Outcome of Obstructed Total Anamalous Pulmonary Venous Connection (TAPVC) Repair Patients with Milrinone Versus Milrinone and Inhaled Nitric Oxide (INO): A Prospective Randomized Observational Study

Background: Obstructed total anomalous pulmonary venous connection (TAPVC) typically present with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. Milrinone and inhaled nitric oxide (iNO) efficiently reduce pulmonary artery pressure (PAP) and help to improve the outcome. The aim was to determine the outcome of patients with high PAP with milrinone alone and a combination of iNO and milrinone. Material and Method: After ethical committee approval, the study was conducted over a period of 3 years in 80 patients with obstructed TAPVC repair. A total of 80 patients having severe PAH (supra systemic arterial pressure) randomly divided into two groups with 40 patients in each (M & MN). Group M (milrinone) patients received milrinone and Group MN (milrinone & iNO) patients received both milrinone (after opening aortic cross clamp) and iNO (post operative ICU). Ventilation time, hospital stay, ICU stay, complications, in hospital mortality were compared between both groups. Result: Ventilation time, Intensive Care Unit (ICU) stay, hospital stay for group M was 8.02 � 5.74 days, 11.25 � 7.33 day, 14.92 � 8.55 days, respectively, and for group MN was 5.02 � 1.78 days, 8.27 � 3.24 days, 10.3 � 3.18 days, respectively. In hospital mortality for group M and MN was 10% and 2.5%, respectively. P value for each variable was significant < 0.05 (except mortality). Conclusion: Most of the patients with obstructed TAPVC had severe PAH. Management of severe PAH with a combination of milrinone with iNO had a better outcome than milrinone alone.

Head and facial anthropometry of the Indian population for designing a spectacle frame

Purpose: To establish the normative data of the head and face measurements needed to design an appropriate spectacle frame for the Indian population. Methods: Indian subjects between 20 and 40 years were included in the study. Thirteen parameters were measured using the direct and indirect methods using ImageJ software. Photographs of subjects were captured in the primary gaze position, with the head turned toward the subject’s right and left by 90° from the primary gaze. Results: The mean ± standard deviation of age was 27.6 ± 5.7; 55.38% were males. An independent t?test showed a significant difference in nose width (P = 0.001), inter?pupillary distance (P = 0.032), and body mass index (P = .012) between males and females. Inner inter?canthi distance (P = .265), outer inter?canthi distance (P = .509), and frontal angles (P = .536) showed no significant difference. There is a significant difference in face width compared with the other studies. The mean head width of males (154.168 ± 9.121) was wider than that of females (145.431 ± 8.923). This suggests a smaller distance between the temples of a spectacle frame for females. Conclusion: Considering the above factors, there is a need for a customized spectacle frame design providing better optics, improved cosmesis, and comfort to the wearer

Knowledge, attitude, and practice of unused and expired medication disposal among second year medical students

Background: Medications are not only used for disease treatment, but also for diagnosis and prevention of the disease. Not all the prescribed drugs are used by the patients, due to lack of adherence to therapy, there are chances of stocking up the unused or expired drugs at home. It is important to provide practical and scientific guidelines for the safe disposal of expired, unused, and leftover medications. Most developing countries lack standard guidelines for the safe disposal of expired, unused, and leftover medications. There are very few studies conducted in this region to assess the knowledge of the safe disposal of unused drugs. Aims and Objectives: The present study was undertaken to assess the knowledge, attitude, and practice of disposal of unused or expired medications. Materials and Methods: This was cross-sectional, questionnaire-based study conducted among 2nd year undergraduate medical students at a Medical College in South India. The questionnaire included three parts: Part I includes demographic details of the students and questions on knowledge of safe disposal of expire/unused drugs, Part II includes questions on attitude towards the safe disposal of expired/unused drugs, and Part III includes questions on practices toward the safe disposal of expired/unused drugs. The responses received from the participant was analyzed using Microsoft Excel (2019 version), and the results are explained in frequency and percentage. Results: A total of 118 2nd year medical undergraduate students participated in the present study. Out of 118, 62 (52.5%) were female students and 56 (47.4%) were male students. Among all the participants, 98 (83%) of students said that they are aware of medicinal waste. In the present study, 73 (61.8%) students knew about the safe disposal of unused, expired, and leftover medications. Most of the students (93.2%), agreed that unsafe disposal of unused, expired, and leftover medications would adversely affect the environmental, animal as well as human health. And 50% of the students, strongly agreed that educational activities like drug take-back programs should be introduced among the public people. When the students were asked about their practice of keeping expired, unused, or left-over drugs at home, 66.1% (78) of the students said yes and 47.2% (40) of the students said they do not keep the leftover medicine at home. Topical formulations (63.5%) were the most common group of drugs that were stored. The majority of students (73%) reported that they would throw unused/expired medications in dust bins at home. Self-discontinuation is most the common reason for storing drugs in the majority of the study participants (39%). Conclusion: In the present study, the 2nd-year medical undergraduate students had awareness regarding the harmful events associated with improper disposal of unused or expired drugs. But due to lack of information or knowledge of safer methods available, majority of the students were following inappropriate methods for disposing leftover or expired medication at home. Indian Government should provide national level guidelines and conduct awareness programs, mediated through healthcare professionals to bring significant changes about the disposal of unused or expired medications.

