Title: Health Care Providers are Now the Frontline for COVID-19 Response: Are We Ready?

Abstract:

The COVID-19 pandemic continues to evolve as the virus mutates to more contagious forms. With the new waves of new variants and continuing federal effort to address COVID-19, the pandemic response is shifting to state and local levels. We all need to recognize that health care providers are and will be playing an increasingly important role in COVID-19 control and treatment.  Measures to fight COVID-19 are widely available to healthcare providers, including tests, vaccines, monoclonal antibodies, and antiviral medications.  Our challenge is to help practitioners take advantage of the ample tools and guidance available to fight COVID-19.  Health care providers can prescribe anit-viral agents. Health care providers can offer protective monoclonal antibodies to immunocompromised patients. Health care providers can register as COVID-19 vaccine providers. It is recognized that the medical community has endured much during this pandemic. It is also recognized that we can continue to step up.

Biography:

Rivkees is a Professor of the Practice of Health Services, Policy, and Practice in the School of Public Health. He served as Florida's State Surgeon General and Secretary of Health from 2019 to 2021. Before moving to Florida, he served as a professor of pediatrics with tenure at Yale University. Dr. Rivkees has had more than 35 years of continuous research funding from the National Institutes of Health. He was responsible for the safety alert on liver toxicity caused by the antithyroid drug propylthiouracil. This led to major international treatment practice changes.

Title: Challenges in the Epidemiological Evaluation of COVID Interventions

Abstract:

Why is it that we are having so much trouble answering the very basic question: What COVID interventions have proven to be most effective?  To answer this question, we need to study population and their behaviors; meaning we need epidemiology. As the COVID epidemic progressed we implemented what seemed be reasonable actions; i.e. social distancing, hand hygiene, wearing gloves, and later resorted to more complicated interventions such as closing businesses, closing schools, masking, double masking, and finally vaccination (followed by booster 1,2,3). But these rapid adoptions, changes and pivots, have produced a study population which is so confounded that deductions are challenging to say the least. While numerous COVID evaluations and investigations have been conducted, they tended to be singular actions within very small and specialized at risk populations; i.e. health care workers, bus drivers etc.. This session will present the historical progression of COVID interventions and review epidemiological study designs and applicable confounding variables. Suggestions for future public health surveillance programs will be presented and evaluated.

Biography:

Jack Caravanos, life in the field ranges from jumping onto a motorcycle and navigating the jungles of Madre de Dios in the Peruvian Amazon studying toxic substances to traveling to remotes areas in Zambia, Indonesia, and Bolivia studying lead and other toxic wastes. By cooperating with local governments, his work provides safe, healthy, and evidence-based solutions for pollution problems in low- and middle-income countries. In partnership with Pure Earth, an international non-profit organization, Caravanos is studying the impact of gold extraction with mercury in Peru and Indonesia. Since miners are in danger of mercury poisoning, his research team is planning interventions that teach safer techniques for gold extraction. In Kabwe, Zambia - a mining town with exposure to lead - his research will provide methods to institute safer mining practices and policy recommendations to improve environmental remediation laws. Caravanos teaches Environmental Health for graduate students and Environmental Health in a Global World for undergraduate students. He also provides opportunities for student researchers in his ongoing projects, including in Indonesia and Ghana.

Title: SARS-CoV-2 Aerosols in Homes of COVID-19 Infected Adults: Presence and Control

Abstract:

Introduction. One key challenge is to reduce secondary attack rates among household contacts, which are estimated by the CDC to be as high as 50%. In addition to close interpersonal contact, emerging evidence suggests that airborne transmission is important for spreading SARS-CoV-2 infections in enclosed and/or poorly ventilated spaces, such as homes. Since one of the virus transmission routes is airborne, we hypothesized that its spread could be controlled using portable air cleaners (PACs). However, the existing data are sparse and based on scripted scenarios. Here, we report the first naturalistic intervention study to reduce SARS-CoV-2 airborne transmission using PACs with HEPA filters in the homes of COVID-19-infected individuals.

