Coronavirus Disease 2019 (COVID-19) pandemic has stirred up chaos in the whole world. After prolonged lockdowns, finally, society is opening again for business and day-to-day life. Mass gatherings are undoubtedly again expected to start, but carry additional risks for transmission of the virus. We designed a concept model that was validated in about 1000 people gathering in a convocation ceremony at the beginning of the COVID-19 outbreak. A protocol was made, a risk assessment was done, and attendees followed-up. The emphasis on thermal screening, hand hygiene, physical distancing, open-air ventilation, refusing attendees having Influenza-Like Illnesses (ILI), and other preventive measures were the means to contain the potential transmission in an organised mass gathering of this magnitude. The dictum “prevention is better than cure” held amidst this outbreak. As a result of this well-structured mass gathering, the event was quite successfully conducted. Further event planning in the COVID-19 scenario or other outbreaks of similar infections must be managed in this way for the prevention of spread.

This paper depicts Box-Behnken design (BBD) approach to optimize the performance and emission characteristics of adjustable compression ratio, single- cylinder diesel engine with nanoparticle-blended biofuel. Cerium oxide (CeO2) nanoparticles and diethyl ether (DEE) are mixed with neem methyl ester (NME) in corresponding ratios as per BBD experimental plan. Engine performance characteristics brake thermal efficiency (BTE), brake-specific fuel consumption (BSFC), and NOx, CO, HC, and CO2 emissions have been analyzed. To study the influence of input parameters, quadratic models are developed on each output response using analysis of variance (ANOVA). Desirability function approach has been used to optimize the performance of multi-response parameters. The results revealed that nanoparticles mixed blends of NME and DEE enhances the performance characteristics and reduce the harmful emissions.

Background: Common obstetric emergencies require blood and blood components transfusion. The use of blood and its components has become a lifesaving strategy in management of obstetric haemorrhage. This study was aimed to know the prevalence, indications and adverse reactions of blood and its components transfusion.Methods: A review of 405 patients of obstetric emergencies requiring blood and its component transfusion was done.Results: Prevalence of blood and blood components transfusion in obstetric emergencies in one-year period was 18.4%. Mostly women who received blood transfusions were multiparous (50.12%) and belonged to rural areas (62%). Anemia is a risk factor for obstetric emergencies and the mean pre transfusion hemoglobin ±SD was 8.04±1.38 (g/dl). Obstetric hemorrhage (68.6%) was the most common indication for transfusion and packed red cells were most commonly (54.07%) transfused. The overall percentage of adverse reactions seen during transfusion was 1.95%.Conclusions: The present study reinforces the importance of appropriate use of blood and its components in obstetric emergencies. Appropriate use of blood components avoids many of the hazards associated with use of whole blood. All blood components should be made available at peripheral hospitals as most of the patients require specific blood component and they are referred to tertiary care centre in emergencies which can be avoided.

Background: The COVID-19 pandemic has resurfaced in India in the form of a hard-hitting second wave. This study aims to compare the clinical profile of the first wave (April-June 2020) and the second wave (March-May 2021) of the severe acute respiratory syndrome coronavirus-2 pandemic (SARS-CoV-2) in a single tertiary care center of India. Methods: In this retrospective observational study, we examined the demographic profile, symptoms at presentation, the severity of illness, baseline investigations, treatments received, underlying comorbidities, and outcomes of the COVID-19 patients belonging to the first (W1) and the second wave (W2) of the pandemic in India. Results: The age group affected most in the W2 is 50.5 (17.7) versus 37•1 (16•9) years for W1. The baseline oxygen saturation is lower in W2, being 84•0 (13•4) % compared with 91•9 (7•4) % in W1 [SpO2 <90% OR 14.3 (6.1-33), P<0.0001]. 70.2 % of the cases belonged to the severe category in W2 compared to 37.5% in W1. W2 has worse outcomes. Incidence of acute respiratory distress syndrome (ARDS) [48.7% v/s 6.45%; OR 15.4 (6.5-35.7), P<0.0001], Acute Kidney Injury (AKI) [18% v/s 2.4%; OR 6 (1.7-22.2), P=0.005], Acute Liver Injury (transaminitis) [12.8% v/s 6.4%, OR 7.3 (3.7-14.3), P<0.0001], and deaths (29% v/s 9.6%, standardized mortality ratio 3.5) is higher in W2. Similarly, the CT severity score for W2 [29.5 (6.7)] was higher than W1 [23•2 (11•5), P<0.05]. The proportion of patients requiring oxygen [81.8% v/s 11.2%; OR 125 (40-333.3), P<0.0001], high flow nasal cannula (HFNC) (11.4% v/s 5.6%), Non-Invasive Ventilation (NIV) (41.2% v/s 1.5%), invasive ventilation [24.5% v/s 0.9%; OR 22.72 (2.94-166.6), P=0.003], as well as ICU/HDU admissions [56.4% v/s 12.0%; OR 10.5 (5.3-21.2), P<0.0001] was higher for W2 as compared with W1. Cough, invasive ventilation, inotrope requirement, and ARDS are significantly related to higher mortality in the W2 than W1. Conclusion: Higher age, oxygen requirement, ventilator requirement, ICU admission, and organ failure are more prevalent in the admitted COVID-19 cases during the second wave that hit India than the first wave and are associated with more fatalities. Strategy for another wave should be planned accordingly.