Biosensors can measure nonpolar molecules, which is not possible by other conventional devices. These sensors provide high specificity and fast response time. During COVID-19, this technology has helped to identify the symptoms of the viral infection. It measures the respiration rate, heart rate, temperature, and any movement in the real time for COVID-19 patients. During any changes in the symptoms of the patient, this technology rapidly contacts and advice to the health-care service provider. It helps to monitor infected patients without any risk of contamination easily. We have identified seven significant applications of the biosensors for the COVID-19 pandemic. Tests of the COVID-19 virus can be carried out effectively by employing these biosensors more appropriately and productively. This technology has completely changed and revolted the health-care world to perform its intended functions in an ongoing situation. In the future, biosensors can offer better treatment of the patients in an epidemic and pandemic, more productively and effectively.

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A multi-agent system (MAS) uses multiple interacting intelligent agents with the support of the computerized system. During this COVID-19 pandemic, there is a requirement to improve service for patients to fulfill the ongoing challenges. This technology provides a digital service continuously for the patients. An MAS-based platform is helpful for different scenarios during this pandemic. This article discusses significant components, as used for developing an MAS to handle COVID-19 situations. Finally, it discusses various significance applications of an MAS for COVID-19 pandemic patients. The knowledge and data required to solve the COVID-19 pandemic are distributed spatially in different locations, which add constraints, toward proper planning of the treatment of patients to combat this pandemic. Governments accept that their systems cannot stop the widespread transmission of this virus. However, by flattening the curve, the mortality rate can be reduced. MAS consist of autonomous entities, also known as agents, who work collaboratively. By using MAS, lots of real-world data of the emerging situation such as an outbreak can be processed gainfully. It will allow doctors and organizations to create flexible models of potential scenarios.

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Nasal myiasis is an opportunistic parasitic infestation of human as well as animals. Infestation of the nasal cavity by dipterous larvae is called nasal myiasis which is commonly seen in developing countries where health and sanitation are poor. Different predisposing factors associated with nasal myiasis are atrophic rhinitis, diabetes with purulent nasal discharge, midline granulomatous lesions or malignancy, and poorly nourished patients with poor hygiene. Other possible predisposing factors causing nasal myiasis include neglected children, mental retardation, and elderly age. Nasal endoscopy is a better method for removal of maggots under direct vision. Nasal endoscopic method is a better technique for the removal of maggots than conventional manual method. The maggots which are often located in deep and inaccessible areas are easily identified and removed.

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Extranodal tuberculosis (TB) of the head-and-neck area is a rare clinical entity and constitutes the less common type of extrapulmonary TB. It often creates challenges among head-and-neck physicians for its diagnosis and treatment. Extranodal TB is a rare clinical entity and has no specific clinical features. It is often a differential diagnosis of head-and-neck malignancies, chronic infective or noninfective ulcers. Early diagnosis and its treatment may avoid complications and needless major surgery. The purpose of this review article is to discuss the epidemiology, pathophysiology, clinical presentations, diagnostic challenges, and treatment of the extranodal TB of the head-and-neck area.

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Almost all countries are struggling with a pandemic created by infection of the severe acute respiratory syndrome coronavirus-2 virus. Health professionals are overstretched and are estimating to treat millions of peoples infected by this virus. However, we see the gainful employment of new technologies to provide fewer human interaction benefits to prevent the transmission of this virus. Here, in this paper, the capabilities of new technologies such as unmanned aerial vehicles, data analysis, three-dimensional (3D) printing, machine learning, and artificial intelligence are used to develop a model to the limit of their autonomous functionalities. We have proposed an automated COVID-19 pandemic emergency response system using the above modern technologies. These technologies are used efficiently to supply essential items in the required location and minimize the need for transportation. Advanced digital technologies are used to observe the crowd in different cities. It can identify people who are not wearing masks in public places. Further, 3D printing technology is used to manufacture personal protective equipment for COVID-19, and drones are used to deliver these items in the required places. The integrated deployment of new technologies can help us to fight this virus in a better way. This model can help through intelligent population screening, improved medical help, timely notification, and suggestions about infection control. It uses an innovative platform supported through different software and machine learning techniques. Furthermore, doctors, analysts, governments, and researcher can take its advantage to analyze the level of infection by the virus.