Methods. Subjects were recruited in the fall/winter of 2020-2021 through an email flyer delivered at the time of notification of test positivity. Saliva screening at the time of the first visit verified continued positivity for all reported subjects. 24-hr air samples of total aerosols were collected in the isolation room (the primary room used by the subject) and the common room (a secondary room) on PTFE filters using open-face filter holders (CH Technologies, Westwood, NJ, USA and SKC, Inc. Eighty-Four, PA, USA) or modified IMPACT filter samplers (SKC Inc.) and Leland Legacy pumps (SKC Inc.) operated at 10 L/min. The PAC was placed only in the primary room, away from any walls. In one 24-hr period, the PAC was operated with a HEPA filter and, during the other, without a filter ("sham" period). The filtration and treatment order was randomized. Samples were analyzed by RT-PCR for expression of three distinct SARS-CoV-2 genes: N, ORF1ab, and S. Samples were considered positive if any one gene and internal control (MS2 phage) were detected at Ct ≤ 40.

Results and Conclusions. Samples were collected in the homes of 17 individuals with newly diagnosed COVID-19 infection. Seven out of sixteen (44%) air samples in primary rooms were positive for at least one gene during the sham period. Seven out of fifteen (47%) air samples in secondary rooms were also positive during the sham period. The data also suggested a strong association between the amount of viral RNA in an infected person's saliva and the likelihood of airborne virus being detected in the primary room. During the filtration period, the proportion of positive aerosol samples decreased to four out of sixteen residences (25%) (p=0.223).

Conclusions

Thus, our results show that SARS-CoV-2 RNA is common in the home air of COVID-19 patients. Therefore, using air cleaners to reduce SARS-CoV-2 exposure should be considered part of guidance for caring for COVID-19 patients in residential and community-based indoor environments, especially in situations of limited space and resources.

Acknowledgments

Supplement to NIEHS P30 Center ES05022, NIH/CATS (UL1TR003017), NIEHS Training Grant in Exposure Science (1T32ES019854; Dr. Nirmala T. Myers), and NIOSH ERC (T42OH008422; Dr. Frederic T. Lu).

Recent Publications

1. Laumbach, R., Mainelis, G., Black, K., Myers, N.T., Ohman-Strickland, P., Alimokhtari, S., Hastings, S., Resende, A.D., Legard, A., Calderón, L., Lu, F., and Kipen, H. (2021) Presence of SARS-CoV-2 in residences of adults with COVID-19, Annals of the American Thoracic Society, 19(2): 338. Link.
2. Myers, N.T., Laumbach, R., Black, K., Ohman-Strickland, P., Alimokhtari, S., Legard, A., Resende, A.D., Calderón, L., Lu, F., Mainelis, G.*, and Kipen, H. (2022) Portable Air Cleaners and Residential Exposure to SARS-CoV-2 Aerosols: A Real-World Study, Indoor Air, 32(4). Link.
3. Grogan, S. and Mainelis, G. (2022) Effect of Sampling Duration on Culturable and Viable Bioaerosol Determination when using Rutgers Electrostatic Passive Sampler (REPS), Journal of Aerosol Science, 106066. Link.
4. Myers, N. T., Han, T.T., Li, M.-L., Brewer, G.; Harper, M., Mainelis, G. (2021) Impact of Sampling and Storage Stress on the Recovery of Airborne SARS-CoV-2 Virus Surrogate Captured by Filtration, Journal of Occupational & Environmental Hygiene, 18 (9), 461-475. Link.
5. Metaxatos, A., Manibusan, S., and Mainelis, G. (2022) Investigation of sources, diversity, and variability of bacterial aerosols in Athens, Greece: a pilot study, Atmosphere, 13(1), 45. Link.

