Clinical presentation of COVID-19 in patients with inflammatory bowel disease: a systematic review and meta-analysis

Background/Aims@#Coronavirus disease 2019 (COVID-19) is recognized to have variable clinical manifestations. The clinical presentation of patients with inflammatory bowel disease (IBD) having COVID-19 is unclear. @*Methods@#We identified articles reporting about the clinical presentation of COVID-19 in those with underlying IBD from PubMed and Embase. The studies, irrespective of design or language, were included. The overall pooled frequency of various symptoms was estimated. Joanna Briggs Institute Critical appraisal checklist was used to assess the quality of studies. @*Results@#Eleven studies, including 1,325 patients, were included in the pooled analysis. The pooled estimates for clinical presentation were; fever: 67.53% (95% confidence interval [CI], 45.38–83.88), cough: 59.58% (95% CI, 45.01–72.63), diarrhea: 27.26% (95% CI, 19.51–36.69), running nose: 27% (95% CI, 15.26–43.19) and dyspnea: 25.29% (95% CI, 18.52–33.52). The pooled prevalence rates for abdominal pain, nausea and vomiting were 13.08% (95% CI, 9.24–18.19), 10.08% (95% CI, 5.84–16.85) and 8.80% (95% CI, 4.43–16.70) per 100 population, respectively. @*Conclusions@#The clinical presentation of COVID-19 in IBD patients is similar to the general population.

Evaluation of Feasibility and Toxicity of Intensity Modulated Radiotherapy in Post-Operative Cases of Oral Cavity Cancer

Background: The combined modality approach incorporating surgery, radiotherapy(RT) and chemotherapy ( CT) forms the corner-stone of management of locally advanced head and neck squamous cell carcinoma(HNSCC). Intensity modulated radiotherapy (IMRT) is an advanced RT technique where large dose of radiation could be delivered to precisely defined target volumes while reducing dose to surrounding OARs It can be delivered in sequential manner or as simultaneous integrated boost(SIB). Aim – The aim of this study was to evaluate the feasibility and toxicity of of IMRT-SIB in post-operative cases of head and neck squamous cell carcinoma (HNSCC). Methods: This was a retrospective study done on 20 patients of HNSCC who received adjuvant RT with IMRT-SIB. Data was analysed for various dosimetric parameters and toxicity profile of patients. Toxicities were recorded using RTOG acute radiation morbidity scoring criteria. Toxicities were evaluated weekly during RT and monthly up to 3 months after RT completion. Results: The median age was 40.5 years WITH 80% patients having locally advanced disease (stage III and IV). Eleven patients received concurrent cisplatin weekly. Majority (60%) of patients developed Gr 1 mucositis with maximum being grade 3 seen in 1 patient. Maximum skin toxicity that appeared was Grade 2; found in 10% patients. Xerostomia was Grade 2 in 75% patients . Sixty percent of patients experienced Grade 2 dysphagia while 15% grade 3. Seventy five percent patients were treated with dose schedule of 66/60/54 Gy in 33# while remaining with 60/54 in 30#.the dose received by organ at risk(OAR) were within normal limits in all the patients. Conclusions: IMRT with SIB can be safely delivered in post-operative squamous cell carcinoma of oral cavity with acceptable toxicity.

Dosimetric Comparison of IMRT and Rapid ARC for High Grade Gliomas

High grade gliomas are common intracranial tumors and adjuvant radiotherapy after maximal safe surgical resection is the cornerstone of the management. Aim: The aim of the present study was to compare the dose distribution characteristics in patients with high grade gliomas planned with Intensity-modulated radiotherapy (IMRT) and Rapid Arc (RA). Methods: Two plan sets by IMRT and RA were generated for each patient on planning Computed Tomography (CT) data sets and were then compared. Results: Total dose prescribed was 60 Gy given in biphasic manner as per Radiation Therapy Oncology Group (RTOG) guidelines guidelines. Planning Target Volume (PTV) coverage (mean values) for IMRT was found 98% and 96% for RA. Conformity Index (CI) was 1.3 for RA, 1.2 for IMRT. Homogeneity Index (HI) was found to be 1.03 for IMRT, 1.04 for RA. Dose maximum (Dmax) for the PTV was equal for IMRT and RA (106%). Conclusions: The dose to Organ at Risks (OARs) was within the acceptable limits and comparable in both the techniques, however RA augments shorter treatment time.

Weeds in Gwalior and nearby regions and their medicinal properties: A case study

Weeds are normally unwanted plants at wrong place. From the perspective of crop protection, they may have anegative effect on cultivated crop, and thus, their effective management is necessary. From a medicinal perspective,they may be useful in disease management due to their secondary metabolites, affordability, inexpensiveness,accessibility, and use by native peoples. The present study reviews the literature available on weeds of MadhyaPradesh, India (Gwalior and nearby region), with their occurrence in changing environment and reported uses indisease management. A comprehensive literature search was done to get the thorough information on the versatileweeds of Gwalior and nearby regions. Amaranthaceae, Asclepiadaceae, Euphorbiaceae, and Asteraceae are found tobe the most prevalent families with plants to treat Prameha, Sandhi sula, Udara sula, and Tvaka roga. The reviewsummarizes the weed plants available in the area under the study with their reported uses, which could be furthervalidated scientifically and could be important from the ethnopharmacological and socioeconomic perspective. Thiscould be the best use of a waste and promote utilization of available resources for the management and treatment ofprevalent diseases in the specific area.

