Objectives: Convalescent plasma (CP) as a passive source of neutralizing antibodies and immunomodulators is a century-old therapeutic option used for the management of viral diseases. We investigated its effectiveness for the treatment of COVID-19. Design: Open-label, parallel-arm, phase II, multicentre, randomized controlled trial. Setting: Thirty-nine public and private hospitals across India. Participants: Hospitalized, moderately ill confirmed COVID-19 patients (PaO2/FiO2: 200-300 or respiratory rate > 24/min and SpO2 ≤ 93% on room air). Intervention: Participants were randomized to either control (best standard of care (BSC)) or intervention (CP + BSC) arm. Two doses of 200 mL CP was transfused 24 hours apart in the intervention arm. Main Outcome Measure: Composite of progression to severe disease (PaO2/FiO2<100) or all-cause mortality at 28 days post-enrolment. Results: Between 22 nd April to 14 th July 2020, 464 participants were enrolled; 235 and 229 in intervention and control arm, respectively. Composite primary outcome was achieved in 44 (18.7%) participants in the intervention arm and 41 (17.9%) in the control arm [aOR: 1.09; 95% CI: 0.67, 1.77]. Mortality was documented in 34 (13.6%) and 31 (14.6%) participants in intervention and control arm, respectively [aOR) 1.06 95% CI: -0.61 to 1.83]. Interpretation: CP was not associated with reduction in mortality or progression to severe COVID-19. This trial has high generalizability and approximates real-life setting of CP therapy in settings with limited laboratory capacity. A priori measurement of neutralizing antibody titres in donors and participants may further clarify the role of CP in management of COVID-19.

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Biomedical waste consists of hospital waste engendered during diagnosis, treatment or immunization of humans or animals like syringes, needles, infected organs, body fluids etc. or generated during any research activity like cultures, broken glasses etc. It is an important issue to be considered as biomedical waste cannot be disposed of like conventional waste and requires special attention for its disposal. The objective of this paper is to explore the best method to be used for disposal of biomedical waste with respect to its impact on environment. For this purpose, the 5 selected methods are assigned ranks using Fuzzy topsis method by taking opinion from decision makers and averaged for further analysis. On the basis of reviews 5 methods of disposal (incineration, autoclaving, microwave irradiation, chemical treatment and deep burial) are taken into considerations and 3 decision maker's opinion is taken on impact on environment (humans, air, soil, water, biodiversity). This survey was taken in Shirpur (Maharashtra). Fuzzy topsis method is a mathematical tool for optimization of results and selects the best method to be applied. In this paper the comparative studies show that incineration is the best method for disposal of biomedical waste followed by autoclaving, microwave irradiation, chemical treatment and deep burial.

Objective Rhino-orbito-cerebral mucormycosis (ROCM) has emerged as a key concern during the period of coronavirus disease 2019 (COVID-19) pandemic. Diabetes mellitus is a known risk factor for invasive fungal infection. The aim of this article was to study and compare the radiological features of COVID-19-associated ROCM between diabetic and nondiabetic patients using magnetic resonance imaging. Materials and Methods A retrospective observational study comprising 78 diabetics and 40 nondiabetics who developed ROCM after COVID-19 was conducted. The imaging data of both groups were analyzed, findings tabulated and compared using statistical methods. Results Maxillary and ethmoid sinuses were commonly involved in both groups. Periantral fat and orbits were the most common sites of disease extension. The spread of infection to periantral soft tissue was significantly higher in diabetics (p = 0.049). Diabetics were more likely to have bone, orbit, and brain involvement than nondiabetics, although the difference was not statistically significant. Diabetic patients were the only ones to experience complications such as fungal abscess and cavernous sinus and internal carotid artery involvement. However, a considerable number of nondiabetic patients (22.5%) also had an intracranial extension of disease. Conclusion The radiological appearances and common sites of invasion in ROCM are similar in diabetic and nondiabetic patients. The extensive spread of infection to extra-sinus regions can occur in nondiabetic patients with COVID-19 but is less frequent compared with diabetics.

Background:  Epidemiological surveillance is the cornerstone for the prevention and control of any pandemic. The purpose of the study was using clinical and radiological data of COVID-19 positive patients to describe the clinical features, risk factors, grading of severity on the basis of chest X-ray and their survival outcome. Methods: A retrospective observational study comprising 9100 COVID-19 positive patients was done in the Department of Radiodiagnosis, M.G.M. Medical College and M.Y. Hospital, Indore. Patients' data including demography, clinical findings, vaccination status and imaging findings was collected and assessed in between March 2020 and March 2022. In the descriptive statistical analysis, continuous variables were noted in terms of the mean and standard deviation and nominal variables were noted in terms of percentage.Results: In our study, there were 9100 patients proven with positive COVID-19 disease had abnormal CXRs were detected in 7553 of 9100 patients (83%). In our study, B/L lung involvement (69%) was found to be more with lower lung zone predominance (86.5%) and peripheral predominance opacities (83.7%). The most common finding of chest X-ray pattern is consolidation (65.7%), followed by ground glass opacity (29.0%). Most of the vaccinated patients were found to be in mild category and majority of mild cases didn’t require oxygen support. The chi-square statistic is 79.3372. The result is significant at p<0.05Conclusions: The chest x-ray severity scoring (CXR-SS) system used in this study is a valuable method of disease prognostication in COVID-19. In our study, we found a significant reverse relationship between chest X-ray severity score and oxygen saturation, which has great clinical importance.