Biography:

Gediminas “Gedi” Mainelis is a Professor in the Department of Environmental Sciences at Rutgers, the State University of New Jersey, USA. He has a Bachelor’s degree in physics from Vilnius University, Lithuania, and a Ph.D. in Environmental Health from the University of Cincinnati, Ohio, USA. His research focuses on various aspects of bioaerosol science, including sampling and analysis methods, exposure assessment, and airborne microbiomes. Over the past years, his research expanded to investigate exposures to manufactured nanoparticles and explore indoor air issues. Several of his current projects focus on COVID-19 issues. His research efforts have resulted in more than 110 peer-reviewed publications, book chapters, and several patents. In addition, multiple papers from his group have been included in the most downloaded article lists of various peer-reviewed journals. Dr. Mainelis has served as Chair of the Bioaerosols and Health-Related Aerosol working groups of the American Association for Aerosol Research (AAAR). He is currently an editor (associate) of the Aerosol and Air Quality Research journal. Prof. Mainelis is a recipient of the Research Excellence Award from Rutgers University and the Lyman A. Ripperton Environmental Educator Award presented by the A&WMA.

Title: Effective secretolytic and bronchodilatativ Strategies by Prolonged Weaning by COPD GOLD D Patients on Respiratory Intensive Care Unit after quantitative based Lung Computertomographie and Lung Volume Reduction Surgery bei massive Emphysema

Abstract:

A meta-analysis of studies published in the 1990s calculated the incidence of VAP (ventilator-associated pneumonia), which is equivalent to 16.5 cases per 1,000 patient days. Attributable mortality due to VAP was estimated to be 20-40%, although the range in different studies was very broad. Healthcare costs related to VAP seem to be remarkable in particular with regard to multidrug-resistant pathogens. VAP is an infection frequently caused by Pseudomonas aeruginosa, Haemophilus spp., and Klebsiella spp. or by Staphylococcus aureus. Anaerobes are a rare cause of VAP. Patients with COPD GOLD D and massive Emphysema, who undergo a Lung Volume Reduction Surgery by prolonged Weaning and long-term treatment on intensive care units, after a quantitative-based Lung Computertomographie to prevent VIDD need an intensive and efficient secrtlytic additionally to bronchoscopy by presenting bronchospasms at the same time. On our Respiratory Intensive Care Unit, we use a Dymedso Frequenzer with sound wave (45 Hz) from the company inspiration medical four times daily in combination with six times deeply bronchodilatativ Aeronep Inhalation from the company Aerogen to reach a 17% lung disposition in compared to 3% by conventional nebulizer. We optimize this by an LALMA/LABA fix combination (Glycopyrroniumbromid/Formoterol) via tracheal cannula from the company AstraZeneca with AEROSPHERE Delivery Technology. Active ingredient particles are connected on aerodynamic Phospholipid particles, which are a natural carrier substance and a component of lung surfactant. Previous studies with health persons could show lung disposition of 38%. The safety and efficiency were demonstrated in phase 3 study PINNACLE 1 and 2 and long-term data of safety and effectiveness in PINNACLE 3.

Biography:

M Lavae-Mokhtari is a consultant in the Respiratory Intensive Care Unit in General Hospital Ibbenburen in Germany since 2013. He has seven publications, 17 national and international poster publications, one book publication, and three scientific international and one national oral presentation. He has 152 citations and a 17.48 RG Score by research gate. He is a member of the German Respiratory Society, Section Intensive-Care and Ventilation Medicine, European Respiratory Society, Section Intensive-Care and Ventilation Medicine, and Section Thorax oncology and German Interdisciplinary Society of Outpatient Ventilation.

Title: How Does Antiviral Technology Stack Up Against Enhanced Ventilation and Filtration Measures?