Customization of spectacle frames for individuals with facial deformities by altering conventional spectacle frames – Phase I

Purpose: Manufacturing a spectacle frame for a facially deformed individual is challenging because of facial asymmetry. One of the solutions is the customization of spectacle frames. Customization of spectacle frames for facially deformed individuals requires a better understanding of the facial anthropometry of deformed faces. This study aimed to analyze the facial anthropometry of deformed faces to understand the range of variability. The results of this study will be used to find customization methods in the future. Methods: We measured and analyzed the 12 facial parameters of individuals with facial deformities using the ImageJ software. Results: The data collected were normally distributed. Paired sample test revealed a statistically significant difference between innercanthus distances (right innercanthus distance [RICD] and left innercanthus distance [LICD]). Correlation analysis showed a positive difference between horizontal and vertical pupillary distance?innercanthus distance (PD?ICD) (0.68, 0.75, and 0.81) and pupillary distance?helix distance (PD?HD) (0.57, 0.68, and 0.59) relations. PD?ICD correlations are stronger compared to the PD?HD relation. Conclusion: Altering the frame center distance and the temple heights are the most important for asymmetric faces. Large population?based data are required to make concrete decisions to design a spectacle frame for asymmetric faces.

Design, synthesis, characterization and in vitro evaluation of some novel thiol-substituted 1,3,4-oxadiazoles as GlmS inhibitors

The development of novel medications with previously unidentified action mechanisms is required due to the increasing in antibiotic resistance amongst dangerous microbes. The major goal of the research was to develop in silico and in vitro antibacterial methods for designing an active thiol substituted oxadiazole inhibitor targeting gram-negative and gram-positive bacteria's GlmS receptor. 1,3,4-Oxadiazole was proposed as a scaffold, and the possibility of its synthesis was examined. The least amount of free energy in the ligand configurations was chosen. Analyses of the novel molecules' characteristics were done using ADMET studies. There were four distinct reactions used in the synthesis processes. As the first reagent, substituted carboxylic acids were utilized. Synthesized compounds were characterized by spectral studies and minimum inhibitory concentration was evaluated by in vitro antibacterial examinations of synthesized compounds. Ciprofloxacin served as the study's reference drug. Based on in vitro studies and in silico molecular docking, ROS1-4 established strong binding energy, while ROS3 revealed significant antibacterial activity. These findings support the hypothesis that the proposed scaffold significantly inhibits the GlmS receptor protein.

AUDIT OF PROPER TECHNIQUE OF LID TAPING

Background: To assess the quality of lid taping done in departments handling patients requiring critical care. Method This study is an observational cohort study which assessed the quality of lid taping from May 2022 to October 2022.This study was done in 10-bedded intensive care unit of a tertiary care medical teaching hospital. Retrospective analysis was done during phase 1 and post intervention, phase 2 was conducted. A 30% reduction in the incidence of exposure ke Result: ratitis was observed in these critical care patients. Protocolized eye care needs to be emphasised in critical ca Conclusion: re units along with training and sensitisation of the care givers and staff members towards the same is mandatory.

