ABSTRACT
Since the first cases were reported in December 2019, infection with the severe acute respiratory corona virus 2 (SARS-CoV-2) has become a worldwide pandemic. COVID-19 the illness caused by SARS-CoV-2 is overwhelming health care systems globally. In the absence of a proven effective therapy, current management consists of supportive care, including invasive and noninvasive oxygen support and off-label or compassionate-use therapies, including anti-retrovirals, anti-parasitic agents, anti-inflammatory compounds, and convalescent plasma. Amongst these experimental therapies, remdesivir a broad-spectrum antiviral drug has shown some promising results. We present a successfully treated patient of severe acute respiratory illness by SARS-CoV-2 with remdesivir along with standard management protocol. Reporting a case with aim to add favoring evidence for remdesivir in the treatment of SARS-CoV-2.
ABSTRACT
Aims and Objectives:A study to determine the effect of glycemic variability measured by continuous blood glucose monitoring as assessed by standard deviation of each SARS CoV -2 patient's mean glucose level and to correlate with the severity of the disease.Study Design:Cross-sectional observational study of 13 patients with SARS CoV-2 infection with Acute Respiratory Distress Syndrome (ARDS) with and without diabetes.Place and Duration of Study:Department of Medicine, Dhiraj Hospital, Smt. Bhikhiben Kanjibhai Shah MedicalCollege and Research Institute; between June 2020 to July 2020.Results:13 patients of SARS CoV-2 with ARDS were enrolled in the study. The median age of the enrolled patients was 55±12 years. Out of the 13 patients, 5 patients belonged to mild and severe category of ARDS each respectively and 3 patients belonged to the moderate category of ARDS. There was a gradual rise in inflammatory markers such as serum LDH, Ferritin, CRP from mild to severe ARDS and D-dimer level was more than double in severe category as compared to the mild ARDS. Normal glycemic variability in adults is 0-3 SD, and we found that there was a significant co-relation of glycemic variability with severity of the disease evidenced by the mean standard deviation of severe ARDS patients as 27.44 SD; whereas 19.26 SD and 9.7 SD for moderate and mild ARDS patients respectively. Hypoglycemia was documented in 10 patients. The maximum stay in the hospital was that of the patients with high glycemic variability that is 22 ± 2 daysConclusion:This preliminary study relates glycemic variability with severity of ARDS in patients of severe SARS CoV-2. Frequent episode of hypoglycemia is not uncommon and should be monitored
ABSTRACT
Background: Esophageal cancer is associated with multiple risk factors and associated with poor prognosis. Incidence of Esophageal cancer is increases now a days and it became a sixth leading cause of cancer related death in world. The purpose of this study was to know the clinical profile of patients of esophageal cancer in a tertiary care teaching hospital of Gujrat, India.Methods: This is a retrospective hospital record based study for a period of 2015 to 2018 in which 103 patients with endoscopic biopsy confirmed cases of esophageal cancer were analyzed for clinical profile.Results: Esophageal cancer was most common in low socioeconomic men (66%) of 5th decades (26.21%) associated with tobacco chewing (64.07%) as a major risk factor and dysphagia (86.76%) as most common presenting feature. Most common type and involvement were sqamous type (72.81%) and distal third (50.48%) part of the esophagus respectively.Conclusions: Primordial prevention and screening of patients may decrease mortality related to esophageal carcinoma.
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Background: Cardiovascular disease which is an outcome measure have several conventional risk factors which include older age, hypertension, diabetes mellitus, alcohol intake, smoking, decreased physical activity, abdominal obesity, high risk diet and psychosocial stress. Stiffening of large arteries known as arterial stiffness (arteriosclerosis) has been shown to be an important risk marker for future cardiovascular events and mortality beyond well-known cardiovascular risk factors. Aim of study: To determine the effect of Hypertension on arterial stiffness and so the cardiovascular disease. Therefore in this study, we attempted to find the effect of hypertension on vascular stiffness. Material and methods: A cross sectional study was conducted at Department of Medicine, Dhiraj Hospital affiliated with SBKS MI & RC Sumandeep Vidyapeeth University to measure and analyse the vascular age in hypertensive patients. Total of 90 hypertensive patients were enrolled for the study after taking informed written consent. Vascular age is calculated in all patients using MOBILO-OGRAPH, after taking into consideration the various vascular parameters. Results: Vascular aging become faster in older patients (>60 years) than in younger patients (p=0.011). Also Male hypertensives had worse vessels compared to their female counterpart (p=0.001). Also the presence of dyslipidaemia had highly significant effect on vascular age of hypertensive patients (p<0.001). We had also seen that greater the duration of hypertension, more the effect on arterial stiffness. Conclusion: Though prediction of exact cardiovascular risk is not possible by measuring vascular age of the hypertensive patients but such information is very useful for mass sensitization and education.
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Only proper control of diabetes has shown statistically significant difference (p < 0.001) on the prevalence and severity of dyslipidemia, consolidating the fact that the proper treatment and strict control of diabetes is the most important step in the prevention and treatment of complications of diabetes.