Hydroxychloroquine in Treatment of Asymptomatic and Mildly Symptomatic COVID-19: A Multi-Centre Cohort Study

Background: Although hydroxychloroquine (HCQ) lacks benefit in patients with moderate-to-severe COVID-19, its role in asymptomatic and mildly symptomatic disease needs better elucidation. Methods: This multi-centre cohort study included asymptomatic and mildly symptomatic, RT-PCR confirmed COVID-19 cases between 30 March and 20 May, 2020. Patients were categorized into two groups (HCQ-treated and untreated) based on exposure to HCQ. Dose of HCQ used was 400 mg twice daily (day one) followed by once daily for seven days. HCQ-untreated patients were managed supportively without any active antiviral or immunomodulatory therapy.h Nasopharyngeal SARS-CoV-2 clearance by RT-PCR (primary outcome) was compared between HCQ-treated and untreated patients using Kaplan-Meier analysis and Cox proportional-hazards regression. Clinical efficacy and safety profile of HCQ were assessed (secondary outcomes). Results:162 patients [84 (51·9%) males; mean age 38·2 (15·2) years] were included. Forty-four (27·2%) patients had mild disease, rest 118 (72·8%) were asymptomatic. Seventy-five (46·3%) patients received HCQ. Median time to virological negativity was lesser in HCQ-treated (13 days) versus untreated patients (15 days) (log- rank<0·001) in both asymptomatic and mildly symptomatic patients. Treatment with HCQ was the only independent predictor of virological negativity (hazard- ratio=2·24; adjusted p-value<0·001). Two (5·4%) mildly symptomatic patients progressed to severe disease within 24 hours (two doses) of HCQ initiation, compared to none in the HCQ-untreated group. Five HCQ-treated patients developed minor gastrointestinal side effects, not requiring drug discontinuation. Conclusion: HCQ reduced the time to virologic negativity (by 2 days) in asymptomatic and mildly symptomatic COVID-19, without any serious adverse events. However, no obvious clinical benefit was noted.

Awareness of andropause in males: A North Indian study.

Background: According to the Indian census 2011, India has the largest population of the elderly. Very few studies have been carried out in North India to assess the awareness about andropause in men, which is why this study was conceived. Objectives: To assess the awareness about andropause and its treatment modalities among the men of Chandigarh. Materials and Methods: The present study was conducted at an Urban Health Training Center (UHTC-44 B) of Government Medical College and Hospital Sector 32, Chandigarh (GMCH) in male patients attending the outpatient department. This non-interventional individual cross-sectional study was carried out from August 2010 to August 2011 in men aged 40 years and above. Systematic, random sampling was carried out and the study sample comprised 757 men. The subjects were given pre-structured and pre-tested questionnaires that had questions pertaining to socio-demographic profile, ADAM scale, views about andropause, its treatment modalities, etc., Results: Out of the sample size of 757 men, subjects from the urban area (323; 43.1) were more in contrast to that of the peri-urban (41; 31.9) and slum areas (393; 259). Maximum number of patients belonged to the age group of 40-49 years (342; 26.3), followed by those in age group 60-69 years (141; 18.6). It was found that awareness about the term andropause was found only among 17 (2.2%) subjects, whereas the knowledge of a syndrome synonymous to that of menopause in females was even less 7 (0.9%) patients positive for andropause were found to increase with increase of age (40-49; 35.7, 50-59; 81.2, 60-69; 96.5). Only 123 (11.4%) had an idea about the treatment of andropause. The keenness to resort to treatment or seek medical advice was shown by 355 (47.3%). Subjects in the age group of less than 60 years resorted to injections (15; 4.7) and transdermal patches (6; 1.09) as testosterone-replacement therapy. Herbal medicines were especially taken by those subjects in the age group 60-70 years, (74.3%; 101). Conclusion: Awareness about andropause and its treatment modalities is less in men.

Needle stick injury and HIV risk among health care workers in North India.

Objectives: To determine the occurrence of needle stick injuries among various categories of health care workers (HCWs), the causal factors, and the circumstances under which these occur. 2. To explore the possibilities of measures to prevent these through improvement in knowledge, attitude, and practice. Materials and Methods: The study was conducted in two government tertiary level hospitals. Study sample comprised 107 HCWs, providing medical care in two government tertiary level hospitals of Chandigarh. Subjects were enquired about their exposure to needle prick injuries during patient management in the last 6 months and also the action taken following exposure. The statistical tools employed were: ratio, proportions, and other basic methods of data interpretation. Results: The study among 107 HCWs included 27 doctors (25.2%), 68 nurses (63.5%), and 12 paramedics (11.2%), with 87 (81.3%) being females. The prevalence of needle stick injury and exposure to blood was reported by 73 (68.2%) participants. The main factor ascribed for this exposure was heavy patient load (42.5%). The maximum accidents occurred during emergency care (30.1%). Most common action following exposure was cleaning with spirit (46.3%). Only 51 (47.7%) of HCWs admitted following universal precautions. Among those exposed, only 10 (13.7%) persons had undergone HIV testing. Conclusion: Two-thirds of HCWs were exposed to needle stick injuries. Lack of awareness about post-exposure prophylaxis (PEP) was found.