Microbial Load, Antibiotic Resistant Bacteria and Antibiotic Residues in Broiler Chicken

Chicken meat is highly preferred protein food worldwide. To meet the demand, huge poultry farms are established and using antibiotics as prophylaxis and treatment against the bacterial diseases. Uncontrolled usage of antibiotics has led to development of antibiotic resistance in poultry and antibiotic residues in poultry chicken. Fifty one chicken meat samples were collected from various retail outlets. Antibiotic residues were quantified by HPLC, total microbial load was measured by growth of bacteria on growth medium and antibiotic resistant profile of Escherichia coli, Salmonella spp, Staphylococcus aureus and Campylobacter spp was determined by well diffusion method. Except neomycin, all tested antibiotics were present in the range of 10-978 ppm, the average microbial load was in the range log 10 of 7.32 per gram of chicken sample, E. coli, Salmonella spp, Staphylococcus aureus and Campylobacter spp were resistant to several antibiotics studied. Hence there is a need of appropriate usage of antibiotics in poultry and proper handling of chicken during farming and slaughtering.

Rehabilitation Professionals’ Perspectives on Psychosocial Needs of Family Caregivers of Persons with Spinal Cord Injury: A Qualitative Study from India / 가정의학회지

Background@#This study explored the psychosocial needs of family caregivers of persons with spinal cord injuries from the perspective of rehabilitation professionals. @*Methods@#An exploratory qualitative approach was used, and a total of 14 rehabilitation professionals from various backgrounds participated in face-to-face interviews. All interviews were audio recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify key themes. @*Results@#Nine need themes emerged: informational, psychological, personal care, financial, social support, welfare, vocational, telemedicine, and referral. @*Conclusion@#The findings of this study will aid the design or development of need-based customized psychosocial interventions for family caregivers of persons with spinal cord injuries in India. Multiple stakeholders involved in spinal cord injury management should understand the importance of meeting the needs of family caregivers of persons with spinal cord injuries and the timely delivery of customized psychosocial interventions.

Efficacy of Buccal Infiltration with or without Palatal Injection for Posterior Maxillary Teeth Extraction - A Split-Mouth Randomized Trial

ABSTRACT Objective: To evaluate the feasibility of posterior maxillary teeth extraction buccal infiltration with or without the use of palatal injection. Material and Methods: A total of 70 patients underwent extraction of bilateral maxillary posterior teeth under 2% lignocaine hydrochloride with 1:2,00000 adrenaline infiltration in this single-centric split-mouth randomized trial. The test side was administered with a buccal infiltration of 2 mL of anesthetic alone. An extended waiting period of 10 minutes was given before the commencement of the procedure. A standard protocol was followed for the control side. A single operator performed all extractions. Results: A total of 140 posterior maxillary teeth were extracted. Patients marked pain perception on a visual analogue scale in three different instances. During the administration of injections for the test side, the pain score was less than that of the control side and was statistically significant. The overall pain during the extraction procedure was comparable and statistically insignificant. The overall success of the method was 90%. Conclusion: Extraction of posterior maxillary teeth was feasible with a single buccal infiltration without palatal injection in most cases using an extended waiting period. Dentists can attempt extraction without palatal injections with optimal success. However, the alternate technique could be used when there is a necessity for rescue palatal anesthesia.

Assessment of Severity of Pancreatitis by Computerized Tomography Using Revised Atlanta Classifica?on and Comparison with BISAP Clinical Scoring System

