Supply Chain Authentication for Vaccine Passport Using Blockchain

The COVID-19 pandemic has led to the creation of vaccination passports as a means of verifying an individual's vaccination status for travel and access to certain services. The validity of immunization records and supply chain procedures, however, are significant issues. The supply chain for vaccination passports has been called for to be made more secure and transparent using blockchain technology. To ensure safe and effective supply chain management, this article suggests a blockchain-based authentication mechanism for vaccination passports. The issuer, the prover, and the verifier will be the system's three key actors. The issuer will be in charge of producing inventory tokens and providing immunization certificates. The prover will verify the authenticity of the vaccination supply chain, and the verifier will ensure that the inventory token is legitimate. The proposed system will enhance transparency, security, and efficiency in the supply chain for vaccination passports, thereby improving the trustworthiness of vaccination records and facilitating safe travel during the pandemic. © 2023 IEEE.

Optimum Use of LMS for Dynamic Mathematics Classrooms in Blended Mode

Recently the education industry has moved at an increasing pace towards quality assurance programs. There is a high demand for efficient use of Information and Communication Technology (ICT) in education, especially to improve the quality of mathematics education. After COVID-19 lockdowns, ICT has become essential in the era of blended learning. Variations in pedagogy and assessments in mathematics are always challenging. Due to difficulties in learning mathematics, the need for innovative mathematical pedagogy is rising daily in online and blended learning environments. Through this paper, the authors attempt to provide more opportunities to mathematics teachers and students to learn through LMS. Through KJSCE-LMS (Moodle based LMS specially customized for students of K J Somaiya College of Engineering (KJSCE), Mumbai), the authors demonstrate the optimum use of innovative Teaching-Learning-Evaluation (TLE) techniques that can be easily practiced in online or blended mode of mathematics education. These technology-enhanced TLE methods were applied in the first year undergraduate engineering mathematics classroom in the urban part of India. To check the promethean ways to enhance pedagogical learning experiences by students, qualitative and quantitative surveys were conducted. Results of the survey reveal that teachers' systematic usage of KJSCE-LMS can make mathematics learning easy, effective and meaningful. 98% of the students agreed that the contents uploaded on LMS helped them to understand the concepts effectively. LMS can also help strengthen the learning process, motivate students, improve their learning outcomes, and positively impact their wholesome development. © 2022, Rajarambapu Institute Of Technology. All rights reserved.

Hemophagocytic Lymphohistiocytosis after ChAdOx1 nCoV-19 Coronavirus Vaccination in a Patient with No Known Comorbidities

Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory condition where there is marked cytopenia and large-scale activation of macrophages and CD8+ cytotoxic T cells. HLH may be of two types - primary HLH caused by genetic abnormalities and secondary HLH due to infections, malignancies, autoimmune disorders, rheumatologic disorders, and metabolic dysfunctions. We describe a case of HLH following the first dose of the ChAdOx1 nCoV-19 Corona Virus vaccine. In this patient, there was no clear precipitant of HLH. The most probable explanation could be intense immune activation by vaccine constituents producing aberrant activation of inflammatory cytokines. There were no signs of infection or malignancy. Since our patient was clinically stable, his symptoms had resolved and HLH parameters had improved, no HLH-specific therapy was given.

A Review on Hyperglycemiaandother Factors in Patients with Post Covidmucormycosis

Mucormycosis in people with COVID-19 or who are immunocompromised in any other way has become a worldwide issue, resulting in severe morbidity and mortality. Infection is incapacitating. and deadly, resulting in organ loss and emotional anguish. Mucormycosis is a rare angioinvasive illness that primarily affects immunocompromised people and is caused by the prolife ration of Mucorales. There are no radiographic symptoms. However a diagnosis can be made by microscopically examining materials recovered from necrotizing lesions Because the fungus enters the body through the skin, treatment involves a multidisciplinary approach. The use of the several antifungal medicines available is restricted by resistance and toxicity factors. The lipid formulation of amphotericin-B (liposomal Am-B) is the first-line treatment for mucormycosis in COVID-19 patients. high cost and limited availability have prompted a shift toward surgery, so surgical debridement to remove all necrotic lesions remains the keystone of effective mucormycosis treatment in COVID-19. This study concentrates on the pathophysiology, clinical manifestations, and therapy of HyperglycemiaAndIts Contributing Factors In Patients With Post Covid - 19 Mucormycosis. Copyright © 2022, Anka Publishers. All rights reserved.

