AI-DRIVEN QUANTIFICATION OF GROUND GLASS OPACITIES IN LUNGS OF COVID-19 PATIENTS USING 3D COMPUTED TOMOGRAPHY IMAGING

ObjectivesGround-glass opacity (GGO) -- a hazy, gray appearing density on computed tomography (CT) of lungs -- is one of the hallmark features of SARS-CoV-2 in COVID-19 patients. This AI-driven study is focused on segmentation, morphology, and distribution patterns of GGOs. MethodWe use an AI-driven unsupervised machine learning approach called PointNet++ to detect and quantify GGOs in CT scans of COVID-19 patients and to assess the severity of the disease. We have conducted our study on the "MosMedData", which contains CT lung scans of 1110 patients with or without COVID-19 infections. We quantify the morphologies of GGOs using Minkowski tensors and compute the abnormality score of individual regions of segmented lung and GGOs. ResultsPointNet++ detects GGOs with the highest evaluation accuracy (98%), average class accuracy (95%), and intersection over union (92%) using only a fraction of 3D data. On average, the shapes of GGOs in the COVID-19 datasets deviate from sphericity by 15% and anisotropies in GGOs are dominated by dipole and hexapole components. These anisotropies may help to quantitatively delineate GGOs of COVID-19 from other lung diseases. ConclusionThe PointNet++ and the Minkowski tensor based morphological approach together with abnormality analysis will provide radiologists and clinicians with a valuable set of tools when interpreting CT lung scans of COVID-19 patients. Implementation would be particularly useful in countries severely devastated by COVID-19 such as India, where the number of cases has outstripped available resources creating delays or even breakdowns in patient care. This AI-driven approach synthesizes both the unique GGO distribution pattern and severity of the disease to allow for more efficient diagnosis, triaging and conservation of limited resources. Key PointsOur approach to GGO analysis has four distinguishing features: O_LIWe combine an unsupervised computer vision approach with convex hull and convex points algorithms to segment and preserve the actual structure of the lung. C_LIO_LITo the best of our knowledge, we are the first group to use PointNet++ architecture for 3D visualization, segmentation, classification, and pattern analysis of GGOs. C_LIO_LIWe make abnormality predictions using a deep network and Cox proportional hazards model using lung CT images of COVID-19 patients. C_LIO_LIWe quantify the shapes and sizes of GGOs using Minkowski tensors to understand the morphological variations of GGOs within the COVID-19 cohort. C_LI

Convalescent plasma in the management of moderate COVID-19 in India: An open-label parallel-arm phase II multicentre randomized controlled trial (PLACID Trial)

ObjectivesConvalescent plasma (CP) as a passive source of neutralizing antibodies and immunomodulators is a century-old therapeutic option used for the management of viral diseases. We investigated its effectiveness for the treatment of COVID-19. DesignOpen-label, parallel-arm, phase II, multicentre, randomized controlled trial. SettingThirty-nine public and private hospitals across India. ParticipantsHospitalized, moderately ill confirmed COVID-19 patients (PaO2/FiO2: 200-300 or respiratory rate > 24/min and SpO2 [≤] 93% on room air). InterventionParticipants were randomized to either control (best standard of care (BSC)) or intervention (CP + BSC) arm. Two doses of 200 mL CP was transfused 24 hours apart in the intervention arm. Main Outcome MeasureComposite of progression to severe disease (PaO2/FiO2< 100) or all-cause mortality at 28 days post-enrolment. ResultsBetween 22nd April to 14th July 2020, 464 participants were enrolled; 235 and 229 in intervention and control arm, respectively. Composite primary outcome was achieved in 44 (18.7%) participants in the intervention arm and 41 (17.9%) in the control arm [aOR: 1.09; 95% CI: 0.67, 1.77]. Mortality was documented in 34 (13.6%) and 31 (14.6%) participants in intervention and control arm, respectively [aOR) 1.06 95% CI: -0.61 to 1.83]. InterpretationCP was not associated with reduction in mortality or progression to severe COVID-19. This trial has high generalizability and approximates real-life setting of CP therapy in settings with limited laboratory capacity. A priori measurement of neutralizing antibody titres in donors and participants may further clarify the role of CP in management of COVID-19. Trial registrationThe trial was registered with Clinical Trial Registry of India (CTRI); CTRI/2020/04/024775.

The 2019 novel coronavirus disease (COVID-19) pandemic: A zoonotic prospective

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus (CoV), has recently emerged as a significant pathogen for humans and the cause for the recent outbreak of the 2019 novel coronavirus disease (COVID-19) throughout the globe. For developing any preventive measure, an understanding of the zoonotic pattern for this virus is a necessity. We should have a clear knowledge of its reservoir host, its distribution pattern and spreading routes. Information about zoonotic reservoirs and its transmission among them can help to understand the COVID-19 outbreaks. In this article, we discuss about the bats as the zoonotic reservoir of several CoV strains, co-existence of bats and CoV/viruses, the sequence similarity of SARS-CoV-2 with bat SARS-like CoV, the probable source of the origin of SARS-CoV-2 strain and COVID-19 outbreak, intermediate host of CoVs and SARS-CoV-2, human to human transmission and the possibility to maintain the zoonotic barriers. Our knowledge about the zoonotic reservoir of SARS-CoV-2 and its transmission ability may help develop the preventive measures and control for the future outbreak of CoV.

Retraction: Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?

