A retrospective study on the clinical picture of COVID-19 patients associated with type 2 diabetes mellitus in India

Background: The clinical characterization of COVID varies from mild to severe. In the initial phases of the disease, symptoms like fever, cough, and dyspnea can occur. The severity and outcome of COVID vary with preexisting conditions, particularly type 2 diabetes mellitus (T2DM). Objective of current study was to assess the clinical presentation and laboratory derangements of COVID-19 patients associated with T2DM.Methods: The present retrospective study was started after the approval of the Institutional Ethics Committee. Various clinical (Sp02, final diagnosis, co-morbidity, and outcome) and biochemical parameters (CBC, LFT, RFT, LDH, Trop I, CK-MB D-dimer, CRP, ferritin levels, RBS, HbA1c) of Covid-19 patients were collected from Central Laboratory and & Medical Record Department of our institution. Patient names were anonymized and data were analyzed. The results are expressed in percentages.Results: A total of 24 COVID-19 patients (with T2DM) details were collected from the medical record department and central laboratory. Out of 24 patients, 16 (66.6%) were male, and the remaining 08 (33.3%) were female. Out of 24, 05 patients had mild covid, 02 were moderate and the remaining 17 suffered from severe COVID. The mean values of oxygen saturation, LDH, D-dimer, Troponin-I, CRP, Ferritin, Procalcitonin, and CK-MB were 76%, 797.3 U/l, 1614.2 ng/ml, 6.93 ng/ml, 72.6 mg/dl, 521.2 µg/l, 2.33 µg/l and 40.59 ng/ml respectively. The average random blood sugar level and glycosylated hemoglobin were 308.8 mg/dl and HbA1c 10.22%. Mean values of 42.5 mg/dl and 1.54 mg/dl were recorded for blood urea and S. creatinine. Regarding liver function test, mean values of 0.87 mg/dl, 0.37 mg/dl, 0.49mg/dl, 344.8U/l, 115.6U/l,108U/l respectively noted for total bilirubin, direct, indirect, SGOT, SGPT and ALP. Regarding patient outcome, 09 (37.5%) patients recovered and 15 (62.5%) died due to COVID. The values of glycosylated Hb and random blood sugar among the 15 patients who died due to covid infection suggested uncontrolled diabetes Mellitus in 7 of them with associated hypertension and died due to septic shock. Conclusions: Though the laboratory mean values of the liver function test and renal function test shows moderate variations the mean values of CRP, LDH, Procalcitonin, and Ferritin which are the acute inflammatory markers are highly disrupted when compared to normal ranges. 

Hemolymph microbiome of Pacific oysters in response to temperature, temperature stress and infection

Microbiota provide their hosts with a range of beneficial services, including defense from external pathogens. However, host-associated microbial communities themselves can act as a source of opportunistic pathogens depending on the environment. Marine poikilotherms and their microbiota are strongly influenced by temperature, but experimental studies exploring how temperature affects the interactions between both parties are rare. To assess the effects of temperature, temperature stress and infection on diversity, composition and dynamics of the hemolymph microbiota of Pacific oysters (Crassostrea gigas), we conducted an experiment in a fully-crossed, three-factorial design, in which the temperature acclimated oysters (8 or 22 °C) were exposed to temperature stress and to experimental challenge with a virulent Vibrio sp. Strain. We monitored oyster survival and repeatedly collected hemolymph of dead and alive animals to determine the microbiome composition by 16s rRNA gene amplicon pyrosequencing. We found that the microbial dynamics and composition of communities in healthy animals (including infection survivors) were significantly affected by temperature and temperature stress, but not by infection. The response was mediated by changes in the incidence and abundance of operational taxonomic units (OTUs) and accompanied by little change at higher taxonomic levels, indicating dynamic stability of the hemolymph microbiome. Dead and moribund oysters, on the contrary, displayed signs of community structure disruption, characterized by very low diversity and proliferation of few OTUs. We can therefore link short-term responses of host-associated microbial communities to abiotic and biotic factors and assess the potential feedback between microbiota dynamics and host survival during disease

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Protective effect of <i style="mso-bidi-font-style: normal">Psidium guajava </i>L. leaves ethanolic extract on doxorubicin-induced nephrotoxicity in rats

129-133The objective of the present study was to investigate the protective effect of ethanolic extract of <i style="mso-bidi-font-style: normal">Psidium guajava L. leaves against doxorubicin-induced nephrotoxicity in rats. Animals treated with doxorubicin (8mg/kg, i.p) once daily for 2 days significantly (P<0.05) increased Serum Urea, BUN, creatinine, total protein, LPO and significantly (P<0.05) decreased CAT, SOD, GSH levels as compared to vehicle treated rats. Treatment with P. guajava (100 & 300 mg/kg, p.o) showed significant (P<0.05) decrease in Serum Urea, BUN, creatinine, total protein, LPO and significant (P<0.05) increase in CAT, SOD, GSH levels as compared to doxorubicin treated group. Histopathological examinations of kidney tissue showed that doxorubicin changed the renal architecture significantly which was less evident in P. guajava (100 mg/kg & 300 mg/kg) pre-treated rats. Results suggest that P. guajava extract has the potential to ameliorate doxorubicin induced nephrotoxicity and might serve as a novel combination agent with doxorubicin to limit renal damage

Protective effect of Psidium guajava L. leaves ethanolic extract on doxorubicin-induced nephrotoxicity in rats

The objective of the present study was to investigate the protective effect of ethanolic extract of Psidium guajava L. leaves against doxorubicin-induced nephrotoxicity in rats. Animals treated with doxorubicin (8mg/kg, i.p) once daily for 2 days significantly (P&lt;0.05) increased Serum Urea, BUN, creatinine, total protein, LPO and significantly (P&lt;0.05) decreased CAT, SOD, GSH levels as compared to vehicle treated rats. Treatment with P. guajava (100 &amp; 300 mg/kg, p.o) showed significant (P&lt;0.05) decrease in Serum Urea, BUN, creatinine, total protein, LPO and significant (P&lt;0.05) increase in CAT, SOD, GSH levels as compared to doxorubicin treated group. Histopathological examinations of kidney tissue showed that doxorubicin changed the renal architecture significantly which was less evident in P. guajava (100 mg/kg &amp; 300 mg/kg) pre-treated rats. Results suggest that P. guajava extract has the potential to ameliorate doxorubicin induced nephrotoxicity and might serve as a novel combination agent with doxorubicin to limit renal damage

Predicting Flight Delays with Error Calculation

Flight delay is vexatious for passengers and incurs an agonizingly high financial loss to airlines and countries. A structured prediction system is an indispensable tool that can help aviation authorities effectively alleviate flight delays. This project aims to build a two stage machine learning engine to effectively predict the arrival delay of a flight after departure based on real-time flight and weather data