Background: Untreated acute pancrea??s can have high morbidity and mortality. It is a serious gastrointes?nal emergency. Its incidence is approximately 51.0 % and it can cause both local and systemic problems. The diagnosis usually involves laboratory tests like amylase and lipase as well as an ultrasound exam. The ideal imaging test is a contrast-enhanced CT scan. This study used scoring systems based on laboratory and radiological inves?ga?ons to determine the clinical progression and outcome. Methods : Pa?ents who were diagnosed with acute pancrea??s and in whom computed tomography was done were included. From the imaging findings, the category and subcategory of acute pancrea??s and types of fluid collec?ons were described in these pa?ents using the revised Atlanta classifica?on. BISAP score was calculated in all these pa?ents. The clinical outcome assessed in these pa?ents is the dura?on of stay in the hospital, mortality, presence of persistent organ failure, the occurrence of infec?on and need for interven?on. Finally, the correla?on between the Revised Atlanta classifica?on and BISAP score was analyzed and compared with clinical outcomes. Results: The analysis of the correla?on between Revised Atlanta classifica?on severity grade and BISAP score, among the n=57 pa?ents with mild acute pancrea??s n=56, had BISAP score less than 3 and only one had BISAP score greater or equal to three. Among the n=25 pa?ents graded as moderately severe acute pancrea??s, n=20 cases had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three. Among the n=08 pa?ents graded as severe acute pancrea??s, n=3 had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three. Conclusion: Standardizing nomenclature and facilita?ng proper documenta?on of a variety of imaging abnormali?es in acute pancrea??s is made possible by incorpora?ng the new Atlanta categoriza?on system into daily prac?ce. We can triage, predict, and treat pa?ents with acute pancrea??s with greater precision by integra?ng the new Atlanta classifica?on with BISAP clinical grading, significantly improving medical care.

NEONATAL OUTCOME IN INFANTS OF DIABETIC MOTHERS

Introduction The prevalence of diabetes is increasing globally . 3 to 5 % of all pregnant women show glucose intolerance. Approximately 90% of these women have GDM.Infants born to diabetic mothers are prone to complications like congenital malformations and metabolic abnormalities.Most of these complications depend on maternal glycemic control which can be prevented by good periconceptional and prenatal care. This Aims and objectives study is taken up to evaluate complications occurring in infants of diabetic mothers and also to compare the outcome of infants of preGDM mothers and GDM mothers This is hospital based observational study done on infants of diabetic Methodology mothers admitted in NICU, KGH, Visakhapatnam Neonates of diabetic mothers who have other complications like heart disease, PIH, Pre eclampsia, twin gestation, etc. which may effect the baby adversely are excluded from study A total of Results 50 neonates are studied out of whom 37 neonates are born to mothers with gestational diabetes and 13 to mothers with overt diabetes . Mean birth weight of infants of GDM is 3.7kg. Hypoglycemia is more common in infants of GDM mothers than in overt DM. Congenital anamolies are seen in 14% of babies. Birth injures including clavicle fracture , erb's palsy are seen in 5 babies, all of then weighed >3.5kg and delivered by assisted vaginal delivery. Macrosomia,birth injuries and metabolic Conclusion complications are common in infants of GDM mothers than in infants of pre GDM mothers.This shows importance of timely screening of all pregnant women for GDM and counsel them regarding importance of glycemic control to prevent neonatal complications

A questionnaire-based study on knowledge and awareness about clinical trials among medical students

Background: Clinical trials (CTs) play a significant role in timely enhancement of health-care quality. It aids us to find an effective and safe treatment. Clinical research is rapidly developing in India and more graduates from medical, paramedical, and other scientific fields are enrolling for clinical research training. Aims and Objectives: The aims of this study were to know the knowledge and awareness of CT among undergraduate medical students. Materials and Methods: This was a cross-sectional and questionnaire-based study conducted among medical students at a tertiary care hospital in South India from January to February 2022. These questions were designed for assessing knowledge and awareness about CT. After validation, students were administered the questionnaire through the Google form. The data were recorded and analyzed using Microsoft Excel (2019 version) and the results are explained in frequency and percentage. Results: A total of 296 students were sent Google form-based questionnaire, out of which 278 responded with completely filled up questionnaire, giving a response rate of 94%. About 82% reported correctly that healthy normal human volunteers participate in phase 1 of CT. Majority of the students (95%) were aware what is informed consent. Only 98 (35%) students were aware that the request for authorization to conduct CT is given in form 44 as per drugs and cosmetics act. Around 43.16% responded correctly about the time period taken for completion of CT, majority of the students (90%) knew who is responsible for conduction of CT. One hundred and seventy (61.15%) reported correctly that adverse drug effects and new indication or use of the drug is studied in phase 4 and majority were aware that phase 4 is also known as post marketing surveillance. In the study, 204 (73.4%) students were aware that innovatory company of a new drug has to take approval from Institutional Review Board or Institutional Ethics Committee before phase 0 of clinical trial. Majority 240 (86.33%) of the students were aware what is pharmacovigilance. The last question in our study was to assess student’s interest in taking up clinical research in future, only 41% of students showed interest in choosing clinical research as a career option. Conclusion: In the present study, undergraduate medical students’ knowledge regarding clinical trial was average and limited number of students expressed their interest in conduct of CT. A scientifically conducted research helps in evidence-based medicine, which, in turn, improves the patient care and promotes health. A great number of medical students may pursue research in future; hence, it is crucial for medical students to be knowledgeable about clinical research. Therefore, formal, educative, and regular training of medical students is required for choosing clinical research as a career option and conduct high-quality research.

