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Aim: Patients who have severe case of kyphoscoliosis face functional and physical difficulties, making anaesthetic treatment challenging. In this example, a severe case of scoliosis was successfully treated under general anaesthesia. The case report aims to highlight the meticulous perioperative management of a patient with severe scoliosis, even after the surgery has been completed. Case: A 69-year-old woman with severe dextroscoliosis, single-vessel disease, and a recent history of covid (1 month ago) was scheduled for L1 to S1 fixation with L2-L4 laminectomy. On post-covid chest x-ray, the patient showed lung fibrosis, making anaesthetic management more challenging. Discussion: Scoliosis can cause a sort of respiratory restriction. The angle of the malformation is connected to the severity of the pulmonary issue. Cardiovascular, respiratory, and neurological dysfunction caused by the abnormality should be assessed prior to surgery. Fluid shift needs to be monitored carefully and corrected if necessary. There were no issues associated to ocular changes or the biracial plexus. Conclusion: Thorough preanaesthetic evaluation and optimization of the respiratory and cardiovascular systems is critical. In severe kyphoscoliosis, precise planning of anaesthesia induction and meticulous approach will result in a satisfactory outcome.
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India is a favorable destination for medical tourism because of its quality healthcare services and affordable treatment costs. It is a continuously growing industry across the globe. But whenever any pandemic situation arises, it adversely affects the industry. Currently, COVID-19 has a severe negative impact on the medical tourism sector. This paper discusses the effects of a pandemic, critical issues, SWOT analysis, and components that mitigate the adverse effects of pandemic diseases on medical tourism in India. During this phase, it is crucial to encourage domestic medical tourism for the sustainability of this sector. India's heritage of ancient medicine promotion, along with modern medicine can captivate the medical tourists. The destination country requires meeting the expectations of tourists through quality services. With India entering this unexpected downturn in this sector, destination country it must emphasize the slow and steady growth of medical tourism against the current and potential future pandemics.
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Multidrug resistance (MDR) bacterial infection is the next pandemic waiting behind the COVID-19 with annual mortality rate 700000 worldwide. Among the MDR bacteria, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecium and Enterococcus faecalis are showing average resistance of 50 to 80% to ampicillin, amoxicillin, third-generation cephalosporin’s and fluoroquinolone and even to combinations antibiotics such as amoxicillin-clavulanic acid. To make the antibiotic resistance issue worst, pharmaceutical industry is reluctant to invest in research and development of new antibiotic typically due to low returns on investment. Accordingly, use of combination of two or more antibiotics or use of the antibiotic adjuvants are only available ways in combatting the ever growing Multidrug resistance (MDR) in bacteria. The present paper is designed to analyze the synergistic potential of black pepper phyto-constituents as the amoxicillin adjuvants in comparison with isolated piperine against the MDR E. coli. using in-silico molecular docking. The result indicates that binding energy (Kcal/mol) and torsion free energy (Kcal/mol) of piperine (-6.23, +0.89), beta caryophyllene (-6.36, +0.00), beta selinene (-6.93, +0.30), beta-Thujene (-5.42, +0.30) is less for the emrD efflux pump as compared to amoxicillin (-5.85, +2.93) respectively indicating strong inhibition for EmrD of MDR E-coli than amoxicillin. The results are also indicating that black pepper extract containing all aforementioned phyto-constituents has synergistic effect in comparison with isolated piperine against the MDR E. coli. ADMET of these phyto-constituents also indicates their safety profile in combination with amoxicillin.
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Introduction: In India modern service delivery technologies like telemedicine are emerging promptly in healthcare sector. Successful implementation and utilization of novel technology hinges on several significant aspects together with knowledge, and attitude regarding technology and its user operating environment. Aim: Primary objective of this study was to determine the knowledge and attitude of health professionals towards telemedicine in Vijayawada division of Andhra Pradesh state of India. Methods: A randomized survey was conducted among healthcare professionals. A total of 123 respondents from medical and para-medical departments have participated in the study. A well-defined questionnaire was utilized to determine the knowledge and attitude of respondents about telemedicine. Data is entered and analysed using MS Excel 365 and SPSS 20. Pearson Correlation test was used to test the correlation between knowledge and attitude and Chi-Square test to assess the significant differences amongst gender and respondent's knowledge, and between gender and attitude of respondents about telemedicine. < 0.05 was considered as significant P-value. Results: 52.57% respondents had good knowledge level, of which 54.34% were males, there was no significant difference between respondent's gender and their level knowledge with respect to telemedicine. Regarding attitude towards telemedicine 57.45% respondents had positive attitude towards telemedicine. Also, there was no significant difference between gender and attitude of respondents towards telemedicine. The Pearson Correlation value 0.699 indicates that a positive correlation exists between Knowledge and Attitude. Conclusion: Outcomes of the analysis indicate that though the respondent's knowledge about telemedicine is average. Majority of respondents had positive attitude about telemedicine. COVID 19 has brought more light on telemedicine, and at this period it is very important to consider creating awareness and training the users as abundant knowledge and optimistic attitude towards the technology are significant factors to for any healthcare professional to implement and practice telemedicine.
