The COVANOS trial - insight into post-COVID olfactory dysfunction and the role of smell training

BACKGROUND

Olfactory dysfunction is a cardinal symptom of COVID-19 infection, however, studies assessing long-term olfactory dysfunction are limited and no randomised-controlled trials (RCTs) of early olfactory training have been conducted.

METHODOLOGY

We conducted a prospective, multi-centre study consisting of baseline psychophysical measurements of smell and taste function. Eligible participants were further recruited into a 12-week RCT of olfactory training versus control (safety information). Patient-reported outcomes were measured using an electronic survey and BSIT at baseline and 12 weeks. An additional 1-year follow-up was open to all participants.

RESULTS

218 individuals with a sudden loss of sense of smell of at least 4-weeks were recruited. Psychophysical smell loss was observed in only 32.1%; 63 participants were recruited into the RCT. The absolute difference in BSIT improvement after 12 weeks was 0.45 higher in the intervention arm. 76 participants completed 1-year follow-up; 10/19 (52.6%) of participants with an abnormal baseline BSIT test scored below the normal threshold at 1-year, and 24/29 (82.8%) had persistent parosmia.

CONCLUSIONS

Early olfactory training may be helpful, although our findings are inconclusive. Notably, a number of individuals who completed the 1-year assessment had persistent smell loss and parosmia at 1-year. As such, both should be considered important entities of long-Covid and further studies to improve management are highly warranted.

A waste to energy technology for Enrichment of biomethane generation: A review on operating parameters, types of biodigesters, solar assisted heating systems, socio economic benefits and challenges

Anaerobic Digestion (AD) is one of the promising wastestoenergy (WtE) technologies that convert organic wastes to useful gaseous fuel (biogas). In this process methane is produced in the presence of methanogens (bacteria). The survival and activities of methanogens are based on several parameters such as pH, temperature, organic loading rate, types of biodigester. Moreover, these parameters influence the production of biogas in terms of yield and composition. Maintaining an appropriate temperaturefor AD is highly critical and energy intensive. This study reviews the various hybrid technologies assistedbio gas production schemes particularly from renewable energy sources. Also discuss the direct and indirect solar assisted bio-digester impacts and recommendation to improve its performance. In addition, the performance analysis Solar Photovoltaic (PV) and thermal collector assisted bio gas plants; besides their impact on the performance of anaerobic digesters. Since opportunities of solar energy are attractive, the effective utilization of the same is selected for the discussion. Besides, the various constraints that affect the yield and composition of biogas are also evaluated along with the current biogas technologies and the biodigesters. The environmental benefits, challenges and socio-economic factors are also discussed for the successful implementation of various technologies.

Anosmia as a presenting symptom of SARS-CoV-2 infection in healthcare workers - A systematic review of the literature, case series, and recommendations for clinical assessment and management

BACKGROUND

Healthcare workers are at the forefront of the ongoing COVID-19 pandemic and are at high risk for both the contraction and subsequent spread of virus. Understanding the role of anosmia as an early symptom of infection may improve monitoring and management of SARS-CoV2 infection.

METHODOLOGY

We conducted a systematic review of the literature of SARS-CoV2 infection/COVID-19 and anosmia to help inform management of anosmia in healthcare works. We report a case series of healthcare workers, who presented with a loss of sense of smell secondary to COVID-19 infection to demonstrate management principles. RT-PCR was used to confirm COVID-19 positivity and psychophysical testing of olfaction was performed using the British version of the University of Pennsylvania Smell Identification Test, UPSIT.

RESULTS

The systematic literature search returned 31 articles eligible for inclusion in the study and informed our recommendations for clinical assessment and management. All three healthcare professionals who presented with loss of sense of smell subsequently tested positive for SARS-CoV-2. Psychophysical testing of olfaction using the UPSIT confirmed mild and moderate microsmia in two, respectively, and normosmia at day 17 in one.

CONCLUSIONS

Olfactory (± gustatory) dysfunction is indicative of COVID-19 infection and thus has important implications in the context of healthcare workers, or key workers in general, who work in close contact with others if not recognised as suffering from COVID. This leads to a potentially higher likelihood of spreading the virus. In conjunction with our literature review these findings have helped with creating recommendations on the assessment and management of olfactory dysfunction during the ongoing COVID-19 pandemic, both for healthcare workers and patients.