Abstract:

How does the Grignard Pure antiviral technology stack up against enhanced ventilation and filtration measures for airborne virus mitigation? Grignard Pure is not intended to replace the enhanced ventilation and filtration strategies recommended by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) and the U.S. Centers for Disease Control and Prevention (CDC). Grignard Pure has been deployed as an additional layer of protection for public health in the fight against the COVID-19 pandemic. The product’s label directs users to follow public health officials’ advice, including enhanced ventilation and filtration guidance.
Grignard Pure can be introduced into an indoor space either through application equipment installed in an HVAC system or by a free-standing dispersion unit. Engineering studies show that aerosol quickly and evenly disperses throughout an indoor space and does so in both small and large spaces. (New Amsterdam Theatre Grignard Pure Proof of Concept Part 1: Enhanced Ventilation Studies and JBB: Grignard Pure Deployment Case Study.) commercially available sensors can measure the level of aerosol in space. In order to ensure a consistent, safe, and efficacious concentration of Grignard Pure in the air, proprietary software can use commercially available sensor measurements to automatically direct the dispersion equipment to maintain Grignard Pure at the concentration level within the EPA-approved concentration range once the target level is reached.
Three criteria are critical to examine when comparing an antimicrobial air treatment with enhanced ventilation and filtration measures. First, the amount of reduction: What percentage of the circulating virus is eliminated? Second, the speed with which the measure works: How quickly does the measure remove virus particles? Third, the mechanism of action—removal versus inactivation of the virus particles: How does the measure achieve its effect? A case Study will be presented to demonstrate the engineering principles developed and executed in the delivery technology and effectiveness of the Grignard Pure deployment.

Biography:

Mitch Simpler joined JB&B, a global consulting engineering firm, in 1977 and currently serves as a partner after having served as Managing Partner from 2012- 2018. He has acted as project manager and partner-in-charge on life/health science institutions, health care facilities, high-rise office buildings, museums, residential and mixed-use buildings, as well as hotels. Simpler’s list of notable projects in the life science sector spans the past 45 years, including premier laboratory facilities and research centers in New York City, such as the Jerome L. Greene Science Center at the Columbia University Manhattanville campus, The East River Science Park in New York, the New York Genome Center, Mount Sinai’s Hess Center for Science and Medicine, Weill Cornell Medical College’s Belfer Research Building, MSK’s David H. Koch Center for Cancer Care and Rockefeller Research Laboratories, Cornell University’s Biotechnology Building, and NYU Langone Health’s Smilow Research Building and Skirball Institute of Biomolecular Medicine. His experience extends around the world to China, with the Innovation Center at Duke Kunshan University in Kunshan and the Rohm & Haas Research Center in Shanghai. Mr. Simpler is a fellow of the American Council of Engineering Companies (ACEC) and recently served as the National Chairman of ACEC. He is also a founding member and Co-Founder of NYC Builds Bio+.

Title: Mechanisms of lung endothelial barrier protection in acute lung injury: role of extracellular purines

Biography:

Verin completed his Ph.D. at the age of 29 years from Moscow State University, Moscow, USSR, and postdoctoral studies at the University of Indiana. During his scientific carrier, he was a faculty member at Johns Hopkins and the University of Chicago. Currently, he is a Professor at the Vascular Biology Center and Pulmonary Division, School of Medicine, Medical College of Georgia, at Augusta University, Augusta, GA.   He has published more than 170 papers in reputed journals primarily in the field of pulmonary vascular endothelial barrier regulation.  He served as an Editorial board member of the American Journal of Physiology (Lung) from 2006-2011 and Editor-in-chief of the academic journal, Vessel Plus, in 2016-2022. He is currently serving as an academic editor of the British Journal of Medicine and Medical Research and Cardiology and Angiology, and an editorial board member in several other journals in the field of pulmonary/cardiovascular research such as Biomolecules, Cardiovascular Pharmacology, Journal of Multidisciplinary Pathology, Tissue Barriers, World Journal of Respirology.

