ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic rapidly spread globally. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, is a positive-sense single-stranded RNA virus with a reported fatality rate ranging from 1% to 7%, and people with immune-compromised conditions, children, and older adults are particularly vulnerable. Respiratory failure and cytokine storm-induced multiple organ failure are the major causes of death. This article highlights the innate and adaptive immune mechanisms of host cells activated in response to SARS-CoV-2 infection and possible therapeutic approaches against COVID-19. Some potential drugs proven to be effective for other viral diseases are under clinical trials now for use against COVID-19. Examples include inhibitors of RNA-dependent RNA polymerase (remdesivir, favipiravir, ribavirin), viral protein synthesis (ivermectin, lopinavir/ritonavir), and fusion of the viral membrane with host cells (chloroquine, hydroxychloroquine, nitazoxanide, and umifenovir). This article also presents the intellectual groundwork for the ongoing development of vaccines in preclinical and clinical trials, explaining potential candidates (live attenuated-whole virus vaccines, inactivated vaccines, subunit vaccines, DNA-based vaccines, protein-based vaccines, nanoparticle-based vaccines, virus-like particles and mRNA-based vaccines). Designing and developing an effective vaccine (both prophylactic and therapeutic) would be a long-term solution and the most effective way to eliminate the COVID-19 pandemic.
ABSTRACT
Objective: To determine the prevalence of restless legs syndrome [RLS] in elderly patients with pure sensory polyneuropathy and correlate the findings with other clinical features
Study Design: Observational / cross sectional study.Place and Duration of Study: This study was conducted at the Dow University Hospital and Civil Hospital Karachi from 2013 to 2015
Materials and Methods: 48 patients with Restless leg syndrome were evaluated in our multicenter, prospective study in 2 years for evidence of pure sensory neuropathy either they have demyelinating or axonal type. Patients were evaluated according age at which symptomsstarted, the severity of symptoms, typical clinical findings and laboratory investigations
Results: In 21 of the 48 [43.7%] patients, peripheral neuropathy was detected. Ten patients had pure sensory polyneuropathy and remaining have mixed sensory motor polyneuropathy. The pure sensory neuropathy group had comparatively intense and frequent symptoms of Restless leg syndrome. Some of them have family history of Restless leg syndrome. Patients with Mixed sensory motor polyneuropathy did not have similar strong symptoms of Restless leg syndrome and pain in legs
Conclusion: The result suggests that Restless leg syndrome is triggered by painful paresthesias is primarilyrelated with pure sensory neuropathy. Patients with mixed sensory motor neuropathy have less intense feature of restless leg syndrome. So the treatment options should be focused on medicines used for neuropathic pain
ABSTRACT
Objective: To determine the frequency of Hyperamylasemia leading to respiratory failure in patients of organophosphate poisoning
Study Design: Observational / descriptive study
Place and Duration of Study: This study was conducted at the Department of Medicine Dow University of Health Sciences, Karachi from June 2014 to June 2015
Materials and Methods: A total of 168 patients of Organophosphate poisoning fulfilling the inclusion criteria were included in the study. Blood was drawn after aseptic measures by a trained phlebotomist for Serum Amylase level and Arterial blood gases. Value more than 101U/L was taken as hyperamylasemia. PaO[2] less than 60mmHg or PCO[2] greater than 55mg was labeled as respiratory failure. All information was noted on proforma
Results: There were 59% were male and 41% were female. Frequency of hyperamylasemia in patients of organophosphate poisoning was 44%. Frequency of respiratory failure in hyperamylasemia in patients was observed in 68%. Respiratory failure was significantly high in male than female [70% vs. 30%; p=0.019]
Conclusion: Hyperamylasemia is more frequently seen in organophosphate poisoning. In patients with respiratory failure the mortality is very high; therefore we recommended early diagnosis, careful monitoring and appropriate management of complications in reducing the mortality rate
ABSTRACT
To study the complications of ND: YAG laser capsulotomy. Clinical trial. Department of Ophthalmology KHYBER Medical University Institute of Medical Sciences Teaching Hospital Kohat Development Authority [KDA] Kohat. Jan 2007 to June 2008. A total number of 250 patients with posterior capsular opacification were studied and look for complications after ND: YAG Laser application. One hundred and thirty five [54%] were male and one hundred fifteen[46%] patients were female. 63% of patients had right eye involvement while 37% had left eye were involved. Patients were thoroughly examined before and after the procedure. All patients were followed for minimum six months after the procedure. Data was analyzed by SPSS version 16. Chi square test was calculated for the significance of analysis. After Nd YAG laser capsulotomy there was significant improvement in visual acuity of my patients. There was transient rise of IOP in 25 [10%] of patients. Mild anterior uveitis in 20 [8.0%] of patients. Intra-ocular Lens pitting or cracks in 30 [12%] of cases. Macular edema in 20 [8.0%] of cases. Retinal detachment in 5 [2.0%] of cases. Nd YAG laser is safe, effective and non-invasive procedure outdoor procedure by which we can get better visual outcome. Which had also some serious complication for that we have to avoid and educate the patient about the complications of procedure
ABSTRACT
Purpose: To find out safety and effectiveness of supratarsal injection of Triamcinolone in cobble stone papilla e in Vernal Keratoconjunctivitis [VKC]
Design: Prospective, uncontrolled trial
Period: June 2009 to January 2010
Setting: Department of Ophthalmology KMU Institute Of Medical Sciences Hospital KDA Kohat
Material and Methods: One hundred and fifty diagnosed patients of VKC, of both sexes and age group between 5 - 40 years were included in the study. Patients with glaucoma, or steroid responder, postherpetic corneal scar, active infection of cornea or conjunctiva, tightly closed eyelids, patients who lost follow-up, and patients unwilling to be enrolled in this study were excluded from the study. The patients were enrolled and informed consent was taken. Supratarsal injection of Triamcinolone was given. Their record was maintained and all the patients were followed up for six months for evaluating their effectiveness and side effects
Results: We treated two hundred and seventy five eyes of one hundred fifty patients. Among them 80% were males. Mean age was 14 years [range: 5-40 years]. All of the patients had itching of eyes, redness, watering, photophobia, cobble-stone papillae and Tranta's dots. Mean duration of disease was 27 weeks [Range: 4 weeks to 10 months]. Patients were followed up and multiple injections were given for controlling disease. Transient redness was the most common side effect of injection therapy. Study shows 100% effectiveness of supratarsal injection of triamcinolone acetonide in VKC although recurrence was seen
Conclusions: Supratarsal injection of Triamcinolone is safe, cost-effective and simple way of management of VKC