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Lay summary The current pandemic of COVID-19 has affected all the countries globally. However, the adverse impact of the pandemic is more seen in the low-income and middle-income countries (LMICs). Although there is evidence on the adverse impact of the SARS-CoV-2 on the health of mothers and neonates, the evidence is mainly from high-income countries. For reducing the mortality and morbidity due to COVID-19 in LMICs, there is a need to generate evidence from the LMICs. The present study is a part of the National Registry of pregnant women with COVID-19 in India (PregCovid registry). Our study demonstrates a higher risk of adverse outcomes such as neonatal sepsis and death in the SARS-CoV-2 infected as compared to the non-infected neonates. The study also showed the risk of SARS-CoV-2 infection in 6.3% of neonates born to mothers with COVID-19. Introduction We describe the clinical characteristics, management, and short-term outcomes of SARS-CoV-2 neonates born to mothers with COVID-19 in a tertiary care hospital in Mumbai, India. Methods The study is a retrospective analysis of 524 neonates born to mothers with COVID-19 admitted from 14th April 2020 to 31st July 2020. Results SARS-CoV-2 infection was detected in 6.3% of the newborns of the mothers with COVID-19. No significant differences were observed between maturity at gestation, birth weight and sex of SARS-CoV-2 infected and non-infected newborns. The risk of sepsis was 4.09 (95% CI,1.28-13.00) fold higher in the neonates with SARS-CoV-2 as compared to the non-infected group (p = 0.031). Poor feeding was significantly more common among SARS-CoV-2 infected neonates (12.1%) as compared to the non-infected neonates (2.7%) (p = 0.017). There was a total of 13 neonatal deaths, of which 3 deaths occurred in SARS-CoV-2 infected neonates (9%) while 10 (3%) in the SAR-CoV-2 negative group. The risk of neonatal death was higher in SARS-CoV-2 infected newborns (OR 4.8; 95% CI 1.25-18.36). Conclusion Neonatal SARS-CoV-2 infection is observed in almost 6% of neonates born to mothers with perinatal COVID-19. There is a higher risk of adverse outcomes such as neonatal sepsis and death in the SARS-CoV-2 infected as compared to the non-infected neonates.

Background: Acute phase insulin secretion is disturbed in individuals with prediabetes. We have previously shown a significant risk reduction in 4,417 prediabetes individuals through Yoga. The present study explores yoga’s mechanism of action. Method: This randomized control trial included 42 (20 yoga;22 walkings;5 days/ week, 3Months) prediabetes (fasting glucose of 100 to 125 mg/dl) adults between 23 to 50 years. Serum Insulin and C peptide were assessed at 0, 3, 5, 7, 10, 15, 30,60and 90th minutes after 75grams of oral glucose. Pre-post assessments included fasting Glucose, HOMA%B(derived), GLP-1, free Triiodothyronine, perceived stress, and Heart rate variability. Results: There was a significant increase in the 10th minute (acute phase) Insulin and c-peptide levels in the yoga as compared to the control group. Improvement in GLP-1 and HOMA%B was significantly better in yoga than walking group. Yoga group also showed positive change in perceived stress and HRV. Simple linear regression of post data using acute phase Insulin as the dependent variable indicated a significant association between all measures(R2 = 0.806; p = Conclusion: The shift to normoglycemia, due to an increase in acute phase insulin release, was associated with improved autonomic balance and reduced stress after yoga. More studies may confirm this unique first time observation. Disclosure R. Nagarathna: None. J. Kurian: None. V. Vijayakumar: None. H. R. Nagendra: None. R. N. Mavathur: None. Funding Ministry of AYUSH, Government of India (Z.28015-HPC (EMR)-AYUSH-B)

ObjectiveTo understand the outcome of hospitalised patients from Mumbai City, which had the highest number of COVID-19 cases in India.DesignObservational study with follow-up.SettingData extraction from medical records of patients with COVID-19 admitted to Nair Hospital & TN Medical College, Mumbai, India.Participants689 patients with COVID-19 were admitted in the hospital from 26 March 2020 to 11 May 2020.Primary and secondary outcome measuresIn-hospital mortality; joint effect of comorbidity and age on the risk of dying.ResultsA total of 689 patients (median age 44 years) admitted with RT-PCR-confirmed COVID-19 were included in the study. Of these, 77.36% of patients were discharged alive while 22.64% died. 11.61% required some kind of oxygen support while 2.8% of patients required intensive care unit admissions. Older age (HR 2.88, 95% CI 2.09 to 3.98), presence of comorbidities (HR 2.56, 95% CI 1.84 to 3.55), history of hypertension (HR 3.19, 95% CI 1.67 to 6.08), and presence of symptoms at the time of admission (HR 3.21, 95% CI 1.41 to 7.26) were associated with increased risk of in-hospital mortality. Treatment with a combination of azithromycin with hydroxychloroquine, antiviral or steroid compared with no treatment did not alter the disease course and in-hospital mortality. The combined effect of old age and presence of comorbid conditions was more pronounced in women than men.ConclusionsIn-hospital patients were younger, less symptomatic with lesser need of ventilators and oxygen support as compared with many western countries.Trial registrationNot applicable (observational study, not a clinical trial).

