Hydroxychloroquine for COVID-19: A Single Center, Retrospective Cohort Study

@#Introduction: The outbreak of coronavirus disease (COVID-19) in December 2019 called for a rapid solution, leading to repurposing of existing drugs. Due to its immunomodulatory effect and antiviral properties, hydroxychloroquine (HCQ) has been used in early 2020 for treatment of COVID-19 patients. This study was conducted to evaluate the treatment outcome of HCQ monotherapy in Malaysia. Methods: A retrospective cohort study was conducted in COVID-19 ward in Hospital Kuala Lumpur (HKL), from March to April 2020. A total of 446 COVID-19 patients were recruited, only 325 patients were finally included for analysis. Statistical analysis was done using SPSS, with a significant value set at p<0.05. Results: The mean age of the patients were 38.5 ±15.5. They were majority male, (n=210, 64.6%) Malaysian (n=239, 73.5%) and Malay ethnicity (n=204, 62.8%). Ninety-one (28%) patients received HCQ monotherapy. HCQ monotherapy was associated with worse outcome (OR: 10.29, 95% CI 1.17-90.80). There was a significant difference in mean length of stay between those with and without HCQ treatment (t323=5.868, p<0.001, 95% CI, 2.56-5.31). The average length of stay for HCQ treated group was 3.84 days longer than those without treatment. 6.6% of the patient receiving HCQ monotherapy encountered adverse drug effects. Conclusion: Similar to study reported worldwide, our study demonstrated that HCQ did not improve length of stay and the outcome of COVID-19 patients.

In vitro Evaluation of Corn Germ Meal as Ruminant Feed

The present study was taken up to assess the chemical composition and in vitro nutritional worth of corn germ meal (CGM) in comparison to conventional oilseed cakes used in livestock feeding. The CP content of protein sources varied from 18.59% in CGM to 49.41% in soybean meal (SBM). CGM had the highest ether extract (EE) content, neutral detergent fibre (NDF), acid detergent fibre (ADF) and total carbohydrates. However, total ash, acid detergent insoluble crude protein (ADICP) and neutral detergent insoluble crude protein (NDICP) was lowest in CGM. In vitro net gas production in CGM (267.91 ml/g DM/24 h) was higher (P<0.05) than other conventional oil cakes. The digestibility of organic matter varied from 85.12% in DMC (deoiled mustard cake) to 96.19% in SBM. The ME availability was highest (P<0.05) in CGM (9.63 MJ/kg DM). Ammonical nitrogen in CGM was lower (P<0.05) than SBM and GNC (groundnut cake).The total volatile fatty acids (TVFA) production (mM/dl) was highest (P<0.05) in GNC (12.56) and lowest (P<0.05) in CGM (9.31). Methane production was lowest (P<0.05) in CGM than other conventional oil cakes. Hydrogen recovery (%) was higher (P<0.05) in CGM (65.76) and SBM (65.78) than other protein sources tested. Fermentation efficiency (%) was higher (P<0.05) in SBM (77.02) and GNC (76.75) while volatile fatty acids utilization index (VFA UI) was higher (P<0.05) in CGM (2.92) and DMC (2.84) than other protein sources tested. The results revealed that CGM can be used as a potential protein source for ruminants.

Post Dural Puncture Headache (PDPH) - A Prospective Study in Tertiary Care Hospital in Solan District (HP)

Spinal Anaesthesia is widely practiced anaesthetic technique for sub - umbilical surgical procedures. However the technique is not without complications and Post Dural Puncture Headache (PDPH) remains important amongst such complications. Aims and Objectives: The present study was prospective , was conducted to study the overall incidence of PDPH using 26 G Quincke type spinal needle and to establish its relations( if any) with the age of patient, type of surgery and time to ambulate following the surgery. Methods: A total of 500 patients of ASA I and II were studied. These patients underwent various orthopaedic, general surgical, obstetrical/ gynaecological surgical procedures under Spinal Anaesthesia using 26 G Quincke type spinal needle. All the patients were followed upto 72 hours post operatively for evaluation of PDPH. Results: The incidence of PDPH in the present study was 1.6%. The incidence was higher in female patients (75%). Among the female patients, 50% of patients were those who underwent Caesarean Section. Conclusion: The present study concludes free and widespread use of 26 G Quincke type needle in all patients who require Spinal Anaesthesia irrespective of type of surgery

Evaluation of the Maternal & Perinatal Outcome in Abruptio Placentae in Reference to Coagulation Profile

Background:Maternal mortality is an important indicator of a woman’s health. Even though MMR has reduced dramatically death from hemorrhage remains prominent even in developed countries. Abruptio placentae is an acute obstetrical emergency. Methods: This study was done in the Department of Obstetrics and Gynecology Government Medical College and Rajindra Hospital Patiala to assess clinical and coagulation profile of patients presenting with abruptio placentae and analyze maternal and fetal outcome. Result: A total of 73 patients with abruptio placentae were studied, giving an incidence of 3.09%.Of these 76.7% patients were in the age group of 21-30 years. (60%) were either nulliparous or primiparous. (65.75%) patients belonged to rural area with no regular antenatal checkup. The 90.41% patients belong to lower socio- economic status and 56% were iIIiterate. The mean gestational age in our study was 34.5 weeks and classical presentation of bleeding per vaginum associated with pain was seen in 54.7%. Most common associated risk factor found to be hypertension (58.9%), followed by PROM (13.7%) and trauma (2.74%). Conclusion: The main complications observed were shock, DIC and PPH. There was only one maternal death in our series; Mode of delivery was Vaginal in 53 Cases (72.60%) and LSCS in 20 (27.40%) Perinatal mortality was observed in 40 patients (54.79%).

