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Lindsay K Finkas,1 Navneet Ramesh,2 Lawrence S Block,3 Bing Q Yu,3 Mei-Tsung Lee,3 Meng Lu,3 Jacek Skarbinski,2,3 Carlos Iribarren3 1Kaiser Permanente San Rafael Medical Center, San Rafael, CA, USA; 2Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 3Kaiser Permanente Division of Research, Oakland, CA, USACorrespondence: Carlos Iribarren, Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94612, USA, Email Carlos.Iribarren@kp.orgIntroduction: Previous studies on the outcomes of asthma and COVID-19 have shown inconsistent results. This study aimed to elucidate the association between asthma and COVID-19 outcomes.Methods: We conducted a prospective study with a large health plan to compare the incidence of COVID-19 infection, hospitalization and ICU admission in a cohort of 41,282 patients with asthma and a 1:1 age-, sex-, and race-ethnicity-matched cohort without asthma across the following pandemic periods: pre-Delta (03/01/2020 to 05/31/2021), Delta (06/01/2021 to 12/31/2021), and Omicron (01/01/2022 to 08/13/2022). Demographic factors, comorbidities, COVID-19 test results, inpatient utilization, and COVID-19 vaccination status were collected from electronic health records.Results: Subjects with asthma were more likely than controls to undergo COVID-19 testing during the three pandemic periods and were less likely to test positive in the Omicron period (fully adjusted odds ratio=0.92; 95% CI=0.86– 0.98; p=0.01). Relative to controls, patients with asthma had an increased risk of hospitalization for COVID-19 (fully adjusted hazard ratio=1.33; 95% CI=1.08– 1.64; p=0.01) and borderline significant (p=0.05) higher rates of ICU admissions in the pre-delta period but not during the delta or Omicron periods. The increased risk of COVID-19 hospitalization associated with asthma was more pronounced in patients with severe asthma and in women compared with men. None of the associations were significantly modified by vaccination status.Conclusion: Asthma was associated with a lower risk of COVID-19 infection but only during the Omicron period. Asthma was an independent risk factor for hospitalization for COVID-19 in the pre-delta period and this association was stronger for severe asthma and in women.Keywords: asthma, COVID-19, severe asthma, cohort study

Introduction: Physiotherapy and medical management have shown to be beneficial in managing COVID-19 patients. Prone positioning was maximally used in managing these patients, which helped improve ventilation. Crocodile breathing emphasizes diaphragmatic recruitment, decreases accessory muscle use, and triggers the body's relaxation response. The study aims to see the immediate effect of crocodile breathing versus prone positioning in COVID-19. Methods: Thirty participants who passed the eligibility criteria were randomly assigned into two groups. Group A was asked to perform standard of care treatment followed by prone positioning, and after a washout period of a day, they were made to perform standard of care treatment followed by crocodile breathing. Group B performed crocodile breathing on Day 1 and prone positioning on the next day. Outcome measures pulse rate, respiratory rate, rate of perceived exertion, oxygen saturation, single-breath count (SBC), and chest expansion. The patient's feedback was recorded immediately within 1 min pre and post-treatment on both days. Results: Significant improvement was seen in physiological parameters (P < 0.0001), chest expansion (P < 0.0001), and SBC (P < 0.0001) in both groups. However, crocodile breathing was seen to be more effective than prone positioning on SBC (P < 0.0001), rate of perceived exertion (P = 0.000), and chest expansion (P < 0.0001). Twenty-six out of 30 (86%) participants reported crocodile breathing was a more comfortable and better position to relieve dyspnea. Conclusion: Crocodile breathing effectively manages COVID-19 and can be safely incorporated into physiotherapy management for patients with COVID-19.