Kinetic study on the effect of temperature on biogas production using a lab scale batch reactor

In the present study, biogas production from food waste through anaerobic digestion was carried out in a 2l laboratory-scale batch reactor operating at different temperatures with a hydraulic retention time of 30 days. The reactors were operated with a solid concentration of 7.5% of total solids and pH 7. The food wastes used in this experiment were subjected to characterization studies before and after digestion. Modified Gompertz model and Logistic model were used for kinetic study of biogas production. The kinetic parameters, biogas yield potential of the substrate (B), the maximum biogas production rate (Rb) and the duration of lag phase (λ), coefficient of determination (R(2)) and root mean square error (RMSE) were estimated in each case. The effect of temperature on biogas production was evaluated experimentally and compared with the results of kinetic study. The results demonstrated that the reactor with operating temperature of 50°C achieved maximum cumulative biogas production of 7556ml with better biodegradation efficiency.

The local view on the role of plant protection in sustainable agriculture in India

Indiscriminate use of chemical insecticides has affected humans and their environment and contributed significantly to reduced productivity of crops. With the increasing realization of the importance of sustainable agriculture, the concept of integrated pest management (IPM) for sustainable agriculture has emerged. In the recent past entomologists and the farmers have identified methods of pest management that are ecologically non-disruptive and stable. Concurrently indigenous crop varieties with resistance to pests and diseases have been developed and cultivated. According to the principle of 'organic farming', several non-chemical methods have become popular among the local farmers. Simple cultural practices like increasing the seed rate to compensate for pest damage, adjusting the time of sowing to avoid pest damage, mulching, intercropping, trap cropping and crop rotation have been found to provide adequate protection from pest damage with no additional cost and without harmful effects on the environment. The age-old method of catch and kill is still being practised by farmers, particularly for cotton. Mechanical methods like the bow trap for control of rats and provision of tin sheets around coconut tree trunks to prevent rats damaging the nuts are still being adopted. The use of botanical materials such as the neem products for pest management has been well received almost all over the world. Biological control using the natural enemies of insect pests has become very popular among the farmers in the 1980s. The farmers who clamoured for chemical pesticides in the 1960s and 1970s are now disillusioned with these poisonous eco-destabilizing substances; they want sensible, biologically rational methods of IPM. Pest surveillance and monitoring play an important role in IPM for sustainable agriculture.

Rolled auricular cartilage grafts for dorsal augmentation rhinoplasty

We present a technique, which has not been previously described in the literature, of using rolled autogenous conchal cartilage for dorsal augmentation via an endonasal or external rhinoplasty approach. This technique gives greater dorsal height compared with the more common layering techniques. It is most appropriate in the minimally or moderately saddled nose.

Mass production of polyhedral occlusion bodies of NPV of Helicoverpa armigera in relation to dose, age and larval weight

A significant difference was noticed in the yield of polyhedral occlusion bodies (POBs) in various larval instars of H. armigera when three different doses of the nuclear polyhedrosis virus (NPV) were administered. The yield of POBs from a single larva ranged from 0.35 x 10(6) to 25033.33 x 10(6) with a mean of 18422.33 x 10(6) for fourth instar inoculated. Positive correlation existed between larval weight and number of POBs recovered. The regression analysis indicated POBs recovered responded with predictable manner to the weight of different larval instars and the various concentration of virus administered. The medium lethal time increased in the instars of the larva advanced with a minimum of 3.5 and maximum of 8 days in the first and fifth instars respectively.

A rare case of cutaneous kaposiform haemangioendothelioma

Kaposiform haemangioendothelioma is a rare vascular neoplasm with a wide anatomical distribution. We describe an unusual case arising in the post-auricular skin of a male infant overlying a ventriculoperitoneal shunt.

Is local anaesthesia actually beneficial in flexible fibreoptic nasendoscopy?

Although the application of a topical local anaesthetic before fibreoptic nasendoscopy is routine practice in many otolaryngological outpatients, the actual benefit to the patient of this procedure remains in doubt. Eighty-two patients were recruited in this double-blind randomized control trial which compared the patients' experiences of fibreoptic nasendoscopy with nasal preparations of Xylocaine (lidocaine), normal saline, and no spray to the nose and throat. A visual analogue scoring system was used to determine scores for the overall unpleasantness of procedure, receiving a spray, and taste of the spray, and pain. This study has shown significantly worse overall experience (P = 0.001) and pain (P = 0.048) scores for Xylocaine spray versus no spray. It is concluded that the routine use of topical local anaesthetics within the nose before routine fibreoptic nasendoscopy is not only of no value, but actually makes the experience worse for the patient.

Incentives and competition in a worksite smoking cessation intervention

We evaluated a worksite smoking cessation program that employed multicomponents including support groups, incentives, and competition. The combination of incentives and other components increased participation rates to over 80%. Forty-two percent of smokers were abstinent at six months, compared to 13 percent of a control group (difference 29 percent, 95% CI 9, 49).