioactive agents were obtained from ashwagandha, liquorice, amla, neem, tinospora, pepper, and stevia. Ivermectin was utilized as a reference agent to compare its efficacy with phytochemicals.

Results

The computational analysis suggested that all the bioactive components from the selected plants possessed negative docking scores (ranging from -6.24 to -10.53). The phytoconstituents were well absorbed, distributed in the body except for the CNS, metabolized by liver enzymes, well cleared from the body, and well tolerated. The data suggest that AYUSH-recommended plants demonstrated therapeutic efficacy against SARS CoV-2 virus infection with significantly reduced toxicity.

Conclusion

The phytoconstituents were found to hinder the early stages of infection, such as absorption and penetration, while ivermectin prevented the passage of genetic material from the cytoplasm to the nucleus. Additional research involving living tissues and clinical trials are suggested to corroborate the computational findings.

Assessment of the Knowledge and Self- Care Practice on Hypoglycemia among Patients with Diabetic Mellitus Attending Medical Opd at Smch

Introduction: Hypoglycemia is a clinical emergency that needs to be recognized and treated promptly to avoid organ damage and death. Knowledge of hypoglycemia prevention is an essential step in self-care practices due to the fact knowledgeable individuals are much more likely to practice hypoglycemia prevention. Prevention of hypoglycemia relies on adequate awareness and rightself-care. Objectives: To evaluate the level of knowledge and to self - care practice of hypoglycemia with their selected demographic variables among diabetic patients. Methods: A cross sectional descriptive research design was adopted with hundred samples who met the inclusion criteria in the hospital setting. Self-structured questionnaire method was used to acquire the data. Data have been through descriptive and inferential statistics. Result: Of 100 samples, 76(76%) had adequate knowledge and 63(63%)had good self-care practice on hypoglycemia. Spearman’s correlation showed positive relationship between knowledge and self-care practice of hypoglycemia (r value = 0.720, p<0.001). In respect to level of knowledge, there was a significant association noted among age, education, occupation, income, religion, marital status, family history and with regards to self-care practice along with all variables including gender is significant at p<0.05. Conclusion: This study result emphasized that majority of the diabetic patients had adequate knowledge and good self-care practice on hypoglycemia. Enlightening the patients further with regular self-monitoring of blood glucose level and obtain medical guidance and support may help the patients to stay fit.

Characterization and application of rhamnolipid from Pseudomonas plecoglossicida BP03

The production of rhamnolipid (glycolipid) biosurfactant was achieved under optimized conditions from newly isolated bacteria (Pseudomonas plecoglossicida BP03) from rice mill effluent. The isolated biosurfactant was structurally characterized using FTIR and NMR spectroscopic studies. The obtained biosurfactant (1·39 g l^-1 ) showed a variety of applications including larvicidal and pupicidal activity against malarial vector (Anopheles sunadicus). It also exhibited antimicrobial activity against human pathogens, and possessed potent anti-biofilm activity against Staphylococcus aureus, Bacillus subtilis and Aeromonas hydrophila. The obtained biosurfactant showed a dose-dependent inhibition of exopolymeric substance (EPS) and growth curve in S. aureus. Furthermore, the cytotoxicity assays revealed that the biosurfactant exhibit a cytotoxic potency against the human fibroblastic sarcoma cells Ht-1080. An in silco analysis was also performed using Schrodinger maestro 9.3 against surface protein (SasG) of S. aureus, and the resultant analysis revealed an interactive docking score of -3·4 kcal mol^-1 . The obtained result indicates that the synthesized economically viable biosurfactant ensures excellent applications towards various fields.

New binuclear Ni(ii) metallates containing ONS chelators: synthesis, characterisation, DNA binding, DNA cleavage, protein binding, antioxidant activity, antimicrobial and in vitro cytotoxicity

Four new binuclear nickel(ii) metallates showed promising antiproliferative activity against MCF-7 and HeLa cell lines and were much less toxic against HaCaT.

Chronic granulomatous disease

A 2(1/2)-year-old child presented with multiple discrete granulomatous lesions on the face and flexural regions since the age of 2 months along with lymphadenopathy. The patient also had recurrent bouts of pyodermas and respiratory tract infections. Biopsy of the lesion showed necrosis of tissue with suppuration and histiocytes but no evidence of tuberculosis, fungal infections or atypical mycobacteria. Lymph node biopsy also showed necrosis with suppuration but no infective organism. Nitroblue tetrazolium test was negative indicating that the neutrophils failed to oxidize the dye. We are reporting here a rare case of chronic granulomatous disease.