Muthukumar Santhanakrishnan,1 Vedavalli Subramanian,2 Nithyakalyani Ramesh,2 R Kamaleeshwari2 1Faculty of Dental Sciences, Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India; 2Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, IndiaCorrespondence: Muthukumar Santhanakrishnan Tel +9884118681Email muthukumars@sriramachandra.edu.inObjective: The purpose of this study was assessment of the changes in soft and hard tissues in the esthetic zone of maxilla following immediate implant placement (IIP) with and without the socket shield technique (SST) and placement of implants 4 months following socket preservation (DIP) in terms of alterations in crestal bone thickness (CBT) and soft tissue changes evaluated by means of pink esthetic scores (PES) following placement of implants in the esthetic zone of maxilla.Materials and Methods: In the maxillary esthetic region, 75 dental implants were placed totally, with 25 implants each in the SST, IIP, and DIP groups. All participants were subjected to undergo CBCT for assessing the variations in thickness of crestal aspect of facial/buccal/labial alveolar bone (CBT). PES and PROMS (patient-related outcome measures) were assessed using VAS for pain threshold and esthetic satisfaction following implant placement and after 6th post-operative month.Results: The mean reduction in CBT showed a statistically significant difference between and within the groups, in comparison to IIP and DIP groups, which demonstrated an average reduction in CBT 0.4 ± 0.1 and 0.2 ± 0.1 at 6 months following implant placement, respectively. The SST group showed a significantly lesser reduction in CBT of 0.05 ± 0.02. However, the mean difference in PES within and among the groups showed no significant difference statistically at P < 0.05. On comparison of individual scores of PES between the groups, the results showed significant difference statistically at P < 0.001.Conclusion: The SST group demonstrated minimal reduction in CBT and a superior PES at the end of 6 months compared with the IIP and DIP groups.Keywords: socket shield technique, immediate implant placement, socket preservation, randomized controlled trial, pink esthetic score

The differential diagnosis of mediastinal masses encompasses a vast spectrum ranging from benign tumors to notorious malignancies. Mediastinal lipoma is a very rarely encountered mediastinal mass. It is usually an incidentally unearthed finding. It has a classical radiographic countenance. Knowledge of its existence and presentation aids early diagnosis and can avert unnecessary invasive investigations for alternative diagnosis. The radiographic picture of cardiophrenic obliteration may be seen in a number of heterogeneous conditions such as loculated pleural effusion, pericardial effusion, diaphragmatic hernias, or in certain mediastinal masses. However, mediastinal masses are rarely kept as a differential of this radiological presentation due to a lack of awareness. This leads to performance of invasive tests like thoracocentesis. We herein report an interesting case of mediastinal lipoma incidentally picked up during a chest radiograph done as a part of preoperative evaluation for an unrelated diagnosis. The chest radiograph exhibited a lesion with an obliteration of the right cardiophrenic angle.

Biomedical signal processing is crucial in many sectors that save lives. Artificial intelligence improvement in signal collection and conditioning boosted this application's adaptability to varied bodily circumstances. In this study, a novel method is put forth for predicting the type of stroke in the human brain based on the observation of the Electroencephalography (EEG) signal. The signal is the first condition for removing undesirable frequencies by passing through a lowpass filter. To accurately extract the signal features, the signal is first transformed into a 1-second frame format and then normalised. Certain statistical and frequency domain aspects are highlighted to increase taxonomic accuracy. Under the wavelet packet transform, the empirical mode decomposition approach is utilised to recover the most information feasible from the signal. After training on extracted characteristics, the extreme learning machine is regarded to conduct classification. These work achieves 94.95 of Sensitivity, 84.95 of Specificity, 93.74 of Precision, 96.96 of Accuracy, 96.12 of F1 Score. Compared to the standard procedures, the proposed techniques have a greater accuracy rate of about 98%. [ABSTRACT FROM AUTHOR]

Solar energy consumption is a systematic study used to review the design of facilities, services, and equipment in an organization against specifications of solar panel. The solar panel energy consumption analysis is a work that should be done at the beginning of a solar energy. This way, potential changes can be highlighted before they affect the solar energy budget and schedule. The proposed model provides the IOT-based smart solar energy consumption analysis and control model by using solar photovoltaic micro grid. The proposed IOT design must meet product and process requirements. The solar panel energy should properly address important aspects of production processes. This should include risks related to product quality and safety. Finally, unacceptable risks must be minimized by design. In the solar energy consumption analysis process, the deliverables should be evaluated; customers should precheck the proposed design and identify problematic areas, if any. Solar energy consumption analysis reveals whether user requirements and features are sufficient to achieve the desired outcome. Likewise, there should be corrective actions for discrepancies found in design reviews.