A Review Article on the Therapeutic Potential of Medicinal Plants for Prevention and Treatment of Secondary Infection in Patients with COVID-19

COVID-19 is an infectious disease caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) that has rapidly spread all over the world, causing an international health crisis. Earlier, various synthetic antiviral drugs and clinical therapies have been used to control viral infections, but at present, there is no specific treatment available for COVID-19 infection. Several drugs, like ritonavir, lopinavir, hydroxychloroquine, and chloroquine, have been proposed. India is a hub of medicinal plants, so there is a chance to find effective means to combat the COVID-19 pandemic. The medicinal herbal formulations may enhance immunity and help develop a powerful antiviral drug, which is urgently needed to control the outbreak of coronavirus. In this review arti-cle, we have discussed the epidemiology, clinical outcomes, treatment, and prevention of this novel epidemic coronavirus from the medicinal herbal formulation perspective. We have also empha-sized the reported antiviral activity and immunity-boosting properties of the Indian medicinal plants. This article also suggests that the drug or formulation obtained from plant sources would have low fatal outcomes, exhibit quick response, and be safe in the management and prevention of this pandemic outbreak. Copyright © 2022 Bentham Science Publishers.

Real Time Social Distance Monitoring with Alarm System

World Health Organization (WHO) recommends social distancing as one of the most effective measures to prevent the spread of COVID-19 infection. Ensuring strict adherence to the norms is challenging especially in public places and work environments. Hence, we propose a system using the existing CCTV cameras or an IP camera and develop a Computer Vision and YOLOv3-based Deep Neural Network (DNN) model for automatic people detection. The model works in both in both indoor and outdoor environments. The model is trained using Microsoft Common Objects (COCO dataset). The model developed can alternatively be deployed for other applications including detection of autonomous cars, anomaly detection, crowd analysis etc. © 2022 IEEE.

Hemophagocytic Lymphohistiocytosis after COVID-19 Vaccination: A Case Report

Aim and background: Cases of thrombotic thrombocytopenia induced by coronavirus disease 2019 (COVID-19) vaccines have been reported recently. Herein, we describe hemophagocytic lymphohistiocytosis (HLH) following COVID-19 vaccination. Case report: A 35-year-old male, chronic alcoholic, 3 years into abstinence received first dose Covishield vaccine. He started developing a fever, testicular pain, diminished sensorium requiring invasive ventilation, and decreased urine output 4 days after getting vaccinated. Initial workup for NCCT brain and HRCT chest was normal, tropical fever panel was negative, cultures for blood and endotracheal aspirate were sterile, liver and renal functions showed mild derangement, CSF study was normal. Ultrasound examination of the abdomen revealed mild hepatosplenomegaly, mild testicular swelling, and suprainguinal lymphadenopathy, with no focus of infection. Subsequently, he developed bicytopenia with haemoglobin 9.0 g/dL and platelet counts 50 × 109/L, ferritin 2130 μg/L, triglyceride 353 mg/dL, and decreased fibrinogen 1.41 g/L. Bone marrow as well as lymph node biopsy showed haemophagocytosis with engulfment of neutrophils, lymphocytes, and normoblasts making HLH a likely diagnosis. Soluble CD25 and NK cell function could not be performed. Extensive evaluation was done to look into the etiology of HLH. SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) test was negative. RT-PCR test for Epstein-Barr virus (EBV), influenza A (H1N1, H3N2), influenza B, cytomegalovirus (CMV) performed from endotracheal aspirate (ETA) was negative. Similarly, the RT-PCR test from serum samples for EBV, Parvo B-19, CMV, and from CSF sample for EBV, Parvo B-19, CMV, and HSV-1 was negative. Hepatitis B, C, and HIV serologies were negative. Culture and sensitivity repeated from blood, ETA and urine was sterile. Autoimmune panel including complements levels were negative. Peripheral smear, bone marrow, and lymph node biopsy were normal and did not reveal abnormal or malignant cells. He had persistent fevers to 38.6°C during the first 6 days of his admission, with a rise in his ferritin to 1950 μg/L. The patient received steroids but not etoposide. By the 8th day, his fevers resolved, with improvement in his lethargy and malaise. Two weeks later, his ferritin had reduced to 510 μg/L, platelet count rose to 180 × 109/L, and repeat ultrasound abdomen demonstrated resolution of his splenomegaly. In our patient, there was no clear precipitant of HLH other than the Covishield vaccine. There was no evidence of an infection or malignancy. Due to our patient's clinical stability, resolution of symptoms, and improvement of HLH parameters he did not require HLH specific therapy. It is unclear if he had a pre-existing genetic predisposition to HLH as genetic testing is pending, however, it is unlikely as he has reached the age of 35 and suffered from previous viral infections without developing HLH.