Association of Serum 8-isoprostaglandin F2? Levels with Glycemic Control in Type 2 Diabetes Patients with Senile Cataract

Background : Lipid Peroxidation (LPO) plays a major initiative factor of cataractogenesis in both age-related or senile cataract and Diabetic cataract. Recently, 8-isoprostaglandin F2? (8-iso-PGF2?) is a reliable biomarker of in-vivo LPO and used as potential indicator of oxidative stress. However, serum 8-iso-PGF2? concentration and its association with glycemic control (HbA1c) in the pathogenesis of diabetic cataract subjects are still unknown. Objectives : The present study was designed to estimate 8-iso-PGF2? and antioxidant enzymes levels in serum of Type 2 Diabetes Mellitus patients with senile cataract compared to healthy individuals without cataract as control. To assess the magnitude of the association between 8-iso-PGF2? and glycemic status in diabetic cataract. Materials and Methods : 60 Diabetic Senile Cataracts (DSC) and 60 healthy individuals without cataract in the age group between 45-75 years of both genders. 8-iso-PGF2?, Superoxide Dismutase [Cu-Zn] (SOD3) and Catalase (CAT) concentration were estimated in serum by ELISA method. Results : The mean concentration of 8-iso-PGF2? was significantly increased (541.6±142.7 pg/ml, p<0.001) and mean concentration of SOD3 (102.1±32.8 ng/ml, p=0.007) and Catalase (1005±274.5 IU/ml, p<0.001) were significantly decreased in serum of diabetic senile cataract when compared to healthy individuals without cataract (control). A negative correlation between serum 8-iso-PGF2? and SOD3 and positive correlation between serum 8- iso-PGF2? and fasting blood glucose were observed in Diabetic Senile Cataracts. Conclusion : The present findings indicate that increased 8-iso-PGF2? is associated with oxidative stress which plays a significant role in the pathogenesis of cataract in diabetic patients

A Prospective and Retrospective Study of Bone Marrow in Patients with Pancytopenia– A Study of 150 Cases

BACKGROUND : The bone marrow is widely distributed organ and is the principle site for blood cells forma?on. The broad spectrum of disorders affects the marrow primarily or secondarily with presenta?on of peripheral pancytopenia. Hence, bone marrow examina?on is extremely helpful in evalua?on of pancytopenia. This study emphasizes the different causes of pancytopenia and bone marrow morphology in cases of pancytopenia. MATERIALS & METHODS: The present study is a retrospec?ve and prospec?ve study done in the department of Pathology, for a period of two years. All the relevant history, clinical details, radiological details, and biochemistry parameters were considered. RESULTS: Out of 150 cases,96 were males and 54 were females. Majority of the pa?ents were in the age group of 41-60 years (54%) amongst whom Megaloblas?c anaemia was the most important cause of pancytopenia. CONCLUSION: Bone marrow aspira?on is rela?vely a very safe invasive procedure and primarily permits cytological assessment since the underlying pathology determines the management and prognosis of the pa?ents.

