ABSTRACT
Background: We studied the real-life experience with Methylene blue administration among the moderate and severe cases of acute respiratory distress syndrome due to Covid-19 infection with the standard of care. Materials and Methods: This study is a prospective, single-center study including 103 hospitalized patients conducted in a tertiary healthcare center from June 2020 to July 2021. The route of administration of Methylene blue was through nebulization (0.5 mL 0.5% solution of Methylene blue + 2.5 mL of distilled water) three times a day as long as the patient was admitted. An ampoule of 10 mL of Methylene blue with 90 mL of potable water through oxygen port was administered as long as they needed oxygen. About 2 mg/kg body weight of Methylene blue in 300 mL of N.S. over 3 h was given once a day for 5 days. Results: Approximately 103 patients were seen with a mean age of 56.49 years. The most prevalent comorbid condition was diabetes. The SpO2 improved by 7.827%. On post-Methylene blue administration, the serum ferritin, C-reactive protein, lactate dehydrogenase, and D-dimer were reduced in comparison to pre-Methylene blue administration. Also, the average total length of stay was 14 ± 4.20, 13 ± 5.66, and 14 ± 3.50 days in 26.78% of patients in intensive care unit, 17.51% of patients in high dependency unit, and 58.71% of patients in Covid general ward, respectively. About 86.4% of the patients recovered and got discharged post-Methylene blue administration. The all-cause mortality was 13.59%, which could be due to underlying comorbidities and complications of Covid-19 infections. Conclusion: Methylene blue administration accelerated recovery in our patients with moderate and severe Covid-19 disease by controlling the hyperimmune response. The clinical improvement was seen by decreased levels of inflammatory markers, improved oxygen saturation, reduced length of hospital stay, and clinical improvements. Methylene blue administered in nebulization form, through oxygen port, and through intravenous infusion in the dose of 2 mg/kg body weight for 5 days and improved patients’ recovery, so it can be considered as a therapeutic option in moderate and severe Covid-19 disease.
ABSTRACT
Background: Poisoning is a global health problem and one of the major causes of hospitalization through emergency department. In several studies, preponderance of males in younger age group and pesticide consumption has been reported. Method: The present study was undertaken at MGM Hospital and Research Centre, Central Business District (CBD) Belapur, Navi Mumbai, India to study the epidemiological profile of acute poisoning cases; following a chance observation of female preponderance among poisoning cases attending the hospital. Acute poisoning cases, who visited the hospital during the period of five years from 1st July 2007 to 30th June 2012, were included in the study. The data were pooled into pre-designed variable structure for the analysis. Results A total of 234 poisoning cases have been reported, majority of which, reside in neighboring areas of Belapur and Kharghar inhabited by middle to high income population group. Out of them, 172 (69.51%) patients were in the age group of 16 to 35 years and mean age was 26 years. The female to male ratio was 1.75:1 and contrary to other comparative studies, this reverse gender trend was found statistically significant (p < 0.001). A total of 137 (58.55%) poisoning cases were married. However, the proportion of married women?92/149 (61.74%), was statistically significant, placing young married women at higher risk of poisoning (p < 0.0001). In 32 (13.68%) cases, poisoning was accidental, while in remaining 202 (86.32%) deliberate self-harm (DSH) was the reason. Among the poisons consumed, psychotropic drugs (24.79%), insecticides (11.54%) and disinfectants (11.11%) constituted the bulk. Conclusion: This is the first study, in Maharashtra and one among few in the country, which has reported high preponderance of young married women among poisoning cases. Adverse male to female ratio (1000:893) in Thane district where Navi Mumbai is located, coupled with findings of high incidence of acute poisoning in females, is a clear indication of social distress among women in this part of the country.