A Case Report of Novel Coronavirus-2019 (COVID-19) Disease and Cytomegalovirus (CMV) Co-Infection: A Lethal Combination

Aim and background: The novel coronavirus-2019 (COVID-19) pandemic is raging all across the world. As we are delving more into the management of COVID-19, many new challenges are emerging, which may pose additional threats. One of these is the emergence or re-activation of concomitant viral infections owing to lymphopenia, use of immunosuppressants, underlying comorbidities, and immune dysregulation. Although we have come across the threat of fungal infections and resistant bacterial infections, experience regarding reactivation or co-infection with other viral infections is still limited. We hereby describe a case of COVID-19 disease with cytomegalovirus (CMV) co-infection. Case summary: COVID-19 with Cytomegalovirus (CMV) Co-infection. A 55-year-old male, COVID unvaccinated, chronic smoker, overweight, and hypertensive patient was admitted to our ICU with a 1-week history of fever, cough, and breathlessness. SARSCoV- 2 reverse transcriptase-polymerase chain reaction (RT-PCR) test was positive. At admission, he had hypoxaemia (SpO2 86% on room air), respiratory rate (RR) 35-40/minute, and ground-glass opacities in chest X-ray involving 50% of bilateral lung parenchyma suggestive of severe COVID-19 pneumonia. He was managed with lung-protective invasive mechanical ventilation, restrictive fluid strategy, 16-18 hour/day proning sessions (4-5), intravenous (IV) remdesivir, IV dexamethasone 6 mg 12 hourly, and enoxaparin thromboprophylaxis. After 2 weeks of ICU stay, weaning was attempted but the weaning attempts failed due to underlying neuromuscular weakness. On examination, bilateral (B/L) cranial nerve palsies, areflexia, and motor power 0/5 in bilateral upper and lower limbs were noticed. A possibility of Guillain-Barre Syndrome (GBS) was kept and IV immunoglobulin therapy was empirically administered for 5 days with some improvement in power up to 1/5 in upper limbs. On day 35 of hospitalization, he developed pancytopenia along with features of deranged liver function and gut dysfunction (in the form of paralytic ileus and abdominal distension). In evaluation, polymerase chain reaction (PCR) for CMV turned out to be positive in blood with a very high viral load.Bone marrow aspiration and biopsy showed hemopoiesis with viral inclusion bodies and haemophagocytosis (HLH). Histological evidence of CMV inclusion bodies was present in the bone marrow besides viremia (detected by PCR for CMV), which confirmed the diagnosis of CMV co-infection. IV ganciclovir was initiated along with steroids in view of HLH. There was a decrease in CMV viral load after initiation of IV gancyclovir with subtle clinical recovery. However, the patient continued to deteriorate and succumbed to his illness in the 8th week of the ICU stay.

A Case Report of Coronavirus (COVID-19) Disease and Herpesviridae Viral Co-Infections: A Lethal Combination? ABS0138)