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Recently, a number of studies have recognized the importance of traumatic pericontusional penumbra as a potential target for therapeutic interventions to prevent the secondary brain damage. We report an illustrative case of a 40-year-old female patient who was brought to the emergency room with the alleged history of fall from the bike. Computed tomography scan brain showed left sylvian and left temporoparietal subarachnoid hemorrhage, patchy contusion of the left frontal and temporal lobes, linear fracture of the right temporal bone with edema, mass effect, and mild midline shift. After 6 h of intensive care unit stay, the patient developed pupillary asymmetry and a repeat scan showed significant increase in the size of cerebral contusions with gross pericontusional edema, mass effect, and midline shift. The patient underwent urgent left frontotemporoparietal craniotomy and evacuation of the contused brain and hematoma. Pericontusional penumbra is increasingly recognized and strategies are being suggested to salvage the apparently hypoxic (not yet ischemic) brain to preserve the neurological functions and to improve functional outcome. In future, we need more studies to support the concept of pericontusional penumbra and further characterize the imaging findings for early clinical diagnosis and to plan early appropriate intervention.

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Fahr's disease (FD) is a rare inherited or sporadic disorder characterized by symmetrical calcium deposits in the basal ganglia and dentate nuclei with the absence of biochemical abnormalities. Clinical manifestations can start at different ages with a variety of presentations. We report a case of a 68-year-old male who presented to our service with clinical signs and symptoms of pure and progressive dementia. Afterward, he developed mood changes, and finally, movement disorders, probably due to a sporadic form of FD. Noncontrast cranial computed tomography scan demonstrated scattered brain parenchyma, bilateral calcifications in the basal ganglia, and dentate nuclei. Standard blood tests were within the normal limits. In this way, FD can present with pure dementia at onset, reflecting a wide range of neurological manifestations. The diagnosis is challenging, and we proposed an acronym to facilitate the learning of the diagnostic criteria.

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A young girl presented with increasing bilateral groin pain for the past 3 months (visual analog scale score 8/10) and inability to weight bear for the last 1 month. Plain X-rays showed bilateral fractures of the femoral neck, extending in the intertrochanteric and subtrochanteric regions on both sides. Laboratory investigations revealed severe Vitamin D deficiency with secondary hyperparathyroidism. The insufficiency fractures are subtypes of stress fractures with decreased mineralization and weakened zone calcification of the bone. Clinical awareness about the insufficiency fractures and a high index of suspicion is required to make an early diagnosis. The majority of insufficiency fractures due to Vitamin D deficiency can be managed conservatively with timely diagnosis, adequate supplementation of Vitamin D, and calcium.

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The novel coronavirus disease 2019 first emerged in Wuhan, China, and is now an emerging pandemic globally. This has strained health-care services leading to restrategizing anesthesia care and management of patients. We describe the anesthetic management of a 30-year-old COVID positive, multigravida, with term pregnancy taken up for elective cesarean section under the subarachnoid block in a dedicated operating room earmarked for COVID cases. For such a case, challenges in the modification of standard procedures to minimize exposure of the health-care professionals are delineated.

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Background: Stroke is a leading cause of death and disability worldwide, accounting for 11.13% of total deaths, and the main cause of disability worldwide. The aim of this study is to know the pattern of stroke admissions at Benghazi Medical Center (BMC) and the possible risk factors. Materials and Methods: This was a cross-sectional study of 110 patients admitted to BMC who were diagnosed with stroke based on the International Classification of Diseases, Revision 10 (ICD-10), from January to June 2019. Data about age, gender, comorbidities, and medical history were collected. Results: In the study period, the medical records of 110 patients were surveyed for stroke diagnostic code based on ICD-10. Our research protocol identified 110 stroke records, out of which 10 cases were unspecified stroke. Of 100 specified stroke cases, 70 cases described an ischemic incidence and 30 cases reported a hemorrhagic incidence. Analysis of demographic attributes over this dataset showed that 65 men and 35 women with mean ages of 66.4 ± 14.2 and 64.6 ± 12.4, respectively, were admitted with stroke diagnosis, irrespective of stroke type. Further analysis indicated that both ischemic and hemorrhagic stroke subtypes had a high incidence in age ≥70 years (P = 0.003). The relationship between age group and stroke subtype was significant (P < 0.05). The mortality rate in this population based on the stroke subtype indicated that the mortality rate in patients diagnosed by hemorrhagic stroke is higher than those with ischemic attack (P = 0.004). Furthermore, there was no significant statistical difference between stroke subtypes and gender (P = 0.768). Analysis of possible relations between comorbid risk factors and stroke subtypes using the Chi-square test showed that, compared to other comorbid risk factors, diabetes mellitus (P = 0.003) and dyslipidemia (P = 0.001) were significantly prevalent among ischemic and hemorrhagic stroke patients. While hypertension (HTN) was strongly associated with hemorrhagic strokes (P = 0.001). There was no significant difference between ischemic and hemorrhagic strokes with regard to other risk factors. Conclusion: Ischemic stroke was more common than hemorrhagic stroke; overall, HTN, diabetes mellitus, and dyslipidemia were the major risk factors of stroke in our studied population.

