A 60-year-old male with a history of primary hypertension presented to the emergency department of a tertiary care hospital, in Pakistan, with complaints of fever, cough, and shortness of breath. He tested positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction, with bilateral infiltrates found in chest X-ray. At admission, oxygen saturation was 80% on room air; hence, he was immediately put on non-invasive ventilation. Laboratory investigation revealed elevated D-dimer, international normalized ratio, and total leukocyte count. C-reactive protein was markedly elevated (82.5 mg/L), indicating the state of a cytokine release syndrome (CRS). Treatment started with antibiotics, prophylactic enoxaparin (40-mg subcutaneous once daily), methyl prednisone 60 mg BD and multivitamins. Intravenous tocilizumab (TCZ) 6 mg/kg was started from Day 1 to address the CRS. On Day 3, he complained of pain in the right lower limb with signs of hypothermia, numbness, and slight blackening of the right foot. Peripheral pulses were not palpable, and vascular ultrasound showed no vascular flow in the popliteal, anterior and posterior tibial, and dorsalis pedis artery. The Vascular Surgery department declared the limb unsalvageable and right limb above-knee amputation. On Day 9, the right foot was blackened and atrophied extending up to the knee. Above-knee amputation was done, and he was discharged on rivaroxaban after 48 hours of observation. We conclude that heparin is effective in treating coronavirus disease 2019-associated coagulopathy, while TCZ, simultaneously, decreases the severity of CRS. Our case suggests that the concomitant use of TCZ and anticoagulation therapy can be beneficial in patients presenting with arterial and venous thrombosis.
Abstract-In our living environment, a non-speech audio signal provides a significant evidence for situation awareness. It also compliments the information obtained from a video signal. In non-speech audio signals, screaming is one of the events in which the people like security guard, care taker and family members are particularly interested in terms of care and surveillance because screams are atomically considered as a sign of danger. Contrary to this concept, this review is particularly targeting automated acoustic systems using non-speech class of scream believing that the screams can further be classified into various classes like happiness, sadness, fear, danger, etc. Inspired by the prevalent scream audio detection and classification field, a taxonomy has been projected to highlight the target applications, significant sound features, classification techniques, and their impact on classification problems in last few decades. This review will assist the researchers for retrieving the most appropriate scream detection and classification technique and acoustic parameters for scream classification that can assist in understanding the vocalization condition of the speaker.
Background: Infertility is defined as the inability to conceive naturally after one year of regular unprotected sexual intercourse. The chance to conceive depends on multiple factors like the length of sexual intercourse, frequency of coitus and age of couples. This could be due to male as well as female factors and deficiencies.Methods: This is a cross sectional observational study conducted on infertility patients. A fertility questionnaire was designed for both the partners with questions covering knowledge and attitude towards infertility.Results: A total 100 couples were selected in which prevalence of primary and secondary infertility was 72% and 28% respectively. The mean duration of infertility was 3 years. On scoring their level of knowledge, 52% had inadequate knowledge, 44% had moderate knowledge and 4% had adequate knowledge. There was no statistically significant difference in the knowledge in relation to their educational qualification and type of infertility among participants.Conclusions: Infertility is common problem affecting 10-15% of the population. The knowledge about infertility and its risk factors is generally limited among the participants, in spite of their educational status.
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