To Study the Clinical Efficacy and Safety of Remdesivir in Hospitalized Adult Patients with Moderate-to-Severe COVID-19 Disease in ICU of a Tertiary Center in Bihar

Background: Coronavirus disease 2019 (COVID-19) pandemic has adversely affected the human health and wealth across the globe and is still posing a serious challenge to us. In the armamentarium of various drugs approved for COVID-19, remdesivir proved to be a major breakthrough in the treatment of moderate-to-severe cases. Our study is regarding its clinical efficacy and safety in hospitalized reverse transcription polymerase chain reaction (RT-PCR) confirmed adult patients with moderate-to-severe COVID-19 disease. Material and methods: A total of 100 patients with moderate-to-severe COVID-19 (RT-PCR positive) admitted in the intensive care unit (ICU) of Sri Krishna Medical College and Hospital (SKMCH), Muzaffarpur, Bihar, were enrolled in the study from 12th August to 11th November, 2020. All patients were given injection remdesivir as 200 mg IV loading dose on Day 1, followed by 100 mg IV daily for next 4 days along with other standard treatment. Results: Out of total 100 patients, 88 patients recovered and were discharged, while 12 patients died. Mean age of patients was 54 ± 16 years with male preponderance (4:1). Mean duration of hospital stay was 10.6 ± 5.4 days. C-reactive protein, D-dimer, ferritin and interleukin-6 decreased significantly after treatment with remdesivir, with p value <0.01, as compared to values at the time of admission, without any significant side effects. Conclusion: Early administration of remdesivir helps contribute to better clinical outcome in moderate-to-severe COVID-19 disease, without any significant side effects.

Evaluation of Genetic Analysis of ESCHERICHIA COLI Isolated from Two Different Environmental Sources: Sewage Water Verses Soiled Bedding Materials of Laboratory Rodents

ABSTRACT The present investigation details an assessment of genetic relationship of E. coli isolates collected from two different environmental sources viz. sewage water and soiled bedding materials of laboratory rodents. Five sewage water samples were collected from the industrial area of Lucknow city and 5 samples of soiled bedding materials of laboratory animals were collected from Animal facility at CSIR-IITR, Lucknow. For this study Random amplified polymorphic DNA markers (RAPD) was chosen as the molecular fingerprinting method. In this study, 10 RAPD primers were used to evaluate the genetic similarity of E. coli. isolates. The RAPD-PCR fingerprints were analyzed and data were scored as 1, 0 matrix. The generated data were fed on Popgene software for calculating genetic diversity and creating dendrogram. The genetic similarity of 85% was recorded from soiled bedding materials and only 71% in sewage water samples in E.coli samples. The dendrogram based generation of clustering of E. coli isolates show two major clusters. Within major cluster sub-cluster were also observed which indicating diversity within isolates of E. coli. The RAPD-PCR based fingerprinting provided a rapid means of discriminating E. coli isolates and considered a relevant tool for molecular typing.

Are Early Onset Alcoholics Different : A Cross Section Observational Study from a General Hospital Psychiatry Unit.

Introduction: Alcohol dependence syndrome has been fraught with significant biopsychosocial problems. Early age of onset of initiation has been seen to complicate the issues further. Method: Clinico-psycho-social profile of all patient of alcohol dependence syndrome admitted to a general hospital psychiatric unit was assessed. Results: Ment age of onset was 25.42 years and that of first medical contact was 38.29 years. Age of onset had significant association with increased amount of alcohol consumption, early age of medical consulation, Presence of delirium, coexisting depression and deranged liver enzymes. Conclusion: Early onset of alcohol consumption had significant impact on course and outcome of the alcohol dependence syndrome. Effective strategies be formulated for early referral and targeted management.

Child and Behaviour: A School Based Study.

Behaviour problems in children are on the rise. Available literature speaks of variability and inadequacies of diagnostic methods, research criteria, treatment modalities and psychosocial interventions. Methods: 50 children of age 6-14 years attending government school were assessed for behaviour problems. Children were selected after appropriate randomization and subsequently assigned to Child behaviour checklist. The data thus collected was suitably interpreted using appropriate statistical tests. Results: Twenty-one (42%) children were found to be above the cut-off score. Mean CBCL score was 43.3. Most common behaviour problems in these subjects were “can not sit still, restless, hyperactive” shown by 62% of the subjects. Female children had behaviour problems like “too concerned with neatness or cleanliness”, “self conscious or easily embarrassed” and “feels she has to be perfect” where as male children had behaviour problems like. “does not feel guilty after misbehaving”, can not concentrate” and “restless”. Conclusion: The analysis of pattern of distribution of behaviour problems in the subjects revealed them to be more of externalizing ones. Female children had more of internalizing behaviour problems.

Study of Behavioural Problems in Mentally Retarded Children.

Behaviour disorders are common in children with mental retardation and in addition to the subjective distress they cause the individual, they restrict opportunities to engage in many normal activities. Methods- 50 children from age group 6-14 years were randomly selected from a special school for mentally retarded children and assessed. Results- Analysis of the data reveled 66% the children to be above cut off score. Mean CBCL score was 56.42.There was significantly higher prevalence of behaviour problems in the younger age group. There was higher prevalence of behaviour problems in children with moderate mental retardation than in children with mild mental retardation. Common behaviour problems reported were ‘ impulsive or acts without thinking’, ‘can not concentrate’ & ‘sudden changes in mood or feelings’. Common behaviour problems in younger age group were ‘impulsive’, ‘can’t concentrate’, ‘ acts too young for her age ‘ etc. and in the older group it was ‘impulsive’, ‘can not concentrate’ and ‘acts too young for her age’. Common behaviour problems in children with mild mental retardation were impulsive’, ‘can’t concentrate’, ‘Gets hurt a lot, accident prone’ etc and in children with moderate retardation were ‘can’t concentrate’, ‘bites fingernails’, ‘Gets hurt a lot, accident prone’ etc. Discussion- Analysis of the data revealed a significantly higher prevalence of behaviour problem in mentally retarded children. Behaviour problems were more in the younger age group There was higher prevalence of behaviour problems in children with moderate mental retardation than in children with mild mental retardation. No specific trend could be observed in the types of behaviour problems as regards to sex, age, income of the parents and severity of mental retardation.

Road Rage: Psychosocial Perspectives.

Road rage has become common and so is its concern and remedial issues. Though it does not reflect many a time the psychological aberrations of the aggressor or the aggressed upon, the psychosocial issues are significantly involved in causation of the road rage. Revisiting the whole issue, implementing certain stress reduction techniques and using preventive measures for better vehicle performance and road traffic safety will go a long way in improving road safety and minimizing yet so far ever-growing menace … the Road Rage.

Undiagnosed purpura: a case of autoerythrocyte sensitization syndrome associated with dermatitis artefacta and pseudo-ainhum.

A 23-year-old young woman presented with recurrent episodes of painful bruising along with linear erosions on the accessible areas of the body of nine years duration with a pseudo-ainhum of her left nipple for the past three months. Her case history included repeated visits to various physicians at different centers and an extensive investigative profile. A diagnosis of autoerythrocyte sensitization was made on the basis of the clinical history, dermatological examination complemented by a positive autoerythrocyte sensitization test, psychiatric evaluation and absence of any organic cause for her ailment. She was placed on psychiatric management and has remained symptom-free after six months follow-up. The case is reported for its rarity, as well as for the association of autoerythrocyte sensitization syndrome with frank dermatitis artefacta and pseudo-ainhum, which to the best of our knowledge has not yet been reported in the literature.