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Background: Porphyrias are a group of inherited metabolic disorders, resulting from the deficiency of specific enzyme in the hemebiosynthesis. Among these, acute intermittent porphyria (AIP) is the most common type with neuropsychiatric features encountered in the clinical practice. In this study, we describe the presentation of AIP in five different patients admitted in our hospital. Materials and Methods: We prospectively collected the data of five patients of AIP admitted in our department in the past 2 years and studied in detail the causes, precipitants, clinical presentation, diagnosis, and management of AIP. Results: All five cases were males in second to third decades of life having a history of prior gastrointestinal symptoms for variable period before presenting to us with neurological manifestations of which one had abdominal pain for 2 years and had undergone appendicectomy also. All patients had seizures and psychiatric manifestations. Four patients had axonal polyneuropathy and respiratory failure requiring prolonged ventilator support. One patient had a past and family history of AIP. Sepsis as a trigger is noted in two patients. All patients had positive urine test for porphobilinogen. All had autonomic dysfunction, hyponatremia, and three patients expired after prolonged intensive care unit stay of which two had status epilepticus. Two patients survived with complete recovery and are under regular follow-up. Conclusion: Porphyria screening should be done in all patients presenting with unexplained motor neuropathy. Avoidance of triggers, early suspicion of the acute attack, and starting treatment immediately will prevent the complications and thus reduce morbidity and mortality due to the acute attack.

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Introduction: Chest injuries constitute an important aspect of trauma. Despite high mortality rates, but the majority of patients with thoracic injuries can be managed by a simple intervention like tube thoracostomy. Aims and Objective: The aim of this study is to analyze the epidemiological pattern of chest injury and assess the outcome at our institute. Materials and Methods: This was a prospective observational study done at a tertiary care center of north India from July 2015 to December 2016, including 200 patients. Results: Road traffic accident was the most common cause of chest trauma (61%) followed by fall from height (23%). We observed rib fracture in 78% of patients, surgical emphysema in 31%, hemopneumothorax in 31.5%, hemothorax in 25%, and pneumothorax in 8.5% patients. Twenty-four percent (48/200) patients were managed conservatively, whereas 72.5% (145/200) patients were managed by chest tube drainage. Only seven (3.5%) patients underwent surgical procedures for chest injury in terms of thoracotomy or laparotomy. The mortality rate in our study was 6.5%, whereas 9.5% of patients required ventilator support. Conclusion: In our study, most of the patients were managed conservatively or simply by chest tube drainage. The overall prognosis depends more on associated injuries and morbidity. Associated head injury is the major factor behind need of ventilator and intensive care unit support and led to death in the majority of patients.

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Objective: The primary purpose of this article is to provide logical conclusions and likely explanations to the patterns in patient visits to the outpatient department (OPD) of an orthopedic hospital in Vadodara, Gujarat. Subjects and Methods: Over the course of 25 days, the author of this work witnessed a total of 244 patients assessed, diagnosed, and treated by the primary physician. Results: Results indicated that fractures, degenerative disc disease (DDD), arthritis, spondylosis, tendon and ligament tears, and muscle pulls were the leading causes of nearly 80% of all OPD visits. Among them, tendon and ligament tears and muscle pulls contributed to 62% of all acute visits to the OPD, while DDD, spondylosis, and arthritis contributed to 65% of all chronic visits to the OPD. Discussion: Analyses of data showed that there was an even split between acute and chronic patient visits to the OPD. However, males were almost two times more likely to visit with acute conditions and only half as much for chronic conditions compared to females. Further, males' acute visit to the OPD was triggered, on an average, by lifestyle-altering orthopedic or other medical conditions compared to females that appeared to seek medical assistance for chronic conditions. Conclusions: This article concludes with recommendations for patient engagement to assist them seek care on a timely and consistent fashion.

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Although the exact pathophysiology of amyotrophic lateral sclerosis (ALS) remains unclear, oxidative stress is known to play a pivotal role. There is no cure for ALS, but there are two drugs available to slow the progression of the disease. Till recently, riluzole, a glutamatergic neurotransmission inhibitor, was the only drug approved for ALS. However, in May 2017, edaravone, which is a potent-free radical scavenger, was also approved by the Food and Drug Administration for the treatment of ALS. In this article, the mechanism of action of edaravone and clinical trials establishing its efficacy are reviewed.

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Diabetes and periodontitis are highly prevalent diseases. Chronic nature, along with shared risk factors, magnifies the complexity of both the diseases. Periodontal treatment results in clinically relevant reductions in HbA1c, and the presence of diabetes worsens the periodontal health and vice-versa. This paper presents an overview on the pathogenic mechanisms, impact of intervention, and significance of interprofessional collaborations for holistic management in diabetes and periodontitis.