This article has been retracted at the request of the Editorial Board.The Editorial Board consulted with the KAMJE (Korean Association of Medical Journal Editors) about ‘Imalas’ matter of the publication and concluded as following:The Paper A is an article on the study of pain, inflammation and formation of granulation tissue using platelet rich fibrin (PRF) for dry socket treatment after tooth extraction. This study was conducted on 100 patients at Teerthankar Mahaveer Dental College and Research Center, Moradabad, from September 2014 to March 2016. The Paper B is a research based on the same conditions as Paper A. This study was conducted on 100 patients using PRF and 100 patients using zinc oxide eugenol, from August 2014 to December 2017. The study was held at the Kothiwal Dental College and Research Centre (KDCRC), Moradabad. The clinical factors studied in above two articles are the same, and the pain scale in Fig. 3 in Paper A is almost identical to the Fig. 2, Group A in Paper B; and Fig. 5 in Paper A is also same as Fig. 4, Group A in Paper B. Both papers are judged to have the overlapping publication in the similar period and the patient, and it is considered intentional not to cite Paper A in Paper B. Therefore, Paper B is believed to be a significant double publication. For this reason, the Editorial Board decided to retracted this article and sincerely apologize for any inconvenience this may have caused.

Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?

OBJECTIVES@#To appraise the effectiveness of platelet-rich fibrin (PRF) in the management of established dry socket in terms of pain, inflammation, and wound healing.@*MATERIALS AND METHODS@#Two hundred patients with established alveolar osteitis were studied to determine the efficacy of PRF and zinc oxide eugenol (ZOE) for pain control, inflammation reduction, and wound healing. Patients were randomly allocated to Group A (PRF) or Group B (ZOE). Patients were examined on the 1st, 3rd, 7th, and 14th postoperative day and evaluated for pain using visual analogue scale scores, inflammation with a gingival index score, and wound healing through a determination of the number of bony walls exposed.@*RESULTS@#Group A showed better results in terms of pain remission, control of inflammation, and wound healing compared to Group B. Results between groups were statistically significant (P<0.05).@*CONCLUSION@#PRF is a better alternative than ZOE for the effective management of alveolar osteitis.

Retraction: Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?

This article has been retracted at the request of the Editorial Board.The Editorial Board consulted with the KAMJE (Korean Association of Medical Journal Editors) about ‘Imalas’ matter of the publication and concluded as following:The Paper A is an article on the study of pain, inflammation and formation of granulation tissue using platelet rich fibrin (PRF) for dry socket treatment after tooth extraction. This study was conducted on 100 patients at Teerthankar Mahaveer Dental College and Research Center, Moradabad, from September 2014 to March 2016. The Paper B is a research based on the same conditions as Paper A. This study was conducted on 100 patients using PRF and 100 patients using zinc oxide eugenol, from August 2014 to December 2017. The study was held at the Kothiwal Dental College and Research Centre (KDCRC), Moradabad. The clinical factors studied in above two articles are the same, and the pain scale in Fig. 3 in Paper A is almost identical to the Fig. 2, Group A in Paper B; and Fig. 5 in Paper A is also same as Fig. 4, Group A in Paper B. Both papers are judged to have the overlapping publication in the similar period and the patient, and it is considered intentional not to cite Paper A in Paper B. Therefore, Paper B is believed to be a significant double publication. For this reason, the Editorial Board decided to retracted this article and sincerely apologize for any inconvenience this may have caused.

Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?

OBJECTIVES: To appraise the effectiveness of platelet-rich fibrin (PRF) in the management of established dry socket in terms of pain, inflammation, and wound healing. MATERIALS AND METHODS: Two hundred patients with established alveolar osteitis were studied to determine the efficacy of PRF and zinc oxide eugenol (ZOE) for pain control, inflammation reduction, and wound healing. Patients were randomly allocated to Group A (PRF) or Group B (ZOE). Patients were examined on the 1st, 3rd, 7th, and 14th postoperative day and evaluated for pain using visual analogue scale scores, inflammation with a gingival index score, and wound healing through a determination of the number of bony walls exposed. RESULTS: Group A showed better results in terms of pain remission, control of inflammation, and wound healing compared to Group B. Results between groups were statistically significant (P<0.05). CONCLUSION: PRF is a better alternative than ZOE for the effective management of alveolar osteitis.

Anti cataract potential of phyllanthus niruri in galactose induced cataractogenesis of rat / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate anti cataract effect of phyllanthus niruri (PN) both in vitro and in vivo galactose induced cataract.METHODS: Aqueous extract of PN was evaluated against galactose-induced cataract both in vitro and in vivo. Galactosaemic cataract was induced in rats by feeding 300g/L galactose diet. PN was administered orally at three-dose levels 75, 150 and 300 mg/kg of body weight. Rat lenses were subjected to osmotic stress in vitro by incorporating galactose (30mmol/L) in the culture medium. The effect of PN (720 and 880μg/mL) on the glutathione (GSH) and polyols levels was studied.RESULTS: PN significantly delayed the onset and progression of cataract in vivo. In addition to the delay in reaching various stages of development of cataract, stage IV did not develop with lower doses till the completion of experimental period. Lenses treated with PN 880μg/mL concentration showed higher levels of GSH and decreased levels of polyols in vitro. In vivo, 75mg/kg significantly delayed the onset and progression of cataract as compared to control.CONCLUSION: PN delayed the process of cataracto-genesis in the experimental models. However, further study is required to extrapolate the use in human beings for the prevention of cataract.