Title: London Hospital Almost Runs out of Oxygen for Covid-19 Patients

Abstract:

Standard delivery of oxygen (O2) to patients with respiratory failure is inadequate, both in pneumonia and in COPD patients.
In COVID-19 mortality rates from pneumonia in UK hospitals rose from 30% to 45%1. This was linked to early use of mechanical ventilation. Similar accounts were reported in USA.2
Currently home O2 is recommended for hypoxic patients at flow rates limited to 3-5L/min for COPD.3 In the USA O2 therapy costs $2.8 billion annually.4 COPD patients appear not to comply with its prescribed use.3 The National Institute Clinical and Care Excellence (NICE) recommends a maximum flow rate of O2 of 15 L/min for patients in acute respiratory failure when arterial O2 saturation (SpO2) falls below 94%.5
These recommended flow rates are below the inspiratory flow rates seen during mild exercise. The Minute Ventilation (MV) rises to 30L/min but requires the peak inspiratory flow rate to rise to 100L/min.6 The same MV occur in pulmonary disease at rest where there is reduction of gas exchange.7 Suggesting that these recommended O2 flow rates for pneumonia or hypoxic COPD patients are too low to match their peak inspiratory flow.
As standard O2 delivery uses open mask to the face/nose, that requires entrainment into the lungs by the inspiratory flow. If the inspiratory flow rate exceeds the flow of O2 then air is entrained so diluting the O2 reaching the lungs.8 The high COVID pneumonia mortality rates and the under use of home O2 can be explained by the use of recommended O2 at flow rates as low as 5L/min to 15L/min could explain.
We recommend instead, automatic matching the flow rate of O2 to the patients inspiratory flow and pulsing automatically selected volumes of O2 to ensure SpO2 remains between 94% - 100%, by using a robotic delivery device.

Biography:

Scientist and Clinician, NHS physician at the Royal Papworth Hospital Cambridge, discoverer of first effective therapies for Pulmonary Arterial Hypertension [PAH] (iv. Prostacyclin and Inhaled NO). Established the UK National Network of PAH centres. Professor, Medicine Sheffield University Medical School and Senior Principal Scientist AstraZeneca plc, Corporate Clinical Director Chiesi Farmaceutici (Italy), Architect of the first triple inhaler for asthma/COPD Trimbow®, Senior Partner TranScrip LLP, R&D Director Allergy Therapeutics plc, Vice President, and President Faculty of Pharmaceutical Medicine Royal Colleges of Medicine UK. CEO and founder of Camcon Robotics Ltd.

Title: Smartphone enabled home based self-management informatics platform for COPD in India

Abstract:

Background: COPD is one of the prominent causes of mortality, morbidity and disability among chronic respiratory diseases. Digital health interventions exist to provide various healthcare services to individual diagnosed with COPD. Training and support to the COPD patients on selfmanagement of their COPD status, improves health related QoL and can reduce unplanned hospital visits and admissions. Method: A prospective non-randomized study will be conducted to implement the selfmanagement informatics platform among 164 COPD patients (82 each in intervention and control group) in the selected hospital of India. A mixed methods will be conducted among identified COPD patients to assess the impact of COPD self-management informatics tool. Intervention: Identified COPD patients (GOLD-2 and 3) will be provided a smartphone application which includes the educational videos in local language on breathing techniques, airway clearance techniques, exercise training, fatigue management, counselling on physical activities, nutrition, smoking cessation, and spirometry. Control group: COPD patients assigned to control group will be treated with standard treatment regime for their COPD. Data Analysis: Data will be analyzed using statistical software like SPSS 21 version. Continuous variable will be summarized using mean and standard deviation and frequencies will be reported for categorical data. Independent or student t-test will be used to analyze the mean difference between intervention and control groups. Chi square test will be used for comparison between groups. Logistic regression will be done where outcome variable is dichotomous. Conclusion: Smartphone enabled informatics platform may assist the COPD patients in the management of the exacerbations, reduced health care facility admissions, hospitalization days and health related quality of life.