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Chronic relapsing inflammatory optic neuropathy (CRION), initially described in 2003, is a form of recurrent optic neuritis (ON) that has relatively good response/dependency to steroid treatment. In demyelinating ON, patients present with periorbital ache and pain elicited by eye movement, which usually begins insidiously and worsens, in synchrony with or preceding a reduction in vision, which deteriorates over days. The etiology of CRION is unknown. However, the excellent response to corticosteroids and the need for immunosuppressive therapy to prevent relapse suggests an immunomediated origin.

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Coronavirus pandemic cases are increasing worldwide, including that in India. Pediatric cases are also increasing, although children may have more of mild manifestation of the disease and are recovering fast. Children with endocrine disorders are considered at a higher risk of contracting the virus due to their immunocompromised status. Children with diabetes, adrenal insufficiency, and thyroid disorders are the usual conditions for which they are on long-term treatment and need to be monitored closely. The article gives an outline of management of children with endocrine disorders during the current pandemic.

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A variety of surgical approaches are available for the treatment of spine diseases. Complications can arise intraoperatively, in the immediate postoperative period, or in a delayed fashion. These complications may lead to severe or even permanent morbidity if left unrecognized and untreated. Postoperative complications such as incomplete fusion, hardware failure, suboptimal positioning of instrumentation, infection, hematoma, and others may be detected at imaging. The article reviews the potential complications of spinal instrumentation, beginning with a description of biomechanics and an overview of surgical approaches and continuing with a discussion of various types of complications and their appropriate radiologic assessment. This systematic review describes the imaging features of immediate and delayed complications including instrumentation malpositioning.

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Background: Seizures due to posterior fossa lesions is an uncommon phenomenon. In this study, a systemic literature review was done to (i) study the incidence of seizures in posterior fossa lesions, (ii) determine factors associated with high risk for seizures, and (iii) ascertain the role of prophylactic antiepileptic drugs (AEDs) in such cases. Methods: Systemic literature review was done, for the MeSH terms “posterior cranial fossa” AND “seizures” AND “anticonvulsants.” All original research articles, case reports, and systematic reviews pertaining to seizures or the use of anticonvulsants in posterior fossa lesions were considered for inclusion. Results: A total of 79 cases of posterior fossa lesions, identified from 8 studies, were included for analysis. The incidence of seizures in posterior fossa lesions ranged from 1.8% to 5% in various studies. The highest incidence for seizures was reported with medulloblastoma, cerebellar hemorrhage, and during microvascular decompression for cases of neurovascular conflict. The most significant risk factor for seizures in the postoperative period was the use of ventricular shunt or ventriculostomy. AEDs were administered symptomatically after the occurrence of seizures in 78 cases except for the use of prophylactic AEDs in a single case of posterior cranial fossa lipoma. Conclusion: Seizures in association with posterior fossa lesions are rare and associated with a poor prognosis. Clinical detection can often be difficult and electroencephalogram helps in early diagnosis and treatment. Further studies are needed to confirm the role of prophylactic AEDs in high-risk cases.

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Coronaviruses including the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are known to affect primarily the respiratory system with additional manifestations on the enteric, hepatic, and cardiac systems as well. Neurological manifestations are increasingly being reported from all over the world though only as case reports and short case series. Neurological manifestations are not uncommon and may be seen in up to a third of patients with COVID-19 infection and may range from minor symptoms of headache, dizziness, anosmia, and ageusia to severe neurological illnesses including encephalitis, acute necrotizing hemorrhagic encephalitis, stroke, myelitis, and Guillain–Barre syndrome. Neurological symptoms may occasionally be the presenting or sole manifestation of COVID-19 infection, and a high index of suspicion is required while dealing with such cases during the COVID-19 pandemic. A Medline search was made till June 20, 2020 using the keywords SARS-CoV-2, COVID-19, and Neurological Manifestations for the review.

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Medical profession requires extensive knowledge and accuracy from the existing data for improved decision-making. Artificial intelligence (AI) is an appropriate technology used to improve the knowledge, skill, quality of treatment, capability, confidence, and effective decision-making process. It has the capability to revolutionize the healthcare industry. It can identify high-risk patients and their associated treatments and can help train doctors for the understanding of diseases and diagnostic treatment for better patient health. We discuss various advantages and limitations of AI in the context of healthcare sector. Various significant capabilities of AI for decision-making are identified and presented, and its significant capabilities for healthcare education are consolidated herewith. AI is helpful for appropriate planning, diagnosis, and associated activities, such as education, training, research, and development of healthcare. This technology provides some excellent capabilities to notice the changes and predict the disease of the patient. AI is now being applied for developing personal health history, and industry is contemplating a great potential for its implementation. However, cost and privacy issues are yet to be taken care of.

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