Background: Coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2, clinically presenting with common symptoms of fever, dry cough, and breathlessness within 14 days of exposure. Its severity ranges from mild to severe, latter manifesting into severe acute respiratory syndrome. As a part of multidisciplinary team, physiotherapy along with medical management was administered to patients with COVID-19 in an acute care setup. This retrospective study aims to explore various patient characteristics and will aid in identifying the impairments associated with the disease, giving a direction to the physiotherapy community in planning future management strategy to improve quality of life. Patients and methods: The present study is a unicentric study wherein prospective analysis of retrospective data of patients referred for physiotherapy from May 13 to July 31, 2020, was performed. (i) Characteristics of patients, (ii) associated comorbidities, (iii) hospital course since the time of admission to discharge, (iv) mode of oxygen delivery, (v) pre- and post-physiotherapy treatment values of oxygen saturation and heart rate, and (vi) physiotherapy treatment were recorded. The archived data were analyzed using the commercially available SPSS software version 24. Wilcoxon's matched pair test was used to compare pre- and post-treatment oxygen saturation and heart rate, and McNemar's test was used to compare mode of oxygen delivery and pre- and post-physiotherapy treatment. Results: Descriptive analysis of data showed a better outcome in terms of grade of dyspnea and rate of discharge on day 14 of physiotherapy treatment. Hence, a comparative analysis of day 1 and day 14 was performed for mode of oxygen delivery, oxygen saturation, and heart rate. A statistically significant improvement was observed in the heart rate (p = 0.001) and oxygen delivery (p = 0.000). However, no significant difference in the level of oxygen saturation was found (p = 0.6433). Conclusion: Physiotherapy treatment in conjunction with medical treatment can be effectively administered in patients with COVID-19 in acute care setup taking into consideration the health status and the hemodynamic stability of the patients. It emphasizes the role of physiotherapy in the alleviation of symptoms, facilitating early weaning and recovery enabling early discharge from the hospital. How to cite this article: Verma CV, Arora RD, Mistry HM, Kubal SV, Kolwankar NS, Patil PC, et al. Changes in Mode of Oxygen Delivery and Physiological Parameters with Physiotherapy in COVID-19 Patients: A Retrospective Study. Indian J Crit Care Med 2021;25(3):317–321.

BACKGROUND A respiratory intensive care unit (RICU) is a designated area specially designed for management of patients with acute respiratory conditions with an essential endeavour of meticulous cardiorespiratory monitoring and holistic management of acute respiratory conditions. Availability of ventilation thorough the non-invasive mode (NIV) has revolutionised therapy in chronic respiratory diseases. METHODS We analysed the data of 50 patients over two-months’ duration. The mean duration of stay and treatment outcomes were analysed. The qualitative data was analysed using percentages and mean. Chi-Square test was used for statistical analysis. RESULTS Study sample was of 50 patients out of which 26 were men and 24 were women. The indications for hospitalisation were classified as per aetiology as COPD- 29 (58%), ILD- 6 (12%), parenchymal diseases- 5 (10%), pleural diseases- 4 (8%), malignancy- 3 (6%), others- 3 (6%). The patients were further classified into; 21 (42%) with type I respiratory failure and 29 (58%) with type II respiratory failure. Of the total 50; one-third (18) required only oxygen therapy and two-third (32) mechanical ventilation (25 NIV and 7 IMV). The mode of ventilation impacted outcomes significantly with oxygen therapy and NIV having very good outcomes (Chi Square test; p-value is 0.000838). CONCLUSIONS RICU is the need of the hour to manage patients with critical respiratory illnesses.