CD10 expression pattern in prostatic adenocarcinoma: Elucidation of differences between Gleason’s grades

CD10, a transmembrane endopeptidase, has been shown to be lost as an early event in prostate cancer. We aimed at evaluating the pattern of expression of CD10 in various Gleason’s grades of prostatic adenocarcinoma in comparison with nodular hyperplasia of prostate. This retrospective study included 30 cases of nodular hyperplasia and 30 of prostatic adenocarcinoma of various Gleason’s grades. Immunohistochemical staining for CD10 was performed on all cases and positivity evaluated as percentage of cells as well as location (membranous or cytoplasmic or both). Of prostatic adenocarcinomas, grade 3 was seen in 10 foci, grade 4 in 28 and grade 5 in 22 foci. CD10 positivity in carcinoma was lower than in nodular hyperplasia, with the lowest positivity in grade 5. The pattern of expression of CD10 also changed from membranous in grade 3 to cytoplasmic in grade 5. Loss of CD10 expression appears to be associated with increasing tumour grade in carcinoma prostate and this can potentially be useful in stratification of such patients.

Prevalence study of oral mucosal lesions, mucosal variants, and treatment required for patients reporting to a dental school in North India: in accordance with WHO guidelines

The aim of the study was to evaluate the prevalence of oral mucosal lesions [OML] in adult patients reporting to the dental outpatient department at the Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India. The purpose was to determine the priorities in oral health education, preventive measures, and identify the group in urgent need of treatment. The study was conducted over a period of 6 months in 2010, when 8866 subjects were offered structured interviews and standardized extraoral and intraoral examinations according to the World Health Organization [WHO] guidelines. Overall prevalence of OML was 1736 [16.8%], the most prevalent being smoker's palate [10.44%] followed by leukoplakia [2.83%], oral submucous fibrosis [1.97%], oral candidiasis [1.61%], recurrent aphthous stomatitis [1.53%], oral lichen planus [0.8%] and others [0.78%]. The highest prevalence of the tobacco habit in both forms was recorded in the group aged 40-44 years and those aged between 60 and 64 years who wore dentures. Lesions were most prevalent in those aged 40-44 years with a significant predominance of males at 3:1 [M = 12.6% and F = 4.3%]. Patients who consumed tobacco in any form or wore dentures had a significantly higher prevalence of OML [P < 0.001]. The highest number of lesions were on the palate [59.7%] followed by buccal mucosa [19.9%]. Various normal mucosal variants were recorded. Fordyce's granules [0.13%], fissured tongue [3.3%], leukoedema [1.47%], and lingual varices [2.73%] were also recorded. The tongue showed the highest number of variants [64.4%]. Patients were grouped according to the treatment needed under the WHO criteria. One hundred and ninety-seven patients were given oral hygiene instructions only, whereas 1422 patients were advised on change of habit and a follow-up and 674 patients needed definitive treatment. This study thus highlights diagnostic criteria, multifactorial risk factors to make standard measurements of OML a basis for planning and evaluating oral health programs for data collection

Seroprevalence and trend of dengue cases admitted to a government hospital, Delhi - 5-year study [2006-2010]: a look into the age shift

Diagnosis of dengue infection is easily and best accomplished by demonstration of specific IgM antibodies in blood. We analyzed retrospectively the dengue IgM seropositivity available for samples obtained over a period of 5 years [2006-2010] from patients with suspected dengue fever [DF]-like illness to investigate whether there was an overall increase in the dengue IgM prevalence over this period. Blood samples were collected from patients with DF-like febrile illnesses attending the Pediatric, Medicine, and Fever clinics of a Government hospital, Delhi. A total of 8138 individuals [suspected dengue cases] obtained over 5 years were tested for dengue specific IgM antibodies. Year wise, month wise, and age wise data on geographic distribution and clinical manifestations were analyzed. Of the 8138 samples, 1600 [19.66%] were positive for dengue specific IgM. The year 2006 had the highest number of reported cases, 761 [46.23%]. In our study, the age group most commonly affected of all 5 years was 11-20 years. Out of the total 1600 cases admitted to the hospital between 2006 and 2010, 279 [58.9%] had DF, 178 [37.6%] had dengue hemorrhagic fever, and 16 [3.38%] had dengue shock syndrome. We found a high burden of dengue in young children and late adolescents in both rural and urban communities at a magnitude greater than previously described. We observed an increase in the dengue positive cases every alternate year, thereby indicating a possible role of herd immunity in northern India. We did not find a steady increase in the number of cases over 5 years. We found an increase in the number of positive cases in children and young adolescents