Introduction: COVID-19 pandemic has affected the whole world. Besides COVID, other viral infections may emerge during the course of the disease owing to lymphopenia, use of immunosuppressants, underlying comorbidities, and immune dysregulation, which may pose additional threats.1 We hereby describe two cases of COVID- 19 with viral co-infections belonging to the Herpesviridae family with undulating clinical course. Case 1: Cytomegalovirus (CMV) Co-infection: A 55-year-old male, COVID unvaccinated, chronic smoker, overweight and hypertensive was admitted to our ICU with a 1-week history of fever, cough, and breathlessness. SARSCoV- 2 reverse transcriptase-polymerase chain reaction (RT-PCR) test was positive. At admission, he had hypoxaemia (SpO2 86%on room air), respiratory rate 35-40/minute, and ground-glass opacities in chest X-ray involving 50% of bilateral lung parenchyma suggestive of severe COVID-19 pneumonia. He was managed with lung-protective invasive mechanical ventilation, restrictive fluid strategy, 16-18 hour/day proning sessions (4-5), intravenous (IV) remdesivir, IV dexamethasone 6 mg 12 hourly, and enoxaparin thromboprophylaxis. After 2 weeks of ICU stay, weaning was attempted but the weaning attempts failed due to underlying neuromuscular weakness. On examination, bilateral (B/L) cranial nerve palsies, areflexia, and motor power 0/5 in bilateral upper and lower limbs were noticed. possibility of Guillain-Barre syndrome (GBS) was kept and IV immunoglobulin therapy was empirically administered for 5 days with some improvement in power up to 1/5 in upper limbs. On day 35 of hospitalization, he developed pancytopenia along with features of deranged liver function and gut dysfunction. In evaluation, PCR for CMV turned out to be positive in blood. Bone marrow aspiration and biopsy showed hemopoiesis with viral inclusion bodies and hemophagocytosis (HLH) [Figs 1 and 2]. A diagnosis of secondary HLH related to CMV was contemplated and IV ganciclovir was initiated along with steroids. Histological evidence of CMV co-infection was present and moreover, the quantitative viral load of CMV showed a decreasing trend after initiating IV gancyclovir. However, the patient continued to deteriorate and succumbed to his illness in the 8th week of the ICU stay. Case 2: Herpes Simplex Virus (HSV) Co-infection: Twenty-three years postpartum female with no comorbidities and uneventful obstetric history was referred to our hospital two weeks after a full-term normal vaginal delivery. She developed generalized status epilepticus on the 10th day of delivery, which was managed with anti-epileptic drugs (AEDs). During the hospital stay, RTPCR for COVID-19 turned out to be positive but she remained asymptomatic and seizures were well-controlled on AEDs. On admission to our hospital, she was fully conscious and alert with no neurological deficits. Notable findings were pancytopenia with megaloblastic features, B/L pedal edema, and hepatosplenomegaly. NCCT brain revealed mild subarachnoid hemorrhage (SAH) along the bilateral parietooccipital region for which conservative management was planned. 2D echocardiography was normal. Ultrasonography of the abdomen showed gross splenomegaly and mild hepatomegaly with mesenteric lymphadenopathy. NCCT thorax and abdomen were unremarkable apart from hepatosplenomegaly. In pancytopenia workup, IgM anti-HSV-1 antibodies turned out to be positive in blood. In addition, tropical workup was suggestive of Leptospirosis (IgM antibodies positive). Serological evidence was suggestive of acute HSV-1 infection (based on antibody titers). Bone marrow workup had features of trilineage hematopoiesis with micronormoblastic maturation consistent with iron deficiency anemia without any evidence of hemophagocytosis. IV acyclovir, IV doxycycline, and iron replacement were added, after which she improved clinically and was discharged in stable condition. Tables 1 and 2 show a detailed description of these cases. Discussion: Herpesviridae family is the most important group of viruses responsible for persistent vi al infections in humans, of which CMV contributes to 60-90% of infections in adults, especially in developing countries.2 In healthy individuals, these viruses are kept dormant by the body's immune mechanisms but in an immunocompromised population, reactivation from the latent state can occur. SARS-CoV-2 infection predisposes patients to concomitant viral co-infections, owing to T-cell lymphopenia, decreased NK cell number, and use of immunosuppressive medications.3,4 The first case of CMV co-infection was first reported by D'Ardes and co-workers in 2020.5 Since then, many studies have been emerging in this area. In an observational study from France, 38 COVID-19 patients on >7 days of MV were studied for HSV and CMV pulmonary co-infections (by quantitative real-time PCR in tracheal samples) out of which 47% of patients had one of these infections (24% HSV, 5% CMV, 18% both).6 Another study looking for HSV-1 in patients on invasive MV found HSV-1 reactivation between days 11 and 40, which correlated with immunological markers of decreased innate immunity.7 A case series looking for CMV infection (by PCR in plasma or BAL) in COVID-19, also found CMV reactivation between day 7 and 45 of illness. Most of these patients were above 60 years of age and immunosuppressed (HIV, diabetes mellitus, medications).8 Although immunocompromised individuals are more vulnerable, healthy immunocompetent adults who are critically ill or on prolonged MV may also be susceptible to these infections.9-12 This may be explained by a state of immunoparalysis inherent to prolonged critical illness. In case 1, an ICU stay of around 9 weeks complicated with recurrent nosocomial infections, multiple blood product transfusions, and steroid usage could have the likely triggers. Whether viral co-infections are merely bystanders or truly pathogenic is difficult to comment but timely management is essential to avoid end-organ damage (EOD) which may occur directly (by enhanced viral load secondary to compromised host immunity) or indirectly (by inflammatory changes consequent to prolonged cell-mediated immunity required to maintain viral dormancy).2-4,13 It also seems imperative to study if a viral co-infection has a proclivity to develop more severe hematological anomalies (besides the inherent risk of HLH with COVID) as was seen in case 1, in which the patient had a downward spiral of illness with multiorgan dysfunction.14-15 Limitations: Dynamics of PCR trends and virology studies of samples from trachea, gut, and urine could not be analysed in our patients. Conclusion: Viral co-infections can occur in COVID-19 disease as these patients are often immunocompromised and critically ill. A high index of suspicion and prompt management is needed to improve the outcome of patients. Patients with organ dysfunctions especially hematologic abnormalities with bone marrow involvement should be worked up in detail to look for concomitant viral co-infections. In the future, large-scale research is needed to better elucidate the relationship between SARS-CoV-2 and other viral co-infections.