Title: Co-pathogens causing respiratory infections in patients with SARS-CoV-2 in Bulgaria

Abstract:

Statement of the Problem: Coinfections with SARS Co-2 and bacterial, fungal, or viral pathogens can worsen the clinical condition and pose challenges to the disease's diagnosis, treatment, and prognosis. This study aims to determine the prevalence and clinical significance of co-infection with SARS-Co-2 and another respiratory pathogen in Bulgaria.Methodology & Theoretical Orientation: Nasopharyngeal swabs from patients with confirmed SARS-CoV-2 infection were prospectively collected from both inpatients and outpatients, with female patients being 55% and male patients being 45%, respectively, and patient ages varied from 45 days to 98 years. RT-PCR was used to detect SARS-Co-2, 8 common respiratory viruses - respiratory syncytial virus(RSV), human metapneumovirus(HMPV), parainfluenza viruses(PIV)1/2/3, rhinoviruses(RV), adenoviruses(AdV), bocaviruses(BoV) and 4 seasonal coronaviruses: OC43, NL63, 229E, and HKU-1. Capillary electrophoresis was used for the detection of three bacterial co-pathogens: Mycoplasma pneumonia(MP), Chlamydophila pneumonia(ChP), and Haemophilus influenza(HI).
Results: From August 2021 to early May 2022, clinical samples from 337 SARS-CoV-2 positive patients were tested for the presence of respiratory co-pathogens, with 42 co-infections detected. Those involving bacterial pathogens were n=23(54.8%) and those involving viral pathogens were n=14(33.3%). The order of evidence of co-pathogens was: HI(n=20; 47.6%), RSV(n=4, 9.5%), ChP(n=3,7.1%), AdV(n=3;7.1%), HI+RSV(n=3;7.1%), BoV(n=2,4;8%), HMPV(n=1;2.4%),PIV-3(n=1;2.4%), RV(n=1;2.4%), HKU-1(n=1;2.4%), NL63(n=1;2.4%), HI+AdV(n=1;2.4%) and HI+PIV2 (n=1;2.4%). Children aged 6-16 years and patients over 65 years had the highest rate of co-infections (37.5%/18.2%). Of the co-infected patients, 32(76%) were hospitalized and three(7.1%) had a fatal outcome. The deaths were in patients co-infected with a bacterial pathogen and SARS-CoV-2.Conclusion & Significance: In patients positive for SARS-Co-2, the frequency of co-infections with a bacterial pathogen prevailed over that with a viral one. Due to the large proportion of antibiotic-treated patients(83%) with complications due to COVID-19 and the risk of the emergence of resistant strains, timely diagnostics aimed at identifying co-pathogens is of particular importance, which would help in the correct and timely treatment of patients.

Biography:

Iveta Madzharova is a biologist at the National Center for Infectious and Parasitic Diseases, National Laboratory "Influenza and SARS", Sofia, Bulgaria since the beginning of 2022. She has а bachelor’s degree in Biotechnology - Sofia University "St. Kliment Ohridski", Biological Faculty and started a master's degree in 2021 in the field of Microbiology and microbiological control - Sofia University "St. Kliment Ohridski", Biological Faculty. She is developing a master's thesis on the research topic. She participated in two projects related to the research topic. She published one article with impact factor in a reputable journal on the topic "Clinical significance and role of co-infections with respiratory pathogens among individuals with confirmed coronavirus-2 infection with severe acute respiratory syndrome". She participated in an international congress.

Title: Efficacy of Grignard Pure Against a Variety of Bioaerosols

Abstract:

The awareness of airborne transmission of infectious diseases has greatly increased during the recent COVID-19 pandemic. Laboratory studies have shown that the SARS-CoV-2 virus can remain viable for up to 16 hours in respiratory droplets with a diameter of 0.09µm. Grignard Pure® (GP) is a unique and proprietary blend of Triethylene Glycol (TEG) and inert ingredients designed for continuous antimicrobial treatment of air. GP received approval from the US EPA under its Section 18 Public Health Emergency Exemption program for use in seven states . Grignard Pure® has been tested by third party accredited labs for efficacy in the air and on hard surfaces against multiple microorganisms (gram positive bacteria, gram negative bacteria, enveloped viruses, non-enveloped virus, mycobacteria and mold endospores). Experiments measured the decrease in the airborne viable bioaerosol concentration in the presence of specified concentrations of GP from 60 to 90 minutes, accounting for both natural die-off and settling of the bioaerosols.  Experiments were conducted with GP in its undiluted form where it was aerosolized in a control time release method utilizing a nebulization dispersion device. Settling slides were used to assess reduction of viable microorganism deposition onto surfaces. GP is consistently able to rapidly reduce viable bioaerosol concentration by 2-3 logs at GP concentrations of 0.02 mg/m3 to 0.5 mg/m3 (corresponding to TEG concentrations of 0.012 mg/m3 to 0.287 mg/m3) for a variety of microorganisms. In addition to being efficacious, GP is also safe to use. The safety of TEG, the active ingredient of GP has been evaluated by third party independent labs as well as the US EPA and FDA. The likelihood of adverse effects from continuous inhalation exposure to TEG resulting from the use of aerosolized GP is considered low. The assessment also indicated that acute, subacute/sub-chronic and chronic toxicity, genotoxicity and carcinogenicity are not expected. This TEG-based antimicrobial air treatment product tested shows high efficacy against a variety of bioaerosols and has a favorable safety profile. As a result, it can be used to reduce transmission of airborne infectious diseases in indoor public spaces.

Biography:

Grishma Desai is multifaceted Scientist and Quality Manager at Grignard Company LLC with experience in Biological Nutrient Removal (BNR), wastewater mineral removal and US EPA Pesticide Testing and Regulations. She has a Bachelor’s of Science in Biotechnology from Rutgers University, New Jersey, USA. During her eight years at Grignard Company, she has led multiple R&D efforts in new product development as well as regulatory compliance for products.  In the past two years, Ms. Desai’s work has focused on developing, testing and obtaining regulatory approvals for Grignard Pure® – an airborne antimicrobial effective against MS2 Bacteriophage, a surrogate for the SARS-CoV-2 as well as other bioaerosols. Ms. Desai worked closely with Dr Katherine Ratliff and her team at the US EPA Office of Research and Development to evaluate the efficacy of Grignard Pure® in reducing airborne virus concentrations using a large-scale test chamber and a standardized testing approach. Ms. Desai recently submitted a paper titled “The efficiency of Grignard Pure to inactivate airborne SARS-CoV-2 surrogate” to a peer reviewed journal detailing the testing conducted on Grignard Pure at independent testing labs.

Title: Socio-Demographic Determinants of Adult Pulmonary Tuberculosis Patients: A Hospital Based Study at Dhanmondi, Dhaka, Bangladesh

Abstract:

Tuberculosis (TB) is a multi-system infectious disease with a major cause of morbidity and mortality all  ver the world but particularly in developing countries like Bangladesh. A normal healthy individual does not face the symptoms causing by tuberculosis due to their immune system that’s why infection among healthy individuals always remain silent. As it is highly infectious air borne disease that’s why treatment completion for TB is the cornerstone of its control and prevention. So to understand these factors efficiently this study was carried out about socio-demographic determinants of adult TB patients attending the tertiary care teaching hospital, Dhanmondi, Dhaka.

Methodology: This was hospital based cross sectional observational study done at Bangladesh Medical College Hospital, Dhanmondi, Dhaka with the study period from January 2020 to December 2021.Total 410 patients of age group 18 years and above with persistent cough with sputum production for more than 2 weeks were enrolled for this study purpose.

Results: Total prevalence of sputum positive adult pulmonary TB among the studied group was 69.02%. Majority 54% were male patients in the age group of 41-50 years (31.45%). Pulmonary TB was predominantly diagnosed among employed group 41.34%, those who have completed their high school level (34.28%) in mainly the rural (66.08%) locality. Joint family (61%) with 8-10 family members (43.46%) have been found mostly affected in our study. The cardinal features were cough with sputum production (80.21%) followed by fatigue (71.73%), fever (42.05%), sweating (46.99%), loss of appetite (32.86%) and weight loss (27.56%). Pulmonary TB was found mostly among smokers (57.23%) with normal BMI (44.88%).