Background: Sleep-disordered breathing (SDB), predominantly obstructive sleep apnea (OSA), is a frequent phenomenon in interstitial lung disease (ILD) and may be associated with significant morbidity and mortality. Methodology: A prospective, observational, hospital-based study was conducted in a tertiary care hospital after ethics committee permission. The study group consisted of 100 consecutive ILD patients diagnosed by a multidisciplinary diagnosis. They were evaluated for the prevalence of SDB with a polysomnography after a comprehensive history, detailed clinical examination, calculation of various pretest probability scores, and relevant prerequisite workup. Results: Out of the total 100 ILD patients, 44 were male (44%) and 56 were female (56%). SDB was present in 57 (57%) patients. Of these, 29 (29%) were found to have only nocturnal oxygen desaturation (NOD), while 28 (28%) had OSA. The 28 cases of OSA were distributed as 15 mild OSA (53.57%), 10 moderate OSA (35.71%), and 3 severe OSA (10.71%). The patients were divided into the following four groups: total study Group (A), patients with OSA (Group B), patients with NOD without OSA (Group C), and no SDB (Group D). The mean forced vital capacity values predicted in the four groups were 53.67%, 50%, 45.56%, and 57.87%, respectively. The mean body mass index in the four groups was 24.56, 27, 26.98, and 24.89 kg/m2, respectively. The mean 6-min walk distance in the four groups was 280.7, 250, 256.65, and 311.4 m, respectively. The mean partial pressure of oxygen in the four groups was 65.65, 60, 62.10, and 75.66 mmHg, respectively. The mean apnea–hypopnea index in the study group was 2.98/h, 8.6/h with mild OSA, 21.69/h with moderate OSA, 48.78/h with severe OSA, 3.89/h in patients having NOD without OSA, and 2.54/h in patients with no SDB. Conclusion: SDB in ILD is associated with a significant impact on the cardinal determinants of functional capacity, lung function, and quality of life.

Abstract Ayurveda (the science of life) is one of the branches of Vedas. It is regarded as upaveda of Atharva Veda. It is a steam of knowledge coming down from generation to generation since eternity parallel to Vedic literature which is why its emergence has been said to be from the creator (Brahman) himself prior to the creation. It is taken as eternal because nobody knows when it was not there. In Ayurveda, food is considered to affect the mind as well as the body. By understanding how to prepare foods best suited to our minds and bodies, we can utilize nutrition as a source of healing. Food is the most essential to sustain a good life and the same food if consumed inappropriately becomes the root cause of many diseases. So, proper knowledge about food and its importance should be known by all human beings to have better benefits from it.

There are limited studies on heart failure in Indian population Objective: Present study aimed to assess the in-hospital 90-day and two year outcomes in patients with ischemic (IHD-HF) and non ischemic heart failure (NIHD-HF). Methods: Patients with NYHA Class III & IV, who were admitted to our intensive care unit with heart failure (HF), were evaluated and followed up for 2 years. Results: In our cohort of 287 patients, there were 192 (66.9%) males and 95 (33.1%) females. Patients were divided into IHD-HF of 180 (62.7%) patients and NIHD-HF of 107 (37.3%) patients. Mean age of IHD-HF group was 66 (+/−10) and in the NIHD-HF group was 61 (+/−11). Prevalence of HF increased with age in the IHD-HF population and there was no relation with age in the NIHD-HF population .Patients readmitted within 90 days in the IHD-HF were 56 % (n−101) and in the NIHD-HF were 32.7 % (n-35) [p- 0.001]. Two- year recurrent admissions were 69.4 % (n-125) in the IHD-HF patients and 52.3 % (n-56) in the NIHD-HF patients, respectively (p-0.004). Mortality at 90 days in the IHD-HF patients was 26.6 % (n-48) and in NIHD-HF patients were 14.9 % (n-16) [p- 0.021]. Two-year mortality was 42.3 % (n-76) in the IHD-HF patients and 29.9 %(n-32) in the NIHD-HF patients, respectively (p-0.037). Conclusions: HF in IHD-HF heralds a bad prognosis with recurrent hospitalizations and high mortality when compared to patients with NIHD-HF. Keywords: Heart failure, Recurrent admissions, Mortality