Social distancing and lockdown due to COVID-19: Impact on sleep and mood of adolescents

The unprecedented situation of countrywide lockdown with closure of physical schools, social distancing, and home confinement which arose due to COVID-19 pandemic had a significant impact on the sleep and mood of all age groups. Adolescence is the age of transition from childhood to adulthood. Students in this phase are anxious with planning for future and thus fall an easy prey to unhealthy lifestyle including irregular sleep cycle and eating habits. Freedom to follow self-decided sleep schedule with extensive use of digital media and sedentary lifestyle during the pandemic further added to the trend of unhealthy lifestyle among them. This perspective is aimed to explore the effect of nationwide or regional lockdowns enforced for curtailment of COVID-19 infection on the mood and sleep habits of adolescents. There were some positive as well as negative impacts on the sleep quality and mood of adolescents. Although home confinement gave a lot of opportunities to follow own sleep schedules and eating habits such as those on weekends or vacations, it also increased the separation stress from their peers, anxiety and fear of disease, erratic sleep schedule, and screen time among adolescents. © 2022 Journal of Nature and Science of Medicine. All rights reserved.

COVID-19: PERVASIVENESS OF COMORBIDITIES WITH EMPHASIS ON CANCER, PATHOGENESIS AND PALLIATIVE CARE MEASURES

In retrospection and review of the available literature, cancer patients are regarded as highly susceptible to the incidence of the ongoing ‘COVID-19' pandemic. Other comorbidities including hypertension, diabetes, kidney problems, high cholesterol are found to be having severe effects on COVID-19 related mortality. Reports associating these diseases with COVID-19 must be carefully elucidated not just because these comorbidities induce severity in COVID-19 patients but also as several other factors increase the risk of occurrence of this pandemic. From vigorous screening to advance researches regarding this association as well as the still elusive mechanism of its pathogenesis, from clinical management to implementation of national and international guidelines, from adopting a dynamic approach to tackle the co-infection to having resourceful hospitals and medical care facilities, a structured and methodical proposition involved in the development of therapeutic strategies promise a better approach to target COVID-19. © 2021. All Rights Reserved.

Students’ opinions about studying from home during the COVID-19 pandemic in Indonesia

The implementation of online learning during the COVID-19 pandemic may affect students’ learning attitude and motivation to some extent. This paper aims to describe the university students’ opinions about learning attitude and motivation while studying from home due to the COVID-19 pandemic in Indonesia. A non-experimental research design was used with an exploratory quantitative method. A total of 238 respondents participated in the online survey from April 22 to 29, 2020. Descriptive statistics was used to analyse the collected data by using SPSS 23. The results showed that 52.5% (n = 125) of the respondent did not enjoy studying from home and 91.5% (n = 218) did not gain as much knowledge as in the traditional mode, although they still had a higher motivation to learn and had a better relationship with their family members. Interesting materials and enjoyable teaching methodology and interaction are therefore suggested. © 2021 Birlesik Dunya Yenilik Arastirma ve Yayincilik Merkezi. All rights reserved.

Computational guided approach for drug repurposing against SARS-CoV-2

Background: In the current SARS-CoV-2 outbreak, drug repositioning emerges as a promising approach to develop efficient therapeutics in comparison to de novo drug development. The present investigation screened 130 US FDA-approved drugs including hypertension, cardiovascular diseases, respiratory tract infections (RTI), antibiotics and antiviral drugs for their inhibitory potential against SARS-CoV-2. Materials & methods: The molecular drug targets against SARS-CoV-2 proteins were determined by the iGEMDOCK computational docking tool. The protein homology models were generated through SWISS Model workspace. The pharmacokinetics of all the ligands was determined by ADMET analysis. Results: The study identified 15 potent drugs exhibiting significant inhibitory potential against SARS-CoV-2. Conclusion: Our investigation has identified possible repurposed drug candidates to improve the current modus operandi of the treatment given to COVID-19 patients.