الملخص
As we know novel coronavirus is an emergent nuisance in this stipulated period. Corona virus is a group of enveloped viruses, with non-segmented, single stranded & positive sense RNA genomes. Human Corona virus is mainly subdivided into four categories such as 229E, NL63, OC43, HKU1. Epidemiologically it has a greater prevalence in the modern era. The features encountered in the clinical course of the disease are multifarious spanning from cough, sneezing, fever, breathlessness. It may take 2-14 days for a person to notice symptoms after infection. Azithromycin and 8 Hydroxychloroquine both plays an instrumental role for management of COVID-19. Azithromycin is a macrolide antibiotic and it binds with a 50s ribosome then inhibits bacterial protein synthesis. On the other hand 8-Hydroxychloroquine was approved by United State in the year of 1955 .Basically it is used as a antimalarial drugs . Briefly, in inflammatory conditions it binds with toll like receptor & blocks them. 8- hydroxychloroquine increases lysosomal pH in antigen presenting cells . In inflammatory conditions it blocks toll like receptors on plasmacytoid dendritic cells. In our review we focused on the role of Azithromycin, and 8-hydroxychloroquine in Covid-19 .Copyright © 2021 International Journal of Pharma and Bio Sciences. All rights reserved.
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With the digitalization of the services across various sectors in an Indian setting, health care is also influenced by the same. It was evidenced during the COVID-19 pandemic that Indian patients were orienting themselves toward more teleconsultations and digital and smartphone-based health care. This not only saves time and money but also reduces the chances of hospital-acquired cross infections. This is more important for patients with rheumatic diseases who try to avoid frequent hospital visits despite the need for regular health-care consultations due to the aforementioned reasons. Apart from the telemedicine and smartphone apps, health care is expanding to robotics and artificial intelligence-based machine learning. Healthcare digitalization will lead to the expansion of precision based medicine. When more robust genomics, proteomics, metabolomics, and transcriptomics data become available for Indian patients with rheumatic diseases, management then would be more personalized than blanket therapy. However, such futuristic advancements face challenges of their own which are neither time nor knowledge bound. We are currently just at the tip of this massive iceberg. We describe various aspects of the future of digital health and precision medicine in rheumatology in an Indian setting. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
الملخص
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) is a known respiratory pathogen, its impact on other organs including the pancreas has been reported. Only case reports and few retrospective studies have linked coronavirus disease 2019 (COVID-19) to acute pancreatitis (AP) and pancreatic injury (PI). Aims & Methods: This prospective study was planned to look at the incidence of PI in COVID-19 positive patients and its implications. All consecutive patients of established COVID-19 positive cases presenting to a tertiary care center in India between July and October 2020 were assessed. Detailed symptomatology was documented including respiratory and gastrointestinal (GI) symptoms. Prior co-morbidities, drug history and medical history were documented, and patients on pancreatic enzyme level influencing drugs were excluded. All patients, on admission, underwent blood cytology, biochemical parameters and serum inflammatory markers estimation. Pancreatic injury (PI) was defined as any abnormal value of amylase (normal 0-100 U/L) or lipase (normal 0-60 U/L). Patients having clinical AP or any pre-existing GI diseases were excluded. Outcome measures such as need for ICU, oxygen requirement, need for ventilation and mortality were noted. Results: Out of 244 patients screened, 40 were excluded. Of the 203 patients, (128 males;63.1%) studied, 72 (35.5%) had PI. Comparing patients with PI and those without (Table 1) showed that both groups had similar respiratory and/or GI symptoms profile, while asymptomatic cases had less pancreatic enzyme elevation (p=0.035). PI was noted in the older age group (49.83 vs 37.12 yrs., p=0.01) with a male predominance. PI group had a higher proportion of severe disease (29.2% vs 8.4%;p<0.0001) with significantly higher levels of serum ferritin, D-dimer, fibrinogen, procalcitonin and C-reactive protein (CRP) and higher baseline triglyceride (TG) levels. PI group showed higher ICU (p<0.0001), oxygen (p<0.0001) & mechanical ventilation (p=0.003) requirements and mortality (p=0.018). Multivariate regression analysis showed that the severity of the disease was a significant predictor (aOR-4.68;p=0.003) of PI. Diabetes was found to be higher in the PI group (p<0.0001), but not so when adjusted for disease severity. Of all PI patients, 7(3.45%) had enzyme elevation >3 times the upper limit of the normal (ULN), more in severe disease (Severe-4;12.5% vs moderate-2;4% vs mild-1;0.8%, p=0.005). Conclusion: Incidence of PI was seen in more than 1/3rd of the COVID-19 positive patients. PI is not uncommon in COVID-19 patients and is a harbinger of severe disease with greater inflammatory burst and higher intensive care requirement with poorer outcome.
الملخص
The world is witnessing a major public health crisis in the wake of the third coronavirus strain pandemic, a novel coronavirus (severe acute respiratory syndrome coronavirus 2). Although initially thought to be a pure respiratory pathogen, recent reports have highlighted not only the extrapulmonary effects of the virus but also, importantly, the gastrointestinal tract (GIT) effects. Various studies have looked into the effects of this novel coronavirus infection (coronavirus-19 disease [COVID-19]) on GIT involvement with reports of more frequent involvement than previously expected. With feco-oral transmission, debate being conclusively proven with fecal samples testing positive for COVID-19 and longer shedding time, it only underlines the importance of GIT involvement. Moreover, the presence of other GI diseases, such as inflammatory bowel disease, with COVID-19 infection might wreak havoc leading to poor patient outcomes.