Hepatic or cystic artery pseudoaneurysms following a laparoscopic cholecystectomy - literature review of aetiopathogenesis, presentation, diagnosis and management

Pseudoaneurysms [PSAs] of the hepatic and/or cystic artery are a rare complication following a laparoscopic cholecystectomy [LC]. Generally, PSA cases present with haemobilia several weeks following the procedure. Transarterial embolisation [TAE] is considered the optimal management approach. We report a 70-year-old woman who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with massive hemoperitoneum two weeks after undergoing a LC procedure in another hospital. She was successfully managed using coil TAE. An extensive literature review revealed 101 cases of hepatic or cystic artery PSAs following a LC procedure. Haemobilia was the main presentation [85.1%] and the mean time of postoperative presentation was 36 days. The hepatic artery was involved in most cases [88.1%], followed by the cystic artery [7.9%] and a combination of both [4.0%]. Most cases were managed with TAE [72.3%], with a 94.5% success rate. The overall mortality rate was 2.0%

[Safety and complications of Double-Lumen Tunnelled Cuffed Central Venous Dialysis Catheters; clinical and radiological perspective from a tertiary centre in Oman]

Objectives: This study aimed to assess the technical success, safety and immediate and delayed complications of double-lumen tunnelled cuffed central venous catheters [TVCs] at the Sultan Qaboos University Hospital [SQUH], Muscat, Oman

Methods: This retrospective study took place between January 2012 and October 2013. The clinical records and radiological data of all patients who underwent ultrasound- and fluoroscopy-guided TVC placement at SQUH during the study period were reviewed. Demographic data and information regarding catheter placement, technical success and peri- and post-procedure complications [such as catheter-related infections or thrombosis] were collected

Results: A total of 204 TVCs were placed in 161 patients. Of these, 68 were female [42.2%] and 93 were male [57.8%]. The mean age of the patients was 54.4 +/- 17.3 years. The most common reason for catheter placement was the initiation of dialysis [63.4%]. A total of 203 procedures were technically successful [99.5%]. The right internal jugular vein was the most common site of catheter placement [74.9%]. Mild haemorrhage which resolved spontaneously occurred in 11 cases [5.4%]. No other complications were observed. Subsequent follow-up data was available for 132 catheters [65.0%]; of these, thrombosis-related catheter malfunction was observed in 22 cases [16.7%] and catheter-related infection in 29 cases [22.0%]. Conclusion: Radiological-guided placement of tunnelled haemodialysis catheters can be performed safely with excellent technical success. The success rate of catheter insertion at SQUH was favourable in comparison with other studies reported in the literature

Pharmacological evaluation of Atremisia annua for Antinociceptive Activity in rats.

Pain has been defined by International Association for the Study of Pain as an obnoxious sensory and emotional incident allied with actual or potential tissue damage. Artemisia annua (Asteraceae) is native to China . Its ancient Chinese name, Qing Hao, literally means “green herb A. annua L. is a source of both essential oil (1.4 – 4.0 %) depending on chemotype, and other substances such as sesquiterpene lactones, flavonoids, polyalkynes and coumarins. The essential oil composition has been studied thoroughly and about 60 components have been identified; camphor, artemisia ketone, germacrene D and 1,8-cineole, are usually the main components.The professed medical uses of artemisia annua include treatment for malaria, infections, fever, inflammation, bleeding, headaches and cancer, particularly some lung and thyroid cancers. The ethanolic extract of aerial parts of Artemisia annua (200mg/kg) was found to be effective against chemical as well as thermal stimuli. So the results are in agreement with the traditional use of plant as analgesic agent.

Pharmacy education in India and its neighbouring countries.

During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. The Pharmacist is a key component of healthcare and manages the human resource to support the growth. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers. The aim of this paper is to highlight the role of pharmacists in developing countries, particularly in India, Pakistan and Bangladesh. The paper draws on the literature related to the pharmacy profession in the country in the context of the current directions of health care. The paper highlights the current scenario and portrays the pharmacy profession in India, Bangladesh and Pakistan. It concludes that although the pharmacy profession in developing countries is continuously evolving, the health care system which yet to recognize the pharmacist's role. This lack of recognition is due to the limited interaction of pharmacists with the public. Pharmacists in developing countries are concerned about their present professional role in the health care system. The information presented in this paper may stimulate discussion and critical analysis and planning, and will be of value in further adaptation of the pharmacy education to desired educational outcomes. These are times of enormous change in healthcare and the pharmacy profession and pharmaceutical education must prepare students to enter into the practice of pharmacy.

Pharmacy education in India and its neighbouring countries.

During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. The Pharmacist is a key component of healthcare and manages the human resource to support the growth. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers. The aim of this paper is to highlight the role of pharmacists in developing countries, particularly in India, Pakistan and Bangladesh. The paper draws on the literature related to the pharmacy profession in the country in the context of the current directions of health care. The paper highlights the current scenario and portrays the pharmacy profession in India, Bangladesh and Pakistan. It concludes that although the pharmacy profession in developing countries is continuously evolving, the health care system which yet to recognize the pharmacist's role. This lack of recognition is due to the limited interaction of pharmacists with the public. Pharmacists in developing countries are concerned about their present professional role in the health care system. The information presented in this paper may stimulate discussion and critical analysis and planning, and will be of value in further adaptation of the pharmacy education to desired educational outcomes. These are times of enormous change in healthcare and the pharmacy profession and pharmaceutical education must prepare students to enter into the practice of pharmacy.

Ovarian vein thrombophlebitis. An unusual cause of postpartum fever and abdominal pain

Ovarian Vein Thrombophlebitis is an uncommon, but potentially serious, complication of complicated deliveries. Prolonged rupture of membranes prior to delivery is a pre-disposing factor. We report a case of a patient with prolonged ruptured membranes, who developed right ovarian vein thrombophlebitis. The patient was managed medically and responded favourably to treatment