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The advent of antibiotics in the 19th century has significantly reduced the morbidity and mortality of infectious diseases. However, irrational use of antibiotics in humans as well as in animals has driven the 21st century to the rapid emergence of MultiDrug Resistance Bacteria (MRB). Moreover, the dissemination of COVID-19 pandemic has paved the way for MRB, typically due to increased use of antibiotics to avoid secondary infections. The fast pace progression of bacterial resistance for the antibiotics and their combinations is making the management of MRB infections tough and increasing the cost of the treatment as well. However, use of Efflux Pump Inhibitors (EPI) as adjuvant for antibiotics has shown a ray of hope by retaining the susceptibility of the antibiotics and thereby reducing the burden of immediate requirement of new antibiotics for MRB. Accordingly, the present paper is aimed to scrutinize the predominant literature depicting the plant Phyto-constituents as an EPI and adjuvant for antibiotics in the management of MRB infections. The systematic review of the present paper indicates that the plant phyto-constituents belonging to the class of alkaloids, terpenoids, flavonoids can effectively be used as EPIs for antibiotics such as Ciprofloxacin, Norfloxacin, Tetracyclines and Chloramphenicol. Bibliometric analysis indicates that the Journal of Antimicrobial Chemotherapy, Antimicrobial Agents and Chemotherapy and BMC Complementary & Alternative Medicine have published impactful articles on EPI potential of plant phyto-constituents. Further, authors Kuete V, Dzotam JK, Falcao-silva VD, Gibbons S, Kuiate JR, Mbaveng AT, Tankeo SB and Voukeng IK are the major contributors and productive authors.
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The COVID-19 pandemic has had a tremendous impact on businesses, educational institutions, and other organizations that require in-person gatherings. Physical gatherings such as conferences, classes, and other social activities have been greatly reduced in favor of virtual meetings on Zoom, Webex or similar video-conferencing platforms. However, video-conferencing is quite limited in its ability to create meeting spaces that capture the authentic feel of a real-world meeting. Without the aid of body language cues, meeting participants have a harder time paying attention and keeping themselves engaged in virtual meetings. Video-conferencing, as it currently stands, falls short of providing a familiar environment that fosters personal connection between meeting participants. This paper explores an alternative approach to virtual meetings through the use of extended reality (XR) and embodied interactions. We present an application that leverages the full-body tracking capabilities of the Azure Kinect and the immersive affordances of XR to create more vibrant and engaging remote meeting environments. © 2021, Springer Nature Switzerland AG.
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The outbreak of COVID-19 has put various restrictions on human lifestyle. At the beginning of the outbreak, almost all public spaces were closed to minimize the spread of this virus. Even as public spaces open up, they have several restrictions. Such restrictions include limited occupancy in common rooms to ensure social distancing and this can lead to increased occupancy costs inside buildings. The strategy of “Design as a cure” has been long used by architects and urban planners to minimize the spread of infectious diseases in urban environments. Re-configuring the space layout and optimizing the heating, ventilation, and air condition (HVAC) operations were some immediate solutions proposed by building designers to minimize the risk of COVID-19 infection in buildings. This paper explores the use of smart re-configurable spaces (SReS) to improve the efficiency of indoor space utilization while maintaining a safe indoor environment. We used an existing smart building design framework to design SReS for a common area/lounge in one of the cadet resident halls at Virginia Tech. User requirements were measured by conducting an interview with the residential coordinator and focus groups among the cadets. The concept of generative design was used in Revit 2021 to design various layouts of the lounge. Towards the end, we create a layout for maximum occupancy and suggest various re-configuration strategies. Future work includes modeling and evaluating the human-building interaction of SReS in virtual reality (VR). © 2021, Springer Nature Switzerland AG.
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Introduction: SARS-CoV-2 virus has infected millions of people worldwide and has claimed lakhs of lives in its wake. The sudden onset of the pandemic has led to increased levels of anxiety and depression amongst healthcare workers. EMS professionals are the first responders and need to provide emergency Medical Care to their patients. They are required to perform lifesaving interventions in a short period of time. As it is not possible to ascertain the Covid status of the patient, hence EMS professionals are at the greatest risk of getting infected. The study aims to assess the level of clinical preparedness of EMS professionals and suggests recommendations to improve upon it. Objective: To assess the level of clinical preparedness amongst EMS professionals in tackling life threatening emergencies in suspected Covid 19 patients. Methodology: The study was conducted amongst 150 Emergency Medical Professionals in Pune, India. Respondents were asked to respond to each item using 5 point Likert scale. The Questionnaire was administered to the respondents through online mode after obtaining informed consent. Responding to all questions was mandatory. The respondents were given a period of two days to fill the questionnaire. Discussion: The present study was aimed at examining the current level of preparedness with regards to the disease after nearly a year of the pandemic. The result obtained in terms of knowledge were encouraging and pointed to the fact that the EMS professionals had received adequate training in identification of suspected cases and their initial management. Majority of the respondents suffered from high grade anxiety of contracting the infection. The study highlights the urgent need to conduct counselling and stress management sessions for better mental health of EMS professionals and showed that hospitals are slowly but steadily devising appropriate protocols and safety measures to protect their employees. Conclusion: The contribution of EMS professionals in providing emergency lifesaving care to suspected Covid 19 patients cannot be over emphasized. As the pandemic continues it is essential to ensure the mental and physical of all healthcare professionals. The study is a small attempt to portray the level of knowledge and mental attitude amongst EMS professionals. The findings need to be corroborated with a larger multicentric study.