Conclusion: To decrease the rate of infection with Tuberculosis, a multifactorial approach can play the pivotal role by improving the living conditions, education level, economic status and adequate sanitation. Awareness can bring a new dimension in this regard.

Biography:

Sadia Saber, currently working as an Assistant Professor in the department of Medicine, Bangladesh Medical College, Dhanmondi, Dhaka, Bangladesh for the last 4 years. She has completed her MBBS under the university of Dhaka in the year July 2010 with honours marks in Anatomy, Physiology, Biochemistry and Pathology. She also secured 4^th position in the merit list during her 2^nd Professional MBBS Examination.Then she completed her 5 years Post-graduation Clinical Training at Bangladesh Medical College Hospital From January 2012 – December 2016. She has acquired her Fellowship (FCPS) in Internal Medicine from Bangladesh College of Physicians and Surgeons (BCPS) in the session of January 2017. She has obtained her MRCP (UK) & MRCP (Ireland) in the year of November 2017 & October 2019 respectively. She has passed MRCP SCE in Respiratory Medicine (UK) in the year of October 2021. She has also completed her Postgraduate Diploma in Respiratory Medicine, under the University of South Wales, Cardiff (UK) in the session of 2021-2022.She has acquired European Diploma on Respiratory Medicine (Switzerland) on 2022. Currently she is doing her Master’s Degree in Sleep Medicine under the European University of Madrid, Madrid, Spain. She is working as an active member of the Royal College of Physicians and Surgeons of Glasgow (UK), the Royal College of Physicians of Edinburgh (UK), American College of Physicians (USA) & American College of Chest Physician (USA). She has got more than 35 publications in both national and international level, among those she is the 1^st author for than 25 publications.

Title: The prevalence of Heart Failure in patients with Chronic Obstructive Pulmonary Disease: A systematic review and meta-analysis

Abstract:

Background: To assess the prevalence of heart failure in patients with COPD.

Methods: CENTRAL, Embase, and MEDLINE were searched for studies from 2017 up to June 2022 using the medical subject headings “COPD” and “Heart failure”. The risk of bias was assessed using the Newcastle-Ottawa scale for observational studies. The studies were narratively and statistically analyzed. Studies were reviewed in accordance with PRISMA guidelines.

Results: Of 3346 studies identified, 2220 were screened for title and abstract, and 348 were selected for full-text review. 11 studies were eligible for inclusion involving 91,919 participants, of which 10 were included in our meta-analyses. 3 conditions were investigated (i.e., HF, LVDD, and RVDD), of which 2 conditions were included in the meta-analyses and all were descriptively synthesized). From our meta-analyses, we found overall pooled prevalence estimated of was 16 %, 95 % CI (12 % to 19 %), for heart failure; and 61 %, 95 % CI (53 % to 70 %), for LVDD. The pooled data for HF were significantly heterogenous (I2= 97.55 %, p<0.001), whereas the pooled data for LVDD were moderately heterogeneous (I2= 50 %, p= 0.16). Discussion: Meta-analyses for LVDD and HF had a moderate to large statistical heterogeneity. Only three studies out of 11 aimed to investigate the primary outcome of HF or LVDD. HF is a clinically important condition that is prevalent within a significant proportion of patients with COPD and negatively impacts important clinical outcomes. There is a need for more research investigating HF prevalence in COPD. In addition, we hope this review raises the awareness of clinicians and policymakers to consider implementing diagnostic tools to assess HF among the COPD population. 

Other: This systematic review is registered with PROSPERO, CRD42022328570

Biography:

Sufana is a Lecturer in the Respiratory Care Department at Imam Abdulrahman bin Faisal University, Saudi Arabia. Master of Respiratory Medicine from the University of Birmingham, UK. Bachelor of Respiratory Care from AlMaarefa University, Saudi Arabia.