ABSTRACT
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing global pandemic that has devastated our globalized economic system. Apart from infecting 12,102,328 human beings and taking a toll of over 551,046 lives globally by the 11th of July 2020, it has fundamentally affected the way we live, work, travel, and relate to each other. Despite imposing early preventive measures, India has crossed a total caseload of 820,916 with a total death of 22,123 till-date, ranking third in the descending list of worst-affected nations. Although comparatively lower, the case fatality rate in India is 2.72% against the global fatality of 4.53%. It is an empirical fact that every process and institution must evolve to meet the needs of its time. A model for categorization of fatality among real-time reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 patients has been developed at Uttar Pradesh University of Medical Sciences (UPUMS), to address the issue of patients being transferred very late in the course of the disease to level-3 facilities. The UPUMS model of categorization of fatalities of COVID-19 patients at level-3 center comprises of category-1 as ‘Institutional COVID-19 fatalities’, category-2 as ‘Imported COVID-19 fatalities’ and category-3 being ‘Imminent with Incidental COVID-19’ fatalities. This endeavor of categorizing COVID-19 fatalities is an opportunity to analyze facts and contemporary science to assess our response to this pandemic and thereby take lessons to prepare better for the future. Following proper analysis, we noted that most of these fatalities (64%) at the higher center are because of delayed referrals hence termed as imported fatalities, which need a modality of early attention and referral. However, there are fatalities which occur because of severe systemic illness like liver failure, cardiovascular accident (CVA), myocardial infarction (MI), etc. They need due treatment at a regional center. These constitute up to 18%. Authors found that actual COVID-19 deaths constitute only 18% of the total projected fatalities.
ABSTRACT
'Holoprosencephaly (HPE) is a structural malformation of the brain that results from the complete or incomplete noncleavage of the forebrain/ prosencephalon of the embryo into 2 hemispheres1. We present a case of twenty-five year-old primigravida presented to the Outpatient department of Obstetrics for routine checkup and diagnosed with Alobar holoprosencephaly on 2nd level USG. Fetal MRI was performed and the findings were confirmed. Even though ultrasonography is diagnostic in the detection of fetal anomalies, MRI plays a vital role due to its multiplanar capability and excellent soft tissue resolution. The purpose of publishing this case is to sensitize the clinicians to the classical features of holoprosencephaly on various imaging modalities and to stress the importance of its detection before 20 weeks of gestation so as to allow for legal medical termination and alleviate maternal psychological trauma of bearing a deformed fetus.
ABSTRACT
Background: The aim of this study was to investigate and compare the CS rates at a tertiary care medical college setting centre which has a high referral rate of complicated pregnancies and make analysis based on the 10-group classification.Methods: This is a retrospective study carried out department obstetrics and gynecology of a tertiary care medical college hospital in Mangalore and includes all deliveries over a period of five years from Jan 14 to Dec 2018 and it was compared with the c-section from January 2007 to December 2011.Results: The overall CS (cesarean section) during the period 2014-18 was 31.85 which were significantly greater then 2007-11 period (20.59%). The main contributing groups to the overall CS rate were the previous CS (Group 5) and Primigravida groups, (Groups 1 and 2) 80%.Conclusions: It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate. The application of Robson’s Ten-group classification (TGCS) in centre has helped to identify the main groups of subjects who had the overall maximum CSR.
ABSTRACT
The garlic (Allium sativum L., Amaryllidaceae) has been popularly used in the treatment of diabetes and cardiac complications. In the present work, we have studied the possible mechanisms, sulfonylurea receptor (SUR) selectivity of allicin in diabetic hypertensive rats. Diabetic hypertension was induced by intraperitoneal injection of streptozotocin (50 mg/kg) followed by daily administration of dexamethasone (10 µg/kg, s.c.). Different parameters, blood pressure and blood glucose levels were studied in the rats weekly up to eight weeks. Allicin (8 mg/kg, p.o.) shows potent antidiabetic (*p<0.001) as well as antihypertensive effect (**p<0.001, *p<0.01). It may act as a vasodilator by hyperpolarizing the membrane of normal vascular smooth muscle cells. The hyperpolarization in vascular smooth muscle occurs due to K+ channel opener activity. Antihypertensive effect of allicin is inhibited by glibenclamide, nonselective SUR blocker while combination of allicin with nateglinide, selective SUR1 blocker exerted synergistic antihypertensive effect. The results indicates that allicin is effective in the treatment of diabetic hypertension; through a mechanism that might involve selective opening of SUR2.
ABSTRACT
Pulsatile drug delivery systems are developed to deliver drug according to circadian behavior of diseases. This means that these systems will deliver drug at time when disease display it’s most morbid and mortal state within a circadian cycle (24 hrs.). The product follow a sigmoidal drug release profile characterized by a time period of no release (lag time) followed by a rapid and complete drug release. Thus drug can be delivered at right time, in right amount and at right site of action by use of such approach. The potential benefits of chronotherapeutics have been investigated and established for number of diseases like asthma, arthritis, cancer, diabetes, epilepsy, hypertension, ulcer, hypercholesterolemia etc. Various capsular, osmotic, single and multiple unit systems that are modulated by soluble or erodible polymer coatings, rupturable membranes are available in market. These systems are beneficial for diseases showing chronopharmacological behavior where night time dosing is required or for the drugs having high first pass effect or having site specific absorption in GIT, or for drugs with high risk of toxicity or tolerance. These systems also improve patient compliance by decreasing dosing frequency.