Sowa-Rigpa (Amchi/Buddhist Medicine): A Review

Sowa-rigpa is known as Amchi or Buddhist medicine or Tibetan system of medicine which is primarily based on Buddhist philosophy. It is the fact that basic concepts of Sowa-Rigpa and Ayurveda are almost same and it seems that there is inter-relation among these two traditional systems of Indian Medicine. The description of Tridosha, Panchamahabhuta, seven Dhatus, three Malas, week wise embryological development are same. In Sowa-Rigpa, it has been mentioned that we all are sick due to ignorance as according to Buddhist philosophy, Ignorance is the cause of sufferings. The relation between ignorance and suffering as per the Sowa-Rigpa may be the unique concept which may show the path for human-beings to eradicate all human sufferings i.e., ultimately to walk on the path of Nirvana which is the goal of Buddhist philosophy and Moksha according to Ayurveda.

Safety and efficacy of ayush rasayana A and B in improving functionality of the elderly – A single-arm multicenter study

Background: As per Ayurvedic classics, Ras?yana is a term used for unique therapeutic measures intended to improve cognition, memory, physical strength and delay the degenerative processes. Ayush Rasayana A & B are developed from extracts of herbs pertaining rasayana property. Aims & Objectives: To assess the safety and effectiveness of ‘Ayush Rasayana A and B’ in improving physical endurance, quality of life and cognition of elderly. Materials and Methods: This is an open label, single arm, multi-centre study among 256 apparently healthy elderly between 60?75 years. Ayush Rasayan A was given for 6 days and Ayush Rayana B for 180 days. The effect of the trial drug was seen on functional capacity, quality of life and cognitive function and, safety of the intervention was assessed through haematological and biochemical tests, clinical examination and incidence of adverse events. Results: Significant improvement in 6 minute walk test and HMSE score was observed at 187th as compared to baseline (p<0.0001). Quality of life of the participants especially in domains of physical health, social relationship and environment also improved at the end of intervention period (p<0.0001). The haematological and bio-chemical parameters showed no significant changes as compared to baseline and no adverse events were observed during the study. Conclusion: Ayush Rasayana A and Ayush Rasayana B, both were well tolerated by all the participants. This ayurvedic intervention can be safely given to apparently healthy elderly to improve their functionality, quality of life and cognition. However, a randomized controlled trial is warranted to substantiate the efficacy of this drug.

Application of mobile phone technology as intervention for the management of tuberculosis patients diagnosed through community survey

Background & objectives: The delay in communicating the results to tuberculosis (TB) patients leads to increased rates of initial loss to follow up of treatment. The gap in communication among healthcare providers requires application of new tools that will address the challenges. Mobile phone technologies could be a useful tool in this context for the delivery of information. The objective was thus to evaluate communication by mobile applications such as the WhatsApp Messenger to decrease initial loss to follow up after initial treatment for TB. Methods: Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India undertook a community prevalence survey to find the burden of TB. During this survey, mobile phone-based technology (WhatsApp messenger) was employed as an intervention among the healthcare providers and researchers involved for communicating. This was further evaluated for its usefulness by examining the initial loss to follow up and patients initiated on treatment. Results: The study covered four blocks of Thiruvallur district of Tamil Nadu, South India, namely Kadambathur, Poondi, Thiruvalangadu and Periyapalayam. The survey population was around 20,000 from each block, and the average patients diagnosed by community TB prevalence survey were 30 patients from each block. Among the patients diagnosed through this survey, in the first block, only 55 per cent were initiated on treatment; subsequently, with the intervention, the initial loss to follow up was significantly reduced from 45 to zero per cent. Interpretation & conclusions: After integrating of WhatsApp messenger application for communication among healthcare providers and research

Peripheral lymphocyte subset alteration in patients with COVID-19 having differential clinical manifestations