To design a large-scale pyrolysis reactor, a complete particle level model was developed using pyrolysis of babul wood. Babul wood, the abundant woody biomass in India, is a highly reactive and promising feedstock for pyrolysis and considered as a case study in the present work. Thermo-balance was used to devolatilize the wood particles at different heating rates from (10 to 20 K min−1), thereby estimate the intrinsic kinetics parameters. Non-condensable gases released from wood pyrolysis were also modeled and derived the kinetic parameters. Large wood single particle dimension of L/D ∼3.5 was chosen to investigate the pyrolysis reaction and developed a particle level model which involves both heat transfer and chemical reactions phenomena. Particle model developed was simulated with intrinsic kinetic parameters generated from kinetic models. Two-step consecutive model with different reaction orders (m = 1, n = 2) was found to explain the experimental data very well. Additionally, optimum conditions for maximum product yields and detail characterization of bio-oil was carried out using different analytical techniques.

Immune cell dysregulation and lymphopenia characterize COVID-19 pathology in moderate to severe disease. While underlying inflammatory factors have been extensively studied, homeostatic and mucosal migratory signatures remain largely unexplored as causative factors. In this study we evaluated the association of circulating IL-6, soluble mucosal addressin cell adhesion molecule (sMAdCAM) and IL-15 with cellular dysfunction characterizing mild and hypoxemic stages of COVID-19. A cohort of SARS-CoV-2 infected individuals (n=125) at various stages of disease progression together with healthy controls (n=16) were recruited from COVID Care Centres (CCCs) across Mumbai, India. Multiparametric flow cytometry was used to perform in-depth immune subset characterization and to measure plasma IL-6 levels. sMAdCAM, IL-15 levels were quantified using ELISA. Distinct depletion profiles, with relative sparing of CD8 effector memory and CD4+ regulatory T cells was observed in hypoxemic disease within the lymphocyte compartment. An apparent increase in the frequency of intermediate monocytes characterized both mild as well as hypoxemic disease. IL-6 levels inversely correlated with those of sMAdCAM and both markers showed converse associations with observed lympho-depletion suggesting opposing roles in pathogenesis. Interestingly, IL-15, a key cytokine involved in lymphocyte activation and homeostasis, was detected in symptomatic individuals but not in healthy controls or asymptomatic cases. Further, negative association of plasma IL-15 with depleted T, B and NK subsets suggested a compensatory production of this cytokine in response to the profound lymphopenia. Finally, higher levels of plasma IL-15 and IL-6, but not sMAdCAM, were associated with longer duration of hospitalization.

Additional file of Genome-wide identification and expression profiling of auxin response factor (ARF) gene family in maize

The aim of the current research is to assess the anticancer activity of the proteins identified from the crude protein extract derived from Hermetiaillucens larvae by computational methods. Bioinformatics methods were used to identify the protein sequence and virtual screening for the prediction of protein structure, their physico-chemical characteristics and functional aspects, that aid in exploring the anti-cancer interaction that is inclined to inhibit the oncoprotein activity. Due to the pathological process transpired by HPV, an array of genetic alterations, including the overexpression of oncoproteins or the inactivation of tumor suppressor proteins like TP53, BCL2, MDM2, ARF and BAX occur. The altered protein signaling pathways convulse to cervical cancer. In this research, we identified proteins, from the crude extract derived from Hermetiaillucens by LC-MS method. Further Computational screening of the selected proteins were employed to assess the functional units which has anticancer activity. We predicted four proteins Metallothionine, Defensin like precursor 1 protein, Heat shock protein 90 and NADH dehydrogenase and eluted the protein sequence from NCBI GenBank database. These sequences were used to predict physicochemical properties and protein structure prediction. Pharmacophore analysis of the peptide sequences as potential targets for cancer treatment was evaluated. Molecular docking of peptide sequences with target protein structure was carried out. To screen the best active potential molecule for cancer treatment the Molecular dynamics of docked protein-peptide structures were administered. The molecular docking of the peptides with onco-proteins has been predicted and virtually screened based on RMSD values. The resultant protein sequence was evaluated further by amino acid sequencing, extensive scrutiny of the proteins, advanced computational imaging, molecular docking examination and assessed the results for clinical interpretation. To summate, bioinformatics assessment enabled us to identify four key proteins derived from Hermetiaillucens larvae that have strong inhibitory function against proteins that cause cervical cancer.

Additional file 1:Primer sequences for full-length cDNA cloning of 13 ZmARFs. (DOC 38 KB)

Additional file 7:Primers used for stability evaluation of housekeeping gene expression. (DOC 31 KB)

Additional file 6:The relative expression levels of 31 ZmARFs in three tissues of maize inbred line B73. Leaves (8-day-old seedling), roots (8-day-old seedling) and embryos (15d after pollination) of maize inbred line B73 were used for real-time RT-PCR analysis. (DOC 78 KB)

Additional file 4:miR160, 167 and TAS3 target site prediction for ZmARF genes. (DOC 37 KB)

Additional file 9:Primers used for expression study of ZmARF genes. (DOC 50 KB)