Background & objectives: The COVID-19 disease profile in Indian patients has been found to be different from the Western world. Changes in lymphocyte compartment have been correlated with disease course, illness severity and clinical outcome. This study was aimed to assess the peripheral lymphocyte phenotype and subset distribution in patients with COVID-19 disease from India with differential clinical manifestations. Methods: Percentages of peripheral lymphocyte subsets were measured by flow cytometry in hospitalized asymptomatic (n=53), mild symptomatic (n=36), moderate and severe (n=30) patients with SARS-CoV-2 infection, recovered individuals (n=40) and uninfected controls (n=56) from Pune, Maharashtra, India. Results: Percentages of CD4+Th cells were significantly high in asymptomatic, mild symptomatic, moderate and severe patients and recovered individuals compared to controls. Percentages of Th memory (CD3+CD4+CD45RO+), Tc memory (CD3+CD8+CD45RO+) and B memory (CD19+CD27+) cells were significantly higher in the recovered group compared to both asymptomatic, mild symptomatic patient and uninfected control groups. NK cell (CD56+CD3-) percentages were comparable among moderate +severe patient and uninfected control groups. Interpretation & conclusions: The observed lower CD4+Th cells in moderate+severe group requiring oxygen support compared to asymptomatic+mild symptomatic group not requiring oxygen support could be indicative of poor prognosis. Higher Th memory, Tc memory and B memory cells in the recovered group compared to mild symptomatic patient groups might be markers of recovery from mild infection; however, it remains to be established if the persistence of any of these cells could be considered as a correlate of protection.

Decaf Score in Predicting Prognosis of Acute Exacerbation of Copd in Patient Required Hospital and ICU Admission

@#Introduction: Exacerbation refers to deterioration of patient’s respiratory indications and requires a robust scoring tool for subjects suffering from Chronic Obstructive Pulmonary Disease (COPD) undergoing acute exacerbation. The Dyspnoea, Eosinopenia, Consolidation, Acidaemia, and atrial Fibrillation (DECAF) score can be utilized bedside and predicts in-hospital mortality using indices. The study aimed at assessing the prognostic standards (of duration of ICU stay, hospital stay and mortality) and the sensitivity and specificity of acute exacerbation of COPD patients based on DECAF score. Methods: This prospective study was carried out in a tertiary hospital with 84 patients between October 2016 to September 2018. On admission, DECAF score of all patients with acute exacerbation of COPD was noted and admitted to ICU. The mean duration of stay in ICU and hospital were compared. Various components of APACHE II, BAP 65, CURB 65 were also noted on admission. Results: Mean age of population was 68.29±11.80 with male predominance (68%). The study observed mortality in 6% of patients with mean ICU stay of 3.65±2.21 days and mean hospital stay of 6.45±3.28 days. For a score of 5 and 6 mean DECAF score could not be calculated as the mortality rate was 100%. ROC of DECAF score was 0.81 which was more than APACHE II (0.72) and BAP 65 (0.69) (p-value 0.07 and 0.056 suggested significance). Conclusion: The DECAF Score has been observed to be a stronger predictor for hospital mortality. Higher the DECAF score, higher is the in-hospital death rate. The DECAF score also helps in forecasting the duration of ICU stay and hospital stay.

Effect of Homoharringtonine as a Combined Regimen for Acute Myeloid Leukemia

Homoharringtonine (HHT), a cephalotaxus alkaloid has shown promising results in the treatment of several hematological disorders such as chronic myeloid leukemia, acute myeloid leukemia (AML), and myelodysplastic syndrome. It is known for its unique mechanism of action by which it prevents the initial elongation step of protein biosynthesis. Hence, it is used in hematological malignancies where it synergistically potentiates the action of other drugs and induces apoptosis. The relevant studies published were searched using an electronic database from 2002 to 2019. The articles published in English were only considered. Search engines such as PubMed, MEDLINE, Google Scholar, and Semantic scholar were used. In this review, we have discussed the effect of HHT in combination with other chemotherapeutic agents for AML with or without genetic mutation specification and the future perspective of these regimens. Although standard treatment options exist for most of these diseases, still cure rates are low with reported morbidity and the drug resistance emergence is pervasive. Thus, novel treatment approaches are crucial for better outcome. Alternative regimens together with HHT have not been a standard practice, although they have shown a very good potential in AML patients. Many of the combinations were also proved to be safe and effective with very low toxic potential. All these data outcomes of various combinations under different scenarios exhibit that HHT has promising results in the treatment of AML which may lead to its approval in the upcoming years.